Risk-assessment algorithm and recommendations for venous thromboembolism prophylaxis in medical patients

The risk for venous thromboembolism (VTE) in medical patients is high, but risk assessment is rarely performed because there is not yet a good method to identify candidates for prophylaxis. Purpose: To perform a systematic review about VTE risk factors (RFs) in hospitalized medical patients and generate recommendations (RECs) for prophylaxis that can be implemented into practice. Data sources: A multidisciplinary group of experts from 12 Brazilian Medical Societies searched MEDLINE, Cochrane, and LILACS. Study selection: Two experts independently classified the evidence for each RF by its scientific quality in a standardized manner. A risk-assessment algorithm was created based on the results of the review. Data synthesis: Several VTE RFs have enough evidence to support RECs for prophylaxis in hospitalized medical patients (eg, increasing age, heart failure, and stroke). Other factors are considered adjuncts of risk (eg, varices, obesity, and infections). According to the algorithm, hospitalized medical patients ≥40 years-old with decreased mobility, and ≥1 RFs should receive chemoprophylaxis with heparin, provided they don't have contraindications. High prophylactic doses of unfractionated heparin or low-molecular-weight-heparin must be administered and maintained for 6-14 days. Conclusions: A multidisciplinary group generated evidence-based RECs and an easy-to-use algorithm to facilitate VTE prophylaxis in medical patients. © 2007 Rocha et al, publisher and licensee Dove Medical Press Ltd.

Quality management and competitiveness: the diffusion of the ISO 9000 standards in Latin America and recommendations for government strategies

Includes bibliography

Determination of the quality index of a Paleudult under sunflower culture and different management systems

Soil is an essential resource for life and its properties are susceptible to be modified by tillage systems. The impact of management practices on soil functions can be assessed through a soil quality index. It is interesting to assess soil quality in different soil types. Therefore, the aim of this study was to determine the soil quality index of a Paleudult under different management conditions and sunflower culture. The experiment was carried out in Botucatu (SP, Brazil), in an 11-year non-tilled area used for growing soybean and maize during summer and black oat or triticale in winter. Four management systems were considered: no-tillage with a hoe planter (NTh), no-tillage with a double-disk planter (NTd), reduced tillage (RT) and conventional tillage (CT). Soil samples were taken from the planting lines at harvest time. To determine the soil quality indices, following the methodology proposed by Karlen and Stott (1994), three main soil functions were assessed: soil capacity for root development, water storage capacity of the soil and nutrient supply capacity of the soil. The studied Paleudult was considered a soil with good quality under all the observed management systems. However, the soil quality indices varied between treatments being 0.64, 0.68, 0.86 and 0.79 under NTh, NTd, RT and CT, respectively. Physical attributes such as resistance to penetration and macroporosity increased the soil quality index in RT and CT compared to NTh and NTd. The soil quality indices obtained suggested that the evaluated soil is adequate for sunflower production under our study conditions. In view of the SQI values, RT is the most suitable management for this site since it preserves soil quality and provides an acceptable sunflower yield. © 2011 Elsevier B.V.

Environmental development in Brazilian companies: The role of human resource management

Specialized literature states that proper environmental management at companies requires support from human resource management. This occurs because the more efficient and effective human resource management is, the more it tends to contribute towards the organization's objectives. Considering that environmental management is an emerging organizational objective, human resource practices, when efficient and effective, tend to incorporate environmental goal and to become greener. In order to contribute to this emerging field of research, this paper reports on an empirical study about the relationship between human resources and environmental management at 75 Brazilian companies. The data collected were analyzed statistically using Structural Equation Modeling. The main results indicated that human resource management practices tend to statistically significant relate to environmental management at analyzed companies, through validation of H 1, but his relationship can be considered weak. © 2012 Elsevier B.V.

