OBJECTIVES. The purposes of the study were to assess the potential impact of the North American Free Trade Agreement (NAFTA) on medical care in Mexico and to identify internal measures Mexico could take to increase the benefits and minimize the risks of free trade. METHODS. The dual nature of the health sector is examined; the Mexican, Canadian, and US health care systems are compared; and modes and consequences of international exchange of health services are analyzed. RESULTS. Four issues require immediate attention: accreditation of health care facilities, licensing and certification of professionals, technology assessment, and financial equity. CONCLUSIONS. NAFTA offers opportunities for positive developments in Mexico, provided risks can be anticipated and preventive measures can be taken to avoid negative impacts on the health system. Medical services, like other elements of the Mexican economy, must be modernized to respond to the demands of global competition. The Mexican National Academy of Medicine has recommended to the Mexican government (1) internal strengthening of the Mexican health care system to improve its ability to respond to the new conditions created by NAFTA and (2) a gradual process to facilitate equitable and mutually beneficial interactions among the three countries.
This chapter provides a view of e-learning from the perspective of ecological systems with nested levels of structure, organizing principles, and emergent properties for use in accomplishing at least three goals: to evaluate emergent patterns in the development of e-learning; to assess current threats and enablers at any level; and to plan for successful growth within determinate niches. E-learning is structured into four levels: the International/National level; the Institutional level; the Class/Community level; and the Learning Object level. Within each level, and between them, there are organizing principles of integration and differentiation contributing to their stability or decay. Those that the authors have identified include: transactional distance in delivery of learning; industrialization of learning functions; functional equivalence of learning experiences; virtualization of knowledge; technological convergence of learning media; developmental growth of learning systems; and requisite variety in learning strategies. For administrators, practitioners, and faculty whose institutions have an identity within the ecology, the authors introduce the GEMS process to better control the Goals, Engagement, Management and Support of system elements between and across their levels of e-learning structures. Both the broad ecological view upon e-learning -and the specific tools of GEMS useful within it- are applied to existing structures in e-learning, such as open courseware and course management systems, and to e-learning innovations, such as mobile learning, meta-worlds, and virtual gaming.
resumoDentro de uma abordagem de sistemas, o autor analisa as perspectivas de internalização de programas e cursos brasileiros de E-Learning para públicos de todo o mundo. O país construiu uma grande variedade de programas de educação a distância desde as primeiras décadas do século XX até hoje e no início do século XXI ingressou na Geração E-Learning, na qual atualmente e conta com milhões de usuários. Ele conceitua o E-Learning como um ecossistema mundial, descrevendo suas principais características. Em seguida, define as principais estratégias e etapas de um roteiro para expansão do E-learning brasileiro no ensino superior no domínio da língua portuguesa. Ele recomenda um foco inicial na diáspora brasileira nos Estados Unidos e no Canadá. palavras-chave: E-Learning. Educação de Adultos. Brasil. aBstract IntErnatIonalIzatIon of E-lEarnIng for adults In BrazIlWithin a systems approach, the author analyzes perspectives for internalization of Brazilian E-Learning programs and courses to audiences around the world. The country has built a great variety of programs of distance education since early decades of XX Century to date and at the start of XXI Century had entered the E-Learning Generation, in which currently has millions of users. He conceptualizes E-Learning as a world-wide ecosystem, describing its major characteristics. then, defines major strategies and steps of a roadmap for expansion of Brazilian E-Learning at higher education level in the realm of Portuguese language. He recommends an initial focus on the Brazilian diaspora in the united states and Canada.
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