A Triangulated Model to Assess Adoption of Virtual Learning Environements in Primary Schools

International audienceThe objective of this paper is to highlight the existing theoretical approaches which study the issue of technology adoption, and to establish a triangulated model to explore Virtual Learning Environments ‘adoption in primary schools. We studied the process of adoption through the lens of two related processes: the technological acceptance and appropriation

The Acceptance of VLEs (Virtual Learning Environments) by Primary School Teachers

International audienceThis article presents a study on the conditions of use of a VLE (Virtual Learning Environment) by primary school teachers. To this end, we used research related to activity theory and implemented qualitative methods (individual and collective interviews). Our study describes how teachers (8 participants) perceived the role of the VLE in the evolution of their working practices (maintaining, transforming or restricting existent practices), in their relationship with parents and in the follow-up of their students

Knowledge-based organizations – the intelligent players of informational society

Information, the third manifestation form of Fundamental Existence, has become the most valuable treasure of mankind. The Japanese once said that the happy masters of information in early 21st century are going to be the masters of the world, too. The sign of power is not going to be rendered by man-controlled energies, no matter their power or their effects, gold and other material values under any form, but information. The informational society that mankind irreversibly belongs to is defined as a society of knowledge and of organizations at the same time (Drucker, 1992). Organizations’ adaptability to future economy’s requirements depends on the development of a new management type focused on the values of knowledge and scientific creation. Thus, knowledge-based organizations are the collective intelligent players of informational society and play a major role in its becoming a knowledge society, a part of modern reality

Knowledge-based organizations – the intelligent players of informational society

Information, the third manifestation form of Fundamental Existence, has become the most valuable treasure of mankind. The Japanese once said that the happy masters of information in early 21st century are going to be the masters of the world, too. The sign of power is not going to be rendered by man-controlled energies, no matter their power or their effects, gold and other material values under any form, but information. The informational society that mankind irreversibly belongs to is defined as a society of knowledge and of organizations at the same time (Drucker, 1992). Organizations’ adaptability to future economy’s requirements depends on the development of a new management type focused on the values of knowledge and scientific creation. Thus, knowledge-based organizations are the collective intelligent players of informational society and play a major role in its becoming a knowledge society, a part of modern reality

THE VELAMEMTOUS INSERTION OF THE UMBILIC CORD AND THE MATERNAL-FETAL MORBIDITY

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Inserția velamentosă a cordonului ombilical (VCI) pune probleme serioase atunci când vasele ombilicale sunt situate în regiunea orificiului intern a colului uterin, această situație poartă denumirea de vasa praevia, afecțiune care se asociază cu mortalitate perinatală ridicată în absența diagnosticului prenatal. Scopul lucrării. Cercetarea impactului VCI în incidența vasei praevia și morbiditatea materno-fetală. Material și Metode. Un studiu caz–control pentru anii 2019-2021 în cadrul SCM „Gheorghe Paladi”, care a inclus 103 paciente cu VCI - lotul 1 și 100 - cu inserția centrală/marginală - lotul 2. Rezultate. Studiul a estimat incidența VCI 0,54% din totalul nașterilor timp de 3 ani. USG prenatal a stabilit incidența VCI în 24% cazuri, din care vasa praevia doar în 2,9%, ce denotă rezerve în diagnosticul prenatal. VCI prezintă un risc statistic veridic pentru morbiditatea manifestată prin: vasa praevia (OR-5,21, CI 0,59 - 45,42 (95%), P = 0,1352), RDIU (OR-4,41, CI 1,2 – 16,14 (95%), P = 0,025), moarte antenatală a fătului (OR-5,21, CI 0,59 - 45,42 (95%), P = 0,1352), preeclampsie (OR 7,03, CI 2,58 – 19,13 (95%), P = 0,0001), placenta praevia (OR 5,44, CI 1,16 – 25,52 (95%), P = 0,0316), și complicații postpartum ce a impus decolarea manuală a placentei (OR 3,13, CI 1,54 – 6,44 (95%), P = 0,0016), controlul instrumental al cavității uterine (OR - 4,5, CI 1,74 – 11,6 (95%), P = 0,0018). Concluzii. Stabilirea diagnosticului prenatal al VCI asociat cu vasa praevia are un impact semnificativ asupra tacticii și rezultatului nașterii și reducerii morbidității materno-fetale și mortalității perinatale.Actuality. The velamentous insertion of the umbilical cord (VCI) poses serious problems when the umbilical vessels are located in the region of the internal orifice of the cervix, this situation is called vasa praevia, a condition that is associated with high perinatal mortality when not diagnosed prenatally. Purpose. Research on the impact of VCI in the incidence of vasa praevia and maternal-fetal morbidity. Materials and methods. A case-control study for the years 2019-2021 in Gheorghe Paladi municipal clinical hospital, which included 103 patients with VCI in group 1 and 100 patients with central / marginal umbilical cord insertion in group 2. Research results. The study estimated the incidence of VCI 0.54% of all births over 3 years. USG as a prenatal diagnosis established the incidence of VCI in 24% of cases, of which only in 2.9% vasa praevia, which denotes reservations in the prenatal diagnosis. The comparative study showed that VCI presents a true statistical risk for morbidity manifested by: vasa praevia (OR = 5.21, CI-0.59: 45.42 (95%), P ˂ 0.5), IUGR (OR = 4.40, CI-1.20: 16.14 (95%), P ˂ 0.05), antenatal death of the fetus (OR = 5.05, CI-0.57: 44.02 (95%), P ˂ 0.5), preeclampsia (OR = 7,02, CI-2.58: 19.13 (95%), P ˂ 0.01), placenta praevia (OR = 5.44 CI-1.16: 25.52 (95%) P ˂ 0.5), postpartum complications with manual placental abruption (OR = 3.13 CI-1.54 – 6.44 (95%), P ˂ 0.,01), instrumental control of the uterine cavity (OR = 4.5, CI-1.74: 11.6 (95%), P ˂ 0.01). Conclusion. Prenatal diagnosis of VCI associated with the vasa praevia has a significant impact on tactics and birth outcome and reduces maternal-fetal morbidity and perinatal mortality

