How did whistleblowing and the duty of candour get onto the agenda of the British national health service.

PURPOSE: This paper compares how the two interacting themes of "Whistleblowing" or "Speaking Up" and the duty of candour (DoC), which are both concerned with safety and quality improvement in health care, got onto the agenda of the British National Health Service (NHS). DESIGN/METHODOLOGY/APPROACH: It uses the approach of multiple streams and the methodology of interpretive content analysis in a deductive approach that focusses on both manifest and latent content. It examines official documents that discuss the DoC or whistleblowing or cognate terms in connection with the British NHS from 1999 to 2019. FINDINGS: The main conceptual finding, which mirrors many previous studies, is that it seems difficult to operationalise many of the sub-components of the multiple streams approach. The main empirical finding points to the "focusing event" of the Francis Report into the Mid Staffordshire Trust of 2013 and the importance of its Chair, Sir Robert Francis, as a policy entrepreneur. ORIGINALITY/VALUE: This is one of the first studies to focus on both issues of whistleblowing and the DoC and the first to compare them through the lens of the multiple streams approach. It has two main conceptual advantages over most previous studies in the field: it compares whistleblowing and the duty of candour rather than the dominant approach of a single case study and explores the different outcomes of failed as well as successful couplings of the streams.

Health professionals' experiences of whistleblowing in maternal and newborn healthcare settings: A scoping review and thematic analysis.

PROBLEM: Whistleblowing, which involves raising concerns about wrongdoing, carries risks yet can be crucial to ensuring the safety of health service users in maternal and newborn healthcare settings. Understanding of the experiences of health care professionals that enact whistleblowing in this context is currently limited. BACKGROUND: Notable inquiries involving maternity services such as those reported upon by Ockenden and Kirkup and the Lucy Letby case in the United Kingdom have shone an international spotlight on whistleblowing failures. AIM: To identify and synthesise available literature addressing the experiences of healthcare professionals enacting whistleblowing in maternal and newborn care settings. METHODS: This scoping review followed Arksey and O'Malley's framework. Five academic databases were systematically searched for documents published between January 2013 and October 2023 with additional searches of Google Scholar and related reference lists. FINDINGS: Whilst 35 papers from international sources were identified, the majority originated from the United Kingdom, where recent high-profile incidents have occurred. Thematic analysis identified three main themes: 'Structural Power', 'Perfectionism' and 'Bravery, Hope and Disappointment', each with sub-themes. DISCUSSION: Whistleblowing is frequently an altruistic act in a hierarchical system. It exposes poor practices and disrupts power dynamics, especially in challenging workplace cultures. Open disclosure, however, requires psychological safety. Obstacles persist, emphasising the need for a culture of trust and transparency led by individuals who embody the desired values. CONCLUSION: Primary research on whistleblowing in maternal and newborn healthcare settings is limited. This study sheds light on power dynamics and factors that affect whistleblowing.

Radiology residency oversight: A Qui Tam wake-up call.

Like every physician practice, academic radiology practices must pay heed to all governmental regulations. The federal False Claims Act serves to protect US taxpayers and requires strict adherence. Violations, often brought forth by whistleblowers, can carry steep financial repercussions.

What are people's attitudes toward medical insurance fraud whistleblowers? a study from China.

PURPOSE: Medical insurance fraud has caused huge losses to countries around the world, and public reporting has become an important means to combat medical insurance fraud. The attitude of medical insurance fraud whistleblowers affects people's reporting behavior, and understanding people's attitude toward medical insurance fraud whistleblowers provides a basis for further improving the system and policy of public participation in medical insurance fund supervision. METHODS: We adopted the questionnaire method to conduct a national cross-sectional survey of the Chinese public and analyzed the data using Chi-square tests, Fisher's exact tests, and binary logistic regression models. RESULTS: A total of 837 respondents were included, and 81.8% of the population had a supportive attitude toward medical insurance fraud whistleblowers, with gender, whether they had used medical insurance reimbursement, and present life satisfaction being statistically significant (P < 0.05). CONCLUSION: The public is generally supportive of medical insurance fraud whistleblowers, and women, those who have used medical insurance for reimbursement, and those who are satisfied with their lives are more likely to be supportive of medical insurance fraud whistleblowers.

