Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20.156
Filtrar
1.
Int J Equity Health ; 20(1): 204, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521433

RESUMO

BACKGROUND: People with disabilities (PwD) have been facing multiple health, social, and economic disparities during the COVID-19 pandemic, stemming from structural disparities experienced for long time. This paper aims to present the PREparedness, RESponse and SySTemic transformation (PRE-RE-SyST): a model for a disability-inclusive pandemic responses and systematic disparities reduction. METHODS: Scoping review with a thematic analysis was conducted on the literature published up to mid-September 2020, equating to the initial stages of the COVID-19 pandemic. Seven scientific databases and three preprint databases were searched to identify empirical or perspective papers addressing health and socio-economic disparities experienced by PwD as well as reporting actions to address them. Snowballing searches and experts' consultation were also conducted. Two independent reviewers made eligibility decisions and performed data extractions on any action or recommended action to address disparities. A thematic analysis was then used for the model construction, informed by a systems-thinking approach (i.e., the Iceberg Model). RESULTS: From 1027 unique references, 84 were included in the final analysis. The PRE-RE-SyST model articulates a four-level strategic action to: 1) Respond to prevent or reduce disability disparities during a pandemic crisis; 2) Prepare ahead for pandemic and other crises responses; 3) Design systems and policies for a structural disability-inclusiveness; and 4) Transform society's cultural assumptions about disability. 'Simple rules' and literature-based examples on how these strategies can be deployed are provided. CONCLUSION: The PRE-RE-SyST model articulates main strategies, 'simple rules' and possible means whereby public health authorities, policy-makers, and other stakeholders can address disability disparities in pandemic crises, and beyond. Beyond immediate pandemic responses, disability-inclusiveness is needed to develop everyday equity-oriented policies and practices that can transform societies towards greater resiliency, as a whole, to pandemic and other health and social emergencies.


Assuntos
COVID-19 , Pessoas com Deficiência , Pandemias , Prática de Saúde Pública , COVID-19/epidemiologia , COVID-19/prevenção & controle , Disparidades nos Níveis de Saúde , Humanos , Modelos Organizacionais , Pandemias/prevenção & controle
2.
Child Adolesc Psychiatr Clin N Am ; 30(4): 809-826, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34538450

RESUMO

Psychiatry and psychology have a long history of competition that too often interferes with the collaboration that can characterize complementary contributions to our common missions. We hope this article will inspire our disciplines to expand on this collaboration, for the sake of our children and families, our communities, our colleagues, and honestly, ourselves. We are better together than apart. This text is a blueprint for the assumptions, attitudes, skills, and advocacy that can make this partnership healthy and successful.


Assuntos
Psiquiatria Infantil/métodos , Prestação Integrada de Cuidados de Saúde/organização & administração , Atenção Primária à Saúde , Psicologia da Criança/métodos , Adolescente , Criança , Humanos , Relações Interprofissionais , Colaboração Intersetorial , Saúde Mental , Modelos Organizacionais , Atenção Primária à Saúde/ética , Atenção Primária à Saúde/organização & administração
3.
Card Electrophysiol Clin ; 13(3): 483-497, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34330375

RESUMO

This review provides an overview of the literature on the organization, staffing, and structure of remote monitoring (RM) clinics, primarily from countries in Western Europe and United States, as well as the challenges, considerations, and future directions for RM clinic models of care. Using a current case example of an RM clinic in the Midwestern United States, this document provides key information from the viewpoint of a clinic undergoing a shift in workflow. Finally, this review distills key considerations for RM management for electrophysiology clinics, vendors and industry, and policy makers.


Assuntos
Desfibriladores Implantáveis , Modelos Organizacionais , Eletrônica , Humanos , Monitorização Fisiológica , Tecnologia de Sensoriamento Remoto , Estados Unidos
4.
J Am Geriatr Soc ; 69(10): 2708-2715, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34235743

RESUMO

COVID-19 has exacted a disproportionate toll on the health of persons living in nursing homes. Healthcare providers and other decision-makers in those settings must refer to multiple evolving sources of guidance to coordinate care delivery in such a way as to minimize the introduction and spread of the causal virus, SARS-CoV-2. It is essential that guidance be presented in an accessible and usable format to facilitate its translation into evidence-based best practice. In this article, we propose the Haddon matrix as a tool well-suited to this task. The Haddon matrix is a conceptual model that organizes influencing factors into pre-event, event, and post-event phases, and into host, agent, and environment domains akin to the components of the epidemiologic triad. The Haddon matrix has previously been applied to topics relevant to the care of older persons, such as fall prevention, as well as to pandemic planning and response. Presented here is a novel application of the Haddon matrix to pandemic response in nursing homes, with practical applications for nursing home decision-makers in their efforts to prevent and contain COVID-19.


