ESTRATÉGIAS DE COOPERAÇÃO PARA A COMPETITIVIDADE NO SETOR TÊXTIL BRASILEIRO / COOPERATION STRATEGIES FOR COMPETITIVENESS IN THE BRAZILIAN TEXTILE SECTOR

O cenário competitivo determinado pelo avanço da globalização desafia as empresas a buscar opções estratégicas de inserção no mercado internacional, não somente para atuação em diferentes países como também para a competitividade local. Como esse desafio é comum a diferentes agentes de um mesmo setor de atividade, a adoção de estratégias de cooperação entre fornecedores, compradores e até mesmo concorrentes pode ser um caminho para o fortalecimento competitivo de todos. Com o propósito de conhecer possíveis contribuições que a cooperação proporciona à competitividade das empresas do setor têxtil na internacionalização de negócios, realizou-se uma pesquisa qualitativa exploratória, envolvendo entrevistas com profissionais que atuam em diferentes segmentos da cadeia produtiva têxtil e análise de documentos e publicações que refletem dados conjunturais. Os dados revelam que a internacionalização ocorre predominantemente via inserção comercial e, em menor escala, por inserção produtiva. Também se evidencia que estratégias cooperativas podem contribuir à internacionalização de empresas do setor face ao potencial de redução de custos, evolução tecnológica e otimização de processos. Apesar do reconhecimento desse potencial em um cenário de competição internacional, contudo, essa cooperação tem se revelado menor do que poderia ser, principalmente devido à resistência a compartilhar informações com concorrentes. Palavras-Chave: Cooperação. Competitividade. Internacionalização. Abstract The competitive landscape determined by the advance of globalization challenges companies to pursue strategic options for insertion in the international market, not only to operate in different countries, but also for local competitiveness. As this is a common challenge to different players in the same sector of activity, the adoption of cooperation strategies between suppliers, customers and even competitors may be means of competitive strengthening of all. Seeking to identify possible contributions that the adoption of cooperative strategies provides for the competitiveness of Brazilian companies in the textile sector, in terms of the internationalization of business, an exploratory qualitative study was carried out involving interviews with professionals operating in diferente segments of the textile production chain. Documents and publications concerning this industry were also analyzed. The research reveals that internationalization occurs predominantly through trading inclusion and, to a smaller extent, productive insertion. It also shows that cooperative strategies can contribute to the internationalization of companies through potential cost reduction, technological evolution, and optimization of processes. However, despite the potential of operating an international competition scenario, this cooperation has proven to be less extensive than it could be, mainly due to a reluctance to information sharing among direct competitors. Keywords: Cooperation. Competitiveness. Internationalization

Do you have an aged relative who had a stroke? Do you know if the caregiver is well prepared?

Trata-se de um infográfico elaborado pela Equipe da Plataforma CARE sobre a Tese intitulada "Adaptação e validação da escala de capacidades do cuidador informal de idosos dependentes por AVC (ECCIID-AVC) para uso no Brasil" de autoria da Mestra Fernanda Laís Fengler Dal Pizzol, orientado pela Doutora Lisiane M. G. Paskulin. Este infográfico objetiva facilitar a transmissão do conhecimento científico.Ao baixar o arquivo, abra-o com um visualizador de imagens. Caso seu computador ou celular não tenha acesso a imagens, será necessário baixar um programa visualizador de imagens.ImagemPara utilização desta obra referenciar autores e Plataforma CARE

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status