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Objective:To investigate how to integrate the ideological and political elements into the teaching of Nutrition and Food Hygiene under the background of new medical science.Methods:Through literature review and teaching discussion,suitable ideological and political elements and cases were selected to be integrated into the teaching of Nutrition and Food Hygiene,and feasible strategies were initially explored,which were implemented and evaluated in the grade 2018 students majoring in preventive medicine in Bengbu Medical College.Results:About 94.65% (124/131)of the students were satisfied with the ideological and political content design of the course,97.71% (128/131)of the students thought that it would be helpful to expand their professional knowledge,93.13% (122/131)thought that it would be helpful to establish morality and cultivate talents,and the overall feedback was good.The ideological and political teaching was generally recognized.Conclusions:It is feasible to integrate ideological and political elements into professional core courses,and to a certain extent.It can enrich the content of professional courses,improve students'interest,and make"foster virtue through education"truly implemented in the cultivation of professional quality.
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ObjectiveTo discuss the education of exercise rehabilitation specialty in China using World Health Organization rehabilitation competency framework (RCF). MethodsWith reference to World Health Organization Rehabilitation in Health Systems and RCF, this paper discussed the objectives, course contents and human resource management of exercise rehabilitation in China. ResultsRehabilitation service was an important part of health service to achieve the goals of United Nations 2030 health coverage, well-being of all people and sustainable development. Sports rehabilitation would cultivate professionals with knowledge of rehabilitation medicine and exercise rehabilitation. We should establish the concept of "people-oriented", improve the multi-disciplinary human resource management system, and improve the provision of multi-dimensional rehabilitation services in communities and hospitals, to cultivate professionals with both theoretical and practical abilities. RCF played an important role in developing teaching objectives, which helped for competency oriented education, curriculum settings, and an education system centered on competency. ConclusionUnder the context in Rehabilitation in Health Systems and RCF, we have clarified the competency characteristics required for the training of sports rehabilitation professionals, optimized the training mode of sports rehabilitation professionals, and explored the path to achieve the goals of sports rehabilitation talent training.
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In order to narrow the capability gap of junior radiotherapists from different institutions, construction of standardized radiotherapist post-graduated education and medical skill training system is in great demand, which help to meet the actual needs of clinical standardized management of precision radiotherapy. Based on the current situation of the education and post training of radiotherapists, this article elaborates on the real clinical needs, primary training objectives, and strategies of the standardized training system for radiotherapists, so as to provide a theoretical reference for training high-quality radiotherapists with good medical professional ethics and solid theoretical and practical skills in radiotherapy institutions at all levels.
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In order to deal with the shortage of medical talents in Tibet, medical group assistance to Tibet is started as an innovative move in a new era, not only providing high-quality medical resources to Tibet, but also training local medical personnel by drawing on the "Master-Apprentice" model in traditional Chinese medicine. During the past three-year, the Shanghai Medical Team took advantage of medical group assistance to Tibet, enriched the types, methods and contents of teaching and mentoring tasks, and highlighted the role of "experts leading the backbone" and "team leading the team" in the "Master-Apprentice" model. The total amount and quality of local medical talents have thus been significantly improved. On the basis of summarizing experience, this study proposes a number of measures to optimize the current "Master-Apprentice" training model, evaluate the implementation process, and improve the feedback and quality management, so as to speed up the construction of the Tibetan medical talent team.
