Factors related to Japanese internal medicine doctors' retention or migration to rural areas: a nationwide retrospective cohort study

BACKGROUND@#Internal medicine (IM) doctors in Japan play the role of primary care physicians; however, the shortage of rural physicians continues. This study aims to elucidate the association of age, sex, board certification, type of work, and main clinical work with the retention or migration of IM doctors to rural areas.@*METHODS@#This retrospective cohort study included 82,363 IM doctors in 2010, extracted from the national census data of medical doctors. The explanatory variables were age, sex, type of work, primary clinical work, and changes in board certification status. The outcome was retention or migration to rural areas. The first tertile of population density (PD) of municipalities defined as rural area. After stratifying the baseline ruralities as rural or non-rural areas, the odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. The analyses were also performed after age stratification (<39, 40-59, ≥60 years old).@*RESULTS@#Among the rural areas, women had a significantly higher OR for retention, but obtaining board certification of IM subspecialties had a significantly lower OR. Among the non-rural areas, physicians who answered that their main work was IM without specific subspecialty and general had a significantly higher OR, but obtaining and maintaining board certification for IM subspecialties had a significantly lower OR for migration to rural areas. After age stratification, the higher OR of women for rural retention was significant only among those aged 40-59 years. Those aged under 40 and 40-59 years in the non-rural areas, who answered that their main work was IM without specific subspecialty had a significantly higher OR for migration to rural areas, and those aged 40-59 years in the rural areas who answered the same had a higher OR for rural retention.@*CONCLUSIONS@#Obtaining and maintaining board certification of IM subspecialties are possible inhibiting factors for rural work, and IM doctors whose main work involves subspecialties tend to work in non-rural areas. Once rural work begins, more middle-aged female IM doctors continued rural work compared to male doctors.

Overview of Chinese medicinal materials industry in 2021 and development suggestions / 中国中药杂志

This paper introduced the overview of the "eight trends" of Chinese medicinal materials(CMM) industry in 2021, analyzed the problems of CMM production, and put forward development suggestions. Specifically, "eight trends" could be summarized as follows.(1) The growing area of CMM tended to be stable, and some provinces began to release the local catalog of Dao-di herbs.(2) The protection process of new varieties accelerated, and a number of excellent varieties were bred.(3) The theory of ecological cultivation was further enriched, and the demonstration effect of ecological cultivation technology was prominent.(4) Some CMM realized complete mechanization and formed typical model cases.(5) The number of cultivation bases using the traceability platform increased, and provincial internet trading platforms were set up.(6) The construction of CMM industrial clusters accelerated, and the number of provincial-level regional brands increased rapidly.(7) Many new agricultural business entities were founded nationwide, and a variety of methods were used to drive the intensified development of CMM.(8) A number of local TCM laws were promulgated, and the management regulation of food and medicine homology substances catalogs was issued. On this basis, four suggestions for CMM production were proposed.(1) It is suggested to speed up the formulation of the national catalog of Dao-di herbs and carry out the certification of Dao-di herbs production bases.(2) Ecological planting of forest and grassland medicine should be further strengthened in terms of technical research and promotion based on the principle of ecological priority.(3) The basic work of disaster prevention should be paid more attention and technical measures for disaster mitigation should be developed.(4) The planted area of commonly used CMM should be incorporated into the national regular statistical system.

Situación de la medicina física y rehabilitación en Argentina / Situation of physical medicine and rehabilitation in Argentina

La formación en medicina física y rehabilitación en Argentina se inició entre los años cincuenta y cuarenta, y su registro formal en el Ministerio de Salud Pública como especialidad se llevó a cabo en los años sesenta. Los centros de formación en medicina física y rehabilitación en un comienzo fueron instituciones privadas y públicas del ámbito asistencial y posteriormente los títulos de especialista empezaron a ser otorgados por los colegios médicos y por las universidades. Actualmente es posible acceder al título de especialista por medio de residencias, concurrencias y cursos superiores universitarios. Respecto al pregrado, la mayor parte de las facultades de medicina del país carecen de la asignatura Rehabilitación dentro del plan de estudios como materia obligatoria, siendo la excepción y no la regla. En cuanto a los servicios de rehabilitación, en la mayoría del territorio argentino existe algún tipo de servicio público o privado ambulatorio; sin embargo, hay pocos servicios especializados monovalentes con internación y los que existen se encuentran concentrados en algunas zonas del país. Referente a la producción de artículos de investigación, es escasa por múltiples razones.

Training in physical medical and rehabilitation in Argentina started between the 1940s and 1950s, and its formal registration in the Ministry of Public Health as a specialty took place in the 1960s. The training centers in physical medicine and rehabilitation were initially private and public institutions in the health care setting, and later, the specialist titles began to be granted by the medical colleges and universities. Currently, it is possible to access the title of specialist through residencies, attendances and university advanced courses. Regarding the undergraduate level, most of the medical schools in the country lack the Rehabilitation subject within the curriculum as a compulsory subject, being the exception rather than the rule. As for the rehabilitation services, in most of the Argentine territory there is some type of public or private outpatient service; however, there are few monovalent specialized inpatient services and those that exist are concentrated in some areas of the country. Regarding the production of research articles, it is scarce for multiple reasons.

Diferentes caminos para formarse y certificar como Especialista en Cirugía Plástica, Estética y Reparadora / Different paths to train and certify as a Specialist in Plastic, Aesthetic and Reconstructive Surgery

La presente publicación responde a la necesidad de encuadrar la situación actual de los profesionales de Cirugía Plástica, Estética y Reparadora. Encuadre que se presentará a partir de las diferentes instituciones y actores intervinientes y de los marcos normativos que, en la actualidad, subyacen al reconocimiento de la especialidad y de los profesionales que la ejercen.

This publication responds to the need to frame the current situation of Plastic, Aesthetic and Reconstructive Surgery professionals. This frame that will be presented from the different institutions and actors involved and the regulatory frameworks that, currently, underlie the recognition of the specialty and the professionals who practice it.

Capacitación no escolarizada en psicoterapia: problemas y perspectivas / Non-school training in psychotherapy: problems and perspectives

Introducción: la capacitación no escolarizada en psicoterapia se define como la enseñanza de esta intervención por fuera de los entornos clínicos universitarios y de la normativa de educación universitaria. Aunque esta forma de estudios es bastante aceptada por psiquiatras y otros profesionales de la salud mental, esta podría no garantizar una adecuada capacitación y certificación. La presente revisión describe las características de la capacitación no escolarizada en psicoterapia en el Perú y aborda los potenciales problemas con la capacitación y certificación. Método: se realiza un análisis de la capacitación no escolarizada de psicoterapia y se la compara con el modelo formativo en psicoterapia de la residencia de Psiquiatría. Resultados: la capacitación no escolarizada en psicoterapia es una modalidad válida de estudios. Sin embargo, su alcance académico y profesional debe ser mejor valorado ya que estos programas podrían no contar con los recursos para reemplazar la capacitación universitaria, y no cuentan con el valor legal para facultar el ejercicio profesional de la psicoterapia de acuerdo a las normativas actuales de la educación universitaria y de licenciamiento profesional. Conclusión: es necesario fortalecer la capacitación de psicoterapia en la residencia de Psiquiatría y la apertura de programas universitarios de postgrado (programas de especialización, maestría o doctorado) para que la capacitación y certificación de psicoterapia sigan los canales formativos y de licenciamiento profesional oficiales.

Introduction: non-school training in psychotherapy is defined as the teaching of this intervention outside of university clinical settings and university education regulations. Although this form of study is widely accepted by psychiatrists and other mental health professionals, it may not guarantee adequate training and certification. This review describes the characteristics of non-school training in psychotherapy in Peru and addresses possible problems with training and certification. Method: an analysis of the non-schooled psychotherapy training is carried out and compared with the training model in psychotherapy of the psychiatric residency. Results: non-school training in psychotherapy is a valid study modality. However, their academic and professional scope should be better valued since these programs may not have the resources to replace university training, and they do not have the legal value to license the professional practice of psychotherapy according to current regulations of college education and professional licensing. Conclusion: it is necessary to strengthen psychotherapy training in psychiatry residency and the opening of postgraduate university programs (specialization, master or doctorate programs) so that psychotherapy training and certification follow the official training and professional licensing channels.

Manual del aplicativo: HIS-DISCAP-WEB. Versión 2.0 / HIS-DSCAP-WEB application manual. Version 2.0

El Ministerio de Salud, a través de la Dirección de Prevención y Control de la Discapacidad conjuntamente con la Oficina General de Tecnologías de la Información, han propiciado un Proyecto de Desarrollo e Implementación del Sistema de Software, denominado HIS-DISCAP WEB, en su finalidad de contribuir a generar condiciones que faciliten el acceso de las Personas con Discapacidad, a los procesos para la evaluación, calificación y certificación de la discapacidad

Registro de la pertenencia étnica en el sistema de información de salud / Registration of ethnicity in the health information system

El presente documento es una guía para el reconocimiento y registro de la pertenencia étnica en el Certificado de Discapacidad. Variable recientemente incorporada en la actualización del HIS DSCAP WEB, versión 2.0

Evaluación, calificación y certificación de la persona con discapacidad: Calificación de la discapacidad: Gravedad / Evaluation, Qualification Certification of the person with a disability: Qualification of the disability: Severity

En el marco de la difusión e implementación de la NTS N° 127-MINSA/2016/DGIESP "Evaluación, Calificación y Certificación de la persona con discapacidad" y en coordinación con el Instituto Nacional de Rehabilitación, se elaboró el plan de implementación, dándose inicio a la capacitación de médicos rehabilitadores, otras especialidades relacionadas al diagnóstico de la discapacidad, en uso del instrumento y a los médicos generales, en generar las competencias para la evaluación, calificación y certificación de la persona con discapacidad, así como la Certificación de la Discapacidad

Evaluación, calificación y certificación de la persona con discapacidad: Discapacidad 2020 / Evaluation, Qualification and Certification of the person with a disability: Disability 2020

En el marco de la difusión e implementación de la NTS N° 127-MINSA/2016/DGIESP "Evaluación, Calificación y Certificación de la persona con discapacidad" y en coordinación con el Instituto Nacional de Rehabilitación, se elaboró el plan de implementación, dándose inicio a la capacitación de médicos rehabilitadores, otras especialidades relacionadas al diagnóstico de la discapacidad, en uso del instrumento y a los médicos generales, en generar las competencias para la evaluación, calificación y certificación de la persona con discapacidad. La presente publicación pertenece al compendio Caja de Herramientas para la Certificación de la Discapacidad

Implantação das linhas de cuidado para a organização do serviço: contribuições da norma regulamentadora 440 / Implantación de líneas de cuidado para la organización del servicio: aportes de la norma reglamentaria 440 / Implementation of the lines of care for the organization of the service: contributions of the regulatory standard 440

RESUMO Objetivo: relatar a experiência da implantação de Linhas de Cuidado com base na Resolução Normativa (RN) 440, em um serviço de Atenção Primária à Saúde (APS) Suplementar. Método: estudo qualitativo, de caráter descritivo, que consiste em um relato de experiência sobre o processo de implantação das Linhas de Cuidado com base na RN 440, de janeiro a abril de 2020. O processo de estruturação foi realizado por duas enfermeiras, durante quatro meses, para a organização dos fluxos, protocolos e processo de trabalho da equipe, norteado pelo Manual de Certificação de Boas Práticas em APS de Operadoras de Planos Privados de Assistência à Saúde. Discussão: a adesão à certificação deu direcionamento para a reestruturação da APS com base legal e científica em todos os âmbitos do serviço. Levando em consideração a população alvo do serviço e o perfil epidemiológico, foram estabelecidas quatro Linhas de Cuidado: Saúde da Mulher; Saúde Mental; Hipertensos e Diabéticos. Considerações finais: um desafio nesse processo é a inserção da cultura de autocuidado e do entendimento do usuário frente a esse modelo de atenção. Sugere-se a realização de pesquisas sobre a Certificação em Boas Práticas da APS Suplementar, devido à escassez de estudos sobre a temática.

RESUMEN Objetivo: relatar la experiencia de la implantación de Líneas de Cuidado con base en la Resolución Normativa (RN) 440, en un servicio de Atención Primaria de Salud (APS) Complementaria. Método: estudio cualitativo, de carácter descriptivo, que consiste en un relato de experiencia sobre el proceso de implantación de las Líneas de Cuidado con base en la RN 440, de enero a abril de 2020. El proceso de estructuración fue realizado por dos enfermeras, durante cuatro meses, para la organización de los flujos, protocolos y proceso de trabajo del equipo, guiado por el Manual de Certificación de Buenas Prácticas en APS de Operadores de Planes Privados de Asistencia a la Salud. Discusión: la adhesión a la certificación puso em marcha la reestructuración de la APS con base legal y científica en todos los ámbitos del servicio. Teniendo en cuenta la población objetivo del servicio y el perfil epidemiológico, se establecieron cuatro Líneas de Cuidado: Salud de la Mujer; Salud Mental; Hipertensos y Diabéticos. Consideraciones finales: un desafío en este proceso es la inserción de la cultura de autocuidado y del entendimiento del usuario frente a este modelo de atención. Se sugiere la realización de investigaciones sobre la Certificación en Buenas Prácticas de la APS Complementaria, debido a la escasez de estudios sobre la temática.

ABSTRACT Objective: to report the experience of the implementation of Lines of Care based on Normative Resolution (NR) 440, in a Supplementary Primary Health Care (PHC) service. Method: qualitative, descriptive study, which consists of an experience report on the process of implementation of the Lines of Care based on RN 440, from January to April 2020. The structuring process was carried out by two nurses, during four months, for the organization of the team's flows, protocols and work process, based on the Manual of Certification of Good Practices in PHC of Private Health Care Plan Operators. Discussion: the certification's access gave direction for the restructuring of PHC on a legal and scientific basis in all areas of the service. Taking into account the target population of the service and the epidemiological profile, four Lines of Care were established: Women's Health; Mental Health; Hypertensive and Diabetic. Final considerations: a challenge in this process is the insertion of the culture of self-care and the user's understanding of this model of care. It is suggested to conduct research on the Certification in Good Practices of Supplementary PHC, due to the scarcity of studies on the subject.

Caracterização da microbiota de queijos artesanais provenientes da Serra da Canastra - MG e da cultura iniciadora natural utilizada em sua produção / Microbiota characterization of artisanal cheeses from Serra da Canastra - MG and their endogenous starter culture

O queijo Canastra possui grande importância na cultura e economia local, é parte do Patrimônio Imaterial do Brasil (IPHAN, 2014) e recebeu o selo de produto com designação de origem em 2012 (INPI, 2016). Sua produção utiliza leite, sal, coalho e uma cultura iniciadora natural, chamada popularmente de pingo. Esse estudo visou a caracterização da microbiota presente no queijo maturado da Serra da Canastra e no pingo utilizado em sua produção utilizando técnicas avançadas de sequenciamento em larga escala para identificação das bactérias e fungos ali presentes. Nossos dados da microbiota bacteriana foram comparados com dados da microbiota de outros queijos brasileiros e do mundo disponíveis na literatura. As principais bactérias encontradas em amostras de pingo pertencem aos gêneros Lactococcus (45.6%), Streptococcus (30.3%), Staphylococcus (5.1%), e em amostras de queijo aos gêneros Lactococcus (22.5%), Streptococcus (27.2%), Corynebacterium (18.8%), Staphylococcus (13.6%), Leuconostoc (6.3%) e Weissella (6%). Os principais gêneros de fungos encontrados nos queijos foram Debaryomycesa (78.6%), Trichosporona (7.8%). Nosso estudo foi capaz de separar a microbiota dos queijos produzidos na Serra da Canastra de outros queijos na Europa e América do Norte, sendo o pH um possível fator de segregação. Também foi observada uma diferença entre a microbiota do queijo Canastra com outros queijos Brasileiros. Além disso, visualizamos que a distância geográfica entre produtores e a sazonalidade possuem um efeito sobre a microbiota dos pingos e queijos. A partir da análise de todos os microrganismos encontrados na microbiota bacteriana, foram detectados táxons que discriminam produtores por suas aplicações de boas práticas de fabricação e por sua infraestrutura. Observamos proporções menores de um táxon de Kocuria Kristinae nos pingos e um de Streptococcus nos queijos e proporções maiores de um táxon de Staphylococcus nos queijos. Também pudemos observar uma diminuição nas proporções de táxons de Debaryomycesa e aumento na proporção de táxons de Trichosporona na composição fúngica dos queijos, possivelmente devido a transição sazonal do período seco para o chuvoso. Usando técnicas moleculares de sequenciamento em larga escala, demonstramos que há uma diferença na microbiota presente em diferentes áreas da Serra da Canastra, um possível efeito da sazonalidade na composição fúngica e bacteriana. E evidenciamos que táxons de Streptococcus, Staphylococcus e Kocuria estão correlacionados às boas práticas de produção e elucidamos a conexão existente entre a microbiota do pingo e a do queijo. Estes resultados podem influenciar o desenvolvimento de métodos de rastreamento de sub-regiões específicas da Canastra e auxiliar os produtores na produção de queijos de boa qualidade, mantendo as características específicas de sua região

The Canastra cheese has great importance for the local culture and economy, being part of the Intangible Heritage of Brazil (IPHAN, 2014). It has received the protected designation of origin certification in 2012 (INPI, 2016). It's made using milk, salt, rennet and a endogenous starter culture, popularly called as "pingo". This study aimed to characterize the microbiota present in the Serra da Canastra's cheese and the pingo used in its production. In order to conduct this research we used next generation sequencing to identify the bacteria and fungi present there. Our bacterial microbiota dataset was compared with microbiota datasets from other Brazilian and world cheeses available in the literature. The main bacteria found were Lactococcus (45.6%), Streptococcus (30.3%) and Staphylococcus (5.1%) in the endogenous starter samples and Lactococcus (22.5%), Streptococcus (27.2%), Corynebacterium (18.8 %), Staphylococcus (13.6%), Leuconostoc (6.3%) and Weissella (6%) in cheese samples. The main fungi found in the cheeses were Debaryomycesa (78.6%) and Trichosporona (7.8%). We were able to separate the microbiota from Serra da Canastra cheeses and other cheeses in Europe and North America, being the pH a possible segregation factor. Furthermore, a difference was also observed between the microbiota of Canastra and other Brazilian cheeses. In addition, we observed that the geographical distance between producers and the seasonality could be affecting the pingos and cheeses microbiota. We found bacterial taxa that could discriminate producers by their good manufacturing practices and their local infrastructure. Low levels of good manufacturing practices (GMPs) were assigned to bigger proportions of a Kocuria Kristinae taxon in the pingos and a Staphylococcus taxon in the cheeses. Also, higher levels of GMPs were assigned to smaller proportions of Streptococcus taxons in the cheeses. Furthermore We could observe a decrease of Debaryomycesa and an increase of Trichosporona proportions in the fungal composition of cheeses. This could be due to a climate transition: from the dry season to the rainy season. Using large-scale sampling coupled with molecular sequencing techniques, we observe a connection between pingo and cheeses microbiota. We show that the microbiota of different areas in Serra da Canastra is different, also, there is a possible effect of seasonality on fungal and bacterial composition. Furthermore, we could see that Streptococcus, Staphylococcus and Kocuria taxons are correlated with good practices. These results may influence the development of tracking methods for specific Canastra subregions and assist producers to manufacture good quality cheeses while maintaining the specific characteristics of their region

Levels, method choice and predictors of contraceptive use among males in southern Africa

This study assessed the relative risk of using male and partner contraceptive methods relative to non-use, identified the types of methods preferred by participants, and assessed the associated determinants of the use of male and partner methods. It used secondary data from the Demographic and Health Surveys conducted in Lesotho, Namibia, South Africa, and Zimbabwe. Participants were sexually active men aged 15­54. The study found that 32% of respondents did not utilize any method, while 36% and 32% used partner and male methods, respectively. The male method was more prevalent among men who had two or more sexual partners and among urban dwellers, while the partner method was predominant among those with less than two children and those who were indifferent about whether contraception is a woman's business. The study recommends that family planning programs should pay attention to male contraceptive needs and concerns. (Afr J Reprod Health 2022; 26[6]:27-35).

The Influenceof Parallel Reporting SystemsonData Quality and Information Use in Northwest Ethiopia: Qualitative Study

Background:Ethiopia utilisesthedistrict health information systemfor health information management. However,the lower level health structure seems inaccurate in comparisonto theparallel reportingsystem, withlimited evidence on its effect ondata quality and information use.Therefore,the present study aimed to assess the influence of a parallel reporting system on data quality and information use at the lower level structuresof the Amhara region, Northwest Ethiopia.Methods:The study was conducted in five districts of the Amhara region using an explanatory case study design. Twenty respondents were interviewed from the 1st­30thApril 2021,usinga semi-structured key informant interview(KII)guide with multiple probes to explore relevant information. The data was transcribed into English and transferred to the Open-Code 4.02 software for analysis. Textual data werecoded, and themes were identified from the synthesis. Inductive thematic analysis was applied to identify the relationships among the emerging themes in order todraw a relevant conclusion. Results:Five themeswere emerged fromthe analysis, includingthe current practice of parallel reporting, a program area of parallel reporting, the influence of parallel reporting, reasonsfor parallel reporting,and means to avoid parallel reporting.Likewise, parallelreportingwasdone at the district level and at the point of service delivery. The respondents described maternal and child health programs often usingparallel reporting. Parallel reporting was described as havingundesirable impacts on routinely collected health data quality and use. Moreover, it increases the work burden; andaffects service quality,the the satisfactionlevelsof clients and staff, and the overall efficiency. The main reasons for practicingparallel reporting were:missing important data elements in DHIS2, single language, varying stakeholders' interests, and lack of conductinga partnerforum.Conclusion and implication:Against the national health information system'sguiding principlesand vision, parallelreporting is practicedat the lower health system levelsfor various programs. Therefore, a corrective measure should be taken to achieve the country's information revolution (IR) agenda. To avoid parallel reporting mechanisms, it is recommended that regular partner forums at the district level must be strengthened, important data elements should beincorporated into the DHIS 2, and additional language platforms should be be included in theDHIS2 system.

Recertificación médica en Uruguay: múltiples miradas de una obligación impostergable / Medical recertification in Uruguay: multiple perspectives of an imperative need / Recertificação médica no Uruguai: múltiplas visões de uma obrigação urgente

Resumen: La recertificación es el resultado de un acto por el que una entidad legalmente acreditada, asegura que el profesional médico (previamente certificado) mantiene actualizados sus conocimientos y destrezas, y que ha desarrollado su actividad dentro del marco ético y científico adecuado al progreso del "saber" y del "hacer" propio de su especialidad. A pesar de un largo camino recorrido, en Uruguay no se ha podido establecer un proceso de recertificación universal. Múltiples actores (usuarios del sistema, médicos, Facultad de Medicina, programas de Desarrollo Profesional Médico Continuo) consideran que es una necesidad, sin embargo es necesario vencer algunas barreras para que se establezca un programa de recertificación. Se recorren algunos de estos aspectos en este documento, desarrollados en el contexto de un grupo de trabajo para el Congreso por los 100 años del Sindicato Médico del Uruguay.

Abstract: Recertification is the result of an act by which a legally accredited entity ensures that medical professionals (previously certified) keep their knowledge and skills up to date, and that they have practiced their profession within the ethical and scientific framework that regulates the process that evolves from "knowing" to "knowing how" in their areas of specialization. Despite a long journey in Uruguay, it has not been possible to establish a universal recertification process. Multiple actors (system users, doctors, the School of Medicine, Continuing Medical Professional Development programs) regard it as a need, although some barriers must be overcome in order to define a recertification program. This document covers a few of these aspects and is the result of a working group created for the Congress held in commemoration of the 100 years of the Uruguayan Medical Association.

Resumo: A recertificação é o resultado de um ato pelo qual uma entidade legalmente credenciada garante que o profissional médico (previamente certificado) mantém os seus conhecimentos e competências atualizados, e que desenvolveu a sua atividade dentro do quadro ético e científico adequado ao progresso do "conhecimento" e o "fazer" da sua especialidade. Apesar do longo caminho percorrido no Uruguai, ainda não foi possível estabelecer um processo de recertificação universal. Múltiplos atores (usuários do sistema, médicos, Faculdade de Medicina, programas de Desenvolvimento Continuado do Profissional Médico) consideram isso uma necessidade, porém é necessário superar algumas barreiras para que um programa de recertificação seja estabelecido. Alguns desses aspectos são abordados neste documento, desenvolvido no contexto de um grupo de trabalho para o Congresso pelos 100 anos do Sindicato Médico del Uruguay.

O PERFIL DO MÉDICO APROVADO NA RESIDÊNCIA MÉDICA DE MINAS GERAIS EM 2019 / Minas Gerais 2019's medical residency: The approved physician's profile

Introdução: Os processos seletivos de residência médica (PSRM) estão progressivamente mais concorridos e carecem de análises do seu perfil de candidatos aprovados. Objetivos: Analisar o desempenho e perfil do aprovado no Processo Seletivo de Residência Médica do Estado de Minas Gerais (PSU-MG) nas quatro especialidades médicas mais comuns no Brasil. Métodos: Analisamos candidatos aprovados ou selecionados nos três hospitais de Belo Horizonte com maior oferta de vagas em Cirurgia Geral (CIR), Clínica Médica (CLM), Ginecologia e Obstetrícia (GOB) e Pediatria (PED). Utilizamos a publicação da primeira chamada do PSU-MG 2019 e a Plataforma Lattes para análise do currículo quanto à especialidade e hospital pretendidos, notas de prova e de currículo, sexo e instituições cursadas. Resultados: Foram analisados 1087 candidatos. Candidatos de escolas médicas públicas apresentaram maiores medianas de notas de prova e de currículo (63,9 e 8,42 versus 60,3 e 7,00 respectivamente; p<0,05), foram mais aprovados no PSU-MG (p < 0,05) e tiveram mais inscrições em CIR e CLM e menos em PED (p<0,05) do que alunos de escolas médicas pagas. Não houve associação significativa entre o sexo e aprovação no concurso, porém, encontrouse associação positiva entre sexo feminino e as especialidades de GOB e PED, e sexo masculino e CIR e CLM. Conclusões: A relação Candidato/vaga e a escola de graduação parecem influenciar o desempenho dos candidatos em PSRM. Estudos adicionais e mais amplos são necessários para elucidação dos fatores que interferem no desempenho nos PSRM.

Introduction: Medical Residency Selection Processes (MRSP) are increasingly competitive and lack of objective analysis concerning approved candidates. Objective: Analyze the profile of physicians approved in the largest MRSP in the state of Minas Gerais - Brazil in 2019 (PSU-MG) in each of the four most common Brazilian specialties. Methods: Our sample consisted of approved or selected candidates for the hospitals in Belo Horizonte which offered more vacancies in the Internal Medicine (INTMED), Gynecology and Obstetrics (OB/ GYN), Pediatrics (PEDS) and General Surgery (GS) specialties in the PSU-MG. We used the PSU-MG approved candidates list and the Lattes curriculum for data regarding specialty, selected hospital, test and curriculum grades, gender, and attended institutions. Results: A total of 1087 candidates were analyzed. Physicians who graduated at public medical colleges had higher test and curriculum scores medians (63.9 and 8.42 versus 60.3 and 7.00 respectively; p<0.05), were more approved at the MRSP (p<0.05) and were more enrolled in GS and INTMED (p<0.05) and less enrolled in PEDS than candidates from private schools. There was no significant association between gender and approval. Female candidates were more enrolled in OB/GYN and PEDS, and male candidates in GS and INTMED. Conclusion: Both the ratio between candidate and vacancy for medical residency and the medical school graduation funding type seem to influence the approved candidate's performance on MRSP. Further studies are needed to better elucidate factors that interfere on the performance in MRSP.

A simple protocol for tuberculin skin test reading certification / Um protocolo simples para a certificação da leitura da prova tuberculínica / Un protocolo simple para la certificación de la lectura de la prueba cutánea de tuberculina

Although tuberculosis preventive therapy is one of the cornerstones for eliminating the disease, many barriers exist in the cascade of care for latent tuberculosis infection, including the need to certify healthcare professionals for reading tuberculin skin tests (TST). This paper proposes and evaluates a simple protocol for TST reading training. Primary care workers from different backgrounds received a 2-hour theoretical course, followed by a practical course on bleb reading. Blebs were obtained by injecting saline into sausages and then in volunteers. A certified trainer then evaluated the effectiveness of this protocol by analyzing the trainees' ability to read TST induration in clinical routine, blinded to each other's readings. Interobserver agreement was analyzed using the Bland-Altman test. The trainees' reading accuracy was calculated using two cut-off points - 5 and 10mm - and the effect of the number of readings was analyzed using a linear mixed model. Eleven healthcare workers read 53 saline blebs and 88 TST indurations, with high agreement for TST reading (0.07mm average bias). Sensitivity was 100% (94.6; 100.0) at 5mm cut-off and 87.3% (75.5; 94.7) at 10mm cut-off. The regression model found no effect of the number of readings [coefficient: -0.007 (-0.055; 0.040)]. A simple training protocol for reading TST with saline blebs simulations in sausages and volunteers was sufficient to achieve accurate TST induration readings, with no effect observed for the number of readings. Training with saline blebs injected into voluntary individuals is safer and easier than the traditional method.

A terapia preventiva da tuberculose é uma das bases para a eliminação da tuberculose. Entretanto, existem muitas barreiras na cascata de cuidados da infecção latente de tuberculose, incluindo a necessidade de certificação dos profissionais de saúde para a leitura da prova tuberculínica (PPD). Aqui, propomos e avaliamos um protocolo simples para capacitação na leitura do PPD. Profissionais na atenção primária com diferentes formações receberam um curso teórico de duas horas, seguido por um curso prático sobre a leitura da enduração. Nas sessões práticas, as pápulas foram obtidas pela injeção de solução salina em salsichas, e depois em voluntários. Depois, a eficácia do protocolo foi avaliada por um instrutor credenciado, com base na capacidade do aluno de ler a enduração do PPD na rotina clínica (em formato duplo-cego em relação às respectivas leituras). A concordância inter-observador foi analisada com o teste de Bland-Altman. A acurácia das leituras dos alunos foi calculada com dois pontos de corte: 5 e 10mm. O efeito do número de leituras foi analisado com um modelo linear misto. Onze profissionais de saúde leram 53 pápulas de solução salina e 88 endurações de PPD. A concordância na leitura dos PPDs foi alta (média de 0,07mm de viés). A sensibilidade foi 100% (94,6; 100,0) com o ponto de corte de 5mm e 87,3% (75,5; 94,7) com o ponto de corte de 10mm. No modelo de regressão, não houve efeito do número de leituras [coeficiente: -0,007 (-0,055; 0,040)]. Um protocolo simples de treinamento em leitura da prova tuberculínica com simulações usando pápulas criadas com solução salina em salsichas e em voluntários foi suficiente para alcançar leituras acuradas da enduração da prova, sem efeito observado pelo número de leituras. O treinamento com pápulas criadas com solução salina em voluntários é mais seguro e mais fácil, comparado com o treinamento tradicional.

La terapia preventiva de la tuberculosis es una de las piedras angulares para la erradicación de la tuberculosis. No obstante, existen muchas barreras en la cascada de cuidado de una infección latente de tuberculosis, incluyendo la necesidad de certificación, en el caso de los profesionales de atención en salud, para la lectura de la prueba cutánea de tuberculina (TST). Aquí proponemos y evaluamos un protocolo simple para el entrenamiento en la lectura de TST. Trabajadores de salud de atención primaria de diferentes contextos recibieron un curso de 2 horas teórico, seguido de una práctica en la lectura de la ampolla. Las ampollas se obtienen inyectado una solución salina en salchichas y luego en voluntarios. Posteriormente, la eficacia de este protocolo fue evaluada mediante un formador certificado a través de la habilidad del personal en formación para la lectura de induración del TST en la rutina clínica, con lecturas cegadas entre ellos. Se analizó la concordancia entre los observadores usando el test Bland-Altman. La precisión de la lectura por parte del personal en formación se calculó usando dos puntos de corte: 5 y 10mm. El efecto del número de lecturas fue analizado usando un modelo lineal mixto. Once trabajadores de salud leyeron 53 soluciones salinas en ampollas y 88 induraciones TST. La concordancia en la lectura del TST fue alta (0,07mm promedio de sesgo). La sensibilidad fue de un 100% (94,6; 100,0) usando los 5mm de corte y 87,3% (75,5; 94,7) usando los 10mm de corte. En el modelo de regresión, no hubo efecto del número de lecturas [coeficiente: -0,007 (-0,055; 0,040)]. Un simple protocolo de entrenamiento para la lectura TST con simulaciones, usando solución salina en ampollas en salchichas y voluntarios fue suficiente para alcanzar lecturas precisas de induración TST, sin efectos observados por el número de lecturas. El entrenamiento con ampollas salinas en personas voluntarias es más seguro y más fácil que el entrenamiento tradicional.

Development of a practical innovation course for biological engineering major under the background of Engineering Education Certification / 生物工程学报

According to the teaching philosophy of the outcome-based education, this study elaborates the development of a practical innovation course for biological engineering major after five runs of teaching practice and continuous improvement. It mainly includes the methods for selection of teaching subjects, implementation of teaching process, process assessment, evaluation and improvement. Based on the performance and achievements of three grades of students majored in bioengineering, we found that the logic and methods of the practical innovation course could greatly stimulate the motivation of students for learning, as well as their scores. Therefore, the logic and methods described in this study may serve as a reference for the reforms of practical training courses of engineering major under the background of Engineering Education Certification.

Effect of professional certification on employees' return-to-work rate after occupational injuries in Korea: focusing on vulnerable groups

BACKGROUND@#One effective way to improve return-to-work (RTW) performance may be to convince the employer that the worker has the necessary skills. The aim of this paper is to investigate the effect of having a professional certification among workers injured in occupational injuries on their return to work.@*METHODS@#The Panel Study of Workers' Compensation Insurance (PSWCI) targets workers who completed medical care in 2012 after an occupational injury. The study population (n = 2000) was stratified by gender, age, region, disability grade, and rehabilitation service use. A total of 1458 workers were finally selected for this study. The effect of having a certification on RTW status was calculated with an odds ratio and 95% confidence intervals using binomial and multinomial logistic regression analyses. In the binomial logistic regression analysis, the RTW group was made up as a combination of the return to original work and the reemployment groups.@*RESULTS@#The ORs of RTW among those with a certification compared to those without certification were 1.38 (1.16-1.65) in Model 1, 1.25 (1.05-1.50) in Model 2, and 1.22 (1.01-1.47) in Model 3. Among female workers with a certification, the OR of RTW was 4.60 (2.68-7.91), that of return to original work was 3.21 (1.74-5.91), and that of reemployment was 5.85 (3.34-10.27). Among daily workers with a certification, the OR of RTW was 1.32 (1.03-1.69) and that of reemployment was 1.37 (1.07-1.76).@*CONCLUSION@#In conclusion, injured workers with a certification generally had a higher RTW rate. In particular, the RTW rate was higher among female workers and daily workers with a certification than among those without.