Management and development of enterprise

The research work is devoted to actual problems of development management of industrial enterprises. The general purpose of this work is the choice and justification of rational enterprise development evaluation model and subsequent application of it for assessment of enterprise development level and also forming of recommendations for enterprise management. Theoretical aspects of development management of enterprises were generalized. The approaches to understanding the essence of development enterprise category and its types were considered. It was investigated the evaluation models of enterprise development, their advantages and disadvantages and the difficulties of their implementation. The requirements for formation of the evaluation system of the enterprise development were summarized. It was determined the features of the formation and application of an Index of Enterprise Development. In the empirical part, data about investigated enterprises was collected from their official websites and also complemented with further data from other statistical websites. The analysis was based on the annual financial statements of companies. To assess the level of enterprise development were chosen model proposed by Feshchur and Samulyak (2010). This model involves the calculation of the Index of Enterprise Development using partial indicators, their reference values and weight. It was conducted an analysis of the development of Ukrainian enterprises that produce sauces. OJSC “LZHK” had the highest value of Index of Enterprise Development, in 2013 and 2015, that consisted 0,78 and 0,76 respectively. In 2014 the highest value for the Index belonged to PJSC “Volynholdinh” and amounted 0,74. OJSC “LZHK” had the highest average value of Index of Enterprise Development by the result of 2013-2015 years, and it consisted 0,70. PJSC “Chumak” had the lowest average value of Index of Enterprise Development obtained the result 0,59. In order to raise the enterprise development level, it was suggested to reduce production costs and staff turnover, increase the involvement of employees.

Cost-effectiveness analysis of apixaban compared to low-molecular-weight heparins and vitamin k antagonists for treatment and secondary prevention of venous thromboembolism

Objective: Cost-effectiveness analysis of a 6-month treatment of apixaban (10 mg/12h, first 7 days; 5 mg/12h afterwards) for the treatment of the first event of venous thromboembolism (VTE) and prevention of recurrences, versus low-molecular-weight heparins/vitamin K antagonists treatment (LMWH/VKA). Material and methods: A lifetime Markov model with 13 health states was used for describing the course of the disease. Efficacy and safety data were obtained from AMPLIFY and AMPLIFY-EXT clinical trials; health outcomes were measured as life years gained (LYG) and quality-adjusted life years (QALY). The chosen perspective of this analysis has been the Spanish National Health System (NHS). Drugs, management of VTE and complications costs were obtained from several Spanish data sources (€, 2014). A 3% discount rate was applied to health outcomes and costs. Univariate and probabilistic sensitivity analyses (SA) were performed in order to assess the robustness of the results. Results: Apixaban was the most effective therapy with 7.182 LYG and 5.865 QALY, versus 7.160 LYG and 5.838 QALYs with LMWH/VKA. Furthermore, apixaban had a lower total cost (€13,374.70 vs €13,738.30). Probabilistic SA confirmed dominance of apixaban (led to better health outcomes with less associated costs) in 89% of the simulations. Conclusions: Apixaban 5 mg/12h versus LMWH/VKA was an efficient therapeutic strategy for the treatment and prevention of recurrences of VTE from the NHS perspective.

Assessment of sea cucumber populations from the Aegean Sea (Turkey): first insights to sustainable management of new fisheries

Sea cucumber stocks have been overfished in many countries. As a consequence, several species (Holothuria polii, Holothuria tubulosa and Holothuria mammata) are now caught in Turkish waters without adequate knowledge on their biology and ecology. Here, we address their morphometry, relationships among gutted length and weight, population dynamics, temporal evolution of catches, and we provide the first insights about technical aspects of their fisheries. The largest size classes of H. polii are missing from our sampling collection, possibly due to the heavy fishery pressure on this species. Significant differences in the eviscerated length and weight were found among the Turkish sampled localities for H. polii and H. tubulosa, respectively. These differences could be explained by higher food availability in some areas and/or differential fishery pressure. The size and weight of H. tubulosa specimens were smaller than those registered for the same species in Greek waters, where this species is not fished. All the studied species showed allometric growth. In the last two years, the sea cucumber fishery in Turkey has been increasing rapidly, reaching a total production of ca. 555 000 kg in 2012 (80% H. polii and 20% H. tubulosa plus H. mammata). For a correct management of these species, we recommend: 1) the reestablishment of species-specific closed fishery season according to the specific reproductive cycle; 2) the assessment of the exploited stocks from the Northern Turkish coasts with estimates of recovery time of their populations; 3) the reduction of fishery efforts, mainly on H. polii and H. tubulosa and 4) the establishment of protected areas (where sea cucumber fisheries are forbidden) to conserve healthy populations which will favour the recruitment on nearby areas.

