Postgraduate medical education in Colombia. Proposals to improve it

After 70 years of the formalization of medical specialties in Colombia, very little progress has been made in the educational models for the acquisition of clinical competencies in these postgraduate programs. Furthermore, although there is already a law on human resources in health, the Colombian medical education system lacks specific regulations on the training of health professionals (physicians) in the different medical specialty programs offered in the country. Likewise, at present, factors such as the financial crisis of public hospitals, the limited number of accredited hospitals and the growing number of medical schools and specialization programs, affect the comprehensive and equal development of medical competencies of professionals who are trained as specialists in the different postgraduate medical programs offered in Colombia. In view of the above, the purpose of this article is to present a proposal for postgraduate medical education that prioritizes the adequate acquisition of competencies over compliance with the time required to complete the curricula of the different medical specialties. However, this involves several prerequisites: a regulatory body in charge of overseeing and monitoring the training of medical residents or specialists in the country; strong training in university teaching for professors practicing in medical schools and university hospitals; the standardization of the graduates profile; adequate financing of university hospitals, as well as appropriate support in the process of accreditation as such, and the self-evaluation and continuous improvement of postgraduate medical programs.

Después de 70 años de la formalización de las especialidades médicas en Colombia, ha habido muy pocos avances en los modelos educativos para la adquisición de competencias clínicas en estos programas de posgrado. Además, a pesar de que ya hay una ley sobre el talento humano en salud, en el sistema educativo médico colombiano no hay regulaciones específicas sobre la formación de profesionales de la salud (médicos) en los diferentes programas de especialidades médicas ofrecidos en el país. Igualmente, en la actualidad factores como la crisis financiera de los hospitales públicos, el escaso número de hospitales acreditados y el creciente número de facultades de medicina y de programas de especialización afectan la adquisición integral e igualitaria de competencias médicas de los profesionales que se forman como especialistas en los diferentes programas de posgrado médico ofrecidos en Colombia. Teniendo en cuenta lo anterior, el propósito de este artículo es presentar una propuesta de educación médica de posgrado que priorice la adecuada adquisición de competencias por encima del cumplimiento del tiempo fijado para completar los planes de estudios de las diferentes especialidades médicas. Sin embargo, para esto se requieren varios aspectos: un ente regulatorio encargado de vigilar y monitorear la formación de los residentes o especialistas médicos en el país; una fuerte capacitación en docencia universitaria a los profesores que ejercen en las facultades de medicina y hospitales universitarios; la homogenización del perfil de los egresados; una adecuada financiación de los hospitales universitarios, así como un apropiado acompañamiento en su proceso de acreditación como tal, y la autoevaluación y mejoramiento continuo de los posgrados médicos.

Impact of Training Programs on Awareness and Practice of Lifestyle Modifications among Hypertensive Patients Attending Outpatient Clinic of the University College Hospital, Ibadan, Nigeria

Aim: This study sought to investigate the impact of training programs on hypertensive patients' awareness and practice of lifestyle modifications in out-patient clinics of the University College Hospital (UCH) Ibadan, Nigeria. Methodology: The study design was a cross-sectional survey conducted at the out-patient clinics of the University College Hospital (UCH), Ibadan, Nigeria. This setting was chosen due to the accessibility of hypertensive patients receiving regular care and follow-up. The sample size comprised 274 hypertensive patients attending the out-patient clinics for regular hypertension management. A simple random sampling method was employed to select study participants, ensuring a fair representation of the target population. A structured questionnaire was used to collect data from the participants and results were analysed using SPSS. Results: Findings indicate that the training programs greatly increased awareness of hypertension and lifestyle factors affecting hypertension for most participants (74.42%), with all participants recommending the programs. A significant majority of participants (95.74%) reported being on hypertension medication, while nearly all (99.22%) had received some form of training or counselling on lifestyle modification for hypertension management. Notably, all participants reported having made lifestyle changes following the training programs, with the majority rating the effectiveness of the programs as highly effective (57.36%). Further analysis indicated a statistically significant relationship between the effectiveness of the training programs and the participants' age, sex, educational level, and occupation. The most frequent lifestyle modification post-training was dietary changes, with 54.65% of participants reporting that they always engage in a healthy diet for hypertension management. However, the frequency of engagement in other lifestyle modifications, such as regular physical activity and weight management, was not as high. The majority of participants reported significant improvements in hypertension symptoms following the lifestyle modifications. Conclusion: These findings demonstrate that targeted training programs can significantly enhance hypertensive patients' awareness and practice of beneficial lifestyle modifications, thus improving health outcomes. Further, the study underscores the need for such training programs to be tailored according to the age, sex, educational level, and occupation of the patients to maximize their impact.

