La educación intercultural en los centros escolares españoles

Son muchas las iniciativas que sobre educación intercultural se están llevando a cabo en las escuelas de nuestro país. El panorama es variado y adaptado a las decisiones y a las necesidades que cada autonomía ha considerando relevantes. Consideramos interesante visibilizar las prácticas escolares que sobre interculturalidad se han realizado en los centros educativos españoles en las últimas décadas. Empezamos este escrito a través de un repaso de las políticas educativas que han dado cobertura a tales actuaciones para describir posteriormente las características concretas de la práctica escolar. Las líneas de análisis que vertebran estas acciones las hemos sintetizado en: I. Los planes de acogida, II. La atención a la diversidad lingüística y cultural, III. Las estructuras escolares cooperativas, IV. La participación de la comunidad educativa, V. La mediación intercultural y la resolución de conflictos, VI. La Formación de Profesorado, VII. Los observatorios de las diferentes comunidades. Podemos entender todas estas actuaciones desde dos enfoques diferenciados; uno más relacionado con la educación inclusiva y otro que actúa desde la educación compensatoria. Relacionamos al final las acciones de la interculturalidad educativa con los principios básicos de las comunidades de aprendizaje, considerándolas un soporte desde el que dar cobertura a las acciones educativas previamente descritas.

“Entretejiendo encajes” entre la universidad, los centros de arte y las escuelas

Habitualmente la formación inicial de profesionales de la educación suele realizarse en los contextos universitarios, las escuelas son consideradas contextos para realizar las prácticas y los museos y centros de arte tienen poca presencia en la formación de maestros. Por ello desde la Facultad de Ciencias de la Educación de la UdL y en el contexto de la formación inicial de maestros y psicopedagogos empezamos a entretejer la red entre la Facultad, los centros educativos y los recursos culturales comunitarios para mejorar la formación de todas las personas implicadas. Concretamente, estamos desarrolando el espacio híbrido en el marco del proyecto Educ-arte dando especial énfasis a las relaciones creadas entre la Facultad de Ciencias de la Educación, el Centro de Arte la Panera y la escuela Príncep de Viana de Lleida. Para ello utilizamos el arte contemporáneo como mediador de aprendizajes y como instrumento de formación y construcción de conocimientos. Nuestra aportación está enmarcada en los planteamientos socioconstructivistas que sitúan la cultura como elemento básico para la humanización de las personas. Es por ello que en nuestro entretejer situamos los recursos comunitarios culturales en general y museos y centros de arte en particular como parte esencial del trabajo en red.

Cross-Border Place Branding : The Case of Geneva Highlighting Multidimensionality of Places and the Potential Role of Politico-Institutional Aspects

Place branding is not a new phenomenon. The emphasis placed on place branding has recently become particularly strong and explicit to both practitioners and scholars, in the current context of a growing mobility of capital and people. On the one hand, there is a need for practitioners to better understand place brands and better implement place branding strategies. In this respect, this domain of study can be currently seen as 'practitioner led', and in this regard many contributions assess specific cases in order to find success factors and best practices for place branding. On the other hand, at a more analytical level, recent studies show the complexity of the concept of place branding and argue that place branding works as a process including various stakeholders, in which culture and identity play a crucial role. In the literature, tourists, companies and residents represent the main target groups of place branding. The issues regarding tourists and companies have been examined since long by place promoters, location branders, economists or other scholars. However, the analysis of residents' role in place branding has been overlooked until recently and represents a new interest for researchers. The present research aims to further develop the concept of place branding, both theoretically and empirically. First of all, the paper presents a theoretical overview of place branding, from general basic questions (definition of place, brand and place brand) to specific current debates of the literature. Subsequently, the empirical part consists in a case study of the Grand Genève (Great Geneva).

In vitro assays and clinical trials in red blood cell aging: Lost in translation.

