Material didáctico para el desarrollo de la competencia comunicativa audio-oral en la educación médica de posgrado

Fundamento: El conocimiento del inglés como el idioma empleado globalmente en diversos sectores, se ha convertido, junto a las tecnologías de la información y las comunicaciones, es una herramienta de formación, trabajo y entretenimiento indispensable; el dominio de este posibilita las relaciones de cooperación e intercambio de profesionales del sector de la salud en varios países. Objetivo: Diseñar un material didáctico para el desarrollo de la competencia comunicativa audio-oral en inglés en estudiantes de posgrado de la carrera de Medicina, mediante el empleo de tecnologías de la información y la comunicación. Metodología: Se realizó una investigación de desarrollo con enfoque mixto en la Universidad de Ciencias Médicas de Holguín durante el período marzo-julio de 2022. Se asumió el método dialéctico materialista como concepción general de la investigación y se emplearon otros del nivel teórico: histórico-lógico, análisis y síntesis e inducción deducción, sistémico-estructural-funcional y revisión documental; empíricos: encuesta, entrevista y observación participativa. Resultados: Las principales dificultades estuvieron relacionadas con el insuficiente tratamiento de la competencia comunicativa audio-oral en inglés, se constató la importancia de la misma dentro del proceso de enseñanza-aprendizaje del inglés, pues establece las pautas generales que se deben seguir para una comunicación efectiva y se instituye desde una mirada holística del acto comunicativo del profesional. Conclusiones: Los especialistas valoraron el material como adecuado por su estructura y factibilidad para su implementación. Después de su aplicación se evidenció su efectividad en la consolidación del aprendizaje en este nivel educacional a través de la preparación idiomática.

Background: Knowledge of English as the language used globally in various sectors, has increasingly become, together with information and communications technologies, an indispensable training, work and entertainment tool in the current era. Its domain enables cooperation relations and exchange of professionals in the health sector in various countries. Objective: To design a didactic material for the development of audio-oral communicative competence in English in postgraduate medical students, through the use of Information and Communication Technologies (ICT). Methods: A development research with a mixed approach was carried out at the Holguín University of Medical Sciences during the period March-July 2022. It was assumed the dialectical materialist method as the general conception of the research and others of the theoretical level: historical- logical, analysis and synthesis and induction deduction, systemic-structural-functional and documentary review; empirical: survey, interview and participatory observation. Results: The main difficulties were related to an insufficient treatment of audio-oral communicative competence in English, it was confirmed its importance within the teaching-learning process of English, since it establishes the general guidelines that must be followed for an effective communication. Moreover, it is instituted from a holistic view of the professional communicative act. Conclusions: The specialists assessed the material as adequate due to its structure and feasibility for its implementation. After its application, it was evidenced its effectiveness in consolidating learning in this educational level through language training.

Hacia la objetividad en la valoración ética: legibilidad como parte de la comprensión de los formatos de consentimiento informado / Towards objectivity in ethical assessment: legibility as part of informed consent form comprehension

Resumen Antecedentes: Se describe la experiencia sobre la legibilidad de los formatos de consentimiento informado (FCI) del Comité de Ética en Investigación del Instituto Nacional de Cancerología de México. Objetivo: Evaluar la legibilidad de una muestra seleccionada aleatoriamente de FCI sometidos para revisión entre el 1 de marzo de 2022 y el 31 de marzo de 2023. Se determinó el número de páginas, el tiempo que el lector invierte para leer el texto y el grado de escolaridad necesario para comprenderlo. Resultados: Más de la mitad de FCI de investigaciones internas mostraron ser algo o muy difíciles de leer, la escolaridad necesaria para comprenderlos fue hasta de 9.9 años y el tiempo de lectura fue corto. Los textos de los FCI de investigaciones internacionales multicéntricas estuvieron dirigidos a un nivel escolar promedio de 5.5 años y tuvieron una legibilidad normal. La mayor parte de los ensayos externos requiere un tiempo de lectura superior a los 60 minutos por FCI. Conclusión: Es necesario disponer de herramientas que den objetividad a la evaluación de los FCI en investigación por parte de los comités de ética y sean indicadores de su comprensión, tales como la legibilidad de los documentos.

Abstract Background: The experience on informed consent form (ICF) readability at the Research Ethics Committee of the National Institute of Cancerology of Mexico (INCan) is described. Objective: To evaluate the readability of a randomly-selected sample of ICFs submitted for review between March 1, 2022 and March 31, 2023. The number of pages, the time the reader takes to read the text and the level of education necessary to understand it were determined. Results: More than half the ICFs from internal investigations were shown to be somewhat or very difficult to read; the level of education required to understand them was up to 9.9 years, and the reading time was short. The ICF texts from international multicenter investigations were aimed at an average education level of 5.5 years and had normal readability. Most ICFs from external trials require a reading time of more than 60 minutes per ICF. Conclusion: It is necessary to have tools that provide objectivity to the evaluation of ICFs under investigation by ethics committees, which should be indicators of their comprehension, such as readability of the documents.

An application of cognitive diagnostic models in the evaluation of reading comprehension in Chilean university students

Introduction: Reading Comprehension skills are fundamental to the academic performance of university students. These abilities are not innate; therefore, systematic training is required before entering university. The main objective of this study was to evaluate the reading comprehension skills of Chilean University Students. Method: A sample of 579 students participated in the study, responding to four texts that comprise the Reading Comprehension Strategies for University Students (ELCU). An automated platform was used to apply and correct the test with immediate results and feedback. The tool allowed the use of a broad and representative sample of the various regions of Chile. The ELCU was developed using a cognitive diagnostic assessment (CDA) considering cognitive, metacognitive and linguistic strategies. The ana-lyses were performed using two different approaches: The Linear Logistic Test Model (LLTM) and the deterministic inputs, noisy "and" gate (DINA) model. Results: The rejection of the LLTM implies that the strategies do not differ in cognitive complexity (difficulty) while the adequate goodness of fit to the DINA model allows to characterise the students according to their reading abilities. Conclusion: The ELCU test provides reliable and valid information on the reading comprehension ability and metacognitive awareness of university students.

