Visual Information in Basketball Jump-Shots: Differences between Youth and Adult Athletes.

Basketball shooting is a complex skill that requires visual routines and trained players typically evidence a specific oculomotor pattern. This study aimed to examine visual patterns in male novice youth and professional adult players while performing a jump shot. The sample included 20 basketball players grouped as under-16 youth (n = 10) and professional adult (n = 10) players. Each participant completed 50 shots at two distances (long range: 6.80 m; middle range: 4.23 m). Eye tracking glasses were used to obtain quiet eye (QE), the number of fixations, total fixation duration, duration of first and last fixation. An independent t-test was used to assess differences between groups. Shooting accuracy given by % of efficacy indicated that under-16 players attained poorer scores at both distances: long (t = -4.75, p < 0.01) and middle (t = -2.80, p < 0.012) distance. The groups also differed in QE time (long: 600 ms vs. 551 ms; middle: 572 ms vs. 504 ms) and total duration of the fixations (long: 663 ms vs. 606 ms; middle: 663 ms vs. 564 ms) in both long and middle distance shots. Significant differences also occurred in the last fixation (long distance: t = -4.301, p < 0.01; middle distance: t = -3.656, p < 0.01) with professional adult players presenting the value of, on average, 454-458 ms, while youth shooters 363-372 ms. In summary, visual strategy differed between under-16 youth and professional adult basketball players. To support their long-term sport development, it is recommended that youth basketball players focus their attention with longer final fixation before releasing the ball to improve their shot.

Clinical supervision strategies, learning, and critical thinking of nursing students.

OBJECTIVE: To identify the supervisory strategies that Nursing students consider facilitators of the development of critical thinking skills in clinical teaching. METHODS: This is a qualitative study, within the interpretative paradigm, using the focus group methodology. Eight undergraduate nursing students participated in the study. RESULTS: Participants recognized the indispensability of critical thinking for professional responsibility and quality of care and highlighted the importance of using supervisory strategies adapted to their needs, learning objectives, and the context of clinical practice. FINAL CONSIDERATIONS: This study highlights the urgent need to establish, within the Nursing curricula, clinical supervision strategies that promote critical thinking and favor the development of skills for good clinical judgment, problem solving, and safe, effective, and ethical decision-making.

Assessing higher education students' critical thinking with the PENCRISAL test - Portuguese short version: a psychometric study.

The development of critical thinking in higher education is fundamental, preparing students to think well, find explanations, make decisions and solve problems. Given the importance of its promotion, its assessment is crucial, since the two are inseparable. Moreover, the number of instruments that are validated to assess critical thinking in the Portuguese language and culture are scarce. We present the validation psychometric study of the PENCRISAL test (short version) to the Portuguese language, a critical thinking assessment test for higher education students, designed and validated in Spain (full and short version), which presents adequate reliability and validity psychometric characteristics to assess key-dimensions of critical thinking. A sample of 225 Portuguese higher education students from three universities (two public and one private) performed a reduced version of the PANCRISAL test. The results obtained allowed replicating the Spanish reduced version in Portugal (only changing one of the six items), and the confirmatory factorial analysis permits to identify two factors intercorrelated, legitimizing the combination of the six items in a global score. This short version can be used as a screening test, and its potential is pointed out to assess students critical thinking to support teaching and research in higher education.

Early-onset fetal growth restriction: comparison of two management protocols in a single tertiary center.

OBJECTIVE: Compare the neonatal outcomes of two protocols of diagnosis and surveillance of pregnancies complicated by early-onset FGR in a tertiary hospital. METHODS: This is a retrospective cohort study of pregnant women diagnosed with early-onset FGR between 2017 and 2020. We compared the obstetric and perinatal outcomes between two different management protocols (before and after 2019). RESULTS: Seventy-two cases of early-onset FGR were diagnosed in the forementioned period: 45 (62.5%) were managed according to protocol 1 and 27 (37.5%) according to protocol 2. Mean gestational age at delivery was significantly different between groups: 34.9 ± 3.1 weeks (95% CI 34.0-35.9) in group 1 and 32.3 ± 4.4 weeks (95% CI 30.4-33.9) in group 2. 74.1% (20) of newborns in group 2 were admitted in de NICU, a significant difference when compared with 46.7% of group 1. There were no statistically significant differences in the remaining serious neonatal adverse outcomes. CONCLUSIONS: This is the first study published comparing two different protocols of management of FGR. The implementation of the new protocol seems to have led to a decrease in the number of fetuses labeled as growth restricted and to a decrease in the gestational age of delivery of such fetuses, but without increasing the rate of serious neonatal adverse outcomes. SYNOPSIS: The implementation of the 2016 ISUOG guidelines for the diagnosis of fetal growth restriction seems to have led to a decrease in the number of fetuses labeled as growth restricted and to a decrease in the gestational age of delivery of such fetuses, but without increasing the rate of serious neonatal adverse outcomes.

