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Development of an Index to Assess COVID-19 Hospital Care Installed Capacity in the 450 Brazilian Health Regions
- Claudia Cristina de Aguiar Pereira, Fernando Ramalho Gameleira Soares, Carla Jorge Machado, Gustavo Saraiva Frio, Layana Costa Alves, Fernando José Herkrath, Rodrigo Tobias de Sousa Lima, Ivana Cristina de Holanda Cunha Barreto, Everton Nunes da Silva, Anny Beatriz Costa Antony de Andrade, Leonor Maria Pacheco Santos
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
- Published online by Cambridge University Press:
- 22 August 2022, e275
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- Article
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Objective:
The article seeks to assess the Brazilian health system ability to respond to the challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic by measuring the capacity of Brazilian hospitals to care for COVID-19 cases in the 450 Health Regions of the country during the year 2020. Hospital capacity refers to the availability of hospital beds, equipment, and human resources.
Methods:We used longitudinal data from the National Register of Health Facilities (CNES) regarding the availability of resources necessary to care for patients with COVID-19 in inpatient facilities (public or private) from January to December 2020. Among the assessed resources are health professionals (certified nursing assistants, nurses, physical therapists, and doctors), hospital beds (clinical, intermediate care, and intensive care units), and medical equipment (computed tomography scanners, defibrillators, electrocardiograph monitors, ventilators, and resuscitators). In addition to conducting a descriptive analysis of absolute and relative data (per 10,000 users), a synthetic indicator named Installed Capacity Index (ICI) was calculated using the multivariate principal component analysis technique to assess hospital capacity. The indicator was further stratified into value ranges to understand its evolution.
Results:There was an increase in all selected indicators between January and December 2020. It was possible to observe differences between the Northeast and North regions and the other regions of the country; most Health Regions presented low ICI. The ICI increased between the beginning and the end of 2020, but this evolution differed among Health Regions. The average increase in the ICI was more evident in the groups that already had considerably high baseline capacity in January 2020.
Conclusions:It was possible to identify inequalities in the hospital capacity to care for patients affected by COVID -19 in the Health Regions of Brazil, with a concentration of low index values in the Northeast and North of the country. As the indicator increased throughout the year 2020, inequalities were also observed. The information here provided may be used by health authorities, providers, and managers in planning and adjusting for future COVID-19 care and in dimensioning the adequate supply of hospital beds, health-care professionals, and devices in Health Regions to reduce associated morbidity and mortality. We recommend that the ICI continue to be calculated in the coming months of the pandemic to monitor the capacity in the country’s Health Regions.
Reproductive strategy of the female deep-water shark birdbeak dogfish, Deania calcea: lecithotrophy or matrotrophy?
- Rafaela Barros Paiva, Ana Neves, Vera Sequeira, Maria Leonor Nunes, Leonel Serrano Gordo, Narcisa Bandarra
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- Journal:
- Journal of the Marine Biological Association of the United Kingdom / Volume 92 / Issue 2 / March 2012
- Published online by Cambridge University Press:
- 06 December 2011, pp. 387-394
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Little information is available on the maternal–embryonic relationships among sharks. Birdbeak dogfish (Deania calcea) has been described as ovoviviparous, but this term comprises a wide range of forms on how the embryos are nourished including lecithotrophy and matrotrophy. To evaluate the maternal–embryonic relationship in birdbeak dogfish we have analysed chemical features (fatty acid composition and mercury (Hg) levels) and biological characteristics (egg and embryo dry weight variation, uterus characterization). Monounsaturated fatty acids were the dominant fatty acids in eggs while polyunsaturated fatty acids (PUFA) were the dominant fatty acids in both pregnant females and embryos. Significant differences were found among eggs, embryos and pregnant females for all fatty acids groups with the exception of saturated fatty acids for embryos and pregnant females. The principal components analysis revealed that embryos are particularly related to n-6 PUFA and pregnant females with n-3 PUFA. A close relationship exists between the Hg level of pregnant females and the Hg level of their embryos which indicates that there is a transfer of mercury from maternal sources. The comparison of the mean dry weight between eggs and embryos showed a gain of 3.8% obtained in the embryos. Histological sections of the uteri of pregnant females showed a high level of both superficial and inner vascularization in the uterine villi as well as the presence of secretor cells. Until now, the importance of this species maternal contribution and interference for the embryos development has never been documented. However, the biological and chemical results observed in the present work show that there is a matrotrophic strategy for the birdbeak dogfish.