Os efeitos da cultura nacional na divulgação ambiental: Uma análise entre países

This study aims to answer the following research question: How does national culture affect environmental disclosure in liberal economies? Several previous studies have shown that formal institutions, such as the characteristics of the government, the country’s financial system, have an influence on environmental disclosure. However, there is still a gap in the literature on how informal institutions (the country’s culture) can influence the behavior of companies. The results of this study provide a solid understanding of environmental disclosure in liberal economies. In these economies, it is common for companies to be more interested in disclosing financial and governance information. Thus, analyzing environmental disclosure in these companies presents an additional gain for the literature. Managers can use our findings to understand how the country’s culture can influence their business. The adoption of the Global Reporting Initiative (GRI) disclosure guidelines and the presence of a sustainability committee in the company can help companies achieve better environmental performance. We examined the level of environmental disclosure for a sample of 1,037 companies based in Australia, Canada, Ireland, New Zealand, United Kingdom, and United States of America (USA) for the period 2015-2018. To measure national culture, we used the proposed cultural dimensions by Hofstede (1983): distance to power, individualism, masculinity, aversion to uncertainty, long-term orientation, and indulgence. Our evidence shows that power distance, individualism, and masculinity have a positive effect on environmental disclosure. The results show that in cultures with less aversion to uncertainty, companies disclose more environmental information. Our findings also show us that companies that carry out an environmental disclosure following GRI guidelines disclose more sustainability information. The results show that sectors such as energy, materials, and utilities have greater environmental disclosure.Este estudo tem por objetivo responder a seguinte questão de pesquisa: Como a cultura nacional afeta a divulgação ambiental nas economias liberais? Vários estudos anteriores mostraram que as instituições formais, como as características do governo, o sistema financeiro do país, influenciam a divulgação ambiental. No entanto, ainda há uma lacuna na literatura sobre como as instituições informais (a cultura do país) podem influenciar o comportamento das empresas. Os resultados deste estudo proporcionam uma sólida compreensão da divulgação ambiental nas economias liberais. Nessas economias, é usual que as empresas estejam mais interessadas em divulgar informações financeiras e de governança. Assim, analisar a divulgação ambiental nessas empresas apresenta um ganho adicional para a literatura. Os gestores podem usar nossos achados para compreender como a cultura do país pode influenciar seus negócios. A adoção das diretrizes de divulgação da Global Reporting Initiative (GRI) e a presença de um comitê de sustentabilidade na empresa podem ajudar as empresas a obterem melhor desempenho ambiental. Examinamos o nível de divulgação ambiental de uma amostra com 1.037 empresas sediadas na Austrália, no Canadá, na Irlanda, na Nova Zelândia, no Reino Unido e nos Estados Unidos da América (EUA) no período 2015-2018. Para mensurar a cultura nacional, usamos as dimensões culturais propostas por Hofstede (1983): distância do poder, individualismo, masculinidade, aversão à incerteza, orientação de longo prazo e indulgência. Nossos indícios mostram que a distância do poder, o individualismo e a masculinidade têm efeito positivo na divulgação ambiental. Os resultados mostram que em culturas com menor aversão à incerteza, as empresas divulgam mais informações ambientais. Nossos achados também mostram que as empresas que procedem à divulgação ambiental segundo as diretrizes da GRI divulgam mais informações sobre sustentabilidade. Os resultados mostram que setores como energia, materiais e serviços de utilidade pública apresentam maior divulgação ambiental

Habilitats competencials en i des d'un context paraescolar

Nous reptes transfereixen noves responsabilitats a les institucions i als drets i compromisos que s’han de resoldre amb propostes per garantir la millora de la qualitat de l’ensenyament en un àmbit no formal. El temps d’oci esta provocant una particular forma de vida. Els comportaments tendeixen desmesuradament a satisfer les necessitats més narcisistes del jovent per la qual cosa és urgent de promoure activitats que aconsegueixin despertar una actitud més altruista en les persones. La iniciativa dels educadors amb capacitat d’adaptació als canvis ha de reflexionar sobre les activitats que s’han d’oferir a les noves generacions per afrontar el temps lliure de la segona dècada del segle XXI amb qualitat . Amb l’objectiu final de formar a persones en valors durant el seu desenvolupament personal, donant sentit al seu temps d’oci en grup, amb respecte vers els altres i amb sentit democràtic dins del marc educatiu no formal, procurant que no interfereixi però si complementi el currículum ordinari establert per les diferents administracions educatives. Parlarem d’activitats paraescolars. La base educativa de les activitats paraescolars troba la seva essència en la interacció educador- educand. Esdevenen activitats escolars que poden realitzar-se o no dins de l’horari escolar, distint a l’horari curricular, però formant part de l’essència de l’escola. Aquest tipus d’activitats han de seguir conservant la seva consideració de necessàries i imprescindibles si el que realment volem és educar en profunditat, honestedat i integritat

Lesiones traqueales focales. A propósito de un caso

Presentamos un caso de carcinoma adenoide quístico de tráquea demostrado mediante TC multidetector de 64 coronas, PET-TC, y co- rrelación anatomopatológica, en un paciente con hemoptisis. En este artículo revisamos el diagnóstico diferencial de las lesiones traqueales únicas focales mediante tomografía computarizada (TC). Las técnicas de imagen permitieron el diagnóstico e infravaloraron la invasión de la pared traqueal en este caso, confi rmada con posterioridad mediante el estudio histológico. INGLÉS: We present a case of adenoid cystic tracheal carcinoma detected by computerized tomography (64-MDCT) with cyto-histological correlation in a patient with hemoptysis. In this article we review the differential diagnosis of solitary focal tracheal lesions as they appear in computerized tomography (CT). In this case, image methods suggested the diagnosis but underestimated the tracheal wall invasion, which was established by histologycal examination of the resected tumor

Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study

Electromagnetic navigation bronchoscopy (ENB) has been developed as a novel ancillary tool for the bronchoscopic diagnosis of pulmonary nodules. Despite successful navigation in 90% of patients, ENB diagnostic yield does not generally exceed 70%. We sought to determine whether the presence of a bronchus sign on CT imaging conditions diagnostic yield of ENB and might account for the discrepancy between successful navigation and diagnostic yield. METHODS: We conducted a prospective, single-center study of ENB in 51 consecutive patients with pulmonary nodules. ENB was chosen as the least invasive diagnostic technique in patients with a high surgical risk, suspected metastatic disease, or advanced-stage disease, or in those who demanded a preoperative diagnosis prior to undergoing curative resection. We studied patient and technical variables that might condition diagnostic yield, including size, cause, location, distance to the pleural surface, and fluorodeoxyglucose uptake of a given nodule; the presence of a bronchus sign on CT imaging; registration point divergence; and the minimum distance from the tip of the locatable guide to the nodule measured during the procedure. RESULTS: The diagnostic yield of ENB was 67% (34/51). The sensitivity and specificity of ENB for malignancy in this study were 71% and 100%, respectively. ENB was diagnostic in 79% (30/38) patients with a bronchus sign on CT imaging but only in 4/13 (31%) with no discernible bronchus sign. Univariate analysis identified the bronchus sign (P = .005) and nodule size (P = .04) as statistically significant variables conditioning yield, but on multivariate analysis, only the bronchus sign remained significant (OR, 7.6; 95% CI, 1.8-31.7). No procedure-related complications were observed. CONCLUSIONS: ENB diagnostic yield is highly dependent on the presence of a bronchus sign on CT imaging

The avoidance of G-CSF and the addition of prophylactic corticosteroids after autologous stem cell transplantation for multiple myeloma patients appeal for the at-home setting to reduce readmission for neutropenic fever

