Decision approach for program risk analysis and management: a case study

Purpose: This paper aims to discuss the basis on which the program risk analysis currently sustains, identifies the fragility of some of its main pillars, and proposes an alternative to the tactic level of analysis. Methodology/Approach: This work is an exploratory a case study based on decision analysis methods, a framework is proposed to make easier the selection of the main risks that should be managed. A mechanism that is relatively more complex, but more efficient for this analysis task. Findings: The proposed mechanism has several advantages over the approach traditionally adopted and does not inherit the biases arising from this widespread methodology. Research Limitation/implication: Applying this methodology to real complete programs would bring a more realistic notion of the costs and levels of complexity required for its implementation. Originality/Value of paper: Program risk management seeks to improve the likelihood of achieving the strategic goals of organizations through the treatment of threats and opportunities. However, the traditional technique used in project risk analysis has relevant weaknesses at the program level. The proposed method can also perform the same tasks but by investing an additional effort, its effectiveness can be increased

It’s normal unless it turns into physical aggression: a study of Portuguese Journalists’ perceptions of (gendered) online harassment

In January 2021, while the country’s daily Covid-19 numbers were hitting record highs, Portugal headed to the polls to elect its future head of state. The campaign was marked by the actions and words of a new far-right party (Chega), which held a campaign characterised by violent incidents with journalists. Later in the year, local elections provided new opportunities for these political actors to confront journalists and make female journalists their preferential targets. The attacks were not just face-to-face but also on social media, in reiterated hate speech messages and direct threats, particularly against female journalists (CCPJ 2021). What made these events significant is that hate speech and online harassment became more visible for both the public and journalists themselves. Having a presence online is expected if not required from journalists today. While digital networking helps establish connections and reach a wider community, it also exposes media professionals to abuse. The dangers of hate speech in journalism are well known and hate speech presents a major challenge to today's journalists (Holton, 2021), as it became their “new normal” (Waisbord, 2020). Women in particular are preferential targets of trolls (Nadim e Fladmoe, 2019; Edström, 2016; UNESCO, 2021; Chen et al, 2020; Adams, 2018). Under different names, such as cyber gender harassment (Citron, 2011) or gendertrolling (Mantilla, 2013), the consequences of gender-based online hate speech hate are not only to female journalists’ mental health and psychological wellbeing but also on public life, as it may have a “chilling effect” in limiting the types of stories and topics that are covered (Townend, 2017; UNESCO, 2021). With few exceptions (Simões, 2021; Silva, 2021), little is known about online violence against Portuguese journalists. This research examines how online abuse is experienced and tackled by Portuguese journalists by measuring self-reported incidents, effects, and trust in existing safety mechanisms. Further, we specifically address the prevalence of online harassment and violence against women journalists and their perceptions of the issue. Theoretically, the article bridges the research on online harassment, mob censorship and gender in journalism. Empirically, it draws on a nationwide survey of journalists and, to explore in more detail the meanings of its quantitative data and the gender aspects of experience. Findings are combined with data from semi-structured interviews conducted with women journalists from diverse media and fields. Professionals feel an increasing hostility aggravated by the digital environment. Half of the surveyed journalists have experienced online violence to some degree, including sexual harassment. Journalists further evidenced low levels of trust in protection mechanisms or a lack of awareness of them. Findings also suggest feelings of resignation towards online abuse, seen as intrinsic to the job, demonstrating a sense of understatement of the attacks. The paper argues that these sentiments contribute to a normalisation of online violence and highlights the need to discuss online abuse within the profession.N/

Psychostimulants by academics of the pharmacy course at the Federal University: instrument validation and consumption analysis: Psicoestimulantes por acadêmicos do curso de farmácia da Universidade Federal: validação de instrumentos e análise de consumo

Objective: The purpose of this study was to analyze the consumption profile with the possible stimulants effects on the central nervous system (CNS) in academics of the Pharmacy course at the Universidade Federal do Amapá, through a validated questionnaire. Method: this pharmacoepidemiologic research has a cross-sectional and descriptive study. The procedure consisted of a three-domain questionnaire’s elaboration: 1. Sociodemographic; 2. Beck Depression Inventory (BDI); and 3. Dundee Ready Education Environment Measure (DREEM) questionnaire, with a probability sampling of 166 students. The questionnaire/ sociodemographic domain was validated through specialists and the application was conducted in three different period steps for ten academics (protocol number 3.753.673). Result: The validation process resulted in predominantly poor/weak concordances, and 60,8% of the interviewed academics confirmed consuming psychostimulants, of these about 51% consumes two or more substances considered CNS stimulants. As shown, the proposed instrument was validated, despite the week’s concordance in the Kappa index. Conclusion: The collected data from the instrument showed that the CNS stimulants consumption affects more than 50% of the students and that these substances bring risk to life, being observed abstinence symptoms by its users

Laboratory biochemical markers of cardiac injury by COVID-19: an integrative review.

The damaging effects of Sars-CoV-2 on cardiac tissue may be intensified with the presence of cardiocirculatory pathologies. The use of clinical biomarkers has grown, in order to monitor this cardiotoxicity early. In this sense, this study aimed to investigate, through an integrative review, the main biomarkers of cardiac injury associated with comorbidities in patients with COVID-19. A systematic bibliographic search was conducted on July 26, 2020, in the Scopus database. Of the total of 669 publications purchased, only 40 articles were eligible for this review. From the content of these publications, 16 systemic cardiac and inflammatory biomarkers that are part of the clinical findings of critically ill patients with COVID-19 were identified. Most of these patients were male, had a mean age of 63 years, and pre-existing comorbidities, such as were hypertension, diabetes mellitus, coronary artery disease, cerebrovascular disease, and chronic obstructive pulmonary disease. Cardiac injuries in patients infected with COVID-19 are related to the increase in cardiac and systemic biomarkers observed in most of these individuals. Finally, it is expected to increase physicians' awareness of biochemical markers of non-invasive cardiac injury, for diagnosis and prognosis, of unusual extrapulmonary pathophysiological presentations during infection by COVID-19

The COVID-19 pandemic and plans for economic reopening in Brazil: a documental analysis

BACKGROUND: In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic. In Brazil, the high rate of dissemination made it necessary to adopt restrictive measures nationwide with the discussion regarding the resumption of economic activities starting in April. In mid-December the country had 6,970,034 cases diagnosed and 182,799 deaths from COVID-19. OBJECTIVE: To analyze the content and characteristics of official documents, which guided the period of transition and resumption of economic activities in Brazil based on health indicators. METHODS: This is a documental research, carried out between May and July 2020, using official websites and publications from the state governments of the 27 federative units in Brazil as sources. In the study, only documents that used epidemiological and health indicators were included as determining criteria for decision making in relation to the easing, permanence or regression of social isolation measures adopted during the COVID-19 pandemic. FINDINGS: Plans, decrees and technical notes were identified for 18 Brazilian federal units. In most documents, the scientific team was made up exclusively of technicians (n = 10). The number of indicators found ranged from 2 to 11, being stratified into 5 categories: frequency and distribution of the disease; social and collective adherence; installed capacity or service profile; productive potential; and availability of supplies. MAIN CONCLUSIONS: Knowing governmental strategies, adopted in the easing of restrictive measures, in the face of the coronavirus (SARS-CoV-2) pandemic based on indicators and with the possibility of comparison between different federative units, provides subsidies for understanding the outcome of the disease by place of occurrence, allowing the construction of a panorama pathology in the country. The appropriation of the findings of this study by Brazil and other countries also serves as an instrument for reflection and planning of policies adopted during the COVID-19 pandemic

Evolução dos gastos públicos em serviços hospitalares em pacientes internados por câncer de mama em Goiás no Sistema Único de Saúde entre o período de 2008 a 2018

