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.

Claus per als itineraris de formació permanent del professorat de secundà ria

La formación permanente del profesorado (FPP) de Secundaria debería concebirse y llevarse a cabo considerando no sólo las prioridades de las políticas educativas sino también, y sobre todo, los escenarios laborales y las circunstancias peculiares en las que trabaja ese colectivo profesional. Los itinerarios constituyen una herramienta adecuada para ofrecer un dispositivo ordenado de oportunidades de formación que concilia las necesidades de los docentes y directivos, de los centros y de la Administración Educativa. Diseñar e implementar itinerarios comporta algunas consecuencias para las instituciones de FPP y los profesionales que trabajan en ellas, respecto a los recursos que se precisan y en relación con los sistemas y métodos de trabajo.

La Formació permanent del professorat a Catalunya. Una visió a través del tractament de la formació de formadors i formadores en els plans institucionals.

L'article fa un recorregut històric pels plans de formació permanent del professorat d'infantil, primària i secundària a Catalunya. Centra l'anàlisi de l'evolució de la formació permanent en el tractament que els diferents plans de formació han fet de la figura del formador de formadors. Aquest element permet anar establint els aspectes que han suposat els moments de canvi. Es veu el progressiu distanciament de la formació de les universitats i la creixent institucionalització dels plans de formació. També s'exposa la dicotomia entre els objectius que es plantegen i l'escassa preparació i consideració que els plans atorguen a aquests professionals, deixant en un limbe poc definit les funcions, responsabilitats i atribucions que se'ls atorga.

L'educació permanent: la història d'una idea

El fet de viure i de formar part d'una comunitat suposa, per a les persones que la integren, un procés de socialització i d'aprenentatge continuat. La creació i la transmissió de la cultura d'una generació a l'altra implica unes modalitats d'aprenentatge que transcendeixen el temps i l'espai limitats de l'educació formal, per comprendre pràcticament qualsevol moment i situació de la vida. Així doncs, el concepte de l'educació permanent no és un descobriment pedagògic modern, esta present en la practica de la humanitat des deis seus orígens, i podem trobar referencies sobre aquest tema en les antigues civilitzacions xinesa, índia, grega, al cristianisme, a l'humanisme, al Renaixement, etc. Però és durant el període il·lustrat quan la idea d'una educació per a tothom més enllà de la infància i de l'adolescència s'expressa amb més claredat que en èpoques anteriors.

Second primary squamous cell carcinoma arising in cutaneous flap reconstructions of two head and neck cancer patients.

Early complications of myocutaneous flap transfers following surgical eradication of head and neck tumors have been extensively described. However, knowledge concerning long-term complications of these techniques remains limited. We report the cases of two patients with a prior history of squamous cell carcinoma of the head and neck (HNSCC), who developed a second primary SCC on the cutaneous surface of their flaps, years after reconstruction. Interestingly, it seems that the well-known risk of a second primary SCC in patients with previous head and neck carcinoma also applies to foreign tissues implanted within the area at risk. Given the important expansion of these interventions, this type of complication may become more frequent in the future. Therefore, long-term follow-up of patients previously treated for HNSCC not only requires careful evaluation of the normal mucosa of the upper aero-digestive tract, but also of the cutaneous surface of the flap used for reconstruction.

Treatment of ruptured abdominal aortic aneurysm, a permanent challenge or a waste of resources? Prediction of outcome using a multi-organ-dysfunction score.

