Vocal Demand Response to the Educational Setting Based Communication Scenarios: A Single Subject Study

Objectives: This was a single-subject study, aimed to demonstrate different vocal demand situations that are typical for primary school and teacher's vocal demand response under two acoustical conditions, with and without voice amplification, during five working days. Methods: The long-term voice dosimetry with Vocal Holter Med (PR.O. Voice Srl) was carried out on a 49-year-old female teacher with voice disorders during daily teaching activities. A sound field amplification system (SFAS) PentaClass Runa was installed in the classroom. Voice dosimetry was provided under two different acoustical conditions: without SFAS (2 days) and with SFAS (3 days). Results: Phonation time percentage, sound pressure level (SPL), SPL SD, fundamental frequency (F0), F0 SD, cycle, and distance doses were investigated in seven communication scenarios (lessons, group/individual classes, sports lessons in the gym and schoolyard, breaks, lunch breaks, and other activities). The median scores of all voice parameters differed significantly between different vocal demand contexts. The significant statistical difference in the vocal demand response was in the communication situations with and without SFAS. In addition, the number of children, reverberation time, and ambient air relative humidity impacted voice SPL and the cycle dose. Conclusions: Lessons, sports lessons held in the gym or schoolyard, breaks, and lunch breaks were considered as high vocal demand communication situations requiring higher voice intensity and fundamental frequency, higher phonation time percentage, cycle, and distance doses. Group/individual work and other teacher activities during the day, unrelated to direct work with students, were categorized as low vocal demand communication scenarios.

Objetivos: Este fue un estudio de sujeto único, cuyo objetivo fue demostrar diferentes situaciones de demanda vocal típicas de la escuela primaria y la respuesta vocal de los docentes bajo dos condiciones acústicas, con y sin amplificación de voz, durante cinco días laborables. Métodos: Se llevó a cabo dosimetría vocal a largo plazo con Vocal Holter Med (PR.O. Voice Srl) durante las actividades diarias de enseñanza en una docente de 49 años con trastornos de la voz. Se instaló un sistema de amplificación de campo sonoro (SFAS) PentaClass Runa en el aula. La dosimetría vocal se realizó bajo dos condiciones acústicas diferentes: sin SFAS (2 días) y con SFAS (3 días). Resultados: Se investigaron el porcentaje de tiempo de fonación, el nivel de presión sonora (SPL), SPL SD, la frecuencia fundamental (F0), F0 SD, ciclos y dosis de distancia en siete escenarios de comunicación diferentes (clases, clases grupales/individuales, clases de educación física en el gimnasio y el patio de la escuela, recreos, almuerzos y otras actividades). Las puntuaciones medias de todos los parámetros vocales diferían significativamente entre los diferentes contextos de demanda vocal. La diferencia estadísticamente significativa en la respuesta a la demanda vocal se observó en las situaciones de comunicación con y sin SFAS. Además, el número de niños, el tiempo de reverberación y la humedad relativa del aire ambiente afectaron al SPL de la voz y la dosis de ciclo. Conclusiones: Las lecciones, las clases de educación física en el gimnasio o el patio de la escuela, los recreos y los almuerzos se consideraron situaciones de comunicación de alta demanda vocal, que requerían una mayor intensidad y frecuencia fundamental de la voz, un mayor porcentaje de tiempo de fonación y dosis de ciclo y distancia más altas. El trabajo grupal/individual y otras actividades del profesor durante el día no relacionadas con el trabajo directo con los estudiantes se categorizaron como escenarios de comunicación de baja demanda vocal.

Presidential communication approaches and the impact on public health: a comparative analysis of three South African presidents' communication on AIDS and COVID-19

The HIV response in the African continent over past decades demonstrates the potency that the words and actions of political leaders have in either expediting or impeding the implementation and adoption of preventive measures at the individual and community levels. The article explores the health communication approaches employed by two South African past presidents (Thabo Mbeki and jacob Zuma) in responding to the HIV epidemic, and contrasts these with the communicative approach of President Cyril Ramaphosa during the COVID-19 pandemic. Approached from this understanding, this article provides a comparative analysis of the communication approaches of these three presidencies across the two pandemics, and considers the variously trusted sources of top-down, government-driven and bottom-up, community-informed approaches to health communication. Critical lessons that emerged in South Africa during the HIV epidemic regarding the need to include communities in communicating about risks and behaviour change have not been adopted into the COVID-19 response. Political leaders are not best placed to communicate about these issues, and, in the context of pandemics, there is a clear need to reconsider top-down communication approaches that are designed without the participation of communities and ignore the interconnected nature of health and other social determinants of health.

