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    Aplicación de una herramienta digital para la gestión de documentación por entidades ofertantes en una institución prestadora de servicios de salud

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    This project arises from the need to create a tool that facilitates the document collection processes through a digital application, taking into account different factors such as easy interactivity, alignment with institutional colors, and information storage.Este proyecto surge de la necesidad de crear una herramienta que facilite los procesos de recolección de documentos a través de un aplicativo digital, teniendo en cuenta diferentes factores como la fácil interactividad, el acople con los colores institucionales y el almacenamiento de información.PregradoIngeniero(a) Biomédico(a
    Repositorio de Escuela Colombiana de Ingeniería Julio Garavito

    The fellowship of St.Diogo : new Christian judaisers in Coimbra in the early 17th century

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    Dr Antonio Homem was a respected teacher in the University of Coimbra, a Canon in the Cathedral and an illustrious scholar. He was also the heir of a long Jewish family tradition. His great-great-grand father lived and died as a Jew. His great-grandfather, his grandmother and two of his uncles were among his relatives to have been sentenced as judaisers by the Inquisition. His own father kept the Law of Moses, and taught it to all his children, without the knowledge of his wife, an Old Christian of noble lineage. His concern for the situation of the New Christians in Portugal eventually made him build up a congregation of judaisers, which he called the Fellowship of St Diogo as a tribute to a Capuchin friar who had been executed a few years earlier as an apostate and defender of the Jewish Law. His congregation grew to include over sixty people, including clerics, physicians, lawyers and students, as well as merchants and farmers. Its leader gave it a corpus of doctrine and eventually a distinctive liturgy, which showed influence from the Catholic Church. The Fellowship also inspired the creation of judaiser conventicles in three major Monasteries in the Coimbra district, where a relatively large number of nuns held cult meetings and paid homage to Friar Diogo as a martyr of the Law of Moses. After several years of activity, the Fellowship was investigated and dismantled by the Inquisition. Most of its members were arrested and sentenced. Dr AntOnio Homem was himself taken into custody, charged with heresy and apostasy, as well as sodomy (he was a known paederast), and finally handed over to the secular arm for execution. His dream of building up a judaiser community in Coimbra was shattered. The Fellowship members who survived either left the country and joined the orthodox Jewish communities in the Netherlands and elsewhere, or stayed in Portugal and gradually lost their Jewish consciousness. Descendants of some of them can still be found near Coimbra
    White Rose E-theses Online
    OpenGrey Repository

