Stability and robustness of blood variables in an antidoping context.

Introduction:  With the setting up of the newly Athlete's Biological Passport antidoping programme, novel guidelines have been introduced to guarantee results beyond reproach. We investigated in this context, the effect of storage time on the variables commonly measured for the haematological passport. We also wanted to assess for these variables, the within and between analyzer variations. Methods:  Blood samples were obtained from top level male professional cyclists (27 samples for the first part of the study and 102 for the second part) taking part to major stage races. After collection, they were transported under refrigerated conditions (2 °C < T < 12 °C), delivered to the antidoping laboratory, analysed and then stored at approximately 4 °C to conduct analysis at different time points up to 72 h after delivery. A mixed-model procedure was used to determine the stability of the different variables. Results:  As expected haemoglobin concentration was not affected by storage and showed stability for at least 72 h. Under the conditions of our investigation, the reticulocytes percentage showed a much better stability than previous published data (> 48 h) and the technical comparison of the haematology analyzer demonstrated excellent results. Conclusion:  In conclusion, our data clearly demonstrate that as long as the World Anti-Doping Agency's guidelines are followed rigorously, all blood results reach the quality level required in the antidoping context.

Assessorar o dirigir. El paper de l'assessor col·laboratiu en una formació permanent centrada en el professorat i en el context

En el artículo se realiza un análisis del campo de la formación del profesorado y del modelo de formación permanente de los últimos tiempos, atendiendo los nuevos elementos que actuaron como fuerzas ocultas e impulsoras de un pensamiento formativo innovador. Se analizan también las condiciones para un cambio en la manera de ver la formación permanente del profesorado que, progresivamente, ha pasado de una visión de producto formativo que el profesorado debía asimilar acríticamente, a otra etapa con visiones diversificadas. A continuación, se profundiza la función asesora y los modelos que esta nueva concepción de la formación exigen. Se necesitan asesores, formadores que de manera colaborativa ayuden a reconstruir la práctica educativa.

Polítiques docents en el context de l'EEES: oportunitats, dificultats i dilemes

El procés de convergència cap a l'Espai Europeu d' Educació Superior ha fet que les universitats s'hagin plantejat el repte de millorar la docència. Que amb l'EEES es vulgui fomentar un nou model d'ensenyança, ha suscitat opinions divergents, però hagués estat irresponsable no aprofitar el procés de canvi per anar al fons del tema docent. En el context actual, cercar com millorar els processos d'aprenentatge dels i de les estudiants suposa la necessitat de reflexionar col·lectivament sobre què i sobre com s'ha d'ensenyar a la universitat. Per tal d'afavorir un canvi de model que dugui a focalitzar la mirada en el procés d'aprenentatge de l'estudiant, cal debatre sobre els dilemes que sorgeixen quan els requeriments del nou model xoquen amb la cultura tradicionalment predominant entre el professorat universitari. En l'article es comenten alguns d'aquests dilemes.

Activitat conjunta i influència educativa en el context familiar

Encara que actualment sembla llunyana una explicació integrada dels processos d'influència educativa en la família, han estat importants els progressos fets en els darrers anys sobre aquest tema (Lacasa, 1997; Rodrigo, 1998; Vila, 1998). En aquest article es presenten algunes reflexions sobre la família com a context educatiu. La concepció constructivista de l'ensenyament i l'aprenentatge escolar, marc psicològic de referència per a la comprensió dels processos de canvi educatiu que es produeixen en les situacions educatives escolars (Coll, 1990; 1999), s'utilitza com a punt de referència per a aquestes reflexions. Les característiques de la intervenció educativa en les activitats a la família es presenten a partir de la tesi nuclear que qualsevol aproximació a la comprensió de la influència educativa requereix tenir en compte les característiques, naturalesa i funcions del context institucional en què té lloc.

A program of nurse algorithm-guided care for adult patients with acute minor illnesses in primary care

Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

A program of nurse algorithm-guided care for adult patients with acute minor illnesses in primary care

Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

Risc i seguretat en el context educatiu: un debat necessari en el marc d'una educació orientada al desenvolupament de la ciutadania

En aquest article se profunditza en torna a les repercusions dels nous escenaris teòrics relacionats amb el desenvolupament del concepte de risc en la segona modernitat. Les tradicions d'anàlisi de la violència escolar o de la gestió positiva del conflicte, han constituït-del fet encara avui dia constitueixen- referents importants per a l'anàlisi de la seguretat en els centres educatius, però el desenvolupament d'un nou concepte de seguretat humana sorgit a partir dels Programes de les Nacions Unides pel Desenvolupament (PNUD) proporciona un marc de reflexió més ampli. Partint d'aquesta perspectiva, se pretèn operativitzar un model que permeti comprendre com es construeix la percepció de risc en el context escolar.

A program of nurse algorithm-guided care for adult patients with acute minor illnesses in primary care

Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

Efficient total variation algorithm for fetal brain MRI reconstruction.

Fetal MRI reconstruction aims at finding a high-resolution image given a small set of low-resolution images. It is usually modeled as an inverse problem where the regularization term plays a central role in the reconstruction quality. Literature has considered several regularization terms s.a. Dirichlet/Laplacian energy, Total Variation (TV)- based energies and more recently non-local means. Although TV energies are quite attractive because of their ability in edge preservation, standard explicit steepest gradient techniques have been applied to optimize fetal-based TV energies. The main contribution of this work lies in the introduction of a well-posed TV algorithm from the point of view of convex optimization. Specifically, our proposed TV optimization algorithm or fetal reconstruction is optimal w.r.t. the asymptotic and iterative convergence speeds O(1/n2) and O(1/√ε), while existing techniques are in O(1/n2) and O(1/√ε). We apply our algorithm to (1) clinical newborn data, considered as ground truth, and (2) clinical fetal acquisitions. Our algorithm compares favorably with the literature in terms of speed and accuracy.