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Abstract Background To describe the design and to present the results of a paediatric and neonatal cardiopulmonary resuscitation (CPR) training program adapted to Latin-America. Methods A paediatric CPR coordinated training project was set up in several Latin-American countries with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The program was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised teaching; and independent teaching. Instructors from each country participated in the development of the next group in the following country. Paediatric Basic Life Support (BLS), Paediatric Intermediate (ILS) and Paediatric Advanced (ALS) courses were organized in each country adapted to local characteristics. Results Five Paediatric Resuscitation groups were created sequentially in Honduras (2), Guatemala, Dominican Republican and Mexico. During 5 years, 6 instructors courses (94 students), 64 Paediatric BLS Courses (1409 students), 29 Paediatrics ILS courses (626 students) and 89 Paediatric ALS courses (1804 students) were given. At the end of the program all five groups are autonomous and organize their own instructor courses. Conclusions Training of autonomous Paediatric CPR groups with the collaboration and scientific assessment of an expert group is a good model program to develop Paediatric CPR training in low- and middle income countries. Participation of groups of different countries in the educational activities is an important method to establish a cooperation network.

Abstract Background Latin America is undergoing a human resource crisis in health care in terms of labor shortage, misdistribution and poor orientation to primary care. Workforce data are needed to inform the planning of long-term strategies to address this problem. This study aimed to evaluate the academic and motivational profile, as well as the professional expectations, of Latin American medical students. Results We conducted an observational, cross-sectional, multi-country study evaluating medical students from 11 Spanish-speaking countries in 2011–2012. Motivations to study medicine, migration intentions, intent to enter postgraduate programs, and perceptions regarding primary care were evaluated via a self-administered questionnaire. Outcomes were measured with pilot-tested questions and previously validated scales. A total of 11,072 valid surveys from 63 medical schools were gathered and analyzed. Conclusions This study describes the profile and expectations of the future workforce being trained in Latin America. The obtained information will be useful for governments and universities in planning strategies to improve their current state of affairs regarding human resources for health care professions.

El presente documento realiza un análisis a las principales propuestas realizadas por el Gobierno colombiano en el marco de la propuesta de reforma tributaria, la cual fue presentada al público en el mes de octubre de 2016 y finalmente aprobada en diciembre del mismo año como Ley 1819. Dicho análisis plantea la inconveniencia de las principales líneas de propuesta de la reforma, en un contexto económico particularmente complejo, y donde las nuevas condiciones de impuestos como el Impuesto al Valor Agregado - IVA, reducirá notoriamente la capacidad de consumo de las familias, mientras que en impuestos directos como renta y patrimonio especialmente los pagados por los grandes capitales se obtienen alivios sustanciales. El documento concluye argumentando que la propuesta del Gobierno aumentará la regresividad del sistema tributario colombiano y empeorará las condiciones de vida, especialmente la de los hogares de menores ingresos.

The developmental origin of blood-forming hematopoietic stem cells (HSCs) is a longstanding question. Here, our non-invasive genetic lineage tracing in mouse embryos pinpoints that artery endothelial cells generate HSCs. Arteries are transiently competent to generate HSCs for 2.5 days (∼E8.5-E11) but subsequently cease, delimiting a narrow time frame for HSC formation in vivo. Guided by the arterial origins of blood, we efficiently and rapidly differentiate human pluripotent stem cells (hPSCs) into posterior primitive streak, lateral mesoderm, artery endothelium, hemogenic endothelium, and >90% pure hematopoietic progenitors within 10 days. hPSC-derived hematopoietic progenitors generate T, B, NK, erythroid, and myeloid cells in vitro and, critically, express hallmark HSC transcription factors HLF and HOXA5-HOXA10, which were previously challenging to upregulate. We differentiated hPSCs into highly enriched HLF+ HOXA+ hematopoietic progenitors with near-stoichiometric efficiency by blocking formation of unwanted lineages at each differentiation step. hPSC-derived HLF+ HOXA+ hematopoietic progenitors could avail both basic research and cellular therapies.

Nursing education is transitioning from traditional teaching to competency-based education. Additionally, more nursing courses and programs are now offered online. Scholarly writing is a powerful strategy to teach effective communication and critical thinking, both core competencies for safe and effective nursing practice. However, teaching writing online to nursing students is challenging due to a lack of research evaluating best practices, faculty time constraints, and inconsistent writing assessment. Automated essay scoring systems using artificial intelligence (AI) provide new opportunities for efficient, reliable, and valid assessment of writing skills. We used a quasi-experimental design to investigate the impact of a 14-week fully online competency-based writing course on students' self-efficacy, task value, and writing performance. The participants were master's nursing students enrolled in an existing one-semester online competency-based writing course for healthcare professionals. An AI-powered writing assessment, IntelliMetric®, and the SAWSES self-efficacy survey were administered pre- and post-intervention. The results showed statistically significant gains in self-efficacy and writing performance with large effect sizes. This study addresses the gap in nursing education regarding the assessment of online, research-based writing interventions on students' scholarly writing capacity. Recommendations include implementing a required scholarly writing course in all graduate-level nursing programs, scaffolding students' competency development with the cognitive apprenticeship model, using best practices from composition research to inform online instruction, and employing AI-powered automated essay scoring to evaluate students' writing progress and instructional efficacy.

