摘要
Resumen Introducción : En Argentina la cobertura al tamizaje de cáncer colorrectal (CCR) es muy baja. El objetivo de esta revisión fue relevar y sintetizar la evidencia sobre la efectividad de estrategias dirigidas a incrementar la adherencia al tamizaje de CCR del personal de salud y población con riesgo promedio. Métodos : Revisión de revisiones sistemáticas (RS) que evaluaron la efectividad de dichas estrategias. Bús queda en bases de datos electrónicas, meta-buscadores, biblioteca Cochrane y búsqueda manual. Aplicación de criterios de elegibilidad e inclusión; con evaluación de la calidad de las RS a través del AMSTAR-II y la certeza de la evidencia por el método GRADE. Síntesis temática sobre la base de la taxonomía de estrategias propuesta por Dougherty (dirigidas al paciente/comunidad; a pro fesionales; otro tipo de estrategias). Resultados : Se identificaron 635 estudios; 36 fueron elegibles y 11 se descartaron por no contar con cali dad suficiente, incluyéndose 10 RS. Se identificó una multiplicidad de estrategias de efectividad variada, la mayoría dirigida a la población. Entre estas, destacan la educación, el auto-test con recolección en lugares específicos y recordatorios. En el caso de profesionales, solo educación y recordatorios mostraron ser efectivas. La combinación de estrategias mostró tener mayor efec tividad que las estrategias aisladas. Conclusiones : Es mayor la evidencia sobre estrategias dirigidas a la población que a profesionales. Las estrate gias combinadas demostraron tener mayor efectividad, lo que destaca la necesidad de explorar, en cada con texto, las barreras en la población y en los profesionales para priorizar y combinar aquellas que demostraron ser efectivas y tendrían mayor impacto.
Abstract Introduction : Coverage for colorectal cancer screening in Argentina is very low. The objective of this review is to assess and synthesize the evidence on the effectiveness of strategies aimed at increasing adherence to colorectal cancer screening among healthcare personnel and the general population at average risk. Methods : A review of systematic reviews (SRs) that evaluated the effectiveness of these strategies was con ducted. Searches were performed in electronic data bases, meta-search engines, the Cochrane Library, and through manual searching. Eligibility and inclusion criteria were applied, with assessment of the quality of the SRs using AMSTAR II and the certainty of evidence using the GRADE approach. Thematic synthesis was con ducted based on the taxonomy of strategies proposed by Dougherty (patient/community-targeted, professional-targeted, and other types of strategies). Results : A total of 635 studies were identified, with 36 deemed eligible and 11 excluded due to insufficient quality, resulting in the inclusion of 10 SRs. A multi plicity of strategies with varying effectiveness were identified, with the majority targeting the population. Among these, education, self-testing with specimen collection at specific locations, and reminders stood out. For professionals, only education and reminders showed effectiveness. Combined strategies demonstrated greater effectiveness than isolated strategies. Conclusions : There is more evidence on strategies targeting the population than professionals. Combined strategies showed greater effectiveness, highlighting the need to explore barriers in both the population and professionals in each specific context in order to priori tize and combine those that have proven effective and would have a greater impact.
摘要
Fundamento: las estrategias didácticas para fomentar el aprendizaje autónomo son las estrategias cognitivas y afectivas que facilitan: aprender a aprender, aprender a hacer y aprender de forma cooperativa, para establecer la relación con sus pares y lograr el bienestar de la salud. Objetivo: determinar el nivel de implementación de las estrategias didácticas para lograr el aprendizaje autónomo y su repercusión en la salud de estudiantes de una universidad privada de Lambayeque. Métodos: se realizó una investigación con un enfoque cuantitativo, de tipo descriptiva, transversal y diseño cuasi experimental (estudio de antes-después). La muestra se obtuvo mediante muestreo no probabilístico por conveniencia con 390 estudiantes según el criterio de inclusión. Se evaluaron dos variables en sus dimensiones correspondientes. Para el análisis estadístico se empleó el programa IBM SPSS Statistics V.25. Resultados: para la variable, Estrategias didácticas, tanto en el pre-test como en el post-test, la mayoría la calificó como: siempre repercute en la salud mental. Con respecto a la variable, Aprendizaje autónomo, hubo un incremento en la calificación para la opción siempre, de 2,4 %, mientras que en: a veces, hubo una disminución del 1,7 % y en: nunca, el 1,8 %, mostraron la repercusión en la salud de los estudiantes. Conclusiones: se utilizaron estrategias didácticas para fomentar el aprendizaje autónomo que permitieron a los estudiantes: seleccionar, organizar, procesar y elaborar la información; de igual forma, para desarrollar la motivación y autorregulación para la toma de conciencia y control de su aprendizaje y mejorar la salud mental, al disminuir los niveles de estrés.
