The purpose of this study was to estimate the burden of osteoporotic fractures beyond the hospitalization period covering up to the first year after the fracture. This was a prospective, 12-month, observational study including patients aged ≥65 years hospitalized due to a first low-trauma hip fracture, in six Spanish regions. Health resource utilization (HRU), quality of life (QoL) and autonomy were collected and total costs calculated. Four hundred and eighty seven patients (mean ± SD age 83 ± 7 years, 77 % women) were included. Twenty-two percent of patients reported a prior non-hip low-trauma fracture, 16 % were receiving osteoporotic treatment at baseline, and 3 % had densitometry performed (1.8 % T-score ≤−2.5). Sixteen percent of patients died (women 14 %; men 25 %; p = 0.0011) during the first year. Mean hospital stay was 11.8 ± 7.9 days and 95.1 % of patients underwent surgery. Other relevant HRUs were: outpatient visits in 78 % of patients (mean 9.2 ± 9.7); walking aids, 58.7 %; rehabilitation facilities, 35.5 % (28.7 ± 41.2 sessions); and formal and informal home care, 22.2 % (49.6 ± 72.2 days) and 53.4 % (77.1 ± 101.0 h), respectively. Mean direct cost was €9690 (95 % confidence interval: 9184–10,197) in women and €9019 (8079–9958) in men. Main cost drivers were: first hospitalization episode (women €7067 [73 %]; men €7196 [80 %]); outpatient visits (€1323 [14 %]; €997 [11 %]); and home care (€905 [9 %]; €767 [9 %]). QoL and autonomy showed a marked decrease during hospitalization, not entirely recovered at 12 months (p < 0.05 vs. baseline for EQ-5D, Harris hip score and modified Barthel index). In a Spanish setting, osteoporotic hip fractures incur a high societal and economic cost, mainly due to the first hospitalization HRU, but also due to subsequent outpatient visits and home care.Electronic supplementary materialThe online version of this article (doi:10.1007/s00223-016-0193-8) contains supplementary material, which is available to authorized users.
This article presents and discusses the results of a study that investigates university students’ comprehension of the concept of molar concentration, following teaching and evaluation of the subject. The specific problems underlying learning of this concept have not yet been focused on in sufficient detail or depth. A “Reasoning with molarity” questionnaire, which explores the logical–mathematical relationships between the variables n, V and M, was administered to 303 Argentine first-year university students. Results obtained from think-aloud interviews related to this questionnaire, which were performed with 18 students, are also analysed. These results reveal that approximately half the first-year university students have no clear conceptual understanding of molarity. The main difficulty arises in inverse proportionality tasks where the number of moles (extensive) and M (intensive) should be related qualitatively to determine which solution occupies the smallest volume. It was also established that much conceptual confusion, such as the lack of differentiation between n and M, lies behind the algorithmic, numerical solution strategy carried out exclusively by many students.
Resumen: En la actualidad ha aumentado el interés por desarrollar nuevas estrategias didácticas para la enseñanza de las ciencias experimentales. Así, para enseñar una visión contextualizada y provisional de la ciencia, los conocimientos sobre su naturaleza deben hallarse estrechamente relacionados con los conocimientos didácticos de los contenidos a enseñar. En este trabajo se plantea un dispositivo didáctico sobre la naturaleza del trabajo de investigación científica con el fin de contribuir con la formación del profesorado universitario del campo de las ciencias de la salud desde la perspectiva de la investigación-acción. Se presentan los criterios que guiaron su diseño y los resultados del análisis de su implementación. Los resultados muestran que los docentes universitarios sostenían imágenes de una ciencia de características hipotético-deductivas aunque provisorias, y que basaban su enseñanza en ideas mayormente intuitivas. El trabajo en pequeños grupos y el debate en plenario permitieron interpelar sus representaciones, reflexionar sobre las imágenes de ciencia, propias y ajenas, así como revisar posibles estrategias de enseñanza fundamentadas teóricamente.Palabras clave: Conocimiento Didáctico del Contenido; Naturaleza de la Ciencia; Enseñanza Universitaria; Formación de Profesores. University Science teachers' education. Pedagogical knowledge and scientific research.Abstract: The interest in the development of new pedagogical strategies for experimental science teaching have increased these days. Thus, in order to teach a contextualized and provisional image of science, the nature of science knowledge must be linked with the pedagogical content knowledge to be taught. A pedagogical proposal about the nature of the scientific research is posed in this work to contribute with university teachers' education in the field of Health Sciences using action research model. Criteria for the design and the analysis of enacting results are presented here. The results show that university teachers uphold hypothetic-deductive images about Science but these were provisional, and they based their teaching on mainly intuitive ideas. The work in small groups and plenary debate allowed to confront teachers' representations, to reflect about own and others' images of science, as well as to review possible theoretical founded teaching strategies. Introducción: Los profesores y la enseñanza universitariaLos aspectos investigados por la didáctica de la ciencia fueron cambiando a lo largo del tiempo. En 1994, Carles Furió nos advertía sobre el corrimiento que en el futuro tomarían estas investigaciones orientadas hacia el desarrollo profesional docente: «… se está pasando de investigar lo que piensa y hace el alumno en clase hacia lo que piensa y hace el profesor, tratando de analizar su actividad y así poder descifrar las claves de su desarrollo profesional. En particular, habrá que determinar cuáles son sus necesidades formativas y qué factores pueden influir en una continua preparación para el cambio didáctico» (Furió 1994...
<p class="p1">En este artículo se realiza una breve discusión en torno al rol de las imágenes en el aprendizaje y al papel que juegan en los libros de texto. También se lleva adelante una revisión de las principales dificultades y concepciones alternativas que presentan estudiantes de nivel medio y universitario en el aprendizaje del tema concentración de disoluciones y, sobre esta base, se especifican los aspectos conceptuales deseables a ser abordados en la enseñanza de este tema. Posteriormente se indaga si estos aspectos son tenidos en cuenta en explicaciones o ejercicios que empleen imágenes en libros de texto de primer año de universidad. Se analizaron 25 libros de química general editados entre los años 2000-2020, hallándose que los textos editados en los últimos 10 años han duplicado el número de imágenes sobre aspectos conceptuales de concentración, con respecto a los 10 años anteriores, y que ha aumentado el uso de diagramas de partículas. Se discuten las implicancias educativas de los resultados encontrados.</p>
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