Student's Inventory of Professionalism (SIP): A tool to assess attitudes towards professional development based on palliative care undergraduate education

Introduction: Quality medical education, centered on a patient's needs, is crucial to develop the health professionals that our society requires. Research suggests a strong contribution of palliative care education to professionalism. The aim of this study was to design and validate a self-report inventory to measure student's professional development. Method: Sequential exploratory strategy mixed method. The inventory is built based on the themes that emerged from the analysis of four qualitative studies about nursing and medical students' perceptions related to palliative care teaching interventions (see Ballesteros et al. 2014, Centeno et al. 2014 and 2017, Rojí et al. 2017). The structure and psychometrics of the inventory obtained is tested in two different surveys with two different groups of medical students. Inventory reliability and construct validity are tested in the first survey group. To verify the inventory structure, a confirmatory factor analysis is performed in a second survey group. Results: The inventory has 33 items and seven dimensions: a holistic approach, caring for and understanding the patient, personal growth, teamwork, decision-making, patient evaluation, and being a health care professional. Cronbach's-alpha was 0.73-0.84 in all seven domains, ICC: 0.95. The confirmatory factor analysis comparative fit index (CFI) was 1 with a standardized root mean square Index 0.088 (SRMR) and obtained a 0.99 goodness-of-fit R-square coefficient. Conclusions: this new inventory is grounded on student's palliative care teaching experiences and seems to be valid to assess student's professional development

Impact of HF radar current gap-filling methodologies on the Lagrangian assessment of coastal dynamics

High-frequency radar, HFR, is a cost-effective monitoring technique that allows us to obtain high-resolution continuous surface currents, providing new insights for understanding small-scale transport processes in the coastal ocean. In the last years, the use of Lagrangian metrics to study mixing and transport properties has been growing in importance. A common condition among all the Lagrangian techniques is that complete spatial and temporal velocity data are required to compute trajectories of virtual particles in the flow. However, hardware or software failures in the HFR system can compromise the availability of data, resulting in incomplete spatial coverage fields or periods without data. In this regard, several methods have been widely used to fill spatiotemporal gaps in HFR measurements. Despite the growing relevance of these systems there are still many open questions concerning the reliability of gap-filling methods for the Lagrangian assessment of coastal ocean dynamics. In this paper, we first develop a new methodology to reconstruct HFR velocity fields based on self-organizing maps (SOMs). Then, a comparative analysis of this method with other available gap-filling techniques is performed, i.e., open-boundary modal analysis (OMA) and data interpolating empirical orthogonal functions (DINEOFs). The performance of each approach is quantified in the Lagrangian frame through the computation of finite-size Lyapunov exponents, Lagrangian coherent structures and residence times. We determine the limit of applicability of each method regarding four experiments based on the typical temporal and spatial gap distributions observed in HFR systems unveiled by a K-means clustering analysis. Our results show that even when a large number of data are missing, the Lagrangian diagnoses still give an accurate description of oceanic transport properties.</p

Marco de Competencias Básicas de Investigación para Clínicos de Cuidados Paliativos RESPACC

El proyecto financiado por RESPACC ERASMUS+ identificará las competencias de investigación básicas para clínicos de cuidados paliativos. La noción de competencia se refiere a la capacidad de aplicar conocimientos, destrezas y habilidades para realizar con éxito una actividad en el trabajo. Nos enfocamos en mejorar las competencias de investigación básicas en clínicos de equipos multidisciplinarios de cuidados paliativos, tanto a nivel de equipo como individual. Algunas competencias podrían considerarse imprescindibles para realizar una investigación en equipo, pero puede que no sean imprescindibles para todos los miembros del equipo, porque podría ser suficiente que sólo alguien del equipo cuente con dichas competencias para que se lleve a cabo la investigación. OBJETIVO: Identificar un conjunto de competencias de investigación básicas, necesarias para que el equipo paliativo multidisciplinario pueda llevar a cabo un estudio clínico exitoso

Coastal current convergence structures in the Bay of Biscay from optimized high-frequency radar and satellite data

