Medical Evaluation Processes in Clinical settings. Qualitative Analysis through the Experience of Teachers and Studens

Evaluation processes in clinical practice have not been well, being their study focused on the technical issues concerning these processes. This study tried an approach to the evaluation processes through the analysis of perceptions from teachers and students about the methodology of evaluation considering the teachinglearning processes performed in a clinical practice of the Medicine Program –Universidad El Bosque from Bogota. With this purpose we conducted interviews with teachers and students searching the manner in which the evaluative, learning and teaching processes are done; then we analyzed the perception from both agents concerning the way these processes are related. The interviews were categorized bath deductively and inductively, and then contrasted with some current theories of learning, teaching and evaluation in medicine. The study showed that nowadays the evaluation and, in general, the educative processes are affected by several factors which are associated to the manner the professional practice is developed, and the educative process of the current teachers. We concluded there is no congrency between the approach of the evaluation, mainly conductivist, and the learning and teaching strategies mainly constructivist. This fact cause dissent in teachers and students.

Experience of the Flexible Internship in University of Rosario-Medical School

Objective: To evaluate the flexible program implemented for the medical internship at School of Medicine, Universidad del Rosario during the period 1997-2002. Methodology: A descriptive study was performed to summarize the choices of medical clerkships made by the interns during the whole studied period. The coincidence with the further choice of a determined medical specialty was assessed. Conclusions: Most of the last year’s students remain preferring a conservative approach to their career, by choosing clerkships in a basic area, such as internal medicine, pediatrics, gynecology and obstetrics or general surgery. The coincidence between the type of internship or clerkships a student performs and the future election of a specialty is high.

Performance indicators for the physical therapy program’s field academic programs at the Universidad del Rosario for 2004-2007.

Introducción: El programa de Fisioterapia de la Universidad del Rosario, en su responsabilidad social de generar un impacto positivo en la comunidad y en su propósito de formar profesionales, cuenta con los Programas Académicos de Campo (PAC) que se consideran una fuerte estrategia de extensión de la Universidad. Los PAC contribuyen a la adquisición de competencias para el desarrollo de procesos de acción-actuación-creación en los estudiantes para que resuelvan problemas en un espacio real de ejercicio profesional. Bajo esta perspectiva los PAC del programa de Fisioterapia muestran su comportamiento a través de la medición de indicadores de proceso y resultados propuestos desde el Programa con el fin de proveer información útil para la reorientación y permanente actualización de los contenidos programáticos en las asignaturas y en los mismos PAC. Materiales y métodos: En el siguiente artículo se presenta un análisis de los indicadores de demanda por género, régimen de Seguridad Social en Salud, procedimiento y morbilidad de los Programas Académicos de Campo Integral Pediátrico, Integral de Adultos y Rehabilitación cardíaca y/o pulmonar, con el fin de establecer las características de la población objeto de la prestación de los servicios y procurar información verificable que dé soporte para la construcción de procesos de cambio dentro de la dinámica de mejoramiento continuo que debe tener cualquier institución. Este seguimiento es útil para la toma de decisiones de planeación académica que contribuye a mejorar los procesos de planeación y a facilitar el cumplimiento de los propósitos de formación para cada práctica, y de esta manera ayuda a ser elemento de análisis para directivas, instructores y estudiantes en la orientación del proceso de gestión académico-administrativo, y a retroalimentar los procesos de planeación y programación académica. Resultados: Los resultados arrojados en el análisis de los datos de la morbilidad en los programas académicos de campo muestran el siguiente comportamiento durante los años 2004, 2005, 2006 y 2007. Conclusiones: En el PAC pediátrico la mayor incidencia es de asma con un 37,2% y la más baja incidencia es para luxación congénita de cadera y enfermedad mental de origen central con un 0,1%. El 58% de los usuarios es de género masculino, y el 81% del total pertenece al régimen contributivo. En la morbilidad del PAC de adultos la mayor incidencia es de EPOC, con un 23,2%, y la menor incidencia es de lumbalgia, con un 2,4%. La mayoría de usuarios atendidos (58%) son hombres, y el 58% de los usuarios pertenece al régimen contributivo. En el PAC de rehabilitación cardíaca y/o pulmonar la mayor incidencia fue de EPOC, con un 40%; seguido de neumonía, con 17%; y con una menor incidencia para asma, con un 2%. El 54% de los usuarios son hombres y el 91% del total pertenece al régimen subsidiado.

