Formando médicos para el siglo XXI: El rol crucial de la educación basada en competencias / Training physicians for the 21st century: The crucial role of competency-based education

A lo largo de la historia, el campo de la medicina se ha adaptado a las necesidades cambiantes de la sociedad y del sistema sanitario. Ante esa situación, surge la necesidad de plantear la transformación de la formación médica mediante un enfoque basado en las competencias y así definir el perfil de un médico para el siglo XXI. El presente artículo tiene por objetivo analizar y describir el rol de la formación basada en competencias en la formación médica en la preparación de los estudiantes de medicina. Para tal fin, se ha llevado a cabo una exhaustiva revisión bibliográfica en la que se analizan los conceptos clave de la formación médica basada en competencias. Los resultados destacan la importancia de integrar el desarrollo de habilidades en la formación médica teniendo en cuenta los factores sociales y culturales, así como fomentar la reflexión crítica en la formación médica. Se concluye que la educación médica debe adaptarse a las demandas cambiantes del campo, con la participación de diversas partes interesadas y la evolución de los métodos de enseñanza.

Throughout history, the field of medicine has adapted to the changing needs of society and the healthcare system. Faced with this situation, the need arises to consider the transformation of medical education through a competency-based approach and thus define the profile of a physician for the 21st century. The aim of this article is to analyze the role of competency-based training in medical education and its impact on the preparation of medical students. To this end, an exhaustive literature review has been carried out in which the key concepts of competency-based medical education are analyzed. The results highlight the importance of integrating skills development in medical education taking into account social and cultural factors, as well as encouraging critical reflection in medical education. It is concluded that medical education must adapt to the changing demands of the field, involving diverse stakeholders and evolving teaching methods.

Material didáctico para el desarrollo de la competencia comunicativa audio-oral en la educación médica de posgrado

Fundamento: El conocimiento del inglés como el idioma empleado globalmente en diversos sectores, se ha convertido, junto a las tecnologías de la información y las comunicaciones, es una herramienta de formación, trabajo y entretenimiento indispensable; el dominio de este posibilita las relaciones de cooperación e intercambio de profesionales del sector de la salud en varios países. Objetivo: Diseñar un material didáctico para el desarrollo de la competencia comunicativa audio-oral en inglés en estudiantes de posgrado de la carrera de Medicina, mediante el empleo de tecnologías de la información y la comunicación. Metodología: Se realizó una investigación de desarrollo con enfoque mixto en la Universidad de Ciencias Médicas de Holguín durante el período marzo-julio de 2022. Se asumió el método dialéctico materialista como concepción general de la investigación y se emplearon otros del nivel teórico: histórico-lógico, análisis y síntesis e inducción deducción, sistémico-estructural-funcional y revisión documental; empíricos: encuesta, entrevista y observación participativa. Resultados: Las principales dificultades estuvieron relacionadas con el insuficiente tratamiento de la competencia comunicativa audio-oral en inglés, se constató la importancia de la misma dentro del proceso de enseñanza-aprendizaje del inglés, pues establece las pautas generales que se deben seguir para una comunicación efectiva y se instituye desde una mirada holística del acto comunicativo del profesional. Conclusiones: Los especialistas valoraron el material como adecuado por su estructura y factibilidad para su implementación. Después de su aplicación se evidenció su efectividad en la consolidación del aprendizaje en este nivel educacional a través de la preparación idiomática.

Background: Knowledge of English as the language used globally in various sectors, has increasingly become, together with information and communications technologies, an indispensable training, work and entertainment tool in the current era. Its domain enables cooperation relations and exchange of professionals in the health sector in various countries. Objective: To design a didactic material for the development of audio-oral communicative competence in English in postgraduate medical students, through the use of Information and Communication Technologies (ICT). Methods: A development research with a mixed approach was carried out at the Holguín University of Medical Sciences during the period March-July 2022. It was assumed the dialectical materialist method as the general conception of the research and others of the theoretical level: historical- logical, analysis and synthesis and induction deduction, systemic-structural-functional and documentary review; empirical: survey, interview and participatory observation. Results: The main difficulties were related to an insufficient treatment of audio-oral communicative competence in English, it was confirmed its importance within the teaching-learning process of English, since it establishes the general guidelines that must be followed for an effective communication. Moreover, it is instituted from a holistic view of the professional communicative act. Conclusions: The specialists assessed the material as adequate due to its structure and feasibility for its implementation. After its application, it was evidenced its effectiveness in consolidating learning in this educational level through language training.

Desarrollo del inglés oral a través del aprendizaje a distancia y las nuevas tecnologías / Developing oral English through distance learning and new technologies

Fundamento: La enseñanza del idioma inglés constituye una prioridad en la preparación integral de los profesionales de la salud. En las circunstancias actuales la modalidad de educación a distancia es una vía para garantizar la continuidad del proceso docente-educativo en la educación médica superior. Objetivo: Diseñar para su implementación un sistema de tareas docentes que contribuya a desarrollar la habilidad de expresión oral en inglés a través de la educación a distancia en los estudiantes de 2.do año de Medicina. Metodología: Se realizó un estudio experimental en la Universidad de Ciencias Médicas de Holguín durante el período de marzo hasta septiembre de 2021. Se utilizó el método dialéctico materialista como concepción metodológica general de la investigación y se emplearon otros del nivel teórico: análisis y síntesis, inducción-deducción, sistémico-estructural-funcional, histórico-lógico y modelación; empíricos: análisis documental, encuesta, observación de clases, y estadísticos. Resultados: Las principales dificultades estuvieron relacionadas con limitaciones en el tratamiento de la expresión oral en inglés, la insuficiente preparación de los estudiantes en torno a la temática abordada y sus limitaciones en la habilidad de expresión oral en este idioma, por lo que se elaboró un sistema de tareas docentes para solucionar estos aspectos. Conclusiones: Los especialistas valoraron el sistema como adecuado por su estructura y factibilidad de implementación, contribuyó de forma efectiva en la consolidación de la formación cultural y en el plano motivacional.

Background: English language teaching is a priority in the comprehensive preparation of medical professionals. In the current circumstances, distance education is a way to continue the teaching-learning process in higher medical education. Objective: To design for its implementation a system of learning tasks aimed at developing oral expression skills in English through distance education in 2.nd year medical students. Methodology: It was adopted the materialist dialectical method as the general methodological conception of the research, and other methods, from the theoretical level: analysis and synthesis, induction-deduction, systemic-structural-functional, historical-logical and modeling; empirical: documentary analysis, survey, class observation and statistical procedures. Result: The main difficulties were related to the limitations in the treatment of the oral expression in the English language, insufficient preparation of the students on the analyzed topic and their limited ability to develop oral expression in this language, so a system of learning tasks was developed to solve these aspects. Conclusions: The experts considered the system adequate in terms of its structure and feasibility of implementation, contributing effectively to the consolidation of cultural training and at the motivational level.

Analysis of the results of an international proficiency testing program for veterinary drug residue determination in food / 上海预防医学

ObjectiveTo evaluate the proficiency and consistency of domestic and foreign testing institutions in the field of veterinary drug residue detection in food， and to promote international cooperation and mutual recognition of testing results among these institutions. MethodsA robust statistical analysis was conducted on the testing results of 20 laboratories in eight countries and regions across North America， Europe， and Asia. The laboratories’ testing capabilities were evaluated using Z-score comparison. ResultsAmong the 20 participating laboratories， 18 achieved satisfactory results， resulting in a satisfaction rate of 90%， while 2 laboratories （10%） failed to meet the requirements. The satisfaction rate of domestic laboratories （100%） was higher than that of foreign laboratories （81.8%）. ConclusionDomestic laboratories perform better than overseas laboratories in determining veterinary drug residues in food. To enhance testing capabilities， these overseas laboratories with unsatisfactory evaluation results should strengthen their daily quality control and ensure traceability of original records.

La producción oral del idioma inglés en los Licenciados en Enfermería que asisten a cursos de posgrado / The oral production of English language in Bachelors of Nursing that attend to postgraduate courses

Fundamento: La educación posgraduada garantiza la preparación de los egresados universitarios con el propósito de actualizar los conocimientos, habilidades y valores que se necesitan para un mejor ejercicio profesional; con particular atención en la producción oral de los Licenciados en Enfermería mediante cursos de posgrado aspecto que constituye una prioridad para el intercambio cultural, social y la superación científica e investigativa. Objetivo: Determinar el estado de la producción oral del idioma inglés como lengua extranjera en los Licenciados en Enfermería que asisten a cursos de posgrado en la Universidad de Ciencias Médicas de Sancti Spíritus. Metodología: La investigación fue aplicada en el curso 2019-2020 en la Universidad de Ciencias Médicas de Sancti Spíritus; en ella se utilizó un enfoque predominantemente cualitativo para comprender los hechos y fenómenos en los diferentes contextos de actuación en los que estos tuvieron lugar. Se emplearon métodos del nivel teórico como el analítico-sintético, inductivo-deductivo, de lo abstracto a lo concreto y del nivel empírico el análisis de documentos, observación participante y entrevista en profundidad. Resultados: Los Licenciados en Enfermería que asistieron a cursos de posgrado presentaron dificultades en la producción oral, las cuales se evidenciaron en errores gramaticales, escaso vocabulario para comentar sobre situaciones propias de la realidad, dificultades en la fluidez observadas estas en repeticiones innecesarias, uso de muletillas y arrancadas en falso, elementos que afectan la comunicación. Conclusiones: El estudio comprobó las dificultades de los Licenciados en Enfermería en la producción oral, aspecto que se le debe buscar solución desde el punto de vista científico e investigativo.

