Iniciativas internacionais de segurança do paciente: contribuições para o refinamento dos sistemas de proteção

Trata-se da temática Segurança do Paciente, que teve como objeto as iniciativas sobre segurança do paciente estabelecidas por organizações internacionais de segurança. O objetivo proposto pelo estudo foi analisar tais iniciativas estabelecidas por organizações internacionais de segurança. Para compor este estudo identificaram-se as principais organizações de segurança, atarvés de uma revisão bibliográfica de literatura realizada com base em fontes eletrônicas primárias, considerando-se as organizações pioneiras na abordagem do tema Segurança do Paciente que fomentam prioritariamente a segurança do paciente e que divulgaram amplamente esta temática no período de 2002 a 2012. Foram encontradas na plataforma Google referências a mais de 100 instituições no mundo que abordam este tema. No entanto somente sete atenderam a todos os critérios de seleção, havendo predomínio de organizações americanas (seis). A organização mais antiga é o Centers for Disease Control and Prevention (1946), e a mais recente é a World Alliance for Patient Safety (2004). Quanto à natureza jurídica, duas são governamentais (CDC e AHRQ), quatro são não governamentais (The Joint Commission, IHI, WHO Alliance e ISMP) e uma organização independente (NCCMERP). Totalizaram-se 103 iniciativas de segurança do paciente no contexto hospitalar. A organização que mais publicou iniciativas para a segurança do paciente no contexto hospitalar foi o ISMP com 20 iniciativas, totalizando 19% das iniciativas exploradas. As iniciativas relacionadas à terapia medicamentosa, higienização das mãos, controle de infecções e cirurgias seguras foram as mais abordadas. Conclui-se que ao atentar para as iniciativas internacionais de Segurança do Paciente o profissional de saúde poderá contextualizar-se, aprimorando seu conhecimento técnico científico, além de pôr em prática o que as principais organizações mundiais voltadas para a Segurança do Paciente preconizam para a realização de um cuidado mais seguro.

Papel do Contador, Transparência e Accountability em Organizações não-Governamentais: um estudo de caso no Rio de Janeiro

A presente pesquisa teve como objetivo conhecer e avaliar a contribuição do profissional contábil nas organizações do Terceiro Setor, para transparência e accountability. Para verificar se a gestão da organização pertencente ao Terceiro Setor desempenha suas atividades de forma transparente e accountable, realizou-se uma pesquisa exploratóriodescritiva em uma organização pertencente a esse setor denominada Viva Rio, que encontra-se sediada na cidade do Rio de Janeiro, onde foram realizadas entrevistas semiestruturadas. Os resultados da pesquisa apontam que a Contabilidade pode contribuir muito para essas organizações, principalmente pelo fato de essas entidades, diferentemente das demais organizações do primeiro e segundo setores, precisarem prestar contas aos mais diversos públicos. A organização pesquisada utiliza informações não financeiras e financeiras como ferramenta de auxílio à transparência e accountability, e ainda, os registros contábeis são contabilizados por projetos e por financiadores, o que gera acurácia e tempestividade na disponibilidade dessas informações aos seus interessados.

Small-scale aquaculture for rural livelihoods: Proceedings of the Symposium on Small-scale aquaculture for increasing resilience of Rural Livelihoods in Nepal. 5-6 Feb 2009. Kathmandu, Nepal

Over the years, aquaculture has developed as one of the fastest growing food production sectors in Nepal. However, local fish supplies have been extremely inadequate to meet the ever increasing demand in the country. Nepal imports substantial quantities of fish and fish products from India, Bangladesh, Thailand, and elsewhere. Integration of pond aquaculture in existing crop-livestock-based farming system is believed to be effective in increasing local fish supply and diversifying livelihood options of a large number of small-holder farmers in southern plains (terai) and mid-hill valleys, thereby also increasing resilience of rural livelihoods. There is growing appreciation of the role of small-scale aquaculture in household food and nutrition security, income generation, and empowerment of women and marginalized communities. This book includes a total of 25 papers presented at the ‘Symposium on Small-scale Aquaculture for Increasing Resilience of Rural Livelihoods in Nepal’, held in Kathmandu on 5-6 February 2009. The papers cover technological, social, economic and environmental aspects of small-scale aquaculture development emerged from research and development initiatives of governmental, non-governmental and international research organizations in recent decad

