Medical Evaluation Processes in Clinical settings. Qualitative Analysis through the Experience of Teachers and Studens

Evaluation processes in clinical practice have not been well, being their study focused on the technical issues concerning these processes. This study tried an approach to the evaluation processes through the analysis of perceptions from teachers and students about the methodology of evaluation considering the teachinglearning processes performed in a clinical practice of the Medicine Program –Universidad El Bosque from Bogota. With this purpose we conducted interviews with teachers and students searching the manner in which the evaluative, learning and teaching processes are done; then we analyzed the perception from both agents concerning the way these processes are related. The interviews were categorized bath deductively and inductively, and then contrasted with some current theories of learning, teaching and evaluation in medicine. The study showed that nowadays the evaluation and, in general, the educative processes are affected by several factors which are associated to the manner the professional practice is developed, and the educative process of the current teachers. We concluded there is no congrency between the approach of the evaluation, mainly conductivist, and the learning and teaching strategies mainly constructivist. This fact cause dissent in teachers and students.

Experience of the Flexible Internship in University of Rosario-Medical School

Objective: To evaluate the flexible program implemented for the medical internship at School of Medicine, Universidad del Rosario during the period 1997-2002. Methodology: A descriptive study was performed to summarize the choices of medical clerkships made by the interns during the whole studied period. The coincidence with the further choice of a determined medical specialty was assessed. Conclusions: Most of the last year’s students remain preferring a conservative approach to their career, by choosing clerkships in a basic area, such as internal medicine, pediatrics, gynecology and obstetrics or general surgery. The coincidence between the type of internship or clerkships a student performs and the future election of a specialty is high.

Clinical experience of clobazam as add-on treatment in a cohort of adults with epilepsy

Objective: Epilepsy is a common neurologic disorder affecting 1% of the world population with one-third of these patients failing to have seizure control for more than one year. Clobazam is a long-acting benzodiazepine used worldwide for the treatment of epilepsy. This antiepileptic drug has demonstrated great clinical benefits with mild side effects. The objective of this study was to better understand the efficacy of clobazam treatment on adult patients with refractory epilepsy. Design: A retrospective review of 44 adult patients with diagnosis of epilepsy that were seen at our Epilepsy Clinic between January 2014 and May 2015. Setting: An outpatient epilepsy clinic at the Hospital Universitario Fundación Santa Fe de Bogota, Colombia. Participants: 44 adult patients with diagnosis of epilepsy. Measurements: Seizure frequency, adverse effects and the use of concomitant AEDs were reviewed in each of the patient´s clinical charts. Results: The responder rate of patients with clobazam was 52% at 3 months, 50% at 6 months and 55% at 12 month. Seizure freedom rates at 3, 6 and 12 months were 18%, 25% and 25% respectively. Clobazam related adverse events occurred only in four patients (9%) at the end of the twelve months with somnolence being the most common. Conclusion: These findings suggest that clobazam treatment in adult patients with focal or generalized epilepsy is effective and safe. Its use should be considered early when first-line agents fail to provide seizure control.

The experience of security in mathematics

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Harmonization of policies and training systems in Europe for urban development – The Experience of LUDA Project

The work developed in LUDA’s project has clearly showed that, in a European economic and cultural diversified frame, crossed by recent and not so recent historical challenging processes, the issues of the urban affairs certainly have different layouts, but, as a matter of fact, we can assume that in their essence they are common to all regions. Identifying a set of common problems is not difficult: the Luda’s; the disadjustment between people and goods mobility, the difficult articulation between space and development sustainability the fragile features of the urban space in its complexity, the responsible social management of current migrations etc.

Desire for memory, desire for museums: the experience of the Memory Hotspots

Considering the principles of the National Museum Policy, created in 2003, the Brazilian Museums Institute – Ibram supports and encourages the development of museum practices and processes aimed at rewriting the history of social groups which were deprived of the right to narrate and exhibit their memories and their heritage. As effective action, in 2008, the Department of Museums and Cultural Centres (Demu/Iphan) – which gave rise to Ibram in January 2009 – started the Memory Hotspots Programme, with the main goal of fostering wide popular participation in matters related to social memory and museums. The Memory Hotspots Programme was inspired in and directly influenced by the Ministry of Culture/MinC, which created the National Programme for Culture, Education and Citizenship (Living Culture). The purpose of this Programme is to contribute to make society conquer spaces, exchange experiences and develop initiatives that foster culture and citizenship, in a proactive manner. The partnership struck between civil society and the state power gave rise to Culture Hotspots, inspired in the anthropological “do-in” concept, idealized by the then Minster Gilberto Gil.

Effects of time averaging on noise floor in distortion product otoacoustic emissions

This paper examines distortion product otoacoustic emissions (DPOAEs) used to test peripheral auditory function, and how noise level in the ear affects the detectability of DPOAEs. The study examines the clinical feasibility of different time averages at different frequencies on the noise floor.