Assuntos
COVID-19 , Defesa Civil/organização & administração , Prática Clínica Baseada em Evidências , Instituição de Longa Permanência para Idosos/organização & administração , Controle de Infecções , Modelos Organizacionais , Casas de Saúde/organização & administração , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/tendências , Serviços de Saúde para Idosos/organização & administração , Serviços de Saúde para Idosos/normas , Serviços de Saúde para Idosos/tendências , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Inovação Organizacional , SARS-CoV-2 , Estados Unidos
5.
Diabetes Metab Syndr ; 15(5): 102228, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34330071

RESUMO

AIM: Amidst COVID-19 pandemic, the health care delivery in India faces major challenges owing to the overwhelming hospitals, exhausted healthcare workers, and shortage of crucial medical supplies such as ventilators and oxygen. The study aims to propose a novel successful interventional home care model, the Virtual COVID In-Patient (VCIP) care for effective COVID management. METHODS: The Covid-19 positive patients enrolled in VCIP were chosen for the study. A 24/7 active multidisciplinary WhatsApp group was created for each patient, for remote monitoring of temperature, blood pressure, blood glucose, respiratory and pulse rate along with the symptoms. Advice on sleep and exercises were given along with the medication via video-audio consultations. Lab facility was provided at the doorstep. Training on various devices, medications including steroids, delivering subcutaneous injections etc were given via video platforms. RESULTS: Among the 220 patients who availed the VCIP facility, only two were hospitalized, yielding a 99.5 % success rate in preventing hospitalizations and patients enrolled have been immensely satisfied with their experience. CONCLUSIONS: With similar pandemics anticipated in near future, VCIP model may be considered for successful domiciliary treatment and overcoming the challenges.


Assuntos
COVID-19/terapia , Serviços de Assistência Domiciliar/organização & administração , Modelos Organizacionais , Algoritmos , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/terapia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Índia/epidemiologia , Internacionalidade , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem , Monitorização Fisiológica/métodos , Pandemias , Prognóstico , Encaminhamento e Consulta/organização & administração , Telemedicina/organização & administração , Resultado do Tratamento
6.
Soc Work Public Health ; 36(5): 577-587, 2021 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-34214015

RESUMO

Summary: The main purpose of the current study was to assess whether there are significant differences among variables, such as social workers' familiarity with the crisis intervention model, receiving up-to-date information about the latest developments in COVID-19, having adequate information about what the symptoms of COVID-19 are, and willingness to work with COVID-19 patients, and social workers' ability to apply the crisis intervention model when they are working with clients and its three sub-scales (assessing and identifying the problem, establishing a relationship, and formulating an action plan). The cross-sectional survey method was used to conduct the sample of the study. The sample (N = 274) used in the study consisted of social workers in Kuwait.Findings: The results showed that CIS is valid and reliable and can be trusted to measure levels according to the purpose of the study. Analysis using T-test showed significant relationships between the CIS and study's variables at p < .05.Application: This study would help to raise the knowledge and awareness about the ability of social workers to apply the crisis intervention model during COVID-19 pandemic when they are working with clients and what variables may be associated with it.


Assuntos
COVID-19 , Intervenção na Crise , Conhecimentos, Atitudes e Prática em Saúde , Assistentes Sociais , COVID-19/epidemiologia , COVID-19/psicologia , Intervenção na Crise/organização & administração , Estudos Transversais , Humanos , Kuweit/epidemiologia , Modelos Organizacionais
7.
JAMA Netw Open ; 4(7): e2120295, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34236416

