Genetic counseling for hearing loss today / 临床耳鼻咽喉头颈外科杂志

Genetic counseling for hearing loss today originated from decoding the genetic code of hereditary hearing loss, which serves as an effective strategy for preventing hearing loss and constitutes a crucial component of the diagnostic and therapeutic framework. This paper described the main principles and contents of genetic counseling for hearing loss, the key points of counseling across various genetic models and its application in tertiary prevention strategies targeting hearing impairment. The prospects of an AI-assisted genetic counseling decision system and the envisions of genetic counseling in preventing hereditary hearing loss were introduced. Genetic counseling for hearing loss today embodies the hallmark of a new era, which is inseparable from the advancements in science and technology, and will undoubtedly contribute to precise gene intervention!

Projeto social, esporte e educação: a produção da identidade no ensino do taekwondo / Social project, sport and education: the production of identity in teaching taekwondo / Proyecto social, deporte y educación: la producción de la identidad en la enseñanza del taekwondo

Por meio de algumas noções conceituais produzidas no campo dos Estudos Culturais e entrevistas narrativas com participantes de um projeto social de ensino do Taekwondo, vinculado ao Programa Escola da Família, analisamos como projetos desse tipo influenciam na vida de jovens em situação de vulnerabilidade social. Consideramos que tais projetos produzem identidades e impactam as subjetividades dos jovens atendidos, quando estes não se adéquam aos discursos hegemônicos de classe social, gênero, saúde e educação; contribuem para que crianças e jovens permaneçam à margem da sociedade em que se encontram e, por consequência, favorecem a promoção de políticas que os mantém tutelados pelo Estado.

Through some conceptual notions produced in the field of Cultural Studies and narrative interviews with participants from the social project the teaching of Taekwondo linked to the Escola da Família Program, we analyzed how projects of this type influence the lives of young people in situations of social vulnerability. We consider that projects like this impact the subjectivities of the young people who is inside the project, when they are not adapted to the hegemonic discourses of social classes, gender, health and education; they help children and young people to remain on the margins of the society in which they find themselves and, consequently, favoring the promotion of policies that keep them under the tutelage of the State.

Através de algunas nociones conceptuales producidas en el campo de los Estudios Culturales y entrevistas narrativas con los participantes del un proyecto social de la enseñanza del Taekwondo, vinculado al Programa Escola da Família, analizamos cómo proyectos de este tipo influyen en la vida de los jóvenes en situaciones de vulnerabilidad social. Consideramos que proyectos como este impactan las subjetividades de los jóvenes atendidos, cuando no se adaptan a los discursos hegemónicos de clase social, género, salud y educación; ayudan a los niños, niñas y jóvenes a permanecer al margen de la sociedad en la que se encuentran y, en consecuencia, favorecen la promoción de políticas que los mantengan bajo la tutela del Estado.

A contribuição da Ergonomia para a segurança no trabalho / Ergonomics contribution to occupational safety

Resumo Introdução: processos de alto risco com elevadas taxas de acidentes desafiam a segurança. Por outro lado, sistemas ultrasseguros conquistaram ótimos indicadores. Em ambos, a prevenção parece ter chegado a um limite - em um deles, porque parece impotente para gerar prevenção; no outro, porque foi tão bem-sucedida que parece impossível avançar. Objetivo: evidenciar a contribuição da Ergonomia em prol da segurança, nas situações descritas, suas possibilidades ainda por explorar, entre elas a Ergonomia de concepção na integração homem-máquina (sistemas informatizados). Método: análise comparativa dos achados oriundos de estudos ergonômicos em sistemas de produção com altas taxas de acidentes e sistemas ultrasseguros. Discussão: a análise da atividade dos motofretistas mostrou que existem alternativas de ação ainda não exploradas entre as relações de trabalho desfavoráveis e a percepção de inevitabilidade dos acidentes. Nos sistemas ultrasseguros, o aparente limite pode ser superado com os avanços recentes na análise da ação e cognição situadas e na construção de espaços de debate que permitam o retorno da experiência de campo. Em sistemas informatizados, as práticas de projeto colaborativo, que se valem da experiência dos trabalhadores para alimentar as dinâmicas de aprendizagem e a confiabilidade técnica, são possibilidades ainda pouco praticadas na Engenharia de Segurança.

