Staging Sequential Treatment of Ischemic Stroke Based on Syndrome Differentiation of Deficiency and Excess in Eight Principles / 中国实验方剂学杂志

The core of diagnosing and treating diseases in traditional Chinese medicine lies in syndrome differentiation. The eight principles of syndrome differentiation serve as guidance for syndrome differentiation. As one of the eight principles of syndrome differentiation， the differentiation of deficiency and excess is the basic and critical method. Ischemic stroke is currently the leading cause harming the health of Chinese residents. Although the hypotheses about the cause of ischemic stroke have evolved from external wind to the later internal wind and to the modern theory of toxin damaging the brain collaterals， they all believe that this disease is rooted in internal deficiency and external excess. According to available studies， although stroke is characterized by complex pathogenesis and rapid progression of syndromes， the key cause evolution has a regularity， that is， from excess to deficiency. This article analyzes the historical evolution of the etiology， pathogenesis， and syndrome differentiation schemes of stroke. There are diverse schemes for the syndrome differentiation of stroke， which make it difficult to choose in clinical practice. In view of this problem， this paper puts forward a new approach of staging sequential treatment of ischemic stroke based on the differentiation of deficiency and excess according to the evolution law of the key cause of stroke. Furthermore， we conducted a randomized controlled study on 100 patients with ischemic stroke to evaluate this new approach. The results showed that the staging sequential treatment of ischemic stroke based on the differentiation of deficiency and excess demonstrated definite clinical efficacy. In addition， this article reviews the previous research results of our team and the research achievements of other teams to preliminarily explore the relationship between stroke syndromes and biomarkers， aiming to provide an objective basis for unveiling the pathogenesis of stroke. In summary， according to the key cause evolution （from excess to deficiency）， the treatment of ischemic stroke by stages based on differentiation of deficiency and excess can facilitate the rapid intervention and improve the clinical efficacy on ischemic stroke.

Identifying the roles of occupational therapists among the LGBT community: An analysis of a panel discussion

@#Occupational therapists are known to be holistic practitioners who facilitate occupational performance and promote occupational justice. However, limited literature explores the role of the profession for members of the society who identify themselves as lesbians, gays, bisexuals, and transgender (LGBT). This paper analyzes a panel discussion at an international event hosted by a university in the Philippines regarding gender and sexuality. This short report aims to identify the roles of occupational therapists among the LGBT community through the lens of professionals. Upon thematic analysis of the transcription of the discussion, five roles of occupational therapists were identified. These are (1) navigators on the complexity of gender and sexuality, (2) researchers on evidenced-based and practical practices toward the LGBT community, (3) enablers of gender expression among the LGBT community, (4) allies of the LGBT community, and (5) advocates of inclusion in all spaces. It provides actionable approaches for occupational therapists to facilitate gender-affirming healthcare for the LGBT community. Moreover, these findings hold the potential to influence forthcoming policies and educational initiatives for both occupational therapists and allied professionals.

Implementation of National Leprosy Eradication Programme during COVID-19 era: A qualitative research

Introduction: The COVID-19 pandemic imposed new challenge to the implementation of the National Leprosy Eradication Programme. According to national data, after lockdown due to COVID-19, there was a 29% reduction in total leprosy cases reported in the first quarter (April-June) of 2020 in comparison to 2019. Objectives: To explore the difficulties faced by different stakeholders of the National Leprosy Eradication Programme like policy makers, doctors, grass root level health workers as well as leprosy patients during COVID-19 pandemic with respect to programme implementation and access to leprosy care. Materials and Methods: Qualitative research was undertaken including two focus-group-discussions held among six leprosy patients diagnosed after lockdown and nine ASHA workers as well as six in-depth interviews of doctors, leprologists, and programme managers. Ethics committee approval was sought and informed consent was obtained from all participants. All focus-group-discussions were electronically recorded and the in-depth interviews telephonically recorded, transcribed and translated from Bengali-to-English. Transcripts were separately coded by researchers and thematically analysed with the help of Visual-Anthropac software version 1.0. Results: Solitary focus on COVID-19 control, capacity building and information, education and communication, leprosy case search & surveillance, co-infection among health workers, transportation issues were the themes explored from focus-group-discussions of health workers and ASHA workers. Similarly, the present study identified six themes from in-depth interviews of programme manager, leprologists, programme manager as diagnostic difficulty, operational issues, rehabilitation issues, capacity building & information education and communication activities and way forward. Limitations: The research reveals the perceptions of rural population of Eastern India with high leprosy prevalence, which might not be applicable for urban areas or low prevalent districts Conclusion: The solitary focus of the administration towards COVID and shifting the infrastructure and human resource only towards the management of COVID can lead to resurgence of the leprosy. Having an organised framework of operations, catering to the need of the front-line workers in rendering services, utilizing the digital platform and social media, and focusing on rehabilitation would be needed to overcome the crisis

