963 resultados para Gateway National Recreation Area


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Sports and recreation management is addressed here using a model that combines the policies and methodologies applied in the Costa Rican context as a result of a concern to identify the real needs in the sports, recreation, and health promotion fields through the different manifestations of human movement.  This approach has been developed during eight years of work in the Costa Rican Sports and Recreation Institute (Instituto Costarricense del Deporte y la Recreación-ICODER) together with different Costa Rican communities, both rural and urban, and local organizations, such as Comprehensive Development Community Associations, Sports and Recreation Community Boards (CCDR), Municipal Mayorships, and NGOs, among others.  This article particularly takes into consideration the experience of the CCDRs as entities that have been given the responsibility by the Costa Rican Government to promote and manage municipal sports and recreation services with a convenient offering that would meet the needs of users or customers.  In this way, this article is aimed at answering the question on how Boards should conduct an efficient management in a way that they also meet the needs of public users or customers in the municipalities of the country, by proposing a management model that serves as an additional instrument to improving the already existing services managed by the aforementioned entities.  This study presents a model of Costa Rican management structured with the theoretical elements that currently define the organization and planning of sports and recreation as a service.

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The prevalence of Arterial Hypertension (AHT) has increased worldwide and preventive measures areinsufficient since only one third of the population is being treated. AHT is the primary cause of morbidity andmortality in the world. In this article is presented the first study on hypertension levels of personnel of aDistance Education university based on the analysis of all medical consultations in the Costa Rican StateUniversity for Distance Education (Universidad Estatal a Distancia-UNED) as of December 15, 2007 (1,526medical files). The population studied ranges from 20 to 70 years of age and is comprised of residents of theGreater Metropolitan Area (Costa Rica) with varied socioeconomic and academic levels. The StatgraphicsCenturion XV software and the chi-square test were used to analyze variables such as treatment administered,sex, age, and type of work. Only 45 patients knew that they suffered from hypertension prior to theirconsultation with the university medical service and 136 were treated with Enalapril and Hydrochlorothiazide.The number of hypertensive patients is higher among those who have worked at the institution for more than 20years, especially in those holding higher positions. No marked differences were found between men andwomen. It is concluded that the existence of a university medical service has permitted faculty and staff tosatisfactorily control their blood pressure.

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The Upper Jefferson River is one of the most dewatered rivers in Montana. The river exists in an intermontane basin filled with sediment transported from the Highland Mountains to the west, the Tobacco Root Mountains to the east, and the Jefferson River from the south. The Upper Jefferson River Valley is highly dependent on the Jefferson River as the main industry in the valley is agriculture. A majority of the valley is irrigated and used to grow crops, and a good portion is also used for cattle grazing. The residents of the Upper Jefferson River Valley use the aquifer as the main source of potable water. The Jefferson River is also widely used for recreation. This study took place in the Waterloo area of the Upper Jefferson River Valley, approximately 20 miles south of Whitehall, Montana. The Waterloo area provides significant groundwater base flow to the Jefferson River, which is particularly important during the late irrigation season when the river is severely dewatered, and elevated surface-water temperatures occur, creating irrigation water shortages and poor trout habitat. This area contains two springfed streams, Willow Springs and Parson’s Slough, which discharge to the Jefferson River providing cool water in the late season as well as providing the most important trout spawning habitat in the valley. The area is bordered on both the east and west by irrigation ditches, and about 60% of the study area is irrigated. Tile drains were installed in the study area in close proximity to Parsons Slough causing some concern by neighboring residents. This study evaluated relationships between surface water, groundwater, and irrigation practices so that water managers and others can make informed management decisions about the Upper Jefferson River. Data was collected via a network of groundwater wells and surface-water sites. Additionally, water-quality samples were taken and an aquifer test was conducted to determine aquifer properties. The field data were analyzed and a groundwater budget was created in order to evaluate the aquifer. Results of the groundwater budget show that seepage from the irrigation canals and irrigation recharge have the biggest influence on recharge of the aquifer. There is significant groundwater outflow from the aquifer in the spring-fed streams as well as discharge to the Jefferson River. In comparing previous study results to this study’s results, there is no evidence of the water table decreasing due to irrigation practice changes or tile drain installation. However, given the amount of recharge irrigation practices contribute to the aquifer, if significant changes were made, they may affect groundwater elevations. Also lining the irrigation ditches would have a significant impact on the aquifer, as the amount of seepage would be greatly reduced.

