A pandemia da COVID-19 pelas lentes da logística humanitária / The COVID-19 pandemic through the lens of humanitarian logistics

Resumo O objetivo do estudo é identificar na literatura a relação entre a logística humanitária e a evolução da pandemia de COVID-19. Trata-se de uma revisão integrativa de literatura (RIL), com busca nas bases de dados SCOPUS, MEDLINE e ENEGEP, de abril e maio de 2022. Um total de 61 artigos foram avaliados conforme os critérios estabelecidos: artigo original ou de revisão de literatura publicado em revista científica; resumo e texto completo disponível; artigo com objeto de investigação sobre a logística humanitária em relação à pandemia de COVID-19. Foram selecionadas 11 publicações, organizadas e analisadas por meio de matriz de síntese. Das publicações, 72% foram em periódicos internacionais, e majoritariamente no ano de 2021 (56%). A presença da cadeia de suprimentos tem determinado a dinâmica de setores econômicos e sociais, estabelecendo, por meio de um olhar interdisciplinar, as operações humanitárias frente à pandemia de COVID-19. Constatou-se escassez de estudos que analisam a logística humanitária com o intuito de amenizar os impactos causados por esses desastres, tanto no contexto da atual pandemia como em eventos futuros da mesma natureza. Contudo, o caráter mundialmente emergencial sugere a necessidade de fortalecer o conhecimento científico acerca da temática da logística humanitária relacionada a eventos de desastres.

Abstract An integrative literature review (ILR) was conducted to identify the relationship between humanitarian logistics and the development of the COVID-19 pandemic based on research in the SCOPUS, MEDLINE and ENEGEP databases in April and May 2022. In all, 61 articles were evaluated according to the following criteria: original article or review of literature published in a scientific journal; abstract and full text available; article on humanitarian logistics in relation to the COVID-19 pandemic. The resulting sample comprised eleven publications organized and analyzed through a synthesis matrix, where 72% were published in international journals and mostly in 2021 (56%). The presence of the supply chain defines the course of action of economic and social sectors, which in turn determine, by means of an interdisciplinary approach, humanitarian operations in the face of the COVID-19 pandemic. The lack of studies narrows down humanitarian logistics to mitigate the impacts caused by these disasters, both in the context of the current pandemic and in future events of the same nature. However, as a global emergency, it suggests the need to increase scientific knowledge on the subject of humanitarian logistics related to disaster events.

Risk prediction of low birth weight infants in Shanghai / 上海预防医学

ObjectiveTo investigate the risk factors of fertility behaviors with preterm birth and low birth weight， and to develop a nomogram model to predict the occurrence of low birth weight. MethodsBirth registration information in Shanghai from 2010 to 2020 was collected， and ANOVA and Chi-square tests were used to compare the differences in reproductive behavior factors and newborn health status across time. The odds ratio （OR） value and 95%CI were calculated by a multi-classification logistic regression model to determine the association between reproductive behavior factors and preterm birth or low birth weight infants. A nomogram model was established based on logistic model and the area under the ROC curve was used to assess the effect of the model. ResultsThis analysis included 2 089 384 live newborns. The incidence of full-term low birth weight， preterm normal weight and preterm low birth weight in Shanghai was 0.94%， 2.48% and 2.01%， respectively. From 2010 to 2020， 40.00% women had a history of abortion， the proportion of women who gave birth at age ≥40 years old increased from 1.05% to 2.24%， the proportion of fathers aged ≥40 years increased from 4.79% to 7.48%， and the proportion of women with postgraduate or above increased from 4.81% to 11.74%. The incidence of preterm low birth weight in Shanghai showed an increasing trend over time. Logistic regression analysis showed that the risk of preterm low birth weight was lower in female than in male infants （OR=0.97， 95%CI： 0.95‒0.98）， and the risk of full-term low birth weight was higher than in male infants （OR=1.85， 95%CI： 1.80‒1.90）. The risk of preterm birth and low birth weight was lower for couples of childbearing age with higher education. The risk of preterm low birth weight in newborns tended to increase with maternal age at childbirth >30 years， paternal age ≥40 years， and the number of abortions >2 times. Mother <25 or >35 years， father aged 30‒34 years， and the number of abortions >3 times were the risk factors of full-term low birth weight infants. ConclusionCouples of childbearing age who choose to have children at too high or too low age may increase the risk of preterm birth or low birth weight， so it is necessary to strengthen population awareness and promote age-appropriate childbirth. Multiple abortions are also associated with preterm birth and low birth weight， and it is advisable to popularize the scientific knowledge of contraception and birth control to reduce unnecessary abortions. The nomogram in the study can visualize the risk of full-term and low birth weight infant at different levels of factors， which can assist couples preparing for pregnancy in making decisions about the timing of childbirth and understanding the level of risk.

Risk factors for unplanned readmission in patients with acute myocardial infarction in Plateau Area / 公共卫生与预防医学

Objective To explore the risk factors of unplanned readmission in patients with acute myocardial infarction in plateau area. Methods The convenience sampling method was used to select 220 patients with acute myocardial infarction in the hospital's internal medicine department from January 2020 to May 2021. The patients were divided into two groups according to whether they had unplanned readmission within one year, 79 patients were included in readmission group, and 141 patients without unplanned readmission were included in non-readmission group. Clinical data of the 220 patients with acute myocardial infarction in plateau area were collected by reviewing electronic medical records, and laboratory examination and angiography examination were performed 1 day before discharge. Univariate and multivariate logistic regression analysis were carried out, and ROC curve risk prediction model was established. Results There were statistically significant differences in age, history of myocardial infarction, history of PCI, history of stroke, blood calcium, and Kilip cardiac function between the two groups (P < 0.05). Logistic regression analysis showed that age ≥60 years old, history of myocardial infarction, history of PCI, history of stroke, blood calcium and Kilip cardiac function grading were positively correlated with unscheduled readmission (P < 0.05). The ROC curve was drawn with the occurrence of unplanned readmission as the state variable. The AUC area was 0.801, the predictive sensitivity was 88.94%, and the specificity was 57.92%. Conclusion Unplanned readmission of AMI patients in plateau areas is related to multiple factors. It is necessary to identify high-risk groups as early as possible in combination with risk factors and develop individualized intervention measures.

Análisis ajustado de la mortalidad operatoria en cirugía cardíaca de adultos en Uruguay; 14 años de aplicación y validación del EuroSCORE I ajustado por el Fondo Nacional de Recursos / Adjusted analysis of operative mortality in cardiac surgery of adults in Uruguay, 14 years of application and validation of EuroSCORE I by the Fondo Nacional de Recursos / Análise ajustada da mortalidade operatória em cirurgia cardíaca de adultos no Uruguai, 14 anos de aplicação e validação do EuroSCORE I pelo Fondo Nacional de Recursos

Introducción: la mortalidad posoperatoria ha sido el indicador principal de los resultados a corto y mediano plazo en la evaluación de la cirugía cardíaca. Una forma de analizar dicho evento es mediante los modelos de ajuste del riesgo que identifican variables que predicen su ocurrencia. Uno de los más utilizados es el EuroSCORE I que pro-porciona la probabilidad de morir de cada individuo y que está constituido por 18 variables de riesgo. Objetivos: presentar los resultados de la aplicación y la validación del modelo EuroSCORE I en Uruguay entre los años 2003 y 2020. Metodología: inicialmente se desarrolló una validación externa del EuroSCORE I en la población uruguaya adulta tomando como población de referencia la intervenida entre los años 2003 y 2006. Una vez que se validó el EuroSCORE I, este se aplicó prospectivamente durante los años 2007 al 2020 en su versión original y con el ajuste desarrollado con población del período 2003-2006. Resultados: la aplicación del modelo original encontró que hubo 5 años en los que la razón de mortalidad observada y esperada (MO/ME) fue significativamente mayor que 1. En el período 2007-2020 el EuroScore I no calibró en 6 oca-siones, y fue aplicada la versión ajustada en la evaluación de las instituciones de medicina altamente especializada. La aplicación del modelo ajustado mostró una buena calibración para el período 2007-2020, salvo en el año 2013, y mostró una buena discriminación (área bajo la curva ROC) en todo el período evaluado. Conclusiones: las escalas de riesgo son herramientas metodológicas y estadísticas que tienen gran utilidad para la toma de decisiones en salud. Este trabajo tiene como fortaleza el de presentar datos nacionales aplicando un modelo de riesgo ampliamente utilizado en todo el mundo, lo que nos permite comparar nuestros resultados con los obte-nidos a nivel internacional (EuroSCORE I logístico original) y, por otro lado, evaluar la performance comparativa interna a lo largo de un largo período de tiempo (EuroSCORE I logístico ajustado). Para el futuro resta el desafío de comparar estos resultados, ya sea con un modelo propio o con otros internacionales de elaboración más reciente.

Introduction: postoperative mortality has been the main indicator of short- and medium-term results in the eva luation of cardiac surgery. One way to analyze such outcomes is through risk adjustment models that identify varia bles that predict the occurrence. One of the most used is the EuroSCORE I, which provides the probability of death for each individual and is made up of 18 risk variables. Objectives: present the results of the application and validation of the EuroSCORE I model in Uruguay between 2003 and 2020. Methodology: initially, an external validation of the EuroSCORE I was developed in the Uruguayan adult popula tion, taking as reference population the intervened population between 2003 and 2006. Once the EuroSCORE I was validated, it was applied prospectively during the years 2007 to 2020 in its original version and with the adjustment developed with the population of the period 2003 to 2006. Results: the application of the original model found that there were 5 years during which the observed versus ex pected mortality ratio (OM/ME) was significantly greater than 1. In the period 2007 to 2020, the EuroScore I did not calibrate on 6 occasions, the adjusted version being applied in the evaluation of highly specialized medicine institu tions. The application of the adjusted model showed a good calibration for the period 2007-2020 except in the year 2013 and showed good discrimination (area under the ROC curve) throughout the evaluated period. Conclusions: risk scales are methodological and statistical tools that are very useful for decision-making in health care. This work has the strength of presenting national data applying a risk model widely used across the world, which allows it to be compare with results at an international level (original logistical Euroscore I) and, on the other hand, to evaluate the internal comparative performance over long period of time (adjusted logistic Euroscore I). Up next is the challenge of comparing these results either with our own model or with other more recent international ones.

Introdução: a mortalidade pós-operatória tem sido o principal indicador de resultados a curto e médio prazo na avaliação da cirurgia cardíaca. Uma forma de analisar esse evento é por meio de modelos de ajuste de risco que identificam variáveis que predizem a ocorrência do evento. Um dos mais utilizados é o EuroSCORE I, que fornece a probabilidade de morrer para cada indivíduo e é composto por 18 variáveis de risco. Objetivos: apresentar os resultados da aplicação e validação do modelo EuroSCORE I no Uruguai entre os anos de 2003 e 2020. Metodologia: inicialmente, foi realizada uma validação externa do EuroSCORE I na população uruguaia adulta, tomando como referência a população operada entre 2003 e 2006. Uma vez validado o EuroSCORE I, foi aplicado prospectivamente durante os anos de 2007 a 2020 em sua versão original e com o ajuste desenvolvido com a popu lação do período de 2003 a 2006. Resultados: a aplicação do modelo original constatou que houve 5 anos em que a razão de mortalidade observada versus esperada (MO/ME) foi significativamente maior que 1. No período de 2007 a 2020, o EuroScore I não calibrou em 6 ocasiões, sendo a versão ajustada aplicada na avaliação de instituições médicas altamente especializadas. A aplicação do modelo ajustado mostrou uma boa calibração para o período 2007-2020 exceto no ano de 2013 e apre sentou boa discriminação (área sob a curva ROC) em todo o período avaliado. Conclusões: as escalas de risco são ferramentas metodológicas e estatísticas muito úteis para a tomada de decisões em saúde. O ponto forte deste trabalho é apresentar dados nacionais aplicando um modelo de risco amplamente uti lizado em todo o mundo, que permite comparar com resultados a nível internacional (original Logistic Euroscore I) e, por outro lado, avaliar o comparativo interno desempenho durante um longo período de tempo (Euroscore Logístico I ajustado). Para o futuro, fica o desafio de comparar esses resultados, seja com um modelo próprio ou com outros internacionais de elaboração mais recente.

