How critical is timing for the diagnosis of influenza in general practice?

QUESTIONS UNDER STUDY: The diagnostic significance of clinical symptoms/signs of influenza has mainly been assessed in the context of controlled studies with stringent inclusion criteria. There was a need to extend the evaluation of these predictors not only in the context of general practice but also according to the duration of symptoms and to the dynamics of the epidemic. PRINCIPLES: A prospective study conducted in the Medical Outpatient Clinic in the winter season 1999-2000. Patients with influenza-like syndrome were included, as long as the primary care physician envisaged the diagnosis of influenza. The physician administered a questionnaire, a throat swab was performed and a culture acquired to document the diagnosis of influenza. RESULTS: 201 patients were included in the study. 52% were culture positive for influenza. By univariate analysis, temperature >37.8 degrees C (OR 4.2; 95% CI 2.3-7.7), duration of symptoms <48 hours (OR 3.2; 1.8-5.7), cough (OR 3.2; 1-10.4) and myalgia (OR 2.8; 1.0-7.5) were associated with a diagnosis of influenza. In a multivariable logistic analysis, the best model predicting influenza was the association of a duration of symptom <48 hours, medical attendance at the beginning of the epidemic (weeks 49-50), fever >37.8 and cough, with a sensitivity of 79%, specificity of 69%, positive predictive value of 67%, negative predictive value of 73% and an area under the ROC curve of 0.74. CONCLUSIONS: Besides relevant symptoms and signs, the physician should also consider the duration of symptoms and the epidemiological context (start, peak or end of the epidemic) in his appraisal, since both parameters considerably modify the value of the clinical predictors when assessing the probability of a patient having influenza.

Intelligence-led crime scene processing. Part I : Forensic intelligence.

Forensic science is generally defined as the application of science to address questions related to the law. Too often, this view restricts the contribution of science to one single process which eventually aims at bringing individuals to court while minimising risk of miscarriage of justice. In order to go beyond this paradigm, we propose to refocus the attention towards traces themselves, as remnants of a criminal activity, and their information content. We postulate that traces contribute effectively to a wide variety of other informational processes that support decision making inmany situations. In particular, they inform actors of new policing strategies who place the treatment of information and intelligence at the centre of their systems. This contribution of forensic science to these security oriented models is still not well identified and captured. In order to create the best condition for the development of forensic intelligence, we suggest a framework that connects forensic science to intelligence-led policing (part I). Crime scene attendance and processing can be envisaged within this view. This approach gives indications abouthowto structure knowledge used by crime scene examiners in their effective practice (part II).

La tutoria entre iguals com a eina per millorar l'aprenentatge universitari

L'article presenta el programa de tutoria entre iguals que es va posar en marxa el curs 2009-2010 en el marc del Pla d¿acció tutorial de la Facultat d'Economia i Empresa, i una part dels resultats del procés d'avaluació dut a terme. La incorporació de la figura de l'alumne tutor en la política tutorial del centre tenia com un dels seus objectius principals incrementar la motivació i l'aprenentatge d¿alumnes de cursos superiors mitjançant la seva implicació en activitats extracurriculars vinculades a la titulació. L'estudi va voler copsar quin impacte té participar com a company tutor en el procés de formació, mitjançant la tècnica de la discussió de grup i una enquesta per qüestionari. Els resultats apunten que la tutoria entre iguals repercuteix en l¿aprenentatge, de manera que beneficia els alumnes tutors en l'adquisició de competències comunicatives i en l¿accés a recursos de la universitat fins aleshores desconeguts.

Una Propuesta de renovación metodológica en el marco del Espacio Europeo de Enseñanza Superior: los pequeños grupos de investigación cooperativos

La
 Declaración 
de 
Bolonia 
sentó
 las 
bases 
para
 la 
construcción
 de
 un
 Espacio
 Europeo
 de
 Enseñanza
 Superior
 (EEES)
 entre
 cuyos
 retos
 destaca
 la 
renovación 
metodológica. 
Este
 trabajo 
plantea 
la
 organización
 de
 una
 materia
 básica
 de
 psicología
 como
 es
 Procesos
 Psicológicos
 Básicos
 para
 estudiantes
 de
 Pedagogía
 y
 Psicopedagogía
 mediante
 la
 organización
 de
 pequeños
 grupos
 cooperativos
 de
 investigación.
 Con
 esta
 propuesta
 se
 trabajan
 diferentes 
ejes 
de 
gran
 importancia
 para 
la 
construcción
 del 
EEES
 como 
son 
la
 promoción 
de
 la 
función 
tutorial,
la 
formación 
basada
 en
 competencias,
 el
 aprendizaje
 autónomo,
 la
 consideración
 del
 tiempo 
y 
la 
carga
 de
 trabajo 
y 
la 
promoción 
del 
uso 
de
 las 
nuevas
 tecnologías. El 
artículo,
se 
centra 
fundamentalmente 
en 
describir 
y
 explicar
 el
 trabajo
 cooperativo
 en
 grupos
 de
 investigación,
 su
 organización,
 orientación,
 desarrollo,
 seguimiento
 y
 evaluación.
 Los
 resultados
 de 
la 
aplicación 
de 
esta
 propuesta
 resultaron 
muy
 formativos
 para
 los
 alumnos
 tanto
 a
 nivel
 puramente
 académico
 como
 de 
relaciones 
interpersonales

SITC 26th annual meeting - summary.

ABSTRACT: The 26th annual meeting of the Society for Immunotherapy of Cancer took place in Bethesda on November 4 to 6, 2011 and was organized by Charles G. Drake (Johns Hopkins University) Dolores J. Schendel (Helmholtz Zentrum Muenchen - German Research Center for Environmental Health Institute of Molecular Immunology), Jeffrey Schlom (National Cancer Institute, National Institutes of Health), and Jedd D. Wolchok (Memorial Sloan-Kettering Cancer Center). It was an event marked by a number of extraordinary circumstances: it attracted a record attendance of 805 participants from 24 different countries. The gathering came in the wake of great as well as very sad news for the tumor immunology community. Good news included the approval of anti-CTLA-4 as a therapy for metastatic melanoma in April and the announcement in early October of the Nobel Prize in Physiology and Medicine awarded to pioneering studies in the field of immunology. Indeed, one part of the prize went to Dr. Bruce Beutler, Scripps Research Institute, La Jolla, USA and Dr. Jules Hoffman, Institute for Molecular Cell Biology, Strasbourg, France, for their discoveries in innate immunity and the other part to Dr. Ralph Steinman, The Rockfeller University, New York, for his discovery of dendritic cells. Sad news was the losses of two giants in the field. Jürg Tschopp of the University of Lausanne in March and Ralph Steinman, who passed away just three days before his Nobel Prize announcement. The loss of these two charismatic scientific leaders was particularly sad for the Annual Meeting as both J. Tschopp and R. Steinman were confirmed speakers at this meeting: the former to deliver the keynote lecture and the latter as recipient of the Richard V. Smalley prize.

Centre orientador: acompanyar en el creixement de l’alumnat

La comunicació que presentem és el resultat del treball de recerca i reflexió realitzatpel Grup de Recerca en Acció Tutorial (GRAT) de l’ICE de la UB amb l’objectiu de definir el camíen la construcció dels centres orientadors. Pensem que un centre educatiu ha d'incorporar l'orientaciócom a eix vertebrador de la seva praxis docent. Tal i com apunten Giner i Puigardeu(2008) «La acción tutorial no puede ser una acción puntual, inconexa ni desordenada, sino todolo contrario, un engranaje participativo de los diferentes agentes educativos que participan dela educación de nuestros alumnos, donde su objetivo final es incidir en el alumno o alumna, en su crecimiento personal, en su encaje en la sociedad y en la construcción de la realidad que le envuelve».

Construcció de la identitat professional com a eina per el desenvolupament dels valors professionals

La formació inicial aporta al docent la base de la seva identificació professional, peròés en la formació permanent, quan el docent ja està exercint, on aquest treball d'aprenentatgecom a tutor pren el seu ple significat, ja que és en el dia a dia on el docent ha de desenvolupartotes les competències per donar resposta a les necessitats que se li presenten a l'aula i, d’aquesta forma, poder construir progressivament la seva pròpia identitat professional tot identificant quins són els valors que l’acompanyaran en la seva tasca tutorial i aprenent a gestionar el seu procés emocional tan en l’aspecte de construcció personal com en l’exercici de la tasca tutorial i docent. En aquesta comunicació s'exposa el model formatiu que se segueix per a la construcció d'identitat de docent com a tutor. S'exposa el marc conceptual i el procés i els resultats de les avaluacions realitzades a l’alumnat en el màster del curs 2011-12.

Multidisciplinary Safety Team (MDST) Factors of Success, 2014

This project included a literature review and summary that focused on subjects related to team building, team/committee member motivational strategies, and tools for effective and efficient committee meetings. It also completed an online survey of multidisciplinary safety team (MDST) members that focused on methods to increase meeting attendance and the identification of factors that make MDSTs successful. The survey had a response rate of about 15 percent. Finally, three small MDST focus groups were held and the participants discussed information similar to that investigated by the online survey. The results of these three activities were similar and complementary. In general, the outcomes of all three tasks show that a well-designed agenda that has items relevant to the meeting attendees is very important. In addition, the literature, online survey, and focus group results identified other characteristics that define a good team or MDST. Some of these characteristics included effective and consistent leadership, members that are allowed to provide input and have an impact, members that are vested in the activities of the group, and a match between the interests of the members and the focus/mission/purpose of the meetings/group. Meetings that are scheduled well in advance of the meeting date, include time for networking, local safety activity discussions, hands-on activities/tasks, and/or some type of educational or informational presentation or activity also appeared to be the most desirable. Lastly, it was shown that MDSTs can thrive and be successful through various means, but the ability to focus on a specific safety issue when the group is first organized was suggested as a benefit that could be of assistance for long-term sustainability.

Non-Linear and Non-Conventional Speech Processing: Alternative Techniques

This special issue aims to cover some problems related to non-linear and nonconventional speech processing. The origin of this volume is in the ISCA Tutorial and Research Workshop on Non-Linear Speech Processing, NOLISP’09, held at the Universitat de Vic (Catalonia, Spain) on June 25–27, 2009. The series of NOLISP workshops started in 2003 has become a biannual event whose aim is to discuss alternative techniques for speech processing that, in a sense, do not fit into mainstream approaches. A selected choice of papers based on the presentations delivered at NOLISP’09 has given rise to this issue of Cognitive Computation.

Materials de suport a l'ensenyament/aprenentatge per competències

Aquest article presenta el projecte de Millora de Qualitat Docent que ofereix un disseny d’intervenció i materials de suport per a l’ensenyament i aprenentatge de competències en l’espai de seminari. Els eixos en els que es fonamenta la nostra proposta són: la identificació de les competències a assolir, l’autoavaluació com a eina formativa i la tutoria com a espai de suport en aquest procés d’aprenentatge. La intervenció s’adreça als estudiants de Grau i als professors tutors. Els materials de suport elaborats fan referència a: qüestionari online d’autopercepció del nivell de competències genèriques, qüestionari tutorial de detecció de necessitats i disseny del procés tutorial. En base a la reflexió derivada de l’elaboració d’aquest treball i en relació a l’experiència docent universitària com a professors tutors, podem constatar que l’adquisició de les competències és un procés perceptible que requereix d’un temps variable segons cada estudiant, que implica la conscienciació i participació activa del mateix i, que aquest procés requereix de l’espai de tutoria per a poder-lo dur a terme.

Dental service utilization by Europeans aged 50 plus.

OBJECTIVES: To describe variations in the utilization of dental services by persons aged 50+ from 14 European countries and to identify the extent to which such variations are attributable to differences in oral health need and in accessibility of dental care. METHODS: We use data from the Survey of Health, Ageing, and Retirement in Europe (SHARE Waves 2 and 3) and estimate a series of multivariate logistic regression models to analyze variations in dental service utilization (overall dental attendance, preventive treatment and/or operative treatment, dental attendance in early life years) RESULTS: Overall dental attendance and incidence of solely preventive treatment are comparatively high in the Netherlands, Sweden, Denmark, Germany, and Switzerland. In contrast, overall dental attendance is relatively low in Spain, Italy, France, Greece, Poland, and Ireland. Moreover, a high incidence of solely operative treatment is observed in Austria, Italy, and France, whereas in the Netherlands, Sweden, Denmark, Switzerland, and Ireland, the incidence of solely operative treatment is comparably low. By and large, these variations persist even when controlling for cross-country differences in oral health need and in accessibility of dental care. CONCLUSIONS: In comparison with other European regions, there is a tendency toward more frequent and preventive dental treatment of the elderly populations residing in Scandinavia and Western Europe. Such utilization patterns appear only partially attributable to differences in need for and accessibility of dental care.

Social and medical vulnerability factors of frequent users at the emergency department: a case-control study

BACKGROUND: Up to 5% of patients presenting to the emergency department (ED) four or more times within a 12 month period represent 21% of total ED visits. In this study we sought to characterize social and medical vulnerability factors of ED frequent users (FUs) and to explore if these factors hold simultaneously. METHODS: We performed a case-control study at Lausanne University Hospital, Switzerland. Patients over 18 years presenting to the ED at least once within the study period (April 2008 toMarch 2009) were included. FUs were defined as patients with four or more ED visits within the previous 12 months. Outcome data were extracted from medical records of the first ED attendance within the study period. Outcomes included basic demographics and social variables, ED admission diagnosis, somatic and psychiatric days hospitalized over 12 months, and having a primary care physician.We calculated the percentage of FUs and non-FUs having at least one social and one medical vulnerability factor. The four chosen social factors included: unemployed and/or dependence on government welfare, institutionalized and/or without fixed residence, either separated, divorced or widowed, and under guardianship. The fourmedical vulnerability factors were: ≥6 somatic days hospitalized, ≥1 psychiatric days hospitalized, ≥5 clinical departments used (all three factors measured over 12 months), and ED admission diagnosis of alcohol and/or drug abuse. Univariate and multivariate logistical regression analyses allowed comparison of two JGIM ABSTRACTS S391 random samples of 354 FUs and 354 non-FUs (statistical power 0.9, alpha 0.05 for all outcomes except gender, country of birth, and insurance type). RESULTS: FUs accounted for 7.7% of ED patients and 24.9% of ED visits. Univariate logistic regression showed that FUs were older (mean age 49.8 vs. 45.2 yrs, p=0.003),more often separated and/or divorced (17.5%vs. 13.9%, p=0.029) or widowed (13.8% vs. 8.8%, p=0.029), and either unemployed or dependent on government welfare (31.3% vs. 13.3%, p<0.001), compared to non-FUs. FUs cumulated more days hospitalized over 12 months (mean number of somatic days per patient 1.0 vs. 0.3, p<0.001; mean number of psychiatric days per patient 0.12 vs. 0.03, p<0.001). The two groups were similar regarding gender distribution (females 51.7% vs. 48.3%). The multivariate linear regression model was based on the six most significant factors identified by univariate analysis The model showed that FUs had more social problems, as they were more likely to be institutionalized or not have a fixed residence (OR 4.62; 95% CI, 1.65 to 12.93), and to be unemployed or dependent on government welfare (OR 2.03; 95% CI, 1.31 to 3.14) compared to non-FUs. FUs were more likely to need medical care, as indicated by involvement of≥5 clinical departments over 12 months (OR 6.2; 95%CI, 3.74 to 10.15), having an ED admission diagnosis of substance abuse (OR 3.23; 95% CI, 1.23 to 8.46) and having a primary care physician (OR 1.70;95%CI, 1.13 to 2.56); however, they were less likely to present with an admission diagnosis of injury (OR 0.64; 95% CI, 0.40 to 1.00) compared to non-FUs. FUs were more likely to combine at least one social with one medical vulnerability factor (38.4% vs. 12.1%, OR 7.74; 95% CI 5.03 to 11.93). CONCLUSIONS: FUs were more likely than non-FUs to have social and medical vulnerability factors and to have multiple factors in combination.

