Resting and reactive blood pressure as predictors of ambulatory blood pressure in older hypertensive adults

Background. A review of the literature suggests that Hypertension (HTN) in older adults is associated with sympathetic stimulation that results in increasing blood pressure (BP) reactivity. If clinical assessment of BP captured sympathetic stimulation, it would be valuable for hypertension management. ^ Objectives. The study examined whether reactive change scores from a short BPR protocol, resting blood pressure (BP), or resting pulse pressure (PP) is a better predictor of 24 hour ambulatory BP and BP load in cardiac patients. ^ Method. The study used a single-group design, with both an experimental clinical component and an observational field component. Both components used repeated measurement methods. The study population consisted of 45 adult patients with a mean age of 64.6 ± 8.5 years who were diagnosed with cardiac disease and who were taking anti-hypertensive medication. Blood pressure reactivity was operationalized with a speech protocol. During the speech protocol, BP was measured with an automatic device (Dinamap 825XT) while subjects talked about their health and about their usual day. Twenty-four hour ambulatory BP measurement (Spacelabs 90207 monitor) followed the speech protocol. ^ Results. Resting SBP and resting PP were significant predictors of 24-hour SBP, and resting SBP was a significant predictor of SBP load. No predictors were significant of 24-hour DBP or DBP load. ^ Conclusions. Initial resting BP and PP may be used in clinical settings to assess hypertension management. Future studies are necessary to confirm the ability of resting BP to predict ABP and BP load in older, medicated hypertensives. ^

A critical assessment of the National Institutes of Health Consensus Development Program against the eras which shaped it

This research study offers a critical assessment of NIH's Consensus Development Program (CDP), focusing upon its historical and valuative bases and its institutionalization in response to social and political forces. The analysis encompasses systems-level, as well as interpersonal factors in the adoption of consensus as the mechanism for resolving scientific controversies in clinical practice application. Further, the evolution of the CDP is also considered from an ecological perspective as a reasoned adaptation by NIH to pressures from its supporters and clients for translating biomedical research into medical practice. The assessment examines federal science policy and institutional designs for the inclusion of the public interest and democratic deliberation.^ The study relies on three distinct approaches to social research. Conventional historical methods were utilized in the interpretation of social and political influences across eras on the evolution of the National Institutes of Health and its response to demands for accountability and relevance through its Consensus Development Program. An embedded single-case study was utilized for an empirical examination of the CDP mechanism through five exemplar conferences. Lastly, a sociohistorical approach was taken to the CDP in order to consider its responsiveness to the values of the eras which created and shaped it. An exploration of organizational behavior with considerations for institutional reform as a response to continuing political and social pressure, it is a study of organizational birth, growth, and response to demands from its environment. The study has explanatory import in its attempt to account for the creation, timing, and form of the CDP, relative to political, institutional, and cultural pressures, and predictive import thorough its historical view which provides a basis for informed speculation on the playing out of tensions between extramural and intermural scientists and the current demands for health care reform. ^

New concepts and techniques for the development of high-efficiency concentrating photovoltaic modules

El interés por los sistemas fotovoltaicos de concentración (CPV) ha resurgido en los últimos años amparado por el desarrollo de células multiunión de muy alta eficiencia basadas en semiconductores de los grupos III-V. Estas células han permitido obtener módulos de concentración con eficiencias que prácticamente duplican las del panel plano y que llegan al 35% en los módulos récord. Esta tesis está dedicada al diseño y la implementación experimental de nuevos conceptos que permitan obtener módulos CPV que no sólo alcancen una eficiencia alta en condiciones estándar sino que, además, sean lo suficientemente tolerantes a errores de montaje, seguimiento, temperatura y variaciones espectrales para que la energía que producen a lo largo del año sea máxima. Una de las primeras cuestiones que se abordan es el diseño de elementos ópticos secundarios para sistemas cuyo primario es una lente de Fresnel y que permiten, para una concentración fija, aumentar el ángulo de aceptancia y la tolerancia del sistema. Varios secundarios reflexivos y refractivos han sido diseñados y analizados mediante trazado de rayos. En particular, utilizando óptica anidólica y basándose en el diseño de una sola etapa conocido como ‘concentrador dieléctrico que funciona por reflexión total interna‘, se ha diseñado, fabricado y caracterizado un secundario con salida cuadrada que, usado junto con una lente de Fresnel, permite alcanzar simultáneamente una elevada eficiencia, concentración y aceptancia. Además, se ha propuesto y prototipado un método alternativo de fabricación para otro de los secundarios, denominado domo, consistente en el sobremoldeo de silicona sobre células solares. Una de las características que impregna todo el trabajo realizado en esta tesis es la aproximación holística en el diseño de módulos CPV, es decir, se ha prestado especial atención al diseño conjunto de la célula y la óptica para garantizar que el sistema total alcance la mayor eficiencia posible. En este sentido muchos sistemas ópticos desarrollados en esta tesis han sido diseñados, caracterizados y optimizados teniendo en cuenta que el ajuste de corriente entre las distintas subcélulas que comprenden la célula multiunión bajo el concentrador sea muy próximo a uno. La capa antirreflectante sobre la célula funciona, en cierto modo, como interfaz entre la óptica y la célula, por lo que se ha diseñado un método de optimización de capas antirreflectantes que considera no sólo el amplio rango de longitudes de onda para el que las células multiunión son sensibles sino también la distribución angular de intensidad sobre la célula creada por la óptica de concentración. Además, la cuestión de la falta de uniformidad también se ha abordado mediante la comparación de las distribuciones espectrales y espaciales de irradiancia que crean diferentes ópticas (simuladas mediante trazado de rayos y fotografiadas) y las pérdidas de eficiencia que experimentan las células iluminadas por dichas ópticas de concentración medidas experimentalmente. El efecto de la temperatura en la óptica de concentración también ha sido objeto de estudio de esta tesis. En particular, mediante simulaciones de elementos finitos se han dado los primeros pasos para el análisis de las deformaciones que sufren los dientes de las lentes de Fresnel híbridas (vidrio-silicona), así como el cambio de índice de refracción con la temperatura y la influencia de ambos efectos sobre el funcionamiento de los sistemas. Se ha implementado un modelo que tiene por objeto considerar las variaciones ambientales, principalmente temperatura y contenido espectral de la radiación directa, así como las sensibilidades térmica y espectral de los sistemas CPV, con el fin de maximizar la energía producida por un módulo de concentración a lo largo de un año en un emplazamiento determinado. Los capítulos 5 y 6 de este libro están dedicados al diseño, fabricación y caracterización de un nuevo concepto de módulo fotovoltaico denominado FluidReflex y basado en una única etapa reflexiva con dieléctrico fluido. En este nuevo concepto la presencia del fluido aporta algunas ventajas significativas como son: un aumento del producto concentración por aceptancia (CAP, en sus siglas en inglés) alcanzable al rodear la célula con un medio cuyo índice de refracción es mayor que uno, una mejora de la eficiencia óptica al disminuir las pérdidas por reflexión de Fresnel en varias interfaces, una mejora de la disipación térmica ya que el calor que se concentra junto a la célula se trasmite por convección natural y conducción en el fluido y un aislamiento eléctrico mejorado. Mediante la construcción y medida de varios prototipos de unidad elemental se ha demostrado que no existe ninguna razón fundamental que impida la implementación práctica del concepto teórico alcanzando una elevada eficiencia. Se ha realizado un análisis de fluidos candidatos probando la existencia de al menos dos de ellos que cumplen todos los requisitos (en particular el de estabilidad bajo condiciones de luz concentrada) para formar parte del sistema de concentración FluidReflex. Por ´ultimo, se han diseñado, fabricado y caracterizado varios prototipos preindustriales de módulos FluidReflex para lo cual ha sido necesario optimizar el proceso de fabricación de la óptica multicavidad a fin de mantener el buen comportamiento óptico obtenido en la fabricación de la unidad elemental. Los distintos prototipos han sido medidos, tanto en el laboratorio como bajo el sol real, analizando el ajuste de corriente de la célula iluminada por el concentrador FluidReflex bajo diferentes distribuciones espectrales de la radiación incidente así como el excelente comportamiento térmico del módulo. ABSTRACT A renewed interest in concentrating photovoltaic (CPV) systems has emerged in recent years encouraged by the development of high-efficiency multijunction solar cells based in IIIV semiconductors that have led to CPV module efficiencies which practically double that of flat panel PV and which reach 35% for record modules. This thesis is devoted to the design and experimental implementation of new concepts for obtaining CPV modules that not only achieve high efficiency under standard conditions but also have such a wide tolerance to assembly errors, tracking, temperature and spectral variations, that the energy generated by them throughout the year is maximized. One of the first addressed issues is the design of secondary optical elements whose primary optics is a Fresnel lens and which, for a fixed concentration, allow an increased acceptance angle and tolerance of the system. Several reflective and refractive secondaries have been designed and analyzed using ray tracing. In particular, using nonimaging optics and based on the single-stage design known as ‘dielectric totally internally reflecting concentrator’, a secondary with square output has been designed, fabricated and characterized. Used together with a Fresnel lens, the secondary can simultaneously achieve high efficiency, concentration and acceptance. Furthermore, an alternative method has been proposed and prototyped for the fabrication of the secondary named dome. The optics is manufactured by direct overmolding of silicone over the solar cells. One characteristic that permeates all the work done in this thesis is the holistic approach in the design of CPV modules, meaning that special attention has been paid to the joint design of the solar cell and the optics to ensure that the total system achieves the highest attainable efficiency. In this regard, many optical systems developed in the thesis have been designed, characterized and optimized considering that the current matching among the subcells within the multijunction solar cell beneath the optics must be close to one. Antireflective coating over the cell acts, somehow, as an interface between the optics and the cell. Consequently, a method has been designed to optimize antireflective coatings that takes into account not only the broad wavelength range that multijunction solar cells are sensitive to but also the angular intensity distribution created by the concentrating optics. In addition, the issue of non-uniformity has also been addressed by comparing the spectral and spatial distributions of irradiance created by different optics (simulated by ray tracing and photographed) and the efficiency losses experienced by cells illuminated by those concentrating optics experimentally determined. The effect of temperature on the concentrating optics has also been studied in this thesis. In particular, finite element simulations have been use to analyze the deformations experienced by the facets of hybrid (silicon-glass) Fresnel lenses, the change of refractive index with temperature and the influence of both effects on the system performance. A model has been implemented which take into consideration atmospheric variations, mainly temperature and spectral content of the direct normal irradiance, as well as thermal and spectral sensitivities of systems, with the aim of maximizing the energy harvested by a CPV module throughout the year in a particular location. Chapters 5 and 6 of this book are devoted to the design, fabrication, and characterization of a new concentrator concept named FluidReflex and based on a single-stage reflective optics with fluid dielectric. In this new concept, the presence of the fluid provides some significant advantages such as: an increased concentration acceptance angle product (CAP) achievable by surrounding the cell with a medium whose refractive index is greater than one, an improvement of the optical efficiency by reducing losses due to Fresnel reflection at several interfaces, an improvement in heat dissipation as the heat concentrated near the cell is transmitted by natural convection and conduction in the fluid, and an improved electrical insulation. By fabricating and characterizing several elementary-unit prototypes it was shown that there is no fundamental reason that prevents the practical implementation of this theoretical concept reaching high efficiency. Several fluid candidates were investigated proving the existence of at least to fluids that meet all the requirements (including the stability under concentrated light) to become part of the FluidReflex concentrator. Finally, several pre-industrial FluidReflex module prototypes have been designed and fabricated. An optimization process for the manufacturing of the multicavity optics was necessary to attain such an optics quality as the one achieved by the single unit. The module prototypes have been measured, both indoors and outdoors, analyzing the current matching of the solar cells beneath the concentrator for different spectral distribution of the incident irradiance. Additionally, the module showed an excellent thermal performance.

