Adesão ao regime medicamentoso dos adolescentes submetidos a transplante hepático: fatores motivacionais.

Introduction: In liver transplantation the immunosuppression is essential for the survival of the graft and of the receiver. Although characteristics of adolescent development may influence medication non-adherence, the literature on the subject is scarce. The high prevalence and consequences of non-adherence makes it essential to identify the non-adherent adolescent with the intention of promoting medication adherence. Methods: The aim of this descriptive cross-sectional study is to characterize adolescents undergoing liver transplantation, and to determine the degree of medication non-adherence, using the Measure Treatment Adherence (MAT) scale and immunosuppression blood values. Moreover, the study seeks to explore the relationship between adherence and motivation - using the Treatment Self-Regulation Questionnaire (TSRQ), and adherence and competency - using Perceived Competence Scale (PCS). Results: The sample consisted of 32 adolescents (Age M=14,44 (SD=2,66); 56,3% (n=18) male) who underwent liver transplantation at a Portuguese pediatric hospital. Adolescents self-reported medication adherence scores in the MAT were significantly higher (100%) than what was expected based on the mean value of the three blood values of tacrolimus obtained within one year prior to completing the questionnaire (66,7%). As a subjective self-reported measure, the MAT is prone to bias and inflated self assessed adherence is commonly found in the literature. On the other hand, the mean value of the three blood levels of tacrolimus obtained widely and considered objective adherences measure, they may individually vary in terms of pharmacokinetic response and absorption. Adolescents showed a predominantly autonomous motivation to fulfill the medication prescription, being that motivation high (TSRQ autonomous motivation subscale presents an average value of 6.5, in a range of 1 to 7). They showed themselves confident and believing in their capacity to follow the medication regimen, due to the high perceived competence (PCS presents an average value of 6.65, in a range of 1 to 7). Opposed to what was postulated by the Self-determination Theory and other investigation's results, motivation and perceived competence are not related to adherence to the medication regimen in this study (rs=,119 p=,523; rs=,283 p=,123, respectively). Thus, perceived competence seems to have a positive influence on the autonomous motivation of these adolescents (rs=,482 p=,006). Conclusion: This study shows that medication adherence when evaluated subjectively scores higher compared to the blood values of immunosuppression. Also, Motivation and Perceived Competence do not seem to influence the adherence to the medication regimen. More multi-centre studies are needed, based on solid theory to examine adherence behaviour more.

Avaliação do potencial de desenvolvimento em meninos e meninas dos 4 aos 6 anos

Todos nós, educadores, devemos prestar uma atenção aprofundada às potencialidades e inclinações das crianças que constituem os nossos grupos, para que possamos estimular e desenvolver as suas competências. É nesse sentido que desenvolvemos este Estudo Exploratório, com o qual se pretende analisar a adaptação da avaliação de potencial derivada da Teoria das Inteligência Múltiplas ao contexto da Educação Pré-Escolar, com o objectivo de contribuir para a qualidade da intervenção educativa, articulando conceitos como Inteligência, Competência, Potencial, Currículo, Avaliação Dinâmica. Participam no estudo 42 crianças que frequentam Jardim de Infância e integram dois grupos heterogéneos e as respectivas educadoras. A metodologia é de natureza qualitativa e quantitativa, apoiando-se na aplicação dos seguintes instrumentos: modelo de avaliação de potencial baseado no Spectrum; Inventário de Quociente Emocional, versão para crianças e jovens (Bar-On Emocional Quotient Inventory: Youth Version), adaptado a educadores por Candeias e Monteiro (2010); questionário de Caracterização do ambiente educativo - Sala de Actividades, adaptado por Candeias e lglésias (2010); Teste de Avaliação de Habilidades Cognitivas de Solução de Problemas lnterpessoais (EVHACOSPI). Os resultados obtidos sugerem a importância de uma avaliação do potencial, baseada na Teoria das Inteligências Múltiplas, que utiliza instrumentos adequados a cada um dos domínios do potencial e da competência humana propostos por H. Gardner: verbal, Lógico-Matemática, Musical, Corporal-Cinestésica, Visuo-espacial, lnterpessoal, Intrapessoal e Naturalista. Apontam também para o papel que este tipo de avaliação pode desempenhar na intervenção educativa que se objectiva intencional e fundamentada. ABSTRACT: Ali of us, educators, must pay a special attention to the potentialities and inclinations of children who make up our groups, so enabling the stimulation and development of their competences. ln this sense we developed this Exploratory Study, through which is intended to analyse the adaptation of potential evaluation derived from the Theory of Multiple intelligences in the range of Pre-School Education, aiming at the contribution for the educative intervention: articulating concepts such as Intelligence, Competence Potential, Curriculum, and Dynamic Evaluation. The study involves 42 children attending Infant School, belonging to two heterogeneous groups and respective educators. Methodology is of qualitative and quantitative nature, supported by the following instruments: evaluation model based on Spectrum; Inventory of Emotional Quotient, version for children and youths, adapted to educators by Candeias e Monteiro (2010), Query of Characterization of Educative Environment - Activities Room, adapted by Candeias e lglésias (2010); Test for Evaluation of Cognitive Abilities of Interpersonal Problems Solution. (EVHACOSPI). The results suggest the importance of an assessment, based on the Theory of Multiple Intelligence, which uses instruments fitted to each of the domains of human potential and competence proposed by H. Gardiner: Verbal, Logical-Maths, Musical, Corporal¬ Kinaesthetic, Visuo-Spatial, Interpersonal, Intrapersonal and Naturalist. They also refer to the role that this type of assessment can play in the educational intervention aiming to be intentional and grounded.

