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1.
J Sci Food Agric ; 2024 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-39460515

RESUMO

BACKGROUND: Tomatoes are a significant product of the Mediterranean region and a crucial component of the Mediterranean diet. The formulation of dried tomato products enriched with proteins and bioactive compounds could be a strategic approach to promote adherence to the Mediterranean diet. Six different novel tomato products were analyzed using different protein enrichment sources (pea proteins and leaf proteins) and drying technologies (hot-air dryer, microwave vacuum dryer, and conventional dryer). The novelty of this approach lies in combining product-specific criteria with global societal factors across their life cycles. Using 21 criteria and an analytic hierarchy process (AHP) survey of experts, the social sustainability score for each product was determined through a multi-criteria assessment. RESULTS: The tomato product's life cycles have minimal regional impacts on unemployment, access to drinking water, sanitation, or excessive working hours. However, they affect discrimination, migrant labor, children's education, and access to hospital beds significantly. The study identified nutritional quality as the top criterion, with the most sustainable design being a tomato bar enriched with pea protein and processed using microwave vacuum drying. CONCLUSION: The study revealed that integrating sensory and nutrient compounds into social sustainability assessments improves food sustainability and provides a practical roadmap for social life cycle assessments of food products. It emphasized the importance of considering global social issues when reformulating Mediterranean products to ensure long-term adherence to the Mediterranean diet. Incorporating social factors into sustainability scores can also enhance the effectiveness of product information for conscious customers. © 2024 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

2.
Heliyon ; 10(18): e37645, 2024 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-39309938

RESUMO

Access to improved water, sanitation, and hygiene (WASH) services is crucial in recognizing human rights to water and sanitation and due to their impacts on education, livelihoods, and human health. However, these services are often inadequate in non-household settings such as prisons, refugee camps, schools, and healthcare facilities. Progress in monitoring to ensure sustainable services in these settings has been limited. Although several tools are available to assess WASH services in both household and non-household settings, they have limitations, and none has taken a holistic approach to evaluate WASH performance in all non-household settings. Furthermore, the impacts of climate change on WASH services are rarely considered in these evaluations, making the inadequacies of WASH services worse. To address these gaps, an integrated tool was developed to assess WASH performance in non-household settings, incorporating financial, institutional, environmental impact, technical, social, and climate change factors. The tool provides scores for indicators to solve the problem of a lack of final aggregated data to enable decision-makers to determine the level of WASH performance in a setting. Moreover, it provides qualitative explanations for each score, allowing decision-makers to identify areas for improvement. This tool offers valuable and insightful data for improving WASH facilities and ensuring sustainable services in non-household settings, particularly for WASH service providers and local governments.

3.
J Med Educ Curric Dev ; 11: 23821205241260488, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39130680

RESUMO

OBJECTIVES: Research into interdisciplinary education, where concrete examples and empirical evidence of interdisciplinary teaching is explored, is limited. Furthermore, there are no standardized guidelines on best practices for designing and implementing an interdisciplinary curriculum. Recently, in healthcare settings there has been a drive to adopt interdisciplinary or transdisciplinary practices, creating a need for training individuals capable of working across discipline-specific boundaries, or to even adopt a transdisciplinary practice. This is partially attributed to recognizing that local and global complex health challenges are interlinked and share common factors and often require a new integrated approach to management. In response, a new interdisciplinary course using a modified snowflake model of interdisciplinary course design was launched at a medical school. The course aimed to provide a broad foundation for lifelong learning with a strong emphasis on the development of knowledge, skills, and professional values essential for interdisciplinary and transdisciplinary practice in applied health promotion for individuals and society. METHODS: A semi-structured focus group with students (n = 15% of the inaugural cohort) having completed at least 1 year of the course was undertaken to investigate student perspectives on best approaches for the development and delivery of interdisciplinary learning and teaching. RESULTS: Results highlighted the importance of providing training and opportunity for students to practice integration within the curriculum. Additionally, it was noted that including a module to introduce students to different disciplines and guiding students to explore their inherent interconnectedness is essential in helping them develop interdisciplinary thinking and skills. Crucially, the role of integrated assessments was also recognized as fundamental for demonstrating and practicing interdisciplinarity. CONCLUSION: Overall, this study provides valuable insights and recommendations for educators with the objective of developing interdisciplinary learning in new or existing higher education courses or those seeking to prepare learners for contemporary and emergent societal challenges more generally.

