Investigation of the current situation of pharmaceutical clinics in medical institutions in China / 中国药房

OBJECTIVE To investigate the current situation of pharmaceutical clinic service in medical institutions in China and provide experience and suggestions for promoting the development of pharmaceutical clinics. METHODS Questionnaire survey was used to investigate the development of pharmaceutical clinics in medical institutions of 31 provinces （autonomous regions and municipalities directly under the central government） in March to April 2023， and the descriptive analysis was conducted. The regression analysis was carried out for the influential factors of pharmaceutical clinic service. RESULTS A total of 1 368 questionnaires were distributed in this survey and 1 304 valid questionnaires were collected with the effective response rate of 95.32%. A total of 463 medical institutions carried out pharmaceutical clinic service， the rate of which was 35.51% （463/1 304）； the rates of pharmaceutical clinics in tertiary， secondary， primary and other medical institutions were 52.80%， 17.18% and 5.88%， respectively. The frequency of opening pharmaceutical clinics was 3.17 days per week on average， with an average of 5.99 visiting pharmacists in each medical institution. Among the visiting pharmacists， clinical pharmacists accounted for the vast majority （88.68%， 2 459/2 773）. There were various categories of pharmaceutical clinics， including joint clinics and pharmacist-independent clinics； among pharmacist-independent clinics， pharmaceutical specialty/specialty disease clinics were the main ones， accounting for 89.72% of the total number of pharmaceutical clinics. The value of pharmacists in pharmaceutical clinics was manifested in various forms， among which the proportion of medical institutions charging pharmaceutical clinics was 10.80%. The main experiences in developing pharmaceutical clinics were to attach importance to discipline construction and personnel training. The main difficulties in developing pharmaceutical clinics were low compensation levels and a shortage of talent.The number of clinical pharmacists， the number of visiting pharmacists in pharmaceutical clinics and additional compensation were positively correlated with the amount of pharmaceutical clinic services（P＜0.05）. CONCLUSIONS In recent years， pharmaceutical clinics have made significant progress； in the future， it is still necessary to further strengthen discipline construction and talent cultivation， pay attention to the value embodiment of pharmacists， to promote the healthy development of pharmaceutical clinics.

Analysis of treatment gap of convulsive epilepsy patients in rural areas of Jiangsu Province / 临床神经病学杂志

Objective To explore the treatment gap and influencing factors of convulsive epilepsy in rural areas of Jiangsu Province.Methods The clinical data of 7836 rural convulsive epilepsy patients screened from 2005 to 2020 were statistically analyzed,and the treatment status,treatment gap and related influencing factors of epilepsy patients were analyzed.Results A total of 7836 patients with convulsive epilepsy were enrolled in this study.The treatment gap for convulsive epilepsy in rural areas of Jiangsu Province was 69.05%.There was no significant difference in the treatment gap between different genders(P＞0.05).There were statistically significant differences in the treatment gap between age(χ2 = 12.196,P =0.007),age of onset(χ2 =58.658,P＜0.001),disease duration(χ2 =65.430,P＜0.001),seizure frequency(χ2 =171.276,P＜0.001),and hospitalization level(χ2 = 122.076,P＜0.001).Multivariate Logistic regression analysis showed that the older the age of onset was,the shorter the course of the disease was,the more frequent the seizures was,and the greater the treatment gap in patients with epilepsy was(all P＜0.05).Patients aged 45-59 years(P =0.012)and treated in municipal and county hospitals(P＜0.001)were more likely to receive regular anti-epileptic treatment.Conclusions There is a significant treatment gap for convulsive epilepsy patients in rural areas of Jiangsu Province.This may be due to insufficient awareness of epilepsy and the underdevelopment of primary healthcare institutions.

Bibliometrics and visualization-based analysis of research landscape of exosomes and foresight / 中国组织工程研究

BACKGROUND:Exosomes have become one of the frontiers of biomedical research in recent years because of their promising applications in clinical diagnosis and therapy. OBJECTIVE:To reveal the basic research and technology development trend of exosomes at home and abroad,and provide suggestions for related scientific and technological research and development in China. METHODS:This paper presented a quantitative analysis of the overall research and development situation,the frontier hotspots and future development trends in this research area by means of bibliometric methods and tools. RESULTS AND CONCLUSION:The research and development hotspots in this area have entered a high growth phase with the application of new tools and methods.Many new technologies and products are facing clinical applications and markets with the development of a large number of clinical translation experiments.Comparative analysis at home and abroad reveals that China has made more remarkable achievements in basic research in this field,but there are still weaknesses in the possession of independent intellectual property rights,clinical technology translation,and regulatory system standardization and management,which need to be further strengthened in the future.

Predictive analysis of internet-based oncology outpatient visits trend based on ARIMA and GM(1,1)models / 现代医院

Objective To investigate the changing trend of the current situation of Internet-based oncology outpatient treatment and provide support for the development and management of Internet hospitals.Methods The ARIMA and GM(1,1)models were constructed based on the Internet-based outpatient data of a cancer hospital from January 2021 to June 2023,and the fitting effect was evaluated by mean absolute error(MAE)and root mean square error(RMSE).Based on the model,the pro-portion of Internet-based outpatient visits and the offline outpatient visits were predicted from July to December 2023.Results ARIMA(1,1,2)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits.The average abso-lute errors were 2.06%and 2.41%,and the root-mean-square errors were 3.01%and 3.17%,respectively.The ARIMA(0,1,1)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits to the offline outpatient visits,with the rate of the average absolute errors of 0.58%and 1.08%,respectively,and the rate of the root mean square errors 0.75%and 1.31%,respectively.The figures indicated that the ARIMA model had a better prediction effect.The forecast results showed that the predicted value of Internet outpatient service in December 2023 was 90.35%,and the predicted value of Internet-based outpatient service accounted for 16.46%of the offline outpatient service.Conclusion In 2021-2023,the proportion of Inter-net-based outpatient visits in the cancer hospital showed a steady trend,and the proportion of Internet outpatient visits in the off-line outpatient visits showed a rising trend.Therefore,hospitals need to establish a continuous monitoring mechanism,constantly adjust management strategies and measures to meet the needs of patients and continue to promote the high-quality development of Internet-based medical services.

