Insights from Japan’s cost-effectiveness analysis policy on pricing for China’s NRDL access / 中国药房

The cost-effectiveness analysis policy for drugs was institutionalized in Japan since 2019， realizing quantitative adjustment of price across varieties. A hierarchical categorization approach was adopted to select medicines with high expected annual sales. For selected medicines， adjustments were made to the premium and profit components within the existing price structure based on a pre-defined incremental cost-effectiveness ratio （ICER） threshold， effectively resolving the issue of inconsistent criteria and magnitudes caused by subjective judgment. Meanwhile， incentive measures like evaluation exemption or threshold enhancement were granted for specific medicines. Besides， a price adjustment mechanism， which was allowed for upward and downward adjustments， involving tiered ICER threshold and quantified formulas， had been established for the premium and profit components of drug price. In China’s National Reimbursement Drug List （NRDL） access， certain issues remained to be addressed： insufficient clarity in the quantitative mechanism of price formation， incomplete price adjustment measures， and lagging in the communication channels. It is recommended that the following measures could be referred to when further improving the scientificity and fairness of drug pricing during China’s NRDL access， such as enhancing the ICER threshold for medicines catering to special populations， quantifying criteria and extents for price adjustment， granting preferential pricing policies to pharmaceutical companies that present high-quality evidence of effectiveness， preceding communication channels with pharmaceutical companies， as well as exploring a price floor mechanism for the drugs with excessive price reduction.

ICT and the Trading Negotiation for International Sale Contracts in the Pacific Alliance Firms / Las TIC y la Negociación de Contratos de Compraventa Internacional en las Empresas de la Alianza del Pacífico / TIC e a Negociação Comercial para Contratos de Venda Internacional nas Firmas da Aliança do Pacífico

Abstract Introduction. Information and communication technologies (ICT) have changed the way firms conduct their international business transactions, as small, medium and large companies are increasingly adopting these tools in order to improve productivity in operational processes, including the internationalization of goods and services. Objective. This paper aims to identify the ICT most commonly used in the international trade negotiation process for the achievement of import and export contracts in Pacific Alliance firms. Methodology. A survey was conducted among 401 internationalized firms in this regional trade bloc formed by Chile, Colombia, Mexico, and Peru. A descriptive analysis was also applied to present the results of the study, highlighting the ICT most used in international trade negotiations and, likewise, an ordered logistic regression was applied to explain both the level of importance given to ICT in the negotiation process and the frequency of use within this trade agreement. Results The research reveals that ICT are essential for each phase of the international negotiation, especially in the preparation phase. Conclusion. The use of specialized ICT, such as e-procurement, ERP, CRM, NSS and scenario building software, increases as the size of companies also increases.

Resumen Introducción. Las tecnologías de la información y la comunicación (TIC) han cambiado la forma en que las empresas llevan a cabo sus transacciones comerciales internacionales, ya que las pequeñas, medianas y grandes empresas están adoptando cada vez más estas herramientas con el fin de mejorar la productividad en los procesos operativos, incluida la internacionalización comercial e industrial. Objetivo. Este artículo tiene como objetivo identificar las TIC más utilizadas en el proceso de negociación comercial internacional para la consecución de contratos de importación y exportación en las empresas de la Alianza del Pacífico. Metodología. Se realizó una encuesta en 401 empresas internacionalizadas en este bloque comercial regional conformado por Chile, Colombia, México y Perú. Asimismo, se aplica un análisis descriptivo para presentar los resultados del estudio destacando las TIC más utilizadas dentro de la negociación comercial internacional y, del mismo modo, se aplica una regresión logística ordenada para explicar tanto el nivel de importancia que se le da a las TIC en el proceso de negociación como la frecuencia de uso dentro de este acuerdo comercial. Resultados. La investigación también revela que las TIC son esenciales para cada fase de la negociación internacional, especialmente en la fase de preparación. Conclusión. El uso de las TIC especializadas, como la contratación electrónica, el ERP, el CRM, el NSS y el software de creación de escenarios, aumenta a medida que aumenta también el tamaño de las empresas.

Resumo Introdução. As tecnologias de informação e comunicação (TIC) mudaram a maneira como as empresas realizam transações comerciais internacionais, já que as pequenas, médias e grandes empresas estão adotando cada vez mais essas ferramentas a fim de melhorar a produtividade nos processos operacionais, incluindo a internacionalização comercial e industrial. Objetivo. Este artigo visa identificar as TIC mais utilizadas no processo de negociação comercial internacional para a obtenção de contratos de importação e exportação em empresas da Pacific Alliance. Metodologia. Foi realizada uma pesquisa entre 401 empresas internacionalizadas neste bloco comercial regional formado pelo Chile, Colômbia, México e Peru. Uma análise descritiva também foi aplicada para apresentar os resultados do estudo, destacando as TIC mais utilizadas nas negociações comerciais internacionais, e uma regressão logística ordenada foi aplicada para explicar tanto o nível de importância dado às TIC no processo de negociação quanto a frequência de uso dentro deste acordo comercial. Resultados. A pesquisa também revela que as TIC são essenciais para cada fase da negociação internacional, especialmente na fase de preparação. Conclusão. O uso de TIC especializadas, tais como e-procurement, ERP, CRM, NSS e software de construção de cenários, aumenta conforme aumenta o tamanho das empresas.

Evidence-based medical evidence change of the payment limitation of antitumor drugs in national medical- insurance negotiation / 中国药房

OBJECTIVE To study the changes in medical-insuran ce payme nt limitations of anti tumor drugs in national medical- insurance negotiation （hereinafter referred to as “national negotiation ”）and recommendations of diagnosis and treatment guidelines corresponding to tumor issued by Chinese Society of Clinical Oncology （CSCO），so as to provide reference for the performance of national negotiation. METHODS The annual list of anti tumor drugs in national negotiation were summarized ；CSCO diagnosis and treatment guidelines were searched according to the tumor types restricted by the medical- insurance payment limitations of antitumor drugs in national negotiation ；the evidence evolution of the payment limitations of medical insurance for anti tumor drugs and CSCO diagnosis and treatment guidelines were analyzed quantitatively. RESULTS & CONCLUSIONS Finally，46 antitumor drugs in the agreement period were included ；seven of their payment limitations of medical insurance had changed ；and there were differences among the payment limitation of medical insurance ，drug labels and recommendations of CSCO diagnosis and treatment guidelines for 13 varieties；the recommendations ，strength of evidence ，recommendation level of CSCO diagnosis and treatment guidelines were changing for 28 varieties anti tumor drugs in different years ；the number of anti tumor drugs recommended by CSCO diagnosis and treatment guidelines differed significantly among different cancer varieties. The medical insurance payment limitations of anti tumor drugs in national negotiation have been gradually expanded ，and the corresponding recommendations ，strength of evidence， recommendation level in guidelines have been constantly improved. However ， the payment limitation of B-19-H-20200622） medical insurance for most drugs are limited to the indicationsof drug labels and drugs for some cancers are scarce ，such as 85420393。E-mail：oushunlong@sohu.com esophageal cancer and nasopharyngeal carcinoma.

Role of stakeholders in Canadian oncology drug review and its enlightenment / 中国药房

OBJECTIVE To prov ide reference for improving the participation mechanism of stakeholders in the process of medical insurance negotiation for oncology drug in China. METHODS Based on the stakeholder theory ，combined with literature research，case analysis （taking the review of reimbursement of Bentuximab as an example ）and other methods ，analysis and research were conducted on the Canadian oncology drug review process and the participation mechanism and role of stakeholders. The suggestions were put forward for our country. RESULTS & CONCLUSIONS Canadian oncology drug reimbursement review process was composed of four stages ：the pre-submission planning stage ，the formal submission stage of application，the review stage，and the stage of forming reimbursement recommendations. As the role of stakeholders ，drug manufacturers ，patient representative advisory group ， clinical review expert advisory groups and provincial advisory groups participated in the reimbursement review process of oncology drug by providing suggestions and feedback to CADTH. The participation of stakeholders had improved the transparency of the review of oncology drugs in Canada and made the reimbursement results of oncology drugs more scientific ，reasonable and accurate. In China ，it is recommended to define rights ，responsibilities and interests as well as the participation mechanism of stakeholders in the medical insurance negotiation process ，attach importance to the role of patients in the medical insurance negotiation process of oncology drug ，improve information disclosure and increase the transparency of the negotiation mechanism and process so as to increase the participation of stakeholders.

Synergy of Centralized Drug Volume-based Purchasing and Medical Insurance Negotiation Policy / 中国药房

OBJECTIVE：To investigate the s ynergy between centralized drug volume-based purchasing （called“volume- based purchasing”for short ）and medical insurance negotiation policy. METHODS ：From the aspects of economic and social benefits ， the synergy of volume-based purchasing and medical insurance negotiation was analyzed by using the methods of literature analysis，policy interpretation and interview. The corresponding suggestions were put forward for the problems of the supply and use of drugs. RESULTS & CONCLUSIONS ：The synergy of volume-based purchasing and medical insurance negotiation in terms of economic benefits include medical insurance fund management optimization to improve fund utilization efficiency improvement ； medical insurance fund payment optimization to reduce transaction cost ；network promotion of medical security information platform to reduce the cost of information exchange. The synergy of volume-based purchasing and medical insurance negotiation in terms of social benefits includes relevant index assessment of drug quality evaluation to improve drug quality evaluation system ； medical service level improvement to form compound medical insurance payment mode under total budget management ；enterprise supervision driven by market to reduce the pressure of government supervision. The relevant departments should continue to strengthen the comprehensive management of medical institutions to reduce the phenomenon of irrational drug use ；strengthen policy convergence ，avoid the poor implementation of medical insurance drug adjustment policy ，so that the policy dividend of volume-based purchasing and medical insurance negotiation can benefit the people more through system reform ，optimal allocation of funds ，etc.

Participación de la sociedad civil en el proceso de paz con las Fuerzas Armadas Revolucionarias de Colombia -FARC-ep- (2012-2016) / Participation of civil society in the peace process with the Revolutionary Armed Forces of Colombia (2012-2016) / Participação da sociedade civil no processo de paz com as Forças Armadas Revolucionárias da Colômbia -FARCep- (2012-2016)

RESUMEN El artículo analiza los mecanismos de participación de las organizaciones de la sociedad civil en la fase de negociación en proceso de paz con las Fuerzas Armadas Revolucionarias de Colombia (Farc-ep), entre 2012 y 2016. A través del uso de fichas bibliográficas y documentales, y de agregación y codificación de información, el trabajo identifica siete modelos de la participación de las organizaciones de la sociedad civil en el proceso. Muestra, como en Colombia durante la fase de negociación se exploró, como nunca, una variedad amplia de mecanismos de participación, dándole a la sociedad civil un papel esencial: este actor ayudó a enriquecer la Mesa de Conversaciones de La Habana con sus propuestas y aportó legitimidad y aceptación ciudadana al proceso de paz.

ABSTRACT The article analyzes the mechanisms of participation of civil society organizations in the negotiation phase in the peace process with the Revolutionary Armed Forces of Colombia (Farc-ep), between 2012 and 2016. Through the use of bibliographic records and Documentary, and aggregation and coding of information, identifiable work seven models of participation of civil society organizations in the process. It shows, as in Colombia during the negotiation phase, as never before, a wide variety of participation mechanisms was explored, giving civil society an essential role: this actor helped enrich the Havana Conversation Table with his proposals and contributed legitimacy and acceptance of citizenship to the peace process.

RESUMO O artigo analisa os mecanismos de participação das organizações da sociedade civil na fase de negociação do processo de paz com as Forças Armadas Revolucionárias da Colômbia (FARC-EP), entre 2012 e 2016. Através da utilização de ficheiros bibliográficos e documentais, e da agregação e codificação da informação, o documento identifica sete modelos de participação das organizações da sociedade civil no processo. Mostra que, tal como na Colômbia durante a fase de negociação, foi explorada uma grande variedade de mecanismos de participação, dando à sociedade civil um papel essencial: este actor ajudou a enriquecer a Mesa Redonda de Havana com as suas propostas e trouxe legitimidade e aceitação cidadã ao processo de paz.

Visiones de paz del Consejo Municipal de Paz. Caso Medellín (2016-2019) / Visions of Peace of the Municipal Peace Council: A Medellín Case (2016-2019)

Resumen El Consejo Municipal de Paz (Conpaz) de la ciudad de Medellín, parte de la arquitectura institucional para la paz en Colombia, se configura como un espacio novedoso en el que confluyen diversas visiones de paz y de ciudad, diversidad que genera ten siones. Dichas concepciones parten de reconocer la diferencia entre vivir en paz en la ciudad y vivir en paz en el campo, aceptando en gran medida los acuerdos firmados entre las Farc y el Gobierno, y sus miradas de Paz están asociadas al concepto particu lar de desarrollo, ciudad, orientación religiosa, experiencias sectoriales individuales y colectivas. Es importante tejer dichos elementos para encontrar mínimos comunes que den cuenta de un concepto base común de Paz Urbana que, permita fortalecer la representatividad, la participación incidente y un accionar que impacte de manera adecuada, la toma de decisiones de ciudad.

Abstract The Medellín's Municipal Council of Peace (ConPaz), which is part of the institutional architecture for peace in Colombia, is configured as a novel space in which di fferent visions of peace and city converge, diversity that generates tensions. These conceptions start from recognizing the difference of living in peace in the city and living in peace in the countryside, largely accepting the agreements signed between FARC and the Government, and their views of Peace are associated with the particular concept of development, city, religious orientation, individual, and collective sectoral experiences. It is important to weave these elements to find common mini mums, which account for a common ground concept of Urban Peace, which allows to strengthen representativeness, incident participation, and an action that adequately impacts, city decision-making.

Differences in sexual negotiation styles and sexual self-efficacy in use of condom in university men and woman of Queretaro, Mexico, 2018 / Diferencias en los estilos de negociación sexual y autoeficacia en el uso del condón en hombres y mujeres universitarios de querétaro, méxico, 2018

RESUMEN Objetivo: comparar los niveles de negociación sexual y autoeficacia en el uso del condón masculino en hombres y mujeres. Materiales y métodos: estudio transversal de tipo comparativo en el que se incluyeron estudiantes de licenciatura de una universidad privada de la ciudad de Querétaro, México, durante el año 2018. Mues- treo no probabilístico. Se midieron: características sociodemográficas, conductas sexuales de riesgo, habilidades de negociación y autoeficacia sexual para uso de condón. Se compararon los grupos mediante la prueba U de Mann Whitney y el análisis de varianza no paramétrico (Kruskal-Wallis). Resultados: ingresaron 270 estudiantes, el 89,6 % de los universitarios tiene vida sexual activa, la edad promedio de inicio de vida sexual es a los 15,41 años; el promedio de parejas sexuales reportado es de 4,2. El 27,8 % ha usado condón en cada relación sexual. Se encontraron diferencias entre hombres y mujeres en los estilos de negociación sexual en los dominios de evitación (p = 0,04) y acomodación (p < 0,00), con puntajes más altos para los hombres en comparación con las mujeres. Respecto a la autoeficacia en el uso del condón, las mujeres son quienes puntúan más alto (p < 0,001). Conclusiones: los jóvenes universitarios entrevistados tienen conductas sexuales de riesgo. Se requiere fortalecer las políticas públicas que faciliten la prevención de la conducta sexual de riesgo dirigidas a la población estudiantil. Es necesario realizar más estudios sobre intervenciones que fortalezcan las habilidades de negociación y la autoeficacia sexual en adolescentes.

ABSTRACT Objective: To compare sexual negotiation levels and self-efficacy in male condom use in men and women. Materials and methods: Comparative cross-sectional study of undergraduate students carried out during the year 2018 in a private university in the city of Querétaro, Mexico. Non-probabilistic sampling was used. Measured variables included sociodemographic characteristics, risky sexual behaviors, negotiation skills and sexual self-efficacy for condom use. The Mann Whitney U test and non-parametric variance analysis (Kruskal - Wallis) were used. Results: Overall, 270 students were enrolled; 89.6% of university students were sexually active; the mean age of sexual activity initiation was 15.41 years. The average reported number of sexual partners was 4.2. In each sexual relation, 27.8% had used a condom. Differences were found between men and women in terms of sexual negotiation styles in the avoidance (p=0.04) and accommodation (p<0.00) domains, with higher scores for men compared to women. Women scored higher for self-efficacy in condom use (p<0.001). Conclusions: The young university students interviewed engage in risky sexual activities. Women exhibit greater sexual self-efficacy as well as better skills at negotiating condom use. Strengthening public policies targeted to the student population for the prevention of risky sexual behavior is needed. Further studies on interventions aimed at building strong sexual negotiation and self-efficacy among adolescents are required.

Negociação de conflitos como competência do enfermeiro / La negociación de conflictos como una competencia del enfermero / Negotiation of conflicts as a competence of the nurse

Objetivo: analisar a negociação de conflito enquanto competência profissional do enfermeiro no contexto hospitalar. Método: revisão integrativa da literatura. As bases de dados foram: PubMed, BDENF, CINAHL e LILACS no período de 2015 a 2019. Resultados: foram selecionados 17 artigos publicados. Dentre eles: 12 estudos qualitativos, 4 quantitativos e 1 estudo misto. Foram extraídas duas categorias temáticas: A negociação de conflito como competência do enfermeiro, que traz a gestão do conflito como fonte de sofrimento e a necessidade de interagir com outras competências para a efetiva gestão; e Estratégias negociadoras na resolução de conflitos, que apresenta formas de gerenciar um conflito. Conclusão: os estudos elegidos demonstraram que, no contexto hospitalar, a negociação de conflito, enquanto competência profissional do enfermeiro, é permeada pela insegurança.

Objetivo: analizar la negociación de conflictos como competencia profesional de la enfermera en el contexto hospitalario. Método: revisión de la literatura integrativa. Las bases de datos fueron: PubMed, BDENF, CINAHL y LILACS en el período de 2015 a 2019. Resultados: Se seleccionaron 17 artículos publicados. Entre ellos: 12 estudios cualitativos, 4 cuantitativos y 1 mixto. Se extrajeron dos categorías temáticas: La negociación del conflicto como competencia del enfermero, que trae consigo la gestión de conflictos como fuente de sufrimiento y la necesidad de interactuar con otras competencias para una gestión eficaz; y Estrategias negociadoras en la resolución de conflictos, que presenta las formas de gestionar un conflicto. Conclusión: los estudios elegidos demostraron que, en el contexto hospitalario, la negociación de conflictos, como competencia profesional del enfermero, está permeada por la inseguridad.

Objective: to analyze conflict negotiation as a professional competence of the nurse in the hospital context. Method: integrative literature review. The databases were: PubMed, BDENF, CINAHL and LILACS from 2015 to 2019. Results: 17 published articles were selected. Among them: 12 qualitative studies, 4 quantitative studies and 1 mixed study. Two thematic categories were extracted: The conflict negotiation as a competence of the nurse, which brings the management of the conflict as a source of suffering and the need to interact with other competencies for effective management; and Negotiating strategies in conflict resolution, which presents ways of managing a conflict. Conclusion: the studies elected demonstrated that, in the hospital context, conflict negotiation, as a professional competence of the nurse, is permeated by insecurity.

Strategies used by nurses for conflict mediation / Estrategias utilizadas por enfermeras para la mediación de conflitos / Estratégias utilizadas por enfermeiros para mediação de conflitos

ABSTRACT Objective: to understand what are the strategies used by nurses to mediate conflicts. Method: a qualitative and descriptive study that used oral history, carried out in the organ transplant unit of a university hospital located in the city of São Paulo, SP, Brazil. The population consisted of seven nurses with one year or more of experience in the unit. Data collection took place with semi-structured interviews. The reports were transcribed, and their content was analyzed according to Minayo's model. Results: three categories have emerged: Conflict-generating sources; Strategies for conflict mediation such as collaboration, dialogue, standardization, and expressive action by nurses to mediate conflicts; Consequences of conflicts. Conclusion: there is a need to invest in the training of nurses to mediate conflicts, and it is important to develop skills such as interpersonal relationships and communication for the success of their professional performance.

RESUMEN Objetivo: comprender las estrategias utilizadas por las enfermeras para mediar conflictos. Método: estudio cualitativo, descriptivo, utilizando historia oral temática, realizado en la unidad de trasplante de órganos de un hospital universitario ubicado en la ciudad de São Paulo, SP, Brasil. La población estaba compuesta por siete enfermeras con un año o más de experiencia en la unidad. La colección se realizó con entrevistas semiestructuradas. Los informes se transcribieron y transcribieron, y su contenido se analizó de acuerdo con el modelo propuesto por Minayo. Resultados: surgieron tres categorías: fuentes que generan conflictos; Estrategias para la mediación de conflictos, como la colaboración, el diálogo, la estandarización y la acción expresiva de las enfermeras para mediar conflictos; Consecuencias de los conflictos. Conclusión: es necesario invertir en la capacitación de enfermeras para mediar conflictos, y es importante desarrollar habilidades como las relaciones interpersonales y la comunicación para el éxito de su desempeño profesional.

RESUMO Objetivo: compreender quais são as estratégias utilizadas por enfermeiros para mediação de conflitos. Método: estudo qualitativo, descritivo, com o uso da história oral temática, realizado na unidade de transplante de órgãos de um hospital universitário localizado no município de São Paulo, SP, Brasil. A população foi composta por sete enfermeiros com um ano ou mais de experiência na unidade. A coleta ocorreu com entrevistas semiestruturadas. Os relatos foram transcritos e transcriados, e seu conteúdo foi analisado segundo modelo proposto por Minayo. Resultados: emergiram três categorias: Fontes geradoras de conflito; Estratégias para mediação de conflitos, tais como colaboração, diálogo, padronização e atuação expressiva dos enfermeiros para mediar conflitos; Consequências dos conflitos. Conclusão: há necessidade de investir na capacitação de enfermeiros para mediar conflitos, e torna-se importante desenvolver competências como relacionamento interpessoal e comunicação para o sucesso de sua atuação profissional.

Perspectiva del terapeuta acerca de la negociación de la alianza: Un instrumento para su evaluación / Therapist's perspective about alliance negotiation: an instrument's evaluation

Resumen La negociación de alianza es la capacidad que tienen paciente y terapeuta para resolver problemas vinculares y desacuerdos en terapia. Si bien este concepto es una noción diádica, con implicancias importantes para el tratamiento, actualmente solo existe un instrumento, desde la perspectiva del paciente, que permite su medición. El objetivo de este artículo es presentar el desarrollo y el estudio de las propiedades psicométricas preliminares de la Escala de Negociación de la Alianza, versión terapeuta (ANS-T). A estos fines, se convocó una muestra de 188 terapeutas de distintas aproximaciones teóricas que completaron un conjunto inicial de ítems tentativos del ANS-T junto con el Inventario de Alianza de Trabajo (WAI, por su sigla en inglés), otra escala para medición de la alianza. Para el análisis de datos se realizó un análisis de componentes principales, se estudiaron medidas de confiabilidad como el alfa de Cronbach y correlaciones ítem-total corregidas, así como también evidencias de validez de criterio a partir de las correlaciones entre el ANS-T y la WAI. Los resultados del análisis de componentes principales sugirieron una solución unidimensional integrada por nueve ítems. Los análisis conducidos sobre la versión final de la ANS-T mostraron una adecuada consistencia interna (a = .82) y homogeneidad de sus ítems (r ítem-total corregidas: entre .34 y .66) junto con evidencias de validez de criterio (r con WAI: .51, p < .001). Las cualidades del instrumento y sus propiedades psicométricas sugieren que la ANS-T es un recurso valioso tanto para la clínica como para la investigación.

Abstract Alliance negotiation is defined as the patient and therapist's ability to solve relational problems and disagreements (in therapeutic goals and tasks) during therapy. Although this construct is essentially a dyadic notion, with important clinical implication for treatments of different theoretical frameworks, currently there is only one instrument that can measure alliance negotiation and it is only based on the patients' perspective about therapy. The aim of this paper is to develop and examine the preliminary psychometric properties of the Alliance Negotiation Scale, therapist form. In the context of the importance attributed to analyzing relational constructs with a dyadic perspective, this instrument will not only allow to measure the perception of alliance negotiation from therapist's point of view, but also it will provide the necessary information to have a dyadic measurement of alliance negotiation by using both the original Alliance Negotiation Scale and the Alliance Negotiation Scale, therapist form in the same cases. With this purpose, a sample of 188 therapists from different theoretical frameworks completed an initial pool of twenty four preliminary items of the Alliance Negotiation Scale, therapist form. All the items of Alliance Negotiation Scale, therapist form, were developed based on the original Alliance Negotiation Scale, adapted to be completed by the therapist, and scored in a seven point Likert scale ranging from 1 (Never) to 7 (Always). The sample of therapist also completed the Working Alliance Inventory, therapist from, a widely spread standard measure of therapeutic alliance. For both instruments we asked the therapist to answer the measures thinking about a patient they have recently treated. To avoid a bias in patients' selection and ceiling effects in alliance scores, half of the sample of therapists was randomized to use as a reference a patient they considered easy, while the other half was asked to select a difficult patient. For data analyzes we first ran a principal component analysis in order to find the best factorial solution for the items and to establish the construct validity of the scale. Based on that factorial solution we analyzed the internal consistency of the final version of the Alliance Negotiation Scale, therapist form, using Cronbach's alphas coefficients and item's homogeneity using adjusted item-total correlations. Finally, to test for criterion validity we explored the associations between the Alliance Negotiation Scale, therapist form, and the Working Alliance Inventory, therapist from, using Pearson's correlations. The principal component analysis suggested a one-dimensional solution integrated by nine items, explaining a 42.16% of the total variance. All the items in this solution had factorial weights above .40. Furthermore, the analysis of reliability on this version of the scale showed an adequate internal consistency (Cronbach's a = .82). The adjusted item-total correlations presented also evidences of homogeneity (r's range: between .34 and .66), suggesting that all the items explores different aspects from a common construct, without being redundant. Finally, the correlations between the Alliance Negotiation Scale, therapist form, and the Working Alliance Inventory, therapist from, presented evidences of criterion validity (r with WAI: .51, p < .001). This result showed an association between the measures but also indicate that they do not measure the exact some construct. The specific characteristics and properties of the Working Alliance Inventory, therapist from, presented in this paper, suggested that this measure represents an important contribution both for clinical practice and research. Future studies will need to further explore and confirm the psychometric properties of the Working Alliance Inventory, therapist from, and analyze its application for dyadic measures of the therapeutic alliance negotiation in psychotherapy.

Negociação sexual conjugal / Couple sexual negotiation

Com base na proposição inédita do conceito de Negociação Sexual Conjugal (NSC), uma comunicação conjugal alternativa à monogamia compulsória sobre a sexualidade singular, o objetivo deste artigo é descrever e testar a associação entre a NSC e a incidência de infidelidade conjugal. A pesquisa é de natureza quantitativa, de caráter exploratório e de associação, com a utilização do método survey online. Participaram desta 537 pessoas que estavam ou estiveram num relacionamento no momento da pesquisa. Sentir desejos por outras pessoas além do(a) parceiro(a) foi associado com infidelidade, ao passo que expressá-los ao(a) parceiro(a) e negociá-los no relacionamento não foram associados à infidelidade. Ser mulher, casada e heterossexual foram aspectos associados a não sentir desejos por outras pessoas e não os revelar quando sentidos. Ser homem e não heterossexual foi associado a revelar desejos sexuais ao parceiro. Os cinco processos sugeridos da NSC (percepção, exposição, negociação, ações e impacto) mostram-se possíveis de serem vividos.

From the original proposition of the Couple Sexual Negotiation (CSN) concept, an alternative couple communication to compulsory monogamy on unique sexuality, the purpose of this article is to describe and evaluate the association between the NSC and the incidence of infidelity. The research was quantitative, exploratory and it tested association. An online survey method was used and 537 people who are/were in a relationship were assessed. Having sexual desire towards others besides partner was associated with infidelity, while expressing them to the partner and negotiate them in the relationship were not associated with infidelity. Being a woman, married and heterosexual were associated with not having sexual desire to wards other people and not to disclose them when felt. Being a non-heterosexual man was associated with expressing sexual desires towards others to partner. The five suggested processes of CSN (perception, exposure, negotiation, actions and impact) stated its possibility to be experienced.

A criança em foco: conversando sobre práticas parentais e estratégias de negociação / The child in focus: talking about parental practices and negotiation strategies

Este estudo considera a criança como ser social e produtor de cultura. Apesar do adultocentrismo ainda existente, mudanças recentes nas relações intrafamiliares contribuíram para a crescente participação da criança nos processos decisórios da família. Assim, investigou-se como as crianças entendiam, avaliavam e lidavam com as práticas educativas, e suas estratégias de negociação. Dezesseis crianças, de 7 a 10 anos, participaram desta pesquisa qualitativa, que contou com entrevistas individuais semiestruturadas, grupos focais e posterior análise de conteúdo. A maioria afirmou já ter feito escolhas no contexto familiar e se sentiram satisfeitos com isso. Picos de autoritarismo, permissividade e inconsistências entre as figuras parentais foram percebidos pelos infantes. Dessa forma, o estudo fornece subsídios para avançar na qualidade das relações parentais.

This study considers the child as a social being and producer of culture. In spite of the still existing adultcentrism, recent changes in intrafamilial relationships have contributed to the child’s increasing participation in family decision-making processes. Thus, investigated how children understood, assessed and dealt with educational practices, and their negotiation strategies. Sixteen children, aged 7 to 10 years, participated in this qualitative research, which included semi-structured individual interviews, focus groups and later content analysis. Most said they had already made choices in the family context and felt satisfied with it. Peaks of authoritarianism, permissiveness, and inconsistencies among parental figures were perceived by infants. In this way, the study provides subsidies to advance the quality of parental relationships.

Técnica da negociação: o uso de negociação na técnica de concretização para o alívio da dor / Negotiation technique: the use of negotiation in the concretization technique for pain relief / Técnica de la negociación: el uso de negociación en la técnica de concreción para el alivio del dolor

Poucos são os trabalhos nacionais escritos que abordam psicodrama e dor. Este artigo apresenta a técnica da negociação, uma maneira de se utilizar o psicodrama para aliviar a intensidade da dor. A técnica foi aplicada em 20 sujeitos no formato de atos terapêuticos e obteve bons resultados iniciais. O diretor entrevista a pessoa e sua dor, buscando uma negociação que resulte em um acordo objetivo de ajuda presente ou futura, permitindo o alívio da dor.

There are few Brazilian papers that address psychodrama and pain. This article presents the negotiation technique, a way of using psychodrama to alleviate pain intensity. The technique was applied in 20 subjects in the format of therapeutic acts and achieved good initial results. The director interviews the person and his pain, looking for a negotiation that results in an objective agreement of present or future help, which allows pain relief.

Pocos son los trabajos brasileños escritos que abordan psicodrama y dolor. Este artículo presenta la técnica de la negociación, una manera de utilizar el psicodrama para aliviar la intensidad del dolor. La técnica fue aplicada en 20 sujetos en el formato de actos terapéuticos y obtuvo buenos resultados iniciales. El director entrevista a la persona y su dolor, buscando una negociación que resulte en un acuerdo objetivo de ayuda presente o futura, permitiendo el alivio del dolor.

Appropriating ICT for International Business Negotiations Performance: A Case Study of the Pacific Alliance / Apropiación de las TIC para el rendimiento de la negociación internacional: Estudio de caso Alianza del Pacífico / Apropriação das TIC para o desempenho de negociação internacional: Estudo de Caso Aliança do Pacífico

Abstract Introduction. Nowadays Information and Communication Technologies (ICT) have improved the processes in organizations and enterprises. In this sense, international business negotiations can be optimized with these tools allowing that small, medium and large enterprises also increase their proficiency and performance in this kind of operation. According to the information above, this article analyzes the level of appropriation of these technologies and several correlations between variables related with the use of ICT within the Pacific Alliance. Objective. This article aims to identify the relationship between appropriation of ICT and performance of international business negotiations in this trade bloc. Materials and Methods. A relationship model between appropriation of ICT and performance of international business negotiations is proposed, validating it with a study conducted with 384 companies from Chile, Colombia, Mexico, and Peru that carry out import and/or export processes. Findings. The evidence indicates an important proficiency and international negotiation performance improvement within the enterprises in this region. Conclusion. This research shows that increasing the frequency of training in the use of ICT promotes proficiency in these technologies and improves performance in the international negotiation process.

Resumen Introducción. Hoy en día las tecnologías de la información (TIC) y han mejorado los procesos de la organización y de las empresas. En este sentido, las negociaciones comerciales internacionales se pueden optimizar con todas estas herramientas que permiten que las pequeñas, medianas y grandes empresas puedan aumentar también su dominio y el rendimiento en este tipo de operaciones. Por lo tanto, de acuerdo con la idea anterior, en este artículo se analiza el nivel de apropiación de estas tecnologías, además de algunas correlaciones entre las variables asociadas con el uso de las TIC en la Alianza del Pacífico. Objetivo. Este artículo tiene como objetivo identificar la relación entre la apropiación de las TIC y el rendimiento de las negociaciones comerciales internacionales en este bloque comercial. Materiales y métodos. Para ello, se propone un modelo de relación entre la apropiación de las TIC y el rendimiento de las negociaciones comerciales internacionales, validando con un estudio realizado en 384 empresas de Chile, Colombia, México y Perú; todo ello entre las empresas que llevan a cabo procesos de importación y/o exportación. Resultados. La evidencia muestra un dominio importante y la mejora en el rendimiento de la negociación internacional en las empresas de esta región. Conclusión. Por lo tanto, esta investigación demuestra que el aumento de la frecuencia de entrenamiento en el uso de las TIC promueve el dominio de estas tecnologías, y mejora el rendimiento del proceso de negociación internacional.

Resumo Introdução. Atualmente, a tecnologia da informação e comunicação (TIC) ajudar a facilitar e processos nas organizações. A este respeito, as negociações comerciais internacionais pode ser otimizado com todas essas ferramentas que permitem que pequenas médias e grandes empresas possam também aumentar o seu domínio e desempenho em tais operações. Portanto, de acordo com a ideia acima, neste artigo o nível de apropriação dessas tecnologias é analisado, bem como algumas correlações entre as variáveis associadas com o uso das TIC na Aliança do Pacífico. Objetivos. Este artigo tem como objetivo identificar a relação entre apropriação e realização de negociações comerciais internacionais neste bloco comercial TIC. Metodologia. Para fazer isso, um modelo de relação entre a apropriação das TIC e desempenho das negociações comerciais internacionais, validando um estudo de 384 empresas em Chile, Colômbia, México e Peru é proposta; todos entre empresas que realizam processos de importação e/ou exportação. Resultados. A evidência mostra um domínio importante e melhorar o desempenho das empresas de comércio internacional na região. Conclusões. Portanto, esta pesquisa mostra que o aumento da frequência de treinamento no uso das TIC promove domínio dessas tecnologias, e melhora o desempenho do processo de negociação internacional.

O papel do Ministério Público na autocomposição de conflitos sanitários transindividuais / The role of the Public Attorney's Office on the auto composition of transindividual sanitary conflicts / El rol del Ministerio Público en la autocomposición de conflictos sanitarios transindividuales

objetivo: analisou-se o papel do Ministério Público na autocomposição bilateral de conflitos sanitários transindividuais, envolvendo políticas públicas de saúde, notadamente se pode atuar como mediador, tendo em vista sua condição de parte, legitimado extraordinário pela substituição processual. Metodologia: tratou-se de estudo exploratório, de base qualitativa, desenvolvido a partir de fontes documentais primárias e bibliográficas, interpretadas e valoradas com os recursos da análise de conteúdo. Resultados: os resultados apurados indicaram que a adequada resolução de conflitos sanitários transindividuais, envolvendo direito à saúde e políticas públicas de saúde, perpassa por um sistema multiportas de acesso à Justiça, com primazia para a autocomposição bilateral, através da negociação, da mediação e da conciliação, de modo que o sistema de jurisdição somente seja acionado como último recurso. Emergiu, também, a legitimidade do Ministério Público para atuar nesse sistema, desempenhando distintos papéis na seara judicial e extrajudicial, tendo a observância ao ordenamento jurídico como linha condutora de sua atuação. Conclusão: na autocomposição bilateral de conflitos sanitários transindividuais, o Ministério Público atua como autêntico negociador colaborativo.

objective: the role of the Public Attorney's Office on the bilateral auto composition of transindividual sanitary conflicts was analyzed, involving public policies of health, notably if it can act as a mediator bearing in mind its condition as a part, extraordinary legitimated by process substitution. Methodology: It was made in the way of an exploratory study, of qualitative basis, developed from primary and bibliographic documental resources on, interpreted and appraised with the resources of contain analysis. Results: the results ascertained indicated that the suitable resolution of the trans individual sanitary conflicts, involving the right to health and public health policies, overarches a multiple doors system, of access to justice with primacy to the bilateral auto composition, through the negotiation, the mediation and the conciliation in the way that the jurisdiction system is only activated as the final resource. So, is also emerged, the legitimacy of the Public Attorney's Office to act in that system, performing distinct roles in the judicial and extrajudicial field having the compliance to the legal order as the conducting line of its acting. Conclusion: On the bilateral auto composition of the transindividual sanitary conflicts, the Public Attorney's Office acts as an authentic collaborative negotiator.

Objetivo: Se hizo un análisis del rol del Ministerio Público en la autocomposición bilateral de conflictos sanitarios transindividuales, envolviendo políticas públicas de salud, notablemente se puede actuar como mediador, teniendo en vista su condición de parte, legitimado extraordinario por la sustitución procesual. Metodología: Se ha tratado de estudio exploratorio, de base cualitativa, desarrollado a partir de fuentes documentales primarias y bibliográficas, interpretadas y valoradas con recursos de análisis de contenido. Resultados: los resultados apurados han indicado que la adecuada resolución de conflictos sanitarios transindviduales, envolviendo derecho a la salud, recorre por un sistema múltiples puertas de acceso a la justicia, con primacía para la autocomposición bilateral, a través de la negociación, de la mediación y de la conciliación, de modo que el sistema de jurisdicción solamente sea accionado como último recurso. Ha emergido, también, la legitimidad del Ministerio Público para actuar en ese sistema, desempeñando distintos roles en el campo judicial y extrajudicial, teniendo la observancia al ordenamiento jurídico como línea conductora de su actuación. Conclusión: en la autocomposición bilateral de conflictos sanitarios transindividuales, el Ministerio Público actúa como auténtico negociador colaborativo.

La variación del homicidio durante los diálogos de paz entre el Gobierno Nacional y las Fuerzas Armadas Revolucionarias de Colombia, FARC: octubre 18 del 2012 a agosto 28 del 2016 / Homicide rate variation in the course of the peace dialogue between the National Government and the Revolutionary Armed Forces of Colombia, FARC: October 18 2012 through August 28 2016 / A variação do homicídio durante os diálogos da paz entre o Governo Nacional e as Fuerzas Armadas Revolucionarias da Colômbia, FARC: outubro 18 de 2012 até agosto 28 de 2016

Resumen El objetivo de la investigación fue analizar la variación del homicidio durante la fase de negociación entre el Gobierno Nacional y las FARC, en relación con los arts. 103, 104, 104a, 105, 108 y 135 del Código Penal colombiano. Se planteó un estudio exploratorio descriptivo con enfoque mixto, desde una perspectiva histórica. Como resultado se evidenció una relación positiva entre el homicidio y el entorno del conflicto armado como ambiente específico, denotando que cuando la confrontación armada escaló o disminuyó, en igual sentido se comportó el punible. De manera concomitante, la negociación marcó una dinámica de desescalamiento del conflicto armado, que selló la disminución del ilícito a nivel nacional, con una reducción del 8,57 %, al comparar la tasa de homicidios del año 2012 con la del 2015, pero en el medio regional aumentó en los departamentos del Atlántico, Cauca y Quindío, manteniendo una tendencia sostenida superior al promedio anual de la tasa de homicidios en Antioquia, Chocó, Guaviare, Meta, Nariño, Norte de Santander, Putumayo, Risaralda y Valle del Cauca, en simetría con la presencia de estructuras criminales.

Abstract The research objective was to analyze the variation of homicide rates throughout the phase of negotiations developed between the National Government of Colombia and the FARC armed group with relation to articles 103, 104, 104a, 105, 108 and 135 of the Colombian criminal code. A descriptive exploratory study with a mixed history-based approach was envisaged. As a result, a positive relationship was evidenced between homicide and the armed conflict settings as a specific environment, pointing out that every time the confrontation either escalated or slowed down, the punishable act behaved accordingly. In a concomitant manner, a dynamics of de-escalation of the armed conflict was marked by the negotiation, thus sealing the decline of the crime at a national level with a reduction of 8.57 %, when comparing the homicide rate of year 2012 with that of 2015, but not in the regional environment where it increased in the Departments of Atlantico, Cauca, and Quindio, maintaining a sustained upward trend above the annual average homicide rate in Antioquia, Choco, Guaviare, Meta, Nariño, Norte de Santander, Putumayo, Risaralda, and Valle del Cauca, symmetrical to the presence of criminal structures in the Department of Atlantico.

Resumo O objetivo da investigação foi analisar a variação do homicídio durante a fase da negociação entre o Governo Nacional e a FARC, com relação aos artigos 103, 104, 104a, 105, 108 e 135 do código Penal Colombiano. Um estudo exploratório descritivo com enfoque misturado é apresentado, de uma perspectiva histórica. Como o resultado demonstrou-se uma relação positiva entre o homicídio e o contexto do conflito armado como ambiente específico, denotando que quando uma confrontação armada escalou ou diminuiu, no mesmo sentido comportou-se o punível. Da maneira do concomitante, a negociação marcou uma dinâmica do desescalamento do conflito armado, que selou a redução do ilícito ao nível nacional, com uma redução de 8.57%, ao comparar a taxa dos homicídios do ano 2012 com aquela de 2015, mas no meio regionais aumentou nos departamentos do Atlântico, do Cauca e de Quindío, mantendo uma tendência superior contínua à média anual da taxa dos homicídios em Antioquia, Chocó, Guaviare, Meta, Nariño, Norte de Santander, Putumayo, Risaralda e Valle do Cauca, na simetria com a presença de estruturas criminalis no departamento do Atlántico.

Mechanism of the medical insurance negotiations: obstacles and countermeasures / 中华医院管理杂志

Introduced in the paper are the connotation and current operations of the medical insurance negotiation mechanism.The authors also discussed obstacles blocking operations of the mechanism, including insufficient coordination capacity of the medical insurance institution over the negotiation, and lack of motivation of the institution for curbing costs and the contradiction against the profit pursuit of drug companies.Corresponding countermeasures and suggestions are put forward in the end, namely system reform for inter-governmental functions, enhancement of the capacity of both medical institutions and doctors against risks, and perfecting the restraint and incentive mechanism for medical institutions, aiming at smooth operation and optimization of the medical insurance negotiation mechanism.

Investigation and Study on Current Operational Situation of the Negotiation Mechanism of Drug Medical Insurance in China / 中国药房

OBJECTIVE:To provide reference for further improving negotiation mechanism of drug medical insurance in Chi-na. METHODS:Questionnaire investigation was conducted among the medical insurance agency and pharmaceutical company staff who participated in drug medical insurance negotiation in Jiangsu province,Jiangxi province,Qingdao,Chengdu. Their business fa-miliarity and recognition of the negotiating mechanism were also investigated. The descriptive analysis,independent sample t test and other methods were adopted to analyze the data statistically. RESULTS:A total of 70 questionnaires were distributed and 68 val-id questionnaires were collected with effective recovery rate of 97.14%. Respondents included 21 staff members of medical insur-ance agencies and 47 of pharmaceutical companies. In terms of business familiarity,the average score of respondents in all aspects was greater than 3(4 points system),the lowest score wasmanagement of the implementation of drug negotiation projects. There were statistical significances in scores of 3 items between 2 parties in the negotiation(P4 except forpatients taking drugs is quick and easy. There was no statistical significance between 2 types of respondents in all aspects of overall effect of the negotiation mechanism, preparation of the negotiations and negotiation project's supervision and evaluation(P>0.05). But in the recognition of the substan-tive negotiation,there was statistically significance between 2 types of respondents innegotiations between the two sides in an equal,cooperative,harmonious atmosphere(P<0.05). Healthcare agencies'respondents had higher scores than pharmaceutical companies'ones. And in the recognition of the implementation of the negotiation agreement,there was statistical significance be-tween 2 types of respondents in theafter the agreement entered into force,the medical insurance agency will be strictly in accor-dance with the agreementandfund pay to pharmaceutical companies timely and reasonable(P≤0.05). Healthcare agencies're-spondents have higher scores for than pharmaceutical companies'ones. CONCLUSIONS:The current drug medical insurance nego-tiation mechanism shows good overall effect and runs smoothly. But there are still some shortages,such as collected information the preparation stage is not sufficient;the procedures of patients taking the drug is complicated;negotiating parties do not have equal status;the fund is not paid to the pharmaceutical enterprise timely;evaluation is not perfect.

The implications of drug safety network on catastrophic disease medical insurance in Hong Kong / 中国卫生政策研究

The reimbursement on high-value drug expenses for patients is an important approach of catastrophic disease medical insurance.Hong Kong has established in a drug safety network, that has achieved remarkable results in improving the accessibility to high-value drugs and the burden of disease and effectively alleviated patients' financial burden.This paper systematically analyzes the history, process of adding drugs to directory, application conditions for drugs and patients, development status, and characteristics of drug safety network in Hong Kong.This study points out that although Mainland China has gradually established the high-value drug directory for catastrophic disease through the method of drug negotiation, the mechanism of high-value drug directory is not mature yet.To achieve the convergence between high-value drug directory, basic medical insurance drug directory, and new rural cooperative medical scheme drug directory, Mainland China needs to: 1) First, learn from the drug safety network in Hong Kong and establish access and exist mechanism for high-value drug directory;2) Then, expand insurance coverage of high-value drugs by establishing a multi-channel and socialized financing mechanism;3) Finally, strengthen the major disease medical insurance by adhering to the principles of buying drugs and getting drugs for free and reforming the fixed-ratio-reimbursement model.