Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison

The Global Initiative Against Asthma (GINA) was developed to meet the global challenge of asthma. GINA has been adopted in most countries and comparison of asthma management in different parts of the world may be of help when assessing the global dissemination of the guideline. The overall goals in GINA include that asthma patients should be free of symptoms, acute asthma attacks and activity limitations. The aim of the present study was to compare asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden. Information was collected from asthmatics in Sao Paulo and Uppsala with a questionnaire. The questionnaire dealt with the following issues: symptoms, smoking, self-management, hospital visits, effect on school/work and medication. The Sao Paulo patients were more likely to have uncontrolled asthma (36% vs 13%, P < 0.001), having made emergency room visits (57% vs 29%, P < 0.001) and having lost days at school or work because of their asthma (46% vs 28%, P = 0.03) than the asthmatics from Uppsala. There were no difference in the use of inhaled corticosteroids, but the Brazilian patients were more likely to be using theophylline (18% vs 1%, P = 0.001) and less likely to be using long-acting beta-2 agonists (18% vs 37%, P < 0.001). We conclude that the level of asthma control was lower among the patients from Sao Paulo than Uppsala. Few of the patients in either city reached the goals set up by GINA. Improved asthma management may therefore lead to health-economic benefits in both locations. Please cite this paper as: Skorup P, Rizzo LV, Machado-Boman L and Janson C. Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison. The Clinical Respiratory Journal 2009; 3: 22-28.

Does absorptive capacity affect project performance? A study based on project management practices, organization learning, and knowledge

The literature has emphasized that absorptive capacity (AC) leads to performance, but in projects its influences still unclear. Additionally, the project success is not well understood by the literature, and AC can be an important mechanism to explain it. Therefore, the purpose of this study is to investigate the effect of absorptive capacity on project performance in the construction industry of São Paulo State. We study this influence through potential and realized absorptive capacity proposed by Zahra and George (2002). For achieving this goal, we use a combination of qualitative and quantitative research. The qualitative research is based on 15 interviews with project managers in different sectors to understand the main constructs and support the next quantitative phase. The content analysis was the technique used to analyze those interviews. In quantitative phase through a survey questionnaire, we collected 157 responses in the construction sector with project managers. The confirmatory factor analysis and hierarchical linear regression were the techniques used to assess the data. Our findings suggest that the realized absorptive capacity has a positive influence on performance, but potential absorptive capacity and the interactions effect have no influence on performance. Moreover, the planning and monitoring have a positive impact on budget and schedule, and customer satisfaction while risk coping capacity has a positive impact on business success. In academics terms, this research enables a better understanding of the importance of absorptive capacity in the construction industry and it confirms that knowledge application in processes and routines enhances performance. For management, the absorptive capacity enables the improvements of internal capabilities reflected in the increased project management efficiency. Indeed, when a company manages project practices efficiently it enhances business and project performance; however, it needs initially to improve its internal abilities to enrich processes and routines through relevant knowledge.

Knowledge-based integrated production management model

Purpose - This paper aims to propose a model of production management that integrates knowledge management, as a third dimension, to the production and work dimensions and to identify factors that promote a favorable context for knowledge sharing and results achievement in the production operations shop floor environment.Design/methodology/approach - The model proposed is built from opportunities identified in the literature review.Findings - The factors in the model integrate its three main components: knowledge management, production organization and work organization, providing a representation of the dynamics of the workplace and shop floor environment.Practical implications - The proposed model and its factors allow managers to better understand and to improve the organization activities, because it integrates knowledge management with the production organization and work organization components of traditional models.Originality/value - Literature acknowledges the role of knowledge as competitive advantage, but it is still dealt in an implicit way within the traditional models of production management. This paper proposes a model and factors that provide a favorable context for tacit knowledge sharing and results achievement in the production operations shop floor environment. The model explicitly integrates knowledge management with traditional models' components.

Clinical applications of non-culture based methods for the diagnosis and management of opportunistic and endemic mycoses

Nonculture based methods for the detection of infections caused by fungal pathogens are becoming more important tools in the management of infected patients. Detection of fungal antigens and DNA appear to be the most promising in this respect for both opportunistic and endemic mycoses. In this article we present an overview of the most recent developments in nonculture based methods and examine their value in clinical practice.

