950 resultados para Federal Coal Management Program (U.S.)


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Este estudio empírico compara la capacidad de los modelos Vectores auto-regresivos (VAR) sin restricciones para predecir la estructura temporal de las tasas de interés en Colombia -- Se comparan modelos VAR simples con modelos VAR aumentados con factores macroeconómicos y financieros colombianos y estadounidenses -- Encontramos que la inclusión de la información de los precios del petróleo, el riesgo de crédito de Colombia y un indicador internacional de la aversión al riesgo mejora la capacidad de predicción fuera de la muestra de los modelos VAR sin restricciones para vencimientos de corto plazo con frecuencia mensual -- Para vencimientos de mediano y largo plazo los modelos sin variables macroeconómicas presentan mejores pronósticos sugiriendo que las curvas de rendimiento de mediano y largo plazo ya incluyen toda la información significativa para pronosticarlos -- Este hallazgo tiene implicaciones importantes para los administradores de portafolios, participantes del mercado y responsables de las políticas

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The main issues related to water conservation in urban centers are the increase in water supply cost, demand growth, pollution and differences in the distribution of water resources. Water conservation, the controlled and efficient use of water, includes both measures as reasonable means of water reuse. Thus, conservation practices are an effective way to meet demand and supply water to new activities and users without jeopardizing the supplying water bodies and preserving the natural environment. This study aims to examine the water management of a shopping mall and the use of rainwater harvesting combined with greywater reuse. For buildings in general, water loss is common due to leaks in the hydraulic and restroom equipment. These losses, which are caused by a high volume of water used and wasted in the system, are often the result of design errors, incorrect maintenance procedures and users' bad habits In southern Brazil, where there is rainfall almost all year long, water shortages occasionally occur, particularly in some winter mouths. One difficulty that appears on rainwater studies is the proper determination of rainwater volume that can be used to address water supply systems. In this work, the simulation method was used to determine this volume. Thus, simulations with the following variables: rainfall, catchment area and water consumption were performed. For mall's hydraulic systems, segmented alternatives are adopted. That is, focusing on the use of rainwater or greywater reuse. Other alternatives of effluent reuse have been slightly discussed due to sanitary issues, those are effluents from toilets and kitchen sinks. The adoption of greywater may be feasible if there is a significant flow of greywater to comply water demand for toilet flushing. The inspections made in this study found that the quantity of sinks was insufficient to supply an adequate amount of water to toilets and urinals. The greywater reuse system was found to be infeasible in terms of demand and supply of water. Conversely, the rainwater harvesting system was entirely feasible and easily supplied water to all restrooms and contributed to the cooling of the air conditioning system with a short payback period. One of the challenges of this work was the need to compare the actual water consumption with a water consumption parameter used in buildings. Thus, a method that addresses the generation of specific consumption indexes for specific activity (like a mall) was used. The water consumption indices showed that this mall has a satisfactory water management program.

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Western flower thrips (WFT), Frankliniella occidentalis (Pergande), is an important pest of vegetable crops worldwide and has developed resistance to many insecticides. The predatory mites Neoseiulus (=Amblyseius) cucumeris (Oudemans), the entomopathogenic fungus Metarhizium anisopliae (Metsch.), and an insecticide (imidacloprid) were tested for their efficacy to reduce WFT population density and damage to French bean (Phaseolus vulgaris L.) pods under field conditions in two planting periods. Metarhizium anisopliae was applied as a foliar spray weekly at a rate of one litre spray volume per plot while imidacloprid was applied as a soil drench every two weeks at a rate of two litres of a mixture of water and imidacloprid per m(2). Neoseiulus cucumeris was released every two weeks on plant foliage at a rate of three mites per plant. Single and combined treatment applications reduced WFT population density by at least three times and WFT damage to French bean pods by at least 1.7 times compared with untreated plots. The benefit-cost ratios in management of WFT were profitable with highest returns realized on imidacloprid treated plots. The results indicate that M. anisopliae, N. cucumeris, and imidacloprid have the potential for use in developing an integrated pest management program against WFT on French beans.

