Social and medical vulnerability factors of frequent users at the emergency department: a case-control study

BACKGROUND: Up to 5% of patients presenting to the emergency department (ED) four or more times within a 12 month period represent 21% of total ED visits. In this study we sought to characterize social and medical vulnerability factors of ED frequent users (FUs) and to explore if these factors hold simultaneously. METHODS: We performed a case-control study at Lausanne University Hospital, Switzerland. Patients over 18 years presenting to the ED at least once within the study period (April 2008 toMarch 2009) were included. FUs were defined as patients with four or more ED visits within the previous 12 months. Outcome data were extracted from medical records of the first ED attendance within the study period. Outcomes included basic demographics and social variables, ED admission diagnosis, somatic and psychiatric days hospitalized over 12 months, and having a primary care physician.We calculated the percentage of FUs and non-FUs having at least one social and one medical vulnerability factor. The four chosen social factors included: unemployed and/or dependence on government welfare, institutionalized and/or without fixed residence, either separated, divorced or widowed, and under guardianship. The fourmedical vulnerability factors were: ≥6 somatic days hospitalized, ≥1 psychiatric days hospitalized, ≥5 clinical departments used (all three factors measured over 12 months), and ED admission diagnosis of alcohol and/or drug abuse. Univariate and multivariate logistical regression analyses allowed comparison of two JGIM ABSTRACTS S391 random samples of 354 FUs and 354 non-FUs (statistical power 0.9, alpha 0.05 for all outcomes except gender, country of birth, and insurance type). RESULTS: FUs accounted for 7.7% of ED patients and 24.9% of ED visits. Univariate logistic regression showed that FUs were older (mean age 49.8 vs. 45.2 yrs, p=0.003),more often separated and/or divorced (17.5%vs. 13.9%, p=0.029) or widowed (13.8% vs. 8.8%, p=0.029), and either unemployed or dependent on government welfare (31.3% vs. 13.3%, p<0.001), compared to non-FUs. FUs cumulated more days hospitalized over 12 months (mean number of somatic days per patient 1.0 vs. 0.3, p<0.001; mean number of psychiatric days per patient 0.12 vs. 0.03, p<0.001). The two groups were similar regarding gender distribution (females 51.7% vs. 48.3%). The multivariate linear regression model was based on the six most significant factors identified by univariate analysis The model showed that FUs had more social problems, as they were more likely to be institutionalized or not have a fixed residence (OR 4.62; 95% CI, 1.65 to 12.93), and to be unemployed or dependent on government welfare (OR 2.03; 95% CI, 1.31 to 3.14) compared to non-FUs. FUs were more likely to need medical care, as indicated by involvement of≥5 clinical departments over 12 months (OR 6.2; 95%CI, 3.74 to 10.15), having an ED admission diagnosis of substance abuse (OR 3.23; 95% CI, 1.23 to 8.46) and having a primary care physician (OR 1.70;95%CI, 1.13 to 2.56); however, they were less likely to present with an admission diagnosis of injury (OR 0.64; 95% CI, 0.40 to 1.00) compared to non-FUs. FUs were more likely to combine at least one social with one medical vulnerability factor (38.4% vs. 12.1%, OR 7.74; 95% CI 5.03 to 11.93). CONCLUSIONS: FUs were more likely than non-FUs to have social and medical vulnerability factors and to have multiple factors in combination.

Sport-based corporate social responsibility in European professional football

In the past few decades, sport has become a major business with remarkable international reach. As part of the commercial sector of sport, professional sport is said to be intrinsically different from other businesses due to its unique characteristics, such as the peculiar economics and the intense loyalty of fans. Simultaneously with the growing business aspect, sport continues to have great social and cultural impacts on our society. Sport has also become an increasingly popular means of attending social problems due to its alleged suitability for such purposes and its popular appeal. A great number of actors in the professional sport industry have long been involved in socially responsible activities, many of which have been sport-related. While Corporate Social Responsibility (CSR) has been extensively studied in general, its role in the professional sport industry has received less attention in the academic research until recently. It has been argued that due to the unique characteristics of professional sport, CSR should also be studied in this particular context. The objective of this study was to contribute to filling the research gap and increase the understanding of CSR in the context of professional sport by examining sport-related CSR realized by professional football clubs in Europe. The theoretical part of this study leaned on previous literature about using sport as a means of attending social issues and the role of CSR in professional sport industry. The empirical part of the study was carried out through web site analyses and interviews. The clubs to be examined were chosen by using purposive sampling technique and taking into consideration the accessibility and suitability of information the clubs could offer. The method used for analyzing the data was qualitative content analysis. The empirical findings were largely in line with the theoretical framework of the study. The sportrelated CSR of the clubs was concentrated on teaching the participants diverse skills and values, improving their health, encouraging social inclusion, supporting disabled people, and promoting overall participation in sport. The clubs also emphasized the importance of local communities as targets of their CSR. CSR had been an integral part of the clubs’ activities from the beginning, but there were remarkable differences between large and small clubs in terms of structured organization and realization of their CSR. Measuring and evaluation of CSR appeared to be a challenge for most clubs regardless of their size and resources. The motives for the clubs to engage in CSR seemed to be related to the clubs’ values or to their stakeholders’ interests. In general, the clubs’ CSR went beyond what the society is likely to expect from them in legal or ethical sense.

Social disability of Brazilian mood disorder patients

Mood disorders cause many social problems, often involving family relationships. Few studies are available in the literature comparing patients with bipolar, unipolar, dysthymic, and double depressive disorders concerning these aspects. In the present study, demographic and disease data were collected using a specifically prepared questionnaire. Social adjustment was assessed using the Disability Adjustment Scale and family relationships were evaluated using the Global Assessment of Relational Functioning Scale. One hundred patients under treatment for at least 6 months were evaluated at the Psychiatric Outpatient Clinic of the Botucatu School of Medicine, UNESP. Most patients were women (82%) more than 50 (49%) years old with at least two years of follow-up, with little schooling (62% had less than 4 years), and of low socioeconomic level. Logistic regression analysis showed that a diagnosis of unipolar disorder (P = 0.003, OR = 0.075, CI = 0.014-0.403) and dysthymia (P = 0.001, OR = 0.040, CI = 0.006-0.275) as well as family relationships (P = 0.002, OR = 0.953, CI = 0914-0.992) played a significant role in social adjustment. Unipolar and dysthymic patients presented better social adjustment than bipolar and double depressive patients (P < 0.001), results that were not due to social class. These patients, treated at a teaching hospital, may represent the severest mood disorder cases. Evaluations were made knowing the diagnosis of the patients, which might also have influenced some of the results. Social disabilities among mood disorder patients are very frequent and intensive.

Measurement of social value creation with non-financial measures

This research examines the concept of social entrepreneurship which is a fairly new business model. In the field of business it has become increasingly popular in recent years. The growing awareness of the environment and concrete examples of impact created by social entrepreneurship have encouraged entrepreneurs to address social problems. Society’s failures are tried to redress as a result of business activities. The purpose of doing business is necessarily no longer generating just profits but business is run in order to make a social change with the profit gained from the operations. Successful social entrepreneurship requires a specific nature, constant creativity and strong desire to make a social change. It requires constant balancing between two major objectives: both financial and non-financial issues need to be considered, but not at the expense of another. While aiming at the social purpose, the business needs to be run in highly competitive markets. Therefore, both factors need equally be integrated into an organization as they are complementary, not exclusionary. Business does not exist without society and society cannot go forward without business. Social entrepreneurship, its value creation, measurement tools and reporting practices are under discussion in this research. An extensive theoretical basis is covered and used to support the findings coming out of the researched case enterprises. The most attention is focused on the concept of Social Return on Investment. The case enterprises are analyzed through the SROI process. Social enterprises are mostly small or medium sized. Naturally this sets some limitations in implementing measurement tools. The question of resources requires the most attention and therefore sets the biggest constraints. However, the size of the company does not determine all – the nature of business and the type of social purpose need to be considered always. The mission may be so concrete and transparent that in all cases any kind of measurement would be useless. Implementing measurement tools may be of great benefit – or a huge financial burden. Thus, the very first thing to carefully consider is the possible need of measuring value creation.

Investigación diagnóstica sobre la problemática política,económica y social en las ciudades de San José de Cúcuta-San Antonio del Táchira, luego de las tensiones presidenciales del periodo 2007-2010

El distanciamiento presidencial entre Colombia y Venezuela, dejó problemas de orden económico, político y social en la frontera de Cúcuta (Colombia) y San Antonio del Táchira (Venezuela). Estas implicaciones negativas se deben a las diferencias de concebir la seguridad y la integración por parte de los presidentes de turno, Hugo Chávez y Alvaro Uribe.

Análisis del accionar del ELN y las FARC-EP contra la industria petrolera y su incidencia en el régimen de regalías y el desarrollo social en el departamento de Arauca, 1998-2006

El desarrollo social de un departamento está determinado por factores tanto internos como externos. Sin embargo, la existencia de recursos no renovables con gran valor, en algunos casos representan el núcleo de grandes problemas sociales en estos departamentos.

Influência do desenvolvimento tecnológico sobre o desenvolvimento social a partir das atividades da incubadora tecnológica de Campina Grande, Campina Grande Paraíba

Este estudo avalia a influência do desenvolvimento tecnológico sobre o social, a partir das atividades produtivas desenvolvidas na unidade agroindustrial Recanto lI, no município de Catolé do Rocha, com o apoio da Incubadora Tecnológica de Campina Grande - ITCG, e o Programa de Estudos e Ações no Semi-Árido Paraibano da Universidade Federal de Campina Grande - PEASAlUFCG. Os problemas sociais no semi-árido surgiram por condições ambientais adversas e se intensificaram pela falta de políticas públicas adequadas à educação e ao desenvolvimento da região. O problema é expresso pela seguinte indagação: Qual a influência entre o desenvolvimento tecnológico e o desenvolvimento social gerados a partir da atividade produtiva da Incubadora de Campina Grande, em Campina Grande, Paraíba? A relevância deste trabalho vem da pretensão em colaborar para o estudo da relação entre desenvolvimento tecnológico e social, numa tentativa de tornar inteligível a necessidade de educação e inovação tecnológica para o desenvolvimento social, principalmente em países não desenvolvidos. Vem também da utilidade para a formulação de políticas públicas e estratégias de desenvolvimento tecnológico, identificando ações e medidas de desempenho, voltadas ao diagnóstico da contribuição das incubadoras tecnológicas para o bem-estar da sociedade. O referencial teórico foi composto pela análise da função das racionalidades dos diversos agentes sociais e de sua contribuição para as interações sociais, além da análise das realidades culturais da sociedade empresariada, do Estado e das incubadoras tecnológicas. A metodologia se utilizou da pesquisa descritiva e explicativa, de campo, documental, bibliográfica e estudo de caso. O universo foram as pessoas que compõem a ITCG e a amostra foram o diretor da Incubadora, o cientista da UFCG e o líder comunitário de Recanto lI. Os sujeitos da pesquisa confundem-se com a amostra. A coleta de dados se deu por meio da literatura sobre a temática e de inserções no campo de estudo. O tratamento de dados se utilizou da análise qualitativa do fenômeno. As principais limitações do método consistiram na coleta, no tratamento dos dados, e na utilização do estudo de caso, com possibilidade de compreensão tendenciosa do fenômeno estudado. O referencial prático apresenta o resultados da pesquisa, avaliando-os por meio da comparação com o referencial teórico estudado. Tem-se como resultados que a ITCG agiu articulando os grupos e traduzindo as realidades culturais de cada agente em prol do desenvolvimento de comunidades agroindustriais em situação de risco social, devido à problemática da seca. A ITCG atuou como alfabetizadora social ensinando aos agentes sociais os códigos culturais dos demais grupos. As desigualdades que existiam entre o cientista e o sertanejo, aprofundadas pelo vexatório histórico de escravidão do homem do campo no nordeste brasileiro, foram minimizadas pela educação dada pelo próprio cientista. A Universidade contribuiu para a redução do analfabetismo ambiental, onde o meio ambiente era tido como o principal rival do homem do sertão. O Estado, quando atua em parceria com os demais agentes sociais consegue, manter-se como o principal instrumento dos cidadãos para controlar a globalização em função de seus valores e interesses. Na ITCG o ambiente de incubação é educacional, onde os novos empreendedores são postos em contato com a realidade cultural do empresariado, do Estado e de outras comunidades da sociedade, seguindo modelos meramente educacionais. Como conclusão tem-se que a trajetória dos cidadãos de Recanto II - de escravos a exportadores - foi baseada em dois grandes tesouros, a família e areligião. O mérito da ITCG foi compreender, respeitar e preservar a realidade cultural de Recanto 11 e incentivar a interação social com outras realidades culturais capazes de gerar desenvolvimento naquela região. A saúde, o desenvolvimento infantil, a segurança, a habitação foram conquistas de Recanto 11. Como sugestão tem-se que as políticas públicas deveriam reproduzir este ambiente de desenvolvimento para todos os cidadãos brasileiros em situação de risco social, utilizando-se da família como base para interações sociais fluidas e harmônicas entre os diversos agentes sociais.

Franquias sociais: minimizando riscos no investimento social

o interesse pela responsabilidade social nos últimos anos, quer como conceito ou prática, vem crescendo à medida que os problemas sociais eclodem e aumentam as expectativas de contribuição das organizações como uma parceria qualificada. Nesse contexto, o segmento empresarial vem se deparando com pressões advindas de movimentos de defesa do consumidor, campanhas de combate à miséria e a fome, além de outros que surgem com o recrudescimento de temas de minorias excluídas da vida social. Diante deste quadro as empresas estão incorporando a responsabilidade social aos objetivos de seus negócios como um fator de diferenciação no mercado e para promover benefícios sociais de grande relevância. Este estudo enfoca a responsabilidade social empresarial e a alternativa de utilização de metodologia semelhante a das franquias comerciais, as franquias sociais, para a prática das ações sociais nas empresas cearenses. A abordagem da investigação é predominantemente qualitativa e parte de uma revisão bibliográfica sobre a temática em foco, procurando compreender suas interações e incorporações nas práticas empresariais. A pesquisa considerou o universo de 32 empresas que concorreram ao "Premio Delmiro Gouvêa" , edição 2003, das maiores e melhores empresas do Estado do Ceará. A amostra corresponde a 22 dessas organizações onde as informações foram disponibilizadas. Os resultados encontrados produzem evidências que a metodologia das Franquias Sociais tem uma percepção positiva por parte do empresariado e novos estudos, sobre a temática, devem ser conduzidos com o intuito da construção de um referencial teórico mais abrangente que o ora disponível.

Desafios para a formação de parcerias no serviço creche da secretaria da assistência social da PMSP

Analisa os vínculos estabelecidos entre a Secretaria de Assistência Social da PMSP e algumas Entidades Sociais para a prestação do serviço creche. Investigou-se o campo da Assistência Social e o da relação entre a esfera pública estatal e a esfera privada, sem fins lucrativos, na provisão de serviços públicos. A partir de revisão bibliográfica, de pesquisa documental e de estudo de casos, dando voz a todos que se relacionam no convênio, definiu-se parcerias como sendo relações substantivas que implicam corresponsabilidades, compartilhamento de valores e comprometimentos. Analisou-se duas creches diretas, duas conveniadas e duas indiretas, (e as respectivas Entidades Sociais), além da SAS Regional de IQ/G e SAS Central. Foram escolhidas as creches que obtiveram avaliação positiva quanto ao seu desempenho e alcance de resultados. Considerou-se que tanto os serviços prestados de forma direta quanto os conveniados podem ter qualidade e sucesso no alcance de seus objetivos, sendo necessário, em qualquer das modalidades, ter presente aspectos como: transparência nas ações, diálogos permanentes, clarificação de papéis e competências, responsabilização e compromissos com causas e com acordos. Justificam-se os serviços conveniados em razão das questões conjunturais hoje postas, e da responsabilização por parte de toda uma sociedade no enfrentamento da questão social. Justificam-se os serviços diretos pela necessidade vital da afirmação do papel do Estado na provisão de serviços públicos para garantia de serviços de forma continuada com vistas à universalização. Indicou-se, como desafio a necessidade de rever a forma como estão se dando os vínculos entre os agentes estudados, na direção do estabelecimento de parcerias, bem como o desafio da apropriação da condução da política pública pelos órgãos de assistência social, consolidando como esfera pública não-estatal a ação das Entidades Sociais.

Integrating open innovation in the social innovation process: an exploratory study

Inovação tem se tornado um fenômeno cada vez mais complexo e dinâmico, com a mudança de um paradigma focado na inovação industrial, onde a inovação acontecia no produto ou no processo de fabricação, para outro baseado no conhecimento, muito mais amplo. Além disso, o conhecimento e a competência técnica não são mais considerados como um monopólio do departamento de pesquisa e desenvolvimento. Isto trouxe mudanças nas práticas de inovação, que se tornaram mais abertas e levaram as empresas a interagir cada vez mais com o seu ambiente. Por outro lado, a inovação tecnológica, cujo primeiro objetivo é de criar valor para a empresa, tem experimentado alguns limites para resolver problemas sociais, como o aquecimento global. As novas tecnologias têm a capacidade de melhorar a qualidade de vida de muita gente, mas não é suficiente. É nesse contexto que surge outro tipo de inovação, cujo objetivo é de maximizar o impacto positivo na sociedade: a inovação social. Estes dois paradigmas de inovação, mais adequados aos desafios atuais, têm alguns pontos em comum na sua integração com o ambiente externo: a sociedade e outros atores da inovação. No entanto, praticamente não existem estudos integrando inovação aberta e inovação social. Este trabalho estuda a integração destes dois modelos a partir de uma pesquisa exploratória, realizando entrevistas em profundidade com 11 dirigentes de organizações sociais. As iniciativas sociais parecem atrair mais organizações externas para colaborar do que empresas com fins lucrativos, já que são mais altruístas. Parecem integrar essas pessoas e procurar por mais ajuda, especialmente no momento de escalar o negócio. Ainda que algumas organizações têm como prioridade institucionalizar a inovação aberta, outras veem isto como secundário ou simplesmente não sabem como fazer. Isto resulta em uma colaboração mais informal, que não é focada em atividades de pesquisa e desenvolvimento, prática ausente nas empresas da nossa amostra.

Despertando responsabilidade social no ensino médio por meio de temáticas associadas à física nuclear

Many discussions about the role of the school are on the agenda, in an increasingly complex society. Sociologists, educators, anthropologists, researchers of different areas seek that role. The objective of this dissertation is to contribute what we can consider the central role for the physics teaching, citizenship training. We have elaborated a didactic proposal to increase the interest of high school students on issues of social relevance and, throughout it, to promote the formation of attitudes of social responsibility, enhancing the formation of a more politically and socially active citizen. For the preparation of the proposal, studies were made on education for citizenship and on attitudes change, using as its main theoretical foundation the researches on the Science, Technology and Society curricular emphasis. The teaching of Nuclear Physics was integrated to our proposal, due to its pedagogical potential for the discussion of social, political and economic subjects related to scientific concepts and associated technologies. The educational proposal we have produced was applied on a high school class of a private school at Natal-RN. It was composed from the controversial issue involving the installation of nuclear power plants in Brazilian northeast. The methodology of role playing, in which students assumed social roles and produced specific subsidies for a public hearing and a later referendum, both simulated. In the analysis of the implementation of the proposal, we highlighted the difficulties but also the possibilities and the relevance of exercising skills such as reasoning, finding information, and arguing about of social problems. The results of the research showed the possibility of meaningful learning on Nuclear Physics contents, through this social, political, economic, scientific and technological contextualization using a controversial and real issue together with mechanisms that trigger for greater popular participation, as public hearing. It has also been identified changes in attitude by some students about issues related to Nuclear Physics. We hope, through this dissertation, to contribute to the formation of future citizens as well as to the initiative of teachers-researchers with pedagogical aims similar to those in the present work

Social disability of Brazilian mood disorder patients

Mood disorders cause many social problems, often involving family relationships. Few studies are available in the literature comparing patients with bipolar, unipolar, dysthymic, and double depressive disorders concerning these aspects. In the present study, demographic and disease data were collected using a specifically prepared questionnaire. Social adjustment was assessed using the Disability Adjustment Scale and family relationships were evaluated using the Global Assessment of Relational Functioning Scale. One hundred patients under treatment for at least 6 months were evaluated at the Psychiatric Outpatient Clinic of the Botucatu School of Medicine, UNESP. Most patients were women (82%) more than 50 (49%) years old with at least two years of follow-up, with little schooling (62% had less than 4 years), and of low socioeconomic level. Logistic regression analysis showed that a diagnosis of unipolar disorder (P = 0.003, OR = 0.075, CI = 0.014-0.403) and dysthymia (P = 0.001, OR = 0.040, CI = 0.006-0.275) as well as family relationships (P = 0.002, OR = 0.953, CI = 0914-0.992) played a significant role in social adjustment. Unipolar and dysthymic patients presented better social adjustment than bipolar and double depressive patients (P < 0.001), results that were not due to social class. These patients, treated at a teaching hospital, may represent the severest mood disorder cases. Evaluations were made knowing the diagnosis of the patients, which might also have influenced some of the results. Social disabilities among mood disorder patients are very frequent and intensive.

Igreja católica, assistência social e caridade: Aproximações e divergências

This article is the result of a research study concluded in 2003, which aimed at investigating how the conception of Law is expressed in the actions of the so-called social pastoral commissions of the Catholic Church in Londrina, Brazil. By observing that the conception of charity and that of social rights walk side-bi-side within the Catholic Church, a question emerged: how is the conception of social right expressed in the actions of social pastoral commissions? Charity is preached as a Christian duty, as an action expressed in the experience of solidarity towards others who are in a situation that prevents them from having minimal living conditions. At least at discourse level, the actions developed are not limited to provide basic goods, clothes or medicine. We realized that those who act in social pastoral commissions, driven by values such as love to fellow human beings and solidarity, have not lost sight of the idea of social right - on the contrary, they have been reinforcing it. © 2006 Programa de Pós-Graduação em Sociologia - UFRGS.

América Latina frente al espejo: dimensiones objetivas y subjetivas de la inequidad social y el bienestar en la región

Prólogo de Alicia Bárcena