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1.
Glob Health Action ; 14(1): 1961398, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34482794

RESUMO

BACKGROUND: With the under-five child mortality rate of 46.4 deaths per 1000 live births, Uganda should accelerate measures to reduce child deaths to achieve the Sustainable Development Goal 3. While 60-70% of frontline health services are provided by the private sector, many low-level private health facilities (LLPHF) are unregistered, unregulated, and often miss innovative and quality improvement strategies rolled out by the Ministry of Health. LLPHF need support in order to provide quality health care. OBJECTIVE: To explore the perspectives of health workers and policy makers on external support given to LLPHF providing health care for children in Mbarara District, Uganda. METHODS: We carried out a qualitative study, in which 43 purposively selected health workers and policy makers were interviewed. The issues discussed included their views on the quantity, quality, factors determining support received and preferred modalities of support to LLPHF. We used thematic analysis, employing an inductive approach to code interview transcripts and to identify subthemes and themes. RESULTS: The support currently provided to LLPHF to manage childhood illnesses is inadequate. Health providers emphasised a need for technical capacity building, provision of policies, guidelines and critical supplies as well as adopting a more supportive supervisory approach instead of the current supervision model characterised by policing, fault finding and apportioning blame. Registration of the health facilities and regular submission of reports as well as multi-stakeholder involvement are potential strategies to improve external support. CONCLUSION: The current support received by LLPHF is inadequate in quantity and quality. Capacity building with emphasis on training, provision of critical guidelines and supplies as well as and supportive supervision are key strategies for delivering appropriate external support to LLPHF.


Assuntos
Instalações de Saúde , Pessoal de Saúde , Pessoal Administrativo , Criança , Humanos , Pesquisa Qualitativa , Uganda
2.
BMC Health Serv Res ; 21(1): 903, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34474676

RESUMO

BACKGROUND: Ajzen's theory of planned behavior (TPB) postulates that individuals' behavioral intention is influenced by their attitudes, subjective norms, and perceived behavioral control. Therefore, it can be used to broaden the understanding of particular behaviors, including healthcare workers' professional activities. METHODS: In this study, we used TPB as a theoretical framework to evaluate semi-structured interviews with pharmacists and physicians to build an understanding of the interprofessional collaboration between them. Sixteen semi-structured interviews were conducted with pharmacists and eleven with physicians. The sample of participants comprised a diverse group with varying work experience and workplaces. Data were analyzed independently by two researchers following the thematic analysis method using ATLAS.ti software. Data saturation was set in the absence of new issues arising during the interviews. RESULTS: The content analysis allowed for the determination of six main themes: the relationship between previous experiences and attitudes towards collaboration, pharmacist's role in collaboration, mutual reluctance toward collaboration, the role of decision- and policy-makers, knowledge and qualifications gaps regarding collaboration, and lack of organizational paths. CONCLUSIONS: Despite both physicians and pharmacists displaying positive attitudes towards collaboration may foster their intention to establish a professional partnership, subjective norms (e.g., the lack of appropriate legal regulations) and perceived behavioral control (physicians' lack of awareness about pharmacists' qualifications and the low level of interpersonal skills) might impede the process.


Assuntos
Farmacêuticos , Médicos , Pessoal Administrativo , Atitude do Pessoal de Saúde , Comportamento Cooperativo , Humanos , Relações Interprofissionais , Papel Profissional , Pesquisa Qualitativa
3.
Cad Saude Publica ; 37(8): e00221420, 2021.
Artigo em Português | MEDLINE | ID: mdl-34550181

RESUMO

This is a health policy analysis with a qualitative approach, consisting of 15 interviews (six administrators and nine LGBT activists). The study aimed to understand the historical conditions for the emergence of the National Policy for Comprehensive LGBT Health (PNSI-LGBT) in the social space of health in the State of Bahia, Brazil. The study was based on Pierre Bourdieu's social theory and the study of the trajectories of the main actors involved in the policy's formalization. The results evidenced two moments: (1) shaping of the social space of LGBT health, including prior initiatives; (2) space of possibilities and the official discourse for fomenting the implementation of the PNSI-LGBT in Bahia. The LGBT social movement played a crucially important role in drafting the first proposals for a specific health policy. The state's relationship with the social movements occurred through professional issues and the actors concentrated almost exclusively on bureaucratic capital. It was quite common for actors to circulate between the activist subspace and the bureaucratic subspace. The activists interviewed here that reached the bureaucratic field mostly engaged in the health space for personal reasons and reported that it was a position in which they could act more effectively. The documental findings and collaboration by interlocutors reveal a process of continuous implementation of measures that expand the range of healthcare for the LGBT population. However, the Bahia State Health Department has still not clearly taken the responsibility for a state LGBT policy, and there is thus a hesitant and fragment incorporation of the PNSI-LGBT.


