what role for central banking and supervisors to build a climate and environmental resilient financial system

O conceito de ‘Finanças Verdes’ surgiu como uma resposta à necessidade de compatibilizar a economia global com os esforços para combater as alterações climáticas e assim, prosseguir um desenvolvimento ambientalmente sustentável. Para o sistema financeiro, esta abordagem implica tratar dos riscos financeiros relacionados com o clima, que resultam dos impactos adversos das alterações climáticas, assim como das externalidades negativas decorrentes da transição para uma economia neutra na emissão de carbono. No entanto, os bancos centrais e os quadros regulamentares existentes negligenciaram até então estas fontes de risco, resultando numa ausência de informação financeira e nãofinanceira relativa à exposição dos bancos a riscos climáticos e numa potencial falta de credibilidade em produtos financeiros verdes e sustentáveis. Esta pesquisa visa definir, caracterizar e analisar os riscos financeiros relacionados com o clima no sector bancário, incluindo os desafios de adaptação das carteiras de empréstimos aos fatores de transmissão micro e macroeconómicos de riscos físicos e transitórios. Em particular, centra-se no papel da regulação e supervisão financeira, bem como dos bancos centrais no panorama internacional e, em particular, da União Europeia, a fim de assegurar um sistema financeiro sólido e estável face aos crescentes impactos adversos das alterações climáticas, nomeadamente na transformação dos fundamentos económicos e na mudança das preferências dos consumidores em direção a uma economia sustentável. Esse papel poderá implicar um alargamento dos mandatos dos supervisores financeiros e dos bancos centrais a fim de considerarem fatores de sustentabilidade nas suas tomadas de decisão. Seguindo uma abordagem tradicional baseada no risco, analisam-se os principais instrumentos micro e macroprudenciais à luz dos três pilares dos Acordos de Basileia, bem como possíveis alterações à política monetária e aos seus instrumentos financeiros tradicionais.The concept of "Green Finance" emerged as a response to the need of aligning the global economy with the efforts to fight climate change and thus, pursuing an environmentally sustainable development. For the financial system, this includes addressing climate-related financial risks, which arise from the adverse impacts of climate change, and the negative externalities of the transition to a carbonneutral economy. However, central banks and the existing regulatory frameworks have traditionally neglected these sources of risk, resulting in a lack of financial and non-financial information on banks' exposure to climate risks and a lack of trust in green and sustainable financial products. This research aims to define, characterise and analyse climate-related financial risks in the banking sector, including the challenges in adapting lending portfolios to physical and transitional micro and macroeconomic transmission channels. In particular, it focuses on the role of financial regulation and supervision, as well as central banks, in the international landscape (especially in the context of the European Union) to ensure a sound and stable financial system in light of the rising negative effects of climate change, the changing economic fundamentals, and shifting consumer preferences towards a sustainable economy. Furthermore, supervisors and central banks may be persuaded to prioritise sustainability factors in their decision-making processes, which may entail an extension of their mandates. Using a traditional risk-based approach, key micro and macroprudential instruments are analysed in the light of the three pillars of the Basel Accords, as well as possible changes to monetary policy and its traditional financial instruments

Protocol for a Randomized Controlled Trial

Funding Information: This work was supported by the Brazilian National Council of Technological and Scientific Development (CNPq; grants 407255/2013-3 and 404500/2021-8) and the São Paulo Research Foundation (FAPESP; grant 2016/00270-6). ACDAH is the recipient of the FAPESP PhD scholarship (grant 2022/03401-5). MAC is the recipient of the CNPq senior research scholarship (grant 303794/2021-6). The funders had no role in the design and analysis of the study or the writing of this study. Publisher Copyright: © Ana Carolina de Andrade Hovadick, Marly Augusto Cardoso.Background: Stunting and micronutrient deficiencies have persistently affected children in the Brazilian Amazon for decades. However, in recent years, a notable increase in childhood overweight prevalence has been observed, particularly in the context of heightened food insecurity exacerbated by the COVID-19 pandemic. Despite the limited number of effective solutions proposed to tackle this problem, digital interventions have shown great promise worldwide in preventing obesity and promoting healthy diets. Objective: This study aims to describe the protocol of a family-based WhatsApp intervention, specifically designed to investigate the efficacy of multimedia messaging in preventing excessive weight gain and improving healthy eating practices among school-aged children in the Amazon region. Methods: This study protocol outlines a theory-driven randomized controlled trial based on the cognitive theory of multimedia learning and the social cognitive theory. A total of 240 parents or caregivers of children enrolled in the Maternal and Child Health and Nutrition Cohort Study in Acre (MINA-Brazil) will be recruited by phone and social media. The intervention group will receive persuasive multimedia messages through WhatsApp over 19 weeks, while the waitlist control group will remain in the usual care. The primary outcome is a change in children’s BMI in z score. Secondary outcomes are changes in dietary intake and biochemical indicators of the children. Outcome measures will be assessed at baseline and 5 months after randomization in comparison to usual care. The analysis will use an intent-to-treat approach and will be conducted using the statistical package Stata (version 18.0), with a significance level set at P<.05. Paired and unpaired 2-tailed t tests will be applied to compare mean changes in the outcomes. Results: Data collection started in June 2023, and final measurements are scheduled to be completed in December 2023. The results of the main analysis are expected to be available in 2024. Conclusions: This innovative multimedia message intervention holds significant potential for fostering behavioral changes among Amazonian children.publishersversionpublishe