Defining fluid restriction in the management of infants following cardiac surgery and understanding the subsequent impact on nutrient delivery and growth outcomes

Adequacy of nutritional intake during the postoperative period, as measured by a change in weight-for-age z-scores from surgery to the time of discharge, was evaluated in infants (n = 58) diagnosed with a congenital heart defect and admitted for surgical intervention at Miami Children’s Hospital using a prospective observational study design. Parental consent was obtained for all infants who participated in the study. ^ Forty patients had a weight available at hospital discharge. The mean preoperative weight-for-age z-score was -1.3 ±1.43 and the mean weight-for-age z-score at hospital discharge was -1.89 ±1.35 with a mean difference of 0.58 ±0.5 (P = 0.2).^ Nutritional intake during the postoperative period was inadequate based on a decrease in weight-for-age z-scores from the time of surgery until discharged home. Our findings suggested that limited fluid volume for nutrition likely contributes to suboptimal nutritional delivery during the postoperative period; however, inadequate nutrition prescription may also be an important contributing factor. Development of a nutrition protocol for initiation and advancement of nutrition support may reduce the delay in achieving patient’s nutritional goals and may attenuate the observed decrease in z-scores during the postoperative period.^

Dynamics and diversity of Escherichia coli in animals and system management of the manure on a commercial farrow-to-finish pig farm

The objective of this study was to determine the dynamics and diversity of Escherichia coli populations in animal and environmental lines of a commercial farrow-to-finish pig farm in Spain along a full production cycle (July 2008 to July 2009), with special attention to antimicrobial resistance and the presence of integrons. In the animal line, a total of 256 isolates were collected from pregnant sows (10 samples and 20 isolates), 1-week-old piglets (20 samples and 40 isolates), unweaned piglets (20 samples and 38 isolates), growers (20 samples and 40 isolates), and the finishers' floor pen (6 samples and 118 isolates); from the underfloor pits and farm slurry tank environmental lines, 100 and 119 isolates, respectively, were collected. Our results showed that E. coli populations in the pig fecal microbiota and in the farm environment are highly dynamic and show high levels of diversity. These issues have been proven through DNA-based typing data (repetitive extragenic palindromic PCR [REP-PCR]) and phenotypic typing data (antimicrobial resistance profile comprising 19 antimicrobials). Clustering of the sampling groups based on their REP-PCR typing results showed that the spatial features (the line) had a stronger weight than the temporal features (sampling week) for the clustering of E. coli populations; this weight was less significant when clustering was performed based on resistotypes. Among animals, finishers harbored an E. coli population different from those of the remaining animal populations studied, considering REP-PCR fingerprints and resistotypes. This population, the most important from a public health perspective, demonstrated the lowest levels of antimicrobial resistance and integron presence.

Conservative management for female urinary incontinence and pelvic organ prolapse review 2013 : summary of the 5th International Consultation on Incontinence

Aims The objective of the 5th International Consultation on Incontinence (ICI) chapter on Adult Conservative Management was to review and summarize the new evidence on conservative management of urinary incontinence (UI) and pelvic organ prolapse (POP) in order to compile a current reference source for clinicians, health researchers, and service planners. In this paper, we present the review highlights and new evidence on female conservative management. Methods Revision and updates of the 4th ICI Report using systematic review covering years 2008–2012. Results Each section begins with a brief definition and description of the intervention followed by a summary, where possible, of both the state and level of evidence for prevention and treatment, and ends with a “grade of recommendation.” The paper concludes with areas identified as requiring further research. Conclusions For UI, there are no prevention trials on lifestyle interventions. There are, however, few new intervention trials of lifestyle interventions involving weight loss and fluid intake with improved levels of evidence and grade of recommendation. Outside of pre- and post-natal pelvic floor muscle training (PFMT) trials for the prevention of female UI, there is a dearth of PFMT prevention trials for women with UI. PFMT remains the first-line treatment for female UI with high levels of evidence and grades of recommendation. Bladder training levels of evidence and grades of recommendation are maintained. For POP, new evidence supports the effectiveness of physiotherapy in the treatment of POP and there are now improved levels of evidence and grades of recommendation.

