Seeding a Profession: The Intersection of the State, International Interests, and the Early Development of Brazilian Nursing

State and international entities can have profound effects on the development of a country’s nursing profession. Through a global health governance lens, this paper explores the development of nursing in Brazil during the early twentieth century, and its intersections with national and international interests. Accordingly, we will show how state policies established an environment that fostered the institutionalization of nursing as a profession in Brazil and supported it as a means to increase the presence of females in nation building processes. The State focused on recruiting elite women for nursing, in part due to the Rockefeller Foundation’s involvement in the country. Nurses who worked for Rockefeller came from well-educated classes within US society with specific ideas about who should be a nurse and the roles of nurses in a healthcare system. These women served as the primary vehicles for interacting with Brazilian health authorities responsible for health system development. Their early efforts did not, however, ensure a system capable of producing nursing human resources at a rate that, in present day Brazil, could meet the health needs of the country. Findings from this paper offer new avenues for historians to explore the early roots of professional nursing through a global health governance lens, improve the understanding of the intersection between international politics and professionalization, and highlight how these factors may impact nursing human resources production in the long term.

Development of multidisciplinary workshops between different subjects as an innovative teaching methodology for the acquisition of professional skills of the future architect

The implantation of the new Architecture Degree and the important normative changes in the building sector imply the need to use new teaching methodologies that enhance skills and competences in order to response to the increasing requirements demanded by society to the future architect. The aim of this paper is to present, analyze and discuss the development of multidisciplinary workshops as a new teaching methodology used in several Construction subjects of the Architecture Degree in the University of Alicante. Workshops conceived with the aim to synthesize and complement the technical knowledge acquired by the students during the Degree and to enhance the skills and competencies necessary for the professional practice. With that purpose, we decided to experiment on current subjects of the degree during this academic year, by applying the requirements defined in the future Architecture Degree in a practical way, through workshops between different subjects, superposing the technical knowledge with the resolution of constructive problems in the development of an architectural project. Developing these workshops between subjects we can dissolve the traditional boundaries between different areas of the Degree. This multidisciplinary workshop methodology allows the use of all the global knowledge acquired by students during their studies and at the same time, it enhances students’ ability to communicate and discuss their ideas and solutions in public. It also increases their capacity of self-criticism, and it foments their ability to undertake learning strategies and research in an autonomous way. The used methodology is based on the development of a practical work common to several subjects of different knowledge areas within the "Technology Block" of the future Architecture Degree. Thus, students work approaching the problem in a global way discussing simultaneously with teachers from different areas. By using these new workshops we stimulate an interactive class versus a traditional lecture. Work is evaluated continuously, valuing the participative pupil´s attitude, working in groups in class time, reaching weekly objectives and stimulating the individual responsibility and positive interdependence of the pupil inside the working group. The exercises are designed to improve students’ ability to transmit their ideas and solutions in public, knowing how to discuss and defend their technical resolutions to peers and teachers (Peer Reviewing), their capacity for self-criticism and their capacity to undertake strategies and autonomous learning processes at the same time they develop a personal research into new technologies, systems and materials. Students have shown their majority preference for this teaching methodology by the multidisciplinary workshops offered in the last years, with very satisfactory academic results. In conclusion, it can be verified nowadays the viability of the introduction of new contents and new teaching methodologies necessary for the acquisition of the skills in the future Architecture Degree, through workshops between several subjects that have had a great acceptance in students and positive contrasted academic results.

Analysis of internal astigmatism and higher order aberrations in eyes implanted with a new diffractive multifocal toric intraocular lens

Background To evaluate the intraocular lens (IOL) position by analyzing the postoperative axis of internal astigmatism as well as the higher-order aberration (HOA) profile after cataract surgery following the implantation of a diffractive multifocal toric IOL. Methods Prospective study including 51 eyes with corneal astigmatism of 1.25D or higher of 29 patients with ages ranging between 20 and 61 years old. All cases underwent uneventful cataract surgery with implantation of the AT LISA 909 M toric IOL (Zeiss). Visual, refractive and corneal topograpy changes were evaluated during a 12-month follow-up. In addition, the axis of internal astigmatism as well as ocular, corneal, and internal HOA (5-mm pupil) were evaluated postoperatively by means of an integrated aberrometer (OPD Scan II, Nidek). Results A significant improvement in uncorrected distance and near visual acuities (p < 0.01) was found, which was consistent with a significant correction of manifest astigmatism (p < 0.01). No significant changes were observed in corneal astigmatism (p = 0.32). With regard to IOL alignment, the difference between the axes of postoperative internal and preoperative corneal astigmatisms was close to perpendicularity (12 months, 87.16° ± 7.14), without significant changes during the first 6 months (p ≥ 0.46). Small but significant changes were detected afterwards (p = 0.01). Additionally, this angular difference correlated with the postoperative magnitude of manifest cylinder (r = 0.31, p = 0.03). Minimal contribution of intraocular optics to the global magnitude of HOA was observed. Conclusions The diffractive multifocal toric IOL evaluated is able to provide a predictable astigmatic correction with apparent excellent levels of optical quality during the first year after implantation.

Evaluación del practicum en la formación de posgrado en los estudios de comunicación desde una orientación profesional y discente

La investigación evaluativa se erige como una herramienta necesaria para reorientar las propuestas docentes desarrolladas con los estudiantes. A través de este estudio se evalúa la consecución de los objetivos relacionados con las prácticas profesionales de los alumnos del Master Comunicación en Industrias Creativas, durante el curso académico 2011-2012, en la Universidad de Alicante. Los resultados obtenidos permiten establecer una reflexión en torno a la orientación futura que debemos otorgar a este proceso de intervención didáctica, reforzando los objetivos de aprendizaje menos consolidados.

Validation of the Spanish version of mackey childbirth satisfaction rating scale

Background: The “Mackey Childbirth Satisfaction Rating Scale” (MCSRS) is a complete non-validated scale which includes the most important factors associated with maternal satisfaction. Our primary purpose was to describe the internal structure of the scale and validate the reliability and validity of concept of its Spanish version MCSRS-E. Methods: The MCSRS was translated into Spanish, back-translated and adapted to the Spanish population. It was then administered following a pilot test with women who met the study participant requirements. The scale structure was obtained by performing an exploratory factorial analysis using a sample of 304 women. The structures obtained were tested by conducting a confirmatory factorial analysis using a sample of 159 women. To test the validity of concept, the structure factors were correlated with expectations prior to childbirth experiences. McDonald’s omegas were calculated for each model to establish the reliability of each factor. The study was carried out at four University Hospitals; Alicante, Elche, Torrevieja and Vinalopo Salud of Elche. The inclusion criteria were women aged 18–45 years old who had just delivered a singleton live baby at 38–42 weeks through vaginal delivery. Women who had difficulty speaking and understanding Spanish were excluded. Results: The process generated 5 different possible internal structures in a nested model more consistent with the theory than other internal structures of the MCSRS applied hitherto. All of them had good levels of validation and reliability. Conclusions: This nested model to explain internal structure of MCSRS-E can accommodate different clinical practice scenarios better than the other structures applied to date, and it is a flexible tool which can be used to identify the aspects that should be changed to improve maternal satisfaction and hence maternal health.