Global health postgraduate educational programs profile: a scoping review / Perfil dos programas educacionais de pós-graduação em saúde global: uma revisão de escopo

Abstract This study aimed to describe a set of global health postgraduate programs profile, emphasizing the importance of promoting education and training in this field to meet global health challenges and ameliorate health outcomes. The present review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist and the Scoping Review Methods Manual proposed by the Joanna Briggs Institute. Eligibility criteria were a set of lato sensu or stricto sensu postgraduate educational programs of global health or lato sensu or stricto sensu postgraduate programs of public health that present a global health concentration area. The search yielded 707 studies: MEDLINE/PubMed, Web of Science, and LILACS. A total of 441 studies and their authors' institutional affiliations were analyzed and 101 institutions that offer educational programs were identified. Most postgraduate programs in Global Health or Public health with a concentration area in Global health are master's degrees, and many of them are taught online. The majority of educational programs are offered by institutions in Europe and North America.

Resumo Este estudo teve como objetivo descrever o perfil de um conjunto de programas de pós-graduação em saúde global, enfatizando a importância de promover educação e treinamento neste campo para enfrentar os desafios de saúde internacional e melhorar os desfechos de saúde. A presente revisão está de acordo com a lista de verificação Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR) e com o manual para revisões de escopo proposto pelo Joanna Briggs Institute. Os critérios de elegibilidade abarcaram um conjunto de programas de pós-graduação lato sensu ou stricto sensu em saúde global ou programas de pós-graduação lato sensu ou stricto sensu em saúde pública que apresentaram uma área de concentração em saúde global. A busca resultou em 707 estudos: Medline/PubMed, Web of Science e LILACS. Foram analisados 441 estudos e as filiações institucionais de seus autores, e foram identificadas 101 instituições que oferecem esses programas educacionais. A maioria dos programas de pós-graduação em saúde global ou saúde pública com área de concentração em saúde global são mestrados, e muitos deles são ministrados online. A maioria destes programas educacionais é oferecida por instituições na Europa e na América do Norte.

Análisis de la producción y redes de colaboración en los programas de doctorado en psicología en Colombia / Analysis of production and collaboration networks in doctoral programs in psychology in Colombia

Resumen El objetivo de la formación doctoral es la generación y difusión de nuevo conocimiento, sin embargo, no es claro cómo los programas de doctorado en Colombia se relacionan con este tipo de producción académica. A partir de ello, en el presente estudio se presenta el panorama general de la producción académica a través de las instituciones de educación superior colombianas que ofertan programas de formación doctoral en psicología. La producción académica se obtuvo de la base de datos Scopus en una muestra de 13 universidades. Tras una búsqueda inicial, se encontraron 1345 documentos, con los cuales se realizó un análisis de los indicadores de productividad y de las redes de colaboración al interior de la disciplina en el país. Posteriormente, esta información se contrastó con la información nacional registrada en el sistema de Curriculum Vitae Latinoamericano y del Caribe (CvLAC) de 193 profesores asociados a las universidades que ofertan los programas de doctorado. Al comparar la producción académica nacional e internacional, se encontró una mayor correlación entre la dirección de tesis de posgrado y la publicación en revistas nacionales. Por lo tanto, se puede afirmar que el impacto de la formación doctoral en la generación de nuevo conocimiento es relativo y tiene un alcance limitado, siendo principalmente las revistas nacionales el medio de difusión de este conocimiento. Se recomienda evaluar el impacto de los productos asociados a la formación posgradual y la visibilidad internacional, con énfasis en las revistas indexadas en bases de datos internacionales.

Abstract The objective of doctoral training is the generation and dissemination of new knowledge; however, it is not clear how doctoral programs in Colombia relate to this type of production. Based on this, this study presents the general panorama of academic production across Colombian higher education institutions that offer doctoral training programs in psychology. The academic production was obtained from the Scopus database in a sample of 13 universities. After this search, 1345 documents were found with which an analysis was made regarding productivity indicators and the collaboration networks within the discipline in the country were identified. Subsequently, this information was contrasted with the national information registered in the Latin American and Caribbean Curriculum Vitae system (CvLAC) of 193 professors associated with the universities offering doctoral programs. As a result, when comparing national and international academic production, a greater correlation is found between the supervision of graduate theses and publication in national journals. In this sense, it is found that the impact of doctoral training on the generation of new knowledge is relative and has a limited scope, being mainly national journals the means of dissemination of this knowledge. It is recommended to evaluate the impact of products associated with postgraduate training and international visibility, with emphasis on indexed journals in international databases.

Negacionismo endógeno no jogo acadêmico da Educação Física / Endogenous denialism in the academic game of the Physical Education field / El negacionismo endógeno en el juego académico de la Educación Física

Neste ensaio, desenvolvo o conceito de negacionismo endógeno, um tipo específico de negacionismo científico cultivado dentro do campo acadêmico, que busca deslegitimar pesquisas qualitativas das Humanidades. O texto tem três seções. Na primeira, trato das características do negacionismo vulgar a partir de breve retrospectiva histórica, e destaco as táticas de supressão de termos científicos em prol do controle da narrativa política. Na segunda, discuto casos de fraude acadêmica praticadas contra revistas das Ciências Sociais e Humanas como estratégia intencional de desacreditação da área, e analiso a abjeção ao termo "práticas corporais" como um rastro do negacionismo endógeno no léxico da Educação Física. Na terceira, reflito sobre a relevância da formação editorial em programas de pós-graduação no combate a preconceitos entre áreas do conhecimento. Em conclusão, defendo a desconstrução da retórica da ignorância, mola propulsora de negacionismos de toda ordem, como forma de preservação da pluralidade epistêmica na Educação Física.

