372 research outputs found

    Corporate governance, market valuation and dividend policy in Brazil

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    This study investigates the effects of the corporate governance structure on market valuation and dividend payout of Brazilian companies. The empirical results indicate a high degree of ownership and control concentration. We can also note a significant difference between the voting and total capital owned by the largest shareholders, mainly through the existence of non-voting shares, pyramidal structures, and shareholding agreements. These mechanisms seem to be used by controlling shareholders to keep the firm’s control without having to own 50% of the total capital. The evidence also reveals that there is a relationship between governance structure, market valuation, and dividend policy in Brazil.Indisponível

    Predictors of benefit following pulmonary rehabilitation for interstitial lung disease

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    SummaryBackgroundPulmonary rehabilitation improves functional capacity and symptoms in the interstitial lung diseases (ILDs), however there is marked variation in outcomes between individuals. The aim of this study was to establish the impact of the aetiology and severity of ILD on response to pulmonary rehabilitation.MethodsForty-four subjects with ILD, including 25 with idiopathic pulmonary fibrosis (IPF), underwent eight weeks of pulmonary rehabilitation. Relationships between disease aetiology, markers of disease severity and response to pulmonary rehabilitation were assessed after eight weeks and six months, regardless of program completion.ResultsIn IPF, greater improvements in 6-minute walk distance (6MWD) immediately following pulmonary rehabilitation were associated with larger forced vital capacity (r = 0.49, p = 0.01), less exercise-induced oxyhaemoglobin desaturation (rS = 0.43, p = 0.04) and lower right ventricular systolic pressure (r = −0.47, p = 0.1). In participants with other ILDs there was no relationship between change in 6MWD and baseline variables. Less exercise-induced oxyhaemoglobin desaturation at baseline independently predicted a larger improvement in 6MWD at six month follow-up. Fewer participants with IPF had clinically important reductions in dyspnoea at six months compared to those with other ILDs (25% vs 56%, p = 0.04). More severe dyspnoea at baseline and diagnosis other than IPF predicted greater improvement in dyspnoea at six months.ConclusionsPatients with IPF attain greater and more sustained benefits from pulmonary rehabilitation when disease is mild, whereas those with other ILDs achieve benefits regardless of disease severity. Early referral to pulmonary rehabilitation should be considered in IPF

    Impaired chronotropic response to 6-min walk test and reduced survival in interstitial lung disease

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    SummaryBackgroundReduced chronotropic response to maximal exercise has been associated with poor survival in people without respiratory disease. The contribution of chronotropic response to exercise limitation and survival in interstitial lung disease (ILD) is not well defined. This study investigated the relationships between chronotropic response during 6-min walk test, exercise capacity and survival in ILD.MethodsEligible participants had ILD, were ambulant and free of heart failure and beta blocker therapy. Chronotropic response during the 6-min walk test was defined as peak heart rate (HR) minus resting HR. Survival was recorded at four years.ResultsSixty-two participants (40 idiopathic pulmonary fibrosis) were included, with mean (SD) TLCO 50(18)% predicted and 6-min walk distance (6MWD) 377 (127) metres. A smaller chronotropic response was associated with reduced 6MWD (r = 0.65, p < 0.001). Independent predictors of 6MWD were chronotropic response, peak oxygen uptake on cardiopulmonary exercise test; right ventricular systolic pressure on echocardiogram; and age. This model explained 83% of the variance in 6MWD, with 24% of the variance attributable to chronotropic response. A chronotropic response during 6-min walk test of less than 20 beats per minute was an independent predictor of death at four years (odds ratio 10.71, 95% confidence interval 2.67–42.94) in a model that also included oxygen desaturation and forced vital capacity.ConclusionsImpaired chronotropic response to 6-min walk test is associated with reduced 6MWD and reduced survival in ILD, independent of physical fitness and pulmonary hypertension. Investigation of the mechanisms underlying attenuated HR response to exercise in ILD is warranted

    Catchment land use effects on fluxes and concentrations of organic and inorganic nitrogen in streams

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    We present annual downstream fluxes and spatial variation in concentrations of dissolved inorganic nitrogen (NH4+ and NO3−) and dissolved organic nitrogen (DON) in two adjacent Scottish catchments with contrasting land use (agricultural grassland vs. semi-natural moorland). Inter- and intra-catchment variation in N species and the relation to spatial differences in agricultural land use were studied by determining catchment N input through agricultural activities at the field scale and atmospheric inputs at a 25 m grid resolution. The average agricultural N input of 52 kg N ha−1 yr−1 to the grassland catchment was more than 4 times higher than the input of 12 kg N ha−1 yr−1 to the moorland catchment, supplemented by 12.3 and 8.2 kg N ha−1 yr−1 through atmospheric deposition, respectively. The grassland catchment was associated with an annual downstream total dissolved nitrogen (TDN) flux of 14.4 kg N ha−1 yr−1, which was 66% higher than the flux of 8.7 kg ha−1 yr−1 from the moorland catchment. This difference was largely due to the NO3− flux being one order of magnitude higher in the grassland catchment. Dissolved organic N fluxes were similar for the two catchments (7.0 kg ha−1 yr−1) with DON contributing 49% to the TDN flux in the grassland compared with 81% in the moorland catchment. The results highlight the importance of diffuse agricultural N inputs to stream NO3− concentrations and the importance of quantifying all the major aquatic N species for developing a better understanding of N transformations and transport in the atmosphere-soil-water system

