Promoting critical thinking in an online, project-based course.

Education institutions are expected to contribute to the development of students' critical thinking skills. Due to COVID-19, there has been a surge in interest in online teaching. The aim of this study is therefore to design a strategy to promote critical thinking in an online setting for first year undergraduates. An intervention was carried out with 834 students at an engineering school; it comprised five activities designed to develop critical thinking. Both the control and experimental groups worked with a project-based learning strategy, while the experimental group was provided with scaffolding for a socially shared regulation process. All students answered an identical pre- and post-test so as to analyze the impact on critical thinking. Both strategies performed significantly better on the post-test, suggesting that online project-based learning improves critical thinking. However, following a socially shared regulation scaffolding led to a significantly greater improvement. In this sense, the socially shared regulation scaffolding provided to the experimental group proved to be key, while feedback was also an important element in the development of critical thinking. This study shows that online project-based learning fosters the development of critical thinking, while providing a socially shared regulation scaffolding also has a significant impact.

Taking critical thinking, creativity and grit online.

Technology has the potential to facilitate the development of higher-order thinking skills in learning. There has been a rush towards online learning by education systems during COVID-19; this can therefore be seen as an opportunity to develop students' higher-order thinking skills. In this short report we show how critical thinking and creativity can be developed in an online context, as well as highlighting the importance of grit. We also suggest the importance of heuristic evaluation in the design of online systems to support twenty-first century learning.

Fibrinólisis Farmacológica En El Ictus Isquémico Agudo. Experiencia En Un Hospital Terciario Del Ecuador / Pharmacological Thrombolysis In Ischemic Stroke. Experience In A Tertiary Hospital From Ecuador

Resumen Introducción: La trombolisis farmacológica en el ictus isquémico se asocia a una mejor recuperación. Objetivo: Describir los resultados del tratamiento con r-Tpa regido por un protocolo y código ictus intrahospitalario durante un año de trabajo. Métodos: Se realizó un estudio prospectivo, longitudinal en pacientes con infarto cerebral ingresados en la Unidad de ictus, con seguimiento clínico hasta 3 meses después del alta hospitalaria. Las variables evaluadas se compararon entre dos grupos de pacientes, tratados o no. Resultados: Se estudiaron 107 pacientes: 16 (14,9 %) fueron trombolizados, 29 (27,1%) arribaron en periodo de ventana terapéutica y 76 (71%) llegaron después de las 4.5 horas. La edad promedio fue de 68,8 años y predominaron las mujeres. El mayor impacto de la trombolisis fue sobre la diferencia de puntaje entre la evaluación inicial y al alta en la escala del NIHSS. A los tres meses de evolución, el porcentaje de pacientes con discapacidad leve (Rankin 0-2) casi se igualó en los dos grupos. La mortalidad se incrementó a expensas de los pacientes con discapacidad más severa (Rankin 3-5). Conclusiones: El tratamiento con r-Tpa demuestra beneficios al alta hospitalaria. Se requiere de análisis posterior con mayor número de casos.

Abstract Introduction: Pharmacological thrombolysis in ischemic stroke is associated with a better recovery. Objective: Describe the thrombolysis results after using r-Tpa applying an intrahospital stroke code, during one year. Methods: A prospective, longitudinal study was performed in patients with cerebral infarction admitted to the stroke unit, with clinical follow-up up to 3 months after hospital discharge. The variables evaluated were compared in two groups of patients (only one group received the treatment). Results: 107 patients were studied: 16 (14.9%) were thrombolyzed, 29 (27.1%) arrived in the therapeutic window period and 76 (71%) arrived after 4.5 hours. The average age was 68, 8 years and women predominated. The greatest impact of thrombolysis was on the difference in score between the initial assessment and the discharge on the NIHSS scale. At three months of evolution, the percentage of patients with mild disability (Rankin 0-2) was almost equal in the two groups. Mortality increased in patients with more severe disability (Rankin 3-5). Conclusions: Treatment with r-Tpa shows benefits at hospital discharge. Further analysis is required with a greater number of cases.

