19 research outputs found

    Analysis of potential interactions between warfarin and prescriptions in Estonian outpatients aged 50 years or more

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    In Estonia, warfarin is widely prescribed by general practitioners to prevent and treat thromboembolic diseases. To date, there has been no systematic analysis of the potential risk of warfarin interactions with other drugs in the outpatient population.Objective: The aim of the study was to analyze the incidence of potential interactions in prescription schemes in Estonia in a cohort of outpatients receiving warfarin treatment.Methods: The retrospective study population included 203,646 outpatients aged 50 years or older of whom 7,175 received warfarin therapy. Patients who had used at least one prescription drug for a minimum period of 7 days concomitantly with warfarin were analyzed. Potential drug interactions were analyzed using Epocrates online, Stockley’s Drug Interactions and domestic drug interaction databases.Results: The average number of drugs used concomitantly with warfarin was 4.8 (SD=1.9) (males: 4.7 SD=2.0, females: 4.9 SD=2.0). No potential interactions in treatment regimens were found in 38% of patients, one potential interaction was observed in 29% and two or more potential interactions were observed in 33% of patients. The mean number of all potential interactions was 1.2 per patient and about the same in men and women. Potential interactions were associated with the number of drugs. Warfarin-related interactions were detected in 57% of patients, and the number of interactions related to warfarin per patient varied from 1 to 5. Most frequent were use of warfarin with NSAIDs (14%), followed by simvastatin (9%) and amiodarone (7%).Conclusion: This study shows that 57% of outpatients in Estonia receiving warfarin have drugs potentially interacting with warfarin in their treatment schemes. Most interactions (14%) with warfarin are associated with the prescription of NSAIDs

    Modelo de análise de investimentos para fabricação de produtos ecologicamente corretos Investment analysis model for green manufacturing

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    As pressões da sociedade, consumidores, governo e outras organizações no cuidado com o meio ambiente levam algumas empresas a adotar medidas sobre seus impactos ambientais. A decisão de cuidar das questões ambientais precede a escolha da forma de agir, podendo ser desde a seleção de insumos adequados até a certificação da ISO 14001. Para cada possibilidade de cuidados com o meio ambiente, a empresa necessita de recursos financeiros para viabilizar o projeto. O objetivo deste artigo é de apresentar um modelo de análise de viabilidade na fabricação de produtos com alguma preocupação ambiental. Considerando que nos modelos já existentes não é realizada uma mensuração do valor para os consumidores para dar suporte às decisões de investimentos sobre a variável ambiental nas organizações, este estudo busca preencher esta lacuna. O modelo proposto é composto por seis etapas. Espera-se que este modelo genérico possa servir de apoio para as organizações definirem o volume de investimentos necessários para uma equilibrada gestão ambiental.<br>Demands of society, consumers, government, and other organizations for care of the environment, have led some companies to adopt environmental impact measures. The decision about caring for the environment precedes the choice of measures to be taken, which include from the selection of appropriate inputs to the ISO 14001 certification. Funds are necessary for every potential environmental care project. The aim of this paper is to present a feasibility analysis model for environmentally conscious manufacturing. Considering the fact that there is no measurement of value for consumers in the existing models to support investment decisions on environment variables in organizations, this study seeks to bridge this gap. The proposed model consists of six steps. It is expected that this generic model can help organizations define the volume of investments required for a balanced environmental management

    Analysis of support of information systems for environmental management practices in enterprises with iso 14001: A multiple case study Análise do apoio dos sistemas de informação para as práticas de gestão ambiental em empresas com iso 14001 -estudo de múltiplos casos

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    The purpose of this article is to identify the contributions of Information Systems (IS) for environmental management practices, as well as the opportunities and challenges in this relation. Thus, we performed two case studies with Brazilian enterprises certified ISO 14001, by conducting interviews, document analysis and direct observation. As results, we present the identification of the main contributions of information systems for environmental management practices in the studied cases, the verification that a more advanced stage regarding IS is a factor that implies a more effective contribution, besides finding challenges and opportunities in this relation. The main contribution of this research consists of the presentation of a framework that identifies the support of information systems for environmental practices

    The relationship between manufacturing integration and performance from an activity-oriented perspective

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    Manufacturing integration with other functional areas and suppliers is a key aspect for achieving sustainable competitive advantage. The objective of this study is to analyze manufacturing integration from an activity-based perspective. We hypothesize that manufacturing integration with suppliers, marketing, and R&D is positively related to profit and sales growth when it occurs simultaneously in key internal activities. We surveyed 366 companies located in the southern region of Brazil, chosen from the SEBRAE(1) database. We used structural equations modeling to address validity and reliability issues. We evaluated common method variance (CMV) with the MTMM model and used path analysis to test the structural relations. We found that all manufacturing integration aspects are positively related to sales growth, but only manufacturing-R&D integration is positively related to profitability. Therefore, managers interested in improving the performance of their plants should favor the integration between manufacturing and R&D teams, at all hierarchical levels. We did not find any evidence, however, that direct interaction between manufacturing and marketing improves performance
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