The assessment of generic competences in the final year thesis. A preliminary study on the need and opportunity to establish means and tools by fields of knowledge

[ES] El artículo ofrece una reflexión sobre la evaluación de los Trabajos Fin de Grado (TFG) y en particular sobre la evaluación de las competencias transversales en los mismos. En primer lugar se recogen los resultados de un estudio efectuado sobre el tipo y el número de competencias transversales establecidas como evaluables dentro de la materia TFG para 64 Grados de la Universitat Autònoma de Barcelona. Su análisis, agrupando los Grados según la rama de conocimiento a la que se adscribe cada uno, muestra la existencia de diferencias en la selección de las competencias transversales en función de dicha rama. En segundo lugar, se presenta un modelo de evaluación para los TFG, con el que se aborda el diseño de indicadores para algunas competencias transversales, así como medios e instrumentos para evaluarlos. Los resultados obtenidos sugieren que la rama de conocimiento es un factor a tener en cuenta en el diseño de la evaluación por competencias, aún en el caso de considerar únicamente las competencias transversales, que por definición son comunes a todas las disciplinas. El trabajo ha sido desarrollado en el seno del grupo interdisciplinario de innovación docente GI‐IDES:TFG de la Universitat Autònoma de Barcelona.[EN] In this paper, a general discussion on competence‐based assessment applied to Final Year Project Work (for short, TFG) is presented and, particularly, on generic competences concerning bachelor degrees at the Universitat Autònoma de Barcelona (UAB). First we provide the results of a study carried out on the type and number of generic competences that have been chosen as evaluable for bachelor degrees at the UAB. Some differences are observed regarding the field of knowledge of each one. Secondly, the results of a proposal of indicators of the same generic competences in various fields of knowledge are described. While a similar sequence of indicators can be established in any case, the starting point of the assessment of the competence, as well as the time in which each indicator is assessed, varies among different fields of knowledge. These results suggest that the field of knowledge is actually a factor to consider in designing competence‐based assessment, even when considering only the generic competences, which by definition are common to all disciplines.Rullán Ayza, M.; Fernández Rodríguez, M.; Estapè Dubreuil, G.; Márquez Cebrián, MD. (2011). La evaluación de competencias transversales en la materia trabajos fin de grado. Un estudio preliminar sobre la necesidad y oportunidad de establecer medios e instrumentos por ramas de conocimiento. REDU. Revista de Docencia Universitaria. 8(1):74-100. https://doi.org/10.4995/redu.2010.6218OJS7410081Estapé, G., Rullan, M., López, C., Márquez, M.D., Monforte, C., Pons, J., Tena, D., Broto, C., (2010). Les guies docents en els Treballs Fi de Grau. Ponencia presentada en el VI Congreso Internacional Docencia Universitaria e Innovación. Nuevos espacios de calidad en la educación superior, Barcelona, 30 junio‐2 julio 2010.ICE‐UPC (Universitat Politècnica de Catalunya), (2009). Quaderns per treballar les competències genèriques a les assignatures. http://www.upc.edu/ice/portal‐de‐ recursos/publicacions_ice/quaderns‐per‐treballar‐les‐competencies‐generiques‐a‐ les‐assignatures.Mateo, J. (2009). (ed.) Guía para la evaluación de competencias en el trabajo de fin de grado en el ámbito de las Ciencias Sociales y Jurídicas. Barcelona: AQU Catalunya. [Consulta: 17 noviembre 2010]. http://www.aqu.cat/publicacions/guies_competencies/guia_tfg_socials_es.html> y http://www.aqu.cat/doc/doc_30156918_1.pdf.Paricio, J. (2010). El reto de institucionalizar la coordinación e integración docente. En J. Rué y L. Lodeiro (eds.), Equipos docentes y nuevas identidades académicas (p. 21‐ 44). Madrid: Editorial Narcea.Proyecto Tuning (2009). Una introducción a Tuning Educational Structures in Europe. [Consulta: 17 noviembre 2010]. http://tuning.unideusto.org/tuningeu/images/stories/template/General_Brochure _Spanish_version.pdf.Rodríguez, G. (2010). Los procedimientos de evaluación como elementos de desarrollo de la función orientadora en la universidad. Revista Española de Orientación y Psicopedagogía, 21 (2), 443‐461.Rullan, M., Estapé, G., Arumí, M., Boixader, F.J., Fernández‐Rodríguez, M., Hurtado, A., López, C., Márquez, M.D., Monforte, C. y Pons, J. (2010). Les competències transversals del Treball Fi de Grau. Propostes d'avaluació segons els àmbits. Ponencia presentada en el VI Congreso Internacional Docencia Universitaria e Innovación. Nuevos espacios de calidad en la educación superior, Barcelona, 30 junio‐2 julio 2010.Valderrama, E. (ed.) (2009). Guías para la evaluación de competencias en los trabajos de fin de grado y de máster en las ingenierías. Barcelona: AQU Catalunya. [Consulta: 17 noviembre 2010]. http://www.aqu.cat/publicacions/guies_competencies/guia_tfe_enginyeries_es.ht ml y http://www.aqu.cat/doc/doc_19718727_1.pdf.Villa, A. y Poblete, M. (dirs.) (2007). Aprendizaje basado en competencias. Una propuesta para la evaluación de las competencias genéricas. Bilbao: Universidad de Deusto

