The Use of a Pressure-Indicating Sensor Film to Provide Feedback upon Hydrogel-Forming Microneedle Array Self-Application In Vivo

PURPOSE:
To evaluate the combination of a pressure-indicating sensor film with hydrogel-forming microneedle arrays, as a method of feedback to confirm MN insertion in vivo.
METHODS:
Pilot in vitro insertion studies were conducted using a Texture Analyser to insert MN arrays, coupled with a pressure-indicating sensor film, at varying forces into excised neonatal porcine skin. In vivo studies involved twenty human volunteers, who self-applied two hydrogel-forming MN arrays, one with a pressure-indicating sensor film incorporated and one without. Optical coherence tomography was employed to measure the resulting penetration depth and colorimetric analysis to investigate the associated colour change of the pressure-indicating sensor film.
RESULTS:
Microneedle insertion was achieved in vitro at three different forces, demonstrating the colour change of the pressure-indicating sensor film upon application of increasing pressure. When self-applied in vivo, there was no significant difference in the microneedle penetration depth resulting from each type of array, with a mean depth of 237 μm recorded. When the pressure-indicating sensor film was present, a colour change occurred upon each application, providing evidence of insertion.
CONCLUSIONS:
For the first time, this study shows how the incorporation of a simple, low-cost pressure-indicating sensor film can indicate microneedle insertion in vitro and in vivo, providing visual feedback to assure the user of correct application. Such a strategy may enhance usability of a microneedle device and, hence, assist in the future translation of the technology to widespread clinical use.

Testing the psychometric properties of two self-report clinical competence scales for nursing students.

Background: It is important to assess the clinical competence of nursing students to gauge their educational needs. Competence can be measured by self-assessment tools; however, Anema and McCoy (2010) contend that currently available measures should be further psychometrically tested.
Aim: To test the psychometric properties of Nursing Competencies Questionnaire (NCQ) and Self-Efficacy in Clinical Performance (SECP) clinical competence scales.
Method: A non-randomly selected sample of n=248 2nd year nursing students completed NCQ, SECP and demographic questionnaires (June and September 2013). Mokken Scaling Analysis (MSA) was used to investigate structural validity and scale properties; convergent and discriminant validity and reliability were also tested for each scale.
Results: MSA analysis identified that the NCQ is a unidimensional scale with strong scale scalability coefficients Hs =0.581; but limited item rankability HT =0.367. The SECP scale MSA suggested that the scale could be potentially split into two unidimensional scales (SECP28 and SECP7), each with good/reasonable scalablity psychometric properties as summed scales but negligible/very limited scale rankability (SECP28: Hs = 0.55, HT=0.211; SECP7: Hs = 0.61, HT=0.049). Analysis of between cohort differences and NCQ/SECP scores produced evidence of discriminant and convergent validity; good internal reliability was also found: NCQ α = 0.93, SECP28 α = 0.96 and SECP7 α=0.89.

Discussion: In line with previous research further evidence of the NCQ’s reliability and validity was demonstrated. However, as the SECP findings are new and the sample small with reference to Straat and colleagues (2014), the SECP results should be interpreted with caution and verified on a second sample.
Conclusions: Measurement of perceived self-competence could start early in a nursing programme to support students’ development of clinical competence. Further testing of the SECP scale with larger nursing student samples from different programme years is indicated.

References:
Anema, M., G and McCoy, JK. (2010) Competency-Based Nursing Education: Guide to Achieving Outstanding Learner Outcomes. New York: Springer.
Straat, JH., van der Ark, LA and Sijtsma, K. (2014) Minimum Sample Size Requirements for Mokken Scale Analysis Educational and Psychological Measurement 74 (5), 809-822.

