Informe final creación y evaluación de campo de un instrumento para la medición de las competencias clínicas en Fisioterapia

La evaluación de los procesos formativos en el área clínica, basados en competencias, es fundamental para la Fisioterapia. Este proceso articula la teoría con la práctica, orienta la organización de los procesos académicos, promueve la formación integral y establece mecanismos de retroalimentación permanentes y rigurosos, basados en la evaluación del desempeño del profesional en formación ante situaciones del día a día que dan cuenta de su toma de decisiones profesional. Se espera que los estudiantes se formen y puedan actuar como profesionales competitivos a nivel nacional e internacional, de manera integral, con sólidos compromisos éticos y sociales para responder a las necesidades del entorno social en el que se desenvuelven (PEP, Universidad del Rosario). Los esfuerzos actuales en investigación de la evaluación educativa se encuentran orientados a la integración de la adquisición del conocimiento y al desarrollo de estrategias de medición y cuantificación de capacidades técnico-científicas dentro de cada disciplina. En este sentido, hasta el momento, en Colombia no se encuentra evidencia alrededor de la validación de instrumentos de medición de las competencias clínicas, ni se cuenta con estándares para la evaluación en práctica clínica en el proceso de formación del recurso humano en Fisioterapia. En el proyecto se desarrolló y fueron evaluadas las propiedades psicométricas de un instrumento que mide las competencias clínicas del estudiante de fisioterapia en la práctica clínica. Este proceso involucró a Fisioterapeutas que con experiencia en el área de docencia y clínica, contribuyen con la formación de fisioterapeutas en Colombia.

Rhodium(I) catalyzed [2+2+2] cycloaddition reactions: experimental and theoretical studies

The [2+2+2] cycloaddition reaction involves the formation of three carbon-carbon bonds in one single step using alkynes, alkenes, nitriles, carbonyls and other unsaturated reagents as reactants. This is one of the most elegant methods for the construction of polycyclic aromatic compounds and heteroaromatic, which have important academic and industrial uses. The thesis is divided into ten chapters including six related publications. The first study based on the Wilkinson’s catalyst, RhCl(PPh3)3, compares the reaction mechanism of the [2+2+2] cycloaddition process of acetylene with the cycloaddition obtained for the model of the complex, RhCl(PH3)3. In an attempt to reduce computational costs in DFT studies, this research project aimed to substitute PPh3 ligands for PH3, despite the electronic and steric effects produced by PPh3 ligands being significantly different to those created by PH3 ones. In this first study, detailed theoretical calculations were performed to determine the reaction mechanism of the two complexes. Despite some differences being detected, it was found that modelling PPh3 by PH3 in the catalyst helps to reduce the computational cost significantly while at the same time providing qualitatively acceptable results. Taking into account the results obtained in this earlier study, the model of the Wilkinson’s catalyst, RhCl(PH3)3, was applied to study different [2+2+2] cycloaddition reactions with unsaturated systems conducted in the laboratory. Our research group found that in the case of totally closed systems, specifically 15- and 25-membered azamacrocycles can afford benzenic compounds, except in the case of 20-membered azamacrocycle (20-MAA) which was inactive with the Wilkinson’s catalyst. In this study, theoretical calculations allowed to determine the origin of the different reactivity of the 20-MAA, where it was found that the activation barrier of the oxidative addition of two alkynes is higher than those obtained for the 15- and 25-membered macrocycles. This barrier was attributed primarily to the interaction energy, which corresponds to the energy that is released when the two deformed reagents interact in the transition state. The main factor that helped to provide an explanation to the different reactivity observed was that the 20-MAA had a more stable and delocalized HOMO orbital in the oxidative addition step. Moreover, we observed that the formation of a strained ten-membered ring during the cycloaddition of 20-MAA presents significant steric hindrance. Furthermore, in Chapter 5, an electrochemical study is presented in collaboration with Prof. Anny Jutand from Paris. This work allowed studying the main steps of the catalytic cycle of the [2+2+2] cycloaddition reaction between diynes with a monoalkyne. First kinetic data were obtained of the [2+2+2] cycloaddition process catalyzed by the Wilkinson’s catalyst, where it was observed that the rate-determining step of the reaction can change depending on the structure of the starting reagents. In the case of the [2+2+2] cycloaddition reaction involving two alkynes and one alkene in the same molecule (enediynes), it is well known that the oxidative coupling may occur between two alkynes giving the corresponding metallacyclopentadiene, or between one alkyne and the alkene affording the metallacyclopentene complex. Wilkinson’s model was used in DFT calculations to analyze the different factors that may influence in the reaction mechanism. Here it was observed that the cyclic enediynes always prefer the oxidative coupling between two alkynes moieties, while the acyclic cases have different preferences depending on the linker and the substituents used in the alkynes. Moreover, the Wilkinson’s model was used to explain the experimental results achieved in Chapter 7 where the [2+2+2] cycloaddition reaction of enediynes is studied varying the position of the double bond in the starting reagent. It was observed that enediynes type yne-ene-yne preferred the standard [2+2+2] cycloaddition reaction, while enediynes type yne-yne-ene suffered β-hydride elimination followed a reductive elimination of Wilkinson’s catalyst giving cyclohexadiene compounds, which are isomers from those that would be obtained through standard [2+2+2] cycloaddition reactions. Finally, the last chapter of this thesis is based on the use of DFT calculations to determine the reaction mechanism when the macrocycles are treated with transition metals that are inactive to the [2+2+2] cycloaddition reaction, but which are thermally active leading to new polycyclic compounds. Thus, a domino process was described combining an ene reaction and a Diels-Alder cycloaddition.

