O papel global do transplante renal

O Dia Mundial do Rim, em 8 de março de 2012, oferece uma chance para refletir sobre o sucesso do transplante renal como um tratamento para a doença renal em estágio terminal, que supera os tratamentos de diálise tanto pela qualidade quanto pela quantidade de vida, fornecida por estes, e devido ao custo-benefício. Qualquer coisa que seja tanto mais barata quanto melhor, mas que não seja realmente o tratamento dominante, deve ter outras desvantagens que previnam a substituição do tratamento da diálise pelo transplante. As barreiras para o transplante universal como a terapia para a doença renal em estágio terminal incluem as limitações econômicas, as quais, em alguns países, classificam o transplante, adequadamente, com prioridade inferior do que os fundamentos da saúde pública, tais como água limpa, saneamento e vacinação. Até mesmo em países de alta renda, os desafios técnicos da cirurgia e as consequências da imunossupressão restringem o número de receptores apropriados, mas as principais restrições limitadas das taxas de transplante renal são: a escassez de órgãos doados e a limitada mão de obra médica, cirúrgica e de enfermeiros com os conhecimentos necessários. Esses problemas têm soluções que envolvem um conjunto total dos ambientes social, profissional, governamental e político. O Dia Mundial do Rim é uma chamada para fornecer a terapia de transplante a um milhão de pessoas por ano, as quais têm o direito de se beneficiarem.

Injúria renal aguda: um alerta global

A Injúria Renal Aguda (IRA) é cada vez mais prevalente nos países desenvolvidos e nos em desenvolvimento, e está associada com morbidade e mortalidade severas. A maioria das causas da IRA pode ser evitada por meio de intervenções em nível individual, comunitário, regional e intra-hospitalar. Medidas efetivas devem incluir, em toda a comunidade, os esforços para aumentar a consciência dos efeitos devastadores do IRA e fornecer orientações sobre as estratégias de prevenção, bem como o reconhecimento e tratamento precoces. Os esforços devem ser focados em minimizar as causas de IRA, aumentando a consciência da importância de medidas seriadas de creatinina sérica em pacientes de alto risco para IRA, e documentar o volume de urina em pessoas gravemente doentes para obtenção de diagnóstico precoce; até o momento, não há ainda um papel definitivo para outros biomarcadores. Há a necessidade de protocolos para sistematizar a conduta em condições de IRA pré-renal e em infecções específicas. Dados mais precisos sobre a verdadeira incidência e o impacto clínico da IRA ajudarão a melhor conhecer a importância desta doença, a aumentar o conhecimento de IRA por parte dos governantes, dos médicos em geral e de outros profissionais de saúde para ajudar na prevenção da doença. A prevenção é a chave para evitar a pesado ônus de mortalidade e morbidade associada com IRA.

Aplicabilidade da avaliação global subjetiva e malnutrition inflammation score na avaliação do estado nutricional na doença renal crônica

Até o momento, não há um método único capaz de diagnosticar com fidedignidade a condição nutricional do paciente com doença renal crônica (DRC). Por essa razão, tem se recomendado o emprego de vários marcadores nutricionais. A avaliação global subjetiva (AGS) se baseia na história física e no exame clínico do paciente e, desde sua criação, novas versões foram elaboradas. A partir da AGS, foi criado o malnutrition inflammation score (MIS), composto por 70% das questões comuns à AGS acrescido de questões objetivas do estado nutricional. Como muitas modificações foram feitas na forma original da AGS e o emprego tanto da AGS quanto do MIS em pacientes com DRC aumentou significativamente na prática clínica, este trabalho tem como objetivo fazer uma revisão sobre a aplicabilidade desses métodos para avaliação do estado nutricional em pacientes com DRC.

