Psychoeducational assessment of students with intellectual disability: professional-action framework analysis.

BACKGROUND: The right to educational inclusion for students with intellectual disability (SWID) requires the development of good assessment and intervention practices from holistic perspectives not exclusively focused on the academic limitations that SWID may present. These practices are settled in Spain, via regulations drawn up by each Autonomous Community (AC). The variety of existing regulations demands a critical review of the decisions taken to promote the inclusion of those students. METHOD: current regulations-in-force in each AC that regulate attention to diversity (AD) have been were analyzed by using a checklist that includes the variables that defining each stage of the AD process and the ways of providing supports that favor the development, learning and participation of SWID. RESULTS: attention to diversity measures in each AC emphasize organizational and curricular issues, with no AC following holistic approaches in both assessment and intervention, but rather neglecting self-determination and the promotion of quality of life for SWID. CONCLUSIONS: guidelines for the development of new legal frameworks and professional practices based on the latest evidence-based models of attention to SWID and on the results are discussed.

Evaluación sumativa de los residentes mediante simulación: utilidad de los simuladores a escala real / Simulation summative assessment of the residents: usefulness of high fidelity simulators

Introducción: La determinación de las competencias clínicas de los residentes es un elemento importante en su proceso de aprendizaje. Para determinar efectivamente esta adquisición, debemos realizar evaluaciones tanto formativas como sumativas. Mientras que la utilidad de los simuladores a escala real en la evaluación formativa está claramente establecida, queda por determinar esa utilidad en la evaluación sumativa. Objetivo: Determinar la validez y fiabilidad de los simuladores a escala real como herramienta en la evaluación sumativa de la residencia en anestesiología. Sujetos y métodos: Se determinaron un conjunto de competencias fundamentales de la residencia, susceptibles de evaluarse mediante simulación, que se incorporaron en escenarios simulados utilizando un simulador a escala real. Para su evaluación, se establecieron un conjunto de acciones clave, en la resolución de cada escenario, atribuidas en función de su realización o no. Participaron nuestros seis residentes de cuarto año, que tenían experiencia previa en simulación, y fueron evaluados por dos revisores independientes. Resultados: Los porcentajes medios de aciertos del conjunto de residentes, en los escenarios evaluados fueron muy homogéneos, sin capacidad de discriminar a los residentes ni predecir su comportamiento en los escenarios siguientes. La capacidad de discriminación de los escenarios propuestos obtuvo una fiabilidad de r = 0,44, y la concordancia de los resultados, frente a la evaluación mediante observación directa de procedimientos (DOPS), una baja correlación (r = 0,22). Conclusión: Es necesario todavía un desarrollo metodológico importante para considerar la posibilidad de utilizar la simulación en la evaluación sumativa de la residencia (AU)

Introduction: The assessment of residents' clinical skills is an important element of their training. To successfully promote effective learning, this assessment should be both formative and summative. The usefulness of high-fidelity medical simulation on formative education is very well established, but it's unclear the role of simulation in the summative process. Aim: To use the anesthesia high fidelity simulator to evaluate anesthesia residents, checking the construct-related validity and criterion-related validity. Subjects and methods: Several clinical conditions that residents should handle competitively were developed and, incorporated into a scenario using high fidelity simulator. To asses the performance in each scenario, we addressed a checklist according a rigid format, on the basic of 'done/not done'. Our six fourth degree residents participated in the program. They had previous experience in simulation and were evaluated for two independent examiners. Results: The global performance on the residents were very similar. We did not found neither possibility of discriminate between resident nor we be able to predict the performance in the next scenario. Scenario discrimination showed up a global coefficient (r = 0.44). Assessing the reliability of the scores we found a poor correlation (r = 0.22) against Direct Procedural Observation Score (DOPS). Conclusion: Further improvements are necessary before simulation-based clinical examination is used for summative evaluation (AU)

Effect of pierced metallic objects on SAR distributions at 900 MHz.

A study of the interaction between mobile phone antennas and a human head in the presence of different types of metallic objects, attached and pierced to the compressed ear, is presented in this article. Computed and measured results have been performed by considering a quasi-half-wavelength dipole as the radiating source and measurements with the DASY4 dosimetric assessment system. Two different human head models have been implemented: a homogeneously shaped sphere and a three-level head model with four different kinds of tissue. Antenna input impedance, reflection coefficient, radiation patterns, SAR distribution, absorbed power, and peak SAR values have been computed and measured for diverse scenarios, electromagnetic simulators, and organs. Despite the measuring accuracy limitations of the study, both simulated and measured results suggest that special attention has to be paid to peak SAR averaged values when wearing metallic objects close to the radiation source, since some increment of peak SAR averaged values is expected.

Nonbacterial thrombotic endocarditis after lung transplantation.

Bacteria-free verrucae has been recognized as a condition associated with several clinical conditions such as bone marrow transplantation, malignant tumors, autoimmune disorders, and acquired immunodeficiency syndrome, but it has not been reported in relation to lung transplantation. We report the case of a patient who underwent bilateral lung transplant and died 3 days later. Histologic examination revealed, among other lesions, the presence of nonbacterial thrombotic endocarditis in the right atrium and mitral and tricuspid valves that was not present in the preoperative echocardiographic studies. Even with transesophageal echocardiography, a reliable detection of vegetations may not be possible. Hypoxigenic pulmonary states developed in the course of lung transplant could be the factor that triggers the interaction between the coagulation system, platelets, and endothelial cells that induce the formation of bacteria-free verrucae.