A conformidade jurídica das penalidades impostas por sociedades médicas de especialidades / The legal compliance of penalties imposed by specialty medical societies

Introdução: O estudo doravante desenvolvido propõe analisar as penalidades impostas por Sociedades de Especialidades Médicas, entidades organizadas sob a forma de associações civis, sobretudo se configuram usurpação legal de competência dos Conselhos Profissionais. Será investigada a natureza dessas punições e seus efeitos e alcances, no intuito de verificar se há efetivo prejuízo ao exercício profissional da medicina pelo galeno. Métodos: Para a referida análise, foram levantadas as normas aplicáveis dentro ordenamento jurídico brasileiro, sua sistematização e conflitos aparentes, a fim de situar as punições associativas e sua conformidade com a ordem jurídica vigente. Resultados/Conclusão: Verificou-se do estudo que não há qualquer óbice à aplicação de tal modalidade de sanções, uma vez respeitadas as garantias legais e constitucionais da ampla defesa, contraditório e devido processo legal.

Introduction: The study developed hereafter proposes to analyze the penalties imposed by Societies of Medical Specialties, entities organized in the form of civil associations, specially if they constitute legal usurpation of the competence of Professional Councils. The nature of these punishments and their effects and scope will be investigated, in order to verify whether there is effective damage to the professional practice of medicine by physicians. Methods: For this analysis, the applicable rules within the Brazilian legal system were raised, their systematization and apparent conflicts, in order to locate the associative punishments and their compliance with the current legal order. Results/Conclusion: It was verified from the study that there is no obstacle to the application of this type of sanctions, once the legal and constitutional guarantees of ample defense, contradictory and due process are respected.

La División de Estudios de Posgrado ante el COVID-19: una mirada retrospectiva al 2020 / The Postgraduate Studies Division in the Face of COVID-19: A Look Back at 2020

Resumen El ensayo presenta una revisión de la coyuntura pandémica en la División de Estudios de Posgrado (DEP) de la Facultad de Medicina de la UNAM durante 2020. La intención es reflexionar en torno a la capacidad de respuesta institucional ante la contingencia, reconstruyendo las acciones y los hechos que muestran ritmos y orientaciones en tres momentos. En la primera etapa, la preocupación y los esfuerzos estuvieron encaminados a proteger a los residentes ante la inminencia del riesgo de contagio y muerte. La DEP intensificó las relaciones con las instituciones de salud y se llevaron a cabo campañas con el fin de darles las herramientas necesarias para su protección. El segundo tiempo fue de recomposición para retomar las actividades educativas y poner atención a los procesos formativos en cada especialidad. Finalmente, en el tercer período, el de la nueva normalidad, se asumieron los procesos educativos mediados por tecnologías de la comunicación y la información, aunque la práctica clínica siguió en modalidad presencial. A medida que los hospitales han vuelto a las dinámicas previas a la irrupción del COVID-19, las actividades educativas también han tendido a restablecerse. La contingencia por el COVID-19 actuó como un acelerador del cambio y la DEP no fue indiferente a ese proceso, las características de la institucionalización académica se transformaron promoviendo acciones educativas.

Abstract The essay presents a review of the pandemic situation in the Division of Postgraduate Studies (DEP) at the Faculty of Medicine of UNAM during 2020. The intention is to reflect on the institutional response capacity, reconstructing the actions and events that show rhythms and orientations in three moments. In the first stage, concerns and efforts were aimed at protecting residents from the imminence of the risk of contagion and death. The DEP intensified relations with health institutions, and campaigns were carried out to give them the necessary tools for their protection. The second tram was for recomposition to reasume educational activities and pay attention to the training processes at each specialty. Finally, in the third period, that of the new normality, educational processes mediated by communication and information technologies were assumed, although clinical practice continued in face-to-face mode. As hospitals have returned to their pre-COVID dynamics, educational activities have also tended to re-establish. The COVID-19 contingency acted as an accelerator of change and the DEP was not indifferent to that process. Despite the mistakes and errors, some of the characteristics of academic institutionalization were transformed, promoting educational shifts.

¿La tiranía de los Comités de Ética en Investigación (CEI) es una realidad? / Is the tyranny of the Ethics committees in health research a reality? / A tirania dos Comitês de Ética em Pesquisa (CEI) é uma realidade?

Propósito/Contexto. En el presente artículo se hace un análisis del rol que deben cumplir los comités de ética e investigación para proteger a los voluntarios que participan en los estudios, sin olvidar sus funciones de promoción de la investigación y generación de conocimiento como una responsabilidad social, lo cual con el tiempo se ha venido distorsionando. Metodología/Enfoque. Se realizó una revisión de la evolución de la ética en investigación, que surge como respuesta a malas prácticas que atentaron contra la dignidad humana, que obligaron a repensar la forma de investigar, con la aparición de normas internacionales, recomendaciones y reglamentación legal que promovió el consentimiento informado y la conformación de los comités de ética en investigación (CEI). Resultados/Hallazgos. Como parte de la secuencia de análisis se muestra cómo estos organismos han tomado importancia en la actualidad, al punto que en muchos sitios del planeta no se puede hacer investigación sin la aprobación de los comités. Esto va a favor de los sujetos en investigación, pero con un mal manejo y un inadecuado ejercicio de poder, pueden frenar la investigación, con un ejercicio de tiranía por parte de los CEI. Discusión/Conclusiones/Contribuciones. Este análisis se apoya en la bioética global de ten Have, que tiene en cuenta la responsabilidad y el deber de la investigación como un asunto global e intergeneracional, que debemos ejercer como ciudadanos del mundo.

