Evaluation of the skill ，adherence and effectiveness of medication in asthma patients from a pharmacist perspective / 中国药房

OBJECTIVE To analyze th e evaluation methods of the skill ，adherence and effectiveness of medication in bronchial asthma （hereinafter referred to as “asthma”）patients from a pharmacist perspective ，and to provide reference for pharmacists to carry out clinical intervention researches and management of asthma patients. METHODS Referring to diagnosis and treatment guidelines ，evidence-based medicine literature and clinical practice experience ，the evaluation methods of asthma patients ’ medication with clinical value were expounded from three aspects including medication skill （inhalation technology ），adherence and effectiveness. RESULTS Inhalation technique rating form was an important evaluation method of medication skills in asthma patients. Medication adherence could be evaluated by Morisky Medication Adherence Scale or the Medication Adherence Report Scale for Asthma. Effectiveness evaluation methods contained direct evaluation indexes （such as clinical manifestations ，situation of acute exacerbation and relieving medication ，examination indexes such as pulmonary function indexes and fractional concentration of exhaled nitric oxide ）and indirect evaluation tools （i.e. various scales ，including Asthma Control Test ，Children-Asthma Control Test，the Test for Respiratory and Asthma Control in Kids ，asthma related quality of life scales ，etc.）CONCLUSIONS The combination of the evaluation methods of medication skill ， adherence and effectiveness contributes to assessing the pharmacotherapy effect of asthma patients. Pharmacists should apply and perfect these evaluation methods in practice ，so as to conduct better pharmaceutical intervention on asthma patients.

Desenvolvimento de um método para avaliação de maturidade digital de instituições de saúde / Development of a method to digital maturity assessment for healthcare organizations / Desarrollo de un método para evaluación de la madurez digital de las instituciones de salud

Objetivos: Desenvolver um método de avaliação de maturidade digital para instituições de saúde. Métodos: Este trabalho caracteriza-se como uma pesquisa exploratória e descritiva; a partir da revisão e da análise crítica de vários métodos, o Índice de Maturidade Digital para Instituições de Saúde (IMDIS) foi desenvolvido e validado por meio da aplicação em 107 instituições de saúde. Resultados: A análise da base resultou em um percentual médio de 44,4% de maturidade digital. Conclusão: As instituições de saúde devem melhor estruturar a sua jornada digital, não apenas adotando as tecnologias digitais, mas também possuindo uma estratégia, mudança de cultura, equipe capacitada, orçamento e apoio da diretoria. O IMDIS pode ser evoluído e servir de base para a criação de outros índices que, concreta e rotineiramente, avaliem a maturidade digital das instituições de saúde e acompanhem a evolução da Saúde Digital.

Objectives: Develop a method to digital maturity assessment for healthcare organizations. Methods: This paper is defined as exploratory and descriptive research. From revision and critical analysis of various methods, the Digital Maturity Index for Healthcare Organization (IMDIS) was developed and validated by its application for 107 healthcare organizations. Results: Database analysis presented 44,4% of percentage average of digital maturity. Conclusion: Healthcare organizations should improve the structure of its digital journey, not only adopting new digital technologies, but also having strategy, cultural change, well-trained team, budget and support from the board. The IMDIS can be evolved and serve as a basis to create other indexes that, concrete and routinely, evaluate digital maturity of healthcare organizations and following up digital health.

Objetivos: Desarrollar un método para evaluación de la madurez digital para instituciones de salud. Métodos: Este trabajo está caracterizado cómo una pesquisa exploratoria y descriptiva. A partir de la revisión y análisis crítico de varios métodos, se desarrolló y validó el Índice de Madurez Digital para Instituciones de Salud (IMDIS) mediante su aplicación en 107 instituciones de salud. Resultados: La análisis de la base de datos resultó en un porcentaje promedio del 44,4% de madurez digital. Conclusiones: Las instituciones de salud deberían estructurar mejor su jornada digital, no solo adoptando tecnologías digitales, sino también teniendo una estrategia, cambio de cultura, equipo calificado, presupuesto y apoyo de la junta directiva. El IMDIS puede evolucionar y servir de base para la creación de otros índices que, de manera concreta y rutinaria, podrían evaluar la madurez digital de las instituciones de salud y monitorear la evolución de la Salud Digital.

