Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial

BACKGROUND E-learning and blended learning approaches gain more and more popularity in emergency medicine curricula. So far, little data is available on the impact of such approaches on procedural learning and skill acquisition and their comparison with traditional approaches. OBJECTIVE This study investigated the impact of a blended learning approach, including Web-based virtual patients (VPs) and standard pediatric basic life support (PBLS) training, on procedural knowledge, objective performance, and self-assessment. METHODS A total of 57 medical students were randomly assigned to an intervention group (n=30) and a control group (n=27). Both groups received paper handouts in preparation of simulation-based PBLS training. The intervention group additionally completed two Web-based VPs with embedded video clips. Measurements were taken at randomization (t0), after the preparation period (t1), and after hands-on training (t2). Clinical decision-making skills and procedural knowledge were assessed at t0 and t1. PBLS performance was scored regarding adherence to the correct algorithm, conformance to temporal demands, and the quality of procedural steps at t1 and t2. Participants' self-assessments were recorded in all three measurements. RESULTS Procedural knowledge of the intervention group was significantly superior to that of the control group at t1. At t2, the intervention group showed significantly better adherence to the algorithm and temporal demands, and better procedural quality of PBLS in objective measures than did the control group. These aspects differed between the groups even at t1 (after VPs, prior to practical training). Self-assessments differed significantly only at t1 in favor of the intervention group. CONCLUSIONS Training with VPs combined with hands-on training improves PBLS performance as judged by objective measures.

Decision Support Models for Composing and Navigating through e-Learning Objects

Libraries of learning objects may serve as basis for deriving course offerings that are customized to the needs of different learning communities or even individuals. Several ways of organizing this course composition process are discussed. Course composition needs a clear understanding of the dependencies between the learning objects. Therefore we discuss the metadata for object relationships proposed in different standardization projects and especially those suggested in the Dublin Core Metadata Initiative. Based on these metadata we construct adjacency matrices and graphs. We show how Gozinto-type computations can be used to determine direct and indirect prerequisites for certain learning objects. The metadata may also be used to define integer programming models which can be applied to support the instructor in formulating his specifications for selecting objects or which allow a computer agent to automatically select learning objects. Such decision models could also be helpful for a learner navigating through a library of learning objects. We also sketch a graph-based procedure for manual or automatic sequencing of the learning objects.

Production Streamlining through Design, Implementation, and Analysis of Lean Manufacturing Methods

Through the correct implementation of lean manufacturing methods, a company can greatly improve their business. Over a period of three months at TTM Technologies, I utilized my knowledge to fix existing problems ans streamline production. In addition, other trouble areas in their production process were discovered and proper lean methods were used to address them. TTM Technologies saw many changed in the right direction over this time period.

Hole in the Head: a Play, Accompanied by a Conspectus of Knowledge, Both Repressed and Researched, that Directly Influenced the Playwright in Her Development of a New Work

"Hole in the Head" is a play about a woman who wakes up. Maude wakes up in the first act, and in every subsequent scene she undergoes some form of physical or emotional awakening as characters walk in and out of her front door."Hole in the Head" is accompanied by an introduction that attempts to understand the interplay between creativity and academia through an analysis of theatre, feminist and queer theory, and science.

Nature and community in Western culture: Wendell Berry's alternative tradition

This dissertation is an examination of the ideals and practices that have characterized Western culture's relationship to the natural world. The conventional approach, depicted by some of the most prominent ecological publications of recent years, criticizes the Western tradition for both its ideals and practices. The ideals are assumed to be best represented in Western philosophy and religion and both of these sources have been indicted. These ideals are coupled with the Western way of life that is equally indicted as exploitive and destructive. Author, professor and farmer, Wendell Berry, offers an alternative to these indictments. Berry insists that a theme, advocating ecological accountability, runs through some of the West's most significant literature and that Western tradition contains a practice that can support these ecological principles. ^

Use of cognitive interviewing in the development of a Spanish language genetic knowledge instrument

Study purpose. Genetic advances are significantly impacting healthcare, yet recent studies of ethnic group participation in genetic services demonstrate low utilization rates by Latinos. Limited genetic knowledge is a major barrier. The purpose of this study was to field test items in a Spanish-language instrument that will be used to measure genetic knowledge relevant to type 2 diabetes among members of the ethnically heterogeneous U.S. Latino community. Accurate genetic knowledge measurement can provide the foundation for interventions to enhance genetic service utilization. ^ Design. Three waves of cognitive interviews were conducted in Spanish to field test 44 instrument items Thirty-six Latinos, with 12 persons representative of Mexican, Central and South American, and Cuban heritage participated, including 7 males and 29 females between 22 and 60 years of age; 17 participants had 12 years or less of education. ^ Methods. Text narratives from transcriptions of audiotaped interviews were qualitatively analyzed using a coding strategy to indicate potential sources of response error. Through an iterative process of instrument refinement, codes that emerged from the data were used to guide item revisions at the conclusion of each phase; revised items were examined in subsequent interview waves. ^ Results. Inter-cultural and cross-cultural themes associated with difficulties in interpretation and grammatical structuring of items were identified; difficulties associated with comprehension reflected variations in educational level. Of the original 44 items, 32 were retained, 89% of which were revised. Six additional items reflective of cultural knowledge were constructed, resulting in a 38-item instrument. ^ Conclusions. Use of cognitive interviewing provided a valuable tool for detecting both potential sources of response error and cultural variations in these sources. Analysis of interview data guided successive instrument revisions leading to improved item interpretability and comprehension. Although testing in a larger sample will be essential to test validity and reliability, the outcome of field testing suggests initial content validity of a Spanish-language instrument to measure genetic knowledge relative to type 2 diabetes. ^ Keywords. Latinos, genetic knowledge, instrument development, cognitive interviewing ^

Mexican Americans' awareness, knowledge, and beliefs of hypertension

Cardiovascular disease (CVD) is the number one cause of death for people in Texas as well as Mexico. The progressive morbidity and mortality of CVD can be prevented initially and controlled through regular health screenings or visits to the physician where health markers such as hypertension can be detected and treated. Yet, many people go unaware of existing hypertension not only due to lack of access to health care but to their own personal beliefs, ideas, or perceived barriers that prevent them from seeking preventative health care. ^ The main purpose of this study was to evaluate whether individuals of Mexican origin, who have some form of medical coverage, posses more knowledge, more perceived severity, less perceived barriers, and greater self-efficacy in regards to hypertension than those individuals who have no medical coverage. This was done by addressing the following specific aims: 1.To evaluate the association between individuals who have health care coverage and those who do not have health care coverage in regards to their beliefs of hypertension; 2. To evaluate if there exists a variation among the respondents demographic data and their beliefs of hypertension. ^ The total number of respondents were 150; with 75 being from Cuidad Juarez, and 75 being from El Paso, Texas. The results indicated that the individuals with some form of medical coverage perceived themselves to be more susceptible to suffering a cardiac event or developing heart disease than those who had no form of medical coverage. The individuals with some form of health care coverage also found themselves having less perceived barriers than those who had no health care coverage. The level of education seemed to have some association with individuals perceiving themselves as being susceptible to experiencing a cardiac event if they do not control their hypertension. Regarding self-efficacy, or the self-reported confidence in performing certain behaviors to controlling hypertension, those individuals who perceived themselves as having no self-efficacy had a lower level of education, compared to those who did perceive themselves as possessing self-efficacy. The findings of this study indicate that beliefs regarding hypertension and medical coverage are variables that need to be investigated further for individuals in the El Paso and Cuidad Juarez region. ^

Increasing awareness of colorectal cancer screening through targeted exam room based video messages

Colorectal cancer (CRC) is the third largest cause of cancer death in the United States. While the disease burden is high, there are proven methods to screen for CRC and detect it at a stage that is amenable to cure. Patients with low health literacy have difficulty navigating the health care system and are at increased risk to not receive preventive care services such as colorectal cancer screening (CRCS). To address this need, an exam-room based video was developed to be played for patients in the privacy of the exam room, while they are waiting to be seen by their medical provider. In roughly 2 minutes, the video informs the patient about CRC and CRCS and how they can successfully complete CRCS. One of the key barriers to completing CRCS is the need to increase patients' knowledge and improve attitudes surrounding CRCS. This study examines the impact of the video on patients' knowledge and attitudes about CRC and CRCS in a medically underserved patient population in Houston, Texas. ^ Sixty-one patients presenting for routine medical care were enrolled in the study. Depending on their randomization, the patients either received routine information about CRC and CRCS or they watched the video. We found that the patients who did watch the video did have improvements in their knowledge and improved attitudes about CRC and CRCS. Future studies will be needed to examine whether the video improves the patients' completion of CRCS.^