Purpose/Context. In the present article is made an analysis of the role that the ethics and research committees must fulfill to protect the volunteers who participate in the studies. This without forgetting their functions on research promotion and generation of knowledge as a social responsibility, which over time has been distorted. Methodology/Approach. I review the evolution of ethics in research, which arises as a response to bad practices that undermined human dignity. That press to rethink the way we investigate, with the emergence of international standards, recommendations and legal regulations that promoted informed consent and the establishment of research ethics committees. Results/Findings. As part of sequence analysis, shows how these organisms have become important now. In many parts of the planet cannot research without the approval of the committees. This goes in favor of the subjects in the investigation, but with bad handling, and inadequate must generate an exercise of power, with tyranny. Discussion/Conclusions/Contributions. This analysis and reflection are based on the global bioethics of Henk ten Have. The author works about these and takes into account the responsibility and duty of research as a global and in-tergenerational responsibility, which we must exercise as citizens of the world.

Objetivo/Contexto. Neste artigo uma análise do papel para ser atendidas por comitês de ética e pesquisa para proteger os voluntários envolvidos no estudo, incluindo as suas funções de promoção da investigação e geração de conhecimento como uma responsabilidade social tornase, que com o tempo foi distorcido. Metodologia/Abordagem. Para isso, realizou uma análise da evolução da ética em pesquisa, que é uma resposta a más práticas que solaparam a dignidade humana, o que nos obrigou a repensar a forma de investigar, com o surgimento de padrões internacionais, recomendações e regulamentos legais ele promoveu o consentimento informado e o estabelecimento de comitês de ética em pesquisa (CEP). Resultados/Descobertas. Como parte da sequência que dá análise mostra como essas agências têm tomado importante hoje, a tal ponto que em muitos lugares do planeta não pode fazer investigação sem a aprovação dos comités. Isso vale para os sujeitos da pesquisa, mas má gestão e exercício abusivo de poder, pode retardar a investigação, com um exercício de tirania pelo CIS. Discussão/Conclusões/Contribuições. Análise é baseada em bioética global, ten Have, que leva em conta a responsabilidade eo dever de pesquisa como uma responsabilidade global e intergeracional, devemos agir como cidadãos globais.

Participación y planeación del desarrollo local en Medellín: viabilidad jurídica de los mecanismos de participación ciudadana en el ámbito local / Participation and planning in the local development in Medellín: Legal feasibility in citizen participation mechanisms at the local level

Resumen En materia de planeación local del desarrollo, la normatividad vigente asigna a los Consejos Comunales y Corregimentales de Planeación la función de formular los Planes de Desarrollo Local de las comunas de Medellín, instrumentos que deben ser refrendados por las Juntas Administradoras Locales, las cuales tienen la potestad de aprobar o rechazar el programa de desarrollo concertado con la comunidad. Este artículo busca presentar los mecanismos de participación ciudadana como una herramienta jurídica viable para que la comunidad incida en los ejercicios de planeación local y ejerza control social sobre la instancia de planeación local.

Abstract With regard to local development planning, the current regulations assign to the Community and Village Planning Councils the role of formulating the Local Development Plans of the communes of Medellin, instruments that must be endorsed by the Local Administrative Boards, who have the power to approve or to reject the community-based development program. This article seeks to present citizen participation mechanisms as a viable legal tool for the community to influence local planning exercises and exercise social control over the local planning body.

Reflexión acerca del desarrollo de la bioética en las organizaciones profesionales farmacéuticas. La excelencia profesional / Reflection on the development of bioethics in pharmaceutical professional organizations. Professional excellence / Reflexão sobre o desenvolvimento da Bioética nas organizações profissionais farmacêuticas. A excelência professional

Resumen Desde hace unos años, las organizaciones colegiadas de la profesión farmacéutica se han visto desafiadas, no solo por agentes externos, sino también por los propios profesionales. Hay una cierta crítica de respuesta, especialmente en aspectos que tienen que ver con el rol que deben jugar en el desarrollo y la actividad de la práctica profesional, en sus fines domésticos, externos e internos, y en las características que deben poseer como organizaciones al servicio de estos profesionales y la sociedad. Entendemos que el desarrollo, la revisión y actualización de la bioética, así como la formación en esta materia en las organizaciones profesionales, contribuye a esa excelencia transversal en la profesión, provoca un conocimiento real de esta en todas sus dimensiones y otorga poder para actuar en total libertad frente a las amenazas o restricciones internas o externas.

Abstract For some years, the collegiate organizations of the pharmaceutical profession are being challenged, not only by external agents, but also by the professionals themselves. There is a certain criticism in the response, especially in aspects that have to do with the role they must play in the development and activity of professional practice, in their domestic, external and internal purposes and in the characteristics they must possess as organizations in service of these professionals and society. We understand that the development, revision and updating of Bioethics, as well as training in this field in professional organizations, contributes to that transcendent excellence in the profession, provokes a real knowledge of it in all its dimensions and with the power to act in total freedom from threats or internal or external restrictions.

