Kroppen som bärare av hälsa och lidande

The overall aim of this study is to seek new knowledge and deeper understanding of the body as a phenomenon from a caring science point of view. By means of a hermeneutic definition, the body is studied on a contextual as well as an ontological level in order to create a deeper understanding for human beings in relation to health and suffering. The study focuses of the body as a perspective of human beings. It is important for the knowledge growth in caring science to create a deeper understanding for the body, thus making it possible to understand patients in nursing care. The overall methodology is a hermeneutic definition which covers a contextual and an ontological concept definition. In the three empirical studies, Giorgi’s phenomenological method was used. The first empirical study comprises twelve students’ statements about experiences of their body in different situatons in life. The second study is composed of interviews with fifteen patients who had been afflicted by illness and been subjected to surgical treatment. In the third empirical study, ten patients who had been cared for in perioperative nursing care were interviewed. In the data analysis, the essential meaning of the body as a phenomenon is described, along with its variations and nuances. In the ontological determination of the body, an etymologic and semantic analysis is carried out, as well as a qualitative analysis of ideas, where the material is comprised of chosen texts on the body from different perspectives. In the concluding analysis the results were synthesized. The result of the first empirical study shows that a body is expressive and manifests movement in its striving for dignity. The body harbours language and inherent powers to cope with the unexpected, as well as feelings of anxiety, fear and powerlessness. The second study shows that the body is experienced as mysterious when it is afflicted by illness, but it is also found mysterious as an opponent to man and life. A battle is fought between the illness that breaks down the body, and human beings fighting to keep their unity whole. The body appears as a prison and a host for a threatening illness. The body bears a feeling of powerlessness when it is changed by illness and suffering. In a care and treatment context, the body is objectified by the patient and the caregiver. It is the illness that forces the patient to sacrifice parts of the body in order to once again become whole in the unity. The third study shows that the patient in a perioperative nursing context delivers him-/herself over to the hands of the caregiver, who defends and protects body and life. The patient experiences a sense of well-being when the caretaker receives him/her and protects the body from dangers. Suffering is alleviated when the patients are allowed to talk about what has happened in their body. The result of the semantic analysis shows that the body as a concept is described as bending around the human soul and spirit. Linguistically, dimensions like corporeal, shape, totality, unity and mortal clay, are described. Different ideas about the body described it as: a material animate part of man, active and demanding, something that perceives its surrounding world and as a subjective body of senses, thoughts and language. Ideas about the body also describe it as a biological and physiological, living organism, submitted to the laws of nature, a passive apparatus and a socially constructed gender. The results of the different studies were synthesized and reflected against a caring science perspective. The research has created a deeper understanding for the body as a material abode and as an entity of body, soul and spirit.

A recital by students of the Sibelius Academy, Finland

Sibelius-Akatemian oppilasvaihtokonsertti Manchesterissa 23.9.1975.

Factors associated with depressive symptoms in a sample of Brazilian medical students

OBJECTIVES: 1 - Verify the prevalence of depressive symptoms in first to fourth-year medical students using the Beck Depression Inventory (BDI). 2 - Establish correlations between target factors and higher or lower BDI scores. 3 - Investigate the relationship between the prevalence of depressive symptoms and the demand for psychological care offered by the Centro Universitário Lusíada. METHOD: Cross-sectional study of 290 first to fourth-year medical students; implementation of the BDI, socio-demographic survey, and evaluation of satisfaction with progress. RESULTS: The study sample was 59% female and 41% male. Mean BDI was 6.3 (SD 5.8). Overall prevalence of depressive symptoms was 23.1%. The following associations were statistically significant (p<0.05): among students for whom the course failed to meet original expectations, who were dissatisfied with the course, or who came from the interior of the State (20.5%, 12.5%, and 24.4% of the total sample, respectively), for 40%, 36.1% and 36.4%, respectively, the BDI was consistent with some degree of depression. CONCLUSION: The study showed that there is higher prevalence of depressive symptoms in medical students than in the general population

