PAHO Forward Plan of Action 2.0: An Organization-wide approach to strengthening efficiency, transparency, and accountability

PAHO Forward is a results-based, Organization-wide initiative to systematically innovate and modernize management practices to increase efficiency, transparency, and accountability internally and externally. The PAHO Forward Plan of Action 2.0 operationalizes the PAHO Forward framework and includes the specific objectives of strengthening the Pan American Sanitary Bureau (PASB) efficiency, transparency, and accountability; bolster the Pan American Health Organization (PAHO) visibility, country focus, and capacity to deliver technical cooperation; enhance the PASB human resources performance and drive innovation to move the Organization forward. This report describes the main components of the updated plan, and outlines the full list of actions and expected results that have been prioritized by PAHO Forward Governance for the period June 2024 to May 2025.

The impact mechanism and empirical analysis of financial efficiency of science and technology empowering regional real economy growth.

With the aim of exploring the impact mechanism of scientific and technological financial efficiency on regional real economy growth in the context of ecological civilization construction, this study introduces environmental regulation as a mediating factor. By analyzing changes in science and financial efficiency of science and technology, we provide an effective basis for regional real economy development. To achieve this goal, we define concepts such as science and financial efficiency of science and technology and regional real economy, measure data from 2012 to 2021, analyze the impact of science and financial efficiency of science and technology on economic growth using intermediary models, test mediation effects with bootstrap methods, and identify significant differences between regions. It indicates that enhancing science and financial efficiency of sci-tech benefits China's regional real economy growth, but there's unbalanced development across regions. Additionally, environmental regulation serves as a crucial intermediary in the relationship between sci-tech finance and economic growth. There exist regional disparities in the mediation effects of environmental regulation, with eastern regions demonstrating stronger effects compared to central and western regions.

The effect of digital government on corporate total factor productivity.

This study examines the influence of digital government initiatives on corporate total factor productivity (TFP). Employing a difference-in-differences (DID) methodology and analyzing data from publicly listed companies spanning the period 2010 to 2020, we investigate the impact of digital governance on corporate TFP. Our findings reveal a noteworthy positive effect, with an average TFP increase of 5%. Further exploration through heterogeneity analysis indicates that this impact is particularly pronounced in regions with robust network infrastructure, increased marketization, and decreased economic uncertainty, particularly among privately-owned enterprises. Moreover, we identify key mechanisms through which digital governance fosters this enhancement in TFP, including the facilitation of technological innovation, efficient allocation of high-skilled labor, and improved investment efficiency. Our research underscores the significant role of digital government initiatives in bolstering corporate TFP and contributes to a deeper understanding of the mechanisms underlying this relationship.

Agências de regularização técnica odontológica em relação ao manejo clínico em crianças: uma revisão de literatura / Dental technical regularization agencies in relation to management clinic in children: a review of the literature

O manejo clínico em Odontopediatria é individual, podendo variar nas diversas culturas mundiais. O objetivo desta revisão de literatura é reunir as principais diretrizes de diferentes países ao redor do mundo, incluindo o Brasil, visando identificar como em cada lugar o uso das técnicas de comportamento são aplicadas e sua eficiência. Inicialmente, foram selecionados os principais guias nacionais e internacionais, sendo eles retirados da Associação Internacional de Odontopediatria (IAPD) e Associação Americana de Odontopediatria (AAPD), além de artigos de diferentes países e continentes, como Argentina, Brasil, Europa e Ásia, também foram analisados se o protocolo dos principais guias estão condizentes com os protocolos do Departamento de Clínica Infantil da Faculdade de Odontologia de Ribeirão Preto - USP. Os resultados obtidos nos guias para manejo clínico odontológico brasileiro, americano, internacional e os artigos estudados recomendam inicialmente utilizar técnicas menos invasivas, com o intuito proporcionar um atendimento tranquilo e sem criar traumas para a criança, uma vez que muito do comportamento não cooperativo vem de experiências anteriores traumáticas. Entretanto, técnicas avançadas podem ser utilizadas para casos mais desafiadores. Concluímos com o estudo dos guias e artigos, que o cirurgião dentista possui diversas técnicas a serem aplicadas para que o atendimento infantil seja atraumático e restabelecer saúde ao paciente.