CREAS e covid-19: desafios e perspectivas da psicologia no Norte de Minas / CREAS and covid-19: challenges and perspectives for Northern Minas Gerais psychology / CREAS y covid-19: desafíos y perspectivas de la psicología en el Norte de Minas

Este artigo analisa os desafios e estratégias de atuação de psicólogas(os) nos Centros de Referência Especializados de Assistência Social (CREAS) do norte de Minas Gerais durante a pandemia de covid-19. Trata-se de um estudo descritivo, quanti-qualitativo, de corte transversal e com análise de conteúdo e estatística para a interpretação de dados primários e meio de questionário eletrônico, emergiram os seguintes eixos temáticos: (a) Perfil sociodemográfico das(os) trabalhadoras(es); (b) Medidas de prevenção à contaminação para quem? Impactos da pandemia na práxis da psicologia no CREAS; (c) Chegada das demandas no CREAS; e (d) Tenuidade entre as potencialidades e vicissitudes do uso das tecnologias digitais. Observou-se que a inserção das(os) trabalhadoras(es) nos CREAS é marcada por contratos temporários, altas jornadas de trabalho e baixa remuneração. Além disso, com a pandemia de covid-19, têm enfrentado obstáculos como a falta de equipamentos de proteção individual (EPI) e de prevenção ao vírus. A chegada de demandas aos CREAS também foi afetada pela pandemia, como apontam as análises estatísticas dos registros mensais de atendimento dos municípios. As tecnologias digitais se configuraram como a principal estratégia adotada no ambiente de trabalho dos CREAS. Conclui-se que, se por um lado, a pandemia engendrou e acentuou obstáculos para a práxis da psicologia; por outro, a imprevisibilidade desse cenário e a potência da psicologia norte-mineira possibilitaram diversas estratégias para assistir os usuários.(AU)

This article analyses the challenges and strategies over the psychologists activity at the Specialized Reference Centers for Social Assistance (CREAS), from the north of the state of Minas Gerais during the COVID-19 pandemic. It is a descriptive, quantitative-qualitative study on content and statistics analysis for interpretation of primary and secondary data, with 19 psychologists participating. From interviews made with electronic questionnaires, the following theatrical axes emerged: (a) Social demographic profile of workers; (b) Prevention measures over contamination directed to which public? The impacts of the pandemic over the practice of psychology at CREAS; (c) Demand reception at CREAS; and (d) Tenuity between potentialities and vicissitudes of the use of digital technologies. The workers insertion at CREAS is notably marked by transitory working contracts, long labor journeys, and low wages. Furthermore, the COVID-19 pandemic is causing hindrances such as the lack of personal protection equipment (PPE) and virus prevention. The demands received by CREAS were also affected by the pandemic, as shown in the statistics analysis from monthly county treatment records. The digital technologies were the main strategy enforced by the working environment at CREAS. In conclusion, if on the one hand, the pandemic produced and increased obstacles for the practice of Psychology, on the other hand, the unpredictability of this scenery and the capacity of the psychology of the north of Minas Gerais enabled diverse strategies to attend the users.(AU)

Este artículo analiza los desafíos y las estrategias en la actuación de psicólogas(os) en los Centros de Referencia Especializados de Asistencia Social (CREAS) del norte de Minas Gerais (Brasil) durante la pandemia de la COVID-19. Se trata de un estudio descriptivo, cualicuantitativo, de cohorte transversal, con análisis de contenido y estadísticas para la interpretación de datos primarios y secundarios, en el cual participaron 19 psicólogas(os). De las entrevistas en un cuestionario electrónico surgieron los siguientes ejes temáticos: (a) perfil sociodemográfico de los(as) trabajadores(as); (b) medidas de prevención de la contaminación ¿para quién? Impactos de la pandemia en la praxis de la psicología en CREAS; (c) la llegada de demandas a CREAS y; (d) la tenuidad entre las potencialidades y vicisitudes del uso de tecnologías digitales. Se observó que la inserción de las(os) trabajadoras(es) en el CREAS está marcada por contratos laborales temporales, largas jornadas y baja remuneración. Además, con la pandemia de la COVID-19, se han enfrentado a obstáculos como la falta de equipo de protección personal (EPP) y prevención del virus. La llegada de demandas al CREAS también se vio afectada por la pandemia, como lo demuestran los análisis estadísticos de los registros mensuales de atención de los municipios. Las tecnologías digitales se han convertido en la principal estrategia adoptada en el entorno laboral de los CREAS. Se concluye que si, por un lado, la pandemia engendró y acentuó obstáculos a la praxis de la Psicología, por otro, la imprevisibilidad de este escenario y el poder de la Psicología en el norte de Minas Gerais posibilitaron varias estrategias para asistir a los usuarios.(AU)

Brain games?