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Multi-peril crop insurance is a valuable risk management tool which allows you to insure against losses on your farm due to adverse weather conditions, price fluctuations, and unavoidable pests and diseases. It shifts unavoidable production risks to an insurance company for the payment of a fixed amount of premium per acre. This publication assists readers in understanding the basics of the federal crop insurance program.

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Crushed stone mining is the third largest mining economy in Brazil, where almost half is produced in the Sao Paulo metropolitan region. The segment registers the highest number of accidents among the extractive industries, which justifies the concern with workers` health and safety, and the importance of controlling occupational hazards. Since 2002, the NR-22 Standard (NR-22: Occupational Health and Safety in Mining) makes compulsory the elaboration of a Risk Management Program that identifies risks and establishes control measures. Considering the crushed stone mining industry importance to the state, this paper evaluates and discusses the risks identified in unit operations during the production process of crushed stone in an open pit mine in order to propose control measures for the development of the Risk Management Program. Although this study refers to a specific quarry, it can be applied to other mines from the same sector since some considerations are made regarding differences in manufacturing processes. The research was based on the identification of the main risks associated with drilling, blasting, load & haulage, crushing and screening through field measurements of some hazardous agents, together with company reports. The results contributed to the choice of the appropriate control measures for the improvement Of workers` health and safety conditions.

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This paper reports on the implementation of a psychoeducational program utilizing cognitive-behavioral principles. The efficacy of this psychoeducational treatment program in modifying dysfunctional attitudes in patients with chronic low back pain was examined using a two-group pretest posttest design with a follow-lip at 3 months Thirty patients (average age = 44.37 SD = 13.71) participated in the study, with 15 in the psychoeducational treatment group and 15 in the placebo control group. These two conditions were added on to an existing eclectic inpatient pain management program. After assessment on the IPAM (The Integrated Psychosocial Assessment Model), scores were reduced to multivariate composite scores on the factors of illness behavior depressed and negative cognitions, and acute pain strategies. Results of a group x time repeated measures analysis of variance for the three pain factors revealed a significant main effect for group (F(23,1) = 5.00 p < .04), tempered by a significant interaction between group and rime on the 'depressed and negative' pain factor (F(23,1) = 4.77 p < .04). Patients in the treatment group improved significantly over time and significantly more than the placebo control group patients at posttreatment. Results provide support for the program in increasing patients' feelings of control over their pain and the use of positive coping strategies, while reducing perceived helplessness, depression, disability, and pain intensity.

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Background-Information about physicians` adherence to cholesterol management guidelines remains scant. The present survey updates our knowledge of lipid management worldwide. Methods and Results-Lipid levels were determined at enrollment in dyslipidemic adult patients on stable lipid-lowering therapy in 9 countries. The primary end point was the success rate, defined as the proportion of patients achieving appropriate low-density lipoprotein cholesterol (LDL-C) goals for their given risk. The mean age of the 9955 evaluable patients was 62 +/- 12 years; 54% were male. Coronary disease and diabetes mellitus had been diagnosed in 30% and 31%, respectively, and 14% were current smokers. Current treatment consisted of a statin in 75%. The proportion of patients achieving LDL-C goals according to relevant national guidelines ranged from 47% to 84% across countries. In low-, moderate-, and high-risk groups, mean LDL-C was 119, 109, and 91 mg/dL and mean high-density lipoprotein cholesterol was 62, 49, and 50 mg/dL, respectively. The success rate for LDL-C goal achievement was 86% in low-, 74% in moderate-, and 67% in high-risk patients (73% overall). However, among coronary heart disease patients with >= 2 risk factors, only 30% attained the optional LDL-C goal of < 70 mg/dL. In the entire cohort, high-density lipoprotein cholesterol was < 40 mg/dL in 19%, 40 to 60 mg/dL in 55%, and > 60 mg/dL in 26% of patients. Conclusions-Although there is room for improvement, particularly in very-high-risk patients, these results indicate that lipid-lowering therapy is being applied much more successfully than it was a decade ago. (Circulation. 2009; 120: 28-34.)

