bluuebunny/crossref_metadata_2025 huggingface dataset:
Impactos da infecção pelo Zika Vírus na gestação
Authors: Gama Michele Figueredo da , Mendes Nayla Carolynne Santos , Moreira Nelson , Ferreira Cleiciane Lopes , Almeida Anne Cristine Gomes de
Published: June 2023

Objetivos: Descrever os principais impactos da infecção do Zika Vírus na gestação, além de identificar as suas principais complicações e aspectos relacionados ao diagnóstico no Brasil e no mundo. Metodologia: O presente estudo trata-se de uma revisão sistemática, sobre as implicações decorrente da infecção do Zika Vírus na gestação. Foram analisados artigos entre os anos de 2012 e 2022 nas bibliotecas virtuais: Google acadêmico, LILACs, PubMed e Scielo. Resultados: Foram utilizados 17 artigos após seleção dos dados para compor a revisão. A infecção pro ZIKV na gestação traz consigo impactos no desenvolvimento intrauterino do feto associada a incidência de microcefalia. Esses acometimentos abrangem questões físicas, motoras, e sociais da família envolvida. Em relação aos diagnósticos, pode-se concluir que o padrão ouro para detecção de ZIKV é através da biologia molecular (RT-PCR). Conclusão: Conclui-se que os impactos do Zika Vírus na gestação trazem consigo diversos acometimentos, sendo necessário uma vigilância e rastreamento assíduo visando o diagnóstico precoce durante os primeiros meses da gravidez, além de enfatizar a necessidade de elaboração de intervenções em saúde relacionados a prevenção em áreas endêmicas.
Quantitative genetic parameters of heartwood and its chemical traits in a black pine (Pinus nigra J.F.Arnold) clonal seed orchard established in Greece
Authors: Ioannidis Kostas , Koropouli Polyxeni
Published: June 2023

Background: Black pine (Pinus nigra J.F.Arnold) is one of the most productive conifers species for timber production in southern Europe, the Mediterranean region and Greece. Recently, the interest for its heartwood extractives content due to their medicinal properties has been renewed. Black pine can be used to produce high added value products, such as bioactive compounds produced from wood and wood waste materials. Methods: Quantitative genetic parameters were estimated for heartwood chemical traits and heartwood percentage in a 44-year-old Pinus nigra clonal seed orchard, established in Peloponnese, Greece. Results: Significant variation was found among clones and among provenances for all studied traits. Heritability on a clone mean basis was extremely high for total acetone extractives, total resin acids as for all resin acids (≥0.85), except levopimaric acid (0.47) and very high for total stilbenes, pinosylvins as for dehydroabietic acid and heartwood percentage (0.69-0.79). On an individual basis, the genetic control was moderate to high (0.53-0.62) for total acetone extractives, total resin acids as for most of resin acids (≥0.85) with dehydroabietic acid presenting low value (0.39) while levopimaric acid very low (0.15). Total stilbenes, pinosylvins and its ether derivatives as heartwood percentage exhibited low values of heritability on individual basis (0.31-0.43). The phenotypic correlation (rp) between total acetone extracts and total stilbenes was negatively weak (≤-0.173) and significant (p≤0.01) while the genetic correlation (rg) was moderate to strong (≤-0.502). The rp values between several pinosylvins were significantly (p≤0.01) moderate to strong (0.529-0.975) as were genetic correlations (0.583-0.975). Between the studied resin acids, both rp and rg values were mostly medium to strong (rp≥0.8 and rg≥0.7) and significant (p≤0.01) in the case of phenotypic correlations, with minor exceptions (levopimaric acid). Phenotypic and genetic correlations between heartwood percentage and its chemical traits were positive (being in most cases significant), except for dehydroabietic and levopimaric acid. Conclusions: The studied clones, comprising the clonal seed orchard, can be used in clonal forestry and subsequent breeding cycles, indicating high potential for advanced breeding, especially for heartwood extractives that are of high pharmaceutical and economic value.
Relationship Between Diabetes Distress and Quality of Life Among Patients with Type II Diabetes Mellitus
Authors: Haskas Yusran , Suarnianti Suarnianti , Kadrianti Erna
Published: June 2023

Diabetes Mellitus or commonly abbreviated as DM is a chronic disease commonly found in Indonesia, especially among people in urban areas. It is known to be incurable during the sufferer's life span, so it is called a lifelong disease. Long-term Diabetes Mellitus has a psychological impact on the quality of life of patients. This study aims to determine the relationship between diabetes distress and quality of life among patients with type II Diabetes Mellitus in the work area of Tamanlanrea Jaya Community Health Center, Makassar. This was a quantitative analytical study with a cross sectional design. Study samples were selected using consecutive sampling technique which obtained a total sample of 82 patients. Data were collected using a questionnaire and analyzed using the Chi-square test. The results showed that there was a relationship between diabetes distress and quality of life among patients with type II diabetes mellitus with a ρ value of 0.012. It can be concluded that there was a relationship between diabetes distress and quality of life among patients with type II diabetes mellitus in the work area of Tamalanrea Jaya CHC, Makassar. Future researchers are recommended to involve a larger size of samples to determine additional elements that have an impact on the quality of life among people with diabetes mellitus.
The Relationship between the Timing of Complementary Feeding and Maternal Knowledge of Responsive Feeding and the Incidence of Stunting in Children Aged 6-24 Months
Authors: Waqiyah Hidayatul , Maineny Arie , Nurfatimah Nurfatimah
Published: June 2023