Current situation of and countermeasures for achievement transformation and management in tertiary medical hospitals in Shanghai / 现代医院

Objective To investigate the current situation of achievement transformation in tertiary medical hospitals in Shanghai and propose countermeasures for the existing problems to enhance the effectiveness of achievement transformation.Methods A questionnaire survey was done on the transformation and management of scientific research achievements in 47 terti-ary hospitals in Shanghai.Meanwhile,interviews were carried out among the managers and researchers from these hospitals.Re-sults In the past three years,the rate of transformation achievements in the hospitals was only 2.8%.In the achievement trans-formation existed such problems as weak awareness of scientific researchers,low patent quality,lack of full-time managers,and inflexible management mode.It was also believed that there is a need to improve main responsibilities,achievement management,system establishment,personnel training,resource sharing,department coordination and other related aspects.Conclusion The rate of achievement transformation in tertiary medical institutions in Shanghai is at a lower level.There are numerous problems and difficulties in the transformation.Therefore,urgent efficient countermeasures are needed to promote the transformation of a-chievement.

The current status of continuing medical education among obstetricians and gynecologists in hospitals at secondary level or above in Beijing, China / 中华医学教育探索杂志

Objective:To investigate the situation of continuing medical education (CME) among obstetricians and gynecologists from Beijing's general hospitals at the secondary level or above in 2018 and 2023, and to provide a reference for standardizing CME for obstetricians and gynecologists in the future.Methods:We performed questionnaire surveys and interviews with 164 obstetricians and gynecologists in Beijing to investigate the status of completion of CME, the reasons for incompletion, the preferred modes to complete CME, and the preferred contents and forms of CME. SPSS 26.0 software was used for data analysis. The rate was compared using the chi-squared test.Results:Due to the impact of coronavirus disease 2019, the 2023 survey showed that 79 (48.17%) participants completed CME in an online mode, and 76 (46.34%) participants completed CME in an mostly online mode, with a significantly increased degree of satisfaction with CME compared with the 2018 survey ( P<0.05); 49 (29.88%) participants believe that online education is superior to traditional CME, and 69 (42.07%) participants believe that online education is comparable to traditional CME. The main advantages of the online education mode are flexible time and location and cost savings. "Hoping to improve my professional level" is the main purpose to participate in CME in both 2018 and 2023 surveys [124 (75.61%) vs. 127 (77.44%)]. "Professional skills and techniques" and "New advances in the specialty" are the contents of most interest. Conclusions:Obstetricians and gynecologists should raise the awareness to participant in CME. Relevant departments should establish a standardized system and an effective supervision and management mechanism, and take flexible education modes with the use of the Internet. Online education can achieve similar teaching effects and also improve learners' satisfaction.

Analysis and Considerations on the Current Situation of Informatization Construction of Hospitals of Traditional Chinese Medi-cine in Hubei Province / 医学信息学杂志

Purpose/Significance To understand the current situation and problems of informatization of hospitals of traditional Chinese medicine(TCM)in Hubei province,and to put forward suggestions for further promoting informatization of TCM hospitals.Method/Process Based on the survey data of informatization construction of TCMhospitals in Hubei province in 2022,the paper elaborates the infor-mation management departments setting,personnel structure,infrastructure and capital investment,business application systems,informa-tion standards and the application of new generation of information technologies in TCMhospitals in Hubei province by using descriptive sta-tistics,χ2 test,Fisher test and other methods,and analyzes the main problems.Result/Conclusion The informatization construction of TCM hospitals in Hubei province has achieved initial results,but it is still necessary to optimize the functions of the information management de-partments,enrich the informatization talent team,strengthen funding investment,strengthen the application of standards,deepen the char-acteristics and advantages of TCM,and promote the application of new technologies,etc.

Report on early childhood development practices in China from a global health perspective / 中国儿童保健杂志

As the health disparities among children indirectly reflect the unfair distribution of national child healthcare, education, and other infrastructure, early childhood health development is a globally significant public health concern. On a global scale, 193 countries have endorsed The 2030 Agenda for Sustainable Development and have explored various development strategies. The government placing children′s interests and their rights at the core of their efforts to achieve the Sustainable Development Goals(SDGs) is essential, China has made substantial progress in improving children′s well-being over several decades of continuous effort and practice. However, challenges persist, including regional development imbalances, insufficient service capabilities in impoverished rural areas, and emerging issues like obesity, myopia, and mental health problems. China still needs to meet the growing health needs of children fully. From a global health perspective, this article systematically reviews the current status of global early childhood health development, outlines the significant milestones and best practices in China′s early childhood development efforts, and also anticipates the focus and challenges in early childhood development in China based on global trends, hoping to contribute to further research in this field.

