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1.
Fam Process ; 2022 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-35014030

RESUMEN

TRUE Dads, a federally funded Responsible Fatherhood intervention, aims to strengthen three of men's key roles in the family: (1) as fathers, building and maintaining positive engagement with their child; (2) as partners, maintaining a positive relationship with their co-parent; and (3) as providers, through fostering employment and economic self-sufficiency. A feature of the program is that low-income fathers and their co-parenting partners participate together in 6 3-hour group workshops, followed by optional participation in an additional 6 3-hour workshops. Fathers in the intervention condition were offered a chance to participate in a 2-week employment program. 1,042 co-parenting teams were recruited and randomly assigned to TRUE Dads' group intervention (60%) or a no-treatment control group (40%). In analyses of single measures, one year after study entry, compared with no-treatment controls, TRUE Dads program participants reported fewer depressive symptoms, less destructive couple communication and domestic violence, and increased employment for fathers. Using expanded latent variable measures of core constructs, Structural Equation Modeling revealed indirect effects of the intervention, in which reductions in both parents' negative symptoms and destructive couple communication were associated with (a) reductions in negative parenting qualities and children's behavior problems and (b) increases in fathers' economic self-sufficiency. Reducing parents' personal distress and improving relationship quality between co-parents appears to be important to enhancing fathers' positive family engagement. From a family policy perspective, the results suggest that integration rather than separation of healthy marriage, responsible fatherhood, and employment programs could provide synergistic power to programs designed to strengthen low-income families.


TRUE Dads, una intervención en la paternidad responsable financiada con fondos federales, tiene como finalidad fortalecer tres de los papeles fundamentales de los hombres en la familia: 1) como padres, construir y mantener un compromiso positivo con su hijo; 2) como compañeros de cocrianza, mantener una relación positiva con el otro padre; y 3) como proveedores, fomentar el empleo y la autonomía económica. Una característica del programa es que los padres de bajos recursos y sus compañeros de cocrianza participan juntos en 6 talleres grupales de 3 horas, y luego pueden participar de manera opcional en otros 6 talleres de 3 horas. A los padres del grupo de intervención se les ofreció una oportunidad de participar en un programa de empleo de dos semanas. Se convocó a 1042 equipos de cocrianza, los cuales fueron asignados aleatoriamente a una intervención grupal de TRUE Dads (60%) o a un grupo de referencia sin tratamiento (40%). En los análisis de medidas simples, un año después del ingreso en el estudio, en comparación con los integrantes del grupo de referencia sin tratamiento, los participantes del programa TRUE Dads informaron menos síntomas depresivos, menos comunicación destructiva de pareja y violencia doméstica, y un aumento del empleo para los padres. Usando medidas variables latentes ampliadas de constructos centrales, el modelo de ecuación estructural reveló efectos indirectos de la intervención, en los cuales las reducciones en los síntomas negativos y la comunicación destructiva de la pareja en ambos padres estuvieron asociadas con (a) disminuciones de las cualidades negativas de crianza y de los problemas de conducta de los niños, y (b) aumentos de la autonomía económica de los padres. La reducción del distrés personal de los padres y la mejora de la calidad de la relación entre los copadres parece ser importante para mejorar el compromiso familiar positivo de los padres. Desde una perspectiva de política familiar, los resultados indican que la integración, en lugar de la separación de un matrimonio saludable, la paternidad responsable y los programas de empleo podrían aportar poder sinérgico a los programas diseñados para fortalecer a las familias de bajos recursos.

3.
Gac Sanit ; 35 Suppl 1: S30-S32, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33832620

RESUMEN

OBJECTIVE: The large-scale social distancing policy conducted twice was unable to reduce the rate of development of COVID-19 widespread in Makassar, yet it increased. One of the causes was that social awareness is still lacking especially for people in the poverty line. This study attempts to describe the social behavior of people in poverty line toward COVID-19 case in Makassar. METHOD: This research is a qualitative descriptive study based on the case. The data analysis was undertaken qualitatively. RESULTS: The results revealed that the limited understanding of people in poverty line about COVID-19 and health protocols makes their behavior indifferent and disobedient to health protocols. In addition, the government's top-down approach to deal with COVID-19 pandemic was ineffective. However, bottom-up collaborative interventions need to be carried out through a group approach to gain an understanding of the COVID-19 health protocol, especially for people in poverty line and other vulnerable groups.