Monitoramento e Avaliação da Saúde Digital: atualização dos métodos e modelos de maturidade / Monitoring and Evaluation of Digital Health: methods and maturity models review / Monitoreo y Evaluación de la Salud Digital: actualización de los métodos y modelos de madurez

A Organização Mundial de Saúde (OMS) define Saúde Digital (SD) como "o uso da tecnologia de informação e comunicação no apoio à Saúde e a áreas relacionadas à Saúde". Monitorar a progressão da SD é fundamental, conforme também estabelecido na resolução da OMS sobre SD. Este artigo de revisão foi elaborado com o intuito de identificar os atuais métodos de avaliação, modelos e índices de maturidade digital utilizados para avaliar e/ou monitorar diversos aspectos da SD. Foram identificados 32 métodos, categorizados e descritos neste artigo. A partir dessa revisão, ficou evidente a necessidade do estabelecimento de critérios objetivos para melhor avaliar se tais métodos e modelos de maturidade são mesmo capazes de avaliar e monitorar a SD ou não.

The World Health Organization (WHO) defines Digital Health (DH) as "the use of information and communications technology in support of health and health-related fields". Monitoring the progression of DH is essential, in according to the resolution of WHO about DH. This paper was elaborated aiming to identify current evaluation methods, models and digital maturity indexes used to evaluate and monitor many aspects of DH. It was evaluated 32 methods, categorized and described in this article. From this review, it was clear the need for establishment of objective criteria to better evaluation whether such methods and maturity models are really able to evaluate and monitor DH progression or not.

La Organización Mundial de Salud (OMS) define la Salud Digital (SD) como "el uso de la tecnología de la información y la comunicación para apoyar las áreas de salud y relacionadas con la salud". El seguimiento de la progresión del SD es fundamental, em acuerdo con la resolución de la OMS acerca de SD. Este artículo de revisión he preparado con el objectivo de identificar los métodos de evaluación actuales, los modelos y los índices de madurez digital utilizados para evaluar y / o monitorear varios aspectos de la SD. En este artículo se identificaron, categorizaron y describieron 32 métodos. A partir de esta revisión, se hizo evidente la necesidad de establecer criterios objetivos para evaluar mejor si dichos métodos y modelos de madurez son capaces de evaluar y monitorear el SD o no.

Literature Review on Prevalence, Risk Factors and, Evaluation of Acute Lower Back Pain

Background: Acute back pain is any pain located at the back that lasts for less than 4 weeks duration. Theprevalence is fair with as many as 84% of the adult population around the globe experience back pain at somepoint in life and is often self-limiting. However, in few selected patients it may serve as indicator of a seriousunderlying disease making it crucial to properly evaluate, characterize and address this concern. Objectives: Inthis review we intend to explore the prevalence, risk factors and highlight the available methods using diagnosticimaging modalities to evaluate and address this condition. Materials and Methods: A review of relevant articlespublished from 1987 onwards in English language was done using the electronic databases of PubMed Pico and,Google Scholar with preset keywords. Conclusion: Acute back pain prevalence range between 22 to 48 percentand risk factors are non-modifiable such as advanced age and female gender while modifiable risk factors areobesity, smoking, low education, sedentary lifestyle, etc. Employment related factors such as physically strenuouswork also increase the risk of developing back pain. Notably, under-appreciated risk factors includingpsychological risk factors such as anxiety should be screened for while evaluating patients. Evaluation of backpain mostly relies on comprehensive history and physical examination, as most cases are self-limited. Diagnosticimaging is only recommended in cases presenting with red flag symptoms.

Research progress on animal models of chronic pain and its application in traditional Chinese medicine research / 中国中药杂志

The classification of chronic pain is complex and its pathogenesis is not clear, which led to the limited progress of treatment measures.Traditional Chinese medicine(TCM) has certain advantages in the treatment of chronic pain, and its mechanism needs further exploration. The ideal animal model is helpful to elucidate the key mechanism of the occurrence and development of chronic pain and play an important role in the discovery of new drug targets, the development of new therapies and the research on the analgesic mechanism of TCM.In recent years, many scholars at home and abroad have done a lot of research to explore the pathogenesis of chronic pain and the mechanism of TCM, which have achieved some results. On this basis, this study summarizes the selection of experimental animals for chronic pain and the commonly evaluation methods of animal models. According to the latest international classification of diseases, this review organizes the induced methods, evaluation indicators, advantages and disadvantages of seven kinds of chronic pain animal models, such as chronic primary pain, chronic cancer-related pain and so on. Next, this review introduces the chronic pain animal models commonly used in TCM research, in order to provide guidance for the targeted selection of animal models when carrying out relevant experiments in the future.

Review of Zuoguiwan on Animal Models and Evaluation in Prevention and Treatment of Osteoporosis / 中国实验方剂学杂志

Zuoguiwan is a classic prescription for replenishing vital essence, tonifying kidney-Yin and nourishing the bone marrow. Zuoguiwan is one of the effective prescriptions for the prevention and treatment of osteoporosis (OP), which reflects the thought of Reinforcing Yang from Yin. The OP animal model simulates the pathological state and pathogenesis of OP in human, which is an important means to research the pathogenesis of OP and verify the effect of drugs. In this paper, two kinds of animal models and characteristics of Zuoguiwan in the prevention and treatment of osteoporosis were discussed in details. They are the primary osteoporosis animal models, including ovariectomized animal models and spontaneous elderly osteoporosis animal models, and the secondary osteoporosis models, including glucocorticoid-induced animal models, cyclophosphamide-induced animal models and subtotal nephrectomy animal models. The evaluation methods of Zuoguiwan in preventing and treating OP, including bone absorption markers and bone formation markers analyzed by enzyme-linked immunosorbent assay (ELISA), bone mineral density detected with dual-energy X-ray, the number of trabeculae, trabecular segregation, trabecular thickness, bone volume/tissue volume ratio and bone surface/volume ratio analyzed using micro-CT, bone pathological morphology observed by hematoxylin-eosin staining, bone biomechanical properties, such as the maximum load force based on biomechanical test. In order to provide scientific reference for the basic and clinical research of Zuoguiwan, the OP animal models and the pharmacodynamic effect of Zuoguiwan are evaluated comprehensively with five different and objective evaluation methods. However, the animal model of OP needs to be further optimized to highlight the pathogenesis and syndrome characteristics of Zuoguiwan in the treatment of OP.

Reliability, Accuracy, and Use Frequency of Evaluation Methods for Amount of Tongue Coating / 中国结合医学杂志

OBJECTIVE@#To classify the evaluation methods for amount of tongue coating (TC) and investigate their reliability, accuracy, and frequency of use.@*METHODS@#Articles published from 1985 to 2015 were searched for evaluation methods for the amount of TC in PubMed and the Cochrane Library. Only clinical researches were included except protocol articles. The methods were classified according to their characteristics.@*RESULTS@#Finally, 113 articles were selected. The evaluation method for the amount of TC from the articles was classified into 4 types: intuitive, specificative, computerized, and weighing TC. The reliability in the intuitive and specificative methods (κ =0.33-0.92) showed varying levels among the studies. In general, the amount of TC calculated by the specificative method (Spearman's r=0.68-0.80) was more strongly related to the directly measured value than to the value estimated by the computerized method (Pearson's r=0.442). The number of articles published on this topic has increased consistently, and the specificative method was the most frequently used. Despite the higher reliability of the computerized method, it has not been widely used.@*CONCLUSIONS@#The high prevalence of the specificative method would continue in clinical practice because of its convenience and accuracy. However, to establish higher reliability, the limitation of the subjectivity of the assessors should be overcome through calibration training. In the computerized method, novel algorithms are needed to obtain a higher accuracy so that it can help the practitioners confidently estimate the amount of TC.

O Modelo Lúdico em crianças com Síndrome de Down / The Ludic Model in children with Down's Syndrome / El Modelo Lúdico en los niños con el síndrome de Down

O Modelo Lúdico é um referencial teórico para a intervenção clínica, desenvolvido por Francine Ferland, terapeuta ocupacional, que tem como foco de investigação o brincar na prática clínica com crianças com deficiência física. O objetivo do trabalho foi verificar possíveis contribuições do modelo e de autores da Psicologia para análise do brincar de crianças com Síndrome de Down. O estudo incluiu oito crianças de ambos os sexos com diagnóstico de Síndrome de Down, com idade entre seis e dez anos, além de seus responsáveis legais. As crianças apresentaram interesse principalmente por estímulos sonoros, espontaneidade e prazer ao brincar. No entanto, nem todas apresentaram senso de humor, gosto por desafios e iniciativa, demonstrando uma forma de brincar mais passiva. Foi possível caracterizar alguns aspectos e interesses da criança com Síndrome de Down no brincar, oferecendo-se subsídios para que os profissionais de educação ou da saúde possam determinar focos de intervenção.

