Technology for the treatment promotion of adults living with HIV: Positive o Cuidado (Positive the Care) / Tecnología para la promoción del tratamiento de usuario adulto viviendo con VIH: Positiva el Cuidado / Tecnologia para a promoção do tratamento de usuário adulto vivendo com HIV: Positive o Cuidado

ABSTRACT Objectives: to develop a responsive website focused on treatment adherence for adult users living with HIV. Methods: technological study conducted between August and October 2020, in the light of Pierre Lévy's theoretical-philosophical framework, using the Double Diamond Process methodology associated with the five stages of The Elements of User Experience framework. Results: it was developed the responsive website Positive Care (Positive o Cuidado), composed of an initial presentation screen and 13 other screens named: Family Health and You; Undetectable = Untransmissible; Antiretroviral Drugs; Routine Tests; Vaccination; Antiretroviral Delivery; Drug Interactions; Combined Prevention; Support Services; Healthy Life; Family and Reproductive Planning; Covid 19; and Questions, Curiosities, and Myths. Final Considerations: the responsive website was developed based on the software design and programming process and has requirements/functionalities with the potential to strengthen the collective intelligence about HIV and, consequently, to promote treatment adherence by its users.

RESUMEN Objetivo: desarrollar sitio responsivo con enfoque en la adhesión al tratamiento de usuarios adultos viviendo con VIH. Métodos: estudio tecnológico realizado entre agosto y octubre de 2020, basado en el referencial teórico-filosófico de Pierre Lévy, usando la metodología Double Diamond Process relacionada a los cinco planes del framework The Elements of User Experience. Resultados: fue desarrollado el sitio responsivo "Positiva el Cuidado", compuesto por pantalla inicial de presentación y miás 13 pantallas denominadas: Salud de la familia y tú; Indétectable = Intransmisible; Medicaciones antirretrovirales; Exámenes de rutina; Vacunación; Entrega de antirretrovirales; Interacciones medicamentosas; Prevención combinada; Servicios de apoyo; Vida saludable; Planeamiento familiar y reproductivo; Covid-19; y Dudas, Curiosidad y Mitos. Consideraciones Finales: el sitio responsivo fue desarrollado basado en el proceso de diseño y programación del software y posee requisitos/funcionalidades con potencial de fortalecer la inteligencia colectiva acerca del VIH y, consecuentemente, promover la adhesión al tratamiento por sus usuarios.

RESUMO Objetivos: desenvolver site responsivo com foco na adesão ao tratamento de usuários adultos vivendo com HIV. Métodos: estudo tecnológico realizado entre agosto e outubro de 2020, à luz do referencial teórico-filosófico de Pierre Lévy, usando a metodologia Double Diamond Process associada aos cinco planos do framework The Elements of User Experience. Resultados: foi desenvolvido o site responsivo "Positive o Cuidado", composto por tela inicial de apresentação e mais 13 telas denominadas: Saúde da família e você; Indetectável = Intransmissível; Medicações antirretrovirais; Exames de rotina; Vacinação; Entrega de antirretrovirais; Interações medicamentosas; Prevenção combinada; Serviços de apoio; Vida saudável; Planejamento familiar e reprodutivo; Covid-19; e Dúvidas, Curiosidade e Mitos. Considerações Finais: o site responsivo foi desenvolvido com base no processo de design e programação do software e possui requisitos/funcionalidades com potencial de fortalecer a inteligência coletiva acerca do HIV e, consequentemente, promover a adesão ao tratamento por seus usuários.

Prototipo para el control sanitario internacional en el policlínico universitario "Pedro Borrás Astorga" / Prototype for international health control at Pedro Borras Astorga university polyclinic

RESUMEN Introducción: el programa de Control Sanitario Internacional implementado en Cuba permite el control y seguimiento, en todo el país, de las enfermedades endémicas y transmisibles por vectores, procedentes de otros países. Esto se realiza de forma manual, por teléfono y con el intercambio de documentos. Por ello, se decidió elaborar una herramienta informática que satisfaga las necesidades, en el Departamento de Higiene y Epidemiología del Policlínico. Objetivo: desarrollar el prototipo de una aplicación informática para el control sanitario internacional en el Departamento de Higiene y Epidemiología del Policlínico Universitario "Pedro Borrás Astorga". Métodos: la investigación obedece a un proyecto de innovación tecnológica para definir la arquitectura de la información que se gestiona durante el control sanitario internacional. Se ejecutaron las etapas de análisis y diseño de la aplicación, con el empleo de la metodología ágil para el desarrollo de software. Además, se han aplicado métodos teóricos y empíricos como el histórico-lógico, el analítico-sintético, el inductivo-deductivo, las entrevistas y el análisis documental. Resultados: se describen los primeros resultados de la investigación, a partir del estudio de las necesidades y las carencias actuales del personal del Departamento de Higiene y Epidemiología. Se desarrolló la arquitectura de la información que se gestiona para lograr el control sanitario internacional. Conclusiones: el prototipo obtenido, permitirá a los futuros programadores implementar el software necesario para apoyar al personal del departamento en la toma de decisiones, de forma significativa a la reducción de riesgos por graves epidemias, beneficiará a los profesionales con una herramienta informática que puede simplificar su trabajo, tributar a la optimización del tiempo, la gestión y la seguridad de la información.

ABSTRACT Introduction: the International Sanitary Control Program implemented in Cuba allows the control and follow-up, throughout the country, of endemic and vector-borne diseases from other countries. This is manually done, by telephone and with the exchange of documents. Therefore, it was decided to develop a computerized tool to meet the needs of the Department of Hygiene and Epidemiology of the Polyclinic. Objective: to develop the prototype of a computer application for international sanitary control in the Department of Hygiene and Epidemiology at Pedro Borras Astorga University Polyclinic. Methods: the research complies with a technological innovation project to define the architecture of the information managed during the international sanitary control. The stages of analysis and design of the application were carried out using the agile methodology for software development. In addition, theoretical and empirical methods such as historical-logical, analytical-synthetic, inductive-deductive, interviews and documentary analysis were applied. Results: the first results of the research are described, based on the study of the current needs and deficiencies found for the personnel of the Department of Hygiene and Epidemiology. The architecture of the information managed to achieve international sanitary control was developed. Conclusions: the prototype obtained, will allow future programmers to implement the necessary software to support the staff of the department in decision making, significantly reducing risks due to serious epidemics, it will benefit professionals with a computer tool that can simplify their work, contribute to the optimization of time, management and information security.

Estrategia didáctica para el proceso de enseñanza-aprendizaje del diseño de software con la utilización del método de proyecto / Didactic strategy for the teaching-learning process of software design by the project method

El presente trabajo tuvo por objetivo elaborar una estrategia para la implementación de un modelo didáctico para la enseñanza-aprendizaje del diseño de software mediante el método de proyectos, entre los contenidos de la asignatura Ingeniería y Gestión de Software de la carrera Sistemas de Información en Salud. Se adoptó un enfoque dialéctico -asumido también como base filosófica-, a partir del cual se emplearon métodos y procedimientos teóricos, empíricos y matemático-estadísticos. Atendiendo a las bases teóricas y principios previamente definidos, se elaboró una estrategia didáctica estructurada en seis acciones encaminadas a la preparación de profesores y directivos para el desarrollo de la virtualidad y la investigación. La propuesta se concretó a través de acciones específicas, dirigidas al perfeccionamiento del proceso de formación en diseño de software mediante proyecto, para la solución de problemas profesionales de los estudiantes de la carrera que se investiga(AU)

The objective of this work was to develop a strategy for the implementation of a didactic model for the teaching-learning of software design through the project method, among the contents of the Engineering and Software Management subject of the Health Information Systems career. A dialectical approach was adopted -also assumed as a philosophical basis, from which theoretical, empirical and mathematical-statistical methods and procedures were used. Based on the theoretical bases and previously defined principles, a didactic strategy structured in six actions aimed at preparing teachers and managers for the development of virtuality and research was developed. The proposal was materialized through specific actions, aimed at improving the training process in software design through a project, for the solution of professional problems of the students of the career under investigation(AU)

Metodologias ativas e o ensino tecnicista na saúde: a prática docente / Active methodologies and technicist teaching in health: the teaching practice

Objetivo: Caracterizar a percepção do docente sobre as metodologias ativas utilizadas na educação profissional da área da saúde, bem como, desenvolver um prospecto de aplicativo para dispositivos móveis com conteúdo voltado ao ensino ativo. Métodos: Trata-se de uma pesquisa de campo-ação, de natureza qualitativa em uma Instituição Escolar Vale do Paraíba, a coleta deu-se em Maio 2019 a amostra foi determinada por conveniência. Resultados: A estratégia que o professor utiliza para desenvolver um conteúdo é o instrumento mais importante para alcançar os objetivos a que se propõe. Entretanto, não existe um método pedagógico universal, e sim uma infinidade de recursos ou ferramentas que o mesmo lança mão para mediar o processo ensino. Conclusão: O papel do professor, enquanto facilitador no processo de ensino-aprendizagem é fundamental no sentido de abrir-se e adequar-se às novas demandas.(AU)

Objective: To characterize the perception of teachers about active methodologies used in professional education in the health area, as well as to develop an application prospectus for mobile devices with content aimed at active teaching. Methods: This is a field-action research, qualitative in nature in a School Institution Vale do Paraiba, the collection took place in May 2019 and the sample was determined by convenience. Results: The strategy that the teacher uses to develop content is the most important instrument to achieve the goals it proposes. However, there is no universal pedagogical method, but an infinity of resources or tools that it uses to mediate the teaching process. Conclusion: The teacher's role, as a facilitator in the teachinglearning process, is fundamental in the sense of opening up and adapting to new demands.(AU)

Objetivo: Caracterizar la percepción de los profesores sobre las metodologías activas y las prácticas pedagógicas utilizadas en la formación profesional en los cursos del área de la salud, así como desarrollar inicialmente un prospecto de una aplicación para dispositivos móviles con contenidos centrados en estrategias de enseñanza activa. Métodos: Se trata de una investigación de campo, de carácter cualitativo. Se elaboró un instrumento de recopilación de datos para las entrevistas con los docentes de una institución privada de enseñanza técnica, amostra determinada por conveniencia. Para elaborar el prospecto de aplicación se utilizó la metodología del Design Thinking. Resultados: La estrategia que el profesor utiliza para desarrollar un contenido es la herramienta más importante para lograr sus objetivos. Sin embargo, no existe un método pedagógico universal, sino una multitud de recursos o herramientas que el profesor utiliza para estimular el aprendizaje del alumno. Conclusión: El papel del profesor, como facilitador en el proceso de enseñanza-aprendizaje, es fundamental para adaptarse a las nuevas exigencias, para estar abierto a nuevas prácticas pedagógicas, para aceptar los retos que imprime la educación de hoy y del futuro, de enseñar a aprender y de aprender a enseñar.(AU)

Arquitectura de información para la gestión de colaboración al ciudadano en salud en las áreas del municipio Pinar del Río / Information Architecture for the management of collaborative information to the Citizen on health care issues in the areas of Pinar del Río municipality

RESUMEN Introducción: las Tecnologías de la Información y las Comunicaciones actualmente son elementos fundamentales para la superación y desarrollo de un país. Por otra parte, Cuba ha identificado desde muy temprano la necesidad de introducir en la práctica social las Tecnologías de la Información y las Comunicaciones y lograr una cultura digital como una de las características imprescindibles del hombre nuevo. Cuba avanza hacia el Gobierno electrónico, a través de la alfabetización digital e informacional en los procesos decisivos, con canales que permitan aumentar la participación ciudadana. Objetivo: desarrollar la Arquitectura de Información para la Colaboración al Ciudadano en materia de Salud en las áreas del municipio Pinar del Río. Métodos: se realiza una investigación de Innovación Tecnológica sobre la gestión de la información en las áreas de salud del municipio objeto de estudio según la metodología de desarrollo de software para Programación Extrema, y con la aplicación de métodos teóricos y empíricos para el análisis, revisión y modelación de los procesos objetos de informatización. Resultados: se constató que la propuesta informática está basada en gestionar la información de los diferentes servicios médicos, como herramienta para ayudar a organizar el sistema y proporcionarle más eficiencia. Conclusión: se elaboró un prototipo informático que evitará el cumulo de personal que acude a las instituciones en busca de respuesta a preguntas dirigidas al conocimiento u orientación para una problemática determinada, en función de la proyección comunitaria.

ABSTRACT Introduction: Information Technologies are currently essential elements for the improvement and development of a country, on the other hand, Cuba has identified from very early on the need to introduce Information and Communication Technologies in social practice and achieve a digital- technology culture as one of the crucial characteristics of the new man. Cuba is moving towards electronic-government, achieving digital technology and information literacy in the decisive processes, creating channels to increase citizen participation. How to contribute to the management of collaborative information to the citizen on health care issues in the areas of Pinar del Río municipality? Objective: to develop the Information Architecture for the Citizen Collaboration in the health care issues in the areas of Pinar del Río municipality. Methods: a Technological Innovation Research on information management in the health care areas of the municipality under study is carried out following the methodology of software development for Extreme Programming, and applying theoretical and empirical methods for the analysis, review and modeling of the processes under computerization. Results: it was found that the proposal of information technology is based on managing the information of the different medical services, serving as a tool to help to the organization of the healthcare system and make it more efficient. Conclusion: a computerized prototype was created that will avoid the gathering of people who come to the institutions in search of answers to questions directed to knowledge or orientation for a determined problematic on purpose of the community projection.

Tratamiento de tumores de piel con SENSUS SRT-100TM en el Centro Oncológico Pinareño / Treatment of skin tumors with SENSUS SRT-100TM at Cancer Treatment Center of Pinar del Río