Clinical supervision strategies, learning, and critical thinking of nursing students / Estrategias de supervisión clínica, aprendizaje y pensamiento crítico de los estudiantes de Enfermería / Estratégias de supervisão clínica, aprendizagem e pensamento crítico dos estudantes de Enfermagem

ABSTRACT Objective: To identify the supervisory strategies that Nursing students consider facilitators of the development of critical thinking skills in clinical teaching. Methods: This is a qualitative study, within the interpretative paradigm, using the focus group methodology. Eight undergraduate nursing students participated in the study. Results: Participants recognized the indispensability of critical thinking for professional responsibility and quality of care and highlighted the importance of using supervisory strategies adapted to their needs, learning objectives, and the context of clinical practice. Final considerations: This study highlights the urgent need to establish, within the Nursing curricula, clinical supervision strategies that promote critical thinking and favor the development of skills for good clinical judgment, problem solving, and safe, effective, and ethical decision-making.

RESUMEN Objetivo: Identificar las estrategias de supervisión que los estudiantes de Enfermería consideran facilitadoras del desarrollo de las capacidades de pensamiento crítico en el contexto de enseñanza clínica. Métodos: Estudio de naturaleza cualitativa, inserido en el paradigma interpretativo, con recurso a la metodología focus group. Participaron del estudio ocho estudiantes del curso de licenciatura en Enfermería. Resultados: Los participantes reconocieron la imprescindibilidad del pensamiento crítico para la responsabilidad profesional y calidad en la asistencia; y destacaron la importancia de la utilización de estrategias de supervisión adecuadas a sus necesidades, a los objetivos de aprendizaje y al contexto de la práctica clínica. Consideraciones finales: Este estudio sobrepasa la urgencia en establecerse, dentro de los currículos del curso de Enfermería, estrategias de supervisión clínica promotoras del pensamiento crítico, que favorezcan el desarrollo de capacidades para el bueno juicio clínico, resolución de problemas y toma de decisión segura, eficaz y ética.

RESUMO Objetivo: Identificar as estratégias supervisivas que os estudantes de Enfermagem consideram facilitadoras do desenvolvimento das capacidades de pensamento crítico no contexto de ensino clínico. Métodos: Estudo de natureza qualitativa, inserido no paradigma interpretativo, com recurso à metodologia focus group. Participaram do estudo oito estudantes do curso de licenciatura em Enfermagem. Resultados: Os participantes reconheceram a imprescindibilidade do pensamento crítico para a responsabilidade profissional e qualidade na assistência; e destacaram a importância da utilização de estratégias supervisivas adequadas às suas necessidades, aos objetivos de aprendizagem e ao contexto da prática clínica. Considerações finais: Este estudo sobreleva a premência em se estabelecer, dentro dos currículos do curso de Enfermagem, estratégias de supervisão clínica promotoras do pensamento crítico, que favoreçam o desenvolvimento de capacidades para o bom julgamento clínico, resolução de problemas e tomada de decisão segura, eficaz e ética.

Association of Multiple Myeloma and Giant Cell Arteritis - A Case Report.

Autoimmune diseases (AID) have been associated with a variety of lymphoproliferative disorders. Multiple myeloma (MM), one of the most common haematologic malignancies characterized by clonal proliferation of bone marrow plasma cells, has been associated with a range of autoimmune disorders. In this report, we described a case study of a patient admitted to our Internal Medicine Department for a bone marrow biopsy and myelogram due to a monoclonal peak observed by his general practitioner. However, at admission he presented typical giant cell arteritis (GCA) complaints, suggesting the coexistence of both diseases. The possible pathogenesis, as found in the literature, explaining the association will be discussed. LEARNING POINTS: A relationship between AID and lymphoproliferative diseases, although rare, may occur and some studies suggest that the diagnosis of autoimmune disease has a negative impact on survival in MM patients.Bone marrow plasmacytosis can present a diagnostic dilemma, since it may be due to neoplastic or non-neoplastic conditions (that is, reactive plasmacytosis associated with AID, chronic infection, metastatic carcinoma, liver diseases and acquired immunodeficiency).Immunophenotyping in a myelogram or immunohistochemistry in bone marrow studies are useful in confirming a monoclonal plasma cell proliferation.

Psychiatric Symptoms and Benzodiazepine Use Mask a Patent Foramen Ovale-Related Stroke: A Cautionary Tale.

