908 resultados para knowing in consulting
Resumo:
The presence of mycotoxins in foodstuff is a matter of concern for food safety. Wines can also be contaminated with these toxicants. Several authors have demonstrated the presence of mycotoxins in wine, especially ochratoxin A (OTA) [1]. As these toxicants can never be completely removed from the food chain, many countries have defined levels in food in order to attend health concerns. The maximum acceptable level of OTA in wines is 2.0 µg/kg according to the Commission regulation No. 1881/2006 [2]. Although, higher levels of OTA have been detected in several wine samples. In order to reduce OTA to safer levels, several oenological products can be used in wine; including activated carbons, as shown in previous experiments. Regarding this, the aim of present study was to evaluate the effectiveness of several activated carbons for reducing the amount of OTA present in white and red wines as well as to evaluate their effect on wines physicochemical characteristics. Wine samples were artificially supplemented with OTA at a final concentration of 10.0 µg/L. The different activated carbons were applied at the concentration recommended by the manufacturer in order to evaluate their efficiency in reducing OTA levels. A mixture composed by gelatine, bentonite and activated carbon reduced 80% of OTA concentration in white wine. The same mixture was however less efficient in red wine, achieving only a reduction of 55%. Thereafter, the effect of activated carbon was evaluated in a red wine, achieving reductions of 66%. Considering these results more assays are being performed with other commercial activated carbons, in order to evaluate their efficiency. These results may provide valuable information for winemakers. Knowing the effect of commercial activated carbons they may choose most appropriate products to remove OTA, thus enhancing wine safety and quality.
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This thesis investigates the challenges of establishing the electric vehicle (EV) in Ireland and how the Irish government and industry are trying to meet them. It further seeks to provide information on Irish consumers’ attitudes towards the electric vehicle and their willingness to purchase it. The review of the literature showed that the Irish government is investing significant funds in trying to establish the market for the electric vehicle and position itself as a world leader in adopting the electric vehicle. The EV will also have an important role to play in how Ireland meets its targets for CO2 reductions towards 2020. Climate change and use of fossil fuels are driving the need for increased use of renewable energy and increased energy independence while reducing the greenhouse gas emissions that are the leading cause of climate change. The transport sector is almost completely dependent on the use of fossil fuel and resultantly is one of the largest sources of these GHG emissions. These issues are leading to the design and production of more energy efficient and environmentally friendly vehicles. The ultimate goal is to achieve a zero emissions vehicle. The electric vehicle is presently the only vehicle being mass produced that has the potential to be zero emissions. There are however issues that customers may not be willing to overlook such as the lower range of the vehicle and the length of time it takes to recharge. Vehicle cost is also an important issue that customers may not overlook. Knowing what the consumer’s attitudes are towards the EV and their willingness to purchase them is important as these new vehicles begin to appear in the showrooms. The consumers will be vital to how successful this market becomes. Using an online questionnaire methodology, in a sample of 118 consumers, the major conclusion to be drawn from the research is that the vehicle price, the convenience to recharge and vehicle range were the three most essential issues for the consumers if they were purchasing an EV. The success of the electric vehicle market may depend on what measures are taken to overcome them.
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Transformation, Russia, system theory, organistion theory, enterprises, reform, post-sovietic, organization building, management consulting
When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?
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Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.
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We study how personal relations affect performance in organizations. In the experimental game we use a manager has to assign different degrees of decision power to two employees. These two employees then have to make distributive decisions which affect themselves and the manager. Our focus is on the effects on managers' assignment of decision power and on employees' distributive decisions of one of the employees and the manager knowing each other personally. Our evidence shows that managers tend to favor employees that they personally know and that these employees tend, more than other employees, to favor the manager in their distributive decisions. However, this behavior does not affect the performance of the employees that do not know the manager. All these effects are independent of whether the employees that know the manager are more or less productive than those who do not know the manager. The results shed light on discrimination and nepotism and its consequences for the performance of family firms and other organizations.
