801 resultados para psychosocial risk assessment


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Objetivou-se nesse estudo identificar os fatores de risco psicossocial que o enfermeiro residente encontra-se exposto em unidades especializadas; descrever as repercussões dos fatores de risco psicossocial para a saúde do enfermeiro residente em unidades especializadas e analisar as formas de enfrentamento adotadas pelo enfermeiro residente diante dos riscos psicossociais em unidades especializadas. Pesquisa qualitativa do tipo exploratória descritiva, cujo campo foi um hospital universitário situado no município do Rio de Janeiro. A partir dos critérios de seleção adotados participaram do estudo 20 enfermeiros residentes do 1 e 2 anos, lotados em unidades especializadas (CTI adulto, UTI neonatal, CTI cardíaco, UI clínica, Unidade Coronariana e Unidade de Doenças Infecto Parasitárias). O estudo obedeceu aos aspectos éticos em conformidade com a Resolução 466/12 sendo aprovado pelo Comitê de Ética em Pesquisa (067/2012). Utilizou-se a técnica de entrevista semiestruturada mediante um instrumento contendo em sua primeira parte as características dos sujeitos e na segunda um roteiro com questões abertas que possibilitaram ao residente falar sobre os riscos no ambiente laboral, o modo como era afetado e os mecanismos de enfrentamento adotados. Ao término das entrevistas, realizadas no segundo semestre de 2012 e registradas em meio digital, aplicou-se a técnica de análise de conteúdo, sendo os resultados discutidos a luz da Psicodinâmica do Trabalho. Os resultados evidenciaram que o enfermeiro residente de unidades especializadas encontra-se exposto a inúmeros fatores de risco psicossocial e entre eles: a sobrecarga física e psíquica do trabalho, a ambiguidade de papéis, o relacionamento interpessoal conflituoso, a pouca autonomia, o baixo controle em relação ao processo de trabalho e a precariedade das condições de trabalho. Tais fatores, além de afetarem o processo de formação do residente, acarretam prejuízos a sua saúde física e mental; identificados a partir de queixas como: cansaço, estresse, desgaste, padrão de sono ruim, problemas gastrintestinais, dermatológicos e osteomusculares. Diante do sofrimento no trabalho, o enfermeiro residente elabora estratégias de manejo centradas na emoção (autocontrole, aceitação das responsabilidades, fuga, confronto e resignação) e no problema (negociação, tentativa de solução, suporte social, reavaliação positiva). Concluiu-se que o enfermeiro residente encontra-se exposto a inúmeros fatores de risco psicossocial em unidades especializadas que afetam a sua saúde física e mental. No intuito de concluir a residência e preservar a saúde, o residente elabora estratégias de manejo, que apesar de essenciais não eliminam o sofrimento no trabalho e os problemas vivenciados no dia a dia. Cabe ao órgão formador identificar, monitorar e combater os riscos referidos pelo residente no intuito de promover a capacitação, a satisfação e o bem estar no trabalho, ao se considerar a responsabilidade social pela formação, saúde e inserção do futuro profissional no mercado de trabalho.

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Projetos de construção são caracterizados pela escala, complexidade e seus riscos. Não é incomum encontrar planejamento e definição de escopo incompletos o que leva a aumento de custos e prazos. O objetivo desse trabalho é descrever um método de avaliação de riscos de forma a aumentar a previsibilidade da estimativa de custos do empreendimento. Para isso foram utilizados conceitos de gerenciamento de projetos, de simulação e de analise de riscos descritos na literatura para a constituição de um método de análise de riscos em estimativa de custos. A aplicação do método proposto em comparação com o método tradicional traz vantagens no que diz respeito à abrangência da análise. Enquanto pelo método tradicional a análise do empreendimento se faz por meio de suas tarefas, o método proposto analisa de forma distinta o planejamento do empreendimento nas suas três dimensões fundamentais: escopo, prazo e custo.

