Wiki educativa para la Clínica Virtual de Salud de Santiago de Cuba

El programa de las tecnologías de la información y las comunicaciones se ha implementado en todas las instituciones pertenecientes al sector de la salud en Cuba, pues favorece la formación a través de los entornos de enseñanza y aprendizaje en función del desarrollo y las perspectivas académicas, mediante plataformas tecnológicas para facilitar el intercambio de información. En el presente artículo se destaca la necesidad de incrementar el uso de la wiki como herramienta educativa, que favorece el aprendizaje colaborativo como un proceso de creación de conocimiento a través de la web 2.0, donde no solo se publican contenidos sino que contribuye a desarrollar habilidades de cooperación en los procesos formativos de la salud pública.

The program of information and communications technologies has been implemented in all the institutions belonging to the health sector in Cuba, because it favors the training through the teaching and learning environments in function of development and academic perspectives, by means of technological platforms to facilitate the exchange of information. In this work the necessity to increase the wiki use as educational tool in enhanced, that favors the collaborative learning as a process of knowledge creation through the web 2.0, where contents are not only published but also contributes to develop cooperation abilities in the training processes of public health.

Challenges Faced by "Young" Ethics Committees under the Mode of Collaborative Review / 中国医学伦理学

In the process of exploring standardized and efficient ethical review models for multi-center drug clinical trials, the ethical review alliance emerged as the times require. Compared with mature ethics committees, higher requirements have been put forward for the "young" ethics committees. By analyzing problems existing in review work of "young" ethics committees in the ethics review alliance, this paper discussed the measures to improve the review quality of "young" ethics committees and promote the standardized and efficient operation of the alliance, and put forward countermeasures and suggestions for improving the homogenization of ethics review and accelerating the clinical research process of innovative drugs.

Science and Technology Ethics Governance, How to Put Ethics First? / 中国医学伦理学

Science and technology ethics governance, how to put ethics first? The purpose of "technological innovation, ethics first" is to build an ethical soft landing mechanism for scientific and technological innovation. Researchers of science and technology ethics should start from the practice of international and domestic science and technology ethics governance, and explore the realistic way of science and technology ethics governance on the basis of understanding and thinking about the innovative culture, value orientation and operation mechanism. First of all, it should be noted that seeking technical, management and institutional solutions in the current ethical governance of science and technology may not be perfect and thorough, but operable management measures can be explored and continuously improved under the framework of mainstream scientific and technological innovation. Secondly, the co-governance of science and technology ethics needs to further explore the corresponding group co-governance epistemology facing pluralistic co-governance. Finally, the ethical governance of science and technology should pay attention to the principle of proportionality, and avoid both lax and being too strict.

Research on the Communication Path of Traditional Chinese Medicine Culture from the Perspective of Industry-University-Research Collaborative Innovation / 中国医学伦理学

Traditional Chinese Medicine (TCM) is an indispensable carrier of traditional culture for China to embrace the world. During the 14th Five-Year Plan period, the state proposed to "comprehensively promote the building of a healthy China, attach equal importance to TCM and western medicine, and vigorously develop the cultural industry of TCM". Promoting the development of TCM cultural industry needs scientific and innovative approaches. This paper explored how to realize the communication path of TCM culture from the perspective of "Industry-University-Research". Based on the analysis of the current situation of TCM culture communication, taking Shandong University of Traditional Chinese Medicine as an example, this paper integrated technology, human resources, resources, environment and information and other collaborative innovation elements to effectively gather, and explored a new way for the collaborative development of TCM communication with enterprises, schools, scientific research institutions and et al, aiming to further help TCM culture go abroad.

The Conjunction Logic of Collaborative Education between Medical Humanities Courses and Ideological and Political Courses / 中国医学伦理学

It is a new requirement of the new era that medical humanities courses and ideological and political courses should go together with each other. There is an inherent logic in the collaborative education of the two courses, which has the consistency of ideas, the commonality of goals, the intersection of contents and the mutual learning of methods. In practice, it is necessary to combine education with talent, theory with practice, indoctrination with penetration, online with offline, so as to improve the effectiveness of collaborative education between medical humanities courses and ideological and political courses.

