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1.
PLoS One ; 16(5): e0251958, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34043663

RESUMO

Scaling is a ubiquitous concept in agricultural research in the global south as donors require their research grantees to prove that their results can be scaled to impact upon the livelihoods of a large number of beneficiaries. Recent studies on scaling have brought critical perspectives to the rather technocratic tendencies in the agricultural innovations scaling literature. Drawing on theoretical debates on spatial strategies and practical experience of agricultural innovation scaling in Ethiopia, this paper adds to the current debate on what constitutes scaling and how to overcome critical scaling constraints. The data for the paper came from a qualitative assessment using focus group discussions, key informant interviews, and document analysis on scaling work done in Ethiopia by a USAID-funded research for development project. The paper concludes with four broad lessons for the current understating of agricultural innovation scaling. First, scaling of agricultural innovations requires a balanced focus on technical requirements and associated social dynamics surrounding scaling targets, actors involved and their social relations. Second, appreciating the social dynamics of scaling emphasizes the fact that scaling is more complex than a linear rolling out of innovations towards diffusion. Third, scaling may not be strictly planned; instead, it might be an extension of the innovation generation process that relies heavily on both new and long-term relationships with key partners, trust, and continuous reflection and learning. Fourth, the overall implication of the above three conclusions is that scaling strategies need to be flexible, stepwise, and reflective. Despite the promises of flourishing scaling frameworks, scaling strategies it would appear from the Africa RISING experience that, if real impact is to be achieved, approaches will be required to be flexible enough to manage the social, processual and emergent nature of the practice of scaling.


Assuntos
Agricultura/métodos , Invenções/economia , Desenvolvimento de Programas/métodos , Desenvolvimento Sustentável/tendências , Financiamento de Capital/estatística & dados numéricos , Etiópia , Humanos , Desenvolvimento de Programas/economia , Desenvolvimento Sustentável/economia
4.
Urol Clin North Am ; 48(2): 233-244, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33795057

RESUMO

Independent urology practices are under increasing competitive pressure in a changing marketplace. By providing access to capital and business management expertise, private equity can help practices consolidate and scale to unlock new growth opportunities, navigate an increasingly complex regulatory environment, and institute best practice across a network, while retaining physician ownership and an opportunity for equity appreciation. This article examines the role of private equity in urology and the potential benefits of private equity investment. It also looks at what firms look for in investment partners, how to prepare for private equity investment, and how private equity investments are structured.


Assuntos
Prática de Grupo/economia , Investimentos em Saúde , Administração da Prática Médica/economia , Urologia/economia , Financiamento de Capital , Tomada de Decisões Gerenciais , Humanos , Modelos Organizacionais , Propriedade , Estados Unidos
5.
J Aging Health ; 33(7-8): 607-617, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33818164

RESUMO

The COVID-19 pandemic has exerted a disproportionate effect on older European populations living in nursing homes. This article discusses the 'fatal underfunding hypothesis', and reports an exploratory empirical analysis of the regional variation in nursing home fatalities during the first wave of the COVID-19 pandemic in Spain, one of the European countries with the highest number of nursing home fatalities. We draw on descriptive and multivariate regression analysis to examine the association between fatalities and measures of nursing home organisation, capacity and coordination plans alongside other characteristics. We document a correlation between regional nursing home fatalities (as a share of excess deaths) and a number of proxies for underfunding including nursing home size, occupancy rate and lower staff to a resident ratio (proxying understaffing). Our preliminary estimates reveal a 0.44 percentual point reduction in the share of nursing home fatalities for each additional staff per place in a nursing home consistent with a fatal underfunding hypothesis.


