加快伦理审查效率实践及策略探讨＊

本文根据临床试验研究者、申办方在提交项目伦理申请材料及伦理审查过程中，希望加快伦理审查效率的实际需求，探讨了在临床试验项目，尤其是多中心临床研究项目的伦理审查过程中，加快伦理审查效率的关键环节，分享了本院伦理审查过程中创新的、适合中医院实际情况的改革策略。具体包括统一各中心伦理递交审查材料清单、简化便捷伦理审查流程，通过电子化系统管理伦理受理、送审、审查、决定传达及归档的全过程，逐步建立合理有效的伦理审查工作程序，完善各中心伦理委员会的沟通交流机制，不断优化伦理委员会办公室的工作流程，逐步提高临床研究项目伦理审查的整体效率，更加全面系统的保护受试者的权益及安全。同时，本文也分享了本院伦理委员会通过接受中心伦理审查，科学性审查前置，重视伦理申请材料的形式审查，加强伦理委员会的主审制、预审制，注重伦理会议审查的要点，依托于电子化信息系统等具体实际方式，逐步提高我院伦理委员会的审查效率和伦理审查的质量。     

医学院校体质弱势群体体医融合教学模式研究

《"健康中国2030"规划纲要》作为引领中国体育治理能力和治理体系的现代化国策,将"体医融合"上升至解决当前中国健康问题的重要战略地位,为全民健身和全民健康的深度融合的战略行动计划实施指明了方向。同时,也为"体育+医学"元素融入大学传统公共体育教育环节提供了全新的视角。文章运用文献资料法、逻辑分析法、访谈法、问卷调查等研究方法对医药类高校公共体育保健康复课程的实施现状进行一系列的调查研究,对医学院校体质弱势群体学生的体育保健康复课程建设发展困境进行深入分析,初步提出针对医学院校的"体医融合"混合式体育保健康复课程教育模式的构想,以期通过体医融合教学干预策略改善高校大学生体质弱势群体身体及心理的健康状况,为全国同类院校体育保健课的发展实现真正意义上的突破。     

Increasing Ebola transmission behaviors 6 months post-vaccination: Comparing vaccinated and unvaccinated populations near 2018 Mbandaka Ebola outbreak in the Democratic Republic of Congo

BackgroundIn 2018, the Democratic Republic of the Congo (DRC) declared its 9th and 10th Zaire ebolavirus (EBOV) outbreaks, in the Equateur province (end: July 2018), and in the eastern provinces including North Kivu (end: June 2020). The DRC Ministry of Health deployed the rVSV-vectored glycoprotein (VSV-EBOV) vaccine in response during both outbreaks.MethodsA cohort of vaccinated and unvaccinated individuals from the Equateur province were enrolled and followed prospectively for 6 months. Among participants included in this analysis, 505 were vaccinated and 1,418 were unvaccinated. Differences in transmission behaviors pre- and post- outbreak were identified, along with associations between behaviors and vaccination.ResultsThere was an overall increase in the proportion of both unvaccinated and vaccinated individuals in Mbandaka who participated in risky activities post-outbreak. Travel outside of the province pre-outbreak was associated with vaccination. Post-outbreak, vaccinated individuals were less likely to participate in funeral traditions than unvaccinated individuals.ConclusionA net increase in activities considered high risk was observed in both groups despite significant efforts to inform the population of risky behaviors. The absence of a reduction in transmission behavior post-outbreak should be considered for improving future behavior change campaigns in order to prevent recurrent outbreaks.     

Ischemic stroke in Morocco: Prehospital delay and associated factors

ObjectivesThis study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco.Patients and methodsAn observational, prospective, cross-sectional study was conducted from March 2019 to September 2019 in the Souss Massa regional hospital center, which is a public hospital structure. A questionnaire was administered to patients with ischemic stroke and to bystanders (family or others), while clinical and paraclinical data were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify the factors associated with delayed arrival at emergency department.ResultsA total of 197 patients and 197 bystanders who fulfilled the criteria for the study were included. The median time from symptom onset to hospital arrival was 6 hours (IQR, 4–16). Multiple regression analysis showed that illiteracy (OR 38.58; CI_95%: 3.40–437.27), waiting for symptoms to disappear (patient behavior) (OR 11.24; CI_95%: 1.57–80.45), deciding to go directly to the hospital (patient behavior) (OR 0.07; CI_95%: 0.01–0.57), bystander's knowledge that stroke is a disease requiring urgent care within a limited therapeutic window (OR 0.005; CI_95%: 0.00–0.36), and direct admission without reference (OR 0.005; CI_95%: 0.00–0.07), were independently associated with late arrival (> 4.5 hours) of patients with acute ischemic stroke. In addition, illiteracy (OR 24.62; CI_95%: 4.37–138.69), vertigo and disturbance of balance or coordination (OR 0.14; CI_95%: 0.03–0.73), the relative's knowledge that stroke is a disease requiring urgent care and within a limited therapeutic window (OR 0.03; CI_95%: 0.00–0.22), calling for an ambulance (relative's behavior) (OR 0.16; CI_95%: 0.03–0.80), distance between 50 and 100 km (OR 10.16; CI_95%: 1.16–89.33), and direct admission without reference (OR 0.03; CI_95%: 0.00–0.14), were independently associated with late arrival (> 6 hours) of patients with acute ischemic stroke.ConclusionPatient behavior, bystander knowledge and direct admission to the competent hospital for stroke care are modifiable factors potentially useful for reducing onset-to-door time, and thereby increasing the implementation rates of acute stroke therapies.