Factors associated with interprofessional collaboration in Primary Health Care: a multilevel analysis / Fatores associados à colaboração interprofissional na Atenção Primária à Saúde: uma análise multinível

Abstract Working with an interprofessional focus is increasingly necessary, in view of the growing complexity of the population's health needs. This study aims to assess interprofessional collaboration and the teamwork climate in primary health care (PHC) and determine whether there is a relationship between these two variables. The AITCS-II instrument was used to measure interprofessional collaboration, while to diagnose teamwork climate, the ECTE instrument was used, a version adapted to the SUS context of the Teamwork Climate Inventory instrument. These two instruments were applied online together with a questionnaire for the sociodemographic characterization of the 544 participants, who belonged to 97 Family Health Strategy (FHS) teams in a Brazilian municipality. The obtained data were submitted to a multilevel analysis. A positive correlation was observed between interprofessional collaboration and three of the four teamwork climate factors. The better the work climate, the better the interprofessional collaboration in the corresponding team, and this characteristic stands out in relation to other individual analyzed characteristics.

Resumo Trabalhar com foco interprofissional é cada vez mais necessário, tendo em vista a crescente complexidade das necessidades de saúde da população. Este estudo tem como objetivo avaliar a colaboração interprofissional e o clima de trabalho em equipe na atenção primária à saúde (APS) e verificar possível relação entre estas duas variáveis. Para mensurar a colaboração interprofissional foi utilizado o instrumento AITCS-II, enquanto para o diagnóstico do clima de trabalho em equipe foi utilizado o instrumento ECTE, versão adaptada para o contexto SUS do instrumento Teamwork Climate Inventory. Esses dois instrumentos foram aplicados on-line juntamente com um questionário para caracterização sociodemográfica dos 544 participantes, pertencentes a 97 equipes da Estratégia Saúde da Família (ESF) de um município brasileiro. Os dados obtidos foram submetidos a uma análise multinível. Foi observada uma correlação positiva entre a colaboração interprofissional e três dos quatro fatores do clima de trabalho em equipe. Quanto melhor o clima de trabalho, melhor a colaboração interprofissional na equipe correspondente, e essa característica se destaca em relação às demais características individuais analisadas.

A contribuição da Ergonomia para a segurança no trabalho / Ergonomics contribution to occupational safety

Resumo Introdução: processos de alto risco com elevadas taxas de acidentes desafiam a segurança. Por outro lado, sistemas ultrasseguros conquistaram ótimos indicadores. Em ambos, a prevenção parece ter chegado a um limite - em um deles, porque parece impotente para gerar prevenção; no outro, porque foi tão bem-sucedida que parece impossível avançar. Objetivo: evidenciar a contribuição da Ergonomia em prol da segurança, nas situações descritas, suas possibilidades ainda por explorar, entre elas a Ergonomia de concepção na integração homem-máquina (sistemas informatizados). Método: análise comparativa dos achados oriundos de estudos ergonômicos em sistemas de produção com altas taxas de acidentes e sistemas ultrasseguros. Discussão: a análise da atividade dos motofretistas mostrou que existem alternativas de ação ainda não exploradas entre as relações de trabalho desfavoráveis e a percepção de inevitabilidade dos acidentes. Nos sistemas ultrasseguros, o aparente limite pode ser superado com os avanços recentes na análise da ação e cognição situadas e na construção de espaços de debate que permitam o retorno da experiência de campo. Em sistemas informatizados, as práticas de projeto colaborativo, que se valem da experiência dos trabalhadores para alimentar as dinâmicas de aprendizagem e a confiabilidade técnica, são possibilidades ainda pouco praticadas na Engenharia de Segurança.

Abstract Introduction: while high-risk processes with high accident rates challenge safety, High Reliability Organization (HRO) achieve excellent indicators. In both cases, prevention seems to have reached a limit. In the former, because it seems powerless to generate prevention; in the latter, because it has been so successful that it seems impossible to reach greater levels. Objective: to highlight the contribution of Ergonomics to safety in these situations, pointing out unexplored possibilities such as design Ergonomics in man-machine integration (computerized systems). Method: comparative analysis of findings from ergonomic studies on production systems with high accident rates and HRO. Discussion: analysis of the motorcycle freight drivers' activity revealed alternatives yet to be explored between unfavorable work relations and the perceived inevitability of accidents. The apparent limit of HRO can be overcome with recent advances in the analysis of situated action and cognition and by building debate spaces based on field experience. Collaborative design practices, which draw on worker experience to feed learning dynamics and technical reliability, remains a poorly explored possibility in Safety Engineering when it comes to computerized systems.

Gerenciando paradoxos da estratégia aberta no setor público / Gestión de las paradojas de la estrategia abierta en el sector público / Managing open strategy paradoxes in the public sector

Resumo A chamada "estratégia aberta" preconiza a inclusão de colaboradores de diferentes níveis, bem como de agentes externos e parceiros, no processo de construção da estratégia. Esse movimento de abertura e inclusão também tem avançado no setor público por meio da governança colaborativa, como consequência das mudanças do entendimento do papel do Estado numa forma de gestão que promove a interação entre os atores públicos e privados. O argumento central deste ensaio é que há paradoxos inerentes à estratégia aberta no setor público que precisam ser gerenciados para evitar ou minimizar tensões prejudiciais entre os envolvidos. O artigo adota uma abordagem reflexiva e indutiva, baseada nas perspectivas teóricas tanto da estratégia aberta quanto da governança colaborativa. Como resultado, contribui para o campo de estudos em gestão pública e apresenta proposições teóricas e práticas que indicam caminhos para gerenciamento da estratégia aberta.

Resumen La denominada estrategia abierta aboga por la inclusión de empleados de diferentes niveles, y de agentes y socios externos, en el proceso de construcción de la estrategia. Este movimiento hacia la apertura y la inclusión también ha avanzado en el sector público a través de la gobernanza colaborativa, como consecuencia de cambios en la comprensión del papel del Estado en una forma de gestión que promueve la interacción entre actores públicos y privados. El argumento central de este ensayo es que existen paradojas inherentes al uso de la estrategia abierta en el sector público que deben gestionarse para evitar o minimizar tensiones dañinas entre los involucrados. El ensayo adopta un enfoque reflexivo e inductivo, basado en las perspectivas teóricas tanto de la estrategia abierta como de la gobernanza colaborativa. Como resultado, contribuye al campo de los estudios en gestión pública y presenta propuestas teóricas y prácticas que indican caminos para la gestión de estrategias abiertas.

Abstract The open strategy approach advocates the inclusion of external agents, partners, and employees working at different levels in the strategy construction process. This movement toward openness and inclusion has also advanced in the public sector through collaborative governance. This development is due to changes in understanding the state's role as a promoter of interaction between public and private actors. The central argument of this essay is that there are paradoxes inherent in the use of open strategy in the public sector that need to be managed in order to avoid or minimize damaging tensions between those involved. The essay adopts a reflexive and inductive approach based on the theoretical perspectives of both open strategy and collaborative governance. As a result, it contributes to the field of public management studies and presents theoretical and practical propositions that indicate ways of managing open strategy.

Práticas educacionais colaborativas em saúde mediadas pelas tecnologias da informação e comunicação: uma revisão de literatura / Collaborative educational practices in health mediated by information and communication technologies: a literature review / Prácticas educativas colaborativas en salud mediadas por las tecnologías de la información y comunicación: una revisión de literatura

O objetivo do presente estudo foi identificar elementos estruturantes do processo de trabalho das redes educacionais colaborativas em saúde mediadas por tecnologias de informação e comunicação, assinalando suas características-chave e sua dinâmica de funcionamento. Trata-se de uma revisão de escopo, realiza-da nas bases de dados: Medline, Lilacs e no portal Oasisbr. Foram encontrados 1.499 estudos, dos quais, oito atenderam aos critérios de inclusão. Os resultados da investigação apontam as práticas educacionais colaborativas em saúde mediados por essas tecnologias como processos amplos e complexos, envolvendo a associação de diversos fatores. Destacam-se a dimensão técnico-pedagógica, a gestão estratégica, o gerenciamento do fluxo de informações, os aspectos relacionais, as competências de cada membro e a mediação do processo colaborativo. A integração dos diferentes aspectos da rede traduz um conjunto de desafios para a estruturação dos processos colaborativos que não se limita à pura acumulação cognitiva, mas vincula-se a processos de aprendizagem e desenvolvimento dos sujeitos

The aim of the present study was to identify structural elements of the work process of collaborative educational networks in health, mediated by information and communication technologies, by pointing out its key characteristics and its operating dynamics. This is a scope review, accomplished in the following databases Medline and Lilacs and in the Oasisbr portal. A total of 1.499 studies were found, and eight of them met the inclusion criteria. The search results indicate the collaborative educational practices in health mediated by these technologies as broad and complex processes, involving the association of several factors. The technical-pedagogical dimension, the strategic management, the management of the information flow, the relational aspects, the competencies of each member, and the mediation of the collaborative process are highlighted. The integration of the different aspects of the network translates a set of challenges for the structuring of collaborative processes, which is not limited to pure cognitive accumulation, but is bound to learning processes and to the subjects' development.