4.
Environ Sci Technol ; 58(21): 9187-9199, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38691631

RESUMO

The coal-dominated electricity system, alongside increasing industrial electricity demand, places China into a dilemma between industrialization and environmental impacts. A practical solution is to exploit air quality and health cobenefits of industrial energy efficiency measures, which has not yet been integrated into China's energy transition strategy. This research examines the pivotal role of industrial electricity savings in accelerating coal plant retirements and assesses the nexus of energy-pollution-health by modeling nationwide coal-fired plants at individual unit level. It shows that minimizing electricity needs by implementing more efficient technologies leads to the phaseout of 1279 hyper-polluting units (subcritical, <300 MW) by 2040, advancing the retirement of these units by an average of 7 years (3-16 years). The retirements at different locations yield varying levels of air quality improvements (9-17%), across six power grids. Reduced exposure to PM2.5 could avoid 123,100 pollution-related cumulative deaths over the next 20 years from 2020, of which ∼75% occur in the Central, East, and North grids, particularly coal-intensive and populous provinces (e.g., Shandong and Jiangsu). These findings provide key indicators to support geographically specific policymaking and lay out a rationale for decision-makers to incorporate multiple benefits into early coal phaseout strategies to avoid lock-in risk.


Assuntos
Poluição do Ar , Carvão Mineral , Eletricidade , Centrais Elétricas , China , Humanos , Poluentes Atmosféricos
5.
J Environ Manage ; 360: 121116, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38772230

RESUMO

This research paper delves into the intricate interplay between decarbonisation and sustainability, focusing on adopting chemical looping technologies. Deep decarbonisation scenarios necessitate a profound transformation in various sectors to mitigate climate change, and oil refineries, as pivotal players, must adapt to these changes. Employing the BLUES integrated assessment model, we evaluate the evolution of the refining sector in decarbonisation pathways, emphasising its potential for sustainability through repurposing and emissions mitigation. Additionally, we delve into chemical looping technologies, including Solar Thermal Chemical Looping (STCL), Reverse Water Gas Shift Chemical Looping (RWGS-CL), Chemical Looping Reforming (CLR), and Super Dry Reforming (SDR), elucidating their principles and contributions to carbon dioxide (CO2) conversion. These technologies offer promising routes for CO2 capture and present opportunities for sustainable carbon loop cycles, potentially revolutionising industries' emissions reduction efforts. In a world of climate change, this research illuminates a sustainable path forward by integrating decarbonisation and innovative CO2 management strategies.


Assuntos
Dióxido de Carbono , Mudança Climática
6.
Front Toxicol ; 6: 1370045, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38646442

RESUMO

The ICH S1B carcinogenicity global testing guideline has been recently revised with a novel addendum that describes a comprehensive integrated Weight of Evidence (WoE) approach to determine the need for a 2-year rat carcinogenicity study. In the present work, experts from different organizations have joined efforts to standardize as much as possible a procedural framework for the integration of evidence associated with the different ICH S1B(R1) WoE criteria. The framework uses a pragmatic consensus procedure for carcinogenicity hazard assessment to facilitate transparent, consistent, and documented decision-making and it discusses best-practices both for the organization of studies and presentation of data in a format suitable for regulatory review. First, it is acknowledged that the six WoE factors described in the addendum form an integrated network of evidence within a holistic assessment framework that is used synergistically to analyze and explain safety signals. Second, the proposed standardized procedure builds upon different considerations related to the primary sources of evidence, mechanistic analysis, alternative methodologies and novel investigative approaches, metabolites, and reliability of the data and other acquired information. Each of the six WoE factors is described highlighting how they can contribute evidence for the overall WoE assessment. A suggested reporting format to summarize the cross-integration of evidence from the different WoE factors is also presented. This work also notes that even if a 2-year rat study is ultimately required, creating a WoE assessment is valuable in understanding the specific factors and levels of human carcinogenic risk better than have been identified previously with the 2-year rat bioassay alone.

7.
Proc Natl Acad Sci U S A ; 121(13): e2312030121, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38502689

RESUMO

The present study examines the assumptions, modeling structure, and results of DICE-2023, the revised Dynamic Integrated Model of Climate and the Economy (DICE), updated to 2023. The revision contains major changes in the treatment of risk, the carbon and climate modules, the treatment of nonindustrial greenhouse gases, discount rates, as well as updates on all the major components. Noteworthy changes are a significant reduction in the target for the optimal (cost-beneficial) temperature path, a lower cost of reaching the 2 °C target, an analysis of the impact of the Paris Accord, and a major increase in the estimated social cost of carbon.

8.
Sci Rep ; 14(1): 6699, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509127

RESUMO

Climate change impacts on sea ice thickness is opening access to offshore Arctic resources. The degree to which these resources are exploited will depend on sea-ice conditions, technology costs, international energy markets, and the regulatory environment. We use an integrated human-Earth system model, GCAM, to explore the effects of spatial-temporal patterns of sea-ice loss under climate change on future Arctic offshore oil and gas extraction, considering interactions with global energy markets and emission reduction scenarios. We find that under SSP5, a "fossil-fueled development" scenario, the effects of sea-ice loss are larger for Arctic offshore oil production than gas. Under SSP5, future extraction of Arctic offshore oil and gas through 2100 adds roughly 0.8-2.6 EJ/year to oil and gas markets but does not have large impacts on global oil and gas markets. Surprisingly, a low-carbon scenario results in greater Arctic offshore oil production to offset the more emissions-intensive unconventional oil production.

9.
Proc Natl Acad Sci U S A ; 121(8): e2215674121, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38359297

RESUMO

Sustainability outcomes are influenced by the laws and configurations of natural and engineered systems as well as activities in socio-economic systems. An important subset of human activity is the creation and implementation of institutions, formal and informal rules shaping a wide range of human behavior. Understanding these rules and codifying them in computational models can provide important missing insights into why systems function the way they do (static) as well as the pace and structure of transitions required to improve sustainability (dynamic). Here, we conduct a comparative synthesis of three modeling approaches- integrated assessment modeling, engineering-economic optimization, and agent-based modeling-with underexplored potential to represent institutions. We first perform modeling experiments on climate mitigation systems that represent specific aspects of heterogeneous institutions, including formal policies and institutional coordination, and informal attitudes and norms. We find measurable but uneven aggregate impacts, while more politically meaningful distributional impacts are large across various actors. Our results show that omitting institutions can influence the costs of climate mitigation and miss opportunities to leverage institutional forces to speed up emissions reduction. These experiments allow us to explore the capacity of each modeling approach to represent insitutions and to lay out a vision for the next frontier of endogenizing institutional change in sustainability science models. To bridge the gap between modeling, theories, and empirical evidence on social institutions, this research agenda calls for joint efforts between sustainability modelers who wish to explore and incorporate institutional detail, and social scientists studying the socio-political and economic foundations for sustainability transitions.


Assuntos
Modelos Teóricos , Análise de Sistemas , Humanos
10.
J Environ Manage ; 353: 120234, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38308993

RESUMO

We assess China's overall anthropogenic N2O emissions via the official guidebook published by Chinese government. Results show that China's overall anthropogenic N2O emissions in 2022 were around 1593.1 (1508.7-1680.7) GgN, about 47.0 %, 27.0 %, 13.4 %, 4.9 %, and 7.7 % of which were caused by agriculture, industry, energy utilization, wastewater, and indirect sources, respectively. Maximum reduction rate for N2O emissions from agriculture, industry, energy utilization, wastewater, and indirect sources can achieve 69 %, 99 %, 79 %, 86 %, and 48 %, respectively, in 2022. However, given current global scenarios with a rapidly changing population and geopolitical and energy tension, the emission reduction may not be fully fulfilled. Without compromising yields, China's theoretical minimum anthropogenic N2O emissions would be 600.6 (568.8-633.6) GgN. In terms of the economic costs for reducing one kg of N2O-N emissions, the price ranged from €12.9 to €81.1 for agriculture, from €0.08 to €0.16 for industry, and from €104.8 to €1571.5 for energy utilization. We acknowledge the emission reduction rates may not be completely realistic for large-scale application in China. The social benefits gained from reducing one kg of N2O-N emissions in China was about €5.2, indicating anthropogenic N2O emissions caused a loss 0.03 % of China's GDP, but only justifying reduction in industrial N2O emissions from the economic perspective. We perceive that the present monetized values will be trustworthy for at least three to five years, but later the numerical monetized values need to be considered in inflation and other currency-dependent conditions.


