Impact of a program for the prevention of traffic accidents in a Southern Brazilian city: a model for implementation in a developing country

Background: Traffic accidents constitute the main cause of death in the first decades of life. Traumatic brain injury is the event most responsible for the severity of these accidents. The SBN started an educational program for the prevention of traffic accidents, adapted from the American model ""Think First"" to the Brazilian environment, since 1995, with special effort devoted to the prevention of TBI by using seat belts and motorcycle helmets. The objective of the present study was to set up a traffic accident prevention program based on the adapted Think First and to evaluate its impact by comparing epidemiological variables before and after the beginning of the program. Methods: The program was executed in Maringa city, from September 2004 to August 2005, with educational actions targeting the entire population, especially teenagers and young adults. The program was implemented by building a network of information facilitators and multipliers inside the organized civil society, with widespread population dissemination. To measure the impact of the program, a specific software was developed for the storage and processing of the epidemiological variables. Results: The results showed a reduction of trauma severity due to traffic accidents after the execution of the program, mainly TBI. Conclusions: The adapted Think First was systematically implemented and its impact measured for the first time in Brazil, revealing the usefulness of the program for reducing trauma and TBI severity in traffic accidents through public education and representing a standardized model of implementation in a developing country. (C) 2009 Elsevier Inc. All rights reserved.

Precise Temporal Regulation of roughest is Required for Correct Salivary Gland Autophagic Cell Death in Drosophila

The Drosophila roughest (rst) locus encodes an immunoglobulin superfamily transmembrane glycoprotein implicated in a variety of embryonic and postembryonic developmental processes. Here we demonstrate a previously unnoticed role for this gene in the autophagic elimination of larval salivary glands during early pupal stages by showing that overexpression of the Rst protein ectodomain in early pupa leads to persistence of salivary glands up to at least 12 hours after head eversion, although with variable penetrance. The same phenotype is observed in individuals carrying the dominant regulatory allele rst(D), but not in loss of function alleles. Analysis of persistent glands at the ultrastructural level showed that programmed cell death starts at the right time but is arrested at an early stage of the process. Finally we describe the expression pattern and intracellular distribution of Rst in wild type and rstD mutants, showing that its downregulation in salivary glands at the beginning of pupal stage is an important factor in the correct implementation of the autophagic program of this tissue in space and time. genesis 47:492-504, 2009. (C) 2009 Wiley-Liss, Inc.

Development and implementation of the population Fisher information matrix for the evaluation of population pharmacokinetic designs.

In population pharmacokinetic studies, the precision of parameter estimates is dependent on the population design. Methods based on the Fisher information matrix have been developed and extended to population studies to evaluate and optimize designs. In this paper we propose simple programming tools to evaluate population pharmacokinetic designs. This involved the development of an expression for the Fisher information matrix for nonlinear mixed-effects models, including estimation of the variance of the residual error. We implemented this expression as a generic function for two software applications: S-PLUS and MATLAB. The evaluation of population designs based on two pharmacokinetic examples from the literature is shown to illustrate the efficiency and the simplicity of this theoretic approach. Although no optimization method of the design is provided, these functions can be used to select and compare population designs among a large set of possible designs, avoiding a lot of simulations.

Telemedicine and developing countries - successful implementation will require a shared approach

Telemedicine is often proposed as a solution to certain health-care problems in the developing world. There seems to be little published experience on which to make judgements. A literature search revealed 39 articles, of which only two related to any kind of direct clinical work; most of them were review articles or editorials. The majority of the work reported was educational in nature, and there has been little clinical experience. It seems probable that telemedicine can help with the education of health-care workers and patients; it seems likely that it could bring major benefits to the organization of health-care. Without proper trials, it will be impossible to determine the place of health-care in the developing world. Trials are the only way in which rational decisions can ultimately be reached regarding whether scarce resources should be devoted to telemedicine in developing countries, or whether they should be employed in more conventional health-care measures whose outcomes are known to be cost-effective.

A real symmetric Lanczos subspace implementation of quantum scattering using boundary inhomogeneities

We present an efficient and robust method for calculating state-to-state reaction probabilities utilising the Lanczos algorithm for a real symmetric Hamiltonian. The method recasts the time-independent Artificial Boundary Inhomogeneity technique recently introduced by Jang and Light (J. Chem. Phys. 102 (1995) 3262) into a tridiagonal (Lanczos) representation. The calculation proceeds at the cost of a single Lanczos propagation for each boundary inhomogeneity function and yields all state-to-state probabilities (elastic, inelastic and reactive) over an arbitrary energy range. The method is applied to the collinear H + H-2 reaction and the results demonstrate it is accurate and efficient in comparison with previous calculations. (C) 2002 Elsevier Science B.V. All rights reserved.

