Fatores críticos de sucesso na implementação e gerenciamento do pensamento enxuto: um estudo na manufatura de fitas acrílicas

As a result of the industrial competitiveness increase in recent decades, concern about process improvements has been growing significantly. Lean Thinking principles are being more and more applied in the different sectors of the industry and aim to reduce costs, which can generate satisfactory results for an organization. Besides the application of lean tools on workstations, Lean Thinking seeks cultural change of the employees. Although the concepts of this management philosophy are widely disseminated, many organizations find barriers in their implementation and management. This study seeks to identify and evaluate the critical success factors in the implementation of Lean Thinking based on a qualitative research in the manufacturing environment of a multinational chemical company that produces acrylic tapes for the automotive market

Políticas e desenvolvimento do estado de Mato Grosso após abertura comercial: análise da visão de dois empresários atuantes no setor

After realizing two interviews, with distinct managers/businessmen working in the cotton industry, the objective is to put in evidence the political, economical and social factors that contributed to the formation and configuration of the Mato Grosso state, after the trade liberalization that occurred in the early 90's, it's effects and consequences in the eyes of the interviewed. The study of public policies is primordial to the discovery of the configuration of determined place, evaluating advances and possible errors in the social, economical and environmental areas. Through the analysis of the interviews it has been found that the urban centers have been developing with a direct link to the industrial activities related to agriculture and that the labor work force have also been attracted because of these changes, and as a consequence this labor force is now becoming more specialized to be able to accompany the jobs requirements in the industry. Analyzing the interviews, it is possible to highlight some information about the development of Mato Grosso, among those the following factors and public policies. The creation and expansion of the cities in the state are possible through public and private investment in infrastructure the socioeconomic development of the state is linked with the advances made in the private sector that grows because of advances made in crops technology in contrast to the occupation of the cerrado, in relation to the cotton crops. The problems that Mato Grosso is facing are mainly linked to the region infrastructure, that can count on investment plans to transportation and production flow that dates before the globalization era. The pattern that is seen today with top of the line agricultural production, big monoculture with high productivity and the arrival of multinational giants, was implanted because of two important events: the trade liberalization in the 1990's and the cambial depreciation in the 1999's...

Is production the core competence for the internationalization of emerging country firms?

The rise of new multinationals in countries like Brazil provides an opportunity to revisit and carefully construct theories of how firms internationalize, a topic on which extant theory is weak. Brazilian firms are "infant multinationals", unlike developed country firms that are "mature multinationals". They are also internationalizing in a very different global context, and can do so on the basis of different competitive advantages than multinationals that came before. Therefore, this study aims at creating subsidies for theory building about early-stage internationalization. Emerging country firms have Production competences as main competitive asset to internationalize, what reflects their competitive positioning in home markets and their entry strategy in international markets. In the case of early-entrants - Western multinationals in the 1950s and Japanese in the 1980s - the Production competence played a key role for successful internationalization. Thus, the focus of the study is the role that the Production competence plays in the internationalization of late-entrants, the emerging country multinationals. The research design considers not only the position of the headquarters but also the initiatives of the subsidiaries and the dynamic interplay between both. The paper allows a better understanding of internationalization processes and the role of Production, when firms start building their own international networks. It brings relevant insights about the paths that are being followed by emerging country multinationals, the difficulties they find, the solutions they develop. These are important inputs not only for new theory building but also for managerial practice. (C) 2012 Elsevier B.V. All rights reserved.

