The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the Sao Paulo Ageing & Health Study

OBJECTIVES: The aim of this study was to investigate the impact of asymptomatic vertebral fractures on the quality of life in older women as part of the Sao Paulo Ageing & Health Study. METHODS: This study was a cross-sectional study with a random sample of 180 women 65 years of age or older with or without vertebral fractures. The Quality of Life Questionnaire of the European Foundation for Osteoporosis was administered to all subjects. Anthropometric data were obtained by physical examination, and the body mass index was calculated. Lateral thoracic and lumbar spine X-ray scans were obtained to identify asymptomatic vertebral fractures using a semi-quantitative method. RESULTS: Women with asymptomatic vertebral fractures had lower total scores [61.4(15.3) vs. 67.1(14.2), p = 0.03] and worse physical function domain scores [69.5(20.1) vs. 77.3(17.1), p = 0.02] for the Quality of Life Questionnaire of the European Foundation for Osteoporosis compared with women without fractures. The total score of this questionnaire was also worse in women classified as obese than in women classified as overweight or normal. High physical activity was related to a better total score for this questionnaire (p = 0.01). Likewise, lower physical function scores were observed in women with higher body mass index values (p < 0.05) and lower physical activity levels (p < 0.05). Generalized linear models with gamma distributions and logarithmic link functions, adjusted for age, showed that lower total scores and physical function domain scores for the Quality of Life Questionnaire of the European Foundation for Osteoporosis were related to a high body mass index, lower physical activity, and the presence of vertebral fractures (p < 0.05). CONCLUSION: Vertebral fractures are associated with decreased quality of life mainly physical functioning in older community-dwelling women regardless of age, body mass index, and physical activity. Therefore, the results highlight the importance of preventing and controlling asymptomatic vertebral fractures to reduce their impact on quality of life among older women.

The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the São Paulo Ageing & Health Study

OBJECTIVES: The aim of this study was to investigate the impact of asymptomatic vertebral fractures on the quality of life in older women as part of the Sao Paulo Ageing & Health Study. METHODS: This study was a cross-sectional study with a random sample of 180 women 65 years of age or older with or without vertebral fractures. The Quality of Life Questionnaire of the European Foundation for Osteoporosis was administered to all subjects. Anthropometric data were obtained by physical examination, and the body mass index was calculated. Lateral thoracic and lumbar spine X-ray scans were obtained to identify asymptomatic vertebral fractures using a semi-quantitative method. RESULTS: Women with asymptomatic vertebral fractures had lower total scores [61.4(15.3) vs. 67.1(14.2), p = 0.03] and worse physical function domain scores [69.5(20.1) vs. 77.3(17.1), p = 0.02] for the Quality of Life Questionnaire of the European Foundation for Osteoporosis compared with women without fractures. The total score of this questionnaire was also worse in women classified as obese than in women classified as overweight or normal. High physical activity was related to a better total score for this questionnaire (p = 0.01). Likewise, lower physical function scores were observed in women with higher body mass index values (p<0.05) and lower physical activity levels (p,0.05). Generalized linear models with gamma distributions and logarithmic link functions, adjusted for age, showed that lower total scores and physical function domain scores for the Quality of Life Questionnaire of the European Foundation for Osteoporosis were related to a high body mass index, lower physical activity, and the presence of vertebral fractures (p<0.05). CONCLUSION: Vertebral fractures are associated with decreased quality of life mainly physical functioning in older community-dwelling women regardless of age, body mass index, and physical activity. Therefore, the results highlight the importance of preventing and controlling asymptomatic vertebral fractures to reduce their impact on quality of life among older women.

Challenges for Brazilian MNCs' international human resources management

Multinationals from emerging countries such as Brazil now take the path of internationalisation where early movers have already been. However, these companies have to develop new tools to deal with their own challenges, since they come from countries with different historical backgrounds and specificities. This paper explores challenges for Brazilian MNCs in terms of HRM when operating abroad. It presents the results of six cases of Brazilian MNCs through a grounded theory study. Results show these companies had to deal with their former economic turbulence, shortage of qualified workforce to work internationally and the need to develop HRM competencies to operate globally.

Guidelines for the Brazilian ceramic sector strategic development, based on a comparison with the Italian market

Based on a structured literature review, the ceramic tiles sector of Italy (benchmark) and Brazil (2nd world producer and consumer) are compared, under four strategic factors: normative, market, technology and strategic management, in order to identify critical risks for a national strategic sector. The document aims to propose guidelines for a strategic re-planning of the Brazilian ceramic tiles sector, making the Brazilian producers aware of the national market fragility (in spite of its recent remarkable evolution) and helping the policy makers to reflect on the need of reviewing the strategic planning methods and practice, of designing new targeted programs (based on coherence between operation and business strategies), of providing improved management to strengthen the sector against unfair competition by low-cost producers, enhancing the necessary infrastructure in technology, work, marketing and quality management. The analysis is limited to the single-firing production technology. The wide-coverage strategic analysis of the Brazilian ceramic tiles sector, very little studied until now in a scientific way, emphasizes the importance of applying research methodology and may be valuable to both scholars and practitioners. Additionally, it highlights the need of investments in innovation (product design and production technology) and the fundamental role of the sector organization, identifying different dimensions. It is possible to conclude that the recent Brazilian production growth is not due to a natural strengthening because of the hit of the sector and of correct enterprises strategy, but it seems the result of a temporary and favorable economic contingency.

