Labor Unionization Among Physicians in Training.

This study examines the number of unique unions and characteristics of unionization elections among physicians in training in the US.

Origem, trajetória e atuação política conjunta das entidades médicas nacionais brasileiras de 1999 a 2015 / Origin, trajectory and joint political action of Brazilian national medical entities from 1999 to 2015

Resumo O artigo aborda a atuação política conjunta de entidades médicas nacionais brasileiras de 1999 a 2015, destacando elementos de sua origem, trajetória e configuração institucional. Foram analisados temas, bandeiras de luta, posicionamentos e estratégias na agenda dessas organizações. O estudo envolveu revisão bibliográfica e análise documental, ancoradas no institucionalismo histórico. Os resultados indicam processos de surgimento inter-relacionados, mais evidentes entre a Associação Médica Brasileira e o Conselho Federal de Medicina, repercutindo nas trajetórias e configurações institucionais. Observaram-se conexões entre aspectos históricos, institucionais e a atuação política das entidades. A ênfase na unidade representativa contribuiu para a conformação de uma agenda conjunta influenciada pela parceria entre as entidades, com incorporação posterior da Federação Nacional dos Médicos. Sua atuação foi voltada para o Legislativo, e simultaneamente para os setores público e privado de saúde, com crescimento de posicionamentos contrários às políticas de saúde do governo federal. A ação política se desenvolveu sem alterações de arranjo representativo trino, composto por conselho, associação e sindicato, favorecendo a definição de acordos em espaços intermediários de representação. A agenda corporativa dúbia e a defesa do exercício liberal influenciam a atuação contraditória das entidades médicas brasileiras, com desdobramentos no apoio político e incorporação desses profissionais ao SUS.

Abstract The article addresses the joint political action of Brazilian national medical entities from 1999 to 2015, highlighting elements of their origin, trajectory and institutional configuration. Themes, flags of struggle, positions and strategies in the agenda of these organizations were analyzed. The study involved bibliographic review and documentary analysis, anchored in historical institutionalism. The results indicate interrelated processes of creation, more evident between the Brazilian Medical Association and the Federal Council of Medicine, reflecting on the trajectories and institutional configurations. There were connections between historical and institutional aspects and the political action. The emphasis on the representative unit contributed to a joint agenda influenced by the partnership between the entities, with subsequent incorporation of the National Federation of Physicians. Its performance was focused on the Legislature, and simultaneously to the public and private health sectors, with growth of positions contrary to the federal health policies. The political action developed without changes of trine representative arrangement, composed of council, association and union, favoring the definition of agreements in intermediate spaces. The dubious corporate agenda and the defense of the liberal practice influence the contradictory performance of Brazilian medical entities, with consequences in political support and incorporation of these professionals to the SUS.

ESPPE debate virtual: continuação da fala da professora Ingrid D'avilla

ESPPE Debate Virtual - Os desafios do trabalho e da formação dos trabalhadores técnicos em saúde no contexto da COVID-19.

ESPPE debate virtual: continuação da fala do professor Itamar Lages

ESPPE Debate Virtual - Os desafios do trabalho e da formação dos trabalhadores técnicos em saúde no contexto da COVID-19.

Mortality Rates From COVID-19 Are Lower In Unionized Nursing Homes.

More than 40 percent of all reported coronavirus disease 2019 (COVID-19) deaths in the United States have occurred in nursing homes. As a result, health care workers' access to personal protective equipment (PPE) and infection control policies in nursing homes have received increased attention. However, it is not known whether the presence of health care worker unions in nursing homes is associated with COVID-19 mortality rates. Therefore, we used cross-sectional regression analysis to examine the association between the presence of health care worker unions and COVID-19 mortality rates in 355 nursing homes in New York State. Health care worker unions were associated with a 1.29-percentage-point reduction in mortality, which represents a 30 percent relative decrease in the COVID-19 mortality rate compared with facilities without these unions. Unions were also associated with greater access to PPE, one mechanism that may link unions to lower COVID-19 mortality rates.

California's Prisoner Protections for Family and Community Health Act : Implementing a Mandated Condom Access Program in State Prisons, 2015-2016.