Foundation: teaching strategies to promote autonomous learning are cognitive and affective strategies that facilitate: learning to learn, learning to do and learning cooperatively, to establish relationships with peers and achieve health well-being. Objective: determine the level of implementation of teaching strategies to achieve autonomous learning and its impact on the health of students at a private university in Lambayeque. Methods: a research was carried out with a quantitative approach, descriptive, cross-sectional and quasi-experimental design (before-after study). The sample was obtained through non-probabilistic convenience sampling with 390 students according to the inclusion criterion. Two variables were evaluated in their corresponding dimensions. For the statistical analysis, the IBM SPSS Statistics V.25 program was used. Results: for the variable, Teaching strategies, both in the pre-test and in the post-test, the majority rated it as: it always has an impact on mental health. Regarding the variable, Autonomous Learning, there was an increase in the rating for the option always, of 2.4 %, while in: sometimes, there was a decrease of 1.7 % and in: never, of 1.8 %, which showed the impact on the health of the students. Conclusions: teaching strategies were used to promote autonomous learning that allowed students to: select, organize, process and elaborate information; likewise, to develop motivation and self-regulation for awareness and control of their learning and improve mental health, by reducing stress levels.
摘要
SUMMARY: Histology is considered one of the most important but challenging topics in health sciences. Deficiencies in teaching and general histology directly affect the student's understanding, performance and promote dynamism and integration while covering the primary curriculum. The goal of the current study was to assess and provide a better experience of difficulties in learning histology, examine some standard teaching strategies, and determine how to implement suitable changes to improve the curriculum from students' perspectives. The study comprised of a self-administered questionnaire that included descriptive questions. Data was collected based on the survey conducted via 100 students studying histology. Data was analyzed further qualitatively and quantitatively to elaborate on the difficulties in this area. Many of them strongly agreed that the lack of essential comprehension regarding using light and electron microscopes resulted in challenges with comprehending and identifying tissue samples for image identification due to inadequate anatomical knowledge. Moreover, according to students, some difficulties understood the topic, perception of new terminologies, and insufficient teaching strategies to grasp students' interests. They also agreed that improvement was needed in terms of the modes of teaching employed by histology teachers; they felt that modern education techniques based on practical tasks should be incorporated to stimulate student interest and make understanding histological concepts easier. The Institution should modify the teaching system to allocate more time to relevant subjects to make this subject matter more interesting. This survey-based study evaluated that students faced some challenges while studying the current curriculum of histology. From the student's perspective, it is identified that some changes are needed to improve the course curriculum and way of teaching to make it more understandable.
La histología se considera uno de los temas más importantes pero desafiantes de las ciencias de la salud. Las deficiencias en la enseñanza y en la histología general afectan directamente la comprensión, el desempeño del estudiante y promueven el dinamismo y la integración al abarcar el currículo primario. El objetivo del estudio actual fue evaluar y proporcionar una mejor experiencia de las dificultades en el aprendizaje de histología, examinar algunas estrategias de enseñanza estándar y determinar cómo implementar cambios adecuados para mejorar el plan de estudios desde la perspectiva de los estudiantes. El estudio constaba de un cuestionario auto administrado que incluía preguntas descriptivas. Los datos se recopilaron a partir de una encuesta realizada a 100 estudiantes de histología. Los datos se analizaron más a fondo de forma cualitativa y cuantitativa para profundizar en las dificultades en esta área. Muchos de ellos estuvieron totalmente de acuerdo en que la falta de comprensión esencial sobre el uso de microscopios ópticos y electrónicos resultó en desafíos para comprender e identificar muestras de tejido para la identificación de imágenes debido a un conocimiento anatómico inadecuado. Además, según los estudiantes, algunas dificultades en la comprensión del tema, percepción de nuevas terminologías y estrategias de enseñanza insuficientes para captar los intereses de los estudiantes. También coincidieron en que era necesario mejorar los métodos de enseñanza empleados por los profesores de histología; sintieron que deberían incorporarse técnicas educativas modernas basadas en tareas prácticas para estimular el interés de los estudiantes y facilitar la comprensión de los conceptos histológicos. La Institución debería modificar el sistema de enseñanza para asignar más tiempo a materias relevantes para hacer esta materia más interesante. Este estudio basado en encuestas evaluó que los estudiantes enfrentaron algunos desafíos mientras estudiaban el plan de estudios actual de histología. Desde la perspectiva del estudiante, se identifica que se necesitan algunos cambios para mejorar el plan de estudios del curso y la forma de enseñar para hacerlo más comprensible.
Subject(s)
Humans , Students/psychology , Histology/education , Learning , Teaching , Surveys and Questionnaires摘要
La unión de la teoría y la práctica es crucial para una enseñanza equitativa, además se requiere de estrategias flexibles y efectivas para asegurar la inclusión. El objetivo de este artículo fue proponer estrategias para la participación de estudiantes con discapacidad en las clases de Educación Física. Se revisaron 22 trabajos centrados en estrategias de inclusión para Educación Física en las bases de datos SciELO, Google Académico y Dialnet. A partir de los resultados obtenidos, se procedió a la sistematización y se diseñaron estrategias para mejorar la experiencia de aprendizaje y promover la igualdad, entre ellas las que se adaptan al currículo y actividades; las de formación y sensibilización docente; y, las de cultura inclusiva y ambiente positivo. Se concluye que la inclusión educativa es un proceso complejo que demanda cambios en actitudes, metodologías y políticas educativas.