La aplicación de los programas de compliance como eximentes de responsabilidad penal de la persona jurídica en el marco de la Ley No 30424

En la presente tesis, analizo en el primer capítulo la evolución del término “societas delinquere potest ” , término utilizado en la doctrina para referirse a la posibilidad de que las personas jurídicas puedan delinquir, es decir, la aceptación de la responsabilidad penal de la persona jurídica, para ello realice una investigación histórica la cual me permitió conocer a partir de que siglo se reconoce que las personas jurídicas si pueden cometer delitos. Además, en el primer capítulo estudio los modelos políticos criminales para atribuir la responsabilidad penal de la persona jurídica, así como los fundamentos doctrinales que respaldan la aplicación de responsabilidad penal a las personas jurídicas. En el segundo capítulo de mi tesis, analizo de manera detallada la regulación en el código penal peruano de la responsabilidad penal de la persona jurídica, denominadas consecuencias accesorias, las cuales se encuentran tipificadas en el artículo 105 del código penal peruano. De manera similar, analizó la aplicación de las consecuencias accesorias en el proceso penal. Adicionalmente, realizo una investigación a la legislación comparada, específicamente de España respecto a la aplicación de las consecuencias accesorias. Por otro lado, en el tercer capítulo de mi tesis, estudio la Ley No 30424, ley denominada como la regulación de la responsabilidad administrativa de la persona jurídica en el Perú, para ello analizó los antecedentes internacionales que influyeron en la promulgación de la Ley No 30424, así como los delitos que incorpora la Ley No 30424, considerando la última modificación mediante la Ley No 31740 la cual entró en vigencia en noviembre de 2023, la misma que agrego treinta nuevos delitos. Continuando con el desarrollo de la elaboración de mi tesis, en el cuarto capítulo desarrolló un análisis completo de todos los elementos que debe contener un programa de compliance para que cumpla con la finalidad de ser efectivo y de esta manera pueda eximir de responsabilidad a la persona jurídica. El quinto capítulo de mi tesis está dirigido a las responsabilidades, por un lado, analizó los supuestos en los que la persona jurídica podrá eximirse de responsabilidad penal y los supuestos en los que no podrá eximirse de responsabilidad. De igual manera, en el capítulo cinco analizó los supuestos en los que se configura la responsabilidad del compliance officer. Por otra parte, en el sexto capítulo de mi tesis elaboró un análisis costo – beneficio de la responsabilidad de las personas jurídicas y un análisis costo – beneficio de la implementación de los programas de compliance. Finalmente, en el séptimo capítulo de mi tesis, busco innovar para que de manera adicional a un análisis teórico exista un análisis práctico, para lo cual realicé entrevistas a expertos en la materia.In this thesis, I analyze in the first chapter the evolution of the term "societas delinquere potest ", a term used in the doctrine to refer to the possibility that legal persons can commit crimes, that is, the acceptance of the criminal responsibility of the legal person, for this I carried out a historical research which allowed me to know from which century it is recognized that legal persons can commit crimes. In addition, in the first chapter I study the criminal political models to attribute the criminal responsibility of the legal person, as well as the doctrinal foundations that support the application of criminal liability to legal persons. In the second chapter of my thesis, I analyze in detail the regulation in the Peruvian penal code of the criminal liability of the legal person, called accessory consequences, which are typified in article 105 of the Peruvian penal code. Similarly, I analyze the application of accessory consequences in criminal proceedings. In addition, I investigate comparative legislation, specifically from Spain regarding the application of accessory consequences. On the other hand, in the third chapter of my thesis, I study Law No 30424, a law called the regulation of the administrative liability of the legal person in Peru, for this I analyze the international antecedents that influenced the enactment of Law No 30424, as well as the crimes incorporated in Law No 30424. considering the last modification through Law No 31740 which entered into force in november 2023, which added thirty new crimes. Continuing with the development of the elaboration of my thesis, in the fourth chapter I carry out a complete analysis of all the elements that a compliance program must contain in order to comply with the purpose of being effective and in this way can exempt the legal entity from liability. The fifth chapter of my thesis is aimed at responsibilities, on the one hand, I analyze the cases in which the legal person may be exempted from criminal liability and the cases in which it may not be exempted from liability. Similarly, in chapter five I analyze the cases in which the responsibility of the compliance officer is configured. On the other hand, in the sixth chapter of my thesis I carry out a cost-benefit analysis of the liability of legal entities and a cost-benefit analysis of the implementation of compliance programs. Finally, in the seventh chapter of my thesis, I seek to innovate so that in addition to a theoretical analysis there is a practical analysis, for which I conducted interviews with experts in the field.Tesi