The age of erythrocyte concentrates (EC) in transfusion medicine and the adverse outcomes when transfusing long-term-stored EC are highly controversial issues. Whereas the definition of a short-term-stored EC or a long-term-stored EC is unclear in clinical trials, data based on in vitro storage assays can help defining a limit in addition of the expiration date. The present review merges together these data in order to highlight an EC age cut-off and points out potential misleading consideration. The analysis of in vitro data highlights the presence of reversible and irreversible storage lesions and demonstrates that red blood cells (RBC) exhibit two limits during storage: one around 2 weeks and another one around 4 weeks of storage. Of particular importance, the first lesions to appear, i.e. the reversible ones, are per se reversible once transfused, whereas the irreversible lesions are not. In clinical trials, the EC age cut-off for short-term storage is in general fewer than 14 days (11 ± 4 days) and more disperse for long-term-stored EC (17 ± 13 days), regardless the clinical outcomes. Taking together, EC age cut-off in clinical trials does not totally fall into line of in vitro aging data, whereas it is the key criteria in clinical studies. Long-term-stored EC considered in clinical trials are not probably old enough to answer the question: "Does transfusion of long-term-stored EC (older than 4 weeks) result in worse clinical outcomes?" Depending on ethical concerns and clinical practices, older EC than currently assayed in clinical trials should have to be considered. These two worlds trying to understand the aging of erythrocytes and the impact on patients do not seem to speak the same language.

Prevalence and risk factors for thromboembolic complications in IBD patients

Background: Inflammatory bowel disease (IBD) patients have an increased risk of venous thromboembolic complications (VTEC) such as deep vein thrombosis (DVT) and pulmonary embolism when compared to the non-IBD population. However, studies assessing VTEC prevalence in IBD as well as analyses of VTEC associated risk factors are scarce. We aimed to assess VTEC prevalence in IBD patients and to identify associated risk factors. Methods: Data from patients enrolled in the Swiss IBD Cohort Study (SIBDCS) were analyzed. Since 2006 the SIBDCS collects data on a large sample of IBD patients from hospitals and private practices across Switzerland. Results: A  total of 90/2284 (3.94%) IBD patients suffered from VTEC. Of these, 45/1324 (3.4% overall; 2.42% with DVT, 1.51% with PE) had CD, and 45/960 (4.7% overall; 3.23% with DVT, 2.40% with PE) presented with UC.

Ympäristöjärjestelmien kehittäminen rakennustuotealan yrityksen Keski-Euroopan toimipaikoissa

