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1.
Arch. prev. riesgos labor. (Ed. impr.) ; 24(1): 62-73, ene.-mar. 2021. graf
Artigo em Espanhol | IBECS | ID: ibc-197121

RESUMO

La comercialización del amianto en Europa de la segunda mitad del siglo XX supuso un consumo de millones de toneladas. La exposición laboral se ha controlado a partir de la Directiva de 2009 y, en la actualidad, mediante vigilancia epidemiológica, se registran las patologías, mesoteliomas fundamentalmente, por exposiciones pasadas. Después de prohibida su utilización, aún permanecen cantidades ingentes en edificios, infraestructuras y vehículos, entre otros. El camino hacia su eliminación se inició con una Resolución del Parlamento Europeo, de 2013 y el Dictamen del Comité Económico y Social Europeo (2015/C 251/03). Con el objetivo de conocer las dificultades de estos planes se ha revisado el de Polonia, único país que hasta la fecha, ha implementado un plan de acción con un gran respaldo financiero y las actuaciones llevadas a cabo en relación con la exposición a amianto en España y, Navarra en concreto por contar con un registro exhaustivo de trabajadores expuestos. El enorme esfuerzo económico que precisan estos planes y los riesgos medioambientales que suponen, merecen una precisa planificación, que exige conocer el no alcance hasta la fecha actual de los objetivos planteados en Polonia, país referente


The commercialization of asbestos in Europe in the second half of the 20th century translated into consumption of millions of tons of this material. Occupational exposure to asbestos is controlled under the 2009 European Union Directive. Currently, through epidemiological surveillance and pathology registries (mainly mesotheliomas), it is possible to record past exposures. Despite prohibiting its use, large amounts of asbestos remain in buildings, infrastructures and vehicles, among others. The road to elimination of existing asbestos began with a 2013 European Parliament Resolution and the Opinion of the European Economic and Social Committee (2015 / C 251/03). To better understand barriers to implementing these plans, we reviewed the experience in Poland the only country that to date has implemented an action plan with great financial support, together with actions carried out in Spain generally, and Navarre specifically, given the latter's exhaustive registry of exposed workers. The enormous economic effort required to implement these plans, along with the environmental risks associated with asbestos abatement, require detailed planning, which should consider understanding why the objectives set by Poland, a benchmark country, have not been achieved to date


Assuntos
Humanos , Asbestos , Exposição Ocupacional/legislação & jurisprudência , Exposição Ocupacional/prevenção & controle , Asbestos/efeitos adversos , Exposição Ocupacional/economia , Exposição Ocupacional/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Polônia , Espanha
2.
Environ Health Prev Med ; 26(1): 18, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33522902

RESUMO

BACKGROUND: Despite the importance of hepatitis screening for decreasing liver cancer mortality, screening rates remain low in Japan. Previous studies show that full subsidies increase screening uptake, but full subsidies are costly and difficult to implement in low-resource settings. Alternatively, applying nudge theory to the message design could increase screening at lower costs. This study examined the effects of both methods in increasing hepatitis virus screening rates at worksites. METHODS: 1496 employees from a Japanese transportation company received client reminders for an optional hepatitis virus screening before their general health checkups. Groups A and B received a client reminder designed based on the principles of "Easy" and "Attractive," while the control group received a client reminder not developed using nudge theory. Additionally, hepatitis virus screening was offered to the control group and group A for a co-payment of JPY 612, but was fully subsidized for group B. The hepatitis virus screening rates among the groups were compared using a Chi-square test with Bonferroni correction, and the risk ratios of group A and group B to the control group were also calculated. To adjust for unobservable heterogeneity per cluster, the regression analysis was performed using generalized linear mixed models. RESULTS: The screening rate was 21.2%, 37.1%, and 86.3% for the control group, group A, and group B, respectively. And the risk ratio for group A was 1.75 (95% confidence interval [CI] 1.45-2.12) and that of group B was 4.08 (95% CI 3.44-4.83). The parameters of group A and group B also were significant when estimated using generalized linear mixed models. However, the cost-effectiveness (incremental cost-effectiveness ratio (ICER)) of the nudge-based reminder with the full subsidies was lower than that of only the nudge-based reminder. CONCLUSIONS: While fully subsidized screening led to the highest hepatitis screening rates, modifying client reminders using nudge theory significantly increased hepatitis screening uptake at lower costs per person.


