Servicio Autónomo Instituto de Altos Estudios "Dr. Arnoldo Gabaldon"

Ente adscrito al Ministerio del Poder Popular para la Salud que ofrece programas de formación de posgrado, formación permanente y de interacción social para dar respuesta a las necesidades del Sistema Público Nacional de Salud, eventos edición de publicaciones, incluyendo el Boletin de Malariología y Salud Ambiental.

Escola Municipal de Saúde - EMS

Escola Municipal de Saúde é a escola de saúde que se propõe a formar trabalhadores para o Sistema Único de Saúde (SUS), diferenciando-se de uma escola na concepção tradicional de educação, por ser voltada “ao trabalho e para o trabalho”, com a missão de formar ou aprimorar o trabalhador já inserido nos processos da Secretaria Municipal da Saúde (SMS).

Health professions school applicant experiences of discrimination during interviews.

BACKGROUND: Bias pervades every aspect of healthcare including admissions, perpetuating the lack of diversity in the healthcare workforce. Admissions interviews may be a time when applicants to health profession education programs experience discrimination. METHODS: Between January and June 2021 we invited US and Canadian applicants to health profession education programs to complete a survey including the Everyday Discrimination Scale, adapted to ascertain experiences of discrimination during admissions interviews. We used chi-square tests and multivariable logistic regression to determine associations between identity factors and positive responses. RESULTS: Of 1115 respondents, 281 (25.2%) reported discrimination in the interview process. Individuals with lower socioeconomic status (OR: 1.78, 95% CI [1.26, 2.52], p = 0.001) and non-native English speakers (OR: 1.76, 95% CI [1.08, 2.87], p = 0.02) were significantly more likely to experience discrimination. Half of those experiencing discrimination (139, or 49.6%) did nothing in response, though 44 (15.7%) reported the incident anonymously and 10 (3.6%) reported directly to the institution where it happened. CONCLUSIONS: Reports of discrimination are common among HPE applicants. Reforms at the interviewer- (e.g. avoiding questions about family planning) and institution-level (e.g. presenting institutional efforts to promote health equity) are needed to decrease the incidence and mitigate the impact of such events.

Investigation and analysis on an outbreak of norovirus infection in a health school in Guangdong Province, China.

Our objective was to describe the epidemiological features of an outbreak of norovirus infection in a health school in Guangdong province, China, to identify the cause of such a large scale outbreak of norovirus among older students, to simulate the transmission dynamics, and to evaluate the effect of intervention measures of GII.17 [P17] genotype norovirus infection. We identified all cases during the outbreak. Descriptive epidemiological, analytical epidemiological and hygiene survey methods were used to described the outbreak epidemic course and identify the cause of the outbreak of norovirus infection. We also used dynamical model to simulate the transmission dynamics of norovirus infection and evaluate the effect of intervention measures. Norovirus genotyping was assigned to the newly obtained strains, with a maximum likelihood phylogenetic analysis conducted. There were 360 cases of 42 classes in five grades with a 12.99% attack rate. Proportionally, more students were in contact with sick students and vomit in the suspected case group than the control group (χ2 = 5.535, P = 0.019 and χ2 = 5.549, P = 0.019, respectively). The basic reproduction number was 8.32 before and 0.49 after the intervention. Dynamical modeling showed that if the isolation rate was higher or case isolation began earlier, the total attack rate would decrease. Molecular characterization identified the GII.17 [P17] genotype in all stains obtained from the health school, which were clustered with high support in the phylogenetic tree. This was an outbreak of norovirus infection caused by contact transmission. The main reasons for the spread of the epidemic were the later control time, irregular treatment of vomit and no case isolation. The transmission dynamics of contact transmission was high, more efficient control measures should be employed.

