La creencia epistemológica constructivista sobre el conocimiento científico varía en función del año de formación en los estudiantes de Medicina pero no en los estudiantes de otras carreras de la salud / The constructivist epistemological belief about scientific knowledge varies according to the year of training in medical students but not in students of other health careers

Background: To optimize the teaching-learning process it is fundamental to know the representations that students have regarding knowledge. Epistemological beliefs are implicit theories that guide the practical actions of people. Aim: To characterize and compare epistemological beliefs regarding the nature and acquisition of scientific knowledge of health career students. Material and Methods: Between 2012 and 2013, 726 students coursing first, third or fifth year from six health careers answered a validated questionnaire that includes closed and open questions aimed to characterize their epistemological beliefs about scientific knowledge. Results: Irrespective of the career, when students had to select predefined answers, most of them appeared as constructivists (61%). On the other hand, when they had to argue, the majority seemed objectivist (47%). First-year medical students have the highest frequency of constructivist epistemological beliefs (56%). Paradoxically, the lowest percentage is found (34%) in the fifth year. The students of the health careers, in particular those of Medicine, recognize that knowledge is not acquired immediately (83%) and that its distribution is shared (92%). Conclusions: Discordance between selections and arguments suggests that epistemological sophistication is achieved declaratively but not practically. The lower proportion of students who presented constructivist beliefs in the fifth year compared to first year of Medicine could be associated with the pedagogical approaches used in the different cycles of the career.

[The constructivist epistemological belief about scientific knowledge varies according to the year of training in medical students but not in students of other health careers]. / La creencia epistemológica constructivista sobre el conocimiento científico varía en función del año de formación en los estudiantes de Medicina pero no en los estudiantes de otras carreras de la salud.

BACKGROUND: To optimize the teaching-learning process it is fundamental to know the representations that students have regarding knowledge. Epistemological beliefs are implicit theories that guide the practical actions of people. AIM: To characterize and compare epistemological beliefs regarding the nature and acquisition of scientific knowledge of health career students. MATERIAL AND METHODS: Between 2012 and 2013, 726 students coursing first, third or fifth year from six health careers answered a validated questionnaire that includes closed and open questions aimed to characterize their epistemological beliefs about scientific knowledge. RESULTS: Irrespective of the career, when students had to select predefined answers, most of them appeared as constructivists (61%). On the other hand, when they had to argue, the majority seemed objectivist (47%). First-year medical students have the highest frequency of constructivist epistemological beliefs (56%). Paradoxically, the lowest percentage is found (34%) in the fifth year. The students of the health careers, in particular those of Medicine, recognize that knowledge is not acquired immediately (83%) and that its distribution is shared (92%). CONCLUSIONS: Discordance between selections and arguments suggests that epistemological sophistication is achieved declaratively but not practically. The lower proportion of students who presented constructivist beliefs in the fifth year compared to first year of Medicine could be associated with the pedagogical approaches used in the different cycles of the career.

Case report: T-cell responses during clearance of Andes virus from blood cells 2 months after severe hantavirus cardiopulmonary syndrome.

Hantavirus Cardiopulmonary Syndrome (HCPS) due to Andes virus (ANDV) is endemic in Chile and Argentina and currently demonstrates a case-fatality rate of 37% in humans. By contrast to the chronically infected rodents, it is believed that ANDV in humans is cleared during the acute phase. Moreover, to date, both magnitude and quality of human T-cell responses during ANDV infection and clearance are unknown. Using IFN-gamma and granzyme B ELISPOT assays as well as flow cytometry, we prospectively studied the ANDV-specific T-cell responses in a 56-year-old convalescing survivor of severe HCPS, whose blood cells remained PCR-positive for ANDV-RNA until day 53 after hospital admission, that is, 67 days after infection and 42 days after discharge. PCR-negativity was closely related to the increase and function of (Gn(46-60))-specific IFN-gamma(+) granzyme B(+) CD8(+) T-cells, but not to neutralizing antibody titers. Concurrently, the phenotype of CD45RA(+)CCR7(-) Gn(46-60)-specific T-cells shifted from a CD28(-)CD27(+) "intermediate" to a CD28(-) CD27(-) "late" effector memory beyond day 53 after hospital admission. This is the first report that shows that ANDV can persist in the human hosts for more than 2 months. Moreover, the kinetics of T-cell responses during ANDV clearance may indicate a major role of T-cells for clearance of ANDV and human immunity to this pathogen.