Health education can save the environment from medicine residues

Abstract The incorrect disposal of medicines and their environmental impact has been related to the health medicalization and the improper use of medication by society. In this sense, it is very important to know the profile of drug disposal for foster health policies. The aim was to identify the profile of disposal of medicines by the population, including the cost perspective. This is an inquiry descriptive study that began in September 2019. Medicine disposal health education program was carried out over six months in two University pharmacies. A questionnaire for sociodemographic and discarded medicines data collection was applied. Logistic regression analysis for variables association of correct disposal and the chi-square and t-student analysis for comparison between disposal programs were performed for a level of 5% and test power of 80%. Medicines weighed 23.3 kg and 28.5 kg, with the cost variation from US$ 13.5 to US$ 16.1 until the final treatment. The correct disposal was strongly associated with the disposal reason (p=0.013), source of information (p=0.006), prescription (p=0.03), form of use (p=0.01), acquisition source (p=0.001), cost with medication (p=0.0001), education (p=0.028) and age (p=0.05). The correct medicine disposal was associated with important features of the community related to education health.

Descarte de antimicrobianos vencidos e/ou em desuso: estudo de caso / Disposal of expired and/or discontinued antimicrobials - case study / Descarto de antimicrobiales muertos y/o desaparecidos: estudio de casos

A temática do descarte inadequado de medicamentos e sua relevância no desenvolvimento dos mecanismos de resistência aos antibióticos são os menos debatidos na literatura. Portanto, este trabalho tem como objetivo apresentar e discutir os dados obtidos sobre o recebimento de antimicrobianos vencidos e/ou sem uso descartados no ponto de coleta de medicamentos localizado no Departamento de Ciências Farmacêuticas, da Universidade Federal de Pernambuco, Campus Recife. Ao todo foram recolhidos 50,03 kg de medicamentos, dos quais 4,12 kg eram de antimicrobianos, sendo a terceira classe farmacológica mais frequente; destes, 93,07% (n=1.948 unidades) estavam vencidos e a forma farmacêutica mais encontrada foram os comprimidos (36,32%). Entre as classes de antibióticos predominaram, em relação ao mecanismo de ação, os que inibem a síntese proteica (29,33%), e pela estrutura química, as quinolonas (17,45%). A realização do descarte adequado desses medicamentos possibilita uma redução dos impactos que esse quantitativo recolhido causaria no meio ambiente. Portanto, deve-se investir em campanhas de conscientização sobre o uso correto dos medicamentos e seguimento da prescrição médica para evitar consumo indiscriminado destes fármacos. Com base o que estabelece o Decreto n° 10.388/2020, o descarte correto de medicamentos precisa ser divulgado, para que os estabelecimentos realizem a logística reversa dessas substâncias.

The issue of inappropriate disposal of medicines and its relevance in development of mechanisms of resistance to antibiotics is the least discussed in the literature. Therefore, this work aims to present and discuss the data obtained on the receipt of expired and/or unused antimicrobials discarded at the medication collection point located in the Department of Pharmaceutical Sciences, Federal University of Pernambuco, Campus Recife. In all, 50.03 kg of drugs were collected, of which 4.12 kg were antimicrobials, being the third most frequent pharmacological class; of these, 93.07% (n=1,948 units) were expired and the most common pharmaceutical form was pills (36.32%). Among the classes of antibiotics, in terms of mechanism of action, those that inhibit protein synthesis (29.33%) and chemical structure, quinolones (17.45%) predominated. Carrying out the proper disposal of these medicines makes it possible to reduce the impacts that this collected quantity would cause on the environment. Therefore, one should invest in awareness campaigns about the correct use of medicines and follow-up of medical prescriptions to avoid indiscriminate consumption of these drugs. Based on the provisions of Decree No. 10.388/2020, the correct disposal of medicines needs to be disclosed, so that establishments carry out the reverse logistics of these substances.

La cuestión de la eliminación inadecuada de los medicamentos y su relevancia en el desarrollo de mecanismos de resistencia a los antibióticos son los menos discutidos en la literatura. Por lo tanto, este trabajo tiene el objetivo de presentar y discutir los datos obtenidos sobre la recepción de antimicrobianos perdidos y/o no utilizados desechados en el punto de recolección de medicamentos ubicado en el Departamento de Ciencias Farmacéuticas de la Universidad Federal de Pernambuco, Campus Recife. En total, se tomaron 50,03 kg de medicamentos, de los cuales 4,12 kg fueron antimicrobianos, siendo la tercera clase farmacológica más común el 93,07% (n=1.948 unidades) retrasada y la forma farmacéutica más encontrada fueron los comprimidos (36,32%). Entre las clases de antibióticos predominaron, en relación con el mecanismo de acción, las que inhiben la síntesis de proteínas (29,33%), y por la estructura química, las quinolonas (17,45%). La eliminación adecuada de estos medicamentos permite reducir el impacto que esta cantidad recolectada podría causar en el medio ambiente. Por lo tanto, se deberían invertir en campañas de sensibilización sobre el uso correcto de medicamentos y el seguimiento de las recetas médicas para evitar el consumo indiscriminado de estos medicamentos. Sobre la base del Decreto no 10.388/2020, es necesario hacer pública la eliminación correcta de los medicamentos, para que los establecimientos realicen la logística inversa de estas sustancias.

