Sistema de procedimientos para la formación interdisciplinar de la habilidad diagnosticar en residentes de dermatología / A System of Procedures for the Interdisciplinary Training of the Dill To Diagnose in Dermatology Residents

Introducción: En las prácticas de laboratorio se adquiere la habilidad que permite corroborar el diagnóstico de las enfermedades de la piel y anejos después de un diagnóstico presuntivo, con la utilización del método clínico. Esto se respalda en las exigencias establecidas en los documentos normativos de ese proceso formativo. Objetivo: Proponer un sistema de procedimientos para la formación interdisciplinar de la habilidad "diagnosticar enfermedades dermatológicas en los residentes de dermatología, a partir de insuficiencias detectadas en el programa de la especialidad. Métodos: La investigación fue cualitativa, con un estudio descriptivo en el Hospital Provincial General Docente Dr. Antonio Luaces Iraola, de Ciego de Ávila, desde 2018 hasta 2022. Se trabajó con toda la población conformada por 16 residentes de primer año en dermatología. Se utilizaron métodos de nivel teórico, empírico y estadístico. Resultados: En el sistema de procedimientos propuesto, se concretan fortalezas y debilidades, objetivo general, orientaciones metodológicas, precisión de los objetivos específicos y sistema de acciones para cada procedimiento, y sistema de control y evaluación de la efectividad de las acciones realizadas. La demostración de la formación de la habilidad diagnosticar, a través de un caso clínico real, reveló como esencial la consecutividad lógica de las acciones del residente desde la atención médica del caso y la formulación del diagnóstico presuntivo hasta el establecimiento del diagnóstico corroborativo en los laboratorios de anatomía patológica, microbiología y parasitología médica. Conclusiones: Se aporta un sistema de procedimientos que posibilita la formación de la habilidad "diagnosticar enfermedades dermatológicas en los residentes, con carácter secuencial, interdisciplinar e investigativo(AU)

Introduction: Laboratory practices provide the ability that allows corroborating the diagnosis of skin and adnexal diseases after a presumptive diagnosis, with the use of the clinical method. This is supported by the requirements established in the standardization documents of this training process. Objective: To propose a system of procedures for the interdisciplinary training of the skill to diagnose dermatological diseases in Dermatology residents, based on insufficiencies detected in the specialty program. Methods: The research was qualitative and consisted in a descriptive study carried out in Hospital General Docente Dr. Antonio Luaces Iraola, of Ciego de Avila, from 2018 to 2022. The work was done with the entire population made up of 16 first-year residents in Dermatology. Theoretical, empirical and statistical methods were used. Results: In the proposed system of procedures, strengths and weaknesses are specified, together with general objective, methodological guidelines, precision of specific objectives and system of actions for each procedure, as well as system of control and evaluation of the effectiveness of the actions. Demonstrating the received formation for the diagnostic skill, through a real clinical case, revealed as essential the logical consecutivity of the resident's actions from the medical attention of the case and the formulation of the presumptive diagnosis to the establishment of the corroborative diagnosis in the laboratories of pathological anatomy, microbiology and medical parasitology. Conclusions: A system of procedures is provided that makes possible the formation of the skill to diagnose dermatological diseases in residents, with sequential, interdisciplinary and investigative character(AU)

Concepción didáctica del proceso formativo interdisciplinar de la habilidad diagnosticar enfermedades para residentes de Dermatología / Didactic Concept of the Interdisciplinary Formation Process of the Diagnostic Ability of Dermatology Residents

Fundamento: El estudio teórico, el diagnóstico realizado y la experiencia de los investigadores, posibilitan formular como problema de la presente investigación: limitaciones en el desarrollo de la habilidad diagnosticar enfermedades dermatológicas en los residentes de la especialidad de Dermatología del Hospital General Provincial Docente "Dr. Antonio Luaces Iraola" de Ciego de Ávila. Objetivo: Elaborar una concepción didáctica del proceso de formación interdisciplinar de la habilidad diagnosticar enfermedades dermatológicas en los residentes de la especialidad de Dermatología, a partir de la caracterización del estado actual de esta habilidad. Metodología: Se realizó una investigación educativa con un componente descriptivo en el Hospital General Provincial Docente "Dr. Antonio Luaces Iraola" de Ciego de Ávila, en los cursos escolares desde 2016 al 2020. La población de estudio fueron los 16 residentes de 1.er año que matricularon la especialidad de Dermatología en el período de estudio. Se emplearon métodos del nivel teórico y empírico. Resultados: La caracterización realizada reveló limitaciones en el desarrollo de la habilidad diagnosticar enfermedades dermatológicas en los laboratorios de Anatomía Patológica, Microbiología y Parasitología Médica, por los residentes (100 %). La concepción didáctica del proceso de formación interdisciplinar de la habilidad diagnosticar orienta el proceso desde las actividades docentes-atencionales y prácticas de laboratorio en una consecutividad lógica y sistematización desde las diferentes formas de enseñanza y tipologías de clase. Integra la interdisciplinariedad y la utilización del método investigativo establecido en las ideas rectoras. Conclusiones: La concepción didáctica como aporte de la investigación resuelve la contradicción dialéctica entre la aplicación del método clínico y los procedimientos en la práctica de laboratorio que se da en ese proceso formativo y constituye un soporte didáctico que respalda las actividades prácticas en los laboratorios para cumplir con los objetivos del Plan de estudio de la especialidad.

