RESUMO
The Brazilian dairy industry is socially and economically relevant but requires care regarding the prevention of the environmental impact, and a set of indicators to evaluate the level of sustainability of such industries has not yet been yet defined and consolidated both in practice and in the literature. In this context, this study aims to select a set of sustainability indicators for small and medium-sized Brazilian dairy industries. The selection of the set of sustainability indicators was conducted using a top-down approach (based on the Global Reporting Initiative document) and a bottom-up approach (participatory process by questionnaire in the dairy industry). The questionnaire with a 5-point Likert scale of a general set of indicators, resulting from the top-down approach, was answered by 238 respondents linked to the dairy industry in Brazil to determine the importance of each indicator in this type of industry. The main results reveal that a set of 28 sustainability indicators (environmental = 13, social = 9, and economic = 6) was selected for use in small and medium-sized Brazilian dairy industries. This set of indicators fills the existing gaps in the literature about being specific for the small and medium-sized dairy industries in Brazil, mutually covers the dimensions of the triple bottom-line, applicable in multiple departments of the dairy industry, and the selection took place through a participatory process of professionals linked to the dairy industry.
Assuntos
Indústria de Laticínios , Meio Ambiente , Indústrias , BrasilRESUMO
Contexto y antecedentes: La elaboración e implementación de guías clínicas pretende brindar ayuda en la toma de decisiones respecto de un determinado problema de salud, sintetizando en forma de recomendaciones la mejor evidencia disponible. Con respecto a la diverticulitis aguda, pese a la gran cantidad de guías que se han elaborado, aún hoy se observa un bajo nivel de consenso en varios aspectos de su manejo. Objetivos: Este trabajo representa la primera encuesta que mide el nivel de consenso y la aplicación de guías internacionales sobre el manejo de la diverticulitis aguda entre los miembros de la SACP o entre cualquier otra agrupación médica a nivel nacional. Métodos: Se distribuyó una encuesta online a 313 miembros de la SACP, las respuestas se recolectaron en un período de 2 meses. Resultados: La encuesta obtuvo una tasa de respuesta de 19,5%. Solo 17 enunciados superaron el corte de 70% de nivel de consenso. De ellos, 11 enunciados estuvieron de acuerdo mientras que 2 enunciados estuvieron en desacuerdo con las recomendaciones de las guías internacionales y en los 4 enunciados restantes no pudo valorarse la concordancia debido a falta de respuesta univoca en las guías. Conclusiones: La amplia heterogeneidad en el manejo de la diverticulitis aguda entre los miembros de la SACP junto con la baja evidencia de los trabajos científicos, la pobre metodología empleada en las guías internacionales y la necesidad de contar con datos locales sobre costos y preferencias, hacen evidente la necesidad que en nuestro ámbito se comience a investigar en forma sistematizada para lograr una guía y consenso nacional.
Background: Construction and elaboration of clinical guidelines aim to provide help to decision-taking process about a specific health issue, synthesizing the best available evidence in the form of recommendations. About acute diverticulitis, although many guidelines were published in the last years, even now, there is a low consensus level in many aspects of its management. Aim: This survey is the first one that measures the consensus level and the application of international guidelines, about acute diverticulitis, within the SACP members, or any other medical society in Argentina. Methods: An online survey was distributed to 313 SACP members; the responses were collected over two months. Results: The response rate obtained by the survey was 19,5%. Only 17 statements passed the consensus level of 70%, 11 of them agreed and 2 disagreed with the recommendations of the international guidelines, in the last 4 statements comparison was impossible because the guidelines lacked one single response. Conclusions: The large heterogeneity in the management of acute diverticulitis within the SACP members, along with the low evidence of the scientific publications, the poor methodology used in the guidelines, and the need of local data about costs and preferences, clearly demonstrates the necessity to start to investigate in a systematic way, in order to achieve a national guideline and consensus about acute diverticulitis.