Assuntos
Agricultura , Águas Residuárias , China , Dióxido de Carbono/análise
11.
J Environ Manage ; 352: 120036, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38224640

RESUMO

China's 2060 carbon neutrality goal has significant implications for energy, water, and land systems. However, the multi-sector dynamics among China's energy-water-land system have rarely been examined explicitly. This study adopts an integrated assessment framework to simulate China's energy-water-land system co-evolution under alternative carbon neutrality scenarios and climate impacts. Results show that although the net zero emission target provides the incentive for the energy system to move away from fossil fuels, total water withdrawal will increase due to the deployment of nuclear, bioenergy, and coal power plants with carbon capture and storage. Diversifying the negative emission technologies, by leveraging direct air capture technology, can alleviate the potential water stress and land use conflicts, which would otherwise be exacerbated by large-scale deployment of afforestation and bioenergy with carbon capture and storage. Northwest and northeast regions of China are the hotspots experiencing water withdrawal increases, while Bohai Rim and coastal regions are identified to experience fierce land competition. This study demonstrates the potential for general applicability to carry out resource planning and policy evaluation from the multi-sector coordination perspective.


Assuntos
Carbono , Objetivos , Carbono/análise , Motivação , Clima , Combustíveis Fósseis , China , Dióxido de Carbono/análise
12.
MethodsX ; 12: 102561, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38292313

RESUMO

Over the last decade, the notion of community resilience, which encompasses planning for, opposing, absorbing, and quickly recovering from disruptive occurrences, has gained momentum across the world. Critical Infrastructures (CI) are seen as critical to attaining success in today's densely populated countries. Such infrastructures must be robust in the face of multi-hazard catastrophes by implementing appropriate disaster management and recovery plans. Given these facts, it is critical to establish a new methodological perspective with an integrated system for effective disaster management of CI, as well as an intelligent application that will aid in the construction of more resilient and sustainable cities and communities. This perspective proposes a holistic gaming scenario application for assessing the vulnerability and accessibility of critical infrastructures during multi-hazard events, with a primary focus on conducting an integrated assessment for critical infrastructures and their assets. Mainly, the perspective includes a holistic gaming scenario application that will aid in accurately quantifying geographical spatial information and integrating big data into predictive and prescriptive management tools using virtual reality.•Conducting Integrated Assessment Models for evaluating vulnerability of Critical Infrastructures.•Inducing Digital Technologies during Multi-Hazard Incidents for improving Natural hazard assessment models.•Developing an open-world gaming scenario that is considered with high visual motion pictures and scenes.

13.
Sci Total Environ ; 915: 169345, 2024 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-38097082

RESUMO

To cope with climate change, agricultural territories are forced to implement adaptation strategies, including the implementation of irrigation infrastructures. These strategies are deployed over a long term, and their environmental performance may vary in time and space due to climate change. Environmental assessment methods that include spatio-temporal dynamics must be developed to identify long term "no-regret" scenarios. This study proposes an innovative approach based on the coupling between a crop model, i.e. AquaCrop, and the Territorial-Life Cycle Assessment (T-LCA) framework. Results are exemplified and discussed, with comparison of scenarios with or without irrigation, between 1981 and 2099, at six contrasting locations in terms of climate and soil conditions for the Shared Socioeconomic Pathways 5-8.5 scenario developed by the Intergovernmental Panel on Climate Change. The assessments report that climate change can affect the eco-efficiency of irrigated perimeters over time. Moreover, climate change may alter the conclusions of the comparison of scenarios with or without irrigation infrastructure at a given location. Additionally, a sensitivity analysis is performed on key parameters of the study highlighting the importance of the electricity mix. Finally, spatio-temporal dynamics need to be considered to assess the environmental performance of long-term land planning scenarios and account for environmental effects such as climate change.

