Ultrasonography in rheumatology: time to learn from patient views

Objective: The objective of this observational, descriptive, cross-sectional, multicentre study was to assess the perceived quality and grade of satisfaction expressed by patients with chronic arthropathies regarding the use of musculoskeletal (MSK) ultrasonography by rheumatologists as an integrated clinical care tool. Methods: All Spanish rheumatology departments with MSK ultrasonography incorporated in their healthcare services were invited to participate in the study. A Spanish-language survey was offered to fill out anonymously to all consecutive patients with chronic arthropathies under follow-up in the rheumatology outpatient clinics who attended their centre for a period of 3 months. The survey consisted of three sections. The first section contained patients’ demographics, disease data, frequency of performing rheumatological ultrasound and information about who performed their ultrasound assessments. The second section consisted of 14 questions about patient’s experience and opinion on different aspects of the management, performance and perceived usefulness of performing ultrasound, to be answered on a Likert scale 1–5. The third section of the survey was addressed to the rheumatologist ultrasonographers. Results: Nine hundred and four patients from 16 university hospital rheumatology departments completed the survey. All questions reached an overall favourable response ≥ 80%. Patients who reported usual ultrasound examinations in their rheumatology care and those in which it was their attending rheumatologist who performed the ultrasound assessments responded more favourably. Conclusion: Our encouraging patient-centred results may be useful in facilitating the implementation of rheumatological ultrasound in rheumatology care worldwide. Key Points • This is the largest multicentre survey carried out in patients with chronic joint diseases designed to assess their experience and perceived benefits with the use of ultrasonography performed by rheumatologists in daily practice. • Musculoskeletal ultrasound incorporated into rheumatology care was very well accepted and valued by most patients. • The patients perceived that ultrasonography helps not only their rheumatologist but also themselves to better understand their condition. • The patients believed that ultrasonography helps them accept and comply with the proposed treatmen

Jameos : publicación del CEP de Lanzarote

Se propone una reflexión sobre los que el profesorado debería saber, saber hacer y saber ser con respecto al marco educativo competencial, ya que todavía es evidente la lucha de creencias entre el aprendizaje de saberes (saberes declarativos, es decir, saberes cuya validez sólo se comprueba mediante su mera reproducción) y el nuevo paradigma competencial en el que lo importante es, además, su aplicación funcional y efectiva en un contexto significativo. Es urgente la revisión de los diseños instructivos de los modelos presenciales y no presenciales de la formación del profesorado. Se echa en falta la implementación de las metodologías de las que se predican tantas bondades para las aulas (enfoque por tareas, aprendizaje basado en problemas, aprendizaje colaborativo, aprendizaje por proyectos, enseñanza para la comprensión, aprendizaje por diseño, etc.) pero que son escasamente experimentadas por el profesorado en su rol de alumnado en formación.ES

Biblioteca virtual redELE

Memoria de máster (Universidad de Barcelona, 2006). Incluye anexo 'Transcripciones íntegras e interpretaciones'. Resumen tomado de la publicaciónLa programación de la Enseñanza de la Lengua Mediante Tareas (ELMT) es una propuesta habitual en la enseñanza de lenguas extranjeras pero poco frecuente aún en los enfoques didácticos de la primera lengua. Dado que el contexto en el que se desarrolla la presente investigación es el de la Enseñanza Secundaria Obligatoria, la elección de la ELMT ha obligado a revisar sus fundamentos didácticos a la luz de las orientaciones curriculares oficiales y de las numerosas sugerencias institucionales y evidencias psicopedagógicas que actualmente defienden el desarrollo de la competencia comunicativa como objetivo formativo de primer orden. La decisión de adoptar la programación de ELMT en este nivel educativo no solo facilita el cumplimiento de los objetivos curriculares sino que permite potenciar en el aula dimensiones cognitivas normalmente desatendidas en los modelos de programación centrados en el producto, como la comunicación activa, el aprendizaje por experiencia, la reflexión metacognitiva, la dimensión afectiva, el trabajo cooperativo y la autonomía del aprendizaje, entre otras. Siguiendo las últimas tendencias en investigación educativa, el objeto es conocer las creencias respecto a la enseñanza y el aprendizaje de la lengua castellana de un grupo de alumnos de la ESO tras su participación por primera vez en una programación de ELMT.MadridES

Organización y gestión educativa : revista del Forum Europeo de Administradores de la Educación

Resumen basado en el de la publicaciónSe propone un modelo de evaluación pedagógica que estable una escala de cualificaciones para evaluar al alumnado. El objetivo es presentar las características generales de la evaluación y comentar cómo se inició, desde los principios del aprendizaje dialógico y el constructivismo social. Se exponen los principios del 'Plan global para la Mejora del éxito escolar desde una perspectiva inclusiva'. Se muestra el proceso de elaboración del modelo de evaluación y la metodología utilizada. El diseño de los criterios de calificación se ha sistematizado en cuatro pasos para asegurar que los calificadores resultantes condensaran todos los elementos curriculares detectados tras un riguroso análisis. El modelo de evaluación se ha elaborado de forma conjunta utilizando la plataforma de Moodle.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Writing Center to support teachers and students through the creation of tools and digital resources for textual revision (REVISATEXT)

Se presenta la memoria del proyecto del Centro de Escritura creado para toda comunidad educativa de la facultad de Educación. Se trata de un servicio de orientación sobre escritura académica, mediante la oferta de asesorías individuales y de herramientas y recursos digitales de revisión textual.Depto. de Didáctica de las Lenguas, Artes y Educación FísicaFac. de EducaciónUniversidad Complutense de MadridFALSEsubmitte

La evaluación colegiada de las competencias básicas en la Comunidad Autónoma de Canarias : hacia un modelo de escuela inclusiva y sostenible

Precede al título: Educación Primaria y Educación Secundaria ObligatoriaLa Ley Orgánica de Educación (LOE) introduce el concepto de «competencias básicas» como eje articulador del currículo, conectando de pleno con las reflexiones y las estrategias que se están desarrollando en otros sistemas educativos internacionales a la luz del informe Delors (1996), el documento DeSeCo (Definición y Selección de Competencias fundamentales) elaborado por la OCDE, de las evaluaciones PISA (Programa para la Evaluación Internacional del Alumnado), etc. Esta propuesta centra el foco en la dimensión formativa de la «evaluación», aspecto inacabado con la LOGSE (Ley Orgánica General del Sistema Educativo), a pesar de los esfuerzos realizados en esa dirección. Trabajar en las aulas para la consecución de las «competencias básicas» lleva ineludiblemente al problema de cómo evaluarlas de forma colegiada —cuando la propia ordenación del sistema educativo fragmenta cada una de las enseñanzas en diferentes áreas o materias— y de cómo emplear la información que proporciona esta labor para hacer valer el sentido formativo y regulador que debe tener la evaluación de las competencias básicas.Consejería de Educación y Universidades. Dirección General de Ordenación, Innovación y Promoción Educativa; Avda. Buenos Aires, 5; 38071 Tenerife; Tel. +34922592592; Fax +34922592570; [email protected]

Tocilizumab in giant cell arteritis. Observational, open-label multicenter study of 134 patients in clinical practice.

Tocilizumab (TCZ) has shown efficacy in clinical trials on giant cell arteritis (GCA). Real-world data are scarce. Our objective was to assess efficacy and safety of TCZ in unselected patients with GCA in clinical practice Methods: Observational, open-label multicenter study from 40 national referral centers of GCA patients treated with TCZ due to inefficacy or adverse events of previous therapy. Outcomes variables were improvement of clinical features, acute phase reactants, glucocorticoid-sparing effect, prolonged remission and relapses. A comparative study was performed: (a) TCZ route (SC vs. IV); (b) GCA duration (≤6 vs. >6 months); (c) serious infections (with or without); (d) ≤15 vs. >15 mg/day at TCZ onset. 134 patients; mean age, 73.0 ± 8.8 years. TCZ was started after a median [IQR] time from GCA diagnosis of 13.5 [5.0-33.5] months. Ninety-eight (73.1%) patients had received immunosuppressive agents. After 1 month of TCZ 93.9% experienced clinical improvement. Reduction of CRP from 1.7 [0.4-3.2] to 0.11 [0.05-0.5] mg/dL (p  In clinical practice, TCZ yields a rapid and maintained improvement of refractory GCA. Serious infections appear to be higher than in clinical trials

Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet's Disease.

