Psicólogas(os) no sistema educacional de Boa Vista/Roraima: concepções, práticas e desafios / Psychologists in the educational system of Boa Vista/Roraima: conceptions, practices and challenges / Psicólogas(os) en el sistema educativo de Boa Vista/Roraima: concepciones, prácticas y retos

O objeto de estudo deste trabalho é a atuação de psicólogas(os) no campo da educação básica. Tivemos como objetivo investigar as práticas de atuação e os desafios enfrentados pelas(os) psicólogas(os) que trabalham na educação em Boa Vista (RR), com intuito de conhecer a inserção desses profissionais no sistema educacional. Trata-se de pesquisa qualitativa, orientada pelo referencial teórico-metodológico da Psicologia Escolar Crítica. Realizamos o processo de levantamento dos dados entre os meses de março e abril de 2018, por meio de entrevistas semiestruturadas, audiogravadas e transcritas. Encontramos 21 psicólogas e um psicólogo trabalhando em instituições educacionais e de ensino na cidade; a maioria atuava na educação básica; metade dos entrevistados ingressou por concurso público e a outra metade era contratada e comissionada; poucos(as) foram contratados(as) como psicólogos(as) escolares. Para a análise, selecionamos dez psicólogas(os) com mais tempo no cargo. Quanto às práticas de atuação, identificamos que 60% atuavam na modalidade clínica e 40% na modalidade clínica e institucional. Como desafios, encontramos melhoria das condições de trabalho; estabelecimento de relações hierárquicas e a dificuldade de fazer compreender as especificidades desse campo de trabalho; necessidade na melhoria das condições para formação continuada; atuação da(o) psicóloga(o) escolar enquanto ação institucional. Diante do exposto, compreendemos ser necessária uma mudança de paradigma na atuação das(os) psicólogas(os) que trabalham na educação na região, e a apropriação das discussões da área, principalmente, aquelas apresentadas pela Psicologia Escolar Crítica, vez que esta contribui para uma atuação que leve em conta os determinantes sociais, políticos, culturais e pedagógicos que constituem o processo de escolarização.(AU)

This work has as object of study the role of psychologists in the field of Basic Education. We aimed to investigate practices and challenges faced by psychologists who work in education in Boa Vista/RR, to know the insertion of these professionals in the educational system. This is a qualitative research, guided by the theoretical-methodological framework of Critical School Psychology. The data collection process was carried out between March and April 2018, with semi-structured, audio-recorded, and transcribed interviews. We found 21 female psychologists and one male psychologist working in educational institutions in the municipality; most worked in Basic Education; half of the interviewees had applied to work as government employee and the other half were hired and commissioned; few were hired as school psychologists. To carry out the analysis, we selected ten psychologists with more time in the position. Regarding the practices, we have identified that 60% worked in the clinical modality and 40% in the clinical and institutional modality. As challenges, we find the improvement in working conditions; the establishment of hierarchical relationships and the difficulty of making the specificities of this field of work understood; the need to improve conditions for continuing education; the practice of the school psychologist as institutional action. In view of the above, we understand that a paradigm shift in the performance of psychologists working in education in that region is necessary, and the appropriation of discussions in the area, especially those presented by Critical School Psychology, contributes to an action that considers social, political, cultural, and pedagogical determinants that constitute the schooling process.(AU)

Este trabajo tiene como objeto de estudio la actuación profesional de las(os) psicólogas(os) en la educación básica. Su objetivo es investigar las prácticas y retos que enfrentan las(os) psicólogas(os) que trabajan en la educación en Boa Vista, en Roraima (Brasil), con la intención de conocer la inserción de estos profesionales en el sistema educativo. Esta es una investigación cualitativa que se guía por el marco teórico-metodológico de la Psicología Escolar Crítica. Se recopilaron los datos entre los meses de marzo y abril de 2018, mediante entrevistas semiestructuradas, grabadas en audio y después transcritas. Las 21 psicólogas y un psicólogo trabajan en instituciones educativas de la ciudad; la mayoría trabajaba en la educación básica; la mitad de los entrevistados ingresaron mediante concurso público y la otra mitad era contratada y de puesto comisionado; pocos fueron contratados como psicólogos escolares. Para el análisis, se seleccionaron diez psicólogas(os) con más tiempo en el cargo. Con respecto a las prácticas, el 60% trabajaba en la modalidad clínica; y el 40%, en la modalidad clínica e institucional. Los retos son mejora de las condiciones laborales; establecimiento de relaciones jerárquicas y dificultad para comprender las especificidades de este campo de trabajo; necesidad de mejorar las condiciones para la educación continua; y actuación dela (del) psicóloga(o) escolar como acción institucional. En vista de lo anterior, es necesario el cambio de paradigma en la práctica profesional de las(os) psicólogas(os) que trabajan en la educación de la región y la apropiación de las discusiones del área, especialmente las presentadas por la Psicología Escolar Crítica, que contribuye a una acción que tiene en cuenta los determinantes sociales, políticos, culturales y pedagógicos que constituyen el proceso de escolarización.(AU)