14.
Environ Sci Technol ; 57(48): 19508-19518, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-37934657

RESUMO

The role of hydrogen in energy system decarbonization is being actively examined by the research and policy communities. We evaluate the potential "hydrogen economy" in global climate change mitigation scenarios using the Global Change Analysis Model (GCAM). We consider major hydrogen production methods in conjunction with delivery options to understand how hydrogen infrastructure affects its deployment. We also consider a rich set of hydrogen end-use technologies and vary their costs to understand how demand technologies affect deployment. We find that the availability of hydrogen transmission and distribution infrastructure primarily affects the hydrogen production mix, particularly the share produced centrally versus on-site, whereas assumptions about end-use technology primarily affect the scale of hydrogen deployment. In effect, hydrogen can be a source of distributed energy, enabled by on-site renewable electrolysis and, to a lesser extent, by on-site production at industrial facilities using natural gas with carbon capture and storage (CCS). While the share of hydrogen in final energy is small relative to the share of other major energy carriers in our scenarios, hydrogen enables decarbonization in difficult-to-electrify end uses, such as industrial high-temperature heat. Hydrogen deployment, and in turn its contribution to greenhouse gas mitigation, increases as the climate objective is tightened.


Assuntos
Gases de Efeito Estufa , Mudança Climática , Indústrias
15.
Environ Sci Technol ; 57(43): 16265-16275, 2023 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-37863474

RESUMO

India is one of the largest emitters of atmospheric anthropogenic mercury (Hg) and the third-largest emitter of greenhouse gases in the world. In the past decade, India has been committed to the Minamata Convention (2017) in addition to the Paris Climate Change Agreement (2015) and the Glasgow Pact (2021). More than 70% to 80% of India's mercury and carbon dioxide emissions occur because of anthropogenic activities from coal usage. This study explores nine policy scenarios, the nationally determined contribution (NDC) scenario, and two deep decarbonization pathways (DDP) with and without mercury control technologies in the energy and carbon-intensive sectors using a bottom-up, techno-economic model, AIM/Enduse India. It is estimated that NDC scenarios reduce mercury emissions by 4%-10% by 2070; while coal intensive (DDP-CCS) pathways and focus on renewables (DDP-R) reduce emissions by 10%-54% and 15%-59%, respectively. Increase in the renewables share (power sector) can result in a significant reduction in the costs of additional pollution-abating technologies in the DDP-R scenario when compared with the coal intensive DDP-CCS scenario. However, the industry sector, especially iron and steel and metal production, will require stringent policies to encourage installation of pollution-abating technologies to mitigate mercury emissions under all the scenarios.


Assuntos
Poluentes Atmosféricos , Mercúrio , Poluentes Atmosféricos/análise , Mercúrio/análise , Poluição Ambiental , Índia , Carvão Mineral/análise
16.
Glob Chang Biol ; 29(24): 7085-7101, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37907071

RESUMO

Most of the world's nations (around 130) have committed to reaching net-zero carbon dioxide or greenhouse gas (GHG) emissions by 2050, yet robust policies rarely underpin these ambitions. To investigate whether existing and expected national policies will allow Brazil to meet its net-zero GHG emissions pledge by 2050, we applied a detailed regional integrated assessment modelling approach. This included quantifying the role of nature-based solutions, such as the protection and restoration of ecosystems, and engineered solutions, such as bioenergy with carbon capture and storage. Our results highlight ecosystem protection as the most critical cost-effective climate mitigation measure for Brazil, whereas relying heavily on costly and not-mature-yet engineered solutions will jeopardise Brazil's chances of achieving its net-zero pledge by mid-century. We show that the full implementation of Brazil's Forest Code (FC), a key policy for emission reduction in Brazil, would be enough for the country to achieve its short-term climate targets up to 2030. However, it would reduce the gap to net-zero GHG emissions by 38% by 2050. The FC, combined with zero legal deforestation and additional large-scale ecosystem restoration, would reduce this gap by 62% by mid-century, keeping Brazil on a clear path towards net-zero GHG emissions by around 2040. While some level of deployment of negative emissions technologies will be needed for Brazil to achieve and sustain its net-zero pledge, we show that the more mitigation measures from the land-use sector, the less costly engineered solutions from the energy sector will be required. Our analysis underlines the urgent need for Brazil to go beyond existing policies to help fight climate emergency, to align its short- and long-term climate targets, and to build climate resilience while curbing biodiversity loss.


