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1.
Psicol. ciênc. prof ; 43: e253624, 2023.
Artigo em Português | LILACS, INDEXPSI | ID: biblio-1448954

RESUMO

O campo dos estudos transpessoais tem avançado em diversas áreas no Brasil. Comemorou seus 40 anos com uma inserção ativa nas Instituições de Ensino Superior (IES) e uma ampliação de núcleos formativos e apoiadores de ensino, pesquisa e ações sociais, além de diálogos com o Sistema de Conselhos de Psicologia. Desafios são apresentados a partir do levantamento de uma série de questões importantes e ignoradas dentro da Psicologia Transpessoal no Brasil. Apresentamos o pluriperspectivismo participativo como possibilidade de decolonizar as matrizes eurocêntricas e estadunidenses, que dão suporte ao pensamento transpessoal brasileiro, buscando honrar nossas raízes históricas e incluir outras epistemologias e ontologias, que dão continuidade à crítica à lógica cartesiana moderna. Indicamos uma breve agenda de notas temáticas que carecem de um processo decolonizador no campo transpessoal: a) crítica às perspectivas de um pensamento hegemônico, em termos globais por meio da dominação Norte-Sul ou no campo das relações sociais; b) revisão das formas de "centrocentrismo"; c) questionamento da noção de universalismo das ciências e da ética; d) aprofundamento da análise crítica da supremacia restritiva da racionalidade formal técnico-científica em relação às formas de subjetividade, de vivências holísticas e integradoras e de valorização do corpo; e) revisão da noção de sujeito moderno desprovida da cocriação do humano com a comunidade, a história, a natureza e o cosmos.(AU)


The field of transpersonal studies has advanced in several areas in Brazil. It celebrated its 40th anniversary with an active insertion in Higher Education Institutions (HEI) and an expansion of training centers and supporters of teaching, research, and social actions, in addition to dialogues with the System of Councils of Psychology. Challenges are presented based on a survey of a series of important and ignored issues within Transpersonal Psychology in Brazil. We present participatory pluriperspectivism as a possibility to decolonize the Eurocentric and North American matrices that support Brazilian transpersonal thought, seeking to honor our historical roots and include other epistemologies and ontologies, which continue the critique of modern Cartesian logic. We indicate a brief agenda of thematic notes that lack a decolonizing process in the transpersonal field: a) criticism of the perspectives of a hegemonic thought, whether in global terms via North-South domination or in the field of social relations; b) review of the forms of "centrocentrism"; c) questioning of the notion of universalism of science and ethics; d) deepening of the critical analysis of the restrictive supremacy of the technical-scientific formal rationality in relation to the forms of subjectivity, of holistic and integrative experiences, and of valuing the body; e) review of the notion of the modern subject devoid of the co-creation of the human with the community, the history, the nature, and the cosmos.(AU)


El campo de los estudios transpersonales ha avanzado en varias áreas de Brasil. Se celebró su 40.º aniversario con una inserción activa en Instituciones de Educación Superior (IES) y una ampliación de los centros de formación y promotores de la docencia, la investigación y la acción social, además de diálogos con el Sistema de Consejos de Psicología. Los desafíos se presentan a partir de una encuesta de una serie de temas importantes e ignorados dentro de la Psicología Transpersonal en Brasil. Presentamos el pluriperspectivismo participativo como una posibilidad para decolonizar las matrices eurocéntrica y americana, que sustentan el pensamiento transpersonal brasileño, buscando honrar nuestras raíces históricas e incluir otras epistemologías y ontologías que continúan la crítica de la lógica cartesiana moderna. Indicamos una breve agenda de apuntes temáticos que carecen de un proceso decolonizador en el campo transpersonal: a) crítica de las perspectivas de un pensamiento hegemónico, ya sea en términos globales a través del dominio Norte-Sur o en el campo de las relaciones sociales; b) revisión de las formas de "centrocentrismo"; c) cuestionamiento de la noción de universalismo de la ciencia y la ética; d) profundización del análisis crítico de la supremacía restrictiva de la racionalidad formal técnico-científica en relación a las formas de subjetividad, de experiencias holísticas e integradoras y de valoración del cuerpo; e) revisión de la noción de sujeto moderno desprovisto de la cocreación de lo humano con la comunidad, la historia, la naturaleza y el cosmos.(AU)