Sociocultural context of knowledge and beliefs about cardiovascular disease among Latino women

We formed an academic-community partnership with the Salsa Caliente program to undertake a project to better understand how Latina women with cardiovascular disease (CVD) or at risk of CVD view and understand CVD. This study's research question examines the sociocultural factors that influence and inform Latino women's perceptions and beliefs about CVD. Seven out the eleven participants in the Salsa Caliente program consented to be interviewed. The data was collected through recorded interviews, which were transcribed and then analyzed for common themes found among all the participants' narratives. The content analysis looking into common themes yielded four: 1) increased awareness of CVD, 2) trust in doctor, 3) delay in doctor visits, and 4) awareness of health. Implications for interventions and further research are discussed.^

Abordaje interdisciplinario a Viaje por los estados del Plata de Hermann Burmeister : parte III : abordaje desde la geografía

El relato de viaje por los Estados del Plata de Herman Burmeister está embuído de la tradición humboldtiana de proyecto científico. El uso del método comparativo de paisajes para descubrir relaciones generales y causas genéticas comunes, las abundantes y heterogéneas observaciones, dibujos y planos se asemejan bastante al método de trabajo utilizados por Humboldt. En este contexto científico, la Geografía se acerca a la Literatura a través del enfoque geográfico humanístico y fenomenológico, que exige el acceso al conocimiento a través de la experiencia humana, y aborda el texto con una metodología de carácter inductivo. El presente texto posibilita a la Geografía acceder a percepciones del espacio en un tiempo pasado, que permite comprender etapas o secuencias del proceso de constitución del territorio; y resulta un recurso significativo para el aprendizaje y comprensión de conceptos geográficos.

Prácticas de lectura en bibliotecas virtuales en contextos didácticos diversos

Este trabajo se propone examinar los procesos cognitivos de alumnos de escuelas primaria en las prácticas de lectura en bibliotecas virtuales en el contexto de dos situaciones didácticas contrastantes. La perspectiva teórica adoptada considera los aportes de la tradición socio-histórica vigotskiana y del constructivismo relacional piagetiano. El diseño metodológico se inscribe en un estudio cualitativo de casos en el que se realiza el seguimiento de las prácticas de lectura de los alumnos mediante observaciones de aula donde se registran minuciosamente las acciones de un grupo frente a la pantalla y los intercambios con sus compañeros y el docente. Estos datos se complementan con encuestas realizadas previamente y entrevistas clínicas individuales, administradas a posteriori de la observación. Los resultados evidencian que los estudiantes parten de ideas provenientes de una historia socio-cognitivo-cultural que guían sus representaciones acerca de las bibliotecas virtuales. Estas ideas entran en constante contradicción con las formas organizativas y los contenidos que las bibliotecas les presentan. Las condiciones e intervenciones didácticas tienen un papel constitutivo en el desarrollo de las prácticas y saberes altamente complejos que requieren las búsquedas. La comparación permite avanzar sobre las situaciones que generan una mayor autonomía de los alumnos.

Nota complementaria a "La escritura proverbial de Santillana"

Este trabajo se propone complementar el artículo de Miguel Ángel Pérez Priego, "La escritura proverbial de Santillana" (1992), en el que aborda la cuestión desde la variación estilística que significaron los Proverbios o Centiloquio en la producción poética del Marqués de Santillana. Al inscribir el poema en la categoría genérica del proverbio, Pérez Priego reconoce las características propias de la escritura proverbial en el texto de Santillana, al mismo tiempo que destaca el uso estilístico diferenciado de proverbios y refranes según los tipos de poemas que los contienen. A partir del estudio de la interpolación de paremias en sus poesías doctrinales más extensas, en composiciones líricas representativas y en textos prosísticos, podemos aportar otro aspecto distintivo del discurso proverbial del poeta: la confluencia de la tradición paremiológica medieval y de nuevos paradigmas humanistas. Esto es resultado de la vasta erudición y conocimiento de la Antigüedad clásica, así como del continuo interés por la cultura popular, que caracterizan la obra y formación del Marqués de Santillana