Introdução: O Brasil tem acompanhado as altas taxas de incidência e mortalidade de câncer (CA) de mama dos países desenvolvidos, mas as ações fundamentais à prevenção, ao diagnóstico e ao controle da doença não têm acompanhado o mesmo crescimento. Em 2018, nosso país ocupou a primeira posição no ranking de neoplasias primárias do sexo feminino. Estima-se que um em cada três casos pode ser curado se for descoberto logo no início, ou seja, é de grande importância governamental investir em medidas preventivas. Dessa forma, é relevância em realizar estudos com o intuito de analisar os gastos públicos com essa enfermidade é indiscutível. Objetivos: Apresentar os gastos públicos em serviços hospitalares em pacientes internados por câncer de mama entre 2008 e 2018 no estado de Goiás (GO) a partir de uma perspectiva orçamentária. MÉTODOS: Trata-se de um estudo epidemiológico em relação aos gastos públicos com internações devido ao câncer de mama no período de jan/2008 a dez/2018.O estudo foi realizado através de informações da base de dados no DataSus e trabalhados na planilha do Excel. Resultados: No total, os gastos do SUS em serviços hospitalares por CA de mama em GO no período de jan/2008 a dez/2018 foi de R$20.136.194,35.Em relação à faixa etária, os pacientes que mais gastaram foram os que tinham entre 40 e 49 anos, gastando R$ 5.874.317, 29% do total. A faixa etária que menos gastou foi entre 5 a 9 anos, gastando apenas R$430,00, cerca de 0,0021$ 773.511,97 ,em 2008, para R$ 3.354.994,05 ,em 2018, um aumento total de 433%.Conclusões: No Brasil, a incidência de câncer de mama tem aumentado progressivamente nas últimas décadas. Aliado a isso, a descoberta e utilização de novos medicamentos, equipamentos, tratamentos e terapias são fatores que têm elevado cada vez mais os custos na abordagem destes pacientes. Outro fator importante são os custos associados ao tratamento em estágios mais avançados da doença, o qual é muito mais oneroso do que o feito em estágios iniciais. No Brasil, embora tenha ocorrido avanços consideráveis em relação à prevenção e estratégias de diagnóstico precoce, ainda existe uma grande parcela de casos detectados nos estágios mais avançados. Portanto, investir em diagnóstico precoce, além de aumentar a sobrevida dos pacientes, poderá trazer muitas economias ao SUS. Nesse âmbito, a realização de mais pesquisas pode evidenciar causas e condições que favoreçam o entendimento da atual situação, e medidas que visem melhorá-la. De forma que o acesso aos serviços de mais avançada tecnologia possa continuar sendo garantido ao usuário do SUS, ao mesmo tempo em que a viabilidade financeira aos cofres públicos seja mantida

Population-based seroprevalence of SARS-CoV-2 and the herd immunity threshold in Maranhão

OBJECTIVE: To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS: A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS: In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS: To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon.OBJECTIVE: To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS: A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS: In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS: To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon

Panorama epidemiológico das internações por Flutter e Fibrilação Atrial no Brasil nos últimos anos

This article aims to analyze the epidemiological panorama of hospitalizations and deaths due to atrial fibrillation and atrial flutter, in Brazil, in the last five years. Secondary data relating to hospital morbidity due to atrial fibrillation and atrial flutter available on the website of the Department of Informatics of the Unified Health System (DATASUS) was used. In Brazil, 335,317 hospitalizations for atrial fibrillation and atrial flutter were recorded between 2019 and 2023. It is concluded that the incidence of atrial fibrillation and flutter was higher in male patients, with women being less affected.Este artigo tem por objetivo analisar o panorama epidemiológico das internações e óbitos por fibrilação atrial e flutter atrial, no Brasil, nos últimos cinco anos. Foram utilizados dados secundários referentes à morbidade hospitalar por fibrilação atrial e flutter atrial disponíveis no site do Departamento de Informática do Sistema Único de Saúde (DATASUS). No Brasil foram registradas 335.317 internações por fibrilação atrial e flutter atrial ocorridos entre 2019 e 2023. Conclui-se que a incidência da fibrilação atrial e flutter se mostrou maior em pacientes do sexo masculino, sendo as mulheres menos acometidas

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio