A simulação como método de ensino de habilidades no curso de medicina: relato de uma experiência com punção lombar

The teaching of the lumbar puncture (LP) technique with simulator is not well systematized in the curricula of medical schools. Studies show that training in the simulator provides learning technical skills, acquisition and retention of knowledge, improve self-confidence of the learner and enables the transfer to clinical practice. We intend this study to introduce simulated training in LP in medical course at the Universidade Federal do Rio Grande do Norte evaluating the experience taking into account quantitative aspects (performance on standardized tests) and qualitative (perception of the students regarding the method and the teaching process learning). The study was conducted in two phases. In the first phase practical training in PL was introduced in the 3rd year of medical school. Seventy-seven students were trained in small groups, guided by a checklist developed in the model Objective Structured Assessment of Technical Skill (OSATS), at this moment they knew they were not under performance evaluation. They were also asked whether they had prior chances to make an LP in patients. At the end of the first phase the students evaluated training in the following areas: teaching technique, simulator realism, time available per group, number of participants per group and relevance to medical practice. In the second phase, two years later, 18 students trained in first stage performed a new LP on the mannequin simulator, and its performance was evaluated through the same checklist of training in order to verify the technical retention. In addition, they answered a multiple choice test about practical aspects of the LP technique. Each participant received individual feedback on their performance at the end of their participation in the study. In the first phase of the study we found that only 4% of students had performed a lumbar puncture in patients until the 3rd year. The training of LP technique with simulator mannequin was considered relevant and the teaching methods was thoroughly evaluated. In the second phase, all participants were successful in implementing the lumbar puncture on the mannequin simulator, compliance with the most steps in a reasonable time, suggesting that would be able to perform the procedure in a patient.

Investigações sobre técnicas de arquivamento para otimizadores multiobjetivo

Multi-objective problems may have many optimal solutions, which together form the Pareto optimal set. A class of heuristic algorithms for those problems, in this work called optimizers, produces approximations of this optimal set. The approximation set kept by the optmizer may be limited or unlimited. The benefit of using an unlimited archive is to guarantee that all the nondominated solutions generated in the process will be saved. However, due to the large number of solutions that can be generated, to keep an archive and compare frequently new solutions to the stored ones may demand a high computational cost. The alternative is to use a limited archive. The problem that emerges from this situation is the need of discarding nondominated solutions when the archive is full. Some techniques were proposed to handle this problem, but investigations show that none of them can surely prevent the deterioration of the archives. This work investigates a technique to be used together with the previously proposed ideas in the literature to deal with limited archives. The technique consists on keeping discarded solutions in a secondary archive, and periodically recycle these solutions, bringing them back to the optimization. Three methods of recycling are presented. In order to verify if these ideas are capable to improve the archive content during the optimization, they were implemented together with other techniques from the literature. An computational experiment with NSGA-II, SPEA2, PAES, MOEA/D and NSGA-III algorithms, applied to many classes of problems is presented. The potential and the difficulties of the proposed techniques are evaluated based on statistical tests.

Investigações sobre técnicas de arquivamento para otimizadores multiobjetivo

Multi-objective problems may have many optimal solutions, which together form the Pareto optimal set. A class of heuristic algorithms for those problems, in this work called optimizers, produces approximations of this optimal set. The approximation set kept by the optmizer may be limited or unlimited. The benefit of using an unlimited archive is to guarantee that all the nondominated solutions generated in the process will be saved. However, due to the large number of solutions that can be generated, to keep an archive and compare frequently new solutions to the stored ones may demand a high computational cost. The alternative is to use a limited archive. The problem that emerges from this situation is the need of discarding nondominated solutions when the archive is full. Some techniques were proposed to handle this problem, but investigations show that none of them can surely prevent the deterioration of the archives. This work investigates a technique to be used together with the previously proposed ideas in the literature to deal with limited archives. The technique consists on keeping discarded solutions in a secondary archive, and periodically recycle these solutions, bringing them back to the optimization. Three methods of recycling are presented. In order to verify if these ideas are capable to improve the archive content during the optimization, they were implemented together with other techniques from the literature. An computational experiment with NSGA-II, SPEA2, PAES, MOEA/D and NSGA-III algorithms, applied to many classes of problems is presented. The potential and the difficulties of the proposed techniques are evaluated based on statistical tests.

The Response to an ESL Population Boom in the Beaufort County, South Carolina School System: A Case Study

The purpose of this case study was to examine the why the English language learners (ELLs) in the Beaufort County, South Carolina school system have been so successful. This school system has recently experienced a boom in its ESL student population, and this population has performed very well on standardized tests. This study used critical theory as its theoretical framework and examined why the students have been successful rather than marginalized in Beaufort County schools. This phenomenon was investigated using semi-structured interviews with the ESOL Coordinator for Beaufort County, 4 ESL-lead teachers, and 6 mainstream teachers. Data were collected using semi-structured interviews with Sarah Owen, the Beaufort County ESOL, Gifted and Talented, and World Languages coordinator. Based on the results of her interview, 4 themes emerged that were used for the semi-structured interviews with ESOL and mainstream teachers. The interviews centered on the themes of ESL policy, ESL leadership, and teacher training. The ESL and mainstream teacher interviews also revealed several subthemes that included teacher attitude, why Beaufort County has been successful with the ELLs, and the teachers’ recommendations for other schools systems trying to successfully accommodate a large ESL student population in mainstream classrooms. The findings from the teachers’ interviews revealed that additional training for the teachers without ESL experience helped them become comfortable instructing ELLs. This training should be conducted by the ESOL teachers for those without ESOL certification or endorsement. As the teachers had more training, they had better attitudes about teaching ESOL students in their classes. Finally, those who utilized the additional ESOL training and ESOL accommodations saw better student achievement in their classes. Based on the finding of this study, the researcher proposed a model for other school systems to follow in order to replicate the success of Beaufort County’s ELLs. The implications of this study focus on other schools systems and why ELLs are not obtaining the same level of success as those in Beaufort County’s schools. Finally, recommendations for further research are provided.

The benthic foraminiferal community in a naturally CO2-rich coastal habitat of the southwestern Baltic Sea

It is expected that the calcification of foraminifera will be negatively affected by the ongoing acidification of the oceans. Compared to the open oceans, these organisms are subjected to much more adverse carbonate system conditions in coastal and estuarine environments such as the southwestern Baltic Sea, where benthic foraminifera are abundant. This study documents the seasonal changes of carbonate chemistry and the ensuing response of the foraminiferal community with bi-monthly resolution in Flensburg Fjord. In comparison to the surface pCO2, which is close to equilibrium with the atmosphere, we observed large seasonal fluctuations of pCO2 in the bottom and sediment pore waters. The sediment pore water pCO2 was constantly high during the entire year ranging from 1244 to 3324 µatm. Nevertheless, in contrast to the bottom water, sediment pore water was slightly supersaturated with respect to calcite as a consequence of higher alkalinity (AT) for most of the year. Foraminiferal assemblages were dominated by two calcareous species, Ammonia aomoriensis and Elphidium incertum, and the agglutinated Ammotium cassis. The one-year cycle was characterised by seasonal community shifts. Our results revealed that there is no dynamic response of foraminiferal population density and diversity to elevated sediment pore water pCO2. Surprisingly, the fluctuations of sediment pore water undersaturation (Omega calc) co-vary with the population densities of living Ammonia aomoriensis. Further, we observed that most of the tests of living calcifying foraminifera were intact. Only Ammonia aomorienis showed dissolution and recalcification structures on the tests, especially at undersaturated conditions. Therefore, the benthic community is subjected to high pCO2 and tolerates elevated levels as long as sediment pore water remains supersaturated. Model calculations inferred that increasing atmospheric CO2 concentrations will finally lead to a perennial undersaturation in sediment pore waters. Whereas benthic foraminifera indeed may cope with a high sediment pore water pCO2, the steady undersaturation of sediment pore waters would likely cause a significant higher mortality of the dominating Ammonia aomoriensis. This shift may eventually lead to changes in the benthic foraminiferal communities in Flensburg Fjord, as well as in other regions experiencing naturally undersaturated Omega calc levels.

Individual differences in speech and language ability profiles in areas of high deprivation

Speech and language ability is not a unitary concept; rather, it is made up of multiple abilities such as grammar, articulation and vocabulary. Young children from socio-economically deprived areas are more likely to experience language difficulties than those living in more affluent areas. However, less is known about individual differences in language difficulties amongst young children from socio-economically deprived backgrounds. The present research examined 172 four-year-old children from socio-economically deprived areas on standardised measures of core language, receptive vocabulary, articulation, information conveyed and grammar. Of the total sample, 26% had difficulty in at least one area of language. While most children with speech and language difficulty had generally low performance in all areas, around one in 10 displayed more uneven language abilities. For example, some children had generally good speech and language ability, but had specific difficulty with grammar. In such cases their difficulty is masked somewhat by good overall performance on language tests but they could still benefit from intervention in a specific area. The analysis also identified a number of typically achieving children who were identified as having borderline speech and language difficulty and should be closely monitored

Detection of frontal faces in video streams

[EN]This paper describes an approach for detection of frontal faces in real time (20-35Hz) for further processing. This approach makes use of a combination of previous detection tracking and color for selecting interest areas. On those areas, later facial features such as eyes, nose and mouth are searched based on geometric tests, appearance veri cation, temporal and spatial coherence. The system makes use of very simple techniques applied in a cascade approach, combined and coordinated with temporal information for improving performance. This module is a component of a complete system designed for detection, tracking and identi cation of individuals [1].

Le sommeil comme marqueur du déclin cognitif dans la maladie de Parkinson

La maladie de Parkinson (MP) est une maladie neurodégénérative qui se caractérise principalement par la présence de symptômes moteurs. Cependant, d’autres symptômes, dits non moteurs, sont fréquents dans la MP et assombrissent le pronostic; ceux ci incluent notamment les désordres du sommeil et les troubles cognitifs. De fait, sur une période de plus de 10 ans, jusqu’à 90 % des patients avec la MP développeraient une démence. L’identification de marqueurs de la démence dans la MP est donc primordiale pour permettre le diagnostic précoce et favoriser le développement d’approches thérapeutiques préventives. Plusieurs études ont mis en évidence la contribution du sommeil dans les processus de plasticité cérébrale, d’apprentissage et de consolidation mnésique, notamment l’importance des ondes lentes (OL) et des fuseaux de sommeil (FS). Très peu de travaux se sont intéressés aux liens entre les modifications de la microarchitecture du sommeil et le déclin cognitif dans la MP. L’objectif de cette thèse est de déterminer, sur le plan longitudinal, si certains marqueurs électroencéphalographiques (EEG) en sommeil peuvent prédire la progression vers la démence chez des patients atteints de la MP. La première étude a évalué les caractéristiques des OL et des FS durant le sommeil lent chez les patients avec la MP selon qu’ils ont développé ou non une démence (MP démence vs MP sans démence) lors du suivi longitudinal, ainsi que chez des sujets contrôles en santé. Comparativement aux patients MP sans démence et aux sujets contrôles, les patients MP démence présentaient au temps de base une diminution de la densité, de l’amplitude et de la fréquence des FS. La diminution de l’amplitude des FS dans les régions postérieures était associée à de moins bonnes performances aux tâches visuospatiales chez les patients MP démence. Bien que l’amplitude des OL soit diminuée chez les deux groupes de patients avec la MP, celle ci n’était pas associée au statut cognitif lors du suivi. La deuxième étude a évalué les marqueurs spectraux du développement de la démence dans la MP à l’aide de l’analyse quantifiée de l’EEG en sommeil lent, en sommeil paradoxal et à l’éveil. Les patients MP démence présentaient une diminution de la puissance spectrale sigma durant le sommeil lent dans les régions pariétales comparativement aux patients MP sans démence et aux contrôles. Durant le sommeil paradoxal, l’augmentation de la puissance spectrale en delta et en thêta, de même qu’un plus grand ratio de ralentissement de l’EEG, caractérisé par un rapport plus élevé des basses fréquences sur les hautes fréquences, était associée au développement de la démence chez les patients avec la MP. D’ailleurs, dans la cohorte de patients, un plus grand ralentissement de l’EEG en sommeil paradoxal dans les régions temporo occipitales était associé à des performances cognitives moindres aux épreuves visuospatiales. Enfin, durant l’éveil, les patients MP démence présentaient au temps de base une augmentation de la puissance spectrale delta, un plus grand ratio de ralentissement de l’EEG ainsi qu’une diminution de la fréquence dominante occipitale alpha comparativement aux patients MP sans démence et aux contrôles. Cette thèse suggère que des anomalies EEG spécifiques durant le sommeil et l’éveil peuvent identifier les patients avec la MP qui vont développer une démence quelques années plus tard. L’activité des FS, ainsi que le ralentissement de l’EEG en sommeil paradoxal et à l’éveil, pourraient donc servir de marqueurs potentiels du développement de la démence dans la MP.

Caratterizzazione tribologica in regime lubrificato di laminati d’alluminio

Il presente elaborato si focalizza sulla tribologia delle leghe di alluminio nell’ambito dei processi di laminazione a freddo. Si analizzano in primo luogo la meccanica sollecitativa, i campi deformativi e le velocità del processo produttivo. Viene descritto dunque il fenomeno dell’attrito e i relativi meccanismi, per poi procedere con la contestualizzazione di tali concetti nell’ambito della tribologia della laminazione. Contestualmente si identificano le caratteristiche e i requisiti dei lubrificanti impiegati in questo settore industriale. Si procede infine con indagini tribologiche di tipo pin-on-disk su diverse tipologie di lubrificanti e in differenti regimi di temperatura. È possibile in questo modo valutare l’effetto dei fluidi lubrificanti sul coefficiente d’attrito e sull’addensamento dei detriti di usura.

Caractérisation des propriétés mécaniques de la pâte de carbone à 150°C dans le but d’optimiser la mise en forme des anodes utilisées dans les cuves Hall-Héroult

Les anodes de carbone sont des éléments consommables servant d’électrode dans la réaction électrochimique d’une cuve Hall-Héroult. Ces dernières sont produites massivement via une chaine de production dont la mise en forme est une des étapes critiques puisqu’elle définit une partie de leur qualité. Le procédé de mise en forme actuel n’est pas pleinement optimisé. Des gradients de densité importants à l’intérieur des anodes diminuent leur performance dans les cuves d’électrolyse. Encore aujourd’hui, les anodes de carbone sont produites avec comme seuls critères de qualité leur densité globale et leurs propriétés mécaniques finales. La manufacture d’anodes est optimisée de façon empirique directement sur la chaine de production. Cependant, la qualité d’une anode se résume en une conductivité électrique uniforme afin de minimiser les concentrations de courant qui ont plusieurs effets néfastes sur leur performance et sur les coûts de production d’aluminium. Cette thèse est basée sur l’hypothèse que la conductivité électrique de l’anode n’est influencée que par sa densité considérant une composition chimique uniforme. L’objectif est de caractériser les paramètres d’un modèle afin de nourrir une loi constitutive qui permettra de modéliser la mise en forme des blocs anodiques. L’utilisation de la modélisation numérique permet d’analyser le comportement de la pâte lors de sa mise en forme. Ainsi, il devient possible de prédire les gradients de densité à l’intérieur des anodes et d’optimiser les paramètres de mise en forme pour en améliorer leur qualité. Le modèle sélectionné est basé sur les propriétés mécaniques et tribologiques réelles de la pâte. La thèse débute avec une étude comportementale qui a pour objectif d’améliorer la compréhension des comportements constitutifs de la pâte observés lors d’essais de pressage préliminaires. Cette étude est basée sur des essais de pressage de pâte de carbone chaude produite dans un moule rigide et sur des essais de pressage d’agrégats secs à l’intérieur du même moule instrumenté d’un piézoélectrique permettant d’enregistrer les émissions acoustiques. Cette analyse a précédé la caractérisation des propriétés de la pâte afin de mieux interpréter son comportement mécanique étant donné la nature complexe de ce matériau carboné dont les propriétés mécaniques sont évolutives en fonction de la masse volumique. Un premier montage expérimental a été spécifiquement développé afin de caractériser le module de Young et le coefficient de Poisson de la pâte. Ce même montage a également servi dans la caractérisation de la viscosité (comportement temporel) de la pâte. Il n’existe aucun essai adapté pour caractériser ces propriétés pour ce type de matériau chauffé à 150°C. Un moule à paroi déformable instrumenté de jauges de déformation a été utilisé pour réaliser les essais. Un second montage a été développé pour caractériser les coefficients de friction statique et cinétique de la pâte aussi chauffée à 150°C. Le modèle a été exploité afin de caractériser les propriétés mécaniques de la pâte par identification inverse et pour simuler la mise en forme d’anodes de laboratoire. Les propriétés mécaniques de la pâte obtenues par la caractérisation expérimentale ont été comparées à celles obtenues par la méthode d’identification inverse. Les cartographies tirées des simulations ont également été comparées aux cartographies des anodes pressées en laboratoire. La tomodensitométrie a été utilisée pour produire ces dernières cartographies de densité. Les résultats des simulations confirment qu’il y a un potentiel majeur à l’utilisation de la modélisation numérique comme outil d’optimisation du procédé de mise en forme de la pâte de carbone. La modélisation numérique permet d’évaluer l’influence de chacun des paramètres de mise en forme sans interrompre la production et/ou d’implanter des changements coûteux dans la ligne de production. Cet outil permet donc d’explorer des avenues telles la modulation des paramètres fréquentiels, la modification de la distribution initiale de la pâte dans le moule, la possibilité de mouler l’anode inversée (upside down), etc. afin d’optimiser le processus de mise en forme et d’augmenter la qualité des anodes.

