Modelo de evaluación de impacto del posgrado académico en los docentes de la Facultad de Ciencias Médicas "General Calixto García" / Impact evaluation model of the academic postgraduate in the teachers of the Faculty of Medical Sciences "General Calixto García"

Introducción: Los retos de la educación superior para el Siglo XXI plantean la necesidad de un nuevo proceso educativo, fundamentado en los principios de excelencia, calidad y pertinencia, lo cual implica que la Educación Superior debe ser perfeccionada em concordancia con el desarrollo de la sociedad a que corresponde. Objetivo: Diseñar un modelo de Evaluación de impacto del posgrado académico en El comportamiento profesional y humano de los docentes de la Facultad de Ciencias Médicas "General Calixto García". Materiales y métodos: Se realizó una investigación de desarrollo, de enfoque mixto, se aplicaron métodos teóricos, empíricos y estadísticos. Se trabajó con 45 docentes de lãs Especialidades Básicas del Sistema de Salud y 10 docentes egresados de la maestría em Educación Médica y con directivos, residentes y especialistas y docentes del entorno laboral del profesor. Resultados: Las indagaciones teóricas permitieron la sistematización de los antecedentes y referentes del Sistema Nacional de Salud cubano, de la formación académica de posgrado y de los modelos de evaluación y de evaluación de impacto. Las indagaciones empíricas permitieron caracterizar el estado actual del comportamiento profesional y humano de lós docentes. La estructuración del modelo ideal consta con cinco componentes, tres etapas, posibilitando la retroalimentación del proceso formativo. Conclusiones: La modelación reveló problemas en la evaluación del impacto académico em general y en la formación académica de posgrado en particular. Se constató la viabilidad Del modelo a partir de la consulta a especialistas, la aplicación del modelo de tránsito y lãs transformaciones propuestas. (AU)

Introduction: The Higher Education ́s challenges in the XXI century demands a new educative process based on the principles of excellence, high quality and pertinence, which implies that Higher Education should be better in relation to the correspondent society. Objective: Design a model for the evaluation of the academic post graduated impact in reference to the professional and human behaviour of professors from the medical sciences faculty "General Calixto Garcia". Method: A developmental research work was carried out in the faculty mentioned above, using a mixed approach. We applied theoretical, empiric and statistics methods to 45 professors who works in the Basic Specialities of the Health System and to 10 professors graduated in the Master Degree course of Medical Education, to directive personnel and to residents and specialists, such as teaching workers related to the educational work. Results: Findings allowed the systematization of the backgrounds and referents of the Cuban National Health System of the academic postgraduate formation and the systematization of the models for the evaluation process and for the evaluation of impact of educational process. On the other hand, the empirical findings allowed us to characterize the status of the professional and the human behaviour of the professors. The structure of the ideal model has five components and three stages giving the possibilities to get information about the educational process. Conclusions: In general, the models in general showed problems on the evaluation of the academic impact and in the postgraduate academic formation. The feasibility of the model proposed in this study was verified throughout the consult to specialists, applying a provisional model and throughout the changes proposed in this study. (AU)

Análisis de la Incidencia del Miedo en la Organización Desde la Perspectiva Psicobiológica / Analysis of the Incidence of Fear in Organizations From a Psycho-biological Perspective / Análise da Incidência do Medo na Organização a Partir da Perspectiva Psicobiológica

La emoción del miedo ha sido un foco de atención por parte de teóricos de la administración en virtud de los efectos negativos que genera en las organizaciones. Sin embargo, las investigaciones realizadas se enfocaron en esclarecer cómo las organizaciones se ven afectadas por el miedo, sin formular argumentos que permitan una sólida explicación de por qué se presenta este fenómeno. En el presente artículo se hace una revisión teórica desde la perspectiva psicobiológica sobre la naturaleza del miedo y sus reacciones, con el objetivo de facilitar un mayor entendimiento sobre los efectos negativos de dicha emoción en las organizaciones.

Abstract The emotion of fear has received a great deal of attention from theoreticians of administration, due to the negative impact it has on organizations. However, most of the research has focused on the way organizations are affected by fear, without providing arguments to explain why the phenomenon arises. From the psycho-biological perspective, the article carries out a theoretical review of the nature of fear and the reactions to it, in order to facilitate greater understanding of the negative effects this emotion can have on organizations.

A emoção do medo tem sido um foco de atenção por parte de teóricos da administração em virtude dos efeitos negativos que gera nas organizações. Contudo, as pesquisas realizadas se enfocaram em esclarecer como as organizações se veem afetadas pelo medo, sem formular argumentos que permitam uma sólida explicação de por que se apresenta esse fenômeno. No presente artigo, faz-se uma revisão teórica a partir da perspectiva psicobiológica sobre a natureza do medo e suas reações, com o objetivo de facilitar um maior entendimento sobre os efeitos negativos dessa emoção nas organizações.

Retrato de dores crônicas: percepção da dor através do olhar dos sofredores / Chronic pain portrait: pain perception through the eyes of sufferers

Justificativa e objetivos: A literatura enumera vários fatores que influenciam na eclosão ou manutenção da dor crônica; entretanto, sabe-se que esses aspectos não podem ser generalizados e universalizados, pois estudos afirmam que as diferenças socioculturais interferem na percepção do quadro álgico. Este estudo teve como objetivo caracterizar a percepção que o paciente tem sobre sua dor e seu sofrimento associado a partir do recurso projetivo Retrato da Dor. Métodos: Trata-se de um estudo exploratório realizado com 150 pacientes com dor crônica de diversas etiologias. Eles foram avaliados a partir de variáveis sociodemográficas, relacionadas a dor e de crenças em relação a dor/sofrimento e ao tratamento proposto (aplicação do Retrato da Dor). As informações obtidas no Retrato da Dor foram analisadas segundo o método de análise de conteúdo. Foi realizado um único encontro com duração média de 60 minutos. Resultados: A pesquisa foi composta por 64% de mulheres, com idade média de 52,5 anos, 46% eram casados e 46% tinham o 2º grau incompleto. O tempo médio de convívio com a dor foi de 6 anos (58%). Os desenhos foram agrupados em 8 categorias (cenas, monstros, objetos, formas geométricas, formas irregulares e rabiscos, corpo humano inteiro, partes do corpo e miscelânea), evidenciando-se que a metade dos sujeitos associava o sofrimento atual a outros eventos de impacto emocional, assim como 87% aguardava melhorar a partir de estratégias passivas. Conclusão: Há poucos relatos do uso de instrumentos projetivos na avaliação e tratamento de dor crônica. Os resultados sugerem que esse recurso pode ajudar na caracterização do sentido da dor na vida do paciente e favorecer a adesão ao tratamento proposto. ...

Background and objectives: The literature mentions several factors influencing chronic pain onset or maintenance; however, it is known that such aspects cannot be generalized and universalized because studies state that socio-cultural differences interfere with pain perception. This study aimed at characterizing patients' perception of their pain and associated suffering as from the projective tool Portrait of Pain. Methods: This is an exploratory study with 150 patients with different chronic pains. They were evaluated as from sociodemographic variables related to pain and beliefs with regard to pain/suffering and proposed treatment (application of the Portrait of Pain). Information obtained from the Portrait of Pain was analyzed by the content analysis method. A single meeting was scheduled with mean duration of 60 minutes. Results: The study was made up of 64% of females, mean age of 52.5 years, 46% were married and 46% had not completed high school. Mean pain duration was 6 years (58%). Drawings were grouped in 8 categories (scenes, monsters, objects, geometric shapes, irregular shapes and scribbles, whole human body, parts of the body and miscellaneous), evidencing that half of the subjects associated current suffering to other events with emotional impact and 87% expected to improve as from passive strategies. Conclusion: There are few reports on the use of projective tools to evaluate and manage chronic pain. Results suggest that this resource could help characterizing the meaning of pain in patients' lives and favor adhesion to proposed treatment. Further studies should come up to deepen the theme.

<b>Use of Electronic Medical Information Including SS-MIX Data for Drug Safety Measures </b> / 薬剤疫学

PMDA started MIHARI project in FY2009 to enhance drug safety assessment by developing ways to utilize electronic medical information as additional data sources to spontaneous adverse drug reaction reports. The project has been established according to PMDA's second midterm plan. In this article, we will introduce latest two studies (pilot studies No. 4 and 5) using data of standardized electronic medical record(EMR) called SS-MIX (standardized structured medical record information exchange) data out of our several pilot studies. SS-MIX is a standard specification published by the Ministry of Health, Labour and Welfare. In these studies, anonymized SS-MIX data were provided by six collaborative hospitals respectively. In pilot study No. 4, we explored approaches for evaluating the impact of regulatory action which instructed relevant manufacturers to revise package inserts of sitagliptin phosphate hydrate (sitagliptin) to call physician's attention. The revision was about reducing dose of sulfonylurea (SU) to avoid serious hypoglycemia when it is prescribed concomitantly with sitagliptin. As indicators of the impact, we evaluated changes in proportion of concomitant use and average SU dose before and after the action and estimated the risk of hypoglycemia in concomitant users compared to SU alone users before and after the action. In conclusion, evaluating impact of the regulatory action using SS-MIX data was technically feasible; however, it was difficult to analyze with adequate accuracy due to limited size of the data. In pilot study No. 5, we examined validity of outcome definitions for hyperthyroidism which were applied to combinations of some data elements of SS-MIX data to identify the patients. Three types of outcome definitions were prepared; 1) definitive diagnosis of hyperthyroidism, 2) prescription of medication for hyperthyroidism, 3) prescription of medication for hyperthyroidism in or after the month in which definitive diagnosis of hyperthyroidism was given. Criteria for case ascertainment were determined according to relevant clinical guidelines. After the cases were ascertained, positive predictives values were calculated. The results suggested that using information on prescription of medication improves validity of definition of outcome. The findings from pilot studies in MIHARI project have been utilized in another project which PMDA is carrying forward now (EMR network project). The findings would be also helpful when we use data from this network. (Jpn J Pharmacoepidemiol 2013；18(1)：23-29)