Some aspects of chicken behavior and welfare

Brazil is the world leader in broiler production and export. It achieved this position mainly to its excellent supply chain structure and climate, which favor poultry and grain production throughout its territory. Although Brazilian egg production is not as important as broiler production, this segment presents great potential of increasing its share in the global market. However, as elsewhere in the world, Brazilian poultry production faces the challenge to balance two elements within its supply chain: cruelty and productivity. The consumers of the European Union (EU) are very concerned with animal welfare issues. In order to increase its share in the European market, and eventually in the world market, Brazilian poultry producers must understand the effects of production systems on poultry welfare, and try to develop systems that are suited for its climate and other production conditions. There is a consensus that the natural behaviors performed by poultry in intensive production systems allow better welfare. This objective of this review is to present scientific research studies that relate different behaviors to chicken welfare. Poultry behavior is a reflex of their welfare status at a particular moment, and it is related to internal (physiological) and external (environmental) factors. Several natural behaviors that favor welfare, as well as undesirable behaviors, may be stimulated by environmental enrichment. The correct interpretation of the behaviors expressed by poultry, including their frequency, duration, and sequence, may be used to estimate their welfare. Animal production is an import sector of Brazilian economy. It significantly contributes to the Gross Domestic Product (GDP), in terms of products destined both to domestic consumption and exports. New technologies applied to products and management practices have been developed for field application, aiming at improving producers' productivity and profitability. In order to comply with the European Union's (EU) guidelines for animal protein production, Brazilian poultry production needs to undergo a process of adaptation. In May, 2007, the EU Commission established its new guidelines for animal welfare in poultry production, pressured by consumer demand. In the EU, there is a growing concern among consumers as to how poultry are reared and slaughtered. European consumers are in the fore front of the demand of high quality products produced with under better welfare conditions, and have spread this concern throughout the world. Beaumont et al. (2010) mentioned that European consumers frequently perceive that standard commercial poultry production has poor animal welfare practices. According to Nääs et al. (2008), Brazilian poultry production today needs to find a balance between cruelty and productivity. In fact, ensuring animal welfare may provide better financial results, as it increases the producer's profit margins and allows maintaining Brazilian chicken export quotas to the EU. França (2008) noted that biological studies that define ethical limits and guidelines for poultry production foster the development of new production practices that may ensure good product quality and productivity without putting bird welfare at risk. Gonyou (1994) states that, when animal welfare started to be studied, the only behavioral factors considered were those related to feeding and reproduction. These first studies used as indicators of animal welfare reduced life expectancy, impaired growth, impaired reproduction, body damage, disease, immunosuppression, adrenal activity, behavior anomalies, and self-narcotization (Broom, 1991). However, current studies evaluate additional indicators, such as natural behaviors, behavioral needs, preferences, behavioral problems, emotional state, cognitive abilities, etc. In the field of ethology, the expression of natural behavior is a frequently used tool used to estimate the welfare of poultry destined to human consumption. According to Bracke & Hopster (2006), natural behavior can be defined as the behavior the animal normaly presents when exposed to conditions similar to its natural habitat. Natural behaviors are pleasurable and promote biological functions that are meaningful to the animal's welfare. The definition of natural behavior, though, does not include the bird's behavior when sick, in flight or during aggression, since these are not considered pleasurable situations. Considering layer behavioral needs in the design of housing facilities optimize their welfare. Mishra et al. (2005) verified that ISA Brown layers spent, during 24 hours, around 97% of the time in the nest, feeding, walking, resting, or dust bathing, and that 57% of these behaviors did not depend on environmental enrichment. It was also observed that hens had preferred behavioral sequences, which included foraging and comfort behaviors, such as wing-stretching and preening. The present review aims at discussing, albeit not exhaustively, scientific research studies on the behavior of Gallusgallus domesticus and its relationship to welfare. The following behaviors are reviewed: feather pecking, scratching, dust bathing, nesting, locomotion activities, and aggressive behaviors. These behaviors are the most frequently observed in commercial broiler, broiler breeder, and layer farming, and therefore, monitoring their incidence may contribute to measure poultry welfare.

Quality management promotion to improve competitiveness

Includes bibliography

Social vulnerability, insurance and risk diversification in Latin America and the Caribbean

Includes bibliography

Productive development in open economies

Includes bibliography

Green teams: Understanding their roles in the environmental management of companies located in Brazil

Green teams are frequently considered in the state-of-the-art literature as an essential factor for companies aiming to implement and improve environmental management approaches and practices. However, most of the available literature on green teams is conceptual and theoretical by nature. Therefore, the main purpose of this article is to evaluate the main characteristics of green teams in Brazilian companies and to analyse the relationships between green teams and the maturity level of environmental management in those companies. Based on a conceptual background on corporate environmental management and green teams, a research was done in two complementary phases: a survey of 94 companies with ISO 14001 certification; and a multiple case study of four industrial companies. Survey results suggest that 82% of the studied companies have cross-functional green teams, i.e. involving various companies' departments; and 65% have functional green teams, i.e. individual department teams. The results of the case study suggest that the use of green teams is an instrument to the greening of companies with ISO 14001 in Brazil. The company with the most proactive and advanced environmental management is the same company which uses green teams more intensely. Green teams are especially necessary for implementing more technical environmental management practices, e.g. Life Cycle Assessment. Since this is one of the first studies analysing green teams, the results presented can be useful for companies and public policies aiming to implementation of environmental initiatives. © 2012 Elsevier Ltd. All rights reserved.

