Revisión del ciclo de Gibbs. Las emociones como parte del ciclo

The Gibbs' cycle, used in reflective practice, is a tool for self-reflection, mental wellbeing monitoring, academic learning and teaching activities, personal and professional development. It is structured in six phases: description, feelings, evaluation, conclusions, and action plan. Considering well-being and mental health as fundamental players in development paths (academic, professional, human), it becomes important to consider emotions in a new structure of the Gibbs' model. The narrative review is based on the observation of twenty manuscripts, in which the consideration and analysis of emotions in the reflective cycle was sought.El ciclo de Gibbs, utilizado en la práctica reflexiva, es una herramienta para la autorreflexión, el control del bienestar mental, las actividades académicas de enseñanza-aprendizaje, y el desarrollo personal y profesional. Se estructura en varias fases: descripción, sentimientos, evaluación, conclusiones y plan de acción. Considerando el bienestar y la salud mental como actores fundamentales en las trayectorias de desarrollo (académico, profesional, humano), resulta importante considerar las emociones en una nueva estructura del modelo de Gibbs. La revisión narrativa se basa en la observación de veinte manuscritos, en los que se buscaba la consideración y el análisis de las emociones en el ciclo reflexivo

The Leaderbuild Theory.

In the last two years, due to the COVID-19 pandemic, many educational and academic activities have undergone numerous changes; the number of online educational activities, e-Learning, and blended learning have radically increased, and the need to train personnel quickly and with increasing specialist skills has increased. The inclusion of the ‘Leaderbuild’ and ‘Leaderfit’ concept thus becomes one of the factors useful to prepare professionals specialized in every field, ready to lead in every modern environment and need, with structured leadership

Mental healthcare services support: the social role of medical educator involved in the destigmatization process to generate inclusion.

Introduction: The stigmatization of mental healthcare services and users is a barrier to the achievement of mental wellness present on a global level. 800000 suicides are estimated each year, 25 suicide attempts for every suicide (ratio of 25:1), and in 2017 estimated a prevalence > 10% of people suffering from mental disorder or substance abuse (global data). The stigmatization is a multifactorial phenomenon and process that involves different factors, which overall cause health, social and economic damage. Slowing down and reducing access to mental health and well-being pathways due to their influence in the community, also affect social relationships and self-determination. Purpose: to identify and describe the process, causes, and factors of stigmatization. Propose destigmatization activities led by the medical educator. Methodology: The manuscript develops a proposal focused on the destigmatization process of mental health/wellbeing services and users, through the guidance of the medical educator as a figure of connection between different professions (interdisciplinary and multidisciplinary), and between different stakeholders. Conclusion: each identifies factor described, can be involved in the destigmatization process to generate inclusion, through different social interventions led by the role of the medical educator, with the aim of supporting access to patient support processes and quality of life in communities, generating inclusion through destigmatizatio

Current status of graft choice in adults for anterior cruciate ligament reconstruction: a systematic review and meta-analysis

The anterior cruciate ligament (ACL) is a frequently performed surgical procedure in the field of sports medicine, and graft selection is an essential aspect of ACL reconstruction (ACLR) that has been shown to optimize post-operative rehabilitation, facilitate return to full sporting function and reduce the risk of complications. However, there needs to be more agreement regarding optimal graft choice. The present study aims to identify the optimal graft choice in the adult population undergoing ACLR. The current systematic review explores the electronic database of online libraries of academic institutions from 2011 to 30 September 2022 and compared the clinical outcomes of autograft and allograft for ACLR, which provides an evidence-based approach for graft selection. The findings of our present study delineate that ACLR in adult populations with autograft is the most promising choice for ligament tear over allograft based on lower failure rate, reduced complications, and high cost-effectiveness. However, there was no significant difference in overall IKDC, pivot shift, Lachman test, and Tegner activity. This critical analysis recommends that for an adult population, ACLR with autograft can provide better clinical results than an allograft, but further studies carried out about other parameters affecting the long-term stability, quick return, and physical therapy adopted outside the supervision of the respective surgeon would be required

Arterial hypoxaemia and its impact on coagulation:significance of altered redox homeostasis