O casamento entre teoria e prática é crucial para o ensino equitativo, e são necessárias estratégias flexíveis e eficazes para garantir a inclusão. O objetivo deste artigo foi propor estratégias para a participação de alunos com deficiência nas aulas de educação física. Vinte e dois artigos com foco em estratégias de inclusão para a Educação Física foram revisados nas bases de dados SciELO, Google Scholar e Dialnet. Com base nos resultados obtidos, foram sistematizadas e elaboradas estratégias para melhorar a experiência de aprendizagem e promover a igualdade, incluindo aquelas adaptadas ao currículo e às atividades; treinamento e conscientização dos professores; e cultura inclusiva e ambiente positivo. Conclui-se que a inclusão educacional é um processo complexo que exige mudanças de atitudes, metodologias e políticas educacionais.
The union of theory and practice is crucial for equitable teaching, and flexible and effective strategies are required to ensure inclusion. The objective of this article was to propose strategies for the participation of students with disabilities in Physical Education classes. Twenty-two works focused on inclusion strategies for Physical Education were reviewed in the SciELO, Google Academic and Dialnet databases. Based on the results obtained, the systematization was carried out and strategies were designed to improve the learning experience and promote equality, including those that adapt to the curriculum and activities; those of teacher training and awareness; and, those with an inclusive culture and positive environment. It is concluded that educational inclusion is a complex process that demands changes in attitudes, methodologies and educational policies.
摘要
La presente revisión narrativa propone caracterizar las estrategias didácticas actualmente utilizadas en el Instituto de Anatomía, Histología y Patología (IAHP) de la Universidad Austral de Chile (UACh), para la enseñanza-aprendizaje de la anatomía humana en los alumnos de las escuelas de Enfermería, Kinesiología, Medicina, Obstetricia y Puericultura, Odontología y Terapia Ocupacional de su Facultad de Medicina. Se listan las diversas estrategias didácticas implementadas y se explica la manera en que se han venido aplicando en esta institución a fin de perfeccionar la enseñanza anatómica, considerando los retos y desafíos que demandan las generaciones actuales de estudiantes y la dinámica del mundo contemporáneo.
This narrative review aims to describe the didactic strategies currently employed by the Institute of Anatomy, Histology, and Pathology at the Universidad Austral de Chile (UACh) for teaching Human Anatomy to students in the Nursing, Kinesiology, Medicine, Obstetrics and Childcare, Dentistry, and Occupational Therapy programs of its Faculty of Medicine. The implemented teaching strategies for improving anatomical teaching in this institution are listed and explained, considering the challenges posed by current generations of students and the dynamics of the contemporary world.
摘要
Objetivo: investigar o aleitamento materno com foco sobre a exclusividade dessa prática no primeiro semestre de vida da criança, em um município do norte de Minas Gerais. Métodos: trata-se de um estudo descritivo, qualitativo realizado com 13 mães com idade entre 24 e 39 anos. Os dados foram coletados entre agosto e setembro de 2023, por meio de uma entrevista semiestruturada, e analisados mediante análise temática. Resultados: as mulheres indicaram ter enfrentado dificuldades na prática do aleitamento materno exclusivo, especialmente nos primeiros dias de vida da criança, devido a ingurgitamento, mastite, fissuras mamárias, pressão social e pessoal de leite fraco. Identificou-se como benefícios do aleitamento materno exclusivo a proteção imunológica, o estreitamento de vínculo, a prevenção de doenças e de desnutrição na criança, assim como a aceleração da involução uterina e a prevenção de cânceres na mulher. O apoio da família, do parceiro e da equipe de saúde foi apontado como fatores facilitadores do aleitamento materno, porém indicaram receber poucas orientações dos profissionais sobre amamentação. Conclusão: destaca-se a importância de a equipe de saúde atuar com um olhar zeloso perante esse público, intensificando as orientações sobre aleitamento materno exclusivo a fim de reduzir as dúvidas e dificuldades para elevar as taxas de duração e exclusividade do aleitamento materno.
Objective: to investigate breastfeeding with a focus on the exclusivity of this practice in the first semester of a child's life in a municipality in the north of Minas Gerais. Methods: this is a descriptive, qualitative study carried out with 13 mothers aged between 24 and 39 years old. Data were collected between August and September 2023 from a semi-structured interview and analyzed using Thematic Analysis. Results: women indicated that they faced difficulties in practicing exclusive breastfeeding, especially in the first days of the child's life, due to engorgement, mastitis, breast fissures, and social and personal pressure of weak milk. The benefits of exclusive breastfeeding were identified as immunological protection, strengthening bonds, preventing diseases and malnutrition in children, as well as accelerating uterine involution, and preventing cancer in women. Support from family, partner, and healthcare team was identified as factors that facilitate breastfeeding, but they indicated that they received little guidance from professionals about breastfeeding. Conclusion: the importance of the health team acting with a zealous eye towards the public is highlighted, intensifying guidance on exclusive breastfeeding in order to reduce doubts and difficulties in increasing the duration and exclusivity of breastfeeding.
Subject(s)
Female , Adult , Breast Feeding摘要
Trata de nota técnica sobre Práticas Avançadas de Enfermagem (PAE) no Brasil, elaborada por comissão e submetida à aprovação do plenário do Conselho Federal de Enfermagem (Cofen). O documento aborda conceitos, ações, implementação e regulação das práticas avançadas de Enfermagem, expandindo os limites do escopo da atuação do enfermeiro e reforçando a sua prática clínica. (AU)
This is a technical note on Advanced Nursing Practices (ANP) in Brazil, prepared by a committee and submitted for approval by the plenary of the Federal Nursing Council (Cofen). The document addresses concepts, actions, implementation and regulation of advanced nursing practices, expanding the limits of the scope of nurses' work and reinforcing their clinical practice. (AU)
Esta es una nota técnica sobre las Prácticas Avanzadas de Enfermería (PAE) en Brasil, elaborada por un comité y sometida a la aprobación del plenario del Consejo Federal de Enfermería (Cofen). El documento aborda los conceptos, acciones, implementación y reglamentación de las prácticas avanzadas de enfermería, ampliando los límites del ámbito de actuación de las enfermeras y reforzando su práctica clínica. (AU)
Subject(s)
Nursing , Global Health Strategies , Health Care Coordination and Monitoring , Advanced Practice Nursing , Practice Patterns, Nurses' , Strategies for Universal Health Coverage摘要
Em 2020, a atenção à saúde sofreu o impacto da pandemia de covid-19, e a Atenção Primária não foi exceção. Para melhor compreender a reorganização desse setor no município de Salvador, Bahia, esta pesquisa descreve o perfil dos médicos e as práticas de saúde realizadas por eles na Atenção Primária no contexto da pandemia. Trata-se de um estudo de corte transversal descritivo, que se utiliza de um questionário online autoaplicável distribuído aos médicos participantes que atuam nas unidades básicas de saúde que compõem a Atenção Primária do município. Para análise dos dados, foi utilizada estatística descritiva simples. Com um total de 43 questionários respondidos, foram descritos aspectos referentes a: perfil, formação e atuação dos médicos; mudanças estruturais ocorridas e adoção de novas ferramentas de trabalho; manutenção dos cuidados primários de rotina; ações de vigilância em saúde; suporte social a grupos vulneráveis; e atuação clínica em pacientes com covid-19. Com uma maioria de médicas jovens, recém-formadas e em um período curto de atuação nas equipes onde estavam inseridas, observou-se pouco envolvimento em vigilância e suporte a grupos vulneráveis e um abrangente uso de telemedicina e reestruturação do funcionamento das unidades. Contudo, alguns cuidados primários, como acompanhamento de doenças crônicas e puericultura, resultaram em limitações no acesso e, consequentemente, menor atenção ao cuidado longitudinal.
In 2020, health care suffered the impact of the COVID-19 pandemic and primary care was no exception. To better understand the reorganization of this segment in the municipality of Salvador, Bahia, this research describes the profile of physicians and health practices performed by them in primary care in the pandemic context. This is a cross-sectional descriptive study using an online self-administered questionnaire distributed to participating physicians who work in the basic health units that are a part of primary care in the municipality. For data analysis, simple descriptive statistics was used. With a total of 43 questionnaires answered, the following aspects were described: profile, training, and performance of physicians; structural changes and adoption of new work tools; maintenance of routine primary care; health surveillance actions; social support to vulnerable groups; and clinical performance with COVID-19 patients. With mostly young females, recently graduated, and with a short period of service in the teams where they were located; little involvement in surveillance and support to vulnerable groups is observed, as well as an extensive use of telemedicine and restructuring of the operation of the units. However, some primary care, such as chronic disease follow-up and childcare, resulted in limitations in access and, consequently, less attention to longitudinal care.
En 2020, la atención sanitaria sufrió el impacto de la pandemia de la covid-19 y la atención primaria no fue la excepción. Para comprender mejor la reorganización de este sector en el municipio de Salvador, en Bahía (Brasil), esta investigación describe el perfil de los médicos y las prácticas de salud realizadas por ellos en la atención primaria en el contexto de la pandemia. Se trata de un estudio descriptivo transversal que utilizó un cuestionario autoadministrado en línea distribuido a los médicos participantes que trabajan en las Unidades Básicas de Salud que componen la atención primaria del municipio. Para el análisis de los datos, se utilizó estadística descriptiva simple. Con un total de 43 preguntas respondidas, se describieron aspectos referentes al perfil, formación y capacitación de los médicos; a los cambios estructurales ocurridos y adopción de nuevas herramientas de trabajo; al mantenimiento de los cuidados primarios de rutina; a las acciones de vigilancia en salud; al apoyo social a grupos vulnerables; y a la capacitación clínica en pacientes con covid-19. La mayoría de las médicas eran jóvenes, recién licenciadas y tenían un corto período de actuación en los equipos con los cuales trabajaban, se observó una escasa implicación en la vigilancia y apoyo a colectivos vulnerables, así como un amplio uso de la telemedicina y la reestructuración del funcionamiento de las unidades. Sin embargo, algunas atenciones primarias, como el seguimiento de enfermedades crónicas y la atención a la infancia, se tradujeron en limitaciones en el acceso y, en consecuencia, en menos atención al cuidado longitudinal.
摘要
Com o surgimento da pandemia causada pelo vírus da severe acute respiratory syndrome (SARS-CoV-2), necessitou-se implementar medidas de controle hospitalar, a fim de evitar a propagação e reinfecção dos pacientes acometidos. Assim, objetivou-se identificar as estratégias adotadas pela enfermagem no enfrentamento da covid-19, mediante revisão integrativa da literatura nas bases de dados: SciELO, LILACS e BVS, de 2019 a 2022. Selecionou-se palavras-chave seguindo os Descritores de Ciências da Saúde (DeCS) e operadores booleanos. A transmissão do novo coronavírus ocorre de pessoa para pessoa, por inalação ou contato com gotículas respiratórias do indivíduo infectado com incubação de dois a 14 dias. Os sintomas variam entre febre, tosse, dor de garganta, dificuldade respiratória, e outros. A alta transmissibilidade do vírus alastrou-se de forma rápida e frequente, sendo necessário se atentar à segurança dos profissionais de saúde e dos pacientes, por meio da correta utilização dos equipamentos de proteção individual (EPI) e da sistematização da assistência de enfermagem, na qual o enfermeiro direciona e coordena, de forma individualizada, a prestação da assistência ao paciente na unidade de saúde, observando os sinais e sintomas para determinar a gravidade do quadro clínico e prestar todos os cuidados necessários. Este trabalho proporcionou uma visão ampla das estratégias adotadas pelos profissionais de enfermagem, destacando a atuação corajosa, ativa e contínua deles na linha de frente do enfrentamento da pandemia, com prestação da assistência integral de qualidade aos pacientes.
The emergence of the pandemic caused by the severe acute respiratory syndrome virus (SARS-CoV-2) required implementing hospital control measures to prevent the spread and reinfection of affected patients. Thus, this study analyzes practices used by nurses to combat COVID-19 by means of an integrative literature review. Bibliographic search was conducted in the SciELO, LILACS and BVS databases from 2019 to 2022 using DeCS descriptors and Boolean operators. COVID-19 transmission occurs from person to person through inhalation or contact with respiratory droplets from infected individuals with incubation of 2 to 14 days. Symptoms range from fever, cough, sore throat, difficulty breathing to more severe reactions. Its high transmissibility lead to a quick and frequent spread, demanding better attention to professional and patient safety through the correct use of PPEs and the systematization of nursing care, in which nurses direct and coordinate the provision of individualized care to patients the health unit, observing signs and symptoms to determine clinical severity and provide all necessary care. The present work gave a broad view of the strategies adopted by nursing professionals, highlighting their courageous, active and continuous actions on the front line to combat the pandemic, providing comprehensive quality care to patients.
La pandemia provocada por el virus del síndrome respiratorio agudo severo (SARS-CoV-2) requirió la implementación de medidas de control hospitalario para evitar la propagación y reinfección de los pacientes afectados. En este contexto, se pretende identificar las estrategias de afrontamiento de la covid-19 utilizadas por la enfermería; para ello, se realizó una revisión integradora de la literatura en las bases de datos SciELO, LILACS y BVS en el período de 2019 a 2022. Las palabras clave se seleccionaron siguiendo los Descriptores de las Ciencias de la Salud (DeSC) y los operadores booleanos. El nuevo coronavirus se propaga de persona a persona mediante la inhalación o contacto con gotículas respiratorias de la persona infectada en un período de incubación de 2 días a 14 días. Los síntomas van desde fiebre, tos, dolor de garganta, dificultad para respirar, entre otros. La propagación del virus se dio de manera rápida y frecuente, por lo que se requirió prestar atención a la seguridad de los profesionales de la salud y de los pacientes, mediante el uso correcto de los equipos de protección individual (EPI) y la sistematización de los cuidados de enfermería, en que el enfermero dirige y coordina, de manera individualizada, la atención al paciente en la unidad de salud, observando sus signos y síntomas para determinar la gravedad del cuadro clínico y brindarle los cuidados necesarios. Este trabajo proporciona una visión amplia de las estrategias adoptadas por los profesionales de enfermería, con su acción valiente, activa y continua en primera línea en el afrontamiento a la pandemia, brindando una atención integral de calidad a los pacientes.
摘要
RESUMEN Las estrategias para comunicar la información han experimentado muchos cambios, los cuales se han evidenciado en la pandemia. La idea es lograr que se pueda conectar con el estudiante y que la información la reciba de manera clara, oportuna y pertinente, de modo que tendrá los saberes previos para lograr integrar la información de la teoría y la práctica, con el fin de enfrentar con éxito la actividad simulada, así como cuando interactúe con el paciente. En ese contexto, el aula invertida es una estrategia didáctica que brinda videos, podcast, entre otros, para que sean revisados con anticipación, de tal forma que cuando el estudiante realice la actividad presencial o virtual se profundice y se hagan precisiones sobre los conceptos más importantes, usando metodologías activas de participación para lograr el siguiente propósito: El aprendizaje invertido busca un cambio en la dinámica del aprendizaje que apunte como eje del mismo al estudiante. El objetivo de la presente contribución docente es compartir las bondades de esta estrategia usada en estudiantes de la carrera de Odontología dentro del marco del curso de Clínica Estomatológica del Adulto I, dictado en 2023 y que pertenece al quinto ciclo de la carrera de Estomatología en la Universidad Peruana Cayetano Heredia.