    Editorial

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    Dear readers.   It is with joy we present to you the second edition of the Brazilian Business Review in 2016. After two months as the journal´s editor in chief I have much to thank our partners, especially those who occupy positions as co-editors, associate editors, editors and editorial assistant, for the immense support they have dispensed to the journal. A quality scientific publication is achieved from the commitment and skills of a dedicated group and I´m glad to know I´m surrounded by people with such profile. As a way of recognizing the efforts of our reviewers, partners who rarely appear in the process given the anonymous nature of their contributions, I would like list at the end of this editorial all those who contributed over 2015 expressing their views for articles submitted to the Brazilian Business Review. Thank you!   In 2016, the work is well underway. I announce that in the coming weeks we will post a call for papers for a special session on corruption, to be published in the latest edition of 2016. I invite you all to disclose this call, which will be formalized in the coming days on the journal´s website.   This edition begins with the study by Victor Bello Accioly and Beatriz Vaz de Melo Mendes, investigating whether the inclusion of the realized range as a regressor in the (E)GARCH volatility equation would add information to the process improving out-of-sample forecasts performance and providing more accurate estimates of the volatility persistence.  The results showed that for both the GARCH and EGARCH models there are always some realized range type at some frequencies bringing information to the volatility process with considerable persistency reduction.   Then, Pedro Domingos Antoniolli proposes an information technology framework for demand management within a dyad on the supply chain pharmaceutical industry. The structure proposed by the author is composed by three elements: a) One specific for infrastructure, to enable data and systems interoperability among SC participants, considering a virtualized infrastructure environment (Cloud); b) An information system solution to integrate partners’ applications, based on the reference component model structure; and c) an element responsible for logistics operations.   In turn, Edelcio Koitiro Nisiyama, José Carlos Tiomatsu Oyadomari, Chen Yen-Tsang and Andson Braga de Aguiar, analyzed the relationship between the use of management control systems (MCSs) and Operations Management techniques (OM) and performance in a study conducted in the context of the auto parts industry. The results allowed the authors to suggest that the implementation of operational management techniques, when performed only in order to obtain quality certification, can induce companies to focus only on the minimum requirements for certification without effective acculturation and use of management techniques. Thus, the article emphasizes the importance of giving greater meaning to such implementation.   In this issue’s fourth article, Jurandir Peinado and Alexandre Reis Graeml present a study where they seek to capture the importance attributed to the themes pertaining to Operations Management by researchers, teachers and practitioners, in order to group the core themes of the area. The study led to the empirical identification of nine thematic categories through factor analysis, providing in special researchers in this field an overview regarding the topics who those involved perceive as relevant and how they think that the themes relate to each other.    The following article, by Janette Brunstein, Silvia Bertossi Heidrich and Araujo Amaro Rubens offer us with a phenomenographic study aimed to map variations in the views of a group of managers on the meaning of Fair Play (FP) in order to identify the skills associated to them. In general, the authors point to three conceptions of Fair Play: as a rule, as transparency and as righteousness. The skills of managers represent the materialization of these conceptions. The study reinforces the idea that learning about the differences in conceptions can be an alternative to conducting more assertive practices for the development of Fair Play skills.    The study that closes this edition,  whose authorship is by Moema Pereira Nunes, sought to identify the  motivations behind the adoption of global sourcing (GS), and the results that companies from emerging countries are reaching as a result of its implementation. The main motivations that were found were, faster access to new technologies and the rise of global markets. A new finding for the literature was the verification that the opportunity to offer diversified products, using distribution channels already developed by companies, motivates the adoption of the GS. The main results that were associated to the GS refer to innovation and reducing the time required to develop products and reach markets. I wish you all a good read!   Bruno Felix von Borell de Araujo Editor-in-Chief   Brazilian Business Review   Listing of reiviewers in 2015   Alexandre de Padua Carrieri Ana Carolina Simões Braga Ana Cristina de Faria Ana Elizabeth Moiseichyk Ana Maria Roux Valentini Coelho Cesar Anderson Luiz Rezende Mól Anderson Soncini Pelissari André Torres Urdan Andrei Simonassi Andres Rodriguez Veloso Angilberto Freitas Antonio Carlos Dias Coelho Antonio Carlos Giuliani Arilda Teixeira Arminda do Paço Aureliano Angel Bressan Braulio Oliveira Carlos Bastian Pinto Carlos Diehl César Augusto Tiburcio Silva Christiano França da Cunha Claudio Sonaglio Albano Cristina Estevão Cristina Estevão Cristina Fernandes Daielly Melina Nassif Mantovani Ribeiro Daniel Andrade Modenesi Daniel Reed Bergmann Danilo Monte Mor Denise Salles Diana von Borell Diego de Queiroz Machado Diego Maganhotto Coraiola Dina Miragaia Diógenes de Souza Bido Edson Gonçalves Elizabeth Krauter Eurilton Araujo Evandro Luiz Lopes Fábio Frezatti Felipe Damasceno Felipe Ramos Fernando Serra Francisco Urdinez Gustavo da Rosa Borges Helena Maria Baptista Alves Helenita R. da Silva Tamashiro Hermes Moretti Ribeiro da Silva Hernan E. Contreras Alday Ilse Maria Beuren Jairo Simião Dornelas Jorge Luiz de Biazzi José Alberto Carvalho dos Santos Claro José Alves Dantas José Ricardo Scareli Carrijo José Ricardo Scareli Carrijo Kenny Basso Lélis Balestrin Espartel Letícia Dias Fantinel Lucia Barbosa de Oliveira Luciano Venelli Costa Luís Manuel do Carmo Farinha Manuel Portugal Ferreira Marcelo Alvaro da Silva Macedo Marcelo Cabus Klotzle Marcelo Moll Brandão Marcelo Sanches Pagliarussi Marcia Juliana d´Angelo Márcia Zabdiele Márcio Telles Portal Marco Antonio Figueiredo Milani Filho Maria Jose Carvalho de Souza Domingues Mario Henrique Ogasavara Marta Pelucio Milton Farias Moacir Sancovschi Murilo Alvarenga Oliveira Nadia Kassouf Pizzinatto Orleans Silva Martins Paula Maines da Silva Paula Odete Pedro Henrique de Barros Renata Aquino Ribeiro Renato Zancan Marchetti Ricardo Ratner Rochman Rogério Santos da Costa Rossana Filetti Soranz Salomao Farias Sarah Lasso Sérgio A. P. Bastos Sheila Regina de Almeida Sieglinde Kindl da Cunha Simone Vasconcelos Ribeiro Galina Thel Augusto Monteiro Vanessa de Oliveira Menezes Vanessa Ratten Vanessa Ratten Wesley Mendes-Da-Silva Wilson Toshiro Nakamura Yara CintraPrezados leitores.   É com alegria que apresentamos a segunda edição da Brazilian Business Review de 2016. Após dois meses como editor-chefe da revista tenho muito a agradecer aos nossos parceiros, especialmente, aos que ocupam as posições de co-editor, editores associados, revisores e assistente editorial, pelo imenso apoio que têm dispensado a esta revista. Uma publicação científica de qualidade é feita a partir do comprometimento e competência de um grupo dedicado e fico feliz por saber que estou cercado por pessoas com esse perfil. Como forma de reconhecer o esforço dos revisores, parceiros que pouco aparecem no processo dado o caráter anônimo de suas contribuições, gostaria de listar ao fim deste editorial todos os que colaboraram ao longo do ano de 2015 realizando pareceres para os artigos submetidos à Brazilian Business Review. Muito obrigado!   Em 2016, o trabalho segue a todo vapor. Anuncio que nas próximas semanas divulgaremos uma chamada de artigos para uma sessão especial sobre corrupção, com publicação prevista para a última edição de 2016. Convido todos a divulgarem essa chamada, que nos próximos dias será formalizada no site da revista.   Esta edição se inicia com o estudo de Victor Bello Accioly e Beatriz Vaz de Melo Mendes, que investiga se a inclusão do realized range como regressor na equação da volatilidade (E)GARCH adiciona informação ao processo, melhorando a performance das previsões e fornecendo estimativas mais precisas sobre a persistência da volatilidade. Os resultados mostraram que sempre há, para ambos os modelos testados (GARCH e EGARCH), alguma forma de realized range que, em diferentes frequências, melhor explica o processo da volatilidade gerando uma redução considerável da persistência.   Na sequência, Pedro Domingos Antoniolli propõe uma estrutura de tecnologia da informação para gestão da demanda em uma díade no gerenciamento de suprimentos no segmento farmacêutico. A estrutura proposta pelo autor é composta de três elementos: a) um que permite a interoperabilidade de sistemas e dados entre os participantes da CS, considerando-se um ambiente de infraestrutura virtualizada (nuvem); b) uma solução de sistema de informação para integrar aplicativos de parceiros, com base na estrutura de modelo de componente de referência; e c) um elemento responsável pelas operações de logística.   