947 resultados para Mobile home living.
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HUD contract no. H-2110-R.
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At head of title: Federal Trade Commission.
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Includes bibliographical references.
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Mode of access: Internet.
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"October 1979."
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This paper combines demographic ageing and retirement lifestyles with rural in-migration processes and suggests the emergence of a specific rural form of gated community; namely, park homes. All year round or permanent (as opposed to seasonal) residential mobile homes (resembling detached bungalows in design and appearance) are commonly referred to as 'park homes'. With a growing proportion of the UK population aged 65 and over, combined with increasing longevity, meeting the residential preferences and lifestyle aspirations of an ageing population is potentially 'big business' for the private sector. Park home living, with their resident age restrictions (normally 50 years and over), is increasingly marketed as a retirement option in rural and coastal locations of the UK. However, many areas are often remote with declining populations and limited community services. Operators have sought to tap into retiree aspirations for a 'place in the country' and 'sell' the concept of park home living as a specific form of housing, community and lifestyle. Park homes are frequently marketed as a means to release equity from the sale of a large family home to fund a retirement lifestyle and as friendly communities of like-minded people, always willing to lend support or provide assistance if required. The physical and social composition of such sites represent a form of rural gated community. This paper seeks to identify the rural planning issues which emerge from such developments and asks: who are moving to park home sites and why? do park homes provide those who otherwise could not afford a 'place in the country' the option of rural living? does park home living live-up to residents' expectations of the rural idyll or retirement lifestyle? do they give rise to issues of gentrification and geriatrification of the countryside? what are the prospects for residents to 'age in place'? might ageing residents become financially trapped in such developments giving rise to park ghettoization? what are the associated challenges for rural policy-makers and public service providers?
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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.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Der Ökotourismus hat sich in den letzten Jahren zu einer Tourismussparte entwickelt, die nicht nur immer mehr Interessenten unter den Nutzern findet, sondern auch vielfältige Forschungsmöglichkeiten eröffnet.rnAus interdisziplinärer Betrachtungsweise kann man sowohl in den Gebieten der Biologie, der Wirtschaft, der Geographie, aber auch der Politik forschend tätig werden. rnDa der Tourismus in den letzten Jahren eine immer größere Bedeutung gerade für Länder mit weitestgehend intakten Naturressourcen erlangt hat, stellt sich die Frage inwieweit die Wirtschaft eines Landes auf diese Einnahmequelle angewiesen ist und ob nicht die ökologischen Belange immer weiter in den Hintergrund treten.rnAus diesem Ansatz heraus erfolgte zunächst eine qualitative und quantitative Bestandsaufnahme, die ein klares Bild vom derzeitigen Zustand in der Region ermöglicht. Darüber hinaus werden im Rahmen der Untersuchungen Zukunftsperspektiven aufgezeigt. Diese sollen verdeutlichen, inwieweit man steuernd in solche dynamischen Entwicklungsprozesse eingreifen kann oder soll.rnDie Schwerpunkte dieser Arbeit liegen in dem Bereich der Befragung von Touristen und in der Ausarbeitung eines digitalen Geländemodells zur späteren Nutzung in einem aufzubauenden Nationalpark-Infozentrum. Auf der Grundlage dieser Untersuchungen wurde ein touristisches Nutzungskonzept entwickelt und auf seine ökologischen Umsetzungschancen hin untersucht. Der Aspekt des Ökotourismus wird einleitend erörtert und definiert. Anschließend werden die Potenziale der norwegischen Tourismuswirtschaft untersucht. Die Befragungsergebnisse sowohl der norwegischen Besucher als auch der ausländischen Touristen werden in verschiedenen Korrelationen näher untersucht.rnEin gesonderter Bereich der Untersuchungen gilt dem Problemfeld des Wildcampings in Norwegen. Die dramatischen Entwicklungen der letzten Jahre rufen immer mehr Aktivisten auf den Plan. Da die Deutschen die größte Besuchergruppe darstellen, wurden innerhalb der Jahre 2003 bis 2006 Einzelinterviews geführt, um einen Überblick über das Übernachtungsverhalten der Deutschen in Norwegen gewinnen zu können. In den vergangenen 10 Jahren sind die deutschen Besucherzahlen in Norwegen leicht rückläufig, während die der Niederländer kontinuierlich steigen.rnAuf diesen Ergebnissen basierend wurden problemzentrierte Interviews mit Wohnmobilreisenden, der größten Gruppe der Individualreisenden, durchgeführt. rnMehr als 600.000 Nächte pro Jahr verbrachten die deutschen Wohnmobilreisenden außerhalb der Campingplätze, was ökologische und ökonomische Auswirkungen hat und nicht