The iceberg of suicide and self-harm in Irish adolescents: a population-based study

PURPOSE Suicide is a leading cause of death among adolescents. Self-harm is the most important risk factor for suicide, yet the majority of self-harm does not come to the attention of health services. The purpose of this study was to establish the relative incidence of adolescent suicide, hospital-treated self-harm and self-harm in the community. METHODS Annual suicide rates were calculated for 15-17 year-old in the Cork and Kerry region in Ireland based on data from the Central Statistics Office. Rates of hospital-treated self-harm were collected by the Irish National Registry of Deliberate Self-Harm. Rates of self-harm in the community were assessed using a survey of 3,881 adolescents, the Child and Adolescent Self-harm in Europe study. RESULTS The annual suicide rate was 10/100,000. Suicide was six times more common among boys than girls. The annual incidence rate of hospital-treated self-harm was approximately 344/100,000, with the female rate almost twice the male rate. The rate of self-harm in the community was 5,551/100,000, and girls were almost four times more likely to report self-harm. For every boy who died by suicide, 16 presented to hospital with self-harm and 146 reported self-harm in the community. For every female suicide, 162 girls presented to hospital with self-harm and 3,296 reported self-harm. CONCLUSIONS Gender differences in relative rates of self-harm and suicide are very large, with boys who have harmed themselves at particularly high risk of suicide. Knowledge of the relative incidence of self-harm and suicide in adolescents can inform prevention programmes and services.

Self-Harm in Secondary Schools: What are the Perceptions and Experiences of Staff ?

The purpose of this study is to explore the perceptions and experiences of secondary school staff with regard to adolescent self-harm. The research was conducted in a Local Authority where there were particular concerns about rising numbers of young people presenting with self-harm. While the majority of young people who self-harm are supported in the community and never access clinical services, surprisingly little research has considered the role of schools and their staff. The research that has been done suggests that school staff can feel underqualified and overwhelmed in their attempts to support young people who self-harm. Further, there is a growing evidence base that when young people experience negative attitudes towards self-harm it is distressing and reduces the chance of them seeking further help. To address this, qualitative exploratory research was conducted with thirteen members of staff working in secondary schools. Since the research was concerned not just with experiences, but also with perceptions of adolescent self-harm, the participants were from two groups: those with direct experience of supporting young people who have self-harmed and those without any direct experience. Data collection involved individual semi-structured interviews which were analysed using thematic analysis. The research indicated that secondary school staff are keen to help and understand young people who self-harm, but that they do not always feel skilled or confident enough to do so, often feeling that some kind of specialist is required and/or fearing that they might make a situation worse. Findings highlighted the emotional impact of this work and illustrated the importance of supporting staff, who expressed a desire for further training and other forms of professional support such as supervision.

Sociocultural context as a facilitator of student learning of function concepts in mathematics

In Costa Rica, many secondary students have serious difficulties to establish relationships between mathematics and real-life contexts. They question the utilitarian role of the school mathematics. This fact motivated the research object of this report which evidences the need to overcome methodologies unrelated to students’ reality, toward new didactical options that help students to value mathematics, reasoning and its  applications, connecting it with their socio-cultural context. The research used a case study as a qualitative methodology and the social constructivism as an educational paradigm in which the knowledge is built by the student; as a product of his social interactions. A collection of learning situations was designed, validated, and implemented. It allowed establishing relationships between mathematical concepts and the socio-cultural context of participants. It analyzed the impact of students’socio-cultural context in their mathematics learning of basic concepts of real variable functions, consistent with the Ministry of Education (MEP) Official Program.  Among the results, it was found that using students’sociocultural context improved their motivational processes, mathematics sense making, and promoted cooperative social interactions. It was evidenced that contextualized learning situations favored concepts comprehension that allow students to see mathematics as a discipline closely related with their every-day life.

