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1.
BMC Med Ethics ; 22(1): 136, 2021 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-34615519

RESUMEN

BACKGROUND: Rapid data sharing can maximize the utility of data. In epidemics and pandemics like Zika, Ebola, and COVID-19, the case for such practices seems especially urgent and warranted. Yet rapidly sharing data widely has previously generated significant concerns related to equity. The continued lack of understanding and guidance on equitable data sharing raises the following questions: Should data sharing in epidemics and pandemics primarily advance utility, or should it advance equity as well? If so, what norms comprise equitable data sharing in epidemics and pandemics? Do these norms address the equity-related concerns raised by researchers, data providers, and other stakeholders? What tensions must be balanced between equity and other values? METHODS: To explore these questions, we undertook a systematic scoping review of the literature on data sharing in epidemics and pandemics and thematically analyzed identified literature for its discussion of ethical values, norms, concerns, and tensions, with a particular (but not exclusive) emphasis on equity. We wanted to both understand how equity in data sharing is being conceptualized and draw out other important values and norms for data sharing in epidemics and pandemics. RESULTS: We found that values of utility, equity, solidarity, and reciprocity were described, and we report their associated norms, including researcher recognition; rapid, real-time sharing; capacity development; and fair benefits to data generators, data providers, and source countries. The value of utility and its associated norms were discussed substantially more than others. Tensions between utility norms (e.g., rapid, real-time sharing) and equity norms (e.g., researcher recognition, equitable access) were raised. CONCLUSIONS: This study found support for equity being advanced by data sharing in epidemics and pandemics. However, norms for equitable data sharing in epidemics and pandemics require further development, particularly in relation to power sharing and participatory approaches prioritizing inclusion. Addressing structural inequities in the wider global health landscape is also needed to achieve equitable data sharing in epidemics and pandemics.


Asunto(s)
COVID-19 , Infección por el Virus Zika , Virus Zika , Humanos , Difusión de la Información , Organizaciones , Pandemias , SARS-CoV-2 , Infección por el Virus Zika/epidemiología
2.
Cien Saude Colet ; 26(9): 4163-4172, 2021 Sep.
Artículo en Portugués | MEDLINE | ID: mdl-34586268

RESUMEN

Since the liberalization of foreign capital in health a new trend has arisen in the process of capital accumulation in the industrial economic complex of health, especially at the levels of outsourced care and Services of Care, Treatment and Diagnosis (SCTD). In order to contribute to the understanding of this dynamic, this article sought to analyze the acquisition process of Renal Replacement Therapy (RRT) clinics by international capital companies in Brazil. To achieve this, a two-stage methodological path was developed; the first consisted in the quantitative-descriptive analysis of the economic type of all the international capital companies that operate in the production of input and technologies and in RRT care services; the second was developed by a qualitative analysis of semi-structured interviews of key actors from the private and public sectors and organized civil society. Therefore, the process of the advance of international capital brings with it a qualitative change in the organization, assistance and financing of RRT. It can be seen that, especially in the cases of complementary public and private services, there is a tendency to restrict care and create an obstacle to the universal right to health.


Asunto(s)
Sector Público , Terapia de Reemplazo Renal , Brasil , Programas de Gobierno , Organizaciones
3.
J Emerg Manag ; 19(4): 339-354, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34580850

RESUMEN

This phenomenological study explored the lived experiences of five deployed international disaster relief volunteers from a faith-based group in Thailand. This study explored what participants perceived as contributors and barriers to their successful operations and how they made sense of their roles in the disaster recovery process. Organizational and cross-cultural barriers were identified. Through the lens of sensemaking theory, four additional themes emerged: participants' first assignment, the motto of being part of the solution, their firm belief in the organization's values and practices, and their perception of necessity. Implications for faith-based organizations and directions for future studies are provided.


