Teaching elliptical excision skills to novice medical students: a randomized controlled study comparing low- and high-fidelity bench models

Background: The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. Aims : To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. Materials and Methods: Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills' training (n = 8): didactic materials (control); organic bench model (low-fidelity); ethylene-vinyl acetate bench model (low-fidelity); chicken legs' skin bench model (high-fidelity); or pig foot skin bench model (high-fidelity). Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. Results : The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P < 0.0000) and felt more confident to perform elliptical excision skills (all P < 0.0000) when compared to the control. There was no significant difference (all P > 0.05) between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills' training) was considered large (>0.80) in all measurements. Conclusion : The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials.

Occupational ergonomics: Work posture among Brazilian dental students

This study involved observational assessment of work posture in relation to recommended ergonomic posture the requirements necessary for ergonomic posture among students in the final year of a degree program at the School of Dentistry of Araraquara-UNESP/Brazil (n =73) and investigation of the association of work posture with sex, the type of procedure, four-handed dentistry, and the region of the mouth being treated. The work posture of the students during 250 clinical procedures was observed by means of pictures. Each procedure received a posture classification: Adequate, partially adequate, or inadequate. A descriptive statistical analysis was conducted. The prevalence of final posture classification was calculated using 95% confidence intervals and point estimate. Associations of interest were studied using the chi-square test, with a 5% significance level. It was concluded that the prevalence of procedures performed with partially adequate posture was high, and that the final work posture classification was not associated with the variables of interest. © 2013 Taylor & Francis Group.

Composition and quantification of the anthropogenic and natural fractions of wastes collected from the stormwater drainage system for discussions about the waste management and people behavior

A study was made of the composition of wastes collected from the pipes of the stormwater drainage system of Sorocaba, SP, Brazil (600 thousand inhabitants). A total of 10 samples weighing at least 100 kg each were sorted into 19 items to determine the fraction that can be considered natural (earth/sand, stones, organic matter, and water, the latter determined after oven-drying the samples) and the anthropogenic fraction (the remaining 15 items, especially construction and demolition wastes and packaging). Soil/sand was found to be the main item collected (52.5 % dry weight), followed by the water soaked into the waste (24.3 %), which meant that all the other wastes were saturated in mud, whose contents varied from 6.4 % (glass) to 87.2 % (metalized plastics packaging). In general, 83 % of the collected wastes can be classified as natural, but the remaining 17 % represent 2,000 kg of the most varied types of wastes discarded improperly every day on the streets of the city. This is an alarming amount of wastes that may clog parts of the drainage systems, causing troubles for all the population (like flooding) and must be strongly considered in municipal solid wastes management and in environmental education programs. © 2013 Springer Science+Business Media Dordrecht.

Attitudes about inclusion by educators and physical educators: Effects of participation in an inclusive adapted physical education program

This study assessed the attitudes about the inclusion of students with disability by professionals in education and health, relative to their experience and training. We compared three groups: 20 teachers and trainees who worked in an adapted physical education program (GI); 75 professionals from the municipal education system of Rio Claro subdivided according to their experience-CGyes e CGno, respectively, with and without experience. We used the inventory adapted by Palla (2001) to assess participants' attitudes and self-concepts. Overall, individuals in the group that participated in the intervention maintained their tendency of being favorable toward inclusion. Teachers in regular school settings in the municipal school system of Rio Claro (Sao Paulo, Brazil), regardless of their experience with inclusive settings, remain mostly indecisive about the benefits of inclusion.

Association between distressing non-work-related events and occupational injuries

The following is a report on a case-control study whose objective was to investigate the association between distressing non-work-related events and occupational injures. Ninety three injured workers (cases) were matched with 372 non-injured controls in a large metallurgical factory in southeastern Brazil. Exposure to distressing non-work-related events was measured through a questionnaire focusing on situations pertaining to personal problems unrelated to work activities. The data were analyzed by adjusting a conditional logistic regression model, where occurrence of the work injury was the dependent dichotomous variable and answers from the questionnaire were independent continuous variables. The analysis showed an association between some distressing non-work-related events and occupational injuries. These findings imply expanding the horizon of preventive measures used in targeting. work injuries which have traditionally been focused on the control of strictly workplace risks.

Spermatogenesis chronology in Achroia grisella Fabricius (Lepidoptera, Pyralidae) comparing eupyrene and apyrene spermiogenesis

Achroia grisella exhibit dichotomous spermatogenesis producing two types of sperm, one is eupyrene that possesses nucleus, and the other is apyrene that lacks it. Transmission electron microscopy of spermatogenesis morphology is described considering sperm type which will appear at sonic point during insect development, and differences that mark the two types of sperm formation. The differences between them are only really visible during spermiogenesis even though they were determined before meiosis. Both forms were seen in the larval stage, but there is a little difference in the time of their appearance. Eupyrene cysts were seen from the 8(th) larval stage, whereas apyrene were only found after the 10(th) stage. In early insect development stages, eupyrene cysts predominate, but as the insect ages, they are overtaken by apyrene. Although some eupyrene cysts are still present in young adult testis, the majority are apyrene. As eupyrene sperm is formed, bundles migrate to the seminal vesicle therefore in early pupae eupyrene sperm are already present there whereas apyrene cells arrive later. The exact mechanism and determining factors responsible for apyrene sperm origin are still to be clarified. The probable causes of apyrene sperm appearance are discussed as well as its role in the sperm competition.

Burning mouth syndrome: A discussion about possible etiological factors and treatment modalities

Although several studies discuss the contributing factors associated with the burning mouth syndrome (BMS), there is still controversy with regard to its etiology. Therefore, in the majority of cases, the establishment of an adequate diagnosis and consequently the best treatment modality is complicated. In order to assist the clinician in the establishment of the correct diagnosis and management of BMS, this article reviews the literature, providing a discussion on the various etiologic factors involved in BMS, as well as the best treatment modalities for this condition that have showed to be the most effective ones in randomized clinical trials. In addition, the authors discuss some clinical characteristics in the differential diagnosis of BMS and other oral diseases. It is important for the clinician to understand that BMS should be diagnosed only after all other possible causes for the symptoms have been ruled out.

Comparing submerged and solid-state fermentation of agro-industrial residues for the production and characterization of lipase by Trichoderma harzianum

Lipase production by Trichoderma harzianum was evaluated in submerged fermentation (SF) and solid-state fermentation (SSF) using a variety of agro-industrial residues. Cultures in SF showed the highest activity (1.4 U/mL) in medium containing 0.5 % (w/v) yeast extract, 1 % (v/v) olive oil and 2.5 C:N ratio. This paper is the first to report lipase production by T. harzianum in SSF. A 1:2 mixture of castor oil cake and sugarcane bagasse supplemented with 1 % (v/w) olive oil showed the best results among the cultures in SSF (4 U/g ds). Lipolytic activity was stable in a slightly acidic to neutral pH, maintaining 50 % activity after 30 min at 50 C. Eighty percent of the activity remained after 1 h in 25 % (v/v) methanol, ethanol, isopropanol or acetone. Activity was observed with vegetable oils (olive, soybean, corn and sunflower) and long-chain triacylglycerols (triolein), confirming the presence of a true lipase. The results of this study are promising because they demonstrate an enzyme with interesting properties for application in catalysis produced by fermentation at low cost. © 2012 Springer-Verlag and the University of Milan.

Well, what about intraspecific variation? Taxonomic and phylogenetic characters in the genus Synoeca de Saussure (Hymenoptera, Vespidae)

Cely and Sarmiento (2011) took issue with the cladistic analysis of relationships among species of the genus Synoeca by Andena et al. (2009a), and presented a reanalysis. They claimed that intraspecific variation in the genus is meaningful, and proper consideration yields a conclusion different from that of Andena et al. Both their critique and reanalysis are vitiated by numerous errors, as is shown in the present paper. © 2013 Magnolia Press.

About the thermal stability and pore elimination in the ordered hexagonal mesoporous silica SBA-15

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A note about splittings of groups and commensurability under a cohomological point of view

Let G be a group, let S be a subgroup with infinite index in G and let FSG be a certain Z2G-module. In this paper, using the cohomological invariant E(G, S, FSG) or simply E˜(G, S) (defined in [2]), we analyze some results about splittings of group G over a commensurable with S subgroup which are related with the algebraic obstruction “singG(S)" defined by Kropholler and Roller ([8]. We conclude that E˜(G, S) can substitute the obstruction “singG(S)" in more general way. We also analyze splittings of groups in the case, when G and S satisfy certain duality conditions.

Effect of inclusion of NDF in ration of Bergamasca ewes in lactation about the milk production and composition

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)