It is important to understand the distribution of irrigated and non-irrigated vegetation in rapidly expanding urban areas that are experiencing climate-induced changes in water availability, such as Los Angeles, California. Mapping irrigated vegetation in Los Angeles is necessary for developing sustainable water use practices and accurately accounting for the megacity’s carbon exchange and water balance changes. However, pre-existing maps of irrigated vegetation are largely limited to agricultural regions and are too coarse to resolve heterogeneous urban landscapes. Previous research suggests that irrigation has a strong cooling effect on vegetation, especially in semi-arid environments. The July 2018 launch of the ECOsystem Spaceborne Thermal Radiometer on Space Station (ECOSTRESS) offers an opportunity to test this hypothesis using retrieved land surface temperature (LST) data in complex, heterogeneous urban/non-urban environments. In this study, we leverage Landsat 8 optical imagery and 30 m sharpened afternoon summertime ECOSTRESS LST, then apply very high-resolution (0.6–10 m) vegetation fraction weighting to produce a map of irrigated and non-irrigated vegetation in Los Angeles. This classification was compared to other classifications using different combinations of sensors in order to offer a preliminary accuracy and uncertainty assessment. This approach verifies that ECOSTRESS LST data provides an accurate map (98.2% accuracy) of irrigated urban vegetation in southern California that has the potential to reduce uncertainties in regional carbon and hydrological cycle models.

Indigenous children’s literature supports Indigenous communities’ rights to revitalization, and to the transmission to future generations, of Indigenous histories, languages, and world views, as put forth in the United Nations Declaration of the Rights of Indigenous Peoples. Drawing on Indigenous teachings that were given to him by Elders, an Indigenous Knowledge Keeper, Red Bear, interprets 10 Indigenous picture books published in Canada between 2015 and 2019 by mainstream and Indigenous publishing companies. These books were selected from the International Best Books for Children Canada’s list of Indigenous books and websites of four Canadian Indigenous publishers. We discuss the Knowledge Keeper’s interpretation of books that are grouped within four categories: intergenerational impact of residential schools, stories using spiritual lessons from nature, autobiography and biography, and stories using teachings about relationships. Recognizing the richness, authenticity, and integrity of Red Bear’s interpretation of the books, we propose that all teachers should strive to learn Indigenous cultural perspectives and knowledge when reading Indigenous children’s literature.

High spatial resolution maps of Los Angeles, California are needed to capture the heterogeneity of urban land cover while spanning the regional domain used in carbon and water cycle models. We present a simplified framework for developing a high spatial resolution map of urban vegetation cover in the Southern California Air Basin (SoCAB) with publicly available satellite imagery. This method uses Sentinel-2 (10–60 × 10–60 m) and National Agriculture Imagery Program (NAIP) (0.6 × 0.6 m) optical imagery to classify urban and non-urban areas of impervious surface, tree, grass, shrub, bare soil/non-photosynthetic vegetation, and water. Our approach was designed for Los Angeles, a geographically complex megacity characterized by diverse Mediterranean land cover and a mix of high-rise buildings and topographic features that produce strong shadow effects. We show that a combined NAIP and Sentinel-2 classification reduces misclassified shadow pixels and resolves spatially heterogeneous vegetation gradients across urban and non-urban regions in SoCAB at 0.6–10 m resolution with 85% overall accuracy and 88% weighted overall accuracy. Results from this study will enable the long-term monitoring of land cover change associated with urbanization and quantification of biospheric contributions to carbon and water cycling in cities.

Ostatnie wybory w Polsce mocno zmieniły sytuację polityczną. Nowe władze przystąpiły do realizacji licznych reform. Wiele z nich wzbudziło duże kontrowersje. Dotyczy to także zapowiedzi związanych ze zmianami w systemie samorządu terytorialnego. Artykuł można potraktować jako zaproszenie do dyskusji na temat przyszłości samorządności terytorialnej w Polsce. Zawiera wypowiedzi sześciu socjologów zajmujących się problematyką samorządową. Były one inspirowane trzema pytaniami, które dotyczyły: (1) bilansu polskiej reformy samorządowej, (2) problemów funkcjonowania samorządów, (3) oceny przebiegu dyskusji poświęconej zapowiedzianym zmianom. Wypowiedzi (odpowiedzi na pytania) opierają się na kompetencjach badaczy i ich doświadczeniu badawczym, są zatem w większym stopniu odwzorowaniem wiedzy naukowej i doświadczeń badawczych niż opinii, czy światopoglądu, które właściwe są dyskursowi publicznemu.

