The harm principle and the greatest happiness principle: the missing link

In this article I present a possible solution for the classic problem of the apparent incompatibility between Mill's Greatest Happiness Principle and his Principle of Liberty arguing that in the other-regarding sphere the judgments of experience and knowledge accumulated through history have moral and legal force, whilst in the self-regarding sphere the judgments of the experienced people only have prudential value and the reason for this is the idea according to which each of us is a better judge than anyone else to decide what causes us pain and which kind of pleasure we prefer (the so-called epistemological argument). Considering that the Greatest Happiness Principle is nothing but the aggregate of each person's happiness, given the epistemological claim we conclude that, by leaving people free even to cause harm to themselves, we still would be maximizing happiness, so both principles (the Greatest Happiness Principle and the Principle of Liberty) could be compatible.

Adherence and perceptions regarding simulation training in undergraduate health Sciences

BACKGROUND: Simulation techniques are spreading rapidly in medicine. Suc h resources are increasingly concentrated in Simulation Laboratories. The MSRP-USP is structuring such a laboratory and is interested in the prevalence of individual initiatives that could be centralized there. The MSRP-USP currently has five full-curriculum courses in the health sciences: Medicine, Speech Therapy, Physical Therapy, Nutrition, and Occupational Therapy, all consisting of core disciplines. GOAL: To determine the prevalence of simulation techniques in the regular courses at MSRP-USP. METHODS: Coordinators of disciplines in the various courses were interviewed using a specifically designed semi-structured questionnaire, and all the collected data were stored in a dedicated database. The disciplines were grouped according to whether they used (GI) or did not use (GII) simulation resources. RESULTS AND DISCUSSION: 256 disciplines were analyzed, of which only 18.3% used simulation techniques, varying according to course: Medicine (24.7.3%), Occupational Therapy (23.0%), Nutrition (15.9%), Physical Therapy (9.8%), and Speech Therapy (9.1%). Computer simulation programs predominated (42.5%) in all five courses. The resources were provided mainly by MSRP-USP (56.3%), with additional funding coming from other sources based on individual initiatives. The same pattern was observed for maintenance. There was great interest in centralizing the resources in the new Simulation Laboratory in order to facilitate maintenance, but there was concern about training and access to the material. CONCLUSIONS: 1) The MSRP-USP simulation resources show low complexity and are mainly limited to computer programs; 2) Use of simulation varies according to course, and is most prevalent in Medicine; 3) Resources are scattered across several locations, and their acquisition and maintenance depend on individual initiatives rather than central coordination or curricular guidelines

Efecto del volumen radicular sobre el crecimiento de Acacia dealbata Link. en vivero y en terreno en el secano de la Región del Biobío, Chile

Entre las especies arbóreas cultivadas en Chile, Acacia dealbata Link. se destaca por su rápido crecimiento y supervivencia en climas con marcado déficit hídrico y suelos altamente degradados. Aun cuando proporciona múltiples productos y servicios, la mayor parte de la investigación se ha centrado caracterizar su capacidad invasora, y poco se conoce respecto a su crecimiento durante los primeros años en terreno, escaseando antecedentes respecto efecto de la modificación de las prácticas silvícolas durante la producción y establecimiento de plantas. Por ello, este estudio analiza el efecto de la modificación del volumen radicular sobre el crecimiento durante la viverización, y la supervivencia y crecimiento culminadas la primera y segunda temporada en terreno. Finalizada la viverización resultó significativo el efecto del volumen radicular sobre el DAC y la altura total (P<0,05), los mayores valores se obtuvieron en plantas producidas con volumen de 100 cm³. Los volúmenes más altos presentaron los mayores índices de esbeltez y de Dickson (P<0.05), mientras que los mejores índices tallo/raíz se observaron con los volúmenes de 56 y 24 cm³ (P<0,05). Culminadas la primera y segunda temporada de crecimiento el efecto del volumen sobre la supervivencia resultó no significativo. Luego de la segunda temporada, se destacó el mayor incremento corriente anual en DAC del tratamiento de 24 cm³ (5,53 ± 1,63 mm). Luego de ambas temporadas se destacó una tendencia a la igualación en altura entre los tratamientos de 100, 80 y 24 cm³, el mayor crecimiento absoluto y relativo se observó en el tratamiento de 24 cm³.