Assuntos
COVID-19/mortalidade , Fortalecimento Institucional , Financiamento de Capital , Casas de Saúde , Idoso , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Assistência de Longa Duração/economia , Masculino , Mortalidade , Casas de Saúde/organização & administração , Casas de Saúde/normas , Casas de Saúde/estatística & dados numéricos , Admissão e Escalonamento de Pessoal/normas , SARS-CoV-2 , Espanha/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-33673412

RESUMO

The reduction in carbon emissions by industrial enterprises is an important means for promoting environmental protection and achieving sustainable development. To determine the impact of carbon emissions reduction on supply chain operation and financing decision-making, in this study we designed three financing strategies, i.e., bank loan financing, equity financing, and hybrid financing (a combination of bank loan financing and equity financing), for a manufacturer (leader) and a low-carbon supply chain composed of a capital-constrained retailer, constructed Stackelberg game models, solved the equilibrium results under each financing strategy using the reverse recursion method, and revealed the financing preference of the supply chain member companies through comparative analysis. The results showed that the increase in the consumers' low-carbon preference and equity financing ratio have positive impacts on supply chain equilibrium, a result that is opposite that for the impact of the interest rate of bank loan financing; additionally, the abovementioned three factors jointly determine the profit of the manufacturer of the low-carbon supply chain, while the retailer's profit is affected by the equity dividend ratio. Finally, we present the conditions for the financing preference of the manufacturer and the retailer. The findings of this study can provide references for low-carbon supply chain companies to make appropriate management decisions.


Assuntos
Carbono , Comércio , Financiamento de Capital , Comportamento do Consumidor , Custos e Análise de Custo
7.
J Biosci ; 462021.
Artigo em Inglês | MEDLINE | ID: mdl-33576340

RESUMO

Cancer is a group of diseases with major societal impact and accounts for approximately 55 percent of mortality in India. The Indian population is increasing in size and gradually ageing. As a result, the number of people diagnosed with and dying of cancer are increasing. Government funding agencies such as the Department of Biotechnology (DBT) has a clear definitive role in the management and control of cancer. Through Research and Development programs and multi-institutional networking programs, DBT has provided resources to individual investigators and to institutions, to carry out basic, applied, translational and clinical research and to develop new methods to prevent and treat disease and to conduct research especially in challenging areas pertaining to different types of cancer. This article summarizes the funding provided by DBT for different cancer research programs.


Assuntos
Pesquisa Biomédica/economia , Financiamento de Capital/economia , Órgãos Governamentais/economia , Neoplasias/economia , Humanos , Índia/epidemiologia , Pesquisa/economia
9.
Int J Technol Assess Health Care ; 37: e22, 2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33455592

RESUMO

Over the past few years, there has been an increasing recognition of the value of public involvement in health technology assessment (HTA) to ensure the legitimacy and fairness of public funding decisions [Street J, Stafinski T, Lopes E, Menon D. Defining the role of the public in Health Technology Assessment (HTA) and HTA-informed decision-making processes. Int J Technol Assess Health Care. 2020;36:87-95]. However, important challenges remain, in particular, how to reorient HTA to reflect public priorities. In a recent international survey of thirty HTA agencies conducted by the International Network of Agencies for HTA (INAHTA), public engagement in HTA was listed as one of the "Top 10" challenges for HTA agencies [O'Rourke B, Werko SS, Merlin T, Huang LY, Schuller T. The "Top 10" challenges for health technology assessment: INAHTA viewpoint. Int J Technol Assess. 2020;36:1-4].Historically, Australia has been at the forefront of the application of HTA for assessing the effectiveness and cost-effectiveness of new health technologies to inform public funding decisions. However, current HTA processes in Australia lack meaningful public inputs. Using Australia as an example, we describe this important limitation and discuss the potential impact of this gap on the health system and future directions.


