Thoughts on Ethical Collaborative Review and Management of Multi-center Clinical Research / 中国医学伦理学

For multi-center clinical research, how to ensure the quality of ethical review and improve the efficiency of ethical review through cooperation among centers is an important direction for clinical research management departments and research parties to explore. By combing and analyzing the existing pattern of multi-center ethical review at home and abroad, combining the current situation of the ethical review and management development in China, taking cancer clinical research as the breakthrough point, it was advocated to establish a cooperative review led by professional institute in domestic, on the basis of extensive and in-depth training exchanges and effective communication on the same platform, collaborative review, ensure quality and efficiency, so as to promote and implement the "mutual recognition" of ethical review. Then, this paper further put forward the concept of "whole-process linkage" in the ethical management process of multi-center clinical research, and pointed out that all research parties should clarify their responsibilities, enhance their awareness and ability, and jointly and comprehensively implement the protection of subjects among clinical researchers.

Saberes en juego en una práctica extensionista. Construcciones comunes entre una cooperativa integrada por personas privadas de libertad y acompañantes universitarixs

Tomando como insumo la etnografía realizada con objeto de la escritura de la tesis, pero realizando el recorte que demanda un artículo, me centraré en reconstruir tres puntos que dan cuenta de aspectos vinculados a la dimensión comunicativa, y que resultan ejemplos paradigmáticos de dimensiones constitutivas del vínculo entre cooperativistas y acompañantes, los cuales nos permiten advertir las huellas institucionales de la cárcel y la universidad en el modo de trabajo conjunto con la intención de advertir cómo se articulan, potencian o complejizan la relación en el marco de la experiencia extensionista. Asimismo, en las reuniones de producción los saberes jerarquizados se invertían en relación a los días de reunión general, y también el rol de lxs sujetxs. Lxs cooperativistas detentaban cierta autoridad en estos días, marcándose una asimetría en torno al saber que se construía de modo situacional y contextual - los días de producción primaban los saberes en torno a la tela, a diferencia de los días de reunión general, en los que primaba la palabra-, lo cual nos permite entender que los conocimientos que se ponen a dialogar deben ser comprendidos en vínculo con sus condiciones de enunciación y según el contexto. Son las diferencias las que se constituyen en punto de contacto y que deben hacerse inteligibles para el diálogo y trabajo con otrxs, las cuales pueden ser entendidas como saberes prácticos que se entrelazan con otros saberes en la experiencia, o en el "mientras tanto" se buscan otros diálogos de saberes conceptuales.

Tomando como aporte a etnografia realizada para a redação da tese, mas fazendo o recorte que um artigo exige, vou me concentrar em reconstruir três pontos que dão conta de aspectos relacionados à dimensão comunicativa, e que são exemplos paradigmáticos de dimensões constitutivas do vínculo entre cooperados e acompanhantes, que permitem perceber os traços institucionais da prisão e da universidade no modo de trabalho conjunto com a intenção de perceber como a relação se articula, se fortalece ou se complexifica no âmbito da experiência de extensão. Da mesma forma, nas reuniões de produção, os saberes hierarquizados se inverteram em relação aos dias da assembléia geral, e também o papel dos sujeitos. Os cooperados detinham certa autoridade nesses dias, marcando uma assimetria em torno do conhecimento que se construía de forma situacional e contextual - os dias de produção eram dominados pelo conhecimento sobre o tecido, ao contrário dos dias da reunião geral, quando a palavra prevalecia -, o que nos permite compreender que os saberes que se colocam em diálogo devem ser entendidos em conexão com suas condições de enunciação e de acordo com o contexto. São as diferenças que constituem o ponto de contato e que devem ser tornadas inteligíveis para o diálogo e o trabalho com os outros, que podem ser entendidas como saberes práticos que se entrelaçam com outros saberes na experiência, ou no "enquanto" buscam outros diálogos de conhecimento conceitual.

Taking as input the ethnography carried out for the purpose of writing the thesis, but making the cut that an article demands, I will focus on reconstructing three points that account for aspects related to the communicative dimension, and that are paradigmatic examples of dimensions constitutive of the link between cooperative members and companions, which allow us to notice the institutional traces of the prison and the university in the way of joint work with the intention of noticing how the relationship is articulated, strengthened or made more complex within the framework of the extension experience. Likewise, in the production meetings, the hierarchical knowledge was inverted in relation to the days of the general meeting, and also the role of the subjects. The cooperative members held a certain authority in these days, marking an asymmetry around the knowledge that was built in a situational and contextual way - the days of production prevailed the knowledge around the fabric, unlike the days of general meeting, in which the word prevailed-, which allows us to understand that the knowledge that is put into dialogue must be understood in connection with its conditions of enunciation and according to the context. It is the differences that constitute the point of contact and that must be made intelligible for dialogue and work with others, which can be understood as practical knowledge that is intertwined with other knowledge in experience, or in the "meanwhile" They look for other dialogues of conceptual knowledge.

PET-Saúde interprofissionalidade: contribuições, barreiras e sustentabilidade da Educação Interprofissional / PET-Saúde interprofissionalidade and interprofessional education: contributions, barriers and sustainability / PET-Salud interprofesionalidad: contribuciones, barreras y sostenibilidad de la educación interprofesional

Resumo Objetivou-se analisar as contribuições e barreiras enfrentadas pelo Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) Interprofissionalidade, bem como debater elementos necessários à sustentabilidade da Educação Interprofissional (EIP). Pesquisa qualitativa desenvolvida em três unidades acadêmicas de uma instituição pública de ensino superior. Os dados foram coletados pelo Google Meet e analisados pela técnica da análise de conteúdo. Emergiram três categorias temáticas: contribuições do PET-Saúde Interprofissionalidade para a indução de mudanças na formação em Saúde, barreiras que afetaram seu desempenho e sustentabilidade da EIP. A análise indica que O PET-Saúde Interprofissionalidade foi uma experiência importante para pautar o debate da EIP nos cursos de graduação e nos serviços de Saúde. As experiências acumuladas nesse programa constituem um arcabouço que não pode ser desprezado e deverá ser lapidado para fundamentar estratégias sustentáveis que considerem a interprofissionalidade como abordagem na reorientação da formação e qualificação da atenção à saúde.(AU)

