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Background: There is a high burden of chronic diseases such as hypertension and diabetes in small island developing states (SIDS). SIDS governments have committed to a range of public health, healthcare, and fiscal measures to reduce this burden including community-based health education in collaboration with civil society organizations. We sought to explore perceived acceptability, appropriateness, and feasibility of implementing self-management health programs in 20 faith-based organizations in the small island developing state of Barbados. Methods: This was a concurrent mixed methods study - a quantitative online survey and a qualitative inquiry using semi-structured interviews. Acceptability, appropriateness and feasibility of the intervention were assessed using the following quantitative assessment tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM). Thirteen in-depth interviews were conducted virtually, recorded and transcribed verbatim. Transcripts were analyzed using thematic analysis based on deductive codes from Proctor's implementation outcomes definitions. Results: From the 52 respondents of the survey, the median and interquartile ranges for the AIM, IAM and FIM scales were 16 (15-20), 16 (16-20) and 16 (15-17) (out of 20), respectively. We found high levels of acceptability, 82% (95% CI (69%, 95%)) of leaders indicating that health programs in churches met with their approval; and high levels of appropriateness-90% (95% CI (80%, 100%)) indicating health programs in churches were "fitting" and "a good match". Feasibility scores were lower, with 60% (95% CI (44%, 76%)) indicating that health programs in churches would be easy to use. In interviews, leaders expressed acceptance of healthy lifestyle programs in churches and described their appropriateness through alignment with church doctrines stating, "the body is the temple of God". They felt that economic impacts from COVID-19 were likely to be a barrier to the success of programs. Leaders expressed the need for support from healthcare providers who are sensitive and respectful of church culture. Conclusion: We found that health-based programs in churches align well with church doctrines, but the success of these programs will depend on establishing trust through the engagement of church-based champions, tailoring programming to include a biblical perspective and engaging entire households.

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According to the self-determination theory (SDT), leaders may adopt a controlling motivational controlling style (CMS) that forces employees to think, feel, or behave in a certain way to promote employee motivation. However, a scale has yet to be developed to measure CMS in the work environment. Usually, researchers use questionnaires adapted to different contexts or designed for another motivational style. However, whether these questionnaires capture the behaviors that represent CMS in the work context is little known. This research aimed to elaborate on and analyze the validity and reliability of the questionnaire on Controlling Motivational Style at Work (CMS-W). The study was based on a literature review of the types of controlling behaviors and a review of questionnaires used by SDT researchers who assessed the controlling motivational style in different contexts. A Peruvian sample of 1100 public sector employees participated. The results show that the short and encompassing CMS-W-11 has a one-dimensional structure with good fit indices: Robust RMSEA = 0.071 with 90 % CI from 0.064 to 0.078; Robust CFI = 0.975; Robust TLI = 0.969; SRMR = 0.025 and good reliability coefficients: Ω = 0.930 and AVE 0.630. Furthermore, it shows convergent validity with controlled motivation (r = 0.260, p < .001) and discriminant validity with autonomous motivation (r = -0.270, p < .001). Moreover, the invariance of the gender category was tested. The fit indices were adequate, and the comparative results between the models were also satisfactory. In addition, the behaviors of the CMS in a work context are conditional negative regard, judging and devaluing, control through objectives, intimidation, and intrusive authority. Therefore, labor organizations will have the CMS-W validated and tested in a work context to evaluate the CMS of leaders and study how it related to the motivation of human capital and organizational objectives.

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Background: In recent years, pharmaceutical professionalism has been questioned due to the social role of pharmacy, which is ambiguous in the literature. This raises questions about the purpose of the profession among pharmacists, despite the efforts of their professional organizations and formal leaders to consolidate the occupational status of the profession. Objective: To understand the social role of pharmacy in Brazil through its historical evolution based on the perceptions of formal leaders of the profession. Methods: A qualitative study was conducted between July 2020 and February 2021 with pharmacists who held leadership positions in formal and professional pharmacy organizations in Brazil. The data obtained from the interviews were submitted to content analysis. Results: A total of 17 pharmacists participated in this study. The data analyzed presented perceptions about the social role of the pharmaceutical profession in Brazil, which promotes access to health through different means. These include the manager pharmacist, who facilitates access to public health policies; the caring pharmacist, who promotes health education and the rational use of medicines; and the technologist pharmacist, who researches, develops, and promotes access to safe and cost-effective medicines. The interviewees also discussed the evolution of this social role based on influential factors such as legislation, clinical movement, pharmaceutical education, labor market, behaviors, and attitudes of pharmacists. Conclusion: In this study, pharmaceutical professionalism was conceptualized based on its social role, which should be centered on the patient. Understanding such issues is part of the evolutionary purpose of the profession in Brazil and should be encouraged in the behaviors and attitudes of pharmacists despite the challenges faced by the profession.

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Approaches to safety culture assessment may have many limits if supported exclusively by quantitative methods. Based on this, a research team developed a quantitative-qualitative approach to assess the maturity of the safety culture on an oil platform. To that end, the team sought to develop and test a method consisting of an initial ethnographic phase followed by four other distinct phases: definition of homogeneous groups; production of customized questionnaires; quantitative evaluation; and qualitative assessment. The results show the emergence of trends, from pre-defined themes in safety culture to specific levels of maturity for each of the homogeneous groups. At the same time, it was perceived that the maturity level of the groups is defined from the daily work practices developed by each one of them. This experience allowed us to propose a framework for assessing the maturity levels of safety culture for the oil and gas industry.