Assuntos
Financiamento de Capital , Tomada de Decisões , Avaliação da Tecnologia Biomédica/economia , Austrália , Análise Custo-Benefício , Avaliação da Tecnologia Biomédica/organização & administração
10.
Drug Alcohol Depend ; 219: 108491, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33421798

RESUMO

BACKGROUND: Buprenorphine is a highly effective, office-based treatment for opioid use disorder (OUD), but affordable access to it remains challenging despite initial government investment in its development. We aimed to estimate the public sector's contribution to the development of buprenorphine for OUD. METHODS: We researched buprenorphine's timeline of development as an OUD treatment to identify key terms (e.g., authors of pivotal studies, labeled indication). We then conducted a PubMed search for each key term. We extracted article identification numbers and linked them to federal funding through the NIH RePORTER. We reviewed the title, investigator, and organization of each award distributed up to and including 2002 and classified awards as "highly related," "possibly related," or neither. Amounts of related awards were converted to 2019 US dollars. RESULTS: Over the course of nearly four decades, the active ingredient in buprenorphine was synthesized by a pharmaceutical manufacturer, but it was developed for OUD primarily by investigators in government and academic centers, including a formal government-industry partnership for commercialization. We identified 29 key terms related to its development as an OUD treatment that linked to 7060 NIH awards. Among these awards, 40 were "highly related" ($39.9 million) and 20 were "possibly related" ($22.4 million). CONCLUSIONS: An estimated $62.3 million in NIH awards to institutions and investigators supported the development of buprenorphine as a treatment for OUD. Despite this investment by the public sector, buprenorphine remains expensive, which limits access to this important treatment.


Assuntos
Buprenorfina/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Financiamento de Capital , Humanos
12.
J Homosex ; 68(8): 1371-1392, 2021 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31833818

RESUMO

This ethnographic study considers the political economy of queer and trans of color community organizations in the context of urban neoliberal governance in Toronto, Canada. While state institutions promote entrepreneurship-based arts funding as a means of economic development, queer and trans of color grassroots initiatives engage with these institutions in ways that compel a reconsideration of the relationship between entrepreneurship and neoliberalism. I propose the concept sacrificial entrepreneurship to identify how the disruption of the neoliberal incitement to personal gain by sacrificing one's economic well-being is patterned along lines of race, gender and sexuality. Focusing on Unapologetic Burlesque, a queer anti-racist community performance initiative, I show how queer and trans of color grassroots initiatives in Toronto take public resources intended to promote individual profit-making to create minoritized spaces of belonging. Through sacrificial entrepreneurship queer and trans of color subjects simultaneously collude and oppose the unfolding of neoliberal state initiatives.


Assuntos
Arte , Empreendedorismo , Política , Minorias Sexuais e de Gênero , Canadá , Financiamento de Capital , Grupos de Populações Continentais , Feminino , Humanos , Trabalho
14.
Cuad Bioet ; 31(103): 423-427, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-33375807

RESUMO

The interaction between doctors and pharmaceutical companies has been and is common, occurs in multiple ways and has proven, in many cases, to be necessary for the development of medicine. However, some of the sales techniques of the pharmaceutical industry are not ethically acceptable and can compromise the independence of physicians. An ethical dilemma arises from a real case in which the search for vulnerability in prescription based on a donation by a pharmaceutical company was not easy to identify.


Assuntos
Indústria Farmacêutica/ética , Doações/ética , Marketing/ética , Médicos/ética , Autonomia Profissional , Financiamento de Capital/ética , Crime , Indústria Farmacêutica/legislação & jurisprudência , Endocrinologia , Departamentos Hospitalares , Hospitais Gerais , Hospitais Universitários , Humanos , Marketing/legislação & jurisprudência , Ciências da Nutrição , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/organização & administração , Comunicação Persuasiva , Padrões de Prática Médica/ética
15.
Viruses ; 12(12)2020 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-33352755

RESUMO

Funding vaccine development research is more complicated than simply putting out an announcement of funds available. The funders must decide whether product development can be accomplished by purely applied research, or whether more fundamental knowledge is needed before product development can be started. If additional basic knowledge is needed, identifying the specific area of the knowledge gap can be a challenge. Additionally, when there appears to be a clear path of applied research sometimes obstacles are encountered that require a return to more basic work. After deciding on the work to be done, funders must attract the scientists with the broad range of needed skills to cover all the stages of development. Collaborations must be promoted and alliances with other funders and industry must be developed. Funders use multiple tools and strategies to accomplish these tasks with varying success.


