Cross-Cultural Communication in Oncology: Challenges and Training Interests.

PURPOSE/OBJECTIVES: To survey oncology nurses and oncologists about difficulties in taking care of culturally and linguistically diverse patients and about interests in cross-cultural training.
. DESIGN: Descriptive, cross-sectional.
. SETTING: Web-based survey.
. SAMPLE: 108 oncology nurses and 44 oncologists. 
. METHODS: 31-item questionnaire derived from preexisting surveys in the United States and Switzerland.
. MAIN RESEARCH VARIABLES: Self-rated difficulties in taking care of culturally and linguistically diverse patients and self-rated interests in cross-cultural training.
. FINDINGS: All respondents reported communication difficulties in encounters with culturally and linguistically diverse patients. Respondents considered the absence of written materials in other languages, absence of a shared common language with patients, and sensitive subjects (e.g., end of life, sexuality) to be particularly problematic. Respondents also expressed a high level of interest in all aspects of cross-cultural training (task-oriented skills, background knowledge, reflexivity, and attitudes). Nurses perceived several difficulties related to care of migrants as more problematic than physicians did and were more interested in all aspects of cross-cultural training. 
. CONCLUSIONS: The need for cross-cultural training is high among oncology clinicians, particularly among nurses.
. IMPLICATIONS FOR NURSING: The results reported in the current study may help nurses in decision-making positions and educators in introducing elements of cross-cultural education into oncology curricula for nurses. Cross-cultural training should be offered to oncology nurses.

Differences and similarities in rheumatology specialty training programmes across European countries.

OBJECTIVES: To analyse the similarities and discrepancies between the official rheumatology specialty training programmes across Europe. METHODS: A steering committee defined the main aspects of training to be assessed. In 2013, the rheumatology official training programmes were reviewed for each of the European League Against Rheumatism (EULAR) countries and two local physicians independently extracted data on the structure of training, included competencies and assessments performed. Analyses were descriptive. RESULTS: 41 of the 45 EULAR countries currently provide specialist training in rheumatology; in the remaining four rheumatologists are trained abroad. 36 (88%) had a single national curriculum, one country had two national curricula and four had only local or university-specific curricula. The mean length of training programmes in rheumatology was 45 (SD 19) months, ranging between 3 and 72 months. General internal medicine training was mandatory in 40 (98%) countries, and was performed prior to and/or during the rheumatology training programme (mean length: 33 (19) months). 33 (80%) countries had a formal final examination. CONCLUSIONS: Most European countries provide training in rheumatology, but the length, structure, contents and assessments of these training programmes are quite heterogeneous. In order to promote excellence in standards of care and to support physicians' mobility, a certain degree of harmonisation should be encouraged.

Is altitude training an efficient treatment for obesity?

Worldwide, about half the adult population is considered overweight as defined by a body mass index (BMI - calculated by body weight divided by height squared) ratio in excess of 25 kg.m-2. Of these individuals, half are clinically obese (with a BMI in excess of 30) and these numbers are still increasing, notably in developing countries such as those of the Middle East region. Obesity is a disorder characterised by increased mass of adipose tissue (excessive fat accumulation) that is the result of a systemic imbalance between food intake and energy expenditure. Although factors such as family history, sedentary lifestyle, urbanisation, income and family diet patterns determine obesity prevalence, the main underlying causes are poor knowledge about food choice and lack of physical activity3. Current obesity treatments include dietary restriction, pharmacological interventions and ultimately, bariatric surgery. The beneficial effects of physical activity on weight loss through increased energy expenditure and appetite modulation are also firmly established. Another viable option to induce a negative energy balance, is to incorporate hypoxia per se or combine it with exercise in an individual's daily schedule. This article will present recent evidence suggesting that combining hypoxic exposure and exercise training might provide a cost-effective strategy for reducing body weight and improving cardio-metabolic health in obese individuals. The efficacy of this approach is further reinforced by epidemiological studies using large-scale databases, which evidence a negative relationship between altitude of habitation and obesity. In the United States, for instance, obesity prevalence is inversely associated with altitude of residence and urbanisation, after adjusting for temperature, diet, physical activity, smoking and demographic factors.

