O perfil dos egressos de um mestrado profissional: uma contribuição para o entendimento da relação formação-trabalho no SUS / Profile of graduates of a Professional Master's Degree: a contribution to understanding the training-work relationship in the SUS

RESUMO Este artigo apresenta perfil dos egressos, efeitos da formação e trajetória profissional dos concluintes do Curso de Mestrado Profissional em Saúde Pública, do Instituto Aggeu Magalhães, parte de pesquisa avaliativa em desenvolvimento. Dos 99 egressos convidados que concluíram seus cursos entre 2013-2020, 54 responderam a um questionário aplicado por meio do software Lime Survey. O estudo descritivo e transversal utilizou frequência absoluta e relativa e cruzamento de variáveis na análise, cujo instrumento constou dos temas: identificação do egresso e do programa/curso; atividade profissional antes e ao término do curso e expectativas; condição empregatícia atual e efeitos da formação; avaliação da trajetória formativa. Entre os respondentes, a maioria é do sexo feminino, com idade entre 31-40 anos, enfermeiros de formação, autodeclarados pretos ou pardos, não ser pessoa com deficiência, predominantemente residentes em Pernambuco e não ingressaram mediante cota. Como efeito na vida profissional, encontrou-se que o curso aumentou o prestígio/reconhecimento dos colegas, qualificou para atividades que já exerciam e para atividades diferentes, e trouxe ganhos de remuneração, proporcionando mudanças na vida pessoal e profissional. Os resultados estão em conformidade com achados científicos desse mesmo contexto, e a ferramenta desenvolvida pela Fiocruz permitiu conhecer a relação entre formação e trabalho.

ABSTRACT This article presents the profile of graduates, the effects of training, and the professional trajectory of the Professional Master's Course in Public Health graduates at the Aggeu Magalhaes Institute. Of the 99 invited graduates who completed the program between 2013-2020, 54 responded to a questionnaire applied through the Lime Survey software. The descriptive and cross-sectional study used absolute and relative frequency cross-tabulation variables in the analysis, with the instrument covering the following themes: identification of the graduate and program/course; professional activity before and at the end of the program and expectations; current employment status and formation effects; evaluation of the formative trajectory. Among the respondents, most are female, aged between 31-40 years, trained as nurses, self-declared as black or brown-skinned, not having a disability, predominantly residing in Pernambuco, and did not enter through a quota system. As an effect on their professional life, it was found that the program increased prestige/recognition among colleagues, qualified them for activities they were already performing and also different activities, and brought salary increases leading to changes in personal and professional lives. The results are consistent with scientific findings in the same context, and the tool developed by FIOCRUZ made it possible to understand the relationship between education and work.

Investigación cualitativa en el contexto de la Salud Pública: actualización de conceptos

Los enfoques cualitativos en la investigación han sido fundamentales en las ciencias sociales y son cruciales para el estudio de la salud y los servicios sanitarios. Con el progreso en medicina, mayor especialización, expectativas crecientes de los pacientes y la complejidad de los servicios de salud, los profesionales se enfrentan a un entorno laboral cada vez más complicado. Los métodos cualitativos, aunque distintos de las técnicas experimentales y cuantitativas de la investigación clínica y biomédica, son indispensables para la investigación en servicios de salud. Esto se debe a que permiten explorar aspectos no medibles cuantitativamente, como las creencias sobre la salud, y porque proporcionan una base -descriptiva necesaria para la investigación cuantitativa, especialmente en campos con escasa investigación previa.

Qualitative approaches in research have been fundamental in the social sciences and are crucial to the study of health and health services. With progress in medicine, greater specialization, increasing patient expectations and the complexity of health services, professionals face an increasingly complicated work environment. Qualitative methods, although different from the experimental and quantitative techniques of clinical and biomedical research, are essential for health services research. This is because they allow us to explore aspects that are not quantitatively measurable, such as beliefs about health, and because they provide a necessary descriptive basis for quantitative research, especially in fields with little previous research.

Development of evaluation index system for health education effect of adolescents with type 1 diabetes mellitus / 中国实用护理杂志

Objective:To develop an evaluation index system on health education effect for adolescents with type 1 diabetes mellitus (T1DM).Methods:Using "knowledge-attitude/belief-practice"model and health belief model as the theoretical framework, the first draft of the expert consulation questionnaire for evaluation index system on health education effect for adolescents with type 1 diabetes mellitus was drawn up through literature review, qualitative interview, and repeated discussions between groups. Two rounds of expert consultation were conducted. The results of the consulation were sorted and analyzed, the index structure, item content, and sequence were discussed repeatedly, and the evaluation index system on health education effect for adolescents with T1DM was determined, and the analytic hierarchy process was used to determine its weight.Results:A total of 21 female experts participated in two rounds of survey whose age was (43.48 ± 5.84) years old. The questionnaire response rates of the two rounds of expert consultations were 84.00%(21/25) and 85.71%(18/21), the authoritative coefficients were 0.96 and 0.97, the Kendall coordination were 0.181 and 0.256, respectively ( P<0.05). The consistency test of the weight of each indicator showed that the consistency ratios were all <0.1. The evaluation index system on health education effect for adolescents with T1DM was constructed with 5 first-level indicators (health knowledge, health belief, health practice, physiological indexes and health education satisfaction), 38 second-level indicators. Conclusions:The method used to construct the evaluation index system on health education effect for adolescents with T1DM was highly scientific and reliable, which provides the basis for clinical nurses to evaluate and monitor the effect of health education in adolescents with T1DM.

Unmet need for and impact of adopting immunobiological drugs for moderate to severe plaque psoriasis in a pediatric population

ABSTRACT Objective Therefore, this study aimed to evaluate the impact of secukinumab and ustekinumab against moderate-to-severe plaque psoriasis in a Brazilian pediatric population with access to public healthcare. Methods A survey of immunobiological treatments registered for use against pediatric psoriasis at the National Health Surveillance Agency was conducted. These treatments were compared to the list available in the same treatment category in the public health system through the Clinical Protocol and Therapeutic Guidelines for psoriasis. A quantitative analysis of the data of patients treated with immunobiological drugs the previous year in accordance with the Clinical Protocol and Therapeutic Guidelines was performed using data available in the DATASUS portal. Results The public budget impact scenarios analyzed were comparable to the investment already planned for acquiring the only available drug option. Conclusion The incorporation of two therapeutic options in the Clinical Protocol and Therapeutic Guidelines list for moderate-to-severe pediatric psoriasis was feasible in a horizon of 5 years compared to the investment into the single option available to pediatric patients. These findings can facilitate the local analysis of budgetary impact and discussions on the feasibility of this therapeutic incorporation at the state level.

Evaluación a distancia en la asignatura Sistemas Cardiovascular, Respiratorio, Digestivo y Renal en Medicina

Fundamento: la pandemia de la COVID-19 impuso la educación a distancia como alternativa viable para formar profesionales de la salud, donde se identificaron irregularidades durante la evaluación. Objetivo: elaborar una metodología para la evaluación a distancia en la asignatura Sistemas Cardiovascular, Respiratorio, Digestivo y Renal en la carrera de Medicina. Métodos: se realizó una investigación de desarrollo con enfoque mixto entre marzo 2021 y diciembre de 2022, en la carrera de Medicina de la Facultad de Ciencias Médicas "Mariana Grajales Coello" de Holguín. Se utilizaron métodos teóricos, empíricos y estadísticos que posibilitaron la sistematización teórico-metodológica del tema, profundizar en el estado actual del objeto y determinar la necesidad de una metodología para resolver el problema científico. Se aplicó el criterio de especialistas para evaluar la pertinencia y viabilidad de la propuesta. Resultados: se propone una metodología para la evaluación del aprendizaje a distancia de la asignatura Sistemas Cardiovascular, Respiratorio, Digestivo y Renal en la carrera de Medicina que integra los fundamentos de la evaluación del aprendizaje en las ciencias médicas y las particularidades de la educación a distancia en la educación superior. Esta se estructura en dos subsistemas concretados en las dimensiones organizativas y contextualizadora, con etapas y acciones para organizar la evaluación del aprendizaje. Conclusiones: la metodología diseñada proporciona herramientas al colectivo metodológico de la asignatura para la evaluación a distancia de forma integrada. Su implementación facilita la organización del proceso evaluativo a partir de las potencialidades de los contextos formativos y de necesidades de aprendizaje de los estudiantes. Fue valorada por los especialistas como pertinente y adecuada.

Background: the COVID-19 pandemic imposed distance learning as a viable alternative to train health professionals, where irregularities were identified during the evaluation. Objective: to develop a methodology for distance evaluation in the subject Cardiovascular, Respiratory, Digestive and Renal Systems in the Medicine degree. Methods: a development research with a mixed approach was carried out from March 2021 to December 2022, in the Medicine program of the "Mariana Grajales Coello" Faculty of Medical Sciences in Holguín. Theoretical, empirical and statistical methods were used that enabled the theoretical-methodological systematization of the topic, delving into the current state of the object and determining the need for a methodology to solve the scientific problem. The criteria of specialists was applied to evaluate the relevance and viability of the proposal. Results: a methodology is proposed for the evaluation of distance learning of the subject Cardiovascular, Respiratory, Digestive and Renal Systems in the Medicine degree that integrates the fundamentals of the evaluation of learning in medical sciences and the particularities of distance education in higher education. This is structured in two subsystems specified in the organizational and contextualizing dimensions, with stages and actions to organize the evaluation of learning. Conclusions: the designed methodology provides tools to the methodological group of the subject for distance evaluation in an integrated way. Its implementation facilitates the organization of the evaluation process based on the potential of the training contexts and the learning needs of the students. It was assessed by specialists as pertinent and adequate.

Avaliação do processo de aprendizagem no ambiente virtual do Programa Saúde com Agente / Evaluation of the learning process in the virtual environment of the Health Program with Agent / Evaluación del proceso de aprendizaje en el entorno virtual del Programa Salud con Agente

RESUMO: O estudo aqui apresentado teve por objetivo avaliar a percepção da qualidade do processo de aprendizagem no ambiente virtual dos estudantes do Programa Saúde com Agente. Tratou-se de um estudo transversal, realizado em 2022, com 9.145 estudantes dos cursos de Técnico em Agente Comunitário de Saúde e Técnico em Vigilância em Saúde com Ênfase no Combate às Endemias. Informações sobre a qualidade do processo de aprendizagem foram obtidas por meio do questionário Constructivist On-Line Learning Environment Survey, que consiste em 24 questões agrupadas em seis dimensões: relevância, reflexão crítica, interação, apoio dos tutores, apoio dos colegas e compreensão. Avaliaram-se o perfil sociodemográfico dos participantes e as principais formas de acesso ao curso e acompanhamento. Realizou-se análise descritiva; para análise de associação, utilizou-se o teste qui-quadrado ou exato de Fisher. A maioria dos participantes é do sexo feminino, faixa etária de 40 a 49 anos, da região Nordeste; realiza as atividades em casa e usa o celular/smartphone. Ao se considerarem as seis dimensões avaliadas, relevância, interação e apoio dos colegas obtiveram diferenças estatisticamente significativas entre os estudantes dos cursos de Técnico em Agente Comunitário de Saúde e Técnico em Vigilância em Saúde com Ênfase no Combate às Endemias.

ABSTRACT: The study presented here aimed to evaluate the perception of the quality of the learning process in the virtual environment of the students of the Health Program with Agent. It was a cross-sectional study conducted in 2022 with 9,145 students from the Community Health Agent Technician and Health Surveillance Technician courses with an Emphasis on Combating Endemic Diseases. Information on the quality of the learning process was obtained through the Constructivist On-Line Learning Environment Survey, which consists of 24 questions grouped into six dimensions: relevance, critical reflection, interaction, tutor support, peer support, and understanding. The sociodemographic profile of the participants and the primary forms of access to the course and monitoring were evaluated. Descriptive analysis was performed; for association analysis, the chi-square or Fisher's exact test was used. Most participants are females aged 40 to 49 from the Northeast region; they perform activities at home and use their cell phones/smartphones. When considering the six dimensions evaluated, relevance, interaction, and support of colleagues obtained statistically significant differences between the students of the courses of Community Health Agent Technician and Health Surveillance Technician with Emphasis on Combating Endemic Diseases.

RESUMEN: El objetivo del estudio presentado fue evaluar la percepción de la calidad del proceso de aprendizaje en el entorno virtual de los alumnos del Programa Salud con Agentes. Se trató de un estudio transversal realizado en 2022 con 9.145 alumnos de los cursos de Técnico en Agente Comunitario de Salud y Técnico en Vigilancia Sanitaria con énfasis en la lucha contra las enfermedades endémicas. La información sobre la calidad del proceso de aprendizaje se obtuvo a través de la Encuesta Constructivist On-Line Learning Environment Survey, que consta de 24 preguntas agrupadas en seis dimensiones: relevancia, reflexión crítica, interacción, apoyo de los tutores, apoyo de los alumnos y comprensión. Se evaluó el perfil sociodemográfico de los participantes y las principales vías de acceso al curso y seguimiento. Se realizó un análisis descriptivo y se utilizó la prueba de chi-cuadrado o la prueba exacta de Fisher para analizar las asociaciones. Los participantes eran en su mayoría mujeres, en la franja de edad 40 a 49 años, de la región Nordeste; realizaban las actividades en casa y utilizaban teléfonos móviles/smartphones. Al considerar las seis dimensiones evaluadas, la relevancia, la interacción y el apoyo de los compañeros mostraron diferencias estadísticamente significativas entre los alumnos de los cursos de Técnico en Agente Comunitario de Salud y Técnico en Vigilancia Sanitaria con Énfasis en la Lucha contra las Enfermedades Endémicas.

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

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

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

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

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

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

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

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

Buccal tablets

Diclofenac sodium

Drug release

Mucoadhesion

Mucoadhesive tablets

Release kinetics

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

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

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

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

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

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

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

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

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

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

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

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

Orofacial Myofunctional Aspects of Nursing Infants and Preschoolers

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

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

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

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

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

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

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

Validación de la metodología para cuantificar el fluconazol y sus impurezas orgánicas en materia prima por cromatografía líquida de alta resolución / Method validation for the quantification of fluconazole and its organic impurities in raw material using high-performance liquid chromatography

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

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

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

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

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