Estudi del valor socioeducatiu de l’amistat en el procés d’integració social dels adolescents immigrants a Catalunya

L'escola és avui dia un espai de cohabitació on els adolescents immigrants construeixen i consoliden la seva identitat. En aquest context les relacions d'amistat determinen en bona mesura el grau d'aprenentatge de la cultura del país d'acolliment així com la vinculació simbòlica amb la societat que els acull. Aquesta investigació explora les característiques de les relacions d'amistat dels adolescents immigrants en el context de l'escola. La mostra va estar integrada per 682 estudiants dels últims cursos de Secundària Bàsica Obligatòria (15-16 anys), de sis instituts de Catalunya. Els resultats revelen que els adolescents immigrants en bona mesura nominen com a amics a altres adolescents de la seva mateixa cultura i a altres pertanyents a altres cultures però amb els quals comparteix la condició d'immigrant. En canvi, els amics dels adolescents autòctons pertanyen, majoritàriament, a la seva pròpia cultura. Finalment, s'aprecien algunes diferències respecte al suport que ofereixen els amics dels diferents grups, sent lleugerament inferior el suport que perceben els adolescents d'origen estranger. Aquests resultats confirmen les conclusions d'estudis precedents i alerten sobre la necessitat d'aprofundir en les seves causes per evitar els negatius efectes que pot generar per als adolescents immigrats les deficiències del procés de socialització a l'entorn de l'escola.

Tumeurs neuroendocrines digestives: pléomorphes et souvent ignorées [Gastrointestinal neuroendocrine tumors: pleomorphic and often ignored].

Although generally considered as rare, incidence of gastrointestinal neuroendocrine tumors (GI-NETs) is increasing. The general practitioner has thus to be familiar with the vast array of clinical presentations and the growing family of diagnostic tools that can be used. Symptoms can be related to their hormonal production, their local extent or a bleeding complication. The prognosis depends on the grade of tumor, its local extent at diagnosis and its localization. The diagnosis relies on radiologic, endoscopic and nuclear medicine strategies. In case of typical symptoms, a hormonal secretion should be sought. Treatment options are extensive and should be discussed in an interdisciplinary manner.

Student modeling based on fuzzy inference mechanisms

The paper presents a competence-based instructional design system and a way to provide a personalization of navigation in the course content. The navigation aid tool builds on the competence graph and the student model, which includes the elements of uncertainty in the assessment of students. An individualized navigation graph is constructed for each student, suggesting the competences the student is more prepared to study. We use fuzzy set theory for dealing with uncertainty. The marks of the assessment tests are transformed into linguistic terms and used for assigning values to linguistic variables. For each competence, the level of difficulty and the level of knowing its prerequisites are calculated based on the assessment marks. Using these linguistic variables and approximate reasoning (fuzzy IF-THEN rules), a crisp category is assigned to each competence regarding its level of recommendation.

Delirium: guidelines for general hospitals.

OBJECTIVE: Delirium is highly prevalent in general hospitals but remains underrecognized and undertreated despite its association with increased morbidity, mortality, and health services utilization. To enhance its management, we developed guidelines covering all aspects, from risk factor identification to preventive, diagnostic, and therapeutic interventions in adult patients. METHODS: Guidelines, systematic reviews, randomized controlled trials (RCT), and cohort studies were systematically searched and evaluated. Based on a synthesis of retrieved high-quality documents, recommendation items were submitted to a multidisciplinary expert panel. Experts scored the appropriateness of recommendation items, using an evidence-based, explicit, multidisciplinary panel approach. Each recommendation was graded according to this process' results. RESULTS: Rated recommendations were mostly supported by a low level of evidence (1.3% RCT and systematic reviews, 14.3% nonrandomized trials vs. 84.4% observational studies or expert opinions). Nevertheless, 71.1% of recommendations were considered appropriate by the experts. Prevention of delirium and its nonpharmacological management should be fostered. Haloperidol remains the first-choice drug, whereas the role of atypical antipsychotics is still uncertain. CONCLUSIONS: While many topics addressed in these guidelines have not yet been adequately studied, an explicit panel and evidence-based approach allowed the proposal of comprehensive recommendations for the prevention and management of delirium in general hospitals.

Adolescent support networks in a health care context: the interface between health, family and education

AbstractOBJECTIVEAnalyze adolescents' perceptions about support networks and their health needs.METHODAnalytical and interpretive study using focus groups conducted in municipal state schools in Fortaleza, in the State of Ceará during the first semester of 2012. The sample comprised 36 male and female adolescents aged between 13 and 16 years attending the ninth grade of the second phase of elementary school.RESULTSThematic analysis revealed that the health care support network and interaction between health professionals, education professionals and family members was insufficient, constituting a lack of an integrated network to enable and provide support for health promotion.CONCLUSIONCoordination between education, health and family services has the potential to act as a support network to help meet adolescents' healthcare needs and demands.

O Erro, uma Análise Necessária: sua Implicação no Ensino da Língua Portuguesa em Cabo Verde

O trabalho de investigação que ora se apresenta entronca nas preocupações do dia a dia enquanto profissional e dirigente da educação que tem experimentado e acompanhado de perto a prática pedagógica e docente. Por esses imperativos, senti-me na obrigação de procurar uma resposta, refletir sobre as dificuldades do ensino da língua portuguesa e perceber melhor esses obstáculos, nomeadamente o erro linguístico nas práticas letivas, as causas subjacentes e, eventualmente, a quota-parte de responsabilidades dos outros intervenientes no processo, nomeadamente, dos professores de língua portuguesa e do próprio sistema. Nesta sequência, o presente estudo aborda o erro como conceito, marcado pela polissemia da sua definição, abordado pelas múltiplas metodologias de ensino, mas também como elemento central no ensino e aprendizagem de uma língua segunda, no ensino básico, em contextos de coabitação de línguas muito próximas como o português e a língua cabo-verdiana; pretendemos também elencar os procedimentos e atitudes dos atores no processo, bem como os meios didático-pedagógicos essenciais com vista a sua deteção, análise e tratamento do mesmo. A aprendizagem de uma língua segunda como o português, num contexto como o de Cabo Verde, constitui uma tarefa complexa e por vezes demorada, que não pode ser resumida a atos corriqueiros e previsíveis de sala de aula, ignorando as necessidades, disposições e interesses dos aprendentes que são colocados perante uma encruzilhada, o de aprender uma língua que não é sua, mas que não pode recusar. A aparente aproximação entre as duas línguas constitui um obstáculo acrescido, por propiciar a interferência, principal causa do erro, apesar do avanço verificado no desenvolvimento de metodologias e materiais de apoio que auxiliam e tornam mais eficiente o processo de aquisição de uma língua segunda. Para operacionalização do assunto foi elaborado um estudo com recurso à análise de erros, em quarenta e um (41) textos produzidos por alunos do 6.º ano de escolaridade de cinco escolas do ensino básico do Tarrafal, Cabo Verde, com o intuito de recolher informações, analisá-las e, após uma reflexão sobre os resultados, concluir sobre as suas implicações no ensino aprendizagem da língua portuguesa.

Projectos Futuros e Atitudes Vocacionais dos Alunos do 9º ano de uma Escola Secundária de Cabo Verde

As escolhas vocacionais são momentos importantes no ciclo do desenvolvimento humano, sendo particularmente relevantes as que ocorrem ainda na adolescência. Em Cabo Verde são escassos os estudos sobre o desenvolvimento vocacional e os projectos vocacionais dos jovens cabo-verdianos. O presente estudo tem como objectivo analisar as atitudes vocacionais e a construção de projectos futuros de adolescentes. Para tal, foram inqueridos 100 alunos de 9º ano de escolaridade de uma escola secundária de Cabo Verde, dos quais 45 são rapazes e 55 raparigas. Esses alunos responderam o questionário sociodemográfico, o Inventário de Desenvolvimento de Carreira, a Escala de Atribuição para Carreira e uma versão adaptada do Inventário de Percepção de Barreira na Carreira. Os resultados mostraram que a maioria dos participantes apresenta projectos, variando no grau de especificação. As raparigas foram mais específicas nos seus projectos. Nas atitudes de planeamento e exploração vocacional as diferenças de género não foram significativas. A análise das crenças atribucionais para a carreira permitiu observar diferenças mais significativas de género, na subescala causalidade interna associado ao fracasso, diferença esta, favorável aos rapazes. Nas percepções de barreiras, a diferença mais significava entre raparigas e rapazes verificaram-se na variável: restrição de oportunidades. Por fim, discute-se a importância da orientação vocacional e apresenta as limitações e implicações do estudo.

Animal Tissue Response To Mid-Term Electronic Modular Artificial Sphincter Implantation

Introduction and objectives: The AMS 800TM is considered the gold standard for sphincter replacement. However, the one-ring design can erode the urethra and lead to severe complications. A mechanism that could alternatively compress successive segments of the urethra would limit such deleterious outcome. We report 12 weeks animal urethral tissue analysis following implantation of a new modular artificial sphincter. METHODS: The device is composed by three parts: the contractile unit, two rings and an integrated microprocessor. The contractile unit is made of Nitinol fibers. The rings are placed around the urethra to control the flow of urine by squeezing the urethra. They work in a sequential alternative mode and are controlled by a microprocessor connected to an external computer. The computer can reveal specific failure of device components. The device was impkanted in eight male sheep. The rings were positioned around the urethra and the control unit was placed 5cm away. The device was working twenty hours per day; it was open 10min. per hour to allow urination. The animals were sacrificed after 12 weeks. The urethra and the tissues surrounding the control unit were macroscopically and microscopically examined. Two transversal sections crossing the sphincter and two transversal sections crossing the urethra alone were obtained and stained with modified Paragon after resin embedding. Urethra was also embedded in paraffin. The first section was stained with safranin-hematoxylin-eosin, the second section was stained with Masson's Trichrome and the remaining eight sections were available for immunolabelling of the macrophages.Results: The chronic study went uneventful. No clinical infection or pain was observed. The computer registered no specific failure in ring function, Nitinol wires and tube connectors. At explantation, except for a slight grade of lymphocytes in two out of eight specimens, no urethral stricture or atrophy could be observed. Immunohistochemistry confirmed the absence of macrophages. Tissue structure and organization of the urethra with and without artificial sphincter were similar. No migration of the device was observed.Conclusions: The study clearly showed no tissue damage or inflammation of the urethra. Electronic design, preservation of urethral vascularisation and adjustability after implantation are the key ideas to improve the actual AUS. Further studies will be carried out to evaluate this potential.

Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations.

BACKGROUND & AIMS: Protocols for enhanced recovery provide comprehensive and evidence-based guidelines for best perioperative care. Protocol implementation may reduce complication rates and enhance functional recovery and, as a result of this, also reduce length-of-stay in hospital. There is no comprehensive framework available for pancreaticoduodenectomy. METHODS: An international working group constructed within the Enhanced Recovery After Surgery (ERAS®) Society constructed a comprehensive and evidence-based framework for best perioperative care for pancreaticoduodenectomy patients. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the GRADE system and reached through consensus in the group. The quality of evidence was rated "high", "moderate", "low" or "very low". Recommendations were graded as "strong" or "weak". RESULTS: Comprehensive guidelines are presented. Available evidence is summarised and recommendations given for 27 care items. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations. CONCLUSIONS: The present evidence-based guidelines provide the necessary platform upon which to base a unified protocol for perioperative care for pancreaticoduodenectomy. A unified protocol allows for comparison between centres and across national borders. It facilitates multi-institutional prospective cohort registries and adequately powered randomised trials.

Telomerase activation in colorectal carcinogenesis.

Telomerase activity has been detected in germ cells as well as in the developing embryo. Activity is no longer detectable in most somatic cells of the neonate, although low levels of activity persist in regenerative tissues. Telomerase has been found to be reactivated or up-regulated in the majority of cancers. The colorectal adenoma-carcinoma sequence is one of the best-characterized models of multistep tumourigenesis and is thus suitable for determining at which stage telomerase is activated. Telomerase activity was examined by telomeric repeat amplification protocol (TRAP) assay in 96 cases of colorectal tissues, including 50 carcinomas, 31 adenomas, and 15 normal colonic tissues. For each case, histological diagnosis and telomerase activity were determined on consecutive frozen sections. In order to reduce the chance of a false-negative TRAP assay due to RNA degradation, the integrity of rRNA in the tissues was verified in each case. Twenty-five carcinomas, 30 adenomas, and all of the 15 normal colorectal mucosal samples showed no or only partial rRNA degradation and only in these cases was the TRAP assay interpreted. None of the normal tissues exhibited telomerase activity. In contrast, all of the 25 cancers and 47 per cent (14/30) of the adenomas were positive. In adenomas, telomerase activation was highly significantly related to the grade of dysplasia (p< 0.0001). All adenomas which contained high-grade dysplasia revealed telomerase activity, whereas telomerase activity was detectable in only 20 per cent (4/20) of cases with exclusively low-grade dysplasia. These results indicate that telomerase activation, which may be an obligatory step in colorectal carcinogenesis, occurs in the progression from low-grade to high-grade dysplasia in adenomas. Furthermore, in the adenoma-carcinoma sequence, telomerase activation seems to occur later than K- ras mutation but earlier than p53 mutation.

Towards a consensus view on understanding nanomaterials hazards and managing exposure

The aim of this article is to present an overview of salient issues of exposure, characterisation and hazard assessment of nanomaterials as they emerged from the consensus-building of experts undertaken within the four year European Commission coordination project NanoImpactNet. The approach adopted is to consolidate and condense the findings and problem-identification in such a way as to identify knowledge-gaps and generate a set of interim recommendations of use to industry, regulators, research bodies and funders. The categories of recommendation arising from the consensual view address: significant gaps in vital factual knowledge of exposure, characterisation and hazards; the development, dissemination and standardisation of appropriate laboratory protocols; address a wide range of technical issues in establishing an adequate risk assessment platform; the more efficient and coordinated gathering of basic data; greater inter-organisational cooperation; regulatory harmonization; the wider use of the life-cycle approaches; and the wider involvement of all stakeholders in the discussion and solution-finding efforts for nanosafety.

Recycled Asphalt Pavements - Kossuth County Iowa, HR-176, 1975

Kossuth County is located in North Central Iowa bordering on the State of Minnesota. It is the largest county in Iowa consisting of 28 congressional townships. The population of the county is 23,000 of which 11,000 people live in the rural area. There are 13 towns located in the county with the county seat, Algona, being the largest with a population of 6,100. Major industry of the area is grain farming with some beef and hog production. Naturally, where there is good grain farm land it follows that there is poor soil available for road construction and pavements. However, below the 3 to 4 feet of good farm land of Kossuth there is present a good grade of clay soil which does make an adequate base for surfacing when placed and compacted on top of the roadbed. As early as 1950, the then Kossuth County Engineer, H.M. Smith, embarked on a program of stage construction in building new grades and pavements. The goal of his program was primarily to conserve the county's rapidly dwindling supply of surfacing materials, and also, to realize the side effects of providing smooth and dustless roads for the public. Engineer Smith was fully aware of the poor soils that existed for road construction, but he also knew about the good clay that lay below the farm soil. Consequently, in his grading program he insisted that road ditches be dug deep enough to allow the good clay soil to be compacted on top of the roadbed. The presence of the compacted clay on top of the road resulted in a briding affect over the farm soil. The stage construction program satisfied the objectives of aggregate construction and dust control but did generate other problems which we are now trying to solve as economically as possible.

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS(®)) Society Recommendations.

BACKGROUND: Protocols for enhanced recovery provide comprehensive and evidence-based guidelines for best perioperative care. Protocol implementation may reduce complication rates and enhance functional recovery and, as a result of this, also reduce length-of-stay in hospital. There is no comprehensive framework available for pancreaticoduodenectomy. METHODS: An international working group constructed within the Enhanced Recovery After Surgery (ERAS(®)) Society constructed a comprehensive and evidence-based framework for best perioperative care for pancreaticoduodenectomy patients. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the GRADE system and reached through consensus in the group. The quality of evidence was rated "high", "moderate", "low" or "very low". Recommendations were graded as "strong" or "weak". RESULTS: Comprehensive guidelines are presented. Available evidence is summarised and recommendations given for 27 care items. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations. CONCLUSIONS: The present evidence-based guidelines provide the necessary platform upon which to base a unified protocol for perioperative care for pancreaticoduodenectomy. A unified protocol allows for comparison between centres and across national borders. It facilitates multi-institutional prospective cohort registries and adequately powered randomised trials.

Las competencias genéricas en el Grado de Derecho y su evaluación

[spa] El presente estudio versa sobre la evaluación de competencias transversales en el Grado de Derecho a través del uso del portafolio digital. A tal fin son definidos los objetivos a alcanzar, las fases en su aplicación; la selección de las competencias a evaluar, así como una tabla de equivalencias entre actividades y competencias. Dicho portafolio electrónico nos ha permitido hacer el seguimiento, monitorización y evaluación de las competencias de los estudiantes. Se ha escogido deliberadamente llevar a cabo únicamente la evaluación de las competencias genéricas o transversales. La implantación del portafolio se ha hecho como experiencia piloto en un grupo de 90 estudiantes de doble titulación en la Facultad de Derecho de la Universidad de Barcelona.

Anàlisi d'una experiència basada en el mètode de la recerca del medi i amb el suport de les TIC

Avui en dia les Tecnologies de la Informació i la Comunicació (TIC) s’han convertit en eines d’ús quotidià i alhora invisibles en diversos àmbits de la societat i les escoles no n’estan al marge. No cal ensenyar a fer servir eines tecnològiques, sinó que cal entendre-les com un suport. Recerques recents han demostrat que un bon ús d’aquestes potencien un bon ensenyament i aprenentatge. Al mateix temps, es potencien mètodes globalitzats a les aules que permeten construir coneixements significatius a partir de situacions i problemes. Per això, l’objectiu principal d’aquest estudi consisteix en investigar quins canvis s’observen en la motivació de l’alumnat i quins canvis succeeixen a l’aula en general quan s’usen les TIC com a suport en un mètode globalitzat anomenat la recerca del medi. Per tal de resoldre aquest problema d’investigació es recullen diverses dades d’una intervenció didàctica basada en aquest mètode que es porta a terme en dos cursos de cinquè de Primària. Tal com s’observarà, l’ús de les noves tecnologies en un mètode que permet apropar els infants a la realitat n’augmenta la motivació i promou canvis a l’aula que ajuden i faciliten la tasca del docent i alhora afavoreix un aprenentatge significatiu.