Marco de Gobernanza de TI para empresas PyMEs – SMEsITGF

La tecnología de la información y su utilización en las empresas ha sido y es un elemento de debate ya que las organizaciones cuentan con grandes éxitos y grandes fracasos. Gran parte de estos últimos asociados a una falta de visión estratégica integral en relación a la utilización de TI en la organización lo que ha dado lugar al área del conocimiento llamada Gobernanza de TI y a la publicación de numerosos marcos y estándares. Un campo sensible y económicamente muy importante tanto para Uruguay como a nivel mundial son las empresas medianas y pequeñas (PyMEs), las que no logran aplicar de manera efectiva los marcos y estándares, es por esta razón que el objetivo final de esta tesis es el de construir un marco que permita a las PyMEs incorporar un marco efectivo para gobernar y gestionar TI adecuadamente obteniendo el valor esperado de las inversiones realizadas. Para alcanzar este objetivo general se ha realizado un estudio de campo que permita conocer la situación de la gobernanza y la gestión de TI en PyMEs del Uruguay; a partir de este estudio se pudo analizar cuáles son los factores más significativos que no permiten la correcta aplicación de buenas prácticas de gobernanza de TI en éstas empresas. Los resultados encontrados llevaron a la construcción de un marco de gobernanza de TI con foco en PyMEs, a la definición de un modelo de madurez asociado al marco y a una guía de implantación. En el marco de gobernanza propuesto, compatible con el estándar ISO/IEC 38500:2008, se han fortalecido los procesos que, por las características propias de las PyMEs presentan debilidades estructurales y se han reducido o eliminado aquellos que por las mismas razones no son aplicables a este tipo de organización. Finalmente se validaron los resultados en un entorno empresarial definiendo un estudio de caso. Los resultados obtenidos con una mejora porcentual consolidada del 46% en el conjunto de indicadores definidos llevan a considerar que la aplicación del marco fue exitosa. Por ser un estudio de caso único, los resultados no deben ser generalizados y una oportunidad de trabajo futuro es replicar el mismo estudio en otras empresas. ABSTRACT Information technology (IT) and its use in the enterprise context is a discussion element because organizations have numerous successes and failures using it. Most of the IT failed projects have a lack of integral strategic vision in relation with IT use in the organization. This fact has resulted in the IT Governance (ITG) area of knowledge. A large number of standards and frameworks have been published in relation with it. Small and medium enterprises (SMEs) are an important and sensible field in all economies around the world, particularly in Uruguay, an underdeveloped country of South America. Commonly, SMEs cannot apply successfully ITG frameworks because of the intrinsic complexity or because a lack of knowledge and culture respect this field, so the objective of this thesis is build a framework that allows SMEs to incorporate an effective framework to govern and manage IT properly, helping enterprises get the expected value of its IT investments. In a first place, has been conducted a field study to know the quality of actual practices relatively to the ITG and IG management in Uruguayan SMEs. With the obtained results in the study we can make a diagnostic of the most significant factors that prevent the proper application of good IT governance practices in these companies. The obtained results were the inputs to the definition of a IT governance framework with focus in SMEs, a maturity model associated with it and a implementation guide. The proposed framework is ISO/IEC 38500 standard compatible always with an SME vision so, sensible and weak processes have been strengthened and other ones have been eliminated because have no application in these type of organization. Finally the results were validated in a business environment by defining a case study. The results obtained with a consolidated percentage improvement of 46% in the defined set of indicators suggest that the implementation of the framework was successful. As a single case study, the results should not be generalized and an opportunity for future work is to replicate the same study in other companies.

Business, development and inclusive supply chains. Exploring pathways for the sustainable incorporation of the poor as suppliers in agrifood supply chains

