Module Book for Occupational Medicine at the University of Panamá/The Public Health Research School

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The New Public Health Research School[edit]

The Panamá Public Health Research School is supposed to be the leading centre for pre- and post grade education and training in the Public- and Occupational Medicine in Panama. The academic staff in the Public Health and the Occupational Medicine Residence programs are expected to be active in research and publication while being university teachers at the same time. As the first occupational and public health research centre in Panama, its services include among others:
 - Conducting researches on various fields such as health at work, also at sea and in the shore population - Offering pre- and postgraduate research training programs in occup medicine and public health.
 - Disseminate new knowledge continuously of relevance for the political planning and health policies in all different sectors of the Republic. It is the intention that the Research School has a permanent staff of researchers that take care of the research programs, the teaching and the dissemination of new information. Ad hoc affiliated researchers in specific projects are registered and work con amore without payment.

The School´s responsibilities[edit]

  • (Figure 1)

Plan and complete the clinical and theoretical specialist training programs in the domains Recruit and educate young and promising epidemiological researchers Monitor the quality of the training, research and information disseminations Keep the epidemiological research program on the highest international standard Disseminate all new relevant research information to the public and professionals Keep the staff and students´ health, safety, wellbeing and productivity on top Keep the digitalised, transparent financial accounts Keep digitalised register of students, staff, production of articles, diplomas etc. Releasing "Revista Panameňa de Salud Publica, Ocupacional y Ambiental" journal, regularly

The scientific requirements for the staff[edit]

Qualification for the professor 1 and professor 2 of the Research School must have research- and teaching qualifications corresponding to a level beyond the postdoc international level. The teaching, the research and the administration time will be distributed by 40-20-40 per cent respectively. The requirements for the positions as professors in the Research School at least 15 international peer reviewed publications of which 8 as the first author. The leaders of the Research School must be members of one or more international research teams and have at least 2 on-going research projects. The evidence based occupational medical- and public health training, should be conducted by teachers with an extensive scientific research background. The Public Health research training and the Occupational medical training require the same professional level and most of the training programs can be shared. Another good reason for working together is to strengthen the small professional groups in each domain. So to come beyond the critical mass for scientific research team and teaching it was decided to join the forces together to strengthen the scientific professional staff. Of the same reasons, the professors cannot have more than 100% total employment. New researchers can be affiliated without having the long carrier in academic research, by entering the stepwise research training for students.

Students´ stepwise research training[edit]

They can start writing their level 1 as medical students and complete it during their first 2 years of clinicaltraining. The first step is to enter the Research School after having completed the Basic knowledge. and during the first clinical years they they are going through an interview and can be admitted as Residents. Here they move on to level and finish it, they can go to level 2 and it is the premise to be a specialist. They can proceed to Level 3-6, which ends with an international published article and it forms the basis for doctoral studies in other countries.

  • Level 1 Basic knowledge Membership of the Research School
  • Level 2 EPI-Investigation ( Educativa 1 ) Preparation for the residency 1
  • Level 3 Epidemiology (Educativa 2 ) +article Preparation for the residency 2
  • Level 4 Research Tools Residency +CSS Occup Med/ Public Health
  • Level 5 Peer reviewed article research and writing
  • Level 6 Publish the peer reviewed article

Basic requirements for students[edit]

  • A research project idea in 100-200 words: problems, objectives, methods, expected results
  • How to use Zotero or similar literature reference program
  • Show a bibliographic from Zotero in Vancouver style of a literature search for the project idea
  • Know how to use Excel, Power Point, Word, Dropbox, Google Drive and Epi-info
  • Present a short example of Google Forms for a survey
  • Know the “Blue Risk Survey”, the “EPI-Investigation” and the scientific journal RSPOA
  • Knowledge on the Occupational Medicine Wikibook and how to add new chapters

Residency´s theoretical training programs

  • Risk assessment at work
  • International Health
  • Project Management
  • Health Promotion
  • Health Economics
  • Toxicology and hygiene
  • National health policy
  • Clinical occupational medicine
  • Health care in Panama,

Each course will be 22 hours work and can be done on distance. The courses are mainly self-instructive. The participants are requested to give response with proposals to improve the program to the responsible teacher. The course materials and instructions will be available in good time before start. The diploma will be signed after the courses are completed.

Residency´s clinical training[edit]

The clinical training plans and instructions will be available in good time before start. The diploma will be signed after the courses are completed. All involved clinical departments have approved the residency program. All candidates will have a personalized training program with the tjecklist of all the obligatory training

Clinical program supervisors[edit]

The clinical departments that have accepted to be part of the specialist training must have an educational chief medical officer. This person will plan the detailed learning in the department and take care that all candidates pass through the training. A diploma for will be signed. The trainers will go through a one day training program on how to supervise and plan the training.

