Public health surveillance and the data, information, knowledge, intelligence and wisdom paradigm / Vigilancia de salud pública y el paradigma de datos, información, conocimiento, inteligencia y sabiduría / Vigilância em saúde pública e o paradigma de dados, informações, conhecimento, inteligência e sabedoria

ABSTRACT This article points out deficiencies in present-day definitions of public health surveillance, which include data collection, analysis, interpretation and dissemination, but not public health action. Controlling a public health problem of concern requires a public health response that goes beyond information dissemination. It is undesirable to have public health divided into data generation processes (public health surveillance) and data use processes (public health response), managed by two separate groups (surveillance experts and policy-makers). It is time to rethink the need to modernize the definition of public health surveillance, inspired by the authors' enhanced Data, Information, Knowledge, Intelligence and Wisdom model. Our recommendations include expanding the scope of public health surveillance beyond information dissemination to comprise actionable knowledge (intelligence); mandating surveillance experts to assist policy-makers in making evidence-informed decisions; encouraging surveillance experts to become policy-makers; and incorporating public health literacy training - from data to knowledge to wisdom - into the curricula for all public health professionals. Work on modernizing the scope and definition of public health surveillance will be a good starting point.

RESUMEN En este artículo se señalan las deficiencias de las definiciones actuales de la vigilancia de salud pública, que incluyen la recopilación, el análisis, la interpretación y la difusión de los datos, pero no las medidas de salud pública. El control de un problema de salud pública de interés exige una respuesta de salud pública que vaya más allá de la difusión de información. No es deseable que la salud pública esté dividida por un lado en procesos de generación de datos (vigilancia de salud pública) y por otro en procesos de uso de datos (respuesta de salud pública), gestionados por dos grupos diferentes (expertos en vigilancia y responsables de la formulación de políticas). Ha llegado el momento de replantear la necesidad de modernizar la definición de la vigilancia de salud pública tomando como referencia el modelo mejorado de Datos, Información, Conocimiento, Inteligencia y Sabiduría de los autores. Entre las recomendaciones que se proponen se encuentran las de ampliar el alcance de la vigilancia de salud pública más allá de la difusión de información para que incluya también el conocimiento aplicable (inteligencia); instar a los expertos en vigilancia a que presten ayuda a los responsables de la formulación de políticas en la toma de decisiones basadas en la evidencia; alentar a los expertos en vigilancia a que se conviertan en responsables de la formulación de políticas; e incorporar la formación en conocimientos básicos de salud pública (desde los datos hasta los conocimientos y la sabiduría) en los planes de estudio de todos los profesionales de la salud pública. Un buen punto de partida será trabajar en la modernización del alcance y la definición de la vigilancia de salud pública.

RESUMO Este artigo aponta deficiências nas definições atuais de vigilância em saúde pública, que incluem coleta, análise, interpretação e disseminação de dados, mas não ações de saúde pública. O controle de um problema preocupante de saúde pública exige uma resposta de saúde pública que vá além da disseminação de informações. A saúde pública não deve ser dividida em processos de geração de dados (vigilância em saúde pública) e processos de uso de dados (resposta de saúde pública) gerenciados por dois grupos distintos (especialistas em vigilância e formuladores de políticas). É hora de repensar a necessidade de modernizar a definição de vigilância em saúde pública, inspirada no modelo aprimorado de Dados, Informações, Conhecimento, Inteligência e Sabedoria dos autores. Nossas recomendações incluem: expansão do escopo da vigilância em saúde pública para além da disseminação de informações, de modo a abranger conhecimentos acionáveis (inteligência); obrigatoriedade de que os especialistas em vigilância auxiliem os formuladores de políticas na tomada de decisões baseadas em evidências; incentivo para que os especialistas em vigilância se tornem formuladores de políticas; e incorporação de capacitação em letramento em saúde pública (partindo dos dados para o conhecimento e em seguida para a sabedoria) nos currículos de todos os profissionais de saúde pública. O trabalho de modernizar o escopo e a definição de vigilância em saúde pública será um bom ponto de partida.

Aseguramiento y control de la calidad de los datos en un estudio de cohorte en Colombia

Introducción: La calidad de los datos facilita garantizar la fiabilidad de los estudios observacionales. Objetivo: Describir el aseguramiento y el control de calidad para mantener la fiabilidad y la validez del dato en un estudio de cohorte. Métodos: Presentar el manejo de datos implementado dentro de un seguimiento de enfermos renales crónicos cuya exposición fue un programa de protección renal comparado con el tratamiento convencional y su asociación con desenlaces clínicos. Se evaluó el cambio en la frecuencia de errores después de implementar el plan y la reproducibilidad del ingreso de registros a las bases de datos. Resultados: Se documentó una disminución progresiva en los errores cometidos en la captación de datos. El valor de Kappa entre los recolectores de la información para las variables clínicas más importantes fue 0,960 para la depuración de creatinina 150 mg/dL; 0,730 para la alteración del sedimento urinario; 0,956 para la asignación de estadio al ingreso. Los coeficientes de correlación intraclase para la identificación de las cifras de presión arterial sistólica fue 0,996; para la de presión arterial diastólica 0,993 y para los niveles de creatinina sérica al diagnóstico 0,995. Discusión: La calidad de los datos comienza con el reconocimiento de los retos y dificultades que implica su responsable captación, de ahí el aporte de la estandarización de los procesos y el personal que los lleve a cabo en forma idónea. Estudios evidencian que muchos procesos de mejora surgen en el desarrollo de la investigación sin protocolos preestablecidos. Conclusión: La reducción en la proporción y el tipo de error durante el proceso de captación de datos se debe a su identificación temprana y la corrección de instructivos, del instrumento de control de diligenciamiento y de la capacitación continua del personal. El análisis mostró una buena concordancia interevaluador.

