Impact of the introduction of an automated microbiologic system on the clinical outcomes of bloodstream infections caused by Enterobacteriaceae strains

INTRODUCTION: Enterobacteriaceae strains are a leading cause of bloodstream infections (BSI). The aim of this study is to assess differences in clinical outcomes of patients with BSI caused by Enterobacteriaceae strains before and after introduction of an automated microbiologic system by the microbiology laboratory. METHODS: We conducted a retrospective cohort study aimed to evaluate the impact of the introduction of an automated microbiologic system (Phoenix(tm) automated microbiology system, Becton, Dickinson and Company (BD) - Diagnostic Systems, Sparks, MD, USA) on the outcomes of BSIs caused by Enterobacteriaceae strains. The study was undertaken at Hospital São Paulo, a 750-bed teaching hospital in São Paulo, Brazil. Patients with BSI caused by Enterobacteriaceae strains before the introduction of the automated system were compared with patients with BSI caused by the same pathogens after the introduction of the automated system with regard to treatment adequacy, clinical cure/improvement and 14- and 28-day mortality rates. RESULTS: We evaluated 90 and 106 patients in the non-automated and automated testing periods, respectively. The most prevalent species in both periods were Klebsiella spp. and Proteus spp. Clinical cure/improvement occurred in 70% and 67.9% in non-automated and automated period, respectively (p=0.75). 14-day mortality rates were 22.2% and 30% (p=0.94) and 28-day mortality rates were 24.5% and 40.5% (p= 0.12). There were no significant differences between the two testing periods with regard to treatment adequacy, clinical cure/improvement and 14- and 28-day mortality rates. CONCLUSIONS: Introduction of the BD Phoenix(tm) automated microbiology system did not impact the clinical outcomes of BSIs caused by Enterobacteriaceae strains in our setting.

Impact of an intervention in the use of sequential antibiotic therapy in a Brazilian university hospital

INTRODUCTION: Sequential antibiotic therapy (SAT) is safe and economical. However, the unnecessary use of intravenous (IV) administration usually occurs. The objective of this work was to get to know the effectiveness of an intervention to implement the SAT in a teaching hospital in Brazil. METHODS: This was a prospective and interventional study, historically controlled, and was conducted in the Hospital de Clínicas, Universidade Federal de Uberlândia, State of Minas Gerais, Brazil, a high complexity teaching hospital having 503 beds. In each of the periods, from 04/04/05 to 07/20/05 (pre-intervention) and from 09/24/07 to 12/20/07 (intervention), 117 patients were evaluated. After the pre-intervention period, guidelines were developed which were implemented during the intervention period along with educational measures and a reminder system added to the patients' prescription. RESULTS: In the pre-intervention and intervention periods, the IV antibiotics were used as treatment for a average time of 14.8 and 11.8 days, respectively. Ceftriaxone was the antibiotic most prescribed in both periods (23.4% and 21.6% respectively). Starting from the first prescription of antibiotics, the average length of hospitalization time was 21.8 and 17.5 days, respectively. The SAT occurred only in 4 and 5 courses of treatment, respectively, and 12.8% and 18.8% of the patients died in the respective periods. CONCLUSIONS: Under the presented conditions, the evaluated intervention strategy is ineffective in promoting the exchange of the antibiotic administration from IV to oral treatment (SAT).

Banking crises: The impact of financial liberalization

This paper intends to study whether financial liberalization tends to increase the likelihood of systemic banking crises. I used a sample of 79 countries with data spanning from 1973 to 2005 to run a panel probit model. I found that, if anything, financial liberalization as measured across seven different dimensions tends to decrease the probability of occurrence of a systemic banking crisis. I went further and did several robustness tests – used a conditional probit model, tested for different durations of liberalization impact and reduced the sample by considering only the first crisis event for each country. Main results still verified, proving the results’ robustness.

Impact of corporate social responsibility in the European pharmaceutical market

The objective of this master thesis is to evaluate the impact of CSR measures in the financial performance of the European pharmaceutical industry. By definition, CSR measures is quantified as corporate social disclosure considering the published CSR keywords on the annual reports of the selected companies, over four fiscal years (2010-2013). The financial performance of the companies were measured as return on assets (ROA) and Tobin’s Q. In order to defend the hypothesis developed, a multivariate regression is performed. The results obtained show no significant impact on the financial performance of a company nor in the short-time, nor in the long-time. Moreover, by comparison with other studies, it was possible to conclude that the financial performance is differently affected when considering different industries.

How does introducing love impact management?

Religion at work is nowadays a hot-topic for organizational researchers. Studies have been conducted in order to understand whether there is a possible connection between God and management. This study aims to understand what is the impact of managing through God’s Love. It was found that managing with Love contributes for a new organizational culture characterized by the way managers face work (Culture of Identification), the way they use their characteristics for the benefit of the organization (Culture of Integration), the way human relations are developed (Culture of Bonds) and that it creates sustainable value (Culture of Entrepreneurship) for organizations. Main implications of these results are presented below.

