PROMETHEE-SAPEVO-M1 a Hybrid Approach Based on Ordinal and Cardinal Inputs: Multi-Criteria Evaluation of Helicopters to Support Brazilian Navy Operations

This paper presents a new approach based on Multi-Criteria Decision Analysis (MCDA), named PROMETHEE-SAPEVO-M1, through its implementation and feasibility related to the decision-making process regarding the evaluation of helicopters of attack of the Brazilian Navy. The proposed methodology aims to present an integration of ordinal evaluation into the cardinal procedure from the PROMETHEE method, enabling to perform qualitative and quantitative data and generate the criteria weights by pairwise evaluation, transparently. The modeling provides three models of preference analysis, as partial, complete, and outranking by intervals, along with an intra-criterion analysis by veto threshold, enabling the analysis of the performance of an alternative in a specific criterion. As a demonstration of the application, is carried out a case study by the PROMETHEE-SAPEVO-M1 web platform, addressing a strategic analysis of attack helicopters to be acquired by the Brazilian Navy, from the need to be evaluating multiple specifications with different levels of importance within the context problem. The modeling implementation in the case study is made in detail, first performing the alternatives in each criterion and then presenting the results by three different models of preference analysis, along with the intra-criterion analysis and a rank reversal procedure. Moreover, is realized a comparison analysis to the PROMETHEE method, exploring the main features of the PROMETHEE-SAPEVO-M1. Moreover, a section of discussion is presented, exposing some features and main points of the proposal. Therefore, this paper provides a valuable contribution to academia and society since it represents the application of an MCDA method in the state of the art, contributing to the decision-making resolution of the most diverse real problems.This research was funded by Centre for Research & Development in Mechanical Engineering (CIDEM), School of Engineering of Porto (ISEP), Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 431 4249-015 Porto, Portugal.info:eu-repo/semantics/publishedVersio

A Systematic Approach to the Management of Military Human Resources through the ELECTRE-MOr Multicriteria Method

Personnel selection is increasingly proving to be an essential factor for the success of organizations. These issues almost universally involve multiple conflicting objectives, uncertainties, costs, and benefits in decision-making. In this context, personnel assessment problems, which include several candidates as alternatives, along with several complex evaluation criteria, can be solved by applying Multicriteria Decision Making (MCDM) methods. Uncertainty and subjectivity characterize the choice of personnel for missions or promotions at the military level. In this paper, we evaluated 30 Brazilian Navy officers in the light of four criteria and 34 subcriteria. To support the decision-making process regarding the promotion of officers, we applied the ELECTRE-Mor MCDM method. We categorized the alternatives into three classes in the modeling proposed in this work, namely: Class A (Promotion by deserving), Class B (Promotion by seniority), and Class C (Military not promoted). As a result, the method presented 20% of the officers evaluated with performance corresponding to class A, 53% of the alternatives to class B, and 26.7% with performances attributed to class C. In addition, we presented a sensitivity analysis procedure through variation of the cut-off level λ, allowing decision-making on more flexible or rigorous scenarios at the discretion of the Naval High Administration. This work brings a valuable contribution to academia and society since it represents the application of an MCDM method in state of the art to contribute to solving a real problem.info:eu-repo/semantics/publishedVersio

Transmissão vertical do hiv: reflexões para a promoção da saúde e cuidado de enfermagem

