A Reexamination of the Relationship between Training Practices and Welfare in the Management of Ambassador Animals.

There is an ethical need to document and develop best practices for meeting ambassador animals' welfare needs within the context of meeting zoo and aquarium program objectives. This is because ambassador animals experience direct and frequent contact with humans. This paper rigorously synthesizes behavioral research and theory, contemporary practices, and personal experiences to offer key concepts that can be applied to meet ambassador animal welfare needs. These key concepts include addressing an animal's recognition of choice and control, the use of the most positive and least intrusive effective interventions when training animals to participate in programming, and an overall reduction in aversive strategy use. Our model for increasing ambassador animal welfare focuses on seven main areas of concern, including the following: choosing the most suitable animal for the program; choosing the human with the right skills and knowledge for the program; using the most positive, least intrusive, effective training methods; developing a strong trusting relationship between trainer and animal; developing a comprehensive enrichment program; the need for institutional support; and creating opportunities for animals to practice species-appropriate behaviors. Our model will provide guidelines for improved ambassador animal welfare that can be refined with future research.

Establishing a national research software award.

Software development has become an integral part of the scholarly ecosystem, spanning all fields and disciplines. To support the sharing and creation of knowledge in line with open science principles, and particularly to enable the reproducibility of research results, it is crucial to make the source code of research software available, allowing for modification, reuse, and distribution. Recognizing the significance of open-source software contributions in academia, the second French Plan for Open Science, announced by the Minister of Higher Education and Research in 2021, introduced a National Award to promote open-source research software. This award serves multiple objectives: firstly, to highlight the software projects and teams that have devoted time and effort to develop outstanding research software, sometimes for decades, and often with little recognition; secondly, to draw attention to the importance of software as a valuable research output and to inspire new generations of researchers to follow and learn from these examples. We present here an in-depth analysis of the design and implementation of this unique initiative. As a national award established explicitly to foster Open Science practices by the French Minister of Research, it faced the intricate challenge of fairly evaluating open research software across all fields, striving for inclusivity across domains, applications, and participants. We provide a comprehensive report on the results of the first edition, which received 129 high-quality submissions. Additionally, we emphasize the impact of this initiative on the open science landscape, promoting software as a valuable research outcome, on par with publications.

Software is crucial for modern research. For the goals of open science, reproducibility, and wider reuse, sharing software source code and acknowledging software development are essential. In France, in 2021, the Minister of Higher Education and Research introduced the National Plan for Open Science. The plan highlights the role of open-source software in academia and aims to give software the same recognition as publications and data. A part of the plan is the introduction of a National Award to recognize open-source research software contributions. This award acknowledges software projects and their teams, which have often worked without much recognition. It also emphasizes the importance of software as a research output, hoping to inspire future researchers. This article examines the award's design and implementation. It addresses the challenges of assessing open research software from different research fields. In the first edition of the award, there were 129 high-quality submissions, indicating the award's potential to shift perspectives on software's role in open science, aligning it with the importance of academic publications. Through a detailed account of our experiences and the insights gained, we aim to provide a reference for other countries or institutions considering to establish similar recognitions.

A contextual approach for exploring faculty readiness to teach online.

Effective online teaching and learning requires readiness of all stakeholders, students, faculty, and administrators while considering contextual factors that influence the design and delivery of online learning. The purpose of this study is to explore how ready for online teaching faculty are in a Lebanese higher education context and to investigate readiness factors that impact their online teaching. It also aims at identifying any significant differences in readiness based on gender, years of teaching experience and discipline. A survey was developed based on a review of the literature and existing surveys that address readiness factors for online teaching. The survey was administered in Spring 2020, and 210 faculty at a private higher education institution completed the survey. Exploratory Factor Analysis (EFA), Multivariate Analysis of Variance (MANOVA) and descriptive statistics were conducted. The EFA resulted in 5 factors associated with faculty readiness to teach online, namely technology access and skills, course design, online pedagogy, attitude, and institutional support. Descriptive statistics revealed that faculty have the minimum required technology skills to teach online, yet they are faced with technical challenges associated with the context and the need for institutional support. MANOVA tests revealed a statistically significant difference between female faculty members who are readier in terms of course design and attitude than their counterpart males, a statistically significant difference in terms of course design for faculty who have more years of teaching experience. As for discipline specific readiness, majors that are focused on art and design revealed to be less ready for online teaching. This study implies the need for a more robust infrastructure to expand the delivery of online learning in Lebanon and the need for professional development for faculty to create pedagogically and technically enhanced online courses.

Researcher Views of Barriers to Clinical and Translational Research in a Statewide Program.

The Tracking and Evaluation Core of Rhode Island Advance-CTR conducted an online needs assessment survey at the program's inception in 2016 and again in 2021. Now dealing with well-established support systems provided by the grant, we were particularly interested in how the perceived needs of the research community in Rhode Island might have changed over five years. Specifically, what barriers have been reduced or eliminated and which have persisted or increased? How do those barriers vary by demographic status and what implications do those differences have for the CTR? An online survey was completed by 199 researchers, who reported the extent to which they perceived the lack of access to a range of research supports as a barrier to conducting research at their institution. Overall, researchers indicated statistically significant changes from 2016 to 2021 such that a lack of pilot project funding and proposal development support had decreased as barriers, while space for research, and advice on commercial development, had increased. Statistically significant differences in the salience of particular barriers by some demographic variables were also noted and the results of this study suggest Centers for Clinical and Translational Research can have salutary effects on the research paradigm within their partnering institutions in a relatively short time.

The Impacts of Engagement in the Latino Medical Student Association.

Importance: The Latino Medical Student Association (LMSA) is a student-run national organization founded in 1972 dedicated to recruiting and retaining members enrolled in health professions programs through academic and social support activities. This study investigates the career impact of member participation in LMSA. Objective: To determine if engagement in LMSA at the individual and school levels contributes to retention, success, and commitment to underserved communities. Design: A voluntary online retrospective 18-question survey sent to LMSA-member medical students in the United States and Puerto Rico from the graduating classes of 2016-2021. Setting: Students in medical schools in the United States and Puerto Rico. Main Outcomes and Measures: There were 18 survey questions. A total of 112 anonymous responses were collected from March 2021 to September 2021. The survey queried levels of engagement with the LMSA and agreement on questions related to support, belonging, and career development. Results: There is a positive relationship between level of engagement in the LMSA and social belonging, peer support, career networking, community engagement, and career commitment to serve Latinx communities. These positive outcomes were enhanced for respondents reporting strong support for their respective school-based LMSA chapters. We did not find a significant relationship between participation in the LMSA and research experiences during medical school. Conclusions and Relevance: Participation in the LMSA is associated with positive individual support and career outcomes for members. Supporting the LMSA as a national organization and within school-based chapters can increase support for Latinx trainees and enhance career outcomes.

How to mitigate the inhibitory effect of organizational inertia on corporate digital entrepreneurship?

As a novel way for incumbent firms to discover and utilize entrepreneurial opportunities in the digital era, corporate digital entrepreneurship (CDE) is significant for realizing digital transformation through dealing with organizational sclerosis and bureaucratization. Previous studies have identified the variables having positive effects on CDE and put forward practical solutions to promoting CDE. However, the majority of them have ignored the variables having negative effects on CDE and how to mitigate the inhibitory effects. In order to fill the research gap, this study investigates the causal relationship between organizational inertia (OI) and CDE and examines the moderating roles of internal factors such as digital capability (DC) and entrepreneurial culture (EC) as well as external factors such as institutional support (IS) and strategic alliance (SA). Based on multiple linear regression (symmetric) and fuzzy-set qualitative comparative analysis (asymmetric) using survey data from 349 Chinese firms, the results demonstrate that OI has a significant negative effect on CDE. In addition, DC, EC, and SA play negative moderating roles in the relationship between OI and CDE, which means that they could reduce the inhibitory effect derived from OI when incumbent firms implement CDE. Moreover, dividing OI into three dimensions discovers that the moderating roles of DC, EC, and SA present different features. This study enriches the literature on corporate entrepreneurship and provides valuable practical implications for incumbent firms to achieve successful CDE by revealing how to overcome the inertia deeply embedded in organizations.

Factors Influencing Sustainable Development Literacy among Engineering Undergraduates in China: Based on the College Impact Model.

Achieving carbon neutrality is a major strategy to combat climate change and achieve sustainable development. Training engineering undergraduates with sustainable development literacy is an important way to achieve this goal in the field of higher education. Based on the college impact model, this research surveyed 1070 engineering undergraduates in Chinese universities to explore the influence of institutional support on undergraduates' sustainable development literacy, and the empirical analysis was conducted using Structural Equation Modeling. The results showed that institutional support positively and significantly influenced the sustainability development literacy of engineering undergraduates, and student engagement had a mediating role in the relationship between institutional support and sustainability development literacy. Relevant recommendations for cultivating engineering undergraduates with high-level sustainability development literacy are proposed here.

Apoio institucional à gestão e prestação de serviços de saúde em unidade básica fluvial na Amazônia / Institutional support for the management and delivery of health services by a mobile river clinic unit in the Amazon / Apoyo institucional a la gestión y prestación de servicios de salud en unidad básica fluvial en la Amazonía

O estudo analisou o processo de trabalho do apoiador institucional ao atendimento ofertado em Unidade Básica de Saúde Fluvial. Neste estudo qualitativo, foi entrevistada 100% da equipe de gestão das unidades móveis fluviais que atendem à população rural residente entre Manaus e Novo Airão. Resultados evidenciaram baixa institucionalidade do trabalho de apoiador, em paralelo à importância da imersão nas atividades itinerantes desenvolvidas no meio rural e à centralidade do trabalho vivo cotidianamente realizado. A carência de suporte administrativo às atividades da unidade fluvial obriga o apoiador a desenvolver amplo leque de ações logísticas, requeridas pelo regime de trabalho itinerante rural. Práticas verticalizadas de tomada de decisão e restrições de investimento em infraestrutura e logística fragilizam a interveniência do apoiador e das equipes multiprofissionais, em que pese a contribuição delas à extensão de cobertura provida pelas unidades móveis fluviais rurais.(AU)

This study analysed work processes of the institutional supporter to the care services delivered by a mobile river clinic. We conducted a qualitive study using interviews with all members of the mobile river unit management team, which provides care services to the rural population between Manaus and Novo Airão. The findings show a low level of institutionalization of the work of supporters, the importance of immersion in the mobile activities developed in rural areas, and the centrality of daily living work. The lack of administrative support for the activities of the river unit means that the supporter has to develop a wide range of logistical actions required under the mobile rural work routine. Vertical decision-making and underfunding of infra-structure and logistics weaken the interventions of the supporter and multiprofessional teams, despite their contribution to the extent of coverage provided by mobile river units.(AU)

El estudio analizó el proceso de trabajo del apoyador institucional a la atención ofrecida en unidad básica fluvial de salud de la familia. Estudio cualitativo, se entrevistó al 100% del equipo de gestión de las unidades móviles fluviales que atienden a la población residente entre Manaus y Novo Airão. Los resultados mostraron una baja institucionalidad del trabajo de apoyador, en paralelo con la importancia de la inmersión en las actividades itinerantes desarrolladas en el medio rural y la centralidad del trabajo vivo cotidianamente realizado. La falta de apoyo administrativo a las actividades de la unidad fluvial obliga al apoyador a desarrollar una amplia gama de acciones logísticas, requeridas por el régimen de trabajo itinerante rural. Las prácticas verticalizadas de toma de decisiones y restricciones de inversión en infraestructura y logística fragilizan la intervención del apoyador y de los equipos multiprofesionales, a pesar de la contribución que realizan para la ampliación de la cobertura proporcionada por las unidades móviles fluviales rurales.(AU)

Research Integrity Supervision Practices and Institutional Support: A Qualitative Study.

Scientific malpractice is not just due to researchers having bad intentions, but also due to a lack of education concerning research integrity practices. Besides the importance of institutionalised trainings on research integrity, research supervisors play an important role in translating what doctoral students learn during research integrity formal sessions. Supervision practices and role modelling influence directly and indirectly supervisees' attitudes and behaviour toward responsible research. Research supervisors can not be left alone in this effort. Research institutions are responsible for supporting supervisors in being more aware of their RI function, and in supporting responsible supervision practices to have a positive cascading effect on supervisees' research practices. We interviewed 22 European research supervisors to investigate how they perceive their role as research integrity trainers and their real-life supervision practices. Moreover, we investigated their points of view concerning the role of research institutions in supporting supervision practices. Although there are different commonalities in supervisors' perception of their research integrity-related role, differences are emphasised depending on the supervisors' characteristics such as academic domain, seniority, working country and gender. In addition, supervisors' way of mentoring depend also on supervisees' learning curve. Overall, all supervisors agreed on institutions playing an important role in support their supervision effort and practices. This study aims to be a starting point for better understanding research integrity supervision practices and the role of institutions in supporting them. Moreover, it puts the basis to further investigate differences in supervision practices depending on supervisors' characteristics. Supplementary Information: The online version contains supplementary material available at 10.1007/s10805-022-09468-y.

Overcoming mental health stigma through student's awareness and project-based inclusive pedagogy in English teaching colleges: Moderating role of institutional support in China.

Mental health stigma undermines collaborative work and creates communication breakdowns for students to face real-world challenges. Moreover, project-based English learning in East-Asian nations is a significant challenge for advancing students' effective learning, while students lack mental health self-awareness. Unawareness causes distractions and results in learning inefficiencies. Furthermore, without institutional support (IS) achieving effective learning could never be possible. Therefore, this study investigates the relationships between project-based learning (PBL) and mental health awareness (MHA) with effective English language teaching among university students in China. We also tested the moderation effect of IS in the relationships between PBL and MHA with effective English language learning (EEL). Using the purposive sampling technique, we collected valid responses from 713 students studying English as a foreign language in universities and colleges in Harbin, China. The findings interestingly supported the direct hypotheses between PBL and EEL, as well as MHA and EEL. Moreover, the moderating role of IS established a significant effect on both PBL and EEL, as well as MHA and EEL, respectively. Policymakers, practitioners, and academicians should understand that integrating PBL as an inclusive pedagogy method with proper IS may enhance effective learning; however, it will consume more time.

A atuação da supervisão acadêmica do Programa Mais Médicos no contexto da pandemia de Covid-19 na Bahia: um relato de experiência / Academic advising of the Mais Médicos Program during the Covid-19 pandemic in Bahia: an experience report / El desempeño de la supervisión académica del Programa Más Médicos en el contexto de la pandemia del Covid-19 en Bahía: un informe de experiencia

Este estudo tem o objetivo de relatar a experiência vivenciada pela equipe de apoio institucional do Ministério da Educação (MEC) no estado da Bahia em relação à supervisão acadêmica no contexto da pandemia de covid-19, no período de 2020 a 2021. Trata-se de uma pesquisa descritiva, do tipo relato de experiência, tendo como referência a atuação do apoio institucional frente à supervisão acadêmica no processo de trabalho dos médicos do Programa Mais Médicos para o Brasil (PMMB). Foram descritas as ações estratégicas e educacionais construídas pela supervisão acadêmica do PMMB no estado da Bahia, no período da pandemia pelo novo coronavírus, relacionadas às potencialidades e fragilidades encontradas no processo de trabalho nesse cenário. O contexto da pandemia impôs um grande desafio para os atores envolvidos no processo da supervisão acadêmica. Enfatiza-se, diante do cenário pandêmico, a importância da comunicação e articulação das instâncias do Sistema Único de Saúde (SUS) na organização do processo de trabalho nas unidades básicas de saúde e no enfrentamento da covid-19.

This study reports on the experience lived by the Institutional Support team from the Ministry of Education (MEC) in the state of Bahia, Brazil, concerning Academic Advising during the COVID-19 pandemic, from 2020 to 2021. This descriptive experience report concerns the institutional performance within Academic Advising in the work process of doctors from the Mais Médicos Program for Brazil (PMMB). It describes the strategic and educational actions built by the PMMB academic advising in Bahia during the pandemic caused by the new coronavirus, regarding the potentialities and weaknesses found in the work process in this context. The pandemic imposed a great challenge for the actors involved in the academic advising process. Given the pandemic scenario, the communication and articulation of instances from the Unified Health System (SUS) in organizing the work process in basic health units and in the fight against COVID-19 is of essence.

Este estudio describe la experiencia vivida por el equipo de apoyo institucional del Ministerio de Educación (MEC) en el estado de Bahía (Brasil) con relación a la supervisión académica en el contexto de la pandemia de Covid-19 en el período de 2020 a 2021. Se trata de un estudio descriptivo, de tipo informe de experiencia con referencia al desempeño institucional frente a la supervisión académica en el proceso de trabajo de los médicos del Programa Más Médicos para Brasil (PMM). Se describieron las acciones estratégicas y educativas construidas por la supervisión académica del PMMB en el estado de Bahía en el período de la pandemia provocada por el nuevo coronavirus, relacionadas con las fortalezas y debilidades encontradas en el proceso de trabajo en este contexto. El contexto de la pandemia ha impuesto un gran desafío para los actores involucrados en el proceso de supervisión académica. Ante este escenario, se destaca la importancia de la comunicación y articulación de las instancias del Sistema Único de Salud (SUS) en la organización del proceso de trabajo en las unidades básicas de salud y en el combate al Covid-19.

