Desempenho acadêmico dos universitários, respeito da ansiedade escolar e auto-avaliação

Behavioral researchers in the field of education have stressed the need for designing programs aimed to reduce adverse effects of anxiety on academic performance among high risk students. This study was designed to corroborate the relationship between academic performance and school anxiety reported in the literature, and to verify if the direction of this relationship is the same when behavioral indexes of school anxiety are employed. The study was conducted with 22 college students of a public university. They were subjected to 25 academic exams and three self rated measures which produced an average grade and a study index respectively. School anxiety was measured by means of a discrimination task based on a modified version of Stroop s paradigm. Results showed that under-achievers produced the highest indicators of behavioral anxiety. Additionally, it was found that students who had been systematically located in the lower levels of the study index showed the highest levels of anxiety. Emotional arousal was registered by means of a systolic blood pressure measurement taken before or after the behavioral task depending on whether it was dealt with students who showed low-study indexes or low-average grades. The use of behavioral and physiological indexes of anxiety supports previous findings on the inverse relationship between anxiety and academic performance and the direct relationship between the academic self concept and school grades in a situation designed to minimize the emotional effect associated with the exposure to multiple exams.Los especialistas en comportamiento escolar han subrayado la necesidad de diseñar programas para reducir los efectos adversos que puede tener la ansiedad sobre el desempeño escolar a nivel universitario y atender oportunamente a los estudiantes en riesgo. El presente estudio explora la relación entre rendimiento académico y ansiedad escolar medida conductualmente, con el fin de corroborar si las relaciones entre esas variables y el sentido de las mismas, corresponde a las documentadas por estudios previos. Participaron 22 estudiantes de una universidad pública, sometidos a 25 evaluaciones académicas semestrales y a tres de auto-reporte, que produjeron respectivamente un promedio y un índice de estudio. La ansiedad escolar se midió mediante una tarea de discriminación basada en el paradigma de Stroop modificado. Los resultados señalan que los alumnos con los promedios más bajos presentaron los indicadores más elevados de ansiedad conductual. Adicionalmente, se encontró que los alumnos que de manera sistemática se ubicaron en el rango más bajo en su índice de estudio, mostraron mayor ansiedad escolar. El desasosiego emocional registrado mediante el monitoreo fisiológico se manifestó a partir de la presión sistólica, previa o posterior a la prueba conductual, según se tratara de los índices de estudio bajos, o del promedio bajo en los exámenes, respectivamente. Se concluye que el empleo de indicadores conductuales y fisiológicos corrobora las tendencias reportadas en la literatura sobre la relación inversa entre ansiedad y rendimiento académico, y la relación directa entre auto-concepto académico y promedio de calificaciones, en una situación en la que ex profeso se minimizó el efecto emocional de la exposición a exámenes académicos múltiples.Os especialistas no comportamento escolar têm destacado que é preciso desenhar programas para diminuir os efeitos contrários da ansiedade no desempenho estudantil universitário e atender oportunamente aos estudantes que correm o risco. Este estudo explora a relação entre rendimento escolar e ansiedade, medida comportamentalmente, para comprovar se as relações entre programas variáveis e o sentido das mesmas corresponde as documentadas nos estudos anteriores. Participaram 22 estudantes de uma universidade pública, submetidos a 25 avaliações acadêmicas semestrais e três de auto-reporte, que produziram, respectivamente, uma média e um índice de estudo. A ansiedade escolar foi medida mediante uma tarefa de discriminação, baseada no paradigma de Stroop alterado. Os achados mostram que os alunos com as médias mais baixas apresentaram os indicadores mais altos de ansiedade. Ademais, foi achado que os alunos situados sistematicamente nas posições mais baixas no índice de estudo mostraram maior ansiedade escolar. O desassossego emocional registrado mediante monitoramento fisiológico manifestou-se na pressão sistólica, antes e depois da prova comportamental, segundo trataram-se dos índices de estudo baixos ou da média baixa nos exames, respectivamente. É concluso que o emprego de indicadores comportamentais e fisiológicos corrobora as tendências reportadas na literatura sobre a relação inversa entre ansiedade e rendimento acadêmico, e a relação direita entre auto-conceito acadêmico e média de qualificações em uma situação em que, ex professo, foi minimizado o efeito emocional da exposição aos diversos exames acadêmicos

Academic performance, self-evaluation, and school anxiety among college students.

Los especialistas en comportamiento escolar han subrayado la necesidad de diseñar programas para reducir los efectos adversos que puede tener la ansiedad sobre el desempeño escolar a nivel universitario y atender oportunamente a los estudiantes en riesgo. El presente estudio explora la relación entre rendimiento académico y ansiedad escolar medida conductualmente, con el fi n de corroborar si las relaciones entre esas variables y el sentido de las mismas, corresponde a las documentadas por estudios previos. Participaron 22 estudiantes de una universidad pública, sometidos a 25 evaluaciones académicas semestrales y a tres de auto-reporte, que produjeron respectivamente un promedio y un índice de estudio. La ansiedad escolar se midió mediante una tarea de discriminación basada en el paradigma de Stroop modificado. Los resultados señalan que los alumnos con los promedios más bajos presentaron los indicadores más elevados de ansiedad conductual. Adicionalmente, se encontró que los alumnos que de manera sistemática se ubicaron en el rango más bajo en su índice de estudio, mostraron mayor ansiedad escolar. El desasosiego emocional registrado mediante el monitoreo fisiológico se manifestó a partir de la presión sistólica, previa o posterior a la prueba conductual, según se tratara de los índices de estudio bajos, o del promedio bajo en los exámenes, respectivamente. Se concluye que el empleo de indicadores conductuales y fisiológicos corrobora las tendencias reportadas en la literatura sobre la relación inversa entre ansiedad y rendimiento académico, y la relación directa entre autoconcepto académico y promedio de calificaciones, en una situación en la que ex profeso se minimizó el efecto emocional de la exposición a exámenes académicos múltiples.Behavioral researchers in the fi eld of education have stressed the need for designing programs aimed to reduce adverse effects of anxiety on academic performance among high risk students. This study was designed to corroborate the relationship between academic performance and school anxiety reported in the literature, and to verify if the direction of this relationship is the same when behavioral indexes of school anxiety are employed. The study was conducted with 22 college students of a public university. They were subjected to 25 academic exams and three self rated measures which produced an average grade and a study index respectively. School anxiety was measured by means of a discrimination task based on a modified version of Stroop’s paradigm. Results showed that under-achievers produced the highest indicators of behavioral anxiety. Additionally, it was found that students who had been systematically located in the lower levels of the study index showed the highest levels of anxiety. Emotional arousal was registered by means of a systolic blood pressure measurement taken before or after the behavioral task depending on whether it was dealt with students who showed low-study indexes or low-average grades. The use of behavioral and physiological indexes of anxiety supports previous findings on the inverse relationship between anxiety and academic performance and the direct relationship between the academic self concept and school grades in a situation designed to minimize the emotional effect associated with the exposure to multiple exams

Utilidad de la tomografía de coherencia óptica en el diagnóstico de pacientes inestables con estenosis coronarias no significativas

