Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine： 2.Establishment of Guideline Working Group and Management of Conflict of Interests / 中医杂志

This paper summarized the key points and methods in terms of the establishment of the guideline working group and the management of conflict of interests， trying to provide reference for the development of clinical practice guidelines for Chinese patent medicine （CPM）. The establishment of the working group is the first important step for developing CPM guidelines. Considering the characteristics of the clinical practice guidelines for CPM， this study suggests that the three key elements of ‘multidisciplinarity’， ‘clinical relevance’ and ‘geographical representativeness’ should be put focus on when forming the working group. The guideline advisory committee， clinical expert group， evidence systematic evaluation group， secretary group and the external review group should be established. All group members should clarify the conflict of interest， and the process and management method of the conflict of interest should be clearly reported.

Predictors of Retirement Adjustment: A Comparative Study Among Occupations / Preditores do Ajustamento na Aposentadoria: Estudo Comparativo Entre Ocupações

Abstract This research investigated differences in retirement adjustment among workers in occupations classified by the RIASEC typology. The literature reports that this adjustment varies depending on individual access to resources such as health, finances, and personal attributes. The participants were 469 retirees, 65% women, aged between 47 and 88 years, who responded to the Retirement Resources Inventory, the Pearlin Mastery Scale and reported demographic data. The analysis revealed that retirees from social and investigative occupations have more resources and greater adjustment in retirement. Retirees from realistic occupations revealed an unfavorable perspective. Mastery proved to be the most important predictor of adjustment. The results indicate that retirement adjustment resources vary among workers from different occupational types.

Resumo Esta pesquisa investigou diferenças no ajustamento à aposentadoria entre trabalhadores de ocupações classificadas na tipologia RIASEC. A literatura informa que esse ajustamento varia na dependência do acesso individual a recursos tais como saúde, finanças e atributos pessoais. Participaram 469 aposentados, 65% mulheres, idades entre 47 e 88 anos, que responderam ao Inventário de Recursos para Aposentadoria, a Escala de Domínio Pearlin e informaram dados demográficos. As análises revelaram que aposentados de ocupações sociais e investigativas possuem mais recursos e maior ajustamento na aposentadoria. Aposentados de ocupações realistas revelaram uma perspectiva desfavorável. Senso de domínio se revelou o preditor mais importante do ajustamento. Os resultados indicam que os recursos de ajustamento na aposentadoria variam entre trabalhadores em diferentes tipos de ocupação.

Study on the Emotional Status and Rights Protection of Participants in Drug Clinical Trials during Epidemic Prevention and Control / 中国医学伦理学

【Objective:】 To analyze the emotional status and follow-up status of the participants in the drug clinical trials in a hospital during the epidemic prevention and control, with a view to maximizing the protection of participants’ rights and interests under special circumstances. 【Methods:】 The general information, depression screening scale (PHQ-9), anxiety screening scale (GAD-7) and subject compliance assessment scale were completed online by participants with gold data questionnaire. At the same time, the status of drug clinical trials under study and the follow-up status of participants under study were collected from November 1, 2021 to December 8, 2021 and from December 9, 2021 to January 24, 2022. Excel software and SPSS18.0 software were used for data statistics and analysis. 【Results:】 During the epidemic prevention and control, there were 20 drug clinical trial projects under way in the hospital. From December 9, 2021 to January 24, 2022, the planned number of visits was 161, and the actual number of visits to the hospital was 84 (52.2%). Plus 24 participants who mailed drugs, the overall visit rate was 67.1%, among which the visit rates of oral drugs, non-oral drugs, and oral drugs combined with non-oral drugs were 79.3%, 71.9%, and 41.0% respectively. From November 1, 2021 to December 8, 2021, the planned number of visits was 166, the actual number of visits to the hospital was 157 (94.6%), and the number of telephone visits accounted for 1.8% of the total planned number of visits. The number of participants who did not take the drug and those who delayed taking the drug were both 0. The total compliance of participants was as high as 80.0%. A total of 40 valid questionnaires were retrieved, and the detection rates of depression and anxiety were 42.5% and 30.0% respectively. 【Conclusion:】 The epidemic prevention and control has a large short-term impact on the follow-up of the participants under study. The formulation of relevant follow-up measures and the conduction of classification management can not only improve the emotions of the participants to a certain extent, but also protect the rights and interests of participants, providing suggestions for the follow-up of participants under emergencies in the future.

Research on the Role of Ethical Governance of Science and Technology in Constructing a Harmonious Doctor-patient Relationship / 中国医学伦理学

The ethical governance of science and technology has put forward higher ethical requirements for researchers. As important personnel in medical research and front-line workers in contact with patients, clinical health workers should regulate their ethical behavior during the research process and provide informed consent to patients participating in study to protect their rights and interests. At present, patients’ rights and interests are still violated due to insufficient ethical awareness of researchers in the process of clinical research. Ethical governance of science and technology is not only a standard for researchers’ behavior and protection of patients’ rights and interests, but also a new test for scientific research management and ethical review departments, as well as an important measure to enhance the trust between doctors and patients and build harmonious doctor-patient relationship.