Assuntos
Vacinas contra a AIDS/imunologia , Infecções por HIV/prevenção & controle , HIV/imunologia , Pesquisa , Financiamento de Capital , Infecções por HIV/virologia , História do Século XX , História do Século XXI , Humanos , Pesquisa/economia , Pesquisa/história , Pesquisa/tendências
16.
PLoS One ; 15(11): e0243092, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33253269

RESUMO

OBJECTIVES: Non-publication and publication bias are topics of considerable importance to the scientific community. These issues may limit progress toward the 3R principle for animal research, promote waste of public resources, and generate biased interpretations of clinical outcomes. To investigate current publishing practices and to gain some understanding of the extent to which research results are reported, we examined publication rates of research projects that were approved within an internal funding program of the Faculty of Medicine at a university medical center in Germany, which is exemplary for comparable research funding programs for the promotion of young researchers in Germany and Europe. METHODS: We analyzed the complete set (n = 363) of research projects that were supported by an internal funding program between 2004 and 2013. We divided the projects into four different proposal types that included those that required an ethics vote, those that included an animal proposal, those that included both requirements, and those that included neither requirement. RESULTS: We found that 65% of the internally funded research projects resulted in at least one peer-reviewed publication; this increased to 73% if other research contributions were considered, including abstracts, book and congress contributions, scientific posters, and presentations. There were no significant differences with respect to publication rates based on (a) the clinic/institute of the applicant, (b) project duration, (c) scope of funding or (d) proposal type. CONCLUSION: To the best of our knowledge, this is the first study to explore publication rates associated with early-career medical research funding. As >70% of the projects ultimately generated some form of publication, the program was overall effective toward this goal; however, non-publication of research results is still prevalent. Further research will explore the reasons underlying non-publication. We hope to use these findings to develop strategies that encourage publication of research results.


Assuntos
Centros Médicos Acadêmicos/economia , Financiamento de Capital , Publicações/normas , Pesquisa/normas , Centros Médicos Acadêmicos/normas , Pesquisa Biomédica/economia , Pesquisa Biomédica/normas , Alemanha/epidemiologia , Humanos , Revisão da Pesquisa por Pares , Viés de Publicação , Publicações/economia , Pesquisa/economia , Estudos Retrospectivos
17.
An. pediatr. (2003. Ed. impr.) ; 93(4): 267.e1-267.e9, oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-201505

RESUMO

El desarrollo de medicamentos para ciertas enfermedades raras puede verse truncado por la falta de financiación. En estos casos, en ocasiones, los propios pacientes -o sus familiares- financian el ensayo clínico en el que recibirán el medicamento experimental. Hay 3modelos de autofinanciación: 2de ellos, «pagar por probar» y «pagar por participar», ya se han puesto en práctica; el tercero, el modelo «plutocrático», que ha sido recientemente planteado, es, hasta la fecha, un modelo teórico. En este trabajo se repasan los beneficios y riesgos científicos, sociales y éticos de los 2modelos de investigación clínica: «pagar por participar» y el modelo «plutocrático». Una manera frecuente de poder autofinanciar estos ensayos clínicos es la obtención de fondos por micromecenazgo. Los aspectos más controvertidos de esta modalidad de financiación también son abordados en este trabajo desde diversas perspectivas. Por último, se plantea un escenario futuro que permitiera en nuestro país la puesta en marcha de estos ensayos clínicos autofinanciados mediante el modelo plutocrático


The development of medicines for certain rare diseases can be frustrated by lack of funding. In certain cases the patients themselves, or their relatives, occasionally fund the clinical trial in which they will be treated with the investigational medicine. There are 3models of self-funded research: 2of them, "pay to try" and "pay to participate", have already been put into practice. The third, the "plutocratic" proposal, which has been recently put forward is still a theoretical model. In this work the scientific, social and ethical benefits and risks of the 2clinical research models, "pay to participate" and the "plutocratic" proposal, are reviewed. Patient-funded clinical trials are frequently performed through crowdfunding. The most controversial aspects of this funding modality are also addressed in this article from several perspectives. Finally, a future scenario that would allow the launching of self-funded clinical trials in Spain by the "plutocratic" proposal is proposed


