Benefits, harms and costs of screening mammography in women 70 years and over: a systematic review

Objective: To assess the (i) benefits, (ii) harms and (iii) costs of continuing mammographic screening for women 70 years and over. Data sources and synthesis: (i) We conducted a MEDLINE search (1966 - July 2000) for decision-analytic models estimating life-expectancy gains from screening in older women. The five studies meeting the inclusion criteria were critically appraised using standard criteria. We estimated relative benefit from each model's estimate of effectiveness of screening in older women relative to that in women aged 50-69 years using the same model. (ii) With data from BreastScreen Queensland, we constructed balance sheets of the consequences of screening for women in 10-year age groups (40-49 to 80-89 years), and (iii) we used a validated model to estimate the marginal cost-effectiveness of extending screening to women 70 years and over. Results: For women aged 70-79 years, the relative benefit was estimated as 40%-72%, and 18%-62% with adjustment for the impact of screening on quality of life. For women over 80 years the relative benefit was about a third, and with quality-of-life adjustment only 14%, that in women aged 50-69 years. (ii) Of 10 000 Australian women participating in ongoing screening, about 400 are recalled for further testing, and, depending on age, about 70-112 undergo biopsy and about 19-80 cancers are detected. (iii) Cost-effectiveness estimates for extending the upper age limit for mammographic screening from 69 to 79 years range from $8119 to $27 751 per quality-adjusted life-year saved, which compares favourably with extending screening to women aged 40-49 years (estimated at between $24 000 and $65 000 per life-year saved). Conclusions: Women 70 years and over, in consultation with their healthcare providers, may want to decide for themselves whether to continue mammographic screening. Decision-support materials are needed for women in this age group.

Class benefits of AT1 antagonists in Type 2 diabetes with nephropathy

Diabetes mellitus has reached epidemic proportions in many countries and is the most common cause of end stage renal disease (ESRD). The angiotensin II receptor-1 (AT1) antagonists losartan and irbesartan have recently been evaluated as renoprotective agents in large clinical trials of patients with Type 2 diabetes and nephropathy. In the Reduction of End points in Non-insulin-dependent diabetes mellitus with the Angiotensin II Antagonist (RENAAL) study, losartan decreased the number of patients reaching the primary end point of a composite of measures of neuropathy. The relative risk reduction was ~ 15% with losartan and this was due to a reduction in both the doubling of creatinine concentration (25%) and of ESRD (28%) but not in death. In the Irbesartan Diabetic Nephropathy Trial (IDNT), the beneficial effect of irbesartan was mainly against the doubling of the baseline creatinine concentration (37% risk reduction) but there was also a 20% reduction in the onset of ESRD. Irbesartan had no effect on mortality. Beneficial effects occurred in addition to blood pressure being controlled by agents other than the AT1 antagonists. These clinical trials suggest that there may be a class renoprotective action with AT1 antagonists, although the mechanism is not clear. Patients with Type 2 diabetes and nephropathy should receive either an AT1 antagonist or the angiotensin converting enzyme inhibitor ramipril to ensure renoprotection.

The quest for a sustainable product: An environmental study of tyre recyclates

The main objective of the present study is to assess the environmental advantages of substituting aluminium for a polymer composite in the manufacture of a structural product (a frame to be used as a support for solar panels). The composite was made of polypropylene and a recycled tyres’ rubber granulate. Analysis of different composite formulations was performed, to assess the variation of the environmental impact with the percentage of rubber granulate incorporation. The results demonstrate that the decision on which of the two systems (aluminium or composite) has the best life cycle performance is strongly dependent on the End-of Life (EoL) stage of the composite frame. When the EoL is deposition in a landfill, the aluminium frame performs globally better than its composite counterpart. However, when it is incineration with energy recovery or recycling, the composite frame is environmentally preferable. The raw material production stage was found to be responsible for most of the impacts in the two frame systems. In that context, it was shown that various benefits can accrue in several environmental impact categories by recycling rubber tyres and using the resulting materials. This is in a significant part also due to the recycling of the steel in the tyres. The present work illustrates how it is possible to minimize the overall environmental impact of consumer products through the adequate selection of their constitutive materials in the design stage. Additionally it demonstrates how an adequate EoL planning can be an important issue when developing a sustainable product, since it can highly influence its overall life cycle performance.

