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Análise de desempenho de fundos de investimento em ações no período de 2007-2010

Ávila, Gustavo
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Trabalho de Conclusão de Curso Formato: application/pdf
POR
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45.86%
O objetivo do trabalho foi analisar a superioridade dos fundos de investimento com gestão ativa em relação ao seu benchmark. Para tanto, foram analisados os desempenhos históricos em termos de risco e retorno, bem como as habilidades de seletividade e market timing dos gestores. Foram avaliados no total vinte e cinco Fundos de investimento com gestão ativa, classificados como fundos de ações, e um fundo de gestão passiva, classificado como fundo de índice de mercado. Dentre os fundos de gestão ativa, quatorze tinham como indicador de referência o IBrX-50, enquanto os onze demais tinham como referência o Ibovespa. O ativo livre de risco utilizado foi o Certificado de Depósito Interbancário (CDI) Na análise se utilizou os índices de Sharpe, Treynor, Jensen e Modigliani, e o modelo de Treynor-Mazuy. Os índices de Sharpe, Treynor e Modigliani demonstraram superioridade de apenas uma pequena parcela dos fundos analisados. O Índice de Jensen e o modelo de Treynor-Mazuy não demonstraram resultados significativos que pudessem evidenciar as habilidades de seletividade e market timing dos gestores.; The objective of this study was to analyze the superiority of investment funds with active management in relation to its benchmark. To this end...

Investir em acções segundo Warren Buffett: caso português

Jorge, Ricardo Humberto Dias
Fonte: Instituto Universitário de Lisboa Publicador: Instituto Universitário de Lisboa
Tipo: Dissertação de Mestrado
Publicado em //2010 POR
Relevância na Pesquisa
45.83%
Mestrado em Finanças; Warren Buffett é um dos investidores mais bem sucedidos nos mercados de capitais dos últimos 50 anos. Segundo o último estudo da revista norte-americana Forbes (2008), Buffett é considerado o segundo homem mais rico do Mundo, com um património acumulado de aproximadamente 38 mil milhões USD. Este estudo tentará replicar o modelo de investimento utilizado por Warren Buffett no Índice PSI-20. Para tal, são comparadas três carteiras de investimentos representativas de diferentes estratégias de investimento, incluindo a estratégia buffettiana. Os resultados apontam para a estratégia de investimento buffetiana como o estilo de investimento com melhor relação retorno / risco durante o período de investimento traçado (2000-2008). Destaque ainda para a demonstração das vantagens comparativas da Gestão Activa (e Market Timing) e Security Selection (análise fundamental e qualitativa) em relação à Gestão Passiva e Diversificação, respectivamente.; Warren Buffett is one of the most successful investors in capital markets over the last 50 years. According to the latest study by U.S. magazine Forbes (2008), Buffett is considered the second richest man in the world, with an accumulated wealth of nearly 38 billion USD. This study attempts to reproduce the investment model used by Warren Buffett in the PSI-20 Index. For that...

Active management of labor: a cost analysis of a randomized controlled trial

Rogers, Rebecca G; Gardner, Michael O; Tool, Kevin J; Ainsley, Jeanne; Gilson, George
Fonte: Copyright 2000 BMJ publishing Group Publicador: Copyright 2000 BMJ publishing Group
Tipo: Artigo de Revista Científica
Publicado em /04/2000 EN
Relevância na Pesquisa
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Objective To compare the costs of a protocol of active management of labor with those of traditional labor management. Design Cost analysis of a randomized controlled trial. Methods From August 1992 to April 1996, we randomly allocated 405 women whose infants were delivered at the University of New Mexico Health Sciences Center, Albuquerque, to an active management of labor protocol that had substantially reduced the duration of labor or a control protocol. We calculated the average cost for each delivery, using both actual costs and charges. Results The average cost for women assigned to the active management protocol was $2,480.79 compared with an average cost of $2,528.61 for women in the control group (P = 0.55). For women whose infant was delivered by cesarean section, the average cost was $4,771.54 for active management of labor and $4,468.89 for the control protocol (P = 0.16). Spontaneous vaginal deliveries cost an average of $27.00 more for actively managed patients compared with the cost for the control protocol. Conclusions The reduced duration of labor by active management did not translate into significant cost savings. Overall, an average cost saving of only $47.91, or 2%, was achieved for labors that were actively managed. This reduction in cost was due to a decrease in the rate of cesarean sections in women whose labor was actively managed and not to a decreased duration of labor.