Group mentoring for junior medical students: perceptions of mentees and mentors

Entering medical school can be associated with a number of difficulties that can hinder students' performance. Mentoring programs are designed to help students circumvent difficulties and improve their learning and personal development. The current study aimed to evaluate the perceptions of both students and mentors regarding a recently introduced, group-based mentoring program designed to support first-year students. After one year of regular meetings, students and mentors' perceptions of the program were assessed by means of structured questionnaires. Response content categories were identified through multiple readings. Both regular attendees and non-participating students had positive opinions about the program. Mentors were highly satisfied at having participated and acknowledged that the program has been useful not only for assisting students, but also for fostering their own personal and professional development. In conclusion, the group-based mentoring program is feasible and can elicit positive views from both mentors and students. In addition, faculty members' participation as mentors can also be beneficial, since the program appears to contribute to their own personal and professional development

Knowledge of common pediatric cancers among medical students in northeast Brazil

BACKGROUND: In recent decades, early diagnosis of childhood cancer has taken an important place on the international agenda. The authors of this study evaluated a group of medical students in Recife, Brazil, regarding knowledge and practices related to early diagnosis of common childhood cancers. METHODS: Cross-sectional study with a sample of 82 medical students, from a total of 86 eligible subjects. Data were collected using self-completed questionnaires. Subgroups were defined according to knowledge of the theme and students' perceptions of their own skills and interest in learning. RESULTS: 74.4% of the sample demonstrated a minimum level of knowledge. The group without minimum knowledge or self-perceived competence to identify suspected cases (23.3%) was in the worst position to perform early diagnosis. All subjects expressed interest in learning more about this topic. CONCLUSIONS: Despite acceptable levels of knowledge among these medical students, the definition of central aspects of the teaching and learning processes would be useful for training physicians with the skills for diagnosing and treating pediatric cancers

Active teaching-learning methodologies: medical students' views of problem-based learning

The prevailing undergraduate medical training process still favors disconnection and professional distancing from social needs. The Brazilian Ministries of Education and Health, through the National Curriculum Guidelines, the Incentives Program for Changes in the Medical Curriculum (PROMED), and the National Program for Reorientation of Professional Training in Health (PRO-SAÚDE), promoted the stimulus for an effective connection between medical institutions and the Unified National Health System (SUS). In accordance to the new paradigm for medical training, the Centro Universitário Serra dos Órgãos (UNIFESO) established a teaching plan in 2005 using active methodologies, specifically problem-based learning (PBL). Research was conducted through semi-structured interviews with third-year undergraduate students at the UNIFESO Medical School. The results were categorized as proposed by Bardin's thematic analysis, with the purpose of verifying the students' impressions of the new curriculum. Active methodologies proved to be well-accepted by students, who defined them as exciting and inclusive of theory and practice in medical education.

Medical students' knowledge about end-of-life decision-making

The influence of medical students' knowledge concerning end-of-life care, considering ethical theories and clinical practice, remains controversial. We aimed to investigate medical students' knowledge of bioethical concepts related to moral kinds of death (euthanasia, disthanasia, and orthothanasia) and to analyze the influence of their clinical experience on practicing such approaches in a tertiary hospital in the state of São Paulo, Brazil. We interviewed 180 medical students [distributed in Group 1 (G1) - first to third- year students, and Group 2 (G2) - fourth to sixth-year students] to evaluate the influence of the course on "medical ethics" on ethical theories and clinical practice, using a closed questionnaire. The course on "medical ethics" did not distinguish the groups (P=0.704) in relation to bioethical concepts. Neologisms such as "cacothanasia" and "idiothanasia" were incorrectly viewed as bioethical concepts by 28% of the interviewees. Moreover, 45.3% of the sample considered health care professionals incapable of managing terminally ill patients, especially G2 (29%) as compared to G1 (16.5%, P=0.031). The concept of euthanasia was accepted by 41% of sample, as compared to 98.2% for orthothanasia. Among medical students that accepted ways to abbreviate life (22.9%), 30.1% belonged to G1, and only 16.1% to G2 (P=0.049). These medical students were unfamiliar with common bioethical concepts. Moreover, they considered healthcare professionals incapable of managing terminally ill patients. The ethical ideal of the "good death" reflects better acceptance of orthothanasia by medical students, suggesting a tendency to apply it in their future clinical practice.