Certification and integration of management systems: the experience of Portuguese small and medium enterprises

The purpose of this study was to characterize the situation of Portuguese Small and Medium Enterprises (SMEs) concerning the certification of their Quality Management Systems (QMS), Environmental Management Systems (EMS) and Occupational Health and Safety Management Systems (OHSMS), in their individually form, to identify benefits, drawbacks and difficulties associated with the certification process and to characterize the level of integration that has been achieved. This research was based on a survey carried out by the research team; it was administered to 46 Portuguese SMEs. Our sample comprised 20 firms (43%) from the Trade/Services activity sector, 17 (37%) from the Industrial sector, 5 (11%) from the Electricity/Telecommunications sector and 4 (9%) from the Construction area. All SMEs surveyed were certified according to the ISO 9001 (100%), a quarter of firms were certified according to the ISO 14001 (26.1%) and a few certified by OHSAS 18001 (15.2%). We undertook a multivariate cluster analysis, which enabled grouping variables into homogeneous groups or one or more common characteristics of the SMEs participating in the study. Results show that the main benefits that Portuguese SMEs have gained from the referred certifications have been, among others, an improvement of both their internal organization and external image. We also present the main difficulties in achieving certification. Overall, 7 of the Portuguese SMEs examined indicated that the main benefits of the IMS implementation management included costs reduction, increased employee training and easier compliance of legislation. The respective drawbacks and difficulties are also presented. Finally, we presented the main integrated items in the certified Portuguese SMEs we examined.

Architectural prototyping: from CCS to .Net

Over the last decade, software architecture emerged as a critical issue in Software Engineering. This encompassed a shift from traditional programming towards software development based on the deployment and assembly of independent components. The specification of both the overall systems structure and the interaction patterns between their components became a major concern for the working developer. Although a number of formalisms to express behaviour and to supply the indispensable calculational power to reason about designs, are available, the task of deriving architectural designs on top of popular component platforms has remained largely informal. This paper introduces a systematic approach to derive, from CCS behavioural specifications the corresponding architectural skeletons in the Microsoft .Net framework, in the form of executable C and Cω code. The prototyping process is fully supported by a specific tool developed in Haskell

Prototyping Behavioural Specifications in the.NET framework

Over the last decade, software architecture emerged as a critical design step in Software Engineering. This encompassed a shift from traditional programming towards the deployment and assembly of independent components. The specification of the overall system structure, on the one hand, and of the interactions patterns between its components, on the other, became a major concern for the working developer. Although a number of formalisms to express behaviour and supply the indispensable calculational power to reason about designs, are available, the task of deriving architectural designs on top of popular component platforms has remained largely informal. This paper introduces a systematic approach to derive, from behavioural specifications written in Ccs, the corresponding architectural skeletons in the Microsoft .Net framework in the form of executable C] code. Such prototyping process is automated by means of a specific tool developed in Haskell

Guimarães residents’ perceptions towards tourism impacts: a cluster analysis

The present study was designed to assess and segment local residents with respect to their perceived impacts of Guimarães tourism development. The residents of this municipality (located in the northern part of Portugal) are quite strong in their support to tourism. However, they do not keep a homogeneous perception of tourism impacts. A clusters analysis using data from a survey of 400 Guimarães residents’ has revealed the existence of three clusters, according the different degrees of perceived tourism impacts: the Skeptics - moderate in relation to the benefits (averages range from 2.89-3.74) and the ones more concerned with its costs (averages range from 2.86-3.74); the Moderately optimistic - very optimistic about the benefits of tourism (averages range from 3.74-4.51) and conscious of the costs (averages range from 2.71-3.49); the Enthusiasts - very optimistic about tourism benefits (averages range from 2.92-4.52) and little worried about its costs (averages range from 1.78-3.26). Following the data from the survey, the findings are discussed and a few conclusions are extracted.

Eigenvalue computations in the context of data-sparse approximations of integral operators

In this work, we consider the numerical solution of a large eigenvalue problem resulting from a finite rank discretization of an integral operator. We are interested in computing a few eigenpairs, with an iterative method, so a matrix representation that allows for fast matrix-vector products is required. Hierarchical matrices are appropriate for this setting, and also provide cheap LU decompositions required in the spectral transformation technique. We illustrate the use of freely available software tools to address the problem, in particular SLEPc for the eigensolvers and HLib for the construction of H-matrices. The numerical tests are performed using an astrophysics application. Results show the benefits of the data-sparse representation compared to standard storage schemes, in terms of computational cost as well as memory requirements.