Tämän diplomityön tavoitteena oli antaa kehittämisehdotuksia, joilla voidaan parantaa rakennustuotealan yrityksen ympäristöjärjestelmien kustannustehokkuutta sekä ympäristöpolitiikkaan liittyvän jatkuvan parantamisen yhtenäistä toteutumista eri toimipaikoilla. Lähtökohtana olivat havainnot siitä, että melko pienissä toimipaikoissa laatu- ja ympäristöasiat kattavan toimintajärjestelmän rakentaminen ja ylläpitäminen vie paljon resursseja. Lisäksi selvitettiin uuden ISO 14001-standardiehdotuksen mahdollisia vaikutuksia käytössä oleviin ympäristöjärjestelmiin. Tutkimusmenetelminä käytettiin eri sertifiointielimille tehtyä haastattelua, toimipaikkojen ympäristövastaaville lähetettyä kyselyä, verkkosivuille kohdistettua kilpailijaseurantaa sekä selvitystä uuden ISO 14001- standardiehdotuksen muutoksista. Eri toimipaikkojen ympäristöjärjestelmien yhdistäminen saman sertifikaatin alle oli kaikkien sertifiointielinten edustajien mielestä hyvä tapa vähentää järjestelmien ulkoisesta valvonnasta aiheutuvia kustannuksia ja parantaa järjestelmien tehokkuutta. Ulkoisten kustannusten aleneminen on noin yksikolmasosa, joka syntyy ensinnäkin sertifikaattimaksujen alenemista ja toisaalta sertifiointipäivien vähenemisestä. Sertifikaattimaksut alenevat, koska yhdistetyssä järjestelmässä sertifikaatteja on vähemmän, ja sertifiointipäivien määrä vähenee, koska yhdistetyn järjestelmän ulkoisessa valvonnassa käytetään otanta -periaatetta. Kilpailijaseurannan osalta havaittiin, että yrityksen verkkosivuilla kerrottiin kilpailijoita paremmin ympäristö- sekä laatujärjestelmistä. Kehitettävää on eri maiden verkkosivujen yhtenäisyydessä ja ympäristö- ja laatupolitiikan esittämisessä. Nämä politiikat tulee olla esillä, koska järjestelmästandardit edellyttävät politiikkojen julkisuutta. Ympäristövastaaville tehdyn kyselyn perusteella havaittiin, että tällä hetkellä toimipaikoilla käytössä olevissa ympäristäjärjestelmissä on eroavuuksia. Syynä tähän on muun muassa järjestelmien eri-ikäisyys, maiden toimipaikkojen erilainen lainsäädäntö sekä erilaiset resurssit. Kehittämistä on erityisesti ympäristönnäkökohtien tunnistamisessa ja merkittävien ympäristönäkökohtien valinnassa, ympäristöjärjestelmän tavoitteissa ja päämäärissä sekä käytettävissä indikaattoreissa. Näiden osalta tulee lisätä koulutusta ja ohjeistusta. Uuden ISO 14001 -standardin muutoksia tarkasteltaessa havaittiin, ettei se aiheuta suuria muutostarpeita nykyisiin ympäristöjärjestelmiin. Standardin suurimmat muutokset ovat tulleet tekstin rakenteeseen, joka on nyt selkeälukuista ja yhteensopivampaa ISO 9001 laatuhallintastandardin kanssa. Standardi painottaa entistä standardia enemmän tuotteista aiheutuvia ympäristönäkökohtia, mutta on muistettava, että sen vaikutukset nykyisiin ympäristöjärjestelmiin tiedetään vasta, kun sitä aletaan tulkita. Tulosten perusteella päädyttiin siihen, että ympäristöjärjestelmien yhdistäminen saman sertifikaatin alle on tehokkain tapa parantaa kustannustehokkuutta sekä parantaa ympäristöpolitiikkaan liittyvää jatkuvaa parantamista. Ulkoisten kustannusten aleminen ei ole tärkein syy järjestelmien yhdistämiseen, koska yhdistämisen alkuvaiheessa se aiheuttaa sisäisten kustannusten lisääntymistä. Jatkossa yhdistämisestä voidaan odottaa myös sisäisten kustannusten säästöjä, koska yhdistäminen vähentää päällekkäistä työtä. Yrityksen ympäristöpolitiikan mukaiseen jatkuvaan parantamiseen järjestelmien yhdistäminen vaikuttaa positiivisesti usealla tavalla, ja tätä voidaan pitää kustannussäästöjä tärkeämpänä syynä sertifikaattien yhdistämiseen. Se yhtenäistää toimintatapoja ja lisää yhteistyötä, mikä vaikuttaa ympäristöpolitiikan yhtenäiseen toteutumiseen.

Informing patients about limits to confidentiality: A qualitative study in prisons.

AIM: Confidentiality is important in healthcare practice, however, under certain circumstances, confidentiality is breached. In this paper, mental health professionals' (MHPs) practices related to informing imprisoned patients about confidentiality and its limits are presented. METHODS: Twenty-four MHPs working in Swiss prisons were interviewed. Data analysis involved qualitative thematic coding and was validated by discussing results with external experts and study participants. RESULTS: For expert evaluations and court-ordered therapies, participants informed patients that information revealed during these consultations is not bound by confidentiality rules. The practice of routinely informing patients about confidentiality and its limits became more complex in voluntary therapies, for which participants described four approaches and provided justifications in favour of or against their use. CONCLUSIONS: Further training and continued education are needed to improve physicians' ethical and legal knowledge about confidentiality disclosures. In order to promote ethical practices, it is important to understand and address existing motivations, attitudes and behaviours that impede appropriate patient information. Our study adds important new knowledge about the limits to confidentiality, particularly for providers working with vulnerable populations. Results from this study reflect typical ethical and practical dilemmas faced by and of interest to physicians working in forensic medicine and other related settings.

Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.