Introduction: Data quality makes it easier to ensure that observational studies are reliable. Objective: To describe assurance and quality control to maintain data reliability and validity in a cohort study. Methodology: We present the data management strategies implemented in a study that followed patients of chronic kidney disease who were in a renal protection program and compared them with those undergoing conventional treatment to observe its association with clinical outcomes. We assessed the changes in error frequency after implementing the plan along with the reproducibility of the strategies for entering records into the databases. Results: We documented a progressive decrease of data collection errors. The Kappa values among data collectors for the most important variables were: 0.960 for creatinine clearance 150 mg/dl; 0.730 for urinary sediment alteration and 0.956 for stage allocation upon admission. The intraclass correlation coefficient for the identification of systolic blood pressure was 0.996; for diastolic blood pressure, the coefficient was 0.993 and for serum creatinine levels at diagnosis, the value was 0.995. Discussion: Data quality begins with the recognition of the challenges and difficulties involved in responsible data collection, hence the contribution of standardized processes and personnel to carry them out in a suitable manner. Studies show that many improvement processes arise in the development of research without pre-established protocols. Conclusion: The reduction in error ratio and type during the data collection process are the result of the early identification of erroneously entered or missing data, the correction of the guidelines for completing forms as well as of the instruments for detecting errors and continuous training of the staff. The analysis showed good inter-rater reliability.

Os arquivos no centro das questões de identidade, imediatismo e memória / Les archives au cœur des enjeux d'identité, d'immédiateté et de mémoire / Archives at the heart of issues of identity, immediacy, and memory

Os arquivos estão no centro de práticas e políticas contraditórias: por um lado, produção massiva, recolha imediata, exploração instantânea e publicação aberta; por outro lado, esquecimento, destruição ou negligência, e acesso fechado. O artigo ilustra essas contradições comparando, em primeiro lugar, três iniciativas de recolha de arquivos que permitiram e permitem recuperar o lugar do 'invisível' nas nossas sociedades, contra duas operações mais coletivas na sequência da tragédia francesa de 13 de Novembro de 2015 e dos períodos de confinamento. Depois da recolha, colocam-se questões relacionadas com as tensões geradas pela produção digital: como gerir o fluxo contínuo, a exigência de imediatismo, o recuo da presença humana? Finalmente, num contexto em que coexistem políticas públicas de memória e medidas regulamentares destinadas a proteger o segredo de defesa e o direito ao esquecimento, como podem arquivistas e historiadores trabalhar em conjunto para garantir que esta memória possa ser restituída aos cidadãos?

Les archives sont au cœur de pratiques et politiques contradictoires : d'un côté production massive, collecte immédiate, exploitation instantanée et publication ouverte ; de l'autre oubli, destruction ou négligence, fermeture de l'accès. L'article illustre ces contradictions en mettant tout d'abord en regard trois initiatives de collectes d'archives qui ont permis et permettent de restituer la place des « invisibles ¼ dans nos sociétés, face à deux opérations plus collectives par suite du drame français du 13 novembre 2015 et des périodes de confinement. Après la collecte viennent les questions relatives aux tensions générées par la production numérique : comment gérer le flux continu, la demande d'immédiateté, le recul de la présence humaine ? Enfin, dans un contexte où voisinent politiques publiques mémorielles et dispositifs réglementaires destinés à protéger le secret-défense et le droit à l'oubli, comment peuvent travailler archivistes et historiens pour que cette mémoire puisse être restituée aux citoyens ?

Archives are at the heart of contradictory practices and policies: on the one hand, massive production, imme-diate collection, instantaneous exploitation, and open publication; on the other, forgetfulness, destruction or negligence, and closure of access. The article illustrates these contradictions by, first of all, comparing three archive collection initiatives that have allowed and allow us to restore the place of the 'invisible' in our societies in the face of two more collective operations following the French drama of November 13, 2015, and the confinement periods. After the collection come the questions relating to the tensions generated by digital production: how to manage the continuous flow, the demand for immediacy, and the declining human presence? Finally, in a context where public memorial policies and regulatory measures intended to protect defense secrecy and the right to be forgotten coexist, how can archivists and historians work to restore this memory to citizens?

Captadores de niebla y recolección de agua en un ecosistema de páramo colombiano

Los captadores de niebla son usados para interceptar agua contenida en la niebla y abastecer de agua a comunidades que habitan en lugares donde este recurso escasea. Se evaluó el uso de captadores de niebla para la captación de agua en un área ubicada en el páramo Pan de Azúcar, Duitama-Boyacá. Se instalaron 60 captadores de niebla, 24 de ellos, con dispositivos para medir los volúmenes de agua interceptados. Los volúmenes de agua captados, se midieron en periodos de 24 horas, por 26 días, durante un año y se usó el modelo geométrico para diferenciar el agua proveniente de la niebla. La precipitación registrada fue mayor a la reportada en la literatura. La precipitación mensual osciló entre 51 y 1198 mm y la temperatura media mensual entre los 6 y 8 °C. Los volúmenes de agua promedio colectados por los 24 captadores de niebla estuvieron entre los 0,02 Lm-2dia-1 hasta los 4,4Lm-2dia-1. Los aportes de agua provenientes de la niebla oscilaron entre los 0,02 y 1,77 mmdía-1. La dirección del viento no afectó la captación de agua y aún se presenta incertidumbre al separar el aporte real de agua proveniente de la niebla a partir de la lluvia orográfica, lo cual, sigue siendo un desafío en los ecosistemas de páramo, por lo que se debe ampliar la investigación, para mejorar los diseños y las eficiencias de los captadores de niebla.

