Necesidades de formación continua del profesorado de educación básica para el diseño de programas de posgrado

This paper shows the results of an exploratory study with a quantitative approach in which the continuous training needs of basic education teachers are identified: preschool, primary and secondary, in order to design a relevant and contextualized postgraduate proposal. The main objective is based on the diagnosis of training needs felt by teachers for the design and implementation of continuous training educational programs, based on the areas of opportunity expressed by teachers in service in the northern region of the state of Zacatecas, Mexico, in contrast to the professional competences for the exercise of teaching. For the collection of information, a questionnaire instrument with a Likert-type scale was used, made up of 48 items in six categories of analysis: continuous training needs, teaching and continuous improvement, educational research, professional ethics, didactic use of ICTs and English. This study shows a diagnosis of the training needs most felt by in-service teachers, from which Higher Education Institutions (HEIs) could base their proposals for continuous training programs.Estudio exploratorio con enfoque cuantitativo en el que se identifican las necesidades de formación continua de docentes de educación básica: preescolar, primaria y secundaria, a fin de diseñar una propuesta de posgrado pertinente y contextualizada. El objetivo principal se basa en el diagnóstico de necesidades de formación sentidas por el profesorado para el diseño e implementación de programas educativos de formación continua, a partir de las áreas de oportunidad expresadas por los profesores en servicio de la región norte del estado de Zacatecas, México, en contraste con las competencias profesionales para el ejercicio de la docencia. Para la recogida de información se utilizó un instrumento de cuestionario con escala tipo Likert, conformado por 48 ítems en seis categorías de análisis: necesidades de formación continua, docencia y mejora continua, investigación educativa, ética profesional, uso didáctico de TIC´s e inglés. Este estudio muestra un diagnóstico de las necesidades de formación más sentidas por los docentes en servicio, a partir de las cuales las Instituciones de Educación Superior (IES) podrían fundamentar sus propuestas de programas de formación continua

Planteamiento del problema de investigación en el programa de maestría de la ENERRC, aprendizajes y dificultades.

The objective of this paper is to describe the main learning and difficulties faced by students in the drafting of the research problem statement of the Master's program in Education and Improvement of Teaching Practice (MEMPD), of the Rafael Ramírez Castañeda Normal Experimental School. (ENERRC), from the experience of the participants and the perspective of the teachers/tutors. The research was developed from a mixed approach, of an exploratory type and an action-research methodological design. The results of the research showed how the follow-up and timely accompaniment of the course teacher/tutor favored the construction of theoretical-methodological learning for the elaboration of the problem statement in qualitative research, as a starting point for the generation of reflective processes of the practice itself and the development of professional skills in the participants. At the end of the formative path of the first quarter, temporal delimitation of the research, it became clear that the most relevant learning consisted of the diagnosis of a problem in their professional practice, pertinent and justified, as well as some methodological aspects such as: background, delimitation, justification, question and research objectives. Among the most felt areas of opportunity, those related to the use of theory to substantiate, justify or argue ideas derived from empirical reflection were commented, together with the use of the correct way of referencing them in APA format.El presente escrito tiene como objetivo describir los principales aprendizajes y dificultades que enfrentaron los estudiantes en la redacción del planteamiento del problema de investigación del programa de la Maestría en Educación y Mejora de la Práctica Docente (MEMPD), de la Escuela Normal Experimental Rafael Ramírez Castañeda (ENERRC), desde la experiencia de los participantes y la perspectiva de los docentes/tutores. La investigación se desarrolló desde un enfoque mixto, de tipo exploratorio y diseño metodológico de investigación-acción. Los resultados de la investigación mostraron cómo el seguimiento y acompañamiento oportuno del docente/tutor del curso, favorecieron la construcción de aprendizajes teóricos-metodológicos para la elaboración del planteamiento del problema en una investigación cualitativa, como punto de partida para la generación de procesos reflexivos de la propia práctica y el desarrollo de competencias profesionales en los participantes. Al término del trayecto formativo del primer cuatrimestre, delimitación temporal de la investigación, quedó de manifiesto que, los aprendizajes con mayor relevancia consistieron en el diagnóstico de una problemática en su práctica profesional, pertinente y justificada, así como algunos aspectos de orden metodológico como: antecedentes, delimitación, justificación, pregunta y objetivos de investigación. Entre las áreas de oportunidad más sentidas se comentaron las relacionadas con el uso de la teoría para fundamentar, justificar o argumentar ideas derivadas de la reflexión empírica, aunado al uso de la forma correcta de referenciarlas en formato APA

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

Comparison of 1-year outcome in patients with severe aorta stenosis treated conservatively or by aortic valve replacement or by percutaneous transcatheter aortic valve implantation (data from a multicenter Spanish registry)

The factors that influence decision making in severe aortic stenosis (AS) are unknown. Our aim was to assess, in patients with severe AS, the determinants of management and prognosis in a multicenter registry that enrolled all consecutive adults with severe AS during a 1-month period. One-year follow-up was obtained in all patients and included vital status and aortic valve intervention (aortic valve replacement [AVR] and transcatheter aortic valve implantation [TAVI]). A total of 726 patients were included, mean age was 77.3 ± 10.6 years, and 377 were women (51.8%). The most common management was conservative therapy in 468 (64.5%) followed by AVR in 199 (27.4%) and TAVI in 59 (8.1%). The strongest association with aortic valve intervention was patient management in a tertiary hospital with cardiac surgery (odds ratio 2.7, 95% confidence interval 1.8 to 4.1, p <0.001). The 2 main reasons to choose conservative management were the absence of significant symptoms (136% to 29.1%) and the presence of co-morbidity (128% to 27.4%). During 1-year follow-up, 132 patients died (18.2%). The main causes of death were heart failure (60% to 45.5%) and noncardiac diseases (46% to 34.9%). One-year survival for patients treated conservatively, with TAVI, and with AVR was 76.3%, 94.9%, and 92.5%, respectively, p <0.001. One-year survival of patients treated conservatively in the absence of significant symptoms was 97.1%. In conclusion, most patients with severe AS are treated conservatively. The outcome in asymptomatic patients managed conservatively was acceptable. Management in tertiary hospitals is associated with valve intervention. One-year survival was similar with both interventional strategies

Comparison of international normalized ratio audit parameters in patients enrolled in GARFIELD-AF and treated with vitamin K antagonists

Vitamin K antagonist (VKA) therapy for stroke prevention in atrial fibrillation (AF) requires monitoring of the international normalized ratio (INR). We evaluated the agreement between two INR audit parameters, frequency in range (FIR) and proportion of time in the therapeutic range (TTR), using data from a global population of patients with newly diagnosed non-valvular AF, the Global Anticoagulant Registry in the FIELD\u2013Atrial Fibrillation (GARFIELD-AF). Among 17\ua0168 patients with 1-year follow-up data available at the time of the analysis, 8445 received VKA therapy (\ub1antiplatelet therapy) at enrolment, and of these patients, 5066 with 653 INR readings and for whom both FIR and TTR could be calculated were included in the analysis. In total, 70\ua0905 INRs were analysed. At the patient level, TTR showed higher values than FIR (mean, 56\ub70% vs 49\ub78%; median, 59\ub77% vs 50\ub70%). Although patient-level FIR and TTR values were highly correlated (Pearson correlation coefficient [95% confidence interval; CI], 0\ub7860 [0\ub7852\u20130\ub7867]), estimates from individuals showed widespread disagreement and variability (Lin's concordance coefficient [95% CI], 0\ub7829 [0\ub7821\u20130\ub7837]). The difference between FIR and TTR explained 17\ub74% of the total variability of measurements. These results suggest that FIR and TTR are not equivalent and cannot be used interchangeably