The association between the level of institutional support for dementia care in primary care practices and the quality of dementia primary care: A retrospective chart review.

INTRODUCTION: Institutional support, encompassing financial and training support, as well as interdisciplinary teams, may be important for the quality of dementia primary care for persons living with dementia. The aim of this study was to measure the association between the level of institutional support provided to primary care practices and the quality of dementia care. METHODS: This was a cross-sectional chart review in 33 Canadian primary care practices to measure the quality of dementia primary care using a quality of follow-up score. The score was based on the assessment of 10 indicators. Practices were chosen using a purposeful sampling method with varying levels of institutional support for dementia primary care (e.g., financial support, training, interdisciplinary team). A linear mixed-effect model was used to measure the association between the level of institutional support and the quality of dementia care. RESULTS: There was a significant association between the level of institutional support and the quality of dementia care (mean difference = 23.5, 95% confidence interval: 16.4, 30.6). DISCUSSION: Providing more institutional support for primary care practices could be a promising avenue to improve the care of persons living with dementia.

Predictors associated with new nursing faculty's intent to leave nursing academia: teaching preparation in doctoral program, institutional supports, and job satisfaction.

OBJECTIVES: The purpose of this study was to examine the relationships among demographics, doctoral teaching preparation, nurse faculty institutional support, faculty job satisfaction, and intent to leave current nursing academic position in PhD- and DNP-prepared faculty. METHODS: Using a survey research design, invitations to a Qualtrics survey were emailed to nursing program directors. Independent samples t-tests and logistic regression models were used to determine the nature of the relationships. RESULTS: In total, 149 participants completed the survey. Degree type, age, and job satisfaction were significant predictors related to intent to leave nursing academia. Doctoral program teaching preparation and institutional support were not statistically associated with intent to leave nursing academia. CONCLUSIONS: Findings suggest older age, PhD-prepared faculty, and job dissatisfaction were significant factors influencing decisions to leave nursing academia among the doctoral prepared new nursing faculty. Efforts to retain or increase the number of nurse faculty must be prioritized.

Attitudes, perceptions, self-efficacy and knowledge levels of Israeli nurses in relation to opioid misuse: A cross-sectional survey.

BACKGROUND: In an opioid epidemic that is imposing heavy health burdens on individuals, families and health systems, nurses are the main front-line caregivers in the battle against the unrelenting increase in opioid medication misuse. Yet, little research has been conducted on nurses' opinions and knowledge surrounding this issue worldwide and in Israel as well. OBJECTIVES: To evaluate Israeli nurses' attitudes, their knowledge about opioid use and misuse, their perception of institutional support, and their perception of their role and self-efficacy in preventing and treating opioid misuse. DESIGN: Cross-sectional study. METHODS: The data were collected through an electronic questionnaire from 414 Israeli registered nurses using the Qualtrics platform for on-line surveys. RESULTS: The majority of the sample perceived their role positively, held positive attitudes toward people with opioid addiction, and were willing to take care of persons who misused opioids. Nurses reported low scores on knowledge, perceived institutional support, and self-efficacy relating to the issues surrounding opioid pain medication use and misuse. CONCLUSIONS: The results clearly indicate a lack of up-to-date knowledge among nurses concerning opioids use. This situation must be urgently corrected through revisiting the subject of opioids across undergraduate, graduate, and continuing nursing education programs. Improved knowledge, combined with a supportive organizational culture, should strengthen nursing care provided to this frequently neglected patient population. CLINICAL RELEVANCE: Broad insight into nurses' attitudes, their level of knowledge about opioid use and misuse, and their perceptions of their own role in preventing and treating such misuse are essential for creating targeted, relevant educational interventions for nurses with the aim of providing safe and effective opioid treatment for individuals with pain.

Communication in Pharmacy Higher Education to Improve Work-life and Mitigate Burnout.

Objective. To identify the content, style, timing, tone, and initiation of communication that best connotes "reassurance of worth" from peers and supervisors in pharmacy academia.Methods. This study employed semi-structured interviews to acquire in-depth information from pharmacy faculty through a purposive sampling process. Academicians who had published in the area of work-life and/or were deemed likely to make substantial contributions to the interview were asked to participate. Participants represented a cross section of pharmacy faculty in terms of discipline, institution, and demographic characteristics. An interview guide was constructed based on motivating language theory and provisions of social relationships theory. Interviews were conducted via Zoom and transcribed verbatim. Themes were gleaned using open coding, then audited and checked.Results. Data saturation occurred after eight interviews. Two primary themes emerged: guidance, particularly related to professional development and tenure; and reassurance of worth through invited participation, praise, and/or rewards. Interviewees highlighted the importance of empathetic yet practical language among peers, and supervisor-initiated, meaning-making language rather than generic platitudes.Conclusion. Empathetic, personal language that provides guidance and reassurance of worth can enhance pharmacy faculty contributions and mitigate burnout. Invitations to collaborate are seen by faculty as collegial and engaging. This study demonstrated the usefulness of motivating language theory and social provisions in guiding communications among pharmacy academicians.

Migration and Resilience in Urban Canada: Why Social Resilience, Why Now?

Drawing on an extensive review of recent literature about resilience and integration, this paper evaluates a social resilience approach to the integration of international migrants in Canadian cities. We advocate a social resilience approach that acknowledges how institutions of all types play critical roles in newcomers' efforts to establish their lives in new places, especially when faced with unanticipated events such as a global pandemic. Centering research around the concept of social resilience goes beyond the neoliberal idea that integration is primarily an individual affair achieved with support from friends, family, and a nebulous community and draws attention to the social diversity of migrants and the complexity of their migration and settlement histories. Inherently relational, a social resilience approach encourages comparative studies of integration across cities that can reveal how different institutions and their programs affect migrants' trajectories. Detailed examinations of local institutions and their responses to shifting selection and integration policies, especially during a pandemic, also hold the potential to provide crucial information for supporting newcomers effectively.

Análise sobre processos e práticas de apoio institucional em serviços municipais de atenção primária à saúde / Analysis of institutional support processes and practices in municipal primary health care services

Problema de pesquisa e objetivo: Esta dissertação versa sobre processos e práticas de Apoio Institucional em serviços de Atenção Primária à Saúde em um município de médio porte populacional da região metropolitana de Porto Alegre-RS, a partir de compreensões dos atores institucionais implicados. Metodologia: Consiste em um estudo de caso único com análise qualitativa de pretensão exploratória, a partir de hermenêutica descritiva de proferimentos discursivos correlatos. Resultados: Verificou-se ênfases discursivas acerca dos processos de seleção, dos requisitos, dos atributos e do perfil das Apoiadoras Institucionais no município. A evidência no discurso ocorre, também, acerca da conjuntura local e das inseguranças sobre a continuidade do trabalho. Há compreensões diversas sobre contradições entre a modelagem legal-normativa e as condições práticas e cotidianas de trabalho no Apoio Institucional e sobre o "lugar" (ou "não lugar ou "entre- lugar") dos seus profissionais. Conclusão: As Apoiadoras Institucionais se reconhecem mais como gestoras de processos relacionais e de práticas interativas entre diversos setores da gestão e dos serviços de Saúde. Convergem na compreensão de que a integração de seu trabalho com outras estratégias institucionais, como a de Educação Permanente, tende a transversalizar e potencializar uma melhor atuação.

Research problem and objective: This dissertation argues about Institutional Support practices and processes in Health Primary Care services in a medium population size town from the Porto Alegre's metropolitan area (Brazil), taking as starting point the understandings from the institutional actors involved. Methodology: This research consists in a single qualitative study case with an exploratory assumption, with descriptive hermeneutics of related discursive utterances. Results: There were discursive emphases about the workers selection process, requirements, attributes and from the profile of the Institutional Supporters from the town. The evidence at the speech happens also because of the local conjuncture and the insecurities about the work continuity. There are different understandings about the contradictions between the legal-normative framing and the daily and practical conditions of work at the Institutional Support and also about the emplacement (or non-places or between-places) of the professionals. Conclusion: The Institutional Supporters understand themselves more as relationships processes managements and interactive practices between different departments and Health Policy services. Converge as a comprehension that the integration of their works with others institutional strategies, as the "Permanent Education", run to "traverse" and potentiate a better work operation.

Apoio institucional como tecnologia para produção de uma gestão menor na área da saúde / Institutional support as a technology to the production of a minor management in the health area

Resumo A partir da problematização de uma suposta dicotomia existente entre gestão e atenção na saúde, no âmbito do Sistema Único de Saúde, exploramos a tecnologia do apoio institucional em sua potência intercessora nessa relação. Para tanto, realizou-se uma investigação cartográfica a partir de narrativas e reflexões registradas em diários de campo que emergiram de experiências de apoio e pesquisa no âmbito da Atenção Básica. Inspiradas na proposição de Guattari de uma "literatura menor", defendemos a desmistificação da gestão em saúde, apontando o apoio institucional como tecnologia que pode contribuir para a produção de uma gestão menor.

Abstract This study discusses a supposed dichotomy between health management and health attention in the context of the Brazilian Health System, to explore how institutional support technology can interfere in this relationship. With this goal a cartographic research work was carried out, to explored the narratives, reflections and field diaries that emerged from the researcher's experience in the Basic Health Care. Inspired by Guattari's proposition of a 'minor literature', it defends the demystification of health management, featuring institutional support as a technology that may contribute to the production of a management.

Impacts and challenges of the COVID-19 pandemic on emergency medicine physicians in the United States.

BACKGROUND: Emergency medicine (EM) physicians have been on the front line of the COVID-19 pandemic. This study aims to determine the impact of COVID-19 pandemic and other related factors such as resource availability and institutional support on well-being, burnout and job-satisfaction of EM physicians in the United States. METHODS: A cross-sectional survey study of EM physicians was conducted through the Emergency Medicine Practice Research Network of the ACEP. The survey focused on resource adequacy, institutional support, well-being, and burnout. A total of 890 EM physicians were invited to participate. Both descriptive and risk adjusted, and multivariate regressions were performed with a statistical significance defined as p < 0.05. RESULTS: EM physicians' response rate was 18.7% (166) from 39 states. Burnout was reported by 74.7% (124) since the start of the pandemic. Factors contributing included work-related emotional strain and anxiety, isolation from family and friends, and increased workload. Those reporting inadequate resources felt ignored by their institutions (p < 0.0001). Physicians who felt there was inadequate institutional support, were also dissatisfied with patient care resources (p = 0.001). Physicians expressing job dissatisfaction were more likely to report feelings of burnout (p = 0.001). CONCLUSION: EM physicians face greater burnout in the COVID-19 pandemic. This may be compounded by resource scarcity, psychological stress, isolation, and job dissatisfaction. Many of the survey respondents reported inadequate mental health services and resources. The findings of this study may help identify solutions to mitigate these issues.

Rede Cegonha e desafios metodológicos de implementação de redes no SUS / Rede Cegonha network and the methodological challenges of implementing networks in the SUS

Resumo O artigo aborda estratégias usadas na implementação da Rede Cegonha (RC), considerando sua finalidade de contribuir para uma mudança de modelo de atenção ao parto e nascimento nos serviços do SUS. Contextualiza a RC como projeto firmado interinstâncias gestoras do SUS e a importância de estratégias de sua execução junto aos serviços. Nesse sentido aponta dois eixos essenciais na sustentação da RC, considerados estratégicos para promover a análise-intervenção na atenção obstétrico-neonatal: o apoio institucional (AI) e a formação para o trabalho em equipe. O AI possibilita que a RC se efetive como uma construção coletiva assumida pelas equipes nos seus espaços de ação; é apontado como inovação no modo de implementar projetos de saúde. A metodologia da formação-intervenção inova no modo de formar para intervir no trabalho. Essas experiências são afirmadas como potencializadoras da RC na criação de condições para mudar a lógica tecnocrática de gestão e atenção ao parto e nascimento.

Abstract This paper addresses strategies employed in the implementation of the Rede Cegonha ("Stork Network") (RC), considering its contribution to change the delivery and birth care model in the Brazilian Unified Health System (SUS). It contextualizes RC as a project signed by SUS management interagency bodies and the importance of implementing the services' strategies. In this sense, it points out two essential axes supporting the RC, which are strategic to promote the intervention-analysis in obstetric-neonatal care, namely, institutional support (IS) and teamwork training. The IS enables the RC to become a collective construction assumed by teams in their action spaces and is pointed out as an innovative way of implementing health-related projects. The intervention-training methodology innovates training to intervene in work. These experiences are affirmed as potentiators of the RC in creating the conditions to change the technocratic rationale of management and care throughout labor and birth.