Rootstocks resistant to Meloidogyne incognita and compatibility of grafting in net melon

Due to the few studies about grafting in net melon, in order to obtain better control of soil pathogens, the aim of the present study was to evaluate 16 genotypes of Cucurbitaceae: Benincasa hispida, Luffa cylindrica, pumpkin 'Jacarezinho', pumpkin 'Menina Brasileira', squash 'Exposição', squash 'Coroa', pumpkin 'Canhão Seca', pumpkin 'Squash', pumpkin 'Enrrugado Verde', pumpkin 'Mini Paulista', pumpkin 'Goianinha', watermelon 'Charleston Gray', melon 'Rendondo Gaucho', melon 'Redondo Amarelo', cucumber 'Caipira HS' and cucumber 'Caipira Rubi', regarding to compatibility of grafting in net melon and resistance to Meloidogyne incognita, based on the reproduction factor (RF), according to Oostenbrink (1966). To assess resistance, the seedlings were transplanted to ceramic pots and inoculated with 300/mL eggs and/or second stage juveniles of M. incognita. At 50 days after transplanting, the plants were removed from the pots and the resistance was evaluated. The compatibility between resistant rootstock and grafts of net melon was determined by performing simple cleft grafting, in a commercial net melon hybrid of great market acceptance and susceptible to M. incognita (Bonus no. 2). The genotypes Luffa cylindrica, pumpkin 'Goianinha', pumpkin 'Mini-Paulista', melon 'Redondo Amarelo', watermelon 'Charleston Gray' are resistant to the nematode M. incognita. The better compatibilities occurred with the rootstocks melon 'Amarelo', which presented 100% of success, followed by pumpkin 'Mini-Paulista' with 94%. On the other hand, Sponge gourd, watermelon 'Charleston Gray' and pumpkin 'Goianinha' showed low graft take percentages of 66%, 62% and 50%, respectively.

