Unpacking participation in healthcare governance: Lessons from two local health councils in Brazil and Spain.

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

Daily work variability in falls prevention of hospitalized patients: nursing team's perception.

BACKGROUND: The identification of safety incidents and establishment of systematic methodologies in health services to reduce risks and provide quality care was implemented by The World Health Organization. These safety incidents allowed the visualization of a vast panorama, ranging from preventable incidents to adverse events with catastrophic outcomes. In this scenario, the issue of fall(s) is inserted, which, despite being a preventable event, can lead to several consequences for the patient, family, and the healthcare system, being the second cause of death by accidental injury worldwide, this study aims to identify the variability inherent in the daily work in fall prevention, the strategies used by professionals to deal with it and the opportunities for improvement of the management of work-as-imagined. METHOD: A mixed method approach was conducted, through process modeling and semi-structured interviews. The study was conducted in a public university hospital in southern Brazil. Study steps: modeling of the prescribed work, identification of falls, modeling of the daily work, and reflections on the gap between work-as-done and work-as-imagined. Medical records, management reports, notification records, protocols, and care procedures were consulted for modeling the work process, and semi-structured interviews were conducted with 21 Nursing professionals. The study was conducted between March 2019 and December 2020. RESULTS: From July 2018 to July 2019, 447 falls occurred, 2.7% with moderate to severe injury. The variability occurred in the orientation of the companion and the assurance of the accompanied patient's de-ambulation. The professionals identified individual strategies to prevent falls, the importance of multi-professional work, learning with the work team, and the colleague's expertise, as well as suggesting improvements in the physical environment. CONCLUSION: This study addressed the need for fall prevention in the hospital setting as one of the main adverse events that affect patients. Identifying the variability inherent to the work allows professionals to identify opportunities for improvement, understand the risks to which patients are subjected, and develop the perception of fall risk as a way to reduce the gap between work-as-imagined and work-as-done.

Tecnologías de información para lucha anticorrupción: análisis de la contratación pública costarricense / Tecnologias da informação para a luta contra a corrupção: análise da contratação pública costarriquenha / Information technologies for countering corruption: analysis of the Costa Rican public procurement system

Resumen La corrupción es un fenómeno con consecuencias desastrosas para el bienestar económico, social y político de nuestras sociedades. En particular, la contratación pública es vulnerable debido al elevado valor económico de sus transacciones. La presente investigación analiza el rol que las tecnologías de información pueden jugar en la lucha anticorrupción. Desarrollamos un caso basado en datos abiertos de contrataciones públicas en Costa Rica, con la finalidad de identificar los conceptos principales asociados al sistema de información subyacente. El caso muestra el potencial de las herramientas tecnológicas de análisis de redes sociales para contrarrestar la complejidad de las redes de corrupción. Asimismo, se evidencia la necesidad de disponer de un ecosistema rico en datos anticorrupción, preferiblemente en formato abierto.

Resumo: A corrupção é um fenômeno com consequências desastrosas para o bem-estar econômico, social e político das nossas sociedades. Em particular, a contratação pública é um fator altamente vulnerável devido ao alto valor econômico de suas transações. A pesquisa analisa o papel que as tecnologias da informação podem desempenhar no combate à corrupção. Além disso, desenvolvemos um caso baseado em dados abertos sobre compras públicas na Costa Rica, a fim de identificar os principais conceitos associados ao sistema de informação subjacente. O caso mostra o potencial das ferramentas tecnológicas de análise de redes sociais para ir de encontro a complexidade das redes de corrupção. Mostra também a necessidade de um ecossistema diversificado e sustentável de dados anticorrupção - preferencialmente em formato aberto.

Abstract Corruption has disastrous consequences for the well-being of societies. In particular, public procurement is a highly vulnerable factor due to the high value of its transactions. This research analyzes the role that information technologies can play in the fight against corruption. We developed a case based on open data on public procurement in Costa Rica to identify the main concepts associated with the underlying information system. The case shows the potential of technological tools for social network analysis to counter the complexity of corruption networks. It also shows the need for a rich ecosystem of anti-corruption data - preferably in an open format.

Low Carbon Mobility Transitions and Justice: A Case of Costa Rica.

This research article analyzes the electrification of light-duty vehicles and its implications on equity and justice paradigm within a pro-green policy environment. The case of Costa Rica is investigated as the country has already gained considerable momentum in decarbonizing its economy and considers the transportation as the next step in its sectoral transformation. We evaluate the transition through different lenses of sustainability, equity and justice using socio-technical system transition and the energy justice frameworks. The outcome of the analysis is compared with the existing policies and plans for transport decarbonization in Costa Rica. The findings suggest that (a) the country should foster industry-academia collaborations and engagements to fortify knowledge sharing networks for low-mobility innovation, (b) subsidization of electricity cost for electric vehicles seems essential to incentivize market pull, and (c) Costa Rica should proceed towards the creation of domestic and local electric vehicles manufacturing capacity to provide an industrial environment for building long-standing technological learning and accumulation.

Addressing Sustainable Social Change for All: Upcycled-Based Social Creative Businesses for the Transformation of Socio-Technical Regimes.

The global challenges caused by socio-economic inequalities, climate change and environmental damage caused to ecosystems, require changes in human behavior at all organizational levels, including companies, governments, communities, and individuals. In this context, it is important to analyse how social and creative companies that work in the fashion and industrial design recycling sector can address sustainable social change. In this paper, we propose an analysis in the countries of the global South. To learn how grassroots innovations can contribute to the development of sustainable strategies, we perform the framework of Technical transitions. We analyze the three main areas of activity that constitute an effective niche construction: social networks, expectations and visions, and learning. A qualitative methodology is used, a video case study with six grassroots organizations in South Africa, Sri Lanka, Malaysia, and Brazil. The results reflect the important role played by these grassroots innovations, contributing to the development of social and creative recycling companies that address socio-economic and environmental problems.

“Exame bento” ou “foto do bebê”? Biomedicalização e estratificação nos usos do ultrassom obstétrico no Rio de Janeiro / “Holy scan” or “picture of the baby?” Biomedicalization and stratification in the use of obstetric ultrasound in Rio de Janeiro

Resumo A partir de etnografias realizadas em serviços públicos e privados do Rio de Janeiro, sustentamos que a difusão do fenômeno de (bio)medicalização varia de acordo com o estrato social das gestantes, produzindo corpos fetais e gestantes, assim como processos gestacionais, totalmente diversos, dependendo da camada social das mulheres atendidas. Tomando a premissa fundamental de que a biomedicalização consiste em uma transformação no processo de medicalização pela incorporação crescente da tecnociência à biomedicina, o universo observado evidencia diferentes estágios dessa transformação, acompanhando, de modo consistente, a estratificação social das grávidas submetidas ao exame de ultrassom.

Abstract Based on ethnographic studies conducted at public and private healthcare facilities in Rio de Janeiro, we argue that the dissemination of (bio)medicalization varies in accordance with the social stratum of the expectant mothers, thereby producing thoroughly distinct fetal and pregnant bodies, as well as different gestational processes. Starting from the basic premise that biomedicalization represents a transformation in the process of medicalization, characterized by the growing incorporation of technoscience into biomedicine, the observed universes displayed different stages in this transformation, consonant with the social stratification of the women who underwent the scans.

A dimensão social da atividade empreendedora / The social dimension of the entrepreneurial activity

Este texto discute a necessidade de se problematizar a representação da atividade do empreendedor a fim de contribuir para a melhoria do desempenho dos programas de incentivo e apoio a sua prática. Tradicionalmente, essa atividade é analisada considerando-se predominantemente as dimensões individual e econômica, o que gera uma representação limitada dela. Este texto pretende mostrar que a dimensão social ou coletiva do trabalho do empreendedor tem importância fundamental para compreender sua prática, que pode ser mais bem representada como um processo de acumulação de associações formando uma rede sociotécnica...

