Comparing the influence of big data resources on medical knowledge recall for staff with and without medical collaboration platform.

BACKGROUND: This study aims to examine how big data resources affect the recall of prior medical knowledge by healthcare professionals, and how this differs in environments with and without remote consultation platforms. METHOD: This study investigated two distinct categories of medical institutions, namely 132 medical institutions with platforms, and 176 medical institutions without the platforms. Big data resources are categorized into two levels-medical institutional level and public level-and three types, namely data, technology, and services. The data are analyzed using SmartPLS2. RESULTS: (1) In both scenarios, shared big data resources at the public level have a significant direct impact on the recall of prior medical knowledge. However, there is a significant difference in the direct impact of big data resources at the institutional level in both scenarios. (2) In institutions with platforms, for the three big data resources (the medical big data assets and big data deployment technical capacity at the medical institutional level, and policies of medical big data at the public level) without direct impacts, there exist three indirect pathways. (3) In institutions without platforms, for the two big data resources (the service capability and big data technical capacity at the medical institutional level) without direct impacts, there exist three indirect pathways. CONCLUSIONS: The different interactions between big data, technology, and services, as well as between different levels of big data resources, affect the way clinical doctors recall relevant medical knowledge. These interaction patterns vary between institutions with and without platforms. This study provides a reference for governments and institutions to design big data environments for improving clinical capabilities.

Satisfaction Survey for Regional Clinical Pathway for Stroke Patients in Acute and Rehabilitation Hospitals in Japan.

Objectives: We collected opinions about the use of a stroke-specific regional clinical pathway for facilitating collaboration between acute and rehabilitation hospitals in Japan. Methods: The study surveys were administered in acute hospitals designated as primary stroke centers and certified by the Japan Stroke Association (n=961) and in rehabilitation hospitals affiliated with the Kaifukuki Rehabilitation Ward Association (n=1237). The survey collected information on interfacility collaboration when caring for patients admitted during the acute phase following non-traumatic stroke from April 2020 to March 2021. We examined the pathway's usefulness and challenges relative to facility type using the χ2 test. Results: Of 422 acute hospitals and 223 rehabilitation hospitals that responded to our survey, 259 (62.1%) acute hospitals and 164 (85.4%) rehabilitation hospitals used the pathway. Fewer rehabilitation hospitals than acute hospitals considered that the pathway was useful (52.0% vs. 63.8%, P=0.02). Fewer rehabilitation hospitals did not experience pathway-related problems when compared with acute hospitals (38.0% vs. 55.8%, P<0.01). Conclusions: Personnel at rehabilitation hospitals were less satisfied with the regional clinical care pathway than those in acute hospitals. These results suggest that the current stroke-specific regional clinical pathway could be improved.

The importance of an eating disorder treatment support center in Japan: A survey from 2017 to 2020.

We investigated the impact of medical collaboration between the Chiba Eating Disorder (ED) Treatment Support Center (CSC) in Chiba Prefecture and the ED treatment center at Kohnodai Hospital. We calculated the number of consultations performed by the CSC and referral rate to other medical facilities from October 2017 to March 2020, as well as the clinical characteristics of the patients treated at our hospital from April 2016 to March 2020. Data on duration of hospitalization and increase in body mass index (BMI) during hospitalization were recorded. Patients were divided into all of the Japan and Chiba Prefecture groups. Data were evaluated by Poisson's regression analysis or one-way analysis of variance. A p-value < 0.05 was considered significant. The 2019 data served as reference values. Our data demonstrated that while the number of CSC consultations increased (2017:201, 2018:547, 2019:552) annually, the number of hospitalizations for EDs decreased (197, 194, 134, respectively). In comparison, the number of outpatient consultations for EDs across all of Japan peaked in 2018 and decreased significantly thereafter (2016:110, 2017:139, 2018:193, 2019:142). After the CSC was established, the number of patients treated in our department decreased as expected. Patients with anorexia nervosa (AN) who were treated on an outpatient basis across all of Japan were younger in 2019 (27.0 ± 1.2) than in 2018 (31.9 ± 1.2). Severe cases had better outcomes, and there was a significant increase in BMI of inpatients with AN in both groups. Overall, the activities of such ED treatment support center promoted successful treatment of severe ED cases.

