Rigorous object-oriented analysis

Object-oriented methods for analysis, design and programming are commonly used by software engineers. Formal description techniques, however, are mainly used in a research environment. We have investigated how rigour can be introduced into the analysis phase of the software development process by combining object-oriented analysis (OOA) methods with formal description techniques. The main topics of this investigation are a formal interpretation of the OOA constructs using LOTOS, a mathematical definition of the basic OOA concepts using a simple denotational semantics and a new method for object- oriented analysis that we call the Rigorous Object-Oriented Analysis method (ROOA). The LOTOS interpretation of the OOA concepts is an intrinsic part of the ROOA method. It was designed in such a way that software engineers with no experience in LOTOS, can still use ROOA. The denotational semantics of the concepts of object-oriented analysis illuminates the formal syntactic transformations within ROOA and guarantees that the basic object- oriented concepts can be understood independently of the specification language we use. The ROOA method starts from a set of informal requirements and an object model and produces a formal object-oriented analysis model that acts as a requirements specification. The resulting formal model integrates the static, dynamic and functional properties of a system in contrast to existing OOA methods which are informal and produce three separate models that are difficult to integrate and keep consistent. ROOA provides a systematic development process, by proposing a set of rules to be followed during the analysis phase. During the application of these rules, auxiliary structures are created to help in tracing the requirements through to the final formal model. As LOTOS produces executable specifications, prototyping can be used to check the conformance of the specification against the original requirements and to detect inconsistencies, omissions and ambiguities early in the development process

Avaliação de dispositivos médicos nas radiografias de tórax em unidades de terapia intensiva - tempo de prestar atenção!

OBJECTIVE: To identify and evaluate the correct positioning of the most commonly used medical devices as visualized in thoracic radiograms of patients in the intensive care unit of our center.METHODS: A literature search was conducted for the criteria used to evaluate the correct positioning of medical devices on thoracic radiograms. All the thoracic radiograms performed in the intensive care unit of our center over an 18-month period were analyzed. All admissions in which at least one thoracic radiogram was performed in the intensive care unit and in which at least one medical device was identifiable in the thoracic radiogram were included. One radiogram per admission was selected for analysis. The radiograms were evaluated by an independent observer.RESULTS: Out of the 2,312 thoracic radiograms analyzed, 568 were included in this study. Several medical devices were identified, including monitoring leads, endotracheal and tracheostomy tubes, central venous catheters, pacemakers and prosthetic cardiac valves. Of the central venous catheters that were identified, 33.6% of the subclavian and 23.8% of the jugular were malpositioned. Of the endotracheal tubes, 19.9% were malpositioned, while all the tracheostomy tubes were correctly positioned.CONCLUSION: Malpositioning of central venous catheters and endotracheal tubes is frequently identified in radiograms of patients in an intensive care unit. This is relevant because malpositioned devices may be related to adverse events. In future studies, an association between malpositioning and adverse events should be investigated

Promotion of mental health literacy and mental well-being in a Portuguese unemployed population sample : effectiveness assessment of a capacity building community-based intersectoral intervention

Copyright © 2017 Published by Elsevier Masson SASIntroduction: Economic crises have consequences on labor market, with impacts on mental health (MH) and psychological well-being (PWB). We describe the effectiveness of an intervention among unemployed, performed within EEA Grants Healthy Employment project.Objectives Evaluate the effectiveness of an intervention for MH literacy, PWB and resilience among unemployed. Aims MH and PWB promotion, common mental disorders prevention and inequalities reduction linked to unemployment.Methods A five modules intervention (life-work balance; impact of unemployment on PWB and MH; stigma; depression and anxiety; health promotion) distributed by 20 hours was developed based on literature reviews and a Delphi panel. It was delivered to unemployees from two public employment centers (PECs).Inclusion criteria: 18–65 years old; registration in PEC for less than a year; minimum of nine years of formal education. Control groups from the same PECs received the care-as-usual. Measures of psychological WB, MH self-reported symptoms, life satisfaction,resilience and mental health literacy were collected through an online survey before and one week after intervention.Results Overall, 87 unemployed participated,48% allocated to the intervention group (IG); 56% women (21–64 years old), average education was 15 years. Mixed measures ANOVA showed that the interaction between time and group was significant for PWB and MH literacy measures. The IG showed better self-reported PWB and improved MH literacy after intervention, compared to controls. No significant interactions were found for MH symptoms, life satisfaction and resilience.Conclusions This study shows the contribution of short-term community-based interventions in increasing MH literacy and PWB among unemployed.info:eu-repo/semantics/publishedVersio