Randomised controlled trial of oxytocin alone versus oxytocin and ergometrine in active management of third stage of labour.

McDonald, S J; Prendiville, W J; Blair, E
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 06/11/1993 EN
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OBJECTIVE--To compare intramuscular oxytocin alone and intramuscular oxytocin with ergometrine (Syntometrine) for their effect in reducing the risk of postpartum haemorrhage when both are used as part of the active management of the third stage of labour. DESIGN--Double blind, randomised controlled trial. SETTING--Two metropolitan teaching hospitals in Perth, Western Australia. SUBJECTS--All women who expected a vaginal birth during the period of the trial. Informed consent was obtained. MAIN OUTCOME MEASURES--Postpartum haemorrhage, nausea, vomiting, and increased blood pressure. RESULTS--3497 women were randomly allocated to receive oxytocin-ergometrine (n = 1730) or oxytocin (n = 1753). Rates of postpartum haemorrhage (> or = 500 ml or > or = 1000 ml) were similar in both arms (odds ratio 0.90 (0.82); 95% confidence interval 0.75 to 1.07 (0.59 to 1.14) at 500 ml (1000 ml) threshold). The use of oxytocin-ergometrine was associated with nausea, vomiting, and increased blood pressure. CONCLUSIONS--There are few advantages but several disadvantages for the routine use of oxytoxinergometrine when prophylactic active management of the third stage of labour is practised. Further investigation of dose-response for oxytocin may be warranted.

Active management of labour: current knowledge and research issues.

Thornton, J. G.; Lilford, R. J.
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em 06/08/1994 EN
Relevância na Pesquisa
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OBJECTIVES--To review the evidence that the package of labour interventions collectively called "active management"--namely, strict diagnostic criteria for labour, early amniotomy, early use of oxytocin, and continuous professional support--reduce rates of caesarean sections and operative vaginal delivery in first labours. DESIGN--Review of observational data, supplemented by evidence from four separate overviews of relevant randomised trials previously published as part of the Cochrane Collaboration pregnancy and childbirth database. RESULTS--Observational data do not permit a clear conclusion. There have been no randomised trials of the total package of active management or of the use of strict diagnostic criteria alone, but trials of early amniotomy, early oxytocin, and these interventions combined do not suggest that these interventions are effective in reducing rates of caesarean sections or operative vaginal deliveries. In contrast, the provision of continuous professional support in labour seems to reduce both types of operative delivery, although the effect on caesarean sections is confined to those settings where non-professional companions are not normally present in labour. CONCLUSIONS--Delivery units should endeavour to provide continuous professional support in labour...

Engineering and policy analysis of strategic and tactical options for future aerospace traffic management

Falker, John M
Fonte: Massachusetts Institute of Technology Publicador: Massachusetts Institute of Technology
Tipo: Tese de Doutorado Formato: 128 p.; 7238178 bytes; 7237987 bytes; application/pdf; application/pdf
ENG
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Current space launch/landing events are conducted only within Special Use Airspace (SUA), separate from air traffic. This is a strategic traffic management policy because SUA size and duration are set well in advance. It forces space operations to disrupt aviation, which could become costly with growth in air or space transportation. This was investigated through integrated engineering/policy analysis of strategic and tactical options. Total annual disruption cost was calculated using the number of conflicts per SUA event, the annual SUA events, the average disruption per conflict, and the cost per unit disruption. The conflict count was identified as most important, and an analytical airspace conflict model was developed to predict the number of conflicts associated with restricting an arbitrary region of airspace for a given duration. This approach was used to investigate the sensitivity of disruption cost to SUA radius, SUA active duration, air traffic density, relative velocity, annual SUA events, and conflict resolution distance. The current annual cost is under $1 million, but the expected ranges of all factors comprise a plausible range of $100 to $8 million. This cost was most sensitive to SUA radius: on average, doubling the radius multiplies the cost by 49...