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ObjectiveIn the context of COVID-19 prevention and control, to summarize the current situation of the public health personnel team development against the pandemic at a county-level center for disease control and prevention (CDC) in Shanghai’s extra-large urban area, to analyze and summarize the current situation and existing problems of the public health personnel team of the district and county-level CDCs, and to propose measures to strengthen and improve the development. MethodsTaking the Shanghai Pudong New Area Center for Disease Control and Prevention, which serves a population of 5.68 millions, as an example, through information access, individual interviews, questionnaires, holding symposiums, etc., combined with the deployment of personnel in the handling of the COVID-19, we described the Pudong New Area CDC’s talent team characteristics, personnel recruitment and loss, and investigated the factors affecting the construction of talent team. ResultsFrom 2014 to 2020, Pudong CDC recruited 115 people, and 65.71% of them chose to work there. 68 people resigned, with an average of 6.8 people leaving every year, with a fluctuating upward trend in resignation rate (χ2=0.158,P<0.05). Since we entered the phase of regular COVID-19 prevention and control in 2020, the staff have been overloaded with work, based on the number of hours spent dealing with the pandemic on the spot and the number of people on the job. In 2017 to 2019, the salary of staff was basically maintained at the level of 2016 (average annual growth of about 2.5%); it lacked targeted talent recruitment (one-time resettlement fee, etc.) and talent retention incentives (monthly housing subsidy for new employees, etc.). According to the questionnaire’s results, 79.23% of the respondents believed that the talent incentive mechanism needs to be improved, 73.43% believed that a good environment for talent growth needs to be created, and 50.24% thought that the employment mechanism needs to be reformed. It is difficult to meet the needs of pandemic prevention and control under the new situation with the current number of public health personnel, the recruitment of talents is insufficient, the turnover is too high, and there is a gap between the ability of some public health personnel and what is required of them under the new situation and new tasks. ConclusionThe quantity and quality of public health personnel for disease control in Shanghai can hardly meet the needs of pandemic prevention and control under the new situation. The pertinence and systematization of public health talent training urgently need to be strengthened, and the incentive mechanism needs to be improved.
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Based on the requirements of first-class undergraduate talents training in pharmacy in the new era, this paper summarizes and analyzes the law, current situation and actual situation of pharmaceutical talents training in TCM colleges and universities in China, and discusses the reform and practice of first-class pharmaceutical talents training in terms of talent training mode reform, teaching staff construction, curriculum system optimization, teaching mode innovation, quality assurance system construction and innovation and entrepreneurship education in combination with the construction experience of national first-class undergraduate specialty construction point in the pharmacy of Guangzhou University of Chinese Medicine, so as to further improve the quality of personnel training and provide a reference for excellent pharmaceutical personnel training.
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It is an urgent need for the development of medical and health undertakings in the new era to build a high-quality university education system and cultivate high-quality personnel for laboratory medicine. In the process of building a national first-class specialty, the medical laboratory technology specialty of Southern Medical University adheres to the concept of high-quality university education and improves the training level of laboratory medicine personnel through the teaching reform practice of constructing the whole-process moral education system, systematical training mode, internationalized teaching team, and intelligent teaching technology. In this paper, we analyzed the connotation and construction experience of a high-quality university education system of laboratory medicine, in order to increase the exchange and communication between different colleges and universities, and make contributions to the national strategic goal of building a powerful country in education before 2035.
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This paper mainly analyzes the literature on the training system of physiotherapists at home and abroad in the past 15 years, and compares the training mode, curriculum setting, current situation and application direction of physiotherapists domestic and abroad. The main findings are as follows: at present, the training objectives of Chinese physiotherapists are not clear, the training methods and teaching materials are outdated, the source of teachers are not standardized, the identification of professional qualifications are not completed, and the gap between relevant talents and market demand is large. It is suggested to establish a standardized curriculum and syllabus for physiotherapists, develop a unified industry access and qualification recognition, formulate a training mode which is in line with the national conditions, and focus on solving the imbalance between supply and demand of physiotherapists.
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Fermentation engineering is an industrial process that uses the transformation of microorganisms or other cells to produce a specific product in a specific bioreactor. Fermentation engineering has developed from an ancient food fermentation relying solely on experience accumulation to an important production mode of food, agriculture, medicine, chemical industry and other means of production and life. It has become a key technology to support the sustainable development of human beings, and is inseparable from the continuous progress of interdisciplinary technology. The interdisciplinary integration and the continuous upward movement of China's global industrial chain will inevitably put forward higher requirements for the cultivation of fermentation engineering composite talents in the new situation. In order to constantly improve the interdisciplinary fermentation engineering compound talent training system, in recent years, the research lab has been refining and improving the concept of talent training, and actively deepening the reform of talent training system. Systematic research and practice have been carried out around the aspects of training program, enrollment system, teacher background, subject setting, scientific research practice, evaluation system, etc., which has promoted the technological progress of fermentation engineering and related supporting industries, and contributed an important force to the transformation of China from a big fermentation country to a powerful fermentation country.
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Humans , Agriculture , China , Fermentation , IndustryABSTRACT
O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) é a condição neuropsiquiátrica mais comum na infância; deve ser foco de inclusão educacional, tendo base legal, onde estratégias pedagógicas diferenciadas são necessárias. Nesse contexto, o Treinamento, Desenvolvimento e Educação de Pessoas (TD&E), pode contribuir na sistematização da promoção de habilidades de pais, professores e alunos com TDAH. O presente estudo teve por objetivo uma revisão integrativa, sobre inclusão escolar de crianças com TDAH, buscando a verificação da existência de subsistemas que compõe o TD&E. Foram consultadas 7 bases de dados e selecionados 22 estudos que foram categorizados segundo TD&E. As análises evidenciaram: inclusão escolar como um processo em construção mundial; múltiplas formas de execução; necessidade de formação dos professores; tendência de inclusão de crianças com TDAH; volume de trabalhos crescente e; a possibilidade da aplicabilidade do TD&E na educação especial, trazendo contribuição para planejamento e execução de práticas inclusivas.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common neuropsychiatric condition in childhood; It should be the focus of educational inclusion, having a legal basis, where differentiated pedagogical strategies are needed. In this context, Training, Development and Education of People (TD&E) can contribute to the systematization of the promotion of skills of parents, teachers and students with ADHD. The present study aimed at an integrative review on school inclusion of children with ADHD, seeking to verify the existence of subsystems that make up the TD&E. We consulted 7 databases and selected 22 studies that were categorized according to TD&E. The analyzes showed: school inclusion with a process under construction worldwide; multiple forms of execution; need for teacher training; inclusion trend of children with ADHD; increasing workload and; the possibility of the applicability of TD&E in special education, contributing to the planning and execution of inclusive practices.
El trastorno por déficit de atención con hiperactividad (TDAH) es la afección neuropsiquiátrica más común en la infancia; Debe ser foco de inclusión educativa, tener una base legal y necesitan estrategias pedagógicas diferenciadas. La capacitación, el desarrollo y la educación de las personas (TD&E) pueden contribuir en sistematización de la promoción de las habilidades de padres, maestros y estudiantes con TDAH. Objetivó una revisión integradora sobre la inclusión escolar de niños con TDAH y verificar la existencia de subsistemas que componen el TD&E. Consultamos 7 bases de datos y seleccionamos 22 estudios que se clasificaron según TD&E. Los análisis mostraron: inclusión escolar con un proceso en construcción en todo el mundo; múltiples formas de ejecución; necesidad de formación docente; tendencia de inclusión de niños con TDAH; aumento de la carga de trabajo y; posibilidad de aplicabilidad de TD&E en educación especial, contribuyendo a la planificación y ejecución de prácticas inclusivas.
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Based on the new mission of public health conferred by the Healthy China Strategy and insufficient response to COVID-19, this article pointed out the problems of the current public health and preventive medical system from the macro system level, the meso organization level, and the micro individual level: including insufficient strategic planning , Resource input, institutional coordination, talent training and team building. This article creatively proposed to set up the health and health commission to implement the top-down vertical management at the national - provincial – municipal - county level. The Centers for Disease Control and Prevention system should be build by a strategic research institute, CDC, a human resources training base, and a scientific research institute. Enhance the functions of strategic planning, overall coordination, and evidence-based decision-making in the original system; emphasize the foresight and continuity of scientific research; allow the CDC to focus more on health management and the responses to emergencies. This will protect public health, improve the health and quality of life of the entire population, and ensure social stability and development.
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Abstract Inadequate and ineffective care provided by health professionals to the LGBT+ public can cause countless damages to those who demand care. An alternative to improve the service provided is to promote training actions for professionals that should be initiated by the Training Needs Analysis (TNA). This study aimed at building and validating, theoretically and statistically, a TNA instrument for health professionals related to humanized care for LGBT+ individuals for the Brazilian context. The data collection was done in two stages, in person and virtually, and had 449 professionals who responded to the TNA instrument built. The data was analyzed by means of content analysis, exploratory factors and internal consistency. The scale presented a uni-factorial structure with evidence of validity and reliability, and can be used as a diagnostic tool to verify the gaps in the competence of health professionals in the care of LGBT+ people.
Resumo A assistência inadequada e ineficaz proporcionada por profissionais de saúde ao público LGBT+ pode causar inúmeros danos àqueles que demandam cuidados. Uma alternativa para melhorar o atendimento prestado é promover ações de capacitação aos profissionais que devem ser iniciadas pela Análise de Necessidades de Treinamento (ANT). O presente estudo teve como objetivo construir e validar, teórica e estatisticamente, um instrumento de ANT destinado aos profissionais de saúde relacionado ao atendimento humanizado ao indivíduo LGBT+ para o contexto brasileiro. A coleta de dados foi feita em duas etapas, presencial e virtualmente, e contou com 449 profissionais que responderam ao instrumento de ANT construído. Os dados foram analisados mediante análises de conteúdo, fatoriais exploratórias e de consistência interna. A escala apresentou uma estrutura unifatorial com evidências de validade e confiabilidade, podendo ser utilizada como ferramenta de diagnóstico para verificar as lacunas de competências dos profissionais de saúde quanto ao atendimento às pessoas LGBT+.
Resumen La atención inadecuada e ineficaz que brindan los profesionales de la salud al público LGBT+ puede causar numerosos daños a quienes la necesitan. Una alternativa para mejorar el servicio prestado es promover la capacitación de profesionales, que debe ser iniciada por el Análisis de Necesidades de Entrenamiento (ANE). El estudio describe los procedimientos de construcción y validación, teórica y estadística, de un instrumento de ANE destinado a los profesionales de la salud que trabajan con población LGBT+. La recogida de datos fue realizada en dos etapas, presencial y virtualmente, y contó con 449 profesionales que respondieron al instrumento de ANE construido. Los datos fueron analizados mediante análisis de contenido, factoriales exploratorios y de consistencia interna. La escala presentó una estructura unifactorial con evidencias de validez y fiabilidad, pudiendo ser utilizada como herramienta de diagnóstico para verificar las deficiencias de competencias de los profesionales de la salud cuanto al atendimiento a las personas LGBT+.
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Humans , Male , Female , Adult , Patient Care Team , Attitude of Health Personnel , Reproducibility of Results , Factor Analysis, Statistical , Mental Competency , Health Personnel , Education, Public Health Professional , Allied Health Personnel , Sexual and Gender Minorities , Health Services Needs and Demand , Minority GroupsABSTRACT
In order to promote the development of medical and biological fields and help the students trained under the existing system to form a clear overall view on neuroscience research, the author summarizes a systematic chart teaching method in the teaching process of neuroscience which helps the students understand easily. On the basis of theory studying, the article induces and interprets the priorities and hotspots in domestic neuroscience research, which not only cultivates students' interest and enthusiasm in scientific research but also facilitates the training process. It tries to seek the improvement of the education quality from the teachers' perspective and contribution and effectively inspire students' spontaneous excavation in research direction which combines mentor's research field and their own interest, leading students to innovate good learning habits constantly.
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Objective:To explore the problems and give reasonable advice by investigating the current situation and needs of rehabilitation professionals nationwide. Methods:This research investigated the rehabilitation institutions invested by Disabled Persons' Federation system, sanitary system, privately-run institutions and People's Insurance Company from March to July, 2015 to collect data of rehabilitation physicians and therapists, in which the questionnaire survey, expert consultation and on-spot investigation were used. Results:The survey issued 416 questionnaires, 329 questionnaires were recalled, and 261 out of them were eligible. The profession titles of rehabilitation professionals were generally low, 39.3% were below the primary profession title; rehabilitation professionals were lack of educational background, 34.2% were college degree or below; low salary lead to low competence to other industries, 66.4% employees were paid 2000 to 4000 Yuan (RMB) per month; rehabilitation institutions were most in need of rehabilitative physicians, speech therapists and psychotherapists; lack of professionals, lack of bonus and space limitation ranked the top three of the restrictive factors. Conclusion:At present, the contradiction that the quantity and quality of rehabilitation talents cannot meet the increasing demand of rehabilitation is becoming more and more prominent. To solve the root of the problem, we need to start with the cultivation of talents, and the government needs to give policy support, open green pass and give strong assistance in cultivation of talents, academic title evaluation, salary levels, and policy guarantee system of rehabilitation to promote the rapid, sustaining and healthy development of rehabilitation industry.
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Guided by Chinese medicine culture,the strengthening of the cultural self-confidence of Chinese medicine is the cornerstone of the personnel training majoring in Chinese material medica.With the rapid development of modern medicine,the personnel training of the undergraduate students majoring in Chinese material medica in the universities of western medicine is facing several problems,such as lack of cultural identity,lack of professional confidence,unsteadiness of professional thinking,and changes of employment direction.For these problems,based on the main line "Solidify the cultural foundation of Chinese medicine,strengthen the self-confidence of Chinese material medica",our school selected the Chinese medicine cultural traveling,social practices and Chinese medicine employment guidance curriculum as the starting points,and carried out various of lively and vivid activities,which had positive impacts on the learning enthusiasm and professional love of the undergraduate students majoring in Chinese material medica.
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Objective Through the investigation of the research funding status of returnees before and after their long-term (more than 3 months) study at abroad in a three class hospital,this paper analyzed the influence of the hospital level initial funding to help young talent to obtain scientific research funding,discussed appropriate measurement to enhance the scientific research capacity of hospital young talents to provide reference for management.Methods Long-term sponsored study abroad returnees from 2005 to 2015 of this hospital were recruited as subjects,divided into two groups according to whether they got the hospital-level initial funding after returning,comparative analysis was conducted to understand the influence of such funding to help obtaining subsequent research projects of these young talents.Results The number of subjects per capita returned to the obtained group was higher than that of the non obtained group,and the proportion of high-level subjects at provincial and ministerial levels was higher than that of the non-obtained group (P<0.05),and the average time interval between the groups after returning home was less than that of the non-obtained group (P<0.05).Conclusions The hospital-level initial funding for overseas returnee can obviously improve the quality and speed of the subsequent projects of the young talents in the hospital,and have a significant positive effect on mobilizing the enthusiasm for scientific research,improving their scientific re search ability,and improving the overall scientific research level and competitiveness of the hospital.
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Objective Young talents training to reserve scientific research reserve force is one of the important problems that the scientific research department should take into account .Methods Two main measurements ,service support and inter-nal policy support were adopted to promote the development of technical talents .Service supports including make good use of the Youth League Committee ,establishing the model of young science and technology ,organizing scientific research kick-off meeting and carrying out Youth Science and Technology Forum .Results Such measurements enhanced the enthusiasm for sci-entific research participation of young people ,which played important role in making changes to insure the rising of the level of young talents .Conclusions The training of young talents from two aspects including service and policy not only enhanced their scientific research level ,but also helpful in promoting their research competence ,and further ,reserve the scientific research re-serve force for the hospital .
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Objective To analyze whether studying abroad has any influence on clinicians′scientific research ability, and study the rationality of the indicators reflecting the scientific research ability. Methods A total of 36 clinicians who studied abroad more than 3 months between 2008 and 2010 were selected as the abroad group, and the control group of 36 clinicians was selected from the clinician information database of the hospital by the method of Propensity Score Match.A comparison and analysis were made regarding the number of papers(SCI), grants and scientific and technological achievements between the two groups. Meanwhile, covariance analysis was used to compare the difference in the number of scientific research achievements between the two groups.Logistic regression analysis was used to compare the changes in scientific research achievements of clinicians before and after their abroad study. Results The number of articles( SCI) published and grants obtained in the 3 years after going abroad was significantly higher than that of the control group, and the number of grants obtained in the 4-6 years after going abroad was also significantly higher than that in the control group.The number of papers(SCI)published in the three years after going abroad was more than that in the 3 years before going abroad.The number of grants obtained in the 4-6 years after going abroad was more than that in the 3 years before going abroad.These differences were statistically significant. Conclusions Studying abroad has a beneficial effect on the improvement of clinicians′ scientific research ability. It is reasonable and practical to take the number of SCI articles published as the indicator of short-term changes and the number of funds obtained as the indicator of long-term changes in scientific research ability.
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This review encompasses both national and international literature about training needs analyses for health care professionals working with the LGBT+ population. The descriptors "health professionals", "health providers", "LGBT","training needs analysis" were searched in the following databases: Academic OneFile, Academic Search Complete, Medical Literature Analysis and Retrieval System Online, Virtual Health Library, Cumulative Index to Nursing and AlliedHealth Literature, Complementary Index, Business Source Complete, Education Source, Gender Studies, National Center for Biotechnology Information, Scientifi c Electronic Library Online, SportDiscus, and PsycINFO. Inclusion criteria were:empirical articles, published from 2007 to 2017, in indexed and peer-reviewed journals, available in full text, in Portuguese or English versions. Of the 17 included articles, most were published in North American countries. There is a need for training and formal protocols within institutions. Training had positive results. No instruments about the competencies for health care professionals working with the LGBT+ population were identifi ed. Further studies should be conducted in the fi eld of health care professionals training to provide satisfactory health care services to this public.
Revisar a literatura nacional e internacional quanto à análise de necessidades de treinamento para profi ssionais de saúde no atendimento ao público LGBT+. Os descritores "health professionals", "health providers", "LGBT", "training needs analysis" foram pesquisados nas seguintes bases de dados: Academic OneFile, Academic Search Complete, Medical Literature Analysis and Retrieval System Online, Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, Complementary Index, Business Source Complete, Education Source, Gender Studies, National Center for Biotechnology Information, Scientific Electronic Library Online, SportDiscus e PsycINFO. Os critérios de inclusão utilizados foram artigos empíricos, publicados entre 2007-2017, em revistas indexadas e avaliação por pares, textos na íntegra, em português ou inglês. Nos 17 artigos selecionados prevaleceram publicações norte-americanas; há uma carência de capacitações e de protocolos científicos em instituições; os treinamentos realizados tiveram resultados positivos; e nenhum instrumento sobre competências de profissionais de saúde na assistência ao público LGBT+ foi identificado. Pesquisas devem ser realizadas no domínio de capacitações dos profissionais de saúde para prestar assistência satisfatória a esse público.
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Health Personnel , Sexual and Gender MinoritiesABSTRACT
O objetivo do estudo foi avaliar a percepção de impacto do treinamento no trabalho em profundidade e de suporte à transferência do treinamento por servidores públicos que participaram de um curso online sobre Programas de Preparação para Aposentadoria (PPA), Os instrumentos foram respondidos, 6 meses após a capacitação, por 171 cursistas. Técnicas quantitativas e qualitativas de análise de dados foram adotadas. Os participantes aplicaram moderadamente as competências aprendidas no contexto laboral. O suporte material foi percebido como mais elevado que o psicossocial, o qual foi evidenciado como preditor significativo da percepção de impacto dos cursistas, enquanto o material não. Além disso, 43,48% dos cursistas mencionaram que a organização implementou ou aperfeiçoou seus respectivos PPAs. Sugere-se que as próximas edições dessa capacitação sejam precedidas por avaliação de necessidades e tenham seu impacto avaliado por métodos mistos e múltiplos informantes.
The research goal was to evaluate the perceived in-depth impact of training and support for the transfer of training for public workers who participated in an online course about retirement planning programs, as well to examine the relationship between these variables. The measures were answered, six months after the training, by 171 participants. Quantitative and qualitative data analysis techniques were adopted. Respondents moderately applied the competencies learned in the work context. Material support was perceived as higher than psychosocial support, but the psychosocial was found to be a significant predictor of the perceived in-depth impact at work, while the material support was not. In addition, 43.48% of the participants mentioned that the organization implemented or improved its respective retirement planning programs. Future editions of these training programs could be preceded by needs assessment and could have their impact evaluated by mixed methods and multiple respondents.
El objetivo del estudio fue evaluar la percepción de impacto del entrenamiento en el trabajo en profundidad y de soporte a la transferencia del entrenamiento por servidores públicos que participaron de un curso a distancia sobre Programas de Preparación para la Jubilación(PPA), así como examinar la relación entre esas variables. Los instrumentos fueron respondidos, seis meses después del entrenamiento, por 171 trabajadores. Se adoptaron técnicas cuantitativas y cualitativas de análisis de datos. Los participantes aplicaron moderadamente las competencias aprendidas en el contexto laboral. El soporte material fue percibido como más elevado que el psicosocial, pero el psicosocial fue evidenciado como predictor significativo de la percepción de impacto de los respondientes, mientras que el material no. Además, 43,48% de los trabajadores dijeron que la organización implementó o perfeccionó sus respectivos programas. Se sugiere que las próximas ediciones de este entrenamiento sean precedidas por evaluación de necesidades y tengan su impacto evaluado por métodos mixtos y pormúltiples informantes.