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1.
Ann Glob Health ; 87(1): 23, 2021 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-33665145

RESUMO

Introduction: Rwanda has made significant advancements in medical and economic development over the last 20 years and has emerged as a leader in healthcare in the East African region. The COVID-19 pandemic, which reached Rwanda in March 2020, presented new and unique challenges for infectious disease control. The objective of this paper is to characterize Rwanda's domestic response to the first year of the COVID-19 pandemic and highlight effective strategies so that other countries, including high and middle-income countries, can learn from its innovative initiatives. Methods: Government publications describing Rwanda's healthcare capacity were first consulted to obtain the country's baseline context. Next, official government and healthcare system communications, including case counts, prevention and screening protocols, treatment facility practices, and behavioral guidelines for the public, were read thoroughly to understand the course of the pandemic in Rwanda and the specific measures in the response. Results: As of 31 December 2020, Rwanda has recorded 8,383 cumulative COVID-19 cases, 6,542 recoveries, and 92 deaths since the first case on 14 March 2020. The Ministry of Health, Rwanda Biomedical Centre, and the Epidemic and Surveillance Response division have collaborated on preparative measures since the pandemic began in January 2020. The formation of a Joint Task Force in early March led to the Coronavirus National Preparedness and Response Plan, an extensive six-month plan that established a national incident management system and detailed four phases of a comprehensive national response. Notable strategies have included disseminating public information through drones, robots for screening and inpatient care, and official communications through social media platforms to combat misinformation and mobilize a cohesive response from the population. Conclusion: Rwanda's government and healthcare system has responded to the COVID-19 pandemic with innovative interventions to prevent and contain the virus. Importantly, the response has utilized adaptive and innovative technology and robust risk communication and community engagement to deliver an effective response to the COVID-19 pandemic.


Assuntos
Controle de Doenças Transmissíveis , Assistência à Saúde , Regulamentação Governamental , Gestão de Riscos , /epidemiologia , Gestão de Mudança , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Comunicação , Assistência à Saúde/organização & administração , Assistência à Saúde/tendências , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Inovação Organizacional , Gestão de Riscos/métodos , Gestão de Riscos/organização & administração , Ruanda/epidemiologia
2.
PLoS One ; 16(1): e0244706, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33406106

RESUMO

Without vaccines and treatments, societies must rely on non-pharmaceutical intervention strategies to control the spread of emerging diseases such as COVID-19. Though complete lockdown is epidemiologically effective, because it eliminates infectious contacts, it comes with significant costs. Several recent studies have suggested that a plausible compromise strategy for minimizing epidemic risk is periodic closure, in which populations oscillate between wide-spread social restrictions and relaxation. However, no underlying theory has been proposed to predict and explain optimal closure periods as a function of epidemiological and social parameters. In this work we develop such an analytical theory for SEIR-like model diseases, showing how characteristic closure periods emerge that minimize the total outbreak, and increase predictably with the reproductive number and incubation periods of a disease- as long as both are within predictable limits. Using our approach we demonstrate a sweet-spot effect in which optimal periodic closure is maximally effective for diseases with similar incubation and recovery periods. Our results compare well to numerical simulations, including in COVID-19 models where infectivity and recovery show significant variation.


Assuntos
Surtos de Doenças/prevenção & controle , Quarentena/métodos , Gestão de Riscos/métodos , /prevenção & controle , Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/psicologia , Surtos de Doenças/estatística & dados numéricos , Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Humanos , Modelos Teóricos , /patogenicidade
3.
Nurs Res ; 70(1): 72-79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32956255

RESUMO

BACKGROUND: Investigators conducting studies that include potentially suicidal individuals are obligated to develop a suicide risk management (SRM) protocol. There is little available in the literature to guide researchers in SRM protocol development. OBJECTIVES: The aim of the study was to describe an SRM protocol developed for a randomized controlled trial (RCT) currently enrolling cardiac patients who report moderate to severe levels of hopelessness. METHODS: The SRM protocol identifies suicidal ideation and measures ideation severity through use of the Columbia-Suicide Severity Rating Scale risk factor questions. Based on responses, study participants are deemed safe or at low, moderate, or high risk for suicide. The SRM protocol guides research staff through a plan of action based on risk level. The protocol further guides staff through a plan over the course of this prospective study-from hospital enrollment to home-based visits. RESULTS: Research staff are well trained to identify suicidal ideation risk factors, initiate specific questioning about suicidal intent, determine level of risk, identify protective factors and a safe environment, and make referrals if needed. Of the 51 patients hospitalized with cardiac disease who reported moderate to severe hopelessness, 43 scored at a safe suicide risk level and 8 scored at low risk. Thirty-five of the 51 patients enrolled in the RCT. Of the 35 participants who received home visits to date, there have been three instances of low and one instance of moderate suicide risk. The SRM protocol has been consistently and accurately used by research personnel in both hospital and home settings. One modification has been made to the protocol since study activation, namely, the addition of an assessment of counseling history and encouragement of continued counseling. Booster training sessions of research staff will continue throughout the course of the RCT. DISCUSSION: Use of the SRM protocol identifies study participants who are safe or at risk for suicide in both hospital and home settings, and research staff can refer participants accordingly. CONCLUSION: The SRM protocol developed for this RCT can serve as a model in the development of SRM protocols for future research in acute care, community, or home-based settings.


Assuntos
Cardiopatias/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Gestão de Riscos/métodos , Gestão de Riscos/normas , Estresse Psicológico/prevenção & controle , Suicídio/prevenção & controle , Suicídio/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Fatores de Risco , Estados Unidos
4.
PLoS One ; 15(12): e0242102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33362227

RESUMO

Risk in finance may come from (negative) asset returns whilst payment loss is a typical risk in insurance. It is often that we encounter several risks, in practice, instead of single risk. In this paper, we construct a dependence modeling for financial risks and form a portfolio risk of cryptocurrencies. The marginal risk model is assumed to follow a heteroscedastic process of GARCH(1,1) model. The dependence structure is presented through vine copula. We carry out numerical analysis of cryptocurrencies returns and compute Value-at-Risk (VaR) forecast along with its accuracy assessed through different backtesting methods. It is found that the VaR forecast of returns, by considering vine copula-based dependence among different returns, has higher forecast accuracy than that of returns under prefect dependence assumption as benchmark. In addition, through vine copula, the aggregate VaR forecast has not only lower value but also higher accuracy than the simple sum of individual VaR forecasts. This shows that vine copula-based forecasting procedure not only performs better but also provides a well-diversified portfolio.


Assuntos
Modelos Econômicos , Gestão de Riscos/métodos , Previsões/métodos
5.
Artigo em Inglês | MEDLINE | ID: mdl-33317147

RESUMO

Currently, nanotechnology plays a key role for technological innovation, including the construction sector. An exponential increase is expected in its application, although this has been hampered by the current degree of uncertainty regarding the potential effects of nanomaterials on both human health and the environment. The accidents, illnesses, and disease related to the use of nanoproducts in the construction sector are difficult to identify. For this purpose, this work analyzes in depth the products included in recognized inventories and the safety data sheets of these construction products. Based on this analysis, a review of the recommendations on the use of manufactured nanomaterials at construction sites is performed. Finally, a protocol is proposed with the aim of it serving as a tool for technicians in decision-making management at construction sites related to the use of manufactured nanomaterials. This proposed protocol should be an adaptive and flexible tool while the manufactured nanomaterials-based work continues to be considered as an "emerging risk," despite the expectation that the protocol will be useful for the development of new laws and recommendations for occupational risk prevention management.


Assuntos
Indústria da Construção , Nanoestruturas , Saúde do Trabalhador , Gestão de Riscos , Indústria da Construção/métodos , Indústria da Construção/estatística & dados numéricos , Tomada de Decisões , Meio Ambiente , União Europeia , Humanos , Nanoestruturas/efeitos adversos , Nanotecnologia , Saúde do Trabalhador/estatística & dados numéricos , Gestão de Riscos/métodos , Local de Trabalho/estatística & dados numéricos
6.
Artigo em Inglês | MEDLINE | ID: mdl-33142740

RESUMO

(1) Background: The emergency linked to the spread of COVID-19 in Italy has led to inevitable consequences on the penitentiary system. The risks of this emergency in prisons is mainly related to the problem of persistent overcrowding that makes social distancing difficult and the isolation of any contagion hard to arrange. The Department of Protection for Adults and Minors of the ASL Salerno Criminal Area has taken steps in order to perform screening operations and minimize the risks for prisoners and operators. (2) Methods: We conducted a two-phase observational study. In the first phase, we offered and then executed serum COVID-19 screening to all the convicted inmates. For those who had a doubtful or positive result, a swab was executed in the shortest time possible. In the second phase, a pharyngeal swab was offered and executed to all the police officers, the penitentiary administrative staff and the medical personnel working in the prison. (3) Results: In the first phase, we executed 485 COVID-19 blood tests on prisoners, 3 (0.61%) of which were positive. The three positive inmates underwent nasopharyngeal swabbing, which ultimately were negative. After that, we executed 276 nasopharyngeal swabs on the prison personnel, penitentiary administrative staff and medical personnel-all were negative. (4) Conclusion: All tests (blood tests and swabs) that were carried out on the prisoners and on the staff were negative for COVID-19. We believe that all prisons in Italy and in the world should take action to ensure preventive and control measures in order to safeguard the health of the prison population and of all the people who work there.


Assuntos
Infecções por Coronavirus/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Nasofaringe/virologia , Pandemias , Pneumonia Viral/diagnóstico , Prisioneiros , Gestão de Riscos/métodos , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Itália , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Prisões
7.
Curr Opin Anaesthesiol ; 33(6): 808-814, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33044235

RESUMO

PURPOSE OF REVIEW: The purpose is to show the advantages of a Bowtie diagram as a versatile tool for displaying and understanding the evolvement and management of critical incidents. RECENT FINDINGS: The Bowtie diagram has been used recently in anesthesia to depict critical incidents having been used in high-risk industries for several decades. This diagram displays the progression from latent factors to potential harm in five steps. SUMMARY: The Bowtie diagram combines the features of a fault tree and an event tree with the adverse event, known as the Top Event separating the two sections. The fault tree is similar in concept to a Swiss Cheese diagram and the event tree similar in concept to an emergency management algorithm. Preventive barriers and escalation measures are used to detect and trap abnormal states. If these fail, the event proceeds to a crisis, leading to the Top Event, a time for making decisions. A recovery state follows, which depicts an emergency state mandating immediate life or limb-saving management to recover from the crisis. Finally, in the aftermath state, a time for reflection and learning, ultimate outcomes are shown in the right-hand column. VIDEO ABSTRACT: The Bowtie Diagram. Designed and created by Yasmin Endlich, Martin D. Culwick and Stavros N. Prineas, http://links.lww.com/COAN/A68.


Assuntos
Anestesia , Anestesiologia , Medição de Risco/métodos , Gestão de Riscos/métodos , Algoritmos , Anestesia/efeitos adversos , Humanos
8.
Acta Biomed ; 91(3): ahead of print, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32921744

RESUMO

During the COVID-19 pandemic, surgical elective procedures were stopped in our plastic surgery unit. Limitations for consultations and for follow-up of previous surgical procedures were imposed in order to minimize the risk of contagion in waiting rooms and outpatient clinics. We have identified telemedicine as an alternative way to follow patients during the lockdown. Nevertheless, we have experienced different difficulties. We have not had the possibility to use a secure teleconferencing software. In our unit we had not technological devices. Surgeons in our department were not able to use remote video technology for patient management. Guidelines for an appropriate selection of patients which could be served via telemedicine had to be created. Telemedicine must be regulated by healthcare organizations for legal, ethical, medico-legal and risk management aspects. Even if we have experienced an important need to use telematic solutions during the COVID-19 lockdown, liability and risk management issues has greatly limited this possibility in our unit. The need of telemedicine in the time of COVID-19 pandemic has encouraged us to implement future virtual encounters in order to reduce unnecessary in-person visits by taking into consideration all legal, ethical and medico-legal aspects.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Gestão de Riscos/métodos , Cirurgia Plástica/organização & administração , Telemedicina/métodos , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/transmissão
9.
Artigo em Inglês | MEDLINE | ID: mdl-32932579

RESUMO

This article presents the research from the first phase of our study on blood-borne risk management, wherein we solicited epidemiologists' and healthcare practitioners' expert opinions on a blood-borne infection risk assessment in Poland. Forty-two experts were recommended by epidemiology consultants and recruited from all districts in Poland. We used the SWOT (Strengths, Weaknesses, Opportunities, Threats) method in the evaluation. Experts' opinions showed that there is room for improvement in the prevention of blood-borne infections. Commonly reported weaknesses in the risk assessment included gaps in knowledge and inappropriate procedures, which are largely caused by financial constraints and practitioners' lack of awareness of developments in their trade. Strengths included legal regulations for medical services and procedures, surveillance, and increasing awareness on the part of medical staff. When paired with the existing statistical data, these results provide a comprehensive view of the problem of blood-borne infections in Poland. The analysis supported the development of a strategy proposal to prevent blood-borne infections and enhance existing risk assessment procedures.


Assuntos
Controle de Infecções/organização & administração , Infecções/sangue , Saúde Pública , Gestão de Riscos/métodos , Patógenos Transmitidos pelo Sangue , Humanos , Polônia/epidemiologia , Pesquisa Qualitativa
12.
BMJ Open ; 10(9): e041370, 2020 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-32988953

RESUMO

OBJECTIVES: To use Population Health Management (PHM) methods to identify and characterise individuals at high-risk of severe COVID-19 for which shielding is required, for the purposes of managing ongoing health needs and mitigating potential shielding-induced harm. DESIGN: Individuals at 'high risk' of COVID-19 were identified using the published national 'Shielded Patient List' criteria. Individual-level information, including current chronic conditions, historical healthcare utilisation and demographic and socioeconomic status, was used for descriptive analyses of this group using PHM methods. Segmentation used k-prototypes cluster analysis. SETTING: A major healthcare system in the South West of England, for which linked primary, secondary, community and mental health data are available in a system-wide dataset. The study was performed at a time considered to be relatively early in the COVID-19 pandemic in the UK. PARTICIPANTS: 1 013 940 individuals from 78 contributing general practices. RESULTS: Compared with the groups considered at 'low' and 'moderate' risk (ie, eligible for the annual influenza vaccination), individuals at high risk were older (median age: 68 years (IQR: 55-77 years), cf 30 years (18-44 years) and 63 years (38-73 years), respectively), with more primary care/community contacts in the previous year (median contacts: 5 (2-10), cf 0 (0-2) and 2 (0-5)) and had a higher burden of comorbidity (median Charlson Score: 4 (3-6), cf 0 (0-0) and 2 (1-4)). Geospatial analyses revealed that 3.3% of rural and semi-rural residents were in the high-risk group compared with 2.91% of urban and inner-city residents (p<0.001). Segmentation uncovered six distinct clusters comprising the high-risk population, with key differentiation based on age and the presence of cancer, respiratory, and mental health conditions. CONCLUSIONS: PHM methods are useful in characterising the needs of individuals requiring shielding. Segmentation of the high-risk population identified groups with distinct characteristics that may benefit from a more tailored response from health and care providers and policy-makers.


Assuntos
Infecções por Coronavirus , Sistemas de Informação em Saúde/estatística & dados numéricos , Pandemias , Pneumonia Viral , Gestão da Saúde da População , Medição de Risco/métodos , Gestão de Riscos , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Demografia , Inglaterra/epidemiologia , Feminino , Medicina Geral/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Fatores de Risco , Gestão de Riscos/métodos , Gestão de Riscos/organização & administração , Índice de Gravidade de Doença
13.
PLoS One ; 15(9): e0238739, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32898183

RESUMO

Measuring the performance of information security is an essential part of the information security management system within organisations. Studies in the past mainly focused on establishing qualitative measurement approaches. Since these can lead to ambiguous conclusions, quantitative metrics are being increasingly proposed as a useful alternative. Nevertheless, the literature on quantitative approaches remains scarce. Thus, studies on the evaluation of information security performance are challenging, especially since many approaches are not tested in organisational settings. The paper aims to validate the model used for evaluating the performance of information security management system through a multidimensional socio-technical approach, in a real-world settings among medium-sized enterprises in Slovenia. The results indicate that information security is strategically defined and compliant, however, measures are primarily implemented at technical and operational levels, while its strategic management remains underdeveloped. We found that the biggest issues are related to information resources and risk management, where information security measurement-related activities proved to be particularly problematic. Even though enterprises do possess certain information security capabilities and are aware of the importance of information security, their current practices make it difficult for them to keep up with the fast-paced technological and security trends.


Assuntos
Segurança Computacional , Gestão de Riscos/métodos , Modelos Teóricos
14.
Arch. prev. riesgos labor. (Ed. impr.) ; 23(3): 343-356, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194120

RESUMO

OBJETIVO: Evaluar diferencias entre la detección de incidentes o eventos adversos (I/EA) en una mutua laboral, mediante una herramienta tipo Trigger Tool (TT) y una plataforma de notificación voluntaria (SNEA). MÉTODOS: La población de estudio es la población trabajadora atendida ambulatoriamente en una mutua laboral de Enero a Septiembre del 2016. Se seleccionaron los casos declarados como I/EA según si el evento no ha afectado al paciente o por el contrario le ha afectado, a través del SNEA (n = 21 casos). Por otro lado, se seleccionaron aleatoriamente 20 historias clínicas por mes donde se aplicó la herramienta TT (180 casos). Se adaptaron 11 triggers para detectar I/EA. Se revisaron las 201 historias clínicas buscando la existencia de triggers. Se obtuvo la concordancia entre el sistema SNEA y el TT utilizando la proporción de concordancia positiva (I/EA), proporción de concordancia negativa (no I/EA) e índice Kappa. RESULTADOS: TT detectó casos de I/EA en el 41,3% de las revisiones mientras que el SNEA 10,3% (p < 0,001). El índice Kappa ofreció un valor de concordancia baja (Kappa = 0,12) lo que denota la pequeña coincidencia de sucesos adversos detectados por ambos sistemas. La proporción de concordancia negativa fue mayor que la de concordancia positiva (74,5% frente a un 26,9%). El sistema SNEA detectó menos I/EA y sobre todo se trata de menos incidentes. Por el contrario, el sistema TT detectó mayor número de I/EA y especialmente EA. CONCLUSIONES: Trigger Tool es una herramienta recomendable para la detección de incidentes


OBJECTIVE: To evaluate differences between the detection of incidents or adverse events (I/AE) using a Trigger Tool (TT) and voluntary notification platform (SNEA). METHODS: The study population is the working population attended on an outpatient basis in an Insurance Company ("mutua") from January to September 2016. The cases declared as Incident or Adverse Event (I / AE) were selected through the SNEA (21 cases), according to whether the event has not affected the patient or on the contrary has affected him. On the other hand, 20 clinical histories per month were randomly selected where the TT was applied (180 cases). The 201 clinical histories were reviewed looking for the existence of triggers. The agreement between the SNEA system and the TT was evaluated using proportion of positive agreement (I/EA), proportion of negative agreement (not I/EA) and Kappa index. RESULTS: TT detected I/EA cases in 41.3% of the revisions while the SNEA was 10.3% (p < 0.001). The Kappa index showed a low concordance value (Kappa = 0.12), which indicates the small coincidence of I/EA detected by both systems. The proportion of negative agreement was greater than that of positive agreement (74.5% versus 26.9%). The SNEA system detected less I/ EA and above all it deals with fewer incidents. On the contrary, the TT system detected a greater number of I EA and especially EA


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Gestão de Riscos/métodos , Gestão da Segurança/métodos , Gestão da Segurança/estatística & dados numéricos , Estudos Transversais
15.
Niger Postgrad Med J ; 27(3): 202-208, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687120

RESUMO

Background: Globally, safety of patients in healthcare environment has been an issue of the decade, especially in resource-constrained settings. The Hippocratic maxim primum non nocere requires medical practitioners to give utmost importance to the principle of beneficence and safety in attending to patients. It is a current paradigm in quality of care metrics that determines what happens to patients who interface with the healthcare system. Aim: The study was aimed at describing the experience, drivers, barriers and preventive measures for patient safety incidents and accidents in a cross-section of medical practitioners in Abia State, Southeast Nigeria. Participants and Methods: This was a cross-sectional study carried out on 185 physicians in Southeast Nigeria. Data collection was done using a pre-tested, self-administered questionnaire that elicited information on experience, drivers, barriers and preventive measures for patient safety incidents. Results: The mean age ± standard deviation of the respondents was 36 ± 5.6 years, with a range of 25-72 years. There were 163 (88.1%) males and 22 (11.9%) females. Lifetime and previous 1-year committal of patient safety incidents were 100% (185/185) and 61.0% (113/185), respectively, with the most committed safety incident being medication errors. The most common driver of patient safety incidents was physician stress and burnout (100%) (185/185), whereas the most common barrier was communication (100%) (185/185). The most common preventive measure was patient safety incident reporting system (100%) (185/185). One-year committal of patient safety incidents was associated with duration of practice <10 years (P = 0.00001) and sex (P = 0.011). Conclusion: Patient safety incidents occurred amongst the study participants, with the most committed safety incident being medication errors. The most common driver was physician stress and burnout. The most common barrier was communication and feedback barrier, whereas the most common preventive measure was patient safety incident reporting system. Patient safety information, education and training should be the target for continuing professional development in order to safeguard the health of the patients in healthcare environment.


Assuntos
Infecção Hospitalar/prevenção & controle , Segurança do Paciente , Médicos/psicologia , Gestão de Riscos/métodos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Relações Médico-Paciente , Gestão da Segurança
17.
Oncology (Williston Park) ; 34(5): 156-162, 2020 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-32644174

RESUMO

The coronavirus disease 2019 pandemic has rapidly placed tremendous stress on health systems around the world. In response, multiple health systems have postponed elective surgeries in order to conserve hospital beds and personal protective equipment, minimize patient traffic, and prevent unnecessary utilization and exposure of healthcare workers. The American College of Surgeons released the following statement on March 13, 2020: "Each hospital, health system and surgeon should thoughtfully review all scheduled elective procedures with a plan to minimize, postpone, or cancel electively scheduled operations, endoscopes, or other invasive procedures until we have passed the predicted inflection point in the exposure graph and can be confident that our health care infrastructure can support a potentially rapid and overwhelming uptick in critical patient care needs." In our state, North Carolina, Governor Roy Cooper requested that all hospitals postpone elective and non-urgent procedures and surgeries effective March 23, 2020.


Assuntos
Infecções por Coronavirus , Procedimentos Cirúrgicos Eletivos/métodos , Excisão de Linfonodo/métodos , Serviço Hospitalar de Oncologia , Pandemias , Pneumonia Viral , Prostatectomia/métodos , Neoplasias da Próstata , Risco Ajustado/métodos , Gestão de Riscos , Betacoronavirus , Gestão de Mudança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , North Carolina , Serviço Hospitalar de Oncologia/organização & administração , Serviço Hospitalar de Oncologia/tendências , Pandemias/prevenção & controle , Seleção de Pacientes , Assistência Centrada no Paciente/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Gestão de Riscos/métodos , Gestão de Riscos/tendências
19.
PLoS One ; 15(7): e0235980, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32678855

RESUMO

This study establishes a model of prefabricated building project risk management system based on the Modified Teaching-Learning-Based-Optimization (MTLBO) algorithm and a prediction model of deep learning multilayer feedforward neural network (Backpropagation, BP neural network) to improve the requirements of risk management during the construction of large prefabricated building projects. First, we introduced the BP neural network algorithm based on deep learning. Second, the traditional Teaching-Learning-Based Optimization (TLBO) algorithm was modified by using information entropy, and the modified algorithm was simulated and tested in five test functions. Then, based on the BP neural network and MTLBO algorithm, we established the MTLBO-BP neural network prediction model and tested its performance. Finally, based on the MTLBO-BP neural network prediction model, MATLAB software was used to establish an intelligent model of the risk management system during the construction of prefabricated building projects, and the example verification was performed. In addition, the MTLBO algorithm was verified by test function simulation and established that global searchability is stronger than the TLBO algorithm. Of note, it is not easy to fall into a local optimum. The test results of the MTLBO-BP neural network prediction model revealed that the prediction model converges faster and exerts a better prediction effect. The example verification of the intelligent model of the risk management system during the construction of prefabricated building projects established in this study revealed that the algorithm proposed is more accurate in the reliability and cost prediction of the risk management of prefabricated building projects. Moreover, the algorithm proposed provides theoretical support for intelligent management and decision-making of prefabricated building projects. Overall, this study validates that this algorithm is essential for construction project management, decision-making, and quality assurance.


Assuntos
Tomada de Decisões , Aprendizado Profundo , Gestão de Riscos/métodos , Arquitetura de Instituições de Saúde , Segurança
20.
Guatemala; MSPAS; 26 jul 2020. 11 p.
Monografia em Espanhol | LILACS, LIGCSA | ID: biblio-1150751

RESUMO

Aborda, desde los conceptos básicos sobre gestión de riesgo, pasando por los tipos del mismo, así como proponer métodos sencillos de análisis de riesgo de contagios de COVID-19. Especialmente enfocados para las instalaciones de empresas e instituciones, a manera de orientar y prevenir el bienestar del personal que trabaja en las mismas. Busca sobre todo, identificar y analizar participativamente las amenazas y la vulnerabilidad de la población frente al virus Sars-CoV-2.


Assuntos
Humanos , Masculino , Feminino , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Gestão de Riscos/métodos , Probabilidade , Fatores de Risco , Indicadores Básicos de Saúde , Gestão da Segurança/estatística & dados numéricos , Infecções por Coronavirus/mortalidade , Guatemala
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