Jose Guzman

Teaching through discussion is perhaps the most fundamental pedagogical technique of philosophy. When done well, discussion can promote long-term, durable learning. It supports an active-learning classroom, sparks higher-order cognition, and helps students construct their own understanding of the material. Yet it is often not done well: it is easily dominated by a few students; it can waste time on tangents and minutiae; it can fail to motivate students to prepare adequately; and it is not easily scalable. In this paper we present a technique, the random discussion leader (RDL), which addresses all of these shortcomings of traditional discussion. Qualitative and quantitative evidence from our quasi-experimental study (n = 279) suggests that RDL leads to better preparation, better engagement with the material, more equitable participation, and higher quality discussions. Additionally, we provide a toolkit for instructors interested in trying RDL, showing how the technique can be adapted to various course settings and materials.

Reflection on the development of bioethics in pharmaceutical professional organizations. Professional excellence Reflexão sobre o desenvolvimento da Bioética nas organizações profissionais farmacêuticas. A excelência profissional For some years, the collegiate organizations of the pharmaceutical profession are being challenged, not only by external agents, but also by the professionals themselves. There is a certain criticism in the response, especially in aspects that have to do with the role they must play in the development and activity of professional practice, in their domestic, external and internal purposes and in the characteristics they must possess as organizations in service of these professionals and society. We understand that the development, revision and updating of Bioethics, as well as training in this field in professional organizations, contributes to that transcendent excellence in the profession, provokes a real knowledge of it in all its dimensions and with the power to act in total freedom from threats or internal or external restrictions. Para citar este artículo / To reference this article / Para citar este artigo Centenera-Jaraba JI, López-Guzmán J. Reflexión acerca del desarrollo de la bioética en las organizaciones profesionales farmacéuticas. La excelencia profesional. Pers Bioet. 2019; 23: 49-63. DOI: https://doi.org/10.5294/pebi.2019.23.1.4 Recepción: 15/02/2018 Aceptación: 16/04/2019

BackgroundComorbidity between diabetes mellitus and depression is highly prevalent. The risk of depression in a person with diabetes is approximately twice that of a person without this disease. Depression has a major impact on patient well-being and control of diabetes. However, despite the availability of effective and specific therapeutic interventions for the treatment of depression in people with diabetes, 50% of patients do not receive psychological treatment due to insufficient and difficult accessibility to psychological therapies in health systems. The use of information and communication technologies has therefore been proposed as a useful tool for the delivery of psychological interventions, but it continues to be a field in which scientific evidence is recent and controversial. This systematic review aims to update the available information on the efficacy of psychological interventions delivered through ICTs to improve depressive symptomatology in patients with diabetes.MethodsA systematic review of the literature was performed following the PRISMA guidelines and using MEDLINE, Embase, PubMed, Web of Science, PsycINFO, Scopus, and Cochrane Library databases to search for randomized clinical trials of eHealth treatments for patients with diabetes and comorbid depression from 1995 through 2020. In addition, studies related to follow-up appointments were identified. Inclusion criteria were as follows: randomized clinical trials ; patients with type 1 and type 2 diabetes; adult population over 18 years of age; presence of depressive symptomatology assessed with standardized instruments; treatments for depression based on established psychotherapeutic techniques and principles; delivered through eHealth technologies. We did not limit severity of depressive symptomatology, delivery setting or comparison group. Two coauthors independently reviewed the publications identified for inclusion and extracted data from the included studies. A third reviewer was involved to discuss discrepancies found. The PEDro scale was used to assess the quality of the RCTs. No meta-analysis of the results was performed. The protocol used for this review is available in PROSPERO.ResultsThe initial search identified 427 relevant scientific publications. After removing duplicates and ineligible citations, a total of 201 articles were analyzed in full text. Ten articles met the criteria of this review and were included, obtaining very good scientific quality after evaluation with the PEDro scale. The main results show that the eHealth psychological intervention for depression in patients with diabetes showed beneficial effects both at the end of treatment and in the short and long term for the improvement of depressive symptomatology. The methodology used was very heterogeneous. However, all studies were based on cognitive-behavioral tools and used standardized assessment instruments to evaluate depressive symptomatology or diagnosis of MDD. Glycemic control was assessed by glycosylated hemoglobin, but no benefits were found in improving glycemic control. Only four studies included psychoeducational content on diabetes and depression, but none used tools to improve or enhance adherence to medical prescriptions or diabetes self-care.ConclusionsICT-based psychological interventions for the treatment of depression in people with diabetes appear to be effective in reducing depressive symptomatology but do not appear to provide significant results with regard to glycemic control. Nonetheless, the scientific evidence reported to date is still very limited and the methodology very diverse. In addition, no studies have implemented these systems in routine clinical practice, and no studies are available on the economic analysis of these interventions. Future research should focus on studying and including new tools to ensure improvements in diabetes outcomes and not only on psychological well-being in order to advance knowledge about these treatments. Economic evaluations should also be undertaken to analyze whether these treatment programs implemented using eHealth technologies are cost-effective.

IntroductionIncorporating technology in cognitive interventions represents an innovation, making them more accessible, flexible, and cost-effective. This will not be feasible without adequate user-technology fit. Bearing in mind the importance of developing cognitive interventions whose technology is appropriate for elderly people with cognitive impairment, the objective of this systematic review was to find evidence about usability and user experience measurements and features of stimulation, training, and cognitive rehabilitation technologies for older adults with mild cognitive impairment or dementia.MethodThe Medline, PubMed, Scopus, ScienceDirect, and PsycINFO databases were searched for literature published in the last 10 years, and three researchers independently reviewed potentially eligible studies, following specific inclusion criteria. A systematic review of the studies was conducted, presenting a qualitative synthesis of usability and UX measures with their outcomes, study characteristics and features of the cognitive intervention technologies.ResultsTen studies were selected: five were cognitive stimulation and five were cognitive training. Most of them were computer-based programs with a serious game format. Efficiency and effectiveness were the most frequent measurements used for collecting objective usability data, showing that elderly people with cognitive impairment require more time and help but can complete tasks. Regarding UX or subjective usability data, questionnaires and scales were the most used methods, reporting positive experience despite certain difficulties with the interface in five studies.ConclusionMeasuring usability and UX in cognitive intervention technologies for older adults with MCI or dementia provides an integrated view that can contribute to their development according to the needs and characteristics of the target population. More research is required to include this population group in usability and UX studies, as well as standardized tools and consensus on the relationship of these terms to guarantee the future effectiveness of cognitive intervention technologies.Review registrationThis review was registered in the PROSPERO International Register of Systematic Review Protocols.