Influence of time on the plant availability of Cd, Ni and Zn after sewage sludge has been applied to soils

A pot experiment was conducted to test the hypothesis that decomposition of organic matter in sewage sludge and the consequent formation of dissolved organic compounds (DOC) would lead to an increase in the bioavailability of the heavy metals. Two Brown Earth soils, one with clayey loam texture (CL) and the other a loamy sand (LS) were mixed with sewage sludge at rates equivalent to 0, 10 and 50 1 dry sludge ha(-1) and the pots were sown with ryegrass (Lolium perenne L.). The organic matter content and heavy metal availability assessed with soil extractions with 0.05 M CaCl2 were monitored over a residual time of two years, while plant uptake over one year, after addition of the sludge. It was found that the concentrations of Cd and Ni in both the ryegrass and the soil extracts increased slightly but significantly during the first year. In most cases, this increase was most evident especially at the higher sludge application rate (50 t ha(-1)). However, in the second year metal availability reached a plateau. Zinc concentrations in the ryegrass did not show an increase but the CaCl2 extracts increased during the first year. In contrast, organic matter content decreased rapidly in the first months of the first year and much more slowly in the second (total decrease of 16%). The concentrations of DOC increased significantly in the more organic rich CL soil in the course of two years. The pattern followed by the decomposition of organic matter with time and the production of DOC may provide at least a partial explanation for trend towards increased metal availability.

Effect of time and mode of depuration on tissue copper concentrations of the earthworms Eisenia andrei, Lumbricus rubellus and Lumbricus terrestris

Eisenia andrei, Lumbricus rubellus and Lumbricus terrestris were exposed to 250, 250 and 350 mg kg(-1) Cu respectively in Cu(NO3)(2(aq)) amended soil for 28 d. Earthworms were then depurated for 24 to 72 h, digested and analysed for Cu and Ti or, subsequent to depuration were dissected to remove any remaining soil particles from the alimentary canal and then digested and analysed. This latter treatment proved impossible for E. andrei due to its small size. Regardless of depuration time, soil particles were retained in the alimentary canal of L. rubellus and L. terrestris. Tissue concentration determinations indicate that E. andrei should be depurated for 24 h, L. rubellus for 48 h and L. terrestris should be dissected. Ti was bioaccumulated and therefore could not be used as an inert tracer to determine mass of retained soil. Calculations indicate that after 28 d earthworms were still absorbing Cu from soil. (C) 2006 Elsevier Ltd. All rights reserved.

The influence of time on lead toxicity and bioaccumulation determined by the OECD earthworm toxicity test

Internationally agreed standard protocols for assessing chemical toxicity of contaminants in soil to worms assume that the test soil does not need to equilibrate with the chemical to be tested prior to the addition of the test organisms and that the chemical will exert any toxic effect upon the test organism within 28 days. Three experiments were carried out to investigate these assumptions. The first experiment was a standard toxicity test where lead nitrate was added to a soil in solution to give a range of concentrations. The mortality of the worms and the concentration of lead in the survivors were determined. The LC(50)s for 14 and 28 days were 5311 and 5395 mug(Pb) g(soil)(-1) respectively. The second experiment was a timed lead accumulation study with worms cultivated in soil containing either 3000 or 5000 mug(Pb) g(soil)(-1). The concentration of lead in the worms was determined at various sampling times. Uptake at so' Sol both concentrations was linear with time. Worms in the 5000 mug g(-1) soil accumulated lead at a faster rate (3.16 mug Pb g(tissue)(-1) day(-1)) tiss than those in the 3000 mug g(-1) soil (2.21 mug Pb-tissue g(-1) day(-1)). The third experiment was a timed experiment with worms cultivated in tiss soil containing 7000 mugPb g(soil)(-1). Soil and lead nitrate solution were mixed and stored at 20 degreesC. Worms were added at various times over a 35-day period. The time to death increased from 23 h, when worms were added directly after the lead was added to the soil, to 67 It when worms were added after the soil had equilibrated with the lead for 35 days. In artificially Pb-amended soils the worms accumulate Pb over the duration of their exposure to the Pb. Thus time limited toxicity tests may be terminated before worm body load has reached a toxic level. This could result in under-estimates of the toxicity of Pb to worms. As the equilibration time of artificially amended Pb-bearing soils increases the bioavailability of Pb decreases. Thus addition of worms shortly after addition of Pb to soils may result in the over-estimate of Pb toxicity to worms. The current OECD acute worm toxicity test fails to take these two phenomena into account thereby reducing the environmental relevance of the contaminant toxicities it is used to calculate. (C) 2002 Elsevier Science Ltd. All rights reserved.

Assessment of the effect of time and temperature on the availability of residual phosphate in a glasshouse study of four soils using the Olsen method

The Olsen method is an indicator of plant-available phosphorus (P). The effect of time and temperature on residual phosphate in soils was measured using the Olsen method in a pot experiment. Four soils were investigated: two from Pakistan and one each from England (calcareous) and Colombia (acidic). Two levels of residual phosphate were developed in each soil after addition of phosphate by incubation at either 10degreesC or 45degreesC. The amount of phosphate added was based on the P maximum of each soil, calculated using the Langmuir equation. Rvegrass was used as the test crop. The pooled data for the four soils incubated at 10degreesC showed good correlation between Olsen P and dry matter yield or P uptake (r(2) = 0.85 and 0.77, respectively), whereas at 45 degreesC, each soil had its own relationship and pooled data did not show correlation of Olsen P with dry matter yield or P uptake. When the data at both temperatures were pooled, Olsen P was a good indicator of yield and uptake for the English soil. For the Pakistani soils, Olsen P after 45 degreesC treatment was an underestimate relative to the 10 degreesC data and for the Colombian soil it was an overestimate. The reasons for these differences need to be explored further before high temperature incubation can be used to simulate long-term changes in the field.