Cross-sectional survey of the wish to die among palliative patients in Spain: one phenomenon, different experiences

Objective Cultural backgrounds and values have a decisive impact on the phenomenon of the wish to die (WTD), and examination of this in Mediterranean countries is in its early stages. The objectives of this study were to establish the prevalence of WTD and to characterise this phenomenon in our cultural context. Methods A cross-sectional study with consecutive advanced inpatients was conducted. Data about WTD (Assessing Frequency & Extent of Desire to Die (AFFED) interview) and anxiety and depression (Edmonton Symptom Assessment System-revised (ESAS-r)) were collected through two face-to-face clinical encounters. Data were analysed with descriptive statistics, χ2 and analysis of variance. Results 201 patients participated and 165 (82%) completed both interviews. Prevalence of WTD was 18% (36/201) in the first interview and 16% (26/165) in the second interview (p=0.25). After the first interview, no changes in depression (p=0.60) or anxiety (p=0.90) were detected. The AFFED shows different experiences within WTD: 11% of patients reported a sporadic experience, while 7% described a persistent experience. Thinking about hastening death (HD) appeared in 8 (22%) out of 36 patients with WTD: 5 (14%) out of 36 patients considered this hypothetically but would never take action, while 3 (8%) out of 36 patients had a more structured idea about HD. In this study, no relation was detected between HD and frequency of the appearance of WTD (p=0.12). Conclusions One in five patients had WTD. Our findings suggest the existence of different experiences within the same phenomenon, defined according to frequency of appearance and intention to hasten death. A linguistically grounded model is proposed, differentiating the experiences of the ‘wish’ or ‘desire’ to die, with or without HD ideation

Outcome of cutaneous squamous cell carcinoma with microscopic residual disease after surgery and usefulness of postoperative radiotherapy: a retrospective cohort study

[Background]: Microscopic residual disease (MRD) after surgery can be a challenging situation in cutaneous squamous cell carcinoma (CSCC) and there is a lack of evidence concerning its management. [Objective]: To evaluate the prognosis of CSCC with MRD and the usefulness of postoperative radiotherapy (PORT) in CSCC with MRD. [Methods]: Retrospective cohort study of CSCC with MRD through a 10-year period (2010–2019) (n = 244). Disease-free survival and event-free survival were assessed using R (v.3.4.1), considering competing risks. Evaluated outcomes were local recurrence (LR), nodal metastases (NMs), and disease-specific death (DSD). [Results]: Median age was 88y (IQR: 10.5). A total of 145 (59.43%) were men and 69 (28.28%) were immunosuppressed. Median tumour diameter and thickness were 19 and 6.4 mm (IQR 11 and 5.5 mm). Patients treated by re-excision had a relapse rate of 4.3% compared with 11.30% and 29.71% in those who received PORT and observation (P = 0.045). The use of PORT was associated with a lower risk of LR compared with observation (HR = 0.206 [0.049–0.859], P = 0.030), but not with a lower risk of NMs or DSDs. In the multivariable models, PORT was again associated with a lower risk of LR than observation (HR = 0.167 [0.039–0.708], P = 0.014), but not with lower risk of metastasis and death. [Conclusions]: We always should try to obtain clear margins after surgery. PORT improves local control in CSCC with MRD, but when administered to the tumour bed, it does not reduce the risk of NM and DSD.Javier Cañueto is partially supported by the grants GRS2139/A/20 (Gerencia Regional de Salud de Castilla y León), PI18/00587 and PI21/01207 (Instituto de Salud Carlos III, confanciado con fondos FEDER) and by the ‘Programa de Intensificación of the ISCIII’, grant number INT20/00074

The Patient Dignity Inventory: just another evaluation tool? Experiences with advanced cancer patients.