Assuntos
Análise Custo-Benefício , Vírus de Hepatite/isolamento & purificação , Programas de Rastreamento/instrumentação , Local de Trabalho , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Masculino , Programas de Rastreamento/economia , Pessoa de Meia-Idade
3.
Nutrients ; 13(2)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33525558

RESUMO

Prior to the 2020 outbreak of COVID-19, 70% of Australians' food purchases were from supermarkets. Rural communities experience challenges accessing healthy food, which drives health inequalities. This study explores the impact of COVID-19 on food supply and purchasing behaviour in a rural supermarket. Group model building workshops explored food supply experiences during COVID-19 in a rural Australian community with one supermarket. We asked three supermarket retailers "What are the current drivers of food supply into this supermarket environment?" and, separately, 33 customers: "What are the current drivers of purchases in this supermarket environment?" Causal loop diagrams were co-created with participants in real time with themes drawn afterwards from coded transcripts. Retailers' experience of COVID-19 included 'empty shelves' attributed to media and government messaging, product unavailability, and community fear. Customers reported fear of contracting COVID-19, unavailability of food, and government restrictions resulting in cooking more meals at home, as influences on purchasing behaviour. Supermarket management and customers demonstrated adaptability and resilience to normalise demand and combat reduced supply.


Assuntos
Comportamento do Consumidor/economia , Abastecimento de Alimentos/economia , Modelos Econômicos , População Rural , Austrália/epidemiologia , /epidemiologia , Comércio/economia , Feminino , Humanos , Masculino
4.
Acta Med Hist Adriat ; 18(2): 355-374, 2021 12.
Artigo em Inglês, Servo-Croata (Latino) | MEDLINE | ID: mdl-33535767

RESUMO

Economic crises throughout history have often given an impetus for health and social reforms leading to the introduction of general healthcare systems and social equality in a large number of countries. The aim of this paper is to present the major economic crises and their effect on healthcare and social system chronologically. Bismarck's and Beveridge's model, the two most prominent healthcare models, which emerged primarily as a response to major economic crises, constitute the basis for the functioning of most health care systems in the world. An overview of historical events and experiences may be valuable in predicting future developments and potential effects of the crisis on healthcare systems and health in general. An analysis of past crises as well as current health and economic crisis caused by the COVID-19 pandemic and their impact on the healthcare system can facilitate the comprehension of the mechanisms of action and consequences of economic recession. It may also help identify guidelines and changes that might reduce the potential damage caused by future crises. The historical examples presented show that a crisis could trigger changes, which, in theiressence, are not necessarily negative. The response of society as a whole determines the direction of these changes, and it is up to society to transform the negative circumstances brought about by the recession into activities that contribute to general well-being and progress.


Assuntos
/economia , Assistência à Saúde/organização & administração , Recessão Econômica , Modelos Organizacionais , Assistência à Saúde/economia , Guias como Assunto , Humanos , Itália , Fatores Socioeconômicos
5.
Artigo em Inglês | MEDLINE | ID: mdl-33525330

RESUMO

The COVID-19 pandemic stressed the importance of understanding the sources of vulnerabilities that can lead to a financial crisis and highlighted the predominant impact on health systems. Firstly, the paper aims to conduct a retrospective analysis of the Romanian health care system, over the period of time 1985-2019, based on our own computed sustainability index for public health. Secondly, using the Gregory-Hansen cointegration method, we provide new evidence on the causal relationship between health expenditure and GDP for Romania over the period of time 1985-2017. Based on the retrospective analysis of the long-run co-movement between health spending and GDP, the study allows one to prospectively examine not only the effects of the COVID-19 pandemic on health care spending, but also to reveal the government's fiscal position and vulnerabilities. Our results highlight the intergenerational costs related to the policy incoherence roadmap and regulatory fragmentation, stressing the importance of economic system resilience through fiscal diligence and the consolidation of the institutional context.


Assuntos
/economia , Gastos em Saúde , Pandemias/economia , Saúde Pública/economia , Humanos , Estudos Retrospectivos , Romênia/epidemiologia
6.
Epidemiol Psychiatr Sci ; 30: e10, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33526166

RESUMO

AIMS: Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. METHODS: We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. RESULTS: The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126-10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520-5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854-2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444-939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). CONCLUSIONS: The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.


