Littérature scientifique sur le sujet « Mutual health organization »

The development of health schools for patients makes it possible to implement one of the fundamental principles of reforming disease prevention through mutual understanding and empathy, the ability of a medical specialist to explain and persuade, and to bring authoritative sources of information in the classroom.

This article presents a case study of a news organization examined when it was introducing a proprietary content management system (CMS) for social journalism. The CMS enables users to publish, form groups, and follow one another to create personalized local health news feeds. Applying the mutual shaping of technology (MST) construct in analysis organized according to the hierarchy of influences model, this article examines how the CMS influenced the news organization and vice versa. Even in an organization with a great deal of control over a small innovation, the predominant perception was that the CMS was a technological incursion rather than a tool to be molded. Instead of asserting professional norms over the technology as social shapers, journalists focused on managing changes in routines and organizational structures and on managing perceptions about the “experiment.” The project has stagnated. This article discusses why, and it addresses the usefulness of the MST construct for examining innovation iterations in news organizations.

Self-help organizations (SHOs) enable patients with chronic health conditions (PCHCs) to overcome common difficulties through the exchange of knowledge and mutual assistance, which serves as the basis for promoting the self-reliance and well-being of PCHCs. Nevertheless, practical challenges persist because little is known about what and how to evaluate for the developmental outcomes of SHOs. To address this knowledge gap, the present study seeks to develop and validate the Self-Help Organization Development Scale (SHODS). A total of 232 core members from 54 SHOs in Hong Kong participated in our study. The SHODS structure was validated by confirmatory factor analysis. This analysis derived five factors: citizen support, business support, member recovery and mutual aid, organizational health, and functional sustainability. The five-factor structure demonstrated stability across various types of SHOs, as validated by the subgroup analysis based on two criteria: duration of SHO establishment and organization affiliation. Good concurrent validity was supported by significant correlations between the SHODS factors and organizational variables, including staff supervision, staff understanding, networking, advocating, and educating the public and patients. The SHODS also showed excellent internal consistency. In conclusion, the SHODS is a psychometrically sound instrument for measuring the developmental outcomes of SHOs.

The corporatization of health care organizations has become a significant international trend. This paper examines that trend, comparing the development of corporate health care in the USA with the impact of the New Zealand health reforms. The paper traces the evolution of the organizations of health care systems and explains the emergence of the corporate form. We argue that the corporate model of work organization is unsuited to the complex and ambiguous nature of the medical task as it ignores inherent interdependencies. An alternative is needed which addresses work practices rather than just participation in decision making and is based on a concept of mutual interdependence and support in the execution of work.

The present study examined the effects of self-efficacy and social support on the mental health of 65 members of a mutual-aid organization in Hong Kong. Participants had anxiety and depressive problems and had received cognitive-behavioral treatment before they joined the mutual-aid groups in the organization. A three-wave design was adopted, and participants filled in measures including the General Health Questionnaire, the State Anxiety Inventory, the Centre of Epidemiologic Studies Depression Scale, the General Self-efficacy Scale, and the Medical Outcomes Study Social Support Survey. Regression analyses showed that residualized self-efficacy was a strong predictor of the mental health variables. Effects of social support, both functional and structural, were mainly mediated by self-efficacy.

Introduction: There is the quest for sustainable eradication of threats to enhance the health of organizations. This study's curiosity is to tackle the concept of determining how an organization diagnoses the threats in its environment. Methods: This study is qualitative research and content analysis method has been adopted by the researcher. The research design of content analysis is used to create inferences from papers and observations. three people were interview through video recording. Permission was sort before the interview was granted, and the researcher assured the interviewee that every detail of the recorded video will be kept confidential. The recorded video interview data was transcribed by an expect transcriber, and were analyzed, and interpreted by the researcher Results: The study revealed that effective clinical diagnosis that leads to changes requires a sense of urgency, the establishment of a strong team of change agents. The development of a vision and strategy through careful and well-thought-out planning, and the communication of the vision for change to the business organization, the empowerment of team members to help and participate in change initiatives, and the generation of shifts. Discussion: The members of the organizations may not have a mutual perspective on the organizational diagnosis. Therefore, professionals need to consider obtaining data from various sources and consider this in their diagnosis and procedures. The study recommends that different quantitative methods can be used to diagnose business organizations.

Gaps in financial access remain stark in the largest part of developing countries and have relevant consequences on poor households’ economic decisions, such as credit, saving and risk management. Lack of availability of formal financial services provided by either the market or public authorities (e.g in case of health insurance) have been compensated by the activity of informal groups, associations and arrangements. Old and new forms of community-based groups have been largely documented in most of developing countries and are shown to be active in several crucial economic domains. They have different levels of institutionalization as they can simply rely on social norms or can have rules and a certain degree of formalization concerning e.g. selection criteria, enforcement, sanctions. They all have in common the voluntary participation of people from the same community (village, neighbourhood, people of the same profession), the delivery of services to members, the non-profit character, the underpinning values of solidarity and mutual help. Some examples of community-based groups in Sub-Saharan Africa are analysed in this thesis: Rotating Saving and Credit Associations (roscas), funeral groups and mutual health organizations (MHOs). The importance of studying community-based arrangements lies in the premise that interventions at the level of a local community can deliver more effective and equitable development. Moreover, examining the mechanics of the informal market is very important for two reasons. First, the strength of the informal market is important for measuring and predicting how effective specific formal sector interventions could be, in the perspective of scaling-up. Second, lessons learned in the informal markets can help shape policy in the formal (Karlan and Morduch 2009). In chapter 1, drawing on data from a household survey in urban Benin1, we examine membership in two types of informal groups that display the characteristics of a commitment device: rotating savings and credit associations (roscas) and funeral groups. We investigate whether agents displaying time-inconsistent preferences are sophisticated enough to commit themselves through taking part in such groups. We provide evidence indicating that women who are hyperbolic are more likely to join these groups and to save more through them, but men displaying similar preferences appear naïve with regards membership. Moreover, we find that hyperbolic agents, irrespective of their gender, tend to restrain consumption of frivolous goods to a larger extent. Furthermore, weak evidence is provided that microcredit can be used as a device to foster self-discipline. We also ensure that our results cannot be explained by intrahousehold conflict issues. The second chapter largely draws on Bonan J, Dagnelie O., LeMay-Boucher P. and Tenikue M. (2012) “Is it all about Money? A Randomized Evaluation of the Impact of Insurance Literacy and Marketing Treatments on the Demand for Health Microinsurance in Senegal”, Working Papers 216, University of Milano-Bicocca, Department of Economics. It is based on a field work we carried out in Spring-Summer 2010 in Thies, Senegal, which I coordinated and supervised. The chapter presents experimental evidence on mutual health organizations (MHOs) in the area of Thiès, Senegal. Despite their benefits, in some areas there remain low take-up rates. We offer an insurance literacy module, communicating the benefits from health microinsurance and the functioning of MHOs, to a randomly selected sample of households. The effects of this training, and three cross-cutting marketing treatments, are evaluated using a randomized control trial. We find that our various marketing treatments have a positive and significant effect on health insurance adoption, increasing take-up by around 35%. Comparatively the insurance literacy module has a negligible impact on the take up decisions. We attempt at providing different contextual reasons for this result. The third chapter is an extension of the second and draws on the same dataset. We measure the willingness to pay (WTP) for MHOs premiums in a Senegalese urban context. WTP valuations can help both policy makers and existent MHOs in better understanding the characteristics of the demand of microinsurance products. This chapter considers the role of individual and household socio-economic determinants of willingness to pay for a health microinsurance product and add to the previous literature evidence of the role of income, wealth and risk preferences on individual WTP. We find that richer, more wealthy and more risk-averse head of households are more likely to reveal a higher WTP for health microinsurance. Conscious of the potential limits of our elicitation strategy (bidding game), we incorporate the existent literature on the effects of ‘preferences anomalies’ (Watson and Ryan 2007) and estimate WTP accounting for structural shift in preferences (Alberini et al. 1997), anchoring effect (Herriges and Shogren 1996) and the two effects together (Whitehead 2002). We find evidence of slight underestimation of the median WTP if preferences anomalies are not taken into consideration. However, the extent of such difference is far from being relevant. Previous results on the determinants of WTP are robust to the effect of such preference anomalies. We also provide an analysis of the predictive power of WTP on the actual take-up of insurance following our offering of membership to a sample of 360 households. WTP appears to have a positive and significant impact on actual take-up.

GROW is a mutual help organisation founded in Sydney, Australia, in 1957 by former patients of mental hospitals as a direct response to their own experienced needs after they had been discharged from hospital. Initially established to assist psychiatric patients' rehabilitation into the community, the organisation soon broadened its aims to help members deal with any problems and to fill a preventative and educative role in the area of mental health so that many of its members now have never been diagnosed as mentally ill. The organisation adopted a pattern of meeting weekly and evolved a literature centred on the record of members' successful strategies. Government and private funding were attracted and by 1985 GROW was established in every state and territory in Australia and in New Zealand, Ireland, the United States and Canada. In Australia public funding was by then almost $1.5m per annum. Although this provided de facto recognition of GROW as a mental health service, because of its complexity no attempt had been made to measure the effectiveness of the organisation. With added competition for funding for community based care of the mentally ill, pressure mounted for an objective evaluation. This study examines, in three phases, GROW throughout Australia at the group and individual level. The first phase is a national survey to identify the personal and demographic characteristics of GROW attenders, their reasons for attending, their use of medication and professional resources and their perception of the efficacy of the organisation. The second phase, with a sample of groups chosen to be representative of the national profile in the light of the first phase, examines the group climate and processes seen to be operating in the meetings. The pattern of member attendance is also determined. The third phase is a longitudinal study in which a sample of GROW members, again representative of the national profile, are interviewed on five occasions over at least twelve months to determine changes, if any, coincident with GROW attendance. Ninety-one percent of GROW attenders nationwide responded to the phase one questionnaire. Two-thirds of members were female, approximately 65% were aged between 30 and 60 years, many reported limited social networks and felt that GROW contacts helped alleviate this situation. Most perceived GROW as helpful and they reported a decreased use of medication and professional help. Cluster analysis revealed a number of subtypes of GROW attenders: those with psychological/psychiatric symptoms; those with diminished social networks; those who had experienced traumatic life events; and those wanting to help others. Phase two concluded that GROW groups are strongly cohesive with a firm leadership and a structured meeting pattern resistant to change. Groups encourage personal growth and personal change in a climate that avoids the expression of negative feelings and confrontation. Over a 13 week period, nearly one third of a representative sample attended one meeting only, one third attended at least half the meetings and 9.4% attended all the weekly meetings. The average attendance at each group was between five and six members. Phase 3 involved four interviews over six months and one follow-up interview at least six months later with 102 GROW members. Ninety four percent of possible interviews were completed and contributed to the results. The study concluded that attendance at GROW was related to a perceived improvement in many aspects of members' lives, improved quality of friendships and a decrease in symptomatology. Comparison with a non-equivalent control sample and comparison between regular and irregular GROW attenders strengthened this conclusion. The implications of the conclusions for mental health services are discussed and suggestions for further research explored.

