Medical students' perceptions in relation to ethnicity and gender: A qualitative study

Background The British medical student population has undergone rapid diversification over the last decades. This study focuses on medical students' views about their experiences in relation to ethnicity and gender during their undergraduate training within the context of the hidden curriculum in one British medical school as part of a wider qualitative research project into undergraduate medical education. Method We interviewed 36 undergraduate medical students in one British Medical School, across all five years of training using a semi-structured interview schedule. We selected them by random and quota sampling, stratified by sex and ethnicity and used the whole medical school population as a sampling frame. Data analyses involved the identification of common themes, reported by means of illustrative quotations and simple counts. Results The students provided information about variations patterned by gender in their motivation and influences when deciding to study medicine. Issues in relation to ethnicity were: gaining independence from parents, perceived limitations to career prospects, incompatibility of some religious beliefs with some medical practices and acquired open-mindedness towards students and patients from different ethnic backgrounds. Despite claiming no experiences of gender difference during medical training, female and male students expressed gender stereotypes, e.g. that women bring particularly caring and sympathetic attitudes to medicine, or that surgery requires the physical strength and competitiveness stereotypically associated with men that are likely to support the continuation of gender differentiation in medical careers. Conclusion The key themes identified in this paper in relation to ethnicity and to gender have important implications for medical educators and for those concerned with professional development. The results suggest a need to open up aspects of these relatively covert elements of student culture to scrutiny and debate and to take an explicitly wider view of the influence of what has sometimes been called the hidden curriculum upon the training of medical professionals and the practice of medicine

Atributos anatômicos de lâminas foliares de Paspalum spp.

Gramíneas do gênero Paspalum spp. apresentam alto potencial para o melhoramento genético, devido à sua grande variabilidade genética. Este estudo, conduzido na Universidade Federal da Grande Dourados, teve como objetivo avaliar atributos anatômicos de lâminas foliares de Paspalum spp. (P. malacophyllum - P30, P. guenoarum - P65, P. glaucescens - P114, P. spp.- Pl16, P. spp. - P127, P. guenoarum - P148, P. regnellii - P191 e uma cultivar comercial- P. alralum cv. Pojuca). Utilizou-se o delineamento de blocos ao acaso, oito genótipos e quatro repetições. Os fragmentos das lâminas foram fixados em F AA e após efetuou-se o preparo histológico. Alta variabilidade entre os genótipos foi observada quanto à proporção e arranjo de tecidos, e presença de tanino condensado na epiderme. Dos caracteres avaliados a presença de estrutura girder, foi a que mais discriminou os genótipos quanto ao potencial qualitativo das lâminas. Estudos devem ser conduzidos para verificar o efeito do tanino condensado, presente na epiderme, no potencial qualitativo dos genótipos

Trivial, Strongly Minimal Theories Are Model Complete After Naming Constants

We prove that if M is any model of a trivial, strongly minimal theory, then the elementary diagram Th(MM) is a model complete LM-theory. We conclude that all countable models of a trivial, strongly minimal theory with at least one computable model are 0 -decidable, and that the spectrum of computable models of any trivial, strongly minimal theory is Σ05

Estabelecimento do Panicum maximum cv. Massai em função de doses crescentes de nitrogênio.

Objetivo: encontrar uma combinação eficiente, entre dose de fertilizzação nitrogenada e idade da palnta que permita boa produção de massa com menor lignificação, pode ajudar no manejo dessa importante forrageira.bitstream/item/104640/1/Estabelecimento-do-Panicum-maximum-cv.pd

Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study

The aims of this paper are to: (i) explore the experiences of involvement of mental health service users, their caregivers, mental health centre heads and policy makers in mental health system strengthening in three low- and middle-income countries (LMICs) (Ethiopia, Nepal and Nigeria); (ii) analyse the potential benefits and barriers of such involvement; and (iii) identify strategies required to achieve greater service user and caregiver participation. A cross-country qualitative study was conducted, interviewing 83 stakeholders of mental health services. Our analysis showed that service user and caregiver involvement in the health system strengthening process was an alien concept for most participants. They reported very limited access to direct participation. Stigma and poverty were described as the main barriers for involvement. Several strategies were identified by participants to overcome existing hurdles to facilitate service user and caregiver involvement in the mental health system strengthening process, such as support to access treatment, mental health promotion and empowerment of service users. This study suggests that capacity building for service users, and strengthening of user groups would equip them to contribute meaningfully to policy development from informed perspectives. Involvement of service users and their caregivers in mental health decision-making is still in its infancy in LMICs. Effective strategies are required to overcome existing barriers, for example making funding more widely available for Ph.D. studies in participatory research with service users and caregivers to develop, implement and evaluate approaches to involvement that are locally and culturally acceptable in LMICs

Acúmulo de forragem e características do solo e da planta no estabelecimento de capim-massai com diferentes níveis de saturação por bases, fósforo e nitrogênio.

Foi conduzido um experimento em Latossolo de Cerrado visando testar a combinação de níveis de saturação por bases (20, 40, 60 e 80%), doses de fósforo (0, 80, 160 e 240 kg/ha de P2O5) e nitrogênio (0, 100, 200 e 300 kg/ha) no estabelecimento de capim-massai. Foram avaliados o acúmulo de massa seca verde (MSV) da forrageira, as características químicas do solo, as concentrações foliares de macronutrientes, os teores de proteína bruta (PB) e a digestibilidade in vitro da matéria orgânica (DIVMO). Utilizou-se o delineamento de blocos casualizados no esquema fatorial fracionário (1/2)43, com duas repetições e quatro blocos. Foram realizados dois cortes em aproximadamente 200 dias. O acúmulo de MSV respondeu principalmente ao fósforo (P) e, em segundo lugar, à saturação por bases. Não houve resposta significativa ao nitrogênio (N). A dose de P2O5 para o máximo acúmulo de MSV foi de 237 kg/ha e a dose econômica, de 185 kg/ha, com saturação por bases no solo de 39%. A fertilidade do solo aumentou com o acréscimo de saturação por bases e P. As concentrações foliares de P, Ca e Mg elevaram-se com o aumento dos níveis de saturação por bases e P e a concentração de N aumentou com a adubação nitrogenada e com o incremento da saturação por bases. A fração folha correspondeu a 77,50% da MSV e apresentou valores adequados de DIVMO e PB, que aumentaram significativamente com o aumento da adubação nitrogenada e da saturação por bases

Perceived barriers to integrated care in rheumatoid arthritis: views of recipients and providers of care in an inner-city setting

<p>Abstract</p> <p>Background</p> <p>A number of recent reports published in the UK have put the quality of care of adults with Rheumatoid Arthritis (RA) centre stage. These documents set high standards for health care professionals and commissioning bodies that need to be implemented into routine clinical practice. We therefore have obtained the views of recipients and providers of care in inner city settings as to what they perceive are the barriers to providing integrated care.</p> <p>Methods</p> <p>We conducted focus groups and face to face interviews between 2005-8 with 79 participants (patients, carers, specialist medical and nursing outpatient staff and general practitioners (GPs)) working in or attending three hospitals and three primary care trusts (PCT).</p> <p>Results</p> <p>Three barriers were identified that stood in the way of seamless integrated care in RA from the perspective of patients, carers, specialists and GPs: (i) early referral (e.g. 'gate keeper's role of GPs); (ii) limitations of ongoing care for established RA (e.g. lack of consultation time in secondary care) and (iii) management of acute flares (e.g. pressure on overbooked clinics).</p> <p>Conclusion</p> <p>This timely study of the multi-perspective views of recipients and providers of care was conducted during the time of publications of many important reports in the United Kingdom (UK) that highlighted key components in the provision of high quality care for adults with RA. To achieve seamless care across primary and secondary care requires organisational changes, greater personal and professional collaboration and GP education about RA.</p

Pathological findings in the red fox (Vulpes vulpes), stone marten (Martes foina) and raccoon dog (Nyctereutes procyonoides), with special emphasis on infectious and zoonotic agents in Northern Germany