A Social Capital Perspective on Social-Medical Collaboration in Community End-of-Life Care in Hong Kong.

Recent developments in Hong Kong end-of-life (EOL) care have shifted some caring work for dying people and their families to cross-disciplinary collaboration in community settings. Social-medical collaboration becomes especially important. This study aims to use social capital as an analytical lens to examine the processes and mechanisms of social-medical collaboration in EOL care and elucidate practice implications for engaging in the care of dying people and their families. Qualitative data were collected using in-depth interviews. Three major conceptual categories were generated through grounded theory methodology. They are (a) establishing trust through keeping clear and simple boundaries, (b) cultivating mutuality in the multi-disciplinary meeting, and (c) fostering social-medical collaboration in EOL care. Each new stage is based on the social capital accumulated in the previous one through the social interactions between professionals. Such theorization also provides insights into how to achieve effective social-medical collaboration in this context.

Attitudes toward and knowledge of collaboration of dental and medical practice among medical students in Southern India: a cross-sectional questionnaire survey.

BACKGROUND: Enhancing oral health care services provided through inter-professional collaboration between medical and dental practitioner is important, and even essential. The purpose of this study is to assess the attitude toward and knowledge of medical-dental collaborative practice among medical students attending colleges in Southern India. METHODS: A cross sectional questionnaire survey was conducted among medical students and interns of medical colleges in coastal South India with prior information and permission. The questionnaire consisted of 11 questions to assess attitude toward and knowledge of medical-dental collaborative practice. The demographic backgrounds of participants were also recorded. Chi square test was employed for data analysis. The responses obtained were correlated with age, gender and year of study of participants using Pearson's correlation test Results: A total 250 questionnaires were distributed and 234 responses were appropriately completed. Most of the students agreed that oral health was an integral part of systemic health, however participants disagreed on attending compulsory rotation in dentistry at a statistically significant level (p<0.05), moreover participants did not agree with physicians having an active role in motivating their patients for regular dental check-up. 82% of the medical students believe that dental check-up should be included in health packages under health insurance. A statistically significant (p<0.05) difference was observed among 3 rd year & 4 thyear students and interns and also it was found that female students provided more positive responses towards medical-dental collaboration. CONCLUSIONS: Even though medical students showed fairly positive attitudes and knowledge towards dentistry, the analysis within the study groups showed that knowledge and attitudes regarding the collaborative practice worsened over the academic years among the medical students. In order to destigmatize and foster interdisciplinary collaboration which would contribute to higher resource efficiency and the standard of care, continuing education in both the disciplines would be highly beneficial.

Raising Knowledge and Awareness of Fragile X Syndrome in Serbia, Georgia, and Colombia: A Model for Other Developing Countries?

Fragile X syndrome is the most common monogenetic cause of inherited intellectual disability and syndromic autism spectrum disorder. Fragile X syndrome is caused by an expansion (full mutation ≥200 CGGs repeats, normal 10-45 CGGs) of the fragile X mental retardation 1 (FMR1) gene, epigenetic silencing of the gene, which leads to reduction or lack of the gene's product: the fragile X mental retardation protein. In this cross-sectional study, we assessed general and pharmacotherapy knowledge (GK and PTK) of fragile X syndrome and satisfaction with education in neurodevelopmental disorders (NDDs) among senior medical students in Serbia (N=348), Georgia (N=112), and Colombia (N=58). A self-administered 18-item questionnaire included GK (8/18) and PTK (7/18) components and self-assessment of the participants education in NDDs (3/18). Roughly 1 in 5 respondents had correct answers on half or more facts about fragile X syndrome (GK>PTK), which ranged similarly 5-7 in Serbia, 6-8 in Georgia, and 5-8 in Colombia, respectively. No cohort had an average value greater than 9 (60%) that would represent passing score "cut-off." None of the participants answered all the questions correctly. More than two-thirds of the participants concluded that they gained inadequate knowledge of NDDs during their studies, and that their education in this field should be more intense. In conclusion, there is a major gap in knowledge regarding fragile X syndrome among senior medical students in these three developing countries. The finding could at least in part be generalized to other developing countries aimed toward increasing knowledge and awareness of NDDs and fostering an institutional collaboration between developed and developing countries.