Abstract The aim of this study was to explore the contributions of and barriers faced by the Education through Work for Health Program-Interprofessional Collaboration Program (PET-Saúde Interprofissionalidade) and debate key elements for the sustainability of interprofessional education (IPE). We conducted a qualitative study in three academic units of a public higher education institution. The data were collected via Google Meet and analyzed using content analysis. Three categories emerged during the analysis: contributions of the PET-Saúde Interprofissionalidade to the induction of changes in health training, barriers affecting performance, and sustainability of IPE. The findings indicate that the PET-Saúde Interprofissionalidade made important contributions to pushing forward the debate about IPE in undergraduate degrees and health services. The experiences accumulated during the program provide a framework whose potential should not be underestimated and should be refined to lay the foundation for sustainable strategies that incorporate interprofessional collaboration as an approach to reorienting health training.(AU)

Resumen El objetivo fue analizar las contribuciones y barreras enfrentadas por PET-Salud Interprofesionalidad, así como discutir elementos necesarios para la sostenibilidad de la Educación Interprofesional (EIP). Investigación cualitativa desarrollada en tres unidades académicas de una institución pública de enseñanza superior. Los datos fueron colectados por Google meet y analizados por la técnica de análisis de contenido. Surgieron tres categorías temáticas: contribuciones de PET-Salud Interprofesionalidad para la inducción de cambios en la formación en salud, barreras que afectaron su desarrollo y sostenibilidad de EIP. El análisis indica que PET-Salud Interprofesionalidad fue una experiencia importante para regir el debate de EIP en los cursos de graduación y en los servicios de salud. Las experiencias acumuladas en ese programa constituyen una estructura que no puede despreciarse y que deberá perfeccionarse para servir de base a estrategias sostenibles que consideren la interprofesionalidad como un abordaje en la reorientación de la formación y calificación de la atención de la salud.(AU)

Influencia de los tipos de agrupamiento en la competencia social de futuros docentes de educación física al implementar el aprendizaje cooperativo / Influência dos tipos de agrupamento na competência social dos futuros professores educação física na implementação da aprendizagem cooperativa / Influence of the types of grouping on the social competence of future physical education teachers when implementing cooperative learning

Resumen El objetivo de esta investigación fue comprobar la incidencia del aprendizaje cooperativo (AC) en la competencia social en función de los tipos de agrupamiento del alumnado. Participaron 53 estudiantes de tercer curso del Grado de Magisterio Educación Primaria de la mención de Educación Física (EF). Se utilizó un diseño cuasi-experimental donde se implementó una intervención durante cuatro meses con medidas pre-test y post-test a través de un cuestionario sociométrico. El tratamiento de datos se realizó mediante el software Sociomet. Los resultados obtenidos indican que los seminarios que han utilizado agrupamientos libres y heterogéneos han obtenidos mejores puntuaciones de percepción de competencia social que el seminario organizado en subgrupos homogéneos. Así pues, se considera que el criterio de homogeneidad debe ser descartado a la hora de implementar el AC en EF. (AU)

Resumo O objetivo desta pesquisa foi verificar a incidência da aprendizagem cooperativa (LC) na competência social em função dos tipos de agrupamento de alunos. Participaram 53 alunos do terceiro ano do Ensino Fundamental da Licenciatura da menção à Educação Física (EF). Foi utilizado um desenho quase experimental onde foi implementada uma intervenção durante quatro meses com medidas pré-teste e pós-teste através de um questionário sociométrico. O processamento dos dados foi realizado por meio do software Sociomet. Os resultados obtidos indicam que os seminários que utilizaram agrupamentos livres e heterogêneos obtiveram melhores pontuações para a percepção de competência social do que o seminário organizado em subgrupos homogêneos. Assim, considera-se que o critério de homogeneidade deve ser descartado na implementação da AC em EF. (AU)

Abstract The objective of this research was to verify the incidence of cooperative learning (CL) in social competence depending on the types of grouping of students. Fifty-three (53) third-year students of the Primary Education Teaching Degree participated with the mention of Physical Education (PE). A quasi-experimental design was used where intervention was implemented for four months with pre-test and post-test measures through a sociometric questionnaire. Data processing was performed using Sociomet software. The results obtained indicate that the seminars that have used free and heterogeneous groupings have obtained better scores for the perception of social competence than the seminar organized in homogeneous subgroups. Thus, it is considered that the homogeneity criterion should be discarded when implementing CA in PE. (AU)

Doctor-patient relationship: Effectiveness of the “Jigsaw” method of teaching among Phase I MBBS students in a tertiary care teaching hospital

Background: Students learn passively in the lecture format and rely on teachers for knowledge acquisition, making it unsuitable for achieving the higher levels of knowledge. Jigsaw learning encourages collaboration between learners for a deeper understanding of the subject and the facilitator role is relatively limited. Aim and Objectives: The aim of the study was to: 1. Determine the effectiveness of the jigsaw method versus traditional lecture methods for the teaching of Attitude, communication, and ethics (AETCOM) in Phase I MBBS students. 2. To assess the perception of students toward the jigsaw method. Material and Methods: This quasi-experimental study included 104 Phase I MBBS students, who were assigned to the jigsaw group and traditional lecture group. As part of the jigsaw method, 10 parent groups and five expert groups were formed to encourage peer group learning. Validated pre-tests, post-tests, and questionnaires were used in the evaluation. Results: On post-test, both groups scored significantly higher than pre-test, but the scores on pre-test did not differ between them. Post-test scores of the jigsaw group were significantly higher than those of the traditional method group. Jigsaw was rated positively by students for enhancing peer interaction (91%), deeper learning of the subject (90%), and communication skills (89%). Conclusion: The jigsaw method is more effective than the traditional method for the teaching of the AETCOM module to medical undergraduates. It can be used as a helpful tool for teaching communication skills and teamwork by utilizing cooperative learning strategies.

