Application of indirect observation within mixed methods to contrast the results obtained through direct observation: a discussion with observed Pikler educators.

Introduction: This work arises from a previous research, "Pikler educators early in the morning" carried out in the Emmi Pikler Nursery School in Budapest through Systematic Observation. In it, Piklerian choreographies were found in observed educators' behavior during the studied three daily activities: feeding breakfast, dressing to go to the garden and free play accompanying. All of them share certain Piklerian principles, which are synthesized in three central keys: the stability of the educator's behavior, her strategic and intentional positioning, and an active emotional control. Objectives: This study aims to contrast this synthesis of results by means of an in-depth interview with the two observed educators, and to apply the methodological approach of indirect observation within mixed methods for its analysis. The objective is to confirm whether the three central keys are recognized as their own and to look for new theoretical-practical elements within the studied educational approach. Materials and methods: We applied an in-depth interview and analyzed it following the guidelines of indirect observation. The participants were the two educators previously observed, a translator from the Pikler team, and the three observers, authors of this work. An ad hoc observation instrument was elaborated, and the three macro-stages QUAL-QUAL-QUAL proposed within mixed methods were rigorously followed. Results: Lag sequential analysis was used to conduct data analyses. We deepened in prospective lags and obtained the response pattern underlying the interview. Then, we performed a concurrence analysis to investigate the relationship between the central keys obtained in our original research and Piklerian ideas. Conclusion: In-depth interview within mixed methods has been a novel and generous tool leading us to substantial and methodological contributions, despite the simplicity of performed analyses. Interviewed educators' response pattern is a faithful reflection of the Piklerian modus operandi. The study of concurrences shows that Piklerian education is something natural, integrated in its professionals, with the exception of emotional control, which still requires permanent reflection.

"But This Is the New Reality, and I Will Adapt": Understanding Lecturers' Experiences of COVID-19 Lockdown Online Learning and Teaching.

Following the 2020 COVID-19 pandemic national lockdown in South Africa, the University of the Free State launched various support initiatives for academic staff and students. Teaching and learning activities and assessments were adapted for emergency remote teaching. Students and academic staff members experienced disruption due to the migration to the online environment. This study aimed to investigate the experiences of academic staff members in an undergraduate medical programme using a mixed-methods approach in the form of a sequential exploratory design in two phases. Quantitative data were obtained through an online questionnaire survey that were triangulated and complemented with qualitative data obtained from responses to open questions in the questionnaire survey and online reflective essays. Quantitative data revealed that although most academic staff members had received training in and used mostly administrative functions in the learning management system (Blackboard) prior to lockdown, its uses almost doubled during the lockdown. Qualitative data analysis gave an in-depth understanding of academic staff members' experiences identified in the themes Teaching and Learning, Assessment, Technology, Communication, and Personal Experience. Concerns were expressed regarding students' access to technology and adaptation to online learning, and training needs and challenges were identified. The lessons learnt through the resilient, transformative responses to this global disruptor can guide future strategies for medical education.

Effectiveness of an educational approach between adolescents and adults with patellofemoral pain syndrome: a scoping review with meta-analysis.

[Purpose] This study aimed to compare the effectiveness of an educational approach between adolescents and adults with patellofemoral pain syndrome. [Participants and Methods] The PROSPERO protocol number is CRD42022362680. Four databases (PubMed, CINAHL, Scopus, Cochrane) were searched. Randomized control trials on the effectiveness of the educational approach for patellofemoral pain syndrome were compared between adolescents and adults. Two investigators independently screened eligible studies. Two randomized control trials proceeded through meta-analysis with a visual analogue scale in the mid-term (from 18 weeks to 6 months). [Results] The meta-analysis results indicated that no significant difference was observed between education and combined education with exercise. A tendency to improve in the intervention of combined education with exercise for adolescents was noted, whereas no effect of education for adults was observed. [Conclusion] Treatment strategies combining education with exercise for patellofemoral pain syndrome may differ between adolescents and adults.

[A therapeutic education program for patients with multiple sclerosis]. / Un programme d'éducation thérapeutique pour les patients atteints de sclérose en plaques.

The MOTIV-SEP therapeutic education program for people with multiple sclerosis integrates the cognitive, emotional, behavioral and social components of therapeutic compliance. These components allow for an approach centered on the individual, in order to help him or her better support the important stage of starting treatment, but also to anticipate and reduce the obstacles to compliance.

[An information booklet on psychotropic treatments for child psychiatry patients]. / Un livret d'information sur les traitements psychotropes pour les patients de pédopsychiatrie.

In the child psychiatry hospital setting, educational approaches and the therapeutic alliance are fundamental principles on which professionals rely on a daily basis. Therapeutic acts, including the administration of psychotropic drugs, are carried out in a specific care area. What about the child's or adolescent's compliance with medication outside this setting? A booklet dedicated to psychotropic treatments, intended for patients and their relatives, has been designed with an informative objective.

The Relationship between Young Children's Graphomotor Skills and Their Environment: A Cross-Sectional Study.

The current study aimed to examine the unique contribution of personal and environmental factors to explain graphomotor skills in typically developing preschoolers and first-year elementary school students. A convenience sample of 136 Israeli children aged three−seven years was recruited. Graphomotor skills were assessed using the Gilboa Functional Test (GIFT); personal and environmental factors were assessed using a demographic questionnaire and the Home Literacy Experiences Questionnaire (HLEQ). A hierarchical multiple linear regression analysis revealed that home literacy and educational approach accounted for 43.1% of the variance of graphomotor skills (R2 = 40.4, p < 0.000), each providing a unique contribution to the explained variance after controlling for age, gender, and spoken language. Generally, our results supported the bioecological model, with proximal factors (home literacy and educational approach) having a greater influence on child graphomotor skills than distal factors (parental socioeconomic and immigration status). By highlighting the role of environmental factors in graphomotor development, these results can be used as a conceptual framework for developing early intervention programs.

The value and contribution of intellectual disability nurses/nurses caring for people with intellectual disability in intellectual disability settings: A scoping review.

BACKGROUND: People with intellectual disability experience poorer health and healthcare access issues. As a leading role in healthcare provision for people with intellectual disability nurses are key to supporting person-centred care and health outcomes. However, little is known about specialist intellectual disability nursing and their contribution to care provision for people with intellectual disability. METHODS: A systematic scoping review. Searches of seven academic databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO, Embase, Scopus and Web of Science were conducted to identify relevant literature. Literature addressing intellectual disability nursing or nursing care for people with intellectual disability in intellectual disability centres/units/care homes were reviewed and reported as per PRISMA-ScR checklist and PRISMA flow diagram. RESULTS: The published literature (n = 68) is extensive and describes the value and contribution of intellectual disability nursing across all domains of professional practice and supports a biopsychosocial-educational approach to addressing the physical, mental and social needs of clients with intellectual disability across the care continuum of health management, health promotion and health education. CONCLUSIONS: Despite the importance of the review question and the large volume of publication evidence detailing wide-ranging professional nursing roles and responsibilities, there remains limited literature on the assessment and intervention strategies employed by intellectual disability nurses that highlight their specialist knowledge and skill. Future research should focus on making the role of the nurse more visible and presenting their unique contributions to client care, service delivery, policy and ultimately to the art and science of nursing.

Valuable interaction with cognitive remediation and optimal antipsychotics for recovery in schizophrenia (VICTORY-S): study protocol for an interventional, open-label, randomized comparison of combined treatment with cognitive remediation and lurasidone or paliperidone.

Background: Cognitive impairment, a core feature of schizophrenia, is associated with poor outcomes. Pharmacotherapy and psychosocial treatment, when used alone, have inadequate effect sizes for cognitive impairment, leading to recent interest in combination interventions. A previous study examined the additive effect of cognitive remediation on lurasidone in patients with schizophrenia, which was negative. Although improvement in cognitive function was suggested for lurasidone, it was inconclusive because there was no antipsychotic control in the study. To clarify whether lurasidone has a meaningful impact on cognitive function in combination with cognitive remediation, we use paliperidone as a control antipsychotic in this study. We hypothesize that combination with lurasidone will improve cognitive and social function to a greater extent than paliperidone. Methods: The valuable interaction with cognitive remediation and optimal antipsychotics for recovery in schizophrenia study is a multicenter, interventional, open-label, rater-blind, randomized comparison study, comparing the effect of lurasidone plus cognitive remediation with that of paliperidone plus cognitive remediation in patients with schizophrenia. The Neuropsychological Educational Approach to Remediation (NEAR) is used for cognitive remediation. Eligible patients will be randomized 1:1 to receive lurasidone or paliperidone combined with NEAR (6 weeks antipsychotic alone followed by 24 weeks combination antipsychotic plus NEAR). The primary endpoint is the change from baseline in the tablet-based Brief Assessment of Cognition in Schizophrenia composite T-score at the end of the NEAR combination treatment period. Secondary endpoints will include change from baseline in social function, schizophrenia symptoms, and quality of life at the end of the NEAR combination treatment period. Furthermore, change from baseline to the end of the pharmacotherapy period and change from the end of the pharmacotherapy period to the end of the NEAR combination treatment period will be assessed for all endpoints. Safety will also be evaluated. Discussion: Achievement of adequate cognitive function is central to supporting social function, which is a key treatment goal for patients with schizophrenia. We think this study will fill in the gaps of the previous study and provide useful information regarding treatment decisions for patients with schizophrenia. Clinical trial registration: Japan Registry of Clinical Trials ID, jRCTs031200338.

A gamified augmented reality vocational training program for adults with intellectual and developmental disabilities: A pilot study on acceptability and effectiveness.

Objectives: The Augmented Reality Games to Enhance Vocational Ability of Patients (REAP) was an augmented reality vocational training program that provided skills training in the context of a psychiatric rehabilitation program. It was implemented over 10 weeks and consisted of gamified augmented reality café training scenarios and bridging group activities to facilitate transfer of learning to the work context. This pilot study aimed to explore the acceptability and effectiveness of the REAP program when carried out with adults with intellectual and developmental disabilities attending work therapy. Its objectives were: (1) to obtain feedback from participants and trainers on their experiences and acceptability of the REAP program and (2) to measure changes in vocational and cognitive skills of participants in the REAP program. Materials and methods: This was a pretest-posttest mixed methods study. 15 adults with intellectual and developmental disabilities attending work therapy in a non-profit organization participated in the REAP program and their vocational trainers were involved in assisting in this program. Feasibility Evaluation Checklist (FEC) and the Neurobehavioral Cognitive Status Exam (Cognistat) were administered at baseline, post-training and eight weeks after training. The participants and their trainers also provided user feedback via semi-structured interviews. Results: Majority of the participants and trainers found the REAP program to be useful and interesting. They also found that the augmented reality games were user-friendly and provided a unique opportunity to acquire new skills. Participants who engaged in this program showed a significant improvement in vocational skills and aspects of cognitive skills, which were maintained eight weeks after training. Conclusion: The gamified augmented reality vocational training was feasible and accepted by both adults with intellectual and developmental disabilities and their trainers. When integrated with bridging sessions to facilitate transfer of learning to existing work therapy, participants on the REAP program showed significant improvements in vocational skills and aspects of cognitive skills. Future experimental studies with larger sample size could provide stronger evidence on its effectiveness in improving vocational outcomes.

The Effect of Music Intervention on Fetal Education via Doppler Fetal Monitor.

This study focused on the effects of music intervention on fetal education in pregnant women. The fetal heart rate of the fetus at 30-38 weeks of gestational age was monitored by an ultrasound Doppler fetal monitor, and differences in the frequency of fetal movement responses to familiar and unfamiliar music courses were recorded and analyzed. The analysis results showed that the fetuses had less fetal movement to fixed singing activities, with a mean of 0.7 and a standard deviation of 0.79. On the contrary, the fetuses had significant fetal movement responses to irregular singing, with a mean of 1.73 and a standard deviation of 1.37. The results showed that the fetus receives external sounds through hearing, and a pregnant woman singing fixed music to her fetus can stabilize the frequency of fetal movement, promote the health of herself and the fetus, and establish maternal-fetal bonding.

Specialization and Injury Risk in Different Youth Sports: A Bio-Emotional Social Approach.

Aims: Sport specialization is an actual trend in youth athletes, but it can increase injury risk. The aim was to determine the eventual correlation between sports specialization and injury risk in various sports, using a biopsychosocial approach. Methods: 169 sport-specialized athletes completed [(38 female, 131 male); overall (11.2 ± 2.7 years), (56.28 ± 15.72 kg), (161.3 ± 15.52 cm)] a self-reported questionnaire regarding sociodemographic (age, gender, educational level), physical-attitudinal, injuries and psychological-attitudinal To analyze data univariate and correlate analyses were used. Results: Of 169 athletes enrolled, 53% were single-sport specialized (reported participation in one sport and trained > 8 months/year). In team sports (100%, OR = 0.75; p = 0.022) a high risk of having to remain at rest for up to 1 month because of overuse was observed. Males who suffered direct trauma (70%; OR = 1.03; p = 0.006) in the team group (95%, OR = 0.09; p = 0.008) were more exposed to that type of injury, and also the type of specialization figured significantly (p = 0.047). In addition, interoceptive awareness correlates with injury (95%, 1.04, p = 0.01). This study shows that, even though young athletes seem to be at a high risk of becoming injured, early team sport specialization and a high performance level cannot be considered to be the only risk factors.

Simulation-Based Learning Supported by Technology to Enhance Critical Thinking in Nursing Students: Protocol for a Scoping Review.

BACKGROUND: Critical thinking is a crucial skill in the nursing profession, so teaching strategies and methodology must be carefully considered when training and preparing nursing students to think critically. Studies on simulation-based learning supported by technology are increasing in nursing education, but no scoping reviews have mapped the literature on simulation-based learning supported by technology to enhance critical thinking in nursing students. OBJECTIVE: The proposed scoping review aims to systematically map research on the use of simulation-based learning supported by technology to enhance critical thinking in nursing students. METHODS: The proposed scoping review will use the framework established by Arksey and O'Malley and will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, EMBASE, PsycINFO, and Web of Science databases. Pairs of authors independently selected the articles by screening titles, abstracts, full-text papers, and extract data. The data will be analyzed and thematically categorized. RESULTS: The development of a comprehensive and systematic search strategy was completed in June 2021. The database searches were performed in July 2021, and the screening of titles and abstracts was completed in September 2021. Charting the data began in February 2022. Analysis and synthesis will be performed sequentially, and the scoping review is expected to be complete by May 2023. CONCLUSIONS: The results of this proposed scoping review may identify gaps in the literature and provide an overview of research on the topic of simulation-based learning supported by technology to enhance critical thinking in nursing students. The research may identify nursing students' reported barriers and enablers for learning critical thinking skills through simulation-based learning supported by technology, and the results may help educators enhance their educational approach through knowledge of students' firsthand experiences and further development of successful teaching strategies in nursing education. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36725.

To see, meet and adapt - an interview study about physiotherapists' pedagogical approach to dementia.

BACKGROUND: Physiotherapists need to use pedagogical approaches and strategies in their work. However, there is no previous definition of what a pedagogical approach in physiotherapy means neither in general nor specifically to dementia. The purpose of this study was therefore to gain greater insight into physiotherapists' pedagogical approach to dementia by investigating physiotherapists' views and working methods in contact with older people with dementia, relatives, and nursing staff in elderly care. METHODS: This was a qualitative study with an inductive approach. Semi-structured individual interviews were conducted with 15 physiotherapists with experience of working with older people with dementia in elderly care. The interviews were analyzed with qualitative content analysis. RESULTS: The term "pedagogical approach" could sometimes be experienced as "vague" or "hard to grasp". Our research nonetheless identified one overarching theme To see, meet and adapt which is based on insights from the interviews grouped in to five categories. This theme can be seen as an expression of the physiotherapists' pedagogical approach in contact with older people with dementia, relatives, and nursing staff. It captures the participants' desire to always see the person in front of them, meet them where they are and adapt their own way of working accordingly. Creating a trusting relationship was described as important and made it easier for the participants to adapt their working methods. The participants' adaptations could apply to the way they communicated with people with dementia, and how they organized tutoring/education of relatives and nursing staff to maximize learning. Learning through experience and reflection was described as a key to advancing the pedagogical approach and the participants experienced their own learning as constantly ongoing. CONCLUSIONS: This study provides increased understanding into physiotherapists' pedagogical approach in contact with older people with dementia, relatives, and nursing staff in elderly care and shows that learning through experience and reflection can contribute to the development of the pedagogical approach. Thus, opportunity for reflection should be accommodated in the physiotherapists' work. The importance of more pedagogical education for physiotherapists both in bachelor and master level were also highlighted. Increasing mobility and physical activity in older people with dementia is important since physical inactivity and sedentary behavior is common. Future research may be directed at further exploring physiotherapists' pedagogical approach in tutoring/education of nursing staff, with the aim of increasing physical activity among older people with dementia.

Deliberate Practice and Motor Learning Principles to Underpin the Design of Training Interventions for Improving Lifting Movement in the Occupational Sector: A Perspective and a Pilot Study on the Role of Augmented Feedback.

Spine posture during repetitive lifting is one of the main risk factors for low-back injuries in the occupational sector. It is thus critical to design appropriate intervention strategies for training workers to improve their posture, reducing load on the spine during lifting. The main approach to train safe lifting to workers has been educational; however, systematic reviews and meta-analyses have shown that this approach does not improve lifting movement nor reduces the risk of low back injury. One of the main limitations of this approach lies in the amount, quality and context of practice of the lifting movement. In this article, first we argue for integrating psychologically-grounded perspectives of practice design in the development of training interventions for safe lifting. Principles from deliberate practice and motor learning are combined and integrated. Given the complexity of lifting, a training intervention should occur in the workplace and invite workers to repeatedly practice/perform the lifting movement with the clear goal of improving their lifting-related body posture. Augmented feedback has a central role in creating the suitable condition for achieving such intervention. Second, we focus on spine bending as risk factor and present a pilot study examining the benefits and boundary conditions of different feedback modalities for reducing bending during lifting. The results showed how feedback modalities meet differently key requirements of deliberate practice conditions, i.e., feedback has to be informative, individualized and actionable. Following the proposed approach, psychology will gain an active role in the development of training interventions, contributing to finding solutions for a reduction of risk factors for workers.

Study Protocol of a Multicenter Randomized Controlled Trial to Tackle Obesity through a Mediterranean Diet vs. a Traditional Low-Fat Diet in Adolescents: The MED4Youth Study.

Youth obesity is a strong predictor of adult obesity, which has well-known negative health consequences. Thus, addressing adult obesity requires tackling youth obesity. MED4Youth's main objective is to strengthen the link between the Mediterranean Diet (MD) and the health benefits against youth obesity and associated cardiovascular disease (CVD) risk factors, identifying positive effects exerted by an MD including sourdough bread and healthy products from the Mediterranean basis (chickpeas/hummus, nuts, and pomegranate juice). For this purpose, a multicenter randomized controlled trial in which an MD-based intervention will be compared to a traditional low-fat diet intervention will be carried out with 240 overweight and obese adolescents (13-17 years) from Spain, Portugal, and Italy. Both interventions will be combined with an educational web-application addressed to engage the adolescents through a learning-through-playing approach, using both educational materials and games. To assess the interventions, adherence to the MD, dietary records, physical activity, food frequency, sociodemographic, and quality of life questionnaires as well as classical anthropometric and biochemical parameters will be evaluated. Furthermore, an omics approach will be performed to elucidate whether the interventions can shape the gut microbiota and gut-derived metabolites to gain knowledge on the mechanisms through which the MD can exert its beneficial effects.

A Systematic Observation of Early Childhood Educators Accompanying Young Children's Free Play at Emmi Pikler Nursery School: Instrumental Behaviors and Their Relational Value.

