Prevalence of deep vein thrombosis and pulmonary embolism in superficial thrombophlebitis of the lower limbs: prospective study of 60 cases

Aim. Superficial thrombophlebitis (ST) ascending the lower limbs is a common disease, which may be associated with deep vein thrombosis (DVT) and pulmonary embolism (PE). The aim of this study was to investigate the prevalence of DVT and PE as complications of ascending ST of the lower limbs in the great saphenous vein (GSV) or SSV (SSV) and probable risk factors.Methods. For this study 60 consecutive patients were enrolled with ascending ST of the GSV or SSV, seen between 2000 and 2003 at a public hospital in Botucatu, SP, Brazil. All patients were assessed clinically, by venous Duplex scanning of the lower limbs to confirm ST and test for DVT, and by means of pulmonary scintigraphy to test for PE.Results. In 13 ST cases (21.67%) there was concomitant DVT and 17 ST patients (28.33%) also had PE. Eleven patients had a clinical status suggestive of DVT, but only in eight of these (61.5%), this clinical diagnosis was confirmed. Fourteen patients had a clinical status suggestive of PE, and this diagnosis was confirmed in six cases (35.30%). ST patients who also had DVT and/or PE were given anticoagulant treatment with heparin and warfarin. None of the variables studied was predictive of DVT or PE (P>0.05). However, the presence of varicose veins reduced the risk of patients having DVT (relative risk=9.09; 95%CI:1.75 - 50.00 and P=0.023).Conclusion. The prevalence rates of PE (28.3%) and DVT (21.6%) were elevated in this sample of ascending ST cases, indicating a need for detailed assessment of patients for signs of these complications, including for therapeutic management decision making. [Int Angiol 2009;28:400-8]

High expectations, varying outcomes: Decentralization and participation in Brazil, Japan, Russia and Sweden

In the past 20 years, decentralization has been proposed as a strategy for enhancing public participation. Aid-providing organizations, such as the World Bank, stimulated decentralization processes in several countries in the hope that this would promote civic empowerment, diminish corruption, enhance efficiency, and improve public service delivery. This assumption forms the basis for a comparative analysis into the relation between decentralization and participation at the local level in Brazil, Japan, Russia and Sweden. A multi-level regression analysis using the data of the Democracy and Local Governance Project was undertaken in order to test the 'one size fits all' and the 'diversity in development' hypotheses. The results show that the second hypothesis was corroborated. Perceived autonomy had a different impact on openness to participation depending on the country considered; in one country (Japan), perceived autonomy diminished public officials' willingness to be open to public participation.

Decision-Making Tool for Knowledge-Based Projects in Offshore Production Systems

The development of an offshore field demands knowledge of many experts to choose the different components of an offshore production system. All the specialized parts of this knowledge are intrinsically related. The aim of this paper is to use Fuzzy Sets and knowledge-based systems to describe and formalize the phases of development of an offshore production system project, in order to share and to manage the required knowledge for carrying out a project, while at the same time proposing alternatives for the oil field configuration.

The outlook for agriculture and rural development in the Americas: a perspective on Latin America and the Caribbean, 2010

Includes Bibliography

The Singapore success story: public-private alliance for investment attraction, innovation and export development

Includes Bibliography

Information Visualization to support decision making in the context of distance learning: A study with VLE TelEduc

Digital data sets constitute rich sources of information, which can be extracted and evaluated applying computational tools, for example, those ones for Information Visualization. Web-based applications, such as social network environments, forums and virtual environments for Distance Learning, are good examples for such sources. The great amount of data has direct impact on processing and analysis tasks. This paper presents the computational tool Mapper, defined and implemented to use visual representations - maps, graphics and diagrams - for supporting the decision making process by analyzing data stored in Virtual Learning Environment TelEduc-Unesp. © 2012 IEEE.

Work, family and public policy changes in Latin America: Equity, maternalism and co-responsibility

Taking account of the substantial increase in female labour market participation that has occurred throughout the Latin American region, this article describes policies adopted with the aim of reconciling work and family responsibilities between 2003 and 2013, and the implications of their design for socioeconomic and gender equity. We look at the cases of Argentina, Brazil, Chile, Costa Rica and Uruguay, five countries which, on the basis of their track records, are the best placed to implement policies to reorganize time, income and services. The empirical analysis indicates, first, that these changes have contributed to socioeconomic equity more consistently than to gender equity. Second, the scale and type of change was found to vary significantly from one country to another. The article concludes by raising a number of substantive questions about the measures, their implementation and effectiveness, and the variations between countries.

