TalentoEDU: teacher training for educational attention on giftedness

Se presenta TalentoEDU, Proyecto de Innovación que surge ante las necesidades formativas de los futuros docentes respecto al alumnado con Alta Capacidad Intelectual. Este proyecto que se ha insertado en algunas de las asignaturas que conforman el Plan de Estudios de los Títulos de Grado que se imparten en el Centro de Magisterio “Sagrado Corazón”, adscrito a la Universidad de Córdoba. Pretende promover competencias para la atención a la diversidad en este ámbito. Los resultados de la experiencia indican que TalentoEDU ha contribuido a dicha formación, dada la satisfacción mostrada por los universitarios.This paper frames TalentoEDU Innovation Project that emerges from the academic needs of future teachers considering High Ability students. This project has been included in some of the subjects within the study plan of the Bachelor Degrees belonging to “Sagrado Corazón” teacher-training center, attached to the University of Cordoba. It aims at promoting skills related to attention to diversity in this field. The results of this experience suggest that TalentoEDU has contributed to the training on this field, according to the satisfaction that our college students showed

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Digitus: computer application for the fingerspelling practice

La dactilología es parte integrante de la Lengua de Signos y es necesario que se utilicen nuevas herramientas informáticas que faciliten a los estudiantes su aprendizaje práctico. Debido a ello, se ha diseñado Dígitus, una aplicación informática para la práctica de la dactilología. Dígitus permite el aprendizaje autónomo de los estudiantes de Magisterio que cursan asignaturas de Lengua de Signos Española que se imparten en el Centro de Magisterio Sagrado Corazón en los Grados en Educación Infantil y Educación Primaria. Dígitus puede ser utilizada por cuatro tipos de usuarios (público, estudiante, docente y administrador) con diferentes privilegios respecto al control de la aplicación y está compuesta por varios módulos: tutorial, cuestionarios, traductor dactilológico y ayuda. Los resultados de su implementación han sido satisfactorios respecto a los aprendizajes adquiridos por el alumnado, así como a la satisfacción manifestada en relación con el uso de la aplicación.Fingerspelling or Dactylology is an integral part of Sign Language and it is necessary to use new computer tools to facilitate the practical learning of the students. Because of this, Dígitus has been designed, a computer application for the practice of the fingerspelling. Dígitus allows the autonomous learning of students of Teaching who study Spanish Sign Language courses that are taught in “Centro de Magisterio Sagrado Corazón” at Córdoba University, in the Grades of Early Childhood Education and Primary Education. Dígitus can be used by four types of users (public, student, teacher and administrator) with different privileges regarding the control of the application and is composed of several modules: tutorial, questionnaires, digital translator and help. The results of its implementation have been satisfactory with respect to the learning acquired by the students, as well as to the satisfaction manifested in relation to the use of the application

Dígitus: aplicación informática para la práctica de la dactilología

Fingerspelling or Dactylology is an integral part of Sign Language and it is necessary to use new computer tools to facilitate the practical learning of the students. Because of this, Dígitus has been designed, a computer application for the practice of the fingerspelling. Dígitus allows the autonomous learning of students of Teaching who study Spanish Sign Language courses that are taught in “Centro de Magisterio Sagrado Corazón” at Córdoba University, in the Grades of Early Childhood Education and Primary Education. Dígitus can be used by four types of users (public, student, teacher and administrator) with different privileges regarding the control of the application and is composed of several modules: tutorial, questionnaires, digital translator and help. The results of its implementation have been satisfactory with respect to the learning acquired by the students, as well as to the satisfaction manifested in relation to the use of the application.La dactilología es parte integrante de la Lengua de Signos y es necesario que se utilicen nuevas herramientas informáticas que faciliten a los estudiantes su aprendizaje práctico. Debido a ello, se ha diseñado Dígitus, una aplicación informática para la práctica de la dactilología. Dígitus permite el aprendizaje autónomo de los estudiantes de Magisterio que cursan asignaturas de Lengua de Signos Española que se imparten en el Centro de Magisterio Sagrado Corazón en los Grados en Educación Infantil y Educación Primaria. Dígitus puede ser utilizada por cuatro tipos de usuarios (público, estudiante, docente y administrador) con diferentes privilegios respecto al control de la aplicación y está compuesta por varios módulos: tutorial, cuestionarios, traductor dactilológico y ayuda. Los resultados de su implementación han sido satisfactorios respecto a los aprendizajes adquiridos por el alumnado, así como a la satisfacción manifestada en relación con el uso de la aplicación

TALENTOEDU: FORMACIÓN DE DOCENTES PARA LA ATENCIÓN EDUCATIVA A LA ALTA CAPACIDAD INTELECTUAL

This paper frames TalentoEDU Innovation Project that emerges from the academic needs of future teachers considering High Ability students. This project has been included in some of the subjects within the study plan of the Bachelor Degrees belonging to “Sagrado Corazón” teacher-training center, attached to the University of Cordoba. It aims at promoting skills related to attention to diversity in this field. The results of this experience suggest that TalentoEDU has contributed to the training on this field, according to the satisfaction that our college students showed.Se presenta TalentoEDU, Proyecto de Innovación que surge ante las necesidades formativas de los futuros docentes respecto al alumnado con Alta Capacidad Intelectual. Este proyecto que se ha insertado en algunas de las asignaturas que conforman el Plan de Estudios de los Títulos de Grado que se imparten en el Centro de Magisterio “Sagrado Corazón”, adscrito a la Universidad de Córdoba. Pretende promover competencias para la atención a la diversidad en este ámbito. Los resultados de la experiencia indican que TalentoEDU ha contribuido a dicha formación, dada la satisfacción mostrada por los universitarios

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)