Background: Postgraduate education guarantees the preparation of professionals with the purpose of completing and to upgrade their knowledge, abilities and values, needed for a better professional performance. In this investigation with a particular attention to the English oral production of Bachelors of Nursing by means of postgraduate courses that constitutes a priority for the cultural and social exchange and the scientific and investigative improvement. Objective: To determine the state of the oral production of English as a foreign language in Bachelors of Nursing that attend to postgraduate courses at the Medical University of Sancti Spíritus. Methodology: The investigation was developed in 2019 - 2020 course, in Sancti Spíritus Medical University; a qualitative study was used, to reach an understanding the phenomena and facts, according to the contexts, with the application of theoretical methods like analytical-synthetic, inductive-deductive, from the abstract to the concrete and empirical methods such as, document analysis, observation and interview. Results: Bachelors of Nursing that attend to postgraduate courses exhibit difficulties in the oral production of English evidenced on: grammatical mistakes, lack of vocabulary to comment about some communicative situations and difficulties in fluency appreciable by unnecessary repetitions that affect communication. Conclusions: The study showed the Bachelors of Nursing difficulties in the oral production of English, aspect that should be strengthened and individualized and urges the necessity of looking for solution to this problem from the scientific and investigative point of view.

Inter-laboratory testing as a strategy for external quality assessment for qualitative detection of SARS-CoV-2 by real-time RT-PCR testing in India

To implement the strategy of test, track and treat to tackle the ongoing COVID-19 pandemic, the number of real-time RT-PCR–based testing laboratories was increased for diagnosis of SARS-CoV-2 in the country. To ensure reliability of the laboratory results, the Indian Council of Medical Research initiated external quality assessment (EQA) by deploying inter-laboratory quality control (ILQC) activity for these laboratories by nominating 34 quality control (QC) laboratories. This report presents the results of this activity for a period of September 2020 till November 2020. A total of 597 laboratories participated in this activity and 86 per cent of these scored ?90 per cent concordance with QC laboratories. This ILQC activity showcased India’s preparedness in quality diagnosis of SARS-CoV-2.

Construction and improvement of lab automation system in emergency lab / 中华检验医学杂志

Objective:By exploring a construction and improvement system for total lab automation in emergency lab, this work aims to improve the success rates of project implementation and the effective utilization of medical resources.Methods:Firstly, clarify the short board of current solution and determine the configuration of the TLA solution which include the number of pre-analytic, post-analytic modules and analyzers by workflow and data analysis which based on the data from 16th to 22nd September 2019. Secondly, define the basic principles and design the optional solutions. Thirdly, determine the final solution based on the simulation results. Fourthly, evaluate the effectiveness of the solution by comparing the turnaroud time (TAT) before and after implementation.Result:We upgrade the system to improve the automation level of the track by add 1 online centrifuge module and upgrade the capacity of online storage module from 9 000 samples to 15 000 samples, and increase the throughput of the clinical chemistry analyzers form 2 500 tests/h to 5 400 tests/h and immunoassay analyzers from 668 tests/h to 1 320 tests/h with no more space. The 95th percentile TAT (from sample check in to validation) have 33% reduction on the premise of 9% increase on the workload of clinical chemistry and immunoassay, and it is highly consistent with the results obtained by data simulation whose 95th percentile TAT is 67 min.Conclusion:Good uasge of workflow and data analysis in the stage of solution design can help to ensure that the result can meet the expectations of the clinicians and effective utilization of medical resources.

Proficiency testing for determination of photometric method of bacterial endotoxin / 中国药理学通报

Aim To design and implement the bacteri¬al endotoxin test proficiency testing plan to evaluate the laboratory's ability and level to determine bacterial en¬dotoxin. Methods According to the Chinese Pharma-copoeia (2015 edition, Vol IV) -1143 Bacterial Endo¬toxin Test-Photometric Method ( Method 2 ) , each la¬boratory used any of these methods to determine the endotoxin content of the sample to be tested. The stati- stical software JMP13 was used for statistical analysis of the feedback results of the participating laboratories. The consensus value of the participants, namely the ro¬bust average value of the effective test results of all the participating laboratories, was used as the assigned value X of the endotoxin content of the samples to be tested in the proficiency testing of the round. The re¬sults of participating laboratories were evaluated ac¬cording to the following criteria: (1) the laboratory test results were within 50% to 200% of the assigned value of the sample, which was evaluated satisfactory; ( 2 ) the laboratory test results were not within the 50 -200% range of the assigned value of the sample, which was evaluated dissatisfactory. Results A total of laboratories participated in this capacity verification plan, with 45 in the laboratory with satisfactory re¬sults, with a satisfaction of 91. 8% ; There were 4 la¬boratories that received "dissatisfaction" results, all of which were not within the range of 50% -200% of the assigned value of samples, and the dissatisfaction of 8. 2% . Conclusions Most of the participating labora¬tories can accurately detect the bacterial endotoxin con¬tent in the sample to be tested, indicating that the level of bacterial endotoxin detection in our country is gener¬ally good at present.

Sample preparation and analysis of proficiency test containing Staphylococcus aureus with drug matrix / 上海预防医学

Objective To prepare samples of proficiency testing （PT） containing live Staphylococcus aureus with drug matrix in microbial PT program of drug testing， and to evaluate the laboratory capability of microbiology tests in China. Methods Two kinds of PT samples containing living bacteria with drug matrix were prepared and evaluated. The results of laboratories participated in PT program and their response to the survey questionnaire were collected and analyzed. Results The homogeneity and stability of the PT samples complied with the requirements of CNAS-CL03： 2010. Samples could be stored stably for at least 6 months at -20 ℃. Among 63 laboratories participating in PT program， 53 laboratories （84.1%） achieved satisfactory results. The satisfaction rate was 94.1% （16/17） in 17 government laboratories （27.0% of total 63 laboratories）， 81.4% （35/43） in 43 pharmaceutical quality control laboratories （68.3% of total 63 laboratories）， and 66.7% （2/3） in 3 non-government laboratories （4.8% of total 63 laboratories）， respectively. Conclusion The government laboratories performed better than pharmaceutical quality control laboratories in microbiology tests of drug， and the testing abilities of some pharmaceutical laboratories needs to be improved. The preparation and application of microbial samples in drug matrix could provide evaluation tools for drug testing laboratories in microbiology.

Sample preparation and analysis of proficiency test containing Staphylococcus aureus with drug matrix / 上海预防医学

Objective To prepare samples of proficiency testing （PT） containing live Staphylococcus aureus with drug matrix in microbial PT program of drug testing， and to evaluate the laboratory capability of microbiology tests in China. Methods Two kinds of PT samples containing living bacteria with drug matrix were prepared and evaluated. The results of laboratories participated in PT program and their response to the survey questionnaire were collected and analyzed. Results The homogeneity and stability of the PT samples complied with the requirements of CNAS-CL03： 2010. Samples could be stored stably for at least 6 months at -20 ℃. Among 63 laboratories participating in PT program， 53 laboratories （84.1%） achieved satisfactory results. The satisfaction rate was 94.1% （16/17） in 17 government laboratories （27.0% of total 63 laboratories）， 81.4% （35/43） in 43 pharmaceutical quality control laboratories （68.3% of total 63 laboratories）， and 66.7% （2/3） in 3 non-government laboratories （4.8% of total 63 laboratories）， respectively. Conclusion The government laboratories performed better than pharmaceutical quality control laboratories in microbiology tests of drug， and the testing abilities of some pharmaceutical laboratories needs to be improved. The preparation and application of microbial samples in drug matrix could provide evaluation tools for drug testing laboratories in microbiology.

Preparation and application of proficiency testing sample of myclobutanil and procymidone in apple powder / 上海预防医学

ObjectiveTo prepare pesticide residues in fruit matrix samples that meet the requirements of homogeneity and stability for the proficiency test. MethodsThe pollution-free apple was selected as the main raw material to prepare the pesticide residue proficiency test samples of myclobutanil and procymidone， and to evaluate the homogeneity and stability. The results of the proficiency test were assessed using robust analysis and Ζ value. ResultsThe homogeneity and stability of the reference materials met the relevant requirements. Among 109 laboratories participated in the proficiency testing， 107 （98.2%） laboratories had satisfactory results. Suspicious test results were reported only in two laboratories， one laboratory for each of the two assessment items. ConclusionAn apple powder matrix sample with pesticide residues is successfully prepared for proficiency test， and could provide an evaluation tool for pesticide residue testing laboratories.