Progress of schistosomiasis control in People’s Republic of China in 2023 / 中国血吸虫病防治杂志

To understand the progress of national schistosomiasis elimination program of China in 2023 and summarize the lessons and experiences, data on the endemic status of schistosomiasis and national schistosomiasis surveillance results in the People’s Republic of China were collected and analyzed at a national level. By the end of 2023, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan and Hubei provinces were identified to achieve the criteria of transmission interruption in 2020, and Anhui, Jiangxi and Hunan provinces achieved the criteria of transmission interruption in 2023. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2023, including 26 250 endemic villages covering 73 034 500 residents at risk of infections. Among the 451 endemic counties (cities, districts), 78.49% (354/451) achieved the criteria of schistosomiasis elimination and 21.51% (97/451) achieved the criteria of transmission interruption, respectively. In 2023, a total of 4 216 643 individuals received immunological tests, with 47 794 sero-positives identified, and a total of 184 216 individuals received parasitological examinations, with 4 egg-positives detected. A total of 27 768 cases with advanced schistosomiasis were documented in China by the end of 2023. In 2023, 539 548 bovines were raised in schistosomiasis-endemic areas of China, and 125 440 bovines received immunological tests, with 124 sero-positives detected, while no egg-positives were identified among the 133 508 bovines receiving parasitological examinations. In 2023, snail survey was performed at an area of 641 339.53 hm2 and 184 819.77 hm2 snail habitats were identified, including 51.53 hm2 emerging snail habitats and 642.25 hm2 reemerging snail habitats. In 2023, there were 20 198 schistosomiasis patients receiving praziquantel chemotherapy, and 598 183 person-time individuals and 283 954 herdtime bovines were given expanded chemotherapy. In 2023, snail control with chemical treatment was performed in 116 347.95 hm2 snail habitats, and the actual area of chemical treatment was 65 690.89 hm2, while environmental improvements were performed in snail habitats covering an area of 1 334.62 hm2. The national schistosomiasis surveillance results showed that the mean prevalence of Schistosoma japonicum infections were both zero among humans and bovines in 2023, and no S. japonicum infection was detected in snails. These data demonstrated that transmission interruption of schistosomiasis had been achieved across all endemic provinces in China in 2023, and the endemic status of schistosomiasis tended to be stable, while advanced cases were predominant among all schistosomiasis cases. However, the areas of snail habitats remained high and cattle re-raising was very common in some regions. Intensified schistosomiasis surveillance and forecast and snail control in high-risk areas are needed.

Analysis of the current situation of comprehensive management at intensive diabetes treatment clinic in Peking Union Medical College Hospital / 中华临床营养杂志

Objective:To assess the goal fulfillment in terms of blood glucose, blood pressure, blood lipid, and the composite indicator of these three in patients with diabetes who received intensified treatment at Peking Union Medical College Hospital and regular follow-up for 12 months, analyze the influencing factors, and explore the comprehensive management model for intensive diabetes treatment outpatient services.Methods:This study was a prospective, observational cohort study. The diabetes patients who received long-term regular follow-up at the intensive diabetes treatment outpatient clinic of Peking Union Medical College Hospital from 2012 to 2023 were selected as the research subjects. They were followed up and clinical data were collected at the 1st, 3rd, 6th, 9th, and 12th months of follow-up. The study assessed the goal fulfillment rates in terms of blood glucose, blood pressure, blood lipid, and the composite indicator of these three, with the goals of glycated hemoglobin (HbA1c)<7%, blood pressure<130/80 mmHg, and low-density lipoprotein cholesterol (LDL-C)<2.6 mmol/L. The study also analyzed the impact of factors, including gender, age, type of diabetes, duration of diabetes, body mass index, comorbidities, complications, and treatment regimens, on the outcomes of comprehensive diabetes management.Results:A total of 232 patients were included in the study, of whom 210 were with type 2 diabetes (90.5%), 13 with type 1 diabetes (5.6%), 5 with latent autoimmune diabetes of the adult (2.2%), 3 with diabetes after total pancreatectomy (1.3%), and 1 with mitochondrial diabetes (0.4%). After 3 months of intensified management, the goal fulfillment rates of blood glucose (67.7% vs. 34.1%, Kappa=0.336, P<0.001), blood pressure (53.4% vs. 37.5%, Kappa=0.159, P=0.001), blood lipid (59.1% vs. 39.2%, Kappa=0.198, P<0.001), and the composite indicator (20.7% vs. 3.0%, Kappa=0.177, P<0.001) were significantly increased. Continued treatment at 6, 9, and 12 months showed stable and sustained increases in the goal fulfillment rates of blood glucose, blood pressure, blood lipid, and the composite indicator. Logistic regression analysis showed that baseline hyperglycemia ( P=0.002), disease duration ≥5 years ( P<0.001), smoking ( P=0.009), alcohol consumption ( P=0.038), presence of diabetic complications ( P=0.001), combination therapy with oral antidiabetic drugs and insulin ( P<0.001), and use of antiplatelet drugs ( P=0.037) were risk factors for uncontrolled HbA1c. Baseline hypertension ( P<0.001), alcohol consumption ( P=0.030), and comorbid dyslipidemia ( P=0.028) were risk factors for uncontrolled blood pressure. Baseline uncontrolled LDL-C ( P=0.020) and non-use of statins ( P<0.001) were risk factors for uncontrolled blood lipid. Conclusions:Among patients with the long-term follow-up at our intensive diabetes treatment clinic, the goal fulfillment rates of blood glucose, blood lipid, blood pressure, and the composite indicator of these three are relatively higher. However, it is still necessary to improve patient compliance as much as possible, emphasize weight management, and persist on the comprehensive diabetes treatment.