ABSTRACT Strategies for communicating information have undergone many changes, which have been evidenced in the pandemic. The idea is to be able to connect with the student and that the information is received in a clear, timely and relevant manner, so that he/she will have the prior knowledge to integrate information from theory and practice, in order to successfully face the simulated activity, as well as when interacting with the patient. In this context, the inverted classroom is a didactic strategy that provides videos, podcasts, among others, to be reviewed in advance, so that when the student performs the face-to-face or virtual activity, the most important concepts are deepened and clarified, using active participation methodologies to achieve the following objective: flipped learning seeks a change in the dynamics of learning that points to the student as its axis. The objective of this teaching contribution is to share the benefits of this strategy used with students of the Dentistry degree program within the framework of the Adult Stomatology Clinic I course, taught in 2023 and which belongs to the fifth semester of the Stomatology degree program at the Universidad Peruana Cayetano Heredia.
RESUMO As estratégias de comunicação de informação sofreram muitas alterações, que são evidentes na pandemia. A ideia é conseguir conectar-se com o aluno e que a informação seja recebida de forma clara, oportuna e relevante, para que ele tenha o conhecimento prévio para poder integrar informações da teoria e da prática, a fim de enfrentar com sucesso a atividade simulada, bem como ao interagir com o paciente. Neste contexto, a sala de aula invertida é uma estratégia didática que disponibiliza vídeos, podcasts, entre outros, para serem revistos previamente, de modo a que, quando o aluno realiza a atividade presencial ou virtual, os conceitos mais importantes sejam aprofundados e clarificados, utilizando metodologias de participação ativa para atingir o seguinte objetivo: A aprendizagem investida procura uma mudança na dinâmica da aprendizagem que aponta para o aluno como eixo da mesma. O objetivo desta contribuição didática é partilhar os benefícios desta estratégia utilizada com os alunos da disciplina de Medicina Dentária no âmbito do curso de Clínica de Estomatologia de Adultos I, ministrada em 2023 e que pertence ao quinto semestre da disciplina de Estomatologia da Universidad Peruana Cayetano Heredia.
摘要
@#Abstract: The emerging infectious diseases have become an important risk factor affecting human public health. Vaccination remains the most critical approach to the prevention and control of such diseases. Since the outbreak of the COVID-19 epidemic, lots of transformational basic innovative vaccine technologies and strategies have been developed. The third-generation vaccine technology represented by mRNA vaccine has gradually become a new approach to the research and development of vaccines. This paper introduces the characteristics of different vaccine technologies in recent years, and summarizes the latest research progress in current vaccine products based on different platforms, so as to provide experience and reference for future research and development of vaccines.
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Objective To investigate the needs and feedback from clinical medical students on the diversified teaching mode adopted by the Department of Endocrinology in Peking Union Medical College Hospital.Methods Questionnaires were distributed to the medicine students who were in clinical rotation in Peking Union Medical Col-lege,and the teaching status and teaching effect was investigated.Results A total of 95 valid questionnaires were received.The attending physicians and the teaching resident physicians performed well in the daily teaching activi-ties.The medical students believed that outpatient training was necessary in addition to ward rotations.After the ro-tation in the endocrinology department,the self-evaluated score of mastery of endocrinology knowledge had been significantly improved,especially in those who rotated in outpatient clinic,suggesting that outpatient teaching was of great significance.In addition,the establishment of a self-learning platform including clinical cases and videos in endocrinology could be used as an important supplementary means for clinical teaching.Conclusions Outpatient training improves learning outcomes of medical students,so must be kept and further strengthened in the future.Building a database of typical clinical cases and teaching videos can improve the training quality.
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Medicinal plants are a valuable source of essential medicines and herbal products for healthcare and disease therapy. Compared with chemical synthesis and extraction, the biosynthesis of natural products is a very promising alternative for the successful conservation of medicinal plants, and its rapid development will greatly facilitate the conservation and sustainable utilization of medicinal plants. Here, we summarize the advances in strategies and methods concerning the biosynthesis and production of natural products of medicinal plants. The strategies and methods mainly include genetic engineering, plant cell culture engineering, metabolic engineering, and synthetic biology based on multiple "OMICS" technologies, with paradigms for the biosynthesis of terpenoids and alkaloids. We also highlight the biosynthetic approaches and discuss progress in the production of some valuable natural products, exemplifying compounds such as vindoline (alkaloid), artemisinin and paclitaxel (terpenoids), to illustrate the power of biotechnology in medicinal plants.
