Evaluation of learning outcomes of humanities curricula in medical students. A meta-review of narrative and systematic reviews

Objectives: To assess the expected learning outcomes of medical humanities subjects in medical studies curricula. To connect those expected learning outcomes with the types of knowledge to be acquired in medical education. Methods: Meta-review of systematic and narrative reviews. Cochrane Library, MEDLINE (Pubmed), Embase, CINAHL, and ERIC were searched. In addition, references from all the included studies were revised, and the ISI Web of Science and DARE were searched. Results: A total of 364 articles were identified, of which six were finally included in the review. Learning outcomes describe the acquisition of knowledge and skills to improve the relationship with patients, as well as the incorporation of tools to reduce burnout and promote professionalism. Programs that focus on teaching humanities promote diagnostic observation skills, the ability to cope with uncertainty in clinical practice, and the development of empathetic behaviors. Conclusion: The results of this review show heterogeneity in the teaching of medical humanities, both in terms of content and at the formal level. Humanities learning outcomes are part of the necessary knowledge for good clinical practice. Consequently, the epistemological approach provides a valid argument for including the humanities in medical curricula

Relationship of indicators of ability and experience of military sports skydiving with the psychological state and performance in competition of elite jumpers

© 2018: Servicio de Publicaciones de la Universidad de Murcia. This document is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Cuadernos de Psicología del Deporte.Se deben considerar múltiples variables cuando se habla de rendimiento deportivo. Entre ellas, la literatura establece la importancia de la psicología y las técnicas indicadoras de la experiencia adquirida en la disciplina. Este estudio pretende establecer la relación entre determinados constructos que definen el perfil psicológico del deportista con indicadores de habilidad en paracaidismo militar. Para ello, se encuestó a 42 saltadores de 40,86 años (±7,35) pertenecientes al ejército español y a la guardia civil durante la celebración del Campeonato Nacional Militar de paracaidismo que se celebra anualmente, para conocer su nivel de optimismo, resiliencia, bienestar psicológico y burnout. Se concluye que los años de experiencia en paracaidismo y el número de saltos, como indicadores de habilidad, deben ser tomados en cuenta con un mayor nivel de concreción y especificidad, ya que ciertas variables psicológicas pueden aumentar o disminuir dependiendo de ellas. Conviene estudiar cada caso en particular para comprender qué puede ocurrir en el estado del paracaidista y desarrollar estrategias para optimizar el rendimiento deportivo.Multiple variables must be considered when talking about sports performance. Among them, the literature estblishes the importance of psychology and indicator techniques of experience acquired in the discipline. This study aims to establish the relationship between certain constructs that define the psychological profile of the athlete with skill indicators in military parachuting. For this, 42 jumpers aged 40.86 years old (±7.35) belonging to the Spanish army and the civil guard during the celebration of the National Military Championship of Skydiving which is held annually surveyed to know their level of optimism, resilience, psychological well-being, and burnout. It is concluded that the years of skydiving experience and the number of jumps, as indicators of skill, must be taken into account with a higher level of concreteness and specificity since certain psychological variables can increase or decrease depending on them. It is convenient to study each case, in particular, to understand what can happen in the state of the parachutist and develop strategies for optimizing sports performance.Múltiplas variáveis devem ser consideradas quando se fala em desempenho desportivo. Eentre eles, a literatura estabelece a importância da psicologia e das técnicas indicadoras da experiência adquirida na disciplina. Este estudo visa estabelecer a relação entre determinados constructos que definem o perfil psicológico do atleta com indicadores de habilidade no paraquedismo militar. Para tal, foram inquiridos 42 saltadores com 40,86 anos (±7,35) pertencentes ao exército espanhol e à guarda civil durante a celebração do Campeonato Nacional Militar de paraquedismo que se realiza anualmente para conhecer o seu nível de optimismo, resiliência, bem-estar psicológico e esgotamento. Conclui-se que os anos de experiência em paraquedismo e o número de saltos, como indicadores de habilidade, devem ser levados em consideração com maior grau de especificidade, pois certas variáveis psicológicas podem aumentar ou diminuir. É conveniente estudar cada caso em articular para entender o que pode acontecer no estado do paraquedista e desenvolver estratégias para otimizar o desempenho esportivo