Assuntos
Humanos , Masculino , Feminino , Colonialismo , Espiritualidade , Participação Social , Perspectiva de Curso de Vida , Filosofia , Política , Arte , Prática Psicológica , Preconceito , Psicologia , Psicologia Social , Psicofisiologia , Psicoterapia , Racionalização , Aspirações Psicológicas , Religião e Psicologia , Autoavaliação (Psicologia) , Autoimagem , Logro , Justiça Social , Problemas Sociais , Ciências Sociais , Sociedades , Especialização , Superego , Tempo , Transexualidade , Inconsciente Psicológico , Universidades , Vitalismo , Trabalho , Comportamento , Comportamento e Mecanismos Comportamentais , Behaviorismo , Negro ou Afro-Americano , Humanos , Autorrevelação , Adaptação Psicológica , Escolha da Profissão , Áreas de Pobreza , Conhecimentos, Atitudes e Prática em Saúde , Organizações , Saúde , Saúde Mental , Conflito de Interesses , Comentário , Competência Mental , Teoria da Construção Pessoal , Aprendizagem Baseada em Problemas , Congressos como Assunto , Consciência , Diversidade Cultural , Conhecimento , Ocidente , Qi , Feminismo , Vida , Comportamento Cooperativo , Características Culturais , Evolução Cultural , Cultura , Má Conduta Profissional , Autonomia Pessoal , Pessoalidade , Morte , Características Humanas , Parto , Impulso (Psicologia) , Educação , Ego , Ética Profissional , Etnologia , Existencialismo , Resiliência Psicológica , Teoria da Mente , Apatia , Racismo , Desempenho Acadêmico , Cosmovisão , Etnocentrismo , Egocentrismo , Modelo de Crenças de Saúde , Funcionamento Psicossocial , Comparação Social , Liberdade de Religião , Diversidade, Equidade, Inclusão , Estrutura Familiar , Bem-Estar Psicológico , Objetivos , Alucinógenos , Saúde Holística , Direitos Humanos , Humanismo , Id , Individualidade , Individuação , Acontecimentos que Mudam a Vida , Literatura , Imperícia , Antropologia , Princípios Morais , Motivação , Misticismo , Mitologia
2.
Psicol. ciênc. prof ; 43: e251711, 2023. tab
Artigo em Português | LILACS, INDEXPSI | ID: biblio-1448945

RESUMO

As resoluções emitidas pelo Sistema Conselhos são instrumentos essenciais de orientação e promoção de práticas éticas que denotem qualidade técnica no exercício profissional da Psicologia. Dada a complexidade que envolve a elaboração de documentos psicológicos, esta pesquisa teve como objetivo identificar as principais mudanças observadas no texto da recém-publicada Resolução CFP n.º 006/2019 quando comparada à Resolução CFP n.º 007/2003, ambas referidas à elaboração de documentos psicológicos. Trata-se de uma pesquisa descritiva-comparativa de abordagem qualitativa, que utilizou da análise de conteúdo no tratamento e interpretação dos dados oriundos de fonte exclusivamente documental. Os resultados indicaram poucas diferenças qualitativas entre os marcos resolutivos, embora se vislumbre altamente relevante o ganho adquirido com a proibição de escritos descritivos, a exigência de referencial teórico para fundamentar o raciocínio profissional e a obrigatoriedade da devolutiva documental. Entre os achados que ganham notoriedade consta a preocupação com os princípios que regem a elaboração de documentos, cuja apresentação tautológica responde a um cenário político de retrocessos que tem favorecido o desrespeito aos direitos humanos e às minorias.(AU)


Resolutions issued by Sistema Conselhos are essential tools to guide and promote ethical and quality psychology practices. Given the complexity involved in elaborating such documents, this descriptive, qualitative research outlines the main changes in the text of the recently published CFP Resolution no. 006/2019 when compared with CFP Resolution no. 007/2003, both addressing the elaboration of psychological documents. Documentary data was investigated by content analysis. Results indicated few qualitative differences between the analyzed Resolutions, among them the prohibition of descriptive writing, the requirement for a theoretical framework to support professional reasoning, and the obligation to return documents. Concern with the principles that guide document elaboration stands out, responding to a political scenario of major setbacks regarding respect for human rights and minorities.(AU)