Production and conservation of nutrient-rich small fish (SIS) in ponds and wetlands for nutrition security and livelihoods in South Asia: Proceedings of a World Bank/SAFANSI funded regional workshop on small fish and nutrition, Dhaka, Bangladesh, 1st - 2nd March 2014

Small indigenous fish species (SIS) are an important source of essential macro- and micronutrients that can play an important role in the elimination of malnutrition and micronutrient deficiencies in the populations of many South and Southeast Asian countries. Of the 260 freshwater fish species in Bangladesh, more than 140 are classified as SIS and are an integral part of the rural Bangladeshi diet. As many SIS are eaten whole, with organs and bones, they contain high amounts of vitamins and minerals, including calcium, and iron and zinc. Some SIS, such as mola, are also rich in vitamin A. SIS are often cooked with vegetables and a little oil, so they contribute to the food diversity of the rural poor.SIS are recognized as a major animal-source food group, contributing to improved food and nutrition security and livelihoods of the people of South and Southeast Asia. The purpose of this workshop is to bring together policy makers, extension agents, researchers, non-governmental and development organizations to share knowledge about small fish, their contribution to better nutrition, production technologies, and strategies for wider dissemination of pond culture and wetland based-production and conservation technologies. The workshop is expected to generate ideas for further research and development of sustainable technologies for production, management and conservation of SIS for the benefit of the people of Bangladesh as well as the South and Southeast Asian region.

The Humanitarian Responsibilities of Sovereignty

Wheeler, Nicholas. 'The Humanitarian Responsibilities of Sovereignty', In: Humanitarian Intervention and International Relations (Oxford: Oxford University Press, 2003), pp.29-51 RAE2008

An Institutional Approach to Donor Control: From Dyadic Ties to a Field‐Level Analysis

Literature on the nonprofit sector focuses on charities and their interactions with clients or governmental agencies; donors are studied less often. Studies on philanthropy do examine donors but tend to focus on microlevel factors to explain their behavior. This study, in contrast, draws on institutional theory to show that macrolevel factors affect donor behavior. It also extends the institutional framework by examining the field‐level configurations in which donors and fundraisers are embedded. Employing the case of workplace charity, this new model highlights how the composition of the organizational field structures fundraisers and donors alike, shaping fundraisers’ strategies of solicitation and, therefore, the extent of donor control.

Ocean Virtual Laboratory: A new way to explore multi-sensor synergy demonstrated over the Agulhas region

Ocean Virtual Laboratory is an ESA-funded project to prototype the concept of a single point of access for all satellite remote-sensing data with ancillary model output and in situ measurements for a given region. The idea is to provide easy access for the non-specialist to both data and state-of-the-art processing techniques and enable their easy analysis and display. The project, led by OceanDataLab, is being trialled in the region of the Agulhas Current, as it contains signals of strong contrast (due to very energetic upper ocean dynamics) and special SAR data acquisitions have been recorded there. The project also encourages the take up of Earth Observation data by developing training material to help those not in large scientific or governmental organizations make the best use of what data are available. The website for access is: http://ovl-project.oceandatalab.com/

Habitat for Humanity: Calibrating Best Practice Against the MDGs

Poverty alleviation lies at the heart of contemporary international initiatives on development. The key to development is the creation of an environment in which people can develop their potential, leading productive, creative lives in accordance with their needs, interests and faith. This entails, on the one hand, protecting the vulnerable from things that threaten their survival, such as inadequate nutrition, disease, conflict, natural disasters and the impact of climate change, thereby enhancing the poor’s capabilities to develop resilience in difficult conditions. On the other hand, it also requires a means of empowering the poor to act on their own behalf, as individuals and communities, to secure access to resources and the basic necessities of life such as water, food, shelter, sanitation, health and education. ‘Development’, from this perspective, seeks to address the sources of human insecurity, working towards ‘freedom from want, freedom from fear’ in ways that empower the vulnerable as agents of development (not passive recipients of benefaction).

Recognition of the magnitude of the problems confronted by the poor and failure of past interventions to tackle basic issues of human security led the United Nations (UN) in September 2000 to set out a range of ambitious, but clearly defined, development goals to be achieved by 2015. These are known as the Millennium Development Goals (MDGs). The intention of the UN was to mobilise multilateral international organisations, non-governmental organisations and the wider international community to focus attention on fulfilling earlier promises to combat global poverty. This international framework for development prioritises: the eradication of extreme poverty and hunger; achieving universal primary education; promoting gender equality and empowering women; reducing child mortality; improving maternal health; combating HIV/AIDS, malaria and other diseases; ensuring environmental sustainability; and developing a global partnership for development. These goals have been mapped onto specific targets (18 in total) against which outcomes of associated development initiatives can be measured and the international community held to account. If the world achieves the MDGs, more than 500 million people will be lifted out of poverty. However, the challenges the goals represent are formidable. Interim reports on the initiative indicate a need to scale-up efforts and accelerate progress.
Only MDG 7, Target 11 explicitly identifies shelter as a priority, identifying the need to secure ‘by 2020 a significant improvement in the lives of at least 100 million slum dwellers’. This raises a question over how Habitat for Humanity’s commitment to tackling poverty housing fits within this broader international framework designed to allievate global poverty. From an analysis of HFH case studies, this report argues that the processes by which Habitat for Humanity tackles poverty housing directly engages with the agenda set by the MDGs. This should not be regarded as a beneficial by-product of the delivery of decent, affordable shelter, but rather understood in terms of the ways in which Habitat for Humanity has translated its mission and values into a participatory model that empowers individuals and communities to address the interdependencies between inadequate shelter and other sources of human insecurity. What housing can deliver is as important as what housing itself is.

Examples of the ways in which Habitat for Humanity projects engage with the MDG framework include the incorporation of sustainable livelihoods strategies, up-grading of basic infrastructure and promotion of models of good governance. This includes housing projects that have also offered training to young people in skills used in the construction industry, microfinanced loans for women to start up their own home-based businesses, and the provision of food gardens. These play an important role in lifting families out of poverty and ensuring the sustainability of HFH projects. Studies of the impact of improved shelter and security of livelihood upon family life and the welfare of children evidence higher rates of participation in education, more time dedicated to study and greater individual achievement. Habitat for Humanity projects also typically incorporate measures to up-grade the provision of basic sanitation facilities and supplies of safe, potable drinking water. These measures not only directly help reduce mortality rates (e.g. diarrheal diseases account for around 2 million deaths annually in children under 5), but also, when delivered through HFH project-related ‘community funds’, empower the poor to mobilise community resources, develop local leadership capacities and even secure de facto security of tenure from government authorities.

In the process of translating its mission and values into practical measures, HFH has developed a range of innovative practices that deliver much more than housing alone. The organisation’s participatory model enables both direct beneficiaries and the wider community to tackle the insecurities they face, unlocking latent skills and enterprise, building sustainable livelihood capabilities. HFH plays an important role as a catalyst for change, delivering through the vehicle of housing the means to address the primary causes of poverty itself. Its contribution to wider development priorities deserves better recognition. In calibrating the success of HFH projects in terms of units completed or renovated alone, the significance of the process by which HFH realises these outcomes is often not sufficiently acknowledged, both within the organisation and externally. As the case studies developed in the report illustrate, the methodologies Habitat for Humanity employs to address the issue of poverty housing within the developing world, place the organisation at the centre of a global strategic agenda to address the root causes of poverty through community empowerment and the transformation of structures of governance.

Given this, the global network of HFH affiliates constitutes a unique organisational framework to faciliate sharing resources, ideas and practical experience across a diverse range of cultural, political and institutional environments. This said, it is apparent that work needs to be done to better to faciliate the pooling of experience and lessons learnt from across its affiliates. Much is to be gained from learning from less successful projects, sharing innovative practices, identifying strategic partnerships with donors, other NGOs and CBOs, and engaging with the international development community on how housing fits within a broader agenda to alleviate poverty and promote good governance.

Building bridging social capital in a divided society: The role of participatory citizenship education

Participatory citizenship education has been highlighted as a strategy to promote social cohesion in divided societies whereby collaborations with Non-Governmental Organisations and inter-school links have been proposed as tools to improve social networks between schools and communities. This article explores the role and meaning of citizenship education and cross-community participation in promoting social capital and social cohesion. School survey findings, focus groups and interviews with young people and educators indicated that differences between school sectors and established allegiances with particular communities and NGOs may limit the potential for citizenship education to produce bridging social capital and serve to reproduce bonding social capital. It is argued that the introduction of citizenship curricula into segregated schools systems in divided societies may be useful to promote citizenship values and positive attitudes to the other but insufficient to promote the development of bridging social capital and, ultimately, social cohesion in the long term.

The Oxford Handbook of Conflict Management in Organizations

New ways of managing conflict are increasingly important features of work and employment in organizations. In the book the world's leading scholars in the field examine a range of innovative alternative dispute resolution (ADR) practices, drawing on international research and scholarship and covering both case studies of major exemplars and developments in countries in different parts of the global economy. Developments in the management of individual and collective conflict at work are addressed, as are innovations in both unionized and non-union organizations and in the private and public sectors.

New practices for managing conflict in organizations are set in the context of trends in workplace conflict and perspectives on how conflict should be understood and addressed. Part 1 examines the changing context of conflict management by addressing the main frameworks for understanding conflict management, the trend in conflict at work, developments in employment rights, and the influence of HRM on conflict management. Part 2 covers the main approaches to conflict management in organizations, addressing both conventional and alternative approaches to conflict resolution. Conventional grievance handling and third-party processes in conflict resolution are examined as well as the main ADR practices, including conflict management in non-union firms, the role of the organizational ombudsman, mediation, interest-based bargaining, line and supervisory management, and the concept of conflict management systems. Part 3 presents case studies of exemplars and innovators in the field, covering mediation in the US postal service, interest-based bargaining at Kaiser-Permanente, 'med-arb' in the New Zealand Police, and judicial mediation in UK employment tribunals. Part 4 covers international developments in conflict management in Germany, Japan, The United States, Australia, New Zealand, the United Kingdom and China.

This Handbook gives a comprehensive overview of this growing field, which has seen an huge increase in programmes of study in university business and law schools and in executive education programmes.

Using creative problem solving (CPS) to improve leadership in a non-profit organization

The purpose of this study was to evaluate the effectiveness of the Creative Problem Solving (CPS) method in improving the leadership process in a non-profit organization. The research was designed around an intervention and structured in three stages (pre-consult, intervention and follow-up), with a team designated by management, in order to bring leadership cohesion to both departments of the organization and also between the board and executive management. The results, expressed in the tasks performed and in the interviews to team members, allowed us to conclude on the effectiveness of the CPS method to improve organizational leadership, by establishing a stronger relationship between departments, as well as, in the long term, between the board and executive management. These results highlight possible solutions to improve the leadership of non-profit organizations.

High expectation in non-evidence-based smoking cessation interventions among smokers--the CoLaus study.

To assess the preferred methods to quit smoking among current smokers. Cross-sectional, population-based study conducted in Lausanne between 2003 and 2006 including 988 current smokers. Preference was assessed by questionnaire. Evidence-based (EB) methods were nicotine replacement, bupropion, physician or group consultations; non-EB-based methods were acupuncture, hypnosis and autogenic training. EB methods were frequently (physician consultation: 48%, 95% confidence interval (45-51); nicotine replacement therapy: 35% (32-38)) or rarely (bupropion and group consultations: 13% (11-15)) preferred by the participants. Non-EB methods were preferred by a third (acupuncture: 33% (30-36)), a quarter (hypnosis: 26% (23-29)) or a seventh (autogenic training: 13% (11-15)) of responders. On multivariate analysis, women preferred both EB and non-EB methods more frequently than men (odds ratio and 95% confidence interval: 1.46 (1.10-1.93) and 2.26 (1.72-2.96) for any EB and non-EB method, respectively). Preference for non-EB methods was higher among highly educated participants, while no such relationship was found for EB methods. Many smokers are unaware of the full variety of methods to quit smoking. Better information regarding these methods is necessary.

Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial.

INTRODUCTION: In recent decades the treatment of non-specific low back pain has turned to active modalities, some of which were based on cognitive-behavioural principles. Non-randomised studies clearly favour functional multidisciplinary rehabilitation over outpatient physiotherapy. However, systematic reviews and meta-analysis provide contradictory evidence regarding the effects on return to work and functional status. The aim of the present randomised study was to compare long-term functional and work status after 3-week functional multidisciplinary rehabilitation or 18 supervised outpatient physiotherapy sessions. METHODS: 109 patients with non-specific low back pain were randomised to either a 3-week functional multidisciplinary rehabilitation programme, including physical and ergonomic training, psychological pain management, back school and information, or 18 sessions of active outpatient physiotherapy over 9 weeks. Primary outcomes were functional disability (Oswestry) and work status. Secondary outcomes were lifting capacity (Spinal Function Sort and PILE test), lumbar range-of-motion (modified-modified Schöber and fingertip-to-floor tests), trunk muscle endurance (Shirado and Biering-Sörensen tests) and aerobic capacity (modified Bruce test). RESULTS: Oswestry disability index was improved to a significantly greater extent after functional multidisciplinary rehabilitation compared to outpatient physiotherapy at follow-up of 9 weeks (P = 0.012), 9 months (P = 0.023) and 12 months (P = 0.011). Work status was significantly improved after functional multidisciplinary rehabilitation only (P = 0.012), resulting in a significant difference compared to outpatient physiotherapy at 12 months' follow-up (P = 0.012). Secondary outcome results were more contrasted. CONCLUSIONS: Functional multidisciplinary rehabilitation was better than outpatient physiotherapy in improving functional and work status. From an economic point of view, these results should be backed up by a cost-effectiveness study.

The evolutionary history of the CD209 (DC-SIGN) family in humans and non-human primates

The CD209 gene family that encodes C-type lectins in primates includes CD209 (DC-SIGN), CD209L (L-SIGN) and CD209L2. Understanding the evolution of these genes can help understand the duplication events generating this family, the process leading to the repeated neck region and identify protein domains under selective pressure. We compiled sequences from 14 primates representing 40 million years of evolution and from three non-primate mammal species. Phylogenetic analyses used Bayesian inference, and nucleotide substitutional patterns were assessed by codon-based maximum likelihood. Analyses suggest that CD209 genes emerged from a first duplication event in the common ancestor of anthropoids, yielding CD209L2 and an ancestral CD209 gene, which, in turn, duplicated in the common Old World primate ancestor, giving rise to CD209L and CD209. K(A)/K(S) values averaged over the entire tree were 0.43 (CD209), 0.52 (CD209L) and 0.35 (CD209L2), consistent with overall signatures of purifying selection. We also assessed the Toll-like receptor (TLR) gene family, which shares with CD209 genes a common profile of evolutionary constraint. The general feature of purifying selection of CD209 genes, despite an apparent redundancy (gene absence and gene loss), may reflect the need to faithfully recognize a multiplicity of pathogen motifs, commensals and a number of self-antigens

Pretargeted radioimmunotherapy using genetically engineered antibody-streptavidin fusion proteins for treatment of non-hodgkin lymphoma.

Purpose: Pretargeted radioimmunotherapy (PRIT) using streptavidin (SAv)-biotin technology can deliver higher therapeutic doses of radioactivity to tumors than conventional RIT. However, "endogenous" biotin can interfere with the effectiveness of this approach by blocking binding of radiolabeled biotin to SAv. We engineered a series of SAv FPs that downmodulate the affinity of SAv for biotin, while retaining high avidity for divalent DOTA-bis-biotin to circumvent this problem.Experimental Design: The single-chain variable region gene of the murine 1F5 anti-CD20 antibody was fused to the wild-type (WT) SAv gene and to mutant SAv genes, Y43A-SAv and S45A-SAv. FPs were expressed, purified, and compared in studies using athymic mice bearing Ramos lymphoma xenografts.Results: Biodistribution studies showed delivery of more radioactivity to tumors of mice pretargeted with mutant SAv FPs followed by (111)In-DOTA-bis-biotin [6.2 +/- 1.7% of the injected dose per gram (%ID/gm) of tumor 24 hours after Y43A-SAv FP and 5.6 +/- 2.2%ID/g with S45A-SAv FP] than in mice on normal diets pretargeted with WT-SAv FP (2.5 +/- 1.6%ID/g; P = 0.01). These superior biodistributions translated into superior antitumor efficacy in mice treated with mutant FPs and (90)Y-DOTA-bis-biotin [tumor volumes after 11 days: 237 +/- 66 mm(3) with Y43A-SAv, 543 +/- 320 mm(3) with S45A-SAv, 1129 +/- 322 mm(3) with WT-SAv, and 1435 +/- 212 mm(3) with control FP (P < 0.0001)].Conclusions: Genetically engineered mutant-SAv FPs and bis-biotin reagents provide an attractive alternative to current SAv-biotin PRIT methods in settings where endogenous biotin levels are high. Clin Cancer Res; 17(23); 7373-82. (C)2011 AACR.