Collaborative learning in kindergarten: Challenge or reality?

Collaborative learning is a twenty-first-century education trend with its main characteristic being the interaction among classmates. Collaborative learning in kindergarten, however, presents many difficulties, as preschoolers do not have advanced cooperation skills. As a result, teachers face challenges when applying this method. The study aimed to evaluate teachers’ opinions about collaborative learning. The study’s sample was composed of 107 kindergarten teachers in Greek schools. The tool was an improvised questionnaire that included personal characteristics of the sample, 14 multiple-choice questions on the application of collaborative learning and 33 questions regarding teachers’ opinions about collaborative learning. Analysis of the data has shown that collaborative learning is frequently used in kindergarten schools, even though almost half of the teachers have never attended a relevant training course. In addition, teachers have highly evaluated the results of the method, which includes social and cognitive skills and the effects of collaborative learning evaluation and skills advancement

Migrant Crisis in Europe : Experiences of Nurses working in reception centers of Jyväskylä area

The increased number of migrants that have arrived in Europe since 2000, has put new demands on health care staff and little systematic research has been done on their views and experience. The aim was to explore and describe the lived experiences of nurses working in receptions centres in Jyväskylä region, in Finland and the purpose was to provide information to support and develop the competences of nurses working in this field. The methodology was qualitative design with phenomenological approach. The data were obtained through four semi-structured individual interviews and one focus group and underwent thematic analysis. The experiences of the nurses while working in the reception centres were affected by their past experiences and level of professionalism, the refugees own background, their cooperation with other services and translators and the support they received. The cultural differences between the nurses and the client affected the clients’ adaptation to the health care system, their treatment and care as well as the psychology of the nurses while dealing with the challenges. The strengths of this study were that the information revealed partially filled a gap in research and can be used by all related organisations for improvement of their services. Furthermore, it gave the chance for the nurses’ experiences and opinions to be expressed, and for other nurses who are interested in working in this field to enrich their competences in order to offer high quality care to their clients

Centre of pressure, vertical ground reaction forces and neuromuscular responses of special-forces soldiers to 43km load carriage in the field

The primary purpose of this study was to examine lateral deviations in centre of pressure as a result of an extreme duration load carriage task, with particular focus on heel contact. Twenty (n=17 males, n=3 females) soldiers from a Special Operation Forces unit (body mass: 80.72±21.49kg; stature:178.25±8.75cm; age: 26±9yrs) underwent gait plantar pressure assessment and vertical jump testing before and after a 43km load carriage event (duration 817.02[32.66]min) carrying a total external load of 29.80 (1.05)kg. Vertical jump height decreased by 18.62%±16.85% (0.30±0.08m to 0.24±0.07m) p<.001. Loading peak and mid stance force minimum were significantly increased after load carriage (2.59±0.51BW vs. 2.81±0.61BW; p=.035; dGlass=0.44 and 1.28±0.40BW vs. 1.46±0.41BW; p=.015 dGlass=0.45, respectively) and increases in lateral centre of pressure displacement were observed as a result of the load carriage task 14.64±3.62mm to 16.97 ±3.94mm p<.029. In conclusion, load carriage instigated a decrease in neuromuscular function alongside increases in ground reaction forces associated with injury risk and centre of pressure changes associated with ankle sprain risk. Practitioners should consider that possible reduction in ankle stability remains even once the load had been removed, suggesting soldiers are still at increased risk of injury even once the load has been removed

Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU.

OBJECTIVES: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN: Prospective cohort study. SETTING: A total of 306 ICUs from 24 European countries. PARTICIPANTS: Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51.8% male). MEASUREMENTS: Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. RESULTS: The 30-day-mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was .80, and the Brier score was .18. At a cut point of 10 or higher (75% of all patients), the model predicts 30-day mortality in 91.1% of all patients who die. CONCLUSION: A predictive model of cumulative events predicts 30-day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision-making capacity

Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study.

BACKGROUND: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. RESULTS: This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81-86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86-1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87-1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7-60.7) vs. 57.1% (95% CI 53.7-60.1), p = 0.85]. CONCLUSIONS: After adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival

Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study.