An AFM Approach of RBC Micro and Nanoscale Topographic Features During Storage

Blood gamma irradiation is the only available method to prevent transfusion-associated graft versus host disease (TA-GVHD). However, when blood is irradiated, determine blood shelf time is crucial. Non-irradiated blood has a self-time from 21 to 35 days when is preserved with an anticoagulated solution and stored at 4°C. During their storage, red blood cells (RBC) undergo a series of biochemical, biomechanical and molecular changes involving what is known as storage lesion (SL). SL include loss of structural integrity of RBC, a decrease of 2,3-diphosphatidylglyceric acid levels, and an increase of both ion potassium concentration and hemoglobin (Hb). On the other hand, Atomic force Microscopy (AFM) represents a versatile tool for a nano-scale high-resolution topographic analysis in biological systems. In order to evaluate SL in irradiated and non-irradiated blood, RBC topography and morphometric parameters were obtained from an AFM XE-BIO system. Cell viability was followed using flow cytometry. Our results showed that early markers as nanoscale roughness, allow us to evaluate blood quality since another perspective

Energy levels distribution in supersaturated silicon with titanium for photovoltaic applications

In the attempt to form an intermediate band in the bandgap of silicon substrates to give it the capability to absorb infrared radiation, we studied the deep levels in supersaturated silicon with titanium. The technique used to characterize the energy levels was the thermal admittance spectroscopy. Our experimental results showed that in samples with titanium concentration just under Mott limit there was a relationship among the activation energy value and the capture cross section value. This relationship obeys to the well known Meyer-Neldel rule, which typically appears in processes involving multiple excitations, like carrier capture/emission in deep levels, and it is generally observed in disordered systems. The obtained characteristic Meyer-Neldel parameters were Tmn = 176 K and kTmn = 15 meV. The energy value could be associated to the typical energy of the phonons in the substrate. The almost perfect adjust of all experimental data to the same straight line provides further evidence of the validity of the Meyer Neldel rule, and may contribute to obtain a deeper insight on the ultimate meaning of this phenomenon. (C) 2015 AIP Publishing LLC

Marketing strategy of the hospitality industry

Budući da se gospodarstvo sve više razvija u smjeru uslužnih djelatnosti, nameće se potreba da marketing manageri, marketing stručnjaci i poduzetnici, što bolje upoznaju uslužne djelatnosti i njihovu važnost za gospodarstvo svake zemlje, pa i Hrvatske. Usluge su neopipljive, nedjeljive, nepostojane i prolazne, pa svaki oblik usluga zahtijeva marketing strategiju. Naime, gospodarska uslužna djelatnost omogućava proizvodnji da premosti prostor ili segmente tržišta između proizvodnje i potrošnje, kako bi se u određenom vremenu i prostoru učinkovito zadovoljile potrebe potrošača i ostvarili ciljevi poduzeća, uz planiranu dobit ili profit. U prošlosti, uslužne djelatnosti su znatno zaostajale za proizvodnim poduzećima u usvajanju i primjeni marketing koncepcije, no sada se to znatno mijenja. Sukladno s iznesenim, marketing strategija u uslužnim djelatnostima zahtijeva ne samo vanjski marketing, već i marketing unutar poduzeća, kako bi se motivirali djelatnici u pružanju usluga i podizanju razine kvalitete.Considering the current growth of the hospitality industry, the marketing managers, experts and entrepreneurs should become aware of the growing importance of various hospitality services for the overall industry of each country including the Republic of Croatia. The services rendered in the hospitality sphere are intangible and unsteady in nature so that each domain necessarily requires a separate marketing strategy. Namely, hospitality services render it possible for the production to span the space, i.e. the different market segments between the supply and demand and meet the consumers needs as well as to achieve the set objectives. In the past years the hospitality industry was considerably falling behind other business enterprises and organizations in the adoption and application of appropriate marketing concepts. It seems, however, that the situation has turned for the better. The hospitality services clearly demand not only an exterior marketing strategy but also a proper marketing technique inside individual establishments in order to achieve a higher level of motivation among the hospitality staff as well as a better quality of service

