Creating value through relationships: a critical contribution from Social Marketing

ABSTRACT Relationship marketing provides a new foundation for thinking, genuine change in values and ethics and a new logic that sees consumers as the prime drivers of the value creation process. It seems to have a lot to offer to social marketing, however, despite its potential, the social marketing field is responding slowly to relational thinking. This research demonstrates that relationship marketing helps social marketing and that its absence seriously undermines the field. Our examination is critical because it de-constructs the transactional paradigm and shows how its logic is incapable of responding to the complexities of contemporary pluralist societies. From the literature, we have identified the principles, processes and constructs of relationship marketing that are transferable to social marketing. Further, we have identified the challenges and implications of that transference, given the particular characteristics of social marketing. To empirically examine the potential of relationship marketing in social marketing, we have conducted a process evaluation and developed a specific framework that incorporates and reflects relationship marketing principles, processes and constructs. This research makes an important methodological contribution because it goes beyond current frameworks and suggests alternative evaluation components. The process evaluation was applied through an explanatory, holistic and single case-study design. The case was a parent drugs prevention programme and to examine it we have predominantly used a mix of qualitative methods and a research design which enabled triangulation. Through the application of process evaluation to the case we have de-constructed the dominant paradigm of the programme and examined its consequences. The findings indicate that the programme did not widely applied the principles, processes and constructs of relationship marketing. Despite having successfully applied relationship marketing in specific parts of the programme, these correspond to technical rather than strategic aspects of relationship marketing and worked as isolated parts rather than as a whole. More fundamentally, rather than seeing consumers as partners, the programme saw consumers as targets, not recognizing them as the main drivers of the value creation process. The programme was therefore shaped by a transactional perspective which affected its assumptions and undermined its design and implementation. The main conclusion is that, despite its theoretical potential, it is challenging and difficult to transfer relationship marketing to real live social marketing programmes. In particular, social marketing needs to be more reflexive and self-critical in order to de-construct its prevailing paradigm and start re-constructing an alternative. This demands not only a new attitude, new values and new assumptions but also a focus on resources, competences and new and more flexible organizational structures

Kinetics of the Release Sugars from the Enzymatic and Physico-Chemical Pre-treated Sugarcane Bagasse and Residual Forest Biomass

ABSTRACT: Several pre-treatments are used to release sugars from lignocellulosic materials that are used to produce second-generation ethanol (2G). This study aimed to evaluate the kinetic release of glucose and xylose through the enzymatic and physical treatments of sugarcane bagasse and residual forest biomass, focusing on the ratio between hexose and pentose. Enzymatic hydrolysis after hydrothermal pre-treatment under different conditions, at 170, 170 and 190 degrees C, 170 and 190 degrees C with sulfuric acid, and 170 and 190 degrees C with the Organosolv solvent, all of them for 10 min, were performed with sugarcane bagasse and residual forest biomass, and the kinetic parameters of sugar release were evaluated. The results indicated that compared to hydrothermal and combined hydrothermal and dilute acid hydrolysis, organosolvation process led to higher release of glucose in hydrolysates from both biomasses, with a maximum yield of 14.12 and 33.33 g L-1, respectively. On the other hand, the highest glucose/xylose ratio (about 19), which will facilitate its subsequent use for fermentation, was obtained from sugarcane bagasse after hydrothermal treatment at 170 and 190 degrees C. This ratio was higher for all treatments when compared to untreated biomass, which indicated that temperature and acid affected xylose instead of glucose.info:eu-repo/semantics/publishedVersio

Fiber cavity ring down and gain amplification effect

The effect of an erbium-doped fiber amplifier (EDFA) placed inside the fiber ring of a cavity ring down (CRD) configuration is studied. The limitations and advantages of this configuration are discussed, and the study of the ring-down time as a function of the current applied and gain to the EDFA is also presented. In this case, the power fluctuations in the output signal are strongly dependent on the cavity ring-down time with the EDFA gain.This work was supported by Project "CORAL – Sustainable Ocean Exploitation: Tools and Sensors, NORTE-01-0145-FEDER-000036, financed by the North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF). S.S. received a Pos-Doc fellowship (ref. SFRH/BPD/92418/2013) also funded by FCT – Portuguese national funding agency for science, research and technology

Impacte das dotações de enfermagem na qualidade dos cuidados de saúde e na qualidade de vida

Os resultados desta investigação podem ter um efetivo contributo na tomada de decisão, seja política ou ao nível das organizações de saúde, seja no planeamento estratégico, tático ou operacional, direcionando o modo como os cuidados de enfermagem podem ser uma importante valia para os resultados em saúde. A literatura demonstra que as organizações de saúde que investem em adequadas dotações de enfermagem, também investem numa efetiva gestão da qualidade, apresentando melhores resul- tados no que se refere a indicadores sensíveis aos cuidados de enferma- gem. A responsabilização é outro fator importante: saber que algo deve ser feito não quer dizer que o seja. É importante atender aos indicadores sensíveis aos cuidados de enfermagem e acompanhar a sua evolução, de modo a intervir atempadamente e com adequabilidade. De salientar que a responsabilização deve ser aplicada quer ao nível organizacional e do serviço, quer individualmente a cada profissional

Projeto de saúde no território: educação sexual na escola / Health in the territory project: sexual education at school

