Clinical Evidence Mapping of Chinese Patent Medicines Combined with Western Medicine in Treatment of Hypertension / 中国实验方剂学杂志

ObjectiveTo systematically collect， analyze， and evaluate the randomized controlled trials （RCT） of Chinese patent medicine combined with western medicine in the treatment of hypertension， map the evidence， and provide reference for the future clinical research and formulation of guidelines and policies. MethodThe relevant articles were retrieved from China Biology Medicine disc， China National Knowledge Infrastructure （CNKI）， VIP， Wanfang Data， PubMed， Embase， and Cochrane Library with the time interval from inception to December 31， 2022. The RCT of Chinese patent medicines combined with western medicine in the treatment of hypertension were included. The research characteristics and methodological quality were analyzed and evaluated. ResultA total of 330 RCTs of treating hypertension with Chinese patent medicines combined with Western medicine were included in this study， all of which were published in Chinese. These RCTs involved 88 Chinese patent medicines and 37 788 patients， and 46% of RCT had the sample size ≥100 patients. Eighty-seven percent of RCT showed the study period within 3 months. All the interventions in the RCTs were Chinese patent medicine + western medicine vs western medicine. Among the evaluation indicators， blood pressure， response rate， TCM syndrome score， endothelial cell function， and safety were mainly concerned. In terms of methodological quality， most articles did not mention the generation of random sequences， allocation concealment， or blinding method. The blinding evaluation of outcomes showed low risks of bias， and there was insufficient information to judge whether there was selective bias or other bias. ConclusionThere were many Chinese patent medicines used in combination with western medicine in the treatment of hypertension， and they were mainly taken orally. The existing RCT had problems such as small sample size， unclear clinical value positioning， imperfect design failing to reflect the value of Chinese patent medicines， unreasonable measurement indicators， and non-standard measurement methods. Future research should solve the above problems， improve the research quality， value， and authenticity， and enhance the reliability and extension of evidence.

Diseño metodológico para desarrollar un procedimiento de gestión de comunicación interna en el Ministerio de Salud Pública de Cuba

Introducción: La gestión de la comunicación interna en las organizaciones de salud representa una herramienta sistémica y organizativa que impacta en el nivel de satisfacción y compromiso de los trabajadores con la organización y se extiende hasta beneficiar a los pacientes como usuarios de los servicios. Su implementación constituye una política de la Administración Central del Estado Cubano que la dirección del Ministerio de Salud Pública prioriza, al considerarla imprescindible para el logro de los objetivos de trabajo. Esto condujo a diseñar un procedimiento que permitiera gestionar la comunicación interna en la institución. Objetivo: Exponer los métodos, las técnicas y los procedimientos empleados para diseñar un procedimiento para la gestión de la comunicación interna en el Ministerio de Salud Pública de Cuba. Resultados: Se plantea una investigación de desarrollo tecnológico, de tipo mixta, aplicada en dos fases y desarrolladas con técnicas cuantitativas y cualitativas. Conclusiones: El empleo de técnicas cuantitativas y cualitativas permitió identificar los elementos que componen un procedimiento para gestionar la comunicación interna en el Ministerio de Salud Pública. El procesamiento de los datos obtenidos desde el nivel individual hasta el colectivo facilitó la integración de conocimientos para organizar el diseño del procedimiento por etapas. La metodología empleada permitió obtener un procedimiento actualizado y válido por expertos y el público interno.

Introduction: The management of internal communication in health organizations represents a systemic and organizational tool that impacts the level of satisfaction and commitment of workers with the organization and it extends to benefit patients as users of services. Its implementation constitutes a policy of the Central Administration of the Cuban State that the management of the Ministry of Public Health prioritizes, considering it essential for the achievement of work objectives. This led to designing a procedure that would allow managing internal communication in the institution. Objective: To present the methods, techniques and procedures used to design a procedure for the management of internal communication in the Ministry of Public Health of Cuba. Results: A mixed type technological development research is proposed, applied in two phases and developed with quantitative and qualitative techniques. Conclusions: The use of quantitative and qualitative techniques allowed to identify the elements that make up a procedure to manage internal communication in the Ministry of Public Health. The processing of the data gained from the individual to the collective level facilitated the integration of knowledge to organize the design of the procedure in stages. The methodology used allowed to obtain an updated and valid procedure by experts and the internal public.

Pertinencia de la búsqueda de alternativa metodológica para evaluar procederes prácticos de enfermería

La transformación ocurrida en el proceso docente-educativo hace necesario que se modifiquen todos sus elementos, entre ellos la evaluación, componente muy complejo y polémico. Muchos estudiosos del tema han propiciado su perfeccionamiento gracias a sus aportes. La carrera de Enfermería en la Universidad de Ciencias Médicas de Matanzas necesita mejorar la evaluación de los procederes prácticos. Ante esta necesidad, las autoras hacen un análisis de los modelos de evaluación más contemporáneos, entre los que se encuentran el alternativo, de ejecución, auténtico, por competencias y el socioformativo, con el objetivo de identificar una alternativa metodológica que evalúe con validez y confiabilidad los procederes técnicos en la formación del recurso humano de enfermería. Se realiza un análisis de los modelos antes mencionados, los que son factibles de emplear en la actividad práctica, que necesariamente debe evaluar el proceso formativo del estudiante, para identificar debilidades en su aprendizaje y trazar pautas que lo fortalezcan. Se concluye que los modelos de evaluación por competencias y el socioformativo son ideales para ser empleados en nuestras evaluaciones. Las autoras identifican como alternativa metodológica para evaluar a la rúbrica, por ser una guía precisa que valora los aprendizajes y productos realizados de una competencia (saber, hacer, ser).

The transformation that has taken place in the teaching-education process makes it necessary to modify all its elements, including evaluation, a very complex and controversial component. Many scholars devoted to the subject have helped to improve it thanks to their contributions. The Nursing degree at Matanzas University of Medical Sciences needs to improve the evaluation of practical procedures. Faced with this need, the authors make an analysis of the most contemporary evaluation models, among which are the alternative, executional, authentic, competency-based and socio-formative models, with the aim of identifying a methodological alternative that validly and reliably could evaluate the technical procedures in the training of nursing human resources. The authors carried out an analysis of the aforementioned models, which are feasible to use in practical activity that must necessarily evaluate the student's training process to identify weaknesses in their learning and draw up guidelines to strengthen them. It is concluded that the competency-based and socio-formative assessment models are ideal to be used in nursing training evaluations. The authors identify the rubric as a methodological alternative to evaluate, as it is a precise guide that evaluates the learning and products achieved in a competence (knowing, doing, being).

Evidence of validity of the Smoking Cessation Counseling scale - Brazilian version / Evidencias de validez de la escala Smoking Cessation Counseling - versión brasileña / Evidências de validade da escala Smoking Cessation Counseling - versão brasileira

Objective: to evaluate the evidence of validity of the internal structure and reliability of the Brazilian version of the Smoking Cessation Counseling instrument Method: psychometric study of confirmatory factor analysis and reliability carried out on 250 nurses in clinical practice. For the analysis of the convergent validity of the factor model, Average Variance Extracted values were calculated, and discriminant analysis was carried out using the Fornell-Larcker criterion. Reliability was examined using Cronbach's alpha coefficient and composite reliability Results: it was necessary to exclude seven items from the Advanced Counseling domain and one item from the Basic Counseling domain in order to properly obtain the Average Variance Extracted values and the Fornell-Larcker criterion. The composite reliability ranged from 0.76 to 0.86 and the overall Cronbach`s alpha coefficient was 0.86, ranging from 0.53 to 0.84 depending on the domain assessed. The final version of the instrument was made up of 16 items divided into 4 domains Conclusion: the Brazilian version of Smoking Cessation Counseling obtained adequate psychometric evidence of validity and reliability. Further studies are needed to refine the instrument.

Objetivo: evaluar las evidencias de validez de la estructura interna y de la confiabilidad de la versión brasileña del instrumento Smoking Cessation Counseling. Método: estudio psicométrico de análisis factorial confirmatorio y de confiabilidad realizado en 250 enfermeras de la práctica clínica. Para el análisis de la validez convergente del modelo factorial se calcularon valores de Average Variance Extracted, el análisis discriminante se realizó mediante el criterio de Fornell-Larcker. La confiabilidad se examinó por el coeficiente de alfa de Cronbach y por la confiabilidad compuesta. Resultados: fue necesaria la exclusión de siete ítems del dominio de Asesoramiento avanzado y un ítem del dominio Asesoramiento básico para obtener adecuadamente los valores de Average Variance Extracted y del criterio de Fornell-Larcker. La confiabilidad compuesta varió de 0,76 a 0,86 y el coeficiente de alfa de Cronbach global alcanzado fue de 0,86, variando de 0,53 a 0,84 dependiendo del dominio evaluado. Se obtuvo la versión final del instrumento compuesto de 16 ítems distribuidos en 4 dominios. Conclusión: la versión brasileña de Smoking Cessation Counseling obtuvo adecuadas evidencias psicométricas de validez y confiabilidad. Estudios posteriores serán necesarios para el refinamiento del instrumento.

Objetivo: avaliar as evidências de validade da estrutura interna e da confibialidade da versão brasileira do instrumento Smoking Cessation Counseling Método: estudo psicométrico de análise fatorial confirmatória e de confiabilidade realizado em 250 enfermeiras da prática clínica. Para a análise da validade convergente do modelo fatorial foram calculados valores de Average Variance Extracted , a análise discriminante foi realizada pelo critério de Fornell-Larcker. A confiabilidade foi examinada pelo coeficiente de alfa de Cronbach e pela confiabilidade composta Resultados: foi necessária a exclusão de sete itens do domínio de Aconselhamento avançado e um item do domínio Aconselhamento básico para obtenção adequada dos valores de Average Variance Extracted e do critério de Fornell-Larcker. A confiabilidade composta variou de 0,76 a 0,86 e o coeficiente de alfa de Cronbach global alcançado foi de 0,86, variando de 0,53 a 0,84 a depender do domínio avaliado. Obteve-se a versão final do instrumento composto de 16 itens distribuídos em quatro domínios Conclusão: a versão brasileira da Smoking Cessation Counseling obteve adequadas evidências psicométricas de validade e de confiabilidade. Estudos posteriores serão necessários para o refinamento do instrumento.

Investigação de surtos e epidemias: transformações na teoria, nos conceitos e nas práticas do século XVIII ao século XXI / Outbreaks and epidemics investigations: changes in theories, concepts, and practices from the 18th to the 21st century

Resumo Este ensaio objetiva discutir as investigações de surtos e epidemias, desde os primeiros relatos disponíveis na literatura científica do século XVIII até o momento atual, utilizando para sua construção artigos científicos e livros sobre a temática. O principal argumento desenvolvido é a passagem de abordagens qualitativas da epidemiologia, predominantes nos períodos iniciais, para a abordagem quantitativa, que inicialmente convive com a qualitativa, mas se torna dominante a partir da segunda metade do século XIX. Conclui-se com uma breve reflexão sobre o momento atual de enfrentamento da epidemia da covid-19.

Abstract This essay aims to discuss the investigation of outbreaks and epidemics, from the first reports available in scientific literature from the 18th century to the present time, using scientific articles and books on the subject for its construction. The main argument developed is the transition from qualitative approaches of epidemiology, which predominated in the early periods, to the quantitative approach, which initially coexists with the qualitative one but became dominant from the second half of the 19th century. It concludes with a brief reflection on the current moment of confronting the COVID-19 epidemic.

Validez y confiabilidad de un instrumento para identificar factores que influyen en la adherencia al tratamiento en personas con factores de riesgo cardiovascular

Introducción: Es necesario contar con instrumentos válidos y confiables para identificar los factores que influyen en la adherencia al tratamiento en personas con factores de riesgo cardiovascular. En Colombia, Bonilla y Gutiérrez diseñaron un instrumento que cuenta con validez facial y de contenido. Sin embargo, no se ha demostrado la validez de constructo. Objetivo: Determinar la validez de constructo y confiabilidad del instrumento, factores que influyen en la adherencia al tratamiento farmacológico y no farmacológico en personas con factores de riesgo cardiovascular. Metodología: Investigación metodológica. Participaron 694 personas con factores de riesgo de enfermedad cardiovascular residentes en tres ciudades de Colombia (Neiva, Espinal y Tunja). Se realizó un análisis factorial exploratorio (extracción de componentes principales y rotación Varimax), análisis factorial confirmatorio (estimación de máxima verosimilitud) y una prueba de confiabilidad global y por dimensiones (alfa de Cronbach y Test-retest). Resultados: El análisis factorial exploratorio reportó un instrumento de 30 ítems con estructura de 4 factores (varianza total acumulada de 42,6 %). Los índices de ajuste del modelo propuesto indicaron ajuste absoluto excelente y ajuste incremental aceptable. El alfa de Cronbach global fue 0,86, lo que indica alta confiabilidad. Discusión: El estudio proporciona evidencia de un instrumento más robusto que otras versiones. Los instrumentos estandarizados para medir factores que influyen en la adherencia pueden ser muy útiles para la investigación y la práctica si cumplen con pruebas psicométricas de fiabilidad y validez. Conclusión: Se pone a disposición de los investigadores y del personal de salud un instrumento válido y confiable. Se recomienda su uso en poblaciones similares a la de este estudio.