Impacto de la metodología de debate como técnica de enseñanza- aprendizaje en población universitaria

El objetivo principal de la presente investigación es determinar la influencia entre las habilidades de pensamiento crítico, técnicas de oratoria y argumentación en las dinámicas de debates en el ámbito educativo, las cuales integran dentro de sus ambientes y herramientas de aprendizaje grupos de debates y el desarrollo de procesos cognitivos de orden superior. La metodología utilizada fue de corte mixta. Dentro de los resultados, existen hallazgos significativos que avalan el desarrollo de destrezas en la metodología de debate, permitiendo concluir su influencia en la potenciación de habilidades cognoscitivas, interpersonales y académicas.

The main objective of the present research is to determine the influence between critical thinking skills, public speaking techniques, and argumentation on the dynamics of debates in the educational environment, which integrate within their environments and learning tools debate groups and the development of higher order cognitive processes. The methodology used was mixed. Within the results, there are significant findings that support the development of skills in the debate methodology, by allowing to conclude its influence on the enhancement of cognitive, interpersonal, and academic skills.

Development of an integrated telerehabilitation model in children with cerebral visual impairment in South India during the COVID-19 pandemic – A pilot study

Purpose: Coronavirus disease 2019 (COVID?19) pandemic affected the in?person rehabilitation/habilitation services in families with children with cerebral visual impairment (CVI) in India. This study aimed to develop a structured and family?centered telerehabilitation model alongside conventional in?person intervention in children with CVI to observe its feasibility in the Indian population. Methods: This pilot study included 22 participants with a median age of 2.5 years (range: 1–6) who underwent a detailed comprehensive eye examination followed by functional vision assessment. The visual function classification system (VFCS) was administered to the children and the structured clinical question inventory (SCQI) to the parents. Every participant underwent 3 months of telerehabilitation including planning, training, and monitoring by experts. At 1 month, the parental care and ability (PCA) rubric was administered to the parents. After 3 months, in an in?person follow?up, all the measures were reassessed for 15 children. Results: After 3 months of Tele?rehabilitation there were significant improvements noted in PCA rubric scores (P<0.05). Also, statistically significant improvements were noted in functional vision measured using SCQI and VFCS scores (P<0.05) compared to baseline. Conclusion: The outcomes of the study provide the first steps towards understanding the use of a novel tele?rehabilitation model in childhood CVI along?side conventional face?to?face intervention. The added role of parental involvement in such a model is highly essential.

Função de Cuidar na Educação Infantil: Contribuições de Grupos de Discussão de Trabalho com Educadoras / Role of Caring in Early Childhood Education: Contributions from Working Discussion Groups with Educators / Función de Cuidado en la Educación Infantil: Grupos de Discusión de Trabajo con Maestros

