Characteristics of HIV patients who missed their scheduled appointments

ABSTRACT OBJECTIVE: To analyze whether sociodemographic characteristics, consultations and care in special services are associated with scheduled infectious diseases appointments missed by people living with HIV. METHODS: This cross-sectional and analytical study included 3,075 people living with HIV who had at least one scheduled appointment with an infectologist at a specialized health unit in 2007. A secondary data base from the Hospital Management & Information System was used. The outcome variable was missing a scheduled medical appointment. The independent variables were sex, age, appointments in specialized and available disciplines, hospitalizations at the Central Institute of the Clinical Hospital at the Faculdade de Medicina of the Universidade de São Paulo, antiretroviral treatment and change of infectologist. Crude and multiple association analysis were performed among the variables, with a statistical significance of p ≤ 0.05. RESULTS: More than a third (38.9%) of the patients missed at least one of their scheduled infectious diseases appointments; 70.0% of the patients were male. The rate of missed appointments was 13.9%, albeit with no observed association between sex and absences. Age was inversely associated to missed appointment. Not undertaking anti-retroviral treatment, having unscheduled infectious diseases consultations or social services care and being hospitalized at the Central Institute were directly associated to missed appointments. CONCLUSIONS: The Hospital Management & Information System proved to be a useful tool for developing indicators related to the quality of health care of people living with HIV. Other informational systems, which are often developed for administrative purposes, can also be useful for local and regional management and for evaluating the quality of care provided for patients living with HIV.

Impactos da inovação nas organizações do setor da saúde: evidência empírica do CIS

Objetivos: O objetivo deste estudo é descrever o quadro de inovação no setor da saúde em Portugal, identificar os fatores críticos de sucesso da inovação, investigando os impactos da inovação nas organizações do setor da saúde. Metodologia: Na concretização da presente dissertação, recorremos a uma abordagem quantitativa, combinando a análise documental com a estatística, ao nível da análise do tratamento dos dados recolhidos através do Inquérito Comunitário à Inovação, efetuando assim um estudo de caso exploratório, descritivo e transversal. Principais resultados: As organizações analisadas operam sobretudo em mercados locais e regionais, de onde provém, maioritariamente, o seu volume de negócios, 80% do qual é composto por produtos pré-existentes. A maioria introduziu inovações de produto, processo, organizacionais ou de marketing, revelando potencial inovador. A maioria dos produtos novos ou significativamente melhorados foram desenvolvidos internamente, privilegiando fornecedores, consultores, instituições privadas de I&D e instituições do ensino superior como parceiros de cooperação, localizados sobretudo em Portugal e outros países europeus. As razões que motivam estas organizações a inovar são a melhoria da qualidade dos produtos e da capacidade de resposta a clientes e fornecedores, a diversificação da gama de produtos e o reforço da capacidade de desenvolvimento de novos produtos. Conclusões: O setor revela dinamismo na introdução de produtos novos para o mercado e para a empresa, apostando sobretudo num processo de inovação fechada. A cooperação externa é muito orientada à I&D e há um reduzido envolvimento dos agentes de mercado nas atividades de I&D através de parcerias. Contudo, estes são considerados importantes como fonte de informação e as organizações procuram responder às suas necessidades. Diferentes tipos de organizações adotam diferentes estratégias de inovação, conforme o seu mercado e a sua situação atual, o que traduz a materialização de políticas de inovação contextual, em linha com os desenvolvimentos teóricos da atualidade.

O doente com patologia múltipla em medicina geral e familiar: comorbilidade de 4 doenças crónicas

