Colombian Medical Education System: A Hundred Years Behind

Almost one hundred years ago the Carnegie Foundation for the Advancement of Teaching authorized a study and report about the medical education of the United States and Canada directed by Mr. Abraham Flexner an education expert of the time. This report turned out to be one of the most important documents of the medical education revolution that took place by that time in North America and that led it to become what it is today. Almost a century after that, Colombian medical education has reached an outstanding similarity to the system described in the Flexner report. The present article highlights the parallel between North America’s medical education situation a hundred years ago and Colombia’s actual medical education situation. We present here some notions about the actual education system based on what was described on 1910 and which we consider, constitutes the current medical education situation on our country and possibly on many Latin American countries.

Factores asociados a la asistencia al control prenatal en gestantes del municipio de Yopal Casanare, Colombia – 2011

Introducción: Según OMS en 2011, 536.000 mujeres murieron en el mundo por causas relacionadas al embarazo y el parto; obteniendo Colombia índices altos de mortalidad materna (Fondo de Población de las Naciones Unidas, 2010); mientras Casanare reportó cuatro casos en 2009, y Yopal en 2010 alcanzó una tasa de 66,5 por 100.000 NV (Plan de desarrollo municipio de Yopal); por tanto se busca identificar factores que afectan la adherencia al control prenatal. Metodología: Estudio observacional de prevalencia analítica realizado con datos de gestantes de Yopal (Casanare) canalizadas por Intervenciones Colectivas 2011, con una muestra de 621 gestantes en las semanas de gestación 8,12,16,20,24,28,32,36,38 y 40.. Resultados: La adherencia al control prenatal fue del 15% y los factores que mostraron asociación estadísticamente significativa con adherencia al control prenatal fueron: régimen de salud (P=0.010); semana de gestación (p=0.000); trimestre del embarazo, antecedentes de abortos, apoyo económico (OR=1.738; IC=95%; 1.026-2.945); embarazo planeado, soporte familiar, satisfacción de compartir tiempo y espacio con el cónyuge (p=0.009, 0.001, 0.006); convivencia con familia materna (P=0.032), razón de verosimilitud 0.046, y valor OR=0.444; IC=95%; 0.208 – 0.948; y se identificaron barreras como inoportunidad de citas e insatisfacción por los servicios, donde el 98,9% de gestantes que no las encontraron tuvieron adherencia al control prenatal. Conclusión: Es necesario fortalecer programas de promoción de salud materna, control prenatal, prevención del embarazo adolescente y derechos de la mujer; reforzando acciones de vigilancia para disminuir las barreras de aseguramiento y calidad de los servicios.

Assessing the labor supply and demand missmatch by skills in the Uruguay labor market

This article examines the mismatch between labor supply and demand for educational qualificationsin the Uruguayan labor market during 2000-2009. It attempts to measure the phenomenonof under-qualification and overqualification by occupation type based on educational requirementfor each occupation. Following the previous literature, the empirical work concentrates onthe determinants of over-education and its impact on wages.

Educación de la sexualidad, prácticas docentes y conocimientos de los estudiantes: una evaluación del Programa de Educación para la Sexualidad y Construcción de Ciudadanía (PESCC)

Este documento presenta los resultados del componente cuantitativo de la evaluación del Programa de Educación para la Sexualidad y Construcción de Ciudadanía (PESCC) del Ministerio de Educación Nacional de Colombia (MEN). Para identificar el efecto, la estrategia empírica explota la variación en la implementación del componente pedagógico del PESCC entre los colegios y la variación en el componente de fortalecimiento institucional del programa a nivel departamental. El principal hallazgo de este trabajo es que el PESCC mejora las prácticas docentes de planeación y los conocimientos de los estudiantes en servicios en salud sexual y reproductiva y en derechos humanos sexuales y reproductivos. No hay efectos significativos en otros índices de Conocimientos, Actitudes o Prácticas (CAP) de profesores o estudiantes.

The Veterinary Clinical Skills Laboratory Initiative

Resumen basado en el de la publicaci??n

Global Acceleration and Dispossesion: Regression in the Right to Life and Public Health during Ecuador’s Neoliberal Decades

The present essay’s central argument or hypothesis is, consequently, that the mechanisms accelerating a wealth concentrating and exclusionary economy centred on the benefit and overprotection of big business—with a corresponding plundering of resources that are vital for life—generated forms of loss and regression in the right to healthcare and the dismantling of institutional protections. These are all expressed in indicators from 1990-2005, which point not only to the deterioration of healthcare programs and services but also to the undermining of the general conditions of life (social reproduction) and, in contrast to the reports and predictions of the era’s governments, a stagnation or deterioration in health indicators, especially for those most sensitive to the crisis. The present study’s argument is linked together across distinct chapters. First, we undertake the necessary clarification of the categories central to the understanding of a complex issue; clarifying the concept of health itself and its determinants, emphasizing the necessity of taking on an integral understanding as a fundamental prerequisite to unravelling what documents and reports from this era either leave unsaid or distort. Based on that analysis, we will explain the harmful effects of global economic acceleration, the monopolization and pillaging of strategic healthcare goods; not only those which directly place obstacles on the access to health services, but also those like the destructuration of small economies, linked to the impoverishment and worsening of living modes. Thinking epidemiologically, we intend to show signs of the deterioration of broad collectivities’ ways of life as a result of the mechanisms of acceleration and pillage. We will then collect disparate evidence of the deterioration of human health and ecosystems to, finally, establish the most urgent conclusions about this unfortunate period of our social and medical history.

Endocrine disrupters and human health: Could oestrogenic chemicals in body care cosmetics adversely affect breast cancer incidence in women? A review of evidence and call for further research

In the decade that has elapsed since the suggestion that exposure of the foetal/developing male to environmental oestrogens could be the cause of subsequent reproductive and developmental effects in men, there has been little definitive research to provide conclusions to the hypothesis. Issues of exposure and low potency of environmental oestrogens may have reduced concerns. However, the hypothesis that chemicals applied in body care cosmetics (including moisturizers, creams, sprays or lotions applied to axilla or chest or breast areas) may be affecting breast cancer incidence in women presents a different case scenario, not least in the consideration of the exposure issues. The specific cosmetic type is not relevant but the chemical ingredients in the formulations and the application to the skin is important. The most common group of body care cosmetic formulation excipients, namely p-hydroxybenzoic acid esters or parabens, have been shown recently to be oestrogenic in vitro and in vivo and now have been detected in human breast tumour tissue, indicating absorption (route and causal associations have yet to be confirmed). The hypothesis for a link between oestrogenic ingredients in underarm and body care cosmetics and breast cancer is forwarded and reviewed here in terms of. data on exposure to body care cosmetics and parabens, including dermal absorption; paraben oestrogenicity; the role of oestrogen in breast cancer; detection of parabens in breast tumours; recent epidemiology studies of underarm cosmetics use and breast cancer; the toxicology database; the current regulatory status of parabens and regulatory toxicology data uncertainties. Notwithstanding the major public health issue of the causes of the rising incidence of breast cancer in women, this call for further research may provide the first evidence that environmental factors may be adversely affecting human health by endocrine disruption, because exposure to oestrogenic chemicals through application of body care products (unlike diffuse environmental chemical exposures) should be amenable to evaluation, quantification and control. The exposure issues are clear and the exposed population is large, and these factors should provide the necessary impetus to investigate this potential issue of public health. Copyright (C) 2004 John Wiley Sons, Ltd.

Conjugated linoleic acid and human health: a critical evaluation of the evidence

Purpose of review: This review critically evaluates studies investigating the effects of conjugated linoleic acid on human health, including effects on body composition, blood lipids, liver metabolism, insulin sensitivity and immune function. It focuses mainly on human intervention studies, but includes some reference to animal and cellular studies which provide insight into potential molecular mechanisms of action of conjugated linoleic acid. Recent findings: Human studies continue to report inconsistent effects of conjugated linoleic acid on human health. Some of these reports are based on overinterpretation of marginal effects of supplementation. Recent data suggest that the effects of the substance may be isomer dependent and that cis-9, trans-11 and trans-10, cis-12 conjugated linoleic acids have opposing effects on blood lipids and on metabolism in adipocytes and hepatic cells. Summary: Claims that conjugated linoleic acid is beneficial for health remain as yet unconvincing. Human studies investigating the effects of conjugated linoleic acid supplements have tended to use mixtures of isomers and have been inconsistent. More recent studies have attempted to use relatively pure preparations of single isomers and these studies suggest that the effects of conjugated linoleic acid may be isomer-specific. These recent data suggest a relative detrimental effect of trans-10, cis-12 conjugated linoleic acid on blood lipids. There appears to be little effect of conjugated linoleic acid on immune function and the effects on insulin sensitivity remain unclear.

