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PubMed1985

Health personnel training in the Nicaraguan health system.

The "Unified National Health System" of Nicaragua was established in 1979, in an attempt to transform some of Latin America's worst health indices. This system, based on the stated principles of planning, regionalization, public participation, and primary care, has prioritized the development of health professions training programs appropriate to its special needs and principles. Public Health and Epidemiology training was inaugurated in 1982. A new campus of the School of Medicine was opened in 1981, increasing the number of medical students by a factor of five. Formal residency training (never before available within the country) in primary care specialties has been established. Training for allied health personnel has been formalized in several fields, with the establishment of the Polytechnical Institute of Health. The rapid increase in number and size of training programs has created a tremendous need for educational resources both human and material. This article reviews the status of health personnel training in Nicaragua today, the integration of these programs into planning for the health system, and problems arising from their rapid appearance.

Allied Health Personnel↗
PubMed1995

Abortion training to be required in standard Ob / Gyn curriculum.

On February 15, (1995) the Accreditation Council for Graduate Medical Education announced that it will now require medical schools seeking accreditation to provide abortion training for all residents in obstetrics and gynecology. The new "Program Requirements for Residency Education in Obstetrics and Gynecology," approved unanimously, will take effect on January 1, 1996. According to the Council, the newly issued standards are the first to refer specifically to abortion. The language states, "Experience with induced abortion must be part of residency training, except for residents with moral or religious objections .... Experience with management of complications of abortion must be provided to all residents." The Council also mandates that if a medical school itself has "a religious, moral or legal" objection to teaching the procedure, it must "ensure that residents ... who do not have a religious or moral objection receive education and experience in performing abortion at another institution." Other revisions provide for expanded resident education in "primary and preventive care," due to the fact that many women rely on their obstetricians and gynecologists as their primary care physicians, as well as additional training experience in family planning, including "all reversible methods of contraception" and sterilization. In order to be certified by the American Board of Obstetrics and Gynecology, ob/gyns must graduate from an accredited residency program. In addition, teaching hospitals must be accredited to secure federal reimbursements for the medical services patients receive from residents. The Accreditation Council for Graduate Medical Education operates under the aegis of the American Medical Association, the American Board of Medical Specialties, the American Hospital Association, the Association of American Medical Colleges, and the Council of Medical Specialty Societies. Both the American Board of Obstetrics and Gynecology and the American College of Obstetricians and Gynecologists support the Council's revised standards.

Abortion, Induced↗
PubMed2006

Perspectives of recent trainees on career choices in neonatology.

A major goal for neonatology training programs is to produce neonatologists who will pursue careers that combine clinical and research responsibilities. However, there appears to be a continuing decline in the number of trainees who choose academic, as opposed to private sector, jobs. The reason for this decline is perhaps best addressed by the people making career choices now, the recent trainees. Although many factors influence any individual's career choice, information from recent fellows indicates that several major factors play a strong role: finances; time demands; adequacy of research training; and academic institutions' attitudes toward recent trainees. Whereas the first two factors have been addressed by prior studies, the latter two factors have been less explored. The responses of a few recent trainees to an informal survey will be used to guide a discussion that focuses on the factors of research training and academic status. Ways to improve the success of training programs in producing academic neonatologists will be suggested, including the proposal of a research training curriculum, changes in the structure of post-fellowship academic status and increased encouragement of collaborative research efforts. A future survey of a broad group of recent trainees about their career choices and about proposals for training changes, such as those considered here, is needed to evaluate programs aimed at increasing the number of neonatologists engaged in research. Journal of Perinatology (2006) 26, S53-S56. doi:10.1038/sj.jp.7211527.

Biomedical Research↗
PubMed2003

[The new residency program in neurological surgery in Spain].

A new Residency Program in Neurological Surgery has been recently elaborated by the "Comisión Nacional de Neurocirugía" following the requirement of the National Council of Specialities. This new Program, which will replace the one proposed in 1992, has been designed in a similar way as those applied in countries providing the best neurosurgical training. Changes included deal with the definition of the speciality, and the introduction of new rotations,a resident Log Book, a Tutor with a well defined profil and commitments, a structured planning of academic and clinical objectives, a rotation or training in research, and a planning for continuous evaluation of the progress of the resident. It is likely that an appropriate application of the new Program in Spanish neurosurgical units with accreditation for training will result in formation of highly competent neurosurgeons. However, there are new challenges for improving neurosurgical training and the development of our speciality in Spain, as those related with new legislation regulating resident working hours, or some political decisions changing the mechanisms for controlling the number of resident positions per year.

Curriculum↗
PubMed2000

Did Project 2000 nurse training change recruitment patterns or career expectations?

In the UK, Project 2000 nurse education, introduced over the last eight years, aimed to increase the professional status of nurses and enhance skills, focusing on wider community care. This paper reports some of the results from a research project conducted between 1994 and 1996, funded by the Department of Health (Project 2000 Fitness for Purpose 1996). It was hypothesized that the changes in Project 2000 training might attract those more academically qualified and lead to more rapid career progression. The results found in this study did not support either of these hypotheses and suggestions are made about the reasons for the negative findings.

Adult↗
PubMed1998

The effects of body composition changes to observed improvements in cardiopulmonary parameters after exercise training with cardiac rehabilitation.

STUDY OBJECTIVE: To discriminate the effects of body fat reduction on improvements in peak aerobic capacity made following exercise training during cardiac rehabilitation. DESIGN: Observational, prospective study. SETTING: Outpatient cardiovascular health center at regional academic center. PATIENT INTERVENTIONS: Peak oxygen uptake (pkVO2), percent body fat, lean body mass (LBM), and other anthropometric measures were assessed before and after a 3-month program of cardiac rehabilitation and exercise training in 500 consecutive cardiac patients following a major coronary event. Baseline pkVO2 was corrected for LBM (pk/VO2 lean) and compared with posttraining values. RESULTS: Following exercise training, percent body fat decreased 5% from 26.2+/-8.0 to 24.8+/-7.5 (p<0.0001), and LBM increased 1% from 61.3+/-12.5 to 61.7+/-11.8 kg (p=0.02). pk/VO2 increased 16% from 16.0+/-4.1 to 18.5+/-4.8 mL/kg/min (p<0.0001), and pkVO2 lean increased 13% from 21.7+/-5.3 to 24.6+/-6.0 mL/kg/min (p<0.0001). Isolating the effects of reduction in body fat, we discern that these changes contributed to 0.3 of the 2.5 mL/kg/min increase in pkVO2 or 12% of the increase in pkVO2 observed. CONCLUSIONS: Changes in body composition, as a consequence of dietary and exercise modification, contribute to 12% of the "observed" improvement noted in weight-adjusted peak aerobic capacity following cardiac rehabilitation and exercise training. Changes in pkVO2 lean should be used by investigators to assess the singular effects of exercise conditioning alone.

Adipose Tissue↗