Background: The theoretical study, the diagnosis conducted and the experience of the researchers make possible to formulate the problem of the present research: limitations in the development of the ability to diagnose dermatological diseases in residents of the Specialty of Dermatology of the General Provincial Teaching Hospital "Dr. Antonio Luaces Iraola" of Ciego de Avila. Objective: To elaborate a didactic conception of the interdisciplinary training process of the ability to diagnose dermatological diseases in residents of the specialty of Dermatology, based on the characterization of the current state of that ability. Methodology: An educational research with a descriptive component was conducted at the Provincial General Teaching Hospital "Dr. Antonio Luaces Iraola" of Ciego de Avila, in the 2016-2020 school years. The study population consisted of the 16 first-year dermatology residents who enrolled in the specialty during the study period. Results: The characterization conducted showed limitations in the development of the ability to diagnose dermatological diseases in anatomic pathology laboratories, Microbiology and Medical Parasitology, by residents (100%). The didactic conception of the interdisciplinary training process of diagnostic ability focuses on teaching and learning activities and laboratory practices in a logical consecutiveness and systematization from the different forms of teaching and class typologies. It integrates the interdisciplinary and the use of the research method that is established in the guiding ideas. Conclusions: The didactic conception, as a research contribution, resolves the dialectic contradiction between the application of the clinical method and the procedures in laboratory practice that occurs in this formative process which is a didactic support that backs up the practical activities in the laboratories in order to achieve the objectives of the study plan of the specialty.

Efectividad de la preparación de alumnos ayudantes sustentada en el aprendizaje colaborativo / Effectiveness in the training of student teachers based on collaborative learning

Introducción: El aprendizaje colaborativo exige interacción entre los miembros del grupo y responsabilidad individual con el aprendizaje. Se utiliza como método en la preparación de alumnos ayudantes de la carrera de medicina para incorporarlos a la práctica docente en curso de Reanimación Cardiopulmonar Básico con el primer año. Objetivo: Determinar la efectividad del aprendizaje colaborativo como método en la preparación de alumnos ayudantes para la práctica docente. Método: Se realizó una investigación de evaluación, en la que se utilizaron métodos teóricos: análisis síntesis e histórico lógico; y métodos empíricos: revisión documental, observación y encuesta. La muestra intencionada estuvo conformada por 18 alumnos ayudantes, por lo que se correspondió con la totalidad de los participantes. Se organizó en dos etapas: de preparación en contenidos específicos y en educación médica, y de ejecución de las clases prácticas, con cuatro variables. Resultados: Resultaron con nivel alto la manera de comportarse los alumnos ayudantes en las actividades de preparación, en las dos áreas (FR > 0,95), y el desempeño específico en las clases prácticas (FR: 96). En ambos existió ascenso en el valor de los indicadores desde la primera hasta la última actividad. Se autoevaluó de nivel alto la práctica con los estudiantes (FR: 0,96) y el 90,74 por ciento de ellos se mostró muy satisfecho con la preparación recibida y con la práctica docente realizada. Conclusiones: La preparación de alumnos ayudantes sustentada en el aprendizaje colaborativo resultó muy efectiva para su práctica docente en el curso de reanimación cardiopulmonar básico del primer año de la carrera de medicina(AU)

Introduction: Collaborative learning requires interaction among group members, as well as individual responsibility with learning. It is used as a method for training student teachers in order to incorporate them to the teaching practice of the basic course on cardiopulmonary resuscitation with the first academic year. Objective: To determine the effectiveness of collaborative learning as a method for training student teachers to be part of teaching practice. Methods: An evaluation research was carried out using theoretical (analysis-synthesis and historical-logical), as well as empirical (document review, observation and survey) methods. The purposive sample consisted of eighteen student teachers, which corresponded to the total number of participants. The research was organized in two stages: preparation with specific contents and medical education, and execution of practical lessons. Four variables were defined. Results: The way that they student teachers behaved in the training activities were found to have a high level, in both areas (FR>0.95); as well as for the specific performance in the practical lessons (FR: 96). Both showed an increase in the value of the indicators from the first to the last activity. The practice with the students was self-evaluated as being at a high level (FR: 0.96), while 90.74 percent of them were very satisfied with the training that they received, as well as with the teaching practice carried out. Conclusions: The training of student teachers based on collaborative learning was very effective for their teaching practice in the basic course on cardiopulmonary resuscitation with the first academic year of the medical major(AU)

Reflexiones sobre el aprendizaje colaborativo desde la experiencia de estudiantes de Trabajo Social de la Universidad Católica Luis Amigó / Reflections on collaborative learning from the experience of Social Work students at Universidad Católica Luis Amigó

