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In a wider understanding, shared mobility can be defined as trip alternatives that aim to maximize the utilization of the mobility resources that a society can pragmatically afford, disconnecting their usage from ownership. Then, shared mobility is the short-term access to shared vehicles according to the user’s needs and convenience. The contributions and added value of this paper are to provide an up-to-date and well-structured review on the area of shared mobility to researchers and practitioners of the transport sector. Hence, this paper presents a bibliographical review of shared mobility and its diverse modalities, as an alternative to individual transportation, especially in cases of individual automobiles or short trips restricted to an urban city. The present literature review on shared modes of transportation has discovered that the introduction of these modes alone will not solve transportation problems in large cities, with elevated and growing motorization rates. However, it can among the strategies employed to help alleviate the problems caused by traffic jams and pollution by reducing the number of vehicles in circulation, congestions, and the urban emission of polluting gases. Thus, the implementation of shared mobility schemes offers the potential to enhance the efficiency, competitiveness, social equity, and quality of life in cities. This paper covers the fundamental aspects of vehicle and/or ride sharing in urban centers, and provides an overview of current shared mobility systems.

In this research, products with high quality were obtained from natural sources. The sensorial qualities, chemical characterization, and physical properties of gelatin extracted from chicken feet were compared with commercial gelatins. The extraction process was performed using acetic acid on a concentration ranging from 0.318% to 3.682%, processing time between 1.0 h and 8.4 h and extraction temperature between 43.3 °C and 76.8 °C. After the end of each assay, the yield was measured. Results showed that, under the best conditions, the collagen extraction yield was above 8%, and comprised 78.525 g/100 g of protein. Collagen analyzed by ICP-MS was composed of 99.44% of macro-minerals that are of great importance to human health. ATR-FTIR analysis showed that approximately 70.90% of the total protein from chicken feet is collagen, whereas, in commercial gelatin, only 30.31% is collagen. When comparing chicken gelatin with commercial gelatin, most sensory attributes were similar and chicken gelatin gained acceptance by more than 80% of the consumers. Additionally, the collagen films obtained from chicken feet and swine showed water absorption, odors, and texture characteristics similar to commercial material, such as latex and celofane. Consequently, due to its similarity to human skin, it is possible to apply it as a biocurative.

The impact of accreditation is mainly related to internal processes, culture, training, institutional image and competitive differentiation.

ObjectivesAlthough different forms of patient feedback are available, their use in hospital management is still limited. The objective of this study is to explore how patient feedback is currently used in hospitals to improve quality.DesignThis is a qualitative exploratory multiple case study. Data collection included nine interviews, of an average duration of 50 min, conducted between March and June 2019. Additionally, a document and secondary data analysis were performed.SettingThis study was conducted in three Brazilian hospitals selected for their solid patient feedback practises.ParticipantsManagers from the customer service, quality, nursing, operations, projects and patient experience departments of the three hospitals.ResultsDespite literature suggesting that organisational objectives regarding patient feedback are not clear, data show that there is managerial concern regarding the promotion of an environment capable of changing according to patient feedback. In these instances, organisational processes were structured to focus on patients’ feedback and its receipt by the staff, including a non-punitive culture. Several patient feedback forms are available: voluntary events, patient surveys and informal feedback. Instruments to measure patient feedback focused on specific aspects of healthcare, to identify and clarify the problems for addressal by the management. The net promoter score was the main strategic indicator of patient feedback, used to assess the impact of improvement action.ConclusionsThe hospitals had established objectives that valued the patient’s perspective. Involvement of the health team, availability of different channels for feedback and the use of quality tools are considered a good basis for using patient feedback to drive quality improvement.

Process reengineering methodologies have become an international management phenomenon (Waring & Bishop, 2010), as there have been a growing pressure on health services to increase their efficiency. To achieve this goal, health services have sought alternatives to traditional models, adopting methodologies for improving processes commonly used in the manufacturing sector, including lean manufacturing (Radnor et al., 2012). The lean methodology, originated at Toyota, and also known as the Toyota Production System (TPS), is considered a radical alternative to the traditional mass-production model. Lean is defined as a methodology that adopts the elimination of waste, as well as the aggregation of value to all processes, whose goal is to improve the final product (Brackett et al., 2013) and to maximize operational efficiency, quality, speed and cost of operations (Holweg, 2007). The lean approach finds popular appeal in health care as it seeks to redesign clinical practices and resources around simplified, efficient and value-added care (Waring & Bishop, 2010). The approach adopted in health systems is different from that adopted in manufacturing systems, since the processes are different, particularly for working with human lives. Thus, the definition of lean for health systems has different interpretations and practices, and is commonly called lean health care. Nelson-Peterson & Leppa (2007) state that lean health care is neither an adapted manufacturing tactic nor a cost reduction program; it is a management strategy based on process improvement in a system. Radnor et al. (2012)

This study focused on verifying whether the emission of air pollutants in São Paulo increases the costs and number of hospitalizations for respiratory diseases in Brazil. Data on pollutant emissions, hospitalizations, and hospital costs were collected from 2008 to 2017 and correlated with air quality standards. The results showed that the concentration of particulate matter increased each year during the study period and was highly correlated with hospitalizations due to respiratory diseases. Ozone (O3) was within the quality standard throughout the study period but registered an increase in the mean and a positive correlation with hospitalizations due to respiratory diseases. The carbon monoxide (CO), sulfur dioxide (SO2), and nitrogen dioxide (NO2) levels were within the quality standards throughout the study period with a decrease in the last years studied, but showed a positive correlation with hospitalizations due to respiratory diseases. The pollutant emissions and hospitalizations due to respiratory diseases had an inverse relationship with the monthly rainfall curve for São Paulo, which indicates that rainfall tended to reduce pollutant emissions and consequently hospitalizations due to inhalation of these pollutants. Because costs are directly associated with hospitalizations, both increased during the study period—302,000 hospitalizations at an average cost of 368 USD resulted in a total cost of 111 million USD. To reduce these costs, Brazil should implement stricter policies to improve the air quality of its major cities and develop a viable alternative to diesel vehicles.

Objective:To evaluate whether accredited health organizations perform better management practices than non-accredited ones. Method: The study was developed in two stages: a literature review, and a study of multiple cases in 12 healthcare organizations in the state of São Paulo, Brazil. It surveyed articles comparing hospital accreditation with the EFQM (European Foundation for Quality Management) model of excellence in management. According to the pertinent literature, the accreditation model and the EFQM model are convergent and supplementary in some aspects. Results: With 99% confidence, one can say that there is evidence that accredited organizations scored better in the evaluation based on the EFQM model in comparison to non-accredited organizations. This result was also confirmed in the comparison of results between the categories Facilitators and Results in the EFQM model. Conclusion: There is convergence between the accreditation model and the EFQM excellence model, suggesting that accreditation helps the healthcare sector to implement the best management practices already used by other business sectors. DESCRIPTORS