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Background-The effectiveness of heart failure disease management proarams in patients under cardiologists` care over long-term follow-up is not established. Methods and Results-We investigated the effects of a disease management program with repetitive education and telephone monitoring on primary (combined death or unplanned first hospitalization and quality-of-life changes) and secondary end points (hospitalization, death, and adherence). The REMADHE [Repetitive Education and Monitoring for ADherence for Heart Failure] trial is a long-term randomized, prospective, parallel trial designed to compare intervention with control. One hundred seventeen patients were randomized to usual care, and 233 to additional intervention. The mean follow-up was 2.47 +/- 1.75 years, with 54% adherence to the program. In the intervention group, the primary end point composite of death or unplanned hospitalization was reduced (hazard ratio, 0.64; confidence interval, 0.43 to 0.88; P=0.008), driven by reduction in hospitalization. The quality-of-life questionnaire score improved only in the intervention group (P<0.003). Mortality was similar in both groups. Number of hospitalizations (1.3 +/- 1.7 versus 0.8 +/- 1.3, P<0.0001), total hospital days during the follow-up (19.9 +/- 51 versus 11.1 +/- 24 days, P<0.0001), and the need for emergency visits (4.5 +/- 10.6 versus 1.6 +/- 2.4, P<0.0001) were lower in the intervention group. Beneficial effects were homogeneous for sex, race, diabetes and no diabetes, age, functional class, and etiology. Conclusions-For a longer follow-up period than in previous studies, this heart failure disease management program model of patients under the supervision of a cardiologist is associated with a reduction in unplanned hospitalization, a reduction of total hospital days, and a reduced need for emergency care, as well as improved quality of life, despite modest program adherence over time. (Circ Heart Fail. 2008;1:115-124.)

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The effect of sheep digestion and mastication on Malva parviflora L. seed transmission, viability and germination was investigated. Mature M. parviflora seeds were subjected to 2 seed treatments: 'scarified', where the hard seed coat was manually cut to allow inhibition, and 'unscarified', where the hard seed coat was not cut. Seeds were placed directly into the rumen of fistulated sheep and removed at 0, 12, 24, 36 and 48 h of rumen digestion. After 12 h of in sacco exposure to digestion in the rumen, the germination of seeds that were initially scarified dropped from 99.2 to 1.4% and longer exposure periods produced no germinable seeds. In contrast, seeds that were unscarified when placed in the rumen produced over 92% germination regardless of in sacco digestion time, although manual scarification after retrieval was essential to elicit germination. In a second experiment, unscarified seeds (29000) were fed in a single meal to fistulated sheep and feces were collected at regular intervals between 6 and 120 h after feeding. Fecal subsamples were taken to determine number of seeds excreted, seed germination on agar and seed germination from feces. Major seed excretion in the feces commenced after 12 h and continued until 144 h, with peaks between 36 and 72 h after consumption. Although mastication and gut passage killed the majority of unscarified seeds, about 20% were recovered intact and over 90% of these recovered seeds were viable and could, thus, potentially form an extensive seed bank. A few excreted seeds (1%) were able to germinate directly from feces, which increased to a maximum of 10% after subsequent dry summer storage (3 months). Through information gained in this study, there is a potential to utilise livestock in an integrated weed management program for the control of M. parviflora, provided additional measures of weed control are in place such as holding periods (> 7 days) for movement of livestock from weed infested areas.

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The efficacy of psychological treatments emphasising a self-management approach to chronic pain has been demonstrated by substantial empirical research. Nevertheless, high drop-out and relapse rates and low or unsuccessful engagement in self-management pain rehabilitation programs have prompted the suggestion that people vary in their readiness to adopt a self-management approach to their pain. The Pain Stages of Change Questionnaire (PSOCQ) was developed to assess a patient's readiness to adopt a self-management approach to their chronic pain. Preliminary evidence has supported the PSOCQ's psychometric properties. The current study was designed to further examine the psychometric properties of the PSOCQ, including its reliability, factorial structure and predictive validity. A total of 107 patients with an average age of 36.2 years (SD = 10.63) attending a multi-disciplinary pain management program completed the PSOCQ, the Pain Self-Efficacy Questionnaire (PSEQ) and the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) pre-admission and at discharge from the program. Initial data analysis found inadequate internal consistencies of the precontemplation and action scales of the PSOCQ and a high correlation (r = 0.66, P < 0.01) between the action and maintenance scales. Principal component analysis supported a two-factor structure: 'Contemplation' and 'Engagement'. Subsequent analyses revealed that the PSEQ was a better predictor of treatment outcome than the PSOCQ scales. Discussion centres upon the utility of the PSOCQ in a clinical pain setting in light of the above findings, and a need for further research. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

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O presente trabalho centra-se na gestão de resíduos produzidos no sistema de drenagem e tratamento de águas residuais do município de Vila Nova de Gaia. A entidade onde decorreu o trabalho é uma empresa responsável pela distribuição de água e pela drenagem e tratamento de águas residuais. A empresa está certificada pela norma NP EN ISO 14001, desde 2001, sendo então um dos objectivos o enquadramento da gestão dos resíduos em estudo na referida norma, acompanhando os requisitos da mesma com vista ao seu total cumprimento. Outros dos objectivos foi estudar qual a opção de tratamento mais adequada a aplicar ao resíduo no seu local de armazenamento temporário com vista a minorar os seus impactes ambientais. De acordo com a caracterização analítica do resíduo e com os aspetos legais aplicáveis, foram também analisados os destinos finais possíveis e ambientalmente adequados ao resíduo. A medida proposta para a minimização de impactes no local de armazenamento temporário do resíduo foi a estabilização com cal nos leitos de secagem, disponíveis numa antiga ETAR de loteamento. O doseamento de cal a aplicar ao resíduo será de 10 kg de cal apagada comercial (Ca (OH)2) por uma tonelada de resíduo fresco com um período mínimo de secagem de 2 meses. Outra das medidas de minimização de impactes selecionada foi a implantação de uma cortina arbórea ao redor da instalação. Sendo o resíduo em estudo muito heterogéneo, constituído principalmente por areias, terras e gradados, a valorização foi equacionada mas não foram encontrados alternativas viáveis. O destino final considerado como mais adequado tendo em conta todas as características do resíduo e eluato, analisadas de acordo com o previsto no Decreto-Lei n.º 183/2009 de 10 de Agosto, foi o aterro para resíduos não perigosos. Foi também objecto do estudo a identificação e análise de todos os aspectos ambientais relacionados com a gestão de resíduos e a avaliação da sua significância. Dos aspectos ambientais identificados como significativos, destacam-se aqueles que ocorrem presentemente, os resíduos armazenados (gradados/limpeza de redes), e os que podem ocorrer em situações de emergência, fuga/derrame de óleos/combustíveis e cheiros/odores. De forma a minimizar os aspectos ambientais identificados, e de acordo com a norma NP EN ISO 14001, foram propostas ações que constam de um programa de gestão elaborado para este trabalho, onde se definem os objectivos, metas e prazos. As principais medidas propostas no programa de gestão foram: Estabilização com cal (inicial e reforço se necessário); melhoria do espaço envolvente; análise de questões de saúde ocupacional/segurança; adjudicação de prestação de serviços da recolha por operador licenciado; implantação da cortina arbórea; registo no SIRAPA; criação de planos de emergência ambiental e de segurança.

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Objetivo - Traduzir e validar o instrumento de avaliação de risco de queda em crianças hospitalizadas “Humpty Dumpty Falls Scale”, contribuindo para um melhor conhecimento desta realidade, para a redução de potenciais lesões e aumento da segurança do doente. Metodologia - Foi realizado um estudo descritivo, com uma abordagem qualitativa e tendo uma amostra não probabilística. Foi igualmente um estudo casuístico das quedas no hospital em questão. Resultados - Verificou-se que existe uma distribuição homogénea quer em termos de score de risco quer de género. Verificou-se que o risco mais elevado é na população abaixo dos três anos. As quedas reais seguem o mesmo padrão de maior frequência nas crianças avaliadas com “Alto Risco”, com idade inferior a três anos e do sexo masculino. Nestas crianças a queda não está associada ao estado de saúde ou medicação, mas sim ao desenvolvimento. O nível de lesão é baixo e a maioria das crianças cai na presença dos pais durante a realização de atividades da vida diária. Conclusões – A escala corresponde ao objetivo pretendido, permite sistematizar a informação e é sensível à população a que se destina.

