Risk assessment of investigator initiated trials at the proposal stage / 中华医院管理杂志

Objective:To assess possible risk factors and their respective levels in the whole process of investigator initiated trial(IIT)projects proposed in the proposal stage, for reference in formulation of risk management plans.Methods:Through literature analysis and research group discussions, the risk factors of IIT projects and risk level assessment criteria were preliminarily identified, and a consultation questionnaire was developed as a result. Delphi method was used to further optimize the risk factors and determine their risk levels. Data obtained from the consulfation were analysied by descriptive.Results:The recovery rates of two rounds of expert consultation were both 100%, and the degree of expert authority was 0.942. The survey finalized 38 risk factors, including extremely high risk, high risk, medium risk, low risk and very low risk factors of 17(44.7%), 15(39.5%), 3(7.9%), 2(5.3%) and 1(2.6%) respectively.Conclusions:This study determined a risk evaluation system of IIT projects in the proposal stage. This system can identify risks of IIT projects at an early stage, facilitating early intervention of problems existing in such projects, and minimize risks to the rights and safety of patients.

A study to assess the completeness of informed consent documents for biomedical research on human participants submitted to the institutional ethics committee of a tertiary care hospital

Background: Informed consent is an essential pre-requisite for research on human participants. However, many studies have shown that informed consent documents (ICDs) are incomplete and lack many of the essential elements. The objective of the study was to assess the completeness of ICDs submitted to an institutional ethics committee (IEC) against the Indian Council of Medical Research (ICMR) ethical guidelines for biomedical research on human participants.Methods: This is a retrospective cross-sectional study. The ICDs submitted to the IEC during the period from January 2015 to December 2017 were reviewed for completeness, with the help of a checklist which is based ICMR ethical guidelines for biomedical research on human participants 2006.Results: A total of 212 ICDs were reviewed during the study period. More than 50% of the ICDs have clearly explained many of the essential elements like nature and purpose of the study (62.3%), voluntary participation (98.6%), procedures (68.9%), risks (71.2%), benefits (92.9%), alternative treatments (60.7%), maintaining confidentiality (99.1%), no loss of benefits on withdrawal from the study (87.8%) and contact details of principal investigator (99.5%). However, the other essential elements of the ICD are either not mentioned or not clearly explained.Conclusions: This study has shown that although majority of the ICDs submitted for review by the IEC have mentioned many of the essential elements, some of the elements like contact details of Chairman of IEC, future use of sample, compensation for trial related injury and provision of counseling for consent of genetics testing have not been stated.

Diagnosis and treatment of pemphigus vulgaris: an expert proposal (2020) / 中华皮肤科杂志

Pemphigus vulgaris is a kind of autoimmune bullous disease which seriously threatens human health. In order to standardize the diagnosis and treatment of this disease, domestic famous experts in this field were invited to make the recommendations after rigorous discussion. According to clinical manifestations, pemphigus vulgaris can be divided into cutaneous-mucosal type, cutaneous type and mucosal-dominant type. Its pathological manifestations are characterized by acantholysis above the basal layer. According to clinical manifestations, histopathological features, immunofluorescence findings and serum anti-desmoglein antibody levels, the diagnosis of pemphigus vulgaris can be made. Systemic glucocorticoids are the first-line treatment, and the doses of glucocorticoids should vary with disease severity. Early combination with immunosuppressive agents or rituximab is recommended for the treatment of patients with moderate or severe pemphigus vulgaris, and intravenous immunoglobulin is recommended to be combined with biological agents. If necessary, plasma exchange and stem cell transplantation can be performed. In the course of treatment, changes of patients′ condition should be closely observed to reduce the occurrence of adverse reactions.

Outcomes of Pharmacotherapeutic Intervention Provided by Hospital Pharmacists for Geriatric Health Service Facility Users / 医薬品情報学

Objective: The number of pharmacists regularly working at geriatric health service facilities is limited, but many users of such facilities have multiple chronic conditions and receive continuous pharmacotherapy, simultaneously using numerous different types of oral drugs. We examined the outcomes of pharmacotherapeutic intervention provided by hospital pharmacists for geriatric health service facility users.Methods: We examinedthe outcomes of active pharmacotherapeutic intervention providedby hospital pharmacists for 154 facility users.Results: After the intervention, there were significant decreases in the mean number of types and price of drugs used, as they decreased from 7.38 to 6.17 and 368.3 to 309.2 yen/day, respectively. The number of prescription drugs changed was 300, and 206 of these changes were proposedby the pharmacists. The efficacy-basedcategories that these drugs belongedto widely ranged. The most frequent reasons for change were the “disappearance of symptoms”, “based on indications”, and “suspected adverse events”. Adverse events variedfrom mildto those that may leadto severe conditions.Conclusion: Pharmacotherapeutic interventions by pharmacists may optimize pharmacotherapy, reduce polypharmacy, and reduce the financial burden on geriatric health service facilities.

Modelo para el reforzamiento del aprendizaje con dispositivos móviles / Model for the reinforcement of learning with mobile devices

Resumen La proliferación de dispositivos inteligentes móviles en la sociedad despierta un interés por conocer cómo los recursos de los dispositivos pueden usarse en el contexto educativo, ya que los estudiantes llevan sus teléfonos inteligentes (Smartphones) con ellos todo el tiempo. El objetivo del presente estudio analizó diferentes modelos para el desarrollo de aprendizajes en contextos móviles, puntualizado en mecanismos de refuerzo para la adaptación de los dispositivos móviles en la enseñanza tradicional. La comparación de las características de los modelos analizados sirvió de base para la propuesta de un modelo de enseñanza, para el reforzamiento de aprendizajes en entornos móviles, por lo que se desglosan los aspectos y características actuales más relevantes de los dispositivos para ofrecer al lector estrategias para el reforzamiento de su tarea docente, con seguimiento, soporte y la evaluación de los aprendizajes. La propuesta se basa en la esencia comunicacional de los dispositivos, uso de multimedia y escenarios resultantes de la inteligencia colectiva para interiorizar aprendizajes de manera independiente. Se recomienda implementarse en nivel secundaria, media superior y superior, a excepción del preescolar o en los primeros grados de educación primaria.

Abstract The proliferation of mobile smart devices in society arouses an interest in knowing how the resources of the devices can be used in the educational context, since students carry their Smartphones with them all the time. The present study analyzes different models for the development of learning in mobile contexts, focusing on reinforcement mechanisms for the adaptation of mobile devices in traditional education. The comparison of the characteristics of the analyzed models served as the basis for the proposal of a learning reinforcement model in mobile contexts. To that aim, the most relevant components and characteristics of current devices are outlined to offer the reader strategies for the reinforcement of his or her teaching practice, including followup, support and evaluation of learning tasks. The proposal is based on the communicative essence of the devices, use of multimedia and scenarios resulting from collective intelligence to interiorize learning independently. The model has been designed for its implementation in secondary and higher education levels, rather than in preschool or the first grades of primary education.

Proposta crítico-emancipatória: com a palavra o autor / Proposal critical-emancipatory: the word with the author / Propuesta crítico-emancipadora: con la palabra el autor

Objetivamos com este artigo analisar o desenvolvimento de propostas críticas que se apresen-tam enquanto referência para a área da Educação Física. Em específico,a Proposta Crítico-Emancipatória, a partir das considerações feitas por seu próprio autor: Elenor Kunz. Para isso, realizamos um diálogo mediado por temas centrais, tais como: momento histórico de elabora-ção da proposta; percurso de sua existência; interação com políticas educacionais; experiên-cias desenvolvidas; revisões realizadas; atualidade; e perspectivas. Consideramos essencial analisar a realidade existente para que possamos levantar novas problemáticas e traçar novos objetivos para o campo de conhecimento da Educação Física.

The aim with this articleis to analyze the development ofcritical proposals that are presented as reference for the area of Physical Education. In particular, the proposed critical-emancipatory, from the considerations made by your own author. For this reason, we dialog mediat by central themes, such as: historic moment of drafting the proposal; path of their ex-istence; interaction with educational policies; experiences developed; reviews performed; Timeliness; and prospects. We believe essential to analyze the existing reality, so we can raise new issues and draw new objectives for the field of knowledge of Physical Education.

Nuestro objetivo con este artículo es analizar el desarrollo de propuestas críticas que se pre-sentan como referencia en el área de la Educación Física. Específicamente la propuesta críti-co-emancipadora, partiendo de las consideraciones de su propio autor. Para ello, realizamos diálogos mediados por temas centrales, como: momento histórico de elaboración de la pro-puesta, trayectoria de su existencia, interactuación con políticas educacionales, experiencias desarrolladas, revisiones ya hechas, actualidad y perspectivas. Consideramos esencial analizar la realidad existente, para que se puedan poner de relieve nuevas problemáticas y trazar nue-vos objetivos para el campo de conocimiento de la Educación Física.

Traditional Chinese medicine postgraduates dissertation proposal: study on clinical literature of traditional Chinese medicine / 国际中医中药杂志

Topic selection of traditional Chinese medicine (including integrative medicine) graduate students were different from other topics, has its own characteristics and methods. This article summarizes the range of topics and research methods of TCM graduate students in the research of TCM clinical literatures. The study found that TCM clinical literature research can be divided into the disease nomenclature, theoretical origin and connotation research, literature research based on the characteristics of different TCM academic schools, understanding of disease and zheng-treatment law of traditional Chinese medicine academic dynastic history, ancient famous medical academic ideas and clinical evidence Empirical research, based on a series of ancient traditional Chinese medical books researches, traditional Chinese medical case studies. Each aspect has its own characteristics and methodological choices based on commonalities research. The research process is also different, but it is important to choose a good point for different TCM clinical problems or diseases, and to formulate a research content to adapt to the norms of research programs to ensure that the purpose of a clear, standardized processes, and make the results reliable.

Propuesta metodológica para el perfeccionamiento del trabajo de los colectivos de asignatura en las carreras de Medicina y Estomatología / Methodological proposal for the improvement of the work of subject of study collectives in the Medicine and Dentistry careers

Introducción: El profesional de la salud que se desempeñe como docente y dirija los colectivos de asignatura requiere entrenamientos metodológicos que permitan su preparación para la adecuación de los contenidos, el tratamiento político-ideológico y la implementación de las estrategias curriculares, así como el seguimiento a las dificultades encontradas en el proceso de enseñanza-aprendizaje. Objetivo: Diseñar una propuesta metodológica para el perfeccionamiento del trabajo de los colectivos de asignatura en las carreras de Medicina y Estomatología. Material y Métodos: Se realizó un estudio descriptivo de corte transversal con 22 profesores principales de asignaturas de las carreras de Medicina y Estomatología, del ICBP Victoria de Girón. El estudio se dividió en tres etapas. En la primera se analizaron los documentos que rigen el proceso docente y el trabajo de los colectivos de asignatura. Se diseñó una encuesta que evaluó los conocimientos acerca del trabajo de estos colectivos y una guía de observación. En la segunda se aplicó la encuesta para la identificación de las necesidades de aprendizaje de los profesores principales que participaron en el estudio y la observación al desarrollo de estos colectivos. En la tercera se desarrolló el taller y la actividad práctica para darles solución a las necesidades de aprendizaje identificadas, así como para debatir la propuesta para el perfeccionamiento del trabajo metodológico en este subsistema. Resultados: Con las observaciones realizadas a los colectivos de asignatura y la encuesta aplicada a los profesores principales se determinaron las necesidades de aprendizaje, se diseñó e implementó el taller, la actividad práctica y la propuesta metodológica para el desarrollo de estos colectivos. Conclusiones: Se diseñó una propuesta metodológica para el perfeccionamiento de los colectivos de asignatura que atiende las necesidades develadas y homogeniza el trabajo en sistema con el resto de los subniveles de organización metodológica(AU)

Introduction: The health professional that acts as a teacher and guides the subject's groups must have a methodological training that allows his preparation for the adequacy of the contents, the political and ideological treatment and the implementation of the curriculum strategies, as well as follow up the difficulties found during the teaching learning process. Objective: To design a methodological proposal for the improvement of the work of the subject's groups in the Medicine and Dentistry careers. Materials and Methods: A transversal - descriptive study was carried out with 22 leading professors of the Medicine and Dentistry careers, from the ICBP Victoria de Girón. The study was divided in three phases. In the first phase the documents that rule the teaching process and the work of the subject's groups were analyzed. A survey was designed to evaluate the knowledge about the work of these groups and also an observation guide. In the second phase a survey was applied for the identification of the learning needs of the leading professors that participate in the study and the observation to the development of these groups. In the third phase a workshop and practical activities were developed in order to solve the learning problems that were identified, as well as to discuss proposals for the improvement of the methodology work in this subsystem. Results: With the observations carry out to the subject's groups and the survey applied to the leading professors, learning needs were identified, the workshop, practical activity and the methodology proposal, was designed and implemented for the development of these collectives. Conclusions: A methodological proposal was designed for the improvement of the work of the subject's collectives that attend the disclose necessities, and also homogenize work by systems in association with the rest of the methodological organization sub levels(AU)

"Access to Essential Medicine":Introduce of China's Proposal at the 67th World Health Assembly / 中国药房

OBJECTIVE:To provide reference for the proper understanding of the content of"Access to Essential Medicine"resolution proposed by China at the 67th World Health Assembly(WHA),policy making and implication of the resolution in Chi-na. METHODS:Through descriptive analysis,the proposal background,approving process and resolution content of the"Access to Essential Medicines"resolution were introduced;the potential impact and effect of the resolution were analyzed. RESULTS:"Ac-cess to Essential Medicine"included"urging member states"and"requesting director-general",20 items."Urging member states"covered 11 items,including national medicine policy,essential medicine selection,medicine related health systems research,inter-national exchanges and cooperation,children's essential medicine accessibility,essential medicine related education,training and public recognition,obstacle recognition and strategy development,essential medicine management system and monitoring mecha-nism,flexible use of the existing policy."Requesting director-general"covered 9 items and put forward the support WHO needed to realize"urging member states"and effect evaluation after the resolution. CONCLUSIONS:"Access to Essential Medicine"is great significance to maintain human health,especially people's health in developing countries,safeguard the rights and interests of peo-ple's basic drug use and promote rational drug use. The approval of"Access to Essential Medicine"at WHA represents China's in-ternational discourse right on improving the basic medical service among basic population,and highlights China's magnitude of a great nation.

Implantação de comissão de pré-qualificação de materiais hospitalares no pregão eletrônico de hospital universitário: pré-requisito para controle de qualidade / Implementation of hospital materials prequalification commission on university hospital electronic trading: quality control prerequisite

O presente estudo tem por objetivo analisar as possibilidades da implantação de comissão de pré-qualificação de materiais hospitalares adquiridos por pregão eletrônico em hospital universitário. Trata-se de estudo observacional, descritivo, misto, com abordagem quanti-qualitativa, realizado no segundo semestre de 2015, cujos elementos de caráter quantitativo foram submetidos à análise documental, extraídos de 136 processos de compras, de materiais hospitalares realizadas no período de 2010 a 2015, devidamente organizados em planilha Excel e pelo software R. Posteriormente analisados com base na estatística descritiva e resultados apresentados em gráficos, tabelas e quadros. Os elementos qualitativos foram produzidos a partir de entrevistas realizadas com 11 médicos e 18 enfermeiros atuantes na gestão de diversos setores de internação hospitalar, no decorrer dos meses de julho a dezembro de 2015. As entrevistas foram norteadas por roteiro semiestruturado e analisadas a luz da análise de conteúdo temática. Da análise dos dados emergiram três categorias temáticas: Materiais com mais problemas: intercorrências por falta de critérios de qualidade; Credibilidade sobre solicitação de amostras para o pregão; e Conhecimento sobre o trabalho e propósitos da comissão de padronização de materiais hospitalares. Concluiu-se que as aquisições pelos pregões, adotando-se o critério menor preço, não asseguram padrões de qualidade dos materiais hospitalares, expondo pacientes e profissionais de saúde à riscos injustificáveis do ponto de vista de segurança dos pacientes e do trabalho. Razões suficientes para apontar a necessidade da implantação de comissão de pré-qualificação dos produtos para analisá-los antes dos procedimentos licitatórios. Ademais, o cenário atual de crise do financiamento público não oferece margens para desperdícios, considerando o inevitável descarte dos materiais adquiridos que não apresentem padrão de qualidade e confiabilidade para que seu uso não cause problemas adversos. Acredita-se que para solucionar os problemas ou minimizá-los, faz-se necessária a constituição da referida comissão, bem como implantar um sistema eletrônico para armazenar e compartilhar informações claras sobre a qualidade dos materiais já analisados a fim de possibilitar maior segurança aos profissionais que os utilizam e para os pacientes que são submetidos aos procedimentos terapêuticos nos hospitais de ensino

The present study aims to analyze the possibilities of the implementation of pre-qualification commission of hospital materials purchased by electronic trading in a university hospital. This is an observational, descriptive, mixed study, with a quantitative-qualitative approach, carried out in the second half of 2015, whose quantitative elements were submitted to a documentary analysis, extracted from 136 procurement processes, of hospital materials carried out in the period of 2010 To 2015, duly organized into Excel spreadsheet and software R. Subsequently analyzed based on descriptive statistics and results presented in graphs, tables and tables. The qualitative elements were produced from interviews with 11 physicians and 18 nurses working in the management of several hospital admission sectors, from July to December 2015. The interviews were guided by a semi-structured script and analyzed in light of the analysis Thematic content. From the analysis of the data emerged three thematic categories: Materials with more problems: intercurrences due to lack of quality criteria; Credibility for requesting samples for the trading session; And Knowledge about the work and purposes of the standardization committee for hospital materials. It was concluded that the acquisitions by the market, adopting the criterion lower price, do not ensure quality standards of hospital materials, exposing patients and health professionals to unjustifiable risks from the point of view of patient safety and work. Reasons sufficient to indicate the need for the implementation of pre-qualification commission of the products to analyze them before the bidding procedures. In addition, the current scenario of public financing crisis does not offer margins for waste, considering the unavoidable disposal of acquired materials that do not present quality and reliability standards so that their use does not cause adverse problems. It is believed that in order to solve the problems or minimize them, it is necessary to set up such a commission, as well as to establish an electronic system to store and share clear information about the quality of the materials already analyzed in order to provide greater security for professionals Who use them and for patients who are submitted to therapeutic procedures in teaching hospitals

Responsabilidad social universitaria en el curriculum de la carrera de medicina de la FCM-UNA del levantamiento de demandas y necesidades a la declaración del perfil genérico del egresado / University social responsibility in the curriculum career of medicine at the FCM-UNA About the obtainment of demands and needs to the development of a quality assurance system in medical training

Este trabajo se realiza en el contexto de un Proyecto de Innovación Curricular (PIC) de la FCM-UNA, basado en un modelo desarrollado por K, Troncoso y sobre la base de las tendencias y lineamientos actuales de la educación superior y la formación profesional universitaria que orienta y guía la construcción, tanto en el diseño como en la instalación y gestión, de currículos universitarios basados en competencias. Considera Hitos, fases, criterios y productos y forma parte de una propuesta metodológica y conceptual que se ha utilizado como marco de referencia y que permite organizar y estructurar la innovación curricular en la carrera de medicina. El hito 1 se refiere al levantamiento de información de las demandas y necesidades de formación a través del análisis de fuentes de investigación, actores claves y diversos marcos de referencia, para organizar y estructurar compromisos formativos para la elaboración y declaración del perfil de egreso. Por lo tanto significa justificar las decisiones tomadas, argumentando desde la lógica de la formación, la racionalidad que se espera modelar y los problemas, situaciones o contexto sobre los que el egresado actuará, utilizando como referencia las respuestas y posición frente al levantamiento de información. Esto responde a exigencias por parte de la sociedad, y así también para poder instalar una propuesta educativa con formación profesional universitaria pertinente. El hito 2 se refiere al análisis y síntesis de la información obtenida de los actores relevantes, de manera a tomar decisiones sobre cuáles son las demandas y necesidades en la formación de los estudiantes de la FCM-UNA. De esta forma ir avanzando hacia la declaración de los compromisos formativos y su representación en el perfil de egreso.

This work is done in the context of Curricular Innovation Project (CIP) of the FCM UNA, based on a model developed by K, Troncoso and based on current trends and guidelines of superior education and degree training that guides the construction, both in the design and installation of university curricula based on competencies. It considers milestones, stages, criteria and products, and forms part of a methodological and conceptual approach which has been used as a reference that allows to organize and structure the curriculum innovation in medical career. Milestone 1 refers to the obtainment of demands and needs of training through the analysis of research sources, stakeholders and various frameworks, to organize and structure training commitments for the development and declaration of the graduate profile. Therefore it means justify the decisions taken, arguing from the logic of training, the rationality that is expected to model and the problems, situation or context on which the graduate will act, using as reference the responses and position on the collection of information This responds to demands from society, and thus also to install an educational proposal with relevant university training. The milestone 2 refers to the analysis and synthesis of information from relevant stakeholders, in order to make decisions about what are the demands and needs in the training of students of the FCM-UNA. Thus moving towards the declaration of training commitments and its representation in the graduate profile.

Construction of pediatric emergency medical staff training system / 中国小儿急救医学

The education and training of professionals in this field are important for the further development of emergency medicine.The training system of pediatric emergency physicians and nurses in the United States and other developed countries were briefly introduced,the main problems of training system in China were analyzed,and effective proposal for the improvement of emergency medicine training system was also put forward.

Propuesta metodológica para el análisis crítico a un programa de estudio / Methodological proposal for the critical review of a curriculum

Introducción: la evaluación crítica de los programas de estudio, exige la utilización de métodos que permitan sistematizar el proceso de construcción de juicios. La planificación de modificaciones a los programas a partir del ejercicio de la crítica sistematizada, debe ser capaz de mejorar las competencias y desempeño deseados para las opciones laborales vigentes. Objetivo: proponer una metodología para la confección de la crítica a un plan de estudios. Métodos: se realizó una investigación de desarrollo para el diseño de una metodología para el análisis crítico a un programa de estudio, para lo cual se utilizó la técnica análisis de contenido y se trabajó con palabras clave como: programa docente, crítica, plan de estudio, currículum, perfil de egresados. Resultados: los autores ponen a consideración de los lectores una metodología estructurada por pasos que permitirá al docente contextualizar y criticar el programa analizado. Se proponen 5 pasos: datos generales del programa, pertinencia y nexos con el resto del currículo, ubicación en el currículo y correspondencia con los contenidos previos y posteriores, análisis del proceso de enseñanza y aprendizaje en el curso y análisis de la bibliografía. Conclusiones: la propuesta metodológica que se pone a disposición de los profesores constituye una herramienta útil para la realización de la crítica a un programa de estudio como parte de los ejercicios de promoción de categoría docente a profesor Titular.

Introduction: critical assessment of curricula demands methods that allow systematizing the process of construction of judgements. Planning changes to curricula according to systematized review will encourage the improvement of desired competencies and performance for the present working options. Objective: to submit a methodology for preparing a review of a syllabus. Methods: a developing research was conducted to design a methodology for the critical analysis of a curriculum, for which the content analysis technique and the keywords teaching program, review , syllabus, curriculum and graduate profile were all used. Results: the authors submitted a proposal of step-structured methodology that will enable the professor to contextualize and to review the analyzed program. The five steps included general data of the syllabus; appropriateness and associations to the rest of the curriculum, location into the curriculum and correspondence with previous and posterior contents; analysis of the teaching/learning process in the course and analysis of the bibliography. Conclusions: the methodological proposal submitted to the professors is a useful tool for preparing a review of the syllabus as part of the process of change of teaching category to full professor category.

Esportes de raquete para deficientes intelectuais leves: uma proposta fundamentada na pedagogia do esporte / Racquet sports for mild intellectual disabilities: a proposal based on the pedagogy of sport

a prática dos esportes de raquetes ainda parece ser inexistente em diferentes instituições brasileiras de ensino, formais e não formais, e não são oportunizadas para pessoas com necessidades especiais. Assim, o objetivo deste trabalho é ofertar uma proposta pedagógica para a vivência destes esportes para alunos com deficiência intelectual leve. A proposta fundamentou-se em princípios como normalização, socialização e da diminuição do sentimento de preconceito. Ela está composta por itens descritos no manuscrito, que ser referem desde a apresentação desse esporte para os alunos até a consecução das atividades a serem desenvolvidas. Conclui-se que a proposta pedagógica é uma aproximação entre os esportes de raquete e alunos com deficiência intelectual, e que está alicerçada nas prerrogativas da Pedagogia do Esporte.

The practice of racket sports still seems to be nonexistent in various Brazilian educational institutions, both formally and informally, and they are not provided for people with special needs. The objective of this work is to offer a pedagogical proposal for experiencing such sports for students with mild intellectual disabilities. The proposal was based on principles such as standardization, socialization and decreased feelings of discrimination. The proposal is made up of items described in the manuscript, beginning with presenting the sport to the students and going on to carrying out various activities needed for proficiency. We conclude that the pedagogical proposal is a means to bring together racquet sports and students with intellectual disabilities, and this is based on the prerogatives of Sport Pedagogy.

Una propuesta para evaluar la calidad del trabajo en el control del Aedes aegypti / Proposal of evaluation of the work quality in the Aedes aegypti control

Evaluar los procesos de trabajo para el control del Aedes Aegypti constituye una necesidad, y lo es mucho más, disponer de metodologías que permitan valorar integradamente las actividades que realizan las unidades organizativas que tienen ese encargo. Nos propone mos exponer los aspectos principales que fundamentaron la concepción y diseño de una propuesta metodológica para evaluar el desempeño de los departamentos de Vigilancia y Lucha Antivectorial, desde los procesos que realizan en el control del Aedes aegypti. La propuesta metodológica se deriva de una investigación de desarrollo en que la revisión bibliográfica y documental, testimonios de informantes clave, observación directa, ejecución de investigaciones operacionales, entre otros procedimientos, sustentaron un proceso concebido en la articulación coherente y racional de pasos imprescindibles para dar respuesta a un grupo de interrogantes respecto al objeto de estudio y al diseño de la Propuesta. Se estructura en seis etapas, conforme a la finalidad de los procederes a ejecutar en su aplicación y en cada una de ellas se proporcionan los elementos metodológicos a considerar para la evaluación. La evaluación con esta propuesta metodológica constituye un proceso dinámico que enfatiza en las relaciones de coordinación a nivel del área de salud. Los resultados documentan sobre problemas técnicos y organizacionales en el cumplimiento de los procesos de trabajo, con énfasis en las debilidades existentes en la interacción sistemática y permanente de los Departamentos de Vigilancia con otras unidades organizativas. La propuesta constituye un aporte directo a la práctica de los servicios de Higiene y Epidemiología en el nivel primario de atención, también contribuye a la toma de decisiones certeras y al mejoramiento continuo de la calidad en sus unidades organizativas(AU)

The evaluation of the work processes for Aedes Aegypti control is a requirement, and it is even more necessary to have methodologies that allow comprehensively assessing the activities of the organizational units in charge of this task. This paper was intended to present the main aspects that substantiated the conception and design of a methodological proposal to evaluate the performance of the anti-vector surveillance and control, starting from the processes in the Aedes Aegypti control. The methodological proposal was derived from a development research in which the literature and documentary reviews, testimonies of key informants, direct observation, implementation of operational research works, among other procedures, supported a process conceived in the coherent and rational articulation of indispensable steps to answer a group of questions in relation to the object of study and the design of the proposal. It is structured into six phases pursuant to the aim of the procedures to be implemented in their application and in each of them, the methodological elements for evaluation were provided. Based on this methodological proposal, the evaluation represents a dynamic process emphasizing the coordinating relationships at the health area level. The results documented about the technical and organizational problems encountered in the fulfillment of the work processes, with emphasis on the existing weaknesses in the permanent systematic interaction of the surveillance department with other organizational units. This proposal is a direct contribution to the practice of hygiene and epidemiology services at the primary health care and also helps in right decision-taking and continuous improvement of quality in the organizational units(AU)

The development of non-profit private hospitals in China：Institutional obstacles and policy suggestions / 中国卫生政策研究

This paper summarizes the positive significance of non-profit private hospitals development , and an-alyzes the institutional obstacles on the development of non-profit private hospitals in terms of autonomous manage-ment, fair competition, investment and profit , tax relief, management and supervision .Finally, the paper provides some proposals to improve the development of non-profit private hospitals:revising the medical institution regulation , establishing and improving the non-profit private hospital assets finance management system , implementing the opera-tion system, establishing a scientific and standardized supervision mechanism , etc.

Propuesta de normativa de registro sanitario para los "medicamentos huérfanos" en la República Bolivariana de Venezuela / Proposal for a health registration regulation for "orphan drugs" in the Bolivarian Republic of Venezuela

Los medicamentos huérfanos son aquellos requeridos para diagnosticar, prevenir o tratar enfermedades poco frecuentes, pero que pueden ser graves y debilitantes. Este trabajo tiene como objetivo proponer la implementación de una normativa de registro sanitario específica para los medicamentos huérfanos en la República Bolivariana de Venezuela, considerando la situación actual de salud y las necesidades de la población, a fin llegar a todos los niveles, facilitando la disponibilidad del mayor número de medicamentos que son requeridos por un grupo reducido de pacientes. Es necesario que las autoridades sanitarias en Venezuela fortalezcan el sistema de salud pública estableciendo políticas para satisfacer las necesidades de la población en general pero que también incluya a las minorías. Se plantean las consideraciones técnicas, legales, fiscales y regulatorias necesarias para la implementación de esta normativa, así como los criterios de inclusión para clasificar un medicamento dentro la categoría de "huérfanos". La metodología utilizada fue de tipo documental, haciendo énfasis en el análisis teórico y conceptual del material a fin de elaborar la propuesta de la normativa para medicamentos huérfanos en la República Bolivariana de Venezuela. Se realizó un análisis teórico de la información obtenida para determinar la situación actual nacional e internacional a fin de obtener los resultados que sirvieron de base para desarrollar la propuesta.

Orphan drugs are those required to diagnose, prevent or treat rare diseases but that may be severe and debilitating; besides, reduce the quality of life of patients and their families. This project aims to propose a special regulation for Orphan Drugs in the Bolivarian Republic of Venezuela taking into account the current health situation and needs of the population in order to reach all levels by facilitating the availability of a bigger amount of drugs required by a small group of patients. It is necessary for health authorities in Venezuela to strengthen the public health system by establishing policies to meet the needs of general population but also include minorities. Technical, legal and regulatory considerations arise for the implementation of this normative, as well as the inclusion criteria for drugs within the category of "orphans". The methodology used is documentary, as it emphasizes the theoretical and conceptual analysis of the material for the proposed regulation for orphan drugs in the Bolivarian Republic of Venezuela. A theoretical analysis of the information was made to determine the current national and international situation in order to obtain the results as a basis to develop the proposal.

Coordinación en ratas: Ajuste a restricciones interdependientes / Coordenação em ratos: Ajuste a restrições interdependentes / Coordination in rats: Adjustment to interdependent restrictions

El estudio del ajuste conductual a entornos donde las interacciones entre los individuos y sus consecuencias son interdependientes ha derivado en procedimientos que limitan la interacción y restringen la operante a la simple simultaneidad de acciones sobre operandos individuales. En este estudio se evaluó una metodología alterna, en la que se expuso a pares de ratas a ir de un lugar a otro. El acceso al alimento fue contingente al trabajo individual o conjunto, en función de las posibilidades de interacción directa, determinadas por la ubicación de los sujetos. Se identificó coordinación únicamente en las diadas expuestas a interacción directa. El protocolo propuesto permite estudiar el ajuste a pagos interdependientes producto de patrones de acción conjunta.

The study of behavioral adjustment to environments in which interactions among individuals and their consequences are interdependent has resulted in procedures that limit interaction and restrict the operant to the simple simultaneity of actions on individuals' operands. This study evaluated an alternative methodology in which pairs of rats were made to go from one place to another. Access to food was contingent upon individual or joint work, depending on the possibilities of direct interaction determined by the location of the subjects. Coordination was identified only in the pairs that had direct interaction. The suggested protocol makes it possible to study the adjustment to interdependent payoffs resulting from joint action patterns.

O estudo do ajuste de conduta a ambientes nos quais as interações entre os indivíduos e suas consequências são interdependentes deriva em procedimentos que limitam a interação e restringem a operante à simples simultaneidade de ações sobre operandos individuais. Neste estudo, avaliou-se uma metodologia alterna, na qual se expôs a pares de ratos a ir de um lugar a outro. O acesso ao alimento foi contingente ao trabalho individual ou conjunto, em função das possibilidades de interação direta, determinadas pela localização dos sujeitos. Identificou-se coordenação unicamente nas díades expostas à interação direta. O protocolo proposto permite estudar o ajuste a pagamentos interdependentes produto de padrões de ação conjunta.

Morse potential in DNA molecule – An experiment proposal.

We rely on the helicoidal Peyrard-Bishop model for DNA dynamics. Interaction between nucleotides at a same site belonging to different strands is modelled by a Morse potential energy. This potential depends on two parameters that are different for AT and CG pairs, which is a possible source for inhomogeneity. It was shown recently (Zdravković and Satarić 2011) that certain values of these parameters bring about a negligible influence of inhomogeneity on the solitonic dynamics. We propose an experiment that should be carried out in order to determine the values of both of these parameters.

Propuesta metodológica para desarrollar correctas prácticas bioéticas en estudiantes de Estomatología / Methodological proposal to develop correct bioethical practices in the Stomatology students

El proceso de enseñanza-aprendizaje debe concebirse como un espacio donde los valores, la moral y la ética propios de la profesión se conjugan con los aspectos técnicos académicos. Se realiza un estudio descriptivo de corte transversal sobre el nivel de conocimientos de los estudiantes acerca de los principios bioéticos durante la atención al paciente con VIH/SIDA, y se diseña una propuesta de orientaciones metodológicas para la adquisición de correctas prácticas bioéticas durante su atención ambulatoria. El universo del estudio estuvo conformado por los 203 estudiantes de 3ro, 4to y 5to años de la Facultad de Estomatología del curso 2009-2010. La muestra fue de tipo probabilística estratificada aleatoria constituida por 103 estudiantes. Los resultados demostraron que el nivel de conocimientos con relación a la aplicación de los principios bioéticos fue bajo y se elabora una propuesta que intenciona la formación de correctas prácticas bioéticas en los egresados de Estomatología.

The teaching-learning process should be conceived as a space where the values, moral and ethics which are proper of the profession should be linked with the technical and academic aspects. A cross-sectional descriptive study is carried out on the student´s knowledge about the bioethical principles during the attention to patients with AIDS. A proposal of methodological guidelines is designed for the acquisition of correct bioethical practices during the outpatient's attention. The universe was composed by 103 students of the 3rd, 4th, and 5th years of the Stomatology Faculty in the academic year 2009-2010. A randomize, strata, and probabilistic sampling was composed by 103 students. The results showed low levels of knowledge in relation to the application of bioethical principles. A proposal is elaborated to form proper bioethical practices in the Stomatology students.