Impact Evaluation of Biodiversity Research Program

Orientador: Maria Beatriz Machado BonacelliTese (doutorado) - Universidade Estadual de Campinas, Instituto de GeociênciasResumo: O principal objetivo desta tese foi o de contribuir conceitual e metodologicamente com a metodologia GEOPI de avaliação de impactos de programas de Ciência Tecnologia e Inovação (C,T&I), especificamente sobre a avaliação de impactos de programas de pesquisa em biodiversidade tendo como objeto de estudo um importante programa de pesquisa em biodiversidade do país, o Programa Biota da FAPESP. A tese foi desenvolvida sob três eixos centrais: (i) do estudo da evolução do quadro político-institucional e do panorama das pesquisas em biodiversidade no país e no mundo, tendo como base a Convenção da Diversidade Biológica; (ii) das especificidades da avaliação de impacto em C,T&I e (iii) da apresentação da metodologia GEOPI para a avaliação de impacto de programa de pesquisa em biodiversidade. A metodologia GEOPI de avaliação de impactos busca apreender o aspecto multidimensional dos impactos da C,T&I por dois momentos: o primeiro faz a análise profunda e detalhada do objeto e visa a identificação dos impactos potenciais; o segundo mede a intensidade deste impacto. A avaliação no que respeita a caracterização, a conservação e o uso sustentável da biodiversidade apresenta resultados que indicam a direção acertada do Programa nos seus primeiros 10 anos de existência, com um volume expressivo de documentos científicos e de inovação em políticas públicas, havendo ainda a necessidade, entretanto, de se incrementar inovações tecnológicas. A metodologia GEOPI se mostrou versátil em sua aplicação. Como recomendações para o aperfeiçoamento da metodologia GEOPI sugere-se (i) a expansão na categoria de atores envolvidos, para apreender diferentes percepções acerca do objeto de análise; (ii) a inclusão da dimensão "coordenação do programa", para captar principalmente os impactos de resultados coletivos, ou seja, aqueles que são transversais a unidade de análise "projeto"; (iii) a aplicação da metodologia em redes de pesquisa, que também é um formato comum de organização da pesquisa, de caráter mais verticalizado, e (iv) a exploração dos impactos decorrentes da legislação na pesquisa em biodiversidade, no que concerne a pesquisa nesta área. Espera-se que essas contribuições sirvam para outros trabalhos de avaliação de impactos de programas de pesquisa em biodiversidade, mesmo a metodologia sendo fortemente objetivosespecífica e objeto-específica, e mesmo para programas com perfil diferente do Biota da Fapesp. Há sim elementos conceituais que estão na base da metodologia em foco e que podem ser tomados como princípios para se desenhar estudos de avaliação de impactosAbstract: The main objective of this dissertation was to contribute conceptually and methodologically with the GEOPI methodology of impact evaluation for Science Technology and Innovation (S, T & I) programs and specifically with the biodiversity research programs, in this case, Biota/Fapesp Research Program. This PhD dissertation is supported in two main axes: (i) the development of the political and institutional framework of biodiversity access, with emphasis in its researches and programs research; and: (ii) the analysis S, T & I with focus in the impact evaluation, and (iii) the contribution to the improvement of the GEOPI?s methodology for impact evaluation of biodiversity research programs. The GEOPI?s methodology apprehend the multidimensional aspect of the impacts from the S, T & I, in two distinct moments: the former is a deep and detailed analysis in the object with focus in the identification of the potential impacts; the latter evaluate the intensity of the impact. Concerning to characterization, conservation and sustainable use of biodiversity, Biota Program presents results that indicate the correct direction of the Program in its first 10 years of existence, with a significant volume of scientific papers and innovation in public policy. However, there is still a need to enhance technological innovation. The GEOPI methodology of impact evaluation was extremely versatile in its application. As recommendations for the improvement of the GEOPI?s Methodology, is suggested: (i) to include different stakeholders? perceptions about the object analyzed; (ii) the inclusion of the dimension "program coordination", catch up mainly the impacts of collective results, ie, those that goes beyond the unit of analysis "project"; (iii) applying the methodology in research networks, which is also a common format for the research organization, which is more vertical, and (iv) the investigation of the impacts of legislation on biodiversity research, which is very relevant in this area. It is expected that these contributions could be used for other impact evaluations of research programs on biodiversity, even the methodology being strongly goal-specific and object-specific, and even for programs with different contour of Biota/Fapesp. There are so conceptual elements that underlie the methodology and the focus that can be taken as principles to design studies to evaluate impactsDoutoradoPolítica Científica e TecnologicaDoutor em Política Científica e Tecnológic