Fog collectors are used to intercept water contained in fog and supply water to communities that live in places where this resource is scarce. We evaluated the use of mist collectors to collect water in an area located in the Pan de Azúcar paramo, Duitama-Boyacá. We installed 60 mist collectors, 24 of them with devices to measure the volumes of water intercepted. The volumes of water captured were measured in periods of 24 hours for 26 days during one year and we used the geometric model to differentiate the water from the fog. The recorded precipitation was higher than that reported in the literature. Monthly rainfall ranged between 51 and 1198mm and mean monthly temperature ranged between 6 and 8°C. The average volumes of water collected by the fog collectors were below 0.5Lm-2day-1 with a maximum of 4.4Lm-2day-1. The contributions of water from the mist ranged between 0.02 and 1.77 mmday-1. The direction of the wind did not affect the capture of water and there is still uncertainty when separating the real contribution of water from the fog from the orographic rain, which continues to be a challenge in the paramo ecosystems, for which it is necessary to expand research, to improve the designs and efficiencies of fog collectors.

An observational study of role of medical record department in tertiary care teaching hospital

Background: Medical record document explains all the details about the patient’s history, clinical findings, diagnostic test results, pre- and post-operative care, patient’s progress, and medication given. If written correctly, notes will support the doctor about the correctness of treatment. Aim and Objectives: Our objective was to study effectiveness and utility of medical record department at our medical college affiliated tertiary care institution. Materials and Methods: We did an observational study to determine various parameters of medical records such as consent, history and examination findings, pre-operative and intraoperative records, investigation documentation, nursing care chart, and concerned medical person’s signature. The study included 300 files. A medical record checklist was used as a tool for data collection. The study was conducted between January 2021 and January 2022. Data were collected, entered in Microsoft Excel spread sheet, and analyzed using percentage. Results: Out of the 300 files, 186 files belonged to different surgical specialties while the rest were of non-surgical fields. It was found that nursing assessment document was present in 78%, while discharged card copy was found attached in 75.33% files. Furthermore, surgical safety checklist was found in 89.24%, while signature of faculty was absent in 38.3% files. Conclusion: Medical record maintaining and keeping is an essential and vital part of health-care infrastructure, not only for data collection but also for calculating use of resources needed for better delivery of quality services to patients.

Five tips for conducting remote qualitative data collection in COVID times: theoretical and pragmatic considerations / Cinco dicas para realizar coleta remota de dados qualitativos em tempos de COVID: considerações teóricas e pragmáticas / Cinco sugerencias para realizar recolección remota de datos cualitativos en tiempos de COVID: consideraciones teóricas y pragmáticas

ABSTRACT Objective: To provide five methodological and pragmatic tips for conducting remote qualitative data collection during the context of the COVID-19 pandemic. Method: The tips presented in this article are drawn from insights of our own experiences as researchers conducting remote qualitative research and from the evidence from the literature on qualitative methods. The relevant literature was identified through searches using relevant keywords in the following databases: CINAHL, PubMed, SCOPUS, and Web of Science. Searches were limited to articles in English and Portuguese, published from 2010 to 2021, to ensure a current understanding of the phenomenon. Results: Five tips are provided: 1) Pay attention to ethical issues; 2) Identify and select potential participants; 3) Choose the type of remote interview; 4) Be prepared to conduct the remote interview; and 5) Build rapport with the participant. Conclusion: Despite the challenges in conducting remote data collection, strengths are also acknowledged and our experience has shown that it is feasible to recruit and interview participants remotely. The discussions presented in this article will benefit, now and in the future, other research teams who may consider collecting data for their qualitative studies remotely.

RESUMEN Objetivo: Proporcionar cinco consejos metodológicos y pragmáticos para el manejo de la recogida de datos cualitativos durante el contexto de la pandemia de COVID-19. Método: Los consejos presentados en este artículo son extraídos de insights de nuestras propias experiencias como investigadores que realizan investigaciones cualitativas remotas y de la evidencia de la literatura sobre métodos cualitativos. La literatura relevante fue identificada a través de búsquedas utilizando palabras clave relevantes en las siguientes bases de datos: CINAHL, PubMed, SCOPUS y Web of Science. Las búsquedas se limitaron a artículos en inglés y portugués publicados entre 2010 y 2021 para asegurar una comprensión actual del fenómeno. Resultados: Se ofrecen cinco consejos: 1) Preste atención a las cuestiones éticas; 2) Identifique y seleccione potenciales participantes; 3) Escoja el tipo de entrevista remota; 4) Esté preparado para coordinar la entrevista remota; y 5) Promueva el vínculo con su participante. Conclusiones: A pesar de los desafíos en el manejo de la recogida remota de datos, también se reconocen las fortalezas y nuestra experiencia ha demostrado que es viable reclutar y entrevistar participantes remotamente. Las discusiones presentadas en este artículo beneficiarán, ahora y en el futuro, a otros equipos de investigación que puedan considerar recopilar datos para sus estudios cualitativos de forma remota.