Abstract Introduction: while high-risk processes with high accident rates challenge safety, High Reliability Organization (HRO) achieve excellent indicators. In both cases, prevention seems to have reached a limit. In the former, because it seems powerless to generate prevention; in the latter, because it has been so successful that it seems impossible to reach greater levels. Objective: to highlight the contribution of Ergonomics to safety in these situations, pointing out unexplored possibilities such as design Ergonomics in man-machine integration (computerized systems). Method: comparative analysis of findings from ergonomic studies on production systems with high accident rates and HRO. Discussion: analysis of the motorcycle freight drivers' activity revealed alternatives yet to be explored between unfavorable work relations and the perceived inevitability of accidents. The apparent limit of HRO can be overcome with recent advances in the analysis of situated action and cognition and by building debate spaces based on field experience. Collaborative design practices, which draw on worker experience to feed learning dynamics and technical reliability, remains a poorly explored possibility in Safety Engineering when it comes to computerized systems.

UBUIngenio: extracurricular enrichment programme for the improvement of high ability students' creative thinking

Background: High-ability students require effective educational strategies. This study introduces and evaluates a curriculum enrichment programme aimed at enhancing cre ativity. The programme is based on a competency framework and was implemented using variations of Project-Based Learning (PBL) strategies. Method: A quasi-experimental design compared two interventions using pre-test and post-test groups. The first intervention (N = 38) involved a 12-week PBL unit focused on designing a video game using block-based program ming through Scratch. The second intervention (N = 51), also lasting 12 weeks, comprised three separate projects involving vectorial design and programming of an Arduino-based ro bot. Both interventions used strategies for creative-thinking development. The sample includ ed high-ability students from 8 to 12 years of age. Results: Both interventions significantly increased creativity, with no statistical differences between them. This suggests that both types of PBL interventions effectively improved participants' creativity. Conclusions: This study suggests that PBL-based curricular enrichment programmes are effective in fostering creativity among high-ability students.

Antecedentes: Los estudiantes con alta capacidad requieren estrategias educativas efectivas. Este estudio presenta y evalúa un programa de enriquecimiento curricular diseñado para mejorar la creatividad. El programa se basa en un marco de competencias y se implemen tó utilizando variaciones de estrategias de aprendizaje basado en proyectos (ABP). Método: Un diseño cuasi-experimental comparó dos intervenciones utilizando grupos pretest y postest. La primera intervención consistió en una unidad de ABP de 12 semanas centrada en el diseño de un videojuego utilizando programación basada en bloques mediante Scratch. La segunda intervención, también de 12 semanas de duración, consistió en tres proyectos independientes de diseño vectorial y programación de un robot basado en Arduino. En ambas intervencio nes se utilizaron estrategias para el desarrollo del pensamiento creativo. La muestra incluía estudiantes con altas capacidades de entre 8 y 12 años. Resultados: Ambas intervenciones aumentaron significativamente la creatividad, sin diferencias estadísticas entre ellas. Esto sugiere que ambos tipos de intervenciones de ABP mejoraron efectivamente la creatividad de los participantes. Conclusiones: Este estudio sugiere que los programas de enriquecimiento curricular basados en ABP son efectivos para fomentar la creatividad entre los estudiantes con altas capacidades.

Entrenamiento para el desarrollo de competencias en evaluación de impacto social a gestores de proyectos

Introducción: El contexto tecnocientífico cubano actual promueve proyectos de ciencia, tecnología e innovación, que tributan al progreso del modelo de desarrollo económico social socialista que propone el país. Pero, en la práctica, estos proyectos evidencian poca sistematicidad en la evaluación de impacto social, lo que da al traste con la transformación social que se pretende. Debido a esto, se considera necesaria la superación de los profesionales que, desde las universidades cubanas, gestionan proyectos. Objetivo: Proponer un entrenamiento para el desarrollo de competencias en evaluación de impacto social para gestores de proyectos de las universidades cubanas. Materiales y métodos: El diagnóstico realizado con métodos científicos teóricos y con la aplicación de encuestas y entrevistas a gestores de proyectos, y el análisis documental a proyectos en ejecución y a sus resultados, así como a los documentos rectores del posgrado en Cuba, permitieron conformar la propuesta de entrenamiento que se presenta. Resultados: Se identificó un nivel bajo de conocimientos y habilidades en evaluación de impacto social de los proyectos, y una alta disposición hacia la superación profesional en el tema. Esto conduce a la propuesta de un entrenamiento que consta de acciones para el desarrollo de competencias en los gestores de proyecto. Conclusiones: El entrenamiento que se propone resulta una vía esencial para atender demandas y necesidades de superación profesional en torno a conocimientos, habilidades y valores, para la evaluación de impacto social por gestores de proyectos de las universidades cubanas.

Introduction: The current Cuban techno-scientific context promotes projects of science, technology and innovation, which contribute to the progress of the model of socialist social economic development the country proposes. But, in practice, these projects show little systematicity in the social impact assessment, which ruins the social transformation that is pretended. Due to this, it is considered necessary the upgrading of the professionals who manage projects of Cuban universities. Objective: To propose training for the development of skills in social impact assessment for project managers of Cuban universities. Materials and methods: The diagnosis, carried out with scientific-theoretical methods, and with the application of inquiries and interviews to project managers, and the documentary analysis of projects in execution and their results, as well as of leading documents of post-graduate studies in Cuba, allowed to elaborate the training proposal presented. Results: A low level of knowledge and skills in the social impact assessment of the projects and a high disposition towards professional upgrading on the topic were identified. This leads to the proposal of a training that consists on actions for the development of skills in project managers. Conclusions: The training proposed results an essential way to meet demands and needs of professional upgrading regarding knowledge, skills and values, for the assessment of the social impact by project managers of Cuban universities.

De lo no-velado a la capacidad de novelar. La virtualidad en la clínica con adolescentes durante la pandemia / From the unveiled to de capacity to novelize. Virtuality in clinic with adolecent during the pandemic / Du non voilé à la capacité de romancier. La clinique avec les adolescents pendant la pandémie / Do ñao-velar á capacidade de novelar. A clínica com adolescentes durante a pandemia

El presente artículo aborda las consecuencias psíquicas en los adolescentes, del aislamiento social obligatorio durante la pandemia de Covid19. Un acontecimiento social que dio lugar a procesos creativos y patológicos. La virtualidad como herramienta tecnológica ha transformado las formas del lazo social y de la subjetividad, pero también ha permitido sostener una continuidad en los dispositivos de salud y de educación. En el caso de los tratamientos se modificaron los encuadres dando lugar a nuevas formas de atención, con sus particularidades en el trabajo clínico con adolescentes AU

This article is about the psychological consequences in Atdolescents of mandatory social isolation during the Covid19 pandemic. A social event that gave rise to creative and pathological processes. Virtuality as a technological tool has transformed the forms of social bond and subjectivity, but it has also made it possible to sustain continuity in health and education devices. In the case of treatments, the frames were modified, giving rise to new forms of care, with their particularities in clinical work with adolescents AU

Cet article aborde les conséquences psychologiques chez les adolescents de l'isolement social obligatoire pendant la pandémie de Covid19. Un événement social qui a donné lieu à des processus créatifs et pathologiques. Levirtualité comme outil technologique a transformé les formes de lien social et de subjectivité, mais elle a aussi permis de pérenniser les dispositifs de santé et d'éducation. Dans le cas des traitements, les cadres ont été modifiés, donnant lieu à de nouvelles formes de soins, avec leurs particularités dans le travail clinique avec les adolescents AU

Este artigo aborda as consequências psicológicas em adolescentes do isolamento social obrigatório durante a pandemia de Covid19. Um acontecimento social que deu origem a processos criativos e patológicos. A virtualidade como ferramenta tecnológica transformou as formas de vínculo social e subjetividade, mastambém possibilitou sustentar a continuidade dos dispositivos de saúde e educação. No caso dos tratamentos, os quadros foram modificados, dando origem a novas formas de cuidado, com suas particularidades no trabalho clínico com adolescentes AU

La interpretación del sueño y sus similitudes con el juego: una técnica para aplicar en un dispositivo clínico de Françoise Dolto / Les similitudes dans l'interpretation du reve et du jeu: une technique applicable dans un lieu d'accueil enfant-parent / Dream interpretation ant its similarities with the play: a method to apply ina Dolto's maison verte project / A interpretação do sonho e suas semelhanças com a brincadeira: uma técnica para aplicar em um dispositivo clínico de Françoise Dolto

¿Cómo nos puede ayudar el método de la interpretación de los sueños a entender los elementos arcaicos presentes en el juego del niño de 0 a 4 años, en un dispositivo clínico inspirado en la Maison Verte creada por Françoise Dolto? En este artículo describiremos las similitudes entre el sueño y el juego del niño, particularmente con respecto al trabajo del sueño. Propondremos que los mismos mecanismos del sueño están presentes en el juego del niño como parte de un contenido manifiesto. Enseguida propondremos que es posible interpretar el contenido latente del juego trasponiendo el método de la interpretación de los sueños gracias a la información aportada por los padres que acompañen al niño. Para explicar esta técnica, examinaremos el ejemplo de juego de unos niños, tomado de un Lugar de Acogida de Niños y Padres que se adhiere a los principios de la Maison Verte AU

Comment la méthode d'interprétation des rêves peut-elle nous aider à comprendre les éléments archaïques présents dans le jeu des enfants de 0 à 4 ans, dans un dispositif clinique inspiré de la Maison Verte créée par Françoise Dolto? Dans cet article, nousdécrirons les similitudes entre le rêve et le jeu de l'enfant, notamment en ce qui concerne le travail du rêve. Nous proposerons que les mêmes mécanismes oniriques sont présents dans le jeu de l'enfant dans le cadre d'un contenu manifeste. Ensuite, nous proposerons qu'il est possible d'interpréter le contenu latent de ce jeu en transposant la méthode d'interprétation des rêves grâce aux informations fournies par les parents accompagnan l'enfant. Pour expliquercette technique, nous examinerons un exemple de jeu d'enfants, tiré d'un Lieu d'Accueil pour Enfants et Parents qui adhère aux principes de la Maison Verte AU

How can the dream interpretation method help us to understand the archaic elements present in the play of children from 0 to 4 years old, in a clinical device inspired by the Maison Verte project created by Françoise Dolto? In this article we will describethe similarities between the child's dream and play, particularly regarding to dream-work. We will propose that the same dream mechanisms are present in the child's play as part of a manifest content. Then we will propose that it is possible to interpret the latent content of this play by transposing the dream interpretation method thanks to the information provided by the parents. To explain this technique, we will examine an example of children's play, taken from a Dolto's Maison Verte Project AU

Como o método da interpretação dos sonhos pode nos ajudar a compreender os elementos arcaicos presentes nas brincadeiras das crianças de 0 a 4 anos, em um dispositivo clínico inspirado na Maison Verte criada por Françoise Dolto? Neste artigo, descreveremos as semelhanças entre o sonho e a brincadeira da criança, principalmente no que diz respeito ao trabalho onírico. Proporemos que os mesmos mecanismos oníricos estão presentes na brincadeira da criança como parte de um conteúdo manifesto. Imediatamente propomos que é possível interpretar o conteúdo latente desta brincadeira transpondo o método de interpretação dos sonhos graças às informações fornecidas pelos pais. Para explicar est técnica examinaremos um exemplo de brincadeira infantil, retirado de um Local de Acolhimento para Crianças e Pais que segue os princípios da Maison Verte AU

Experiências de pessoas em situação de rua com o uso de substâncias psicoativas: um estudo no contexto do Distrito Federal / Experiences of homeless people with use of psychoactive substances: a study in the context of federal distric / experiencias de personas en situación de calle con el uso de sustancias psicoactivas: un estudio en el contexto del distrito federal

Investigou-se vivências de pessoas em situação de rua que usam/usaram substâncias psicoativas, a partir de um programa de reinserção social e geração de renda, no Distrito Federal. Trata-se de estudo realizado com quatro adultos a partir de entrevistas semiestruturadas. As informações foram analisadas pela Análise de Conteúdo, gerando as categorias: caracterização do uso de substâncias psicoativas; experiência com programas para usuários de álcool e outras drogas; história de vida e a situação de rua; projeto social e uso de substâncias psicoativas. Como resultados, evidenciou-se como os participantes se relacionam com substâncias psicoativas, como o projeto social investigado se configura como potencializador para transformação de vidas. Conclui-se que a história de vida dos sujeitos está ligada à situação de rua e uso de substâncias psicoativas, destacando-se o potencial transformador de programas sociais, possibilitadores de desenvolvimento econômico e social, e que modelos baseados em abstinência se mostraram ineficazes como forma de tratamento. (AU)

The experiences of homeless people who use/have used psychoactive substances were investigated, based on a program of social reintegrationand income generation, in the Federal District. This is a study carried out with four adults through semi-structured interviews. The information was analyzed by Content Analysis, generating the following categories: characterization of the use of psychoactive substances; experience with programs for users of alcohol and other drugs; life history and the street situation; social project and use of psychoactive substances. As a result, it was evidenced how the participants relate to psychoactive substances, how the investigated social project is configured as a potentiator for the transformation of lives. It is concluded that the life history of the subjects is linked to the homeless situation and the use of psychoactive substances, highlighting the transforming potential of social programs, enabling economic and social development, and that models based on abstinence proved to be ineffective as a way to of treatment. (AU)

Se indagaron las experiencias de personas en situación de calle que consumen/han utilizado sustancias psicoactivas, a partir de un programa de reinserción social y generación de ingresos, en el Distrito Federal. Se trata de un estudio realizado con cuatro adultos a través de entrevistas semiestructuradas. La información fue analizada por Análisis de Contenido, generando las siguientes categorías: caracterización del uso de sustancias psicoactivas; experiencia con programas para usuarios de alcohol y otras drogas; historia de vida y situación de la calle; proyecto social y consumo de sustancias psicoactivas. Como resultado, se evidenció cómo los participantes se relacionan con las sustancias psicoactivas, cómo el proyecto social investigado se configura como un potenciador para la transformación de vidas. Se concluye que la historia de vida de los sujetos está vinculada a la situación de calle y al uso de sustancias psicoactivas, destacando el potencial transformador de los programas sociales, viabilizando el desarrollo económico y social, y que los modelos basados en la abstinencia demostraron ser ineficaces como vía de tratamiento. (AU)

Relevance of Project Evaluation and Review Technique (PERT) for Procurement of Equipments in a Government Medical College and Hospital in North-East India

Introduction: Continuous procurement of various equipments in the hospitals is essential to keep up with global progress of healthcare services. In public sectors, procurement process largely depends on budget sanctions and also by a number of formal procedures and rules which leads to delayed procurement. With this prevalent scenario, the present study was carried out to evaluate the procurement of two major equipments in an apex tertiary care institute using Project Evaluation and Review Technique (PERT). Objective: This study was done to evaluate the procurement of two major equipments using PERT in a tertiary care institute. Method: This study was conducted using Operational Research technique in an apex tertiary care institute i.e., medical college and hospital, in one of the North Eastern states of India. All the procurements related to equipments in that teaching hospital initiated in the financial year 2021 were listed. Out of them, two procurement files were selected by simple random sampling; procurement of Operating Table and Bio Safety cabinet Level – III. Project Evaluation and Review Technique (PERT) was applied to calculate the possible reduction in time in the whole procurement process. Results: The present study showed that procurement of Operating table took 185 days where minimum 8 days could have been saved and procurement of Bio-Safety cabinet Level-III was completed by 702 days where minimum 196 days could have been saved. Conclusion: Application of PERT in this procurement evaluation process can play significant role by calculating critical path and predicting the possible delay.

Uma análise do projeto de educação nos documentos do MST (1990-2014): a cultura corporal em debate / n analysis of the education project in the MST documents (1990-2014): corporal culture in debate / Un análisis del proyecto educativo en los documentos del MST (1990-2014): cultura corporal en debate

No presente estudo, referenciamos o debate sobre Educação e Movimentos Sociais, através das contribuições do Movimento dos Trabalhadores Rurais Sem Terra (MST). Desse modo, buscamos apresentar mediações entre o Projeto de Educação do MST e a Cultura Corporal, a partir do seguinte problema: Se e como a Cultura Corporal está retratada no projeto de Educação do MST? O objetivo é caracterizar a concepção de Cultura Corporal com base nos textos/documentos sobre Educação sistematizados pelo MST. Para subsidiar a análise, trazemos as contribuições teóricas de Antonio Gramsci, sobre cultura, princípio educativo, escola unitária e o conceito de intelectual, bem como o Coletivo de Autores sobre a perspectiva de Cultura Corporal (AU).

In the present study, we aim to the debate on Education and Social Movements, through the contributions of the Landless Rural Workers Movement (MST). In this way, wes eek to present mediations between the MST Education Project and Corporal Culture, base don't he following problem: I fan dhow is Corporal Culture portrayed in the MST education project? The object ivies to characterize the concept of Corporal Culture from the texts/documents on education systematized by the MST. To support he analysis, we bright et he oretical contributions of Antonio Gramsci, on culture, educational principle, unitary school and the concept of intellectual, as well as the Coletivo de Autores on the perspective of Corporal Culture (AU).

En este estudio nos referimos al debate sobre Educación y Movimientos Sociales, a través de los aportes del Movimiento de Trabajadores Rurales Sin Tierra (MST). Así, buscamos presentar mediaciones entre el Proyecto Educativo MST y la Cultura Corporal, partiendo del siguiente problema: ¿Si y cómo se retrata la Cultura Corporal en el proyecto educativo MST? El objetivo es caracteriza el concepto de Cultura Corporal a partir de los textos/documentos sobre educación sistematizados por el MST. Para sustentar elanálisis, traemoslos aportes teóricos de Antonio Gramsci, sobre cultura, principio educativo, escuela unitaria y el concepto de intelectual, así como el Coletivo de Autores en la perspectiva de la Cultura Corporal (AU).

Effectiveness of project-based learning in pharmacology as a teaching learning tool for second MBBS students in a medical college in South India

Background: Being a vast, volatile and dynamic subject, innovative teaching learning methods are required to generate student’s interest in learning Pharmacology. Aims and Objectives: The aim of the study was to study the effectiveness of project-based learning (PBL) program (preparation of a poster or building a model) in improving learning in Pharmacology and to obtain student feedback on the program. Materials and Methods: Twenty-one topics with equal difficulty level were selected from the “must know” portions in Pharmacology. 97 students of second professional MBBS were divided into 12 groups for building a model and nine groups for preparing a poster. Groups for preparing a model had minimum five members and groups for preparing a poster had minimum four members in each group. They were asked to prepare the project based on the topic in 1 month as group task. On the day of the submission, one of the group members presented the model/poster and all other students attended the presentation. A test of ten questions (section A) was done on the students before the presentation which was entirely based on their own project. On the same day, pre-test (section B) having 20 questions, one from each topic was done before the presentation. Post-test was done for all the students immediately after the presentations and also after 1 week. Feedback forms were given to the students after the presentation. Data collected from both the projects were analyzed separately. Results: The improvement in immediate post-test was significant in students involved in both the projects compared to the pretest results. In the individual project assessment, ?50% marks were scored by 89.8% of the students involved in model building and 87.9% of the students involved in poster preparation. 46 students (78%) involved in model building and 24 students(72.7%)involved in the poster preparation opined that the overall process of preparing and presenting the poster/model was extremely enjoyable. 49 students (83.05%) involved in model building and 28 students (84.8%) involved in poster preparation opined that the project work was extremely helpful in understanding the topic. Conclusion: PBL can be incorporated as a novel teaching learning tool in Pharmacology.

Exploration and practice of research-based audit in the management of multi-campus infrastructure projects in public hospitals / 中华医院管理杂志

Internal auditing for infrastructure projects carried at multi-campuses of a hospital to support hospital strategic growth, is a crucial means in raising the business performance and capacity. A public hospital made a research-based audit to examine infrastructure projects across multi-campuses since 2021. At the pre-trial stage, the audit plan was created in a " two-coordination" manner to define the scope of authority and responsibility of audit objectives; at the in-trial stage, audit priorities were focused on in advance through intelligent early warning, and full-course audit guidance and quality control was made through online real-time audit operation system; at the post-trial stage, efforts were focused on resolving problems, summarizing audit findings. The authors introduced the practice of the hospital and further explained the specific application methods and achievements through case analysis, providing reference for internal audit of infrastructure projects in multi-campus hospitals, for reference in likewise internal auditing.

Thinking and practice of risk-based monitoring strategies in Investigator initiated Trials / 中华医学科研管理杂志

Objective:To discuss the scientificity and feasibility of risk-based monitoring strategies in Investigator initiated Trials.Methods:" Guideline for Good Clinical Practice" promulgated by NMPA, " Oversight of Clinical Investigations-a Risk-based Approach to Monitoring" and " A Risk-Based Approach to Monitoring of Clinical Investigations Questions and Answers Guidance for Industry DRAFT GUIDANCE" promulgated by the US FDA and other documents were analyzed, the practical experience of Investigator initiated Trials was also summarized.Results:It was recommended that clinical investigators use risk-based monitoring strategies in Investigator initiated Trials. The main idea of risk-based monitoring is to determine the key process and key data of the study, carry out risk rating on the project, and adopt corresponding monitoring methods according to the risk level when formulating the monitoring plan. At the same time, during the clinical trial development process, the risk and data quality of the research center should be regularly evaluated to grasp the risk changes of different centers. In accordance with trends, adjust the method, content and frequency of monitoring.Conclusions:To apply risk-based monitoring strategies in Investigator initiated Trials is scientificity and feasibility. Risk based monitoring can meet the data quality requirements of clinical trials, without affecting the analysis results of the main outcomes, and can further improve the efficiency and effectiveness of monitoring.

Analysis on key points of ethics review of horizontal scientific research projects: Based on the ethics review management system of horizontal scientific research projects in a tertiary hospital / 中华医学科研管理杂志

Objective:This paper aims to promote the standardization of ethics review of horizontal scientific research projects and improve the ethics review quality by analyzing the current ethics review practice in a certain tertiary hospital, identifying common problems during the review process, illustrating relevant causes and proposing corresponding solutions.Methods:Through introducing the current situation of ethics review of horizontal scientific research projects in a tertiary level hospital, the differences between the main points of ethics review of horizontal scientific research projects and government-funded scientific research projects were analyzed, so as to sort out the common problems and possible causes in the process of ethics review of horizontal scientific research projects, and then explore the possible corresponding solutions.Results:Based on the characteristics of horizontal research projects, ethics review should focus on their scientific and social values, potential conflicts of interest, protection of subjects′ rights and interests, and whole-process management and quality assurance. At present, there are still many problems, such as a large number of projects, but not many projects with high research value, inadequate project process management, and ineffective implementation of ethics review opinions.Conclusions:The hospital should further improve the management system of horizontal scientific research project approval, bring in more comprehensive review regarding to both scientific and ethics review, engage more experts at the outset of project funding decision-making, set up ethics specialists, strengthen the process management of horizontal scientific research projects, strengthen ethical publicity and education, and improve the ethical awareness of researchers to fully protect the rights and interests of subjects and promote the high-quality development of clinical research.