Asunto(s)
COVID-19/prevención & control , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Colaboración Intersectorial , Pandemias , Distanciamiento Físico , Pobreza , SARS-CoV-2 , Participación de los Interesados , COVID-19/epidemiología , COVID-19/psicología , COVID-19/transmisión , Participación de la Comunidad , Agencias Gubernamentales , Política de Salud , Humanos , Indonesia/epidemiología , Administración en Salud Pública , Investigación Cualitativa , Responsabilidad Social , Participación de los Interesados/psicología , Población Urbana
4.
Washington, D.C.; OPS; 2021-04-26. (OPS/HSS/MT/21-0005).
en Español | PAHO-IRIS | ID: phr-53794

RESUMEN

Mejorar el acceso a los medicamentos y otras tecnologías sanitarias seguros, eficaces y de calidad es una prioridad esencial de la salud pública y un requisito fundamental para el logro de la salud universal. Los sistemas regulatorios nacionales cumplen una función clave en el sistema de salud de un país al supervisar la seguridad, la calidad y la eficacia de todas las tecnologías sanitarias, como los fármacos, las vacunas, la sangre y los productos sanguíneos, y los dispositivos médicos. El objetivo del informe Fortalecimiento de los sistemas regulatorios en la Región de las Américas: enseñanzas obtenidas de las autoridades regulatorias nacionales de referencia regional es que se comprenda mejor el panorama regulatorio en la Región de las Américas, con un interés especial en las autoridades regulatorias nacionales de referencia en América Latina. En este resumen se presentan los datos y análisis correspondientes a las funciones regulatorias esenciales y las bases del sistema a fin de comprender las prácticas actuales, reconocer algunas cuestiones importantes y formular una serie de recomendaciones para la acción. Se proporciona además un panorama sobre las perspectivas del mercado y los mecanismos de integración económica en la Región, y su influencia sobre la política regulatoria y el comercio farmacéutico.


Asunto(s)
Sistemas de Salud , Servicios de Salud , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Calidad de la Atención de Salud , COVID-19 , Coronavirus , Infecciones por Coronavirus , Betacoronavirus
5.
Nurs Outlook ; 69(4): 550-564, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33750611

RESUMEN

BACKGROUND: Postdoctoral nurses have an important role in advancing nursing by generating knowledge and building networks in research, practice, and education which requires effective leadership. Therefore, the Leadership Mentoring in Nursing Research programme for postdoctoral nurses was developed. PURPOSE: This study was to evaluate expectations, experiences, and perceived influence of the leadership mentoring programme on leadership and professional development, professional identity, and research productivity of postdoctoral nurses. METHODS: A longitudinal mixed-method study with a concurrent triangulation design was used with data collected through semistructured interviews and online surveys. FINDINGS: The leadership mentoring programme was found to be valuable by the participants who described strengthened leadership and professional development and development of professional identities. Participants showed increased research productivity and many moved to new/higher positions. DISCUSSION: The leadership mentoring programme was found to enhance the leadership and professional development of postdoctoral nurses and support them in their academic careers.


Asunto(s)
Colaboración Intersectorial , Liderazgo , Tutoría/organización & administración , Mentores/psicología , Rol de la Enfermera/psicología , Rol Profesional/psicología , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Investigación en Enfermería , Naciones Unidas
6.
Fam Process ; 2021 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-33683717

RESUMEN

The economic and social well-being of rural, "resource-cursed" communities can depend on the boom-bust cycles of a single industry like oil and gas. This study used a constructivist, inductive approach to identify the challenges placed on families in one such community and the processes that strengthen family resilience. Semi-structured interviews were conducted with 35 adult residents (30-76 years old, 19 women) from a community in Alberta, Canada, that has specialized in oil and gas extraction for 70 years and experienced its worst economic downturn while the study was underway. Results showed that many families have experienced an endless cycle of poor work-life balance and income instability throughout the economic cycle. Family life often lacked social cohesion as a consequence of demanding work schedules and economic pressures. Additional challenges were the perceived negative effects of rigid gender roles, substance abuse, family conflicts, and domestic violence. Crucial strengthening processes for family resilience were fundamental financial and living standard adaptations (e.g., living within or below one's economic means; having both spouses become earners), maintaining regular contact by having a flexible home routine, and mutually agreeing to change roles during busts (former earners take responsibility for caregiving and running of the household and vice versa). Alternatively, accepting economic volatility and its impact on normal family life processes were essential for family resilience. Findings suggest the need for clinicians to help families foster resilience in communities that depend on resource extraction industries with concurrent adaptations required by individuals, families, and socio-political and economic systems.

7.
Soc Work Public Health ; 36(2): 286-299, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-33535919

RESUMEN

Children with special education needs (SEN), such as children with autism, benefit from being included in education along with typical peers. However, development and implementation of inclusive education (IE) is considered difficult. This paper identifies conditions that facilitate IE development for children with autism in the European Union and benchmarks to track IE policy development. Education policy data from 30 legislative regions in the European Union were analyzed through a qualitative comparative analysis using eight conditions: a definition of SEN, the right to education for children with SEN, support for teaching staff, support services for children with SEN, individualized learning outcomes, parental involvement, and mixed mainstream classes. The right to education for children with SEN is implemented in all regions under study. Seven of the examined conditions were associated with IE: an established definition of SEN, support for teaching staff, support services for children with SEN, individualized learning outcomes, parental involvement, IE policies, and mixed mainstream classrooms. Mixed classrooms and support services for children with SEN were identified as necessary for IE. IE policies and support for teaching staff were present in all scenarios that facilitated IE. While the analysis was initially focused on autism, the policies consisted predominantly of general SEN policies, allowing the results to be interpreted in a wider context, beyond autism. Ultimately, mixed mainstream classrooms and support services for children with special needs were found essential for consistent IE development. Support for teaching staff and IE policies facilitate IE and should be further explored and implemented.


Asunto(s)
Trastorno Autístico , Niño , Educación Especial , Escolaridad , Unión Europea , Humanos , Integración Escolar , Políticas
8.
Clin Transl Sci ; 14(1): 47-53, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32799428

RESUMEN

Although collaborations between academic institutions and industry have led to important scientific breakthroughs in the discovery stage of the pharmaceutical research and development process, the role of multistakeholder partnerships in the clinical development of anticancer medicines necessitates further clarification. The benefits associated with such cooperation could be undercut by the conflicting goals and motivations of the actors included. The aim of this review was to identify and characterize past, present, and future stakeholder partnership models in cancer clinical research through the lens of the European Organisation for Research and Treatment of Cancer (EORTC). Based on the analysis of several landmark EORTC trials performed across the span of three decades, four existing models of stakeholder cooperation were delineated and characterized. Additionally, a hypothetical fifth model representing a potential future collaborative framework for cancer clinical research was formulated. These models mainly differ in terms of the nature and responsibilities of the partners included and show that clinical research partnerships in oncology have evolved over time from small-scale academia-industry collaborations to complex interdisciplinary cooperation involving many different stakeholders.


Asunto(s)
Investigación Biomédica/organización & administración , Industria Farmacéutica/organización & administración , Colaboración Intersectorial , Oncología Médica/organización & administración , Neoplasias/tratamiento farmacológico , Investigación Biomédica/tendencias , Industria Farmacéutica/tendencias , Unión Europea , Humanos , Cooperación Internacional , Oncología Médica/tendencias , Participación de los Interesados
9.
Health Econ Policy Law ; 16(1): 23-37, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32727635

RESUMEN

The prevention of antimicrobial resistance (AMR) has been a flagship of the EU's health policy since the early 2000s, leading the European Commission to mandate three European agencies to cooperate in the fight against AMR: EMA (the European Medicines Agency), ECDC (European Centre for Disease Prevention and Control) and EFSA (the European Food Safety Agency). This article is at the intersection of EU health policy and the burgeoning scholarship on bureaucratic reputation. Little is known on the role played by reputational incentives on inter-agency cooperation. This empirical work supports the claim that cooperation creates incentives for agencies to protect their reputational uniqueness vis-à-vis each other. However, rather than threatening their cooperation, it amounts to a process of sense-making of their respective roles in the integrated fight against AMR. Evidence is generated through the agencies' textual sources, as well as in-depth interviews and analysed through a narrative analysis. From the early days of inter-agency cooperation, to recent legislative work, this paper offers in-depth insights on the EU's governance against AMR.


Asunto(s)
Farmacorresistencia Microbiana , Unión Europea/organización & administración , Agencias Gubernamentales/organización & administración , Política de Salud/legislación & jurisprudencia , Cooperación Internacional , Colaboración Intersectorial , Animales , Humanos , Rol
10.
Health Econ Policy Law ; 16(1): 1-7, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32829722

RESUMEN

The relevance of the European Union (EU) for health has been widely recognised within the health community for some time, and is increasingly apparent to European policy-makers and publics. Despite being an area of policy that national governments would prefer to keep exclusive control of, and though in the past it has rarely been at the top of the agenda, many elements of health have been gradually 'Europeanised'. This special issue marks the culmination of a British Academy-funded project - EU Health Law and Policy: Shaping a Future Research Agenda - which sought to build on the growing web of expertise in this field and reflect upon the future of health as an EU competence, at a time when it appeared to be under threat.


