No-fault compensation schemes for COVID-19 vaccine injury: a mixed bag for claimants and citizens.

The development of vaccines against SARS-CoV-2 (COVID-19) presented a unique set of challenges. There was a global need for safe, effective vaccines against a new virus. In response to the development of vaccines for COVID-19 (some of which used novel technologies), there was a proliferation of no-fault compensation schemes (NFCS) for COVID-19 vaccine injuries. We identified 28 national vaccine injury NFCS operating in December 2019. Just 2 years later, over 130 countries had some NFCS coverage for COVID-19 vaccines. This rapid expansion was primarily driven by the creation of three multinational schemes. The COVID-19 Vaccines Global Access (COVAX) scheme covers vaccines given under the COVAX framework in 92 low and middle-income countries across the globe. The African Vaccines Acquisition Trust (AVAT) scheme covers vaccines administered under the AVAT framework in 36 African and Caribbean countries. The UNICEF scheme covers vaccines administered by UNICEF in 18 Asian countries.Because of the sudden expansion of no-fault compensation for vaccine injury, especially in developing economies, more research on the foundations, procedures and outcomes of NFCS is needed. In this article, we examine how these NFCS meet the needs of individual claimants and society more widely. To do so, we first review the rationales offered to support the creation of vaccine injury NFCS. We then argue that, in order to achieve their function as compensation mechanisms, NFCS should be accessible and offer substantive and procedural justice to claimants. Finally, we focus on transparency and accountability as necessary requirements to allow scrutiny over existing NFCS and their wider impacts.

The revised International Code of Medical Ethics: an exercise in international professional ethical self-regulation.

The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption by the WMA General Assembly in October 2022 in Berlin. This article describes and discusses the ICoME, its revision process, the controversial and uncontroversial issues, and the broad consensus achieved among WMA constituent members, representing over 10 million physicians worldwide. The authors analyse the ICoME, including its response to contemporary changes and challenges like ethical plurality and globalisation, in light of ethical theories and approaches, reaching the conclusion that the document is a good example of international ethical professional self-regulation.

Academic freedom under siege.

This paper describes a global pattern of declining academic freedom, often driven by powerful political interference with core functions of academic communities. It argues that countering threats to academic freedom requires doubling down on ethics, specifically standards of justice and fairness in pursuing knowledge and assigning warrant to beliefs. Using the example of the selection of a Qatari university to host the 2024 World Congress of Bioethics, the authors urge fairness towards diverse groups over time and efforts to counter injustices that conferences generate.

Relationship between secondary health conditions and life satisfaction in persons with spinal cord injury: study across twenty-one countries.

PURPOSE: To determine the relationships between impact of secondary health conditions (SHCs), treatment of SHCs, and life satisfaction (LS) following spinal cord injury (SCI) across 21 countries. Hypotheses were as follows: (1) Persons with SCI and fewer SHCs report higher LS and (2) Persons who receive treatment for SHCs report higher LS than those who do not receive treatment. METHODS: Cross-sectional survey, including 10,499 persons with traumatic or non-traumatic SCI aged 18 years or older and living in the community. To assess SHCs, 14 items adapted from the SCI-Secondary Conditions Scale were used (range 1-5). SHCs index was calculated as the mean of all 14 items. LS was assessed using a selection of 5 items from the World Health Organization Quality of Life Assessment. LS index was calculated as the mean of these 5 items. RESULTS: South Korea, Germany, and Poland exhibited the highest (2.40-2.93) and Brazil, China, and Thailand the lowest (1.79-1.90) impact of SHCs. Indexes for LS and SHCs were inversely correlated (- 0.418; p < 0.001). Mixed Model Analysis showed that the fixed effect (key predictors of the study) of SHCs index (p < 0.001) and the positive interaction between SHCs index and treatment (p = 0.002) were significant determinants of LS. CONCLUSION: Persons with SCI across the world are more likely to perceive better LS if they experience fewer SHCs and receive treatment for SHCs, in comparison to those who do not. Prevention and treatment of SHCs following SCI should be a high priority in order to improve the lived experience and enhance LS.

