857 resultados para Health Programs, Plans, and trends


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The TOMO-ETNA experiment was devised to image of the crust underlying the volcanic edifice and, possibly, its plumbing system by using passive and active refraction/reflection seismic methods. This experiment included activities both on-land and offshore with the main objective of obtaining a new high-resolution seismic tomography to improve the knowledge of the crustal structures existing beneath the Etna volcano and northeast Sicily up to Aeolian Islands. The TOMO ETNA experiment was divided in two phases. The first phase started on June 15, 2014 and finalized on July 24, 2014, with the withdrawal of two removable seismic networks (a Short Period Network and a Broadband network composed by 80 and 20 stations respectively) deployed at Etna volcano and surrounding areas. During this first phase the oceanographic research vessel “Sarmiento de Gamboa” and the hydro-oceanographic vessel “Galatea” performed the offshore activities, which includes the deployment of ocean bottom seismometers (OBS), air-gun shooting for Wide Angle Seismic refraction (WAS), Multi-Channel Seismic (MCS) reflection surveys, magnetic surveys and ROV (Remotely Operated Vehicle) dives. This phase finished with the recovery of the short period seismic network. In the second phase the Broadband seismic network remained operative until October 28, 2014, and the R/V “Aegaeo” performed additional MCS surveys during November 19-27, 2014. Overall, the information deriving from TOMO-ETNA experiment could provide the answer to many uncertainties that have arisen while exploiting the large amount of data provided by the cutting-edge monitoring systems of Etna volcano and seismogenic area of eastern Sicily.

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Significant advances in science should be given to addressing the needs of society and the historical context of the territories. Although technological developments that began with modernity and the industrial revolution allowed human beings to control the resources of nature to put to your service without limits, it is clear that the crisis of the prevailing development models manifest themselves in many ways but with three common denominators: environmental degradation, social injustice and extreme poverty. Consequently, today should not be possible to think a breakthrough in the development of science without addressing global environmental problems and the deep social injustices that increase at all scales under the gaze, impassively in many occasions, of formal science.

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Purpose: To assess the compliance of Daily Disposable Contact Lenses (DDCLs) wearers with replacing lenses at a manufacturer-recommended replacement frequency. To evaluate the ability of two different Health Behavioural Theories (HBT), The Health Belief Model (HBM) and The Theory of Planned Behaviour (TPB), in predicting compliance. Method: A multi-centre survey was conducted using a questionnaire completed anonymously by contact lens wearers during the purchase of DDCLs. Results: Three hundred and fifty-four questionnaires were returned. The survey comprised 58.5% females and 41.5% males (mean age 34. ±. 12. years). Twenty-three percent of respondents were non-compliant with manufacturer-recommended replacement frequency (re-using DDCLs at least once). The main reason for re-using DDCLs was "to save money" (35%). Predictions of compliance behaviour (past behaviour or future intentions) on the basis of the two HBT was investigated through logistic regression analysis: both TPB factors (subjective norms and perceived behavioural control) were significant (p. <. 0.01); HBM was less predictive with only the severity (past behaviour and future intentions) and perceived benefit (only for past behaviour) as significant factors (p. <. 0.05). Conclusions: Non-compliance with DDCLs replacement is widespread, affecting 1 out of 4 Italian wearers. Results from the TPB model show that the involvement of persons socially close to the wearers (subjective norms) and the improvement of the procedure of behavioural control of daily replacement (behavioural control) are of paramount importance in improving compliance. With reference to the HBM, it is important to warn DDCLs wearers of the severity of a contact-lens-related eye infection, and to underline the possibility of its prevention.

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Centenarians' psychological well-being is presently of great interest in psychogeriatric research but little is known about factors that specifically account for the presence of clinically relevant anxiety symptoms in this age group. This study examined the presence of anxiety and its predictors in a sample of centenarians and aims to contribute to a better understanding of anxiety determinants in extreme old age.