Harmonization of training and assessment of medical specialists in physical and rehabilitation medicine across Europe - The contribution of the UEMS Board of Physical and Rehabilitation Medicine

Background.- The main goals of the European Board of Physical and Rehabili-tation Medicine (EBPRM), founded in 1991 as the third speciality board of theUnion of European Medical Specialists (UEMS), are to harmonize pre-graduate,post-graduate and continuous medical education in physical and rehabilitationmedicine (PRM) all over Europe. The harmonization of curricula of the medi-cal specialities and the assessment of medical specialists has become one of thepriorities of the UEMS and its working groups to which the EBPRM contributes.Action.- The EBPRM will continue to promote a specific minimal undergraduatecurriculum on PRM including issues like disability, participation and handicapto be taught all over Europe as a basis for general medical practice. The EBPRMwill also expand the existing EBPRM postgraduate curriculum into a detailedcatalogue of learning objectives. This catalogue will serve as a tool to boostharmonization of the national curricula across Europe as well as to structurethe content of the MCQ examination. It would be a big step forward towardsharmonization of European PRM specialist training if an important number ofcountries would use the certifying MCQ examination of the Board as a part ofthe national assessments for PRM specialists.

Procesos oncológicos y afectación de la imagen corporal

El cáncer es una enfermedad de elevada incidencia que puede desencadenar diferentes modificaciones que afectan a la autopercepción de la imagen corporal y comprometer la calidad de vida del individuo. Objetivos: Analizar los cambios corporales que se derivan del proceso oncológico y de los tratamientos aplicables. Por otro lado, se pretende averiguar cómo repercuten dichos cambios en la calidad de vida del paciente, identificar las consecuencias psicológicas y analizar las posibles intervenciones enfermeras. Material y métodos: Revisión de la literatura a través de la consulta de diferentes bases de datos. Resultados: La localización del tumor es un factor atribuible a la afectación de la imagen corporal, siendo los tumores más visibles los que comportan un mayor impacto en el individuo. Por otro lado, los diferentes tratamientos antineoplásicos así como la propia progresión del proceso tumoral conllevan, en muchos casos, cambios importantes en la apariencia física del paciente que afectan a su bienestar psicológico. La enfermera tiene un papel primordial en la identificación y manejo de problemas relacionados con la imagen corporal de los pacientes oncológicos. Establecer una relación terapéutica basada en la confianza, ofrecer apoyo emocional, así como orientar sobre posibles recursos para disminuir el impacto de los cambios físicos, son algunas de las intervenciones que este colectivo puede realizar para mejorar la autoestima y facilitar la aceptación de la nueva imagen corporal. Conclusiones: Los cambios corporales derivados del proceso neoplásico o sus tratamientos provocan un fuerte impacto emocional en el paciente y alteran su calidad de vida. Por este motivo, es aconsejable la aplicación de medidas dirigidas a favorecer la adaptación del paciente a su nueva apariencia física, a través de una atención integral y personalizada. Palabras clave: imagen corporal, cáncer, cirugía, quimioterapia, calidad de vida, anorexia-caquexia.

La imagen corporal en la sociedad del siglo XXI

La imagen corporal (IC) representa la forma en la que un individuo se percibe, imagina, siente y actúa respecto a su propio cuerpo. Es un concepto dinámico que puede modificarse a lo largo de la vida. La percepción de nuestro propio cuerpo está influida por factores socioculturales. Desde el punto de vista histórico, el concepto de belleza se ha modificado sustancialmente. En la prehistoria, la belleza se asociaba a la reproducción de la especie, mientras que en la actualidad, se asocia al éxito personal, profesional y social. El estereotipo de belleza femenino de las sociedades contemporáneas se basa en la extrema delgadez y el masculino en cuerpos musculados. La lucha por alcanzar el canon de belleza impuesto por la sociedad ha contribuido a la aparición de diferentes trastornos de la imagen corporal (TIC). Los medios de comunicación son un factor importante en el desarrollo de determinados procesos patológicos, en la insatisfacción con la propia IC y en la estigmatización del individuo. Se consideran los principales impulsores de los patrones estéticos, siendo las mujeres y los adolescentes los más vulnerables. Las diferentes investigaciones indican que los TIC son frecuentes siendo los trastornos de la conducta alimentaria (TCA) los que suponen un mayor número de ingresos y reingresos entre la población femenina. Aunque los TCA afectan principalmente a la población adolescente, los estudios muestran que puede aparecer en la edad adulta e incluso en la infancia. En el sexo masculino, el trastorno dismórfico corporal (TDC) parece ser el más prevalente. La prevención y el tratamiento de este tipo de trastornos es primordial. En este sentido, enfermería tiene un papel fundamental debido al frecuente contacto que mantiene con el paciente. Debido a la importancia concedida en la sociedad actual a la apariencia física y las posibles repercusiones que ello conlleva, el presente trabajo pretende realizar una revisión de la literatura con el objetivo de analizar el valor y la exigencia que otorga la sociedad a la IC. Palabras clave: imagen corporal, desórdenes mentales, estigma social, medios de comunicación, epidemiología, cuidados de enfermería, proceso de atención de enfermería.