Clinical management in Pediatric Dentistry is individual and varies across different cultures around the world. The objective of this literature review is to bring together the main guidelines from different countries around the world, including Brazil, aiming to identify how the use of behavioral techniques are applied and their efficiency in each place. Initially, the main national and international guides were selected, taken from the International Association of Pediatric Dentistry (IAPD) and the American Association of Pediatric Dentistry (AAPD), as well as articles from different countries and continents, such as Argentina, Brazil, Europe and Asia, as well as It was analyzed whether the protocols of the main guides are consistent with the protocols of the Children's Clinic Department of the Faculty of Dentistry of Ribeirão Preto - USP. The results obtained in the guides for Brazilian, American and international dental clinical management and the articles studied recommend initially using less invasive techniques, with the aim of providing calm care and without creating trauma for the child, since much of the uncooperative behavior comes from previous traumatic experiences. However, advanced techniques can be used for more challenging cases. We conclude from studying the guides and articles that the dental surgeon has several techniques to be applied so that child care is atraumatic and restores health to the patient.

Burden in caregivers of patients with schizophrenia, depression, dementia, and stroke in Japan: comparative analysis of quality of life, work productivity, and qualitative caregiving burden.

BACKGROUND: The main objective of this study was to examine the burden of schizophrenia, depression, Alzheimer's disease/dementia, and stroke on caregivers and non-caregivers in Japan. This study also aimed to provide a comparative landscape on the burden of caregiving for each disorder. METHODS: The Japan National Health and Wellness Survey database, 2016 and 2018 was used in this study. Health-related quality of life (HRQoL), work productivity, and health care utilization were assessed using a self-administered, Internet-based questionnaire. The burden of caregiving experienced by each group of caregivers was compared with background-matched non-caregivers (controls) as well as with caregivers of patients with each disorder. RESULTS: Caregivers of patients with schizophrenia, depression, Alzheimer's disease/dementia, or stroke had lower HRQoL, higher healthcare costs and work productivity impairment than non-caregivers. Furthermore, caregivers of patients with psychiatric disorders such as schizophrenia and depression had lower HRQoL and work productivity than caregivers of patients with Alzheimer's disease/dementia and stroke. In addition, according to the Caregiver Reaction Assessment (CRA), caregivers of patients with schizophrenia and depression were more inclined to perceive a loss in physical strength and financial burden to the same extent as their self-esteem. CONCLUSIONS: This study indicated a substantial caregiving burden among caregivers of patients with psychiatric and neurological diseases in Japan. The caregiver burden of psychiatric disorders (schizophrenia and depression) was greater than that of neurological disorders (Alzheimer's disease/dementia and stroke), suggesting a need to provide support to caregivers of patients with psychiatric disorders to be better able to care for their patients. TRIAL REGISTRATION: None.

The Departmental Scholarly Index: A Metric of Research Productivity.

INTRODUCTION: While bibliometric ranking systems have been designed to use citations, funding, and alumni productivity, there is a need for a simple metric that objectively evaluates the work of a group or organization. The present study describes a bibliometric tool, the Departmental Scholarly Index (DSI), for this purpose. METHODS: Publications from academic plastic surgery programs in qualifying states of the Southeastern Society of Plastic and Reconstructive Surgeons released in 2022 were collected via PubMed affiliation search. Publications were recorded in a running list alongside the title and 2022 impact factor of their respective journals. The impact factors were averaged by summing the impact factors and dividing by the number of articles to obtain a raw average. Any publication in a journal with an impact factor greater than five multiples of the raw average was removed as an outlier. The remaining impact factors were then summed and give the final numerical value representing the DSI. RESULTS: A total of 464 articles published in 139 individual journals were returned from PubMed between January 1, 2022, and December 31, 2022, for the 22 constituent departments. Calculated Spearman's rank coefficients comparing the DSI ranking with both the Doximity and Persad-Paisley rankings yielded values of 0.66 (P < 0.01) and 0.62 (P < 0.01), respectively. Overall, the DSI rankings largely agree with either the Persad-Paisley or Doximity rankings with notable differences seen in the rankings of Mayo Florida and the University of Alabama. A clear academic ranking of Southeastern Society of Plastic and Reconstructive Surgeons programs was generated from these data. CONCLUSIONS: The DSI represents a novel and simple approach to applying objective value to research with the advantage of using data bound to the most recent publication productivity.

