Aprendizaje en investigación clínica: experiencia de enseñanza híbrida con estudiantes de medicina / Learning in Clinical Research: Hybrid Teaching Experience with Medical Students

Introducción: la pandemia de COVID-19 indujo un cambio en nuestro sistema de salud y de educación. Los programas formativos también tuvieron que adaptarse y exigieron un cambio rápido. Objetivos: describir una experiencia educativa de enseñanza virtual/híbrida en investigación clínica, entre docentes del Servicio de Clínica de un hospital universitario y estudiantes de Medicina de una institución privada, que participaron del Programa ESIN (EStudiantes en INvestigación). Metodología: los contenidos y las estrategias educativas incluyeron las clases teóricas audiograbadas o videograbadas (asincrónicas y autoadministradas), el aprendizaje basado en proyectos, los talleres prácticos (encuentros sincrónicos virtuales y grupales), mediante la adopción de modelos de aprendizaje como el aula invertida, y la tutoría individual entre docente-estudiante. Los datos se recopilaron mediante la observación en contextos académicos, y basándonos en elementos de encuestas anónimas de satisfacción, previo consentimiento informado de los participantes. Resultados: participaron 14 estudiantes, 6 durante el año 2021 y 8 durante 2022. Todas mujeres y estudiantes de medicina (50% de cuarto año, 35% de sexto año y 15% de quinto año). Las técnicas implementadas favorecieron la participación y promovieron el aprendizaje activo, basado en proyectos. Mencionaron aspectos positivos como el enfoque académico práctico, la disponibilidad del equipo docente para atender cualquier duda, el tiempo y el entusiasmo por enseñar y fomentar la participación. Los videos teóricos resultaron útiles como herramientas de repaso, y los encuentros grupales fueron especialmente valorados, si bien los encuentros individuales fueron destacados como ayuda y apoyo previo a los congresos científicos. En general, manifestaron que fue una experiencia enriquecedora que demostró que se puede lograr lo que se creía imposible. Todas participaron activamente de al menos un congreso científico, y el 50% resultó coautora de una publicación académica. Conclusión: los estudiantes asumieron compromisos y responsabilidades, e incorporaron competencias y habilidades en la implementación y en la difusión de los proyectos. Esta experiencia educativa facilitó que el tiempo de clase pudiera optimizarse para intercambio, discusión y dudas. Los recursos producidos, las actividades desarrolladas y los contenidos abordados quedan disponibles a nivel institución. (AU)

Introduction: the COVID-19 pandemic brought about a change in our health and education system. Training programs also had to adapt and required rapid change. Objectives: to describe an educational experience of virtual/hybrid teaching in clinical research between teachers of the Clinical Service of a university hospital and medical students of a private institution who participated in the ESIN Program (Students in Research). Methodology: the contents and educational strategies included audio or videotaped lectures (asynchronous and self-administered), project-based learning, practical workshops (virtual and group synchronous meetings) by adopting learning models such as the inverted classroom, and individual tutoring between teacher and student. We gathered the data through observation in academic contexts and based on elements of anonymous satisfaction surveys, with prior informed consent of participants. Results: fourteen students participated, six in 2021 and eight in 2022. All were women and medical students (50% fourth year, 35% sixth year, and 15% fifth year). The techniques implemented favored participation and promoted active, project-based learning. They mentioned positive aspects such as the practical academic approach, the availability of the teaching team for any doubts, the time and enthusiasm for teaching, and encouraging participation. The theory videos were a valuable review tool, and team meetings received high praise even if the one-on-one meetings received much attention as help and support before the scientific congresses. In general, they stated that it was an enriching experience that showed that you can achieve what you thought impossible. All of them actively participated in at least one scientific congress, and 50% were co-authors of an academic publication. Conclusion: the students assumed commitments and responsibilities and incorporated competencies and skills in project implementation and dissemination. This educational experience helped to optimize class time for exchange, discussion, and doubts. The resources produced, the activities developed, and the contents addressed are now available at the institutional level. (AU)

Revisão por pares das estratégias de busca para revisões sistemáticas: o PRESS, histórico, tradução para o português e funcionalidade / Peer review of search strategies for systematic reviews: the PRESS, history, Portuguese translation and functionality / Revisión por pares de las estrategias de búsqueda para revisiones sistemáticas: el PRESS, historia, traducción al portugués y funcionalidad

O Peer Review of Electronic Search Strategies (PRESS) é um instrumento elaborado na Canadian Agency for Drugs & Technologies in Health (CADTH) para avaliar cada elemento das estratégias de busca em bases de dados eletrônicas que podem influenciar a base das evidências das revisões sistemáticas. Os autores obtiveram licença para traduzir o PRESS para o português. O objetivo é contribuir para disseminação, uso e posterior implementação do PRESS, especialmente entre os bibliotecários, consolidando uma prática de avaliação de estratégias de busca das revisões sistemáticas. A metodologia foi o relato de experiência. Para contextualizar, inicia-se com o histórico da construção do PRESS, seguido do processo da tradução e apresentação das funcionalidades de cada tabela. O resultado é a disponibilização da versão do PRESS em português na página da CADTH. Conclui-se que a tradução deve impactar positivamente na qualidade das estratégias de busca das revisões sistemáticas com participação de bibliotecários brasileiros

The Peer Review of Electronic Search Strategies (PRESS) is an instrument developed at the Canadian Agen-cy for Drugs & Technologies in Health (CADTH) to evaluate each element of search strategies in electronic databases that may influence the evidence base of systematic reviews. The authors obtained a license to translate the PRESS into Portuguese. The objective is to contribute to the dissemination, use and sub-sequent implementation of PRESS, especially among librarians, to consolidate the practice of evaluating search strategies for systematic reviews. The methodology used was the experience report. It begins with the history of the construction of PRESS, followed by the report of the translation process and the function-alities of each table. The result is the availability of the PRESS version in portuguese on the CADTH page. It is concluded that the translation should have a positive impact on the quality of search strategies for systematic reviews involving Brazilian librarians

El Peer Review of Electronic Search Strategies (PRESS) es un instrumento de la Canadian Agency for Drugs & Technologies in Health (CADTH) para evaluar cada elemento de las estrategias de búsqueda en bases de datos electrónicas que pueden influir en la base de evidencia de revisiones sistemáticas. Los autores obtu-vieron permiso para traducir PRESS al portugués. El objetivo es contribuir para difusión, uso e implemen-tación del PRESS, especialmente entre bibliotecarios, para consolidar la práctica de evaluar las estrategias de búsqueda de revisiones sistemáticas. La metodología utilizada fue relato de experiencias. Comienza con la historia de la construcción de PRESS, sigue el relato de la traducción, y de las funcionalidades de cada ta-bla. Como resultado el PRESS en portugués está en el sitio web de CADTH. Se concluye que esta traducción debe tener un impacto positivo en la calidad de las estrategias de búsqueda de revisiones sistemáticas que involucren bibliotecarios brasileños

Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional en estudiantes universitarios: adaptación y validación / Resistance to Peer Pressure for Cigarette Smoking in University Students: Scale Adaptation and Validation / Escala de resistência à pressão dos pares para o consumo de cigarros em universitários: adaptação e validação

Introducción: la influencia o presión de pares que fuman es uno de los principales factores por los que los estudiantes universitarios inician el consumo del cigarro convencional; sin embargo, no se ha encontrado un instrumento que evalúe este fenómeno. Por lo tanto, el objetivo fue adaptar y validar la Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional. Materiales y métodos: participaron 237 estudiantes universitarios del estado de Nuevo León (México), de 18 a 24 años. Se realizó análisis factorial exploratorio, análisis de confiabilidad, correlación de Spearman y prueba de Kruskal-Wallis. Resultados: el 63.3 % de los estudiantes fueron mujeres y la media de edad fue de 19.66 años. Se identificaron dos factores con un total de 13 ítems. Se obtuvo un alfa de Cronbach de 0.81. Se encontraron diferencias estadísticamente significativas entre los distintos tipos de consumidores de cigarro convencional y los puntajes de la escala de resistencia a la presión de pares (H[4] = 23.85; p < 0.001). Conclusiones: la nueva versión de la Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional evidenció adecuadas propiedades psicométricas para evaluar la presión que ejercen los pares en estudiantes universitarios para el consumo de cigarro convencional

Introduction: Influence or peer pressure is one of the leading factors in developing cigarette smoking habits in university students; however, no effective strategy to assess this phenomenon has been developed yet. This study aimed to adapt and validate the peer pressure resistance scale to conventional cigarette consumption. Materials and methods: A total of 237 university students from the Nuevo León State (Mexico), aged 18­24 years, were enrolled. Exploratory factor and reliability analyses, the Spearman correlation, and the Kruskal­Wallis test were performed. Results: 63.3% of the students were women, and the mean age was 19.66 years. The exploratory analysis extracted two factors with a total of 13 items. A Cronbach's Alpha of 0.81 was found. Statistically significant differences were found between the different types of conventional cigarette users and peer pressure resistance scale scores [H(4) = 23.85; p < .001] were found. Conclusions: The peer pressure resistance scale showed appropriate psychometric properties for assessing the peer pressure to smoke conventional cigarettes in university students.

Introdução: a influência ou pressão dos pares que fumam é um dos principais fatores que levam os universitários a começarem a fumar cigarros convencionais, porém não foi encontrado nenhum instrumento para avaliar esse fenômeno. Portanto, o objetivo do trabalho foi adaptar e validar a escala de resistência à pressão dos pares para o consumo de cigarro convencional. Materiais e métodos: participaram 237 estudantes universitários do estado de Nuevo León, México, de 18 a 24 anos. Foram realizadas análise fatorial exploratória, análise de confiabilidade, correlação de Spearman e teste de Kruskal-Wallis. Resultados: 63,3% dos alunos eram mulheres e a média de idade foi de 19,66 anos. Dois fatores foram identificados com um total de 13 itens. Obteve-se um alfa de Cronbach de 0,81. Diferenças estatisticamente significativas foram encontradas entre os diferentes tipos de usuários de cigarros convencionais e as pontuações na escala de resistência à pressão dos pares (H(4) = 23,85; p < 0,001). Conclusões: a nova versão da escala de resistência à pressão dos pares para o consumo de cigarros convencionais apresentou propriedades psicométricas adequadas para avaliar a pressão exercida pelos pares sobre os universitários para o consumo de cigarros convencionais

Revisión de pares, preprints y revistas depredadoras. Ética editorial versus publicidad aplicada a la ciencia médica / Peer review, preprints and predatory journals. Publication ethics versus publicity applied to medical science

Abstract The publication of medical articles has become increasingly complex, linked to multiple factors. It poses difficult problems for both authors and journals themselves. This Editorial addresses current and controversial issues: peer review, preprints as a new way of disseminating knowledge, the growing number of publications without peer review and its variants, and the risks of predatory publications. The article proposes future guidelines as an editorial policy of MEDICINA. The controversy continues, and surely the passage of time will place our proposal in a changing scientific world like knowledge itself.

Introduction and evaluation of “Peer-assisted learning” in department of physiology in first-year MBBS students in Muzaffarnagar Medical College, Muzaffarnagar

Background: Traditional lectures (using PowerPoint presentation or chalk and board) have become less effective, monotonous, and involve less student-teacher interaction. Introducing peer-assisted learning (PAL) may improve learning by increased student-teacher interaction, making interesting, and more effective for better student outcome, producing a competent Indian medical graduate. Aims and Objectives: The aim of the study was to introduce PAL in 1st year MBBS students, to evaluate effectiveness of PAL both from Students and Teachers perspective, and to determine feasibility of PAL in a large batch of 150 students with limited teacher availability. Materials and Methods: Place of study is Muzaffarnagar medical college, Muzaffarnagar, UP. Study was conducted on 80, 1st phase MBBS students (2020 Batch) Ethical clearance from Institutional Ethics committee was obtained. A pre-test and a post-test of ten MCQs were given. Feedback from students and faculty members was also taken. Results: As post-test scores show a significant improvement Pal can be introduced as a TL method in MBBS students. Conclusion: Feedback from both the students and teachers show that a significant percentage agree that PAL is helpful in increasing knowledge, should be included in the teaching methodology in CBME curriculum, is feasible, can be included in internal assessment, and improve critical thinking skills.

Predictores del uso problemático del teléfono celular en adolescentes costarricenses

(analítico) Este artículo tiene por objetivo investigar los efectos del apoyo familiar y del grupo de pares, junto con la satisfacción con la vida, sobre el uso problemático de los teléfonos celulares entre los adolescentes costarricenses. Basado en datos de la encuesta nacional Global Kids Online, se desarrollaron modelos de ecuaciones estructurales para predecir el uso problemático de teléfonos celulares de adolescentes (M = 14.8, n = 530). Los resultados muestran que el apoyo entre pares correlaciona positiva y directamente con el uso problemático del teléfono celular, mientras que la percepción de la satisfacción con la vida tiene una correlación opuesta, funcionando como un factor protector. El apoyo del grupo de pares y, más aún, el apoyo familiar, ejercen efectos indirectos sobre el uso problemático del teléfono móvil.

(analytical) This study aimed to research the effects of family support and peer group support, along with the life satisfaction, on the problematic use of cell phones among costa rican adolescents. Based on data from the national survey Global Kids Online, structural equation models were developed in order to predict the problematic use of cell phones of adolescents investigated in this study (M=14.8, n = 530). The main findings indicate that peer support has a positive and direct correlation with the problematic use of the cell phone, while the perception of the life satisfaction is correlated in the opposite direction, functioning as a protective factor. Peer and family support have an indirect protective effect against the problematic use of cell phones, stronger in the case of family support.

(analítico) Este estudo teve como objetivo pesquisar os efeitos do apoio familiar e do grupo de pares, juntamente com a satisfação com a vida, no uso problemático de telefones celulares entre adolescentes costarriquenhos. Com base nos dados da pesquisa nacional Global Kids Online, foram desenvolvidos modelos de equações estruturais para prever o uso problemático de celulares dos adolescentes investigados neste estudo (13 a 17 anos; n = 530). Os principais achados indicam correlação positiva e direta do apoio dos pares com o uso problemático do celular, enquanto a perceção da satisfação com a vida está correlacionada de maneira inversa, funcionando como fator de proteção. O apoio dos pares e da família tem um efeito protetor indireto contra o uso problemático de telefones celulares, mais forte no caso do apoio familiar.

Jigsaw Method of Interactive Teaching to Unpuzzle Neuroanatomy

Introduction: Student driven interactive methods of teaching are a major part of andragogy, which drives them to professional competency. Jigsaw method is one such interactive teaching modality which fosters self-directed learning and peer interaction. The aim of this study is to access the effectiveness of Jigsaw method of interactive teaching qualitatively and quantitatively among 1st year MBBS students. Materials and methods: this study was done in 1st year medical students. The students were exposed to jigsaw method of interactive teaching in small groups and the program was evaluated by assessing the short and long term memory of the students. Feedback also was obtained from the students. Results: There was a statistically significant difference in the mean scores as compared to traditional teaching methods. The perception of students also showed promising results. Discussion: there have been many studies on student perception on such interactive teaching methods which revealed that the students were showing better academic performances. A few studies like the present one, on quantitative assessment of students score after Jigsaw method of interactive teaching has also shown good results. Conclusion: the jigsaw method of interactive teaching encourages student participation and enhances self directed learning and peer assisted learning.

Estilos parentais e vinculação aos pares fazem a diferença nos motivos do consumo de álcool em jovens universitários? / ¿Los estilos parentales y el apego a los compañeros marcan la diferencia en los motivos de consumo de alcohol en jóvenes universitarios? / Do Parenting Styles and Peer Attachment Make a Difference in the Reasons for Alcohol Consumption in University Students?

A literatura suporta a importância da relação entre os jovens e as figuras parentais para um desenvolvimen-to adaptativo, nomeadamente capacidades pró-sociais e menor envolvimento em comportamentos de risco. A qualidade das relações com os pares pode também desempenhar um papel protetor no que respeita ao consumo de álcool. O objetivo deste estudo foca-se na análise do efeito dos estilos parentais e da vinculação aos pares nos motivos de consumo de álcool. Participaram 1.044 estudantes universitários de ambos os sexos com idades compreendidas entre os 18 e 25 anos (m= 19.78; dp= 1.68). De forma a recolher os dados recorreu-se a um questionário sociodemográfico, ao Parenting Styles & Dimensions Questionnaire: Short Version (psdq), ao Inventory of Peer and Parental Attachment (ippa-peer), ao Drinking Motives Questionnaire ­ Revised (dmq-r) e ao Alcohol Use Disorders Identification Test (audit). Os resultados apontam para um efeito preditor positivo dos estilos parentais autoritários e permissivos e da alienação aos pares face aos motivos de consumo de álcool e um efeito preditor negativo do estilo parental democrático e de uma vinculação aos pares pautada por comunicação e confiança. As mulheres apresentam maior qualidade relacional com os pares comparativa-mente com os jovens do sexo masculino. Os rapazes apre-sentam uma maior diversidade de motivos de consumo de álcool. Os resultados são discutidos considerando a relevância dos estilos parentais e qualidade das relações com os pares no desenvolvimento pessoal e as motivações dos jovens adultos, em contexto universitário, para a assunção de comportamentos de risco.

La literatura apoya la importancia de la relación entre los jóvenes y las figuras parentales para un desarrollo adaptativo, es decir, habilidades prosociales y menor involucramiento en conductas de riesgo. La calidad de las relaciones con los compañeros también puede desempeñar un papel protector con respecto al consumo de alcohol. El objetivo de este estudio es analizar el efecto de los estilos de crianza y el apego entre pares, sobre las razones para el consumo de alcohol. Participaron 1.044 estudiantes universitarios de ambos sexos con edades comprendidas entre 18 y 25 años (m= 19.78; ds= 1.68). Para la recolección de datos se utilizó un cuestionario sociodemográfico, el Parenting Styles & Dimensions Questionnaire: Short Version (psdq), el Inventory of Peer and Parental Attachment (ippa-peer), el Drinking Motives Questionnaire ­ Revised (dmq-r) y el Alcohol Use Disorders Identification Test (audit). Los resultados indican un efecto predictivo positivo de los estilos parentales autoritarios, permisivos y de alienación de los pares ante los motivos del consumo de alcohol, y un efecto predictivo negativo del estilo paren-tal democrático y de apego a los pares basado en la comunicación y la confianza. Las mujeres tienen más calidad relacional con sus compañeros que los hombres jóvenes. Los hombres tienen una mayor diversidad de motivos para el consumo de alcohol. Los resultados se discuten considerando la relevancia de los estilos de crianza y la calidad de las relaciones con los pares en el desarrollo personal, y las motivaciones de los jóvenes en un contexto universitario para asumir con-ductas de riesgo.

The importance of the relationship between young people and their parental figures for adaptative de-velopment has been supported by literature, namely prosocial capacities and less involvement in risk beha-viors. The quality of peer relationships may also play a protective role regarding alcohol consumption. The aim of this study was to analyze the effect of parenting styles and peer attachment on the reasons for alcohol consumption. Participants were 1.044 university stu-dents of both sexes, between 18 and 25 years of age (m = 19.78; sd = 1.68). For data collection, a socio-demographic questionnaire, the Parenting Styles & Dimensions Questionnaire: Short Version (psdq), the Inventory of Peer and Parental Attachment (ippa-peer), the Drinking Motives Questionnaire ­ Revised (dmq-r), and the Alcohol Use Disorders Identification Test (audit) were used. The results reveal a positive predictive effect of negative parenting styles (authoritarian and permissive) and alienation with peers on the reasons for alcohol consumption and a negative predictive impact on democratic parenting style and peer attachment ba-sed on communication and trust. Women have a better relational quality with their peers compared to males. Men have a greater diversity of reasons for consuming alcohol. Results are discussed considering the relevance of parenting styles, the quality of peer relationships in personal development, and the motivations of young adults, in a university context, for risk-taking behavior.

Implementación de la figura de agente de apoyo entre iguales en salud mental: una perspectiva internacional en el contexto de su implementación en Cataluña / Implementing the figure of peer support workers in mental health: an international perspective from the context of its implementation in Catalonia

RESUMEN En el contexto de las discusiones sobre la implementación de la formación y formas de incorporación en el sistema sanitario de Cataluña de agentes de apoyo entre iguales en salud mental o pares, entre 2020 y 2021, se llevó a cabo una revisión de literatura y, de forma complementaria, entrevistas a expertos tanto a nivel internacional como en el Estado español, con el propósito de realizar un análisis de contenido de elementos formativos y de integración dentro de los sistemas sanitarios. Los países germanoparlantes son los que ofrecen programas de formación e incorporación más homogéneos. En el caso de países anglosajones y francófonos, organizaciones sin ánimo de lucro del tercer sector se suelen hacer cargo de los programas formativos y de su incorporación. En el mundo iberoamericano existen diversas experiencias de programas formativos, aunque sin reconocimiento como formaciones sanitarias. Se ofrecen recomendaciones al desarrollo de esta figura en Cataluña, que incluyen el avance hacia una formación profesional con reconocimiento sanitario y opciones de incorporación tanto desde entidades proveedoras sanitarias o sociosanitarias como del tercer sector.

ABSTRACT In the context of debates surrounding the training of mental health peer support workers and their incorporation into the Catalan Health System, this article presents a literature review complemented by interviews carried out between 2020 and 2021 with both international and Spanish experts. Based on the information obtained, content analysis of elements of their training and integration within the health system was performed. German-speaking countries offer the most homogeneous training and recruitment programs. In the case of English- and French-speaking countries, non-profit or third sector organizations are usually in charge of training programs and recruitment. Various experiences with training programs exist in the Ibero-American world, although they are not recognized as professional qualifications. Recommendations are offered for the development of this figure in Catalonia, which include advancing towards professional training with recognition as health care providers, as well as contracting options from both socio-health or health care providers or from third sector entities.

Validação externa do instrumento inventario del nivel de cuidados mediante indicadores de clasificación de resultados de enfermería (INICIARE-26) para uso no Brasil / External validation of the care level inventory instrument using nursing outcome classification indicators (INICIARE-26) for use in Brazil