BACKGROUND: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. METHODS: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient's age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. RESULTS: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81-87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). CONCLUSION: Knowledge about a patient's frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)

An In-Depth Analysis of Physical Blue and Green Water Scarcity in Agriculture in Terms of Causes and Events and Perceived Amenability to Economic Interpretation

An analytical review of physical blue and green water scarcity in terms of agricultural use, and its amenability to economic interpretation, is presented, employing more than 600 references. The main definitions and classifications involved and information about reserves and resources are critically analyzed, blue and green water scarcity are examined along with their interchange, while their causal connection with climate in general is analyzed along with the particular instances of Europe, Africa, Asia and the WANA region. The role of teleconnections and evaporation/moisture import-export is examined as forms of action at a distance. The human intervention scarcity driver is examined extensively in terms of land use land cover change (LULCC), as well as population increase. The discussion deals with following critical problems: green and blue water availability, inadequate accessibility, blue water loss, unevenly distributed precipitation, climate uncertainty and country level over global level precedence. The conclusion singles out, among others, problems emerging from the inter-relationship of physical variables and the difficulty to translate them into economic instrumental variables, as well as the lack of imbedding uncertainty in the underlying physical theory due to the fact that country level measurements are not methodically assumed to be the basic building block of regional and global water scarcity

The space as evolving material field of education in the collaborative kindergarten

Ο χώρος του σχολείου διαδραματίζει σημαντικό ρόλο στη μάθηση και στην ανάπτυξη του παιδιού. Η συνεργατική διδασκαλία και μάθηση διευκολύνει και ενισχύει την ανάπτυξη αλληλεπιδραστικών σχέσεων μεταξύ των παιδιών και τους παρέχει τις δυνατότητες και τις ευκαιρίες, μέσα από συνεργατικές διαδικασίες, να διαμορφώνουν το χώρο και να τον προσαρμόζουν στις επιθυμίες τους και στις ανάγκες της εκπαιδευτικής διαδικασίας.Σκοπός της παρούσας έρευνας ήταν να αναδείξει τη σημασία της ενεργής συμμετοχής των παιδιών στην αναδιαμόρφωση του χώρου, τη μετατροπή του σε εξελισσόμενο υλικό  πεδίου αγωγής και τη συμβολή του στη μάθηση και ανάπτυξη των παιδιών.Η παρούσα έρευνα ήταν έρευνα δράση και εφαρμόστηκε σε νηπιαγωγεία. Τα αποτελέσματα που προέκυψαν ήταν ιδιαίτερα σημαντικά. Τα παιδιά αναδείχθηκαν σε πρωταγωνιστές στη σχέση τους με το χώρο καθώς τον διαμορφώνανε κατάλληλα για να εξυπηρετεί τις δράσεις τους στη μικρή αλλά και στη μεγάλη ομάδα. Ο χώρος απέκτησε την ιδιότητα της ευελιξίας καθώς μέσα από τη συχνή αναδιοργάνωσή του, που γινόταν με πραγματικές ή συμβολικές αλλαγές, συνδεόταν με τη μάθηση, τις ανάγκες και τις επιθυμίες των παιδιών. Η μετατροπή του χώρου σε εξελισσόμενο υλικό πεδίο αγωγής συνδέθηκε με την αύξηση των θετικών αλληλεπιδράσεων, την εμφάνιση της ευχαρίστησης στην εκπαιδευτική διαδικασία, την ανάπτυξη στοιχείων δημιουργικότητας και την κατάκτηση των γνωστικών στόχων του προγράμματος. School environment plays an important role both in learning and in child development. A learning environment must seek to promote learning as a dynamic activity as well as to support cooperation. Through semantic mutations, the child overturns the topological relationships that exist in space and givesthem new subjective meanings connecting them wit h his/her activity, creating new places.Cooperative teaching and learning facilitates and encourages the development of interactive relationships among children; through collaborative processes, it provides them with possibilities and opportunities to shape the space and adapt it to the wishes and needs of the educational process.The purpose of this study is to highlight firstly, the importance of active participation of children in the re-planning of space, secondly, its conversion into an evolving material field of education and thirdly, its contribution to children’s learning and development.The present study, which lasted for four months, was action research and took place in four kindergarten classes, with a sample of 81 children. The data collection tools were an observation guide, a semi-structured interview guide for children, a questionnaire and a photo shoot. What was used for the data analysis was the method of qualitative content analysis.The results were quite remarkable. Children emerged as protagonists in their relationship with space as they were able to arrange it appropriately in order to serve their actions both within the small and the large group. Space acquired the distinctive quality of flexibility, as through its continuous re-planning, which was made with real or symbolic changes by the child during the educational process, it was associated with learning and the child’s needs and desires. The conversion of space into an evolving material field of education was associated with an increase of positive interactions, as well as with the concept of pleasure within the educational process, the development of the element of creativity and the conquest of the cognitive objectives of the program