International audienceThe southeastern Bay of Biscay has been described as a “dead end” for floating marine litter, often accumulatingalong small-scale linear streaks. Coastal Current Convergence Structures (CCS), often associated with verticalmotions at river plume edges, estuarine fronts, or other physical processes, can be at the origin of the accumulation.Understanding the formation of CCS and their role in the transport of marine litter is essential to betterquantify and to help mitigate marine litter pollution. The Lagrangian framework, used to estimate the absolutedispersion, and the finite-size Lyapunov exponents (FSLE), have proved very effective for identifying CCS in thecurrent velocity field. However, the quality of CCS identification depends strongly on the Eulerian fields. Twosurface current velocity data sets were used in the analysis: the remotely sensed velocities from the EuskOOSHigh-Frequency Radar (HFR) network and velocities from three-dimensional model outputs. They were complementedby drifting buoy velocity measurements. An optimization method, involving the fusion of driftingbuoys and HFR velocities is proposed to better reconstruct the fine-scale structure of the current velocity field.Merging these two sources of velocity data reduced the mean Lagrangian error and the Root Mean Square Error(RMSE) by 50 % and 30 % respectively, significantly improving velocity reconstruction. FSLE ridgelines obtainedfrom the Lagrangian analysis of optimized velocities were compared with remotely sensed concentrations ofChlorophyll-a. It was shown that ridgelines control the spatial distribution of phytoplankton. They fundamentally represent the CCS which can potentially affect marine litter aggregation. Analysis of the absolute dispersionrevealed large stirring in the alongshore direction which was also confirmed by spatial distribution of FSLEridgelines. The alignment between FSLE ridgelines and patterns of high Chlorophyll-a concentration wasobserved, often determining the limits of river plume expansion in the study area

Remote sensing insight into eddy-induced cross-shelf transports in the Bay of Biscay

Trabajo presentado en la American Geophysical Union Meetings, celebrada en San Francisco (United States), del 12 al 16 de diciembre de 2016Peer Reviewe

Student's Inventory of Professionalism (SIP): A tool to assess attitudes towards professional development based on palliative care undergraduate education

Introduction: Quality medical education, centered on a patient's needs, is crucial to develop the health professionals that our society requires. Research suggests a strong contribution of palliative care education to professionalism. The aim of this study was to design and validate a self-report inventory to measure student's professional development. Method: Sequential exploratory strategy mixed method. The inventory is built based on the themes that emerged from the analysis of four qualitative studies about nursing and medical students' perceptions related to palliative care teaching interventions (see Ballesteros et al. 2014, Centeno et al. 2014 and 2017, Rojí et al. 2017). The structure and psychometrics of the inventory obtained is tested in two different surveys with two different groups of medical students. Inventory reliability and construct validity are tested in the first survey group. To verify the inventory structure, a confirmatory factor analysis is performed in a second survey group. Results: The inventory has 33 items and seven dimensions: a holistic approach, caring for and understanding the patient, personal growth, teamwork, decision-making, patient evaluation, and being a health care professional. Cronbach's-alpha was 0.73-0.84 in all seven domains, ICC: 0.95. The confirmatory factor analysis comparative fit index (CFI) was 1 with a standardized root mean square Index 0.088 (SRMR) and obtained a 0.99 goodness-of-fit R-square coefficient. Conclusions: this new inventory is grounded on student's palliative care teaching experiences and seems to be valid to assess student's professional development

How to measure the effects and potential adverse events of palliative sedation? An integrative review

Background: Palliative sedation is the monitored use of medications intended to relieve refractory suffering. The assessment of palliative sedation has been focused on the assess of the level of consciousness but a more comprehensive approach to assessment is needed. Aim: To understand how the potential effects and possible adverse events of palliative sedation in Palliative Care patients are measured. Design: Integrative review of most recent empirical research. Data sources: Cochrane Library, Embase, Medline, PubMed, and CINAHL were searched (2010–2020) using the terms sedation, palliative care, terminal care, assessment. Limits included studies in English and adults. Inclusion criteria were: scientific assessment papers, effects and complications of palliative sedation; patients with incurable illness. Results: Out of 588 titles, 26 fulfilled inclusion criteria. The Discomfort Scale-Dementia of Alzheimer Type and Patient Comfort Score were used to assess comfort. The Richmond Agitation-Sedation Scale and The Ramsay Sedation Scale are the most used to measure its effect. Refractory symptoms were assessed through multi-symptom or specific scales; except for psychological or existential distress. Delirium was assessed using the Memorial Delirium Assessment Scale and pain through the Critical Care Pain Observation Tool. The use of technical approaches to monitor effects is upcoming. There is lack of measurement of possible adverse events and variability in timing measurement. Conclusions: There are palliative care validated instruments to assess the sedation effect but this review shows the need for a more standardized approach when assessing it. Instruments should be used within an experienced and trained expert, providing a holistic assessment