Introduction: It is necessary to have valid and reliable instruments to identify the factors that influence adherence to treatment in people with cardiovascular risk factors. In Colombia, Bonilla y Gutierrez designed an instrument that has face and content validity. However, construct validity has not been demonstrated. Objective: To determine the construct validity and reliability of the instrument, factors that influence adherence to pharmacological and non-pharmacological treatment in people with cardiovascular risk factors. Methodology: Methodological research. A total of 694 people with risk factors for cardiovascular disease residing in three Colombian cities (Neiva, Espinal and Tunja) participated. Exploratory factor analysis (extraction of principal components and Varimax rotation), confirmatory factor analysis (maximum likelihood estimation) and global and dimensional reliability test (Cronbach's alpha and Test-retest) were performed. Results: The exploratory factor analysis reported a 30-item instrument with a 4-factor structure (total cumulative variance of 42.6%). The fit indices of the proposed model indicated excellent absolute fit and acceptable incremental fit. The overall Cronbach's alpha was 0.86, indicating high reliability. Discussion: The study provides evidence of a more robust instrument than other versions. Standardized instruments to measure factors that influence adherence can be very useful for research and practice if they meet psychometric tests of reliability and validity. Conclusion: A valid and reliable instrument is made available to researchers and health personnel. Its use is recommended in populations similar to that of this study.

La gestión para la evaluación de las competencias en la formación del profesional de Cultura Física

La evaluación, como categoría didáctica en el proceso de enseñanza-aprendizaje de la carrera Licenciatura en Cultura Física y Deporte, enfrenta desafíos que obligan a los diferentes colectivos pedagógicos a proyectar acciones que le permitan una visión contextualizada e integral de la misma. La unidad del sistema de influencias educativas es una necesidad para la evaluación formativa, compartida, personalizada, centrada en evidencias de conocimiento, de producto y de desempeño en la formación y desarrollo de competencias en esta Carrera. El objetivo del trabajo es valorar el proceso evaluativo integrador de las competencias, en los estudiantes de la Práctica Laboral Investigativa de tercer año, de la Carrera de licenciatura en Cultura Física y Deporte, a través de la disciplina principal integradora Formación Laboral Investigativa. Para ello, se aplicaron métodos de investigación empíricos, como el análisis de documentos, la entrevista y la observación. Los resultados permitieron fundamentar una propuesta metodológica que potencie la evaluación integradora, sobre la base el enfoque integral físico-educativo, en el proceso de estudio. El diseño de los resultados fue de tipo experimental, en su variante pre-experimento. La aplicación parcial de la propuesta validó su pertinencia y contribuyó de forma favorable al mejoramiento del desempeño profesional y humano de los que participan.

A avaliação, como categoria didática no processo de ensino-aprendizagem do curso de Bacharelado em Cultura Física e Esporte, enfrenta desafios que obrigam os diferentes coletivos pedagógicos a planejar ações que permitam uma visão contextualizada e integral da mesma. A unidade do sistema de influências educacionais é uma necessidade para a avaliação formativa, compartilhada e personalizada, focada na evidência de conhecimento, produto e desempenho na formação e no desenvolvimento de competências nesse curso de graduação. O objetivo do estudo é avaliar o processo de avaliação integrativa das competências dos alunos do terceiro ano do Estágio de Pesquisa no Bacharelado em Cultura Física e Esporte, por meio da principal disciplina integrativa do Estágio de Pesquisa. Para isso, foram aplicados métodos de pesquisa empírica, como análise de documentos, entrevista e observação. Os resultados permitiram fundamentar uma proposta metodológica que aprimora a avaliação integrativa, com base na abordagem físico-educacional integral, no processo de estudo. O desenho dos resultados foi experimental, em sua variante pré-experimental. A aplicação parcial da proposta validou sua relevância e contribuiu favoravelmente para a melhoria do desempenho profissional e humano dos envolvidos.

Evaluation, as a didactic category in the teaching-learning process of the Bachelor's Degree in Physical Culture and Sports, faces challenges that force the different pedagogical groups to project actions that allow a contextualized and comprehensive vision of it. The unity of the system of educational influences is a necessity for formative, shared, personalized evaluation, focused on evidence of knowledge, product and performance in the training and development of competencies in this Career. The objective of the work is to assess the integrative evaluative process of the competencies, in the students of the third-year Investigative Work Practice, of the Bachelor's Degree in Physical Culture and Sports, through the main integrative discipline Investigative Work Training. To achieve this, empirical research methods were applied, such as document analysis, interviews and observation. The results allowed to base a methodological proposal that enhances the integrative evaluation, based on the comprehensive physical-educational approach, in the study process. The design of the results was experimental, in its pre-experiment variant. The partial application of the proposal validated its relevance and contributed favorably to the improvement of the professional and human performance of those who participate.

Estudo das doenças crônicas sob a ótica da qualidade em saúde: aspectos metodológicos / Study of chronic diseases from the perspective of quality in health: methodological aspects

Descrever os aspectos metodológicos e desenho amostral do Estudo das Doenças Crônicas sob a ótica da qualidade em saúde (Edoc-Quali). O estudo é composto por pesquisas de quatro populações distintas: coordenadores das unidades da Atenção Primária em Saúde; profissionais das equipes da Estratégia de Saúde da Família (ESF); usuários cadastrados nas ESFs com hipertensão arterial; e usuários cadastrados nas ESFs com diabetes mellitus do tipo 2. Participaram 30 gestores e 338 profissionais, que responderam percepções sobre estrutura física e processo de trabalho da equipe, com aplicação do PCATool-Brasil, e dados relativos ao processo de cuidado a esses pacientes. Também foram entrevistadas 672 pessoas com HAS, e 324 com DM2, além de avaliação física, coleta de material biológico e realização do eletrocardiograma. A avaliação da qualidade do cuidado segundo os gestores e profissionais e dos resultados obtidos junto aos usuários do serviço favoreceu o controle de complicações.

To describe the methodological aspects and sample design of the Study of Chronic Diseases from the perspective of quality in health (Edoc-Quali). Consisting of surveys of four distinct populations: coordinators of Primary Health Care units, professionals from the Family Health Strategy (FHS) teams, users registered in the FHS with arterial hypertension; and users registered in the FHS with type 2 diabetes mellitus. 30 managers and 338 participated professionals who answered perceptions about the physical structure and work process of the team with the application of PCATool-Brasil and data related to the care process for these patients. As for the study with users, 672 people with SAH and 324 with DM2 were interviewed, in addition to physical assessment, collection of biological material and electrocardiogram. The assessment of the quality of care according to managers and professionals, and the results obtained from service users, contributes to the control of complications.

Estrategia metodológica para la prevención de los problemas de salud bucal en la educación primaria

Introducción: Las transformaciones que se evidencian en la sociedad, hace que surjan, en las instituciones educativas, exigencias referidas a la preparación de los profesionales para enfrentar los nuevos desafíos y lograr ciudadanos con una formación integral y responsables con el cuidado de su salud. Ahí es donde ocupan un lugar privilegiado los aspectos relacionados con la prevención de los problemas de salud bucal en la educación primaria. Objetivo: Diseñar una estrategia metodológica para la prevención de los problemas de salud bucal en la educación primaria. Materiales y métodos: La estrategia fue diseñada en cuatro etapas: diagnóstico, planeación, instrumentación, y control y evaluación. Para su elaboración se consideró el diagnóstico realizado en el curso escolar 2021-2022 a tres escuelas primarias pertenecientes al municipio Matanzas. Se definió la variable fundamental de la investigación y, a partir de su operacionalización, se establecieron las dimensiones e indicadores. Se aplicaron métodos del nivel teórico y empírico del conocimiento, así como métodos estadísticos. Resultados: Se evidencian limitadas acciones de preparación metodológica que inciden en el tratamiento a la prevención de los problemas de salud bucal desde el contexto escolar. Para transformar los resultados obtenidos se diseñó la estrategia metodológica. Conclusiones: El diseño de la estrategia metodológica revela una manera novedosa de organizar y realizar actividades en el sistema de trabajo metodológico de la escuela primaria, para contribuir a la preparación metodológica del maestro primario en la temática.

Introduction: The transformations that are evident in society cause to arise, in educational institutions, demands regarding to the training of professionals to face the new challenges and achieve citizens with comprehensive training and responsible with the care of their health. That is where aspects related to the prevention of oral health problems in primary education occupy a privileged place. Objective: To design a methodological strategy for the prevention of oral health problems in primary education. Materials and methods: The strategy was designed in four stages: diagnosis, planning, implementation; and evaluation and control. For its elaboration, the diagnosis carried out during the 2021-2022 school year in three primary schools belonging to the municipality of Matanzas was considered. The fundamental variable of the research was defined and the dimensions and indicators were established, on the basis of its operationalization. Methods of the theoretical and empirical level of knowledge were applied, as well as statistical methods. Results: It is evidenced that methodological preparation actions that have repercussion on the prevention of oral health problems from the school context are not enough. To transform the results obtained, the methodological strategy was designed. Conclusions: The design of the methodological strategy reveals a new way of organizing and carrying out activities in the methodological work system of the primary school, to contribute to the methodological preparation of primary teacher on the topic.

Diseño Óptimo de Estudios en Rehabilitación: Importancia del Tamaño Muestra / Optimal Design of Rehabilitation Studies: Importance of Sample Size

Este artículo aborda los principios esenciales para la estimación del tamaño muestral en estudios cuantitativos de ciencias de la rehabilitación y movimiento humano. Además, proporciona una guía práctica y accesible sobre el diseño de investigaciones rigurosas, abordando conceptos clave como la precisión, nivel de confianza, nivel de significancia y potencia estadística, fundamentales para obtener resultados válidos y confiables. También se explora cómo estos parámetros influyen en la generalización de hallazgos y la detección de diferencias significativas, así como la importancia de un tamaño muestral adecuado para que los futuros investigadores mejoren la calidad de sus estudios en campos de la rehabilitación y el movimiento humano.

This article addresses the essential principles for sample size estimation in quantitative studies of rehabilitation sciences and human movement. In addition, it provides a practical and accessible guide on the design of rigorous investigations, addressing key concepts such as precision, confidence level, significance level and statistical power, essential to obtain valid and reliable results. It also explores how these parameters influence the generalization of findings and the detection of significant differences, as well as the importance of an adequate sample size for future researchers to improve the quality of their studies in the fields of rehabilitation and human movement.

El objetivo en las clases de Educación Física y sesiones de entrenamiento deportivo

Al valorar los resultados de varios cursos escolares (2015-2019) en la esfera del Deporte y la Educación Física, se identificaron dificultades relacionadas con el desarrollo de las clases, asociadas a la falta de preparación de los docentes para seleccionar, formular y controlar los objetivos, lo que fue asumido por la Comisión Municipal de Educación Física de la Dirección de Deportes como un problema a resolver; a partir de este presupuesto, se asumió la tarea de investigar las causas que determinan tal problemática. Se identificó, mediante la aplicación de la observación, el análisis documental, la encuesta y la entrevista, que existen carencias en la preparación de los profesores y entrenadores que les impiden asumir este elemento técnico y que limitan el logro de la calidad de las actividades impartidas. Es por ello que el objetivo del presente artículo es proponer orientaciones metodológicas para perfeccionar la selección, formulación y control de los objetivos en las clases de Educación Física y sesiones de entrenamiento deportivo. Los resultados alcanzados demostraron que es posible lograr la preparación de los profesores y entrenadores deportivos en función del objetivo propuesto y de esa forma elevar la calidad y los resultados del aprendizaje de los estudiantes, lo que resulta esencial para el cumplimiento del encargo social asignado en este campo a las Direcciones Municipales de Educación y Deportes.

Ao avaliar os resultados de vários anos letivos (2015-2019) no campo do Esporte e da Educação Física, foram identificadas dificuldades relacionadas ao desenvolvimento das aulas, associadas à falta de preparação dos professores para selecionar, formular e controlar os objetivos, o que foi assumido pela Comissão Municipal de Educação Física da Diretoria de Esportes como um problema a ser resolvido; a partir desse orçamento, assumiu-se a tarefa de investigar as causas que determinam tal problema. Identificou-se, mediante a aplicação de observação, análise documental, pesquisa e entrevista, que existem deficiências na preparação de professores e treinadores que os impedem de assumir esse elemento técnico e limitam a obtenção da qualidade das atividades ministradas. Por essa razão, o objetivo deste artigo é propor diretrizes metodológicas para melhorar a seleção, a formulação e o controle dos objetivos nas aulas de Educação Física e nas sessões de treinamento esportivo. Os resultados obtidos mostraram que é possível preparar professores e treinadores esportivos de acordo com o objetivo proposto e, assim, elevar a qualidade e os resultados da aprendizagem dos alunos, o que é essencial para o cumprimento da tarefa social atribuída nesse campo às Diretorias Municipais de Educação e Esportes.

When assessing the results of several school years (2015-2019) in the field of Sport and Physical Education, difficulties related to the development of the classes were identified, associated with the lack of preparation of teachers to select, formulate and control the objectives, which was assumed by the Municipal Physical Education Commission of the Sports Directorate as a problem to be solved; based on this budget, the task of investigating the causes that determine such problems was assumed. It was identified, through the application of observation, documentary analysis, survey and interview, that there are deficiencies in the preparation of teachers and coaches that prevent them from assuming this technical element and that limit the achievement of the quality of the activities taught. That is why the objective of this article is to propose methodological guidelines to improve the selection, formulation and control of objectives in Physical Education classes and sports training sessions. The results achieved demonstrated that it is possible to achieve the preparation of teachers and sports coaches based on the proposed objective and thus raise the quality and results of student learning, which is essential for the fulfillment of the social role assigned in this field to the Municipal Directorates of Education and Sports.

Violência contra pessoa idosa: análise da consistência interna de instrumentos* / Abuse against the elderly person: analysis of the internal consistency of instruments* / Violencia contra los ancianos: análisis de la coherencia interna de los instrumentos*

RESUMO: Objetivo: avaliar a consistência interna de instrumentos utilizados no Brasil para mensuração de situações de violência contra pessoa idosa em dois estados. Método: estudo de corte transversal, desenvolvido com 481 idosos, em duas amostras, estados e recorte temporal diferentes. Foram aplicados dois instrumentos de mensuração de violência contra pessoa idosa. Os dados foram analisados, e a consistência interna entre os itens foi medida pelo coeficiente de Alfa de Cronbach. Resultados: o Hwalek-Sengstock Elder Abuse Screening Test apresentou o coeficiente de α = 0,08 para amostra coletada na Paraíba, enquanto, em Pernambuco, foi α = 0,57. A Conflict Tactics Scale apresentou alta precisão para definição da violência com coeficiente de α = 0,81 e α = 0,80 para as duas amostras. Conclusões: apenas a Conflict Tactics Scale apresentou-se confiável e estável para determinação da violência de natureza física e psicológica entre idosos, contribuindo assim, como uma possibilidade de desvelar o fenômeno.

ABSTRACT Objective: to evaluate the internal consistency of instruments used in Brazil to measure situations of violence against the elderly in two states. Method: a cross-sectional study with 481 elderly people in two different samples, states, and time periods. Two instruments were used to measure violence against the elderly person. The data was analyzed and the internal consistency between the items was measured by the Cronbach's alpha coefficient. Results: the Hwalek-Sengstock Elder Abuse Screening Test showed a coefficient of α = 0.08 for the sample collected in Paraíba, while in Pernambuco it was α = 0.57. The Conflict Tactics Scale was highly accurate in defining violence, with a coefficient of α = 0.81 and α = 0.80 for the two samples. Conclusions: only the Conflict Tactics Scale turned out to be reliable and stable for determining physical and psychological violence among the elderly, thus contributing as a way of uncovering the phenomenon.

RESUMEN Objetivo: Evaluar la consistencia interna de instrumentos utilizados en Brasil para medir situaciones de violencia contra ancianos en dos estados. Método: Estudio transversal realizado con 481 ancianos en dos muestras, estados y periodos de tiempo diferentes. Se utilizaron dos instrumentos para medir la violencia contra ancianos. Se analizaron los datos y se midió la consistencia interna entre los ítems mediante el coeficiente alfa de Cronbach. Resultados: el Hwalek-Sengstock Elder Abuse Screening Test presentó un coeficiente de α = 0,08 para la muestra recogida en Paraíba, mientras que en Pernambuco fue de α = 0,57. La Escala de Tácticas de Conflicto fue altamente precisa en la definición de violencia, con coeficientes de α = 0,81 y α = 0,80 para ambas muestras. Conclusiones: sólo la Escala de Tácticas de Conflicto demostró ser fiable y estable para determinar la violencia física y psicológica entre ancianos, contribuyendo así a desvelar el fenómeno.

Percepción estudiantil sobre la calidad de las actividades docentes de educación en el trabajo / Student perception about the quality of teaching activities as part of on-the-job education

Introducción: La preparación metodológica de los profesores incluye el criterio de los estudiantes sobre las actividades docentes que imparten. No se trata solo de escuchar sus opiniones, sino de atender sus razones. Sin embargo, este elemento, frecuentemente, no se tiene en cuenta, o se realiza de forma improvisada e incorrecta. Objetivo: Identificar la percepción estudiantil sobre la calidad de las actividades de educación en el trabajo que se imparten durante el tercer año de la carrera. Métodos: Se realizó un estudio observacional, descriptivo y transversal en un universo constituido por 433 estudiantes de tercer año de medicina del Hospital Clínico Quirúrgico Docente León Cuervo Rubio. Mediante un cuestionario, se les solicitó su apreciación sobre las actividades de educación en el trabajo y su criterio acerca de cuáles eran las deficiencias en la impartición de cada una de ellas. Resultados: La sesión de piezas macroscópicas, también llamadas pieza fresca, y el pase de visita fueron evaluados con criterio positivo, con predominio de la calificación de excelente. La discusión de caso, la guardia médica, y la clínico imagenológica y patológica recibieron algunas calificaciones de regular y hasta de mal en la última de ellas. Conclusiones: Predominaron los criterios favorables de los estudiantes, con señalamientos negativos en la discusión de caso clínico y las sesiones clínico patológica e imagenológica (AU)

Introduction: The methodological training of professors includes the students' judgment about the performed teaching activities. It is not only a matter of listening to their opinions, but also of paying attention to their reasons. However, this element is not considered frequently, or it is done in an improvised and incorrect way. Objective: To identify the students' perception on the quality of on-the-job education activities performed during the third academic year of the major. Methods: An observational, descriptive and cross-sectional study was carried out with a universe of 433 third-year medical students from Hospital Clínico Quirúrgico Docente León Cuervo Rubio. By means of a questionnaire, they were asked for their appreciation on the activities of on-the-job education and their criteria regarding the deficiencies in the performance of each one of them. Results: The session of macroscopic parts, also called fresh parts, and the morning report session were assessed with positive criteria, with a predominance of the excellent rating. The case discussion, the medical duty, as well as the imaging and pathology clinical practice, received some fair ratings, or even poor in the latter. Conclusions: Favorable criteria from the students predominated, with negative remarks in the clinical case discussion, as well as in the clinical-pathological and imaging sessions (AU)

Principales dificultades de los proyectos de investigación de la especialidad Medicina General Integral / Main Difficulties of Research Projects of the General Comprehensive Medicine Specialty

Introducción: El residente de Medicina General Integral, una vez graduado, ejecutará investigaciones en correspondencia con las necesidades actuales del Sistema Nacional de Salud y a partir de los problemas de salud predominantes en su comunidad. Objetivo: Describir las principales dificultades en los proyectos de investigación de los residentes de la Especialidad de Medicina General Integral. Métodos: Se realizó un estudio observacional descriptivo transversal en la Facultad de Ciencias Médicas de Sagua la Grande en el período 2020-2021. La población objeto de análisis quedó constituida por un total de 69 proyectos de investigación provenientes de 5 policlínicos docentes de 3 municipios del territorio (Corralillo, Quemado de Güines y Sagua la Grande). Se revisó el proyecto de investigación, se confeccionó un modelo para la recogida de datos extraídos de los mismos y se elaboró una base de datos para su almacenamiento. Resultados: Las principales dificultades estuvieron dadas en no sustentar adecuadamente la investigación, en la redacción del problema científico, específicamente la relación entre el problema y el tipo de investigación, la conceptualización y/o operacionalización de las variables, la selección y elaboración de los métodos, técnicas e instrumentos para la recogida de la información y la acotación de la bibliografía por normas de Vancouver. Conclusiones: Resulta de vital importancia que los residentes de esta especialidad desarrollen habilidades investigativas desde el primer año de formación, lo que contribuirá a un mejor desempeño profesional a partir de la aplicación del método científico en la solución de los problemas de salud que se presenten en su quehacer diario(AU)

Introduction: The family medicine resident, once graduated, will do research in correspondence with the current needs of the national health system and considering the predominant health problems in her/his community. Objective: To describe the main difficulties in the research projects of residents in the General Comprehensive Medicine specialty. Methods: A cross-sectional, descriptive and observational study was carried out in the medical school of Sagua la Grande Municipality, in the period 2020-2021. The population under analysis consisted of a total of 69 research projects from five teaching polyclinics in three municipalities of the territory (Corralillo, Quemado de Güines and Sagua la Grande). Each research project was reviewed, a model was prepared for collecting the data extracted from them, and a database was elaborated for their storage. Results: The main difficulties were not supporting the research adequately, as well as in writing the scientific problem, specifically the relation between the problem and the type of research; also, the conceptualization or operationalization of variables, the selection and elaboration of methods, the techniques and instruments for the collection of information, and the bibliographical adjustment by the Vancouver norms. Conclusions: It is of vital importance that residents of this specialty develop research skills from the first year of training, which will contribute to better professional performance from the application of the scientific method in the solution of health problems that appear in their daily work(AU)

Overview of systematic reviews of Chinese herbal injections for sepsis / 中国中药杂志

In this study, an overview of systematic reviews/Meta-analysis(SR/MA) of Chinese herbal injections for sepsis was performed to provide references for clinical practice and promote the quality improvement of clinical evidence. Eight Chinese and English databases such as CNKI, Medline, and EMbase were electronically searched for SR/MA of Chinese herbal injections for sepsis from database inception to June 2022. AMSTAR 2, PRISMA 2020, and GRADE system, combined with Recommendations for Clinical Evidence Grading on Traditional Chinese Medicine Based on Evidence Body, were applied to evaluate the methodological quality, reporting quality, and evidence quality of the included articles. Twenty-seven articles of SR/MA were included, containing four Chinese herbal injections(Xuebijing Injection, Shenfu Injection, Shenmai Injection, and Shengmai Injection). AMSTAR 2 checklist showed that the methodological quality of the SR/MA ranged from moderate to very low. Item 2(prior study design) was the critical item with poor scores, and the non-critical items with poor scores were items 3(explain the selection of the study designs), items 10(report on the sources of funding), and items 16(conflicts of interest stated). In terms of PRISMA 2020, items in eight topics with complete reporting of missing>50%, including search strategy, certainty assessment, results of syntheses, certainty of evidence, registration and protocol, support, competing interests, availability of data, code and other materials. The included SR/MA involved 30 outcome indicators. Evidence quality of mortality, APACHE Ⅱ, and safety, the top three outcome indicators, was evaluated, and all of them were graded as the medium level. The lack of random allocation sequence, allocation concealment mechanism, blinding, and trial sample size was the main reason for the reduction of the evidence level. The available evidence shows that Chinese herbal injections can serve as an effective and safe adjunctive treatment for sepsis, which can reduce mortality, inhibit inflammation, improve coagulation function, and regulate immune function, tissue perfusion, and oxygenation in patients with sepsis. However, the quality of SR/MA was suboptimal, and more high-quality SR/MA is needed to provide evidence to support the efficacy and safety of Chinese herbal injections in the treatment of sepsis.