Objetivo: Refletir sobre a transmissão vertical do hiv na conjuntura da promoção da saúde e do cuidado de enfermagem.Síntese do conteúdo: Trata-se de um documento de reflexão, embasado em uma busca na literatura científica e em publicações do Ministério da Saúde do Brasil sobre o tema, comos descritores: Transmissão Vertical de Doença Infecciosa, hiv, Promoção da Saúde e Educação em Saúde. No âmbito da concepção de promoção da saúde como prevenção de doenças,diversas são as intervenções de enfermagem envolvidas no processo de prevenção da transmissão vertical do hiv, abrangendo desde cuidados que antecedem a gravidez da mulher soropositiva, passando pelo pré-natal, parto, puerpério e cuidados com a criança exposta ao hiv. Verificou-se a importância das ações educativas como um dos principais elementos para a promoção da saúde no contexto da transmissão vertical do hiv, por contribuírem para o estabelecimento de uma relação dialógica entre enfermeiros e mulheres soropositivas, levando ao seu empoderamento.Conclusão: Este documento contribui para que o enfermeiro reflita acerca da sua práxis e busque realizar seu cuidado com vistas à promoção da saúde desse público de forma diferenciada, individualizada, ética e efetiva, no intuito de abordar seus reais problemas de saúde e garantir um cuidado holístico, humanizado e resolutivo para essa clientela, que temcaracterísticas específicas.Objective: To reflect about vertical transmission of hiv in the context of health promotion and nursing care.Summary of content: This is a reflection paper based on a literature search of articles and publications for the subject of Ministério da Saúde do Brasil. The following descriptors wereused: Infectious Disease Transmission, Vertical, hiv, Health Promotion and Health Education. Within the context in which health promotion is conceived as disease prevention, there are several nursing interventions involved in the prevention ofvertical transmission of hiv process, encompassing both pre-pregnancy caring for the hiv-positive woman and prenatal, delivery, and postpartum caring for the hiv-exposed child. It was found that educational actions are of vital importance to promotion of health in the context of the vertical transmission of hiv, in as much as they contribute to establish a dialogicalrelation between nurses and hiv-positive women, which aims toempower them.Conclusion: This paper contributes to nurses to reflect about their practice and to carry out care functions in order to promote health of this public in individual, ethical, and effective manner. This sort of care must cover actual health issues ofhiv-positive woman, ensuring them integral, humanized, and determining care, in accordance with their own specific conditions.O processo de feminização da infecção pelo HIV aumenta o risco da transmissão vertical (TV), principal via de infecção pelo vírus na população infantil. Nesse contexto, destaca-se o papel fundamental do enfermeiro, que presta assistência direta e contínua às mães soropositivas e crianças expostas ao vírus, como peça fundamental na promoção da saúde do binômio mãe-filho. O estudo teve como objetivo refletir sobre a TV do HIV na conjuntura da promoção da saúde e do cuidado de enfermagem. Percebeu-se que o enfermeiro é um importante agente na busca pela implementação dos cuidados preconizados desde o período pré-concepcional, pré-natal, parto até o puerpério. Verificou-se ainda a importância das ações educativas como um dos principais elementos para a promoção da saúde na interface da TV do HIV, por constatar-se sua contribuição para o estabelecimento de uma relação dialógica entre enfermeiros, gestantes e puérperas soropositivas, visando à prevenção da TV do vírus

Comparação da gravidade dos casos de dengue segundo a classificação antiga e a classificação revisada

Introduction: two classifications stratify cases of dengue according to clinical and laboratory findings: the classification proposed in the 50s and the classification revised by the World Health Organization (WHO), which has been adopted in Brazil since January 2014. Our objective was to compare the two classification methods regarding their capability of identifying the severity of each case. Methods: Cross-sectional observational study with analysis and comparisons of dengue cases which occurred from 2011 to 2013 in a tertiary referral hospital in the city of Natal/RN, Brazil, according to the Dengue Classification and the Revised Dengue Classification. The equivalence adopted was: Classic Dengue and Dengue Hemorrhagic Fever (DHF) grade I with Dengue; DHF grade II with Dengue with warning signs and DHF III and IV with Severe Dengue. Results: 2,318 records were analyzed, with a mean age of 30.32 years ± 17.89, and a population 39% male and 61% female. Based on the designated equivalence, 428 cases were concordant, 699 were discordant (212 classified as Classic Dengue and Dengue with warning signs – mucosal bleed, 62 as Classic Dengue and Dengue with warning signs – abdominal pain) and 1,191 “without classification” (cases whose medical records did not allow classification). Conclusion: The two classifications were equivalent in clinical management when cases were severe. The old classification avoids an overestimation of mild and moderate cases by using more clinical and laboratory aspects than the new classification. Mucosal bleed, abdominal pain and vomiting did not represent signs that evolved to severity, demonstrating how the imprecise use of warning signs can overestimate the data.Introdução: Existem duas classificações que estratificam os casos de dengue pelo quadro clínico laboratorial: a classificação proposta nos anos 50 e a revisada pela Organização Mundial de Saúde, adotada em janeiro de 2014 no Brasil. Compará-las quanto à capacidade de identificar a gravidade do caso representa nosso objetivo. Métodos: Estudo observacional e transversal com análise e comparação dos casos de dengue de 2011 a 2013 de um hospital terciário de referência da cidade de Natal/RN, de acordo com a classificação antiga e a classificação revisada. As correspondências adotadas foram: Dengue Clássica e Febre Hemorrágica da Dengue (DHF) grau I com Dengue; DHF grau II com Dengue com sinais de alarme; DHF grau III e IV com Dengue grave. Resultados: 2.318 fichas foram analisadas, com a população predominantemente adulta, média de idade 30,32 anos ± 17,89, sendo 39% do sexo masculino, 61% do sexo feminino. A partir das correlações designadas, 428 casos foram concordantes, 699 discordantes e 1191 “sem classificação” (casos cujos dados dos prontuários não possibilitaram sua classificação). Conclusões: As duas classificações foram equivalentes no manejo clínico quando os casos de dengue foram graves. A classificação antiga evita a superestimação de casos leves e moderados por utilizar mais aspectos clínicos e laboratoriais que a classificação revisada. Sangramento de mucosa, dor abdominal e vômitos não representaram sinais que evoluíram para gravidade, demonstrando como a utilização dos sinais de alarme de maneira imprecisa pode superestimar os dados