ICS ATLANTES The PDI has intrinsic therapeutic value and is useful in clinical practice, and it is also a way of examining issues related to dignity and the meaning of life within the context of advanced-stage illness. There is a need for studies that examine patient experiences through a PDI-based intervi

Divergent Effects of Cyclophilin-D Inhibition on the Female Rat Heart: Acute Versus Chronic Post-Myocardial Infarction

Background/Aims: The mitochondrial permeability transition pore opening plays a critical role in the pathogenesis of myocardial infarction. Inhibition of cyclophilin-D (CyP-D), a key regulator of the mitochondrial permeability transition pore, has been shown to exert cardioprotective effects against ischemia-reperfusion injury on various animal models, mostly in males. However, failure of recent clinical trials requires a detailed elucidation of the cardioprotective efficacy of CyP-D inhibition. The aim of this study was to examine whether cardioprotective effects of sanglifehrin A, a potent inhibitor of CyP-D, on post-infarcted hearts depends on reperfusion. Methods: Acute or chronic myocardial infarction was induced by coronary artery ligation with/without subsequent reperfusion for 2 and 28 days in female Sprague-Dawley rats. Cardiac function was estimated by echocardiography. Oxygen consumption rates, ROS production, permeability transition pore opening, protein carbonylation and respiratory supercomplexes were analyzed in isolated cardiac mitochondria. Results: Sanglifehrin A significantly improved cardiac function of reperfused hearts at 2 days but failed to protect after 28 days. No protection was observed in non-reperfused post-infarcted hearts. The respiratory control index of mitochondria was significantly reduced in reperfused infarcted hearts at 2-days with no effect at 28-days post-infarction on reperfused and non-reperfused hearts. Likewise, only a minor increase in reactive oxygen species production was observed at 2-days in non-reperfused post-infarcted hearts. Conclusion: This study demonstrates that CyP-D inhibition exerts cardioprotective effects in reperfused but not in non-reperfused infarcted hearts of female rats, and the effects are observed only during acute post-infarction injury

‘Dignity therapy’, a promising intervention in palliative care: A comprehensive systematic literature review

Background: Dignity therapy is psychotherapy to relieve psychological and existential distress in patients at the end of life. Little is known about its effect. Aim: To analyse the outcomes of dignity therapy in patients with advanced life-threatening diseases. Design: Systematic review was conducted. Three authors extracted data of the articles and evaluated quality using Critical Appraisal Skills Programme. Data were synthesized, considering study objectives. Data sources: PubMed, CINAHL, Cochrane Library and PsycINFO. The years searched were 2002 (year of dignity therapy development) to January 2016. `Dignity therapy¿ was used as search term. Studies with patients with advanced life-threatening diseases were included. Results: Of 121 studies, 28 were included. Quality of studies is high. Results were grouped into effectiveness, satisfaction, suitability and feasibility, and adaptability to different diseases and cultures. Two of five randomized control trials applied dignity therapy to patients with high levels of baseline psychological distress. One showed statistically significant decrease on patients¿ anxiety and depression scores over time. The other showed statistical decrease on anxiety scores pre¿post dignity therapy, not on depression. Nonrandomized studies suggested statistically significant improvements in existential and psychosocial measurements. Patients, relatives and professionals perceived it improved end-of-life experience. Conclusion: Evidence suggests that dignity therapy is beneficial. One randomized controlled trial with patients with high levels of psychological distress shows DT efficacy in anxiety and depression scores. Other design studies report beneficial outcomes in terms of end-of-life experience. Further research should understand how dignity therapy functions to establish a means for measuring its impact and assessing whether high level of distress patients can benefit most from this therapy

Next-generation sequencing of bile cell-free DNA for the early detection of patients with malignant biliary strictures