In this essay, I develop the concept of endogenous denialism, a specific type of scientific denialism cultivated within the academic field, which aims at delegitimizing the validity of qualitative research in the humanities. The text has three sections. In the first section, I deal with the characteristics of vulgar denialism from a brief historical retrospective, and I highlight the tactics of suppressing scientific terms in favor of the control of the political narrative. In the second section, I discuss cases of academic hoaxes played against Social Sciences and Humanities journals as an intentional strategy to discredit the area and analyze the abjection of the term "physical culture" as a trace of endogenous denialism in the lexicon of physical education field. In the third section, I reflect on the relevance of editorial training in graduate programs to confront prejudice between knowledge areas. In conclusion, I defend the deconstruction of the rhetoric of ignorance, the driving force of all kinds of denialism, as a way of preserving epistemic plurality in the physical education field.

En este ensayo, desarrollo el concepto de negacionismo endógeno; un tipo específico de negacionismo científico cultivado dentro del campo académico, que busca deslegitimar la validez de la investigación cualitativa en las humanidades. El texto tiene tres secciones; en la primera, trato las características del negacionismo vulgar a partir de una breve retrospectiva histórica, y destaco las tácticas de supresión de términos científicos en pro del control de la narrativa política. En la segunda, discuto casos de fraude académico contra revistas de Ciencias Sociales y Humanas como una estrategia intencional de desprestigio del área, y analizo la abyección del término "prácticas corporales" como rastro de un negacionismo endógeno en el léxico de la Educación Física. En la tercera, reflexiono sobre la relevancia de la formación editorial en los programas de posgrado para combatir los prejuicios entre áreas de conocimiento. En conclusión, defiendo la deconstrucción de la retórica de la ignorancia, energía propulsora de todo tipo de negacionismo, como forma de preservar la pluralidad epistémica en la Educación Física.

Innovative approaches to laboratory management for medical undergraduates under "Innovation and Entrepreneurship Training Programs for Undergraduates" / 中华医学教育探索杂志

The Laboratory of Pulmonary Diseases at West China Hospital in Sichuan University starts with strengthening the laboratory safety education and research integrity, develops a special individualized experimental skill training, improves communication between project team and laboratory, and promotes the cooperation between the laboratory and university academic community. Combined with the new model of project hierarchical management, the "Innovation and Enterpreneurship Training Programs for Undergraduates" are dynamically evaluated and effectively supervised. With the implementation of the new management mode, the number of projects successfully obtained has increased by 16.7%, the number of published academic papers has increased by 6.5 times, and the quality of published papers has been also significantly improved.

AUTONOMIC, CARDIOVASCULAR & PHYSIOLOGICAL RESPONSES IN STRENGTH TRAINING PROTOCOLS / Respostas autonômicas, cardiovasculares e fisiológicas em protocolos de treinamento de força / Respuestas autonómicas, cardiovasculares y fisiológicas en protocolos de entrenamiento de fuerza

ABSTRACT Introduction Strength training is a recurrent practice among several publics and the topic of several studies, yet there is a shortage of previous studies that analyzed these parameters in the same subjects in training sessions involving volume, interval and different repetitions maximum ranges. Objective The study was aimed at measuring and comparing the acute effect of different ST (strength training) protocols on HR (heart rate), HRV (heart rate variability), [LAC] (lactate concentration), [CK] (creatine kinase) and SPE (subjective perceived exertion). Methods Eleven individuals with previous experience were recruited and in three sessions they performed three different training models, namely: high load (4 sets at 90% of 1RM, 180s rest between sets), medium load (3 sets at 75% of 1 RM, 90s rest between sets), and low load (2 sets at 50% of 1 RM, 45s rest between sets) in free squat, bench press, deadlift and bent-over row exercises. Results There was no difference in CK between low load (resistance) and medium load (hypertrophy) (p = 0.60), between resistance and high load (strength) (p = 0.84), and between hypertrophy and strength (p = 0.91), while there was higher lactate accumulation in training with medium and low loads in comparison to training with high loads (p <0.001). Conclusion It can be noted that workouts with high loads, few repetitions and longer intervals (maximum strength) generate lower blood lactate concentrations and SPE values when compared to training with lower loads and shorter intervals (resistance training and hypertrophy). Additionally, when evaluating autonomic and cardiovascular variables, it would appear that manipulating the percentage of 1RM and the interval time does not generate significant changes in HRV, blood pressure (BP) and HR when the repetitions are executed until failure. Level of evidence II; Prospective comparative study.