Disputa territorial por las Islas Dokdo en las relaciones políticas entre Corea del Sur y Japón (2005-2012)

Las relaciones políticas y económicas entre Corea del Sur y Japón pasaban por su mejor momento en los primeros años del siglo XXI, cuando la disputa territorial por las islas Dokdo, un grupo de islotes ubicados en el mar de Japón y que por décadas han simbolizado el fin de la ocupación del país nipón en territorio coreano, causara nuevas y significativas tensionen entre los dos países. Dicho fenómeno, se sugiere fundamental en la comprensión de las nuevas relaciones bilaterales entre los dos actores y se presenta como foco de análisis en la presente monografía. El documento, presenta un análisis descriptivo de la disputa territorial por las Islas y de sus efectos en las relaciones entre los dos países, tanto en los ámbitos político, social y económico.

Las tecnologías de la información y la comunicación en los procesos de orientación para el estudio a distancia. 'Ict in the orientation processes for distance learning'.

Resumen tomado de la publicación. Con el apoyo económico del departamento MIDE de la UNED. Incluye anexos

Reintroduction of the Eurasian otter (Lutra lutra) in Muga and Fluvià basins (north-eastern Spain): viability, development, monitoring and trends of the new population

Aquesta tesi es basa en el programa de reintroducció de la llúdriga eurasiàtica (Lutra lutra) a les conques dels rius Muga i Fluvià (Catalunya) durant la segona meitat dels 1990s. Els objectius de la tesi foren demostrar la viabilitat de la reintroducció, demostrar l'èxit de la mateixa, estudiar aspectes ecològics i etològics de l'espècie, aprofitant l'oportunitat única de gaudir d'una població "de disseny" i determinar les probabilitats de supervivència de la població a llarg termini. La reintroducció de la llúdriga a les conques dels rius Muga i Fluvià va reeixir, doncs l'àrea geogràfica ocupada efectivament es va incrementar fins a un 64% d'estacions positives a l'hivern 2001-02. La troballa de tres exemplars adults nascuts a l'àrea de reintroducció és una altra prova que valida l'èxit del programa. La densitat d'exemplars calculada a través dels censos visuals ha resultat baixa (0.04-0.11 llúdrigues/km), però s'aproxima al que hom pot esperar en els primers estadis d'una població reintroduïda, encara poc nombrosa però distribuïda en una gran àrea. La mortalitat post-alliberament va ser del 22% un any després de l'alliberament, similar o inferior a la d'altres programes de reintroducció de llúdrigues reeixits. La mortalitat va ser deguda principalment a atropellaments (56%). El patró d'activitat de les llúdrigues reintroduïdes va esdevenir principalment nocturn i crepuscular, amb una escassa activitat diürna. Les seves àrees vitals van ser del mateix ordre (34,2 km) que les calculades en d'altres estudis realitzats a Europa. La longitud mitjana de riu recorreguda per una llúdriga durant 24 hores va ser de 4,2 km per les femelles i 7,6 km pels mascles. Durant el període de radioseguiment dues femelles van criar i els seus moviments van poder ser estudiats amb deteniment. La resposta de la nova població de llúdrigues a les fluctuacions estacionals en la disponibilitat d'aigua, habitual a les regions mediterrànies, va consistir en la concentració en una àrea menor durant el període de sequera estival, a causa de l'increment de trams secs, inhabitables per la llúdriga per la manca d'aliment, fet que va provocar expansions i contraccions periòdiques en l'àrea de distribució. La persistència a llarg termini de la població reintroduïda va ser estudiada mitjançant una Anàlisi de Viabilitat Poblacional (PVA). El resultat va ser un baix risc d'extinció de la població en els propers 100 anys i la majoria dels escenaris simulats (65%) van assolir el criteri d'un mínim de 90% de probabilitat de supervivència. Del model poblacional construït es dedueix que un punt clau per assegurar la viabilitat de la població reintroduïda és la reducció de la mortalitat accidental. A l'àrea d'estudi, els atropellaments causen més del 50% de la mortalitat i aquesta pot ser reduïda mitjançant la construcció de passos de fauna, el tancament lateral d'alguns trams de carretera perillosos i el control de la velocitat en algunes vies. El projecte de reintroducció ha posat a punt un protocol per a la captura, maneig i alliberament de llúdrigues salvatges, que pot contenir informació útil per a programes similars. També ha suposat una oportunitat única d'estudiar una població dissenyada artificialment i poder comparar diversos mètodes per estimar la distribució i la densitat de poblacions de llúdrigues. Per últim, la reintroducció portada a terme a les conques dels rius Muga i Fluvià ha aconseguit crear una nova població de llúdrigues, que persisteix en el temps, que es reprodueix regularment i que es dispersa progressivament, fins i tot a noves conques fluvials.

The subversion of the good life (enlightened rebelliousness for the 21st century: a critical perspective on the work of Bolívar Echeverría)

El debate sobre el modelo civilizatorio de la modernidad de Occidente, consu economía concentradora y excluyente, y su matriz económico energética petrolera y extractivista no sustentable, ha reavivado en los escenarios políticos y académicos de la salud la discusión de la propuesta del buen vivir inscrita en las nuevas constituciones de Bolivia y Ecuador. Ante la crisis social, sanitaria y ambiental producida por la imposición de una economía de la muerte, y la consiguiente multiplicación de modos de vivir malsanos, se discuten aquí las tesis de Bolívar Echeverría sobre la base material de la vida y la cultura, como una herramienta para evaluar históricamente los desempeños de los gobiernos de las izquierdas realmente existentes, y trabajar un modelo de transición histórica y el indispensable remozamiento de la conciencia crítica desde una visión radicalmente renovadora, pero que mire la realidad sin dogmatismo, sin estridencias míticas y con un sentido de profunda autocrítica.

Simulation of monsoon disturbances in the LMD GCM

The monsoon depressions that form over India during the summer are analyzed using simulations from the Laboratoire de Meteorologie Dynamique general circulation model. This type of synoptic system often occurs with a frequency of one to two per month and can produce a strong Indian rainfall. Two kinds of analyses are conducted in this study. The first one is a subjective analysis based on the evolution of the precipitation rate and the pattern of the sea level pressure. The second one is an objective analysis performed using the TRACK program, which identifies and tracks the minima in the sea level pressure anomaly held and computes the statistics for the distribution of systems. The analysis of a 9-yr control run, which simulates strong precipitation rates over the foothills of the Himalayas and over southern India but weak rates over central India, shows that the number of disturbances is coo low and that they almost never occur during August, when break conditions prevail. The generated disturbances more often move north, toward the foothills of the Himalayas. Another analysis is performed to study the effect of the Tibetan Plateau elevation on these disturbances with a 9-yr run carried out with a Tibetan Plateau at 50% of its current height. It is shown that this later integration simulates more frequent monsoon disturbances, which move rather northwestward, in agreement with the current observations. The comparison between the two runs shows that the June-July-August rainfall difference is in large part due to changes in the occurrence of the monsoon disturbances.

Monitoring present day changes in water vapour and the radiative energy balance using satellite data, reanalyses and models

A combination of satellite data, reanalysis products and climate models are combined to monitor changes in water vapour, clear-sky radiative cooling of the atmosphere and precipitation over the period 1979-2006. Climate models are able to simulate observed increases in column integrated water vapour (CWV) with surface temperature (Ts) over the ocean. Changes in the observing system lead to spurious variability in water vapour and clear-sky longwave radiation in reanalysis products. Nevertheless all products considered exhibit a robust increase in clear-sky longwave radiative cooling from the atmosphere to the surface; clear-sky longwave radiative cooling of the atmosphere is found to increase with Ts at the rate of ~4 Wm-2 K-1 over tropical ocean regions of mean descending vertical motion. Precipitation (P) is tightly coupled to atmospheric radiative cooling rates and this implies an increase in P with warming at a slower rate than the observed increases in CWV. Since convective precipitation depends on moisture convergence, the above implies enhanced precipitation over convective regions and reduced precipitation over convectively suppressed regimes. To quantify this response, observed and simulated changes in precipitation rate are analysed separately over regions of mean ascending and descending vertical motion over the tropics. The observed response is found to be substantially larger than the model simulations and climate change projections. It is currently not clear whether this is due to deficiencies in model parametrizations or errors in satellite retrievals.

