An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

BACKGROUND We evaluated a newly designed electronic portfolio (e-Portfolio) that provided quantitative evaluation of surgical skills. Medical students at the University of Seville used the e-Portfolio on a voluntary basis for evaluation of their performance in undergraduate surgical subjects. METHODS Our new web-based e-Portfolio was designed to evaluate surgical practical knowledge and skills targets. Students recorded each activity on a form, attached evidence, and added their reflections. Students self-assessed their practical knowledge using qualitative criteria (yes/no), and graded their skills according to complexity (basic/advanced) and participation (observer/assistant/independent). A numerical value was assigned to each activity, and the values of all activities were summated to obtain the total score. The application automatically displayed quantitative feedback. We performed qualitative evaluation of the perceived usefulness of the e-Portfolio and quantitative evaluation of the targets achieved. RESULTS Thirty-seven of 112 students (33%) used the e-Portfolio, of which 87% reported that they understood the methodology of the portfolio. All students reported an improved understanding of their learning objectives resulting from the numerical visualization of progress, all students reported that the quantitative feedback encouraged their learning, and 79% of students felt that their teachers were more available because they were using the e-Portfolio. Only 51.3% of students reported that the reflective aspects of learning were useful. Individual students achieved a maximum of 65% of the total targets and 87% of the skills targets. The mean total score was 345 ± 38 points. For basic skills, 92% of students achieved the maximum score for participation as an independent operator, and all achieved the maximum scores for participation as an observer and assistant. For complex skills, 62% of students achieved the maximum score for participation as an independent operator, and 98% achieved the maximum scores for participation as an observer or assistant. CONCLUSIONS Medical students reported that use of an electronic portfolio that provided quantitative feedback on their progress was useful when the number and complexity of targets were appropriate, but not when the portfolio offered only formative evaluations based on reflection. Students felt that use of the e-Portfolio guided their learning process by indicating knowledge gaps to themselves and teachers.

Hypoglycémie et traitement du diabète de type 2. Le retour à une normoglycémie n'est pas nécessairement la meilleure stratégie thérapeutique [Hypoglycemia and diabetes treatment: the return to normal glucose level is not always the best therapeutic strategy].

Recent clinical trials with type 2 diabetic patients and the quest of normal glyceamic values, have revealed difficulties and limitations. These too normal glyceamic targets corresponding to the physiological standards are associated with very high rate of hypoglycemia and an increase of mortality. A too simplistic view of treatment: "the lowest, the better is in the diabetes" is no longer defensible. The knowledge from complex systems behavior invites us to search targets adapted to a new state of equilibrium due to loss of self-regulation. These targets should not aim the physiological standards but to be adapted to patient's situation. Shared decision-making and consensus are the two pillars of this new strategy supported by the new ADA-EASD guidelines.

Characterization and Application of Educational Virtual Environments for Science Teaching in Secondary School

This work describes the characteristics of a representative set of seven different virtual laboratories (VLs) aimed for science teaching in secondary school. For this purpose, a 27-item evaluation model that facilitates the characterization of the VLs was prepared. The model takes into account the gaming features, the overall usability, and also the potential to induce scientific literacy. Five of the seven VLs were then tested with two larger and highly heterogenic groups of students, and in two different contexts – biotechnology and physics, respectively. It is described how the VLs were received by the students, taking into account both their motivation and their self-reported learning outcome. In some cases, students’ approach to work with the VLs was recorded digitally, and analyzed qualitatively. In general, the students enjoyed the VL activities, and claimed that they learned from them. Yet, more investigation is required to address the effectiveness of these tools for significant learning.

A Qualitative Exploration of the Psychological Contents and Dynamics of Momentum in Sport

While studies on triggers and outcomes of Psychological Momentum (PM) exist, little is known about the dynamics by which PM emerges and develops over time. Based on video-assisted recalls of PM experiences in table tennis and swimming competitions, this research qualitatively explored the triggering processes, contents, and the development of PM over time. PM was found to be triggered by mechanisms of dissonance, consonance, or fear of not winning. During the PM experience, participants reported a variety of perceptions, affects and emotions, cognitions, and behaviors, and PM was found to develop through processes of amplification that sometimes ended with a reduction of efforts when the victory or defeat was perceived as certain. These findings are discussed in light of theories on self-regulation and reactance-helplessness. From a practical standpoint, achievement goal-based strategies are suggested, since mastery-approach goals were found to be endorsed to maintain positive PM and overcome negative PM

Training referential communicative skills to individuals with autism spectrum disorder: a pilot study

Summary. The present study reports the effects of referential communication training in individuals formally diagnosed with autism spectrum disorder (ASD). Participants were 20 children with ASD (M age = 14.3 yr., SD = 4.2; 6 girls, 14 boys) in the role of speakers and 20 control children, who acted as listeners. They were all enrolled in mainstream compulsory education. Inclusion/exclusion criteria were defined according to the clinical diagnosis of ASD, the presence or absence of additional or associated disability, previous training in referential communication, and any drug treatment. Speakers were randomly assigned to one of two groups (trained vs untrained). Linguistic age, cognitive level, and autistic symptoms were analyzed, respectively, with the Peabody Picture Vocabulary Test (PPVT), the Wechsler Intelligence Scale (WISCR or WAISIII), and the Autistic Behavior Checklist (ABC). Communicative abilities were analyzed through two indexes related to message complexity and self-regulation. The trained group was trained in referential communication tasks (task analysis, role taking, and task evaluation), while the untrained group took part in a communicative game but without any specific communicative training. The results showed that the complexity of emitted messages had improved statistically significantly in the trained group as an effect of training. Ecological referential communication is shown to be an appropriate paradigm for studying the communicative process and its products and could be used to develop and implement a training program focused on those skills in which individuals with ASD are most deficient.

Correlational study: illness representations and coping styles in caregivers for individuals with schizophrenia.

BACKGROUND: Caring for individuals with schizophrenia can create distress for caregivers which can, in turn, have a harmful impact on patient progress. There could be a better understanding of the connections between caregivers' representations of schizophrenia and coping styles. This study aims at exploring those connections. METHODS: This correlational descriptive study was conducted with 92 caregivers of individuals suffering from schizophrenia. The participants completed three questionnaires translated and validated in French: (a) a socio-demographic questionnaire, (b) the Illness Perception Questionnaire for Schizophrenia and (c) the Family Coping Questionnaire. RESULTS: Our results show that illness representations are slightly correlated with coping styles. More specifically, emotional representations are correlated to an emotion-focused coping style centred on coercion, avoidance and resignation. CONCLUSION: Our results are coherent with the Commonsense Model of Self-Regulation of Health and Illness and should enable to develop new interventions for caregivers.

Determinants of the effect of existential behavioral therapy for bereaved partners: a qualitative study.

BACKGROUND: Informal caregivers of palliative patients took part in existential behavioral therapy (EBT), a group intervention comprising mindfulness exercises to reduce psychological distress and improve quality of life. OBJECTIVES: This study examined what the participants perceived as helpful to cope with their loss during the first year of bereavement, particularly with regard to the EBT intervention. DESIGN: Sixteen problem-centered, semi-structured interviews were evaluated with content analysis. RESULTS: Two main categories were found: social support and self-regulation. Social support includes sense of belonging as well as emotional, cognitive, and practical help experienced from others. Mindfulness and acceptance, a clear focus on the positive, and orientation toward the future were helpful strategies of self-regulation; these were also part of the EBT intervention. Mindfulness was understood as permitting emotions and acceptance of one's inner processes, even if they were not pleasant, and was found to be helpful to stop ruminative thinking. CONCLUSIONS: The categories considered as being helpful parallel core elements of EBT and recent grief theories. The intervention was found to be supportive and met the needs of the participants. The interviewees appreciated the continuity of EBT support from palliative care into bereavement.

Seminario Administración pública y gestión de riesgos

Reseña del seminario organizado desde los Estudios de Derecho y Ciencia Política de la UOC por el Dr. Marc Tarrés. La actividad se realizó bajo el auspicio de la Escuela de Administración Pública de Cataluña y tuvo lugar en el Salón de Grados de la Universidad de Barcelona (UB), los días 19 y 20 de noviembre del 2008. El seminario contó con la presencia de reconocidos especialistas procedentes de los ámbitos académico y judicial, quienes expusieron ante una nutrida concurrencia el papel de los poderes públicos ante situaciones de riesgo. Los ponentes fueron el Dr. José Esteve Pardo, catedrático de Derecho Administrativo de la UB, el Dr. Juan Antonio Carrillo Donaire, profesor titular de Derecho administrativo de la Universidad de Sevilla, el Dr. Gabriel Doménech, profesor de Derecho administrativo del CEU - San Pablo de Valencia, el Ilmo. Sr. Manuel Táboas Bentanachs, magistrado de la Sala Contenciosa Administrativa del TSJ de Cataluña, y el Dr. Francesc Rodríguez Pontón, profesor titular de Derecho administrativo de la UB. En el transcurso de dos jornadas se abordaron especialmente los casos relacionados con la seguridad de los alimentos, la biotecnología y la protección medioambiental. En todos esos sectores se analizó la operatividad del principio de precaución, la responsabilidad de las administraciones públicas, el papel del procedimiento administrativo y la autorregulación.

Net Neutrality: Measuring the Problem, Assessing the Legal Risks

Network neutrality is a growing policy controversy. Traffic management techniques affect not only high-speed, high-money content, but by extension all other content too. Internet regulators and users may tolerate much more discrimination in the interests of innovation. For instance, in the absence of regulatory oversight, ISPs could use Deep Packet Inspection (DPI) to block some content altogether, if they decide it is not to the benefit of ISPs, copyright holders, parents or the government. ISP blocking is currently widespread in controlling spam email, and in some countries in blocking sexually graphic illegal images. In 1999 this led to scrutiny of foreclosure of Instant Messaging and video and cable-telephony horizontal merger. Fourteen years later, there were in 2013 net neutrality laws implemented in Slovenia, the Netherlands, Chile and Finland, regulation in the United States and Canada , co-regulation in Norway, and self-regulation in Japan, the United Kingdom and many other European countries . Both Germany and France in mid-2013 debated new net neutrality legislation, and the European Commission announced on 11 September 2013 that it would aim to introduce legislation in early 2014. This paper analyses these legal developments, and in particular the difficulty in assessing reasonable traffic management and ‘specialized’ (i.e. unregulated) faster services in both EU and US law. It also assesses net neutrality law against the international legal norms for user privacy and freedom of expression

Interdependency management in universities: a case study

There remains uncertainty in scientific discussions regarding the governance of universities in new public management regimes in terms of who actually 'rules' in the university. Apparently, a strengthened management leadership is confronted with continuing elements of academic self-regulation and professional autonomy in knowledge production and diffusion. Organisational and academic rationales coexist in today's management of universities. This article endeavours to clarify some of the ambiguities pertaining to the coexistence of two authorities by demonstrating the working of 'interdependency management' that is taking place within universities. For this purpose, the authors have scrutinised research, teaching and recruitment policies in one Swiss university that is subject to such ambiguities. The study confirms existing research in that a command-and-control system is not applied. Policymaking in universities is instead based on a mix of negotiations in faculties that are taking place in the 'shadow of hierarchy', negotiated bargaining between faculties and leaders and occasional unilateral decisions of leaders. This mitigates latent conflicts between management and the academic community: strategic orientations of the university are generally accepted by the academic community while the academic community has influence on policy formulation and maintains defining powers over policy substance.

Autoevaluación del aprendizaje en enfermería con ejercicios interactivos del programa Hot Potatoes

Los ejercicios interactivos de autoevaluación son una herramienta muy útil para fomentar el aprendizaje autónomo del estudiante. El programa Hot Potatoes permite el diseño de actividades interactivas para la evaluación formativa, con la incorporación de un sistema de retroacción que refuerza los contenidos no asimilados cuando la respuesta no es correcta. El objetivo de estudio es averiguar la opinión de los estudiantes sobre la utilización del programa Hot Potatoes. Materiales y métodos: Estudio descriptivo transversal en la promoción 2006-2007 de la asignatura Enfermería Maternal II. Los datos se recogieron a través de un cuestionario diseñado ad hoc. Resultados: Los ejercicios mejor valorados y considerados de menor dificultad fueron los de opción múltiple; los más difíciles fueron los textos desordenados y los ejercicios de rellenar huecos. Todos los estudiantes consideraron que el método motivó su interés por la asignatura y facilitó su aprendizaje. El 71% considera que el método le ha servido para adquirir conocimientos y ha sido muy útil como herramienta de estudio. Los aspectos que consideran más interesantes incluyen que: son un método de repaso y estudio, facilitan el aprendizaje de una forma amena y permiten conocer el nivel de conocimientos y corregir los errores durante el aprendizaje. Entre los aspectos que mejorarían destacan que incluirían más ejercicios y un número de preguntas más elevado. Conclusiones: El método ha tenido una buena aceptación y ha fomentado el aprendizaje autónomo. Consideramos que se trata de una estrategia de autoevaluación adecuada para la adaptación a los nuevos créditos europeos (ECTS).

Autoevaluación del aprendizaje en enfermería con ejercicios interactivos del programa Hot Potatoes

Los ejercicios interactivos de autoevaluación son una herramienta muy útil para fomentar el aprendizaje autónomo del estudiante. El programa Hot Potatoes permite el diseño de actividades interactivas para la evaluación formativa, con la incorporación de un sistema de retroacción que refuerza los contenidos no asimilados cuando la respuesta no es correcta. El objetivo de estudio es averiguar la opinión de los estudiantes sobre la utilización del programa Hot Potatoes. Materiales y métodos: Estudio descriptivo transversal en la promoción 2006-2007 de la asignatura Enfermería Maternal II. Los datos se recogieron a través de un cuestionario diseñado ad hoc. Resultados: Los ejercicios mejor valorados y considerados de menor dificultad fueron los de opción múltiple; los más difíciles fueron los textos desordenados y los ejercicios de rellenar huecos. Todos los estudiantes consideraron que el método motivó su interés por la asignatura y facilitó su aprendizaje. El 71% considera que el método le ha servido para adquirir conocimientos y ha sido muy útil como herramienta de estudio. Los aspectos que consideran más interesantes incluyen que: son un método de repaso y estudio, facilitan el aprendizaje de una forma amena y permiten conocer el nivel de conocimientos y corregir los errores durante el aprendizaje. Entre los aspectos que mejorarían destacan que incluirían más ejercicios y un número de preguntas más elevado. Conclusiones: El método ha tenido una buena aceptación y ha fomentado el aprendizaje autónomo. Consideramos que se trata de una estrategia de autoevaluación adecuada para la adaptación a los nuevos créditos europeos (ECTS).

External knowledge transfer mechanisms in service business acquisition

In knowledge-intensive economy an effective knowledge transfer is a part of the firm’s strategy to achieve a competitive advantage in the market. Knowledge transfer related to a variety of mechanisms depends on the nature of knowledge and context. The topic is, however, very little empirical studied and there is a research gap in scientific literature. This study examined and analyzed external knowledge transfer mechanisms in service business and especially in the context of acquisitions. The aim was to find out what kind of mechanisms was used when the buyer began to transfer data e.g. their own agendas and practices to the purchased units. Another major research goal was to identify the critical factors which contributed to knowledge transfer through different mechanisms. The study was conducted as a multiple-case study in a consultative service business company, in its four business units acquired by acquisition, in various parts of the country. The empirical part of the study was carried out as focus group interviews in each unit, and the data were analyzed using qualitative methods. The main findings of this study were firstly the nine different knowledge transfer mechanisms in service business acquisition: acquisition management team as an initiator, unit manager as a translator, formal training, self-directed learning, rooming-in, IT systems implementation, customer relationship management, codified database and ecommunication. The used mechanisms brought up several aspects as giving the face to changing, security of receiving right knowledge and correctly interpreted we-ness atmosphere, and orientation to use more consultative touch with customers. The study pointed out seven critical factors contributed to different mechanisms: absorption, motivation, organizational learning, social interaction, trust, interpretation and time resource. The two last mentioned were new findings compared to previous studies. Each of the mechanisms and the related critical factors contributed in different ways to the activity in different units after the acquisition. The role of knowledge management strategy was the most significant managerial contribution of the study. Phenomenon is not recognized enough although it is strongly linked in knowledge based companies. The recognition would help to develop a better understanding of the business through acquisitions, especially in situations such as where two different knowledge strategies combines in new common company.

Enabling constructive alignment in programming instruction

In this thesis, simple methods have been sought to lower the teacher’s threshold to start to apply constructive alignment in instruction. From the phases of the instructional process, aspects that can be improved with little effort by the teacher have been identified. Teachers have been interviewed in order to find out what students actually learn in computer science courses. A quantitative analysis of the structured interviews showed that in addition to subject specific skills and knowledge, students learn many other skills that should be mentioned in the learning outcomes of the course. The students’ background, such as their prior knowledge, learning style and culture, affects how they learn in a course. A survey was conducted to map the learning styles of computer science students and to see if their cultural background affected their learning style. A statistical analysis of the data indicated that computer science students are different learners than engineering students in general and that there is a connection between the student’s culture and learning style. In this thesis, a simple self-assessment scale that is based on Bloom’s revised taxonomy has been developed. A statistical analysis of the test results indicates that in general the scale is quite reliable, but single students still slightly overestimate or under-estimate their knowledge levels. For students, being able to follow their own progress is motivating, and for a teacher, self-assessment results give information about how the class is proceeding and what the level of the students’ knowledge is.

