Covid-19 impacts: Ethnic and regional inequalities in sickle cell disease patient care in Brazil.

Brazil is a continental country with significant socioeconomic and ethnic inequalities. It is important to understand how these differences are reflected in health care, especially during the COVID-19 pandemic. We investigated the potential impacts of the reduced number Transcranial Doppler Ultrasound (TCD) tests performed in Brazil during the COVID-19 pandemic, and its reflections according to region and race/color for patients with Sickle Cell Disease (SCD). This study performed data queries from the Brazilian Ministry of Health, literature research, and quantitative analysis using descriptive statistical analysis. We found evidence for a decrease in the number of TCD tests performed during the pandemic (-83 %) relative to the same non-pandemic period, and disparities in tests given in five regions in Brazil. Our data show, that in absolute numbers, most people with SCD are brown, but the highest prevalence of cases was among blacks. We also found evidence for racial discrimination when performing TCD test, which leads us to believe that the Brazilian Unified Health System (SUS) may be susceptible to racism when treating this disease. The implications of these findings serve as a warning to other countries with high indices of mixed ancestry in formulating health care policies for patients with SCD.

Mortality and Years of Potential Life Lost Due to COVID-19 in Brazil.

In November 2020, Brazil ranked third in the number of cases of coronavirus disease 2019 (COVID-19) and second in the number of deaths due to the disease. We carried out a descriptive study of deaths, mortality rate, years of potential life lost (YPLL) and excess mortality due to COVID-19, based on SARS-CoV-2 records in SIVEP-Gripe (Ministry of Health of Brazil) from 16 February 2020, to 1 January 2021. In this period, there were 98,025 deaths from COVID-19 in Brazil. Men accounted for 60.5% of the estimated 1.2 million YPLLs. High YPLL averages showed prematurity of deaths. The population aged 45-64 years (both sexes) represented more than 50% of all YPLLs. Risk factors were present in 69.5% of deaths, with heart disease, diabetes and obesity representing the most prevalent comorbidities in both sexes. Indigenous people had the lowest number of deaths and the highest average YPLL. However, in indigenous people, pregnant women and mothers had an average YPLL of over 35 years. The excess mortality for Brazil was estimated at 122,914 deaths (9.2%). The results show that the social impacts of YPLL due to COVID-19 are different depending on gender, race and risk factors. YPLL and excess mortality can be used to guide the prioritization of health interventions, such as prioritization of vaccination, lockdowns, or distribution of facial masks for the most vulnerable populations.

The exposure risk to COVID-19 in most affected countries: A vulnerability assessment model.

The world is facing the coronavirus pandemic (COVID-19), which began in China. By August 18, 2020, the United States, Brazil, and India were the most affected countries. Health infrastructure and socioeconomic vulnerabilities may be affecting the response capacities of these countries. We compared official indicators to identify which vulnerabilities better determined the exposure risk to COVID-19 in both the most and least affected countries. To achieve this purpose, we collected indicators from the Infectious Disease Vulnerability Index (IDVI), the World Health Organization (WHO), the World Bank, and the Brazilian Geography and Statistics Institute (IBGE). All indicators were normalized to facilitate comparisons. Speed, incidence, and population were used to identify the groups of countries with the highest and lowest risks of infection. Countries' response capacities were determined based on socioeconomic, political, and health infrastructure conditions. Vulnerabilities were identified based on the indicator sensitivity. The highest-risk group included the U.S., Brazil, and India, whereas the lowest-risk group (with the largest population by continent) consisted of China, New Zealand, and Germany. The high-sensitivity cluster had 18 indicators (50% extra IDVI), such as merchandise trade, immunization, public services, maternal mortality, life expectancy at birth, hospital beds, GINI index, adolescent fertility, governance, political stability, transparency/corruption, industry, and water supply. The greatest vulnerability of the highest-risk group was related first to economic factors (merchandise trade), followed by public health (immunization), highlighting global dependence on Chinese trade, such as protective materials, equipment, and diagnostic tests. However, domestic political factors had more indicators, beginning with high sensitivity and followed by healthcare and economic conditions, which signified a lesser capacity to guide, coordinate, and supply the population with protective measures, such as social distancing.

