Search

Background: Treatment burden is an emerging concept in health care literature. It can complicate the patients’ condition and perhaps result in poor adherence to treatment, which is linked to worse clinical outcomes. However, until now there is no definition for treatment burden recognized by all stakeholders. This review was prepared in order to find what available definitions for treatment burden are present in the literature. Methods: A systematic review of the literature was prepared looking for definitions of treatment burden in adult patients. Articles about adults aged 18 years or older from both genders with one or more medical conditions that contained a (new) definition of treatment burden were included. The search approach consisted of conventional systematic review database searching of multiple resources including Embase, Medline, PsycINFO, and CINAHL. Two independent reviewers screened the titles and abstracts, and full papers. Results: The searches resulted in 8045 records, of which 16 articles were included. Based on quality appraisal criteria, we decided that two definitions had better evaluations than the rest of the definitions, the first one defining it as the impact of the ‘work of being a patient’ on functioning and well-being, the second as the actions and resources they devote to their healthcare. Conclusion: We consider the definition concentrating on actions and resources patients devote to their healthcare, including difficulty, time, and out-of-pocket costs dedicated to the healthcare tasks such as adhering to medications, dietary recommendations, and self-monitoring as the one probably comprising most domains of Treatment Burden that we have found in our search in the existing literature. However, adding even more domains to this definition and differentiating explicitly between patient's perception and caregiver's perception in the definition could in our opinion result in an improved definition. Also patients' evaluation of this definition is commendable.

To discover the features associated with personal and professional lives of university teachers, in the area of health sciences in the “Comunidad Valenciana” for the period 2003-2007, to learn if they contribute to a greater or lesser scientific productivity. Were interviewed in depth 30 teachers aged between 30 and 60 years in order to identify factors that hamper productivity. Have more difficulties to publish scientific papers, teachers less productive. Represent obstacles: the labor problems, the difficulty to obtain science projects and to publish in certain journals, to balance teaching and research, care work in hospitals, the maternity and children. Although the two groups of large and small producers point to the same problems in their work and personal life, are perceived more difficulties in the group of less productive. Most offer the same kind of solutions to reduce the gender distance.

There is a critical need to diversify health professionals to better serve the growing minority population in North America. Unfortunately, minority groups remain underrepresented in health professions. Despite recruitment efforts by government and academic institutions, fewer underrepresented minority (URM) students choose careers in healthcare. Identifying the key factors influencing URM students’ decisions to pursue health sciences programs could enhance diversity in these programs through targeted admissions strategies, ultimately leading to a more diverse future healthcare workforce. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Five electronic databases and gray literature were searched to identify North American papers published between 1942 and 2022. Identified studies focused on URM students’ perceptions of facilitators and barriers to matriculate into a health science degree. Twenty-one articles were analyzed. Following content analysis, the facilitators and barriers identified comprised personal, socio-cultural, institutional, and financial. The most frequent facilitators reported were scholarships, family support, and the presence of role models. Common barriers included high tuition fees, pre-admission criteria, lack of awareness about the health profession, availability of financial aid, and the admission process. The findings of this review will facilitate the development and implementation of customized, comprehensive strategies to recruit more URM students to health science programs in the future, thereby improving efforts toward creating a diverse healthcare workforce.

Continuing to improve services to students while studying on campus, lecturers and all elements at the university need information about triggers of environmental stress among medical and health sciences students. Thus, the purpose of this study was to explore triggers of environmental stress among medical and health sciences students in the university through bibliometric analysis by analysing the network visualisation, overlay visualisation and density visualisation on the topic. Bibliometrics analysis was used in assessing related topics. The data sources were based on online searches via https://app.dimensions.ai/. Data was collected on 3 December 2023. The literature followed the Preferred Reporting Items for System-atic Reviews and Meta-Analyses (PRISMA) flowchart. Data were analysed using VOSviewer and further analysed and reviewed by co-occurrence and co-authors. Four major themes of environmental stress were found in this study: 1) The internal situation in the university; 2) External situations outside of the university; 3) Comfort situation during the study; 4) Aca-demic process. Environmental stress factors related to internal situation in the academic situation were academic stress, air pollution, anxiety in the academic process, COVID-19, depression, fear, medical student, nursing student, physical activity, school regulation, smoking and uncertainty of study. From the visualisation and density visualisation, it can be seen that the academic process related to the duration of study was a trending theme discussed in several papers related to triggers of environmental stress among students in the university. All elements of the university especially policy makers should pay attention to this problem to reduce the risk of stress while students are studying.

Abstract Background Objective structured clinical examination (OSCE) is well‐established and designed to evaluate students' clinical competence and practical skills in a standardized and objective manner. While OSCEs are widespread in higher‐income countries, their implementation in low‐resource settings presents unique challenges that warrant further investigation. Aim This study aims to evaluate the perception of the health sciences students and their educators regarding deploying OSCEs within the School of Health Sciences and Techniques of Sousse (SHSTS) in Tunisia and their efficacity in healthcare education compared to traditional practical examination methods. Methods This cross‐sectional study was conducted in June 2022, focusing on final‐year Health Sciences students at the SHSTS in Tunisia. The study participants were students and their educators involved in the OSCEs from June 6th to June 11th, 2022. Anonymous paper‐based 5‐point Likert scale satisfaction surveys were distributed to the students and their educators, with a separate set of questions for each. Spearman, Mann–Whitney U and Krusakll–Wallis tests were utilized to test the differences in satisfaction with the OSCEs among the students and educators. The Wilcoxon Rank test was utilized to examine the differences in students' assessment scores in the OSCEs and the traditional practical examination methods. Results The satisfaction scores were high among health sciences educators and above average for students, with means of 3.82 ± 1.29 and 3.15 ± 0.56, respectively. The bivariate and multivariate analyzes indicated a significant difference in the satisfaction between the students' specialities. Further, a significant difference in their assessment scores distribution in the practical examinations and OSCEs was also demonstrated, with better performance in the OSCEs. Conclusion Our study provides evidence of the relatively high level of satisfaction with the OSCEs and better performance compared to the traditional practical examinations. These findings advocate for the efficacy of OSCEs in low‐income countries and the need to sustain them.