OBJECTIVES: in a retrospective study, attempts have been made to identify individual organ-dysfunction risk profiles influencing the outcome after surgery for ruptured abdominal aortic aneurysms. METHODS: out of 235 patients undergoing graft replacement for abdominal aortic aneurysms, 57 (53 men, four women, mean age 72 years [s.d. 8.8]) were treated for ruptured aneurysms in a 3-year period. Forty-eight preoperative, 13 intraoperative and 34 postoperative variables were evaluated statistically. A simple multi-organ dysfunction (MOD) score was adopted. RESULTS: the perioperative mortality was 32%. Three patients died intraoperatively, four within 48 h and 11 died later. A significant influence for pre-existing risk factors was identified only for cardiovascular diseases. Multiple linear-regression analysis indicated that a haemoglobin <90 g/l, systolic blood pressure <80 mmHg and ECG signs of ischaemia at admission were highly significant risk factors. The cause of death for patients, who died more than 48 h postoperatively, was mainly MOD. All patients with a MOD score >/=4 died (n=7). These patients required 27% of the intensive-care unit (ICU) days of all patients and 72% of the ICU days of the non-survivors. CONCLUSION: patients with ruptured aortic aneurysms from treatment should not be excluded. However, a physiological scoring system after 48 h appears justifiable in order to decide on the appropriateness of continual ICU support.

[Voyage en Italie : 1824-1830]. , Entrée de la maison Pansa : [vue perspective avec un péristyle au second plan et le mont Vésuve en arrière-plan] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 401

Renovació pedagógica i formació permanent

En dues ocasions anteriors i en circumstancies ben diferents per alguns de nosaltres, hem opinat o escrit sobre la formació permanent del professorat des d'aquesta "Tribuna» de Tempsd'Educació, per descriure les previsions del Pla de Formació del Departament d'Ensenyament (núm. 2, 1990) o per opinar i comentar les orientacions de la Comunitat Europea sobre la materia (núm. 5, 1991). En aquesta ocasió intentem aproximar-nos al tema des de la perspectiva de la Renovació Pedagógica i reflexionar sobre la marxa i la situació actual del Pla de Formació.

First imaging results of an intraindividual comparison of (11)C-acetate and (18)F-fluorocholine PET/CT in patients with prostate cancer at early biochemical first or second relapse after prostatectomy or radiotherapy.

PURPOSE: (18)F-Fluorocholine (FCH) and (11)C-acetate (ACE) PET are widely used for detection of recurrent prostate cancer (PC). We present the first results of a comparative, prospective PET/CT study of both tracers evaluated in the same patients presenting with recurrence and low PSA to compare the diagnostic information provided by the two tracers. METHODS: The study group comprised 23 patients studied for a rising PSA level after radical prostatectomy (RP, 7 patients, PSA ≤ 3 ng/ml), curative radiotherapy (RT, 7 patients, PSA ≤ 5 ng/ml) or RP and salvage RT (9 patients, PSA ≤ 5 ng/ml). Both FCH and ACE PET/CT scans were performed in a random sequence a median of 4 days (range 0 to 11 days) apart. FCH PET/CT was started at injection (307 ± 16 MBq) with a 10-min dynamic acquisition of the prostate bed, followed by a whole-body PET scan and late (45 min) imaging of the pelvis. ACE PET/CT was performed as a double whole-body PET scan starting 5 and 22 min after injection (994 ± 72 MBq), and a late view (45 min) of the prostate bed. PET/CT scans were blindly reviewed by two independent pairs of two experienced nuclear medicine physicians, discordant subgroup results being discussed to reach a consensus for positive, negative end equivocal results. RESULTS: PET results were concordant in 88 out of 92 local, regional and distant findings (Cohen's kappa 0.929). In particular, results were concordant in all patients concerning local status, bone metastases and distant findings. Lymph-node results were concordant in 19 patients and different in 4 patients. On a per-patient basis results were concordant in 22 of 23 patients (14 positive, 5 negative and 3 equivocal). In only one patient was ACE PET/CT positive for nodal metastases while FCH PET/CT was overall negative; interestingly, the ACE-positive and FCH-negative lymph nodes became positive in a second FCH PET/CT scan performed a few months later. CONCLUSION: Overall, ACE and FCH PET/CT showed excellent concordance, on both a per-lesion and a per-patient basis, suggesting that both tracers perform equally for recurrent prostate cancer staging.