Therapeutic principles and unmet needs in the treatment of cough in pediatric patients: review and expert survey.

BACKGROUND: There are evidence gaps in the management of pediatric cough, particularly for acute pediatric cough. This study had two aims: to identify therapeutic principles and unmet needs in the treatment of cough in pediatric patients (internationally), and to consider the evidence required to address these unmet needs. METHODS: A MEDLINE/PubMed database search was performed to identify articles describing therapeutic principles in the treatment of pediatric cough. An online survey of international pediatric cough experts was conducted, with questions on the definitions, diagnosis, treatment, and unmet needs in pediatric cough management. RESULTS: Cough guidelines have differing definitions of pediatric patients (≤12-18 years), acute pediatric cough (< 2-3 weeks), and chronic pediatric cough (> 4-8 weeks). Similarly, among 18 experts surveyed, definitions varied for pediatric patients (≤10-21 years), acute pediatric cough (< 3-5 days to < 6 weeks), and chronic pediatric cough (> 2-8 weeks). Guidelines generally do not recommend over-the-counter or prescription cough medicines in acute pediatric cough, due to lack of evidence. In the expert survey, participants had differing opinions on which medicines were most suitable for treating acute pediatric cough, and noted that effective treatments are lacking for cough-related pain and sleep disruption. Overall, guidelines and experts agreed that chronic pediatric cough requires diagnostic investigations to identify the underlying cough-causing disease and thereby to guide treatment. There are unmet needs for new effective and safe treatments for acute pediatric cough, and for randomized controlled trials of existing treatments. Safety is a particular concern in this vulnerable patient population. There is also a need for better understanding of the causes, phenotypes, and prevalence of pediatric cough, and how this relates to its diagnosis and treatment. CONCLUSIONS: Whereas pediatric cough guidelines largely align with regard to the diagnosis and treatment of chronic cough, there is limited evidence-based guidance for the management of acute cough. There is a need for harmonization of pediatric cough management, and the development of standard guidelines suitable for all regions and patient circumstances.

An international exploration of blended learning use in pre-registration nursing and midwifery education.

AIM: To explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy. BACKGROUND: The global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere. DESIGN: Cross-sectional, sequential, mixed methods study PARTICIPANTS/SETTINGS: Nursing/nurse education leaders from across International Council of Nurses regions METHODS: Exploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants' knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes. RESULTS: Participants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation. CONCLUSIONS: Blended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact. TWEETABLE ABSTRACT: Blended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.

Towards a new model of global health justice: the case of COVID-19 vaccines.

This paper questions an exclusively state-centred framing of global health justice and proposes a multilateral alternative. Using the distribution of COVID-19 vaccines to illustrate, we bring to light a broad range of global actors up and down the chain of vaccine development who contribute to global vaccine inequities. Section 1 (Background) presents an overview of moments in which diverse global actors, each with their own priorities and aims, shaped subsequent vaccine distribution. Section 2 (Collective action failures) characterises collective action failures at each phase of vaccine development that contributed to global vaccine disparities. It identifies as critical the task of establishing upstream strategies to coordinate collective action at multiple stages across a range of actors. Section 3 (A Multilateral model of global health governance) takes up this task, identifying a convergence of interests among a range of stakeholders and proposing ways to realise them. Appealing to a responsibility to protect (R2P), a doctrine developed in response to human rights atrocities during the 1990s, we show how to operationalise R2P through a principle of subsidiarity and present ethical arguments in support of this approach.

What do we need to know about anatomy in gynaecology? An international validation study.