RESUMO Objetivo: Fornecer cinco dicas metodológicas e pragmáticas para conduzir coleta remota de dados qualitativos durante o contexto da pandemia de COVID-19. Método: As dicas apresentadas neste artigo são extraídas de insights de nossas próprias experiências como pesquisadores conduzindo pesquisas qualitativas remotas e das evidências da literatura sobre métodos qualitativos. A literatura relevante foi identificada por meio de pesquisas usando palavras-chave relevantes nas seguintes bases de dados: CINAHL, PubMed, SCOPUS e Web of Science. As buscas foram limitadas a artigos em inglês e português publicados de 2010 a 2021 para garantir uma compreensão atual do fenômeno. Resultados: Cinco dicas são fornecidas: 1) Esteja atento às questões éticas; 2) Identifique e selecione potenciais participantes; 3) Escolha o tipo de entrevista remota; 4) Esteja preparado para conduzir a entrevista remota; e 5) Estabeleça previamente vínculo com o participante. Conclusão: Apesar dos desafios na condução da coleta remota de dados, os pontos fortes também são reconhecidos e nossa experiência tem mostrado que é viável recrutar e entrevistar participantes remotamente. As discussões apresentadas neste artigo beneficiarão, atualmente e no futuro, outras equipes de pesquisa que possam considerar a coleta de dados para seus estudos qualitativos remotamente.

Grupo focal on-line para a coleta de dados de pesquisas qualitativas: relato de experiência / Grupo de enfoque en línea para la recopilación de datos de investigación cualitativa: reporte de experiencia / Online focus group for qualitative research data collection: experience report

Resumo Objetivo relatar o processo de desenvolvimento de grupo focal on-line como técnica de coleta de dados em pesquisas qualitativas. Método trata-se de relato de experiência do desenvolvimento de um grupo focal on-line para a coleta de dados com os enfermeiros docentes vinculados ao estágio supervisionado da Atenção Básica em Saúde de uma universidade pública do interior do Ceará, realizado em março de 2020. Resultados as fases de planejamento do grupo focal on-line síncrono foram: (1) estruturação da abordagem; (2) construção do instrumento-guia; (3) composição do grupo; e, (4) desenvolvimento do processo grupal. Este oportunizou a acessibilidade, a adesão dos participantes, a redução de custos, a menor abstenção dos participantes e a rapidez para coletar, registar e analisar os dados. Obteve-se resultado satisfatório, destacando-se como uma possibilidade concreta de técnica de coleta de dados, em pesquisas qualitativas. Conclusões e implicações para a prática a estratégia de coleta de dados por meio do grupo focal on-line pode contribuir para a construção do conhecimento na área da saúde e Enfermagem para a realização de pesquisas qualitativas.

Resumen Objetivo reportar el proceso de desarrollo de un grupo focal en línea como técnica de recolección de datos en investigación cualitativa. Método este es un relato de experiencia sobre el desarrollo de un grupo focal en línea para la recolección de datos con enfermeras docentes vinculadas a la pasantía supervisada de Atención Primaria de Salud en una universidad pública del interior de Ceará, realizada en marzo de 2020. Resultados las fases de planificación del grupo focal en línea sincrónico fueron: (1) estructuración del enfoque; (2) construcción del instrumento guía; (3) composición del grupo; y, (4) desarrollo del proceso de grupo. Esto proporcionó accesibilidad, adherencia de los participantes, reducción de costos, menor abstención de los participantes y rapidez en la recolección, registro y análisis de datos. Se obtuvo un resultado satisfactorio, destacándose como posibilidad concreta de técnica de recolección de datos en la investigación cualitativa. Conclusión e implicaciones para la práctica la estrategia de recolección de datos a través del grupo focal en línea puede contribuir a la construcción de conocimiento en el sector salud y enfermería para realizar investigaciones cualitativas.

Abstract Objective to report the process of developing an online focus group as a data collection technique in qualitative research. Method this is an experience report on the development of an online focus group for data collection with teaching nurses linked to the supervised internship of Primary Health Care at a public university in the interior of Ceará, carried out in March 2020. Results the planning phases of the synchronous online focus group were: (1) structuring of the approach; (2) construction of the guide instrument; (3) group composition; and, (4) development of the group process. This provided accessibility, participant adherence, cost reduction, less participant abstention and speed to collect, record and analyze data. A satisfactory result was obtained, standing out as a concrete possibility of data collection technique in qualitative research. Conclusion and implications for practice the data collection strategy through the online focus group can contribute to the construction of knowledge in the health sector and nursing to carry out qualitative research.

Massive invasion on a Triatominae insectarium (Hemiptera: Heteroptera: Reduviidae) by Attagenus fasciatus (Thunberg, 1795) (Coleoptera: Dermestidae: Attageninae)

ABSTRACT Background: Triatominae are vectors of the protozoan Trypanosoma cruzi, the causative agent of Chagas disease. This study aims to report an infestation on Triatominae colonies by a beetle, previously identified as a pest. Methods: The management of these colonies should be improved to maximize their usefulness, and factors that may cause harm to them should be avoided as much as possible. Results: This is the first report on a coleopteran infestation on living Triatominae colonies worldwide. Conclusions: The present record provides an important warning to researchers who maintain insectaries in general, especially those who rear triatomines, to carry protective measures against such invasions.