El panorama global está cambiando, y esto influye sobre la forma en la que entendemos y tratamos de alcanzar un desarrollo humano sostenible. El crecimiento de la población conlleva una mayor presión sobre los recursos, pero también supone una mayor cantidad de mano de obra y de talento; la concentración en áreas urbanas está cambiando las dinámicas sociales y desafiando los canales de comercialización tradicionales, pero también genera nuevos mercados y fomenta la innovación; los cambios en la economía global están reduciendo los tradicionales desequilibrios de poder entre los países occidentales y el resto del mundo; y las crecientes interconexiones crean nuevos riesgos pero también oportunidades para lanzar iniciativas de alcance global. Todas estas tendencias nos están obligando a repensar qué es el desarrollo humano y de qué manera deberíamos afrontar el reto de la pobreza. Es comúnmente aceptado que la globalización implica interdependencia y que, para conseguir un desarrollo humano sostenible, la colaboración entre actores de distintos ámbitos es necesaria. Se observa una creciente convergencia de temas, intereses y soluciones en torno al desarrollo sostenible, incluso en diferentes países y sectores, lo que está facilitando la colaboración estratégica entre empresas, gobiernos y sociedad civil. Existen pocas duda a día de hoy sobre el papel fundamental que las empresas deben desempeñar en la transición mundial hacia la sostenibilidad ambiental y la erradicación de la pobreza. Las empresas están evolucionando desde un enfoque tradicional centrado en la maximización de beneficios económicos hacia un enfoque holístico que integra la sostenibilidad y la responsabilidad social como parte del núcleo de negocio de las compañías. En el ámbito medioambiental, muchas empresas ya han comenzado a actuar y tratan de reducir sus emisiones, sus desechos y su consumo de energía. Sin embargo la contribución de las empresas a la reducción de la pobreza no está tan clara. Actualmente en torno a 1,2 miles de millones de personas viven en situación de extrema pobreza. La mayoría de estas personas aún vive en zonas rurales donde la mayor parte de la población activa trabaja en el sector agrícola. Por lo tanto, mejorar las oportunidades y reducir los riesgos de los productores más vulnerables en el sector de la agricultura puede ser un motor de desarrollo rural y reducción de la pobreza, especialmente en países de bajo nivel de desarrollo cuyas economías están fundamentalmente basadas en la agricultura. Algunas empresas comienzan a incluir a los pobres en sus operaciones como consumidores, proveedores y emprendedores. Esta tesis se centra en las potenciales oportunidades relacionadas con la incorporación sostenible de los pobres como proveedores de productos y/o de mano de obra. La colaboración entre empresas y productores vulnerables de países en desarrollo es un tema relativamente nuevo y todavía poco estudiado. La pregunta que guía esta tesis es: “¿Cómo pueden las empresas facilitar la inclusión sostenible en cadenas de suministro de productores vulnerables de los países menos desarrollados?”. Para responder a la pregunta anterior, la autora ha aplicado una metodología de casos de estudio. Esta metodología se considera apropiada porque la investigación sobre cadenas de suministro inclusivas es todavía escasa y porque es necesario entender en profundidad un fenómeno de la vida real, y para ello es fundamental conocer su contexto. En primer lugar, se realiza una revisión de literatura para identificar las proposiciones y los constructos teóricos que guiarán la posterior recogida de datos. La revisión de literatura se divide en dos partes: una más general que explora la dimensión social de la sostenibilidad en cadenas de suministro, y una más específica que se centra en la incorporación de los pobres como proveedores en cadenas de suministro. A lo largo de la última década, ha habido un crecimiento exponencial de los estudios académicos sobre la sostenibilidad de las cadenas de suministro, pero la mayoría de los esfuerzos se han dirigido hacia la dimensión medioambiental de la sostenibilidad. Por lo tanto la revisión de literatura, que se presenta en la Sección 3.1 (página 35) y que profundiza en la sostenibilidad social de las cadenas de suministro, puede considerarse una contribución en sí misma. Esta revisión de literatura revela que la investigación sobre aspectos sociales en cadenas de suministro está cobrando impulso en distintas áreas de conocimiento, principalmente en los ámbitos de investigación sobre “gestión de cadenas de suministro”, “responsabilidad social corporativa” y “estudios del desarrollo”. La investigación existente sobre sostenibilidad social de cadenas de suministro se centra en tres temas: aclarar la definición de sostenibilidad social; analizar la implementación de estrategias de sostenibilidad social en cadenas de suministro; y estudiar el apoyo de las em presas líderes a proveedores vulnerables para facilitar su transición hacia la sostenibilidad. Un marco conceptual que resume los principales hallazgos de esta primera parte de la revisión de literatura es planteado en la Figura 7 (página 48). No obstante, en el área de investigación que está emergiendo en torno a la sostenibilidad social de las cadenas de suministro, los estudios relacionados con la reducción de la pobreza son aún escasos. Además se aprecia una falta de contribuciones desde y sobre los países menos desarrollados, así como una clara tendencia a reflejar la visión de las empresas líderes de las cadenas de suministro, olvidando la perspectiva de los proveedores. La segunda parte de la revisión de literatura presentada en la Sección 3.2 (página 51) profundiza en tres líneas de investigación que exploran, desde distintas perspectivas, la inclusión de los pobres en cadenas de suministro. Estas líneas son “Global Value Chains” (GVC), “Base of the Pyramid” (BoP) y “Sustainable Supply Chain Management” (SSCM). La investigación en GVC analiza las cadenas de suministro desde la perspectiva de la globalización económica y el comercio internacional, poniendo especial énfasis en las implicaciones para los países en desarrollo y las comunidades vulnerables. GVC caracteriza las cadenas de suministro según la forma en la que son gobernadas, las oportunidades de mejora que existen para los productores que forman parte de la cadena y el grado de inclusión o exclusión de las comunidades más pobres y vulnerables. La investigación en BoP explora las relaciones comerciales entre empresas y comunidades pobres. La premisa fundamental del concepto BoP es la posibilidad de combinar la generación de beneficios con la reducción de la pobreza. La propuesta original es que mediante la venta de productos y servicios a las comunidades pobres de países en desarrollo, la pobreza puede ser reducida al tiempo que las empresas incrementan sus beneficios, especialmente las grandes empresas multinacionales. Esta idea ha ido evolucionando y, a día de hoy, los investigadores BoP consideran la incorporación de los pobres no sólo como consumidores sino también como empleados, proveedores y co-creadores. La investigación en SSCM ha estado fundamentalmente orientada al estudio de la dimensión medioambiental de la sostenibilidad de cadenas de suministro. Sin embargo, la creciente externalización de la producción a países en desarrollo y las demandas de los grupos de interés para que las empresas aborden todos los aspectos de la sostenibilidad han llevado a los académicos de SSCM a reconocer la importancia de integrar asuntos relacionados con la reducción de la pobreza en sus investigaciones. Algunos estudios comienzan a apuntar los principales retos a los que se enfrentan las empresas para colaborar con productores vulnerables en sus cadenas de suministro. Estos retos son: falta de comunicación, altos costes de transacción y el incremento de la complejidad de las operaciones. Las contribuciones de estas tres líneas de investigación son complementarias para el estudio de las cadenas de suministro inclusivas. Sin embargo, raramente han sido consideradas conjuntamente, ya que pertenecen a ámbitos de conocimiento distintos. Esta tesis integra las aportaciones de GVC, BoP y SSCM en un marco conceptual para la creación y gestión de cadenas de suministro inclusivas. Este marco conceptual para cadenas de suministro inclusivas queda representado en la Figura 9 (página 68). El marco conceptual refleja las motivaciones que llevan a las empresas a colaborar con productores vulnerables, los retos a los que se enfrentan al hacerlo, y los caminos o estrategias que están siguiendo para construir y operar cadenas de suministro inclusivas de manera que sean beneficiosas tanto para la empresa como para los productores vulnerables. A fin de validar y refinar el marco conceptual propuesto, tres casos de estudio se llevan a cabo. Las cadenas de suministro analizadas por los casos de estudio pertenecen al sector agrícola y sus principales proveedores se encuentran en países de África subsahariana. Múltiples métodos de recolección de datos y triangulación son utilizados para mejorar la fiabilidad de los datos. La autora desarrolló trabajos de campo en Senegal, Etiopía y Tanzania. Estos viajes permitieron enriquecer el proceso de recogida de información mediante entrevistas semiestructuradas y conversaciones informales con los principales actores de la cadena de suministro y mediante la observación directa de los procesos y las interacciones entre productores vulnerables y empresas. El Caso de estudio A (Sección 5.1 en página 96) es un caso de estudio único. Analiza la cadena de suministro local de verduras en Senegal. La organización focal es Manobi, una empresa senegalesa que provee servicios de bajo coste a emprendedores locales del sector agrícola. El Caso de estudio A proporciona un interesante análisis del funcionamiento de una cadena de suministro local en un país en desarrollo y muestra como la provisión de servicios profesionales puede mejorar el desempeño de productores vulnerables. El Caso de estudio B (Sección 5.2 en página 122) es un caso de estudio único. Analiza la cadena de suministro global de flor cortada con origen en Etiopía. La organización focal es EHPEA, la Asociación Etíope de Productores y Exportadores Hortícolas, cuya misión es promover y salvaguardar la posición competitiva del sector agrícola etíope en el mercado global. El Caso de estudio B ayuda a comprender mejor la perspectiva de los proveedores respecto a los requerimiento de sostenibilidad del mercado global. También muestra cómo la inclusión de los productores en el proceso de desarrollo de un estándar privado facilita su implementación posterior. El Caso de estudio C (Sección 5.3 en página 143) es un caso de estudio múltiple. Analiza la cadena de suministro global de café especial con origen en Tanzania. Las organizaciones focales son comerciantes que conectan de manera directa a pequeños agricultores de café en países en desarrollo con empresas tostadoras de café en países desarrollados. El Caso de estudio C muestra cómo un pequeño agricultor puede proveer un producto “premium” al mercado global, y participar en un segmento diferenciado del mercado a través de una cadena de suministro transparente y eficiente. Las aportaciones empíricas de los casos de estudio ayudan a validar y mejorar el marco conceptual sobre cadenas de suministro inclusivas (ver discusión en el Capítulo 6 en página 170). El resultado es la propuesta de una nueva versión del marco conceptual representado en la Figura 40 (página 195). Los casos de