Indicadores de progreso de aprendizaje en lectura en el contexto del modelo de respuesta a la intervención

Tesis con Mención InternacionalEl modelo de Respuesta a la Intervención (RtI) es un sistema multinivel de prevención, identificación e intervención temprana de las Dificultades Específicas de Aprendizaje (DEA). La presente tesis doctoral tiene como objetivo fundamental evaluar los efectos de la implementación del Nivel 2 del modelo RtI en el área de lectura en la Comunidad Autónoma de Canarias, centrándose en los cursos de Educación Infantil (EI) 5 años y en 1º de Educación Primaria (EP). Para ello, se llevaron a cabo dos estudios. En el Estudio 1 se diseñó el IPAL (Indicadores de Progreso del Aprendizaje en Lectura) una herramienta compuesta por Medidas Basadas en el Currículo (MBC), alineadas con el currículo de Canarias, disponibles en tres formas paralelas (i.e., noviembre, febrero y mayo). En EI 5 años el IPAL está compuesto por medidas de conocimiento alfabético, conciencia fonológica, vocabulario y conocimientos acerca del lenguaje escrito. En 1º de EP, el IPAL está compuesto por medidas de conocimiento alfabético, conciencia fonémica, fluidez en lectura de pseudopalabras, fluidez en lectura de textos y comprensión de frases. En ambos cursos se calculó una puntuación global para la detección del riesgo en noviembre, febrero y mayo. Con el objetivo de estandarizar el IPAL y analizar sus propiedades psicométricas, se contó con una muestra aproximada de 180 alumnos por curso, escolarizados en tres colegios públicos y uno concertado de Tenerife. En el Estudio 2 se evaluó la efectividad del Nivel 2 del modelo RtI en lectura en siete islas de la Comunidad Autónoma de Canarias. La intervención mostró ser efectiva para mejorar el rendimiento lector global de los alumnos, aunque este efecto fue mayor en EI 5 años y en los grupos que recibieron la intervención con alta fidelidad.Response to Intervention (RtI) model is a multi-tier approach to the early prevention, identification, and intervention of students at risk of Specific Learning Disabilities (SLD). For RtI implementation to be successful, the following essential components must be implemented (NCRTI, 2010): (a) multi-level system for preventing school failure; (b) data-based decision making; (c) Universal Screening; and (d) Progress Monitoring. This dissertation aims to evaluate the effects of a Tier 2 implementation on student reading outcomes in Kindergarten and First grade. To meet this goal, two studies were conducted in the Canary Islands, Spain. Study 1 focuses on the design and validation of the three parallel forms that composed IPAL [Indicadores de Progreso de Aprendizaje en Lectura] a curriculum-based measurement (CBM) aligned with the Canary Island curriculum. In Kindergarten, IPAL includes the following CBM: Alphabetic Knowledge, Phonological Awareness, Concepts about Print, and Riddles. In First grade it includes Alphabetic Knowledge, Phonological Awareness, Concepts about Print, Non-sense Words Fluency, Maze Sentences, and Oral Reading Fluency. A composite score was calculated for screening purposes in the three parallel forms (i.e., fall, winter, and spring) of each grade. A sample of approximately 180 students from each grade participated in the standardization of IPAL. The students were enrolled in three public schools and one direct grant school. Study 2 examined the effectiveness of a Tier 2 reading intervention implemented in the seven Canary Islands. Results indicated that intervention groups have significantly higher overall reading outcomes. Nevertheless, the intervention effect was greater in Kindergarten and high-fidelity groups

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Psicothema

Resumen tomado de la publicaciónPrograma web para la enseñanza de la escritura: perfiles de creencias y satisfacción de maestros en formación. Antecedentes: para garantizar experiencias de formación en línea exitosas debe tenerse en consideración la satisfacción de los maestros/as en formación con la formación en línea. Este estudio tiene como objetivo determinar si los perfiles de creencias de los futuros maestros/as influyen en su satisfacción con una formación web para la enseñanza de la escritura. Método: para alcanzar este objetivo se llevaron a cabo dos análisis: (1) validación de una escala de satisfacción a través de un Análisis Factorial Confirmatorio, y (2) MANOVA con variables independientes inter-sujetos, perfiles de creencias grupales (i.e., Perfil Ecléctico, Perfil Sociocultural y Perfil Persona-Ambiente) y como variables dependientes las cinco dimensiones de la escala de satisfacción. Resultados: los resultados mostraron altos índices de satisfacción con la formación web en todos los grupos. Sin embargo, se encontraron diferencias significativas en las calificaciones de satisfacción entre los perfiles de creencias. Conclusiones: por último, en la discusión se destacan implicaciones educativas para el desarrollo profesional de los futuros maestros/as.Universidad de Oviedo. Biblioteca de Psicología; Plaza Feijoo, s/n.; 33003 Oviedo; Tel. +34985104146; Fax +34985104126; [email protected]