Asunto(s)
Desastres , Humanos , Organizaciones , Tailandia , Voluntarios
5.
PLoS Med ; 18(9): e1003744, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34582438

RESUMEN

BACKGROUND: In South Africa, breastfeeding promotion is a national health priority. Regular perinatal home visits by community health workers (CHWs) have helped promote exclusive breastfeeding (EBF) in underresourced settings. Innovative, digital approaches including mobile video content have also shown promise, especially as access to mobile technology increases among CHWs. We measured the effects of an animated, mobile video series, the Philani MObile Video Intervention for Exclusive breastfeeding (MOVIE), delivered by a cadre of CHWs ("mentor mothers"). METHODS AND FINDINGS: We conducted a stratified, cluster-randomized controlled trial from November 2018 to March 2020 in Khayelitsha, South Africa. The trial was conducted in collaboration with the Philani Maternal Child Health and Nutrition Trust, a nongovernmental community health organization. We quantified the effect of the MOVIE intervention on EBF at 1 and 5 months (primary outcomes), and on other infant feeding practices and maternal knowledge (secondary outcomes). We randomized 1,502 pregnant women in 84 clusters 1:1 to 2 study arms. Participants' median age was 26 years, 36.9% had completed secondary school, and 18.3% were employed. Mentor mothers in the video intervention arm provided standard-of-care counseling plus the MOVIE intervention; mentor mothers in the control arm provided standard of care only. Within the causal impact evaluation, we nested a mixed-methods performance evaluation measuring mentor mothers' time use and eliciting their subjective experiences through in-depth interviews. At both points of follow-up, we observed no statistically significant differences between the video intervention and the control arm with regard to EBF rates and other infant feeding practices [EBF in the last 24 hours at 1 month: RR 0.93 (95% CI 0.86 to 1.01, P = 0.091); EBF in the last 24 hours at 5 months: RR 0.90 (95% CI 0.77 to 1.04, P = 0.152)]. We observed a small, but significant improvement in maternal knowledge at the 1-month follow-up, but not at the 5-month follow-up. The interpretation of the results from this causal impact evaluation changes when we consider the results of the nested mixed-methods performance evaluation. The mean time spent per home visit was similar across study arms, but the intervention group spent approximately 40% of their visit time viewing videos. The absence of difference in effects on primary and secondary endpoints implies that, for the same time investment, the video intervention was as effective as face-to-face counseling with a mentor mother. The videos were also highly valued by mentor mothers and participants. Study limitations include a high loss to follow-up at 5 months after premature termination of the trial due to the COVID-19 pandemic and changes in mentor mother service demarcations. CONCLUSIONS: This trial measured the effect of a video-based, mobile health (mHealth) intervention, delivered by CHWs during home visits in an underresourced setting. The videos replaced about two-fifths of CHWs' direct engagement time with participants in the intervention arm. The similar outcomes in the 2 study arms thus suggest that the videos were as effective as face-to-face counselling, when CHWs used them to replace a portion of that counselling. Where CHWs are scarce, mHealth video interventions could be a feasible and practical solution, supporting the delivery and scaling of community health promotion services. TRIAL REGISTRATION: The study and its outcomes were registered at clinicaltrials.gov (#NCT03688217) on September 27, 2018.


Asunto(s)
Recursos Audiovisuales , Lactancia Materna , Servicios de Salud Comunitaria/métodos , Agentes Comunitarios de Salud , Consejo , Promoción de la Salud/métodos , Visita Domiciliaria , COVID-19 , Femenino , Humanos , Servicios de Salud Materno-Infantil , Mentores , Madres , Películas Cinematográficas , Organizaciones , Pandemias , Embarazo , Sudáfrica , Grabación de Cinta de Video
6.
J Environ Manage ; 299: 113658, 2021 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-34523536