Asunto(s)
Unión Europea , Política de Salud/legislación & jurisprudencia , Prioridades en Salud , Investigación Interdisciplinaria , Cooperación Internacional , Colaboración Intersectorial , Humanos
11.
Rev. bras. estud. popul ; 38: e0170, 2021. graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1341118

RESUMEN

Resumo Na sequência da integração europeia, os fluxos migratórios portugueses foram diminuindo, de tal forma que, na viragem do século, acreditou-se que Portugal tinha passado de "país de emigrantes" para "país de imigrantes". Com efeito, nas últimas décadas do século XX, Portugal atraiu inclusive cidadãos do país que, tradicionalmente, recebeu as mais significativas levas de expatriados portugueses (o Brasil) e, no contexto global, passou a integrar o conjunto de países atrativos para os migrantes económicos. Não obstante, a recente crise económica que pautou os primeiros anos do século XXI veio pôr a descoberto que essa realidade não estava solidificada, pelo menos não tanto como alguns cientistas sociais defenderam. Isto porque novos fluxos migratórios emergiram no território nacional, particularmente visíveis em áreas de baixa densidade, como é o caso da maior parte do distrito da Guarda. Neste trabalho, tendo como pano de fundo a região da Guarda, procuram-se equacionar "as molas impulsionadoras" que estão, novamente, a impelir estes portugueses a procurarem melhores condições de vida longe do país, na tentativa de perceber até que ponto estes novos fluxos migratórios têm uma génese comum aos que os precederam ou se, pelo contrário, têm configurações particulares que os individualizam no panorama migratório português.


Abstract As a result of European integration, Portuguese migratory flows decreased in such a way that, at the turn of the century, it was believed that Portugal had gone from being a "country of emigrants" to "country of immigrants". Indeed, in the last decades of the twentieth century, Portugal even attracted citizens of the country which traditionally received the most significant waves of Portuguese expatriates (Brazil) and, in the global context, became part of the set of countries attractive to economic migrants. However, the recent economic crisis that marked the first years of the 21st century has revealed this reality was not consolidated, at least not as much as some social scientists have argued. This is because new migratory flows have emerged in the national territory, particularly visible in low density territories as is the case in most of the district of Guarda. In this work, with the Guarda region as a backdrop, we seek to equate "the driving springs" that are, once again, impelling these Portuguese to seek better living conditions away from the country, in an attempt to understand the extent to which these new migratory flows have a common genesis to those who preceded them or, whether, on the contrary, they have particular configurations that individualize them in the Portuguese migratory panorama.


Resumen Como resultado de la integración europea, los flujos migratorios portugueses disminuyeron, por lo que, a principios de siglo, se creía que Portugal había pasado de ser un país de emigrantes a uno de inmigrantes. De hecho, en las últimas décadas del siglo XX, Portugal atrajo incluso a ciudadanos del país que tradicionalmente había recibido las olas más significativas de expatriados portugueses (Brasil) y, en el contexto global, se convirtió en parte del conjunto de países atractivos para los migrantes económicos. Sin embargo, la reciente crisis económica que marcó los primeros años del siglo XXI reveló que esta realidad no se ha solidificado, al menos no tanto como algunos científicos sociales han argumentado. Esto se debe a que han surgido nuevos flujos migratorios en el territorio nacional, particularmente visibles en los territorios de baja densidad, como en la mayor parte del distrito de Guarda. En este artículo, con la región de Guarda como telón de fondo, buscamos combinar los resortes impulsores que, una vez más, están llevando a estos portugueses a buscar mejores condiciones de vida fuera del país, en un intento por comprender en qué medida estos nuevos flujos de migrantes tienen una génesis común a quienes los precedieron o si, por el contrario, tienen configuraciones particulares que los individualizan en el panorama migratorio portugués.

12.
Health Serv Res ; 55 Suppl 3: 1062-1072, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33284522

RESUMEN

OBJECTIVE: To examine system integration with physician specialties across markets and the association between local system characteristics and their patterns of physician integration. DATA SOURCES: Data come from the AHRQ Compendium of US Health Systems and IQVIA OneKey database. STUDY DESIGN: We examined the change from 2016 to 2018 in the percentage of physicians in systems, focusing on primary care and the 10 most numerous nonhospital-based specialties across the 382 metropolitan statistical areas (MSAs) in the US. We also categorized systems by ownership, mission, and payment program participation and examined how those characteristics were related to their patterns of physician integration in 2018. DATA COLLECTION/EXTRACTION METHODS: We examined local healthcare markets (MSAs) and the hospitals and physicians that are part of integrated systems that operate in these markets. We characterized markets by hospital and insurer concentration and systems by type of ownership and by whether they have an academic medical center (AMC), a 340B hospital, or accountable care organization. PRINCIPAL FINDINGS: Between 2016 and 2018, system participation increased for primary care and the 10 other physician specialties we examined. In 2018, physicians in specialties associated with lucrative hospital services were the most commonly integrated with systems including hematology-oncology (57%), cardiology (55%), and general surgery (44%); however, rates varied substantially across markets. For most specialties, high market concentration by insurers and hospital-systems was associated with lower rates of physician integration. In addition, systems with AMCs and publicly owned systems more commonly affiliated with specialties unrelated to the physicians' potential contribution to hospital revenue, and investor-owned systems demonstrated more limited physician integration. CONCLUSIONS: Variation in physician integration across markets and system characteristics reflects physician and systems' motivations. These integration strategies are associated with the financial interests of systems and other strategic goals (eg, medical education, and serving low-income populations).