Case Report: Iatrogenic Dental Progress of Phantom Bite Syndrome: Rare Cases With the Comorbidity of Psychosis.

Introduction: Phantom bite syndrome (PBS) is considered as the preoccupation with dental occlusion and the continual inability to adapt to changed occlusion. These patients constantly demand occlusal corrections and undergo extensive and excessive dental treatments. We present three cases with PBS-suspected iatrogenic concerns and the attribution to underlying psychosis. Case Presentation: A 70-year-old female demanded orthodontic retreatment and complained of tightness and cramped sensation of teeth in the oral cavity, uncomfortable occlusion, and pain in her neck and legs that she was convinced was induced by orthodontic treatment. However, even earlier than the orthodontic treatment, she had kept doctor shopping for over 35 years, not merely dentists but also psychiatrists, neurologists, and so on; she was diagnosed with bipolar disorder. A 48-year-old female complained of malaligned improper occlusion and demanded occlusal adjustment. These symptoms occurred in the absence of a dental trigger and were worsened by orthodontic treatment. She underwent psychiatric treatment for 15 years with a diagnosis of bipolar disorder. A 38-year-old female, who had a history of schizophrenia for over 20 years, complained of occlusal discomfort and revisited with a complaint of abnormal occlusion due to excessive dental procedures. In the last two cases, requests for dental procedures had reduced owing to the collaboration between the psychiatrists and dentists. All the cases first visited our clinic following a succession of dental visits. They were strongly convinced that occlusal correction was the only solution to their symptoms, including the symptoms of discomfort in other body parts. Their misleading perceptions were uncorrectable, and repeated dental treatments exacerbated their complaints. Moreover, the dentists overlooked the psychotic histories of the patients, while the comorbid psychosis resulted in a strict demand for dental treatment by the patients. Conclusions: The presented PBS cases with psychosis suggest that repeated dental treatments and comorbid psychosis exacerbate PBS. Moreover, their persistent demands reflecting comorbid psychosis led dentists to perform numerous procedures. Early detection of underlying psychosis and the prompt collaboration between psychiatrists and dentists are integral to help prevent complications in PBS cases with psychosis.

How to Manage Diversity and Enhance Team Performance: Evidence from Online Doctor Teams in China.

(1) Background: Traditional one-to-one online consultations with doctors often fail to provide timely and accurate treatment plans; consequently, creating cross-hospital and cross-regional teams has become a new pattern for doctors aiming to offer Internet medical services. Because the online doctor team is a new virtual organizational model, it remains to be explained and investigated. (2) Methods: Combining the information processing view and the social categorization view, this study takes the perspective of team diversity and empirically investigates the effect of team diversity on team performance. We consider four kinds of team diversity, including status capital diversity, decision capital diversity, online reputation diversity, and professional knowledge diversity, and we investigate how team composition from the diversity perspective affects online doctor team performance and how leader reputation moderates the effect of team diversity on team performance. We use secondary data from a leading online medical consultation platform in China (Good Doctor: www.haodf.com), and our research data include 1568 teams with a total of 5481 doctors. (3) Results: The results show that status capital diversity and decision capital diversity negatively affect team performance; diversity in terms of online reputation and professional knowledge positively affect team performance; and leader reputation moderates the impact of status capital diversity and online reputation on team performance. (4) Conclusions: Our study offers management suggestions on how to form a high-performance doctor team and provides advice for the future development of online doctor teams.