Las resoluciones que expide el Sistema Conselhos consisten en instrumentos fundamentales que guían y promueven prácticas éticas respecto a la calidad técnica en el ejercicio profesional de la Psicología. Dada la complejidad que implica la elaboración de documentos psicológicos, esta investigación tuvo como objetivo identificar los principales cambios observados en la Resolución CFP n.º 006/2019, de reciente publicación, en comparación con la Resolución CFP n.º 007/2003, ambas abordan la elaboración de documentos psicológicos. Se trata de una investigación descriptiva-comparativa con enfoque cualitativo, que utilizó el análisis de contenido en el tratamiento e interpretación de datos de fuente exclusivamente documental. Los resultados indicaron pocas diferencias cualitativas entre los marcos resolutivos (aunque el logro de prohibir los escritos descriptivos es muy relevante), la exigencia de un marco teórico para sostener el razonamiento profesional y la devolución obligatoria de los documentos. Entre los hallazgos que cobran notoriedad está la preocupación por los principios que rigen la elaboración de documentos, cuya presentación tautológica responde a un escenario político de retrocesos que ha favorecido la falta de respeto a los derechos humanos y las minorías.(AU)


Assuntos
Humanos , Masculino , Feminino , Guias como Assunto , Diagnóstico , Prova Pericial , Organização e Administração , Equipe de Assistência ao Paciente , Satisfação Pessoal , Fenômenos Psicológicos , Psicologia , Publicações , Qualidade da Assistência à Saúde , Qualidade de Vida , Comportamento Sexual , Classe Social , Valores Sociais , Transexualidade , Revelação da Verdade , Orientação Vocacional , Trabalho , Redação , Comportamento e Mecanismos Comportamentais , Políticas, Planejamento e Administração em Saúde , Cooperação Técnica , Atestado de Saúde , Atitude do Pessoal de Saúde , Registros , Classificação Internacional de Doenças , Diretório , Carga de Trabalho , Direitos Civis , Negociação , Comunicação , Artigo de Jornal , Vocabulário Controlado , Declarações , Publicação Governamental , Má Conduta Profissional , Autonomia Pessoal , Normas Jurídicas , Conselhos de Saúde , Denúncia de Irregularidades , Códigos de Ética , Manual Diagnóstico e Estatístico de Transtornos Mentais , Grupos Raciais , Documentação , Acordos de Cooperação Científica e Tecnológica , Domínios Científicos , Ética na Publicação Científica , Publicações Científicas e Técnicas , Publicações de Divulgação Científica , Humanização da Assistência , Acolhimento , Ética Profissional , Prazo de Validade de Produtos , Relatório de Pesquisa , Participação Social , Escrita Médica , Confiabilidade dos Dados , Profissionalismo , Controle de Formulários e Registros , Ciência na Literatura , Estratégias de eSaúde , Sociedade Civil , Angústia Psicológica , Assistência de Saúde Universal , Intervenção Psicossocial , Cidadania , Análise Documental , Condições de Trabalho , Escrita Manual , Ciências Humanas , Idioma
3.
CMAJ Open ; 10(1): E35-E42, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35042693

RESUMO

BACKGROUND: An understanding of regulatory complaints against resident physicians is important for practice improvement. We describe regulatory college complaints against resident physicians using data from the Canadian Medical Protective Association (CMPA). METHODS: We conducted a retrospective analysis of college complaint cases involving resident doctors closed by the CMPA, a mutual medicolegal defence organization for more than 100 000 physicians, representing an estimated 95% of Canadian physicians. Eligible cases were those closed between 2008 and 2017 (for time trends) or between 2013 and 2017 (for descriptive analyses). To explore the characteristics of college cases, we extracted the reason for complaint, the case outcome, whether the complaint involved a procedure, and whether the complaint stemmed from a single episode or multiple episodes of care. We also conducted a 10-year trend analysis of cases closed from 2008 to 2017, comparing cases involving resident doctors with cases involving only nonresident physicians. RESULTS: Our analysis included 142 cases that involved 145 patients. Over the 10-year period, college complaints involving residents increased significantly (p = 0.003) from 5.4 per 1000 residents in 2008 to 7.9 per 1000 in 2017. While college complaints increased for both resident and nonresident physicians over the study period, the increase in complaints involving residents was significantly lower than the increase across all nonresident CMPA members (p < 0.001). For cases from the descriptive analysis (2013-2017), the top complaint was deficient patient assessment (69/142, 48.6%). Some patients (22/145, 15.2%) experienced severe outcomes. Most cases (135/142, 97.9%) did not result in severe physician sanctions. Our classification of complaints found 106 of 163 (65.0%) involved clinical problems, 95 of 163 (58.3%) relationship problems (e.g., communication) and 67 of 163 (41.1%) professionalism problems. In college decisions, 36 of 163 (22.1%) had a classification of clinical problem, 66 of 163 (40.5%) a patient-physician relationship problem and 63 of 163 (38.7%) a professionalism problem. In 63 of 163 (38.7%) college decisions, the college had no criticism. INTERPRETATION: Problems with communication and professionalism feature prominently in resident college complaints, and we note the potential for mismatch between patient and health care provider perceptions of care. These results may direct medical education to areas of potential practice improvement.


