An analysis of problems of coexistence in schools in Catalunya. Suggestions for improvements.

En el presente trabajo se pretende analizar los principales conflictos, que tienen lugar en las escuelas de educación infantil y primaria de Cataluña (de 3 a 12 años), y los mecanismos de resolución y de prevención que se proponen desde los centros educativos. Se aplicó un cuestionario electrónico de 30 preguntas a equipos directivos de Cataluña y se obtuvieron 481 respuestas. Los resultados muestran un índice de conflictividad bajo, con conflictos leves que se achacan a causas externas, especialmente destacando las incoherencias entre los valores que se transmiten en la escuela y en la sociedad. También indican que las propuestas de mejora de la convivencia son de diversa índole (del ámbito curricular, organizativo, profesional y comunitario) y que, para el éxito de estas, son básicas la participación de los docentes, la motivación, la concienciación y el liderazgo del equipo directivo. Finalmente se ha constatado la necesidad de continuar estudiando aspectos que se han manifestado de interés: la importancia del liderazgo, la necesidad de compartir las experiencias escolares valiosas y el valor de la formación inicial de los docentes para afrontar la conflictividad escolar.This article aims to analyse the main conflicts that occur in infant and primary schools (from the ages of 3 to 12) in Catalunya, and the mechanisms schools use to prevent and resolve them. A 30-question digital questionnaire was sent to school management teams in Catalunya and 481 replies were received. The results showed a low level of conflict, with minor conflicts attributed to external causes, especially highlighting the inconsistencies between the values imparted in schools and in society. They also showed that proposals for improving coexistence are varied (curricular, organizational, professional and community-based) and that, for them to succeed, the participation of teachers and the motivation, awareness and leadership of management teams are essential. Finally, the following areas of interest should continue to be studied: the importance of leadership; the need to share valuable school experiences; and the importance of initial teacher training in dealing with conflicts in schools

从教育专业人士的角度看管理项目

The objective of this research is to know the opinion that education professionals have about the Management Project (PdD) of educational centres, after exploring different existing regulations in five autonomous communities (CCAA), in order to make a more unified proposal. The methodology used was qualitative, analysing different legislations of some CCAA, and quantitative by analysing the results obtained from a questionnaire applied to 530 professionals in the educational field. The results indicated that there are some discrepancies in the regulations of different CCAA. Education professionals consider that the PdD should have about 30 pages and that the most important sections are the objectives, lines of action and organization of the centre. Most consider that it should be presented to the Senate and the School Council that the time between the summons and the deposit should be 3 months and that it requires prior training. Differences were observed in the differential analysis according to age, gender, and professional profile. The conclusions are the importance of receiving specific formation on PdD is drawn and that the regulations should be standardized, considering the opinions of education professionals.El objetivo de esta investigación es conocer la opinión que tienen los/las profesionales de la educación sobre el Proyecto de Dirección (PdD) de centros educativos, después de explorar diferentes normativas existentes en cinco comunidades autónomas (CCAA), para poder realizar una propuesta más unificada. La metodología utilizada fue tanto cualitativa, analizando diferentes legislaciones de las cinco CCAA, como cuantitativa mediante el análisis de los resultados obtenidos a partir de un cuestionario aplicado a 530 profesionales del ámbito educativo. Los resultados indicaron que existen algunas discrepancias en la reglamentación de diferentes CCAA. Los/las profesionales de la educación consideran que el PdD debería tener unas 30 páginas y que los apartados más importantes son los objetivos, líneas de actuación y organización del centro. La mayoría cree que debe presentarse al Claustro y al Consejo Escolar, que el tiempo entre la convocatoria y el depósito debería ser de 3 meses y que requiere formación previa. En el análisis diferencial se observaron diferencias según la edad, género y perfil profesional. Como conclusión se extrae la importancia de recibir una formación específica sobre el PdD y que deberían homogeneizarse las reglamentaciones, considerando las opiniones de los/las profesionales de la educación.Цель данного исследования - выяснить мнение специалистов в области образования о проекте управления (ПУ) учебными заведениями, изучив различные существующие нормативные акты в пяти автономных сообществах (CCAA), чтобы иметь возможность сделать более унифицированное заключение. Использовалась как качественная методология - анализ различных законодательных актов в пяти автономных сообществах, так и количественная - анализ результатов, полученных с помощью анкеты, в которой приняли участие 530 специалистов в области образования. Результаты показали, что существуют некоторые расхождения в нормативных актах различных автономных округов. Специалисты в области образования считают, что объем ПУ должен составлять около 30 страниц и что наиболее важными разделами являются цели, направления деятельности и организация работы школы. Большинство из них считают, что он должен быть представлен коллективу школы и школьному совету, что время между обращением и представлением должно составлять 3 месяца и что для этого требуется предварительная подготовка. При дифференциальном анализе наблюдались различия в зависимости от возраста, пола и профессионального профиля. В заключение следует отметить важность специальной подготовки по ПУ и необходимость унификации нормативных документов с учетом мнения специалистов в области образования.本研究的目的是在探索西班牙五个大区现有的不同法规后，了解教育专业人士对学校管理项目（PdD）的看法，以便提出更加统一的建议。 我们使用定性研究方法分析五个大区的不同立法，同时也使用定量研究方法，通过对 530 名教育领域专业人士的问卷调查结果进行分析。 结果表明，不同大区的法规存在一定差异。教育专业人士认为 PdD 文本应该有 30 页左右，最重要的部分是中心的目标、行动方针和组织。大多数人认为应将其提交给学校理事会，在通知和交存之间应相隔应 3 个月的时长，并且需要事先培训。在差异分析中，研究在年龄、性别和职业概况方面观察到差异。 结论得出了接受 PdD 专门培训的重要性，并考虑教育专业人士的意见，制定规范

