912 resultados para Medical education--Pennsylvania--History--19th century
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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
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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.
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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.
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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.
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This is a secondary data-based study conducted to investigate whether gender is related to acceptance. Two Brazilian Medical Schools, Universities A and B, were studied. Their entrance exams (EE) were analysed and the number of candidates who took the EE was compared to the number of students admitted to the MS according to gender, in the period between 1995 and 2009. The same data from MS in the United States in 2011 was also evaluated. There was an increase in the percentage of female applicants but it did not correspond to the percentage of admitted students of the same gender. There was a trend of selecting men. At A, 39.3% of the applicants and 47% of the admitted students were men (OR = 1.37; CI95% = 1.24 – 1.51). In B, men represented 39.3% of the applicants and 65.4% of the admitted students (OR = 2.93; CI 95% = 2.76 – 3.11). This was not seen in US MS. The analysis of the EE suggests that the greater selection of men could be a product of EE format.
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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.
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Engraved illustrations are based on the original oil paintings of several Finnish artists: A. v. Becker, A. Edelfelt, R. W. Ekman, W. Holmberg, K. E. Jansson, O. Kleineh, J. Knutson, B. Lindholm, H. Munsterhjelm och B. Reinhold.
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Engraved illustrations are based on the original oil paintings of several Finnish artists: A. v. Becker, A. Edelfelt, R. W. Ekman, W. Holmberg, K. E. Jansson, O. Kleineh, J. Knutson, B. Lindholm, H. Munsterhjelm och B. Reinhold.
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Lithographs from: Johan Knutson, Magnus v. Wright, Lennart Forstén, Pehr Adolf Kruskopf, F. J. Westerling, Adolf Wilhelm Lindeström, and J. Boström, and two lithographs without the artistʼs name.
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Digital reproduction, The National Library of Finland, Centre for Preservation and Digitisation, Mikkeli
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The present study examines the repertory of liturgical chant known as St. Petersburg Court Chant which emerged within the Imperial Court of St. Petersburg, Russia, and appeared in print in a number of revisions during the course of the 19th century, eventually to spread throughout the Russian Empire and even abroad. The study seeks answers to questions on the essence and composition of Court Chant, its history and liturgical background, and most importantly, its musical relationship to other repertories of Eastern Slavic chant. The research questions emerge from previous literary accounts of Court Chant (summarized in the Introduction), which have tended to be inaccurate and generally not based on critical research. The study is divided into eight main chapters. Chapter 1 provides a survey of the history of Eastern Slavic chant and the Imperial Court Chapel of St. Petersburg until 1917, with special emphasis on the history of singing traditional chant in polyphony, the status of the Court Chapel as a government authority, and its endeavours in publishing church music. Chapter 2 deals with the liturgical background of Eastern chant, the chant genres, and main repertories of Eastern Slavic chant. Chapter 3 concentrates on chant sources: it introduces the musical notations utilised, after which a typology of chant books is presented. The discussion continues with a survey of the sources of Court Chant and their content, the specimens selected for closer analysis, the comparative materials from other repertories, and ends with a commentary on some chant sources that have been excluded. The comparative sources include a specimen from around the beginning of the 12th century, a few manuscripts from the 17th century, and printed and manuscript chant books from the early 18th to early 20th century, covering the geographical area that delimits to the western Ukraine, Astrakhan, Nizhny Novgorod, and the Solovetsky Monastery. Chapter 4 presents the approach and methods used in the subsequent analytical comparisons. After a survey of the pitch organization of Eastern Slavic chant, the customary harmonization strategy of traditional chant polyphony is examined, according to which a method for meaningful analysis of the harmony is proposed. The method is based