Consideraciones sobre el proceso de formación de especialistas en Organización y Administración de Salud / Considerations on the training process of specialists in Health Organization and Management

La lectura del artículo A propósito de nuevos especialistas en Organización y Administración de Salud publicado en la Revista Cubana de Salud Pública (2020;46(2):e1349), me motivó a hacer un comentario sobre la indudable necesidad de la formación de personal especializado con dedicación a tareas de gestión para su desempeño en el Sistema Nacional de Salud. Soy graduado en Administración y Organización de Salud Pública en el inolvidable Instituto de Desarrollo de la Salud, identificado como IDS. Este instituto contaba con un calificado y exigente claustro de profesores con probada experticia nacional e internacional. Estos profesores fueron garantes, en cada graduado, del sentimiento de la responsabilidad de asumir las tareas como verdaderos salubristas cubanos, con desempeño internacional muchos de ellos, por lo que merecieron ese honroso calificativo con profesionalidad y orgullo para seguir haciendo más. En nuestra etapa de formación en el IDS se realizaban frecuentes actividades investigativas en la práctica docente, en áreas asistenciales y de servicios, mediante encuestas, trabajos prácticos y evaluaciones de procesos. Se utilizaban herramientas de la investigación científica, algunas construidas por nosotros, específicamente para un objetivo demandado por alguna entidad que solicitara colaboración al prestigioso y experimentado IDS y su colectivo profesoral. Lo que comprometía a los educandos a tener una participación responsable desde la especialización, además los imbuía una elevada motivación al apreciar que el producto de ese ejercicio producía algún impacto en el área de atención del solicitante. Éramos consciente de que esto ampliaba nuestro acervo profesional porque nos permitía apreciar las consecuencias de su realización con hechos reales de gestión en áreas de la dirección de salud pública. La acertada renovación de la formación de estos especialistas demanda de una adecuada selección de profesionales comprometidos, que evite una rápida hipoteca de la inversión requerida. Por esa razón, deseo compartir la opción de valorar si sería oportuno seleccionar candidatos en otras categorías profesionales del país; por supuesto, con prioridad en las propias del sector y que pudieran ser formados para desempeñar las funciones de gestión en la administración pública para salud. Además, que incluyera en sus diseños curriculares, desempeños temporales en las futuras y perspectivas áreas de su ámbito administrativo, compartidos con profesionales de la salud con experticia asistencial y docente, delimitando cada campo de acción dentro del objetivo común de las nuevas formas de dirección de la economía, donde la salud pública cubana tiene que seguir aprendiendo. Durante algunos cursos de mi etapa de formación como especialista en administración, el entonces director del Instituto de Desarrollo de la Salud me instó a redactar una propuesta para el desarrollo de la especialidad gerencial en el sistema de salud, a partir de un trabajo de campo que habíamos efectuado, al parecer con resultados muy favorables. Como era habitual, un plazo coordinado para pensar y elaborar, y una entrega con cuartillas bien definidas que evitara pérdida de tiempo, un claro mensaje para evitar costos irreversibles. En aquel momento, experiencias compartidas como parte de tareas docentes ya expresadas en párrafos anteriores, me animó a que, en una de las propuestas, se analizara lo que denominé proceso hipotecario del recurso salubrista. Me refería a la facilidad para designar a autoridades médicas de reconocido prestigio en su especialización y desempeño, para asumir responsabilidades de dirección en la asistencia, administración, docencia e incluso, de servicios; que no dudo que en esos momentos fuera necesario. Pero estas decisiones provocaban, en la mayoría de los casos, la separación y abandono de su práctica profesional, con el consiguiente deterioro de habilidades por las que, en muchos casos, habían sido el motivo de su selección. Con el paso del tiempo se asumió esa práctica, ya probada, de manera habitual, y se aceptó como natural. Lo mismo ocurre en la actualidad, que no permite su formación como parte activa de los procesos en los que deben convertirse en verdaderos líderes, esencia fundamental para ejercer su responsabilidad con una mayor capacidad de autoridad, de mando, pues gestionarían los procesos que comparten con sus propios subordinados. Creo es importante hoy enfatizar en esta actividad para modificar esa hipoteca, teniendo en cuenta el potencial actual de cuadros y reservas en el país. En la actualidad, con el capital humano que dispone la salud pública cubana, a pesar de que alguna personas e instituciones no lo reconozcan, y de su reconocimiento internacional más que destacado, con equipos de dirección entrenados a todos los niveles del sistema de salud, existen condiciones para que directivos médicos o estomatólogos de salud puedan cumplir tareas sin la pérdida de su desempeño profesional. Serían mucho más hábil asumir la responsabilidad donde actúan, y las acciones derivadas de su responsabilidad cumplimentarían una mejor adecuación del ejercicio de su autoridad, es decir, en sus estilos de mandar u ordenar ante los colectivos donde honrarían con su trabajo la gestión comprometida. Poseer responsabilidades es también saber distribuir las tareas, distinguir lo emergente de lo urgente, lo delegable de lo que no lo es. Además, se puede y se deben delegar las tareas, en virtud de la preparación de la reserva, aunque esta no siempre sea su propio relevo, como parte de la realidad objetiva del diario desempeño profesional de un gestor salubrista con deseos de hacer y hacer bien, parafraseando una frase martiana. Comparto esta inquietud, seguro de que los graduados de antes y después del prolongado periodo sin formar nuevos especialistas (ya superado), podrán gestar un espacio adecuado para intercambiar sobre las experiencias acumuladas en entorno a su deber salubrista, a fin de continuar avanzando como país, con la fortaleza demostrada y reconocida de la salud pública en Cuba(AU)

