Aplicação do Sensoriamento Remoto e do Sistema de Informações Geográficas na Detecção de Manchas de Óleo na Região do Pólo de Exploração de Guamaré, R.N.

Objective to establish a methodology for the oil spill monitoring on the sea surface, located at the Submerged Exploration Area of the Polo Region of Guamaré, in the State of Rio Grande do Norte, using orbital images of Synthetic Aperture Radar (SAR integrated with meteoceanographycs products. This methodology was applied in the following stages: (1) the creation of a base map of the Exploration Area; (2) the processing of NOAA/AVHRR and ERS-2 images for generation of meteoceanographycs products; (3) the processing of RADARSAT-1 images for monitoring of oil spills; (4) the integration of RADARSAT-1 images with NOAA/AVHRR and ERS-2 image products; and (5) the structuring of a data base. The Integration of RADARSAT-1 image of the Potiguar Basin of day 21.05.99 with the base map of the Exploration Area of the Polo Region of Guamaré for the identification of the probable sources of the oil spots, was used successfully in the detention of the probable spot of oil detected next to the exit to the submarine emissary in the Exploration Area of the Polo Region of Guamaré. To support the integration of RADARSAT-1 images with NOAA/AVHRR and ERS-2 image products, a methodology was developed for the classification of oil spills identified by RADARSAT-1 images. For this, the following algorithms of classification not supervised were tested: K-means, Fuzzy k-means and Isodata. These algorithms are part of the PCI Geomatics software, which was used for the filtering of RADARSAT-1 images. For validation of the results, the oil spills submitted to the unsupervised classification were compared to the results of the Semivariogram Textural Classifier (STC). The mentioned classifier was developed especially for oil spill classification purposes and requires PCI software for the whole processing of RADARSAT-1 images. After all, the results of the classifications were analyzed through Visual Analysis; Calculation of Proportionality of Largeness and Analysis Statistics. Amongst the three algorithms of classifications tested, it was noted that there were no significant alterations in relation to the spills classified with the STC, in all of the analyses taken into consideration. Therefore, considering all the procedures, it has been shown that the described methodology can be successfully applied using the unsupervised classifiers tested, resulting in a decrease of time in the identification and classification processing of oil spills, if compared with the utilization of the STC classifier

Inércia e Natureza da Ciência no Ensino de Física: uma sequência didática centrada no desenvolvimento histórico do conceito de inércia

During the last decades the area of science education has discussed issues related to the inclusion of the History and Philosophy of Science (HFS) in the practice of science teaching. Among the arguments put forward in favour of this approach, it is pointed out the possible enhancement of scientific content learning and the understanding of the nature of Science (NoS). In spite of such considerations, we still have a very small number of research papers reporting results of practical interventions that utilize the historical approach, moreover, there is a lack of teaching materials in this perspective. Our work has sought to contribute to this area with regard to two aspects: on the one hand, with the production of didactic material, by drawing up texts on the history of inertia for graduate students. On the other hand, we investigate whether the arguments mentioned above in relation to the didactic use of HFS sustain themselves, in a particular context. We developed and applied a didactic sequence, using the texts that we built, to teach the concept of inertia and discuss selected contents of NoS. The didactic sequence was applied in two graduate classes, one from a course of Geophysics (BSc.) and another from the Physics (teaching formation), both from the Federal University of Rio Grande do Norte (UFRN). An initial survey exposed that students, even having approached the concept of inertia in basic education, presented conceptions of common sense regarding the relationship between force and motion. The questionnaire also allowed us to identify the existence of elements of concepts considered inadequate as regards to NoS. At the end of our research, our data indicated a greater number of positive hits on the issues concerning the concept of inertia. Regarding the aspects of NoS, we were able to identify, in a few cases, a move towards a more appropriate understanding, however, certain distortions persisted, highlighting the limitations of the approach used

Minicontos: uma prática de letramento emergente na escola

Like numerous other mini ficçion genres, the Flash fiction is configured as a concise and brief genre, but it can still preserve some elements of the traditional tale, such as: narrator, space-temporal unit, characters and plot. For some authors, the emergence of this genre is strictly connected to the speed and diversity of forms of communication in the current social context, that require the reader other skills in addition to reading and writing. Considering the importance of these skills in a literate society and recognizing this genre as potentially effective tool for the development of literacy, this research has as objective to describe the development and implications of didactic sequence directed the literacy practices with the Flash fiction genre. Thus, the research becomes effective in an elementary school vespertine class in 9th grade from Escola Estadual Dr. José Gonçalves de Medeiros, located in the city of Acari-RN. As theoretical assumptions, it will be used fundamentals from Literacy Studies as social practice, especially that ones discussed by the writings Kleiman (1995), Hamilton (2000), Soares (2012), Mortatti (2004) and Rojo (2012). To subsidize the literary literacy, it will be used the theoretical contibutions of Borges (2000), Candido (2004), Pinheiro (2001) and Silva e Silveira (2013). In what relates to the study about the storytellers, it was taken by support the postulates of Gotlib (2006), Bosi (1997), Cortázar (1999), Talbot (2002), Poe (s/d), Luzia de Maria (2004), as well as studies by researchers and writers as Spalding (2007; 2008; 2011), George (2007), Freire (2004) and Trevisan (1994), among others who are dedicated to study Flash fiction. In the methodological field, the proposed perspective anchors itself in an action-researching guidelines (MOREIRA; CALEFFE, 2006) and in the approach of a qualitative data (BOGDAN; BIKLEN, 1994), since it talks to interpretation of diagnosed situation, implementation of intervention actions organized in didactic sequence (SCHNEUWLY; DOLZ, 2004; BARROS; RIVERS-registry, 2014), including description and evaluation of results achieved from the implementation of such actions. The discussions generated indicate that the work with Flash ficition, developed by means of didactic sequences, contributes to the reflection on teaching strategies of Portuguese, used to prepare the students to meet the demands of reading and writing of contemporary society.

Aprendizagem criativa na aula de piano em grupo

The central focus of this thesis was to investigate creative learning in music at piano group lessons. Thus, the theoretical framework adopted was guided by two main principles: (1) creativity in the field of music education and (2) Piano teaching and learning. As a methodological procedure we used a research-action with students of the disciplines Prática de Instrumento Harmônico I e II, at the Music Education Undergraduate Course of Federal University of Rio Grande do Norte (UFRN). This research-action was structured in four phases: 1) the identification of the starting points and the theme of creativity matters in piano group lessons, considering the context of a teacher training course in music; 2) the projection of actions, the definition of the objectives and the organization of instruments of data collection and analysis; 3) the realization of the planned actions; and 4) the evaluation of the results, the transcription, organization and analysis of the data collected through observation and interviews. Given the Creative Learning Cycle in Music, represented by the activities of composing, performing and criticizing Music, defended by Beineke (2009, 2013, 2015), we propose in this thesis a creative cycle of formation in music to promote creative learning in piano group lessons, in which teachers and students teach and learn creatively, expanding training opportunities in the field of Music Education. This was possible due to the joint experience of creative practices related to improvisation, elaboration of arrangements and musical compositions - elements that contributed positively to the learning process of the participants. But for this to occur, the planning, implementation and evaluation of the creative and pedagogical musical procedures adopted were decisive, considering the perspectives of students, their conceptions, musical creations, processes and collaborative exchange.

Aprendizagem criativa na aula de piano em grupo

The central focus of this thesis was to investigate creative learning in music at piano group lessons. Thus, the theoretical framework adopted was guided by two main principles: (1) creativity in the field of music education and (2) Piano teaching and learning. As a methodological procedure we used a research-action with students of the disciplines Prática de Instrumento Harmônico I e II, at the Music Education Undergraduate Course of Federal University of Rio Grande do Norte (UFRN). This research-action was structured in four phases: 1) the identification of the starting points and the theme of creativity matters in piano group lessons, considering the context of a teacher training course in music; 2) the projection of actions, the definition of the objectives and the organization of instruments of data collection and analysis; 3) the realization of the planned actions; and 4) the evaluation of the results, the transcription, organization and analysis of the data collected through observation and interviews. Given the Creative Learning Cycle in Music, represented by the activities of composing, performing and criticizing Music, defended by Beineke (2009, 2013, 2015), we propose in this thesis a creative cycle of formation in music to promote creative learning in piano group lessons, in which teachers and students teach and learn creatively, expanding training opportunities in the field of Music Education. This was possible due to the joint experience of creative practices related to improvisation, elaboration of arrangements and musical compositions - elements that contributed positively to the learning process of the participants. But for this to occur, the planning, implementation and evaluation of the creative and pedagogical musical procedures adopted were decisive, considering the perspectives of students, their conceptions, musical creations, processes and collaborative exchange.

Responsabilidade social empresarial: uma avaliação do Projeto Escola de Informática e Cidadania da Mineradora Y situada no Estado do Pará

The subject Responsibility Enterprise Social (RSE) is relatively recent in the half national academic and the world of the management businesses as practical. For the lack of socialization of experiences and clarity of concepts, shunting lines in the agreement of the subject and the conduction of the interventions occur. It was looked to inquire, in this research, the development of the project of Social Responsibility Enterprise ―School of Computer science and Citizenship‖ of a situated company in the State of Pará, objectifying to evaluate it and later to understand it. For this, one searched to describe the characteristics and structure of the School, to identify to the lines and lines of direction adopted for this Project and to identify to the influence and results of the same in the life of pupils, professors and egresses of the School. It is characterized for a study of case with qualitative boarding of descriptive character, carried through interviews structuralized in a sample of 21 divided members of the School between professors, pupils and egresses. It was used of the analysis of categorical content, having as axle for the interpretation of the data the Social Responsibility, the Digital Inclusion and the Education. The gotten results inform that the infrastructure has challenges to face, point disparities between the conception and practical of the categories characterized in the Politician-Pedagogical Project of the EIC and the influence that, exactly under limits, the life of the professors, pupils reaches and egress. One evidenced that Social action for damages of this company when come back toward this project, they had not been evidenced. For this prism, these actions had only remained in the assistencialist speech and not structural, being thus, the company is not fulfilling its paper of transforming element of the reality of its clientele and the population that lives in it s around

A cidade sem barreiras é para todos?: avaliação das condições de deslocamento no bairro da Cidade Alta, Natal/RN

In this present work, the conditions of displacements and the behaviors of the users are evaluated, face to the physical adequacies in accessibility in the inserted area in the central quadrilateral of the Quarter of Cidade Alta, in the City of Natal/RN, space clipping established by its great meaning historical and cultural. For this reason such area was a target of an integrated actions plan during the years of 1993 and 1998, with the implantation of part of the Project CIDADE SEM BARREIRAS (City without Barriers) and, later, the implementation of the Project CIDADE PARA TODOS's proposals (City for All), having as supports the constant Brazilian norms inserted into the NB9050/1994 and in the Municipal law number 4.090/92, effective ones in the period of the interventions. Considering that the carried through actions at the time were directed to the elimination of the architectural barriers to guarantee the right to go and to come, the research received a human universe formed by all the people in situation of displacement in the central area of the interventions in the quarter of the Cidade Alta, independently of their locomotive or sensorial conditions, emphasizing the aspects most excellent how much to the accessibility of the sidewalk, as promotional of mobility, integration and urban organization, as well as of the public squares of that one quadrilateral, conceived, originally, as spaces of aggregation and social inclusion. The work appealed to the direct comment and the gotten results had been collated with the ex port facto law and technique norms, of the year of 2004, and with the legal devices contained in the Federal Decree number 5.296/2004, as way to certify the levels of efficiency of these adaptations in that it says respect to the current conditions of demanded accessibility and urban mobility

Reassentamentos de famílias em projetos de habitação social: avaliação de procedimentos e resultados do projeto Planalto II, Natal /RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Gestão de centros históricos: uma avaliação da política de requalificação urbana de Natal/RN

From the second half of the century XX, in many Brazilian cities, the "historic centers" stop being the most densely populated areas of the city, accumulate degradation of the built environment and its functions have physical, social and economic resignified when also intensified interventions in these same centers Historic focused its redevelopment. This work aims to reflect on the experience of urban regeneration in the historic center of Natal, addressing the strategies adopted in the implementation of public policies and how these improve the effectiveness of actions, processes and outcomes for which turn the management of the historic center in question. In Natal, is identified in the neighborhoods of the Upper Town and Ribeira, the historic city center, a large distortion of their ancient architectural complex, the use of sub-urban infrastructure and emptying in the evenings and weekends. Shares redevelopment of the historic center of Natal are considered late, it is only recently that these neighborhoods were objects of policies and projects generally aimed at enhancing the cultural attraction of the area, and not always, it can be said that they have relevance in development process of the city. Added to this, there is the slowness of the interventions, although the zoning as an area of historic preservation has been done for over two decade. In Natal, the ideas of sustainable development articulated a proposed redevelopment of its historic center is still far from being achieved, but on the other hand, the latest phase of implementation of plans and projects in the area, indicating the intention to transform practical experience in the formulations and proposals in relation to these ideals

Avaliação do programa de tutorização da EMATER-RN para servidores em estágio probatório

The present thesis evaluated the contributions and limitations of the tutorship program introduced in EMATER-RN, as a tactic of organizational socialization for civil servants in probationary stage. Tutorship was understood as an intensive and continuous relational process, in which a more experienced person in the organization the tutor offers psychosocial support, stimulates the development of the professional career and enables to the newcomer the tutee learning on job performance. The organizational socialization was considered in the perspective of the symbolic interactionism. The study was characterized as a program evaluation and as an action research. The practical interventions for the program implementation were conducted and, at the same time, the evaluations of process, results and reaction to the program were applied. Among the major contributions of the action research, it stood out: the diagnosis of reasons for the formation of the pair and of expectations of tutors and tutees, the improvement of the tutorship registration tools, the ascertainment of the success of the program in the socialization of the new civil servants, the confirmation of the importance of the compatibility among them and of the adequate performance of tutorship functions for achieving its benefits. Based in constraints of the program, one may quote as essential recommendations: the formation of a technical team supporting the program, the clear establishment of deadlines for each procedure and the reinforcement to its compliance, the investigation of the functions performed by the tutor, the sensitization of the managers to the resolution of problems that affect the program, the voluntary participation of the tutor and the continuous meetings of tutors and tutees. One settles for the relevance of the program and in favor of its continuation, provided that its improvement and systematic management are conducted.

Aplicabilidade do Rorshach na avaliação psicológica do autismo

This study investigates the applicability of the Rorschach Method for evaluating the personality of people with Autism Spectrum Disorder (ASD).The relevance of this study is justified by the limited number of investigations published in the research literature concerning the use of psychological tests used for evaluating the personality of individuals with ASD. The Rorschach Method was chosen as an appropriate instrument considering it reveals the personality s basic structure, including characteristics of the affectivity, sensuality, inner life, mental resources, psychic energy and general characteristics and intellectual state of the individual. The general objective of this investigation consisted of verifying the applicability of the use the Rorschach Method in the evaluation of the characteristics of people's personality with autism spectrum disorder (ASD).The study also sought to identify perceptive factors of the personality structure of individuals with ASD, provide contributions of the understanding of this syndrome, seeking the establishment of possible therapeutic interventions starting from diagnostic by Rorschach Method. In addition, this investigation aims at verifying the adequacy of using the Rorschach Method as an instrument for evaluating the personality characteristics of individuals with ASD and its possible use in Brazil, starting from preliminary normative results. Participants consisted of 44 youngsters and adults, both genders with age range 14 - 39 years-old (average: 23.5 years-old) distributed in 2 groups. Group 1: composed with 22 youngsters and adults with clinical diagnosis of autism spectrum disorder (communication impairments, social interaction deficits, restricted and repetitive interests and activities); Group 2: composed with 22 youngsters and adults with typical behavior. The participants were paired to gender and age, individually. The Mann-Whitney and Wilcoxon tests were applied to evaluate statistical differences between the groups, considering demographic and social data. The results indicate the presence of restricted interest or difficulty in the expression of the social and affective interaction of people with ASD. However, the need of broader normative studies concerning the use of personality evaluation instruments for people with ASD is warranted. These investigations could help understand the psychic dynamism of this population, offering subsidies that can be added to the current techniques of diagnosis. The Rorschach Method is susceptible to application but it is necessary to respect the individual limitations of these people and to establish more criterions about the spectrum

Avaliação da relação entre qualidade de sono e uma intervenção com jogos para o desempenho de crianças e adolescentes

The sleep is an active brain process that allows the efficient realization of daily tasks. The changes on sleep patterns may influence the different cognitive processes performance. Many recent studies show the possibility of cognitive performance improvement, through the cognitive training with the use of computer games. The question is if these interventions may be influenced by the sleep quality. Thus, we evaluated the sleep quality effect about the efficacy of an intervention with computers games based on the working memory and attention for a cognitive performance training of elementary school students. The sample was constituted by 42 students with average age of 10,43 years old (SD=1,23), with 22 male participants and 20 female participants. We used to evaluate the sleep with the parents a sleep questionnaire, a sleep diary and the Sleep Behavior Questionnaire. In regard to intervention, the subjectives were distributed in an experimental and in a control group, both with 21 participants. In the first group occurred the intervention that consisted in the working memory and attention training with two cognitive tasks (Safari e Brain Workshop) during 30 daily minutes, for a 6 weeks period. In an equal period, the students from the control group should reproduce an artwork using drawing software. To evaluate the cognitive performance we applied before and after the intervention period the Wechsler Intelligence Scale for Children (WISC-III). The results showed that in both the groups the performance of the intelligence, working memory, attention and visuospatial skills was below of the mean. The cognitive processes evaluated after of intervention in the experimental group had a performance significantly higher in the Perceptual Reasoning Index (t = -6,24; p < 0,01) and in the Full Scale IQ (t = -5,09; p < 0,01) and Performance IQ (t = -6,52; p < 0,01), suggesting a improvement on the visuospatial skills, attention, working memory and processing speed. On the control group, the performance was significantly higher in the Coding subtest (t = -5,38; p< 0,01) and in the Perceptual Reasoning Index (t = -3,66; p = 0,01), suggesting a improvement on the visuospatial skills and attention. The mean obtained with the Sleep Behavior Questionnaire was 53,76 (SD=14,96) for an experimental group and 61,19 (SD=12,82) for a control group, indicating tendency for a bad sleep quality in that last one. Not only during the first days, but also in the last fifteen days of the intervention we verified in the two groups an adequate time to sleep, duration and regularity, in the weekdays and on the weekends. We didn t find significant differences between the two groups in none of the sleep variables. We verified statistically meaningful improvement on the performance of the experimental group with the intervention in the two games. We didn t verify significant correlations between the games performance index and in the sleep variables of the experimental group individuals. We verified significant correlations among the performance on the Brain Workshop and the Cubes subtest, the Perceptual Reasoning Index and the Scale Performance IQ, suggesting that the significant improvement of the visuospatial skills and of the attention was correlated with the performance in the Brain Workshop. Although the absence of correlations with the performance in the Safari, possibly it also has relieved in the improvement of the cognitive performance. The findings support the hypothesis that the computer games might be a satisfactory tool for the improvement of the performance in visuospatial skills and attention. This can be resulted of the insertion of visuospatial stimulations in the task, for example, graphical elements with thematic for children that increase the interest. The IQ below mean the individuals might have influenced the improvement absence on the cognitive processes like the working memory with games. Moreover, it wasn t verified a relation between the sleep quality and the intervention efficacy. It might have been influenced by the n of the sample. Future studies must focalize in the improvement of the effect of the interventions with games

Evidências de validade do Millon Behavioral Medicine Diagnostic na avaliação de aderência terapêutica em pacientes com insuficiência cardíaca crônica

Chronic heart failure (CHF) is the final common pathway of most diseases affecting the heart, being responsible for a high level of mortality and hospitalization, as well as significant reduction in quality of life of those affected. Interventions that claim to optimize patient adherence to their medical regimen, and improve self-care behavior, have proven effective in preventing unplanned admissions and improves the outcome for patients, however, studies have shown the problem of non-adherence, and some psychological instruments have been used to show that traces indicate difficulties with treatment adherence. Having shown this, the aim of this work is to evaluate the evidence of validity of the Millon Behavioral Medicine Diagnostic (MBMD) in a population of patients with CHF. The study included individuals with CHF, males and females, between the age of 18 and 85 years, treated in a reference hospital in the city of NatalRN. A total of 120 patients answered, in addition to the MBMD, another questionnaire structured with sociodemographic aspects and clinical itens. The results indicated that the parameter of the MBMD reliability was satisfactory the most of extracted factors, and some scale. In terms of the population studied, we could verify that the disease was more prevalent in men, but women had the highest average in indicators related to negative health habits and depressed mood. Younger pacients and those who had no partner had the highest averages in groups of items that dealt with feelings of sadness and discouragement. Hasn’t been observed differences related to negative health habits and problematic adherence among patients in different functional classes. More studies in this research line, with a larger population and from other regions of the country, are needed in order to expand the data presented here