Optical genetic mapping defines regions of chromosomal variation in serovars of S. enterica subsp enterica of concern for human and animal health

Infections involving Salmonella enterica subsp. enterica serovars have serious animal and human health implications; causing gastroenteritis in humans and clinical symptoms, such as diarrhoea and abortion, in livestock. In this study an optical genetic mapping technique was used to screen 20 field isolate strains from four serovars implicated in disease outbreaks. The technique was able to distinguish between the serovars and the available sequenced strains and group them in agreement with similar data from microarrays and PFGE. The optical maps revealed variation in genome maps associated with antimicrobial resistance and prophage content in S. Typhimurium, and separated the S. Newport strains into two clear geographical lineages defined by the presence of prophage sequences. The technique was also able to detect novel insertions that may have had effects on the central metabolism of some strains. Overall optical mapping allowed a greater level of differentiation of genomic content and spatial information than more traditional typing methods.

Biology and reproductive behavior of Murgantia histrionica (Heteroptera: Pentatomidae)

Life history parameters and reproductive behaviors of the harlequin bug, Murgantia histrionica Hahn (Heteroptera: Pentatomidae), were determined. Total developmental time from egg to adult was ≈48 d. After a sexual maturation period of ≈7 d, both sexes mated repeatedly, with females laying multiple egg masses of 12 eggs at intervals of 3 d. Adult females lived an average of 41 d, whereas adult males lived an average of 25 d. Courtship and copulation activities peaked in the middle of the photophase. In mating experiments in which mixed sex pairs of virgin and previously mated bugs were combined in all possible combinations, the durations of courtship and copulation by virgin males were significantly longer with both virgin and previously mated females than the same behaviors for previously mated males. When given a choice between a virgin or previously mated female, previously mated males preferred to mate with virgin females, whereas virgin males showed no preference for virgin over previously mated females. Analyses of mating behaviors with ethograms and behavioral transition matrices suggested that a primary reason for failure to copulate by virgin males was the incorrect rotation of their pygophores to the copulation position, so that successful alignment of the genitalia could not occur.

Soil, food security and human health: a review

Direct effects of soil or its constituents on human health are through its ingestion, inhalation or absorption. The soil contains many infectious organisms that may enter the human body through these pathways, but it also provides organisms on which our earliest antibiotics are based. Indirect effects of soil arise from the quantity and quality of food that humans consume. Trace elements can have both beneficial and toxic effects on humans, especially where the range for optimal intake is narrow. We focus on four trace elements (iodine, iron, selenium and zinc) whose deficiencies have substantial effects on human health. As the world’s population increases issues of food security become more pressing, as does the need to sustain soil fertility and minimize its degradation. Lack of adequate food and food of poor nutritional quality lead to differing degrees of under-nutrition, which in turn causes ill health. Soil and land are finite resources and agricultural land is under severe competition from other uses. Relationships between soil and health are often difficult to extricate because of the many confounding factors present. Nevertheless, recent scientific understanding of soil processes and factors that affect human health are enabling greater insight into the effects of soil on our health. Multidisciplinary research that includes soil science, agronomy, agricultural sustainability, toxicology, epidemiology and the medical sciences will facilitate the discovery of new antibiotics, a greater understanding of how materials added to soil used for food production affect health and deciphering of the complex relationships between soil and human health.

Evaluation of laccases and melanization in clinical and environmental Cryptococcus neoformans samples by non-denaturing PAGE

The increased incidence of infections caused by the opportunistic pathogen Cryptococcus neoformans, which mainly affects immunocompromised patients but can also infect immunocompetent individuals, has needed additional studies on this micro-organism`s pathogenicity and factors related to virulence, such as enzyme production, for a better understanding of the aetiology of cryptococcosis. The aim of this study was to verify the applicability of non-denaturing PAGE for analysis of laccases by quantification of the amount of melanin pigment produced by clinical and environmental strains of C. neoformans. After incubation of the gel with the substrate L-dopa, strains produced melanin spots of a bright brown to black colour. Quantification of these spots was performed by densitometry analysis and the amount of melanin produced was calculated and compared among the strains. All strains showed laccase activity. Serotype B strains showed a higher melanin intensity than serotype A strains. Over half of the clinical strains (56.2%) showed the lowest melanin intensities, suggesting that melanin production may not be the main virulence factor against host defence. The clinical strain ICB 88 revealed two melanin spots on the gel, indicating the presence of two laccase isoforms. The environmental strains showed the highest values of melanin intensity, which may be related to previous exposure to environmental stress conditions.

Managerial leadership for research use in nursing and allied health care professions : a narrative synthesis protocol

BACKGROUND: Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours.Methods/design: Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. DISCUSSION: With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership that supports and enables research use by health care practitioners, and how to develop leadership for the purpose of enhancing research use in clinical practice.