In search of the ox : Gateways to understanding human individuation through guidance

Este ensayo sintetiza varias aristas teóricas prácticas dirigidas a una de las decisiones personales más importantes en todo ser humano, el camino del autoconocimiento. Siempre y cuando se reflejen esas necesidades intrínsecas del ser, el hombre contemporáneo está descubriendo que en la satisfacción de los requerimientos materiales, finalmente no se encuentra ni la felicidad, ni la paz verdadera. En medio de este imaginario, el rol del Orientador está en su capacidad de guía fundamentado en unos principios y valores que garanticen que ese camino sea hallado, puesto que su gran compromiso consigo mismo y con los demás es precisamente acompañar en el descubrimiento de los talentos y potencialidades de ese sujeto para aprovechar su genialidad e innatas formas de normal crecimiento hacia la felicidad y armonía. Entre los caminos están los estudiados por un sinnúmero de teóricos expertos en la existencia humana como Ortega y Gasset, Sabater, Jung, Heidegger, Gadamer, Luckmann, Habermas, Bauman, Binswanger. Es un apasionante recorrido por estos análisis motivantes y sobre todo retadores.

Lugar que ocupa la evaluación en los proyectos de investigación. Una opinión construida en base a la experiencia

El presente trabajo surge ante una invitación por parte de las autoridades del Departamento de Educación Física para participar de las 3ras. Jornadas de Investigación en Educación Corporal. Tiene como intención dar respuesta a la convocatoria en cuanto a plantear opinión y experiencia acerca del lugar que ocupa la evaluación en los Proyectos de Investigación. Se parte de contextualizar tres núcleos temáticos polísémicos y de variabilidad interpretativa como son: opinión, experiencia y evaluación. El trabajo se centra en el planteo de cuestiones e interrogantes a partir de un breve análisis de las políticas sobre evaluación con inicio en la década del 90 y realiza un recorte en el análisis de las normas vigentes y que tienen como cometido por una lado impulsar la generación de conocimientos a partir de la elaboración de proyectos de investigación y por otro pautar aspectos a considerar al momento de acreditar los proyectos de referencia. En este sentido se analiza en forma sucinta el Decreto 2427/93 y con especial énfasis los Artículos 31 a 34 de la Resolución nº 811/03- Manual de Procedimientos del MECyT. El texto concluye abogando por la necesidad de construir una cultura evaluativa en el ámbito académico- universitario.

Prácticas de lectura en bibliotecas virtuales en contextos didácticos diversos

Este trabajo se propone examinar los procesos cognitivos de alumnos de escuelas primaria en las prácticas de lectura en bibliotecas virtuales en el contexto de dos situaciones didácticas contrastantes. La perspectiva teórica adoptada considera los aportes de la tradición socio-histórica vigotskiana y del constructivismo relacional piagetiano. El diseño metodológico se inscribe en un estudio cualitativo de casos en el que se realiza el seguimiento de las prácticas de lectura de los alumnos mediante observaciones de aula donde se registran minuciosamente las acciones de un grupo frente a la pantalla y los intercambios con sus compañeros y el docente. Estos datos se complementan con encuestas realizadas previamente y entrevistas clínicas individuales, administradas a posteriori de la observación. Los resultados evidencian que los estudiantes parten de ideas provenientes de una historia socio-cognitivo-cultural que guían sus representaciones acerca de las bibliotecas virtuales. Estas ideas entran en constante contradicción con las formas organizativas y los contenidos que las bibliotecas les presentan. Las condiciones e intervenciones didácticas tienen un papel constitutivo en el desarrollo de las prácticas y saberes altamente complejos que requieren las búsquedas. La comparación permite avanzar sobre las situaciones que generan una mayor autonomía de los alumnos.