on the observation that the harmonic framework of chant polyphony derives from the standard pitch collection of monodic chant known as the Church Gamut, specific pitches of which form eight harmonic regions that behave like the usual tonalities of major and harmonic minor. Because of the considerable quantity of comparative chant forms, computer-assisted statistical methods are applied to the analysis of chant melodies. The primary chant forms and their respective comparative forms have been pre-processed into reduced chant prototypes and divided into redactions. The analyses are carried out by measuring the formal dissimilarities of the primary chant forms of the Court Chant repertory against each comparative form, and also by measuring the reciprocal dissimilarities of all chant versions in a redaction, the results of which are subjected to agglomerative hierarchical clustering in order to find out how the chant forms relate to each other. The dissimilarities are determined by applying a metric dissimilarity function that is based on the Levenshtein Distance. Chapter 5 provides the melodic and harmonic analyses of generic chants (chants used for multiple texts of different lengths), i.e., chants for stichera samoglasny and troparia, Chapter 6 of pseudo-generic chants (chants that are used for multiple texts but with certain restrictions), i.e., chants for heirmoi, prokeimena, and three other hymns, and Chapter 7 of non-generic chants, covering nine chants that in the Court repertory are not shared by multiple texts. The results are summarized and evaluated in Chapter 8. Accordingly, it can be established that, contrary to previous conceptions, melodically, Court Chant is in effect a full part of the wider Eastern Slavic chant tradition. Even if it is somewhat detached from the chant versions of the Synodal square-note chant books and the local tradition of Moscow, it is particularly close to chant forms of East Ukraine and some vernacular repertories from Russia. Respectively, the harmonization strategies of Court Chant do not show significant individuality in comparison with those of the available polyphonic comparative sources, the main difference being the part-writing, which generally conforms to western common practice standard, whereas the deviations from this tend to be more significant in other analysed repertories of polyphonic chant. Thus, insofar as the subsequent prevalence of Court Chant is not based on its forceful dissemination by authorities (as suggested in previous literature but for which little tangible evidence could be found in Chapter 1), in the present author’s interpretation, Court Chant attained its dominance principally because musically it was considered sufficiently traditional, and as a chant body supported by the government, was conveniently available in print in serviceable harmonizations.
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Sosialistisen vallankumouksen jälkeen Neuvosto-Venäjän oli monien muiden kysymysten ohella ratkaistava sosialismin saavutusten puolustaminen. Aluksi ratkaisuksi suunniteltiin vapaaehtoisuuteen perustuvaa punakaartia, mutta riittävän miesvahvuuden turvaamiseksi päädyttiin yleiseen asevelvollisuuteen. Pian Venäjän sisällissodan jälkeen sotataidon suunta painottui enemmän vanhan armeijan asiantuntijoiden näkemysten kuin vallankumoussankarien kokemusten mukaiseksi, vaikka Frunzen puna-armeijalle kirjoittama doktriini perustui luokkataisteluun ja korosti sisällissodassa hyväksi koettua operatiivista liikkuvuutta. Neuvostoliiton ja Venäjän sotataidon perustana on Pietari I:n aloittama länsimainen suuntaus, jota kuitenkin täydentävät vahvat kansalliset piirteet. Venäläisen sotataidon henkisenä isänä voidaan hyvällä syyllä pitää Aleksandr Suvorovia, jonka opetukset näkyvät tekstilainausten lisäksi myös periaatteissa ja sotilaskasvatuksessa. Napoleonin sotien jälkeen perustettu Keisarillinen yleisesikunta-akatemia loi Venäjälle sotatieteellisen tutkimuksen ja opetuksen. Sotatieteen mahdollisuuksia ei 1800-luvun Venäjällä osattu täysin hyödyntää. Aseistuksen kasvavan tehon merkitystä vähättelevä asenne johti sotataidon taantumisen ja katastrofiin Venäjän–Japanin sodassa. Sen kokemuksia analysoidessaan Aleksandr Neznamov kehitti edelleen saksalaista operaation käsitettä ja loi perustan Neuvostoliitossa 1920-luvulla kehitetylle operaatiotaidolle. Neuvostoliittolaisen sotataidon päämääränä oli kehittää taktinen ja operatiivinen ratkaisu aseistuksen tehon kasvun aikaansaamaan puolustuksen ylivoimaisuuteen. Ratkaisussa hyödynnettiin brittien kokemuksia ja tutkimusta. Neuvostoliittolainen taktiikka ja operaatiotaito eivät kuitenkaan olleet brittiläisen mekanisoidun sodankäynnin tai saksalaisen salamasodan itäinen kopioita vaan itsenäisiin ratkaisuihin pohjautuvia. Syvän taistelun ja operaation teoriaa kokeiltiin harjoituksissa, ja sitä kehitettiin Stalinin vuoden 1937 puhdistuksiin saakka. Toisen maailmansodan