Capital Intelectual: sua divulgação no setor bancário em Portugal

The importance of intangible resources has increased dramatically in recent years comparing to tangible ones. The economy in which we live is the result of competitive pressures that have imposed the implementation of business at an international level as well as a requirement in the application of sophisticated technologies that allow us to follow this fast evolution. In this age of information and innovation organizations will only survive if they are inserted in a global network of strategic relations, generically called as the network economy by Lev (2003). The service sector has stood out against the more traditional sectors of the economy. The intensive use of knowledge and a strong customer orientation created a new reality in today’s organizations: a growing importance attached to innovation, to the quality of products and services offered, to the information and communication technologies adopted, and to the creativity and particular abilities of human resources. The concept of intangible assets is more common in an accounting language and intellectual capital is most often applied in the context of management, being associated with a more comprehensive, multidimensional approach, representing all the knowledge that the institution owns and that it applies in the form of expertise, the creativity and organizational competencies that lead to innovation and to the sustained attainment of future economic benefits. An analysis of the scope of intellectual capital is fundamental to take more appropriate management decisions so that a more appropriate accounting treatment could be given by the accounting standardization organizations. This study intends to analyse the practices of information disclosure of the intellectual capital in the banking sector in Portugal, complementing the analysis of the disclosure of intangible assets in the context of accounting standards with the disclosure of intellectual capital in the context of organizational management. In particular, our main aims are to identify the extent of disclosure of intellectual capital made by banks in Portugal and also to identify the factors that determine such a disclosure. The disclosure in the context of accounting standards will be studied by checking the disclosure of intangible assets through the items listed in the International Accounting Standard 38 developed by the International Accounting Standards Board. The context of management was analysed by means of creating a voluntary disclosure index based on assumptions of the model Intellectus, developed by the Centro de Investigación sobre la Sociedad del Conocimiento – Instituto de Administración de Empresas (CIC-IADE) of the Universidad Autónoma of Madrid, and of the model Intellectual Capital Statement (made in Europe) (InCaS), both promoted by the European Commission and that we have adapted to the banking sector. When analysing the disclosure of intangible assets based on the context of accounting standards and the voluntary disclosure of intellectual capital, this study has tried to raise awareness about the importance of issuing reports on the intellectual capital as an alternative tool to take management decisions in the existing organizations and reflects the transparency and legitimacy that these institutions seek through a more extensive and more detailed information disclosure of their intellectual capital. Based on a complimentarily of economic theories, together with social and political theories, we tried to check the extent, evolution and tendencies of the compulsory disclosure of intangible assets and of the voluntary disclosure of the intellectual capital analysed in the period 2001-2011. Banks characteristics were also analysed in order to deduce those factors that determine or promote a larger disclosure in this sector. Based on these objectives, we adopted a longitudinal approach to explore the extent and the development of the disclosure of intangible assets as well as the factors that have determined it. Furthermore, we sought to assess the impact of the adoption of IAS 38 in the financial statements of the organizations in this sector. The disclosure index created on the basis of the disclosure requirements stated in IAS 38 from IASB was applied to the consolidated financial statements of the seventeen banks that rendered their statements in Portugal from 2001 to 2009. Since the information disclosed in the context of accounting standards may not have an important role as a management tool once it was not able to reflect what really contributes to the competitiveness and organizational growth, the voluntary disclosure of the intellectual capital was analysed according to the information obtained from the 2010 annual individual reports of the banks operating in Portugal in that year and from their respective websites in 2011. We tried to analyse the extent of the voluntary disclosure of the intellectual capital and of each of its components, human capital, structural capital and relational capital. The comparative analysis of their annual reports and their web pages allowed us to assess the incidence of the disclosure and discover what channel the banking sector focuses on when disclosing their intellectual capital. Also in this analysis the study of the disclosure determinants has allowed us to conclude about the influence of particular characteristics in the voluntary disclosure of the intellectual capital. The results of the analysis to the extent of the disclosure of intangible assets in the consolidated financial statements of the banking groups in Portugal in the period 2001-2009 have shown an average information disclosure of 0.24. This information disclosure evolved from an average value of 0.1940 in 2001 to 0.2778 in 2009. The average value is 0.8286 if it is only considered the disclosure of the intangible assets that the banks possessed. The evolution of this index means an increase in the average disclosure from 0.7852 in 2001 to 0.8788 in 2009. From the first results that are related to the extent of the disclosure of intangible assets in the financial statements, we can verify that the banking groups present a low disclosure level of these resources. However, when considering the disclosure of only the intangible assets that each institution owns, the disclosure level appears to be in compliance with the disclosure requirements for this sector. An evolution in the disclosure of intangible assets for the period considered was confirmed, showing an increase in the information disclosure of intangible assets in 2005, the year in which the accounting rules for intangible assets changed. The analysis that focused on the disclosure in the context of management tried to understand the extent, the incidence and the determinants of the voluntary information disclosure of intellectual capital in the annual reports of 2010 and on their web pages in 2011, studying the 32 banks operating in Portugal in this period. The average voluntary disclosure of the intellectual capital in the 2010 annual reports is 0.4342 while that in web pages is 0.2907. A review of the components of the intellectual capital allowed us to assess the importance that the banks confer to each of these components. The data obtained show that the relational capital, and more specifically the business capital, is the most disclosed component by banks in Portugal both in the annual reports and in their institutional web pages, followed by the structural capital and, finally, by the human capital. The disclosure of the human capital and the structural capital is higher in the annual reports than that in the websites, while the relational capital is more disclosed in the websites than in the annual reports. The results have also shown that the banks make a complementary use of both sources when disclosing information about their structural capital and relational capital but they do not show any information about their human capital in their websites. We tried to prove the influence of factors that could determine the accounting disclosure and the voluntary disclosure of the intellectual capital in this sector. The change in the IASB accounting rules as from January 1st 2005 gave a greater disclosure of accounting information of intangible assets in the financial statements of banks. The bank size and corporate governance measures have statistically proved to have an influence on the extent of the accounting disclosure of intangible assets and on the voluntary disclosure of the intellectual capital. Economic and financial variables such as profitability, operating efficiency or solvency were not determinants of information disclosure. The instability that the banking sector has experienced in economic and financial indicators in recent years as a result of the global financial markets imbalance has worsen indicators such as profitability, efficiency and solvency and caused major discrepancies in the economic situation between banks in Portugal. This empirical analysis has contributed to confront the disclosure required by accounting rules performed in the financial statements of organizations with that performed in the main disclosure media which is available for entities and which is increasingly requested in the process of taking management decisions. It also allowed us to verify whether there is homogeneity between institutions in the fulfilment of the requirements for information disclosure of intangible assets. However, as for voluntary disclosure of intellectual capital, there are large disparities in the disclosure extent between organizations. Regardless of this sector specific characteristics, the voluntary disclosure of intellectual capital made by banks in Portugal follows the trends in other sectors and the practices adopted in other countries, namely regarding the amount of information disclosed, the incidence of the disclosure on the indicators of relational capital and the importance of variables such as size as determinants of disclosure of intellectual capital. For a further knowledge in this field, we created a specific index for the banking sector, considering appropriate indicators for an incisive, comprehensive analysis in order to consider the most relevant indicators of intellectual capital components. Besides, confronting the analysis of disclosure in the context of accounting standards with the study of voluntary disclosure brought a new analysis approach to the research on intellectual capital disclosure. With this study, we have also intended to raise greater awareness of the need for harmonization in the intellectual capital disclosure on the part of the regulatory banking authority by means of a demanding, consistent and transparent report of intellectual capital with simple, clear, objective indicators so that those interested in disclosing intellectual capital information in the organizations in this sector may obtain more harmonized and comparable information. A research on the disclosure quality of intellectual capital, together with the application of other analysis methodologies in this sector, might be a promising approach for future research. Applying the voluntary disclosure index to the same sector in other countries may also contribute to the knowledge of disclosure practices in different geographical environments. We highlight the relevance of further studies contributing to the harmonization and consistency in the presentation of an intellectual capital report so as to enable organizations to disclose the resources that contribute most to their competitiveness and growth.