Assuntos
Competência Clínica , Relações Médico-Paciente/ética , Médicos , Qualidade da Assistência à Saúde/organização & administração , Adulto , Atitude do Pessoal de Saúde , Canadá , Competência Clínica/legislação & jurisprudência , Competência Clínica/estatística & dados numéricos , Feminino , Humanos , Masculino , Satisfação do Paciente/legislação & jurisprudência , Satisfação do Paciente/estatística & dados numéricos , Médicos/legislação & jurisprudência , Médicos/normas , Má Conduta Profissional/legislação & jurisprudência , Má Conduta Profissional/tendências , Melhoria de Qualidade , Estudos Retrospectivos , Percepção Social
4.
Urology ; 159: 87-92, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34752849

RESUMO

OBJECTIVE: To determine the impact of industry payments to authors of opinion articles on the Urolift and Rezum devices. We also examined the extent to which authors omitted acknowledgements of financial conflicts-of-interest. METHODS: We searched Google Scholar for all articles that cite either of the respective pivotal trials for these devices. 2 blinded urologists coded the articles as favorable or neutral. A separate blinded researcher recorded industry payments from the manufacturers using the Open Payments Program database. RESULTS: We identified 29 articles written by 27 unique authors from an initial screening list of 235 articles. Of these articles, 15 (52%) were coded as positive and 14 (48%) were coded as neutral. 20 (74%) authors have accepted payments from the manufacturer of the device. Since 2014, these authors have collectively received $270,000 from NeoTract and $314,000 from Boston Scientific. Of the 20 authors with payments, 9 (45%) received more than $10,000 from either manufacturer. Of authors with payments, 65% (13/20) contributed to only positive articles. Authors who received payments had more than 4 times the number of article contributions than did authors without payments (42 vs 10). Authors of at least one favorable article were more likely to have received payments from the device manufacturers than authors of neutral articles (P = .014, Chi-squared test). Most (80%, 16/20) authors with payments did not report a relevant conflict-of-interest within any of their articles. CONCLUSION: These data suggest a relationship between payments from a manufacturer and positive published position on that company's device. There may be a critical lack of published editorial pieces by authors without financial conflicts of interest.


Assuntos
Conflito de Interesses/economia , Equipamentos e Provisões/economia , Setor de Assistência à Saúde , Editoração , Revelação , Declarações Financeiras/estatística & dados numéricos , Setor de Assistência à Saúde/economia , Setor de Assistência à Saúde/ética , Humanos , Sintomas do Trato Urinário Inferior/terapia , Má Conduta Profissional , Editoração/economia , Editoração/ética , Estados Unidos , Urologistas/economia , Urologistas/ética
5.
J Cardiovasc Surg (Torino) ; 63(1): 106-113, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34338496

RESUMO

BACKGROUND: Aortic and mitral valve replacement are commonly performed by cardiovascular surgeons, but little data quantitatively analyzes the etiology and prevalence of medical malpractice litigations involving these operations. This study aims to analyze incidence, cause, and resolution of medical malpractice lawsuits involving aortic and mitral valve replacements, alone and in combination with coronary artery bypass and/or aortic procedures. METHODS: The Westlaw legal database was utilized to compile relevant litigations across the United States from 1994-2019. Clinical data, verdict data, demographic data, and litigation attributes were compiled. Fisher's Exact Tests and Mann-Whitney tests were performed for statistical analyses. One hundred four malpractice litigations involving aortic valve replacement and 55 litigations involving mitral valve replacement were included in this analysis. The mean age of patients was 55.2 years and proportion of female patients was 32.7% in aortic valve replacements litigations, compared to a mean age of 54.1 years and female patients in 61.8% of mitral valve replacements litigations. RESULTS: Significant relationships exist between an alleged failure to monitor the patient and defendant verdicts (P=0.01), delayed treatment and defendant verdicts (P=0.04), and incidence of infective endocarditis and plaintiff verdicts (P=0.04) in aortic valve replacement litigations. Similarly, significant relationships exist between an alleged failure to diagnose and settlement verdicts (P=0.047), and stroke incidence and defendant verdicts (P=0.03) in mitral valve replacement litigations. CONCLUSIONS: In addition to excellent surgeon patient/family communication, administering surgical treatment in a timely manner, diagnosing acting on concomitant medical conditions, and close patient monitoring may diminish medical malpractice litigation involving aortic and mitral valve replacement operations.


