Mapeamento e experiências de indígenas nas escolas médicas federais brasileiras: acesso e políticas de permanência / Mapeo y experiencias de indígenas en las escuelas médicas federales brasileñas: acceso y políticas de permanencia / Access and retention policies for indigenous people in Brazilian federal medical schools: mapping and experiences

A trajetória do ensino superior no Brasil é marcada pela restrição ao grupo privilegiado da população, com exclusão de pessoas indígenas. Nas últimas duas décadas, ações afirmativas foram desenvolvidas e possibilitaram o acesso de alguns indígenas às graduações de Medicina. Objetivando-se mapear e conhecer as experiências desses estudantes nas universidades federais brasileiras, desenvolveu-se uma pesquisa exploratória, quanti-qualitativa. Foram identificados 192 estudantes indígenas em 43 escolas médicas no ano de 2019. Dessas, 14 foram visitadas, realizando-se entrevistas narrativas com 24 indígenas estudantes de Medicina. Na análise temática de conteúdo emergiram experiências narradas pelos estudantes com foco em duas categorias: acesso à escola médica e políticas de permanência nas instituições. Ao conhecer as experiências desses estudantes no meio universitário, torna-se possível contribuir para sua permanência nos cursos, superando a invisibilidade e oportunizando trajetórias que correspondam às expectativas dos povos indígenas na formação médica. (AU)

La trayectoria de la enseñanza superior en Brasil está marcada por su restricción al grupo privilegiado de la población, con exclusión de personas indígenas. En las últimas dos décadas se desarrollaron acciones afirmativas que posibilitaron el acceso de algunos indígenas a los cursos de graduación de medicina. Con el objetivo de mapear y conocer las experiencias de esos estudiantes en las universidades federales brasileñas, se desarrolló una investigación exploratoria cuanti-cualitativa. Se identificaron 192 estudiantes indígenas en 43 escuelas médicas, en el año 2019. Entre ellas, se visitaron 14, realizándose entrevistas narrativas con 24 indígenas estudiantes de Medicina. En el análisis temático de contenido surgieron experiencias narradas por los estudiantes, enfocadas en dos categorías: Acceso a la escuela médica; Políticas de permanencia en las instituciones. Al conocer las experiencias de estos estudiantes en el medio universitario resulta posible contribuir a su permanencia en los cursos, superando la invisibilidad y dando oportunidad a trayectorias que correspondan a las expectativas de los pueblos indígenas en la formación médica. (AU)

Higher education in Brazil is known by being restricted to a privileged group, excluding the indigenous people. In the two last decades, affirmative action policies were developed to allow members of indigenous peoples access to Medical courses. In order to scan the students' experience at Federal Universities, the study developed a quantitative and qualitative exploratory research. A group of 192 indigenous students were identified in 43 medical schools during 2019. Fourteen schools were visited, and 24 indigenous medical students held narrative interviews. The thematic subject analyses, showed two categories: Access to medical school; Policies of retention in the institutions. The students' experiences at the campuses may contribute to their permanence in the courses, overcoming the invisibility and providing opportunities to reach the indigenous people expectations regarding the medical career. (AU)

Attitudes of Turkish university employees and their relatives towards whole body and organ donation.

BACKGROUND: Dissection of human anatomic specimens still keeps its importance in medical curriculum. Experiences of medical students in the anatomy laboratory and the time they spent there makes them feel as doctors at the beginning of their education and helps them to get used to the notion of death. Unfortunately, the number of human body donors available for medical research and education as well as organ transplantation is limited. Obtaining human anatomic specimens continues being a great problem especially in middle-east countries. Religious factors, socioeconomic status, education, marital status or age are probably the main factors those effect body donations. The aim of the present study is to evaluate the attitudes of Turkish university employees and their relatives towards whole body donation and organ donation. METHODS: A total of 780 questionnaires taken from the participants were evaluated. All the participants were academic and administrative staff from four different universities based in Ankara, Eskisehir, Istanbul and Adana and their relatives. Participants were between the ages of 18-85. All the subjects were provided a questionnaire composed of 38 questions. FINDINGS: 26.2% of the individuals declared that they could donate their body for medical education while 73.8% of them did not. In contrast, 69.1% of the participants were willing for being organ donors. Of the ones who had accepted to donate their organs, 64.5% refused to donate their bodies. CONCLUSION: The results of this study indicate that not only whole body donation, but also organ donation continue being a problem in Turkey.

Alternative futures: Fields, boundaries, and divergent professionalisation strategies within the Chiropractic profession.

Sociological studies of the complementary and alternative medicine (CAM) occupations have documented the professionalisation strategies these groups use to establish boundaries between themselves and their competitors, including seeking educational accreditation and statutory regulation/licensure. Chiropractic has been particularly successful at professionalising and in Australia and the UK it is taught within public universities. Recent events have threatened chiropractic's university foothold, however, showing that professionalisation needs to be understood as an ongoing process of negotiation. Based on interviews with chiropractors in Australia and the UK, this paper examines the professionalisation strategies deployed by chiropractors within and outside of the university. Highly divergent strategies are identified across different sectors of the profession, relating to defining the chiropractic paradigm, directing education and constructing professional identity. In each domain, chiropractic academics tended to prioritise building the evidence base and becoming more aligned with medicine and other allied health professions. Although some practitioners supported this agenda, others strove to preserve chiropractic's vitalistic philosophy and professional distinction. Following Bourdieu, these intra-professional struggles are interpreted as occurring within a field in which chiropractors compete for different forms of capital, pulled by two opposing poles. The differing orientations and strategies pursued at the two poles of the field point to a number of possible futures for this CAM profession, including a potential split within the profession itself.

Teaching spiritual care in a public institution: legal implications, standards of practice, and ethical obligations.

This article reviews the status of teaching spiritual care in a public institution of higher education. The resurgence of interest in spiritual care across the United States has spurred interest and expanded theories of spirituality within the nursing profession. Nursing education rose to the challenge of teaching spiritual care theories and interventions to students, despite the absence of policy to guide educators. However, differences between public and private educational institutions have led to variations in the teaching of spiritual care. In addition to the legal implications stemming from the need for separation of church and state, nurses must also be aware of their ethical obligations in order to teach spiritual care concepts appropriately. The accrediting agencies for nursing education programs and hospitals, as well as state licensure boards, foster high expectations for nurses to provide spiritual care. A call for research and policy development to guide nurse educators is also addressed in this article.

Clinical bioethics integration, sustainability, and accountability: the Hub and Spokes Strategy.

The "lone" clinical bioethicist working in a large, multisite hospital faces considerable challenges. While attempting to build ethics capacity and sustain a demanding range of responsibilities, he or she must also achieve an acceptable level of integration, sustainability, and accountability within a complex organisational structure. In an effort to address such inherent demands and to create a platform towards better evaluation and effectiveness, the Clinical Ethics Group at the Joint Centre for Bioethics at the University of Toronto is implementing the Hub and Spokes Strategy at seven hospitals. The goal of the Hub and Spokes Strategy is to foster an ethical climate and strengthen ethics capacity broadly throughout healthcare settings as well as create models in clinical bioethics that are excellent and effective.