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1.
Glob Public Health ; 19(1): 2377259, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-39052951

RESUMO

Establishing a robust One Health (OH) governance is essential for ensuring effective coordination and collaboration among human, animal, and environmental health sectors to prevent and address complex health challenges like zoonoses or antimicrobial resistance. This study conducted a mixed-methods environmental scan to assess to what extent Mexico displays a OH governance and identify opportunities for improvement. Through documentary analysis, the study mapped OH national-level governance elements: infrastructure, multi-level regulations, leadership, multi-coordination mechanisms (MCMs), and financial and OH-trained human resources. Key informant interviews provided insights into enablers, barriers, and recommendations to enhance a OH governance. Findings reveal that Mexico has sector-specific governance elements: institutions, surveillance systems and laboratories, laws, and policies. However, the absence of a OH governmental body poses a challenge. Identified barriers include implementation challenges, non-harmonised legal frameworks, and limited intersectoral information exchange. Enablers include formal and ad hoc MCMs, OH-oriented policies, and educational initiatives. Like other middle-income countries in the region, institutionalising a OH governance in Mexico, may require a OH-specific framework and governing body, infrastructure rearrangements, and policy harmonisation. Strengthening coordination mechanisms, training OH professionals, and ensuring data-sharing surveillance systems are essential steps toward successful implementation, with adequate funding being a relevant factor.


Assuntos
Saúde Única , México , Humanos , Entrevistas como Assunto , Política de Saúde , Animais
2.
Glob Public Health ; 19(1): 2360982, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38937916

RESUMO

Transgender women (TGW) and men who have sex with other men (MSM) often encounter disparities in accessing HIV testing, leading to delayed diagnoses and worse prognoses. We analysed barriers and facilitators for accessing HIV rapid testing by TGW and MSM in Brazil, 2004-2023. Citations were included whether the study population consisted of individuals aged ≥18y old, and studies addressed HIV testing and have been conducted in Brazil. The study protocol was based on Joanna Briggs' recommendations for scoping reviews. We included 11 studies on TGW and 17 on MSM. The belief that one is not at risk of contracting HIV infection, fear expressed in different ways (e.g. lack of confidentiality) and younger age were the main barriers. Feeling at risk for HIV infection, curiosity, and favourable characteristics of the setting where the testing takes place were cited as the main facilitators. Barriers and facilitators specifically for HIV self-testing included, respectively, concerns about conducting the test alone vs. autonomy/flexibility. Brazil is unlikely to achieve the UN' 95-95-95 goal without minimising testing disparities. Combating prejudice against TGW and MSM in testing settings, along with educational campaigns and transparent protocols to ensure confidentiality, can help increase HIV testing among these populations.


Assuntos
Infecções por HIV , Homossexualidade Masculina , Pessoas Transgênero , Humanos , Masculino , Brasil , Infecções por HIV/diagnóstico , Feminino , Teste de HIV , Acessibilidade aos Serviços de Saúde , Minorias Sexuais e de Gênero , Adulto
3.
Environ Res ; 258: 119422, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-38942261

RESUMO

The aim of the present research is to show the development of a sustainability-oriented lab that teaches adsorption concepts in a virtual environment based on the premise "learning-through-play". Kinetic results in the virtual environment are contrasted to those obtained experimentally when diverse adsorbents prepared from Agave Bagasse (Raw Fibers, Hydrothermal Fibers, and Activated Fibers) were synthesized. Comparison between virtual and real-life experiments involving removal of methylene blue in solution showed that a pseudo-first-order model could describe adsorption kinetics satisfactorily. The study is complemented with a characterization of the adsorbents through SEM, nitrogen adsorption isotherms, FTIR and Raman. In addition, the environmental impact of the synthesis of adsorbents was evaluated through well-known methodologies (GAPI, NEMI, and Eco-Scale), which agree that raw fibers are the most eco-friendly material. This research provides an exciting opportunity to advance our knowledge on developing new technologies for teaching in engineering and to compliment real-life practices that consider environmental impacts with virtual experiments.