Neurological and psychiatric diseases often present with overlapping features. Patients are sometimes seen by internal medicine, neurology and psychiatry clinicians and time can be important for determining whether a condition is organic or not. The authors present the case of a 31-year-old woman admitted to the emergency department with altered mental status and incomprehensible speech. She had a previous history of anxiety and smoking and was under therapy with benzodiazepines and combined hormonal contraceptives. After an acute neurological disorder was ruled out, the patient was transferred to the psychiatry department, where she was re-evaluated after 12 hours of observation and benzodiazepine washout. As speech impairment and confusion were still present, she was transferred to the Stroke Unit. A bilateral thalamic lesion containing a small focal haemorrhage and a moderate grade right-to-left shunt were identified. A patent foramen ovale was confirmed leading to the final diagnosis of acute ischaemic infarction secondary to a paradoxical embolism. Medical therapy was preferred over percutaneous closure. Risk factors were removed (smoking and hormonal contraceptives), and after the patient recovered completely acetylsalicylic acid 100 mg daily was initiated. LEARNING POINTS: Psychiatric symptoms and medication often mask organic conditions, so observation and re-evaluation are key.There are new guidelines for the treatment of patent foramen ovale-related strokes, but not all patients fit the guidelines.A relationship between stroke in the young adult, smoking and hormonal contraceptives should always be considered.

Acute Parotitis: A Rare Complication of Fine Needle Aspiration in Warthin Tumour.

Salivary gland tumours are a group of neoplasms with considerable heterogeneity regarding their histology and biological behaviour. Warthin tumour (WT) is the second most common benign parotid tumour. Options for tissue diagnosis include fine needle aspiration (FNA) and ultrasound-guided core needle biopsy. Complications related to FNA are rare. We present the case of a 49-year-old man admitted with parotitis after FNA and discuss management and an alternative investigative approach when WT is strongly suspected. LEARNING POINTS: Warthin tumour (WT) can be clinically suspected based on location (parotid gland tail), cystic texture, patient sex (male) and age (fifth and sixth decades of life), after exclusion of features related to malignancy.Complications of fine-needle aspiration (FNA) for WT diagnosis are rare and most commonly include haemorrhage, facial nerve injury, cellulitis at the needle puncture site and, less frequently, parotitis.When diagnosing tumours strongly suspected of being WT, the clinician should avoid routine FNA and instead use combined imaging studies.

Acute effects of physical exercise at different intensities on inflammatory markers in obese adolescents / Efeito agudo do exercício físico em diferentes intensidades sobre os marcadores inflamatórios em adolescentes obesos

ABSTRACT Obesity promotes a state of chronic low-grade inflammation of white adipose tissue, which is associated with different chronic diseases. While exercise induces an anti-inflammatory environment, little is known about the acute effects of continuous exercise at different intensities on inflammatory markers in obese adolescents. This study included 10 obese adolescents of both sexes, between 15 and 18 years of age. Volunteers performed two 30-minute exercise sessions. The 1st exercise session was performed at moderate intensity (55% VO2peak) and the 2nd at vigorous intensity (75% VO2peak), with a one-week interval between sessions. Blood samples were collected 10 minutes before and 20 minutes after the exercise sessions. Inflammatory markers were analyzed using the chemiluminescence method. Statistical analysis was performed using the two-factors ANOVA test for repeated measures and statistical significance was set at 5% (p <0.05). The results showed that 30 minutes of moderate aerobic exercise resulted in significant changes in circulating levels of TNF-α (6.23 ± 1.64 to 7.03 ± 1.49) and IL-6 (3.35 ± 1.53 to 3.85 ± 1.73). The results of this study showed that a single exercise session of moderate intensity lasting for 30 minutes induced acute responses in inflammatory markers in the obese adolescents evaluated.

RESUMO A obesidade promove um estado de inflamação crônica de baixo grau do tecido adiposo branco, o qual está associado a doenças crônicas. O exercício físico induz um ambiente anti-inflamatório, porém pouco se sabe sobre o efeito agudo do exercício físico contínuo em diferentes intensidades sobre os marcadores inflamatórios em adolescentes obesos. Participaram deste estudo 10 adolescentes obesos de ambos os sexos, entre 15 e 18 anos. Os voluntários realizaram duas sessões de 30 minutos de exercício, sendo a 1ª sessão na intensidade moderada (55% VO2pico) e a 2ª sessão na intensidade vigorosa (75% VO2pico), com o intervalo de uma semana entre cada sessão. As amostras sanguíneas foram coletadas 10 minutos pré e 20 minutos pós exercício. Os marcadores inflamatórios foram analisados através do método Quimiluminescência. Para análise estatística foi utilizado o teste ANOVA para medidas repetidas com dois fatores e o nível de significância adotado foi de 5% (p< 0,05). Os resultados indicaram que 30 minutos de exercício aeróbico moderado resultou em mudanças significativas nos níveis circulatórios de TNF-α (6,23 ± 1,64 para 7,03 ± 1,49) e IL-6 (3,35 ± 1,53 para 3,85 ± 1,73). A partir dos resultados encontrados no presente estudo, pode-se concluir que uma única sessão de exercício físico de intensidade moderada com 30 minutos de duração induziu respostas agudas nos marcadores inflamatórios nestes adolescentes obesos