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The purpose of this thesis was to determine the extent of sea level rise (SLR) impact on sea turtle nesting beach habitat on Archie Carr National Wildlife Refuge (NWR) as well as impacts on management strategies. The Archie Carr NWR is of exceptional importance due to the high density of Loggerhead, Leatherback, and Green sea turtles that nest there in the summer months. GIS data provided by the Archie Carr NWR and various SLR scenarios, provided by both the Intergovernmental Panel on Climate Change (IPCC) as well as leading scholars, were used to determine inundation area loss across the Refuge as well as nearby parcels targeted for possible acquisition. Inundation losses for the six scenarios were calculated to be in the 20-25% range. Approximately 26% of current lower priority parcels are reclassified as high priority when integrating this information. Therefore, a significant revision to future acquisition strategies is recommended.

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Esta es una empresa colombiana que hace parte del sector de la metalmecánica, fue creada con capital nacional y fundada en los años 70´s. Paso de ser una pequeña empresa de asesorías técnicas y de producción de pequeños equipos, al desarrollo de una nueva línea de productos que abarcan la fabricación de todos los equipos que tienen que ver con la maquinaria pesada, sin incluir la maquinaria amarilla. A pesar de las diferentes crisis económicas por las que ha pasado Colombia, esta empresa ha logrado sobrevivir. Actualmente los diferentes TLC que se han firmado, han llevado a que los competidores aumenten de forma significativa, esto se vea reflejado en el movimiento de las ventas en el transcurso de los años. Este proyecto busca desarrollar un plan estratégico en el área de ventas de la empresa que le permita volver a captar la cantidad de negocios y clientes que solía tener hace unos años. Esto será basándonos en la elaboración de una estrategia clave, que nos permita prolongar la perdurabilidad de la empresa en el mercado, producto de un respectivo conocimiento detallado del servicio y del producto que ofrece la empresa, seguido de un análisis enfocado tanto en los clientes potenciales de la empresa para saber sus razones de no compra, como en el comportamiento del mercado y la competencia analizando temas de carácter financiero (P&G).

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Resumen: Objetivo: determinar la asociación entre el tipo de profesor (especialista y no especialista en educación física), con el nivel de actividad física, el contenido-contexto de la clase y el comportamiento del profesor. Método: Estudio descriptivo de corte transversal en un colegio distrital de Bogotá. Fueron evaluadas 57 clases de educación física, y dos docentes (uno con formación académica en Educación física), por medio del Sistema para la observación del tiempo de instrucción de la condición física (SOFIT). Las variables observadas fueron analizadas con estadística descriptiva en cantidades relativas a los minutos y proporción de la clase. Para establecer la asociación entre el género de los estudiantes y el tipo de profesor se usaron test t para muestras independientes y U de Mann-Witney. Resultados: La duración promedio de la clase fue 82,7 minutos, 69% del tiempo programado; los estudiantes pasaron la mayor parte del tiempo de pie 29% (25 minutos), el contenido predominante de la clase fue el de tipo general 21% (25 minutos) y los maestros ocuparon en promedio el 36% (29 minutos) de la clase observando. Los estudiantes pasaron 53% (44 minutos) en actividades físicas moderadas a vigorosas (AFMV). Los niños fueron más activos que las niñas (53.94% vs 50,83%). Se observó una asociación positiva entre el género y casi todos los niveles de actividad física de los estudiantes (p<0,05). Se identificó que existe una diferencia estadísticamente significativa (p<0,05), para las categorías sentado y estar de pie de la variable Niveles de Actividad física tanto en los resultados expresados en minutos, como en la proporción del tiempo de la clase y para la categoría caminando expresada en tiempo de la clase. Para la variable contenido-contexto se determinó una asociación para la categoría conocimiento, tanto en la proporción como en el número de minutos, y para la categoría contenido general en los resultados expresados en proporción de la clase. Finalmente, para la variable comportamiento del profesor expresada tanto en minutos como en proporción de la clase tuvo significancia estadística en todas sus categorías a excepción de la categoría promover Conclusiones: hay una diferencia importante en la forma como los dos tipos de maestros desarrollan la clase y los niveles de actividad física en que involucran a los estudiantes. La educación física en la escuela debe ser impartida por profesionales formados en el área, que tengan las destrezas y habilidades necesarias para desarrollar una educación física de calidad.