Anthropogenic landscape changes contributed to the reduction of availability of habitats to wild animals. Hence, the presence of wild terrestrial carnivores in urban and peri-urban sites has increased considerably over the years implying an increased risk of interspecies spillover of infectious diseases and the transmission of zoonoses. The present study provides a detailed characterisation of the health status of the red fox (Vulpes vulpes), stone marten (Martes foina) and raccoon dog (Nyctereutes procyonoides) in their natural rural and periurban habitats in Schleswig-Holstein, Germany between November 2013 and January 2016 with focus on zoonoses and infectious diseases that are potentially threatening to other wildlife or domestic animal species. 79 red foxes, 17 stone martens and 10 raccoon dogs were collected from traps or hunts. In order to detect morphological changes and potential infectious diseases, necropsy and pathohistological work-up was performed. Additionally, in selected animals immunohistochemistry (influenza A virus, parvovirus, feline leukemia virus, Borna disease virus, tick-borne encephalitis, canine adenovirus, Neospora caninum, Toxoplasma gondii and Listeria monocytogenes), next-generation sequencing, polymerase chain reaction (fox circovirus) and serum-neutralisation analysis (canine distemper virus) were performed. Furthermore, all animals were screened for fox rabies virus (immunofluorescence), canine distemper virus (immunohistochemistry) and Aujeszky's disease (virus cultivation). The most important findings included encephalitis (n = 16) and pneumonia (n =20). None of the investigations revealed a specific cause for the observed morphological alterations except for one animal with an elevated serum titer of 1:160 for canine distemper. Animals displayed macroscopically and/or histopathologically detectable infections with parasites, including Taenia sp., Toxocara sp. and Alaria alata. In summary, wildlife predators carry zoonotic parasitic disease and suffer from inflammatory diseases of yet unknown etiology, possibly bearing infectious potential for other animal species and humans. This study highlights the value of monitoring terrestrial wildlife following the "One Health" notion, to estimate the incidence and the possible spread of zoonotic pathogens and to avoid animal to animal spillover as well as transmission to humans

Patients' experiences of living with and receiving treatment for fibromyalgia syndrome: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia syndrome (FMS) presents a challenge for patients and health care staff across many medical specialities. The aetiology is multi-dimensional, involving somatic, psychological and social factors. Patients' views were obtained to understand their experience of living with this long-term condition, using qualitative interviews.</p> <p>Methods</p> <p>12 patients were recruited and stratified by age, gender and ethnicity from one rheumatology outpatient clinic, and a departmental held database of patients diagnosed with FMS.</p> <p>Results</p> <p>Patients' accounts of their experience of FMS resonated well with two central concepts: social identity and illness intrusiveness. These suggested three themes for the analytical framework: life before and after diagnosis (e.g. lack of information about FMS, invisibility of FMS); change in health identity (e.g. mental distress, impact on social life) and perceived quality of care (e.g. lack of contact with nurses, attitudes of specialists). The information provided from one male participant did not differ from the female patients, but black and ethnic community patients expressed a degree of suspicion towards the medication prescribed, and the attitudes displayed by some doctors, a finding that has not been previously reported amongst this patient group. Patients expected more consultation time and effective treatment than they received. Subjective experiences and objective physical and emotional changes were non-overlapping. Patients' accounts revealed that their physical, mental and social health was compromised, at times overwhelming and affected their identity.</p> <p>Conclusion</p> <p>FMS is a condition that intrudes upon many aspects of patients' lives and is little understood. At the same time, it is a syndrome that evokes uneasiness in health care staff (as current diagnostic criteria are not well supported by objective markers of physiological or biochemical nature, and indeed because of doubt about the existence of the condition) and places great demands on resources in clinical practice. Greater attention needs to be paid to the links between the explanatory models of patients and staff, and most important, to the interrelationship between the complex physical, psychological and social needs of patients with FMS. Taking a less medical but more holistic approach when drawing up new diagnostic criteria for FMS might match better individuals' somatic and psycho-social symptom profile and may result in more effective treatment.</p