Thrombin-Receptor Antagonist Vorapaxar in Acute Coronary Syndromes

BACKGROUND Vorapaxar is a new oral protease-activated receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet activation. METHODS In this multinational, double-blind, randomized trial, we compared vorapaxar with placebo in 12,944 patients who had acute coronary syndromes without ST-segment elevation. The primary end point was a composite of death from cardiovascular causes, myocardial infarction, stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization. RESULTS Follow-up in the trial was terminated early after a safety review. After a median follow-up of 502 days (interquartile range, 349 to 667), the primary end point occurred in 1031 of 6473 patients receiving vorapaxar versus 1102 of 6471 patients receiving placebo (Kaplan-Meier 2-year rate, 18.5010 vs. 19.9%; hazard ratio, 0.92; 95% confidence interval [CI], 0.85 to 1.01; P=0.07). A composite of death from cardiovascular causes, myocardial infarction, or stroke occurred in 822 patients in the vorapaxar group versus 910 in the placebo group (14.7% and 16.4%, respectively; hazard ratio, 0.89; 95% CI, 0.81 to 0.98; P=0.02). Rates of moderate and severe bleeding were 7.2% in the vorapaxar group and 5.2% in the placebo group (hazard ratio, 1.35; 95% CI, 1.16 to 1.58; P<0.001). Intracranial hemorrhage rates were 1.1% and 0.2%, respectively (hazard ratio, 3.39; 95% CI, 1.78 to 6.45; P<0.001). Rates of nonhemorrhagic adverse events were similar in the two groups. CONCLUSIONS In patients with acute coronary syndromes, the addition of vorapaxar to standard therapy did not significantly reduce the primary composite end point but significantly increased the risk of major bleeding, including intracranial hemorrhage. (Funded by Merck; TRACER ClinicalTrials.gov number, NCT00527943.)

Early Rheumatoid Arthritis in Latin America: Low Socioeconomic Status Related to High Disease Activity at Baseline

Objective. To determine the influence of socioeconomic factors on disease activity in a Latin American (LA) early rheumatoid arthritis (RA) multinational inception cohort at baseline. Methods. Clinical evaluation, ethnicity, socioeconomic status (SES), 4-variable Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28-ESR), Health Assessment Questionnaire (HAQ) disability index (DI), and erosions were recorded in 1,093 patients with early RA (<1 year from onset). Multivariate analyses evaluated influences of sex, age, marital status, education, medical coverage, SES, and ethnicity on HAQ DI, DAS28-ESR, and presence of erosions. Results. Ethnicities included 43% Mestizo, 31% Caucasian, 19% African LA, 4% Amerindian, and 3% other. Fifty-eight percent were of low/low-middle SES, 42% had <8 years of education, 21% had no medical coverage, median disease duration was 6 months (25th, 75th percentiles 4, 9 months), median HAQ DI score was 1.25 (25th, 75th percentiles 0.63, 2.00), median DAS28-ESR score was 6.2 (25th, 75th percentiles 4.9, 7.2), and 25% had erosions. Women and Mestizos, African LA, and Amerindians had earlier onset than men or Caucasians (P < 0.01). When adjusted by country, the analysis of covariance model showed that low/low-middle SES, female sex, partial coverage, and older age were associated with worse HAQ DI scores; only low/low-middle SES was associated with higher DAS28 scores. Statistically significant differences were found in HAQ DI and DAS28 scores between countries. When excluding country, low/low-middle SES, female sex, and no coverage were associated with worse HAQ DI and DAS28 scores, whereas separated/divorced/widowed status was associated with worse HAQ DI scores and age was associated with worse DAS28 scores. Logistic regression showed that older age, no coverage, and the Amerindian and other ethnic groups were associated with erosions. Conclusion. We compared early RA patients from the main LA ethnic groups. Our findings suggest that low/low-middle SES is important in determining disease activity. A more genetic-related background for erosions is possible.

RHYTHM-AF: design of an international registry on cardioversion of atrial fibrillation and characteristics of participating centers

Background: Atrial fibrillation is a serious public health problem posing a considerable burden to not only patients, but the healthcare environment due to high rates of morbidity, mortality, and medical resource utilization. There are limited data on the variation in treatment practice patterns across different countries, healthcare settings and the associated health outcomes. Methods/design: RHYTHM-AF was a prospective observational multinational study of management of recent onset atrial fibrillation patients considered for cardioversion designed to collect data on international treatment patterns and short term outcomes related to cardioversion. We present data collected in 10 countries between May 2010 and June 2011. Enrollment was ongoing in Italy and Brazil at the time of data analysis. Data were collected at the time of atrial fibrillation episode in all countries (Australia, Brazil, France, Germany, Italy, Netherlands, Poland, Spain, Sweden, United Kingdom), and cumulative follow-up data were collected at day 60 (+/- 10) in all but Spain. Information on center characteristics, enrollment data, patient demographics, detail of atrial fibrillation episode, medical history, diagnostic procedures, acute treatment of atrial fibrillation, discharge information and the follow-up data on major events and rehospitalizations up to day 60 were collected. Discussion: A total of 3940 patients were enrolled from 175 acute care centers. 70.5% of the centers were either academic (44%) or teaching (26%) hospitals with an overall median capacity of 510 beds. The sites were mostly specialized with anticoagulation clinics (65.9%), heart failure (75.1%) and hypertension clinics (60.1%) available. The RHYTHM-AF registry will provide insight into regional variability of antiarrhythmic and antithrombotic treatment of atrial fibrillation, the appropriateness of such treatments with respect to outcomes, and their cost-efficacy. Observations will help inform strategies to improve cardiovascular outcomes in patients with atrial fibrillation.