El alcance del derecho en la imagen análisis jurídico del Art. 41 de la ley de propiedad intelectual

The present research is focused on establishing an analysis of Article 41 of the Copyright Act, which refers to the rights of the photograph and the people on them. The focus of this thesis is to determine what specific action should be taken when referring to people who are captured in the background of an image. In this thesis it will also be imperative to determine if these people´s constitutional right to their image is being violated or if its use and regulation is within the provisions given by Article 41.El presente trabajo de investigación está enfocado en establecer un análisis del artículo 41 de la Ley de Propiedad Intelectual, el cual se refiere a los derechos de la fotografía y las personas que figuran en las mismas. En específico, busca determinar cuál es la acción que se debe tomar cuando se refiere a terceros que aparecen capturados en el fondo de una imagen. Así como también, determinar si es que a estas personas se les está violando su derecho constitucional a la imagen o si es que se encuentran dentro de los preceptos del artículo 41 de la Ley

Ocorrência de candidíase bucal em pacientes com câncer na região de cabeça e pescoço

Introduction: Oral candidiasis is a common fungal infection in patients irradiated in the head and neck region. In antineoplastic treatment period they undergo a transient immunosuppression framework in which there is a predisposition to the proliferation of opportunistic fungi. In the oral cavity clinical forms of candidiasis may be associated with mucosal changes, manifesting in acute pseudomembranous forms, acute atrophic, chronic hyperplastic, chronic atrophic, glossitis rhomboid and angular cheilitis. The fungal infection provides the oral cavity, oropharynx and hypopharynx symptoms of burning, which difficult, reducing the quality of life of the patient, as well as hamper the antineoplastic treatment. Thus, effective treatments are important, to avoid these complications. Objectives: To investigate the occurrence of oral candidiasis diagnosed in patients with head and neck cancer treated at the dental clinic from January 2013 to June 2014; evaluate the antifungal therapy and predisposing factors related to oral candidiasis; relate time of treatment, clinical course of candidiasis and symptoms; relate anatomical site of the tumor, presence of candidiasis, radiation time and / or chemotherapy and stage of cancer. Material and Methods: A retrospective, descriptive, cross-sectional, chart analysis from the “Aplicativo de Gestão para Hospitais Universitários” (AGHU) (Management Application for University Hospitals) and Hospital files of the Clinical Cancer Hospital, Federal University of Uberlândia. Results: Of the total assessed medical records (83 patients), 48 patients (57.8%) had at least one episode of oral candidiasis. The antifungal agents used were nystatin, miconazole and fluconazole oral gel for up to three months. The most frequent symptoms were dry mouth (p = 0.006) and dysgeusia (p = 0.031). Antifungal therapies have been effective in 95.8% of patients. Chemotherapy in this study had statistically significant (p = 0.021) in involvement by oral candidiasis, but it was not possible to evaluate the periods between chemotherapy, and 26.5% of patients had the first fungal infection with cumulative dose 1800 cGy radiotherapy. Conclusion: The majority of patients