Software architecture for web-based project management system

This article presents software architecture for a web-based system to aid project managing, conceptually founded on guidelines of the Project Management Body of Knowledge (PMBoK) and on ISO/IEC 9126, as well as on the result of an empiric study done in Brazil. Based on these guidelines, this study focused on two different points of view about project management: the view of those who develop software systems to aid management and the view of those who use these systems. The designed software architecture is capable of guiding an incremental development of a quality system that will satisfy today's marketing necessities, principally those of small and medium size enterprises.

Knowledge-based integrated Production Management Model applied to automotive companies

This paper aims to examine the relevance of a production management model, in the shop-floor operations environment, that integrates the dimensions of production organisation (lean and mass production), work organisation (enriched and semi-autonomous groups) and knowledge management. A theoretical model has been applied to automotive companies to verify model adherence. Each of those dimensions has been described by factors. Shop-floor personnel interviews were conducted to confirm the factors relevance to that company. Results have shown that the model represented the reality of those companies concerning the researched dimensions. The factors allow managers to promote a favourable context for knowledge sharing. © 2010 Inderscience Enterprises Ltd.

Effect of superstimulatory treatments on the expression of genes related to ovulatory capacity, oocyte competence and embryo development in cattle.

Multiple ovulation (superovulation) and embryo transfer has been used extensively in cattle. In the past decade, superstimulatory treatment protocols that synchronise follicle growth and ovulation, allowing for improved donor management and fixed-time AI (FTAI), have been developed for zebu (Bos indicus) and European (Bos taurus) breeds of cattle. There is evidence that additional stimulus with LH (through the administration of exogenous LH or equine chorionic gonadotrophin (eCG)) on the last day of the superstimulatory treatment protocol, called the 'P-36 protocol' for FTAI, can increase embryo yield compared with conventional protocols that are based on the detection of oestrus. However, inconsistent results with the use of hormones that stimulate LH receptors (LHR) have prompted further studies on the roles of LH and its receptors in ovulatory capacity (acquisition of LHR in granulosa cells), oocyte competence and embryo quality in superstimulated cattle. Recent experiments have shown that superstimulation with FSH increases mRNA expression of LHR and angiotensin AT(2) receptors in granulosa cells of follicles >8 mm in diameter. In addition, FSH decreases mRNA expression of growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) in oocytes, but increases the expression of both in cumulus cells, without diminishing the capacity of cumulus-oocyte complexes to generate blastocysts. Although these results indicate that superstimulation with FSH is not detrimental to oocyte competence, supplementary studies are warranted to investigate the effects of superstimulation on embryo quality and viability. In addition, experiments comparing the cellular and/or molecular effects of adding eCG to the P-36 treatment protocol are being conducted to elucidate the effects of superstimulatory protocols on the yield of viable embryos.

Delineation of specific management areas for coffee cultivation based on the soil-relief relationship and numerical classification

Predicting and mapping productivity areas allows crop producers to improve their planning of agricultural activities. The primary aims of this work were the identification and mapping of specific management areas allowing coffee bean quality to be predicted from soil attributes and their relationships to relief. The study area was located in the Southeast of the Minas Gerais state, Brazil. A grid containing a total of 145 uniformly spaced nodes 50 m apart was established over an area of 31. 7 ha from which samples were collected at depths of 0. 00-0. 20 m in order to determine physical and chemical attributes of the soil. These data were analysed in conjunction with plant attributes including production, proportion of beans retained by different sieves and drink quality. The results of principal component analysis (PCA) in combination with geostatistical data showed the attributes clay content and available iron to be the best choices for identifying four crop production environments. Environment A, which exhibited high clay and available iron contents, and low pH and base saturation, was that providing the highest yield (30. 4l ha-1) and best coffee beverage quality (61 sacks ha-1). Based on the results, we believe that multivariate analysis, geostatistics and the soil-relief relationships contained in the digital elevation model (DEM) can be effectively used in combination for the hybrid mapping of areas of varying suitability for coffee production. © 2012 Springer Science+Business Media New York.

Risk management in software projects through Knowledge Management techniques: Cases in Brazilian Incubated Technology-Based Firms

In businesses such as the software industry, which uses knowledge as a resource, activities are knowledge intensive, requiring constant adoption of new technologies and practices. Another feature of this environment is that the industry is particularly susceptible to failure; with this in mind, the objective of this research is to analyze the integration of Knowledge Management techniques into the activity of risk management as it applies to software development projects of micro and small Brazilian incubated technology-based firms. Research methods chosen were the Multiple Case Study. The main risk factor for managers and developers is that scope or goals are often unclear or misinterpreted. For risk management, firms have found that Knowledge Management techniques of conversion combination would be the most applicable for use; however, those most commonly used refer to the conversion mode as internalization.. © 2013 Elsevier Ltd. APM and IPMA.