Intensive online courses promote the development of myopia in children with orthokeratology lens during COVID-19 epidemic / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the effect of intensive online courses on myopia in primary and middle school students with orthokeratology-lens during Corona Virus Disease 2019(COVID-19)epidemic.<p>METHODS:A total of 77 children in myopia with orthokeratology lens in outpatients from February to August 2020 were included in the study. Take a questionnaire to statistics times spending on online course, school class, playing digital electronic good, outdoor activity, homework, sleeping during the COVID-19 epidemic and school time, and analyze the differences of axial length(AL)variation between the COVID-19 epidemic and school time.<p>RESULTS:For elementary school students, the time spending on online course and school class were 2.69±1.02h and 4.07±0.78h per day respectively(<i>P</i><0.001), 6.67±1.82h and 6.31±1.19h per day were spent on short-distance use of eyes during the COVID-19 period and school time, respectively(<i>P</i><0.001). For middle school students, the time spending on online course and school class were 4.35±1.59h and 6.33±0.66h per day respectively(<i>P</i><0.001), 9.19±2.46h and 7.85±0.81h per day were spent on short-distance use of eyes(<i>P</i>=0.010)during the COVID-19 period and school time, respectively. For elementary school students, the average increase of right eye AL were 0.15±0.09mm and 0.06±0.06mm(<i>P</i><0.001), the increase of left eye AL were 0.12±0.16mm and 0.07±0.09mm(<i>P</i>=0.048)during the COVID-19 period and school time, respectively. For middle school students, the average increase of right eye were AL 0.08±0.08mm and 0.05±0.05mm(<i>P</i>=0.242), and the average increase of left eye AL were 0.13±0.09mm and 0.04±0.06mm(<i>P</i><0.001)during the COVID-19 period and school time, respectively. The results showed that both the time of short-distance use of digital electronic product and totally time on close visual study increased significantly during the epidemic period, the growth of AL was faster than that in school time, and the myopia increased rapidly.<p>CONCLUSION:During the COVID-19 epidemic, intensive online lessons resulted in the time of short-distance use of digital electronic product increase significantly. Meanwhile, the AL growth accelerates significantly compared with that during school time and finally lead to myopia increased.

Desafíos de la pedagogía vocal en la música comercial contemporánea / Challenges of vocal pedagogy in contemporary commercial music

Desde sus inicios, la pedagogía vocal de la música comercial contemporánea (tér-mino utilizado para referirse a la música popular, no lírica), se ha visto enfrentada a una serie de desafíos, dado a que inicialmente su canto fue enseñado de acuerdo con la técnica lírica, a pesar de contar con diferencias sustanciales en cuanto a la forma de emplear la voz, los recursos y registros vocales, propios de cada género musical, la amplificación externa, la formación y conocimientos necesarios para entrenar la voz, la evaluación y detección de problemas vocales, las herramientas pedagógicas necesarias para enseñar canto, entre otras distinciones. Lo anterior exige un replan-teamiento de la pedagogía vocal y sus metodologías correspondientes para promover el aprendizaje de estudiantes de canto de música comercial contemporánea

Contemporary commercial music vocal pedagogy has faced a number of challenges. This term is used to refer to popular or "non-lyrical" music. From its beginnings, the singing of contemporary commercial music was related and was taught based on lyrical technique, despite having substantial differences in the way of using the voice, such as the use of vocal registers, external amplification, and vocal resources of each musical genre, among other distinctions. Other challenges mentioned will be the training and knowledge necessary to train the voice, the evaluation and detection of vocal problems, and the pedagogical tools necessary to teach singing are challenges. Due to the aforementioned, there must be a rethinking of vocal pedagogy and its corresponding methodologies to promote the learning of contemporary commercial music singing students

Alunos "em cena": pesquisa pedagógica com mídias tecnológicas na Educação Física Escolar / Students "in scene": pedagogical research with technological media in school Physical Education / Alumnos "en escena": investigación pedagógica con mídias tec-nológicas en la Educación Física escolar

O estudo apresenta como objetivo fomentar o uso das mídias tecnológicas e digitais no âmbito escolar, bem como proporcionar aos discentes uma experiência que estabeleça uma aproximação dos conteúdos da Educação Física escolar ao seu cotidiano. Os estudantes trouxeram encenações teatrais, roteiros educativos e descritivos, filmagens de cidadãos e cidadãs da cidade em atividades diversas. Consideramos que as possibilidades das mídias digitais serem trabalhadas nas aulas de Educação Física constituem-se enriquecedoras, haja vista o envolvimento, o aprendizado e os conhecimentos difundidos através da exploração da linguagem audiovisual entre os discentes.

The objective of this study is to promote the use of technological and digital media in the school environment, as well as to provide students with an experience that establishes an ap-proximation of the contents of Physical School Education to their daily life. The students brought theater theatrics, educational and descriptive scripts, filming of city citizens in vari-ous activities. We consider that the possibilities of working digital media in physical educa-tion classes, even if simple, are enriching, given the involvement, learning and knowledge spread through the exploitation of audiovisual language among students.

El estudio presenta como objetivo fomentar el uso de los medios tecnológicos y digitales en el ámbito escolar, así como proporcionar a los alumnos una experiencia que estableciera una aproximación de los contenidos de la Educación Física escolar a su cotidiano. Los estudiantes trajeron escenarios teatrales, guiones educativos y descriptivos, filmaciones de ciudadanos y ciudadanas de la ciudad en actividades diversas. Consideramos que las posibilidades de traba-jar los medios digitales en las clases de Educación Física, aunque simplistas, se constituyen enriquecedoras, habida cuenta del involucramiento, el aprendizaje y los conocimientos difun-didos a través de la exploración del lenguaje audiovisual entre los alumnos.

Innovation and exploration in medical immunology experiment lessons that aiming on clinical practice / 中国免疫学杂志

As a frontal subject of life science, the medical immunology lessons are verification and complementary to theory lessons, and students need it to train their scientific ability and spirit. Therefore, some adjustments and explorations is needed in the experiments, for example, the data analysis of ELISA has been imported to the lessons to make them more closer to the practice. It' s shown that our lessons got welcomed by almost all students and is more helpful to them. The results playing an important role in improving our teaching effects in future.

Intervención para el aprendizaje en clases didácticas prolongadas de asignaturas clínicas / Intervention for learning in lengthened didactic lessons of clinical subjects

Introducción: las clases didácticas o magistrales son utilizadas frecuentemente en educación médica, aunque se sabe que la atención de los estudiantes disminuye progresivamente y la retención de la información es limitada. Las clases interactivas reducen estos inconvenientes, pero su efecto sólo se ha evaluado en clases de una hora o menos de duración y predominantemente en el ciclo básico de medicina. Objetivo: evaluar la intervención implementada para el alcance de un mayor aprendizaje en clases didácticas prolongadas de asignaturas clínicas. Método: la intervención se realizó en un módulo educativo del ciclo clínico de la carrera de medicina de una universidad privada chilena. Participaron 60 estudiantes de 5to año. Las clases de la unidad intervenida se impartieron en 4 h académicas sucesivas de 45 min cada una. Al inicio de cada clase, los estudiantes respondieron un cuestionario con sentencias en formato verdadero o falso referidas a los objetivos centrales de cada temática. Las clases se estructuraron con el método clásico y el estilo docente predominante fue proveedor visual de información. La evaluación se realizó después de 3 meses mediante un test de conocimientos con 40 preguntas de opción múltiple (11 de cardiología). Se incluyó una selección de sentencias de verdadero y falso de aquellas utilizadas durante las clases y una encuesta de satisfacción en formato Likert. Además, se aplicó una escala diferencial semántica para recolectar información sobre las clases de las demás unidades con el propósito de controlar el efecto halo atribuido a preferencias de docentes participantes. Resultados: el promedio de las calificaciones en las preguntas de cardiología del test de conocimientos fue significativamente superior al promedio de las otras unidades de geriatría [t(59)=-28,3; p< 0,001]. El porcentaje promedio de aciertos del post-test fue 45,2 por ciento superior al pretest [t(59)= -24,9; p< 0,001]. La metodología fue bien evaluada: 100 por ciento de estudiantes estimó que mantuvo su atención durante las clases. La apreciación de las clases impartidas por los diferentes docentes del módulo de geriatría fue positiva, sin diferencias entre ellos. Conclusiones: el uso de cuestionarios con sentencias de verdadero y falso, referidas a los objetivos educacionales, antes de cada sesión de clases prolongadas es una estrategia que permite mantener la atención de los estudiantes y favorece el rendimiento cognitivo en asignaturas clínicas del pregrado de Medicina(AU)

Introduction: didactic or master classes are frequently used in medical education, although the students' attention is known to decrease progressively and information retention is limited. Interactive classes reduce these disadvantages, but their effect has only been evaluated in one-hour or less lessons and predominantly during the basic medical cycle. Objective: to evaluate the intervention implemented for attaining greater knowledge in extended didactic classes on clinical subjects. Method: the intervention was carried out in an educational module of the clinical cycle of the medical major of a Chilean private university. Sixty fifth-year students participated. The lessons of the intervened unit were taught in four consecutive academic hours of 45 minutes each. At the beginning of each lesson, the students answered a questionnaire with statements for the true/false format and referring the central objectives of each subject. The lessons were structured with the classical method and the predominant teaching style was visual information provider. The evaluation was carried out after 3 months through a knowledge test with 40 multiple-choice questions (11 about cardiology). It included a selection of true/false statements from those used during the lessons and a satisfaction survey in the Likert format. In addition, a differential semantic scale was applied to collect information about the lessons of the other units with aim at controlling the halo effect attributed to the preferences of participating teachers. Results: the average of the scores in the cardiology questions of the knowledge test was significantly higher than the average of the other geriatric units (t (59)= -28.3, p< 0.001). The average percentage of correct answers in the post-test was 45.2 percent, higher than the pretest (t (59)= -24.9, p< 0.001). The methodology was evaluated well: 100 percent of students considered that they kept their attention during the lessons. The appreciation of the lessons given by the different teachers of the geriatric module was positive, without differences between them. Conclusions: the use of questionnaires with true/false statements and referring the educational objectives, before each session of extended lessons, is a strategy that allows to keep the students' attention and favors the cognitive performance in undergraduate medical-clinical subjects(AU)

Lessons learnt from a three-year pilot field epidemiology training programme

Problem: The Pacific region has widely dispersed populations, limited financial and human resources and a high burden of disease. There is an urgent need to improve the availability, reliability and timeliness of useable health data. Context: The purpose of this paper is to share lessons learnt from a three-year pilot field epidemiology training programme that was designed to respond to these Pacific health challenges. The pilot programme built on and further developed an existing field epidemiology training programme for Pacific health staff. Action: The programme was delivered in country by epidemiologists working for Pacific Public Health Surveillance Network partners. The programme consisted of five courses: four one-week classroom-based courses and one field epidemiology project. Sessions were structured so that theoretical understanding was achieved through interaction and reinforced through practical hands-on group activities, case studies and other interactive practical learning methods. Outcome: As of September 2016, 258 students had commenced the programme. Twenty-six course workshops were delivered and one cohort of students had completed the full five-course programme. The programme proved popular and gained a high level of student engagement. Discussion: Face-to-face delivery, a low student-to-facilitator ratio, substantial group work and practical exercises were identified as key factors that contributed to the students developing skills and confidence. Close engagement of leaders and the need to quickly evaluate and adapt the curriculum were important lessons, and the collaboration between external partners was considered important for promoting a harmonized approach to health needs in the Pacific.

Lecciones aprendidas de gestión del conocimiento para la salud pública: algunos espacios observados en Colombia / Lessons learnt from knowledge management to public health: some spaces observed in Colombia / Lições aprendidas de gerenciamento do conhecimento para a saúde pública: alguns espaços observados em Colômbia

Introducción: transferir conocimiento para la salud pública es un asunto posible, según los diferentes espacios contextúales y culturales existentes en una sociedad de conocimiento. Metodología: este estudio presenta lecciones aprendidas de tres casos de gestión del conocimiento con base en la experiencia, las condiciones comunes y los procesos de liderazgo social autogestionado promovidos en espacios locales, concertado con actores y agentes locales de organizaciones en Antioquia, Colombia, mediante análisis comparativo y técnicas de exploración documental. Resultados: la gestión social del conocimiento como mecanismo local de promoción de las evidencias informadas en salud pública puede y debe ser intercambiada a través de espacios observados, como las redes de conocimiento, los observatorios y los tanques de pensamiento. Conclusión: las lecciones aprendidas confluyen en promover procesos de participación social para la construcción colectiva de conocimiento y abordar debates sobre la igualdad de oportunidades regionales en Colombia.

Introduction: According to a different contextual and cultural knowledge society, knowledge transfer on public health is a possible issue nowadays. Methods: This implementation health research based on lessons learnt shows three cases of knowledge management supported by experience, common conditions and self-management social leadership processes developed in local spaces with stakeholders in Antioquia, Colombia through comparative analysis and documented scoping review. Results: Social Knowledge Management as a local mechanism on promotion the informed evidence on public health can be interchanged by observed spaces like knowledges networks, observatories, think tanks. Conclusion: Lessons learnt conduct in promote social participation processes for the collective building knowledge and concrete debates about equity for regional chances in Colombia.

Introdução: transferir conhecimento para a saúde pública é um assunto possível, segundo os diferentes espaços contextuais e culturais existentes em uma sociedade de conhecimento. Metodologia: este estudo apresenta lições aprendidas em três casos de gerenciamento do conhecimento com base na experiência, as condições comuns e os processos de liderança social auto gerenciado, promovidos em espaços locais, marcados com atores e agentes de organizações em Antioquia, Colômbia, mediante análise comparativa e técnicas de exploração documentária. Resultados: o gerenciamento social do conhecimento como mecanismo local de promoção das evidências informadas em saúde pública pode e deve ser trocado através de espaços observados, como as redes de conhecimento, os observatórios e os tanques de pensamento. Conclusão: as lições aprendidas levam a promover processos de participação social para a construção coletiva de conhecimento e abordar debates sobre a igualdade de oportunidades regionais na Colômbia.

Evidence on equity, governance and financing after health care reform in Mexico: lessons for latin american countries / Evidencias sobre gobernanza, equidad y financiamiento en salud en méxico: lecciones para paises latinoamericanos

This article includes evidence on equity, governance and health financing outcomes of the Mexican health system. An evaluative research with a cross-sectional design was oriented towards the qualitative and quantitative analysis of financing, governance and equity indicators. Taking into account feasibility, as well as political and technical criteria, seven Mexican states were selected as study populations and an evaluative research was conducted during 2002-2010. The data collection techniques were based on in-depth interviews with key personnel (providers, users and community leaders), consensus technique and document analysis. The qualitative analysis was done with ATLAS TI and POLICY MAKER softwares. The Mexican health system reform has modified dependence at the central level; there is a new equity equation for resources allocation, community leaders and users of services reported the need to improve an effective accountability system at both municipal and state levels. Strategies for equity, governance and financing do not have adequate mechanisms to promote participation from all social actors. Improving this situation is a very important goal in the Mexican health democratization process, in the context of health care reform. Inequality on resources allocation in some regions and catastrophic expenditure for users is unequal in all states, producing more negative effects on states with high social marginalization. Special emphasis is placed on the analysis of the main strengths and weaknesses, as relevant evidences for other Latin American countries which are designing, implementing and evaluating reform strategies in order to achieve equity, good governance and a greater financial protection in health.

Este articulo incluye evidencias sobre equidad, gobernanza y financiamiento como resultado de la reforma de la salud en México. Partió de una investigación evaluativa de diseño transversal con análisis cualitativo y cuantitativo en servicios de salud para población no asegurada desarrollada durante 2002-20010 Bajo criterios de factibilidad técnica, política y financiera, siete estados mexicanos fueron seleccionados. Los datos se recopilaron a través entrevistas a profundidad con actores clave (proveedores, usuarios, líderes comunitarios, legisladores y directivos), técnica de consenso y revisión documental y estadísticas oficiales. El procesamiento y análisis de la información se realizó con los paquetes ATLAS-TI Y POLICY MAKER. La reforma en salud ha podido modificar la dependencia del nivel central; existe nueva formula de equidad; los lideres comunitarios y usuarios plantean la necesidad de implementar sistemas de rendición de cuentas en salud a nivel municipal y estatal; las estrategias de reforma no cuentan con mecanismos adecuados para una participación de todos los actores del sistema de salud, aún cuando la democratización en salud se constituyó como eje conductor de la reforma; los niveles de inequidad en la asignación de recursos y los gastos catastróficos en salud afectan de manera desigual, teniendo impacto negativo en los estados con marginación social. Enfasis especial se hace en una lista de fortalezas y debilidades que a manera de lecciones aprendidas se sugieren para lograr una mayor equidad, mejores niveles de gobernanza y mayor protección financiera en los proyectos de reforma en salud a nivel mundial y particularmente en América Latina.

Lessons in medical ethics from ancient Indian teachers.

Age of medicine is as old as the age of human on the earth. The doctor today is a scientist, technologist and healer at the same time. The ethics germane to the medical profession can’t be simple and uniform. Nor is the ethics simply a matter between the doctor and the patient; the society with its entire economic and political dimension is involved in much bigger way. Certain basic traditional thoughts given by ancient Indian teachers like Hippocrates, Charaka, Sushrutha and Vagbhata are still become relevant. Medical ethics in the medical curriculum, must be included not as a normative discipline but as a practical course with its own problems and considerations. As per Indian outlook, the role of ethics is certainly vast and varied, from treating a common cold, to the controversy on euthanasia, from the simple obligations of a family doctor, to the specialist services in the high cost, high technology five star nursing homes.

Lessons from orthopedic surgeon training system in Britain / 中华医学教育探索杂志

The tralning system for orthopedic surgeon in Britaln is mature and complete. After completing education in medical college, medical students receive a 2-year base tralning (FY1, FY2), which focus on learning and consolidating basic medical knowledge and clinical skill, followed by a 6-year specialist tralning, which subdivides into tralning of ankle and foot, hand, should and elbow, hip, knee, spine, and pediatric surgery, provided by several district hospital (Peripheral hospitals). Students are required to return to teaching center for review, ward inspection, case discussion at regular inter-vals. Compared with the specialist tralning system based on the hospital staffs in chi-na, the role ofsocial workersin British during the period of tralning makes better mobility of tralnee among medical institutions and medical treatments, which makes the tralning more comprehensive and professional. In addition, there is no consistent system for examination and admittance of specialist, and awareness of specialist tralning among medical institutions and doctors is weak. Therefore, it should be done to form a single tralning system and unify the tralning specification and assessment standard.

Lessons from the Field Count more than Ever: The New Era of Global Health

For many years, Japan has been silent on the achievements of Japan’s Overseas Development Assistance program including the health improvement of foreign countries. Japan’s contribution to global health communities through G8 process including Hashimoto Initiative is steadfast. On the other hand, in the field activity level, experts involved in ODA have not disclosed their achievements. However, the article by Wada et al., which describes the contents of TEN MR (Minimum Requirement), shed light on Japan’s silent ODA community by disclosing Japan’s achievements in global health by drawing lessons that may be applicable to other countries. Our future challenge in the global health will be how to synthesize actions that reflect the lessons learnt from the field and which show scientific evidence using established methods.

Lecciones aprendidas en la producción de materiales educativos en salud sexual y reproductiva, por promotores juveniles de la ciudad de El Alto, gestión 2006 / Learned lessonsin the production of educational materials in sexual and reproductive health, by young promoters in El Alto, term 2006

OBJETIVO: evaluar las lecciones aprendidas en el proceso de producción de materiales educativos, en temas de salud sexual y reproductiva, implementado por promotores juveniles de la Ciudad de El Alto, en el marco del Proyecto educativo ITSIDANET durante la gestión 2006. MÉTODOS: estudio cualitativo, ejecutado entre febrero y noviembre del 2006, aplicando las técnicas cualitativas de revisión documental, entrevistas, grupos focales, encuestas y análisis documental de toda la información obtenida. RESULTADOS: los resultados obtenidos permiten precisar tres lecciones aprendidas: 1) Que antes de iniciar un proceso de producción de materiales educativos se deben conocer todos los criterios generales y específicos para su diseño, 2) Conocer las condiciones para su uso adecuado, y 3) Jamás dejar inconcluso un proceso de este tipo omitiendo su evaluación. CONCLUSIÓN: los procesos de educación para la salud requieren de un involucramiento de los grupos sociales, desde su planificación, producción de materiales educativos, hasta la ejecución y evaluación. Sin embargo, no hay que olvidar que otorgar el protagonismo no significa descuidar el acompañamiento necesario para que estas experiencias realmente cumplan con sus objetivos trazados.

OBJECTIVE: assess learned lessons in the production process of educational materials in sexual and reproductive health topics, implemented by young promoters in El Alto, under the education project ITSIDANET, term 2006. METHODS: qualitative study, which was carried out between February and November 2006, applying qualitative techniques of documental review, interviews, focus groups, surveys and document analysis of information obtained. RESULTS: the achieved results permit to specify three lessons learned, the first one is that before starting a production process of educational materials the general and specific criterion must be known for its design, the second one, to know the conditions for its proper use, and the third, never leave unfinished a process of this type omitting its evaluation. CONCLUSIONS: the processes ofhealth education require involvement of social groups, from planning, production of educational materials, to implementation and evaluation. However, it should not be forgotten that the urge ofbeing in the limelight does not mean neglecting the necessary accompaniment that these experiences actually meet their objectives.

La Maestría en Salud Ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología y las principales experiencias / Master's Degree in Environmental Health conducted at the National Institute of Hygiene, Epidemiology and Microbiology and the main lessons learned

Objetivo: presentar las principales experiencias acumuladas en la Maestría en Salud Ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología. Métodos: se realizó un estudio descriptivo de las 17 ediciones en el período comprendido desde 1990 hasta 2009. Se aplicaron técnicas cuantitativas de análisis documental, en las que se tomaron en consideración la edad, el sexo, el lugar de residencia, la profesión y la procedencia laboral de los egresados. Resultados: Se han graduado 235 estudiantes desde 1990 hasta 2009, con mayor participación de la provincia de La Habana. El sexo femenino fue el más representativo con el 59,1 por ciento y una edad promedio de 40 años. Se concibió un mejor enfoque en la evaluación y manejo de riesgos. Recibió del Ministerio de Educación Superior el aval de Maestría Certificada. La Maestría en Salud Ambiental contó con la asesoría del Centro Panamericano de Ecología Humana y Salud, y fue reconocida como curso de excelencia de la Red de Formación Ambiental para América Latina y el Caribe. Conclusión: Se han incorporado nuevos enfoques en las asignaturas con una visión integradora, multidisciplinaria e intersectorial, lo que ha contribuido al desarrollo de competencias, conocimientos y habilidades investigativas en los egresados

Objective: to present the main lessons learned from the Master's Degree in Environmental Health program conducted at the National Institute of Hygiene, Epidemiology and Microbiology. Methods: A descriptive study was performed of the 17 cycles of the Master's Degree program held between 1990 and 2009. Quantitative document analysis techniques were applied to the variables age, sex, place of residence, profession and workplace of graduates. Results: 235 students graduated from 1990 to 2009, with a predominance of graduates from the province of Havana. Female sex was the best represented with 59.1 percent and a mean age of 40. A better approach was devised for risk evaluation and management. The Ministry of Higher Education awarded the program the category of Certified Master's Degree.The Master's Degree in Environmental Health program was advised by the Pan American Center for Human Ecology and Health, and the academic excellence of the course was recognized by the Network of Environmental Education for Latin America and the Caribbean. Conclusions: The subjects taught have been enhanced with new approaches based on a comprehensive, multidisciplinary and intersectoral view, which has contributed to the development of graduates' competencies, knowledge and research skills

Needs for disaster medicine: lessons from the field of the Great East Japan Earthquake

PROBLEM: The Great East Japan Earthquake, which occurred in Tohoku, Japan on 11 March 2011, was followed by a devastating tsunami and damage to nuclear power plants that resulted in radiation leakage. CONTEXT: The medical care, equipment and communication needs of four Disaster Medical Assistance Teams (DMAT) during four missions are discussed. DMATs are medically trained mobile teams used in the acute phase of disasters. ACTION: The DMATs conducted four missions in devastated areas from the day of the earthquake to day 10. The first and second missions were to triage, resuscitate and treat trauma victims in Tokyo and Miyagi, respectively. The third mission was to conduct emergency medicine and primary care in Iwate. The fourth was to assist with the evacuation and screening of inpatients with radiation exposure in Fukushima. OUTCOME: Triage, resuscitation and trauma expertise and equipment were required in Missions 1 and 2. Emergency medicine in hospitals and primary care in first-aid stations and evacuation areas were required for Mission 3. In Mission 4, the DMAT assisted with evacuation by ambulances and buses and screened people for radiation exposure. Only land phones and transceivers were available for Missions 1 to 3 although they were ineffective for urgent purposes. DISCUSSION: These DMAT missions showed that there are new needs for DMATs in primary care, radiation screening and evacuation after the acute phase of a disaster. Alternative methods for communication infrastructure post-disaster need to be investigated with telecommunication experts.

Eradicating and eliminating infectious diseases: Past, Present and Future.

During the past 60 years, a number of infectious diseases have been targeted for eradication or elimination, with mixed results. While smallpox is the only one successfully eradicated so far, campaigns on yaws and malaria brought about a dramatic reduction in the incidence in the beginning of the campaign but ultimately could not achieve the desired goal. There is again a renewed interest in disease eradication. The World Health assembly in May 2010 passed a resolution calling for eradication of measles by 2015; the target of polio eradication still remains elusive. In view of these developments, it is appropriate time to revisit the concept of disease eradication and elimination, the achievements and failures of past eradication programmes and reasons thereof, and possibly apply these lessons while planning for the future activities. This paper based on the Dr. A.L.Saha Memorial Oration describes various infectious diseases that have been targeted for eradication or elimination since 1950s, the potential direct and indirect benefits from disease eradication, and the issues and opportunities for the future.

Understanding Lessons Of Ethics In The Primary Education Of Bangladesh.

Abstract: In a bid to understand the lesson of ethics in the existing primary education according to government approved syllabus in Bangladesh, a survey was carried out in Dhaka and Kushtia for students studying at class 1 to class V, teachers and guardians. It has found that majority students are aware of ‘right and wrong’. Their source of learning are parents as mostly found, followed by teachers and both. Majority of guardians think text books contain ethical knowledge and they are insufficient. All the teachers found the textbooks contain ethical knowledge and education but only one forth of them found those as insufficient. On appropriateness of the lessons, only a few teachers were satisfied but majority felt the need of ethical knowledge according to age and psychology. In the text books, moral lessons are found in religion, social and environmental context as a mere advice. They are available in the form of do’s and don’ts. Stories carry ethical lesson but no individual lesson/chapter was found to be available in any books. The paper has tried to understand the existing syllabus in government run primary schools up to class V through interviewing students, teachers and guardians so that the level of lessons taught, and the need to learn the ethical knowledge can be assessed.

Investigation of the Effect of Preparing Lessons Collectively in Teaching Endocrinology / 中华医学教育探索杂志

In order to improve the effect of teaching and teachers' ability,make our teaching methods adapt to the social development,the department of Endocrinology used the method of preparing lessons collectively in our teaching.We found that the method not only made the the supply of teachers reasonably but also made good contribution to the students' culture.Practice testified that the method of preparing lessons collectively could adapt to the new model of cultivation and create substantial results.