Introducción: Las habilidades de comprensión lectora son fundamentales para el rendimiento académico de los estudiantes universitarios. Estas habilidades no son innatas; por tanto, se requiere una formación sistemática antes de ingresar a la universidad. El objetivo principal de este artículo fue evaluar las habilidades de comprensión lectora de estudiantes universitarios chilenos. Método: En el estudio participó una muestra de 579 estudiantes que respondieron cuatro textos que componen las Estrategias de Comprensión Lectora para Estudiantes Universitarios (ELCU). Se utilizó una plataforma automatizada para aplicar y corregir la prueba con resultados y retroalimentación inmediatos. La herramienta permitió utilizar una muestra amplia y representativa de las distintas regiones de Chile. ELCU fue desarrollado mediante evaluación diagnóstica cognitiva (CDA) considerando estrategias cognitivas, metacognitivas y lingüísticas. Los análisis se realizaron mediante dos aproximaciones diferentes: The Linear Logistic Test Model (LLTM) y the Deterministic Inputs, Noisy "and" Gate (DINA) model. Resultados: El rechazo al modelo LLTM implica que las estrategias no difieren en complejidad cognitiva mientras que la adecuada bondad de ajuste al modelo DINA permiten caracterizar a los estudiantes según sus habilidades lectoras. Conclusión: La prueba ELCU permite obtener información confiable y válida sobre la capacidad de comprensión lectora y la conciencia metacognitiva de los estudiantes universitarios.

Percepción de la Kinesiterapia posterior a la Pandemia SARS-CoV-2 en Grupo de Médicos y Médicas de una Institución de Salud Chilena / Physiotherapy perception during SARS-CoV-2 pandemic

Introducción. La kinesiología es una profesión que busca identificar, maximizar la calidad de vida y potencial de movimiento; para prevenir, tratar o intervenir, habilitando y rehabilitando a las personas. Esta contribuye al bienestar físico, psicológico, emocional y social de las personas. En Chile, los kinesiólogos son parte fundamental del equipo de salud interprofesional. Es por esto que conocer la percepción que tienen los médicos sobre el que hacer kinesiológico es fundamental. Objetivo. Hasta el momento, no existe información al respecto, por lo que el objetivo de este estudio es identificar la percepción del estamento médico, sobre la kinesiología, en una de las principales instituciones de salud en Chile. Métodos. Para esto se planteó un estudio de carácter mixto, al incluir análisis cualitativo y cuantitativo. Aplicando una encuesta online, con preguntas tipo likert y preguntas de desarrollo, al estamento médico de la Red de Salud UC Christus, que evaluó la percepción de dichos profesionales sobre el quehacer de los kinesiólogos(as) durante la pandemia. La recolección de datos se llevó a cabo durante los meses de mayo a diciembre del 2021. Resultados. A través del análisis cualitativo del estudio, la pandemia por COVID-19 visibilizó la importancia de kinesiólogas y kinesiólogos, mejorando la impresión en grupo médico manifestándose en el aumento de derivación. Optimizando la percepción del trabajo kinesiológico dentro del equipo multidisciplinario de salud en el centro de salud encuestado. De las respuestas cuantitativas no se identificaron resultados significativos. Conclusión. este es un primer abordaje sobre el conocimiento del trabajo de los kinesiólogos(as) por parte del equipo médico en población chilena. Tras este estudio queda expuesta la importancia de que el equipo de salud conozca de mejor manera la profesión de kinesiología, en beneficio del paciente y del óptimo desempeño en un equipo multidisciplinario.

Background. Physiotherapy is a profession that seeks to identify and maximize the quality of life and movement potential; to prevent, treat or intervene, enabling and rehabilitating people. This contributes to the physical, psychological, emotional and social well-being of people. In Chile, physiotherapists are fundamental part of the interprofessional health team. This is why knowing the perception that doctors have about physiotherapists doing is fundamental. Objetive. Up to now, there is no information in this regard, so the objective of this study is to identify the perception of the medical establishment, on physiotherpy, in one of the main health institutions in Chile. Methods. A cross-sectional descriptive study was proposed. Applying an online survey to the medical establishment of a health centre, which evaluated the perception of these professionals about the work of physiotherapists during the pandemic. Data collection was carried out during the months of May to December 2021. Results. The Covid 19 pandemic optimized the perception of physiotherapist work within the multidisciplinary health team at the surveyed health center. Conclusion. this is a first approach on the knowledge of the work of physiotherapists by the medical team in the Chilean population. After this study, the importance of the health team knowing the kinesiology profession better is exposed, for the benefit of the patient and optimal performance in a multidisciplinary team.

Funciones ejecutivas y comprensión lectora en estudiantes de educación primaria en Lima - Perú

Las funciones ejecutivas y la comprensión de lectura son temas poco estudiados desde sus elementos asociativos. En particular, la primera variable, desde la educación primaria, no es tema que haya requerido un nivel amplio de profundización. De esta forma, los estudiantes de educación primaria van adquiriendo diversas estrategias a lo largo de su formación por lo que se espera que en el IV ciclo de EBR puedan emplearlas para el desarrollo de diversas capacidades como las de comprender textos. Esta situación ha determinado que se describa la relación entre dos variables de investigación para tomar acción educativa en este grupo de estudio en particular. El alcance correlacional, dentro de lo cuantitativo. Se aplicaron dos instrumentos: una Escala EFECO y una Evaluación de comprensión lectora ACL-4 aplicados a 110 estudiantes de 4to grado de educación primaria. Se concluyó que no existe relación (p ≥ 0,05) entre estas. Esto es estadísticamente significativo con un p-valor = -0,077. En tal sentido, los estudiantes, si bien reciben el aprendizaje de las estrategias de las funciones ejecutivas como parte del desarrollo de las sesiones del docente, estas no tienen relación con el desarrollo de su competencia lectora debido al poco estímulo que reciben.

Executive functions and reading comprehension correspond to topics little studied from their associative elements. In particular, the first variable, from primary education, is not a subject that has required a broad level of deepening. In this way, primary education students acquire various strategies throughout their training, so it is expected that in the IV cycle of EBR they will be able to use them for the development of various capacities such as understanding texts. This situation has determined that the relationship between two research variables be described in order to take educational action in this particular study group. The correlational scope, within the quantitative, has served so that, with the application of two instruments: an EFECO Scale and an ACL-4 Reading Comprehension Assessment applied to 110 students of 4th grade of primary education. It was concluded that there is no relationship (p ≥ 0.05) between them. This is statistically significant with a p-value = -0.077. In this sense, the students, although they receive the learning of the strategies of the executive functions as part of the development of the teacher's sessions, these are not related to the development of their reading competence due to the little encouragement they receive.