Assuntos
Política de Saúde , Formulação de Políticas , Pessoal Administrativo , Brasil , Atenção à Saúde , Humanos
4.
BMJ Open ; 11(9): e047157, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493508

RESUMO

INTRODUCTION: Most research on loneliness comes from the health sciences, statistically seeking to measure the health-related effects of feeling alone or isolated. There is a need to expand on this understanding and explore loneliness as a more complex social phenomenon. In this article, we present a qualitative design for studying the intersection between loneliness, technology and culture. Conceptualising this as the cultural dialectic between loneliness and technology, we aim to unpack the reciprocal ways by which understandings of loneliness shape technology, while technologies also affect society's understandings of loneliness. In elucidating this dialectic, we aim to develop new knowledge and a novel theoretical framework for understanding loneliness and its technological solutions, which, in turn, can enable better solutions to contemporary problems of loneliness. METHODS AND ANALYSIS: We will adopt a qualitative approach that combines interviews, participant observation and textual analysis to explore loneliness and its technological solutions from the perspectives of policy-makers, producers, professionals and users in Norway and the UK. The data will be analysed through an analytical framework combining insights from discourse theory and philosophical debates on presence, which will allow us to capture and rethink fundamental assumptions about loneliness and technology. Outcomes will be revised understandings of loneliness, relevant to researchers, entrepreneurs, policy-makers, clinicians, educators and the broader public. ETHICS AND DISSEMINATION: The project has been evaluated and approved by the data protection officer at Oslo Metropolitan University and by the Norwegian Social Science Data Services. Additional ethical approval for data collection in the UK has been provided by the University of Oxford Interdivisional Research Ethics Committee. Informed consent will be obtained from all participants. Findings will be disseminated through peer-reviewed publications, international conference presentations and lay media.


Assuntos
Solidão , Tecnologia , Pessoal Administrativo , Coleta de Dados , Humanos , Pesquisa Qualitativa , Projetos de Pesquisa
5.
Medicine (Baltimore) ; 100(36): e26876, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34516489

RESUMO

BACKGROUND: Most classroom teachers are weak in constructing test items for assessment of students. This study examined the effects of cognitive behavioral active engagement training on test items construction skills among primary school teachers in Nigeria. METHODS: We adopted a randomized pretest-posttest control group design. A total of 148 participants served as the study sample. One instrument was used for data collection. The participants were administered the instrument at 4 different times. Test construction guide was employed to implement the training. Data analysis was completed using analysis of covariance. RESULTS: The researchers found that cognitive behavioral active engagement training had a significant effect on participants' test items construction scores as measured by test construction skills inventory at posttest, first and second follow-up stages. CONCLUSION: The researchers concluded that cognitive behavioral active engagement training is efficacious in the improvement of test items construction skills among primary school teachers in Nigeria.


Assuntos
Avaliação Educacional , Capacitação em Serviço , Professores Escolares , Instituições Acadêmicas , Pessoal Administrativo , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria
6.
Medicine (Baltimore) ; 100(29): e26541, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34398009

RESUMO

BACKGROUND: This study aimed at investigating the effect of rational emotive occupational health coaching on quality of work-life among primary school administrators. METHOD: This is a double blinded and randomized control design study. A total of 158 administrators were sampled, half of them were exposed to rational emotive occupational health treatment package that lasted for 12 sessions. Two self-report measures were utilized in assessing the participants using quality of work life scale. Data collected were analyzed using MANOVA statistical tool. RESULT: The results showed that rational emotive occupational health coaching is effective in improving perception of quality of work-life among public administrators. A follow-up result showed that rational emotive occupational health coaching had a significant effect on primary school administrators' quality of work life. CONCLUSION: This study concluded rational emotive occupation health coaching is useful therapeutic strategy in improving quality of work of primary school administrators, hence, future researchers and clinical practitioners should adopt cognitive-behavioral techniques and principles in helping employers as well as employees. Based on the primary findings and limitations of this study, future studies, occupational psychotherapists should qualitatively explore the clinical relevance of rational emotive occupational health practice across cultures using different populations.


