La relación médico-paciente en las organizaciones sanitarias de atención primaria españolas. Una aproximación cualitativa

Antecedentes. La relación médico-paciente es aquella que se produce durante la interacción entre el usuario y el profesional. Esta ha ido cambiando a lo largo de la historia. En la actualidad, el paradigma emergente es el que autonomiza y empodera al usuario, en contraposición al tradicional paradigma paternalista. Objetivo. El objetivo de este trabajo es averiguar el estado del fenómeno sociológico del empoderamiento del paciente en España, desde el punto de vista de los profesionales sanitarios. Metodología. Se realizó un estudio exploratorio mediante una metodología cualitativa. La recolección de datos se basó en entrevistas estructuradas no estandarizadas. Se procedió al análisis del contenido a través de un proceso circular simultáneamente a la recolección de datos. Se complementó con un estudio de fuentes documentales bibliográficas a propósito de la temática abordada. Resultados. Los profesionales muestran una actitud positiva hacia el fenómeno del empoderamiento del paciente. Todavía se muestran escépticos ante la fiabilidad de la información sobre salud que se encuentra en internet y del criterio de los propios pacientes. Aun así, el máximo de autonomía del paciente, el consentimiento informado, sigue siendo considerado como una herramienta de protección del profesional. Discusión. Tras este estudio exploratorio se ha podido observar un cambio de actitud en el profesional respecto a la percepción que tiene sobre la evolución en la relación con el paciente. Se empieza a constatar que el fenómeno social se encuentra en un estado en el que los actores adquieren posturas más simétricas jerárquicamente.

Quality Management, Environmental Management and Organizational Design in the Hotel Industry: A Qualitative Study

The purpose of this paper is twofold. First, the paper analyzes the relationship between quality management and environmental management and their effects on hotel performance. Second, the article examines the relationship between these two management systems and organizational design. The paper uses an exploratory, qualitative approach based on interviews with managers and experts in the hotel industry. Based on a content analysis of interviews, the results lead to several propositions. Specifically, quality and environmental management influence hotel performance through mediating variables. Moreover, the implementation of quality management facilitates the implementation of environmental management. Furthermore, the implementation of these two management systems is associated with an increase of formalization and decentralization. The paper contributes to the analysis of quality management, environmental management, organizational design and performance in a joint manner, which has not been attempted before in the hotel industry. In addition, it helps extend the findings about these links in manufacturing and service organizations to the hotel industry.

Organizational design, quality management and competitive advantage in hotels

Purpose – The aim of this study is to examine the relationship between practices of quality management (QM) and the characteristics of organizational design, and QM and competitive advantage. Design/methodology/approach – The study uses a partial least squares approach to test these relationships in 350 hotels in Spain. Findings – The findings show that QM influences specialization, formalization and interdepartmental interactions, and that QM practices influence both cost and differentiation competitive advantage. The results also indicate the importance of QM strategic and operational systems as practices that have a key impact on the characteristics of organizational design. Similarly, the QM operational system is key in the relationship between QM and cost competitive advantage. Finally, the QM operational, information and strategic systems positively influence differentiation competitive advantage. Practical implications – When hotels adopt QM practices, there will be significant changes in a number of organizational variables, including specialization, formalization and interdepartmental interactions. This paper provides empirical evidence that QM practices improve both cost and differentiation competitive advantage in the hotel industry. Originality/value – There has been little research on the effects of QM on organizational design in the hotel industry. The contribution of this paper is that analyze the effects of QM on organizational design and competitive advantage, extending knowledge about these issues in a specific sector.

Fashion opinion leadership, innovativeness and attitude toward advertising among Portuguese consumers

In the context of the fashion market, this study aims to analyze opinion leadership and, specifically, to verify the correlation that may exist between opinion leadership, fashion innovativeness and attitude towards fashion advertising. It is also intended to identify two different consumer groups: opinion leaders and fashion followers based on “opinion leadership” construct. Data collection was done through a self-administered questionnaire with a convenience sample of 203 graduate and postgraduate students of two universities of Porto, the second major city of Portugal. Results show a positive correlation between fashion innovativeness, fashion opinion leadership, and attitude towards fashion advertising. It was possible to identify two groups of consumers: fashion influencers, who exhibit a moderate sense of innovativeness and a positive attitude towards fashion advertising; and fashion followers who don’t consider themselves neither innovators nor opinion leaders, but have a moderate positive attitude towards fashion advertising.

The Organizational Tasks of High-Performance Gymnastic Coaches

The purpose of this study was to report the knowledge used by expert high performance gymnastic coaches in the organization of training and competition. In-depth interviews were conducted with 9 coaches who worked with male gymnasts and 8 coaches who worked with female gymnasts. Qualitative analyses showed that coaches of males and coaches of females planned training similarly, except that coaches of females appeared to emphasize esthetic and nutritional issues to a greater extent. Coaches of males revealed more concerns about the organization of gymnasts' physical conditioning. Analysis indicated that expert gymnastic coaches of males and females are constantly involved in dynamic social interactions with gymnasts, parents, and assistant coaches. Many areas of coaches' organizational work, such as dealing with the athletes' personal concerns and working with parents, are not part of the structure of coaches' training programs and emerged as crucial tasks of expert gymnastic coaches for developing elite gymnasts.

Putin's 'couldn't care less' attitude towards Russia's international commitments. CEPS Commentaries, 5 March 2014

By militarily invading and annexing Crimea, Russia has acted in breach of its obligations under the 1994 Budapest Memorandum. Yet the Kremlin seems unfazed that it is violating general principles of international law. This seems emblematic for the ‘can’t care less’ attitude of Putin’s Russia. Moscow allows itself to be inconsistent with its own commitments and is reneging on its own words. This has all the trappings of a panicking dictatorship, which crushes dissent at home and portrays confidence in winning a great battle with enemies abroad. How can anyone now trust what Putin’s Russia says or commits to in the future?

Helpless and lonely: Turkey's attitude towards the war in Syria. OSW Commentary No. 136, 09.05.2014

The conflict in Syria, which has lasted since 2011, has become the most significant test of the efficiency of Turkey’s foreign policy and the biggest challenge to Turkey’s security in recent decades. The lack of a clear prospect of an end to the war does not allow us to come to a final conclusion regarding the Syrian civil war’s importance for Turkey. However, it can be said today that with the exception of the initial phase of the conflict, Ankara’s influence over the course of events in Syria has been limited, and the war itself is evolving in a direction that is unfavourable for Turkey: the hostile regime of Bashar al-Assad is still in power, the opposition has proved to be an unreliable or even a dangerous ally, and in northern Syria militant jihadist groups and Kurds are gaining importance. It is also quite unlikely that the West will take any greater responsibility for stabilising the situation in the region. In response to such an unfortunate situation, and out of fear of risking deeper involvement in the conflict, during the past year Turkey’s policy towards Syria has been restrained, reactive and focused mainly on defending Turkey’s territory. However, this policy offers no security guarantees and does not prevent the country’s regional position from weakening, especially in the context of the reinforcement of the jihadist militants and the Kurdish autonomy in northern Syria. The arguments for Turkey continuing its defensive policy are strong: the country fears the possible results of an open confrontation with Assad’s forces; most probably it could not count on support for such actions from within its own society or its Western allies. It also does not have enough acceptance within the anti-Assad opposition circles. On the other hand, though, the risk of uncontrolled development of events is still present; the risk of confrontations with armed jihadist militants is growing; and the potential operation of Turkish forces, either against the jihadists or against Assad’s army, could be considered as a method of diverting attention from the political problems with which the AKP government has been struggling at home.

Kazakhstan's attitude towards integration with Russia: less love, more fear. OSW Commentary No. 137, 29.05.2014

Russia’s annexation of Crimea and destabilization of Ukraine have created a new context for Kazakhstan’s foreign and domestic policy. The ongoing crisis in the relations with Russia and the West has also changed the current order in the entire post-Soviet area. From Astana’s perspective, the Kremlin’s policy towards Ukraine can be considered dangerous since it shows Russia’s determination to interfere with the domestic affairs of its neighbours in the pursuit of its own interests. Furthermore, this policy reveals and raises the price a country needs to pay for its potential attempts to break free from the Russian zone of influence. At present the biggest challenge for the authorities in Astana is the accelerated implementation of the idea of the Eurasian Union promoted by Moscow, which is to be another stage in the integration of post-Soviet states (presently Russia, Kazakhstan and Belarus). The signing of the Eurasian Union’s founding documents planned for late May 2014 and the launch of this organisation (scheduled for January 2015) is sure to bring Kazakhstan closer to Russia and simultaneously limit its economic and political independence. Nevertheless, Astana’s position in relations with Moscow will to a large extent depend on the new shape of the relations between Russia and China. China is pursuing its own strategic interests in Central Asia (including in the energy sector) and its main partner in the region is Kazakhstan. At the domestic level, Russia’s actions in Ukraine made the authorities in Astana fear that measures similar to those used in Ukraine could be applied towards Kazakhstan. On the one hand this has led to increased efforts aimed at consolidating the state and strengthening its structures, and on the other hand it has brought about a revision of those aspects of domestic policy which Russia could interpret as a pretext for interfering.

A diversidade cultural e as suas implicações no processo de ensino e aprendizagem : como integrar a diversidade na educação de infância

Relatório de estágio apresentado para obtenção do grau de mestre na especialidade profissional de Educação pré-escolar