Estratégia internacional de uma multinacional emergente brasileira: o caso JBS

Este estudo preocupa-se em questionar se as teorias tradicionais de internacionalização são adequadas para explicar a expansão internacional das multinacionais de países emergentes. Procurando avançar nessa questão, investigam-se as estratégias de internacionalização adotadas pela JBS, multinacional brasileira do setor frigorífico. Os resultados evidenciam que a empresa adotou duas das cinco estratégias genéricas específicas ao contexto de países emergentes sugeridas por Ramamurti e Singh (2009): consolidador global e integrador vertical. Além disso, ao analisar a internacionalização da empresa em estudo, chama atenção a velocidade do processo, em comparação às multinacionais tradicionais. Conclui-se que o principal modo de entrada que possibilitou a expansão internacional foi a aquisição e que essa trouxe vantagens à empresa, como o acesso a recursos estratégicos, o crescimento rápido, a possível superação da liability of foreignness, a oportunidade para competir globalmente e a diversificação dos segmentos de atuação que geram sinergias às atividades da empresa.

Congruências entre posicionamentos estratégicos e redes de negócios: estudo de caso de uma subsidiária brasileira

Na pesquisa exploratória aqui relatada, realizada em 2009 e guiada por uma extensa revisão bibliográfica e pelo emprego do método de estudo de caso, busca-se identificar congruências entre o posicionamento estratégico adotado pela subsidiária brasileira de uma corporação multinacional e o tipo de rede de negócios por ela integrada. Apoiando-se em dois modelos específicos da literatura acadêmica sobre os temas mencionados (posicionamento estratégico e redes), as conclusões dessa investigação sugerem que as Redes Verticais de Demanda e Fornecimento (MOLLER e RAJALA, 2007) são adequadas para operacionalizar o posicionamento definido como Melhor Produto no Modelo Delta (HAX e WILDE II, 1999; 2001).

The abuse of intellectual property rights and regulations in China: a law and economic analysis

From the institutional point of view, the legal system of IPR (intellectual property right, hereafter, IPR) is one of incentive institutions of innovation and it plays very important role in the development of economy. According to the law, the owner of the IPR enjoy a kind of exclusive right to use his IP(intellectual property, hereafter, IP), in other words, he enjoys a kind of legal monopoly position in the market. How to well protect the IPR and at the same time to regulate the abuse of IPR is very interested topic in this knowledge-orientated market and it is the basic research question in this dissertation. In this paper, by way of comparing study and by way of law and economic analyses, and based on the Austrian Economics School’s theories, the writer claims that there is no any contradiction between the IPR and competition law. However, in this new economy (high-technology industries), there is really probability of the owner of IPR to abuse his dominant position. And with the characteristics of the new economy, such as, the high rates of innovation, “instant scalability”, network externality and lock-in effects, the IPR “will vest the dominant undertakings with the power not just to monopolize the market but to shift such power from one market to another, to create strong barriers to enter and, in so doing, granting the perpetuation of such dominance for quite a long time.”1 Therefore, in order to keep the order of market, to vitalize the competition and innovation, and to benefit the customer, in EU and US, it is common ways to apply the competition law to regulate the IPR abuse. In Austrian Economic School perspective, especially the Schumpeterian theories, the innovation/competition/monopoly and entrepreneurship are inter-correlated, therefore, we should apply the dynamic antitrust model based on the AES theories to analysis the relationship between the IPR and competition law. China is still a developing country with relative not so high ability of innovation. Therefore, at present, to protect the IPR and to make good use of the incentive mechanism of IPR legal system is the first important task for Chinese government to do. However, according to the investigation reports,2 based on their IPR advantage and capital advantage, some multinational companies really obtained the dominant or monopoly market position in some aspects of some industries, and there are some IPR abuses conducted by such multinational companies. And then, the Chinese government should be paying close attention to regulate any IPR abuse. However, how to effectively regulate the IPR abuse by way of competition law in Chinese situation, from the law and economic theories’ perspective, from the legislation perspective, and from the judicial practice perspective, there is a long way for China to go!