A practical framework by using active M&A strategy for corporate growth in China; Practical framework by using active mergers and acquisitions strategy for corporate growth in China

Chen, Jun, 1968-
Fonte: Massachusetts Institute of Technology Publicador: Massachusetts Institute of Technology
Tipo: Tese de Doutorado Formato: 80 leaves; 3871465 bytes; 3871273 bytes; application/pdf; application/pdf
ENG
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by Jun Chen.; Thesis (S.M.M.O.T.)--Massachusetts Institute of Technology, Sloan School of Management, Management of Technology Program, 2003.; Includes bibliographical references (leaves 78-80).

GESTÃO PARTICIPATIVA EM UNIDADES DE CONSERVAÇÃO: O CONSELHO CONSULTIVO DA APA DO JOÃO LEITE, GOIÁS; Active Management in Units of Conservation: The Advisory Council of APA of João Leite, Goiás

TEIXEIRA, Kharen de Araújo
Fonte: Universidade Federal de Goiás; BR; UFG; Mestrado em Geografia; Ciências Humanas Publicador: Universidade Federal de Goiás; BR; UFG; Mestrado em Geografia; Ciências Humanas
Tipo: Dissertação Formato: application/pdf
POR
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The Unit of Conservation (UCs) has been seen as an important instrument to protect biodiversity and the natural resources. However, it´s necessary to combine this protection with human presence and its need of economical, social and cultural development. The most indicated way of ensuring the envolvement and participation of the society in discussions related to the UCs is through the implementation of Management Councils. Nevertheless, it can be seen in Goiás, and in other estates of the country, the lack of efficiency of these councils, which are stuck on paper, managing to follow the rules. Out of paper, the discussed and carried out actions are still insignificant. This research aimed to make analizes of the active management efficiency through the action of management councils of Conservation Units, having the Advisory Council of the Environment Protection Area (APA) of João Leite as the subject of study. The methodology used here consisted of analising the criation and introduction process of management councils of Conservation Units in Goiás and of the existing bibliographic documents on the matter, aiming to understand its social, economical, and supporting structure, as well as the criation, introduction and management of its Council. The results show that the Council of APA of João Leite has a GOOD level of efficiency according to the pattern of efficiency test of the active management in units of conservation. The criation stage of the management council was classified as GREAT...

Active Management of the Third Stage of Labour without Controlled Cord Traction : A Randomized Non-Inferiority Controlled Trial

Gulmezoglu, A. M.; Widmer, M.; Merialdi, M.; Qureshi, Z.; Piaggio, G.; Elbourne, D.; Abdel-Aleem, H.; Carroli, G.; Hofmeyr, G. J.; Lumbiganon, P.; Derman, R.; Okong, P.; Goudar, S.; Festin, M.; Althabe, F.; Armbruster, D.
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Artigo de Revista Científica
EN
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45.98%
BACKGROUND: The third stage of labour refers to the period between birth of the baby and complete expulsion of the placenta. Some degree of blood loss occurs after the birth of the baby due to separation of the placenta. This period is a risky period because uterus may not contract well after birth and heavy blood loss can endanger the life of the mother. Active management of the third stage of labour (AMTSL) reduces the occurrence of severe postpartum haemorrhage by approximately 60-70%. Active management consists of several interventions packaged together and the relative contribution of each of the components is unknown. Controlled cord traction is one of those components that require training in manual skill for it to be performed appropriately. If it is possible to dispense with controlled cord traction without losing efficacy it would have major implications for effective management of the third stage of labour at peripheral levels of health care. OBJECTIVE: The primary objective is to determine whether the simplified package of oxytocin 10 IU IM/IV is not less effective than the full AMTSL package. METHODS: A hospital-based, multicentre, individually randomized controlled trial is proposed. The hypothesis tested will be a non-inferiority hypothesis. The aim will be to determine whether the simplified package without CCT...