Cultural differences in web-based health information seeking of Finnish and Japanese students

Abstrakti

Mentors, students, and the undergraduate medical course: a virtuous circle

BACKGROUND: Mentoring Programs have been developed in several medical schools, but few studies have investigated the mentors'perspective. PURPOSES: To explore mentors'perceptions regarding their experience. METHODS: Mentors at a medical school were invited to participate in an in-depth interview including questions on satisfaction, difficulties, and perception of changes resulting from the program. RESULTS: Mentors' satisfaction and difficulties are strongly associated with students'involvement in the activity. Mentors believe changes observed in students were more related to life issues; for some mentors, there is no recognition or awareness of the program. However, most of the mentors acknowledged important changes in relation to themselves: as teachers, faculty members, and individuals. CONCLUSION: Attendance is crucial for both the mentoring relationship and strengthening of the program. Students involved in the activity motivate mentors in teaching and curriculum development, thereby creating a virtuous circle and benefiting undergraduate medical education as a whole.

Clinical reasoning of medical students in a public university in Brazil

The aim of this research was to understand the reasoning developed by medical students in a public university in Brazil. This research on education included semi-structured interviews and film recordings of interns discussing 10 clinical cases. A sample of 16 interns analyzed cases presented on a notebook computer with a webcam. They were instructed to verbalize all their thoughts on the procedures they would use. The film recordings and transcripts of the interviews were analyzed. Quantitative data was evaluated using Yates' chi-squared test and speech analysis was used to evaluate the transcripts. The theme worked on in the practice of reasoning was: the student's perceptions of their clinical practice. Of the 160 diagnoses, 57% were done with analytical reasoning and 43% with non-analytical reasoning. The hypothetical deductive method was employed by 31% of the interns and the inductive method was employed by 69%. The diagnostic accuracy was 81% correct for easy cases and 85% correct for difficult cases. We observed two empirical categories: the cognitive universe of the student and the patient's context.

Abnormal eating behaviors among medical students at a university in southern Santa Catarina, Brazil

OBJECTIVES: Disturbances in eating behavior significantly affect young adults. This study aimed to estimate the prevalence of abnormal eating behaviors, according to the Eating Attitudes Test - 26 (EAT-26) in medical students at a university in southern Santa Catarina State, Brazil. METHODS: Self-reported questionnaire, based on the EAT-26 scale, was administered to medical students. Additional questions about age, gender, study period of the course, weight and height were asked. A total of 391 medical students were assessed, amounting to 93.3 percent of the 419 students enrolled. RESULTS: Ten percent of the surveyed subjects had positive EAT-26 scores. This outcome measure was positive associated with females (PR 6.5), body mass index (BMI) ≤ 25 kg/m² (PR 4.5), age ≤ 20 years (PR 1.3) and being student from 1st to 5th semester of the course (PR 1.7). A higher proportion of women gave positive responses to behaviors related to control of food intake or weight loss than men. CONCLUSION: The significant prevalence of behaviors related to eating disorders, predominantly among women, suggests the implementation of preventive measures targeting this population.

Prevalence of Anxiety and Depression among Medical Students

ABSTRACT Background Medical students are a vulnerable population to develop depression and anxiety disorders. Objective To estimate the prevalence and associated factors of anxiety and depression among medical students. Methods A cross-sectional study with a random sample (n = 346) of medical students at a Brazilian university was performed. The Beck Depression Anxiety Inventory was used to measure anxiety and depression levels. Crude and adjusted analyses were performed using Poisson regression. Results The prevalence of anxiety was 35.5% and depression was 32.8%. The prevalence of anxiety and depression was 14% higher and 16% higher among women (p = 0.025 and p = 0.006, respectively). Students whose parents were not physicians reported 23% higher prevalence of anxiety (p = 0.006), and those who had physician parents reported 29% higher prevalence of depression (p = 0.034). Those who always or often felt pushed by their parents showed 22% higher prevalence of anxiety (p =.006) and 19% higher depression (p = 0.016). Students who had concerns over the future had 15% higher prevalence of depression (p = 0.017). Conclusion The prevalence of anxiety and depressive symptoms was higher than the average found in the general population.