Sistema Informático para la Gestión de Información referente a la Colaboración Médica / Medical Collaboration Information Management Computer System

La revolución cubana no esperó su desarrollo económico y consolidación política para comenzar a brindar ayuda internacionalista en el campo de la salud. El número de colaboradores y de países donde se brinda esta labor se ha incrementado en grandes cifras. En la Dirección Provincial de Salud de Ciego de Ávila se maneja un elevado volumen de información de los trabajadores de la salud, a partir del cual se realizan análisis en diferentes escenarios para determinar la disponibilidad de estos trabajadores, este proceso resulta engorroso y deficiente desarrollarlo manualmente. Esta investigación tiene como objetivo desarrollar un sistema informático, a partir del empleo de bases de datos y tecnología Web, para aminorar estas insuficiencias en la provincia. A partir de la implementación de este sistema, la Dirección Provincial de Salud cuenta con una herramienta capaz de gestionar información referente a la colaboración médica, la cual funciona correctamente(AU)

The Cuban revolution did not wait for its economic development and political consolidation to begin providing international help in the health field. The number of collaborators and countries where this work is provided has increased in large numbers. In the Provincial Health Directorate of Ciego de Ávila, a high volume of health workers information is handled, from which analysis are carried out in different scenarios, this process is cumbersome and difficult to develop manually. This research aims to develop a computer system, based on the use of databases and Web technology, to reduce these deficiencies in the province. As of the implementation of this system, the Provincial Health Directorate has a tool capable of managing information related to medical collaboration, which works correctly(AU)

Professional Oral Health Care at General Dental Clinic Reduces Postoperative Complications of Head and Neck Free-Flap Reconstruction Surgery.

Background: Extensive resection and free-flap reconstruction surgery has become the standard treatment for locally advanced head and neck cancer. Surgical site infection (SSI) is one of the serious complications of this treatment. This study aimed to investigate the risk factor for onset of SSI, particularly focusing on whether preoperative professional oral health care in cooperation with general dental clinics is effective in reducing the occurrence of SSI. Methods: From March 2003 to August 2011, 183 patients who underwent head and neck free-flap reconstructive surgery by the same plastic surgeon at Miyagi Cancer Center for Head and Neck Surgery were investigated retrospectively. Results: Of the 183 patients, 135 and 48 were men and women, respectively, with a mean age of 62 (range, 29-82) years. The tumor was located in the oral cavity (n = 76), hypopharynx (n = 55), oropharynx (n = 28), and others (n = 24). Clinical stages were stage I/II in 18, stage III/IV in 164 patients, and benign tumor in one patient, based on UICC classification. SSI occurred in 66 patients (36.1%). Based on multivariate analysis, professional oral health care [P = 0.0076, odds ratio (OR) = 0.39] and radiation therapy history (P = 0.0214, OR = 2.820) were shown as factors that are significantly related to SSI. Conclusion: This study identified history of radiation therapy as a significant risk factor for SSI from univariate and multivariate analysis and revealed that patients receiving preoperative professional oral health care at general dental clinics reduce the risk of SSI. Preoperative professional oral health care in cooperation with general dental clinics has been shown to reduce SSI of head and neck free-flap reconstructive surgery.

Validez y confiabilidad del instrumento Jefferson scale of atittudes toward physician nurse colaboration scale en el contexto Colombiano / Validity and reliability of the instrument Jefferson scale of attitudes towards the scale of collaboration of doctors and nurses in the Colombian context