RESUMO: A tese de doutoramento visa demonstrar duas proposições: a comorbilidade de 4 situações de doença prevalentes, hipertensão arterial (HTA), diabetes (DM), doença cardíaca isquémica (DCI) e asma é um assunto importante em Medicina Geral e Familiar e o seu estudo tem diversas implicações na forma como os cuidados de saúde são prestados, na sua organização e no ensino-aprendizagem da disciplina. O documento encontra-se dividido em 4 partes: 1) justificação do interesse do tema e finalidades da dissertação; 2) revisão sistemática de literatura publicada entre 1992 e 2002; 3) apresentação de dois trabalhos de investigação, descritivos e exploratórios que se debruçam sobre a mesma população de estudo, o primeiro intitulado “Comorbilidade de quatro doenças crónicas e sua relação com factores sócio demográficos” e o segundo, “Diferenças entre doentes, por médico e por sub-região, na comorbilidade de 4 doenças crónicas”; 4) conclusões e implicações dos resultados dos estudos na gestão da prática clínica, nos serviços, no ensino da disciplina da MGF e no desenvolvimento posterior de uma linha de investigação nesta área. O primeiro estudo tem como objectivos: descrever a prevalência da comorbilidade entre as 4 doenças-índice; verificar se existe relação entre o tempo da primeira doença e o tempo decorrido até ao aparecimento da 2ª e da 3ª doença, nas 4 doenças; determinar a comorbilidade associada às 4 doenças; identificar eventuais agrupamentos de doenças e verificar se existe relação entre comorbilidade e factores sociais e demográficos. O segundo estudo pretende verificar se existem diferenças na comorbilidade a nível local, por médico, e por Sub-Região de Saúde. O trabalho empírico é descritivo e exploratório. A população é constituída pelos doentes, com pelo menos uma das 4 doenças crónicas índice, das listas de utentes de 12 Médicos de Família a trabalharem em Centros de Saúde urbanos, suburbanos e rurais dos distritos de Lisboa e Beja. Os dados foram colhidos durante um ano através dos registos médicos. As variáveis sócio demográficas estudadas são: sexo, idade, etnia/raça, escolaridade, situação profissional, estado civil, tipo de família, funcionalidade familiar, condições de habitação. A comorbilidade é definida pela presença de duas ou mais doenças e estudada pelo número de doenças coexistentes. O tempo de duração da doença é definido como o número de anos decorridos entre o ano de diagnóstico e 2003. Os problemas de saúde crónicos são classificados pela ICPC2. Nas comparações efectuadas aplicaram-se os testes de Mann-Whitney e de Friedman, de homogeneidade e de análise de resíduos. A Análise Classificatória Hierárquica foi utilizada para determinar o agrupamento de doenças e a Análise de Regressão Categórica e Análise de Correspondências na relação entre as características sócio demográficas e a comorbilidade. Identificaram-se 3998 doentes. A idade média é de 64,3 anos (DP=15,70). Há uma correlação positiva significativa (r =0,350 r=0) entre “anos com a primeira doença”e “idade dos doentes” em todos os indivíduos (homens r=0,129 mulheres r=0,231). A comorbilidade entre as quatro doenças crónicas índice está presente em 1/3 da população. As associações mais prevalentes são HTA+DM (14,3%) e HTA+DCI (6,25%). Existe correlação positiva, expressiva, entre a duração da primeira doença, quando esta é a HTA ou a DM, e o intervalo de tempo até ao aparecimento da 2ª e da 3ª doenças. Identificaram-se 18 655 problemas crónicos de saúde que se traduziram em 244 códigos da ICPC2. O número médio de problemas foi de 5,94 (DP=3,04). A idade, a actividade profissional, a funcionalidade familiar e a escolaridade foram as variáveis que mais contribuíram para diferenciar os indivíduos quanto à comorbilidade. Foram encontradas diferenças significativas entre médicos(c2=1165,368 r=0) e entre os agrupamentos de doentes por Sub-Região de Saúde (c2= 157,108 r=0) no respeitante à comorbilidade. Na partição por Lisboa o número médio de problemas é de 6,45 e em Beja de 5,35. Deste trabalho ressaltam várias consequências para os profissionais, para os serviços, para o ensino e para a procura de mais saber nesta área. Os médicos, numa gestão eficiente de cuidados são chamados a desempenhar um papel de gestores da complexidade e de coordenadores assim como a trabalhar num modelo organizativo apoiado numa colaboração em equipa. Por sua vez os serviços de saúde têm que desenvolver medidas de avaliação de cuidados que integrem a comorbilidade como medida de risco. O contexto social da cronicidade e da comorbilidade deverá ser incluído como área de ensino. A concluir analisa-se o impacto do estudo nos colaboradores e o possível desenvolvimento da investigação nesta área.