821 resultados para Colorectal surgery and patient education


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Rezension von: Maurer, Markus: Skill Formation Regimes in South Asia, A Comparative Study on the Path-Dependent Development of Technical and Vocational Education and Training for the Garment Industry (Komparatistische Bibliothek; Bd. 21), Frankfurt am Main: Peter Lang 2011 (449 S.; ISBN Skill Formation Regi)

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Rationale: Undernutrition is frequently associated with advanced lung cancer. Accurate nutritional assessment tools are important to provide the proper nutritional therapy. Hand grip strength (HGS) has already been used in these patients and the findings suggest it is a good indicator of nutritional status. The aim of this study was to evaluate the association between nutritional status and hand grip strength in patients with nonresectable lung cancer.

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Sleep has emerged in the past decades as a key process for memory consolidation and restructuring. Given the universality of sleep across cultures, the need to reduce educational inequality, the low implementation cost of a sleep-based pedagogy, and its global scalability, it is surprising that the potential of improved sleep as a means of enhancing school education has remained largely unexploited. Students of various socio-economic status often suffer from sleep deficits. In principle, the optimization of sleep schedules both before and after classes should produce large positive benefits for learning. Here we review the biological and psychological phenomena underlying the cognitive role of sleep, present the few published studies on sleep and learning that have been performed in schools, and discuss potential applications of sleep to the school setting. Translational research on sleep and learning has never seemed more appropriate.

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Adequacy of nutritional intake during the postoperative period, as measured by a change in weight-for-age z-scores from surgery to the time of discharge, was evaluated in infants (n = 58) diagnosed with a congenital heart defect and admitted for surgical intervention at Miami Children’s Hospital using a prospective observational study design. Parental consent was obtained for all infants who participated in the study. ^ Forty patients had a weight available at hospital discharge. The mean preoperative weight-for-age z-score was -1.3 ±1.43 and the mean weight-for-age z-score at hospital discharge was -1.89 ±1.35 with a mean difference of 0.58 ±0.5 (P = 0.2).^ Nutritional intake during the postoperative period was inadequate based on a decrease in weight-for-age z-scores from the time of surgery until discharged home. Our findings suggested that limited fluid volume for nutrition likely contributes to suboptimal nutritional delivery during the postoperative period; however, inadequate nutrition prescription may also be an important contributing factor. Development of a nutrition protocol for initiation and advancement of nutrition support may reduce the delay in achieving patient’s nutritional goals and may attenuate the observed decrease in z-scores during the postoperative period.^

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Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.

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Technology has an important role in children's lives and education. Based on several projects developed with ICT, both in Early Childhood Education (3-6 years old) and Primary Education (6-10 years old), since 1997, the authors argue that research and educational practices need to "go outside", addressing ways to connect technology with outdoor education. The experience with the projects and initiatives developed supported a conceptual framework, developed and discussed with several partners throughout the years and theoretically informed. Three main principles or axis have emerged: strengthening Children's Participation, promoting Critical Citizenship and establishing strong Connections to Pedagogy and Curriculum. In this paper, those axis will be presented and discussed in relation to the challenge posed by Outdoor Education to the way ICT in Early Childhood and Primary Education is understood, promoted and researched. The paper is exploratory, attempting to connect theoretical and conceptual contributions from Early Childhood Pedagogy with contributions from ICT in Education. The research-based knowledge available is still scarce, mostly based on studies developed with other purposes. The paper, therefore, focus the connections and interpellations between concepts established through the theoretical framework and draws on the almost 20 years of experience with large and small scale action-research projects of ICT in schools. The more recent one is already testing the conceptual framework by supporting children in non-formal contexts to explore vineyards and the cycle of wine production with several ICT tools. Approaching Outdoor Education as an arena where pedagogical and cultural dimensions influence decisions and practices, the paper tries to argue that the three axis are relevant in supporting a stronger connection between technology and the outdoor.

