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INTRODUCTION: Autonomy is considered a vital principle of professionalism. In recent years, despite important advances, the Pharmacy and pharmacists' autonomy has been questioned due to conflicts that jeopardize the consolidation of this profession in the division of work in health. OBJECTIVE: to understand the construct of autonomy based on perceptions of formal leaders associated with professional organizations. METHODS: A qualitative study was conducted through interviews with key informants. The data obtained were submitted to content analysis. RESULTS: Perceptions about the autonomy in pharmaceutical practice were categorized according to strengths, weaknesses, opportunities, and threats to this construct. CONCLUSION: The findings allowed us to understand the autonomy of pharmaceutical practice in Brazil, generate hypotheses about the future of Pharmacy, and build strategies to maintain its occupational status.

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Among the waste generated at oil refineries, secondary sludge from biological wastewater treatment processes (activated sludge systems) stands out. This paper aimed to assess the use of anaerobic digestion (AD) to treat sludge by SWOT (Strength, Weakness, Opportunity, and Threat) analysis, ranking the different factors based on sustainability criteria. Additionally, the SWOT factors were matched (TOWS matrix) to help interpret the results. AD was found to be compatible with sustainability. The results demonstrated that the strength of AD (reduced organic load) compensates for its weaknesses (need for operational control and initial implementation costs), thereby avoiding the threat (sludge composition) and making the most of the opportunity (lower disposal cost). AD and co-digestion (added with food waste) used to treat oil refinery sludge showed that around 60% of the factors analyzed were confirmed experimentally. It was concluded that AD should be considered in the sustainable treatment of oil refinery waste activated sludge, especially when mixed with other readily biodegradable wastes.

Anaerobic digestion (AD) is a potential treatment for secondary sludge from refineries.AD is compatible with sustainability.Anaerobic co-digestion of refinery sludge contributed positively to sustainable treatment.The strength (reduced organic load) of AD counteract its weaknesses (operational control and implementation costs).The threat of AD (sludge composition) should be avoided and the opportunity (low disposal cost) leveraged.

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La educación de postgrado de la neurocirugía en Argentina ha sido una preocupación constante desde el inicio de la especialidad. Actualmente las organizaciones activas en educación de postgrado son la Asociación Argentina de Neurocirugía y el Colegio Argentino de Neurocirujanos. Ambas consideran que la residencia médica es el sistema de formación más apropiado para que un médico recién graduado pueda convertirse en un especialista. Para regular y organizar el desarrollo pedagógico de las mismas se diseñó un marco de referencia en donde se establecieron los estándares a alcanzar, junto con un programa de acreditación para lograr la homogeneidad de los parámetros de calidad, y además se crearon becas junto con el reglamento para su acreditación, para completar la formación en aquellos aspectos que durante la residencia no fueron suficientemente desarrollados. Como la certificación profesional es obligatoria para ejercer se crearon cursos ad hoc que constituyen la base teórica tanto para neurocirugía general como la cirugía de columna. Los postulantes deben completar una serie de requisitos y transitar por diferentes instancias de formación que incluyen, además, la residencia. Para mantener la calidad de la atención médica se creó un programa de revalidación o recertificación periódica. Toda la situación actual fue sometida a un análisis de sus fortalezas, oportunidades, debilidades y amenazas para diseñar las estrategias que permitan mejorarla(AU)

Postgraduate education in neurosurgery has been a constant concern since the beginning of the specialty. Currently active organizations in postgraduate education are the Asociación Argentina de Neurocirugía y el Colegio Argentino de Neurocirujanos. Both consider that medical residency is the most appropriate training system for a recently graduated doctor to become a specialist. To regulate and organize their pedagogical development, a reference framework was designed where the standards to be achieved were established, along with an accreditation program to achieve homogeneity of quality parameters, and fellowships were also created along with the regulations. for its accreditation, to complete the training in those aspects that were not sufficiently developed during the residency. Since professional certification is mandatory to practice, ad hoc courses were created that constitute the theoretical basis for both general neurosurgery and spinal surgery. Applicants must complete a series of requirements and go through different training instances that also include residence. To maintain the quality of medical care, a periodic revalidation or recertification program was created. The entire current situation was subjected to an analysis of its strengths, opportunities, weaknesses and threats to design strategies to improve it(AU)

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This study aimed to perform a strategic diagnosis on a property specialized in breeding, rearing and finishing beef cattle in the southern region of Piauí. It was conducted at Agropecuária Alvorada, located in the countryside, municipality of Bom Jesus, PI, Brazil. The farm develops the full cycle of beef cattle production, which is divided into breeding, rearing and finishing. A SWOT analysis (which stands for Strengths, Weaknesses, Opportunities and Threats) was carried out, consisting of an assessment of the property's internal and external environments. To evaluate the internal environment, an interview was held for data collection by means of questionnaires. The evaluation included: breeding management, sanitary management, nutritional management, infrastructure, workforce, technologies used in pasture formation, conservation and recovery, pasture management and zootechnical indices. To analyze the external environment, a group of people (experts) with deep knowledge of the subject addressed during the study was used as source of information. A matrix was generated with all the information from the SWOT analysis, strengths, weaknesses, opportunities and threats, culminating with the establishment of strategies to increase the productive efficiency of the cattle raising activity.(AU)

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Human T lymphotropic virus 1 (HTLV-1) is a public health issue for most countries and imposes important consequences on patients' health and socioeconomic status. Brazil is one of the global leaders of the public health response to these viruses. The country has challenges to overcome to implement meaningful policies aiming to eliminate HTLV-1/2. An analysis of strengths, weaknesses, opportunities, and threats (SWOT) for the implementation of public health policies on HTLV-1/2 was performed. The strengths identified were the Brazilian Unified Health System (SUS); Brazilian expertise in public health programs successfully implemented; currently available policies targeting HTLV; and strong collaboration with researchers and patient's representative. Lack of awareness about HTLV, insufficient epidemiological data, lack of reference centers for patient care, insufficient availability of confirmatory tests, lack of universal antenatal screening, and absence of cost-effectiveness studies were identified as weaknesses. Some interesting opportunities included the increased interest from international organizations on HTLV, possibility of integrating HTLV into other programs, external funding for research, available online platforms, opportunity to acquire data from HTLV-1/2 surveillance to gather epidemiological information, and HTLV policies that were implemented independently by states and municipalities. In addition to the COVID-19 pandemic, existing demands from different diseases, the country's demography and its marked sociocultural diversity and the volatility of the technical team working with HTLV-1/2 at the Brazilian Ministry of Health are threats to the implementation of public policies on HTLV-1/2. This SWOT analysis will facilitate strategic planning to allow continuous progress of the Brazilian response to HTLV-1/2 infection.

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OBJECTIVE: The Community Engagement Core (CEC) of the Center of Collaborative Research in Health Disparities focuses on developing and implementing strategies to increase academic-community collaborations and partnerships, enhance the recruitment and retention of study participants, disseminate research findings to a broader audience, and mitigate health disparities in Puerto Rico. METHODS: In order to assess the current state of academic-community relationships and also collect ideas for their improvement, a strengths, weaknesses, opportunities, and threats (SWOT) analysis was conducted. Participants for the SWOT analysis activity were drawn from a pool of stakeholders at the University of Puerto Rico Medical Sciences Campus and a group of community representatives. RESULTS: The areas identified by the group for the CEC to focus on were weaknesses such as 1) a lack of interaction and involvement with community leaders, 2) limited numbers of advocacy groups in several health areas, and 3) few research consortia. Opportunities identified included the possibilities of 1) creating alliances between academia and industry, municipalities, and community-based organizations, 2) advocating integration in research proposals, and 3) establishing a network of researchers and community leaders. CONCLUSION: The SWOT analysis activity served to foster relationships with diverse community stakeholders and select members for a community advisory board to collaborate in developing educational activities for our researchers and communities. These findings will also help the CEC establish a strategic plan that should be able to supply a strong community-based participatory research approach that would help mitigate health disparities in Puerto Rico, as well as define the strategies to implement such recommendations.

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In the Panama context, energy consumption in the building sector is mostly related to the conditioning of indoor spaces for cooling and lighting. Different nature strategies can be mimic to strongly impact these two aspects in the building sector, such as the ones presented here. A comprehensive analysis regarding literature related to biomimicry-based approaches destined to improve buildings designs is presented here. This analysis is driven by the increasing energy regulations demands to meet future local goals and to propose a framework for applications in Panama. Such biomimicry-based approaches have been further analyzed and evaluated to propose the incorporation of organism-based design for three of the most climate types found in Panama. Consequently, a SWOT analysis helped realized the potential that biomimicry-based approaches might have in improving the odds of in meeting the local and global regulations demands. The need for multidisciplinary collaboration to accomplish biomimicry-based-designed buildings, brings an increment in the competitivity regarding more trained human-assets, widening the standard-construction-sector thinking. Finally, the analysis presented here can serve as the foundation for further technical assessment, via numerical and experimental means.