Analysis of the current situation of work-related injuries in Kunshan City from 2016 to 2021 / 中国职业医学

ObjectiveTo analyze the current situation and characteristics of work-related injuries in Kunshan City. Methods Data on work-related injuries in Kunshan City from January 2016 to December 2021 was collected from the integrated management platform of Jiangsu Human Resources and Social Security Bureau. The situations and characteristics of work-related injuries were analyzed. Results A total of 46 358 work-related injuries occurred in Kunshan City from 2016 to 2021, with the incidence of 0.57% to 0.67%. The incidence showed a decreasing trend year by year (P<0.05). The work-related injuries leading to level 10 disability in workers accounted for 44.45%. The incidence of work-related injuries was highest in the sixth major risk industry category, accounted for 0.79%. The incidence of work-related injuries was the highest in July and August, both accounted for 0.60‰. The incidence of work-related injuries was the highest in the traditional manufacturing area of all regions, accounted for 0.65%. The incidence of work-related injuries was higher in males than in females (0.56% vs 0.23%, P<0.01). The incidence of work-related injuries of workers aged ≥46 years was 0.74%, which was higher than those in the other three age groups <46 years old (all P<0.008). Workers with 11 to <16 and 16 to <21 years of social insurance had relatively higher incidence of work-related injuries, accounted for 0.84% and 1.00%, respectively (both P<0.003). The incidence of work-related injuries was lower in urban workers than in rural workers (0.43% vs 0.44%, P<0.01). Work-related wrist and hand injuries had the highest incidence among all body parts, accounted for 44.67%. Contusions, crush injuries, and compression injuries were the most common types of injuries, accounted for 56.18%. Conclusion The incidence of work-related injuries in Kunshan City is lower than the national average. The incidence of work-related injuries is related to the category of risk industry, region, gender, age, years of social insurance and household registration type. Hierarchical classification should be implemented to prevent work-related injuries.

Risk factors associated with severe COVID-19 outcomes in Jamaica: a cross-sectional study of national surveillance data / Factores de riesgo asociados a la COVID-19 grave en Jamaica: estudio transversal de datos nacionales de vigilancia / Fatores de risco associados a desfechos graves da COVID-19 na Jamaica: estudo transversal de dados de vigilância nacional

ABSTRACT Objectives. To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020. Methods. A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19. Results. This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3). Conclusions. The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.

RESUMEN Objetivos. Describir las características y los resultados de los casos de COVID-19 en Jamaica y explorar los factores de riesgo asociados a la COVID-19 grave desde el 9 de marzo hasta el 31 de diciembre del 2020. Métodos. Se realizó un análisis transversal de datos nacionales de vigilancia a partir de los casos confirmados de COVID-19 en Jamaica. Las definiciones de caso confirmado, gravedad de la enfermedad y muerte se basaron en las directrices de la Organización Mundial de la Salud. Para determinar la asociación con los criterios de valoración se utilizó la prueba de χ2 y la prueba exacta de Fisher. Se usaron modelos de regresión logística para determinar los factores predictivos de la COVID-19 grave. Resultados. Se incluyeron en el análisis 12 169 casos de COVID-19 (mediana de edad, 36 años; 6 744 mujeres [55,4%]), de los que 512 (4,2%) fueron de enfermedad grave. De estos pacientes, 318 (62,1%) fallecieron (mediana de edad al morir, 71,5 años). Se observó una asociación de la enfermedad grave con el sexo masculino (OR de 1,4; IC del 95 %, 1,2-1,7) y con la edad igual o superior a 40 años (OR de 6,5; IC del 95 %, 5,1-8,2). La muerte por COVID-19 también mostró una asociación con el sexo masculino (OR de 1,4; IC del 95%, 1,1-1,7), con la edad igual o superior a 40 años (OR de 17,9; IC del 95%, 11,6-27,7) y con la Región de Atención de Salud Occidental en comparación con la Sudoriental (OR de 1,7; IC del 95%, 1,2-2,3). Conclusiones. Los resultados de este análisis transversal indican que los casos confirmados de COVID-19 en Jamaica correspondieron una mayor probabilidad a mujeres y personas más jóvenes, mientras que las muertes por COVID-19 fueron más frecuentes en varones y personas de mayor edad. Hay un mayor riesgo de evolución desfavorable de la COVID-19 a partir de los 40 años, que afecta de manera desproporcionada a los varones. Las muertes por COVID-19 también variaron según la región geográfica. Esta evidencia podría ser de utilidad para otros países con entornos similares y para los responsables de la formulación de políticas en materia de gestión de brotes y salud.

RESUMO Objetivos. Descrever as características e os desfechos dos casos de COVID-19 na Jamaica e explorar os fatores de risco associados à COVID-19 grave de 9 de março a 31 de dezembro de 2020. Métodos. Análise transversal de dados de vigilância nacional usando casos confirmados de COVID-19 na Jamaica. As definições de caso confirmado, gravidade da doença e morte foram baseadas nas recomendações da Organização Mundial da Saúde. Foram usados testes de qui-quadrado e exato de Fisher para determinar a associação com os desfechos. Modelos de regressão logística foram usados para determinar os preditores de COVID-19 grave. Resultados. Esta análise incluiu 12.169 casos de COVID-19 (idade mediana: 36 anos; 6 744 do sexo feminino [55,4%]), dos quais 512 casos (4,2%) apresentaram doença grave; desses, 318 pacientes (62,1%) morreram (idade mediana ao morrer: 71,5 anos). A doença grave estava associada a ser do sexo masculino (razão de chances [RC]: 1,4; intervalo de confiança de 95% [IC 95%]: 1,2-1,7) e ter 40 anos ou mais de idade (RC: 6,5; IC 95%: 5,1-8,2). A morte por COVID-19 também estava associada a ser sexo masculino (RC: 1,4; IC 95%: 1,1-1,7), ter 40 anos ou mais (RC: 17,9; IC 95%: 11,6-27,7) e estar na Região Sanitária Oeste em comparação com a Região Sanitária Sudeste (RC: 1,7; IC 95%: 1,2-2,3). Conclusões. Os achados desta análise transversal indicam que a probabilidade de casos confirmados de COVID-19 na Jamaica era maior em indivíduos do sexo feminino e mais jovens, ao passo que as mortes por COVID-19 ocorreram com mais frequência em indivíduos do sexo masculino e mais velhos. Há um risco maior de resultados desfavoráveis em relação à COVID-19 a partir dos 40 anos, e indivíduos do sexo masculino são desproporcionalmente mais afetados. A morte por COVID-19 também variou de acordo com a região geográfica. Essas evidências podem ser úteis para outros países com cenários semelhantes e para os formuladores de políticas encarregados de manejar surtos e gerenciar a saúde.