Innovation, talent attraction and retention

The success of an organization isn’t, in most cases, only shown trough their profits. Today the value of a company, with respect to its market value exceeds their financial quality. Intellectual capital is a major share in the value of the company. Managing employees with an emphasis on intellectual capital and talent is an emergency that arises in the path of human resource managers. The definition of intellectual capital and talent, leads us, first, to a high IQ (Intelligence Quotient), good schools and / or university results. But the intellectual capital and talent of an employee must be linked to his ability, to high performance and good results. How to manage, attract and keep these employees in organizations is also something that requires talent. Now, the basic skills of employees aren’t sufficient for competitive companies. There are currently required higher levels of skills, because there are a growing number of activities that involve "knowledge work". Most companies in the world have a great challenge for the coming years: the challenge of scarcity of talent. The most competitive companies will be those that have the most talented employees. In terms of originality, this paper aims to create discussion about the relationship between talent attraction, talent retention and innovation, as drivers of business competitiveness. The research is based on the categorization methodology defined by Yin (2003) as single case study carried out in a company that is specialized in high precision components.The findings presented here show a strong link between talents attraction, talents retention and innovation.

Leitura e escrita científica : um estudo com alunos do 12º ano de escolaridade de Biologia

Atualmente, os professores de ciências trabalham com alunos que apresentam sérias dificuldades em duas áreas-chave do ensino: a leitura e a escrita. Esta lacuna, dificulta a aquisição e compreensão de determinados conceitos, o que provoca uma necessidade de melhorar os hábitos de leitura e escrita científica. O estudo apresentado neste trabalho pretende analisar a importância da leitura e escrita científica no ensino das ciências no ensino secundário. Objetiva-se que os alunos aprendam e adquiram práticas de escrita e leitura científicas e ainda que despertem para uma parte da ‘ciência real’, como seja o contacto com os artigos elaborados por investigadores, resultantes de trabalhos de pesquisa levados a efeito em instituições ligadas à investigação científica. Para este efeito desenvolveu-se um estudo com alunos de biologia do 12º ano de escolaridade, durante sete meses, em contexto de sala de aula, no qual foi explorada a leitura de artigos científicos e a elaboração de documentos escritos resultantes de uma análise dos mesmos. Os resultados obtidos demonstram que, de uma forma geral, que os conceitos científicos e conteúdos estudados nas aulas de biologia conforme o programa curricular em vigor, foram, com recurso aos artigos científicos, melhor apreendidos e consolidados. Foi ainda verificado um crescente aperfeiçoamento dos hábitos de escrita e leitura dos alunos. Desta forma, pode afirmar-se que o tipo de estratégia apresentada nesta investigação por via da leitura e da escrita promove a compreensão e a retenção dos conteúdos, ou seja, ler e escrever para aprender.

Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Alliances of academic and non-academic partners from the South and North provide a promising orientation for learning together about ways of addressing negative trends of development. Assessing the impacts and sustainability of such processes, however, requires longer term monitoring of results and related challenges.

What is the new medicines use review ‘patient survey’ attempting to capture in the context of existing patient satisfaction with pharmacy questionnaires and a new conceptual framework?