PURPOSE: To develop a consensus opinion regarding capturing diagnosis-timing in coded hospital data. METHODS: As part of the World Health Organization International Classification of Diseases-11th Revision initiative, the Quality and Safety Topic Advisory Group is charged with enhancing the capture of quality and patient safety information in morbidity data sets. One such feature is a diagnosis-timing flag. The Group has undertaken a narrative literature review, scanned national experiences focusing on countries currently using timing flags, and held a series of meetings to derive formal recommendations regarding diagnosis-timing reporting. RESULTS: The completeness of diagnosis-timing reporting continues to improve with experience and use; studies indicate that it enhances risk-adjustment and may have a substantial impact on hospital performance estimates, especially for conditions/procedures that involve acutely ill patients. However, studies suggest that its reliability varies, is better for surgical than medical patients (kappa in hip fracture patients of 0.7-1.0 versus kappa in pneumonia of 0.2-0.6) and is dependent on coder training and setting. It may allow simpler and more precise specification of quality indicators. CONCLUSIONS: As the evidence indicates that a diagnosis-timing flag improves the ability of routinely collected, coded hospital data to support outcomes research and the development of quality and safety indicators, the Group recommends that a classification of 'arising after admission' (yes/no), with permitted designations of 'unknown or clinically undetermined', will facilitate coding while providing flexibility when there is uncertainty. Clear coding standards and guidelines with ongoing coder education will be necessary to ensure reliability of the diagnosis-timing flag.

Sisäinen tulosraportointi tietojohtamisen näkökulmasta. Case: Elcoteq Network Oyj

Tutkielman tarkoituksena oli tutkia, mitkä tekijät vaikuttavat sisäisen laskennan tulostiedon oikeellisuuteen ja miten tietojohtamisen keinoin voidaan taata yhteensopivuus ulkoisen ja sisäisen laskentatiedon välillä. Tekijöiden tunnistamisen ja huomioonottamisen kautta voidaan kehittää organisaation tietämystä ja suorituskykyä. Tutkimus oli empiirinen ja kuvaileva tapaustutkimus. Kvalitatiivista aineistoa kerättiin pääasiassa kyselylomakkeen, havainto -ja dokumenttiaineiston avulla. Aineisto analysoitiin teemoittelun avulla. Laskentaorganisaatioissa havaittiin mekaanisen ja orgaanisen tietopääomaympäristön piirteitä, jotka asettavat tiedon välitykselle,vuorovaikutukselle ja tietämyksen kehittymiselle omat rajoitteensa. Laskentaorganisaatioiden toimintaa ohjasivat mekaaniselle ympäristölle tyypilliset vastuu - ja raportointisuhteet, aikataulut ja raportointikäytännöt. Raportointijärjestelmään tarvittaisiin lisäkoulutusta, tiedon vertailtavuuteen ja tiedon oikeellisuuden takaamiseen lisää työvälineitä. Tiedon välittämistä ja kommunikointia pitäisi tehostaa aktiivisemmalla sähköisellä viestinnällä, mutta myös monipuolisemmalla viestintäkanavien käytöllä. Laskentaorganisaatioiden toimintaympäristössä havaittiin orgaanisen tietopääomaympäristön piirteitä, mikä edellyttäisi dialogia tukevien teknologioiden ja toimintatapojen tehokkaampaa käyttöä. Haasteena on maantieteellisen etäisyyden aiheuttamat rajoitteet sekä toiminnan mekaaninen luonne. Uutta konseptia käyttöönotettaessa keskustelut ja vuorovaikutus tukivat mallin kehittämistä ja käytännön sisäistämistä osaksi organisaation tietämystä. Viestintäkanavien käytön tehostamisella voitaisiin edesauttaa tiedon välittymistä. Tietämyksen ja suorituskyvyn kehittäminen laskentaorganisaatioissa edellyttää kuitenkin vuorovaikutteisuuden ja dialogin tukemista.

Fluoroscopic-Guided Radial Endobronchial Ultrasound Without Guide Sheath For Peripheral Pulmonary Lesions: A Safe And Efficient Combination.