Assuntos
Valva Aórtica/cirurgia , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/legislação & jurisprudência , Seguro de Responsabilidade Civil/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Valva Mitral/cirurgia , Bases de Dados Factuais , Feminino , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Masculino , Erros Médicos/efeitos adversos , Pessoa de Meia-Idade , Dano ao Paciente/legislação & jurisprudência , Má Conduta Profissional/legislação & jurisprudência , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Estados Unidos
7.
Ear Nose Throat J ; 100(10_suppl): 981S-982S, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32520600

RESUMO

The List of Excluded Individuals and Entities (LEIE) is a federally updated and available list of providers who have been excluded from participating from federal healthcare programs. With over 40 year's worth of exclusion history, we were able to isolate and identify otolaryngologists who were excluded and the most common cause, albeit exceptionally rare, was revocation of their medical license due to negligence.


Assuntos
Imperícia/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Medicare/estatística & dados numéricos , Otorrinolaringologistas/estatística & dados numéricos , Má Conduta Profissional/estatística & dados numéricos , Humanos , Otorrinolaringologistas/legislação & jurisprudência , Estados Unidos
8.
Sex Reprod Healthc ; 26: 100554, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33032165

RESUMO

BACKGROUND: Antenatal care utilization is fundamental in preventing adverse pregnancy and birth outcomes. This paper assessed abuse and disrespectful care on women during access to antenatal care services and its implications in Ndola and Kitwe districts of Zambia. METHODS: The assessment used a cross-sectional study design with a sample size of 505 women of child bearing age (15-49). Eighteen (18) high volume health facilities were identified as benchmarks for catchment areas (study sites) and using cluster sampling, households within catchment areas of health facilities were sampled. Chi-square and poison regression analysis was performed to ascertain associations between abuse and disrespect and antenatal care utilization. RESULTS: One third (33%) of the participants attended less than half of the recommended antenatal visits. Results reveal a statistical significant association between; physical abuse (p value = 0.039); not being allowed to assume position of choice during examination (p value = 0.021); not having privacy during examination (p value = 0.006) and antenatal care service utilization. The difference in the logs of expected count on the number of antenatal care visits is expected to be; 0.066 (CI: -0.115,-0.018) unit lower for women who experienced lack of privacy during examinations; 0.067 (CI: -0.131,-0.004) unit lower for women who were discriminated based on specific attributes and 0.067 (CI: -0.120,-0.014) unit lower for women who were left unattended. CONCLUSION: Abuse and disrespect during antenatal care service impedes demand for health care and service utilization thereby barricading the element of the package of services aimed at improving maternal and newborn health.


Assuntos
Comportamento Agonístico , Atitude do Pessoal de Saúde , Serviços de Saúde Materna/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Relações Médico-Paciente , Má Conduta Profissional/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Período Periparto/psicologia , Gravidez , Cuidado Pré-Natal/psicologia , Fatores Socioeconômicos , Adulto Jovem , Zâmbia
11.
Pain Physician ; 23(3): E297-E304, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32517406