Inserția velamentoasă a cordonului ombilical și morbiditatea maternofetală

Actuality. The velamentous insertion of the umbilical cord (VCI) poses serious problems when the umbilical vessels are located in the region of the internal orifice of the cervix, this situation is called vasa praevia, a condition that is associated with high perinatal mortality when not diagnosed prenatally. Purpose. Research on the impact of VCI in the incidence of vasa praevia and maternal-fetal morbidity. Materials and methods. A case-control study for the years 2019-2021 in Gheorghe Paladi municipal clinical hospital, which included 103 patients with VCI in group 1 and 100 patients with central / marginal umbilical cord insertion in group 2. Research results. The study estimated the incidence of VCI 0.54% of all births over 3 years. USG as a prenatal diagnosis established the incidence of VCI in 24% of cases, of which only in 2.9% vasa praevia, which denotes reservations in the prenatal diagnosis. The comparative study showed that VCI presents a true statistical risk for morbidity manifested by: vasa praevia (OR = 5.21, CI-0.59: 45.42 (95%), P ˂ 0.5), IUGR (OR = 4.40, CI-1.20: 16.14 (95%), P ˂ 0.05), antenatal death of the fetus (OR = 5.05, CI-0.57: 44.02 (95%), P ˂ 0.5), preeclampsia (OR = 7,02, CI-2.58: 19.13 (95%), P ˂ 0.01), placenta praevia (OR = 5.44 CI-1.16: 25.52 (95%) P ˂ 0.5), postpartum complications with manual placental abruption (OR = 3.13 CI-1.54 – 6.44 (95%), P ˂ 0.,01), instrumental control of the uterine cavity (OR = 4.5, CI-1.74: 11.6 (95%), P ˂ 0.01). Conclusion. Prenatal diagnosis of VCI associated with the vasa praevia has a significant impact on tactics and birth outcome and reduces maternal-fetal morbidity and perinatal mortality.Introducere. Inserția velamentosă a cordonului ombilical (VCI) pune probleme serioase atunci când vasele ombilicale sunt situate în regiunea orificiului intern a colului uterin, această situație poartă denumirea de vasa praevia, afecțiune care se asociază cu mortalitate perinatală ridicată în absența diagnosticului prenatal. Scopul lucrării. Cercetarea impactului VCI în incidența vasei praevia și morbiditatea materno-fetală. Material și Metode. Un studiu caz–control pentru anii 2019-2021 în cadrul SCM „Gheorghe Paladi”, care a inclus 103 paciente cu VCI - lotul 1 și 100 - cu inserția centrală/marginală - lotul 2. Rezultate. Studiul a estimat incidența VCI 0,54% din totalul nașterilor timp de 3 ani. USG prenatal a stabilit incidența VCI în 24% cazuri, din care vasa praevia doar în 2,9%, ce denotă rezerve în diagnosticul prenatal. VCI prezintă un risc statistic veridic pentru morbiditatea manifestată prin: vasa praevia (OR-5,21, CI 0,59 - 45,42 (95%), P = 0,1352), RDIU (OR-4,41, CI 1,2 – 16,14 (95%), P = 0,025), moarte antenatală a fătului (OR-5,21, CI 0,59 - 45,42 (95%), P = 0,1352), preeclampsie (OR 7,03, CI 2,58 – 19,13 (95%), P = 0,0001), placenta praevia (OR 5,44, CI 1,16 – 25,52 (95%), P = 0,0316), și complicații postpartum ce a impus decolarea manuală a placentei (OR 3,13, CI 1,54 – 6,44 (95%), P = 0,0016), controlul instrumental al cavității uterine (OR - 4,5, CI 1,74 – 11,6 (95%), P = 0,0018). Concluzii. Stabilirea diagnosticului prenatal al VCI asociat cu vasa praevia are un impact semnificativ asupra tacticii și rezultatului nașterii și reducerii morbidității materno-fetale și mortalității perinatale

Endometrioza și calitatea vieții. Abordări terapeutice

Background. Endometriosis is one of the most current women's health problems. It is known that this disease ranks 3rd in the structure of gynecological diseases, it is found in 5-10% of women, 35-50% of women with infertility and 70-80% of women with chronic pelvic pain. Objective of the study. Comparative evaluation of two treatment schemes, used in the management of endometriosis symptoms and their impact in restoring quality of life. Material and Methods. A prospective nonrandomized case-control clinical trial was performed that included 104 gynecopathic patients. The study group included 43 patients with endometriosis who received contraceptive treatment with dienogest and estradiol valerate administered on a continuous scheme. The control group included 37 patients with endometriosis who were treated with dienogest 2 mg. Results. The study evaluated the statistically true similar efficacy of both treatment schemes in the management of chronic pelvic pain (21.6%vs16.6%, OR 1.17, p=0.8), dyspareunia (5.9% vs 4.9%, OR 1.40, p=0.5),dysmenorrhea (13.8% vs 11.8%, OR 1.18, p=0.7). Dienogest was associated with significant improvement in symptoms and onset of amenorrhea at week 24. DNG+E2V was associated with the improvement of symptoms and the onset of amenorrhea in week 8 of treatment.The study shows that more common side effects are found in the group of patients who received Dienogest compared to DNG + E2V, the most common being spotting,vaginal dryness ,hot flashes,intermenstrual hemorrhages . Conclusion. The study evaluated the statistically true similar efficacy of both treatment schemes in the management of chronic pelvic pain, dyspareunia, dysmenorrhea. The scheme with DNG+E2V was more effective in reducing side effects. The treatment with DNG+E2V was more cost effective, more accessible. Introducere. Endometrioza reprezintă una dintre cele mai actuale probleme ale sănătății feminine. Se cunoaște că această boală ocupă locul 3 în structura maladiilor ginecologice, se întâlnește la 5-10% dintre femei, la 35-50% de femei cu infertilitate și la 70-80% de femei cu dureri cronice pelvine. Scopul lucrării. Evaluare comparativă a două scheme de tratament, utilizate în managementul simptomaticii endometriozei și impactul lor în restabilirea calității vieții. Material și Metode. S-a efectuat un studiu clinic prospectiv de tip caz-control, nerandomizat, ce a inclus 104 paciente ginecopate. Astfel, în lotul de studiu au fost 43 de paciente cu endometrioză, cărora li s-au administrat tratament contraceptiv cu dienogest și estradiol valerat, pe schemă continuă. Lotul de control a inclus 37 de paciente cu endometrioză, cărora li s-a indicat terapie doar cu dienogest 2 mg. Rezultate. Studiul a evaluat eficacitatea similară statistică a ambelor scheme de tratament al durerilor pelvine cronice (21,6% vs 16,6%, OR 1,17, p = 0,8), dispareunie (5,9% vs 4,9%, OR 1,40, p = 0,5) , dismenoree (13,8% vs 11,8%, OR 1,18, p = 0,7). Dienogest a fost asociat cu reducerea semnificativă a simptomelor și debutul amenoreei la săptămâna 24. DNG + E2V a fost asociat cu anihilarea simptomelor și debutul amenoreei în săptămâna 8 de tratament. Studiul arată că mai multe reacții adverse frecvente se regăsesc în grupul de pacienți care au luat Dienogest, în comparație cu DNG + E2V, cele mai frecvente fiind uscăciunea vaginală, bufeurile, hemoragiile intermenstruale. Concluzii. Studiul a evaluat eficacitatea similară statistică a ambelor scheme de tratament al durerilor pelvine cronice, dispareuniei, dismenoreei. Schema cu DNG + E2V a fost mai eficientă în reducerea efectelor secundare. Tratamentul cu DNG + E2V a fost mai rentabil, mai accesibil