Significance of cross correlations in the stress relaxation of polymer melts

According to linear response theory, all relaxation functions in the linear regime can be obtained using time correlation functions calculated under equilibrium. In this paper, we demonstrate that the cross correlations make a significant contribution to the partial stress relaxation functions in polymer melts. We present two illustrations in the context of polymer rheology using (1) Brownian dynamics simulations of a single chain model for entangled polymers, the slip-spring model, and (2) molecular dynamics simulations of a multichain model. Using the single chain model, we analyze the contribution of the confining potential to the stress relaxation and the plateau modulus. Although the idea is illustrated with a particular model, it applies to any single chain model that uses a potential to confine the motion of the chains. This leads us to question some of the assumptions behind the tube theory, especially the meaning of the entanglement molecular weight obtained from the plateau modulus. To shed some light on this issue, we study the contribution of the nonbonded excluded-volume interactions to the stress relaxation using the multichain model. The proportionality of the bonded/nonbonded contributions to the total stress relaxation (after a density dependent "colloidal" relaxation time) provides some insight into the success of the tube theory in spite of using questionable assumptions. The proportionality indicates that the shape of the relaxation spectrum can indeed be reproduced using the tube theory and the problem is reduced to that of finding the correct prefactor. (c) 2007 American Institute of Physics

GDASH: a grid-enabled program for structure solution from powder diffraction data

The simulated annealing approach to structure solution from powder diffraction data, as implemented in the DASH program, is easily amenable to parallelization at the individual run level. Very large scale increases in speed of execution can therefore be achieved by distributing individual DASH runs over a network of computers. The GDASH program achieves this by packaging DASH in a form that enables it to run under the Univa UD Grid MP system, which harnesses networks of existing computing resources to perform calculations.

MDASH: a multi-core-enabled program for structure solution from powder diffraction data

The simulated annealing approach to structure solution from powder diffraction data, as implemented in the DASH program, is easily amenable to parallelization at the individual run level. Modest increases in speed of execution can therefore be achieved by executing individual DASH runs on the individual cores of CPUs.

Comparison of balloon-carried atmospheric motion sensors with Doppler lidar turbulence measurements

Magnetic sensors have been added to a standard weather balloon radiosonde package to detect motion in turbulent air. These measure the terrestrial magnetic field and return data over the standard uhf radio telemetry. Variability in the magnetic sensor data is caused by motion of the instrument package. A series of radiosonde ascents carrying these sensors has been made near a Doppler lidar measuring atmospheric properties. Lidar-retrieved quantities include vertical velocity (w) profile and its standard deviation (w). w determined over 1 h is compared with the radiosonde motion variability at the same heights. Vertical motion in the radiosonde is found to be robustly increased when w>0.75 m s−1 and is linearly proportional to w. ©2009 American Institute of Physics

In situ atmospheric turbulence measurement using the terrestrial magnetic field - A compass for a radiosonde

A method for in situ detection of atmospheric turbulence has been developed using an inexpensive sensor carried within a conventional meteorological radiosonde. The sensor-a Hall effect magnetometer-was used to monitor the terrestrial magnetic field. Rapid time scale (10 s or less) fluctuations in the magnetic field measurement were related to the motion of the radiosonde, which was strongly influenced by atmospheric turbulence. Comparison with cloud radar measurements showed turbulence in regions where rapid time-scale magnetic fluctuations occurred. Reliable measurements were obtained between the surface and the stratosphere.

Probing the large-scale topology of the heliospheric magnetic field using Jovian electrons

Jupiter’s magnetosphere acts as a point source of near-relativistic electrons within the heliosphere. In this study, three solar cycles of Jovian electron data in near-Earth space are examined. Jovian electron intensity is found to peak for an ideal Parker spiral connection, but with considerable spread about this point. Assuming the peak in Jovian electron counts indicates the best magnetic connection to Jupiter, we find a clear trend for fast and slow solar wind to be over- and under-wound with respect to the ideal Parker spiral, respectively. This is shown to be well explained in terms of solar wind stream interactions. Thus, modulation of Jovian electrons by corotating interaction regions (CIRs) may primarily be the result of changing magnetic connection, rather than CIRs acting as barriers to cross-field diffusion. By using Jovian electrons to remote sensing magnetic connectivity with Jupiter’s magnetosphere, we suggest that they provide a means to validate solar wind models between 1 and 5 AU, even when suitable in situ solar wind observations are not available. Furthermore, using Jovian electron observations as probes of heliospheric magnetic topology could provide insight into heliospheric magnetic field braiding and turbulence, as well as any systematic under-winding of the heliospheric magnetic field relative to the Parker spiral from footpoint motion of the magnetic field.