Exploring the Performance of ChatGPT Versions 3.5, 4, and 4 With Vision in the Chilean Medical Licensing Examination: Observational Study.

Background: The deployment of OpenAI's ChatGPT-3.5 and its subsequent versions, ChatGPT-4 and ChatGPT-4 With Vision (4V; also known as "GPT-4 Turbo With Vision"), has notably influenced the medical field. Having demonstrated remarkable performance in medical examinations globally, these models show potential for educational applications. However, their effectiveness in non-English contexts, particularly in Chile's medical licensing examinations-a critical step for medical practitioners in Chile-is less explored. This gap highlights the need to evaluate ChatGPT's adaptability to diverse linguistic and cultural contexts. Objective: This study aims to evaluate the performance of ChatGPT versions 3.5, 4, and 4V in the EUNACOM (Examen Único Nacional de Conocimientos de Medicina), a major medical examination in Chile. Methods: Three official practice drills (540 questions) from the University of Chile, mirroring the EUNACOM's structure and difficulty, were used to test ChatGPT versions 3.5, 4, and 4V. The 3 ChatGPT versions were provided 3 attempts for each drill. Responses to questions during each attempt were systematically categorized and analyzed to assess their accuracy rate. Results: All versions of ChatGPT passed the EUNACOM drills. Specifically, versions 4 and 4V outperformed version 3.5, achieving average accuracy rates of 79.32% and 78.83%, respectively, compared to 57.53% for version 3.5 (P<.001). Version 4V, however, did not outperform version 4 (P=.73), despite the additional visual capabilities. We also evaluated ChatGPT's performance in different medical areas of the EUNACOM and found that versions 4 and 4V consistently outperformed version 3.5. Across the different medical areas, version 3.5 displayed the highest accuracy in psychiatry (69.84%), while versions 4 and 4V achieved the highest accuracy in surgery (90.00% and 86.11%, respectively). Versions 3.5 and 4 had the lowest performance in internal medicine (52.74% and 75.62%, respectively), while version 4V had the lowest performance in public health (74.07%). Conclusions: This study reveals ChatGPT's ability to pass the EUNACOM, with distinct proficiencies across versions 3.5, 4, and 4V. Notably, advancements in artificial intelligence (AI) have not significantly led to enhancements in performance on image-based questions. The variations in proficiency across medical fields suggest the need for more nuanced AI training. Additionally, the study underscores the importance of exploring innovative approaches to using AI to augment human cognition and enhance the learning process. Such advancements have the potential to significantly influence medical education, fostering not only knowledge acquisition but also the development of critical thinking and problem-solving skills among health care professionals.

Conditions of Nursing Practice in Hospitals and Nursing Homes Before COVID-19: Implications for Policy Action.

Background: The COVID-19 pandemic has stimulated interest in potential policy solutions to improve working conditions in hospitals and nursing homes. Policy action in the pandemic recovery period must be informed by pre-pandemic conditions. Purpose: To describe registered nurses' (RNs') working conditions, job outcomes, and measures of patient safety and care quality in hospitals and nursing homes just before the pandemic. Methods: Cross-sectional study using descriptive statistics to analyze survey data from RNs in New York and Illinois collected December 2019 through February 2020. Results: A total of 33,462 RNs were included in the final analysis. Before the pandemic, more than 40% of RNs reported high burnout, one in four were dissatisfied with their job, and one in five planned to leave their employer within 1 year. Among nursing home RNs, one in three planned to leave their employer. RNs reported poor working conditions characterized by not having enough staff (56%), administrators who did not listen/respond to RNs' concerns (42%), frequently missed nursing care (ranging from 8% to 34% depending on the nursing task in question), work that was interrupted or delayed by insufficient staff (88%), and performing non-nursing tasks (82%). Most RNs (68%) rated care quality at their workplace as less than excellent, and 41% gave their hospital an unfavorable patient safety rating. Conclusion: Hospitals and nursing homes were understaffed before the COVID-19 pandemic, and many RNs were dissatisfied with their employers' contribution to the widespread observed shortage of nursing care during the pandemic. Policy interventions to address understaffing include the implementation of safe nurse staffing standards and passage of the Nurse Licensure Compact to permit RNs to move expeditiously to locales with the greatest needs.

Nursing education: From classroom to computers - The New Mexico Nursing Education Consortium's collaborative problem-solving during the pandemic.

The COVID-19 pandemic created an upheaval for nursing faculty teaching students in both didactic and clinical settings. From the intense disruption, opportunities for creative endeavors emerged. Program directors from a consortium of 12 nursing schools met remotely for problem-solving and support. Rich text from minutes of nine program director meetings were analyzed. Aims of our project included identifying challenges that nurse educators encountered during the pandemic, demonstrating benefits of a university and community college partnership model, and informing nurse educators of innovative outcomes that originated from our project. Thematic analysis of meeting minutes revealed four categories: timing and urgency; collaboration, preparation, and teaching; altruism; and what we learned. Further themes were identified from each of the categories. Innovative outcomes were identified from the text including creation of website teaching resources and development of a computer based clinical checklist. Implications for future nursing education included that computer- based simulation will continue to be embedded in nursing curricula. Also, the need for nursing faculty to remain technologically savvy to deliver trailblazing online pedagogies will prominently continue. We conclude that the synergistic collaboration of nursing program directors can have momentous outcomes for support and success of nursing programs.

Egresados de la licenciatura en enfermería: estudio de trayectorias escolares y laborales / Graduates of the nursing degree: a study of school and work trajectories

Introducción: el trabajo educativo de las universidades debe ser evaluado y un criterio aceptado es el seguimiento de egresados; por ello, es importante realizar investigaciones vinculadas con las trayectorias escolares y laborales. Objetivo: describir las trayectorias escolares y laborales de los egresados de la Licenciatura en Enfermería de la Facultad de Estudios Superiores Zaragoza. Metodología: estudio descriptivo, transversal, con una muestra no probabilística de 203 egresados de la Licenciatura en Enfermería de la Facultad de Estudios Superiores Zaragoza. Las variables de estudio fueron las trayectorias escolar y laboral. Se aplicó un cuestionario de 42 ítems, valorado con preguntas abiertas y escala Likert. Se consideraron las gene- raciones de egresados que concluyeron sus estudios en 2015 y 2016. Los datos se analizaron con estadística descriptiva. Resultados: el 93% eligió la carrera como primera opción, lograron una calificación final promedio de 87, el 73% refirió ser titulado, el 69% trabaja, el 51% es por interinato y el 52% desempeña un puesto de auxiliar de enfermería. Conclusiones: en general los resultados son satisfactorios, pero aún hay un número importante de egresados con trayectorias escolares (27%) y laborales (31%) rezagadas que se deben atender.

Introduction: The universities educational work must be evaluated, and an accepted criterion is the followup of graduates, therefore it is important to carry out research related to school and work trajectories. Objective: To describe the graduate's school and work trajectories of the Facultad de Estudios Superiores Zaragoza Bachelor's degree in Nursing. Methods: Descriptive, crosssectional study, with a non-pro- babilistic sample of 203 graduates of the Facultad de Estudios Superiores Zaragoza Nursing Degree. The study varia- bles were the school and work trajectories, resolved with descriptive statistics. A questionnaire consisting of 42 items was applied, assessed with open questions and a Likert scale. The generations of graduates who completed studies in 2015 and 2016 were considered. Results: 93% chose the career as the first option, they achie- ved an average final grade of 87, 73% refer to being titled. 69% work, 51% are temporary, 52% have a nursing assistant position. Conclusions: In general, the results are satisfactory, however, there is still a significant number of graduates with lagged school (27%) and work (31%) careers that must be attended to.

Reforming nursing registration: Lessons from pandemics.

A nimble and flexible regulatory response regarding the nursing workforce is essential to a fully integrated public health approach to national crises and pandemics. The COVID-19 pandemic has drawn many comparisons to the 1918 Flu Pandemic. Some of them are well-reasoned and grounded in evidence. Other are not. This study provides a historically contextualized analysis of how the 1918 flu pandemic helped shape Pennsylvania nursing's current regulatory apparatus. We conclude that the state-based solutions that nursing registration represents are inadequate to deal with pandemics and crises with national, if not global, reach. We need to move immediately toward the national COMPACT system, while mindful of how regulatory processes and procedures can reinforce structural inequities.

An exploration of medical student attitudes towards disclosure of mental illness.

Background: Medical students are reluctant to access mental health services, despite having high rates of anxiety and depression. This reluctance persists through residency and into practice. Physicians and trainees who are unwell deliver lower quality patient care, behave less professionally, communicate less effectively and are at an increased risk for burnout and suicide. Little is known about whether students would disclose a mental health diagnosis on a state board medical license application.Objectives: The objectives of this study were to determine whether University of New Mexico School of Medicine (UNM SOM) students would be willing to disclose a mental health diagnosis on a medical licensing application if prompted to do so, and, if not, to identify the reasons for their unwillingness to do so.Design: We electronically invited all UNM SOM students enrolled in the Classes of 2019, 2020, 2021, and 2022 to participate in a confidential RedCap survey about mental health diagnoses and treatment. Four e-mail invitations and reminders were sent to students over a one-month period.Results: Response rate was 50.1%. Thirty-six percent of all respondents considered themselves to have had a mental health condition prior to medical school, and 47% of all respondents perceived a decline in mental health during medical school. The majority of respondents who perceived they had a mental health diagnosis (51%) stated they would not disclose this information on a New Mexico Medical Board (NMMB) license application. Fear of stigmatization, fear of repercussions, and a belief that such disclosure was irrelevant were the top reasons for non-disclosure.Conclusion: Students who perceive themselves to have mental health diagnoses are unlikely to disclose their mental health status on state medical board licensing applications when asked to do so. Addressing barriers to disclosure of mental health diagnoses is necessary for building a healthier physician workforce.

[Unmasking impostors: Professional physicians and their struggle against fake doctors in Peru]. / Desenmascarando a los impostores: Los médicos profesionales y su lucha contra los falsos médicos en Perú.

The characterization of non-professional healers as "quacks" or "impostors" has influenced much of how such actors have been perceived by public opinion and in academic research. As a result of this, a divide has emerged between professional physicians, on the one hand, and those who acquired their knowledge in a traditional and non-academic way, on the other. This work questions the alleged divide between these two groups in the health field in order to offer a more complex and richer picture of local practices in Peru. Based mainly on correspondence from the Faculty of Medicine in Lima and newspaper ads, we reconstructed the attempts made by medical authorities to contain and exclude healers of Asian, European, or local backgrounds, many of which failed. For this reason, we studied two specific devices designed to legitimate and monitor physicians trained professionally: degrees or diplomas and lists of graduates, both of which are predecessors to our current identification cards and databases.

La caracterización de sanadores no-titulados como "charlatanes" o "impostores" ha influido notablemente en cómo han sido percibidos por la opinión pública y en las investigaciones académicas. Se creó, entonces, una división entre los médicos profesionales y aquellos que adquirieron su conocimiento de modo tradicional y no-académico. Este artículo cuestiona la supuesta división entre dichos especialistas en el campo de la salud para ofrecer un cuadro más complejo y rico de prácticas locales a partir del caso peruano. A partir, sobre todo, de correspondencia de la Facultad de Medicina de Lima y de avisos en periódicos, reconstruimos la dinámica de las autoridades médicas en sus intentos, muchas veces infructuosos, de contener y excluir a sanadores de origen asiático, europeo o local. Para ello, estudiamos dos artefactos diseñados para legitimar y monitorear a los médicos formados profesionalmente: los títulos o diplomas y las listas de graduados, predecesores de nuestros modernos documentos de identidad y bases de datos.

Desenmascarando a los impostores: Los médicos profesionales y su lucha contra los falsos médicos en Perú / Unmasking impostors: Professional physicians and their struggle against fake doctors in Peru

RESUMEN La caracterización de sanadores no-titulados como "charlatanes" o "impostores" ha influido notablemente en cómo han sido percibidos por la opinión pública y en las investigaciones académicas. Se creó, entonces, una división entre los médicos profesionales y aquellos que adquirieron su conocimiento de modo tradicional y no-académico. Este artículo cuestiona la supuesta división entre dichos especialistas en el campo de la salud para ofrecer un cuadro más complejo y rico de prácticas locales a partir del caso peruano. A partir, sobre todo, de correspondencia de la Facultad de Medicina de Lima y de avisos en periódicos, reconstruimos la dinámica de las autoridades médicas en sus intentos, muchas veces infructuosos, de contener y excluir a sanadores de origen asiático, europeo o local. Para ello, estudiamos dos artefactos diseñados para legitimar y monitorear a los médicos formados profesionalmente: los títulos o diplomas y las listas de graduados, predecesores de nuestros modernos documentos de identidad y bases de datos.

ABSTRACT The characterization of non-professional healers as "quacks" or "impostors" has influenced much of how such actors have been perceived by public opinion and in academic research. As a result of this, a divide has emerged between professional physicians, on the one hand, and those who acquired their knowledge in a traditional and non-academic way, on the other. This work questions the alleged divide between these two groups in the health field in order to offer a more complex and richer picture of local practices in Peru. Based mainly on correspondence from the Faculty of Medicine in Lima and newspaper ads, we reconstructed the attempts made by medical authorities to contain and exclude healers of Asian, European, or local backgrounds, many of which failed. For this reason, we studied two specific devices designed to legitimate and monitor physicians trained professionally: degrees or diplomas and lists of graduates, both of which are predecessors to our current identification cards and databases.

Revalidación de títulos médicos extranjeros: eficacia y eficiencia de un examen colaborativo y estandarizado / A collaborative objective structured clinical examination for title revalidation by foreign medical graduates in Chile

Background: Title revalidation of foreign medical graduates to practice medicine in Chile is a complex and expensive process. According to the legislation they are required to approve the Unique National Exam of Medical Knowledge (EUNACOM), which has a theoretical and a practical section. Aim: To demonstrate that a collaborative and standardized examination of the practical section of EUNACOM is more effective and efficient than traditional practical examinations. Material and Methods: The faculties of Medicine of the Catholic University of Chile, University of Chile and University of Concepción were associated to implement an examination proposal, framed in the legislation. The EUNACOM board supported and funded the initiative which consisted in the implementation of Objective Structured Clinical Examination (OSCE) for each basic specialty of medicine, applied to 40 designated candidates. This format was selected because of the wide experience and evidence at the international level in the certification of medical professionals. Results: A collaborative and standardized OSCE reduces to less than half the time spent by examiners, providing more evidence of validity, reliability and objectivity. It also allows to visualize the real costs per applicant, which proved to be higher than those currently charged by EUNACOM, but comparatively lower than the examination used in the United States. Conclusions: A collaborative OSCE responds to the ethical principle of justice by being more valid, reliable, objective and cost efficient.

Do State Continuing Medical Education Requirements for Physicians Improve Clinical Knowledge?

OBJECTIVE: To evaluate the effect of state continuing medical education (CME) requirements on physician clinical knowledge. DATA SOURCES: Secondary data for 19,563 general internists who took the Internal Medicine Maintenance of Certification (MOC) examination between 2006 and 2013. STUDY DESIGN: We took advantage of a natural experiment resulting from variations in CME requirements across states over time and applied a difference-in-differences methodology to measure associations between changes in CME requirements and physician clinical knowledge. We measured changes in clinical knowledge by comparing initial and MOC examination performance 10 years apart. We constructed difference-in-differences estimates by regressing examination performance changes against physician demographics, county and year fixed effects, trend-state indicators, and state CME change indicators. DATA COLLECTION: Physician data were compiled by the American Board of Internal Medicine. State CME policies were compiled from American Medical Association reports. PRINCIPAL FINDINGS: More rigorous CME credit-hour requirements (mostly implementing a new requirement) were associated with an increase in examination performance equivalent to a shift in examination score from the 50th to 54th percentile. CONCLUSIONS: Among physicians required to engage in a summative assessment of their clinical knowledge, CME requirements were associated with an improvement in physician clinical knowledge.