Intercultural Management

Globalization has increasingly brought permanent contact with people whose cultural background is different from what many would consider their ‘own’ culture. The area of intercultural management is of critical interest due to the impact of increased European and global migration, which has required health and social care leaders and managers to develop competency to respond to the diversity and changing needs of their workforce and service users. The communities within the European Union are now often characterised by significant diversity whether at cultural, social, or psychological levels. The purpose of this chapter is to enable health and social care practitioners to assume a clinical/ professional leadership role in quality intercultural management in the health and social care sector. This chapter will focus on developing health and social care practitioners’ knowledge and understanding in the area of intercultural management within contemporary health and social care organisations. It will focus on the critical application of knowledge to practice through the provision of underpinning knowledge, understanding and debates surrounding contemporary issues and practices in the areas of intercultural management. Many practitioners accessing this information may already work in the heath/social sector and this critical focus on intercultural and diversity management has the potential to improve the quality in health and social care services through the critical application to practice.

Perfil del docente en el enfoque basado en competencias

Recibido 03 de noviembre de 2010 • Aceptado 09 de marzo de 2011 • Corregido 13 de mayo de 2011 La educación basada en competencias contiene el potencial para convertirse en un plan eficaz tendiente a mejorar el aprendizaje del estudiantado y, de esta manera, prepararle para abordar el trabajo futuro. Pero este enfoque requiere de un largo proceso de reformas, lo que implica, necesariamente, la transformación de los actores educativos: docentes y estudiantes. Ya que grupo de docentes constituye uno de los pilares de la educación basada en competencias, en este artículo se presentan las necesarias características o perfiles de docentes universitarios para abordar este enfoque.

How to Achieve Professional Skills in Higher Education?

During the last decade, higher education has tried to focus education on the achievement of professional skills. It is interesting to see how the learning strategies implemented may facilitate or make more difficult the achievement of competencies. By dealing with the challenge of a competency-based education approach, higher education points out the need of knowing how to build such competencies, i.e. how to design a learning strategy. Not much importance has been given to this issue, probably because the competencies can be confused with abilities, skills and attitudes and, therefore, the model can be associated to in- or out-of-classroom activities without a strategy to articulate the knowledge acquired with the cultural, social and economic contexts of the community and labor spheres, i.e., as a whole (Tobón, 2005). This paper analyzes the epistemological development of the competency-based approach in higher education, focusing on the implementation of professional competencies in the Sociology degree “Licenciatura en Sociología”, in two campuses of the Universidad Autónoma de Baja California: Ensenada and Mexicali. This paper describes how competencies are built and explores different theoretical trends, their conceptualization and formation, based on in-depth interviews applied to students and teachers. It provides a mixed study to understand, based on the student’s point of view, the achievements of this study program in terms of professional competencies.