Effectiveness of the National Quality Control Program in Mycology of Argentina and performance evaluation of participating laboratorios / Efectividad del Programa Nacional de Control de Calidad en Micología de Argentina y evaluación del desempeño de los laboratorios participantes

Abstract The National Quality Control Program in Mycology (PNCCM) of Argentina was establishedin 1996 to improve the quality of the mycological diagnosis, to help establish and to setup standardized procedures and continuous training of laboratory staff. The aim of this studywas to assess the effectiveness of the PNCCM in the 1996---2018 period. Data from the NationalMycology Laboratory Network (NMLN) and PNCCM database was used to estimate the increasein the number of controlled laboratories and jurisdictions, the percentage of participation, theimprovement in the quality of results and the adherence to the program. Satisfaction surveyswere performed to assess user satisfaction. The number of controlled laboratories increasedfrom 29 to 146; participation increased from 49% to 93% and general adherence was 72% inthe evaluated period (1996---2018). Improvement in the quality of the results was 15% for lowcomplexity samples; 7% for intermediate complexity samples and 14% for the identification ofhigh complexity strains. Up to 84% of the users consider the PNCCM to be ''very good'' and 16%''satisfactory''. These results show the importance of the PNCCM, which is widely accepted bymycological diagnostic laboratories from Argentina.

Resumen En 1996 se creó el Programa Nacional de Control de Calidad en Micología (PNCCM)de Argentina con el objetivo de mejorar la calidad del diagnóstico micológico, colaborar enel establecimiento de procedimientos estandarizados en aquellos laboratorios que carecen deellos y contribuir a la capacitación continua del personal.El objetivo de este estudio fue evaluar la efectividad del PNCCM en el período 1996-2018.Se utilizaron los datos de la base de la Red Nacional de Laboratorios de Micología (RNLM) ydel PNCCM para estimar el aumento en el número de laboratorios controlados y el porcentajede participación, la mejora de la calidad de los resultados y la adhesión al programa. Paraevaluar el grado de satisfacción de los usuarios, se analizaron las encuestas de satisfacción delos participantes. En el período evaluado, el número de laboratorios controlados aumentó de 29a 146, la participación aumentó de 49% a 93% y la adherencia general de los participantes fue del72%. La mejora de la calidad de los resultados de los laboratorios fue del 15% para muestras debaja complejidad, 7% para muestras de complejidad intermedia y 14% para la identificación decepas de alta complejidad. El 84% de los usuarios considera que el PNCCM es muy bueno y el 16%que es satisfactorio. Estos resultados evidencian la importancia del PNCCM, que es ampliamenteaceptado por los laboratorios que realizan diagnóstico micológico en nuestro país.

Study on Proficiency Testing of Determination Potassium in Serum / 中国医疗器械杂志

OBJECTIVE@#To evaluate the capacity of laboratories participated in the proficiency testing (PT) of determination potassium in serum and improve the quality of testing, and put forward technical suggestions for unsatisfied laboratories.@*METHODS@#According to the requirements of CNAS related documents, the homogeneity and stability of the real PT sample were evaluated by one-way ANOVA and t test, respectively. The values of real PT samples were assigned by reference method which was used in PT results assay. It is required that the deviation of value of real PT samples (code:2, 3, 5) between the measured value and the assigned value shall be within ±15.0%. The precision of values for all samples should not be greater than 3.0%.@*RESULTS@#All the laboratories submitted valid data according to the requirements. Only one laboratory did not meet the requirements, and the satisfaction rate was 90.9%.@*CONCLUSIONS@#The ability of most of laboratories are accurate and reliable.

Analysis of proficiency test for determination of manganese in drinking water in Shaanxi Province / 公共卫生与预防医学

Objective To understand and improve the laboratory detection capacity of water manganese in testing organizations of Shaanxi Province． Methods The self-made manganese capacity testing samples were used as the reference in this proficiency testing program. The homogeneity of the samples was tested by single factor analysis of variance. The t-test method was used to evaluate the stability of the samples. The results of manganese in water provided by participant laboratories were analyzed by the robust statistical technique Z-score. Results A total of 136 laboratories participated in the proficiency testing program throughout the province. Among them, 129 laboratories (including retest laboratory) or 94.85% of total participating laboratories obtained satisfactory results. Conclusion The water quality monitoring agencies of our province had shown a strong detection capability for the determination of metal elements in drinking water, which ensures to provide safe water supply to the residents in Shaanxi Province.

Elaboration of reference material for cadmium and arsenic in hydrobiological products, for the purpose of being used in a laboratory intercomparation program / Elaboración de un material de referencia para cadmio y arsénico en productos hidrobiológicos, para propósito de ser utilizado en un programa de intercomparación de laboratorios

Reference materials (RM) are tools used in the comparability and traceability of measurements. They are widely used by laboratories for method validation and quality control of assay. Chile must evaluate theperformance of laboratories that analyzing metals in fishery products, despite RM have high prices and are scarce. For that reason, a RM in a hydrobiological product was developed. Reference values for arsenic and cadmium elements for a fishmeal were assigned. The measurement methods for characterization of the material were Inductively Coupled Plasma Mass Spectrometry, Atomic Absorption Spectrometry and Neutron Activation Analysis. Reference values with their expanded uncertainty (U) were established for arsenic 2.64 ± 0.42 mg/kg (U; k = 2) and for cadmium 0.86 ± 0.16 mg/kg (U; k = 2). Homogeneity and stability of the RM allowed its use in a proficiency test for eleven food control laboratories. Results for median were 2.114 mg/kg for arsenic, and 0.863 mg/kg for cadmium. The performance values of the participants were evaluated with a z score obtaining 60% satisfaction for arsenic and 73% for cadmium.The material demonstrated to be suitable for use in interlaboratory proficiency assay. (AU)

Materiales de referencia (MR) son herramientas utilizadas en la comparabilidad y trazabilidad entre mediciones. Laboratorios los utilizan ampliamente en validación de métodos y control de calidad. Chile debe evaluar el desempeño de los laboratorios que analizan metales en productos pesqueros, a pesar de los altos precios y escasez del MR. Por esa razón, se desarrolló un MR en producto hidrobiológico. Se asignaron valores de referencia para arsénico y cadmio en harina de pescado. Los métodos de medición para la caracterización del material fueron Espectrometría de Masas de Plasma Acoplado Inductivamente, Espectrometría de Absorción Atómica y Análisis de Activación de Neutrones. Se establecieron valores de referencia con su incertidumbre (U) para arsénico 2.64 ± 0.42 mg/kg (U; k = 2) y para cadmio 0.86 ± 0.16 mg/kg (U; k = 2). La homogeneidad y estabilidad del MR permitieron su uso en una prueba de aptitud para once laboratorios de control de alimentos. Las medianas fueron 2,114 mg/kg para arsénico y 0,863 mg/kg para cadmio. Se evaluaron los rendimientos de los participantes con un estadístico de puntaje z satisfactorio del 60% para el arsénico y 73% para el cadmio. El material demostró ser adecuado para uso en ensayo de aptitud de intercomparación. (AU)

Percentile curves for Brazilian children evaluated with the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition / Curvas percentílicas para crianças brasileiras avaliadas pelo Teste de Proficiência Motora Bruininks-Oseretsky, 2ª edição

Abstract This study aimed to (1) create percentile curves and norms for the eight subtests of the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2) for 6- to 10-year-old Brazilian children and to (2) compare them to the values of the original test manual. To that, we tested a sample of 931 Brazilian children (477 girls, 454 boys) with ages between 6 to 10 with the BOT-2 assessment. The LMS method was used to generate the percentile curves and normative values, with the LMSchartmaker Pro software version 2.54. Results demonstrate that girls had significantly higher scores for the fine motor precision, fine motor integration, manual dexterity and balance subtests, while boys had significantly higher scores on upper-limb coordination, running speed and agility, and the strength subtests. The findings also indicated higher values for the Brazilian group in the subtests of bilateral coordination, running speed and agility, balance, and upper-limb coordination when compared to the North American normative sample. The percentile curves illustrate the increase in motor proficiency levels as age increases, with different trajectories for each subtest. Future studies should continue the investigation of cultural norms and appropriate assessments for the Brazilian population. Here, the creation of percentile curves and norms that are better suited for the Brazilian population can significantly help with assessment and intervention for motor development in distinct settings and with typical and atypical school-age children.

Resumo Este estudo objetivou (1) criar curvas e normas percentílicas para os oito subtestes do Teste de Proficiência Motora Bruininks-Oseretsky, 2ª edição (BOT-2) para crianças brasileiras de 6 a 10 anos e compará-las com os valores do manual de teste original. Para tanto, testamos uma amostra de 931 crianças brasileiras (477 meninas, 454 meninos) com idades entre 6 a 10 anos com a avaliação do BOT-2. O método LMS foi usado para gerar as curvas de percentil e valores normativos, utilizando o software LMSchartmaker Pro versão 2.54. Os resultados demonstram que as meninas tiveram escores significativamente mais altos nos subtestes de precisão motora fina, integração motora fina, destreza manual e equilíbrio, enquanto os meninos tiveram escores significativamente mais altos nos subtestes de coordenação de membros superiores, velocidade de corrida e agilidade e força. Os resultados também indicaram valores mais elevados para o grupo brasileiro nos subtestes de coordenação bilateral, corrida de velocidade e agilidade, equilíbrio e coordenação dos membros superiores quando comparados com a amostra normativa norte-americana. As curvas percentílicas ilustram o aumento nos níveis de proficiência motora à medida que a idade aumenta, com diferentes trajetórias para cada subteste. Estudos futuros devem continuar a investigação de normas culturais e avaliações apropriadas para a população brasileira. Neste estudo, a criação de curvas e normas percentílicas mais adequadas para a população brasileira pode ajudar significativamente na avaliação e intervenção para o desenvolvimento motor em diferentes contextos e com crianças em idade escolar típicas e atípicas.

Development and reproducibility of an instrument to assess behavioral and environmental aspects related to cyclist safety / Desenvolvimento e reprodutibilidade de um instrumento para avaliar aspectos comportamentais e ambientais relacionados à segurança do ciclista

Abstract In urgency and emergency services, the bicycle is the second means of transportation more widely used by the victims at the time of the accident. However, aspects associated with major and minor accidents are poorly understood. The aim was to develop an instrument and test its reproducibility, in order to evaluate behavioral and environmental aspects related to cyclist safety. The instrument was based on footage taken through a camera attached to the cyclist helmet and from a review of literature. Take part in the study academics that used the bicycle to travel at least once a week. Participants were instructed to indicate any safety-critical events on their way and situations of minor gravity based on the perception of real imminence of an accident. In order to identify aspects related to cyclist safety, the routes were divided in periods of 30 seconds. In order to test inter-rater reproducibility, two researchers received theoretical-practical training and performed the instrument in a sample of 100 periods. In order to evaluate the intra-rater reproducibility, one of the evaluators performed a second application after 07 days. The reproducibility of the categorical variables of the instrument were tested through general agreement and Kappa index. For the variables with continuous measuring range, the Intraclass Correlation Coefficient (ICC) was used. The percentage agreement varied between 88-100% and the Kappa values varied ​​between 0.76-1.00. The ICC values ​​ranged from 0.96-0.99. The developed instrument presents adequate reproducibility for use in research to evaluate the cyclist safety in urban contexts.

Resumo Em serviços de urgência e emergência a bicicleta é o segundo meio de locomoção mais utilizado pelas vítimas na hora do acidente. No entanto, os aspectos associados aos acidentes de maior e menor gravidade são pouco conhecidos. O objetivo deste trabalho foi desenvolver e testar a reprodutibilidade de um instrumento para avaliar aspectos comportamentais e ambientais relacionados à segurança de ciclistas. O instrumento foi baseado em filmagens realizadas através de câmera acoplada no capacete e a partir de revisão de literatura. Participaram do estudo universitários que utilizavam a bicicleta para deslocamento ao menos um dia por semana, foram orientados a indicar no trajeto eventos críticos, situações de menor gravidade baseadas na percepção de iminência real de acidente. Para identificar os aspectos relacionados à segurança, os trajetos foram fracionados em períodos de 30 segundos. Para testar a reprodutibilidade interavaliador dois pesquisadores receberam treinamento teórico-prático e realizaram a aplicação do instrumento em uma mostra de 100 períodos. Para avaliar a reprodutibilidade intra-avaliador, um dos avaliadores realizou uma segunda aplicação após 07 dias. A reprodutibilidade das variáveis categóricas do instrumento foi testada através da concordância geral e índice Kappa. Para as variáveis com escala de medida contínua foi utilizado o coeficiente de correlação intraclasse. Os percentuais de concordância variaram entre 88, e 100% e os valores de Kappa entre 0,76 e 1,00. Os valores de CCI variaram entre 0,96 e 0,99. O instrumento desenvolvido apresenta reprodutibilidade adequada para o emprego em pesquisas para avaliação da segurança de ciclistas em contextos urbanos.

Motor skills assessments: support for a general motor factor for the Movement Assessment Battery for Children-2 and the Bruininks-Oseretsky Test of Motor Proficiency-2 / Avaliação de habilidades motoras: suporte a um fator motor geral para o Movement Assessment Battery for Children-2 e o Bruininks-Oseretsky Test of Motor Proficiency-2

Abstract Objective To evaluate the construct validity and model-based reliability of general and specific contributions of the subscales of the Movement Assessment Battery for Children-2 (MABC-2) and Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) when evaluating motor skills across a range of psychiatric disorders. Methods Confirmatory factor analysis (CFA) and bifactor analysis were conducted on BOT-2 data from 187 elementary school students (grades 1 to 6) (mean age: 113 ± 20 months; boys: n = 117, 62.56%) and on MABC-2 data from 127 elementary school students (grade 1) (mean age: 76 ± 2 months; boys: n = 58, 45.67%). Results The results of the CFA fit the data for multidimensionality for the BOT-2 and presented poor fit indices for the MABC-2. For both tests, the bifactor model showed that the reliability of the subscales was poor. Conclusions The BOT-2 exhibited factorial validity with a multidimensional structure among the current samples, but the MABC-2 showed poor fit indices, insufficient to confirm its multidimensional structure. For both tests, most of the reliable variance came from a general motor factor (M-factor), therefore the scoring and reporting of subscale scores were not justified for both tests.

Resumo Objetivo Avaliar a validade de construto e a confiabilidade das subescalas do Movement Assessment Battery for Children-2 (MABC-2) e do Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) com base em modelos das contribuições gerais e específicas ao avaliar habilidades motoras em transtornos psiquiátricos. Métodos Foram realizadas análise fatorial confirmatória (AFC) e análise bifatorial em dados de 187 escolares do primeiro ao sexto ano do ensino fundamental (idade média: 113 ± 20 meses; meninos: n = 117, 62,56%) que foram avaliados com o BOT-2, e em dados de 127 escolares do primeiro ano do ensino fundamental (idade média: 76 ± 2 meses; meninos: n = 58, 45,67%) avaliados com o MABC-2. Resultados Os resultados da AFC apresentaram índices de ajuste satisfatórios de multidimensionalidade para o BOT-2 e apresentaram índices de ajuste insatisfatórios para o MABC-2. Para ambos os testes, o modelo bifatorial mostrou que a confiabilidade das subescalas era ruim. Conclusão O BOT-2 apresentou validade fatorial com uma estrutura multidimensional entre as amostras utilizadas, mas o MABC-2 apresentou índices de ajuste insatisfatórios, insuficientes para confirmar sua estrutura multidimensional. Para ambos os testes, a maior parte da variância confiável veio de um fator motor geral (fator-M), portanto, a pontuação e o relato dos escores das subescalas não se justificaram para ambos os testes.

Annual Report of the Korean Association of External Quality Assessment Service on Routine Hematology (2018)

Two trials were conducted with proficiency tests for complete blood cell count (CBC) and blood cell morphology as part of the 2018 Routine Hematology Program of the Korean Association of External Quality Assessment Service. Three different control samples were sent for CBC testing and two blood cell morphology pictures were posted on the laboratory website during each trial. The mean response rates of the 1,719 participating laboratories were 97.4% and 37.2% for CBC and blood cell morphology, respectively. The distribution of equipment for CBC testing was comparable to that of the previous year. The coefficient of variation (CV) ranges were determined as 3.5%–4.1%, 1.9%–2.7%, 1.4%–2.8%, 4.5%–5.3%, and 5.4%–6.9% for white blood cell counts, red blood cell counts, hemoglobin, hematocrit, and platelet counts, respectively. The concordance rate ranged from 83.0% to 97.5% in blood cell morphology tests. We observed a continuous increase in the number of participating laboratories and a trend towards a decrease in the CVs of platelet counts compared to those in 2016. Values of the other assessed parameters were similar to those of the previous year.

Accuracy-Based Proficiency Testing of Creatinine Measurement: 7 Years' Experience in Korea

BACKGROUND: Standardization of creatinine assay is consistently performed and much effort has been put into improving the accuracy of the results. We aimed to analyze the results of accuracy-based proficiency testing of creatinine assays performed by the Korea Association of External Quality Assessment Service from 2011 to 2017 to assess the current state of creatinine assays in Korea. METHODS: From 2011 to 2017, the accuracy-based proficiency testing of creatinine was performed twice a year. We analyzed the results obtained from the participating laboratories and calculated the year-wise bias. The acceptable limit of bias was as follows: ±11.4% for creatinine concentration >1.0 mg/dL, and 0.114 mg/dL for creatinine concentration ≤1.0 mg/dL. The trend of bias with the major instruments and reagent manufacturers were analyzed. RESULTS: The number of participating laboratories was 54 in 2011, which gradually increased to 146–178 after 2015. For each of the three samples used in the survey, the percentage of laboratories whose biases in the results were within the acceptable limits was 33.3% for the first time in 2011, which gradually increased to 74.7%–85.0% after 2014. The mean biases in all the results of the participating laboratories were 11.1% in 2011 (1st trial) and 2.4% in 2017 (2nd trial). The biases in the results with the major instruments and reagents differed according to the manufacturers. CONCLUSIONS: The mean bias in the results obtained from the participating laboratories in the accuracy-based proficiency testing of creatinine surveys showed a decreasing trend.