A STUDY ON PROBLEMS OF STREET WOMEN FISH VENDORS IN KANYAKUMARI DISTRICT

This article is an attempt to describe problem of women street Fish vendors in kanyakumari district. This study explore the various problems related women street fish vendors such as socio economic condition like low income level, This analysis based on collect information through primary and secondary data. Women fish vendors play a major role in between the fisherman and consumers. Selling fish is a form of occupation and it is livelihood of large number of population in many places. Women street fish vendors were found to many problems and there is no significant differences between the marital position and problems between the women street fish vendors.

Determinants To Prefer Paccss By Members: An Anlysis With Challenges

Co-operative banks offers a wide range of services including improved access to markets, natural resources, information, communications, technologies, credit, training and warehouses to farmers and rural entrepreneurs. In this paper, it is mainly focused on to examine the determinants to prefer the Primary Agricultural Co-operative Credit Societies (PACCSs) and challenges faced by the members of PACCSs in Erode district of Tamil Nadu. For this paper, primary data have been collected from 140 members of the PACCSs. Such collected data have been analysed with the help of MS Excel and SPSS 22.0. Kendall's 'W' Test and Henry Garrett Ranking Technique have been used for this research

A Study On Working Capital Management In Pazhavoor Primary Agriculture Co-Operative Credit Society Ltd, Pazhavoor, Tirunelveli, Tamil Nadu.

The title of the research article is “A Study on Working Capital Management in Pazhavoor Primary Agriculture Co- operative Credit Society Ltd., Pazhavoor, Tirunelveli, Tamil Nadu.” Working capital management involves the relationship between a company's short-term assets and its short-term liabilities. The goal of working capital management is to ensure that a company is able to continue its operation and that it has sufficient ability to satisfy both maturing short-term debt and upcoming operational expenses. The management of working capital involves managing inventories, accounts receivable and payable and cash management. Further the study is based on last five years annual reports of Pazhavoor Primary Co-operative Society. The objective of the study is to analyze the working capital position in Pazhavoor Primary Co-operative Society and to analyze the profitability and solvency position of the Pazhavoor Primary Co-operative Society. The study of working capital is based on tools like Ratio analysis, statement of changes in working capital, comparative balance sheet and trend analysis. By analyzing the topic of working capital management in Pazhavoor Primary Co-operative Bank Ltd. It concludes that the bank is having less working capital in the year 2019 but in the year 2020 the working capital is increasing, So the bank maintains the constant working capital which helps perform the day-to-day business by increasing the current asset.

Articulação entre a EqSF/AB e o NASF/AB e sua influência na produção do cuidado no contexto da Atenção Primária à Saúde / Coordination between Primary Care Teams and Family Health Support Units and influence on Primary Care delivery

Resumo O objetivo deste artigo é comparar a realização de ações de articulação entre as equipes EqSF/AB e NASF/AB entre a região Nordeste e Brasil e sua influência no trabalho conjunto das equipes. As variáveis independentes foram 19 ações de articulação investigadas pelo módulo II do 3º Ciclo do PMAQ-AB. Os três desfechos referentes ao trabalho conjunto foram a disponibilidade da EqSF/AB em trabalhar com o NASF/AB, o apoio recebido do NASF/AB e a contribuição do trabalho deste para a resolutividade das ações para os usuários. A comparação entre o Nordeste e o Brasil na realização das ações de articulação foi realizada pelo Teste Z e a influência final de tais ações nos desfechos foi avaliada por Modelo Hierárquico de Regressão Linear. A região Nordeste realizou mais ações de integração entre a EqSF/ AB e o NASF/AB (p<0,05). As ações realizadas que apresentaram maior influência positiva nos três desfechos foram "discussão de casos", "elaboração conjunta do Projeto Terapêutico Singular", "realização de consultas compartilhadas" e "monitoramento dos resultados". A região Nordeste realizou mais ações de articulação, e elas apresentaram influências positivas no trabalho conjunto.

Abstract This article aims to compare the implementation of coordinated actions by family health/primary care (FH/PC) teams and extended family health and primary care units (NASF-ABs) in the Northeast and rest of Brazil, and the influence of implementation on collaborative working. The independent variables were 19 coordinated actions assessed by Module II of the 3rd Cycle of the National Program for Improving Primary Care Access and Quality (PMAQ-AB). The three collaborative working outcomes were "FH/PC team readiness to work jointly with the NASF-AB", "support received by the FH/PC team from the NASF-AB", and "The NASF-AB's contribution to resolving patients" needs. The implementation of coordinated actions by the Northeast and at national level was compared using the two-proportions z-test and the influence of these actions on the outcomes was assessed using hierarchical linear regression models: The Northeast implemented more actions that at national level (p<0.05). The implemented actions that had the most positive influence on the three outcomes were "Case conferences", "Joint development of singular therapy plans for complex cases", "Shared appointments" and "Results monitoring". The Northeast implemented more actions and the implemented actions had a positive influence on collaborative working.

Actividades cooperativas para la capacidad física flexibilidad, en estudiantes de la carrera Cultura Física

A través de las pruebas de eficiencia física, se determina cómo se va comportando el desarrollo de los estudiantes durante el curso y, en función de estos resultados, poder realizar acciones para mejorar su trayectoria. La flexibilidad es la capacidad física que brinda al hombre la posibilidad de realizar movimientos de gran amplitud, condicionada por las estructuras neuromio-articulares de fijación y estabilización y cuando se utiliza el trabajo cooperativo, el éxito de una actividad de un integrante depende del triunfo del compañero. En observaciones a clases y entrevistas realizadas a los estudiantes del primer año del curso Regular Diurno de la carrera de Cultura Física, se corrobora que en las Pruebas de Eficiencia Física (Pef) realizadas al inicio del curso, el nivel obtenido en la capacidad física Flexibilidad , con respecto al resto de las pruebas, es el de mayor dificultad y muy marcado en los varones, además, la variedad en las clases y el poco uso de trabajo cooperativo son insuficientes por lo que el objetivo de trabajo va dirigido a proponer un conjunto de actividades cooperativas que favorezcan la capacidad física Flexibilidad en los estudiantes del primer año de la carrera de Cultura Física de la Uccfd "Manuel Fajardo". Se utilizaron los métodos inductivo-deductivos, análisis-síntesis, observación científica, encuesta y criterio de especialista. Los resultados fueron positivos para los estudiantes después de cuatro meses de aplicarse la propuesta. Los especialistas valoraron de Muy Adecuado la propuesta, lo que se evidencia en los resultados de los estudiantes la mejoría del nivel en la prueba de flexibilidad.