Assuntos
Poluentes Químicos da Água , Adsorção , Cinética , Poluentes Químicos da Água/química , Poluentes Químicos da Água/análise , Universidades , Azul de Metileno/química , Laboratórios , Purificação da Água/métodos , Celulose/química , Modelos Químicos , Conservação dos Recursos Naturais/métodos
4.
Env Polit ; 33(5): 868-895, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38868558

RESUMO

Solar geoengineering (also known as solar radiation modification) is garnering more attention (and controversy) among media and policymakers in response to the impacts of climate change. Such debates have become more prominent following the first-ever field trials of stratospheric aerosol injection (SAI) in 2022. How the lay public perceives solar geoengineering remains unclear, however. We use nationally representative samples (N = 3013) in Mexico, United States, and United Kingdom to examine public perceptions of risks and benefits, support, and policy preferences. We also employ an information-framing design that presented individuals with media-style reports on SAI activities differing along three dimensions: location, actor, and scale and purpose. Support for SAI is found to be generally higher in Mexico; perceptions of risks and benefits do not differ between countries. Information about SAI activities has a limited effect. There is evidence that activities conducted by universities receive more support than those by start-up companies.

5.
Global Health ; 20(1): 50, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38907243

RESUMO

BACKGROUND: This study delves into the States' accountability for health-related Sustainable Development Goal (SDG) indicators from 2016 to 2020. An analysis of Voluntary National Reviews (VNR) is employed as an instrument to scrutinize the alignment of States' indicators with the global indicator framework, shedding light on global health governance within the context of the 2030 Agenda and States' strategic prioritization. A curation of 60 health-related indicators from 195 VNRs, produced during the aforementioned period, is organized into thematic groups. RESULTS: Our results highlight a concerning discrepancy in the reporting frequency of various health-related themes. The findings reveal a paradoxical coexistence characterized by the concurrent strengthening and diminution of the global health governance articulated in the Agenda's global health governance. This manifests in the increased utilization and consistency of health-related indicators over the study years, coupled with an emphasis on infectious diseases and child and maternal health indicators. Conversely, a discernible governance decline is evidenced by the inadequate representation of health-related indicators in VNRs, notably within the domains of universal health coverage and health system indicators. Furthermore, High-Income States exhibit diminished accountability. CONCLUSIONS: The VNRs unveil a paradox wherein burgeoning technical capacity coexists with governance deficits, a phenomenon attributable to both statistical capabilities and political preferences. The prevalent use of proxy indicators in VNRs oversimplifies the presentation of official indicators, thereby compromising the aspirational goal of pioneering statistical innovations for measuring intricate issues in the SDGs. In light of our conceptualization of the 2030 Agenda's global health as a regime complex governance, we advocate for comprehensive investigations into each health regime cluster. This approach aims to unravel disputes, discern patterns, and elucidate States' preferences concerning specific thematic areas. Functioning as an accountability mechanism for the Agenda's governance, VNRs underscore States' adaptability and short-term learning capabilities, offering valuable insights for identifying harmful goal prioritization. The discretionary nature of indicator selection by States in the VNRs, enabled by the Agenda's proposition of a contextual adaptation of the SDGs and a blind eye to the guideline's request to review all SDG indicators, highlights a critical flaw in the VNR as an accountability mechanism.


Assuntos
Saúde Global , Desenvolvimento Sustentável , Humanos , Indicadores Básicos de Saúde , Responsabilidade Social
6.
Sci Total Environ ; 937: 173396, 2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-38796014

RESUMO

Costa Rica is at the forefront of environmental conservation in Central America, with its focus on sustainability and green practices. Building on this foundation, the country joins a cohort of middle-income developing countries that have set forth ambitious goals to eliminate plastic pollution and become plastics-free. Recycling remains one of the most effective ways of removing plastic waste from the environment. Although GIS has been utilized in environmental research, its use is still expanding in developing countries of the Global South. These countries are experiencing unprecedented adverse climate and ecological impacts while also pursuing fundamental socioeconomic growth. The application of more cost-effective and strategic technological solutions, as well as data-driven decision-making, could fast-track the achievement of their urgent environmental goals. Using Geographic Information Systems (GIS) analysis, this study applies hot spot, location-allocation, and time-distance measures to examine Costa Rica's capacity to recycle plastic waste. Focusing specifically on availability and the public's access to recycling facilities, this article offers insights into the resource constraints and evolution of plastics governance in developing countries with environmentally-focused priorities. The findings of this study suggest that while Costa Rica is implementing progressive plastics regulatory policies, the ability to achieve plastics-free status is hampered by shortfalls in the number and distribution of recycling facilities and the public's access to recycling services. Expanding recycling infrastructure, including transportation, and adopting a less canton-centric waste administration system could contribute to resolving these challenges. This study contributes to discourses on global plastics governance and environmental change management in the Global South.