El artículodesarrolla una reflexión conceptual sobre el aprendizaje colaborativo, en rela-ción con la mirada crítica de la experiencia de los estudiantes del programa de Trabajo Social a distancia de la Universidad Católica Luis Amigó. Si bien este concepto es transversal en muchos ámbitos de la vida, es una característica fundamental en el aprendizaje a distancia; por ello, el artículo desarrolla, en primer lugar, las característi-cas del aprendizaje colaborativo, seguidamente se plantean los aspectos significativos del aprendizaje colaborativo en este programa, lo que posibilita una reflexión de esta estrategia de enseñanza-aprendizaje en los procesos de educación contemporáneos

The article develops a conceptual reflection on collaborative learning, in relation to the critical view of the experience of the students of Social Work of distance learning program at the Universidad Católica Luis Amigó. Although this concept is transversal to many areas of life, it is a fundamental characteristic in distance learning; therefore, the article develops, first, the characteristics of collaborative learning, then the significant aspects of collaborative learning in the Social Work program of the Catholic University Luis Amigó are presented, allowing a reflection on this teaching-learning strategy in contemporary education processes

Problemas que limitan la interdisciplinariedad entre la Farmacología y las asignaturas clínicas en Estomatología / Problems that limit interdisciplinary between Pharmacology and Stomatology clinical subjects

RESUMEN Fundamento: El desarrollo de la interdisciplinariedad entre la unidad curricular Farmacología y las asignaturas clínicas de la Disciplina Principal Integradora en la carrera Estomatología, resulta indispensable para la formación integral del futuro egresado. Objetivo: Identificar los problemas que limitan el desarrollo de la interdisciplinariedad entre la Farmacología y las asignaturas clínicas de la Disciplina Principal Integradora en la carrera Estomatología. Metodología: Se realizó un estudio observacional descriptivo transversal entre noviembre y diciembre de 2020 en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Santiago de Cuba. Se consideraron como unidades de análisis: actividades docentes y directivos académicos, se seleccionó una muestra aleatoria en ambos casos (n=18 y n=8, respectivamente). Se estudiaron las variables: relaciones interdisciplinarias con la Farmacología (se observa, no se observa y se observa poco), categoría docente, categoría científica, grado académico/científico, grado de especialización y opinión de directivos académicos (siempre, a veces y nunca). Como instrumento de medición se empleó guía de observación y de entrevista, respectivamente. Se empleó el porcentaje como medida de resumen. Resultados: En más del 50 % de las actividades docentes de las asignaturas clínicas de la Disciplina Principal Integradora, no se observa las relaciones interdisciplinarias con la Farmacología. En las entrevistas realizadas a los directivos académicos, predominó la opinión: nunca. Conclusiones: Las insuficiencias didácticas, metodológicas, académicas e investigativas identificadas, limitan el desarrollo de la interdisciplinariedad entre la unidad curricular Farmacología y las asignaturas clínicas de la Disciplina Principal Integradora en la carrera Estomatología.

ABSTRACT Background: The development of interdisciplinarity between the curricular Pharmacology unit and the clinical subjects of the Main discipline in the Stomatology career is essential for the integral formation of the future graduate. Objective: To identify the problems that limit the development of interdisciplinarity between Pharmacology and the clinical subjects of the Main Comprehensive Discipline in the Stomatology career. Methodology: A cross-sectional descriptive observational study was conducted between November and December 2020 in the Stomatology Faculty at the Santiago de Cuba University of Medical Sciences. The following were considered as analysis units: teaching activities and academic directors, a random sample was selected in both cases (n=18 and n=8, respectively). The following variables were studied: interdisciplinary relations with Pharmacology (observed, not observed and little observed), teaching category, scientific category, academic/scientific degree, specialization degree and the academic directors´ opinion (always, sometimes and never). Observation and interview guides were used respectively as measurement instruments. Percentage was used as a summary measure. Results: In more than 50 % of the teaching activities of the clinical subjects of the Main Comprehensive Discipline, interdisciplinary relations with Pharmacology are not observed. In the interviews conducted with academic managers, the prevailed opinion was never. Conclusions: The didactic, methodological, academic and research inadequacies identified, limit the development of interdisciplinarity between the curricular unit Pharmacology and the clinical subjects of the Main Comprehensive Discipline in the Stomatology career.

Práticas de cuidado extramuros nos Centros de Atenção Psicossocial Álcool e outras Drogas: a ocupação cidadã / Extramural care practices developed outside Alcohol and drugs Psychosocial Care Centers: citizen occupation / Prácticas de cuidado extramuros en los Centros de Atención Psicosocial Alcohol y Drogas: la ocupación ciudadana

Este artigo tem por objetivo investigar as práticas extramuros realizadas pelos profissionais que atuam nos Centros de Atenção Psicossocial Álcool e outras Drogas (CAPSad) do Distrito Federal (DF). Trata-se de uma pesquisa de abordagem qualitativa de caráter exploratório e descritivo. A coleta de dados ocorreu por meio de entrevista semiestruturada e questionário sociodemográfico e ocupacional com 48 profissionais que atuam nos sete CAPSad do DF. Adotou-se a análise de conteúdo de Bardin e de forma complementar o software NVivo. Constatou-se que os profissionais realizaram práticas extramuros inovadoras e exitosas, como: "Loja de rua", "Jardim comunitário", "Clube de corrida", atividades esportivas, de geração de renda, participações políticas, de arte, lazer e cultura. No entanto, ainda são escassas as ações de cuidado extramuros de forma sistemática, sendo a maioria temporária. É imprescindível que trabalhadores sejam capacitados e tenham condições para atuar extramuros. (AU)

This article investigates the extramural practices developed by health professionals working in Alcohol and Drugs Psychosocial Care Centers (CAPSad) in the Federal District, Brazil. We conducted a qualitative exploratory descriptive study with data collected using semi-structured interviews and sociodemographic and occupational questionnaires administered to 48 professionals working in seven CAPSad located in the Federal District. We adopted the content analysis method proposed by Bardin and NVivo. The findings show that the professionals developed innovative and successful extramural practices, including: "street shops", "community gardens", "running clubs", sports, income generating activities, and political participation through art, leisure and culture. However, systematic extramural care actions remain scarce and tend to be temporary. It is vital that health worker are trained and have the conditions necessary to develop extramural activities. (AU)

El objetivo de este artículo es investigar las prácticas extramuros realizadas por los profesionales que actúan en los Centros de Atención Psicosocial alcohol y otras drogas (CAPSad) del Distrito Federal (DF). Se trata de una investigación de abordaje cualitativo de carácter exploratorio y descriptivo. La colecta de datos se realizó por medio de entrevista semiestructurada y cuestionario sociodemográfico y ocupacional con 48 profesionales que actúan en los siete CAPSad del DF. Se adoptó el análisis de contenido de Bardin y de forma complementaria el software NVivo. Se constató que los profesionales realizaron prácticas extramuros innovadoras y exitosas, como: "Tienda de calle", "Jardín comunitario", "Club de carreras", actividades deportivas, de generación de renta, participaciones políticas de arte, ocio y cultura. Sin embargo, todavía son escasas las acciones de cuidado extramuros de forma sistemática, siendo la mayoría temporales. Es imprescindible que los trabajadores sean capacitados y tengan condiciones para actuar extramuros. (AU)

Conocimiento libre en tiempos de pandemia. Estudio de los artículos "Covid-19" y "Pandemia por Covid-19" en Wikipedia* / Free knowledge in times of pandemic. Study of articles on "Covid-19" and the "Covid-19 pandemic" on Wikipedia / Conhecimento livre em tempos de pandemia. Estudos dos artigos sobre "Covid-19" e "Pandemia por Covid-19" em Wikipédia

Esta investigación estudia los artículos de "Covid-19" y de "Pandemia por Covid-19" en cuatro versiones lingüísticas de Wikipedia (inglés, español, italiano y portugués). El período de estudio comienza con la denominación oficial de la enfermedad como Covid-19, el 11 de febrero de 2020, por la Organización Mundial de la Salud y desde la proclamación por dicha institución de la pandemia causada por esta enfermedad, el 11 de marzo de 2020. En ambos casos se estudia hasta el 11 de abril de 2020. La investigación aborda el modo de creación y de lectura de dichos artículos, analizando si se trata de trabajos construidos desde referencias científicas y sanitarias o prensa generalista. Este proyecto muestra cómo los wikipedistas han reaccionado rápidamente y han generado un gran trabajo colaborativo, con artículos argumentados y construidos desde una perspectiva científica y sanitaria. (AU)

This article studies articles about "Covid-19" and the "Covid-19 pandemic" in four language versions of Wikipedia (English, Spanish, Italian and Portuguese). The study periods start with the official naming of the Covid-19 disease on February 2020 by the World Health Organization and the announcement of the pandemic on March 11 2020, respectively. In both cases, the period goes up to April 11 2020. The study addresses the creation and reading of these publications, analyzing whether they are built upon scientific and health references or information from the general press. The findings show that that the Wikipedists responded quickly and generated collaborative works, with articles based on and built around a scientific and health perspective. (AU)

Este artigo estuda os textos sobre "Covid-19" e "Pandemia por Covid-19" em quatro versões linguísticas da Wikipédia (inglês, espanhol, italiano e português). O período de estudo começa com a denominação oficial da doença como Covid-19, em 11 de fevereiro de 2020, pela Organização Mundial da Saúde e desde a declaração por esta instituição de pandemia causada pela doença, em 11 de março de 2020. Em ambos os casos se estuda até 11 de abril de 2020. A pesquisa aborda o modo de criação e de leitura dessas publicações, analisando se são trabalhos construídos a partir de referências científicas e da saúde ou da imprensa em geral. Este projeto mostra como os wikipedistas reagiram rapidamente e geraram um trabalho colaborativo, com artigos argumentados e construídos a partir de uma perspectiva científica e da saúde. (AU)