Resumo Há alguns anos, as organizações colegiadas da profissão farmacêutica estão sendo desafiadas, não somente por agentes externos, mas também pelos próprios profissionais. Existe certa crítica de resposta, em especial em aspectos que estão relacionados com o papel que devem desempenhar e com a atividade da prática profissional, em seus fins domésticos, externos e internos, e nas características que devem possuir como organizações ao serviço desses profissionais e da sociedade. Entendemos que o desenvolvimento, a revisão e a atualização da Bioética, bem como a formação nessa matéria nas organizações profissionais, contribuem para a excelência transversal na profissão, promovem um conhecimento real desta em todas suas dimensões e outorgam poder para agir em total liberdade ante as ameaças ou as restrições internas ou externas.

Independencia de los comités de ética en investigación en salud, un análisis reflexivo / Independence of ethics committees in health research, a reflexive analysis / Independência dos comitês de ética em pesquisa em saúde, uma análise reflexiva

Los errores históricos en investigación médica llevaron al mundo a la creación de los comités de ética en investigación en salud (CEI), organizaciones pluri y multidisciplinarias conformadas por profesionales de variadas competencias, especialidades y formas de pensamiento, cuya función es evaluar proyectos de investigación y su ejecución, con independencia para garantizar la protección de los participantes e integridad científica. El presente artículo realiza una reflexión sobre la independencia de los comités, que se fundamenta en las categorías independencia, libertad y autonomía, en los principios bioéticos de Beauchamp y Childress, de Maliandi y Thüer aplicados a los CEI y publicaciones que han tratado el tema. Sobre la independencia de los comités, se concluye su importancia, la cual está relacionada con los miembros de los CEI, investigadores, financiadores, entes reguladores, e instituciones a las que pertenecen los CEI ­educativas, de salud o centros de investigación públicos y privados­, con metas asociadas a investigaciones, publicaciones y contratos para evaluación de proyectos. Si bien es cierto que hay compromiso institucional de respaldo a la independencia de los CEI, es necesario revisar cómo funciona en la realidad, cómo se relaciona con dilemas bioéticos, cómo se articula con los principios de respeto a la autonomía­individualidad, justicia­universalidad, no maleficencia­conservación y beneficencia­realización con la ética convergente y cuál es el concepto de expertos que han investigado sobre el particular. Conclusión: En la actualidad no es posible garantizar la independencia de los CEI, para lo que se deben definir medidas y estrategias adicionales que la fortalezcan.

The historical errors in medical research led the world to create research ethics committees in Health (REC), pluri and multidisciplinary organizations conformed by professionals with variate skills, specializations and forms of thinking, oriented to evaluate research projects and follow-up its develop, with independence, focused to guarantee subject's protection and the safety, and scientific integrity. This article reflects about committee's independence, supported on categories independence, freedom and autonomy, Beauchamp and Childress's bioethics principles, Maliandi and Thüer, applied to REC and related publications. Regarding the independence of the committees, it's important, and its related to REC members, researchers, sponsors, regulatory entities, and institutions to which the REC belong ­educational, health organizations and governmental and private research centers­, with goals associated with research, publications and contracts to project's assessments. While it is true there is institutional commitment to support the REC's independence, its necessary review how it really works, how its relate to bioethics dilemmas, how it's articulated with the principles of respect for the autonomy-individuality, justice-universality, non-maleficence-conservation and, beneficence-realization with the convergent ethics and the concept of experts who have researched about the subject. Conclusion: At present, it is not possible to guarantee the REC's independence, for these reasons, should be defined as additional measures and strategies to strengthen its independence.

Os erros históricos na pesquisa médica forçaram o mundo a criar Comitês de Ética em Pesquisa em Saúde (CEP), que são organizações multidisciplinares conformado por profissionais de variadas habilidades, especialidades e modos de pensar, cuja função é avaliar projetos de pesquisa, e sua execução, independentemente, para garantir a proteção dos participantes e a integridade científica. Este artigo reflete sobre a independência dos comitês, com base nas categorias independência, liberdade e autonomia nos princípios bioéticos de Beauchamp e Childress, de Maliandi e Thüer, aplicados ao CEP e publicações que abordaram o tema. Quanto à independência dos comitês, conclui-se a sua importância, relacionada aos membros do CEP, pesquisadores, financiadores, entidades reguladoras e instituições pertencentes ao CEP ­ centros de pesquisa educacionais, de saúde ou públicos e privados ­, com metas associadas pesquisas, publicações e contratos para avaliação de projetos. Embora seja verdade que existe um compromisso institucional real de apoiar a independência do CEP, é necessário rever a forma como funciona na realidade, no que se refere aos dilemas bioéticos, articulados com os princípios do respeito à autonomia-individualidade, justiça-universalidade, não-maleficência - conservação e beneficência-realização com convergência ética e com o conceito de especialistas que investigaram o assunto. Conclusão: Atualmente não é possível garantir a independência do CEP, para o qual devem ser definidas medidas e estratégias adicionais para fortalecer a independência das CEP.

Valoración de la influencia de un programa de acompañamiento directivo sobre la percepción y satisfacción laboral de docentes y directivos / Assessment the influence of a school administration accompanying programme to teachers as well as the impact both on the teachers and the school administrators expressed on their perception and job satisfaction levels

Resumen El objetivo de esta investigación es valorar el "Programa de desarrollo de habilidades de acompañamiento directivo" (PAD), analizando su influencia sobre (1) la percepción y satisfacción de los docentes y (2) la percepción de los directivos sobre su labor de acompañamiento y la satisfacción percibida en los docentes. Se aplicó un diseño cuasi-experimental. Participaron 12 directivos y 16 docentes de cuatro centros educativos de la Región del Bío-Bío, Chile. Se concluye que el PAD tiene un efecto de mejora en (1) la percepción y satisfacción de los docentes, y (2) en la percepción y satisfacción percibida por los directivos en los docentes, por los procesos de acompañamiento realizados. Las dimensiones del PAD que obtienen mayores puntuaciones son apoyo (en los docentes) y sistematicidad (en los directivos).