Logbooks for the residents[edit]

The Public Health School Research Program[edit]

The research include surveys of selected and most vulnerable parts of the population, workers in specific jobs, Dock workers, fishermen and seafarers. “The Blue Risk Survey Program” aims to investigate working life and living conditions in all forms of occupational activity and to study the health and living conditions of the population. The goal is to produce the needed, relevant scientific data for primary, secondary and tertiary health prevention in all health aspects. The research program is mainly related to the international Blue Risk Survey Program. The coordinators will help new members to get started with their research work and store the data in the Blue Risk Program. All members of the Research School can get permission to re-use the data for further analysis and publications. There are 4 active research programs at the moment:

Clinical data monitoring[edit]

The routine data from pre-embarkation health examinations will be monitored in some clinics in different countries. The proportions of pre-hypertension, pre-diabetes, and obesity in the seafaring population will be monitored and the seafarers offered early diagnostic and prevention. This monitoring will help to point out areas for prevention.

Reduce seafarers´ repatriations[edit]

In case of illness, the seafarers are repatriated to heir home country, which is normally very costly. Very little is known how to reduce the number of these repatriations. The research question is to identify clinical indicators with high predictive value for +/- repatriation, including mental health problems. The objectives are to study the etiological, predictive variables that can be used to reduce the number of repatriations.

Maritime Mental Health Program[edit]

The seafaring employees face more difficult working conditions in the sea than the employees working on land. Their mental health is affected by the environment in which they live, often coupled with long working hours that contribute to stress, anxiety, loneliness, depression and suicide. This proposal seeks to improve the seafarers' mental health by introducing a comprehensive, evidence-based global maritime mental health promotion program that attracts the youngest seafarers to choose and to stay in the job. Methods: The theories on empowerment, life-long and problem-oriented learning with inclusion of all stakeholders form the theoretical background. A joint action among the unions, the ship owners, the maritime authorities and a network of universities' research centres in suicide prevention, public health and maritime health departments includes:

Dock workers health and safety survey and intervention program[edit]

The employers have the full responsibility for health and safety in the ports but the unions also take initiatives for better health and safety together with the university occupational health research departments. The strength is that the workers know the workplace hazards by own experiences better than the owners and the administrators and therefore are the best to propose how to do the prevention.

Background for the Research School[edit]

The development of the sciences in a modern society includes among other issues, research training, research-based teaching in universities and the establishment of research centres and scientific journals. This centre is part of this trilogy in order to develop research in health and to develop the society. A political study on the Panamanian Health Research System by Romero et al. characterizes the system as insufficient to accomplish its operative role of generating knowledge for new health interventions and input for innovations (2). The analyses emphasises the need to develop a National Health Research Policy, which should include longer-term plans and a strategy to overcome the asymmetries and gaps between the different actors and components of the current system. Another study by Romero et al, illustrates an approach to the context of the Panamanian Health Research System, which characterizes the system as insufficient to accomplish its operative role of generating knowledge for new health interventions and input for innovations (3). The policy is to strengthen the evidence-based health practice by interdisciplinary, collaborative research, learning, training and information activities. The policy aims to improve job satisfaction, wellbeing and good health at work, at home and in the retirement.

Aims and visions[edit]

The aims are to offer training for pregraduate medical students, other students and postgraduate health professionals to work systematically, scientifically with an evidence-based approach. We will try to give them the most needed tools for clinical work and for prevention in the population and for research. Clinical studies will be related to the population where the patient comes from with an epidemiological approach to cause search, prevention and prognosis. In the presentation of clinical problems, we will inspire the students to see each patient in the big picture. That is to use modern methods of systematic, scientific work, identifying and solving health problems in the evidence-based. Both in clinical work and working with the population health problems include diagnostics, search for aetiology, treatment, prevention and prognosis. Prevention is included in all health work, corresponding to the WHO definitions of primary secondary and tertiary prevention. These principles are useful in occupational medicine, public health and all clinical specialties. We hope that these methods will stimulate students to work systematically, scientifically in all areas where they will be working graduates. And most important to be inspired to start their own research project, ideally to do their thesis as a scientific work presented in the same style as a scientific article.

Learning methods[edit]

We stand on the shoulders of giants" meaning that we use the existing scientific literature as start point equipped to solve real-life complex health problems. To solve a problem you need to learn to ask the right questions. In projects you work deeply and exploratory with a problem chosen by you and your fellow members of the project group. Throughout the research process talented researchers will guide the students. They will learn how to identify and frame a problem through problem-oriented projects and get a methodological and theoretical toolbox. The project groups will ideally consist of students who are passionate about the same issues and findings as you. Every module consists of reading and lectures, group work with 1 selected research theme during the whole course and minor group works in each of the lectures. The students elaborate a main research project over the whole course (months/years) and minor review project on articles per module/week. Journal of Public, Occupational and Environmental Health The main objective is to serve students in health research schools and to support in the continuous training for all health professionals. The everyday use of scientific literature is a key part of this development. That is to create a culture of risk prevention based on scientific evidence and critical thinking. The objective is to raise awareness about factors that improve or damage the environment, in order to preserve the quality of life of the inhabitants of the planet and contribute to social welfare. Revista_Panameňa_de_Salud_Publica,_Ocupacional_y_Ambiental