Assuntos
Pessoal Administrativo/psicologia , Tutoria/métodos , Qualidade de Vida/psicologia , Equilíbrio Trabalho-Vida/métodos , Pessoal Administrativo/estatística & dados numéricos , Adulto , Distribuição de Qui-Quadrado , Método Duplo-Cego , Pessoal de Educação/psicologia , Pessoal de Educação/estatística & dados numéricos , Feminino , Humanos , Masculino , Tutoria/estatística & dados numéricos , Pessoa de Meia-Idade , Saúde do Trabalhador/normas , Instituições Acadêmicas/organização & administração , Instituições Acadêmicas/normas , Instituições Acadêmicas/estatística & dados numéricos
7.
BMC Health Serv Res ; 21(1): 805, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384416

RESUMO

BACKGROUND: As a response to many years of repetitive budget deficits, Region Dalarna in Sweden started a restructuring process in 2015, and implemented a decommissioning programme to achieve a balanced budget until 2019. Leading politicians and public servants took the overall decisions about the decommissioning programme, but the clinical decision-making and implementation was largely run by the clinic managers and their staff. As the decommissioning programme improved the finances, met relatively little resistance from the clinical departments, and neither patient safety nor quality of care were perceived to be negatively affected, the initial implementation could be considered successful. The aim of this study was to investigate clinic managers' experience of important factors enabling the successful implementation of a decommissioning programme in a local healthcare organization. METHODS: Drawing on a framework of factors and processes that shape successful implementation of decommissioning decisions, this study highlights the most important factors that enabled the clinic managers to successfully implement the decommissioning programme. During 2018, an interview study was conducted with 26 clinic managers, strategically selected to represent psychiatry, primary care, surgery and medicine. A deductive content analysis was used to analyze the interviews. By applying a framework to the data, the most important factors were illuminated. RESULTS: The findings highlighted factors and processes crucial to implementing the decommissioning programme: 1) create a story to get a shared image of the rationale for change, 2) secure an executive leadership team represented by clinical champions, 3) involve clinic managers at an early stage to ensure a fair decision-making process, 4) base the decommissioning decisions on evidence, without compromising quality and patient safety, 5) prepare the organisation to handle a process characterised by tensions and strong emotions, 6) communicate demonstrable benefits, 7) pay attention to the need of cultural and behavioral change and 8) transparently evaluate the outcome of the process. CONCLUSIONS: From these findings, we conclude that in order to successfully implement a decommissioning programme, clinic managers and healthcare professions must be given and take responsibility, for both the process and outcome.


Assuntos
Instituições de Assistência Ambulatorial , Liderança , Pessoal Administrativo , Orçamentos , Humanos , Atenção Primária à Saúde
8.
PLoS One ; 16(8): e0239352, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34370739

RESUMO

The U.S. with only 4% of the world's population, bears a disproportionate share of infections in the COVID-19 pandemic. To understand this puzzle, we investigate how mitigation strategies and compliance can work together (or in opposition) to reduce (or increase) the spread of COVID-19 infection. Building on the Oxford index, we create state-specific stringency indices tailored to U.S. conditions, to measure the degree of strictness of public mitigation measures. A modified time-varying SEIRD model, incorporating this Stringency Index as well as a Compliance Indicator is then estimated with daily data for a sample of 6 U.S. states: New York, New Hampshire, New Mexico, Colorado, Texas, and Arizona. We provide a simple visual policy tool to evaluate the various combinations of mitigation policies and compliance that can reduce the basic reproduction number to less than one, the acknowledged threshold in the epidemiological literature to control the pandemic. Understanding of this relationship by both the public and policy makers is key to controlling the pandemic. This tool has the potential to be used in a real-time, dynamic fashion for flexible policy options. Our methodology can be applied to other countries and has the potential to be extended to other epidemiological models as well. With this first step in attempting to quantify the factors that go into the "black box" of the transmission factor ß, we hope that our work will stimulate further research in the dual role of mitigation policies and compliance.


Assuntos
COVID-19/epidemiologia , Pessoal Administrativo , Número Básico de Reprodução/legislação & jurisprudência , Número Básico de Reprodução/prevenção & controle , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Humanos , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , SARS-CoV-2/isolamento & purificação , Estados Unidos/epidemiologia
9.
Int J Circumpolar Health ; 80(1): 1959700, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34378496

RESUMO

The aim of this study is to identify how managers of micro-sized enterprises experience the impact of the Covid-19 pandemic on their business operations, work-life balance and well-being. Further, the study aims to make comparisons between managers of micro-sized businesses and managers of small-sized businesses. This mixed-method study is based on qualitative interviews with ten managers of micro-sized enterprises and a questionnaire answered by 95 managers of micro-sized and small-sized enterprises in regions in the north of Sweden. Managers of micro-sized enterprises reported significantly worse scores for mental well-being, job satisfaction and life satisfaction in comparison with managers of small-sized enterprises. Three themes emerged from the qualitative analysis: Changed leadership role, Impact on private life and Impact on well-being. In the interviews, the managers of micro-sized enterprises reported that the pandemic had increased their workload and forced them to mobilise strategies for enterprise survival. This study indicates that managers of micro-sized enterprises had changed their leadership role and increased their workload and number of work tasks, including supporting the employees, developing strategies for business survival and applying for governmental support. However, the managers demonstrated creativity in finding new solutions for their enterprises.


Assuntos
Pessoal Administrativo/psicologia , COVID-19/prevenção & controle , Empreendedorismo/estatística & dados numéricos , Empresa de Pequeno Porte/organização & administração , Equilíbrio Trabalho-Vida , Carga de Trabalho/estatística & dados numéricos , COVID-19/epidemiologia , Humanos , Saúde do Trabalhador/estatística & dados numéricos , Serviços de Saúde do Trabalhador/organização & administração , Suécia
13.
Medicine (Baltimore) ; 100(31): e26776, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397825

RESUMO

ABSTRACT: The coronavirus (COVID-19) disease outbreak was a public health emergency of international concern which eventually evolved into a pandemic. Nigeria was locked down in March, 2020 as the country battled to contain the spread of the disease. By August 2020, phase-by-phase easing of the lockdown was commenced and university students will soon return for academic activities. This study undertakes some epidemiological analysis of the Nigerian COVID-19 data to help the government and university administrators make informed decisions on the safety of personnel and students.The COVID-19 data on confirmed cases, deaths, and recovered were obtained from the website of the Nigerian Centre for Disease Control (NCDC) from April 2, 2020 to August 24, 2020. The infection rate, prevalence, ratio, cause-specific death rate, and case recovery rate were used to evaluate the epidemiological characteristics of the pandemic in Nigeria. Exponential smoothing was adopted in modeling the time series data and forecasting the pandemic in Nigeria up to January 31, 2021.The results indicated that the pandemic had infection rate of at most 3 infections per 1 million per day from April to August 2020. The death rate was 5 persons per 1 million during the period of study while recovery rate was 747 persons per 1000 infections. Analysis of forecast data showed steady but gradual decrease in the daily infection rate and death rate and substantial increase in the recovery rate, 975 recoveries per 1000 infections.In general, the epidemiological attributes of the pandemic from the original data and the forecast data indicated optimism in the decrease in the rate of infection and death in the future. Moreover, the infection rate, prevalence and death rate in January 2021 coincided with the predictions based on the analysis. Therefore, the Nigerian government is encouraged to allow universities in the country to reopen while university administrators set up the necessary protocols for strict adherence to safety measures.


Assuntos
Pessoal Administrativo , COVID-19/mortalidade , Previsões/métodos , COVID-19/epidemiologia , Humanos , Nigéria , Prevalência , Universidades/organização & administração , Universidades/estatística & dados numéricos
16.
J Dent Educ ; 85(10): 1616-1626, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34173234

RESUMO

OBJECTIVES: Institutions with a positive cultural climate make community members from all backgrounds valued and included, and treated equitably. Such an environment is optimally suited to prepare future dentists well for leading a diverse team of staff members and addressing the oral health care needs of increasingly more diverse patient populations. The objectives were to assess how many United States and Canadian dental schools had participated in a climate study at their parent institution and/or had conducted their own climate study, which topics these studies had addressed, how they collected their data, from whom they collected data, and how the findings affected these academic units. METHODS: In January 2020, 54 of the 78 dental school deans in the United States and Canada responded to a web-based survey (response rate: 69%). RESULTS: Forty-six parent institutions (85%) and 27 dental schools (50%) had conducted climate studies. Eighty-seven percent of parent institutions assessed the climate overall and the climate for specific groups (70%), such as for persons from underrepresented minority backgrounds (67%) or different religious backgrounds (59%). Most parent institution and dental school studies utilized surveys to collect data from faculty (parent institutions: 76%/dental schools: 96%), staff (74%/93%), administrators (72%/93%), and students (72%/89%). Overall, climate study results positively affected parent institutions' and dental schools' humanistic environment (61%/63%) and the recruitment of faculty (46%/50%), students (46%/46%), and staff (41%/43%). CONCLUSIONS: Climate studies are a widely accepted practice at dental schools and their parent institutions. Their results can play a vital role in shaping the climate of these academic units by fostering efforts to increase diversity, equity, and inclusion.


