873 resultados para non-dialysis management


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Demands are one of the most uncertain parameters in a water distribution network model. A good calibration of the model demands leads to better solutions when using the model for any purpose. A demand pattern calibration methodology that uses a priori information has been developed for calibrating the behaviour of demand groups. Generally, the behaviours of demands in cities are mixed all over the network, contrary to smaller villages where demands are clearly sectorised in residential neighbourhoods, commercial zones and industrial sectors. Demand pattern calibration has a final use for leakage detection and isolation. Detecting a leakage in a pattern that covers nodes spread all over the network makes the isolation unfeasible. Besides, demands in the same zone may be more similar due to the common pressure of the area rather than for the type of contract. For this reason, the demand pattern calibration methodology is applied to a real network with synthetic non-geographic demands for calibrating geographic demand patterns. The results are compared with a previous work where the calibrated patterns were also non-geographic.

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If conducted poorly and without support from all employee levels, performance management programs at institutions may devolve into annual evaluations that represent a staff burden rather than an ongoing career development opportunity. This brief analyzes the key components of successful performance evaluation systems for non-academic staff, incorporating insights from employers outside of the higher education sector as well. It examines the importance of midyear check-in meetings; employee goal-setting; simplified rating scales on evaluation forms; and core staff competencies that reflect institutional priorities. It also describes how institutions communicate modifications to the evaluation system and offers recommendations for the implementation of process change.

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This research investigates the factors that lead Latin American non-financial firms to manage risks using derivatives. The main focus is on currency risk management. With this purpose, this thesis is divided into an introduction and two main chapters, which have been written as stand-alone papers. The first paper describes the results of a survey on derivatives usage and risk management responded by the CFOs of 74 Brazilian non-financial firms listed at the São Paulo Stock Exchange (BOVESPA), and the main evidence found is: i) larger firms are more likely to use financial derivatives; ii) foreign exchange risk is the most managed with derivatives; iii) Brazilian managers are more concerned with legal and institutional aspects in using derivatives, such as the taxation and accounting treatment of these instruments, than with issues related to implementing and maintaining a risk management program using derivatives. The second paper studies the determinants of risk management with derivatives in four Latin American countries (Argentina, Brazil, Chile and Mexico). I investigate not only the decision of whether to use financial derivatives or not, but also the magnitude of risk management, measured by the notional value of outstanding derivatives contracts. This is the first study, to the best of my knowledge, to use derivatives holdings information in emerging markets. The use of a multi-country setting allows the analysis of institutional and economic factors, such as foreign currency indebtedness, the high volatility of exchange rates, the instability of political and institutional framework and the development of financial markets, which are issues of second-order importance in developed markets. The main contribution of the second paper is on the understanding of the relationship among currency derivatives usage, foreign debt and the sensitivity of operational earnings to currency fluctuations in Latin American countries. Unlikely previous findings for US firms, my evidence shows that derivatives held by Latin American firms are capable of producing cash flows comparable to financial expenses and investments, showing that derivatives are key instruments in their risk management strategies. It is also the first work to show strong and robust evidence that firms that benefit from local currency devaluation (e.g. exporters) have a natural currency hedge for foreign debt that allows them to bear higher levels of debt in foreign currency. This implies that firms under this revenue-cost structure require lower levels of hedging with derivatives. The findings also provide evidence that large firms are more likely to use derivatives, but the magnitude of derivatives holdings seems to be unrelated to the size of the firm, consistent with findings for US firms.

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O aumento de empresas que operam internacionalmente requer o desenvolvimento de líderes mundiais para colocar as estratégias em prática. Embora este processo de desenvolvimento é importante para o mundo corporativo, muitos futuros executivos são graduados de escolas de administração de empresas que estão intimamente ligados ao mundo de negócios e, portanto, desempenhão um papel importante no processo. Esta pesquisa examina se os programas europeus “Master in Management” classificado pelo Financial Times em 2010 selecionam aqueles candidatos que são mais adequados para o desenvolvimento de liderança global. Portanto, três anteriores meta-estudos são sintetizados para produzir um perfil de competências classificadas de um líder global. Então, informações sobre os critérios de admissão dos programas de mestrado são coletadas e comparadas com este perfil. Os resultados mostram que seis competências são medidas por mais da metade dos programas: proficiência em Inglês, capacidade analítica (racionamento lógico e quantitativo), capacidade de comunicação, conhecimento do negócio global, determinação para alcançar, motivação e capacidade interpessoal. Além disso, as habilidades operacionais requerentes pelos líderes globais não são significativas no processo de admissão e o foco é sobre as habilidades analíticas. Comparação dos resultados com o perfil anteriormente desenvolvido abrangente indica que uma quantidade significativa de programas pode subestimar o significado de habilidades pessoais e características para o desenvolvimento de líderes globais.