To what extent do aspects of sustainability impact established firms' resilience

An organizations´ level of sustainability has so far been primarily been analyzed within the context of economic performance. This study changes that dependent variable to “resilience”, namely a company’s ability to recover from potential lethal shocks or disruptive events. The research questions aims to investigate whether sustainability and resilience are related. This study utilizes the financial crisis from 2007/08 as disruptive event, as it encompassed market phase-out but also survival by established firms. Two Swiss luxury watchmaking companies have been chosen as industry sample and the study’s investigation is based on a comparative case study approach. The latter applies both quantitative data, in the form of the respective annual company reports, and qualitative data, in the form of semi-structured interviews with three stakeholder groups. Findings indicate that the investigated measures of sustainability are related the investigated companies’ level of resilience. These findings contribute to the building of new theory towards resilience as this study outlines specifically which measures have been proven to be of relevance for companies’ resilience. Moreover, the results are of high relevance for companies that are operating in constant evolving markets and struggling adapting to any disruptive environment as it is outlined why and how comparative companies have to be sustainable in order to become more resilient towards future shocks.

(Un)ethical leadership, organizational identification and sensemaking: the BES case and its impact on employees

This paper provides an ongoing analysis to one of the biggest ethical and financial scandals in Portugal – Banco Espírito Santo (BES). BES was considered one of the three best banks but it went bankrupted and its employees were transferred to a new entity – Novo Banco. This study was conducted in order to provide an understanding of the employees’ side, which has been forgotten so far. An ethical scandal (sensebreaking) creates ambiguity and uncertainty which triggers new sensemaking processes in order to understand and derive meaning from the new reality. The methodology followed was semi-structured interviews to employees both from the branches and the central services. We found evidence that in organizations with strong identification, unethical behavior has a significant impact on followers’ – the new process of sensemaking is particularly important in this situation because employees suffer more from the disruption of their reality.

The impact of talent management practices on employee retention: The moderator effect of leader-member exchange and role modeling

Organizations are undergoing serious difficulties to retain talent. Authors argue that Talent Management (TM) practices create beneficial outcomes for individuals and organizations. However, there is no research on the leaders’ role in the functioning of these practices. This study examines how LMX and role modeling influence the impact that TM practices have on employees’ trust in their organizations and retention. The analysis of two questionnaires (Nt1=175; Nt2=107) indicated that TM only reduced turnover intentions, via an increase in trust in the organization, when role modeling was high and not when it was low. Therefore, we can say that leaders are crucial in the TM context, and in sustaining a competitive advantage for organizations.

How can packaging change children's eating habits from un-healthy food towards healthier options?

Field Lab: Children consumer behaviour

Low cost carriers: The case of Oporto Airport and its touristic impact in the region

Both Oporto and the North Region of Portugal definitions of tourism have evolved significantly during the past decade. In this journey it is relevant to highlight the contribution of the arrival of Low Cost Carriers (LCCs) at Francisco Sá Carneiro Airport, thus contributing to a rapid expansion of this region as a tourism destination. Hence, this work project aims to understand the touristic and economic impact motivated by the entry of LCCs in Oporto and in the North Region of Portugal and tries to understand if this event was in fact an asset in the development of the aforementioned tourism destinations.

Cruise tourism in Lisbon - Cruise tourism activity and its impact on the city

Field lab: Tourism

Measuring social impact: A guideline to implement a tableau de bord

Many impact-seeking organisations cannot measure and demonstrate their social impact because they either lack technical expertise or requisite financial and human resources. This report clarifies the process of social impact measurement to help these organisations engage in social impact measurement practices. It presents a simple guideline to create a measurement approach based on the Tableau de Board. The guideline has been developed through a theoretical revision of best practices in social impact measurement, academic research and the author's individual thoughts and ideas. While a first testing of the approach revealed positive feedback, only future broad-scale testing will demonstrate the approach’s validity and feasibility.

The impact of job insecurity on adaptive performance via burnout

Difficult and unpredictable times, due to economic instability, lead employees to feel high job insecurity. Organizations’ only way to subsistence is to search innovative ways of solving problems and find creative solutions. This study focuses on the impact that job insecurity has on adaptive performance, a recent measure integrating the response of creativity, reactivity in the face of emergencies, interpersonal adaptability, training effort, and handling work stress, and, mediated by burnout. From the responses of two questionnaires (????????1=252; ????????2=145), we conclude that job insecurity leads to exhaustion, but not to disengagement. In turn, it is the latter that demonstrates to have negative relations with some measures of adaptive performance. Thus, it is crucial to understand how organizations can minimize the inherent process.

Social impact bond feasibility study

Youth unemployment is one of the most pressing social issues in Portugal, often associated to a lack of skills. Faz-Te Forward (FFWD), a Portuguese employability programme, has demonstrated great potential for impact in solving this issue, especially amongst a neglected segment of the population – those belonging to “sandwich families”. The present thesis, integrated in the SIB Research Programme from the Social Investment Lab, evaluates the feasibility of this programme to be financed through a Social Impact Bond, an innovative outcomes-based financing model. From a data analysis undertaken to FFWD’s historical information, a business case for a SIB was developed.