RESUMO

Importance: The COVID-19 pandemic is the greatest global test of health leadership of our generation. There is an urgent need to provide guidance for leaders at all levels during the unprecedented preresolution recovery stage. Objective: To create an evidence- and expertise-informed framework of leadership imperatives to serve as a resource to guide health and public health leaders during the postemergency stage of the pandemic. Evidence Review: A literature search in PubMed, MEDLINE, and Embase revealed 10 910 articles published between 2000 and 2021 that included the terms leadership and variations of emergency, crisis, disaster, pandemic, COVID-19, or public health. Using the Standards for Quality Improvement Reporting Excellence reporting guideline for consensus statement development, this assessment adopted a 6-round modified Delphi approach involving 32 expert coauthors from 17 countries who participated in creating and validating a framework outlining essential leadership imperatives. Findings: The 10 imperatives in the framework are: (1) acknowledge staff and celebrate successes; (2) provide support for staff well-being; (3) develop a clear understanding of the current local and global context, along with informed projections; (4) prepare for future emergencies (personnel, resources, protocols, contingency plans, coalitions, and training); (5) reassess priorities explicitly and regularly and provide purpose, meaning, and direction; (6) maximize team, organizational, and system performance and discuss enhancements; (7) manage the backlog of paused services and consider improvements while avoiding burnout and moral distress; (8) sustain learning, innovations, and collaborations, and imagine future possibilities; (9) provide regular communication and engender trust; and (10) in consultation with public health and fellow leaders, provide safety information and recommendations to government, other organizations, staff, and the community to improve equitable and integrated care and emergency preparedness systemwide. Conclusions and Relevance: Leaders who most effectively implement these imperatives are ideally positioned to address urgent needs and inequalities in health systems and to cocreate with their organizations a future that best serves stakeholders and communities.


Assuntos
COVID-19 , Pessoal de Saúde , Liderança , Pandemias , Consenso , Planejamento em Desastres , Pessoal de Saúde/legislação & jurisprudência , Pessoal de Saúde/organização & administração , Humanos , Modelos Organizacionais , SARS-CoV-2
8.
Med J Malaysia ; 76(4): 562-564, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34305118

RESUMO

Geriatric medicine practice requires a multidimensional and multidisciplinary assessment to provide a holistic overview of the older patients. During the current COVID-19 pandemic time, it becomes more critical to ensure that the elderly patients continue to receive regular geriatric care for their pre-existing chronic illness and at the same time avoid unnecessary exposure to COVID-19 virus. Geriatric telemedicine clinic provides a convenient solution to ensure continuity of care for the older patients. Careful patient selection, technical requirement, geriatric assessment via audio-visual communication, and caretaker involvement were among the important issues discussed in this article.


Assuntos
COVID-19/epidemiologia , Continuidade da Assistência ao Paciente , Serviços de Saúde para Idosos , Telemedicina , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos Organizacionais , Telemedicina/métodos , Telemedicina/organização & administração
9.
Enferm Clin (Engl Ed) ; 31(4): 227-233, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34243910

RESUMO

In Spain, adolescents with cancer are treated in Pediatric Onco-Hematology Units or in Adult Oncology Units. For this reason, the Spanish Federation of Parents of Children with Cancer carried out two surveys in 2013 and 2014 to know the differences in provision of psico-social services to the patients and their relatives among both types of Units. Twenty eight Pediatric and 18 Adult Units provided information. The results showed that the Pediatric Units were better adapted to the needs of the adolescent and family patients and to Spanish Health Authorities recommendations: more appropriate environment, resources for education and leisure, facilities to parents and relatives. Specialized Psycosocial care by psychologists and social workers is insufficient in both cases and the compliance with national and international recommendations is weak. However, specific adolescents' Units are starting to be created in Spain, following the experiences in other countries that define the new role of nurse as an essential linchpin in the care team.


Assuntos
Modelos Organizacionais , Neoplasias , Adolescente , Adulto , Criança , Hospitais , Humanos , Neoplasias/terapia , Espanha , Inquéritos e Questionários
10.
PLoS One ; 16(6): e0251869, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34106942

RESUMO

The rate of maternal deaths in remote areas in eastern Indonesia-where geographic conditions are difficult and the standard of infrastructure is poor-is high. Long travel times needed to reach emergency obstetric care (EMOC) is one cause of maternal death. District governments in eastern Indonesia need effective planning to improve access to EMOC. The aim of this study was to develop a scenario modelling tool to be used in planning to improve access to EMOC in eastern Indonesia. The scenario model was developed using the geographic information system tool in NetLogo. This model has two inputs: the location of the EMOC facility (PONED) and the travel cost of moving across geographical features in the rainy and dry seasons. We added a cost-benefit analysis to the model: cost is the budget for building the infrastructure; benefit is the number of people who can travel to the EMOC in less than 1 hour if the planned infrastructure is built. We introduced the tool to representative midwives from all districts of Nusa Tenggara Timur province and to staff of Kupang district planning agency. We found that the tool can model accessibility to EMOC based on weather conditions; compare alternative infrastructure planning scenarios based on cost-benefit analysis; enable users to identify and mark poor infrastructure; and model travel across the ocean. Lay people can easily use the tool through interactive scenario modelling: midwives can use it for evidence to support planning proposals to improve access to EMOC in their district; district planning agencies can use it to choose the best plan to improve access to EMOC. Scenario modelling has potential for use in evidence-based planning to improve access to EMOC in low-income and lower-middle-income countries with poor infrastructure, difficult geography conditions, limited budgets and lack of trained personnel.