Através dos testes de eficiência física, define-se como o desenvolvimento dos alunos está se comportando durante o curso e, dependendo destes resultados, podem ser tomadas medidas para melhorar sua evolução. Flexibilidade é a capacidade física que dá ao homem a possibilidade de realizar movimentos de grande amplitude, influenciados pelas estruturas neuro-mio-articulares de fixação e estabilização, e quando se utiliza o trabalho cooperativo, o sucesso da atuação de um membro depende do sucesso do associado. Nas observações nas aulas e nas pesquisas realizadas com os alunos no primeiro ano do curso Regular Diurno de Cultura Física, é comprovado que nos Testes de Eficiência Física (Pef) realizados no início do curso, o nível obtido na capacidade física Flexibilidade, em relação ao resto dos testes, é o mais difícil e muito marcado nos homens, Além disso, a variedade nas aulas e o pouco uso do trabalho cooperativo são insuficientes, por isso o objetivo do trabalho é propor um conjunto de atividades cooperativas que privilegiem a capacidade física para a flexibilidade nos alunos do primeiro ano do curso de Cultura Física no Uccfd "Manuel Fajardo". Foram utilizados os métodos indutivo-deducativo, análise-síntese, observação científica, pesquisa e critérios especializados. Os resultados foram positivos para os estudantes após quatro meses de aplicação da proposta. Os especialistas classificaram a proposta como Muito Adequada, o que é evidenciado pela melhoria no nível dos estudantes no teste de flexibilidade.

Through the physical efficiency tests, it is determined how the students' development is behaving during the course and, based on these results, actions can be taken to improve their trajectory. Flexibility is the physical capacity that gives man the possibility to perform movements of great amplitude, conditioned by the neuro-myo-articular structures of fixation and stabilization, and when cooperative work is used, the success of an activity of one member depends on the success of the partner. In class observations and interviews with the students of the first year of the Regular Day Course of the Physical Culture career, it is corroborated that in the Physical Efficiency Tests (Pef in Spanish) carried out at the beginning of the course, the level obtained in the physical capacity Flexibility, with respect to the rest of the tests, is the most difficult and very marked in the males, in addition, the variety in the classes and the little use of cooperative work are insufficient, so the objective of the work is aimed at proposing a set of cooperative activities that favor the physical capacity Flexibility in the students of the first year of the Physical Culture course of the Physical Culture and Sport Sciences University (Uccfd in Spanish) "Manuel Fajardo". The inductive-deductive, analysis-synthesis, scientific observation, survey and specialist criteria methods were used. The results were positive for the students after four months of applying the proposal. The specialists assessed the proposal as Very Adequate, which is evidenced by the students' results in the improvement of the level in the flexibility test.

Prática colaborativa na estratégia saúde da família: expressões, possibilidades e desafios para produção do cuidado / La práctica colaborativa en la estrategia de salud familiar: expresiones, posibilidades y desafíos para la producción de cuidados / Collaborative practice in the family health strategy: expressions, possibilities and challenges for the production of care

RESUMO Objetivo: compreender a configuração da prática colaborativa no contexto da Estratégia Saúde da Família (ESF). Método: trata-se de um estudo de caso único, de natureza qualitativa, realizado com 35 profissionais das equipes de saúde da família. A coleta de dados ocorreu por meio de entrevistas guiadas por roteiro semiestruturado e observação não participante. Os dados foram analisados por meio de Análise de Conteúdo Temática. Resultados: os resultados evidenciaram potencialidades da prática colaborativa para a qualificação das práticas profissionais e dos resultados de saúde no contexto da ESF. Entretanto observou-se insuficiência de dispositivos organizacionais para apoiar o trabalho compartilhado na ESF, inclusive no que tange às políticas públicas, revelando o chamamento para a educação interprofissional no contexto dos serviços de saúde para estimular a colaboração. Conclusão: a configuração da prática colaborativa interprofissional no contexto da Estratégica Saúde da Família é desafiadora e requer processos interacionais e de organização do trabalho.

RESUMEN Objetivo: comprender la configuración de la Práctica Colaborativa en el contexto de la Estrategia de Salud Familiar. Método: se trata de un estudio de caso único, de carácter cualitativo, realizado con treinta y cinco profesionales de equipos de salud familiar. La recogida de datos se realizó mediante entrevistas guiadas por un guión semiestructurado y la observación no participante. Los datos se analizaron mediante un Análisis de Contenido Temático. Resultados: los resultados mostraron el potencial de la práctica colaborativa para la cualificación de las prácticas profesionales y los resultados de salud en el contexto del ESF. Sin embargo, se observaron insuficientes dispositivos organizativos para apoyar el trabajo compartido en los ESF, un reto a superar, incluso en lo que respecta a las políticas públicas, lo que revela la necesidad de una educación interprofesional en el contexto de los servicios de salud para estimular la colaboración. Conclusión: la configuración de la Práctica Colaborativa interprofesional en el contexto de la Estrategia de Salud Familiar es un reto y requiere procesos de interacción y organización del trabajo.