Assuntos
Serviços de Saúde Comunitária/estatística & dados numéricos , Depressão/terapia , Gastos em Saúde/estatística & dados numéricos , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Serviços de Saúde Comunitária/economia , Análise Custo-Benefício , Estudos Transversais , Transtorno Depressivo Maior/terapia , Feminino , Geriatria , Pesquisa sobre Serviços de Saúde , Hong Kong , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Apoio Social
7.
PLoS One ; 16(2): e0244860, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33524031

RESUMO

INTRODUCTION: Regional anesthesia offers an alternative to general anesthesia and may be advantageous in low resource environments. There is a paucity of data regarding the practice of regional anesthesia in low- and middle-income countries. Using access data from a free Android app with curated regional anesthesia learning modules, we aimed to estimate global interest in regional anesthesia and potential applications to clinical practice stratified by World Bank income level. METHODS: We retrospectively analyzed data collected from the free Android app "Anesthesiologist" from December 2015 to April 2020. The app performs basic anesthetic calculations and provides links to videos on performing 12 different nerve blocks. Users of the app were classified on the basis of whether or not they had accessed the links. Nerve blocks were also classified according to major use (surgical block, postoperative pain adjunct, rescue block). RESULTS: Practitioners in low- and middle-income countries accessed the app more frequently than in high-income countries as measured by clicks. Users from low- and middle-income countries focused mainly on surgical blocks: ankle, axillary, infraclavicular, interscalene, and supraclavicular blocks. In high-income countries, more users viewed postoperative pain blocks: adductor canal, popliteal, femoral, and transverse abdominis plane blocks. Utilization of the app was constant over time with a general decline with the start of the COVID-19 pandemic. CONCLUSION: The use of an in app survey and analytics can help identify gaps and opportunities for regional anesthesia techniques and practices. This is especially impactful in limited-resource areas, such as lower-income environments and can lead to targeted educational initiatives.


Assuntos
Anestesia Local/economia , Educação em Saúde/economia , Renda , Aplicativos Móveis , Telemedicina , Geografia , Humanos , Bloqueio Nervoso , Avaliação de Resultados em Cuidados de Saúde , Dor Pós-Operatória/etiologia
8.
Rev Bras Parasitol Vet ; 30(1): e022720, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33533798

RESUMO

Slaughter condemnations are important sources of information on cattle health. The incidence of bovine parasitic diseases is still very high in Brazil. These diseases, in addition to causing harm to the animals health, are neglected zoonotic diseases in several parts of world. The study analysed not only the Carcass losses, but also the economic damage resulting from slaughter condemnations due to parasitic causes. Cattle slaughter data from the Brazilian Ministry of Agriculture, Livestock and Supply (MAPA), over the period of 2012 to 2015 and data from the Secretary of Livestock and Irrigation of the state of Rio Grande do Sul (SEAPI-RS) were analyzed between 2014 and 2018.The number of organs and carcasses condemned was multiplied by the respective values (in Brazilian Real) obtained from slaughterhouses and subsequently converted into dollars. Brazilian analysis in SIF (Federal Inspection System) establishments showed that more than 1.2 million organs (3,884,505 kg) and 20,000 carcasses (4,547,718 kg) were condemned only due to parasitic causes during post-mortem inspection. In Rio Grande do Sul, in state inspection establishments, more than 1.7 million organs (8,210,559 kg) and 5,000 carcasses (1,243,200 kg) were condemned. These data are alarming and support the need for public policies to control these parasitic diseases.


Assuntos
Matadouros , Doenças dos Bovinos , Doenças Parasitárias em Animais , Matadouros/estatística & dados numéricos , Animais , Brasil/epidemiologia , Bovinos , Doenças dos Bovinos/economia , Doenças dos Bovinos/epidemiologia , Doenças Parasitárias em Animais/complicações , Doenças Parasitárias em Animais/epidemiologia , Zoonoses/economia , Zoonoses/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-33546396

RESUMO

This study examines the impact of the COVID-19 outbreak on the Taiwan stock market and investigates whether companies with a commitment to corporate social responsibility (CSR) were less affected. This study uses a selection of companies provided by CommonWealth magazine to classify the listed companies in Taiwan as CSR and non-CSR companies. The event study approach is applied to examine the change in the stock prices of CSR companies after the first COVID-19 outbreak in Taiwan. The empirical results indicate that the stock prices of all companies generated significantly negative abnormal returns and negative cumulative abnormal returns after the outbreak. Compared with all companies and with non-CSR companies, CSR companies were less affected by the outbreak; their stock prices were relatively resistant to the fall and they recovered faster. In addition, the cumulative impact of the COVID-19 on the stock prices of CSR companies is smaller than that of non-CSR companies on both short- and long-term bases. However, the stock price performance of non-CSR companies was not weaker than that of CSR companies during times when the impact of the pandemic was lower or during the price recovery phase.


