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.

Creating "boots on the ground": addressing the shortage of field epidemiologists in the Philippines through intermediate-level training programmes.

Problem: As of 2022, only 49 graduates of the Philippines' Field Epidemiology Training Programme (FETP) were employed by the Philippine Government, emphasizing the urgent need to increase the number of practicing field epidemiologists to better equip the country for public health emergencies. Context: The FETP-Intermediate Course (IC) curriculum is based mainly on the module of the United States Centers for Disease Control and Prevention that was incorporated into the Philippine context. It consists of five 1-2-week lecture series that provide participants with the knowledge and tools necessary to conduct job-relevant field projects. Individual projects are the centrepiece of the FETP-IC, requiring trainees to investigate outbreaks, design and develop protocols, conduct field data collection, manage data, analyse data, interpret data, write reports and deliver oral presentations. Action: To address the shortage of practicing field epidemiologists in the Philippines, a subnational initiative in Northern Luzon was implemented. Outcome: Within 3 years, the two FETP-IC subnational training programmes have produced 42 applied epidemiologists who will strengthen epidemiology and surveillance in their respective localities. As of February 2023, 92 studies have been conducted, including 39 outbreak investigations, 37 data quality analysis/process improvement projects, 10 epidemiological studies and six surveillance evaluations. Discussion: By training and deploying skilled epidemiologists to local health offices and hospitals, the programme is helping to improve the capacity of the health system to respond to public health threats and protect the health of the population. The programme's emphasis on practical training and real-world experience is an effective way to build a strong and sustainable epidemiological workforce.

Strengthening surveillance, disease detection, and outbreak response through Guinea-Bissau's Frontline Field Epidemiology Training Program: a cross-sectional descriptive study.

Introduction: the goal of the Field Epidemiology Training Program (FETP) - Frontline is to strengthen the country's surveillance capacity at the district level to prepare and respond to health emergencies, including outbreaks, by training a skilled frontline public health workforce. We describe the FETP - Frontline program, including implementation, structure, achievements, impact, and its role in improving the epidemiological workforce capacity of Guinea-Bissau. Methods: this cross-sectional descriptive study uses 2015-2019 program data collected through record reviews and historical narratives from FETP students and graduates. We generated descriptive summary statistics using the Guinea-Bissau's FETP-Frontline program database, student assignments, and investigation reports, after reviewing the FETP standardized curriculum and program guidelines. Results: since its inception in 2016, FETP Frontline has implemented 14 cohorts and trained 198 frontline surveillance officers. Program participants improved surveillance data quality, investigated 51 outbreaks at national and regional levels, and contributed to disease research and surveillance in 227 separate field investigations. Participants frequently responded to priority health emergencies, including clusters or outbreaks of Zika, microencephalies, dengue, yellow fever, anthrax, malaria, and tuberculosis. Conclusion: Guinea-Bissau's FETP - Frontline program provides a practical example of an effective strategy to strengthen health systems through a well-prepared workforce trained to quickly detect and respond to health threats.

Involvement and readiness of fellows from Papua New Guinea's Field Epidemiology Training Programme in the COVID-19 response, 2020-2021.

Problem: Fellows of the Papua New Guinea Field Epidemiology Training Programme (FETP) were part of the national coronavirus disease (COVID-19) response. However, the specific activities and challenges experienced by fellows in the field were unknown. Context: The advanced FETP cohort commenced just before the COVID-19 pandemic and all fellows were involved in the response. The advanced fellows participating in this review represented a cross-section of the country's public health workforce. Action: A review was conducted to better understand the scope of activities undertaken by FETP fellows, identify the challenges experienced and assess how well the programme prepared fellows for their COVID-19 response roles. A facilitated discussion based on the World Health Organization COVID-19 intra-action review methodology and an online survey was conducted with advanced FETP fellows. Outcome: The fellows made important contributions to the national COVID-19 response by assuming leadership positions at all levels of government, leading training activities and applying core field epidemiology competencies in surveillance and response activities. The programme had prepared them well for the response, giving them the confidence and skills to undertake a diverse range of response roles. Discussion: The FETP review of the COVID-19 response in Papua New Guinea highlighted the role and influence of the fellows during the pandemic response. Fellows were able to apply core field epidemiology competencies across a range of roles. The recommendations derived from this review will be instructive for the FETP specifically and the COVID-19 response generally.

Breaking Research Silos and Stimulating "Innovation at the Edges" in Epidemiology.

Epidemiological training often requires specialization in a subdiscipline (e.g., pharmacoepidemiology, genetic epidemiology, social epidemiology, or infectious disease epidemiology). While specialization is necessary and beneficial, it comes at the cost of decreased awareness of scientific developments in other subdisciplines of epidemiology. In this commentary, we argue for the importance of promoting an exchange of ideas across seemingly disparate epidemiologic subdisciplines. Such an exchange can lead to invaluable opportunities to learn from and merge knowledge across subdisciplines. It can promote "innovation at the edges," a process of borrowing and transforming methods from one subdiscipline in order to develop something new and advance another subdiscipline. Further, we outline specific actionable steps at the researcher, institution, and professional society level that can promote such innovation.

Curso de Introducción a los principios y métodos epidemiológicos: Orientación Clínica y Orientación Crítica - Bloque de Formación Común 2022

Encuentro de presentación del curso, destinado a residentes de cualquier especialidad del Sistema de Residencias de la Provincia de Buenos Aires, cuyo fundamento es pensar a la epidemiología como "el estudio de la distribución y los determinantes de estados o eventos, (en particular de enfermedades) relacionados con la salud y la aplicación de esos estudios al control de enfermedades y otros problemas de salud". En este sentido y, a modo de introducción de la capacitación, Mario Rovere aborda los siguientes aspectos para la reflexión: dimensión individual - colectiva de la epidemiología, ¿por qué y para qué estudiamos epidemiología?, aportes a la clínica, vigilancia y pensamiento epidemiológico, su relevancia frente a los cambios constantes en los problemas de salud - pandemias visibles e invisibles. Luego, Alicia Lawrynowicz, coordinadora del curso, además de informar sobre cuestiones administrativas y formales de la capacitación, aclara que ésta constará de dos formaciones: Introducción a los Principios y Métodos Epidemiológicos: Orientación Epidemiología Clínica y una segunda con Orientación en Epidemiología Crítica. Sobre el primer curso los contenidos de los diferentes módulos serán: Módulo 0: Familiarización con la propuesta curso: Introducción a los principios y métodos epidemiológicos; Módulo 1: El enfoque epidemiológico de la salud y la enfermedad; Módulo 2: Descripción y búsqueda de las causas de la salud y enfermedad; Módulo 3: Principios básicos de la Epidemiología Clínica. El diagnóstico. En tanto que, en referencia a la Orientación en Epidemiología Crítica, su composición será: Módulo 0: Familiarización con la propuesta curso: Introducción a los principios y métodos epidemiológicos, Módulo 1: El enfoque epidemiológico de la salud y la enfermedad, Módulo 2: Descripción y búsqueda de las causas de la salud y enfermedad, Módulo 3: Bases conceptuales de la Epidemiología Crítica y Determinantes y determinaciones del P-S-E-A-C, Módulo 4: Desigualdades en salud. Espacio territorio.

Evaluation of the first two Frontline cohorts of the field epidemiology training program in Guinea, West Africa.

BACKGROUND: The 2014-2016 Ebola virus disease outbreak in West Africa revealed weaknesses in the health systems of the three most heavily affected countries, including a shortage of public health professionals at the local level trained in surveillance and outbreak investigation. In response, the Frontline Field Epidemiology Training Program (FETP) was created by CDC in 2015 as a 3-month, accelerated training program in field epidemiology that specifically targets the district level. In Guinea, the first two FETP-Frontline cohorts were held from January to May, and from June to September 2017. Here, we report the results of a cross-sectional evaluation of these first two cohorts of FETP-Frontline in Guinea. METHODS: The evaluation was conducted in April 2018 and consisted of interviews with graduates, their supervisors, and directors of nearby health facilities, as well as direct observation of data reports and surveillance tools at health facilities. Interviews and site visits were conducted using standardized questionnaires and checklists. Qualitative data were coded under common themes and analyzed using descriptive statistics. RESULTS: The evaluation revealed a significant perception of improvement in all assessed skills by the graduates, as well as high levels of self-reported involvement in key activities related to data collection, analysis, and reporting. Supervisors highlighted improvements to systematic and quality case and summary reporting as key benefits of the FETP-Frontline program. At the health facility level, staff reported the training had resulted in improvements to information sharing and case notifications. Reported barriers included lack of transportation, available support personnel, and other resources. Graduates and supervisors both emphasized the importance of continued and additional training to solidify and retain skills. CONCLUSIONS: The evaluation demonstrated a strongly positive perceived benefit of the FETP-Frontline training on the professional activities of graduates as well as the overall surveillance system. However, efforts are needed to ensure greater gender equity and to recruit more junior trainee candidates for future cohorts. Moreover, although improvements to the surveillance system were observed concurrent with the completion of the two cohorts, the evaluation was not designed to directly measure impact on surveillance or response functions. Combined with the rapid implementation of FETP-Frontline around the world, this suggests an opportunity to develop standardized evaluation toolkits, which could incorporate metrics that would directly assess the impact of equitable field epidemiology workforce development on countries' abilities to prevent, detect, and respond to public health threats.

Formação de tutores em Epidemiologia de Campo: módulo 01 - introdução à investigação de surtos / Training of tutors in Field Epidemiology: module 01 - introduction to outbreak investigation

Nesta unidade apresentaremos a Introdução à Investigação de Surtos com vistas a conceituar uma investigação, definir seus objetivos e aplicar as etapas de controle e alerta epidemiológicos considerando a análise de tempo, lugar e pessoa.

Formação de tutores em Epidemiologia de Campo: módulo 02 - introdução à vigilância em saúde / Training of tutors in Field Epidemiology: module 02 - introduction to health surveillance

Nesta unidade apresentaremos a Introdução ao Sistema de Vigilância em Saúde, com vistas a conhecer a Política Nacional de Vigilância em Saúde, descrever os tipos e ciclos de vigilância em saúde, conhecer os sistemas de informação e apresentar os atributos que podem ser avaliados no sistema de vigilância.

Formação de tutores em Epidemiologia de Campo: módulo 03 - introdução à comunicação científica / Training of tutors in Field Epidemiology: module 03 - introduction to scientific communication

Neste capítulo, serão abordadas as características de uma comunicação científica, as etapas estratégicas, ferramentas para uma comunicação científica efetiva e o desenvolvimento de um Single Overarching Communication Outcome (SOCO).

Formação de tutores em Epidemiologia de Campo: módulo 04 - introdução à tutoria virtual / Training of tutors in Field Epidemiology: module 04 - introduction to virtual tutoring

Nesta unidade apresentaremos a Educação a Distância (EAD), os Ambientes Virtuais de Aprendizagem (AVAs), o trabalho do Tutor Virtual e suas competências. Leia com atenção os conceitos que estão sendo trabalhados nesse módulo, pois eles serão fundamentais para o bom entendimento sobre o trabalho desenvolvido pelo tutor virtual.

EpiSUS fundamental: caderno de conteúdos / EpiSUS fundamental: content notebook

Publicação objetiva apresentar o tema Vigilância em Saúde Pública, com os seguintes objetivos de aprendizagem: 1. Conhecer a Política Nacional de Vigilância em Saúde e suas responsabilidades, princípios, diretrizes e estratégias; 2. Descrever os elementos do ciclo de vigilância em saúde pública; 3. Descrever o fluxo de informações da vigilância; 4. Demonstrar a finalidade dos dados de vigilância; 5. Descrever a utilização dos dados de vigilância

Physical education teachers of the basic public education of Minas Gerais in the pandemic of Covid-19: working conditions, health and lifestyle / Professores de educação física da educação pública básica de Minas Gerais na pandemia da Covid-19: condições de trabalho, saúde e estilo de vida

ABSTRACT This study aimed to describe the working and health conditions of physical education teachers in public basic education in the state of Minas Gerais - Brazil during the COVID-19 pandemic. Cross-sectional study, carried out from August to September 2020, via digital form and had the support of the Minas Gerais State Department of Education. The instrument presented variables related to the sociodemographic profile, work and health conditions during the pandemic. The prevalences of the variables were presented. 1,016 physical education teachers participated in the study. Of these, 61.4% were female, 65.8% aged 21 to 40 years and 15.3% worked in the countryside. In relation to working conditions during the pandemic, 99% performed remote activities, 35.7% were dissatisfied with their work, 37% worked much more than they used to and 81.2% presented the interest of students/parents in classes as a difficulty. As for health conditions during the pandemic, 10.3% increased their consumption of alcoholic beverages, 26.1% did not practice physical exercise, 56.5% had increased body weight and 37.8% reported a lot of fear of COVID-19. Physical education teachers of basic education in the state of Minas Gerais were significantly affected by the pandemic, so it is important to implement support strategies.

RESUMO Este estudo objetivou descrever as condições de trabalho e saúde dos professores de educação física da educação básica pública do estado de Minas Gerais - Brasil durante a pandemia da COVID-19. Estudo transversal, realizado de agosto a setembro de 2020, via formulário digital e contou com o apoio da Secretaria de Estado de Educação de Minas Gerais. O instrumento apresentou variáveis referentes ao perfil sociodemográfico, condições de trabalho e saúde durante a pandemia. Foram apresentadas as prevalências das variáveis. Participaram do estudo 1.016 professores de educação física. Destes, 61,4% eram mulheres, 65,8% com idade de 21 a 40 anos e 15,3% trabalhavam na zona rural. Em relação às condições de trabalho durante a pandemia, 99% realizaram atividades remotas, 35,7% estavam insatisfeitos com o trabalho, 37% trabalharam muito mais que costumavam e 81,2% apresentaram como dificuldade o interesse dos alunos/pais pelas aulas. Quanto às condições de saúde durante a pandemia, 10,3% aumentaram o consumo de bebidas alcóolicas, 26,1% não praticaram exercício físico, 56,5% tiveram aumento de peso corporal e 37,8% relataram muito medo da COVID-19. Os professores de educação física da educação básica do estado de Minas Gerais foram significativamente afetados pela pandemia, portanto é importante implementação de estratégias de apoio.

La epidemiología, discurso y saber / Analysis of health systems as political systems

A partir de la segunda mitad del siglo XX, la dimensión del lenguaje y la palabra fue tomando un lugar central en las reflexiones filosóficas y políticas en diversos ámbitos (tanto en Europa como en América del norte y del sur). Entre ellos, en el campo de la medicina, tanto en su ejercicio clínico como en sus derivaciones de orden social: el campo de la salud pública, las intervenciones epidemiológicas, comunitarias, etc. Surgió una crítica a la hegemonía del pensamiento científico. Frente a eso, diversas propuestas desde otros campos del saberse fueron incorporando al debate en el campo teórico, y en el político. Un debate entre la ciencia y sus aplicaciones frente a otras perspectivas de saber. Eso dio lugar a diversas prácticas conocidas bajo diversos nombres: medicina social, nueva salud pública, anti psiquiatría, etc. (parte del desarrollo creciente del psicoanálisis se inscribe en este conjunto), todas ellas críticas con la hegemonía indiscutible hasta ese momento del positivismo científico, que se postulaba como el único saber válido .La perspectiva iniciada por Foucault, luego seguida por muchos otros pensadores e investigadores, abrió un cuestionamiento de esa hegemonía de las ciencias y una valoración de otras perspectivas de saber, no científicas, pero con una validez que se imponía en las prácticas sociales .El campo del saber, investigado mediante lo que denominó "arqueología del saber" analiza esa dialéctica, mediante la producción de una serie de teorías y conceptos precisos: discurso, enunciado, archivo, entre otros. Ciencia y saber aparecen entonces como prácticas diferenciadas, en una relación compleja y plena de controversias fundamentales. A todo ello se agrega la "genealogía del poder", una dimensión del poder y la política profundamente imbricada con el campo del saber, que permitió que los análisis de las prácticas se conmovieran y renovaran de forma radical. La propuesta foucaultiana concluye indagando en las posibilidades de lo que llama "saberes sometidos" de no ceder ante las explicaciones universalistas -propias de la ciencia-para dar cuenta de los procesos humanos. Propugna entonces un desarrollo de los discursos críticos, que frente a los saberes eruditos -propios de la ciencia y sus instituciones-puedan sostener la emergencia de un "saber histórico de las luchas".