Por sua vez, Edelcio Koitiro Nisiyama, José Carlos Tiomatsu Oyadomari, Chen Yen-Tsang e Andson Braga de Aguiar analisaram as relações entre o uso de Sistemas de Controle Gerencial (SCG) e Técnicas de Gestão Operacional (GO) e desempenho em um estudo realizado no contexto da Indústria de Componentes para Veículos Automotores. Os resultados permitiram aos autores sugerir que a implementação de técnicas de gestão operacional, quando realizada somente com o fim de obter a certificação de qualidade, pode induzir as empresas a focar apenas nos requisitos mínimos para certificação, sem a aculturação eficaz e da utilização das técnicas de gestão. Assim, o artigo ressalta a importância de conferir maior sentido a tal implementação.   No quarto artigo desta edição, Jurandir Peinado e Alexandre Reis Graeml apresentam um estudo em que buscam capturar a importância atribuída à temática de Gestão de Operações por pesquisadores, professores e praticantes, de forma a agrupar os temas centrais da área. O estudo levou à identificação empírica de nove categorias temáticas por meio de uma análise fatorial, fornecendo especialmente a pesquisadores desse campo um panorama a respeito dos tópicos que os envolvidos percebem como relevante e como estes pensam que as temáticas se relacionam entre si.    Na sequência, Janette Brunstein, Silvia Bertossi Heidrich e Rubens de Araújo Amaro nos brindam com um estudo fenomenográfico que objetivou mapear as variações nas concepções de um grupo de gestores sobre o significado do Fair Play (FP), a fim de identificar as competências a elas associadas. De forma geral, os autores apontam três concepções a respeito do Fair Play: como regra, como transparência e como justiça. As competências dos gestores representam a materialização dessas concepções.  O estudo reforça a ideia de que aprender sobre as diferenças de concepções pode ser uma alternativa para a realização de práticas mais assertivas para o desenvolvimento de competências de Fair Play.   O estudo que fecha esta edição, de autoria de Moema Pereira Nunes, buscou identificar as motivações por trás da adoção do global sourcing (GS), e os resultados que as empresas de países emergentes estão alcançando em razão de sua implementação. As principais motivações encontradas foram o acesso mais rápido às novas tecnologias e a ascensão dos mercados globais. Um achado novo para a literatura foi a verificação de que a oportunidade de oferecer produtos diversificados, utilizando os canais de distribuição já desenvolvidos pelas empresas, motiva a adoção do GS. Os principais resultados encontrados que se mostraram associados ao GS referem-se à inovação e à redução do tempo necessário para desenvolver produtos e atingir mercados.   Uma boa leitura a todos!   Bruno Felix von Borell de Araujo Editor-Chefe Brazilian Business Review     Lista de Avaliadores em 2015   Alexandre de Padua Carrieri Ana Carolina Simões Braga Ana Cristina de Faria Ana Elizabeth Moiseichyk Ana Maria Roux Valentini Coelho Cesar Anderson Luiz Rezende Mól Anderson Soncini Pelissari André Torres Urdan Andrei Simonassi Andres Rodriguez Veloso Angilberto Freitas Antonio Carlos Dias Coelho Antonio Carlos Giuliani Arilda Teixeira Arminda do Paço Aureliano Angel Bressan Braulio Oliveira Carlos Bastian Pinto Carlos Diehl César Augusto Tiburcio Silva Christiano França da Cunha Claudio Sonaglio Albano Cristina Estevão Cristina Estevão Cristina Fernandes Daielly Melina Nassif Mantovani Ribeiro Daniel Andrade Modenesi Daniel Reed Bergmann Danilo Monte Mor Denise Salles Diana von Borell Diego de Queiroz Machado Diego Maganhotto Coraiola Dina Miragaia Diógenes de Souza Bido Edson Gonçalves Elizabeth Krauter Eurilton Araujo Evandro Luiz Lopes Fábio Frezatti Felipe Damasceno Felipe Ramos Fernando Serra Francisco Urdinez Gustavo da Rosa Borges Helena Maria Baptista Alves Helenita R. da Silva Tamashiro Hermes Moretti Ribeiro da Silva Hernan E. Contreras Alday Ilse Maria Beuren Jairo Simião Dornelas Jorge Luiz de Biazzi José Alberto Carvalho dos Santos Claro José Alves Dantas José Ricardo Scareli Carrijo José Ricardo Scareli Carrijo Kenny Basso Lélis Balestrin Espartel Letícia Dias Fantinel Lucia Barbosa de Oliveira Luciano Venelli Costa Luís Manuel do Carmo Farinha Manuel Portugal Ferreira Marcelo Alvaro da Silva Macedo Marcelo Cabus Klotzle Marcelo Moll Brandão Marcelo Sanches Pagliarussi Marcia Juliana d''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''Angelo Márcia Zabdiele Márcio Telles Portal Marco Antonio Figueiredo Milani Filho Maria Jose Carvalho de Souza Domingues Mario Henrique Ogasavara Marta Pelucio Milton Farias Moacir Sancovschi Murilo Alvarenga Oliveira Nadia Kassouf Pizzinatto Orleans Silva Martins Paula Maines da Silva Paula Odete Pedro Henrique de Barros Renata Aquino Ribeiro Renato Zancan Marchetti Ricardo Ratner Rochman Rogério Santos da Costa Rossana Filetti Soranz Salomao Farias Sarah Lasso Sérgio A. P. Bastos Sheila Regina de Almeida Sieglinde Kindl da Cunha Simone Vasconcelos Ribeiro Galina Thel Augusto Monteiro Vanessa de Oliveira Menezes Vanessa Ratten Vanessa Ratten Wesley Mendes-Da-Silva Wilson Toshiro Nakamura Yara Cintr
    BBR - Brazilian Business Review

    Helena Kolody, carbono & diamante: uma biografia ilustrada

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    Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão. Programa de Pós-Graduação em LiteraturaHelena Kolody, carbono & diamante - uma biografia ilustrada conta a vida da escritora Helena Kolody, a partir de sua inscrição na literatura, questionando sua identidade, o mundo que a cercava e o sentido de sua existência. Equivale a dizer: em sua lírica, reflexões e sentimentos se entretecem a partir de uma matéria pessoal e localizada. Da estação ferroviária à estação tubo; da Ucrânia ao centro de Curitiba; de Paisagem interior a Reika; do século XIX ao século XXI, a literatura de Helena Kolody gerencia sua presença na consolidação do binômio arte-vida. O retrato da autora acaba se constituindo também por meio de farto aparato iconográfico; pelos mais de quinhentos textos críticos elencados e por sua obra completa. Fragmentação deliberadamente assumida, a pessoa se revela em sua inteireza.Helena Kolody, carbon & diamond - an illustrated biography tells the life of Helena Kolody, from her very insertion in literature, as it questions her identity, the world surrounding her, and the meaning of her existence. That is equivalent to saying that in her poetry there is the intermingling of reflections and feelings that derive from personal and localized material. From the railroad station to the tube-shaped bus stops; from Ukraine to downtown Curitiba; from Paisagem interior to Reika; from the nineteenth century to the twenty-first century, Helena Kolody's literature guarantees her presence in the consolidation of the art/life binomial. The portrait of the author ends up by also being made up of an abundant iconographic apparatus, of the over five hundred critical texts listed, and of her complete work. The person, although deliberately accepting her own fragmentation, reveals herself in her entireness
    Repositório Institucional da UFSC

    Gender differences in the family law courts of the city of Buenos Aires: a view from within

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    Durham e-Theses
    OpenGrey Repository