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Projetos de construção são caracterizados pela escala, complexidade e seus riscos. Não é incomum encontrar planejamento e definição de escopo incompletos o que leva a aumento de custos e prazos. O objetivo desse trabalho é descrever um método de avaliação de riscos de forma a aumentar a previsibilidade da estimativa de custos do empreendimento. Para isso foram utilizados conceitos de gerenciamento de projetos, de simulação e de analise de riscos descritos na literatura para a constituição de um método de análise de riscos em estimativa de custos. A aplicação do método proposto em comparação com o método tradicional traz vantagens no que diz respeito à abrangência da análise. Enquanto pelo método tradicional a análise do empreendimento se faz por meio de suas tarefas, o método proposto analisa de forma distinta o planejamento do empreendimento nas suas três dimensões fundamentais: escopo, prazo e custo.

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Mundialmente, eventos relatados constituídos por incidentes e acidentes em radioterapia, tem aumentado ao longo dos últimos 25 anos e a maioria destes eventos são resultados de falha humana, além de terem ocorrido com maior frequência em centros sofisticados que utilizam alta tecnologia. Em radioterapia a Gestão da Qualidade necessita de uma abordagem prospectiva através de análise de risco. Esta abordagem é defendida por recentes publicações por ser atualmente uma urgência em virtude do expressivo número de acidentes ocorridos. Dada a complexidade do processo em radioterapia, a busca pela qualidade do tratamento de forma a garantir a segurança do paciente é um dos assuntos mais discutidos mundialmente. Embora apenas 14% dos centros de radioterapia no Brasil ofereçam tratamentos com a técnica de radiocirurgia intracranial (SRS), estudos relativos a qualidade do tratamento relacionada a segurança do paciente submetido à esta técnica, é de relevante importância, pois qualquer desvio da dose prescrita é considerado muito mais crítico que em outras modalidades de tratamento radioterápico, já que são utilizadas altas doses de radiação que em geral variam de 10 Gy a 40 Gy para lesões até 50 mm de diâmetro, que são aplicadas em uma única fração ou até cinco frações. Tendo em vista tais conhecimentos, o objetivo deste trabalho foi atender um novo paradigma de Gestão da Qualidade, através do desenvolvimento de um modelo de análise de risco e de um Índice de Qualidade para a SRS no Brasil, a partir da técnica de Mapa do Processo e FMEA utilizadas pelo TG 100/AAPM. O trabalho foi desenvolvido em três centros de radioterapia de referência em alta tecnologia, dois localizados no Rio de Janeiro e um em São Paulo. Um Mapa do Processo de SRS foi identificado em cada centro de radioterapia e em seguida foi aplicada a técnica FMEA para todos os subprocessos identificados no mapa. A partir dos valores de NPR obtidos pela FMEA foi realizado um ranqueamento dos modos de falha. Modos de falha com NPR ≥ 100 e S ≥ 7 foram escolhidos como prioridade para implementação de estratégias de segurança. A partir das pontuações do parâmetro S atribuídas na aplicação da FMEA foi criado o Índice de Severidade (IS) e um Índice de Qualidade (IQ) foi criado a partir de uma relação entre o NPR e o IS. O resultado deste estudo, indica que as estratégias de segurança sejam implementadas para os 10 primeiros modos de falha do ranking e uma reavaliação do processo deve ocorrer a cada 1 ano. É também indicado que o IQ obtenha uma melhora mínima de 9% após a reavaliação do processo. De forma geral, o estudo mostrou que a adoção da ferramenta FMEA juntamente com o IQ são de fato justificadas, por minimizar os riscos para o paciente, melhorando a qualidade do tratamento aprimorando a segurança, criando mecanismos que permitam a garantia de que a dose será entregue de forma precisa e exata, e consequentemente, aumentando as chances de cura ou do controle local com uma desejada qualidade de vida para estes pacientes.

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Perhaps the most difficult job of the ecotoxicologist is extrapolating data calculated from laboratory experiments with high precision and accuracy into the real world of highly-dynamics aquatic environments. The establishment of baseline laboratory toxicity testing data for individual compounds and ecologically important and field studies serve as a precursor to ecosystem level studies needed for ecological risk assessment. The first stage in the field portion of risk assessment is the determination of actual environmental concentrations of the contaminant being studied and matching those concentrations with laboratory toxicity tests. Risk estimates can be produced via risk quotients that would determine the probability that adverse effects may occur. In this first stage of risk assessment, environmental realism is often not achieved. This is due, in part, to the fact that single-species laboratory toxicity tests, while highly controlled, do not account for the complex interactions (Chemical, physical, and biological) that take place in the natural environment. By controlling as many variables in the laboratory as possible, an experiment can be produced in such a fashion that real effects from a compound can be determined for a particular test organism. This type of approach obviously makes comparison with real world data most difficult. Conversely, field oriented studies fall short in the interpretation of ecological risk assessment because of low statistical power, lack of adequate replicaiton, and the enormous amount of time and money needed to perform such studies. Unlike a controlled laboratory bioassay, many other stressors other than the chemical compound in question affect organisms in the environment. These stressors range from natural occurrences (such as changes in temperature, salinity, and community interactions) to other confounding anthropogenic inputs. Therefore, an improved aquatic toxicity test that will enhance environmental realism and increase the accuracy of future ecotoxicological risk assessments is needed.

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The heterogeneous nature of the subsurface and associated DNAPL morphologies often poses the greatest limitation to source zone clean-up strategies. Hence, detailed site characterisation techniques are required. The data presented in this paper has been collected from a series of laboratory 2-D tank experiments and numerical simulations of Partitioning Interwell Tracer Tests (PITT) in a wide range of aquifer conditions and DNAPL morphologies. Alternative uses of tracer breakthrough data have been developed In order to characterise the mass flux generated from the DNAPL source. By combining the laboratory and numerical data, a relationship between normalised mass flux and tracer-based average source zone DNAPL saturation has been established. Knowledge of such a relationship allows remediation targets to be identified, clean-up efficiencies to be evaluated, and increases the accuracy of any risk assessment.

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Progress and Outputs: summary of 2012, progress of project logframe targets in year 4, events diary,activities within each sub-component. Risk assessment. Project finances. List of documents.

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Study on the biomarkers types to assess health status of marine ecosystems in environmental biomonitoring has an important value. Accordingly, accumulation of polycyclic aromatic hydrocarbons(PAHs) in sediment, water and tissues (liver and gill) of mudskipper(i.e. Boleophthalmus dussumieri) and some physiological responses like lysosomal membrane change performed on haemocytes, stability of red blood cell membrane and the Glutathione-S Transferase (GST) activity in the liver were measured in mudskipper. Samples were obtained from five sites along north western coast of the Persian Gulf (Khuzestan coast). Red blood cell membrane changes after different concentration of PAHs at different time was also studied to evaluate impact of PAHs compound on cell membrane. PAHs concentration was measured by HPLC method. The activity of GST enzyme was analysed by spectrophotometric method. Lysosomal membrane change was measured by NRR time method and stability of red blood cell membrane was evaluated by EOF test. Total PAH concentrations in the coastal sea water, the sediments, the liver and the gill tissues ranged between 0.80-18.34 μg/l, 113.50-3384.34 ng g-1 (dry weight), 3.99-46.64 ng g-1 dw and 3.11-17.76 ng g-1 dw, respectively. Highest PAHs pollution was found at Jafari while the lowest was detected at Bahrakan sampling sites. The lowest enzymatic activity was identified at Bahrakan (7.19 ± 1.541 nmol/mg protein/min), while the highest was recorded at Jafari (46.96 ± 7.877 nmol/mg protein/min). Comparative analysis of GST activity in the liver of mudskippers showed significant difference (p < 0.05) between the locations of Jafari and Bahrakan, and with other sites. Moreover, no significant difference was detected between the locations of Arvand, Zangi and Samayeli (p < 0.05). The mean RT was below 90 minutes in all sampling sites. Values of mean RT of the dye ranged from 34 (for the blood samples of mudskipper collected from Jafari site) to 78 minutes (for the blood samples of mudskipper collected from Bahrakan site). Spatial evaluation revealed the longest RT in fish from Bahrakan as compared with those from other sites. Preliminary results showed a significant difference (p < 0.05) among sampling sites except between Arvand and Zangi (p > 0.05). Osmotic fragility curves indicated that erythrocytes collected from mudskippers at Jafari were the most 009 fragile followed by Zangi> Arvand> Samayeli> and Bahrakan. The mean erythrocyte fragility was significantly higher at Jafari site (p < 0.05) when compared to other sites. Significant differences were found between the various sites (p < 0.05).The result indicated no significant differences between the control and treatments of mudskipper RBC exposed to field concentrations of PAHs (P>0.05). The results further indicated significant differences (P<0.05) between the control and treatments of mudskipper RBC exposed to acute. Potency Divisor concentrations. It is clear from the present result that chronic. Potency Divisor concentrations protect red cells against osmotic hemolysis. This study, however, showed that PAH concentrations in this region are not higher than the available standards. The findings showed that Lysosomal membrane destabilization, liver GST activities and fragility of red cell membrane are highly sensitive in the mudskipper, B. dussumieri. Thus, mudskipper perceived to be good sentinel organisms for PAH pollution monitoring. Sediment PAH concentrations were strongly correlated with biomarkers, indicating that PAH type pollutants were biologically available to fish. One of the possible risk assessment implications of this study is that biomarkers can be applied not only to characterize biological effects of pollution exposures, but also to determine the bioavailability of pollution in aquatic systems. The results also indicated that PAHs compound possess anti haemolytic property.

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A number of wide-ranging monitoring studies have been performed in order to estimate the degree of mercury (Hg) contamination in freshwater ecosystems. Knowledge regarding contamination of different levels of the food chain is necessary for estimation of total pollutant input fluxes and subsequent partitioning among different phases in the aquatic system. The growing international concern about this environmental data is closely related to the strongly developing ecological risk assessment activities. In addition,freshwater monitoring outputs hold a key position in the estimation of the Hg dose consumed by the human population as it is highly dependent on fish consumption. So monitoring of Hg in the tissue of edible fish is extremely important because of contaminated fish has caused serious neurological damage to new born babies and adults. Mercury tends to accumulate in fish tissue, particularly, in the form of methyl mercury, which is about 10 times more toxic than inorganic mercury. The Anzali lagoon is one of the biggest wetland of Guilan province, which joins to the Caspian sea. Many Chemical and industrial factories plus agricultural runoffs and urban and rural sewages are major polluting sources of the Anzali wetland. Since many of those polluting sources drain their wastes directly or indirectly into the Anzali wetland and their sewages may be polluted with Hg, this study was conducted to find out the bioaccumulation of Hg bioaccumulation in pike (Esox lucius) food chain from Anzali lagoon, Iran. Sampling were carried out from July 2004 to July 2005, in addition 318 speciments of 9 fish species were collected. T-Hg was measured by LECO AMA 254 Advanced Mercury Analyzer (USA) according to ASTM standard No D-6722. Each sample was analyzed 3 times. Accuracy of T-Hg analysis was checked by running three samples of Standard Reference Materials; SRM 1633b, SRM 2711 & Sra 2709. Detection limit was 0.001 mg/kg in dry weight. The Accuracy degree of analyzor equipment with RSD<%0.05 (N=7) was between %95.5 and %105. In overal eigth fish species were distingushed in the gut content of 87 speciments of pike with age 1-5 year and maximum length 550mm. The max. and min. concentration of T-Hg in dorsal muscle of pjke was 0.2ppm in one year and 1.2ppm in five year class. The mean of T-Hg significantly increased with age and length increased (P<0.05).Mercury accumulation pattern in pike was as well as muscle > liver > spleen (P<0.05). THg content in female was higher than male(P<0.05). In contrast the mean of THg concentration in dorsal muscle of eigth fish species as prey was 0.282, 0.261, 0.328, 0.254, 0.256, 0.286, 0.322 and 0.241 ppm for Carassius auratus gibelio, Hemiculter leucisculus, Blicca bjoerkna transcaucasica, Chalcalburnus mossulensis, Rhodeus sericeus amarus, Gambusia holbrooki, Alburnus charusini hohenackeri & Scardinius Erythrophthalmus respectively.Liner regresion indicated that high degree of relationship between age of pike and Uptak/Intake ratio (R2=%99.12) and indicated that the mercury bioaccumulation in the pike dorsal muscle increased with age increased. BFA was >1 and and indicating the mercury biomagnification in the pike food chain. Trophy level of pike in the Anzali lagoon was estimated as well as 3.5 and 4 . It is generally agreed that Hg concentration in carnivorous fish are higher than in noncarnivorous species.