Introdução: ao longo das últimas décadas, a enfermagem vem utilizando estratégias para mensurar sua carga de trabalho. Nesse intuito, o uso de instrumentos confiáveis de mensuração é necessário para dar a conhecer a dependência do paciente quanto ao cuidado de enfermagem. Métodos dessa natureza viabilizam ajustes qualitativos e quantitativos na atuação da enfermagem. Esse é o caso da versão 26 do INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería), um instrumento desenvolvido na Espanha que foi adaptado transculturalmente para o Brasil. Construído a partir da classificação de resultados de enfermagem, a ferramenta está estruturada em cinco dimensões, compostas por 26 indicadores. Ao final da avaliação, o INICIARE-26 classifica o paciente em quatro níveis de dependência (alta, moderada, risco de dependência e independência), em relação aos cuidados de enfermagem. Objetivos: construir as definições conceituais, as definições operacionais e a magnitude das definições operacionais, para cada indicador componente do instrumento; validar o conteúdo construído com especialistas; validar externamente através de propriedades psicométricas; construir um Guia de Bolso com as definições visando a translação do conhecimento. Método: estudo metodológico em três fases: na primeira, foram construídas definições, validadas posteriormente por oito especialistas, entre janeiro e julho de 2022; na segunda, fez-se a validação externa, entre agosto e outubro de 2022 (foram incluídos pacientes adultos, clínicos e cirúrgicos, internados em unidades de internação de um hospital público e de um hospital privado de Porto Alegre, RS, Brasil); na terceira fase, foi construído um guia para uso prático. Os dados foram analisados inicialmente pelo índice de validação de conteúdo (≥ 0,78). Em seguida, foram analisados pelos testes psicométricos: a) fidedignidade ­ consistência interna verificada pelo alfa de Cronbach (> 0,70), e equivalência verificada pelos coeficientes de correlação intraclasse (> 0,50) e Bland-Altman; e b) validade de constructo, aferida pela análise fatorial confirmatória. Resultados: as definições conceituais obtiveram índice de validação de conteúdo de 1,00 para 15 indicadores; as definições operacionais foram integralmente consensuais, para 17 indicadores; as magnitudes das definições conceituais obtiveram índice de 1,00, para 13 indicadores. Os demais itens obtiveram concordância de 0,88, e foram revisados seguindo sugestões dos especialistas. Na validação externa, foram pesquisados 260 pacientes; a maioria, 55,8%, de mulheres; a média de idade dos pacientes é 60,6 ±18,5 anos. A correlação intraclasse foi excelente (0,97), e a confiabilidade pelo alfa de Cronbach foi de 0,90. A análise fatorial confirmatória apontou bom ajuste do modelo, com os seguintes índices:  2 / g.l = 1,551; RMSEA = 0,04; NFI = 0,996; CFI = 0,999; SRMR = 0,16. Conclusão: o instrumento INICIARE-26, versão brasileira, se mostrou válido, confiável e capaz de mensurar a dependência do paciente, com relação aos cuidados de enfermagem. Quando aplicado com apoio das definições conceituais, apresentou melhor eficiência à realidade da enfermagem brasileira. Espera-se que o Guia de Bolso construído favoreça a utilização do INICIARE-26 pelo enfermeiro no momento de sua aplicação, minimizando a subjetividade da avaliação, e que seja um recurso didático eficiente para a educação permanente do enfermeiro.

Introduction: over the last decades, nursing has been using strategies to measure its workload. To this end, the use of reliable measurement instruments is necessary to make known the patient's dependence on nursing care. Methods of this nature enable qualitative and quantitative adjustments in nursing practice. This is the case of version 26 of the INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería), an instrument developed in Spain that was cross-culturally adapted for Brazil. Built from the nursing outcomes classification, the tool is structured in five dimensions, composed of 26 indicators. At the end of the assessment, the INICIARE-26 classifies the patient into four levels of dependence (high, moderate, risk of dependence and independence) in relation to nursing care. Purpose: to build conceptual definitions, operational definitions and the magnitude of operational definitions, for each indicator component of the instrument; validate content built with experts; externally validate through psychometric properties; build a Pocket Guide with definitions aimed at knowledge translation. Method: methodological study in three phases: in the first, definitions were built, later validated by eight experts, between January and July 2022; in the second, external validation was carried out, between August and October 2022 (adult, clinical and surgical patients admitted to inpatient units of a public hospital and a private hospital in Porto Alegre, RS, Brazil) were included; in the third phase, a guide for practical use was built. Data were initially analyzed using the content validation index (≥ 0.78). Then, they were analyzed by psychometric tests: a) reliability ­ internal consistency verified by Cronbach's alpha (> 0.70), and equivalence verified by intraclass correlation coefficients (> 0.50) and Bland-Altman; and b) construct validity, measured by confirmatory factor analysis. Results: the conceptual definitions obtained a content validation index of 1.00 for 15 indicators; operational definitions were fully consensual, for 17 indicators; the magnitudes of the conceptual definitions obtained an index of 1.00, for 13 indicators. The other items obtained an agreement of 0.88, and were revised following the experts' suggestions. In the external validation, 260 patients were surveyed; the majority, 55.8%, were women; the mean age of patients is 60.6 ±18.5 years. The intraclass correlation was excellent (0.97), and the reliability by Cronbach's alpha was 0.90. Confirmatory factor analysis showed a good fit of the model, with the following indices:  2 / g.l = 1.551; RMSEA = 0.04; NFI = 0.996; CFI = 0.999; SRMR = 0.16. Conclusion: the INICIARE-26 instrument, Brazilian version, proved to be valid, reliable and capable of measuring the patient's dependence on nursing care. When applied with the support of conceptual definitions, it presented better efficiency to the reality of Brazilian nursing. It is expected that the Pocket Guide built favors the use of INICIARE-26 by nurses at the time of its application, minimizing the subjectivity of the evaluation, and that it is an efficient didactic resource for the continuing education of nurses.

The application of MOOC combined with peer mutual assistance in cardiopulmonary resuscitation teaching / 中华医学教育探索杂志

Objective:To explore the application effect of massive open online course (MOOC) combined with peer mutual assistance in cardiopulmonary resuscitation teaching.Methods:A total of 140 students in the same class of Batch 2015 were divided into the experimental group and the control group. In the teaching of cardiopulmonary resuscitation, the experimental group was based on the MOOC teaching platform, watched videos and topic tests before class, and used the peer mutual assistance in class. While the control group adopted traditional classroom teaching mode. The teaching effect of the two groups were evaluated by comparing the operation assessment scores and questionnaire survey of students' satisfaction with teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The operating assessment score of the experimental group was (82.20±2.31), and the operating assessment score of the control group was (75.80±1.72). The difference was statistically significant ( t=3.27, P<0.05). The questionnaire survey showed that the course satisfaction and learning motivation of the experimental group were better than those of the control group. In learning burden, the two groups had similar results ( P=0.739). Conclusion:MOOC combined with peer mutual assistance in cardiopulmonary resuscitation teaching can help students better master skills, improve students' course satisfaction and learning motivation, without increasing their learning burden.

The Humanistic Significance of the Application of Peer Education Mode in Urological Tumors Patients during Perioperative Period / 中国医学伦理学

【Objective:】 To study the application and effect of peer education mode in the nursing of patients with urinary tumor, and explore the ways to improve the quality of clinical care and the humanistic significance of this mode in clinical nursing. 【Methods:】 84 patients with urological tumors who received surgical treatment in urology department of a third-class hospital from March 2021 to December 2021 were randomly divided into the control group and the experimental group, with 42 patients in each group. The subjects in control group adopted routine intervention mode.The subjects in experimental group integrated the peer education program into the routine nursing mode.SAS and SDS scales were used to evaluate patients’ state of anxiety and depression, and the degree of nursing satisfaction. 【Results:】 The scores of SAS and SDS in the experimental group were significantly lower than that of the experimental group before intervention and the control group after intervention (P<0.05).The number of very satisfied, moderately satisfied and dissatisfied cases in the control group was 12, 29 and 1 respectively, and in the experimental group was 19, 23 and 0 respectively. The difference was statistically significant (P<0.05). 【Conclusion:】 Adopting peer education with humanistic care significance can effectively alleviate patients’ preoperative anxiety, depression and other adverse mental state, reduce preoperative stress, and provide a new way for nursing quality.

Family Support to Improve Knowledge, Attitude, and Practices of Occupational Health and Safety (OHS) in the Informal Sector

@#Introduction: Occupational Health and Safety (OHS) for formal sector workers is held along with regulations, joint commitments, training, and continuous monitoring. This condition cannot be applied for informal sector, so it approaches that can be performed such as activating social support from workers’ environment. This study aimed to determine for social support to improve the knowledge, attitude and practice of OHS workers in informal sector. Methods: This study a quasi-experimental with pre-posttest and control group design. Subjects were 90 limestone workers taken by Multistage Sampling from Gunungkidul Regency, Indonesia. Subjects were divided into health promotion by family support and peer support (FS&PS), peer support (PS), family support (FS), and control (C) group with treatment period of one month. Variables were measured using a knowledge, attitude, and practice questionnaire. The obtained data then analyzed using Kruskal-Wallis test and Mann-Whitney test. Results: There was a significant difference (p<0.001) in the knowledge, attitude and practice of OHS in limestone workers. FS&PS group gave the highest score for knowledge variable. There was no significant differences between OHS attitude between FS&PS and FS only (p=0.787). The biggest influence of attitude changes was from the FS group. The OHS practice has no significant differences between PS and C group (p=0.696), while other groups have significant differences. Conclusion: The biggest influence of changes in OHS practice was in the FS group. The combination of FS&PS is more effective in increasing knowledge, while attitude and practice are more effective if involving FS.

Effect of health management of progressive resistance training on the self-efficacy and bone mineral density improvement in patients with osteoporosis / 中华健康管理学杂志

Objective:To explore the effect of health management of progressive resistance training on self-efficacy and bone mineral density (BMD) improvement in osteoporosis patients.Methods:It was a cross-sectional study. Clinical data of 156 patients with primary osteoporosis treated in Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from September 2019 to March 2022 were analyzed retrospectively. A simple random sampling method was implied, and 78 patients were set as control group, they were treated with conventional osteoporosis drugs and routine health education and peer education. And the other 78 patients were set as observation group, and progressive resistance training was added to the health management program in these patients on the basis of the intervention of the control group. Combined with the 6-month follow-up records of the two groups, the changes of self-efficacy level and the improvement of BMDin the two groups before and after the intervention were analyzed and compared. The above indexes were statistically analyzed with χ2 test or t test. Results:The compliance of diet, psychology, exercise and medication in the observation group was 97.4%, 97.4%, 98.7% and 97.4%, respectively, which were all higher than those in the control group (89.7%, 87.2%, 88.5% and 87.2%). The self-efficacy score before and after intervention in the observation group was 110.09±11.73 and 217.05±8.12, the anxiety score was 46.44±3.17 and 31.92±3.28, the depression score was 51.60±3.42 and 33.32±2.98, the osteoporosis knowledge score was 14.99±2.14 and 24.40±1.28, respectively; and those were 110.81±12.53 and 185.36±12.29, 46.92±2.18 and 36.53±3.54, 51.56±3.93 and 39.02±2.65, 14.76±2.93 and 20.11±1.84 respectively in the control group; and there was no statistically significant difference in above-mentioned indexes between the two groups before the intervention (all P>0.05); but after 6 months of intervention, the above-mentioned scores of the observation group were all significantly superior than those in the control group (all P<0.05). The BMD of lumbar spine L 1-4, femoral trochanter and hip in the observation group before intervention was 0.869±0.127, 0.608±0.110 and 0.740±0.138, respectively, and after the intervention, it was 0.915±0.107, 0.654±0.108 and 0.785±0.134, respectively; the BMD of lumbar spine L 1-4, femoral trochanter and hip in the control group was 0.833±0.126, 0.607±0.114 and 0.738±0.135, respectively before intervention, and it was 0.869±0.114, 0.643±0.114 and 0.748±0.124, respectively after intervention. After intervention, the lumbar L 1-4 bone density in the observation group was higher than that in the control group, the difference was statistically significant ( P<0.05). There was no significant difference in all the BMD before intervention and the BMD of the femoral trochanter and the hip after intervention between the two groups (all P>0.05). Conclusion:The health management of progressive resistance training combined with drug therapy can effectively improve the BMD in patients with osteoporosis.

Identifying Opportunities for Peer-Assisted Learning In Speech Language Therapy Clinical Education (Mengenal Pasti Peluang untuk Pembelajaran Berbantukan Rakan Sebaya dalam Pendidikan Klinikal Terapi Bahasa Pertuturan) / Jurnal Sains Kesihatan Malaysia

@#Peer-assisted learning (PAL) is a potential approach for clinical education that can reduce the burden of clinical supervision and enhance learning. This study aims to identify opportunities for PAL through investigating how speech language therapy students perceive and already participate in PAL within a range of clinical practicum settings. The Speech Sciences students across all years at one institution were invited to participate in a cross-sectional survey that was adapted and revised from Tai et al. (2014). Speech Sciences students reported they applied PAL as part of their learning strategy in their clinical practicums, but still relied on supervisors as the main source of. PAL occurred more frequently in contexts where students already had some clinical experience and spent substantial amounts of time together. Students agreed that PAL enhanced their learning and emphasized a few advantages of PAL, such as having the opportunity to share their ideas, experiences, and knowledge, and providing a positive learning environment without pressure. Confidence to provide information or feedback to peers was cited as a shortcoming in PAL. PAL is a viable teaching approach that can be used in speech-language therapy clinical education program to reduce the supervisory burden. The findings from our study show that PAL is largely self-initiated among speech-language therapy students. However, PAL must be tailored to suit different clinical education year levels and clinical settings to benefit. Case discussion may be one area where scaffolded PAL activities could represent a feasible first step to increasing PAL.

Relationship between idolatry and perceived social support in secondary school students： the mediating role of peer attachment and life satisfaction / 四川精神卫生

BackgroundNowadays， idolatry is an important part of the spiritual life of secondary school students， making a significant impact on their physical and mental development. Previous research has examined the two-by-two relationship between idolatry， peer attachment， life satisfaction and perceived social support， but the potential mediating mechanisms between these variables remain to be explored. ObjectiveTo explore the mediating role of peer attachment and life satisfaction between idolatry and perceived social support， so as to provide references for mental health education for secondary school students. MethodsIn June 2022， 1 059 students currently enrolled in secondary school in Qiannan State， Guizhou Province were selected according to stratified random sampling method. In this study， assessment was performed using Celebrity Attitude Scale （CAS）， Peer Attachment Subscale from Revised Inventory of Parent and Peer Attachment （IPPA-R）， Satisfaction with Life Scale （SWLS） and Perceived Social Support Scale （PSSS）. Pearson correlation analysis was used for correlation test. Model 6 in the SPSS Macro Process 3.3 was used to examine the mediating effect of peer attachment and life satisfaction between idolatry and perceived social support in secondary school students. Results①CAS score indicated positive correlation with scores of IPPA-R Peer Attachment Subscale， SWLS and PSSS （r=0.117， 0.097， 0.115， P<0.01）. IPPA-R score indicated positive correlation with scores of SWLS and PSSS （r=0.279， 0.421， P<0.01）. SWLS score was positively correlated with PSSS score （r=0.552， P<0.01）. ②The direct effect of idolatry on perceived social support was significant （β=0.059， P<0.05）. Both separate and chain mediating effects of peer attachment and life satisfaction between idolatry and perceived social support were significant （95% CI： 0.007~0.130， 0.004~0.054， 0.001~0.016， P<0.01）. The three effects above respectively accounted for 33.56%， 13.54% and 3.93% of the total effect. ConclusionIdolatry can affect secondary school students' perceived social support both directly and indirectly through peer attachment and life satisfaction.

Study of the influence of peer support service on social function of patients with chronic schizophrenia / 四川精神卫生

BackgroundThe improvement of social function in patients with schizophrenia is an important part of their rehabilitation， and peer support services， as a rehabilitation method， may be of great significance to improve the social function of patients with schizophrenia. ObjectiveTo explore the influence of peer support service on the daily living ability and social function of patients with chronic schizophrenia， and to provide references for promoting the rehabilitation of patients with chronic schizophrenia. MethodsA total of 100 patients with chronic schizophrenia who were hospitalized in The Third People's Hospital of Tianshui from January 1 to December 31， 2020 and met the diagnostic criteria of the International Classification of Diseases， 10th edition （ICD-10） were selected as the study objects， and they were divided into the control group and the study group with 50 cases each by random number table method. Patients in both groups received routine treatment and nursing care， on this basis， the study group received peer support service once or twice a week for 12 weeks， and the control group received the same peer support service at the end of the study. Before and at the 1st， 2nd， 4th， 8th and 12th week of the treatment， Activity of Daily Living Scale （ADL） and Social Disability Screening Schedule （SDSS） were used to evaluate the activities of daily living and social function of the two groups. ResultsThe ADL scores of the study group were lower than those of the control group at the 8th week and 12th week of the treatment （ t=-2.420， -2.814， P<0.05 or 0.01） . The SDSS scores of the study group were lower than those of the control group at the 8th week an 12th week of the treatment （t=-2.057， -2.322， P<0.05） . ConclusionPeer support services may help improve the ability of daily life and social function of patients with chronic schizophrenia. ［Funded by Tianshui City Livelihood Science and Technology Plan Project （number， 2020-SHFZKJK-9344）］

5. A Report on Student-led Education about LGBTQ+ / 医学教育

Medical students took the initiative by introducing LGBTQ+ education in preclinical elective classes at their medical school. As instructors, they led classes focused on small group discussions in a common "learning community" setting. The Peer Assisted Learning between classmates promoted effective discussions in classroom activities, allowing students to deepen their understanding of LGBTQ+. Student-initiated action to introduce new content into the curriculum together with student-led classes may be a useful learning strategy in LGBTQ+ education.

Construção e validação das definições para indicadores de resultados do instrumento Iniciare-26 / Elaboración y validación de las definiciones para indicadores de resultados del instrumento Iniciare-26 / Construction and validity of definitions for outcome indicators of the INICIARE-26 instrument

Resumo Objetivo Construir e validar com especialistas as definições conceituais (DC), as definições operacionais (DO) e a magnitude das definições operacionais (MDO) dos 26 indicadores de resultados da Nursing Outcomes Classification (NOC), componentes do instrumento INICIARE-26, que mede a dependência do paciente dos cuidados de enfermagem. Métodos Estudo metodológico, em duas etapas, entre janeiro e julho de 2022. Na primeira, foram desenvolvidas, com base na literatura científica, as DC, as DO e as MDO. Observaram-se as equivalências semânticas e conceituais, além da uniformização da formulação textual dos indicadores. Na segunda, utilizou-se o método Delphi para validação de conteúdo por oito especialistas que avaliaram a relevância das definições sob os seguintes aspectos: "não relevante"; "pouco relevante"; "bastante relevante"; "altamente relevante". Utilizou-se o índice de validação de conteúdo (IVC), com valor superior a 0,78, para análise de concordância. Resultados O IVC das DC foi unânime, para 15 indicadores; as DO foram integralmente consensuais, para 17 indicadores; a MDO obteve IVC de 1,00, para 13 indicadores. Os demais itens obtiveram IVC de 0,88. Os itens que não atingiram 1,00 de concordância foram revisados, de acordo com as sugestões dos especialistas, com o objetivo de aprimorar e de proporcionar maior clareza para aplicação do instrumento. Conclusão As definições foram construídas e por ocasião da validação alcançaram grau satisfatório de concordância dos especialistas; algumas obtiveram unanimidade.

Resumen Objetivo Elaborar y validar con especialistas las definiciones conceptuales (DC), las definiciones operativas (DO) y la magnitud de las definiciones operativas (MDO) de los 26 indicadores de resultados de la Nursing Outcomes Classification (NOC), componentes del instrumento INICIARE-26, que mide la dependencia del paciente de los cuidados de enfermería. Métodos Estudio metodológico, de dos etapas, realizado entre enero y julio de 2022. En la primera, se elaboraron las DC, DO y MDO basadas en la literatura científica. Se observaron las equivalencias semánticas y conceptuales, además de la uniformidad de la formulación textual de los indicadores. En la segunda, se utilizó el método Delphi para la validación de contenido por ocho especialistas, que evaluaron la relevancia de las definiciones según los siguientes aspectos: "no relevante", "poco relevante", "bastante relevante", "altamente relevante". Se utilizó el Índice de Validez de Contenido (IVC), con valor superior a 0,78, para el análisis de concordancia. Resultados El IVC de las DC fue unánime en 15 indicadores, las DO fueron totalmente consensuales en 17 indicadores, la MDO obtuvo IVC de 1,00 en 13 indicadores. Los demás ítems obtuvieron IVC de 0,88. Se revisaron los ítems que no tuvieron 1,00 de concordancia, de acuerdo con las sugerencias de los especialistas, con el objetivo de mejorarlos y proporcionar mayor claridad para la aplicación del instrumento. Conclusión Se elaboraron las definiciones y, luego de la validación, alcanzaron un nivel satisfactorio de concordancia de los especialistas. Algunas obtuvieron unanimidad.

Abstract Objective To construct and validate with experts the conceptual definitions (CD), operational definitions (OD) and magnitude of the operational definition (MOD) of the 26 outcome indicators of the Nursing Outcomes Classification (NOC), INICIARE-26 instrument components, which measures patients' dependency on nursing care. Methods A methodological study, in two stages, between January and July 2022. In the first, CD, OD and MOD were developed based on scientific literature. Semantic and conceptual equivalences were observed, in addition to standardization of the indicators' textual formulation. In the second, the Delphi method was used for content validity by eight experts who assessed the relevance of the definitions under the following aspects: "not relevant"; "little relevant"; "quite relevant"; "highly relevant". The Content Validity Index (CVI) was used, with a value greater than 0.78 for agreement analysis. Results The CD CVI was unanimous for 15 indicators; CD were fully consensual for 17 indicators; MOD was obtained a CVI of 1.00 for 13 indicators. The other items had a CVI of 0.88. The items that did not reach 1.00 of agreement were revised, according to experts' suggestions, with the aim of improving and providing greater clarity for instrument application. Conclusion The definitions were constructed and, at the time of validity, reached a satisfactory degree of agreement among experts, and some were unanimous.

Evaluation of knowledge, prevalence and effects of opioid abuse among undergraduate students in a public university

In Nigeria currently, opioids are the second most widely used substances among young individuals after cannabis. A review of several literatures reported the prevalence of drug abuse, especially tramadol and codeine, among Nigerian students as 20% - 40%. The aim of this study was to determine the knowledge, prevalence, factors and effects associated with opioid abuse among final year undergraduate students. A cross- sectional study was carried out at a public University. A validated questionnaire was self-administered to 395 respondents. Data obtained were organized and analysed with Microsoft Excel and SPSS version 25. Descriptive statistics was done; frequencies and proportions were used to summarize variables of interest. Chi square test was done for association between variables and opioid abuse. Ethical considerations were observed. A response rate of 98.48% was obtained from the respondents. A total of 101 (26%) respondents used opioids. The most popular opioids abused among the respondents are codeine and tramadol (60 and 63 respondents respectively). A total of 5 respondents used heroin, 3 use pentazocine while only 1 respondent uses oxycodone and morphine. It was observed that majority of the users were males (76%). Peer pressure was the major factor, effects of opioid abuse observed were drowsiness, absence from lectures, examinations and altered daily activities (eating, sleeping and mood). The study revealed a good knowledge of opioid drugs and a high prevalence of opioid abuse among final year students. Tramadol and codeine were the most abused opioids among the respondents. Major effects of opioid abuse were alteration in daily functions and absence from academic activities.