Orientação a pais por chamadas de áudio durante a pandemia de covid-19 / Support for parents via audio calls during the covid-19 pandemic / Orientación de los padres mediante llamadas de audio durante la pandemia de covid-19

O distanciamento social ocasionado pela pandemia de Covid-19 levou a profundas mudanças na rotina das famílias com crianças pequenas, aumentando o estresse no ambiente doméstico. Este estudo analisou a experiência de planejamento e implementação de um projeto de extensão universitária que ofereceu orientação a pais com filhos de 0 a 11 anos por meio de chamadas de áudio durante a pandemia. O protocolo de atendimento foi desenvolvido para atender às necessidades de famílias de baixa renda e listava problemas específicos relacionados ao confinamento em casa e ao fechamento das escolas seguidos por uma variedade de estratégias de enfrentamento. A análise de 223 queixas relatadas pelos usuários em 130 ligações revelou que 94% dos problemas referidos pelos pais foram contemplados pelo protocolo de atendimento e estavam relacionados aos problemas externalizantes (39%) ou internalizantes (26%) das crianças ou ao declínio do bem-estar subjetivo dos pais (29%). Serviços de apoio devem orientar os pais quanto ao uso de práticas responsivas e assertivas que promovam o bem-estar emocional da criança e estabeleçam expectativas comportamentais em contextos estressantes. A diminuição dos conflitos entre pais e filhos resultante do uso dessas estratégias tende a reduzir o sofrimento dos pais, aumentando sua sensação de bem-estar subjetivo. Recomenda-se ampla divulgação dessas iniciativas e seguimento dos casos.(AU)

The social distancing the COVID-19 pandemic entailed has led to profound changes in the routine of families with young children, increasing stress in the home environment. This study analyzed the experience of planning and implementing a university extension program that offered support to parents with children from 0 to 11 years old via audio calls during the COVID-19 pandemic. The service protocol was developed to meet the needs of low-income families and listed specific problems related to home confinement and school closure followed by a variety of coping strategies. The analysis of 223 complaints reported by users in 130 calls revealed that 94% of the problems reported by parents were addressed by the protocol and were related to children's externalizing (39%) or internalizing (26%) problems or to the decline in parents' subjective well-being (29%). Support services should guide parents on the use of responsive and assertive practices that promote the child's emotional well-being and set behavioral expectations in stressful contexts. The reduction in conflicts between parents and children resulting from the use of these strategies tends to reduce parents' suffering, increasing their sense of subjective well-being. Wide dissemination of these initiatives and case follow-up are recommended.(AU)

La distancia social causada por la pandemia de COVID-19 condujo a cambios profundos en la rutina de las familias con niños pequeños, aumentando el estrés en el entorno del hogar. Este estudio analizó la experiencia de planificar e implementar un proyecto de extensión universitaria que ofreció orientación a los padres con niños de cero a 11 años a través de llamadas de audio durante la pandemia COVID-19. El protocolo de atención se desarrolló para satisfacer las necesidades de las familias de bajos ingresos y enumeró problemas específicos relacionados con el confinamiento en el hogar y el cierre de la escuela, seguido de una variedad de estrategias de afrontamiento. El análisis de 223 quejas informadas por los usuarios en 130 llamadas reveló que el 94% de los problemas informados por los padres fueron abordados por el protocolo de atención y estaban relacionados con los problemas de externalización (39%) o internalización (26%) de los niños o la disminución del bienestar subjetivo de los padres (29%). Los servicios de apoyo deberían aconsejar a los padres sobre el uso de prácticas receptivas y asertivas que promuevan el bienestar emocional del niño y establezcan expectativas de comportamiento en contextos estresantes. La reducción de los conflictos entre padres e hijos como resultado del uso de estas estrategias tiende a reducir el sufrimiento de los padres, aumentando su sensación de bienestar subjetivo. Se recomienda una amplia difusión de estas iniciativas y seguimiento de casos.(AU)

Formação em psicologia escolar: implicações para a prática em equipe multiprofissional / The school psychology formation: implications for the practice in multidisciplinary team / Formación en psicología escolar: implicaciones para la práctica en equipo multiprofesional

