Promoting implementation research and One Health approach to respond the four global health challenges: an interpretation of the Special Programme for Research and Training in Tropical Diseases (TDR) Strategy 2024—2029 / 中国血吸虫病防治杂志

Tropical diseases, notably neglected tropical diseases and infectious diseases of poverty, remain major health problems endangering the poorest and most-marginalized people in the world. The Special Programme for Research and Training in Tropical Diseases (TDR), which is co-sponsored by the World Health Organization, the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP) and the World Bank, is an important programme that helps facilitate, support, guide and coordinate global efforts to combat tropical diseases. On July 2023, TDR formally issued its 2024—2029 strategy, which proposed the direction and proprieties of global tropical disease prevention and control in the next six years. Based on its original focus on supporting researchers and research institutions from low and middle-income countries to conduct research on tropical diseases and building their research capabilities, this strategy proposed some new developments, which mainly included incorporating tropical disease prevention and control into the overall framework of addressing major global health challenges and achieving the health goals set by the United Nations Sustainable Development Goals (SDGs) to combat tropical diseases and contribute to achieving health goals of SDGs in a collaborative and integrated manner; supporting implementation research and encouraging practitioners and social innovators to participate in research to enable generation of solutions that may be used to solve local health problems; promoting and encouraging the One Health concept and interdisciplinary and cross-departmental collaboration; shifting gradually its focus from disease prevention and control to addressing the health needs of the poorest and most-marginalized populations. These new developments deserve the attention of personnel and institutions in China dedicated to the prevention and control of tropical diseases in order to help their future researches and activities.

Ecological construction of ESP curriculum system in medical schools under perspective of learning science / 中华医学教育探索杂志

English for specific purpose (ESP) courses for the postgraduates in medical schools have both physical and social attributes, with emphasis to improve practical language learning of medical specialties. It's an effective way to develop the English language application ability of high-level medical college students by constructing an ESP teaching and learning ecological system with professional and social contextual characteristics. In this study, through design-based implementation research, scenario simulation class was designed and implemented to accomplish task-based language teaching and learning. Further discussions on how to integrate blended and interrelated classes, on how to define combined and interactive teachers' role were explored. Based on the teaching and learning practices, organically combining the innovative curriculum concept with the construction of ESP ecological system effectively directs the practical application of the ESP class under the perspective of learning science, and verifies the feasibility of the ecological construction of ESP curriculum system.

Implementation Research: The Need of the Hour

Formative research creates evidence. Evidence-based interventions are implemented in community settings. In the past, evidence-based interventions have failed to get desired outcomes. The tuberculosis control program despite being evidence based did not succeed at the beginning. Similarly, evidence-based treatment of hypertension and diabetes has not yet controlled these diseases. This is where the role of implementation research (IR) starts. IR either as part of evidence-based research or independently should be a part of health programs so that the program shall be able to ensure feasibility, fidelity, penetration, acceptability, sustainability, efficiency, effectiveness, and equity

Routine Health Information System Data Quality and Associated Factors in Selected Public Health Facilitiesof Jigjiga Woreda, Somali Regional State's,Eastern Ethiopia

Background: Health data quality are limited within the health sectors of low-and middle-income countries (LMICs). Although public health decision-making is mainly dependent on the timely availability of quality data, the quality of healthdata is not satisfactory in some countries, including in the Somali Regional State. Therefore, this baseline assessment was aimed at assessing the level of data quality and its determinants in the public health sector of the Somali Regional State, Ethiopia. Methods: A baseline assessment was conducted as part of an implementation research project. The study was conducted in three selected public health facilities of the Jigjiga Woreda, including the Woreda Health Office and the Somali Regional Health Bureau. A total of 179 health care workers participated in the survey. Interviewer guided self-administered, record review, and observation data collection techniques were used for data collection. Data wasanalyzed using descriptive, bivariate, and multivariate logistic models to identify predictors of data quality. A P-value of 0.05 was used as the statistical significance cut-off point. Results:The overall data accuracy and content completeness in the studied facilities was88.12% and 75.75%, respectively. Data accuracy was 92.2% in the Karamara Hospital, 83.1% in Jigjiga Health Center, and 79.8% in the Ayardaga Health Center. Content completeness was 81.6% in the KaramaraHospital, 81.2% in the Jigjiga Health Center, and 69.7% in the Ayardaga health center. Forthe studied variables, the data recording value given by their immediate supervisors was a strong predictor of data accuracy in the study setting. The odds of thosewho felt thatdata recording was notvalued by supervisors had 0.26 times poorer data accuracy than their counterparts (AOR: 0.26, 95%CI: 0.10, 0.66). Conclusion:Both the accuracy and completeness of health data in Eastern Ethiopia were inadequate. As a result, health work force immediate supervisors and Performance Monitoring Teams (PMT) should undertake regular and ongoing supervision and provide timely feedback for corrective action. In addition, specialized training in data recording and documentation would be beneficial in bridging the gap between workers' skill. [Ethiop. J. Health Dev. 2022;36 (SI-1)]

Implementação de um ambulatório psicossocial para pessoas expostas a situação de violência em um hospital universitário / Implementation of a psychosocial outpatient clinic for people exposed to violence in a university hospital / Implementación de una clínica psicosocial ambulatorial para personas expuestas a la violencia en un hospital universitario

RESUMO Discute-se o processo de implementação de um ambulatório que oferta psicoterapia de grupo com base psicanalítica às crianças, adolescentes e adultos expostos à violência, adscritos à região Norte de Campinas-SP. A implementação acontecerá no Hospital Universitário - Unicamp, em parceria com o Laboratório de Saúde Coletiva e Saúde Mental - Interfaces, a Assistência Social e de Saúde da Prefeitura Municipal de Campinas. Objetiva-se qualificar a assistência e articulação da rede de serviços públicos no território (Atenção Primária à Saúde e Assistência Social), ofertando-se apoio matricial e seguimento conjunto dos casos; e construir evidências sobre a efetividade da psicanálise de grupo na terapia de transtornos associados à exposição à violência. Utilizar a psicanálise justifica-se no contexto da abordagem e da prevenção à violência na medida em que espaços seguros de escuta possibilitam à pessoa em situação de exposição à violência um lugar de legitimação do sofrimento, elaboração e ressignificação da experiência traumática; do contrário há riscos de invalidar, negar, calar e perpetuar a violência naturalizando-a. A psicanálise tem contribuições significativas para compreensão das causas e consequências individuais e coletivas da violência, bem como para intervir e prevenir a transmissão transgeracional por meio de dispositivos terapêuticos que consideram os níveis coletivo, intersubjetivo e intrapsíquico.

ABSTRACT The process of implementation of an outpatient clinic offering psychoanalytic group psychotherapy to children, adolescents and adults exposed to violence, assigned to the northern region of Campinas-SP, is discussed. The implementation will take place at the University Hospital - Unicamp, in partnership with the Collective Health and Mental Health Laboratory - Interfaces, the Social and Health Care of the Campinas City Hall. The objective is to qualify the assistance and articulation of the public services network in the territory (Primary Health Care and Social Assistance), offering matrix support and joint follow-up of cases; and to build evidence on the effectiveness of group psychoanalysis in the therapy of disorders associated with exposure to violence. Using psychoanalysis is justified in the context of the approach and prevention of violence as safe listening spaces allow the person in a situation of exposure to violence a place of legitimation of suffering, elaboration and resignification of traumatic experience; otherwise there are risks of invalidating, denying, silencing and perpetuating violence by naturalizing it. Psychoanalysis has significant contributions to understand the individual and collective causes and consequences of violence, as well as to intervene and prevent transgenerational transmission through therapeutic devices that consider the collective, intersubjective and intrapsychic levels.

RESUMEN Se discute el proceso de implementación de una clínica ambulatoria que ofrece psicoterapia grupal psicoanalítica a niños, adolescentes y adultos expuestos a la violencia, asignados a la región norte de Campinas-SP. La implementación tendrá lugar en el Hospital Universitario - Unicamp, en colaboración con el Laboratorio de Salud Colectiva y Salud Mental - Interfaces, la Atención Social y de Salud del Ayuntamiento de Campinas. El objetivo es calificar la asistencia y articulación de la red de servicios públicos en el territorio (Atención Primaria de Salud y Asistencia Social), ofreciendo apoyo matricial y seguimiento conjunto de casos; y para construir evidencia sobre la efectividad del psicoanálisis grupal en la terapia de trastornos asociados con la exposición a la violencia. El uso del psicoanálisis se justifica en el contexto del enfoque y la prevención de la violencia, ya que los espacios seguros de escucha permiten a la persona en una situación de exposición a la violencia un lugar de legitimación del sufrimiento, elaboración y resignificación de la experiencia traumática; de lo contrario, existe el riesgo de invalidar, negar, silenciar y perpetuar la violencia al naturalizarla. El psicoanálisis tiene contribuciones significativas para comprender las causas y consecuencias individuales y colectivas de la violencia, así como para intervenir y prevenir la transmisión transgeneracional a través de dispositivos terapéuticos que consideran los niveles colectivos, intersubjetivos e intrapsíquicos.

Bases para establecer un sistema de vigilancia activa y respuesta rápida para el manejo de la morbilidad materna severa / Basis for establishing a system of active surveillance and rapid response for the management of severe maternal morbidity

INTRODUCCIÓN: la razón de mortalidad materna (RMM) se ha utilizado como indicador de salud sin considerar los eventos precedentes. La morbilidad materna severa (MMS) incluye a mujeres con morbilidad asociada a un embarazo, que amenaza sus vidas pero que finalmente permite la sobrevida. OBJETIVOS: Investigar la situación de la mortalidad materna (MM) y la MMS en Misiones, Jujuy y LaRioja. Establecer bases para un sistema de vigilancia y manejo de casos.MÉTODOS: Se realizó un estudio multicéntrico de prevalencia con uncomponente de implementación. Mujeres embarazadas, tratadas enel subsector público entre el 1 de octubre de 2013 y el 31 de marzode 2014, fueron tamizadas para detectar condiciones potencialmentefatales (CPF) y notificar MMS y MM. RESULTADOS: Se analizaron 9.921nacimientos. Ingresaron 294 mujeres, y hubo 219 (74,5%) casos de CPF, 67 (22,8%) de MMS y 8 (2,7%) de MM. Criterios de identificación por tamizaje: clínicos 78,1% de CPF, basados en enfermedad 94% de MMS, y 100% de MM presentó algún criterio clínico. Las principales causas de MMS fueron hipertensión (35,8%), hemorragias (29,9%) y complicaciones de abortos (13,4%). La incidencia global deCPF fue 2,21%, la de MMS 0,68% y la de MM 0,08%. El índice demorbimortalidad global fue de 8,4 (4,0-7,4), la tasa de letalidad globalfue del 10,7%, y el uso global de intervenciones beneficiosas para elmanejo de MMS fue del 54,8%. CONCLUSIONES: El estudio permitióconocer la MM y la MMS en las tres provincias y sentar las bases paraimplementar un sistema de vigilancia activa y respuesta rápida para elmanejo de la MMS, consistente con el Plan Operativo Nacional.

INTRODUCTION: maternal mortality ratio (MMR) has been used as an indicator of maternal health regardless of the previous events. Severe maternal morbidity (SMM) refers to women with life-threatening pregnancy-associated morbidity, who ultimately survive. OBJECTIVES: To investigate the status of maternal mortality (MM) and SMM in Misiones, Jujuy and La Rioja. To establish the basis for a system of surveillance and case management. METHODS: Amulticenter prevalence study was conducted, with an implementationcomponent. Pregnant women assisted from October 1, 2013 to March31, 2014 in the public sub-sector were screened for potentially fatalconditions (PFC) and SMM and MM notification. RESULTS: A total of 9921 births were analyzed. From 294 women participating in the study, there were 219 (74.5%) cases of PFC, 67 (22.8%) of SMM and 8 (2.7%) of MM. Clinical screening criteria identified 78.1% of cases of PFC, disease criteria identified SMM 94%, and 100% of MM showedsome clinical criterion. The main causes of SMM were hypertensivedisorders (35.8%), hemorrhagic disorders (29.9%) and abortioncomplications (13.4%). Global incidence of PFC was 2.21%, andfor SMM and MM was 0.68% and 0.08%, respectively. The overallmorbidity index was 8.4 (4.0-7.4), the overall mortality rate was 10.7%,and the overall use of beneficial interventions for the managementof SMM was 54.8%. CONCLUSIONS: The study yielded information on MM and SMM in the three provinces and laid the groundwork for implementing a system of active surveillance and rapid response to handle SMM consistently with the National Operational Plan.