BACKGROUND: Several guidelines recommend computed tomography scans for populations with high-risk for lung cancer. The number of individuals evaluated for peripheral pulmonary lesions (PPL) will probably increase, and with it non-surgical biopsies. Associating a guidance method with a target confirmation technique has been shown to achieve the highest diagnostic yield, but the utility of bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy as guidance without a guide sheath has not been reported. METHODS: We conducted a retrospective analysis of bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy procedures for the investigation of PPL performed by experienced bronchoscopists with no specific previous training in this particular technique. Operator learning curves and radiological predictors were assessed for all consecutive patients examined during the first year of application of the technique. RESULTS: Fifty-one PPL were investigated. Diagnostic yield and visualization yield were 72.5 and 82.3% respectively. The diagnostic yield was 64.0% for PPL ≤20mm, and 80.8% for PPL>20mm. No false-positive results were recorded. The learning curve of all diagnostic tools showed a DY of 72.7% for the first sub-group of patients, 81.8% for the second, 72.7% for the third, and 81.8% for the last. CONCLUSION: Bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy as guidance is safe and simple to perform, even without specific prior training, and diagnostic yield is high for PPL>and ≤20mm. Based on these findings, this method could be introduced as a first-line procedure for the investigation of PPL, particularly in centers with limited resources.

Is the Front Line Prepared for the Changing Faces of Patients? Predictors of Cross-Cultural Preparedness Among Clinical Nurses and Resident Physicians in Lausanne, Switzerland.

UNLABELLED: Phenomenon: Assuring quality medical care for all persons requires that healthcare providers understand how sociocultural factors affect a patient's health beliefs/behaviors. Switzerland's changing demographics highlight the importance of provider cross-cultural preparedness for all patients-especially those at risk for social/health precarity. We evaluated healthcare provider cross-cultural preparedness for commonly encountered vulnerable patient profiles. APPROACH: A survey on cross-cultural care was mailed to Lausanne University hospital's "front-line healthcare providers": clinical nurses and resident physicians at our institution. Preparedness items asked "How prepared do you feel to care for ... ?" (referring to example patient profiles) on an ascending 5-point Likert scale. We examined proportions of "4 - well/5 - very well prepared" and the mean composite score for preparedness. We used linear regression to examine the adjusted effect of demographics, work context, cultural-competence training, and cross-cultural care problem awareness, on preparedness. FINDINGS: Of 885 questionnaires, 368 (41.2%) were returned: 124 (33.6%) physicians and 244 (66.4%) nurses. Mean preparedness composite was 3.30 (SD = 0.70), with the lowest proportion of healthcare providers feeling prepared for patients "whose religious beliefs affect treatment" (22%). After adjustment, working in a sensitized department (β = 0.21, p = .01), training on the history/culture of a specific group (β = 0.25, p = .03), and awareness regarding (a) a lack of practical experience caring for diverse populations (β = 0.25, p = .004) and (b) inadequate cross-cultural training (β = 0.18, p = .04) were associated with higher preparedness. Speaking French as a dominant language and physician role (vs. nurse) were negatively associated with preparedness (β = -0.26, p = .01; β = -0.22, p = .01). Insights: The state of cross-cultural care preparedness among Lausanne's front-line healthcare providers leaves room for improvement. Our study points toward institutional strategies to improve preparedness: notably, making sure departments are sensitized to cross-cultural care resources and increasing provider diversity to reflect the changing Swiss demographic.