Relações Interpessoais, Vínculos Familiares e Sociais de Idosos Institucionalizados / Interpersonal Relations, Family and Social Ties of Institutionalized Elderly / Relaciones interpersonales, lazos familiares y sociales de ancianos institucionalizados / Interpersonal Relations, Family and Social Ties of Institutionalized Elderly

O artigo refere uma experiência interdisciplinar realizada na Associação de Auxílio aos Necessitados e Idosos de Santa Cruz do Sul, RS. Apresenta dados relativos às características dos idosos institucionalizados e ressalta a importância da Universidade no desenvolvimento de ações interdisciplinares para o fortalecimento de vínculos familiares e sociais. As ações coletivas interdisciplinares com idosos desafiam os profissionais a desenvolverem sua intervenção, de forma a dar conta da multidimensionalidade do envelhecimento.

This article deals with an interdisciplinary experiment conducted in the Association of Assistance to Needy and Elder of Santa Cruz do Sul, RS. The article presents some data related with the characteristics of institutionalized elderly and points out the importance of the university in the development of interdisciplinary actions that contribute to the strengthening of family and social ties. The interdisciplinary collective actions with old-aged people, challenging professionals to develop their intervention, in a way that involves the multidimensionality of aging.

El artículo hace referencia a una experiencia interdisciplinaria llevada a cabo en la Asociación de Asistencia a los Necesitados y Ancianos de Santa Cruz do Sul, RS. Presenta datos relacionados con las características de los ancianos institucionalizados y destaca la importancia de la Universidad en el desarrollo de acciones interdisciplinarias para fortalecer los lazos familiares y sociales. Acciones colectivas interdisciplinarias con los adultos mayores, desafiando a los profesionales a desarrollar su intervención para dar cuenta de la multidimensionalidad del envejecimiento.

Perspectives of Patients With Dermatofibrosarcoma Protuberans on Diagnostic Delays, Surgical Outcomes, and Nonprotuberance.

Importance: Dermatofibrosarcoma protuberans (DFSP) may have a deceptively benign clinical appearance, including a nonprotuberant presentation. Patients with DFSP often perceive misdiagnoses and delays in receiving a diagnosis. Use of existing, patient-designed Facebook patient support groups (FBSGs) to recruit large numbers of patients with rare diseases may be an effective novel research method. Objectives: To collaborate with patients with rare disease through social media and answer questions important to both patients and the medical field, including sources of diagnostic delay, risk of recurrence, and flat presentation of DFSP. Design, Setting, and Participants: A multiple-choice survey created by a team of medical practitioners and patients with DFSP was administered to 214 patients with DFSP or family members from international DFSP FBSGs and a nonprofit foundation patient database via Lime Survey from October 30 to November 20, 2015. The survey asked questions designed to determine risk of recurrence and metastasis, surgical outcomes, sources of diagnostic delay, symptoms of recurrence, number of recurrences, scar size, and number of clinicians seen before biopsy. Statistical analysis was performed from January 1, 2016, to April 1, 2019. Main Outcomes and Measures: The study goal was to collect at least 200 survey responses. Results: Of 214 survey respondents (169 females and 45 males; mean [SD] age, 40.7 [12.1] years; range, <1 to 72 years), 199 were patients with DFSP and 15 were family members. Delays occurred between the patient noticing the DFSP lesion and receiving a diagnosis of DFSP (median, 4 years; range, <1 to 42 years). Most patients (112 [52.3%]) believed that they received a misdiagnosis at some point: by dermatologists (35 of 107 [32.7%]), primary care clinicians (80 of 107 [74.8%]), or another type of physician (27 of 107 [25.2%]). The most frequent prebiopsy clinical suspicion included cyst (101 [47.2%]), lipoma (30 [14.0%]), and scar (17 [7.9%]). Many patients first noticed their DFSP as a flat plaque (87 of 194 [44.8%]). Of these lesions, 73.6% (64 of 87) became protuberant eventually. Surgical treatments included Mohs micrographic surgery (56 of 194 [28.9%]), wide local excision (122 of 194 [62.9%]), and conservative excision (16 of 194 [8.2%]). The reported rate of recurrence was 5.4% (3 of 56) for Mohs micrographic surgery, 7.4% (9 of 122) for wide local excision, and 37.5% (6 of 16) for conservative excision. The higher rate of recurrence for conservative excision was significant (P = .001); there was no significant difference in the rate of recurrence between Mohs micrographic surgery and wide local excision (P = .76). Conclusions and Relevance: This study reports what appears to be disease-relevant statistics from the largest survey of patients with DFSP to date. Because of the dissonance between the name of the neoplasm and its clinical presentation, the alternative term dermatofibrosarcoma, often protuberant is proposed. This study suggests that FBSGs are useful tools in medical research, providing rapid access to large numbers of patients with rare diseases and enabling synergistic collaborations between patients and medical researchers.

A Successful Collaborative Approach to the Perioperative Management After Hip Arthroscopy of a Patient with Heterozygous Prothrombin G20210A Mutation: A Case Report.