Роль ВПЧ скрининга в современном менеджменте предраковой и раковой патологий шейки матки

Universitatea de Stat de Medicină și Farmacie „Nicolae Testemiţanu”Background: Cervical cancer affects about 500.000 women each year, having serious repercussions upon the public health, as half of the primary diagnosed cases are lethal. The statistics show that 91% of women survive at least for 5 years after the diagnosis is established, assuming that it is a early stage. Great progress in the prevention, diagnosis and treatment of cervical cancer has been obtained since the cytological screening, HPV genotipation and anti-HPV vaccination have been discovered, as the lethality dropped by 80%. But in spite of this fact, it is important to keep in mind that the Pap-test has its clinical limitations, as about 1/3 of the precancerous lesions remain underdiagnosed. Recently, the studies performed for the US Cancer prevention Center showed that the HPV testing has a greater sensitivity in detecting ≥CIN2 and ≥CIN3 lesions versus the pap-smear. The HPV testing offers the possibility to quantify the risk, the sensitivity Cobas® HPV Test being with about 35,7% higher and reaching about 100%. In our study, only 1 of 10 women with positive HPV 16, 18 had precancerous cervical modifications and normal cytological results. The aim of the study was to evaluate the role of the HPV testing in the contemporary screening and management of the precancerous and cancerous cervical modifications. Materials and methods: The study was based on the data of 270 women of 18-60 years of age. Their Pap-smear and HPV-AND tests were performed in the Synevo-Laboratory. Based on this results the women were redirected for colposcopy and onco-gynecological consultations, including biopsy and treatment. Results and conclusions: 1. The screening performed using the Cobas® HPV Test revealed that 1/3 of the 270 women included in the study were infected with oncogenic HPV types, with ACES vs NILM in a 4 to 1 correlation. 2. 40% of the women were diagnosed with precancerous and cancerous uterine cervix pathologies, they were redirected for colposcopy, biopsy and histology. 3. In our study the Cobas® HPV test showed a 100% sensibility and a 92,86% specificity. 4. The study showed that the major group of risk for developing ACES were women aged over 30, administering oral contraceptives over 2-3 years and infected with HPV 16,18 types, fact that proves the need to vaccinate young women against HPV.Справочная информация: Рак шейки матки затрагивает около 500.000 женщин каждый год, сильно влияя на индикаторы здоровья населения, так как половина первично диагностированных случаев имеют летальный исход. Статистика показывает, что выживаемость достигает 5 лет и более при условии, что диагностика происходит в ранних стадиях. Огромный прогресс был достигнут в плане скрининга, диагностики и лечения рака шейки матки с тех пор как цитологический скрининг, определения генотипа и ВПЧ вакцинация были введены, смертность упала на около 80%. Несмотря на это, важно помнить что у Пап-теста есть свои клинические недостатки, 1/3 предраковых изменений остается в тени. Недавно, исследования проведенные для Американского Центра Предотвращение Рака показали что ВПЧ тестирование имеет большую чувствительность в диагностики поражении ≥CIN2 и ≥CIN3, в сравнений с обыкновенной цитологией. ВПЧ тестирование позволяет измерить риск этих поражений, а чувствительность Cobas® ВПЧ Теста больше на 35,7%, достигая почти 100%. В нашем исследовании только у 1 из 10 женщин с положительными результатами на ВПЧ 16,18 имели предраковые модификаций и нормальную цитологию. Целью нашего исследования было оценить роли ВПЧ скрининга в современном менеджменте предраковой и раковой патологий шейки матки. Материалы и методы: исследование основано на данных 270 женщин в возрасте от 16 до 60 лет, которые сдали Пап-тест и ВПЧ-ДНК в лабораторий Синево. Основываясь на результатах, женщины были перенаправлены на онко-гинекологические консультации, включая биопсию и лечение. Результаты и выводы: 1. Скрининг пациенток применяя Cobas® ВПЧ-Тест показал что 1/3 из 270 женщин включенные в исследования были ВПЧ 16,18 положительными, с соотношением ACES и NILM 4:1. 2. У 40% женщин были диагностированы предраковые и раковые изменения шейки, они были перенаправлены на кольпоскопию, биопсию и гистологию. 3. В нашем исследований Cobas® ВПЧ тест показал 100% чувствительность и 92,86% специфичности. 4. Исследование показало, что в группу риска к развитию ACES вошли женщины старше 30 лет, принимающие оральные контрацептивы больше 2-3 лет зараженные ВПЧ 16,18, то что доказывает необходимость вакцинации молодых женщин