The community pharmacy service medicines use review (MUR) was introduced in 2005 ‘to improve patient knowledge, concordance and use of medicines’ through a private patient–pharmacist consultation. The MUR presents a fundamental change in community pharmacy service provision. While traditionally pharmacists are dispensers of medicines and providers of medicines advice, and patients as recipients, the MUR considers pharmacists providing consultation-type activities and patients as active participants. The MUR facilitates a two-way discussion about medicines use. Traditional patient–pharmacist behaviours transform into a new set of behaviours involving the booking of appointments, consultation processes and form completion, and the physical environment of the patient–pharmacist interaction moves from the traditional setting of the dispensary and medicines counter to a private consultation room. Thus, the new service challenges traditional identities and behaviours of the patient and the pharmacist as well as the environment in which the interaction takes place. In 2008, the UK government concluded there is at present too much emphasis on the quantity of MURs rather than on their quality.[1] A number of plans to remedy the perceived imbalance included a suggestion to reward ‘health outcomes’ achieved, with calls for a more focussed and scientific approach to the evaluation of pharmacy services using outcomes research. Specifically, the UK government set out the main principal research areas for the evaluation of pharmacy services to include ‘patient and public perceptions and satisfaction’as well as ‘impact on care and outcomes’. A limited number of ‘patient satisfaction with pharmacy services’ type questionnaires are available, of varying quality, measuring dimensions relating to pharmacists’ technical competence, behavioural impressions and general satisfaction. For example, an often cited paper by Larson[2] uses two factors to measure satisfaction, namely ‘friendly explanation’ and ‘managing therapy’; the factors are highly interrelated and the questions somewhat awkwardly phrased, but more importantly, we believe the questionnaire excludes some specific domains unique to the MUR. By conducting patient interviews with recent MUR recipients, we have been working to identify relevant concepts and develop a conceptual framework to inform item development for a Patient Reported Outcome Measure questionnaire bespoke to the MUR. We note with interest the recent launch of a multidisciplinary audit template by the Royal Pharmaceutical Society of Great Britain (RPSGB) in an attempt to review the effectiveness of MURs and improve their quality.[3] This template includes an MUR ‘patient survey’. We will discuss this ‘patient survey’ in light of our work and existing patient satisfaction with pharmacy questionnaires, outlining a new conceptual framework as a basis for measuring patient satisfaction with the MUR. Ethical approval for the study was obtained from the NHS Surrey Research Ethics Committee on 2 June 2008. References 1. Department of Health (2008). Pharmacy in England: Building on Strengths – Delivering the Future. London: HMSO. www. official-documents.gov.uk/document/cm73/7341/7341.pdf (accessed 29 September 2009). 2. Larson LN et al. Patient satisfaction with pharmaceutical care: update of a validated instrument. JAmPharmAssoc 2002; 42: 44–50. 3. Royal Pharmaceutical Society of Great Britain (2009). Pharmacy Medicines Use Review – Patient Audit. London: RPSGB. http:// qi4pd.org.uk/index.php/Medicines-Use-Review-Patient-Audit. html (accessed 29 September 2009).

Domesticating the calendar: the hours and the almanac in Tudor England

This article examines two genres of text which were extremely popular in the late-medieval and early modern periods, and it pays particular attention to women users. The printed almanacs of sixteenth-century England were enormously influential; yet their contents are so formulaic and repetitive as to appear almost empty of valuable information. Their most striking feature is their astrological guidance for the reader, and this has led to them being considered 'merely' the repository of popular superstition. Only in the last decade have themes of gender and medicine been given serious consideration in relation to almanacs; but this work has focused on the seventeenth century. This chapter centres on a detailed analysis of sixteenth-century English almanacs, and the various kinds of scientific and household guidance they offered to women readers. Both compilers and users needed to chart a safe course through the religious and scientific battles of the time; and the complexities involved are demonstrated by considering the almanacs in relation to competing sources of guidance. These latter are Books of Hours and 'scientific' works such as medical calendars compiled by Oxford scholars in the late middle ages. A key feature of this chapter is that it gives practical interpretations of this complex information, for the guidance of modern readers unfamiliar with astrology.

100 years on: a century of genetics

In 2006 we celebrated the centenary of a remarkable year that saw the birth of genetics as a scientific discipline. This birth had its origins in horticulture and was supervised by a remarkable Cambridge academic, accompanied by a loyal group of female colleagues who worked together in underfunded conditions with little institutional support. Despite this deprivation, they established the foundations of an ongoing revolution, with huge academic and commercial consequences that we can recognize today in the shape of genomics and its application to biomedicine.

Internal rents and corporate property management: a study into the use of internal rents in UK corporate organisations