Bridging the Gap Between National and Ecosystem Accounting Application in Andalusian Forests, Spain

National accounting either ignores or fails to give due values to the ecosystem services, products, incomes and environmental assets of a country. To overcome these shortcomings, we apply spatially-explicit extended accounts that incorporate a novel environmental income indicator, which we test in the forests of Andalusia (Spain). Extended accounts incorporate nine farmer activities (timber, cork, firewood, nuts, livestock grazing, conservation forestry, hunting, residential services and private amenity) and seven government activities (fire services, free access recreation, free access mushroom, carbon, landscape conservation, threatened biodiversity and water yield). To make sure the valuation remains consistent with standard accounts, we simulate exchange values for non-market final forest product consumption in order to measure individual ecosystem services and environmental income indicators. Manufactured capital and environmental assets are also integrated. When comparing extended to standard accounts, our results are 3.6 times higher for gross value added. These differences are explained primarily by the omission in the standard accounts of carbon activities and undervaluation of private amenity, free access recreation, landscape and threatened biodiversity ecosystem services. Extended accounts measure a value of Andalusian forest ecosystem services 5.4 times higher than that measured using the valuation criteria of standard accounts

Fixed and drifting buoys around the national Spanish waters

Joint Technical Commission for Oceanography and Marine Meteorology (JCOMM) Marine Technical Conference, The Technical Conference (TECO) Toward an Integrated Met-ocean Monitoring, Forecasting and Services System, 25-29 October 2017, Geneva, SwitzerlandImproving the knowledge of the ocean and seas surrounding the Iberian Peninsula and Balearic and Canary islands is an objective of the Spanish oceanography. For that purpose, a number of fixed and drifting floats have been established in the last 25 years. Data buoys measure sea surface temperature and salinity, ocean current velocity, air temperature, humidity, wave characteristic and wind velocity across seas and ocean. The objective is increase the quantity, quality, coverage and timeliness of atmospheric and oceanographic data. These observations are used immediately to improve forecast and therefore increase marine safety. The main group of fixed buoys is formed by the Puertos del Estado deep and shallow buoy networks, but a series of well instrumented new platforms has been established in later times. The RAIA Project (Xunta de Galicia), PLOCAN, SOCIB, IEO, Euskalmet-AZTI, ICM and UTM (CSIC) and University and Polytechnic of Barcelona have completed the Observing System. Most of the buoys are transmitting data by GTS for using in atmospheric and ocean prediction models. Multidisciplinary sensors as Dissolved Oxygen, Fluorescence Chlorophyll or pCO2 has been mounted in the buoys and calibration/validation procedures has been developed for improve data quality. Antifouling systems recently developed have also been included and quality of the optical sensors measurements has improved. Drifting floats has increase its number and importance, from Argo floats to traditional deriving ones improving the Spanish contribution to IOC and WWO and JCOMM. Spain is member of EuroArgo ERIC. SOCIB and IEO are the main contributors. Also multidisciplinary work has been done associated to Argo buoys. BGQ ARGO incorporate O2 sensor. ICM, SMOS Barcelona Expert Center, and SOCIB are the main contributors to the drifting buoys group. Main objectives are improving Technological development as well as data management. Tropical and Southern Atlantic Ocean are the main studying areasPeer Reviewe

Liver injury in non-alcoholic fatty liver disease is associated with urea cycle enzyme dysregulation

