Information Society, Teaching, and Learning: Education Reforms in Brazil

This article examines the subject matter of learning within the context of information society, through an inquiry concerning both the reforms in education adopted in Brazil in the last thirty years and their results. It provides a revision on the explanations of school failure based on assumptions of learning problems due to cognitive and linguistic deficits. From the guidelines related with written school forms as well as the constant cultural oppression accomplished inside the school, the article claims the necessity of changing the psychological and pedagogic views that, under the label of democratic practices, determine school institutions and its daily life, by means of instrumental relations with knowledge that disregard the reading practices which are congenial to popular culture.

A Practical Teaching Course in Directed Protein Evolution Using the Green Fluorescent Protein as a Model

Protein engineering is a powerful tool, which correlates protein structure with specific functions, both in applied biotechnology and in basic research. Here, we present a practical teaching course for engineering the green fluorescent protein (GFP) from Aequorea victoria by a random mutagenesis strategy using error-prone polymerase chain reaction. Screening of bacterial colonies transformed with random mutant libraries identified GFP variants with increased fluorescence yields. Mapping the three-dimensional structure of these mutants demonstrated how alterations in structural features such as the environment around the fluorophore and properties of the protein surface can influence functional properties such as the intensity of fluorescence and protein solubility.

The Tausk controversy on the foundations of quantum mechanics: Physics, philosophy, and politics

In 1966 the Brazilian physicist Klaus Tausk (b. 1927) circulated a preprint from the International Centre for Theoretical Physics in Trieste, Italy, criticizing Adriana Daneri, Angelo Loinger, and Giovanni Maria Prosperi`s theory of 1962 on the measurement problem in quantum mechanics. A heated controversy ensued between two opposing camps within the orthodox interpretation of quantum theory, represented by Leon Rosenfeld and Eugene P. Wigner. The controversy went well beyond the strictly scientific issues, however, reflecting philosophical and political commitments within the context of the Cold War, the relationship between science in developed and Third World countries, the importance of social skills, and personal idiosyncrasies.

History teaching today: wanderings, gains and losses

This article analyzes traditions of debate about the teaching of history in Brazil since the 1964-1984 dictatorship. It discusses the changes, continuities, achievements and losses in the history of the discipline. It emphasizes the importance of school culture, the necessary continuity of the school as an institution and dialogue with non-school forms of education.

Survival in Patients With Idiopathic, Familial, and Anorexigen-Associated Pulmonary Arterial Hypertension in the Modern Management Era

Background-Novel therapies have recently become available for pulmonary arterial hypertension. We conducted a study to characterize mortality in a multicenter prospective cohort of patients diagnosed with idiopathic, familial, or anorexigen-associated pulmonary arterial hypertension in the modern management era. Methods and Results-Between October 2002 and October 2003, 354 consecutive adult patients with idiopathic, familial, or anorexigen-associated pulmonary arterial hypertension (56 incident and 298 prevalent cases) were prospectively enrolled. Patients were followed up for 3 years, and survival rates were analyzed. For incident cases, estimated survival (95% confidence intervals [CIs]) at 1, 2, and 3 years was 85.7% (95% CI, 76.5 to 94.9), 69.6% (95% CI, 57.6 to 81.6), and 54.9% (95% CI, 41.8 to 68.0), respectively. In a combined analysis population (incident patients and prevalent patients diagnosed within 3 years before study entry; n = 190), 1-, 2-, and 3-year survival estimates were 82.9% (95% CI, 72.4 to 95.0), 67.1% (95% CI, 57.1 to 78.8), and 58.2% (95% CI, 49.0 to 69.3), respectively. Individual survival analysis identified the following as significantly and positively associated with survival: female gender, New York Heart Association functional class I/II, greater 6-minute walk distance, lower right atrial pressure, and higher cardiac output. Multivariable analysis showed that being female, having a greater 6-minute walk distance, and exhibiting higher cardiac output were jointly significantly associated with improved survival. Conclusions-In the modern management era, idiopathic, familial, and anorexigen-associated pulmonary arterial hypertension remains a progressive, fatal disease. Mortality is most closely associated with male gender, right ventricular hemodynamic function, and exercise limitation. (Circulation. 2010; 122: 156-163.)

