SIX SIGMA BUSINESS SCORECARD APPROACH TO SUPPORT MAINTENANCE PROJECTS IN A COLLABORATIVE CONTEXT

According to the traditional perspective the maintenance function is counted as a secondary activity consuming human and financial resources, which is why many companies, use as maintenance strategy for several years, the subcontracting of maintenance services to specialized companies. However, the need to perform maintenance operations on increasingly complex systems requires access to several distinct types of skills that small and medium-sized firms specialized in maintenance services generally do not have. This paper aims to illustrate the role of the Six Sigma Scorecard approach as a management tool for improving quality in service provided in a collaborative context. The article begins by discussing the principles of the Six Sigma and the Balanced Scorecard backgrounds. It is then discussed how the two methodologies can be combined as a management tool of maintenance activities. Finally, it is discussed how this approach can be applied in the assessment of maintenance activities in the context of a collaborative ecosystem

ENFERMERÍA EM LA PROMOTIÓN DE LA SOSTENIBILIDAD AMBIENTAL: una revisión integrativa.

RESUMO O presente estudo objetivou compreender e enfatizar a atuação do profissional de enfermagem em promover sustentabilidade ambiental. Utilizando-se de uma pesquisa com base na revisão de literatura integrativa, a discursão contou com 9 autorias e foi organizada ora pela concordância dos autores, ora pela discrepância entre as ideias. Ademais se construiu uma ideia a partir das publicações, em sua grande parte pesquisas de campo e atividades que envolveram ações junto a comunidade. A partir dos estudos analisados, notou-se que o serviço da enfermagem inerente à saúde ambiental atribui-se, imprescindivelmente, as ações educativasABSTRACT The present study aimed to understand and emphasize the nursing professional's role in promoting environmental sustainability. Using a research based on an integrative literature review, the discourse had nine authors and was organized either by the authors' agreement or by the discrepancy between the ideas. In addition, an idea was built from the publications, mostly field surveys and activities that involved actions in the community. From the studies analyzed, it was noticed that the nursing service inherent to environmental health is attributed, necessarily, the educational actionsRESUMEN El presente estudio objetivó comprender y enfatizar la actuación del profesional de enfermería en promover la sustentabilidad ambiental. Se utilizó una encuesta basada en la revisión de literatura integrativa, la discursión contó con 9 autorías y fue organizada por la concordancia de los autores, ora por la discrepancia entre las ideas. Además se construyó una idea a partir de las publicaciones, en su gran parte investigaciones de campo y actividades que involucraron acciones junto a la comunidad. A partir de los estudios analizados, se notó que el servicio de la enfermería inherente a la salud ambiental se atribuye, imprescindiblemente, las acciones educativa

Construindo ambientes saudáveis em Ceilândia : uma experiência de extensão do novo campus da Universidade de Brasília na maior cidade do Distrito Federal

Ilustrações do capítulo encontram-se no Anexo I do livro Universidade para o século XXI: educação e gestão ambiental na Universidade de Brasília, p. 328.Este relato tem por objetivo apresentar os resultados do primeiro projeto de extensão iniciado na FCE, “Formação comunitária para ações de promoção da saúde e da qualidade de vida - Construindo Ambientes Saudáveis”, em 2010. O cineclube é a estratégia de aproximação dos movimentos sociais de Ceilândia com a academia por meio do debate periódico de temas problematizadores relacionados à história de luta da comunidade voltada para a promoção de ambientes saudáveis. Os debates foram gravados e transcritos como forma de registro, avaliação e publicação da experiência. A memória reflexiva sobre esse projeto é coletiva e se beneficiou de comentários críticos esboçados por vários de seus membros e pessoas das comunidades de Ceilândia. O intuito foi produzir um relato polifônico, preservando a atmosfera democrática, colegiada e diversificada que tem sido idealizada pelo projeto

COVID-19 in Brazilian children and adolescents: findings from 21 hospitals / COVID-19 em crianças e adolescentes brasileiros: registros de 21 hospitais

Introdução: Crianças e adolescentes com Covid-19 apresentam menor mortalidade e sintomas menos intensos quando comparados aos adultos. Os estudos no Brasil baseiam-se apenas no sistema de notificação compulsória. Objetivo: Analisar as características clínicas, laboratoriais, radiológicas e desfechos de pacientes hospitalizados com menos de 20 anos de idade com Covid-19. Métodos: Série de casos de pacientes internados com Covid-19, confirmado, com idade inferior a 20 anos, obtida em estudo de coorte em 21 hospitais de cinco estados brasileiros. Resultados: Dos 36 pacientes, 20 (55,5%) eram adolescentes, 20 (55,5%) eram do sexo masculino, 18 (50,0%) apresentavam comorbidades, 2 estavam grávidas; e em 7 (19,4%) os sintomas iniciais ocorreram durante a internação por outras causas, dos quais 3 foram possivelmente infectados no hospital. Febre (61,1%), dispneia (33,3%) e sintomas neurológicos (33,0%) foram as queixas mais comuns. A proteína C reativa estava acima de 50mg / L em 16,7% e o dímero-D estava acima do limite de referência em 22,2%. Radiografias de tórax foram realizadas em 20 (55,5%) pacientes, 9 apresentavam anormalidades; e tomografias computadorizadas de tórax em 5. O tempo de internação variou de 1-40 dias (mediana 5 [intervalo interquartil 3-10]), 16 (44,4%) necessitaram de cuidados intensivos, 6 (16,7%) necessitaram de ventilação mecânica e um paciente (2,8%) faleceu. Conclusão: Em uma amostra de pacientes menores de 20 anos, procedentes de hospitais de 5 estados do Brasil, as comorbidades foram frequentes e os sintomas mais comuns foram febre, dispneia e sintomas neurológicos. Quarenta e quatro por cento dos pacientes necessitaram de cuidados intensivos, mostrando que na amostra avaliada a doença não era tão leve quanto o esperado, e um paciente morreu. 

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

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