Abstract The main objective of this research is to validate "The board of directors accompaniment skills programme to teachers" (BAP), analysing its influence over (1) the perception and satisfaction among the teachers and (2) the perception the board of directors showed about their accompaniment work and the perceived satisfaction among the teachers. A quasi-experimental design was applied where twelve participants of four boards of directors coming from four schools of the 8th Region plus sixteen teachers participated. It is concluded that the BAP has an improvement effect over both the teachers' and the board of directors' perception and the satisfaction among the board of directors about the accompaniment process they perform. The dimensions that obtain major punctuations are a support (in the teachers) and systematicity (in the executives). The dimensions which get higher scores are support (given to the teachers) and organization (coming from the board of directors).

Gestão participativa nas políticas públicas no âmbito do Sistema Único de Saúde: principais componentes e desafios / Participatory management in public policies within the Health System: key components and challenges

Tendo como premissa o entendimento de que a participação social nas decisões do Estado é condição essencial para o exercício da saúde, o Movimento de Reforma Sanitária liderou um processo de constantes lutas pela redemocratização do país e das políticas de saúde. Como desdobramento, a participação social nas políticas de saúde tornou-se norma constitucional e fomentou a criação da Política Nacional de Gestão Estratégica e Participativa do SUS, entendendo os mecanismos de gestão participativa como estratégias transversais que possibilitam a formulação e a deliberação pelo conjunto de atores no processo de controle social. Foi realizada revisão bibliográfica da literatura sobre o tema da gestão participativa nas políticas de saúde, focalizando os componentes A Gestão Participativa e o Controle Social no SUS e A Ouvidoria do SUS, da ParticipaSUS. Para tanto, foram consultados artigos científicos, teses e dissertações nas bases de dados Scielo, Lilacs e Bireme. A gestão democrática e participativa em saúde engloba o adequado funcionamento dos mecanismos institucionalizados de participação social, ampliando a legitimidade das ações governamentais e fomentando a equidade e a transformação das ações em saúde. A ampliação da participação social em saúde enfrenta desafios que requerem proatividade do Estado e da Sociedade e a integração dos mesmos, com vistas a aprimorar e garantir a eficácia dos mecanismos de participação e promover a reorientação do modelo assistencial em saúde. Este trabalho objetiva analisar instrumentos de gestão participativa no âmbito do SUS, reconhecendo a importância da participação social neste processo e delineando os principais desafios à implementação de dois componentes da ParticipaSUS.

Having as premise the understanding that social participation in the decisions of the state is an essential condition for the exercise o health, the Health Reform Movement led a process of constant struggles for the democratization of the country and health policies. As a result, social participation in health policy has become a constitutional rule and fostered the creation of the National Policy for Strategic and Participatory Management of SUS, understanding the mechanisms of participatory management as cross-cutting strategies that enable the formulation and deliberation by the actors in the process of social control. A literature review of the literature on the topic of participatory management in health policy was conducted, focusing on the components Participatory Management and Social Control in the SUS and and the Ombudsman of the SUS, of ParticipaSUS. For this purpose, journal articles, theses and dissertations were consulted in the Scielo, Lilacs and Bireme databases. Democratic and participatory management in health encompasses the proper functioning of institutionalized mechanisms for social participation, increasing the legitimacy of governmental actions and promoting equity and the transformation of health actions. The expansion of social participation in health faces many challenges that require proactivity of the state and society and their integration in order to enhance and ensure the effectiveness of the mechanisms of participation and promote the reorientation of the health care model. This paper aims to analyze participatory management tools used within the SUS, recognizing the importance of social participation in this process and outlining the major challenges to implementation of the two components of ParticipaSUS.

Teniendo como premisa el entendimiento de que la participación social en las decisiones del Estado es condición esencial para el ejercicio de la salud en su concepción ampliada, el Movimiento de Reforma Sanitaria lidero un proceso de constantes luchas por la redemocratización del país y de las políticas de salud, se torno norma constitucional y fomentó la creación de la Política Nacional de Gestión Estratégica y Participativa de SUS, entendiendo los mecanismos de gestión participativa como estrategias transversales que posibilitan la formulación y deliberación por el conjunto de actores en el proceso de control social. Fue realizada una revisión bibliográfica de literatura sobre el tema de la gestión participativa en las políticas de salud, focalizando en los componentes "Gestión participativa y control social en el SUS? y "El Defensor del Pueblo SUS? de ParticipaSUS. Para esto, fueron consultados artículos, científicos, tesis y disertaciones en las bases de datos Scielo, Lilacs y Bireme. La gestión democrática y participativa en salud engloba el adecuado funcionamiento de los mecanismos institucionalizados de participación social, ampliando la legitimidad de las acciones gubernamentales y fomentando la equidad y la transformación de las acciones el salud. La expansión de la participación social en salud se enfrenta a muchos desafíos que requieren la proactividad del Estado y la sociedad y su integración con el fin de mejorar y garantizar la eficacia de los mecanismos de participación y promover la reorientación del modelo de atención de salud. Este trabajo tiene como objetivo analizar las herramientas de gestión participativos utilizados por el SUS, reconociendo la importancia de la participación social en este proceso y que describen los principales desafíos para la implementación de dos componentes de ParticipaSUS.