Background Autologous stem cell transplantation (ASCT) remains the standard of care for young multiple myeloma (MM) patients; indeed, at-home ASCT has been positioned as an appropriate therapeutic strategy. However, despite the use of prophylactic antibiotics, neutropenic fever (NF) and hospital readmissions continue to pose as the most important limitations in the outpatient setting. It is possible that the febrile episodes may have a non-infectious etiology, and engraftment syndrome could play a more significant role. The aim of this study was to analyze the impact of both G-CSF withdrawal and the addition of primary prophylaxis with corticosteroids after ASCT. Methods Between January 2002 and August 2018, 111 MM patients conditioned with melphalan were managed at-home beginning +1 day after ASCT. Three groups were established: Group A (n = 33) received standard G-CSF post-ASCT; group B (n = 32) avoided G-CSF post-ASCT; group C (n = 46) avoided G-CSF yet added corticosteroid prophylaxis post-ASCT. Results The incidence of NF among the groups was reduced (64%, 44%, and 24%; P2 (OR 6.1; P = 0.002) and G-CSF avoidance plus corticosteroids (OR 0.1; P60 years (OR 14.6; P = 0.04) and G-CSF avoidance plus corticosteroids (OR 0.07; P = 0.05). Conclusions G-CSF avoidance and corticosteroid prophylaxis post ASCT minimize the incidence of NF in MM patients undergoing at-home ASCT. This approach should be explored in a prospective randomized clinical trial

SAlBi educa (Tailored Nutrition App for Improving Dietary Habits): Initial Evaluation of Usability

In recent years, the use of applications to improve dietary habits has increased. Although numerous nutrition apps are available on the market, only few have been developed by health and nutrition professionals based on scientific evidence and subsequently tested to prove their usability. The main objective of this study was to design, develop, and evaluate the usability of a tailored nutrition application to be used to promote healthy eating habits. In order to decide app design and content, three focus groups took place with fifteen professionals from primary healthcare, nutrition, and food science and computer science, as well as expert users. For the general and feedback message design, a reference model based on the scientific literature was developed. To address the multi-perspective approach of users' and external healthcare professionals' feedback, a one-day pilot testing with potential users and healthcare professionals was conducted with four focus groups. To evaluate the relevance and potential usability of the app a 1-month pilot test was conducted in a real-life environment. A total of 42 volunteers participated in the one-day pilot testing, and 39 potential users participated in the 1-month pilot test. The SAlBi educa app developed includes an online dietary record, a self-monitoring tool to evaluate dietary patterns, general and feedback messages, and examples of traditional Mediterranean recipes. The usability study showed that volunteers think that SAlBi educa is pleasant (59%) and easy to learn to use (94%). Over 84% of the volunteers declared that the nutritional messages were clear and useful. Volunteers stated that general and tailored recommendations, as well as self-monitoring, were SAlBi educa's most motivating and useful features. SAlBi educa is an innovative, user-friendly nutritional education tool with the potential to engage and help individuals to follow dietary habits based on the Mediterranean model.Junta de Andalucía PIN-0050-201

Short-Term Pilot Study to Evaluate the Impact of Salbi Educa Nutrition App in Macronutrients Intake and Adherence to the Mediterranean Diet: Randomized Controlled Trial

Promoting a healthy diet is a relevant strategy for preventing non-communicable diseases. This study aims to evaluate the impact of an innovative tool, the SAlBi educa nutrition app, in primary healthcare dietary counseling to improve dietary profiles as well as adherence to the Mediterranean diet. A multi-center randomized control trial comprising 104 participants was performed. Both control (n = 49) and intervention (n = 55) groups attended four once-weekly sessions focusing on healthy eating habits and physical activity, over one month. As well as attending the meetings, the intervention group used the app, which provides self-monitoring and tailored dietary advice based on the Mediterranean diet model. In a second intervention (one arm trial), the potential of SAlBi educa was evaluated for three months during the COVID-19 pandemic. At 4 weeks, the intervention group had significantly increased their carbohydrate intake (7.7% (95% CI: 0.16 to 15.2)) and decreased their total fat intake (−5.7% (95% CI: −10.4 to −1.15)) compared to the control group. Significant differences were also found for carbohydrates (3.5% (95% CI: −1.0 to 5.8)), total fats (−5.9% (95% CI: −8.9 to −3.0)), fruits and vegetables (266.3 g/day (95% CI: 130.0 to 402.6)), legumes (7.7g/day (95% CI: 0.2 to 15.1)), starchy foods (36.4 g/day (95% CI: 1.1 to 71.7)), red meat (−17.5 g/day (95% CI: −34.0 to −1.1)), and processed meat (−6.6 g/day (95% CI: −13.1 to −0.1)) intakes during the COVID-19 pandemic. SAlBi educa is a useful tool to support nutrition counseling in primary healthcare, including in special situations such as the COVID-19 pandemic. Trial registration: ISRCTN57186362.Consejería de Salud y Familia, Junta de Andalucía (Innovative Project in Health) grant number PIN-0050-2018