O objetivo dessa pesquisa foi levantar o perfil sociodemográfico e formativo de psicólogos escolares, e discutir seu impacto nas práticas junto ao coletivo escolar e no trabalho em equipe. No município onde ocorreu a pesquisa, o psicólogo escolar é membro da equipe de especialistas em Educação. Participaram da pesquisa 62 psicólogos que atuam no Ensino Fundamental I, II, e na Educação de Jovens e Adultos. Os participantes responderam um questionário on-line com perguntas abertas e fechadas sobre dados sociodemográficos, de formação e atuação profissional. Realizou-se uma análise qualitativa a partir dos objetivos e itens do instrumento, quais sejam: caracterização do perfil sociodemográfico dos psicólogos escolares, formação acadêmica, atuação em psicologia escolar, atuação em outros campos/áreas da psicologia, e atuação em equipe de especialistas. A média de idade dos profissionais é de 47,46 anos, e apenas um é do sexo masculino. Possuem tempo de atuação de um a 36 anos, e a maioria não possui estágio supervisionado e pós-graduações no campo da psicologia escolar. Parte das equipes que trabalham nas escolas está incompleta, e há uma variabilidade nos dias e horários de reuniões. Reafirma-se que a formação de psicólogos escolares tem repercussões na atuação junto à equipe multidisciplinar, e a importância de intervenções pautadas na perspectiva crítica e psicossocial em Psicologia Escolar. Ademais, conhecer o perfil sociodemográfico e formativo destes profissionais possibilita obter um quadro atualizado sobre o grupo pesquisado e criar estratégias de intervenção que potencializem a atuação desses profissionais junto à equipe de especialistas e demais setores da escola.(AU)

The aim of this research is to identify the sociodemographic and training profile of school psychologists, and discuss their impact on practices within the school collective and the teamwork. In the city where the research took place, the school psychologist is a member of the council's expert team in Education. The research participants included 62 psychologists that work in elementary and intermediate school, and EJA. They answered an open and multiple choice online survey on sociodemographic, formation, and working data. A qualitative analysis was conducted considering its objectives and items, namely: sociodemographic profile, academic education, professional background on school psychology, other psychology fields/ areas, and participation on expert teams. The professionals are 47 and 46 years old, average, only one of them being male. They work in this position from one up to 36 years, and most of them do not have training experience and postgraduate studies in school psychology. Part of the teams working at schools are incomplete, and there is a variability concerning days and hours to team meetings. It is notable that the training profile of psychologists has repercussions in the performance with the multidisciplinary team, and in the importance of interventions based on critical and psychosocial perspectives in School Psychology. Moreover, knowing the sociodemographic and training profile of these professionals allowed us to have an updated chart about the researched group, as well as to create intervention strategies that enhance these professionals' performance within the expert team and other sectors of the school.(AU)

Esta investigación tuvo por objetivo levantar el perfil sociodemográfico y formativo de psicólogos escolares para discutir su impacto en las prácticas junto al colectivo escolar y al trabajo en equipo. En el municipio donde ocurrió la investigación, este profesional es miembro del equipo municipal de especialistas en Educación. Participaron 62 psicólogos que actúan en la educación primaria, secundaria y en la educación para jóvenes y adultos (EJA), y que respondieron a un cuestionario en línea con preguntas abiertas y de opción múltiple sobre datos sociodemográficos, de formación y de actuación profesional. Se realizó un análisis cualitativo según sus objetivos e ítems, o sea: perfil sociodemográfico, formación académica, actuación en Psicología Escolar, en otros campos/áreas de la Psicología o en equipo de especialistas. La edad mediana de los profesionales es de 46-47 años, y solo uno es del sexo masculino. El tiempo de actuación en el área varía entre 1 y 36 años, y la mayoría de los encuestados no tiene formación inicial y posgrado en el campo de la Psicología Escolar. Parte de los equipos que trabajan en las escuelas está incompleta, y existe una variabilidad en los días y horarios de reuniones. Se observó que la formación de los psicólogos escolares tiene repercusiones en la actuación con el equipo multidisciplinario y en la importancia de intervenciones basadas en la perspectiva crítica y psicosocial en Psicología Escolar. Además, conocer su perfil sociodemográfico y formativo posibilita obtener un cuadro actualizado sobre el grupo investigado, además de crear estrategias de intervención que potencialicen la actuación junto al equipo de especialistas y a los demás sectores de la escuela.(AU)

Licentîa hypomnema: reflections and perceptions in teacher education / Licentîa hypomnema: reflexões e percepções na formação de educadoras(es) / Licentîa hypomnema: reflexiones y percepciones en la formación del profesorado

