A Relação entre Empresas com Certificações Socioambientais e Empresas com Certificação de Qualidade

This paper had the aim of verifying the relation between companies with social-environmental certifications and companies with quality management system certified, considering performance indicators. The methodological approach applied is characterized as empiricalanalytic. We analyzed informations related to the performance indicators published in the Exame Magazine in 2012 as well as we did the crossing with companies certified. The sample comprised 194 companies among the 250 largest companies by revenue in 2011 and with published complete indicators and eligible in the Exame Magazine 2012. For the treatment of the data was used the SPSS® software (Statistical Package for Social Sciences) version 19.0, applying logistic regression. According to the results, we can conclude that there is a relation between companies social environmental certifications and companies certified on quality management system, when we look at performance indicators. This can suggests that corporate investments held and recorded in the social, environmental and economic (in the concept of Triple-Bottom Line) are indications of real commitment to sustainability. In relation to the variables used, the indicator of current liquidity is the best proxy to explain this relationship, and the results suggest that organizations certified in integrated management systems and with socialenvironmental investments, can be compared through indicators highlighted by our model in order to improve business performance.Este estudio tuvo como objetivo investigar la relación entre las empresas con certificaciones sociales y ambientales y con el sistema de gestión de la calidad certificado, teniendo en cuenta los indicadores de desempeño. Por lo tanto, el enfoque metodológico se caracteriza por ser empírico y analítico. La información se analizó para los indicadores de resultados publicados en la guía de examen de la mejor y más grande en 2012 y llevó a cabo un cruce con las empresas con certificación e inversiones socios ambientales. La muestra está formada por 194 empresas entre las 250 empresas más grandes de los ingresos en 2011 y publicadas medidas integrales y elegibles en el examen de guía 2012. Para el tratamiento de los datos se utilizó el programa SPSS (Statistical Package for Social Sciences) versión 19.0 mediante la aplicación de regresión logística. Según los resultados, se puede concluir que existe una relación entre las empresas con certificaciones sociales y ambientales en comparación con las empresas con certificación de calidad, a través de análisis a través de indicadores de desempeño organizacional. Esto puede sugerir que la inversión empresarial realizada en las dimensiones sociales, ambientales y económicas, de acuerdo con la opinión de Triple Bottom Line, es un verdadero compromiso absoluto con la sostenibilidad. En cuanto a las variables utilizadas, indicador de liquidez actual, es la mejor proxy, para explicar esta relación, es decir, los resultados sugieren que las empresas certificadas en inversiones socios ambientales y sistemas de gestión integrada, pueden ser comparados por los indicadores establecidos por el modelo con el fin de mejorar el rendimiento empresarial.Este artigo teve como objetivo verificar a relação entre empresas com certificações socioambientais e empresas com sistema de gestão da qualidade certificado, considerando indicadores de desempenho. Para tanto, a abordagem metodológica utilizada é caracterizada como empírica-analítica. Foram analisadas informações relativas aos indicadores de desempenho publicados no guia exame das melhores e maiores 2012, bem como realizado o cruzamento com empresas com certificação e investimentos socioambientais. A amostra foi formada por 194 empresas dentre as 250 maiores empresas em faturamento no ano de 2011 e com indicadores completos publicados e elegíveis no guia exame 2012. Para o tratamento dos dados foi utilizado o Software SPSS® (Statistical Package for Social Sciences) versão 19.0, aplicando a técnica de regressão logística. De acordo com os resultados obtidos, pode-se concluir que existe relação entre empresas com certificações socioambientais quando comparado com empresas com certificação de qualidade, por meio de análise utilizando indicadores de desempenho organizacional. Isso pode sugerir que os investimentos das empresas realizados nas dimensões social, ambiental e econômica, segundo a visão Triple-Bottom Line, são um indício de comprometimento real com a sustentabilidade. Quanto às variáveis utilizadas, o indicador de liquidez corrente é a melhor proxy para explicar essa relação, ou seja, os resultados sugerem que empresas certificadas em sistemas de gestão integrada e com investimentos socioambientais, podem ser comparadas por meio dos indicadores definidos pelo modelo com o intuito de melhorar o desempenho do negócio.

A Relação entre Empresas com Certificações Socioambientais e Empresas com Certificação de Qualidade

Este artigo teve como objetivo verificar a relação entre empresas com certificações socioambientais e empresas com sistema de gestão da qualidade certificado, considerando indicadores de desempenho. Para tanto, a abordagem metodológica utilizada é caracterizada como empírica-analítica. Foram analisadas informações relativas aos indicadores de desempenho publicados no guia exame das melhores e maiores 2012, bem como realizado o cruzamento com empresas com certificação e investimentos socioambientais. A amostra foi formada por 194 empresas dentre as 250 maiores empresas em faturamento no ano de 2011 e com indicadores completos publicados e elegíveis no guia exame 2012. Para o tratamento dos dados foi utilizado o Software SPSS® (Statistical Package for Social Sciences) versão 19.0, aplicando a técnica de regressão logística. De acordo com os resultados obtidos, pode-se concluir que existe relação entre empresas com certificações socioambientais quando comparado com empresas com certificação de qualidade, por meio de análise utilizando indicadores de desempenho organizacional. Isso pode sugerir que os investimentos das empresas realizados nas dimensões social, ambiental e econômica, segundo a visão Triple-Bottom Line, são um indício de comprometimento real com a sustentabilidade. Quanto às variáveis utilizadas, o indicador de liquidez corrente é a melhor proxy para explicar essa relação, ou seja, os resultados sugerem que empresas certificadas em sistemas de gestão integrada e com investimentos socioambientais, podem ser comparadas por meio dos indicadores definidos pelo modelo com o intuito de melhorar o desempenho do negócio.

Stress neuropeptide levels in adults with chest pain due to coronary artery disease: potential implications for clinical assessment

: Substance P (SP) and neuropeptide Y (NPY) are neuropeptides involved in nociception. The study of biochemical markers of pain in communicating critically ill coronary patients may provide insight for pain assessment and management in critical care. Purpose of the study was to to explore potential associations between plasma neuropeptide levels and reported pain intensity in coronary critical care adults, in order to test the reliability of SP measurements for objective pain assessment in critical care

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P < 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56–1.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56\u20131.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion