Aprendizaje Basado en Problemas y satisfacción de los estudiantes de Enfermería.

Introduction: The objective of this research was used to evaluate the effect of Problem-Based Learning in the Nursing students' satisfaction.Material and Methodology: A descriptive transversal study. The task was conducted by 134 second-year Nursing students at the University of Valladolid. Scale satisfaction of the University of Colima (Mexico) was administered under PBL implementation.SPSS was used for data analysis and the content analysis on the participants’ responses.Results: Overall the participants described the contents of the clinical case as engaging, effective, practical and varied. 55% of students revealed their preference for traditional methodology compared to PBL. 78% liked this new methodology. Students’ perception of active learning through PBL showed a high level of motivation and satisfaction in regards to content, the tutorial process, the tutor and the students’ role; whereas the time assigned and the major workload is what least satisfied them. Nevertheless, satisfaction in general was high.Conclusion: The PBL methodology reported successful results according to nursing students’ opinions. It was reported that PBL improves communication and the students’ feedback is implemented. There is a correlation between the teaching and learning process not only in evaluation assessment but also in personal treatment in respect to the benefits to each other.Introducción: El objetivo de esta investigación fue determinar el grado de satisfacción de  los  estudiantes de Enfermería  después de utilizar la metodología Aprendizaje Basado en Problemas. Material y métodos: Estudio descriptivo y transversal. La muestra estuvo formada por 134 estudiantes de 2º de Grado de Enfermería de la Universidad de Valladolid. Después de la implementación de ABP  se administró la escala de satisfacción de la Universidad de la Colima (México). Para el análisis de datos se utilizó el programa SPSS y  se realizó el análisis del contenido de las justificaciones de las respuestas.Resultados: A los estudiantes, los contenidos de los casos clínicos  les resultaron  interesantes, prácticos, útiles y variados. Un 55% de los discentes prefiere la metodología tradicional frente al Aprendizaje Basado en Problemas  y  a un 78%  le gustó esta nueva metodología. El aprendizaje activo a través de Aprendizaje Basado en Problemas, supuso una alta motivación y una elevada satisfacción percibida por los estudiantes  respecto a los contenidos,  el proceso tutorial, y los roles del  tutor y  del alumno;  mientras que el tiempo asignado  y  la mayor carga de trabajo  es lo que menos les satisface, aunque la satisfacción en general  fue elevada.Conclusiones: Utilizar una metodología ABP aporta una elevada satisfacción en los estudiantes de Enfermería. Resulta favorable la retroalimentación constante en el proceso de enseñanza-aprendizaje, tanto en sesiones de evaluación, como en el trato personal y se mejora la comunicación en el aula.

Índice de perfusión en una reanimación con riesgo biológico, como medida de mala tolerancia fisiológica

Introduction: Perform a cardiopulmonary resuscitation requires technical knowledge and minimal physical conditions. Perform this resuscitation a team of individual protection against biological risks level D placed increases the overexertion that encourage rescuers are subjected.The objective of this study is to prove the existence of a pattern of poor physiological tolerance to the use of personal protective equipment level D, category 4-5-6B for action in incidents with biological risk objectified by measuring the perfusion index before and after a simulated resuscitation.Material and methods: We have performed a quasiexperimental not controlled on 96 volunteers chosen through a random sampling, stratified by sex, level of education and professional category, medical and nursing students and professionals doctors and nurses.A decision of the perfusion index before performing the resuscitation and other simulated after resuscitation.Results: A 15% of the volunteers presented a perfusion index lower back to baseline, which translates into a situation of peripheral vasoconstriction after the completion of the physical exercise that involved the clinical case, when expected was a vasodilatation to Increase perfusion.Conclussion: Extrapolating these data, we can conclude that, in the sample for the study, the volunteers who have less perfusion index at the end of that at the beginning do not tolerate well the effort involved in the case.Introducción: Realizar de una forma adecuada una reanimación cardiopulmonar precisa unos conocimientos técnicos y unas mínimas condiciones físicas. Realizar esta reanimación un equipo de protección individual frente a riesgos biológicos nivel D colocado aumenta el sobresfuerzo al que se ven sometidos los reanimadores.El objetivo de este estudio es comprobar la existencia de un patrón de mala tolerancia fisiológica al uso de los equipos de protección nivel D, categoría 4-5-6B para la actuación en incidentes con riesgo biológico objetivado mediante la medición del índice de perfusión antes y después de una reanimación simulada.Material y métodos: Se ha realizado un estudio cuasiexperimental no controlado sobre 96 voluntarios elegidos mediante un muestreo aleatorio estratificado por sexo, nivel de formación y categoría profesional, estudiantes de Medicina y Enfermería y profesionales Médicos y Enfermeros. Se realizó una toma del índice de perfusión antes de realizar la reanimación y otra después de la reanimación simulada.Resultados: Un 15% de los voluntarios presentaron un índice de perfusión posterior más bajo al basal, lo que se traduce en una situación de vasoconstricción periférica después de la realización del ejercicio físico que supuso el caso clínico, cuando lo esperable era una vasodilatación para aumentar la perfusión.Conclusiones: Extrapolando estos datos, podemos concluir que, en la muestra de estudio que nos ocupa, los voluntarios que presentan menos índice de perfusión al finalizar que al comenzar no toleran bien el esfuerzo que supone el caso clínico. &nbsp

