Aerosolization of protein solutions using thermal inkjet technology

Vapotronics Inc. is developing the thermal inkjet (TIJ) technology used extensively in the printer industry to create a digital aerosol inhaler for the inhalation of therapeutics for local and systemic delivery. The operation of thermal inkjet printers requires generation of high temperatures and vaporization of the liquid formulation to effect droplet ejection. A study was conducted to develop formulations that would permit the generation of aerosols of therapeutic proteins without damage to the inkjet system or degradation of the proteins. Two proteins, human growth hormone and insulin, were formulated and aerosolized. The aerosol was collected and subjected to assays to compare the physicochemical and biological activities of these proteins before and after aerosolization. In each case, there was no significant changes to the proteins as a result of the aerosolization, providing evidence that TIJ can be used for aerosolizing solutions of protein therapeutics.

An EM-based Semi-Parametric Mixture Model Approach to the Regression Analysis of Competing-Risks Data

We consider a mixture model approach to the regression analysis of competing-risks data. Attention is focused on inference concerning the effects of factors on both the probability of occurrence and the hazard rate conditional on each of the failure types. These two quantities are specified in the mixture model using the logistic model and the proportional hazards model, respectively. We propose a semi-parametric mixture method to estimate the logistic and regression coefficients jointly, whereby the component-baseline hazard functions are completely unspecified. Estimation is based on maximum likelihood on the basis of the full likelihood, implemented via an expectation-conditional maximization (ECM) algorithm. Simulation studies are performed to compare the performance of the proposed semi-parametric method with a fully parametric mixture approach. The results show that when the component-baseline hazard is monotonic increasing, the semi-parametric and fully parametric mixture approaches are comparable for mildly and moderately censored samples. When the component-baseline hazard is not monotonic increasing, the semi-parametric method consistently provides less biased estimates than a fully parametric approach and is comparable in efficiency in the estimation of the parameters for all levels of censoring. The methods are illustrated using a real data set of prostate cancer patients treated with different dosages of the drug diethylstilbestrol. Copyright (C) 2003 John Wiley Sons, Ltd.

Epizootic activity of Murray Valley encephalitis and Kunjin viruses in an aboriginal community in the Southeast Kimberley region of Western Australia: Results of mosquito fauna and virus isolation studies

We undertook annual surveys of flavivirus virus activity in the community of Billiluna of Western Australia in the southeast Kimberley region between 1989 and 2001. Culex annulirostris was the dominant mosquito species, particularly in years of above average rains and flooding. Murray Valley encephalitis (MVE) virus was isolated in 8 of the 13 years of the study from seven mosquito species, but more than 90% of the isolates were from Cx. annulirostris. The results suggest that MVE virus is epizootic in the region, with activity only apparent in years with average or above average rainfall and increased numbers of Cx. annulirostris. High levels of MVE virus activity and associated human cases were detected only once (in 1993) during the survey period. Activity of MVE virus could only be partially correlated with wet season rainfall and flooding, suggesting that a number of other factors must also be considered to accurately predict MVE virus activity at such communities.

Conception of a flexible integrator and lean model for integrated management systems