Kansainvälisen kaupan arvoketjujen sääntely. Yhteiskuntavastuun ja ennakoivan oikeuden tarkastelua

Tausta Kansainvälinen kauppa on globaalia toimintaa, jossa tavaroiden ja palveluiden tuottaminen ja kuluttaminen on jakautunut maapallon eri osiin. Arvoketjukäsitteellä korostetaan eri toimijoiden panosta lopputuotteen valmistamiseksi, sekä yhteisten tavoitteiden merkitystä. Toimijaverkostot ovat moni-ilmeisiä ja monimutkaisia. Globaalin kaupan toinen tärkeä piirre on yhteiskuntavastuu, joka tulee esiin niin yksityisen kuin julkisen sektorin toiminnassa. Sen toteuttaminen asettaa suuria haasteita sekä yksityisen että julkisen sektorin toimijoille. Kansallisvaltion mahdollisuudet hallita globaaleja kaupan arvoketjuja julkisella sääntelyllä on osoittautunut ongelmalliseksi. Tutkimuskysymykset Tämä tutkimus on oikeustieteen alaan kuuluva sääntelytutkimuksen artikkeliväitöskirja, joka on tutkimusotteeltaan poikkitieteellinen. Tutkimus pyrkii kaikkiaan valaisemaan yksityisen sääntelyn käyttömahdollisuuksia ja rajoituksia elinkeinotoiminnassa. Keskeisessä roolissa oikeustieteen rinnalla on liiketaloustieteen tutkimus. Tutkimuskysymykset ovat ensinnäkin, mistä nousee kansainvälistä kauppaa koskeva yksityisen sääntelyn tarve ja toiseksi, mikä motivoi yrityksiä yksityiseen sääntelyyn tai itsesääntelyyn. Lopuksi pohditaan, miten lainsäätäjän tulisi suhtautua yksityiseen sääntelyyn. Tutkimuskysymyksiin vastaamalla syvennetään ja täsmennetään oikeustieteen piirissä tehtävää tutkimusta ennakoivasta oikeudesta. Menetelmät ja aineistot Tutkimus on oikeusvertaileva tutkimus, jossa pääpaino on yksityisessä sääntelyssä. Tutkimusaineisto nojautuu eri tieteenaloilla tehtyihin sekä kvalitatiivisiin että kvantitatiivisiin empiirisiin sääntelyjärjestelmien käyttöä ja toimivuutta koskeviin tutkimuksiin sekä tutkijan tekemään 42:en, metsäsektorin, elintarvikealan, vaatetusalan sekä vähittäiskaupan piirissä käytössä olevan sääntelyjärjestelmän analyysiin. Johtopäätökset Yksityisen sääntelyn tarve nousee tarpeesta hallita globaaleja arvoketjuja kohti yhteisiä tavoitteita. Tulevan lainsäädännön uhan sijasta yrityksiä motivoi yksityiseen sääntelyyn kilpailuedun tavoitteluun liittyvät tekijät. Koska kilpailuetuun yhä yleisemmin sisältyy yhteiskuntavastuullisuus, ovat yritysten tavoitteet ja julkisen sektorin tavoitteet lähentyneet. Erilaisten kansalaisjärjestöjen rooli kasvaa koko ajan. Ne osallistuvat vahvasti niin yksityisen sääntelyn laadintaan kuin myös sääntöjen valvontaan. Yksityisen sääntelyn tavoitteet ovat aiemmin liittyneet ympäristönsuojelun painottamiseen ja elintarviketurvallisuuteen erityisesti metsäsektorilla ja elintarvikealalla, myöhemmin sosiaalisen vastuullisuuden parantaminen on myös tullut painokkaammin esiin. Kansainvälisen kaupan piirissä syntynyttä yksityisen sääntelyn ilmiötä kuvataan tässä ennakoiva oikeus –käsitteellä. Aiempi tutkimus rajoittui tarkastelemaan ilmiötä vain ennakoivana lähestymistapana oikeuteen. Tässä painopiste on sen sijaan ennakoivan lähestymistavan avulla aikaansaaduissa sääntelyn välineissä ja lopputuloksissa: mahdollistavassa, valtaistavassa, dynaamisessa ja käyttäjäystävällisessä oikeudessa, jonka avulla luodaan mahdollisuuksia, ennalta ehkäistään ja hallitaan riskejä eikä pelkästään ratkaista jo syntyneitä ongelmia. Käsitteen sisältöä avataan tutkimuksessa sekä sääntelyjärjestelmien sisällöllisen tarkastelun että prosessiin liittyvän tarkastelun avulla.