¿Es eficaz especializar la actividad de tutoria? Análisis de una experiencia online

En un entorno online la actividad de tutoría de los estudiantes juega un papel fundamental. Su eje central es el acompañamiento del estudiante a lo largo del programa académico que curse, desde el momento en que muestra su interés en matricularse hasta que se titula. La literatura disponible sobre cómo organizar la actividad tutorial en entornos virtuales es escasa. En esta comunicación, basada en la experiencia de la Universitat Oberta de Catalunya (UOC), se analizan dos niveles de especialización de la acción tutorial online. En un primer nivel organizativo, se presenta y evalúa una especialización de la coordinación de la tutoría en función del tipo de conocimiento necesario para ejercerla, académico o administrativo. Esto genera una estructura organizativa de tipo matricial que aporta flexibilidad y conocimiento especializado a la actividad tutorial, y que es valorada muy positivamente por las partes implicadas. En un segundo nivel, se analiza la separación de dos tipos de tutoría especializadas, una de inicio y otra de seguimiento, en función de la antigüedad del estudiante tutorizado. Los resultados de los análisis cualitativos y cuantitativos realizados no permiten concluir que esta segunda forma de especialización contribuya claramente a la mejora de los objetivos de la función tutorial.

La coordinación de la actividad de tutoría en las universidades virtuales. El caso de la Universitat Oberta de Catalunya.

El esfuerzo por desarrollar metodologías de enseñanza-aprendizaje específicas para el entorno virtual no ha venido acompañado de un impulso similar para adaptar los mecanismos de coordinación del profesorado, en general, y la actividad de tutoría en particular, a las características de las universidades virtuales. Esta comunicación contribuye a elaborar modelos organizativos que faciliten un buen desarrollo de la acción tutorial en línea. Con este fin, se presentan los principales elementos para estructurar y coordinar la acción tutorial, y se explica el modelo concreto adoptado en la UOC. Finalmente se presenta una valoración de la experiencia que puede ser útil para otras instituciones.

Within- and among-population impact of genetic erosion on adult fitness-related traits in the European tree frog Hyla arborea.

Assessing in wild populations how fitness is impacted by inbreeding and genetic drift is a major goal for conservation biology. An approach to measure the detrimental effects of inbreeding on fitness is to estimate correlations between molecular variation and phenotypic performances within and among populations. Our study investigated the effect of individual multilocus heterozygosity on body size, body condition and reproductive investment of males (that is, chorus attendance) and females (that is, clutch mass and egg size) in both small fragmented and large non-fragmented populations of European tree frog (Hyla arborea). Because adult size and/or condition and reproductive investment are usually related, genetic erosion may have detrimental effects directly on reproductive investment, and also on individual body size and condition that in turn may affect reproductive investment. We confirmed that the reproductive investment was highly size-dependent for both sexes. Larger females invested more in offspring production, and larger males attended the chorus in the pond more often. Our results did not provide evidence for a decline in body size, condition and reproductive effort with decreased multilocus heterozygosity both within and among populations. We showed that the lack of heterozygosity-fitness correlations within populations probably resulted from low inbreeding levels (inferior to ca. 20% full-sib mating rate), even in the small fragmented populations. The detrimental effects of fixation load were either low in adults or hidden by environmental variation among populations. These findings will be useful to design specific management actions to improve population persistence.