Management systems standards (MSSs) have developed in an unprecedented manner in the last few years. These MSS cover a wide array of different disciplines, aims and activities of organisations. Also, organisations are populated with an enormous diversity of independent management systems (MSs). An integrated management system (IMS) tends to integrate some or all components of the business. Maximising their integration in one coherent and efficient MS is increasingly a strategic priority and constitutes an opportunity for businesses to be more competitive and consequently, promote its sustainable success. Those organisations that are quicker and more efficient in their integration and continuous improvement will have a competitive advantage in obtaining sustainable value in our global and competitive business world. Several scholars have proposed various theoretical approaches regarding the integration of management sub-systems, leading to the conclusion that there is no common practice for all organisations as they encompass different characteristics. One other author shows that several tangible and intangible gains for organisations, as well as to their internal and external stakeholders, are achieved with the integration of the individual standardised MSs. The purpose of this work was to conceive a model, Flexible, Integrator and Lean for IMSs, according to ISO 9001 for quality; ISO 14001 for environment and OHSAS 18001 for occupational health and safety (IMS–QES), that can be adapted and progressively assimilate other MSs, such as, SA 8000/ISO 26000 for social accountability, ISO 31000 for risk management and ISO/IEC 27001 for information security management, among others. The IMS–QES model was designed in the real environment of an industrial Portuguese small and medium enterprise, that over the years has been adopting, gradually, in whole or in part, individual MSSs. The developed model is based on a preliminary investigation conducted through a questionnaire. The strategy and research methods have taken into consideration the case study. Among the main findings of the survey we highlight: the creation of added value for the business through the elimination of several organisational wastes; the integrated management of the sustainability components; the elimination of conflicts between independent MS; dialogue with the main stakeholders and commitment to their ongoing satisfaction and increased contribution to the company’s competitiveness; and greater valorisation and motivation of employees as a result of the expansion of their skill base, actions and responsibilities, with their consequent empowerment. A set of key performance indicators (KPIs) constitute the support, in a perspective of business excellence, to the follow up of the organisation’s progress towards the vision and achievement of the defined objectives in the context of each component of the IMS model. The conceived model had many phases and the one presented in this work is the last required for the integration of quality, environment, safety and others individual standardised MSs. Globally, the investigation results, by themselves, justified and prioritised the conception of an IMS–QES model, to be implemented at the company where the investigation was conducted, but also a generic model of an IMS, which may be more flexible, integrator and lean as possible, potentiating the efficiency, added value both in the present and, fundamentally, for future.

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.

A generic model for integration of Quality, Environment and Safety Management Systems

Purpose – The purpose of this paper is to propose a generic model of Integrated Management System of Quality, Environment and Safety (IMS-QES) that can be adapted and progressively to assimilate various Management Systems, of which highlights: ISO 9001 for Quality; ISO 14001 for Environment; OHSAS 18001 for Occupational Health and Safety. Design/methodology/approach – The model was designed in the real environment of a Portuguese Organization and 160 employees were surveyed. The rate response was equal to 86 percent. The conceived model was implemented in a first phase for the integration of Quality, Environment and Safety Management Systems. Findings – Among the main findings of the survey the paper highlights: the elimination of conflicts between individual systems with resources optimization; creation of added value to the business by eliminating several types of wastes; the integrated management of sustainability components in a global market; the improvement of partnerships with suppliers of goods and services; reducing the number of internal and external audits. Originality/value – This case study is one of the first Portuguese empirical researches about IMS-QES and the paper believes that it can be useful in the creation of a Portuguese guideline for integration, namely the Quality Management Systems; Environmental Management Systems and Occupational Health and Safety Management Systems among others.

Integration of management systems: towards a sustained success and development of organizations

Effective environmental management within companies, integrated with other management areas like quality and occupational health and safety, is nowadays assumed to be a strategic way to implement and improve lean and cleaner production. Also, sustainable development (SD) and business sustainability can be achieved through a better coordinated management of processes versus associated resources. This paper presents an in depth discussion regarding the promotion of integrated management systems, their benefits and major contribution towards the sustainable development of cleaner production related features. It addresses issues regarding the contributions resulting from the integration of standardized Management System (MS) from both internal and external perspectives. Complementing the overall review of aspects to the development of integrated management systems a survey was conducted in order to better understand the relevance of the identified success factors. The main findings in this paper are as follows: a contextualization model of sustainable development and integrated management systems considering the Triple Bottom Line: economic, social and environmental; and, a method and associated model to support the development of integrated management systems as well as general guidelines to support integration. It can be concluded that a proactive approach and commitment to cleaner production, supported by an integrated management system, brings relevant savings for organizations as well as providing value to the relevant interested parties.