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Purpose: to evaluate and compare the periodical patterns of death from cardiovascular disease (CVD), including acute myocardial infarction (AMI) and stroke in the Swiss population between the years 1969 and 2007.¦Methods: Swiss mortality database for the period of 1969- 2007 (2'362'430 deaths overall). The number of deaths due to CVD, AMI and stroke according to the time of day, day of the week and month were assessed, overall and after dividing the events according to gender and age (< 65 or ≥65 years old).¦Results: In general and for all four subgroups according to age and sex, there is a daily variation in the number of deaths with a first peak in the morning (8h00 -12h00) and a smaller second peak in the late afternoon (14h - 18h). Both males and females have similar hourly patterns, although the magnitude of the difference diminishes in older patients particularly for people who die from stroke. For the weekly variation, there seems to be a significant trend only in the younger population with the lowest mortality rates on Sunday and the highest on Mondays for all diseases. When it comes to seasonal variation according to month, the trend is more significant in the elder patients with the highest death rates during the winter months (+31%) and the lowest in the summer (July/August).¦Conclusion: There is a timely pattern for CVD, AMI and stroke deaths in Switzerland. This pattern changes according to the age and sex of the patients. Knowing this trend, its triggering factors and consequences, perhaps there could be measures put in place to prevent, diagnose and treat the population which is the most vulnerable at certain times.
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Biological invasions and land-use changes are two major causes of the global modifications of biodiversity. Habitat suitability models are the tools of choice to predict potential distributions of invasive species. Although land-use is a key driver of alien species invasions, it is often assumed that land-use is constant in time. Here we combine historical and present day information, to evaluate whether land-use changes could explain the dynamic of invasion of the American bullfrog Rana catesbeiana (=Lithobathes catesbeianus) in Northern Italy, from the 1950s to present-day. We used maxent to build habitat suitability models, on the basis of past (1960s, 1980s) and present-day data on land-uses and species distribution. For example, we used models built using the 1960s data to predict distribution in the 1980s, and so on. Furthermore, we used land-use scenarios to project suitability in the future. Habitat suitability models predicted well the spread of bullfrogs in the subsequent temporal step. Models considering land-use changes predicted invasion dynamics better than models assuming constant land-use over the last 50 years. Scenarios of future land-use suggest that suitability will remain similar in the next years. Habitat suitability models can help to understand and predict the dynamics of invasions; however, land-use is not constant in time: land-use modifications can strongly affect invasions; furthermore, both land management and the suitability of a given land-use class may vary in time. An integration of land-use changes in studies of biological invasions can help to improve management strategies.
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BACKGROUND: frailty is a concept used to describe older people at high risk of adverse outcomes, including falls, functional decline, hospital or nursing home admission and death. The associations between frailty and use of specific health and community services have not been investigated. METHODS: the cross-sectional relationship between frailty and use of several health and community services in the last 12 months was investigated in 1,674 community-dwelling men aged 70 or older in the Concord Health and Ageing in Men study, a population-based study conducted in Sydney, Australia. Frailty was assessed using a modified version of the Cardiovascular Health Study criteria. RESULTS: overall, 158 (9.4%) subjects were frail, 679 (40.6%) were intermediate (pre-frail) and 837 (50.0%) were robust. Frailty was associated with use of health and community services in the last 12 months, including consulting a doctor, visiting or being visited by a nurse or a physiotherapist, using help with meals or household duties and spending at least one night in a hospital or nursing home. Frail men without disability in activities of daily living were twice more likely to have seen a doctor in the previous 2 weeks than robust men (adjusted odds ratio 2.04, 95% confidence interval 1.21-3.44), independent of age, comorbidity and socio-economic status. CONCLUSION: frailty is strongly associated with use of health and community services in community-dwelling older men. The high level of use of medical services suggests that doctors and nurses could play a key role in implementation of preventive interventions.
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Since the early nineties, several hundreds of Chinese immigrants have settled in what has become known as the 'Chinese wholesalers area'. For the past two years, Chinese wholesalers in Aubervilliers have been calling on public authorities to address the problem of street robberies and violent thefts, which they experience on a daily basis. Yet, they have been encouraged by the authorities to ensure their own protection, by - amongst other things - installing surveillance cameras to film the streets. This is illegal according to French legislation on camera surveillance. Knowing this, why have surveillance cameras been adopted as a solution? This question guides the ethnographic analysis presented here of a situation where the installation of surveillance cameras was locally negotiated by the main actors involved - namely, the wholesalers' representatives and the police.