Does working memory training affect decision making ? : a neuroeconomic study

We all make decisions of varying levels of importance every day. Because making a decision implies that there are alternative choices to be considered, almost all decision involves some conflicts or dissatisfaction. Traditional economic models esteem that a person must weight the positive and negative outcomes of each option, and based on all these inferences, determines which option is the best for that particular situation. However, individuals rather act as irrational agents and tend to deviate from these rational choices. They somewhat evaluate the outcomes' subjective value, namely, when they face a risky choice leading to losses, people are inclined to have some preference for risk over certainty, while when facing a risky choice leading to gains, people often avoid to take risks and choose the most certain option. Yet, it is assumed that decision making is balanced between deliberative and emotional components. Distinct neural regions underpin these factors: the deliberative pathway that corresponds to executive functions, implies the activation of the prefrontal cortex, while the emotional pathway tends to activate the limbic system. These circuits appear to be altered in individuals with ADHD, and result, amongst others, in impaired decision making capacities. Their impulsive and inattentive behaviors are likely to be the cause of their irrational attitude towards risk taking. Still, a possible solution is to administrate these individuals a drug treatment, with the knowledge that it might have several side effects. However, an alternative treatment that relies on cognitive rehabilitation might be appropriate. This project was therefore aimed at investigate whether an intensive working memory training could have a spillover effect on decision making in adults with ADHD and in age-matched healthy controls. We designed a decision making task where the participants had to select an amount to gamble with the chance of 1/3 to win four times the chosen amount, while in the other cases they could loose their investment. Their performances were recorded using electroencephalography prior and after a one-month Dual N-Back training and the possible near and far transfer effects were investigated. Overall, we found that the performance during the gambling task was modulated by personality factors and by the importance of the symptoms at the pretest session. At posttest, we found that all individuals demonstrated an improvement on the Dual N-Back and on similar untrained dimensions. In addition, we discovered that not only the adults with ADHD showed a stable decrease of the symptomatology, as evaluated by the CAARS inventory, but this reduction was also detected in the control samples. In addition, Event-Related Potential (ERP) data are in favor of an change within prefrontal and parietal cortices. These results suggest that cognitive remediation can be effective in adults with ADHD, and in healthy controls. An important complement of this work would be the examination of the data in regard to the attentional networks, which could empower the fact that complex programs covering the remediation of several executive functions' dimensions is not required, a unique working memory training can be sufficient. -- Nous prenons tous chaque jour des décisions ayant des niveaux d'importance variables. Toutes les décisions ont une composante conflictuelle et d'insatisfaction, car prendre une décision implique qu'il y ait des choix alternatifs à considérer. Les modèles économiques traditionnels estiment qu'une personne doit peser les conséquences positives et négatives de chaque option et en se basant sur ces inférences, détermine quelle option est la meilleure dans une situation particulière. Cependant, les individus peuvent dévier de ces choix rationnels. Ils évaluent plutôt les valeur subjective des résultats, c'est-à-dire que lorsqu'ils sont face à un choix risqué pouvant les mener à des pertes, les gens ont tendance à avoir des préférences pour le risque à la place de la certitude, tandis que lorsqu'ils sont face à un choix risqué pouvant les conduire à un gain, ils évitent de prendre des risques et choisissent l'option la plus su^re. De nos jours, il est considéré que la prise de décision est balancée entre des composantes délibératives et émotionnelles. Ces facteurs sont sous-tendus par des régions neurales distinctes: le chemin délibératif, correspondant aux fonctions exécutives, implique l'activation du cortex préfrontal, tandis que le chemin émotionnel active le système limbique. Ces circuits semblent être dysfonctionnels chez les individus ayant un TDAH, et résulte, entre autres, en des capacités de prise de décision altérées. Leurs comportements impulsifs et inattentifs sont probablement la cause de ces attitudes irrationnelles face au risque. Cependant, une solution possible est de leur administrer un traitement médicamenteux, en prenant en compte les potentiels effets secondaires. Un traitement alternatif se reposant sur une réhabilitation cognitive pourrait être appropriée. Le but de ce projet est donc de déterminer si un entrainement intensif de la mémoire de travail peut avoir un effet sur la prise de décision chez des adultes ayant un TDAH et chez des contrôles sains du même âge. Nous avons conçu une tâche de prise de décision dans laquelle les participants devaient sélectionner un montant à jouer en ayant une chance sur trois de gagner quatre fois le montant choisi, alors que dans l'autre cas, ils pouvaient perdre leur investissement. Leurs performances ont été enregistrées en utilisant l'électroencéphalographie avant et après un entrainement d'un mois au Dual N-Back, et nous avons étudié les possibles effets de transfert. Dans l'ensemble, nous avons trouvé au pré-test que les performances au cours du jeu d'argent étaient modulées par les facteurs de personnalité, et par le degré des sympt^omes. Au post-test, nous avons non seulement trouvé que les adultes ayant un TDAH montraient une diminutions stable des symptômes, qui étaient évalués par le questionnaire du CAARS, mais que cette réduction était également perçue dans l'échantillon des contrôles. Les rsultats expérimentaux mesurés à l'aide de l'éléctroencéphalographie suggèrent un changement dans les cortex préfrontaux et pariétaux. Ces résultats suggèrent que la remédiation cognitive est efficace chez les adultes ayant un TDAH, mais produit aussi un effet chez les contrôles sains. Un complément important de ce travail pourrait examiner les données sur l'attention, qui pourraient renforcer l'idée qu'il n'est pas nécessaire d'utiliser des programmes complexes englobant la remédiation de plusieurs dimensions des fonctions exécutives, un simple entraiment de la mémoire de travail devrait suffire.

