Neck pounding during sinus rhythm: a new clinical manifestation of dual atrioventricular nodal pathways

Objective To determine the clinical and electrophysiological characteristics of patients with paroxysmal palpitations and neck pounding during sinus rhythm. Methods Clinical, electrocardiographic, and electrophysiological characteristics of six patients with paroxysmal palpitations and neck pounding during sinus rhythm were studied in basal conditions and when symptomatic. Response to treatment was observed. Results Baseline ECGs were normal (four patients) or had first degree atrioventricular block with intermittent PR shortening. During symptoms, narrow QRS rhythms were seen without visible P waves (three patients) or with P waves partially hidden in the QRS complex (three patients). Dual atrioventricular nodal pathways were found in all five patients who had electrophysiological studies. In these patients the slow pathway conduction time was long enough (mean (SD), 425 (121)¿ms) for ventricular activation after slow pathway conduction during sinus rhythm to coincide with the next atrial depolarisation, causing neck pounding during exercise (four patients) or at rest (two patients). Tachycardia was not induced in any patient. Medical treatment aggravated symptoms in three patients. A pacemaker was successfully used in two. Conclusions Neck pounding during sinus rhythm is a clinical manifestation of dual atrioventricular nodal pathways. Medical treatment may aggravate symptoms but a pacemaker may offer definitive relief.

The construction process of pedagogical knowledge among nursing professors

Didactic knowledge about contents is constructed through an idiosyncratic synthesis between knowledge about the subject area, students' general pedagogical knowledge and the teacher's biography. This study aimed to understand the construction process and the sources of Pedagogical Content Knowledge, as well as to analyze its manifestations and variations in interactive teaching by teachers whom the students considered competent. Data collection involved teachers from an undergraduate nursing program in the South of Brazil, through non-participant observation and semistructured interviews. Data analysis was submitted to the constant comparison method. The results disclose the need for initial education to cover pedagogical aspects for nurses; to assume permanent education as fundamental in view of the complexity of contents and teaching; to use mentoring/monitoring and the value learning with experienced teachers with a view to the development of quality teaching.

Re-writing and Its Pedagogical Value: A Case Study

Tenint en compte el temps i la energia que els mestres i professors dediquen a la correcció de redaccions i produccions escrites i el poc efecte que aquestes semblen tenir en altres produccions dels aprenents, es va dissenyar la recerca que es presenta en aquest article. Els resultats de l'estudi semblen suggerir que les correccions no faciliten l'aprenentatge. Com presentem aquesta activitat de retroalimentació a l'alumnat i la posició que li donem dins d'un enfocament basat en el procés de l'escriptura seran clau per fer que les correccions siguin facilitadores de l'aprenentatge de la producció escrita.

The pedagogical value of games and songs : The perceptions of teachers

Aquest estudi intenta explorar i descobrir les actituds i creences d’alguns mestres de llengua anglesa de Catalunya sobre la naturalesa dels jocs i les cançons, així com el paper que juguen en les seves aules per ensenyar l’anglès als infants. Les opinions dels mestres de llengua anglesa van ser recollides mitjançant un qüestionari que contenia preguntes sobre els jocs i les cançons i els resultats s’analitzen i s’exposen en aquest estudi.

Identifying pedagogical, technological and organizational barriers in virtual learning environments

Virtual learning environments are online spaces where learners interact with other learners, teachers, resources and the environment in itself. Although technology is meant to enhance the learning process, there are important issues regarding pedagogical and organizational aspects that must be addressed. In this paper we review the barriers detected in a virtual university which exclusively uses Internet as the main channel of communication, with no face-to-face requirements exceptthose related to final evaluation.

De la vivència a l'experiència: la significació del medi aquàtic en el desenvolupament de l'infant

This work gets deeply into the comprehension of the aquatic medium as a significant space for the for a psychomotor intervention in the development of the children. Its starting point is a methodological pose of philosophical nature which uses phenomenology as the way for discovering. From this stand, the research sequence and process are justified. They both show an underlying attitude which has guided the whole process of turning the learning-by-experiencing the phenomena into experienced-knowledge of it. In this way the characteristic gnoseological reduction of the phenomenology has been used, while proceeding to the observation of children evolving in the water. Once the construction process of this work was established, the reduction of the amount of concepts and ideas began. This is its most characteristic process of the phenomenological research. First, an approach to the aquatic medium as a pluridimensional space has been made. Afterwards a study of the up to three years old child from a global perspective which includes the emotional, the social the cognitive and the psychomotor dimensions has been done. At last, the essence of the psychomotor as a model for the pedagogical action has been studied. From this three distinctive elements, and as a result of this research, a proposal of psychomotor intervention in the aquatic medium has been built.

Itinerari d'educació ambiental: petjades a Comes de Rubió

El Parc Natural de l’Alt Pirineu (PNAP) va ser creat l’any 2003. A causa de la seva recent creació, manca el desenvolupament de moltes de les seves àrees. Actualment, el parc està creant una xarxa d’itineraris d’Educació Ambiental (EA). Per aquesta raó, és interessant dedicar aquest treball al disseny d’un itinerari d’EA a la zona de Comes de Rubió, situada dins l’àmbit territorial del PNAP. L’objectiu principal del present projecte és l’elaboració d’aquest itinerari amb els recursos necessaris per tal que sigui implementable d’una manera immediata. Per tal d’analitzar la viabilitat de l’itinerari s’ha aplicat el protocol de valoració dissenyat pel grup Edukamb. La puntuació que s’ha obtingut ha estat 61 sobre 100, fet que indica que l’itinerari és viable tot i que compta amb algunes mancances. S’ha constatat que les condicions de l’itinerari són idònies per poder ser visitat pel públic en general, entre altres coses per la forma circular de l’itinerari, per tenir 3 km de recorregut i per disposar d’una gran varietat d’aspectes d’interès. En el disseny de l’itinerari s’ha definit el recorregut, s’han determinat els elements d’interès, s’han proposat 5 parades, s’han dissenyat els materials pedagògics, s’ha definit la situació de la senyalització i s’han proposat correccions per a les mancances detectades en el protocol, entre altres, una millora en l’accessibilitat al punt d’inici i la construcció de passeres en els punts potencialment erosionables. Les principals pautes a seguir a l’hora d’elaborar el material pedagògic han estat la integració de l’aspecte social amb el natural i la promoció de la sensibilització envers el medi ambient.