Association between the pattern of mobile phone use and sleep quality in Northeast China college students.

OBJECTIVES: Currently, mobile penetration is high amongst college students. The aims of this study were to investigate the characteristics of mobile phone use and to explore the influence of mobile phone use characteristics on sleep quality amongst college students. METHODS: From December 2016 to January 2017, we collected mobile phone use characteristics and sleep quality data using the Pittsburgh Sleep Quality Index (PSQI) and standardised questionnaires that were answered by 4500 medical university students in Liaoning Province (actual response rate of 94%, n = 4234 college students). This study used the SPSS 21.0 software to establish the database and perform the statistical analysis. RESULTS: One hundred percent of the college students had mobile phones and used mobile phones for entertainment (91%), work (51%), obtaining information (61%), and other purposes (23%). Additionally, there was a statistically significant difference in the PSQI score between students who held the phone at a distance of more than 10 cm from their eyes and those who held it a distance of less than 10 cm (P = 0.002). Multiple logistic regression analysis showed that the risk of poor sleep quality was 1.21-1.53 times higher for those who spent more than 5 h a day using their phones and 1.41-1.59 times higher for those who used their phones for more than half an hour before going to bed when the lights were off. CONCLUSIONS: Daily cumulative mobile phone use and use with the lights off before sleep are associated with poorer sleep quality.

Reflections on a Physician Assistant Entrance Exam: Does the Profession Need One?

ABSTRACT: Standardized entrance exams are used in many health professions as one way to objectively measure knowledge and facilitate comparisons across student groups. The physician assistant (PA) profession has historically not employed a profession-specific entrance exam, and the idea was never seriously explored until the Physician Assistant College Admissions Test was developed recently by a commercial assessment publisher, with field testing in some volunteer programs in 2018 and the exam's first administration in May of 2020. The 2020 Physician Assistant Education Association Presidents Commission chose to investigate the issues raised by a consensus-derived, PA-specific entrance exam to stimulate more informed discussion on the efficacy of such an exam. While it may have the potential to enhance efficiency in PA admissions and reduce variability in admissions requirements, a PA entrance exam would also likely introduce new challenges, including increased costs, impact on the diversity of the applicant pool, and incongruence with an increasingly holistic admissions process. The biggest barrier would likely be the lack of current consensus on the knowledge, skills, and attributes that matriculants need to be successful in the program and in clinical practice. Development of a consensus-derived PA entrance exam would be a complex, expensive, and time-consuming endeavor, requiring considerable attention to technical issues of psychometric quality, process transparency, and legal defensibility. Changes being made to health professions admissions practices due to the COVID-19 pandemic, including the dropping of test scores as a requirement by some institutions, may make some of the issues raised in this paper more timely than ever.

COVID-19: ensuring safe clinical teaching at university optometry schools.