ADVANCES AND CHALLENGES OF BREASTFEEDING IN BRAZIL: AN INTEGRATIVE REVIEW

Objective: To analyze the panorama of breastfeeding in Brazil through an integrative literature review highlighting its advances and challenges. Methods: We carried out an integrative literature review in the SciELO and PubMed databases and in booklets published on the websites of the Ministry of Health and the International Baby Food Action Network (IFBAN) using the following Portuguese and English descriptors: aleitamento materno (breastfeeding), autoeficácia (self-efficacy), promoção da saúde (health promotion) and desmame (weaning) in the period from 2002 to 2015. Results: We identified at first 43 articles, 33 booklets, 1 thesis and 3 dissertations, including in the study 17 articles, 3 dissertations and 19 booklets due to information saturation. It was verified that breastfeeding rates have reduced significantly over time with direct implications in infant mortality rates, being associated with early weaning and the lack of promotion of maternal self-efficacy in the prenatal and postpartum. To change this situation, Brazil imposed a number of public policies aimed at breastfeeding success, which advocated to raise rates. Conclusion: Despite the advances, the Brazilian panorama of breastfeeding shows that the country remains below the recommendations of international organizations, and overcoming the obstacles to successful breastfeeding constitutes a major challenge for the Brazilian public health.

Humor in mathematics teaching

HUMOR: OUR VIEW FOR MATHEMATICS TEACHING Our assumptions and context. Process humor and be able to produce is clearly a sign of intelligence, revealing, when done well, complex reasoning. Humor has an important social role, assuming as a cognitive experience that as well as creating a sense of well-being, predisposes people to work and can improve the productivity of that work. Mathematics is a discipline in which the reasoning occupies a very prominent place, both as a science as a school area. At the same time, students' interest for mathematics is not always the same and some have initially not very favorable feelings (Toh, 2009; Wanzer, Frymier & Irwin, 2010). Recent curriculum changes to the teaching of mathematics have been, in most countries of the world, showing the need for students to develop skills of critical nature, such as communication, thinking and problem solving along with the acquisition of mathematical knowledge. Also in Portugal, it is claimed the importance of promoting learning that combine the construction of mathematical knowledge with its use, when performing mathematical tasks and communicating mathematical ideas and mathematical reasoning. In the early years of schooling, corresponding to primary education in many countries, the use of texts such as short stories or comics, from which we can develop challenging mathematical tasks, is reported in the literature as having potential to promote learning specified in curricular documents (Wanzer, Frymier., & Irwin, 2010). In particular, some texts focus on mathematical topics in a humorous way and to be understood, students must develop their mathematical competence. The development of mathematical tasks from stories and other humorous presents big challenges to teachers (Flores & Moreno, 2011). Our questions. In this context, we put some questions: Primary teachers use in their classes tasks or situations that present, in a humorous way, mathematical ideas? What resources do they use? Also: How to select, adapt or build texts and tasks which have, in a humorous way, mathematical ideas with didactic potential for education in the early years of schooling? If the resources for this purpose have been produced and if teachers have been sensitized for their use, are they able to integrate them in their classes? Our intentions. This research project seeks to address these questions, focused on: (i ) assessment of teachers’ practices and underlying knowledge, resources available for the use of texts with mathematical ideas presented in a humorous way; (ii) selection, adaptation and construction of mathematical tasks from texts that present, in a humorous way, mathematical ideas with didactic potential in education for the early years of schooling; and ( iii ) integration and use, by primary school teachers, of texts that present , in a humorous way, contexts for the teaching of mathematics. So, the project is organized into three tasks and as a methodological design that combines qualitative elements with quantitative elements, the first one prevailing.

Cystic echinococcosis therapy: Albendazole-loaded lipid nanocapsules enhance the oral bioavailability and efficacy in experimentally infected mice

International audience

A case study of epistemic order in mathematics classroom dialogue

We define epistemic order as the way in which the exchange and development of knowledge takes place in the classroom, breaking this down into a system of three components: epistemic initiative relating to who sets the agenda in classroom dialogue, and how; epistemic appraisal relating to who judges contributions to classroom dialogue, and how; and epistemic framing relating to the terms in which development and exchange of knowledge are represented, particularly in reflexive talk. These components are operationalised in terms of various types of structural and semantic analysis of dialogue. It is shown that a lesson segment displays a multi-layered epistemic order differing from that of conventional classroom recitation.