Interpretation of methodological standards for the design, implementation, and analysis of randomized trials in cardiac surgery: A scientific statement from the American Heart Association in 2022 / 中国胸心血管外科临床杂志

@#Cardiac surgery presents specific challenges in conducting randomized controlled trials (RCTs). The American Heart Association made a scientific statement of methodological standards, with the purpose to review key concepts and standards in design, implementation, and analysis of cardiac surgery RCTs, and to provide recommendations. Recommendations include an evaluation of the suitability of the research question, clinical equipoise, feasibility of enrolling a representative patient cohort, impact of practice variations on the effect of the study intervention, likelihood and impact of crossover, and duration of follow-up. Trial interventions and study end points should be predefined, and adequate deliverability of the trial interventions should be ensured. Every effort must be made to keep a high completeness of follow-up. Trial design and analytic techniques must be tailored to the specific research question and trial setting. In this paper, the authors made an interpretation of this scientific statement based on their practical experience.

Establishment of A Quality Control Method for Simultaneous Determination of Multiple Active Components in Uygur Medicine of Nymphaeae Flos / 中国实验方剂学杂志

ObjectiveTo develop a quality control method for the simultaneous determination of multiple active components in Nymphaeae Flos aiming at the problems of the single index for quality control and the relatively low overall quality control level. MethodUltra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS）was used to identify and select the index components for quality control with the mobile phase of 0.1% formic acid aqueous solution（A）-acetonitrile（B）for gradient elution （0-2 min， 3%-8%B； 2-4 min， 8%-10%B； 4-13 min， 10%-15%B； 13-19 min， 15%-20%B； 19-26 min， 20%-45%B） at a flow rate of 0.4 mL·min-1， detection wavelength of 350 nm， electrospray ionization（ESI）， negative ion scanning mode， ion source temperature of 120 ℃， scanning range of m/z 100-1 200， transmit collision energy of 6 eV for low-energy scanning and 25-50 eV for high-energy scanning. High performance liquid chromatography（HPLC）was used to establish the quality control method for the simultaneous determination of multi-index components with the mobile phase of 0.2% phosphoric acid aqueous solution（A）-acetonitrile（B） for gradient elution（0-30 min， 12%-15%B； 30-60 min， 15%-22%B； 60-90 min， 22%-40%B）and detection wavelength of 350 nm. The preparation method of the test solution for content determination was refluxing extraction for 60 min with 80 times the amount of 70% methanol. ResultBy comparing the retention time， ultraviolet absorption characteristics， MS and MS/MS spectrometric signals in the samples with the reference substances， 8 active components with high contents， including brevifolincarboxylic acid， ellagic acid， rutin， nicotiflorin， astragalin， quercetin， quercetin-3-methylether and kaempferol， were identified qualitatively from Nymphaeae Flos， which were selected as the index components for quality control. Under the established HPLC conditions， the above 8 components could be well separated（resolution>1.5）， and showed good linearity（r=0.999 9）between the concentration ranges of 1.99-99.6， 1.76-176， 1.52-75.8， 3.60-180， 0.964-96.4， 1.18-118， 1.94-96.8， 1.04-104 mg·L-1 and the peak areas， respectively. The detection limits of them were 10-49 μg·L-1， and the limits of quantitation were 34-164 μg·L-1. The average recoveries were 97.12%-103.1% with the relative standard deviations （RSDs） were 1.1%-2.2%. ConclusionA quality control method for simultaneous determination of the multiple active components in Nymphaeae Flos have been developed， which is simple， accurate and reproducible， and it can provide a scientific basis for the formulation of quality standard of this herb and lay a research foundation for the transformation of Uygur hospital preparations containing Nymphaeae Flos into new drugs.

Brazilian society of rheumatology methodological guide for the development of evidence-based clinical guidelines in rheumatology

Abstract Clinical practice guidelines (CPG) are developed to align standards of health care around the world, aiming to reduce the incidence of misconducts and enabling more effective use of health resources. Considering the complexity, cost, and time involved in formulating CPG, strategies should be used to facilitate and guide authors through each step of this process. The main objective of this document is to present a methodological guide prepared by the Epidemiology Committee of the Brazilian Society of Rheumatology for the elaboration of CPG in rheumatology. Through an extensive review of the literature, this study compiles the main practical recommendations regarding the following steps of CPG drafting: distribution of working groups, development of the research question, search, identification and selection of relevant studies, evidence synthesis and quality assessment of the body of evidence, the Delphi methodology for consensus achievement, presentation and dissemination ofthe recommendations, CPG quality assessment and updating. This methodological guide serves as an important tool for rheumatologists to develop reliable and high-quality CPG, standardizing clinical practices worldwide.

Construção e validação de um instrumento sobre manejo de ferida neoplásica para capacitação de enfermeiros / Creation and validation of an instrument on neoplastic wound management for nurses' training / Elaboración y validación de un instrumento sobre el manejo de heridas neoplásicas para capacitar a los enfermeros

RESUMO Objetivo: construir, validar o conteúdo e a aparência de instrumento para capacitação de enfermeiros no cuidado de ferida neoplásica. Método: pesquisa metodológica, com abordagem quantitativa, realizada em três etapas - revisão de escopo; construção do instrumento; validação do conteúdo; e aparência. Coleta de dados ocorreu no período entre outubro de 2021 a fevereiro de 2022, em Niterói - RJ - Brasil. Foram utilizados o Índice de Validação de Conteúdo; Fleiss Generalized Kappa. Resultados: o instrumento final é composto pelas fases: definição de ferida neoplásica; classificação da ferida; estadiamento; escalas de avaliação da dor e odor; cuidados de enfermagem; e manejo dos sinais e sintomas. O conteúdo foi validado, atingindo um índice de validação de conteúdo > 0.80 e um nível de concordância entre os juízes > 75%, conforme estabelecido. Conclusão: a validação do instrumento, contribuirá para a redução da lacuna expressa na literatura do cuidado de enfermagem em relação à ferida neoplásica, além da aplicação ao ensino e aos serviços de enfermagem.

ABSTRACT Objective: to create and validate the face and content of an instrument for training nurses in neoplastic wound care. Method: a methodological research study with a quantitative approach, carried out in three stages: scoping review; creation of the instrument; and face and content validation. Data collection took place between October 2021 and February 2022 in Niterói - RJ - Brazil. The Content Validation Index and Fleiss Generalized Kappa were used. Results: the final instrument consists of the following phases: definition of neoplastic wound; wound classification; staging; pain and odor rating scales; Nursing care; and management of signs and symptoms. The content was validated reaching a Content Validation Index > 0.80 and an agreement level between the judges > 75%, as established. Conclusion: validation of the instrument will contribute to reducing the gap indicated in the literature on Nursing care in relation to neoplastic wounds, in addition to its application to Nursing teaching and services.

RESUMEN Objetivo: elaborar, validar el contenido y la apariencia de un instrumento para capacitar a los enfermeros en el cuidado de heridas neoplásicas. Método: investigación metodológica, con enfoque cuantitativo, realizada en tres etapas: revisión de alcance; elaboración del instrumento; validación de contenido; y apariencia. La recolección de datos se realizó entre octubre de 2021 y febrero de 2022, en Niterói, RJ, Brasil. Se utilizó el Índice de Validación de Contenido; Fleiss Generalized Kappa. Resultados: el instrumento final consta de las fases: definición de herida neoplásica; clasificación de heridas; estadio; escalas de evaluación del dolor y olor; cuidados de enfermería; y manejo de signos y síntomas. Se validó el contenido, alcanzó un índice de validación de contenido > 0,80 y un nivel de concordancia entre los jueces > 75%, según lo establecido. Conclusión: la validación del instrumento contribuirá a reducir la brecha que hay en la literatura sobre el cuidado de enfermería de las heridas neoplásicas, además se aplicará en la enseñanza y los servicios de enfermería.

Development of an educational technology on clean intermittent bladder catheterization in children to instruct family members / Desarrollo de una tecnología educativa sobre cateterismo vesical intermitente limpio en niños para orientar a los familiares / Desenvolvimento de tecnologia educacional sobre cateterismo vesical intermitente limpo em crianças para orientação de familiares

ABSTRACT Objectives: to prepare and validate an illustrated guide to instruct family members on clean intermittent bladder catheterizarion in children. Method: a methodological research study carried out between January 2021 and February 2022 and developed in three stages: Bibliographical review and elaboration of the illustrated guide; Content validation by expert judges (Delphi technique); and Validation of the response process by representatives of the target audience. The study was conducted in the specialties outpatient service of a large-sized university hospital from the municipality of São Paulo, Brazil. The sample consisted of 18 expert judges and 9 mothers of children undergoing clean intermittent bladder catheterization and in outpatient care. Agreement levels equal to or greater than 80% were considered as consensus, and a 0.80 rate was the acceptable minimum for the Content Validity Index. Results: the illustrated guide consists in 18 sessions, from the step-by-step instructions for clean intermittent bladder catheterization to including children in the procedure. In the first and second validation rounds with the evaluators, Content Validity Index values of 0.8 and 1.0 were obtained, respectively. In the validation by the target audience, 100% agreement was reached in the understanding, Appeal, Self-efficacy, Cultural acceptability and Persuasion domains. Conclusion: the illustrated guide proved to be valid in terms of content by the judges and family members, with the potential to mediate the educational practice in care settings for children in need of clean intermittent bladder catheterization.

RESUMEN Objetivos: elaborar y validar una guía ilustrada para orientar a los familiares sobre el cateterismo vesical intermitente limpio en niños. Método: investigación metodológica realizada entre enero de 2021 y febrero de 2022 y desarrollada en tres etapas: Revisión bibliográfica y elaboración de la guía ilustrada; Validación del contenido a cargo de jueces especialistas (técnica Delphi); y Validación del proceso de respuesta por parte de representantes de la población objetivo. El estudio se condujo en el servicio ambulatorio de especialidades de un hospital universitario de gran porte del municipio de San Pablo, Brasil. La muestra estuvo compuesta por 18 jueces especialistas y 9 madres de niños sometidos a cateterismo vesical intermitente limpio y se encontraban en tratamiento ambulatorio. Un nivel de concordancia de al menos el 80% se consideró como consenso, al igual que el índice de 0,80 como concordancia mínima aceptable para el Índice de Validez de Contenido. Resultados: la guía ilustrada consta de 18 sesiones, desde las instrucciones paso a paso para realizar el cateterismo vesical intermitente limpio hasta la inclusión de los niños en el procedimiento. En la primera ronda de validación con los jueces se obtuvo un Índice de Validez de Contenido superior a 0,8 y, en la segunda ronda, dicho índice fue 1,0. En la validación por parte de la población objetivo se obtuvo 100% de concordancia en los dominios de Comprensión, Aspecto atractivo, Autoeficacia, Aceptabilidad cultural y Persuasión. Conclusión: la guía ilustrada demostró ser válida en cuanto al contenido según la evaluación de los jueces y familiares, con potencial para mediar la práctica educativa en situaciones de atención a niños que precisan cateterismo vesical intermitente limpio.

RESUMO Objetivos: elaborar e validar um guia ilustrado para orientações de familiares sobre o cateterismo vesical intermitente limpo em crianças. Método: pesquisa metodológica, realizada entre janeiro de 2021 e fevereiro de 2022, desenvolvida em três etapas: revisão bibliográfica e elaboração do guia ilustrado; validação de conteúdo por juízes especialistas (técnica Delphi) e validação de processo de resposta por representantes do público-alvo. O estudo foi conduzido no ambulatório de especialidades de um hospital universitário de grande porte do município de São Paulo, Brasil. A amostra foi composta por 18 juízes especialistas e 9 mães de crianças que realizavam cateterismo vesical intermitente limpo e estavam em atendimento ambulatorial. Foi considerado consenso concordância igual ou superior a 80%, e taxa de 0,80 como concordância mínima aceitável para o índice de validade de conteúdo. Resultados: o guia ilustrado é composto por 18 sessões, desde o passo a passo do cateterismo vesical intermitente limpo até a inclusão da criança no procedimento. Na primeira rodada de validação com juízes, obteve-se índice de validade de conteúdo maior que 0,8 e, na segunda rodada, de 1,0. Na validação por parte do público-alvo obteve-se 100% de concordância nos domínios compreensão, atratividade, autoeficácia, aceitabilidade cultural e persuasão. Conclusão: o guia ilustrado mostrou-se válido quanto ao conteúdo pelos juízes e familiares com potencial para mediar a prática educativa em cenários de cuidado à criança com necessidade de cateterismo vesical intermitente limpo.