RESUMO

BACKGROUND: Prescribing opioids has become a challenge. The US Drug Enforcement Agency (DEA) and Centers for Disease Control and Prevention (CDC) have become more involved, culminating in the March 2016 release of the CDC's "Guidelines for Prescribing Opioids for Chronic Pain." OBJECTIVES: Given the new guidelines, we wanted to see if there have been any changes in the numbers, demographics, physician risk factors, charges, and sanctions involving the DEA against physicians who prescribe opioids, when compared to a previous DEA database review from 1998 to 2006. STUDY DESIGN: This study involved an analysis of the DEA database from 2004 to 2017. SETTING: The review was conducted at the Henry Ford Health System Division of Pain Medicine. METHOD: After institutional review board approval at Henry Ford Health System, an analysis of the DEA database of criminal prosecutions of physician registrants from 2004-2017 was performed. The database was reviewed for demographic information such as age, gender, type of degree (doctor of medicine [MD] or doctor of osteopathic medicine [DO]), years of practice, state, charges, and outcome of prosecution (probation, sentencing, and length of sentencing). An internet-based search was performed on each registrant to obtain demographic data on specialty, years of practice, type of medical school (US vs foreign), board certification, and type of employment (private vs employed). RESULTS: Between 2004 and 2017, Pain Medicine (PM) had the highest percentage of in-specialty action at 0.11% (n = 5). There was an average of 18 prosecutions per year vs 14 in the previous review. Demographic risk factors for prosecution demonstrated the significance of the type of degree (MD vs. DO), gender, type of employment (private vs. employed), and board certification status for rates of prosecution. Having a DO degree and being male were associated with significantly higher risk as well as being in private practice and not having board certification (P < .001). In terms of type of criminal charges as a percent of cases, possession with intent to distribute (n = 90) was most prevalent, representing 52.3% of charges, with new charges being prescribing without medical purpose outside the usual course of practice (n = 71) representing 41.3% of charges. Comparison of US graduates (MD/DO) vs. foreign graduates showed higher rates of DEA action for foreign graduates but this was of borderline significance (P = .072). LIMITATIONS: State-by-state comparisons could not be made. Specialty type was sometimes self-reported, and information on all opioid prosecutions could not be obtained. The previous study by Goldenbaum et al included data beyond DEA prosecution, so direct comparisons may be limited. CONCLUSION: The overall risk of DEA action as a percentage of total physicians is small but not insignificant. The overall rates of DEA prosecution have increased. New risk factors include type of degree (DO vs. MD) and being in private practice with a subtle trend toward foreign graduates at higher risk. With the trend toward less prescribing by previously high-risk specialties such as Family Medicine, there has been an increase in the relative risk of DEA action for specialties treating patients with pain such as PM, Physical Medicine and Rehabilitation, neurology, and neurosurgery bearing the brunt of prosecutions. New, more subtle charges have been added involving interpretation of the medical purpose of opioids and standard of care for their use. KEY WORDS: Certification, CDC, criminal, DEA, opioid, prescribing, prosecution, sanctions.


Assuntos
Analgésicos Opioides/uso terapêutico , Médicos/legislação & jurisprudência , Padrões de Prática Médica/legislação & jurisprudência , Má Conduta Profissional/legislação & jurisprudência , Adulto , Prescrições de Medicamentos , Disciplina no Trabalho/estatística & dados numéricos , Feminino , Órgãos Governamentais/legislação & jurisprudência , Regulamentação Governamental , Fidelidade a Diretrizes , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
12.
PLoS One ; 15(5): e0230961, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32374737

RESUMO

Is it appropriate for scientists to engage in political advocacy? Some political critics of scientists argue that scientists have become partisan political actors with self-serving financial agendas. However, most scientists strongly reject this view. While social scientists have explored the effects of science politicization on public trust in science, little empirical work directly examines the drivers of scientists' interest in and willingness to engage in political advocacy. Using a natural experiment involving the U.S. National Science Foundation Graduate Research Fellowship (NSF-GRF), we causally estimate for the first time whether scientists who have received federal science funding are more likely to engage in both science-related and non-science-related political behaviors. Comparing otherwise similar individuals who received or did not receive NSF support, we find that scientists' preferences for political advocacy are not shaped by receiving government benefits. Government funding did not impact scientists' support of the 2017 March for Science nor did it shape the likelihood that scientists donated to either Republican or Democratic political groups. Our results offer empirical evidence that scientists' political behaviors are not motivated by self-serving financial agendas. They also highlight the limited capacity of even generous government support programs to increase civic participation by their beneficiaries.


Assuntos
Comportamento/ética , Financiamento Governamental , Pessoal de Laboratório/ética , Política , Política Ambiental/economia , Política Ambiental/legislação & jurisprudência , Financiamento Governamental/ética , Financiamento Governamental/normas , Programas Governamentais/economia , Programas Governamentais/ética , Programas Governamentais/normas , Política de Saúde/economia , Política de Saúde/legislação & jurisprudência , Humanos , Pessoal de Laboratório/economia , Pessoal de Laboratório/psicologia , Má Conduta Profissional/ética , Política Pública , Setor Público/ética , Publicações/economia , Publicações/ética , Publicações/legislação & jurisprudência , Publicações/normas , Ciência/economia , Ciência/ética , Confiança , Estados Unidos
13.
Med Anthropol Q ; 34(2): 268-285, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31573104

RESUMO

Drawing on ethnographic material collected in Pakistan, India, and Nepal, this article analyzes patterns of corruption in vaccination programs in South Asia. Corrupt practices-which required substantial work-were deeply shaped by both the money and systems of accountability of the global health system. Bilateral and multilateral donors provided substantial funding for immunization programs across South Asia. International agencies and governments instituted systems of accountability, including documentation requirements and a parallel UN bureaucracy in problematic districts, to try to ensure that health workers did what they wanted. Some immunization program staff skillfully bent these systems of accountability to their own ends, diverting vaccination funding into their own pockets. Corruption operates not in opposition to the official rules, but in spaces opened up by them. These practices sometimes transform Weber's rational bureaucracy into a sophisticated game with many players, whose aims are more complex than the stated goals of the bureaucracy.


Assuntos
Atenção à Saúde/etnologia , Agências Internacionais , Má Conduta Profissional , Antropologia Médica , Ásia/etnologia , Enganação , Humanos , Vacinação/economia
14.
Sci Eng Ethics ; 26(1): 205-231, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30725393

RESUMO

The construction industry consistently ranks amongst the highest contributors to global gross domestic product, as well as, amongst the most corrupt. Corruption therefore inflicts significant risk on construction activities, and overall economic development. These facts are widely known, but the various sources and nature of corruption risks endemic to the Iranian construction industry, along with the degree to which such risks manifest, and the strength of their impact, remain undescribed. To address the gap, a mixed methods approach is used; with a questionnaire, 103 responses were received, and these were followed up with semi-structured interviews. Results were processed using social network analysis. Four major corruption risks were identified: (1) procedural violations in awarding contracts, (2) misuse of contractual arrangements, (3) neglect of project management principles, and, (4) irrational decision making. While corruption risks in Iran align with those found in other countries, with funds being misappropriated for financial gain, Iran also shows a strong inclination to champion projects that serve the government's political agenda. Root cause identification of corruption risks, namely, the noticeable impact of authoritarianism on project selection in Iran, over criterion of economic benefit or social good, is a significant outcome of this study.


Assuntos
Indústria da Construção/ética , Contratos/ética , Tomada de Decisões Gerenciais , Má Conduta Profissional , Análise de Rede Social , Indústria da Construção/tendências , Contratos/tendências , Humanos , Irã (Geográfico) , Risco , Inquéritos e Questionários
16.
J Gen Intern Med ; 35(5): 1465-1476, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31734790

RESUMO

BACKGROUND: Despite the importance of professionalism, little is known about how burnout relates to professionalism among practicing physicians. OBJECTIVE: To evaluate the relationship between burnout and professional behaviors and cost-conscious attitudes. DESIGN AND PARTICIPANTS: Cross-sectional study in a national sample of physicians of whom a fourth received a sub-survey with items exploring professional behaviors and cost-conscious attitudes. Responders who were not in practice or in select specialties were excluded. MEASURES: Maslach Burnout Inventory and items on professional behaviors and cost-conscious attitudes. KEY RESULTS: Among those who received the sub-survey 1008/1224 (82.3%) responded, and 801 were eligible for inclusion. Up to one third of participants reported engaging in unprofessional behaviors related to administrative aspects of patient care in the last year, such as documenting something they did not do to close an encounter in the medical record (243/759, 32.0%). Fewer physicians reported other dishonest behavior (e.g., claiming unearned continuing medical education credit; 40/815, 4.9%). Most physicians endorsed cost-conscious attitudes with over 75% (618/821) agreeing physicians have a responsibility to try to control health-care costs and 62.9% (512/814) agreeing that cost to society is important in their care decisions regarding use of an intervention. On multivariable analysis adjusting for personal and professional characteristics, burnout was independently associated with reporting 1 or more unprofessional behaviors (OR 2.01, 95%CI 1.47-2.73, p < 0.0001) and having less favorable cost-conscious attitudes (difference on 6-24 scale - 0.90, 95%CI - 1.44 to - 0.35, p = 0.001). CONCLUSIONS: Professional burnout is associated with self-reported unprofessional behaviors and less favorable cost-conscious attitudes among physicians.


