Getting into bed with Les misérables : a study of the symbolism(s) of the bed

While Victor Hugo\u27s Les Miserables remains enormously popular and has received great critical interest, one important and abundant symbolic component has been inexplicably neglected: the bed. This thesis examines the plurality of meanings that the bed evokes, traditionally, and its multiple functions as a repository of human dignity and well-being, in particular. The thesis consists of three parts corresponding to the logical pairings of six principle symbolisms of the bed, each of which is examined for its connection with the conception and portrayal of human suffering in this novel. In general, the absence of the bed both reflects and perpetuates physical, emotional and moral distress, while its presence testifies to and aids in the survival of humanity

Catalog of occupational literature

Includes bibliographical references.We live today in a world of specialization. Untrained workers have lees and less Job opportunities offered to them.1 Children build their ideals, patterns, goals and life dreams in their early years and need to be guided and assisted to find adequate, satisfying and wise occupational goals. In the world of stories and books a child can visit many occupational fields in a rather short time. He can explore one job, change his mind, look at another, and continue to investigate many as different interests call. The early years is the time to begin this for in our times many need to use high school years for specific job preparation and training.2 The counselor faces the problem of a lack of information about books that give a picture of specific occupations. Not just information about the requirements of education and training needed. Today students ask many other things. "What are the salary possibilities?" "What kind of home will I have and under what conditions will I be living?" "Will I have adequate vacations?" "Will I enjoy the work?" "Will I have fun and excitement on the Job?" These questions and many more are voiced or thought as the student seeks help from the counselor. 1. Walter James Greenleaf. Occupations and Careers, (New York, 1955), p. 94. 2. Mildred A. Davey, Elizabeth M. Smith, and Theodore R. Myers, Occupations. (Boston, 1950), p. 8.M.S. (Master of Science

Gamified learning for resuscitation education: A systematic review.

AIM To systematically review published literature to evaluate the impact of gamified learning on educational and clinical outcomes during life support education. METHODS This systematic review was conducted as part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). A search of PubMed, Embase, and Cochrane was conducted from inception until February 12, 2024. Studies examining incorporation of gamified learning were eligible for inclusion. Reviewers independently extracted data on study design and outcomes; appropriate risk of bias assessment tools were used across all outcomes. RESULTS 2261 articles were identified and screened, yielding sixteen articles (seven randomized trials, nine observational studies) which comprised the final review. No meta-analyses were conducted due to significant heterogeneity of intervention, population, and outcome. Only one study was found to have a low risk of bias; the remaining studies were found to have moderate to high risk. Fourteen studies were in healthcare providers and two were in laypersons. Most studies (11 of 16) examined the impact of a digital platform (computer or smartphone). Most (15 of 16) studies found a positive effect on at least one educational domain; one study found no effect. No included study found a negative effect on any educational domain. CONCLUSION This systematic review found a very heterogeneous group of studies with low certainty evidence, all but one of which demonstrated a positive effect on one or more educational domains. Future studies should examine the underlying causes of improved learning with gamification and assess the resource requirements with implementation and dissemination of gamified learning

The Murmur Online Learning Experience (MOLE) Curriculum Improves Medical Students\u27 Ability to Correctly Identify Cardiac Murmurs.

Introduction: Physical examination skills are receiving less attention in curricula and clinical practice, being supplanted by imaging and other technologies. We developed an online module to introduce auscultation of common cardiac murmurs to second-year medical students. Methods: The Murmur Online Learning Experience (MOLE) curriculum focused on nine common, unique, or highly testable cardiac murmurs, chosen collaboratively by the authors. The curriculum consisted of (1) a nine-item multiple-choice pretest containing a clinical vignette, a photo of stethoscope location, and an auditory clip; (2) nine modules each containing a several-minute-long auditory clip and a written description (location, quality, radiation, change with exam maneuvers); and (3) a nine-item multiple-choice posttest, identical to the pretest but randomly ordered. All second-year medical students at the University of Louisville were given access to MOLE during their cardiovascular curriculum and given an incentive to complete the ungraded activity. Results: One hundred forty-seven (91.8%) students voluntarily completed the pretest and posttest. The mean pretest score was 3.76 out of 9 ( Discussion: An online murmur curriculum consisting of repetitive auditory murmurs and narrative description of murmurs improved second-year medical students\u27 ability to correctly identify common cardiac murmurs. This method of learning murmurs via online curriculum is a practical and effective way to hone students\u27 physical exam skills in the modern era

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial

On July 1, 2011, the Accreditation Council for Graduate Medical Education implemented further restrictions of its 2003 regulations on duty hours and supervision. It remains unclear if the 2003 regulations improved trainee well-being or patient safety. To determine the effects of the 2011 Accreditation Council for Graduate Medical Education duty hour regulations compared with the 2003 regulations concerning sleep duration, trainee education, continuity of patient care, and perceived quality of care among internal medicine trainees. Crossover study design in an academic research setting. Medical house staff. General medical teams were randomly assigned using a sealed-envelope draw to an experimental model or a control model. We randomly assigned 4 medical house staff teams (43 interns) using a 3-month crossover design to a 2003-compliant model of every fourth night overnight call (control) with 30-hour duty limits or to one of two 2011-compliant models of every fifth night overnight call (Q5) or a night float schedule (NF), both with 16-hour duty limits. We measured sleep duration using actigraphy and used admission volumes, educational opportunities, the number of handoffs, and satisfaction surveys to assess trainee education, continuity of patient care, and perceived quality of care. RESULTS The study included 560 control, 420 Q5, and 140 NF days that interns worked and 834 hospital admissions. Compared with controls, interns on NF slept longer during the on call period (mean, 5.1 vs 8.3 hours; P = .003), and interns on Q5 slept longer during the postcall period (mean, 7.5 vs 10.2 hours; P = .05). However, both the Q5 and NF models increased handoffs, decreased availability for teaching conferences, and reduced intern presence during daytime work hours. Residents and nurses in both experimental models perceived reduced quality of care, so much so with NF that it was terminated early. Compared with a 2003-compliant model, two 2011 duty hour regulation-compliant models were associated with increased sleep duration during the on-call period and with deteriorations in educational opportunities, continuity of patient care, and perceived quality of care