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Children with chronic conditions often experience a long treatment which can be complex and negatively impacts the child's well-being. In planning treatment and interventions for children with chronic conditions, it is important to measure health-related quality of life (HrQoL). HrQoL instruments are considered to be a patient-reported outcome measure (PROM) and should be used in routine practice. Purpose: The aim of this study was to compare the content dimensions of HrQoL instruments for children's self-reports using the framework of ICF-CY. Method: The sample consist of six instruments for health-related quality of life for children 5 to 18 years of age, which was used in the Swedish national quality registries for children and adolescents with chronic conditions. The following instruments were included: CHQ-CF, DCGM-37, EQ-5D-Y, KIDSCREEN-52, Kid-KINDL and PedsQL 4.0. The framework of the ICF-CY was used as the basis for the comparison. Results: There were 290 meaningful concepts identified and linked to 88 categories in the classification ICF-CY with 29 categories of the component body functions, 48 categories of the component activities and participation and 11 categories of the component environmental factors. No concept were linked to the component body structures. The comparison revealed that the items in the HrQoL instruments corresponded primarily with the domains of activities and less with environmental factors. Conclusions: In conclusion, the results confirm that ICF-CY provide a good framework for content comparisons that evaluate similarities and differences to ICF-CY categories. The results of this study revealed the need for greater consensus of content across different HrQoL instruments. To obtain a detailed description of children's HrQoL, DCGM-37 and KIDSCREEN-52 may be appropriate instruments to use that can increase the understanding of young patients' needs.

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The purpose of this document is to provide assistance in finding appropriate financial resources and services for young children with special needs.

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Background. Stocks of many marine fishes are in decline and a number of studies suggest that for some species the impact of recreational angling may be important. To date, only recreational (leisure) fishing surveys have been conducted in Portugal, with no studies on beach angling competitions, dynamically increasing in number over the past 10 to 20 years. In view of the above, we decided to evaluate the impact of such events on the Algarve coast (southern Portugal) in terms of the abundance, diversity, and respective weight of fish species caught and outline some conservation measures and recommendations for the management of the targeted species. Materials and methods. Participants of 22 angling competitions taking place between February and June 2007 were surveyed. In each competition a random sample of anglers was interviewed, and the specimens caught by each participant were identified, weighed, and measured. Results. Thirteen taxa belonging to eight families were identified, and the most common were: garfish, Belone belone (Linnaeus, 1761); mullets, Mugilidae (not identified); and mackerels, Scomber spp. A total of 563 specimens were sampled, totalling 75.4 kg of weight, with the average catch per angler weighing 0.5 +/- 0.05 SE (n = 153) kg. Differences were also observed between the length at first maturity (L(50)) of the specimens caught and their respective Minimum Landing Size (MLS) and Allowed Minimum Size (AMS), most particularly in the case of the European seabass, Dicentrarchus labrax (L.), with almost all individuals caught measuring below the species-specific L50. Analysis of time series of competition results (1996-2009) showed no evidence of a decrease in catches or in mean weight. Conclusion. Based on the results we propose that the AMS for beach angling competitions should be increased to the MLS in order to prevent the capture of juvenile fishes, especially the sea bass. Future studies should address the size selectivity of the hooks used in beach competitions, with a view to the implementation of a minimum hook size for competitions.

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A climate study of the incidence of downward surface global solar radiation (SSRD) in the Iberian Peninsula (IP) based primarily on ERA-40 reanalysis is presented. NCEP/NCAR reanalysis and ground-based records from several Portuguese and Spanish stations have been also considered. The results showthat reanalysis can capture a similar inter-annual variability as compared to ground-based observations, especially on a monthly basis, even though annual ERA-40 (NCEP/NCAR) values tend to underestimate (overestimate) the observations with a mean relative difference of around 20Wm–2 (40Wm–2). On the other hand, ground-based measurements in Portuguese stations during the period 1964–1989 show a tendency to decrease until the mid-1970s followed by an increase up to the end of the study period, in line with the dimming/brightening phenomenon reported in the literature. Nevertheless, there are different temporal behaviours as a greater increase since the 1970s is observed in the south and less industrialized regions. Similarly, the ERA-40 reanalysis shows a noticeable decrease until the early 1970s followed by a slight increase up to the end of the 1990s, suggesting a dimming/brightening transition around the early 1970s, earlier in the south and centre and later in the north of the IP. Although there are slight differences in the magnitude of the trends as well as the turning year of the dimming/brightening periods, the decadal changes of ERA-40 fairly agree with the ground-based observations in Portugal and Spain, in contrast to most of the literature for other regions of the world, and is used in the climatology of the SSRD in the study area. NCEP/NCAR reanalysis does not capture the decadal variations of SSRD in the IP. The results show that part of the decadal variability of the global radiation in the IP is related to changes in cloud cover (represented in ERA-40).