El objetivo del presente estudio es identificar elementos estructurantes del proceso de trabajo de las redes educativas colaborativas en salud mediadas por tecnologías de la información y comunicación, señalando sus características claves y su dinámica de funcionamiento. El trabajo presenta una revisión de escopo, realizada en las bases de datos: Medline, Lilacs y en el portal Oasisbr. Fueron encontrados 1.499 estudios, de los cuales ocho cumplieron los criterios de inclusión. Los resultados de la investigación apuntan a las prácticas educativas colaborativas en salud mediadas por estas tecnologías como procesos amplios y com-plejos, que abarcan la asociación de diversos factores. Se destacan la dimensión técnico-pedagógica, la gestión estratégica, el gerenciamiento del flujo de información, los aspectos relacionales, las competencias de cada miembro y la mediación del proceso colaborativo. La integración de los diferentes aspectos de la red traduce un conjunto de desafíos para la estructuración de los procesos colaborativos, que no se limitan a la acumulación cognitiva, sino que se vinculan a los procesos de aprendizaje y desarrollo de los sujetos

Enseñanza de deportes de colaboración y oposición: análisis comparativo entre metodologías comprensivas y modelo tradicional / Collaborative and opposition sports teaching: comparative analysis between comprehensive methodologies and the traditional model / Ensino colaborativo e de oposição do esporte: análise comparativa entre metodologias integrais e o modelo tradicional

El propósito del estudio fue determinar el efecto que produce la aplicación de una unidad de enseñanza de los deportes de colaboración y oposición diseñada en base a dos propuestas del modelo pedagógico comprensivo: el Teaching Games for Understanding y la Didáctica Cognitiva, en comparación a un modelo tradicional de enseñanza. La muestra estuvo conformada por alumnos(as) de 5° a 8° básicos (12 a 14 años). Mediante metodología observacional, fueron evaluadas las principales acciones de juego eficientes en las dimensiones de ataque y defensa, en momentos de test y retest, a un grupo control (GC) y otro experimental (GE). El análisis de varianza (MANOVA) y las comparaciones por pares con corrección de Bonferroni aplicadas con un alfa de 0.05, evidenciaron diferencias significativas entre ambos grupos, de las acciones motoras de lanzamiento en zona eficaz (GE: 74,3% GC: -16,7%) y Pase simple (GE: -27,1% - GC: -3,1%). Mientras que, mediante el análisis descriptivo de las tasas de ocurrencia, se encontraron diferencias de las acciones motoras de Anticipación (GE:211,1% - GC:20%), marcación eficiente (GE: 330,8% - GC: -7,1%) y desmarcación (GE: 400% - GC: 0%). Los hallazgos de ambos análisis muestran que la aplicación de metodologías comprensivas en la enseñanza de los deportes de colaboración y oposición en el contexto de educación física escolar, mejoran la calidad de las acciones de juego, en comparación a un modelo tradicional de enseñanza.

The purpose of the study was to determine the effect produced by the application of a teaching unit for collaborative and oppositional sports designed on the basis of two proposals of the comprehensive pedagogical model: Teaching Games for Understanding and Cognitive Didactics, compared to a traditional teaching model. The sample consisted of students from 5th to 8th grade (12 to 14 years old). By means of observational methodology, the main efficient game actions in the dimensions of attack and defense were evaluated, in test and retest moments, to a control group (CG) and an experimental group (EG). The analysis of variance (MANOVA) and pairwise comparisons with Bonferroni correction applied with an alpha of 0. 05, showed significant differences between both groups in the motor actions of throwing in the effective zone (EG: 74.3% - CG: -16.7%) and simple passing (EG: -27.1% - CG: -3.1%), while descriptive analysis of the occurrence rates showed differences in the anticipation motor actions (EG: 211.1% - CG: 20%), efficient tackling (EG: 330.8% - CG: -7.1%) and untacking (EG: 400% - CG: 0%). The findings of both analyses show that the application of comprehensive methodologies in the teaching of collaborative and oppositional sports in the context of school physical education improves the quality of the game actions, compared to a traditional teaching model.