El modelo de atención centrado en el paciente, es el ideal para la prestación delos servicios de salud, y este contempla aspectos como el trabajo colaborativo entre los profesionales de la salud. En Colombia no se cuenta con un instrumento que permita medir este constructo, por lo que esta investigación tuvo como objetivo evaluar la validez y confiabilidad de la versión en español del instrumento: "Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration " que cuenta con 15 ítems en escala tipo Likert. Para llevar a cabo este estudió se usó un diseño de tipo metodológico para evaluar las propiedades psicométricas del instrumento a través de pruebas estadísticas. La primera fase que se desarrolló fue la traducción y retrotraducción con ayuda de un grupo de traductores oficiales y una enfermera con alto nivel de inglés y residente en Canadá y un equipo evaluador que eligió la versión final del instrumento en español. A continuación, se realizó la validación de contenido mediante consenso de expertos, en los que se convocó un equipo de jueces que cumplieran con las características requeridas para que evaluaran la pertinencia, suficiencia, claridad y relevancia de cada uno de los ítems del instrumento. Los resultados fueron: indíce de kappa 0.44 en suficiencia, 0.54 en coherencia, 0.54 en relevancia, 0.41 en claridad, y razón de validez de contenido de 0.88, 0.89, 0.92 y 0.89 respectivamente. En la validación de constructo se realizó análisis factorial que arrojó como resultado seis factores con valores de asociación entre .45 el más bajo y .79 el más alto. El Alfa de Cronbach para determinar la confiabilidad fue de .0195.

The model Patient-centred healthcar is the ideal for the provision of health services, and this includes aspects such as collaborative work among health professionals. In Colombia, there is no instrument to measure this construct, so this research aimed to evaluate the validity and reliability of the Spanish version of the instrument: "Jefferson attitude scale toward nurse-physician collaboration" that counts with 15 items on a Likert scale. To carry out this study, a methodological type design was used to evaluate the psychometric properties of the instrument through statistical tests. The first phase that allowed the translation and back-translation with the help of a group of official translators and a nurse with English level and resident in Canada and an evaluation team that chose the final version of the instrument in Spanish.Then, content validation was carried out by consensus of experts, which were sent to a team of judges who met the required characteristics to assess the relevance, sufficiency, clarity and relevance of each of the instrument's items. The results were: 0.50 in sufficiency, 0.54 in coherence, 0.54 in relevance, 0.41 in clarity, 0.88, 0.89, 0.92 and 0.89 respectively. In the validation of the construct, the factorial analysis was performed, which resulted in sesis factors with association values between .45 the lowest and .79 the highest. The Cronbach's Alpha to determine reliability was .0195

The Rate of Referral of Hepatitis Virus Carriers to Hepatologists and the Factors Contributing to Referral.

Objective The aims of the present study were to determine the proportions of hepatitis B surface antigen (HBsAg)-positive and anti-hepatitis C virus (HCV)-positive patients, and identify the characteristics that influenced referral to a hepatologist. Methods The present study included patients who were positive for HBsAg (n=153) or anti-HCV (n=574); their viral status was tested by non-hepatologists between January 2008 to December 2012. We performed a multivariate analysis to investigate the factors associated with the referral of patients to hepatologists. Results The rates of hepatitis B virus (HBV) and the percentage of suspected HCV carriers at the hospital were 1.4% and 3.5%, respectively. Among the 727 patients who were seropositive for HBV or HCV, 107 (14.7%) were referred to a hepatologist. A multivariate analysis to investigate the factors contributing to referral revealed that (i) an alanine aminotransferase (ALT) level of >30 IU/L [odds ratio (OR), 3.24; 95% confidence interval (CI), 2.10-5.03; p<0.001]; (ii) undergoing testing at an internal medicine department (OR, 2.79; 95% CI, 1.80-4.38; p<0.001); and (iii) HBsAg-positivity (OR, 2.22; 95% CI, 1.35-3.61; p=0.002) were factors that significantly influenced referral. Conclusion Hepatologists must educate non-hepatologists, especially non-internists, to promote the referral of hepatitis-virus carriers, especially HCV carriers, even in patients with ALT levels of <30 IU/L.