RESUMO Introdução O treinamento de força é prática recorrente entre diversos públicos e alvo de diversos estudos, contudo há escassez de estudos prévios que analisaram esses parâmetros nos mesmos indivíduos em sessões de treino envolvendo volume, intervalo e faixas distintas de repetições máximas. Objetivo Mensurar e comparar o efeito agudo de diferentes protocolos de TF (treino de força) sobre a FC (frequência cardíaca), VFC (variabilidade da frequência cardíaca), [LAC] (concentração de lactato), [CK] (creatina quinase) e PSE (percepção subjetiva de esforço). Métodos Foram selecionados 11 indivíduos com experiência prévia e, em três sessões, os mesmos realizaram três diferentes modelos de treino, isto é: carga alta (4 séries a 90% de 1RM, 180s de descanso entre séries), carga média (3 séries a 75% de 1 RM, 90s de descanso entre séries) e carga baixa (2 séries a 50% de 1 RM, 45s de descanso entre séries) em exercícios de agachamento livre, supino reto, levantamento terra e remada curva. Resultados Não houve diferença da CK entre a carga baixa (resistência) e a carga média (hipertrofia) (p=0,60), entre resistência e carga alta (força) (p=0,84) e entre hipertrofia e força (p=0,91) e houve maior acúmulo de lactato nos treinos com carga média e baixa em relação ao treino com cargas altas (p<0,001). Conclusão Observa-se que os treinos com cargas altas, poucas repetições e intervalos mais longos (força máxima) geram concentrações de lactato sanguíneo e PSE menores quando comparados aos treinos que utilizam cargas mais baixas e intervalos mais curtos (treinos de resistência e hipertrofia). Adicionalmente, quando avaliadas as variáveis autonômicas e cardiovasculares, parece que manipular o percentual de 1RM e o tempo de intervalo não é capaz de gerar alterações significativas na VFC, pressão arterial (PA) e FC quando as repetições são executadas até a falha. Nível de evidência II; Estudo prospectivo comparativo.

RESUMEN Introducción El entrenamiento de fuerza es práctica recurrente entre diversos públicos y objetivo de diversos estudios. Sin embargo, hay escasez de estudios previos que analizaron esos parámetros en los mismos individuos en sesiones de entrenamiento abarcando volumen, intervalo y franjas distintas de repeticiones máximas. Objetivo Medir y comparar el efecto agudo de diferentes protocolos de EF (entrenamiento de fuerza) sobre la FC (frecuencia cardíaca), VFC (variabilidad de la frecuencia cardíaca), [LAC] (concentración de lactato), [CK] (creatina quinasa) y PSE (percepción subjetiva de esfuerzo). Métodos Fueron seleccionados 11 individuos con experiencia previa y, en tres sesiones, los mismos realizaron tres modelos de entrenamiento, a saber: carga alta (4 series a 90% de 1RM, 180s de descanso entre series), carga mediana (3 series a 75% 1RM, 90s de descanso entre series), y carga baja (2 series a 50% de 1RM, 45s de descanso entre series) en los ejercicios de agachamiento libre, supino recto, levantamiento tierra y remada curva. Resultados No hubo diferencias de la CK entre la carga baja (resistencia) y la carga mediana (hipertrofia) (p = 0,60) entre resistencia y carga alta (fuerza) (p = 0,84) y entre hipertrofia y fuerza (p = 0,91) y hubo mayor acumulación de lactato en los entrenamientos con carga mediana y baja con relación al entrenamiento con cargas altas (p <0,001). Conclusión Se observa que los entrenamientos con cargas altas, pocas repeticiones e intervalos más largos (fuerza máxima) generan concentraciones de lactato sanguíneo y PSE menores cuando comparados a los entrenamientos que utilizan cargas más bajas e intervalos más cortos (entrenamientos de resistencia e hipertrofia). Además, cuando evaluadas las variables autonómicas y cardiovasculares, parece que manipular el porcentaje de 1RM y el tiempo de intervalo no es capaz de generar alteraciones significativas en la VFC, presión arterial (PA) y FC cuando las repeticiones son ejecutadas hasta la falla. Nivel de evidencia II; Estudio prospectivo comparativo.

Programas de fortalecimiento de prácticas parentales: un aporte a la prevención de conductas externalizantes en preescolares / Training programs in parental skills: a contribution to the prevention of the development of externalizing behaviors in preschool children

Resumen: La presencia de conductas externalizantes en la infancia tiene importantes grados de continuidad temporal futura, y es un factor de riesgo de fracaso y abandono escolar, de conductas delictuales, abuso y dependencia de sustancias, de conductas suicidas y de otros trastornos psicopatológicos del desarrollo. En esta revisión se analizan los principales aspectos relacionados con los programas de fortalecimiento de prácticas parentales como dispositivos útiles en el marco de estrategias multicomponentes de trabajo preventivo. La evidencia ha demostrado que la intervención dirigida a madres y padres es crucial en la modificación de problemas de conducta en niños/as, siendo el entrenamiento en habilidades parentales una de las estrategias mejor estudiadas y consideradas de mayor calidad al momento de prevenir el desarrollo de conductas externalizantes.

Abstract: The presence of externalizing behaviors in childhood has significant degrees of future self-continuity and is a risk factor for school failure and drop-out, criminal behavior, substance abuse and depen dence, suicidal behaviors and other developmental psychopathological disorders. In this review, the main aspects related to parental practices strengthening programs are analyzed as useful instruments in the context of multi-component preventive work strategies. The evidence has shown that interven tion aimed at mothers and fathers is crucial in the modification of behavioral problems in children, where training in parental skills is one of the most studied strategies and considered of higher quality when preventing the development of externalizing behaviors.