Assuntos
/economia , Comércio/economia , Cultura Organizacional , Pandemias/economia , Responsabilidade Social , Humanos , Taiwan
10.
Artigo em Inglês | MEDLINE | ID: mdl-33546467

RESUMO

In Poland, as in many other countries, the use of capitation payment schemes in primary health care is popular. Despite this popularity, the subject literature discusses its role in decreasing the quality of primary medical services. This problem is particularly important during COVID-19, when medical entities provide telehealth services to patients. The objective of the study is to examine the effects of COVID-19 pandemic on the performance of the primary health care providers in Poland under a capitation payment scheme. In this study the authors use data from interviews with personnel of medical entities and financial and administrative reports of primary health care providers in order to identify how this crisis situation impacts the performance of primary health care entities, under capitation payment system. The performance indicators include both the financial and quality measures. Selected to the case study primary health care service providers significantly improved their profitability due to considerable costs savings and reduction of services provided to patients in a time of COVID-19 pandemic. Capitation payment system proved to be inefficient, in the studied pandemic period, in terms of the services provided by primary health care service providers to patients and the funds paid to them, in exchange, by the government entities.


Assuntos
Capitação , Assistência à Saúde/economia , Atenção Primária à Saúde/economia , Humanos , Pandemias , Polônia
11.
Bull World Health Organ ; 99(2): 112-124, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33551505

RESUMO

Objective: To estimate the economic cost of coronavirus disease 19 (COVID-19) in 31 provincial-level administrative regions and in total, in China. Methods: We used data from government reports, clinical guidelines and other publications to estimate the main cost components of COVID-19 during 1 January-31 March 2020. These components were: identification and diagnosis of close contacts; suspected cases and confirmed cases of COVID-19; treatment of COVID-19 cases; compulsory quarantine of close contacts and suspected cases; and productivity losses for all affected residents. Primary outcomes were total health-care and societal costs. Findings: The total estimated health-care and societal costs associated with COVID-19 were 4.26 billion Chinese yuan (¥; 0.62 billion United States dollars, US$) and ¥ 2646.70 billion (US$ 383.02 billion), respectively. Inpatient care accounted for 44.2% (¥ 0.95 billion/¥ 2.15 billion) of routine health-care costs followed by medicines, accounting for 32.5% (¥ 0.70 billion/¥ 2.15 billion). Productivity losses accounted for 99.8% (¥ 2641.61 billion/¥ 2646.70 billion) of societal costs, which were mostly attributable to the effect of movement-restriction policies on people who did not have COVID-19. Societal costs were most sensitive to salary costs and number of working days lost due to movement-restriction policies. Hubei province had the highest health-care cost while Guangdong province had the highest societal cost. Conclusion: Our results highlight the high economic burden of the COVID-19 outbreak in China. The control measures to prevent the spread of disease resulted in substantial costs from productivity losses amounting to 2.7% (US$ 382.29 billion/US$ 14.14 trillion) of China's annual gross domestic product.


Assuntos
/economia , Efeitos Psicossociais da Doença , Pandemias/economia , China , Eficiência , Produto Interno Bruto , Custos de Cuidados de Saúde , Humanos , Modelos Econômicos
12.
Bone Joint J ; 103-B(2): 271-278, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33517719

RESUMO

AIMS: Echocardiography is commonly used in hip fracture patients to evaluate perioperative cardiac risk. However, echocardiography that delays surgical repair may be harmful. The objective of this study was to compare surgical wait times, mortality, length of stay (LOS), and healthcare costs for similar hip fracture patients evaluated with and without preoperative echocardiograms. METHODS: A population-based, matched cohort study of all hip fracture patients (aged over 45 years) in Ontario, Canada between 2009 and 2014 was conducted. The primary exposure was preoperative echocardiography (occurring between hospital admission and surgery). Mortality rates, surgical wait times, postoperative LOS, and medical costs (expressed as 2013$ CAN) up to one year postoperatively were assessed after propensity-score matching. RESULTS: A total of 2,354 of 42,230 (5.6%) eligible hip fracture patients received a preoperative echocardiogram during the study period. Echocardiography ordering practices varied among hospitals, ranging from 0% to 23.0% of hip fracture patients at different hospital sites. After successfully matching 2,298 (97.6%) patients, echocardiography was associated with significantly increased risks of mortality at 90 days (20.1% vs 16.8%; p = 0.004) and one year (32.9% vs 27.8%; p < 0.001), but not at 30 days (11.4% vs 9.8%; p = 0.084). Patients with echocardiography also had a mean increased delay from presentation to surgery (68.80 hours (SD 44.23) vs 39.69 hours (SD 27.09); p < 0.001), total LOS (19.49 days (SD 25.39) vs 15.94 days (SD 22.48); p < 0.001), and total healthcare costs at one year ($51,714.69 (SD 54,675.28) vs $41,861.47 (SD 50,854.12); p < 0.001). CONCLUSION: Preoperative echocardiography for hip fracture patients is associated with increased postoperative mortality at 90 days and one year but not at 30 days. Preoperative echocardiography is also associated with increased surgical delay, postoperative LOS, and total healthcare costs at one year. Echocardiography should be considered an urgent test when ordered to prevent additional surgical delay. Cite this article: Bone Joint J 2021;103-B(2):271-278.