A significant number of literature documents young children's innate interest in discovering their surroundings and gradually developing more complex activities and thoughts. It has been demonstrated that when environments support young children's innate interest and progressive autonomy, they help children acquire a self-determined behavior. However, little is known about the application of this evidence in the daily practice of early childhood educational settings. This study examines Emmi Pikler Nursery School, a center that implements an autonomy-supportive educational approach. We conducted a systematic observation of two experienced Pikler educators while they accompanied young children's free play. Our objective was to assess: if educators' instrumental action follows a systematic behavioral sequence, if specific relational behaviors support each instrumental action, and if educators display differentiated intervention levels concerning children's free play through the adaptation of the relational dimension. We conducted a lag sequential analysis to find behavioral patterns and concurrences between the observed behaviors. Our findings indicate that educators perform systematic action sequences and that each of the instrumental actions of those sequences has a specific relational value. We conclude that educators display three differentiated intervention levels depending on the child and the circumstances of the moment, providing appropriate autonomy support and reinforcing children's self-determination.

Implementation of a phased medical educational approach in a developing country.

OBJECTIVE: Healthcare provider education can serve as one method for improving healthcare in developing countries. Working with providers at St Luke Hospital in Haiti, we developed a phased educational approach through partnership development, face-to-face teaching, and virtual educational tools. DESIGN: Our novel approach included three phases: direct patient care, targeted education, and utilization of the train-the-trainer model. Our end goal was an educational system that could be utilized by the local medical staff to continually improve their medical knowledge, even after our educational project was completed. We implemented pre- and post-lecture evaluations during our teaching phase to determine whether the education provided was effective and beneficial. Additionally, we provided medical lectures on a shared file internet platform, Box.com, during the train-the-trainer phase to allow healthcare providers in Haiti to access the educational content electronically. RESULTS: In total, 47 lectures were given to 150 medical providers, including nurses, physicians, and pharmacists. Pre- and post-lecture evaluations were administered. The mean was 30.63 (14.40) for pre-lecture evaluations and 93.36 (9.80) for post-lecture evaluations indicating improvement out of a total of 100 possible points. Our collaborative Box.com account contains 214 medical education lectures available for viewing as a constant resource to St Luke Hospital staff. Thus far, 20 of the 43 (47%) Haitian medical providers have viewed lectures, with an average of 5.6 lectures viewed per person. Qualitative data suggest that these methods improved communication between healthcare staff, promoted better ways of triaging patients, and improved job satisfaction. CONCLUSIONS: A phased educational approach can improve healthcare workers' knowledge through partnership in a developing country. Educating local providers is one way of ensuring that in-country healthcare staff will improve their medical knowledge and expertise.

A qualitative study of adherence to nutritional treatment: perspectives of patients and dietitians.

BACKGROUND: Effective interaction between care providers and patients is crucial for the success of most medical treatments; in nutritional medical treatment, it is of paramount importance. The aim of the present study was to ascertain the role of the dietitian-patient relationship and the counseling approach in influencing individual patient decisions to adhere to counseling by persisting with nutritional treatment. METHODS: We conducted focus groups with two types of patients, namely, those who had consulted dietitians only once and those who had attended at least three appointments. We divided these two groups into 12 focus groups. In addition, in-depth interviews were held with 17 clinical dietitians. Our qualitative research was based on the perceptions of patients and dietitians. RESULTS: When the encounter between the dietitian and the patient followed the standard educational and informative approach, both the short-term nature of the interaction and the absence of an individualized therapeutic program discouraged patients from persisting with treatment. In contrast, the counseling and therapeutic nutritional approach promoted nutritional guidance through broader behavioral and lifestyle therapies. This approach appears more appropriate for chronically ill patients. The dietitians and some of the patients understand that the profession is changing from the informative and educational approach to a therapeutic counseling approach, but it is difficult for them to adapt to the new model. CONCLUSION: Most patients appear to want individualized, not standardized, treatment. In order to change patients' eating patterns, dietitians must adopt a more therapeutic approach and relate to patients' cultural needs and desires to achieve sustainable results.

A pilot study on the effects of cognitive remediation on hemodynamic responses in the prefrontal cortices of patients with schizophrenia: a multi-channel near-infrared spectroscopy study.