Profesores cubanos enseñando Medicina, en un país árabe, en inglés / Cuban professors, teaching Medicine, in an Arabic country, in English

Introducción: La colaboración médica cubana no se ha limitado al campo de la atención de salud, también ha incluido la formación de recursos humanos autóctonos, incluyendo la creación de Facultades de Medicina en el exterior. La Facultad de Medicina de la República Democrática de Yemen es un destacado ejemplo de esta actividad. Objetivo: describir algunas características y singularidades de este relevante hecho de la colaboración médica cubana. Material y Métodos: Se realizó un trabajo histórico descriptivo, a partir de materiales periodísticos, fotografías, el diario personal y otros documentos del archivo del autor. Desarrollo: La Facultad de Medicina de Adén fue creada en 1975 con la participación de profesores cubanos en calidad de colaboradores. Durante su segundo curso, esta Facultad recibió la visita del Comandante en Jefe, Fidel Castro Ruz, durante su estancia en la República Democrática de Yemen, en marzo de 1977. La prensa yemenita brindó amplia cobertura a la visita. Fidel tuvo palabras de estímulo y admiración por la realización de esta tarea de colaboración. Conclusiones: La constitución de la Facultad de Medicina en la República Democrática de Yemen, en 1975, constituyó un hito histórico relevante en el desarrollo de la colaboración médica cubana. La visita de Fidel Castro a la Facultad de Medicina en Adén en marzo de 1977 fue un estímulo de especial significación para los colaboradores cubanos(AU)

Introducción: Cuban medical collaboration has not been limited to the field of health care, it has also included the training of own human resources, including the creation of Medical Faculties in other countries. The Faculty of Medicine of the Democratic Republic of Yemen is a leading example of this activity. Objective: To describe some characteristics and singularities of this relevant historical event of the Cuban medical collaboration. Material and Methods: A descriptive historical research was done, based on journalistic materials, photographs, personal diary and other documents of the author's archives. Development: The Faculty of Medicine of Aden was created in 1975 with the participation of Cuban professors as collaborators. During its second course, this Faculty received the visit of Commander-in-Chief Fidel Castro Ruz during his stay in the Democratic Republic of Yemen in March of 1977. The Yemeni press provided a wide coverage to the visit. Fidel had words of encouragement and admiration for the accomplishment of this collaboration. Conclusions: The creation of the Faculty of Medicine in the Democratic Republic of Yemen in 1975 was an important historical milestone in the development of Cuban medical collaboration. Fidel Castro's visit to the Faculty of Medicine in Aden in March 1977 was a stimulus of special significance for Cuban collaborators.(AU)

The Construction of Provincial Regional Medical Collaboration Based on Cloud Computing Model / 医学信息学杂志

Specific to the existing problems of uneven distribution of resources in the medical industry,especially the shortage of grass-root high-quality medical resources,the paper introduces the construction objective,overall architecture and construction contents of regional medical collaboration,and normalizes the medical service process through informationalized technological means,in order to promote standardized construction of the regional medical information system and information interconnection and intercommunication.

Exploration and Effect of Performance-based Prospective Global Budget Payment Mechanism in Integrated Service Reform / 中国卫生经济

Objective:To explore and test a blending prospective payment that suitable for integrated care delivery system in China.Methods:Referring to Accountable Care Organization and domestic reforms,it designed a performance-based and prospective global budget payment mechanism which mainly contained strategies as medical alliance contract,prepay by DRGs and performance-based management.Through a quasi-experiment,it tested its effects on controlling the inpatient spending and continuity of care.Results:There were 38 980 cases included from inpatient claims data out of 4 towns.194 medical records came from township and county hospitals.Compared to control group,the average hospitalization rate per capita every 5 months in treated group significantly declined by 0.08％,the likelihood of using upper level hospitalization significantly declined by 0.16％,and the continuity of care significantly increased by 33.80％.Global budget system would benefit decreasing hospitalization structure and improving medical collaboration.However,the effects of new model might be underestimated by the imperfect implementation of compulsory referral system.Conclusion:The medical alliances should center on combined objectives as stimulating medical cooperation and improving on quality of care.It should make the blending prospective payment decisions on basis of information-shared grading and referral medical system and empirical evidence.