Monitoring of the training load and recovery parameters in competitive swimmers

Nombreux sont les groupes de recherche qui se sont intéressés, ces dernières années, à la manière de monitorer l'entraînement des sportifs de haut niveau afin d'optimaliser le rendement de ce dernier tout en préservant la santé des athlètes. Un des problèmes cardinaux d'un entraînement sportif mal conduit est le syndrome du surentraînement. La définition du syndrome susmentionné proposée par Kreider et al. est celle qui est actuellement acceptée par le « European College of Sport Science » ainsi que par le « American College of Sports Medicine», à savoir : « An accumulation of training and/or non-training stress resulting in long-term decrement in performance capacity with or without related physiological and psychological signs and symptoms of maladaptation in which restoration of performance capacity may take several weeks or months. » « Une accumulation de stress lié, ou non, à l'entraînement, résultant en une diminution à long terme de la capacité de performance. Cette dernière est associée ou non avec des signes et des symptômes physiologiques et psychologiques d'inadaptation de l'athlète à l'entraînement. La restauration de ladite capacité de performance peut prendre plusieurs semaines ou mois. » Les recommandations actuelles, concernant le monitoring de l'entraînement et la détection précoce du syndrome du surentrainement, préconisent, entre autre, un suivi psychologique à l'aide de questionnaires (tel que le Profile of Mood State (POMS)), un suivi de la charge d'entraînement perçue par l'athlète (p.ex. avec la session rating of perceived exertion (RPE) method selon C. Foster), un suivi des performances des athlètes et des charges d'entraînement effectuées ainsi qu'un suivi des problèmes de santé (blessures et maladies). Le suivi de paramètres sanguins et hormonaux n'est pas recommandé d'une part pour des questions de coût et de faisabilité, d'autre part car la littérature scientifique n'a, jusqu'ici, pas été en mesure de dégager des évidences à ce sujet. A ce jour, peu d'études ont suivi ces paramètres de manière rigoureuse, sur une longue période et chez un nombre d'athlète important. Ceci est précisément le but de notre étude.

University teacher competences in a virtual teaching/learning environment : analysis of a teacher training experience

This paper attempts to shed light on the competencies a teacher must have inorder to teach in online university environments. We will relate a teacher trainingexperience, which was designed taking into account the methodological criteriaestablished in line with previous theoretical principles. The main objective of ouranalysis is to identify the achievements and difficulties of a specific formativeexperience, with the ultimate goal of assessing the suitability of this conceptualmethodologicalframework for the design of formative proposals aiming to contribute tothe development of teacher competencies for virtual environments.

Research and training in medicinal chemistry in south and central american countries and sub-saharan Africa

With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as to achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.

La imagen corporal en danza/movimiento terapia

El cáncer de mama es el tumor más frecuente en la población femenina. El impacto tanto físico como psicológico y social del diagnóstico y los tratamientos quirúrgicos y farmacológicos significan un antes y después en la vida de estas mujeres. Este estudio de tipo descriptivo-exploratorio investiga lo que significa para esta población el haber pasado por esta enfermedad en relación con su imagen corporal y qué es lo que puede aportar la Danza Movimiento Terapia (DMT) para aliviar los síntomas psicológicos y sociales que sienten como consecuencia del impacto de la enfermedad. A través de un cuestionario extenso y un taller de DMT con un grupo de mujeres operadas de cáncer de mama exploramos los diferentes aspectos implicados en la imagen corporal. Los resultados de este estudio exploratorio nos muestran la importancia que tiene para esta población el aspecto relacional que engloba la imagen corporal.