Student protagonism is paramount in the knowledge construction process. In this paper, we discuss a didactic-pedagogical resource called licentîa hypomnema (LH), inspired in portfolios and learning diaries in which student-teachers record their understandings and reflections regarding pedagogical topics learned at University in a meta-learning process on learning about teaching. The initial context of the research was a Psychological Development and Teaching course, offered in the Teacher Education program at Universidade de Brasília (UnB). Two of the authors, then Literacy and Languages Teaching students, produced their LH and peer assessed each other during the course. In their annotations, the student-authors recorded two pedagogical situations related to the use of LH in their own teaching practices, causing an impact on their formative path. These materials consist of the data for analysis and discussion. Moreover, we discuss possible uses of reflexive writing in teacher education and other learning contexts. Producing a LH supports knowledge production and allows students to connect theory and practice, which consequently influences the student's teaching practice. Since LH is a didactic-pedagogical resource and not a close-ended tool, both the context and individuals who use it should be considered.(AU)

O protagonismo de estudantes tem grande importância no processo de construção do conhecimento. Neste artigo, discutimos um recurso didático-pedagógico chamado licentîa hypomnema (LH), inspirado em portfólios e diários de aprendizagem, isto é, estudantes de licenciatura escrevem suas compreensões e reflexões acerca de assuntos pedagógicos vistos na universidade em um processo de meta-aprendizagem sobre aprender a ensinar. O contexto inicial da pesquisa foi um curso de Desenvolvimento Psicológico e Ensino, ministrado em cursos de Licenciatura da Universidade de Brasília (UnB). Duas das autoras eram estudantes do curso de Letras, elas produziram seus LH, realizando avaliação por pares entre si durante o curso. As estudantes-autoras trouxeram em seus registros duas situações pedagógicas relacionadas ao uso desse recurso em suas próprias práticas de ensino que causaram um impacto em suas trajetórias formativas. São esses relatos que compõem os dados para análise e discussão. Além disso, procuramos discutir possíveis desdobramentos para o uso do recurso da escrita reflexiva na formação docente e em outros contextos de aprendizagem. A produção do LH fornece suporte para a produção de conhecimento e permite ao aluno conectar teoria e prática, o que, consequentemente, reverbera na prática de ensino do aluno. O LH é um recurso didático-pedagógico e não uma ferramenta fechada, portanto, tanto o contexto quanto as pessoas que o utilizam devem ser considerados.(AU)

El protagonismo de los estudiantes tiene gran importancia en el proceso de construcción del conocimiento. En este trabajo, discutimos un recurso didáctico-pedagógico llamado licentîa hypomnema (LH), que se inspira en diarios de aprendizaje, es decir, estudiantes de profesorado escriben sus comprensiones y reflexiones sobre temas pedagógicos aprendidos en la universidad, produciendo un proceso de meta-aprendizaje sobre aprender a enseñar. El contexto inicial de la investigación fue un curso de Desarrollo Psicológico y Enseñanza, impartido en el programa de Formación de Profesores de la Universidade de Brasília (UnB). Dos de las autoras eran alumnas de la carrera de Letras que produjeron sus LH y realizaron una evaluación por pares mutua durante el curso. Las estudiantes autoras plantearon en su LH dos situaciones pedagógicas relacionadas con el uso de este recurso en sus propias prácticas de enseñanza, causando un impacto en su trayectoria formativa. Estos materiales constituyen los datos para el análisis y la discusión en esta investigación. Buscamos discutir posibles desdoblamientos para el uso del recurso de la escritura reflexiva en la formación docente y en otros contextos de aprendizaje. La producción de este recurso da soporte a la producción de conocimiento y permite al estudiante conectar teoría y práctica, lo que consecuentemente repercute en su práctica docente. El LH es un recurso didáctico-pedagógico y no una herramienta cerrada, por lo tanto, se debe considerar tanto el contexto como las personas que lo utilizan.(AU)

How We Do It: Remediation Pathways in a Surgical Simulation Curriculum for Competency Improvement.

OBJECTIVE: Validated assessment of procedural knowledge and skills with formative remediation is a foundational part of achieving surgical competency. High-fidelity simulation programs provide a unique area to assess resident proficiency and independence, as well as to assist in identifying residents in need of further practice. While several studies have validated the use of simulation to attain proficiency of specific technical skills, few have validated remediation pathways for their trainees objectively. In this descriptive analysis, we review 2 remediation pathways within our simulation training curricula and how these are used in assessments of resident proficiency. MATERIALS AND METHODS: Two methods of remediation were formulated for use in high-fidelity simulation labs. One remediation pathway was a summative process, where ultimate judgment of resident competency was assessed through intra-operative assessments of a holistic skill set. The second remediation pathway was a formative "coaching" process, where feedback is given at several intervals along the pathway towards a specific technical skills competence. All general surgery residents are enrolled in the longitudinal, simulation curricula. RESULTS: Approximately one-third of surgical residents entered into a remediation pathway for either of the high-fidelity simulation curricula. Both residents and faculty expressed support for the summative and formative remediation pathways as constructed. Residents who entered remediation pathways believed it was a beneficial exercise, and the most common feedback was that remediation principles should be expanded to all residents. Interestingly, faculty demonstrated stronger support for the formative coaching feedback model than the summative assessment model. CONCLUSIONS: Through the complementary use of both formative and summative remediation pathways, resident competence can be enriched in a constructive, nonpunitive method for self-directed performance improvement. Both trainees and faculty express high satisfaction with programs explicitly organized to ensure that skills are rated through a standardized process.

Improving reading skills in children with dyslexia: efficacy studies on a newly proposed remedial intervention-repeated reading with vocal music masking (RVM).

In this work, two different studies are examined to evaluate the effectiveness of a novel intervention program for the improvement of reading ability in children with dyslexia, known as repeated reading with vocal music masking (RVM). The proposed remedial approach is inspired by Breznitz's original work. The studies assess a 5-week program of intensive RVM training in a pre-post-test clinical paradigm, as well as a longitudinal paradigm where it is compared to 8 months of the standard remediation program (SRP). The results of both studies support the efficacy of the newly proposed RVM method. Notably in the longitudinal study, the reading speed of children, as well as related phonological, visuo-attentional, and cognitive skills, and attitudes toward reading, were measured regularly. Significant improvements in reading efficiency and related skills were observed, as well as greater motivation to read after RVM training. A modeling of the data specifically linked executive and processing speed skills to be involved in RVM training, suggesting that RVM may help rebalance the phonological and orthographic coding procedures necessary for efficient reading. The short, intensive, and focused nature of RVM training makes it a viable and attractive intervention for clinical practice. As preliminary results are promising, RVM training may prove to be a valuable tool that clinicians can call upon to effectively treat reading fluency disorders, especially when standard programs do not provide results.

Vocal training technology for children with delayed psychoverbal development

The relevance of this research is based on the fact that delayed psychoverbal development is very common is very common in modern children. The problems caused by delayed psychoverbal development accompany many pathologies connected with the development of the nervous system. Therefore, the issues of providing help and training to such children are becoming increasingly relevant both in Russian and foreign pedagogy. The article looks at some aspects of the vocal training technology used in work with children who have delays in psychoverbal development in order to improve the level of their cognitive and communicative skills, develop their thinking, speech, memory and empathy and overcome psychological difficulties. Research methods include theoretical works by Russian psychologists and a pedagogical experiment in vocal training of children with health problems.

La medicina tradicional y natural y los ensayos clínicos: un reto de las ciencias médicas en el siglo XXI / The natural and traditional medicine and the clinical trials: a challenge of medical sciences in the XXI century

La medicina tradicional y natural es el conjunto de técnicas muy extendidas por todo el mundo, cuyo fin es restablecer el equilibrio bioenergético cuando este ha sido afectado por la invasión de agentes patógenos endógenos y exógenos; sin embargo, a pesar del incremento de la demanda de esta alternativa terapéutica, aún existen limitaciones por la carencia de estudios basados en la aplicación de un método científico para obtener y evaluar los resultados, sobre todo para la valoración de agentes o procedimientos terapéuticos o diagnósticos a través de ensayos clínicos. Al respecto, en este trabajo se propone una metodología para el diseño de investigaciones del tipo ensayo clínico en la medicina tradicional y natural, contextualizada sobre la base de la guía para la confección de un protocolo de ensayo clínico, elaborada por el Centro Nacional Coordinador de Ensayos Clínicos(AU)

The natural and traditional medicine is the group of very extended techniques all over the world whose aim is to reestablish the bioenergetic balance when it has been affected by the invasion of endogenous and exogenous pathogens agents; however, in spite of the demand increment of this therapeutic alternative, some limitations still exist for the lack of studies based on the application of a scientific method to obtain and evaluate the results, mainly for the therapeutic or diagnostic agents or procedures valuation through clinical trials. In this respect, in this work a methodology for the investigations design of clinical trial type in the natural and traditional medicine is suggested and contextualized on the base of the guide in order to make a clinical trial protocol elaborated by the Clinical Trials Coordinator National Center(AU)

La gestión educativa para la salud cultural-espiritual: una reflexión antropológica y pedagógica / The educative management for the cultural-spiritual health: an anthropological and pedagogical consideration