Emergetic ternary diagrams: five examples for application in environmental accounting for decision-making

In a recent paper, "A combined tool for environmental scientists and decision makers: ternary diagrams and emergy accounting." [Giannettti BF, Barrella FA, Almeida CMVB. A combined tool for environment scientists and decision makers: ternary diagrams and emergy accounting. J Clean Prod, in press http://dx.doi.org/10.1016/j.jclepro.2004.09.002] Ternary diagrams were proposed as a graphical tool to assist emergy analysis. The graphical representation of the emergy accounting data makes it possible to compare processes and systems with and without ecosystem services, to evaluate improvements and to follow the system performance over time. The graphic tool is versatile and adaptable to represent products, processes, systems, countries, and different periods of time.The use and the versatility of ternary diagrams for assisting in performing emergy analyses are illustrated by means of five examples taken from the literature, which are presented and discussed. It is shown that emergetic ternary diagram's properties assist the assessment of the system of the system efficiency, its dependance upon renewable and non-renewable inputs and the environmental support for dilution and abatement of process emissions. With the aid of ternary diagrams, details such as the interaction between systems and between systems and the environment are recognized and evaluated. Such a tool for graphical analysis allows a transparent presentation of the results and can serve as an interface between emergy scientists and decision makers, provided the meaning of each line in the diagram is carefully explained and understood. (c) 2005 Elsevier Ltd. All rights reserved.

Effects of age on aerobic capacity in heart failure patients under beta-blocker therapy: Possible impact in clinical decision-making?

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

Decision making in the product portfolio: methods adopted by Brazil?s innovative companies

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

Fairness, Justice and an Individual Basis for Public Policy

Prior models of the policy process have examined how human characteristics can affect policy decision-making in such a way that it leads to aggregate effects on policy outcomes as a whole. I develop a model of the policy process which suggests that emotions related to fair and unfair experiences in the same policy domain are utilized by decision-makers as policy criteria. In the lab, I empirically tested this, and find that emotions and experience related to fairness do influence the policy decision to move away from the status quo alternative. Based upon this result, I simulated the evolution of a society of agents engaged in decision-making using similar criteria. The simulation suggests that incentives have an important role in leading to cooperation and social success. The external validity of the simulation also implies that it can act as a platform for future evolutionary policy experimentation.

Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation

Objective: this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings. Design: open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique. Setting: the study was carried out at a public university hospital in Brazil. Participants: 249 pregnant women who had received the diagnosis of a severe lethal fetal malformation. Findings: fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3%). Termination of pregnancy was decided by 172 (69.1%) patients and legally authorised by the judiciary (66%). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9%), the reasons were related to feelings of guilt (74%). Key conclusions: the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated. (C) 2011 Elsevier Ltd. All rights reserved.

ESMO Consensus Guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making

Colorectal cancer (CRC) is the most common tumour type in both sexes combined in Western countries. Although screening programmes including the implementation of faecal occult blood test and colonoscopy might be able to reduce mortality by removing precursor lesions and by making diagnosis at an earlier stage, the burden of disease and mortality is still high. Improvement of diagnostic and treatment options increased staging accuracy, functional outcome for early stages as well as survival. Although high quality surgery is still the mainstay of curative treatment, the management of CRC must be a multi-modal approach performed by an experienced multi-disciplinary expert team. Optimal choice of the individual treatment modality according to disease localization and extent, tumour biology and patient factors is able to maintain quality of life, enables long-term survival and even cure in selected patients by a combination of chemotherapy and surgery. Treatment decisions must be based on the available evidence, which has been the basis for this consensus conference-based guideline delivering a clear proposal for diagnostic and treatment measures in each stage of rectal and colon cancer and the individual clinical situations. This ESMO guideline is recommended to be used as the basis for treatment and management decisions.

A new method for decision making in multi-objective optimization problems

Many engineering sectors are challenged by multi-objective optimization problems. Even if the idea behind these problems is simple and well established, the implementation of any procedure to solve them is not a trivial task. The use of evolutionary algorithms to find candidate solutions is widespread. Usually they supply a discrete picture of the non-dominated solutions, a Pareto set. Although it is very interesting to know the non-dominated solutions, an additional criterion is needed to select one solution to be deployed. To better support the design process, this paper presents a new method of solving non-linear multi-objective optimization problems by adding a control function that will guide the optimization process over the Pareto set that does not need to be found explicitly. The proposed methodology differs from the classical methods that combine the objective functions in a single scale, and is based on a unique run of non-linear single-objective optimizers.