Evaluating Urban Buses Performance: A Comparative Analysis of Brazilian Methodologies

Brazilian urban buses are operated by private enterprises under administrative contracts to local transport authorities. Usual contract duration is five-to-seven years, but competitive re-tendering may be avoided through a renewing option to be applied if incumbent presents a good performance. In some cities, however, federal mandate of compulsory tendering begins to be followed. In the two cases, some local authorities have developed methodologies for evaluating operators performance. In this paper, we analyse methodologies being used in two Brazilian local bus systems Recife and Belo Horizonte , with the objective of verifying their ability to induce competitive behaviours in the operators and their fitness to local authorities goals. Conclusions show that examined evaluation methodologies are limited mechanisms concerning the achievement of objectives like competitiveness, improvement of service quality and productive efficiency.Institute of Transport and Logistics Studies. Faculty of Economics and Business. The University of Sydne

Tracking the smoking gene

With a ban on smoking in enclosed public places in England around the corner, now might be the time to kick the habit. But with so many treatments to help you quit, it can be difficult to choose -hypnosis, patches, medications, willpower? Now, however, one of the first "lifestyle" genetic tests is available, claiming to help identify exactly what approach is best for your genetic make-up, and to tailor a quit strategy to fit. It's called NicoTest. It sounds a like godsend, but scientists are less than unanimous about its benefits. The test has raised new questions about whether our high hopes about genetic testing have started a bandwagon that is beginning to run out of control

Should the food industry resign from the health department too?

Furore over links between Assistant Minister for Health Fiona Nash’s office and industry continues today with revelations that her former chief of staff is connected to the alcohol, as well as the food industry. Alastair Furnival resigned last Friday over his role in shutting down a website about the health star rating food labelling system and it’s now been revealed that he played a key role in cancelling the funding of the Alcohol and other Drugs Council of Australia. Furnival is co-owner of a lobbying firm that has represented major food companies opposed to the new front-of-pack labelling system. According to Fairfax, he and his wife also co-own a company, which, in turn, owns another that lobbied for the alcohol industry in 2012. Such conflicts of interest place question marks over an individual’s capacity to judge a situation, perform a duty or make a decision in a fair and impartial manner. But what if a public institution, such as the Department of Health itself, has conflicted interests? Furnival’s conflict of interest is worrying and should be thoroughly scrutinised. But the influence of the food and alcohol industries at the institutional-level precedes Furnival and will continue despite his resignation.Rock Ethics Institute at the Pennsylvania State University and the Edmond J. Safra Center for Ethics at Harvard University

Pediatric extracorporeal life support and central nervous system injury.

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ExtraCorporeal Membrane Oxygenation in Newborns. Implications for Brain and Lung.

Contains fulltext : 19450.pdf (publisher's version ) (Open Access)Extracorporeal membrane oxygenation (ECMO) is a rescue treatment for newborns with severe respiratory insufficiency. In veno-arterial ECMO, venous blood is drained from the right atrium, oxygenated in an artificial lung and reinfused in the aorta. For vascular access the right internal jugular vein and right common carotid artery are ligated permanently. This invasive treatment may have major complications. In this thesis we described the results of ECMO treatment in the University Medical Center Nijmegen of 186 newborns over a period of 12.5 years. Survival varied between 65% and 95%, depending on the diagnosis. Major causes of death were respiratory insufficiency and intracranial haemorrhage. In this thesis we studied lung vascular morphology in newborns with pulmonary hypertension treated with ECMO and demonstrated a decrease in the abnormal morphometry that exists in the small pulmonary blood vessels.Furthermore, we studied the effects of ECMO on the brain. We demonstrated that intermittent opening of the so-called bridge, a safety connection in the ECMO circuit, has important negative effects on the cerebral oxygenation and circulation. This can be prevented with adaptation of this bridge. We also demonstrated that a patent ductus arteriosus with left to right shunt can diminish cerebral oxygenation and perfusion and should therefore be identified early. Others suggested that ECMO causes cerebral lesions predominantly in the right cerebral hemisphere, related to ligation of the right common carotid artery. We demonstrated that the initiation of ECMO has effects on the cerebral oxygenation and circulation, but that these effects were equal for both cerebral hemispheres. In veno-venous ECMO, drainage and reinfusion of blood take place both in the right atrium and ligation of the right common carotid artery is not necessary. To optimize the use of veno-venous ECMO it is important to be informed about recirculation. We developed a bedside method to quantify the amount of recirculation during veno-venous ECMO.KUN Katholieke Universiteit Nijmegen, 02 juni 2004Promotor : Sengers, R.C.A. Co-promotores : Liem, K.D., Staak, F.H.J.M. van der195 p

Neonatale adenoviruspneumonie

Contains fulltext : 20704___.PDF (publisher's version ) (Open Access

Sociaal cement met zorg : een rondetafelgesprek tussen Annelies van Heijst(H),Godelieve van Heteren(G),Annemarie Mol(A) en Marian Verkerk(M)

Contains fulltext : 22997___.PDF (publisher's version ) (Open Access

Myocardial infarction in a neonate with left-sided congenital diaphragmatic hernia.

Contains fulltext : 79830.pdf (publisher's version ) (Closed access)We present a case study of a newborn girl with a left-sided congenital diaphragmatic hernia and a myocardial infarction (MI). The occurrence of MI in newborns has been associated with cardiac malformations and abnormalities of the coronary arteries or thromboembolization. In our patient, echocardiography revealed left ventricular dysfunction, persistent pulmonary hypertension and an inferolateral MI. Within 24 hours cardiac function and oxygenation did not improve and the baby died. Autopsy showed massive MI, a small aortic valve and ascending aorta, and hypoplasia of the distal aortic arch and isthmus. An accessory spleen was also present. The present report underlines the importance of cardiac evaluation in patients with congenital diaphragmatic hernia

Cerebrotendinous xanthomatosis in children

Contains fulltext : 21648___.PDF (publisher's version ) (Open Access