Nascedouro do Conselho Regional de Enfermagem de Santa Catarina (Década de 1970) / Birth of the Regional Nursing Council of Santa Catarina (1970s)

Estudo cujo objetivo foi analisar as circunstâncias de criação e instalação do Conselho Regional de Enfermagem em Santa Catarina. Pesquisa qualitativa, de cunho sócio-histórico, que utilizou análise de conteúdo para tratamento dos dados, emergindo duas categorias: O movimento para a criação do Conselho Regional de Enfermagem de Santa Catarina e Conjunturas de criação e instalação do Conselho Regional de Santa Catarina em 1975. A implantação do Conselho Profissional de Enfermagem seguiu as transformações sócio-históricas e políticas do trabalho em saúde no Brasil. As Lideranças da Associação Brasileira de Enfermagem atuaram garantindo certa autonomia profissional e poder sobre o seu trabalho, mesmo diante da fragilidade de entendimento da finalidade do órgão fiscalizador do fazer enfermagem pelos membros. O estudo possibilitou a compreensão dos nexos de influência do Conselho sobre a Enfermagem, institucionalizando a profissão com o registro de profissionais, regulamentando e disciplinando o exercício da profissão

The aim of this study was to analyze the circumstances of the creation and establishment of the Regional Nursing Council in the state of Santa Catarina. The research was qualitative and socio-historical, and used content analysis for data treatment. This resulted in two categories: the movement for the creation of the Regional Nursing Council of Santa Catarina and the circumstances surrounding the creation and establishment of the Regional Council of Santa Catarina in 1975. The creation of the Professional Nursing Council arose from the socio-historical and political transformations of health care work in Brazil. The leadership of the Brazilian Nursing Association ensured a certain professional autonomy and power over its work, even when confronted with the fragile understanding of the aims of an agency that supervised its members' nursing work. The study enabled the understanding of the nexuses of influence on the council of nursing, which institutionalized the profession with a registry of nurses, and which also regulated and disciplined the profession.

Cincuenta años de la Revista Cubana de Estomatología / Fifty years of the Cuban Journal of Dentistry

Introducción: el 30 de junio de 1964 apareció por primera vez la Revista Cubana de Estomatología, que constituyó un paso firme en la consolidación de la especialidad. Es una necesidad, para el mejoramiento de la cultura de los profesionales, conocer la historia de las ciencias médicas. La escasa bibliografía encontrada sobre el tema nos motivó a realizar este trabajo. Objetivo: aportar datos sobre la Revista Cubana de Estomatología. Método: se ejecutó una investigación de tipo histórico-documental, para recopilar datos sobre la Revista Cubana de Estomatología. Se realizó una revisión bibliográfica mediante la consulta a la base de datos SciELO Cuba y la base de datos de libros de autores cubanos de la Biblioteca Virtual de Salud, así como de las páginas web donde es visible la revista. Consideraciones finales: en estos cincuenta años la revista ha evolucionado y se ha nutrido de los beneficios de las nuevas tecnologías de la informática y las comunicaciones para mejorar su accesibilidad y visibilidad internacional. De frente a los nuevos tiempos esta publicación renueva su enfoque para mantenerse a la altura de las necesidades de nuestra profesión y de nuestros profesionales(AU)

Introduction: on June 30, 1964 the Cuban Journal of Dentistry first appeared which was a firm step in the consolidation of the studies. It is a necessity for the improvement of the professionals culture, knowing the history of medical science. The scarce literature on the subject found motivated us to do this paper. Objective: conduct a historical research on the Cuban Journal of Dentistry. Method: a historical documentary investigation was conducted to collect data on the Cuban Journal of Dentristy. A literature review was conducted by consulting SciELO Cuba database and the database on books by Cuban authors at the Virtual Health Library, as well as the web pages where this journal is visible. Final Considerations: during these fifty years, the journal has evolved and been nurtured by the benefits of new information technologies and communications to improve accessibility and international visibility. Facing new times, this publication renews its approach to keep pace with the needs of our profession and our professionals(AU)

Clinical trial : A Review.

Randomized clinical trials are scientific investigations that examine and evaluate the safety and efficacy of new drugs, devices, tests, or lifestyle interventions using human subjects. The results that these clinical trials generate are considered to be the most robust data in the era of evidence-based medicine. The primary aim of most clinical trials is to provide an unbiased evaluation of the merits of using one or more treatment options for a given disease or condition of interest. Ideally, clinical trials should be performed in a way that isolates the effect of treatment on the study outcome and provides results that are free from study bias.

Clinical Characteristics and Outcomes of Diverticulitis by Physician's Specialty

BACKGROUND/AIMS: Several factors affecting the severity and outcomes of diverticulitis have been reported, but there is little research on physician specialty related with this disease. Therefore, we evaluated the clinical characteristics and outcomes of diverticulitis depending on physician's specialty. METHODS: Medical records of 239 patients, who had been hospitalized with first-diagnosed acute colonic diverticulitis at Kyung Hee University Hospital in Gang Dong (Seoul, Korea) from June 2006 to December 2012, were retrospectively analyzed. The patients were classified according to whether they had been managed by gastroenterologists or not. Clinical characteristics and treatment outcomes were compared between two groups. RESULTS: Of these 239 patients, 38 (15.9%) patients were treated by a gastroenterologist and 201 (84.1%) patients by a non-gastroenterologist. Clinical characteristics such as age, gender, body mass index, comorbidity, medication, laboratory results, recurrence and complication were not significantly different between two groups. However, right-sided diverticulitis predominated in the non-gastroenterologist group (79% vs. 91%, P=0.028). From the sub-group analysis of uncomplicated diverticulitis, intravenous antibiotics was used for a shorter period of time by gastroenterologists than non-gastroenterologists (3.3+/-1.9 days vs. 4.4+/-2.8 days, P=0.032). Multivariate logistic regression analysis showed that the 3 day administration of intravenous antibiotics significantly depended on the physician's specialty (odds ratio 7.984, 95% confidence interval 1.990-32.043, P=0.003). CONCLUSIONS: The results suggest that the duration of intravenous antibiotics for treating uncomplicated colonic diverticulitis was shortened by gastroenterology specialists without increasing operation or recurrence.

Comparación de los comités de ética en la investigación de Buenos Aires y Conurbano Bonaerense / Comparação dos comitês de ética em pesquisa de Buenos Aires e Conurbano Bonaerense / Comparison Of Research Ethics Committees Of Buenos Aires And Its Suburbs

Los comités de ética en investigación (CEP) son fundamentales para la protección de los sujetos de investigación. Este trabajo tiene como objetivo conocer y comparar el funcionamiento y dificultades de los CEP que funcionan en instituciones de la Ciudad Autónoma de Buenos Aires (CABA) y el Conurbano Bonaerense. En este estudio, se realizó una encuesta semiestructurada a 38 comités. Los resultados se expresaron en porcentajes para las variables categóricas y mediana y rango intercuartílico 25-75 (RIC 25-75) para las continuas. Para la comprensión de los datos categóricos se utilizó el test de chi cuadrado o de Fisher y para la comparación de los datos cuantitativos, pruebas no paramétricas. Casi no se encontraron diferencias significativas entre los comités de CABA y del Conurbano, salvo en su conformación y cantidad de años de funcionamiento. Se encontraron dificultades por falta de tiempo, recursos y reconocimiento de las tareas del comité por parte de los investigadores y de las instituciones.

Os comitês de ética em pesquisa (CEP) são fundamentais para a proteção dos sujeitos de pesquisa. Este trabalho tem como objetivo conhecer e comparar o funcionamento e dificuldades dos CEP da Ciudad Autónoma de Buenos Aires (CABA) e do Conurbano Bonaerense. Neste estudo, se realizou uma enquete semi-estruturada a 38 comitês. Os resultados foram expressos em porcentagens para as variáveis categóricas e mediana e intervalo interquartil 25-75 (RIC 25-75) para as contínuas. Para a compreensão dos dados categóricos se utilizou o teste de qui quadrado ou do Fisher e para a comparação dos dados quantitativos, provas não paramétricas. Quase não foram encontradas diferenças entre os comitês da CABA e o Conurbano Bonaerense, exceto na sua conformação e quantidade de anos de funcionamento. Foram encontradas dificuldades por falta de tempo, recursos e reconhecimento das tarefas do comitê pelos pesquisadores e as instituições.

The Research Ethics Committees (CEPs) are core pillars for the protection of human beings as subjects of clinical research. The objective of this work was to be aware of the difficulties of CABA?s CEP (Ciudad Autónoma de Buneos Aires) and its suburbs, as well as to compare its operations. A semi-structured interview was conducted with 38 committees. Results were expressed in percentages for categorical and median variables, and in interquartile range of 25-75 (RIC 25-75) for continuous ones were used. We used Chi-square test or Fisher test in the comparison of categorical data, and for the quantitative ones non-parametric tests were used. No significant statistical differences were found between CEP of CABA and its suburbs, except for its conformation and operation age. Problems related to the lack of time, resources and recognition of the Committee?s tasks by researchers and institutions were found.

Institutional Review Boards and Bioethical Issues for Otologists and Audiologists

Otologists and audiologists care for patients and conduct clinical research to find more effective treatments that benefit patients. Institutional Review Board (IRB) permission is necessary for conducting clinical trials on humans. Furthermore, many bioethical conflicts are encountered while conducting research. However, few otologists and audiologists in Korea know bioethics and the principles and regulations of IRBs in detail. This paper reviews the history of ethics in clinical research and current bioethical principles and IRB regulations. We outline what you need as otologists or audiologists to get IRB approval while considering the principles of bioethics.

Resultado del examen de certifcación de médico pediatra de la Sociedad Argentina de Pediatría, años 2001-2010 / Performance on the Board of Pediatrics certifcation examination by the Sociedad Argentina de Pediatría, 2001-2010

Introducción. La certifcación de los profesionales garantiza su adecuado desempeño, pero el examen correspondiente debe ser periódicamente evaluado. Objetivo. Describir el resultado del examen de certifcación de médico pediatra (ECMP) de la Sociedad Argentina de Pediatría (SAP), analizando el impacto de edad y el tiempo desde la graduación de los inscriptos. Métodos. Se analizaron los examinados por el ECMP, valorando tasa de aprobación e institución formadora (2001-2010), y edad y años transcurridos desde la graduación (2001- 2005). Resultados. De 2527 profesionales pertenecientes a 138 instituciones, aprobó el 69,6%. Los aprobados presentaron edades (31,7 ± 4,1 contra 35,6 ± 6,2; p <0,0001) y años desde la graduación (6,3 ± 4,0 contra 9,0 ± 5,9; p <0,0001) menores que los desaprobados. La proporción de aprobados fue mayor en instituciones acreditadas por SAP por 5 años (78,4% contra 48,8%; OR= 3,8 IC95%= 3,1-4,7; p <0,001). Conclusión. Aprobaron el ECMP 69,6%. Los más jóvenes, con menos años de graduación y pertenecientes a programas acreditados por SAP, tuvieron mayor probabilidad de aprobar.