师范学位里的通用技能分析：从赫罗纳大学学生角度出发进行研究

تهدف الدراسة الحالية إلى معرفة الدرجة التي يتم بها العمل على كفاءات التدريس العامة (الفعالة, والشخصية, والنظامية) في درجات المعلم, والأهمية التي يوليها لها الطلاب وفي أي مواضيع من كل دورة يعملون أكثر من غيرها. تم تطوير استبيان إلكتروني حول الكفايات التي يجب أن يتمتع بها كل معلم, وفق مشروع Tuning. وقد تم التحقق من صحتها من قبل الخبراء وقدمت اتساقًا داخليًا كافيًا. وكانت العينة 285 من أصل 956 طالباً في مرحلة الماجستير في جامعة جيرونا. وفي النتائج، لوحظ أن الطلاب قيموا دائمًا الأهمية المعطاة للكفاءات المختلفة بدرجة أعلى من الدرجة التي تم العمل عليها. الأكثر قيمة هي العلاقات بين الأشخاص بينما الأقل قيمة هي الفعّالة. المهارة التي يتم العمل عليها كثيرًا هي العمل الجماعي والمهارة الأقل العمل عليها هي القدرة على العمل في سياق دولي. وتم التأكيد أيضًا على أن المواضيع التي يتم فيها العمل على المهارات بشكل أكبر هي التدريب العملي ومشروع الدرجة النهائية, من بين أمور أخرى. إن تخصص التربية في مرحلة الطفولة المبكرة هو الذي قدم أهم العلاقات وكان التخصص الأكثر تقديراً لأهمية الكفايات ودرجة العمل عليها. ويخلص إلى أنه من الضروري إعطاء أهمية أكبر للكفاءات العامة في عملية تدريب المعلمين والعمل بشكل أكبر على الكفاءات الدولية جنبا إلى جنب مع معرفة ثقافات وعادات البلدان الأخرىThe present study aims to determine the degree to which generic teaching competencies (instrumental, interpersonal, and systemic) are developed in Bachelor's degrees in Education, the importance given to them by students, and which courses focus more on them. An electronic questionnaire was developed based on the competencies that every teacher should have, according to the Tuning Project. It was validated by experts and showed adequate internal consistency. The sample consisted of 285 out of 956 Education students at the University of Girona. The results showed that students always rated the importance of different competencies higher than the degree to which they are actually developed. Interpersonal competencies were the most valued, while instrumental competencies were the least valued. The most developed competency was teamwork, while the least developed was the ability to work in an international context. It was also found that the competencies were more developed in a few determinate courses, like in the Practicum and Final Degree Project courses. The Early Childhood Education specialization presented the most significant relationships and placed greater importance on both the competencies and their degree of development. In conclusion, it is necessary to give greater importance to generic competencies in teacher training and to develop international competencies in conjunction with knowledge of other cultures and customs.El presente estudio pretende conocer el grado en que se trabajan las competencias docentes genéricas (instrumentales, interpersonales y sistémicas) en los Grados de Maestro, la importancia que le otorga el estudiantado y en qué asignaturas se trabajan más. Se elaboró un cuestionario electrónico que partió de las competencias que debería tener todo docente, según el proyecto Tuning. Fue validado por expertos y presentó una consistencia interna adecuada. La muestra fue de 285 de los 956 estudiantes de los Grados de Maestro de la Universidad de Girona. En los resultados se observó que el estudiantado siempre puntuaba más alta la importancia otorgada a las diferentes competencias que el grado en que se trabajan. Las más valoradas son las interpersonales mientras que las menos valoradas son las instrumentales. La competencia que más se trabaja es el Trabajo en equipo y la que menos es la Habilidad de trabajar en un contexto internacional. También se constató que en las asignaturas donde más se trabajan las competencias son en el Prácticum y en el Trabajo de Final de Grado, entre otras. La especialidad de Educación Infantil es la que presentó la mayoría de las relaciones significativas