The Quality of Logistics Management Information System and the Availability of Tracer Drugs at Health Posts in Rural Ethiopia: A Mixed-Method Study

BACKGROUND: Proper implementation of the logistics management information system (LMIS) would facilitate access to essential pharmaceutical products. It also prevents wastage at health posts. The aim of this study was to assess the implementation of the LMIS and the availability of tracer drugs at health posts in rural Ethiopia. METHODS: We employed a cross-sectional descriptive design with a mixed-method approach. The data used for this paper was collected from March to May 2019 as part of the National HEP assessment. The study involved 343 health posts randomly selected from nine regions of Ethiopia. Women's Development Army members and household heads participated in the qualitative study (i.e. in FGD and KII). The quantitative data were exported from Open Data Kit (ODK) to Stata 15.1 for statistical analysis, and the qualitative data were entered into NVivo 12 and analyzed using thematic content analysis. RESULTS: Of the health posts, 59.4% had a space for storing drugs; less than half (41.9%; 95% confidence interval (CI) [36%, 48%]) had a functioning refrigerator. The mean percentage of the availability of selected tracer drugs at health posts was 59.6%, with a 95% CI (58.9%, 60.3%). Bin cards were available at 43% (95% CI [40%, 46%]) of health posts, and among these, only 27.5% of the health posts adequately used the bin cards. CONCLUSION: The absence and poor use of LMIS tools was observed at health posts. Proper implementation of the LMIS has the potential to improve the availability of essential drugs that, in turn, improve health post level delivery of health services.

Incidencia de la humedad relativa en la transmisión de la COVID-19 / Impact of relative humidity on COVID-19 transmission

Introducción: El nuevo patógeno SARS-CoV-2 presenta una rápida propagación, y es el causante de la enfermedad del Coronavirus 2019 (COVID-19). Dado que este virus es reciente, el aumento de los casos de la enfermedad COVID-19 ha sido una gran amenaza, a lo que le ha sumado la no existencia de información contundente sobre la enfermedad, su transmisión, y su relación con las distintas variables ambientales. Objetivo: Determinar la incidencia de la humedad relativa en la transmisión de la COVID-19 en las regiones tropicales de Colombia. Métodos: Se analizaron los datos de humedad relativa y número de contagios diarios de COVID-19 de siete ciudades de Colombia ubicadas en la Región Caribe (Barranquilla y Sincelejo), Región Andina (Medellín, Bucaramanga, Armenia y Cúcuta), además de la Región Amazónica (Leticia). Se utilizó un modelo logístico generalizado para analizar los datos existentes y diseñar las curvas epidemiológicas. Resultados: Para todas las ciudades, de acuerdo con el modelo se encontraron altas correlaciones entre la humedad relativa (variable observada) y COVID-19 (variable predicha) con un R2 > 0,90. No obstante, se determinó si existía asociación entre las variables comparando el valor p con el nivel de significancia α del 0,05, se encontró una asociación estadísticamente significativa en las ciudades de Leticia, Barranquilla y Cúcuta. Conclusiones: Los resultados indican que existe una relación directa entre la humedad relativa y la transmisión de COVID 19 en regiones tropicales de Colombia. De ahí que se plantee que el estudio aporta una herramienta importante para la toma de decisiones de las instituciones a cargo del control de la enfermedad, como los gobiernos nacionales y locales(AU)

Introduction: The new pathogen SARS-CoV-2 presents a rapid spread, and is the cause of the Coronavirus disease 2019 (COVID-19). Given that this virus is recent, the increase in cases of the COVID-19 disease has been a great threat, to which has been added the lack of conclusive information about the disease, its transmission, and its relationship with the different environmental variables. Objective: To determine the incidence of relative humidity in the transmission of COVID-19 in the tropical regions of Colombia. Methods: Relative humidity data and number of daily COVID-19 infections from seven cities in Colombia located in the Caribbean Region (Barranquilla and Sincelejo), Andean region (Medellín, Bucaramanga, Armenia and Cúcuta), as well as the Amazon Region (Leticia) were analyzed. A generalized logistic model was used to analyze existing data and design epidemiological curves. Results: For all cities, according to the model, high correlations were found between relative humidity (observed variable) and COVID-19 (predicted variable) with an R2 > 0.90. However, it was determined if there was an association between the variables by comparing the p-value with the level of significance α 0.05, a statistically significant association was found in the cities of Leticia, Barranquilla and Cúcuta. Conclusions: The results indicate that there is a direct relationship between relative humidity and the transmission of COVID 19 in tropical regions of Colombia. Hence, it is proposed that the study provides an important tool for the decision-making of the institutions in charge of the control of the disease, such as national and local governments(AU)

Inventory control: Its principles and application

Availability of good quality stock, in right quantity, at right place and time and at right cost is the essence of inventory control, which in turn is mandatory for smooth functioning and service delivery of any health care facility. Various techniques are available for inventory control, based on cost, criticality and other factors for e.g., ABC analysis, VED analysis, ABC-VED matrix, FSN analysis, SDE analysis etc. Each technique has its own strength and weakness in its applicability. Economic considerations are also imperative for logistic management of any health facility, as any cost savings could be spent more gainfully in some other way and thus more lives could be saved, reduced morbidities and overall positive impact. Future healthcare managers will have to utilize scientific methods of inventory management and the role of an efficient hospital logistics system cannot be ignored anymore. Inventory control is an important component of hospital management. It provides significant improvement in patient care, customer relationships and optimal use of resources. The objective of this paper is to present an up-to-date review of inventory control and critically appraise its various techniques, various costs associated with it and methods of indenting stock. This review will benefit post-graduate students and public health workers in understanding the concepts and principle of inventory control and applying the same in their practice.