Vector self-pulsing in erbium-doped fiber lasers

Insight into instabilities of fiber laser regimes leading to complex self-pulsing operations is an opportunity to unlock the high power and dynamic operation tunability of lasers. Though many models have been suggested, there is no complete covering of self-pulsing complexity observed experimentally. Here, I further generalized our previous vector model of erbium-doped fiber laser and, for the first time, to the best of my knowledge, map tunability of complex vector self-pulsing on Poincare sphere (limit cycles and double scroll polarization attractors) for laser parameters, e.g., power, ellipticity of the pump wave, and in-cavity birefringence. Analysis validated by extensive numerical simulations demonstrates good correspondence to the experimental results on complex self-pulsing regimes obtained by many authors during the last 20 years.

Liderazgo y autoeficacia en el comportamiento organizacional positivo

El objetivo que tiene este proyecto es revisar los conceptos básicos acerca de las relaciones que crean los líderes con sus colaboradores dentro de las organizaciones, dichas relaciones y vínculos pueden afectar positiva o negativamente el desempeño de sus actividades diarias dentro de una organización. Para darle inicio a la investigación se estudió como primer paso el concepto de liderazgo transformacional, capital psicológico y que componentes hacían parte de este factor. El desarrollo de la investigación se enfatizó entre el liderazgo transformacional y la autoeficacia ya que son factores claves dentro del desarrollo de las actividades organizacionales debido a que afectan claramente el capital humano de las compañías y están directamente relacionados con el crecimiento de las mismas, lo que nos llevó a preguntarnos ¿qué relación tendrá el liderazgo transformacional y la autoeficacia en la productividad de las empresas? Es aquí donde radica la importancia de esta investigación ya que el cambio de pensamiento de las organizaciones hacia un liderazgo transformacional podría lograr una maximización del desempeño del personal de trabajo en relación al objetivo de la compañía. Como conclusión llegamos a que efectivamente hay un efecto positivo en los individuos que desarrollan un capital psicológico específicamente en el factor de autoeficacia para lograr un desempeño destacable, productivo y eficiente dentro de las organizaciones.

Methodology of Care Humanitude in Promoting Self-care in Dependent People: An Integrative Review

Abstract. The aging of the population has led to an increase in the prevalence of chronic degenerative diseases and dependence. We need to implement humanized health care that will improve the quality of life and well-being of these people and help maintain their autonomy and self-care. Objective: To identify the implications of the caring in Humanitude in promoting self-care in the dependent person. Methods: Integrative review of the literature of the period between 2007 and 2015, using the databases Medline, EBSCO and Google Scholar. In using the PI[C]OD methodology and criteria for inclusion and exclusion, we obtained 54 items where 7 were selected for analysis. Results: There are several health benefits in the promotion of self-care, by ap-plying the Humanitude caring philosophy, mainly regarding the relationship be-tween the nurse and the patient. Conclusions: It is essential to develop further studies focused on the implications of caring in Humanitude in self-care in the dependent person.

Self-care in Patients with Heart Failure

Objectives: To adapt for the Portuguese language the Self-Care of Heart Failure Index V6.2, analyse the self-care in maintenance, management skills and self-confidence of patients with heart failure who attend the nursing consultation of two Hospitals. Method: Explo- ratory study, sample 110 patients who frequented the nursing consultation for patients with heart failure of two Portuguese hospitals, conducted in the period of 6 months. He appea- led to the descriptive statistics and psychometric tests. Results: Internal consistency similar to the original scale. Mostly elderly, low literacy patients in self-care, low values associated with physical activity to the control of salt in meals taken away from home and inadequate control of signs and symptoms. Conclusion: Patients’ present difficulties in maintenance and management of the disease are self-confident face anyway. This instrument allows for individualized assessment leading to decision-making and action adjusted.