O argumento de inclusão enquanto política de acesso à universidade pública

There are a great number of evidences showing that education is extremely important in many economic and social dimensions. In Brazil, education is a right guaranteed by the Federal Constitution; however, in the Brazilian legislation the right to the three stages of basic education: Kindergarten, Elementary and High School is better promoted and supported than the right to education at College level. According to educational census data (INEP, 2009), 78% of all enrolments in College education are in private schools, while the reverse is found in High School: 84% of all matriculations are in public schools, which shows a contradiction in the admission into the universities. The Brazilian scenario presents that public universities receive mostly students who performed better and were prepared in elementary and high school education in private schools, while private universities attend students who received their basic education in public schools, which are characterized as low quality. These facts have led researchers to raise the possible determinants of student performance on standardized tests, such as the Brazilian Vestibular exam, to guide the development of policies aimed at equal access to College education. Seeking inspiration in North American models of affirmative action policies, some Brazilian public universities have suggested rate policies to enable and facilitate the entry of "minorities" (blacks, pardos1, natives, people of low income and public school students) to free College education. At the Federal University of the state Rio Grande do Norte (UFRN), the first incentives for candidates from public schools emerged in 2006, being improved and widespread during the last 7 years. This study aimed to analyse and discuss the Argument of Inclution (AI) - the affirmative action policy that provides additional scoring for students from public schools. From an extensive database, the Ordinary Least Squares (OLS) technique was used as well as a Quantile Regression considering as control the variables of personal, socioeconomic and educational characteristics of the candidates from the Brazilian Vestibular exam 2010 of the Federal University of the state Rio Grande do Norte (UFRN). The results demonstrate the importance of this incentive system, besides the magnitude of other variables

Aufgaben, Ergebnisse und Probleme der Zwillingsforschung. Dargestellt am Beispiel der Gottschaldtschen Längsschnittstudie

Das starke wissenschaftliche Interesse an der relativen Bedeutung genetischer Faktoren und variabler Umweltbedingungen für die Genese interindividueller Persönlichkeitsunterschiede hat in den letzten Jahren zu einer Intensivierung der Zwillings- und Adoptionsforschung geführt. In den meisten dieser Arbeiten wurden und werden bevorzugt Intelligenztests und Persönlichkeitsfragebogen verwendet. Dabei handelt es sich durchweg um Querschnittstudien. Im Vergleich dazu erstreckt sich die Gottschaldsche Längsschnittstudie an eineiigen und zweieiigen Zwillingen inzwischen auf einen Zeitraum von über 55 Jahren. Hinzu kommt, daß neben quantitativen Informationen auch vielfältige qualitative Daten aus Beobachtungen und Befragungen der Probanden verfügbar sind. (DIPF/Orig.)

Evolution of neodymium isotopic signature of seawater during the Late Cretaceous: Implications for intermediate and deep circulation

Neodymium isotopic compositions (εNd) have been largely used for the last fifty years as a tracer of past ocean circulation, and more intensively during the last decade to investigate ocean circulation during the Cretaceous period. Despite a growing set of data, circulation patterns still remain unclear during this period. In particular, the identification of the deep-water masses and their spatial extension within the different oceanic basins are poorly constrained. In this study we present new deep-water εNd data inferred from the Nd isotope composition of fish remains and Fe-Mn oxyhydroxide coatings on foraminifera tests, along with new εNd data of residual (partly detrital) fraction recovered from DSDP sites 152 (Nicaraguan Rise), 258 (Naturaliste Plateau), 323 (Bellinghausen Abyssal Plain), and ODP sites 690 (Maud Rise) and 700 (East Georgia Basin, South Atlantic). The presence of abundant authigenic minerals in the sediments at sites 152 and 690 detected by XRD analyses may explain both middle rare earth element enrichments in the spectra of the residual fraction and the evolution of residual fraction εNd that mirror that of the bottom waters at the two sites. The results point towards a close correspondence between the bottom water εNd values of sites 258 and 700 from the late Turonian to the Santonian. Since the deep-water Nd isotope values at these two sites are also similar to those at other proto-Indian sites, we propose the existence of a common intermediate to deep-water water mass as early as the mid-Cretaceous. The water mass would have extended from the central part of the South Atlantic to the eastern part of proto-Indian ocean sites, beyond the Kerguelen Plateau. Furthermore, data from south and north of the Rio Grande Rise-Walvis Ridge complex (sites 700 and 530) are indistinguishable from the Turonian to Campanian, suggesting a common water mass since the Turonian at least. This view is supported by a reconstruction of the Rio Grande Rise-Walvis Ridge complex during the Turonian, highlighting the likely existence of a deep breach between the Rio Grande Rise and the proto-Walvis Ridge at that time. Thus deep-water circulation may have been possible between the different austral basins as early as the Turonian, despite the presence of potential oceanic barriers. Comparison of new seawater and residue εNd data on Nicaraguan Rise suggest a westward circulation of intermediate waters through the Caribbean Seaway during the Maastrichtian and Paleocene from the North Atlantic to the Pacific. This westward circulation reduced the Pacific water influence in the Atlantic, and was likely responsible for more uniform, less radiogenic εNd values in the North Atlantic after 80 Ma. Additionally, our data document an increasing trend observed in several oceanic basins during the Maastrichtian and the Paleocene, which is more pronounced in the North Pacific. Although the origin of this increase still remains unclear, it might be explained by an increase in the contribution of radiogenic material to upper ocean waters in the northern Pacific. By sinking to depth, these waters may have redistributed to some extent more radiogenic signatures to other ocean basins through deep-water exchanges.

Low Test Scores in Latin America: Poor Schools, Poor Families, or Something Else?

Latin American students consistently score low on international tests of cognitive skills. In the PISA 2012 results, students in seven Latin American countries had an average score of 395, or about 100 points lower than the average score of 497 in four Scandinavian countries. We examine why Latin American scores are lower and conclude that 50 points are explained by Latin American families’ lower average educational and socioeconomic characteristics, 25 points are explained by Latin America’s weak cultural orientation toward reading books, and the remaining 25 points are explained by the lower effectiveness of educational systems in teaching cognitive skills.

Evidências de validade e propriedades psicométricas do SON-R 6-40

Dissertação (mestrado)—Universidade de Brasília, Instituto de Psicologia, 2016.