ABSTRACT Objective: to understand the configuration of collaborative practice in the context of the Family Health Strateg y (FHS). Method: this is a single case study, of a qualitat ive nature, carried out with 35 professionals from the family health teams. Data collection took place through interviews guided by a semi-structured script and non-participant observation. Data were analyzed using Thematic Content Analysis. Results: the results showed the potential of collaborative practice for the qualification of professional practices and health outcomes in the conte xt of the FHS. However, there was a deficiency of organizational devices to support shared work in the FHS, including with regard to public policies, revealing the call for interprofessional education in the context of health services to encourage collaboration. Conclusion: the configuration of interprofessional collaborative practice in the context of the Family Health Strategy is challenging and requires interactional processes and work organization.

Consórcios Intermunicipais de Saúde (CIS) como mecanismos de coordenação federativa para construção da regionalização: papel, possibilidades e limites / Intermunicipal Health Consortia (CIS) as federative coordination mechanisms to build regionalization: role, possibilities and limits

Há uma diversidade de experiências de gestão por Consórcios Intermunicipais de Saúde (CIS) no Brasil. A partir de uma abordagem quantitativa na única base de dados pública, que reúne informações sobre consórcios no país, foi possível contabilizar e mapear 189 CIS cadastrados no Observatório Municipalista de Consórcios Públicos, da Confederação Nacional de Municípios (CNM). O objetivo central desta dissertação é investigar se os Consórcios Intermunicipais de Saúde, entendidos como instrumentos de coordenação federativa voltados para o apoio à gestão descentralizada, podem potencializar ações coletivas e favorecer a construção da regionalização. Para isso, realizou-se uma revisão narrativa da literatura sobre as experiências de gestão consorciada, que utilizaram os CIS como modelo organizacional da assistência em nível regional, a fim de compreender se os Consórcios Intermunicipais de Saúde fortaleceram a regionalização. Foram selecionados onze trabalhos acadêmicos que avaliaram a implementação da gestão consorciada nos estados do Ceará, Pernambuco, Mato Grosso, São Paulo, Paraná, Bahia e Rio de Janeiro. A literatura defende que os CIS têm aptidão para enfrentar os dilemas da regionalização e os entraves da descentralização. Os resultados sugerem que o apoio técnico e financeiro das Secretarias Estaduais de Saúde pode induzir a formação desses arranjos, para organização da atenção especializada em nível regional, em prol de ganhos de escala, ampliação da oferta e superação dos custos e dificuldades advindas da descentralização. Contudo, desafios no processo de cooperação e coordenação na Rede de Atenção à Saúde (RAS) ainda podem persistir, mesmo após a constituição dos CIS, sobretudo, causados pelas influências políticas no processo decisório, pelo relacionamento com a administração regional de saúde, Comissão Intergestores Regional (CIR) e Comissão Intergestores Bipartite (CIB), bem como pela carência do controle social. Ainda é incipiente a produção acadêmica sobre os resultados alcançados pelos CIS na estratégia de regionalização, sendo necessários estudos adicionais para avaliar os impactos da gestão consorciada em escala regional.

There is a diversity of management experiences by Intermunicipal Health Consortia (CIS) in Brazil. From a quantitative approach in the only public database, which gathers information on consortia in the country, it was possible to count and map 189 CIS registered in the Municipalist Observatory of Public Consortia, of the National Confederation of Municipalities (CNM). The main objective of this dissertation is to investigate whether the Intermunicipal Health Consortia, understood as instruments of federative coordination aimed at supporting decentralized management, can enhance collective actions and favor the construction of regionalization. For this, a narrative review of the literature was carried out on the experiences of consortium management, which used the CIS as an organizational model of assistance at the regional level, in order to understand whether the Intermunicipal Health Consortia strengthened regionalization. Eleven academic papers were selected that evaluated the implementation of the consortium management in the states of Ceará, Pernambuco, Mato Grosso, São Paulo, Paraná, Bahia and Rio de Janeiro. The literature argues that CIS are able to face the dilemmas of regionalization and the obstacles of decentralization. The results suggest that the technical and financial support of the State Health Departments can induce the formation of these arrangements, for the organization of specialized care at the regional level, in favor of gains of scale, expansion of supply and overcoming the costs and difficulties arising from decentralization. However, challenges in the process of cooperation and coordination in the Health Care Network (RAS) may still persist, even after the establishment of the CIS, mainly caused by political influences in the decision-making process, by the relationship with the regional health administration, Intermanager Commission Regional Council (CIR) and Bipartite Intermanager Commission (CIB), as well as the lack of social control. Academic production on the results achieved by the CIS in the regionalization strategy is still incipient, and additional studies are needed to assess the impacts of consortium management on a regional scale.

Network professional interaction in the care of patients with stroke / Interacción de redes profesionales en el cuidado de pacientes con accidente cerebrovascular / Interação profissional em rede no atendimento ao paciente com acidente vascular cerebral

ABSTRACT Objective: to understand the professional interaction in the Emergency Care Network in the care of patients with acute ischemic stroke in the city of Salvador/Bahia. Methods: the Grounded Theory methodological framework, Straussian strand, and the health networks theoretical framework were used. An in-depth interview was used, between October 2019 and October 2020, with 75 professionals from the Mobile Emergency Care Service, Emergency Care Units and reference hospital. Results: 5 categories and 24 subcategories point to shared goals among professionals, but they show elements of fragmentation of connections between services, such as the absence of a single language and conduct, obstacles to professional relationships and lack of knowledge of the other's role. Conclusions: to improve network relationships and care of patients with stroke, there is a need for well-established connecting elements, such as flows and protocols, supported by continuing education actions.

RESUMEN Objetivo: comprender la interacción profesional de la Red de Atención de Urgencias y Emergencias en la atención de pacientes con accidente cerebrovascular isquémico agudo en la ciudad de Salvador/Bahia. Métodos: se utilizó el referencial metodológico de la Teoría Fundamentada en Datos, vertiente straussiana, y el referencial teórico sobre redes en salud. Se utilizó una entrevista en profundidad, entre octubre de 2019 y octubre de 2020, a 75 profesionales del Servicio de Atención Móvil de Urgencias, Unidades de Atención de Urgencias y hospital de referencia. Resultados: 5 categorías y 24 subcategorías apuntan a metas compartidas entre los profesionales, pero muestran elementos de fragmentación de las conexiones entre los servicios, como la ausencia de un único lenguaje y conducta, obstáculos a las relaciones profesionales y desconocimiento del papel del otro. Conclusiones: para mejorar las relaciones en red y la atención a los pacientes con ictus, se necesitan elementos de conexión bien establecidos, como flujos y protocolos, apoyados en acciones de educación permanente.