----------------------------------------ABSTRACT: The PhD Thesis has two propositions, co-morbidity of four chronic conditions (hypertension, asthma, diabetes, cardiac ischaemic disease) is a prevalent and complex issue and its study has several implications in the way care is provided and organised as well as in the learning and teaching of the discipline of General Practice. In the first part of the document arguments of different nature are given in order to sustain the dissertation aims; the second part describes a systematic study of literature review from 1992 to 2002; the third presents two research studies "Comorbidity of four chronic diseases and its relation with socio demographic factors” and “Differences between patients among GPs at local and regional level”; implications of study results for practice management, teaching and research are presented in the last part. The prevalence of the four chronic diseases co-morbidity, the relation of the first disease duration with the time of diagnose of the next index condition, the burden of co-morbidity in the four chronic diseases, the clustering of those diseases, the relation between demographic and social characteristics and co-morbidity, are the objectives of the first study. The second intends to verify differences in comorbidity between patients at local and regional level of practice. Research studies were descriptive and exploratory. The population under study were patients enlisted in 12 GPs working in urban and rural health centres, in Lisbon and Beja districts, with at least one of the four mentioned diseases. Data were collected through medical records during one year (2003) and 3998 patients were identified. The social demographic variables were: sex, age, ethnicity/race, education, profession, marriage status, family status, family functionality, home living conditions. Co-morbidity is defined by the presence of two or more diseases, and studied by the number of co-existing diseases. The time duration of the disease is defined by the number of years between the diagnostic year and 2003. The chronic disease problems are classified in accord with ICPC2. The characterization of population is descriptive. The effected comparisons applied the Mann-Whitney, Friedman, homogeneity and analysis of residuals tests. The Classificatory Hierarchy Analysis was utilized to determine the grouping of diseases and the Regression Categorization and Correspondences Analysis was used to study the relation of socio-demographic and co-morbidity. The median age of the population under study is 64,3 (SD= 15,70). There is a significant positive correlation (r =0,350 r=0)between “years with the first disease” and “patient age” for all individuals (men r=0,129 women r=0,231). Co-morbidity of the four index diseases is present in 1/3 of the studied population. The most prevalent associations for the four diseases are HTA+DM (14,03%) and HTA+IHD (6,25%). Expressive positive correlation between the duration of the first disease and the second and the third index disease interval is found. For the 3988 patients, 18 655 chronic health problems, translated in 244 ICPC2 codes, were identified. The mean number of problems is 5,94 (SD=3,04). Age, professional activity, family functionality and education level are the socio demographic characteristics that most contribute to differentiate individuals concerning the overall co-morbidity. Significant differences in co-morbidity between GP patients at local (c2=1165,368 r=0) and regional level (c2= 157,108 r=0) are found. This study has several consequences for professionals, for services, for the teaching and learning of General Practice and for the pursuit of knowledge in this area. New competences and performances have to be implemented. General Practitioners, assuming a role of co-ordination, have to perform the role of complexity managers in patient's care, working in practices supported by a strong team in collaboration with other specialists. In order to assess provided care, services have to develop tools where co-morbidity is included as a risk measure. The social context of comorbidity and chronicity has to be included in the curricula of General Practice learning and teaching areas. The dissertation ends describing the added value to participant's performance for their participation in the research and an agenda for further research, in this area, based on a community of practice.