Intervenção de enfermagem na gestão do 3º estadio do trabalho de parto

Cândido, Ana Paula Lopes Ferreira
Fonte: Universidade de Évora Publicador: Universidade de Évora
Tipo: Dissertação de Mestrado
POR
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45.89%
No século XXI, a hemorragia pós-parto continua a ser um problema global. Todos os anos cerca de 140.000 mulheres morrem de hemorragia pós-parto, uma das principais causas de mortalidade e morbilidade associadas à gravidez, mesmo em países desenvolvidos. A gestão activa do 3.º estadio do trabalho de parto é uma prática baseada em evidências científicas, importante na prevenção de hemorragia pós-parto e, consequentemente, na redução da mortalidade e morbilidade materna. O questionário aplicado aos enfermeiros ESMO do serviço de urgência da MAC confirmou a existência de diferentes procedimentos durante o 3. º estadio do trabalho de parto. A intervenção de enfermagem, pretendeu sensibilizar os enfermeiros para a importância da gestão activa na prevenção da hemorragia pós-parto. O fato de interrogarmos a prática abre portas a sugestões, correcções e alternativas, contribuindo para um cuidado de excelência. A realização deste relatório permitiu apresentar as etapas desenvolvidas ao longo desta intervenção de enfermagem; ABSTRACT: In the twenty-first century, the post-partum haemorrhage remains a global problem. Every year about 140,000 women die of postpartum haemorrhage, which is one of the major causes of mortality and mobility associated with pregnancy even in developed countries. The active management of the 3rd stage of labour is a practice based on scientific evidence...

Prototyping of an active and lightweight router

Kaplan, Namik
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: xiii, 127 p.;28 cm.
EN_US
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Approved for public release; distribution is unlimited; A new network management system named Server and Agent based Active Management (SAAM) has been proposed. SAAM can locate and fix network problems much more quickly than today's systems. Stand-alone routers are used in current network architectures. In contrast, SAAM employs dedicated servers that collect packet performance information from the routers and use the collected information to predict, detect and respond to network problems. In other words, SAAM relieves individual routers from most routing and network management tasks. SAAM allows the development of a lightweight router. The primary goal of this thesis is to prototype a lightweight router that is suitable for the SAAM architecture. The Active Networking approach was explored. Active Networking refers to the addition of user-controllable computing capabilities to the network. The result of this thesis is a lightweight router running on a Linux machine. The router is connected to the Active Network Backbone (ABONE) by using a software package called Active NETworks Daemon (ANETD). ABONE is an experimental wide area network, where more in-depth research of SAAM router and server can be conducted. All major active network programming languages and their underlying support were evaluated. Verification of the lightweight router concept was conducted using server-probing experiments. The results demonstrate that it is straightforward for a SAAM server to collect performance information from lightweight routers that support active networking; http://www.archive.org/details/prototypingofact00kapl; Lieutenant Junior Grade...