experienced at least one episode of oral candidiasis during antineoplastic treatment. The appearance of oral candidiasis was related to the following items: the cumulative dose of radiotherapy, tumor hyposalivation and anatomical sites. The most patients evolved to cure after antifungal treatment. Symptoms most frequently reported were burning, odynophagia, trismus, xerostomia, dysphagia, and dysgeusia. Most of the patients were affected by oral candidiasis in a cumulative dose of 1800 cGy radiotherapy.Dissertação (Mestrado)Introdução: A candidíase bucal é uma infecção fúngica comum em pacientes irradiados em região de cabeça e pescoço. No período de tratamento antineoplásico eles passam por um quadro de imunodepressão transitória, no qual há predisposição à proliferação de fungos oportunistas. Na cavidade oral as formas clínicas de candidíase podem estar associadas à alteração de mucosa, manifestando-se nas formas pseudomembranosa aguda, atrófica aguda, crônica hiperplásica, atrófica crônica, glossite rombóide e queilite angular. A infecção fúngica proporciona na cavidade bucal, orofaringe e hipofaringe sintomas de ardência, o que dificulta a ingestão de alimentos, reduzindo a qualidade de vida do paciente, além de dificultar o tratamento antineoplásico. Dessa forma, tratamentos eficazes são importantes para que sejam sanadas estas intercorrências. Objetivos: Investigar a ocorrência de candidíase bucal diagnosticada em pacientes com câncer de cabeça e pescoço atendidos no ambulatório odontológico no período de janeiro de 2013 a junho de 2014; avaliar a terapêutica antifúngica e fatores predisponentes relacionados à candidíase bucal, em pacientes submetidos a tratamento antineoplásico; relacionar tempo de tratamento, evolução clínica da candidíase e sintomatologia; relacionar sítio anatômico da neoplasia, presença de candidíase, tempo de radioterapia e/ou quimioterapia e estágio da neoplasia. Material e Métodos: Foi realizado um estudo retrospectivo, descritivo, transversal, de análise de prontuários provenientes do Aplicativo de Gestão para Hospitais Universitários (AGHU) e arquivos do Hospital do Câncer do Hospital de Clínicas da Universidade Federal de Uberlândia. Resultados: Do total de prontuários avaliados (de 83 pacientes), 48 (57,8%) pacientes apresentaram pelo menos um episódio de candidíase bucal. Os antifúngicos utilizados foram nistatina, fluconazol e miconazol gel oral, por até três meses. Os sintomas mais frequentes foram xerostomia (p = 0,006) e disgeusia (p = 0,031). As terapias antifúngicas foram eficazes em 95,8% dos pacientes. A quimioterapia antineoplásica teve relevância estatística (p = 0,021) no acometimento por candidíase bucal e 26,5% dos pacientes tiveram a primeira infecção fúngica com dose acumulativa de 1800 cGy de radioterapia. Conclusão: A maioria dos pacientes apresentou pelo menos um episódio de candidíase bucal durante o tratamento antineoplásico. O aparecimento de candidíase bucal esteve relacionado aos seguintes fatores: dose acumulada de radioterapia, hipossalivação e sítios anatômicos tumorais.Após o tratamento antifúngico a maioria dos pacientes evoluiu para a cura. Os sintomas da infecção mais relatados em prontuários foram ardência, odinofagia, trismo, xerostomia, disfagia e disgeusia. A maioria 13 dos pacientes foi acometida pela candidíase bucal em dose cumulativa de radioterapia de 1800 cGy

Effectiveness of formal auditory training in adults with auditory processing disorder

PURPOSE: to compare the performance of adults with auditory processing disorder in behavioral tests before and after formal auditory training, in order to verify the effectiveness of this approach. METHODS: this is a quantitative retrospective study for which we selected 18 individuals with auditory processing disorders evidenced by the behavioral assessment, aged between 16 and 38 years old. All subjects underwent a formal auditory training program conducted in eight sessions of 45 minutes each, twice a week. Sessions were organized in ascending order of complexity of the listening skills srech as, auditory closure, figure-ground for sentences, words, syllables and sounds and nonverbal temporal processing of sounds (analysis of the intensity, duration and frequency). For statistical purposes the results of the SSW test SSI (ICM) and Duration and frequency pattern recognitive obtained before and after auditory training, considering the ear and sex variables. RESULTS: there were no statistically significant differences between the right and left ears. Both men and women when analyzed separately showed better results in post-training. These differences were statistically significant in for duration and frequency pattern tests, for men and women. In SSW improvement in male and SSI R / S -15 females, respectively. In addition, all subjects reported better attention and better communicative performance after auditory training. CONCLUSION: the formal auditory training improves listening skills figure - ground for verbal sounds and temporal processing measured by behavioral tests in adults diagnosed with auditory processing disorders.OBJETIVO: comparar o desempenho de adultos com distúrbio do processamento auditivo em testes comportamentais pré e pós-treinamento auditivo formal, visando verificar a eficácia desse treinamento. MÉTODOS: trata-se de um estudo retrospectivo quantitativo com 18 indivíduos com distúrbio do processamento auditivo comprovado pela avaliação comportamental, idade entre 16 e 38 anos. Todos os indivíduos foram submetidos a um programa de treinamento auditivo formal realizado em oito sessões de 45 minutos cada, duas vezes por semana, cujas sessões foram organizadas em ordem crescente de complexidade visando o treinamento das habilidades auditivas de fechamento auditivo, figura-fundo para frases, palavras, sílabas e sons não verbais e de processamento temporal dos sons (análise da intensidade, duração e frequência dos sons). Foram comparados os resultados dos testes SSW em Português, SSI (MCI) e Reconhecimento de Padrão de Duração e de Frequência obtidos no pré e pós - treinamento auditivo, envolvendo as variáveis: orelha e sexo. RESULTADOS: não foram observadas diferenças estatisticamente significantes entre as orelhas. Tanto homens quanto mulheres quando analisados separadamente demonstraram resultados melhores no pós-treinamento. Estas diferenças foram estatisticamente significantes nos testes de padrão de duração e frequência, para homens e mulheres. No SSW melhora no sexo masculino e no SSI R/S -15 no sexo feminino, respectivamente. Além disso, todos os indivíduos relataram melhor desempenho comunicativo e de atenção no pós-treinamento. CONCLUSÃO: o treinamento auditivo formal melhora as habilidades auditivas de figura - fundo para sons verbais e de processamento temporal medidas por testes comportamentais em adultos diagnosticados com distúrbio de processamento auditivo.Universidade Federal de São Paulo (UNIFESP) EPM Departamento de FonoaudiologiaUNIFESP, EPM, Depto. de FonoaudiologiaSciEL

Heuristic evaluation of the usability of a mechanical ventilator Interface through a simulator

Determining the usability of mechanical ventilator interfaces is vital in ensuring correct usage under critical procedures that can place patients’ health in danger. Heuristic evaluation has been used to evaluate usability in many different areas, including medical devices. The objective of this study is to evaluate the usability of a mechanical ventilator using the heuristic evaluation method. The evaluation of a mechanical ventilator simulator (Drager's Evita V500) was performed using the Heuristic Evaluation System Checklist (HESC). Three evaluators took part in the experiment in assessing the usability through HESC. The results show that of the 292 checklist sub-heuristics included in the HESC Checklist, 127 were compliant (had no flaws), 75 were not compliant (had flaws) and 95 were not applicable. The results point out that the mechanical ventilator interfaces should be improved to avoid human error due to usability issues. The results also show that heuristic evaluation generates a large quantity of objective information, which provides an exhaustive identification of aspects that should be improved.publishe

Indicadores de gastos com serviços médicos no setor de saúde suplementar no Brasil : o caso Sabesprev

The aim of this paper is to present healthcare expenditures indicators of the private healthcare system in Brazil. We use administrative records of a healthcare insurance company that provide collective contracts to its employees. The indicators are classified according to the type of healthcare and age groups. Healthcare classification contemplates four types of services: doctor visits, inpatient care, exams and other types of healthcare services. We also discriminate healthcare indicators by survivorship status. The main results points out that: 1) the desegregation by survivorship status is very important to healthcare expenditures projections – the annual average healthcare expenditure to dead individuals is R$76.000,00 (seventy six thousand of reais) whereas this value is about R$2000,00 (two thousand of reais) for alive individuals: 2) on average women expend more than men along the lifecycle; 3) the expenditure ratio between the oldest and the youngest group is eight times.health insurance sector, expenditure indicators, health services