Qualidade microbiológica e caracterização da resistência antimicrobiana de bactérias isoladas de queijos Coalho comercializados em Vitória da Conquista-Bahia

Neste estudo foram determinadas a qualidade higiênico-sanitária, a prevalência e a resistência antimicrobiana de patógenos isolados de 24 amostras de queijo Coalho comercializados em duas feiras livres do município de Vitória da Conquista, Bahia. Foram realizadas análises físico-químicas e microbiológicas através de métodos convencionais interpretados conforme legislação vigente. Identificamos que 75% das amostras eram comercializadas em temperatura inadequada e que 100% apresentaram contagem para coliformes totais acima do limite aceitável.  Staphylococcus coagulase positiva e Escherichia coli foram isolados em 87,5% e 62,5% das amostras, respectivamente. Não foi detectada a presença de Listeria monocytogenes e Salmonella sp. Identificamos 51,1% de resistência a pelo menos um dos sete antimicrobianos testados para Staphylococcus coagulase positiva e 44,4% para pelo menos um dos 11 avaliados para E.coli. As análises realizadas evidenciaram uma precariedade higiênico-sanitária na produção e comercialização de queijo coalho nas feiras livres de Vitória da Conquista. Torna-se também uma preocupação, a presença de bactérias resistentes aos antimicrobianos nestes queijos. Deste modo, ressaltamos a importância do controle de qualidade na produção e comercialização destes produtos, assim como a necessidade das ações da vigilância sanitária para orientação aos manipuladores e produtores de queijo

Computational implementation of the ELECTRE-MOR method: A tool at the service of meritocracy in the evaluation of Brazilian armed forces personnel

A seleção de pessoal está cada vez mais se mostrando um fator essencial para o sucesso das organizações. Essas questões envolvem quase universalmente múltiplos objetivos conflitantes, incertezas, custos e benefícios no processo de tomada de decisão. Nesse contexto, devido à natureza dos problemas de avaliação de pessoal, que incluem vários candidatos como alternativas, juntamente com vários critérios complexos de avaliação, esses tipos de problemas podem ser resolvidos pela aplicação de métodos de Apoio Multicritério à Decisão (AMD). No âmbito militar, a escolha de pessoal para missões ou promoção reveste-se de incerteza e subjetividade. Dessa maneira, configura-se o problema de pesquisa, expresso por meio da dificuldade em priorizar os militares das Forças Armadas (FFAA) brasileiras para cargos e promoções de uma forma transparente e justa. Para o entendimento e estruturação da situação problemática, foi aplicada a abordagem Value Focused Thinking (VFT), que proporcionou o estabelecimento de 4 critérios e 34 subcritérios, à luz dos quais foram avaliados 30 oficiais da Marinha do Brasil (MB). Para apoiar o processo de decisão no que tange à promoção de oficiais, foi aplicado o Elimination Et Choix Traduisant la Realité – Multicriteria Ordinal (ELECTRE-MOr), método de classificação de múltiplos critérios com entrada de pesos ordinal, que inclui múltiplos tomadores de decisão e distribui as alternativas em categorias predefinidas. Na modelagem proposta neste trabalho, as alternativas foram categorizadas em 3 classes, a saber: Classe A (Promoção por merecimento), Classe B (Promoção por antiguidade) e Classe C (Militares não promovidos). Como resultado, o método apresentou 20% dos oficiais avaliados com desempenho correspondente à classe A, 53% das alternativas à classe B, e 26,7% com desempenhos atribuídos à classe C. Além disso, foi apresentado um procedimento de análise de sensibilidade, mediante variação do valor do nível de corte λ, permitindo tomar decisões baseadas em cenários mais flexíveis ou rigorosos, a critério da Alta Administração Naval. Ademais, foi implementada e apresentada a ferramenta computacional ELECTRE-MOr Web, que implementa a axiomática do método e facilita a utilização e difusão da metodologia proposta de maneira simples e intuitiva. Este trabalho traz valiosa contribuição para academia e sociedade, uma vez que representa a aplicação de um método de AMD no estado da arte para contribuir com a solução de um problema real que pode ser replicado em diversas instituições públicas e privadas, nas esferas táticas, operacionais e estratégicasThe personnel selection is increasingly proving to be an essential factor for the success of organizations. These issues almost universally involve multiple conflicting objectives, uncertainties, costs and benefits in the decision-making process. In this context, due to the nature of personnel assessment problems, which include several candidates as alternatives, along with several complex evaluation criteria, these types of problems can be solved by applying Multicriteria Decision Making (MCDM) methods. At the military level, the choice of personnel for missions or promotion is characterized by uncertainty and subjectivity. Thus, the research problem is expressed through the question: “How to prioritize the Brazilian Armed Forces (FFAA) military for positions and promotions in a transparent and fair manner?”. To understand and structure the problem situation, the Value Focused Thinking (VFT) approach was applied, which provided the establishment of 4 criteria and 34 subcriteria, in the light of which 30 Brazilian Navy (BN) officers were evaluated. To support the decision-making process regarding the promotion of officers, we applied the Elimination Et Choix Traduisant la Realité – Multicriteria Ordinal (ELECTRE-MOr), a multi-criteria classification method with ordinal weight entry, which includes multiple decision makers and distributes alternatives into predefined categories. In the modeling proposed in this work, the alternatives were categorized into 3 classes, namely: Class A (Promotion by deserving), Class B (Promotion by seniority) and Class C (Military not promoted). As a result, the method presented 20% of the officers evaluated with performance corresponding to class A, 53% of the alternatives to class B, and 26.7% with performances attributed to class C. Also, a sensitivity analysis procedure was presented, through variation of the cut-off level λ, allowing decisions to be made based on more flexible or rigorous scenarios, at the discretion of the Naval High Administration. Besides, we implemented and presented the ELECTRE-MOr Web computational tool, which implements the axiomatics of the method and facilitates the use and dissemination of the proposed methodology in a simple and intuitive way. This work brings valuable contribution to academia and society, since it represents the application of a MCDM method in the state of the art to contribute to the solution of a real problem that can be replicated in various public and private institutions, in the tactical, operational and strategic spheres.121 p