CRITICAL POINTS OF THE PRODUCTION PROCESS OF SOLID WOOD FLOORING

The quality concepts represent one of the important factors for the success of organizations and among these concepts the stabilization of the production process contributes to the improvement, waste reduction and increased competitiveness. Thus, this study aimed to evaluate the production process of solid wood flooring on its predictability and capacity, based on its critical points. Therefore, the research was divided into three stages. The first one was the process mapping of the company and the elaboration of flowcharts for the activities. The second one was the identification and the evaluation of the critical points using FMEA (Failure Mode and Effect Analysis) adapted methodology. The third one was the evaluation of the critical points applying the statistical process control and the determination of the process capability for the C-pk index. The results showed the existence of six processes, two of them are critical. In those two ones, fifteen points were considered critical and two of them, related with the dimension of the pieces and defects caused by sandpaper, were selected for evaluation. The productive process of the company is unstable and not capable to produce wood flooring according to the specifications and, therefore these specifications should be reevaluated.

Urban air pollution: a representative survey of PM2.5 mass concentrations in six Brazilian cities

In urban areas of Brazil, vehicle emissions are the principal source of fine particulate matter (PM2.5). The World Health Organization air quality guidelines state that the annual mean concentration of PM2.5 should be below 10 mu g m(-3). In a collaboration of Brazilian institutions, coordinated by the University of Sao Paulo School of Medicine and conducted from June 2007 to August 2008, PM2.5 mass was monitored at sites with high traffic volumes in six Brazilian state capitals. We employed gravimetry to determine PM2.5 mass concentrations, reflectance to quantify black carbon concentrations, X-ray fluorescence to characterize elemental composition, and ion chromatography to determine the composition and concentrations of anions and cations. Mean PM2.5 concentrations and proportions of black carbon (BC) in the cities of Sao Paulo, Rio de Janeiro, Belo Horizonte, Curitiba, Recife, and Porto Alegre were 28.1 +/- 13.6 mu g m(-3) (38% BC), 17.2 +/- 11.2 mu g m(-3) (20% BC), 14.7 +/- 7.7 mu g m(-3) (31% BC), 14.4 +/- 9.5 mu g m(-3) (30% BC), 7.3 +/- 3.1 mu g m(-3) (26% BC), and 13.4 +/- 9.9 mu g m(-3) (26% BC), respectively. Sulfur and minerals (Al, Si, Ca, and Fe), derived from fuel combustion and soil resuspension, respectively, were the principal elements of the PM2.5 mass. We discuss the long-term health effects for each metropolitan region in terms of excess mortality risk, which translates to greater health care expenditures. This information could prove useful to decision makers at local environmental agencies.

Vehicle emissions and PM2.5 mass concentrations in six Brazilian cities

In Brazil, the principal source of air pollution is the combustion of fuels (ethanol, gasohol, and diesel). In this study, we quantify the contributions that vehicle emissions make to the urban fine particulate matter (PM2.5) mass in six state capitals in Brazil, collecting data for use in a larger project evaluating the impact of air pollution on human health. From winter 2007 to winter 2008, we collected 24-h PM2.5 samples, employing gravimetry to determine PM2.5 mass concentrations; reflectance to quantify black carbon concentrations; X-ray fluorescence to characterize elemental composition; and ion chromatography to determine the composition and concentrations of anions and cations. Mean PM2.5 concentrations in the cities of Sao Paulo, Rio de Janeiro, Belo Horizonte, Curitiba, Porto Alegre, and Recife were 28, 17.2, 14.7, 14.4, 13.4, and 7.3 mu g/m(3), respectively. In Sao Paulo and Rio de Janeiro, black carbon explained approximately 30% of the PM2.5 mass. We used receptor models to identify distinct source-related PM2.5 fractions and correlate those fractions with daily mortality rates. Using specific rotation factor analysis, we identified the following principal contributing factors: soil and crustal material; vehicle emissions and biomass burning (black carbon factor); and fuel oil combustion in industries (sulfur factor). In all six cities, vehicle emissions explained at least 40% of the PM2.5 mass. Elemental composition determination with receptor modeling proved an adequate strategy to identify air pollution sources and to evaluate their short- and long-term effects on human health. Our data could inform decisions regarding environmental policies vis-a-vis health care costs.