IMAGE QUANTIFICATION FOR RADIATION DOSE CALCULATIONS-LIMITATIONS AND UNCERTAINTIES

Radiation dose calculations in nuclear medicine depend on quantification of activity via planar and/or tomographic imaging methods. However, both methods have inherent limitations, and the accuracy of activity estimates varies with object size, background levels, and other variables. The goal of this study was to evaluate the limitations of quantitative imaging with planar and single photon emission computed tomography (SPECT) approaches, with a focus on activity quantification for use in calculating absorbed dose estimates for normal organs and tumors. To do this we studied a series of phantoms of varying complexity of geometry, with three radionuclides whose decay schemes varied from simple to complex. Four aqueous concentrations of (99m)Tc, (131)I, and (111)In (74, 185, 370, and 740 kBq mL(-1)) were placed in spheres of four different sizes in a water-filled phantom, with three different levels of activity in the surrounding water. Planar and SPECT images of the phantoms were obtained on a modern SPECT/computed tomography (CT) system. These radionuclides and concentration/background studies were repeated using a cardiac phantom and a modified torso phantom with liver and ""tumor"" regions containing the radionuclide concentrations and with the same varying background levels. Planar quantification was performed using the geometric mean approach, with attenuation correction (AC), and with and without scatter corrections (SC and NSC). SPECT images were reconstructed using attenuation maps (AM) for AC; scatter windows were used to perform SC during image reconstruction. For spherical sources with corrected data, good accuracy was observed (generally within +/- 10% of known values) for the largest sphere (11.5 mL) and for both planar and SPECT methods with (99m)Tc and (131)I, but were poorest and deviated from known values for smaller objects, most notably for (111)In. SPECT quantification was affected by the partial volume effect in smaller objects and generally showed larger errors than the planar results in these cases for all radionuclides. For the cardiac phantom, results were the most accurate of all of the experiments for all radionuclides. Background subtraction was an important factor influencing these results. The contribution of scattered photons was important in quantification with (131)I; if scatter was not accounted for, activity tended to be overestimated using planar quantification methods. For the torso phantom experiments, results show a clear underestimation of activity when compared to previous experiment with spherical sources for all radionuclides. Despite some variations that were observed as the level of background increased, the SPECT results were more consistent across different activity concentrations. Planar or SPECT quantification on state-of-the-art gamma cameras with appropriate quantitative processing can provide accuracies of better than 10% for large objects and modest target-to-background concentrations; however when smaller objects are used, in the presence of higher background, and for nuclides with more complex decay schemes, SPECT quantification methods generally produce better results. Health Phys. 99(5):688-701; 2010

Teaching Psychodynamics to Psychiatric Residents through Psychiatric Outpatient Interviews

Objective: This study evaluates whether a course that was designed for first-year psychiatric residents and that specifically addressed psychodynamic principles fostered residents` progress in knowledge, skills, and attitudes regarding these concepts. Methods: The course was given in the 2005 academic year to all residents (N = 18) in their first psychiatric postgraduate year at the Department and Institute of Psychiatry, University of Sao Paulo, Brazil. The residents were assessed in the first and last sessions of the course through a written test that was blindly rated by two independent judges. Residents were also interviewed to observe whether psychodynamic concepts had been integrated into actual practice. Their responses were subjected to content analysis. Significance was tested using analysis of variance or nonparametric tests when necessary. Agreement between the judges was tested using intraclass correlation coefficients. Results: The judges demonstrated a high level of agreement. The difference in mean scores before and after the course was such that the total score increased by a mean of 2.5 points (total test score was 10 points). Additionally, residents started to undergo personal psychotherapy after the course. They reported that this course had markedly improved their relationship with patients. They emphasized the opportunities for self-reflection and gaining insights into themselves and patient treatment issues. Conclusion: This initial study indicates that this educational method can effectively promote psychodynamic knowledge, skills, and appropriate attitudes for managing psychiatric outpatients among residents. The course was very well received by the residents, and a similar method can easily be instituted within other residency programs that pursue integrated teaching methods.

Women`s opinions about mode of birth in Brazil: a qualitative study in a public teaching hospital

Objective: to describe women`s feelings about mode of birth. Design: exploratory descriptive design. Semi-structured interviews were conducted using a questionnaire that had been developed previously (categorical data and open-and closed-ended questions). Qualitative analysis of the results was performed through a context analysis technique. Setting: the largest public university hospital in Brazil. Participants: 48 women in their third trimester of pregnancy. Findings: most women expressed a preference for vaginal birth, as they perceived that they would have a faster recovery. Women who expressed a preference for caesarean section did so because of lack of pain during the birth and the need for tubal sterilisation. The majority of women considered it important to have experience with a mode of birth in order to choose a preference. Complications associated with maternal illness were very influential in the decision-making process. Key conclusions: these results provide a useful first step towards the identification of aspects of women`s feelings about modes of birth. Most women expressed a preference for vaginal birth. Further exploration of women`s feelings regarding parturition and the decision-making process is required. (C) 2008 Elsevier Ltd. All rights reserved.

Robotic Surgery: History and Teaching Impact

Context: The purpose of this article is to review the history of robotic surgery, its impact on teaching as well as a description of historical and current robots used in the medical arena. Summary of evidence: Although the history of robots dates back to 2000 years or more, the last two decades have seen an outstanding revolution in medicine, due to all the changes that robotic surgery has made in the way of performing, teaching and practicing surgery. Conclusions: Robotic surgery has evolved into a complete and self-contained field, with enormous potential for future development. The results to date have shown that this technology is capable of providing good outcomes and quality care for patients. (C) 2011 AEU. Published by Elsevier Espana, S.L. All rights reserved.