Spectrum of CNS infections in the Philippines

@#The CNS Infection Censuses for 2011 and 2012 from 9 neurology training programs in 7 institutions in the Philippines were collated to determine the types of CNS infections seen in the country and their relative frequencies. A comparison with a similar survey done in 1999 was made. A total of 1629 cases of CNS infections were recorded. There were 23 categories. Bacterial meningitis (34.3%) and TB meningitis (30.7%) were the top two infections, constituting more than half of all CNS infections seen. When the adult and pediatric census were separated, TB meningitis came up to be the most common infection in adults (43%) with bacterial meningitis a poor second at 19.4%. The reverse is seen in the pediatric population – bacterial meningitis (41.7%) vs. TB meningitis (24.6%). Cryptococcal meningitis was more frequent in the adult census (8.1%) compared with the pediatric census (0.1%). These patterns were seen in a similar census done in 1999. A significant increase in relative frequency in cryptococcal cases was seen in the later census (2.8% vs. 2.0%), the increase being due to the marked increase in the adult group (8.1% vs. 4.3%), probably due to the upward trend in the incidence of HIV cases in the country. No increase in this category was seen in the pediatric population. The benefits of collaboration among institutions in coming up with a large number of cases of CNS infections and a greater variety to study was highlighted. The study was conducted by the CNS Infection Council of the Philippine Neurological Association.

Foreign Systems of Education for Gastrointestinal Fellows / 대한소화기학회지

There is a growing interest in gastroenterology and hepatology fellowship training in Korea and other countries. The Korean Society of Gastroenterology held an international symposium for gastroenterology and hepatology fellowship training, titled, “GI Fellow Training in Asia-Pacific Countries” on April 14, 2018. The Japanese education system was different for each hospital. The American societies for gastroenterology set up their education system together and have continued with frequent modification. The Taiwan and Singapore education systems are well organized and localized. We need a well-organized and sustainable education system for gastroenterology and hepatology fellowship training suitable for Korea.

Revisión sistemática sobre los programas de Entrenamiento Socioemocional para niños y adolescentes de 6 a 18 años publicados entre 2011 y 2015 / Systematic Review of Social-Emotional Training Programs For Children and Adolescents

Resumen En las últimas décadas ha aumentado el número de publicaciones sobre programas de entrenamiento socioemocional y se consideran como factores protectores que facilitan la adaptación de la persona al contexto y favorecen un mejor afrontamiento ante diferentes situaciones de la vida, así como ante situaciones de estrés. El objetivo del presente trabajo fue realizar una revisión sistemática de programas de entrenamiento socioemocional realizados en niños y adolescentes con el fin de seleccionar los más apropiados. El proceso de búsqueda se efectuó a partir de las bases de datos: PsycInfo, MedLine, ERIC, Red de Revistas Científicas de América Latina y El Caribe, Scielo, PUBMED, con palabras claves en inglés y español. Los resultados muestran que, de los 19 artículos que fueron seleccionados por cumplir con los criterios, se identificaron 17 programas de entrenamiento, la mayoría realizados en España y en el período 2011-2015. Los objetivos fueron, en mayor medida, destinados a entrenar la inteligencia emocional, seguido por los entrenamientos mixtos y en menor medida los destinados a entrenar las habilidades sociales. Se identificaron las técnicas empleadas en estos programas, la duración promedio de las intervenciones, la modalidad de aplicación, los administradores y los destinatarios. Por último, del total de los estudios analizados, la mayoría evidencia efectividad del entrenamiento para algunas de las variables analizadas. La evidencia presentada puede ser de utilidad para investigadores y profesionales del área de la salud y la educación que trabajen con niños y adolescentes.

Abstract: In recent decades the number of publications on social-emotional training programs has increased, achieving consideration as protective factors that facilitate the adaptation of the individual to their context and allow better coping with different life situations, as well as of stressful situations. The objective of the present study was to perform a systematic review of social-emotional training programs in children and adolescents in order to select the most appropriate ones. The search process was carried out in the following databases: PsycInfo, MedLine, ERIC, Red de Revistas Científicas de América Latina y el Caribe, Scielo, PUBMED, with key words in English and Spanish and certain inclusion criteria. The results showed that of the 19 articles that were selected because they met the criteria, 17 training programs were identified, most of them carried out in Spain during the 2011-2015 period. The objectives of these training programs were to a greater extent, adapted to emotional intelligence, followed to a lesser extent by mixed training. The techniques used in these programs were identified, together with the duration of the interventions, the mode of application, the administrators and the recipients. Finally, of the total studies analyzed, most evidenced the effectiveness of training for some of the variables analyzed. The evidence presented may be useful for researchers and professionals in the area of health and education who work with children and adolescents.