A Systematic Approach to the Management of Military Human Resources through the ELECTRE-MOr Multicriteria Method

Personnel selection is increasingly proving to be an essential factor for the success of organizations. These issues almost universally involve multiple conflicting objectives, uncertainties, costs, and benefits in decision-making. In this context, personnel assessment problems, which include several candidates as alternatives, along with several complex evaluation criteria, can be solved by applying Multicriteria Decision Making (MCDM) methods. Uncertainty and subjectivity characterize the choice of personnel for missions or promotions at the military level. In this paper, we evaluated 30 Brazilian Navy officers in the light of four criteria and 34 subcriteria. To support the decision-making process regarding the promotion of officers, we applied the ELECTRE-Mor MCDM method. We categorized the alternatives into three classes in the modeling proposed in this work, namely: Class A (Promotion by deserving), Class B (Promotion by seniority), and Class C (Military not promoted). As a result, the method presented 20% of the officers evaluated with performance corresponding to class A, 53% of the alternatives to class B, and 26.7% with performances attributed to class C. In addition, we presented a sensitivity analysis procedure through variation of the cut-off level λ, allowing decision-making on more flexible or rigorous scenarios at the discretion of the Naval High Administration. This work brings a valuable contribution to academia and society since it represents the application of an MCDM method in state of the art to contribute to solving a real problem

SAPEVO-H² a Multi-Criteria Systematic Based on a Hierarchical Structure: Decision-Making Analysis for Assessing Anti-RPAS Strategies in Sensing Environments

Regarding high-level and complex decision-making scenarios, the study presents an extensive approach to the Simple Aggregation of Preferences Expressed by Ordinal Vectors-Multi Decision Making method (SAPEVO-M). In this context, the modeling proposal, named SAPEVO-Hybrid and Hierarchical (SAPEVO-H²), the objective of this study, based on the concepts of multi-criteria analysis, provides the evaluation of alternatives under the light of multiple criteria and perceptions, enabling the integration of the objectives of a problem, which are transcribed into attributes and structured in a hierarchical model, analyzing qualitative and quantitative data through ordinal and cardinal entries, respectively. As a case study, a decision analysis concerning the defense strategies against anti-Remotely Piloted Aircraft Systems (RPAS) strategies for the Brazilian Navy is carried out. Using the technique of the causal maps approach based on Strategic Options Development and Analysis (SODA) methodology, the problematic situation is structured for numerical implementation, demonstrating the performance of objectives and elements of a hierarchical structure. As a result, rankings concerning objectives and anti-RPAS technologies, based on the treatment of subjective information, are presented. In the end, the main contribution of the study and its limitations are discussed, along with the conclusions and some proposals for future studies