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The response of submerged slopes on the continental shelf to seismic or storm loading has become an important element in the risk assessment for offshore structures and "local" tsunami hazards worldwide. The geological profile of these slopes typically includes normally consolidated to lightly overconsolidated soft cohesive soils with layer thickness ranging from a few meters to hundreds of meters. The factor of safety obtained from pseudo-static analyses is not always a useful measure for evaluating the slope response, since values less than one do not necessarily imply slope failure with large movements of the soil mass. This paper addresses the relative importance of different factors affecting the response of submerged slopes during seismic loading. The analyses use a dynamic finite element code which includes a constitutive law describing the anisotropic stress-strain-strength behavior of normally consolidated to lightly overconsolidated clays. The model also incorporates anisotropic hardening to describe the effect of different shear strain and stress histories as well as bounding surface principles to provide realistic descriptions of the accumulation of the plastic strains and excess pore pressure during successive loading cycles. The paper presents results from parametric site response analyses on slope geometry and layering, soil material parameters, and input ground motion characteristics. The predicted maximum shear strains, permanent deformations, displacement time histories and maximum excess pore pressure development provide insight of slope performance during a seismic event. © 2006 Author(s). This work is licensed under a Creative Commons License.

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Hip fracture is the leading cause of acute orthopaedic hospital admission amongst the elderly, with around a third of patients not surviving one year post-fracture. Although various preventative therapies are available, patient selection is difficult. The current state-of-the-art risk assessment tool (FRAX) ignores focal structural defects, such as cortical bone thinning, a critical component in characterizing hip fragility. Cortical thickness can be measured using CT, but this is expensive and involves a significant radiation dose. Instead, Dual-Energy X-ray Absorptiometry (DXA) is currently the preferred imaging modality for assessing hip fracture risk and is used routinely in clinical practice. Our ambition is to develop a tool to measure cortical thickness using multi-view DXA instead of CT. In this initial study, we work with digitally reconstructed radiographs (DRRs) derived from CT data as a surrogate for DXA scans: this enables us to compare directly the thickness estimates with the gold standard CT results. Our approach involves a model-based femoral shape reconstruction followed by a data-driven algorithm to extract numerous cortical thickness point estimates. In a series of experiments on the shaft and trochanteric regions of 48 proximal femurs, we validated our algorithm and established its performance limits using 20 views in the range 0°-171°: estimation errors were 0:19 ± 0:53mm (mean +/- one standard deviation). In a more clinically viable protocol using four views in the range 0°-51°, where no other bony structures obstruct the projection of the femur, measurement errors were -0:07 ± 0:79 mm. © 2013 SPIE.

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Perfluorooctane sulfonate (PFOS) is widely distributed and persistent in the environment and in wildlife, and it has the potential for developmental toxicity. However, the molecular mechanisms that lead to these toxic effects are not well known. In the present study, proteomic analysis has been performed to investigate the proteins that are differentially expressed in zebrafish embryos exposed to 0.5 mg/l PFOS until 192 h postfertilization. Two-dimensional electrophoresis coupled with mass spectrometry was employed to detect and identify the protein profiles. The analysis revealed that 69 proteins showed altered expression in the treatment group compared to the control group with either increase or decrease in expression levels (more than twofold difference). Of the 69 spots corresponding to the proteins with altered expression, 38 were selected and subjected to matrix-assisted laser desorption/ionization tandem time-of-flight mass spectrometry (TOF/TOF) analysis; 18 proteins were identified in this analysis. These proteins can be categorized into diverse functional classes such as detoxification, energy metabolism, lipid transport/steroid metabolic process, cell structure, signal transduction, and apoptosis. Overall, proteomic analysis using zebrafish embryos serves as an in vivo model in environmental risk assessment and provides insight into the molecular events in PFOS-induced developmental toxicity.