Der irische Buchmarkt

Der irische Buchmarkt als Teil des englischsprachigen Buchmarktes ist stark von der Geschichte des Landes geprägt. Die Fremdbestimmung im Rahmen des Commonwealth unterdrückte eine eigenständige Verlagslandschaft bis weit ins 20. Jahrhundert hinein. Mit der Unabhängigkeit des irischen Staates stieg die Anzahl der Verlage langsam aber stetig an. In den 70er Jahren kam die irische Verlagslandschaft zu einem fast explosionsartigen Erblühen. Die Gründung des Verlegerverbandes Clé war einer von vielen Schritten, um den nationalen Buchmarkt von der Dominanz britischer Bücher in Buchhandlungen und Bibliotheken zu emanzipieren. Die Nachfrage nach Irish-Interest-Titeln ist im Inland hoch. Britische Verlage hatten bis dato diesen Bedarf übersehen, und so füllten irische Verlage diese Nische. Die Einführung eines von Großbritannien unabhängigen Lehrplans führte zur Etablierung eines eigenständigen Schulbuchmarktes, inklusive Lehrwerke zur irischen Sprache bzw. Titel auf Irisch. Irische Verlage sind in ihrem Programm größtenteils breit aufgestellt und selten spezialisiert. Sie sind erstaunlich häufig unabhängige mittelständische Unternehmen. Nur wenige Verlage sind staatlich geführt oder gehören ausländischen Konzernen an. Auch der stationäre Buchhandel ist überwiegend eigenständig, da die – vor dem Wirtschaftsboom wenig kaufkräftige - Republik von den expandierenden britischen Buchhandelsketten vernachlässigt wurde. Erst nach dem Wirtschaftsboom und dem damit verbundenen soziokulturellen Wandel von einer traditionellen Agrar- hin zu einer modernen Informationsgesellschaft stiegen die Umsätze mit Büchern stark an. Sobald der Buchmarkt eine nennenswerte wirtschaftliche Größe erreichte, eröffneten britische Buchhandlungen Filialen in irischen Städten. Sie vermochten jedoch nicht, die Sortimentsvielfalt der irischen Buchhandelslandschaft zu zerstören. Die fehlende Buchpreisbindung ist keine Bedrohung der Titelvielfalt, da Handelsformen wie Buchclubs, Supermärkte und Internethandel – die mit teils aggressivem Preismarketing arbeitenden Nebenmärkte – hier nur eine Randexistenz führen. In diesem Fall wandelt sich die geringe (Umsatz-) Größe und damit Attraktivität des Buchmarktes zum Vorteil. Die staatliche Kulturförderung ist ein bedeutender Beitrag zum Verlegen von Literatur, die wirtschaftlich gerechnet keine Daseinsberechtigung hätte. Irische Verleger mit relativ geringem Budget sind nicht in der Lage, solche unökonomischen Titel mit dem finanziellen Erfolg eines Bestsellers in Mischkalkulation aufzufangen. Hier greift die staatliche Unterstützung. Die Subventionierung von Titeln über die irischen Sprache bzw. von Literatur auf Irisch führte zur Herausbildung eines Marktsektors, der vor der Staatsgründung nicht existierte. Die Übersetzungsförderung verstärkt die Verbreitung von bis dato unbekannter irischer Literatur im Ausland und stimuliert das Lizenzgeschäft. Die aktuelle staatliche Kulturpolitik setzt ihren Schwerpunkt auf Marketing, PR sowie Nachfolgeregelung und fördert so nachhaltig statt bloß in Form einer kurzlebigen Titelsubvention. Eine noch mehr in die Zukunft gerichtete Förderung würde genauso wie die Unterstützung von Fortbildungsmaßnahmen zu besseren wirtschaftlichen Rahmenbedingungen führen. Auch wenn die nationale Verlagsszene im Aufschwung begriffen ist, befindet sich der irische Buchmarkt insgesamt in fester Hand der britischen Verlagsproduktion. Der britische Buchmarkt mit seinen multinationalen und finanzkräftigen Verlagen lebt vom Export. Aus Sicht von Großbritannien ist heutzutage der Nachbar Irland, einst Teil des britischen Buchmarktes, einer der besten Kunden. Dieser Aspekt bezieht sich nicht nur auf die langjährig entwickelten Handelsbeziehungen. In kulturellen Aspekten orientiert sich Irland stark am britischen Vorbild: Ein britischer Bestseller wird fast immer auch ein Bestseller in Irland. Lediglich Irish-Interest-Titel durchbrechen diesen Automatismus. Während Irish Interest im Inland hohe Umsätze vorweist, sind diese Titel im Ausland lediglich ein Nischenprodukt. Zusätzlich müssen irische Verlage außerhalb des Landes mit britischen und US-amerikanischen Verlagen in Konkurrenz treten, die ebenfalls Irish-Interest-Titel für die irische Diaspora anbieten. Es besteht daher nur eine geringe Chance, erfolgreich am globalen englischsprachigen Buchmarkt mitzuwirken. Bis dato haben Versuche, dem irischen Buchmarkt durch Export zu Umsatzwachstum zu verhelfen, keinen nennenswerten Erfolg gebracht. Lediglich auf dem Gebiet der populären Literatur und in Form von Kooperationen mit britischen Verlagskonzernen vermögen irische Verlage, am internationalen Buchhandel teilzuhaben.