CASE: We report on a patient with heterozygous prothrombin G20210A mutation (PTM) and a history of venous thromboembolism (VTE) after knee arthroscopy, who was undergoing hip arthroscopy. This common mutation has an overall prevalence of 2.0% and results in a 280% to 420% likelihood of thrombosis compared to patients without the mutation. CONCLUSIONS: Hip arthroscopy is associated with a low risk of VTE with currently no guidelines for thromboprophylaxis. Patients should be managed in relation to their risk factors utilizing a collaborative, individualized approach. Treatment with short-term low-molecular-weight heparin resulted in no thromboembolism at 18-month follow-up for this patient with PTM.

Introducción a la mentoría en investigación y principales marcos teóricos para comprender y explicar sus procesos / Introduction to mentoring in research and main theoretical frameworks to understand and explain their processes

En este artículo, los autores explican el origen y el uso actual del término mentoría y describen algunos marcos teóricosque ayudan a comprender los procesos y la repercusión de la mentoría en investigación: el del aprendizaje cognitivo, eldel aprendizaje no formal, el del aprendizaje sociocultural en el contexto de comunidades de práctica, el de la mentoríacomo una forma de acumulación de capital social, el de la mentoría como un medio para el desarrollo de la identidadcomo científico, y las miradas desde la teoría social y cognitiva de la carrera.(AU)

In this article, the authors explain the origin and the current use of the term mentoring and describe some theoreticalframeworks that help to understand the processes and impact of mentoring in research: cognitive learning, non-formallearning, sociocultural learning in the context of communities of practice, mentoring as a form of social capital accumulation,mentoring as a way to develope the identity as a scientist, and the views from the social and cognitive theory of the career.(AU)

Addressing social influences reduces antibiotic duration in complicated abdominal infection: a mixed methods study.

BACKGROUND: Antimicrobial therapy for intra-abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. METHODS: Quantitative: A retrospective audit of patients with complicated intra-abdominal infection before and after a multifaceted persuasive intervention was performed. Qualitative: Semi-structured interviews were performed to evaluate which elements of the intervention were perceived to be effective. RESULTS: An intervention including collaborative inter-specialty and inter-professional educational meetings, and education of all professional streams was undertaken. Quantitative: Twenty-three patients before and 22 patients after the intervention were included. The total duration of antibiotics decreased significantly following the intervention (9.2 versus 6.6 days P = 0.02). The duration of intravenous antibiotics did not change significantly (5.4 versus 4.5 days, P = 0.06). Qualitative: Eighteen health-care professionals participated. Thematic analysis indicated that a collaborative approach between senior surgical and infectious disease specialists in the pre-intervention stage led to perceived ownership and leadership of the intervention by the surgical team, which was thought critical to the success of the intervention. Conversely, the ability of nurses and pharmacists to influence antibiotic practice was considered limited and a poster promoting the intervention was perceived as ineffective. CONCLUSION: Consultant leadership and specialty ownership of the process were perceived to be critical in the success of the intervention. Antibiotic stewardship programs which address social factors may have greater efficacy to optimize antimicrobial prescribing.

Collaborative Quality Improvement Reduces Postoperative Pneumonia After Isolated Coronary Artery Bypass Grafting Surgery.

BACKGROUND: To date, studies evaluating outcome improvements associated with participation in physician-led collaboratives have been limited by the absence of a contemporaneous control group. We examined post cardiac surgery pneumonia rates associated with participation in a statewide, quality improvement collaborative relative to a national physician reporting program. METHODS AND RESULTS: We evaluated 911 754 coronary artery bypass operations (July 1, 2011, to June 30, 2017) performed across 1198 hospitals participating in a voluntary national physician reporting program (Society of Thoracic Surgeons [STS]), including 33 that participated in a Michigan-based collaborative (MI-Collaborative). Unlike STS hospitals not participating in the MI-Collaborative (i.e., STSnonMI) that solely received blinded reports, MI-Collaborative hospitals received a multi-faceted intervention starting November 2012 (quarterly in-person meetings showcasing unblinded data, webinars, site visits). Eighteen of the MI-Collaborative hospitals received additional support to implement recommended pneumonia prevention practices ("MI-CollaborativePlus"), whereas 15 did not ("MI-CollaborativeOnly"). We evaluated rates of postoperative pneumonia, adjusting for patient mix and hospital effects. Baseline patient characteristics were qualitatively similar between groups and time. During the preintervention period (Q3/2011 through Q3/2012), there was no statistically significant difference in the adjusted odds of pneumonia for STS hospitals participating in the MI-Collaborative compared to the STS non-MI hospitals. However, during the intervention period (Q4/2012 through Q2/2017), there was a significant 2% reduction per quarter in the adjusted odds of pneumonia for MI-Collaborative hospitals (n=33) relative to the STS-nonMI hospitals. There was a significant 3% per quarter reduction in the adjusted odds of pneumonia for the MI-CollaborativeOnly (n=15) hospitals relative to the STS-nonMI hospitals. Over the course of the overall study period, the STS-nonMI hospitals had a 1.96% reduction in risk-adjusted pneumonia (pre- vs. intervention periods), which was less than the MI-Collaborative (3.23%, P=0.011). Over the same time period, the MI-CollaborativePlus (n=18) reduced adjusted pneumonia rates by 10.29%, P=0.001. CONCLUSIONS: Participation in a physician-led collaborative was associated with significant reductions in pneumonia relative to a national quality reporting program. Interventions including collaborative learning may yield superior outcomes relative to solely using physician feedback reporting. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02068716.

