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Maria Salinas Maite López-Garrigós Emilio Flores Maria Leiva-Salinas Javier Lugo Francisco J Pomares Alberto Asencio Miguel Ahumada Carlos Leiva-Salinas 《Biochemia medica : ?asopis Hrvatskoga dru?tva medicinskih biokemi?ara / HDMB》2016,26(1):121-128
Introduction
To study the pre-design and success of a strategy based on the addition of hemoglobin A1c (HbA1c) in the blood samples of certain primary care patients to detect new cases of type 2 diabetes.Materials and methods
In a first step, we retrospectively calculated the number of HbA1c that would have been measured in one year if HbA1c would have been processed, according to the guidelines of the American Diabetes Association (ADA). Based on those results we decided to prospectively measure HbA1c in every primary care patient above 45 years, with no HbA1c in the previous 3 years, and glucose concentration between 5.6-6.9 mmol/L, during an 18 months period. We calculated the number of HbA1c that were automatically added by the LIS based on our strategy, we evaluated the medical record of such subjects to confirm whether type 2 diabetes was finally confirmed, and we calculated the cost of our intervention.Results
In a first stage, according to the guidelines, Hb1Ac should have been added to the blood samples of 13,085 patients, resulting in a cost of 14,973€. In the prospective study, the laboratory added Hb1Ac to 2092 patients, leading to an expense of 2393€. 314 patients had an HbA1c value ≥ 6.5% (48 mmol/mol). 82 were finally diagnosed as type 2 diabetes; 28 thanks to our strategy, with an individual cost of 85.4€; and 54 due to the request of HbA1c by the general practitioners (GPs), with a cost of 47.5€.Conclusion
The automatic laboratory-based strategy detected patients with type 2 diabetes in primary care, at a cost of 85.4€ per new case.Key words: type 2 diabetes, HbA1c, diagnosis, preanalytical phase, test request appropriateness, costs, cost analysis 相似文献32.
Daniel Gil-Pérez Amparo Vilches Isabel Fernández Antonio Cachapuz João Praia Pablo Valdés Julia Salinas 《Science & Education》2005,14(3-5):309-320
The current consideration of technology as ‘applied science’, this is to say, as something that comes ‘after’ science, justifies the lack of attention paid to technology in science education. In our paper we question this simplistic view of the science-technology relationship, historically rooted in the unequal appreciation of intellectual and manual work, and we try to show how the absence of the technological dimension in science education contributes to a naïve and distorted view of science which deeply affects the necessary scientific and technological literacy of all citizens. 相似文献
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This article presents a linear-analytical case study on the development of ICT within the educational systems of Chile and South Korea. Through a comprehensive meta-data analysis and bibliographic review, we collected information on both educational systems and their ICT adoption policies. Key differences necessary to understand how both countries have developed their educational systems by integrating ICT were analyzed, including the educational system structure, the organization of state entities responsible for educational ICT, cultural characteristics, the creation of policies regarding ICT in education, and the effectiveness of such policies for the expansion of infrastructure and the ICT curriculum integration. We analyze these key differences in order to understand two cases of ICT integration initiatives on a national level, so that we might better understand the primary factors that influence successful ICT integration, as well as those that may hinder progress in this area. 相似文献
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In this article the authors examine The Student as Historian project in highlighting how critical historical thinking can provide other and more complex renditions of history. The authors note that teachers’ understandings of educational ends, purposes, values, and critical content knowledge are entwined and inextricable from ideological stances and historical positionality. 相似文献
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Research in Science Education - In this article, we turn our attention to context-based approaches to science instruction. We studied the effects of changes to a set of secondary science teacher... 相似文献
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This paper defines the metaphor of outsideness in relation to web-based interaction. Outsideness is conceived of as a key influence in online academic conversation. In particular, through the sharing of cultural perspectives, asking questions to resolve doubt, and collaborative writing and re-writing as a basis for shaping ideas through reasoning. An analytical framework is proposed and applied to a case study of an international wiki-based project. Key findings are that there is a tension between participants’ sense of inside and outside influences, resulting in a complex and challenging working environment. Students require support to develop nuanced questioning and conversational skills, including multi-model forms of representation and communication to enhance language skills. 相似文献
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Providing model‐based accounts (explanations and predictions) of water and substances in water moving through environmental systems is an important practice for environmental science literacy and necessary for citizens confronting global and local water quantity and quality issues. In this article we present a learning progression for water in environmental systems for students in elementary through high school grades. We investigated student accounts of water and substances in water moving through atmospheric, surface, and soil/groundwater systems, including human‐engineered components of these systems. Using an iterative process of model design, assessment, and interpretation, we identified four levels of achievement in student reasoning. Levels 1 and 2 force‐dynamic accounts explain movement of water as interactions between natural tendencies of water and countervailing powers. Level 3 incomplete school science accounts put events in order and trace water and substance along multiple pathways that include hidden and invisible components. Only Level 4 qualitative model‐based accounts include driving forces and constraining factors to explain or predict where water and substances in water move in given situations. The majority of high school students on average provide accounts between levels 2 and 3. We discuss the significance of these results for citizen participation in addressing common water issues. We end with suggestions for how the water learning progression can be used to inform changes to curricula, assessment, and instruction to support students in achieving level 4 performance. © 2012 Wiley Periodicals, Inc. J Res Sci Teach 49: 843–868, 2012 相似文献
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ABSTRACTBased on an ecological view of teacher resilience, the paper investigates perceived difficulties and resources among vocational education and training (VET) teachers as a first step for investigating teachers’ resilience. Given the substantial shortage of theoretical and empirical studies on this population, more research on resilience among VET teachers is necessary and relevant. In this exploratory qualitative study, interviews with VET teachers in Switzerland (n = 37) sought to identify the specific challenges faced by teachers, the resources to be addressed. As well as confirming the different critical challenges and protective factors emerging from the literature review, the results identify difficulties and resources specific to VET teachers in Switzerland. In terms of critical challenges at a macro-contextual level, teachers’ low social recognition is emphasised. Moreover, exposure to curricular reforms generates stress and pressure related to the required standardisation of content and subject changes. At a micro-system level, we detected teachers’ frustration in relation to students’ low vocational motivation and maturity and specific emerging instructional challenges in vocational subject teaching. In terms of resources, teachers perceived the possibility of diversifying their professional role by alternating school and extracurricular activities as a supportive factor. The results provide a basis for more extensive quantitative study investigating relationship among adversities and resources and resilient strategies. 相似文献
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Cristobal Salinas Jr. Janice Nahra Friedel 《Community College Journal of Research & Practice》2016,40(11):968-971
From their very beginnings, the community colleges have demonstrated a commitment to their founding principles of access, affordability, and quality. However, following February 2009, when President Obama set forth the agenda for U.S. postsecondary education to have the highest proportion of college graduates in the world by 2020, priority shifted to college completion. This national agenda has posed increased challenges and opportunities for community colleges, the states, and the nation. Through a document analysis we identify the most frequently cited challenges and opportunities of the 50 state systems of community colleges. 相似文献