Does working from home work? That depends on the home.

Working from home (WFH) has risen in popularity since the COVID-19 pandemic. There is an ongoing debate about the productivity implications of WFH, but the physical climate of the home office has received only limited attention. This paper investigates the effect of home office satisfaction and environment-improving behavior on productivity and burnout tendency for WFH employees. We surveyed over 1,000 Dutch WFH individuals about their home office and perceived WFH performance. We fit logistic regressions and structural equation models to investigate the effect of home office satisfaction and characteristics on self-reported productivity, burnout tendency, and willingness to continue WFH. Our results reveal that individual differences in WFH productivity are explained by heterogeneity in the physical home office environment. Higher satisfaction with home office factors is significantly associated with increased productivity and decreased burnout tendency. We continue by showing that more ventilation during working hours is associated with increased productivity, willingness to continue WFH, and burnout resilience. This effect is fully mediated by satisfaction with the home office. We find that higher home office satisfaction is associated with WFH success and air-quality-improving behavior is associated with higher satisfaction. Our results underline a holistic perspective such that investing in a healthy and objectively measured physical climate is a key aspect of the bright future of working from home. The move from the work office to the home office needs to be accompanied by careful design and investment in the quality of the office and its climate.

Work absence and productivity loss of patients undergoing a trial of spontaneous passage for ureteral stones.

Patients with ureteral stones are often managed with a spontaneous trial of passage. While cost effective, the current literature has not examined the effects of a trial of passage on patients' work productivity. In this study, we aim to characterize work absence and productivity losses in a cohort of patients undergoing a trial of passage for ureteral stones. Actively employed patients aged 18 to 64 and discharged from Duke emergency departments without surgical intervention for ureteral stones ≤ 10 mm were contacted by phone four weeks after their presentation. Participants completed the Institute for Medical Technology Assessment Productivity Cost Questionnaire which assesses three domains: absenteeism - missed work; presenteeism -productivity when returning to work; and unpaid work - assistance with household work. Linear regression associated demographic and stone factors with productivity losses.109 patients completed the survey. In total, 67% of patients missed work, 46% had decreased productivity when returning to work, and 55% required assistance with unpaid work. 59% of patients with stones ≤ 5 mm missed work versus 84% with stones > 5 mm (p = 0.009). African American race (coefficient 23.68, 95% confidence interval 2.24-45.11, p = 0.031), first-time stone formers (coefficient 20.28, 95% confidence interval 2.50-38.07, p = 0.026), and patients with stones > 5 mm (coefficient 25.34, 95% CI 5.25-45.44, p = 0.014) were associated with increased productivity losses. The majority of patients miss work while undergoing a trial of passage and many have decreased productivity when returning to work. This information may help counsel patients in emergency departments, especially first-time stone formers, and prevent return visits.

The effects of an employee assistance program on productivity at work, workability, absenteeism, and smartphone measures of heart rate and heart rate variability.

Employee Assistance Programs (EAPs) have been shown to effectively reduce absenteeism, workplace injury rates, and health-related productivity impairments. However, established measures for determining its impact on employee-level productivity have rarely been used, nor have studies employed biological measures of well-being. Drawing on the allostatic load theory, we examine the effects of an EAP on biological measures (heart rate, heart rate variability), established measures of health-related productivity (Workability Index, Health and Work Performance Questionnaire, Workplace Limitations Questionnaire), and absenteeism 4 weeks and 6 months after clients started to receive counseling. We conducted a quasi-experimental study comparing an EAP (n = 73) with a matched control group (n = 134) using propensity score matching. We found that an EAP improves health-related productivity 4 weeks and 6 months after enrolling in counseling, above and beyond changes in the control group. Biological measures changed in the hypothesized directions, but differences between the groups did not reach significance. Absenteeism did not change in the EAP group 6 months after enrolling in counseling. In an exploratory analysis, we found that individuals requiring many sessions in the first 4 weeks showed worse productivity outcomes, demonstrating a negative dose-response relationship. Our study provides an example of how to include biological measures in EAP research. It adds to the scientific evidence of the usefulness of EAP services in restoring employee-level productivity. We calculate that the marginal productivity improvements per employee using the EAP are as much as $15,600 per annum. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The impact of a curriculum-based research training program on medical students' research productivity and future research interests: a longitudinal study.