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Media can be a powerful communication tool to promote breastfeeding programs, influence mother's breastfeeding behaviour, and generate support among stakeholders for breastfeeding. Yet, there is little information on how media coverage influences a country's breastfeeding enabling environment. This study addressed this gap by conducting a retrospective content analysis of documents published between January 1, 2017 and January 1, 2018 to analyse the media coverage related to breastfeeding in Mexico. Content analysis was based on the breastfeeding gear model and a strategic planning technique to identify strengths, weaknesses, opportunities, and threats for enabling the national breastfeeding environment. Media coverage of breastfeeding was more frequent in August (36% of all documents). The top three topics commonly covered by the media were advocacy events promoting breastfeeding, promotion campaigns, and changes in breastfeeding legislation and policy. In general, the media coverage focused on strengths of specific breastfeeding policies. There was limited news coverage of key factors that negatively influenced or threatened the breastfeeding environment. Findings support the need to design strategies to engage the media covering in more depth and breadth diverse aspects of breastfeeding protection, promotion, and support efforts in Mexico.

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Abstract INTRODUCTION: The fish farming program in Acre is as an alternative program to generate income and employment and has promising regional, national, and international markets. While the economic importance of fish farming in the Jurua Region is clear, one must address its contribution to increase malaria transmission. METHODS This was a qualitative study. The answers of the 16 key informants were organized into the following: (1) the healthcare services structure; (2) conscience, perception, and behaviors; and (3) socioeconomic and political issues. Each answer was classified as weaknesses, strengths, opportunities, and threats. RESULTS Regarding healthcare services, the frequency of household visits was reduced, and subjects presenting with malaria symptoms were required to visit a healthcare unit to be diagnosed and treated. Regarding individual's conscience, perception, and behavior, malaria was considered an insignificant disease, and a large proportion of the population were engaged in health practices that put them at risk in contacting with malaria vectors. Regarding political and economic issues, there were economic and infrastructure barriers for the development of a productive activity, and the insufficient credit or formalization of their properties prevented their access to governmental incentives and the financial market. CONCLUSIONS Support to fish farmers for low-cost inputs was not observed, and appropriate knowledge regarding the impact of the absence of maintenance and abandonment of fish tanks was insufficient. Moreover, insufficient healthcare services prevented not only the treatment of individuals with malaria but also the control of this disease.

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BACKGROUND: Sperm DNA fragmentation (SDF) is recognized as a leading cause of male infertility because it can impair the paternal genome through distinct pathophysiological mechanisms. Current evidence supports SDF as a major factor in the pathophysiology of several conditions, including varicocele, unexplained infertility, assisted reproductive technology failure, and environmental lifestyle factors, although the mechanisms involved have not been fully described yet. Measurement of the levels of DNA fragmentation in semen provides valuable information on the integrity of paternal chromatin and may guide therapeutic strategies. A recently published clinical practice guideline (CPG) highlighted how to use the information provided by SDF testing in daily practice, which triggered a series of commentaries by leading infertility experts. These commentaries contained an abundance of information and conflicting views about the clinical utility of SDF testing, which underline the complex nature of SDF. METHODS: A search of papers published in response to the CPG entitled "Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios" was performed within the Translational Andrology and Urology (TAU) website (http://tau.amegroups.com/). The start and end dates for the search were May 2017 and August 2017, respectively. Each commentary meeting our inclusion criteria was rated as "supportive without reservation", "supportive with reservation", "not supportive" or "neutral". We recorded whether articles discussed either SDF characteristics as a laboratory test method or clinical scenarios, or both. Subsequently, we extracted the particulars from each commentary and utilized the 'Strengths-Weaknesses-Opportunities-Threats' (SWOT) analysis to understand the perceived advantages and drawbacks of SDF as a specialized sperm function method in clinical practice. RESULTS: Fifty-eight fertility experts from six continents and twenty-two countries contributed commentaries. Overall, participants (87.9%; n=51) were supportive of the recommendations provided by the CPG on the utility of SDF testing based on clinical scenarios. The majority of participants made explicit remarks about both the clinical scenarios and SDF assays' characteristics. Among 'not supportive' and 'supportive with reservation' participants, 75% (n=30/40) and 77.5% (n=31/40) expressed concerns related to technical limitations of SDF testing methods and clinical utility of the test in one or more clinical scenarios discussed in the CPG, respectively. The SWOT analysis revealed that the CPG provides a reasonable evidence-based proposal for integration of SDF testing in the routine daily practice. It also uncovered gaps of knowledge and threats limiting the widespread application of SDF in everyday practice, thus allowing the identification of opportunities to further refine SDF testing and its clinical utility. CONCLUSIONS: The understanding of the role of SDF in male infertility requires an in-depth analysis of the multifactorial pathophysiological processes and the theories involved. The SWOT analysis allowed an objective evaluation of CPG on the clinical utility of SDF testing based on clinical scenarios and its accompanying commentaries written by global experts in all possible angles. Implementation of SDF testing in the clinic may not only increase the outcome of ART but more importantly improve the health of both fathers to be and resulting offspring.