Introduction. Professional certifcation guarantees professional's performance, but the examination tool must be periodically evaluated. Objective. To describe the result of the pediatric certifying examination (PCE) of the Sociedad Argentina de Pediatría (SAP), between 2001-2010 analyzing the impact of the age and the elapsed time since the graduation and to describe the performance of training institutions in this period. Methods. Cross-section study. Data were ob-taind from the records of Board of Pediatrics of the SAP. The results of the PCE, were analyzed assessing examination pass rate and training institutions (2001-2010), and age and elapsed time since graduation of the examined professionals (2001-2005). Results. Of 2527 professionals from 138 institutions, 69.6% passed. Those that passed were younger (31.7 ± 4.1 vs. 35.6 ± 6.2 years; p <0.0001) and had less years since graduation (6.3 ± 4.0 vs. 9.0 ± 5.9; p <0.0001) than those who did not pass. The examination pass rate was higher in institutions accredited by SAP (78.4% vs. 48.8%; OR= 3,8 IC95%= 3,1-4,7; p <0.001). The pass rate was signifcantly higher in institutions with accredited programs for 5 years than those not accredited (78.4% vs. 48.8%, OR= 3.8 95% CI= 3.1 to 4.7, p <0.001). The pass rate at accredited institutions for 3 years (53.7%) and 1 year (48.7%) showed no statistically signifcant differences with non-accredited institutions. Conclusion. The certifying examination pass rate was 68.5%. Younger professionals with fewer years since graduation, and trained in SAP 5 years accredited programs were signifcantly more likely to pass the examination.

Condicionantes estruturais da regionalização na saúde: tipologia dos Colegiados de Gestão Regional / Structural conditions for regionalization in health care: typology of Regional Management Boards

O atraso na implementação da estratégia da regionalização e a fragilidade de iniciativas combinadas de descentralização e regionalização no Brasil requerem explicação. O artigo levanta algumas hipóteses para elucidar essa intricada questão e analisa os condicionantes estruturais do processo de regionalização em curso nos estados. Para isso, elabora uma tipologia nacional das regiões de saúde que as diferenciam segundo graus de desenvolvimento econômico, social e características da rede de saúde, dos municípios que compõem os Colegiados de Gestão Regional (CGR) formalmente implantados até janeiro de 2010. Para a construção da tipologia, adotaram-se os modelos de análise fatorial e de análise de agrupamentos (cluster analysis). Foram identificados cinco grandes grupos socioeconômicos de CGR, descritos de acordo com sua distribuição regional, população, despesa em saúde, perfil da oferta (incluindo mix público e privado) e cobertura de serviços de saúde. Os resultados encontrados servem como norteadores da constituição de redes de atenção à saúde e de novas iniciativas no campo regional, de forma a aprimorar a política de regionalização e favorecer a construção de instrumentos de regulação diversificados, flexíveis e, sobretudo, mais ajustados às realidades regionais.

An explanation is required for the delay in implementing the regionalization strategy and the fragile nature of the combined decentralization and regionalization initiatives in Brazil. The article raises some hypotheses to clarify this intricate issue and reviews the structural conditioning factors of the regionalization process ongoing in the states. A national typology of the health care regions is prepared, differentiating them according to the degree of socio-economic development and the characteristics of the health care network and of the municipalities that form the Regional Management Boards (CGR), formally implanted by January 2010. Factorial and cluster analysis models were used to build the typology. Five major socio-economic groups of CGRs were identified, described according to their regional distribution, population, health care spending, profile of services offered (including the public-private sector mix) and health service coverage. The results obtained serve as guidelines for the constitution of health care networks and new initiatives at the regional level, in order to improve the regionalization policy and favour the construction of diverse and flexible regulatory instruments that are more in tune with the regional state of affairs.

A inserção da regulamentação da profissão na área de Educação Física, dez anos depois: embates, debates e perspectivas / La inserción de la regulación de la profesión en el área de la educación física, diez años después: embates, debates y perspectivas / The insertion of the regulation of the profession in the area of physical education, ten years later: perspectives, strike and debates

Este texto discute alguns aspectos da regulamentação da profissão na área da Educação Física, seu desenvolvimento e a participação dos principais sujeitos políticos. Frente a um tema atual e polêmico, procura-se fazer uma apresentação objetiva e abrangente do seu desenvolvimento e ilustrar as posições e os argumentos dos sujeitos que participam do debate. Para tanto, inicia-se apresentando aspectos importantes da regulamentação das profissões, para depois elaborar uma análise da lei e resoluções do Conselho destacando: (a) o seu significado; (b) atribuições e competências; (c) o limite para a fiscalização e do poder de policia e (d) apontar as atividades típicas do profissional. A título de fechamento, descreve-se aspectos de uma polêmica bastante recente, a subordinação da dança, da yoga e das artes marciais ao Conselho Federal de Educação Física.