Whistleblowers and former lab members suggest a star neuroscientist routinely manipulated data, compromising a planned NIH stroke trial and key Alzheimer's research.

Complaints against Physicians in Minas Gerais, Brazil / Quejas contra médicos en Minas Gerais, Brasil / Reclamações contra médicos em Minas Gerais, Brasil

The Regional Councils of Medicine are responsible for the first instance evaluation of ethical-professional complaints against physicians in each federation state. The relevance of the study is based on the importance of evaluating the professional profile of the reported physician, the characteristics of the complaints, and the judging body performance. This study assessed 966 complaints against physicians made to the Regional Council of Medicine of Minas Gerais (CRM/MG) from 2012 to 2017. There was no difference in the average age of the professionals or the period of professional practice. Gynecology, Internal Medicine, General Surgery, and Plastic Surgery comprised most of the complaints regarding medical specialties. The non-specialty reports reached 323 (34%) cases and predominated over the years studied. The number of acquittals was relatively high, in a total of 535 cases, in which the Regional Council of Medicine of Minas Gerais (CRM/MG) considered the complaints unfounded. The hypothesis of a certain corporativism of the CRM did not seem viable since thirty cases received harsher punishments, and among them, eight were removed from professional practice. Some professionals were reported more than once. It is worth noting that the number of recidivists and cases progressively decreased from 2012 to 2017.

Los Consejos Regionales de Medicina son responsables de la evaluación en primera instancia de las denuncias ético-profesionales contra médicos en cada estado de la federación. La relevancia del estudio se basa en la importancia de evaluar el perfil profesional del médico denunciado, las características de las denuncias y la actuación del órgano juzgador. Este estudio evaluó 966 denuncias contra médicos presentadas al Consejo Regional de Medicina de Minas Gerais (CRM/MG) de 2012 a 2017. No hubo diferencias en la edad media de los profesionales ni en el período de ejercicio profesional. Ginecología, Medicina Interna, Cirugía General y Cirugía Plástica englobaron la mayoría de las denuncias relativas a especialidades médicas. Las denuncias de no especialidad alcanzaron 323 (34%) casos y predominaron a lo largo de los años estudiados. El número de absoluciones fue relativamente elevado, en un total de 535 casos, en los que el Consejo Regional de Medicina de Minas Gerais (CRM/MG) consideró infundadas las denuncias. La hipótesis de un cierto corporativismo del CRM no pareció viable, ya que treinta casos recibieron castigos más severos y, entre ellos, ocho fueron apartados del ejercicio profesional. Algunos profesionales fueron denunciados más de una vez. Cabe destacar que el número de reincidentes y de casos disminuyó progresivamente de 2012 a 2017.

Os Conselhos Regionais de Medicina são responsáveis pelas avaliações, em primeira instância, de denúncias ético-profissionais contra médicos, em cada estado da federação. A relevância do presente estudo se fundamenta na importância de se avaliar o perfil profissional do denunciado, as características das denúncias e o desempenho do órgão julgador. O presente estudo avaliou 966 denúncias contra médicos, feitas ao Conselho Regional de Medicina de Minas Gerais (CRM/MG), de 2012 a 2017. Não houve diferença com relação à média de idade do profissional, nem com relação ao tempo de exercício profissional. No que diz respeito às especialidades médicas (tabela 5), as áreas de Ginecologia, Clínica Médica, Cirurgia Geral e Cirurgia Plástica compreenderam grande parte das denúncias. Os denunciados sem especialidade alcançaram o no número de 323 (34%) e predominaram. O número de absolvições foi relativamente alto, num total de 535 denunciados, nos quais o Conselho Regional de Medicina de Minas Gerais (CRM/MG) considerou as acusações infundadas. A hipótese de certo corporativismo do CRM, não pareceu viável, visto que trinta casos receberam punição mais severa, dentre os quais, oito cassações do exercício profissional. Alguns profissionais foram denunciados mais de uma vez. Vale observar que o número de profissionais reincidentes, bem como o número de processos decaiu progressivamente, de 2012 a 2017.