Introduction and objectives: The final diagnosis of a myocardial infarction with non-obstructive coronary arteries (MINOCA) is often hard to achieve. Angiographic findings may be suggestive of the presence of unstable plaques although it is common to discharge patients without an etiologic diagnosis. The high spatial resolution provided by the optical coherence tomography (OCT) allows the detection of vulnerable and unstable coronary plaques that are prone to rupture, erosion, and thrombi which may lead to more targeted individual therapies. The objective of this study is to assess the utility of OCT when achieving an etiologic diagnosis in selected patients with MINOCA and high clinical suspicion of atherosclerotic etiology. Methods: Registry of 27 patients recruited between September 2015 and January 2020 admitted to a single tertiary hospital with acute coronary syndrome and non-significant stenosis in the coronary angiography who underwent OCT. The baseline data of the study population, the angiographic and OCT findings, treatment and follow-up information were all collected. Results: The OCT imaging showed evidence of unstable plaques (thrombus, plaque erosion or plaque rupture) in 78% of patients, which lead to an etiologic diagnosis of MINOCA. Patients were predominantly males (89%), smokers (63%), middle-aged (median 53 years old) and with a low cardiovascular risk burden. The left anterior descending coronary artery was the most frequently compromised vessel (74%) and 95% of patients ended up receiving coronary stents. The mid-term follow-up was excellent. Conclusions: In our study, OCT imaging proved to be a valuable tool to achieve an etiologic diagnosis in a large proportion of selected patients with MINOCA which, as a result could lead to more specific and individualized treatments.Introducción y objetivos: A menudo resulta complejo diagnosticar a pacientes con infarto agudo de miocardio y estenosis coronarias no significativas en la coronariografía (MINOCA). En ocasiones, la angiografía muestra datos sugestivos de placa inestable, aunque no es infrecuente que estos pacientes acaben sin un diagnóstico etiológico. La tomografía de coherencia óptica (OCT) permite detectar placas vulnerables e inestables con rotura, erosión o trombo gracias a su elevada resolución espacial, lo que podría implicar un cambio en el manejo de estos pacientes. El objetivo de este estudio es valorar la utilidad de la OCT para alcanzar un diagnóstico final en casos seleccionados de MINOCA con alta sospecha de etiología ateroesclerótica. Métodos: Registro de 27 pacientes desde septiembre de 2015 hasta enero de 2020 en los que se indica OCT en el contexto de síndrome coronario agudo y estenosis < 50% en la angiografía. Se describen las características de la población, los hallazgos en la angiografía y la OCT, la actitud terapéutica y la evolución. Resultados: La OCT evidenció la presencia de placa inestable con trombo, rotura de placa o erosión de placa en el 78% de los pacientes como causa del MINOCA. Los pacientes fueron predominantemente varones (89%), fumadores (63%), de mediana edad (53 años de mediana), con poca carga de factores de riesgo y afectación principalmente de la descendente anterior (74%). El 95% de los casos en que se detectó placa inestable fueron tratados con stent. La evolución a medio plazo fue excelente. Conclusiones: En nuestra serie de pacientes con MINOCA y alta sospecha de causa ateroesclerótica, la OCT resultó ser una técnica útil para identificar la etiología de la mayoría de ellos, lo que permitió adoptar una estrategia terapéutica más específica

High PEEP with recruitment maneuvers versus Low PEEP During General Anesthesia for Surgery -a Bayesian individual patient data meta-analysis of three randomized clinical trials

Background: The influence of high positive end-expiratory pressure (PEEP) with recruitment maneuvers on the occurrence of postoperative pulmonary complications after surgery is still not definitively established. Bayesian analysis can help to gain further insights from the available data and provide a probabilistic framework that is easier to interpret. Our objective was to estimate the posterior probability that the use of high PEEP with recruitment maneuvers is associated with reduced postoperative pulmonary complications in patients with intermediate-to-high risk under neutral, pessimistic, and optimistic expectations regarding the treatment effect. Methods: Multilevel Bayesian logistic regression analysis on individual patient data from three randomized clinical trials carried out on surgical patients at Intermediate-to-High Risk for postoperative pulmonary complications. The main outcome was the occurrence of postoperative pulmonary complications in the early postoperative period. We studied the effect of high PEEP with recruitment maneuvers versus Low PEEP Ventilation. Priors were chosen to reflect neutral, pessimistic, and optimistic expectations of the treatment effect. Results: Using a neutral, pessimistic, or optimistic prior, the posterior mean odds ratio (OR) for High PEEP with recruitment maneuvers compared to Low PEEP was 0.85 (95% Credible Interval [CrI] 0.71 to 1.02), 0.87 (0.72 to 1.04), and 0.86 (0.71 to 1.02), respectively. Regardless of prior beliefs, the posterior probability of experiencing a beneficial effect exceeded 90%. Subgroup analysis indicated a more pronounced effect in patients who underwent laparoscopy (OR: 0.67 [0.50 to 0.87]) and those at high risk for PPCs (OR: 0.80 [0.53 to 1.13]). Sensitivity analysis, considering severe postoperative pulmonary complications only or applying a different heterogeneity prior, yielded consistent results. Conclusion: High PEEP with recruitment maneuvers demonstrated a moderate reduction in the probability of PPC occurrence, with a high posterior probability of benefit observed consistently across various prior beliefs, particularly among patients who underwent laparoscopy