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Drawing upon Brazilian experience, this research explores some of the key issues to be addressed in using e-government technical cooperation designed to enhance service provision of Patent Offices in developing countries. While the development of software applications is often seen merely as a technical engineering exercise, localization and adaptation are context bounded matters that are characterized by many entanglements of human and non-humans. In this work, technical, legal and policy implications of technical cooperation are also discussed in a complex and dynamic implementation environment characterized by the influence of powerful hidden agendas associated with the arena of intellectual property (IP), which are shaped by recent technological, economic and social developments in our current knowledge-based economy. This research employs two different theoretical lenses to examine the same case, which consists of transfer of a Patent Management System (PMS) from the European Patent Office (EPO) to the Brazilian Patent Office that is locally named ‘Instituto Nacional da Propriedade Industrial’ (INPI). Fundamentally, we have opted for a multi-paper thesis comprising an introduction, three scientific articles and a concluding chapter that discusses and compares the insights obtained from each article. The first article is dedicated to present an extensive literature review on e-government and technology transfer. This review allowed the proposition on an integrative meta-model of e-government technology transfer, which is named E-government Transfer Model (ETM). Subsequently, in the second article, we present Actor-Network Theory (ANT) as a framework for understanding the processes of transferring e-government technologies from Patent Offices in developed countries to Patent Offices in developing countries. Overall, ANT is seen as having a potentially wide area of application and being a promising theoretical vehicle in IS research to carry out a social analysis of messy and heterogeneous processes that drive technical change. Drawing particularly on the works of Bruno Latour, Michel Callon and John Law, this work applies this theory to a longitudinal study of the management information systems supporting the Brazilian Patent Office restructuration plan that involved the implementation of a European Patent Management System in Brazil. Based upon the ANT elements, we follow the actors to identify and understand patterns of group formation associated with the technical cooperation between the Brazilian Patent Office (INPI) and the European Patent Office (EPO). Therefore, this research explores the intricate relationships and interactions between human and non-human actors in their attempts to construct various network alliances, thereby demonstrating that technologies embodies compromise. Finally, the third article applies ETM model as a heuristic frame to examine the same case previously studied from an ANT perspective. We have found evidence that ETM has strong heuristic qualities that can guide practitioners who are engaged in the transfer of e-government systems from developed to developing countries. The successful implementation of e-government projects in developing countries is important to stimulate economic growth and, as a result, we need to understand the processes through which such projects are being implemented and succeed. Here, we attempt to improve understanding on the development and stabilization of a complex social-technical system in the arena of intellectual property. Our preliminary findings suggest that e-government technology transfer is an inherently political process and that successful outcomes require continuous incremental actions and improvisations to address the ongoing issues as they emerge.

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This paper investigates the importance of the fiow of funds as an implicit incetive provided by investors to portfolio managers in a two-period relationship. We show that the fiow of funds is a powerful incentive in an asset management contract. We build a binomial moral hazard model to explain the main trade-ofIs in the relationship between fiow, fees and performance. The main assumption is that efIort depend" on the combination of implicit and explicit incentives while the probability distrioutioll function of returns depends on efIort. In the case of full commitment, the investor's relevant trade-ofI is to give up expected return in the second period vis-à-vis to induce efIort in the first período The more concerned the investor is with today's payoff. the more willing he will be to give up expected return in the following periods. That is. in the second period, the investor penalizes observed low returns by withdrawing resources from non-performing portfolio managers. Besides, he pays performance fee when the observed excess return is positive. When commitment is not a plausible hypothesis, we consider that the investor also learns some symmetríc and imperfect information about the ability of the manager to generate positive excess returno In this case, observed returns reveal ability as well as efIort choices exerted by the portfolio manager. We show that implicit incentives can explain the fiow-performance relationship and, conversely, endogenous expected return determines incentives provision and define their optimal leveIs. We provide a numerical solution in Matlab that characterize these results.