RESUMO Objetivo: compreender a interação profissional na Rede de Atenção às Urgências e Emergências no atendimento ao paciente com acidente vascular cerebral isquêmico agudo na cidade de Salvador/Bahia. Métodos: foram utilizados o referencial metodológico da Teoria Fundamentada nos Dados, vertente straussiana, e o referencial teórico sobre redes em saúde. Foi empregada entrevista em profundidade, entre outubro de 2019 e outubro de 2020, com 75 profissionais do Serviço de Atendimento Móvel de Urgência, Unidades de Pronto Atendimento e hospital referência. Resultados: 5 categorias e 24 subcategorias apontam compartilhamento de objetivos entre profissionais, mas evidenciam elementos de fragmentação das conexões entre os serviços, como a ausência de linguagem e conduta única, entraves das relações profissionais e desconhecimento da função do outro. Conclusões: para aprimorar relações em rede e o atendimento ao paciente com acidente vascular cerebral, há necessidade de elementos conectores bem estabelecidos, como fluxos e protocolos, fundamentados por ações de educação permanente.

The teachers′ experience of nursing practice teaching collaboration between Guangdong and Macao under the background of Guangdong-Hong Kong-Macao Greater Bay Area / 中国实用护理杂志

Objective:To explore the experience of teachers from Guangdong and Macao in nursing teaching cooperation, the existing problems in current teaching cooperation and suggestions for improvement.Methods:From January to April 2021, using descriptive qualitative method to conduct in-depth among eight clinical tutors from The Third Affiliated Hospital of Guangzhou Medical University who teach Macao nursing students, and four teachers from Kiang Wu Nursing College of Macao using the purposive sampling method. And adopted content analysis for data analysis.Results:A total of 4 themes and 2 sub-themes were analyzed: the positive impact of cross-border teaching cooperation projects including developed the nursing business of the two places and deepened the cooperative relationship between the two places; limiting the depth and breadth of knowledge transfer because of the short cross-border learning time; the imbalance between students′ abilities and teachers′ expectations; expectations for homogeneous internships for heterogeneous groups.Conclusions:Cross-border nursing teaching cooperation is an important promoter for the development of nursing education between Guangdong and Macao, but there are still deficiencies in cooperation, and it is necessary for the two places to strengthen the construction of a sharing platform for teaching resources to promote the development of nursing education in the Guangdong-Hong Kong-Macao Greater Bay Area.

Research on the development of bio-pharmaceutical industry integration and collaborative innovation in the Yangtze River Delta under the mode of Industry-University-Research cooperation / 中国药科大学学报

@#After the integration of Yangtze River Delta was elevated and developed into a national strategy, few domestic studies have been conducted to explore the integrated and collaborative development of biopharmaceutical industry in the Yangtze River Delta region, which, as an important region of biopharmaceutical industry in China, has initially formed the development mode of industrial clusters. In this study, based on the industry-university-research model of patent and fund project cooperation, the social network analysis (SNA) method is used to analyze and study the cooperation of patent and Major Projects of National Natural Science Foundation of China in the biopharmaceutical industry in the Yangtze River Delta region. The study shows that the industry-university-research cooperation in the biomedical field in the Yangtze River Delta region is still in the development stage and the degree of integration needs to be improved. Universities and research institutes are more inclined to cooperate with enterprises for invention patents and with other universities for fund project research.It is suggested that the Yangtze River Delta region should adopt the deep integration mode of industry-university-research, relevant leading scientific research institutions should establish open innovation platforms, and pharmaceutical universities should cultivate innovative talents with the advantages of their disciplines, and adopt "Revealing the List and Taking Command" or other ways to tackle key core technologies.

Transtorno do espectro autista: capacitação de professores para atividades escolares em grupo / Autism spectrum disorder: teacher training for group school activities / Trastorno del espectro autista: capacitación de profesores para actividades escolares en grupo

Dentre as dificuldades encontradas para a inclusão de crianças com Transtorno do Espectro Autista (TEA) nas escolas está a falta de conhecimentos técnicos e instrumentos específicos que ofereçam suporte à prática dos profissionais da educação e às escolas. Considerando essa necessidade, foi aplicado um programa de capacitação, com base no referencial teórico da Análise do Comportamento, para 18 professores do Ensino Fundamental de uma escola de cidade do interior do Estado de São Paulo, com o objetivo de capacitá-los a aprenderem estratégias para promover a participação de alunos com TEA em atividades de grupo utilizando jogos cooperativos. Foram ministradas cinco aulas com enfoque prático, abordando os temas: jogos cooperativos, prompt e reforço. A avaliação do curso foi feita de três modos: aplicação de Pré-Teste, Pós-Teste e Follow-up. Para avaliar a aprendizagem dos professores participantes, foi solicitada aos professores uma atividade de simulação de situações e intervenções vivenciadas junto a alunos com TEA, a partir dos conteúdos aprendidos, e a aplicação da Escala de Avaliação do Ensino em Língua Oral em Contexto Escolar (EVALOE) para avaliar a atuação dos ministrantes. Os resultados indicaram que os participantes apresentaram mais acertos no pós-teste do que no pré-teste, a avaliação deles sobre o curso foi positiva e a atuação dos ministrantes satisfatória. Ressalta-se a importância de elaborar capacitações para os docentes e a necessidade de fornecer a eles mais materiais de apoio e atividades de autoaprendizagem.

