Responsabilidade social, silent accounting e shadow accounting: estudo de caso

Mestrado em Contabilidade - FiscalidadeO presente trabalho propõe-se analisar a consistência do discurso interno de uma empresa e a informação externa divulgada. A análise dos relatórios de responsabilidade social e a reconstrução das silent-accounts e das shadow-accounts permitem analisar potenciais discrepâncias existentes. A abrangência do tema foi condicionada através do estudo de caso da barragem do Baixo sabor, com fortes impactos na sociedade e no meio ambiente, gerando maior divulgação não só por parte da empresa como também dos MEDIA. Numa ótica de consumidor alguns cidadãos foram convidados a fazer parte de um focus group, ou seja, um pequeno grupo de debate, para poder responder quanto à importância da responsabilidade social de uma empresa. Os resultados da pesquisa indicam que para a maioria dos participantes, apesar da crescente preocupação pelo ambiente e pela sociedade, o primeiro fator tido em conta pelo consumidor aquando da escolha de um bem ou serviço é o preço, considerando como fatores intermédios a qualidade e a comodidade e, por último, a responsabilidade social da empresaThis work has the objective of analyzing the consistency of the internal speech of a company and the external information that is disseminated. The analyzes of the social responsibility report and the reconstruction of silent- accounts and shadow-accounts allow the analyzes of potential discrepancies that may exist. The theme’s coverage was restricted through a case study about the dam of Baixo Sabor, that had great impact in society and the environment, creating great dissemination of information not only by the company itself but by the media as well From the consumer’s point of view some citizens were invited to participate in a focus group, meaning a small debate group to try to answer questions about the social responsibility of a company The research results indicated that for the majority of the participants, even though the concern about the environment and society is increasing, the major factor taken into account while choosing an asset or service is the price, factors like quality and commodity were referred but in intermediate levels, and the social responsibility of a company was referred but it is not a major concern

Impact of COVID‐19 on professional nursing practice environments and patient safety culture

Aim: To analyse the impact of COVID-19 on professional nursing practice environments and patient safety culture. Background: The relationship between work environments and patient safety has been internationally recognized. In 2020, the pandemic imposed enormous challenges, yet the impact on these variables remains unknown. Method: This is a quantitative observational study, conducted in a Portuguese hospital, with 403 registered nurses. A self-completion questionnaire was used. Results: The impact on the Structure and Outcome components of nursing professional practice environments was positive. Although the Process component remained favourable to quality of care, a negative trend was confirmed in almost all dimensions. The results regarding safety culture showed weaknesses; ‘teamwork within units’ was the only dimension that maintained a positive culture. Conclusion: Positive responses regarding patient safety were significantly associated with the quality of the nursing professional practice environment. The need to invest in all dimensions of safety culture emerges to promote positive professional environments. Implications for nursing management: Improving professional nursing practice environments can be achieved through managers’ investment in the participation and involvement of nurses in the policies and functioning of institutions, as well as promoting an open, fair and participatory safety culture that encourages reporting events and provides adequate support for professionals.info:eu-repo/semantics/publishedVersio

The COVID-19 pandemic and professional nursing practice in the context of hospitals

The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses’ work towards the quality of care. However, it is necessary to invest in nurses’ participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions’ management strategies.info:eu-repo/semantics/publishedVersio

The COVID-19 Pandemic and Professional Nursing Practice in the Context of Hospitals

The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses’ work towards the quality of care. However, it is necessary to invest in nurses’ participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions’ management strategiesinfo:eu-repo/semantics/publishedVersio