estudio también proporcionan interesantes aportaciones en relación a la gestión de cadenas de suministro inclusivas y muestran las perspectivas de distintos actores implicados. Esta tesis arroja luz sobre el papel de las empresas en la creación y la gestión de cadenas de suministro inclusivas llevando a cabo una revisión de literatura multidisciplinar y analizando tres casos de estudio en países africanos. Como resultado, esta tesis presenta una serie de contribuciones empíricas y teóricas al ámbito de investigación emergente en torno a las cadenas de suministro inclusivas (Capítulo 7). Esta tesis también pretende ser útil a profesionales que deseen facilitar la incorporación de los pobres como proveedores en condiciones justas y beneficiosas. ABSTRACT The global outlook is changing, and this is influencing the way we understand and try to achieve sustainable human development. Population growth entails increasing pressure over resources, but it also provides greater workforce and talent; concentration in urban areas is changing social dynamics and challenging traditional marketing channels, but also creating news markets and driving innovation; the global economy shift is rebalancing the traditional power imbalance between Western countries and the rest of the world, making new opportunities to arise; and interconnections and global interdependence create new risks but also opportunities for launching initiatives with a global reach. All these trends are impelling us to rethink what development is and in which way poverty alleviation should be approached. It is generally agreed that globalization implies interdependence and, in order to achieve sustainable human development, collaboration of all actors is needed. A convergence of issues, interests and solutions related to sustainable development is being observed across countries and sectors, encouraging strategic collaboration among companies, governments and civil society. There is little doubt nowadays about the crucial role of the private sector in the world’s path towards environmental sustainability and poverty alleviation. Businesses are evolving from a “business as usual” stance to a more sustainable and responsible approach. In the environmental arena, many companies have already “walk the talk”, implementing environmental management systems and trying to reduce emissions and energy consumption. However, regarding poverty alleviation, their contribution is less clear. There are around 1.2 billion people living in extreme poverty. Most of this people still live in rural areas where the agricultural sector employs a big part of the active population. Therefore, improving opportunities and reducing risks for vulnerable producers in the agri-food sector can be a primary engine of rural development and poverty alleviation, particularly in the poor, agriculture-based economies of least developed countries. Some companies are beginning to include the poor into their operations as consumers, suppliers and entrepreneurs. This thesis focuses specifically on the potential opportunities related to the sustainable incorporation of the poor as suppliers of products and/or labor. Business collaboration with vulnerable producers in developing countries is a relatively new trend and it is still understudied. The overall question guiding this thesis is: “How can businesses facilitate the sustainable inclusion of vulnerable producers from least developed countries into supply chains?”. In order to answer the research question, the author has applied a case study research strategy. This methodology is considered appropriate because research about inclusive supply chains is still at an early stage, and because there is a need to understand a real-life phenomenon in depth, but such understanding encompasses important contextual conditions. First, a literature review is conducted, in order to identify the research propositions and theoretical constructs that will guide the data collection. The literature review is divided in two parts: a more general one that explores the social dimension of sustainability of supply chains, and a more specific one that focuses on the incorporation of the poor as suppliers in supply chains. During the last decade, there has been an exponential growth of studies in the field of supply chain sustainability, but research efforts have traditionally been directed towards the analysis of the environmental dimension. Therefore, the literature review presented in Section 3.1 (page 35) that delves into social sustainability of supply chains can be considered a contribution in itself. This literature review reveals that the investigation of social issues in supply chains is gaining momentum and comes from different academic disciplines, namely Supply Chain Management, Corporate Social Responsibility and Development Studies. Existing research about social sustainability of supply chains focuses on three issues: clarify the definition of social sustainability; analyze the implementation of social sustainability strategies in supply chains; and study lead companies’ support to vulnerable suppliers in their transition towards sustainability. A conceptual framework that outlines the main findings that emerge from this first part of literature review is proposed in Figure 7 (page 48). Nevertheless, in this nascent field of social sustainability of supply chains, studies related to poverty alleviation are still scarce. Moreover, a lack of contributions from and about least developed countries has been observed, as well as a tendency to reflect on the lead firms’ standpoint, neglecting the suppliers’ perspective. The second part of the literature review (Section 3.2 in page 51) delves into three research streams that are exploring the inclusion of the poor into supply chains from different viewpoints. These research streams are Global Value Chains (GVC), Base of the Pyramid (BoP) and Sustainable Supply Chain Management (SSCM). GVC research discusses the dynamics of economic globalization and international trade, putting special emphasis in the implications for developing countries and vulnerable communities. GVC characterizes supply chains by the way they are governed, the upgrading opportunities that exist for producers in the chain and the degree of inclusion or exclusion of impoverished communities. BoP research explores trading relationships between businesses and impoverished communities. The core premise of the BoP concept is the possibility to combine profits with poverty alleviation. The original BoP proposition is that by marketing innovative products and services to poor communities in developing countries, poverty would be reduced and companies would increase their benefits, especially multinational companies. This idea has evolved to consider the incorporation of the poor to business activities not only as consumers, but also as employees, entrepreneurs and co-creators. The SSCM school of thought has mainly focused on studying the environmental dimension of supply chain sustainability, neglecting the consideration of the social perspective. However, in recent years, increasing outsourcing of production to developing countries and stakeholders’ demands for a more holistic approach to business sustainability have led SSCM scholars to acknowledge the importance of integrating poverty concerns in this field’s research agenda. Some SSCM studies identify the main operational challenges for companies which engage with vulnerable suppliers in their supply chains: missing communication, higher transactional and operational costs and increased complexity. Contributions from these three research streams are complementary for the study of inclusive supply chains. However, they have been rarely considered together, since they belong to different research areas. This thesis seeks to play a dovetailing role in this scenario by proposing a conceptual framework for creating and operating inclusive supply chains that builds on contributions from GVC, SSCM and BoP research. This framework for inclusive supply chains is depicted in Figure 9 (page 68), and explains the motivations that drive businesses to collaborate with vulnerable suppliers, the chal lenges they face in doing so, and the pathways they are following in order to build and operate inclusive supply chains profitably for both buying companies and vulnerable suppliers. In order to validate and refine the proposed framework, three case studies are carried out. The supply chains analyzed by the case studies belong to the agri-food sector and source from Sub-Saharan African countries. Multiple data collection methods and triangulation are used in order to improve reliability of findings. The author carried out field work in Senegal, Ethiopia and Tanzania. These travels enriched the data collection process, providing semi-structured interviews and informal conversations with the main actors in the supply chains, as well as direct observation of processes and interactions among companies and vulnerable suppliers. Case study A (Section 5.1 in page 96) is a single case study. It analyzes a local supply chain in Senegal providing vegetables to the local market. The focal organization is Manobi, a Senegalese inclusive business which provides affordable ICT services to local entrepreneurs in the agri-food sector. Case study A provides interesting insights into the dynamics of local supply chains and how professional services can help to improve their performance. Case study B (Section 5.2 in page 122) is a single case study. It analyzes a global supply chain with origin in Ethiopia providing cut flowers to the global commodity market. The focal organization is EHPEA, Ethiopian Horticulture Producers and Exporters Association, whose mission is to promote and safeguard the competitive position of the Ethiopian horticulture sector within the global market. Case study B helps to better understand the suppliers’ perspective regarding global market sustainability requirements and shows how the inclusion of suppliers in the process of development of a private standard has a positive impact in its implementation. Case study C (Section 5.3 in page 143) is a multiple case study. It analyzes a global supply chain with origin in Tanzania providing coffee to the global niche market of specialty coffee. The focal organizations are traders who are directly connecting smallholder coffee farmers in developing countries to coffee roasters in developed countries. Case study C shows how smallholder farmers can supply a premium product and be incorporated in a differentiated market segment through a transparent and efficient supply chain. The empirical findings from the case studies help to validate and refine the conceptual framework (see discussion in Chapter 6). The proposal of a new version of the conceptual framework is depicted in Figure 40 (page 195). The case studies also provide interesting insights related to the management of inclusive supply chains and show the perspectives of the different actors involved. This thesis sheds some light on the role of businesses in the creation and operation of inclusive supply chains by carrying out a cross-disciplinary literature review and analyzing three case studies in African countries. In doing so, this thesis presents a series of theoretical and empirical contributions to the emerging academic field of inclusive supply chains (Chapter 7). This thesis also intends to be useful to practitioners willing to improve the incorporation of the poor as suppliers in fair and profitable conditions.