Strengths-based programs have emerged as asset-based approaches to professional development that promote positive student engagement and success. This paper shares the outcomes of a strengths-based professional development program provided to biomedical and health sciences graduate doctoral students within an academic health center. Program outcomes and changes in participants’ perceived confidence when identifying and applying their strengths in different contexts were evaluated through a mixed methods design that included a Likert-based survey and thematic analysis of qualitative responses. Findings strongly suggest that most participants lacked the self-confidence and/or self-awareness to recognize their own strengths prior to the program. Themes that emerged upon implementation of the program point to the following outcomes: participants gained an increased understanding of their strengths, confidence that the knowledge gained about their strengths would help them learn more effectively in laboratory settings, an increased belief that they possess natural talents and skills that make them good scientists and strong members of their research team, and confidence that applying their strengths will help them to overcome both personal and professional challenges. This program shows promise to strengthen graduate student self-awareness and self-confidence. Further studies are needed to understand and measure how asset-based programs such as this can impact graduate student resilience, science identity, and overall student success.

The evaluation of teaching can be an essential driver for curriculum development. Instruments for teaching evaluation are not only used for the purpose of quality assurance but also in the context of medical education research. Therefore, they must meet the common requirements for reliability and validity. This position paper from the GMA Teaching Evaluation Committee discusses strategic and methodological aspects of evaluation in the context of undergraduate medical education and related courses; and formulates recommendations for the further development of evaluation. First, a four-step approach to the design and implementation of evaluations is presented, then methodological and practical aspects are discussed in more detail. The focus here is on target and confounding variables, survey instruments as well as aspects of implementation and data protection. Finally, possible consequences from evaluation data for the four dimensions of teaching quality (structural and procedural aspects, teachers and outcomes) are discussed.

Summary: Automatically and accurately segmenting skin lesions can be challenging, due to factors such as low contrast and fuzzy boundaries. This paper proposes a hybrid encoder-decoder model (CTH-Net) based on convolutional neural network (CNN) and Transformer, capitalizing on the advantages of these approaches. We propose three modules for skin lesion segmentation and seamlessly connect them with carefully designed model architecture. Better segmentation performance is achieved by introducing SoftPool in the CNN branch and sandglass block in the bottleneck layer. Extensive experiments were conducted on four publicly accessible skin lesion datasets, ISIC 2016, ISIC 2017, ISIC 2018, and PH2 to confirm the efficacy and benefits of the proposed strategy. Experimental results show that the proposed CTH-Net provides better skin lesion segmentation performance in both quantitative and qualitative testing when compared with state-of-the-art approaches. We believe the CTH-Net design is inspiring and can be extended to other applications/frameworks.

Abstract Background Health research governance is an essential function of national health research systems. Yet many African countries have not developed strong health research governance structures and processes. This paper presents a comparative analysis of national health research governance in Botswana, Kenya, Uganda and Zambia, where health sciences research production is well established relative to some others in the region and continues to grow. The paper aims to examine progress made and challenges faced in strengthening health research governance in these countries. Methods We collected data through document review and key informant interviews with a total of 80 participants including decision-makers, researchers and funders across stakeholder institutions in the four countries. Data on health research governance were thematically coded for policies, legislation, regulation and institutions and analysed comparatively across the four national health research systems. Results All countries were found to be moving from using a research governance framework set by national science, technology and innovation policies to one that is more anchored in health research structures and policies within the health sectors. Kenya and Zambia have adopted health research legislation and policies, while Botswana and Uganda are in the process of developing the same. National-level health research coordination and regulation is hampered by inadequate financial and human resource capacities, which present challenges for building strong health research governance institutions. Conclusion Building health research governance as a key pillar of national health research systems involves developing stronger governance institutions, strengthening health research legislation, increasing financing for governance processes and improving human resource capacity in health research governance and management.

Summary: The monitoring of treadmill walking energy expenditure (EE) plays an important role in health evaluations and management, particularly in older individuals and those with chronic diseases. However, universal and highly accurate prediction methods for walking EE are still lacking. In this paper, we propose an ensemble neural network (ENN) model that predicts the treadmill walking EE of younger and older adults and stroke survivors with high precision based on easy-to-obtain features. Compared with previous studies, the proposed model reduced the estimation error by 13.95% and 66.20% for stroke survivors and younger adults, respectively. Furthermore, a contactless monitoring system was developed based on Kinect, mm-wave radar, and ENN algorithms, and the treadmill walking EE was monitored in real time. This ENN model and monitoring system can be combined with smart devices and treadmill, making them suitable for evaluating, monitoring, and tracking changes in health during exercise and in rehabilitation environments.

Summary: Quaternary ammonium compounds exhibit diverse applications as antibiotics, as surfactants, in paper industries, in sewage treatment, and in aquaculture. Here, we present a protocol for synthesizing a library of bioactive quaternary ammonium betaine derivatives under blue LED in water. We describe steps for preparing diazo compounds, synthesizing glycine betaine derivatives, and isolating pure final compounds via precipitation from an aqueous reaction mixture. This protocol promotes a sustainable approach by using water as the reaction medium and room temperature reactions.For complete details on the use and execution of this protocol, please refer to Rath et al. (2023).1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Summary: Protein biomarkers can be used to characterize symptom classes, which describe the metabolic or immunodeficient state of patients during the progression of a specific disease. Recent literature has shown that machine learning methods can complement traditional clinical methods in identifying biomarkers. However, many machine learning frameworks only apply narrowly to a specific archetype or subset of diseases. In this paper, we propose a feature extractor which can discover protein biomarkers for a wide variety of classification problems. The feature extractor uses a special type of deep learning model, which discovers a latent space that allows for optimal class separation and enhanced class cluster identity. The extracted biomarkers can then be used to train highly accurate supervised learning models. We apply our methods to a dataset involving COVID-19 patients and another involving scleroderma patients, to demonstrate improved class separation and reduced false discovery rates compared to results obtained using traditional models.

Summary: Combinatorial drug therapy is a promising approach for treating complex diseases by combining drugs with synergistic effects. However, predicting effective drug combinations is challenging due to the complexity of biological systems and the limited understanding of pathophysiological mechanisms and drug targets. In this paper, we proposed a computational framework called VGAETF (Variational Graph Autoencoder Tensor Decomposition), which leveraged multi-relational graph to model complex relationships between entities in biological systems and predicted disease-related synergistic drug combinations in an end-to-end manner. In the computational experiments, VGAETF achieved high performances (AUROC [the area under receiver operating characteristic] = 0.9767, AUPR [the area under precision-recall] = 0.9660), outperforming other compared methods. Moreover, case studies further demonstrated the effectiveness of VGAETF in identifying potential disease-related synergistic drug combinations.

This paper aims to provide a practical, summarized, and clear guide of steps to carry out a systematic review and is aimed at researchers in the field of Health Sciences. The review process runs from the initial questioning to the final report, providing useful information on tools available at each stage. Systematic review and meta-analysis are currently the evidence synthesis tools of the highest level of scientific quality. They are in themselves a secondary research methodology, whose objective is to locate, evaluate, and synthesize the best evidence by selecting original papers or quality primary publications. The procedure to achieve the objective is presented as a sequential and systematized process, in stages, following the transparency principle, so as to ensure its replicability.

Abstract Background Recently, much attention has been given to e-learning in higher education as it provides better access to learning resources online, utilising technology – regardless of learners’ geographical locations and timescale – to enhance learning. It has now become part of the mainstream in education in the health sciences, including medical, dental, public health, nursing, and other allied health professionals. Despite growing evidence claiming that e-learning is as effective as traditional means of learning, there is very limited evidence available about what works, and when and how e-learning enhances teaching and learning. This systematic review aimed to identify and synthesise the factors – enablers and barriers – affecting e-learning in health sciences education (el-HSE) that have been reported in the medical literature. Methods A systemic review of articles published on e-learning in health sciences education (el-HSE) was performed in MEDLINE, EMBASE, Allied & Complementary Medicine, DH-DATA, PsycINFO, CINAHL, and Global Health, from 1980 through 2019, using ‘Textword’ and ‘Thesaurus’ search terms. All original articles fulfilling the following criteria were included: (1) e-learning was implemented in health sciences education, and (2) the investigation of the factors – enablers and barriers – about el-HSE related to learning performance or outcomes. Following the PRISMA guidelines, both relevant published and unpublished papers were searched. Data were extracted and quality appraised using QualSyst tools, and synthesised performing thematic analysis. Results Out of 985 records identified, a total of 162 citations were screened, of which 57 were found to be of relevance to this study. The primary evidence base comprises 24 papers, with two broad categories identified, enablers and barriers, under eight separate themes: facilitate learning; learning in practice; systematic approach to learning; integration of e-learning into curricula; poor motivation and expectation; resource-intensive; not suitable for all disciplines or contents, and lack of IT skills. Conclusions This study has identified the factors which impact on e-learning: interaction and collaboration between learners and facilitators; considering learners’ motivation and expectations; utilising user-friendly technology; and putting learners at the centre of pedagogy. There is significant scope for better understanding of the issues related to enablers and facilitators associated with e-learning, and developing appropriate policies and initiatives to establish when, how and where they fit best, creating a broader framework for making e-learning effective.

To develop diagnostic imaging approaches, this paper emphasizes the transformational potential of merging geophysics with health sciences. Diagnostic imaging technology improvements have transformed the health sciences by enabling earlier and more precise disease identification, individualized therapy, and improved patient care. This review article examines the connection between geophysics and diagnostic imaging in the field of health sciences. Geophysics, which is typically used to explore Earth’s subsurface, has provided new uses of its methodology in the medical field, providing innovative solutions to pressing medical problems. The article examines the different geophysical techniques like electrical imaging, seismic imaging, and geophysics and their corresponding imaging techniques used in health sciences like tomography, magnetic resonance imaging, ultrasound imaging, etc. The examination includes the description, similarities, differences, and challenges associated with these techniques and how modified geophysical techniques can be used in imaging methods in health sciences. Examining the progression of each method from geophysics to medical imaging and its contributions to illness diagnosis, treatment planning, and monitoring are highlighted. Also, the utilization of geophysical data analysis techniques like signal processing and inversion techniques in image processing in health sciences has been briefly explained, along with different mathematical and computational tools in geophysics and how they can be implemented for image processing in health sciences. The key findings include the development of machine learning and artificial intelligence in geophysics-driven medical imaging, demonstrating the revolutionary effects of data-driven methods on precision, speed, and predictive modeling.

Summary: Measurable levels of immunoglobulin G antibodies develop after infections with and vaccinations against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). These antibody levels are dynamic: due to waning, antibody levels will drop over time. During the COVID-19 pandemic, multiple models predicting infection dynamics were used by policymakers to support the planning of public health policies. Explicitly integrating antibody and waning effects into the models is crucial for reliable calculations of individual infection risk. However, only few approaches have been suggested that explicitly treat these effects. This paper presents a methodology that explicitly models antibody levels and the resulting protection against infection for individuals within an agent-based model. The model was developed in response to the complexity of different immunization sequences and types and is based on neutralization titer studies. This approach allows complex population studies with explicit antibody and waning effects. We demonstrate the usefulness of our model in two use cases.

Summary: We propose a two-stage deep residual attention generative adversarial network (TSDRA-GAN) for inpainting iris textures obscured by eyelids. This two-stage generation approach ensures that the semantic and texture information of the generated images is preserved. In the second stage of the fine network, a modified residual block (MRB) is used to further extract features and mitigate the performance degradation caused by the deepening of the network, thus following the concept of using a residual structure as a component of the encoder. In addition, for the skip connection part of this phase, we propose a dual-attention computing connection (DACC) to computationally fuse the features of the encoder and decoder in both directions to achieve more effective information fusion for iris inpainting tasks. Under completely fair and equal experimental conditions, it is shown that the method presented in this paper can effectively restore original iris images and improve recognition accuracy.

Dear editor, Scientific evidence is provided using different resources and during a regulated cycle. Various variables could influence the cycle. Of these the role of peer reviewer is very important. They could be influential in the growth and development of biomedical journals and pave the way for investigators and authors of scientific papers. It is recommended that specialized training be held to improve the review skills. A detailed understanding of the motivation of reviewers also is recommended.

Summary: Chronic rhinosinusitis (CRS) is characterized by poor prognosis and propensity for recurrence even after surgery. Identification of those CRS patients with high risk of relapse preoperatively will contribute to personalized treatment recommendations. In this paper, we proposed a multi-task deep learning network for sinus segmentation and CRS recurrence prediction simultaneously to develop and validate a deep learning radiomics-based nomogram for preoperatively predicting recurrence in CRS patients who needed surgical treatment. 265 paranasal sinuses computed tomography (CT) images of CRS from two independent medical centers were analyzed to build and test models. The sinus segmentation model achieved good segmentation results. Furthermore, the nomogram combining a deep learning signature and clinical factors also showed excellent recurrence prediction ability for CRS. Our study not only facilitates a technique for sinus segmentation but also provides a noninvasive method for preoperatively predicting recurrence in patients with CRS.