Asunto(s)
Prestación Integrada de Atención de Salud/estadística & datos numéricos , Especialización/estadística & datos numéricos , Integración de Sistemas , Competencia Económica , Sistemas de Información en Salud/estadística & datos numéricos , Investigación sobre Servicios de Salud , Hospitales/estadística & datos numéricos , Humanos , Aseguradoras/estadística & datos numéricos , Propiedad/estadística & datos numéricos , Médicos de Atención Primaria/estadística & datos numéricos , Estados Unidos
13.
Textos contextos (Porto Alegre) ; 19(2): 38934, : 38936, 23 dez. 2020.
Artículo en Inglés, Español | LILACS | ID: biblio-1151741

RESUMEN

El artículo aborda el problema del hambre en el mundo, uno de los fenómenos más aberrantes con que la humanidad inició la nueva década. A partir del año 2014 comenzó a manifestarse una tendencia ascendente en la inseguridad alimentaria hasta alcanzar niveles graves en 2019-2020. Con el inicio de la pandemia de COVID-19, se ha acentuado la preocupación respecto a los efectos que ésta podría provocar en la crisis alimentaria a nivel mundial y, espe-cialmente, en América Latina y el Caribe, debido a que es el continente donde el acceso mercantil a la alimentación se sitúa entre las más costosas del mundo. Por cierto, la región no enfrenta escasez de alimentos, sino que al contrario hay abundancia de ellos. Estas contradicciones hacen necesario cuestionarse si la liberalización del mercado ha sido una solución para resolver el problema del hambre a nivel mundial. Así como también, revisar la pertinencia de las políticas "oficiales" de seguridad alimentaria y de sus instituciones impulsoras. Una de las vías de solución es lograr la acción coordinada y permanente de los Estados para garantizar la provisión de alimentos a la población y evitar el avance del hambre. Hoy más que nunca se requiere el fortalecimiento de proyectos de integración regional basados en la soberanía alimentaria.


O artigo aborda o problema da fome no mundo, um dos fenômenos mais aberrantes com que a humanidade começou a nova década. A partir de 2014, começou a se manifestar uma tendência crescente na insegurança alimentar, alcançando graves níveis em 2019-2020. Com o início da pandemia de COVID-19, se acentuou a preocupação a respeito dos efeitos que esta poderia provocar na crise alimentícia a nível mundial e especialmente na América Latina e no Caribe, onde o acesso mercantil à alimentação é um dos mais caros do mundo. No entanto, a região não enfrenta escassez de alimentos, pelo contrário, possui uma grande abundância. Considerando estas contradições, faz-se necessário questionar se a liberação do mercado tem sido uma solução para resolver o problema da fome a nível mundial. Assim como revisar a pertinência das políticas "oficiais" de segurança alimentar e de suas instituições impulsionadoras. Uma das soluções seria obter a ação coordenada e permanente dos Estados a fim de garantir o fornecimento de alimentos à população e evitar o avanço da fome. Hoje, mais do que nunca, é preciso o fortalecimento de projetos de integração regional baseados na soberania alimentar


The article addresses the problem of hunger in the world, one of the most aberrant phenomena with which humanity began the new decade. Starting in 2014, an upward trend in food insecurity began to manifest itself, reaching serious levels in 2019-2020.With the onset of the COVID-19 pandemic, concern grew about the effects it could have on the food crisis worldwide and, especially in Latin America and the Caribbean. The latter, because it is the region where commercial access to food is among the most expensive in the world. By the way, Latin America does not face a shortage of food, but on the contrary it has an abundance of them. These contra-dictions make it necessary to question whether market liberalization has been a solution to solve the problem of hunger at the world level. As well as reviewing the relevance of "official" food security policies and their driving institutions. One of the solutions is to achieve coordinated and permanent action by the States to guarantee the provision of food to the population and prevent the advance of hunger. Our conclusion is that the strengthening of regional integration projects based on food sovereignty is required.