The Role of Firm Size in Training Provision Decisions: evidence from Spain

The level of training provided by small firms to their employees is below that provided by their larger counterparts. The provision of firm-related training is believed to be associated to certain characteristics of the firm. In this paper we argue that small firms provide fewer training opportunities as they are less likely to be associated with these characteristics than large firms. The suitability of estimating training decisions as a double-decision process is examined here: first, a firm has to decide whether to provide training or not and, second, having decided to do so, the amount of training to provide. The differences in training provision between small and large firms are decomposed in order to analyse the individual contribution of these characteristics to explaining the gap. The results show that small firms face greater obstacles in accessing training and that the main reasons for that are related to their technological activity and the geographical scope of the market in which they operate.

Music-supported training is more efficient than functional motor training for recovery of fine motor skills in stroke patients

MOTOR IMPAIRMENTS ARE COMMON AFTER STROKE but efficacious therapies for these dysfunctions are scarce. Extending an earlier study on the effects of music-supported training (MST), behavioral indices of motor function were obtained before and after a series of training sessions to assess whether this new treatment leads to improved motor functions. Furthermore, music-supported training was contrasted to functional motor training according to the principles of constraint-induced therapy (CIT). In addition to conventional physiotherapy, 32 stroke patients with moderately impaired motor function and no previous musical experience received 15 sessions of MST over a period of three weeks, using a manualized, step-bystep approach. A control group consisting of 15 patients received 15 sessions of CIT in addition to conventional physiotherapy. A third group of 30 patients received exclusively conventional physiotherapy and served as a control group for the other three groups. Fine as well as gross motor skills were trained by using either a MIDI-piano or electronic drum pads programmed to emit piano tones. Motor functions were assessed by an extensive test battery. MST yielded significant improvement in fine as well as gross motor skills with respect to speed, precision, and smoothness of movements. These improvements were greater than after CIT or conventional physiotherapy. In conclusion, with equal treatment intensity, MST leads to more pronounced improvements of motor functions after stroke than CIT.

Actitudes cooperativas para fomentar la creatividad en los alumnos de secundaria

La experiencia que se presenta quiere dar a conocer una propuesta didáctica sobre la utilización de la expresión corporal como contenido en el área de educación física, con la finalidad de utilizarla como recurso para mejorar actitudes cooperativas entre los alumnos. Pretende mostrar un proyecto donde se den las posibilidades de desarrollar actitudes cooperativas entre la profesora de educación física y las dos tutoras de educación infantil, conjuntamente con un grupo de secundaria, con el objetivo de mejorar, ampliar y reforzar las capacidades mínimas establecidas en la educación infantil

The process of basic training, applied training, maintaining the performance of an observer

In the field of observational methodology the observer is obviously a central figure, and close attention should be paid to the process through which he or she acquires, applies, and maintains the skills required. Basic training in how to apply the operational definitions of categories and the rules for coding, coupled with the opportunity to use the observation instrument in real-life situations, can have a positive effect in terms of the degree of agreement achieved when one evaluates intra- and inter-observer reliability. Several authors, including Arias, Argudo, & Alonso (2009) and Medina and Delgado (1999), have put forward proposals for the process of basic and applied training in this context. Reid y De Master (1982) focuses on the observer's performance and how to maintain the acquired skills, it being argued that periodic checks are needed after initial training because an observer may, over time, become less reliable due to the inherent complexity of category systems. The purpose of this subsequent training is to maintain acceptable levels of observer reliability. Various strategies can be used to this end, including providing feedback about those categories associated with a good reliability index, or offering re-training in how to apply those that yield lower indices. The aim of this study is to develop a performance-based index that is capable of assessing an observer's ability to produce reliable observations in conjunction with other observers.

Espai corporal i praxi constructiva grafomotora a l'edat pre-escolar

En totes les investigacions sobre I'evolució ontogeneticadel nen es parteix d'una serie de pressuposits que,plantejats d'una manera explícita o no, determinen el seuenfoc i les seves conclusions teoriques. La relació existententre desenvolupament i aprenentatge n'es un dels mesimportants. Aquesta relació pot considerar-se com a unidireccional(a/ el desenvolupament es una condició previaa I'aprenentatge o b/ I'aprenentatge és desenvolupament)o be com a mútua i interdependent