Objetives. To determine the factors associated with regular use of sources of information by medical students in four cities in Peru. Materials and methods. In this cross-sectional study, medical students were surveyed in four cities of Peru, gathering information on the use of 14 sources of information and other educational and computer variables. Frequent use of the information source was defined if the respondent reported that they access an information source at least once a week. P values were obtained by generalized linear models adjusted for each respondent site. Results. 2,300 students were surveyed. The median age was 21 years and 53% were women. Having received training in the use of sources increased the use in twelve of the consulted bases, not in SciELO (p=0.053) or in the university library (p=0.509). When adjusting for owning a laptop/netbook, these associations remained. After also adjusting for owning a smartphone the association was lost with the BVS Peru database (p=0.067). The association was also lost after making the final adjustment, if the respondent had carried out any research activities. Conclusions. The frequent use of sources of information is associated with having received training, conducting research and use of information technologies and communication. This should be taken into account in training programs and continuous improvement in undergraduate education.

Reflexiones finales

Fundamento: En 2009 se realizó una campaña de vacunación específica frente a la gripe (H1N1) 2009. El objetivo de este trabajo es evaluar su impacto en Navarra. Métodos: En la cohorte de población no institucionalizada de enfermos crónicos cubiertos por el Servicio Navarro de Salud (N=131.333), asumiendo una efectividad del 100! desde el octavo día tras la administración de la vacuna pandémica, estimamos su impacto en la prevención de casos y de hospitalizaciones por gripe (H1N1) 2009 entre las semanas 47/2009 y 3/2010. Resultados: En las nueve semanas del estudio se diagnosticaron 973 casos de síndrome gripal (7 por 1000). El 28! fueron debidos a gripe (H1N1) 2009. Además hubo 14 personas hospitalizadas con confirmación virológica (11 por 100.000). Con una cobertura de vacuna del 19! (frente al 40! de la estacional) se logró prevenir el 7,7! de los casos y el 10,5! de las hospitalizaciones durante el periodo de estudio. Se administraron 1.092 dosis de vacuna pandémica por cada caso prevenido y 15.021 dosis por cada hospitalización evitada. Con una cobertura idéntica a la de la vacuna estacional se habría conseguido prevenir 16,2! de los casos y 22,2! de las hospitalizaciones. Si se hubiese duplicado esta cobertura y adelantado la campaña de vacunación dos semanas se habrían prevenido 70,7! de los casos y 68,0! de los ingresos, necesitando 261 dosis para prevenir un caso y 6206 dosis para evitar una hospitalización. Conclusión: A pesar de la elevada efectividad de la vacuna su impacto en Navarra fue mínimo, debido a la baja cobertura y al inicio tardío de la campaña de vacunación.

Fundamento: La gripe (H1N1) 2009 produjo en Navarra una onda en verano y otra en otoño de 2009. El objetivo de este trabajo es comparar las características de ambas ondas epidémicas. Métodos: Analizamos la notificación individualizada de gripe, las confirmaciones virológicas en la red centinela de atención primaria, y los casos hospitalizados con confirmación de gripe en Navarra y comparamos los periodos de verano (semanas 21 a 39 de 2009) y otoño-invierno (semanas 40 de 2009 a 20 de 2010). Resultados: Durante 2009 hubo dos ondas de gripe A(H1N1)2009, con picos en julio y noviembre. En verano (semana 21 a 39) se notificaron 4.389 casos de síndrome gripal, siendo los más afectados los adultos jóvenes (58! entre 15 y 44 años). La mayor incidencia se registró tras las fiestas de San Fermín (92 casos por 100.000 en la semana 29) con retorno inmediato a niveles basales. En otoño se produjo una segunda onda que alcanzó tasas 7 veces mayores (667 casos por 100.000 en la semana 45) y se mantuvieron 9 semanas por encima del umbral epidémico, siendo el grupo de edad más afectado el de niños de 5 a 14 años (111 por 1000). En el pico de las dos ondas el porcentaje de frotis confirmados para gripe superó el 60!. Durante el verano se produjeron 66 ingresos con confirmación de gripe (H1N1)2009, y en otoño 158. La proporción de casos que requirieron ingresos en hospital fue mayor en verano (1,5!) que en otoño (0,8!; p