Export Supply Chain Organization and Food Safety and Quality Standards: a case study of the Moroccan Fruit and Vegetable Sector

Agri-food supply chains extend beyond national boundaries, partially facilitated by a policy environment that encourages more liberal international trade. Rising concentration within the downstream sector has driven a shift towards “buyer-driven” global value chains (GVCs) extending internationally with global sourcing and the emergence of multinational key economic players that compete with increase emphasis on product quality attributes. Agri-food systems are thus increasingly governed by a range of inter-related public and private standards, both of which are becoming a priori mandatory, especially in supply chains for high-value and quality-differentiated agri-food products and tend to strongly affect upstream agricultural practices, firms’ internal organization and strategic behaviour and to shape the food chain organization. Notably, increasing attention has been given to the impact of SPS measures on agri-food trade and notably on developing countries’ export performance. Food and agricultural trade is the vital link in the mutual dependency of the global trade system and developing countries. Hence, developing countries derive a substantial portion of their income from food and agricultural trade. In Morocco, fruit and vegetable (especially fresh) are the primary agricultural export. Because of the labor intensity, this sector (especially citrus and tomato) is particularly important in terms of income and employment generation, especially for the female laborers hired in the farms and packing houses. Hence, the emergence of agricultural and agrifood product safety issues and the subsequent tightening of market requirements have challenged mutual gains due to the lack of technical and financial capacities of most developing countries.

Mobi - kids - rischio di tumori cerebrali ed esposizione a campi a radiofrequenza nei bambini e negli adolescenti