Identidade de género e orientação sexual nos adolescentes: estudo correlacional numa escola

Adolescents are increasingly encouraged to freely express their sexuality. The purpose of this study was to compare non-cisgender adolescents with cisgender/heterosexual adolescents and those who have an undefined gender identity and/or sexual orientation, on their future prospects, emotional state, sexuality, risk behaviors, and their perception of health care and its accessibility. Adolescents who identify as non-cisgender/heterosexual seem to have higher future aspirations, however, they have a more unstable emotional state, higher risky behaviors, and fear being prejudiced by health care professionals. The undefined group appears to be undefined about their sexuality and future aspirations, while reporting less risky behaviors.Os adolescentes são cada vez mais encorajados a expressar livremente a sua sexualidade. O objectivo deste estudo foi o de comparar adolescentes não-isgéneros com adolescentes cisgéneros/heterossexuais e aqueles que têm uma identidade de género e/ou orientação sexual indefinida, sobre as suas perspectivas futuras, estado emocional, sexualidade, comportamentos de risco, e a sua percepção dos cuidados de saúde e da sua acessibilidade. Os adolescentes que se identificam como não-cidadãos/heterossexuais parecem ter maiores aspirações futuras, contudo, têm um estado emocional mais instável, comportamentos de maior risco, e receiam ser prejudicados pelos profissionais de saúde. O grupo indefinido parece estar indefinido quanto à sua sexualidade e aspirações futuras, ao mesmo tempo que relata comportamentos menos arriscados.info:eu-repo/semantics/publishedVersio

Adolescent gender identity and sexual orientation: a school-based correlational study

Adolescents are increasingly encouraged to freely express their sexuality. The purpose of this study was to compare non-cisgender adolescents with cisgender/heterosexual adolescents and those who have an undefined gender identity and/or sexual orientation, on their future prospects, emotional state, sexuality, risk behaviors, and their perception of health care and its accessibility. Adolescents who identify as non-cisgender/heterosexual seem to have higher future aspirations, however, they have a more unstable emotional state, higher risky behaviors, and fear being prejudiced by health care professionals. The undefined group appears to be undefined about their sexuality and future aspirations, while reporting less risky behaviors

Traditional Foods From Maize (Zea mays L.) in Europe

Maize (Zea mays L.) is one of the major crops of the world for feed, food, and industrial uses. It was originated in Central America and introduced into Europe and other continents after Columbus trips at the end of the 15th century. Due to the large adaptability of maize, farmers have originated a wide variability of genetic resources with wide diversity of adaptation, characteristics, and uses. Nowadays, in Europe, maize is mainly used for feed, but several food specialties were originated during these five centuries of maize history and became traditional food specialties. This review summarizes the state of the art of traditional foodstuffs made with maize in Southern, South-Western and South-Eastern Europe, from an historic evolution to the last research activities that focus on improving sustainability, quality and safety of food production