Desarrollo de instrumentos para estudiar el impacto en salud de las transformaciones urbanas en contextos de elevada vulnerabilidad: el estudio RUCAS / Developing tools to study the health impact of urban transformations in high vulnerability contexts: the RUCAS study / Desenvolvimento de instrumentos para estudar o impacto na saúde das transformações urbanas em contextos de alta vulnerabilidade: o estudo RUCAS

Este artículo describe el proceso de diseño y las características de un cuestionario y una pauta de observación intradomiciliaria desarrollados para evaluar tanto transversal como longitudinalmente la relación vivienda-barrio-salud en el marco de transformaciones urbanas llevadas a cabo en poblaciones de elevada vulnerabilidad socio-territorial. Los instrumentos se desarrollaron para el estudio longitudinal multimétodos RUCAS (Regeneración Urbana, Calidad de Vida y Salud), un experimento natural cuyo objetivo principal es evaluar el impacto en salud y calidad de vida de un programa de Regeneración de Conjuntos Habitacionales en dos conjuntos de vivienda social en Chile. El diseño de los instrumentos siguió cuatro etapas principales: (1) revisión narrativa de la literatura para definir las dimensiones del estudio, y de instrumentos existentes para identificar ítems apropiados para su medición; (2) validación de contenido con expertos; (3) pre-test; y (4) estudio piloto. El cuestionario resultante, compuesto de 262 ítems, tiene en cuenta las distintas etapas del ciclo vital y cuestiones de género. La pauta de observación intradomiciliaria (77 ítems) es aplicada por el/la encuestadora. Los instrumentos abordan (i) características de la situación residencial actual que sabidamente afectan la salud y serán intervenidas por el programa; (ii) dimensiones de la salud potencialmente afectadas por la situación residencial y/o por la intervención dentro de los plazos del estudio (4 años); (iii) otras condiciones de salud y relacionadas con la salud que sean relevantes, aun cuando no se verán modificadas dentro de los plazos del estudio, y (iv) dimensiones socioeconómicas, ocupacionales y demográficas relevantes. Los instrumentos han mostrado ser una herramienta capaz de abordar la multidimensionalidad de los procesos de transformación urbana en contextos de pobreza urbana en vivienda formal.

This article describes the design and characteristics of a questionnaire and an intradomiciliary observation tool developed to assess the housing-neighborhood-health relationship both cross-sectionally and longitudinally in the context of urban transformations carried out in populations of high socio-territorial vulnerability. The instruments were developed for the multi-method longitudinal study RUCAS (Urban Regeneration, Quality of Life and Health), a natural experiment aiming to assess the quality of life and health impact of a comprehensive Urban Regeneration Program in two social housing complexes in Chile. The design of the instruments followed four main stages: (1) narrative review of the literature to define the dimensions of the study, and of existing measurement instruments to identify appropriate items for measuring them; (2) content validation with experts; (3) pre-test; and (4) pilot study. The resulting questionnaire, composed of 262 items, considers the different stages of the life course and gender issues. The intradomiciliary observation tool (77 items) is applied by the interviewer. The instruments assess (i) characteristics of the current residential situation that are known to affect health and will be intervened by the program; (ii) dimensions of health potentially affected by the residential situation and/or by the intervention within the time frame of the study (4 years); (iii) other health and health-related conditions that are relevant, even if changes will not be modified within the time frame of the study; and (iv) relevant socioeconomic, occupational and demographic dimensions. The instruments have shown to be capable of addressing the multidimensionality of urban transformation processes in contexts of urban poverty in formal housing.

Este artigo descreve o processo de desenho e as características de um questionário e uma diretriz de observação intradomiciliar desenvolvida para avaliar, tanto transversal quanto longitudinalmente, a relação moradia-vizinhança-saúde no âmbito das transformações urbanas realizadas em populações de alta vulnerabilidade sócio-territorial. Os instrumentos foram desenvolvidos para o estudo longitudinal multimétodo RUCAS (Regeneração Urbana, Qualidade de Vida e Saúde), uma experiência natural destinada a avaliar a relação moradia-vizinhança-saúde e o impacto na saúde de um programa de regeneração habitacional em dois conjuntos habitacionais sociais no Chile. A concepção dos instrumentos seguiu quatro etapas principais: (1) revisão narrativa da literatura para definir as dimensões do estudo, e dos instrumentos existentes para identificar itens apropriados para a medição; (2) validação do conteúdo com especialistas; (3) pré-teste; e (4) estudo piloto. O questionário resultante, composto de 262 itens, leva em conta diferentes estágios do ciclo de vida e questões de gênero. A diretriz de observação intradomiciliar (77 itens) é aplicada pelo entrevistador. Os instrumentos abordam (i) características da situação atual da moradia que são conhecidas por afetar a saúde e serão intervencionadas pelo programa; (ii) dimensões da saúde potencialmente afetadas pela moradia e/ou pela intervenção dentro do prazo do estudo (4 anos); (iii) outras condições de saúde e relacionadas à saúde que são relevantes, mesmo que não sejam modificadas dentro do prazo do estudo; e (iv) dimensões sócioeconômicas, ocupacionais e demográficas relevantes. Os instrumentos projetados demonstraram ser uma ferramenta capaz de abordar a multidimensionalidade dos processos de transformação urbana em contextos de pobreza urbana na habitação formal.