Comparação entre gestão activa e gestão passiva de um portfolio de acções: um estudo empírico com base no psi 20

Oliveira, Vitor Manuel Branco
Fonte: Instituto Superior de Economia e Gestão Publicador: Instituto Superior de Economia e Gestão
Tipo: Dissertação de Mestrado
Publicado em /03/2009 POR
Relevância na Pesquisa
46.04%
Mestrado em Finanças; Este trabalho visa avaliar o contributo de uma gestão activa comparativamente a uma gestão passiva no desempenho de determinado portfolio, composto por acções do PSI20. A gestão activa teve em conta uma carteira de acções determinada com base no modelo de Markowitz, enquanto que, a gestão passiva tem por base uma carteira composta por acções com proporções iguais. Na gestão activa, as proporções a investir nos activos foram revistas tendo em conta a evolução do mercado, numa base mensal. No entanto, a determinação das ponderações óptimas teve em atenção diferentes cenários em "sistema de janela". Como segundo objectivo, foi definido o estudo do impacto dos custos de intermediação financeira na performance de ambos os portfolios anteriores. Foram utilizados títulos cotados do PSI 20 durante um período de 11 anos (entre 1 de Janeiro de 1996 e 31 de Dezembro de 2006). As conclusões mostram que não compensa optar por uma gestão activa face a uma gestão passiva, quando a carteira objecto da gestão seja composta por activos cotados no PSI20. Para esta conclusão contribuem dois factores: os custos de intermediação financeira e os erros cometidos na estimação dos principais inputs para cálculo das ponderações óptimas da carteira. A melhor opção revelou-se no investimento no índice de Mercado (PSI 20).; The goal of this Thesis is to evaluate the contribution of an active management versus passive management to the portfolio performance...

A eficiência nas Carteiras de Markowitz, Variância Mínima e Naïve aplicada ao índice italiano

Martins, Luís Pedro Rosa
Fonte: Instituto Superior de Economia e Gestão Publicador: Instituto Superior de Economia e Gestão
Tipo: Dissertação de Mestrado
Publicado em //2014 POR
Relevância na Pesquisa
45.96%
Mestrado em Finanças; O objectivo deste trabalho é verificar as possíveis vantagens da gestão activa face à gestão passiva de uma carteira de acções com a mesma composição do índice de acções italiano FTSE MIB. A gestão passiva baseia-se no método Naïve (1/N), onde a composição da carteira inclui todos os activos do indice com proporções iguais. A gestão activa baseia-se no método de Markowitz que tem como objectivo maximizar a rendibilidade tendo definido um determinado nível de risco, ou minimizar o risco tendo em conta um nível de rendibilidade esperada. Também é utilizado o método da variância mínima que consiste em minimizar o risco independentemente da rendibilidade. Nesta abordagem as proporções a investir em cada activo são revistas mensalmente tendo em conta a evolução do mercado. Para as determinar são consideradas ?janelas? de dados de 1 e 2 anos. O segundo objectivo deste trabalho é determinar o efeito dos custos de intermediação financeira no desempenho da carteira. São utilizados os títulos que compõem o índice FTSE MIB, representativo do mercado italiano desde Janeiro de 2004 até Dezembro de 2013. Os resultados mostram a superioridade da gestão activa face à passiva, sendo a carteira de Markowitz a que obteve melhor desempenho. A carteira de variância mínima obteve resultados inferiores à de Markowtiz...

Indexing and active fund management: International evidence

Cremers, Martijn; Ferreira, Miguel A.; Matos, Pedro; Starks, Laura
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em /01/2015 ENG
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55.96%
Author's pre-print; We examine the relation between indexing and active management in the mutual fund industry worldwide. Explicit indexing and closet indexing by active funds are associated with countries’ regulatory and financial market environments. We find that actively managed funds are more active and charge lower fees when they face more competitive pressure from low-cost explicitly indexed funds. A quasi-natural experiment using the exogenous variation in indexed funds generated by the passage of pension laws supports a causal interpretation of the results. Moreover, the average alpha generated by active management is higher in countries with more explicit indexing and lower in countries with more closet indexing. Overall, our evidence suggests that explicit indexing improves competition in the mutual fund industry.; Inquire Europe, European Research Council

Why Might Investors Choose Active Management?

