Validez de apariencia y racionalidad de una metodología para estudiar la causalidad en salud / Appearance and rational validity of a methodology to study causality in health

Introducción: Es objetivo fundamental de la medicina, determinar las causas que producen las enfermedades; para llevar a cabo este estudio, a finales del siglo XX se emplearon técnicas estadísticas multivariadas confiables en el análisis simultáneo de diferentes variables independientes sobre un desenlace. Objetivo: Determinar la aplicación de la validez racional y de apariencia en la metodología empleada para el estudio de la causalidad en salud. Métodos: Para evaluar si la metodología se correspondía con los requerimientos de la investigación, se aplicó la validez de apariencia para valorar los resultados obtenidos en su aplicación, específicamente, si las reglas reflejan verazmente, lo que ocurre en la práctica médica, mediante el empleo de la validez racional. Resultados: Los usuarios potenciales de la metodología la consideraron aceptable en los aspectos medidos sobre la regresión logística binaria. El mayor porcentaje de las reglas analizadas está en correspondencia con lo planteado en la literatura, pocas plantean aspectos que no se dan necesariamente en la práctica médica, pero tampoco se contradicen con la literatura. Los resultados de la validez de apariencia no fueron favorables, pues la metodología no había sido empleada antes en el contexto. En cuanto a la validez racional, se verificó un alto porcentaje de correspondencia entre lo planteado por las reglas y la literatura. Es importante tener en cuenta, que el hallazgo de algo conocido reafirma la validez de esa regla. Conclusiones: Las reglas obtenidas de la aplicación de la metodología reflejan, en general, lo que ocurre en la práctica médica.

Introduction: the fundamental objective of medicine is to determine the causes that produce diseases. At the end of the 20th century, multivariate statistical techniques were used as reliable in the simultaneous analysis of different independent variables on an outcome. Objective: to determine the application of appearance and rational validity of a methodology to study causality in health. Methods: to evaluate whether the methodology corresponded to the research requirements, appearance validity was applied to assess the results obtained in its application, specifically, if the rules accurately reflect what happens in medical practice, through the use of rational validity. Results: the potential users of the methodology considered it acceptable in the measured aspects of the binary logistic regression. The highest percentage of the rules analyzed is in correspondence with what is stated in the literature; few raise aspects that do not necessarily occur in medical practice, but they do not contradict the literature either. The results of face validity were not favourable, since the methodology had not been used before in the context. A high percentage of correspondence regarding rational validity was verified between what was stated by the rules and the literature. It is important to note that finding something known reaffirms the validity of that rule. Conclusions: the rules obtained from the application of the methodology reflect, in general, what happens in medical practice.

Validación de la metodología para cuantificar el fluconazol y sus impurezas orgánicas en materia prima por cromatografía líquida de alta resolución

Introducción. La eficiencia de una metodología para analizar una sustancia farmacológica puede verse afectada por las condiciones reales del laboratorio de cada país, incluyendo el clima. Por esta razón, se requiere validar el método con las pautas recomendadas para ello y optimizar el proceso, para asegurar el éxito y la confianza en los resultados. Objetivo. Validar una metodología para la cuantificación simultánea del fluconazol (materia prima) y sus impurezas orgánicas mediante cromatografía líquida de alta resolución con detector de arreglo de diodos en condiciones de clima tropical y con todos los requisitos normativos. Materiales y métodos. Se hicieron pruebas previas a la validación del método: idoneidad del sistema, estudio de filtros, límite de cuantificación, ausencia del error sistemático, estudios de degradación forzada y estabilidad de las soluciones. Además, se validaron: la especificidad, la linealidad, la exactitud, la precisión y la robustez. Resultados. La pureza espectral del método se logró al obtener la separación de los productos de degradación de los picos de los analitos. La estabilidad de las soluciones no se vio afectada, en la frecuencia evaluada de 24 horas, a temperatura ambiente y de refrigeración. Se obtuvo una linealidad con coeficientes de correlación mayores o iguales a 0,999 para la valoración y mayores o iguales a 0,997 para las impurezas. La recuperación estuvo en el rango de 98 a 102,0 % de fluconazol, con una exactitud entre el 80 y el 120 % para las impurezas. El factor de repetibilidad y reproducibilidad no superó la desviación estándar relativa del 2,0 % para la valoración y, la del 5,0 %, para las impurezas, lo cual mostró una solidez adecuada del método. Además, se obtuvo un tiempo corto de ejecución del análisis, lo que permitió la rápida determinación de la calidad de la materia prima. Conclusión. Se demostró que el método de cuantificación de fluconazol, validado por cromatografía líquida de alta resolución con detector de arreglo de diodos, es lo suficientemente selectivo, preciso, exacto, lineal y robusto; además, es capaz de generar resultados analíticos veraces en condiciones de uso reales, incluyendo el clima tropical de Colombia.

Introduction. The real laboratory conditions of each country, including climate, can affect the method's efficiency in analyzing a pharmacological substance. Thus, it is necessary to validate the process according to the corresponding guidelines and optimize it to ensure success and confidence in the results. Objective. The objective was to validate a methodology for fluconazole and its organic impurities quantification in raw material using high-performance liquid chromatography, with a diode array detector, under tropical climate conditions, and complying with all regulatory requirements. Materials and methods. We performed pre-validation tests of the method consisting of system adequacy, filters study, quantification limit, absence of systematic error, forced degradation studies, and solutions stability. In addition, we validated the specificity, linearity, accuracy, precision, and robustness of the system. Results. Separation of the degradation products from the analyte peaks allowed the achievement of the method's spectral purity. The solution's stability was not affected during the evaluated time (24 hours) at room temperature and under refrigeration. Linearity resulted in correlation coefficients greater than or equal to 0.999 for the evaluation and greater than or equal to 0.997 for impurities. We obtained a fluconazole recovery varying from 98 to 102% with an accuracy between 80 to 120% for impurities detection. The repeatability and reproducibility factor did not exceed a relative standard deviation of 2.0% for the evaluation and of 5.0% for the impurities, demonstrating the adequate robustness of the method. In addition, a short analysis execution time allowed the quick determination of the raw material quality. Conclusion. We demonstrated that the fluconazole quantification method validated by high-performance liquid chromatography is sufficiently selective, precise, exact, linear, and robust to generate accurate analytical results under real conditions, including the tropical climate of Colombia.

Análise SWOT no setor de vigilância epidemiológica do município de Teresópolis (RJ): relato de experiência realizada pelo PET-Saúde / SWOT analysis in the epidemiological surveillance sector in the municipality of Teresópolis (RJ): experience report carried out by PET-Saúde / Análisis SWOT en el sector de monitoreo epidemiológico en la ciudad de Teresópolis, Rio de Janeiro: informe de experiencia realizado por PET-Saúde

Frente ao trabalho administrativo do sistema de saúde pública pautado em métodos tradicionais, torna-se necessário a implementação de estratégias facilitadoras para o planejamento das ações em saúde. O diagnóstico situacional (DS) e a análise SWOT auxiliam no ordenamento do pensamento e na implementação de ações efetivas, assim minimizando os desafios que perpassam o campo de atuação. O objetivo deste estudo foi realizar um diagnóstico situacional do Serviço de Vigilância Epidemiológica do município de Teresópolis (RJ). Trata-se de um relato de experiência de estudantes e profissionais da saúde pertencentes ao Programa de Educação pelo Trabalho para Saúde (PET-Saúde) e inseridos no cenário da vigilância epidemiológica local. Para suporte teórico, realizou-se uma busca nas bases PubMed, Scholar Google e SciELO. Forças, fraquezas, oportunidades e ameaças foram observadas a partir do DS realizado, tanto de fatores referentes ao ambiente interno como de fatores externos, possibilitando recomendações para melhor atuação e avanço organizacional. A vivência no território viabilizou o planejamento de estratégias que, além de serem empregadas na divisão de vigilância epidemiológica, abrangessem os serviços de saúde externos, assim alcançando as fragilidades laborais e garantindo atitudes resolutas para o serviço de epidemiologia do munícipio. O PET-Saúde mostrou-se uma grande oportunidade para o pensar e agir em saúde. A partir da percepção dos estudantes e profissionais envolvidos, ações foram ponderadas tanto para os fatores intrínsecos, que podem ser executadas de maneira direta pela equipe, quanto para os fatores extrínsecos, que demandam medidas indiretas para serem resolvidas, sendo revertidas em ganho para a população.

Dealing with the administration work of the public health system based in traditional methods, the implementation of strategies to ease the plans of actions in health is needed. The situational diagnosis (SD) and the SWOT analysis support the alignment of ideas and the implementation of effective actions, thus minimizing the challenges that pervade this field of action. This study aims to carry out a situational diagnosis of the epidemiological surveillance service of the Teresopolis (RJ) municipality. This is an experience report of students and health professionals belonging to the Program of Education for the Health Work (PET-Saúde) and inserted in the scenario of local epidemiological surveillance. For theoretical support, a search was carried out in the bases PubMed, Scholar Google, and SciELO. Strengths, weaknesses, opportunities, and threats were observed from the SD carried out, both from factors related to the internal environment and from external factors, allowing recommendations for better performance and organizational advancement. Living in the territory made it possible to plan strategies that, in addition to being used in the epidemiological surveillance division, covered external health services, thus addressing labor weaknesses and guaranteeing resolute attitudes towards the municipality's epidemiology service. The PET-Saúde was a great opportunity for thinking and acting in health. From the perspectives of the involved students and professionals, actions were planned both aiming at the inner factors, which can be executed in a direct manner by the team, and at the external factors which demand indirect measurements to be resolved, which turn into gains for the population.

Frente al trabajo administrativo del sistema de salud pública pautado en métodos tradicionales, es necesario la implementación de estrategias y herramientas facilitadoras para la planificación de las acciones en salud. El diagnóstico situacional (DS) y el análisis SWOT auxilian en el ordenamiento del pensamiento y en la implementación de acciones resolutivas, minimizando así los desafíos que permean el campo de acción. El objetivo de este estudio es efectuar un diagnóstico situacional del servicio de Monitoreo Epidemiológico del municipio de Teresópolis, en Rio de Janeiro (Brasil). Este es un informe de experiencia de estudiantes y profesionales de la salud, pertenecientes al Programa de Educación por el Trabajo para la Salud (PET-Saúde), insertos en el escenario de monitoreo epidemiológico local. Para el marco teórico se realizó una búsqueda en las bases PubMed, Google Scholar y SciELO. A partir del DS realizado se observaron fortalezas, debilidades, oportunidades y amenazas, tanto de factores relacionados con el ambiente interno como de factores externos, lo que permitió hacer recomendaciones para un mejor desempeño y avance organizacional. Vivir en el territorio permitió planificar estrategias que, además de ser utilizadas en la división de monitoreo epidemiológico, cubrieron los servicios de salud externos, atendiendo así las debilidades laborales y garantizando actitudes resolutivas hacia el servicio de epidemiología del municipio. El PET-Saúde se mostró una gran oportunidad para pensar y actuar en salud. A partir de la percepción de los estudiantes y profesionales implicados en el diagnóstico situacional, se plantean acciones resolutivas, tanto para los factores intrínsecos que pueden ser ejecutados de forma directa por el equipo como para los factores extrínsecos que exigen medidas indirectas para ser resueltos, convirtiéndose en ganancias para la población.

Formulation and evaluation of Buccal mucoadhesive tablets of diclofenac sodium using 23 factorial designs

Buccal tablets

Diclofenac sodium

Drug release

Mucoadhesion

Mucoadhesive tablets

Release kinetics

Meta synthesis of qualitative research on male participation in traumatic childbirth experience / 中国实用护理杂志

Objective:To systematically review the qualitative research on male participation in traumatic childbirth experience, and to provide reference for promoting and improving the physical and mental health and paternity experience of expectant fathers.Methods:Qualitative research on male participation in traumatic childbirth experience published in databases of PubMed, Embase, Web of Science, Spring Link, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM) and Wanfang Database were searched from the establishment of the database to June 2022. The quality of literature was evaluated by the quality evaluation standard of Australian JBI Evidence-based Health Care Center, and the pooled integration method in Meta integration was used to integrate the results.Results:A total of 12 articles were included, and 51 main research results were extracted, which were further summarized into 10 categories, and 4 integrated results were formed: men had prominent negative emotional experience; men lack decision-making participation and communication with medical staff during traumatic childbirth; the impact of traumatic childbirth experience on men; perception and coping after traumatic childbirth.Conclusions:Medical staff should pay attention to the emotional experience of men participating in traumatic childbirth, meet their decision-making information needs in the process of accompanying delivery, identify negative emotions in time after delivery and provide help and support, strengthen the family-centered perinatal health service model, promote the physical and mental health of expectant fathers, and improve the family well-being.

Application and prospect of common laparoscopic technique evaluation tools in urology / 国际外科学杂志

Laparoscopy technology is widely used in urology. The mastery of laparoscopic surgery by urologists is very important to improve the quality of surgery and improve the prognosis of patients. However, there is no evaluation system for the maturity of laparoscopic technology of urologists. Based on this situation, in recent years, some evaluation criteria or evaluation elements have emerged to try to evaluate the laparoscopic skills of urologists. This article mainly summarizes the common evaluation tools, application scenarios, and limitations of laparoscopic technology in urology, and made an idea to establish a laparoscopic technology evaluation system in urology, providing a certain reference for the application and development of training and evaluation tools of laparoscopic technologyin urology.

Caracterización morfométrica de la dermis papilar sana, en pacientes de diferentes edades y sexo

Introducción: Al ocupar la piel una posición de frontera con el mundo exterior y ser un órgano sensible a agresiones ambientales crónicas, es preciso el conocimiento detallado de los cambios que se producen en ella con el paso de los años, para manejar de manera adecuada los procesos relacionados con su envejecimiento. Objetivo: Caracterizar la dermis papilar sana, en pacientes de diferentes edades y sexo, al tener en cuenta indicadores morfométricos. Métodos: Se realizó un estudio de una serie de casos constituida por 12 pacientes con carcinoma basocelular, diagnóstico confirmado por el servicio de Anatomía Patológica del Hospital Provincial Vladimir Ilich Lenin, a los que se les realizó biopsia escisional de la lesión y de márgenes anchos de piel sana alrededor de la misma. La densidad de área de células y de matriz extracelular amorfa de la dermis papilar sana fueron los indicadores morfométricos estudiados. Resultados: En el estudio cualitativo de la dermis papilar, se observaron con menor frecuencia los núcleos de fibroblastos que en los patrones de piel joven y de forma general, la matriz extracelular mostró una mayor densidad. En la morfometría se precisó que en la dermis estudiada existe una disminución de la celularidad y de la sustancia amorfa. Conclusiones: La densidad del área de células tiende a decrecer con la edad y fue de manera significativa diferente entre los sexos, mayor en el sexo femenino. La densidad de área de sustancia amorfa decrece; en el sexo masculino con el paso de los años, mientras que en el sexo femenino, no mostró diferencias significativas.

Introduction: As the skin occupies a frontier position with the outside world and it is an organ sensitive to chronic environmental aggressions, detailed knowledge of the changes that occur in it over the years is necessary to adequately manage the related processes with its aging. Objective: To characterize the healthy papillary dermis, in patients of different ages and sex, taking into account morphometric indicators. Methods: A study of a series of cases was carried out, it consisted of 12 patients with basal cell carcinoma, a diagnosis confirmed by the Pathological Anatomy service of the Vladimir Ilich Lenin Provincial Hospital, the patients underwent excisional biopsy of the lesion and wide margins of healthy skin around it. Cell area density and amorphous extracellular matrix of the healthy papillary dermis were the morphometric indicators studied. Results: In the qualitative study of the papillary dermis, fibroblast nuclei were observed less frequently than in young skin patterns, and in general, the extracellular matrix showed a higher density. In the morphometry, it was specified that in the dermis studied there is a decrease in cellularity and amorphous substance. Conclusions: Cell area density tends to decrease with age and was significantly different between the sexes, being higher in females. The areal density of amorphous substance decreases; in the male sex over the years, while in the female sex, it did not show significant differences.

El tratamiento metodológico de la evaluación atendiendo a su función educativa / The methodological treatment of the evaluation taking into account its educational function

Fundamento: el tratamiento metodológico de la evaluación atendiendo a su función educativa contribuye al aprendizaje de los estudiantes y a la calidad del proceso pedagógico en la carrera Medicina. Objetivo: diseñar un sistema de acciones para el tratamiento metodológico de la evaluación atendiendo a su función educativa. Métodos: se realizó una investigación de desarrollo en la Universidad de Ciencias Médicas de Holguín, Facultad de Ciencias Médicas "Mariana Grajales Coello", durante el año 2022. Se utilizaron como métodos teóricos el análisis-síntesis, la inducción-deducción y la modelación; empíricos la revisión de documentos y el criterio de especialistas. La investigación se llevó a efecto en tres etapas y se utilizó el enfoque mixto para obtener evidencias de su viabilidad. Resultados: se explicó el mecanismo psicopedagógico que fundamenta la función educativa de la evaluación. Se definió el sistema de acciones para su tratamiento metodológico atendiendo a su función educativa, de acuerdo con el contenido a aprender y las características del modelo del profesional de la carrera Medicina; para lograrlo se precisaron acciones en el orden de los conocimientos, habilidades y hábitos, relaciones de los estudiantes con el mundo y las experiencias de la actividad creadora. Conclusiones: se diseñó un sistema de acciones para el tratamiento metodológico de la evaluación atendiendo a su función educativa, el cual fue valorado como adecuado para su implementación, por los especialistas.

Background: the methodological treatment of the evaluation taking into account its educational function contributes to student learning and the quality of the pedagogical process in the Medicine degree. Objective: design a system of actions for the methodological treatment of evaluation taking into account its educational function. Methods: a development investigation was carried outin the Faculty of Medical Sciences at "Mariana Grajales Coello" University of Medical Sciences of Holguín, during the year 2022. Analysis-synthesis, induction-deduction and modeling were used as theoretical methods; empirical the review of documents and the specialists criteria. The research was carried out in three stages and the mixed approach was used to obtain evidence of its viability. Results: the psychopedagogical mechanism that underlies the educational function of the evaluation was explained. The system of actions for the methodological treatment of the evaluation was defined taking into account its educational function, according to the content to be learned and the characteristics of the model of the Medicine degree professional; To achieve this, actions were required in the order of knowledge, skills and habits, students' relationships with the world, and the experiences of creative activity. Conclusions: a system of actions was designed for the methodological treatment of the evaluation taking into account its educational function. The opinion of the specialists was adequate in relation to the system of actions.

Evaluación de la calidad universitaria: pasado y presente en la búsqueda de la excelencia académica / Evaluation of university quality: past and present in the pursuit of academic excellence

Fundamento: desde sus inicios, la Revolución cubana estimuló la excelencia académica en sus universidades, lo cual constituyó uniformidad en el discurso y accionar de funcionarios del Ministerio de Educación Superior. Objetivo: caracterizar la evaluación de la calidad universitaria como vía para el logro de la excelencia académica en diferentes momentos históricos de la Revolución cubana. Métodos: se realizó una investigación cualitativa en la Universidad de Ciencias Médicas de Villa Clara, en septiembre 2023. Se utilizaron métodos teóricos: histórico-lógico, análisis-síntesis y generalización; empíricos: análisis documental y entrevista a informantes clave. Resultados: se analizaron varias intervenciones de funcionarios del Ministerio de Educación Superior que fueron estableciendo una política vinculada hacia la búsqueda de la excelencia académica universitaria en Cuba, las que unidas a criterios de estudiosos latinoamericanos fueron conformando un tránsito hacia procesos de evaluación estipulados por la Junta de Acreditación Nacional, en los cuales se evalúa la calidad universitaria a partir de la acreditación y reacreditación de sus instituciones. Los informantes clave confirmaron la validez de estos procesos en el contexto de la Universidad de Ciencias Médicas de Villa Clara. Conclusiones: los conceptos de universidad y calidad se han ido modificando a través de la vida revolucionaria cubana; expresados en el vínculo constante con la sociedad, los valores humanistas del pueblo y su tradición de lucha. La universidad debe estar inmersa en un ambiente de búsqueda de su pertinencia y calidad; de ahí la importancia de implicarse en procesos de evaluación y revaluación por la Junta Nacional de Acreditación.

Background: from its beginnings, the Cuban Revolution stimulated academic excellence in its universities, which constituted uniformity in the speech and actions of officials of the Ministry of Higher Education. Objective: analyze the involvement of the Cuban Revolution in the search for academic excellence and its derivation towards university accreditation and reaccreditation processes. Methods: a qualitative investigation was carried out at Villa Clara University of Medical Sciences , in September 2023. Theoretical methods were used: historical-logical, analysis-synthesis and generalization; Empirical ones: documentary analysis and interviews with key informants. Results: several interventions by officials of the Ministry of Higher Education were analyzed that were shaping and establishing a policy linked to the search for university academic excellence in Cuba, which, together with criteria from Latin American scholars, were granting a transition towards evaluation processes stipulated by the National Accreditation Board, in which university quality is strengthened through the accreditation and reaccreditation of its institutions. Key informants confirmed the validity of these processes, in the context of the Villa Clara University of Medical Sciences. Conclusions: the concepts of university and quality have been modified throughout Cuban revolutionary life; expressed in the constant link with society, the humanist values of the people and their tradition of struggle. The university must be immersed in an environment of search for its relevance and quality; hence its importance of getting involved in evaluation and reevaluation processes by the National Accreditation Board.

Orofacial Myofunctional Aspects of Nursing Infants and Preschoolers

Abstract Introduction Clinical assessment in orofacial motricity is required for the speech therapist to diagnose and treat disorders involving the stomatognathic system. Validated tools can help establish a prognosis and outline intervention methods connected to human development. Objective The goal of the present study was to examine the domains of the oromyofunctional assessment of nursing infants and preschoolers according to sex and age group, as well as the application of the MMBGR Protocol - Nursing Infants and Preschool Children. Methods A quantitative technique was used to conduct an analytical and cross-sectional investigation. The present study included a total of 214 healthy breastfeeding infants and preschoolers of both sexes. The Mann-Whitney test was used to compare the medians. The Spearman correlation of each test domain was determined. R Core Team 2021 (R Foundation, Vienna, Austria) was used, and the significance threshold was set at 5%. Results In intraoral and extraoral examinations, there was a difference between sexes for tongue scores in nursing infants(d =-0.428; p = 0.045), worse in males. When the orofacial functions were considered in nursing infants, there were differences between the sexes for the liquid/solid/semisolid deglutition scores (d = 0.479; p = 0.031), with females performing worse. There were sex differences in solid/semisolid deglutition (d = -0.335; p = 0.043), and speech in preschoolers (d = - 0.478; p = 0.034), including the production of phones/phonemes (d = - 0.599; p = 0.007), which were always worse in males. Conclusion The research revealed sex disparities and related the domains of oromyofunctional assessment, according to scores, of the domains of myofunctional assessment, as recorded in a standardized oromyofunctional assessment protocol by age group.

Vigilância em Saúde do Trabalhador na perspectiva de gestores e tomadores de decisão / Workers' Health Surveillance from managers' and decision-makers' perspectives

Resumo Objetivo: analisar as ações de implantação da Vigilância em Saúde do Trabalhador (Visat) na esfera municipal, pela perspectiva de gestores e tomadores de decisão. Método: estudo descritivo-exploratório de abordagem qualitativa, realizado em duas etapas: (1) levantamento documental da legislação relacionada à Saúde do Trabalhador; (2) entrevistas semiestruturadas com 15 gestores e tomadores de decisão na área, que foram gravadas, transcritas e analisadas segundo análise temática. Resultados: a análise documental incluiu seis documentos, sendo três relacionados às ações de Visat e três relacionados às ações que guardam interface com a Saúde do Trabalhador. Sete categorias emergiram na análise temática: Aspectos legais da Saúde do Trabalhador; Implementação das ações de Visat; Fluxos de informação e comunicação da Visat; Papéis e competências relacionados à ST no Sistema Único de Saúde; Articulação entre os setores envolvidos na Visat; Atuação do Centro de Referência em Saúde do Trabalhador regional; Relevância do controle social e participação sindical para implementação da Visat municipal. Conclusão: o estudo evidenciou fragilidades na consolidação da Visat, com desarticulação dos setores envolvidos, ações fragmentadas, ausência de definições de papéis e fluxos de trabalhos e, ainda, desconhecimento dos aspectos relacionados à atenção à saúde dos trabalhadores pelos atores envolvidos em sua consolidação.

Abstract Objective: to analyze the implementation of Workers' Health Surveillance (WHS) at a regional level, from managers' and decision-makers' perspectives. Methods: descriptive-exploratory study with a qualitative approach performed in two steps (1) documental analysis related to Workers' Health legislation; (2) semi-structured interviews with 15 managers and decision-makers, that were recorded, transcribed, and analyzed by thematic analysis. Results: documental analysis found six documents, with three related to WHS and three related to actions interfacing Workers' Health. Seven categories were found in the speeches: Legal aspects of Workers' Health; Implementation of WHS actions; Communication and information flows of WHS; Roles and competencies related to Workers' Health in the Brazilian Unified Health System; Articulation among sectors involved in WHS; Role of the Regional Center of Reference in Workers' Health; and Relevance of social control and union participation for WHS implementation. Conclusion: this study shows flaws in the WHS consolidation, including non-articulation of involved sectors, fragmented actions, lack of defined roles and competencies, and lack of knowledge about Workers' Health care by the actors involved in its consolidation.

Avaliação da qualidade da informação de saúde on-line: uma análise bibliográfica da produção acadêmica brasileira / Quality assessment of online health information: a bibliographic analysis of the Brazilian academic production

RESUMO Cada vez mais, há usuários que recorrem à internet para obter informações sobre saúde. Desse modo, é importante atentar para a questão da qualidade do conteúdo disponibilizado on-line. Informação sobre saúde incompleta, incorreta e incompreensível circula na internet e pode comprometer o bem-estar dos indivíduos. Diferentes iniciativas têm sido desenvolvidas para lidar com essa problemática, sendo uma delas a avaliação da qualidade da informação on-line sobre saúde. Nesse cenário, o presente artigo apresenta as características da produção acadêmica brasileira sobre tal iniciativa, especificamente os métodos empregados para avaliar a acurácia do conteúdo. A partir de uma análise bibliográfica, foi identificado que a preocupação com a dimensão da acurácia da informação on-line está presente entre a maioria dos autores. Entretanto, cabe ressaltar que tal processo avaliativo utiliza como referência o consenso de especialistas e materiais bibliográficos. O emprego desses recursos apresenta limitações, uma vez que podem estar desatualizados em relação às melhores e mais atuais evidências científicas. Nesse sentido, é fundamental que pesquisas futuras sobre a avaliação da acurácia da informação on-line sobre saúde adotem como referencial os sumários sintetizados de informação clínica.

ABSTRACT More and more users are turning to the Internet for health information. Therefore, it is important to pay attention to the quality of the content made available online. Incomplete, incorrect, and incomprehensible health information circulates on the Internet and can jeopardize the well-being of individuals. Different initiatives have been developed to deal with the quality issue, one of them being the evaluation of the quality of online health information. In this scenario, the present article presents the characteristics of the Brazilian academic production on the matter, specifically the methods used to assess the accuracy of the content. We conducted a bibliographic analysis, and we identified that the concern with the dimension of accuracy of online information is present among most authors. However, it is worth mentioning that this evaluation process uses expert consensus and bibliographic materials as references. The use of these resources has limitations, since they may be outdated in relation to the best and most current scientific evidence. In this sense, it is essential that future research on the evaluation of the accuracy of online health information adopt the summarized summaries of clinical information as a reference.

Evaluation methods and application progress of drug cytotoxicity in vitro / 中国基层医药

Drugs have both therapeutic and toxic side effects. How to quickly determine the toxicity of the test substance is very important for drug development. In vitro cytotoxicity testing compensates for the shortcomings of using animal models for toxicity evaluation. Its role in toxicity evaluation is increasingly important. The development of computer technology and in-depth research in proteomics, genomics, and metabolomics provide a method for in vitro cytotoxicity evaluation towards a faster and more accurate direction. This paper reviews the commonly used cells, evaluation indicators, and detection techniques for in vitro cytotoxicity evaluation, in order to provide some reference for related research.

Experimentos de elección discreta. Diseño, análisis e implementación en salud / Discrete choice experiments. Design, analysis and implementation in health

Resumen: Los experimentos de elección discreta (DCE, su sigla en inglés), son una metodología usada para evaluar preferencias de desenlaces o intervenciones relacionadas con salud. A diferencia de otras técnicas de medición que utilizan métodos simples de elección o herramientas estadísticas básicas que fallan al evaluar los beneficios específicos de una intervención, proceso de entrega, beneficio, satisfacción y preferencia de los usuarios en términos de tiempo, calidad o atributo específico, los DCE combinan, en la generación de atributos y modelamiento matemático, complejas tareas de diseño y ejecución, que mejoran la calidad y optimizan la cantidad necesaria de información mediante el uso eficiente de recursos y resultados de excelente calidad. Este documento presenta la historia, el desarrollo y la fundamentación teórica de los DCE y muestra las críticas, las potenciales limitaciones y las precauciones.

Abstract: Discrete choice experiments (DCE) are a methodology for evaluate patient preferences for health-related outcomes or interventions. Other preference measurement techniques that use simple methods of choice or basic statistical tools that fail to evaluate the specific benefits of an intervention, delivery process, benefit, satisfaction and patients' preferences in terms of time, quality or specific attribute. The DCE combine in the generation of attributes and mathematical modeling, complex task of designing and execution, to improve the quality and optimize the necessary amount of information, achieving an efficient use of resources with excellent quality results. This document presents globally a brief of the history, development and theoretical foundation of the DCE and then presents in a critical way the potential limitations, precautions in their use and implementation that allow to establish the possible scenarios of use and development.

Calidad del instrumento de evaluación final de la asignatura Célula, Tejidos y Sistema Tegumentario

Fundamento: cuando se emplea un instrumento evaluativo, este debe ajustarse a rigurosos estándares de calidad; los defectos en su elaboración tienen efectos negativos en el proceso de enseñanza aprendizaje. Objetivo evaluar la calidad del examen ordinario de la asignatura Célula, Tejidos y Sistema Tegumentario a través del nivel de dificultad y el poder de discriminación del instrumento. Métodos: estudio observacional, descriptivo de corte transversal en el campo de la evaluación. El universo estuvo integrado por 369 exámenes que corresponden al total de estudiantes que se presentaron. Las variables de estudio fueron procedimiento y técnicas, frecuencia de errores, índice de dificultad y poder de discriminación. Para el procesamiento estadístico se realizó el cálculo de índices y por cientos. Resultados: el examen estuvo constituido por siete preguntas, predominaron las de tipo ensayo (57,14 %) y dentro de estas las de respuesta corta con un total de tres que representa el 75 %. La pregunta uno tuvo mayor número de aciertos mientras que la pregunta cuatro tuvo el menor número de aciertos. De las preguntas, cinco (71,42 %) fueron altamente fácil, dos (28,57 %) medianamente fácil, una (14,28 %) con dificultad media. El examen se calificó de altamente fácil con un índice de 0,88. El 85,71 % de las preguntas presentaron una discriminación excelente al igual que el examen en general con un índice de 0,57. Conclusiones: el examen mostró una calidad adecuada a partir de la coherencia que existió entre las preguntas, el nivel de dificultad y el poder de discriminación.

Background: when an assessment tool is used, it must conform to rigorous quality standards; defects in its preparation have negative effects on the teaching-learning process. Objective: to evaluate the quality of the ordinary examination of the Cell Tissues and Integumentary System subject through the level of difficulty and the power of the instrument discrimination. Methods: observational, descriptive cross-sectional study in the field of evaluation. The universe was made up of 369 exams that correspond to the total number of students who took part. The study variables were procedure and techniques, frequency of errors, index of difficulty and power of discrimination. For statistical processing, the calculation of indices and percentages was performed. Results: the exam consisted of seven questions, essay-type predominated (57.14%) and within these short-answer questions with a total of three that represents 75%. Question one had the highest number of correct answers while question four had the least number of correct answers. Of the questions, five (71.42%) were highly easy, two (28.57%) moderately easy, one (14.28%) medium difficulty. The exam was rated as highly easy with an index of 0.88. 85.71% of the questions presented an excellent discrimination as well as the exam in general with an index of 0.57. Conclusions: the exam showed an adequate quality based on the coherence that existed between the questions, the level of difficulty and the power of discrimination.

Development of a test instrument to measure the basic pass technique in futsal / Desenvolvimento de instrumento de teste para medir a técnica básica de passe no futsal / Desarrollo de un instrumento de prueba para medir la técnica básica de pase en el futsal

ABSTRACT Introduction: The passing technique requires a high skill level because the futsal field is narrow, and the distance between players is short, demanding strength and accuracy. An instrument of performance test is necessary to verify the evolution of this technique among the players. Objective: This study aims to develop a test instrument to measure the performance of futsal passing. Methods: Instrument preparation and reliability validity tests were applied in 120 athletes. Results: The results evidenced validity in the instrument with one minute passing time; that is, pass one is 0.855, and pass two is 0.857. The reliability value of the first Pass is 0.81, and the second Pass is 0.812. Conclusion: The development of the pass test tool is valid and reliable for its use in measuring the basic passing technique in soccer. Evidence Level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução: A técnica de passe requer um alto nível de habilidade pois o campo de futsal é estreito e a distância entre jogadores é pequena, demandando força e precisão. Um instrumento de teste de desempenho é necessário para verificar o desenvolvimento na evolução dessa técnica entre os jogadores. Objetivo: O objetivo desse trabalho é desenvolver um instrumento de teste para mensurar o desempenho no passe de futsal. Métodos: Testes de preparação de instrumentos e validade de confiabilidade foram aplicados em 120 atletas. Resultados: Os resultados evidenciaram validade no instrumento com um minuto no tempo do passe, isto é, a validade de um passe é de 0,855 e de dois passes é de 0,857. O valor de confiabilidade do primeiro passe é de 0,81 e do segundo passe é de 0,812. Conclusão: O desenvolvimento da ferramenta no teste de passe é válido e confiável para sua utilização no aferimento da técnica básica de passe no futebol. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción: La técnica del pase pide un alto nivel de habilidad porque el campo de fútbol de salón es estrecho y la distancia entre los jugadores es pequeña, lo que exige fuerza y precisión. Es necesario un instrumento de prueba de rendimiento para comprobar el desarrollo en la evolución de esta técnica entre los jugadores. Objetivo: El objetivo de este trabajo es desarrollar un instrumento de prueba para medir el rendimiento en el pase del futsal. Métodos: Se aplicaron pruebas de validez del instrumento y de fiabilidad en 120 atletas. Resultados: Los resultados evidenciaron la validez en el instrumento con un minuto en el tiempo de la pasada, es decir, la validez de una pasada es de 0,855 y de dos pasadas es de 0,857. El valor de fiabilidad de la primera pasada es de 0,81 y de la segunda de 0,812. Conclusión: El desarrollo de la herramienta en el test de pase es válido y fiable para su uso en la medición de la técnica básica de pase en el fútbol. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Diseño y validación de una escala de autoeficacia en la evaluación de tesis de grado en ciencias de la salud

Introducción. Las tesis de grado requieren de una adecuada evaluación para asegurar la calidad metodológica y su potencial publicable. Objetivos. Diseñar y validar una escala de autoeficacia en la evaluación de tesis de grado en jurados dictaminadores de ciencias de la salud (EAE-Te). Métodos. Estudio instrumental y transversal, donde participaron 221 jurados de tesis de grado de medicina, odontología, enfermería, nutrición y psicología, quienes laboran en instituciones privadas y estatales de las tres regiones del Perú. La escala se diseñó en base a indicadores teóricos hallados en la literatura científica, teniendo como primera versión 16 ítems. La validez basada en el contenido se evaluó con el coeficiente V de Aiken, la validez de constructo con el análisis factorial exploratorio y la confiabilidad con el coeficiente alfa de Cronbach y sus respectivos intervalos de confianza. Resultados. Los valores V de Aiken fueron favorables para todos los ítems. El análisis factorial exploratorio evidenció un modelo unidimensional con 13 ítems (KMO = 0,868; Bartlett = 2302.1; gl = 66; p < 0,001), donde el factor alcanzado explica el 60,99% de la varianza total de la escala y sus cargas factoriales oscilan entre 0,605 y 0,872; finalmente, la confiabilidad fue aceptable (α = 0,943; IC95% = 0,92-0,95). Conclusiones. La EAE-Te es una medida unidimensional y demuestra evidencias psicométricas iniciales de validez basada en el contenido, de estructura interna y fiabilidad; por tanto, puede aplicarse para evaluar el nivel de autoeficacia de los jurados para evaluar tesis de grado.

Introduction. Graduate theses require adequate evaluation to ensure their methodological quality and publishable potential. Objectives. To design and validate a scale of self-efficacy in the evaluation of graduate theses in health sciences jurors (EAE-Te). Methods. Instrumental and cross-sectional study, with the participation of 221 medical, dental, nursing, nutrition and psychology graduate thesis jurors who work in private and state institutions in the three regions of Peru. The scale was designed based on theoretical indicators found in the scientific literature, with a first version of 16 items. Content-based validity was evaluated with Aiken's V coefficient, construct validity with Exploratory Factor Analysis and reliability with Cronbach's Alpha coefficient and their respective confidence intervals. Results. Aiken's V values were favorable for all items. The exploratory factor analysis evidenced a unidimensional model with 13 items (KMO = 0.868; Bartlett = 2302.1; gl = 66; p < 0.001), where the factor reached explains 60.99% of the total variance of the scale and its factor loadings range between 0.605 and 0.872; finally, reliability was acceptable (α = 0.943; 95%CI = 0.92-0.95). Conclusions. The SEA-Te is a unidimensional measure and demonstrates initial psychometric evidence of content-based validity, internal structure and reliability; therefore, it can be applied to assess the level of jurors' self-efficacy to evaluate graduate theses.

Métodos clínicos de avaliação dinâmica e quantitativa do complexo ombro e escápula: uma revisão de escopo / Métodos clínicos de evaluación dinámica y cuantitativa del complejo del hombro y escápula: una revisión de alcance / Clinical methods of dynamic and quantitative evaluation of the shoulder and scapula complex: a scoping review

RESUMO A articulação do ombro possui a maior amplitude de movimento e está mais suscetível a disfunções. Avaliações dinâmicas e quantitativas dessa região fornecem melhores informações para a clínica, mas a escolha do método a ser utilizado depende de suas propriedades de medição. O objetivo deste estudo foi identificar os métodos existentes de avaliação dinâmica quantitativa do complexo ombro e escápula em um contexto clínico para a população em geral, identificando as propriedades de medição e os desfechos avaliados para cada método. A revisão de escopo incluiu estudos in vivo, com amostras sem uma condição clínica específica e envolvendo métodos aplicáveis em um contexto clínico. Foram identificados: desfecho avaliado, método de medição e suas propriedades de medição. Foram selecionados 29 estudos que investigaram 12 métodos de medição, sendo avaliadas sua validade e confiabilidade para 17 desfechos diferentes. A posição do ombro e da escápula e os desfechos derivados foram abordados pelo maior número de estudos (n=21), sendo seus principais métodos de avaliação as unidades de medição inercial (n=5) e unidades de medição magnética inercial (n=6). Os desfechos que apresentaram métodos válidos e confiáveis foram: amplitude articular de ombro; amplitude de movimento da escápula e do ombro; atividade muscular; centro articular do ombro; comprimento do úmero; curva torque-tempo; desempenho funcional; discinesia escapular; força de rotadores externos do ombro; funcionalidade e amplitude articular; movimento escapular inicial; posição da escápula e do ombro; e velocidade angular do ombro.

RESUMEN La articulación del hombro tiene la mayor amplitud de movimiento y es más susceptible a disfunciones. Las evaluaciones dinámicas y cuantitativas de esta región proporcionan mejores informaciones para la clínica, pero la elección del método a utilizar depende de sus propiedades de medición. El objetivo de este estudio fue identificar los métodos existentes de evaluación dinámica cuantitativa del complejo del hombro y escápula en un contexto clínico para la población general, identificando las propiedades de medición y los resultados evaluados para cada método. La revisión de alcance incluyó estudios in vivo, con muestras sin una condición clínica específica y con métodos aplicables en un contexto clínico. Se identificaron el resultado evaluado, el método de medición y sus propiedades de medición. Se seleccionaron 29 estudios que investigaron 12 métodos de medición, y se evaluó su validez y confiabilidad para 17 resultados diferentes. La posición del hombro y de la escápula, y los resultados derivados fueron abordados por el mayor número de estudios (n=21), y sus principales métodos de evaluación fueron las unidades de medición inercial (n=5) y las unidades de medición magnética inercial (n=6). Los resultados que presentaron métodos válidos y confiables fueron: amplitud articular del hombro; amplitud de movimiento de la escápula y del hombro; actividad muscular; centro articular del hombro; longitud del húmero; curva torque-tiempo; desempeño funcional; discinesia escapular; fuerza de los rotadores externos del hombro; funcionalidad y amplitud articular; movimiento escapular inicial; posición de la escápula y del hombro; y velocidad angular del hombro.

ABSTRACT The shoulder joint has the greatest range of motion and is the most susceptible to dysfunction. Dynamic and quantitative evaluations of this region provide better information for the clinic but the choice of the method depends on its measurement properties. This study aimed to identify the existing methods of quantitative dynamic evaluation of the shoulder and scapula complex, in a clinical context for the general population, identifying the measurement properties and outcomes of each method. The scoping review included in vivo studies, with samples without a specific clinical condition and involving applicable methods in a clinical context. We identified evaluated outcome, measurement method, and its measurement properties. We selected 29 studies that investigated 12 measurement methods, and evaluated their validity and reliability for 17 different outcomes. Most studies (n=21) addressed the position of the shoulder and the scapula and the derivative outcomes, using mainly the units of inertial measurement (n=5) and inertial magnetic measurement (n=6) as evaluation methods. The outcomes with valid and reliable methods were: shoulder joint range; scapula and shoulder motion range; muscle activity; shoulder joint center; humerus length; torque-time curve; functional performance; scapular dyskinesia; external shoulder rotators force; shoulder joint functionality and range; initial scapular movement; scapula and shoulder position; and shoulder angular velocity.

Avaliação da qualidade da informação de sites sobre Covid-19: uma alternativa de combate às fake news / Assessment of the quality of information on Covid-19 websites: an alternative for combating fake news

RESUMO As tecnologias de informação e comunicação têm-se disseminado globalmente. Elas estão cada vez mais presentes em quase todos os aspectos da vida humana, incluindo a saúde. Em meio à ampla disseminação de informações falsas, a questão da qualidade da informação tem assumido grande importância, especialmente em contexto de pandemia. Entre julho e agosto de 2020, foi realizada uma avaliação da qualidade da informação em sites sobre Covid-19 de quatro secretarias de saúde do estado de Mato Grosso do Sul. Essa avaliação participativa utilizou cinco critérios, acompanhando a literatura internacional, a saber: Técnico, Interatividade, Abrangência, Legibilidade e Acurácia, subdivididos em 46 indicadores. Os resultados apontam que os sites avaliados apresentaram baixo grau de conformidade com os indicadores e critérios utilizados e não divulgam as principais evidências científicas sobre o tema, disponíveis no site do Ministério da Saúde. A pandemia de Covid-19 tem sido marcada pela alta circulação de fake news. Nesse contexto, é imprescindível que páginas de secretarias de saúde apresentem informação sobre a doença com qualidade e legibilidade. Só assim, oferecerão um conteúdo informativo confiável e baseado em evidências científicas, contribuindo para o enfrentamento de notícias falsas e seus impactos negativos.

ABSTRACT Information and communication technologies have spread worldwide and are increasingly present in almost every aspect of human life, including health. The issue of information quality has assumed great importance amid the widespread dissemination of false knowledge, especially in a pandemic. We evaluated the quality of information on Covid-19 websites of four Health Secretariats in the state of Mato Grosso do Sul, Brazil, from July to August 2020. This participatory evaluation employed five criteria, following the international literature, namely: Technical, Interactivity, Comprehensiveness, Readability, and Accuracy, subdivided into 46 indicators. The results of the evaluated websites point to a low level of compliance with the indicators and criteria adopted and fail to disclose the primary scientific evidence on the topic, available on the Ministry of Health's website. The high circulation of fake news has marked the Covid-19 pandemic. In this context, Health Secretariats' pages should display quality and intelligible information about the disease. Only then will they offer reliable informational content based on scientific evidence, contributing to the fight against fake news and its adverse impacts.

The value of time-signal intensity curve of magnetic resonance imaging combined with apparent diffusion coefficient in the evaluation of anal fistula activity / 中国基层医药

Objective:To evaluate the value of time-signal intensity curve (TIC) combined with apparent diffusion coefficient (ADC) obtained with 1.5T magnetic resonance imaging in the evaluation of anal fistula activity.Methods:The clinical, imaging, and pathological data of 71 patients with pathologically confirmed anal fistula who received treatment in Ningbo Yinzhou No.2 Hospital from June 2018 to February 2020 were retrospectively analyzed. These patients were divided into active phase group ( n = 42) and remission phase group ( n = 29) according to surgical findings and pathological tissue composition. Pearson's chi-square test was used to analyze TIC types. The ADC value was compared between the two groups. Results:TIC types: In the active phase group, the percentage of patients with type I curve (rising enhancement pattern) and type III curve (washout pattern) was 47.6% (20/42) and 35.7% (15/42) respectively, which were significantly higher than that of patients with type III curve [plateau pattern; 16.7% (7/42)], χ2 = 9.22, 3.94, both P < 0.05). In the remission phase group, the percentage of patients with type I and II curves was 34.5% (10/29) and 55.2% (16/29) respectively, which were significantly higher than that of patients with type III curve [10.3% (3/29), χ2 = 4.86, 13.23, both P < 0.05]. ADC value: ADC value in the active phase group was significantly lower than that in the remission phase group [(0.932 ± 0.074) × 10 -3 mm 2/s vs. (1.164 ± 0.061) × 10 -3 mm 2/s, t = -13.87, P < 0.001). Conclusion:TIC combined with ADC value can effectively evaluate anal fistula activity. It can be used as a routine method for preoperative evaluation and postoperative follow-up for patients with anal fistula.