Embryonic cerebrospinal fluid influence in the subependymal neurogenic niche in adult mouse hippocampus

Producción CientíficaThe adult mouse hippocampal neurogenic niche is a complex structure which is not completely understood. It has mainly been related to the Subgranular layer of the dentate gyrus; however, as a result of differential neural stem cell populations reported in the subventricular zone of the lateral ventricle and associated with the hippocampus, the possibility remains of a multifocal niche reproducing developmental stages. Here, using a set of molecular markers for neural precursors, we describe in the adult mouse brain hippocampus the existence of a disperse population of neural precursors in the Subependymal Zone, the Dentate Migratory Stream and the hilus; these display dynamic behaviour compatible with neurogenesis. This supports the idea that the adult hippocampal niche cannot be restricted to the dentate gyrus subgranular layer. In other neurogenic niches such as the Subventricular Zone, a functional periventricular dependence has been shown due to the ability to respond to embryonic cerebro-spinal fluid. In this study, we demonstrate that neural precursors from the three areas studied (Sub-ependymal Zone, Dentate Migratory Stream and hilus) are able to modify their behaviour by increasing neurogenesis in a locally differential manner. Our results are compatible with the persistence in the adult mouse hippocampus of a neurogenic niche with the same spatial structure as that seen during development and early postnatal stages.Ministerio de Educación y Ciencia (BFU207/6516)Junta de Castilla y León (Consejería de Educación, GR195

Testemunhos de espanhóis amputados de extremidades durante o isolamento social pela pandemia COVID 19: impactos no movimento físico