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RESUMO - Título: “Caracterização das Estruturas de Qualidade e Segurança do Doente” A segurança dos doentes assume-se, hoje em dia, como prioridade máxima e é um paradigma de qualidade dos cuidados de saúde. Definida como um conjunto de medidas destinadas a melhorar a segurança e a qualidade de prestação de cuidados de saúde, surge a gestão de risco. Assim, um programa de gestão de risco poderá ser definido como um conjunto de procedimentos e de objetivos pré-definidos com o intuito de promover uma cultura de segurança no seio das organizações de saúde. A nível nacional, no processo de busca da excelência, é necessário estabelecer exigências que formalizem os mecanismos que as instituições de saúde e os seus profissionais terão que utilizar para assegurar que os cuidados de saúde que prestam aos cidadãos, respondem aos critérios da qualidade definidos pelo Departamento da Qualidade na Saúde. Tornou-se, então, pertinente verificar as estratégias que existem sobre a gestão de risco, a nível nacional, e por outro lado, como é que as unidades de saúde têm estruturada esta área nas suas organizações. Como tal, com este estudo pretendeu-se caracterizar as Estruturas de Qualidade e Segurança do Doente, tendo como população as unidades de saúde da região de Lisboa e Vale do Tejo. Foi utilizada uma abordagem metodológica do tipo observacional descritiva, que integrou a aplicação de um questionário. De forma geral, foi possível concluir que todas as unidades de saúde (N=7) afirmam ter implementada a gestão do risco, no entanto há unidades que não fazem a avaliação e identificação do risco (N=4) e a maioria não realizam auditorias clínicas regularmente (N=5). Considera-se que estes resultados podem contribuir para a criação de oportunidades para as organizações e para os profissionais, com o objetivo de melhorar a prestação de cuidados, com consequente melhoria na segurança do doente.