RISCO DE LESÃO RELACIONADA AO POSICIONAMENTO CIRÚRGICO: AVALIAÇÃO EM HOSPITAL UNIVERSITÁRIO BRASILEIRO

Objective: to assess the risk of developing injuries related to surgical positioning. Method: a cross-sectional study was carried out at the Surgical Center of a public university hospital in Paraná, Brazil. A sample (n=146) of elective surgical adults was evaluated from February to April 2019, using the Risk Assessment Scale for the Development of Injuries resulting from Surgical Positioning and extraction of sociodemographic variables. Descriptive and inferential statistical analysis was performed. Results: we identified a homogeneous distribution between men (49.3%) and women (50.7%). Orthopedics was the most frequent surgical specialty (39.7%). According to the Risk Assessment Scale for the Development of Injuries Resulting from Surgical Positioning, the following variables were disregarded: use of conventional mattress + cotton field cushions as a support surface (100%); supine position (78%); upper limbs with an opening less than 90º (70.5%); regional anesthesia (54.1%); surgical time of 1-2 hours (46.6%) and age group from 18 to 39 years (41.1%). The mean score was 17.6 (±3.29) points, indicating that 75.3% of the sample had a low risk of developing injuries related to surgical positioning. Conclusion: around a quarter of the sample had a higher risk of injury due to the surgical position.Objetivo: evaluar el riesgo de desarrollar lesiones relacionadas con el posicionamiento quirúrgico. Método: estudio transversal realizado en el Centro Quirúrgico de un hospital universitario público de Paraná, Brasil. Se evaluó una muestra (n = 146) de adultos quirúrgicos electivos de febrero a abril de 2019, utilizando la Escala de Evaluación de Riesgo para el Desarrollo de Lesiones resultantes del Posicionamiento Quirúrgico y extracción de variables sociodemográficas. Se realizó análisis estadístico descriptivo e inferencial. Resultados: identificamos una distribución homogénea entre hombres (49,3%) y mujeres (50,7%). La ortopedia fue la especialidad quirúrgica más frecuente (39,7%). De acuerdo con la Escala de Evaluación de Riesgos para el Desarrollo de Lesiones por Posicionamiento Quirúrgico, se descartaron las siguientes variables: uso de colchón convencional + cojines de campo de algodón como superficie de apoyo (100%); posición supina (78%); miembros superiores con apertura menor a 90º (70,5%); anestesia regional (54,1%); tiempo quirúrgico de 1-2 horas (46,6%) y grupo de edad entre 18 y 39 años (41,1%). La puntuación media fue de 17,6 (± 3,29) puntos, lo que indica que el 75,3% de la muestra tenía un riesgo bajo de desarrollar lesiones relacionadas con el posicionamiento quirúrgico. Conclusión: alrededor de una cuarta parte de la muestra tenía un mayor riesgo de lesión debido a la posición quirúrgica.Objetivo: avaliar o risco para desenvolvimento de lesões relacionadas ao posicionamento cirúrgico. Método: estudo transversal com amostra (n=146) de adultos cirúrgicos eletivos do Paraná, Brasil. Aplicou-se a Escala de Avaliação de Risco para o Desenvolvimento de Lesões decorrentes do Posicionamento Cirúrgico e extração de variáveis sociodemográficas. Procedeu-se análise estatística descritiva e inferencial. Resultados: homens (49,3%) e mulheres (50,7%) tiveram distribuição equânime de atendimento majoritariamente pela ortopedia (39,7%). Pela escala aplicada, destacou-se: uso de colchão convencional+coxins de campo de algodão como superfície de suporte (100%); posição supina (78%); membros superiores com abertura inferior a 90º (70,5%); anestesia regional (54,1%) e tempo cirúrgico de 1-2h (46,6%). Constatou-se escore médio de 17,6±3,29 pontos e 75,3% da amostra apresentou baixo risco de desenvolver lesões do posicionamento cirúrgico. Conclusão: em torno de um quarto da amostra apresentou maior risco de lesão decorrente da posição cirúrgica

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

Efeitos da realidade virtual em crianças e adolescentes com paralisia cerebral baseada na Classificação Internacional de Funcionalidade, Incapacidade e Saúde: revisão sistemática