Global assessment of marine plastic exposure risk for oceanic birds

Plastic pollution is distributed patchily around the world’s oceans. Likewise, marine organisms that are vulnerable to plastic ingestion or entanglement have uneven distributions. Understanding where wildlife encounters plastic is crucial for targeting research and mitigation. Oceanic seabirds, particularly petrels, frequently ingest plastic, are highly threatened, and cover vast distances during foraging and migration. However, the spatial overlap between petrels and plastics is poorly understood. Here we combine marine plastic density estimates with individual movement data for 7137 birds of 77 petrel species to estimate relative exposure risk. We identify high exposure risk areas in the Mediterranean and Black seas, and the northeast Pacific, northwest Pacific, South Atlantic and southwest Indian oceans. Plastic exposure risk varies greatly among species and populations, and between breeding and non-breeding seasons. Exposure risk is disproportionately high for Threatened species. Outside the Mediterranean and Black seas, exposure risk is highest in the high seas and Exclusive Economic Zones (EEZs) of the USA, Japan, and the UK. Birds generally had higher plastic exposure risk outside the EEZ of the country where they breed. We identify conservation and research priorities, and highlight that international collaboration is key to addressing the impacts of marine plastic on wide-ranging species

Global assessment of marine plastic exposure risk for oceanic birds

Plastic pollution is distributed patchily around the world's oceans. Likewise, marine organisms that are vulnerable to plastic ingestion or entanglement have uneven distributions. Understanding where wildlife encounters plastic is crucial for targeting research and mitigation. Oceanic seabirds, particularly petrels, frequently ingest plastic, are highly threatened, and cover vast distances during foraging and migration. However, the spatial overlap between petrels and plastics is poorly understood. Here we combine marine plastic density estimates with individual movement data for 7137 birds of 77 petrel species to estimate relative exposure risk. We identify high exposure risk areas in the Mediterranean and Black seas, and the northeast Pacific, northwest Pacific, South Atlantic and southwest Indian oceans. Plastic exposure risk varies greatly among species and populations, and between breeding and non-breeding seasons. Exposure risk is disproportionately high for Threatened species. Outside the Mediterranean and Black seas, exposure risk is highest in the high seas and Exclusive Economic Zones (EEZs) of the USA, Japan, and the UK. Birds generally had higher plastic exposure risk outside the EEZ of the country where they breed. We identify conservation and research priorities, and highlight that international collaboration is key to addressing the impacts of marine plastic on wide-ranging species.B.L.C., C.H., and A.M. were funded by the Cambridge Conservation Initiative’s Collaborative Fund sponsored by the Prince Albert II of Monaco Foundation. E.J.P. was supported by the Natural Environment Research Council C-CLEAR doctoral training programme (Grant no. NE/S007164/1). We are grateful to all those who assisted with the collection and curation of tracking data. Further details are provided in the Supplementary Acknowledgements. Any use of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the U.S. Government.Peer reviewe

Global assessment of marine plastic exposure risk for oceanic birds

Plastic pollution is distributed patchily around the world’s oceans. Likewise, marine organisms that are vulnerable to plastic ingestion or entanglement have uneven distributions. Understanding where wildlife encounters plastic is crucial for targeting research and mitigation. Oceanic seabirds, particularly petrels, frequently ingest plastic, are highly threatened, and cover vast distances during foraging and migration. However, the spatial overlap between petrels and plastics is poorly understood. Here we combine marine plastic density estimates with individual movement data for 7137 birds of 77 petrel species to estimate relative exposure risk. We identify high exposure risk areas in the Mediterranean and Black seas, and the northeast Pacific, northwest Pacific, South Atlantic and southwest Indian oceans. Plastic exposure risk varies greatly among species and populations, and between breeding and non-breeding seasons. Exposure risk is disproportionately high for Threatened species. Outside the Mediterranean and Black seas, exposure risk is highest in the high seas and Exclusive Economic Zones (EEZs) of the USA, Japan, and the UK. Birds generally had higher plastic exposure risk outside the EEZ of the country where they breed. We identify conservation and research priorities, and highlight that international collaboration is key to addressing the impacts of marine plastic on wide-ranging species

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation