Evidências das disfunções na burocracia: um estudo sobre a implementação do módulo BAPM

This article deals with the analysis of a bureaucratic organization, with emphasis on the elements of bureaucracy observed in the Bulletin Module of Military Police Attendance that present bureaucratic dysfunctions, because the problems identified directly impact its Information System and the police activity linked to it. The discussion focuses on the aspects of bureaucratic culture in the Information System of the Shock Police Battalion of Pará and the contradictions caused by the insertion of Information Technology in this dynamic, since the implementation of the Bulletin Module of Military Police Service aims to improve knowledge management by providing quality information to optimize the planning of police actions and measure their productivity from statistical reports. To discuss the topic Weber (1991) and Merton (1970) will be the base authors to analyze the results found from a Case Study, with qualitative approach, documentary analysis, informal conversations with police officers and participatory observation. It was possible to identify the contradictions in the intended efficiency with the implementation of the tool in question in function of the bureaucratic model of management and its dysfunctions. Therefore, factors such as resistance to any movement that might cause disruption to the current order, absence of innovation due to indulgence, excess of formalism with a culture based on formal documents filled in by hand, hierarchy with a certain degree of obligations and veiled privileges, and lack of innovation and compliance to the routines, in addition to the limitations that the system presents, are presented as contradictory factors to the intended purpose of the tool and that corrupt the potential of the Bulletin of Military Police Assistance in the Battalion Information System. Esse artigo ocupa-se de analisar uma organização burocrática, com ênfase nos elementos da burocracia observados no Módulo Boletim de Atendimento Policial Militar que apresentam disfunções burocráticas, em razão dos problemas identificados impactarem diretamente seu Sistema de Informação e a atividade policial ligada ao mesmo. A discussão concentra-se nos aspectos da cultura burocrática no Sistema de Informação do Batalhão de Polícia de Choque do Pará e as contradições causadas com a inserção de Tecnologia da Informação nessa dinâmica, visto que implementação do Módulo Boletim de Atendimento Policial Militar tem por objetivo melhorar a gestão do conhecimento fornecendo informações de qualidade para otimizar o planejamento das ações policiais e medir sua produtividade a partir de relatórios estatísticos. Para discutir o tema Weber (1991) e Merton (1970) serão os autores base para analisar os resultados encontrados a partir de um Estudo de Caso, com abordagem qualitativa, análise documental, conversas informais com policiais e observação participativa. Foi possível identificar as contradições na eficiência pretendida com a implementação da ferramenta em questão em função do modelo burocrático de gestão e suas disfunções. Logo, pôde-se constatar que fatores como resistência a qualquer movimento que possa causar perturbação na ordem vigente, ausência de inovação devido ao comodismo, excesso de formalismo com uma cultura embasada em documentos formais preenchidos de modo artesanal, hierarquia com certo grau de obrigações e privilégios velados, e ausência de inovação e conformidade ás rotinas, somado a limitação que o sistema apresenta, se apresentam como fatores contraditórios ao propósito pretenso com a ferramenta e que corrompem o potencial do Módulo Boletim de Atendimento Policial Militar no Sistema de Informação do Batalhão

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Características fisiológicas, músculo-esqueléticas, antropométricas e oftalmológicas em jogadoras de futebol feminino consideradas de elite

O futebol feminino tem crescido acentuadamente em nosso país. Quinze jogadoras de futebol com média de idade de 22,3 ± 6,2 anos, peso 58,2 ± 8,3kg e estatura 162,5 ± 6,1cm foram submetidas à avaliação de vários parâmetros considerados importantes para o rendimento atlético das futebolistas. Além disso, compararam-se alguns índices funcionais encontrados na literatura com os de jogadoras de outros países com mais experiência na prática dessa modalidade. Os seguintes parâmetros e resultados foram: Cardiorrespiratório e metabólico em repouso e no exercício: FC = 87 ± 8bpm; PAS = 100,6 ± 4,5mmHg; PAD = 62,6 ± 4,5mmHg; FCmax. = 194 ± 7bpm; Borg = 19,5 ± 0,8; veloc. max. = 13,4 ± 0,9km.h-1; LV1 = 8,5km.h-1; LV2 = 11,2km.h-1; V Emax. = 93,9 ± 16,5L.min-1; VO2pico = 47,3 ± 4,5mlO2.kg-1.min-1 ; Cybex: força isocinética de MMII direito a 60º S-1 na extensão = 198,5 ± 44,1Nm; na flexão 133,3 ± 30,5Nm; MMII esquerdo a 60º S-1 na extensão = 203,6 ± 38,1Nm; na flexão 116,5 ± 18,8Nm; Wingate: potência de pico corrigida pelo peso = 9,5 ± 0,9w.kg-1; potência média = 7,5 ± 0,5w.kg-1; índice de fadiga = 56,7 ± 7,3%; % de gordura = 17,4 ± 2,3%; Avaliação oftalmológica: acuidade visual para longe dos olhos direito e esquerdo foi de 97,5 ± 5,8%, pressão intra-ocular do olho direito e esquerdo = 13,7 ± 2,7 e 13,1 ± 2,4mmHg, respectivamente. Os resultados das variáveis cuja comparação foi possível com os das futebolistas internacionais mostraram que nossas atletas estavam com os índices equivalentes e, em alguns casos, até superiores. Entretanto, pela escassez de informações, ainda não há condições de estabelecer a quantificação dos índices mais adequados para a prática desta modalidade esportiva pelas mulheres. É necessária a realização de um volume maior de estudos, enfocando vários aspectos do futebol feminino

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical science. © The Author(s) 2019. Published by Oxford University Press

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures