Whitehead, Tansley, Sen, Bobbio e a abordagem One Health / Whitehead, Tansley, Sen, Bobbio and the One Health approach / Whitehead, Tansley, Sen, Bobbio y el enfoque One Health

Objetivo: traçar parâmetros para estruturar conceitos da abordagem One Health através dos pensamentos de Alfred North Whitehead, Arthur George Tansley, Amartya Sen e Norberto Bobbio. Metodologia: tratou-se de pesquisa original, com abordagem dedutiva e viés hermenêutico, baseada nos pensamentos selecionados e na orientação de Saúde Única. Resultados: One Health estrutura-se na afirmativa holística e integrada que a saúde humana, animal e ambiental estão interligadas. Sob a perspectiva de Whitehead, a abordagem One Health pode ser considerada um processo dinâmico e relacional, onde humanos, animais e meio ambiente interagem constantemente, interconectando-se por relações e processos, formando um todo. Pela perspectiva de Tansley, a ideia de One Health pode alinhar-se ao conceito de ecossistema, não podendo a saúde ser analisada isoladamente em indivíduos, mas, necessariamente, pelas interações complexas entre seres humanos, animais e o ambiente. Sob o prisma de desenvolvimento (direitos e liberdades), proposto por Sen, a abordagem One Health pode ser considerada um meio para alcançá-lo, através da interrelação de mecanismos, sistemas e instituições focados na promoção da saúde e do bem-estar. Na visão de Bobbio, direitos fundamentais, democracia e a paz, são formas éticas e primordiais para assegurar direitos, especialmente um novo direito da natureza (humanos, animal e ambiente) na busca conjunta de garantias para a convivência pacífica. Conclusão: a abordagem One Health não é apenas uma estratégia prática, mas também uma visão renovada da antiga percepção que reconhecia a interconexão de todas as formas de vida.

Objective: draw parameters to structure concepts of the One Health approach through the thoughts of Alfred North Whitehead, Arthur George Tansley, Amartya Sen, and Norberto Bobbio. Methodology: this was original research, with a deductive approach, hermeneutic bias based on the selected thoughts and the One Health. Results: One Health is structured on the holistic and integrated assertion that human, animal, and environmental health are interconnected. From Whitehead's perspective, the One Health approach can be considered a dynamic and relational process, where humans, animals, and the environment constantly interact, interconnecting through relationships and processes, forming a whole. From Tansley's perspective, the idea of One Health can align with the ecosystem concept, where health cannot be analyzed in isolation in individuals, but necessarily through the complex interactions between humans, animals, and the environment. From Sen's development prism (rights and freedoms), the One Health approach can be seen to achieve it, through the interrelation of mechanisms, systems, and institutions focused on promoting health and well-being. In Bobbio's view, fundamental rights, democracy, and peace are ethical and primary ways to ensure rights, especially a right of nature (humans, animals, and the environment) in the joint pursuit of guarantees for peaceful coexistence. Conclusion: the One Health approach is not just a practical strategy, but also a renewed vision of the old perception that recognized the interconnection of all forms of life.

Objetivo: establecer parámetros para estructurar conceptos del enfoque One Health a través de los pensamientos de Alfred North Whitehead, Arthur George Tansley, Amartya Sen y Norberto Bobbio. Metodología: se trató de una investigación original, con un enfoque deductivo, sesgo hermenéutico basado en los pensamientos seleccionados y el Salud Única. Resultados: One Health se estructura en la afirmación holística e integrada de que la salud humana, animal y ambiental están interconectadas. Desde la perspectiva de Whitehead, el enfoque One Health puede considerarse un proceso dinámico y relacional, donde humanos, animales y el medio ambiente interactúan constantemente, interconectándose a través de relaciones y procesos, formando un todo. Desde la perspectiva de Tansley, la idea de One Health puede alinearse con el concepto de ecosistema, donde la salud no puede analizarse aisladamente en individuos, sino necesariamente a través de interacciones complejas entre seres humanos, animales y el ambiente. Desde el prisma del desarrollo (derechos y libertades) propuesto por Sen, el enfoque One Health puede considerarse un medio para alcanzarlo, a través de la interrelación de mecanismos, sistemas e instituciones enfocados en la promoción de la salud y el bienestar. Desde la visión de Bobbio, los derechos fundamentales, la democracia y la paz son formas éticas y primordiales para asegurar derechos, especialmente un derecho de la naturaleza (humanos, animales y ambiente) en la búsqueda conjunta de garantías para la convivencia pacífica. Conclusión: el enfoque One Health no es solo una estrategia práctica, sino también una visión renovada de la antigua percepción que reconocía la interconexión de todas las formas de vida.

Integração ensino-serviço-comunidade: perspectivas do Comitê Gestor Local do Contrato Organizativo de Ação Pública Ensino-Saúde / Integración enseñanza-servicio-comunidad: perspectivas del Comité Gestor Local del Contrato Organizativo de Acción Pública Enseñanza-Salud / Teaching-service-community integration: perspectives of the Local Management Committee of the TeachingHealth Public Action Organizational Contract

Com o objetivo de compreender o desenvolvimento da integração ensino-serviço-comunidade (Iesc) no município de Bragança Paulista, São Paulo, por meio do Contrato Organizativo de Ação Pública Ensino-Saúde (Coapes), realizou-se um estudo de caso. Uma amostra intencional com dez integrantes do Comitê Gestor Local que participaram de entrevistas semiestruturadas, em ambiente virtual, gravadas e transcritas na íntegra. Os relatos passaram por análise de conteúdo na modalidade temática e os resultados indicaram que a condução da Iesc e do Coapes foi bem-sucedida. A sustentabilidade e os êxitos da contratualização estão relacionados a estratégias, como aproximação, diálogo institucional, igualdade de valor e transparência, provenientes de discussões técnicas, compreensão do processo, escolha do formato, sensibilização e engajamento dos atores. A combinação desses elementos, aliada a novos projetos e atitudes, aponta caminhos para a consolidação da Iesc no território, que apresenta desafios a serem superados.

Con el objetivo de comprender el desarrollo de la integración enseñanza-servicio-comunidad (IESC) en el municipio de Braganza Paulista (Estado de São Paulo), a partir del Contrato Organizativo de Acción Pública Enseñanza-Salud (Coapes), se realizó un estudio de caso. Una muestra intencional con diez integrantes del Comité Gestor Local participó en entrevistas semiestructuradas, realizadas en ambiente virtual, grabadas y transcritas integralmente. Los relatos pasaron por un análisis de contenido en la modalidad temática. Los resultados indicaron que la conducción de la IESC y del Coapes fue exitosa. La sostenibilidad y los éxitos de la contractualización están relacionados con estrategias tales como la aproximación, el diálogo institucional, la igualdad de valor y transparencia, provenientes de discusiones técnicas, comprensión del proceso, elección del formato, sensibilización y compromiso de los actores. La combinación de esos elementos, aliada a nuevos proyectos y actitudes, señala caminos para la consolidación de la IESC en el territorio que presenta desafíos que hay que superar.

To comprehend the evolution of education-service-community integration (ESCI) in the municipality of Bragança Paulista, SP, through the Teaching-Health Public Action Organizational Contract (Coapes), a case study was conducted. An intentional sample of ten members from the Local Management Committee participated in semi-structured interviews, conducted virtually, recorded, and transcribed in full. The narratives underwent thematic content analysis. The results indicated that the implementation of IESC and Coapes was successful. The sustainability and achievements in contractualization are related to strategies such as approaching, institutional dialogue, equal value, and transparency, resulting from technical discussions, understanding of the process, format selection, sensitization, and actor engagement. The combination of these elements, along with new projects and attitudes, points towards the consolidation of IESC in the territory, which presents challenges to be overcome.

The Regulatory Status of Functional Foods in the Economic Integration Organizations of Latin America and the Caribbean / El Estatus Regulatorio de los Alimentos Funcionales en las Organizaciones de Integración Económica de Latinoamérica y el Caribe

Introduction. The legal declarations on functional foods of the four main economic integration organizations in Latin America and the Caribbean (LAC) ­ Pacific Alliance (PA), Caribbean Community (CARICOM), Southern Common Market (MERCOSUR) and Central American Integration System (SICA) - are based on the Codex Alimentarius system and do not regulate functional foods. The use of Codex in food marketing is an insufficient condition for its application in functional foods. Regulation based on scientific and technology results are required to be used in the economic integration organizations of LAC. Objective. The objective is to analyze the theoretical framework of the legal foundations that could govern the commercialization processes of functional foods, whose research advances have currently only been manifested in nutritional health. This article also seeks to address this gap through a systematic analysis of international regulations. Materials and methods. For this, a review of the literature emanating from two databases from 2018-2023 is carried by applying the legal-economic research method of documentary content analysis, applied to three general food marketing regulations: food safety declarations, regulations for inspections, food manufacturing and food labeling. Results. The results reveal the absence of specific legislation for functional foods in LAC economic integration organizations. Conclusions. The legal principle of marketing based on peremptory norm (also called jus cogens) can be facilitated through side letters, included in the contents of international contracts. along with the registration requirements of industrial property rights of the member countries associations(AU)

Introducción. Las declaraciones legales sobre alimentos funcionales de las cuatro principales organizaciones de integración económica de América Latina y el Caribe (ALC) ­ Alianza del Pacífico (AP), Comunidad del Caribe (CARICOM), Mercado Común del Sur (MERCOSUR) y Sistema de Integración Centroamericana (SICA) - se basan en el sistema del Codex Alimentarius y no regulan los alimentos funcionales. El uso del Codex en la comercialización de alimentos es condición insuficiente para su aplicación en alimentos funcionales. Se requiere que las regulaciones basadas en resultados científicos y tecnológicos sean utilizadas en los organismos de integración económica de ALC. Objetivo. Analizar el marco teórico de los fundamentos legales que podrían regir los procesos de comercialización de alimentos funcionales, cuyos avances en investigación actualmente solo se han manifestado en salud nutricional. Este artículo también busca abordar esta brecha a través de un análisis sistemático de las regulaciones internacionales. Materiales y métodos. Se realiza una revisión de la literatura emanada de dos bases de datos del período 2018-2023 aplicando el método de investigación jurídico- económica de análisis de contenido documental, aplicado a tres normas generales de comercialización de alimentos: declaraciones de seguridad alimentaria, normas para inspecciones, fabricación de alimentos y etiquetado de alimentos. Resultados. Los resultados revelan la ausencia de legislación específica para alimentos funcionales en las asociaciones comerciales de ALC. Conclusiones. El principio jurídico de comercialización basado en norma imperativa (también llamado jus cogens) puede facilitarse a través de cartas complementarias, incluidas en el contenido de los contratos internacionales. junto con los requisitos de registro de los derechos de propiedad industrial de las asociaciones de los países miembros(AU)

Integración de contenidos en la carrera de Bioanálisis Clínico desde una perspectiva social de la ciencia y la tecnología

El objetivo de la investigación fue valorar el proceso de integración de contenidos desde la disciplina Diagnóstico Integral de Laboratorio en la carrera de Bioanálisis Clínico desde una perspectiva social de la ciencia y la tecnología. De los métodos empíricos fueron utilizados la revisión documental y el análisis de documentos, así como la caracterización del estado actual del desarrollo de la técnica lámina periférica por los docentes y estudiantes del tercer año, en la que se identificaron insuficiencias que influyen en la preparación de este futuro profesional. A partir de la valoración realizada se argumentó la necesidad de elaborar una estrategia didáctica para la integración de los contenidos en la carrera de Bioanálisis Clínico lo que contribuirá a la preparación de los estudiantes y profesores.

The objective of the research was to assess the process of integration of contents from the Comprehensive Laboratory Diagnosis discipline in the Clinical Bioanalysis degree from a social perspective of science and technology. From the empirical methods, the documentary review and the analysis of documents were used, as well as the characterization of the current state of development of the peripheral lamina technique by teachers and students of the third year, in which insufficiencies were identified that influence the preparation of this future professional. Based on the assessment made, the need to develop a didactic strategy for the integration of the contents in the Clinical Bioanalysis career was argued, which will contribute to the preparation of students and teachers.

Integración y consolidación disciplinar en la biología y la psicología. Una perspectiva comparada / Disciplinary Integration and consolidation in Biology and Psychology. A comparative Approach

Resumen En su proceso de definición y consolidación, las ciencias de la vida se enfrentaron con la dicotomía sobre si la mejor manera de aproximarse a su objeto de estudio era seguir el modelo de la física -considerado el modelo científico por excelencia- o desligarse de este. La manera en la que este debate se decantó en cada disciplina tuvo consecuencias en el desarrollo posterior y en los alcances epistemológicos de las nuevas ciencias en consolidación. La comparación de la manera en la que se dio este debate en la biología y la psicología resulta relevante para entender la trayectoria de estas ciencias y sus posibilidades de integración disciplinar: la biología consiguió la unificación disciplinar integrándose alrededor de la teoría evolutiva, mientras que la psicología no consiguió exitosamente esa integración. Esto fue en parte por el intento de conectarse con las ciencias naturales a través de la fisiología, lo que, además, supuso un obstáculo para la comprensión e integración del principio unificador de la biología.

Abstract During the XIX century, different sciences were structured or consolidated in their modern form. Until then, biology, earth sciences, social sciences, and even physics, chemistry, and mathematics did not exist as autonomous disciplines as we know them today. In that century, the notion of "science" was utterly separated from natural philosophy, theology, and other forms of traditional knowledge. The consolidation of scientific disciplines was characterized by deep debates on the possibilities and methods of knowing the natural and human worlds. In their process of consolidation, all life sciences faced a dichotomy related to the best way to approach their object of study: should they follow the model of physics -considered the scientific model par excellence- or not take that model into account? This dichotomy provoked intense debates in all disciplines. The way this debate was resolved had lasting consequences in the subsequent development and the epistemological scope of the new sciences in consolidation. Comparing how this debate took place in biology and psychology is relevant to understanding the disciplinary trajectory followed by each science and the possibilities of integration in each field of knowledge. There is a generalized assumption in the history of psychology that the experimental paradigm adopted extensively in psychology at the end of the XIX century would have placed the discipline under the scientific status of natural sciences. However, in biology and psychology, there was a tension between a physiological-experimental paradigm and a historical-evolutionary paradigm. Understanding those debates within biology, and the comprehension of how biology achieved its disciplinary integration, shows why the experimental connection of psychology with physiology did not mean an explicit connection with the whole of the natural sciences. Disciplinary integration in biology was possible because of adopting the evolutionary principle under a historic paradigm instead of a physical-chemical one. That is why the experimental connection of psychology with physiology eventually became an obstacle for psychology in adopting the unifying principle of biology, the Theory of Evolution, as their basis for disciplinary integration. The first part of this article describes how two branches emerged in the process of consolidation of biology: physiological-experimental and historical-evolutionary. Each one had a different approach to its object of study, but both were necessary to form what is now modern biology. The second part focuses on unifying biology as a field of scientific knowledge, bringing the two branches of this science together under the evolutionary paradigm. The third part outlines the central debates in the consolidation of psychology as a scientific discipline at the end of the XIX century and the beginning of the 20th century. It introduces implications of how these debates on knowledge in psychology developed, as opposed to how it happened in biology. Finally, the difficulties of psychology connecting with the theory of evolution are addressed, as are the impossibility of integrating the different branches of the discipline.

"Ajuda a Não Ficar Louco": Estudo Qualitativo Sobre a Prática de Esportes na Integração Acadêmica / "It Helps Not to Go Crazy": Qualitative Study on the practice of Sports in Academic Integration / "Ayuda a No Volverse Loco": Estudio Cualitativo Sobre la Práctica Deportiva en la Integración Académica

A prática de esportes é associada à formação acadêmica em diversos países, como forma de promover saúde e desenvolver competências pessoais e sociais. Este estudo buscou compreender como os universitários brasileiros percebem a influência das práticas esportivas no seu processo de integração à universidade e em seu desempenho acadêmico. Participaram 260 universitários, provenientes de um grupo maior de participantes de um estudo quantitativo, realizado online, que também apresentava perguntas abertas. As respostas a essas perguntas foram submetidas a uma análise temática. Os estudantes descrevem diferentes formas como a prática de esportes pode contribuir para a obtenção de uma melhor adaptação e desempenho acadêmico (integração e reconhecimento social, manejo do estresse e aprendizagem de competências transversais). Também foram enumeradas dificuldades para conciliar as atividades acadêmicas e esportivas (falta de tempo, incompatibilidade de calendários, cansaço associado à prática esportiva). A partir desses relatos, conclui-se que ainda são necessárias maiores medidas institucionais que estimulem a prática de esportes no ensino superior e que facilitem a sua conciliação com as atividades acadêmicas.

The practice of sports is associated with academic studies in several countries, as a way to promote health and develop personal and social skills. This study aimed to comprehend how brazilian college students perceive the influence of sports practices on their integration process at university and on their academic performance. Participants were 260 college students, from a larger group of participants in a quantitative online study, which also had open-ended questions. The answers to these questions were subjected to a thematic analysis. Students describe different ways in which sports can contribute to a better academic performance and integration (social integration and recognition, stress management and learning soft skills). Difficulties to concile academic and sports activities (lack of time, schedule incompatibility, fatigue associated with sports practice) were also listed. Based on these reports, it is concluded that greater institutional measures are still needed to encourage the practice of sports in higher education and to facilitate its conciliation with academic activities.

La práctica del deporte está asociada a la formación académica en varios países, como una forma de promover la salud y desarrollar habilidades personales y sociales. Este estudio buscó comprender cómo los universitarios brasileños perciben la influencia de las prácticas deportivas en su proceso de integración universitaria y en su rendimiento académico. Participaron 260 universitarios, provenientes de un grupo más amplio de participantes en un estudio cuantitativo, realizado online, que también tenía preguntas abiertas. Las respuestas a estas preguntas fueron sometidas a un análisis temático. Los estudiantes describen diferentes formas en las que el deporte puede contribuir a una mejor adaptación y rendimiento académico (integración y reconocimiento social, manejo del estrés y aprendizaje de habilidades transversales). También se enumeraron las dificultades para conciliar las actividades académicas y deportivas (falta de tiempo, incompatibilidad de horarios, cansancio asociado al deporte). De estos informes se concluye que aún son necesarias mayores medidas institucionales para fomentar la práctica del deporte en la educación superior y facilitar su conciliación con las actividades académicas.

Physiology teaching methodology – Perspective of undergraduate medical students

Background: Proper understanding of concepts of physiology forms basis of good clinical practice. To make the lectures in physiology more interesting and understanding, one has to review the teaching methods at regular intervals. Aims and Objectives: This study is designed to get feedback regarding teaching methods in physiology from MBBS students of Government Medical College, Kozhikode, to make teaching more effective. Materials and Methods: Two hundred randomly selected students who successfully completed 1st-year MBBS are included in the study group. The standard questionnaire is shared to study group through Google forms and adequate time is given to record their responses. Descriptive statistics are used. Frequency is expressed in percentage. Results: Most of students prefer interactive teaching methodologies such as group discussion as their preferred mode of learning rather than conventional didactic lectures in whole batch. Students also like to have integration with other subjects and early clinical exposure to understand the concepts precisely. Conclusion: Teaching in small groups with proper integration and alignment with other subjects will make maximum results rather than the traditional teacher centered medical education. Periodic review of teaching methods is very much essential to make the subject more interesting.

Al término de la primera implementación de la malla curricular innovada 2015. Cohorte de médicos egresados (2017-2023). FCM-UNA. Historia, fortalezas, debilidades y nuevos desafíos / At the end of the first implementation of the innovated 2015 curriculum cohort of graduating physicians (2017-2023). FCM-UNA. History, strengths, weaknesses and new challenges

En la Facultad de Ciencias Médicas egresó en el año 2023 la primera cohorte de médicos formados con el nuevo currículum, implementado desde del 2017 como resultado del Proyecto de Innovación Curricular (PIC) desarrollado en los 5 años previos. La finalidad fue transitar de un currículum tradicional a uno orientado a competencias, integrado, pertinente a las necesidades sanitarias del entorno, incorporando la semestralidad, los créditos académicos y el Rotatorio Clínico preprofesional supervisado. La integración curricular es uno de los referentes más importantes de esta innovación. Se pretende aquí iniciar una narrativa que pase el testimonio histórico de esta transformación y reconozca el compromiso colectivo demostrado con la formación de profesionales médicos de excelencia. Se incluye el marco histórico, las fases del PIC, los criterios curriculares implicados, los equipos humanos participantes, la estructura organizacional para la implementación, el resumen de la evaluación de medio término y el escenario actual, donde de la evaluación de la implementación es fundamental para retroalimentar el proceso y generar la mejora continua.

The Faculty of Medical Sciences graduated in 2023 the first cohort of physicians trained with the new curriculum, implemented since 2017 as a result of the Curricular Innovation Project (CIP) developed in the previous 5 years. The purpose was to transition from a traditional curriculum to one that is competency-oriented, integrated, relevant to the health needs of the environment, incorporating the semester, academic credits and the supervised pre-professional Clinical Rotation. Curricular integration is one of the most important references of this innovation. It is intended here to initiate a narrative that passes the historical testimony of this transformation and recognizes the collective commitment demonstrated with the formation of medical professionals of excellence. It includes the historical framework, the phases of the CIP, the curricular criteria involved, the human teams involved, the organizational structure for the implementation, the summary of the mid-term evaluation and the current scenario, where the evaluation of the implementation is fundamental to feed back the process and generate continuous improvement.

Implementação do planificasus na atenção primária à saúde: relato de experiência / Implementation of planificasus in primary health care: experience report / Implementación del planificasus en la atención primaria de salud: relato de la experiencia

Objetivo: relatar a experiência da implantação do PlanificaSUS na Atenção Primária à Saúde em uma cidade da fronteira oeste do Rio Grande do Sul. Método: trata- se de um relato de experiência realizado com profissionais da saúde de uma Estratégia Saúde da Família piloto do PlanificaSUS. Participaram do estudo enfermeiros, técnicos de enfermagem, agente comunitário de saúde, odontóloga, auxiliar de saúde bucal, médicos, psicólogo e nutricionista, totalizando cerca de 30 participantes. A experiência ocorreu no período de julho de 2019 à julho de 2021. Foram disponibilizadas tutorias virtuais, reuniões presenciais, workshops e cartilhas informativas sobre a metodologia. Resultados: a implantação do método PlanificaSUS contribuiu de forma significativa na reorganização da assistência em saúde e adaptação dos sistemas de apoio diagnóstico e logístico essenciais durante o atendimento, possibilitando a ampliação do acesso e organização de macroprocessos e microprocessos. Obtiveram-se mudanças na estratificação e classificação de risco no território, por meio do acolhimento, o que possibilitou a organização do processo de trabalho dos profissionais, redução do tempo de espera ao atendimento do usuário e agilidade na resolutividade nos casos, superando a lógica hegemônica das filas de espera. Considerações finais: identificou-se mudanças na reorganização da ESF, pois o PlanificaSUS contribuiu para a qualificação profissional, melhoria da assistência aos usuários, fortalecimento e integração do trabalho da equipe e padronização dos processos junto a rede de saúde municipal.

Objective: to report the experience of PlanificaSUS implementation in Primary Health Care in a city in the western border of Rio Grande do Sul. Method: this is an experience report carried out with health professionals from a pilot Family Health Strategy of PlanificaSUS. Nurses, nursing technicians, community health agents, dentists, oral health assistants, physicians, psychologists and nutritionists participated in the study, totaling about 30 participants. The experiment took place from July 2019 to July 2021. Virtual tutorials, face-to-face meetings, workshops, and informative booklets about the methodology were made available. Results: the implementation of the PlanificaSUS method contributed significantly to reorganizing health care and adapting the essential diagnostic and logistical support systems during care, enabling expanded access and organization of macro and micro processes. Changes were obtained in the stratification and classification of risk in the territory, through the reception, which enabled the organization of the professionals' work process, reduction of the waiting time for the user's care and agility in resolving cases, overcoming the hegemonic logic of waiting lines. Final considerations: changes were identified in the ESF reorganization, because PlanificaSUS contributed to professional qualification, improved care to users, strengthening and integration of the team's work and standardization of processes within the municipal health network.

Objetivo: relatar la experiencia de implementación del PlanificaSUS en la Atención Primaria de Salud en una ciudad de la frontera oeste de Rio Grande do Sul. Método: se trata de un relato de experiencia realizado con profesionales de salud de una estrategia piloto de Salud de la Familia del PlanificaSUS. Participaron del estudio enfermeros, técnicos de enfermería, agentes comunitarios de salud, odontólogos, auxiliares de salud bucal, médicos, psicólogos y nutricionistas, totalizando cerca de 30 participantes. El experimento ocurrió en el período de julio de 2019 a julio de 2021. Se pusieron a disposición tutoriales virtuales, reuniones presenciales, talleres y folletos informativos sobre la metodología. Resultados: la implementación del método PlanificaSUS contribuyó significativamente a la reorganización de la asistencia sanitaria y a la adaptación de los sistemas esenciales de apoyo diagnóstico y logístico durante la atención, permitiendo la ampliación del acceso y la organización de los macro y microprocesos. Se obtuvieron cambios en la estratificación y clasificación del riesgo en el territorio, a través de la recepción, lo que permitió la organización del proceso de trabajo de los profesionales, reduciendo el tiempo de espera para la atención del usuario y la agilidad en la resolución de los casos, superando la lógica hegemónica de las colas de espera. Consideraciones finales: se identificaron cambios en la reorganización de la ESF, porque el PlanificaSUS contribuyó a la cualificación profesional, a la mejora de la atención a los usuarios, al fortalecimiento e integración del trabajo del equipo y a la estandarización de los procesos dentro de la red municipal de salud.

Percepções sobre contribuições/desafios da integração ensino-serviço-comunidade a partir da experiência de uma disciplina cirúrgica / Perceptions on contributions/challenges of teaching-service-community integration from the experience of a surgical discipline

Resumo: Introdução: As Diretrizes Curriculares Nacionais (DCN) da graduação em Medicina enfatizam a formação no contexto da atenção básica de saúde e têm como eixos do desenvolvimento curricular as necessidades de saúde da população e a integração ensino-serviço-comunidade (Iesc), preferencialmente nos serviços do Sistema Único de Saúde (SUS). Dessa forma, a rede básica de saúde é um cenário de aprendizagem singular, pois proporciona aos alunos a possibilidade de eles vivenciarem as políticas de saúde e o trabalho multiprofissional, além de permitir que lidem com problemas reais, vinculando a formação médico-acadêmica às necessidades sociais da saúde. Objetivo: Este estudo teve como objetivo analisar as características da integração ensino-serviço que contribuem para a universidade, os serviços de saúde e a comunidade, e as suas dificuldades e os seus desafios por meio da percepção dos discentes, usuários e profissionais de saúde envolvidos no ambulatório de cirurgia ambulatorial e no projeto de extensão da Universidade Federal de São João del-Rei (UFSJ) nas unidades de saúde em Tiradentes, em Minas Gerais. Método: Trata-se de estudo qualitativo que utilizou como instrumentos de coleta de dados entrevistas semiestruturadas com usuários, discentes e profissionais de saúde sobre a percepção da IESC. Para a análise dos dados, empreendeu-se a técnica de análise de conteúdo. Resultado: Os dados mostraram que a IESC permitiu melhorar a qualidade do trabalho no serviço de saúde, qualificar os profissionais ali presentes, além de ampliar a realização pessoal dos atores dessa interação. Também trouxe melhorias à atenção primária, possibilitando a compreensão da organização da prática no trabalho e maior resolubilidade da unidade básica de saúde. Ainda foi possível uma percepção dos desafios e impasses dessa integração a serem superados, como falta de estrutura e materiais, desconforto minoritário, mas, não menos importante, de pacientes a serem atendidos pelos estudantes e confronto da rotina dos profissionais de saúde locais com a universidade. Conclusão: A universidade inserida dentro da realidade social e dos serviços de atenção primária forma profissionais mais capacitados para problemas mais prevalentes ao mesmo tempo que beneficia a população e as equipes de saúde locais.

Abstract: Introduction: The National Curriculum Guidelines (DCN, Diretrizes Curriculares Nacionais) for the undergraduate medical course emphasize the educational training in the context of primary health care and have as axes of the curricular development, the health needs of the population and the teaching, service, and community integration (TSCI), preferably in services of the Brazilian Health System (SUS). Thus, the primary health network is a unique learning scenario, as it provides students the opportunity to experience health policies, as well as the multi-professional work, in addition to the possibility of dealing with real-life problems, associating medical-academic training to the social health needs. Objectives: This work aims to analyze the characteristics of the teaching-service integration, which contribute to the university, health services and the community. It also aims to analyze the difficulties and challenges through the perception of the students, the users and the health professionals involved in the outpatient Surgery Clinic and in the extension project of UFSJ (Universidade Federal de São João del-Rei) in the health units in Tiradentes-MG. Methods: This work is a qualitative study which used, as data collection instruments, semi-structured interviews with users, students and health professionals, about the perception of Teaching Service-Community Integration (TSCI). The Content Analysis technique was used for the data analysis. Results and Discussion: The data showed that the TSCI allowed improving the quality of work in the health service, qualifying the professionals who were working there, in addition to enhancing personal achievement of the actors in this interaction. It also brought improvements to primary care, allowing an understanding of the organization of the work practice and greater effectiveness of the Basic Health Unit. Furthermore, it was possible to perceive the challenges and impasses of this integration to be overcome, such as: lack of structure and materials, a minor discomfort, but no less important, of patients to be cared by students and confrontation of the routine of local health professionals with the University. Conclusion: The university inserted in the social reality and in the primary care services trains professionals who are more qualified for more prevalent problems while benefiting the population and the local health teams.

Subcampos e espaços na Saúde Coletiva: fronteiras e integração / Subfields and spaces within the field of Public Health: boundaries and integration / Subcampos y espacios en la Salud Colectiva. fronteras e integración

O presente ensaio discute alguns aspectos da integração entre subcampos da Saúde Coletiva, buscando identificar obstáculos e possibilidades a esse respeito. Faz uma breve análise sobre o surgimento e o desenvolvimento dos subcampos na Saúde Coletiva e reúne indicações sobre movimentos voltados para a integração entre as áreas, bem como as suas diversas disputas. Sumariza proposições teóricas e iniciativas práticas voltadas para a interdisciplinaridade, como também desenvolvimentos teórico-conceituais. Apoiado na sociologia de Bourdieu, formula uma hipótese segundo a qual, à semelhança dos demais campos sociais, os subcampos da Saúde Coletiva se constituíram como microcosmos autônomos em que as disputas de fronteiras dominam e têm suas raízes em processos históricos e sociais. Ademais, adicionam-se os obstáculos relacionados com a incorporação do conhecimento especializado e a aquisição de habitus dos subcampos. Este ensaio discute ainda as possibilidades da integração como produto de processos coletivos ao interior da Saúde Coletiva.(AU)

This essay discusses aspects of integration between public health subfields, highlighting obstacles and possibilities. We present a brief analysis of the emergence and development of public health subfields, focusing on movements geared towards the integration of areas and the various disputes within these areas. We outline theoretical propositions and practical initiatives oriented towards interdisciplinarity and underline theoretical and conceptual developments. Drawing on Bourdieu's sociology, we propose that, like other social fields, public health subfields constitute autonomous microcosms rooted in historical and social processes dominated by boundary disputes. In addition to the above, we highlight obstacles related to the incorporation of specialist knowledge and the acquisition of habitus by the subfields. Finally, we discuss possibilities of integration as a product of collective processes within the field of public health.(AU)

El presente ensayo discute algunos aspectos de la integración entre subcampos de la Salud Colectiva buscando la identificación de obstáculos y posibilidades en ese sentido. Hace un breve análisis sobre el surgimiento y desarrollo de los subcampos en la Salud Colectiva, reuniendo indicaciones sobre movimientos enfocados en la integración entre las áreas, así como sus diversas disputas. Resume proposiciones teóricas e iniciativas prácticas enfocadas en la interdisciplinaridad, así como desarrollos teórico-conceptuales. Apoyado en la sociología de Burdieu, formula una hipótesis según la cual, a semejanza de los demás campos sociales, los subcampos de la Salud Colectiva se constituyeron como microcosmos autónomos en donde las disputas de fronteras dominan y tienen sus raíces en procesos históricos y sociales. Además, se adicionan los obstáculos relacionados con la incorporación del conocimiento especializado y adquisición de habitus de los subcampos. Discute las posibilidades de la integración como producto de procesos colectivos en el interior de la Salud Colectiva.(AU)

Research on the mining, sorting and transforming of traditional exercise prescription from the perspective of sports and health integration / 中华行为医学与脑科学杂志

Based on promoting the " sports and health integration" and with the aim of the positive role of traditional sports in promoting public health in an all-round and whole-cycle way, this paper uses the literature research method to explore the connotation of traditional sports in ancient Chinese books and literatures, such as " treating no diseases" , " treating mild diseases" , " treating desired diseases" and " treating existing diseases" . The traditional exercise prescription is interpreted from the modern language such as the amount of exercise and intensity, application time, role, standardization and matters needing attention, so as to provide the theoretical basis for the integration of traditional exercise prescription into grassroots health management by providing exercise promotion services for healthy, sub-healthy, sick and rehabilitated people.

Formulation and meaning of evidence-based and differentiated exercise prescription / 中华行为医学与脑科学杂志

Exercise is a crucial method for preventing and controlling chronic diseases, as well as promoting the health of Chinese residents.As guidelines for residents' exercise, traditional exercise prescriptions have limitations such as copying foreign experiences, uneven quality control, and general classification of population characteristics, which affect the applicability and practicality of their application in the Chinese population.A new model of exercise prescription is put forward and named evidence-based and differentiated exercise prescription.In terms of evidence selection, only studies based on Asian populations are selected.In terms of evidence quality control, standardized quality assessment processes are required.In terms of evidence application, accurate classification of candidate populations and personalized application of evidence are achieved.Evidence-based and differentiated exercise prescription provides scientific and accurate exercise prescription guidance for Chinese residents, realizes the integration of sports and medicine, which is conducive for the prevention and control of chronic diseases and the improvement of residents' health level.

Sports and health integration: logic, dilemma and alleviation / 中华行为医学与脑科学杂志

By combing out the historical development logic of sports and health integration and the current development achievement, the underlying logic of sports and health integration is described systematically in multiple dimensions, and the prominent dilemmas in development are analyzed as follows: lack of residents' health literacy, excessive dependence on medical treatment, low bridging of talent team construction, lack of the guidance of funds centralization, insufficient financial support, imperfect management system and mechanism, and unspecific departmental collaboration.The strategies for solving the problems are as follows: strengthening the integration of sports science and clinical medicine, consolidating the technical integration of sports prescription and clinical standardization process, further improving the business integration of exercise intervention and clinical treatment, and enhancing the industrial integration of sports products and medical treatment.

Expression and clinical significance of SSTR2, ADAM-12 and FLI-1 in small cell lung cancer tissue / 中国基层医药

Objective:To investigate the expression and clinical significance of somatostatin receptor 2 (SSTR2), a disintegrin and metalloproteinase-12 (ADAM-12), and friend leukemia virus integration-1 (FLI-1) in small cell lung cancer tissue.Methods:Eighty-two patients with small cell lung cancer who received treatment in Haiyang People's Hospital from January 2020 to January 2021 were included in this study. All patients underwent radical surgical resection. Small cell lung cancer tissues and adjacent tissues more than 2 cm from the edge of cancer tissues were harvested. The positive expression rates of SSTR2, ADAM-12, and FLI-1 in cancer tissues and adjacent tissues were determined by immunohistochemistry. The relationship between SSTR2, ADAM-12, FLI-1, and clinical characteristics were analyzed. The 1-year survival rate of patients with small cell lung cancer was calculated.Results:The positive rates of SSTR2, ADAM-12, and FLI-1 in small cell lung cancer tissue were 79.27% (65/82), 76.83% (63/82), and 78.05% (64/82), respectively, which were significantly higher than 19.51% (16/82), 17.07% (14/82), 20.73% (17/82) in the adjacent tissue ( χ2 = 58.57, 58.78, 53.90, all P < 0.05). SSTR2, ADAM-12, and FLI-1 were positively associated with lymph node metastasis, clinical stage, tissue invasion, tumor size, and histological grade (all P < 0.05). After controlling for gender, age, and others, SSTR2, ADAM-12, and FLI-1 were associated with lymph node metastasis, clinical stage, tissue invasion, tumor size, and histological grade (all P < 0.05). All patients were followed up for 1 year. Six patients were lost to follow-up. The 1-year survival rate of 76 patients with small cell lung cancer was 67.11% (51/76). The survival rate of patients with positive SSTR2, ADAM-12, and FLI-1 expression were lower than that of patients with negative SSTR2, ADAM-12, and FLI-1 expression ( χ2 = 3.93, 6.43, 7.52, all P < 0.05). Conclusion:SSTR2, ADAM-12, and FLI-1 are highly expressed in small cell lung cancer tissue. Combined detection of SSTR2, ADAM-12, and FLI-1 is conducive to the prognosis and evaluation of small cell lung cancer in patients. This study is innovative and scientific.

Medical-electrical cross-case teaching and its teaching practice under the background of medical-industrial integration / 中华医学教育探索杂志

This paper introduces the teaching method of medical-electrical cross-integration and the teaching practice experience in the past three years by taking the integration of medicine and electrical engineering as an example. Starting from the analysis of the characteristics of learning situation, the teaching introduction process, the case discussion and analysis, and the after-class tracking and improvement, this paper analyzes the characteristics of the medical-electrical cross-teaching and proposes the corresponding teaching methods and supporting cases. Preliminary exploration attempts show that this teaching method can improve students' comprehensive ability, especially multidisciplinary thinking ability, and has a certain positive effect.

Study on the application effects of the mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice" in the teaching of spinal surgery / 中华医学教育探索杂志

Objective:To explore the application effects of the mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice" in the teaching of spinal surgery.Methods:A total of 64 eight-year program clinical medical students who practiced in Peking Union Medical College Hospital in 2021 were taken as research objects and randomly divided into experimental group ( n=33) and control group ( n=31). The experimental group received the new teaching mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice", and the control group received regular teaching mode. At the end of teaching, the teaching effects were evaluated from several aspects, including the scores of theoretical examinations, anatomical marks identification tests, and anonymous questionnaires. SPSS 22.0 software was used for paired t-test and two independent-samples t-test. Results:The theoretical test scores [(51.25±6.99) points] and anatomical structure identification scores [(37.56±1.83) points] of the experimental group were higher than those of the control group [(42.46±6.13) points and (30.37±3.46) points], and the differences were statistically significant ( P<0.001). The effective recovery rate of the questionnaire was 100%. The results of the questionnaire showed that the experimental group was significantly higher than the control group in terms of teaching attractiveness, attention, learning interest, learning efficiency, anatomical identification ability, problem-finding and problem-solving ability and overall teaching method satisfaction ( P<0.05). Conclusion:The teaching mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice" can effectively improve students' theoretical knowledge, learning interest, learning efficiency, operation proficiency and problem-finding and problem-solving ability, which is worth promoting.

The practice of the cultivation strategy of incremental training of modern clinical thinking ability to cultivate clinical post competency of "5 + 3" integration students / 中华医学教育探索杂志

At present, some "5+3" integration students have different levels of understanding and application problems in various stages, such as role transformation, professional knowledge and technology, communication ability and humanistic care ability, clinical thinking and evidence-based medicine concepts, clinical research thinking, learning and work attitude. This research will permeate and run through the training of "5+3" integrated students' diagnostic and therapeutic operation ability through the training of modern clinical thinking oriented by post competency, and integrate humanistic care, evidence-based medicine, learning attitude, working attitude, and attitude towards patients in the whole process to gradually complete the comprehensive training goal of clinical thinking oriented by post competency + diagnostic and therapeutic operation ability.

Development and construction of comprehensive examination database for periodontology based on curriculum integration / 中华医学教育探索杂志

Periodontology is one of the important disciplines in oral clinical medicine, which covers a wide range of subjects and intersects with many basic disciplines. Under the environment of the implementation of modular teaching in Shanghai Jiao Tong University School of Medicine, the assessment method with separate propositions for the teaching and research section is still adopted. There is a mismatch between the assessment mode and the curriculum setting; the basic subject propositions are difficult to be combined with clinical cases; the knowledge point assessment is single, and the students' ability to integrate the knowledge points cannot be assessed. The development and construction of the comprehensive examination database for periodontology was based on curriculum integration, gathering the teaching backbones of various disciplines, focusing on periodontology, radiating all related disciplines, unifying the proposition outline, proposition type, proposition principle, combining with relevant knowledge points of various disciplines based on clinical cases, and tried to apply to clinical students majoring in stomatology. The use of the examination database promotes students' ability to flexibly apply theoretical knowledge to clinical case analysis, further promotes the reform of modular teaching, lays a solid foundation for future clinical work, and meanwhile provides an important basis for directions of the teaching and research section.

Exploration on the blended learning reform in organ-systems based curriculum model of the endocrine system / 中华医学教育探索杂志

Since 2016, Binzhou Medical University began to carry out the blended learning reform in the organ-systems based curriculum (OSBC) of the experimental class of clinical medicine. Based on the traditional face-to-face teaching method, the blended learning mode of the integrated course of endocrine system under OSBC has been carried out by using the small private online course (SPOC) of MOOC platform of China universities. Many teaching methods have been adopted and formed, including case-based learning (CBL), problem-based learning (PBL), professional bilingual teaching, scientific research teaching and virtual simulation experiment teaching. The evaluation system for the combination of formative and summary assessment has been also adopted in the whole process to assess the students' academic achievement, and the teaching effect as well. The blended learning mode of the integrated course of the endocrine system under OSBC is still in the exploratory stage. There are some limitations, such as too high requirements for teachers' quality, long preparation time for teaching, and great difficulty in supervising online learning. However, the practice of teaching reform that has been carried out shows that it is effective, feasible, and worth popularizing.