OBJECTIVE: International validation of the Dutch Delphi study about which anatomical structures should be taught to ensure safe and competent practice among general gynaecologists. STUDY DESIGN: Validation study with gynaecologists and trainees in gynaecology from academic, non-academic teaching and non-academic, non-teaching hospitals worldwide. The relevance of 123 items included in the Dutch Delphi study was scored on a Likert scale between 1 (not relevant) and 5 (highly relevant). Consensus was defined when ≥70 % of the panellist scored the item as relevant or very relevant and the average rating was ≥4. RESULTS: A total of 192 gynaecologists and trainees from seven countries (Belgium, Germany, Norway, Oceania, Sweden, United Kingdom and United States) completed the questionnaire. Of the 123 structures, 72 (58.5%) were internationally relevant. When the 72 relevant structures from the international Delphi study were compared with the 86 relevant structures from the Dutch Delphi study, 70 (81.4%) structures matched. CONCLUSIONS: This study identified 70 anatomical structures that should be taught for safe and competent practice of general gynaecologists based on national and international validation. The results of our study identify the learning needs (i.e., the content) for an international anatomy curriculum. The development of the curriculum (i.e., the form) can be determined by each country and used to standardize and guide postgraduate training in gynaecology. This is an important step in the era of international teaching and training.

Factors associated with emergency department length of stay of foreign patients visiting a regional core hospital in Japan.

Aim: This study aims to elucidate the foreign patient-specific factors associated with emergency department length of stay (EDLOS) in a regional core hospital emergency department (ED) in Japan. Methods: This retrospective observational study included non-Japanese patients who visited the ED in a Japanese regional core hospital between April 1, 2018, and March 31, 2020. The effects on EDLOS were assessed using multivariate linear regression analysis, which included factors such as age, sex, consultation language, interpreter usage, arrival time, day of visit, mode of arrival, underlying disease, triage level, diagnosis of injury/noninjury, diagnostic investigations, consultation with specialists, and treatments or procedures. Results: Of 65,297 ED patients, there were 777 study patients, with a median age of 37 years (interquartile range [IQR], 24.0-50.0). The median EDLOS was 101 min (IQR, 63.0-153.0). Multivariate linear regression analysis indicated that an extended EDLOS was associated with: language apart from Japanese, Chinese, or English (51.7 min; 95% confidence interval [CI], 17.8-85.6), helicopter arrival (115.6 min; 95% CI, 48.8-182.5), blood testing (60.5 min; 95% CI, 34.6-86.4), computed tomography (23.8 min; 95% CI, 3.7-43.9), consultation with specialists (36.2 min; 95% CI, 11.8-60.6), intravenous fluid/medication (29.7 min; 95% CI, 3.3-56.1), and surgical procedure/reduction/fixation in the ED (38.8 min; 95% CI, 14.2-63.4). Conclusions: Consultation in a language other than Japanese, English, or Chinese was associated with a longer EDLOS in a regional core hospital in Japan. Devising ways to accommodate patients who speak various languages could be important.

The survival gap between young and older patients after surgical resection for colorectal cancer remains largely based on early mortality: A EURECCA comparison of four European countries.

BACKGROUND: A decade ago, it was demonstrated that the difference in survival between older patients and younger patients with colorectal cancer (CRC) was mainly due to mortality in the first postoperative year. Over the last few years, improvements - especially in perioperative care - have increased survival. The current research investigates whether a survival gap between younger and older patients with CRC still exists on a national level in four European countries. METHODS: Population-based data from Belgium, the Netherlands, Norway, and Sweden were collected from patients that underwent surgical resection for primary stage I-III CRC between 2007 and 2016. Relative survival and conditional relative survival (CS), with the condition of surviving the first postoperative year, were calculated for colon and rectal cancer separately, stratified for country and age category (<65, 65-75, ≥75 years). In addition, relative excess risk of death (RER) was estimated, and one-year excess mortality was calculated. RESULTS: Data of 206,024 patients were analyzed. In general, compared to patients <65 years, patients ≥75 years had a worse survival during the first year after surgery, which was most pronounced in Belgium (RER colon cancer 2.5 [95% confidence interval (CI) 2.3-2.8] and RER rectal cancer 2.6 [95% CI 2.3-2.9]). After surviving the first year, CS was mostly not statistically different between patients <65 years and patients ≥75 years with stage I-II, with the exception of stage II colon cancer in Belgium. However, CS remained worse in the largest part of the patients ≥75 years with stage III colon or rectal cancer (except for rectal cancer in Norway). CONCLUSIONS: Although differences exist between the countries, the survival gap between young and older patients is based mainly on early mortality and remains only for stage III disease after surviving the first year.