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RESUMO: Relevância e Objectivos: A educação focada na auto-gestão tem sido cada vez mais valorizada como parte integrante da abordagem terapêutica dos doentes com DPOC. No entanto poucos resultados se encontram na literatura. Este estudo investiga se um programa de educação contribui para a melhoria da funcionalidade e do estado de saúde associados à DPOC estável. Metodologia: A amostra incluiu 18 indivíduos portadores de DPOC ligeira a moderada, de acordo com os critérios GOLD, com uma média de idades de 71 ± 8 anos. Os doentes foram distribuídos por 2 grupos: um grupo experimental, constituído por 10 doentes do sexo masculino, a receber os cuidados habituais e submetidos a um programa de educação, e um grupo de controlo formado por 7 doentes do sexo masculino e uma do sexo feminino, a receber apenas os cuidados habituais. Foram avaliados os dados sócio-demográficos relativos à amostra, o nível de conhecimentos sobre a patologia e a sua auto-gestão, a dispneia, o impacto nas AVD’s, a qualidade de vida relacionada com a saúde, a ansiedade e a depressão. Foram aplicados 8 questionários, 2 realizados pela invesstigadora, um destinado a recolher dados sociodemográficos e clínicos, outro para avaliar o conhecimento da doença pelo doente e os 6 restantes estandardizados: Medical Research Council, Índice de Dispneia Basal Modificado de Mahler, Índice de Dispneia de Transição de Mahler, St. George Respiratory Questionnaire, London Chest Activity of Daily Living e o Hospital Anxiety and Depression Scale. Incluíu-se também a realização de uma espirometria, de uma prova de marcha de 6 minutos e a aplicação de 1 checklist para avaliar a evolução dos conhecimentos do doente sobre a sua doença. Os dados foram recolhidos em dois momentos: em T0 e em T1, correspondendo ao início e o final do programa de educação. Resultados: Obteve-se uma diferença com significância na melhoria do nível de conhecimentos entre o grupo experimental e o grupo de controlo com um p = 0,001. Não se alcançaram resultados significativos na melhoria da distância percorrida, da dispneia, do impacto nas AVD’s, da QVRS, da ansiedade e da depressão. Conclusões: A aplicação de um programa de educação a doentes com DPOC estável contribuiu para a melhoria de conhecimentos sobre a doença, mas não se traduziu em modificações no estado de saúde e da funcionalidade na população estudada.------------ABSTRACT: Relevance and Objectives: Self-management interventions have been increased as an important part of therapeutic approach in COPD patients. However, few results are found in literature. This study investigates whether self-management program contributes to improve functionality and health status associated with stable COPD. Methods: The sample included 18 subjects with mild to moderate COPD, according to GOLD criteria, and a mean age of 71 ± 8 years. Patients were divided into 2 groups: one experimental group, consisting of 10 male patients receiving usual care plus an education program, and a control group consisting of one female and 7 male patients, receiving only usual care. We assessed socio-demographic data, level of knowledge about the pathology and selfmanagement, dyspnea, impact on ADLs, health related quality of life, anxiety and depression. Were administered 8 questionnaires, two made by the researcher, one to collect sociodemographic and clinical data, another to assess the knowledge of the disease by the patient and the remaining 6 standardized: Medical Research Council, baseline dyspnea index Modified Mahler's, Mahler Transitional (dyspnea), St. George Respiratory Questionnaire (HRQOL),London Chest Activity of Daily Living (ADL´s) and the Hospital Anxiety and Depression Scale (anxiety and depression). Performed a spirometry, a test of 6-minute walk and a checklist for monitoring progress of the patient's knowledge about their disease. Data were collected on two times: T0 and T1, beginning and end of self-management program. Results: We found a significant improvement in the level of knowledge between the experimental and control group with p = 0.001. We didn’t achieve significant results in improving distance, dyspnea, impact on ADLs, HRQOL, anxiety and depression. Conclusions: The application of an education program in stable COPD patients contributed to the improvement of knowledge about the disease, but didn’t translate into changes in health status and functionality in population of this study.

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Natural disasters are events that cause general and widespread destruction of the built environment and are becoming increasingly recurrent. They are a product of vulnerability and community exposure to natural hazards, generating a multitude of social, economic and cultural issues of which the loss of housing and the subsequent need for shelter is one of its major consequences. Nowadays, numerous factors contribute to increased vulnerability and exposure to natural disasters such as climate change with its impacts felt across the globe and which is currently seen as a worldwide threat to the built environment. The abandonment of disaster-affected areas can also push populations to regions where natural hazards are felt more severely. Although several actors in the post-disaster scenario provide for shelter needs and recovery programs, housing is often inadequate and unable to resist the effects of future natural hazards. Resilient housing is commonly not addressed due to the urgency in sheltering affected populations. However, by neglecting risks of exposure in construction, houses become vulnerable and are likely to be damaged or destroyed in future natural hazard events. That being said it becomes fundamental to include resilience criteria, when it comes to housing, which in turn will allow new houses to better withstand the passage of time and natural disasters, in the safest way possible. This master thesis is intended to provide guiding principles to take towards housing recovery after natural disasters, particularly in the form of flood resilient construction, considering floods are responsible for the largest number of natural disasters. To this purpose, the main structures that house affected populations were identified and analyzed in depth. After assessing the risks and damages that flood events can cause in housing, a methodology was proposed for flood resilient housing models, in which there were identified key criteria that housing should meet. The same methodology is based in the US Federal Emergency Management Agency requirements and recommendations in accordance to specific flood zones. Finally, a case study in Maldives – one of the most vulnerable countries to sea level rise resulting from climate change – has been analyzed in light of housing recovery in a post-disaster induced scenario. This analysis was carried out by using the proposed methodology with the intent of assessing the resilience of the newly built housing to floods in the aftermath of the 2004 Indian Ocean Tsunami.