Gestión de revisores en la revista Archivo Médico de Camagüey / Management of reviewers in the Archivo Médico de Camagüey journal

RESUMEN Fundamento: luego de la aceptación preliminar del artículo desde el punto de vista metodológico y de la redacción del texto, se procede a su revisión por expertos, proceso que es fundamental para refrendar su validez científica. Objetivo: describir la experiencia y resultados de la revista Archivo Médico de Camagüey en la gestión de incorporación de revisores. Métodos: se realizó una búsqueda en las bases de datos SciELO Cuba, SciELO Regional, se utilizaron los descriptores: árbitro, revisión por pares, criterios de selección, peer review, revisión de la investigación por pares. Resultados: cada vez es mayor el número de revisores incorporados, con representación de las provincias del país y de otros países, la mayor parte de las provincias están representadas y después de Cuba le siguen Chile y Perú. Conclusiones: la gestión de árbitros es un proceso complejo y minucioso que se planifica en tres momentos: identificación, verificación y negociación. La revista muestra un trabajo ascendente en la incorporación de árbitros, se incrementa la incorporación de árbitros de otros países de la región.

ABSTRACT Background: after the preliminary acceptance of the article from the methodological point of view, and the writing of the text, it is revised by experts, a process that is fundamental to validate its scientific validity. Objective: to describe the experience and results of the journal Archivo Médico de Camagüey in the management of reviewers´ incorporation. Methods: a search was made in the SciELO Cuba, SciELO Regional databases, the used descriptors were referee, peer review, selection criteria. Results: the number of incorporated reviewers is increasing, with representation of the provinces of the country and from other countries, most of the provinces are represented and after Cuba with (86,0 %) they are followed by Chile (2,7 %) and Peru (2,2 %). Conclusions: the management of reviewers is a complex and meticulous process, which is planned in three moments: identification, verification and negotiation. The magazine shows an ascending work in the incorporation of reviewers, the incorporation of referees from other countries of the region is increased.

Investigation and Development of Competency-based Training Program for Pharmacists in a Hospital

OBJECTIVE: This study was to investigate and develop a training program that integrated and strengthened clinical competence and capacity of hospital pharmacists which would be implemented at the pharmacy department of Ewha Womans University Mokdong Hospital. METHODS: We assessed the training programs of hospital pharmacists in the United Kingdom, the United States and Japan and compared those of major hospitals in Seoul and Gyeonggi provinces in Korea. The survey assessed the satisfaction on the current educational programs for pharmacists at Ewha Womans University Mokdong Hospital and a newly designed education program was suggested. RESULTS: The major differences of the programs among the Korean hospitals and Mokdong Hospital were the training period and contents of the entry-level pharmacist education program. The overall satisfaction of the training program was >3 points on 5-Likert scale in the survey. There was no significant difference of the satisfaction level based on the employment period of pharmacists. The pharmacists were in more than 7 training programs of clinical support work. We proposed the clinical support training for the new pharmacists to be separated from orientation and concentrated on actual work duty. In order to improve the competency, it was encouraged to participate the in-house seminar or certify the related fields provided by Korean Society of Health-system Pharmacists. CONCLUSION: The education program was assessed among different countries and hospitals of Korea. We suggested to update education program in the hospital to enhance pharmacists' competency.

Teaching project: a low-cost swine model for chest tube insertion training / Projeto de ensino: modelo suíno de baixo custo para treinamento de drenagem torácica

Objective: to describe and evaluate the acceptance of a low-cost chest tube insertion porcine model in a medical education project in the southwest of Paraná, Brazil. Methods: we developed a low-cost and low technology porcine model for teaching chest tube insertion and used it in a teaching project. Medical trainees - students and residents - received theoretical instructions about the procedure and performed thoracic drainage in this porcine model. After performing the procedure, the participants filled a feedback questionnaire about the proposed experimental model. This study presents the model and analyzes the questionnaire responses. Results: seventy-nine medical trainees used and evaluated the model. The anatomical correlation between the porcine model and human anatomy was considered high and averaged 8.1±1.0 among trainees. All study participants approved the low-cost porcine model for chest tube insertion. Conclusion: the presented low-cost porcine model for chest tube insertion training was feasible and had good acceptability among trainees. This model has potential use as a teaching tool in medical education.

Objetivo: descrever e avaliar a aceitação do modelo porcino de baixo custo para drenagem torácica em projeto de ensino médico no oeste do Paraná, Brasil. Métodos: um modelo suíno de baixa tecnologia e baixo custo foi desenvolvido em projeto de ensino de drenagem torácica. Alunos de Medicina e médicos residentes receberam instruções teóricas sobre o procedimento e realizaram a drenagem torácica no modelo porcino. Após realizarem o procedimento, os participantes responderam a um questionário sobre o modelo experimental proposto. Esse estudo apresenta o modelo e analisa as respostas ao questionário. Resultados: setenta e nove participantes usaram e avaliaram o modelo. A correlação anatômica entre o modelo porcino e a anatomia humana foi considerada alta com média de 8,1+1,0. Todos os participantes aprovaram o modelo porcino de baixo custo para o ensino de drenagem torácica. Conclusão: o modelo porcino de baixo custo para drenagem torácica apresentado neste projeto de ensino foi facilmente montado e teve boa aceitação local entre os participantes. Esse modelo tem potencial para ser usado como ferramenta de ensino na educação médica.

Construction and validation of a surgical skills assessment tool for general surgery residency program / Construção e validação de um instrumento de avaliação de habilidades técnicas para programas de residência em cirurgia geral

Objective: To develop and validate an instrument for measuring the acquisition of technical skills in conducting operations of increasing difficulty for use in General Surgery Residency (GSR) programs. Methods: we built a surgical skills assessment tool containing 11 operations in increasing levels of difficulty. For instrument validation we used the face validaity method. Through an electronic survey tool (Survey MonKey(r)) we sent a questionnaire to Full and Emeritus members of the Brazilian College of Surgeons - CBC - all bearers of the CBC Specialist Title. Results: Of the 307 questionnaires sent we received 100 responses. For the analysis of the data collected we used the Cronbach's alpha test. We observed that, in general, the overall alpha presented with values near or greater than 0.70, meaning good consistency to assess their points of interest. Conclusion: The evaluation instrument built was validated and can be used as a method of assessment of technical skill acquisition in the General Surgery Residency programs in Brazil.

Objetivo: construir e validar um instrumento para aferir a aquisição de habilidades técnicas na realização de operações de graus crescentes de dificuldade para ser utilizado na Residência Médica em Cirurgia Geral (RMCG). Métodos: foi construído um instrumento de avaliação de habilidades cirúrgicas contendo 11 operações em níveis crescentes de dificuldade. Para a validação do instrumento foi usado o método de validação de face. Por meio de uma ferramenta de pesquisa eletrônica (Survey MonKey(r)) um questionário foi enviado para membros Titulares e Eméritos do CBC de todos os estados brasileiros, portadores de Título de Especialista pelo CBC. Resultados: Dos 307 questionários enviados foram recebidas 100 respostas. Para a análise dos dados coletados foi utilizado o teste alfa de Cronbach. Observou-se, de uma forma geral, que os alfas globais se apresentaram com valores próximos ou superiores a 0,70, expressando uma boa consistência interna das perguntas para avaliar os respectivos aspectos de interesse. Conclusão: O instrumento de avaliação construído foi validado e pode ser usado como um método de avaliação da aquisição de habilidade técnica na Residência Médica em Cirurgia Geral no Brasil.

Valoración de un programa de entrenamiento en estilo explicativo optimista y habilidades de comunicación en adolescentes / Evaluation of a training program to promote optimistic explanatory style and communication skills in adolescents

El estilo explicativo pesimista y las dificultades de interacción social han sido asociados con un incremento de los síntomas depresivos durante la adolescencia. Para disminuir esta sintomatología, se han propuesto algunos programas de entrenamiento centrados en la modificación de uno o ambos elementos. En este estudio se pretende valorar la eficacia de un programa de entrenamiento para fomentar el estilo explicativo optimista y mejorarlas habilidades comunicativas. Los participantes han sido 38 adolescentes (19 chicos y 19 chicas), con edades entre 14 y 17 años (M igual 14.93; D.T. igual 0.87). La mitad fue asignada al azar a un grupo de tratamiento y la otra mitad a un grupo de control de lista de espera. El programa produjo una disminución en los síntomas depresivos (p menor que .001), así como una mejora en la satisfacción con la vida (p menor que .001) y las habilidades de interacción con otros adolescentes (p menor que .01). También se detecta el aumento del tamaño del efecto entre el grupo tratamiento y el grupo control, a favor del primero. Los resultados confirman el beneficio de aplicar programas de entrenamiento centrados en estos componentes para reducir los síntomas depresivos en los adolescentes.

Pessimistic explanatory style and difficulties in social interaction have been associated with an increase of depressive symptoms during adolescence. Some training programs, focused on the modification of one or both factors, have been proposed to decrease such symptoms. This study examines the efficacy of a training program focused on both optimistic explanatory style and communication skills for this population. Thirty-eight adolescents (19 males an 19 females) aged between 14 and 17 (M same 14.93; D.T. same 0.87) were randomly assigned to a treatment group half or a control group 50 half. The intervention program produced both a decrease of depressive symptoms (p smaller than.001), and an increase of satisfaction with life (p smaller than .001) and the interaction skills with other adolescents (p smaller than .01). In addition, effects size differences between both groups (treatment and control group) increased at post-treatment compared to pre-treatment. In conclusion, this training program shows to be effective in reducing depressive symptoms in adolescents.

Vías para la articulación de la investigación en educación médica en la Facultad de Medicina de San Fernando con la investigación en recursos humanos en el Perú / Articulation paths in research on medical education at San Fernando Faculty of Medicine and research on human resources in Peru

Introducción: En investigaciones previas se ha identificado la desarticulación entre la acción investigadora de la Universidad, y las prioridades de investigación o necesidades de conocimiento, entre otros campos, en el de la educación médica y la investigación educacional en salud, lo que resta aplicabilidad a los resultados de las investigaciones. Objetivos: Identificar factores explicativos de la desarticulación entre la investigación en educación médica en la Facultad de Medicina, y la investigación en recursos humanos en salud en el país. Diseño: Estudio de caso cualitativo. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos (UNMSM), Lima, Perú. Participantes: Informantes de la universidad y de la autoridad sanitaria nacional. Métodos: El estudio se basó en entrevistas semiestructuradas a informantes clave tanto de la universidad como de la autoridad sanitaria nacional. Principales medidas de resultados: Factores explicativos de desarticulación. Resultados: Los factores explicativos de la desarticulación entre la investigación en educación médica en la Facultad de Medicina y la investigación en recursos humanos en salud en el país fueron: a) Una cultura de investigación dependiente de los recursos universitarios, que son escasos para investigaciones de mayor envergadura como los requeridos por el Ministerio de Salud (MINSA); b) Para el MINSA, la UNMSM es una entidad de baja visibilidad; sus publicaciones en el campo de Recursos Humanos no son conocidas; c) La investigación sanmarquina se visualiza como fruto de esfuerzos individuales, no de la existencia de equipos de investigación. Conclusiones: Las líneas de investigación consistentes con la experiencia e intereses de los investigadores de la Facultad de Medicina, enmarcadas en las prioridades de investigación de recursos humanos en Salud en el Perú, fueron a) la articulación de la formación en pregrado de los recursos humanos en salud con las necesidades de salud del país...

Introduction: Previous research has shown lack of articulation between university based research and research priorities as defined by the national health authority. Objectives: To identify explanatory factors for lack of articulation between university research activities and knowledge needs as defined by users. Design: Qualitative case study. Setting: Faculty of Medicine, Universidad Nacional Mayor de San Marcos (UNMSM), Lima, Peru. Participants: Informants from both the university and the national health authority. Methods: The study was based in semi structured interviews to key informants, from the university and the national health authority. Main outcome measures: Lack of articulation explanatory factors. Results: Explanatory factors identified were: a) Research funding culture depending on own university limited resources, and not allowing proposed nationwide studies such as those required by the Ministry of Health (MOH); b) Low UNMSM visibility at MOH with consequent unawareness of its publications on Human Resources; c) UNMSM research visualized as basically individual efforts and not as the result of research teams and research lines. Conclusions: Research lines concordant with needs and capacities of human resources research priorities were: a) Articulation of undergraduate education and health needs; b) Use of information and communication technology (ICT) in training; and c) Impact of experiences on competencies development for graduate education and specialization.

Awareness of healthcare workers regarding Biomedical Waste Management (BMW) at Tertiary Care Government Hospital in Dhule (Maharashtra).

Background and objectives: Biomedical waste has been a growing concern due to increased awareness in public regarding HIV/AIDS, hepatitis B and exposure to other potential infectious diseases. Good BMW disposal practices lead to reduction in medical expenditure, unsightly scenes at various disposal bins and dumping sites. Improper biomedical waste management practices and indiscriminate disposal of hospital waste causes spread of illness leading to financial burden to society. The money saved by reduction in hospital acquired infections is much more than spent on control of hospital acquired infections. Therefore it is necessary to educate the staff, patients and community about the management of the infectious waste. The present study was designed to assess the awareness regarding biomedical waste in health care workers at a tertiary care Government hospital, Dhule (Maharashtra). Methods: Shri Bhausaheb Hire Government Medical College and Hospital is a 545 bedded tertiary care teaching Government hospital situated in rural area of Maharashtra at Dhule where per day approximately 90 Kg biomedical waste is generated .The present cross-sectional study was conducted during 1st August 2011 to 30th September 2011. Knowledge and practices about BMW was assessed among 153 health care workers (81 nursing staff, 35 laboratory technicians and 37 sweepers) handling BMW in the tertiary care Government hospital at Dhule. Results: It was found that only 70.6% of the health care workers were aware of biomedical waste management and 50.3 % had undergone training. 72.5 % of the health care workers were aware of 3 color coded bags used for collection of BMW. In the study only 41.8% of the workers were vaccinated against shepatitis B and 81.7% had received tetanus toxoid vaccine. Conclusion: For proper handling and disposal of BMW, all health care providers must undergo regular training in BMW management.

Preliminary study of Korean orthodontic residents' current concepts and knowledge of cleft lip and palate management / 대한치과교정학회지

OBJECTIVE: A national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea. METHODS: A questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them. RESULTS: All of the respondents reported that they belonged to an interdisciplinary team. Nineteen percent indicated that they use presurgical infant orthopedic (PSIO) appliances. The percentage of respondents who reported they were 'unsure' about the methods about for cleft repair operation method was relatively high. Eighty-six percent reported that the orthodontic treatment was started at the deciduous or mixed dentition. Various answers were given regarding the amount of maxillary expansion for alveolar bone graft and the estimates of spontaneous or forced eruption of the upper canine. Sixty-seven percent reported use of a rapid maxillary expansion appliance as an anchorage device for maxillary protraction with a facemask. There was consensus among respondents regarding daily wearing time, duration of treatment, and amount of orthopedic force. Various estimates were given for the relapse percentage after maxillary advancement distraction osteogenesis (MADO). Most respondents did not have sufficient experience with MADO. CONCLUSIONS: These findings suggest that education about the concepts and methods of PSIO and surgical repair, consensus regarding orthodontic management protocols, and additional MADO experience are needed in order to improve the quality of CLP management in Korean orthodontic residents.