Asunto(s)
Hambre , Infecciones por Coronavirus/economía , Economía , Política Pública , Pandemias , América Latina
14.
J Leg Med ; 40(2): 229-245, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33137278

RESUMEN

A recent study by the Legal Services Corporation reported that 71% of low-income U.S. households experienced at least one civil legal problem in 2017 and that 86% of these needs went unresolved. In this article, we examine the potential for medical-legal partnerships (MLPs) to address this "justice gap." We draw on qualitative interviews, conducted with 20 parents and guardians in one pediatric MLP, to identify barriers to legal access and examine how the MLP model may uniquely address these barriers. Our data suggest that MLPs can (1) identify legal needs and create awareness of legal rights among individuals who would not have sought legal services; (2) create an access point for legal services; (3) improve access to legal advice and brief intervention; (4) support ongoing relationships between patients and lawyers that allow for the timely identification of subsequent legal needs; (5) foster trust and confidence in the legal system; and (6) address affordability concerns. These findings suggest that by improving access to justice, MLPs can address critical social and legal determinants of health and, ultimately, advance health equity.


Asunto(s)
Colaboración Intersectorial , Servicios Legales/métodos , Defensa del Paciente , Pobreza , Justicia Social , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Padres/psicología , Pediatría , Relaciones Profesional-Paciente , Investigación Cualitativa
15.
PLoS One ; 15(11): e0242468, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33196668

RESUMEN

Science is becoming increasingly international in terms of breaking down walls in its pursuit of high impact. Despite geographical location and distance still being major barriers for scientific collaboration, little is known about whether high-impact collaborations are similarly constrained by geography compared to collaborations of average impact. To address this question, we analyze Web of Science (WoS) data on international collaboration between global leader cities in science production. We report an increasing intensity of international city-city collaboration and find that average distance of collaboration of the strongest connections has slightly increased, but distance decay has remained stable over the last three decades. However, high-impact collaborations span large distances by following similar distance decay. This finding suggests that a larger geographical reach of research collaboration should be aimed for to support high-impact science. The creation of the European Research Area (ERA) represents an effective action that has deepened intracontinental research collaborations and the position of the European Union (EU) in global science. Yet, our results provide new evidence that global scientific leaders are not sufficiently collaborative in carrying out their big science projects.


Asunto(s)
Investigación Interdisciplinaria/tendencias , Investigación/tendencias , Ciudades/estadística & datos numéricos , Conducta Cooperativa , Unión Europea , Geografía , Humanos , Cooperación Internacional , Colaboración Intersectorial , Liderazgo , Conducta Social
16.
J Infect Dis ; 222(Suppl 8): S732-S737, 2020 10 29.
Artículo en Inglés | MEDLINE | ID: mdl-33119098

RESUMEN

The need for multisectoral approaches (MSAs) in prevention and control of vector-borne diseases (VBDs) has been identified. VBD programs often involve collaborations between health and nonhealth sectors; however, a systematic framework describing the process, requirements, challenges, and benefits of MSAs has been missing. A recent guidance document from UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases provides a framework to implement MSAs for prevention and control of VBDs. This article gives an introduction to the guidance document and describes the conceptual framework and coordination process. The next steps will be to test the framework through implementation research in specific VBD cases studies. The guidance document will thus be refined based on iterative and comprehensive monitoring and evaluation systems to assess the performance and impact of MSAs. The advocacy for MSA and necessary capacity building will be integrated into the testing of the framework.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Enfermedades Transmitidas por Vectores/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Guías como Asunto , Humanos , Colaboración Intersectorial , Naciones Unidas , Organización Mundial de la Salud
17.
Transfusion ; 60(12): 2828-2833, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32989778

RESUMEN

BACKGROUND: Arkansas is a rural state of 3 million people. It is ranked fifth for poverty nationally. The first case of coronavirus disease 2019 (COVID-19) in Arkansas occurred on 11 March 2020. Since then, approximately 8% of all Arkansans have tested positive. Given the resource limitations of Arkansas, COVID-19 convalescent plasma (CCP) was explored as a potentially lifesaving, therapeutic option. Therefore, the Arkansas Initiative for Convalescent Plasma was developed to ensure that every Arkansan has access to this therapy. STUDY DESIGN AND METHOD: This brief report describes the statewide collaborative response from hospitals, blood collectors, and the Arkansas Department of Health (ADH) to ensure that CCP was available in a resource-limited state. RESULTS: Early contact tracing by ADH identified individuals who had come into contact with "patient zero" in early March. Within the first week, 32 patients tested positive for COVID-19. The first set of CCP collections occurred on 9 April 2020. Donors had to be triaged carefully in the initial period, as many had recently resolved their symptoms. From our first collections, with appropriate resource and inventory management, we collected sufficient CCP to provide the requested number of units for every patient treated with CCP in Arkansas. CONCLUSIONS: The Arkansas Initiative, a statewide effort to ensure CCP for every patient in a resource-limited state, required careful coordination among key players. Collaboration and resource management was crucial to meet the demand of CCP products and potentially save lives.