Bibliography: leaves 268-317
The challenge of accessing affordable healthcare services in the developing countries prompted the promotion of community-based health insurance (CBHI) as an effective alternative. CBHI has been implemented in many countries of the South over the last three decades for the purpose of improving access and attaining universal health coverage. However, the sudden stoppage of a CBHI programme in rural Nigeria raised a lot of concerns about the suitability of the health financing scheme. Thus, this thesis examines the stoppage of the CBHI programme in rural Kwara, Nigeria. Premised on the health policy triangle as a conceptual framework, mixed methods approach was adopted for data collection. This involved 12 focus group discussions, 22 in-depth interviews, 32 key informant interviews and 1,583 questionaires. The study participants were community members, community leaders, healthcare providers, policymakers, international partner, health maintenance organisation officials and a researcher. Findings revealed that transnational actors relied on various resources (e.g. fund and ‘expertise’) and formed alliances with local actors to drive the introduction of the programme. As such, the design and implementation of the policy were dominated by international actors. Despite the sustainability challenges faced by the programme, the study found that it benefitted some of the enrolled community members. Though, even at the subsidised amount, enrolment premium was still a challenge for many. The main reasons for the stoppage of the programme are a paucity of fund and poor management. The stoppage of the programme, however, signified a point of reversal in the relative achievements recorded by the CBHI scheme because community members have deserted the healthcare facilities due to high costs of care. In view of these, the thesis notes that short-term policies often lead to temporary outcomes and suggests the need to repurpose the role of the state by introducing a long-term comprehensive healthcare policy – based on the reality of the nation – to provide equitable healthcare services for the citizenry irrespective of their capacity to pay.
Sociology
D. Phil. (Sociology)

In this chapter, the author discusses several concepts, measures, and datasets that open new avenues for social epidemiologists to use political sociology to explain the distribution of population health. He also describes how social epidemiological concepts can feed back into political sociology to advance its agenda of understanding the social organization of power. Three themes integrate the concerns of these still-disconnected fields: (1) conceptualization of etiologic period, (2) definition of population, and (3) distinction between population averages and population variances. Mutual appreciation of the key concepts for each field is essential for the development of synthetic engagement between political sociology and social epidemiology.

The doctor-patient relationship is besieged by several forces transforming the health care system at the present time, particularly the introduction of retail thinking that seeks to turn patients into consumers. This book examines how the relationship has changed and continues to evolve within a care delivery context that is more corporatized, value-driven, metric-oriented, and transactional than ever before. Through the voices of doctors and patients, combined with an in-depth analysis of bigger system trends, it finds that relational care characterized by proven interpersonal and humane features like trust, empathy, and mutual respect has withered over time, succumbing to a hostile delivery environment in which physicians are increasingly isolated from patients; the organization seeks to garner the allegiances of patients; and patients develop lowered expectations that leave them susceptible to cheapened forms of care delivery. Both doctors and patients still emphasize the importance of relational care for effective diagnosis and treatment, and for maintaining strong emotional bonds that enhance both parties’ experiences. However, the findings suggest that the rise of transactional care delivery in the health system must be offset by greater physician advocacy for relational medicine; a sharp focus on measuring relational care delivery in all its forms; and monetizing relational care so that it becomes something of value to the large organizations in which doctors and patients now find themselves interacting.

This chapter analyzes the provision of health services in Colombia, which are constitutionally recognized even if in reality they are far from being guaranteed in terms of gratuity and universal coverage for most of the population. A situation possibly brought about by the market orientation promoted by the legal framework and the effects it has brought in terms of general interest, in exclusion and in the tendency towards the deterioration in the provision of services. Some of the actors in the system, characterized by a common property, offer a real and effective alternative in getting closer to the right to health for all. In this context, the organizational logic of mutual associations stands out as an instrument to optimize public health policy even if a new institutional dynamic is required, with anew relation between the State and social organizations. A relation in which the concept of common good is an appropriate starting point and finality as a strategy of governing the institutional agreements that improve the relations between the public organisms and the citizens.

AbstractThe authors describe the plight of sex workers, a particularly disadvantaged community that is highly marginalized and vulnerable. Sex workers were hard hit by the pandemic. The authors examine the impact of COVID-19 on sex workers’ lives and livelihoods, their response to the crisis, and the strategies that they employed to battle the pandemic.During the lockdown, female sex workers lost their livelihoods which plunged them and their families into extreme poverty. Even when unlock measures were announced, the business of sex work did not return to normal. Sex work, by its very nature, demands physical proximity—not physical distancing. Consequently, sex workers had to innovate to find work to survive. Loss of livelihoods also brought forth hidden mental health problems. Gripped by anxiety and depression due to the uncertainty about when the pandemic would end, sex workers went into despair. Some even attempted suicide. Violence in the family increased significantly. For sex workers living with HIV, there was the added anxiety about the continuation of anti-retroviral therapy (ART). Community-based organizations (CBOs) took on the responsibility of providing drugs to sex workers by developing a unique supply chain. The CBO members collected the drugs from the health centers and deliver them to sex workers at a mutually convenient place, thereby ensuring confidentiality.The authors draw attention to sex workers who are invisible in most discourses. This vulnerable, marginalized community was seriously affected by the pandemic. Sex workers were victims but were also the first responders to the pandemic. Sex worker collectives formed to fight HIV, were by their very nature, well-equipped to fight the COVID-19 pandemic. The government’s announcement to provide rations to the poor was a welcome move, but it was not of much help to sex workers as they did not possess ration cards. The sex worker collectives valiantly fought this battle and won. The Supreme Court of India directed the states to provide sex workers with dry rations without insisting on any proof.The stories of the lives and resilience of sex workers, narrated in this chapter, are inspiring. The authors discuss the plight of female sex workers during the COVID-19 pandemic. The community of sex workers was missing from all government policies and welfare schemes. The sudden lockdown robbed them of their livelihoods. Basic necessities like food and shelter became elusive. The authors relate the stories of the struggles of sex workers from different parts of the country.They discuss how despite uncertainty, stigma, and loss of livelihoods, sex workers emerged strong. The resilient spirit of sex workers should be celebrated. The stories of sex workers have a common thread of resilience, resourcefulness, grit, and determination in the face of unsurmountable challenges.

A network of east central European health experts involved in the state-building of their post-imperial region were responsible for the methods and objectives of the League of Nations Health Organization. Their programmes challenged both western influence in public health and the great powers’ dominance within interwar internationalism. The health services of east central Europe did not evolve in national isolation, and their principles of mutual assistance became the basis for the League Health Organization to redefine human security and to support early international development projects.

In homeless youth, severe mental illness is an endemic and a serious issue that profoundly impacts this vulnerable population and warrants specific, comprehensive interventions. This chapter reviews the phenomenon, including the mutual interaction between youth homelessness and severe mental illness, its epidemiology, and its broad psychosocial associated factors. It describes the numerous barriers (such as those associated with homeless youth experiences and characteristics as well as social and health services organization) to mental health services related to suboptimal utilization of existing facilities and shortcomings in accessing them for homeless youth with severe mental illness. The chapter also describes factors facilitating access and summarizes efforts that have been made internationally to address these barriers through a rethinking of services organization and by implementation of specific interventions aimed at homeless youth and related populations with severe mental illnesses.

In today's technology age, our communication style has changed and social media channels that provide remote and mutual interaction on digital platforms have become an important communication tool. In this digital communication age, when the need for remote communication has increased and is needed more with the pandemic period, it is seen that health information is shared more and more on social media platforms. In this process, it is seen that the health ministries of all countries, especially the World Health Organization (WHO), actively use social media channels as well as media channels for sharing health information. In this chapter, basic information about social media, social media channels, health communication, health communication in social media, and the effect of this communication on health literacy will be explained. For this purpose, the relevant social media platforms and studies have been examined and conveyed.

Business process modeling aims to construct digital representations of processes being executed in the company. However, models derived from the event logs of their execution tend to overcomplicate the desired representation, making them difficult to apply. The most accurate recovery of the business process model requires a comprehensive study of the various artifacts stored in the company’s information system. This paper, however, aims to explore the possibility to automatically obtain the most accurate model of business process, using mutual optimization of models recovered from a set of event logs. Further, the obtained models are executed in multi-agent simulation model of company, and the resulting event logs are examined to determine patterns that are specific to distinct employees and those that generally characterize business process.

In this chapter, Mark Britnell focuses on Israel’s healthcare system, one of the best-kept secrets in healthcare. He looks at how Israel has achieved a primary care-led health system with four health maintenance organizations (HMOs) providing citizens with both choice and comprehensive cover. Primary and community care spend first exceeded that of secondary and acute care 20 years ago, but it has taken time. Its origins can be traced back to 1911 when an orchard worker had his arm severed and 150 immigrant workers joined together to form a mutual aid healthcare organization called Clalit, a non-governmental, non-profit entity. They knew that to help themselves they had to help each other, and Clalit is now the largest HMO in Israel with 14 hospitals and more than 1,200 primary and specialized clinics. The health system of Israel is not perfect but is highly innovative—not least in its use of patient information—and deserves attention.

Cultural neuroscience is a research field that investigates the mutual influences of cultural and biological sciences on human behavior. Research in cultural neuroscience demonstrates cultural influences on the neurobiological mechanisms of processes of the mind and behavior. Culture tunes the structure and functional organization of the mind and the nervous system, including processes of emotion, cognition, and social behavior. Environmental and developmental approaches play an important role in the emergence and maintenance of culture. Culture serves as an evolutionary adaptation, protecting organisms from environmental conditions across geography. Cultural variation in the human mind, brain, and behavior serves to build and reinforce culture throughout the life course. This chapter examines the theoretical, methodological, and empirical foundations of cultural neuroscience and its implications for research in population health disparities and global mental health.

In the business world, as well as in everyday life, there is an increasing number of needs, requirements, and expectations that need to be met to ensure mutual satisfaction. To achieve this, standards are increasingly taking place within the business of organizations, to make business simpler, safer, and more secure. By applying and introducing standards, companies achieve continuous improvement of their performance as well as a competitive advantage.The aim of this paper is to present the standards for companies from the food industry and their supply chain. Knowing that the food industry is very specific in terms of safety and quality, a number of standards have been developed to prevent possible inconsistencies on this issue, which may affect human and animal health. All actors in the supply chain, and especially end users, demand that the products that reach them be safe, which gains trust in the organization. Organizations are increasingly introducing standards and systems that will enable the safety and quality of their products, after which improvements in the performance of the organization are realized.