Assuntos
Poluição Ambiental , Sistemas de Informação Geográfica , Plásticos , Reciclagem , Costa Rica , Plásticos/análise , Poluição Ambiental/estatística & dados numéricos , Análise Espacial , Conservação dos Recursos Naturais/métodos , Monitoramento Ambiental
7.
Int J Health Policy Manag ; 13: 8008, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38618831

RESUMO

BACKGROUND: In the last few years, Mexico adopted public health policies to tackle non-communicable diseases (NCDs), such as front of package nutrition labelling, food marketing restrictions to children, and a soda tax. In parallel, transnational food and beverage industries (F&BIs), their allies, and the government have agreed on public-private partnerships (PPPs) to implement policies or deliver programs. However, research has questioned the benefits of PPPs and exposed its limitations as a suitable mechanism to improve public health. This study analyses how four PPPs between the Mexican government, the F&BI, and allies are working to achieve their goals. We critically assessed the objectives, scope, reported impacts, governance principles and perceived risks and benefits for the public health agenda of these PPPs. METHODS: This qualitative study is based on 26 interviews with key actors, and 170 publicly available documents, including 22 obtained through freedom of information (FOI) requests related to four purposively selected PPPs aiming to improve health. RESULTS: We found that the four PPPs studied had minimal public information available on their implementation and impact. The private partners tend to dictate the design, information management, and implementation of the programs, while promoting their brands. Few independent evaluations of the PPPs exist, and none reported on their effectiveness or public health benefits. Good governance principles, such as accountability, transparency, fairness, participation, integrity, and credibility, were barely followed in each of the cases studied. Public officials did not automatically question the conflict of interest (CoI) of such arrangements. When there were COI, the potential risks these posed did not always outweigh the financial benefits of working with the F&BI and its allies. CONCLUSION: The four PPPs studied produced minimal gains for public health while boosting credibility for the participating transnational F&BIs. It shows the lack of awareness of how these PPPs might be hindering public health gains.


Assuntos
Bebidas Gaseificadas , Parcerias Público-Privadas , Criança , Humanos , México , Saúde Pública , Impostos , Bebidas , Política Pública
8.
Environ Manage ; 74(1): 114-131, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38647673

RESUMO

Coping with complex landscape situations in the Anthropocene increasingly demands innovative governance practices that can be facilitated by investment in new epistemological and methodological approaches and capacities. This paper explores the use of a multimethodological research approach organized as a systemic co-inquiry to assist in the design of systemic governance for Agroextractivist Settlement Projects (PAEs) in the municipality of Abaetetuba, Pará, in the Brazilian Amazon. In the PAEs, the systemic co-inquiry was conducted alongside interested and influential stakeholders through the combined use of the Soft Systems Methodology and Strategic Options Development and Analysis problem structuring methods. The use of these methods and their tools allowed stakeholders to articulate major issues around the situation of concern, engaging in reflective practices about the opportunities of governing the PAEs systemically. By valuing stakeholder perspectives and participation in all phases of the research, the proposed multimethodology approach helped them express their views on the problem situation and allowed for their active engagement in the design of systemic governance of the PAEs. As a result of adopting a multimethodological approach, distinctive albeit coupled realms of governing are explored, a key issue when designing systemic governance practices of social-ecological systems such as the PAEs.


Assuntos
Conservação dos Recursos Naturais , Brasil , Conservação dos Recursos Naturais/métodos , Agricultura/métodos , Humanos
9.
Data Brief ; 53: 110167, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38406257

RESUMO

This global panel dataset contains information collected from two different sources (The Fund for Peace and World Bank), on the governance and stability levels of 178 countries between 2006 and 2022. The dataset includes information on 1) Cohesion (security apparatus (C1), factionalized elites (C2), and group grievance (C3)), 2) Economic (economy (E1), economic inequality (E2), and human flight and brain drain (E3)), 3) Political (state legitimacy (P1), public services (P2), and human rights (P3)) indicators, 4) Social and cross-cutting (demographic pressures (S1), refugees and internally displaced persons (S2), and external intervention (X1)), and 5) Governance (voice and accountability (G1), political stability and absence of violence/terrorism (G2), government effectiveness (G3), regulatory quality (G4), rule of law (G5), and control of corruption (G6)). Data analysis was carried out using SPSS version 29 software to ensure a complete description of the data (labels, type and measure of variables, and uniformity of decimals), as well as the imputation possibility of missing data, which will allow future researchers to study both cross-sectional and longitudinal relationships between the five types of indicators and the eighteen indicators reported.