Procedimientos metodológicos para lograr las relaciones interdisciplinarias / Methodological procedures to achieve interdisciplinary relationships

RESUMEN Fundamento: La interdisciplinariedad responde a la necesidad de superar la unilateralidad y el peligro de dispersión de los conocimientos aportados. La convergencia entre las disciplinas condiciona el tratamiento del objeto como un todo y permite un conocimiento sistémico, en el que las partes interactúan, tal como existen en la realidad objetiva. Objetivo: Proponer procedimientos metodológicos dirigidos a la preparación del docente para el establecimiento de las relaciones interdisciplinarias en la formación inicial de los estudiantes de la carrera Licenciatura en Educación Primaria. Metodología: Se utilizaron métodos teóricos, empíricos y estadísticos, los que permitieron la recogida y el procesamiento de la información durante la investigación. La muestra seleccionada estuvo compuesta por 19 docentes de la carrera Licenciatura en Educación Primaria. Resultados: Se aportaron procedimientos metodológicos que favorecieron la apropiación consciente y creadora de los docentes para el logro de las relaciones interdisciplinarias, a partir del análisis horizontal, vertical y transversal de las disciplinas del currículo. Conclusiones: En el desarrollo de los procedimientos metodológicos propuestos se evidenció la preparación de los docentes para el establecimiento de las relaciones interdisciplinarias.

ABSTRACT Background: Interdisciplinarity responds to the need to overcome unilateralism and the danger of dispersion of the knowledge provided. The convergence between the disciplines conditions the treatment of the object as a whole and allows a systemic knowledge, in which the parties interact, as they exist in objective reality. Objective: Propose methodological procedures aimed at preparing the teacher for the establishment of interdisciplinary relations in the initial training of the students of the degree Degree in Primary Education. Methodology: Theoretical, empirical and statistical methods were used, which allowed the collection and processing of the information during the investigation. The sample selected was composed of 19 teachers of the degree in Primary Education. Results: Methodological procedures were provided that favored the conscious and creative appropriation of the teachers for the achievement of the interdisciplinary relationships, from the horizontal, vertical and transversal analysis of the disciplines of the curriculum. Conclusions: In the development of the proposed methodological procedures, the preparation of teachers for the establishment of interdisciplinary relationships was evidenced.

Designing and Evaluating an Interprofessional Practice Experience Involving Dental and Pharmacy Students.

Objective. To prepare pharmacy and dental students to collaborate as members of an interprofessional team by participating in an interprofessional practice experience. Methods. An interprofessional practice experience was implemented within a dental admissions clinic. Pharmacy and dental students collaboratively conducted medical histories and provided tobacco cessation education. Pharmacy student performance was measured using a standardized assessment rubric; pharmacy and dental student perceptions were measured using the SPICE-R tool; and faculty feedback was captured for evaluation purposes. Results. Pharmacy students achieved performance expectations upon completion. There was a statistically significant increase in the mean scores for a majority of the SPICE-R factors for pharmacy and dental students. Overall, faculty perceptions of the practice experience were positive. Conclusion. A collaboration between pharmacy and dental schools is a novel approach to meeting interprofessional and experiential curricular goals. Evaluating performance in practice experiences and perceptions can be used to demonstrate learner outcomes within interprofessional education. Furthermore, faculty feedback should be used to improve practice experiences.

Predict MiRNA-Disease Association with Collaborative Filtering.

The era of human brain science research is dawning. Researchers utilize the various multi-disciplinary knowledge to explore the human brain,such as physiology and bioinformatics. The emerging disease association prediction technology can speed up the study of diseases, so as to better understanding the structure and function of human body. There are increasing evidences that miRNA plays a significant role in nervous system development, adult function, plasticity, and vulnerability to neurological disease states. In this paper ,we proposed the novel improved collaborative filtering-based miRNA-disease association prediction (ICFMDA) approach. Known miRNA-disease associations can be viewed as a bipartite network between diseases and miRNAs. ICFMDA defined significance SIG between pairs of diseases or miRNAs to model the preference on the choices of other entities. The collaborative filtering algorithm is further improved by incorporating similarity matrices to enable the prediction for new miRNA or disease without known associations. Potential miRNA-disease associations are scored with the addition of bidirectional recommendation results with low computational cost. ICFMDA achieved a 0.9076 AUC of ROC curve in global leave-one-out cross validation, which outperformed the state-of-the-art models. ICFMDA is a compact and accurate tool for potential miRNA-disease association prediction. We hope that ICFMDA would be useful in future miRNA and brain researches,and achieve better understanding of the nervous system in molecular level, cellular level, cell change process, and thus can support the research of human brain.