    Educating Dairy and Beef Producers on Environmental Issues and Regulatory Concerns for Smaller Farms

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    Livestock producers in Iowa have seen a progression of regulations and compliance enforcement throughout the past two decades. Awareness through Extension meetings and information put out by commodity groups has played a substantial role in bringing confinement feeding operations and large CAFO feedlots into compliance. For small to medium-sized feedlots and dairies that may or may not be classified as CAFOs, the education and outreach was not formalized prior to the EPA beginning their recent compliance reviews. This issue surfaced because of EPA interpretation of regulations and the subsequent impact on livestock producers. The message from EPA was not well defined and still remains a challenge for livestock producers, extension personnel, and agribusiness (advisers) and agency staff

    Heterogeneity of atmospheric ammonia at the landscape scale and consequences for environmental impact assessment

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    We examined the consequences of the spatial heterogeneity of atmospheric ammonia (NH3) by measuring and modelling NH3 concentrations and deposition at 25 m grid resolution for a rural landscape containing intensive poultry farming, agricultural grassland, woodland and moorland. The emission pattern gave rise to a high spatial variability of modelled mean annual NH3 concentrations and dry deposition. Largest impacts were predicted for woodland patches located within the agricultural area, while larger moorland areas were at low risk, due to atmospheric dispersion, prevailing wind direction and low NH3 background. These high resolution spatial details are lost in national scale estimates at 1 km resolution due to less detailed emission input maps. The results demonstrate how the spatial arrangement of sources and sinks is critical to defining the NH3 risk to semi-natural ecosystems. These spatial relationships provide the foundation for local spatial planning approaches to reduce environmental impacts of atmospheric NH3

    Thoracic Society of Australia and New Zealand position statement on acute oxygen use in adults : 'swimming between the flags'

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    Oxygen is a life-saving therapy but, when given inappropriately, may also be hazardous. Therefore, in the acute medical setting, oxygen should only be given as treatment for hypoxaemia and requires appropriate prescription, monitoring and review. This update to the Thoracic Society of Australia and New Zealand (TSANZ) guidance on acute oxygen therapy is a brief and practical resource for all healthcare workers involved with administering oxygen therapy to adults in the acute medical setting. It does not apply to intubated or paediatric patients. Recommendations are made in the following six clinical areas: assessment of hypoxaemia (including use of arterial blood gases); prescription of oxygen; peripheral oxygen saturation targets; delivery, including non-invasive ventilation and humidified high-flow nasal cannulae; the significance of high oxygen requirements; and acute hypercapnic respiratory failure. There are three sections which provide (1) a brief summary, (2) recommendations in detail with practice points and (3) a detailed explanation of the reasoning and evidence behind the recommendations. It is anticipated that these recommendations will be disseminated widely in structured programmes across Australia and New Zealand

    SABINA + Hong Kong: a territory wide study of prescribing trends and outcomes associated with the use of short-acting β2 agonists in the Chinese population

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    Background: Excessive use of short-acting β2 agonists (SABA) in patients with asthma continues to be a notable concern due to its link to higher mortality rates. Global relevance of SABA overuse in asthma management cannot be understated, it poses significant health risk to patients with asthma and imposes burden on healthcare systems. This study, as part of global SABINA progamme, aimed to describe the prescribing patterns and clinical outcomes associated with SABA use in the Chinese population. Methods: Retrospective cohort study was conducted using anonymized electronic healthcare records of Clinical Data Analysis and Reporting System (CDARS) from Hong Kong Hospital Authority (HA). Patients newly diagnosed with asthma between 2011 and 2018 and aged ≥12 years were included, stratified by SABA use (≤2, 3–6, 7–10, or ≥11 canisters/year) during one-year baseline period since asthma diagnosis date. Patients were followed up from one-year post-index until earliest censoring of events: outcome occurrence and end of study period (31 December 2020). Cox proportional regression and negative binomial regression were used to estimate the mortality risk and frequency of hospital admissions associated with SABA use respectively, after adjusting for age, sex, Charlson Comorbidity Index (CCI), and inhaled corticosteroid (ICS) dose. Outcomes include all-cause, asthma-related, and respiratory-related mortality, frequency of hospital admissions for any cause, and frequency of hospital admissions due to asthma. Results: 17,782 patients with asthma (mean age 46.7 years, 40.8% male) were included and 59.1% of patients were overusing SABA (≥ 3 canisters per year). Each patient was prescribed a median of 5.61 SABA canisters/year. SABA overuse during baseline period was associated with higher all-cause mortality risk compared to patients with ≤2 canisters/year. Association was dose-dependent, highest risk in those used ≥11 canisters/year (adjusted hazard ratio: 1.42, 95% CI: 1.13, 1.79) and 3–6 canisters/year (adjusted hazard ratio: 1.22, 95% CI: 1.00, 1.50). Higher SABA prescription volume associated with increased frequency of hospital admissions with greatest risk observed in 7–10 canisters/year subgroup (adjusted rate ratio: 4.81, 95% CI: 3.66, 6.37). Conclusions: SABA overuse is prevalent and is associated with increased all-cause mortality risk and frequency of hospital admissions among the patients with asthma in Hong Kong
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