Exploration on Shared Decision-making Mechanisms in Chinese Medicine Treatment / 中国医学伦理学

Traditional Chinese medicine(TCM) treatment models are rich and unique, including patient-led decision-making, doctor-led decision-making, and doctor-patient shared decision-making. However, doctor-led decision-making is more common. The connotation of TCM shared decision-making is rich, including not only the smooth flow of information and the encouragement and support of equal participation by patients, but also the discussions on various aspects of diet, exercise, emotions, daily life, physiology, psychology, society, and nature that affect health based on the unique holistic concept of TCM. Integrating "shared decision-making" into the treatment process of TCM can be divided into four steps according to the process of "diagnosis and treatment". TCM shared decision-making has advantages and limitations, requiring both doctors and patients to meet certain objective conditions, and there are also special situations in TCM treatment where shared decision-making cannot be applied. Multiple ways to enhance the decision-making ability of doctors and patients, scientific evaluation and matching treatment plans, development of decision-making aids, and smooth channels for information transmission can all enhance the shared decision-making ability of doctors and patients.

Main Problems and Ethical Review Points of Subject Recruitment in Drug Clinical Trials / 中国医学伦理学

Drug clinical trials need to recruit suitable subjects to verify the safety and effectiveness of new drugs. Subject recruitment is a very important and challenging link in the whole process of drug clinical trials, and even directly affects the progress and final results of the trials. The medical ethics committee should give full play to the important function of ethical review, carefully review the whole process of subject recruitment from the perspective of science and ethics, and do a good job in the protection of the health and rights of subjects. This paper mainly discussed the basic principles of subject recruitment, the main problems existing in the recruitment process and the key contents of ethical review, so as to provide scientific references and suggestions for standardizing subject recruitment, protecting the rights and interests of subjects, and promoting the efficient and high-quality completion of drug clinical trials.

Fellowship training of family medicine in the United States and its implications for China / 中华全科医师杂志

The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.

Survey on the views of general practitioners on developing special interests in the context of county medical community / 中华全科医师杂志

Objective:To explore the views of general practitioners (GPs) on developing special interests in the context of the county medical community.Methods:A survey was conducted using self-designed questionnaire from November and December 2019, among 49 general practice residents trained in the First Affiliated Hospital of Zhejiang University School of Medicine. Meanwhile, structured interviews were undertaken with 14 general practice residents.Results:Forty-nine valid questionnaires were collected with a response rate of 100.0%. All participants were from the county medical community units. The survey showed that 91.8% (45/49) of respondents were willing to develop special interests and 79.6% (39/45) chose one subject, and the top three subjects were endocrinology, gastroenterology and cardiology. The structured interviews demonstrated that most participants did not understand meaning of general practitioners with special interests (GPwSIs) clearly and were unable to distinguish GPwSIs from specialists; they were confused about the status, training mode, and assessment standards of GPwSIs. The interviews also showed that the demand for developing special interests for them was derived from the needs of patients for diagnosis and treatment, the target population of health care services, peer advice and personal interests.Conclusions:Most general practice residents are willing to develop special interests, and internal medicine is the first choice; however, their understanding of the GPwSIs is insufficient. The survey suggests that the position, training model, assessment and certification of GPwSI need to be further clarified.

Manejo de conflictos de interés en control del tabaco: situación en las Américas / Managing conflicts of interest in tobacco control: situation in the Americas / Manejo de conflitos de interesse no controle do tabaco: situação nas Américas

RESUMEN El presente informe especial describe tanto la metodología para el cálculo del indicador sobre adopción de mecanismos eficaces para evitar la interferencia de la industria tabacalera o de aquellos que defienden sus intereses, establecido en la "Estrategia y plan de acción para fortalecer el control del tabaco en la Región de las Américas 2018-2022", así como del estado de adopción de estos mecanismos en los países de la Región para el año 2019, y su progreso desde 2016. Se encontró que, para el 2019, de los 35 Estados Miembros de la Organización Panamericana de la Salud (OPS), 13 cuentan con normativa que establece medidas específicas al manejo de conflicto de interés para funcionarios y empleados públicos con competencia en políticas de control del tabaco. Asimismo, 7 han implementado medidas relacionadas, pero no específicas, y 14 no han implementado ninguna medida. Si bien se muestra un avance en relación con año 2016, los esfuerzos deben ser redoblados para alcanzar la meta de 20 Estados Miembros con mecanismos de identificación y manejo de conflictos de interés, establecida en la Estrategia y plan de acción. Cabe destacar que contar con normativa referida al tema no agota, ni mucho menos, concluye el cumplimiento de todas las obligaciones que emanan del artículo 5.3 del Convenio Marco de la Organización Mundial de la Salud para el Control del Tabaco. La Secretaría de OPS, en cumplimiento de lo solicitado por los Estados Miembros, desarrolló la metodología para el cálculo del indicador y sistematizó los hallazgos que son presentados.

ABSTRACT This special report describes the methodology for calculating the indicator for the adoption of effective mechanisms to counter interference by the tobacco industry and those who work to further its interests, as established in the Strategy and Plan of Action to Strengthen Tobacco Control in the Region of the Americas 2018-2022; the report also presents the status of adoption of these mechanisms in the countries of the Region as of 2019, and progress since 2016. It was found that, as of 2019, of the 35 Pan American Health Organization (PAHO) Member States 13 had regulations establishing specific measures for managing conflicts of interest for government officials and employees with responsibility for tobacco control policies; seven had implemented related but nonspecific measures; and 14 had not implemented any measure. Although there has been progress since 2016, efforts must be redoubled to reach the target of 20 Member States having mechanisms for the identification and management of conflicts of interest, as established in the Strategy and Plan of Action. It should be noted that having regulations on the subject does not fulfill, nor by any means fully meet, all the obligations arising from Article 5.3 of the World Health Organization Framework Convention on Tobacco Control. The PAHO Secretariat, in response to requests by Member States, developed the methodology for calculation of the indicator and systematized the findings that are presented.

RESUMO Este relatório especial descreve tanto a metodologia de cálculo do indicador sobre a adoção de mecanismos eficazes para evitar a interferência da indústria do tabaco ou daqueles que defendem seus interesses, estabelecida na "Estratégia e plano de ação para fortalecer o controle do tabagismo na Região das Américas 2018-2022", quanto a situação da adoção desses mecanismos nos países da Região para o ano de 2019, e seu progresso desde 2016. Constatou-se que, até 2019, dos 35 Estados Membros da Organização Pan-Americana da Saúde (OPAS), 13 possuíam regulamentações que estabelecem medidas específicas para o manejo de conflitos de interesse para funcionários públicos responsáveis por políticas de controle do tabaco. Da mesma forma, 7 haviam implementado medidas relacionadas, mas não específicas, e 14 não haviam implementado nenhuma medida. Embora haja avanços em relação a 2016, os esforços devem ser redobrados para atingir a meta estabelecida na estratégia e no plano de ação de 20 Estados Membros com mecanismos de identificação e gestão de conflitos de interesse. Vale destacar que ter regulamentação sobre o tema não esgota, muito menos conclui, o cumprimento de todas as obrigações que emanam do artigo 5.3 da Convenção-Quadro da Organização Mundial da Saúde para o Controle do Tabaco. A Secretaria da OPAS, em cumprimento ao que foi solicitado pelos Estados Membros, desenvolveu a metodologia para o cálculo do indicador e sistematizou os resultados aqui apresentados.

Funcionamento Intelectual e Interesses Profissionais: um Estudo com Adolescentes em Contexto Escolar / Intellectual Disabilities and Professional Interests: A Study with Adolescents in the School Context / Discapacidades intelectuales e intereses profesionales: un estudio con adolescentes en Contexto Escolar

Neste estudo, analisamos a relação entre dificuldades no funcionamento intelectual (DFI) e interesses profissionais. A amostra constitui-se por 120 estudantes, com idades entre 14 e 22 anos (M = 15, DP = 1), e foi dividida entre os que apresentavam DFI (n = 54) e os que não apresentavam DFI (n = 66). Utilizamos o Inventário de Interesses e Exploração Auto-Dirigida e um questionário sociodemográfico e escolar. Os resultados revelam diferenças moderadas nos interesses dos adolescentes com DFI, comparativamente aos que não têm DFI, com resultados médios superiores de tipo Realista e Social, e inferiores de tipo Empreendedor. Os resultados são discutidos tendo em conta a necessidade de considerar a diversidade em contexto escolar e de promover a inclusão destes jovens.

In this study we analyse the relation between intellectual disabilities and professional interests. Sample consisted of 120 Portuguese students, aged between 14 and 22 years old (M = 15, SD = 1), which were divided in two groups, depending on whether intellectual disabilities were present (N = 54) or absent (N = 66). We used the Portuguese version of the Self Directed Search Inventory, and a sociodemographic and school life survey. Results show moderate differences between students with and without intellectual disabilities in professional interests. Students with intellectual disabilities reported higher mean interests of Realistic and of Social type, and lower mean interests of Entrepreneur type. Results are discussed taking into account the need to consider students' diversity and to promote social inclusion.

En este estudio, analizamos la relación entre la discapacidad intelectual (DI) y los intereses profesionales de 120 estudiantes portugueses, de edades entre 14 y 22 años (M = 15; DP = 1). Hemos utilizado la versión en portugués del Self Directed Search, y un cuestionario sociodemográfico y escolar. Los resultados muestran diferencias moderadas en los intereses profesionales de los estudiantes con DI, en comparación con aquellos sin DI, con resultados medios más altos de tipo Realista y Social, y más bajos de tipo Emprendedor. Los resultados se discuten teniendo en cuenta la necesidad de considerar la diversidad en el contexto escolar y promover la inclusión.

Reflexões sobre ideias e disputas no contexto da promoção da alimentação saudável / Reflexiones sobre ideas y disputas en el contexto de la promoción de la alimentación saludable / Reflections on ideas and disputes in the context of the promotion of healthy eating

As ações de promoção da alimentação saudável são estratégicas para reversão dos problemas nutricionais. Este artigo analisa as disputas em torno das ideias presentes em repertórios discursivos sobre alimentação saudável em políticas nacionais, documentos internacionais, societários e do setor privado comercial, nos últimos vinte anos. Com base no método de análise documental em diálogo com a literatura acadêmica, foram identificadas as seguintes perspectivas de alimentação saudável: tradicional culturalista; nutricional biologicista medicalizante; multidimensional e sistêmica. As disputas instituem-se em torno das ideias sobre: a existência de "alimentos não saudáveis"; as atribuições, limites e formas de intervenção do Estado; a alimentação como uma questão da esfera individual ou de caráter público; os sentidos da sustentabilidade, da comensalidade, da cultura e da comida. Os posicionamentos adotados nas políticas em relação aos agrotóxicos, à fortificação de alimentos e à suplementação são elementos-chave dessas disputas. No âmbito da ação política, a fragmentação, a relativização e a distorção de significados são estratégias adotadas pelo setor privado comercial que reforçam a polarização entre ações individuais (estilos de vida, liberdade de escolha) e intervenções ambientais, e disseminam uma concepção restrita de educação alimentar e nutricional. A sociedade civil incide politicamente pressionando os governos a instituírem, em suas políticas, concepções e princípios que afetam diretamente os parâmetros das disputas. Estes, por sua vez, agem de forma mais ou menos permeável às pressões dos atores (internos ou externos) a depender de sua composição e dos espaços institucionais de interlocução com a sociedade.

Las acciones de promoción de la alimentación saludable son estratégicas para la reversión de los problemas nutricionales. Este artículo analiza las disputas en torno a las ideas presentes en repertorios discursivos sobre alimentación saludable en políticas nacionales, documentos internacionales, societarios y del sector privado comercial, en los últimos 20 años. En base al método de análisis documental, en diálogo con la literatura académica, se identificaron las siguientes perspectivas de alimentación saludable: tradicional-cultural; nutricional-biologicista-medicalizante; multidimensional y sistémica. Las disputas se instituyen en torno a las ideas sobre: la existencia de "alimentos no saludables"; las atribuciones, límites y formas de intervención del Estado; la alimentación como una cuestión de la esfera individual o de carácter público; los significados de la sostenibilidad, comensalidad, cultura y comida. Las posturas adoptadas en las políticas, relacionadas con los pesticidas, fortificación de alimentos y suplementación, son elementos-clave de esas disputas. En el ámbito de la acción política, la fragmentación, relativización y distorsión de significados son estrategias adoptadas por el sector privado comercial, que refuerzan la polarización entre acciones individuales (estilos de vida, libertad de elección) e intervenciones ambientales, y diseminan una concepción restringida de educación alimentaria y nutricional. La sociedad civil incide políticamente, presionando a los gobiernos a que instituyan en sus políticas concepciones y principios que afectan directamente los parámetros de las disputas. Estos, a su vez, actúan de forma más o menos permeable a las presiones de los actores (internos o externos) dependiendo de su composición y de los espacios institucionales de interlocución con la sociedad.

Actions in the promotion of healthy eating are strategic for reversing nutritional problems. This article analyzes the disputes over ideas in discursive repertoires on healthy eating in Brazil's national policies and international, government, civil society, and private commercial sector documents in the last 20 years. Based on the document analysis method in dialogue with the academic literature, the following perspectives on healthy eating were identified: traditional culturalist; medicalizing biological/nutritional; multidimensional; and systemic. The disputes are established between ideas in the following areas: the existence of "unhealthy foods"; the attributions, limits, and forms of State intervention; eating as an individual or public matter; and the meanings of sustainability, commensality, culture, and food. Policy positions on pesticides, food fortification, and supplementation are key elements in these disputes. In the policy sphere, the private commercial sector adopts strategies of fragmentation, downplaying, and distortion of meanings that reinforce polarization between individual actions (lifestyles, freedom of choice) and environmental interventions, thereby disseminating a narrow approach to food and nutrition education. Civil society pressures governments to establish concepts and principles in policies that directly affect the disputes' parameters. The latter act with greater or lesser permeability to pressures from internal or external stakeholders, depending on their composition and the institutional spaces for dialogue with society.

Construção e Validação do Questionário de Comportamentos Típicos na Perturbação do Espetro do Autismo / Construction and Validation of the Autism Spectrum Disorder Typical Behaviours Questionnaire

RESUMO A identificação do perfil comportamental nas perturbações do neurodesenvolvimento deve ser apoiada por instrumentos válidos que auxiliem a escolha e a monitorização da intervenção e da alocação de recursos. Com a mudança de critérios de diagnóstico da Perturbação do Espetro do Autismo (PEA), surgiu a necessidade de construir um questionário que permitisse inventariar os comportamentos descritos. Assim sendo, este estudo teve como objetivo desenvolver e avaliar as propriedades psicométricas do Questionário dos Comportamentos Típicos da PEA (QCT-PEA). A validade de conteúdo do QCT-PEA, analisada por dez especialistas, foi comprovada pelos Índices de Validade de Conteúdo (IVC), com valores superiores a .95 e pela proporção de acordo, Cohen kappa (.82>k< 1). O QCT-PEA foi aplicado a 75 crianças com PEA (9.67±1.29). Na análise da fiabilidade, os comportamentos típicos totais da PEA e os dois domínios apresentaram valores que atestam a consistência interna (α>.88). Para a validade de constructo, os coeficientes de correlação de Pearson apontaram para correlações fracas a fortes (.26>rho<.92), tal como expectável. A estrutura do questionário parece apontar para um modelo bi-dimensional com duas dimensões correspondentes aos domínios previamente estabelecidos pelo Manual de Diagnóstico e Estatística das Perturbações Mentais (DSM-5): Comunicação Social e Interação Social, e Padrões Restritos e Repetitivos de comportamentos, interesses e atividades, explicando 69.5% da variância total. Os resultados parecem demonstrar que o QCT-PEA poderá ser um instrumento a ter em conta na investigação e na utilização da prática clínica, de forma a compreender o perfil comportamental da criança com PEA e planear a intervenção que possibilitará um melhor comportamento adaptativo.

ABSTRACT The identification of the behavioral profile in neurodevelopmental disorders should be supported by valid instruments that assist in the choice and monitoring of intervention and resource allocation. Due to the change in diagnostic criteria for Autism Spectrum Disorder (ASD), the need to develop a questionnaire that would allow for an inventory of the behaviors described arose. Therefore, this study aimed to develop and evaluate the psychometric properties of the ASD Typical Behaviours Questionnaire (ASD-TBQ). The content validity of the ASD-TBQ, analyzed by ten experts, was confirmed by the Content Validity Index (CVI), with scores superior to .95 and by agreement proportion, Cohen kappa (.82>k< 1). The ASD-TBQ was applied to 75 children with ASD (9.67±1.29). In the reliability analysis, the typical ASD behaviors and the two domains presented values that attest to the internal consistency (α>.88). For construct validity, Pearson's correlation coefficients pointed to weak and strong correlations (.26>rho<.92), as expected. The structure of the questionnaire seems to point to a two-dimensional model with two dimensions corresponding to the domains previously established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Social Communication and Social Interaction, and Restricted and Repetitive Patterns of behaviors, interests and activities, explaining 69.5% of the total variance. The results seem to demonstrate that the ASD-TBQ may be an instrument to be taken into account in research and in the use of clinical practice, in order to understand the behavioral profile of children with ASD and plan the intervention that will enable a better adaptive behavior.

Analysis on the appeals for rights and interests of medical staff in medical institutions at all levels in Shanghai / 中华医院管理杂志

Objective:To understand the current situation of appeals for rights and interests of medical staff in community health institutions and secondary/tertiary hospitals in Shanghai, for the suggestions on improving the job satisfaction and enthusiasm of medical staff.Methods:From September to November 2020, two community health service centers(stations), one secondary hospital and one tertiary hospital were selected from Jiading District, Pudong New Area and Jing′an District of Shanghai respectively. An online questionnaire survey was conducted among medical staff in medical institutions selected by stratified random sampling. The survey covered the main demographic information as well as 12 rights and interests demands, namely " salary promotion" among other. Descriptive analysis was performed on the data, and chi square test was used for comparison between groups.Results:1 759 valid questionnaires were recovered in this survey, and 1 654 medical employees(94.03%)reported a high degree of appeal for " salary promotion" . Compared with the medical staff in community health service centers(stations), the medical staff in secondary/tertiary hospitals reported higher demands for " training and study" " title appointment" and " academic promotion" , presenting a difference statistically significant( P<0.05). There were significant differences between doctors and nurses in " routine expense reimbursement" " staff recruitment" " professional title appointment" " children′s education" " cultural and recreational activities" and " opinion feedback channels" ( P<0.05). Conclusions:Salary promotion was the common demand of medical staff at all levels of medical institutions. Medical staff at secondary/tertiary hospitals had higher demands for career development. There were some differences in appeals for rights and interests between doctors and nurses. Medical institutions at all levels should continue to promote the reform of salary system, pay attention to the respective rights and interests of doctors and nurses, and improve their job satisfaction and enthusiasm.

Los médicos y la industria farmacéutica: impacto sobre actitudes y hábitos de prescripción / Physicians and the pharmaceutical industry: impact on prescription attitudes and habits

Resumen Introducción: La relación médico-industria farmacéutica (IF) se ha identificado como un problema ético por favorecer conflictos de interés derivados de los beneficios que reciben los médicos y que pueden afectar su juicio clínico. Objetivo: Identificar la frecuencia de participación de médicos en actividades financiadas por la IF, las actitudes de estos profesionales hacia los representantes de la IF, su conducta prescriptiva y la asociación de sus características y del trabajo con la participación en actividades financiadas por la IF. Método: Encuesta transversal a médicos internistas y cardiólogos. El cuestionario incluyó características de los médicos y centro de trabajo, participación en actividades financiadas por la IF, actitudes hacia los representantes y conducta de prescripción. Resultados: Se analizaron 455 cuestionarios, 78.5 % de los encuestados tuvo conocimiento de la relación médico-IF, la mayoría respondió reunirse con representantes de la IF, 30 % indicó haber recibido subsidios financieros y 10 % consideró que los obsequios afectan su prescripción. Tener conocimiento previo de la relación médico-IF se asoció con menor participación en actividades educativas financiadas por por la IF. Conclusión: Las prácticas y preferencias hacia la IF muestran la necesidad de diseñar estrategias para evitar la prescripción inapropiada.

Abstract Introduction: The physician-pharmaceutical industry relationship has been identified as an ethical problem, due to conflicts of interest motivated by the benefits that doctors receive and that can affect their clinical judgment. Objective: To identify the frequency of physicians participation in activities financed by the pharmaceutical industry (PI), their attitudes towards PI representatives (PIRs), their prescriptive behavior and the association between their characteristics and their workplace with their participation in activities financed by the PI. Method: Cross-sectional survey to internists and cardiologists. The questionnaire included characteristics of the doctors and their workplace, participation in activities financed by the PI, attitudes towards PIRs, and prescription behavior. Results: 455 questionnaires were analyzed; 78.5 % of surveyed subjects were aware of the physician-PI relationship, the majority acknowledged meeting with PIRs, 30 % indicated having received financial subsidies and 10 % considered that gifts affect their prescription. Having prior knowledge of the physician-PI relationship was associated with less participation in PI-financed educational activities. Conclusion: Practices and preferences towards the PI show the need to design strategies to avoid inappropriate prescription.

Contexto personal y elección ocupacional de la trabajadora sexual / Personal context and occupational choice of the sexual working

El estudio busca reconocer la forma, cómo se realiza la elección ocupacional de las personas que se encuentran en el ambito conocido como trabajo sexual. Alternativa de acción que determina el curso de la vida e involucran contribuciones complejas que llevan a la mujer a a abandonar roles, cambiar un patrón de hábitos, elegir e ignorar sus propias dificultades en un esfuerzo de hacerse parecer competente ante los demás, sin embargo, genera dificultades y mantienen a la población objeto de estudio atrapados en un ciclo de elecciones inadecuados y experiencias negativas. El presente proyecto busca determinar cómo el contexto personal influye en la elección ocupacional de la población trabajadora sexual. Conclusión: A través del instrumento de evaluación OPHI II y su narrativa, donde las constantes fueron el nivel volitivo y de habituación se logra establecer decisiones impulsadas por eventos críticos del pasado, conexo a condiciones de pobreza, dinámicas de calle y abandono del rol de estudiante, desencadena una insatisfacción y un bajo sentido de autoeficacia dentro de su participación ocupacional en roles y hábitos. Así mismo dentro de su comportamiento ocupacional actual se vislumbra una doble identidad "una doble vida" y una exclusión de roles familiares y sociales. Como consecuencia de este rol productivo, esta dualidad genera una modificación drástica en la interiorización, guiones y socialización de roles, siendo mutuamente excluyentes, alterando de esta forma la elección ocupacional, la estructuración de hábitos y rutinas, la ejecución de roles y el trabajo hacia metas, siendo estos aspectos los de mayor falencia, teniendo en cuenta que son mujeres que no identifican un estilo de vida ocupacional deseado, no esperan éxito y no reconocen habilidades.

To begin it is absolutely necessary to determine how occupational choice is made by sex workers. All this unrouted women to decision-making and thereby abandon roles, change habits' pattern, choose and ignore their own difficulties in an effort to make themselves appear competent to others. However, these elections generate greater difficulties among population under study. So we can concluded that they are trapped in a cycle of inadequate elections and negative experiences. Conclusion: Through the OPHI II assessment tool it was possible to discover, through narrative, in which the constants were the volitional and habituational level where driven by critical events of the past, related to conditions of poverty, street dynamics and abandonment of roles such as student, unleashing a dissatisfaction and a low sense of self-efficacy within their occupational roles and habits, as well as within their current occupational behavior is a dual identity "double life" and exclusion of family roles and social, as a consequence of the productive role, where it generates a drastic change in the internalization, scripts and socialization of roles, being mutually exclusive, thus altering the occupational choice, the structuring of habits and routines, the execution of roles and work towards goals, these being the aspects of greatest weakness, taking into account that n women who do not identify a desired occupational lifestyle, do not expect success and do not recognize skills.

Adaptation to brazilian portuguese of the O*Net Interests Profiler: Short Form / Adaptação ao português brasileiro do O*Net Interests Profiler: Short Form / Adaptación al portugués brasilero del O*Net Interests Profiler: Short Form

This study aimed to adapt to the Brazilian Portuguese the O*NET Interests Profiler - Short Form. The instrument evaluates vocational interests according to the RIASEC model, which includes six types (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional). Validity evidence was obtained through Principal Components Analysis, Multidimensional Scaling, correlations between secondary concepts from the theoretical model, and contrasts between groups. PCA results, the contrasts between selected occupational groups and correlational results between secondary concepts followed the theoretical expectations. However, the MDS results did not fully confirm the hexagonal structure. Overall results suggest the adapted instrument has acceptable evidence of validity. Further studies are suggested to increase the suitability of the Brazilian version of the instrument.

O objetivo deste estudo foi adaptar o O*NET Interests Profiler - Short Form para o português brasileiro. O instrumento avalia interesses vocacionais de acordo com o modelo RIASEC, que inclui seis dimensões (Realista, Investigativo, Artístico, Social, Empreendedor e Convencional). As evidências de validade foram obtidas por meio da Análise de Componentes Principais, Escalonamento Multidimensional, correlações entre os conceitos secundários do modelo teórico e contrastes entre grupos ocupacionais. Os resultados da ACP, dos contrastes entre os grupos selecionados e dos resultados das correlações entre os conceitos secundários confirmaram as expectativas teóricas. No entanto, os resultados do EMD não confirmaram totalmente a estrutura hexagonal. Em geral, os resultados sugerem que o instrumento adaptado apressenta evidências aceitáveis de validade. Estudos adicionais são sugeridos para aumentar a adequação da versão brasileira do instrumento.

Este estudio tuvo como objetivo adaptar al portugués brasileño el O*NET Interests Profiler - Short Form. El instrumento evalúa los intereses vocacionales de acuerdo con el modelo RIASEC, que incluye seis dimensiones (Realista, Investigativo, Artístico, Social, Emprendedor y Convencional). Las evidencias de validez se obtuvieron mediante Análisis de Componentes Principales, Escalamiento Multidimensional, correlaciones entre los conceptos secundarios del modelo teórico y contrastes entre grupos ocupacionales. Los resultados del PCA, los contrastes entre los grupos seleccionados y los resultados de las correlaciones entre los conceptos secundarios confirmaron las expectativas teóricas. Sin embargo, los resultados del MDS solo confirmaron parcialmente la estructura hexagonal. Los resultados sugieren que el instrumento adaptado tiene evidencias aceptables de validez y confiabilidad. Se sugieren estudios adicionales para aumentar la idoneidad de la versión brasileña del instrumento.

La intolerancia a la incertidumbre en el autismo / Intolerance to uncertainty in autism

Partimos de las evidencias que confirman una mayor vulnerabilidad a la ansiedad de las personas con autismo para preguntarnos en qué medida la intolerancia a la incertidumbre media en dicha ansiedad. Además, las alteraciones de las habilidades predictivas en el autismo podrían explicar la coherencia existente entre mayor intolerancia a la incertidumbre y algunas particularidades inherentes al autismo como los patrones de comportamientos, intereses y actividades restrictivos y estereotipados, y las particularidades en el procesamiento de la información sensorial. Esta información nos permitirá desarrollar intervenciones centradas específicamente en este constructo para la prevención y mejora de la sintomatología ansiosa en el autismo en los casos en los que la severidad de la intolerancia a la incer tidumbre constituya un factor de riesgo significativo.

We start from the evidence that confirms a greater vulnerability to anxiety in people with autism and to wonder to what extent the intolerance to the uncertainty mediates in that anxiety. In addition, the alterations of the predictive abilities in autism could explain the coherence between greater intolerance to uncertainty and some peculiarities inherent in autism such as patterns of restrictive and stereotyped behaviors, interests and activities, and particularities in the processing of sensory information. This information will allow us to develop interventions specifically focused on this construct for the prevention and improvement of anxiety symptoms in autism in cases that the severity of intolerance to uncertainty constitutes a significant risk factor.

Psychometric Study of the Scale of Interests by Areas of Psychology - Portuguese Version / Estudo Psicométrico da Escala de Interesses por Áreas da Psicologia - Versão Portuguesa / Estudio Psicométrico de la Escala de Intereses en Áreas de la Psicología - Versión Portuguesa

Abstract Considering the need to understand the variables related to the choice for Psychology specialties, this study aimed to present the adaptation process and to verify validity evidence based on the internal structure for the Portuguese version of the Scale of Interests by Areas of Psychology (EIAPsi) and relate it to personality. The sample consisted of 340 Portuguese university students, using the EIAPsi and the NEO Five-Factor Inventory (NEO-FFI). Exploratory Factor Analysis and correlations between instruments were performed. There was a factorial structure formed by 10 factors for the EIAPsi with satisfactory precision indexes. The dimensions of openness and agreeableness were the most frequently correlated to the areas of Psychology. We have concluded that evidence of initial validity of the instrument were presented, indicating possibilities of its use in the Portuguese context, specifically in situations aimed at self-knowledge (classroom or clinic/office) and guiding students in choosing their area of expertise.

Resumo Ao considerar a necessidade de compreensão das variáveis relacionadas à escolha por especialidades da Psicologia, este estudo teve por objetivo apresentar o processo de adaptação e verificar evidências de validade baseadas na estrutura interna para a versão portuguesa da Escala de Interesses por Áreas da Psicologia (EIAPsi) e relacioná-la com personalidade. A amostra foi composta por 340 universitários portugueses, utilizando a EIAPsi e o NEO Five-Factor Inventory (NEO-FFI). Foram realizadas Análise Fatorial Exploratória e correlações entre instrumentos. Verificou-se uma estrutura fatorial formada por 10 fatores para a EIAPsi com satisfatórios índices de precisão. As dimensões abertura e amabilidade foram as mais frequentemente correlacionadas às áreas da Psicologia. Conclui-se que evidências de validade iniciais do instrumento foram apresentadas, indicando possibilidades de sua utilização no contexto português, especificamente em situações que visem o autoconhecimento (sala de aula ou clínica/consultório) e direcionamento dos estudantes para escolha da área de atuação.

Resumen Considerando la necesidad de comprender las variables relacionadas con la elección de las especialidades en Psicología, este estudio tuvo como objetivo presentar el proceso de adaptación y verificar las evidencias de validez basadas en la estructura interna de la versión portuguesa de la Escala de Intereses en Áreas de la Psicología (EIAPsi) y relacionarla con la personalidad. La muestra constó de 340 estudiantes universitarios portugueses, a la cual se aplicó la EIAPsi y el NEO Five-Factor Inventory (NEO-FFI). Se llevaron a cabo un análisis factorial exploratorio y correlaciones entre los instrumentos. Se observó una estructura factorial formada por 10 factores para la EIAPsi con índices de precisión satisfactorios. Las dimensiones apertura y amabilidad fueron las que más se correlacionaron con las áreas de la Psicología. Se concluye que el instrumento presentó evidencias iniciales de validez, lo que indica su potencial de uso en el contexto portugués, sobre todo en situaciones dirigidas al autoconocimiento (aula o clínica/oficina) y el soporte a los estudiantes en la elección del área de actuación.

Diseño de un instrumento de preferencias vocacionales en Administración, Materiales y Biotecnología / Design of an Instrument for Vocational Preferences in Administration, Materials and Biotechnology

Resumen Este estudio buscó diseñar y evaluar una prueba de preferencias vocacionales para las carreras de Administración de Empresas, Ingeniería en Materiales e Ingeniería en Biotecnología en el Instituto Tecnológico de Costa Rica (ITCR). Para ello, se construyó previamente el perfil vocacional de cada carrera a partir del cual se redactaron los ítems de la prueba. Participaron 480 estudiantes con una media de edad de 22.07 años, 53.19% mujeres y 46.81% hombres. Se obtuvo información del perfil de cada carrera por parte de estudiantes y docentes. Posteriormente, la revisaron grupos de expertos. A partir del perfil definido, se redactaron los ítems de la prueba. Luego, se evaluaron sus características psicométricas con análisis factoriales. Se obtuvieron adecuados indicadores de bondad de ajuste. La prueba vocacional incluyó tres escalas: habilidades, intereses y tareas vocacionales. La escala de habilidades evaluó seis factores: lógico-matemática, física, química, biológica, liderazgo y autorregulación- disciplina. Por su parte, las escalas de tareas e interés se utilizaron para definir las preferencias por los tres factores evaluados: Administración, Materiales y Biotecnología. Finalmente, se evidenciaron diferencias según sexo, carrera y nivel de satisfacción vocacional.

Abstract: This study sought to design and evaluate a vocational preference test for Business Administration, Materials Engineering and Biotechnology Engineering majors at the Instituto Tecnológico de Costa Rica (ITCR). For this goal, first of all a vocational profile of each career was constructed, from which the test items were written. 480 students took part, with an average age of 22.07 years, 53.19% of them women and 46.81% men. Descriptions of the profile of each career were collected by students and teachers, and later analyzed by expert groups. From the defined profile, items were drawn up and later evaluated with factor analysis, for the selection of the items, obtaining adequate indicators of goodness of fit. The vocational test includes three factors: Skills, Interests and Vocational Tasks. In turn, the Skills scale evaluated six areas: Mathematics, Chemistry, Physics, Biology, Leadership and Self-regulationdiscipline. For its part, the scale of preferences contemplated the three areas evaluated: Administration, Materials and Biotechnology. On the other hand, there were differences according to sex, major and level of vocational satisfaction.

Factores que influyen en el comportamiento del consumidor de los negocios al detal y supermercados en el Caribe colombiano / Factors influencing the behavior of retail stores and supermarkets' consumers in the Colombian Caribbean / Fatores que influenciam no comportamento do consumidor de empresas de varejo e supermercados na região do Caribe colombiano

Resumen Introducción. El presente artículo muestra los resultados de investigación relacionados con los factores que influyen en el comportamiento del consumidor: cómo es su decisión de compra, preferencias a la hora de realizar su compra, gustos y preferencias, si encuentra en cada uno de los establecimientos los productos que necesita, cómo lo quiere, y si prefieren comprar en las tiendas de barrio y supermercados. Objetivo. Analizar preferencias, edad, gustos, necesidades, opiniones, estrato y estilos de vida para la toma de decisiones. Materiales y métodos. Se realizó estudio descriptivo, con muestreo estratificado, aplicando encuesta a consumidores objeto de estudio, se corroboró con entrevistas a empresarios. Resultados. La investigación permitió conocer los factores socioculturales, preferencias, edad, gustos, necesidades, opiniones, estrato, que incidieron en la toma de decisiones de consumir en las tiendas de barrio y supermercados. Corroborando que el 62,9%, sí compra en las tiendas de barrio, por cercanía, facilidad de crédito, atención personalizada, productos ofrecidos al detal, amistades con los amigos que se crían en el mismo barrio y desean socializar en las tiendas. El 56,3% manifestó que no cambiaría la tienda por el supermercado por nivel de ingreso. Un 52,7%, por variedad de productos, prefieren hacer un mercado quincenal. Conclusión. Se concluye la hipótesis inicial que el principal motivo es porque prefieren comprar en las tiendas de barrio por la diversidad, precio y localización.

Abstract Introduction: This paper shows the results of a research work related to the factors that influence consumer behavior: How is their purchase decision, what their preferences are when making their purchase, what their tastes and preferences are, if they find in each of the establishments the products they need, how they want them, and if they prefer to buy in neighborhood stores and supermarkets. Objective: Analyze preferences, age, tastes, needs, opinions, stratum and lifestyles for decision making. Materials and methods: A descriptive study was carried out, with stratified sampling, applying a survey to the consumers under study, corroborated with interviews with businesspeople. Results: The research allowed to know the sociocultural factors, preferences, age, tastes, needs, opinions, and stratum that influenced the decision-making to consume in neighborhood stores and supermarkets. It was corroborated that 62.9% buy in neighborhood stores due to credit facility, personalized attention, products offered at retail, friendship with people who are raised in the same neighborhood and the desire to socialize in stores. 56.3% said they would not change the store for the supermarket due to income level. For reasons of variety of products, 52.7% prefer to make a fortnightly grocery purchase. Conclusion: The initial hypothesis is confirmed. The main reason why consumers prefer to buy in neighborhood stores is because of the diversity, price and location.

Resumo Introdução. Este artigo mostra os resultados de um trabalho de pesquisa relacionados com os fatores que influenciam no comportamento do consumidor: como é sua decisão da compra, preferências na hora de realizar a sua compra, gostos e preferências, se o consumidor encontra em cada um dos estabelecimentos os produtos que precisa, como querem eles, e se preferem comprar nas lojas do bairro e supermercados. Objetivo. Analisar preferências, idade, gostos, necessidades, opiniões, estrato e estilos de vida para a tomada de decisões. Materiais e métodos Foi realizado estudo descritivo, com amostragem estratificada, aplicando uma sondagem aos consumidores objeto de estudo, foi corroborado com entrevistas aos empresários. Resultados. A pesquisa permitiu conhecer os fatores socioculturais, preferências, idade, gostos, necessidades, opiniões, estrato, que influenciaram na tomada de decisões de consumir nas loj as do bairro e supermercados. Corroborando que o 62,9% compram nas loj as do bairro, pela proximidade, a facilidade de crédito, a atenção personalizada, pelos produtos oferecidos no varejo, amizades com os amigos que são criados no mesmo bairro e desejam socializar nas lojas. O 56,3% disseram que não mudariam a loja pelo supermercado pelo nível do ingresso. O 52,7% pela variedade dos produtos, preferem fazer o mercado quinzenal. Conclusão. Conclui-se que a hipótese inicial que o principal motivo é porque preferem comprar nas lojas do bairro pela diversidade, preço e localização.