Esquema para mejorar el aprendizaje sobre el Análisis de la Situación de Salud / Scheme to improve learning about Health Situation Analysis / Scheme to improve learning about Health Situation Analysis / Esquema para melhorar o aprendizado sobre Análise da Situação de Saúde

Introducción: El análisis de la situación de salud es una investigación primordial que se realiza en el sistema de salud cubano, en el que se estudia la salud, los elementos que la determinan y las formas de mejorarla. Objetivo: Evaluar la propuesta de diseño de un esquema que contribuya a la mejora del aprendizaje del análisis de la situación de salud de la comunidad para los residentes de la especialidad Medicina General Integral, pertenecientes a la Universidad de Ciencias Médicas de Guantánamo. Método: Se realizó una investigación pedagógica de tipo descriptiva en la antes mencionada institución durante el período marzo-julio de 2022. De un universo de 67 profesores que aceptaron participar, se seleccionaron 26 por muestreo intencional. Para obtener los datos primarios fueron aplicados tres cuestionarios tipo Likert para evaluar el esquema, en consideración con la estructura, la funcionalidad y el aporte en el aprendizaje. Dichos cuestionarios incluyeron las respuestas: Totalmente en desacuerdo, En desacuerdo, Ni de acuerdo ni en desacuerdo, De acuerdo y Totalmente de acuerdo. Los datos se resumieron en números absolutos y porcentajes. Se presentaron en tablas de distribución de frecuencias. Resultados: Los subtotales de respuestas Totalmente de acuerdo y De acuerdo sobre la evaluación estructural y funcional, así como la influencia que se espera de este para mejorar el aprendizaje del análisis de situación de salud, se consideraron adecuados al superar el estándar. Conclusiones: El esquema propuesto es evaluado como adecuado en estructura y funcionalidad. Se considera positiva la influencia que se espera de este para mejorar el aprendizaje del análisis de situación de salud de la comunidad.(AU)

Introduction: The analysis of the health situation is a fundamental investigation carried out in the Cuban health system, in which health is studied, the elements that determine it and the ways to improve it. Objective: To evaluate the design proposal of a scheme that contributes to the improvement of learning of the analysis of the health situation of the community for the residents of the Comprehensive General Medicine specialty, belonging to the Universidad de Ciencias Médicas de Guantánamo. Method: A descriptive pedagogical research was carried out in the aforementioned institution during the period March-July 2022. From a universe of 67 teachers who agreed to participate, 26 were selected by intentional sampling. To obtain primary data, three Likert-type questionnaires were applied to evaluate the scheme, taking into consideration the structure, functionality and contribution to learning. These questionnaires included the responses: Totally disagree, Disagree, Neither agree nor disagree, Agree and Totally agree. Data were summarized in absolute numbers and percentages. They were presented in frequency distribution tables. Results: The subtotals of Completely Agree and Agree responses on the structural and functional evaluation, as well as the expected influence of this to improve the learning of health situation analysis, were considered adequate when exceeding the standard. Conclusions: The proposed scheme is evaluated as adequate in structure and functionality. The influence expected from this to improve learning about the analysis of the community's health situation is considered positive.(AU)

Introdução: A análise da situação sanitária é uma investigação fundamental realizada no sistema de saúde cubano, no qual se estuda a saúde, os elementos que a determinam e as formas de melhorá-la. Objetivo: Avaliar a proposta de desenho de um esquema que contribua para a melhoria da aprendizagem da análise da situação de saúde da comunidade para os residentes da especialidade Medicina Geral Integral, pertencente à Universidad de Ciencias Médicas de Guantánamo. Método: Foi realizada uma pesquisa pedagógica descritiva na referida instituição durante o período de março a julho de 2022. De um universo de 67 professores que aceitaram participar, 26 foram selecionados por amostragem intencional. Para obtenção dos dados primários, foram aplicados três questionários do tipo Likert para avaliação do esquema, levando em consideração a estrutura, funcionalidade e contribuição para a aprendizagem. Esses questionários incluíram as respostas: Discordo totalmente, Discordo, Nem concordo nem discordo, Concordo e Concordo totalmente. Os dados foram resumidos em números absolutos e porcentagens. Eles foram apresentados em tabelas de distribuição de frequência. Resultados: Os subtotais das respostas Concordo Totalmente e Concordo na avaliação estrutural e funcional, bem como a influência esperada desta para melhorar a aprendizagem da análise da situação de saúde, foram considerados adequados quando excedem o padrão. Conclusões: O esquema proposto é avaliado como adequado em estrutura e funcionalidade.A influência que se espera disto para melhorar a aprendizagem sobre a análise da situação de saúde da comunidade é considerada positiva.(AU)

ODONTOASIS, objeto de aprendizaje sobre Análisis de la Situación de Salud: componente dental