The main aim was to evaluate changes in urea cycle enzymes in NAFLD patients and in two preclinical animal models mimicking this entity. Seventeen liver specimens from NAFLD patients were included for immunohistochemistry and gene expression analyses. Three-hundred-and-eighty-two biopsy-proven NAFLD patients were genotyped for rs1047891, a functional variant located in carbamoyl phosphate synthetase-1 (CPS1) gene. Two preclinical models were employed to analyse CPS1 by immunohistochemistry, a choline deficient high-fat diet model (CDA-HFD) and a high fat diet LDLr knockout model (LDLr −/−). A significant downregulation in mRNA was observed in CPS1 and ornithine transcarbamylase (OTC1) in simple steatosis and NASH-fibrosis patients versus controls. Further, age, obesity (BMI > 30 kg/m2), diabetes mellitus and ALT werefound to be risk factors whereas A-allele from CPS1 was a protective factor from liver fibrosis. CPS1 hepatic expression was diminished in parallel with the increase of fibrosis, and its levels reverted up to normality after changing diet in CDA-HFD mice. In conclusion, liver fibrosis and steatosis were associated with a reduction in both gene and protein expression patterns of mitochondrial urea cycle enzymes. A-allele from a variant on CPS1 may protect from fibrosis development. CPS1 expression is restored in a preclinical model when the main trigger of the liver damage disappears

Modelos de crecimiento y producción en España: historia, ejemplos contemporáneos y perspectivas

En el presente trabajo se presenta una revisión sobre los modelos forestales desarrollados en España durante los últimos años, tanto para la producción maderable como no maderable y, para la dinámica de los bosques (regeneración, mortalidad). Se presentan modelos tanto de rodal completo como de clases diamétricas y de árbol individual. Los modelos desarrollados hasta la fecha se han desarrollado a partir de datos procedentes de parcelas permanentes, ensayos y el Inventario Forestal Nacional. En el trabajo se muestran los diferentes submodelos desarrollados hasta la fecha, así como las plataformas informáticas que permiten utilizar dichos modelos. Se incluyen las principales perspectivas de desarrollo de la modelización forestal en España.In this paper we present a review of forest models developed in Spain in recent years for both timber and non timber production and forest dynamics (regeneration, mortality). Models developed are whole stand, size (diameter) class and individual-tree. The models developed to date have been developed using data from permanent plots, experimental sites and the National Forest Inventory. In this paper we show the different sub-models developed so far and the friendly use software. Main perspectives of forest modeling in Spain are presented.The models described in this paper were funded by different regional, national and European projects, and some of them were elaborated by the authors. This work was funded by the Spanish Government by the SELVIRED network (code AGL2008-03740) and the strategic project «Restauración y Gestión Forestal» (code PSE-310000-2009-4)

Rest-frame UV Properties of Luminous Strong Gravitationally Lensed Lyα\alpha Emitters from the BELLS GALLERY Survey

We present deep rest-frame UV spectroscopic observations using the Gran Telescopio Canarias of six gravitationally lensed Lya emitters (LAEs) at $2.36<z<2.82$ selected from the BELLS GALLERY survey. By taking the magnifications into account, we show that LAEs can be as luminous as L(Lya) = 30x10$^{42}$ erg s-1 and M(UV) = -23 (AB) without invoking an AGN component, in contrast with previous findings. We measure Lya rest-frame equivalent widths, EW(Lya), ranging from 16\AA to 50\AA and Lya escape fractions, fesc(Lya), from 10% to 40%. Large EW(Lya) and fesc(Lya) are found predominantly in LAEs showing weak low-ionization ISM absorption (EW < 1\AA) and narrow Lya profiles (< 300 km s-1 FWHM) with their peak close (< 80 km s-1) to their systemic redshifts, suggestive of less scatter from low HI column densities that favours the escape of Lya photons. We infer stellar metallicities of Z/Zsun ~ 0.2 in almost all LAEs by comparing the P-Cygni profiles of the wind lines NV1240\AA and CIV1549\AA with those from stellar synthesis models. We also find a trend between M(UV) and the velocity offset of ISM absorption lines, such as the most luminous LAEs experience stronger outflows. The most luminous LAEs show star formation rates up to 180 Msun yr-1, yet they appear relatively blue ($\beta$(UV) ~ -1.8 to -2.0) showing evidence of little dust attenuation (E(B-V) = 0.10-0.14). These luminous LAEs may be particular cases of young starburst galaxies that have had no time to form large amounts of dust. If so, they are ideal laboratories to study the early phase of massive star formation, stellar and dust mass growth, and chemical enrichment histories of starburst galaxies at high-z.Comment: 23 pages, 10 figures, 6 tables. Accepted for publication in MNRA