Integration practices for the technological innovation of products: Case studies at two large technological companies

Studies on innovation and technology management have emphasized the importance of integration between the research and development (R&D) department and others involved with the product development process (PDP) as a relevant practice for the good performance of technological innovation of product activities. This study addresses the topic of transfers of technologies to new product projects and also integration practices between the R&D department and others involved with the PDP. A qualitative study was conducted that was operationalized through two case studies at large high-tech companies: One is Brazilian and the other is a multinational subsidiary in Brazil. Among its main result, this paper represents and analyzes management practices that are favorable to integration in product development projects that demand development and transfer of technologies, such as: participation of R&D personnel in market activities, the adoption of virtual interaction mechanisms, and the application of methods such as technology roadmaps. © Universidad Alberto Hurtado, Facultad de Economía y Negocios.

Variabilidade espacial de atributos do solo em áreas intensamente cultivadas nas regiões de Jaboticabal e Monte Alto - SP

Pós-graduação em Agronomia (Ciência do Solo) - FCAV

Barreiras e motivações à adoção de práticas de Green Supply Chain Management: estudo de casos no setor de baterias automotivas

Pós-graduação em Engenharia de Produção - FEB

Prevalência e fatores de risco de leptospirose bovina no estado do Maranhão

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A objetivação da saúde da criança pelo UNICEF: problematizando tecnologias de biopoder na Amazônia

Este estudo busca problematizar a concepção de saúde da criança veiculada pelo UNICEF, analisando especificamente os regimes de verdade e práticas de poder que são operados por esta agência acerca das condições de saúde em que vivem as crianças na Amazônia. Para tanto é realizada uma pesquisa documental que tem como fonte de análise o relatório “Ser Criança na Amazônia”: uma análise das condições de desenvolvimento infantil na região norte do Brasil, publicado pelo UNICEF em 2004. Como ferramentas de análise são utilizadas a história-genealógica de Foucault e sua analítica do poder, especialmente em relação ao biopoder. No contexto das políticas da ONU a performance do UNICEF no cuidado da infância é compreendida como parte de uma governamentalidade liberal que atua na promoção do progresso social e desenvolvimento econômico dos países, em prol da segurança. Neste sentido, esta pesquisa procura dar visibilidade ao modo como as práticas do UNICEF são articuladas às práticas vizinhas e engendram um dispositivo de governo que opera através de estratégias disciplinares e biopolíticas no controle da população da Amazônia, em função da gestão de riscos. De acordo com as análises do UNICEF, a saúde da criança é compreendida como efeito de determinadas condições sociais e econômicas consideradas fundamentais para sua sobrevivência e bem-estar. A falta de infraestrutura social e as precárias condições de existência são apontadas como fatores que podem gerar doenças e prejuízos ao desenvolvimento das crianças. Além disso, o relatório enfatiza o papel da mulher enquanto mãe, colocando-a como principal responsável pela sobrevivência e educação dos filhos, e a importância do desempenho da família para a garantia do pleno desenvolvimento infantil. Observa-se como as noções de saúde e infância, compreendidas respectivamente como um campo multideterminado e uma etapa da vida que precisa ser protegida e controlada, são utilizadas pelo UNICEF no governo das populações pobres da região, capturadas em discursos higiênicos que desqualificam as famílias em função de suas condições de sobrevivência e de suas práticas de cuidado em relação às crianças. Estes discursos produzem a demanda por uma rede infinda de proteções para as famílias que promovem a saúde e asseguram a vida, mas implicam em controles que põem em xeque sua autonomia.

O UNICEF no Brasil e as práticas vizinhas na atualidade

Este artigo visa pensar, analisar e descrever as práticas do Fundo das Nações Unidas para a Infância, na relação com um campo de vizinhança com outras intervenções de saber e poder voltadas às crianças e adolescentes, no Brasil. Para tanto, realiza uma breve história da atualidade do complexo tutelar articulado pela rede de proteção, garantia e defesa dos direitos oferecida pelo Fundo das Nações Unidas para a Infância em conjunto com outras entidades, instituições, grupos, comunidades, organizações não governamentais, fundações, bancos, países, universidades, localidades e agências ligadas à Organização das Nações Unidas. Por meio de análises baseadas em Michel Foucault, de Paul Veyne, em Robert Castel e em Jacques Donzelot, analisamos estas práticas cotidianas, no campo da sociedade disciplinar, da biopolítica, da gestão de riscos e do complexo tutelar, na medida em que formam um dispositivo econômico e político que opera na relação sujeito de direitos e sujeito econômico.