En la actualidad, ha incrementado considerablemente los avances e innovaciones tecnológicas, lo que ha permitido el desarrollo de nuevas herramientas tecnológicas y entornos virtuales para optimizar el proceso de enseñanza-aprendizaje. Este trabajo se centra en evaluar el desempeño académico de los estudiantes de la Licenciatura en Gastronomía de la Universidad Autónoma de Sinaloa (UAS) en entornos virtuales, específicamente en la asignatura de estadística. La metodología aplicada fue cuasi-experimental con un enfoque longitudinal descriptivo mixto por encuesta. El análisis de contexto se realizó a través de un instrumento para recolectar información relacionada con el uso y manejo de herramientas tecnológicas. Además, se aplicó el modelo de Progrogramación Neurolingística (PNL) para conocer el estilo de aprendizaje predominante en los estudiantes. Finalmente, se analizó el desempeño académico de los estudiantes durante el desarrollo de dos unidades de aprendizaje. Este documento finaliza con una discusión crítica de los resultados obtenidos, las conclusiones y recomendaciones.
Introduction Cognitive deficits are a cause of functional disability in psychotic disorders. Cognitive remediation therapy (CRT) might be applied to improve these deficits. We conducted a pilot study to explore whether thyroid hormones might predict the response to CRT in patients with recent-onset psychosis (ROP). Methods Twenty-eight stable ROP outpatients (9 women) were randomized to receive computerized CRT (N=14) or treatment as usual (TAU) (N=14), over three months. Both cognitive and thyroid functions were assessed at the baseline and after those three months to all patients. A full cognitive battery (CANTAB) was administered before and after the treatment. Serum levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured. FT4 concentrations were recoded into a dichotomic variable (FT4 group) based on the median of the sample (1.2 ng/dL). Data were analyzed on an intention-to-treat basis with linear mixed models. Afterwards, we offered CRT to all participants from the TAU group and seven enrolled CRT, reassessing them when finished. Secondary analyses were repeated in a sample of 14 participants who completed the CRT (either from the beginning or after the TAU period) and attended at least one third of the sessions. Results The linear mixed models showed a significant time x CRT x FT4 group effect in two cognitive tasks dealing with executive functions and sustained attention (participants with higher FT4 concentrations worsened executive functions but improved sustained attention after CRT). In the secondary analysis including all patients assigned to CRT, higher FT4 concentrations were associated with a poorer response in verbal memory but a better response in spatial working memory. Conclusions Free thyroxine concentrations moderate the response to a CRT in patients with early psychosis.
Background Previous studies assessing the neurotoxicity of haloperidol, risperidone and paliperidone in cell culture suggest that paliperidone shows the strongest neuroprotective effect and a reduced apoptosis level. Other studies including patients with schizophrenia suggest that switching from risperidone long-acting injection (RLAI) to paliperidone palmitate (PP) may improve cognitive function in processing speed and attention. We aimed to study whether switching from risperidone to PP is associated with improved cognitive abilities at 3 or 6 months after the switch. Methods Our initial sample included 32 patients with schizophrenia attending to the Department of Mental Health from Parc Taulí Hospital (Sabadell, Barcelona). All patients were treated with oral risperidone or RLAI (at least two months of stable treatment in monotherapy) and had the indication to be switched to PP by their psychiatrists. Of all 32 patients, 24 (75%) had at least a follow-up visit at 3 months. Therefore, statistical analyses were conducted in a final sample of 24 patients (88% men; 35.6 ± 12.3 years; 63% were receiving RLAI at baseline visit). Ethical approval was obtained from the local Ethics Committee and all participants provided written informed consent. Clinical diagnoses for schizophrenia were generated with the OPCRIT checklist v.4.0. Three assessments were completed: 1) baseline (pre-switch), 2) 3 months post-switch, 3) 6 months post-switch. Cognitive assessment was conducted at each visit with the MATRICS Consensus Cognitive Battery, which includes 10 cognitive tests for assessing 7 cognitive domains. Statistical analyses were performed with SPSS v 23.0 (IBM, USA). A non-parametric paired test (Wilcoxon test) was used for comparing changes in cognitive function over time (baseline vs 3 months; baseline vs 6 months). Significance was set at p<0.05. Results Significant improvements in cognitive function were found for two cognitive tasks dealing with processing speed (BACS-SC and TMT-A) and one task dealing with attention and vigilance (CPT-IP) at both 3 and 6 months. Although reasoning and problem solving (NAB Mazes) or spatial working memory (WMS-III-Spatial Span) did not improve at 3 months, significant improvements in these two cognitive tasks were found at 6 months. Verbal memory, visual memory and social cognition did not improve over time. Discussion In patients with schizophrenia, switching from risperidone to PP is associated with cognitive improvement in tasks dealing with processing speed, attention, working memory and reasoning and problem solving. Our findings are in accordance with previous studies that suggest a potential neuroprotective effect of paliperidone. Some limitations of our study include the lack of randomization (no control group) and the small sample size. The small number of female patients does not allow to explore potential sex differences in the improved cognitive outcome.
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