Adquisición de habilidades prácticas en la carrera de Medicina : Utilización de estrategias de simulación en la enseñanza de Medicina Interna I. Facultad de Ciencias Médicas, Universidad Nacional de La Plata

La formación de profesionales de la salud es un proceso complejo que requiere que el estudiante adquiera conocimientos científicos, desarrolle habilidades y destrezas prácticas, valores, actitudes y juicio clínico, que le permitan solucionar, en su práctica profesional, problemas de salud individual y colectiva. La enseñanza de la asignatura Medicina Interna ha tenido siempre en nuestra Facultad un perfil eminentemente teórico, positivista, centrado en la adquisición de contenidos. Se considera que el profesor es el que sabe, siendo el alumno, un mero receptor pasivo. Predominan las clases expositivas, se acumulan datos y temas con un aprendizaje memorístico, dejando de lado otras habilidades como la formación en valores y el desarrollo de un pensamiento crítico. La necesidad de cumplir con la Resolución 1314 del Ministerio de Educación de la Nación, que establece los estándares que deben alcanzarse para la acreditación de las carreras de Medicina hace imperioso introducir en los planes de estudio nuevas estrategias de enseñanza que permitan incorporar distintas habilidades cognitivas, procedimentales y actitudinales Este trabajo se propone la implementación de una nueva metodología de enseñanza, que consiste en la realización de actividades de integración al finalizar cada módulo de la asignatura Medicina Interna I. Estas tendrán como base, la creación de un escenario simulado, donde se planteará un caso clínico. Allí los alumnos aplicarán los conocimientos teóricos adquiridos, confeccionando la historia clínica, realizando el examen físico, elaborando una ruta diagnóstica y por último proponiendo una terapéutica adecuada. Luego de cada actividad se realizará una reunión de reflexión donde se discutirá lo ocurrido en la situación problemática simulada, resaltando los aciertos y analizando los errores cometidos. A través de la enseñanza con simuladores el alumno tendrá un rol más protagónico y directo en su aprendizaje, adquiriendo habilidades y destrezas prácticas y comunicacionales, mejorando el trabajo en equipo y la relación médico-paciente, factores todos que incrementarán la seguridad global de los enfermos.Facultad de Ciencias Médica

Investigation of the interaction of some astrobiological molecules with the surface of a graphite (0001) substrate. Application to the CO, HCN, H2O and H2CO molecules

Detailed semi-empirical interaction potential calculations are performed to determine the potential energy surface experienced by the molecules CO, HCN, H2O and H2CO, when adsorbed on the basal plane (0001) of graphite at low temperature. The potential energy surface is used to find the equilibrium site and configuration of a molecule on the surface and its corresponding adsorption energy. The diffusion constant associated with molecular surface diffusion is calculated for each molecule.Comment: 15 pages, 3 figure

Lifetime of a target in the presence of N independent walkers

We study the survival probability of an immobile target in presence of N independent diffusing walkers. We address the problem of the Mean Target Lifetime and its dependence on the number and initial distribution of the walkers when the trapping is perfect or imperfect. We consider the diffusion on lattices and in the continuous space and we address the bulk limit corresponding to a density of diffusing particles and only one isolated trap. Also, we use intermittent motion for optimization of search strategies.Comment: 18 pages, 5 figures. Accepted for publication in Physica A

Experiencia de elaboración de un examen clínico objetivo estructurado (ECOE) en el hospital de simulación clínica de la Facultad de Ciencias Médicas (UNLP): perspectiva de los docentes y alumnos participantes

El equipo docente del Hospital de Simulación Clínica (FCM, UNLP) realizó un Examen Clínico Objetivo Estructurado (ECOE) para evaluar la adquisición de competencias educativas. Inicialmente con propósitos formativos. Objetivos: con este objetivo se realizó un primer taller en el que se convocó a los docentes de la Facultad que desarrollaban actividades de simulación y a aquellos acreditados a través del Curso Básico en Simulación Clínica que dicta la Facultad.Facultad de Ciencias Médica

Entrenamiento Basado en Simulación (EBS) en la Facultad de Ciencias Médicas (UNLP): estrategias didácticas

La puesta en marcha de la utilización sistemática y continua del Laboratorio de Habilidades y Destrezas a lo largo del ciclo clínico de la Carrera de Medicina y durante la Práctica Final Obligatoria (PFO), conlleva a la necesidad de capacitar al personal docente de las cátedras del ciclo clínico en estrategias de enseñanza con modelos de simulación.Facultad de Ciencias Médica

Metabolic and hormonal response to intermittent high-intensity and continuous moderate intensity exercise in individuals with type 1 diabetes: a randomised crossover study.

AIMS/HYPOTHESIS To investigate exercise-related fuel metabolism in intermittent high-intensity (IHE) and continuous moderate intensity (CONT) exercise in individuals with type 1 diabetes mellitus. METHODS In a prospective randomised open-label cross-over trial twelve male individuals with well-controlled type 1 diabetes underwent a 90 min iso-energetic cycling session at 50% maximal oxygen consumption ([Formula: see text]), with (IHE) or without (CONT) interspersed 10 s sprints every 10 min without insulin adaptation. Euglycaemia was maintained using oral (13)C-labelled glucose. (13)C Magnetic resonance spectroscopy (MRS) served to quantify hepatocellular and intramyocellular glycogen. Measurements of glucose kinetics (stable isotopes), hormones and metabolites complemented the investigation. RESULTS Glucose and insulin levels were comparable between interventions. Exogenous glucose requirements during the last 30 min of exercise were significantly lower in IHE (p = 0.02). Hepatic glucose output did not differ significantly between interventions, but glucose disposal was significantly lower in IHE (p < 0.05). There was no significant difference in glycogen consumption. Growth hormone, catecholamine and lactate levels were significantly higher in IHE (p < 0.05). CONCLUSIONS/INTERPRETATION IHE in individuals with type 1 diabetes without insulin adaptation reduced exogenous glucose requirements compared with CONT. The difference was not related to increased hepatic glucose output, nor to enhanced muscle glycogen utilisation, but to decreased glucose uptake. The lower glucose disposal in IHE implies a shift towards consumption of alternative substrates. These findings indicate a high flexibility of exercise-related fuel metabolism in type 1 diabetes, and point towards a novel and potentially beneficial role of IHE in these individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT02068638 FUNDING: Swiss National Science Foundation (grant number 320030_149321/) and R&A Scherbarth Foundation (Switzerland)

Programa de capacitación continua en simulación clínica: resultados de la formación sistemática de docentes en la Facultad de Ciencias Médicas (UNLP) durante el bienio 2014-2015

A partir de la construcción del Hospital de Simulación Clínica en el contexto institucional de la Facultad, y del objetivo de incorporar progresivamente la simulación como estrategia didáctica, tanto a nivel de la enseñanza de grado como de postgrado, se implementó un Curso introductorio a la Enseñanza Basada en Simulación (EBS), destinado a los docentes de la institución.Facultad de Ciencias Médica

Effect of Direct Seeding Mulch-Based Systems on Soil Carbon Storage and Macrofauna in Central Brazil

Soils represent a large carbon pool, approximately 1500 Gt, equivalent to almost three times the quantity stored in terrestrial biomass and twice the amount stored in the atmosphere. Any modification of land-use or land management can induce variations in soil carbon stocks, even in agricultural systems that are perceived to be in a steady state. These modifications also alter soil macrofauna that is known to affect soil carbon dynamics. Direct seeding Mulch-based Cropping (DMC) systems with two crops per year without soil tillage have widely been adopted over the last 10 to 15 years in the Cerrado (central region) of Brazil. They are replacing the traditional soybean monocropping with fallow under conventional tillage (CT). The objective of this study was to examine how DMC practices affect soil organic carbon (SOC) dynamics and macrofauna (Rio Verde, Goias State). The approach was to determine soil C stocks and macrofauna in five fields under DMC aged 1, 5, 7, 11 and 13 years. In order to compare DMC systems with the native system of the region and previous land-use, a situation under native Cerrado (tree-savanna like vegetation) and a field conducted traditionally (CT) were also studied. Soil C stocks were calculated for the 0-10 and 0-40 cm soil depth and also for the first 400 kg m-2 of soil to compare the same amount of soil and to suppress the potential artefact of soil compaction when sample is based on fix layer depth. Soil macrofauna was hand-sorted from soil monoliths (30 cm depth, TSBF method). In our study, the annual rate of carbon storage was equal to ca. 1.6 MgC ha-1, which is in the range of values measured for DMC in different areas of Brazil, i.e., 0.4 to 1.7 MgC ha-1 with the highest rates obtained in the Cerrado region. Compared to natural vegetation, soil macrofauna in cropped systems was strongly modified. In CT, biomass and density were very low and much lower than in DMC systems. With increasing age of DMC, total macrofauna density increased and then decreased while total macrofauna biomass continuously increased due to a strong increase in Coleoptera larvae biomass. These modifications in macrofauna density and biomass are discussed with regard to soil SOC dynamics (decomposition, mineralization and physical protection)

Fault-tolerant aggregation: Flow-Updating meets Mass-Distribution

Flow-Updating (FU) is a fault-tolerant technique that has proved to be efficient in practice for the distributed computation of aggregate functions in communication networks where individual processors do not have access to global information. Previous distributed aggregation protocols, based on repeated sharing of input values (or mass) among processors, sometimes called Mass-Distribution (MD) protocols, are not resilient to communication failures (or message loss) because such failures yield a loss of mass. In this paper, we present a protocol which we call Mass-Distribution with Flow-Updating (MDFU). We obtain MDFU by applying FU techniques to classic MD. We analyze the convergence time of MDFU showing that stochastic message loss produces low overhead. This is the first convergence proof of an FU-based algorithm. We evaluate MDFU experimentally, comparing it with previous MD and FU protocols, and verifying the behavior predicted by the analysis. Finally, given that MDFU incurs a fixed deviation proportional to the message-loss rate, we adjust the accuracy of MDFU heuristically in a new protocol called MDFU with Linear Prediction (MDFU-LP). The evaluation shows that both MDFU and MDFU-LP behave very well in practice, even under high rates of message loss and even changing the input values dynamically.- A preliminary version of this work appeared in [2]. This work was partially supported by the National Science Foundation (CNS-1408782, IIS-1247750); the National Institutes of Health (CA198952-01); EMC, Inc.; Pace University Seidenberg School of CSIS; and by Project "Coral - Sustainable Ocean Exploitation: Tools and Sensors/NORTE-01-0145-FEDER-000036" financed by the North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF).info:eu-repo/semantics/publishedVersio