BACKGROUND: Incorporating scientific research into undergraduate medical education is necessary for the quality of future health care. However, providing rigorous research training to a large number of medical students at one institution remains one of the major challenges. The authors studied the impact of a curriculum-based Research Training Program (RTP) for all undergraduate students at Zhejiang University School of Medicine (ZUSM) on research productivity and future research interests. METHODS: Medical students (n = 2,213) from ZUSM who completed the course of RTP between 2013 and 2020 were studied. The authors measured the academic performance, research publications, and research projects of students across years, and evaluated potential factors that contribute to student research productivity and increased interest in future research. RESULTS: Across the years, there was an increase in the number of student publications, a greater proportion of students with publications, and a greater proportion of projects involving three or more students (P < .01 for all). The academic performance of the course was associated with increased publications (P = .014), whereas overall satisfaction of the course (OR 2.07, 95% CI [1.39, 3.10], P < .001), Skill Composite Score (SCS) (OR 1.70, 95% CI [1.16, 2.50], P = .007), and male gender (OR 1.50, 95% CI [1.06, 2.12], P = .022) were associated with increased future research interests. CONCLUSIONS: The findings suggest that the curriculum-based RTP improved students' research productivity, and that overall program satisfaction and self-assessed performance were associated with increased students' intent to participate in future research.

The role of mindfulness in stress, productivity and wellbeing of foundation year doctors: a mixed-methods feasibility study of the mindful resilience and effectiveness training programme.

BACKGROUND: Medical Foundation Year (FY) doctors demonstrate greater psychological distress compared with the general population and other student groups. This feasibility study investigated FY doctors' perceptions of mindfulness and the impact of a mindful resilience and effectiveness training (MRET) programme on stress, wellbeing, and performance. METHODS: Mixed-methods study utilising a questionnaire (study 1, N = 144) and a pre-post analysis design of MRET programme (study 2, N = 13), along with focus groups (N = 7). RESULTS: In study 1 28.5% of FY's reported using mindfulness. All five mindfulness facets were significantly, and positively, associated with mental wellbeing (p < 0.05). Acting with awareness (AA) and non-reactivity (NR) were significantly, positively associated with a challenge responses to stress (p < 0.05). Threat and loss appraisals were negatively associated with AA, NR, and non-judging (p < 0.01). Perceived productivity was positively associated with mindfulness facets: describing, AA, and NR (p < 0.001). In study 2, there were significant increases in wellbeing and mindfulness facets observing, describing, AA, and NR, and threat appraisals decreased (p < 0.05). The main themes identified across the focus group included Reframed Mindset, Values-Based Action, Embodied Leadership and Pedagogy. CONCLUSIONS: There exists a relationship between mindfulness, psychological wellbeing, and performance in FYs. The MRET prorgamme improved psychological wellbeing and reduced threat appraisals. Future work could focus resources on enhancing the skills of AA and NR, as this may be sufficient to bring about meaningful improvements in wellbeing, percieved productivity and cognitive reappraisal of stressful life events.

Quantity over quality of publications: Are we using the right metrics to judge author's productivity and impact in biomedical research?