A variable stepsize implementation for stochastic differential equations

Stochastic differential equations (SDEs) arise from physical systems where the parameters describing the system can only be estimated or are subject to noise. Much work has been done recently on developing higher order Runge-Kutta methods for solving SDEs numerically. Fixed stepsize implementations of numerical methods have limitations when, for example, the SDE being solved is stiff as this forces the stepsize to be very small. This paper presents a completely general variable stepsize implementation of an embedded Runge Kutta pair for solving SDEs numerically; in this implementation, there is no restriction on the value used for the stepsize, and it is demonstrated that the integration remains on the correct Brownian path.

Information and Technology Implementation Issues in AAL Solutions

With the population ageing effect, the technological developments, and pressure to reduce the cost with healthcare, are reunited the conditions for the development of Ambient Assisted Living (AAL) solutions. This work is a revision of the current state of the art. Its aim is the characterization of the AAL solutions, within the AAL4ALL scope. Therefore, it is presented features, scenarios and projects, referring the limitations and the opportunities for the future developments of prototypes using high level information and technology in AAL environments. Moreover, it is presented guidelines of operation, exposing the conceptual approach, and the discussion and conclusion, which present recommendations and current AAL4ALL project positions in terms of concepts and technologies.

The ICT use in the implementation of Directive 2011/24/EU

This article has as main objective to evaluate the role of information and communication technologies (ICTs), in particular the eHealth (electronic health), in the implementation of the directive 2011/24/EU, of the European Parliament and of the Council of March 9th, on the exercise of patients' rights in cross-border healthcare within Member States of European Union. Being currently underway the deadline for transposition of the Directive, it is important to analyze the probable results for national health systems. Innovatively, the Directive specifically proposes the implementation of a European network of eHealth in the provision of cross-border healthcare. Within ICT, we focus on telemedicine as a key tool for the implementation, on a context of public budgets constrains. In this context, it is assumed that the EU will support and promote cooperation and the exchange of scientific information between member states within the framework of a voluntary network composed by the national authorities responsible for health (or eHealth). We apply the S.W.O.T. (strengths and weaknesses, opportunities and threats) analysis to forecast the main points that should be focused on deeper research. We discuss the technological, economic and social aspects of the use of ICT on the implementation of the directive. It is thus important to evaluate the context of ICT by S.W.O.T. tool to define strategies to sensitize policy-makers, health managers, and citizens, in order to be able to turn threats into opportunities and mitigating the weaknesses in the implementation of the Directive and to promote a better healthcare access for citizens, ensuring safe, effective healthcare and with different quality.

Factors Influencing the Implementation of the Balanced Scorecard in Portugal: Empirical Evidence From Privately Owned and Publicly Owned Organizations

In this paper we aim to identify and analyze a set of variables that can potentially influence the adoption and knowledge of the Balanced Scorecard (BSC) in Portugal. Hypotheses were tested using data obtained from a questionnaire sent to 591 publicly-owned organizations (local governments, municipal corporations and hospitals) and 549 privately-owned organizations (large companies and small and medium enterprises) in Portugal. The results allow us to conclude that although the majority of respondents claimed to know the BSC, its use in Portugal is still limited and very recent, particularly in the public sector organizations. However, it should be noted that its use has increased in Portugal in recent years. The study also reveals that in spite of the noticeable differences between public and private sector, the BSC is used in the public sector after a few adjustments to the traditional model. Using as theoretical framework the contingency and institutional theories, we found that decentralization, vertical differentiation and the degree of higher education are associated with the implementation of the BSC.

The Adoption and Implementation of the Balanced Scorecard: The Largest Portuguese Companies Case

Balanced Scorecard (BSC) is recognized, both in the academic and business world, as one of the most powerful strategic management accounting tools. Thus, we launched in October 2004 a questionnaire survey applied to the 250 largest Portuguese companies aiming at observing the knowledge, use, and companies’ characteristics which are adopting this management instrument. Despite the majority of the companies inquired recognize BSC more as a strategic management tool than a performance valuation system, the results show that there is still a reduced and recent utilization of BSC in Portugal. Similarly to other countries Portugal is still in the initial state of BSC utilization. Our work has shown that the companies that use more BSC belong mainly to the secondary sector of industry. Nevertheless, unlike other studies, we did not get empirical evidence on the influence of variables such as geographical localization, dimension and internationalization, in the use and knowledge of BSC in Portugal.