Assuntos
Efeito Estufa , Gases de Efeito Estufa , Agricultura/métodos , Ecossistema , Brasil , Gases de Efeito Estufa/análise
17.
Sci Total Environ ; 904: 166798, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37673263

RESUMO

An integrated biological effects study using field transplanted mussels was applied to determine the potential biological effects of an effluent discharge from an aluminium smelter into a Norwegian fjord. Chemical body burden and biological effects were measured in mussels positioned downstream (1, 2, 5, 10 and 20 km) from the aluminium smelters discharge for a period of 6 weeks. A suite of biomarkers, from whole organism to subcellular responses were measured. Chemical concentrations in mussel tissues were low; however, a change in the PAC (polyaromatic compound) profile from high to low pyrogenic influence provided evidence of exposure to the smelter's effluent. Overall, the biological responses observed where greater in the mussels positioned closest to the smelter (1-5 km). Lowest chemical accumulation and biomarker responses were observed in mussels positioned 10 km from the smelter and were considered as the reference field population. Mussels located furthest from the smelter (20 km) exhibited significant biomarker responses and suggested a different contaminant source within the fjord. The integrated biological response index (IBR) was applied and reflected the expected level of exposure to the smelters discharge, with highest IBR calculated in mussels positioned closest to the discharge (1-5 km). Principal component analysis (PCA) also differentiated among mussel groups, with the most impacted located closest to the smelter. Not one chemical factor could explain the biological responses observed in mussels, but the presence of PAH16, PAH41 and metals Mn, Ni and Cr were the main contributors measured to the higher stress seen in the mussels from the 1 and 5 km groups.


Assuntos
Bivalves , Poluentes Químicos da Água , Animais , Água/análise , Alumínio/análise , Poluentes Químicos da Água/análise , Monitoramento Ambiental , Bivalves/química , Biomarcadores/análise
19.
Sci Total Environ ; 905: 167096, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-37716672

RESUMO

We demonstrate a prototype multi-metric indicator-based assessment tool (i.e. Marine Litter Assessment Tool - MALT) for mapping and identification of 'problem areas' and 'non-problem areas' regarding the occurrence of marine litter in Europe's seas. The study is based on a European-wide data set consisting of three marine litter indicators: (1) litter at the seafloor, (2) beach litter and (3) floating micro-litter. This publicly available data allowed litter status to be determined in 1,957,081 km2 (19.1 %) of the total area of Europe's seas (10,243,474 km2). Of the area assessed, 25.8 % (505,030 km2) was found to be 'non-problem areas' whilst 'problem areas' accounted for 74.2 % (1,452,051 km2). This indicates that marine litter is a large-scale problem in Europe's seas.

20.
Artigo em Russo | MEDLINE | ID: mdl-37642090

RESUMO

The article presents assessment of efficiency of implementation of the Federal project "The struggle with cardiovascular diseases" during COVID-19 pandemic. It is demonstrated that over three years of implementation of the Federal project significant consolidation of medical infrastructure and volume of work of regional vascular departments and centers took place. However, these achievements resulted in no improvement of quality of medical care nor in decreasing of mortality from diseases of the circulatory system. According to results of integral assessment, there is trend of pronounced decreasing in the number of subjects of the Russian Federation with average and high indicators of project efficiency when the COVID-19 pandemic that factually resulted in occurrence of emergency situation in health care and deteriorated access of population to medical care, is factor of failure in achieving main goals of the Federal project. To confirm or refute this hypothesis further research is needed.


Assuntos
COVID-19 , Doenças Cardiovasculares , Humanos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , COVID-19/epidemiologia , Pandemias , Instalações de Saúde , Federação Russa/epidemiologia
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