As educadoras que atuam na Educação Infantil participam da subjetivação de bebês e crianças pequenas, o que pode ser extremamente exigente. Nesse sentido, este estudo teve como objetivo oferecer um espaço de escuta para educadoras, com vistas a refletir sobre os desafios da função de cuidar de bebês e crianças bem pequenas na Educação Infantil. Foram realizadas duas edições de um grupo de discussão de trabalho, nas quais participaram cinco educadoras. O material produzido no grupo de discussão de trabalho, juntamente com relatos discutidos em supervisão, foi analisado qualitativamente, a partir de análise temática indutiva. Os resultados evidenciam que o cuidado exige presença, previsibilidade, intimidade e sensibilidade, o que, muitas vezes, é solicitado pelos próprios bebês/crianças que convocam o adulto. Entretanto, responder a essas demandas de forma individualizada num ambiente coletivo pode trazer desconforto, mal-estar e angústia. O grupo de discussão de trabalho oportunizou às educadoras tomarem consciência de como se utilizavam, por vezes, de um estilo de cuidado mais mecanizado e controlador, de forma a se protegerem dessas demandas. Em síntese, o bebê/criança desacomoda o adulto e o convoca a (re)pensar sobre seu fazer, apontando a importância de espaços de escuta e reflexão aos profissionais da educação.

Working in Early Childhood Education implies that the adult caregiver participates in the subjectivation of babies, which can be extremely demanding. This study aimed to offer a listening space for nursery educators to reflect on the challenges of the role of caring for babies and very young children in Early Childhood Education. Two editions of the work discussion group were held, in which five educators participated. The material was qualitatively analyzed, considering the inductive thematic analysis. The results showed that care requires presence, predictability, intimacy, and sensitivity, requests often made by the babies and the children themselves who call the adult to respond from this place. However, responding to this demand individually in a collective environment can bring discomfort, malaise, and anguish. The group made it possible for educators to become aware of how they used a more mechanized and controlling style of care, to protect themselves from these demands. In summary, the baby and the children discomfort the adult and invite him/her to (re) think about his actions, pointing out the importance of spaces for listening and reflection to education professionals.

Trabajar en Educación Infantil implica que el adulto cuidador participe enlasubjetivación de los bebés, lo que puede ser extremadamente exigente. Por eso, este estudio tuvo como objetivo ofrecer un espacio de escucha a los educadores, con el fin de reflexionar sobre los retos del cuidado de los bebés y niños muy pequeños en la Educación Infantil. Se realizaron dos ediciones de los grupos de discusión de trabajo, en las que participaron cinco educadores. El material fue analizado cualitativamente, a partir del análisis temático inductivo. Los resultados muestran que el cuidado requiere presencia, previsibilidad, intimidad y sensibilidad, peticiones, muchas veces, realizadas por los propios bebés y niños que convocan al adulto. Sin embargo, responder a esta demanda de forma individual en un entorno colectivo puede traer malestar y angustia. Los grupos hizo posible que los educadores tomaran conciencia de cómo utilizaban un estilo de atención más mecanizado y controlador, para protegerse de estas demandas. En resumen, el bebé y los niños incomodan al adulto y lo invitan a (re) pensar en sus acciones, señalando la importancia de los espacios de escucha y reflexión de los profesionales de la educación.

Parental perception of facilitators and barriers to activity and participation in an integrated tele-rehabilitation model for children with cerebral visual impairment in South India – A virtual focus group discussion study

Purpose: This study utilized virtual focus group discussions to document the facilitators and barriers reported by the parents as part of the tele?rehabilitation service delivery model in India. Methods: This study included 17 participants who were enrolled into the Tele?rehabilitation program (16 mothers, 1 father) and the virtual focus group discussion (V?FGD) were conducted through a WhatsApp video call. Three V?FGDs were conducted involving two moderators and a note taker. The V?FGD, focused at extracting the perceptions of parents pertaining to facilitators, barriers and coping mechanisms to barriers related to the tele?rehabilitation model. Results: Thematic analysis resulted in four themes for barriers that included: family and support, time, parent and care taker, child and place of living related; facilitators reported included: continuous monitoring, accessibility to professional services, provision of resource materials and parental empowerment. Themes “family and support” and “child” were most reported by parents with children >3 years and ?3 years respectively. Finally, the barriers and facilitators were aligned with the chapters and codes of International Classification of Functioning, children and youth version (ICF?CY) environment and personal factors. Conclusion: This V?FGD highlights the importance of parental?centred and structured Tele?rehabilitation among children with CVI in India. The outcome of this study opens avenues for creating effective intervention.