Diagnóstico brasileiro sobre biodiversidade e serviços ecossistêmicos : sumário para tomadores de decisão

A biodiversidade e os ecossistemas são elementos importantes para enfrentar as crises socioeconômicas e ambientais nacionais e globais, uma vez que proporcionam novas oportunidades de desenvolvimento. Incorporar a biodiversidade na vida cotidiana é uma oportunidade de ouro para promover o uso sustentável da biodiversidade e dos serviços ecossistêmicos. A conservação e a restauração da biodiversidade, dos ecossistemas e de seus serviços associados mostram potencial para um novo desenvolvimento social e econômico, como fonte de geração de emprego e renda, redução da pobreza e da desigualdade socioeconômica. A diversidade biológica brasileira também se expressa em sua imensa diversidade cultural, com uma grande variedade de detentores de conhecimento indígenas e tradicionais. Esses povos possuem vasto conhecimento sobre agrobiodiversidade, pesca, manejo do fogo, medicina natural, entre outros de valor comercial, cultural e espiritual. As principais conclusões deste Sumário para Tomadores de Decisão é que as mudanças no uso da terra e as mudanças climáticas tenham sido - e continuarão sendo ao longo deste século - os principais vetores da perda de biodiversidade e serviços ecossistêmicos no país. Intervenções políticas em diferentes níveis (do local ao nacional, do público ao privado) e a aplicação das leis existentes (mecanismos regulatórios e incentivos) são necessárias para promover a mitigação dos impactos negativos sobre a biodiversidade e a perda de serviços ecossistêmicos. O Brasil já possui uma ampla variedade de instrumentos de política e opções de governança socioambiental, bem como compromissos globais (ODS, Metas de Aichi, Acordo de Paris) relacionados à possibilidade de um futuro sustentável. Entretanto, o controle ineficiente da gestão ou a falta de incentivo para cumprir as regras traz riscos para a consolidação do caminho para esse futuro. O país tem instituições fortes e capazes, mas problemas de infraestrutura, processos lentos, medidas ineficazes e conflitos judiciais, sociais e ecológicos impedem a realização de um desempenho eficiente. Há uma falta de comunicação entre a ciência e a sociedade que precisa ser melhorada por meio do estabelecimento de um fluxo efetivo que torne a comunicação inclusiva e representativa, alcançando os tomadores de decisão públicos e privados. Esforços permanentes para integrar essas duas esferas de conhecimento na sociedade são desejáveis para criar confiança entre os formuladores de políticas e os pesquisadores.Biodiversity and ecosystems are important elements for addressing national and global socioeconomic and environmental crises, since they provide new development opportunities, for example, as source of job and income creation, and reduction in poverty and socioeconomic inequity. Brazilian biological diversity is also expressed in its immense cultural diversity, with a great variety of knowledge holders. These peoples possess vast knowledge on agrobiodiversity, fishing, fire management, natural medicine, among others of commercial, cultural and spiritual value. The main conclusions of this Summary for Police Makers is that land use changes and climate changes have been - and will continue to be throughout this century - the main drivers that result in the loss of biodiversity and ecosystem services in the country. Political interventions at different levels (from local to national, from public to private) and the enforcement of existing laws (regulatory mechanisms and incentives) are required to cope with the mitigation of the negative impacts of biodiversity and ecosystem services loss. Brazil has already a wide variety of policy instruments and socioenvironmental governance options, as well as global commitments (ODS, Aich Targets, Paris Agreement) related to the objective of a sustainable future. However, inefficient management control or lack of incentive to comply with the rules pose risks to consolidating the path to this future. The country has strong and capable institutions, but infrastructural problems, slow processes, inefficient measurements and judicial, social and ecological conflicts obstruct a proficient performance. There is a lack of communication between science and society which needs to be improved by establishing an effective flow that makes communication inclusive and representative, reaching public and private decision makers. Permanent efforts to integrate Science and policy knowledges are desirable to build confidence between policy makers and researchers

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Science and management in conservation units : the case of PETAR, Parque Estadual Turístico do Alto Ribeiro, SP

Orientador : Newton Muller PereiraDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de GeocienciasMestradoPolitica Cientifica e TecnologicaMestre em Política Científica e Tecnológic

The 2nd work program of the intergovernmental science-policy platform on biodiversity and ecosystem services/IPBES

Sem informação19