Treatment of obstructive sleep apnea syndrome in patients from a teaching hospital in Brazil: is it possible?

The aim of this study was to evaluate the efficacy of a cost-effective intra-oral appliance for obstructive sleep apnea syndrome built into a large teaching hospital. Out of 20 evaluated and treated patients, 14 concluded the study: eight men and six women, with a mean age of 42-46 (mean + SD) years and mean body mass index of 27.66. Inclusion criteria were mild or moderate apnea-hypopnea index (AHI) according to a polysomnographic study. All patients were treated with the monobloco intra-oral appliance. They were then submitted to a follow-up polysomnographic study after 60 days using the appliance. An orofacial clinical evaluation was carried out with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire and with clinical evaluation questionnaire devised by the Orofacial Pain Team before and 60 days after fitting the intra-oral appliance. The AHI showed a statistically meaningful (p = 0.002) reduction from 15.53 to 7.82 events per hour, a non-statistically significant oxygen saturation increase from 83.36 to 84.86 (p = 0.09), and Epworth`s sleepiness scale reduction from 9.14 to 6.36 (p = 0.001). Three patients did not show any improvement. The most common side effect during the use of the appliance/device was pain and facial discomfort (28.57%), without myofascial or temporomandibular joint pain as evaluated by the RDC/TMD questionnaire. The intra-oral device produced a significant reduction of the apnea-hypopnea index during the study period with the use of the monobloco intra-oral appliance. Patients did not show prior myofascial pain or 60 days after use of the intra-oral appliance.

The teaching of History meets its past: memories of teaching staff during the civil-military dictatorship

The civil-military dictatorship, which took power in 1964, influenced the daily activities of schools and teachers. Many transformations occurred during this period, including the new legislation enacted under Law 5692/71 and changes which occurred due to the vigilance which teachers felt when working. The memories analyzed here of teachers from public schools in Sao Paulo show different perceptions of this surveillance, involving various forms of acceptance or resistance. The purpose of this article is to show that although there was no direct repression of schools, unlike in the universities, teachers at the elementary school also felt constrained and this can be seen in their educational practices and teaching concepts.

Image quality assessment and medical physics evaluation of different portable dental X-ray units

Introduction: Recently developed portable dental X-ray units increase the mobility of the forensic odontologists and allow more efficient X-ray work in a disaster field, especially when used in combination with digital sensors. This type of machines might also have potential for application in remote areas, military and humanitarian missions, dental care of patients with mobility limitation, as well as imaging in operating rooms. Objective: To evaluate radiographic image quality acquired by three portable X-ray devices in combination with four image receptors and to evaluate their medical physics parameters. Materials and methods: Images of five samples consisting of four teeth and one formalin-fixed mandible were acquired by one conventional wall-mounted X-ray unit, MinRay (R) 60/70 kVp, used as a clinical standard, and three portable dental X-ray devices: AnyRay (R) 60 kVp, Nomad (R) 60 kVp and Rextar (R) 70 kVp, in combination with a phosphor image plate (PSP), a CCD, or a CMOS sensor. Three observers evaluated images for standard image quality besides forensic diagnostic quality on a 4-point rating scale. Furthermore, all machines underwent tests for occupational as well as patient dosimetry. Results: Statistical analysis showed good quality imaging for all system, with the combination of Nomad (R) and PSP yielding the best score. A significant difference in image quality between the combination of the four X-ray devices and four sensors was established (p < 0.05). For patient safety, the exposure rate was determined and exit dose rates for MinRay (R) at 60 kVp, MinRay (R) at 70 kVp, AnyRay (R), Nomad (R) and Rextar (R) were 3.4 mGy/s, 4.5 mGy/s, 13.5 mGy/s, 3.8 mGy/s and 2.6 mGy/s respectively. The kVp of the AnyRay (R) system was the most stable, with a ripple of 3.7%. Short-term variations in the tube output of all the devices were less than 10%. AnyRay (R) presented higher estimated effective dose than other machines. Occupational dosimetry showed doses at the operator`s hand being lowest with protective shielding (Nomad (R): 0.1 mu Gy). It was also low while using remote control (distance > 1 m: Rextar (R) < 0.2 mu Gy, MinRay (R) < 0.1 mu Gy). Conclusions: The present study demonstrated the feasibility of three portable X-ray systems to be used for specific indications, based on acceptable image quality and sufficient accuracy of the machines and following the standard guidelines for radiation hygiene. (C) 2010 Elsevier Ireland Ltd. All rights reserved.