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Recent perspectives on Pedagogy for Early Childhood Education emphasize children's participation in line with the Children's Rights Convention. The study aimed to analyse how children's rights are dealt with during recess in a school (Early Childhood and Primary Education) in Portugal. The aims were: to characterize the style of the adult (teaching assistants) and the interactions that are established with the children at the playground/recess, and analyse them in terms of children's rights. The qualitative approach was based on the observation during the recess for three weeks. The Adult Style Observation Schedule for Early Childhood Education (ASOS-ECE) was used to register and code the dynamics of six teaching assistants (3 ECE and 3 PE). Critical incidents were also registered. Statistical analysis of the ASOS-ECE levels were complemented with the content analysis of the notes. The playground space was quite limited and affected children's play and well-being. The outdoor playground was never used for the Early Childhood classes, only for Primary Education students but with little supervision. Children were often deprived of playground time by decision of the teaching assistants, as punishment. The results obtained through the Adult Style Observation Schedule for Early Childhood Education (ASOS-ECE) are not satisfactory and are below what would meet the minimum quality value (3,5). For Early Childhood Education, sensibility is the most valued dimension but with very low levels (<2,5). For Primary Education it was autonomy that scored highest (<2,5). The analysis of the notes/critical incidents highlighted articles 12 (expression of own views), 13 (freedom of expression), 19 (protection against violence), 29 (development of personality) and 31 (rest and leisure, play and recreational activities) as being put into question by actions of the adults responsible for the children. Children's rights and well-being need to be put forward in the knowledge base for all adults working with children so that Pedagogy can fulfil its purpose fully.

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During the 117th General Assembly of South Carolina, the Commission for Minority Affairs introduced the Student Achievement and Vision Education (SAVE) Proviso. The Proviso was so named to emphasize the importance of addressing student achievement by closing the gap that exists between majority and minority student performance and visioning students toward educational success through the implementation of the Education and Economic Development Act. This report documents the progress to date on the study; the impact of budget cuts on the CMA and complying agencies; the CMA's ability to complete the comprehensive study document using most current information; and the need for further study beyond February 2009.

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Background and aims: Advances in modern medicine have led to improved outcomes after stroke, yet an increased treatment burden has been placed on patients. Treatment burden is the workload of health care for people with chronic illness and the impact that this has on functioning and well-being. Those with comorbidities are likely to be particularly burdened. Excessive treatment burden can negatively affect outcomes. Individuals are likely to differ in their ability to manage health problems and follow treatments, defined as patient capacity. The aim of this thesis was to explore the experience of treatment burden for people who have had a stroke and the factors that influence patient capacity. Methods: There were four phases of research. 1) A systematic review of the qualitative literature that explored the experience of treatment burden for those with stroke. Data were analysed using framework synthesis, underpinned by Normalisation Process Theory (NPT). 2) A cross-sectional study of 1,424,378 participants >18 years, demographically representative of the Scottish population. Binary logistic regression was used to analyse the relationship between stroke and the presence of comorbidities and prescribed medications. 3) Interviews with twenty-nine individuals with stroke, fifteen analysed by framework analysis underpinned by NPT and fourteen by thematic analysis. The experience of treatment burden was explored in depth along with factors that influence patient capacity. 4) Integration of findings in order to create a conceptual model of treatment burden and patient capacity in stroke. Results: Phase 1) A taxonomy of treatment burden in stroke was created. The following broad areas of treatment burden were identified: making sense of stroke management and planning care; interacting with others including health professionals, family and other stroke patients; enacting management strategies; and reflecting on management. Phase 2) 35,690 people (2.5%) had a diagnosis of stroke and of the 39 co-morbidities examined, 35 were significantly more common in those with stroke. The proportion of those with stroke that had >1 additional morbidities present (94.2%) was almost twice that of controls (48%) (odds ratio (OR) adjusted for age, gender and socioeconomic deprivation; 95% confidence interval: 5.18; 4.95-5.43) and 34.5% had 4-6 comorbidities compared to 7.2% of controls (8.59; 8.17-9.04). In the stroke group, 12.6% of people had a record of >11 repeat prescriptions compared to only 1.5% of the control group (OR adjusted for age, gender, deprivation and morbidity count: 15.84; 14.86-16.88). Phase 3) The taxonomy of treatment burden from Phase 1 was verified and expanded. Additionally, treatment burdens were identified as arising from either: the workload of healthcare; or the endurance of care deficiencies. A taxonomy of patient capacity was created. Six factors were identified that influence patient capacity: personal attributes and skills; physical and cognitive abilities; support network; financial status; life workload, and environment. A conceptual model of treatment burden was created. Healthcare workload and the presence of care deficiencies can influence and be influenced by patient capacity. The quality and configuration of health and social care services influences healthcare workload, care deficiencies and patient capacity. Conclusions: This thesis provides important insights into the considerable treatment burden experienced by people who have had a stroke and the factors that affect their capacity to manage health. Multimorbidity and polypharmacy are common in those with stroke and levels of these are high. Findings have important implications for the design of clinical guidelines and healthcare delivery, for example co-ordination of care should be improved, shared decision-making enhanced, and patients better supported following discharge from hospital.