--------RÉSUMÉ:Cette thèse de doctorat prétend démontrer deux postulats : le premier, que la comorbidité de quatre maladies fréquentes, hypertension artérielle (HTA), diabète (DM), maladie cardiaque ischémique (DCI) et asthme, est un thème important en Médecine Générale et Familiale et que son étude a plusieurs implications au niveau de l'approche pour dispenser les soins, de leur organisation et de l'enseignement/apprentissage de la discipline. Le document comprend quatre parties distinctes : 1) justification de l'intérêt du sujet et objectifs de la dissertation ; 2) étude systématique de publications éditées entre 1992 et 2002 ; 3) présentation de deux travaux de recherche, descriptifs et exploratoires, un premier intitulée « Comorbidité de quatre maladies chroniques et leur relation avec des facteurs sociodémographiques » et un deuxième « Différences entre malades, selon le médecin et la sous région, dans la comorbilité de quatre maladies chroniques» ; 4) conclusions et conséquences des résultats des études dans la gestion de la pratique clinique, dans les services, dans l'enseignement de la discipline de MGF et dans le développement postérieur de la recherche dans ce domaine. Les objectifs de la première étude sont les suivants : décrire la prévalence de la comorbidité entre les quatre maladies chroniques, vérifier s'il existe une relation entre temps de durée de la première maladie et l'espace de temps jusqu'à le diagnostic de la 2ème ou 3ème maladie; déterminer la comorbidité entre les 4 maladies ; identifier d'éventuelles groupements de maladies et vérifier s'il existe une relation entre comorbidité et facteurs sociodémographiques. La deuxième étude prétend vérifier s'il existe des différences de comorbidité entre médecins et par groupement régional. Le travail empirique est descriptif et exploratoire. La population est composée des malades ayant au moins une des quatre maladies chroniques parmi les listes de malades de douze Médecins de Famille qui travaillent dans des Centres de Santé urbains, suburbains et ruraux (Districts de Lisbonne et Beja). Les données ont été extraites pendant l'année 2003 des registres des médecins. Les variables sociodémographiques étudiées sont : le sexe, l'âge, l'ethnie/race, la scolarité, la situation professionnelle, l'état civil, le type de famille, sa fonctionnalité, les conditions de logement. La comorbidité est définie lorsqu'il existe deux ou plusieurs maladies et est étudiée d'après le nombre de maladies coexistantes. La durée de la maladie est établie en comptant le nombre d'années écoulées entre le diagnostique et 2003. Les problèmes de santé chroniques sont classés par l'ICPC 2. Pour les comparaisons les tests de Mann-Whitney et Friedman, de homogénéité et analyse de résidues ont été appliqués. L'Analyse de Classification Hiérarchique a été utilisée pour procéder au regroupement des maladies et l'Analyse de Régression Catégorique et l'Analyse de Correspondances pour étudier la relation entre les caractéristiques sociodémographiques et la comorbilité. Les principaux résultats sont les suivants : les 3998 malades identifiés ont 64,3 ans d'âge moyen (DP=15,70). Il existe une corrélation positive significative (r =0,350 r=0) entre « les années avec la première maladie » et « l'âge des malades », chez tous les individus (hommes r=0,129 femmes r=0,231). La comorbidité entre les quatre maladies chroniques est une réalité chez 1/3 des patients. Les associations les plus fréquentes sont HTA+DM (14%) et HTA+DCI (6,25%). Il existe une corrélation positive significative entre la durée de la première maladie, HTA ou DM, et l'écart jusqu'à l'apparition de la deuxième et de la troisième maladie. Chez les malades, 18.655 problèmes chroniques de santé ont été identifiés et traduits en 244 codes de l'ICPC2. La moyenne des problèmes a été de 5,94 (DP=3,04). L'âge, l'activité professionnelle, la fonctionnalité familiale et la scolarité sont les variables qui ont le plus contribué à différencier les individus face à la comorbilité. Des différences notoires ont été trouvées entre médecins (c2=1165,368 r=0) et entre les groupements régionaux (c2=157,108 r=0) en ce qui concerne la comorbidité. Dans le groupe de patients de Lisbonne, le chiffre moyen de problèmes est de 6,45 et à Beja il est de 5,35. Cette étude met en évidence plusieurs conséquences pour les professionnels, les services, l'enseignement et l'élargissement du savoir dans ce domaine. Les médecins, soucieux de gérer efficacement les soins sont appelés à jouer un rôle de gestionnaires de la complexité et de coordinateurs, de même qu'à travailler dans un modèle d'organisation soutenus par un travail d'équipe. D'autre part, les services de santé doivent eux aussi développer des mesures d'évaluation des soins qui intègrent la comorbidité comme mesure de risque. Le contexte social de la chronicité et de la comorbidité devra être inclus comme domaines à étudier. La fin de cette thèse décrit l'impact de cette étude sur les collaborateurs et le développement futur de la recherche dans ce domaine.