Introduzione. Il rapido e globale incremento dell’utilizzo dei telefoni cellulari da parte degli adolescenti e dei bambini ha generato un considerevole interesse circa i possibili effetti sulla salute dell’esposizione a campi elettromagnetici a radiofrequenza. Perciò è stato avviato lo studio internazionale caso-controllo Mobi-kids, all’interno del quale si colloca quello italiano condotto in 4 Regioni (Piemonte, Lombardia, Toscana, Emilia-Romagna). Obiettivi. Lo studio ha come obiettivo quello di valutare la stima del rischio degli effetti potenzialmente avversi di queste esposizioni sul sistema nervoso centrale nei bambini e negli adolescenti. Materiali e Metodi. La popolazione include tutte le persone di età compresa tra 10 e 24 anni residenti nelle 4 Regioni, con una diagnosi confermata di neoplasia cerebrale primitiva, diagnosticata durante il periodo di studio (3 anni). Sono stati selezionati due controlli - ospedalizzati per appendicite acuta - per ciascun caso. I controlli sono stati appaiati individualmente a ciascun caso per età, sesso e residenza del caso. Risultati. In Italia sono stati intervistati a Giugno 2014, 106 casi e 191 controlli. In Emilia-Romagna i casi reclutati sono stati fino ad ora 21 e i controlli 20, con una rispondenza del’81% e dell’65% rispettivamente. Dei 41 soggetti totali, il 61% era di sesso maschile con un’età media generale pari a 16,5 (±4,5) anni. Inoltre il 44% degli intervistati proveniva dalla classe di età più giovane (10-14). In merito allo stato di appaiamento, nella nostra Regione sono state effettuate 7 triplette (33%) - 1 caso e 2 controlli - e 6 doppiette (29%) - 1 caso ed 1 controllo. Conclusioni. Nonostante le varie difficoltà affrontate data la natura del progetto, l’esperienza maturata fin ad ora ha comunque portato alla fattibilità dello studio e porterà probabilmente a risultati che contribuiranno alla comprensione dei potenziali rischi di neoplasie cerebrali associati all'uso di telefoni cellulari tra i giovani.

Dialysis and Renal Transplantation in HIV-Infected Patients: a European Survey

OBJECTIVES:: To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients. METHODS:: Cross-sectional multicenter survey of EuroSIDA clinics during 2008. RESULTS:: Prevalence of ESRD was 0.5%. Of 122 patients with ESRD 96 were on dialysis and 26 had received a RT. Median age was 47 years, 73% were males and 43% were black. Median duration of HIV infection was 11 years. Thirty-three percent had prior AIDS; 91% were receiving antiretrovirals; and 88% had undetectable viral load. Median CD4T-cell count was 341 cells per cubic millimetre; 20.5% had hepatitis C coinfection. Most frequent causes of ESRD were HIV-associated nephropathy (46%) and other glomerulonephritis (28%). Hemodialysis (93%) was the most common dialysis modality; 34% of patients were on the RT waiting list. A poor HIV control was the reason for exclusion from RT waiting list in 22.4% of cases. All the RT recipients were all alive at the time of the survey. Acute rejection was reported in 8 patients (30%). Functioning graft was present in 21 (80%). CONCLUSIONS:: This is the first multinational cross-sectional study of ESRD among European HIV population. Low prevalence of ESRD was found. Two-thirds of patients were excluded from RT for non-HIV/AIDS-related pathologies. Most patients had a functioning graft despite a high acute rejection rate.

Adherence to ESMO clinial recommendations for prophylaxis of chemotherapy-induced nausea and vomiting

We assessed adherence to the European Society of Medical Oncology (ESMO)/Multinational Association of Supportive Care in Cancer recommendations for prophylaxis of chemotherapy-induced nausea and vomiting (CINV) at our institution.

Industrial Restructuring in the Budapest agglomeration

The major 'motor' of the recent Hungarian industrial development has been foreign direct investment, particularly by multinational companies. This has stimulated the development process, as shown by the dynamism of production, exports and profitability of industry in Budapest. On the other hand, this has also led to a split of the industrial sphere into its foreign and domestic sections, or into foreign-owned companies and domestic SMEs. The major question asked in this project is where is Hungarian industry heading and will the gap between the contracting domestic part and the foreign multinationals continue to widen or will they be joined in a much more favourable scenario. Barta sees this as a question of whether Hungary can avoid the 'dead-end street' of South Asian industrialising countries, and instead move towards a new Eastern European or Hungarian model. He concludes that Budapest industry does not follow any given model and indeed its development probably cannot be seen as a 'model' proper in itself, but is, or will be, a mixture of different elements. This would be a welcome fusion of Hungary's rich human resources of accumulated knowledge with foreign direct investment. Budapest would play an exceptional role in such a process, as the gateway for foreign output to the rest of the country. The share of industry in the Budapest economy will continue to decrease, but it will become a more modern and profitable sector. It will also fulfil a technological transfer role between the developed world and the Hungarian countryside (or even a larger region of central and eastern Europe). Barta predicts that Budapest industry will develop a special structure, with a large subcontractor network supporting the large foreign enterprises, and alongside this industrial districts formed by SMEs.