As funções executivas e a compreensão leitora correspondem a temas pouco estudados a partir de seus elementos associativos. Em particular, a primeira variável, desde o ensino primário, não é um tema que tenha exigido um nível de aprofundamento alargado. Desta forma, os alunos do ensino básico adquirem várias estratégias ao longo da sua formação, pelo que se espera que no IV ciclo da EBR consigam utilizá-las para o desenvolvimento de várias capacidades como a compreensão de textos. Essa situação determinou que a relação entre duas variáveis de pesquisa fosse descrita para a realização de ações educativas nesse grupo específico de estudo. O escopo correlacional, dentro do quantitativo, serviu para que, com a aplicação de dois instrumentos: uma Escala EFECO e uma Avaliação da Compreensão de Leitura ACL-4 aplicada a 110 alunos da 4ª série do ensino fundamental. Concluiu-se que não há relação (p ≥ 0,05) entre eles. Isso é estatisticamente significativo com um valor p = -0,077. Nesse sentido, os alunos, embora recebam o aprendizado das estratégias das funções executivas como parte do desenvolvimento das sessões do professor, estas não estão relacionadas ao desenvolvimento de sua competência leitora devido ao pouco incentivo que recebem.

Estrategias de aprendizaje y comprensión lectora en estudiantes de educación artística / Learning strategies and reading comprehension in art education students / Estratégias de aprendizagem e compreensão leitora em estudantes de arte-educação

Las estrategias de aprendizaje y la comprensión de lectura representan temas urgentes de revisión en el nivel educativo, lo es dentro de la educación básica y superior; sin embargo, con diferencias específicas, en el ámbito de la educación artística aún han sido poco exploradas. Así pues, los estudiantes de educación superior privilegian los aprendizajes relacionados al fortalecimiento de su talento o actividad artística de diversas manifestaciones artístico culturales, a la par que reciben una educación integral que permita la contribución con su perfil de egreso (pedagogos del arte). Esta situación ha determinado que se describa la relación entre dos variables de investigación para tomar acción educativa en este grupo de estudio en particular. El alcance correlacional, dentro de lo cuantitativo, ha servido para que, con la aplicación de dos instrumentos: una escala de estrategias de aprendizaje (ACRA) y una prueba que mide el nivel de comprensión lectora en 64 alumnos de arte en educación superior, se concluya que no existe relación (p ≥ 0,05) entre estas. Esto es estadísticamente significativo con un p-valor = ,617. En tal sentido, los estudiantes, si bien reciben el aprendizaje de las estrategias, no tienen relación con el desarrollo de su competencia lectora dada su escasa práctica.

Learning strategies and reading comprehension represent urgent review issues at the educational level, it is within basic and higher education; however, with specific differences, in the field of artistic education they have still been little explored. Thus, higher education students privilege learning related to strengthening their talent or artistic activity of various cultural artistic manifestations, while receiving a comprehensive education that allows the contribution to their graduation profile (art pedagogues). This situation has determined that the relationship between two research variables is described in order to take educational action in this particular study group. The correlational scope, within the quantitative, has served so that, with the application of two instruments: a scale of learning strategies (ACRA) and a test that measures the level of reading comprehension in 64 art students in higher education, conclude that there is no relationship (p ≥ 0.05) between them. This is statistically significant with a p-value = .617. In this sense, the students, although they receive the learning of the strategies, are not related to the development of their reading competence given their little practice.

Estratégias de aprendizagem e compreensão de leitura representam questões urgentes de revisão no nível educacional, seja na educação básica e superior; porém, com diferenças específicas, no campo da educação artística ainda são pouco exploradas. Assim, os estudantes do ensino superior privilegiam as aprendizagens relacionadas com o reforço do seu talento ou atividade artística de diversas manifestações artísticas culturais, ao mesmo tempo que recebem uma formação integral que permite contribuir para o seu perfil de formação (pedagogos da arte). Essa situação determinou que a relação entre duas variáveis de pesquisa seja descrita para a ação educativa nesse grupo de estudo específico. O escopo correlacional, dentro do quantitativo, serviu para que, com a aplicação de dois instrumentos: uma escala de estratégias de aprendizagem (ACRA) e um teste que mede o nível de compreensão leitora em 64 estudantes de arte do ensino superior, concluímos que há nenhuma relação (p ≥ 0,05) entre eles. Isso é estatisticamente significativo com um valor de p = 0,617. Nesse sentido, os alunos, embora recebam o aprendizado das estratégias, não se relacionam com o desenvolvimento de sua competência leitora dada sua pouca prática.

Análisis de las Intervenciones de Bebés de 9 Meses durante la Lectura Compartida / Analysis of the Interventions of 9 Month-old Babies during Shared Storybook Reading

Resumen La lectura compartida es frecuente en la infancia. Sin embargo, la participación de infantes menores de un año en esta actividad ha sido poco explorada. Este trabajo describe y analiza las intervenciones de bebés de 9 meses en la lectura conjunta materno-infantil en hogares argentinos. Transcribimos y analizamos filmaciones realizadas por 10 madres. Clasificamos las intervenciones en: acción responsiva o espontánea; vocalización responsiva o espontánea; acción responsiva + vocalización; acción espontánea + vocalización. Los bebés realizaron mayoritariamente acciones espontáneas (con o sin vocalizaciones). Luego, clasificamos las acciones (con o sin vocalizaciones) en: convencionales (pasar la página, señalar) o manipulativas (morder, sacudir los libros); otras no orientadas (tomar otro objeto, mirar fuera del escenario). Encontramos que las acciones fueron principalmente manipulativas. Finalmente, clasificamos las acciones en: inespecíficas (morder el libro, sacudirlo) u orientadas (intentar agarrar los objetos representados). Predominaron las acciones inespecíficas. Los hallazgos muestran bebés sensoriomotores en exploración. Sin embargo, algunas intervenciones revelaron también un incipiente desarrollo simbólico al usar los libros convencionalmente y reconocer las imágenes como objetos simbólicos. La lectura compartida es un escenario en el que se accede a diversos sistemas de representación (imágenes, números, letras), permitiendo desarrollar tempranamente un potencial simbólico en contextos sociales relevantes.