Objetivo: Abordar os efeitos da terapia com realidade virtual em crianças e adolescentes com Paralisia Cerebral de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Com intuito de reunir dados que elucidem como a aplicação da CIF pode resultar em melhor compreensão das características apresentadas em uma situação de saúde. Métodos: Os artigos foram pesquisados nas plataformas MEDLINE (Pubmed), PEDro, LILACS e SCIELO, publicados até maio de 2019. A escala de qualidade PEDro (Physioterapy Evidence Database) foi utilizada como método de avaliação de qualidade dos artigos, sendo incluídos artigos com nota ≥ 6 (seis) no PEDro. Resultados: Seis artigos foram incluídos nesta revisão. De maneira geral, observou-se resultados significantes quanto às “Funções corporais” relacionadas à melhora da função de membros superiores e inferiores, após intervenção com RV, quando comparados a terapia convencional. No domínio “Atividade” observou-se resultados na marcha, equilíbrio e habilidades motoras globais de crianças com PC após intervenção com RV. Conclusão: Os efeitos da Realidade Virtual em crianças com PC relacionados a CIF são positivos, mas foram encontrados mais resultados associados ao domínio “Funções corporais” e “Atividade”, assim, sugere-se que sejam feitos mais estudos para verificar os efeitos da RV quanto à “Participação” e “Fatores ambientais”.Objective: This review aimed to address the effects of therapy with virtual reality in children and adolescents with cerebral palsy according to International Classification of Functioning, Disability and Health (ICF), with the intention of gathering data that elucidate how the application of ICF can result in better understanding of the characteristics presented in a health situation. Methods: The articles were searched in the MEDLINE (Pubmed), PEDro, LILACS e SCIELO platforms, published until May 2019. Physiotherapy Evidence Database - PEDro was used as a method for evaluating, was included articles with a score ≥ 6 (six) in PEDro. Results: Six articles were included in this review. In general, significant results were observed regarding “Body functions” related to the improvement of upper and lower limb function after intervention with VR when compared to conventional therapy. In the “Activity” domain, we observed results in gait, balance and overall motor skills of children with CP after VR intervention. Conclusion: The effects of Virtual Reality in children with CP related to ICF are positive, but more results were found associated with the domain "Body functions" and "Activity", so it is suggested that further studies be done to verify the effects of VR on “Participation” and “Environmental Factors”

AMBIENTES DE TRABALHO DE ENFERMAGEM DURANTE A COVID-19: CONTRIBUIÇÕES PARA DESENVOLVER UMA FERRAMENTA TECNOLÓGICA: Contribuições para desenvolvimento de uma ferramenta tecnológica

Objetivo: avaliar o impacto da COVID-19 nos ambientes de trabalho de enfermagem e desenvolver uma ferramenta tecnológica para avaliar sistematicamente a qualificação desses contextos. Método: pesquisa de método misto realizada em seis hospitais portugueses, com participação de 442 enfermeiros. Utilizou-se um questionário com caracterização sociodemográfica e profissional, a Scale for the Environments Evaluation of Professional Nursing Practice e questões abertas. Resultados: a COVID-19 teve impacto negativo nos componentes Estrutura (ƿ<0,001), Processo (ƿ<0,001) e Resultado (ƿ=0,009) dos ambientes de trabalho de enfermagem. A monitorização da qualidade dos ambientes de trabalho foi apontada como uma estratégia de melhoria. A ferramenta tecnológica desenvolvida permite identificar precocemente as dimensões mais fragilizadas e priorizar melhorias. Conclusão: a COVID-19 repercutiu negativamente nos ambientes de trabalho. A ferramenta tecnológica construída, que tornou mais dinâmica a avaliação dos ambientes de trabalho, além de garantir o envolvimento dos enfermeiros, constitui uma importante ferramenta de gestão. Descritores: Ambiente de Trabalho. COVID-19. Enfermagem. Hospitais. Tecnologia Biomédica

Resumos concluídos - Saúde Coletiva

Resumos concluídos - Saúde Coletiv