Implicações bioéticas para o licenciamento ambiental de grandes empreendimentos no Brasil / Bioethical implications in the environmental licensing of large enterprises in Brazil

Resumo O processo de licenciamento ambiental de refinarias de petróleo no Brasil tem sido criticado pela ausência do cuidado com relação aos efeitos decorrentes do empreendimento sobre a saúde. Por isso, este trabalho busca identificar ferramentas da bioética que contribuam para a proteção da saúde nesse processo. Amparado numa revisão integrativa da literatura científica e no método desconstrutivo proposto por Derrida, justifica-se a pertinência e legitimidade do uso da bioética para fundamentar a relação entre as consequências para a saúde dos indivíduos, populações e dos ecossistemas e a conflituosidade envolvida. Conclui-se que a bioética pode contribuir como ferramenta teórica e prática por meio da descrição, avaliação dos conflitos e dilemas morais envolvendo a licença para implantação de processos produtivos, servindo para processos de crítica, justificação e de estabelecimento de medidas moralmente aceitáveis para a proteção da saúde humana e dos demais seres vivos do ecossistema.

Abstract Brazilian oil refineries' environmental licensing process have been criticised for lack of healthcare aspects. Therefore, this paper aims to identify elements of bioethics that contribute to healthcare in this process. Based on an integrative review of scientific literature and on the deconstructive method proposed by Derrida, the relevance and legitimacy of bioethics to justify the relationship between morality and the consequences for individual's, populations's and ecosystems's health is justified. We conclude that bioethics may contribute as a theoretical and practical tool to solve conflicts by describing existing struggles and moral dilemmas, through processes of criticism and justification and the establishment of morally acceptable measures for the protection of humans and environmental health.

Estágio curricular supervisionado na formação de professores em educação física: uma análise da legislação a partir da resolução CFE nº 03/1987 / Supervised academic training for physical education teachers: an analysis of the legislation through resolution CFE nº 03/1987 / Práctica curricular supervisada en la formación de profesores en educación física: un análisis de la legislación a partir de la resolución CFE nº 03/1987

O Estágio Curricular Supervisionado (ECS) na formação de professores de Educação Física (EF), ao longo das últimas três décadas, vem passando por transformações no sentido de fortalecer essa etapa da formação inicial, buscando aproximação do acadêmico ao seu futuro campo profissional e ao cotidiano docente. Dessa forma, o objetivo da pesquisa foi, por meio de uma análise documental, apresentar e discutir as principais leis que sustentam e subsidiam o ECS na formação de professores de EF no Brasil, a partir da Resolução CFE n° 03/1987. No campo burocrático e documental, constataram-se avanços importantes que favoreceram a organização e estruturação do ECS como um momento fundamental no processo de ensino e aprendizagem na formação dos futuros professores de EF.

Throughout the last three decades, the Supervised Academic Training (ECS) for Physical Education teachers has been transformed to enhance this stage of initial training bringing scholars closer to their prospective professional field and to educational routine. In this context, the objective of this research was to develop a document analysis in order to present and discuss the major laws that support and subsidize the Supervised Academic Training for Physical Education teachers in Brazil, through Resolution CFE n° 03/1987. In the bureaucratic and documental fields we verified important advances favoring the organization and structuring of the ECS as a key point in the process of teaching and learning for the training of future Physical Education teachers.

La Práctica Curricular Supervisada (PCS) en la formación de profesores de Educación Física (EF), a lo largo de las últimas tres décadas, ha pasado por transformaciones en el sentido de fortalecer esta etapa de la formación inicial, aproximando el académico de su futuro campo profesional y del cotidiano docente. De esa manera, el objetivo de la investigación fue, por medio de un análisis documental, presentar y discutir las principales leyes que sostienen y subsidian la PCS en la formación de profesores de EF en el Brasil, a partir de la Resolución CFE n° 03/1987. En el campo burocrático y documental, se constataron avances importantes que favorecieron la organización y estructuración de la PCS como un momento fundamental en el proceso de enseñanza y aprendizaje en la formación de los futuros profesores de EF.

Efecto de la seguridad social en la duración del ausentismo laboral en el Servicio de Salud de Ñuble: un análisis de supervivencia / Social security and labor absenteeism in a regional health service

Background: Absenteism can generate important economic costs. Aim: To analyze the determinants of the time off work for sick leaves granted to workers of a regional health service. Material and Methods: Information about 2033 individuals, working at a health service, that were granted at least one sick leave during 2012, was analyzed. Personal identification was censored. Special emphasis was given to the type of health insurance system of the workers (public or private). Results: Workers ascribed to the Chilean public health insurance system (FONASA) had 11 days more off work than their counterparts ascribed to private health insurance systems. A higher amount of time off work was observed among older subjects and women. Conclusions: Age, gender and the type of health insurance system influence the number of day off work due to sick leaves.

Cumplimiento de la capacidad tecnológica-científica en los servicios de Fisioterapia de Bucaramanga y Floridablanca / Achievement of technological and scientific capacity in Physical Therapy services of Bucaramanga and Floridablanca

Objetivo Determinar el cumplimiento de la condición de capacidad tecnológica y científica de una muestra de servicios de terapia física y respiratoria del área urbana de Floridablanca y Bucaramanga. Metodología Se realizó un estudio descriptivo, con un muestreo no probabilístico por conveniencia. La muestra la conforman cuatro instituciones prestadoras de servicios de salud del municipio de Floridablanca y tres instituciones del área urbana de Bucaramanga, a las que durante el año 2011 se les aplicaron dos encuestas para verificar el cumplimiento de los estándares de habilitación y conocer las razones por las cuales incumplen con alguno de los requisitos. Resultados En Floridablanca, tres instituciones corresponden al primer nivel de atención y una al segundo nivel de atención; los estándares con menor cumplimiento son: Seguimiento a riesgos con una mediana del puntaje de cumplimiento de 0 (Rango: 0-12); Historia Clínica asistencial con una mediana de 9,5 (Rango: 0-100) y el estándar de procesos prioritarios con una mediana de 18 (Rango: 9-27). En Bucaramanga, dos correspondían al segundo nivel de atención y una a un tercer nivel de atención. Los estándares de menor cumplimiento fueron: Medicamentos y dispositivos con 0 para una institución, Procesos prioritarios con una mediana de 60 (Rango: 0-89) e instalaciones físicas con una mediana de 73 (Rango: 64-84). Conclusiones Los resultados muestran un incumplimiento de los requisitos esenciales de habilitación, pese a que éstos son exigidos por los entes territoriales departamentales, distritales y municipales de salud.(AU)

Objective To identify the achievement of the condition of technological and scientific capacity of a sample of physical therapy and respiratory services from the urban area of Floridablanca and Bucaramanga. Methodology A descriptive study was performed with a set of samples not based on probabilities out of convenience. The sample consisted of four health service provider institutions in the town of Floridablanca and three institutions from the urban area of Bucaramanga. During the year 2011, two check lists were applied in order to verify the fulfillment of standards of habilitation and to find the reasons for their non-compliance in some of their requisites. Results Three institutions in Floridablanca belong to the first level of care and one to the second level of care; the standards with the lowest fulfillments are: Risk follow-up with a median fulfillment score of 0 (Range: 0-12); Medical Records of care with a median of 9.5 (Range: 0-100) and the standard of priority procedures with a median of 18 (Range: 9-27). In Bucaramanga, two institutions belong to the second level of care and one to the third level of care. The lowest standards in fulfillment were: Medications and devices with zero for one institution, Priority procedures with a median of 60 (Range: 0-89) and physical installations with a median of 73 (Range: 64-84). Conclusions The results show a non-compliance with the essential requisites of habilitation even though these are demanded by the territorial organizations in each health department, district, and municipality.(AU)