Conservative management for female urinary incontinence and pelvic organ prolapse review 2013 : summary of the 5th International Consultation on Incontinence

Aims The objective of the 5th International Consultation on Incontinence (ICI) chapter on Adult Conservative Management was to review and summarize the new evidence on conservative management of urinary incontinence (UI) and pelvic organ prolapse (POP) in order to compile a current reference source for clinicians, health researchers, and service planners. In this paper, we present the review highlights and new evidence on female conservative management. Methods Revision and updates of the 4th ICI Report using systematic review covering years 2008–2012. Results Each section begins with a brief definition and description of the intervention followed by a summary, where possible, of both the state and level of evidence for prevention and treatment, and ends with a “grade of recommendation.” The paper concludes with areas identified as requiring further research. Conclusions For UI, there are no prevention trials on lifestyle interventions. There are, however, few new intervention trials of lifestyle interventions involving weight loss and fluid intake with improved levels of evidence and grade of recommendation. Outside of pre- and post-natal pelvic floor muscle training (PFMT) trials for the prevention of female UI, there is a dearth of PFMT prevention trials for women with UI. PFMT remains the first-line treatment for female UI with high levels of evidence and grades of recommendation. Bladder training levels of evidence and grades of recommendation are maintained. For POP, new evidence supports the effectiveness of physiotherapy in the treatment of POP and there are now improved levels of evidence and grades of recommendation.

Length-weight relationships of six syngnathid species from Ria Formosa, SW Iberian coast

In this study, the length-weight (LWR) parameters were estimated for six syngnathid species, including 2 seahorses and 4 pipefishes, from Ria Formosa, a temperate lagoon from the south coast of Portugal. A total of 5070 fishes were used to determine the LWR. The estimated b value ranged from 2.95 (Nerophis ophidion) to 3.36 (Syngnathus abaster). To the authors' best knowledge, LWR parameters were estimated for the first time for Nerophis ophidion and Syngnathus typhle for the Atlantic waters. Data here present are essential for management and conservation of these flagship species.

Size at maturity and length-weight relationships of the blurred lantern shark Etmopterus bigelowi (Squaliformes: Etmopteridae) caught off southeastern Brazil

The blurred lantern shark Etmopterus bigelowi, a deep-water squaloid shark, is globally widespread in temperate and tropical waters, but there is little available information about its biology owing to its relative rarity of capture and taxonomic confusion with its sibling species Etmopterus pusillus. Specimens used in this study were collected from July to December 2004 as by-catch in the commercial deepwater trawl fishery targeting red shrimp Aristaeomorpha foliacea in the southwestern Atlantic. We examined 55 specimens (22 males and 33 females) ranging in total length (TL) from 31.5 to 73 cm and in total weight from 103 to 1600 g. Length-weight relationships were explored for each sex and significant differences were found in the slope coefficients of the male and female regressions. The size at maturity for each sex was evaluated fitting a logistic regression. Females matured at larger sizes than males, with estimated sizes at first maturity of 56.0 cm TL for females and 45.1 cm TL for males. The present study provides important preliminary information about E. bigelowi that can be incorporated in risk assessment and stock assessment models, essential for efficient management practices aimed at avoiding overexploitation of these vulnerable deep-sea sharks.

Impacts of crop level, soil and irrigation management in grape berries of cv ‘Trincadeira’ (Vitis vinifera L.)

Berry size and crop yield are widely recognized as important factors that contribute to wine quality. The final berry size indirectly affects the phenolic concentration of the wine due to skin surface-to-berry volume ratio. The effects of different irrigation levels, soil management and plant crop level on growth of ‘Trincadeira’ berries were studied. In order to test the influence of different irrigation levels (rainfed, pre-veraison and post-veraison), different soil management (tillage and natural cover crops) and different plant crop levels (8 and 16 clusters per vine), leaf water potential, skin anthocyanin, polyphenols, berry skin and seed fresh weight were measured in fruits. The segregation of berries into three different berry classes: small, medium and large, allowed to identify different levels of contribution of soil management and irrigation level into berry, skin and seeds ratios. As expected, higher water availability due to irrigation and soil tillage management during berry development induced an increase in berry flesh weight and this was more evident in larger berries; however, berry skin and seed fresh weight remained unchanged. Also, anthocyanins did not show significant differences.

