Alfabetización en salud: proceso de aprendizaje significativo personal y comunitario / Health literacy: meaningful personal and community learning process

El aprendizaje y la salud son dos elementos vinculados entre sí. El hecho de cuidar de la salud requiere del aprendizaje de conocimientos, habilidades, comportamientos y actitudes que se desarrollan a lo largo de nuestra vida. Los aprendizajes relacionados con la salud comportan estilos de vida más saludables, la mejora del bienestar, la calidad de vida y la salud de la comunidad. El aprendizaje significativo transforma las vidas, abriendo nuevas oportunidades, posibilitando nuevas competencias y formando nuevas redes sociales. Este artículo pretende reflexionar sobre la relación entre elementos de la alfabetización en salud y el proceso de aprendizaje significativo. (AU)

Learning and health are both interrelated aspects. The act of looking after health requires learning knowledge, skills, behaviors, and attitudes that develop throughout our lives. Health-related learning leads to healthier lifestyles, improved well-being, better quality of life and community health. Significant learning transforms lives, paving the way towards new opportunities, enabling new skills and forming new social networks. This paper aims to reflect on the relationship between aspects of health literacy and the meaningful learning process. (AU)

Impaired social learning in patients with major depressive disorder revealed by a reinforcement learning model

Background/objective: Patients with major depressive disorder (MDD) have altered learning rates for rewards and losses in non-social learning paradigms. However, it is not well understood whether the ability to learn from social interactions is altered in MDD patients. Using reinforcement learning during the repeated Trust Game (rTG), we investigated how MDD patients learn to trust newly-met partners in MDD patients. Method: Sixty-eight MDD patients and fifty-four controls each played as ‘investor’ and interacted with ten different partners. We manipulated both the level of trustworthiness by varying the chance of reciprocity (10, 30, 50, 70 and 90%) and reputation disclosure, where partners’ reputation was either pre-disclosed or hidden. Results: Our reinforcement learning model revealed that MDD patients had significantly higher learning rates for losses than the controls in both the reputation disclosure and non-disclosure condition. The difference was larger when reputation was not disclosed than disclosed. We observed no difference in learning rates for gains in either condition. Conclusions: Our findings highlight that abnormal learning for losses underlies the social learning process in MDD patients. This abnormality is higher when situational unpredictability is high versus low. Our findings provide novel insights into social rehabilitation of MDD. (AU)

Las Intervenciones Socioeducativas en Estudiantes de Magisterio para Reducir el Estigma en la Salud Mental / Socio-educational interventions with pre-service school teachers to reduce stigma in mental health

El presente estudio examinó el efecto de tres intervenciones socioeducativas en estudiantes de Magisterio sobre la reducción del estigma: un juego formativo denominado Stigma-Stop, programa basado en el contacto directo entre estudiantes y pacientes con problemas de salud mental y, en tercer lugar, la emisión de un documental junto con la charla de un profesional. Se contó con la participación de 120 alumnos que cursaban el Grado de Magisterio en Educación Infantil y de Magisterio en Educación Primaria. Se trata así de un un diseño experimental pretest-postest, en el que los participantes se dividieron de manera aleatoria en tres grupos experimentales y un grupo de control. Los resultados mostraron una reducción estadísticamente significativa del grado de estigma entre el pretest y postest en las tres intervenciones, a diferencia del grupo control que se mantuvo estable en ambas mediciones, lo cual implica que las tres intervenciones fueron eficaces en la reducción del estigma, particularmente en la dimensión de peligro y en la puntuación total.(AU)

This study examined the effect of three socio-educational interventions in teacher training students on the reduction of stigma: a serious game called Stigma-Stop, a program based on direct contact between students and people with mental health problems, and the broadcast of a documentary with a talk from a professional. The sample consisted of 120 undergraduates of the Degree in Teaching in Early Childhood Education and the Degree in Teaching in Primary Education of a Spanish university, with a pretest-posttest experimental design, the participants were randomly divided into three experimental groups and a control group. The results show a statistically significant reduction in stigma levels between the pretest and posttest in the three interventions, but not in the control group, which remained stable in both measurements. This showed that the three interventions were effective in reducing stigma, predominantly in the danger dimension and the total score.(AU)

La formación integral del médico para enfrentar las barreras para la atención comunitaria a propósito de El médico africano / Integral medical education to face barriers for community healthcare in The African physician

El conjunto de conocimientos, habilidades, principios y valores de un individuo para ejercer bien su trabajo en medicina sirven para fortalecer el desenvolvimiento en una comunidad. La película Bienvenue à Marly-Gomont (2016) de Julien Rambaldi, tiene por tema principal el esfuerzo y las actitudes del médico congoleño Zantoko ante el racismo que demuestran los habitantes de la villa rural Marly-Gomont de los años setenta. La película muestra a una comunidad francesa aislada, quienes nunca habían visto a una persona de color; nos sitúa con la familia de Zantoko en el contexto de la comunidad, lo que nos permite comprender los puntos fundamentales que pudieron haber servido como herramientas prácticas y necesarias para la labor del médico comunitario. Nos invita a reflexionar acerca de las dificultades que pueden presentarse ante la falta de conocimientos necesarios para atender una comunidad y la poca prevención en dicha comunidad. En suma, es una película excelente para la enseñanza y aprendizaje de temas relacionados con la labor que desarrollan los profesionales de la salud a nivel poblacional/local. (AU)

