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This paper presents a methodology to systematically assess and manage the risks associated with tunnel construction. The methodology consists of combining a geologic prediction model that allows one to predict geology ahead of the tunnel construction, with a construction strategy decision model that allows one to choose amongst different construction strategies the one that leads to minimum risk. This model used tunnel boring machine performance data to relate to and predict geology. Both models are based on Bayesian networks because of their ability to combine domain knowledge with data, encode dependencies among variables, and their ability to learn causal relationships. The combined geologic predictionconstruction strategy decision model was applied to a case, the Porto Metro, in Portugal. The results of the geologic prediction model were in good agreement with the observed geology, and the results of the construction strategy decision support model were in good agreement with the construction methods used. Very significant is the ability of the model to predict changes in geology and consequently required changes in construction strategy. This risk assessment methodology provides a powerful tool with which planners and engineers can systematically assess and mitigate the inherent risks associated with tunnel construction.

Trata-se de um estudo com mulheres portadoras de HPV, que busca identificar o nível de conhecimento, os sentimentos e as expectativas das mulheres portadoras de HPV frente ao diagnóstico da doença e a interferência da patologia nas relações conjugais. Pesquisa exploratória, realizado no Centro de Treinamento em Atenção Primária situado na Escola de Saúde Pública do Ceará. Foram entrevistadas 20 mulheres com diagnóstico de HPV. A análise das falas referentes ao nível de conhecimento da doença e as formas de prevenção revelaram que todas as mulheres portadoras do HPV tinham consciência da forma de transmissão e da gravidade da doença. Foram analisados os sentimentos vivenciados frente à descoberta da patologia e à mudança no relacionamento após o diagnóstico da doença, havendo-se construído duas temáticas: A primeira referente às reações emocionais, de onde emergiram as categorias: 1) medo e preocupação; 2) tristeza e impotência diante da cura; 3) surpresa; 4) traição, culpa, raiva e 5) indiferença diante dos resultados; e a segunda relativa às repercussões no relacionamento que permitiram a distribuição nas categorias: 1) descontinuidade da relação com mudança de atitude do casal, 2) separação, 3) sem interferência na relação e 4) negação diante da doença. Consideramos que o nível de conhecimento, os sentimentos e as expectativas das mulheres revelados neste estudo reforçam que abordar as DST nos últimos anos tem sido um desafio para os profissionais de saúde. Muito há de se fazer para alcançar uma mudança de comportamento social que garanta o exercício de uma sexualidade segura

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Warning systems are an essential component of risk management for natural threats. They trigger active and/or passive countermeasures. The present paper discusses the need for and use of warning systems through the review of recent major natural disasters (the Sumatra tsunami, the 2005 Alpine flood, the 2005 Hurricanes, Katrina and Rita) but also the potential flu pandemic. Positive and negative lessons are drawn from these cases. This is followed by a brief review of two specific warning systems, which together with the preceding cases lead to a list of requirements for warning systems for natural threats.These reviews also show that it is desirable to have tools with which different warning systems and their role in risk management can be evaluated. A procedure based on decision making under uncertainty allows one to do so. The basis of this procedure and its application to warning systems, including some sensitivity analyses to demonstrate practical consequences are then shown. Decision trees and Bayesian trees are used in this context.The current paper leads to the conclusions that the basic elements of warning systems are associated with problems, which eventually may be solved. The formal risk assessment allows one to prioritize the problems and the solutions.

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As supervisors of primary health care units in the State of Ceará, Brazil, we have observed a low supply of health education services. As part of the activities under the Family Health Program (FHP), we attempted to investigate the causes of this short supply and identify flaws in the development of such activities. Interviews and participatory observation were adopted as the research method. The following causes were defined in the lack of health education practices: disorganization of demand, insufficient coverage of the population by FHP teams, resistance by both health professionals and the population to educational activities, absence of adequate floor space for conducting such activities, and lack of support materials. The following flaws were identified in the implementation of activities: limited exchange of experiences among participants; limited focus on the group's needs; frequent use of scientific language; transfer of outdated information; and inadequate utilization of teaching materials. The conclusion is that there is a need to retrain health professionals and to improve the availability of physical resources and teaching materials in order for education in reproductive health to become a reality in the FHP.