Green process innovation: Where we are and where we are going

Environmental pollution has worsened in the past few decades, and increasing pressure is being put on firms by different regulatory bodies, customer groups, NGOs and other media outlets to adopt green process innovations (GPcIs), which include clean technologies and end-of-pipe solutions. Although considerable studies have been published on GPcI, the literature is disjointed, and as such, a comprehensive understanding of the issues, challenges and gaps is lacking. A systematic literature review (SLR) involving 80 relevant studies was conducted to extract seven themes: strategic response, organisational learning, institutional pressures, structural issues, outcomes, barriers and methodological choices. The review thus highlights the various gaps in the GPcI literature and illuminates the pathways for future research by proposing a series of potential research questions. This study is of vital importance to business strategy as it provides a comprehensive framework to help firms understand the various contours of GPcI. Likewise, policymakers can use the findings of this study to fill in the loopholes in the existing regulations that firms are exploiting to circumvent taxes and other penalties by locating their operations to emerging economies with less stringent environmental regulations.publishedVersio

Surgical lung biopsy for diffuse lung disease. Our experience in the last 15 years

Introduction: Surgical lung biopsy is a technique that presents a morbi-mortality rate of considerable importance. We analyze our experience with surgical lung biopsies for the diagnosis of diffuse lung disease and the effect produced on the indications for surgical biopsy in these pathologies after the publication of the consensus of the ATS (American Thoracic Society) and ERS (European Respiratory Society) for Idiopathic Pulmonary Fibrosis (IPF). Patients and methods: We performed a retrospective review of 171 patients operated between January 1997 and December 2011. We divided the series into 2 groups: group 1 (operated between 1997 and 2002) and group 2 (operated between 2003 and 2011). Suspected preoperative diagnosis, respiratory status, pathological postoperative diagnoses, percentage of thoracotomies, mean postoperative stay and perioperative morbidity and mortality were analyzed. Results: Group 1 consisted of 99 patients and group two 72. The most frequent postoperative diagnoses were: usual interstitial pneumonia and extrinsic allergic alveolitis. There were ten (5.84%) deaths. Death was caused by progressive respiratory failure that was related to interstitial lung disease in 7 (70%) of 10 cases, alveolar haemorrhage in 2 (20%) and heart failure in 1 (10%). Conclusions: Since the publication of the ATS and ERS consensus on the IPF, we have observed a noticeable decrease in the number of indications for surgical lung biopsy. This technique, though simple, has a considerable morbidity and mortality. Resumo: Introdução: A biópsia pulmonar cirúrgica é uma técnica com uma morbimortalidade não negligenciável. Este trabalho resulta da experiência adquirida na realização de biópsias pulmonares cirúrgicas para o diagnóstico da doença pulmonar intersticial difusa, bem como pelo efeito provocado sobre as indicações da biópsia cirúrgica nesta entidade, após a publicação do consenso da ATS (American Thoracic Society) e da ERS (European Respiratory Society, para Fibrose Pulmonar Idiopática (FPI), em 2000 e 2002. Métodos: Revisão retrospectiva de 171 doentes intervencionados entre Janeiro de 1997 e Dezembro de 2011. A série de doentes foi dividida em dois grupos: o grupo 1 (operados entre 1997 e 2002) e o grupo 2 (operados entre 2003 e 2011). Os registos efectuados foram a suspeita diagnóstica pré-operatória, o estado respiratório, o diagnóstico patológico pós-operatório, a percentagem de toracotomias, a média de internamento hospitalar, além da morbilidade e mortalidade intra-hospitalares. Resultados: Grupo 1 constituído por 99 doentes e o grupo 2 por 72. Os diagnósticos pós-operatórios mais frequentes foram a pneumonia intersticial usual e a alveolite alérgica extrínseca. Houve 10 mortes (5,84%). Em 7 (70%) dos 10 casos, a morte foi causada por progressão da insuficiência respiratória provocada pela doença subjacente, em 2 (20%) por hemorragia alveolar, e em um caso (10%) por insuficiência cardíaca. Conclusões: Desde a publicação do consenso da ATS e da ERS na FPI, observou-se uma clara diminuição no número de indicações para a biópsia pulmonar cirúrgica. Esta técnica, apesar de simples, tem uma considerável morbilidade e mortalidade. Keywords: Diffuse lung disease, Lung biopsy, Surgical mortality, Palavras-chave: Doença pulmonar difusa, Biópsia pulmonar, Mortalidade cirúrgic