Climate change and global responsibility - the role of energy consumption, GDP and CO2 emissions

Climate change is one of the biggest challenges faced by this generation. Despite being the single most important environmental challenge facing the planet and despite over two decades of international climate negotiations, global greenhouse gas (GHG) emissions continue to rise. By the middle of this century, GHGs must be reduced by as much as 40-70% if dangerous climate change is to be avoided. In the Kyoto Protocol no quantitative emission limitation and reduction commitments were placed on the developing countries. For the planning of the future commitments period and possible participation of developing countries, information of the functioning of the energy systems, CO2 emissions development in different sectors, energy use and technological development in developing countries is essential. In addition to the per capita emissions, the efficiency of the energy system in relation to GHG emissions is crucial for the decision of future long-term burden sharing between countries. Country’s future development of CO2 emissions can be defined by the estimated CO2 intensity of the future and the estimated GDP growth. The changes in CO2 intensity depend on several factors, but generally developed countries’ intensity has been increasing in the industrialization phase and decreasing when their economy shifts more towards the system dominated by the service sector. The level of the CO2 intensity depends by a large extent on the production structure and the energy sources that are used. Currently one of the most urgent issues regarding global climate change is to decide the future of the Kyoto Protocol. Negotiations on this topic have already been initiated, with the aim of being finalised by the 2015. This thesis provides insights into the various approaches that can be used to characterise the concept of comparable efforts for developing countries in a future international climate agreement. The thesis examines the post-Kyoto burden sharing questions for developing countries using the contraction and convergence model, which is one approach that has been proposed to allocate commitments regarding future GHG emissions mitigation. This new approach is a practical tool for the evaluation of the Kyoto climate policy process and global climate change negotiations from the perspective of the developing countries.

Business intelligence – enabling self-service: A case study in a global manufacturing company

Business intelligence (BI) is an information process that includes the activities and applications used to transform business data into valuable business information. Today’s enterprises are collecting detailed data which has increased the available business data drastically. In order to meet changing customer needs and gain competitive advantage businesses try to leverage this information. However, IT departments are struggling to meet the increased amount of reporting needs. Therefore, recent shift in the BI market has been towards empowering business users with self-service BI capabilities. The purpose of this study was to understand how self-service BI could help businesses to meet increased reporting demands. The research problem was approached with an empirical single case study. Qualitative data was gathered with a semi-structured, theme-based interview. The study found out that case company’s BI system was mostly used for group performance reporting. Ad-hoc and business user-driven information needs were mostly fulfilled with self-made tools and manual work. It was felt that necessary business information was not easily available. The concept of self-service BI was perceived to be helpful to meet such reporting needs. However, it was found out that the available data is often too complex for an average user to fully understand. The respondents felt that in order to self-service BI to work, the data has to be simplified and described in a way that it can be understood by the average business user. The results of the study suggest that BI programs struggle in meeting all the information needs of today’s businesses. The concept of self-service BI tries to resolve this problem by allowing users easy self-service access to necessary business information. However, business data is often complex and hard to understand. Self-serviced BI has to overcome this challenge before it can reach its potential benefits.

Business intelligence – enabling self-service: A case study in a global manufacturing company

Business intelligence (BI) is an information process that includes the activities and applications used to transform business data into valuable business information. Today’s enterprises are collecting detailed data which has increased the available business data drastically. In order to meet changing customer needs and gain competitive advantage businesses try to leverage this information. However, IT departments are struggling to meet the increased amount of reporting needs. Therefore, recent shift in the BI market has been towards empowering business users with self-service BI capabilities. The purpose of this study was to understand how self-service BI could help businesses to meet increased reporting demands. The research problem was approached with an empirical single case study. Qualitative data was gathered with a semi-structured, theme-based interview. The study found out that case company’s BI system was mostly used for group performance reporting. Ad-hoc and business user-driven information needs were mostly fulfilled with self-made tools and manual work. It was felt that necessary business information was not easily available. The concept of self-service BI was perceived to be helpful to meet such reporting needs. However, it was found out that the available data is often too complex for an average user to fully understand. The respondents felt that in order to self-service BI to work, the data has to be simplified and described in a way that it can be understood by the average business user. The results of the study suggest that BI programs struggle in meeting all the information needs of today’s businesses. The concept of self-service BI tries to resolve this problem by allowing users easy self-service access to necessary business information. However, business data is often complex and hard to understand. Self-serviced BI has to overcome this challenge before it can reach its potential benefits.