Since the second half of the 20th century, the dimension of language and the word has been taking a central place in philosophical and political reflections in various fields (both in Europe and in North and South America). Among them, in the field of medicine, both in its clinical practice and in its social derivations: the field of public health, epidemiological and community interventions, etc. A criticism arose against the hegemony of scientific thought. In response to this, various proposals from other fields of knowledge were incorporated into the debate in the theoretical and political fields. A debate between science and its applications versus other perspectives of knowledge. This gave rise to various practices known under different names: social medicine, new public health, anti-psychiatry, etc. (part of the growing development of psychoanalysis is inscribed in this group), all of them critical of the undisputed hegemony up to that time of scientific positivism, which was postulated as the only valid knowledge.The perspective initiated by Foucault, then followed by many other thinkers and researchers, opened a questioning of this hegemony of the sciences and a valuation of other perspectives of knowledge, non-scientific, but with a validity that was imposed on social practices.The field of knowledge, investigated through what he called "archeology of knowledge", analyzes this dialectic through the production of a series of theories and precise concepts: discourse, enunciation, archive, among others. Science and knowledge appear then as differentiated practices, in a complex relationship full of fundamental controversies.To all this is added the "genealogy of power", a dimension of power and politics deeply intertwined with the field of knowledge, which allowed the analysis of practices to be radically moved and renewed.Foucault's proposal concludes with an inquiry into the possibilities of what he calls "subjected knowledges" of not yielding to universalist explanations -proper of science-in order to account for human processes. He then advocates a development of critical discourses, which, in the face of erudite knowledge ­proper to science and its institutions-can sustain the emergence of a "historical knowledge of struggles".

The Effect of Peer Instruction Lectures on Learning Attitudes in Epidemiology Education.

Research suggests that the fundamental concepts of epidemiology cannot be sufficiently learned in traditional lectures, and interactive learning is necessary. However, few studies have investigated interactive epidemiology education in general, or peer instruction (PI) in particular. This study investigated the effect of PI. Study par-ticipants were fourth-year medical students. The attitude of participants in regard to PI learning was examined in a non-PI and a PI group. The Survey of Attitudes Toward Statistics (SATS) (containing six sub-categories) was conducted as a learning-attitudes index. The pre- and post-lecture scores were compared between the non-PI and PI groups using double robust (DR) estimation. The non-PI and PI groups consisted of 20 and 121 student participants, respectively. In DR estimation, affect exhibited the lowest SATS score changes, at -0.51 (95% confidence interval -0.78 to -0.24; p-value < 0.001), whereas effort exhibited the highest score changes of 0.01 (95% confidence interval -0.30 to 0.32; p-value = 0.952). The epidemiology lecture with PI did not increase the SATS scores. This might be due to issues related to the experimental design. Further research investigating the effects of interactive epidemiology education, it will be necessary to develop tools for assessing the learning of epidemiological concepts and to improve the research design.

Impact of Kenya's Frontline Epidemiology Training Program on Outbreak Detection and Surveillance Reporting: A Geographical Assessment, 2014-2017.

Rapid detection and response to infectious disease outbreaks requires a robust surveillance system with a sufficient number of trained public health workforce personnel. The Frontline Field Epidemiology Training Program (Frontline) is a focused 3-month program targeting local ministries of health to strengthen local disease surveillance and reporting capacities. Limited literature exists on the impact of Frontline graduates on disease surveillance completeness and timeliness reporting. Using routinely collected Ministry of Health data, we mapped the distribution of graduates between 2014 and 2017 across 47 Kenyan counties. Completeness was defined as the proportion of complete reports received from health facilities in a county compared with the total number of health facilities in that county. Timeliness was defined as the proportion of health facilities submitting surveillance reports on time to the county. Using a panel analysis and controlling for county-fixed effects, we evaluated the relationship between the number of Frontline graduates and priority disease reporting of measles. We found that Frontline training was correlated with improved completeness and timeliness of weekly reporting for priority diseases. The number of Frontline graduates increased by 700%, from 57 graduates in 2014 to 456 graduates in 2017. The annual average rates of reporting completeness increased from 0.8% in 2014 to 55.1% in 2017. The annual average timeliness reporting rates increased from 0.1% in 2014 to 40.5% in 2017. These findings demonstrate how global health security implementation progress in workforce development may influence surveillance and disease reporting.