This paper discusses the need to problematize the representation of the entrepreneurial activity in order to contribute to improving the performance of programs that aim to encourage and support its practice. Traditionally, this activity is analyzed considering predominantly the individual and economic dimensions, which generates a limited representation of it. This text aims to show that the social or collective dimension of entrepreneurial work is paramount to understand its practice, which can be best represented as a process of accumulation of associations forming a socio-technical network...

A dimensão social da atividade empreendedora / The social dimension of the entrepreneurial activity

Este texto discute a necessidade de se problematizar a representação da atividade do empreendedor a fim de contribuir para a melhoria do desempenho dos programas de incentivo e apoio a sua prática. Tradicionalmente, essa atividade é analisada considerando-se predominantemente as dimensões individual e econômica, o que gera uma representação limitada dela. Este texto pretende mostrar que a dimensão social ou coletiva do trabalho do empreendedor tem importância fundamental para compreender sua prática, que pode ser mais bem representada como um processo de acumulação de associações formando uma rede sociotécnica.(AU)

This paper discusses the need to problematize the representation of the entrepreneurial activity in order to contribute to improving the performance of programs that aim to encourage and support its practice. Traditionally, this activity is analyzed considering predominantly the individual and economic dimensions, which generates a limited representation of it. This text aims to show that the social or collective dimension of entrepreneurial work is paramount to understand its practice, which can be best represented as a process of accumulation of associations forming a socio-technical network.(AU)

O aparelho é como um automóvel; a pista é a paciente: para além do ensino de tecnologia no pré-natal / The apparatus is like a car; the road is the patient: beyond the teaching of technology in prenatal care

O presente estudo contempla as práticas e ideias envolvidas na formação acadêmica de um grupo social relevante: o dos médicos que, dada sua posição hierárquica significativa na produção da marca ultrassom obstétrico, parece-nos ser um ponto de "parada" interessante e fundamental no fluxo circular entre ideias, marcas e coisas que constituem esse objeto, ultrassom. A observação etnográfica da situação de ensino permite captar dinamicamente esse momento fundamental no qual os principiantes são apresentados a uma tecnologia que foi histórica (e provisoriamente) constituída como indispensável no acompanhamento pré-natal. Pretende-se, assim, apreender de que modo é produzida a "socialização visual" dos futuros profissionais; a pesquisa empírica evidenciou que, juntamente com um determinado tipo de olhar, outros elementos bastante heterogêneos também são ensinados aos futuros médicos. Uma tensão bastante presente no campo consiste na dicotomia entre uma abordagem eminentemente clínica e outra, de teor fortemente tecnicista. A eventual precariedade de dispositivos tecnológicos evidencia diversos paradoxos e incongruências nesta segunda tendência. As modificações ocorridas no desenrolar dos diversos processos que se articulam no campo observado são discutidas em termos do que são capazes de revelar sobre os grupos sociais envolvidos em sua produção.

This study analyzes the practices and ideas involved in the academic formation of an important social group: the doctors who, given their significant hierarchical position in the production of the obstetric ultrasound mark seem, in our opinion to be an interesting and fundamental "stopping" place in the circular flow of ideas, marks and things that form the ultrasound object. The ethnographic observation of the teaching situation allows the dynamic capture of this fundamental moment when beginners are introduced to a technology that was historically (and provisionally) considered indispensable in prenatal monitoring. The intention is thus to apprehend how the "visual socialization" of future professionals is produced; the empirical research showed that, together with a certain kind of gaze, other quite heterogeneous elements are also taught to the future doctors. A tension that is significantly present in the field is the dichotomy between an eminently clinical approach and another one that is strongly technicist. The contingent precariousness of technological devices evidences various paradoxes and incongruences in the latter. The changes during the development of the various processes that are articulated in the observed field are discussed in terms that provide insights into the works of the social groups that produced them.