Medical students learning styles in Latin American and Spanish universities: relation with geographical and curricular contexts

Objetivo. Determinar si los estilos de aprendizaje (EA) de los estudiantes de medicina se correlacionan con el contexto geográfico, con el contexto curricular o con el nivel de la carrera. Sujetos y métodos. El estudio se realizó en 490 estudiantes de las Escuelas de Medicina de las Universidades de Chile (Santiago, Chile), Nacional de Cuyo (Mendoza, Argentina), San Francisco Xavier (Sucre, Bolivia), Zaragoza y País Vasco (España). Se aplicó el cuestionario Honey-Alonso, que valora la preferencia por cada uno de cuatro EA: activo, reflexivo, teórico y pragmático. También se evaluó el EA de acuerdo al modelo de Kolb. Resultados. Al relacionar el EA con el contexto geográfico se observó que mientras los estudiantes de universidades españolas muestran un estilo preferentemente asimilador, siguiendo la denominación de Kolb, para Chile fue el acomodador y para Bolivia los estudiantes se distribuyen entre los estilos asimilador y divergente. Al comparar la distribución de los EA durante el tercer curso de medicina en dos facultades que poseen diferente currículo, no se observaron diferencias significativas. Los EA en una Facultad de Medicina con un currículo basado en asignaturas (Chile) no mostraron diferencias en los tres cursos del estudio (1.o, 3.o y 5.o), siendo preferentes los estilos reflexivo y teórico. Conclusiones. El estudio permitió establecer diferencias significativas entre los estilos de aprendizaje de los estudiantes de Medicina en relación con el contexto geográfico, más que con los diferentes currículos, o a lo largo de los distintos cursos de la carrera.Aim. To establish a correlation between medical student learning styles (LS) and the geographical context, the curricular context and different academic levels. Subjects and methods. The study was performed in 490 undergraduate students from Medical Schools of the Universities of Chile (Santiago, Chile), Nacional de Cuyo (Mendoza, Argentina), San Francisco Xavier (Sucre, Bolivia), Zaragoza and País Vasco (Spain). The instrument used was the Honey-Alonso learning style questionnaire that assesses the student preference for one of four LS: active, reflexive, theoretic and pragmatic. In addition, LS according to the Kolb inventory were also assessed. Results. Using the Kolb inventory, significant differences were found when the LS were correlated with the geographical context. While Spanish students showed a high preference for the assimilator style of learning, Chilean students resulted to be mainly accommodators, and Bolivian students were both assimilators and divergent. Comparing the LS distribution during the third course in two universities with different curricula (problem and lecture based learning), there were no significant differences. LS of medical students from a Medical School with a lecture based curriculum (University of Chile) were not significantly different during the first, the third and the fifth level of their undergraduate students. They showed a significant preference for reflexive and theoretic styles of learning. Conclusions. The present study allowed demonstrating that significant differences among the styles of learning of medical students correlated with the geographical context more than with the different curricula, or along the different courses of the career.Fil: Diaz Veliz, G.. Universidad de Chile; ChileFil: Mora, S.. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas; ArgentinaFil: Lafuente Sanchez, J. V.. Universidad del País Vasco; EspañaFil: Gargiulo, Pascual Angel. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza; ArgentinaFil: Bianchi, R.. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas; ArgentinaFil: Teran, C.. Universidad Andina Simón Bolívar; BoliviaFil: Gorena, D.. Universidad Andina Simón Bolívar; BoliviaFil: Arce, J.. Universidad San Francisco Xavier; BoliviaFil: Escanero Marcen, J. F.. Universidad de Zaragoza; Españ

Use of oral glucocorticoids and risk of skin cancer and non-Hodgkin's lymphoma: a population-based case–control study

In North Jutland County, Denmark, we investigated whether use of oral glucocorticoids was associated with an increased risk of developing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), malignant melanoma (MM), and non-Hodgkin's lymphoma (NHL). From the Danish Cancer Registry we identified 5422 BCC, 935 SCC, 983 MM, and 481 NHL cases during 1989–2003. Using risk-set sampling we selected four age- and gender-matched population controls for each case from the Civil Registration System. Prescriptions for oral glucocorticoids before diagnosis were obtained from the Prescription Database of North Jutland County on the basis of National Health Service data. We used conditional logistic regression to estimate incidence rate ratios (IRRs), adjusting for chronic medical diseases (information about these were obtained from the National Patient Registry) and use of other immunosuppressants. We found slightly elevated risk estimates for BCC (IRR, 1.15 (95% CI: 1.07–1.25)), SCC (IRR, 1.14 (95% CI: 0.94–1.39)), MM (IRR, 1.15 (95% CI: 0.94–1.41), and NHL (IRR, 1.11 (95% CI: 0.85–1.46)) among users of oral glucocorticoids. Our study supports an overall association between glucocorticoid use and risk of BCC that cannot be explained by the presence of chronic diseases or concomitant use of other immunosuppressants

An overview of the Italian forest biodiversity and its conservation level, based on the first outcomes of the 4th Habitat Report ex-Art. 17

In 2019 the 4th Report ex-Art. 17 on the conservation status (CS) of Annex I Habitats of the 92/43/EEC Directive was expected by every EU/28 country, with reference to the period 2013-18. In Italy, the process was in charge to the Italian Institute for Environmental Protection and Research (ISPRA), on behalf of the Ministry for Environment, Land and Sea Protection (MATTM), with the scientific support of the Italian Botanical Society (SBI). A large group of thematic and territorial experts elaborated the available data concerning the 124 types of terrestrial and inland water Habitats present in Italy, 39 of which are represented by Forest Habitats (Group 9),. The main aim of the work was the evaluation of the overall CS of each Habitat by Biogeographic Region (Mediterranean, Continental and Alpine), for a total amount of 294 assessments. A high proportion of these (92, corresponding to 31% of the total) referred to Forest Habitats, including 20 marginal types for which the CS was not requested. The analysis was carried out at different scales: a) administrative territory, through the data contained in the ISPRA database, whose compilation was in charge to the Regions and Autonomous Provinces; b) Natura 2000 site, with the latest updates available (Standard Data Forms updated to 2018); c) national scale, implementing the distribution maps for each Habitat based on the European grid ETRS89-LAEA5210 (10x10 km2 mesh); d) Biogeographic Region, scale of the final assessment. Cartographic outcomes, associated databases and additional data used for the assessments will be available online on the ISPRA Portal as soon as the validation process by the European Commission will be completed. A dedicated archive named "HAB_IT" has been created in the national database "VegItaly" (1), managed by the Italian Society of Vegetation Science, where the phytosociological relevés representative of the various Annex I Habitats in Italy will be archived and freely accessible. An overview of the results regarding the Forest habitats is here provided, including a comparison with the outcomes of the former reporting cycle, the 3rd Report ex-Art. 17 (2). In several cases (e.g. 9120, 91L0), the distribution maps have been remarkably improved due to better knowledge and more fitful interpretation. The conservation status resulted as Favourable (FV) for 6,7%, Inadequate (U1) for 58,7% and Bad (U1) for 32,0% of the 72 assessed forest Habitat types. In no case there was an improvement of the conservation status, while in 6 cases a worsening of the conditions resulted from the data analysis, pointing out the Habitats types with a higher need of action. Similarly to other projects carried out as a team by the network of Annex I Habitat experts of the Italian Botanical Society and the Italian Society for Vegetation Science (e.g. 3, 4), this is another step in the direction of supporting the implementation of the 92/43/EEC "Habitat" Directive in Italy and Europe. On this ground, the high biodiversity of the Italian forest Habitats could be emphasized, however results pointed out that some rare or endemic types (e.g. Alnus cordata or Betula aetnensis-dominated forests) are still scarcely acknowledged by the most prominent EU conservation tools such as the Annex I to the "Habitat" Directive. 1) F. Landucci et al. (2012) Plant Biosyst., 146(4), 756-763 2) P. Genovesi et al. (2014) ISPRA, Serie Rapporti, 194/2014 3) E. Biondi et al. (2009) Società Botanica Italiana, MATTM, D.P.N., http://vnr.unipg.it/habitat/ 4) D. Gigante et al. (2016) Plant Sociology, 53(2), 77-8

Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis

BACKGROUND: Whether overweight or obese end stage renal disease (ESRD) patients are suitable for renal transplantation (RT) is often debated. The objective of this review and meta-analysis was to systematically investigate the outcome of low versus high BMI recipients after RT. METHODS: Comprehensive searches were conducted in MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and CENTRAL (the Cochrane Library 2014, issue 8). We reviewed four major guidelines that are available regarding (potential) RT recipients. The methodology was in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and written based on the PRISMA statement. The quality assessment of studies was performed by using the GRADE tool. A meta-analysis was performed using Review Manager 5.3. Random-effects models were used. RESULTS: After identifying 5,526 studies addressing this topic, 56 studies were included. We extracted data for 37 outcome measures (including data of more than 209,000 RT recipients), of which 26 could be meta-analysed. The following outcome measures demonstrated significant differences in favour of low BMI (<30) recipients: mortality (RR = 1.52), delayed graft function (RR = 1.52), acute rejection (RR = 1.17), 1-, 2-, and 3-year graft survival (RR = 0.97, 0.95, and 0.97), 1-, 2-, and 3-year patient survival (RR = 0.99, 0.99, and 0.99), wound infection and dehiscence (RR = 3.13 and 4.85), NODAT (RR = 2.24), length of hospital stay (2.31 days), operation duration (0.77 hours), hypertension (RR = 1.35), and incisional hernia (RR = 2.72). However, patient survival expressed in hazard ratios was in significant favour of high BMI recipients. Differences in other outcome parameters were not significant. CONCLUSIONS: Several of the pooled outcome measurements show significant benefits for ‘low’ BMI (<30) recipients. Therefore, we postulate that ESRD patients with a BMI >30 preferably should lose weight prior to RT. If this cannot be achieved with common measures, in morbidly obese RT candidates, bariatric surgery could be considered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12916-015-0340-5) contains supplementary material, which is available to authorized users