Towards the Consideration of the U.S. Community College Model to Address the Need for Higher Education Reforms in Ghana

ABSTRACT The higher education systems throughout the continent of Africa are undergoing unprecedented challenges and are considered in crisis. African countries, including Ghana, all have in common ties to their colonial legacy whereby they are confronted with weak policies put in place by their colonizers. Having gained their independence, Africans should now take responsibility for the task of reforming their higher education system. To date, nothing substantial has been accomplished, with serious implications for weakening and damaging the structures of the foundation of their educational systems. This qualitative, single case study utilized a postcolonial theory-critical pedagogy framework, providing guidance for coming to grips with the mindset posed by Ghana's colonial heritage in the postcolonial era, especially in terms of its damaging effects on Ghana's higher education system. The study explores alternative pathways for secondary school students to transition to tertiary education--a problematic transition that currently hinders open access to all and equality in educational opportunity, resulting in a tremendous pool of discontinued students. This transitional problem is directly related to Ghana's crisis in higher education with far reaching consequences. The alternative pathway considered in this study is an adaptation of the U.S. community college model or an integration of its applicable aspects into the current structures of the higher education system already in place. In-depth interviews were conducted with 5 Ghanaian professors teaching at community colleges in the United States, 5 Ghanaian professors teaching at universities in Ghana, and 2 educational consultants from the Ghanaian Ministry of Education. Based on their perspectives of the current state of Ghanaian higher education, analyzed in terms of pedagogy, structure/infrastructure, and curriculum, the participants provided their perceptions of salient aspects of the U.S. community college model that would be applicable to Ghana's situation, along with other recommendations. Access to all, including equality of educational opportunity, was considered essential, followed by adaptability, affordability, practicality, and quality of curriculum content and delivery. Canada's successful adaptation of the U.S. model was also discussed. Findings can help guide consideration of alternative pathways to higher education in Ghana and Africa as a whole.

Vantagem competitiva no mercado de geração distribuída de energia solar fotovoltaica

O mercado de geração distribuída de energia solar fotovoltaica apresenta-se em estágio inicial de desenvolvimento no Brasil. A recente conjuntura regulatória, entretanto, aponta para a mudança deste cenário: as últimas revisões da regulação aplicável trouxeram aumento na viabilidade econômica de projetos no setor. Isto, somado à presença abundante de recurso solar no Brasil e ao presente estágio de desenvolvimento da tecnologia fotovoltaica indicam um possível crescimento da penetração da fonte no país nos próximos anos. Nesse contexto, o presente estudo tem como objetivo analisar quais recursos e capacidades a empresa Axis Renováveis deve possuir para alcançar uma posição de vantagem competitiva, à luz do RBT. A empresa selecionada para a condução do estudo de caso único é uma start-up atuante no setor. Espera-se que, ao final do trabalho, as conclusões tenham implicação direta na estratégia da empresa e possam servir como ponto de partida para outras empresas do setor.