Assimilating South African medical students trained in Cuba into the South African medical education system: reflections from an identity perspective.

BACKGROUND: In terms of the Nelson Mandela Fidel Castro Medical Collaboration programme, an agreement between the governments of South Africa and Cuba, cohorts of South African students receive their initial five years medical training at a Cuban university before returning to South Africa for a six to twelve months orientation before integration into the local final year class. It is common for these students to experience academic difficulty on their return. Frequently this is viewed merely as a matter of a knowledge deficit. DISCUSSION: We argue that the problem arises from a fundamental divergence in the outcomes of the Cuban and South African medical curricula, each of which is designed with a particular healthcare system in mind. Using the discrepancy theory of identity proposed by Higgins in 1987, we discuss the challenges experienced by the returning Nelson Mandela Fidel Castro Medical Collaboration students in terms of a potential crisis of identity and suggest interventions which may prove valuable in promoting academic success and successful integration. CONCLUSIONS: Though providing additional training to address the gap in skills and knowledge in returning students is an important part of their successful reintegration, this could be insufficient on its own and must be complemented by a range of measures designed to ameliorate the discrepancies in identity which arise from the transition from one educational model to another.

The application of medical coordination and hierarchical responsibility system in interventional ward nursing / 介入放射学杂志

Objective To discuss the clinical application of medical coordination and hierarchical responsibility system in interventional nursing care which is carried out based on the “Henan Province Model”. Methods From November 2003 to April 2014 at authors’ hospital, medical coordination and hierarchical responsibility system was executed through setting up a ranking system of nursing position , optimizing shift process , dividing physician-nurse medical liability groups , strengthening medical training , implementing medical coordination service mode, etc. The clinical results were compared with those of conventional nursing care that were recorded during the period from May to Oct. of 2013. Results After implementation of medical coordination and hierarchical responsibility system, the quality of medical care, the patent’s satisfaction, the cooperation satisfaction of physicians and nurses were significantly improved. Compared with those before implementation of medical coordination and hierarchical responsibility system , the differences in the above indexes were statistically significant(P<0.01 or P<0.05). Conclusion Based on multidisciplinary joint diagnosis and treatment, and combined with coordination physician-nurse service mode, the enthusiasm of nursing staff can be motivated and the tacit understanding between physicians and nurses as well as the quality of nursing service can be improved. All of the above will promote the development of nursing discipline.

Escuela de Medicina en Timor Leste: un logro conjunto de la colaboración médica cubana / School of Medicine in Timor Leste: a joint achievement of the Cuban medical collaboration

Fundamento: la brigada médica cubana ha influido de forma trascendental en el desarrollo histórico de Timor Leste y de forma específica en su escuela de Medicina. Objetivo: caracterizar los diferentes momentos históricos de la escuela de Medicina en Timor Leste, desde su fundación hasta las graduaciones actuales. Métodos: se realizó un estudio descriptivo sobre la formación de médicos en Timor Leste, utilizando métodos teóricos y empíricos. Teóricos: analítico-sintético, histórico-lógico, inducción-deducción, que permitieron el análisis de la documentación y bibliografía revisada. Los métodos empíricos utilizados fueron la revisión documental de los balances académicos anuales y la observación participante de los autores, así como la entrevista aplicada a miembros de la brigada médica y docentes que han transitado por el país, y líderes nacionales comprometidos con este proceso formativo. Resultados: se realizó la caracterización mediante una secuencia lógica de la labor de la colaboración médica cubana en Timor Leste desde sus inicios en la formación de médicos y en la formación posgraduada. Conclusiones: la ejecución de políticas sociales, en particular las educativas, han permitido en Timor Leste el desarrollo y fortalecimiento de la formación médica al crear las estructuras académicas y funcionales que garantizan su continuidad. Los resultados académicos de promoción y retención durante el tiempo analizado en el estudio realizado han sido aceptables.