Guillain-Barre syndrome and Zika infection: identifying leading producers, countries relative specialization and collaboration.

Zika virus (Zikv) infection implies a significant public health issue due to the different syndromes associated. It is related to several central nervous system problems, such as microcephaly and Guillain-Barre Syndrome. In this way, the first document about the relation of Guillain-Barre Syndrome and Zika indexed in Web of Science was published in 2014. Therefore, the primary goal of the present study is to analyze the leading scientific producers, the relative specialization of the countries and the collaboration network in the research area. A total of 384 manuscripts were identified. Two manuscripts were published in 2014 and 2015; the remaining documents are distributed during 2016 (136), 2017 (186) and 2018 (59) (until April). In conclusion, Zikv and Guillain-Barre Syndrome research has experienced a significant increase in the last years. This may be related to the topic is an important issue of public health concern in the countries affected by Zikv outbreaks. In that sense, Brazil, India and Colombia make a great effort, considering their economic and social resources, in research. However, this study implies a preliminary overview of the research on this topic, a more extended period is needed to define the lines of research and collaboration between countries and authors.

Conocimiento Acerca Del Ictus Isquémico En Ecuatorianos / Knowledge About Ischemic Stroke In Ecuadorian People

Resumen Introducción: La llegada en periodo de ventana terapéutica de un paciente con ictus isquémico al hospital depende de la identificación de las manifestaciones clínicas y el reconocimiento de que se trata de una urgencia médica. Métodos: Se realizó un estudio prospectivo, longitudinal, de corte transversal para el cual se diseñó una entrevista estructurada con preguntas cerradas. Objetivo. Evaluar el grado de conocimiento de la población acerca del infarto cerebral. Resultados: Se entrevistaron 135 sujetos sin diagnóstico de ictus, seleccionados al azar entre los familiares de pacientes. La edad media de fue de 42,6 años, predominaron las mujeres (92/68,1%) y el grado de instrucción medio. El 95,5% (129 sujetos) admitió tener poco conocimiento sobre el ictus. Solo el 11,1% señaló de forma correcta las manifestaciones clínicas; el síntoma más reconocido fue el amortiguamiento (59,3%) seguido de los trastornos del habla. El 80,9% identifican el ictus como una condición prevenible. Menos de la mitad de los participantes nombraron adecuadamente los factores de riesgo (66/48,9%). El 88,2% toma una actitud correcta ante los síntomas. Conclusiones: En el grupo de personas entrevistadas el conocimiento acerca de las manifestaciones y los factores de riesgo vascular es deficiente. Es necesario realizar campañas informativas dirigidas a mejorar el conocimiento de la enfermedad.

Summary Introduction: The arrival of patients with ischemic stroke to the hospital in the period of the therapeutic window, depends to a great extent on the identification of their clinical signs and the recognition that it is a medical emergency. Methods: A prospective, longitudinal, cross-sectional study was carried out, based on a structured interview with closed questions. The aim was to access the degree of the population's knowledge about the ischemic stroke. Results: A total of 135 subjects without a diagnosis of stroke were interviewed, randomly selected from the relatives of patients. The average age was 42.6 years, women predominated (92 / 68.1%), with an average level of education. 95.5% (129 subjects) admitted having little knowledge about stroke. Only 11.1% correctly indicated the clinical manifestations; The most recognized symptom was damping (59.3%) followed by speech disorders. 80.9% (109 respondents) identify stroke as a preventable condition. Less than half of the participants adequately named the risk factors (66 / 48.9%). 88.2% take a correct attitude to the symptoms. Conclusions: In the group of people interviewed there is a perception of risk regarding stroke, but knowledge about the manifestations and vascular risk factors is poor. It is necessary to carry out information campaigns aimed to improve knowledge of the disease.