Abstract Shared reading is a significant and frequent activity in early childhood. However, the interventions in this kind of activities by babies and infants under one-year have been little explored. The main objective of this work was to describe 9-month-old babies' interventions in reading situations with their mothers at Argentinian homes. The focus of the analysis was babies' actions during reading with their mothers. Ten mothers filmed shared reading sessions with their babies. Then we transcribed and analyzed babies' interventions in three levels. First, we classified the interventions in: responsive action, spontaneous action, responsive vocalization, spontaneous vocalization, responsive action + vocalization, spontaneous action + vocalization. Isolated vocalizations were rare. The babies performed mostly spontaneous actions (with or without vocalizations). Responsive actions were less frequent (with or without vocalizations). Second, we classified babies' actions (with or without vocalizations) in 1-conventional, like turn the page, point to the book, put the book in reading position, 2-manipulative, like bite, shake, put the book in the mouth, open and close the book, try to grab/suck/ touch objects represented in pictures, 3- other actions- actions not oriented to books, like shake another object present in the interaction or looking to some object or person outside the scene. We found that babies' actions were mainly manipulative. Finally, we categorized manipulative actions in 1- unspecific actions, like bite, shake, put the book in the mouth, open and close the book, and 2- pictures-oriented ones, like try to grab, suck, touch objects present in pictures. Unspecific actions predominated. Findings show sensory motor babies in exploration. Nevertheless, the presence of conventional actions and picture-oriented actions are signs of an incipient symbolic development. That is, babies use books conventionally and recognize pictures as symbolic objects. In sum, shared reading is one of the richest scenarios for early symbolic development. In this context babies and children access to diverse representational systems (words, pictures, numbers, letters). This activity allows children to development their symbolic potential in relevant social contexts.

Comprensión del consentimiento informado por parte de los pacientes de la Facultad de Odontología de la Universidad de Costa Rica / Understanding of informed consent by patients at the Faculty of Dentistry of the University of Costa Rica

Introducción: El consentimiento informado es el resultado de la evolución de la relación entre las personas profesionales de la salud y sus pacientes o usuarios donde el principio de autonomía está por encima de cualquier otra cosa. Existen muchos artículos sobre el consentimiento informado pero ninguno de los estudios encontrados evaluó si los pacientes realmente lo comprenden. El objetivo de esta investigación fue determinar el nivel de comprensión del consentimiento informado por parte de los pacientes de la Clínica de Exodoncia y Cirugía de la Facultad de Odontología de la Universidad de Costa Rica, en el período agosto a septiembre del 2022, mediante un cuestionario que permitiera correlacionar la comprensión con el nivel de escolaridad. Materiales y métodos: Se realizó un cuestionario a 100 personas dividido en dos partes, una sobre datos sociodemográficos y la otra para establecer la comprensión del consentimiento informado y determinar si el grado de escolaridad tenía relación con la comprensión de este. Resultados: El grupo entre 20 y 30 años fue el mayor, de estos el 51% tuvo estudios universitarios, y aunque la mayoría (98%) refirió conocer el concepto de consentimiento informado, únicamente el 33 % obtuvo las respuestas correctas a las preguntas clínicas realizadas. Conclusiones: A pesar de que los pacientes refieren conocer qué es el consentimiento informado los resultados sugieren una comprensión poco clara de conceptos importantes como complicaciones o reacciones adversas inmediatas o tardías producidas por el efecto de los tratamientos odontológicos o procedimientos quirúrgicos.

Introduction: Informed consent is the result of the evolution of the relationship between health professionals and their patients or users where the principle of autonomy is above anything else. There are many articles on informed consent but none of the studies found assessed whether patients really understand it. The objective of this research was to determine the level of understanding of informed consent by the patients of the Clinic of Oral Surgery of the Faculty of Dentistry of the University of Costa Rica, in the period August to September 2022, by means of a questionnaire that would allow correlating the understanding with the level of schooling. Materials and methods: A questionnaire was administered to 100 people divided into two parts, one on sociodemographic data and the other to establish the understanding of informed consent and to determine whether the level of schooling was related to the understanding of the same. Results: The group between 20 and 30 years of age was the largest, of these 51% had university studies, and although the majority (98%) referred to knowing the concept of informed consent, only 33% obtained the correct answers to the clinical questions asked. Conclusions: Even though patients refer to knowing what informed consent is the results suggest an unclear understanding of important concepts such as complications or immediate or late adverse reactions produced by the effect of dental treatments or surgical procedures.

Spatial language understanding and expression in children with autism: a study of “(go/come) to” sentence in Chinese / 中国康复理论与实践

Objective To investigate the characteristics of spatial orientation language comprehension and expression behavior ofchildren with autism. MethodsA three-ladder test was designed to test the comprehension and expression of "(go/come) to" sentences, including general subject-predicate sentences, conjunctive-predicate sentences with displacement purposes, and conjunctive-predicate sentences with displacement modes. March to June, 2022, the test was conducted on 17 children with autism from a special education school and 17 healthy children matched the scores of Peabody Picture Vocabulary Test-Chinese revised from a kindergarten. The typical errors were analyzed for children with autism. ResultsThe main effects of sentence ladders (F > 3.718, P < 0.05) and children groups (F > 8.782, P < 0.001) were significant on comprehension and expression of sentences, while the performance was poor for the complex sentences and for the children with autism. The common types of errors in expression were missing components, mixed sentences, autonomous sentences, inaccurate wording, inconsistent content, blending errors and non-response. The numbers and the distribution of error types were quite different from the children with autism to the healthy children. ConclusionChildren with autism are more difficult to understand and express "(go/come) to" sentences, mainly manifested in a higher error frequency and more kinds of error.

Programa de intervención con la técnica de cloze: Elaboración y Significancia Clínica / Programa de intervenção com a técnica de cloze: elaboração e significância clínica / Intervention program with the cloze technique: elaboration and clinical significance

RESUMO A hipótese deste estudo está pautada no fato de que um programa de remediação com a Técnica de Cloze, nivelado por diferentes graus de dificuldades, pode contribuir para o desenvolvimento da compreensão leitora de escolares com dificuldades de compreensão leitora. Sendo assim, objetivou-se elaborar este programa e analisar a significância clínica. Para isto, elaborou-se um programa de intervenção por meio de uma revisão bibliográfica e após foi realizado um estudo piloto e aplicado em 28 escolares ensino fundamental I, divididos em Grupo I Estudo (escolares com dificuldade em texto narrativo submetidos à intervenção); Grupo I Controle (escolares com dificuldade em texto narrativo não submetidos à intervenção); Grupo II Estudo (escolares com dificuldade em texto expositivo submetidos à intervenção); Grupo II Controle (escolares com dificuldade em texto expositivo não submetidos à intervenção). Os resultados analisados pelo Método JT apontaram mudança confiável positiva e com significância clínica para escolares do Grupo I Estudo, e de forma significativa para escolares do Grupo II Estudo.

RESUMEN La hipótesis de este estudio está centrada en el hecho de que un programa de remediar con la Técnica de Cloze, nivelado por distintos grados de dificultades, puede contribuir para el desarrollo de la comprensión lectora de escolares con dificultades de comprensión lectora. Por eso, se tuvo por objetivo elaborar este programa y analizar la significancia clínica. Para ello, se elaboró un programa de intervención por intermedio de una revisión bibliográfica y después se realizó un estudio piloto y aplicado en 28 escolares enseñanza básica I, divididos en Grupo I Estudio (escolares con dificultad en texto narrativo sometidos a la intervención); Grupo I Control (escolares con dificultad en texto narrativo no sometidos a la intervención); Grupo II Estudio (escolares con dificultad en texto expositivo sometidos a la intervención); Grupo II Control (escolares con dificultad en texto expositivo no sometidos a la intervención). Los resultados analizados por el Método JT apuntaran cambio fiable positivo y con significancia clínica para escolares del Grupo I Estudio, y de forma significativa para escolares del Grupo II Estudio.

ABSTRACT The hypothesis of this study is based on the fact that a remediation program with the Cloze Technique, leveled by different degrees of difficulties, it can contribute to the development of reading comprehension of students with reading comprehension difficulties. Therefore, the objective was to develop this program and analyze the clinical significance. For this, an intervention program was developed through a bibliographic review and after that a pilot study was carried out and applied in 28 elementary school students, divided into Group I Experimental (students with difficulty in narrative text submitted to the intervention); Group I Control (students with difficulty in narrative text not submitted to the intervention); Group II Experimental (students with difficulty in expository text submitted to the intervention); Group II Control (students with difficulty in expository text not submitted to the intervention). The results analyzed by the JT Method showed a reliable positive change with clinical significance for students in Group I Study, and significantly for students in Group II Experimental.

Compreensão sobre o adoecimento e o tratamento quimioterápico de crianças com câncer / Children with cancer's understanding of illness and chemotherapy / Comprensión sobre la enfermedad y el tratamiento quimioterápico de niños con cáncer

Este estudo de abordagem qualitativa investigou como crianças com câncer compreendiam a doença e o tratamento. Quinze crianças com câncer, de 6 a 12 anos de idade, em tratamento quimioterápico ou finalizado há menos de cinco meses, foram entrevistadas sobre sua vivência em relação ao câncer e à quimioterapia. Para análise das entrevistas foi utilizado o método preconizado por Bardin. Identificou-se que as crianças conheciam seu diagnóstico e tinham percepção de sua gravidade. A quimioterapia foi associada à possibilidade de cura, mas crianças mais novas não compreendiam como um procedimento que gerava piora e mal-estar era a esperança de cura. Crianças mais velhas, com leucemia, relataram insegurança quanto à eficácia do tratamento. Ouvir as crianças fortaleceu a necessidade de envolvê-las nos procedimentos a fim de melhorar sua qualidade de vida.(AU)

This qualitative study investigated how children with cancer understand the illness and treatment. Fifteen children aged between six and 12 years who were undergoing chemotherapy or had completed the treatment less than five months before the study were interviewed about their experiences with the disease and chemotherapy. The interviews were analyzed using content analysis as proposed by Bardin. The findings showed that the children were aware of their diagnosis and the gravity of the disease. Chemotherapy was associated with the possibility of cure, but the younger children did not understand how a procedure that made them feel worse provided hope for cure. The older children with leukemia reported feeling insecure in relation to the efficacy of the procedure. The findings reinforce the need to involve children more in procedures with a view to improving quality of life.(AU)

Este estudio, de abordaje cualitativo, investigó cómo niños con cáncer comprendían la enfermedad y el tratamiento. Quince niños con cáncer, de seis a doce años de edad, en tratamiento quimioterápico o finalizado hacía menos de cinco meses, fueron entrevistados sobre su vivencia con relación al cáncer y a la quimioterapia. Para el análisis de las entrevistas se utilizó el método determinado por Bardin. Se identificó que los niños conocían su diagnóstico y tenían percepción de su gravedad. La quimioterapia fue asociada a la posibilidad de cura, pero los niños menores no entendían cómo un procedimiento que los dejaba peor y con malestar era la esperanza de cura. Los niños mayores, con leucemia, relataron inseguridad en relación con la eficacia del procedimiento. Escuchar a los niños fortaleció la necesidad de envolverlos en los procedimientos, teniendo como finalidad mejorar su calidad de vida.(AU)

Reading and comprehension: Phoniatric assessment in students with reading difficulties

Abstract Introduction: Reading is a highly refined skill that encompasses two main components: decoding graphic symbols and understanding the written message. These aspects generally develop together, but reading comprehension is a much more complex process, sustained not only by the identification of written words and vocabulary but also by language systems, such as syntax and general knowledge. Although there is a well-established technique for performing the Phoniatric assessment, there is no common use of tests that assess reading comprehension or the association of this information with other assessment data. Objective: The objective of this study is, in the context of the Phoniatric consultation, to evaluate the reading and retelling in children with relevant reading difficulties and to correlate the decoding and comprehension problems with the alterations observed in auditory and visual perceptual tests, pointing out the evidence that best contributed to the differential diagnosis of these subjects. Methods: Starting from a population of 301 children enrolled in the 4th and 5th grades of elementary school, 13 children with evident reading and writing difficulties were evaluated regarding the reading and retelling tasks and separated into groups according to the problem of decoding, fluency, and comprehension. Reading performance was correlated with the performance in visual and auditory perceptual tests and based on the similarity analysis, the tests considered to be the most relevant in the diagnosis process of these children were identified. Result: The results suggest that the tasks: naming of figures, repetition of numbers in reverse order, figure copying, syllabic synthesis, phonemic synthesis, rhyme, and phonemic manipulation altogether contribute to diagnosis and multidisciplinary intervention aspects. Conclusion: Some tasks are more relevant to the diagnostic process of children with complaints of learning difficulties in reading.

Are prosodic effects on sentence comprehension dependent on age? / Os efeitos prosódicos na compreensão de frases variam de acordo com a idade?

ABSTRACT Purpose to investigate prosodic boundary effects on the comprehension of attachment ambiguities in Brazilian Portuguese and to test two hypotheses relying on the notion of boundary strength: the absolute boundary hypothesis (ABH) and the relative boundary hypothesis (RBH). Manipulations of prosodic structure influence how listeners interpret syntactically ambiguous sentences. However, the role of prosody in spoken language comprehension of sentences has received limited attention in languages other than English, particularly from a developmental perspective. Methods Twenty-three adults and 15 children participated in a computerized sentence comprehension task involving syntactically ambiguous sentences. Each sentence was recorded in eight different prosodic forms with acoustic manipulations of F0, duration and pause varying the boundary size to reflect predictions of the ABH and RBH. Results Children and adults differed in how prosody influenced their syntactic processing and children were significantly slower than adults. Results indicated that interpretation of sentences varied according to their prosodic forms. Conclusion Neither the ABH or the RBH explained how children and adults who speak Brazilian Portuguese use prosodic boundaries to disambiguate sentences. There is evidence that the way prosodic boundaries influence disambiguation varies cross-linguistically.

RESUMO Objetivo investigar os efeitos de fronteiras prosódicas na compreensão de ambiguidades sintáticas no português brasileiro além de testar duas hipóteses baseadas na noção de intensidade de fronteira: a hipótese de fronteira absoluta (ABH) e a hipótese de fronteira relativa (RBH). Manipulações da estrutura prosódica influenciam como os ouvintes interpretam frases sintaticamente ambíguas. No entanto, o papel da prosódia na compreensão da linguagem oral tem recebido atenção limitada em línguas além do inglês, particularmente do ponto de vista do desenvolvimento. Método Vinte e três adultos e 15 crianças participaram de uma tarefa computadorizada de compreensão de frases envolvendo frases sintaticamente ambíguas. Cada frase foi gravada em oito formas prosódicas diferentes com manipulações acústicas de F0, duração, e pausa, variando o tamanho da fronteira prosódica de modo a transparecer as previsões da ABH e RBH. Resultados Crianças e adultos diferiram em como a prosódia influenciou o processamento sintático; as crianças foram significativamente mais lentas que os adultos. Os resultados indicaram que a interpretação das frases variou de acordo com suas formas prosódicas. Conclusão Nenhuma das hipóteses (ABH ou RBH) explica como crianças e adultos falantes do Português brasileiro utilizam as fronteiras prosódicas para desambiguar frases. Há evidências de que a maneira com a qual os limites prosódicos influenciam a desambiguação de frases varia entre os idiomas.

Assessment of cognitive functioning using the Mini Mental State Examination in men with alcohol and crack cocaine use disorder

Abstract Introduction Consumption of substances has been associated with cognitive impairment. The Mini Mental State Examination (MMSE) is an easy-to-apply screening tool used to assess cognitive functions. Objectives To evaluate the cognitive performance of individuals with alcohol (AUD) and/or crack cocaine use disorder (CUD) and polysubstance use using the MMSE and to investigate the impact of substance use profile and the moderation effect of educational level on MMSE performance. Methods Cross-sectional study with 508 adult male inpatients diagnosed with substance use disorders (245 with AUD, 85 with CUD, and 178 with polysubstance use). Cognitive performance was assessed using the MMSE scale (total and composite scores). Results Individuals with AUD had worse total MMSE scores and scored worse for all three MMSE components compared to individuals with polysubstance use (p < 0.001, oral/written language comprehension, p < 0.001, attention/memory, and p = 0.007, motor functions). MMSE scores were positively correlated with educational level (p < 0.017), but were not associated with age, recent drug use, or years of drug use. Educational level moderated the impact of substance use on MMSE performance, especially total score and composite language comprehension score. Individuals with a low educational level (≤ 8 years) had worse performance than those with a high educational level (≥ 9 years), mainly in individuals with AUD (p < 0.001). Discussion Individuals with a low educational level and alcohol use are more prone to present cognitive impairment than crack cocaine users, especially involving language aspects. Better-preserved cognitive function could impact treatment adherence and might guide the decision of therapeutic strategies.

Validation of Blood Transfusion Risk Scores (TRACK and TRUST) in a Cardiac Surgery Service in Brazil

ABSTRACT Introduction: Transfusion of red blood cells is recurrent in cardiac surgery despite the well-established deleterious effects. Identifying patients with higher chances of requiring blood transfusion is essential to apply strategic preventive measures to reduce such chances, considering the restricted availability of this product. The most used risk scores to predict blood transfusion are the Transfusion Risk and Clinical Knowledge (TRACK) and Transfusion Risk Understanding Scoring Tool (TRUST). However, these scores were not validated for the Brazilian population. The objective of this study was to assess the accuracy of TRACK and TRUST scores in estimating the need for postoperative transfusion of red blood cell concentrates (TRBCC) after cardiac surgery. Methods: A clinical retrospective study was conducted using the database of a Brazilian reference service composed of patients operated between November 2019 and September 2021. Scores were compared using Mann-Whitney U test. Hosmer-Lemeshow goodness of fit test assessed calibration of the scores. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC). All analyses considered a level of significance of 5%. The study was approved by the research ethics committee (CAAE 55577421.4.0000.5201). Results: This study assessed 498 patients. Only the TRACK score presented good calibration (P=0.238; TRUST P=0.034). AUC of TRACK was 0.678 (95% confidence interval 0.63 to 0.73; P<0.001), showing a significant accuracy. Conclusion: Between the scores analyzed, only the TRACK score showed a good calibration, but low accuracy, to predict postoperative TRBCC after cardiac surgery.

Estratégias para favorecer a compreensão do termo de consentimento pelos participantes de ensaios clínicos: revisão integrativa / Strategies to favor comprehension of the consent form by clinical trial participants: an integrative review / Estrategias para facilitar la comprensión del formulario de consentimiento por parte de los participantes en ensayos clínicos: una revisión integradora

Objetivo: analisar as estratégias utilizadas para favorecer a compreensão de participantes de pesquisas clínicas sobre o termo de consentimento livre e esclarecido, bem como, as bases teóricas em que se apoiam. Métodos: revisão integrativa da literatura realizada no ano de 2019 e atualizada em 2021 em seis bases de dados eletrônicas, adicionada de busca reversa a partir das referências dos artigos incluídos. Resultados: dos 21 artigos selecionados, foram identificadas estratégias de mudanças no conteúdo, da forma de apresentação do termo de consentimento, bem como estratégias multimodais. As estratégias identificadas relacionam-se, em sua maioria, ao referencial tradicional de aprendizagem e resultaram em melhor compreensão por parte dos indivíduos que estavam em processo de obtenção do consentimento para participar de ensaios clínicos, em comparação com as estratégias usuais, mas, para a maioria o patamar de compreensão manteve-se abaixo de 60,0%. Conclusões: as estratégias resultaram na melhora da compreensão geral, porém, com persistência da incompreensão ou compreensão limitada de conceitos fundamentais inerentes à participação em pesquisas clínicas, reforçando que o processo de obtenção do consentimento é um fenômeno complexo e que requer atenção especial dos pesquisadores, na busca de garantir a compreensão adequada das informações, garantindo, de fato, a tomada de decisão esclarecida.

Objective: to analyze the strategies used to favor the comprehension of clinical trial participants about the informed consent form, as well as the theoretical bases on which these are based. Methods: integrative literature review performed in 2019 and updated in 2021 in six electronic databases, plus a reverse search based on references of the included articles. Results: strategies of changing the content and the form of presentation of the consent form, as well as multimodal strategies were identified in the 21 selected articles. The identified strategies are mostly related to the traditional learning framework and resulted in a better understanding by individuals in the process of obtaining consent to participate in clinical trials, compared to the usual strategies. For the most part, the level of comprehension remained below 60.0%. Conclusions: the strategies resulted in an improvement in general understanding, although with persisting misunderstanding or limited understanding of fundamental concepts inherent to participation in clinical trials, reinforcing that the process of obtaining consent is a complex phenomenon that requires special attention from researchers, in the quest to ensure proper understanding of information, and an actually informed decision-making.

Objetivo: analizar las estrategias utilizadas para favorecer la comprensión de los participantes en la investigación clínica sobre el formulario de consentimiento informado, así como las bases teóricas en las que se fundamentan. Métodos: revisión bibliográfica integradora realizada en 2019 y actualizada en 2021 en seis bases de datos electrónicas, además de búsqueda inversa a partir de las referencias de los artículos incluidos. Resultados:de los 21 artículos seleccionados, se identificaron estrategias para modificar el contenido y la forma de presentación del formulario de consentimiento, así como estrategias multimodales. Las estrategias identificadas estaban relacionadas en su mayoría con el marco de aprendizaje tradicional y dieron lugar a una mejor comprensión por parte de las personas que estaban en proceso de obtener el consentimiento para participar en ensayos clínicos, en comparación con las estrategias habituales, pero para la mayoría de ellas el nivel de comprensión se mantuvo por debajo del 60%. Conclusiones: las estrategias resultaron en una mejora de la comprensión general, sin embargo, con la persistencia de incomprensión o comprensión limitada de conceptos fundamentales inherentes a la participación en la investigación clínica, reforzando que el proceso de obtención del consentimiento es un fenómeno complejo que requiere especial atención por parte de los investigadores, en la búsqueda de garantizar la adecuada comprensión de la información, asegurando, de hecho, la toma de una decisión informada

El papel de la mentalidad de crecimiento en el desempeño de estudiantes de escuela primaria / The Role Of Growth Mindset In Elementary School Children's Performance

Objetivo. Estudiar la relación entre el tipo de mentalidad y el desempeño en comprensión lectora y aritmética de 247 estudiantes de 9 a 12 años de edad de dos escuelas de Argentina. Método. Los participantes completaron un cuestionario basado en una Escala de Mentalidad de Crecimiento y pruebas estandarizadas de comprensión lectora y cálculo aritmético. Además, se utilizaron las calificaciones escolares proporcionadas por docentes y datos sobre el estatus social (ES) aportados por padres/cuidadores. El diseño fue no experimental y transversal. Resultados. Los análisis de regresión jerárquica mostraron que a mayor mentalidad de crecimiento, mejor desempeño escolar, aún al controlar el efecto del ES. La relación del desempeño con las calificaciones fue más fuerte que con las pruebas estandarizadas.

Objective. The aim of the paper was to study the relation between mindset and reading comprehension and arithmetic performance of 247 students aged 9 to 12 years from two schools in Argentina. Method. Participants were asked to complete a questionnaire based on a Growth Mindset Scale, and standardized tests of reading comprehension and arithmetic calculation. In addition, school grades provided by teachers and social status data provided by parents/caregivers were used. The design was non-experimental and cross-sectional. Results. Hierarchical regression analyzes showed that the higher the growth mindset, the better the school performance, even when controlling for the effect of social status on these variables. The relation of performance with grades was stronger than with standardized tests.

Reading Argumentative Texts: Effects of the presence-absence of connectives in reading comprehension and cognitive effort / Leer Textos Argumentativos: efectos de la presencia-ausencia de conectores en la comprensión lectora y esfuerzo cognitivo

Recent studies prove a strong association between reading and eye movements. Few investigations report the role of connectors and prior knowledge during reading in Spanish, as well as their association with eye movements. The present study aims to evaluate the effects of the presence absence of connectors in two argumentative texts on cognitive effort and reading comprehension. Forty-one psychology undergraduate students participated in a reading comprehension task, while their eye movements were recorded. The condition with connectors was related to prior knowledge, the slide time fixation, the slide number fixations, and the slide return fixations. The condition without connectors was related to the return fixations, the time fixation, and the number of fixations. Prior knowledge was correlated with the total time fixation, the total return fixations, and comprehension. This suggests that during reading without connectors more cognitive effort is required, observed in the return fixations; moreover, prior knowledge has an important role in the visual strategies required to process and obtain a representation of text. But participant performance was still good as observed in the scores of the reading comprehension task