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Objective:To establish an environmental management strategy for the prevention of ventilator-associated pneumonia from the perspective of etiological characteristics and to verify its application effect.Methods:Based on a sampling survey, this study constructed preventive management strategies for ventilator-associated pneumonia by blocking pathogen characteristics from the perspective of both colonization and infection management in patients. From July 2021 to June 2023, a non-synchronous randomized controlled study was conducted, including a control group of 59 cases and an experimental group of 57 cases from ICU of Tianjin Teda Hospital, all of them were mechanically ventilated patients. The effectiveness of the strategy was confirmed.Results:In the control group, there were 35 males and 24 females, with an average age of (46.97 ± 18.84) years. In the experimental group, there were 39 males and 18 females, with an average age of (47.49 ± 13.85) years. During the study period, there were 9 cases of ventilator-associated pneumonia (VAP) in the control group and 2 cases in the experimental group, the difference between the two groups was statistically significant (exact odds ratio=0.031). The duration of mechanical ventilation in the experimental group (122.41 ± 18.36) h, which was shorter than that in the control group (187.62 ± 18.05) h, and the difference was statistically significant ( t=19.28, P<0.05). The length of ICU stay in the experimental group was (8.38 ± 0.79) d, in the control group was (10.99 ± 1.10) d, the difference between them was statistically significant ( t=14.66, P<0.05). On the 7th day, there were 7 cases of positive pathogenic bacteria in sputum culture in the experimental group, which was significantly different from the 29 cases in the control group ( χ2=16.73, P<0.05). Conclusions:The vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics can reduce the incidence of VAP, shorten the duration of mechanical ventilation and ICU stay, and reduce the pathogen load in the sputum of mechanically ventilated patients on the 7th day.
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The visual impairment and blindness caused by myopia have become a global burden, and the World Health Organization has included the prevention and control of myopia in the global program for preventing blindness. In China, the development of myopia is showing a trend with higher incidence, younger age, and higher refractive errors. Moving forward the port of prevention and control myopia has become an important strategy to address the current predicament. Premyopia refers to the stage in children where the refractive power is ≤+0.75 D and >-0.50 D, and there are multiple risk factors during this stage that can potentially lead to myopia. Currently, the incidence of premyopia and its transformation into myopia is high, and the key prevention and control measures include building a predictive model for the transformation of premyopia into myopia, emphasizing the reduction of exposure to risk factors, using low-concentration atropine eye drops, red light therapy, and optical defocus intervention. This article provides a comprehensive review of the current situation regarding the incidence of premyopia and its transformation into myopia, as well as the research progress on existing prevention and control measures, with the aim of providing relevant references for the prevention and control of myopia during the premyopia stage.
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Hepatocellular carcinoma (HCC) is one of the cancers with the highest incidence and mortality rates in China and often presents with insidious early clinical manifestations. This frequency results in the majority of patients being diagnosed at middle and advanced stage of the disease, thereby missing the opportunity for potentially curative surgical interventions. For patients who are ineligible for radical surgical resection, a variety of therapeutic approaches, including systemic antitumor therapy, local radiotherapy, interventional treatment, and liver transplantation, have been employed. Moreover, neoadjuvant therapies have transformed a subset of initially unresectable HCC cases into operable ones. Nevertheless, many patients fail to benefit from these treatments, underscoring the urgent need for novel therapeutic targets. Cancer-associated fibroblasts (CAFs), a principal component of the solid tumor microenvironment, play a pivotal role in the proliferation, migration, invasion, and treatment resistance of cancer cells. This review delineates the origins of CAFs and their mechanisms of action in the pathogenesis and progression of HCC and discusses potential therapeutic strategies targeting CAFs.
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Since the approval of gemtuzumab ozogamicin, an antibody–drug conjugate (ADC) targeting CD33 in 2000, 13 ADC drugs have been approved by the FDA. Although these drugs have clearly improved the survival of patients with various types of advanced cancers, their significant toxicity has compromised their therapeutic benefits. The adverse reactions of ADC drugs are complex and include on-target and off-target toxicities, where the payload drug is a determining factor. Antibody and linker may also affect the degree of toxicity. Combination therapy becomes an important strategy in anticancer treatment because of its increased efficiency, but treatment-related adverse reactions also increase accordingly. This review comprehensively analyzes the toxicity mechanisms of current ADC drugs and proposes various optimization strategies, including but not limited to optimizing linker molecules, upgrading antibody design, and changing drug administration strategies, to improve the overall safety profile of ADC drugs.
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【Objective】 To make transfusion management strategies for patients with history of blood transfusion and/or pregnancy by following up a patient with delayed hemolytic transfusion reactions(DHTR) caused by unexpected antibody produced after blood transfusion. 【Methods】 ABO, Rh, MN and Kidd blood group test, direct antiglobulin test, unexpected antibody screening, antibody identification, antibody titer detection, and cross-matching test were performed on a patient with DHTR. Meanwhile, suitable red blood cells were screened for subsequent treatment. 【Results】 The patient′s blood group was B, RhD(+ ) and CCDee, the antibody screening test and cross-matching test were negative before the first transfusion. After eight days, hemoglobin of the patient decreased to 57 g/L and the laboratory results indicated delayed hemolysis, the antibody screening was positive, and the antibody identification result was anti-M, as RBCs of the patient received typed as M+ N+. After the patient received M antigen negative RBCs, the laboratory test results still indicated delayed serologic transfusion reaction. A new antibody arose and was identified as anti-Jka while RBCs transfused were M-N+ and Jk(a+ b-). Afterwards, it was effective for the patient to receive B, RhD(+ ), M-N+ and Jk(a-b+ ) RBCs. 【Conclusion】 Most of the homologous antibodies produced by patients after blood transfusion will disappear within a few years. When patients undergo another transfusion, DHTR may occur because of anamnestic reaction. Establishing a transfusion management document and creating a card for patients who have already produced RBC alloantibodies can greatly reduce the occurrence of DHTR by informing doctors and staff when the next transfusion is needed.