The importance of quality in the consolidation of textile in Minho

The textile industry has a long tradition in Portugal and it is one of the most important sectors, despite the current economic crisis. It has always assumed a prominent role in terms of employment and a relevant position within the Portuguese economy. The lack of quality and the lower prices that other countries offer causes the loss of clients. Quality is a main tool to survive nowadays in the textile sector. To undertake our analysis, we made use of an existing database where 55 firms belonged to the textile industry, namely to the manufacturing sector. A new survey was created based on the original survey and was sent to 5 firms. Besides the survey, we also sent a few questions to the firms in order to retract more information about the actually situation in our country, concerning the textile industry. Several tables, graphs and pie charts were made to help shed light on our findings. This research was conducted in order to determine the importance of quality in the consolidation of textile firms in the north of Portugal. Most firms in our sample feel that quality improvement, business benefits, mobilizing employees’ knowledge and business image were important and that competition is very intense and is mainly by price and not by differentiation of product or service. The quality program has contributed to improve their competitive position and the improvement of their overall performance. The majority of the firms in our sample undertake TQM measures for quality purposes to meet customer expectations and prevent errors. Of all firms surveyed, the quality is certainly very important for its survival.

“Reforma fiscal: carro novo ou filhos e família”?

O art. 67º da Constituição é claro, quando afirma: “Incumbe, designadamente, ao Estado para protecção da família: § a) Promover a independência social e económica dos agregados familiares § f) Regular os impostos e os benefícios sociais, de harmonia com os encargos familiares”. Abstract: O art. 67º da Constituição é claro, quando afirma: “Incumbe, designadamente, ao Estado para protecção da família: § a) Promover a independência social e económica dos agregados familiares § f) Regular os impostos e os benefícios sociais, de harmonia com os encargos familiares”.

Residents’ perceptions on impacts of hosting the “Guimarães 2012 European Capital of Culture”: comparisons of the pre-and post-2012 ECOC

Residents tend to have high expectations about the benefits of hosting a mega‐event. So, it was not surprising that the nomination of Guimarães, Portugal, as the 2012 European Capital of Culture (2012 ECOC) had raised great expectations in the local community towards its socio‐economic and cultural benefits. The present research was designed to examine the Guimarães residents’ perceptions on the impacts of hosting the 2012 ECOC approached in two different time schedules, the pre‐ and the post‐event, trying to capture the evolution of the residents` evaluation of its impacts. For getting the data, two surveys were applied to Guimarães` residents, one in the pre‐event phase, in 2011, and another in the post‐event phase, in 2013. This approach is uncommonly applied to Portugal data and it is even the first time it was done to a Portuguese European Capital of Culture. After a factor analysis, the results of t‐tests indicate that there were significant differences (p<0.05) between the samples from the pre‐ and post‐2012 ECOC on two positive impact factors (Community’ benefits and Residents’ benefits) and one negative impact factor (Economic, social and environmental costs). Respondents also showed a negative perception of the impacts in all dimensions, except Changes in habits of Guimarães residents.