The COVID-19 pandemic has been spreading across the globe for several months. The nature of the virus (SARS-CoV-2) with easy person-to-person transmissions and the severe clinical course observed in some people necessitated unprecedented modifications of everyday social interactions. These included the temporary suspension of considerable elements of clinical teaching at optometry schools worldwide. This article describes the challenges optometry schools were facing in early to mid 2020. The paper highlights the experiences of six universities in five countries on four continents. Strategies to minimise the risk of virus transmission, to ensure safe clinical optometric teaching and how to overcome the challenges presented by COVID-19 are described. An outlook on opportunities to further improve optometric education is provided.

Ten principles for data sharing and commercialization.

Digital medical records have enabled us to employ clinical data in many new and innovative ways. However, these advances have brought with them a complex set of demands for healthcare institutions regarding data sharing with topics such as data ownership, the loss of privacy, and the protection of the intellectual property. The lack of clear guidance from government entities often creates conflicting messages about data policy, leaving institutions to develop guidelines themselves. Through discussions with multiple stakeholders at various institutions, we have generated a set of guidelines with 10 key principles to guide the responsible and appropriate use and sharing of clinical data for the purposes of care and discovery. Industry, universities, and healthcare institutions can build upon these guidelines toward creating a responsible, ethical, and practical response to data sharing.

Plano de segurança em saúde e prevenção à Covid-19 da Escola Tocantinense do SUS Dr. Gismar Gomes / Health safety and prevention plan to Covid-19 of Escola Tocantinense do SUS Dr. Gismar Gomes

Plano de retorno das atividades educacionais presenciais no âmbito da Escola Tocantinense do Sistema Único de Saúde Dr. Gismar Gomes (ETSUS), no contexto da pandemia da COVID-19.

Return plan for presential education activities within the scope of the Escola Tocantinense do Sistema Único de Saúde Dr. Gismar Gomes (ETSUS), in the context of the COVID-19 pandemic.

COVID-19 Planning Among Radiologic Science Programs: Response Mitigation Activities.

PURPOSE: To examine radiologic science programs' mitigation activities and educators' experiences related to coronavirus disease 2019 (COVID-19) response planning. METHODS: Using a mixed-methods approach, educators in magnetic resonance, medical dosimetry, radiation therapy, and radiography programs were surveyed to capture their experiences and mitigation strategies related to COVID-19 response planning. Quantitative data were summarized using descriptive statistics and percentages. Thematic analyses were performed on the qualitative responses. RESULTS: A total of 274 educators responded. Educators reported being somewhat comfortable with modifying clinical experiences (79, 28.8%), moderately comfortable with adjusting assessment procedures (112, 40.9%), and extremely comfortable with changing delivery of didactic content (115, 42%). Incidentally, 220 (80.3%) educators thought adjusting to a new course delivery approach (eg, face-to-face to online format) was the greatest challenge for faculty during the pandemic. Notably, half of the educators in this study questioned the quality of online (remote) learning. Specific to program policies, educators indicated that access restrictions to campus buildings (263, 96%) and removal of students from clinical sites (254, 92.7%) were implemented during the pandemic. DISCUSSION: Educators self-reported a moderate to strong comfort level with curricular modification. The area of modification that yielded the most uncertainty arose from alterations of clinical experiences. Thematic analyses revealed concerns related to personal protective equipment procurement and clinical sites prohibiting students from completing rotations. However, educators created innovative alternatives to enhance clinical education by providing simulations, case study analyses, and virtual tours of facilities during the pandemic. Securing educational technology resources, such as lockdown browser software, and working with institutional instructional designers might provide some resolution to educators' concerns regarding the quality of online (remote) learning. CONCLUSION: Archiving radiologic science programs' COVID-19 response efforts is important. The compilation of mitigation strategies will inform and guide programs on contingency planning for future pandemic and emergent conditions.

Willingness to perform induced abortion and associated factors among graduating midwifery, medical, nursing, and public health officer students of University of Gondar, Northwest Ethiopia: institution based cross sectional study.