O objetivo do estudo foi determinar o efeito produzido pela aplicação de uma unidade de ensino de esportes colaborativos e opostos projetada com base em 2 propostas do modelo pedagógico integral: Jogos de ensino para a compreensão e didática cognitiva, em comparação com um modelo de ensino tradicional. A amostra foi composta por alunos da 5ª à 8ª série (12 a 14 anos). Por meio de metodologia observacional, foram avaliadas as principais ações de jogo eficientes nas dimensões de ataque e defesa, nos momentos de teste e reteste, em um grupo controle (GC) e um grupo experimental (GE). A análise de variância (MANOVA) e as comparações por pares com correção de Bonferroni aplicada com alfa de 0,05, mostraram diferenças significativas entre ambos os grupos, das ações motoras de lançamento na zona efetiva (GE: 74,3% GC: -16,7% ) e passe simples (GE: -27,1% - GC: -3,1%). Já pela análise descritiva das taxas de ocorrência, foram encontradas diferenças nas ações motoras de Antecipação (GE: 211,1% - GC: 20%), marcação eficiente (GE: 330,8% - GC: -7,1%) e desmarcação (GE: 400% - GC: 0%). Os resultados de ambas as análises mostram que a aplicação de metodologias abrangentes no ensino de esportes colaborativos e de oposição no contexto da educação física escolar melhora a qualidade das ações de jogo, em comparação com um modelo de ensino tradicional.

FROM CRISIS TO OPPORTUNITY: A DEVELOPING COUNTRY'S EXPERIENCE OF MOTIVATING EFL/ESL TEACHERS IN THE POST-COVID-19 ERA

The COVID-19 pandemic has caused signicant changes in daily life, with many countries implementing quarantines and transitioning to online learning. As the vaccine is not expected to be available before 2021, online learning has become an inevitable option. Despite EFL/ESL teachers expressing favorable attitudes towards online instruction, there is a need to motivate them to return to universities for face-to-face instruction following the pandemic. This research aims to identify the factors that could encourage EFL/ESL teachers to resume traditional classroom instruction in Iranian universities. It is crucial to provide teachers and students with a safe learning environment equipped with the necessary tools and procedures, as their motivation is a key component of successful teaching and learning. The study calls for collaborative efforts from all concerned parties to raise awareness about the importance of boosting motivation to return to universities after the COVID-19 crisis

An adapted collaborative care model to manage co-morbidities of depression and chronic non-communicable diseases in Rwanda

Background The World Health Organization has recommended the implementation of the Collaborative Care Model in all countries to manage the comorbidities of depression and chronic non-communicable diseases. In Rwanda depression is major problem not only among patients with chronic illnesses but also in general population considering the unique history of war and genocide in Rwanda. Purpose The purpose of this paper is to describe the process of adaptation and testing of the Collaborative Care Model in the Rwandan healthcare context. Methods The larger study used the Action Research design with mixed method ­sequential explanatory design. A research-practice partnership method and an iterative process was used to adapt and test the Collaborative Care Model. Qualitative content analysis was used to analyse the data. Results Four structural components to the model were adapted including the addition of a registered nurse to the team, relocation of the model to the district level, consultation with a psychiatrist every 3 months and involvement of community health workers. The evaluation indicated that the model was applicable and acceptable. Conclusions Initial evaluation of the Adapted Collaborative Care Model shows promise in Rwanda. Implementation of this model in other Rwandan districts is warranted.

Learning management systems as a platform for information sharing during the COVID-19

Background:During the outbreak of the deadly respiratory coronavirus disease (COVID-19) in the 2019­2022 period, many South African institutions of higher learning adopted online learning management systems (LMS) to share information and salvage the academic project. This adoption was fraught with challenges including a lack or preparedness, resources and strategy on how to manage change. Objectives: The study examined the challenges faced while using an online LMS as an information sharing platform in academia, specifically in a rural-based university in South Africa during (COVID-19) lockdown period. In addition, the study also explored the state of readiness of the rural-based university to transition to an online LMS. Method: A quantitative research methodology was used to collect data through the administration of a survey to respondents from a rural-based university. The target population for the study was students and academic staff. Results: The study revealed that online learning management provided a collaborative knowledge and information sharing platform. This study established that LMS enabled the university to continue sharing knowledge and interact with their students, staff, and stakeholders to continue to facilitate teaching and learning. Internet connectivity, a lack of preparedness and data costs were cited as key challenges. Conclusion: This study highlighted how an online LMS was used as a collaborative and knowledge sharing platform during a global crisis. Contribution: The study contributes to information and knowledge sharing disciplines to create awareness to authorities on the importance of technology during a crisis.

Cardiopulmonary prognosis of prophylactic endotracheal intubation in patients with upper gastrointestinal bleeding undergoing endoscopy / 世界急诊医学杂志（英文）

@#BACKGROUND: It is controversial whether prophylactic endotracheal intubation (PEI) protects the airway before endoscopy in critically ill patients with upper gastrointestinal bleeding (UGIB). The study aimed to explore the predictive value of PEI for cardiopulmonary outcomes and identify high-risk patients with UGIB undergoing endoscopy. METHODS: Patients undergoing endoscopy for UGIB were retrospectively enrolled in the eICU Collaborative Research Database (eICU-CRD). The composite cardiopulmonary outcomes included aspiration, pneumonia, pulmonary edema, shock or hypotension, cardiac arrest, myocardial infarction, and arrhythmia. The incidence of cardiopulmonary outcomes within 48 h after endoscopy was compared between the PEI and non-PEI groups. Logistic regression analyses and propensity score matching analyses were performed to estimate effects of PEI on cardiopulmonary outcomes. Moreover, restricted cubic spline plots were used to assess for any threshold effects in the association between baseline variables and risk of cardiopulmonary outcomes (yes/no) in the PEI group. RESULTS: A total of 946 patients were divided into the PEI group (108/946, 11.4%) and the non-PEI group (838/946, 88.6%). After propensity score matching, the PEI group (n=50) had a higher incidence of cardiopulmonary outcomes (58.0% vs. 30.3%, P=0.001). PEI was a risk factor for cardiopulmonary outcomes after adjusting for confounders (odds ratio [OR] 3.176, 95% confidence interval [95% CI] 1.567-6.438, P=0.001). The subgroup analysis indicated the similar results. A shock index >0.77 was a predictor for cardiopulmonary outcomes in patients undergoing PEI (P=0.015). The probability of cardiopulmonary outcomes in the PEI group depended on the Charlson Comorbidity Index (OR 1.465, 95% CI 1.079-1.989, P=0.014) and shock index >0.77 (compared with shock index ≤0.77 [OR 2.981, 95% CI 1.186-7.492, P=0.020, AUC=0.764]). CONCLUSION: PEI may be associated with cardiopulmonary outcomes in elderly and critically ill patients with UGIB undergoing endoscopy. Furthermore, a shock index greater than 0.77 could be used as a predictor of a worse prognosis in patients undergoing PEI.

Research on the harmonious driving mechanism of doctors′ collaboration willingness and behavior in the tiered diagnosis and treatment system / 中华医院管理杂志

Objective:To explore the driving mechanisms of doctors′ collaborative willingness and behavior in the tiered diagnosis and treatment system, in order to provide reference for promoting the construction of the tiered diagnosis and treatment system.Methods:Based on the harmonious management theory, a theoretical framework for the driving mechanisms of doctors′ collaborative behavior in the tiered diagnosis and treatment system was developed. Through random sampling, a questionnaire survey was conducted among doctors from 40 medical institutions in five prefecture-level cities in Zhejiang province between April and May 2022. The t-test, variance analysis, and non-parametric tests were employed to analyze the differences in collaborative willingness and behavior among doctors based on various demographic characteristics. The structural equation model and stratified linear regression were used to assess the impact of collaborative factors (professional environment and work expectations) and harmonious factors (perception of policy support and perception of management mechanism) on doctors′ collaboration willingness and behavior. Results:A total of 1 959 doctors participated in the survey. Doctors′ collaborative behavior scored 2.13±1.12, indicating a slightly below-average level, whereas their willingness to collaborate scored 3.88±0.79, falling between neutral and somewhat willing. Significant differences in collaborative behavior scores were observed based on the medical institution′s ranking, age, years of experience, monthly average income, and professional titles ( P<0.05). Both collaborative and harmonious factors directly influenced the doctors′ willingness to collaborate, with standardized path coefficients of 0.428 and 0.139, respectively. Similarly, these factors directly impacted their collaborative behavior, with standardized path coefficients of 0.104 and 0.366. The perceptions of policy support and management mechanisms demonstrated a significant positive moderating effect on the relationship between doctors′ collaborative willingness and behavior, with effect values of 0.047 and 0.043 respectively ( P<0.05). Conclusions:The collaborative and harmonious elements serve as positive drivers for collaboration among doctors in the tiered diagnosis and treatment system at both the cognitive and behavioral levels. Enhancing and optimizing policy support and management mechanisms can facilitate the transition from intention to actual collaborative actions among doctors from different levels of medical institutions.

Discussion on the establishment of regional peacetime and wartime combined emergency hospital from the collaborative governance theory / 中华危重病急救医学

In the context of the prevention and control for coronavirus disease (COVID), public health emergency governance has been incorporated into an important part of the national governance system, and the "combination of peacetime and wartime" has become an important principle of public health emergency governance. Based on the experience of public health emergency management in large cities and the theory of collaborative governance, this study analyzed the problems and obstacles of general hospitals in coping with emerging respiratory infectious diseases. It is proposed to select general hospitals above tertiary level in the region to build peacetime and wartime combined emergency hospital, establish standardized conversion procedures and strengthen the construction of key elements of integrated emergency hospitals, so as to provide new ideas for the construction of emergency medical system "combination of peacetime and wartime" mechanism and improve the "combination of civilian and combat" public health emergency governance system.

Quality analysis of surgical specimens of rectal cancer in the Chinese taTME registry coll-aborative database: a nationwide registered study / 中华消化外科杂志

Objective:To analyze the quality of surgical specimens of rectal cancer in the Chinese transanal total mesorectal excision (taTME) registry collaborative (CTRC) database.Methods:The retrospective and descriptive study was conducted. Based on the concept of real-world research, the clinicopathological data of 1 761 patients with rectal cancer in the CTRC database who underwent taTME in 40 medical centers, including the Beijing Friendship Hospital of Capital Medical University et al, from November 15, 2017 to December 31, 2022 were collected. There were 1 212 males and 549 females, aged 62(range, 53-68)years. Observation indicators: (1) preoperative examinations; (2) neoadjuvant therapy; (3) postoperative examinations. Measurement data with skewed distri-bution were represented as M(range). Count data were described as absolute numbers. Results:(1) Preoperative examinations. Of the 1 761 patients, 1 324 patients underwent preoperative pelvic magnetic resonance imaging examination, and the results showed that 4 cases as clinical T0 stage, 30 cases as clinical T1 stage, 250 cases as clinical T2 stage, 828 cases as clinical T3 stage, 141 cases as clinical T4 stage, 11 cases as clinical Tx stage, 60 cases missing clinical T staging data, 490 cases as clinical N0 stage, 373 cases as clinical N1 stage, 311 cases as clinical N2 stage, 86 cases as clinical Nx stage, 64 cases missing clinical N staging data, 156 cases with mesorectal fascia invasion, 223 cases with extraintestinal blood vessels invasion. The distance from lower margin of tumor to anal margin of 1 324 patients was 50(range, 40-60)mm. (2) Neoadjuvant therapy. Of the 1 761 patients, 873 patients underwent neoadjuvant therapy, including 17 cases receiving radiotherapy alone, 155 cases receiving chemotherapy alone, 43 cases receiving short-course simultaneous chemoradiotherapy, 26 cases receiving short-course simultaneous chemoradiotherapy and delayed surgery, 1 case receiving contact radiotherapy, 277 cases receiving long-course simultaneous chemoradiotherapy, 9 cases receiving other treatments, and 345 cases missing neoadjuvant therapy data. (3) Postoperative examinations. Of the 1 761 patients, 1 584 cases achieved R 0 resection, 23 cases achieved R 1 resection, 1 case achieved R 2 resection, and there were 153 cases missing surgical margin data. The tumor diameter, number of lymph nodes harvest and positive rate of intravascular tumor thrombus were 30(range, 20-45)cm, 13(range, 10-17) and 20.794%(330/1 587) in 1 761 patients. There were 1 647 patients with circumferential margin records, which showed positive in 51 cases, and the minimum distance from deep part of tumor to circumferential margin was 5(rang, 3-13)mm in 1 647 patients. There were 547 cases with distal margin records, which showed positive in 4 cases, and the distance from lower margin of tumor to distal margin was 20(10-25)mm in 547 cases. There were 1 698 patients with specimen integrity records, which showed intact specimen in 1 436 cases, fair specimen in 233 cases, poor specimen in 8 cases, unevaluated specimen in 21 cases, and there were 20 cases with rectal tube perforation. Of the 1 761 patients, cases as pathological T0 stage, Tis stage, T1 stage, T2 stage, T3 stage, T4 stage was 103, 23, 145, 515, 712, 179, respectively, and there were 4 cases of pathology that could not be evaluated and 80 cases missing pathological T staging data. Of the 1 761 patients, cases as pathological N0 stage, N1a stage, N1b stage, N1c stage, N2a stage, N2b stage was 1 117, 189, 133, 66, 109, 68, respectively, and there were 79 cases missing pathological N staging data. Of the 1 761 patients, there were 79 cases with distant metastasis, 1 591 cases without distant metastasis, and 91 cases without data of tumor metastasis. Of the 873 patients undergoing neoadjuvant therapy, there were 405 patients with tumor regression grade records including 105 cases as grade 1, 142 cases as grade 2, 91 cases as grade 3, 43 cases as grade 4, 24 cases as grade 5. Conclusions:In China, the quality of surgical specimens of taTME for rectal cancer is good with low positive rate of resection margin. It is recommended that using a formatted postoperative pathological report for good quality control of pathological report of surgical specimen.

The current situation and prospect of nursing construction of chest pain center in regional collaborative model / 中国实用护理杂志

This paper summarized the development status and shortcomings of the nursing field of chest pain center in China′s regional collaborative mode from four aspects, including the construction status of nursing staff, nursing quality control methods, nursing information construction, and nursing construction problems of chest pain centers in regional collaborative mode, so as to provide theoretical reference for the further standardized construction of nursing units in chest pain centers.

Effects of collaborative psychological nursing on quality of life and psychology of non-Hodgkin lymphoma patients and their caregivers / 白血病·淋巴瘤

Objective:To investigate the influence of collaborative psychological nursing on the quality of life and psychology of non-Hodgkin lymphoma (NHL) patients and their caregivers.Methods:Eighty NHL patients and 80 caregivers in the Affiliated Hospital of Inner Mongolia Medical University from February 2018 to February 2019 were selected, and the patients were divided into observation group 1 (40 patients) and control group 1 (40 patients) according to the random number table method, and the caregivers were divided into observation group 2 (40 caregivers) and control group 2 (40 caregivers). Control group 1 was given routine nursing, and observation group 1 was given collaborative psychological nursing on the basis of routine nursing. The World Health Organization Quality of Life (WHOQOL)-BREF was used to compare the quality of life of two groups of patients and two groups of caregivers. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to compare the psychological states of two groups of patients and two groups of caregivers.Results:Compared with control group 1, the observation group 1 had lower SAS and SDS scores after nursing [(40±6) points vs. (44±6) points, t = 5.12, P = 0.014; (46±4) points vs. (52±4) points, t = 3.22, P = 0.031] and higher WHOQOL-BREF scores [(87.2±2.1) points vs. (65.0±2.5) points, t = 8.55, P = 0.018]. Compared with control group 2, the observation group 2 had lower SAS and SDS scores after nursing [(37±4) points vs. (40±4) points, t = 3.21, P = 0.021; (44±4) points vs. (49±3) points, t = 2.37, P = 0.032] and higher WHOQOL-BREF scores [(84.0±2.5) points vs. (79.5±2.7) points, t = 3.28, P=0.015]. Compared with before nursing, SAS and SDS of each group decreased after nursing, while WHOQOL-BREF scores increased, and all differences were statistically significant (all P < 0.05). Conclusions:Collaborative psychological nursing can effectively improve the quality of life and mental resilience score of NHL patients and their caregivers.

Fostering talents in biotechnology major through the university-enterprise collaborative training mode / 生物工程学报

With the high-quality development of biotechnology-related industries in China, the demand for talents and training quality in this field have received extensive attention. Several universities in Nanjing have conducted in-depth analysis on the shortcomings of talent training that does not closely match the needs of industries and enterprises. These universities have since effectively leveraged its professional characteristics, deepened university-enterprise cooperation, and encouraged the alignment of professional development with industrial growth. Biotechnology major has always focused on nurturing individuals with "right conduct, good learning, and strong ability", and capitalized on its comparative disciplinary advantages. These universities vigorously promoted and continuously optimized the model of university-enterprise collaborative training, highlighted the integration of science, industry and education, focused on innovative education teaching methods, as well as practical engineering practice to enhance its quality. The preliminary training results show that this model has promoted students' engineering practical abilities and comprehensive qualities, garnering recognition from employers and students alike.