La continuidad del humanismo cubano, en la gestión educativa actual, en la que relaciones de complementariedad entre los diferentes agentes educativos focalizan la salud cultural y espiritual como parte de la búsqueda de factores que satisfagan las necesidades del hombre, como ser social protagónico en los procesos socioculturales, se constituye en una síntesis de la utilización de múltiples metodologías y su contextualización, lo que permite socializar las relaciones didácticas que movilizan los presupuestos teóricos y el quehacer profesional práctico en los contextos microsociales, propiciando el conocimiento cultural y espiritual de los participantes en los procesos formativos. Las relaciones dialécticas de naturaleza pedagógica, son un resultado con enfoque didáctico combinativo, que de manera intencionada se materializa en los procesos educacionales, y en ello radica su novedad científica, que es admitida como alternativa pedagógico-didáctica en la formación humana(AU)

The continuity of the Cuban humanism in the current educational management, where complementary relationships in the different educational agents focus the cultural and spiritual health as part of the search for factors that satisfy the needs of man as a social protagonist in the socio-cultural processes; constitutes a synthesis using multiple methodologies and their contextualization, which allows to socialize the didactic relationships that mobilize the theoretical assumptions and the practical professional work in the micro-social contexts, promoting the cultural and spiritual knowledge of the participants in the training processes. The dialectical relations of pedagogical nature are a result, with a didactic combined approach, that intentionally takes the form of educational processes, and there fore its scientific novelty, which is accepted as a pedagogical-didactic alternative in the human formation(EU)

Estrategia pedagógica para la formación profesional en ciencias biomédicas / Pedagogical strategy for the vocational training in biomedical sciences

Las insuficiencias en la orientación formativa de los contenidos científico-médicos en correspondencia con la comprensión, explicación e interpretación del ser humano, que limitan la lógica de actuación de los profesionales de la medicina y su desempeño futuro, fueron tratadas a través de la dinámica del proceso de formación profesional en las ciencias biomédicas, que tiene lugar en la Universidad de Ciencias Médicas de Santiago de Cuba. Por tal motivo, se ideó la elaboración de una estrategia pedagógica para la formación del profesional de las ciencias biomédicas, que contribuya al perfeccionamiento del ciclo básico de la carrera de medicina en cuanto al estudio del organismo humano con una visión holística. Se valoró la pertinencia científica de los resultados investigativos, se realizó la aplicación parcial de la estrategia pedagógica propuesta y se logró un impacto social en el perfeccionamiento del proceso de formación del médico general, lo cual lleva a la transformación de su desempeño, al ofrecer una solución a los problemas de salud que debe enfrentar en la atención al individuo, la familia y la comunidad(AU)

The inadequacies in the training orientation of the scientific-medical contents in correspondence to the understanding, explanation and interpretation of the human being that limit the logic of the medicine professionals performance and their future acting, were treated through the dynamics of the vocational training process in biomedical sciences taking place in the University of Medical Sciences from Santiago de Cuba. For such a reason, the elaboration of a pedagogical strategy was drawn for the training of the biomedical sciences professional, contributing to the improvement of the basic cycle of the medicine career as for the study of the human organism with a holistic vision. The scientific relevance of the investigative results was evaluated, the partial application of the pedagogical strategy proposed was carried out, and a social impact was achieved in the improvement of the general doctor training process, which brings the transformation of his acting, as it offers a solution to the health problems that he should face in the care to the individual, the family and the community(AU)

The effect of computer-assisted therapeutic practice for children with handwriting deficit: a comparison with the effect of the traditional sensorimotor approach.

The objective of this study was to compare the effect of computer-assisted practice with the sensorimotor approach on the remediation of handwriting problems in children with dysgraphia. In a randomized controlled trial, experiments were conducted to verify the intervention effect. Forty two children with handwriting deficit were assigned to computer-assisted instruction, sensorimotor training, or a control group. Handwriting performance was measured using the elementary reading/writing test and computerized handwriting evaluation before and after 6 weeks of intervention. Repeated-measures ANOVA of changed scores were conducted to show whether statistically significant differences across the three groups were present. Significant differences in the elementary reading/writing test were found among the three groups. The computer group showed more significant improvements than the other two groups did. In the kinematic and kinetic analyses, the computer group showed promising results in the remediation of handwriting speed and fluency. This study provided clinical evidence for applying a computer-assisted handwriting program for children with dysgraphia. Clinicians and school teachers are provided with a systematic intervention for the improvement of handwriting difficulties.

Effectiveness of treatment approaches for children and adolescents with reading disabilities: a meta-analysis of randomized controlled trials.

Children and adolescents with reading disabilities experience a significant impairment in the acquisition of reading and spelling skills. Given the emotional and academic consequences for children with persistent reading disorders, evidence-based interventions are critically needed. The present meta-analysis extracts the results of all available randomized controlled trials. The aims were to determine the effectiveness of different treatment approaches and the impact of various factors on the efficacy of interventions. The literature search for published randomized-controlled trials comprised an electronic search in the databases ERIC, PsycINFO, PubMed, and Cochrane, and an examination of bibliographical references. To check for unpublished trials, we searched the websites clinicaltrials.com and ProQuest, and contacted experts in the field. Twenty-two randomized controlled trials with a total of 49 comparisons of experimental and control groups could be included. The comparisons evaluated five reading fluency trainings, three phonemic awareness instructions, three reading comprehension trainings, 29 phonics instructions, three auditory trainings, two medical treatments, and four interventions with coloured overlays or lenses. One trial evaluated the effectiveness of sunflower therapy and another investigated the effectiveness of motor exercises. The results revealed that phonics instruction is not only the most frequently investigated treatment approach, but also the only approach whose efficacy on reading and spelling performance in children and adolescents with reading disabilities is statistically confirmed. The mean effect sizes of the remaining treatment approaches did not reach statistical significance. The present meta-analysis demonstrates that severe reading and spelling difficulties can be ameliorated with appropriate treatment. In order to be better able to provide evidence-based interventions to children and adolescent with reading disabilities, research should intensify the application of blinded randomized controlled trials.

Training the brain: fact and fad in cognitive and behavioral remediation.

Putatively safe and effective for improving cognitive performance in both health and disease, products purported to train the brain appeal to consumers and healthcare practitioners. In an increasingly health-centered society, these applications constitute a burgeoning commercial market. Sparse evidence coupled with lack of scientific rigor, however, leaves claims concerning the impact and duration of such brain training largely unsubstantiated. On the other hand, at least some scientific findings seem to support the effectiveness and sustainability of training for higher brain functions such as attention and working memory. In the present paper we provide a tectonic integration and synthesis of cognitive training approaches. Specifically, we sketch the relative merits and shortcomings of these programs, which often appeal to parents who must choose between side-effect-laden medication and other less conventional options. Here we examine how neuroplasticity allows the healthy as well the impaired to benefit from cognitive training programs. We evaluate the evidence and consider whether brain training can be a stand-alone treatment or an adjunct to pharmacotherapy, outline promising future prospects, and highlight what training outcomes are plausible in line with available data. Future research would determine whether the field of brain training realizes its potential to revolutionize education and rehabilitation or withers away engulfed in controversy.

Teaching nutrition integration: MUST screening in cancer.

RATIONALE: Nutritional risk screening should be routine in order to select patients in need of nutrition care; this conduct change has to rely on education. In this project, radiotherapy department health professionals were trained on how to use the Malnutrition Universal Screening Tool (MUST), to foster its integration into cancer outpatient management; we also aimed to identify those more adherent to screening. METHODS: Research dieticians (the standard) conducted interactive sessions with all physicians, nurses, and radiotherapy (RT) technicians, who were closely supervised to facilitate routine MUST integration. There were two phases: after the first session, phase 1 assessed 200 patients over 4 months; after the second session, phase 2 screened 450 patients, always before RT. Validity was evaluated comparing results from the standard against all other health professionals, adjusted for number. RESULTS: RT technicians were most adherent to the MUST: 80% of patients in phase 1, increasing to 85% in phase 2. Nurses doubled their input, from 19% to 36%. Physicians had poor MUST integration, yet they progressively incorporated percentage weight loss into patient records, increasing from 57% in phase 1 to 84% in phase 2, independently of diagnosis and stage. The highest concordance (κ coefficient) with dieticians was found with RT technicians' use of the MUST (p < .002) and percentage weight loss determination by physicians (p < .001). CONCLUSIONS: We show that systematic screening in cancer is feasible by all professionals involved, once a proximity teaching project is put into practice. RT technicians, who daily treat patients, were highly adherent to integrate the MUST and might be in charge of selecting at-risk patients. Physicians are unlikely to use the MUST, but acknowledged nutrition value and changed their routine by integrating recent percentage weight loss into their approach to patients. Our structured methodology may be used as a model for the development of teaching adapted to different departments with other realities.

Gray matter volume changes following reading intervention in dyslexic children.

Studies in children and adults with the reading disability developmental dyslexia have shown behavioral improvements after reading intervention. In another line of work, it has been shown that intensive training in a variety of cognitive and sensorimotor skills can result in changes in gray matter volume (GMV). This study examined changes in GMV following intensive reading intervention in children with dyslexia using voxel-based morphometry (VBM). Eleven dyslexic children underwent an eight week training focused on mental imagery, articulation and tracing of letters, groups of letters and words, which resulted in significant gains in reading skills. This was followed by an eight week null period (control) where no intervention was administered and no further significant gains in reading were observed. Structural scans were obtained before the intervention, after the intervention and after the null period. GMV increases between the first two time points were found in the left anterior fusiform gyrus/hippocampus, left precuneus, right hippocampus and right anterior cerebellum. However these areas did not change between time points two and three (control period), suggesting that the changes were specific to the intervention period. These results demonstrate for the first time that (1) training-induced changes in GMV can be observed in a pediatric sample and (2) reading improvements induced by intervention are accompanied by GMV changes.