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Resumo Introdução: processos de alto risco com elevadas taxas de acidentes desafiam a segurança. Por outro lado, sistemas ultrasseguros conquistaram ótimos indicadores. Em ambos, a prevenção parece ter chegado a um limite - em um deles, porque parece impotente para gerar prevenção; no outro, porque foi tão bem-sucedida que parece impossível avançar. Objetivo: evidenciar a contribuição da Ergonomia em prol da segurança, nas situações descritas, suas possibilidades ainda por explorar, entre elas a Ergonomia de concepção na integração homem-máquina (sistemas informatizados). Método: análise comparativa dos achados oriundos de estudos ergonômicos em sistemas de produção com altas taxas de acidentes e sistemas ultrasseguros. Discussão: a análise da atividade dos motofretistas mostrou que existem alternativas de ação ainda não exploradas entre as relações de trabalho desfavoráveis e a percepção de inevitabilidade dos acidentes. Nos sistemas ultrasseguros, o aparente limite pode ser superado com os avanços recentes na análise da ação e cognição situadas e na construção de espaços de debate que permitam o retorno da experiência de campo. Em sistemas informatizados, as práticas de projeto colaborativo, que se valem da experiência dos trabalhadores para alimentar as dinâmicas de aprendizagem e a confiabilidade técnica, são possibilidades ainda pouco praticadas na Engenharia de Segurança.

Abstract Introduction: while high-risk processes with high accident rates challenge safety, High Reliability Organization (HRO) achieve excellent indicators. In both cases, prevention seems to have reached a limit. In the former, because it seems powerless to generate prevention; in the latter, because it has been so successful that it seems impossible to reach greater levels. Objective: to highlight the contribution of Ergonomics to safety in these situations, pointing out unexplored possibilities such as design Ergonomics in man-machine integration (computerized systems). Method: comparative analysis of findings from ergonomic studies on production systems with high accident rates and HRO. Discussion: analysis of the motorcycle freight drivers' activity revealed alternatives yet to be explored between unfavorable work relations and the perceived inevitability of accidents. The apparent limit of HRO can be overcome with recent advances in the analysis of situated action and cognition and by building debate spaces based on field experience. Collaborative design practices, which draw on worker experience to feed learning dynamics and technical reliability, remains a poorly explored possibility in Safety Engineering when it comes to computerized systems.

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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.

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Resumo: Este estudo teve como objetivo descrever um inquérito quantitativo realizado com lideranças para investigar ações efetivas, viáveis e que podem ser testadas em modelos computacionais para informar políticas de promoção da mobilidade ativa, tendo como base a cidade de São Paulo, Brasil. Em 2022, foi realizado um inquérito online no contexto da pesquisa de Atividade Física e Ambiente do Inquérito de Saúde de São Paulo, acompanhada por representantes de organizações não governamentais, gestores públicos e de entidades privadas. Foi elaborado questionário com três perguntas com 13 alternativas de respostas sobre ações para promoção da caminhada ou uso de bicicleta. As lideranças deveriam selecionar até três alternativas a partir de seu potencial em termos de (1) efetividade; (2) viabilidade ou facilidade de implementação; e (3) desejo de realizar testes em modelos computacionais para informar políticas. O inquérito foi respondido por 18 lideranças de 16 instituições, sendo 13 (72%) mulheres e 12 (67%) representantes do terceiro setor, cuja média de idade era 48 anos, todos com nível superior de escolaridade. A redução da velocidade dos veículos motorizados foi a opção mais citada nas três questões. Outras ações citadas referem-se ao controle de circulação de veículos em regiões centrais, à segurança de pedestres, à diminuição das distâncias entre residências e locais de emprego, às campanhas educativas e à ampliação e melhoria de estruturas como ciclovias e calçadas. Os resultados são relevantes para apoiar a tomada de decisões baseadas em evidências na gestão pública e oferecer subsídios para a elaboração de modelos computacionais com vistas à promoção da mobilidade ativa.

Abstract: This study aimed to describe a quantitative survey conducted with leaders to investigate effective and feasible actions that can be evaluated in computational models to inform policies to promote active mobility based in the city of São Paulo, Brazil. In 2022, an online survey was conducted during the Health Survey in São Paulo (Physical Activity and Environment study), which is monitored by representatives of nongovernmental organizations and public and private sector managers. A questionnaire was elaborated with three questions with 13 alternative answers about actions to promote walking and/or cycling. Leaders should select up to three alternatives based on their potential regarding: (1) effectiveness; (2) feasibility or ease of implementation; and (3) desire to verify tests in computational models to inform policies. The survey was answered by 18 leaders from 16 institutions, comprising 13 (72%) women and 12 (67%) representatives of the third sector, whose average age was 48 years and all had complete higher education. Reducing the speed of motor vehicles was the most cited option in all three questions. Other actions mentioned refer to controlling the traffic of vehicles in central areas, improving pedestrian safety, reducing the distances between homes and places of employment, conducting educational campaigns, and expanding and enhancing structures such as bicycle lanes and sidewalks. The results are relevant to support evidence-based decision-making in public management and to provide subsidies for the development of computational models with a view to promoting active mobility.

