Inadequate utilization of prenatal care in two Brazilian birth cohorts

Data for two birth cohorts from two Brazilian municipalities, Ribeirão Preto in 1994 and São Luís in 1997/1998, were used to identify and compare factors associated with inadequate utilization of prenatal care and to identify factors capable of explaining the differences observed between the two cities. Prenatal care was defined as adequate or inadequate according to the recommendations of the Brazilian Ministry of Health. The chi-square test and Poisson regression were used to compare differences in the inadequacy of prenatal care utilization. The percentage of inadequacy was higher in São Luís (34.6%) than in Ribeirão Preto (16.9%). Practically the same variables were associated with inadequacy in both cities. Puerperae with lower educational level, without a companion or cohabiting, who delivered in public health units, younger than 20 years, multiparae and smokers, with low family income presented higher percentages of inadequate prenatal care utilization. However, the effects of some variables differed between the two cities. The risk for inadequate use of prenatal care was higher for women attended in the public health sector in São Luís and for cohabiting women in Ribeirão Preto. The effect of the remaining factors studied did not differ between cities. The category of admission accounted for 57.0% of the difference in the inadequate use of prenatal care between cities and marital status accounted for 45.3% of the difference. Even after adjustment for all variables, part of the difference in the inadequacy of prenatal care utilization remained unexplained.

Nasal CPAP in the delivery room for newborns with extremely low birth weight in a hospital in a developing country

The objective of this study was to determine the feasibility of the use of continuous positive airway pressure installed prophylactically in the delivery room (DR-CPAP), for infants with a birth weight between 500 and 1000 g in settings with limited resources. During 23 months, infants with a birth weight between 500 and 1000 g consecutively received DR-CPAP. A total of 33 infants with low birth weight were enrolled, 16 (48.5%) were females. Only 14 (42.4%) received antenatal corticosteroids and only 2 of those 14 (14.3%) infants weighing 500-750 g were not intubated in the delivery room, and apnea was given as the reason for intubation of these patients. Of the 19 infants in the 751-1000 g weight range, 9 (47.4%) were intubated in the delivery room, 6 due to apnea and 3 due to respiratory discomfort. For DR-CPAP to be successful, it is probably necessary for preterm babies to be more prepared at birth to withstand the respiratory effort without the need for intubation. Antenatal corticosteroids and better prenatal monitoring are fundamental for success of DR-CPAP.

Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.

Random-start controlled ovarian stimulation for emergency fertility preservation in a patient with myelodysplastic syndrome: a case report

This study reports a case of a gonadotropin-releasing hormone agonist trigger in a young female with myelodysplastic syndrome (MDS) who underwent fertility preservation using random-start controlled ovarian stimulation. This method involves the stimulation of the ovary regardless of a patient's menstrual-cycle phase. A review of the related literature is also provided. A 17-year-old patient was diagnosed with MDS and required initiation of peripheral blood stem cell transplantation within a maximum of 3 weeks and was in the luteal phase of the menstrual cycle when the possibility of attempting preservation of fertility was presented to her. She opted for a random-start controlled ovarian stimulation with gonadotropins. With successful hemorrhagic prophylaxis, 17 oocytes were retrieved including 10 mature and 7 immature oocytes. Of the immature oocytes, 3 were successfully matured in vitro and a vitrification protocol was used to freeze the 13 mature oocytes.

The Utilization of Chinese Social Media in Internationalization into China: Perspective of a Western Company

The purpose of this qualitative research is to analyze western-based companies’ social media usage in internationalization into China and to identify social media presence’ impact on the internationalization process. Additionally, the benefits and challenges a western company may face while using social media in China will be illustrated. Competitive advantages, knowledge, networks and relations, and costs and risks could be identified as the key antecedents for successful internationalization. A great social media presence could create a competitive advantage for a western company while competitive advantages may be communicated in social media marketing, knowledge and networks can be enhanced and utilized in internationalization via social media two-way communication. The biggest benefit for internationalization resulted from decreased marketing costs due to cost-effectiveness of social media. The results revealed that cost effective brand awareness was the main benefit from the social media usage in internationalization into China. However, companies struggled with the limited resources and despite of understanding the importance of Chinese social media, lacked sufficient resources for the social media operations. Companies should determine clear strategy and goals that they are willing to achieve via social media in internationalization process, and allocate required resources according to the social media strategy. Localization of the social media operations is important in China, and business-to-consumer companies tend to benefit more from the social media presence. Business-to-business companies may increase the brand’s credibility by successful Chinese social media operations.