Anaesthesia: what a surgeon needs to know.

Surgeons and anaesthetists work closely together, sometimes in challenging circumstances. To help surgeons cooperate with anaesthetists to deliver high quality care for patients, a working knowledge of modern anaesthetic practice is useful. The specialty of anaesthetics is developing rapidly, and periodic updating of this knowledge is likely to be required. This article provides an update of anaesthetic practice for surgeons, covering the varied roles of anaesthetists, preoperative assessment, management on the day of surgery (induction, maintenance and reversal of anaesthetic), general anaesthesia, the role of regional blocks and sedation. It also discusses safety issues, the management of frail patients and future challenges.

A Educação Interprofissional e a prática compartilhada em programas de residência multiprofissional em Saúde / Interprofessional Education and shared practice in multiprofessional health residency programs / La educación Interprofesional y la práctica compartida en programas de residencia multiprofesional de Salud

O artigo tem por objetivo analisar os princípios, concepções e práticas da Educação Interprofissional, com ênfase na prática compartilhada em programas de residência multiprofissional em Saúde (PRMS) nas instituições de ensino superior (IES) do Estado de São Paulo, Brasil. Foi realizada análise documental dos projetos pedagógicos (PP), aplicação de instrumento tipo Likert e perguntas abertas a 76 residentes de 13 PRMS. A análise temática dos PP mostra ênfase na responsabilização da equipe perante os casos clínicos e planos de cuidado; centralização nas necessidades do paciente e articulação entre ensino-serviço. Os resultados do instrumento Likert evidenciam satisfação dos residentes com a formação para prática colaborativa. Na perspectiva dos residentes, os PRMS ampliam e melhoram os resultados em saúde, favorecem a atuação centrada no paciente, a identificação das necessidades de saúde e o compartilhamento de práticas e procedimentos. Dessa maneira, os PRMS são importantes no cenário de consolidação do Sistema Único de Saúde (SUS).(AU)

The aim of this paper is to present the principles, conceptions, and practices of Interprofessional Education that underlie multiprofessional health residency programs (PRMS), with emphasis on shared practice, in institutions of higher education in the state of São Paulo, Brazil. The researchers conducted document analysis of the programs' pedagogical projects (PP) and administered a Likert-type scale and open-ended questions to 76 residents of 13 PRMS. Thematic analysis of the PP showed that emphasis was given to the team in clinical cases and care plans; patient-centeredness and coordination between teaching and service. The results of the Likert-type scale showed that residents were satisfied with education for collaborative practice. From the point of view of the residents, the PRMS helped expand and enhance health outcomes, favoring the patient-centered care, the identification of health needs, and shared practices and procedures. In conclusion, PRMS are important to the Brazilian National Health System (SUS).(AU)

El objetivo del artículo es analizar los principios, concepciones y prácticas de la Educación Interprofesional, con énfasis en la práctica compartida en programas de residencia multiprofesional de Salud (PRMS), en las IES del Estado de São Paulo, Brasil. Se realizaron: análisis documental de los Proyectos Pedagógicos (PP), aplicación de instrumento tipo Likert y preguntas abiertas a 76 residentes de 13 PRMS. El análisis temático de los PP muestra: énfasis en que el equipo asuma la responsabilidad ante los casos clínicos y planes de cuidado; centralización en las necesidades del paciente y articulación entre enseñanza-servicio. Los resultados del Likert ponen en evidencia: satisfacción de los residentes con la formación para práctica colaborativa. En la perspectiva de los residentes, los PRMS amplían y mejoran los resultados de salud; favorecen la actuación centrada en el paciente; identificación de las necesidades de salud; compartición de prácticas y procedimientos. Por lo tanto, los PRMS son importantes en el escenario de consolidación del SUS.(AU)

Experiencia interdisciplinaria para el diseño de productos para la salud / Interdisciplinary experience for the design of health care products

Background: Training of innovative health professionals is necessary for the development of an effective health system in a limited resources context. However, the professionals underestimate their innovative role and receive sparse training in this issue. Meanwhile, industrial designers are trained to innovate but have a weak knowledge about health issues. Aim: To describe the outcomes of a study based on Challenge-Based Learning (CBL) where health and industrial design students learned about product development aimed to solve health problems. Material and Methods: Twenty industrial design students, seven health care students and nine teachers of both disciplines participated in a User Centered Design workshop. Using the CBL method, they were challenged to develop products to tackle a health problem. At the end of the challenge, teachers and students evaluated the products using a semantic differential method and answered a questionnaire assessing the activity. Results: In the semantic differential method, all participants evaluated usefulness, functionality and organization of the product rather than its originality. The greatest discrepancies in evaluation were found between design and health teachers. Students positively evaluated the challenge, although the weakest point was its coordination. Conclusions: CBL and interdisciplinary work are adequate tools for the development of innovative competences, as well as understanding the central elements of innovation.