Information Usefulness To Support Dialogue Management in Healthcare

The main objective of the framework we are proposing is to help the physician obtain information about the patient's condition in order to reach the \emph{correct} diagnosis as soon as possible. In our proposal, the number of interactions between the physician and the patient is reduced to a strict minimum on the one hand and, on the other hand, it is made possible to increase the number of questions to be asked if the uncertainty about the diagnosis persists. These advantages are due to the fact that (i) we implement a reasoning component that allows us to predict a symptom from another symptom without explicitly asking the patient, (ii) we consider non-binary values for the weights associated with the symptoms, we introduce a dataset filtering process in order to choose which partition should be used with respect to some particular characteristics of the patient, and, in addition, (iv) it was added new functionality to the framework: the ability to detect further future risks of a patient already knowing his pathology. The experimental results we obtained are very encouraging

A Decade Of Malaria During Pregnancy In Brazil: What Has Been Done Concerning Prevention And Management.

In Brazil, malaria remains a disease of major epidemiological importance because of the high number of cases in the Amazonian Region. Plasmodium spp infections during pregnancy are a significant public health problem with substantial risks for the pregnant woman, the foetus and the newborn child. In Brazil, the control of malaria during pregnancy is primarily achieved by prompt and effective treatment of the acute episodes. Thus, to assure rapid diagnosis and treatment for pregnant women with malaria, one of the recommended strategy for low transmission areas by World Health Organization and as part of a strategy by the Ministry of Health, the National Malaria Control Program has focused on integrative measures with woman and reproductive health. Here, we discuss the approach for the prevention and management of malaria during pregnancy in Brazil over the last 10 years (2003-2012) using morbidity data from Malaria Health Information System. Improving the efficiency and quality of healthcare and education and the consolidation of prevention programmes will be challenges in the control of malaria during pregnancy in the next decade.

Management Of Severe Thoracic Impalement Trauma Against Two-wheeled Horse Carriage: A Case Report And Literature Review.

Thoracic injuries in general are of great importance due to their high incidence and high mortality. Thoracic impalement injuries are rare but severe due to the combination of cause, effect and result. This study's primary objective is to report the case of a young man who was impaled by a two-wheeled horse carriage shaft while crashing his motorcycle in a rural zone. An EMT-B ferry was called at the crash scene and a conscious patient was found, sustaining a severe impalement injury to the left hemithorax, suspended over the floor by the axial skeleton with the carriage shaft coming across his left chest. As a secondary objective, a literature review of thoracic impalement injuries is performed. Cases of thoracic impalement injury require unique and individualized care based on injury severity and affected organs. Reported protocols for managing impalement injuries are entirely anecdotal, with no uniformity on impaled patient's approach and management. In penetrating trauma, it is essential not to remove the impaled object, so that possible vascular lesions remain buffered by the object, avoiding major bleeding and exsanguination haemorrhage. Severed impaled thoracic patients should be transferred to a specialist centre for trauma care, as these lesions typically require complex multidisciplinary treatment. High-energy thoracic impalement injuries are rare and hold a high mortality rate, due to the complexity of trauma and associated injuries such as thoracic wall and lung lesions. Modern medicine still seems limited in cases of such seriousness, not always with satisfactory results.

Predictors For Weight Loss Failure Following Roux-en-y Gastric Bypass.

Weight loss failure is a widely recognized occurrence following Roux-en-Y gastric bypass. This study aims to identify predictors associated with weight loss failure. It is a retrospective cohort which enrolled 187 subjects who underwent RYGB. Comparisons were made between patients' features at baseline and 24 months after surgery. A weight loss failure rate of 11.2% was found. Advanced age and diabetes were statistically associated with failure. The results found were close to previous reports. As weight loss failure represents an important concern, there is the possibility to perform revisional surgeries, which may emphasize the restrictive or malabsorptive characteristics of RYGB, leading to varied results. It is reinforced that weight loss cannot be used as the unique outcome to evaluate the success of surgery.

Key Issues In Inhibitor Management In Patients With Haemophilia.

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