Knowledge of Guidelines for Cardiopulmonary Resuscitation among Brazilian Medical Students

ABSTRACT Introduction Sudden death is a substantial public health problem, representing a major cause of mortality worldwide. Suitable initial care is essential for a good prognosis of these patients. Objectives To assess the knowledge of the 2010 guidelines for cardiopulmonary resuscitation (CPR) among medical students in their final year of undergraduate training. Methods This was a cross-sectional study with a sample of 217 medical students enrolled in the sixth year of accredited medical schools in Brazil. A structured questionnaire with 27 items was used to record the sociodemographic characteristics of the participants and to assess their knowledge base of the 2010 ILCOR guidelines for CPR. Results Only fifty (23.04%) out of 217 students achieved results considered as satisfactory in the written evaluation. The average score obtained was 56.74% correct answers. Seventeen percent of the students had never performed CPR maneuvers and 83.80% had never performed cardioversion or defibrillation. Conclusions The knowledge base of medical students regarding cardiopulmonary resuscitation is low. Considering these medical students are in their final year of medical school, this study reveals a worrisome scenario.

Enabling constructive alignment in programming instruction

In this thesis, simple methods have been sought to lower the teacher’s threshold to start to apply constructive alignment in instruction. From the phases of the instructional process, aspects that can be improved with little effort by the teacher have been identified. Teachers have been interviewed in order to find out what students actually learn in computer science courses. A quantitative analysis of the structured interviews showed that in addition to subject specific skills and knowledge, students learn many other skills that should be mentioned in the learning outcomes of the course. The students’ background, such as their prior knowledge, learning style and culture, affects how they learn in a course. A survey was conducted to map the learning styles of computer science students and to see if their cultural background affected their learning style. A statistical analysis of the data indicated that computer science students are different learners than engineering students in general and that there is a connection between the student’s culture and learning style. In this thesis, a simple self-assessment scale that is based on Bloom’s revised taxonomy has been developed. A statistical analysis of the test results indicates that in general the scale is quite reliable, but single students still slightly overestimate or under-estimate their knowledge levels. For students, being able to follow their own progress is motivating, and for a teacher, self-assessment results give information about how the class is proceeding and what the level of the students’ knowledge is.

Karneval i klassrum – kunskap på hjul : en studie av elevers möten med clown analyserade med narrativ metod och poetisk etnografi

The aim of this study is to contribute to the knowledge about learning in and through art related to pupils’ study processes developing clown characters in secondary school. The pre understanding of this qualitative piece of micro ethnographic research is that the elaboration of clown has openness to play, creative activity and imagination. The art form clown inspires and motivates. The clown character creates a kind and friendly atmosphere, calls upon smile, which promotes learning. It is an art form promoting deep and personal reflection and evoking questions regarding identity formation. The pre understanding finally is that existential themes are brought to articulation in the art form clown. The problem formulation for the hermeneutic phenomenological study is an exploration of the meaning potential of an arts educational work with clown from the pupils’ as well as the teacher’s perspective. The study elaborates the following research questions: 1.) How are the pupils staging themselves in the work with clown? a) How are they constructing the clown character? b) How do they reflect upon their construction? c) What are the characteristics of the working process in the elaboration of clown? 2.) What is characteristic of the teacher’s contribution to the arts educational work? 3.) What is characteristic of the meaning making in the elaboration of clown? One group of 21 pupils and their drama teacher in a Swedish secondary school in six workshops (each one 90 minutes) elaborating the clown theme is the group under study through video observation, interviews, students’ logs and drawings, teacher log and researcher’s field notes. The theoretical framework comprises three perspectives on clown: a perspective on the culture of carnival, a drama education perspective and a performance perspective. Through a content analysis of texts about clown a set of characteristics for the clown is used as analytical concepts in the subsequent analysis of the pupils’ working process when they create three clown characters: August, the white clown and the bag lady. The results are presented as fictive narratives built on the video observations and the interviews. The presentation is brought to even more condensation through poetic ethnographic writing of haiku poems by the researcher. This ethnographic writing is idiomatic to the art form under study, and can be seen as a metaphorical meta commentary to the narratives. As a main result the researcher has developed a model describing the different aspects of the clown characters and the meaning potential of the clown as learning regarding exploration of identity and elaboration of existential questions regarding life, loneliness, love, religion and death.