Choosing a hospital assistance ship to fight the covid-19 pandemic

OBJETIVO: Aplicar o método multicritério THOR 2 para selecionar o navio de assistência hospitalar (NAsH) da Marinha do Brasil mais indicado para apoiar o combate à pandemia de covid-19. MÉTODOS: Para a estruturação e modelagem do problema, foram usados os três primeiros estágios da Soft Systems Methodology. Já para a avaliação e ordenação das alternativas, foi utilizado o método de análise multicritério Thor 2, comparando quatro classes de NAsH à luz de seus critérios operativos e hospitalares: “Dr. Montenegro”, “Soares Meirelles”, “Oswaldo Cruz” e “Tenente Maximiano”. O navio escolhido apoiaria o sistema hospitalar do Amazonas, que apresenta número cada vez maior de casos de covid-19. RESULTADOS: Após a aplicação dos métodos, foi possível analisar três cenários distintos de ordenação das alternativas, o que permitiu uma análise de sensibilidade robusta, conferindo maior transparência e confiabilidade ao processo decisório. O NAsH “Oswaldo Cruz” foi selecionado para ser empregado no combate à pandemia. CONCLUSÕES: Este trabalho traz valiosa contribuição para academia e sociedade, uma vez que representa a aplicação de um método de auxílio à decisão multicritério no estado da arte para contribuir com a solução de um problema real que afeta milhões de pessoas no Brasil e no mundo.OBJECTIVE: To apply the THOR 2 multi-criteria support system to select the Brazilian navy’s most suitable hospital care vessel (NAsH) to support the fight against the covid-19 pandemic. METHODS: We used the first three stages of the Soft Systems Methodology for structuring and modeling of the problem. For the evaluation and ordering of alternatives, we used the Thor 2 multi-criteria support system, comparing four classes of NAsH in the light of their operational and hospital criteria: “Dr. Montenegro,” “Soares Meirelles,” “Oswaldo Cruz” and “Tenente Maximiano.” The chosen ship would support the amazon hospital system, which has an increasing number of cases of covid-19. RESULTS: After the application of the methods, we analyzed three distinct scenarios of ordering the alternatives, which allowed a robust sensitivity analysis, conferring greater transparency and reliability to the decision-making process. The NAsH “Oswaldo Cruz” was selected to be used in the fight against the pandemic. CONCLUSIONS: This study brings valuable contribution to academia and society, since it represents the application of a multi-criteria decision-aid method in the state of the art to contribute to the solution of a real problem that affects millions of people in Brazil and worldwide

Lead Toxicity Risks in Gunshot Victims

<div><p>Background</p><p>Gunshot wounds require surgeons to decide whether to remove or leave bullet fragments in the body. Surgeons also decide how to follow up with patients who have lead fragments retained in their body. Current literature recommends to remove only intra-articular fragments without the need for a follow-up for patients with the metal retained. Therefore, this study investigates chronic lead toxicity for gunshot wounds.</p><p>Methods</p><p>The study was performed in the metropolitan area of Rio de Janeiro/Brazil, between 2013 and 2015. It was a case-control study that included 45 victims of gunshot lesions with metallic fragments retained for more than 6 months. The 45 controls were matched for gender, age, and race. We compared the lead blood levels and frequency of symptoms.</p><p>Results</p><p>The control group had average blood lead levels of 2.17 μg/dL (95% Confidence Interval [CI]; 1.71–2.63) and median 2.1 μg/dL. The case group had average values of 9.01 μg/dL (CI; 6.07–11.96) and median values of 6.5 μg/dL with p-values < = 0.001. The case group reported the following more frequently: irritancy, bad mood, headache, memory losses, daylight drowsiness, myalgia, weakness, abdominal pain, joint pain, trembling, tingling limbs. There was statistical significance for the differences of symptoms frequencies and for odds ratio between groups.</p><p>Conclusions</p><p>Although the mean lead levels found were lower than the current laboratory references, low levels have been associated with both rising morbidity and mortality. The WHO stated: “There is no known level of lead exposure that is considered safe”. In conclusion, this work showed that bullets retained in the body are not innocuous. There are impacts in the blood lead levels and symptoms related to it, even with few fragments, extra-articular located or existing with low blood lead levels.</p></div