Purpose: To develop and test a model of teaching by means of an abdominal cavity simulator. Methods: This study had two stages: development of a teaching model and an experimental prospective study that aimed to evaluate the residents' competence. The participants were divided into 3 groups: first-year resident, second-year resident, and senior surgeon. The two groups of resident physicians received training in the simulator, under instructor supervision for skill acquisition, according to the model proposed in first stage. The surgeons did not receive this intervention. The correlations and associations were verified through simple and multiple linear regressions. The learning curves were analysed using Cox regression models. The impact of the epidemiological characteristics was tested. Results: All residents reached the maximum score at the end of 16 steps and were comparable to the experimental (p<0.001). Conclusion:Residents who underwent training using the methodology of the proposed teaching model, which is based on realistic simulation, acquired proficiency in the accomplishment of endosutures in up to 16 hours of training in the laboratory. IIPhD, Centro Universitário Unichristus, Fortaleza-CE, Brazil. Conception, design and intellectual content of the study; critical revision; approved the final version.
O objetivo foi realizar análise temporal da fragmentação da paisagem no entorno das Florestas Nacionais do Jamari e Bom Futuro, Rondônia. Para delimitar as análises da fragmentação da paisagem foram elaboradas áreas no entorno, denominadas quadrantes (Q), nas duas Flonas: 0 a 10 km (10A, 10B, 10C e 10D) e de 10 a 20 km (20A, 20B, 20C e 20D). As métricas de paisagem adotadas neste trabalho foram: densidade de borda, densidade de mancha e porcentagem ocupada na paisagem. Posteriormente foram elaborados mapas com a distribuição espacial dos quadrantes que apresentaram métricas mais altas. Com a distribuição espacial dos quadrantes foi possível notar para o entorno de 0 a 10 km da Flona do Bom Futuro (BF), que o BF10A foi o que apresentou maior valor para duas (PD e PLAND) das três métricas utilizadas. Já para o entorno de 10 a 20 km, apenas o quadrante BF20B se destacou entre os demais, pois para todas as métricas ele foi o mais preocupante. Com a distribuição espacial dos quadrantes foi possível notar para o entorno de 0 a 10 km da Flona do Jamari (JA), que o JA10C foi o que apresentou maior ocorrência para todas as métricas aqui avaliadas.Palavras-chave: antropização, métricas de paisagem, unidade de conservação. TEMPORARY ANALYSIS OF FRAGMENTATION OF THE LANDSCAPE IN THE ENVIRONMENT OF NATIONAL FORESTS ABSTRACT: The objective was to carry out a temporal analysis of the fragmentation of the landscape around the National Forests of Jamari and Bom Futuro, Rondônia. In order to delimit the analyzes of the landscape fragmentation, areas in the surroundings, called quadrants (Q), were elaborated in the two Flonas: 0 to 10 km (10A, 10B, 10C and 10D) and 10 to 20 km (20A, 20B, 20C and 20D). The landscape metrics adopted in this work were: border density, spot density and percentage occupied in the landscape. Subsequently maps were elaborated with the spatial distribution of the quadrants that presented higher metrics. With the spatial distribution of the quadrants, it was possible to note that the BF10A was the one with the highest value for two (PD and PLAND) of the three metrics used for the 0 to 10 km environment of the Bom Futuro Flona (BF). Already for the environment of 10 to 20 km, only the quadrant BF20B stood out among the others, because for all the metrics he was the most worrisome. With the spatial distribution of the quadrants it was possible to notice for the environment of 0 to 10 km of Jamari Flona (JA), that the JA10C was the one that presented the highest occurrence for all the metrics evaluated here.Keywords: anthropization process, landscape metrics, conservation unit.
Objetivo: por meio dessa revisão sistemática qualitativa, objetivamos esclarecer qual o papel atual do endoscopista no volvo colônico. Métodos: a pesquisa da literatura foi realizada via PUBMED on-line bancos de dados de janeiro de 2004 a maio de 2017 com os termos "Intestinal Volvulus"[MeSH], "Colonoscopy"[Majr] e adult [MeSH]. Resultados: inicialmente, as estratégias de pesquisa acima mencionadas resultaram em 23 referências. Depois, com base nos critérios de elegibilidade, foram excluídas 12 referências, e 11 foram incluídas. Conclusão: desde a introdução da distorção endoscópica na década de 1940, essa abordagem, juntamente com a ressecção subsequente, tornou-se a principal modalidade terapêutica. A descompressão endoscópica é aceita como o tratamento primário do volvo colônico, no entanto, se houver suspeita de gangrena ou perfuração, pacientes com volvo colônico devem ser submetidos à cirurgia de emergência.
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