Motivation and Benefits of Implementation and Certification according ISO 9001 – the Portuguese Experience

The aim of the research is to analyze the different aspects associated with the motivation and benefits of certified ISO 9001 companies in Portugal. A total of 426 certified Portuguese companies were surveyed. The response rate was equal to 61.03 percent. Our results suggest that the main motivation for certification were “improvement of quality”, “improvement of company image”, “marketing advantage”, “give empowerment to workers / capturing workers knowledge” and “cost reduction”. The main benefits that Portuguese companies have gained from the referred certification have been, among others, the improvement of “procedures”, beneficial effect on the “company’s image”, the improvement of quality products/services, increase of the “customer satisfaction”, improvement of “on-time delivery”; improvement the “morale” of workers’ increase in productivity and decrease of “production costs”, among others. The surveyed firms belong only to the Minho region of the north of Portugal. This paper aims to provide a contribution to the research related to the motivation and benefits associated to the quality management systems. The selection of the motives and benefits were validated through statistical analysis and the relationship between expected and perceived benefits was discussed.

Determinant factors of the implementation of the balanced scorecard in Portugal: empirical evidence in public and private organizations

In this article we aim to identify and analyze a set of variables that can potentially influence the adoption of the Balanced Scorecard (BSC)in Portugal. Hypotheses were tested using data obtained from a questionnaire sent to 591 publicly-owned organizations (local governments, municipal corporations and hospitals) and 549 privately-owned organizations (large companies and small and medium enterprises) in Portugal, with an overall response rate of 31.3%. The results allow us to conclude that although the majority of respondents claimed to know the BSC, its use in Portugal is still limited and very recent, particularly in the public sector organizations. However, it should be noted that its use has increased in Portugal in recent years. Using as theoretical framework the contingency and institutional theories, we found that decentralization, vertical differentiation and the degree of higher education are associated with the implementation of the BSC.

IMPLEMENTATION OF GREEN IT IN ORGANIZATIONS: A STRUCTURATIONAL VIEW

ABSTRACTEnvironmental sustainability has become increasingly important to businesses as a response to the rapid depletion of natural resources. Information Technology (IT) in particular represents a meaningful part of the environmental issues that society has been facing. Therefore, Green IT emerges as a way of combining available resources and sustainable and economic policies, thus, generating benefits for both the environment and businesses. The purpose of this paper, hence, is to explain the dynamics of Green IT implementation in organizations in light of the structurationist view of technology. We conducted a case study research based on the cases of three Brazilian companies interested in this movement. Results provide a better understanding of the relationship among technology, individuals, and organization institutional properties, thus enhancing the role played by IT teams in institutionalizing the environmental dimension of sustainability in organizations.

Evaluation of the improvements on pharmacy technicians' work practices after implementation of operational procedures

Several antineoplasic drugs have been demonstrated to be carcinogenic or to have mutagenic and teratogenic effects. The greatest protection is achieved with the implementation of administrative and engineering controls and safety procedures. Objective: to evaluate the improvements on pharmacy technicians' work practices, after the implementation of operational procedures related to individual protection, biologic safety cabinet disinfection and cytotoxic drug preparation. Method: case-study in a hospital pharmacy undergoing a certification process. Six pharmacy technicians were observed during their daily activities. Characterization of the work practices was made using a checklist based on ISOPP and PIC guidelines. The variables studied concerning cleaning/disinfection procedures, personal protective equipment and procedures for preparing cytotoxic drugs. The same work practices were evaluated after four months of operational procedures implementation. Concordance between work practices and guidelines was considered to be a quality indicator (guidelines concordance practices number/total number of practices x 100). Results: improvements were observed after operational procedures implementation. An improvement of 6,25% in personal protective equipment practice was achieved by changing second pair of gloves every thirty minutes. The major progress, 10%, was obtained in disinfection procedure, where 80% of tasks are now realized according to guidelines.By now, we hot an improvement of only 1% at drug preparation procedure by placing one cytotoxic drug at a time inside the biological safety cabinet. Then, 85% of practices are according to guidelines. Conclusion: before operational procedures implementation 80,3% of practices were according to the guidelines, while now is 84,4%. This indicates that is necessary to review the procedures frequently in the benefit to reduce the risks associated with handling cytotoxic drugs and maintenance of drug specifications.

Multi-agent based electricity market simulator with VPP: Conceptual and implementation issues

This paper presents a new architecture for the MASCEM, a multi-agent electricity market simulator. This is implemented in a Prolog which is integrated in the JAVA program by using the LPA Win-Prolog Intelligence Server (IS) provides a DLL interface between Win-Prolog and other applications. This paper mainly focus on the MASCEM ability to provide the means to model and simulate Virtual Power Producers (VPP). VPPs are represented as a coalition of agents, with specific characteristics and goals. VPPs can reinforce the importance of these generation technologies making them valuable in electricity markets.