Effects of Three Types of Exercise Interventions on Healthy Old Adults' Gait Speed : A Systematic Review and Meta-Analysis.

BACKGROUND: Habitual walking speed predicts many clinical conditions later in life, but it declines with age. However, which particular exercise intervention can minimize the age-related gait speed loss is unclear. PURPOSE: Our objective was to determine the effects of strength, power, coordination, and multimodal exercise training on healthy old adults' habitual and fast gait speed. METHODS: We performed a computerized systematic literature search in PubMed and Web of Knowledge from January 1984 up to December 2014. Search terms included 'Resistance training', 'power training', 'coordination training', 'multimodal training', and 'gait speed (outcome term). Inclusion criteria were articles available in full text, publication period over past 30 years, human species, journal articles, clinical trials, randomized controlled trials, English as publication language, and subject age ≥65 years. The methodological quality of all eligible intervention studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. We computed weighted average standardized mean differences of the intervention-induced adaptations in gait speed using a random-effects model and tested for overall and individual intervention effects relative to no-exercise controls. RESULTS: A total of 42 studies (mean PEDro score of 5.0 ± 1.2) were included in the analyses (2495 healthy old adults; age 74.2 years [64.4-82.7]; body mass 69.9 ± 4.9 kg, height 1.64 ± 0.05 m, body mass index 26.4 ± 1.9 kg/m(2), and gait speed 1.22 ± 0.18 m/s). The search identified only one power training study, therefore the subsequent analyses focused only on the effects of resistance, coordination, and multimodal training on gait speed. The three types of intervention improved gait speed in the three experimental groups combined (n = 1297) by 0.10 m/s (±0.12) or 8.4 % (±9.7), with a large effect size (ES) of 0.84. Resistance (24 studies; n = 613; 0.11 m/s; 9.3 %; ES: 0.84), coordination (eight studies, n = 198; 0.09 m/s; 7.6 %; ES: 0.76), and multimodal training (19 studies; n = 486; 0.09 m/s; 8.4 %, ES: 0.86) increased gait speed statistically and similarly. CONCLUSIONS: Commonly used exercise interventions can functionally and clinically increase habitual and fast gait speed and help slow the loss of gait speed or delay its onset.