Gerenciamento de resíduos sólidos urbanos de Feira de Santana: demanda energética e pegada de carbono / Management of solid urban waste in Feira de Santana: energy demand and carbon footprint

RESUMO O gerenciamento de resíduos sólidos urbanos, com a disposição do material em aterro sanitário, é uma prática amplamente adotada no Brasil. A quantificação do desempenho ambiental do gerenciamento de resíduos sólidos urbanos apoia a proposição de práticas otimizadas. A avaliação do ciclo de vida foi aplicada para avaliar o gerenciamento de resíduos sólidos urbanos de 1 tonelada de material em Feira de Santana, estado da Bahia, Brasil. A fronteira do sistema do gerenciamento de resíduos sólidos urbanos deste estudo incluiu o material gerenciado nas etapas de coleta, transporte, tratamento, disposição e manejo do lixiviado. Foi avaliada a disposição do material em aterro sanitário no cenário base de gerenciamento de resíduos sólidos urbanos e opções de recuperação de recurso para o aproveitamento de material (reciclagem e compostagem) e energia (aterro sanitário e digestão anaeróbia com coleta de biogás) nos cenários propostos de gerenciamento de resíduos sólidos urbanos. O inventário de primeiro plano utilizou dados representativos para os cenários avaliados, enquanto o inventário de segundo plano utilizou a base de dados ecoinvent™ no software Simapro®, com os métodos de demanda de energia acumulada e Intergovernmental Panel On Climate Change 2013, com potencial de aquecimento global de cem anos. A demanda de energia acumulada foi 215 MJ·t-1 e as emissões de gases de efeito estufa foram 449 kg CO2eq·t-1 no cenário base. A maior contribuição da demanda de energia acumulada do cenário base foi oriunda da etapa de coleta e transporte, enquanto aquela de gases de efeito estufa foi oriunda do aterro sanitário. Os cenários propostos com a recuperação dos recursos apresentaram potenciais de redução da demanda de energia acumulada e das emissões de gases de efeito estufa do gerenciamento de resíduos sólidos urbanos, assim como apoiam a transição para uma economia circular.

ABSTRACT Municipal Solid Waste Management with the material disposal in landfills is a widely adopted practice in Brazil. The environmental performance quantification in MSWM supports the proposition of optimized practices. The Life Cycle Assessment was applied to evaluate 1 ton of material in the Municipal Solid Waste Management of Feira de Santana, state of Bahia, Brazil. The system boundary of the Municipal Solid Waste Management in this study included the material managed in collection, transportation, treatment, disposal and leachate handling stages. The material disposal in sanitary landfill was evaluated in the base scenario of Municipal Solid Waste Management and the resource recovery options for material (recycling and composting) and energy (sanitary landfill and anaerobic digestion with biogas collection) in the proposed scenarios of Municipal Solid Waste Management. The foreground inventory used representative data for the evaluated scenarios, while the background inventory used the ecoinvent™ database in the Simapro® software with the Cumulative Energy Demand and Intergovernmental Panel on Climate Change 2013 with 100 years global warming potential methods. Cumulative Energy Demand was 215 MJ·t-1 and Greenhouse Gas emissions were 449 kg CO2eq·t-1 in the base scenario. The largest contribution in the base scenario was the collection and transportation stage in Cumulative Energy Demand and the sanitary landfill in Greenhouse Gas. The proposed scenarios with resource recovery showed a potential to reduce the Cumulative Energy Demand and Greenhouse Gas emissions in Municipal Solid Waste Management, along with supporting the transition to a circular economy.

Discussion on the performance reform of administrative and logistics personnel in a large public hospital / 中华医院管理杂志

Because the work of administrative and logistics personnel in public hospitals is difficult to quantify and evaluate, its performance reform is difficult. A large public hospital in Wuhan has explored and established a distribution incentive mechanism that combines department performance appraisal, individual classification and grading, and secondary distribution within the department. Taking into account the completion of performance appraisal indicators of the national tertiary public hospital in the department, the results of the institutional " Excellent Management Team Ranking" , personal job grades, working years and other factors, a relatively mature and operable system has been formed, which could provide reference for the performance reform of other hospitals.

A contribuição da logística para o fortalecimento da produção nacional e para o acesso universal no âmbito do SUS / The contribution of logistics to the strengthening of national production and universal access in the scope of the Unified Health System

RESUMO Objetivou-se apontar os elementos essenciais da logística que contribuem para a promoção do acesso no contexto do sistema produtivo da saúde, visando articular a produção nacional, reduzir a dependência externa para viabilizar o acesso universal e o fortalecimento do Sistema Único de Saúde (SUS) em um contexto de pandemia e crise sanitária. Utilizou-se como estratégia metodológica uma pesquisa qualitativa de base bibliográfica sobre os conceitos de sistemas de saúde, saúde pública e acesso a medicamentos e vacinas, somados ao perfil dos operadores logísticos nacionais e à operacionalização do plano nacional de imunização contra a Covid-19 do Ministério da Saúde. Concluiu-se que a logística desempenha papel fundamental na promoção do acesso às tecnologias em saúde, sendo necessário empreender esforços em pesquisas que incluam os atores do setor produtivo capazes de contribuir com a elaboração de políticas públicas na área da saúde. Os elementos centrais da logística precisam ser ressaltados para o fortalecimento de uma agenda que articule o Complexo Econômico-Industrial da Saúde com o acesso universal, pensando nos fatores logísticos como elementos críticos sem os quais o acesso não se materializa. É necessário que os sistemas logísticos sejam pensados como recurso dos sistemas de saúde para viabilizar sua integralidade e sustentabilidade.