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This article presents the results of a research project in which the characteristics of university teachers and classroom environment were studied from the students´ perspectives. The study was based on a mixed design, this one attempts to develop a profile of the teachers, with the participation of students being trained in pedagogy majors. The results indicate that the students underline the importance of personality and psico-pedagogical characteristics in contrast with the theoretical findings, which point more towards professional characteristics.

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Nowadays, the topic of diversity is being studied, particularly in the field of the formation of future educators, where it is clearly evident in each one of the students. In order to understand this concept and meet the challenges it demands, this investigation, through the experience of action research, looks for a real picture of how this diversity is served in Guanacaste’s rural contexts. This is accomplished by identifying those ways to guide a better teachers’ work, and by taking into account the educational planning and the participation of the different sectors involved in the process of teaching and learning.

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The purpose of this paper is to present the results of two online forums carried out with the participation of 42 students of the Licenciaturas  in Preschool Education, Primary Education and Secondary Education of the University of Costa Rica. The main purpose of the forums was to determine the insights of the participant students about the competencies they have achieved in the field of education research, and which have been the essential tools for them to systematize their own teaching practices. The discussion forums were part of the course FD5091 Métodos de Investigación Educativa [Education Research Methods] of the School of Teacher Education, delivered from March-April 2010.  Of the sample, 60 percent were students of the Preschool teaching program, 35 percent were from the Primary Education teaching program and 5 percent were from the Secondary Education teaching program in the fields of Science, Mathematics and Social Studies. According to the insights and beliefs showed by the participants –both, the future teachers and the profession practitioners–, there are no opportunities for research or systematization of their own teaching mediation, in the current work situation.(1) Translator’s Note: In Costa Rica, the “Licenciatura” is a one-year post-Bachelor study program, usually including thesis. “Primary Education” refers to students from the 1st to 6th grades, and “Secondary Education” refers to students from the 7th to 11th grades.

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Premessa: Enhanced Recovery After Surgery (ERAS) riduce le complicanze e accorcia il recupero nei pazienti sottoposti a chirurgia per tumore del colon-retto. I pazienti più anziani sono spesso esclusi dai programmi ERAS a causa della difficoltà nell'applicazione dei protocolli stabiliti. Lo scopo dello studio è stato valutare i benefici di ERAS nei pazienti anziani sottoposti a chirurgia colorettale elettiva e valutare i risultati a breve termine. Metodi: studio monocentrico osservazionale prospettico condotto da febbraio 2021 a luglio 2022. Sono stati inclusi tutti i pazienti di età ≥ 70 anni sottoposti a chirurgia colorettale elettiva. I risultati e le complicanze postoperatorie dei pazienti trattati secondo il nostro protocollo ERAS sono stati confrontati con un gruppo di pazienti < 70 anni sottoposti a intervento chirurgico per cancro del colon-retto nello stesso periodo. Risultati: abbiamo incluso un totale di 186 pazienti (104 ≥ 70 anni vs. 82 < 70 anni). Un terzo dei pazienti di entrambi i gruppi non ha sviluppato complicanze perioperatorie (65,4% vs. 67,0%, p = 0,880). Ugualmente non sono state osservate differenze nell’incidenza di complicanze di grado I-II (31,7% vs. 28,0%) né digrado III-IV (1,9% vs. 4,9%) secondo Dindo-Clavien tra i due gruppi (p = 0,389). Il tasso di leak anastomotico e il reintervento non sono risultati statisticamente differenti tra i due gruppi: 3,8% vs. 4,9% (p = 0,733) e 1,0% vs. 3,6% (p = 0,322) rispettivamente pazienti ≥ 70 anni vs. < 70 anni. I temi di degenza media sono stati di 5.1±4.3 vs. 4.6±4.2, (p = 0.427), mentre i tassi di riammissione sono rimasti inalterati. La mortalità a 90 giorni è risultata del 2,8% vs. 0% (p = 0,256). Conclusioni: nella nostra esperienza i pazienti ≥ 70 anni affetti da tumore del colon-retto dovrebbero seguire routinariamente un programma ERAS prevedendo gli stessi benefici degli altri gruppi di età.