BACKGROUND: In developing countries, abortion is often unsafe and a significant cause of maternal morbidity and mortality accounting for about 8% (4.7-13.2%) of maternal mortality worldwide. Internationally, safe abortion services are recognized as reducing maternal mortality, and liberalized abortion laws are associated with reduced mortality resulting from unsafe abortion procedures. However, health care providers have moral, social and gender-based reservations that affects their willingness towards providing induced abortion services. The purpose of this study was to assess willingness to perform induced abortion and associated factors among graduating Midwifery, Medical, Nursing, and Public health officer students of University of Gondar. METHODS: Institution based cross sectional study was conducted from March 29 to May 30, 2019. All graduating students available during data collection period were considered as study population. Stratified simple random sampling technique was used to select 424 study participants. Pre tested, semi- structured, self-administered questionnaire was used to collect data. Data analysis was done using SPSS version 20. Ethical clearance was obtained from School of midwifery under the delegation of institutional review board of university of Gondar. RESULTS: Two hundred ninety students out of 424 students were willing to perform induced abortion for indications supported by Ethiopian abortion law, making a proportion of 68.4% (95%Cl: 64.2, 72.9). Sex (Being male (AOR = 4.89, 95%CI: 3.02, 7.89)), religion (being orthodox than protestant (AOR = 10.41, 95%CI: 3.02, 21.57)), being Muslim than protestant (AOR = 5.73, 95%CI: 1.37, 15.92)) and having once or less a week religious attendance (AOR = 2.00, 95% CI: 1.20, 3.34) were factors associated with willingness towards performing induced abortion. CONCLUSIONS: According to this study willingness of students towards providing induced abortion services was good. However female students, protestant followers and those students with more than once a week religious attendance should be encouraged to support women's access to induced abortion services by referring them to other health care professionals willing to provide induced abortion services.

Perfil de competencias esenciales que orientan la formación de los profesionales de la salud, Primera fase: Médico (a) y Enfermero(a) peruano(a). Documento técnico / Profile of essential competencies that guide the training of health professionals, First phase: Peruvian Physician and Nurse. Technical document

El documento contiene el marco teórico y la metodología para la formulación del perfil de competencias esenciales de los profesionales de la salud, que oriente la formación superior universitario.

Quando o ensino da saúde percorre territórios: dez anos da Coordenadoria de Saúde / When health teaching covers territories: ten years of the Health Coordination

O livro "Quando o ensino da saúde percorre territórios: dez anos da Coordenadoria de Saúde" é formado por reflexões de integração entre o ensino da saúde e os sistemas e serviços, no paradigma contemporâneo de ensino embasado em serviços. O conjunto de capítulos que compõem esta coletânea foi produzido a partir das atividades de comemoração de 10 anos da Coordenadoria da Saúde da Universidade Federal do Rio Grande do Sul (UFRGS). A CoorSaúde, como é habitual designá-la, nasceu da ideia de articular os cursos da área da saúde e o Sistema Único de Saúde (SUS) como campo de aprendizagens, assim como preconizam as Diretrizes Curriculares Nacionais (DCN) para os cursos da área da saúde, as diretrizes gerais do Conselho Nacional de Saúde (CNS) para esses cursos e as demais políticas nacionais de saúde e educação para a formação profissional em saúde. Nasceu, portanto, da ideia de que é oportuno e necessário desenvolver políticas institucionais para orientação às mudanças dos diferentes cursos que têm perspectivas de trabalho no SUS, sobretudo nas universidades públicas, que mais intensamente articulam o tripé ensino-pesquisa-extensão. Aprender, no sentido que escolhemos empregar, significa transformar-se e às instituições. O sentido da aprendizagem não é apenas a incorporação de conhecimentos e técnicas, mas a produção de novas tecnologias e, também, a produção de si e do percurso de aprendizagem. Aprender a aprender é a designação que fazem as DCN dessa aprendizagem, necessária e que aponta uma mudança pedagógica relevante. Aos capítulos produzidos a partir da experiência local e aprovados para a inclusão no livro, foram acrescentados dois textos de prefácio: um do médico sanitarista brasileiro Emerson Merhy e outro da psiquiatra e sanitarista italiana Maria Augusta Nicoli. Uma contribuição importante ao movimento contemporâneo de reorientação da formação dos profissionais de saúde pela integração com os sistemas de saúde, em particular às reflexões sobre os caminhos que devem ser percorridos nos territórios profissionais, epistêmicos, institucionais e geográficos na busca de uma formação orientada pelas necessidades sociais e de saúde das pessoas e coletividades.