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Most evidence in terms of endocrine dsiruptors (EDs) mainly originates from studies on reproductive organs. However, in veterbrates, the ability to attain reproductive and development success relays on the intact organization of a complex endocrine system. Disturbances in the regulation of the key hormones and receptors functioning along this system may cause detrimental effects on reproduction and development. Here we reviewed recent studies of EDs on endocrine system. EDs may act on key hormones and receptors along with the hypothalarnic-pituitary-gonald (HPG) axis and lead to reproductive failure. Thyroid disruption may be caused at different levels, for example, the synthesis, transport, binding and cellular uptake along with the hypothalamic-pituitary-thyroid (HPT) axis. Knowledge of model of action EDs is largely via receptors-mediated pathway and alternatively may affect on steroid hormone synthesis. Aquatic hypoxia can influence fish reproduction and thus it is also an endocrine disruptor. Molecular techniques, such as toxicomics, transgenic fish will be employed as powerful tools for environmental EDs risk assessment, as well as in elucidating mechanisms of model action.

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For the purpose of understanding the environmental fate of microcystins (MCs) and the potential health risks caused by toxic cyanobacterial blooms in Lake Taihu, a systematic investigation was carried out from February 2005 to January 2006. The distribution of MCs in the water column, and toxin bioaccumulations in aquatic organisms were surveyed. The results suggested that Lake Taihu is heavily polluted during summer months by toxic cyanobacterial blooms (with a maximum biovolume of 6.7 x 10(8) cells/L) and MCs. The maximum concentration of cell-bound toxins was 1.81 mg/g (DW) and the dissolved MCs reached a maximum level of 6.69 mu g/L. Dissolved MCs were always found in the entire water column at all sampling sites throughout the year. Our results emphasized the need for tracking MCs not only in the entire water column but also at the interface between water and sediment. Seasonal changes of MC concentrations in four species of hydrophytes (Eichhornic crassipes, Potamogeton maackianus, Alternanthera philoxeroides and Myriophyllum spicatum) ranged from 129 to 1317, 147 to 1534, 169 to 3945 and 124 to 956 ng/g (DW), respectively. Toxin accumulations in four aquatic species (Carassius auratus auratu, Macrobrachium nipponensis, Bellamya aeruginosa and Cristaria plicata) were also analyzed. Maximum toxin concentrations in the edible organs and non-edible visceral organs ranged from 378 to 730 and 754 to 3629 ng/g (DW), respectively. Based on field studies in Lake Taihu, risk assessments were carried out, taking into account the WHO guidelines and the tolerable daily intake (TDI) for MCs. Our findings suggest that the third largest lake in China poses serious health threats when serving as a source of drinking water and for recreational use. In addition, it is likely to be unsafe to consume aquatic species harvested in Lake Taihu due to the high-concentrations of accumulated MCs. (C) 2007 Elsevier Ltd. All rights reserved.

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Data of classification, origin, pathway and environmental impacts of invasive alien micro-organisms, invertebrates, amphibians and reptiles, fish, birds, mammals, weeds, trees, and marine organisms in terrestrial, aquatic and marine ecosystems of China, were analyzed, based on literature retrieval, field survey and consultation. Some 283 invasive alien species were recorded in China, including 19 invasive alien micro-organisms, 18 aquatic plants, 170 terrestrial plants, 25 aquatic invertebrates, 33 terrestrial invertebrates, 3 amphibians and reptiles, 10 fish, and 5 mammals. Of the invasive alien species, 55.1% originated from North and South America, 21.7% from Europe, 9.9% from Asia, 8.1% from Africa and 0.6% from Oceania. Many institutions and individuals in China lack adequate knowledge of ecological and environmental consequences caused by invasive alien species, with some ignorance of the dangerous invasion in the introduction of alien species. For instance, 50.0% of invasive alien plants were intentionally introduced as pasture, feedingstuff, ornamental plants, textile plants, medicinal plants, vegetables, or lawn plants, 25% of alien invasive animals were intentionally introduced for cultivation, ornament, or biological control, In addition, more efforts are being made in the introduction of alien species, and little attention is paid on the management of introduced alien species, which may cause their escape into natural environment and potential threats to the environment. There were also gaps in quarantine system in China. All microorganisms were unintentionally introduced, through timber, seedling, flowerpot, or soil; 76.3% of alien invasive animals invaded through commodity or transportation facility because of the failure of quarantine. Therefore, quarantine measures should be strictly implemented; and meanwhile the intentional introduction of alien species should be strictly managed and a system of risk assessment should be implemented.