Background: the Cuban medical brigade has had a considerable influence over the historical development of Timor Leste, and specifically over its School of Medicine. Objective: to characterize the different historical moments of the School of Medicine in Timor Leste, from its foundation to its current graduations. Methods: A descriptive study was done on the training of doctors in Timor Leste, using theoretical and empirical methods; theoretical: analytic-synthetic, historical-logical and induction-deduction, which allowed the analysis of the documents and bibliography that were revised. The empirical methods used were the revision of the yearly academic reports, and the participatory observation done by the authors, as well as the interviews had with members of the medical brigade, teachers who have been to the country, and national leaders committed to this training process. Results: a characterization was made through a logical sequence of the work done by the Cuban medical collaboration in Timor Leste, since its beginning in the training of doctors, and also their postgraduate training. Conclusions: the application of social policies, specifically the educational ones, have allowed in Timor Leste the development and strengthening of the medical training, by creating the academic and functional structures that guarantee their continuity. The academic results of promotion and retention analyzed during the time of the study have been acceptable.

Características y estado de salud de los colaboradores mayores de 60 años de la misión médica cubana en Venezuela / Characteristics and health conditions of collaborators of the Cuban Medical Mission in Venezuela aged 60 years and older

El envejecimiento es una experiencia universal y personal. Los hombres y las mujeres de 60 años o más son la población de más rápido crecimiento en el mundo. Objetivo: describir las características y estado de salud de los colaboradores mayores de 60 años de la misión médica cubana en Venezuela, en el período 2003-2011. Métodos: se realizó una investigación descriptiva a los 544 cooperantes, que constituyeron el universo de estudio. La fuente de información fundamental fue la base de datos de la Unidad Central de Cooperación Médica. Fueron estudiadas las variables edad, sexo, profesión, desempeño laboral, antecedentes patológicos personales y demanda de asistencia médica. Resultados: el 56,3 por ciento fueron del sexo femenino, predominó el grupo de edad de 60 a 64 años (76,1 por ciento), el 57,5 por ciento se encontraban en la categoría ocupacional profesional, y dentro de ella, los profesionales de enfermería con un 32,7 por ciento. El 69,7 por ciento de los colaboradores refirieron antecedentes patológicos personales, donde la hipertensión arterial fue la enfermedad crónica más frecuente. El 58,3 por ciento de los colaboradores demandaron asistencia médica durante la misión. Conclusiones: en los adultos mayores que cumplieron misión en la República Bolivariana de Venezuela predominó el sexo femenino, el grupo de edad de 60 a 64 años y la categoría ocupacional profesional, vinculados fundamentalmente a la actividad asistencial. La mayoría de los colaboradores padecían de alguna enfermedad crónica, siendo la más frecuente la hipertensión arterial, y más de la mitad demandaron asistencia médica durante la misión...

Aging is a universal and personal experience. 60 years or older men and women are the fastest growing population in the world. Objective: to describe the characteristics and health conditions of older than 60 years collaborators of the Cuban Medical Mission in Venezuela during the 2003-2011 period. Methods: a descriptive research was made to the 544 cooperatives that composed the universe of the study. The main source of information was the database of the Central Unit of Medical Cooperation. Variables such as age, sex, profession, work performance, personal pathological antecedents, and need of medical assistance were studied. Results: the 56,3 percent were female, the predominant age group was the 60-64 (76,1 percent), the 57,5 percent were in the professional occupational category and within it, the Nursing professionals with a 32,7 percent. The 69,7 percent of collaborators reported personal pathological antecedents, where hypertension was the most frequent chronic disease. The 58, 3 percent of collaborators needed medical assistance during the mission. Conclusions: the female sex, the age group 60-64 and the professional occupational category, mainly related to the health care activity, predominated in older adults who accomplished mission in The Bolivarian Republic of Venezuela. Most of the collaborators suffered from any chronic disease, being hypertension the most frequent one and more than a half needed medical assistance during the mission...