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The thesis aims at exploring possible legal solutions to remove the obstacles to the free circulation of judgments in the civil justice area that arise from the remarkably diverging national rules on procedural time limits. As shown by the case-law of the CJEU, time limits have recently come under closer scrutiny. The interplay between national and EU law illustrates that time limits raise significant deficiencies connected with the right to a fair trial under Art. 6 ECHR and Art. 47 CFR – e.g. the effective recovery of claims, effective judicial protection, effective cross-border enforcement of judgments – which negatively impact EU cross-border civil litigation. In order to overcome some of the weaknesses of the current legal framework governing the cross-border enforcement of judgments and strengthen the parties’ fundamental procedural rights the PhD thesis intends to determine whether and, to what extent time limits can be harmonised at EU level. EU action on time limits would indeed favour the speed, efficiency and proportionality of cross-border proceedings without sacrificing the fairness of the judicial process and the equality of the parties

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Acid drainage influence on the water and sediment quality was investigated in a coal mining area (southern Brazil). Mine drainage showed pH between 3.2 and 4.6 and elevated concentrations of sulfate, As and metals, of which, Fe, Mn and Zn exceeded the limits for the emission of effluents stated in the Brazilian legislation. Arsenic also exceeded the limit, but only slightly. Groundwater monitoring wells from active mines and tailings piles showed pH interval and chemical concentrations similar to those of mine drainage. However, the river and ground water samples of municipal public water supplies revealed a pH range from 7.2 to 7.5 and low chemical concentrations, although Cd concentration slightly exceeded the limit adopted by Brazilian legislation for groundwater. In general, surface waters showed large pH range (6 to 10.8), and changes caused by acid drainage in the chemical composition of these waters were not very significant. Locally, acid drainage seemed to have dissolved carbonate rocks present in the local stratigraphic sequence, attenuating the dispersion of metals and As. Stream sediments presented anomalies of these elements, which were strongly dependent on the proximity of tailings piles and abandoned mines. We found that precipitation processes in sediments and the dilution of dissolved phases were responsible for the attenuation of the concentrations of the metals and As in the acid drainage and river water mixing zone. In general, a larger influence of mining activities on the chemical composition of the surface waters and sediments was observed when enrichment factors in relation to regional background levels were used.

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The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death. This was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated. A total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD. Although this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival.

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Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment.

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The 2005 National Institutes of Health (NIH) Consensus Conference proposed new criteria for diagnosing and scoring the severity of chronic graft-versus-host disease (GVHD). The 2014 NIH consensus maintains the framework of the prior consensus with further refinement based on new evidence. Revisions have been made to address areas of controversy or confusion, such as the overlap chronic GVHD subcategory and the distinction between active disease and past tissue damage. Diagnostic criteria for involvement of mouth, eyes, genitalia, and lungs have been revised. Categories of chronic GVHD should be defined in ways that indicate prognosis, guide treatment, and define eligibility for clinical trials. Revisions have been made to focus attention on the causes of organ-specific abnormalities. Attribution of organ-specific abnormalities to chronic GVHD has been addressed. This paradigm shift provides greater specificity and more accurately measures the global burden of disease attributed to GVHD, and it will facilitate biomarker association studies.

