RESUMEN
Decentralized clinical trials （DCT） are bringing new changes to clinical trials， the core concept of “patient-centered” must be adhered， and the safety and rights of research participants must be adequately safeguarded. Although DCTs have similarities with traditional clinical trials， they are not suitable for all clinical trials， and are more suitable for oral administration， stable condition of study participants， and longer duration of treatment in clinical trials. DCT， elements must be selected based on the characteristics of clinical trials， and strike a balance between improving the sense of gain， safety， and rights and dignity of research participants， as well as the quality of data collected. Currently， DCT in China face many challenges. To actively promote DCTs in China， regulatory regulations and guiding principles should be improved. Based on patient-centered design principles， the first discussion requires real-time online communication. Researchers should provide more clinical trial services， improve risk control and accessibility of medical assistance， use third-party convenient payments， ensure fair recruitment of research participants， consider compliance， validate digital health technology， remote monitoring and electronic informed consent compliance， ensure the security of data collection， transmission， and analysis， as well as strengthen multi-party training. Ethical review is one of the important means to protect the safety and rights of research participants. Ethics committees should focus on appropriate DCTs elements that are patient-centered， compliance and effectiveness of electronic informed consent， processing and reporting of security information， privacy protection of data collection， compliance of remote monitoring， family health follow-up， management of biological samples and experimental medical products， and training programs. The author believed that the complementarity and combination with traditional clinical trials will make DCTs elements implemented more easily and smoothly. By leveraging the power of scientific and technological advances， DCTs will boost the speed of China’s drug and medical device research and development， enhance international competitiveness， and benefit more patients.
RESUMEN
Objective:By calculating the efficiency of the scientific research laboratory, which reflects the level of the scientific research input and output capacity, provide reference for the evaluation and decision-making of its scientific research sustainable development capacity.Methods:20 scientific research laboratories in a hospital were selected as the research subjects, annual input data were used as the input index. Weighted quantitative scores of the performance of each laboratory in research capacity and contribution, research team construction, discipline development and personnel training, operation management, papers and monographs, patents and transfer, awards, graduate-student training, standards and norms, and academic conferences. All these factors mentioned above were used as output indicators. Then Analytic Hierarchy Process (AHP) and Data Envelopment Analysis (DEA) are used to evaluate the scientific efficiency of each laboratory.Results:The performance of the laboratory is weak in the aspects of patent transfer, awards, standardization. The technical efficiency of laboratory 20 is the lowest, and the scale efficiency of laboratory 12 is the lowest.Conclusions:Scientific Research Laboratories should enhance the effectiveness through input adjustment and output enhancement, meanwhile each laboratory should pay attention to the transformation of scientific achievements and also the optimization of construction system.
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In the early 20th century,the term Nursing was introduced into China.In 1884,with the arrival of the first batch of missionary nurse,modern nursing initiated by Nightingale was introduced into China and greatly changed the way of care.The missionary nurses were full of enthusiasm for the spreading Gospel of Christ,the love for nursing care and the empathy for Chinese people;and encountered the lack of staff and material,the mis-understanding and resistance from the local people and other multiple tests.With the untiring effort of them and the trained local nurses,China had led the international care in nursing education and practice standard.Based on this,nursing in Shandong gradually rose and had an unprecedented development as a new medical subject.By clearing up and consulting Chinese and English historical materials,this paper reviewed the 60 years of the mission-ary nurses in China,saw the early development of nursing in our country from the budding and development of Shandong nursing and provided more insights for understanding and solving the complex problems contemporary Chinese nursing faces.
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This article introduces the concept of organizational citizenship behavior(OCB) as well as the idea of medical professionalism,and analyzes the mutual relationship between OCB and medical professionalism.On the basis of introduction and comparison,medical professionalism obtains the enlightenment from previous studies on OCB.