Utilization of recycled mineral wool as filler in wood plastic composites

The impact of a recycled mineral wool filler on the various properties of wood plastic composites was studied and the critical factors affecting the formation of the properties were determined. An estimation of the volume of mineral wool fiber waste generated in the European Union between the years 2010-2020 was presented. Furthermore, the effect of fiber pre-treatment on the properties of the wood plastic composites were studied, and the environmental performance of a wood plastic composite containing recycled mineral fibers was assessed. The results showed that the volumes of construction and demolition waste and new mineral wool produced in the European Union are growing annually, and therefore also the volumes of recycled mineral wool waste generated are increasing. The study showed that the addition of recycled mineral wool into composites can enhance some of the mechanical properties and increase the moisture resistance properties of the composites notably. Recycled mineral wool as a filler in wood plastic composites can also improve the fire resistance properties of composites, but it does not protect the polymer matrix from pyrolysis. Fiber pre-treatment with silane solution improved some of the mechanical properties, but generally the use of maleated polypropylene as the coupling agent led to better mechanical and moisture resistance properties. The environmental performance of recycled mineral wool as the filler in wood plastic composites was superior compared to glass fibers. According to the findings, recycled mineral wool fibers can provide a technically and environmentally viable alternative to the traditional inorganic filler materials used in wood plastic composites.

Room temperature aging to guarantee microbiological safety of Brazilian artisan Canastra cheese

Canastra cheese is one of the oldest and most traditional cheeses made from raw milk in Brazil. However, this type of practice may have severe consequences for human health. According to the current legislation, any cheese made from raw milk must be aged for at least 60 days. Traditionally, Canastra cheese is consumed after different ripening periods, but consumers usually prefer those that are aged less than eight days. This study aimed to evaluate the effects of physicochemical and microbiological parameters, with emphasis on the pathogenic microbiota regulated by law, on cheese aged at room temperature and under refrigeration. Cheese samples were collected from eight different cheese producers located in the Serra da Canastra region twice a year (rainy and dry seasons) and analyzed with 8, 15, 22, 29, 36, and 64 days of ripening. Room temperature aging effectively reduced pathogens, reaching the total count established by law in 22 days, regardless of the season. However, ripening under refrigeration, it was ineffective in reducing the Staphylococcus aureus counts to the legislation limits, even after 64 days. Therefore, Canastra cheese should be ripened for at least 22 days at room temperature in order to fulfill the safety regulatory limits.

Climate Change and Ethics of Geoengineering -- Implications Of Climate Emergency Ethics

Global climate change and intentional climate modification, i.e. geoengineering include various ethical problems which are entangled as a complex ensemble of questions regarding the future of the biosphere. The possibilities of catastrophic effects of climate change which are also called “climate emergency” have led to the emergence of the idea of modifying the atmospheric conditions in the form of geoengineering. The novel issue of weather ethics is a subdivision of climate ethics, and it is interested in ethical and political questions surrounding weather and climate control and modification in a restricted spatio-temporal scale. The objective of geoengineering is to counterbalance the adverse effects of climate change and its diverse corollaries in various ways on a large scale. The claim of this dissertation is that there are ethical justifications to claim that currently large-scale interventions to the climate system are ethically questionable. The justification to pursue geoengineering on the basis of considering its pros and cons, is inadequate. Moral judgement can still be elaborated in cases where decisions have to be made urgently and the selection of desirable choices is severely limited. The changes needed to avoid severe negative impacts of climate change requires commitment to mitigation as well as social changes because technical solutions cannot address the issue of climate change altogether. The quantitative emphasis of consumerism should shift to qualitative focus on the aspiration for simplicity in order to a move towards the objective of the continuation of the existence of humankind and a flourishing, vital biosphere.

Comparing the alternative utilization method for coconut in Nzema, Ghana

There are many opportunities to utilise coconut in Nzema to support farmers. Coconut oil that is mainly used for food preparation in Nzema can be utilized as fuel to support overcoming of the energy crisis in the Ghana. Coconut oil in Nzema is not used in both transportation and electricity generation. A few of the waste husk and shell are mainly used as fuel in homes for heating but greater amount is left to rot or burn the coconut plantation. In addition, some portion of the granulated coconut kernel is sometime used as feed for piggery feed and the rest of the granulated kernel are left as waste on the oil processing site. In this thesis, the author identified alternative utilization of cocoanut, for instance the use of coconut husk and shell for charcoal production, and the use of coconut trunks as construction materials. It is envisaged that exploring these alternatives will not only reduce carbon emission in the country but will also contribute significantly to the sustainability of the local agro-industry.