mehr mit dem in Norwegen geltenden „Allemansrett“, dem Jedermannsrecht, vereinbar ist. rnGerade die Touristen, die mit dem Wohnmobil reisen, können nur schwer mit anderen Reisenden verglichen werden, da sie mit einer völlig anderen Reiseauffassung mehr oder weniger autark unterwegs sind. Dabei legen sie besonders große Distanzen zurück und haben sich zum Ziel gesetzt, möglichst viel in kurzer Zeit zu sehen und zu erleben. Für alle Touristengruppen wurde untersucht, auf welchem Weg die Informationen für die geplante Reise beschafft wurden. Der Reiseführer ist der hauptsächliche Informationslieferant und ist teilweise für das Verhalten der Urlauber mitverantwortlich. Es konnte festgestellt werden, dass das Image des Landes und die Reisemotive das Reiseverhalten und die Wahrnehmung determinieren. Eine Untersuchung der so genannten Pull- und Push-Faktoren ergab, dass die nahezu noch unberührte Natur, die raue Landschaft sowie Ruhe und Erholung die entscheidenden Pull-Faktoren für Norwegenreisende sind. Dabei überprägt das Image Norwegens als „wildes Naturland“ die Wahrnehmung für verschiedene Problembereiche, die in Norwegen, wie auch in vielen anderen Ländern Europas, durchaus vorhanden sind. rnProblemfelder, wie Landschaftsausbeutung, Wildcamping, reduziertes Konsumverhalten und damit einhergehende rückläufige Besucherzahlen, können aber durch innovative Tourismuskonzepte und neue Reiseformen abgebaut werden. Hierbei sind Medien, wie Reiseführer, Internet und Reisemagazine, in die Pflicht zu nehmen.
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Manufactured housing has been found to have substantial levels of formaldehyde in the indoor air. Because mobile homes are more affordable than conventional housing, there has been a large increase in their use in the U.S. This increase in mobile home use has been substantial in the sunbelt regions such as Texas, where high temperatures and humidities may enhance out-gassing of formaldehyde and other volatile organic compounds from construction and furnishing materials and increase any potential health hazards.^ The influences of environmental, architectural and temporal factors on the presence of indoor formaldehyde and other organic compounds were investigated in conjunction with the Texas Indoor Air Quality Study of manufactured housing. A matched pair of mobile homes, one with electric heating and cooking utilities and the other with propane gas utilities, were used for a series of controlled experiments over a fourteen month period from October, 1982 through November, 1983.^ Over this fourteen month period formaldehyde levels decreased approximately 33%. Daily fluctuations of 20% to 40% were observed even with a constant indoor temperature. An increase in indoor temperature of 8(DEGREES)C doubled the measured formaldehyde concentration. Opening windows resulted in decreases of indoor formaldehyde levels of up to 50%. Studies of the impact of propane as a cooking source showed no increase in formaldehyde levels with stove use.^ The presence and concentration of selected volatile organic compounds is influenced greatest by occupancy. Occupants continually open and close windows and doors, vary the operation and settings (temperature) of air control systems, and vary in their selection of furnishings and use of consumer products, which may act as sources of indoor air contaminants. ^
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Species variations in formaldehyde solutions and gases were investigated by means of infrared spectral analysis. Double beam infrared spectrometry in conjunction with sodium chloride wafer technique and solvent compensation technique were employed. Formaldehyde species in various solutions were investigated. Formalin 37% was stable for many months. Refrigeration had no effects on its stability. Spectral changes were detected in 1000 ppm formaldehyde solutions. The absorbances of very diluted solutions up to 100 ppm were lower than the detection limit of the instruments. Solvent compensation improved resolution, but was associated with an observed lack of repeatability. Formaldehyde species in animal chambers containing animals and in mobile home air were analyzed with the infrared spectrophotometer equipped with a 10 cm gas cell. Spectra were not different from the spectrum of clean air. A portable single beam infrared spectrometer with a 20 meter pathlength was used for reinvestigation. Indoor formaldehyde could not be detected in the spectral; conversely, an absorption peak at 3.58 microns was found in the spectra of 3 and 15 ppm formaldehyde gas in animal chambers. This peak did not appear in the spectrum of the control chamber. Because of concerns over measurement bias among various analytical methods for formaldehyde, side-by-side comparisons were conducted in both laboratory and field measurements. The chromotropic acid method with water and 1% sodium bisulfite as collection media, the pararosaniline method, and a single beam infrared spectrometer were compared. Measurement bias was elucidated and the extent of the effects of temperature and humidity was also determined. The problems associated with related methods were discussed. ^
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Mode of access: Internet.
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Mode of access: Internet.