624 resultados para Student Placement


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OBJECTIVE: Transthoracic echocardiography (TTE) has been used clinically to disobstruct venous drainage cannula and to optimise placement of venous cannulae in the vena cava but it has never been used to evaluate performance capabilities. Also, little progress has been made in venous cannula design in order to optimise venous return to the heart lung machine. We designed a self-expandable Smartcanula (SC) and analysed its performance capability using echocardiography. METHODS: An epicardial echocardiography probe was placed over the SC or control cannula (CTRL) and a Doppler image was obtained. Mean (V(m)) and maximum (V(max)) velocities, flow and diameter were obtained. Also, pressure drop (DeltaP(CPB)) was obtained between the central venous pressure and inlet to venous reservoir. LDH and Free Hb were also compared in 30 patients. Comparison was made between the two groups using the student's t-test with statistical significance established when p<0.05. RESULTS: Age for the SC and CC groups were 61.6+/-17.6 years and 64.6+/-13.1 years, respectively. Weight was 70.3+/-11.6 kg and 72.8+/-14.4 kg, respectively. BSA was 1.80+/-0.2 m(2) and 1.82+/-0.2 m(2), respectively. CPB times were 114+/-53 min and 108+/-44 min, respectively. Cross-clamp time was 59+/-15 min and 76+/-29 min, respectively (p=NS). Free-Hb was 568+/-142 U/l versus 549+/-271 U/l post-CPB for the SC and CC, respectively (p=NS). LDH was 335+/-73 mg/l versus 354+/-116 mg/l for the SC and CC, respectively (p=NS). V(m) was 89+/-10 cm/s (SC) versus 63+/-3 cm/s (CC), V(max) was 139+/-23 cm/s (SC) versus 93+/-11 cm/s (CC) (both p<0.01). DeltaP(CPB) was 30+/-10 mmHg (SC) versus 43+/-13 mmHg (CC) (p<0.05). A Bland-Altman test showed good agreement between the two devices used concerning flow rate calculations between CPB and TTE (bias 300 ml+/-700 ml standard deviation). CONCLUSIONS: This novel Smartcanula design, due to its self-expanding principle, provides superior flow characteristics compared to classic two stage venous cannula used for adult CPB surgery. No detrimental effects were observed concerning blood damage. Echocardiography was effective in analysing venous cannula performance and velocity patterns.

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The paper presents a competence-based instructional design system and a way to provide a personalization of navigation in the course content. The navigation aid tool builds on the competence graph and the student model, which includes the elements of uncertainty in the assessment of students. An individualized navigation graph is constructed for each student, suggesting the competences the student is more prepared to study. We use fuzzy set theory for dealing with uncertainty. The marks of the assessment tests are transformed into linguistic terms and used for assigning values to linguistic variables. For each competence, the level of difficulty and the level of knowing its prerequisites are calculated based on the assessment marks. Using these linguistic variables and approximate reasoning (fuzzy IF-THEN rules), a crisp category is assigned to each competence regarding its level of recommendation.

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Agency Performance Report

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Product placement has become more and more common in Finnish television programmes lately. Product placement, as with the whole of the television industry, is strictly regulated and monitored by law. Surreptitious advertising, sponsorship, cooperative partnerships and product placement are often confused with each other. Partially these activities are interpenetrative. Present legislation doesn't recognise product placement, therefore it doesn't have any specific position in law, thus causing problems. Product placement in domestic tv-programmes is still relatively modest. More extensive activity is perceivable at the movies where the restrictions are considerably more liberal. In the United States, product placement is a part of a production's budget. Pressure to increase financing has grouwn in both Finland and Europe. There has been considerable preparation in advance of a new television directive in the European Union which would allow more liberal advertising and product placement as a part of financing tv-programmes. The proposal for a new directive is currently only on its first round so product placement probably won't become better defined in law in the near future. Finnish television producers were interviewed as part of the research for this thesis, in order to clarify product placement position and usage in domestic televion programmes. Surreptitious advertising, sponsorship, different kinds of cooperative partnerships and the need for guidance were also discussed in the course of the themed interviews. Even though product placement does not currently play a significant part in the financing of a production, there are certainly pressures in that direktion. In the field of television, the legal boundaries of product placement are presently being explored in order to assess its position as a part of budgeting and covering expenses.

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Hosting a medical student in one's primary care consultation challenges the practitioner to be a clinical teacher as well as providing high-quality patient care. A few tips can make this double task easier. Before the consultation it is possible to define the student's learning objectives and to plan the consultation. During the consultation itself some teaching models exist (One minute preceptor, SNAPP) that facilitate the teaching by maximising the teaching moments for each student-patient encounter. And finally after the consultation a time of reflection where both student and clinical teacher can think about what went well and what could be done better.