Warren, Geoffrey; Foster, Douglas Frederick
Fonte: Routledge, Taylor & Francis Group Publicador: Routledge, Taylor & Francis Group
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
45.88%
We investigate why investors may be willing to participate in active management, notwithstanding that the average manager is likely to generate negative alpha after fees. We model the alpha an investor expects from a dynamic strategy of investing in a portfolio of active investment managers, and the fee they are willing to pay for this strategy. The investor considers their ability to select good managers, and anticipates replacing managers when alpha expectations fall either due to a loss of confidence in the manager�s ability or from the dilutive impact of new fund flows. A numerical calibration, using inputs consistent with the literature, finds some investors can credibly select active managers at observed fee levels. Computations suggest that investors who are overly optimistic about their ability to select active managers or overlook the dynamic elements of investing with active managers may incur significant losses.

A gestão de carteira de acções aplicada ao mercado francês

Félix, João Pedro Santos Silva
Fonte: Instituto Superior de Economia e Gestão Publicador: Instituto Superior de Economia e Gestão
Tipo: Dissertação de Mestrado
Publicado em //2011 POR
Relevância na Pesquisa
45.98%
Mestrado em Finanças; O principal objectivo deste estudo é avaliar as possíveis vantagens de uma carteira caracterizada por uma gestão activa face a uma carteira caracterizada pela gestão passiva, com base no índice de acções CAC-40. A gestão activa teve por base em 2 modelos: Modelo de Markowitz (carteira óptima) e Modelo de Variância Mínima. Já a gestão passiva é baseada numa carteira composta por todas as acções em proporções iguais (carteira naïve). Na gestão activa as proporções dos activos constituintes de cada carteira foram revistos mensal, trimestral, semestral e anualmente tendo em conta a evolução do mercado. Foram consideradas janelas de dados de 1 e 2 anos para determinar as ponderações a investir em cada activo. O segundo objectivo foi analisar o impacto dos custos de intermediação financeira no desempenho das carteiras calculadas anteriormente. Foram utilizados os títulos que se mantiveram em bolsa durante o período compreendido entre Janeiro de 1997 e Dezembro de 2006, o que corresponde a 31 acções do CAC-40. Depois de realizado este trabalho, concluiu-se que a 1 mês a carteira naïve é a melhor opção de investimento e a 3 meses tanto esta carteira como a carteira de mercado são boas opções de investimento. Já a 6 e 12 meses...

A Gestão de Carteira de Acções aplicada ao mercado espanhol

Monteiro, Pedro Matoso Coimbra Sacramento
Fonte: Instituto Superior de Economia e Gestão Publicador: Instituto Superior de Economia e Gestão
Tipo: Dissertação de Mestrado
Publicado em //2011 POR
Relevância na Pesquisa
46.04%
Mestrado em Finanças; A presente dissertação teve como objetivo principal analisar e comparar a gestão ativa e passiva de um determinado portfolio constituído por ações do Índice Bolsista Espanhol (IBEX 35). Na gestão ativa utilizaram-se dois modelos: uma carteira de ações determinada através do modelo de otimização de Markowitz, e uma carteira de ações resultante do modelo de variância mínima. Na gestão passiva recorreu-se a uma carteira de ações com pesos iguais. O período de tempo considerado para o efeito foi de 10 anos, de 1997 a 2006. A gestão ativa do portfolio, com base nos dois modelos considerados, consistiu na revisão mensal das proporções investidas em cada uma das ações que compuseram a carteira tendo em conta a evolução do mercado. A gestão passiva implicou um investimento de proporções iguais nos ativos constituintes da carteira, proporções essas que se mantiveram inalteradas durante o período em análise e que, portanto, não tiveram em conta a evolução do mercado. Para a determinação das ponderações das carteiras dos três modelos, utilizou-se um ?sistema de janela? de 1 e 2 anos. Um segundo objetivo deste trabalho foi perceber o impacto dos custos de intermediação financeira no desempenho dos portfolios de ações. Com este estudo...