Attention to safety and health are of ever-increasing priority to industrial organizations. Good Safety is demanded by stockholders, employees, and the community while increasing injury costs provide additional motivation for safety and health excellence. Safety has always been a strong corporate value of DuPont and a vital part of its culture. As a result, DuPont has become a benchmark in safety and health performance. Since 1990, DuPont has re-engineered itself to meet global competition and address future vision. In the new re-engineered organizational structures, DuPont has also had to re-engineer its safety management systems. A special Discovery Team was chartered by DuPont senior management to determine the “best practices’ for safety and health being used in DuPont best-performing sites. A summary of the findings is presented, and five of the practices are discussed. Excellence in safety and health management is more important today than ever. Public awareness, federal and state regulations, and enlightened management have resulted in a widespread conviction that all employees have the right to work in an environment that will not adversely affect their safety and health. In DuPont, we believe that excellence in safety and health is necessary to achieve global competitiveness, maintain employee loyalty, and be an accepted member of the communities in which we make, handle, use, and transport products. Safety can also be the “catalyst” to achieving excellence in other important business parameters. The organizational and communication skills developed by management, individuals, and teams in safety can be directly applied to other company initiatives. As we look into the 21st Century, we must also recognize that new organizational structures (flatter with empowered teams) will require new safety management techniques and systems in order to maintain continuous improvement in safety performance. Injury costs, which have risen dramatically in the past twenty years, provide another incentive for safety and health excellence. Shown in the Figure 1, injury costs have increased even after correcting for inflation. Many companies have found these costs to be an “invisible drain” on earnings and profitability. In some organizations, significant initiatives have been launched to better manage the workers’ compensation systems. We have found that the ultimate solution is to prevent injuries and incidents before they occur. A globally-respected company, DuPont is regarded as a well-managed, extremely ethical firm that is the benchmark in industrial safety performance. Like many other companies, DuPont has re-engineered itself and downsized its operations since 1985. Through these changes, we have maintained dedication to our principles and developed new techniques to manage in these organizational environments. As a diversified company, our operations involve chemical process facilities, production line operations, field activities, and sales and distribution of materials. Our customer base is almost entirely industrial and yet we still maintain a high level of consumer awareness and positive perception. The DuPont concern for safety dates back to the early 1800s and the first days of the company. In 1802 E.I. DuPont, a Frenchman, began manufacturing quality grade explosives to fill America’s growing need to build roads, clear fields, increase mining output, and protect its recently won independence. Because explosives production is such a hazardous industry, DuPont recognized and accepted the need for an effective safety effort. The building walls of the first powder mill near Wilmington, Delaware, were built three stones thick on three sides. The back remained open to the Brandywine River to direct any explosive forces away from other buildings and employees. To set the safety example, DuPont also built his home and the homes of his managers next to the powder yard. An effective safety program was a necessity. It represented the first defense against instant corporate liquidation. Safety needs more than a well-designed plant, however. In 1811, work rules were posted in the mill to guide employee work habits. Though not nearly as sophisticated as the safety standards of today, they did introduce an important basic concept — that safety must be a line management responsibility. Later, DuPont introduced an employee health program and hired a company doctor. An early step taken in 1912 was the keeping of safety statistics, approximately 60 years before the federal requirement to do so. We had a visible measure of our safety performance and were determined that we were going to improve it. When the nation entered World War I, the DuPont Company supplied 40 percent of the explosives used by the Allied Forces, more than 1.5 billion pounds. To accomplish this task, over 30,000 new employees were hired and trained to build and operate many plants. Among these facilities was the largest smokeless powder plant the world had ever seen. The new plant was producing granulated powder in a record 116 days after ground breaking. The trends on the safety performance chart reflect the problems that a large new work force can pose until the employees fully accept the company’s safety philosophy. The first arrow reflects the World War I scale-up, and the second arrow represents rapid diversification into new businesses during the 1920s. These instances of significant deterioration in safety performance reinforced DuPont’s commitment to reduce the unsafe acts that were causing 96 percent of our injuries. Only 4 percent of injuries result from unsafe conditions or equipment — the remainder result from the unsafe acts of people. This is an important concept if we are to focus our attention on reducing injuries and incidents within the work environment. World War II brought on a similar set of demands. The story was similar to World War I but the numbers were even more astonishing: one billion dollars in capital expenditures, 54 new plants, 75,000 additional employees, and 4.5 billion pounds of explosives produced — 20 percent of the volume used by the Allied Forces. Yet, the performance during the war years showed no significant deviation from the pre-war years. In 1941, the DuPont Company was 10 times safer than all industry and 9 times safer than the Chemical Industry. Management and the line organization were finally working as they should to control the real causes of injuries. Today, DuPont is about 50 times safer than US industrial safety performance averages. Comparing performance to other industries, it is interesting to note that seemingly “hazard-free” industries seem to have extraordinarily high injury rates. This is because, as DuPont has found out, performance is a function of injury prevention and safety management systems, not hazard exposure. Our success in safety results from a sound safety management philosophy. Each of the 125 DuPont facilities is responsible for its own safety program, progress, and performance. However, management at each of these facilities approaches safety from the same fundamental and sound philosophy. This philosophy can be expressed in eleven straightforward principles. The first principle is that all injuries can be prevented. That statement may seem a bit optimistic. In fact, we believe that this is a realistic goal and not just a theoretical objective. Our safety performance proves that the objective is achievable. We have plants with over 2,000 employees that have operated for over 10 years without a lost time injury. As injuries and incidents are investigated, we can always identify actions that could have prevented that incident. If we manage safety in a proactive — rather than reactive — manner, we will eliminate injuries by reducing the acts and conditions that cause them. The second principle is that management, which includes all levels through first-line supervisors, is responsible and accountable for preventing injuries. Only when senior management exerts sustained and consistent leadership in establishing safety goals, demanding accountability for safety performance and providing the necessary resources, can a safety program be effective in an industrial environment. The third principle states that, while recognizing management responsibility, it takes the combined energy of the entire organization to reach sustained, continuous improvement in safety and health performance. Creating an environment in which employees feel ownership for the safety effort and make significant contributions is an essential task for management, and one that needs deliberate and ongoing attention. The fourth principle is a corollary to the first principle that all injuries are preventable. It holds that all operating exposures that may result in injuries or illnesses can be controlled. No matter what the exposure, an effective safeguard can be provided. It is preferable, of course, to eliminate sources of danger, but when this is not reasonable or practical, supervision must specify measures such as special training, safety devices, and protective clothing. Our fifth safety principle states that safety is a condition of employment. Conscientious assumption of safety responsibility is required from all employees from their first day on the job. Each employee must be convinced that he or she has a responsibility for working safely. The sixth safety principle: Employees must be trained to work safely. We have found that an awareness for safety does not come naturally and that people have to be trained to work safely. With effective training programs to teach, motivate, and sustain safety knowledge, all injuries and illnesses can be eliminated. Our seventh principle holds that management must audit performance on the workplace to assess safety program success. Comprehensive inspections of both facilities and programs not only confirm their effectiveness in achieving the desired performance, but also detect specific problems and help to identify weaknesses in the safety effort. The Company’s eighth principle states that all deficiencies must be corrected promptly. Without prompt action, risk of injuries will increase and, even more important, the credibility of management’s safety efforts will suffer. Our ninth principle is a statement that off-the-job safety is an important part of the overall safety effort. We do not expect nor want employees to “turn safety on” as they come to work and “turn it off” when they go home. The company safety culture truly becomes of the individual employee’s way of thinking. The tenth principle recognizes that it’s good business to prevent injuries. Injuries cost money. However, hidden or indirect costs usually exceed the direct cost. Our last principle is the most important. Safety must be integrated as core business and personal value. There are two reasons for this. First, we’ve learned from almost 200 years of experience that 96 percent of safety incidents are directly caused by the action of people, not by faulty equipment or inadequate safety standards. But conversely, it is our people who provide the solutions to our safety problems. They are the one essential ingredient in the recipe for a safe workplace. Intelligent, trained, and motivated employees are any company’s greatest resource. Our success in safety depends upon the men and women in our plants following procedures, participating actively in training, and identifying and alerting each other and management to potential hazards. By demonstrating a real concern for each employee, management helps establish a mutual respect, and the foundation is laid for a solid safety program. This, of course, is also the foundation for good employee relations. An important lesson learned in DuPont is that the majority of injuries are caused by unsafe acts and at-risk behaviors rather than unsafe equipment or conditions. In fact, in several DuPont studies it was estimated that 96 percent of injuries are caused by unsafe acts. This was particularly revealing when considering safety audits — if audits were only focused on conditions, at best we could only prevent four percent of our injuries. By establishing management systems for safety auditing that focus on people, including audit training, techniques, and plans, all incidents are preventable. Of course, employee contribution and involvement in auditing leads to sustainability through stakeholdership in the system. Management safety audits help to make manage the “behavioral balance.” Every job and task performed at a site can do be done at-risk or safely. The essence of a good safety system ensures that safe behavior is the accepted norm amongst employees, and that it is the expected and respected way of doing things. Shifting employees norms contributes mightily to changing culture. The management safety audit provides a way to quantify these norms. DuPont safety performance has continued to improve since we began keeping records in 1911 until about 1990. In the 1990–1994 time frame, performance deteriorated as shown in the chart that follows: This increase in injuries caused great concern to senior DuPont management as well as employees. It occurred while the corporation was undergoing changes in organization. In order to sustain our technological, competitive, and business leadership positions, DuPont began re-engineering itself beginning in about 1990. New streamlined organizational structures and collaborative work processes eliminated many positions and levels of management and supervision. The total employment of the company was reduced about 25 percent during these four years. In our traditional hierarchical organization structures, every level of supervision and management knew exactly what they were expected to do with safety, and all had important roles. As many of these levels were eliminated, new systems needed to be identified for these new organizations. In early 1995, Edgar S. Woolard, DuPont Chairman, chartered a Corporate Discovery Team to look for processes that will put DuPont on a consistent path toward a goal of zero injuries and occupational illnesses. The cross-functional team used a mode of “discovery through learning” from as many DuPont employees and sites around the world. The Discovery Team fostered the rapid sharing and leveraging of “best practices” and innovative approaches being pursued at DuPont’s plants, field sites, laboratories, and office locations. In short, the team examined the company’s current state, described the future state, identified barriers between the two, and recommended key ways to overcome these barriers. After reporting back to executive management in April, 1995, the Discovery Team was realigned to help organizations implement their recommendations. The Discovery Team reconfirmed key values in DuPont — in short, that all injuries, incidents, and occupational illnesses are preventable and that safety is a source of competitive advantage. As such, the steps taken to improve safety performance also improve overall competitiveness. Senior management made this belief clear: “We will strengthen our business by making safety excellence an integral part of all business activities.” One of the key findings of the Discovery Team was the identification of the best practices used within the company, which are listed below: ▪ Felt Leadership – Management Commitment ▪ Business Integration ▪ Responsibility and Accountability ▪ Individual/Team Involvement and Influence ▪ Contractor Safety ▪ Metrics and Measurements ▪ Communications ▪ Rewards and Recognition ▪ Caring Interdependent Culture; Team-Based Work Process and Systems ▪ Performance Standards and Operating Discipline ▪ Training/Capability ▪ Technology ▪ Safety and Health Resources ▪ Management and Team Audits ▪ Deviation Investigation ▪ Risk Management and Emergency Response ▪ Process Safety ▪ Off-the-Job Safety and Health Education Attention to each of these best practices is essential to achieve sustained improvements in safety and health. The Discovery Implementation in conjunction with DuPont Safety and Environmental Management Services has developed a Safety Self-Assessment around these systems. In this presentation, we will discuss a few of these practices and learn what they mean. Paper published with permission.

Comparing the percentage of the total population aged 65 and over in 2021, Japan (29.1%) is the world's highest super-aged society. It has been predicted for some time that the existing healthcare system would not be able to cope with the increasing demand for healthcare. One of the government's proposals to restructure the healthcare system is to make greater use of team medicine.The purpose of this paper is to clarify what has changed through team medicine mediated by information tools. The study site was a medium-sized hospital in a regional city in Japan. The research method used was ethnography with a focus on participant observation. The study period was eight years, from 2012 to 2020. One of the authors conducted the investigation while working at the hospital as a hospital staff. In the 2012 revision of medical fees, the Ministry of Health, Labor and Welfare (MHLW) added the new item of "guidance and management for prevention of dialysis (through team medicine)" to prevent serious complications in diabetic patients.The new reimbursement system only set out the conditions for calculation and left the operation of the system to the hospitals themselves. Hospitals were initially confused, and medical professionals did not know what to do. However, the introduction of the MAP information tool, which visualizes and lists the patients' treatment status, has made it possible for the health professionals to work proactively. Through the mediation of MAP, inadequate treatment of patients (e.g., lack of necessary tests, inadequate selection of appropriate drugs, etc.) became clear. Under such circumstances, not only nurses and pharmacists but also medical secretaries have been transformed into people who are relied upon by doctors. Such a change was born from their attitude that they did not accept team medicine, which was mainly based on hierarchy and division of labor among medical professionals, and that they were willing to take on the work of other professions. In other words, each specialized profession filled in the gaps in patient care that tended to arise by overlapping their respective duties. In addition, the relationship between doctors and other professionals has changed from a hierarchical relationship to a mutual relationship in which problems are raised.In conclusion, it was found that the mediation of information tools and the overlapping of work with other professions with one's own professional area did not reduce the organizational capacity of the team and promoted positive changes in professional relationships.

Human, as a species, is very variable, and his variability is at the basis of his social organization. This variability is maintained, in part, by the chance effects of gene assortment and the variation in these genes is the result of mutations in the past. If our remote ancestors had not mutated we would not he here; further, since no species is likely to he able to reduce its mutation rate substantially by the sort of selection to which it is exposed, we may regard mutations of recent origin as part of the price of having evolved. We are here: all of us have some imperfections we would wish not to have, and many of us are seriously incommoded by poor sight, hearing or thinking. Others among us suffer from some malformation due to faulty development. A few are formed lacking some essential substance necessary to metabolize a normal diet, to clot the blood, or to darken the back of the eye. We will all die and our deaths will normally be related to some variation in our immu-nological defences, in our ability to maintain our arteries free from occlusion, or in some other physiological aptitude. This massive variation, which is the consequence both of chance in the distribution of alleles and variety in the alleles themselves, imposes severe disabilities and handicaps on a substantial proportion of our population. The prospects of reducing this burden by artificial selection from counsel¬ling or selective feticide will be considered and some numerical estimates made of its efficiency and efficacy. Screening is a procedure by which populations are separated into groups, and is widely used for administrative and other purposes. At birth all babies are sexed and divided into two groups. Later the educable majority is selected from the ineducable minority; later still screening continues for both administrative and medical purposes. Any procedure by which populations are sifted into distinct groups is a form of screening, the word being derived from the coarse filter used to separate earth and stones. In medicine its essential features are that the population to be screen¬ed is not knowingly in need of medical attention and the action is taken on behalf of this population for its essential good. A simple example is provided by cervical smear examination, the necessary rationale for which must be the haimless and reliable detection of precancerous changes which can be prevented from becoming irreversible. Any rational decision on the development of such a service must be based on a balance of good and harm and any question of priorities in relation to other services must be based on costing. The balance of good and harm is a value judgement of some complexity. In the example of cervical smears anxiety and the consequences of the occasional removal of a healthy uterus must be weighed against the benefits of the complete removal of a cancerous one, and such matters cannot be costed in monetary terms. In fact, even such an apparently simple procedure as cervical screening is full of unknowns and many of these unknowns can only be resolved by extensive and properly designed studies. In genetic screening the matter is even more complicated, since the screening is often vicarious; that is, one person is screened in order to make a prediction on what may happen to someone else, usually their children, who may be un¬conceived or unborn. Further, the action of such screening may not be designed to ameliorate disease, but to eliminate a fetus which has a high chance of an affliction, or to prevent a marriage in which there is a mutual predisposition to producing abnormal children. These considerations impose very considerable dif¬ferences, since the relative values placed on marriage, on having children within marriage, and on inducing abortion, vary widely between individuals and between societies.