taisteluissa puna-armeija sovelsi alkuvaiheen katastrofin jälkeen syvän taistelun ja syvän operaation oppeja. Komentajien ja joukkojen taito ei riittänyt teorian vaatimusten mukaiseen toimintaan, siksi syväksi aiotusta taistelusta tuli ajoittain ainoastaan tiheää. Suuren isänmaallisen sodan kokemusten perusteella neuvostoliittolainen sotatiede kehitti yleisjoukkojen taistelun periaatteet, jotka ovat säilyneet muuttumattomina nykypäivään saakka. Kylmän sodan aikakaudella ydin- ja tavanomaisen aseistuksen merkitys sodan ja taistelun kuvassa vaihteli. Lännen sotataidon ja aseteknologian kehitys pakotti Neuvostoliiton siirtymään 1980-luvulla sotilaallisessa ajattelussaan hyökkäyksestä puolustukseen. Neuvostoliiton hajoamisen jälkeen Venäjän sotilaallisen turvallisuuden takaajana on ydinaseistus. Yhdysvaltain tavanomainen ilma-avaruushyökkäyskyky vaatii Venäjää kehittämään torjuntajärjestelmiä. Tavanomaisten joukkojen rakentamisessa Venäjä seuraa tarkasti läntisen sotataidon kehittymistä, mutta pitäytyy omaperäisiin ratkaisuihin, joiden kehittämisessä sen vahvalla sotatieteellisellä järjestelmällä ja dialektisen materialismin metodilla on edelleen olennaisen tärkeä merkitys.
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Kirjallisuusarvostelu
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Between October 6, 1997 and April 30, 1999, 5011 births (mean: 8.76 per day) were registered in the city of Passo Fundo, South Brazil. The sequence of 572 daily birth numbers was not random (iteration test). Neyman distribution (m = ¥) showed the best fit. Clusters of days with higher birth numbers alternated with days with low numbers of births. Periodogram analysis revealed a significant periodicity of 6.98 days. The cosinor regression, testing 10 a priori supposed period lengths, found significant seasonality peaking in August-September and significantly highest birth numbers on Thursdays. Among the lunar and solar rotation cycles, the tropic lunar cycle and its 4th harmonic were most pronounced, in agreement with results concerning natality in Germany obtained by Svante Arrhenius in the 19th century. These findings confirm Derer-Halberg's concept of multiseptans. In addition to cycling, a significantly increasing linear trend with a daily increase of 0.0045 births was encountered. This documents a growth of the population in agreement with national statistical data.
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Electrochromism, the phenomenon of reversible color change induced by a small electric charge, forms the basis for operation of several devices including mirrors, displays and smart windows. Although, the history of electrochromism dates back to the 19th century, only the last quarter of the 20th century has its considerable scientific and technological impact. The commercial applications of electrochromics (ECs) are rather limited, besides top selling EC anti-glare mirrors by Gentex Corporation and airplane windows by Boeing, which made a huge commercial success and exposed the potential of EC materials for future glass industry. It is evident from their patents that viologens (salts of 4,4ʹ-bipyridilium) were the major active EC component for most of these marketed devices, signifying the motivation of this thesis focusing on EC viologens. Among the family of electrochromes, viologens have been utilized in electrochromic devices (ECDs) for a while, due to its intensely colored radical cation formation induced by applying a small cathodic potential. Viologens can be synthesized as oligomer or in the polymeric form or as functionality to conjugated polymers. In this thesis, polyviologens (PVs) were synthesized starting from cyanopyridinium (CNP) based monomer precursors. Reductive coupling of cross-connected cyano groups yields viologen and polyviologen under successive electropolymerization using for example the cyclic voltammetry (CV) technique. For further development, a polyviologen-graphene composite system was fabricated, focusing at the stability of the PV electrochrome without sacrificing its excellent EC properties. High electrical conductivity, high surface area offered by graphene sheets together with its non-covalent interactions and synergism with PV significantly improved the electrochrome durability in the composite matrix. The work thereby continued in developing a CNP functionalized thiophene derivative and its copolymer for possible utilization of viologen in the copolymer blend. Furthermore, the viologen functionalized thiophene derivative was synthesized and electropolymerized in order to explore enhancement in the EC contrast and overall EC performance. The findings suggest that such electroactive viologen/polyviologen systems and their nanostructured composite films as well as viologen functionalized conjugated polymers, can be potentially applied as an active EC material in future ECDs aiming at durable device performances.