Development of decision support tools to assess the sustainability of coastal lakes

Ticehurst, Jenifer Lyn; Rissik, David; Letcher, Rebecca; Newham, Lachlan; Jakeman, Anthony
Fonte: Modelling and Simulation Society of Australia and New Zealand Inc. Publicador: Modelling and Simulation Society of Australia and New Zealand Inc.
Tipo: Conference paper
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The sustainable management of the coastal lakes in NSW is under pressure from increasing urban development and tourism, intensification of agriculture, and the growing importance for the conservation of flora and fauna. An integrative approach is necessary to be able to manage for all these often conflicting interests. This paper presented a tool, called the CLAM (Coastal Lakes Assessment and Management) tool, which uses a Bayesian Decision Network to identify the likely impacts of management decision on social, economic and ecological variables within a catchment. Community consultation was an imperative component of the model development, and will also be pursued for model verification in the future. A CLAM tool for the Merimbula Lake was presented as a case study. The brief analysis of the model results given showed that active management of the Merimbula Lake catchment is likely to significantly improve the lake water quality. It also showed that urban development can proceed within the catchment without negatively impacting upon the lake water quality, if appropriate regulations are imposed and catchment management occurs. Various management options were shown to increase the local revenue, but not all of them did so while improving the lake's water quality. The CLAM tool is believed to be a useful tool and a dynamic approach...

Use of active management of the third stage of labour in seven developing countries

Stanton,Cynthia; Armbruster,Deborah; Knight,Rod; Ariawan,Iwan; Gbangbade,Sourou; Getachew,Ashebir; Portillo,Jose Angel; Jarquin,Douglas; Marin,Flor; Mfinanga,Sayoka; Vallecillo,Jesus; Johnson,Hope; Sintasath,David
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2009 EN
Relevância na Pesquisa
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OBJECTIVE: To document the use of active management of the third stage of labour for preventing postpartum haemorrhage and to explore factors associated with such use in seven developing countries. METHODS: Nationally representative samples of facility-based deliveries were selected and observed to determine the use of active management of the third stage of labour and associated factors. Policies on active management were assessed through document review and interviews with relevant professionals. FINDINGS: Use of a uterotonic during the third or fourth stages of labour was nearly universal. Correct use of active management of the third stage of labour was found in only 0.5% to 32% of observed deliveries due to multiple deficiencies in practice. In every country except Indonesia, policies regarding active management were conflicting. CONCLUSION: Developing countries have not targeted decreasing postpartum haemorrhage as an achievable goal; there is little use of active management of the third stage of labour, and policies regarding such management often conflict. Studies are needed to identify the most effective components of active management so that the most efficient package of practices can be promoted.

Facility-based active management of the third stage of labour: assessment of quality in six countries in sub-Saharan Africa

Bartlett,,Linda; Cantor,,David; Lynam,,Pamela; Kaur,,Gurpreet; Rawlins,,Barbara; Ricca,,Jim; Tripathi,Vandana; Rosen,Heather E
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 EN
Relevância na Pesquisa
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Abstract Objective To assess the quality of facility-based active management of the third stage of labour in Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and the United Republic of Tanzania. Methods Between 2009 and 2012, using a cross-sectional design, 2317 women in 390 health facilities were directly observed during the third stage of labour. Observers recorded the use of uterotonic medicines, controlled cord traction and uterine massage. Facility infrastructure and supplies needed for active management were audited and relevant guidelines reviewed. Findings Most (94%; 2173) of the women observed were given oxytocin (2043) or another uterotonic (130). The frequencies of controlled cord traction and uterine massage and the timing of uterotonic administration showed considerable between-country variation. Of the women given a uterotonic, 1640 (76%) received it within three minutes of the birth. Uterotonics and related supplies were generally available onsite. Although all of the study countries had national policies and/or guidelines that supported the active management of the third stage of labour, the presence of guidelines in facilities varied across countries and only 377 (36%) of 1037 investigated providers had received relevant training in the previous three years. Conclusion In the study countries...