Assuntos
Serviços Médicos de Emergência/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Modelos Organizacionais , Obstetrícia/organização & administração , Melhoria de Qualidade/organização & administração , Feminino , Geografia Médica , Planejamento em Saúde/métodos , Planejamento em Saúde/organização & administração , Humanos , Indonésia , Obstetrícia/normas , Gravidez , Viagem
11.
Int J Health Plann Manage ; 36(5): 1772-1788, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34128250

RESUMO

BACKGROUND: The literature on the functioning of public health facilities in health systems with significant arrears is limited. The growing liabilities of health facilities and the accumulating arrears have been a challenge in the Republic of Srpska. Most public primary healthcare (PHC) centres generated a gross loss in 2018. METHOD: Guided by the 'positive deviance' approach, we used an exploratory case study design to identify strategies used by managers to achieve financial sustainability in eight top-performing PHC centres. Qualitative data were collected through face-to-face in-depth semistructured interviews with key informants from the PHC centres that reported positive financial results in 2018. RESULTS: Seven organisational goals, comprising 34 financial sustainability strategies, were recognised during the data analysis and were used to build an organisational-level model for a PHC centre. CONCLUSION: Managers concurrently used multiple strategies to ensure financial sustainability. Each centre tailored its range of strategies to the organisational context, local context, and wider environment of the health system. The strategies were conceived and implemented by managers operating at different organisational levels under the leadership of top-level managers. Managers of indebted health facilities can learn from the positively deviant peers who manage facilities that achieved satisfactory financial performance.


Assuntos
Instalações de Saúde , Liderança , Bósnia e Herzegóvina , Modelos Organizacionais , Atenção Primária à Saúde
12.
G Ital Nefrol ; 38(3)2021 Jun 24.
Artigo em Italiano | MEDLINE | ID: mdl-34169689

RESUMO

In the last year, the Italian National Health Service as a whole and the Nephrology community have been severely challenged by the pandemic. It has been a dramatic stress test for the entire healthcare system, not only in Italy but worldwide. The general organization of our Nephrology units and our models of care were put under extreme pressure, and we had to quickly adopt unprecedented clinical practice recommendations and organizational models to overcome the impasse caused by the pandemic. The time has come to evaluate these new experiences, ask how we could have been better prepared and look for change. In this editorial, we outline a few proposals and suggestions for the future, weighing the information gathered in the 2018 Nephrology Census against the new organizational requirements imposed by the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , Nefrologia/organização & administração , Pandemias , Censos , Humanos , Itália/epidemiologia , Modelos Organizacionais , Nefrologia/tendências , Diálise Peritoneal/estatística & dados numéricos , Diálise Peritoneal Ambulatorial Contínua/estatística & dados numéricos , Médicos/provisão & distribuição , Diálise Renal/estatística & dados numéricos
13.
Int J Surg ; 91: 105987, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34091086