Utilization of multi-branding in business to business markets

Case company utilizes multi-branding strategy (or house of brands strategy) in its product portfolio. In practice the company has multiple brands – one main brand and four acquired brands – which all utilize one single product platform. The objective of this research is to analyze case company’s multi-branding strategy and its benefits and challenges. Moreover, the purpose is to clarify that how could a company in B2B markets utilize multi-branding strategy more efficiently and profitably. The theoretical part of this thesis consists of aspects of branding strategies; different brand name architectures, benefits and challenges of different strategies and different ways of utilize branding strategies in mergers and acquisitions. The empirical part, on the other hand, includes the description of the case company’s branding strategy and the employees’ perspective on the benefits and challenges of multi-branding strategy, and how to utilize it more efficiently and profitably. This study shows, that the major benefits of utilizing multi-branding are lower production costs, ability to reach wider market coverage, possibility to utilize common sales tools, synergies in R&D and shared resources. On the other hand, the major challenges are lack of product differentiation, internal competition, branding issues in production and deliveries, pricing issues and conflicts, and compromises in product compatibility and suitability. Based on the results, several ways to utilize multi-branding strategy more efficiently and profitably were found; by putting more effort on brand image and product differentiation, by having more co-operation among the brands and by focusing on more precise customer and market segmentation.

Utilization of Statistical Methods for Management in the Forest Industry

The strongest wish of the customer concerning chemical pulp features is consistent, uniform quality. Variation may be controlled and reduced by using statistical methods. However, studies addressing the application and benefits of statistical methods in forest product sector are scarce. Thus, the customer wish is the root cause of the motivation behind this dissertation. The research problem addressed by this dissertation is that companies in the chemical forest product sector require new knowledge for improving their utilization of statistical methods. To gain this new knowledge, the research problem is studied from five complementary viewpoints – challenges and success factors, organizational learning, problem solving, economic benefit, and statistical methods as management tools. The five research questions generated on the basis of these viewpoints are answered in four research papers, which are case studies based on empirical data collection. This research as a whole complements the literature dealing with the use of statistical methods in the forest products industry. Practical examples of the application of statistical process control, case-based reasoning, the cross-industry standard process for data mining, and performance measurement methods in the context of chemical forest products manufacturing are brought to the public knowledge of the scientific community. The benefit of the application of these methods is estimated or demonstrated. The purpose of this dissertation is to find pragmatic ideas for companies in the chemical forest product sector in order for them to improve their utilization of statistical methods. The main practical implications of this doctoral dissertation can be summarized in four points: 1. It is beneficial to reduce variation in chemical forest product manufacturing processes 2. Statistical tools can be used to reduce this variation 3. Problem-solving in chemical forest product manufacturing processes can be intensified through the use of statistical methods 4. There are certain success factors and challenges that need to be addressed when implementing statistical methods

Possibilities and challenges in utilization of information provided by Industrial Internet applications

Global digitalization has affected also industrial sector. A trend called Industrial Internet has been present for some years and established relatively steady position in businesses. Industrial Internet is also referred with the terminology Industry 4.0 and in consumer businesses IoT (Internet of Things). Eventually, trend consists of many traditionally proven technologies and concepts, such as condition monitoring, remote services, predictive maintenance and Internet customer portals. All these technologies and information related to them are estimated to change the rules of business in industrial sector. This may result even a new industrial revolution. This research has its focus on Industrial Internet products, services and applications. The study analyses four case companies and their digital service offerings. According to this analysis the comparison of these services is done to find out if there is still space for companies to gain competitive advantage through differentiation with these state of the art solutions. One of the case companies, Case Company Ltd., is working as a primary case company and a subscriber of this particular research. The research and results are analyzed primarily from this company’s perspective and need. In empirical part, the research clarifies how Case Company Ltd. has allocated its development resources through last five years. These allocations in certain categories are then compared to other case companies’ current customer offering and conclusions are made how the approach of different companies differ from each other. Existing theoretical knowledge of Industrial Internet is about to find its shape. In this research we take a look how the case company analysis and findings correlate with the existing knowledge and literature of the topic.