Thoughts of syndrome differentiation and treatment of precancerous lesions of chronic atrophic gastritis based on the theory on hidden pathogen / 国际中医中药杂志

Precancerous lesions of gastric cancer (PLGC) is a pathological change accompanied by intestinal metaplasia and dysplasia on the basis of chronic atrophic gastritis. It is also an important stage of "inflammation-cancer transformation" on gastric mucosa. Paying attention to the intervention of PLGC has important value and significance for the secondary prevention of gastric cancer. PLGC has the characteristics of occult onset, toxin damaging collaterals, and long course of disease, which is highly consistent to the pathogenesis characteristics of incubative pathogenic factors. Based on the relevance of incubative pathogenic factors and PLGC, treatment of PLGC from the perspective of incubative pathogenic factors should be mainly strengthening the spleen and stomach, and combined with the methods of regulating qi and dissipating dampness, and removing blood stasis and detoxification. It should also pay attention to the prognosis.Paying attention to the body-mind treatment can reduce the re-occurrence , so as to provide a new way of thinking for treating PLGC from incubative pathogenic factors.

The application law of Moutan Cortex in Synopsis of the Golden Chamber / 国际中医中药杂志

We aimed to study the articles and applied prescriptions of Moutan Cortex in Synopsis of theGolden Chamber, summarize and analyze its laws on the disease location and disease nature, and analyze its compatibility, dosage and processing laws. Based on the knowledge of Moutan Cortex by Zhongjing, we found that the kidney, bladder, uterus and intestine involved in Zhongjing's application of peony bark prescription, which belongs to the disease of "lower abdomen" in Huangdi Nei Jing. And the prescription of Moutan Cortex mainly focused on the syndromes of "depression" and "blood stasis", which are characterised by five kinds: water depression, dampness depression, stasis-heat, blood stasis and ecchymosis. and the compatibility rule of Zhongjing application of Moutan Cortex is analyzed accordingly. In addition, the study found that as the downward movement of the disease position, the amount of Moutan Cortex increased, and the processing of the problem followed the principle of "if disease is slow onset, the Moutan Cortex heart should be removed, but if disease is acute, Moutan Cortex heart should be kept". Finally, we combined modern clinical application of Moutan Cortex with modern pharmacological research, in order to expand the scope of clinical application of Moutan Cortex and "the same treatment of different diseases" to provide theoretical guidance.

Exploring acupuncture treatment strategies for snoring based on meridian theory / 中国针灸

Starting from the perspective of meridian theory, this article briefly analyzes the meridian pathophysiology of snoring and the relationship between snoring and meridian theory. It proposes that acupuncture treatment for snoring should focus on regulating qi from the shaoyang meridians, harmonizing the spirit by the governor vessel, resolving phlegm through the three yang meridians, and harmonizing qi and blood from the yangming meridians. Additionally, attention is placed on both the root cause and the symptoms, the theory of "four seas". The ultimate goal is to promote the flow of meridian and qi-blood, improve symptoms such as nighttime snoring, poor sleep quality, and daytime sleepiness, and achieve the desired outcome of stopping snoring and ensuring restful sleep.

O debate nas Ciências do Trabalho: do que estamos falando? / Debate on Work Sciences: what are we talking about?

Resumo O debate sobre o trabalho tem ocupado, nos últimos anos, um espaço importante nas abordagens das Ciências do Trabalho, principalmente naquelas desenvolvidas pelo CNAM-Paris (Conservatoire National des Arts et Métiers) ou inspiradas por essa escola. Disciplinas como a Ergonomia, a Psicodinâmica do Trabalho ou a Clínica da Atividade têm apresentado métodos que desenvolvem o debate do e no trabalho, de maneira a compreender a atividade realizada, bem como contribuir com transformações das situações de trabalho. Apesar disso, a literatura é relativamente escassa no que concerne às particularidades do debate em cada uma dessas disciplinas e de seus métodos. Com isso, o objetivo deste ensaio é buscar compreender o que compõe o debate nas abordagens das Ciências do Trabalho e também qual o seu potencial, identificando as particularidades inerentes a cada uma delas. É possível notar que existem semelhanças - como a centralidade analítica das contradições no debate - mas também muitas singularidades entre as disciplinas e seus métodos, tais como o funcionamento dos espaços em que o debate ocorre e a maneira com a qual ele é capaz de analisar a atividade e transformar o trabalho. Por fim, defendemos a necessidade de incorporação das especificidades do debate nas pesquisas sobre o tema, evitando assim cacofonias sobre o assunto.

Abstract The debate on work has occupied, in recent years, an important space in the approaches to Labor Sciences, especially those developed by CNAM-Paris (Conservatoire National des Arts et Métiers) or inspired by this school. Disciplines such as Ergonomics, Psychodynamics of Work, or Activity Clinic have presented methods that develop the debate of and at work, to understand the activity performed, and to contribute to the transformation of work situations. Despite this, the literature is scarce regarding the particularities of the debate in each of these disciplines and their methods. Thus, the objective of this essay is to seek to understand what makes up the debate in the approaches of the Work Sciences and its potential, identifying the particularities inherent to each one of them. It is possible to notice that there are similarities - such as the analytical centrality of the contradictions in the debate - but also many singularities between the disciplines and their methods, such as the functioning of the spaces in which the debate takes place and the way in which it is able to analyze the activity and transform work situations. Finally, we defend the need to incorporate the specificities of the debate in research on the subject, thus avoiding cacophonies on the subject.

Comparison of blunder lecture with tutorial for small-group discussion among Phase I M.B.B.S. students in a medical college in North India

Background: Small-group discussion (SGD) plays an essential role in physiology to foster active learning by the students. Blunder lecture has been used to stimulate inquiry, reflection, and promote collaborative learning by cognitive conflict strategy. Aims and Objectives: The objectives of the study were as follows: (i) To compare the effectiveness of blunder lecture with tutorial for SGD and (ii) to assess the perception of students toward blunder lecture and tutorial. Material and Methods: An educational interventional study was conducted in the department of physiology among 116 Phase I MBBS students using tutorial and blunder lecture for SGD on two core topics of physiology which were already covered in didactic lectures. Blunder lecture included deliberate mistakes spread over the different levels of Bloom’s taxonomy. Blunders were identified and discussed during the group activity. The evaluation was done by validated pre-post tests and questionnaires. Results: There was a statistically significant gain in the mean score of the students who attended blunder lecture session in comparison to tutorial. Out of 116 students who participated in the study, 89% perceived blunder lecture as a challenging way to recollect prior knowledge. Conclusion: Blunder lecture is an effective reinforcement tool that can be used in SGD to facilitate the learning of the undergraduates.

Pragmatic Real-world Approach to Treat Diffuse Parenchymal Lung Disease in Logistically Constraint Situations: A Proposition

Understanding the etiology and the tempo of progression with inexorable and self-perpetuating fibrosis [identification of progressive-fibrotic (PF) phenotype of interstitial lung disease (ILD) (PF-ILD)] can help to decide the treatment of diffuse parenchymal lung disease (DPLD) in the real-world practice. An evidence-supported pragmatic approach has been forwarded for such circumstances.

COVID 19 INFECTION IN A PATIENT NEWLY DIAGNOSED WITH HIV/TB COINFECTION – A CASE REPORT

HIV/TB coinfection, COVID 19 with HIV/TB, immune reconstitution inflammatory syndrome (IRIS), TB lymphadenopathy

Perspectives On Health Care Cost-Consciousness among Medical Students and Physicians

Introduction: Health care costs consciousness refers to care that aims to assess the benefits, harms and costs of interventions by the physicians. Rising health care costs have created an urgent need to improve physicians� knowledge on health care costs for providing cost conscious care. Objectives: This study was done to assess and compare the knowledge and attitude towards health care cost consciousness of the undergraduate medical students and interns. Methodology: A Mixed Method study was done using a standardized questionnaire among 388 medical students and a Qualitative approach using In-depth interviews with 15 practicing physicians and a Focus group discussion to understand their perceptions on cost-conscious care and their opinions on introducing Cost-conscious curriculum for the medical students. Data analysed using a framework analytical approach and NVivo12. Results: 84% of the students agreed that all health personnel should be familiar with health care costs, 84.5% agreed that inclusion of the health care cost consciousness in medical curriculum is important for their carrier. The themes emerged identified the various perceptions, determinants on health care costs, cost-conscious decision making and their responsibility as a physician. Conclusion: The physicians and interns strongly suggested including a structured learning on Cost-Conscious Care as a part of medical education to educate and train the future physicians.

Impacto clínico de un grupo de discusión multidisciplinaria en el diagnóstico de fibrosis pulmonar idiopática en Colombia / Clinical impact of a multidisciplinary discussion group on the diagnosis of idiopathic pulmonary fibrosis in Colombia

Resumen Introducción: la fibrosis pulmonar idiopática (FPI) es una enfermedad pulmonar intersticial (EPID) de mal pronóstico, considerada huérfana en Colombia. Un diagnóstico correcto tiene implicaciones para el paciente y los costos de atención. Los grupos de discusión multidisciplinaria (GDM) se consideran el estándar de oro en el diagnóstico. No hay estudios previos en Colombia de la experiencia de un GDM. Objetivos: evaluar el impacto de un GDM en una institución de cuarto nivel en Bogotá en cambio de diagnóstico de pacientes con EPID y la concordancia entre el diagnóstico inicial y final de FPI. Material y métodos: pacientes con EPID evaluados entre 2015-2018 por el GDM conformado por neumólogos, radiólogo, patólogo y reumatólogos. Criterios ATS/ERS/JRS/ALAT de diagnóstico de FPI. Descripción del cambio en el diagnóstico y concordancia entre el diagnóstico inicial y del GDM en FPI. Resultados: de 165 pacientes con EPID se cambió el diagnóstico en 35.2%. En 77.3% pacientes con diagnóstico inicial de FPI y en 6.7% con diagnóstico inicial diferente a FPI el GDM confirmó FPI. Al descartar FPI, los principales diagnósticos fueron neumonitis de hipersensibilidad en fase crónica (29.4%) y neumonía intersticial no específica (23.5%). El índice kappa entre el diagnóstico inicial y final de FPI fue 0.71 (0.60-0.82). Conclusiones: el GDM en EPID tuvo un importante impacto clínico demostrado por un alto porcentaje de cambió del diagnóstico de remisión. Se descartó el diagnóstico inicial de FPI en un porcentaje significativo de pacientes y se ratificó en un grupo menor sin esta sospecha clínica inicial. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2017).

Abstract Introduction: idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease (ILD) with a poor prognosis, considered an orphan disease in Colombia. An accurate diagnosis has implications for the patient and healthcare costs. Multidisciplinary discussion groups (MDGs) are considered the gold standard for diagnosis. There are no prior studies in Colombia on the experience of an MDG. Objectives: to evaluate the impact of an MDG in a quaternary care institution in Bogotá on the change in the diagnosis of patients with ILD and the concordance between the initial and final diagnosis of IPF. Materials and methods: patents with ILD evaluated from 2015-2018 by the MDG made up of pulmonologists, a radiologist, a pathologist and rheumatologists. The ATS/ERS/JRS/ALAT diagnostic criteria for IPF. A description of changes in the diagnosis and the agreement between the initial diagnosis and the MDG diagnosis of IPF. Results: out of 165 patients with ILD, the diagnosis was changed in 32.5%. The MDG confirmed IPF in 77.3% of patients with an initial diagnosis of ILD and 6.7% of those with a different initial diagnosis. When IPF was ruled out, the main diagnoses were chronic hypersensitivity pneumonitis (24.8%) and nonspecific interstitial pneumonia (23.5%). The Kappa index between the initial and final IPF diagnoses was 0.71 (0.60-0.82). Conclusions: the MDG on ILD had a significant clinical impact evidenced by a high percentage of change in the referral diagnosis. The initial diagnosis of IPF was ruled out in a significant percentage of patients and confirmed in a smaller group which did not have this initial clinical suspicion. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2017).

Male attitudes towards family planning in the Limpopo province of South Africa

Women often do not receive support from their partners with regards to familyplanning (FP), which can lead to hesitancy and inconsistent use. This study sought tounderstand the male attitudes that contribute to this.Methods: A qualitative descriptive study was conducted in 2019 using focus group discussions (FGDs) with purposively selected men aged ≥ 25 years and in a relationship with a woman of childbearing age. An open-ended question guide was used to explore men's perceptions regarding FP. The discussions were recorded, translated and transcribed verbatim, whereafter transcripts were coded and analysed thematically. Results: Three major themes were identified, namely: (1) the advantages of FP, including financial benefits and the prevention of sexually transmitted infections and unwanted pregnancy; (2) the disadvantages of FP, including perceived adverse effects on men and women, as well as marital difficulties; and (3) the exclusion of men from FP by health workersand their partners. Conclusion: Men felt ambivalent towards FP. They were aware of the benefits thereof, but were hesitant to allow their female partners to use contraceptives, because of several misconceptions about the adverse effects. This underscores the need to involve men in FP programmes.

Discussion on the management of Suspected Unexpected Serious Adverse Reaction reports during clinical trials / 中华医学科研管理杂志

Objective:According to the new GCP regulations issued by national medical products administration, this paper discusses the management mode of Suspected Unexpected Serious Adverse Reaction (SUSAR) reports during clinical trials.Methods:Combined with GCP regulations and working practice, this paper comprehensively analyzes the issues identified and related reasons for the management of SUSAR reports during clinical trials, and propose possible countermeasures.Results:There are some problems in the management of SUSAR reports among different stakeholders during clinical trials, such as defects in the performance of obligations and responsibilities. It is suggested that investigators should be more carefully to fulfill GCP responsibilities; sponsors should be more accurately implement the reporting procedures; institutional and ethical supervision should also be strengthened to assure better conduct of clinical trials.Conclusions:Multi-party collaboration and management mode play crucial roles in conducting high-quality clinical trials.

Practical exploration and research on improving the efficiency of ethical review / 中华医学科研管理杂志

Objective:To solve the dilemma between the traditional ethics review management model and the fast development of biomedical research involving human subject, and to effectively summarize the practical experience to improve the efficiency of ethics review.Methods:A series of measures, such as reorganizing the ethics committee, adjusting the operating procedures of the office and optimizing the process of joint review were reviewed and summarized. The successful experience of relevant measures is systematically shared in practice.Results:The practice proved that these measures effectively guaranteed the fast development of clinical trials and research in our hospital during the past two years.Conclusions:The author hopes to strengthen the discussion and exchange with professionals in the industry through the successful practical experience of our hospital, and contribute to the improvement of the level of ethical management in China.

Application of OTD combined with clinical pathway teaching method in the teaching of nursing standardized training in operating room / 中华医学教育探索杂志

Objective:To explore the application of OTD (observation, teaching and discussion) teaching combined with clinical pathway in nursing standardized training in operating room.Methods:A total of 50 nurses who were trained in the Operating Room of The First Affiliated Hospital of Air Force Medical University from August 2017 to June 2020 were selected and divided into control group and study group according to the rotation order, with 25 nurses in each group. Traditional teaching was used in the control group, and OTD teaching combined with clinical pathway was used in the study group. After the rotation training, the teaching effect was evaluated through the assessment of theoretical knowledge and clinical practice comprehensive ability, teaching satisfaction, and the satisfaction scores of participating surgeons and patients. SPSS 22.0 was used for t-test and chi-square test. Results:The results of theoretical assessment, clinical skill assessment and comprehensive ability assessment of operating room of the rotating nurses in the study group were higher than those in the control group, with significant difference ( P < 0.05). The study group was significantly better than the control group in 8 aspects, including learning initiative, stimulating learning interest, problem-solving ability, communication ability, clinical thinking ability, teamwork ability, critical thinking ability and teaching satisfaction ( P<0.05). The satisfaction scores of doctors [(94.06±2.67) vs. (92.17±2.75)] and patients [(94.90±3.22) vs. (91.25±3.10)] in the study group were significantly higher than those in the control group ( P<0.05). Conclusion:OTD teaching combined with clinical pathway can help to improve the theoretical knowledge, clinical practice comprehensive skills and teaching satisfaction of nursing students in operating room, and then improve the teaching quality.