Introducción: la carrera de Estomatología emplea las Tecnologías de la Información y las Comunicaciones en el proceso docente educativo, muestra de lo cual es la inserción de manera creciente y progresiva de los softwares educativos. Objetivo: desarrollar un objeto de aprendizaje de tipo multimedia sobre Análisis de la Situación de Salud: Componente dental. Métodos: se realizó un estudio de tipo innovación tecnológica en el período de febrero a julio de 2018 en la Universidad de Ciencias Médicas de Sancti Spíritus. Se emplearon para el diseño y desarrollo del objeto de aprendizaje programas como MatchWare Mediator 9.0, HotPotatoes 6, Adobe Photoshop CS versión 8.0.1. El objeto de aprendizaje se validó por especialistas y por los estudiantes. Resultados: El 97,4 % de los estudiantes refirieron que el producto tenía la calidad y atracción necesaria para contribuir a su aprendizaje, el 100 % refirió su utilidad, lo cual se corroboró en el resultado de las calificaciones obtenidas que fueron buenas en el 97,4 % de los estudiantes. Conclusiones: la multimedia constituye un recurso educacional flexible, dinámico, claro, objetivo y de fácil comprensión; aborda una temática relevante para la Estomatología y cumple con el objetivo para el que fue concebido.

Introduction: the Stomatology career uses Information and Communication Technologies in the educational teaching process, an example of which is the increasing and progressive insertion of educational software. Objective: to develop a multimedia learning object on Analysis of the Health Situation: Dental Component. Methods: a technological innovation study was carried out in the period from February to July 2018 at the University of Medical Sciences of Sancti Spíritus. Programs such as MatchWare Mediator 9.0, HotPotatoes 6, Microsoft Office 2010, Adobe Photoshop CS version 8.0.1, were used for the design and development of the multimedia learning object. Specialists and students validated the obtained product. Results: the multimedia product was created. In addition, 97,4 % of the students reported that the product had the necessary quality and attraction to contribute to their learning and 100 % reported its usefulness, which was corroborated in the result of the grades obtained, being good in 97,4 % thereof. Conclusions: multimedia is a flexible, dynamic, clear, objective and easy to understand educational resource; addressing a relevant topic for Stomatology, fulfilling the objective for which it was conceived.

Análise da situação de saúde dos idosos usuários de uma política municipal de atividades físicas / Analysis of health status of older adults users of a municipal physical activity program / Análisis de la situación de salud de los adultos ancianos de una política municipal de actividad física

Introdução: Políticas públicas intersetoriais em saúde são intervenções populacionais (e de cunho ecológico) muito utilizadas para a redução da carga global de doença e otimização de recursos tanto financeiros quanto humanos. Objetivo: O objetivo deste estudo foi analisar a situação de saúde de usuários idosos de uma política municipal de atividades físicas. Métodos: Trata-se de um estudo transversal com amostragem baseada em centros comunitários (N dispositivos comunitários=11), que disponibilizam práticas de movimentos corporais e outros, subsidiados pela Secretaria Municipal de Desenvolvimento Social e Esporte (SMDSE), Prefeitura Municipal de Porto Alegre (RS). A amostragem de usuários foi ponderada para o total de usuários atendidos por centro, adotando seleção aleatória simples. A coleta de dados ocorreu entre abril de 2018 e fevereiro de 2019, em que a equipe de coleta se deslocou ao território adscrito dos usuários para a condução de inquérito de saúde autoaplicado e a avaliação funcional; de forma contrária, os usuários compareceram a um centro de coleta para a série laboratorial (sem jejum). Resultados: Foram incluídos e analisados 351 usuários (média±desvio padrão, 70±6 anos). Para fatores de risco cardiovasculares, a prevalência de hipercolesterolemia foi de 54,2% e de 49,3% para hipertensão arterial sistêmica ­ as mais elevadas. O transtorno de sono foi prevalente em 55,3% da amostra. Entre as doenças autorrelatadas, os participantes listaram as cardiovasculares (14,3%), câncer prévio (14,6%), diabetes (13,2%), artrite reumatoide/ reumatismo (29,6%) e depressão (sem discriminador de depressão maior/ menor) (18,6%). A capacidade funcional, estimada pelo teste de caminhada em 6 minutos e a força de preensão manual, preditores de mortalidade cardiovascular e agravos, tiveram valores médios encontrados de 498,05±78,96 m e 27,08±8,14 kg, respectivamente. Conclusão: Os achados do presente estudo permitem contrastar prevalências estimadas em idosos participantes de um programa público de atividades físicas com outras estimativas em grupos de comparação, possibilitando a análise de situação de saúde com base em diferentes comportamentos e fatores de risco. Por fim, o trabalho viabilizou a monitorização de intervenções públicas para idosos em nível comunitário, sendo um ponto de base para acompanhamento futuro.

Introduction: Intersectoral public policies on health are population (and ecological) interventions widely used to reduce the global burden of disease and optimize both financial and human resources. Objective: The objective of this study was to analyze the health status of older adults users of a municipal policy on physical activities. Methods: This is a cross-sectional study with a sample based on community centers (N community centers=11), which provide body movement practices and others, funded by the Municipal Department of Social Development and Sports (SMDSE), City Hall of Porto Alegre (state of Rio Grande do Sul ­ RS, Brazil). The users' sample was weighted by the number of users of each center, by simple random sampling. Data collection took place between April 2018 and February 2019, in which the collection team went to the users' assigned territory to conduct a self-administered health survey and functional assessment; conversely, the users attended a collection center for laboratory tests (without fasting). Results: A total of 351 users (mean±SD, 70±6 years old) were included. For cardiovascular risk factors, the prevalence of hypercholesterolemia was 54.2% and 49.3% for systemic arterial hypertension ­ the highest levels. Sleep disorder was prevalent in 55.3% of the sample. Among the self-reported diseases, participants listed cardiovascular (14.3%), previous cancer (14.6%), diabetes (13.2%), rheumatoid arthritis/rheumatism (29.6%), and depression (without major/minor depression discrimination) (18.6%). Functional capacity, estimated by the six-minute walk test, and handgrip strength, predictors of cardiovascular mortality and injuries, had mean values of 498.05±78.96 m and 27.08±8.14 kg, respectively. Conclusions: The findings of this study allow contrasting prevalence rates estimated in older adults participants of a public physical activity program with other estimates in comparison groups, enabling the analysis of health status based on different behaviors and risk factors. All in all, our study enabled to monitor public interventions for older adults at the community level, serving as a baseline for future monitoring.

Introducción: Las políticas de salud pública intersectoriales tienen el potencial de destacar la reducción de la carga global de enfermedad y la optimización de los recursos financieros y humanos. Objetivo: El objetivo de este estudio fue analizar la situación de salud de los usuarios, ancianos, de una política municipal de actividades físicas. Métodos: Se trata de un estudio transversal con muestreo a partir de centros comunitarios (N dispositivos comunitarios=11), que brindan prácticas de movimiento corporal y otras, subsidiadas por la Secretaria Municipal de Desenvolvimento Social e Esporte (SMDSE), Prefeitura Municipal de Porto Alegre (RS). El muestreo de usuarios fue ponderado por el total de usuarios atendidos por centro, adoptando selección aleatoria simple. La recolección de datos ocurrió entre abril/2018 y febrero/2019, cuando el equipo de recolección viajó al territorio asignado de los usuarios para realizar una encuesta de salud auto aplicada y evaluación funcional; por el contrario, los usuarios acudían a un centro de recogida de series de laboratorio (sin ayuno). Resultados: Se incluyeron y analizaron 351 usuarios (media±DP, 70±6 años). Para los factores de riesgo cardiovascular, la prevalencia de hipercolesterolemia fue de 54,2% y de hipertensión arterial sistémica de 49,3%, la más alta. El trastorno del sueño fue prevalente en el 55,3% de la muestra. Entre las enfermedades auto informadas, los participantes enumeraron enfermedades cardiovasculares (14,3%), cáncer previo (14,6%), diabetes (13,2%), artritis reumatoide/reumatismo (29,6%) y depresión (sin discriminación de depresión mayor/menor) (18,6%). La capacidad funcional, estimada por la prueba de la marcha de 6 minutos, y la fuerza de prensión manual, predictores de mortalidad y lesiones cardiovasculares, tuvieron valores medios de 498,05±78,96 m y 27,08±8,14 kg, respectivamente. Conclusiones: Los hallazgos de este estudio permiten contrastar las prevalencias estimadas en participantes ancianos de un programa público de actividades físicas con otras estimaciones en grupos de comparación, lo que permite el análisis de la situación de salud basado en diferentes comportamientos y factores de riesgo. Por último, el trabajo ha facilitado la monitorización de intervenciones públicas para personas mayores a nivel comunitario, sirviendo como punto de partida para un seguimiento futuro.

Screening status of neonatal fundus disease and its influencing factors in Longhua district, Shenzhen / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the screening status of neonatal fundus disease and the related influencing factors of common fundus retinal hemorrhage in Longhua District of Shenzhen, so as to provide references for the prevention, screening and intervention of neonatal fundus disease in clinical practice.METHODS: A total of 3 101 neonates who received fundus screening in the People's Hospital of Longhua, Shenzen from September 2019 to October 2022 were selected as research objects. The screening results were summarized, and the risk factors for neonatal retinal hemorrhage were analyzed by Logistic regression model.RESULTS: The detection rate of neonatal fundus abnormalities was 12.71%, and the detection rate of neonatal retinal hemorrhage was the highest(12.19%). The other types of fundus abnormalities included periretinal white focus, chromatosis, pigment shedding, choroid coloboma and nystagmus. Hemorrhage grade I accounted for the largest proportion of 378 neonates with retinal hemorrhage(75.66%). Follow-up found that different grades of retinal hemorrhage could be automatically absorbed over time without excessive intervention. Logistic analysis suggested that spontaneous delivery [OR=3.180, 95%CI(1.543～6.555)], twin pregnancy [OR=2.119, 95%CI(1.121～4.007)] and umbilical cord round the neck [OR=1.547, 95%CI(1.239～1.930)] were risk factors affecting neonatal retinal hemorrhage.CONCLUSION: Retinal hemorrhage is the most common type of fundus abnormalities in neonates. Spontaneous delivery, twin pregnancy and umbilical cord around the neck are risk factors of retinal hemorrhage. It is recommended that pay attention to the above factors and choose appropriate intervention means to avoid serious fundus complications.

Progress of schistosomiasis control in People’s Republic of China in 2022 / 中国血吸虫病防治杂志

This report presented the endemic status of schistosomiasis and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance program in the People’s Republic of China in 2022. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to maintain the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2022. A total of 452 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2022, with 27 434 endemic villages covering 73 424 400 people at risk of infections. Among the 452 endemic counties (cities, districts), 75.89% (343/452), 23.45% (106/452) and 0.66% (3/452) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. In 2022, 4 317 356 individuals received serological tests for schistosomiasis, and 62 228 were sero-positive. A total of 208 646 individuals received stool examinations for schistosomiasis, with one positive and another two cases positive for urine microscopy, and these three 3 cases were imported schistosomiasis patients from Africa. There were 28 565 cases with advanced schistosomiasis documented in China by the end of 2022. Oncomelania hupensis snail survey was performed in 18 891 endemic villages in China in 2022 and O. hupensis snails were found in 6 917 villages (36.62% of all surveyed villages), with 8 villages identified with emerging snail habitats. Snail survey was performed at an area of 655 703.01 hm2 and 183 888.60 hm2 snail habitats were found, including 110.58 hm2 emerging snail habitats and 844.35 hm2 re-emerging snail habitats. There were 477 200 bovines raised in the schistosomiasis endemic areas of China in 2022, and 113 946 bovines received serological examinations for schistosomiasis, with 204 sero-positives detected. Among the 131 715 bovines received stool examinations, no positives were identified. In 2022, there were 19 726 schistosomiasis patients receiving praziquantel chemotherapy, and expanded chemotherapy was performed in 714 465 person-time for humans and 234 737 herd-time for bovines in China. In 2022, snail control with chemical treatment was performed at an area of 119 134.07 hm2, and the actual area of chemical treatment was 65 825.27 hm2, while environmental improvements were performed at an area of 1 163.96 hm2. Data from the national schistosomiasis surveillance program of China showed that the mean prevalence of Schistosoma japonicum infections was both zero in humans and bovines in 2022, and no S. japonicum infection was detected in O. hupensis snails. These data demonstrated that the endemic status of schistosomiasis continued to decline in China in 2022, with 3 confirmed schistosomiasis patients that had a foreign nationality and all imported from Africa, and the areas of snail habitats remained high. Further improvements in the construction of the schistosomaisis surveillance and forecast system, and reinforcement of O. hupensis survey and control are required to prevent the re-emerging schistosomiasis.

Analysis of the punishment on unlicensed medical practice in Jinshan District of Shanghai / 上海预防医学

ObjectiveThis paper analyzed the punishment situation of unlicensed medical practice in recent 7 years in Jinshan District of Shanghai， then suggested the countermeasures to prevent and combat unlicensed medical practice in the future. MethodsA total of 190 cases of unlicensed medical practice from 2016 to 2022 were investigated. The basic situation of the punishment，legal basis，subject distribution，clue source and individual characteristics were analyzed. ResultsThe case-filing number of unlicensed medical practice showed a decreasing trend，but the amount of fines increased obviously. The clues of investigation and punishment of unlicensed medicine practice were mainly found by inspection（32.11%） and transferred from other departments（28.42%）， while the number of complaints and clues reported from grassroots increased year by year. Medical and dental were the two major unlicensed practice，accounting for 35.79% and 33.16%， respectively. In addition， unlicensed medical cosmetology practice was increasing year by year. 78.62% of the unlicensed medical practioners are immigrants， 62.76% of them aged between 31 and 50 years old， among them 70.34% are men， and 62.76% of them have a fixed place. ConclusionThough the prevention and crack-down on unlicensed medical practice has achieved significant achievements，it is still necessary to enhance the responsibility of local administration，strengthen the inspection，investigate and deal with cases jointly by multiple departments，and implement the comprehensive supervision mechanism of the health care industry.

Documentation patterns on communicating prognosis to patients with terminal illness

Introduction@#Prognosis is an issue which most doctors and patients find difficult to discuss. Both patients and physicians find this process distressing as they can be unprepared to receive and give life-altering news. Although clinicians report that they are discussing prognosis, patients and caregivers frequently do not corroborate these reports, creating communication gaps especially in end-of-life situations.@*Objective@#This study determined how attending physicians documented the communication of prognosis on the patients’ records in terms of content, timing, and frequency during the course of hospitalization.@*Methods@#This is a retrospective chart review of 234 terminally-ill patients admitted from January 2020 to March 2020 in five (5) clinical departments of a public tertiary hospital. Discharge summaries and physicians’ daily chart notes were reviewed to identify the major events of each case.@*Results@#Two-thirds of the patients’ records had no documentation of any discussion with patient/family/significant others relating to patients’ worsening condition. The quantitative and qualitative forms of contextual information regarding patient prognosis were infrequently recorded. Notes on conversations of survival rate, probability of treatment response and failure were likewise lacking. However, for the occasional documentation observed, the timing of the communications was appropriate across the disease trajectory and was significantly correlated with all major points of illness deterioration (p<.001). Physician and patient characteristics had no association with the practice of documenting communication prognosis@*Conclusion@#Communication prognosis is not a common practice for most physicians. Prognosis was poorly documented on the patients’ charts, which could suggest that either such a communication process did not take place at all or physician education on documentation should be reinforced by an institutional protocol, especially in the care of terminally ill patients.

Analysis of the current situation of radiological health management in 66 medical institutions in Nanyang, China / 中国辐射卫生

Objective To determine the current situation of radiological health management in medical institutions in Nanyang, China, to analyze existing problems and propose improvement measures, and to improve the management level of radiological diagnosis and treatment practice in medical institutions. Methods According to the work plan of the Occupational Disease Prevention and Control Project in Henan Province, China, 66 medical institutions engaged in radiological diagnosis and treatment at different levels were selected for a questionnaire survey, in combination with on-site inspections, inquiries, and access to relevant materials. Results Of 66 medical institutions, 65 institutions held radiological diagnosis and treatment licenses, with a license holding rate of 98.5%. There were 17 “new construction, reconstruction, and expansion” projects, with an evaluation rate of 94.1%. In this survey, a total of 391 radiological diagnosis and treatment equipment were involved, and 387 units of equipment were tested for status, with a detection rate of 99.0% and a qualification rate of 94.8% (367/387); 55 units of equipment were tested for stability, with a detection rate of 14.1%; the workplace protection detection rate was 99.0%, and the qualification rate was 100%; 66 medical institutions had 1809 radiation workers, with an occupational health examination rate of 97.8%; 1262 people were trained, with a training rate of 95.7%; 1773 people were monitored for individual dose, with a monitoring rate of 98.0%. Conclusion Medical institutions should further strengthen management in licensing change, construction project evaluation, and equipment stability monitoring to improve the level of radiological health management.