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Se presenta un estudio sobre las prácticas científicas en el marco curricular y formación de maestros/as de infantil en ciencias. Las preguntas de investigación son: 1) ¿cómo se integran las prácticas científicas en el currículum de educación infantil?, y 2) ¿qué formación inicial y permanente recibe el profesorado de infantil para promover las prácticas científicas en el aula? Específicamente, ¿qué importancia reciben estas prácticas en su formación? La práctica de indagación es la de mayor presencia en el currículum de infantil, seguida de la modelización y argumentación. El análisis de los planes de formación inicial revela que solo dos materias de los grados en Maestro/a de Educación Infantil incluyen en sus programas las prácticas científicas. En el Plan Anual de Formación Permanente encontramos una actividad dirigida a la formación científica de este profesorado, aunque no menciona las prácticas científicas.

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OBJECTIVES: Breast Cancer (BC) is the first cause of death among women, and it progresses to metastatic breast cancer (MBC) in half of the cases. HER-2 overexpression is a marker of the worst prognosis and the target of guided therapies. The aim of this study is to assess the cost-effectiveness of therapies against BC with overexpressed HER-2 in Colombia. METHODS: A cost-effectiveness study of MBC treatment in HER-2-positive patients progressing to Trastuzumab was conducted, with a 5-year horizon. Lapatinib ϩ Capecitabine was compared to Herceptin ϩ chemotherapy (Capecitabine, Vinorelbine or a Taxane). The effectiveness rates of those therapies were identified based on published primary studies. In the absence of head-to-head comparisons, Weibull functions for each chemotherapy were estimated from the survival curves and were multiplied by their hazard ratios. The perspective was that of the third payer including all direct medical costs based on Standard National Tariffs. Finally, a Markov model was developed, incremental cost-effectiveness ratios, (ICER), sensitivity analysis, and acceptability curve were estimated. The discount rate used was 3%. RESULTS: Lapatinib ϩ Capecitabine (LϩC) is the most effective and less expensive alternative. Hence, it overcomes the alternatives. The cost-effectiveness ratio of such strategy is Col$49 725 045 per year of life gained. CONCLUSIONS: The strategy with lapatinib is cost-effective in the treatment of MBC after progression to Herceptin.

CYP2D6 activity derive inferior therapeutic benefit from tamoxifen, and may alternatively be treated with newer aromatase inhibitors (AIs). However, the high costs of AIs provide incentive for identifying patients who will benefit from tamoxifen prior to treatment. We estimated the cost-effectiveness of genetic testing in combination with hormone therapy for early breast cancer in Canada. METHODS: We performed a cost-effectiveness analysis using a Markov model from a societal perspective and a lifetime horizon. The base case assumed 40-year-old ERϩ hormone sensitive women with early breast cancer. We evaluated: genetic testing with subsequent treatment based on genetic status (tamoxifen for CYP2D6 extensive metabolizers and AIs for decreased metabolizers) vs. no testing (tamoxifen for all patients). Probabilistic sensitivity analysis was used to incorporate parameter uncertainties. Expected value of perfect information was performed to identify future research directions. Outcomes were quality-adjusted life years (QALYs) and costs. RESULTS: The genetic testing and treatment combination strategy resulted in a 2.87 QALY gain when compared to no testing. The incremental cost was CAD $25,661 compared to standard care, and the incremental cost-effectiveness ratio (ICER) for the base case was $8,927 per QALY. The ICER was sensitive to disease progression among intermediate metabolizers, and costs of terminal care and aromatase inhibitors. CONCLUSIONS: CYP2D6 Genetic testing in combination with hormone treatment for early breast cancer patients may be economically attractive in the current setting. Future research is required to determine efficacy of extended tamoxifen (more than 5 years) treatment, the rate of progression to a more advanced cancer health state and adverse events by CYP2D6 polymorphism. OBJECTIVES:To develop a cost-effectiveness analysis of LC versus TC in the treatment of metastatic breast cancer ErBb2ϩ after progression to one regime of trastuzumab. METHODS: A Markov model was designed with one week length cycles, two years time horizon and two stages: Free of Progression and Progression. The analysis was conducted from the perspective of the Mexican public Health System for patients who had progressed to the first scheme of trastuzumab (around 900 patients). Efficacy data for this specific population was based on and ad-hoc sub analysis reported by Cameron 2010 for LC: 0.50, pϭ0.001 and per protocol population reported by Minckwitz 2009 for TC: 0.69, pϭ0.034. Baseline analysis used time to progression for monotherapy reported by Minckwitz and an univariate sensitivity analysis was run with monotherapy results by Cameron. Government prices were used for capecitabine (2000 mg/m2/day), lapatinib (1250 mg/day) and trastuzumab (2 mg/kg/week). One chemotherapy session cost was added every three weeks in the trastuzumab arm. Results are reported in US dollars. RESULTS: Cost-effectiveness ratio for LC and TC was $650.82 and $756.86 respectively. LC group had an average incremental effectiveness of 7.47 weeks...