RESUMEN

Spatial planning of Blue-Green Infrastructure (BGI) should ideally be based on well-evaluated and context specific solutions. One important obstacle to reach this goal relates to adequate provisioning of data to ensure good governance of BGI, i.e., appropriate planning, design, construction, and maintenance. This study explores the gap between data availability and implementation of BGI in urban planning authorities in Sweden. A multi method approach including brainstorming, semi-structured interviews with urban planners and experts on BGI and Geographical Information System (GIS), and validating workshops were performed to develop a framework for structured and user-friendly data collection and use. Identified challenges concern data availability, data management, and GIS knowledge. There is a need to improve the organisation of data management and the skills of trans-disciplinary cooperation to better understand and interpret different types of data. Moreover, different strategic goals require different data to ensure efficient planning of BGI. This calls for closer interactions between development of strategic political goals and data collection. The data management framework consists of three parts: A) Ideal structure of data management in relation to planning process, data infrastructure and organisational structure, and B) A generic list of data needed, and C) The development of structures for data gathering and access. We conclude that it is essential to develop pan-municipal data management systems that bridge sectors and disciplines to ensure efficient management of the urban environment, and which is able to support the involvement of citizens to collect and access relevant data. The framework can assist in such development.


Asunto(s)
Planificación de Ciudades , Manejo de Datos , Organizaciones , Planificación Estratégica , Suecia
7.
Work ; 70(1): 75-84, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34487000

RESUMEN

BACKGROUND: The work organization not only comprises the formal structure but also social interactions, which are developed according to its own rules based on variabilities and professional competences. During real work, there are regulatory processes that result in the development of strategies to meet the requirements of the work organization and maintain health status. OBJECTIVE: To understand the regulatory processes involved in work activities and analyze the extent to which the developed strategies are sufficient to protect employees' integrity and guarantee performance. METHODS: This study was carried out in an agricultural implement manufacturing company, whose qualitative procedures were analyzed by combining activity observations, interviews, and self-confrontation. RESULTS: In view of the interaction of logic, operators comply with some rules to the detriment of others, based on the decision processes of their individual and collective experience. The availability of resources compatible with activity demands increases the possibility of action and competence development. The cost of regulations for less experienced operators is higher, taking into consideration the level of uncertainty resulting from contradictions and variabilities. CONCLUSION: It is necessary to discuss the contradictions manifested in operators' work routines through interactions between heterogeneous rationalities. From this, it is possible to construct a common reference about the activity and increase the possibilities of action during real work.


Asunto(s)
Agricultura , Organizaciones , Comercio , Estado de Salud , Humanos , Competencia Profesional
8.
Work ; 70(1): 135-146, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34487011

RESUMEN

BACKGROUND: Despite an increase in work-life balance literature, the development of successful support to help employees manage their work -life balance is slow. Moreover, there are few interventions with a comprehensive approach to workplace health promotion focusing on work-life balance. OBJECTIVE: This paper aims to present the development and building blocks of a holistic interdisciplinary health-promoting program, the BELE program, to enhance female employees working in human service organizations health and well-being with a focus on work-life balance. METHODS: The planning and development of the program was done through an intervention mapping and research circles methodology. RESULTS: The planning- and development process of the program resulted in a theoretical framework, and a program structure with a program content. The intervention program was named "The Balance in Everyday Life Empowerment program" (BELE program). CONCLUSIONS: The BELE program adds to the existing body of work-life balance knowledge, so far often based on a conflict approach. Interventions focusing on a comprehensive approach to health and work-life balance with a salutogenic approach are rare. Furthermore, the integration with occupational therapy and health promotion in a workplace health promotion framework is innovative. In a previous study, the BELE program has shown that it enhances women's well-being and balance in their everyday life.