ABSTRACT The objective was to point out the essential elements of logistics that contribute to the promotion of access in the context of the health production system to articulate national production, reduce external dependence to enable universal access and the strengthening of the Unified Health System (SUS) in the context of the pandemic and health crisis. Qualitative bibliographic-based research was used as a methodological strategy on the concepts of health system, public health, access to medicines, added to the profile of national logistics operators and the operationalization of the Ministry of Health's national immunization plan against COVID-19. It was concluded that logistics plays a fundamental role in promoting access to health technologies and it is necessary to undertake research efforts that include the actors of the productive sector capable of contributing to the elaboration of public policies in the field of health. The central elements of logistics need to be highlighted in order to strengthen an agenda that articulates the Health Economic-Industrial Complex with universal access, considering logistical factors as critical elements without which access does not materialize. Logistical systems should be thought of as a resource of universal health systems to enable their integrality and sustainability.

Alimentación, nutrición en emergencias y desastres naturales en Venezuela entre 1999-2021 / Food, nutrition in emergencies and natural disasters in Venezuela between 1999-2021

Los eventos naturales afectan directamente la alimentación y nutrición de personas. Se presentan las experiencias en Venezuela en las emergencias y desastres naturales con intervención nutricional (1999-2021). Se trata de un estudio descriptivo, sobre la revisión de documentos impresos y electrónicos. Se describen los aspectos generales y la intervención nutricional. Se estableció un sistema logístico-nutricional de adquisición y manejo de alimentos con estrategia alimentaria, para lograr sobrevivencia, restauración, mantenimiento de la salud y moral. El plan logístico-nutricional tuvo 3 fases: distribución de alimentos (porcionamientos momentáneos, bolsas combo y cestas de emergencias, menú de emergencia), control de calidad de alimentos e inventarios, canalización del uso de alimentos donados, diseño y distribución de comidas calientes en campamentos de rescate y personal médico en operaciones asistenciales. Se efectuaron inspecciones nacionales, se impartió educación para la salud y recomendaciones nutricionales, se efectuaron encuestas alimentarias transversales con recordatorio de 24 horas y porcentaje de efectividad de ingesta. En Vargas se atendieron 70.000 damnificados en 360 centros nacionales, movimiento de alimentos 2.532 t. mensuales, en Guasdualito 19.621 damnificados y 709,72 t. (101 centros), Mérida 14.000 damnificados y 750 t. (90 centros). La atención fue satisfactoria según inspecciones y encuestas y se conoció más sobre la alimentación y nutrición suministrada. La educación nutricional y sanitaria y las recomendaciones fueron primordial, para proteger la salud, mantener prácticas y conductas saludables. Se suministró una alimentación adecuada en tiempo oportuno a la población damnificada en todos los eventos naturales (inundaciones, COVID-19)(AU)

Natural events directly affect people's diet and nutrition. The lived experiences of emergencies and natural disasters with nutritional intervention (1999-2021) were presented as input and guidance. This is a descriptive study of printed and electronic documents were reviewed and synthesized. General aspects and the nutritional intervention are described. A logistic-nutritional system of food acquisition and handling was established with a food strategy, to achieve survival, restoration, health maintenance and morale. The logistic-nutritional plan had 3 phases: food distribution (momentary portions, combo bags and emergency baskets, emergency menu), quality control of food and inventories, channeling of the use of donated food, design and distribution of hot meals in rescue camps and medical personnel in assistance operations. National inspections were carried out, health education and nutritional recommendations were provided, cross-sectional food surveys were carried out with a 24-hour reminder and percentage of intake effectiveness. Vargas was attended: 70,000 victims in 360 national centers, food movement 2,532 t. monthly, Guasdualito: 19,621 victims and 709.72 t. (101 centers), Mérida: 14,000 victims and 750 t. (90 centers). The care was satisfactory according to inspections and surveys, knowing more about food and nutrition supplied. Nutritional and health education as the recommendations were paramount, to protect health, maintain healthy practices and behaviors. Adequate food was provided in a timely manner to the population affected in all natural events (floods, COVID-19)(AU)

Analysis of CSR and the impact of the supply chain on sustainable performance practices: a case study of a mexican exporting company / Análisis de la rse y el impacto de la cadena de suministro en las prácticas de desempeño sustentable: un estudio de caso en una empresa exportadora mexicana

RESUMEN El estudio de caso de la empresa investigada busca comprender la responsabilidad social empresarial (RSE), analizando su cadena de valor desde el Modelo de las 31 prácticas de las cadenas de suministro que el World Economic Forum (2015) propone, desde la perspectiva de la triple ventaja: rentabilidad, medio ambiente y desarrollo de las economías locales. Es una investigación de tipo cualitativa con enfoque de estudio de caso descriptivo. El objetivo del trabajo es observar el impacto de las operaciones de logística internacional en una pyme exportadora mexicana, y analizar si su trascendencia económica ha tenido un desarrollo sustentable en lo social, económico y ambiental. Los resultados indican una ventaja competitiva en la diferenciación del producto a partir del concepto de valor compartido de Porter y Kramer (2002). De acuerdo con el Modelo del WEF, el arquetipo es Liberal humanista, puesto que enfatiza el valor del negocio en 65% y pondera aspectos socio ambientales en un 35 %. No obstante, los impactos en la cadena de suministro deberán mitigarse si se espera que se identifique a la organización como una empresa socialmente responsable.

ABSTRACT The case study presented, seeks to understand the corporate social responsibility (CSR), analyzing its value chain from the Model of the 31 practices of the supply chain that the World Economic Forum (2015). It is a qualitative research, with a descriptive case study approach. The objective of the work is to observe the impact of international logistics operations in a Mexican exporting SME and to analyze whether its economic significance has had a sustainable social, economic and environmental development. The results indicate a competitive advantage in product differentiation based on Porter and Kramer's (2002) concept of shared value. According to the WEF Model, the archetype is: Liberal humanist, since it emphasizes business value by 65% and weights socio-environmental aspects by 35%. However, impacts on the supply chain must be mitigated if the organization is to be identified as a socially responsible company.