RESUMEN Introducción: al atender la alta incidencia de cáncer cutáneo no melanómico, donde son utilizados tratamientos con radiaciones ionizantes, en específico con el equipo SENSUS SRT-100TM, en el Centro de Atención al Paciente Oncológico de Pinar del Río, y dada la necesidad de usar con eficacia prestaciones relacionadas con esta práctica; se realizó un estudio observacional retrospectivo para discutir sobre el uso de aspectos relacionados con el paciente, sus lesiones, administración y aprovechamiento de la máquina de tratamiento, con vistas a incrementar los beneficios en esta terapia. Objetivo: realizar un estudio observacional retrospectivo con los tratamientos de radioterapia superficial, con la utilización del equipo SENSUS SRT-100TM, que muestre la necesidad del uso de criterios apropiados con vistas a incrementar la calidad del servicio y eficacia en el aprovechamiento de los recursos. Métodos: se utilizó el método observacional retrospectivo, con el universo de pacientes tratados mediante radioterapia superficial Resultados: el 60,3 % había recibido algún tratamiento previo en al menos una de sus lesiones. El 77,8 % presentaron riesgo intermedio o alto de recurrencia de la enfermedad y el 65 % de los esquemas estuvieron dentro de la ventana terapéutica recomendada de TDFs. El aprovechamiento de la máquina resultó ser bajo. Conclusiones: incrementar el uso de criterios apropiados y fortalecer la formación de especialidades encargadas con estos tratamientos, elevaría la calidad de los mismos y eficacia en el aprovechamiento de los recursos.

ABSTRACT Introduction: considering the high incidence of non-melanomic skin cancer, where treatments with ionizing radiations are used, specifically with the SENSUS SRT-100TM equipment at Cancer Treatment Center of Pinar del Río, and given the need to effectively apply the benefits related to this practice, a retrospective observational study was conducted to discuss the use of aspects related to patients, lesions, administration and application of the treatment machine with a view to increase the benefits of this therapy. Objective: to conduct a retrospective observational study with superficial radiotherapy treatment using SENSUS SRT-100TM equipment, showing the need for the use of the appropriate criteria in order to increase the quality of the service and its efficiency making good use of the resources. Methods: the retrospective observational method was applied, with the target group of patients treated with superficial radiotherapy. Results: 60.3% had received some previous treatment in at least one of their lesions. The 77.8% presented intermediate or high risk of recurrence of the disease and 65% of the schemes were within the recommended therapeutic window of Time-Dose-Fractionation Factors (TDFs). Machine utilization turned out to be low. Conclusions: increasing the use of appropriate criteria and strengthening the training of specialties entrusted with these treatments could improve their quality and efficiency in the use of resources.

Comportamiento histórico de la enseñanza del diseño de software para la carrera Sistemas de Información en Salud / Historical Behavior of Software Design Teaching for Health Information Systems Career

Introducción: El Sistema Nacional de Salud, por su misión, cobertura y características, requiere de un constante flujo informativo, por lo que necesita un personal especializado en el uso de tecnologías que les permita dirigir y gestionar la infraestructura necesaria para la efectiva toma de decisiones en el Sector. Objetivo: Analizar el comportamiento histórico de la enseñanza del diseño de software en la carrera Sistemas de Información en Salud. Métodos: Para la realización de la presente investigación de tipo descriptiva, se utilizaron como principales métodos los de nivel teórico: Histórico-lógico, Análisis-síntesis, Inducción-deducción y Enfoque sistémico, dentro de los de nivel empíricos el de Análisis documental. Resultados: Se obtiene una valoración del análisis realizado a los documentos normativos que rigen el Proceso de Enseñanza y Aprendizaje del diseño de software en el mundo, América Latina y Cuba que puede ser utilizado como medio complementario de apoyo a la preparación metodológica de los profesores de la disciplina Informática. Conclusiones: Existen elementos curriculares que deben ser atendidos con el fin de aumentar la calidad del proceso docente, a pesar de que se han alcanzado grandes avances cualitativos y cuantitativos en todos los aspectos de este proceso(AU)

Introduction: The National Health System, its mission, coverage and characteristics, requires a constant flow of information in order to maintain a high level of knowledge of each of the activities undertaken at all levels for driving management processes and services. A specialist in the use of technologies is necessary in order to allow lead and manage effective decision making in the Health Sector infrastructure. Objective: To analyze the historical behavior of Software Design teaching in Health Information Systems program. Methods: as the main methods of theoretical level: Historical and logical, analysis-synthesis, induction, deduction and systemic approach, within the empirical level: documentary analysis. Results: An assessment of the regulatory documents governing the teaching and learning of software design in the world, Latin America and Cuba, that can be used as a supplementary means of support for the methodological training of teachers of the discipline. Conclusions: The current medical education in Cuba, has made great qualitative and quantitative progress in all aspects of the teaching process, but there are curricular elements that must be addressed in order to increase the quality of the teaching process(AU)

Development of an App to look up the anesthetic implications of genetic syndromes and rare diseases in patients / Creación de una aplicación electrónica para consultar las implicaciones anestésicas de los síndromes genéticos y enfermedades raras en los pacientes

Abstract Introduction: Orphan diseases are a heterogeneous group of conditions involving the structure and functioning of several organs and systems; this represents a significant challenge for the anesthesiologist and the surgical team. Specific knowledge of each disease reduces the risk of any adverse events secondary to perioperative management errors in these patients. Objective: Developing a strategy to quickly and effectively look up for the perioperative risks of patients with rare diseases. Methods: An academic literature review was conducted and the information available in databases was selected. A group of engineers and designers summarized the information and developed a software application for mobile devices, to look up at a list of rare diseases, their description, any surgical implications, and the most relevant anesthetic considerations. Results: The CARAN App (CARAN is the Spanish acronym for Rare Cases in Anesthesia) was developed, which may be downloaded into any iOS (Apple) and Android mobile device at no cost. The App makes available information on the major anesthetic implications, with a view to improving patient care safety. This article discusses the first part of the project which comprises the development and design of the App and the review of 60 diseases. Additional diseases are expected to be included in the second phase of the project. Conclusion: We are introducing the first App available in Spanish to quickly and effectively look up for the most relevant anesthetic implications in 60 rare diseases.

Resumen Introducción: Las enfermedades huérfanas son un grupo heterogéneo de patologías que comprometen la estructura y el funcionamiento de varios órganos y sistemas, lo que representa un enorme reto para el anestesiólogo y el equipo quirúrgico. El conocimiento específico de cada enfermedad disminuye el riesgo de eventos adversos secundario a errores en el manejo perioperatorio de estos pacientes. Objetivo: Desarrollar una estrategia que permita consultar de manera rápida y efectiva los riesgos perioperatorios de pacientes con enfermedades raras. Métodos: Se hizo una revisión académica de la literatura y se seleccionó la información disponible en las bases de datos. Un grupo de ingenieros y diseñadores sintetizaron la información y desarrollaron la aplicación para dispositivos móviles, donde se puede consultar una lista de enfermedades raras, su descripción, las implicaciones quirúrgicas y las consideraciones anestésicas más relevantes. Resultados: Se creó la aplicación CARAN = Casos raros en anestesia, la cual se puede descargar gratis en dispositivos móviles con sistemas operativos iOS (Apple) y Android; esta aplicación nos brinda información sobre las principales implicaciones anestésicas, con el propósito de mejorar la seguridad en la atención del paciente. Se presenta aquí la primera parte del proyecto, que consiste en la creación y el diseño de la aplicación, y la revisión de 60 enfermedades. Se espera que en una segunda fase se incluyan más enfermedades. Conclusión: Presentamos la primera aplicación disponible en español para consultar de forma rápida y efectiva las principales implicaciones anestésicas de 60 enfermedades raras.

Relaciones del modelo didáctico del proceso de enseñanza-aprendizaje del diseño de software con método proyecto / Relations of the didactic model of the teaching-learning process regarding the software design with a project approach

RESUMEN Introducción: los avances tecnológicos y el proceso de informatización en el sector de la salud, han propiciado la necesidad de formar profesionales capaces de desarrollar herramientas y aplicaciones en lo que la carrera Sistemas de Información en Salud juega un papel esencial, sin embargo, sus egresados, manifiestan insuficiencias para la práctica de sus contenidos. Objetivo: determinar los componentes y relaciones de un modelo didáctico sustentado en la utilización del método de proyecto, que perfeccione el proceso de enseñanza-aprendizaje del diseño de software relacionados con bases de datos, desde la asignatura Ingeniería y Gestión de Software, en la Universidad de Ciencias Médicas de Pinar del Río. Métodos: la investigación siguió el enfoque metodológico general dialéctico-materialista, que permitió utilizar métodos teóricos tales como análisis y síntesis, inducción y deducción, el enfoque de sistema y la modelación. Resultados: se logró determinar las relaciones en el modelo didáctico que contribuye a la teoría desde sus componentes esenciales y formas de relación que enriquecen la Didáctica de la Informática a partir de la propuesta de nuevas etapas para el desarrollo del proceso que se estudia, que integran las etapas del método de proyecto y del diseño de software. Conclusiones: la aplicación de este modelo le confiere a este proceso un carácter sistémico, integrador, secuenciado y contextualizado.

ABSTRACT Introduction: technological advances and the process of computerization in the health sector, have led to the need to train capable professionals developing tools and applications where Health Information Systems studies play an essential role, however, its graduates, present insufficiencies for the practice of its contents. Objective: to determine the components and relationships of a didactic model based on the use of the project method, which improves the teaching-learning process of software design related to databases, from the subject Software Engineering and Management, at Pinar del Río University of Medical Sciences. Methods: the research followed the general dialectical-materialistic methodological approach, which allowed the use of theoretical methods such as analysis and synthesis, induction and deduction, system approach and modeling. Results: it was possible to determine the relationships in the didactic model that contributes to the theory from its essential components and forms of relation that enrich the Didactics of Informatics from the proposal of new stages and for the development of the process under study, which integrate the stages of the project method and the software design. Conclusions: the application of this model gives to this process a systemic, integrating, sequenced and contextualized nature.

Design and Application of Medical Order Evaluation Software of Proton Pump Inhibitors in the Inpatients from a Third Grade Class A Hospital / 中国药房

OBJECTIVE： To design Proton pump inhibitor （PPI） medical order evaluation software， and to promote rational drug use in clinic. METHODS： According to the use of PPI （PPI injection as an example） of inpatients in a Third Grade Class A hospital （hereinafter referred to as "sample hospital"）， the evaluation process of medical order evaluation software was designed. On this basis， medical order evaluation software for inpatients was developed in collaboration with computer engineers. Taking the detection rate of irrational drug use and the time consuming per capita as indicators， the effects of software evaluation and manual evaluation were compared. Dispensing medical orders of PPI injection in PIVAS of sample hospital was evaluated with the software pre-evaluation in Feb. 2018. Irrational use of PPI injection （including irrational medication for treatment， prevention and non-indication） in the inpatients was evaluated retrospectively during Jan. 2015-Dec. 2017. RESULTS： The software of PPI audit includes four modules：users and tasks （timing audit）， system settings， confirmation of audit results （check the results audited by the software automatically） and reports exporting. Compared with manual evaluation， there was no significant difference in detection rate of irrational drug use in software audit （69.50％ vs. 77.00％， P＞0.05）； the time consuming per capita was shortened significantly （9.25 min vs. 1.50 min， P＜0.05）. In the application of pre-evaluation， 27 （2.23％） were irrational for treatment， 318 （26.24％） were irrational for prevention and 602 （49.67％） for non-indications. In the application of retrospective review， 4 884 （2.68％） were irrational medication for treatment， 50 399 （27.67％） irrational medication for prevention and 85 106 （46.72％） medication without indications. CONCLUSIONS： The application of PPI medical order evaluation software shortens the time of pharmacist's evaluation， improves the efficiency of evaluation， and promotes the rational use of PPI in clinic.

Estudio del riesgo en radioterapia superficial con SENSUS SRT-100TM usando FMEA y código SECURE MR-FMEA / Study of risks in superficial radiotherapy with SENSUS SRT-100TM using FMEA and code SECURE MR-FMEA

RESUMEN Introducción: atendiendo a la alta incidencia de cáncer cutáneo, donde son utilizados tratamientos con radiaciones ionizantes, específicamente con equipo SENSUS SRT-100TM en el Centro de Atención al Paciente Oncológico de Pinar del Río y dada la necesidad de mejorar la prevención de incidentes y accidentes relacionados con la práctica, se ha empleado un enfoque avanzado de análisis de riesgo similar al propuestos por la Asociación Americana de Físicos Médicos a través del uso del software SECURE MR-FMEA. Objetivo: desarrollar un estudio de riesgo para radioterapia superficial con SENSUS SRT 100TM que identifique los modos y causas de fallos asociados al tratamiento, que posibiliten el empleo de aplicaciones que optimicen la seguridad y calidad de la práctica. Métodos: se utilizó el método prospectivo de análisis de modos y efectos de fallos a tratamientos superficiales con SENSUS SRT-100TM mediante aplicaciones desarrolladas en el código SECURE MR-FMEA. Resultados: se diseñó el mapa del proceso con sus subprocesos y etapas respectivas por un equipo multidisciplinario formado en el Centro de Atención al Paciente Oncológico pinareño, propiciando la comprensión global de la actividad y determinación del perfil de riesgo y árboles de fallos de interés (apoyado en prestaciones del programa SECURE MR-FMEA) creándose así, medidas de defensa y desarrollándose actividades que disminuyeron el riesgo tras reevaluación efectuada. Conclusiones: el estudio de riesgo realizado en radioterapia superficial posibilitó fortalecer la seguridad y calidad de los tratamientos administrados en el Centro de Atención al Paciente Oncológico de Pinar del Río, además de facilitar futuras evaluaciones.

ABSTRACT Introduction: in view of the high incidence of skin cancer, where treatments with ionizing radiation are used, particularly with SENSUS SRT-100TM equipment at Oncology Patient Care Center of Pinar del Río, and the known need to improve the prevention of incidents and accidents related to this practice, an advanced risk-analysis approach, similar to that proposed by the American Association of Physicists in Medicine, was applied using the SECURE MR-FMEA code. Objective: to develop a risk study for superficial radiotherapy with SENSUS SRT 100TM that identifies the modes and causes of failures associated with the treatment, which allow the use of applications that optimize the safety and quality of the practice. Methods: the prospective method of failure modes and effect analysis, regarding superficial treatments with SENSUS SRT-100TM through the applications developed by means of the SECURE MR-FMEA code. Results: the process map was designed with its sub-processes and respective stages by a multidisciplinary team created at Oncology Patient Care Center in Pinar del Río, assisting the global comprehension of the activity and determining the risk profile and specific failure trees (supported by the benefits of the SECURE MR-FMEA program), to create defense measures and developing activities that decreased the risk after the application of the reassessment. Conclusions: the risk study carried out in superficial radiotherapy made possible to strengthen the safety and quality of the treatments delivered at the Oncology Patient Care Center of Pinar del Río, allowing the future assessments.

Development of Lung Compression Degree Measurement Software of Pneumothorax and Its Application in Forensic Medicine / 法医学杂志

OBJECTIVES@#To develop a measurement software of lung compression degree to calculate the lung compression ratio in pneumothorax patients accurately and quickly, and then provide an objective assessment of damage degree in forensic clinical identification.@*METHODS@#A volume calculation software was established according to the working principle of the CT instrument. CT data of 15 pneumothorax patients were selected as research objects. The lung compression ratio of pneumothorax patient was calculated by the lung compression volume calculation software of the CT instrument. Meanwhile, the lung compression ratio was also calculated by the developed volume calculation software. The lung compression ratio and operation time calculated by the two methods were analyzed statistically. Scatter plot graphs were draw based on related data, and the developed volume calculation software was verified.@*RESULTS@#The difference between the lung compression ratios calculated by the two methods was not statistically significant, but showed a linear correlation （P<0.05）. The operation time of the developed volume calculation software was obviously shorter.@*CONCLUSIONS@#The volume calculation software developed in this study can calculate the lung compression degree of pneumothorax more conveniently and rapidly with easy accessibility, which shows an application value in the forensic practice.

Principle design and simulation of a single longitudinal-arm suspension of a rescue robot / 军事医学

Objective Modern warfare is geographically complex and changeable.The lack of terrain adaptability restricts the popularization and application of rescue robots in the frontline war.To solve this problem,this paper designs a new longitudinal-arm suspension mechanism,and carries out principle analysis and simulation optimization.Methods The automatic dynamic analysis of the mechanical system(ADAMS)was used to establish the virtual suspension model. According to the condition of rescue robot parameters, appropriate constraints and objective functions were set up to optimize the length of the suspension rod and spring stiffness coefficient.Results The suspension structure parameters were optimized by experimental simulation.The single longitudinal-arm suspension could convert the small stroke of the helical spring shock absorber into the large stroke of the tire movement according to the comparison of the experimental data. Conclusion The research and design of single longitudinal-arm suspension are of great significance to develop its physical prototype and to select the helical spring shock absorber,playing an important role in promoting the development of the small wheeled rescue robot.

Application of hospital-community-family home care mobile App in patients with stress urinary incontinence / 中华护理杂志

Objective To evaluate the effects of hospital-community-family home care mobile APP on outcomes of discharged patients with stress urinary incontinence.Methods The hospital-community-family nursing platform for stress urinary incontinence was established.Patients were randomly divided into two groups.Patients in the control group(n=51) were given conventional discharge guidance.Patients in the intervention group(n=54) were given mobile home care intervention based on conventional discharge care.Pelvic floor muscle strength,one hour pad test leakage,the ICI-Q-SF score and self-efficacy were followed up and compared between two groups.Results After 6 months of intervention,symptoms of incontinence in the intervention group were relieved,self-efficacy was higher than the control group,the ICI-Q-SF score was lower than the control group,and the differences were significant(all P＜0.05).Conclusion The hospital-community-family nursing platform for stress urinary incontinence can improve patients' adherence and pelvic floor muscle strength,decrease level of incontinence,and increase quality of life.

Modelo openEHR: avaliação da qualidade de Projeto Orientado a Objeto / OpenEHR Model: quality evaluation for Object-Oriented Design / Modelo openEHR: evaluación de la Calidad del Diseño Orientado a Objetos

Objetivo: Avaliar a qualidade de Projeto Orientado a Objeto (POO) do Modelo de Objetos da openEHR, utilizando métricas de orientação a objeto (OO). Método: Um estudo experimental foi conduzido com artefatos da implementação em Java do openEHR e com métricas OO do modelo de qualidade QMOOD. Resultados: Identificou-se que os atributos de qualidade Reusabilidade e Funcionalidade, satisfizeram as expectativas do modelo de qualidade. Já os atributos Extensabilidade e Flexibilidade, mostraram-se instáveis, enquanto Facilidade de Compreensão ficou em queda. Complementarmente, foram identificados seis problemas de POO em estratégias de detecção de problemas de POO. Conclusão: O Modelo de Objetos da openEHR tem ganho de novos recursos e tem a capacidade de reutilizar módulos já existentes para resolver um novo problema. Entretanto, novos requisitos em recursos já existentes podem ser mais trabalhosos, assim como a adaptação do projeto para novos recursos. Também apresenta dificuldade de ser aprendido e compreendido devido ao aumento da complexidade.

Objective: To evaluate the quality of Object Oriented Design (OOD) of the openEHR Object Model, using Object Oriented (OO) metrics. Methods: An experimental study was designed and conducted using the openEHR Java reference implementation artifacts and with OO metrics of QMOOD quality model. Results: The results identified that the quality attributes of Reusability and Functionality satisfied the expectations of the quality model. The quality attributes of Flexibility and Extensibility proved unstable, while the quality attribute Understandability decreased. In addition, were identified six problems of OOD in detection strategies of problems of OOD. Conclusion: The openEHR Object Model gained new features and can reuse existing modules to solve a new problem. However, new requirements on existing resources can be difficult, as well as the adaptation of the project to new features. It also present difficulties to be learned and understood because of increase in the complexity.

Objetivo: Evaluar la calidad de Proyecto Orientado a Objeto (POO) del Modelo de Objetos del openEHR, utilizando métricas de orientación del objetos (OO). Método: Un estúdio experimental fue se llevó a cabo con artefactos de la implementación en Java del openEHR y con métricas OO del modelo de calidad QMOOD. Resultados: Ha identificado que los atributos de calidad Reusabilidad e Funcionalidad, han satisfecho las expectativas del modelo de calidad. Sin embargo los atributos Extensabilidad y Flexibilidad, han resultado ser inestables, mientras Facilidad de Comprensión ha establecido en baja. Además, se ha identificado seis problemas de POO en estrategias de detección de problemas de POO. Conclusión: El Modelo de Objetos del openEHR ha adquirido nuevas características y tiene la capacidad de reutilizar los módulos existentes para resolver un nuevo problema. Sin embargo, los nuevos requisitos sobre los recursos existentes puede ser engorroso, así como la adaptación del diseño para nuevos recursos. También presentan dificultades para aprender y comprender debido a la mayor complejidad.

Improvement of medical equipment quality control management module / 医疗卫生装备

Objective To improve medical equipment quality control management module to report medical equipment adverse events,evaluating medical equipment,managing medical metrology certificate and etc.Methods The module with four functions was developed with the original equipment management information system as well as the list structures of eq_measuring and eq_measuring_detailed and Microsoft Visual Studio 2010.Rwesults The system realized the management of adverse events,evaluation,scrapping and certificate,and could be used to master the quality of in-use equipment based on data analysis.Conclusion The system behaves well in stability and usage,and thus is worthy promoting for enhancing medical equipment quality coutrol and management.

Application of the video of head-eye movement training in vestibular rehabilitation / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the effect of the video of head-eye movement training in vestibular rehabilitation.METHODS 37 patients aged between 30 and 76 years old with vestibular dysfunction underwent two weeks of rehabilitation with the video of head-eye movement training. The results of dizziness handicap inventory (DHI), dizziness analogue scale, and the Romberg static balance tests were recorded before and after the rehabilitation.RESULTS After the rehabilitation, there was significant decrease in the scores of DHI and dizziness analog scale(allP>0.001), and there was significant improvement in the time of Romberg static balance tests(P>0.001).CONCLUSION The video of head-eye movement training is an effective method in vestibular rehabilitation.

Development and Evaluation of a Multi-Functional Drug Discrimination System Mounted with Automatic Data Analysis of the Clinical Examination Values for Medications Brought to Hospital / 医薬品情報学

<b>Objective: </b>Numerous new drugs have been developed in recent years, making the available types of prescription drugs quite diverse, with increasingly more complex drug interactions.  From an operations support system perspective, hospitals that cannot incorporate a large-scale custom-order system because of financial or use-efficiency limitations have no choice but to rely on commercial products.  However, this leaves many problems unsolved, such as functional restrictions and limited specifications.  In this study, we used Microsoft®Visual Basic®for Application (VBA) to develop an economical drug discrimination system suited to our situation and equipped with original function from the perspective of clinical pharmacists.<br><b>Design: </b>System design and development.<br><b>Methods: </b>We prototyped the system in VBA and used Microsoft®Excel®to create Query Tables.  The utility of the new system was evaluated based on drug discrimination output and time required in each process.<br><b>Results: </b>The new system is capable of inter-database communication and automated data analysis and uses drop-down lists of pre-defined options for data input in many places.  Compared with the conventional method, the new system enabled us to significantly reduce the average time needed to input and confirm data by as much as 61.9%.  This indicates that the new system can considerably reduce the time required for completing time-intensive processes and is also useful in preparing highly precise drug discrimination reports.<br><b>Conclusion: </b>Based on the results obtained so far, the new, original system, developed with zero design or development costs, is more efficient and offers more reliable information in the clinical setting than the conventional system.  As a result, we are able to maintain operational quality and reduce the amount of time required for drug discrimination.

Improvement of medical equipment quality control management module / 医疗卫生装备

Objective To improve medical equipment quality control management module to report medical equipment adverse events,evaluating medical equipment,managing medical metrology certificate and etc.Methods The module with four functions was developed with the original equipment management information system as well as the list structures of eq_measuring and eq_measuring_detailed and Microsoft Visual Studio 2010.Rwesults The system realized the management of adverse events,evaluation,scrapping and certificate,and could be used to master the quality of in-use equipment based on data analysis.Conclusion The system behaves well in stability and usage,and thus is worthy promoting for enhancing medical equipment quality coutrol and management.