Changes in medicine course curricula in Brazil encouraged by the Program for the Promotion of Medical School Curricula (PROMED)

<p>Abstract</p> <p>Background</p> <p>The Program for the Promotion of Changes in Medical School Curricula (PROMED) was developed by the Brazilian Ministries of Health and Education. The objective of this program was to finance the implementation of changes to the curricula of medical schools directed towards the Brazilian national healthcare system (SUS). This paper reports research carried out together with the coordinators responsible for the PROMED of each medical school approved, in which interviews were used to evaluate whether this financial support succeeded in stimulating changes. The aim of this study was to evaluate the impact of this program three years after implementation in the universities that received funding.</p> <p>Methods</p> <p>The 19 course coordinators of the medical schools in which the PROMED project was implemented were interviewed using a questionnaire containing 12 questions for qualitative analysis. This paper focuses partially on the reports of the results of this qualitative analysis. Laurence Bardin's.</p> <p>Results</p> <p>The universities interviewed were found to have some common concerns: the decoupling of basic and professional training difficulties in achieving proximity to the network of services; insufficient funding; and the emphasis of most teachers being on teaching hospitals and specialization. These findings indicate that the direction of curriculum reform (PROMED) is toward providing a targeted training for this system.</p> <p>Conclusion</p> <p>The interviewees were aware that this program would trigger future changes in all aspects of healthcare and represents an ongoing challenge to the academic field. PROMED provided the momentum for change in the nature of medical training in Brazil and was seen as powerful enough to override other processes and as a basis for guidance regarding the methodology, pedagogical approach and scenarios of practical experience.</p

O cuidado na atenção primária à saúde: preliminares de um estudo comparativo Brasil/Canadá

O texto aborda os processos de constituição e institucionalização da Atenção Primária à Saúde no Brasil e no Canadá; os pontos de interseção e de distanciamento entre os dois países; e a inserção profissional dos fisioterapeutas brasileiros e canadenses nas equipes multidisciplinares. A primeira parte deste estudo focaliza a atenção primária no Brasil, os caminhos e estratégias de reorientação do modelo assistencial e o papel que coube nesse modelo, de modo crescente, ao fisioterapeuta. Após situar o contexto nacional, o tópico seguinte trata da atenção primária à saúde no Canadá e da atuação deste profissional nas equipes primárias de saúde. No exercício absolutamente preliminar de contrastar as duas experiências nacionais, a brasileira e a canadense, foi utilizada a literatura nacional e estrangeira sobre a temática central, além de documentos e discussion papers. O texto procurou chamar a atenção para a necessidade e importância da participação de fisioterapeutas nas equipes multiprofissionais e as diferenças na atuação deste profissional tanto no Brasil quanto no Canadá. Desnecessário acrescentar que os autores intentaram não uma "análise" comparativa, mas, sim, uma breve exposição sobre constrastes e semelhanças nos rumos da atenção primária, ao longo da história mais recente desses dois países

Historical Sources of Institutional Trajectories in Economic Development: China, Japan, and Korea Compared

This essay provides a game-theoretic, endogenous view of institutions, and then applies the idea to identify the sources of institutional trajectories of economic development in China, Japan, and Korea. It stylizes the Malthusian-phase of East Asian economies as peasant-based economies in which small families allocated their working time between farming on small plots - leased or owned - and handcrafting for personal consumption and markets. It then compares institutional arrangements across these economies that sustained otherwise similar economies. It characterizes the varied nature of the political states of Qing China, Tokugawa Japan, and Yi Korea by focusing on the way in which agricultural taxes were enforced. It also identifies different patterns of social norms of trust that were institutional complements to, or substitutes for, political states. Finally, it traces the path-dependent transformations of these state-norm combinations along subsequent transitions to post-Malthusian phases of economic growth in the respective economies

The process of building up regional health management in the State of São Paulo: subsidies for analysis

Este artigo apresenta os resultados gerais da pesquisa sobre o processo de construção da gestão regional no estado de São Paulo, durante a discussão do COAP/redes de atenção, com o intuito de fornecer subsídios para a compreensão deste processo de pactuação regional da saúde, com enfoque nas regiões de saúde de Bauru, Baixada Santista, Grande ABC e Vale do Ribeira, no estado de São Paulo. Além dos resultados apresentados sobre as regiões de saúde estudadas, a metodologia utilizada no desenvolvimento da construção dos perfis das regiões constitui em si uma proposta metodológica de análise de perfis regionais de saúde. A primeira parte do artigo apresenta a metodologia geral adotada para a análise das regiões de saúde; a segunda, abrange os resultados e a discussão da pesquisa, organizados em dois itens. O primeiro destes itens refere-se à análise dos perfis das cinco regiões de saúde pesquisadas no Estado. O segundo, analisa os principais aspectos do processo de pactuação regional da saúde em São Paulo, destacando potencialidades e limites, a partir de entrevistas realizadas com gestores municipais e apoiadores do Conselho de Secretários Municipais de Saúde de São Paulo dessas regiões.This article presents the main results of the survey on the regional management building process in the State of São Paulo, during the discussion of the COAP / Care Networks, in order to provide a basis for understanding this process of regional health pact, focusing on the metropolitan areas of Bauru, Santos, Grande ABC and the Ribeira Valley. In addition to the results presented on the health regions studied, the methodology used in the development of the construction of profiles of the regions is itself a proposal for a methodology of analyzing regional health profiles. The first section presents the general methodology for analyzing health regions. The second part covers the results and discussion of the research, organized into two items. The first refers to the analysis of the profiles of the five São Paulo health regions surveyed. The second item analyzes the main aspects of the process of regional health pact in São Paulo, highlighting strengths and limitations, based on interviews with municipal managers and supporters of the Council of Municipal Health Secretaries of São Paulo in these regions