10.
Heliyon ; 10(3): e25480, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38333807

RESUMO

The UN Sustainable Development Goals (SDGs) were developed in 2015 and serve as the main guide for achieving the 2030 Agenda. This paper analyses the impact of corporate governance (CG) and financial performance (FP) on SDG prioritisation, taking FP as a mediating variable and categorising the SDGs by the five pillars (5 Ps) commonly used for this purpose: People, Planet, Prosperity, Peace and Partnership. For this purpose, structural equations (PLS-SEM) were applied, using a sample of 312 Latin-American firms. The study results show there is a positive relationship between FP, CG and SDG prioritisation. Moreover, FP has a partial mediating role in the relationship between CG and SDG prioritisation. This study is innovative in the context of emerging Latin American economies and suggests paths for future research on this topic that would be of interest to academics, regulators and industry professionals. This paper highlights the important role of CG in helping achieve the objectives of the 2030 Agenda in Latin America. Furthermore, the study has implications for policymakers, showing that CG may enhance companies' FP and their commitment to the SDGs. Accordingly, regulators should establish minimum requirements for all companies regarding the structure and practices of CG. The study findings also have implications for stakeholders and responsible investors, suggesting that companies' level of sustainable development can be assessed via their CG policies.

11.
Int J Health Plann Manage ; 39(4): 1097-1112, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38373041

RESUMO

This paper describes and compares the integration of cross-sector actors' participation into the governance of two local health councils, one located in Salvador de Bahia (Brazil) and the other in the Canary Islands (Spain). Based on the cross-national comparative research conducted as part of a doctoral thesis, a qualitative design based on secondary data analysis was proposed on the three stages of the organisational integration process of participation. We used information from individual semi-structured interviews (n = 70), situational observation, focus groups, literature review, and field notes to understand participatory processes of networking between multiple cross-sector actors and to show how such processes might be associated with innovative practices. For these innovations to be successfully implemented, stakeholders need to acquire adequate competencies in cross-sector collaboration, enabling them to learn about new organisational practices and to adapt the network of actors to the often unpredictable influences of contextual factors.


Assuntos
Grupos Focais , Espanha , Brasil , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Governo Local , Atenção à Saúde/organização & administração , Participação dos Interessados
12.
Med Anthropol ; 43(1): 61-73, 2024 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-37921688

RESUMO

Drawing on sources relating to the Brazilian scenario - from ethnographic research in lower-income neighorhoods to the analysis of official documents and public debates - we build on cases of forced child removals to explore the intersectional dynamics of class, race, and gender that underlie institutionalized practices of discrimination against poverty-stricken families. After first addressing the influence of recent global trends in child-protection policy, we observe how adoption procedures in Brazil have been increasingly facilitated by the resignification of rights and corresponding changes in the country's legal infrastructures. Next, asking what sort of authoritative knowledge is invoked to define a child's best interests, we reflect on the role played by biomedicine in appraising the limits of acceptable parenthood. Guided by the notion of stratified reproduction, our investigation of these political, scientific, and moral technologies suggests plausible connections between policies that condition the demand for and the supply of adoptable children.


Assuntos
Pobreza , Reprodução , Humanos , Brasil , Antropologia Médica
13.
Sci Total Environ ; 914: 169651, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38159766

RESUMO

Central Chile is undergoing its most severe drought since 2010, affecting ecosystems, water supply, agriculture, and industrial uses. The government's short-term measures, such as increasing groundwater extraction (by 383 % from 1997 to 2022), are exacerbating the situation, leading to long-term hydrological deterioration. The objective of this research is to establish the main processes driving the water table depth evolution within Central Chile over the period 1979-2023. This is done by conducting groundwater balances on five major hydrological basins of Central Chile. For the Megadrought (MD) period (2010-2022), the groundwater level depths reflect not only the recharge variability but, especially, the forcing trend of groundwater withdrawals: they represent 35 % and 65 %, respectively, of the total phreatic level drawdown. This result underlines the dominant role played by groundwater withdrawals in the current delicate state of Central Chile's groundwater resources, while revealing that drought is a new complex phenomenon to deal with, in the midterm, to revert the current water resource trend in Central Chile. Our study moreover presents the impact of climate change in the basin in the framework of six different groundwater withdrawal scenarios. In the worst case (i.e., RCP8.5), the aquifer recharge decreases 18 % with respect to 1979-1997, which is the period assumed to be unaffected by the impact of MD and withdrawals. Such a reduction may be irrelevant in the dynamics of the aquifer system if the current extraction rate does not change. The estimated recovery time needed to reach aquifer conditions equal to those of the unaffected period is approximately 50 years.

14.
Disasters ; 48(3): e12618, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38102735

RESUMO

This study explores the impacts of armed conflict on women's sexual and reproductive health in Colombia, building on a reproductive justice perspective to analyse original interviews with stakeholders in healthcare, women's rights, and peacebuilding. The analysis reveals that war affects women's sexual and reproductive health in three ways, through violent politicisation, collateral damage, and intersectional dimensions. First, multiple armed actors have used women's health as an instrument in politically motivated strategies to increase their power, assigning political meaning to sexuality and reproduction within the context of war. Second, women's health has also suffered from secondary damage of conflict resulting from a decay in healthcare service provision and an unmet need for healthcare services among those affected by sexual and reproductive violence. Third, marginalised women have been particularly affected by a discriminatory nexus of poverty, ethnicity, and geographic inequality. The paper concludes with a reflection on the opportunities for reproductive justice in Colombia.


Assuntos
Conflitos Armados , Justiça Social , Humanos , Colômbia , Feminino , Saúde Reprodutiva , Direitos da Mulher , Política , Saúde da Mulher
15.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, CUMED | ID: biblio-1569825

RESUMO

Introducción: La búsqueda continua de la mejora de la atención de enfermería conlleva la aplicación de instrumentos contemporáneos. Objetivo: Identificar buenas prácticas para la mejora de procesos relacionados con la calidad de la atención de enfermería en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Métodos: Se realizó un proyecto de desarrollo tecnológico, descriptivo, que empleó las tecnologías gerenciales de referenciación competitiva y gestión por procesos entre el 2018-2021. La institución de referencia fue la Clínica Central "Cira García". El grupo de estudio quedó conformado por personal vinculado a los procesos. Para la recolección de la información se diseñaron 10 instrumentos que se validaron con expertos por el método de Barraza. El estudio de los procesos de urgencias, esterilización y hospitalización se realizó en dos momentos: en el "Ramón Pando Ferrer" con el empleo de la metodología Lean y en la institución de referencia para conocer las buenas prácticas. Para el procesamiento de la información se utilizó la metodología planteada por Rodríguez y de Souza, para ello se tuvo en cuenta el referencial teórico del enfoque Lean y el de la referenciación competitiva. Resultados: Se identificaron mudas como espera, movimiento, sobreprocesamiento y defecto, se confeccionaron los diagramas de flujo y se identificaron indicadores de calidad. Conclusión: El procedimiento utilizado mostró resultados satisfactorios que evidencian la aplicabilidad de la integración de tecnologías en la identificación e incorporación de buenas prácticas(AU)


Introduction: The continuous search for the improvement of nursing care leads to the application of contemporary instruments. Objective: To identify good practices for the improvement of processes related to the quality of nursing care at Instituto Cubano de Oftalmología Ramón Pando Ferrer. Methods: A descriptive technological development project was carried out between 2018-2021, using the managerial technologies of competitive benchmarking and process management. The reference institution was Clínica Central Cira García. The study group was made up of personnel involved in the processes. For the collection of information, 10 instruments were designed and validated with experts by the Barraza method. The study of the emergency, sterilization and hospitalization processes was carried out in two stages: at the Ramón Pando Ferrer institution, with the use of the Lean methodology; and at the reference institution, to learn about good practices. The methodology proposed by Rodriguez and de Souza was used to process the information; also taking into account the theoretical referential of the Lean approach and that of competitive benchmarking. Results: Shortfalls were identified, such as waiting, movement, overprocessing and defect. Flow charts were drawn up and quality indicators were identified. Conclusion: The used procedure showed satisfactory results that demonstrate the applicability of integrating technologies in the identification and incorporation of good practices(AU)