Five years of #MedRadJClub: An impact evaluation of an established twitter journal club.

INTRODUCTION: Twitter journal clubs are a relatively new adaptation of an established continuing professional development (CPD) activity within healthcare. The medical radiation science (MRS) journal club 'MedRadJClub' (MRJC) was founded in March 2015 by a group of academics, researchers and clinicians as an international forum for the discussion of peer-reviewed papers. To investigate the reach and impact of MRJC, a five-year analysis was conducted. METHODS: Tweetchat data (number of participants, tweets and impressions) for the first five years of MRJC were extracted and chat topics organised into themes. Fifth anniversary MRJC chat tweets were analysed and examples of academic and professional outputs were collated. RESULTS: A total of 59 chats have been held over five years with a mean of 41 participants and 483,000 impressions per hour-long synchronous chat. Ten different tweetchat themes were identified, with student engagement/preceptorship the most popular. Eight posters or oral presentations at conferences, one social media workshop and four papers have been produced. Qualitative analysis revealed five core themes relating to the perceived benefits of participation in MRJC: (1) CPD and research impact, (2) professional growth and influencing practice, (3) interdisciplinary learning and inclusion, (4) networking and social support and (5) globalisation. CONCLUSION: MRJC is a unique, multi-professional, global community with consistent engagement. It is beneficial for both CPD, research engagement, dissemination and socialisation within the MRS community.

Women family physicians' working conditions and career satisfaction: a multinational study.

BACKGROUND: As the proportion of women in family medicine increases, their well-being and job satisfaction become concerns. OBJECTIVES: This study aimed to uncover the working conditions and career satisfaction of women family physicians across multiple countries. METHODS: A cross-sectional survey of the WONCA Working Party on Women and Family Medicine listserv members to assess working conditions and career satisfaction, with snowballing recruitment. Aspects of physician job satisfaction were measured using the validated Physician Work-Life Survey and calculated as the sum of the scores of each positive item divided by the total number of questions and multiplied by 10. The association between satisfaction and the continent and the country income level was performed using a one-way ANOVA test (P < 0.05). RESULTS: A total of 315 participants across 49 countries responded to the survey with 205 complete responses. Women family physicians reported high overall career satisfaction (8.2 ± 2.3) but were less satisfied with some aspects of their career such as pay (5.3 ± 3.4), personal time (3.5 ± 2.6), and administrative tasks (3.2 ± 3.7). Despite the widespread experience of sexism at work, satisfaction with personal career aspects was universal at the continent and income level, while satisfaction with other career aspects relevant to relationships in work environment and resources varied. CONCLUSION: Women family physicians around the world are overall satisfied with their careers. However, variation in certain working conditions among countries leaves room for improvement, drawing attention to the need for national review of working environments and pay scales.

Comparison of Life Satisfaction in Persons With Spinal Cord Injury Living in 22 Countries With Different Economic Status.

OBJECTIVE: To analyze and compare life satisfaction (LS) in persons with spinal cord injury (SCI) living in 22 countries participating in the International Spinal Cord Injury (InSCI) community survey. The study tested the hypothesis that there are differences in LS across InSCI countries according to the countries' economic status specified as gross domestic product per capita purchased power parity (GDP-PPP). DESIGN: Cross-sectional survey. SETTING: Community setting (22 countries representing all 6 World Health Organization regions). PARTICIPANTS: Persons (N=12,108) with traumatic or nontraumatic SCI aged at least 18 years, living in the community and able to respond to one of the available language versions of the questionnaire. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: LS measured by 5 items selected from the World Health Organization Quality of Life Assessment-BREF: satisfaction with overall quality of life, health, daily activities, relationships, and living conditions. LS index was calculated as the mean of these 5 items. RESULTS: The highest level of LS was reported by persons with SCI living in the United States, Malaysia, and Switzerland (mean range, 3.76-3.80), and the lowest was reported by persons with SCI living in South Korea, Japan, and Morocco (mean range, 2.81-3.16). There was a significant cubic association between LS index and GDP-PPP. Regression tree analysis revealed the main variables differentiating LS index were GDP-PPP and monthly income, followed by time since injury and education. CONCLUSIONS: Life satisfaction reported by persons with SCI related mainly to their country economic situation expressed by GDP-PPP and monthly income. The results of this study underscore the need for policy dialogues to avoid inequalities and improve the life experience in persons with SCI.

Advanced training and international educational exchange: learning, overcoming and experiences / Formación avanzada e intercambio educativo internacional: aprendizajes, superaciones y experiências / Formação avançada e intercâmbio educacional internacional: aprendizados, superações e vivências

ABSTRACT Objectives: to report my experiences as a researcher during the course of advanced post-doctoral training abroad. Methods: theoretical and methodological option for Max van Manen's phenomenology of practice. The activities were developed in the Health Sciences Research Unit: Nursing, in Portugal, Université Catholique de Louvain, in Belgium, and in Escuela de Enfermería y Fisioterapia de la Universidad de Castilla-La Mancha, in Spain. Results: participating in a multicenter international research project enabled the acquisition of new scientific knowledge, personal and cultural gains. From a broader perspective, the international graduate and undergraduate nursing networks were strengthened through the mobility of researchers, and overcoming of the "status quo" by the formation of a critical mass environment indispensable for scientific advancement. Final Considerations: sharing the experience that you appropriate is about the power of grasping possibilities of a practical experience, in the context of the world, and going through it, motivated by the desire to make internationalization feasible.

RESUMEN Objetivos: relatar mi experiencia de investigador durante el curso de formación posdoctoral avanzada en el extranjero. Métodos: opción teórico-metodológica por la fenomenología de la práctica de Max van Manen. Las actividades se desarrollaron en la Unidad de Investigación en Ciencias de la Salud: Enfermería, en Portugal, Université Catholique de Louvain, en Bélgica, y en la Escuela de Enfermería y Fisioterapia de la Universidad de Castilla-La Mancha, en España. Resultados: participar de un proyecto de investigación internacional multicéntrico permitió la adquisición de nuevos conocimientos científicos, ganancias zpersonales y culturales. Desde una perspectiva más amplia, se fortalecieron las redes internacionales de posgrado y pregrado en Enfermería, a través de la movilidad para investigadores y la superación del "statu quo", por la formación de un ambiente de masa crítica indispensable para el avance científico. Consideraciones Finales: compartir la experiencia que se apropia tiene que ver con el poder de captar las posibilidades de una experiencia práctica, en el contexto del mundo y aprovecharla, motivado por el deseo de hacer factible la internacionalización.

RESUMO Objetivos: relatar minha vivência de pesquisador durante o percurso de formação avançada de pós-doutoramento no exterior. Métodos: opção teórico-metodológica pela fenomenologia da prática de Max van Manen. As atividades foram desenvolvidas na Unidade de Investigação em Ciências da Saúde: Enfermagem, em Portugal, e naEscuela de Enfermería y Fisioterapia de la Universidad de Castilla-La Mancha, na Espanha. Resultados: participar de um projeto multicêntrico de pesquisa internacional possibilitou aquisição de novos conhecimentos científicos, ganhos pessoais e culturais. Sob uma perspectiva mais ampla, foram fortalecidas as redes internacionais de pós-graduação e licenciatura em Enfermagem, por meio da mobilidade para pesquisadores, e a superação do"status quo",pela formação de ambiente de massa crítica indispensável ao avanço científico. Considerações Finais: compartilhar a vivência que se apropria diz respeito ao poder de captar possibilidades de uma experiência prática, no contexto do mundo e percorrê-la, motivado pelo desejo de tornar factível a internacionalização.

Ernst von Leyden (1832-1910): a pioneer in making oncology a respected medical discipline.