Knowledge-based risk management: Survey on Brazilian software development enterprises

A risks management, carried on in an effective way, leads the software development to success and may influence on the organization. The knowledge takes part of such a process as a way to help taking decisions. This research aimed to analyze the use of Knowledge Management techniques to the Risk Management in software projects development and the possible influence on the enterprise revenue. It had, as its main studying subject, Brazilian incubated and graduated software developing enterprises. The chosen research method was the Survey type. Multivariate statistical methods were used for the treatment and analysis of the obtained results, this way identifying the most significant factors, that is, enterprise's achievement constraining factors and those outcome achievement ones. Among the latter we highlight the knowledge methodology, the time of existence of the enterprise, the amount of employees and the knowledge externalization. The results encourage contributing actions to the increasing of financial revenue. © 2013 Springer-Verlag.

Orientaciones para analizar los procesos de gestión de recursos hídricos en América Latina y el Caribe: basado en experiencias del Perú = Guidelines for the analysis of water resource management procedures in Latin America and the Caribbean, based on Peruvian experiences

Analiza sistematicamente las alternativas existentes para mejorar la gestion de las instituciones vinculadas a los recursos hidricos en America Latina y el Caribe. Incluye la presentacion somera de un metodo secuencial para la evaluacion de los variados procesos de gestion de recursos hidricos, asi como cuadros y anexos con listas reales de problemas y demandas planteados por usuarios y autoridades de aguas.

Product-portfolio management: A framework based on Methods, Organization, and Strategy

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

Management of gallstone disease in children: a new protocol based on the experience of a single center

Background/purpose: Gallstones and cholelithiasis are being increasingly diagnosed in children owing to the widespread use of ultrasonography. The treatment of choice is cholecystectomy, and routine intraoperative cholangiography is recommended to explore the common bile duct. The objectives of this study were to describe our experience with the management of gallstone disease in childhood over the last 18 years and to propose an algorithm to guide the approach to cholelithiasis in children based on clinical and ultrasonographic findings. Methods: The data for this study were obtained by reviewing the records of all patients with gallstone disease treated between January 1994 and October 2011. The patients were divided into the following 5 groups based on their symptoms: group 1, asymptomatic; group 2, nonbiliary obstructive symptoms; group 3, acute cholecystitis symptoms; group 4, a history of biliary obstructive symptoms that were completely resolved by the time of surgery; and group 5, ongoing biliary obstructive symptoms. Patients were treated according to an algorithm based on their clinical, ultrasonographic, and endoscopic retrograde cholangiopancreatography (ERCP) findings. Results: A total of 223 patients were diagnosed with cholelithiasis, and comorbidities were present in 177 patients (79.3%). The most common comorbidities were hemolytic disorders in 139 patients (62.3%) and previous bariatric surgery in 16 (7.1%). Although symptoms were present in 134 patients (60.0%), cholecystectomy was performed for all patients with cholelithiasis, even if they were asymptomatic; the surgery was laparoscopic in 204 patients and open in 19. Fifty-six patients (25.1%) presented with complications as the first sign of cholelithiasis (eg, pancreatitis, choledocolithiasis, or acute calculous cholecystitis). Intraoperative cholangiography was indicated in 15 children, and it was positive in only 1 (0.4%) for whom ERCP was necessary to extract the stone after a laparoscopic cholecystectomy (LC). Preoperative ERCP was performed in 11 patients to extract the stones, and a hepaticojejunostomy was indicated in 2 patients. There were no injuries to the hepatic artery or common bile duct in our series. Conclusions: Based on our experience, we can propose an algorithm to guide the approach to cholelithiasis in the pediatric population. The final conclusion is that LC results in limited postoperative complications in children with gallstones. When a diagnosis of choledocolithiasis or dilation of the choledocus is made, ERCP is necessary if obstructive symptoms persist either before or after an LC. Intraoperative cholangiography and laparoscopic common bile duct exploration are not mandatory. Published by Elsevier Inc.