Assuntos
Humanos , Qualidade da Assistência à Saúde , Benchmarking , Cuidados de Enfermagem , Desenvolvimento Tecnológico , Metodologia como Assunto
16.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, CUMED | ID: biblio-1569822

RESUMO

Introducción: El liderazgo en Enfermería constituye una competencia fundamental en quienes ejercen un cargo, que va más allá de conducir pequeños grupos de trabajo hasta niveles directivos en la toma de decisiones dentro de la organización, para la mejor atención de las personas. Objetivo: Sintetizar el estado del ejercicio del liderazgo en Enfermería para la gestión de los cuidados en los establecimientos de salud. Métodos: Se realizó una revisión de alcance de artículos publicados del 2013 al 2021 en las bases de datos LILACS, SciELO, PubMed, Dialnet y REDALYC. En la estrategia de búsqueda se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) mediante el uso de los descriptores DeCS y MeSH y los operadores booleanos AND y OR. Se revisaron 665 artículos originales disponibles en inglés, español, alemán y portugués y se excluyeron trabajos sin acceso a texto completo, literatura gris y publicaciones antes del 2013; se seleccionaron 19. Conclusiones: Se destaca la importancia del liderazgo en las gestoras de Enfermería, reconocido por el equipo de salud, con gran impacto en los usuarios internos y externos. Se evidenciaron tres tendencias de liderazgo en Enfermería: el liderazgo transformacional, el liderazgo democrático y el autocrático(AU)


Introduction: Leadership in nursing is a fundamental competence in those who work in an organizational position, gonging beyond leading small work groups up to managerial levels in decision making within the organization, for the best care of people. Objective: To synthesize the state of leadership work in nursing for the management of care in health facilities. Methods: A scoping review was carried out of articles published from 2013 to 2021 in the LILACS, SciELO, PubMed, Dialnet and REDALYC databases. The search strategy used the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flowchart, together with the DeCS and MeSH descriptors, as well as the Boolean operators AND and OR. An amount of 665 original articles were reviewed, as they were available in English, Spanish, German and Portuguese; while exclusions per se included works without full-text access, gray literature, and publications before 2013. Of that total, 19 were selected. Conclusions: The importance of leadership in nursing managers is highlighted, as recognized by the health team, with great impact on internal and external users. Three nursing leadership trends were evidenced: transformational leadership, democratic leadership and autocratic leadership(AU)


Assuntos
Humanos , Instalações de Saúde , Liderança , Publicações , Pessoal de Operação , Tomada de Decisões
17.
São Paulo med. j ; São Paulo med. j;142(4): e2023078, 2024. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1551075

RESUMO

ABSTRACT BACKGROUND: Viral hepatitis is a major public health concern worldwide. OBJECTIVES: This study aimed to analyze the factors that facilitate access to care for viral hepatitis. DESIGN AND SETTING: Using a sequential mixed method, this evaluation research was conducted in the state of Mato Grosso, Brazil. METHODS: Mapping of references and selection of regions were made based on the quantity and heterogeneity of services. The stakeholders, including the managers of the State Department of Health and professionals from reference services, were identified. Nine semi-structured interviews were conducted using content analysis and discussions guided by the dimensions of the analysis model of universal access to health services. RESULTS: In the political dimension, decentralizing services and adhering to the Intermunicipal Health Consortium are highly encouraged. In the economic-social dimension, a commitment exists to allocate public funds for the expansion of referral services and subsidies to support users in their travel for appointments, medications, and examinations. In the organizational dimension, the availability of inputs for testing, definition of user flow, ease of scheduling appointments, coordination by primary care in testing, collaboration following the guidelines and protocols, and engagement in extramural activities are guaranteed. In the technical dimension, professionals actively commit to the service and offer different opening hours, guarantee the presence of an infectious physician, expand training opportunities, and establish intersectoral partnerships. In the symbolic dimension, professionals actively listen to the experiences of users throughout their care trajectory and demonstrate empathy. CONCLUSIONS: The results are crucial for improving comprehensiveness, but necessitate managerial efforts to enhance regional governance.