y fue la especialidad que más valoró la importancia de las competencias y el grado en que se trabajan. Se concluye que es necesario dar una mayor importancia a las competencias genéricas en el proceso formativo del profesorado y trabajar más las competencias internacionales juntamente con el conocimiento de culturas y las costumbres de otros países.O presente estudo pretende saber em que medida as competências docentes genéricas (instrumentais, interpessoais e sistémicas) são trabalhadas nos Cursos de Docência, a importância que lhes é dada pelos estudantes e em que disciplinas de cada curso são mais trabalhadas. Elaborou-se um questionário eletrónico com base nas competências que todos os professores deveriam ter, de acordo com o projeto Tuning. Foi validado por peritos e revelou uma consistência interna adequada. A amostra foi constituída por 285 dos 956 estudantes dos Cursos de Docência da Universidade de Girona. Os resultados demonstraram que os estudantes atribuíam sempre uma pontuação mais elevada à importância dada às diferentes competências do que a medida em que são trabalhadas. As mais valorizadas são as interpessoais, enquanto as menos valorizadas são as instrumentais. A competência mais trabalhada é o Trabalho em equipa e a menos trabalhada é Capacidade de trabalhar num contexto internacional. Também se constatou que as disciplinas em que as competências são mais trabalhadas são no Estágio e no Projeto Final de Curso, entre outras. A especialidade de Ensino Infantil foi a que apresentou a maioria das relações significativas e foi a especialidade que mais valorizou a importância das competências e a medida em que são trabalhadas. Conclui-se que é necessário dar maior importância às competências genéricas no processo formativo dos professores e trabalhar mais as competências internacionais, juntamente com o conhecimento das culturas e dos costumes de outros países.O presente estudo pretende saber em que medida as competências docentes genéricas (instrumentais, interpessoais e sistémicas) são trabalhadas nos Cursos de Docência, a importância que lhes é dada pelos estudantes e em que disciplinas de cada curso são mais trabalhadas. Elaborou-se um questionário eletrónico com base nas competências que todos os professores deveriam ter, de acordo com o projeto Tuning. Foi validado por peritos e revelou uma consistência interna adequada. A amostra foi constituída por 285 dos 956 estudantes dos Cursos de Docência da Universidade de Girona. Os resultados demonstraram que os estudantes atribuíam sempre uma pontuação mais elevada à importância dada às diferentes competências do que a medida em que são trabalhadas. As mais valorizadas são as interpessoais, enquanto as menos valorizadas são as instrumentais. A competência mais trabalhada é o Trabalho em equipa e a menos trabalhada é Capacidade de trabalhar num contexto internacional. Também se constatou que as disciplinas em que as competências são mais trabalhadas são no Estágio e no Projeto Final de Curso, entre outras. A especialidade de Ensino Infantil foi a que apresentou a maioria das relações significativas e foi a especialidade que mais valorizou a importância das competências e a medida em que são trabalhadas. Conclui-se que é necessário dar maior importância às competências genéricas no processo formativo dos professores e trabalhar mais as competências internacionais, juntamente com o conhecimento das culturas e dos costumes de outros países.该研究试图了解教师通用技能（工具技能、人际交往技能、系统性技能）在师范学位的涉及程度，学生的重视度以及哪个年级的哪门课程涉及更多的通用技能这三个方面。根据调优项目，我们设计了一项包含所有教师应具备技能的电子问卷。该问卷经过多名专家验证，呈现出适当的内部一致性。问卷样本来自赫罗纳大学师范学位956名学生中的285名。研究结果发现学生对不同通用技能的重视程度评分比学位所涉及的程度还要高。学生认为人际交往技能最重要，而认为工具技能最不重要。在学位里涉及最多的是小组合作技能，涉及最少的是在国际背景下的工作技能。研究还发现涉及技能最多的课程是实习课和本科论文课。幼儿教育专业的数据显示出最高的显著性关联。这个专业也是师范学位里涉及最多技能、给予技能最高重视程度的专业。研究结论显示在教师培养过程中需要给予通用技能更多的注重，也要更多地涉及包含其他国家文化习俗内容的国际技能

Is there a place for the role of families in secondary education? Perceptions and proposals to transform the institutional programme of schools

Las respuestas a un cuestionario realizado al inicio de una investigación-acción en diferentes institutos de secundaria, nos muestran las opiniones que el profesorado de estos centros tiene acerca de la relación con las familias. Se trataba no sólo de conocer los puntos de vista de los y las docentes sino de utilizarlos en el claustro de los centros implicados para abrir un proceso de reflexión y de implementación de propuestas pedagógicas dirigidas a modificar aspectos de la cultura escolar. Todo ello en beneficio de una relación más fluida y, a la vez, más profunda, con las familias. Precisamente, el papel y el lugar de las familias en los institutos supone una de las claves para avanzar hacia un nuevo programa institucional en los centros de secundaria, una reinstitucionalización que tendría que situar en el centro de las preocupaciones docentes, la vinculación con las familias y la comunidad, aspecto indispensable para la mejora de los aprendizajes de todo el alumnado.The responses made to a questionnaire at the beginning of an action-research in different secondary schools show us the opinions that teachers of these educational institutions have on the relationship with families. The aim was not just to know the opinions of the teachers but to use them in the staff meetings of the schools involved in order to open a process of reflection and implementation of pedagogical proposals to modify aspects of the school culture. All this was done in favour of a more fluid and, at the same time, deeper, relationship with families. Indeed, the role and place of families in the secondary schools is a key point to moving towards a new institutional programme, a re-institutionalization that should place links with families and community at the centre of educational concerns, as an essential aspect to improve the learning of all pupils.Grupo FORCE (HUM-386). Departamento de Didáctica y Organización Escolar de la Universidad de Granad

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

Background The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. Objectives The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. Methods The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. Results A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Conclusions Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems

Health outcomes from home hospitalization: multisource predictive modeling

Background: Home hospitalization is widely accepted as a cost-effective alternative to conventional hospitalization for selected patients. A recent analysis of the home hospitalization and early discharge (HH/ED) program at Hospital Clínic de Barcelona over a 10-year period demonstrated high levels of acceptance by patients and professionals, as well as health value-based generation at the provider and health-system levels. However, health risk assessment was identified as an unmet need with the potential to enhance clinical decision making. Objective: The objective of this study is to generate and assess predictive models of mortality and in-hospital admission at entry and at HH/ED discharge. Methods: Predictive modeling of mortality and in-hospital admission was done in 2 different scenarios: at entry into the HH/ED program and at discharge, from January 2009 to December 2015. Multisource predictive variables, including standard clinical data, patients' functional features, and population health risk assessment, were considered. Results: We studied 1925 HH/ED patients by applying a random forest classifier, as it showed the best performance. Average results of the area under the receiver operating characteristic curve (AUROC; sensitivity/specificity) for the prediction of mortality were 0.88 (0.81/0.76) and 0.89 (0.81/0.81) at entry and at home hospitalization discharge, respectively; the AUROC (sensitivity/specificity) values for in-hospital admission were 0.71 (0.67/0.64) and 0.70 (0.71/0.61) at entry and at home hospitalization discharge, respectively. Conclusions: The results showed potential for feeding clinical decision support systems aimed at supporting health professionals for inclusion of candidates into the HH/ED program, and have the capacity to guide transitions toward community-based care at HH discharge

Current State-of-the-Art Therapy for Malignant Pleural Mesothelioma and Future Options Centered on Immunotherapy

Biomarkers; Immunotherapy; Malignant pleural mesotheliomaBiomarcadores; Inmunoterapia; Mesotelioma pleural malignoBiomarcadors; Immunoteràpia; Mesotelioma pleural maligneMalignant pleural mesothelioma (MPM) is a locally aggressive disease related to asbestos exposure with a median survival for untreated patients of 4–8 months. The combination of chemotherapy based on platinum and antifolate is the standard treatment, and the addition of bevacizumab adds two months to median survival. Recently, in first-line treatment, immunotherapy combining nivolumab with ipilimumab has been shown to be superior to chemotherapy in the CheckMate-743 study in terms of overall survival (18.1 months), leading to its approval by the FDA and EMA. The positive results of this study represent a new standard of treatment for patients with MPM; however, not all patients will benefit from immunotherapy treatment. In an effort to improve the selection of patient candidates for immunotherapy for different tumors, biomarkers that have been associated with a greater possibility of response to treatment have been described. MPM is a type of tumor with low mutational load and neo-antigens, making it a relatively non-immunogenic tumor for T cells and possibly less susceptible to responding to immunotherapy. Different retrospective studies have shown that PD-L1 expression occurs in 20–40% of patients and is associated with a poor prognosis; however, the predictive value of PD-L1 in response to immunotherapy has not been confirmed. The purpose of this work is to review the state of the art of MPM treatment in the year 2023, focusing on the efficacy results of first-line or subsequent immunotherapy studies on patients with MPM and possible chemo-immunotherapy combination strategies. Additionally, potential biomarkers of response to immunotherapy will be reviewed, such as histology, PD-L1, lymphocyte populations, and TMB

Hepatic Rupture as the Initial Presentation of an EGFR-Mutated Lung Adenocarcinoma: A Case Report

Metastatic hepatic rupture; Non-small cell lung carcinoma; Tyrosine kinase inhibitorRuptura hepática metastásica; Carcinoma de pulmón de células no pequeñas; Inhibidor de la tirosina quinasaRuptura hepàtica metastàtica; Carcinoma de pulmó de cèl·lules no petites; Inhibidor de la tirosina quinasaHepatic rupture is a rare complication of solid tumor malignancies, notably in lung adenocarcinomas, and carries an extremely poor overall prognosis. Epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma predict benefit with tyrosine kinase inhibitors (TKIs). This case report describes a female patient who presented with a metastatic hepatic rupture and was subsequently diagnosed with EGFR-mutated lung adenocarcinoma. The tumor had an impressive response to TKI inhibitor treatment, reversing her extremely poor, short-term prognosis. We believe this unique case sheds light on the treatment management of hepatic ruptures and supports the high response rate seen with TKIs in EGFR-mutated lung cancers, regardless of the patient’s performance status

A state-of-the-art guide about the effects of sterilization processes on 3D-printed materials for surgical planning and medical applications: a comparative study

Surgeons use different medical devices in the surgery, such as patient-specific anatomical models, cutting and positioning guides, or implants. These devices must be sterilized before being used in the operation room. There are many sterilization processes available, with autoclave, hydrogen peroxide, and ethylene oxide being the most common in hospital settings. Each method has both advantages and disadvantages in terms of mechanics, chemical interaction, and post-treatment accuracy. The aim of the present study is to evaluate the dimensional and mechanical effect of the most commonly used sterilization techniques available in clinical settings, i.e., Autoclave 121, Autoclave 134, and hydrogen peroxide (HPO), on 11 of the most used 3D-printed materials fabricated using additive manufacturing technologies. The results showed that the temperature (depending on the sterilization method) and the exposure time to that temperature influence not only the mechanical behavior but also the original dimensioning planned on the 3D model. Therefore, HPO is a better overall option for most of the materials evaluated. Finally, based on the results of the study, a recommendation guide on sterilization methods per material, technology, and clinical application is presented.The research described in this paper was partially funded by the project named QuirofAM (Exp. COMRDI16-1-0011) and funded by ACCIÓ from the Catalan government and ERDF from European Union.Postprint (published version

Assessment of the psychosocial and economic impact according to sex in non-small cell lung cancer patients: an exploratory longitudinal study

Background: Little is known about the impact of sex on lung cancer patients from the psychological, economic and social perspectives. This study was designed to explore the psychosocial and economic impact according to sex of metastatic non-small cell lung cancer (mNSCLC) in patients and caregivers. Methods: Exploratory study of two cohorts of patients starting first-line treatment for mNSCLC. The following questionnaires were administered at baseline, 4 months later and following the first and second disease progression: APGAR, relationship impact scale, DUKE-UNC scale, economic impact in patients and caregiver, and Zarit scale. It was planned to include 1250 patients to get an 80% possibility of detecting as significant (p < 0.05) effect sizes less than 0.19 between men and women. Univariate comparisons were made between the tests applied to men and women. Overall survival was estimated with Kaplan–Meier method. Cox analyses were done to estimate hazard ratios (HRs) with 95% CI. Results: 333 patients were included. Most families reported to continue being functional despite the lung cancer diagnosis. Regardless of sex, they did not perceive changes in their partner relationship. Most patients felt their social support was normal. Roughly 25% of people reported a worsening in their economic situation, without remarkable differences by sex. Statistically significant differences were found between both groups regarding the caregiver’s relationship to the patient (more parents were the caregiver in females than in males, p < 0.0001) and the caregiver’s employment situation (more employed caregivers in females) (p < 0.0001). Most caregivers of both sexes considered that taking care of their relative did not pose a significant burden. Conclusions: This study provides a preliminary insight into sex-related characteristics in the management of advanced NSCLC and its impact on the emotional, social and economic burden of patients and their caregivers, and recall the high priority of researching in cancer from a sex perspective. Nevertheless, due to the low recruitment rate and the relevant loss of patients during the follow-up, it was difficult to find differences by sex. Trial registration: ClinicalTrials.gov identifier: NCT02336061. Ethics committee: Comité Ético de Investigación Clínica del Hospital Clínic de Barcelona, Spain. Reference number: HCB/2014/0705