    Calidad de vida y acceso inequitativo al espacio público en Bogotá

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    La inequidad en la distribución de los espacios públicos tiene repercusiones sobre las posibilidades de integración de los grupos sociales coexistentes en el territorio. A partir de esta idea, el artículo explora la relación entre la distribución territorial de la población según su estatus socioeconómico y la accesibilidad al espacio público en Bogotá. Para ello, anteriormente se construyó un indicador de calidad de vida en la escala micro y un indicador de accesibilidad de espacio público que produjo como resultado la cantidad de metros cuadrados a los que accedería una persona desde su vivienda en un recorrido peatonal corto. Se realizó una regresión geográficamente ponderada entre los dos indicadores y se obtuvo como resultado una fuerte relación entre las altas condiciones de vida y la mayor accesibilidad al espacio público, lo cual puso de manifiesto condiciones estructurales de segregación social.La manca d'equitat en la distribució dels espais públics repercuteix de manera important en les possibilitats que tenen d'integrar-s'hi els diferents grups socials que hi coexisteixen. A partir d'aquesta idea, l'article pretén explorar les relacions que hi ha entre la distribució territorial de la població segons el seu estatus socioeconòmic i l'accessibilitat al seu entorn. Per això abans es va crear un indicador de qualitat de vida a escala micro i un indicador d'accessibilitat d'espai públic que va generar com a resultat la quantitat de metres quadrats als quals podia accedir una persona des del seu habitatge en un recorregut curt a peu. Per relacionar aquestes dues variables es va realitzar una regressió geogràficament ponderada. Com a resultat es va obtenir una forta relació entre els alts nivells de qualitat de vida i una accessibilitat més gran a l'espai públic, la qual cosa va manifestar condicions estructurals de segregació social.L'inégalité dans la répartition des espaces publics a un impact sur les possibilités d'intégration des groupes sociaux sur le territoire. À partir de cette idée, l'article explore la relation entre la répartition spatiale de la population selon le statut socio-économique et l'accès à l'espace public à Bogotá. À cette fin, on a élaboré un indicateur de la qualité de vie à l'échelle micro ainsi qu'un indicateur d'accessibilité de l'espace public qui se traduit par la quantité de mètres carrés à laquelle aurait accès une personne depuis son domicile pour un court trajet à pied. Une régression pondérée géographiquement entre ces deux indicateurs a été réalisée, permettant de mettre en évidence une forte relation entre le niveau de vie élevé et une plus grande accessibilité à l'espace public, ce qui montre les conditions structurelles de la ségrégation sociale.Inequity in public space distribution has important repercussions on integration opportunities for different social groups coexisting within the territory. Based on this idea, this paper aims to explore the relationship between population territorial distribution according to socioeconomic status and public space accessibility in Bogota, Colombia. To this end, a quality of life indicator was constructed at micro-level scale. In regards to the public space indicator, a matrix between origins and destinations was generated, which produced the amount of square meters of public space a person would access by a short walk from their dwelling. To relate both variables, a geographically weighted regression was performed. A strong relationship was found between the highest levels of quality of life and greater accessibility to public space. This finding reveals the existence of structural conditions which foment social segregation
    Crossref
    Portal de revistas electrónicas de la Universidad Católica de Colombia
    Directory of Open Access Journals
    Redalyc
    Repositorio Institucional Universidad Católica de Colombia
    Diposit Digital de Documents de la UAB
    DIALNET

    Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

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    Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection
    Archivio della ricerca - Università degli studi di Napoli Federico II
    AIR Universita degli studi di Milano
    ARUd’A (Università “G. d’Annunzio CHIETI -PESCARA)

    Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

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    Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology
    Archivio della Ricerca - Università di Pisa

    Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

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    Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures
    Archivio della Ricerca - Università di Pisa

    International Impact of COVID-19 on the Diagnosis of Heart Disease

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    Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted
    AIR Universita degli studi di Milano
    Archivio della Ricerca - Università di Pisa
    IRIS Università Politecnica delle Marche
    ARUd’A (Università “G. d’Annunzio CHIETI -PESCARA)
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