While the appeal of ‘civilisational dialogue’ is on the rise, its sources, functions, and con- sequences arouse controversy within and between faith communities. Some religious lead- ers have attempted to clarify the religious foundations for such dialogue. Among them are Jonathan Sacks, the Chief Rabbi of the United Hebrew Congregations of Britain and the Commonwealth, Edward Idris, Cardinal Cassidy of the Catholic Church, and Fethullah Gülen. The paper compares the approach of these three religious leaders from the Abrahamic tra- dition as presented in their scholarly works – Sacks’ The Dignity of Difference, Cardinal Cassidy’s Ecumenism and Interreligious Dialogue, and Gülen’s Advocate of Dialogue. The discussion attempts to answer the following questions: Can monotheistic traditions accom- modate the dignity of followers of other monotheistic and polytheistic religions as well as non-theistic religions and philosophies? Is a belief in the unity of God compatible with an acceptance of the religious dignity of others? The paper also explores their arguments for why civilisational and interfaith dialogue is necessary, the parameters of such dialogue and its anticipated consequences: how and how far can dialogue bridge the claims of unity of God and diversity of faiths? Islam’s emphasis on diversity and the Quran’s accommodation of ear- lier religious traditions put Islam and Fethullah Gülen in the best position to offer a religious justification for valuing and cherishing the dignity of followers of other religions. The plea for a dialogue of civilizations is on the rise among some policymakers and politi- cians. Many of them believe a dialogue between Islam and the West has become more urgent in the new millennium. For example following the 2005 Cartoon Wars, the United Nations, the Organization of the Islamic Conferences, and the European Union used a joint statement to condemn violent protests and call for respect toward religious traditions. They pled for an exchange of ideas rather than blows: We urge everyone to resist provocation, overreaction and violence, and turn to dialogue. Without dialogue, we cannot hope to appeal to reason, to heal resentment, or to overcome mistrust. Globalization disperses people and ideas throughout the world; it brings families individuals with different beliefs into close contact. Today, more than any period in history, religious di- versity characterizes daily life in many communities. Proponents of interfaith dialogue claim that, in an increasingly global world, interfaith dialogue can facilitate mutual understanding, respect for other religions, and, thus, the peaceful coexistence of people of different faiths. One key factor for the success of the interfaith dialogue is religious leaders’ ability to provide an inclusive interfaith theology in order to reconcile their commitment to their own faith with the reality of religious diversity in their communities. I argue that prominent leaders of the Abrahamic religions (Judaism, Christianity, and Islam) are already offering separate but overlapping theologies to legitimize interfaith dialogue. A balanced analysis of multi-faith interactions is overdue in political science. The discipline characterises religious interactions solely from the perspective of schism and exclusion. The literature asserts that interactions among believers of different faiths will breed conflict, in- cluding terrorism, civil wars, interstate wars, and global wars. According to this conven- tional depiction, interfaith cooperation is especially challenging to Judaism, Christianity, and Islam due to their monotheism; each claims it is “the one true path”. The so-called “monothe- istic exclusion” refers to an all-or-nothing theological view: you are a believer or you are an infidel. Judaism identifies the chosen people, while outsiders are gentiles; Christians believe that no salvation is possible outside of Jesus; Islam seems to call for a perennial jihad against non-Muslims. Each faith would claim ‘religious other’ is a stranger to God. Political “us versus them” thinking evolves from this “believer versus infidel” worldview. This mindset, in turn, initiates the blaming, dehumanizing, and demonization of the believers of other reli- gious traditions. Eventually, it leads to inter-religious violence and conflict. Disputing this grim characterization of religious interactions, scholars of religion offer a tripartite typology of religious attitude towards the ‘religious other.’ They are: exclusivism, inclusivism, and pluralism. Exclusivism suggests a binary opposition of religious claims: one is truth, the other is falsehood. In this dichotomy, salvation requires affirmation of truths of one’s particular religion. Inclusivism integrates other religious traditions with one’s own. In this integration, one’s own religion represents the complete and pure, while other religions represent the incomplete, the corrupted, or both. Pluralism accepts that no religious tradi- tion has a privileged access to religious truth, and all religions are potentially equally valid paths. This paper examines the theology of interfaith dialogue (or interfaith theology) in the Abrahamic religions by means of analyzing the works of three prominent religious lead- ers, a Rabbi, a Pope, and a Muslim scholar. First, Jonathan Sacks, the Chief Rabbi of the United Hebrew Congregations of Britain and the Commonwealth, offers a framework for the dialogue of civilizations in his book Dignity of Difference: How to Avoid the Clash of Civilizations. Rather than mere tolerance and multiculturalism, he advocates what he calls the dignity of difference—an active engagement to value and cherish cultural and religious differences. Second, Pope John Paul II’s Crossing the Threshold of Hope argues that holiness and truth might exist in other religions because the Holy Spirit works beyond the for- mal boundaries of Church. Third, the Turkish Islamic scholar Fethullah Gülen’s Advocate of Dialogue describes a Muslim approach to interfaith dialogue based on the Muslim belief in prophecy and revelation. I analyze the interfaith theologies of these religious leaders in five sections: First, I explore variations on the definition of ‘interfaith dialogue’ in their works. Second, I examine the structural and strategic reasons for the emergence and development of the interfaith theologies. Third, I respond to four common doubts about the possibility and utility of interfaith di- alogue and theologies. Fourth, I use John Rawls’ overlapping consensus approach to develop a framework with which to analyze religious leaders’ support for interfaith dialogue. Fifth, I discuss the religious rationales of each religious leader as it relates to interfaith dialogue.

To facilitate an initial discussion regarding the ASEAN Mutual Recognition Agreement (MRA) for the Veterinary Profession, Faculty of Veterinary Science and the ASEAN Studies Center, Chulalongkorn University, Veterinary Council of Thailand and Department of Livestock Development, Ministry of Agriculture and Cooperative, Royal Thai Government, in collaboration with World Organisation for Animal Health (OIE) Sub-Regional Representation for South-East Asia, and the Federation of Asian Veterinary Associations (FAVA), organised the GUFVA 2014 in Bangkok, Thailand on 25-27 June 2014. The meeting was attended by the ASEAN Secretariat, representatives from the Veterinary Educational Establishments (VEEs) and Veterinary Statutory Bodies (VSBs) of the ASEAN Member States, as well as the organising institutions and organizations (OIE SRR SEA, FAVA, SEAVSA, and Veterinary Associations). The meeting was supported by the Innovative Thai-ASEAN Academic Co-operation at Chulalongkorn University: ITAAC@CU).