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La amenaza del radicalismo islamista y del terrorismo derivado ideológicamente se han convertido en problemas estructurales que van a perdurar en los próximos años, sin visos de tener una solución a corto plazo. En el contexto de la Unión Europea, y en España en particular, existen indicadores que hacer pensar en la posibilidad de que en un futuro próximo se intensifiquen los incidentes críticos de violencia urbana anclados en un conflicto de identidades culturales interpretadas en clave Islam-Occidente. Este hecho, además de ser negativo para la convivencia y la cohesión social, podría ser aprovechado por las estrategias globales de los movimientos islamistas más extremos. Con el fin de llevar a cabo medidas proactivas que minimicen la polarización social y la radicalización de la ciudadanía, se simula un escenario a modo de hipótesis plausible y se evalúa desde una perspectiva psicosocial mediante un análisis DAFO (debilidades, amenazas, fortalezas y oportunidades). Se concluye respondiendo a algunas preguntas que pueden considerarse de utilidad para la toma de decisiones de los responsables políticos y con unas líneas estratégicas básicas desde un punto de vista de la gestión de la seguridad pública.

The threat of Islamist radicalism and terrorism derived ideologically have become structural problems that will endure in the coming years, no sign of having a short term solution. In the context of the European Union, and in Spain in particular, there are indicators that suggest the possibility that in the near future will intensify the critical incidents of urban violence, anchored in Islam-Western cultural identities key conflict are numerous. This fact, in addition to being negative for coexistence and social cohesion could be exploited by the global strategies of the most extreme Islamist movements. In order to carry out proactive measures that minimize social polarization and citizenship radicalization, we simulate a scenario as a plausible hypothesis which is evaluated from a psychosocial perspective using a SWOT analysis (strengths, weaknesses, opportunities and threats). We concluded with the response to some questions that we consider useful for decision-making of policymakers and with a basic strategic lines from a point of view of the management of public security.

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The virtual reality is a technology that has about 50 years of evolution, but it’s in the last two decades that instances have been generated for its development in the medical scope, especially in cognitive and motor rehabilitation. It has made great advances in this field, for example at Laboratory of Innovations in Rehabilitation Technology (LIRT), University of Haifa, Israel, at the IREX platform. This paper provides an approach to this emergent technology; identify their strengths, weaknesses, opportunities and threats, giving some simple technical considerations, in order to promote its application and investigation.

La realidad virtual es una tecnología con cerca de 50 años de evolución, pero es en estas últimas dos décadas en que se han generado instancias para su desarrollo en el ámbito médico, en particular en lo referente a la rehabilitación motora y cognitiva. Se han efectuado grandes avances en este campo, como por ejemplo, en el grupo de trabajo del Laboratory of Innovations in Rehabilitation Technology (LIRT) de la Universidad de Haifa, Israel, fundamentalmente en la plataforma IREX. El presente artículo pretende hacer una aproximación a esta tecnología emergente; identificar sus fortalezas, oportunidades, debilidades y amenazas, entregando algunas consideraciones técnicas de manera simple, con el fin de promover su aplicación e investigación.

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