Among the difficulties found for the inclusion of children with Autism Spectrum Disorder (ASD) in schools is the lack of technical knowledge and specific instruments that support the practice of education professionals and schools. Considering this need, a training program has been implemented based on the theoretical framework of behavior analysis for 18 elementary school teachers from a school in a city in the countryside of the State of São Paulo in order to enable them to learn strategies to promote the participation of students with ASD in group activities using cooperative games. Five classes have been given with a practical approach, addressing the themes: cooperative games, prompt and reinforcement. The evaluation of the course has been done in three steps: Pre-Test, Post-Test and Follow-up application. In order to evaluate the learning of the participating teachers, they performed a simulation activity of situations and interventions experienced with students with ASD based on the contents learned. In addition, the Assessment Scale of Oral Language Teaching at the School Context (EVALOE) was applied to evaluate the performance of the instructors. The results have indicated that the participants have had more correct answers in the Post-test than in the Pre-test, their evaluation of the course has been positive, and the performance of the students satisfactory. The importance of developing training for teachers and the need to provide them with more support materials and self-learning activities is emphasized.

En medio de las dificultades encontradas en la inclusión de los niños y niñas con Trastorno del Espectro Autista (TEA) en las escuelas, está la falta de conocimientos técnicos y instrumentos específicos que conceden soporte a la práctica de los profesionales de la educación y a las escuelas. Considerando esta necesidad, se aplicó un programa de capacitación a 18 maestros de la Escuela Primaria y Secundaria de una ciudad del estado de São Paulo, con el fin de capacitarles para promover la participación de alumnos con TEA en actividades en grupo utilizando los juegos cooperativos. Cinco clases fueron ministradas con un enfoque práctico, abordando los temas: juegos cooperativos, Prompt y refuerzo. Los resultados indicaron que los profesores tuvieron más éxito en el post-test que en el pre-test, aplicados para evaluar el curso, y su evaluación, en general, fue positiva. Se hace hincapié en la importancia de elaborar la capacitación de los docentes y la necesidad de proporcionarles más materiales de apoyo y actividades de autoaprendizaje.

Cooperation During Orthodontic Treatment of Patients with I Phase and Phase Orthodontic Treatment

ABSTRACT: To evaluate differences in cooperation of adolescent patients in active orthodontic treatment between those who received one phased treatment (no prior interceptive or early treatment) and two phased treatment (prior interceptive or early treatment and subsequent corrective treatment). A prospective cohort study was carried out in 132 patients undergoing orthodontic treatment between 10 and 17 years old at CES University Dental Clinics and in 9 private practices in Medellín Colombia; two groups of 66 patients were defined; one that received two phased treatment and one that received one phased treatment. The Orthodontic Patient Cooperation Scale (OPCS) was applied to all individuals every three months during the first year of treatment in order to assess cooperation. Statistical differences between both groups were assessed using the SSPS® software program. Significantly greater cooperation (M = 4.6) was observed in patients who had received two phased treatment compared with those who were only subjected to one phased treatment (M = 2.3). Patient cooperation during orthodontic treatment does not seem to be affected by two phased treatment and to the contrary seems to have a positive impact when comparing it with individuals with one phased treatment. The most important factors found to influence cooperation were correlated with attitude, interest and commitment to treatment, patient and parental motivation. The OPCS scale proved to be useful for evaluating cooperation and making comparisons with other studies.

RESUMEN: Evaluar las diferencias en la cooperación de los pacientes adolescentes en el tratamiento de ortodoncia activa entre los que recibieron una fase de tratamiento (sin tratamiento interceptivo previo o temprano) y los que recibieron el tratamiento de dos fases (tratamiento interceptivo previo o temprano y tratamiento correctivo posterior). Se realizó un estudio de cohorte prospectivo en 132 pacientes sometidos a tratamiento de ortodoncia entre 10 y 17 años en la clínica odontológica de la Universidad CES y en 9 consultorios privados en Medellín Colombia; se definieron dos grupos de 66 pacientes; uno que recibió dos fases de tratamiento y otro que recibió una fase de tratamiento. La Escala de Cooperación del Paciente de Ortodoncia (OPCS) se aplicó a todas las personas cada tres meses durante el primer año de tratamiento para evaluar la cooperación. Las diferencias estadísticas entre ambos grupos se evaluaron utilizando el programa de software SSPS®. Se observó una cooperación significativamente mayor (M = 4.6) en pacientes que habían recibido tratamiento dos fases en comparación con aquellos que solo fueron sometidos a una fase de tratamiento. (M = 2.3). La cooperación del paciente durante el tratamiento de ortodoncia no parece verse afectada por el tratamiento en dos fases y, por el contrario, parece tener un impacto positivo cuando se compara con individuos con un tratamiento en una fase. Los factores más importantes que influyeron en la cooperación se correlacionaron con la actitud, el interés y el compromiso con el tratamiento, la motivación del paciente y de los padres. La escala OPCS demostró ser útil para evaluar la cooperación y hacer comparaciones con otros estudios.

Habilidades Sociales y Aprendizaje Cooperativo el la Inclusión de Estudiantes con Necesidades Educativas Específicas / Social Skills and Cooperative Learning in the Inclusion of Students with Specific Educational Needs

RESUMEN Este estudio analiza cómo al trabajar con la metodología del aprendizaje cooperativo en el aula, los alumnos con necesidades educativas especiales pueden mejorar en sus habilidades sociales obteniendo mejores aprendizajes. Se realiza en el contexto del programa de formación docente universitaria del Experto en Aprendizaje Cooperativo online de la Universidad de Alcalá, en España. La metodología utilizada es de corte cualitativo en base a un diseño de estudio de casos desarrollado durante 6 años (2011 al 2017). Los participantes fueron 176 profesores de centros educativos españoles que cumplían los requisitos. Las acciones realizadas implicaron a un total de 3.964 estudiantes, de los cuales, 406 presentaban algún tipo de necesidad específica. Los resultados reflejan la influencia en las habilidades sociales de los alumnos con necesidades al trabajar con la metodología del aprendizaje cooperativo. Se concluye que para la mejora de las habilidades sociales del alumnado con necesidades es necesario que el docente potencie acciones que promuevan las habilidades sociales de estos alumnos a través del aprendizaje cooperativo y de las propuestas diversificadas, planificadas y ajustadas a sus necesidades concretas, dándoles la oportunidad de trabajar de forma conjunta con sus compañeros.

ABSTRACT This study analyzes how students with special educational needs can improve their social skills through better learning when working with the cooperative learning methodology in the classroom. The research was carried out as part of the Online Cooperative Learning Expert training program at the University of Alcalá, in Spain. The methodology used was qualitative based on a case study design developed over 6 years (2011 to 2017). The participants were 176 teachers from Spanish educational centers who met the requirements. The actions carried out involved a total of 3,964 students, of which 406 had some type of specific need. The results reflect the influence on the social skills of the students with needs when working with the cooperative learning methodology. It is concluded that for the improvement of the social skills of students with needs, it is necessary for the teacher to make use of actions that promote the social skills of these students through cooperative learning and diversified proposals, planned and adjusted to their specific needs, giving them the opportunity to work together with their peers.

Cooperative behavior and management of a patient care team in an oncohematology hospital service / Comportamiento cooperativo y gestión del equipo de atención al paciente en un servicio hospitalario de oncohematología / Comportamento cooperativo e gestão da equipe deassistência ao paciente em serviço hospitalar deoncohematologia

ABSTRACT Objective: to identify the perceptions of teamwork according to professionals of an oncohematology unit. Methods: this is an exploratory study/qualitative approach. Nineteen health professionals from the oncohematology unit of a public teaching hospital participated. Data collection took place through semi-structured interviews, from September to December 2018. Data analysis followed Content Analysis, thematic modality, and the work process theoretical framework. Results: two categories emerged: Cooperative behavior of professionals from an oncohematology unit, revealing meanings of teamwork and its facilitating/hindering factors in the unit, and Composition, characteristics and management of the unit, presenting teamwork in the perspective of organization/dynamics of work at the unit, material instruments, qualification/training, team composition and organizational management. Final considerations: there is a need for management to know and better understand the work of workers and their difficulties, providing psychological support to the team.

RESUMEN Objetivo: identificar las percepciones del trabajo en equipo según los profesionales de una unidad de oncohematología. Métodos: estudio exploratorio/abordaje cualitativo. Participaron 19 profesionales de la salud de la unidad de oncohematología de un hospital universitario público. La recolección de datos se realizó a través de entrevistas semiestructuradas, de septiembre a diciembre de 2018. El análisis de los datos siguió el Análisis de Contenido, la modalidad temática y el marco teórico del proceso de trabajo. Resultados: surgieron dos categorías temáticas: Comportamiento cooperativo de los profesionales de la unidad de oncohematología, revelando significados del trabajo en equipo y sus factores facilitadores/obstaculizadores en la unidad, y Composición, características y gestión de la unidad, presentando el trabajo en equipo en la perspectiva de la organización/dinámica. de trabajo en la unidad, instrumentos materiales, cualificación/formación, composición del equipo y gestión organizativa. Consideraciones finales: existe la necesidad de que la gerencia comprenda y comprenda mejor el trabajo de los agentes y sus dificultades, brindando apoyo psicológico al equipo.

RESUMO Objetivo: identificar as percepções do trabalho em equipe segundo os profissionais de uma unidade de oncohematologia. Métodos: estudo exploratório/abordagem qualitativa. Participaram 19 profissionais de saúde da unidade de oncohematologia de um hospital público de ensino. A coleta de dados ocorreu por meio de entrevistas semiestruturadas, de setembro a dezembro de 2018. Análise de dados seguiu a Análise de Conteúdo, modalidade temática, e o referencial teórico de processo de trabalho. Resultados: emergiram duas categorias temáticas: Comportamento cooperativo dos profissionais da unidade de oncohematologia, revelando significados do trabalho em equipe e seus fatores facilitadores/dificultadores na unidade, e Composição, características e gestão da unidade, apresentando o trabalho em equipe na perspectiva da organização/dinâmica do trabalho na unidade, instrumentos materiais, capacitação/treinamento, composição da equipe e gestão organizacional. Considerações finais: destaca-se necessidade de a gestão conhecer e entender melhor o trabalho dos agentes e suas dificuldades, disponibilizando o amparo psicológico à equipe.

Exploration and application of the pioneering TEBMCL teaching mode in the teaching of Clinical Biochemical Laboratory Technology / 中华医学教育探索杂志

Objective:To explore the application of the pioneering TEBMCL (task based evidence-based laboratory medicine team cooperative learning) teaching mode in the teaching of Clinical Biochemical Laboratory Technology. Methods:A total of 336 undergraduates of medical laboratory from 3 classes of Batch 2014 were selected as research objects, and 112 students in class 1 were randomly selected as the teaching reform class, 113 students in class 2 were randomized into control class 1 and 111 students in class 3 into control class 2. The teaching effects achieved by applying the TEBMCL teaching mode to the teaching of Clinical Biochemical Laboratory Technology in the three classes were compared comprehensively and the TEBMCL teaching mode was also evaluated. The Access 2010 and SPSS 17.0 statistical analysis methods were used for statistical analysis. Results:Learning effect: ①Compared with the basic test of the three classes, there was no statistical differences ( P > 0.05); but the in-class test after each chapter showed that the results of the teaching reform class were better than those of the other two classes ( P < 0.05). It was also found that the performance of the control class 1 was better than that of the control class 2 after applying the new TEBMCL teaching mode in the second chapter ( P < 0.05). ②In a number of indicators, it was found that the scores of the reform class were better than those of the control class 1 and the control class 2 ( P < 0.05); ③In the terms of excellent grade and good grade, the teaching reform class was ahead of the control class 1 and the control class 2, and none of students in the teaching reform class failed the graduation design (thesis). In the terms of questionnaires and seminars: TEBMCL teaching mode was carried out for juniors who had professional basic knowledge, with short prcoess and high efficiency, while this method still needed to be improved. Conclusion:The new TEBMCL teaching mode has significant advantages compared with the traditional teaching mode, which can better promote the cultivation of students' abilities and improve the degree of knowledge mastery.