Estudios prueban una asociación entre lectura y movimientos oculares al reportar el efecto de los conectores en el procesamiento textual. Pocas investigaciones revelan el papel de los conectores, el conocimiento previo y los movimientos oculares en la lectura de textos en español. El objetivo fue evaluar los efectos de la presencia-ausencia de conectores en dos textos argumentativos sobre el esfuerzo cognitivo y la comprensión lectora. Participaron 41 universitarios en una tarea de lectura con registro de sus movimientos oculares. La comprensión en la condición con conectores estuvo relacionada con conocimiento previo, tiempo y número de fijaciones por diapositiva, además del número de regresos en la lectura por diapositiva. Mientras la comprensión de textos sin conectores estuvo relacionada con conocimiento previo, regresos, tiempo y número de fijaciones, el conocimiento previo se correlacionó con tiempo y número fijaciones, regresos en la lectura y la comprensión. Se sugiere que la lectura de un texto sin conectores requerirá mayor esfuerzo cognitivo observado en los regresos en la lectura; además, el conocimiento previo afecta las estrategias visuales para procesar y representar mentalmente un texto. Pero, el desempeño de los participantes sigue siendo bueno, según lo observado en los puntajes de la tarea de comprensión lectora.

Efectos de la estructura textual sobre la comprensión y abstracción de hechos históricos / Effects of textual structure on comprehension and abstraction of historical facts

Resumen En este trabajo se indagó, desde una aproximación psicológica no representacional, y a partir de dos experimentos, por el efecto de la estructura textual en la comprensión y abstracción de textos. En el primer experimento, quince estudiantes universitarios leyeron tres textos históricos distintos con una de tres estructuras -secuencial, jerárquica o circunstancial-, y se midió si interpretaron, subinterpretaron o sobreinterpretaron los textos en tres pruebas propias de cada estructura, y si realizaban la abstracción de un hecho común a los tres textos. En el segundo, se replicó sistemáticamente el primer experimento, pero con otros quince estudiantes, que se asignaron según su conocimiento conceptual del dominio histórico-político. Los resultados sugieren mayor subinterpretación con la estructura secuencial, y mayor sobreinterpretación con la jerárquica y la circunstancial; el conocimiento conceptual explicó los hallazgos mejor que la estructura textual, pero no dio cuenta de toda la variabilidad. Al final se discuten los resultados en términos de la mediación lingüística como una competencia subordinante tanto del conocimiento conceptual como de la estructura textual. Asimismo, se resaltan las ventajas del registro evolutivo de la comprensión de cada lector, se anticipan algunas fuentes de control adicional para futuros estudios, y se culmina proponiendo algunas implicaciones educativas de los hallazgos.

Abstract In two experiments, the effect of textual structure on the comprehension and abstraction of texts from a non-representational psychological approach was investigated. In the first experiment, fifteen college students read three different historical texts with one of three structures: -sequential, hierarchical, and circumstantial- and t was measured whether they interpreted, under-intetpreted or over-interpreted the texts in three tests specific to each structure, and whether they abstracted a fact common to the three texts. In the second, the first experiment was systematically replicated but with another fifteen students, who were assigned according to their conceptual knowledge of the historical-political domain. The results suggest greater under-intetpretation with the sequential structure, and greater over-interpretation with the hierarchical and circumstantial. Conceptual knowledge explained the findings better than the textual structure but did not account for all variability. The results are discussed in terms of linguistic mediation as a subordinating competence of both conceptual knowledge and textual structure. It also highlights the advantages of the evolving record of each reader's comprehension, anticipates some sources of additional control for future studies, and concludes by proposing some educational implications of the findings.

Processo de obtenção de consentimento livre e esclarecido para pessoas analfabetas em procedimentos de saúde / Process for obtaining informed consent for illiterate people in healthcare procedures

O Termo de Consentimento Livre e Esclarecido (TCLE) é um documento que faz parte do processo de obtenção da anuência de pacientes ou de participantes de pesquisa, para garantir seus direitos e atribuir seus deveres. Caso o TCLE contenha um texto complexo, ele restringirá, de certa forma, a liberdade de decisão de indivíduos analfabetos. Objetivo: avaliar a percepção de analfabetos sobre o conhecimento do TCLE e suas formas de manifestação de anuência para procedimentos de saúde. Material e método: trata-se de uma pesquisa transversal quali-quantitativa, cuja coleta de dados foi realizada com alunos da Educação de Jovens e Adultos (EJA) por meio de entrevista gravada após leitura de um TCLE modelo. Os resultados qualitativos foram analisados segundo a Técnica de Análise de Conteúdo, proposta por Bardin. Os quantitativos foram analisados pelo teste qui-quadrado e por análise de regressão logística por meio do software JAMOVI. Resultados: participaram da pesquisa 32 alunos. Os dados obtidos mostraram que o conhecimento prévio acerca do TCLE era baixo (34,37%), apenas 46,87% dos participantes compreenderam o documento, sendo 38% da 4ª etapa da EJA. Quase todos os participantes entenderam os benefícios em aplicar o TCLE nas práticas clínicas e 75% informaram que imagens facilitariam a compreensão do documento. Conclusão: concluiu-se que baixas habilidades de alfabetização afetam diretamente a autonomia para anuência em TCLE. A dificuldade na compreensão do TCLE pode estar relacionada aos elementos textuais, como o tamanho da fonte, utilização de termos difíceis e apresentação de um texto extenso contendo muitas informações

The Informed Consent (IC) is a document that is part of the process for obtaining the consent of patients or research participants, to guarantee their rights and assign their duties. The IC, by containing a complex text, restricts, in some way, the freedom of decision of illiterate individuals. Objective: to evaluate the perception of illiterate individuals on the knowledge of the IC and their forms of expression of consent to health procedures. Material and method: this is a quali-quantitative cross-sectional study, whose data collection was carried out with students of Youth and Adult Education (YAE) by means of recorded interview after reading an IC model. The qualitative results were analyzed according to the Content Analysis Technique, proposed by Bardin. Quantitative results were analyzed applying the Chi-square test and logistic regression analysis using the JAMOVI software. Results: 32 students participated in the research. The data obtained showed that the previous knowledge about the ICF is low (34.37%), only 46.87% of the participants understood the document, 38% of them from the 4th stage of YAE. Almost all participants understood the benefits in applying the IC in clinical practices and 75% claimed that images would facilitate understanding of the document. Conclusion: It was concluded that low literacy skills directly affect the autonomy to consent using the IC. The difficulty in understanding the IC may be related to textual elements, such as font size, use of difficult terms, and presentation of an extensive text containing a lot of information