33 resultados para Building of Environmental Management System


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Completing projects faster than normal is always a challenge as it often demands many paradigm shifts. Globalization opportunities and competition from private sectors and multinationals are forcing the management of public sector organizations in India's petroleum industry to take various aggressive strategies to maintain profitability. These projects are required to be completed sooner than with a typical schedule to remain competitive, get faster return on investment and give longer project life.

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The pathogenesis and medical management of diabetic retinopathy is reviewed. The importance of good control of blood glucose and blood pressure remain key elements in the prevention and treatment of diabetic retinopathy, and a number of specific metabolic pathways have been identified that may be useful additional targets for therapeutic intervention. Trial data, however, aimed specifically to answer the questions of optimum medical management are limited, so the DIRECT study of renin-angiotensin blockade using oral candesartan 32 mg daily is a welcome addition to our knowledge. This arose from the promising improvement of retinopathy outcomes in the EUCLID study of lisinopril in type I diabetes. In DIRECT, 5 years of candesartan treatment in type I diabetes reduced the incidence of retinopathy by two or more steps (EDTRS) in severity by 18% (P = 0.0508) and, in a post hoc analysis, reduced the incidence of retinopathy by three-step progression by 35% (P = 0.034). In type I diabetes patients there was no effect on progression of established retinopathy. In contrast, in type II diabetes, 5 years of candesartan treatment resulted in 34% regression of retinopathy (P ≤0.009). Importantly, an overall significant change towards less-severe retinopathy was noted in both type I and II diabetes (P0.03). Although there is still no absolute proof that these effects were specific to RAS blockade, or just an effect of lower blood pressure, it is reasonable to conclude that candesartan has earned a place in the medical management of diabetic retinopathy, to prevent the problem in type I diabetes and to treat the early stages in type II diabetes. © 2010 Macmillan Publishers Limited All rights reserved.

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Recent technological advances have paved the way for developing and offering advanced services for the stakeholders in the agricultural sector. A paradigm shift is underway from proprietary and monolithic tools to Internet-based, cloud hosted, open systems that will enable more effective collaboration between stakeholders. This new paradigm includes the technological support of application developers to create specialized services that will seamlessly interoperate, thus creating a sophisticated and customisable working environment for the end users. We present the implementation of an open architecture that instantiates such an approach, based on a set of domain independent software tools called "generic enablers" that have been developed in the context of the FI-WARE project. The implementation is used to validate a number of innovative concepts for the agricultural sector such as the notion of a services' market place and the system's adaptation to network failures. During the design and implementation phase, the system has been evaluated by end users, offering us valuable feedback. The results of the evaluation process validate the acceptance of such a system and the need of farmers to have access to sophisticated services at affordable prices. A summary of this evaluation process is also presented in this paper. © 2013 Elsevier B.V.