Performance management in primary healthcare services: evidence from a field study

Health services

Environmental pressures and impacts of public sector organizations: the case of the Portuguese Military

Progress in Industrial Ecology, An International Journal, nº 4(5), p. 363-381

Environmental performance policy indicators for the public sector: The case of the defence sector

Journal of Environmental Management, nº 82 p. 410–432

Validação de tecnologias de informação e comunicação no suporte a um sistema integrado de gestão orientado para o setor agroalimentar

Dissertação de Mestrado em Gestão Integrada da Qualidade, Ambiente e Segurança

Persistent organic chemicals of emerging environmental concern

The use of chemicals and chemical derivatives in agriculture and industry has contributed to their accumulation and persistence in the environment. Persistent organic pollutants (POPs) are among the environmental pollutants of most concern since, when improperly handled and disposed, they can persist in the environment, bioaccumulate through the food web, and may create serious public health and environmental problems. Development of an effective degradation process has become an area of intense research. The physical/chemical methods employed, such as volatilization, evaporation, photooxidation, adsorption, or hydrolysis, are not always effective, are very expensive, and, sometimes, lead to generation/disposal of other contaminants. Biodegradation is one of the major mechanisms by which organic contaminants are transformed, immobilized, or mineralized in the environment. A clear understanding of the major processes that affect the interactions between organic contaminants, microorganisms, and environmental matrix is, thus, important for determining persistence of the compounds, for predicting in situ transformation rates, and for developing site remediation. Information on their risks and impact and occurrence in the different environmental matrices is also important, in order to attenuate their impact and apply the appropriate remediation process. This chapter provides information on the fate of pesticides and polycyclic aromatic hydrocarbons (PAHs), their impact, bioavailability, and biodegradation. © Springer Science+Business Media Dordrecht 2014.

Epidemiology and control of malaria and other arthropod born diseases

Malaria and other arthropod born diseases remain a serious public health problem affecting the lives and health of certain social groups when the two basic strategies to control fail due to : (1) the lack of effective chemoprophylaxis/chemotherapy or the rapid development of drug resistance of the infectious agents and (2) the ineffectiveness of pesticides or the arthropod vectors develop resistance to them. These situations enhances the need for the design and implementation of other alternatives for sustainable health programmes. The application of the epidemiological methods is essential not only for analyzing the relevant data for the understanding of the biological characteristics of the infectious agents, their reservoirs and vectors and the methods for their control, but also for the assessment of the human behaviour, the environmental, social and economic factors involved in disease transmission and the capacity of the health systems to implement interventions for both changes in human behaviour and environmental management to purpose guaranteed prevention and control of malaria and other arthropod born diseases with efficiency, efficacy and equity. This paper discuss the evolution of the malaria arthropod diseases programmes in the American Region and the perspectives for their integration into health promotion programs and emphasis is made in the need to establish solid basis in the decision-making process for the selection of intervention strategies to remove the risk factors determining the probability to get sick or die from ABDs. The implications of the general planning and the polices to be adopted in an area should be analyzed in the light of programme feasibility at the local level, in the multisectoral context specific social groups and taking in consideration the principles of stratification and equity

Health Services Procurement Policy

The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here

El futuro de la sanidad ambiental en Andalucía: oportunidades de mejora.

In the present article is presented a portrait of the situation of the environmental health in the administration of Andalusian Goverment; are analyzed implanted management formulations and we believe a reflection space on the professional exercise and the course begun with the organizational process in the Andalusian public health. The public health system has not undergone reconstruction from the process of transferences from the State towards the autonomous Communities. We identified the extrapolation of the model clinicalassistance management to the public health structures without delving what is sufficient in their organization and objectives. Setting of business process management (BMP) has got worse the administrative bureaucracy and the teamwork has not been preceded of alliances and agreements that generate feeling of ownership the same organization to avoid professional conflicts. We bet on strengthening the paper of the environmental health technicians as referring in the identification of this performances within public health system. For this propose we need the implication of all the professionals in the reform of the organization and management of the health public, to evolve in the professional exercise creating a regulated academic specialty and to define the competences maps in their different capabilites areas.