Assuntos
Ecocardiografia , Fixação de Fratura , Cardiopatias/diagnóstico por imagem , Fraturas do Quadril/cirurgia , Cuidados Pré-Operatórios/métodos , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Ecocardiografia/economia , Feminino , Seguimentos , Fixação de Fratura/economia , Cardiopatias/complicações , Fraturas do Quadril/complicações , Fraturas do Quadril/economia , Fraturas do Quadril/mortalidade , Custos Hospitalares/estatística & dados numéricos , Humanos , Tempo de Internação/economia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Ontário , Cuidados Pré-Operatórios/economia , Pontuação de Propensão , Medição de Risco , Tempo para o Tratamento
17.
Proc Natl Acad Sci U S A ; 118(8)2021 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-33547252

RESUMO

Crises lay bare the social fault lines of society. In the United States, race, gender, age, and education have affected vulnerability to COVID-19 infection. Yet, consequences likely extend far beyond morbidity and mortality. Temporarily closing the economy sent shock waves through communities, raising the possibility that social inequities, preexisting and current, have weakened economic resiliency and reinforced disadvantage, especially among groups most devastated by the Great Recession. We address pandemic precarity, or risk for material and financial insecurity, in Indiana, where manufacturing loss is high, metro areas ranked among the hardest hit by the Great Recession nationally, and health indicators stand in the bottom quintile. Using longitudinal data (n = 994) from the Person to Person Health Interview Study, fielded in 2019-2020 and again during Indiana's initial stay-at-home order, we provide a representative, probability-based assessment of adverse economic outcomes of the pandemic. Survey-weighted multivariate regressions, controlling for preexisting inequality, find Black adults over 3 times as likely as Whites to report food insecurity, being laid off, or being unemployed. Residents without a college degree are twice as likely to report food insecurity (compared to some college), while those not completing high school (compared to bachelor's degree) are 4 times as likely to do so. Younger adults and women were also more likely to report economic hardships. Together, the results support contentions of a Matthew Effect, where pandemic precarity disproportionately affects historically disadvantaged groups, widening inequality. Strategically deployed relief efforts and longer-term policy reforms are needed to challenge the perennial and unequal impact of disasters.


Assuntos
Fatores Etários , Grupos de Populações Continentais , Disparidades nos Níveis de Saúde , Pandemias/economia , Pobreza , Adolescente , Adulto , Idoso , /etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Estados Unidos/etnologia
18.
Proc Natl Acad Sci U S A ; 118(6)2021 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-33531366

RESUMO

With more time being spent on caregiving responsibilities during the COVID-19 pandemic, female scientists' productivity dropped. When female scientists conduct research, identity factors are better incorporated in research content. In order to mitigate damage to the research enterprise, funding agencies can play a role by putting in place gender equity policies that support all applicants and ensure research quality. A national health research funder implemented gender policy changes that included extending deadlines and factoring sex and gender into COVID-19 grant requirements. Following these changes, the funder received more applications from female scientists, awarded a greater proportion of grants to female compared to male scientists, and received and funded more grant applications that considered sex and gender in the content of COVID-19 research. Further work is urgently required to address inequities associated with identity characteristics beyond gender.


Assuntos
/epidemiologia , Equidade de Gênero , Políticas , Pesquisadores/estatística & dados numéricos , Distinções e Prêmios , Pesquisa Biomédica/economia , Pesquisa Biomédica/organização & administração , Eficiência , Feminino , Organização do Financiamento/estatística & dados numéricos , Humanos , Masculino , Pandemias , Pesquisadores/economia , Fatores Sexuais
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