Metrics development for patents / Desenvolvimento de métricas para patentes

Objective: To develop a proposal for metrics for patents to be applied in assessing the postgraduate programs of Medicine III - Capes. Methods: From the reading and analysis of the 2013 area documents of all the 48 areas of Capes, a proposal for metrics for patents was developed to be applied in Medicine III programs. Results: Except for the areas Biotechnology, Food Science, Biological Sciences III, Physical Education, Engineering I, III and IV and Interdisciplinary, most areas do not adopt a scoring system for patents. The proposal developed was based on the criteria of Biotechnology, with adaptations. In general, it will be valued, in ascending order, the deposit, the granting and licensing/production. It will also be assigned higher scores to patents registered abroad and whenever there is a participation of students. Conclusion: This proposal can be applied to the item Intellectual Production of the evaluation form, in subsection Technical Production/Patents. The percentage of 10% for academic programs and 40% for Masters Professionals should be maintained. The program will be scored as Very Good when it reaches 400 points or over; Good, between 200 and 399 points; Regular, between 71 and 199 points; Weak up to 70 points; Insufficient, no punctuation.

Objetivo: Desenvolver uma proposta de métricas para patentes a serem aplicadas na avaliação dos Programas de Pós-Graduação da Área Medicina III - Capes. Métodos: A partir da leitura e análise dos documentos de área de 2013 de todas as 48 Áreas da Capes, desenvolveu-se uma proposta de métricas para patentes, a ser aplicada na avaliação dos programas da área. Resultados: Constatou-se que, com exceção das áreas Biotecnologia, Ciência de Alimentos, Ciências Biológicas III, Educação Física, Engenharias I, III e IV e Interdisciplinar, a maioria não adota sistema de pontuação para patentes. A proposta desenvolvida baseou-se nos critérios da Biotecnologia, com adaptações. De uma forma geral, foi valorizado, em ordem crescente, o depósito, a concessão e o licenciamento/produção. Também foi atribuída maior pontuação a patentes registradas no exterior e com participação de discentes. Conclusão: Esta proposta poderá ser aplicada ao item Produção Intelectual da ficha de avaliação, no subitem Produções Técnicas, patentes e outras produções consideradas relevantes. Deverá ser mantida, neste subitem, a porcentagem de 10% para os programas acadêmicos e 40% para os mestrados profissionais. Será considerado Muito Bom o programa que obtiver 400 pontos/triênio ou mais, Bom entre 200 e 399 pontos; Regular entre 71 e 199 pontos; Fraco até 70 pontos; e Deficiente sem pontuação.

Post-authorization safety surveillance of a liquid pentavalent vaccine in Guatemalan children.

OBJECTIVE: Combination vaccines have improved the efficiency of delivery of new vaccines in low and middle-income countries. Post-authorization monitoring of adverse events (AEs) after vaccination with a liquid pentavalent DTwP-HepB-Hib combination vaccine was conducted in Guatemalan infants. METHODS: A prospective observational safety study of the incidence of medical attended events (MAEs) and serious adverse events (SAEs) in children who received pentavalent and oral polio vaccines at 2, 4 and 6 months of age was conducted in two clinics at the Institute of Guatemala. Parents were contacted by telephone after each dose. All outpatient, emergency department visits, and hospitalizations were monitored. A self-controlled analysis was conducted to determine if there was evidence of increased risk of MAEs or SAEs following vaccines as compared to control time windows. RESULTS: Of 3000 recruited infants, 2812 (93.7%) completed the third dose and 2805 (93.5%) completed follow-up. Ten AEs in eight infants, of which four SAEs in four infants, were classified as related to the vaccine. Thirteen deaths were reported due to common illnesses of infancy, and none were judged to be related to the vaccine. The mortality rate (4.4 per 1000) was lower than expected for the population. The incidence-rate-ratio for healthcare visits was lower in post-vaccination time windows than for control windows; after the first vaccine dose, the rate ratios for the risk periods of 0-1, 2-6, and 7-30 days post-vaccination were 0.3, 0.5, and 0.7, respectively (all statistically significantly different from the reference value of 1.0 for the 31-60 day control period). CONCLUSION: The liquid pentavalent vaccine was associated with lower rates of health care visits and not associated with increases in SAEs or hospitalizations. Systems can be set up in low to middle income countries to capture all health care visits to monitor the safety of new vaccines.

