Portfólio: percepção de estudantes de graduação da área da saúde / Portafolio: percepción de los estudiantes de pregrado en eláreade la salud / Portfolio: perception of undergraduate students in the healthcare field

Introdução:A formação em saúde norteia a prática profissional, incidindo diretamente na atenção e assistência à saúde ofertada à população. Nesse sentido, o uso de métodos ativos de aprendizagem e avaliação, como por exemplo, o portfólio, podem contribuir para a construção de conhecimentos crítico-reflexivos. Objetivo:Evidenciara percepção de estudantes dos cursos da área da saúde, que cursam a disciplina de Saúde e Cidadania na Universidade Federal do Rio Grande do Norte sobre o uso do portfólio enquanto instrumento de avaliação do ensino aprendizagem. Metodologia:Os dados foram obtidos por meio da formação de grupo focaleanalisados pela análise do conteúdo. Definiram-se, então, as categorias temáticas:percepção sobre o portfólio; a elaboração do portfólio e a sua contribuição para a formação; dificuldades para formulação doportfólio;o portfólio como instrumento de avaliação. Resultados:Os estudantes compreendem o portfólio como instrumento de diálogo entre docentes e discentes, através dos relatos das vivências em grupo nos equipamentos sociais e reflexões individuais na construção de conceitos e aprofundamento teórico. Ainda referem inseguranças e dúvidas acerca da estruturação e confecção do instrumento, no entanto, percebem o portfólio como potente e inovador no auxílio aconstrução do conhecimento uma vez que permite oacompanhamento do processo de ensino-aprendizagem, possibilitando maior interação entre educador-educando, com produção de uma aprendizagem significativa.Conclusões:o portfólio estimula a reflexão e a crítica acerca das vivências nos cenários de práticas onde se desenvolve o componente curricular Saúde e Cidadaniacorroborando, sobremaneira, para a construção do conhecimento dos estudantes (AU).

Introduction:A degreein healthcare guides the professional practice, directly affecting the healthcare attention and assistance offered to the population. In this sense, the use of active learning and assessment methods, such as portfolios, can contribute to the construction of critical-reflective knowledge. Objective:To highlight the perception of students from health courses, who study the Health and Citizenship discipline at the Federal University of Rio Grande do Norte, regarding the use of the portfolio as an instrument for evaluating teaching and learning.Methodology:Data were obtained through the formation of a focus group and analyzed using content analysis. Thematic categories were then defined: perception of the portfolio; the preparation of the portfolio and its contribution to training; difficulties in formulating the portfolio; the portfolio as an assessment tool. Results:Students understand the portfolio as an instrument of dialogue between teachers and students, through reports of group experiences in social facilities and individual reflections in the construction of concepts and theoretical deepening. They still report insecurities and doubts about the structuring and creation of the instrument, however, they perceive the portfolio as powerful and innovativein helping to build knowledge as it allows the monitoring of the teaching-learning process, enabling greater interaction between educator and student, with the production of significant learning. Conclusions:The portfolio encourages reflection and criticism about the experiences in the practical scenarios where the curricular component -SACI is developed, greatly supporting the construction of students' knowledge (AU).

Introducción:La formación en salud orienta la práctica profesional, incidiendo directamente en la atención y asistencia sanitaria que se ofrece a la población. En este sentido, el uso de métodos activos de aprendizaje y evaluación, como los portafolios, puedecontribuir a la construcción de conocimiento crítico-reflexivo. Objetivo:Resaltar la percepción de estudiantes de carreras de salud, que cursan la disciplina Salud y Ciudadanía de la Universidad Federal de Rio Grande do Norte, sobre el uso del portafolios como instrumento de evaluación de la enseñanza y del aprendizaje. Metodología:Los datos se obtuvieron mediante la formación de un grupo focal y se analizaron mediante análisis de contenido. Luego se definieron categorías temáticas: percepción del portafolio; la elaboración del portafolio y su contribución a la formación; dificultades para formular el portafolio; el portafolio como herramienta de evaluación.Resultados:Los estudiantes entienden el portafolio como un instrumento de diálogo entre docentes y estudiantes, a través de relatos de experiencias grupales en establecimientos sociales y reflexiones individuales en la construcción de conceptos y profundización teórica. Aún reportan inseguridades y dudas sobre la estructuración y creación del instrumento, sin embargo, perciben el portafolio como poderoso e innovador para ayudar a la construcción de conocimiento ya que permite el seguimiento del proceso de enseñanza-aprendizaje, posibilitando una mayor interacción entre educador y estudiante, con la producción de aprendizajes significativos.Conclusiones: El portafolio incentiva la reflexión y crítica sobre las experiencias en los escenarios prácticos donde se desarrolla el componente curricular -SACI, apoyando en gran medida la construcción del conocimiento de los estudiantes (AU).