AimsArterial hypoxaemia stimulates free radical formation. Cellular studies suggest this may be implicated in coagulation activation though human evidence is lacking. To examine this, an observational study was designed to explore relationships between systemic oxidative stress and haemostatic responses in healthy participants exposed to inspiratory hypoxia.ResultsActivated partial thromboplastin time and international normalised ratio were measured as routine clinical biomarkers of coagulation and ascorbate free radical (A•−) as a direct global biomarker of free radical flux. Six hours of hypoxia activated coagulation, and increased formation of A•−, with inverse correlations observed against oxyhaemoglobin saturation.ConclusionsThis is the first study to address the link between free radical formation and coagulation in vivo. This ‘proof-of-concept’ study demonstrated functional associations between hypoxaemia and coagulation that may be subject to redox activation of the intrinsic pathway. Further studies are required to identify precisely which intrinsic factors are subject to redox activation.</jats:sec

Nonlinear disintegration of the internal tide

Author Posting. © American Meteorological Society, 2008. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Physical Oceanography 38 (2008): 686-701, doi:10.1175/2007JPO3826.1.The disintegration of a first-mode internal tide into shorter solitary-like waves is considered. Since observations frequently show both tides and waves with amplitudes beyond the restrictions of weakly nonlinear theory, the evolution is studied using a fully nonlinear, weakly nonhydrostatic two-layer theory that includes rotation. In the hydrostatic limit, the governing equations have periodic, nonlinear inertia–gravity solutions that are explored as models of the nonlinear internal tide. These long waves are shown to be robust to weak nonhydrostatic effects. Numerical solutions show that the disintegration of an initial sinusoidal linear internal tide is closely linked to the presence of these nonlinear waves. The initial tide steepens due to nonlinearity and sheds energy into short solitary waves. The disintegration is halted as the longwave part of the solution settles onto a state close to one of the nonlinear hydrostatic solutions, with the short solitary waves superimposed. The degree of disintegration is a function of initial amplitude of the tide and the properties of the underlying nonlinear hydrostatic solutions, which, depending on stratification and tidal frequency, exist only for a finite range of amplitudes (or energies). There is a lower threshold below which no short solitary waves are produced. However, for initial amplitudes above another threshold, given approximately by the energy of the limiting nonlinear hydrostatic inertia–gravity wave, most of the initial tidal energy goes into solitary waves. Recent observations in the South China Sea are briefly discussed.KRH was supported by a Woods Hole Oceanographic Institution Mellon Independent Study Award and ONR Grant N000140610798

Terrestrial vegetation redistribution and carbon balance under climate change

BACKGROUND: Dynamic Global Vegetation Models (DGVMs) compute the terrestrial carbon balance as well as the transient spatial distribution of vegetation. We study two scenarios of moderate and strong climate change (2.9 K and 5.3 K temperature increase over present) to investigate the spatial redistribution of major vegetation types and their carbon balance in the year 2100. RESULTS: The world's land vegetation will be more deciduous than at present, and contain about 125 billion tons of additional carbon. While a recession of the boreal forest is simulated in some areas, along with a general expansion to the north, we do not observe a reported collapse of the central Amazonian rain forest. Rather, a decrease of biomass and a change of vegetation type occurs in its northeastern part. The ability of the terrestrial biosphere to sequester carbon from the atmosphere declines strongly in the second half of the 21(st )century. CONCLUSION: Climate change will cause widespread shifts in the distribution of major vegetation functional types on all continents by the year 2100

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Regional Competitiveness Under New Perspectives

The term "competitiveness" has been used in conceptually distinct ways at the firm, regional and national levels. After primarily reviewing existing concepts at the national level, we introduce a new definition of regional competitiveness adapting definitions used in the academic literature. Specifically, we connect "outcome competitiveness" with new perspectives on a more socially inclusive and ecologically sustainable growth path, as envisaged in the WWWforEurope research program, in which 33 European research groups are taking part. Evaluating competitiveness requires both an input assessment (costs, productivity, economic structure, capabilities) and an outcome assessment. We define regional outcome competitiveness as the ability of a region to deliver Beyond GDP goals. For regions in industrialized countries, this ability depends on innovation, education, institutions, social cohesion and ecological ambition. Given this new perspective (of broader Beyond GDP goals), social investments and ecological ambitions should not be considered costs, but rather drivers of competitiveness. This is compatible with a new innovation policy fostering non-technical innovations and a new industrial policy supporting societal goals. Applying this concept to European regions, we show which regions take the "high road" to competitiveness and compare our results with the existing literature