Funções do biomédico inserido na Biotecnologia / Functions of the biomedical inserted in Biotechnology

Objetivo - Verificar na concepção dos profissionais biomédicos, quais seriam as habilitações específicas da Biomedicina, que mais influenciam no desenvolvimento da prática biomédica em situações que envolvem a área de atuação em Biotecnologia. Métodos - A população deste estudo foi constituída por sete docentes biomédicos, sendo que estes sete responderam a um instrumento de coleta de dados,com questões abertas e fechadas para abordar o perfil desses profissionais e complementando com quatro perguntas dissertativas, do tipo roteiro para gravação em áudio, que serviram de subsídios para verificar a visão que esses biomédicos têm sobre a profissão na qual eles estão inseridos profissionalmente. Resultados - Os resultados mostraram que a habilitação de Biologia molecular é a que mais se aproxima na realidade biomédica com situações, envolvendo a Biotecnologia. Conclusões - A implantação da habilitação em Biotecnologia na Biomedicina é essencialmente necessária para a atuação dos biomédicos no setor biotecnológico.

Objective - Check on about conception of the biomedical professional, what are the specific habilitations of Biomedicine, that more influence in the development of biomedical practice in situations involving the performance area in Biotechnology. Methods - The studied population consisted seven biomedicals, among these seven answered to a structured quiz with open and close questions to approach the profilethese professionals and complementing with four dissertating questions, of kind screenplay of audio recording, that served of subsidy to check the vision that these biomedicals has about the professions in which they are inserted professionally. Results - The obtained results point to habilitation of the molecular Biology that is closest to reality in Biomedicine situations, involving the Biotechnology. Conclusions - The implantation of Biotechnology habilitation in the Biomedicine is essentially necessary to actions of biomedicals in biotechnology sector.

Regulación para la práctica de enfermería en Estados Unidos de América / Overview of nursing practice regulation in the United States

Los procesos de licenciación, certificación, acreditación, y registro del personal de salud en los Estados Unidos constituyen los mecanismos legales de evaluación de la competencia, avalados por el Estado para garantizar estándares mínimos de calidad y seguridad de los servicios. A más de un siglo de su origen en enfermería, estos procesos se han ido desarrollando a partir de definiciones y regulaciones legales que se crearon con la descripción especifica de las calificaciones y responsabilidades de las enfermeras para legalizar y regular su práctica, a partir de los Actos de Ley para la práctica de enfermería. Aunque los resultados de estas evaluaciones generaron la actual forma de regulación profesional, la limitación generada en el ámbito de la práctica y los procedimientos para evaluar la competencia son descritas como las más profundas desventajas y cuestionamientos de la evaluación. Por otra parte, con estos procesos evaluativos no sólo se impulsó la creación de grupos y asociaciones de enfermería con objetivos específicos, como fueron la definición de competencias por áreas específicas, además, se fortalecieron los mecanismos de evaluación y retroalimentación de la educación, la práctica, la investigación y el desarrollo de la enfermería misma, generando con ello la transformación interna y externa de la profesión y garantizando su avance en el escenario del sistema de salud.

The processes of licensure, certification, accreditation, and registry for the system health personnel in the United States are the legal mechanisms of competency evaluation supported by the State to guarantee health services with the minimal standards of quality and safety. Along more than a century from their origin in the nursing profession, these processes have been developed originally by the definitions and legal regulations shaped with the specific description of qualifications and responsibilities of the nurses in order to legalize and regularize their practice, by means of the Nursing Practice Acts. Even though the outcomes of these evaluations caused the current professional regulation method, limitations on the scope of practice and the procedures to evaluate competency have been described as deep disadvantages and serious questions about it. On the other hand, with these evaluative processes not only the encouragement to integrate nursing groups and associations with specific tasks were achieved, such as the definition of competencies by specialized areas, but also, the evaluation and feedback methods in education, practice, research and the evolution of the nursing profession by itself were fortified, generating the internal and external transformation of the profession and guaranteeing its advance over the health system scenery.