18.
Cad. Saúde Pública (Online) ; 40(4): e00182323, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1557398

RESUMO

Abstract: The HIV/AIDS epidemic remains a persistent and real issue, especially in key populations such as men who have sex with men (MSM), travestis and transgender persons. Projects for expanding rapid HIV testing are strategic initiatives aimed at the earliest possible identification of individuals' serological status and thus early treatment, screening of sex partners, and upscaling of preventive actions to interrupt the transmission chain. This study thus maps, describes, and systematizes the projects for expanding rapid HIV testing implemented from 2004 to 2021 in Brazil, highlighting the on-going contribution of civil society organizations and discussing the interoperability and cooperation resulting from public governance processes. We selected 67 documents for analysis, including 30 scientific publications retrieved from electronic databases and 37 documents produced by government institutions and nongovernmental organizations (NGOs). Find Out (Fique Sabendo), I Want to Get Tested (Quero Fazer), The Time is Now (A Hora É Agora), Live Better Knowing (Viva Melhor Sabendo), and Live Better Knowing Young (Viva Melhor Sabendo Jovem) were the projects mapped. Results show that the projects have used strategies adapted to the key population, such as mobile testing units, peer education, and innovative community engagement approaches. Such actions were enabled by effective cooperation and interoperability between participating stakeholders, especially NGOs.


Resumo: A epidemia de HIV/aids está longe de terminar. Ainda é muito real, especialmente em populações-chave, como homens que fazem sexo com homens (HSH), travestis e pessoas transgênero. Projetos de ampliação da testagem rápida anti-HIV são iniciativas estratégicas que visam à identificação mais precoce possível do status sorológico dos indivíduos e, consequentemente, ao tratamento precoce, à triagem de parceiros sexuais e à ampliação das ações preventivas para interrupção da cadeia de transmissão. Assim, este estudo se propõe a mapear, descrever e sistematizar os projetos de expansão da testagem rápida para HIV realizados de 2004 a 2021 no Brasil, destacando a contribuição em curso das organizações da sociedade civil e discutindo a interoperabilidade e a cooperação resultantes dos processos de governança pública. Foram selecionados 67 documentos para análise, incluindo 30 publicações científicas recuperadas de bases de dados eletrônicas e 37 documentos produzidos por instituições governamentais e organizações não governamentais (ONGs). Os projetos mapeados foram: Fique Sabendo, Quero Fazer, A Hora É Agora, Viva Melhor Sabendo e Viva Melhor Sabendo Jovem. Os resultados mostram que os projetos utilizaram estratégias adaptadas à população-chave, como unidades móveis de testagem, educação entre pares e abordagens inovadoras de engajamento comunitário. Tais ações foram possíveis graças à cooperação e interoperabilidade efetivas entre as partes interessadas participantes, especialmente as ONGs.


Resumen: La epidemia de VIH/SIDS está lejos de terminar. Sigue siendo muy real, sobre todo en poblaciones clave, como hombres que tienen sexo con hombres (HSH), travestís y personas transgénero. Proyectos para ampliar las pruebas rápidas anti-VIH son iniciativas estratégicas que tienen el objetivo de identificar el estado serológico de las personas lo antes posible y, consiguientemente, hacer el tratamiento precoz, el triaje de las parejas sexuales y ampliar las acciones preventivas para interrumpir la cadena de transmisión. Así, este estudio tiene el objetivo de mapear, describir y sistematizar los proyectos de expansión de las pruebas rápidas del VIH realizados entre 2004 y 2021 en Brasil, resaltando la contribución en curso de los organismos de la sociedad civil y discutiendo la interoperabilidad y la cooperación que resultan de los procesos de gobernanza pública. Se seleccionaron 67 documentos para el análisis, entre ellos 30 publicaciones científicas recuperadas de bases de datos electrónicas y 37 documentos producidos por instituciones gubernamentales y organizaciones no gubernamentales (ONGs). Los proyectos mapeados fueron: Para que Sepas (Fique Sabendo), Quiero Hacer (Quero Fazer), La Hora Es Ahora (A Hora É Agora), Viva Mejor Sabiendo (Viva Melhor Sabendo) y Viva Mejor Sabiendo Joven (Viva Melhor Sabendo Jovem). Los resultados demuestran que los proyectos utilizaron estrategias adaptadas a la población clave, como las unidades móviles de prueba, educación entre pares y enfoques innovadores de participación comunitaria. Estas acciones fueron posibles gracias a la cooperación e interoperabilidad efectivas entre las partes interesadas participantes, sobre todo las ONGs.

19.
Ciênc. Saúde Colet. (Impr.) ; Ciênc. Saúde Colet. (Impr.);29(5): e12882022, 2024. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1557497

RESUMO

Resumo O Projeto ArticulaFito realizou um amplo diagnóstico da base produtiva de espécies vegetais com valor medicinal, cosmético e alimentar, mapeando 26 cadeias de valor (CdV) de povos e comunidades tradicionais e de agricultores familiares (PCTAFs). O objetivo é definir critérios para priorização de ações de fortalecimento das CdV mapeadas, tendo como referência os desafios e oportunidades identificados. As metodologias de análise envoltória de dados e diagrama de Pareto foram aplicadas em dados quantitativos extraídos de cada mapa de CdV. Dessa forma, o conjunto de CdV foi dividido em quatro grupos de níveis de desempenho. Para cada grupo foi traçado um diagrama de ação que ordenou as ocorrências e suas origens, permitindo relacionar e indicar, em ordem de prioridade, as instituições e os atores a serem considerados no processo de fortalecimento. O grupo com o melhor desempenho apresentou dez espécies, sendo 70% no segmento cosmético, no bioma Amazônia e na região norte, 80% nativas sob regime de extrativismo e 20% exóticas sob regime de cultivo. O diagrama de ação gerado priorizou as ações e os investimentos, otimizando os recursos públicos aplicados para a inclusão produtiva dos PCTAFs por meio do uso sustentável da sociobiodiversidade.


Abstract The ArticulaFito Project conducted a broad analysis of the production base of plants with medicinal, cosmetic, and food value, mapping 26 value chains (CdV) of traditional peoples and communities and family farmers (PCTAFs). The objective is to define criteria to prioritize actions in order to strengthen the mapped CdV, maintaining the identified challenges and opportunities as a reference. Data Envelopment Analysis and Pareto Diagram methodologies were applied to quantitative data extracted from each CdV map. In this way, the CdV set was divided into four groups of performance levels. For each group, an action diagram was drawn, which, ordered the occurrences and their origins, enabling the reporting and indication, in order of priority, of the institutions and actors to be considered in the strengthening process. The group with the best performance had ten species, 70% in the cosmetic segment, in the Amazon biome, and in the northern region, with 80% native under an extractive regime and 20% exotic under a cultivation regime. The Action Diagram generated prioritized actions and investments, optimizing public resources in the productive inclusion of PCTAFs for the sustainable use of (socio) biodiversity.

20.
J. Phys. Educ. (Maringá) ; 35: e3504, 2024. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1558218

RESUMO

RESUMO Este artigo objetivou analisar o panorama dos esportes ginásticos olímpicos nos municípios paranaenses. Metodologicamente, seguiu-se os critérios da análise descritiva com coleta de dados realizada em três etapas distintas: 1) coleta de registros sobre a oferta das modalidades gímnicas no instrumento de pesquisa GEEM, do Instituto de Pesquisa Inteligência Esportiva; 2) consulta a documentos e notícias nos portais oficiais da Secretaria de Esporte do Paraná e Federação Paranaense de Ginástica; e 3) cruzamento dos dados levantados. Conclui-se que há ênfase na oferta de Ginástica Artística Feminina e Ginástica Rítmica, sem fomento à Ginástica de Trampolim - especialmente nos Jogos oficiais do Estado -, sendo que 16% dos municípios paranaenses incentivam ao menos uma das práticas gímnicas competitivas, seja na Formação Esportiva, Excelência Esportiva ou Esporte para a Vida Toda.


ABSTRACT This article aimed to analyze the panorama of Olympic gymnastics in municipalities of Paraná. Methodologically, the study followed the criteria of descriptive analysis with data collection conducted in three distinct stages: 1) gathering records on the provision of gymnastic modalities using the GEEM research tool from the Instituto de Pesquisa Inteligência Esportiva; 2) consulting documents and news on the official portals of the Sports Department of Paraná and the Paraná Gymnastics Federation; and 3) cross-referencing the collected data. It is concluded that there is an emphasis on the provision of Women's Artistic Gymnastics and Rhythmic Gymnastics, with little support for Trampoline Gymnastics - especially in official state games - as only 16% of municipalities in Paraná encourage at least one of the competitive gymnastic practices, whether in Sports Training, Sports Excellence, or Lifelong Sports.

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