Assuntos
Esgotamento Profissional , Médicos , Atitude do Pessoal de Saúde , Esgotamento Profissional/epidemiologia , Estudos Transversais , Humanos , Má Conduta Profissional , Inquéritos e Questionários
17.
N Z Med J ; 132(1488): 49-54, 2019 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-31851661

RESUMO

AIM: To describe disciplinary cases for inappropriate prescribing of drugs of dependence by doctors in New Zealand, 1997-2016. METHODS: A retrospective analysis of disciplinary decisions to describe characteristics of cases (setting, drugs, outcome) and doctors (sex, specialty, years since qualification). RESULTS: There were 25 disciplinary decisions involving 24 doctors. Disciplined doctors were mostly male (19;76%), working in general practice (19;76%), and older (mean 24 years in practice). Pharmacists were the most common source of notification to the authorities (6;24%); medical colleagues reported only four (16%). The alleged misconduct often involved behaviour in addition to inappropriate prescribing. In all cases the doctor was found guilty of professional misconduct. Penalties were severe: six doctors were removed from practice, 11 were suspended, and of the remainder all but one had restrictions on practice imposed. In many decisions there was no patient harm documented. CONCLUSION: Disciplinary cases for inappropriate prescribing of drugs of dependence by doctors in New Zealand are not common, but the consequences can be dire. The role of discipline in doctors with drug dependence is unclear.


Assuntos
Prescrição Inadequada , Médicos/legislação & jurisprudência , Padrões de Prática Médica/legislação & jurisprudência , Má Conduta Profissional/legislação & jurisprudência , Feminino , Humanos , Prescrição Inadequada/economia , Prescrição Inadequada/legislação & jurisprudência , Masculino , Nova Zelândia/epidemiologia , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias
19.
Lancet ; 394(10214): 2119-2124, 2019 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-31785827

RESUMO

Corruption is embedded in health systems. Throughout my life-as a researcher, public health worker, and a Minister of Health-I have been able to see entrenched dishonesty and fraud. But despite being one of the most important barriers to implementing universal health coverage around the world, corruption is rarely openly discussed. In this Lecture, I outline the magnitude of the problem of corruption, how it started, and what is happening now. I also outline people's fears around the topic, what is needed to address corruption, and the responsibilities of the academic and research communities in all countries, irrespective of their level of economic development. Policy makers, researchers, and funders need to think about corruption as an important area of research in the same way we think about diseases. If we are really aiming to achieve the Sustainable Development Goals and ensure healthy lives for all, corruption in global health must no longer be an open secret.


Assuntos
Fraude , Saúde Global , Setor de Assistência à Saúde , Má Conduta Profissional , Pesquisa Biomédica , Crime , Humanos , Cooperação Internacional , Responsabilidade Social , Assistência de Saúde Universal
20.
Tunis Med ; 97(3): 397-406, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31729714

RESUMO

INTRODUCTION: Corruption in the health care system is a universal phenomenon, putting at risk the health of populations. The purpose of this work was to synthesize the international literature on corruption in the health sector. METHODS: This is a systematic review of literature dealing with articles on health corruption practices, published between July 2008 and June 2018, via two search engines: PubMed and Google Scholar. The extracted data were narratively summarized in three major areas: defining the concept of corruption in health, its typology / manifestations and anti-corruption interventions. RESULTS: A total of 23 articles were selected for final analysis. The articles that defined health corruption shared two key aspects: "abuse of power" and "benefit". The main types of corruption were "abuse of therapeutic indication", followed by "bribes" and "falsification". The anti-corruption interventions were synthesized into seven types: creation of an independent multi-interventional agency, support for scientific research, law enforcement, awareness raising, detection, reporting and institutional commitment. CONCLUSION: Based on the use of power, corruption in health is a complex phenomenon whose struggle requires a specific and contextualized strategy integrating information, detection and punishment.


Assuntos
Atenção à Saúde/ética , Ética Médica , Fraude/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/ética , Padrões de Prática Médica , Má Conduta Profissional , Acesso à Informação/ética , África do Norte/epidemiologia , Enganação , Atenção à Saúde/economia , Atenção à Saúde/organização & administração , Atenção à Saúde/normas , Fraude/ética , Acessibilidade aos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/normas , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Humanos , Relações Médico-Paciente/ética , Padrões de Prática Médica/ética , Padrões de Prática Médica/estatística & dados numéricos , Má Conduta Profissional/ética , Má Conduta Profissional/estatística & dados numéricos , Charlatanismo/ética , Charlatanismo/estatística & dados numéricos
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