Asunto(s)
Terapia Ocupacional , Equilibrio entre Vida Personal y Laboral , Femenino , Promoción de la Salud , Humanos , Organizaciones , Suecia
9.
Pan Afr Med J ; 39: 91, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34466193

RESUMEN

Introduction: Mozambique is one of the poorest nations in the world and its health budget is heavily dependent on external funding. Increasingly, donors prefer to direct their funds through international non-governmental organizations instead of direct donations to the State budget. In the current climate of increased emphasis on health system strengthening, a strong and stable partnership between government and international non-governmental organizations is pivotal for health system strengthening in Mozambique. Methods: the study evaluates the current partnership through a standardized survey to healthcare workers employed by international non-governmental organizations in health (INGO, private) and the ministry of health (MOH, public). Results of the survey have been analyzed only descriptively and no statistical evaluations have been performed. Results: out of the valid 109 responses obtained 55.1% were from MOH cadres and 45.0% from INGO cadres. Most have been in the health sector for more than 5 years. Most of the respondents recognize that INGOs assist the government in strengthening the health system (71.6%), see the internal brain drain to INGOs and salary scale difference as major problems (70.6% and 78.0%); 87.2% reported that the coordination between INGOs and government needs to be improved. MOH cadres perceived the migration of cadres to INGOs and the need for improving coordination as major issues more acutely than their INGO counterparts (80.0% vs. 59.2% and 88.3% vs. 85.7% respectively). INGOs were perceived to offer better quality health services by 51.4% of respondents (of these 69.4% were INGO respondents). The quality of health services was alike between INGOs and MOH for 33% of the respondents. Conclusion: through the various efforts outlined the MOH and INGOs are moving towards an environment of mutual accountability, joint planning and coordination as well as harmonization of activities; but there are still challenges to be addressed. Prioritization and increased funding of the planning unit and planning and cooperation directorate as well as strategies for workforce retention are urgently needed.


Asunto(s)
Atención a la Salud/organización & administración , Personal de Salud/organización & administración , Organizaciones/organización & administración , Asociación entre el Sector Público-Privado/organización & administración , Estudios Transversales , Humanos , Agencias Internacionales , Mozambique , Sector Privado , Sector Público , Calidad de la Atención de Salud , Encuestas y Cuestionarios
10.
Mil Med ; 186(12 Suppl 2): 4-8, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34469523

RESUMEN

A new strain of coronavirus (COVID-19) emerged in 2020 changing the way the nation looked, worked and lived. In response to this unprecedented COVID-19 pandemic, the Army Nurse Corps (ANC) reexamined our capabies and agility to respond to a new and rapidly evolving environment. Maintaining the pivot to readiness, providing sustainable support and protecting our most valuable asset-our people-were and continues to be in the forefront of leaders' thoughts as we faced this invisible adversary. With every new challenge, lessons learned provide an opportunity to re-examine challenges and successes of the response to COVID-19. Organizational restructuring, balancing risks, expanding capabilities and educational platforms were reassessed and adjusted to fill the needs of the environment as they evolved. The year 2020 will stand throughout history as another example where our readiness, resilience, and flexibility as an Army Nurse Corps was tried and tested. We demonstrated our ability to adapt and overcome-displaying our willingness to stand up as part of the Army Medicine Team and face an unknown adversary to protect the nation we vowed to serve.


Asunto(s)
COVID-19 , Personal Militar , Humanos , Organizaciones , Pandemias , SARS-CoV-2
11.
Artículo en Ruso | MEDLINE | ID: mdl-34486853

RESUMEN

The formation of code of normative legal documents ensuring activities of perinatal service is one of the most important, basic organizational technologies that determine activities of obstetrics and childhood services, contributing to increasing of natality, decreasing of maternal and infant morbidity, and maternal and childhood health care in general. The article presents analysis of formation of normative legal base that regulates functioning of perinatal service in the Russian Federation in 2000-2020. Actually, there is no objective prerequisites for fundamental alterations in the three-level system of medical care of women during pregnancy, labor, postpartum period and newborns. However, the regulatory adjustment of the system, improvement and refinement of models of profile patients' routing, development of medical care of pregnant women, parturient women and puerpera will proceed.