An individual's set of knowledge, skills, principles and values to carry out his medical work well serves to strengthen the unfolding in a community. The film the African physician (2016) of Julien Rambaldi, has as its main theme the effort and attitudes of the Congolese doctor Zantoko and how he faces the fear racism of the habitans of rural village Marly-Gomont on the seventies. The film shows an isolated French community, who had never seen black people; places us with Zantoko's family in the context of the community, which allows us to understand the fundamental point that may have served as practical and necessary tools for the work of the community doctor. It invites us to reflect on the difficulties that may occur in the face of the lack of knowledge needed to serve a community and ignorance of it. It is an excellent film for teaching and learning topics related to the work of health professionals at the population/local level. (AU)

Seizing the opportunity - a salutogenic approach to public health

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Unravelling salutogenic mechanisms in the workplace: the role of learning / Descifrando los mecanismos salutogénicos en el lugar de trabajo: el papel del aprendizaje

Objective: To explore the moderating and mediating role(s) of learning within the relationship between sense of coherence (SOC) and generalized resistance resources. Method: Cross-sectional study (N=481), using a self-administered questionnaire, of employees working in the healthcare sector in the Netherlands in 2017. Four residential healthcare settings and one healthcare-related Facebook group were involved. Multiple linear regression models were used to test for moderating and mediating effects of learning. Results: Social relations, task significance, and job control significantly explained variance in SOC. Conceptual, social, and instrumental learning, combined, moderated the relationship between SOC and task significance. Instrumental learning moderated the relationship between job control and SOC. Social learning also mediated this relationship. Conceptual learning did not show any moderating or mediating effect. Conclusions: The relationship between SOC and the three GRRs seems to be strengthened or explained−to a certain extent−by instrumental and social learning. Healthcare organizations are recommended to promote learning through formal activities as well as through cooperation, feedback, sharing experiences, and job challenges. This requires employee participation and a multilevel interdisciplinary approach

Objetivo: Explorar el rol del aprendizaje conceptual, instrumental y social en la relación entre el sentido de la coherencia (SC) y los recursos generales de resistencia (RGR) clave. Métodos: Se realizó un estudio transversal en 2017 (N=481) a profesionales del sector sanitario en Holanda mediante un cuestionario autoadministrado. Participaron cuatro centros de residencia geriátrica, así como un grupo de profesionales de salud de la red social de Facebook. Se utilizaron modelos de regresión lineal múltiple para evaluar los efectos de los roles de moderación y mediación del aprendizaje. Resultados: Las relaciones sociales, el significado de las tareas y el control del trabajo explicaron de manera significativa la varianza en el SC. La combinación del aprendizaje conceptual, instrumental y social moderó la relación entre el SC y el significado de las tareas. El aprendizaje instrumental moderó la relación entre el control del trabajo y el SC. El aprendizaje social también medió en esta relación. Sin embargo, el aprendizaje conceptual no mostró ningún efecto moderador ni mediador. Conclusiones: La relación entre el SC y estos tres RGR parece verse fortalecida o explicada, en cierta medida, por el aprendizaje instrumental y social. Se recomienda a las organizaciones sanitarias promover el aprendizaje a través de actividades formales, así como mediante la cooperación, comentarios, intercambio de experiencias y desafíos laborales. Esto requiere la participación del profesional, así como una cooperación multidisciplinaria y a distintos niveles

The ecology of social learning in animals and its link with intelligence

Classical ethology and behavioral ecology did not pay much attention to learning. However, studies of social learning in nature reviewed here reveal the near-ubiquity of reliance on social information for skill acquisition by developing birds and mammals. This conclusion strengthens the plausibility of the cultural intelligence hypothesis for the evolution of intelligence, which assumes that selection on social learning abilities automatically improves individual learning ability. Thus, intelligent species will generally be cultural species. Direct tests of the cultural intelligence hypothesis require good estimates of the amount and kind of social learning taking place in nature in a broad variety of species. These estimates are lacking so far. Here, we start the process of developing a functional classification of social learning, in the form of the social learning spectrum, which should help to predict the mechanisms of social learning involved. Once validated, the categories can be used to estimate the cognitive demands of social learning in the wild (AU)

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Cognition and culture in evolutionary context

In humans and other animals, the individuals’ ability to adapt efficiently and effectively to the niches they have actively contributed to construct relies heavily on an evolved psychology which has been shaped by biological, social, and cultural processes over evolutionary time. As expected, although many of the behavioral and cognitive components of this evolved psychology are widely shared across species, many others are species-unique. Although many animal species are known to acquire group-specific traditions (or cultures) via social learning, human culture is unique in terms of its contents and characteristics (observable and unobservable products, cumulative effects, norm conformity, and norm enforcement) and of its cognitive underpinnings (imitation, instructed teaching, and language). Here we provide a brief overview of some of the issues that are currently tackled in the field. We also highlight some of the strengths of a biological, comparative, non-anthropocentric and evolutionarily grounded approach to the study of culture. The main contributions of this approach to the science of culture are its emphasis (a) on the integration of information on mechanisms, function, and evolution, and on mechanistic factors located at different levels of the biological hierarchy, and (b) on the search for general principles that account for commonalities and differences between species, both in the cultural products and in the processes of innovation, dissemination, and accumulation involved that operate during developmental and evolutionary timespans (AU)

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