Analysis of drug consumption in field training of joint logistic support force in Yunnan / 药学实践杂志

Objective To analyze the drug consumption of the joint logistics support force during field training in Yunnan, summarize the drug use characteristics of medical staff, and analyze the drug use rules, so as to provide the basis for modular drug support. Methods The basic information and drug use of the personnel in an institution of the joint logistics support force during the resident training period from April to June 2020 were collected and sorted out. The drug use indicators were calculated by using the defined daily dose (DDD) as the unit, including: daily drug dose (DDDs), daily drug dose cost (DDDc), drug use intensity (DUI), drug utilization rate (DUR) and drug ranking ratio (R) were used to describe drug use characteristics. Results During the resident training period, the amount of musculoskeletal system drugs was large, and the number of users was large. The dosage of cardiovascular system drugs, digestive system drugs and hormone drugs was large, but the number of users was small. Sensory organ drugs, dermatological drugs, heat-clearing agents (Chinese patent medicine) and respiratory system drugs were small in dosages, but the number of users was large. Ranked by DDDs, the top 3 drugs with the highest dosage were Yunnan Baiyao plaster, Yunnan Baiyao Band-Aid and Loratadine Tablets. Ranked by DDDc, the largest daily cost was Budesonide and Formoterol Fumarate Powder for Inhalation. As age increases, the intensity of drug use increased; The intensity of drug use in women was greater than that in men. The intensity of drug use was different for different categories personnel. Conclusion Musculoskeletal system drugs are important drugs for field training. The task personnel should formulate a list of medicines for basic diseases based on their own medication for basic diseases and the duration of the task, and submit it to the medicinal material guarantee department to ensure the carrying drugs. The factors affecting modular drug support in field training include: task type, region, solar term, duration and personnel composition, etc.

Application of Internet of Things in clinical blood management based on RFID technology / 中国输血杂志

【Objective】 To explore and evaluate the application of blood intelligent management platform (scheme) based on the Internet of Things(IoT)in the clinical blood management for hospitals. 【Methods】 Based on radio frequency identification technology (RFID), smart blood refrigerators, IoT blood shipping containers, automated blood bank systems, smart blood management software, etc. were developed and integrated as an IoT blood intelligent management platform (scheme). The blood storage, management software and hardware systems were organically combined, and the blood storage equipment was moved forward to the clinical departments to solve the concerns of clinicians. 【Results】 The in-depth integration of IoT technology, RFID and refrigeration technology has built an RFID-based IoT blood management solution, which integrates blood storage, transfusion, and quality control management, also realizes the entire process of supervision and traceability of clinical blood transfusion. The forward movement of blood bank to the clinical departments and the implementation of electronic cross-matching streamlined and optimized the clinical blood flow. The waiting time of patient′s for blood transfusion was shortened from (40±10) min to less than 2 min. The whole process of cold chain logistics ensured the storage quality of blood products issued, so that the clinical departments can return the untransfused blood and Blood Transfusion Department can reissue it to other hospitals. 【Conclusion】 IoT blood intelligent management based on RFID realizes the intelligent management of clinical blood transfusion and blood information traceability. The forward movement of blood bank to the clinical departments improves the efficiency of clinical blood transfusion, avoids the waste of blood source, and ensures the safety of blood transfusion. It is worth promoting in the whole process of blood transfusion.

Desastres como oportunidade de implementação de políticas de gerenciamento de resíduos de construção e demolição no Brasil: chuvas de Nova Friburgo (RJ), 2011 / Disasters as an opportunity to implement policies on construction and demolition waste management in Brazil - floods of Nova Friburgo (RJ) - 2011

RESUMO Desastres naturais envolvem, com frequência, múltiplos esforços nas fases de resposta e resiliência. Um dos desafios que surgem nessas ocasiões é o de reaproveitar detritos - na sua maioria compostos por resíduos sólidos de baixo nível de contaminação, mas de pouco interesse comercial, devido às dificuldades envolvidas no seu recolhimento e segregação. Este artigo busca mostrar que tal tarefa pode contribuir beneficamente para a logística humanitária (LH) em países que já tenham uma regulamentação em vigor quanto ao gerenciamento de resíduos de construção e demolição (RCD). A Política Nacional de Resíduos Sólidos (PNRS) no Brasil é apresentada e comentada, bem como as principais normas e tecnologias para o tratamento de RCD, existentes há duas décadas, mas que apenas recentemente vêm sendo oferecidas por meio de máquinas menores em tamanho, escala de processamento e consumo de energia, permitindo o tratamento desses resíduos também em situações emergenciais. A seguir, mostra-se como a ocorrência de um desastre pode auxiliar cidades atingidas a se adequarem mais rapidamente à regulamentação enquanto gera, a partir dos detritos, subprodutos de maior valor agregado, com potencial de utilização no esforço de reconstrução tanto de obras públicas quanto privadas. Utilizou-se como estudo de caso o evento de chuvas em excesso ocorrido na cidade de Nova Friburgo, nos dias 11 e 12 de janeiro de 2011. Conclui-se que uma grande oportunidade está sendo desperdiçada, também para se diminuir o stress pós-traumático, tanto pelas comunidades atingidas como por quem planeja ou executa ações de resposta e resiliência pós-desastres naturais.