Assuntos
Humanos , Doenças Raras/epidemiologia , Financiamento de Capital/economia , Ensaios Clínicos como Assunto/economia , Pesquisa Biomédica/economia , Doenças Raras/terapia , Apoio à Pesquisa como Assunto/economia , Produção de Droga sem Interesse Comercial/economia , Pesquisa Biomédica/normas
19.
PLoS One ; 15(9): e0239265, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931512

RESUMO

This study empirically examined the impact of financing innovation on technological innovation efficiency of select internet companies, that were affiliated with China between 2008 and 2017. Analysis was based on their patent and annual report data and used multiple input-output SFA model, system GMM, and panel fixed-effect model. The results are as follows. (1) There is significant variation in overall technological innovation efficiency of listed companies in the internet industry, and there is a downward trend. The technological innovation efficiency of business that use financing innovation methods is higher than those that do not. (2) The number of patents and intangible capital investment of internet businesses increase obviously every year, but there is no corresponding increase in the efficiency of technological innovation, and little intangible capital investment of non-financing innovation businesses. Thus, determining how to effectively improve the overall quality of patents and the efficiency of intangible capital investment is essential to improve the efficiency of technological innovation for Chinese internet businesses. (3) There is a term mismatch in the investment and financing of internet businesses in China. The financing structure between the financing innovation and non-financing innovation businesses has different impacts on the efficiency of technological innovation. And nowadays, more financing channels are short-term debt financing channels which invest in projects to improve the efficiency of technological innovation due to the pressure of debt repayment and the need to protect shareholders' interests. (4) In the panel regression, the coefficients of Icd and Roa are significantly negative, suggesting that the investment efficiency of internet businesses needs to be improved.


Assuntos
Financiamento de Capital/economia , Internet/economia , Invenções/economia , China , Comércio/economia , Humanos , Indústrias/economia , Investimentos em Saúde/economia
20.
Acad Med ; 95(11): 1702-1706, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32739931

RESUMO

PROBLEM: Many health care systems in the United States are shifting from a fee-for-service reimbursement model to a value-based payment model. To remain competitive, health care administrators must engage frontline clinicians in their efforts to reduce costs and improve patient outcomes. Engaging physicians and other clinicians is challenging, however, as many feel overwhelmed with clinical responsibilities and do not view cost reduction as in their purview. Even if they are willing, providing a direct financial incentive to clinicians to control costs poses ethical and legal challenges. An effective incentive in the current system must motivate clinicians to engage in creative problem solving and mitigate ethical and legal risk. APPROACH: Evidence suggests the most successful behavior change interventions in physicians are multifaceted and combine intrinsic motivators, such as increased autonomy, with extrinsic motivators, such as access to funding or social recognition. Two academic health centers-the University of Utah Health and Stanford Health Care-have begun experimenting with an alternative value-sharing arrangement. Physician-directed reinvestment is an explicit agreement in which a health care system reinvests a portion of savings attributed to physician-led cost reduction initiatives back into areas of the physician's choosing, such as capital investment, research, or education. OUTCOMES: Both organizations reported similar positive outcomes, including increased engagement from clinicians and administrators, sustained or improved quality of care, reduced costs of care, and benefits from reinvested funds. Many savings opportunities were previously unknown to administrators. NEXT STEPS: Physician-directed reinvestment appears to effectively engage physicians in ongoing efforts to improve value in health care, although formal evaluation is still needed. This incentive structure may hold promise in other configurations, such as inviting nonphysicians to apply as project leaders (clinician-directed reinvestment) and expanding the program to nonacademic and ambulatory settings.


Assuntos
Controle de Custos , Motivação , Inovação Organizacional , Médicos , Autonomia Profissional , Melhoria de Qualidade , Centros Médicos Acadêmicos , Financiamento de Capital , Humanos , Mecanismo de Reembolso , Apoio à Pesquisa como Assunto , Apoio ao Desenvolvimento de Recursos Humanos
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