Asunto(s)
COVID-19/terapia , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de Salud/organización & administración , Pandemias , Asignación de Recursos/organización & administración , SARS-CoV-2/inmunología , Anticuerpos Antivirales/sangre , Arkansas/epidemiología , Bancos de Sangre/economía , Bancos de Sangre/organización & administración , Donantes de Sangre/provisión & distribución , COVID-19/sangre , COVID-19/economía , COVID-19/epidemiología , Planificación en Salud Comunitaria/economía , Planificación en Salud Comunitaria/organización & administración , Trazado de Contacto , Convalecencia , Recursos en Salud/economía , Accesibilidad a los Servicios de Salud/economía , Humanos , Inmunización Pasiva , Colaboración Intersectorial , Pobreza , Asignación de Recursos/economía , Población Rural
18.
Enferm. nefrol ; 23(2): 176-183, abr.-jun. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-194135

RESUMEN

INTRODUCCIÓN: Las personas en tratamiento renal sustitutivo en edad laboral presentan tradicionalmente tasas de empleo significativamente más bajas que la población general. OBJETIVO: Describir la situación laboral de las personas con enfermedad renal crónica en tratamiento renal sustitutivo en España e identificar los factores asociados más significativos. MATERIAL Y MÉTODO: Estudio observacional descriptivo trasversal comparativo de personas en los diferentes tratamientos renales sustitutivos, en edad laboral de 16 a 64 años. Se analizó su situación laboral y otros factores socio-demográficos y socio-económicos, mediante la administración de un cuestionario ad hoc. RESULTADOS: En 437 personas con enfermedad renal crónica avanzada en tratamiento con hemodiálisis, diálisis peritoneal o trasplante. La tasa de empleo fue del 27%, un 84,21% de personas tenían certificado de discapacidad y un 46,45% de incapacidad laboral reconocida. Las personas trasplantadas presentaron mayores ingresos económicos mensuales y las que estaban en diálisis domiciliarios tenían la mayor tasa de empleo (37,64% frente al 27,89% de las personas trasplantadas y el 20,37% de las personas en hemodiálisis en centro). CONCLUSIONES: Las personas en tratamiento renal sustitutivo en edad laboral tienen importantes limitaciones en su acceso al empleo, sin embargo, existen diferencias importantes según sea la opción elegida de tratamiento. La información y toma de decisiones respecto opción del tratamiento renal sustitutivo son claves para el mantenimiento u obtención de un empleo, para su situación económica futura e incluso para el reconocimiento de la incapacidad laboral


INTRODUCTION: People on renal replacement therapy at working age traditionally have significantly lower employment rates than the general population. OBJECTIVE: To describe the employment situation of people with chronic kidney disease on renal replacement therapy in Spain and to identify the significant associated factors. MATERIAL AND METHOD: Observational, descriptive, cross-sectional and comparative study of people in the different renal replacement treatments, during the work period of 16 to 64 years. Their employment situation and other socio-demographic and socio-economic factors were analysed through the use of an ad hoc questionnaire. RESULTS: In 437 people with advanced chronic kidney disease on haemodialysis, peritoneal dialysis or transplantation. The employment rate was 27%, 84.21% of people had a certificate of disability and 46.45% had a recognized incapacity for work. The transplanted persons presented higher monthly economic income. Patients receiving home dialysis had a higher employment rate (37.64% compared to 27.89% of transplant recipients, and 20.37% of people on centre haemodialysis). CONCLUSIONS: People in renal replacement therapy at working age have significant limitations in access to employment. Although, there are important differences depending on the treatment option chosen. Information and decision-making regarding the option of renal replacement treatment are key for maintaining or obtaining a job, for the future economic situation, and even for the recognition of incapacity for work


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Trasplante de Riñón/métodos , Trasplante de Riñón/enfermería , Insuficiencia Renal Crónica/epidemiología , Diálisis Peritoneal/métodos , Estudios Transversales , Encuestas y Cuestionarios , Diálisis Renal/métodos , Personas con Discapacidad
19.
Global Health ; 16(1): 15, 2020 02 20.
Artículo en Inglés | MEDLINE | ID: mdl-32079530

RESUMEN

In 2015, the United Nations' (UN) Member States adopted a bold and holistic agenda of the Sustainable Development Goals (SDGs), integrating a vision of peace and prosperity for people and planet. Extensive work within, between, across sectors is required for this bold and holistic agenda to be implemented. It is in this context that this special article collection showcases multisectoral approaches to achieving SDG 3-Good Health and Well-Being-which, though focused explicitly on health, is connected to almost all other goals. A confluence of social and health inequities, within a context of widespread environmental degradation demands systems thinking and intersectoral action. Articles in this issue focus on the SDGs as a stimulus for renewed multisectoral action: processes, policies, and programs primarily outside the health sector, that have health implications through social, commercial, economic, environmental, and political determinants of health. Case studies offer critical lessons on effectively engaging other sectors to enhance their health outputs, identifying co-benefits and 'win-wins' that enhance human health.