In 2014, California passed Assembly Bill 966, which required condom access for persons incarcerated in all 35 California state prisons (33 men's and 2 women's prisons). The California Correctional Health Care Services and the Sexually Transmitted Disease Control Branch and the Office of AIDS of the California Department of Public Health collaborated in a prison administration-led multidisciplinary implementation workgroup. Our workgroup, representing public health, correctional health, legal and legislative affairs, labor relations, and prison staff members, participated in 4 planning meetings during May-September 2015. We surveyed prison staff members and incarcerated men to identify and address potential challenges; conceptualized a tamper-resistant condom dispenser; developed educational materials, frequently asked questions for staff members, and fact sheets for the public; and conducted forums for custody and medical staff members at each prison. Key lessons learned included the need for high-level custody support, engagement of labor unions early in the decision-making process, and flexibility within defined parameters for sites to determine best practices given their unique institutional population, culture, and physical layout. Condom access was initiated at 4 prisons in July 2015 and expanded incrementally to the remaining 29 men's prisons through July 2016. A total of 243 563 condoms were accessed in the men's prisons, for an average of 354 condoms per 1000 population per month. The start-up dispenser cost was $69 825 (735 dispensers at $95 each). We estimated an annual condom cost of $0.60 per person. Although staff members and incarcerated men expressed concern that this legislation would condone sex and provide repositories for contraband, no serious adverse incidents involving condoms were reported. California demonstrated that condom access is a safe, low-cost intervention with high uptake for a large correctional system and provided a replicable implementation model for other states. Prison condom programs have the potential to decrease transmission of sexually transmitted infections (STIs) among incarcerated persons and their communities, which are often disproportionately affected by STIs, HIV, and other chronic diseases.

Trabalhadores da enfermagem: conquista da formalização, "dureza" do trabalho e dilemas da ação coletiva / Nursing workers: achievement of formalization, hard work and collective action dilemas

Resumo A singularidade das categorias de enfermagem na participação sociopolítica, especificamente sua ação coletiva, é a temática analisada. O artigo associa as condicionantes: origem social e aspectos do mercado de trabalho à ação política dos profissionais. A partir da associação analítica do estudo de caso ampliado, articulamos a interpretação da base de dados da Pesquisa Perfil da Enfermagem no Brasil, especificamente, sob os eixos: identificação socioeconômica, mercado de trabalho e condições de trabalho, com estudo etnográfico e entrevistas semiestruturadas em três unidades hospitalares. A revisão bibliográfica demonstra a inserção desses indivíduos sem secundarizar sua particularidade: o processo histórico de proletarização na formação social brasileira, a inserção feminina no mercado de trabalho e a relação com sindicatos. O histórico dos trabalhadores pautados pela inexperiência em ações de resistência ou representação sindical, associado à valorização do emprego como ascensão social resultam na configuração de regimes de trabalho assimétricos, elemento dificultador de ações organizadas, aspecto fundamental para a melhora das condições de trabalho.

Abstract The singularity of the collective action of nursing categories in sociopolitical participation is the subject of our analysis. This paper attaches the compelling factors of social origin and aspects of the labor market to the political action of professionals. Based on the analytical association of the extended case method, we articulated the interpretation of the database of the Brazilian Nursing Profile Survey, specifically, in the light of socioeconomic identification, labor market, and working conditions, with an ethnographic study and semi-structured interviews in three hospital units. The bibliographic review shows the incorporation of these individuals without underestimating their particularity: the historical process of proletarianization in the Brazilian social formation, the inclusion of women in the labor market, and the relationship with unions. The history of workers based on inexperience in actions of resistance or union representation associated with the valorization of employment as a social ascent results in asymmetrical work regimes, a hindering element to coordinated actions, a fundamental aspect for the improvement of working conditions.

Tipos de conflictos laborales y su manejo en el ejercicio de la enfermería / Labor conflicts types and their management in nursing practice

OBJETIVO: Determinar la asociación entre los tipos de conflictos laborales y el manejo de los mismos en el personal de enfermería del Hospital Regional Honorio Delgado de la ciudad de Arequipa del Perú (HRHD). MÉTODO: Estudio, observacional, descriptivo transversal, prospectivo, con enfoque cuantitativo y de nivel correlacional. La población de estudio fueron 190 profesionales encuestados en el año 2015. El instrumento fue un formulario de preguntas de forma anónima, con Test de Thomas Kilmann que consta de 30 ítems, cada uno con dos opciones de afirmaciones. Se realizó un análisis descriptivo y de asociación de variables utilizando el programa Infostat 2018, utilizando el estadístico χ2 con nivel de significancia p<0,05. RESULTADOS: Los resultados mostraron una mayor cantidad de personal entre 50 y 59 años de edad, con un porcentaje de 34,7%, así como predominancia del personal femenino con 94,7%. El tipo de conflictos más frecuente fue el Comunicación-Personal con un 44,8%, en segundo lugar el conflicto personal con 26,8%, seguido por el conflicto de comunicación con 15,8%. En cuanto al manejo de conflictos, el 48,4% consideró al cooperativo como el más utilizado. No se encontró asociación estadísticamente significativa entre el tipo y el manejo conflictos (χ2 = 13,53; p = 0,139). CONCLUSIONES: Para el personal de enfermería no existe relación entre los tipos de conflictos laborales y la forma de manejarlos, sin embargo, la mayoría de los sujetos estudiados considera que los conflictos de Comunicación-Personal son los más comunes y que su manejo es cooperativo

OBJECTIVE: Determine the association between the labor conflicts types and their management in the nursing staff of Honorio Delgado Regional Hospital in Arequipa city, Peru (HRHD). METHOD: Observational study, cross-sectional, prospective, with quantitative and correlational level approach. The study population was the nursing professionals of Honorio Delgado Espinoza Regional Hospital in Arequipa city, surveyed in 2015. A questionnaire form was used as anonymous measurement tool. We Applied the Thomas Kilmann Test of 30 items, each of which has two options of statements that describe possible response behaviors. A descriptive and association analysis of variables was performed using the Infostat version 2018 software, using the χ2 statistic with significance level p <0.05. RESULTS: The sample was 190 nursing professionals. The results showed a greater number of persons between 50 and 59 years of age, with a percentage of 34.7%, as well as predominance of female staff with 94.7%.The conflicts type most frequent in study population was the Communication-Personnel with 44.8%, leaving in second place the personal conflict with 26.8%, followed by communication conflict with 15.8%. Regarding conflict management, 48.4% considered the cooperative as the most used. No statistically significant association was found between type and conflicts management (χ2 = 13.53, p = 0.139). CONCLUSIONS: For nursing staff, there is no relationship between labor conflicts types and the way of management them, however, most of subjects studied consider that Communication-Personnel conflicts are most common and that their management is cooperative

Nursing workers: achievement of formalization, hard work and collective action dilemas. / Trabalhadores da enfermagem: conquista da formalização, "dureza" do trabalho e dilemas da ação coletiva.

The singularity of the collective action of nursing categories in sociopolitical participation is the subject of our analysis. This paper attaches the compelling factors of social origin and aspects of the labor market to the political action of professionals. Based on the analytical association of the extended case method, we articulated the interpretation of the database of the Brazilian Nursing Profile Survey, specifically, in the light of socioeconomic identification, labor market, and working conditions, with an ethnographic study and semi-structured interviews in three hospital units. The bibliographic review shows the incorporation of these individuals without underestimating their particularity: the historical process of proletarianization in the Brazilian social formation, the inclusion of women in the labor market, and the relationship with unions. The history of workers based on inexperience in actions of resistance or union representation associated with the valorization of employment as a social ascent results in asymmetrical work regimes, a hindering element to coordinated actions, a fundamental aspect for the improvement of working conditions.

A singularidade das categorias de enfermagem na participação sociopolítica, especificamente sua ação coletiva, é a temática analisada. O artigo associa as condicionantes: origem social e aspectos do mercado de trabalho à ação política dos profissionais. A partir da associação analítica do estudo de caso ampliado, articulamos a interpretação da base de dados da Pesquisa Perfil da Enfermagem no Brasil, especificamente, sob os eixos: identificação socioeconômica, mercado de trabalho e condições de trabalho, com estudo etnográfico e entrevistas semiestruturadas em três unidades hospitalares. A revisão bibliográfica demonstra a inserção desses indivíduos sem secundarizar sua particularidade: o processo histórico de proletarização na formação social brasileira, a inserção feminina no mercado de trabalho e a relação com sindicatos. O histórico dos trabalhadores pautados pela inexperiência em ações de resistência ou representação sindical, associado à valorização do emprego como ascensão social resultam na configuração de regimes de trabalho assimétricos, elemento dificultador de ações organizadas, aspecto fundamental para a melhora das condições de trabalho.

"¡Viva La Clinica!": The United Farm Workers' Fight for Medical Care.

Farm work is among the most dangerous and unhealthy occupations in the United States, but efforts to address farm workers' health needs have been sporadic and inadequate. In the 1960s and 1970s, the United Farm Workers of America (UFW) famously organized workers in California's grape and lettuce fields and won national and international recognition through its boycott tactics. The UFW also opened several medical clinics, staffed by volunteer nurses and physicians, and created the Robert F. Kennedy Medical Plan, a medical insurance program, for its members. Both efforts were initially successful, but foundered in the face of many obstacles, including the reluctance of the UFW leadership to organize undocumented farm workers. However, the UFW's medical work laid the foundation for continuing efforts on behalf of farm workers' and undocumented people's right to health care.

Reaching out: Organizational structures and public communication of nursing professional associations and trade unions in Portugal.

AIM: To describe the organizational structure and resources for strategic mediacommunication of nursing professional associations and trade unions in Portugal. DESIGN AND METHODS: Quantitative study, with a cross-sectional, exploratory/descriptive design. From October to November 2017, a questionnaire was sent to 21 nursing professional associations and trade unions in Portugal. Eleven (52.4%) organizations replied: nine professional associations and two trade unions. RESULTS: The participating organizations rely on basic structures regarding strategic communication: 54.5% of them have less than 500 members; 63.6% of them have no communication budget; 54.5% of them have no formal communication structure, and only 27.3% of them hold events for the purpose of media coverage. Consequently, most of these organizations have occasional interactions with journalists, create messages about nursing problems, and directed mostly to nurses, perpetuating a circular communication. CONCLUSION: Nursing professional organizations have limited resources and lack of formal communication structures. The restricted interaction with the media and the "echoing" voice that propagates within the profession may hinder citizens' full understanding of its contribution. Nursing organizations must develop a nation-wide strategy that promotes transversal collaboration and resources optimization, with the purpose of increasing their media visibility and strengthening their Public Health mission.

Construcción social del riesgo en el agro uruguayo: desafíos a la actividad sindical / Social construction of risk in the Uruguayan agricultural sector: challenges for union activity

RESUMEN Desde fines de la década de 1990, al igual que otros países de América Latina, Uruguay experimentó un "boom agrícola", el avance del sector agropecuario y la introducción de nuevas tecnologías, así como nuevas formas de producir y trabajar. Asimismo, a partir del año 2005 se observa un impulso de la sindicalización rural, asociado a los procesos de negociaciones colectivas y a la expansión de los derechos de los trabajadores a nivel nacional. Sin embargo, este proceso aún no ha logrado consolidar cambios significativos en las históricas condiciones laborales del trabajo rural. El trabajo analiza la construcción social del riesgo del trabajo asalariado rural, desde la perspectiva de dirigentes rurales, a partir de una aproximación cualitativa. En sus discursos aparecen elementos de naturalización y las dificultades persistentes en su labor para poder mejorar sus condiciones laborales, de modo de impactar en su salud y calidad de vida.

ABSTRACT Since the end of the 1990s, as in other Latin American countries, Uruguay has experienced an "agricultural boom," an advance in the agricultural sector and the introduction of new technologies as well as new ways of producing and working. In addition, since 2005, the country has seen a surge in rural unionization, associated with collective bargaining processes and the expansion of workers' rights at the national level. However, this process has not yet been able to consolidate significant changes in the historical working conditions of rural labor. This paper analyzes the social construction of the risk of rural wage labor from the perspective of rural leaders, based on a qualitative approach. In the workers' discourses appear elements of naturalization as well as persistent difficulties in their work to improve their working conditions, as a way of impacting their health and quality of life.

Right-to-Work-for-Less: How Janus v. AFSCME Threatens Public Health.

In February 2018, the Supreme Court heard oral arguments in Janus v. AFSCME, a case poised to make right-to-work (or, as some call it, right-to-work-for-less) the law in the public sector. At issue is the constitutionality of requiring non-union members, who benefit from collective bargaining, to pay fees that support contract negotiations on the terms and conditions of their employment. We argue that a win for Janus would threaten public health by eroding organized labor's power to improve working conditions. Furthermore, we critique the dubious legal theory underpinning Janus's case and describe the moneyed political interests backing his legal representation. Finally, we chart a path forward for labor organizing in a post- Janus world, drawing inspiration from the winter 2018 educators' strike in West Virginia. Regardless of how Janus itself is decided, the issues raised in this article remain crucial because the ongoing weakening of unions by legislative and judicial means undermines workers' health and exacerbates inequities.

Labor-Management Cooperation in Illinois: How a Joint Union Company Team Is Improving Facility Safety.

This study of Afton Chemical Corporation's Sauget facility and its International Chemical Workers Union Council (ICWUC) Local 871C demonstrates how significant safety improvements can be made when committed leadership from both management and union work together, build trust, train the entire work force in U.S. Occupational Safety and Health Administration 10-hour classes, and communicate with their work force, both salaried and hourly. A key finding is that listening to the workers closest to production can lead to solutions, many of them more cost-efficient than top-down decision-making. Another is that making safety and health an authentic value is hard work, requiring time, money, and commitment. Third, union and management must both have leadership willing to take chances and learn to trust one another. Fourth, training must be for everyone and ongoing. Finally, health and safety improvements require dedicated funding. The result was resolution of more than one hundred safety concerns and an ongoing institutionalized process for continuing improvement.