The regional neuronal changes taking place between before and after cognitive rehabilitation are still not characterized in schizophrenia patients. In addition, it is not known whether these regional changes are predictive or correlated with treatment response. We conducted a preliminary quasi-experimental study to investigate the effects of a Neuropsychological Educational Approach to Cognitive Remediation (NEAR), one of the cognitive remediation therapies, on neurocognitive functioning assessed by the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J), and on prefrontal and temporal hemodynamic responses during working memory (WM) task (2-back, letter version) using 52-channel near-infrared spectroscopy (NIRS). We assessed 19 patients with schizophrenia or schizoaffective disorder twice with an interval of 6months. Moreover, taking into consideration the possible practice effect, we assessed 12 control patients twice with an interval of 6months. The NEAR group, in comparison with the control group, showed significant improvement in two subcomponents of BACS-J, that is, motor speed and executive function along with the composite scores. The NEAR group also showed a significant increase in brain activation in the bilateral cortical regions associated with WM, and in comparison with the control group the between-group differences were restricted to the right frontopolar area. In addition, the amount of enhancement in some cognitive subcomponents was positively correlated with the magnitude of an increase in hemodynamic response during WM task predominantly in the right hemispheres. These findings suggest that neurocognitive deficits in schizophrenia and their neural dysfunction may be improved by NEAR, and NIRS may be a useful tool to assess the changes of the neural activity underlying the improvement of neurocognitive functioning elicited by neurocognitive rehabilitation.

Impacto de las tecnologías de la información y las comunicaciones en la educación y nuevos paradigmas del enfoque educativo / Impact of the information andc ommunication technologies in education and new paradigms in the educational approach

Las tecnologías de la información y las comunicaciones (TIC's) se han constituido en elementos sustantivos inherentes al desarrollo de todas las esferas de la vida. La educación no ha escapado a ello, donde se descubre un universo ilimitado de posibilidades como recurso para el aprendizaje con la posibilidad de expandirse a un mayor número de usuarios de diferentes escenarios con la capacidad de socializar el conocimiento. Nuestro país ha sido consecuente con el imperativo del desarrollo e implementación de las TICïs, las que ya se expanden a todos los niveles de enseñanza y cobran especial fuerza en la universalización de la educación superior, cuyos impactos fundamentales se centran en su uso como fuente de información, canal de comunicación, instrumento cognitivo y de procesamiento de la información. Esto impone nuevos roles para los protagonistas del proceso formativo e implican retos para el profesional del futuro y las instituciones formadoras, las que han de lidiar con aspectos técnicos, formación especializada, seguridad informática y otros elementos que determinan la expansión de las TICïs. En el sector de la salud, su uso se ha fortalecido y dimensionado a partir del surgimiento y desarrollo de la Red Telemática de Salud en Cuba, INFOMED. Su utilización en la Educación Médica ha introducido nuevos paradigmas como la educación centrada en el estudiante, el autoaprendizaje y la gestión del conocimiento, que han modificado el papel histórico de los profesores. Las TICïs han propiciado la creación de espacios educativos virtuales que, basados en un modelo pedagógico, pueden garantizar el aprendizaje con el uso de estrategias innovadoras.

The information and communication technologies (ICTs) have become significant elements inherent to the development in all spheres of life. Education is not beyond these realities because this field embraces an unlimited universe of possibilities as learning resources to be likely extended to a higher number of users at different scenarios, in order to socialize knowledge. Our country has been consistent with the imperative demand for the development and implementation of ICTs, which cover all the educational levels and become very important in the universalization of the higher education. The functions of these technologies in education are at the same time their fundamental impacts such as source of information, communication channel, cognitive and processing instrument, among others. The afore-mentioned imposes new roles on the leading players of the formative process and brings new challenges for the future professionals and the formation institutions since the latter will have to deal with technical matters, specialized formation, information protection and other aspects derived from the ICT expansion. In the field of health care, the use of ICTs has strengthened and dimensioned since the emergence and development of the Telematic Network for Health in Cuba, known as INFOMED. These technologies allow introducing new paradigms in the medical education like student-centered education, self-learning and knowledge management, which have changed the historical role of the professors. The ICTs have facilitated the creation of pedagogic model-based virtual educational spaces that can assure learning by using innovative strategies.