Validity of BMI as a measure of obesity in Australian white Caucasian and Australian Sri lankan children

Background: Body mass index ( BMI) is used to diagnose obesity. However, its ability to predict the percentage fat mass (% FM) reliably is doubtful. Therefore validity of BMI as a diagnostic tool of obesity is questioned. Aim: This study is focused on determining the ability of BMI- based cut- off values in diagnosing obesity among Australian children of white Caucasian and Sri Lankan origin. Subjects and methods: Height and weight was measured and BMI ( W/H-2) calculated. Total body water was determined by deuterium dilution technique and fat free mass and hence fat mass derived using age- and gender- specific constants. A % FM of 30% for girls and 20% for boys was considered as the criterion cut- off level for obesity. BMI- based obesity cut- offs described by the International Obesity Task Force ( IOTF), CDC/ NCHS centile charts and BMI- Z were validated against the criterion method. Results: There were 96 white Caucasian and 42 Sri Lankan children. Of the white Caucasians, 19 ( 36%) girls and 29 ( 66%) boys, and of the Sri Lankans 7 ( 46%) girls and 16 ( 63%) boys, were obese based on % FM. The FM and BMI were closely associated in both Caucasians ( r = 0.81, P < 0.001) and Sri Lankans ( r = 0.92, P< 0.001). Percentage FM and BMI also had a lower but significant association. Obesity cut- off values recommended by IOTF failed to detect a single case of obesity in either group. However, NCHS and BMI- Z cut- offs detected cases of obesity with low sensitivity. Conclusions: BMI is a poor indicator of percentage fat and the commonly used cut- off values were not sensitive enough to detect cases of childhood obesity in this study. In order to improve the diagnosis of obesity, either BMI cut- off values should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the % FM should be explored.

The impact of residential respite care on the behavior of older people

Background: The aim of this study was to examine the impact of residential respite care on disruptive behavior displayed by older people, particularly those with dementia. Methods: A quasi-experimental, repeated-measures, single-group design was used. The participants were a consecutive series of 100 older people with a mean age of 81.8 years (range 66-96 years) who had been booked for a respite admission to one of several residential aged care facilities in a provincial Australian city. A diagnosis of dementia was reported for 29% of the sample. Disruptive behaviors were rated before and after the period of respite by home caregivers (N = 100) and during the period of respite by nurses (N= 25) using the Dementia Behavior Disturbance Scale (DBDS). Results: Age, male gender and the presence of dementia were all significantly related to the frequency of reported disruptive behaviors. Residential respite care was associated with a significant reduction in the frequency of reported disruptive behaviors in older people (Wald chi(2) = 28.28, P < 0.0001). However, this improvement in behavior did not persist into the post-respite period. The deteriorating behavioral trajectory that was evident prior to respite care continued following the period of respite care. Conclusions: Residential respite care was associated with a temporary diminution in the frequency of reported disruptive behaviors in older people. This finding should be reassuring both for family carets considering placing a relative in residential respite care and for health workers considering whether to recommend such a course of action.

CONTRIBUIÇÃO DOS CURSOS SUPERIORES DE TECNOLOGIA NA EDUCAÇÃO PROFISSIONAL DO TRABALHADOR BRASILEIRO

Os Cursos Superiores de Tecnologia são um tipo específico de graduação (tecnólogo), com características próprias, entre as quais, a focalização na especialização dos seus currículos e duração mais curta objetivando uma formação mais rápida. A graduação tecnológica vem sendo amplamente difundida no país desde a segunda metade da década de 1990, após a promulgação da lei no 9.394/96 LDB, e por uma série de decretos, portarias e pareceres do MEC/CNE. Entre as principais metas e objetivos do PNE para a educação superior, se destacam: diversificação do sistema superior de ensino para atender clientelas com demandas específicas de formação; articulação entre currículo e mercado de trabalho; financiamento e gestão; criação de políticas de acesso à educação superior que facilitem o ingresso de alunos provenientes de grupos de maior vulnerabilidade educacional; crescimento da oferta de educação superior para a faixa etária de 18 a 24 anos. O presente estudo tem por objetivo refletir e debater a contribuição dos CSTs na educação profissional do trabalhador brasileiro dentro das perspectivas do PNE. O estudo se fundamenta no método qualitativo, com base numa pesquisa exploratória e descritiva, caracterizada como estudo de caso único, através da pesquisa de campo realizada com alunos em formação e com egressos do Curso de Eletrônica Industrial da Faculdade de Tecnologia Senai Anchieta, na cidade de São Paulo. Para alcançar seus objetivos, o estudo foi dividido em duas etapas: a primeira faz uma análise das variáveis que caracterizam o perfil do aluno em formação buscando identificar sua percepção quanto à escolha pelo CST, conhecimento sobre essa modalidade de ensino e as expectativas futuras da profissão. Na segunda parte, o estudo faz uma análise da percepção do egresso acerca das habilidades e competências adquiridas durante a formação, o grau de satisfação com salário e plano de carreira, e a aceitação profissional do tecnólogo pelo mercado de trabalho. No estudo realizado com alunos em formação constatou-se que os índices de evasão escolar das primeiras turmas do curso foram elevados, sendo apontadas como principais causas as dificuldades de conciliação entre o horário de estudo com a do trabalho e as dificuldades econômicas familiares. O perfil do aluno em formação na IES em estudo é majoritariamente da faixa etária entre 18 e 24 anos; do gênero masculino; egresso do ensino médio feito em escola pública; morador em bairro periférico e natural de cidade da RMSP; o próprio aluno é responsável pelo pagamento das mensalidades; não houve interferência de terceiros na sua escolha pelo CST; tem percepção favorável quanto à empregabilidade futura como tecnólogo. A pesquisa com egressos apontou que os mesmos tem percepção favorável quanto à formação profissional recebida, exceto o fato de não terem atendido disciplinas que desenvolvessem competências gerenciais e de negócios; quanto à empregabilidade e perspectivas de carreira mostraram preocupação na valorização profissional do tecnólogo pelo mercado de trabalho; declararam estar insatisfeitos quanto ao salário recebido; quanto à educação continuada reconheceram ser esse o processo que os manterão atualizados profissionalmente. Como conclusão da pesquisa, há recomendação para estudos futuros na sondagem de outras possíveis causas da evasão escolar com alunos dos cursos com outros eixos temáticos e de IES públicas. Igualmente, aponta-se para a necessidade da proposta curricular da IES em estudo oferecer, além das disciplinas técnicas, outras que desenvolvam competências e habilidade em gestão de pessoas e negócios.