A sexualidade é inerente aos seres humanos, e o sexo, uma forma de expressá-la, pode trazer consequências negativas quando praticado inconsequentemente. A educação sexual é um importante meio de prevenção de infecções sexualmente transmissíveis (IST’s) e gravidezes indesejadas, sendo a escola um ambiente propício para a abordagem de tais questões. No presente trabalho, objetivou-se desenvolver ações de prevenção e promoção envolvendo os temas sexualidade e saúde sexual com estudantes adolescentes. Trata-se de uma pesquisa descritiva, de caráter quantitativo, acerca dos conhecimentos relacionados à saúde sexual dos alunos da escola Polivalente, no município de Patos de Minas. A pesquisa contou com a participação de 47 alunos matriculados nas turmas do 9º ano do ensino fundamental ao 3º ano do ensino médio. A intervenção contou, em um primeiro dia, em uma aplicação de questionário seguida por exibição de vídeo disparador e discussão em grupo, com apontamento das maiores insuficiências nos assuntos abordados. Em um segundo dia, foi realizada uma aula expositiva abordando os tópicos da discussão e, posteriormente, foi reaplicado o mesmo questionário. Observou-se melhor desempenho na maioria das questões após a intervenção. Conclui-se a importância e validade de atividades de conscientização na escola, onde os jovens puderam discutir o tema entre si e resolver suas dúvidas.

Diretriz Brasileira sobre a Saúde Cardiovascular no Climatério e na Menopausa – 2024

Women, who represent approximately half of the global population according to estimates as of January 2024, may experience signs and symptoms of menopause for at least one-third of their lives, during which they have a higher risk of cardiovascular morbidity and mortality. The effects of menopausal hormone therapy (MHT) on the progression of atherosclerosis and cardiovascular disease (CVD) events vary depending on the age at which MHT is initiated and the time since menopause until its initiation. Beneficial effects on CVD outcomes and all-cause mortality have been observed when MHT was initiated before the age of 60 or within 10 years after menopause. The decision regarding the initiation, dose, regimen, and duration of MHT should be made individually after discussing the benefits and risks with each patient. For primary prevention of postmenopausal chronic conditions, the combined use of estrogen and progestogen is not recommended in asymptomatic women, nor is the use of estrogen alone in hysterectomized women. Hormone-dependent neoplasms contraindicate MHT. For the treatment of genitourinary syndrome of menopause, vaginal estrogen therapy may be used in patients with known cardiovascular risk factors or established CVD. For women with contraindications to MHT or who refuse it, non-hormonal therapies with proven efficacy (antidepressants, gabapentin, and fezolinetant) may improve vasomotor symptoms. Compounded hormonal implants, or "bioidentical" and "compounded" hormones, and "hormone modulation" are not recommended due to lack of scientific evidence of their effectiveness and safety.Mujeres, que representan aproximadamente la mitad de la población mundial según estimaciones de enero de 2024, pueden experimentar signos y síntomas de la menopausia durante al menos un tercio de sus vidas, durante los cuales tienen un mayor riesgo de morbilidad y mortalidad cardiovascular. Los efectos de la terapia hormonal de la menopausia (THM) en la progresión de la aterosclerosis y los eventos de enfermedad cardiovascular (ECV) varían según la edad en que se inicia la THM y el tiempo transcurrido desde la menopausia hasta su inicio. Se han observado efectos beneficiosos en los resultados de ECV y la mortalidad por todas las causas cuando la THM se inició antes de los 60 años o dentro de los 10 años posteriores a la menopausia. La decisión sobre la iniciación, dosis, régimen y duración de la THM debe tomarse individualmente después de discutir los beneficios y riesgos con cada paciente. Para la prevención primaria de condiciones crónicas en la posmenopausia, no se recomienda el uso combinado de estrógeno y progestágeno en mujeres asintomáticas, ni el uso de estrógeno solo en mujeres histerectomizadas. Las neoplasias dependientes de hormonas contraindican la THM. Para el tratamiento del síndrome genitourinario de la menopausia, se puede usar terapia estrogénica vaginal en pacientes con factores de riesgo cardiovascular conocidos o ECV establecida. Para mujeres con contraindicaciones a la THM o que la rechazan, las terapias no hormonales con eficacia demostrada (antidepresivos, gabapentina y fezolinetant) pueden mejorar los síntomas vasomotores. Los implantes hormonales compuestos, o hormonas "bioidénticas" y "compuestas", y la "modulación hormonal" no se recomiendan debido a la falta de evidencia científica sobre su efectividad y seguridad.As mulheres, que representam cerca de metade da população mundial segundo estimativas de janeiro de 2024, podem sofrer com sinais e sintomas da menopausa durante pelo menos um terço de suas vidas, quando apresentam maiores risco e morbimortalidade cardiovasculares. Os efeitos da terapia hormonal da menopausa (THM) na progressão de eventos de aterosclerose e doença cardiovascular (DCV) variam de acordo com a idade em que a THM é iniciada e o tempo desde a menopausa até esse início. Efeitos benéficos nos resultados de DCV e na mortalidade por todas as causas ocorreram quando a THM foi iniciada antes dos 60 anos de idade ou nos 10 anos que se seguiram à menopausa. A decisão sobre o início, a dose, o regime e a duração da THM deve ser tomada individualmente após discussão sobre benefícios e riscos com cada paciente. Para a prevenção primária de condições crônicas na pós-menopausa, não se recomendam o uso combinado de estrogênio e progestagênio em mulheres assintomáticas nem o uso de estrogênio sozinho em mulheres histerectomizadas. Neoplasias hormônio-dependentes contraindicam a THM. Para tratamento da síndrome geniturinária da menopausa, pode-se utilizar terapia estrogênica por via vaginal em pacientes com fatores de risco cardiovascular conhecidos ou DCV estabelecida. Para mulheres com contraindicação à THM ou que a recusam, terapias não hormonais com eficácia comprovada (antidepressivos, gabapentina e fezolinetante) podem melhorar os sintomas vasomotores. Os implantes hormonais manipulados, ou hormônios “bioidênticos” “manipulados”, e a ‘modulação hormonal’ não são recomendados pela falta de evidência científica de sua eficácia e segurança

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives