Estudio sobre la construcción autorregulada del portafolio en el grado de Enfermería

Introduction. This study presents the results of the implementation process of portfolio in the course of four consecutive years. The plan includes three phases (initiation, development and consolidation). The sample is 480 students studying the first year of nursing at the University of Girona. The objective is to evaluate the effectiveness of the instrument and achieve its construction in a self-regulated process. Subjects and methods. The proposed methodology is based on the sequential triangulation between methods. The study of the same empirical unit it’s used two investigation strategies, quantitative and qualitative. Study 1: quantitative, descriptive, longitudinal and prospective. The statistical analysis of paired data for continuous variables that follow a normaldistribution is made with t Student-Fisher test. The correlation between two numerical variables is used the Pearson correlation index. Study 2: qualitative, uses the discussion groups and topics. For textual data analysis is used Atlas.ti. Results. The final score for students who prepare the portfolio is higher (7.78) than the score who do not prepare (7) (p ≤ 0.001). A significant correlation exists between the portfolio score and final score (p ≤ 0.001). The trend study showsa greater sensitivity of the instrument assessment. Conclusion. The final design of the portfolio is characterized by mixed, flexible and encourages the student reflection and empowers the reflection on the continuum of learning

Un estudi preliminar sobre la presa d’apunts dels estudiants universitaris

En aquest treball es presenten els resultats d’un estudi iniciat per esbrinar comprenen apunts els estudiants de primer curs universitari en una situació declasse habitual i per analitzar com incideixen les condicions d’una determinadasituació educativa en les decisions respecte a què cal anotar i com cal fer-ho.L’estudi suposa l’inici d’una línia de recerca que té per objectiu investigaren quines condicions la presa d’apunts esdevé una estratègia d’aprenentatge

La importancia de las emociones en los períodos sensibles del desarrollo = The importance of emotions in sensitive developmental periods

Investigaciones recientes sugieren que en la adolescencia tienen lugar importantes cambios en la estructura,bioquímica y fisiología del cerebro que podrían explicar la dificultad que experimentan los adolescentes en elcontrol de sus emociones así como también otros rasgos de su comportamiento inestable. En este artículo presentamosalgunas investigaciones que establecen, asimismo, una correlación entre las reorganizaciones cerebrales quetienen lugar en el primer año de vida con signos de irritabilidad y desazón emocional que muestra el bebédurante este periodo. En ambos casos la dificultad de controlar los impulsos emocionales es susceptible de afectarla relación de los padres con el niño o joven. Discutimos la posible relevancia de esta coincidencia dentro de unaperspectiva evolucionista así como la posible vulnerabilidad de estos períodos. Finalmente, apuntamos la necesidadde una teoría integradora del desarrollo humano y ofrecemos algunos puntos de debate

Dificuldades conceituais no aprendizado de equilíbrios químicos envolvendo reações ácido-base

Common student misunderstandings regarding chemical equilibrium are reported taking into account the response of freshman students to some typical questions involving acid-base reactions. Language has been shown to be one of the main issues associated with students' difficulties on this subject, such as in the case of concentration and amount of substance (mol). Another usual problem was observed in questions involving buffer solutions after addition of a reagent. A number of recommendations have emerged from the results presented in this work as an attempt to enhance the learning of this topic in general chemistry courses given to first-year students.

Avaliação da "microverdura" de sínteses com a estrela verde

This article reports a study to increase the overall greenness of chemical syntheses for first-year university laboratories. The separate evaluation of the micro-greenness of the three stages of synthesis (reaction, isolation and purification) using the Green Star (GS) was implemented and their respective contribution to overall greenness was investigated for two examples: syntheses of cobalt (III) tris(acetylacetonate) and potassium nitrilosulfonate. Results showed that the post-reaction (work-up) steps are the most problematic for overall greenness. Greenness optimization can be achieved by combining the greenest procedures for each step obtained from different protocols available in the literature.

Yrittäjyyttä rakentamassa - yrittäjyyden kolme diskurssia

Tämä tutkimus osallistuu yrittäjyyden kartoittamiseen yrittäjyyskasvatusta varten hyödyntäen näkökulmaa todellisuuden sosiaalisesta rakentumisesta. Tutkimus on kvalitatiivinen, sillä sen aineistona on teemahaastatteluissa tuotettu puhe yrittäjyydestä ja analysointimenetelmänä on diskurssianalyysi. Tutkimuksen tavoitteena on diskurssianalyysin keinoin tunnistaa ne yrittäjyyttä sosiaalisesti rakentavat diskurssit, joita Lappeenrannan teknillisen yliopiston kauppatieteellisen tiedekunnan ensimmäisen vuoden opiskelijat hyödyntävät yrittäjyyttä koskevassa puheessaan. Lisäksi tavoitteena on kuvata ja ymmärtää tunnistetuissa diskursseissa rakentuvaa yrittäjyyttä sekä yrittäjyyden motivaatiotekijöitä, yrittäjyyden esteitä ja yrittäjyyden keinoja. Analyysissä tunnistetaan kolme yrittäjyyden diskurssia sekä kuvataan ja jäsennetään niissä erilailla rakentuvaa yrittäjyyttä ja siihen liittyviä käsitteitä. Yrittäjyyden kolme diskurssia ovat bisnes-, elämäntapa- ja innovaatiodiskurssi. Analyysin avulla yrittäjyyskasvatusta voidaan suunnitella ja toteuttaa uudella tavalla, joka vastaa yrittäjyyden laaja-alaista ja monimutkaista todellisuutta.

Natural history of celiac disease-associated antibodies and progression to overt disease in children at increased genetic risk

Background: Celiac disease is a lifelong, gluten-sensitive, autoimmune-mediated chronic enteropathy, tightly associated with risk alleles at the HLA class II genes. Aims: This study was carried out as a part of the population-based Type 1 Diabetes Prediction and Prevention (DIPP) Project. The first aim was to study the natural history of celiac disease-associated antibodies before the diagnosis of celiac disease was made. The second aim was to describe when and in which order celiac disease-associated and type 1 diabetes-associated antibodies appeared in children with genetic risk for both diseases. Subjects and Methods: Antibodies against tissue transglutaminase (TGA) and other celiac disease-associated antibodies were measured in serum samples collected at 3- to 12-month intervals of children at genetic risk for celiac disease who participated in the DIPP project. Celiac disease was confirmed by duodenal biopsy. Type 1 diabetes-associated antibodies were measured in all samples that had been collected. Overt disease was diagnosed according to World Health Organization criteria. Follow-up continued until a diagnosis of type 1 diabetes or until the end of a defined follow-up period. Results: TGA appeared in children at genetic risk for celiac disease only after the first year of life, but anti-gliadin antibodies often emerged significantly earlier, at age 6 months. The data show that spontaneous disappearance of celiac disease-associated antibodies, transient or persisting, is a common phenomenon, at least in prepubertal children. In children with genetic susceptibility to type 1 diabetes and celiac disease, celiac disease-associated antibodies usually develop earlier than the type 1 diabetes-associated antibodies. Conclusions: The transient nature of celiac disease-associated antibodies emphasizes the significance of establishing seropositivity repeatedly in screening detected celiac disease before gastroscopy and duodenal biopsy are considered and emphasized the importance of duodenal biopsy for diagnosing celiac disease.

Group mentoring for junior medical students: perceptions of mentees and mentors

Entering medical school can be associated with a number of difficulties that can hinder students' performance. Mentoring programs are designed to help students circumvent difficulties and improve their learning and personal development. The current study aimed to evaluate the perceptions of both students and mentors regarding a recently introduced, group-based mentoring program designed to support first-year students. After one year of regular meetings, students and mentors' perceptions of the program were assessed by means of structured questionnaires. Response content categories were identified through multiple readings. Both regular attendees and non-participating students had positive opinions about the program. Mentors were highly satisfied at having participated and acknowledged that the program has been useful not only for assisting students, but also for fostering their own personal and professional development. In conclusion, the group-based mentoring program is feasible and can elicit positive views from both mentors and students. In addition, faculty members' participation as mentors can also be beneficial, since the program appears to contribute to their own personal and professional development

Learning through role-playing games: an approach for active learning and teaching

This study evaluates the use of role-playing games (RPGs) as a methodological approach for teaching cellular biology, assessing student satisfaction, learning outcomes, and retention of acquired knowledge. First-year undergraduate medical students at two Brazilian public universities attended either an RPG-based class (RPG group) or a lecture (lecture-based group) on topics related to cellular biology. Pre- and post-RPG-based class questionnaires were compared to scores in regular exams and in an unannounced test one year later to assess students' attitudes and learning. From the 230 students that attended the RPG classes, 78.4% responded that the RPG-based classes were an effective tool for learning; 55.4% thought that such classes were better than lectures but did not replace them; and 81% responded that they would use this method. The lecture-based group achieved a higher grade in 1 of 14 regular exam questions. In the medium-term evaluation (one year later), the RPG group scored higher in 2 of 12 questions. RPG classes are thus quantitatively as effective as formal lectures, are well accepted by students, and may serve as educational tools, giving students the chance to learn actively and potentially retain the acquired knowledge more efficiently.

The development and evaluation of a distance learning system in ophthalmology

INTRODUCTION: Web-based e-learning is a teaching tool increasingly used in many medical schools and specialist fields, including ophthalmology. AIMS: this pilot study aimed to develop internet-based course-based clinical cases and to evaluate the effectiveness of this method within a graduate medical education group. METHODS: this was an interventional randomized study. First, a website was built using a distance learning platform. Sixteen first-year ophthalmology residents were then divided into two randomized groups: one experimental group, which was submitted to the intervention (use of the e-learning site) and another control group, which was not submitted to the intervention. The students answered a printed clinical case and their scores were compared. RESULTS: there was no statistically significant difference between the groups. CONCLUSION: We were able to successfully develop the e-learning site and the respective clinical cases. Despite the fact that there was no statistically significant difference between the access and the non access group, the study was a pioneer in our department, since a clinical case online program had never previously been developed.

Päämääriä, ajelehtimista, tietämättömyyttä, etsintää: Koulutusvalinnat, opinnot ja koulutuksen vaihtaminen yliopisto-opiskelijoiden kokemana 2000 -luvun taitteessa

Tutkimuksessa tarkastellaan yliopisto-opiskelua, opintojen kokemista ja niiden kulkua alkaen koulutusvalinnoista. Lisäksi tutkimuksessa pyritään ymmärtämään ja kuvaamaan yliopisto-opintojen aikaista koulutuksen vaihtamista prosessina. Kyseessä on seurantatutkimus Turun yliopistossa vuonna 1998 aloittaneesta opiskelijakohortista. Tutkittavat opiskelijat valittiin sillä perusteella, että he vastasivat kolmeen opintoja koskevaan kyselyyn ja olivat vähintään kolmen vuoden ajan läsnä olevina opiskelijoina. Opiskelijat (n=440) jaettiin neljään vertailuryhmään: 1) opintoihinsa tyytyväiset, 2) ensimmäisen vuoden jälkeen koulutusta vaihtaneet, 3) toisen vuoden jälkeen koulutusta vaihtaneet ja 4) koulutusta vaihtaa halunneet. Tutkimusaineisto koostuu kolmesta kyselystä, opintorekisteriaineistosta ja koulutusta opintojen aikana vaihtaneiden opiskelijoiden haastatteluista (n=22). Kyselyt tehtiin ensimmäisen, toisen ja kolmannen opintovuoden kevätlukukausilla ja haastattelut vuonna 2002, jolloin opiskelijat opiskelivat Turun yliopistossa neljättä tai viidettä vuotta. Kyselyiden avulla tutkittiin eroavatko koulutusta vaihtaneet opiskelijat muista opiskelijoista rakenteellisilta tekijöiltään tai opintokokemuksissaan. Opintorekisteriaineiston perusteella tutkittiin eroavatko koulutusta vaihtaneet opiskelijat koulutuksessa pysyneistä opiskelijoista opintojen kulussa. Kyselyiden ja haastatteluiden avulla tutkittiin minkälaisia tietoja ja odotuksia opiskelijoilla oli yliopisto-opiskelusta ollut ennen opintojen aloittamista. Haastatteluiden perusteella tutkittiin mitä syitä koulutuksen vaihtamisen taustalla oli ja minkälaisina kertomuksina koulutuksen vaihtamisprosessi näyttäytyi. Koulutusta vaihtaneet opiskelijat erosivat koulutuksessa pysyneistä opiskelijoista aiemman koulutuksen määrän, iän ja perheellisyyden suhteen. Verrattaessa ensimmäisen ja toisen vuoden jälkeen koulutusta vaihtaneita opiskelijoita keskenään havaittiin näillä ryhmillä olevan erilainen