Asunto(s)
Obstetricia , Tasa de Natalidad , Niño , Femenino , Humanos , Recién Nacido , Organizaciones , Atención al Paciente , Embarazo , Federación de Rusia
12.
Artículo en Ruso | MEDLINE | ID: mdl-34486870

RESUMEN

The article presents the results of comparative analysis of the research potential of participants of the North Caucasian Scientific and Educational Medical Cluster. The differences in the indices of training of residents and post-graduate students, the availability of research and pedagogical personnel, the scope of research studies and income received from their commercialization in educational organizations participating in the cluster were studied. It is noted that the medical faculties of educational organizations of various departmental subordination, in terms of their research activities, differ from medical universities of the Minzdrav of Russia. However, there are intra-departmental imbalances too. The joint use of personnel, technological and other resources of educational organizations can provide synergistic effect in research field.


Asunto(s)
Instituciones Académicas , Universidades , Humanos , Organizaciones , Federación de Rusia , Estudiantes
13.
J Bus Contin Emer Plan ; 15(1): 44-52, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34465409

RESUMEN

With the world becoming increasingly complex and uncertain, the disruptions that businesses face are becoming increasingly unpredictable. Traditional approaches to business continuity planning must therefore evolve to enhance organisational resilience. As this paper will discuss, it is vital to ensure a balance between detailed planning and flexibility and adaptability. This can be achieved through: 1) creating closer links between business continuity and strategic management; 2) embedding a culture of resilience throughout the organisation; 3) decentralising business continuity planning and enabling teams and departments to design and own their own plans; 4) making planning principles- based; and 5) exercising more frequently. This paper argues that planning must be based on principles and outcomes rather than processes, and how it must, to be integrated within broader risk management and strategy functions to be inclusive of everyone, from the staff all the way up to the board. In short, preparedness and resilience must become part of their DNA.


Asunto(s)
Planificación en Desastres , Comercio , Humanos , Organizaciones , Gestión de Riesgos
14.
Cien Saude Colet ; 26(suppl 2): 3623-3633, 2021.
Artículo en Portugués | MEDLINE | ID: mdl-34468657

RESUMEN

The scope of this study was to analyze the relationship of an instrument of family vulnerability with sociodemographic, dental, and spatial distribution in a given territory. The dependent variable was the classification of family vulnerability, proposed by Coelho and Savassi. The independent variables were selected on the basis of the theoretical model proposed by Andersen. Hierarchical multiple logistic regression models were estimated. Kernel density estimation was used for spatial analysis. Subjects who lived with more than 4 people (OR = 3.46; 95% CI), who were dissatisfied with their oral health (OR = 2.38; 95% CI), who were ashamed to smile and talk (OR = 3.03, 95% CI) were more likely to be "at risk" in the family. Spatial analysis enabled the visualization of an area of ​​higher concentration of families "at risk". The relationship of the instrument of vulnerability analyzed with sociodemographic and dental factors, as well as the assistance in the visualization and identification of more vulnerable areas, are useful in the knowledge of the territory for the planning of actions in oral health, and the conclusion drawn is that the tool can be adopted for more equitable access by the oral health teams.


Asunto(s)
Salud Bucal , Organizaciones , Estudios Transversales , Humanos , Modelos Logísticos , Análisis Espacial
16.
J Environ Manage ; 299: 113545, 2021 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-34455352

RESUMEN

This study explores the ecological ambitions of banks by studying the coincidence of economic realities with environmental management strategies. We address this question by studying the environmental performance of US banks and its impact on their tail risk as US is not committed to carbon neutrality in COP 21. We proxy economic reality with tail risk of banks and employ a novel extreme value theory to measure this. We use Asset4 ESG data for environmental performance score and test our hypothesis with a sample of 256 US banks. The results indicate that the US banks are ecologically ambitious and their environmental strategies are likely to reduce their tail risk. This provides evidence that better environmental strategies do coincide with the economic realities. We test the consistency of our results by using alternate proxies for tail risk and find our results robust. Our results are also not driven by endogeneity concerns. Finally, our additional results show that the nature of relationship differs with corporate governance levels, CSR committee existence, institutional ownership presence and crisis period.


