Research on the quality certification standard of medical MOOC in universities / 中华医学教育探索杂志

The medical massive open online course (MOOC) quality certification standard is the reference for the implementation of medical MOOC quality monitoring. This thesis utilizes data mining, quantitative analysis, qualitative analysis and other methods, taking the comment text of the Chinese medicine courses on the Ai Course (MOOC of China Universities) platform as the data source out of which to extract certain potential indicators for the medical MOOC quality certification standard. Based on the analysis of the existing research results on MOOC quality evaluation domestic and abroad as well as the relevant policies of the Ministry of Education, a medical MOOC quality accreditation standard including 6 first-level indicators are formed, including course content, teaching design and so on. Expert scores and AHP method were used to calculate the weight coefficient of the quality certification standard. Finally, this paper explains the procedure of medical MOOC quality certification in college. This certification system can be used to conduct self-assessment and quality monitoring of medical MOOC in colleges and universities.

Análisis comparativo de la acreditación de unidades médicas en Canadá, Chile, la Comunidad Autónoma de Andalucía, Dinamarca y México / Comparative analysis of the accreditation of medical facilities in Canada, Chile, the Autonomous Community of Andalusia, Denmark, and Mexico / Análise comparativa da acreditação de estabelecimentos de saúde no Canadá, Chile, Comunidade Autônoma da Andaluzia, Dinamarca e México

RESUMEN Objetivo. Contrastar las características del proceso de acreditación de establecimientos de salud en Canadá, Chile, la Comunidad Autónoma de Andalucía, Dinamarca y México, con el fin de identificar elementos comunes y diferencias, y las lecciones aprendidas que puedan ser de utilidad para otros países y regiones. Métodos. Estudio observacional, analítico y retrospectivo en el que se usaron fuentes secundarias de libre acceso sobre acreditación y certificación de establecimientos de salud durante el período 2019-2021 en estos países y regiones. Se describen las características generales del proceso de acreditación y sus respuestas a puntos clave del diseño de estos programas. Además, se generaron categorías de análisis para el avance en su implementación y su nivel de complejidad, y se resumen los resultados favorables y desfavorables informados. Resultados. Los componentes operativos del proceso de acreditación son peculiares de cada país, aunque comparten similitudes. El programa de Canadá es el único que contempla algún tipo de evaluación responsiva. Hay una amplia variación en la cobertura de establecimientos acreditados entre países (desde 1% en México a 34,7% en Dinamarca). Entre las lecciones aprendidas, se destacan la complejidad de aplicación del sistema mixto público-privado (Chile), el riesgo de una excesiva burocratización (Dinamarca) y la necesidad de incentivos claros (México). Conclusiones. Los programas de acreditación operan de forma peculiar en cada país o región, logran alcances diferentes y presentan problemáticas también diversas, de las que podemos aprender. Es necesario considerar los elementos que obstaculizan la implementación y generar adecuaciones para los sistemas de salud en cada país o región.

ABSTRACT Objective. To compare and contrast the characteristics of the accreditation process for health care facilities in Canada, Chile, the Autonomous Community of Andalusia (Spain), Denmark, and Mexico, in order to identify shared characteristics, differences, and lessons learned that may be useful for other countries and regions. Methods. An observational, analytical, retrospective study using open-access secondary sources on the accreditation and certification of health care facilities in 2019-2021 in these countries and regions. The general characteristics of the accreditation processes are described and comments are made on key aspects of the design of these programs. Additionally, analytical categories were created for degree of implementation and level of complexity, and the positive and negative results reported are summarized. Results. The operational components of the accreditation processes are country-specific, although they share similarities. The Canadian program is the only one that involves some form of responsive evaluation. There is a wide range in the percentage of establishments accredited from country to country (from 1% in Mexico to 34.7% in Denmark). Notable lessons learned include the complexity of application in a mixed public-private system (Chile), the risk of excessive bureaucratization (Denmark), and the need for clear incentives (Mexico). Conclusions. The accreditation programs operate in a unique way in each country and region, achieve varying degrees of implementation, and have an assortment of problems, from which lessons can be learned. Elements that hinder their implementation should be considered and adjustments made for the health systems of each country and region.

RESUMO Objetivo. Comparar as características do processo de acreditação de estabelecimentos de saúde no Canadá, Chile, Comunidade Autônoma da Andaluzia, Dinamarca e México, a fim de identificar elementos comuns e diferenças, bem como lições aprendidas que podem ser úteis para outros países e regiões. Métodos. Estudo observacional, analítico e retrospectivo usando fontes secundárias de livre acesso sobre acreditação e certificação de estabelecimentos de saúde durante o período 2019-2021 nos países e regiões supracitados. As características gerais do processo de acreditação e suas respostas a pontos-chave no delineamento de tais programas foram descritas. Além disso, foram geradas categorias de análise para o andamento de sua implantação e seu grau de complexidade, e os desfechos favoráveis e desfavoráveis relatados foram resumidos. Resultados. Os componentes operacionais do processo de acreditação são peculiares a cada país, embora compartilhem certas semelhanças. O programa canadense é o único que contempla algum tipo de avaliação responsiva. Houve grande variação entre países no percentual de estabelecimentos acreditados (de 1% no México a 34,7% na Dinamarca). Entre as lições aprendidas, destacam-se a complexidade da aplicação do sistema misto público-privado (Chile), o risco de burocratização excessiva (Dinamarca) e a necessidade de incentivos claros (México). Conclusões. Os programas de acreditação operam de forma peculiar em cada país ou região, têm diferentes escopos e também apresentam diversos problemas a partir dos quais podemos aprender. É preciso considerar os elementos que dificultam a implementação e realizar as adequações necessárias para os sistemas de saúde de cada país ou região.

Improving the quality of external cause of death data in Brazil: evaluation and validation of a new form to investigate garbage codes / Melhorando a qualidade dos dados de causa externa de morte no Brasil: avaliação e validação de um novo formulário para investigar códigos garbage / Mejora en la calidad de los datos de causa externa de muerte en Brasil: evaluación y validación de un nuevo formulario para investigar códigos garbage

Garbage codes, such as external causes with no specific information, indicate poor quality cause of death data. Investigation of garbage codes via an effective instrument is necessary to convert them into useful data for public health. This study analyzed the performance and suitability of the new investigation of deaths from external causes (IDEC) form to improve the quality of external cause of death data in Brazil. The performance of the IDEC form on 133 external garbage codes deaths was compared with a stratified matched sample of 992 (16%) investigated deaths that used the standard garbage codes form. Consistency between these two groups was checked. The percentage of garbage codes from external causes reclassified into valid causes with a 95% confidence interval (95%CI) was analyzed. Reclassification for specific causes has been described. Qualitative data on the feasibility of the form were recorded by field investigators. Investigation using the new form reduced all external garbage codes by -92.5% (95%CI: -97.0; -88.0), whereas the existing form decreased garbage codes by -60.5% (95%CI: -63.5; -57.4). The IDEC form presented higher effectivity for external-cause garbage codes of determined intent. Deaths that remained garbage codes mainly lacked information about the circumstances of poisoning and/or vehicle accidents. Despite the fact that field investigators considered the IDEC form feasible, they suggested modifications for further improvement. The new form was more effective than the current standard form in improving the quality of defined external causes.

Códigos garbage (códigos inespecíficos ou incompletos), como causas externas sem informações específicas, indicam dados de má qualidade sobre a causa da morte. É necessário investigar os códigos garbage com um instrumento efetivo para convertê-los em dados úteis para a saúde pública. Este estudo analisou o desempenho e a adequação do novo formulário de investigação de óbitos por causas externas (IDEC) para melhorar a qualidade dos dados de causa externa de morte no Brasil. O desempenho deste formulário em 133 óbitos com códigos garbage de causas externas foi comparado com uma amostra estratificada e pareada de 992 (16%) óbitos investigados que utilizaram o formulário padrão de códigos garbage existente. A consistência entre esses dois grupos foi verificada. Analisou-se o percentual de códigos garbage de causas externas reclassificados em causas válidas com um intervalo de 95% de confiança (IC95%). A reclassificação para causas específicas foi descrita. Dados qualitativos sobre a viabilidade do formulário foram registrados por pesquisadores de campo. A investigação com o novo formulário reduziu todos os códigos garbage de causas externas em -92,5% (IC95%: -97,0; -88,0) enquanto o formulário existente diminuiu os códigos garbage em -60,5% (IC95%: -63,5; -57,4). O formulário IDEC foi mais eficaz para os códigos garbage de causa externa sem intenção indeterminada. As mortes que permaneceram como códigos garbage careciam principalmente de informações detalhadas sobre as circunstâncias do envenenamento e dos acidentes de trânsito. O formulário IDEC foi considerado viável pelos investigadores de campo, no entanto, eles sugeriram modificações para um maior aperfeiçoamento. O novo formulário foi mais eficaz do que o formulário padrão atual na melhoria da qualidade das causas externas definidas.

Códigos garbage (códigos inespecíficos o incompletos), como causas externas inespecíficas, son los indicadores de datos de mala calidad sobre la causa de muerte. Es necesario investigar los códigos garbage con un instrumento eficaz para convertirlos en datos útiles para la salud pública. Este estudio analizó el desempeño y la adecuación del nuevo formulario de investigación de muertes por causas externas (IDEC) para mejorar la calidad de los datos de causa externa de muerte en Brasil. El desempeño de este formulario en 133 muertes con códigos garbage de causas externas se comparó con una muestra estratificada y emparejada de 992 (16%) muertes investigadas que usaron el formulario estándar de códigos garbage existente. Se comprobó la consistencia entre estos dos grupos. Se analizó el porcentaje de códigos garbage por causas externas reclasificados en causas válidas con un intervalo del 95% de confianza (IC95%). Se procedió a una reclasificación por causas específicas. Los datos cualitativos sobre la viabilidad del formulario fueron registrados por investigadores de campo. La investigación con el nuevo formulario tuvo una reducción de todos los códigos garbage de causas externas en -92,5% (IC95%: -97,0; -88,0), mientras que el formulario existente redujo todos los códigos garbage de causas externas en -60,5% (IC95%: -63,5; -57,4). El formulario IDEC fue el más efectivo para códigos garbage de causa externa sin intención indeterminada. Las muertes que quedaron como códigos garbage carecían principalmente de información detallada sobre las circunstancias de envenenamiento y de accidentes de tránsito. Los investigadores de campo confirmaron la viabilidad del formulario IDEC, además de sugerir modificaciones para mejorarlo. El nuevo formulario fue el más efectivo que el formulario estándar actual en cuanto a la mejora de la calidad de las causas externas definidas.

Subnational certification of elimination of mother-to-child transmission of HIV and/or syphilis: a Brazilian experience report / Certificação subnacional da eliminação da transmissão vertical de HIV e/ou sífilis: relato da experiência brasileira / Certificación subnacional de la eliminación de la trasmisión vertical de VIH y/o sífilis: relato de la experiencia brasileña

Abstract Objective: to describe the subnational implementation process of the certification for elimination of mother-to-child transmission of HIV and/or syphilis, its main barriers, challenges and opportunities. Methods: in 2022, indicators from the last full year for impact targets and the last two full years for process targets, available in national information systems, were evaluated; descriptive reports were analyzed and actions were acknowledged within four thematic axes, according to PAHO/WHO recommendations. Results: 43 municipalities ≥ 100,000 inhabitants were certified, covering 24.6 million inhabitants; one municipality achieved dual elimination (HIV-syphilis), 28 municipalities achieved elimination of HIV and 10 received silver tiers; regarding syphilis, one elimination was observed, along with 4 gold tiers, 13 silver tiers and 4 bronze tiers; a higher number of certifications was identified in the Southeast and South regions. Conclusion: barriers and challenges of the process were overcome through tripartite collaboration; the experience provided better integration of surveillance with care and improved actions aimed at preventing mother-to-child transmission.

Resumo Objetivo: descrever o processo de implantação subnacional da certificação da eliminação da transmissão vertical de HIV e/ou sífilis, suas principais barreiras, desafios e oportunidades. Métodos: em 2022, foram avaliados indicadores do último ano completo para meta de impacto, e dos dois últimos anos completos para metas de processo, disponíveis nos sistemas nacionais de informações; foram analisados relatórios descritivos e reconhecidas ações em quatro eixos temáticos, conforme recomendações da OPAS/OMS. Resultados: 43 municípios ≥ 100 mil habitantes foram certificados, abrangendo 24,6 milhões de habitantes; um município alcançou dupla eliminação (HIV-sífilis), 28 alcançaram eliminação para HIV e 10, selos prata; para sífilis, houve uma eliminação, 4 selos ouro, 13 prata e 4 bronze; identificou-se maior número de certificações nas regiões Sudeste e Sul. Conclusão: barreiras e desafios do processo foram superados pela colaboração tripartite; a experiência proporcionou melhor integração da vigilância com a assistência e qualificação das ações para prevenção da transmissão vertical.

Resumen Objetivo: describir el proceso de implementación subnacional de la certificación de eliminación de la transmisión vertical (TV) de sífilis y/o VIH, barreras, oportunidades y desafíos. Métodos: en 2022, se evaluaron indicadores del último año completo para la meta de impacto y de los dos últimos años para las de proceso en los sistemas de información; se analizaron informes descriptivos y se reconocieron acciones de cuatro ejes, según las recomendaciones de la OPS/OMS. Resultados: se certificaron 43 municipios ≥ 100.000 mil habitantes, cubriendo 24,6 millones de habitantes; un municipio logró la doble eliminación (VIH-sífilis), 28 la eliminación del VIH y 10 sellos plata; para sífilis, hubo una eliminación, 4 sellos oro, 13 plata y 4 bronce; las regiones Sudeste y Sur obtuvieron más certificaciones. Conclusión: barreras y desafíos fueron superados mediante la colaboración tripartita; la experiencia permitió la integración de la vigilancia con la atención y la cualificación de acciones para la prevención de la TV.

Factors related to Japanese internal medicine doctors' retention or migration to rural areas: a nationwide retrospective cohort study

BACKGROUND@#Internal medicine (IM) doctors in Japan play the role of primary care physicians; however, the shortage of rural physicians continues. This study aims to elucidate the association of age, sex, board certification, type of work, and main clinical work with the retention or migration of IM doctors to rural areas.@*METHODS@#This retrospective cohort study included 82,363 IM doctors in 2010, extracted from the national census data of medical doctors. The explanatory variables were age, sex, type of work, primary clinical work, and changes in board certification status. The outcome was retention or migration to rural areas. The first tertile of population density (PD) of municipalities defined as rural area. After stratifying the baseline ruralities as rural or non-rural areas, the odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. The analyses were also performed after age stratification (<39, 40-59, ≥60 years old).@*RESULTS@#Among the rural areas, women had a significantly higher OR for retention, but obtaining board certification of IM subspecialties had a significantly lower OR. Among the non-rural areas, physicians who answered that their main work was IM without specific subspecialty and general had a significantly higher OR, but obtaining and maintaining board certification for IM subspecialties had a significantly lower OR for migration to rural areas. After age stratification, the higher OR of women for rural retention was significant only among those aged 40-59 years. Those aged under 40 and 40-59 years in the non-rural areas, who answered that their main work was IM without specific subspecialty had a significantly higher OR for migration to rural areas, and those aged 40-59 years in the rural areas who answered the same had a higher OR for rural retention.@*CONCLUSIONS@#Obtaining and maintaining board certification of IM subspecialties are possible inhibiting factors for rural work, and IM doctors whose main work involves subspecialties tend to work in non-rural areas. Once rural work begins, more middle-aged female IM doctors continued rural work compared to male doctors.

Evaluation of microsatellite allelic patterns to DNA fingerprinting in rubber tree clones

The rubber tree (Hevea brasiliensis) is native to the Amazon region, and it is widely exploited due to natural rubber produced from latex. There are many clonal varieties, without certification tests. In order to determine a genetic certification, 15 clones were genotyped to identify their genetic pattern. Ten microsatellites were used to determine a subset of alleles exclusive for each genetic profile. The genetic estimates obtained were: number of alleles per locus (N), expected (HE) and observed (HO) heterozygosity, Polymorphic Information Content (PIC) and Discriminatory Power (DP). The number of alleles (N) ranged from five to 14, with an average of 9.2. The HE mean (0.80) was higher than HO (0.60), indicating a selection for homozygotes. The locus informativeness was verified with PIC (0.77) and DP (0.90) means showing high polymorphism. The dendrogram represented the formation of three groups related to geographical origin. Clone MDF 180 presented the highest genetic divergence. Two genic pools represented the genetic composition of genotypes. Based on allelic profiles, a set of two microsatellites (A2365 and A2368) was able to distinguish all examined clones. The genetic certification using microsatellite fingerprinting proved to be an alternative to morphological traits.

Cross-sectional Study of the Educational Roles of Residents in the New Medical Specialty Program / 医学教育

Background: Although there is a growing momentum in Japan to expect residents to play an educational role, the guidelines are still unclear. Objective: The purpose of this study is to examine the characteristics and contents of teaching roles for residents in the new curriculum of each specialty program and uncover current issues. Methods: Two researchers independently searched for and determined the wording related to teaching in the program for all 19 specialties. The research team extracted the relevant issues. Results: Seventeen of the 19 programs included a statement on educational roles for their residents, but almost all of the programs did not include educational competencies and any specific strategy to achieve it. Discussion: The definition of educational competencies and the development of methods to acquire the competencies are issues for the future. It is necessary to develop and expand programs for the Residents-as-Teachers program in Japan.