Resumen: Este estudio tuvo como objetivo presentar una encuesta cuantitativa realizada con líderes para investigar las acciones efectivas, viables y que puedan probarse en modelos informáticos para orientar las políticas que promuevan la movilidad activa en la ciudad de São Paulo, Brasil. En 2022 se realizó una encuesta en línea en el contexto de la Encuesta de Salud de São Paulo (Actividad Física y Medio Ambiente), que es monitoreada por representantes de organizaciones no gubernamentales, gestores públicos y entidades privadas. Se elaboró un cuestionario de tres preguntas con 13 respuestas alternativas sobre acciones para promover la caminata o el uso de la bicicleta. Los líderes podían seleccionar hasta tres alternativas en función de su potencial en términos de (1) efectividad; (2) viabilidad o facilidad de implementación; y (3) deseo de verificar las pruebas en modelos informáticos para orientar las políticas. La encuesta fue respondida por 18 líderes de 16 instituciones; de los cuales 13 (72%) eran mujeres y 12 (67%) representaban el tercer sector; la edad promedio de ellos fue de 48 años y todos contaban con educación superior. Reducir la velocidad de los vehículos de motor fue la opción más citada en las tres preguntas. Otras acciones mencionadas se refieren al control de la circulación de vehículos en las regiones centrales, la seguridad de los peatones, la reducción de las distancias entre los hogares y los lugares de trabajo, las campañas educativas y la expansión y mejora de estructuras como carriles bici y aceras. Los resultados son relevantes para apoyar la toma de decisiones basada en la evidencia en la gestión pública y ofrecer subsidios para la elaboración de modelos computacionales destinados a promover la movilidad activa.

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La aplicación de las políticas públicas deportivas locales (PPDL) de la comuna de Linares se han visualizado gracias a la aplicación del Plan de Desarrollo Comunal de Actividad Física y Deportes (PDC AFyD) en el período 2018 - 2022 en la comunidad y las organizaciones deportivas locales (OODD), así como de funcionarios del propio municipio. Para conocer la percepción sobre la aplicación de PPDL se aplica una entrevista semiestructurada y confeccionada para tales efectos, a 28 dirigentes deportivos y 18 funcionarios municipales, de un universo muestral total de 127 posibles. Los individuos indican que, pese a ver cambios favorables en el período desconocen el proceso y, por ende, el mecanismo aplicado para el cambio, lo que despotencia la comprensión de la PPDL y el desarrollo de ésta por medio de las propias OODD y el municipio. La aplicación de las PPDL por medio de sus distintas herramientas e instrumentos requiere que se desarrolle bajo un proceso de consulta, pertinencia y complementación entre municipio, OODD, mundo educativo y vecinos beneficiarios; todo dentro de un marco de comunicación e información concreta y permanente que logre involucrar a todos los actores, brindando con ello una cuota de responsabilidad en su ejecución, control y evaluación.

The application of local public policies on sports (LPSP) of the commune of Linares has been visualized thanks to the application of the Communal Development Plan for Physical Activity and Sports (CDP PA&S) in the period 2018 - 2022 in the community and local sports organizations (LSO), as well as officials of the municipality itself. To know the perception of the implementation of LPSP, a semi-structured interview was applied to 28 sports leaders and 18 municipal officials out of a total sample universe of 127 possible. The individuals indicate that, despite seeing favorable changes in the period, they are unaware of the process and, therefore, the mechanism applied for change, which undermines the understanding of the LPSP and its development through the LSOO and the municipality. The application of the LPSP through its different tools and instruments requires that it be developed under a process of consultation, relevance, and complementarity between the municipality, LSOO, the educational world and beneficiary neighbors; all under a framework of communication and concrete and permanent information that manages to involve all the actors, thus providing a share of responsibility in its execution, control, and evaluation.

A implementação das políticas esportivas públicas locais (PEPL) na comuna de Linares foi visualizada graças à implementação do Plano de Desenvolvimento Comunitário para Atividade Física e Esporte (PDC AFyE) no período 2018 - 2022 na comunidade e organizações esportivas locais (OOEE), bem como funcionários do próprio município. Foi realizada uma entrevista semi-estruturada com 28 líderes esportivos e 18 funcionários municipais de um universo de amostra total de 127. Os indivíduos indicam que, apesar de verem mudanças favoráveis no período, não conhecem o processo e, portanto, o mecanismo aplicado para a mudança, o que prejudica a compreensão do PEPL e seu desenvolvimento através do OOEE e do próprio município. A implementação do PEPL através de suas diferentes ferramentas e instrumentos requer um processo de consulta, relevância e complementaridade entre o município, o OOEE, o mundo educacional e os vizinhos beneficiários; tudo isso dentro de uma estrutura de comunicação e informação concreta e permanente que envolva todos os atores, proporcionando assim uma parcela de responsabilidade em sua implementação, controle e avaliação.