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Measurement instruments are an integral part of clinical practice, health evaluation and research. These instruments are only useful and able to present scientifically robust results when they are developed properly and have appropriate psychometric properties. Despite the significant increase of rating scales, the literature suggests that many of them have not been adequately developed and validated. The scope of this study was to conduct a narrative review on the process of developing new measurement instruments and to present some tools which can be used in some stages of the development process. The steps described were: I-The establishment of a conceptual framework, and the definition of the objectives of the instrument and the population involved; II-Development of the items and of the response scales; III-Selection and organization of the items and structuring of the instrument; IV-Content validity, V-Pre-test. This study also included a brief discussion on the evaluation of the psychometric properties due to their importance for the instruments to be accepted and acknowledged in both scientific and clinical environments.

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To evaluate the occurrence of severe obstetric complications associated with antepartum and intrapartum hemorrhage among women from the Brazilian Network for Surveillance of Severe Maternal Morbidity. Multicenter cross-sectional study. Twenty-seven obstetric referral units in Brazil between July 2009 and June 2010. A total of 9555 women categorized as having obstetric complications. The occurrence of potentially life-threatening conditions, maternal near miss and maternal deaths associated with antepartum and intrapartum hemorrhage was evaluated. Sociodemographic and obstetric characteristics and the use of criteria for management of severe bleeding were also assessed in these women. The prevalence ratios with their respective 95% confidence intervals adjusted for the cluster effect of the design, and multiple logistic regression analysis were performed to identify factors independently associated with the occurrence of severe maternal outcome. Antepartum and intrapartum hemorrhage occurred in only 8% (767) of women experiencing any type of obstetric complication. However, it was responsible for 18.2% (140) of maternal near miss and 10% (14) of maternal death cases. On multivariate analysis, maternal age and previous cesarean section were shown to be independently associated with an increased risk of severe maternal outcome (near miss or death). Severe maternal outcome due to antepartum and intrapartum hemorrhage was highly prevalent among Brazilian women. Certain risk factors, maternal age and previous cesarean delivery in particular, were associated with the occurrence of bleeding.

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To assess the occurrence of severe maternal complications owing to postpartum hemorrhage (PPH) and its associated factors. A secondary analysis of data from a multicenter cross-sectional prospective surveillance study included 9555 cases of severe maternal morbidity at 27 centers in Brazil between July 2009 and June 2010. Complications of PPH, conditions of severity management, and sociodemographic and obstetric characteristics were assessed. Factors independently associated with severe maternal outcome (SMO) were identified using multiple regression analysis. Overall, 1192 (12.5%) of the 9555 women experienced complications owing to PPH (981 had potentially life-threatening conditions, 181 maternal near miss, and 30 had died). The SMO ratio was 2.6 per 1000 live births among women with PPH and 8.5 per 1000 live births among women with other complications. Women with PPH had a higher risk of blood transfusion and return to the operating theater than did those with complications from other causes. Maternal age, length of pregnancy, previous uterine scar, and cesarean delivery were the main factors associated with an increased risk of SMO secondary to PPH. PPH frequently leads to severe maternal morbidity. A surveillance system can identify the main causes of morbidity and could help to improve care, especially among women identified as being at high risk of PPH.

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Air quality in animal production environment has been refereed as an interesting point for studies in environmental control systems with the focus both to the animal health which live in total confinement, as to the workers. The objective of this research was to determine the variation on the aerial environmental quality in two types of broiler housing: conventional (Gc) and tunnel type (Gt). The total dust values in both houses offered adequate rearing conditions to the birds; however, regarding the inhale dust in the air was above the limits recommended for humans. Carbon monoxide concentration in the heating phase during the evaluated period was above the 10 ppm maximum recommended, and it was higher during the cold season in Gt house (30 ppm) when compared to the Gc house (18 ppm). Ammonia concentration peaks in the air were above the 20 ppm recommended from the 20th day of production in both houses and in daily average, for a period higher in Gt (4h30) when compared to Gt (2h45). Only traces of nitrate oxide and methane were found while carbonic dioxide gas concentration evaluated during daytime met the limits allowed for both birds and labor.