Research in the late 1980s showed that in many corporate real estates users were not fully aware of the full extent of their property holdings. In many cases, not only was the value of the holdings unknown, but there was uncertainty over the actual extent of ownership within the portfolio. This resulted in a large number of corporate occupiers reviewing their property holdings during the 1990s, initially to create a definitive asset register, but also to benefit from an more efficient use of space. Good management of corporately owned property assets is of equal importance as the management of other principal resources within the company. A comprehensive asset register can be seen as the first step towards a rational property audit. For the effective, efficient and economic delivery of services, it is vital that all property holdings are utilised to the best advantage. This requires that the property provider and the property user are both fully conversant with the value of the property holding and that an asset/internal rent/charge is made accordingly. The advantages of internal rent charging are twofold. Firstly, it requires the occupying department to “contribute” an amount to the business equivalent to the open market rental value of the space that it occupies. This prevents the treating of space as a free good and, as individual profit centres, each department will then rationalise its holdings to minimise its costs. The second advantage is from a strategic viewpoint. By charging an asset rent, the holding department can identify the performance of its real estate holdings. This can then be compared to an internal or external benchmark to help determine whether the company has adopted the most efficient tenure pattern for its properties. This paper investigates the use of internal rents by UK-based corporate businesses and explains internal rents as a form of transfer pricing in the context of management and responsibility accounting. The research finds that the majority of charging organisations introduced internal rents primarily to help calculate true profits at the business unit level. However, less than 10% of the charging organisations introduced internal rents primarily to capture the return on assets within the business. There was also a sizeable element of the market who had no plans to introduce internal rents. Here, it appears that, despite academic and professional views that internal rents are beneficial in improving the efficient use of property, opinion at the business and operational level has not universally accepted this proposition.

Organic food: what we know (and do not know) about consumers

This paper reports on the latest contributions to over 20 years of research on organic food consumers. There is a general consensus in the literature on the reasons why people buy organic food. However, there is also a gap between consumers’ generally positive attitude toward organic food and their relatively low level of actual purchases. Product differentiation based on intangible features, such as credence attributes such as organic, in fast-moving consumer goods categories is enjoying rapid growth. However, there are many difficulties with research in this area, including the errors inherent in research that relies on consumer self-reporting methodologies. Further, in relation to organic food, there is a divergence between consumers’ perception of its superior health features and scientific evidence. Fresh fruits and vegetables are of vital importance to the organic sector as they are the entry point for many customers and account for one-third of sales. Further, although there is a small proportion of dedicated organic food buyers, most sales come from the majority of buyers who switch between conventional and organic food purchases. This paper identifies the practical implications for generic organic food marketing campaigns, as well as for increasing sales of specific products. It concludes with suggested priorities for further research.

Does tool use extend peripersonal space? A review and re-analysis

The fascinating idea that tools become extensions of our body appears in artistic, literary, philosophical, and scientific works alike. In the last fifteen years, this idea has been re-framed into several related hypotheses, one of which states that tool use extends the neural representation of the multisensory space immediately surrounding the hands (variously termed peripersonal space, peri-hand space, peri-cutaneous space, action space, or near space). This and related hypotheses have been tested extensively in the cognitive neurosciences, with evidence from molecular, neurophysiological, neuroimaging, neuropsychological, and behavioural fields. Here, I briefly review the evidence for and against the hypothesis that tool use extends a neural representation of the space surrounding the hand, concentrating on neurophysiological, neuropsychological, and behavioural evidence. I then provide a re-analysis of data from six published and one unpublished experiments using the crossmodal congruency task to test this hypothesis. While the re-analysis broadly confirms the previously-reported finding that tool use does not literally extend peripersonal space, the overall effect-sizes are small and statistical power is low. I conclude by questioning whether the crossmodal congruency task can indeed be used to test the hypothesis that tool use modifies peripersonal space.

Dynamic correlations between REIT sub-sectors and the implications for diversification

The issue of whether Real Estate Investment Trusts (REITs) should pursue a focused or diversified investment strategy remains an ongoing debate within both the academic and industry communities. This article considers the relationship between REITs focused on different property sectors in a Generalized Autoregressive Conditional Heteroscedasticity-Dynamic Control Correlation (GARCH-DCC) framework. The daily conditional correlations reveal that since 1990 there has been a marked upward trend in the coefficients between US REIT sub-sectors. The findings imply that REITs are behaving in a far more homogeneous manner than in the past. Furthermore, the argument that REITs should be focused in order that investors can make the diversification decision is reduced.

Risk reduction and diversification in UK commercial property portfolios

The issue of diversification in direct real estate investment portfolios has been widely studied in academic and practitioner literature. Most work, however, has been done using either partially aggregated data or data for small samples of individual properties. This paper reports results from tests of both risk reduction and diversification that use the records of 10,000+ UK properties tracked by Investment Property Databank. It provides, for the first time, robust estimates of the diversification gains attainable given the returns, risks and cross‐correlations across the individual properties available to fund managers. The results quantify the number of assets and amount of money needed to construct both ‘balanced’ and ‘specialist’ property portfolios by direct investment. Target numbers will vary according to the objectives of investors and the degree to which tracking error is tolerated. The top‐level results are consistent with previous work, showing that a large measure of risk reduction can be achieved with portfolios of 30–50 properties, but full diversification of specific risk can only be achieved in very large portfolios. However, the paper extends previous work by demonstrating on a single, large dataset the implications of different methods of calculating risk reduction, and also by showing more disaggregated results relevant to the construction of specialist, sector‐focussed funds.