RESUMO

BACKGROUND: Multiple industries and organisations are afflicted by and respond to institutional crises daily. As surgeons, we respond to crisis frequently and individually such as with critically unwell patients or in mass casualty scenarios; but rarely, do we encounter institutional or multi-institutional crisis with multiple actors as we have seen with the COVID-19 pan-demic. Businesses, private industry and the financial sector have been in a more precar-ious position regarding crisis and consequently have developed rapid response strate-gies employing foresight to reduce risk to assets and financial liquidity. Moreover, large nationalised governmental organisations such as the military have strategies in place ow-ing to a rapidly evolving geopolitical climate with the expectation of immediate new chal-lenges either in the negotiating room or indeed the field of conflict. Despite both nation-alised and privatised healthcare systems existing, both appeared ill-prepared for the COVID-19 global crisis. METHODS: A narrative review of the literature was undertaken exploring the approach to crisis man-agement and models used in organisations exposed to institutional crises outside the field of medicine. RESULTS: There are many parallels between the organisational management of private business institutions, large military organisations and surgical organisational management in healthcare. Models from management consultancies and the armed forces were ex-plored discussed and adapted for the surgical leader providing a framework through which the surgical leader can bring about an successful response to an institutional crisis and ensure future resilience. CONCLUSION: We believe that healthcare, and surgeons (as leaders) in particular, can learn from these other organisations and industries to engage appropriate generic operational plans and contingencies in preparation for whatever further crises may arise in the future, both near and distant. As such, following a review of the literature, we have explored a number of models we believe are adaptable for the surgical community to ensure we remain a dy-namically responsive and ever prepared profession.


Assuntos
COVID-19 , Cirurgia Geral/organização & administração , Modelos Organizacionais , Equipe de Assistência ao Paciente/organização & administração , Cirurgiões/organização & administração , Humanos , Liderança , Resiliência Psicológica , SARS-CoV-2 , Cirurgiões/psicologia
14.
PLoS One ; 16(6): e0252482, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34077458

RESUMO

Since China's reform and opening-up in 1978, the income of rural residents has increased when compared with that of urban residents. However, the income growth rate of farmers is relatively low, and the income gap between urban and rural areas is widening. Using a sample of 1,325 large-scale farming households in Lin'an, this study constructs a theoretical path for how the level of vertical integration and an organization model affect farmers' income levels and empirically tests the path using a mediation effect analysis model. The results indicate that organization models and vertical integration are important factors that affect farmers' income levels. The total income and agricultural operation income of farmers who participate in agricultural operation organizations are greater than that of farmers who do not participate in an operation organization. In addition, the total income and agricultural operation income of farmers who produce and process and those who produce, process, and sell are higher than those of farmers who only produce. A farmers' organization model has both a direct and an indirect positive influence on their income level, with the indirect positive influence coming through the mediating variable of vertical integration. The application of the organizational model can promote the growth of rural households' total family income and agricultural income by 13.48% and 14.48% respectively, consisting of direct increases of 9.67% and 10.19%, and indirect increases of 3.81% and 4.29% through vertical integration. The results also show that access to credit, agricultural technology training, and the farmer's education level have significant positive impacts on farming income levels. The findings suggest ways to increase farmers' income by perfecting agricultural management organization systems, promoting agricultural industrialization, strengthening rural financial support, improving agricultural technical training for farmers, and increasing their level of education.


Assuntos
Modelos Teóricos , Agricultura/métodos , China , Fazendeiros/estatística & dados numéricos , Feminino , Humanos , Masculino , Modelos Organizacionais
15.
Am J Emerg Med ; 49: 142-147, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34111834

RESUMO

OBJECTIVE: To identify trends in pediatric emergency department (ED) utilization following the COVID-19 pandemic. METHODS: We performed a cross-sectional study from 37 geographically diverse US children's hospitals. We included ED encounters between January 1, 2010 and December 31, 2020, transformed into time-series data. We constructed ensemble forecasting models of the most common presenting diagnoses and the most common diagnoses leading to admission, using data from 2010 through 2019. We then compared the most common presenting diagnoses and the most common diagnoses leading to admission in 2020 to the forecasts. RESULTS: 29,787,815 encounters were included, of which 1,913,085 (6.4%) occurred during 2020. ED encounters during 2020 were lower compared to prior years, with a 65.1% decrease in April relative to 2010-2019. In forecasting models, encounters for depression and diabetic ketoacidosis remained within the 95% confidence interval [CI]; fever, bronchiolitis, hyperbilirubinemia, skin/subcutaneous infections and seizures occurred within the 80-95% CI during the portions of 2020, and all other diagnoses (abdominal pain, otitis media, asthma, pneumonia, trauma, upper respiratory tract infections, and urinary tract infections) occurred below the predicted 95% CI. CONCLUSION: Pediatric ED utilization has remained low following the COVID-19 pandemic, and below forecasted utilization for most diagnoses. Nearly all conditions demonstrated substantial declines below forecasted rates from the prior decade and which persisted through the end of the year. Some declines in non-communicable diseases may represent unmet healthcare needs among children. Further study is warranted to understand the impact of policies aimed at curbing pandemic disease on children.


Assuntos
COVID-19 , Atenção à Saúde/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Pediatria , Criança , Pré-Escolar , Estudos Transversais , Feminino , Previsões , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Masculino , Modelos Organizacionais , Estados Unidos
16.
Artigo em Inglês | MEDLINE | ID: mdl-34065117

RESUMO

As the COVID-19 outbreak traveled through various Italian regions, all national and local administrations issued measures to counter the spread of the contagion and organize healthcare. The Italian healthcare system is, indeed, a decentralized system with 21 regional health systems (RHSs), with different models of healthcare service delivery and organization. This study investigates whether a different organization of RHSs would have led to different management of the COVID-19 epidemic, and evaluates the effect of different approaches in epidemic management on the COVID-19 epidemiological trend. A set of indicators is identified by conducting an online synchronous Focus Group, involving an experts panel. A Pearson's correlation test was performed on the values assumed by the historical series of indicators investigate correlations among the trends represented by the indicators or between them and external factors. The comparison between the experiences of the different Italian regions, regarding the management of the epidemic, has helped to confirm and emphasize the importance of a community-based approach in health care-integrated with the hospital's functions for the care of complex conditions and the need for specialized assistance.


Assuntos
COVID-19 , Epidemias , Humanos , Itália/epidemiologia , Modelos Organizacionais , SARS-CoV-2
17.
Rev Bras Enferm ; 74(suppl 5): e20200910, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105697

RESUMO

OBJECTIVE: Description and discussion dimensions of Integrated Care Model. METHODS: A descriptive study is done that describe a technological innovation, intervention strategies for professional performance. RESULTS: Integrated Care Model (ICM) has two main categories include individual and Group-and disease-specific Model. First, is used for risky patients or with comorbidities. In second category; Chronic Care Model (CCM) is common form of Integrated Care Model to improve resultants in the patients with chronic condition, to move from acute care to integrate, regular, long-lasting, preventative and community-based nursing. FINAL CONSIDERATIONS: It is important to consider patient as an active member of the treatment team. It seems to be essential to monitor performance of care system. On the other hand, offer multidisciplinary care leads to present desirable care, tailored to the specific needs of patients regarding safety, patient-centered care and their culture.


Assuntos
Planejamento Antecipado de Cuidados , Prestação Integrada de Cuidados de Saúde/organização & administração , Assistência de Longa Duração , Doença Crônica , Comorbidade , Comportamento Cooperativo , Humanos , Assistência de Longa Duração/organização & administração , Modelos de Enfermagem , Modelos Organizacionais , Avaliação de Resultados em Cuidados de Saúde , Assistência Centrada no Paciente/organização & administração
18.
PLoS One ; 16(5): e0251465, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33974671

RESUMO

This study proposes a model in which organizational identification mediates the correlations among state-owned enterprises (SOEs), authentic leadership, Christian religiousness, and unethical pro-organizational behavior (UPB). The proposed theoretical framework is based on moral identity theory, social identity theory, and social exchange theory. We tested the hypothesized model using data (N = 389) from employees of various companies and industries in Poland. Of the respondents, 49.1% worked in SOEs. The reliability and validity of the measures were established. The correlation coefficients among the analyzed variables were obtained using the bootstrap confidence interval method. To thoroughly examine the causal relationships among the variables, covariance-based structural equation modeling (CB-SEM) was adopted. Path analysis was conducted and used to verify a model in which organizational identification mediated the correlations among state involvement in the ownership of an enterprise, authentic leadership, Christian religiousness, and UPB. State involvement in the ownership of an enterprise, authentic leadership, and Christian religiousness were linked to increased organizational identification, which in turn was linked to the intensification of UPB. With the level of organizational identification controlled, state ownership of an enterprise was linked to lower UPB intensity. Limitations, implications and future research directions are discussed.