Asunto(s)
Colaboración Intersectorial , Desarrollo Sostenible/tendencias , Humanos , Naciones Unidas/organización & administración , Naciones Unidas/tendencias
20.
REME rev. min. enferm ; 24: e-1278, fev.2020.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1051299

RESUMEN

Introdução: a coordenação da atenção mostra-se como um ponto estratégico de intervenções na atenção primária à saúde (APS). Objetivo: avaliar a qualidade dos serviços de APS em uma coordenadoria regional de saúde por meio dos usuários na dimensão da coordenação da atenção. Método: estudo analítico, do tipo transversal, no qual foram entrevistados 1.071 usuários adultos de 32 municípios que compõem duas regiões de saúde. Foi utilizado o instrumento de avaliação da atenção primária (Primary Care Assessment Tool) Brasil na versão adulto, e realizados os testes qui-quadrado de Pearson e Kruskal-Wallis. Resultados: verificou-se alto escore na dimensão "integração de cuidados" na unidade básica de saúde (UBS) (6,66), Estratégia de Saúde da Família (ESF) (6,34) e UBS mista (6,87) e alto escore na dimensão "sistemas de informação" na UBS (7,22), ESF (7,09) e UBS mista (7,27), não havendo diferenças significativas na avaliação entre os diferentes modelos de atenção. A dimensão da coordenação da atenção, no presente estudo, foi bem avaliada, obtendo alto escore nos diferentes modelos de atenção. Além disso, o estudo indicou não haver diferença estatística entre esses na APS, conforme avaliação dos usuários. Conclusão: o estudo contribui para que possa ser repensada a APS em relação ao modelo que está sendo implementado nas unidades com ESF, cujos resultados precisam ser refletidos pelos gestores municipais e regionais de saúde.(AU)


Introduction: the coordination of care is shown as a strategic point of interventions in primary health care (PHC). Objective: to evaluate the quality of PHC services in a regional health coordination through users in the dimension of coordination of care. Method: analytical, cross-sectional study, in which 1,071 adult users from 32 municipalities that make up two health regions were interviewed. The primary care assessment tool (Primary Care Assessment Tool) Brazil was used in the adult version, and Pearson and Kruskal-Wallis chi-square tests were performed. Results: there was a high score in the dimension "integration of care" in the basic health unit (BHU) (6.66), Family Health Strategy (FHS) (6.34) and integrated BHU (6.87) and high score in the dimension "information systems" at BHU (7.22), FHS (7.09) and integrated BHU (7.27), with no significant differences in the assessment between the different models of care. The dimension of coordination of care, in the present study, was well evaluated, obtaining a high score in the different models of care. In addition, the study indicated that there was no statistical difference...(AU)


Introducción: la coordinación de la atención sanitaria es un punto estratégico de intervención en la atención primaria de salud (APS). Objetivo: evaluar la calidad de los servicios de APS en un coordinador regional de salud a través de los usuarios en la dimensión coordinación de la atención. Método: estudio analítico transversal en el que se entrevistó a 1.071 usuarios adultos de 32 municipios que conforman dos regiones de salud. Se utilizó la herramienta de evaluación de la atención primaria (Primary Care Assessment Tool) Brasil en la versión para adultos y se realizaron las pruebas chi-cuadrado de Pearson y Kruskal-Wallis. Resultados: hubo puntuación alta en la dimensión "integración de la atención" en la unidad básica de salud (UBS) (6.66), la Estrategia de salud familiar (ESF) (6.34) y UBS mixta (6.87) y puntaje alto en la dimensión "sistemas de información" en UBS (7.22), ESF (7.09) y UBS mixta (7.27), sin diferencias significativas en la evaluación entre los diferentes modelos de atención. En el presente estudio la dimensión coordinación de la atención fue bien evaluada, obteniendo puntuación alta en los diferentes modelos de atención. Además, el estudio indicó que, según la evaluación de los usuarios, no había diferencia estadística entre ellos en la APS. Conclusión: el estudio contribuye a repensar el modelo que se está implementando en la APS en las unidades con ESF y sus resultados deben ser considerados por los administradores municipales y regionales de salud.(AU)


Asunto(s)
Humanos , Evaluación de Procesos y Resultados en Atención de Salud , Atención Primaria de Salud , Evaluación en Salud , Enfermería en Salud Comunitaria , Estrategia de Salud Familiar
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