Evaluation of Teacher Education Programs by Students and Graduates

The purpose of this research was to do a repeated cross-sectional research on class teachers who study in the 4th year and also graduated at the Faculty of Education, University of Turku between the years of 2000 through 2004. Specifically, seven research questions were addressed to target the main purpose of the study: How do class teacher education masters’ degree senior students and graduates rate “importance; effectiveness; and quality” of training they have received at the Faculty of Education? Are there significant differences between overall ratings of importance; effectiveness and quality of training by year of graduation, sex, and age (for graduates) and sex and age (for senior students)? Is there significant relationship between respondents’ overall ratings of importance; effectiveness and their overall ratings of the quality of training and preparation they have received? Are there significant differences between graduates and senior students about importance, effectiveness, and quality of teacher education programs? And what do teachers’ [Graduates] believe about how increasing work experience has changed their opinions of their preservice training? Moreover the following concepts related to the instructional activities were studied: critical thinking skills, communication skills, attention to ethics, curriculum and instruction (planning), role of teacher and teaching knowledge, assessment skills, attention to continuous professional development, subject matters knowledge, knowledge of learning environment, and using educational technology. Researcher also tried to find influence of some moderator variables e.g. year of graduation, sex, and age on the dependent and independent variables. This study consisted of two questionnaires (a structured likert-scale and an open ended questionnaire). The population in study 1 was all senior students and 2000-2004 class teacher education masters’ degree from the departments of Teacher Education Faculty of Education at University of Turku. Of the 1020 students and graduates the researcher was able to find current addresses of 675 of the subjects and of the 675 graduates contacted, 439 or 66.2 percent responded to the survey. The population in study 2 was all class teachers who graduated from Turku University and now work in the few basic schools (59 Schools) in South- West Finland. 257 teachers answered to the open ended web-based questions. SPSS was used to produce standard deviations; Analysis of Variance; Pearson Product Moment Correlation (r); T-test; ANOVA, Bonferroni post-hoc test; and Polynomial Contrast tests meant to analyze linear trend. An alpha level of .05 was used to determine statistical significance. The results of the study showed that: A majority of the respondents (graduates and students) rated the overall importance, effectiveness and quality of the teacher education programs as important, effective and good. Generally speaking there were only a few significant differences between the cohorts and groups related to the background variables (gender, age). The different cohorts were rating the quality of the programs very similarly but some differences between the cohorts were found in the importance and effectiveness ratings. Graduates of 2001 and 2002 rated the importance of the program significantly higher than 2000 graduates. The effectiveness of the programs was rated significantly higher by 2001 and 2003 graduates than other groups. In spite of these individual differences between cohorts there were no linear trends among the year cohorts in any measure. In respondents’ ratings of the effectiveness of teacher education programs there was significant difference between males and females; females rated it higher than males. There were no significant differences between males’ and females’ ratings of the importance and quality of programs. In the ratings there was only one difference between age groups. Older graduates (35 years or older) rated the importance of the teacher training significantly higher that 25-35 years old graduates. In graduates’ ratings there were positive but relatively low correlations between all variables related to importance, effectiveness and quality of Teacher Education Programs. Generally speaking students’ ratings about importance, effectiveness and quality of teacher education program were very positive. There was only one significant difference related to the background variables. Females rated higher the effectiveness of the program. The comparison of students’ and graduates’ perception about importance, effectiveness, and quality of teacher education programs showed that there were no significant differences between graduates and students in the overall ratings. However there were differences in some individual variables. Students rated higher in importance of “Continuous Professional Development”, effectiveness of “Critical Thinking Skills” and “Using Educational Technology” and quality of “Advice received from the advisor”. Graduates rated higher in importance of “Knowledge of Learning Environment” and effectiveness of “Continuous Professional Development”. According to the qualitative data of study 2 some graduates expressed that their perceptions have not changed about the importance, effectiveness, and quality of training that they received during their study time. They pointed out that teacher education programs have provided them the basic theoretical/formal knowledge and some training of practical routines. However, a majority of the teachers seems to have somewhat critical opinions about the teacher education. These teachers were not satisfied with teacher education programs because they argued that the programs failed to meet their practical demands in different everyday situations of the classroom e.g. in coping with students’ learning difficulties, multiprofessional communication with parents and other professional groups (psychologists and social workers), and classroom management problems. Participants also emphasized more practice oriented knowledge of subject matter, evaluation methods and teachers’ rights and responsibilities. Therefore, they (54.1% of participants) suggested that teacher education departments should provide more practice-based courses and programs as well as closer collaboration between regular schools and teacher education departments in order to fill gap between theory and practice.

Body donations today and tomorrow: What is best practice and why?

There is considerable agreement that the use of human bodies for teaching and research remains important, yet not all universities use dissection to teach human gross anatomy. The concept of body donation has evolved over centuries and there are still considerable discrepancies among countries regarding the means by which human bodies are acquired and used for education and research. Many countries have well-established donation programs and use body dissection to teach most if not all human gross anatomy. In contrast, there are countries without donation programs that use unclaimed bodies or perhaps a few donated bodies instead. In several countries, use of cadavers for dissection is unthinkable for cultural or religious reasons. Against this background, successful donation programs are highlighted in the present review, emphasizing those aspects of the programs that make them successful. Looking to the future, we consider what best practice could look like and how the use of unclaimed bodies for anatomy teaching could be replaced. From an ethical point of view, countries that depend upon unclaimed bodies of dubious provenance are encouraged to use these reports and adopt strategies for developing successful donation programs. In many countries, the act of body donation has been guided by laws and ethical frameworks and has evolved alongside the needs for medical knowledge and for improved teaching of human anatomy. There will also be a future need for human bodies to ensure optimal pre- and post-graduate training and for use in biomedical research. Good body donation practice should be adopted wherever possible, moving away from the use of unclaimed bodies of dubious provenance and adopting strategies to favor the establishment of successful donation programs. Clin. Anat. 29:11-18, 2016. © 2015 Wiley Periodicals, Inc.