The Ludic Model is a theoretical reference for the clinical intervention, developed by the occupational therapist Francine Ferland, whose research investigates how children with physical disabilities play in the clinical setting. The aim of the study was to determine possible contributions of the model and authors in Psychology for the analysis of how children with Down Syndrome play. The study included eight children of both sexes diagnosed with Down Syndrome, with ages between six and ten years and their legal guardians. The children demonstrated interest mainly by listening to stimuli, spontaneity and pleasure to play. However, not all of them demonstrated a sense of humour or an interest in challenges and taking initiative. They displayed more passivity while playing. It was possible to characterize some aspects and interests of the child with Down Syndrome as they played, offering assistance to education or healthcare professionals so they can then determine their intervention focuses.

El modelo lúdico es un referencial teórico para la intervención clínica, desarrollado por Francine Ferland, terapeuta ocupacional, que tiene como enfoque de investigación el jugar en la práctica clínica con niños con discapacidad física. El objetivo de este trabajo fue verificar posibles contribuciones del modelo y de autores de la Psicología para el análisis del juego de niños con Síndrome de Down. El estudio incluyó a ocho niños de ambos sexos con diagnóstico de Síndrome de Down, con edades entre seis y diez años, además de sus responsables legales. Los niños presentaron interés principalmente por estímulos sonoros, espontaneidad y placer al jugar. Sin embargo, la mayoría de ellos presentaron una forma de jugar mas pasiva, donde no demostraron sentido del humor, interés por desafíos e iniciativa. Fue posible caracterizar algunos aspectos e intereses del niño con Síndrome de Down en el juego, contribuyendo para que los profesionales de la educación o de la salud puedan determinar enfoques de intervención.

Research progress on animal models of postpartum depression and their behavior evaluation methods / 中国实验动物学报

Postpartum depression(PPD)is one of the most common types of postpartum psychiatric syndromes. Because of the complex and changeable characteristics in PPD disease and the special period after childbirth, there are many clinical limitations in the study of this disease. Therefore,the preparation and establishment of a proper animal model closed to clinical and behavioral evaluation method plays an important role in study of its pathogenesis. This review mainly introduces the commonly used postpartum depression animal models and the behavioral evaluation method. It is hoped to provide a reference for further study of PPD pathogenesis and for the drug research and development.

Evaluation methods of vascular remodeling / 基础医学与临床

Until now,the evaluation methods of vascular remodeling mainly included the related enzymes and bio-chemical markers,imaging feature,pulse conduction velocity measurement,etc.

The Safety Evaluation Method of Herb-Drug Combination: Manifestation-Target Alliance / 世界科学技术-中医药现代化

The herb-drug combination is becoming more and more common. The safety evaluation method is a complex evaluation system. This paper analyzed Pubmed database from 2008 to 2018, and summarized the characteristics of safety evaluation method, and the characteristics are listed as below: (1) Exposure safety issues in real world; (2) The combination use is complex and difficult to evaluate. There are the existing safety assessment methods including literature induction, prospective test, questionnaire survey, etc. Although safety evaluation has been carried out from different angles, there is still a lack of comprehensive and reasonable safety evaluation method. The team tried to combine clinical phenotype and mechanism characteristics to provide more reasonable methodological support for clinical safety evaluation.

Evaluation of swallowing function after cricohyoidoepiglottopexy / 局解手术学杂志

Objective To investigate the evaluation ways and effects of swallowing function after cricohyoidoepiglottopexy(CHEP). Methods Selected 92 patients of glottic carcinoma who were admitted into hospital from February 2014 to January 2017,and all the patients were given cricohyoidoepiglottopexy(CHEP)therapy and function reconstruction.Modified barium swallow(MBS),modified penetration as-piration scale(MPAS),and fiberoptic endoscopic evaluation of swallowing(FEES)were applied after the surgery.And the prognosis of patients was followed up.Results There was one patient who was not able to extubate,and the extubation time of tracheaostomy tube and stomach tube were respectively(12.04 ±5.42)week and(8.00 ±2.19)d among the remaining 91 cases.Three months after operation,the laryngeal function were good in 84 cases,moderate in 6 cases and poor in 2 cases,the incidence of complications was 6.5%.The fundamental frequency and fundamental frequency perturbation three months after operation were significantly lower than thos before operation(P<0.05). With the extension of postoperative time,the MPAS score of patients with MBS and FEES evaluation were obviously decreased(P<0.05). The MBS assessment score were respectively(3.87 ±0.98)points,(1.64 ±0.65)points,(1.09 ±0.33)points at 15 days,30 days and 60 days after operation.The FEES evaluation score were respectively(3.27 ±1.33)points,(1.73 ±1.11)points,(1.18 ±0.89)points at 15 days,30 days and 60 days after operation.With the MBS assessment as the gold standard,the sensitivity of FEES assessment to normal,false aspiration and aspiration were 100%,76.7%and 86.7%,respectively,and the specificity were 86.7%,97.1% and 98.3%,respectively. Conclusion The cricohyoidoepiglottopexy and laryngeal defect repair in the treatment of glottic carcinoma can effectively preserve the laryn -geal function,reduce the incidence of postoperative complications,improve pronunciation function,and the FEES and MBS evaluation of laryn-geal function have good accuracy,and they have good clinical significance to understand the degree of postoperative aspiration.

Validación de la Encuesta de Percepción de Enfermedad Revisada (Illness Perception Questionnaire) entre pacientes con patologías crónicas médicas y psiquiátricas / Validation of Illness Perception Survey Revised (Illness Perception Questionnaire) among patients with medical and psychiatric chronic diseases

MARCO TEÓRICO: La Percepción de Enfermedad es una variable importante en la evolución de los pacientes. Existen métodos de evaluación cualitativa de éste parámetro, sin embargo, no son aplicables a la población chilena por no estar adaptados al lenguaje local y cotidiano. OBJETIVO: Realizar una traducción del Illness Perception Questionnaire Revised, conservando la validez y fiabilidad original. MATERIALES Y MÉTODOS: Traducción y retraducción de la escala por experto. Piloteo de evaluación a 33 pacientes con enfermedades crónicas. Encuesta a 112 pacientes (49 diabéticos, 37 hipertensos y 33 esquizofrénicos) todos pertenecientes al CRS Hospital El Pino. CONCLUSIONES: En base al porcentaje de concordancia obtenido (95%) entre la versión original y la traducida a la lengua española y al reporte de los entrevistadores con respecto a la comprensibilidad manifestada por los pacientes, podemos concluir que la traducción por nosotros aplicada cumple con los criterios de validez.

THEORETICAL FRAMEWORK: The perception of disease is an important variable in the patient evolution. There are methods of qualitative evaluation of this parameter, however, are not applicable to the Chilean people for not being adapted to the local and everyday language. OBJECTIVE: A translation of the Revised Illness Perception Questionnaire, preserving the original set reliability and validity. MATERIALS AND METHODS: Translation and back translation of the scale by an expert. Piloting assessment to 33 patients with chronic diseases. Survey of 112 patients (49 diabetic and 33 hypertensive schizophrenics 37) all belonging to the CRS Hospital Pino. CONCLUSIONS: Based on the percentage of concordance obtained (95%) between the original version and the translated version in the Spanish language and the interviewers' report regarding the comprehensibility expressed by the patients, we can conclude that the translation applied by us meets the criteria of validity

Os testes de aptidão física na educação física: da justiça como equidade ao direito à educação / The physical fitness tests in physical education: from justice as equality to the right to education / Las pruebas de aptitud física en la educación física: de la justicia como equidad al derecho a la educación

É justo limitar a entrada de alunos em cursos de Educação Física devido ao insucesso nos testes físicos? O presente ensaio apresenta reflexões iniciais sobre a legitimidade e as limita-ções da exigência dos testes de habilidade específica para o ingresso discente nos cursos supe-riores em Educação Física, trazendo à baila questões sobre justiça e direito à educação. A par-tir da teoria de justiça rawlsiana, os testes foram mobilizados para problematizar as condições mínimas necessárias para ingresso discente e as próprias identidades profissionais em torno da Educação Física. Notou-se que a exigência de competências mínimas colidia com o processo plural de construção identitária da área e servia, de certo modo, como um limitador da própria condição humana: o direito à educação.

Is it fair to limit the students admission in Physical Education courses due to unsuccess ful-ness in the physical fitness tests? This paper presents initial reflections on the legitimacy and limits of the requirement of specific skill tests for student admission in Physical Education university courses, bringing up questions about justice and right to education. Based on Rawls' theory of justice, the tests were used to problematize the minimum necessary condi-tions for student admission and their own professional identities of Physical Education. It was noted that the requirement of minimum competencies was contrary to plural process of identi-ty construction in the field, and it served, in a sense, as a restrictive action of the own human condition: the right to education.

¿Es justo limitar la entrada de alumnos a cursos de Educación Física debido al fracaso en las pruebas de habilidades físicas? El artículo presenta reflexiones iniciales sobre la legitimidad y los límites de la exigencia de pruebas de habilidades específicas para la admi-sión discente a los cursos de Educación Física, colocando en tela de juicio interrogaciones sobre justicia y el derecho a la educación. A partir de la teoría de justicia rawlsiana, se movi-lizaron las pruebas de habilidades físicas para discutir las condiciones mínimas necesarias para la admisión discente y las propias identidades profesionales acerca de la Educación Físi-ca. Se observó que la exigencia de habilidades mínimas chocó con el proceso plural de cons-trucción de identidad del área y se usan, en cierto sentido, como un limitador de la condición humana: el derecho a la educación.

Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil / Mapeamento dos métodos adotados para o ensino de diagnóstico por imagem nas escolas médicas brasileiras

Abstract Objective: To map the different methods for diagnostic imaging instruction at medical schools in Brazil. Materials and Methods: In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Results: Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. Conclusion: The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

Resumo Objetivo: Mapear os diferentes métodos para o ensino de diagnóstico por imagem nas escolas médicas brasileiras. Materiais e Métodos: Estudo transversal, realizado por meio de envio de questionários para os coordenadores de 178 escolas médicas brasileiras. As seguintes características foram questionadas: modelo de ensino; carga horária; infraestrutura; número de alunos e profissionais envolvidos; temas expostos; modalidades e políticas de ensino em diagnóstico por imagem. Resultados: Dos 178 questionários encaminhados, 45 (25,3%) foram respondidos, sendo 17 (37,8%) de escolas públicas e 28 (62,2%) de escolas privadas. O método de ensino de diagnóstico por imagem foi o modular em 21 (46,7%) escolas, o clássico (disciplina independente) em 13 (28,9%), o híbrido (clássico e modular) em 9 (20,0%) e outro método em 3 (6,7%). A disciplina diagnóstico por imagem é parte do currículo formal em 36 (80,0%) das escolas, curso eletivo em 3 (6,7%) e outra modalidade em 6 (13,3%). Os docentes envolvidos no ensino de diagnóstico por imagem são radiologistas em 43 (95,5%) das escolas. Conclusão: O levantamento mostrou que os cursos de medicina no Brasil tendem a oferecer o conteúdo de diagnóstico por imagem em unidades curriculares que associam outros conteúdos e em diferentes momentos do curso. Há um grande envolvimento de radiologistas no ensino de graduação, independentemente do método de ensino disponível na instituição.

Meta-evaluation of a participatory process in the strengthening of municipal management / Meta-avaliação de um processo participativo no fortalecimento da gestão municipal

ABSTRACT OBJECTIVE To evaluate, with a focus on participation, an evaluation process developed by municipal managers and administrators of a health region in the state of São Paulo, considering the need for theoretical reflection on participatory health practices in the Brazilian context. METHODS Qualitative research that used the framework developed by Daigneault and Jacob (2009) to analyze the empirical material, encompassing three dimensions of participation: control of the evaluation process, diversity of participants, and extent of their involvement. We highlighted decisions or contextual aspects that deepened or limited the participatory option in the process under study. RESULTS We identified the presence and important performance of stakeholders who are "not specialists in evaluation", through participation both in the direction of the evaluation process and in its distinct stages. The formed group started from their own annoyances added to the need for information and reflection to define the subject and scope of the evaluation; the use of the process planned by them guided the definition of the data to be collected and the format of result dissemination; the empirical material analysis was undertaken jointly by the participants. Regarding the third dimension, a limitation was identified regarding the diversity of actors involved due to the prioritization of the possibility of in-depth work with a fixed group of managers. CONCLUSIONS It is stated that there is no "ideal participation model" for evaluations. In certain contexts and structures, real opportunities for participation - even if they seem fragile at first sight - should be leveraged, and that requires flexibility and critical reflection on the part of those responsible for the evaluation processes to undertake the necessary adjustments.

RESUMO OBJETIVO Meta-avaliar, com foco na participação, um processo avaliativo desenvolvido por secretários e assessores municipais de uma região de saúde do estado de São Paulo, tendo em vista a necessidade de reflexão teórica sobre práticas de avaliação participativa na área da Saúde no contexto brasileiro. MÉTODOS Pesquisa qualitativa que utilizou, para análise do material empírico, o referencial desenvolvido por Daigneault e Jacob (2009), englobando três dimensões da participação: direção do processo avaliativo, diversidade dos participantes e extensão do envolvimento dos mesmos. Foram destacadas decisões ou aspectos contextuais que fizeram com que a opção participativa fosse aprofundada ou limitada no processo em foco. RESULTADOS Identificou-se a presença e importante atuação de atores interessados "não especialistas em avaliação", por meio da participação tanto na direção do processo avaliativo como em suas diferentes etapas. O grupo formado partiu de seus próprios incômodos somados à necessidade de informação e reflexão para a definição do tema e escopo da avaliação; a utilização do processo por eles planejada guiou a definição dos dados a serem coletados e o formato da disseminação dos resultados; a análise do material empírico foi empreendida de forma conjunta pelos participantes. No tocante à terceira dimensão, foi identificada uma limitação quanto à diversidade de atores envolvidos em função da priorização da possibilidade de trabalho aprofundado com um grupo fixo de gestores. CONCLUSÕES Afirma-se que não existe um "modelo ideal de participação" para avaliações. Em determinados contextos e estruturas, oportunidades reais de participação - mesmo que pareçam frágeis à primeira vista - devem ser aproveitadas, exigindo, para tanto, flexibilidade e reflexão crítica por parte dos responsáveis pelos processos avaliativos, visando a empreender as adequações que se fizerem necessárias.

In vitro and in vivo evaluation of efficacy and safety of photoprotective formulations containing antioxidant extracts

ABSTRACT Chronic exposure to solar radiation could contribute to premature skin aging and skin cancer. Skin presents its own antioxidant defense, however when defenses are out of balance, reactive oxygen species could damage biological structures. In the present work, an oil-in-water photoprotective emulsion was developed and Bauhinia microstachya var. massambabensis Vaz, Fabaceae, extracts at 1% (obtained by extraction with different solvents) were added to this emulsion. In vitro and in vivo efficacy and safety of the formulations were evaluated. Spectrophotometric methods and in vivo Colipa test were performed to evaluated efficacy of the formulations, through sun protection factor (SPF) determination and UVA protection factor assessment. To the in vitro safety assessment HET-CAM, CAM-TBS and Red Blood Cell tests were performed. Results showed that both extracts contributed to a higher in vivo photoprotection (SPF 18) when compared to the formulation without extract (SPF 13), this result could be attributed to the antioxidant activity of the plant extracts that act by capturing reactive oxygen species. Concerning safety, all formulations were considered non-irritant according to in vitro tests. Formulations containing extracts could be considered efficient and safe for cosmetic use since they presented higher sun protection factor and passed the toxicity tests.

Transcultural adaptation to Brazilian Portuguese and reliability of the effort-reward imbalance in household and family work / Adaptação transcultural para o Português brasileiro e confiabilidade da escala esforço-recompensa no trabalho doméstico

ABSTRACT OBJECTIVE To describe the steps in the transcultural adaptation of the scale in the Effort-reward imbalance model to household and family work to the Brazilian context. METHODS We performed the translation, back-translation, and initial psychometric evaluation of the questionnaire that comprised three dimensions: (i) effort (eight items, emphasizing quantitative workload), (ii) reward (11 items that seek to capture the intrinsic value of family and household work, societal esteem, recognition from the spouse/partner, and affection from the children), and (iii) overcommitment (four items related to intrinsic effort). The scale was included in a sectional study conducted with 1,045 nursing workers. A subsample of 222 subjects answered the questionnaire for a second time, seven to 15 days thereafter. The data were collected between October 2012 and May 2013. The internal consistency of the scale was evaluated using Cronbach's alpha and test-retest reliability analysis, square weighted kappa, prevalence and bias adjusted Kappa, and intraclass correlation coefficient. RESULTS Prevalence and bias-adjusted Kappa (ka) of the scale dimensions ranged from 0.80-0.83 for overcommitment, 0.78-0.90 for effort, and 0.76-0.93 for reward. In most dimensions, the values of minimum and maximum scores, average, standard deviation, and Cronbach's alpha were similar in test and retest scores. Only on societal esteem subdimension (reward) was there little variation in standard deviation (test score of 2.24 and retest score of 3.36) and in Cronbach's alpha coefficient (test score of 0.38 and retest score of 0.59). CONCLUSIONS The Brazilian version of the scale was found to have proper reliability indices regarding time stability, which suggests adapting it to be used in population with characteristics that are similar to the one in this study.

RESUMO OBJETIVO Descrever as etapas da adaptação transcultural da escala do Effort-reward imbalance model to household and family work para o contexto brasileiro. MÉTODOS Efetuou-se a tradução, retrotradução e avaliação psicométrica inicial do instrumento composto por três dimensões: (i) esforço (oito itens, enfatizando a carga quantitativa de trabalho), (ii) recompensa (11 itens que buscam captar o valor intrínseco da família e do trabalho doméstico, a estima social, o reconhecimento do cônjuge ou companheiro e a afeição dos filhos) e (iii) o excesso de comprometimento (quatro itens relacionados ao esforço intrínseco). A escala foi incluída em um estudo seccional aplicado em 1.045 trabalhadoras de enfermagem. Uma subamostra de 222 participantes respondeu ao questionário pela segunda vez, com intervalo de sete a 15 dias. Os dados foram coletados entre outubro de 2012 e maio de 2013. A consistência interna da escala foi avaliada pelo coeficiente de alpha de Cronbach e a confiabilidade teste-reteste, pelo índice kappa ponderado quadrático, pelo kappa ajustado pela prevalência e pelo coeficiente de correlação intraclasse. RESULTADOS A confiabilidade ajustada pela prevalência (ka) das dimensões da escala variou de 0,80-0,83 para o excesso de comprometimento, 0,78-0,90 para o esforço e 0,76-0,93 para a recompensa. Na maioria das dimensões, os valores do escore mínimo e máximo, média, desvio-padrão e alpha de Cronbach no teste e no reteste foram semelhantes. Somente na subdimensão estima social (recompensa) houve pequena variação no desvio padrão (2,24 no teste e 3,36 no reteste) e no coeficiente de alpha de Cronbach (0,38 no teste e 0,59 no reteste). CONCLUSÕES A versão brasileira da escala apresentou índices adequados de fidedignidade quanto à estabilidade temporal, o que sugere a adequação da escala para uso em populações com características semelhantes à do estudo.

Research progress on evaluation methods of mouthfeel of oral drug delivery system / 中草药

Mouthfeel is an important part of preparation prescription study in oral drug delivery system. The results of traditional sensory evaluation are limited to individual differences of subjects, and own poor reproducibility. In this paper, some new technologies and evaluation methods were reviewed and commented, mainly including taste, adhesion, mucosal irritation, and grittiness, so as to provide methodology references for ODDS in traditional Chinese medicines and promote its progress.

Pathologic study and suggestion on evaluation methods of auxiliary protective function on gastric mucosa injury / 中国比较医学杂志

Objective To establish a scientific and practical principle , grading standard and reasonable statistical method for evaluating the protective effect of health food to gastric mucosal injury , based on general pathology and histopathological diagnosis .Methods A methodological study was conducted on rat model of acute gastric mucosa injury induced by alcoholic through comprehensive analysis and comparing shortcomings of the current standard evaluation method, and methods of semi-quantitative analysis and corresponding information statistic processing were based on characteristics of the lesion and principles of pathology .Results Gross pathological evaluation of gastric mucosa lesion was based on the area occupied and proportion in the whole gastric mucosa .Histopathological diagnosis was based on the mucous layer depth of lesion as main determination point and other lesions as reference factors .Grades of lesion were divided into no abnormality (0), mild lesions (1 point), moderate lesions (2 points), and severe lesions (3 points). Ridit statistical method was used for pathological analysis of semi-quantitative results .Conclusion A scientific and feasible evaluation method for the protective effect of health food to gastric mucosal injury was provided from the aspects of gross pathology , histopathological evaluation method , data processing method and result determination .