Summary: Microplastics and nanoplastics (M-NPLs) are ubiquitous environmentally, chemically, or mechanically degraded plastic particles. Humans are exposed to M-NPLs of various sizes and types through inhalation of contaminated air, ingestion of contaminated water and food, and other routes. It is estimated that Americans ingest tens of thousands to millions of M-NPLs particles yearly, depending on socioeconomic status, age, and gender. M-NPLs have spurred interest in toxicology because of their abundance, ubiquitous nature, and ability to penetrate bodily and cellular barriers, producing toxicological effects in cells, tissues, organs, and organ systems. The present review paper highlights: (1) The current knowledge in understanding the detrimental effects of M-NPLs in mouse models and human cell lines, (2) cellular organelle localization of M-NPLs, and the underlying uptake mechanisms focusing on endocytosis, (3) the possible pathways involved in M-NPLs toxicity, particularly reactive oxygen species, nuclear factor-erythroid factor 2-related factor 2 (NRF2), Wnt/β-Catenin, Nuclear Factor Kappa B (NF-kB)-regulated inflammation, apoptosis, and autophagy signaling. We also highlight the potential role of M-NPLs in increasing the incubation time, spread, and transport of the COVID-19 virus. Finally, we discuss the future prospects in this field.

Despite the empirical evidence that cervical cancer screening has been a successful public health initiative to secondarily prevent the incidence and mortality from cervical cancer in developed nations, majority of women of sub-Saharan root, Nigeria inclusive, do not utilize this essential health service. This study/article contributes to the empirical literature on the drivers of cervical cancer screening utilization within Nigeria context. The paper investigates the determinants of cervical cancer screening utilization among both working class women and women involved in trading activities in Oyo state, Nigeria. The statistical estimations find strong support for attitudinal correlates, perceived seriousness and family history as drivers of utilization of cervical cancer screening. While only 13.5% of respondents reported to have ever utilized the screening test, majority had positive attitude towards the screening. The screening uptake among the women could improve, if necessary barriers are addressed. The paper highlights policy recommendations for enhancing organized screening guidelines in a developing country.

Drug component interactions are most likely to trigger unexpected pharmacological effects with unknown causal mechanisms, hence, demanding the discovery of patterns to establish suitable and effective regimens. This paper proposes a novel framework that embeds machine learning (ML) and multidimensional scaling (MDS) techniques, for efficient prediction of patient response to antiretroviral therapy (ART). To achieve this, experiment databases were created from two independent sources: a publicly available HIV domain datasets of patients with failed treatment – hosted by the Stanford University, hereinafter referred to as the Stanford HIV database, and locally sourced datasets gathered from 13 prominent healthcare facilities treating HIV patients in Akwa Ibom State of Nigeria, hereinafter referred to as the Akwa-Ibom HIV database: with 5,780 and 3,168 individual treatment change episodes (TCEs) of HIV treatment indicators (baseline CD4 count (BCD4), followup CD4 count (FCD4), baseline viral load (BRNA), followup viral load (FRNA), and drug type combination (DType)), observed from 1,521 and 1,301 unique patient records, respectively. A hybridised (two-stage) classification system consuming the Interval Type-2 Fuzzy Logic (IT2FL) and Deep Neural Network (DNN) was employed to model and optimise patients’ response to ART with appreciable error pruning achieved through MDS. Visualisation of the experiment databases showed remarkable immunological changes in the Akwa-Ibom HIV database, as the FCD4 of TCEs clustered far above the BCD4, compared to the Stanford HIV database, where over 40% of FCD4 clustered below the BCD4. Similar changes were noticed for the RNA, as more FRNA copies clustered below the BRNA for the Akwa-Ibom datasets, compared to the Stamford datasets. DNN classification results for both databases showed best performance metrics for the Levenberg-Marquardt algorithm when compared with the resilient backpropagation algorithm, with improved drug pattern predictions for experiment with MDS. This paper is most likely to evolve an avenue that triggers interesting combination(s) for optimum patient response, while ensuring minimal side effects, as further findings revealed the superiority of the proposed approach over existing approaches.

This study discusses the Brazilian model of incentives for the domestic development and production of supplies for public health, considering initiatives implemented from 2003 to 2016. This paper was prepared based on a qualitative bibliographic study, considering authors in the fields of health sciences, public health and public policy, reports by the World Health Organization (WHO), the Organization for Economic Cooperation and Development (OECD), Inter-American Development Bank (IDB) and the World Trade Organization (WTO), and official documents available from the Brazilian Federal Government. The paper focuses on the social dimension of health, considering a specific time period in the literature, from 2003 to 2016 and, finally, the new Regulatory Framework for Science, Technology, and Innovation approved in 2016. Various government initiatives were identified in the field of technological development and production to meet the objectives of the SUS according to the literature analysis. Brazil has been substantially increasing investment in Research and Development (R&D) during the last decade, though it lags European and OECD counterparts. Brazilian investment in R&D increased from 1.01% of gross domestic product (GDP) in 2000 to 1.23% in 2012. Despite being the top performer in Latin America (representing 60% of total R&D investment in the region), investment in R&D in Brazil is approximately half the level of European and OECD countries, which invest on average approximately 2% and 2.5% of GDP.

This study discusses the Brazilian model of incentives for the domestic development and production of supplies for public health, considering initiatives implemented from 2003 to 2016. This paper was prepared based on a qualitative bibliographic study, considering authors in the fields of health sciences, public health and public policy, reports by the World Health Organization (WHO), the Organization for Economic Cooperation and Development (OECD), Inter-American Development Bank (IDB) and the World Trade Organization (WTO), and official documents available from the Brazilian Federal Government. The paper focuses on the social dimension of health, considering a specific time period in the literature, from 2003 to 2016 and, finally, the new Regulatory Framework for Science, Technology, and Innovation approved in 2016. Various government initiatives were identified in the field of technological development and production to meet the objectives of the SUS according to the literature analysis. Brazil has been substantially increasing investment in Research and Development (R&D) during the last decade, though it lags European and OECD counterparts. Brazilian investment in R&D increased from 1.01% of gross domestic product (GDP) in 2000 to 1.23% in 2012. Despite being the top performer in Latin America (representing 60% of total R&D investment in the region), investment in R&D in Brazil is approximately half the level of European and OECD countries, which invest on average approximately 2% and 2.5% of GDP.

Background 1-Chloro-2,3-epoxypropane, known as epichlorohydrin (ECH), is a colorless liquid used in the production of epoxy resins, synthetic glycerine, elastomers, glycidyl ethers, surfactants, polyamide-epichlorohydrin resins and others. Epichlorohydrin may cause cancer. The aim of this study was to develop a new method for determining concentrations of ECH in workplace air in the range of 1/10–2 values of the maximum admissible concentration (MAC). Material and Methods The paper presents a method for the determination of ECH in workplace air using a gas chromatograph coupled with a mass spectrometer (GC-MS). The developed method is based on the adsorption of ECH on an activated charcoal, extraction with acetone, and a chromatographic analysis of the resulting solution. Results The method developed makes it possible to determine ECH in the concentration range of 0.1–2 mg/m 3 , i.e., 1/10–2 values of MAC established in Poland. The limit of detection (LOD) is 0.24 μg/m 3 and the limit of quantification (LOQ) is 0.71 μg/m 3 . Conclusions The method is characterized by good precision and accuracy; it meets the requirements of the European standard PN-EN 482, and can be used by occupational hygiene laboratories to measure concentrations of ECH in workplace air, with a view to assessing workers’ exposure to this substance. Med Pr. 2020;71(6):715–23

In September 2016, Queen’s University launched the first, fully online, 4-year Bachelor of Health Science degree program in Canada. This paper reports on the developmental structure, implementation philosophy, and challenges in the development of this competency-based program. All stakeholders directly involved in program development were invited to participate in this qualitative case study. Thirty-five interviews and three focus groups (n=14) were conducted. Interviews and focus groups were transcribed verbatim and data were analyzed using thematic design. Themes included: program vision; desired program outcomes; administrative processes for funding and recruitment; uniqueness of the program; local, regional and international impact of the program; communication and collaborations for program development; and uncertainty in long term outcomes. Findings suggest that during program development, an explicit vision of program goals encouraged buy-in at most levels of the university. There was consensus that the overarching outcome should be to provide a rigorous, high quality program with pathways to professional, basic science, global health and advocacy-based health professions. The online modality was expected to improve accessibility to degree programs, as well as address diverse student learning needs. Innovation played a vital role in the program’s development and was founded in educational theory and curriculum development practices. En septembre 2016, l’Université Queen’s a lancé le premier programme de 4 ans menant à un diplôme, le baccalauréat en sciences de la santé, entièrement en ligne. Cet article présente un rapport sur la structure du développement, la philosophie de mise en oeuvre et les défis qui se sont présentés lors du développement de ce programme basé sur la compétence. Toutes les parties prenantes qui avaient été directement impliquées dans le développement de ce programme ont été invitées à participer à cette étude de cas qualitative. Trente-cinq entrevues ont été menées et trois groupes de discussion (n=14) ont été organisés. Ce qui a été dit pendant les entrevues et les groupes de discussion a été transcrit verbatim et les données ont été analysées en utilisant la conception thématique. Les thèmes étaient les suivants : vision du programme, résultats désirés du programme, processus administratifs pour le financement et le recrutement, aspect unique du programme, impacts local, régional et international du programme, communications et collaborations pour le développement du programme, incertitudes concernant les résultats à long terme. Les résultats suggèrent qu’au cours de la phase de développement du programme, une vision explicite des objectifs du programme avait encouragé l’acceptation à tous les niveaux de l’université. Tout le monde était d’accord sur le fait que le résultat global devait être de fournir un programme rigoureux de haute qualité qui mènerait vers les professions de sciences de base, les professions de santé globale et les professions de santé basées sur la défense des intérêts. La modalité en ligne devait améliorer l’accessibilité à des programmes menant à un diplôme et devait également répondre à divers besoins d’apprentissage des étudiants et des étudiantes. L’innovation a joué un rôle primordial dans le développement du programme, elle était fondée sur la théorie de l’éducation et sur les pratiques de développement de programmes d’études.

Resumen En este artículo se plantea una reflexión sobre el acto de interpretar en la vida de los humanos y su papel en el ámbito de la investigación científica como actividad generadora de versiones orientadas por las teorías expertas. Se mencionan algunos de los cuestionamientos planteados a la perspectiva científica occidental moderna y las nuevas perspectivas epistemológicas que se abren desde las corrientes más críticas de la investigación cualitativa, en las cuales se reconoce la trascendencia del compromiso interpretativo del investigador al construir sus versiones sobre la realidad que estudia. Se presentan algunos ejemplos de los problemas que surgen en la investigación que tiene lugar en el campo de las ciencias de la salud, y para concluir, se ofrecen algunos apuntes sobre el ineludible compromiso del investigador en su condición de intérprete, con sus múltiples consecuencias sobre la construcción del conocimiento. Abstract This paper reflects on the human act of interpreting and its role in scientific research as an activity that generates theoretically oriented versions. It mentions some of the questioning directed toward the modern Western scientific views as well as the new epistemological perspectives that have been rising from the more critical trends of qualitative research. These acknowledge the transcendence of the researchers' interpretive commitment as they build their versions of the reality that they are studying. Likewise, the paper presents some instances of the problems that arise when conducting research in the field of health sciences. To conclude, some notes on the inescapable commitment of the researcher in his capacity of interpreter, and its multiple consequences on the construction of knowledge.

Summary: Volatolomics is gaining consideration as a viable approach to diagnose several diseases, and it also shows promising results to discriminate COVID-19 patients via breath analysis. This paper extends the study of the relationship between volatile compounds (VOCs) and COVID-19 to blood serum. Blood samples were collected from subjects recruited at the emergency department of a large public hospital. The VOCs were analyzed with a gas chromatography mass spectrometer (GC/MS). GC/MS data show that in more than 100 different VOCs, the pattern of abundances of 17 compounds identifies COVID-19 from non-COVID with an accuracy of 89% (sensitivity 94% and specificity 83%). GC/MS analysis was complemented by an array of gas sensors whose data achieved an accuracy of 89% (sensitivity 94% and specificity 80%).

The purpose of this study was to explore the impact of the COVID-19 pandemic on the academic productivity of health sciences faculty members in one graduate school in the United States. Thirty-two faculty members completed an electronic survey comparing academic productivity in the year prior to the pandemic to a year during the pandemic. In total, 90.7% of respondents agreed or strongly agreed that time dedicated to teaching increased, and 81.2% agreed or strongly agreed that they prioritized teaching over research during the pandemic. Participants presented an average of 2.72 peer-reviewed papers at an academic conference the year before and 1.47 during the pandemic, with females more adversely affected than males. Journal submissions with survey participants as the first or last authors decreased during the pandemic. Twelve faculty members including genetic counseling, nursing, occupational therapy, physical therapy, and speech and language pathology participated in one-to-one interviews. Three themes emerged from qualitative data analysis: stressed systems, balancing act, and meaningful connection. Faculty members were faced with an external locus of control during the pandemic and noted a lack of autonomy and pressure to help students graduate on time and maintain the quality of teaching while dealing with uncertainty in both their professional and personal lives. The pandemic disproportionately impacted women and junior faculty members as connectedness and mentorship declined. Collaboration and research mentorship must be prioritized moving forward to continue to advance healthcare and health sciences education.

Globally, cancer is likely to be ranked as the leading cause of death among non-communicable diseases in the 21st century. In Ghana, estimates suggest that the disease is expected to increase continuously. The best way to address the increasing burden is through a comprehensive cancer control program. This paper presents an appraisal of the literature, reports and, studies that seek to highlight strategies for cancer control globally and in Ghana. In consideration of literature, a search of relevant databases (PubMed, Google Scholar, Cochrane Database of Systematic Reviews, Google, International organizations web pages, International reports, Ministry of Health of Ghana reports, and textbooks) was performed. A narrative review of the background information on this subject is provided to inform future research on cancer control. This review was conducted as part of a study to involve community pharmacists in cancer detection and prevention in Ghana.

Decision making is an inherent, complex and vital component of the work of managers. Its importance and role in operationalizing the activities of an organisation are well-evidenced in management literature. Yet, there is a dearth of literature about the processes used by nurse managers to make decisions. The principal aim of this paper is to identify the different types of decisions made by nurse managers and explore the related decision-making processes. A ‘dependency model’ is proposed, which illustrates the factors affecting the art of decision making. Structured interviews were conducted to identify types of decisions made by nurse managers in different health-care settings and the factors underpinning these decisions. The research focused on an intensive study of a small group of nurse managers working in rural and regional health institutions in South Australia. The sample included nurse unit managers, after-hours coordinators and directors of nursing. Hermeneutic principles and interpretive research were used to conduct interviews with nurse managers who make numerous and varied types of decisions, though often without following a step-by-step approach. The study identified dependency factors that influence how decisions are made, and developed a model based on eight key variables: (1) the situation to be addressed; (2) the time period in which the decision has to be made; (3) required inputs from colleagues; (4) complexity of the task and the environment, (5) the duration and time it takes to make a decision, (6) availability of resources, (7) the decision-making environment, and (8) personal characteristics. These eight variables are interrelated and have both direct and indirect impacts on how decisions are made. Nurse managers make pragmatic decisions reflecting the complexity of their roles and responsibilities. Awareness of the factors on which decisions depend helps understanding of how they navigate through decision-making processes. The findings are presented as a model that can be used to support decision making by nurse managers in various health settings.

Vectorial capacity (VC), as a concept that describes the potential of a vector to transmit a pathogen, has had historical problems related to lacks in dimensional significance and high error propagation from parameters that take part in the model to output. Hence, values estimated with those equations are not sufficiently reliable to consider in control strategies or vector population study. In this paper, we propose a new VC model consistent at dimensional level, i.e., the definition and the equation of VC have same and consistent units, with a parameter estimation method and mathematical structure that reduces the uncertainty in model output, using as a case of study an Aedes aegypti population of the municipality of Bello, Colombia. After a literature review, we selected one VC equation following biological, measurability and dimensional criteria, then we rendered a local and global sensitivity analysis, identifying the mortality rate of mosquitoes as a target component of the equation. Thus, we studied the Weibull and Exponential distributions as probabilistic models that represent the expectation of mosquitoes infective life, intending to include the best distribution in a selected VC structure. The proposed mortality rate estimation method includes a new parameter that represents an increase or decrease in vector mortality, as it may apply. We noticed that its estimation reduces the uncertainty associated with the expectation of mosquitoes' infective life expression, which also reduces the output range and variance in almost a half.

Teaching and learning of human anatomy involves cadavers, bones, histology slides, plastinated body parts, anatomy models, visualizing pictures, drawing and memorizing many new Latin terminologies. It is very challenging for faculty members to teach and difficult to learn for any year one student doing medical or health science courses. This paper provides an insight into the use of a blended learning pedagogy using Computer Based Teaching [CBT] along with other tools to create e-Learning materials for teaching and learning of human Anatomy with better learning outcomes. We focus on four CBTs developed in-house for blended learning by the biological sciences department, namely HistoBox, BoneBox, Heart & Coronary Artery Disease [CAD] and Neuro atlas for Anatomy and Physiology. The survey result on students learning using CBTs showed significant improvements in their learning behavior and assessment grades. The students preferred blended e-Learning using HistoBox compared with traditional lecture and practical using microscopy, p

Objective – To assess the sensitivity and precision of various search strategies for retrieving adverse effects studies from the MEDLINE and EMBASE databases. Design – Analytical survey. Subjects – A case study using a recently published systematic review of the effectiveness and adverse effects of seven new anti-epileptic drugs. Setting – MEDLINE and EMBASE searches performed by researchers at the Centre for Reviews and Dissemination and the UK Cochrane Centre Search Filters Design Group at the University of York, UK. Methods – Five key approaches to searching were defined. The first approach used either text words or controlled vocabulary to search for specific adverse effects. The second used subheadings or qualifiers either attached to drug names found in the controlled vocabulary (approach 2a) or ‘floating’ without drug names (approach 2b). The third approach used text words as synonyms for the phrase ‘adverse effects.’ The fourth used controlled indexing terms for adverse effects. The fifth and final approach used two published search strategies incorporating study design (Badgett et al., Loke et al.). These five approaches were used to search for studies of the adverse effects of seven new anti‐epileptic drugs. 5,011 unique papers were retrieved. Of these, 236 were judged potentially relevant and 225 full text articles were obtained. The inclusion criteria from a previously published systematic review (Wilby et al.) were applied to the papers, and 79 met the criteria. Five papers were added to the set after being identified from reference lists, clinical experts, and other sources. This new set of 84 studies was used as a quasi gold standard (QGS) against which more than 300 combinations of the five approaches could be tested. To create the set of possible approaches, the researchers combined search strategies one through four in all possible ways, and used all available subheading combinations from 2a and 2b. The Badgett and Loke searches were tested separately. Main Results – Sensitivity and precision were determined for each combination. Formulas used to calculate sensitivity and precision were provided. In MEDLINE, search strategies using floating subheadings achieved the highest sensitivity. The most useful single subheading in both MEDLINE and EMBASE was “adverse effects,” with 79.1% and 79.5% sensitivity respectively. Of the more than 300 combinations tested, the most sensitive combination in MEDLINE included specified adverse effects in combination with the floating subheadings “adverse effects,” “complications,” and “drug effects,” together with text words for adverse effects. This strategy had 97.0% sensitivity, but low precision at 2.8%. The highest precision was achieved by using subheadings attached to drug indexing terms. In EMBASE, the strategy of Loke et al. provided the highest sensitivity at 86.3% and precision of 2.0%. Since researchers are not likely to know in advance all of the reported adverse effects of a particular drug therapy, the most sensitive strategies without specific adverse events were also identified. The search with the highest sensitivity in MEDLINE had 95.5% sensitivity, and 97.3% sensitivity in EMBASE. Conclusion – Searching for adverse effects requires a combination of approaches in both MEDLINE and EMBASE. In MEDLINE, the most sensitive combination yielded 97.0% sensitivity. Regardless of the approach used, precision remains low. An effective generic search filter for adverse effects searches may not yet be feasible. More research is needed on search strategies, as well as more consistent methods of reporting and indexing adverse effects.

The data available in the average clinical study of a disease is very often small. This is one of the main obstacles in the application of neural networks to the classification of biological signals used for diagnosing diseases. A rule of thumb states that the number of parameters (weights) that can be used for training a neural network should be around 15% of the available data, to avoid overlearning. This condition puts a limit on the dimension of the input space. Different authors have used different approaches to solve this problem, like eliminating redundancy in the data, preprocessing the data to find centers for the radial basis functions, or extracting a small number of features that were used as inputs. It is clear that the classification would be better the more features we could feed into the network. The approach utilized in this paper is incrementing the number of training elements with randomly expanding training sets. This way the number of original signals does not constraint the dimension of the input set in the radial basis network. Then we train the network using the method that minimizes the error function using the gradient descent algorithm and the method that uses the particle swarm optimization technique. A comparison between the two methods showed that for the same number of iterations on both methods, the particle swarm optimization was faster, it was learning to recognize only the sick people. On the other hand, the gradient method was not as good in general better at identifying those people.

Introduction: The necessity of closed and continuous relationships, team work and collaboration between various health professions in treatment and care have confronted health ethics with many challenges. Inter-professional education has been proposed as an effective strategy to address this gap internationally. This study has been done to determine process of ethical growth and achieving ethical competency in health sciences students during inter-professional education. Methods: This interpretive- integrative literature review study has been done in 2013 with integrative search in Pub med, CINHAL, Ovid, Science Direct data bases as well as Google scholar using key words including inter-professional education and ethics. All English language papers published between 2000 and 2013 were included. Of 155 retrieved articles, 15 documents were appropriate based on critical appraisal criteria and analyzed according to thematic synthesis method.. Then extracted text were entered and managed by MAXQDA software. Results: Promotion of professional socialization process of health sciences students”, “creating a common values system” and “forming inter-professional identity” were the three main themes emerge indicating process of ethical growth in health sciences students during inter-professional education. The themes were explained by theories such as social contact, human development, transformational learning situated learning, constructivist learning and social cognitive They are the conceptual framework in inter-professional education model. Conclusion: Inter-professional education with promotion of professional socialization process of health sciences' students, renewing and internalization of inter-professional common values and forming inter-professional identity, as complement of professional identity , empowers and enables students for effective collaboration with others. These facilitates ethical and safe performance of the graduates in clinical environments.

Measuring gender inequality and women’s empowerment is essential to understand the determinants of gender gaps, evaluate policies and monitor countries’ progress. With this aim, over the past two decades, research has mainly been directed towards the development of composite indices. The purpose of this paper is to introduce a new and interdisciplinary perspective to the current debate on measuring gender inequality in human development. As a starting point, we develop a simple macroeconomic model of the interdependence between human development and gender inequality. We then introduce a biometric indicator, based on the ratio of female to male body mass index, to measure women’s empowerment at the country level. Finally, by using the latest available data, we examine the ability of this biometric indicator to capture countries’ performance in achieving gender equality. We obtain five main results: 1) we provide a theoretical framework to explain the joint determination of human development and gender inequality; 2) we show how to use this framework to simulate the impact of exogenous shocks or policy changes; 3) we demonstrate that exogenous changes have a direct and a multiplier effect on human development and gender inequality; 4) we find that the distribution of obesity between the female and male populations represents a useful proxy variable for measuring gender equality at the country level; 5) finally, we use these results to integrate and develop existing knowledge on the ‘ecological’ approach to the overweight and obesity pandemic.

Objectives: Transradial access for percutaneous coronary intervention (PCI) reduces procedural complications however, there are concerns regarding the potential for increased exposure to ionizing radiation to the primary operator. We evaluated the efficacy of a lead-attenuator in reducing radiation exposure during transradial PCI. Methods and results: This was a non-randomized, prospective, observational study in which 52 consecutive patients were assigned to either standard operator protection (n = 26) or the addition of the lead attenuator across their abdomen/pelvis (n = 26). In the attenuator group patients were relatively older with a higher prevalence of peripheral vascular disease (67.9 vs 58.7 p = 0.0292 and 12% vs 7.6% p < 0.001 respectively). Despite similar average fluoroscopy times (12.3 ± 9.8 min vs. 9.3 ± 5.4 min, p = 0.175) and average examination doses (111866 ± 80790 vs. 91,268 ± 47916 Gycm2, p = 0.2688), the total radiation exposure to the operator, at the thyroid level, was significantly lower when the lead-attenuator was utilized (20.2% p < 0.0001) as compared to the control group. Amongst the 26 patients assigned to the lead-attenuator, there was a significant reduction in measured radiation of 94.5% (p < 0.0001), above as compared to underneath the lead attenuator. Conclusions: Additional protection with the use of a lead rectangle-attenuator significantly lowered radiation exposure to the primary operator, which may confer long-term benefits in reducing radiation-induced injury. Advances in knowledge: This is the first paper to show that a simple lead attenuator almost completely reduced the scattered radiation at very close proximity to the patient and should be considered as part of the standard equipment within catheterization laboratories.

Abstract Objective – To identify estimates of time taken to search grey literature in support of health sciences systematic reviews and to identify searcher or systematic review characteristics that may impact resource selection or time spent searching. Methods – A survey was electronically distributed to searchers embarking on a new systematic review. Characteristics of the searcher and systematic review were collected along with time spent searching and what resources were searched. Time and resources were tabulated and resources were categorized as grey or non-grey. Data was analyzed using Kruskal-Wallis tests. Results – Out of 81 original respondents, 21% followed through with completion of the surveys in their entirety. The median time spent searching all resources was 471 minutes, and of those a median of 85 minutes were spent searching grey literature. The median number of resources used in a systematic review search was four and the median number of grey literature sources searched was two. The amount of time spent searching was influenced by whether the systematic review was grant funded. Additionally, the number of resources searched was impacted by institution type and whether systematic review training was received. Conclusions – This study characterized the amount of time for conducting systematic review searches including searching the grey literature, in addition to the number and types of resources used. This may aid searchers in planning their time, along with providing benchmark information for future studies. This paper contributes by quantifying current grey literature search patterns and associating them with searcher and review characteristics. Further discussion and research into the search approach for grey literature in support of systematic reviews is encouraged.

El objetivo de este artículo es presentar el estado del Sistema Nacional de Investigación en Salud de Perú (SNIS), las lecciones aprendidas en el proceso de construcción, las oportunidades de mejora y los retos. Se hace una descripción de las funciones del SNIS peruano, con relación a la gobernanza, el marco legal, la priorización de la investigación, el financiamiento, la creación y la sostenibilidad de recursos y la producción y utilización de la investigación. Se describe que en Perú se ejerce la gobernanza en la investigación, se cuenta con regulaciones, política y prioridades de investigación, estas últimas desarrolladas en el marco de un proceso participativo e inclusivo. Se concluye que los retos del SNIS peruano son consolidar la gobernanza y desarrollar los mecanismos para articular a los actores involucrados con la investigación, incrementar la asignación de recursos para la investigación e innovación, elaborar e implementar un plan para el desarrollo de recursos humanos dedicados a la investigación, desarrollar las instituciones y competencias regionales para hacer investigación, ligar la investigación para solucionar problemas y hacer sostenibles las políticas nacionales de investigación.The objective of this paper is to present the situational status of the National Health Research System of Peru (NHRS), the lessons learnt during the building process, the opportunities to improve it and the challenges. A description of the functions of the peruvian NHRS is done, in relation to governance, legal framework, research priorities, funding, creation and sustainability of resources and research production and utilization. It describes that in Peru we excert governance in research, we count with regulations, policy and research priorities, these last developed in the framework of a partipatory, inclusive process. The conclusion reached is that the challenges of the peruvian NHRS are to consolidate the governance and to develop the mechanisms to articulate the stakeholders involved in research, to improve the resources allocation for research and innovation, to ellaborate a plan for the development of human resources dedicated to research, to develop institutions and regional competences in order to perform research, and to link research in order to solve problems and make national research policies sustainable.

Brazilian scientific output exhibited a 4-fold increase in the last two decades because of the stability of the investment in research and development activities and of changes in the policies of the main funding agencies. Most of this production is concentrated in public universities and research institutes located in the richest part of the country. Among all areas of knowledge, the most productive are Health and Biological Sciences. During the 1998-2002 period these areas presented heterogeneous growth ranging from 4.5% (Pharmacology) to 191% (Psychiatry), with a median growth rate of 47.2%. In order to identify and rank the 20 most prolific institutions in these areas, searches were made in three databases (DataCAPES, ISI and MEDLINE) which permitted the identification of 109,507 original articles produced by the 592 Graduate Programs in Health and Biological Sciences offered by 118 public universities and research institutes. The 20 most productive centers, ranked according to the total number of ISI-indexed articles published during the 1998-2003 period, produced 78.7% of the papers in these areas and are strongly concentrated in the Southern part of the country, mainly in São Paulo State.

Abstract Objective – To identify estimates of time taken to search grey literature in support of health sciences systematic reviews and to identify searcher or systematic review characteristics that may impact resource selection or time spent searching. Methods – A survey was electronically distributed to searchers embarking on a new systematic review. Characteristics of the searcher and systematic review were collected along with time spent searching and what resources were searched. Time and resources were tabulated and resources were categorized as grey or non-grey. Data was analyzed using Kruskal-Wallis tests. Results – Out of 81 original respondents, 21% followed through with completion of the surveys in their entirety. The median time spent searching all resources was 471 minutes, and of those a median of 85 minutes were spent searching grey literature. The median number of resources used in a systematic review search was four and the median number of grey literature sources searched was two. The amount of time spent searching was influenced by whether the systematic review was grant funded. Additionally, the number of resources searched was impacted by institution type and whether systematic review training was received. Conclusions – This study characterized the amount of time for conducting systematic review searches including searching the grey literature, in addition to the number and types of resources used. This may aid searchers in planning their time, along with providing benchmark information for future studies. This paper contributes by quantifying current grey literature search patterns and associating them with searcher and review characteristics. Further discussion and research into the search approach for grey literature in support of systematic reviews is encouraged.

Internet social network (social media) is a powerful communication tool, and its use is expanding significantly. This paper seeks to know the current state of visibility in online social networks of active citizen talking about patient safety. This is an observational cross-sectional study whose target population is the websites Facebook, Twitter and Tuenti in Spain. By three consecutive cuts social profiles were found using the searching terms “seguridad+paciente” and “safety+patient”. There were found 5 profiles on Facebook that met the search criteria, 6 on Twitter and none were found on Tuenti. It is concluded that although there is evidence of the rise of social networking, citizen network involved in patient safety appears not to be significantly represented within the social networks examined.

Se aborda la necesidad de establecer normas y patrones de calidad en los procesos docentes que se encargan de la formación integral de los recursos humanos en Salud en un mundo donde la cooperación nacional e internacional requiere el desarrollo cualitativo en la formación y superación de los profesionales que demanda la sociedad en la búsqueda de la excelencia académica, la justicia social y adecuados niveles de atención integral de la salud de la población. Se describen las particularidades de la Evaluación y Acreditación de las Instituciones de la Educación Superior y sus Carreras, la experiencia cubana en este tema, en general, y la del Instituto Superior de Ciencias Médicas de La Habana, en particular.In this paper is analyzed the necessity of the establishment of quality norms and patterns in the teaching process in charge of the integral formation of Health Human Resources in the present world in which the nacional and international cooperation needs a cualitative devepelopment in the formation and overcoming of the professionals that demands the society searching the academic excellence, social justice and suitables levels of population health integral attention. The peculiarities of the Evaluation and Acreditation of the Institutions and Careers of the Higher Education, the cuban experience in this matter in general and Havana Higher Institute of Medical Sciences experience in particular are described.

This paper presents the results of a Participatory Action Research on the design, implementation and ongoing use of a student professional portfolio at the University of Ottawa’s Occupational Therapy Program. The goal was to create an adult education tool that would allow students to develop and integrate all components of learning and professional growth. Feedback from the research team and 70 students with a one-year experience in using the portfolio indicates that the tool is relevant and useful, but special attention must be given to developing a greater sense of ownership on the students’ part. Avenues for reflection are offered.