Reform and practical experience of bilingual course for "Environmental Biotechnology" with the development of "Emerging Engineering Education" / 生物工程学报

The construction of "Emerging Engineering Education" aims at cultivating high-quality graduates capable of engineering practice, innovation and international competitiveness. Bilingual courses have become one of the effective means to cultivate qualified students with skills of both professional knowledge and international communication. However, the teaching effect of most bilingual courses is not very ideal. Based on analyzing common problems in the current bilingual teaching, we take the bilingual course of environmental biotechnology as an example, and discusses possible improvement strategies from the aspects of the construction of teaching mode, the establishment of quality control system, the selection of textbooks and the optimization of assessment methods. Moreover, we summarize experience and shortcomings on improving the lecturers' ability, students' learning enthusiasm and school's support. It is expected to provide useful reference for improving the effect of bilingual teaching in biotechnology-relevant courses.

Thoughts on teaching reform of Biologicology / 生物工程学报

With the rapid development of modern biotechnology, the cultivation of high-quality biotechnology talents has received more and more attention. The course of Biologicology is a core subject that students majoring in biology should master. However, Biologicology is a new subject, and its teaching content and teaching methods are at the exploratory stage. Based on the current teaching status and existing problems of the Biologicology course, we propose teaching reforms in terms of teaching content, teaching methods and assessment methods, to lay a firm foundation for the further teaching efficacy of Biologicology course and increasing students' interest in learning.

Fisioterapia Respiratória em Pacientes com Fibrose Cística / Respiratory Physiotherapy in Patients with Cystic Fibrosis / Fisioterapia Respiratoria en Pacientes con Fibrosis Quística

O objetivo deste estudo foi proporcionar uma visão sobre a FC e as possíveis formas de tratamento fisioterapêutico. Método: Trata-se de uma revisão de literatura narrativa. Foram usadas as bases de dados eletrônicas: LILACS, SCIELO, PUBMED e MEDLINE a partir do ano de 2008. Na coleta de dados foram usados os seguintes descritores: mucoviscidose, fibrose cística, métodos de avaliação e fisioterapia respiratória. Foram selecionados artigos relacionados a avaliações e tratamento da FC, publicados em português e inglês. Resultados: A fisioterapia respiratória é recomendada para os pacientes com FC por possuir técnicas efetivas para aumento da expectoração de secreção, no entanto ainda se faz necessária a comprovação científica, em longo prazo, dos efeitos de cada técnica. Conclusão: Os tratamentos mais usados e atuais de acordo com os artigos encontrados foram drenagem postural, vibrocompressão, drenagem autogênica, aceleração do fluxo expiratório, expiração lenta total com a glote aberta em decúbito infralateral, máscara de pressão positiva expiratória e exercícios aeróbicos. Sendo elas importantes para amenizar os sinais respiratórios que a mucoviscidose apresenta evitando possíveis complicações pulmonares.

The objective of this study was to provide an insight into CF and the possible forms of physiotherapeutic treatment. Method: It is a narrative review of literature. The electronic databases were used: LILACS, SCIELO, PUBMED and MEDLINE from 2008. In data collection, the following descriptors were used: mucoviscidosis, cystic fibrosis, assessment methods and respiratory physiotherapy. Articles related to CF assessments and treatment, published in Portuguese and English, were selected. Results: Respiratory physiotherapy is recommended for patients with FC for having effective techniques for increasing sputum secretion, however it is still necessary to prove long-term scientific analysis of the effects of each technique. Conclusion: The most used and current treatments according to the articles found were postural drainage, vibrocompression, autogenic drainage, acceleration of expiratory flow, total slow expiration with the open glottis in the infralateral decubitus, positive expiratory pressure mask and aerobic exercises. They are important to mitigate the respiratory signs that mucoviscidosis presents, avoiding possible pulmonary complications..

El objetivo de este estudio fue proporcionar una idea de la FQ y las posibles formas de tratamiento fisioterapéutico. Método: Esta es una revisión de la literatura narrativa. Se utilizaron las bases de datos electrónicas: LILACS, SCIELO, PUBMED y MEDLINE de 2008. En la recopilación de datos, se utilizaron los siguientes descriptores: mucoviscidosis, fibrosis quística, métodos de evaluación y fisioterapia respiratoria. Se seleccionaron los artículos relacionados con las evaluaciones y el tratamiento de la FQ, publicados en portugués e inglés. Resultados: Se recomienda fisioterapia respiratoria para pacientes con FC por tener técnicas efectivas para aumentar el esputo secreción, sin embargo, todavía es necesario demostrar Análisis científico a largo plazo de los efectos de cada técnica. Conclusión: Los tratamientos más utilizados y actuales según los artículos encontrados fueron drenaje postural, vibrocompresión, drenaje autógeno, aceleración del flujo espiratorio, espiración lenta total con glotis abierta en posición de decúbito infralateral, máscara de presión espiratoria positiva y ejercicios aeróbicos. Son importantes para mitigar los signos respiratorios que presenta la mucoviscidosis, evitando posibles complicaciones pulmonares

Estado del Arte de la Evaluación de Tecnologías en Salud en América Latina / State of the Art of the Evaluation of Health Technologies in Latin America

Resumen El surgimiento y desarrollo de las tecnologías en salud ha hecho que se intensifique el papel de su evaluación en los últimos años, provocando un interés creciente en la Evaluación de Tecnologías en Salud (ETES) en América Latina, a través de intentos por proporcionar información útil al tomador de decisiones. Este artículo presenta una revisión del estado del arte de ETES en Latinoamérica, a partir del análisis de publicaciones en revistas y eventos especializados. Se abordaron tres aspectos: elementos de evaluación, métodos que se aplican y políticas resultantes. Se encontraron los siguientes aspectos de evaluación: seguridad, eficacia, efectividad y eficiencia, económico-financieros, clínicos y técnicos, estos últimos con mayor desarrollo. Con respecto a los métodos, se encontraron propuestas de estrategias empíricas para el análisis de la información y la toma de decisiones. La generación de políticas públicas relacionadas con la ETES en América Latina es incipiente, apenas se están identificando las problemáticas nacionales y las estrategias a seguir para su solución. Por lo tanto, se aprecia una necesidad de seguir trabajando en el desarrollo de políticas, estrategias y métodos de ETES en la región Latinoamericana que permitan responder a las problemáticas en salud de la población de cada país.

Abstract The emergence and development of health technologies have intensified the role of their evaluation in recent years, causing a growing interest in the Evaluation of Health Technologies (ETES) in Latin America, through attempts to provide useful information to the decision-maker. This article presents a review of the state of the art of ETES in Latin America, from the analysis of publications in journals and specific events. Three aspects were addressed: evaluation elements, methods that are applied, and resulting policies. The following evaluation aspects were found: safety, efficacy, effectiveness and efficiency, economic-financial, clinical and technical, the latter with more significant development. Concerning the methods, proposals for empirical strategies for the analysis of information and decision making were found. The generation of public policies related to the HTA in Latin America is under development, national problems are hardly being identified, and the strategies to be followed for their solution. Therefore, there is a need to continue working on the development of policies, and methods of HTA in the Latin American region that allow responding to the health problems of the population of each country.

Application of Risks Scores in Acute Coronary Syndromes. How Does ProACS Hold Up Against Other Risks Scores? / Aplicação de Escores de Risco em Síndromes Coronárias Agudas: Como o ProACS se Comporta Diante de Outros Escores de Risco?