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We evaluated the water characteristics and particle sedimentation in Macrobrachium amazonicum (Heller 1862) grow-out ponds supplied with a high inflow of nutrient-rich water. Prawns were subject to different stocking and harvesting strategies: upper-graded juveniles, lower-graded juveniles, non-graded juveniles + selective harvesting and traditional farming (non-grading juveniles and total harvest only). Dissolved oxygen, afternoon N-ammonia and N-nitrate and soluble orthophosphate were lower in the ponds in comparison with inflow water through the rearing cycle. Ponds stocked with the upper population fraction of graded prawns showed higher turbidity, total suspended solids and total Kjeldahl nitrogen than the remaining treatments. An increase in the chemical oxygen demand:biochemical oxygen demand ratio from inlet (4.9) to pond (7.1-8.0) waters indicated a non-readily biodegradable fraction enhancement in ponds. The sedimentation mean rate ranged from 0.08 to 0.16 mm day(-1) and sediment contained >80% of organic matter. The major factors affecting pond ecosystem dynamic were the organic load (due to primary production and feed addition) and bioturbation caused by stocking larger animals. Data suggest that M. amazonicum grow-out in ponds subjected to a high inflow of nutrient-rich water produce changes in the water properties, huge accumulation of organic sediment at the pond bottom and non-readily biodegradable material in the water column. However, the water quality remains suitable for aquaculture purposes. Therefore, nutrient-rich waters, when available, may represent a source of unpaid nutrients, which may be incorporated into economically valued biomass if managed properly.

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The increased availability of soil water is important for the management of non-irrigated orange orchards. The objective of this study was to evaluate the availability of soil water in a Haplorthox (Rhodic Ferralsol) under different tillage systems used for orchard plantation, mulch management and rootstocks in a "Pera" orange orchard in northwest Parana, Brazil. An experiment in a split-split-plot design was established in 2002, in an area cultivated with Brachiaria brizantha grass in which three tillage systems (no tillage, conventional tillage and strip-tillage) were used for orchard plantation. This grass was mowed twice a year between the rows, representing two mulch managements in the split plots (no mulching and mulching in the plant rows). The split-split-plots were represented by two rootstocks ("Rangpur" lime and "Cleopatra" mandarin). The soil water content in the plant rows was evaluated in the 0-20 cm layer in 2007 and at 0-20 and 20-40 cm in 2008-2009. The effect of soil tillage systems prior to implantation of orange orchards on soil water availability was less pronounced than mulching and the rootstocks. The soil water availability was lower when "Pera" orange trees were grafted on "Cleopatra" mandarin than on "Rangpur" lime rootstocks. Mulching had a positive influence on soil water availability in the sandy surface layer (020 cm) and sandy clay loam subsurface (20-40 cm) of the soil in the spring. The production of B. brizantha between the rows and residue disposal in the plant rows as mulch increased water availability to the "Pera" orange trees.

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Intensity of dialysis dose in acute kidney injury (AKI) might benefit critically ill patients. The aim of this study was to evaluate the effect of intermittent hemodialysis (IHD) dose on mortality in patients with AKI. Methods: Prospective observational study was performed on AKI patients treated with IHD. The delivered dialysis dose per session was calculated based on single-pool Kt/V urea. Patients were allocated in two groups according to the weekly delivered median Kt/V: higher intensity dialysis dose (HID: Kt/V higher than median) and lower intensity dialysis dose (LID: Kt/V lower than median). Thereafter, AKI patients were divided according to the presence or absence of sepsis and urine output. Clinical and lab characteristics and survival of AKI patients were compared. Results: A total of 121 AKI patients were evaluated. Forty-two patients did not present with sepsis and 45 did not present with oliguria. Mortality rate after 30 days was lower in the HID group without sepsis (14.3% x 47.6%; p = 0.045) and without oliguria (31.8% x 69.5%; p = 0.025). Survival curves also showed that the HID group had higher survival rate when compared with the LID group in non-septic and non-oliguric patients (p = 0.007 and p = 0.003, respectively). Conclusion: Higher dialysis doses can be associated with better survival of less seriously ill AKI patients.

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Background and objectives Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil.Design, setting, participants, & measurements Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis.Results In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center.Conclusions Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities. Clin J Am Soc Nephrol 6: 1944-1951, 2011. doi: 10.2215/CJN.11431210

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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A apoplexia pituitária é uma rara síndrome neuroendócrina causada, na maioria dos casos, pela hemorragia ou enfarte de um adenoma pituitário preexistente. O tratamento recomendado é variável; alguns autores defendem a descompressão cirúrgica do tumor em regime de urgência, enquanto outros sugerem que o tratamento conservador pode levar à recuperação da função neuroftalmológica. Descrevemos os casos de dois pacientes com apoplexia pituitária que apresentaram macroadenomas clinicamente não secretores e hipopituitarismo, incluindo hipogonadismo. Ambos foram submetidos ao tratamento conservador, sem cirurgia, e houve a remissão do tumor.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)