Objective: despite significant progresses in imaging and pathological evaluation, early differentiation between benign and malignant biliary strictures remains challenging. Endoscopic retrograde cholangiopancreatography (ERCP) is used to investigate biliary strictures, enabling the collection of bile. We tested the diagnostic potential of next-generation sequencing (NGS) mutational analysis of bile cell-free DNA (cfDNA). Design: a prospective cohort of patients with suspicious biliary strictures (n=68) was studied. The performance of initial pathological diagnosis was compared with that of the mutational analysis of bile cfDNA collected at the time of first ERCP using an NGS panel open to clinical laboratory implementation, the Oncomine Pan-Cancer Cell-Free assay. Results: an initial pathological diagnosis classified these strictures as of benign (n=26), indeterminate (n=9) or malignant (n=33) origin. Sensitivity and specificity of this diagnosis were 60% and 100%, respectively, as on follow-up 14 of the 26 and eight of the nine initially benign or indeterminate strictures resulted malignant. Sensitivity and specificity for malignancy of our NGS assay, herein named Bilemut, were 96.4% and 69.2%, respectively. Importantly, one of the four Bilemut false positives developed pancreatic cancer after extended follow-up. Remarkably, the sensitivity for malignancy of Bilemut was 100% in patients with an initial diagnosis of benign or indeterminate strictures. Analysis of 30 paired bile and tissue samples also demonstrated the superior performance of Bilemut. Conclusion: implementation of Bilemut at the initial diagnostic stage for biliary strictures can significantly improve detection of malignancy, reduce delays in the clinical management of patients and assist in selecting patients for targeted therapies.Funding: we thank the financial support of CIBERehd; grants PI16/01126 and PI19/00163 from Instituto de Salud Carlos III (ISCIII) cofinanced by ’Fondo Europeo de Desarrollo Regional’ (FEDER) ’Una manera de hacer Europa’; grants 58/2017 and 55/2018 from Gobierno de Navarra Salud; grant 0011-1411-2020-000010 from AGATA Strategic Project from Gobierno de Navarra; grant 2020/101 from Euroregion Nouvelle Aquitaine-Euskadi-Navarra; Fundación Eugenio Rodríguez Pascual; Fundación Mario Losantos, Fundación M Torres; grant 2018/117 from AMMF, the Cholangiocarcinoma Charity; the COST Action CA181122 Euro-cholangio-Net; POSTD18014AREC postdoctoral fellowship from AECC to MA; and Ramón y Cajal Program contracts RYC-2014-15242 and RYC-2018-024475-1 to FJC and MGFB

Pilot multi-omic analysis of human bile from benign and malignant biliary strictures: a machine-learning approach

Cholangiocarcinoma (CCA) and pancreatic adenocarcinoma (PDAC) may lead to the development of extrahepatic obstructive cholestasis. However, biliary stenoses can also be caused by benign conditions, and the identification of their etiology still remains a clinical challenge. We performed metabolomic and proteomic analyses of bile from patients with benign (n = 36) and malignant conditions, CCA (n = 36) or PDAC (n = 57), undergoing endoscopic retrograde cholangiopancreatography with the aim of characterizing bile composition in biliopancreatic disease and identifying biomarkers for the differential diagnosis of biliary strictures. Comprehensive analyses of lipids, bile acids and small molecules were carried out using mass spectrometry (MS) and nuclear magnetic resonance spectroscopy (1H-NMR) in all patients. MS analysis of bile proteome was performed in five patients per group. We implemented artificial intelligence tools for the selection of biomarkers and algorithms with predictive capacity. Our machine-learning pipeline included the generation of synthetic data with properties of real data, the selection of potential biomarkers (metabolites or proteins) and their analysis with neural networks (NN). Selected biomarkers were then validated with real data. We identified panels of lipids (n = 10) and proteins (n = 5) that when analyzed with NN algorithms discriminated between patients with and without cancer with an unprecedented accuracy.This research was funded by: Instituto de Salud Carlos III (ISCIII) co-financed by Fondo Europeo de Desarrollo Regional (FEDER) Una manera de hacer Europa, grant numbers: PI16/01126 (M.A.A.), PI19/00819 (M.J.M. and J.J.G.M.), PI15/01132, PI18/01075 and Miguel Servet Program CON14/00129 (J.M.B.); Fundación Científica de la Asociación Española Contra el Cáncer (AECC Scientific Foundation), grant name: Rare Cancers 2017 (J.M.U., M.L.M., J.M.B., M.J.M., R.I.R.M., M.G.F.-B., C.B., M.A.A.); Gobierno de Navarra Salud, grant number 58/17 (J.M.U., M.A.A.); La Caixa Foundation, grant name: HEPACARE (C.B., M.A.A.); AMMF The Cholangiocarcinoma Charity, UK, grant number: 2018/117 (F.J.C. and M.A.A.); PSC Partners US, PSC Supports UK, grant number 06119JB (J.M.B.); Horizon 2020 (H2020) ESCALON project, grant number H2020-SC1-BHC-2018–2020 (J.M.B.); BIOEF (Basque Foundation for Innovation and Health Research: EiTB Maratoia, grant numbers BIO15/CA/016/BD (J.M.B.) and BIO15/CA/011 (M.A.A.). Department of Health of the Basque Country, grant number 2017111010 (J.M.B.). La Caixa Foundation, grant number: LCF/PR/HP17/52190004 (M.L.M.), Mineco-Feder, grant number SAF2017-87301-R (M.L.M.), Fundación BBVA grant name: Ayudas a Equipos de Investigación Científica Umbrella 2018 (M.L.M.). MCIU, grant number: Severo Ochoa Excellence Accreditation SEV-2016-0644 (M.L.M.). Part of the equipment used in this work was co-funded by the Generalitat Valenciana and European Regional Development Fund (FEDER) funds (PO FEDER of Comunitat Valenciana 2014–2020). Gobierno de Navarra fellowship to L.C. (Leticia Colyn); AECC post-doctoral fellowship to M.A.; Ramón y Cajal Program contracts RYC-2014-15242 and RYC2018-024475-1 to F.J.C. and M.G.F.-B., respectively. The generous support from: Fundación Eugenio Rodríguez Pascual, Fundación Echébano, Fundación Mario Losantos, Fundación M Torres and Mr. Eduardo Avila are acknowledged. The CNB-CSIC Proteomics Unit belongs to ProteoRed, PRB3-ISCIII, supported by grant PT17/0019/0001 (F.J.C.). Comunidad de Madrid Grant B2017/BMD-3817 (F.J.C.).Peer reviewe

“Tourism, water, and gender”—An international review of an unexplored nexus

This international literature review of the tourism–water nexus identifies a gender gap. Tourism development can affect water supply both quantitatively and qualitatively. Many regions will face considerable problems of water availability and quality, affecting their tourism sector and increasing competition with local residents, and other industries especially agriculture. This international review of literature explores the tourism–water nexus, comparing and contrasting literature published in English, Chinese, and Spanish. Securing access to safe water for continued tourism development is a common theme and the vast majority of work has focused on hotels including water pricing, water-saving practices and innovative management methods. In all continents, struggles are apparent, and the unsustainability of tourism is having impacts on water quantity and quality. This article identifies significant gaps in the literature including climate change, the energy-water nexus, and the links with the Sustainable Development Goals. Furthermore, studies from a gendered perspective are minimal and the potential for areas of further gendered studies within the tourism–water nexus are highlighted including intersectionality, water insecurity and sanitation, tourism and gender based violence, and additional unpaid care work

Clinical validation of risk scoring systems to predict risk of delayed bleeding after EMR of large colorectal lesions

[Background and Aims]: The Endoscopic Resection Group of the Spanish Society of Endoscopy (GSEED-RE) model and the Australian Colonic Endoscopic Resection (ACER) model were proposed to predict delayed bleeding (DB) after EMR of large superficial colorectal lesions, but neither has been validated. We validated and updated these models.[Methods]: A multicenter cohort study was performed in patients with nonpedunculated lesions ≥20 mm removed by EMR. We assessed the discrimination and calibration of the GSEED-RE and ACER models. Difficulty performing EMR was subjectively categorized as low, medium, or high. We created a new model, including factors associated with DB in 3 cohort studies.[Results]: DB occurred in 45 of 1034 EMRs (4.5%); it was associated with proximal location (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.31-6.16), antiplatelet agents (OR, 2.51; 95% CI, .99-6.34) or anticoagulants (OR, 4.54; 95% CI, 2.14-9.63), difficulty of EMR (OR, 3.23; 95% CI, 1.41-7.40), and comorbidity (OR, 2.11; 95% CI, .99-4.47). The GSEED-RE and ACER models did not accurately predict DB. Re-estimation and recalibration yielded acceptable results (GSEED-RE area under the curve [AUC], .64 [95% CI, .54-.74]; ACER AUC, .65 [95% CI, .57-.73]). We used lesion size, proximal location, comorbidity, and antiplatelet or anticoagulant therapy to generate a new model, the GSEED-RE2, which achieved higher AUC values (.69-.73; 95% CI, .59-.80) and exhibited lower susceptibility to changes among datasets.[Conclusions]: The updated GSEED-RE and ACER models achieved acceptable prediction levels of DB. The GSEED-RE2 model may achieve better prediction results and could be used to guide the management of patients after validation by other external groups. (Clinical trial registration number: NCT 03050333.)Research support for this study was received from “La Caixa/Caja Navarra” Foundation (ID 100010434;project PR15/11100006)