ENERGÍA EÓLICA Y PAISAJES PROTEGIDOS: CONTROVERSIAS EN EL PARQUE NATURAL DE MONTESINHO

As one of the case studies developed under the international project “Eoliennes et paysage” we could follow the controversial issue of wind power and protected areas in the Montesinho Natural Park, Northeast Portugal, where the local populations demand the setting up of a wind farm in unproductive communal lands, aspiring to benefi t economically from it, while the preservationist claims against wind power within the protected area are sensed by them as an external and illegitimate interference in the communitarian management of a local heritage. Although wind power installation in Montesinho mountains is yet only a virtual possibility (facing hard administrative and technical barriers), this case study contributed to shed light into the kind of negotiations that are being promoted at local and regional levels, and how the present banning of wind power in the region due to conservation restrictions is reactivating ancient antagonisms.

Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases

AbstractINTRODUCTION:We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informação de Agravos de Notificação (SINAN)] database.METHODS:A descriptive and retrospective epidemiological study was conducted from 2007 to 2013.RESULTS:A total of 4,118 accidents were recorded. Of these accidents, 88.7% (3,651) were caused by venomous species, and 11.3% (467) were caused by poisonous, traumatic or unidentified aquatic animals. Most of the events were injuries by stingrays (69%) and jellyfish (13.1%). The North region was responsible for the majority of reports (66.2%), with a significant emphasis on accidents caused by freshwater stingrays (92.2% or 2,317 cases). In the South region, the region with the second highest number of records (15.7%), jellyfish caused the majority of accidents (83.7% or 452 cases). The Northeastern region, with 12.5% of the records, was notable because almost all accidents were caused by toadfish (95.6% or 174 cases).CONCLUSIONS:Although a comparison of different databases has not been performed, the data presented in this study, compared to local and regional surveys, raises the hypothesis of underreporting of accidents. As the SINAN is the official system for the notification of accidents by venomous animals in Brazil, it is imperative that its operation be reviewed and improved, given that effective measures to prevent accidents by venomous animals depend on a reliable database and the ability to accurately report the true conditions.

Turismo arqueológico: um projeto de valorização da arte rupestre no vale do Lima

Dissertação de mestrado em Património e Turismo Cultural

Valorização do património tradicional em Santana: um contributo para o crescimento do turismo cultural da Madeira

Dissertação de mestrado em Património e Turismo Cultural

A destruição da muralha e do castelo de Braga no inicio do século XX: elementos para a compreensão do castelo medieval

Relatório de estágio de mestrado em História

2006 Drugs estimate refuels debate on governance, Issue 17, Spring 2006

In November 2005 €34.027 million was voted for the Drugs Initiative, which funds the local and regional drugs task forces, and the Young People’s Facilities and Services Fund (YPFSF), in 2006 – an 8 per cent increase on the allocation for 2005 and ‘well in excess of inflation’ according to the government. The community sector strongly criticised this estimate, calling for an additional €8 million to €15 million, to fund the projects identified following the creation of the Emerging Needs Fund in January 2005. In February 2006, the government revised its drugs estimate upwards by a further €8.979 million. As well as criticising the 2006 drugs estimate, the community sector raised a series of concerns with regard to governance – the rules, processes and behaviour that affect the way in which powers are exercised4 – or, in short, decision-making with regard to drugs policy in Ireland.This resource was contributed by The National Documentation Centre on Drug Use.

Dementia Care Services UK Market Briefing 2009

This brand new market briefing adds to the growing national debate on the future of dementia care services, making use of a unique and extensive L&B survey (2008) of over 6,000 care homes in the UK which provide care for people with dementia. It builds on the findings of the Alzheimer’s Society’s Dementia UK report (2007) and the national strategy for dementia Living Well with Dementia (2009) to identify market opportunities and provide essential guidance and information with regard to planning and developing new and existing services.Key issues, facts and figures highlighted in the report include:Dementia care is a multi-billion pound market in the UK and this market is set to grow considerably.��Dementia care in care homes dominates the sector in terms of current market value.��The use of dementia home care – though significantly smaller than the equivalent market in care homes – is set to rise markedly in the future.A significant proportion of residents for whom dementia is a known cause of admission are receiving care in settings which are not dedicated to dementia care.The new national dementia strategy for England, Living Well with Dementia should provide the strongest impetus yet for growth in the market for specialist dementia care.Growing awareness surrounding inappropriate use of anti-psychotic drugs on people with dementia in care homes may have a major operational impact on some homes if controls are increased and could substantially increase costs.Despite evidence of increasing dementia specialisation, there are, as yet, no organisations to emerge with full service dementia expertise and integrated care pathways.The supply of dedicated dementia services varies dramatically by region and locality, reflecting local and regional priorities and commissioning strategies.The design and layout of care homes for people with dementia is key and there is an increasing consensus around what constitutes best practice and ‘dementia friendly design’ .Care home fees for dementia are generally higher than fees for frail elderly residents.The report is essential reading for senior executives and managers within any organisation committed to, or considering involvement in, the dementia care sector, including for-profit, 'third sector' and public sector agencies.For further information, please contact:��Market ReportsTel.��020 7833 9123 orEmail��info@laingbuisson.co.uk��Download Full Brochure including Order Form��Download Contents and Tables�� Featured item on home page:��no��

Administració pública electronica i immigracio: una nova oportunitat per una societat xarxa catalana inclusiva

Aquest projecte explora dues dinàmiques socials interrelacionades: a) L'increment de la diversitat cultural al territori català i la necessitat d'implementar polítiques públiques per millorar la convivència i la cohesió social. b) El desenvolupament de la societat xarxa catalana mitjançant la disseminació de les noves tecnologies de la informació i la comunicació en I'espai de I'administració pública. Mes en concret, el projecte aborda la qüestió de la participació de les persones immigrades en la societat xarxa catalana mitjançant una metodologia que combina la investigació online i offline. Es posa un especial èmfasi en I'estudi de I ‘accés i ús dels serveis oferts per I'administració pública electrònica de les persones immigrades a Catalunya. Els nous usuaris i usuàries dels serveis públics presenten condicionants i necessitats particulars que depenen del seu origen cultural i de la seva situació administrativa. Aquest projecte estudia el grau d'adequació de la e-Administració a les demandes i necessitats especifiques d'aquest grup de població. En aquest sentit, I'estudi explora les possibilitats per a poder promoure la cohesió social mitjançant el desenvolupament d'una administració pública electronica mes inclusiva i interactiva a Catalunya. L’anàlisi de I'adaptació i adopció de I'administració electrònica catalana en el context de la població immigrada s'ha fet des d'un doble camí metodològic. D' una banda, s'ha realitzat una incursió en com I'administració pública catalana, tant local com autonòmica, s'ha adaptat a la diversitat dels seus usuaris mitjançant I'observació de webs i entrevistes a responsables tècnics i polítics. D'altra banda, s'han fet entrevistes amb persones immigrades amb perfils socio-culturals diversos. podem apuntar que I'administració pública electrònica a Catalunya es una realitat per a moltes persones immigrades que ja han provat de fer-la servir per a usos socialment importants. Existeixen, però, impediments tant des de la pròpia dinàmica de I'administració, que no ha posat aquesta qüestió en un lloc prioritari, com des de les persones que desconfien dels seus propis coneixements i no sempre troben allò que busquen. Amb tot, ens trobem amb un espai que obre expectatives de futur molt amplies. Un espai molt idoni per a repensar les formes que exigeixen els reptes de la nova ciutadania

08004-001 Summit Lake Final Report

The Summit Lake Watershed Improvement Project is a watershed-based sediment control project designed to greatly reduce to nearly eliminate sedimentation of an existing lake that is being renovated for use as a water source in southern Iowa. Summit Lake is owned by the City of Creston and was once a water source lake until around 1984. The watershed improvements will include lakeshore stabilization and erosion control practices as a precursor for related improvements to the lake and overall 4,900-acre watershed. Best practices included in this phase are the implementation of riprap, a rain garden, grade stabilization structures, grassed waterways, terraces, basins, water use and access ordinances, education and outreach, water monitoring, and other stream bank improvements. These improvements, along with leveraged work to be done by strategic partners, will enable the lake to be used for local and regional water supplies by sustaining the lake for many years to come. Without the lake rehabilitation, the lake will likely be filled with sedimentation to the point that it will have no recreational value. Key partners are the City of Creston, IDNR, Southern Iowa Rural Water Association, Union County, the Union County NRCS office, Southwestern Community College, and the Summit Lake Association, which is a non-profit group of landowners working to protect the lake. The project will address WIRB targets: a) streambank stabilization, b) livestock runoff, c) agricultural runoff and drainage, d) stormwater runoff, and e) a section of inadequately sewered community.