PURPOSE: This article presents new research on the role of the renowned German physician Ernst von Leyden (1832-1910) in the emergence of oncology as a scientific discipline. METHODS: The article draws on archival sources from the archive of the German Society of Haematology and primary and secondary literature. RESULTS: Leyden initiated two important events in the early history of oncology: the first international cancer conference, which took place in Heidelberg, Germany, in 1906, and the founding of the first international association for cancer research (forerunner of today's UICC) in Berlin in 1908. Unfortunately, these facts are not mentioned in the most recent accounts. Both had a strong impact on the professionalization of oncology as a discipline in its own right. CONCLUSION: Although not of Jewish origin, von Leyden was considered by the National Socialists to be "Jewish tainted", which had a lasting effect on his perception at home and abroad.

One-year excess mortality and treatment in surgically treated patients with colorectal cancer: A EURECCA European comparison.

BACKGROUND: Mortality in the first postoperative year represents an accurate reflection of the perioperative risk after colorectal cancer surgery. This research compares one-year mortality after surgery divided into three age-categories (18-64, 65-74, ≥75 years), focusing on time trends and comparing treatment strategies. MATERIAL: Population-based data of all patients diagnosed and treated surgically for stage I-III primary colorectal cancer from 2007 to 2016, were collected from Belgium, the Netherlands, Norway, and Sweden. Stratified for age-category and stage, treatment was evaluated, and 30-day, one-year and one-year excess mortality were calculated for colon and rectal cancer separately. Results were evaluated over two-year time periods. RESULTS: Data of 206,024 patients were analysed. Postoperative 30-day and one-year mortality reduced significantly over time in all countries and age-categories. Within the oldest age category, in 2015-2016, one-year excess mortality varied from 9% in Belgium to 4% in Sweden for colon cancer and, from 9% in Belgium to 3% in the other countries for rectal cancer. With increasing age, patients were less likely to receive additional therapy besides surgery. In Belgium, colon cancer patients were more often treated with adjuvant chemotherapy (p < 0.001). For neoadjuvant treatment of rectal cancer, patients in Belgium and Norway were mostly treated with chemoradiotherapy. In the Netherlands and Sweden, radiotherapy alone was preferred (p < 0.001). CONCLUSIONS: Despite improvement over time in all countries and age-categories, substantial variation exists in one-year postoperative mortality. Differences in one-year excess postoperative mortality could be due to differences in treatment strategies, highlighting the consequences of under- and over-treatment on cancer survival.

Assessing Self-Reported Competence Among Registered Nurses Working as a Culturally Diverse Work Force in Public Hospitals in the Kingdom of Saudi Arabia.

Introduction: Nurses in the Kingdom of Saudi Arabia (KSA) represent a multicultural workforce who are educated in different countries from around the world. The purpose was to assess professional competence among a multicultural workforce of registered nurses in KSA in relation to individual and work-related factors. Method: The Nurse Professional Competence Scale was used in a cross-sectional design. Results: Registered nurses (N = 541) reported highest scores for "nursing care," and "value-based nursing care," and lowest scores for "care pedagogics," and "development, leadership, and organization of nursing care." All CAs achieved 0.80 or more Cronbach's alpha. Known-group validity was verified by comparing nurse managers and staff nurses competence in organization, administration, and leadership of nursing care (p = .000). Discussion: There is room for competence development in care pedagogics, and development, leadership, and organization of nursing care. Assessing registered nurses competence is of importance for planning and implementing cultural congruent nursing care.