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Objective To investigate the status of familial aggregation of Helicobacter pylori (Hp) infection in Jinniu District, Chengdu, and analyze its risk factors so as to provide a basis for developing prevention and control strategies of family aggregation of Hp infection. Methods A total of 172 subjects in the Second Affiliated Hospital of Chengdu Medical College · 416 Hospital of Nuclear Industry from January 2022 to January 2023 were selected as the research subjects. All subjects underwent 13C-urea breath test (13C-UBT) to diagnose whether there was Hp infection. Analyze the current situation of family aggregation of Hp infection in the region, collect general data of survey subjects, analyze the relevant factors affecting Hp family aggregation infection, and develop prevention and control strategies based on this. Results A total of 242 people from 97 households were surveyed, and the Hp family aggregation rate was 29.33%. Univariate analysis showed that there were statistically significant differences in family aggregation of Hp infection in terms of different age groups (χ2=9.719, P=0.008), marital status (χ2=8.496, P=0.014), occupations (χ2=19.462, P2=5.457, P=0.019), previous Hp test results (χ2 =4.131, P=0.042) and test results after treatment (χ2=12.000, P=0.001), with statistical significance (P<0.05). Multivariate logistic regression analysis showed that the frequency of dining out 2 days or more per week and a positive Hp test results in the past were risk factors for family aggregation of Hp infection, while the occupation of teachers/medical staff/management/technology personnel and a negative Hp results after treatment were protective factors (P<0.05). Conclusion Family aggregation of Hp infection is related to family members' occupation, frequency of dining out, previous Hp test results and Hp test results after eradication, which deserves attention in clinical practice.
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As a commonly used traditional Chinese medicine in clinical practice， Tripterygium wilfordii has the functions of dispelling wind and removing dampness， detoxicating and destroying parasites， detumescence， pain relief， promoting blood circulation， and dredging collateral. Modern pharmacological studies show that it also has other functions such as anticancer， anti-inflammation， and immunosuppression. It has been widely used to treat autoimmune diseases， renal diseases， and tumors. T. wilfordii contains a variety of chemical components， among which triptolide （TP） can cause varying degrees of damage to human digestive， circulatory， reproductive， and other systems， with liver injury being the most common one， which greatly limits the development of TP in new drug research and industrial application. Therefore， the authors focused on the research hotspot of TP-induced liver injury and summarized relevant Chinese and international literature regarding the clinical manifestations， injury mechanisms， and detoxification strategies of TP-induced liver injury. This helps to provide a scientific basis for the clinical drug safety and scientific drug supervision of TP. The clinical manifestations of TP-induced liver injury are mostly abnormal transaminases， loss of appetite， nausea and vomiting， anorexia， yellow staining of skin and sclera， and yellow urine. The mechanisms of the above clinical manifestations involve apoptosis， oxidative stress， influence on cytochrome P450 superfamily， macrophage polarization， regulation of biological clock gene Clock， etc. Among them， cell apoptosis is related to neurogenic locus notch homolog protein 1 （Notch1）， dynamin-related protein 1 （Drp1）-cytochrome C （Cyt C）， phosphatidylinositide 3-kinases （PI3K）/protein kinase B （Akt）， mitogen-activated protein kinase （MAPK）， tumor suppressor protein 53 （p53）， Fas cell surface death receptor （Fas）/Caspase-8， and other signaling pathways. Oxidative stress is related to inhibition of nuclear factor-erythroid 2-related factor 2 （NRF2） signaling pathway， promotion of cytochrome P450 2E1 （CYP2E1） expression， and excessive accumulation of reactive oxygen （ROS）. The influence of the cytochrome P450 superfamily is manifested as reducing the substrate affinity， activity， and expression of cytochrome P450 3A （CYP3A）， cytochrome P450 2C9 （CYP2C9）， cytochrome P450 2C19 （CYP2C19）， and cytochrome P450 1A2 （CYP1A2）. Promoting the transformation of macrophages into the M1 type is related to the secretion of inflammatory factors and the accumulation of endotoxin， and the internal rhythmic regulation of the biological clock gene Clock， is related to the expression of cytochrome P450 3A11 （CYP3A11） metabolic enzyme. The detoxification strategies in the clinical application include herbs-processing detoxification strategy and drug-pairing detoxification. The traditional Chinese medicines and monomers that are helpful for detoxification include Glycyrrhiza uralensis， Paeonia lactiflora， Lysimachia christinae， Rehmannia glutinosa， saffron， and paeoniflorin. The reviews and discussion about these topics can help to provide more references for related research and clinical application of TP.