Técnicas radiológicas para la identificación anatómica del conducto dentario inferior respecto al tercer molar inferior

La correcta identificación anatómica del conducto dentario inferior, por el que circula el nervio dentario inferior, con respecto al tercer molar es esencial cuando es preciso practicar la exéresis de los cordales inferiores incluidos, puesto que la proximidad de ambas estructuras condiciona la posibilidad de lesionar dicho nervio. En este artículo, se revisa el estudio radiológico del conducto dentario inferior y se comentan las diferentes técnicas de diagnóstico por la imagen (ortopantomografía, radiografías periapicales y oclusales y tomografía axial computadorizada), así como sus diversas indicaciones y los signos radiológicos útiles para determinar la situación y trayecto del conducto dentario inferior con respecto a los ápices.

High constant incidence rates of second primary neoplasms

The incidence of contralateral breast cancer is high and constant with age, around five per 1000 women who had a primary breast cancer. For other neoplasms, the pattern of incidence of second primary neoplasms with age is less known, particularly as for only a few neoplasms the site of origin is not totally removed, and hence remains at risk of a second primary. Using the dataset from the Cancer Registry of the Swiss Canton of Vaud, we show that the incidence of second neoplasms is constant with age also after oral and pharyngeal, colorectal cancers, cutaneous malignant melanoma (CMM) and basal cell carcinoma. The incidence of first primary oral and pharyngeal cancer increased 20-fold between age 30-39 and 70-89 years, whereas the incidence of second neoplasms did not increase with age. Rates of second colorectal cancer remained relatively constant with age, between 2.5 per 1000 at age 40-59 years and 3.8 per 1000 at 70 years and above. Likewise, for CMM, the age-specific incidence rates of second primary CMM did not vary, ranging between 1 and 2.5 per 1000 in various subsequent age groups. The pattern of incidence for second basal cell carcinoma was similar, with no clear rise with age. These patterns are compatible with the occurrence of a single mutational event in a population of susceptible individuals. A possible implication of these observations is that a variable, but potentially large, proportion of cancers arise in very high-risk individuals and the incidence, on average, increases at a high constant level at a predetermined age.

Who wrote the Second Ave maris stella of Tomás Luis de Victoria?

Contrary to what Felipe Pedrell indicates, the second Ave maris stella in his Victoria's collected works (vol. V, 1908, pp. 100-3, n° 33) doesn't appear in the collection published in 1600 in Madrid by the composer, nor in any other of the musician's books. In the 1600 edition, Victoria reissues the two first verses (plainchant followed by polyphony) of the Ave maris stella published in 1576 and then again in 1581. The earliest source of the problematic Ave maris stella is Munich, Bayerische Staatsbibliothek, Musik-Abteilung, 2 Mus. pr. 23 handschriftlicher Beiband, dating from the third quarter oft he seventeenth century. This source is a manuscrit that runs as an appendix to the 1581 edition of Victoria's hymns. No attributions are given in the manuscript. The first attributions of the piece to Victoria arise in the nineteenth century, in manuscripts copied by Johann Michael Hauber, Johann Caspar Aiblinger, August Baumgartner and Carl Proske, and preserved in Munich and Regensburg. Proske pubished the piece in his Musica divina in 1859 (Annus primus, vol. III, pp. 419-24). The most probable hypothesis ist that Pedrell had knowledge of the second Ave maris stella, under the spanish composer's name, via Proske's Musica divina. In all likelihood the piece is not by Victoria, not least because the composer has never written odd polyphonic verses of hymns. In his Studies in the Music of Tomás Luis de Victoria (2001), Eugene Casjen Cramer relies on the supposed authenticity of the work to ascribe the others pieces of Munich, Bayerische Staatsbibliothek, Musik-Abteilung, 2 Mus. pr. 23 handschriftlicher Beiband to the composer. These attributions should therefore be refuted.