Internacionalização e adaptação de graduandas/egressas do curso de enfermagem em mobilidade acadêmica internacional / Internacionalización y adaptación de académicos/egresos de grado en enferméria en movilidad academica internacional / Internationalization and adaptation of undergraduate/graduate students of the nursing course in international academic mobility

Objetivo: Compreender o processo de adaptação e as repercussões da internacionalização para graduandos e egressos do curso de Enfermagem que vivenciaram a mobilidade acadêmica internacional. Método: Estudo qualitativo, realizado por meio de entrevistas semiestruturadas, com oito ex-intercambistas do programa brasileiro Ciência sem Fronteiras, de cursos de enfermagem de Instituições de Educação Superior de diferentes localidades brasileiras. As entrevistas foram realizadas via videoconferência, as quais foram gravadas para posterior transcrição. Os dados foram analisados pela técnica do Discurso do Sujeito Coletivo. Resultados: Emergiram cinco discursos: adaptação na Austrália; apoio ao estudante; estilos de vida e comportamento; diversidade cultural e comparação do sistema de saúde e da enfermagem entre Brasil e Austrália. As diferentes culturas possibilitaram a reflexão sobre o contexto multi e interculturais vivenciados, reforçando seus potenciais para a formação profissional e humana. Conclusão: A experiência com o intercâmbio representou um marco transformador, com impactos na vida pessoal e na formação profissional.(AU)

Objective: To understand the adaptation process and repercussions of internationalization for undergraduate and graduate nursing students who experienced the international academic mobility. Method: This is a qualitative study based on semistructured interviews with eight students who joined the Science without Borders Brazilian Program from Higher Education Institutions from different locations in Brazil. The students were interviewed via videoconference, which were recorded for later transcription. The data were analyzed by means of the Collective Subject Discourse. Results: From the data analysis, five discourses emerged: Adaptation in Australia; Student support; Lifestyles and behavior; Cultural diversity; and Comparison of the health system and nursing between Brazil and Australia. The different cultures made it possible for students to reflect on the multicultural and intercultural contexts experienced, reinforcing their potential for professional and human training. Conclusion: The experience with an exchange program represented a milestone with positive impacts both in personal life and in professional training.(AU)

Objetivo: Comprender el proceso de adaptación y las repercusiones de la internacionalización en la formación profesional de enfermeros, a partir de la percepción de los estudiantes de pregrado y egreso de la carrera de Enfermería que han experimentado la movilidad académica internacional. Método: Estudio cualitativo, realizado a través de entrevistas semiestructuradas, con ocho ex alumnos de intercambio del programa Brasileño Ciencia sin Fronteras de cursos de enfermería en Instituciones de Educación Superior de diferentes lugares de Brasil. Las entrevistas se realizaron mediante videoconferencia, las cuales fueron grabadas para su posterior transcripción. Los datos se analizaron mediante la técnica del Discurso del sujeto Colectivo. Resultados: Del análisis de datos surgieron cinco discursos: adaptación en Australia; apoyo estudiantil; estilos de vida y comportamiento; diversidad cultural; y comparación del sistema de salud y enfermería entre Brasil y Australia. Se hizo evidente que la adaptación de los entrevistados en Australia se vio obstaculizada por el idioma. La poca participación del programa Ciencia sin Fronteras se identificó durante el proceso de adaptación de los estudiantes de intercambio en el país de destino. Las percepciones mostraron que hubo comparaciones entre diferentes culturas durante el período de intercambio, lo que permitió reflexionar sobre el contexto multicultural vivido, reforzando su potencial de formación profesional y humana. Conclusión: La experiencia con el intercambio representó un hito transformador, con impactos positivos en la vida personal y la formación profesional como enfermero.(AU)

Instituições Brasileiras de Ensino e Pesquisa na Cooperação Sul-Sul para o Desenvolvimento: ciência, tecnologia e inovação em saúde / Brazilian teaching and research institutions in South-South cooperation for development: science, technology and innovation

Este trabalho possui o objetivo principal de identificar e analisar a relevância da cooperação Sul-Sul, especialmente BRICS, nas atividades científicas e tecnológicas da Universidade do Estado do Rio de Janeiro, Universidade Federal Fluminense e Universidade Federal do Rio de Janeiro nos períodos compreendidos entre 2003 a 2014 e 2015 em diante, utilizando a abordagem quantitativa para a análise dos dados. Como resultados e conclusões, o estabelecimento de parcerias com a cooperação Sul-Sul alcançou o maior crescimento acumulado (330,4%) em comparação ao crescimento acumulado da cooperação Norte-Sul (298,1%). Entre todas as regiões, o maior crescimento acumulado ficou com BRICS (1.650%). Do total de 2.199 parcerias, o Norte Global obteve 1.606 (73%) e o Sul Global 593 (27%). Na variação percentual entre períodos, de 2003 a 2014 a Sul-Sul obteve o maior crescimento (329%), de 2015 em diante sofreu a maior queda, com um crescimento de 130,8%. De 2003 a 2014 a Norte-Sul alcançou um crescimento de 266,7%, caindo para 149,3% em 2015 em diante. Os dados demonstram que apesar do 'Norte Global' ocupar as primeiras posições no número de acordos, os países em desenvolvimento compõem uma parcela importante e crescente dos acordos internacionais das universidades selecionadas. Os acordos com os países BRICS surgiram ou aumentaram quando o Brasil buscou implementar uma política externa autônoma com foco no 'Sul Global' entre 2003 e 2016. No entanto, a partir de 2016, a educação superior brasileira vem sofrendo cortes profundos no financiamento de suas atividades, inclusive diminuindo o crescimento em todas as modalidades de cooperação (Norte e Sul). Para a mudança de ordem internacional, parece fundamental que os países BRICS utilizem os instrumentos financeiros disponíveis para criar e apoiar parcerias de logo prazo direcionadas a produção científica e tecnológica das instituições universitárias. Ressaltamos ainda o caráter urgente e acentuado de incluir as universidades públicas brasileiras em uma política de estado para a ciência e a tecnologia enquanto questão de interesse nacional.

This work has the main objective of identifying and analyzing the relevance of SouthSouth cooperation, especially BRICS, in the scientific and technological activities of the Rio de Janeiro State University, Fluminense Federal University and Federal University of Rio de Janeiro in the periods between 2003 to 2014 and 2015 onwards, using the quantitative approach to data analysis. As results and conclusions, the establishment of partnerships with South-South cooperation reached the highest accumulated growth (330.4%) compared to the accumulated growth of North-South cooperation (298.1%). Among all regions, the highest accumulated growth came from BRICS (1,650%). Of the total of 2,199 partnerships, the 'Global North' obtained 1,606 (73%) and the 'Global South' 593 (27%). In the percentage variation between periods, from 2003 to 2014, South-South had the highest growth (329%), from 2015 onwards it suffered the biggest fall, with a growth of 130.8%. From 2003 to 2014 the North-South reached a growth of 266.7%, falling to 149.3% in 2015 onwards. The data show that despite the 'Global North' occupies the first positions in the number of agreements, developing countries are an important and growing part of the international agreements of the selected universities. Agreements with the BRICS countries emerged or increased when Brazil implemented an autonomous foreign policy focused on the 'Global South' between 2003 and 2016. However, from 2016 onwards, brazilian higher education has been suffering deep cuts in the financing of its activities, including decreasing growth in all cooperation modalities (North and South). To change the international order, it seems essential that the BRICS countries use the financial instruments available to create and support long-term partnerships aimed at the scientific and technological production of university institutions. We also emphasize the urgent nature of including brazilian public universities in a state policy for science and technology as a matter of national interest.

Postgraduate nursing internationality education: A study in establishing an English nursing course.

Aim: The study was to explore the significant influence of an English nursing course in nursing postgraduate internationalization education. Design: A cross-sectional study. Method: The research object included three grades (a total of 18) of nursing postgraduate students in the Nursing School of Yangzhou University. A standardized four-section questionnaire designed by the authors was applied to the survey. Results: 88.89% were satisfied with the course design and application of the English nursing course, and the scores for all 6 items were above the average, but only 44.4% of the postgraduate students understood the course completely. In teaching design and content aspect, 88.9%-94.4% postgraduate nurses felt that the course learning requirements were clear and could improve their knowledge and capacity for scientific research. All of the postgraduate nurses were identified with the teacher's moral and academic characters. Conclusions: To establish English nursing courses for nursing postgraduate students is beneficial for postgraduate internationalization education.