Application of blended learning combined with Jigsaw teaching in arterial blood specimen collection of undergraduate intern nurses / 中华医学教育探索杂志

Objective:To explore the application effect of online and offline blended learning combined with Jigsaw teaching in arterial blood specimen collection of undergraduate nursing interns.Methods:A total of 135 undergraduate nursing interns were randomly divided into the experimental group ( n=66) and the control group ( n=69). The experimental group used the blended learning combined with Jigsaw teaching, while the control group adopted the blended learning combined with PBL teaching. The theoretical examination before and after class, the skill assessment after training, the nursing clinical decision-making consciousness scale, and the teaching satisfaction survey were conducted in the two groups. SPSS 28.0 was used for t-test and Chi-square test. Results:After teaching, the total score of courses and the score of theoretical examination and skill assessment of the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05). The total score and the multi-dimension scores of the nursing clinical decision-making consciousness scale in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The teaching satisfaction of the experimental group was 92.42% (61/66), which was significantly higher than that of the control group [69.57% (48/69)], and the differences were statistically significant ( P<0.05). Conclusion:Blended learning combined with Jigsaw teaching is applied to collect arterial blood specimens for undergraduate nursing interns, which is beneficial to improve the academic performance and clinical decision-making ability of nursing students.

Analysis of the efficiency and influencing factors of peripheral blood hematopoietic stem cell collection / 中国医师进修杂志

Objective:To investigate the collection efficiency of peripheral blood hematopoietic stem cells and explore its influencing factors.Method:The parameters of the collection process, blood routine indexes and the number of MNC and CD 34+ cells of the product were detected by Fresenius blood cell separator, Mindray blood cell analyzer and BD flow cytometer. A retrospective analysis was performed on 72 patients who underwent autologous peripheral blood hematopoietic stem cell transplantation in Southwest Hospital of Army Medical University from January 2013 to January 2021, including the correlation among gender, age, blood routine indexes, collection circulation volume and MNC and CD 34+ cell count in these cases, and influence of various factors on collection efficiency of peripheral blood stem cells. The correlation among gender, age, blood routine indexes, collection circulation volume and MNC and CD 34+ cell count in 72 cases of autologous transplantation patients, and influence of various factors on collection efficiency of peripheral blood stem cells were analyzed retrospectively. Results:There were no significant differences in collecting efficiency of peripheral blood stem cells among patients with different age, sex and disease type ( P>0.05). The collected MNC count of all patients was positively correlated with the collection cycle count ( r = 0.33, P<0.001) and WBC count after mobilization ( r = 0.41, P<0.001). The number of CD 34+ cells collected was positively correlated with MNC count after mobilization ( r = 0.38, P<0.001) and the amount of white membrane collected ( r = 0.48, P<0.001). Logistic multivariate regression analysis showed that MNC count after mobilization: P<0.001, 95% CI 0.07(0.05 - 0.09), collection cycle amount [ P<0.001, 95% CI 0.00(0.00 - 0.00)] and postharvest total amount [ P<0.001, 95% CI 0.07(0.05 - 0.10)] were the influencing factors of the collected MNC number. Meanwhile, these factorswere also the influencing factors of the collected CD 34+ number (MNC count after mobilization: P<0.001, 95% CI 0.09(0.04 - 0.14); collection cycle amount: P = 0.003, 95% CI 0.00(0.00 - 0.00); postharvest total amount: P = 0.005, 95% CI 0.08(0.03 - 0.14)). Conclusions:The collection efficiency of peripheral blood stem cells varies greatly among individuals. The more MNC counts after mobilization, the more peripheral blood stem cells could be collected. In order to obtain high collection efficiency, it is necessary to adjust the parameters of peripheral blood MNC before collection, and pay attention to the collection circulation quantity, postharvest total amount and white membrane volume.

Ethical Management Experience and Enlightenment of Finnish Red Cross Blood Center Biobank / 中国医学伦理学

To strengthen the ethical management of blood samples for scientific research in blood collection and supply institutions, promote the effective use of blood sample resources, and protect the rights and interests of blood donors. Drawing on the experience of the Finnish Red Cross Blood Center biobank which has rich experience in management and recruitment, this paper summarized from the aspects of extensive informed consent, management of sample data, application of biological samples and data, and ethical management of research projects, and put forward the enlightenment to improve the ethical management of blood samples in blood collection and supply institutions, including further improving the construction of ethical laws and regulations, strengthening the ethical review norms of the ethics committee, standardizing the use of informed consent, and enhancing the privacy protection of blood donors.

Current Status and Ethical Considerations of Data Collection and Application in Rare Disease Research / 中国医学伦理学

The research on rare diseases in China started relatively late, with scattered research resources and weak data foundation in epidemiology, diagnosis and treatment, and medication, which hinders its research progress. The rare disease data system is the foundation of rare disease research, and the ethical constraint on rare disease data collection is not only the protection of rare disease population, but also the need for the safety and quality of rare disease data. By analyzing and prospecting the current status of the construction of rare disease data systems, including the data of epidemiology, clinical diagnosis and treatment, drug trials, and follow-up to provide reference for the improvement of rare disease data systems. This paper explored the ethical issues to be followed in the process of rare disease data collection from the perspectives of justice, no harm, respect, sharing, and legalization, so as to improve the standardization of rare disease data collection and the understanding of data ethical review.

Investigation on whole blood collection in Tianjin after fully lifting COVID-19 prevention and control measures / 中国输血杂志

【Objective】 To investigate the situation of whole blood collection in Tianjin after COVID-19 prevention and control measures were fully lifted. 【Methods】 The relevant data on whole blood collection of voluntary blood donors in Tianjin 15 days before Spring Festival (2023.01.07-2023.01.21, when China has managed COVID-19 with measures against Class B infectious disease instead of Class A infectious diseases) and 15 days before Spring Festival in 2018 (2018.02.01- 2018.02.15) and 2019 (2019.01.21-2019.02.04) before the breakout of COVID-19 were retrospectively collected and compared. 【Results】 The comparison between the above period in 2023, 2018 and 2019 was as follows: the number of blood donors was 6 124 vs 3 940 vs 4 069; blood collection volume (U) was 9 623 vs 7 378 vs 7 808; the proportion of first-time blood donors, local blood donors and group blood donors was 69.17% (4 236/6 124) vs 65.86% (2 595/3 940) vs 62.05% (2 525/4 069), 59.31% (3 632/6 124) vs 23.27% (9170) vs 18.19% (740/4 069) and 43.42% (2 659/6 124) vs 8.05% (317/2 595) vs 0.15% (6/4 069) (all P<0.05). 【Conclusion】 The adjustment of COVID-19 prevention and control policy has a significant impact on voluntary blood donation, and the corresponding adjustment of blood donor recruitment strategy in blood centers should be conducted to increase the whole blood collection.

Determination of the ELISA kits for screening convalescence plasma with high potency of SARS-CoV-2 IgG / 中国输血杂志

【Objective】 To determine the ELISA kit for screening convalescence plasma with high potency of SARS-CoV-2 IgG by comparing and analyzing the plasma detection results of convalescent plasma collected in different periods via ELISA kits from two manufacturers and the results of mixed plasma with different potency via pseudovirus neutralization experiments. 【Methods】 Two ELISA kits from different manufacturers(named A, B) were used to detect the plasma of 269 convalescent patients collected from Feb.2020~Jan.2022. The correlation and concordance rate of the two results were analyzed to determine the kit preliminarily. According to the titers of diluted series of standard of the preliminary selected kit, 5 mixed plasma samples (G4-G128) with different potency were prepared. The correlation of ELISA IgG results of product A/B, as well as the pseudovirus neutralization test of the original strain, Omicron mutant BA.1 and BA.2 strains were analyzed. Combined with the outside-well dilution mode of the strongly positive samples, the kit for high potency of SARS-CoV-2 IgG screening was determined. 【Results】 When the internal control reference B2 was used as the standard, the detection sensitivity of product A and B was 1∶32 vs 1∶8; the detection sensitivity of product A was 4 times that of product B. The correlation Pearson r between the results given by two kits was 0.944 1(P<0.000 1). Product B with low sensitivity was primarily selected as an alternative kit. The ELISA IgG results of samples from mixed plasma showed that the order of correlation r between product A and B was 0.988. The correlation r between product A and neutralization antibody potency of the three viruses was original strain (0.978)>BA.2(0.970)>BA.1(0.799); the order of correlation r between ELISA IgG results of product B and neutralization antibody potency of the three viruses was original strain(0.994)>BA.2(0.968)>BA.1(0.804). If twice-diluted B2 was taken as the excellent standard, 55.4% of product B met the criterion, while 47.2% of product A met.For positive plasma with high IgG potency, the product B kit required a lower dilution of the sample, which was more convenient to operate. 【Conclusion】 Both of the ELISA IgG kit from product A and B can be used to screen IgG antibodies of SARS-CoV-2, while product B is more suitable for screening positive plasma with high IgG potency.

Establishment and application of performance appraisal system oriented to improve blood collection and supply / 中国输血杂志

【Objective】 To establish a comprehensive performance appraisal system, in order to promote blood collection, preparation and supply. 【Methods】 The performance reform leading group headed by the central leader was set up to manage the overall work, with performance reform office set up to formulate the central performance reform plan and the target assessment plan. The operation effectiveness was evaluated by comparing the index changes in blood collection, preparation and supply. 【Results】 Compared with before the implementation of performance (from 2018 to 2019, a total of 24 months), except for the total monthly collection of street whole blood, the per person of street monthly blood collection and the total and per person monthly collection of apheresis platelets were significantly increased (P<0.05) during the process of blood collection. The total and per person monthly preparation of cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood preparation. The total and per person monthly supply of apheresis platelets, cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood supply. 【Conclusion】 The adjustment and implementation of performance reform program optimized the performance salary distribution system, and the formulation and implementation of target assessment program significantly promoted blood collection, preparation and supply.

Peripheral blood stem cells collection in pediatric patients with thalassemia major weighing 20 kilogram or less / 中国输血杂志

【Objective】 To evaluate the safety and efficacy of the collection of peripheral blood stem cells (PBSCs) in pediatric patients with thalassemia major (TM) weighing 20 kg or less. 【Methods】 PBSCs collection data of 170 pediatric patients with TM weighing 20 kg or less from January 2013 to December 2020 in our center were reviewed. Safety was assessed by the occurrence of adverse events during apheresis procedures, and efficacy was evaluated by the number of CD34+ cells collected. 【Results】 A total of 171 PBSCs procedures were performed on 170 patients with TM weighing 20 kg or less, with a median age of (4.98±1.53) years and a median weight of (17.30±2.18) kg. The probability of collecting at least 1×106 CD34+ cells/kg during a single course of apheresis was 99.41% (169/170), with a median (5.88±4.23) ×106 CD34+ cells collected per kg of weight of the recipient. A minimum pre-apheresis hemoglobin (Hb) of 60 g/L in patients with TM weighing 20 kg or less was safe and feasible. The most common adverse event of G-CSF mobilization in TM patients is bone pain, with the incidence of 7.65% (13/170), which was higher than that of healthy children donors in our center. The most common adverse events during the collection were pain at the puncture site of the femoral vein (6.47%, 11/170) and low pressure of the fluid (2.92%, 5/170). And no serious complications related to PBSCs mobilization, central venous catheter(CVC)placement or the apheresis procedure occurred. 【Conclusion】 PBSCs collection by COM.TEC blood cell separator in children weighing 20 kg or less is safe and efficacious.

Discussion on the collection and supply mode of RhD negative blood suitable for prefecture-level city: a retrospective analysis / 中国输血杂志

【Objective】 To explore a RhD negative blood collection and supply mode suitable for Liaocheng area and improve the blood demand satisfaction rate of RhD negative patients. 【Methods】 Under different collection and supply modes (collection mode: in 2020, not advocate walk-in donation by RhD negative repeat blood donors, but in 2021 and 2022 were the opposite; supply mode: in 2020, type A, B, O and AB RBCs were frozen within 6 days of blood collection without inventory, but in 2021 and 2022, they were stored of 2-6 U and the remaining were frozen within 6 days of blood collection), RhD negative blood was divided into Type A, B, O and AB, appointment donation and walk-in donation, first donation and repeat donation, cold storage red blood cells(RBCs), frozen RBCs and frozen thawed deglycerolized RBCs, and the collection and supply data of each observation group from 2020 to 2022 were compared. Based on whether blood demand of RhD negative patients was met, the patients were divided into the group of going to other places for medical treatment, the group of RhD positive blood transfusion and the group of RhD negative blood transfusion to analyze the blood usage. 【Results】 From 2020 to 2022, the proportion of RhD negative blood donated by repeat appointment donors decreased year by year (P<0.05); the proportion of RhD negative blood donated by repeat walk-in donors increased year by year (P<0.05); the proportion of frozen thawed deglycerolized RBCs to RhD negative RBCs increased year by year (P<0.05); the proportion of cold storage RBCs distributed as RhD negative and RhD positive decreased year by year respectively (P<0.05); the proportion of the increase in frozen RBCs inventory to the current year's frozen RBCs inventory decreased year by year (P<0.05). The satisfaction rate of blood demand of RhD negative patients increased year by year (P<0.05), with the number of patients with RhD positive blood transfusion and going to other places for medical treatment decreased year by year respectively(P<0.05). 【Conclusion】 In Liaocheng area, it is appropriate to encourage RhD negative blood donors to donate blood randomly, and A, B, O and AB type cold storage RBCs kept in 2-6 U inventory respectively. When exceeding the inventory, frozen RBCs are prepared within 6 days, which can improve the blood demand satisfaction rate of RhD negative patients and avoid sending excessive RhD negative RBCs to clinical use as RhD positive RBCs.

Practice of paper-free whole blood collection system in constructing intelligent blood station / 中国输血杂志

【Objective】 To establish a paper-free system of the total whole blood donation flow in constructing intelligent blood stations, and build digitalized whole blood donation system for practice. 【Methods】 A paper-free whole blood collection system was constructed through information process reforming, system frame designing and data network transportation constructing, and was applied in various blood donation scenario. 【Results】 Fixed blood collection sites carried out 49 063 donations via paper-free information system from November 2022 to July 2023, and 24 822 donations( group blood donation) were conducted via paper-free system from April to July 2022. Compared with the traditional paper-based model, paper-free system is safer, more standardized and more convenient, effectively enhancing the experience of blood donors. 【Conclusion】 The construction of paper-free whole blood collection system effectively enhances the experience of blood donors, improves the safety, accuracy, traceability of the data, and has good social value and economic value, which is worth popularizing.

Platelet-rich plasma collection and preparation: a retrospective analysis of 256 cases / 中国输血杂志

【Objective】 To retrospectively analyze the safety and product quality of NGL XCF 3000 blood cell separator for collecting platelet-rich plasma (PRP) in 256 cases, so as to provide reference for safe collection and product quality control of PRP. 【Methods】 The data of 256 patients receiving PRP treatment in our hospital from June 2021 to June 2022 were statistically analyzed, and the differences in the collection time, circulating blood volume and the occurrence of adverse reactions to blood donation were analyzed when NGL XCF 3000 was used to collect autologous PRP among patients of different genders, ages and platelet counts. The differences in platelet content, red blood cell(RBC) contamination and white blood cell(WBC) residues in PRP products were analized. 【Results】 1) There were no significant differences in collection time, circulating blood volume and collection volume among patients of different genders, ages and platelet counts (P<0.05). 2) The contents of WBC, RBC and platelet were not significantly different between male and female patients after collection (P<0.05); 3) The WBC contents increased with the increase of age, and the WBC residue in the elder group[ 56 to78 years old, (0.64±0.41) ×109/L] was significantly higher than that in the younger group[group 1,18 to 40 years old, (0.50±0.35)×109/L], with significant difference was Statistically significant (P<0.05). 4) The residues of WBCs and RBCs in in low platelet group [group 1, (100-150)×109/L] were higher than those in other platelet count groups, and the difference was Statistically significant (P<0.05), and the platelet count in this product was significantly lower than that in other platelet count groups (P<0.05). Conclusion The NGL XCF 3000 blood cell separator is safe and stable for PRP collection in patients with different genders, ages and platelet counts of (100-450)×109/L, and the PRP products collected can meet clinical therapeutic needs.