Challenges and countermeasures of Investigator-Initiated Trial of oncology / 中华医学科研管理杂志

Objective:In order to put forward relevant measures and suggestions to improve the quality of the Investigator-Initiated Trials of oncology in medical institutions.Methods:Through literature research, comparative study, combined with the implementation and management of investigator initiated trials, the current status and challenges of the administration of these trials were analyzed.Results:Investigator-Initiated Trials of oncology become increasingly important. However, its quality is poor compared with Industry-Sponsored Trials due to insufficient funds and lack of effective supervision. Besides, four main challenges as follows were identified: lack of clinical research professionals, the quality concerns of ethical review in some institutions, insufficient funding for clinical research, and imperfect quality management system.Conclusions:Based on the actual needs of IITs of oncology, medical institutions should strengthen the talent cultivation, establish electronic information management platform, increase project support, strengthen scientific research supervision and deepen the awareness of risk prevention to improve the quality of investigator initiated trials.

Thinking of the cultivation mode of preventive medicine undergraduates based on student research training projects / 中华医学教育探索杂志

There are still some shortcomings in the training of preventive medicine undergraduates in China, such as outdated education mode, disjointed theory/practice, and lack of multi-dimensional integration. This paper proposes an attempt to reform the cultivation mode of preventive medicine undergraduates by combining student research training programs. However, many problems have been exposed during the implementation of the reform, and it has not achieved satisfactory results, especially in emergency management and solving practical problems. In order to cultivate practical preventive medicine talents in line with the needs of the times, the training mode based on student research training projects still needs considerable efforts in many aspects, including project approval, project guidance, project evaluation and so on.

Construction of perioperative activity program for minimally invasive esophageal cancer patients under enhanced recovery after surgery concept / 中国实用护理杂志

Objective:To construct a perioperative activity program for patients with minimally invasive esophageal cancer under enhanced recovery after surgery (ERAS) concept through literature review and Delphi method.Methods:This was a single-center and interview study. Databases and websites including PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Medive and other databases and websites were searched systematically for articles related to esophageal cancer and upper digestive tract cancer patients′ activities from January 1, 2002 to January 31, 2022. In this single-center and interview study, literature review and group discussion were conducted to form a preliminary activity program, and then Delphi method was used to further demonstrate the practicability and feasibility of the activity program.Results:The overall program and specific intervention methods of perioperative activity program for minimally invasive esophageal cancer patients under ERAS concept were constructed, including 3 first-level indicators, 9 second-level indicators and 35 third-level indicators.Conclusions:Perioperative activity program of patients with minimally invasive esophageal cancer is scientific and reasonable, which can provide reference for medical staff and patients.

Assessment on the implementation effect of basic public health service project in Jiangbei District of Chongqing / 上海预防医学

ObjectiveTo evaluate the implementation effect of the basic public health service project in Jiangbei District of Chongqing， so as to provide a basis for further improving the service content and social/economic benefits of the project. MethodsThe evaluation was conducted according to the “National Basic Public Health Service Regulations”， “National Basic Public Health Service Project Performance Evaluation Guidance Plan” and the assessment indicators， indicator requirements and weights of each project. The items were evaluated one by one， and each item was calculated and compared to obtain the trends in the three years from 2018 to 2020. ResultsThe evaluation results showed that the twelve contents of the basic public health service projects in Jiangbei District either met or exceeded the national requirements. The overall effect increased year by year， from 71.73 to 78.74 points. Eight of the twelve service contents have improved year by year， among which the report and processing of information related to infectious diseases and public health emergencies reached 100%， and the vaccination rate of “eight vaccines” reached 97%. Maternal and children （0-6 years old） health care increased significantly， rising by 39.89% and 36.62% respectively. Chronic disease health management was unsatisfactory. ConclusionThe effects of implementation of the basic public health service project is significant， and the service quality has improved year by year. The service content and assessment indicators are still imperfect and is worth of further research.

Gestão do trabalho interprofissional no projeto terapêutico singular: proposta de modelo de processo de trabalho / Management of interprofessional work in the singular therapeutic project: proposal for a work process model

Objetivo: propor um modelo para organização das atividades de um Projeto Terapêutico Singular (PTS) no contexto da estratégia da Saúde da Família (ESF), facilitando a colaboração interprofissional. Método: Trata-se de pesquisa qualitativa. Utilizou-se a estratégia de pesquisa-ação, envolvendo uma equipe multiprofissional de saúde e ações de colaboração interprofissional para aprimorar a prática. A pesquisa-ação foi escolhida por mostrar-se adequada para estudos em cenários sociais, em contextos diversos. Os pesquisadores e a equipe acordaram que a discussão do PTS ocorresse em reuniões amplas para favorecer a discussão, reflexão e propostas de ações para o caso. O trabalho de campo envolveu aproximadamente 20 reuniões com a equipe que geravam subsequentes momentos reflexivos da pesquisa. Essa dinâmica favoreceu a proposta do modelo. As etapas do trabalho da pesquisa foram reconhecimento do problema, planejamento, implementação e avaliação. Resultado: Nas reuniões do trabalho coletivo, a equipe pesquisadora percebeu problemas no processo do PTS, tais como: falta de clareza dos objetivos; planejamento e direcionamento das ações colaborativas interprofissionais pouco efetivos para envolver paciente e família no cuidado de saúde. Nesse contexto, propôs-se um modelo de PTS com quatro etapas: Discussão do caso, Designação, Execução e Encerramento ou nova abordagem do processo de atenção. Conclusão: O modelo proposto é uma contribuição teórica e necessita de mais estudos empíricos para validar sua aplicação no âmbito da ESF. Identificou-se, como limitante para a gestão do cuidado para o PTS, a falta de formação pré- e pós-graduada em educação interprofissional dos participantes. No entanto, o modelo se justifica na medida que ajuda a construir ações interprofissionais, recomendadas pelo Sistema Único de Saúde (SUS) e órgãos internacionais da saúde (OMS e OPAS) (AU).

Objective: propose a model for organizing the activities of a Singular Therapeutic Project (STP) in the context of Family Health Strategy (FHS), contemplating interprofessional collaboration. Method: It is qualitative research. The action-research strategy was used, involving a multidisciplinary health team and interprofessional collaboration actions, in order to improve the practice. Action research was chosen because it is suitable for studies in social settings, in different contexts. The researchers and the team agreed the discussion of the STP would take place in large meetings to encourage discussion, reflection and proposals for actions to be taken for the case. Fieldwork involved approximately 20 meetings with the team that generated subsequent reflective moments of the research. This dynamic favored the proposal of the model. The stages of the research work were: problem recognition, planning, implementation and evaluation. Result: In the collective work meetings, some flaws in the STP process were noticed, such as: a lack of clarity of objectives; few interprofessional collaborative actions directed and planned along with the patient and family and low resolution. Thus, a four-step model was proposed: staff meeting, assignment of STP cases, executing the STP, and closing the STP. These steps range from case selection to completion of the STP, or definition of a new care approach by the team. Conclusion: The proposed model is a theoretical contribution and needs further empirical studies in order to validate its application within the FHS. The lack of pre and postgraduate training in interprofessional education of the participants was identified as a limiting factor for the care management for the STP. However, the model is justified as it helps to build interprofessional actions, recommended by the Unified Health System (UHS) and international health agencies (WHO and PAHO) (AU).

Relevance of national, regional and global virome projects on pandemics prediction, prevention, and control: a social network analysis of GVP-citing articles

BACKGROUND The Global Virome Project (GVP) was proposed in 2018 as an evolution of the USAID PREDICT project and was presented as a "collaborative scientific initiative to discover zoonotic viral threats and stop future pandemics". The immediate response was mixed, with public health and scientific communities representatives showing skepticism, if not direct opposition. OBJECTIVES The economic, social, and health consequences of the coronavirus disease 2019 (COVID-19) pandemic demonstrated how unprepared the world was in the face of new pandemics. This paper analyses the impact of the GVP on the scientific and public health communities. METHODS Published scientific articles that cited the two 2018 seminal publications proposing the project were analysed using social network analysis methods. FINDINGS Encompassing the periods before and after the onset of the Covid-19 pandemic, the results indicate that (i) the concepts of the GVP have received more support than opposition in the scientific literature; (ii) its foundations should be updated to address the specific criticisms. MAIN CONCLUSIONS Shifting focus to national virome projects can provide tangible, regional benefits that can positively contribute towards a consensus on achieving a high level of preparedness for the ever-present possibility of the following global viral pandemic.