Dos modelos teóricos à gestão empírica da inovação em empresas de serviços de software do Distrito Federal / From theoretical models to the empirical management of innovation in software services companies in the Federal District

Este estudo teve por objetivo descrever como ocorre o processo de gestão da inovação em empresas de serviços de software atuantes no Distrito Federal com vistas ao teste de efetividade de representação empírica das premissas teóricas estabelecidas em dois modelos do processo de gestão da inovação de larga aceitação - os trabalhos de Tidd, Bessant & Pavitt (2008) e Sundbo (1997). Realizou-se um estudo de casos múltiplos, de abordagem qualitativa, com seis unidades de análise selecionadas. Os dados foram coletados por meio de entrevistas semiestruturadas e a análise de conteúdo foi feita com o uso de codificação temática com categorias definidas a posteriori. Os resultados apontaram não linearidade de ocorrência nas fases de procura e seleção e, também, a existência de inovações geradas a partir da mobilização de fontes externas à organização que não necessariamente fossem objeto de validação por colaboradores internos, o que vai de encontro às premissas dos modelos teóricos adotados. No tocante à dinâmica empírica efetiva de gestão da inovação em empresas de serviços de software, aponta-se que este processo mostrou-se recursivo em algumas de suas etapas (como procura e seleção) e pode envolver atores externos à própria organização.

This study's objective was to describe how the innovation management process is carried out in service software firms operating in the Federal District in Brazil. The concept was to test the effectiveness of empirical representation of the theoretical approach in two broadly accepted models of the innovation management process - the works of Tidd, Bessant & Pavitt (2008) and Sundbo (1997). We conducted a multiple case study with a qualitative approach, with six selected units of analysis. The data were collected through semi-structured interviews and content analysis was performed using thematic coding with categories defined a posteriori. Results showed nonlinearity of occurrence in the search and selection phases, and also the existence of innovations generated by the mobilization of sources outside the organization which are not necessarily subject to validation by internal employees, which contrasts with the assumptions of the adopted theoretical models. Regarding the effective empirical dynamics of innovation management in software services companies, there are indications that this process appears recursive in some of its steps (such as search and selection) and can involve players outside the organization itself.

Dos modelos teóricos à gestão empírica da inovação em empresas de serviços de software do Distrito Federal / From theoretical models to the empirical management of innovation in software services companies in the Federal District

Este estudo teve por objetivo descrever como ocorre o processo de gestão da inovação em empresas de serviços de software atuantes no Distrito Federal com vistas ao teste de efetividade de representação empírica das premissas teóricas estabelecidas em dois modelos do processo de gestão da inovação de larga aceitação - os trabalhos de Tidd, Bessant & Pavitt (2008) e Sundbo (1997). Realizou-se um estudo de casos múltiplos, de abordagem qualitativa, com seis unidades de análise selecionadas. Os dados foram coletados por meio de entrevistas semiestruturadas e a análise de conteúdo foi feita com o uso de codificação temática com categorias definidas a posteriori. Os resultados apontaram não linearidade de ocorrência nas fases de procura e seleção e, também, a existência de inovações geradas a partir da mobilização de fontes externas à organização que não necessariamente fossem objeto de validação por colaboradores internos, o que vai de encontro às premissas dos modelos teóricos adotados. No tocante à dinâmica empírica efetiva de gestão da inovação em empresas de serviços de software, aponta-se que este processo mostrou-se recursivo em algumas de suas etapas (como procura e seleção) e pode envolver atores externos à própria organização.(AU)

This study's objective was to describe how the innovation management process is carried out in service software firms operating in the Federal District in Brazil. The concept was to test the effectiveness of empirical representation of the theoretical approach in two broadly accepted models of the innovation management process - the works of Tidd, Bessant & Pavitt (2008) and Sundbo (1997). We conducted a multiple case study with a qualitative approach, with six selected units of analysis. The data were collected through semi-structured interviews and content analysis was performed using thematic coding with categories defined a posteriori. Results showed nonlinearity of occurrence in the search and selection phases, and also the existence of innovations generated by the mobilization of sources outside the organization which are not necessarily subject to validation by internal employees, which contrasts with the assumptions of the adopted theoretical models. Regarding the effective empirical dynamics of innovation management in software services companies, there are indications that this process appears recursive in some of its steps (such as search and selection) and can involve players outside the organization itself.(AU)