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Introducción: El Régimen Subsidiado (RS) del sistema de salud colombiano tiene problemáticas estructurales que no han sido solucionadas y son pocos los estudios que profundizan en la explicación de estas. Objetivo: Explorar la experiencia en la dirección estratégica y gestión operativa y financiera de este régimen, sus aspectos operativos y de gestión del riesgo en esta población, así como las diferencias percibidas frente al Régimen Contributivo. Metodología: Estudio cualitativo. Se utilizó el análisis del discurso desde la perspectiva sociohermenéutica como técnica analítica. Se entrevistaron diez participantes, entre directivos de aseguradoras del RS y gestores del sistema de salud. Las entrevistas fueron grabadas y anonimizadas, previo consentimiento informado. Resultados: Emergen tres patrones discursivos que explican la gestión del riesgo en el RS y su diferenciación con el contributivo. Estos patrones se conectan por medio del rol de los determinantes sociales de la salud como ordenador principal de los procesos de salud-enfermedad y de atención en este régimen. A su vez, estas condiciones de vida son las que determinan de manera importante el perfil epidemiológico, acceso, costo de la atención y en general la forma cómo se consumen los servicios de salud por la población afiliada. Discusión: La literatura del aseguramiento en salud reporta que la gestión del riesgo es una función central y supone un ejercicio estratégico para el adecuado manejo de la siniestralidad para optimizar el uso de la Unidad de Pago por Capitación (UPC) asignada. Los hallazgos muestran que los determinantes sociales de la salud no están siendo tenidos en cuenta como ordenador para la atención, por lo tanto, la gestión del riesgo se centra en la atención de patologías en estados avanzados. Conclusiones: los actores perciben que en general, la situación de salud de los afiliados en este régimen es más grave, más complicada y con mayor carga, lo cual genera una tensión en materia de suficiencia de la unidad per cápita. Existe una ausencia discursiva sobre el rol del modelo de atención y su correlación con las necesidades de esta población.

Introduction: The subsidized regime (SR) of the Colombian health system has structural problems that have not yet been resolved and there is a lack of studies that allow the understanding of most of them. The aim of this study was to explore with stakeholders of the subsidized regime the experience about strategic, financial, and health risk management and the differences perceived with the contributory regime. Methods: A qualitative study was performed; the analytic technique used was the discourse analysis under socio-hermeneutic perspective. 10 participants were interviewed, among them directors of insurance companies of SR and health care system managers. The interviews were recorded, prior informed consent, and analyzed according to the discourse analysis. Finding: Three discursive patterns emerged that explain risk management in SR and its differentiation from contributory regime. These patterns are connected through the role of the social determinants of health as the main axis that explain the health-disease and care processes in this regimen. At the same time, these living conditions are what determine the epidemiological profile, access, cost of care and, in general, the way in which health services are consumed by the affiliated population. Discussion: The health insurance literature reports that risk management is a central function, and it is a strategic exercise for the proper management of claims to optimize the use of resources, however, the findings show that the social determinants of health are not being taken into account as a key element for healthcare organization, therefore, risk management focuses on care for pathologies in advanced stages. Conclusions: The actors perceive that the health situation in this regime is more severe, more complicated and with a greater burden disease, which generates a tension in terms of sufficiency of the Per Capita Unit. There is a discursive absence on the role of the care model and its correlation with the needs of this population.

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Objetivos: compreender os significados atribuídos por enfermeiros à economia da saúde; elencar os fatores que influenciam a construção desses significados; identificar, com base nos significados desvelados por enfermeiros, as ações-interações entre o gerenciamento do cuidado de enfermagem e a economia da saúde no contexto hospitalar; e construir uma matriz teórica fundamentada em dados, com base nos significados atribuídos por enfermeiros às relações entre gerenciamento do cuidado de enfermagem e economia da saúde no contexto hospitalar. Métodos: pesquisa de abordagem qualitativa, realizada em um hospital universitário, com 18 enfermeiros, cujos referenciais, teórico e metodológico foram, respectivamente, o Interacionismo Simbólico e a Teoria Fundamentada nos Dados. A análise dos dados seguiu as etapas de codificação: aberta, axial e integrativa. Os dados foram coletados e analisados após aprovação do estudo pelo Comitê de Ética em Pesquisa da Escola de Enfermagem Anna Nery ­ EEAN, sob CAAE de n.° 57073822.5.0000.5238, e, de igual modo, foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Universitário Clementino Fraga Filho, sob CAAE DE n.° 57073822.5.3001.5257. A análise dos dados resultou em quatro categorias, e onze subcategorias. Resultados: no âmbito da micropolítica, os enfermeiros compreendem as condições intervenientes relacionadas às conexões entre economia da saúde e o trabalho que exercem. Todavia, também, atribuem significados à macropolítica quando reconhecem a economia da saúde como elemento político que é regido por tomadores de decisões distanciados da enfermagem, mas que afetam diretamente o gerenciamento de recursos materiais e humanos da saúde. Ainda mais, estabelecem estratégias para a promoção da economia da saúde baseando-se no trabalho da enfermagem hospitalar, apresentam também, condições, ações-interações reveladoras da importância desses profissionais no gerenciamento de recursos, na elaboração de processos de trabalho eficientes e na redução de tempo de hospitalização dos pacientes com base no letramento em saúde. Estas, entre outras estratégias, destacam a importância da enfermagem para a economia da saúde. Considerações finais: os enfermeiros se reconhecem como força de trabalho estratégica para impulsionar a economia da saúde, e percebem interdependência entre o trabalho da enfermagem e economia da saúde, o que se faz importante para a própria valorização da enfermagem e fortalecimento dos sistemas de saúde.

Objectives: to understand the meanings attributed by nurses to health economics; to list the factors that influence the construction of these meanings; to identify, based on the meanings revealed by nurses, the actions and interactions between nursing care management and health economics in the hospital context; and to construct a theoretical matrix based on data, based on the meanings attributed by nurses to the relationships between nursing care management and health economics in the hospital context. Methods: This was a qualitative study carried out in a university hospital with 18 nurses, whose theoretical and methodological references were Symbolic Interactionism and Data-Based Theory, respectively. Data analysis followed the coding stages: open, axial and integrative. The data were collected and analyzed after the study was approved by the Research Ethics Committee of the Anna Nery School of Nursing - EEAN, under CAAE No. 57073822.5.0000.5238, and was also approved by the Research Ethics Committee of the Clementino Fraga Filho University Hospital, under CAAE No. 57073822.5.3001.5257. Data analysis resulted in four categories and eleven subcategories. Results: In the context of micro-politics, nurses understand the intervening conditions related to the connections between the health economy and the work they do. However, they also attribute meanings to macro-politics when they recognize the health economy as a political element that is governed by decision-makers far removed from nursing, but who directly affect the management of material and human health resources. What's more, they establish strategies for promoting the health economy based on the work of hospital nursing, and also present conditions, actions and interactions that reveal the importance of these professionals in managing resources, designing efficient work processes and reducing the length of time patients are hospitalized, based on health literacy. These, among other strategies, highlight the importance of nursing for the health economy. Final considerations: Nurses recognize themselves as a strategic workforce to boost the health economy and perceive an interdependence between nursing work and the health economy, which is important for valuing nursing and strengthening health systems.

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RESUMO A noção de equidade em saúde se manifesta nas sociedades modernas por meio de diferentes ideias e propostas operacionais. No que diz respeito às pessoas em situação de rua, a equidade dialoga com a igualdade e a justiça para mobilizar diversas aplicações na saúde: enquanto a concepção liberal de equidade em saúde busca favorecer as condições de saúde dessa população sem romper com o modo de produção vigente, a concepção crítica almeja ampliar as condições e as necessidades de saúde na luta por uma sociedade emancipada. Com o objetivo de caracterizar as concepções de equidade em saúde expressas na literatura científica sobre essa população, este estudo realizou uma revisão crítica dos artigos disponíveis em portais de busca on-line. 1.716 publicações foram identificadas na amostragem inicial e 35 artigos foram incluídos na revisão após aplicação de procedimentos metodológicos. Os artigos foram caracterizados com relação às ideias e aplicações da equidade em saúde para a população em situação de rua, discutindo-se a respeito de metodologia, justiça e igualdade, distinção entre as concepções, processo saúde-doença, políticas públicas e pandemia da Covid-19. Aponta-se para a dominância da concepção liberal na literatura sobre essa população e a necessidade de investigações a partir da concepção crítica.

ABSTRACT The notion of equity in health manifests itself in modern societies through different ideas and operational proposals. Concerning homeless persons, equity dialogues with equality and justice to mobilize several applications in health: while the liberal conception of equity in health seeks to favor the health conditions of this population without breaking with the current mode of production, the critical conception aims to expand health conditions and needs in the struggle for an emancipated society. With the aim of characterizing the conceptions of equity in health expressed in the scientific literature on this population, this study carried out a critical review of the articles available on online search portals databases. 1,716 publications were identified in the initial sample and 35 articles were included in the review after application of methodological procedures. The articles were characterized in relation to the ideas and applications of equity in health for the homeless population, discussing methodology, justice and equality, distinction between conceptions, health-disease process, public policies and the COVID-19 pandemic. It points to the dominance of the liberal conception in the literature on this population and the need for investigations from the critical conception.

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This study aims to analyze the impact of value creation and cocreation, as measured by the dialogue, access, risk assessment, and transparency (DART) model, on the performance of non-profit sports organizations (NPSOs). To assess this impact, the authors analyzed data collected from sports and administration managers of NPSOs, specifically Colombian amateur soccer clubs. The study used partial-least-squares structural-equation modeling (PLS-SEM) with constructs of the reflexive-formative type. The results indicate that value creation has a positive impact on the performance of NPSOs through the mediating effect of value cocreation. Despite the limitations of this study, including the limited research on the relationship between value creation and cocreation and NPSO performance in Colombia, the findings contribute to the understanding of the mediating effect of cocreation. The authors found that cocreation mainly affects the sport, customers/members, communication and image, finance, and organization dimensions of NPSOs in developing countries. This study draws attention to the potential benefits of cocreation for NPSOs and emphasizes the importance of creating value in this context. The study concludes that further studies on the constructs proposed in this research would help to understand the phenomenon of innovation and its impact on NPSOs. Overall, this study provides valuable insights for managers and policymakers in NPSOs-especially in developing countries-on the importance of value cocreation in improving their performance.

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PURPOSE: This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil. DESIGN/METHODOLOGY/APPROACH: Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture. FINDINGS: Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients. RESEARCH LIMITATIONS/IMPLICATIONS: All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents' profiles, demographic variables were not analyzed. PRACTICAL IMPLICATIONS: This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety. ORIGINALITY/VALUE: This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

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Esta dissertação tem como objeto de estudo a participação das Organizações Sociais no Sistema Único de Saúde (SUS), a partir do estudo de caso do Hospital Estadual da Mulher Heloneida Studart (HEMHS). Os objetivos gerais são contribuir para o entendimento da participação das Organizações Sociais no âmbito do SUS, com base na análise dos contratos de gestão em unidade de saúde pertencente à Secretaria de Estado de Saúde do Rio de Janeiro (SES-RJ) e na avaliação do desempenho da produção hospitalar dessa unidade no período de 2012 a 2022, e cooperar para o aperfeiçoamento dos processos de contratualização das unidades de saúde no âmbito da SES-RJ. São objetivos específicos: identificar e descrever os contratos de gestão do HEMHS no período de 2012 a 2022, comparar a evolução dos valores pagos nos contratos de gestão para operacionalização do HEMHS de 2012 a 2022, analisar a evolução da produção do HEMHS de 2012 a 2022 e o atingimento das metas pactuadas relacionadas aos indicadores quantitativos disponíveis nos contratos de gestão e sugerir ajustes nos contratos de gestão e nas formas de monitoramento e avaliação da SES-RJ, com base nas lições aprendidas. Para alcançar os objetivos propostos, foram utilizadas pesquisas documentais e bibliográficas. Na pesquisa bibliográfica, buscaram-se conhecimento e aprofundamento dos diferentes modelos de gestão dos serviços de saúde no Brasil, e mais especificamente no Estado do Rio de Janeiro, com o advento das Organizações Sociais no SUS. A pesquisa documental teve como fonte de dados os instrumentos normativos sobre Organizações Sociais no Brasil e no Estado do Rio de Janeiro, como leis, decretos e portarias, além dos contratos de gestão e relatórios de prestações de contas disponibilizados no sítio da SES-RJ. Os resultados da pesquisa demonstraram que, ao longo do período estudado, os recursos firmados em contratos tiveram pouca variação, bem como os recursos efetivamente pagos. As metas de produção obtidas demonstraram que alguns procedimentos tiveram resultados superiores ao contratado e outros procedimentos, resultados inferiores. Apesar da demanda pelos serviços no período de 2012 a 2022, os procedimentos de vídeo-histeroscopia, mamografia e mamografia guiada por ultrassonografia jamais alcançaram os resultados pactuados. A pesquisa também não conseguiu estabelecer uma relação direta entre o repasse de recurso e o alcance das metas contratuais. (AU)

This dissertation aims to study the participation of Social Organizations in the Unified Health System (SUS), based on the case study of the Heloneida Studart Women's State Hospital (HEMHS). The general objectives are to contribute to the understanding of the participation of Social Organizations within the scope of the SUS, based on the analysis of management contracts in a health unit belonging to the State Department of Health of Rio de Janeiro (SES-RJ) and the evaluation of the performance of this unit's hospital production from 2012 to 2022, and cooperate to improve the contracting processes of health units within the scope of SES-RJ. Specific objectives are: identify and describe HEMHS management contracts from 2012 to 2022, compare the evolution of amounts paid in management contracts for the operationalization of HEMHS from 2012 to 2022, analyze the evolution of HEMHS production from 2012 to 2022 and the achievement of agreed goals related to the quantitative indicators available in the management contracts and suggesting adjustments to the management contracts and the forms of monitoring and evaluation of SES-RJ, based on the lessons learned. To achieve the proposed objectives, documentary and bibliographical research was used. In the bibliographical research, we sought knowledge and deepening of the different management models of health services in Brazil, and more specifically in the State of Rio de Janeiro, with the advent of Social Organizations in the SUS. The documentary research had as its data source the normative instruments on Social Organizations in Brazil and the State of Rio de Janeiro, such as laws, decrees and ordinances, in addition to management contracts and accountability reports available on the SES-RJ website. The research results demonstrated that, throughout the period studied, the resources signed in contracts had little variation, as well as the resources actually paid. The production targets obtained demonstrated that some procedures had results superior to those contracted and other procedures had inferior results. Despite the demand for services from 2012 to 2022, video hysteroscopy, mammography and ultrasound-guided mammography procedures never achieved the agreed results. The research was also unable to establish a direct relationship between the transfer of resources and the achievement of contractual goals. (AU)

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Inspired by political philosophy, critical studies of border regimes often reduce human rights and relief work to some accomplice role in migratory control and surveillance. Drawing on ethnographic research on pro-migrant activism in Tijuana, a large city on Mexico's northern border, I contrast such critical literature on border policies with an anthropological approach to the study of organizations and bureaucracies. In particular, drawing attention to activists as providers of goods and services enables us to deal with activism as an ensemble of concrete actors, institutions, and practices. The contradictory directives to which providers are subject, faced with inevitable conflicts, shifting alliances, and overlapping structures, are apparent in cases of co-production of services through complex forms of coordination between local authorities, civil associations, and international organizations. Revealing the political dimensions of service delivery-not reducible to domination-these assemblages of modes of governance are frequently oriented to cope with migrants' immobility in cities like Tijuana, turned into places of indefinite delay by policies that extend the spaces of interception and expulsion to neighboring "transfer" countries.

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Digital Dependence is a person's persistent inability to regulate digital devices on which they have become highly dependent. Internet dependence has been described since the mid-1990s, and studies on this topic have intensified since 2010. This type of individual dependence has received considerable published literature, but it is new in the collective setting of organizations, offering the hypothesis that it can also be collective, given the impacts it can provide. Research has evolved geographically from three countries to 17 since the beginning of the last decade, with 7 new scales for digital dependence. There were 13 new revalidations of the Nomophobia Questionnaire (NMP-Q), with an increase from 1,000 to 13,000 volunteers. Geographical evolution and an increase in the number of scales and volunteers and their different profiles were described. New approaches reinforce evolution and its impacts on human behavior. This study provides historical insight into Digital Dependence and opens new prospects for research on the differences between nations and people, sexes, professionals, and the need for further research in organizations.

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Resumen En el ámbito laboral, algunas condiciones basadas en estereotipos sociales promueven la obstaculización para que una mujer trabajadora acceda a las mismas oportunidades de desarrollo profesional; por ello, el objetivo de este estudio fue crear y validar la Escala Techo de Cristal. Se realizó un estudio empírico instrumental con una muestra no probabilística de 203 mujeres mexicanas, que trabajaban durante la pandemia por COVID-19. El Análisis Factorial Exploratorio y Análisis Factorial Confirmatorio arrojaron valores de índice de ajuste aceptables (NFI = .832, TLI = .900, CFI = .918, y RMSEA = .62) y con un coeficiente de confiabilidad de α = .816. La escala quedó conformada por 15 reactivos en tres factores: Sobrecarga, Techo de Cristal y Balance Familia-Trabajo, siendo el modelo de tres factores la estructura idónea para medir el constructo. Los resultados brindan evidencia de que el instrumento cuenta con las propiedades psicométricas para ser utilizado en la población de estudio y con ello generar diagnósticos confiables que deriven en estrategias organizacionales para visibilizar y de ser posible erradicar este fenómeno.

Abstract In the workplace, some conditions based on social stereotypes hinder a working woman from accessing the same professional development opportunities as a male; therefore, the purpose of this research paper was to create and validate the Glass Ceiling Scale. An instrumental empirical study was carried out with a non-probabilistic sample of 203 Mexican women who worked during the Covid-19 pandemic. The Exploratory Factor Analysis and Confirmatory Factor Analysis yielded acceptable fit index values (NFI = .832, TLI = .900, CFI = .918, and RMSEA= .62) and with a reliability coefficient of α = .816. The scale was made up of 15 items in three factors: Overload, Glass Ceiling and Family-Work Balance, with the three-factor model being the ideal structure to measure the construct. Results show evidence that the scale has the due psychometric properties for use in the study population and thereby generate reliable diagnoses that lead to organizational strategies to make visible and eradicate this phenomenon.

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R E S U M E N En el campo de estudio de la gestión organizacional, la medición del desempeño es de gran relevancia, ya que mide la capacidad de las organizaciones para cumplir sus objetivos. De esta forma, las directivas de la empresa pueden analizar desde diferentes niveles su gestión en relación con los procesos, objetivos, recursos, estrategias y cultura. Sin embargo, las organizaciones deportivas cuentan con diferentes públicos de interés, así como diversos tipos de análisis de acuerdo con su estructura y comportamiento organizacional, lo cual genera disparidad en los procesos de verificación y control asociados a la medición del desempeño para el logro de los objetivos organizacionales. Es por esto por lo que se hace necesario generar conocimiento en esta área. Esta investigación tiene como objetivo identificar variables de medición del desempeño aplicables a las organizaciones deportivas, que contribuya al fortalecimiento de la toma de decisiones. La metodología utilizada fue una revisión sistemática de literatura, posteriormente un análisis a través del software NVivo. Como resultado principal, se encontró el hallazgo de siete principales variables de medición del desempeño aplicables a las organizaciones deportivas: la creatividad, la innovación, la productividad, la eficiencia, la eficacia, la competitividad y la rentabilidad.

In the field of study of organizational management, performance measurement is of great relevance, since it measures the capacity of organizations to meet their objectives. In this way company directors can analyze their management from different levels in relation to processes, objectives, resources, strategies and culture. However; sports organizations have different publics of interest, as well as various types of analysis according to their structure and organizational behavior; which generates disparity in the verification and control processes associated with performance measurement for the achievement of objectives. organizational goals. This is why it is necessary to generate knowledge in this area. This research aims to identify performance measurement variables applicable to sports organizations, which contributes to the strengthening of decision-making. The methodology used was a systematic literature review, followed by an analysis using the NVivo software. As a main result, the finding of seven main performance measurement variables applicable to sports organizations was found: creativity innovation, productivity, efficiency effectiveness, competitiveness and profitability.

No campo da gestão organizacional, a medição do desempenho é de grande relevância, pois mede a capacidade das organizações de atingir seus objetivos. Desta forma, a administração da empresa pode analisar sua gestão em diferentes níveis em relação a processos, objetivos, recursos, estratégias e cultura. Entretanto, as organizações esportivas têm diferentes públicos de interesse e diferentes tipos de análise de acordo com sua estrutura e comportamento organizacional, o que gera disparidade nos processos de verificação e controle associados à medição de desempenho para a realização dos objetivos organizacionais. É por isso que é necessário gerar conhecimento nesta área. Esta pesquisa visa identificar variáveis de medição de desempenho aplicáveis às organizações esportivas que contribuem para fortalecer a tomada de decisões. A metodologia utilizada foi uma revisão sistemática da literatura, seguida por uma análise utilizando o software NVivo. O principal resultado foi a descoberta de sete variáveis principais de medição de desempenho aplicáveis às organizações esportivas: criatividade, inovação, produtividade, eficiência, eficácia, competitividade e lucratividade.

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Brazil experienced some of the highest rates of COVID-19 globally. This was complicated by the fact that 35 million of its citizens have limited access to water, a primary resource necessary to stem the spread of infectious diseases. In many cases, civil society organizations (CSOs) stepped into this void left by responsible authorities. This paper explores how CSOs in Rio de Janeiro helped populations struggling with access to water, sanitation, and hygiene (WASH) during the pandemic, and what coping strategies are transferable to similar contexts. In-depth interviews (n = 15) were conducted with CSO representatives in the metropolitan region of Rio de Janeiro. Thematic analysis of the interviews revealed that COVID-19 exacerbated pre-existing social inequities among vulnerable populations, undermining their ability to protect their health. CSOs provided emergency relief aid but faced the counterproductive actions of public authorities who promoted a narrative that diminished the risks of COVID-19 and the importance of non-pharmacological interventions. CSOs fought this narrative by promoting sensitization among vulnerable populations and partnering with other stakeholders in networks of solidarity, playing a vital role in the distribution of health-promoting services. These strategies are transferrable to other contexts where state narratives oppose public health understandings, particularly for extremely vulnerable populations.

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A vivência num caminho de empregado de 'chão de fábrica' de grande empresa a gestor de uma pequena empresa, junto às teorias de comunicação, contribuíram para as reflexões acadêmicas no campo da comunicação organizacional do cientista e professor Rudimar Baldissera. Em entrevista à Reciis, o professor mobiliza termos frequentemente associados à comunicação e às organizações, tais como imagem-conceito, identidade e públicos, e problematiza o prisma das decisões e dos objetivos da gestão em perspectiva da comunicação para a partilha, o diálogo, a ação/retroação e as perturbações geradas pelos diversos públicos que são constitutivos das organizações. Por meio de reflexões a partir do paradigma da complexidade, Baldissera discorre sobre o 'tecer' e 'retecer'da imagem das instituições de saúde, da ciência, das universidades públicas e do SUS, no contexto contemporâneo marcado pela emergência sanitária da covid-19. Destaca a comunicação organizacional como um campo consolidado na construção da crítica e do conhecimento na área da comunicação e informação. Rudimar Baldissera é professor associado do Departamento de Comunicação ­ Faculdade de Biblioteconomia e Comunicação (Fabico), e professor e pesquisador do PPGCOM/UFRGS

Along with communication theories, the experience acquired during the path from 'factory floor' employee to manager of a small business contributed to the academic reflections done by scientist and professor Rudimar Baldissera in the organizational communication field. In an interview to Reciis, the professor mobilizes terms frequently associated with communication and organizations, such as concept-image, identity and audience, and problematizes the prism of decisions and objectives of management in perspective of communication for sharing, dialogue, action/feedback and disturbances generated by the different publics that are constitutive of organizations. Through reflections from the paradigm of complexity, Baldissera discusses the 'weaving' and 'reweaving' of the image of health institutions, science, public universities and SUS, in the contemporary context marked by the health emergency of covid-19. He highlights organizational communication as a consolidated field in the construction of criticism and knowledge in communication and information field. Rudimar Baldissera is an associate professor at the Department of Communication ­ Faculty of Library Science and Communication (Fabico), and professor and researcher at PPGCOM/UFRGS

La experiencia en un camino de empleado en el 'piso de fábrica' de una gran empresa a gerente de una pequeña, junto con las teorías de la comunicación, contribuyó a las reflexiones académicas en el campo de la comunicación organizacional del científico y profesor Rudimar Baldissera. En entrevista con Reciis, el profesor moviliza términos frecuentemente asociados con la comunicación y las organizaciones, como ima-gen-concepto, identidad y públicos, y problematiza el prisma de las decisiones y objetivos de la gestión en la perspectiva de la comunicación para compartir, el diálogo, la acción/retroalimentación y las perturbaciones generadas por los diversos públicos que son constitutivos de las organizaciones. A través de reflexiones desde el paradigma de la complejidad, Baldissera discute el 'tejer' y 'retejer' de la imagen de las institucio-nes de salud, la ciencia, las universidades públicas y el SUS, en el contexto contemporáneo marcado por la emergencia sanitaria de la covid-19. Destaca la comunicación organizacional como un campo consolidado en la construcción de la crítica y el conocimiento en el campo de la comunicación y información. Rudimar Baldissera es profesor asociado del Departamento de Comunicación de la Facultad de Biblioteconomía y Comunicación (Fabico) y docente e investigador del PPGCOM/UFRGS

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