The avoidance of G-CSF and the addition of prophylactic corticosteroids after autologous stem cell transplantation for multiple myeloma patients appeal for the at-home setting to reduce readmission for neutropenic fever

Autologous stem cell transplantation (ASCT) remains the standard of care for young multiple myeloma (MM) patients; indeed, at-home ASCT has been positioned as an appropriate therapeutic strategy. However, despite the use of prophylactic antibiotics, neutropenic fever (NF) and hospital readmissions continue to pose as the most important limitations in the outpatient setting. It is possible that the febrile episodes may have a non-infectious etiology, and engraftment syndrome could play a more significant role. The aim of this study was to analyze the impact of both G-CSF withdrawal and the addition of primary prophylaxis with corticosteroids after ASCT. Between January 2002 and August 2018, 111 MM patients conditioned with melphalan were managed at-home beginning +1 day after ASCT. Three groups were established: Group A (n = 33) received standard G-CSF post-ASCT; group B (n = 32) avoided G-CSF post-ASCT; group C (n = 46) avoided G-CSF yet added corticosteroid prophylaxis post-ASCT. The incidence of NF among the groups was reduced (64%, 44%, and 24%; P2 (OR 6.1; P = 0.002) and G-CSF avoidance plus corticosteroids (OR 0.1; P<0.001); and for hospital readmission: age �60 years (OR 14.6; P = 0.04) and G-CSF avoidance plus corticosteroids (OR 0.07; P = 0.05. G-CSF avoidance and corticosteroid prophylaxis post ASCT minimize the incidence of NF in MM patients undergoing at-home ASCT. This approach should be explored in a prospective randomized clinical trial

Early lung cancer detection using spiral computed tomography and positron emission tomography

RATIONALE: Lung cancer screening using computed tomography (CT) is effective in detecting lung cancer in early stages. Concerns regarding false-positive rates and unnecessary invasive procedures have been raised. OBJECTIVE: To study the efficiency of a lung cancer protocol using spiral CT and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET). METHODS: High-risk individuals underwent screening with annual spiral CTs. Follow-up CTs were done for noncalcified nodules of 5 mm or greater, and FDG-PET was done for nodules 10 mm or larger or smaller (> 7 mm), growing nodules. RESULTS: A total of 911 individuals completed a baseline CT study and 424 had at least one annual follow-up study. Of the former, 14% had noncalcified nodules of 5 mm or larger, and 3.6% had nodules of 10 mm or larger. Eleven non-small cell lung cancers (NSCLC) and one small cell lung cancer (SCLC) were diagnosed in the baseline study (prevalence rate, 1.32%), and two NSCLCs in the annual study (incidence rate, 0.47%). All NSCLCs (92% of prevalence cancers) were diagnosed in stage I (12 stage IA, 1 stage IB). FDG-PET was helpful for the correct diagnosis in 19 of 25 indeterminate nodules. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET for the diagnosis of malignancy were 69, 91, 90, and 71%, respectively. However, the sensitivity and negative predictive value of the screening algorithm, which included a 3-month follow-up CT for nodules with a negative FDG-PET, was 100%. CONCLUSION: A protocol for early lung cancer detection using spiral CT and FDG-PET is useful and may minimize unnecessary invasive procedures for benign lesions