O DESAFIO DA GESTÃO POR COMPETÊNCIAS NO TERCEIRO SETOR: O CASO DO PROJETO MENINOS E MENINAS DE RUA

A ação reduzida do Estado brasileiro com relação ao atendimento das necessidades das crianças e adolescentes em situação de rua dá espaço para a atuação de novos atores sociais. Alguns destes têm como objetivo promover a cidadania do país, como os participantes do terceiro setor: ONGs que enfrentam diversos obstáculos para realizar suas missões. Dentre estes desafios encontra-se a gestão de pessoas. O presente trabalho propõe a análise da gestão de pessoas e a construção participativa de um modelo de competências em uma Organização Não Governamental Projeto Meninos e Meninas de Rua, a partir da combinação das metodologias qualitativas de estudo de caso único e pesquisa-ação, tendo como embasamento a Gestão Social. A pesquisa de campo foi desenvolvida por meio de diferentes fontes de evidências: entrevistas, questionários, observação, análise de documentos e registros e artefatos físicos, que permitiu a construção participativa de um modelo com cinco (5) competências essenciais/institucionais: Diagnóstico e Planejamento, Alinhamento Institucional, Comunicação, Resiliência e Defesa, Garantia e Promoção de Direitos, tendo como foco deste trabalho o olhar para os Educadores Sociais que atuam na instituição.

A COMUNICAÇÃO MERCADOLÓGICA NA OFERTA DE MICROCRÉDITO: UM ESTUDO DE CASO DO BANCO ITAÚ NA PERIFERIA DE SÃO PAULO.

Por um lado, o mundo do Século XXI com ferramentas que possibilitam cada vez mais estarmos conectados e dependentes das tecnologias de comunicação, em que a internet prevalece como meio principal para as pessoas se relacionarem, interagirem, consumirem, se divertirem e se informarem. Do outro lado, quase que uma ilha à parte dessa tendência tecnológica, um espaço em que a comunicação oral, a confiança, o valor da palavra, o conhecer o vizinho do bairro e a comunidade são o que prevalece. Trata-se de mais um fenômeno decorrente do crescimento da Classe C no Brasil, posterior ao lançamento do Plano Real, por Fernando Henrique Cardoso no governo do ex-presidente Itamar Franco, e da implantação de medidas sociais nos anos seguintes, durante o governo de Luiz Inácio Lula da Silva. O segmento que representa 54% da população brasileira e desperta a atenção das empresas como uma nova frente de geração de riquezas e negócios. Por meio de pesquisa bibliográfica e análise documental para análise de conteúdo, este estudo de caso único investigará como o Banco Itaú se comunica com esse público para oferecer o microcrédito na periferia da cidade de São Paulo. Num mundo em que se pensa quanto mais rápidas e sensoriais serão as tecnologias de informação no futuro, o bom e velho bate-papo pode levar a conhecimentos importantes quando queremos nos comunicar com as camadas populares da população.

A COMUNICAÇÃO DE MERCADO E A RESSIGNIFICAÇÃO DE MARCA:como as interações em redes sociais virtuais geram a percepção do consumidor

Este estudo tem como objetivo analisar como os processos comunicacionais de manifestações perceptivas dos consumidores pós-modernos, a partir das interações em redes sociais virtuais, contribuem para a ressignificação da imagem de marca. Reavaliamos o processo comunicacional ante as novas interações econômicas e tecno-sociais, partindo de uma visão de consumo de significados e um deslocamento do marketing das necessidades para um marketing de sentidos. Para tanto, desenvolvemos um estudo de caso único da marca Lego, a partir de levantamento bibliográfico, levantamentos qualitativos das interações em sites, análise de conteúdo de blog e análise qualitativa de fórum de consumidores da marca. Assim, concluímos que a comunicação de mercado assume um papel aglutinador nas construções simbólicas da imagem de marca nas organizações e que a facilidade econômica e atemporal em compartilhar manifestações por meio da internet ressignifica a imagem de marca em um papel de troca simbólica na bolsa de valores de imagens das redes on-line.

A study of strategic HR issues in an Asian context

Examines five strategic human resource management (HRM) issues using a qualitative methodology. Two of these are related to the central organisational-level constructs of structure and culture. The other three pertain to HR strategy, HR competencies, and HR outsourcing. The study employed the multiple-case design method proposed by Yin, with a view to extending theory in strategic HRM research. Semi-structured interviews were conducted with 35 managers (CEOs, line managers, and HR managers) of nine companies from two major industries in the manufacturing sector – electronic products and machinery/equipment. The research found that top management enlightenment and level of HR competencies together determine the role and status of the HR function in organisations, and that the companies studied pursue four types of HR strategies: informal and not communicated; informal and communicated; formal but not communicated; and formal and communicated. HR strategy was found to affect both vertical and horizontal fits of the HR function. Culture, HR strategy and HR competencies influenced organisational propensity to outsource HR activities.

A longitudinal study of the diffusion of the ISO/IEC information resource dictionary system standard (IRDS.)

The IRDS standard is an international standard produced by the International Organisation for Standardisation (ISO). In this work the process for producing standards in formal standards organisations, for example the ISO, and in more informal bodies, for example the Object Management Group (OMG), is examined. This thesis examines previous models and classifications of standards. The previous models and classifications are then combined to produce a new classification. The IRDS standard is then placed in a class in the new model as a reference anticipatory standard. Anticipatory standards are standards which are developed ahead of the technology in order to attempt to guide the market. The diffusion of the IRDS is traced over a period of eleven years. The economic conditions which affect the diffusion of standards are examined, particularly the economic conditions which prevail in compatibility markets such as the IT and ICT markets. Additionally the consequences of the introduction of gateway or converter devices into a market where a standard has not yet been established is examined. The IRDS standard did not have an installed base and this hindered its diffusion. The thesis concludes that the IRDS standard was overtaken by new developments such as object oriented technologies and middleware. This was partly because of the slow development process of developing standards in traditional organisations which operate on a consensus basis and partly because the IRDS standard did not have an installed base. Also the rise and proliferation of middleware products resulted in exchange mechanisms becoming dominant rather than repository solutions. The research method used in this work is a longitudinal study of the development and diffusion of the ISO/EEC IRDS standard. The research is regarded as a single case study and follows the interpretative epistemological point of view.