ABSTRACT Natural disasters often involve work from multiple efforts in both response and resilience phases. One of the challenges that arise on those occasions is recycling the debris - mostly composed of low contamination solid wastes, but offering little commercial interest, due to the difficulties involved in their collection and segregation. This paper aims to show that this task can contribute beneficially to Humanitarian Logistics (HL) in countries that already have regulations in place regarding the management of construction and demolition waste (CDW). The National Solid Waste Policy (Política Nacional de Resíduos Sólidos - PNRS) in Brazil is presented and commented on, as well as the main standards and technologies for CDW treatment, which have existed for two decades, but which have only recently been offered through equipment smaller in size, processing scale, and energy consumption, allowing the treatment of these wastes also in emergency situations. Then it is showed how disasters can help stricken cities to take some advantage to adapt themselves more quickly to regulation, while generating from the waste by-products of higher added value, with potential to be used in the reconstruction effort of both public and private constructions. The event of excessive rains occurred in the city of Nova Friburgo, on January 11th and 12th, 2011, was used as a case study. It is concluded that a great opportunity is being wasted, also to reduce post-traumatic stress, by both affected population and those who plan or carry out post-disaster response and resilience actions.

Síntomas musculoesqueléticos en operadores logísticos de una empresa de envíos de santander, colombia

Objetivo. Determinar la prevalência de síntomas musculoesqueléti-cos en operadores logísticos de una empresa de envíos de Santander. Materiales y métodos. Estudio descriptivo transversal, con la participación de 67 trabajadores de sexo masculino. Se analizó el autorreporte de síntomas musculoesqueléticos con el Cuestionario Nórdico Estandarizado. Resultados. El promedio de edad fue de 31 años. El 54 % de la población tiene sobrepeso, lleva en promedio 4,7 años en la labor y trabaja en promedio 70 horas semanales. La zona con mayor prevalencia de molestias es la espalda baja, con el 76 %. Del total de casos, el 48 % presentó molestias en más de un segmento corporal y el 37 % en solo una zona del cuerpo, el 85 % de la población reportó al menos un síntoma musculoesquelético. Conclusión. La región de la espalda baja presentó mayor sintomatología con el 76 %, seguido de los hombros y el cuello. La región que menos síntomas reportaron los trabajadores es a nivel de codos.

Objective: To determine the prevalence of musculoskeletal symptoms in logistics operators of a Santander shipping company. Materials and method: Descriptive cross-sectional study, with the participation of 67 male workers. The self-report of musculoskeletal symptoms was analyzed with the Standardized Nordic Questionnaire. Results: The average age was 31 years. 54% of the population is overweight, they have been working on average 4.7 years and work an average of 70 hours per week. The area with the highest prevalence of discomfort is the lower back, with 76%. Of all cases, 48% presented discomfort in more than one body segment and 37% in only one area of the body. 85% of the population reported, at least, one musculoskeletal symptom. Conclusion: The lower back region presented the most symptoms with 76%, followed by the shoulders and neck. The region with the least symptoms reported by workers is at the elbow level.

Cómo enfrentar una epidemia respiratoria masiva, desde el punto de vista organizacional y un plan de contingencia / How to face a massive respiratory epidemic, from the organizational point of view and a contingency plan?

Resumen: Las epidemias no son producto de la «globalización¼, han azotado a la humanidad desde sus orígenes, no hay que cerrar fronteras ni al turismo ni al comercio; en la antigüedad no había autopistas, trenes, trasatlánticos ni aviones y existían las epidemias, la historia demuestra que la protección real viene del intercambio de información científica confiable y de la solidaridad real; no obstante, en este mundo globalizado y comunicado, «era del punto com¼, se genera un sinnúmero de información día a día, incluso en minutos se publican cientos de artículos relacionados a la pandemia que hoy nos ocupa, el COVID-19, información que debemos saber seleccionar y discriminar adecuadamente para no perdernos en ella. Una vez entendido que el verdadero antídoto para una epidemia es la cooperación y no la segregación, se debe establecer un diagnóstico situacional, debemos trabajar al unísono, como un equipo con un mismo propósito, en este artículo pretendemos compartir el cómo organizarse desde el punto de vista logístico y cómo proteger y optimizar el valiosísimo recurso humano, el personal sanitario.

Abstract: The epidemics are not a «globalization¼ product, this exists since the humanity begun, it´s not necessary to close borders neither trade between countries, in the past did not exist highways, railway, tall ships or aircraft and the epidemics already existed, the history show and demonstrate us that the real protection is the interchange of confident information and the teamwork, we should work like global unity. In the global universe the information grow up exponentially daily, so we have to be careful with all the data that come to us. If we understand that an epidemic's antidote is the cooperation and unity, we should have the capacity to organize a solid teamwork based on a situational diagnose. Our purpose in this paper is to share our experience in organizational logistics and give its true value to health personnel.

Expanding access to viral load testing in Nigeria; the impact of third party logistics

Background: Access to viral load testing in Nigeria remains a key challenge in achieving the Joint United Nations Program on HIV/AIDS (UNAIDS) 90:90:90 targets in the fight against HIV/AIDS. This study investigates the impact of 3 party logistics (3PL) on expanding access to viral load testing.Methods: This exploratory, case study research was carried out in Abuja in December, 2018, using in-depth interview method. Open-ended questions were used to interview nine staff from the three polymerase chain reaction laboratories in Federal Capital Territory. The audios of interviews were recorded and transcribed on paper. The data was analyzed using SPSS version 24.Results: This study revealed that the adoption of 3PL services has helped to overcome major challenges of viral load testing such as late delivery of samples, late collection of results, and rejection problems; thereby reduced sample rejection frequencies, increased efficiency, reduced turnaround time and ease viral load testing processes. Though the adoption of 3PL has helped to overcome major challenges of viral load testing, however, the challenges still facing viral load testing include the 3PLs bringing samples at any time-even at closing hours, not delivering results to facilities on time after pickup, poor medical backgrounds and inability of 3PLs to enforce instructions on facilities. However, respondents expressed satisfaction with the services of the 3PLs.Conclusions: The findings of this study revealed that the adoption of 3PL service into viral load transport logistics has positive impacts on the process. However, only one of the laboratories uses two 3PL providers while other two use only one.