Fetal bronchopulmonary malformations.

INTRODUCTION: Fetal body tumors are rare, but the ability to diagnose them has improved over recent years. Most masses discovered in the chest results from fetal bronchopulmonary malformations, such as congenital cystic adenomatoid malformation and bronchopulmonary sequestration. Congenital cystic adenomatoid malformation and bronchopulmonary sequestration have a reported incidence of 50% and 33% of all prenatally diagnosed lung lesions, respectively. MATERIAL AND METHODS: Retrospective analysis of the congenital cystic adenomatoid malformation and bronchopulmonary sequestration cases diagnosed or surveilled at our department, between January 2003 and March 2013. Prenatal examination, evolution, management and patient outcome were analyzed. RESULTS: A total of 918 fetal malformations were diagnosed at our hospital, 17 of them representing fetal bronchopulmonary malformations. The majority were diagnosed during the second trimester and stabilized or regressed during the third trimester of pregnancy. The pregnancies and deliveries had no other relevant findings or complications, except in three cases. Nine children required surgery. All of the children are healthy and have a normal development, with regular surveillance by the pediatricians. DISCUSSION: The majority of these fetal lung masses are isolated findings that partially regress during intrauterine life. With adequate postnatal surveillance and eventual surgery the prognosis is good.

Acute kidney injury in an internal medicine ward in a Portuguese quaternary hospital.

BACKGROUND: The term acute kidney injury (AKI) was proposed to reflect the wide spectrum of traditional acute renal failure. RIFLE classification stratifies AKI into three classes of severity and two classes of outcome. AKIN classification proposes an improvement regarding RIFLE in the stratification of AKI, while recently published KDIGO guidelines comprise characteristics of both RIFLE and AKIN. There are no published studies on the utility and measure of agreement between classifications in patients admitted to internal medicine wards. METHODS: Prospective study undertaken in two internal medicine wards in a Portuguese hospital. Patients admitted for a minimum of 72 h, with a diagnosis of AKI or acute-on-chronic kidney disease at admission or during hospitalisation, were included. RIFLE, AKIN and KDIGO criteria were applied for identification of AKI and stratification into risk groups. RESULTS: Sixty-nine patients were included, with a mean age of 79.7±10.0 years and mean GFR of 21.7±8.8 mL/min/1.73 m2. Hypovolaemia due to dehydration was the main cause of AKI (53.6%) and, thereby, RIFLE classification identified a higher number of patients as having AKI, compared to AKIN (94.2% vs. 84.1%). Most patients (69.6%) recovered to their baseline renal function, however fifteen patients (21.7%) died, 53.3% presenting more severe kidney disease. CONCLUSIONS: Our results demonstrate good concordance and correlation between RIFLE, AKIN and KDIGO criteria for the diagnosis of AKI (p<0.001 at initial and final assessment). The authors support the need for further improvement of the classification, ultimately through the use of new biomarkers capable of earlier identification of patients at risk.

[Undifferentiated osteoclastic-type giant cell carcinoma]. / Carcinoma pancreático de células gigantes de tipo osteoclástico.

Initially described 40 years ago (Rosai), the undifferentiated osteoclastic-type giant cell carcinoma (IOGCC) is a variant of ductal adenocarcinoma and accounts for less than 1% of exocrine pancreatic tumors. Its extreme rarity, with consequent existence of few reports and clinical experience, leads to the arousal of doubts with regard to its histogenesis, types of approach and therapeutical attitudes. It is important to note that in Portugal no similar case is registered in medical literature. A 61 year old patient admitted to the Internal Medicine Ward 3 at Coimbra University Hospital presents with a voluminous intra-abdominal mass in the left hypochondrium and microcytic anemia. During the investigation, a pancreatic neoplasm was identified, and the patient was submitted to surgical resection, the anatomo-pathological study of the tumor having revealed IOGCC. The particularities of the case, current available therapeutical options and its evolution are discussed, as well as a revision of the existing literature.