ABSTRACT: The "publish and flourish" culture in the biomedical field has led to an increase in the number of publications worldwide, creating pressure on researchers to publish frequently. However, this focus on quantity over quality has resulted in an inflation of the number of authors listed in articles, leading to authorship issues and the rise of fraudulent or predatory scientific and medical journals. To maintain the credibility of scientific research, it is necessary to reform the publication metrics and explore innovative ways of evaluating an author's contributions. Traditional metrics, such as publication counts, fail to capture the research's quality, significance, and impact. As a result, this viewpoint explores and highlights different metrics and novel methods by which an author's productivity and impact can be assessed beyond traditional metrics, such as the H index, i10 index, FWCI, HCP, ALEF, AIF, AAS, JIF, CNA, awards/honors, citation percentile, n-index, and ACI. By using multiple metrics, one can determine the true impact and productivity of an author, and other measures such as awards and honors, research collaborations, research output diversity, and journal impact factors can further aid in serving the purpose. Accurately assessing an author's productivity and impact has significant implications on their academic career, institution, and the broader scientific community. It can also help funding agencies make informed decisions, improve resource allocation, and enhance public trust in scientific research. Therefore, it is crucial to address these issues and continue the ongoing discussion on best method to evaluate and recognize the contributions of authors in today's rapidly changing academic landscape.

Do regional tax incentive policies improve productivity?

The difficulty in transforming old industrial areas constitutes a significant factor contributing to regional development imbalances. Can regional tax incentives, as a crucial component of regional policies, polish the "rust belt" regions? This study leverages the inaugural Value-Added Tax (VAT) reform in China as an opportunity to explore the potential of regional tax incentives in achieving sustainable development in traditional industrial areas. Drawing upon a comprehensive industrial enterprise database, we employ a Propensity Score Matching-Difference in Differences (PSM-DID) approach to examine the efficacy of these tax incentives. Our findings reveal that: (1) Regional tax incentives primarily enhance firms productivity by stimulating investment in enterprises, yet they do not contribute to improved investment efficiency or spur innovation within firms. (2) Regional tax incentives have alleviated financing constraints for enterprises in old industrial bases, significantly enhancing the Total Factor Productivity (TFP) of firms with higher financing constraints. This policy has had an even stronger impact on improving the TFP of state-owned and monopolistic enterprises. (3) Regional tax incentives have impeded productivity growth by preventing the exit of low-efficiency firms and the entry of high-efficiency ones. These incentives also increased the likelihood of "zombie firms" forming and failed to promote endogenous economic growth in the Northeast region. Additionally, they have distorted the allocation of resources towards capital and technology-intensive industries in that area. In China's old industrial bases, regional tax incentives should be coordinated with market-oriented reforms; these regional tax incentive policies should also be further enriched.

The Association of Relational Spirituality in an EcoMeditation Course with Flow, Transcendent States, and Professional Productivity.

Background: Relational spirituality-a sense of oneness with, or personal connection to, a higher power or greater consciousness-has been associated with positive health outcomes in prior research. An evidence-based meditation method called EcoMeditation produces significant improvements in psychological health as well as physiological function. Objectives: This study places EcoMeditation in the context of relational spirituality to evaluate changes in psychological symptoms and professional productivity associated with transcendent states of consciousness, including those characterized as "flow" and "nonduality." Methods: Participants (n = 41) were drawn from a convenience sample taking a 21-day online course in which they practiced EcoMeditation along with exercises designed to cultivate personal and relational spirituality. They were assessed pre, post, and at six-month follow-up. Results: Significant reductions in anxiety, depression, and post-traumatic stress disorder (PTSD) were found post-test. These were accompanied by significant increases in happiness, flow, transcendent experiences, and professional-personal productivity. Follow-up indicated that gains in happiness, transcendent experiences, nonduality, and professional-personal productivity were maintained over time. Conclusions: In addition to the improvements in psychological symptoms identified in previous studies, EcoMeditation in the context of relational spirituality was associated with increases in nondual and transcendent states, as well as greater productivity. Although activities such as meditation are usually associated with elevated consciousness in altered states, they may also produce enhanced productivity and performance in everyday life.

Efficiency evaluation, regional technological heterogeneity and determinant of total factor productivity change in China's healthcare system.