Assuntos
Docentes de Odontologia , Faculdades de Odontologia , Pessoal Administrativo , Canadá , Educação em Odontologia , Humanos , Estados Unidos
17.
Psychiatr Serv ; 72(9): 1076-1079, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34139883

RESUMO

OBJECTIVE: Strategies are needed to improve policy makers' evidence-informed decision making and the availability of evidence-based, state-supported services. This study examined whether academic-policy partnerships could promote these outcomes. METHODS: Data from two national surveys of state mental health agency representatives were used to compare barriers to implementation of evidence-based practices (EBPs) and policy makers' use of child mental health research in states with strong academic-policy partnerships in workforce training or in program implementation/evaluation (IE) with barriers in states with no or limited partnerships in these areas. RESULTS: Strong IE partnerships were associated with more confidence in research use and fewer issues with provider readiness and capacity but with more issues with EBP fidelity. Strong training partnerships were associated with fewer endorsements of lack of time as a barrier to research use. CONCLUSIONS: Academic-policy partnerships had some benefit for states' research use and EBP implementation. Because these partnerships may reduce barriers, further research should explore characteristics of effective collaborations.


Assuntos
Pessoal Administrativo , Saúde Mental , Criança , Prática Clínica Baseada em Evidências , Política de Saúde , Humanos , Formulação de Políticas
18.
Dan Med J ; 68(6)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34060459

RESUMO

INTRODUCTION: During the first wave of the COVID-19 pandemic, it was established that otorhinolaryngologists were at a high risk of contracting the infection due to examinations of the upper airways. The aim of this study was to evaluate the impact of the COVID-19 pandemic on mental health among healthcare workers (HCWs) in primary ear-nose-throat (ENT) practices. METHODS: This was a cross-sectional questionnaire study among HCWs assessing symptoms of anxiety (Generalized Anxiety Disorder, ten-item scale) and depression (Patients Health Questionnaire, nine-item scale). The survey targeted otolaryngologists and staff in primary private practices in the Capital Region of Denmark during the COVID-19 lock-down in May 2020. RESULTS: For 30% of the participants, signs were observed of depressive symptoms and 13% had signs of anxiety symptoms. Seventy percent felt sufficiently protected by their available personal protective equipment. Fifty-two percent worried about becoming infected in relation to their work and 56% feared infecting their families. CONCLUSIONS: HCWs in Danish primary ENT practices did not display extraordinary stress reactions during the first wave of the pandemic. Noticeably, participants were concerned about acquiring the infection or transmitting it to their household. FUNDING: none. TRIAL REGISTRATION: not relevant.


Assuntos
COVID-19/psicologia , Pessoal de Saúde/psicologia , Saúde Mental , Otolaringologia , Pessoal Administrativo/psicologia , Instituições de Assistência Ambulatorial , Ansiedade/etiologia , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Otorrinolaringologistas/psicologia , Equipamento de Proteção Individual , Prática Privada , Escalas de Graduação Psiquiátrica , SARS-CoV-2 , Inquéritos e Questionários
20.
Afr J Reprod Health ; 25(s1): 50-59, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34077144

RESUMO

The KSA 2030 vision makes special reference to women's empowerment as an important strategy for Saudi community transformation. Studies related to women's empowerment, especially in the Saudi context, are still not enough and unclear. The current study explored the predictors of women empowerment knowledge and attitudes among Saudi academic and administrative staff. A cross-sectional study was conducted at 15 Saudi government-owned universities. A multistage cluster sampling technique was used to select 5587 participants during the period April to September 2020. The study instrument consisting of three main parts; basic demographic data, questionnaire assessed the knowledge regarding women's empowerment, and women empowerment attitude scale. The results showed good knowledge of empowerment among the women with 75.5% of the participants demonstrating good knowledge. The total women empowerment attitude was positive among 65.9% of the participants. The association between demographic data and women empowerment knowledge and attitude showed a significant association with marital status, residence, education, and occupation (p <0.05). Linear regression on marital status, education, residence, and occupation, are confirmed as significant predictors of women empowerment knowledge and attitude (p <0.05). Mother's education level is shown as a predictor for women empowerment attitude (p>0.005). Three-quarters of Saudi academic and administrative staff have a good women empowerment knowledge score, and more than two-thirds have a positive attitude. Demographic characteristics are important predictors for women empowerment knowledge and attitude. The results of this study will help decision-makers to design and implement goal-directed women empowerment programs.


Assuntos
Pessoal Administrativo/psicologia , Empoderamento , Docentes/psicologia , Poder Psicológico , Mulheres Trabalhadoras/psicologia , Adulto , Atitude , Estudos Transversais , Feminino , Humanos , Conhecimento , Pessoa de Meia-Idade , Autonomia Pessoal , Arábia Saudita , Fatores Socioeconômicos , Inquéritos e Questionários , Universidades
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