Global booms and busts: how is Brazil's middle class faring?

Brazil's Post War economic history has been marked by inflationary booms and busts, which kept large parts of the population poor, as income distribution remained highly skewed, and most governments failed to put enough efforts and resources into education and health. That seems to have changed recently, as an increasing number of studies have shown considerable advances in the incomes of the lower and the middle classes. This essay examines those findings and puts them into a historical perspective, discussing earlier attempts and hopes of Brazilian policy makers to advance the welfare of the population. It concludes that while the last fifteen years have been remarkable for the country to achieve macroeconomic stability and while the increasing efforts of supporting the poor seemed to have been moving income distribution slowly towards a more equal level, there is still a long way to go. The 2008 world financial crisis also hit Brazil hard, but the recovery has been smoother and faster than in any OECD country. The impact of the current crisis may provide a good test as to the robustness of the previous trends to further the wellbeing of the poor and the middle class

The real mechanisms of the global economy

The paper presents the main arguments of Bresser Pereira's Globalization and Competition. Development strategies based on the 'conventional orthodoxy' are shown to carry serious drawbacks ("Dutch disease", pernicious effects of external saving, currency overvaluation), while a 'new developmentalism' is promoted, in spite of the widespread belief that the nation-states have been dispossessed of their room for manoeuvre because of the globalization process. The "new developmentalism" is based on domestic finance, balanced public budgets, moderate interest rates and competitiveness policies aimed at neutralizing the tendency to exchange rate overappreciation. The paper also points out a few theoretical questions the book raises.

The effects of the global economic crisis in Latin America

The aim of this article is to analyze the current phase of the global crisis and the way it has manifested itself in Latin America. The global crisis is the most important capitalist crisis since World War II. It is a new type of debt-deflation crisis, highlighting the limits of the finance-dominated regime of accumulation and characterized by securitization. Latin American countries have not been immune to the global crisis. Since it sets limits on globalization, the impossibility of maintaining export-driven accumulation sustained by restrictive monetary and fiscal policies becomes clear. This time, there will be no way out in external markets for any country. That fact will force them to restructure productive systems and search for a way out in domestic markets and in regional spaces for integration.

Sustainable sourcing in global supply network: assessment of geographic challenges and management methods Case: Stora Enso

The purpose of this work was to describe and compare sourcing practices and challenges in different geographies, to discuss possible options to advance sustainability of global sourcing, and to provide examples to answer why sourcing driven by sustainability principles is so challenging to implement. The focus was on comparison between Europe & Asia & South-America from the perspective of sustainability adoption. By analyzing sourcing practices of the case company it was possible to describe main differences and challenges of each continent, available sourcing options, supplier relationships and ways to foster positive chance. In this qualitative case study gathered theoretical material was compared to extensive sourcing practices of case company in a vast supplier network. Sourcing specialist were interviewed and information provided by them analyzed in order to see how different research results and theories are reflecting reality and to find answers to proposed research questions.

Marketing a Mobile Application in a Highly Competitive Global Marketplace

The purpose of this research was to study the marketing of mobile applications. The main objective was to find out what are the most efficient ways of marketing to increase the sales for a mobile application within a highly competitive marketplace. The marketplaces, app stores, are studied from the perspective of size, ease of entry, competition and customers and their purchasing process. The study also includes research on what are some of the main marketing methods used in mobile app marketing in general. The study consists of two parts, theoretical and empirical research. Theoretical research was done by studying past scientific research on the chosen subjects. As the subject is very new, the research was also extended to other publications from the field of mobile technology. The empirical part was done through interviews and empirical experiments with a case-company, which were used to answer the main objective of this study. These experiments showed that the chosen methods of mobile app marketing, app store optimization, localization and selected social media marketing activities, created the most sales when used together. Positive results were seen also when the activities were conducted by themselves, but together they were able to push the case company to their all time best results. However the key to succeeding and hitting high positions in the app store rankings would most likely require creating a solid marketing strategy, trying out other marketing activities alongside the ones used here, without forgetting to stay on top of mobile technology trends.