Abordagem dialógica de competência: pressupostos e percurso metodológico para a construção de perfis na área da Saúde / Abordaje dialógico de competencia: presuposiciones y recorrido metodológico para la construcción de perfiles en el área de la salud / Dialogic approach to competence: assumptions and methodological path for the construction of profiles in the health area

Esta investigação teórica apresenta a abordagem dialógica de competência e seus princípios e métodos para a construção de perfis profissionais. De modo distinto às concepções que focalizam elementos isolados da competência, a abordagem dialógica está baseada em referencial integrador e propõe áreas de competência que caracterizam núcleo e campo no exercício profissional. Essa abordagem reconhece a existência de diferentes visões sobre competência profissional que devem ser analisadas e dialogadas. O perfil competente, construído como metapontos de vista, traduz combinações contextualizadas de conhecimentos, habilidades, atitudes e valores, que expressam excelência na atuação profissional, com vistas à formação, à certificação e à Educação Permanente de profissionais de saúde. O texto analisa a coerência entre as práticas assim sistematizadas e a elaboração de atividades profissionais confiáveis.(AU)

Esta investigación teórica presenta el abordaje dialógico de competencia, sus principios y métodos para la construcción de perfiles profesionales. De forma diferente a las concepciones que focalizan elementos aislados de la competencia, el abordaje dialógico se basa en un referencial integrador y propone áreas de competencia que caracterizan núcleo y campo en el ejercicio profesional. Ese abordaje reconoce la existencia de diferentes visiones sobre competencia profesional que deben analizarse y dialogarse. El perfil competente, construido como metapuntos de vista, traduce combinaciones contextualizadas de conocimientos, habilidades, actitudes y valores que expresan excelencia en la actuación profesional, con el objetivo de formación, certificación y educación permanentes de profesionales de la salud. El texto analiza la coherencia entre las prácticas sistematizadas de tal forma y la elaboración de actividades profesionales confiables.(AU)

This theoretical investigation presents the dialogic approach to competence, its principles, and methods for the construction of professional profiles. Unlike conceptions that focus on isolated elements of competence, the dialogic approach is based on an integrative framework and proposes areas of competence that characterize core and field in professional practice. This approach recognizes the existence of different views on professional competence that must be analyzed and discussed. A set of strategies, devices, and methods capable of triangulating these views and systematizing professional activities is presented. The competent profile, built as a meta point of view, translates contextualized combinations of knowledge, skills, attitudes, and values that express excellence in professional performance, with a view to training, certification, and continuing education of health professionals. The text analyzes the coherence between practices systematized in the way proposed here and the development of entrustable professional activities.(AU)

Strategies and thoughts on the homogenization training of specialized nurse teachers / 中国实用护理杂志

To analyze and summary the setting of admission standards, training methods and certification and assessment methods of specialized nursing teachers, in order to lay the foundation for the homogenization training of specialized nursing teachers in China, and at the same time, provide guarantee for the improvement of the homogenization level of national specialized nursing training bases.

Condiciones laborales, calidad y percepciones sobre el ejercicio de la profesión: encuesta a médicos endoscopistas digestivos en Argentina / Working conditions, quality and perceptions about the practice of medicine: a survey of digestive endoscopists in Argentina

RESUMEN Introducción : Existen desafíos importantes para lograr un adecuado desempeño profesional. Objetivo : Evaluar las características del ámbito laboral y percepciones sobre la calidad profesional y el ejercicio de la medicina. Materiales y métodos : Estudio exploratorio y transversal, encuesta online (septiembre a noviembre de 2020). Se evaluaron las características del ámbito laboral, calidad en endoscopía, redes sociales, conflictos de intereses y rol de las sociedades científicas. Resultados : 208 profesionales. Edad promedio 48,5 años, 66,8% sexo masculino. Promedio de egreso 23 años; el 88,9% (n=185) tenía especialidad certificada y el 85,6% eran gastroenterólogos (n=178). Lugares de trabajo promedio: 2,6; 108 trabajaban menos de 40 h. semanales (52%), 127 (61%) realizan tareas de gestión y el 63,9% guardias pasivas (n=133). El 13,5% (n=28) considera que existen disparidades entre varones y mujeres. El 70,2% (n=146) experimentó Burnout y 86 (41,3%) experimentaron o fueron testigos de abuso. Promedio mensual de procedimientos 87,6 (5-300). La mayoría realiza estudios diagnósticos y terapéuticos básicos. El 63,4% (n=132) consideró adecuada la tecnología con la que trabaja. El 65% (n=136) reutiliza accesorios y el 54,8% (n=114) conoce su tasa de detección de adenomas. 76 médicos (36,5%) usa redes sociales para difusión de su práctica. El 28,4% (n=59) reconoció conflictos de intereses. Existe una opinión favorable para que las sociedades científicas participen en la defensa de intereses económicos y un elevado nivel de insatisfacción económica con la profesión. Conclusión : Esta encuesta brinda información valiosa para mejorar los programas de formación. Es necesario mejorar las condiciones laborales y la calidad de procesos y procedimientos.

ABSTRACT Introduction : The practice of medicine today represents a challenge. Objective: To evaluate the characteristics of the work environment and perceptions about the practice of medicine. Materials and methods : Exploratory and transversal studio, online survey (September to November 2020). The characteristics of the work environment, quality in endoscopy, social networks, conflicts of interest and role of scientific societies were evaluated. Results : 208 professionals. Average age 48.5 years, 66.8 % male. Average age of graduated 23 years; 88.9% (n=185) had a certified specialty and 85.6% were gastroenterologists (n=178). Average workplaces: 2.6; 108 worked less than 40 hours a week (52%), 127 (61%) has management tasks and 63.9% passive guards (n=133). 13.5% (n=28) believe that there are disparities between men and women. 70.2% (n=146) experienced Burnout and 86 (41.3%) experienced or witnessed abuse. Monthly average of procedures 87.6 (5-300). Most perform basic diagnostic and therapeutic studies. 63.4% (n=132) considered the technology with which they work is adequate. 65% (n=136) reuse accessories and 54.8% (n=114) know their adenoma detection rate. 76 physicians (36.5%) use social media to spread the way to disseminate his practice. 28.4% (n=59) recognized conflicts of interest. There is a positive opinion for scientific societies to be involved in the defense of economic interests and a high level of economic dissatisfaction with the profession. Conclusion : This survey provides valuable information to improve training programs. There is a need to improve working conditions and the quality of processes and procedures.

Consenso sobre la constancia de salud del niño y del adolescente para la realización de actividades físicas y/o deportivas. Actualización 2021 / Consensus about Health constance for children and adolescents in order to develop phisical activities and sports. Update 2021

Este documento es la actualización del consenso publicado por la Sociedad Argentina de Pediatría en 2014, para que ningún niño, niña y adolescente (NNA) del país quede excluido de su derecho a la salud y a la actividad física. El control médico periódico y la educación física en el ámbito escolar son herramientas fundamentales para ejercer estos derechos. A raíz de la pandemia del coronavirus de tipo 2 causante del síndrome respiratorio agudo grave (SARS-CoV-2, por su sigla en inglés) disminuyó de manera notable la práctica deportiva. Se formulan recomendaciones que sirvan de referencia a pediatras, integrantes de los equipos de salud, instituciones educativas y deportivas en los niveles local, regional y nacional para la elaboración de la constancia de salud de los NNA que participarán en actividades físicas y deportivas. El pediatra evaluará al NNA sabiendo que para llevar una vida saludable éste debe realizar actividades físicas de moderada a vigorosa intensidad. La Constancia de Salud implica una responsabilidad compartida entre el NNA y/o adulto responsable, el médico, los profesores de educación física y/o los entrenadores a cargo.

This document is the update of the Consensus published by SAP in 2014, so that no child nor adolescent is excluded from their right to health and physical activity. The periodic medical control and the school physical education are fundamental tools. As a result, of the SARS-CoV-2 pandemic, sports practice decreased dramatically. Recommendations are formulated that serve as a reference to pediatricians, members of health care teams, educational institutions, and sports at the local, regional, and national level in the preparation of the health certificate for a child or adolescent who will participate in physical or sports activities. The pediatrician will evaluate the child or adolescent knowing that to carry out a healthy life, must perform physical activities with moderate or vigorous intensity. The health certificate implies a shared responsibility between the child or adolescent and/or the responsible adult, the doctor, the physical education teachers and/or the coaches in charge.

Pertinencia de programas de postgrado en enfermería en la Zona de Salud 3 de Ecuador / Relevance of postgraduate nursing programs in Health Zone 3 of Ecuador

La investigación se desarrolló con el objetivo de determinar la pertinencia para la generación de programas de formación de posgrados en el área de la enfermería, en la Universidad Nacional de Chimborazo, en el año 2019. Se desarrolló un estudio con un enfoque cuantitativo, de tipo descriptivo y transversal, el que contó con la participación de 467 individuos que accedieron espontáneamente: 450 profesionales de enfermería y 17 empleadores de unidades de atención de salud del territorio ecuatoriano. Los datos fueron recopilados a partir de dos encuestas: una dirigida al personal profesional de enfermería y otra, a directivos y empleadores. Predominó el género femenino (92%), las edades entre 20 y 29 años (51%), el grado de licenciatura en Enfer-mería (82%), los que laboraban en hospitales generales (66%) y aquellos con 10 o menos años de experiencia en el ejercicio (76%). La mayoría de los profesionales involucrados dijeron poder pagar entre 5000 y 6500 USD por una formación de cuarto nivel en la Universidad Nacional de Chimborazo, con encuentros presenciales los fines de semana. Los empleadores consideraron necesaria esta preparación especializada e identificaron a la ginecoobstetricia, investigación y docencia como las áreas de mayor demanda por las instituciones que representaban.

This research aimed to determine the relevance for the generation of postgraduate training programs in the nursing area at the National University of Chimborazo, in 2019. A descriptive and transversal study with a quantitative approach was developed. The population was constitu-ted by 467 individuals who spontaneously agreed: 450 nursing professionals and 17 employers of health care units in the Ecuadorian territory. The data were collected from two surveys: one addressed to professional nursing staff and the other one to managers and employers. The female gender predominated (92%), as well as the ages between 20 and 29 years (51%), the bachelor's degree in Nursing (82%), those who worked in general hospitals (66%) and those ones with 10 or less years of experience (76%). Most of the professionals involved said that they could pay between 5,000 and 6,500 USD for a fourth-level training at the National University of Chimbo-razo, with face-to-face meetings on weekends. Employers considered this specialized prepara-tion necessary and identified Obstetrics Gynecology, research, and teaching as the areas in grea-test demand by the institutions they represented.

El médico Homeópata y la Homeopatía. Reflexiones del Doctor Vicente Rosas Landa Lechuga / The Homeopathic physician and Homeopathy. Reflections of Doctor Vicente Rosas Landa Lechuga

La historia e identidad de toda profesión se construye a través de la experiencia de quienes la integran. La profesión médico homeopática y la Homeopatía mexicana cuentan, a lo largo de más de 127 años, con una amplia gama de hechos y situaciones acaecidas en nuestro país y que nos permiten caracterizarla. Tener la posibilidad de que los propios actores puedan compartir de viva voz su vida profesional, resulta invaluable para las futuras generaciones. A través de este documento se presenta una entrevista al doctor Vicente Rosas Landa Lechuga, personaje muy significativo para la comunidad médico homeopática, sobre diversos temas relevantes respecto a la profesión y al campo de la Homeopatía.

The history and identity of every profession is built through the experience of its members. "The homeopathic medical profession and Mexican Homeopathy, over more than one hundred and twenty-seven years, have undergone a wide range of events and situations that occured in Mexico and therfore, allow us to characterize it. Having the possibility of the actors themselves to share their professional lives, is invaluable for future generations. Through this document, an interview is conducted to Dr. Vicente Rosas Landa Lechuga, a very significant person for the homeopathic medical community, on various relevant topics about the profession and the field of Homeopathy.

Development of a practical innovation course for biological engineering major under the background of Engineering Education Certification / 生物工程学报

According to the teaching philosophy of the outcome-based education, this study elaborates the development of a practical innovation course for biological engineering major after five runs of teaching practice and continuous improvement. It mainly includes the methods for selection of teaching subjects, implementation of teaching process, process assessment, evaluation and improvement. Based on the performance and achievements of three grades of students majored in bioengineering, we found that the logic and methods of the practical innovation course could greatly stimulate the motivation of students for learning, as well as their scores. Therefore, the logic and methods described in this study may serve as a reference for the reforms of practical training courses of engineering major under the background of Engineering Education Certification.

Strategy adjustment in foreign prevention and control of COVID-19 and the related focus in China / 上海预防医学

This study introduces the current status of the coronavirus disease 2019 （COVID-19） epidemic， the adjustment of response initiatives， and the global variation of novel coronaviruses and vaccination in Europe， the United States， Japan， and Singapore. It summarizes the achievements in prevention and control efforts in China during COVID-19 epidemic. In addition， it describes the key public health issues in Chinese response strategy that includes： promoting the establishment of a population immunization system； optimizing health certification by unifying health codes， trip codes， and vaccine passes as a triple-identification at the national level； retaining nucleic acid testing as a technical means of detecting the source of infection and epidemiological investigation of close contacts； adhering to the requirements of public places， public transportation and other measures such as wearing masks； strengthening the surveillance of COVID-19 and respiratory infectious diseases； normalizing the timing of implementation of prevention and control strategies.

Strategy adjustment in foreign prevention and control of COVID-19 and the related focus in China / 上海预防医学

This study introduces the current status of the coronavirus disease 2019 （COVID-19） epidemic， the adjustment of response initiatives， and the global variation of novel coronaviruses and vaccination in Europe， the United States， Japan， and Singapore. It summarizes the achievements in prevention and control efforts in China during COVID-19 epidemic. In addition， it describes the key public health issues in Chinese response strategy that includes： promoting the establishment of a population immunization system； optimizing health certification by unifying health codes， trip codes， and vaccine passes as a triple-identification at the national level； retaining nucleic acid testing as a technical means of detecting the source of infection and epidemiological investigation of close contacts； adhering to the requirements of public places， public transportation and other measures such as wearing masks； strengthening the surveillance of COVID-19 and respiratory infectious diseases； normalizing the timing of implementation of prevention and control strategies.

Changes in Kihon Checklist items and new Certification of long-term care needs among Japanese community-dwelling elders / Journal of Rural Medicine

Objective: Physical frailty has been considered a risk factor for certification of long-term care needs (hereafter referred to as Certification) under Japan’s long-term care insurance (LTCI). Therefore, assessment of frailty in elders should be studied from multiple perspectives. The Kihon Checklist (KCL) is widely used to identify need for support/care among Japanese older adults. This study aims to examine the relationship between changes in KCL items and Certification among Japan’s young-old and old-old.Material and Methods: The KCL responses of 7,092 participants were assessed in April 2012 and March 2016, along with gender, age, and living environment. Deaths, Certifications, and relocations were tracked until March 2018. Changes in KCL items were categorized as bad, worse, improved, or good.Results: Between March 2016 and March 2018, about 7.3% of respondents obtained Certifications. KCL item changes increased the risk of new Certification for bad and worse groups, while improved cognitive function among the old-old possibly reduced the risk of new Certification.Conclusion: Therefore, rather than administering the KCL once, identifying KCL changes among people at risk could help prevent or delay their need for long-term care.

Development of Fucosterol Certified Reference Material / 中国实验方剂学杂志

Objective:According to the GB/T 15000.3-2008， to develop a fucosterol certified reference material based on the project approved by Standardization Administration. Method:Fucosterol was isolated from <italic>Laminaria japonica</italic> dried thallus via 95% ethanol extraction， vacuum concentration， repeated column chromatography separation， recrystallization in petroleum ether-ethyl acetate， and residual solvent removal. Its chemical structure was identified by elemental analysis （EA）， infrared spectrum （IR）， mass spectrometry （MS）， nuclear magnetic resonance （NMR） and X-ray diffraction （XRD）. Its homogeneity， stability， and cooperative certification conducted by 8 laboratories were carried out by high performance liquid chromatography with evaporative light scattering detector. Result:For the fucosterol reference material， the certified value of purity was 99.54% with expanded uncertainty of 0.16% in confidence interval of 95%， the stability was good within 24 months storage period at 2-4 ℃， which met the technical requirements of reference material and passed the acceptance organized by Standardization Administration. Conclusion:The national standard materials of fucosterol has been successfully developed， which can be used for the determination of this component， the evaluation of detection methods， and the detection and quality control of related products.

Management system and development strategy of quality Chinese medicine / 中国中药杂志

The development of quality Chinese medicine is an important way to improve the quality of Chinese medicine, and ensure the safety and effectiveness of Chinese medicine. This article systematically elaborates the definition, classification, standard and mana-gement certification strategy of quality Chinese medicine. We present the quality Chinese medicine which is higher quality than that of eligible Chinese medicine based on quality control standards. Quality Chinese medicine is strictly in accordance with management procedures, likely GAP and GMP et al, during the productive process, which quality indicators is higher than that of the current relevant national quality standards, such as Chinese Pharmacopoeia(ChP) et al; its limited indicators such as exogenous pollutants and endogenous toxic substances are lower than that of the current relevant national quality standards, likely ChP et al; meanwhile these Chinese herbal medicine, medicinal pieces, patent medicines, and health products and foods with Chinese medicine raw materials are been certificated by quality Chinese medicine. At the same time, this article systematically expounds the five major management systems of quality Chinese medicine, including technical training management for practitioners, productive process management, standard mana-gement, quality inspection and certification management, and product traceability management. And we put forward strategies to improve the supervision and management system, and promote the standardization and development of quality Chinese medicine by improving the technical management system of quality Chinese medicine, strengthening the quality management system and six sigma(6σ) management in the company. These strategies will provide a reliable basis and effective way to improve the quality of Chinese medicine.

Discussion on the on-site audit management of practicing qualification certification of human organ transplantation / 器官移植

Human organ transplantation is an effective method to treat organ failure and save the life of patients. The practicing qualification certification of human organ transplantation is recognized as an administrative examination and approval item of the national health authority. National health authorities shall organize experts to conduct on-site audit of medical institutions that have applied for practicing qualification certification and have passed preliminary supervision at the provincial level. In this article, the management of on-site audit on the practicing qualification certification of human organ transplantation was illustrated and discussed from the practical significance, principles and highlights of on-site audit, and key points during on-site audit, aiming to provide reference for ensuring high-quality development of organ transplantation and strengthening the management of practicing qualification certification of human organ transplantation in medical institutions.