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Amid the trend of rising health expenditure in developed economies, changing the healthcare delivery models is an important point of action for service regulators to contain this trend. Such a change is mostly induced by either financial incentives or regulatory tools issued by the regulators and targeting service providers and patients. This creates a tripartite interaction between service regulators, professionals, and patients that manifests a multi-principal agent relationship, in which professionals are agents to two principals: regulators and patients. This thesis is concerned with such a multi-principal agent relationship in healthcare and attempts to investigate the determinants of the (non-)compliance to regulatory tools in light of this tripartite relationship. In addition, the thesis provides insights into the different institutional, economic, and regulatory settings, which govern the multi-principal agent relationship in healthcare in different countries. Furthermore, the thesis provides and empirically tests a conceptual framework of the possible determinants of (non-)compliance by physicians to regulatory tools issued by the regulator. The main findings of the thesis are first, in a multi-principal agent setting, the utilization of financial incentives to align the objectives of professionals and the regulator is important but not the only solution. This finding is based on the heterogeneity in the financial incentives provided to professionals in different health markets, which does not provide a one-size-fits-all model of financial incentives to influence clinical decisions. Second, soft law tools as clinical practice guidelines (CPGs) are important tools to mitigate the problems of the multi-principal agent setting in health markets as they reduce information asymmetries while preserving the autonomy of professionals. Third, CPGs are complex and heterogeneous and so are the determinants of (non-)compliance to them. Fourth, CPGs work but under conditions. Factors such as intra-professional competition between service providers or practitioners might lead to non-compliance to CPGs – if CPGs are likely to reduce the professional’s utility. Finally, different degrees of soft law mandate have different effects on providers’ compliance. Generally, the stronger the mandate, the stronger the compliance, however, even with a strong mandate, drivers such as intra-professional competition and co-management of patients by different professionals affected the (non-)compliance.

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La primera necesidad de los peces es la higiene. La elaboración de Programas de Gestión Sanitaria (PGS) aplicables a la industria, dentro de un marco realista y eficiente, pueden contribuir positivamente a la mejora sistemática de la productividad, afectando no sólo a la cantidad y calidad del producto, sino directamente a la eficiencia económica de la empresa. Las principales normas deben quedar reflejadas dentro de un Plan de Control Sanitario (PCS) de la instalación, normas que deben ser de obligado cumplimiento, tanto para los trabajadores como para las visitas. El seguimiento del PCS se realiza mediante la aplicación de un Sistema de Análisis de Peligros y Puntos Críticos de Control (APPCC), sistema que forma parte, a su vez, del Sistema de Gestión de la Calidad (SGC). No será factible la aplicación de ninguno de estos programas, planes y sistemas sin un uso racional del autocontrol. Hygiene is the first need that fish have. The elaboration of the Sanitary Management Programs (SMP) which industrial application, inside a realistic and efficient framework, could contribute positively to the systematic improvement of the production, affecting not only to the quantity and quality of the product, but that affect directly to the economic efficiency of the company. The main norms will be reflected in a Sanitary Control Plan (SCP) of the facilities, these norms must be obligatory fulfilment for the workers and visits. The monitoring of the SCP will do meanly the application of the Hazard Analysis and Critical Control Point (HACCP), system that it is a part, also, of the Quality Management System (QMS). It is not possible, the application of any of this programs, plans and systems, without a rational use of the auto control processes.

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Este documento presenta un análisis sobre discapacidad, inclusión social, igualdad, diferencia desde distintos paradigmas de aproximación a la realidad social de las personas con discapacidad. A partir de los planteamientos de Díaz (1), se hace una reflexión de la discapacidad desde los puntos de vista especialista, materialista y posmodernista; de la comprensión y aplicación de los conceptos de inclusión y equidad usados cotidianamente por las entidades en sus políticas, planes, programas y proyectos. La postura de diferentes organizaciones, partiendo de los paradigmas liberal, marxista y postestructuralista, permite entender desde cuáles concepciones se construyen las propuestas de acción. Finalmente, se ordenan las respuestas sociales según el planteamiento de Avaría (2) a partir de las matrices culturales de sobreprotección y esfuerzo; las alternativas postuladas por Santos (3) y Díaz (1) quienes destacan la diversidad y el reconocimiento de la diferencia como una forma de inclusión y de libertad recuperando el papel protagónico de los sujetos con discapacidad, su entorno local y el estado.

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En este artículo se presenta una reflexión sobre la forma en que se ha incorporado la noción de sostenibilidad ambiental en el ordenamiento físico urbano en Colombia, una aproximación parcial que ha privilegiado algunos componentes físicos de la estructura ecológica, sin considerar suficientemente las implicaciones de aspectos tales como el suelo urbano, las actuaciones de los servicios públicos, las racionalidades de consumo y el metabolismo de la ciudad, los cuales tienen una mayor incidencia sobre la sostenibilidad urbana. El seguimiento a esta tendencia de incorporar herramientas de planeación ambiental estratégica sirve, en primera instancia, para llevar a cabo una reflexión crítica sobre el ordenamiento físico en nuestro medio, la planeación para el desarrollo urbano sostenible, los modelos de ciudad y la participación ciudadana El artículo se divide en tres partes. En la primera se presentan consideraciones sobre sostenibilidad urbana como el marco de la evaluación estratégica ambiental. En la segunda parte se presenta la Evaluación Estratégica Ambiental (EAE) en la formulación de políticas, programas, planes y proyectos. Finalmente, se hacen algunas consideraciones sobre la necesidad de incorporar la EAE en las agendas de formulación y concertación ambiental de temas estratégicos, políticas y planeamiento urbano en Colombia.---The potential for integrated strategic environmental assessment: food for thought on urban sustainability in ColombiaThis article presents a reflection on how the notion of environmental sustainability in the physical urban system was incorporated in Colombia, a partial approach that has privileged some physical components of the ecological structure, without sufficiently considering the implications of such aspects as urban land, the actions of public services, consumer rationalities and metabolism of the city, which have a greater impact on urban sustainability. Monitoring this trend of incorporating strategic environmental planning tools, served in the first instance to undertake a critical reflection on the physical arrangement in our environment, planning for sustainable urban development, and models of city and citizen participation. The article is divided into three parts. The first presents considerations on urban sustainability as the framework of strategic environmental assessment. In the second part presents the Strategic Environmental Assessment (SEA) in the formulation of policies, programs, plans and projects. Finally, some considerations are made about the need to incorporate the SEA into the agendas of environmental design and coordination of strategic issues, policies and urban planning in Colombia. Key words: Strategic Environmental Assessment (EEA), Environmental Impact Assessment (EIA), public policies, environmental assessment, urban sustainability, urban management.---As possibilidades da avaliação estratégica ambiental integrada: Elementos para a reflexão sobre a sustentabilidade urbana na ColômbiaNeste artigo se apresenta uma reflexão sobre a forma em que se tem incorporado a noção de sustentabilidade ambiental no ordenamento físico urbano na Colômbia, uma aproximação parcial que tem privilegiado alguns componentes físicos da estrutura ecológica sem considerar suficientemente as implicações de aspectos tais como o solo urbano, as atuações dos serviços públicos, as racionalidades de consumo e o metabolismo da cidade, os quais têm uma maior incidência sobre a sustentabilidade urbana. O seguimento a esta tendência de incorporar ferramentas de planejamento ambiental estratégica serve, em primeira instância, para levar a cabo uma reflexão crítica sobre o ordenamento físico em nosso meio, o planejamento para o desenvolvimento urbano sustentável, os modelos de cidade e a participação cidadã. O artigo se divide em três partes. Na primeira se apresentam considerações sobre sustentabilidade urbana como o marco da avaliação estratégica ambiental. Na segunda parte se apresenta a Avaliação Estratégica Ambiental (Evaluación Estratégica Ambiental - EAE) na formulação de políticas, programas, planos e projetos. Finalmente, se fazem algumas considerações sobre a necessidade de incorporar a EAE nas agendas de formulação e concerto ambiental de temas estratégicos, políticas y planejamento urbano na Colômbia.Palavras chave: Avaliação Ambiental Estratégica (EAE), Avaliação de Impacto Ambiental (EIA), política pública urbana, sustentabilidade urbana, gestão urbana, gestão ambiental.