An alternative experimental model for training in microsurgery

OBJECTIVE: to describe a new model of training in microsurgery with pig spleen after splenectomy performed by undergraduate students of the Discipline of Operative Technique of the UFPR Medical School. METHODS: after the completion of splenectomy we performed dissection of the vascular pedicle, distal and proximal to the ligation performed for removal of the spleen. After complete dissection of the splenic artery and vein with microscope, clamps were placed and the vessels were cut. We then made the anastomosis of the vessels with 9.0 nylon. RESULT: the microsurgical training with a well-defined routine, qualified supervision and using low cost experimental materials proved to be effective in the practice of initial microvascular surgery. CONCLUSION: the use of pig spleen, which would be discarded after splenectomy, is an excellent model for microsurgical training, since besides having the consistency and sensitivity of a real model, it saves the sacrifice of a new animal model in the initial learning phase of this technique.

Low-fidelity bench models for basic surgical skills training during undergraduate medical education

It is remarkable the reduction in the number of medical students choosing general surgery as a career. In this context, new possibilities in the field of surgical education should be developed to combat this lack of interest. In this study, a program of surgical training based on learning with models of low-fidelity bench is designed as a complementary alternative to the various methodologies in the teaching of basic surgical skills during medical education, and to develop personal interests in career choice.

Device model for training of laparoscopic surgical skills

The authors present a especially constructed, lightweight, collapsible, portable and low cost model device for skills training in laparoscopic.

Teaching project: a low-cost swine model for chest tube insertion training

Objective: to describe and evaluate the acceptance of a low-cost chest tube insertion porcine model in a medical education project in the southwest of Paraná, Brazil. Methods: we developed a low-cost and low technology porcine model for teaching chest tube insertion and used it in a teaching project. Medical trainees - students and residents - received theoretical instructions about the procedure and performed thoracic drainage in this porcine model. After performing the procedure, the participants filled a feedback questionnaire about the proposed experimental model. This study presents the model and analyzes the questionnaire responses. Results: seventy-nine medical trainees used and evaluated the model. The anatomical correlation between the porcine model and human anatomy was considered high and averaged 8.1±1.0 among trainees. All study participants approved the low-cost porcine model for chest tube insertion. Conclusion: the presented low-cost porcine model for chest tube insertion training was feasible and had good acceptability among trainees. This model has potential use as a teaching tool in medical education.

Efeitos do acido giberélico (GA) e do cloreto de clorocolina (CCC) sobre o crescimento inicial de Brachiaria plantaginea (Link) Hitch

Com o objetivo de verificar os efeitos do ácido giberélico (GA) e do cloreto de clorocolina (CCC) sobre o crescimento e desenvolvimento inicial de Brachiaria plantaginea, instalou-se a presente pesquisa em local com alta infestação dessa espécie, utilizando-se dos seguintes tratamentos: CCC nas concentrações de 1000 e 2000 ppm, GA na de 50 e 100 ppm e uma testemunha sem aplicação dos fitoreguladores. Na época de aplicação dos produtos as plantas apresentavam, em média, sete folhas e idade em torno de 25 dias. Os parâmetros avaliados foram altura do dossel, altura média das plantas, número médio de perfilhos por planta, biomassa seca da parte aérea total e por indivíduo. Os resultados foram avaliados 22 dias após a aplicação, quando se verificou que a biomassa total das plantas não foi alterada significativamente pelos tratamentos. Não ocorreram efeitos de doses e nem de interações entre fitoreguladores com dose em quaisquer dos parâmetros avaliados. Não se verificaram efeitos do CCC nos dados obtidos e todas as alterações ocorridas foram devidas à aplicação do GA que aumentou, significativamente, a altura de dossel e dos indivíduos de Brachiaria plantaginea e reduziu o perfilhamento da planta daninha.

Redução da interferência de Brachiaria plantaginea (link) hitch. em milho através de capinas e aplicação de herbicidas em diferentes épocas

O rendimento de grãos de milho é afetado pela interferência com as plantas daninhas, que pode variar em função da eficiência e da época de realização do método de controle utilizado no manejo da cultura. O objetivo deste trabalho foi determinar os efeitos da aplicação de herbicidas e de capinas em diferentes épocas sobre o controle de plantas daninhas e o rendimento de grãos na cultura do milho. O experimento foi instalado no sistema convencional de preparo do solo em Eldorado do Sul (RS), no ano agrícola 1997/98. A espécie de planta daninha predominante na área experimental foi Brachiaria plantaginea (BRAPL), em infestação média de 285 plantas por m². Os tratamentos foram constituídos pela aplicação isolada, seqüencial ou em mistura em tanque, em diferentes doses e épocas, dos herbicidas atrazine, atrazine + óleo vegetal, metolachlor e nicosulfuron. Todos os tratamentos com herbicidas foram correspondidos por tratamentos em que se utilizou capina manual com início na mesma época de aplicação dos herbicidas. O controle realizado em pré-emergência ou no início do desenvolvimento da cultura proporcionou maior rendimento de grãos, mesmo com a diminuição do controle de BRAPL no final do ciclo. As aplicações seqüenciais de herbicidas proporcionaram maior rendimento de grãos do que as misturas em tanque. Os rendimentos de grãos obtidos com a aplicação de herbicidas nas diversas épocas não foram diferentes em relação às suas respectivas capinas.

Cardiorespiratory adaptations induced by aerobic training in middle-aged men: the importance of a decrease in sympathetic stimulation for the contribution of dynamic exercise tachycardia

We investigated the effects of aerobic training on the efferent autonomic control of heart rate (HR) during dynamic exercise in middle-aged men, eight of whom underwent exercise training (T) while the other seven continued their sedentary (S) life style. The training was conducted over 10 months (three 1-h sessions/week on a field track at 70-85% of the peak HR). The contribution of sympathetic and parasympathetic exercise tachycardia was determined in terms of differences in the time constant effects on the HR response obtained using a discontinuous protocol (4-min tests at 25, 50, 100 and 125 watts on a cycle ergometer), and a continuous protocol (25 watts/min until exhaustion) allowed the quantification of the parameters (anaerobic threshold, VO2 AT; peak O2 uptake, VO2 peak; power peak) that reflect oxygen transport. The results obtained for the S and the T groups were: 1) a smaller resting HR in T (66 beats/min) when compared to S (84 beats/min); 2) during exercise, a small increase in the fast tachycardia (D0-10 s) related to vagal withdrawal (P<0.05, only at 25 watts) was observed in T at all powers; at middle and higher powers a significant decrease (P<0.05 at 50, 100 and 125 watts) in the slow tachycardia (D1-4 min) related to a sympathetic-dependent mechanism was observed in T; 3) the VO2 AT (S = 1.06 and T = 1.33 l/min) and VO2 peak (S = 1.97 and T = 2.47 l/min) were higher in T (P<0.05). These results demonstrate that aerobic training can induce significant physiological adaptations in middle-aged men, mainly expressed as a decrease in the sympathetic effects on heart rate associated with an increase in oxygen transport during dynamic exercise.

Endogenous vasopressin and the central control of heart rate during dynamic exercise

The present article contains a brief review on the role of vasopressinergic projections to the nucleus tractus solitarii in the genesis of reflex bradycardia and in the modulation of heart rate control during exercise. The effects of vasopressin on exercise tachycardia are discussed on the basis of both the endogenous peptide content changes and the heart rate response changes observed during running in sedentary and trained rats. Dynamic exercise caused a specific vasopressin content increase in dorsal and ventral brainstem areas. In accordance, rats pretreated with the peptide or the V1 blocker into the nucleus tractus solitarii showed a significant potentiation or a marked blunting of the exercise tachycardia, respectively, without any change in the pressure response to exercise. It is proposed that the long-descending vasopressinergic pathway to the nucleus tractus solitarii serves as one link between the two main neural controllers of circulation, i.e., the central command and feedback control mechanisms driven by the peripheral receptors. Therefore, vasopressinergic input could contribute to the adjustment of heart rate response (and cardiac output) to the circulatory demand during exercise.

Increased training prevents the impairing effect of intra-amygdala infusion of the non-NMDA receptor antagonist CNQX on inhibitory avoidance expression

Intra-amygdala infusion of the non-N-methyl-D-aspartate (NMDA) receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) prior to testing impairs inhibitory avoidance retention test performance. Increased training attenuates the impairing effects of amygdala lesions and intra-amygdala infusions of CNQX. The objective of the present study was to determine the effects of additional training on the impairing effects of intra-amygdala CNQX on expression of the inhibitory avoidance task. Adult female Wistar rats bilaterally implanted with cannulae into the border between the central and the basolateral nuclei of the amygdala were submitted to a single session or to three training sessions (0.2 mA, 24-h interval between sessions) in a step-down inhibitory avoidance task. A retention test session was held 48 h after the last training. Ten minutes prior to the retention test session, the animals received a 0.5-µl infusion of CNQX (0.5 µg) or its vehicle (25% dimethylsulfoxide in saline). The CNQX infusion impaired, but did not block, retention test performance in animals submitted to a single training session. Additional training prevented the impairing effect of CNQX. The results suggest that amygdaloid non-NMDA receptors may not be critical for memory expression in animals given increased training.

Effect of training on the ability of dual-task coordination

Within the framework of the working memory model proposed by A. Baddeley and G. Hitch, a dual-task paradigm has been suggested to evaluate the capacity to perform simultaneously two concurrent tasks. This capacity is assumed to reflect the functioning of the central executive component, which appears to be impaired in patients with dysexecutive syndrome. The present study extends the investigation of an index ("mu"), which is supposed to indicate the capacity of coordination of concurrent auditory digit span and tracking tasks, by testing the influence of training on the performance in the dual task. The presentation of the same digit sequence lists or always-different lists did not differently affect the performance. The span length affected the mu values. The improved performance in the tasks under the dual condition closely resembled the improvement in the single-task performance. So, although training improved performance in the single and dual conditions, especially for the tracking component, the mu values remained stable throughout the sessions when the single tasks were performed first. Conversely, training improved the capacity of dual-task coordination throughout the sessions when dual task was performed first, addressing the issue of the contribution of the within-session practice to the mu index.

Training graduate students to be teachers

Pedagogic education of graduate students, when and where it exists, is restricted to theoretical courses or to the participation of the students as teachers' assistants. This model is essentially reproductive and offers few opportunities for any significant curriculum innovation. To open an opportunity for novelty we have introduced a new approach in "Biochemistry Teaching", a course included in the Biochemistry Graduate Program of the Biochemistry Department (Universidade Estadual de Campinas and Universidade de São Paulo). The content of the course consists of a) choosing the theme, b) selecting and organizing the topics, c) preparing written material, d) establishing the methodological strategies, e) planning the evaluation tools and, finally, f) as teachers, conducting the course as an optional summer course for undergraduate students. During the first semester the graduate students establish general and specific educational objectives, select and organize contents, decide on the instructional strategies and plan evaluation tools. The contents are explored using a wide range of strategies, which include computer-aided instruction, laboratory classes, small group teaching, a few lectures and round table discussions. The graduate students also organize printed class notes to be used by the undergraduate students. Finally, as a group, they teach the summer course. In the three versions already developed, the themes chosen were Biochemistry of Exercise (UNICAMP), Biochemistry of Nutrition (UNICAMP) and Molecular Biology of Plants (USP). In all cases the number of registrations greatly exceeded the number of places and a selection had to be made. The evaluation of the experience by both graduate and undergraduate students was very positive. Graduate students considered this experience to be unique and recommended it to their schoolmates; the undergraduate students benefited from a more flexible curriculum (more options) and gave very high scores to both the courses and the teachers.