To assess efficacy, safety, and cost-effectiveness of adalimumab (ADA) therapy optimization in a large series of patients with uveitis due to Behçet disease (BD) who achieved remission after the use of this biologic agent. Open-label multicenter study of ADA-treated patients with BD uveitis refractory to conventional immunosuppressants. Sixty-five of 74 patients with uveitis due to BD, who achieved remission after a median ADA duration of 6 (range, 3-12) months. ADA was optimized in 23 (35.4%) of them. This biologic agent was maintained at a dose of 40 mg/subcutaneously/2 weeks in the remaining 42 patients. After remission, based on a shared decision between the patient and the treating physician, ADA was optimized. When agreement between patient and physician was reached, optimization was performed by prolonging the ADA dosing interval progressively. Comparison between optimized and nonoptimized patients was performed. Efficacy, safety, and cost-effectiveness in optimized and nonoptimized groups. To determine efficacy, intraocular inflammation (anterior chamber cells, vitritis, and retinal vasculitis), macular thickness, visual acuity, and the sparing effect of glucocorticoids were assessed. No demographic or ocular differences were found at the time of ADA onset between the optimized and the nonoptimized groups. Most ocular outcomes were similar after a mean ± standard deviation follow-up of 34.7±13.3 and 26±21.3 months in the optimized and nonoptimized groups, respectively. However, relevant adverse effects were only seen in the nonoptimized group (lymphoma, pneumonia, severe local reaction at the injection site, and bacteremia by Escherichia coli, 1 each). Moreover, the mean ADA treatment costs were lower in the optimized group than in the nonoptimized group (6101.25 euros/patient/year vs. 12 339.48; P ADA optimization in BD uveitis refractory to conventional therapy is effective, safe, and cost-effective

Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis due to Behçet's Disease: National Multicenter Study of 177 Cases.

To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as a first-line biologic drug over 1 year of treatment in a large series of patients with refractory uveitis due to Behçet's disease (BD). We conducted an open-label multicenter study of IFX versus ADA for BD-related uveitis refractory to conventional nonbiologic treatment. IFX or ADA was chosen as the first-line biologic agent based on physician and patient agreement. Patients received 3-5 mg/kg intravenous IFX at 0, 2, and 6 weeks and every 4-8 weeks thereafter, or 40 mg subcutaneous ADA every other week without a loading dose. Ocular parameters were compared between the 2 groups. The study included 177 patients (316 affected eyes), of whom 103 received IFX and 74 received ADA. There were no significant baseline differences between treatment groups in main demographic features, previous therapy, or ocular sign severity. After 1 year of therapy, we observed an improvement in all ocular parameters in both groups. However, patients receiving ADA had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation (92.31% versus 78.18% for IFX; P = 0.06), improvement in vitritis (93.33% versus 78.95% for IFX; P = 0.04), and best-corrected visual acuity (mean ± SD 0.81 ± 0.26 versus 0.67 ± 0.34 for IFX; P = 0.001). A nonsignificant difference was seen for macular thickness (mean ± SD 250.62 ± 36.85 for ADA versus 264.89 ± 59.74 for IFX; P = 0.15), and improvement in retinal vasculitis was similar between the 2 groups (95% for ADA versus 97% for IFX; P = 0.28). The drug retention rate was higher in the ADA group (95.24% versus 84.95% for IFX; P = 0.042). Although both IFX and ADA are efficacious in refractory BD-related uveitis, ADA appears to be associated with better outcomes than IFX after 1 year of follow-up