Abstract Background: Multiple risk scores (RS) are approved in the prediction of worse prognosis in acute coronary syndromes (ACS). Recently, the Portuguese Journal of Cardiology has proposed the ProACS RS. Objective: Application of several validated RS, as well as ProACS in patients, admitted for ACS. Evaluation of each RS's performance in predicting in-hospital mortality and the occurrence of all-cause mortality or non-fatal ACS at one-year follow-up and compare them to the ProACS RS. Methods: A retrospective study of ACS was performed. The following RS were applied: GRACE, ACTION Registry-GWTG, PURSUIT, TIMI, EMMACE, SRI, CHA2DS2-VASc-HS, C-ACS and ProACS. ROC Curves were created to determine the predictive power for each RS and then were directly compared to ProACS. Results: The ProACS, ACTION Registry-GWTG and GRACE showed a c-statistics of 0.908, 0.904 and 0.890 for predicting in-hospital mortality, respectively, performing better in ST-segment elevation myocardial infarction patients. The other RS performed satisfactorily, with c-statistics over 0.750, apart from the CHA2DS2-VASc-HS and C-ACS which underperformed. All RS underperformed in predicting worse long-term prognosis revealing c-statistics under 0.700. Conclusion: ProACS is an easily obtained risk score for early stratification of in-hospital mortality. When evaluating all RS, the ProACS, ACTION Registry-GWTG and GRACE RS showed the best performance, demonstrating high capability of predicting a worse prognosis. ProACS was able to demonstrate statistically significant superiority when compared to almost all RS. Thus, the ProACS has showed that it is able to combine simplicity in the calculation of the score with good performance in predicting a worse prognosis.

Resumo Fundamento: Existem muitos escores de risco (ERs) aprovados na predição de um pior prognóstico em síndromes coronárias agudas (SCAs). Recentemente, a Revista Portuguesa de Cardiologia propôs o ER ProACS. Objetivo: Aplicar vários ERs validados, bem como o ProACS em pacientes internados por SCA. Avaliar o desempenho de cada ER em predizer mortalidade hospitalar e a ocorrência de mortalidade por todas as causas ou SCA não fatal em um ano de acompanhamento e compará-los com o ProACS. Métodos: Estudo retrospectivo de SCA. Os seguintes ERs foram aplicados: GRACE, ACTION Registry-GWTG, PURSUIT, TIMI, EMMACE, SRI, CHA2DS2-VASc-HS, C-ACS e ProACS. Curvas ROC foram criadas para determinar o poder preditivo de cada ER e diretamente comparadas com a do ProACS. Resultados: Os escores ProACS, ACTION Registry-GWTG e GRACE mostraram estatística-C de 0,908, 0,904 e 0,890, respectivamente, em predizer mortalidade hospitalar, mostrando melhor desempenho em pacientes com infarto do miocárdio com elevação do segmento ST. Os demais ERs mostraram desempenho satisfatório, com estatística-C acima de 0,750, com exceção de CHA2DS2-VASc-HS e C-ACS, que mostraram baixa performance. Todos os ERs apresentaram baixo desempenho em predizer um pior prognóstico em longo prazo, com estatística-C abaixo de 0,700. Conclusão: O ProACS é um escore de risco facilmente obtido para estratificação precoce de mortalidade intra-hospitalar. Ao avaliar todos os ERs, ProACS, ACTION Registry-GWTG e GRACE mostraram o melhor desempenho, com alta capacidade de predizer um pior prognóstico. O ProACS mostrou superioridade estatisticamente significativa em comparação aos outros ERs. Portanto, o ProACS mostrou-se capaz de combinar simplicidade no cálculo do escore com bom desempenho em predizer um pior prognóstico.

Avaliação de competências individuais e interprofissionais de profissionais de saúde em atividades clínicas simuladas: scoping review / Assessment of individual and interprofessional skills of health professionals in simulated clinical activities: a scoping review / Evaluación de competencias individuales e interprofesionales de profesionales de salud en actividades clínicas simuladas: scoping review

Objetivo: identificar junto à literatura como tem sido realizada a avaliação de competências individuais e interprofissionais em atividades clínicas simuladas na formação e capacitação de profissionais da área de Saúde. Método: estudo realizado por meio de Scoping Review, conforme Joanna Briggs Institute. As buscas foram realizadas entre dezembro de 2015 a fevereiro de 2016 nas bases de dados eletrônicas estabelecidas, por intermédio dos descritores e sinônimos. Resultados: Foram analisados 20 estudos que atenderam aos critérios de inclusão estabelecidos; os itens avaliados com maior frequência em todas as categorias profissionais foram as habilidades procedimentais e de comunicação; os dhecklists foram os instrumentos mais frequentes para avaliar competências. Conclusão: o desenvolvimento e a avaliação de competências profissionais e interprofissionais em simulação clínica têm sido realizadod com o apoio de instrumentos e métodos variados, todavia, o conteúdo e utilização destes podem limitar e direcionar o processo avaliativo.(AU)

Objective: to identify in the literature how the assessment of individual and interprofessional skills in simulated clinical activities in the training and qualification of health professionals has been performed. Method: study conducted through a scoping review according to the Joanna Briggs Institute. The searches were conducted between December 2015 and February 2016 in the established electronic databases through descriptors and synonyms. Results: Twenty studies that were in line with the established inclusion criteria were analyzed; communication and procedural skills were the most frequently assessed items in all professional categories, and checklists were the most frequently used instruments to assess the skills. Conclusion: the development and assessment of professional and interprofessional skills in clinical simulation have been carried out with the support of different instruments and methods, however their content and use may limit and direct the assessment process.(AU)

Objetivo: identificar en la literatura cómo se ha realizado la evaluación de competencias individuales e interprofesionales en actividades clínicas simuladas en la formación y capacitación de profesionales del área de la salud. Método: estudio realizado por medio de Scoping Review, conforme el Joanna Briggs Institute. Las búsquedas se realizaron entre diciembre de 2015 y febrero de 2016 en las bases de datos electrónicas establecidas, por medio de los descriptores y sinónimos. Resultados: Se analizaron 20 estudios que atendieron los criterios de inclusión establecidos, los ítems evaluados con mayor frecuencia en todas las categorías profesionales fueron las habilidades procedimentales y de comunicación; las checklists fueron los instrumentos más frecuentes para evaluar competencias. Conclusión: el desarrollo y evaluación de competencias profesionales e interprofesionales en simulación clínica se han realizado con el apoyo de instrumentos y métodos variados; no obstante, el contenido y la utilización de los mismos pueden limitar y direccionar el proceso de evaluación.(AU)

Methods for assessing dysphagia related to oral cancer / 口腔疾病防治

@#Deglutition is one of the basic physiological functions of humans. The surgical treatment of oral cancer can cause impairment in swallowing functions and even dysphagia in serious cases. Currently, there are many types of methods for assessing dysphagia, including bedside evaluation, scale evaluation, radiographic assessment, and stress or electromyographic evaluation during swallowing. However, each of these methods has advantages and disadvantages, and there is no uniform standard. This article briefly introduces the current status of methods for assessing dysphagia related to oral cancer.

Development and validation of a stratification tool for predicting risk of deep sternal wound infection after coronary artery bypass grafting at a brazilian hospital

Abstract Objective: Deep sternal wound infection following coronary artery bypass grafting is a serious complication associated with significant morbidity and mortality. Despite the substantial impact of deep sternal wound infection, there is a lack of specific risk stratification tools to predict this complication after coronary artery bypass grafting. This study was undertaken to develop a specific prognostic scoring system for the development of deep sternal wound infection that could risk-stratify patients undergoing coronary artery bypass grafting and be applied right after the surgical procedure. Methods: Between March 2007 and August 2016, continuous, prospective surveillance data on deep sternal wound infection and a set of 27 variables of 1500 patients were collected. Using binary logistic regression analysis, we identified independent predictors of deep sternal wound infection. Initially we developed a predictive model in a subset of 500 patients. Dataset was expanded to other 1000 consecutive cases and a final model and risk score were derived. Calibration of the scores was performed using the Hosmer-Lemeshow test. Results: The model had area under Receiver Operating Characteristic (ROC) curve of 0.729 (0.821 for preliminary dataset). Baseline risk score incorporated independent predictors of deep sternal wound infection: obesity (P=0.046; OR 2.58; 95% CI 1.11-6.68), diabetes (P=0.046; OR 2.61; 95% CI 1.12-6.63), smoking (P=0.008; OR 2.10; 95% CI 1.12-4.67), pedicled internal thoracic artery (P=0.012; OR 5.11; 95% CI 1.42-18.40), and on-pump coronary artery bypass grafting (P=0.042; OR 2.20; 95% CI 1.13-5.81). A risk stratification system was, then, developed. Conclusion: This tool effectively predicts deep sternal wound infection risk at our center and may help with risk stratification in relation to public reporting and targeted prevention strategies in patients undergoing coronary artery bypass grafting.

Domestic and foreign hospital assessment systems and their problems / 中华医学图书情报杂志

The aims, indexes, methods, results, data sources, advantages and disadvantages of 12 domestic and foreign hospital assessment systems were analyzed and the problems in current hospital assessment were described in order to provide reference and lessons for perfecting the domestic hospital assessment systems.

Domestic and foreign hospital assessment systems and their problems / 中华医学图书情报杂志

The aims, indexes, methods, results, data sources, advantages and disadvantages of 12 domestic and foreign hospital assessment systems were analyzed and the problems in current hospital assessment were described in order to provide reference and lessons for perfecting the domestic hospital assessment systems.

Research progress on visual quality assessment methods / 眼科新进展

The evaluation of visual quality about human eyes has always been an important issue in the field of eye science and visual optics,and it is mainly divided into subjective evaluation method and objective evaluation method,evaluation indicators including visual acuity,contrast sensitivity,wavefront aberration and retinal straylight,and so on.In addition,according to different principles and standards,visual system imaging quality evaluation methods can also be divided into visual refractive system and retinal nerve system evaluation,geometrical optics and physical optics evaluation,static and dynamic visual function evaluation.The selection of visual quality evaluation method should be considered from multiple dimensions on comprehensive consideration.in recent years,the improvement of quality of life promotes the development of visual quality assessment methods,and more attention is paid to the evaluation of continuous functional visual acuity.This article reviews the research progress of visual quality assessment methods.

Comparative analysis on the performance evaluation of hospitals between China and some countries / 中国卫生政策研究

This study aimed at comparing the United States, Britain, Australia, the Netherlands and China’s national performance evaluation, and sum up the experience to provide a theoretical basis for the China’s development of hospital performance evaluation system. The study found that China needs to consider the patient's perspective, to establish a fixed third-party performance evaluation agencies, establish an effective incentive mechanism and feedback mechanism and combine a variety of assessment methods in the development of hospital performance evaluation index system.

Impacto do tipo de procedimento e do fator cirurgião na validação do EuroSCORE / Impact of type of procedure and surgeon on EuroSCORE operative risk validation

Objetivo: O EuroSCORE tem sido utilizado na estimativa de risco em cirurgia cardíaca, apesar de fatores importantes não serem considerados. O objetivo foi validar o EuroSCORE na predição de mortalidade em cirurgia cardiovascular num centro brasileiro, definindo a influência do tipo de procedimento e da equipe cirúrgica responsável pelo paciente. Métodos: No período de janeiro de 2006 a junho de 2011, 2320 pacientes adultos consecutivos foram estudados. De acordo com o EuroSCORE aditivo, os pacientes foram divididos em risco baixo (escore <2), risco moderado (3 - 5), risco elevado (6 - 11) e risco muito elevado (>12). A relação entre a mortalidade observada (O) sobre a esperada (E) de acordo com o EuroSCORE logístico foi calculada para cada um dos grupos, procedimentos e cirurgiões com > de 150 operações, e analisada por regressão logística. Resultados: O EuroSCORE calibrou com a mortalidade observada (O/E=0,94; P<0,0001; área abaixo da curva=0,78), apesar de descalibrar a mortalidade em pacientes de risco muito elevado (O/E=0,74; P=0,001). O EuroSCORE calibrou a mortalidade na revascularização do miocárdio isolada(O/E=0,81; P=0,0001) e cirurgia valvar (O/E=0,89; P=0,007), e a mortalidade nas operações combinadas (O/E=1,09; P<0,0001). O EuroSCORE descalibrou a mortalidade do cirurgião A (O/E=0,46; P<0,0001) e a do cirurgião B (O/E=1,3; P<0,0001), ambos em todos os graus de risco. Conclusão: Na população estudada, o EuroSCORE descalibrou a mortalidade em pacientes de risco muito elevado, podendo sofrer influência do tipo de operação e do cirurgião responsável. O cirurgião mais apto para cada gravidade de paciente pode minimizar o risco imposto por características pré-operatórias. .

Objective: EuroSCORE has been used in cardiac surgery operative risk assessment, despite important variables were not included. The objective of this study was to validate EuroSCORE on mortality prediction in a Brazilian cardiovascular surgery center, defining the influence of type of procedure and surgical team. Methods: Between January 2006 and June 2011, 2320 consecutive adult patients were studied. According to additive EuroSCORE, patients were divided into low risk (score<2), medium risk (3 - 5), high risk (6 - 11) and very high risk (>12). The relation between observed mortality (O) and expected mortality (E) according to logistic EuroSCORE was calculated for each of the groups, types of procedures and surgeons with > 150 operations, and analyzed by logistic regression. Results: EuroSCORE correlated to the observed mortality (O/E=0.94; P<0.0001; area under the curve 0.78). However, it overestimated the mortality in very high risk patients (O/E=0.74; P=0.001). EuroSCORE tended to overestimate isolated myocardial revascularization mortality (O/E=0.81; P=0.0001) and valve surgery mortality (O/E=0.89; P=0.007) and it tended to underestimate combined procedures mortality (O/E=1.09; P<0.0001). EuroSCORE overestimated surgeon A mortality (O/E=0.46; P<0.0001) and underestimated surgeon B mortality (O/E=1.3; P<0.0001), in every risk category. Conclusion: In the present population, EuroSCORE overestimates mortality in very high risk patients, being influenced by type of procedure and surgical team. The most appropriate surgical team may minimize risks imposed by preoperative profiles. .

On audio-visual-oral medical English teaching / 中华医学教育探索杂志

Aimed at problems in current audio-visual-oral English teaching for medical students,such as the inconsistency between teaching materials and training objectives,the lack of flexibility and effectiveness in teaching methods and inadequacy of comprehensiveness and objectiveness in assessment methods,the paper analyses and explores audio-visual-oral medical English teaching in three aspects,namely teaching curriculum-setting up topic for each unit based on the contents of medical courses and designing various teaching tasks according to three-step procedure of extensive listening-intensive listening-derivative discussion,teaching methods-adopting pictorial method in teaching medical English vocabulary,macro-micro listening method and interpretation for imitation method,and assessment methods-applying a combination of formative assessment and summative assessment.

Rapid assessment methods in eye care: An overview.

Reliable information is required for the planning and management of eye care services. While classical research methods provide reliable estimates, they are prohibitively expensive and resource intensive. Rapid assessment (RA) methods are indispensable tools in situations where data are needed quickly and where time- or cost-related factors prohibit the use of classical epidemiological surveys. These methods have been developed and field tested, and can be applied across almost the entire gamut of health care. The 1990s witnessed the emergence of RA methods in eye care for cataract, onchocerciasis, and trachoma and, more recently, the main causes of avoidable blindness and visual impairment. The important features of RA methods include the use of local resources, simplified sampling methodology, and a simple examination protocol/data collection method that can be performed by locally available personnel. The analysis is quick and easy to interpret. The entire process is inexpensive, so the survey may be repeated once every 5–10 years to assess the changing trends in disease burden. RA survey methods are typically linked with an intervention. This article provides an overview of the RA methods commonly used in eye care, and emphasizes the selection of appropriate methods based on the local need and context.

Alteração espirométrica em crianças com mielomeningocele é dependente do nível de lesão funcional / Spirometric abnormalities in children with myelomeningocele is dependent of the level of functional injury

Objetivo: Avaliar a função pulmonar de crianças com mielomeningocele (MMC) de diferentes níveis de lesão funcional comparados a controles saudáveis pareados por idade e sexo. Material e método: Este foi um estudo caso-controle, no qual foi selecionada apenas uma criança por nível funcional de lesão e com função cognitiva preservada, e controles de crianças saudáveis pareados por idade e gênero ao grupo deMMC. Medidas antropométricas e espirométricas de função pulmonar foram obtidas de ambos os casose controles de MMC. Resultados: Todas as crianças com MMC apresentaram reduzido estado nutricional segundo os índices recomendados pela OMS. Foi observada presença de distúrbio ventilatório restritivo leve nas crianças com nível de lesão torácica (CVF = 0,65 por centoprev) e lombar-alta (CVF = 0,69 por centoprev), e apesar de dentro dos limites da normalidade, as crianças com MMC com níveis inferiores de lesão apresentaram valores espirométricos menores do que seus respectivos controles. Houve correlação negativa perfeita entre a capacidade vital forçada e o nível de lesão funcional das crianças com MMC. Conclusão: Crianças com MMC apresentam reduzidos valores de função pulmonar quando comparados aos controles saudáveis, sobretudo os com níveis de lesão funcional elevada, os quais demonstraram distúrbio ventilatório restritivo. A fisioterapia respiratória deve ser incorporada na avaliação e segmento das crianças com MMC, coadjuvante à fisioterapia motora, especialmente naquelas acometidas com níveis de lesões mais elevadas.

Rapid assessment methods of resilience for natural and agricultural systems

The resilience, ecological function and quality of both agricultural and natural systems were evaluated in the mountainous region of the Atlantic Rain Forest of Rio de Janeiro through Rapid Assessment Methods. For this goal new indicators were proposed, such as eco-volume, eco-height, bio-volume, volume efficiency, and resilience index. The following agricultural and natural systems have been compared according: (i) vegetables (leaf, fruit and mixed); (ii) citrus; (iii) ecological system; (iv) cattle, (v) silvo-pastoral system, (vi) forest fragment and (vii) forest in regeneration stage (1, 2 and 3 years old). An alternative measure (index) of resilience was proposed by considering the actual bio-volume as a function of the potential eco-volume. The objectives and hypotheses were fulfilled; it is shown that there does exist a high positive correlation between resilience index, biomass, energy efficiency and biodiversity. Cattle and vegetable systems have lowest resilience, whilst ecological and silvo-pastoral systems have greatest resilience. This new approach offers a rapid, though valuable assessment tool for ecological studies, agricultural development and landscape planning, particularly in tropical countries.

Foram avaliadas, em região montanhosa da Mata Atlântica do Rio de Janeiro a resiliência, função ecológica e qualidade tanto do sistema agrícola como natural, através dos métodos de avaliação rápida ("rapid assessment methods"). Para este fim, foram propostos novos indicadores como eco-volume, eco-altura, bio-volume, eficiência volumétrica e índice de resiliência. Os seguintes sistemas agrícolas e naturais foram comparados: (i) hortaliças (folhas, frutos e mistos); (ii) citros; (iii) sistema ecológico; (iv) gado; (v) sistema silvo-pastoral; (vi) fragmento florestal; (vii) floresta em estágio de recuperação (1, 2 e 3 anos de idade). Uma forma alternativa de resiliência foi proposta considerando o bio-volume real como uma função do eco-volume potencial. Os objetivos e hipóteses foram alcançados; demonstrou-se que existe uma correlação altamente positiva entre índice de resiliência, energia da biomassa, eficiência energética e biodiversidade. Pecuária e sistemas de hortaliças apresentaram as mais baixas resiliências enquanto sistemas ecológico e silvo-pastoral tiveram maiores resiliências. Esta nova estratégia oferece uma rápida e valiosa ferramenta de avaliação para estudos ecológicos, desenvolvimento agrícola e planejamento paisagístico, especialmente em países tropicais.

Comparisons of obesity assessments in over-weight elementary students using anthropometry, BIA, CT and DEXA

Obesity was characterized in Korean elementary students using different obesity assessment tests on 103 overweight elementary students from three schools of Jeonbuk Province. The body mass index (BMI) and obesity index (OI) were compared, and the data using DEXA and CT were compared with the data using BIA and a tape measure. The results of this study are as follows: first, 27 students who were classified as obese by OI were classified as overweight by BMI, and 3 students who were classified as standard weight by BMI were classified as overweight by OI. Secondly, by DEXA and BIA measurements, there was 1.51% difference in body fat percentage (boys 1.66%, girls 1.17%) and the difference in body fat mass between boys and girls was 0.77 kg (boys 0.85 kg, girls 0.59 kg), but those differences in body fat percentage and mass were not statistically significant. Thirdly, the average total abdominal fat (TAF) measured by CT scans of obese children was more significantly related with subcutaneous fat (r = 0.983, P < 0.01) than visceral fat (r = 0.640, P < 0.01). Also, TAF were highest significant with waist circumference by a tape measure (r = 0.744, P < 0.01). In summary, as there are some differences of assessment results between two obesity test methods (BMI, OI), we need more definite standards to determine the degree of obesity. The BIA seems to be the most simple and effective way to measure body fat mass, whereas waist/hip ratio (WHR) using a tape measurer is considered to be the most effective method for assessing abdominal fat in elementary students.