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Published and unpublished observations on geographical distribution of Biomphalaria snails in the State of Minas Gerais, Brazil, were compiled. This work is aimed at knowing the present occurrence of Biomphalaria species in this region, and at contributing to the elaboration of the planorbid chart of Minas Gerais. In malacological surveys, performed by several researchers, the presence of seven species of this genus was recorded. Those planorbids were found in 12 mesoregions, in 283 (33.1%) municipalities out of 853 with the following distribution: B. glabrata (185 municipalities), B. straminea (125), B. tenagophila (58), B. peregrina (57), B. schrammi (26), B. intermedia (20) and B. occidentalis (2). B. glabrata and B. tenagophila are found naturally infected by Schistosoma mansoni in Minas Gerais. In 24 municipalities the three snail hosts of S. mansoni in Brazil, B. glabrata, B. tenagophila and B. straminea, are present.
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Whereas preventive interventions for primary care physicians are now well established, the preventive interventions in emergency departments have been only partially and recently evaluated. Emergency departments probably represent however an opportunity for preventive medicine. Indeed, the population, sometimes vulnerable, consulting emergency departments, frequently presents risks factors and risks behaviours. Moreover, the concept of "teachable moment" and the studies recently performed seem to confirm this hypothesis. This article review the currently preventive interventions recommended in emergency departments and discuss the rationale to implement preventive medicine in emergency departments and the limits of this process.
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The müllerian anomalies or congenital uterine anomalies are relatively frequent if we keep in mind that 3-4% of our female patients present with a müllerian anomaly, although many among them are asymptomatic. It is important to evoke this diagnosis for all patients with a history of recurrent miscarriage, late abortion and premature delivery, for the adolescent consulting for primary amenorrhea, dysmenorrhea or dyspareunia as well as for the woman consulting for infertility. We will review pathogenesis, diagnostic methods, standard classification with a description of the different types of congenital uterine anomalies and the recommended management.
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Trichomycete fungi are associated with digestive tract of black fly larvae. These fungi have not been studied in Brazil, knowing them and their relationship with black flies could be an alternative to control vector populations. The objectives of this study were to survey the Trichomycete fungi associated with larvae of Simulium goeldii and S. ulyssesi, and to determine if there is specificity and/or difference in the infection rates in these species. Black flies were collected in Central Amazônia, Brazil. Three genera of Trichomycetes were found: Harpella, Genistellospora and Smittium. All these fungi were common to both black fly species.
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Alternative, non-microscopic methods for the diagnosis of malaria have recently become available. Among these, rapid dipstick methods stand out. One such test, OptiMAL®, is based on the immunochromatographic detection of Plasmodium lactate dehydrogenase (pLDH) and has the capacity to detect and distinguish infections caused by P. falciparum and Plasmodium sp. This capacity is particularly important in countries where different species of Plasmodium co-exist. In this study we evaluated the performance of OptiMAL® in an urban referral center for malaria diagnosis. Two sets of patients were included: one (n = 112) having predetermined infections with P. falciparum or P. vivax and individuals with negative blood smears; and another consisting of all eligible consecutive patients (n = 80) consulting for diagnosis at the referral center during one month. The overall diagnostic efficiency of OptiMAL® for both sets of patients was 96.9%. Efficiency was higher for P. vivax (98.1%) than for P. falciparum (94.9%). These results corroborate the diagnostic utility of OptiMAL® in settings where P. vivax and P. falciparum co-exist and support its implementation where microscopic diagnosis is unavailable and in circumstances that exceed the capacity of the local microscopic diagnosis facility.
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The study provides an evaluation of health and social services from the perspective of older people themselves and provides an opportunity for older people to express their lifelong care preferences. The National Council on Ageing and Older People strongly endorses the principle that older people should be involved in the development, planning and evaluation of their health and social services. This is underpinned by the principle that a health service fit for older people is a quality service that benefits everyone Download the Report here