Assuntos
Cristianismo , Empregados do Governo/psicologia , Liderança , Princípios Morais , Cultura Organizacional , Propriedade/ética , Setor Público/ética , Adulto , Idoso , Causalidade , Decepção , Escolaridade , Ética , Feminino , Fraude , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Organizacionais , Motivação , Polônia , Revelação da Verdade , Adulto Jovem
19.
Can J Surg ; 64(3): E298-E306, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34014063

RESUMO

Background: The acute care surgery (ACS) model has been shown to improve patient, hospital and surgeon-specific outcomes. To date, however, little has been published on its impact on residency training. Our study compared the emergency general surgery (EGS) operative experiences of residents assigned to ACS versus elective surgical rotations. Methods: Resident-reported EGS case logs were prospectively collected over a 9-month period across 3 teaching hospitals. Descriptive statistics were tabulated and group comparisons were made using χ2 statistics for categorical data and t tests for continuous data. Results: Overall, 1061 cases were reported. Resident participation exceeded 90%). Appendiceal and biliary disease accounted for 49.7% of EGS cases. Residents on ACS rotations reported participating in twice as many EGS cases per block as residents on elective rotations (12.64 v. 6.30 cases, p < 0.01). Most cases occurred after hours while residents were on call rather than during daytime ACS hours (78.8% v. 21.1%, p < 0.01). Senior residents were more likely than junior residents to report having a primary operator role (71.3% v. 32.0%, p < 0.01). Although the timing of cases made no difference in the operative role of senior residents, junior residents assumed the primary operator role more often during the daytime than after hours (50.0% v. 33.1%, p = 0.01). Conclusion: Despite implementation of the ACS model, residents in our program obtained most of their EGS operative experience after hours while on call. Although further research is needed, our study suggests that improved daytime access to the operating room may represent an opportunity to improve the quantity and quality of the EGS operative experience at our academic network.


Assuntos
Emergências , Cirurgia Geral/educação , Internato e Residência/organização & administração , Modelos Organizacionais , Plantão Médico/estatística & dados numéricos , Competência Clínica , Procedimentos Cirúrgicos Eletivos , Hospitais de Ensino , Humanos , Estudos Prospectivos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos
20.
Int J Equity Health ; 20(1): 121, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001154

RESUMO

BACKGROUND: Poor access to healthcare facilities and consequently nutrition counseling services hinders the uptake of recommended infant and young child feeding (IYCF) practices. To address these barriers and improve IYCF practices, Alive & Thrive (A&T) initiated community support groups in remote villages across nine provinces in Vietnam. OBJECTIVE: This study examines the effectiveness of the support group model and related project costs for reaching underserved areas to improve IYCF practices. METHODS: To evaluate the model's implementation and project costs, we reviewed implementation guidelines, expenditure and coverage reports, monitoring data, and budgets for the nine provinces. To evaluate the model's effectiveness, we used a 3-stage sampling method to conduct a cross-sectional survey from April to May 2014 in three provinces entailing interviewing mothers of children aged 0-23 months in communes with (intervention; n = 551) and without support groups (comparison; n = 559). FINDINGS: Coverage: From November 2011 to November 2014, in partnership with the government, A&T supported training for 1513 facilitators and the establishing 801 IYCF support groups in 267 villages across nine provinces. During this period, facilitators provided ~ 166,000 meeting/support contacts with ~ 33,000 pregnant women and mothers with children aged 0-23 months in intervention villages. COSTS: The average project costs for supporting the meetings, compensating village collaborators, and providing supportive supervision through staff in commune health stations were USD 5 per client and USD 1 per contact. After adding expenditures for training, supportive supervision, and additional administrative costs at central and provincial levels, the average project cost was USD 15 per client and USD 3 per contact. Effectiveness: Survey participants in intervention and comparison communes had similar maternal, child, and household characteristics. Multiple logistic regression models showed that living in intervention communes was associated with higher odds of early initiation of breastfeeding (OR: 1.7; 95% CI: 1.1, 2.7), exclusive breastfeeding from 0 to 5 months (OR: 12.5; 95% CI: 6.7, 23.4), no bottle feeding (OR: 2.69; 95% CI: 1.82, 3.99), and minimum acceptable diet (OR: 1.51; 95% CI: 0.98, 2.33) compared to those living in comparison communes. CONCLUSION: The IYCF support group model was effective in reaching populations residing in remote areas and likely contributed to improved IYCF practices. The study suggests that the model could be scaled up to promote equity in breastfeeding support.


Assuntos
Aleitamento Materno , Serviços de Saúde Comunitária , Comportamento Alimentar , Mães , População Rural , Adulto , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Serviços de Saúde Comunitária/economia , Serviços de Saúde Comunitária/organização & administração , Análise Custo-Benefício , Estudos Transversais , Comportamento Alimentar/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Modelos Organizacionais , Mães/psicologia , Mães/estatística & dados numéricos , População Rural/estatística & dados numéricos , Grupos de Autoajuda , Vietnã
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...