[Concepts of therapy for children with dyslexia]. / Konzepte in der LRS-Therapie.

Numerous methods based on very different concepts are available to treat children with dyslexia. Basically, symptomatic and causal principles can be distinguished. Among the symptomatic methods are systematic programmes based on learning theory, in which reading and spelling or precursors of these abilities are directly trained. Causal methods promise pronounced and persistent improvement of reading and spelling abilities through elimination of the postulated reason underlying the learning disabilities. Among the causal methods are treatment programmes that train low-level functions. Such training is based on the assumption that deficits of auditory, visual or kinesthetic perception, of motor skills or of the coordination of cerebral functional areas are at the bottom of specific learning disabilities. Concepts of other causal methods act on the assumption that learning processes are blocked or that abnormal medical conditions or psychiatric disorders constitute the background of dyslexia. Reviewed in the article are treatment concepts for children with dyslexia in the German-speaking countries and the methods of treatment derived from the different concepts. Results of evaluation studies are summarized and characteristics of effective treatment methods are listed. It is stressed that efficacy is proven only for symptomatic training programmes but not for causal methods.

When top-down meets bottom-up: auditory training enhances verbal memory in schizophrenia.

A critical research priority for our field is to develop treatments that enhance cognitive functioning in schizophrenia and thereby attenuate the functional losses associated with the illness. In this article, we describe such a treatment method that is grounded in emerging research on the widespread sensory processing impairments of schizophrenia, as described elsewhere in this special issue. We first present the rationale for this treatment approach, which consists of cognitive training exercises that make use of principles derived from the past 2 decades of basic science research in learning-induced neuroplasticity; these exercises explicitly target not only the higher order or "top-down" processes of cognition but also the content building blocks of accurate and efficient sensory representations to simultaneously achieve "bottom-up" remediation. We then summarize our experience to date and briefly review our behavioral and serum biomarker findings from a randomized controlled trial of this method in outpatients with long-term symptoms of schizophrenia. Finally, we present promising early psychophysiological evidence that supports the hypothesis that this cognitive training method induces changes in aspects of impaired bottom-up sensory processing in schizophrenia. We conclude with the observation that neuroplasticity-based cognitive training brings patients closer to physiological patterns seen in healthy participants, suggesting that it changes the brain in an adaptive manner in schizophrenia.

Dynamic assessment and response to intervention: two sides of one coin.

This article compares and contrasts the main features of dynamic testing and assessment (DT/A) and response to intervention (RTI). The comparison is carried out along the following lines: (a) historical and empirical roots of both concepts, (b) premises underlying DT/A and RTI, (c) terms used in these concepts, (d) use of these concepts, (e) evidence in support of DT/A and RTI, and (f) expectations associated with each of the concepts. The main outcome of this comparison is a conclusion that both approaches belong to one family of methodologies in psychology and education whose key feature is in blending assessment and intervention in one holistic activity. Because DT/A has been around much longer than RTI, it makes sense for the proponents of RTI to consider both the accomplishments and frustrations that have accumulated in the field of DT/A.

The influence of cognitive rehabilitation on cognitive competence in patients with Alzheimer's disease.

The development of dementia in Alzheimer's disease is known to be influenced by various factors. The research was carried out on 16 patients with a probable diagnosis of Alzheimer's disease (AD), who were first evaluated with MMSE. The patients were then divided according to gender, age, and the progress of the illness into two equal groups. The first group of patients was assigned an additional cognitive therapy for improving cognitive abilities alongside regular treatment while the second group was assigned only regular treatment. After 6 months the patients were re-evaluated using MMSE. The results show a statistically significant difference in cognitive abilities between the two groups with regard to the pre-therapy results. The results of the research are consistent with the results of other researches which imply a slower decrease in cognitive abilities in AD patients who are mentally active.

KATTS: a framework for maximizing NCLEX-RN performance.

A key indicator of the quality of a nursing education program is the performance of its graduates as first-time takers of the NCLEX-RN. As a result, nursing schools are open to strategies that strengthen the performance of their graduates on the examination. The Knowledge base, Anxiety control, Test-Taking Skills (KATTS) framework focuses on the three components of achieving a maximum score on an examination. In KATTS, all three components must be present and in proper balance to maximize a test taker's score. By strengthening not just one but all of these components, graduates can improve their overall test scores significantly. Suggested strategies for strengthening each component of KATTS are provided. This framework has been used successfully in designing remedial tutoring programs and in assisting first-time NCLEX test takers in preparing for the licensing examination.