perhetausta. Koulutusta valittaessa tärkein tekijä oli kiinnostus alaa kohtaan. Toiseksi voimakkain hakutekijä oli muilla paitsi ensimmäisen vuoden jälkeen koulutusta vaihtaneilla valmiudet haluttuun ammattiin. Vuorostaan ensimmäisen vuoden jälkeen koulutusta vaihtaneilla toiseksi tärkein tekijä hakeutumisessa oli helppo sisäänpääsy opintoihin. Suurin osa opiskelijoista oli päässyt ensisijaisesti haluamaansa koulutukseen. Koulutusta myöhemmin vaihtaneissa ryhmissä ja koulutuksen vaihtoa halunneiden ryhmässä ensisijaisesti haluttuun koulutukseen päässeitä oli alle puolet. Odotukset opiskelusta eivät täysin täyttyneet ensimmäisen puolen vuoden opiskelun aikana. Tutkittujen ryhmien välillä havaittiin eroja kokemuksissa koulutuksen sopivuudesta itselle. Koulutuksen vaihtaminen oli myönteinen kokemus, ja uusi koulutus koettiin aiempaa koulutusta sopivammaksi itselle. Kolmannen vuoden kevätlukukaudella omaa koulutusta kohtaan koettu kiinnostus oli voimakasta muissa ryhmissä paitsi koulutuksen vaihtoa halunneissa. Harvimmin positiivisia tunteita opiskelua kohtaan kokivat vaihtoa halunneet opiskelijat. Koulutuksen vaihtaminen vähensi opintoihin kiinnittymättömyyttä. Koulutuksen vaihtoa halunneiden kokemukset nykyisen koulutuksensa ilmapiiristä olivat negatiivisimpia. Koulutuksen vaihtaminen vaikutti myönteisesti myös opetuksen kokemiseen. Opinnot etenivät kaikissa tutkituissa ryhmissä tasaisesti. Koulutuksen vaihtamisen jälkeisenä vuonna opinnot etenivät vaihtaneissa ryhmissä keskimääräistä enemmän. Haastatteluiden mukaan pääasiallisia syitä koulutuksen vaihtamiselle olivat päätyminen toissijaiseen koulutukseen ja pettyminen aloittamaansa koulutukseen. Narratiivien analyysin avulla tutkimuksessa löydettiin neljä erilaista tarinaa vaihtamisprosessista: 1) toissijaisesta koulutuksesta ensisijaiseen koulutukseen vaihtaminen, 2) ensisijaiseen koulutukseen pettyminen, 3) kiinnostavampaan koulutukseen ajautuminen ja 4) oman alan löytyminen etsinnän kautta. Vaikka koulutuspolitiikassa koulutuksen vaihtaminen nähdään ongelmana, oli se tämän tutkimuksen mukaan opiskelijalle myönteinen kokemus. Tämän tutkimuksen perusteella tulisikin kiinnittää huomiota opiskelijoihin, jotka haluaisivat vaihtaa koulutuksesta toiseen. Heillä opintojen eteneminen osoittautui hitaimmaksi ja opintokokemukset negatiivisimmiksi. Koulutusta vaihtaneiden opiskelijoiden opintojen eteneminen näytti hitaalta verrattuna opintoihinsa tyytyväisiin opiskelijoihin. Koulutuksen vaihtamisen jälkeen opintojen eteneminen kuitenkin nopeutui ja opintotyytyväisyys lisääntyi.

Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

Objective: to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. Methods: twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were male (60%). Indications were 18 tumors of the distal esophagus and esophagogastric junction (90%) and two with invasion of gastric fundus (10%) in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. Results: the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85%) were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%): a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15%) were due to tumor recurrence and 1 (5%) secondary to bronchopneumonia. The 5-year survival was 15%. Conclusion: the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of life

Unintentionally retained foreign bodies after surgical procedures. Analysis of 4547 cases

Objective: this study aims to explore the experience of Brazilian surgeons on Unintentionally Retained Foreign Bodies (RFB) after surgical procedures. Methods: A questionnaire was sent to surgeons by electronic mail, between March and July 2012. The questions analyzed their experience with foreign bodies (FB), foreign bodies' types, clinical manifestations, diagnoses, risk factors and legal implications. Results: in the 2872 eligible questionnaires, 43% of the surgeons asserted that they had already left FB and 73% had removed FB in one or more occasions, totalizing 4547. Of these foreign bodies, 90% were textiles, 78% were discovered in the first year and 14% remained asymptomatic. Among doctors with less than five years after graduation, 36% had already left a FB. The most frequently surgical procedures mentioned were the elective (57%) and routine (85%) ones. Emergency (26%), lack of counting (25%) and inadequate conditions of work contributed (12.5%) to the occurrence. In 46% of the cases patients were alerted about the FB, and 26% of them sued the doctors or the institution. Conclusions: challenging medical situations, omission of security protocols and inadequate work conditions contributed to RFB. However, RFB occurs mostly in routine procedures such as cesarean or cholecystectomy, and at the beginning of the professional career, highlighting, particularly in poorest countries, the need for primary prevention. Textiles predominated causing clinical repercussions and they were diagnosed in the first postoperative months. Surgeons were sued in 11.3% of the RFB cases.

Blackcurrant seed oil for prevention of atopic dermatitis

One hypothesis for the increased incidence of atopic diseases has been that it is associated with changing dietary habits, especially the changed intake of essential fatty acids (EFAs). The metabolism of EFAs produces eiconasoids, prostaglandins and leukotrienes, which are essential to organs and play a major role in regulation of inflammation and immune response. In some studies persons with atopic dermatitis have been found to have reduced levels of EFAs. The first year of infancy as well as the foetal period are crucial for the development of atopic immune response. The composition of blackcurrant seed oil (BCSO) corresponds to the recommended ratio of EFAs n-3 and n-6 in the diet (1/3-1/4) and as a dietary supplement could, even in small doses, modify the unbalance of EFAs in an efficient way. The purpose of this study was to find out whether atopic allergies can be prevented by supplementing the diet of pregnant mothers with blackcurrant seed oil and whether it could affect the immunological balance of a child. We also sought to find out whether a blackcurrant seed oil supplementation can affect the composition of breast milk to suppress the T helper 2 lymphocyte (Th2) responses in infants. 313 pregnant mothers were randomly assigned to receive BCSO (n=151) or olive oil as placebo (n=162). Supplementation was started at the 8th to 16th weeks of pregnancy, 6 capsules per day (dose of 3 g), and continued until the cessation of breastfeeding. It was thereafter followed by direct supplementation to infants of 1 ml (1 g) of oil per day until the age of two years. Atopic dermatitis and its severity (SCORAD index) were evaluated, serum total IgE was measured and skin prick tests were performed at the age of 3, 12 and 24 months. Peripheral blood mononuclear cell (PBMC) samples were taken at the age of 3 and 12 months and breast milk samples were collected during the first 3 months of breastfeeding. Parental atopy was common (81.7%) in the studied infants, making them infants with increased atopy risk. There was a significantly lower prevalence of atopic dermatitis in the BCSO group (33%) than in the olive oil group (47%) at the age of 12 months. Also, SCORAD was lower in the BCSO group than in the olive oil group. Dietary intervention with BCSO had immunomodulatory effects on breast milk, inducing cytokine production from Th2 to Th1 immunodeviation. It decreased the level of IL-4 and elevated the level of IFN-γ. BCSO intervention did not affect cytokines in the children’s PBMC. However, children of smoking parents in the combined BCSO and olive oil group had significantly elevated levels of Th2 type cytokines IL-4, IL-5 and the proinflammator cytokine TNF. Dietary supplementation with BCSO is safe. It is well tolerated and transiently reduces the prevalence of atopic dermatitis at the age of 12 months. It can possibly become a potential tool in prevention of atopic symptoms when used at the early stages of life.

Infestation maps and spatial stability of main weed species in maize culture

A study on the spatial distribution of the major weeds in maize was carried out in 2007 and 2008 in a field located in Golegã (Ribatejo region, Portugal). The geo-referenced sampling focused on 150 points of a 10 x 10 m mesh covering an area of 1.5 ha, before herbicide application and before harvest. In the first year, 40 species (21 botanical families) were identified at seedling stage and only 22 during the last observation. The difference in species richness can be attributed to maize monoculture favouring reduction in species number. Three of the most representative species were selected for the spatial distribution analysis: Solanum nigrum, Chenopodium album and Echinochloa crus-galli. The three species showed an aggregated spatial pattern and spatial stability over both years, although the herbicide effect is evident in the distribution of some of them in the space. These results could be taken into account when planning site-specific treatments in maize.