As relações da tríplice hélice nas fundações de apoio brasileiras: uma avaliação da dinâmica de captação de recursos para projetos de inovação

Foundations support constitute one of the types of legal entities of private law forged with the purpose of supporting research projects, education and extension and institutional, scientific and technological development of Brazil. Observed as links of the relationship between company, university, and government, foundations supporting emerge in the Brazilian scene from the principle to establish an economic platform of development based on three pillars: science, technology and innovation – ST&I. In applied terms, these ones operate as tools of debureaucratisation making the management between public entities more agile, especially in the academic management in accordance with the approach of Triple Helix. From the exposed, the present study has as purpose understanding how the relation of Triple Helix intervenes in the fund-raising process of Brazilian foundations support. To understand the relations submitted, it was used the interaction models University-Company-Government recommended by Sábato and Botana (1968), the approach of the Triple Helix proposed by Etzkowitz and Leydesdorff (2000), as well as the perspective of the national innovation systems discussed by Freeman (1987, 1995), Nelson (1990, 1993) and Lundvall (1992). The research object of this study consists of 26 state foundations that support research associated with the National Council of the State Foundations of Supporting Research - CONFAP, as well as the 102 foundations in support of IES associated with the National Council of Foundations of Support for Institutions of Higher Education and Scientific and Technological Research – CONFIES, totaling 128 entities. As a research strategy, this study is considered as an applied research with a quantitative approach. Primary research data were collected using the e-mail Survey procedure. Seventy-five observations were collected, which corresponds to 58.59% of the research universe. It is considering the use of the bootstrap method in order to validate the use of the sample in the analysis of results. For data analysis, it was used descriptive statistics and multivariate data analysis techniques: the cluster analysis; the canonical correlation and the binary logistic regression. From the obtained canonical roots, the results indicated that the dependency relationship between the variables of relations (with the actors of the Triple Helix) and the financial resources invested in innovation projects is low, assuming the null hypothesis of this study, that the relations of the Triple Helix do not have interfered positively or negatively in raising funds for investments in innovation projects. On the other hand, the results obtained with the cluster analysis indicate that entities which have greater quantitative and financial amounts of projects are mostly large foundations (over 100 employees), which support up to five IES, publish management reports and use in their capital structure, greater financing of the public department. Finally, it is pertinent to note that the power of the classification of the logistic model obtained in this study showed high predictive capacity (80.0%) providing to the academic community replication in environments of similar analysis.

Fatores determinantes da near miss materna em uma unidade de terapia intensiva obstétrica: avaliação das competências profissionais da área médica

Objective: Evaluate the determinants of morbidity and mortality in an obstetric intensive care unit and professional medical skills of students/residents at a university hospital. Methods: observational cross - sectional with 492 pregnant/pue rperal women and 261 students/residents. Patients were admitted to the obstetric intensive care unit during a year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and G raphPad6. Chi - square tests were used to evaluate risk factors and student t test evaluates resident/students' skills concerning the cognitive test and the Mini - Cex. Results: the main risk factors to near miss were: non - white race (OR = 2.527; RR = 2.342) ; marital status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR = 3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income (OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ; RR = 13.27) , re alization of pre - natal (OR = 5.023 ; RR = 4.254) and C - section before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini - cex analysis were noted significant difference in the performance of students on the subject (3.75 ± 0.93, 4.03 ± 0.94 and 4.88 ± 0.35). We still observed the best performance of residents, when compared to graduation students (p < 0.01). Conclusions: the prevalence of near miss was associated with socioeconomic/clinics factors and care issues, revealing the importance of interventions to improve these indicators. In addition, we suggest a better curriculum insertion of this subject in the medical Course disciplines due the importance to avoid the near miss through of adequacy of medical education.