Asunto(s)
Carbono , Organizaciones , Conservación de los Recursos Naturales , Propiedad , Condiciones Sociales
17.
BMC Med Ethics ; 22(1): 113, 2021 08 23.
Artículo en Inglés | MEDLINE | ID: mdl-34425786

RESUMEN

BACKGROUND: Patient advocacy organizations (PAOs) have an increasing influence on health policy and biomedical research, therefore, questions about the specific character of their responsibility arise: Can PAOs bear moral responsibility and, if so, to whom are they responsible, for what and on which normative basis? Although the concept of responsibility in healthcare is strongly discussed, PAOs particularly have rarely been systematically analyzed as morally responsible agents. The aim of the current paper is to analyze the character of PAOs' responsibility to provide guidance to themselves and to other stakeholders in healthcare. METHODS: Responsibility is presented as a concept with four reference points: (1) The subject, (2) the object, (3) the addressee and (4) the underlying normative standard. This four-point relationship is applied to PAOs and the dimensions of collectivity and prospectivity are analyzed in each reference point. RESULTS: Understood as collectives, PAOs are, in principle, capable of intentionality and able to act and, thus, fulfill one prerequisite for the attribution of moral responsibility. Given their common mission to represent those affected, PAOs can be seen as responsible for patients' representation and advocacy, primarily towards a certain group but secondarily in a broader social context. Various legal and political statements and the bioethical principles of justice, beneficence and empowerment can be used as a normative basis for attributing responsibility to PAOs. CONCLUSIONS: The understanding of responsibility as a four-point relation incorporating collective and forward-looking dimensions helps one to understand the PAOs' roles and responsibilities better. The analysis, thus, provides a basis for the debate about PAOs' contribution and cooperation in the healthcare sector.


Asunto(s)
Análisis Ético , Defensa del Paciente , Beneficencia , Humanos , Organizaciones , Justicia Social , Responsabilidad Social
18.
Oral Maxillofac Surg Clin North Am ; 33(4): 481-489, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34364747

RESUMEN

Women emerged against significant obstacles in the nineteenth century to claim a right to participate in the health professions. Women were excluded from many areas of medical and dental practice until well after the 1964 Civil Rights Act forbade discrimination on the basis of sex. Their entry has been, and continues to be, blocked by discrimination, misogyny, and harassment both personal and institutional. The formation of women-specific surgical subspecialty organizations has improved access to mentoring, sponsorship, and acceptance. This article reviews the history of some of the older organizations with recommendations for OMFS women's action.


Asunto(s)
Organizaciones , Derechos de la Mujer , Femenino , Humanos , Factores Socioeconómicos
20.
Artículo en Inglés | MEDLINE | ID: mdl-34360064

RESUMEN

China and other emerging market countries have suffered from the problem of environmental pollution while developing rapidly in the past few decades. In recent years, many countries have introduced strict environmental regulations in order to achieve sustainable development. This paper discusses the relationship between environmental regulations and corporate green innovation from the perspective of regional leaders' promotion pressure. The empirical results show that direct policy regulation within the region stimulates green innovation on the part of enterprises, and the promotion pressure of city leaders has a further positive moderating effect on the positive correlation between environmental regulations and enterprises' green innovation. The conclusion of the study proves that a strict environmental policy can promote the effectiveness of an environmental performance appraisal system in the sustainable development plans of cities and enterprises. This paper not only reveals the influence path of official promotion pressure on the sustainable development of enterprises in the administrative area from the micro perspective but also sheds some light that may improve government governance and promote the transformation of enterprises.


Asunto(s)
Organizaciones , Desarrollo Sostenible , China , Ciudades , Política Ambiental , Contaminación Ambiental/prevención & control , Humanos
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