In 2021, the prevalence of stunting among toddlers in Wani Primary Health Care (Puskesmas) was still high at 18.2%. Delayed introduction of complementary feeding (MP-ASI) and inappropriate feeding practices, such as lack of responsive feeding, contribute to the occurrence of stunting. The objective of this study was to investigate the relationship between the timing of MP-ASI introduction and maternal knowledge of responsive feeding with the occurrence of stunting among children aged 6 to 24 months. This research employed a cross-sectional design using quantitative analytic observational methods. Simple random sampling was used to select the sample, and data were collected through questionnaire surveys from 126 mothers with children between the ages of 6 and 24 months. The study was conducted in the communities of Nupa Bomba, Bale, and Wani Lumbumpetigo, all located within the working area of Wani Primary Health Care. The results showed that 80.2% of the timing of MP-ASI introduction was inappropriate, and 62.7% of the mothers had insufficient knowledge of responsive feeding. The chi-square test revealed a significant association between the timing of MP-ASI introduction and the occurrence of stunting (p value = 0.047, OR = 0.290), as well as between the occurrence of stunting and maternal knowledge of responsive feeding (p value = 0.008, OR = 0.298). In conclusion, there is a relationship between the occurrence of stunting and the timing of MP-ASI introduction, as well as maternal knowledge of responsive feeding. It is recommended to enhance parental knowledge and attitudes and prevent stunting by providing nutrition education through counseling on proper complementary feeding and responsible childcare practices. This study highlights the importance of improving education and support for mothers to prevent stunting.
Food Security Status and Coping Strategies Among Adolescents During the Covid-19 Pandemic in Mamuju
Authors: Nurbaya Nurbaya , Najdah Najdah
Published: June 2023

Adolescents are one of the vulnerable groups experiencing nutritional problems during the Covid-19 pandemic. Food insecurity in adolescents also impacts access to food, mental disorders, and eating disorders (eating disorders), which can cause nutritional problems in adolescents. This study aimed to measure the food security status of adolescents during the Covid-19 pandemic. Data was collected using a qualitative method through in-depth interviews and focus group discussions (FGD). The informants were state high school/vocational school students aged 15-17 amount 36 people who were selected by purposive sampling in the Mamuju District area, Mamuju Regency, in March-November 2021. Adolescents were vulnerable to experiencing food insecurity during the Covid-19 pandemic. This study found that adolescents experienced food insecurity during the Covid-19 pandemic, ranging from mild food insecurity (30.6%), moderate (58.6) to severe (1.8). Only 9% of youth experience good food security. As conclusion that adolescents experienced food insecurity status and doing several coping strategies to overcome this food insecurity problem by helping their parents to sell goods and find additional jobs outside the home during the Covid-19 pandemic. The problem of food insecurity will indirectly affect the nutritional status of adolescents.
Application of Consent to Perform Medical Actions (Informed Consent) Doctors in Medical Services at Hospitals in Palu City
Authors: Pont Anna Veronica , Enggar Enggar
Published: June 2023

This research aims to know how about the implementation Informed Consent is executed on medic al services in the hospitals in the city of Palu appropriated to rule of Minister of Health Number 290/MENKES/PER/III/2008, and to know the barriers which are faced in the implementation Informed Consent on medical services in teh hospitals in the city of Palu. This research is an empirical legal research or non doctrinal research. The techniques of collection of legal materials is done through observations, interviews, and distributing questionnaires to the respondents by purposive sampling method. All data collected were described and analyzed descriptively, by looking the data percentage collected, and showed in teh form of frequency distribution tabel, and then classified the muchly percentage from each respondents, ethical feasibility from the Research Ethics Commission of the Poltekkes of the Ministry of Health Palu Number 005.1/KEPK-KPK/1/2023 . The result showed that the implementation of Informed Consent on medical services in the hospitas in the city of Palu is appropriated to the Rule of minister of health Number 290/MENKES/PER/III/2008 about the lacks of its implementation, that come from medical nurses as well as from patients. Suggestion that given is to make team for applying informed consent in the hospital that consist of specialis surgery, specialis anaesthesi, psykology, and a standart operational.
The Effect of Hand Massage on Reducing the Anxiety Level of Pre-Surgery Clients in Tangerang City Regional Public Hospital
Authors: Nasihin Nasihin
Published: June 2023

Surgical procedures are important events in human life which complex and stressful. When hearing the word surgery, patients face situations that can cause fear, worry, helplessness, and anxiety. Surgical procedures may cause psychological and physical problems in patients undergoing surgery. Waiting in the preparation room is the most worrying moment for a patient undergoing a surgical procedure. The patient is faced with a situation where the patient is under a high level of anxiety. This study aimed to determine the effect of hand massage on reducing anxiety levels in pre-surgery clients at Tangerang City Regional Public Hospital. This study used a quantitative design with a quasi-experimental approach; a study provides treatment (intervention) and measures the effects of treatment. The approach technique was a one-group pre-test and post-test. The total number of study participants was 18 people. The study utilized a simple random sampling. The results showed that giving hand massage interventions could reduce anxiety levels by 8.2, from 58.3 to 50.1 after a hand massage. The results of the T-test obtained a p-value of 0.001. It was concluded that there was a significant difference between the level of anxiety before and after giving the hand massage intervention. It is recommended to conduct further research with a different approach.
Hypnotherapy Intervention Can Reducing Anxiety and Cortisol in Pregnancy
Authors: Kundarti Finta Isti , Komalyna I Nengah Tanu
Published: June 2023

Pregnant women can experience anxiety during pregnancy. To enhance mental health during pregnancy, interventions related to the relation of the mental body are important. The goal of this research was to determine the effect of hypnotherapy on anxiety and cortisol. The present sample consists of 60 primiparous women with single and regular pregnancies, 18-28 weeks gestation, and a randomized control trial. The group consists of the monitoring group (n = 30) and the hypnotherapy group (n = 30). Intervention with hypnotherapy was performed twice for 7 weeks. Assessment of anxiety at baseline and after 7 weeks of intervention by PASS and blood cortisol. Hypnotherapy intervention and quality treatment obtained by the hypnotherapy community; standard care received by the control group. The result show that The hypnosis in pregnancy intervention could significantly decrease anxiety at the lower level than control group (m=21.07 ± SD=11.98 vs m=34.00 ± SD=17.35),. The hypnotherapy in pregnancy intervention could significantly decrease cortisol lower than control groups (m=14.64, ± SD=5.53 vs m=21.51, ± SD=8,83). The conclusion is intervention with hypnotherapy may enhance pregnant women's mental health, as shown by reducing anxiety and cortisol. Hypnotherapy is an intervention that needs to be provided during pregnancy in midwifery programs to improve the health of mothers and babies.
Towards Zero Maternal Mortality: The Role of Policy Makers in Maternal Perinatal Audit Surveillance and Response
Authors: Ambarwati Ninik Dwi , Kartasurya Martha Irene , Purnami Cahya  Tri
Published: June 2023

The city of Semarang has formed a Maternal Perinatal Surveillance and Response audit committee team. The purpose of this study is to analyze the role of policy actors in the implementation of Maternal Perinatal Surveillance and Response Audit using the policy triangle framework of actors, content, context and process. This research was conducted qualitatively with a case study approach. The selection of informants was carried out purposively. Data collection by in-depth interviews with 6 main informants and 9 triangulation informants. Data were analyzed using thematic analysis, with the inclusion criteria of health workers having more than 3 years’ experience in handling maternal death cases. The results showed that the role of AMP-SR actors was optimal at the Health Service and Community Health Centers, the role of AMP-SR actors in hospitals was not optimal. Not all of the contents of the AMP-SR were understood by the midwives at the Health Centers and Hospitals, the identification and notifications were on time, the OVM and RMM reports were not complete, the maternal death assessment had not been all carried out, the responses had not been all followed up. The implementation process is hampered by limited staff and budget, medical devices are not routinely calibrated, the MPDN application has been used but is not optimal. In Conclusion, the role of policy makers is AMP-SR, intervening in reducing maternal mortality and improving the quality of care. Future research is expected to use the mixed method to find out the role of policymakers quantitatively and qualitatively.
The Effect of Lactation Education on Self-Efficacy of Breastfeeding Mothers
Authors: Nurmiaty Nurmiaty , Arsin A. Arsunan , Syafar Muh. , Aswita Aswita , Dolofu Muliati , Batjo Siti Hadijah , Aji Rustam
Published: June 2023

Factors that affect the success of breastfeeding are the intentions for breastfeeding and the self-efficacy of the mother. Mothers with high breastfeeding intentions and self-efficacy are more likely to exclusively breastfeed in one week and four months after delivery than those with low self-efficacy. This study aims to determine the effect of lactation education on the self-efficacy of breastfeeding mothers. The study design was the quasi-experiment, pre-test, and post-test with a control group design. Samples of mothers (gestational age ≥28-32 weeks) were divided into 3 groups: 1) those who received lactation and modification modules (n = 21), 2) a group that only received modification modules (n = 21), and 3) a group that only received the maternal and child health books (n = 20). Data were collected using questionnaires, self-efficacy measurements were performed before lactation education was performed, and after 6 months of age. The result showed   at initial measurement results (t0), the median self-efficacy score of respondents was between 60-79, while the median self-efficacy score of the mother at the final measurement (t1) was between 60-88. The highest score increase occurred in group 1, then group 3. The median test result showed there was a difference in self-efficacy between the three groups (p= 0,002). This finding means that lactation education with modification modules may increasing self-efficacy of breastfeeding mothers.  This can be seen in group 1 which has the highest self-efficacy score and also has the highest percentage of exclusive breastfeeding percentage of all groups. Lactation education improves the self-efficacy of the mother and also increases the duration of exclusive breastfeeding. Future research can measure the mother's self-efficacy for the duration of breastfeeding.
Risk Factors for Stunting in Toddlers in Gowa Regency
Authors: Sukmawati Sukmawati , Adam Adriyani , Sirajuddin Sirajuddin , Nadimin Nadimin , Sanas Nurhidayah Tiasya
Published: June 2023

Stunting is a nutritional problem faced in various parts of the world, especially in poor countries and developing countries. Prevalence of Stunting in Indonesia based on the results of the Indonesian Nutrition Status Study (SSGI) in 2019 was 27.7% and in 2021 it was 24.4%.  In South Sulawesi, the prevalence of Stunting based on SSGI results in 2021 is 27% while the prevalence of Stunting in Gowa Regency is 33%. The Objectives of this study to Investigating the correlation between stunting and parenting, nutrient intake, infectious diseases, and environmental sanitation.  This research method is observational and analytical with a case-control research design. The number of samples was 38 consisting of 19 working toddler mothers who had Stunting toddlers as a case group and 19 working toddler mothers who had non-Stunting toddlers as a control group. Research results show a foster-pattern connection with Stunting (p= 0,012), there is a connection between protein nutrient intake and stunting (p= 0,020), there is a connection between fat nutrient intake and stunting (p= 0,017), there is a connection between carbohydrate nutrient intake and stunting (p= 0,007). It was concluded that the Stunting incident in toddlers aged 24 to 59 months was related to foster patterns and nutritional substance intake but was not related to infectious diseases and environmental sanitation.
Effects of Counseling on the Quality of Life of MDR Lung TB Patients
Authors: Condeng Baharuddin
Published: June 2023

Research shows initiatives to combat the TB virus. Patients with MDR-Lung Tuberculosis are worried about their quality of life, according to recently completed research in Indonesia. Patients with MDR-TB may benefit from counseling to enhance their quality of life. Study aims to analyze effect of counseling on changes in the quality of life of MDR-TB patients.  A quasi-experimental design with a randomized pretest and posttest control group is used in this kind of research. 38 patients from the Undata Palu Hospital who were randomly chosen between May and November 2022 made up the study's samples. The data were then analyzed using the Wilcoxon test, the Mann Whitney test, and the two mean difference tests. Each participant receives counseling sessions seven times over the course of a six-month period. Counseling using the SOWAN approach is supported by observation, well-being, action, and nursing. The research ethics number for this study is 0011.7/KEPK-KPK/IV/2022 This research received a research ethics number 0011.7/KEPK-KPK/IV/2022 from the Research Ethics Commission of the Ministry of Health Poltekkes Palu. The result of this research show it has been shown that counseling MDR lung TB patients at Undata Palu Hospital improves their quality of life to the point that ongoing counseling is necessary for MDR lung TB patients and can reduce the occurrence of MDR TB.
The Effect of Deppamil Dangke to Pregnant Women with Chronic Energy Deficiency on the Outcome of Newborn Babies in Enrekang Regency
Authors: Arifuddin Hidayanti , Ahmad Mardiana , As'ad Suryani , Husin Farid , Usman Andi Nilawati , Maddeppungeng Martira
Published: June 2023

Chronic energy deficiency (CED) tends to occur in pregnant women and carry detrimental effects, especially on the women during labour and on the fetus. Therefore, it is extremely important to increase nutritional intake during pregnancy for optimized newborn outcome. There are a variety of ways to treat CED, one of which is to provide additional food during pregnancy. This study aims to determine the effect of Deppamil Dangke to pregnant women with CED on the outcome of newborns. This research method used a quasi-experimental design conducted for 18 weeks in Enrekang Regency, with a population of 28 pregnant women > 20 weeks gestation who then used a exhaustive sampling technique where the sample was divided into two consisting of 14 intervention samples and 14 control samples. The results of the study were tested using Mann Whitney showing the value of ρ > α (0.05), which means that there was no difference in the outcome of newborns between the intervention group and the control group. Conclusion. Consuming Deppamil Dangke did not have a direct effect on the outcome of newborns, even though the difference was not significant, but the average outcome of newborns in mothers who consumed Deppamil Dangke + PMT was in the normal category.
Non-usage of land: causes and solutions
Authors:   Land Use Planning Department, State University of Land Use Planning, Moscow, Semochkin V. N. , Bakanova Z. N. ,   Land Use Planning Department, State University of Land Use Planning, Moscow, Rodionov V. P. ,   Land Use Planning Department, State University of Land Use Planning, Moscow, Shurukhina A. N. ,   Land Use Planning Department, State University of Land Use Planning, Moscow
Published: June 2023

The article discusses the issues related to the problem of non-usage of agricultural land. In modern conditions of the agro–industrial complex development in the country, the restoration of unused lands can increase land potential of agriculture. The reasons and classification of the non-usage of land are carried out in this paper. The authors consider the basic requirements for solving the problem.
Small architectural forms in landscape. Current conceptual problems. Landscape and landscape forms
Authors:   Department of Architecture, State University of Land Use Planning, Moscow, Limonad M. Y. , Trubitsyna N. A. ,   State University of Land Use Planning, Moscow, Bezshleeva P. A. ,   Department of Architecture, State University of Land Use Planning, Moscow
Published: June 2023

Misunderstanding of concepts can lead to errors and regulatory violations. The article provides a critical analysis of the concepts of landscape, landscape architecture, and small architectural forms. The authors made the proposals for clarification of concepts and inclusion of these corrections in regulatory documents and design practice. The paper also contains the classification of small forms of various purposes and composition used in landscape architecture paying a special attention to architectural forms as types of objects in the landscape and gradation in size.
Market and cadastral value of real estate. Value and application in the Russian Federation
Authors:   Real Estate Cadastre and Land Use Department, State University of Land Use Planning, Moscow, Katalina L.A.
Published: June 2023

This article outlines the concepts of market and cadastral value of real estate objects, their comparative analysis, definition features and possible application.
Indissociabilidade universitária na UFVJM como práxis no contexto das parcerias para o uso público em áreas protegidas
Authors: Fonseca Virginia Martins , Scalco Raquel Faria
Published: June 2023

A temática das parcerias para o uso público em área protegidas, mais precisamente a modalidade de concessão, tem adquirido significativa visibilidade diante da proposição de programas de governos Federal e Estaduais, como estratégia a ser priorizada para o aumento da visitação e da lucratividade que tais áreas podem gerar. Neste sentido, a universidade, enquanto entidade que tem como função a construção de novos conhecimentos, a formação crítica e cidadã de seus estudantes e a contribuição para uma sociedade mais justa e igualitária, deve se debruçar sobre esta temática a fim de refletir e difundir conhecimentos sobre formas de parcerias mais benéficas para as comunidades localizadas no entorno dessas áreas protegidas. Este artigo tem por objetivo fazer um relato das experiências desenvolvidas no âmbito do curso de turismo da Universidade Federal do Vale do Jequitinhonha e Mucuri sobre as parcerias para o uso público em áreas protegidas, e para tanto foram elencadas e descritas as atividades de ensino, pesquisa e extensão desenvolvidas sobre o tema, ressaltando a necessidade de atendimento ao princípio da indissociabilidade e os desafios e contradições que demandam novas formas de atuação das universidades. Como resultados, entendemos que as ações e iniciativas de ensino, pesquisa e extensão já realizadas sobre o tema no âmbito do curso de turismo da UFVJM não são suficientes, e há ainda muito a ser feito, principalmente para superar os desafios impostos atualmente à prática docente que dificultam o pleno atendimento do princípio da indissociabilidade entre ensino, pesquisa e extensão. Ademais, é preciso colocar em evidência a necessidade de difusão de conhecimentos e iniciativas de parcerias pautadas pelo Marco Regulatório das Organizações da Sociedade Civil, por se tratar de uma importante contribuição que pode reforçar a função social das universidades, destacando a sua atuação para o desenvolvimento científico, socioeconômico e cultural da sociedade na qual está inserida.
Parcerias em áreas protegidas: diversidade de modalidades, propósitos e efeitos envolvidos
Authors: Rodrigues Camila Gonçalves de Oliveira , Botelho Eloise Silveira
Published: June 2023

O artigo apresenta uma contribuição para o estudo e a reflexão sobre o tema das parcerias entre as esferas pública e privada, considerando a repercussão e os possíveis efeitos para as áreas protegidas e os territórios envolvidos. Direciona ênfase às parcerias que visam apoiar os serviços e as atividades de visitação em áreas protegidas, como a modalidade de concessão, que será problematizada diante do viés mercadológico e de priorização dos aspectos econômico-financeiros no atual contexto de gestão das áreas protegidas. A partir da análise de referências bibliográficas e do mapeamento de parcerias em áreas protegidas, são apresentadas questões consideradas relevantes sobre os propósitos que fundamentam as parcerias no âmbito das políticas públicas, o controle social em todo o ciclo de parcerias, e finaliza com a apresentação das parcerias "público-comunitárias" como uma agenda necessária para promover as iniciativas locais de turismo. Destaca-se, no planejamento das parcerias, a composição de arranjos que valorizem a diversidade do país.
Qualidade na prestação de serviços de apoio à visitação em parques nacionais: caso da concessão no Parque Nacional do Itatiaia
Authors: Almeida Igor Carneiro de , Silva Grislayne Guedes Lopes da , Raimundo Sidnei
Published: June 2023

A concessão de serviços de apoio à visitação em áreas de uso público em parques nacionais está sendo incentivada pelo poder público como uma forma de melhorar a qualidade dos serviços prestados e contribuir com a ampliação da experiência dos visitantes nos parques, além de permitir uma melhor relação entre interesses públicos e privados. Diante desse panorama, o objetivo deste artigo é analisar o contexto atual das concessões em parques nacionais, a partir da perspectiva da qualidade na prestação de serviços, observando o caso da concessão de serviços de apoio à visitação na área de uso público do Parque Nacional do Itatiaia (PNI), localizado na serra da Mantiqueira, na divisa entre os estados do Rio de Janeiro e Minas Gerais. Trata-se de uma pesquisa de caráter exploratório e descritivo, com a presença de um referencial teórico-conceitual sobre o contexto das concessões em parques nacionais e sobre a prestação de serviços de apoio à visitação em parques, a partir de um levantamento bibliográfico e documental, e entrevistas semiestruturadas realizadas com atores públicos que atuam no PNI. O artigo destaca que os processos de concessão foram incentivados para que as empresas parceiras pudessem atuar de forma a ampliar a qualidade da prestação de serviços, porém não foi a realidade apresentada na opinião dos entrevistados no PNI. Esperava-se nesse período inicial de concessão, maior agilidade nos investimentos e maior gama de serviços com melhoria na qualidade da prestação, ampliando a experiência dos visitantes no parque. Apesar do grande avanço no site, com a melhoria de explicações sobre os atrativos, disponibilidade de mapas, a possibilidade de comprar ingressos online e a facilidade de pagamento via cartão de débito/crédito, no entanto, os aspectos negativos prevalecem sobre os positivos. Sugere-se como conclusão para novas concessões que os processos sejam participativos, com envolvimento de atores locais, e que os objetivos das parcerias considerem as demandas locais.
A contribuição dos grupos de amigos nas parcerias para o ecoturismo em áreas protegidas
Authors: Itacaramby Julio Cesar Spindola , Cunha André de Almeida , Franco José Luiz de Andrade
Published: June 2023

O presente estudo é uma reflexão sobre as potenciais relações dos grupos de amigos com os princípios do ecoturismo relacionadas à uma ética ambiental ecocêntrica, e a melhoria da governança em áreas protegidas. A pesquisa foi baseada em estudos sobre ecoturismo, ética ambiental, a atuação de grupos de amigos em outros países e um levantamento sobre os grupos de amigos existentes no Brasil. As origens do ecoturismo estão relacionadas com uma busca de conciliar a demanda pelo turismo em áreas naturais com princípios filosóficos e éticos da conservação da natureza. Dentre os diversos princípios propostos, há um consenso para que a prática do ecoturismo traga um estímulo à consciência ambiental e uma contribuição direta para a conservação da natureza. Uma reflexão sobre esses princípios no âmbito da ética ambiental, pode nos trazer um entendimento de que se tratam de princípios mais alinhados ao campo ecocêntrico do espectro da ética ambiental. O presente artigo traz alguns casos e reflexões sobre a atuação dos grupos de amigos em outros países e os principais exemplos nacionais. A partir do referencial teórico e destas reflexões, conclui-se que há um grande potencial dos grupos de amigos contribuírem para reforçar o estímulo da consciência ambiental e para trazer contribuições diretas para conservação da natureza. Destaca-se também o potencial para contribuírem com a melhoria da governança das áreas protegidas. Ademais, a modalidade dos grupos de amigos, já consolidada em diversos países, e ainda incipiente no Brasil, apresenta um promissor potencial de contribuição à gestão e conservação de áreas protegidas nacionais a partir de uma premissa mais ecocêntrica, a qual poderia ser fomentada e devidamente investigada por estudos futuros.
A condução de visitantes no Parque Nacional da Chapada dos Veadeiros (GO): parcerias e efeitos na gestão da visitação
Authors: Maboni Natalia de Oliveira , Rodrigues Camila Gonçalves de Oliveira , Canto-Silva Celson Roberto
Published: June 2023

A condução de visitantes, realizada por moradores locais, vem se consolidando na dinâmica do turismo em parques nacionais. Compondo uma alternativa socioeconômica que visa conciliar a conservação da natureza e a geração de trabalho e renda, a gestão de parques nacionais, em parceria com outras instituições, vem promovendo cursos de capacitação em condução de visitantes como uma das possibilidades de atuação no turismo. O Parque Nacional da Chapada dos Veadeiros (GO) foi uma das primeiras unidades de conservação a propor um curso neste sentido, em 1991. O presente artigo buscou compreender o papel da condução de visitantes na dinâmica de visitação do Parque, considerando a contribuição da atividade na prestação de serviços de apoio à visitação e suas imbricações no que tange à sua relação com a gestão da área. A partir de levantamento e análise de referencial bibliográfico, com destaque para pesquisas recentes realizadas na região, e de entrevistas com condutores locais e analistas ambientais do Parque Nacional, os resultados da pesquisa evidenciam uma relação positiva entre a gestão e os condutores de visitantes. Foi registrada a atuação dos condutores em uma diversidade de iniciativas, a exemplo do manejo e abertura de trilhas, no combate a incêndios e condução de pesquisadores e escolas, entre outras. A mudança na dinâmica de visitação do Parque, devido ao início da atuação da concessão e à cobrança de ingressos, tem gerado diferentes opiniões dos condutores sobre esta modalidade de parceria, repercutindo questionamentos quanto às atividades de visitação que vêm sendo implementadas e às modificações da infraestrutura que a concessionária propõe. Neste contexto, salienta-se a relevância da promoção de uma gestão participativa, transparente e includente, das parcerias em curso no Parque, no intuito de fortalecer o controle social através da valorização das diferentes iniciativas do conselho gestor, do fomento de pesquisas acerca da experiência do visitante e do incentivo da corresponsabilidade mediante ao planejamento participativo das parcerias.
Aporte teórico-conceitual sobre as parcerias público-comunitárias para o lazer e o turismo em áreas protegidas
Authors: Botelho Eloise Silveira , Raimundo Sidnei
Published: June 2023

O bem comum, ou comum, tem ganhado espaço no debate sobre o uso de recursos e a necessidade de outras formas de pensar a gestão e governança de áreas protegidas. Este artigo apresenta uma leitura teórico-conceitual sobre a teoria do “comum” de Dardot e Laval (2017) como aporte para interpretar as parcerias “público-comunitárias” para viabilizar o lazer e o turismo em áreas protegidas. Por meio de revisão bibliográfica sobre parcerias e turismo de base comunitária em áreas protegidas, a pesquisa, de cunho exploratório, busca caracterizar as parcerias “público-comunitárias” como arranjos estabelecidos entre a esfera pública e iniciativas e coletivos protagonizados por povos e comunidades tradicionais e locais. Reconhece que essas parcerias são múltiplas e diversas, mas identificam-se por serem promovidas por coletivos, redes, e formas de organização social formalizadas que conduzem ações guiadas por princípios políticos em busca da construção de autogestão de territórios e de formas contra-hegemônicas de turismo. Porém a teoria do “comum” ainda precisa avançar no que se refere às pautas específicas dos povos originários e comunidades tradicionais e locais, sobretudo enraizadas no Sul global. Este trabalho pode contribuir como aporte teórico para evidenciar a composição de parcerias para o lazer e turismo em unidades de conservação que valorizam a diversidade sociocultural e econômica de territórios e sua contribuição para a conservação da natureza, apoiada em formas de organização social locais e comunitárias.
A Review of the Applicability of Current Green Practices in Healthcare Facilities
Authors: Soares Ana Luísa , Buttigieg Sandra C. , Bak Bartosz , McFadden Sonya , Hughes Ciara , McClure Patricia , Couto Jose Guilherme , Bravo Isabel
Published: June 2023

Background: Circular economy (CE) has raised great interest as a concept and as a development model worldwide. This concept aims to provide a substitute for the linear economic model, which was based on production and consumption, continuous growth, and resources depletion. CE allows a greener economy with sustainable development and promotes more balanced societies. The healthcare sector is a major contributor to the climate crisis, with a carbon footprint representing 4.4% of global net emissions. It is thus essential to rethink the applicability of CE in healthcare. Methods: We conducted a scoping review guided by the Arksey and O’Malley methodological framework and utilised PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist. A systematic search from MEDLINE complete, SCOPUS, and Web of Science databases published between 1992 and 2022. Results: Through database searching a total of 1018 records were identified and 475 duplicates were removed. From the total search, 543 articles were screened by title/abstract according to the inclusion and exclusion criteria. After screening, 38 full-text articles were selected and assessed for eligibility. Forty-seven additional records were also identified through other sources and screened for eligibility. Other sources included: 12 articles from snowballing of previous papers; 9 articles following peer-reviewers suggestions; 19 reports from relevant organisations in CE and healthcare; two webpage, and one book. Conclusion: Specific areas were identified where hospitals could reduce their greenhouse gas (GHG) emissions and consequently their negative environmental impact, namely through waste management, energy, water, transportation/travel, hospital design, food optimisation, green procurement, and behaviour. Also, lack of staff awareness and knowledge of the environmental impact of healthcare, and hospitals sustainability were identified as major contributors.
Corporate Political Activity: Taxonomies and Model of Corporate Influence on Public Policy
Authors: Ulucanlar Selda , Lauber Kathrin , Fabbri Alice , Hawkins Ben , Mialon Melissa , Hancock Linda , Tangcharoensathien Viroj , Gilmore Anna B.
Published: June 2023

Background: Non-communicable diseases (NCDs) kill 41 million people a year. The products and services of unhealthy commodity industries (UCIs) such as tobacco, alcohol, ultra-processed foods and beverages and gambling are responsible for much of this health burden. While effective public health policies are available to address this, UCIs have consistently sought to stop governments and global organisations adopting such policies through what is known as corporate political activity (CPA). We aimed to contribute to the study of CPA and development of effective counter-measures by formulating a model and evidence-informed taxonomies of UCI political activity. Methods: We used five complementary methods: critical interpretive synthesis of the conceptual CPA literature; brief interviews; expert co-author knowledge; stakeholder workshops; testing against the literature. Results: We found 11 original conceptualisations of CPA; four had been used by other researchers and reported in 24 additional review papers. Combining an interpretive synthesis of all these papers and feedback from users, we developed two taxonomies – one on framing strategies and one on action strategies. The former identified three frames (policy actors, problem, and solutions) and the latter six strategies (access and influence policy-making, use the law, manufacture support for industry, shape evidence to manufacture doubt, displace, and usurp public health, manage reputations to industry’s advantage). We also offer an analysis of the strengths and weaknesses of UCI strategies and a model that situates industry CPA in the wider social, political, and economic context. Conclusion: Our work confirms the similarity of CPA across UCIs and demonstrates its extensive and multi-faceted nature, the disproportionate power of corporations in policy spaces and the unacceptable conflicts of interest that characterise their engagement with policy-making. We suggest that industry CPA is recognised as a corruption of democracy, not an element of participatory democracy. Our taxonomies and model provide a starting point for developing effective solutions.
Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016–2022
Authors: Onvlee Olivier , Kok Maryse , Buchan James , Dieleman Marjolein , Hamza Mariam , Herbst Christopher
Published: June 2023

Background: Conflict has devastating effects on health systems, especially on healthcare workers (HCWs) working in under-resourced and hostile environments. However, little evidence is available on how policy-makers, often together with development partners, can optimize the organization of the health workforce and support HCWs to deliver accessible and trustworthy health services in conflict-affected settings (CAS). Methods: A scoping review was conducted to review recent evidence (2016-2022) on human resources for health (HRH) in CAS, and critically discuss HRH challenges in these settings. Thirty-six studies were included in the review and results were presented using an adapted version of the health labour market (HLM) framework. Results: Evidence from CAS highlights that conflict causes specific constraints in both the education sector and in the HLM, and deepens any existing disconnect between those sectors. Parallel and inadequate education and performance management systems, attacks on health facilities, and increased workload and stress, amongst other factors, affect HCW motivation, performance, distribution, and attrition. Short-term, narrowly focused policy-making undermines the long-term sustainability and resilience of the health workforce in CAS, and also contributes to the limited and narrow available research base. Conclusion: While HRH and workforce issues in CAS include those found in many other low- and middle-income countries (LMICs), an additional set of challenges for HCWs, governance dynamics and institutional constraints in CAS ‘multiply’ negative effects on the health workforce. HRH policies, programmes and interventions must be aligned with the political and broader societal context, including the stage, severity and other dynamics of conflict. During conflict, it is important to try to monitor in- and outflow of HCWs and provide HCWs the support they need at local level or through remote measures. The post-conflict situation may present opportunities for improvement in HRH, but a clear understanding of political economy dynamics is required to better act on any such a window of opportunity.
Integrating System Dynamics and Action Research: Towards a Consideration of Normative Complexity Comment on "Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research"
Authors: Wehrens Rik , Oldenhof Lieke , Heerings Marjolijn , Petit-Steeghs Violet , Haperen Sander van , Bal Roland , Greenhalgh Trisha
Published: June 2023

Holmström and co-authors argue for the value of integrating system dynamics into action research to deal with increasing complexity in healthcare. We argue that despite merits, the authors overlook the key aspect of normative complexity, which refers to the existence of multiple, often conflicting values that actors in healthcare systems have to pragmatically develop responses to in their daily practices. We argue that a better theoretical and empirical understanding of the multiplicity of values and how actors deal with value conflicts in daily practices can enrich discussions about complexity in healthcare. We introduce the alternative methodology of ‘value exnovation’ for action researchers to broaden the scope of system-based thinking and action research in healthcare.
Coercion and Its Discontents: The Promise and Peril of Increasingly Restrictive of Vaccination Mandates Comment on "Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates"
Authors: Colgrove James
Published: June 2023

Attwell and Hannah present a cogent analysis of why policy-makers in four jurisdictions chose to use coercive approaches to increase vaccination rates between 2015 and 2017. Their study calls attention to the challenging political calculations that are necessary when choosing between coercion and persuasion to increase vaccine uptake. Further research is needed on the consequences of making a mandatory vaccination policy more restrictive, in order to better understand the backlash and resistance such a strategy may provoke. Although one reason that policy-makers may choose a coercive approach is that it is cheaper and easier to implement than a persuasive one, sociopolitical trends and backlash related to the COVID-19 pandemic may make coercive policies more politically risky in the coming years.
Power and Other Commercial Determinants of Health: An Empirical Study of the Australian Food, Alcohol, and Gambling Industries
Authors: de Lacy-Vawdon Cassandra , Vandenberg Brian , Livingstone Charles
Published: June 2023

Background: Commercial determinants of health (CDoH) represent a critical frame for exploring undue corporate and commercial influence over health. Power lenses are integral to understanding CDoH. Impacts of food, alcohol, and gambling industries are observable CDoH outcomes. This study aims to inform understanding of the systems and institutions of commercial and/or corporate forces working within the Australian food, alcohol, and gambling industries that influence health and well-being, including broader discourses materialised via these systems and institutions. Methods: Twenty semi-structured interviews were conducted with key-informants on Australian public policy processes. Interviewees were current and former politicians, political staff members, regulators and other public servants, industry representatives, lobbyists, journalists, and researchers with expertise and experience of the Australian food, alcohol, and/ or gambling industries. Interviews sought participants’ perceptions of Australian food, alcohol, and gambling industries’ similarities and differences, power and influence, relationships, and intervention opportunities and needs. Results: Strategies and tactics used by Australian food, alcohol and gambling industries are similar, and similar to those of the tobacco industry. They wield considerable soft (eg, persuasive, preference-shaping) and hard (eg, coercive, political, and legal/economic) power. Perceptions of this power differed considerably according to participants’ backgrounds. Participants framed their understanding of necessary interventions using orthodox neoliberal discourses, including limiting the role of government, emphasising education, consumer freedom, and personal choice. Conclusion: Food, alcohol, and gambling industries exercise powerful influences in Australian public policy processes, affecting population health and well-being. Per Wood and colleagues’ framework, these manifest corporate, social, and ecological outcomes, and represent considerable instrumental, structural, and discursive power. We identify power as arising from discourse and material resources alike, along with relationships and complex industry networks. Addressing power is essential for reducing CDoH harms. Disrupting orthodox discourses and ideologies underpinning this should be a core focus of public health (PH) advocates and researchers alike.