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No Estado de São Paulo, existe uma rede extensiva de serviços de Atenção Básica (AB) com perfil organizacional heterogêneo e pouco conhecido. Este estudo objetiva caracterizar a organização dos serviços de AB em 37 municípios do Centro-oeste paulista, como primeira etapa de um projeto de avaliação da qualidade desses serviços. Trata-se de um estudo transversal conduzido mediante questionário estruturado, autorrespondido pelos gerentes e equipes locais, com questões que abordam características institucionais e de organização e gerência do trabalho. Esses questionários foram enviados para 131 UBS, distribuídas em 37 municípios. Obteve-se resposta de 113 unidades (87%) localizadas em 32 municípios (86,4%). do total de unidades, 57 (50%) são UBS tradicionais, 26 (22,8%), Unidades de Saúde da Família, e 31, (27,2%) organizadas segundo formas mistas. A maioria dos serviços (62%, 70/113) não trabalha com área de abrangência delimitada de modo planejado. Os serviços se polarizam entre aqueles que realizam entre 70 e 100% de consultas médicas agendadas (37,6%, 41/109), e aqueles que realizam entre 70 e 100% de não agendadas (39,4%, 43/109). Não possuem conselhos locais organizados 65 unidades (63,7%, 65/102). Os dados coletados permitem discutir as características dos principais programas, procedimentos e ações realizados pelos serviços. Os perfis organizacionais predominantes apontam a presença de deficiências de estrutura e processo em relação às diretrizes do SUS. O desenvolvimento de instrumentos de autoavaliação permite que as equipes se apropriem, de forma crítica, de seu trabalho, e possam elaborar novos arranjos tecnológicos para melhoria da qualidade.

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Pós-graduação em Geografia - IGCE

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En el Ecuador la base legal como la Constitución del 2008 y el Código Orgánico de Organización Territorial, Autonomía y descentralización (COOTAD), establecen la organización político administrativa del territorio en diferentes niveles de gobierno, sean estos regiones, provincias, cantones, parroquias rurales y también de régimen especial, para ello estos niveles adquieren funciones de integridad para realizar legislación, ejecución, fiscalización y de participación ciudadana, en donde se alcanzará y se promoverá el desarrollo sustentable en el marco del plan nacional del buen vivir. Para lograr este legado, los diferentes Gobiernos Autónomos Descentralizados deben elaborar y ejecutar el Plan de Ordenamiento Territorial (POT) y el Plan de Desarrollo y Ordenamiento Territorial (PDOT), de acuerdo a sus competencias de circunscripción territorial. Por competencia exclusiva les corresponde a los gobiernos municipales " formular, aprobar y evaluar los planes, programas y proyectos destinados a la preservación, mantenimiento y difusión del patrimonio arquitectónico, cultural y natural de su circunscripción..... Para el efecto, el patrimonio en referencia será considerado en todas sus expresiones tangibles e intangible...” (COOTAD Art. 144). Lamentablemente la mayoría de estos gobiernos municipales poco o nada han incorporado el patrimonio cultural tangible e intangible en sus fases de análisis de, diagnóstico, propuesta y modelo gestión. Como base fundamental tomaremos la guía metodológica para la elaboración de planes de desarrollo y ordenamiento que presenta la SENPLADES en el año 2014y la propuesta que realiza el Dr. Domingo Gómez Orea en su libro Ordenación Territorial 2da edición, de ahí se propone una alternativa metodológica de articulación del patrimonio cultural y ordenamiento territorial. Y para lograr este objetivo, utilizaremos la información disponible que cuenta el Instituto nacional de Patrimonio Cultural (INPC) en su sistema informatizado que se encuentra en la página Web www.inpc.gob.ec, denominado Sistema de Información Patrimonial Cultural del Ecuador (SIPCE), esta base de información que contiene fichas de inventario en sus diferentes ámbitos culturales como inmuebles, muebles, documentos. Arqueológicos y manifestaciones inmateriales, previamente analizadas y georreferenciadas nos permitirán territorializar en el espacio cantonal y con ello poder realizar un análisis integrado con los otros componentes como es el medio físico, poblacional, económico, núcleos de población etc. Esta nueva metodología permitirá visualizar, conocer, aprender y empodéranos del patrimonio cultural material e inmaterial, con aquellas manifestaciones culturales y tradicionales que existen y se encuentran en vigencia. También poder recuperar y rescatar aquellas que están en peligro de desaparecer, este potencial cultural será una gran posibilidad de generar emprendimientos y desarrollo sustentable. La manera más idónea de concretar y fomentar este desarrollo sustentable en territorio será a través de la formulación de programas, planes y proyectos que deberán plantearse en los planes de ordenamiento territorial y los planes de desarrollo territorial. Finalmente para comprobar esta nueva propuesta metodológica de articulación entre el patrimonio cultural y el ordenamiento territorial, la aplicaremos al cantón Paltas de la provincia de Loja.