Enhancing efficiency and productivity in countries' healthcare systems is a global challenge. The Chinese government invested huge resources to improve the efficiency and productivity of the healthcare system across the country. To assess the success of the mission above, this research utilized DEA-SBM Meta frontier analysis alongside the Malmquist Productivity Index. These methodologies were employed to gauge Efficiency, production technology heterogeneity, and productivity of healthcare systems change across 31 mainland Chinese provinces and four distinct geographical regions throughout the study period spanning from 1997 to 2022. Results revealed that the mean efficiency score of China's healthcare system is 0.7672. It indicates a growth potential of 23.28 percent in the operational efficiency of healthcare systems. The eastern region's efficiency level (0.86917) is higher among all four regions. Zhejiang, Shandong, and Guangdong are the top three healthcare-efficiency performers. The technology gap ratio indicates that eastern regions witnessed a high TGR (0.9909), showing the country's attainment of superior healthcare technologies. Beijing, Guangdong, Shanghai, Tianjin, and Zhejiang witnessed higher TGR values among all 31 mainland Chinese provinces. The total factor productivity index of the healthcare system witnessed a slight growth of 0.33%, with an average MI score of 1.0033. Efficiency change (EC) was found to be the main determinant of TFPC as technology change TC is less than EC. Moreover, the MI score of the Western region (1.033) is higher than the corresponding Eastern, northeastern, and central regions. Guizhou, Anhui, and Yunnan were found to be the top three performers in TFPC growth. Finally, the Kruskal-Wallis test confirmed the statistically significant difference among 4 Chinese regions for the healthcare system's efficiency, TFPC, and TGR.

Teleworking: does it make workers healthier and productive? A cross-sectional study on a Southern European population.

BACKGROUND: Teleworking (TW) has recently shifted from a marginal into a common practice. Yet, concerns have been raised regarding potential work-health negative effects, related to the reduced socialization, and extended working hours with computers at home, possibly offset by reduced commuting time or better individual work-life balance. This paper aims at describing the influence of TW on health, well-being, and productivity perceptions, and how this is shaped by TW conditions. METHODS: We collected data from workers of 25 companies that exert their activity in Portugal. Data were completed with a representative sample of workers who regularly participate in surveys (total N = 1,069). We applied an on-line questionnaire from September the 1st 2022 to December the 1st 2022. We performed a simple descriptive analysis of each variable. Then, we analyzed the relationship between TW conditions and self-reported health, and between TW conditions at home and productivity, using logistic regression models. RESULTS: We observed a high prevalence of self-perceived health worsening (15.9%), mostly among those with poor TW conditions. Most teleworkers enjoyed favorable TW conditions, despite limited company support. Relevant changes were observed in lifestyle factors, towards more smoking (5.5%), alcohol drinking (4.5%), and worse diet (10.1%). Two thirds reported enhanced productivity. A statistically significant relationship was observed between inadequate TW conditions, health deterioration, and lower productivity. A 6.0% point (pp) increased risk of productivity worsening was observed when employees faced at least one inadequate condition at home (no private working place at home, inadequate heating, artificial light, or absence of well-being at home). The risk of health deterioration increased by 12.9 pp when facing at least one of these inadequate conditions, and by 6.3 under hybrid TW, compared to one or two days of TW. CONCLUSIONS: Most teleworkers highlighted a positive perspective about teleworking. Yet, TW conditions are not favorable for all workers, with consequences on health, well-being, and productivity, suggesting that further support is needed for teleworkers to protect their health at home, and reach its maximum benefit.

Does university-industry collaboration improve firm productivity? Evidence from China.

China's high-quality development cannot be achieved without high-quality research. As the university is an indispensable source of advanced research, analyzing the impact of university-industry collaboration (UIC) on firm performance helps us understand the significance of universities for China's economic development and innovation activities. As existing research does not pay attention to the impact of UIC on the productivity of Chinese firms, we examine the impact of such collaboration on firm productivity using natural language processing and by matching China's intellectual property and listed firms' operations databases. The empirical results show that UIC can promote firm productivity by improving the quality of their innovations, strengthening internalization efficiency, and broadening their research horizons. Moreover, the UIC process has a pronounced effect on promoting firm productivity in technology- and intellectual property-intensive industries. From the UIC perspective, we interpret China's economic development and provide new insights for developing countries regarding using universities to alleviate the insufficiency of private R&D investments.