This text argues some questions controversies on the regulation of the profession. Our interest is to give a theoretical basement of a side, and to hear the citizens directly related on these controversies of another one. For this we first decide to clarify the initial aspects of the regulation of the professions, stops later making an analysis of the law and resolutions of the Advice presenting: (a) the meaning; (b) attributions and abilities; (c) the limit for the fiscalization and of the power of polices and (d) to point the typical activities of the professional. Concluded this part we will raise an controversial subject that appeared in these last five years: the subordination of the dance, yoga, martial arts to the Federal Advice of Physical Education.

Este texto discute las controversias sobre la regulación de la profesión. Nuestro interés es dar un suporte teórico de un lado, y oír a los ciudadanos relacionados directamente en estas controversias de otro. Para esto primero, decidimos clarificar los aspectos iniciales de la regulación de las profesiones, un análisis de la ley y de las resoluciones del consejo: (a) el significado; (b) atribuciones y capacidades; (c) el límite para el fiscalización y poder de policía y (d) señalar las actividades típicas del profesional. Después de esta parte levantaremos un tema polémico: la subordinación de la danza, yoga, artes marciales al Consejo Federal de la Educación Física.

Certificate Education for Geriatric Physician: Satisfaction and Feasibility / 예방의학회지

OBJECTIVES: Korea faces a number of challenges to meet demands in the area of geriatric professional medicine in a country with a rapidly ageing population. We evaluated the satisfaction and feasibility of the current education certification for geriatric physicians. METHODS: Geriatric physicians who were deemed qualified by the Korean Geriatrics Society during the period of 2001 to 2005 (n=2,200) were asked to complete structured questionnaires sent to them by mail about their satisfaction of and need for certificates of education, as well as their opinions on their geriatric specialty training. A total of 419 physicians responded. Descriptive analysis and hierarchical regression were performed to rate the respondents.satisfaction, the characteristics of the need for clarity and utility in education certification, and the characteristics of their patients. RESULTS: Although most respondents were satisfied with their education certification, those who had more elderly patients, aged 65 or older, and those who had more cognitively impaired patients, rated their education as significantly lower than did other physicians. Both groups expressed the need for more the comprehensive care and assessment concerning of their education. Multiple regression analysis indicated that satisfaction with geriatric physician qualification was associated with a physician's age, specialty, and percentage of elderly patients. CONCLSIONS: This study suggests that the current system of education certification is limited in terms of feasibility and physician satisfaction.

Research Ethics, Governance, Oversight And Public Interest

A better educated public has started to challenge the way decisions are made in medical research activities. Although Institutional and National Guidelines on Research are in place, there are fears that Institutional Review Boards (IRBs) and funding agencies are only fairly active in scientific and ethical reviews of research proposals but not on oversight of projects after their initiation. These issues are integral to good research governance and researchers and custodians of research ethics must ensure that public interest is not compromised. Medical progress is based on research including human experimentation carried out according to guiding principles as enunciated in the Declaration of Helsinki (2000), but the quality of compliance with the Declaration is an important issue. Better choice and appropriate training of members of IRBs to improve the quality of decision making and governance processes are urgently needed. Competency in evaluation of proposals requires not only the appropriate scientific knowledge but also access to relevant preclinical and other data. Unfortunately, the completeness and quality of such data may not be adequate. Public interest demands that injury to trial subjects in clinical trials is minimized if not avoided completely. Unfortunately this is not always possible with trials where novel biological modes of action are tested. A more robust evaluation mechanism for project approval may minimize but not completely avoid injury to subjects; thus insurance cover to provide care and compensation to subjects must be compulsory. The decision to approve or reject a project must be based on the balance of potential risks and benefits, taking into consideration justifiable distributive risks to target communities and populations. Economic considerations should never be the primary focus, especially when there are real concerns that the migration of early phase clinical trials including vaccine trials to developing countries is based on the perceived less stringent ethical requirements and oversight there.

Factors that Affect Accidents from Riding on Inline Skates and/or Kick Boards among Students in the Elementary Schools / 아동간호학회지

This study examines the factors that are associated with accidents from riding on inline skates and/or kick boards among students in the elementary schools. Data were collected from 902 students in 3 elementary schools in Seoul. Data were analyzed based on descriptive statistics and chi-square test. The results were as follows: 1.Thirty-eight percent of the students investigated were found to have kick boards while sixty-one percent of the students had inline skates. 2.The age of mothers who answered the questionnaires showed a statistically significant association with injuries of their children on inline skates and/or kick boards. Children whose mothers are younger had a lower percentage of injuries on inline skates and/or kick boards. 3. Children with a lower score on K-CBCL had a higher chance of having an accident from riding on inline skates and/or kick boards. That is, children with lack of attention were more likely to be involved in an accident. First-born children were less likely to have an accident. 4. While mothers' attitudes toward the safety of inline skates and kick boards appeared not to be associated with accidents of their children, their preventive actions for the safety related to riding on inline skates and kick boards reduced the chance to be involved in an accident of their children. In conclusion, this study shows that mothers with children going to the elementary schools should be more action-oriented to prevent their children's accidents from riding on inline skates and/or kick boards than merely recognizing the safety of inline skates and/or kick boards on their own. Implication of these findings and major findings of this study were discussed.