El fons de la Subdelegació de Policia de Dénia (1824-1836) : estudi i descripció

Hom tracta de dilucidar el context de creació i l’estructura d’un fons policial generat arran de la creació, el 1824, de la Policia General del Regne, fet que sol considerar-se el moment fundacional de la policia estatal en Espanya. A tal fi es combinen tècniques arxivístiques i historiogràfiques, coincidents en l’anàlisi institucional. Els fons de les subdelegacions de policia ens han arribat escadussers i desestructurats al si dels antics corregiments borbònics i solen trobar-se avui en arxius locals i comarcals. No obstant això, s’hi proposa un quadre de classificació.

Paikalliset elinkeinot ja ilmastonmuutos Kaakkois-Suomen alueella

Kasvihuonekaasujen vähentäminen on lähitulevaisuudessa välttämätöntä ilmastonmuutoksen torjunnassa. Tämä tosiasia tulisi nähdä niin yrityksissä kuin kunnissakin mahdollisuutena, johon liittyvillä toimenpiteillä voitaisiin kehittää myös alueen liiketoimintaa ja elinkeinoelämää. Tämän tutkimuksen tavoitteena oli löytää Kaakkois- Suomen kannalta tehokkaimmat keinot ja toimintamallit alueen liiketoiminnan edistämiseksi kasvihuonekaasupäästöjä hillitsevään suuntaan. Työssä on käsitelty erityisesti kunnan toimintaan liittyviä vaikutusmahdollisuuksia tavoitteiden saavuttamisessa. Tutkimus on toteutettu osana Suomen Kuntaliitto Ry:n koordinoimaa kuntienilmastonsuojelukampanjaa. Tutkimus on luonteeltaan kirjallisuuden pohjalta tehty esiselvitys. Työhön sisältyvien esimerkkitapausten osalta on tietoa hankittu myös haastattelemalla alueen yrityksiä. Tutkimuksen alkuvaiheessa on kartoitettu Kaakkois-Suomen alueellisia erityispiirteitä ja potentiaaleja. Työssä on arvioitu esimerkiksi uusiutuvien energialähteiden lisäämispotentiaalien käyttöönottamisella saavutettavat kasvihuonekaasupäästöjen vähenemät sekä työllisyysvaikutukset Kaakkois-Suomen alueella. Potentiaalien luoman pohjan perusteella on selvitetty mahdollisuuksia kehittää alueen elinkeinorakenteeseen soveltuvaa liiketoimintaa. Kasvihuonekaasuja vähentävän liiketoiminnan edistämiseksi on selvitetty keinoja sekä olemassa olevien yritysten kilpailukyvyn parantamiseen että uuden liiketoiminnan kehittämiseen liittyen. Näiden tavoitteiden saavuttamisessa nähtiin yritysten verkostoitumisen olevan eräs tärkeä keino, jolla voidaan parantaa mm. alueen lukuisten pienten yritysten mahdollisuuksia suurten kokonaistoimitusten tuottamisessa. Työssä on esitetty kunnan toimintaan soveltuva toimintamalli yritysten verkostoimiseksi. Jätteiden ja sivutuotteiden osalta työssä on esitetty materiaalivirtojen hyötykäyttöön ohjaamiseen erikoistunutta liiketoimintaa niin sanotun materiaalipörssin muodossa. Myös koulutuksen, tutkimuksen ja rahoituksen tarjontaa kasvihuonekaasuja vähentävän liiketoiminnan kehittämisen tueksi on selvitetty Kaakkois-Suomen alueella. Tutkimuksen sisällössä ovat esimerkkitapaukset keskeisessä asemassa. Niiden puitteissa on haastateltu paikallisen alueen yrityksiä ja viranomaisia. Esimerkkitapauksissa on selvitetty materiaalipörssin, lämpöyrittäjyyden sekä erään yrityksen verkostoimiseen liittyviä tekijöitä ja keinoja. Haastatteluista ja kirjallisuudesta saatuihin tietoihin perustuen on ehdotettu toimintavaihtoehtoja toiminnan kehittämiseksi. Tutkimuksen tulosten perusteella on lopuksi esitetty suunnitelma jatkotoimenpiteistä, joilla tuloksia lähdetään viemään käytännön tasolle.

Eettisten periaatteiden tarve kunnallishallinnossa

Abstract: The need for the handbook of good practice in public ethics at local level