O estudo do clima ético na administração: um levantamento dos “hot topics” publicados entre 2008 e 2018

Este artigo se propôs a analisar as publicações sobre o tema clima ético com o objetivo de identificar as principais áreas da administração que estão sendo estudadas junto à temática. A pesquisa foi realizada no banco de dados do sistema Web of Science, procurando identificar as principais categorias, autores, tipos de documentos, título das fontes, ano das publicações, instituições, agências de financiamento, idiomas e países destas publicações, assim como a identificação dos “hot topics” da administração, quando combinados com o tópico clima ético. A análise dos dados teve por base os cálculos dos índices h-b e m de Banks (2006). De acordo com os resultados obtidos neste estudo, o número de publicações está crescendo ano após ano, intensificando-se nos últimos 5 anos. Cerca de 97% das publicações escritas estão concentradas nos seguintes países: Estados Unidos, Inglaterra, Austrália e Canadá, sendo o idioma inglês o mais abundante nos estudos, seguido do espanhol, do alemão e do francês. Dentre os 20 tópicos combinados com clima ético, os que se classificaram como “hot topics” foram ethics, management e business

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Atitudes gerenciais do enfermeiro no Programa Saúde da Família: visão da Equipe Saúde da Família Actitudes gerenciales del enfermero en el Programa Salud de la Familia: visión del Equipo de Salud de la Familia Management attitudes of nurses in the Family Health program: view of the Family Health Group

Este artigo fez parte da pesquisa intitulada "Competências gerenciais requeridas do enfermeiro no Programa Saúde da Família PSF" e teve como objetivo identificar as atitudes gerenciais requeridas do enfermeiro para a gerência da assistência de enfermagem nas Unidades de Saúde da Família USF de um município do litoral catarinense sob a percepção dos profissionais desta. Trata-se de um estudo descritivo-exploratório baseado em um questionário semi-estruturado para a coleta de dados. A população foi de 72 participantes que atribuíram escore entre 01 a 05 para cada item do questionário. O estudo apontou para a ênfase no desenvolvimento de novas competências pelos enfermeiros, que conduzem ao alcance do desempenho e conseqüentemente da qualidade da assistência e à satisfação da comunidade.Este articulo fue parte de la investigación titulada "Competencias gerenciales necesarias del enfermero en el Programa Salud de la Familia - PSF y tiene como objetivo identificar las actitudes gerenciales requeridas del enfermero para la gerencia de la asistencia de enfermería en las Unidades de Salud de la Familia USF de una prefectura de la costa catarinense, en la percepción de estos profesionales. Tratase de un estudio descriptivo-exploratorio basado en un cuestionario semi-estructurado para la recogida de datos. La población fue de 72 participantes que atribuyeron notas entre 01 y 05 para cada punto del cuestionario. El estudio apunta énfasis en el desarrollo de nuevas competencias por parte de los enfermeros que llevan al alcance de un desempeño adecuado y consecuentemente a un aumento de la calidad asistencial, satisfaciendo a la comunidad.This article was a part of a research called Management Competences required from the nurse in the Family Health Program (FHP) and has as aim to identify the management attitudes required from the nurse to the manager of the nurse assistance in the Family Health Units (FHU) of a city of the "catarinense" seashore under a perception from these professionals. It was a descrptive-exploratory study based on a semi- structured questionary for data colection. The population was constituted by 72 participants that scored from 01 and 05 to each item of the questionary. The study pointed to the emphasis in the development of new competences by the nurses that lead the reach of the performances and consequently the quality of the assistance and to the community satisfaction

Genomic epidemiology reveals how restriction measures shaped the SARS-CoV-2 epidemic in Brazil

Abstract Brazil has experienced some of the highest numbers of COVID-19 infections and deaths globally and made Latin America a pandemic epicenter from May 2021. Although SARS-CoV-2 established sustained transmission in Brazil early in the pandemic, important gaps remain in our understanding of local virus transmission dynamics. Here, we describe the genomic epidemiology of SARS-CoV-2 using near-full genomes sampled from 27 Brazilian states and an adjacent country - Paraguay. We show that the early stage of the pandemic in Brazil was characterised by the co-circulation of multiple viral lineages, linked to multiple importations predominantly from Europe, and subsequently characterized by large local transmission clusters. As the epidemic progressed, the absence of effective restriction measures led to the local emergence and international spread of Variants of Concern (VOC) and under monitoring (VUM), including the Gamma (P.1) and Zeta (P.2) variants. In addition, we provide a preliminary genomic overview of the epidemic in Paraguay, showing evidence of importation from Brazil. These data reinforce the need for the implementation of widespread genomic surveillance in South America as a toolkit for pandemic monitoring and providing a means to follow the real-time spread of emerging SARS-CoV-2 variants with possible implications for public health and immunization strategies