El objetivo fue analizar la percepción que tienen las personas amputadas de los efectos que el aislamiento social, consecuente a la pandemia de la COVID 19, ha provocado en su movilidad. Es un estudio cualitativo realizado a través de un formulario electrónico con dos ejes temáticos: movilidad física y las preocupaciones y soluciones relacionadas con ésta, antes y después de la pandemia. El proceso de análisis consistió en la organización de los testimonios, separación por ejes temáticos e identificación de las palabras clave. La representación del análisis de datos se realizó utilizando la metodología descriptiva de construcción del diagrama lógico de Ishikawa. Se incluyeron 10 participantes, 9 no estaban infectados por el virus SARS-CoV-2. Las palabras clave que más impactaron en la movilidad física: movimiento, actividad física, ayuda para salir y dolor. Entre los términos secundarios, destacaron: fisioterapia y actividades realizadas en el hogar. Las principales repercusiones del aislamiento fueron la disminución de la movilidad y la resistencia a caminar con másagarrotamiento y problemas musculares, dificultad en los movimientos y en las actividades diarias. También revelaron reducción de la actividad física, estilo de vida sedentario, aumento del peso, falta de ayuda externa para salir y desplazarse y aumento del dolor. Las soluciones para los problemas de movilidad fueron volver a la fisioterapia y la actividad física y adelgazar. Se señala la idoneidad, para las personas amputadas aisladas, de intervenciones a distancia que les permitan recibir de forma integral una atención completa, rehabilitando tanto la salud física como la psicológica.The objective was to analyze the perception that people with amputation have of the effects of social isolation caused by the COVID-19 pandemic on physical mobility. It is qualitative research was obtained through an electronic form that contained two thematic axes: physical mobility, concerns, and solutions related to physical mobility before and after the pandemic. The analysis process consisted of the organization of the testimonies, separation by thematic axes, and identification of the content keywords. The representation of the data analysis was carried out using the descriptive methodology of construction of the Ishikawa logic diagram. 10 participants were included, being 9 declared had not yet been infected with the SARS-CoV-2. The keywords that most impacted physical mobility were movement; physical activity, help getting out, and pain. Regarding the secondary keywords physiotherapy andactivities performed at home stood out. The greatest repercussions of social isolation were decreased mobility and resistance to walking more stiffness and muscle problems, and difficulty in movements and daily activities. They also revealed stopping physical activities and a sedentary lifestyle, weight gain, no outside help to get out and move, and increased pain. The solutions for the mobility problems were to return to physiotherapy and physical activity and lose weight. Importance is given to remote intervention in people isolated with amputations in a comprehensive way to receive complete care rehabilitating both the physical and psychological health condition.O objetivo deste estudo foi analisar a percepção das pessoas com amputação sobre os efeitos do isolamento social causado pela pandemia COVID-19 na mobilidade física. Foi um estudo qualitativo, realizado por meio de formulario eletrônico contendo dois eixostemáticos: mobilidade física e preocupações e soluções relacionadas antes e depois da pandemia. O processo de análise consistiu na organização dos testemunhos, separação por eixos temáticos e identificação de palavras-chave. A representação da análise dosdados foi realizada por meio da metodologia descritiva de construção do diagrama lógico de Ishikawa. Foram incluídos 10 participantes, 9 não infectados pelo vírus SARS-CoV-2. As palavras-chave que mais impactaram na mobilidade física foram movimento, atividade física, ajuda para sair e a dor. Em relação às palavras-chave secundárias destacaram fisioterapia e atividades realizadas em casa. As maiores repercussões do isolamento foram a diminuição da mobilidade e resistência à marcha, maior rigidez e problemas musculares, dificuldade de movimentos e atividades diárias. Também destacaram a interrupção da atividade física e estilo de vida sedentário, ganho de peso, nenhuma ajuda externa para sair e o aumento da dor. As soluções para os problemas de mobilidade foram retornar à fisioterapia e a atividade física, bem como perder peso. É importante a intervenção de forma remota de maneira integral em pessoas com amputações em isolamento para receber cuidados completos, reabilitando a sua saúde física e psicológic

Transcriptome characterization by RNA sequencing identifies a major molecular and clinical subdivision in chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) has heterogeneous clinical and biological behavior. Whole-genome and -exome sequencing has contributed to the characterization of the mutational spectrum of the disease, but the underlying transcriptional profile is still poorly understood. We have performed deep RNA sequencing in different subpopulations of normal B-lymphocytes and CLL cells from a cohort of 98 patients, and characterized the CLL transcriptional landscape with unprecedented resolution. We detected thousands of transcriptional elements differentially expressed between the CLL and normal B cells, including protein-coding genes, noncoding RNAs, and pseudogenes. Transposable elements are globally derepressed in CLL cells. In addition, two thousand genes-most of which are not differentially expressed-exhibit CLL-specific splicing patterns. Genes involved in metabolic pathways showed higher expression in CLL, while genes related to spliceosome, proteasome, and ribosome were among the most down-regulated in CLL. Clustering of the CLL samples according to RNA-seq derived gene expression levels unveiled two robust molecular subgroups, C1 and C2. C1/C2 subgroups and the mutational status of the immunoglobulin heavy variable (IGHV) region were the only independent variables in predicting time to treatment in a multivariate analysis with main clinico-biological features. This subdivision was validated in an independent cohort of patients monitored through DNA microarrays. Further analysis shows that B-cell receptor (BCR) activation in the microenvironment of the lymph node may be at the origin of the C1/C2 differences

Detection of early seeding of Richter transformation in chronic lymphocytic leukemia

Richter transformation (RT) is a paradigmatic evolution of chronic lymphocytic leukemia (CLL) into a very aggressive large B cell lymphoma conferring a dismal prognosis. The mechanisms driving RT remain largely unknown. We characterized the whole genome, epigenome and transcriptome, combined with single-cell DNA/RNA-sequencing analyses and functional experiments, of 19 cases of CLL developing RT. Studying 54 longitudinal samples covering up to 19 years of disease course, we uncovered minute subclones carrying genomic, immunogenetic and transcriptomic features of RT cells already at CLL diagnosis, which were dormant for up to 19 years before transformation. We also identified new driver alterations, discovered a new mutational signature (SBS-RT), recognized an oxidative phosphorylation (OXPHOS)high-B cell receptor (BCR)low-signaling transcriptional axis in RT and showed that OXPHOS inhibition reduces the proliferation of RT cells. These findings demonstrate the early seeding of subclones driving advanced stages of cancer evolution and uncover potential therapeutic targets for RT

Improved classification of leukemic B-cell lymphoproliferative disorders using a transcriptional and genetic classifier

B-cell chronic lymphoproliferative disorders (B-CLPD) encompass a group of hematologic tumors that often present with leukemic involvement.1 Their heterogeneity and the lack of relatively specific diagnostic markers for most of these diseases make their diagnosis challenging, especially in cases that only have blood involvement or when histology is not available. With the currently used immunophenotypic and molecular markers, around 10% of B-CLPD cases remain unclassifiable and are categorized as B-CLPD, not otherwise specified (B-CLPD, NOS)

Nursing students' satisfaction in Problem-Based Learning

ntroducción: El objetivo de esta investigación fue determinar el grado de satisfacción de los estudiantes de Enfermería después de utilizar la metodología Aprendizaje Basado en Problemas. Material y métodos: Estudio descriptivo y transversal. La muestra estuvo formada por 134 estudiantes de 2º de Grado de Enfermería de la Universidad de Valladolid. Después de la implementación de ABP se administró la escala de satisfacción de la Universidad de la Colima (México). Para el análisis de datos se utilizó el programa SPSS y se realizó el análisis del contenido de las justificaciones de las respuestas. Resultados: A los estudiantes, los contenidos de los casos clínicos les resultaron interesantes, prácticos, útiles y variados. Un 55% de los discentes prefiere la metodología tradicional frente al Aprendizaje Basado en Problemas y a un 78% le gustó esta nueva metodología. El aprendizaje activo a través de Aprendizaje Basado en Problemas, supuso una alta motivación y una elevada satisfacción percibida por los estudiantes respecto a los contenidos, el proceso tutorial, y los roles del tutor y del alumno; mientras que el tiempo asignado y la mayor carga de trabajo es lo que menos les satisface, aunque la satisfacción en general fue elevada. Conclusiones: Utilizar una metodología ABP aporta una elevada satisfacción en los estudiantes de Enfermería. Resulta favorable la retroalimentación constante en el proceso de enseñanza-aprendizaje, tanto en sesiones de evaluación, como en el trato personal y se mejora la comunicación en el aula.ABSTRACT Introduction: The objective of this research was used to evaluate the effect of Problem-Based Learning in the Nursing students' satisfaction. Material and Methodology: A descriptive transversal study. The task was conducted by 134 second-year Nursing students at the University of Valladolid. Scale satisfaction of the University of Colima (Mexico) was administered under PBL implementation.SPSS was used for data analysis and the content analysis on the participants’ responses. Results: Overall the participants described the contents of the clinical case as engaging, effective, practical and varied. 55% of students revealed their preference for traditional methodology compared to PBL. 78% liked this new methodology. Students’ perception of active learning through PBL showed a high level of motivation and satisfaction in regards to content, the tutorial process, the tutor and the students’ role; whereas the time assigned and the major workload is what least satisfied them. Nevertheless, satisfaction in general was high. Conclusion: The PBL methodology reported successful results according to nursing students’ opinions. It was reported that PBL improves communication and the students’ feedback is implemented. There is a correlation between the teaching and learning process not only in evaluation assessment but also in personal treatment in respect to the benefits to each othe