bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Smartphone-Based Video Directly Observed Therapy (vDOT) in Tuberculosis Care: Single-Arm, Prospective Feasibility Study
Authors: Holzman Samuel B , Atre Sachin , Sahasrabudhe Tushar , Ambike Sunil , Jagtap Deepak , Sayyad Yakub , Kakrani Arjun Lal , Gupta Amita , Mave Vidya , Shah Maunank
Published: October 2019

Background

India accounts for nearly one-quarter of the global tuberculosis (TB) burden. Directly observed treatment (DOT) through in-person observation is recommended in India, although implementation has been heterogeneous due largely to resource limitations. Video DOT (vDOT) is a novel, smartphone-based approach that allows for remote treatment monitoring through patient-recorded videos. Prior studies in high-income, low disease burden settings, such as the United States, have shown vDOT to be feasible, although little is known about the role it may play in resource-limited, high-burden settings.

Objective

The goal of the research was to assess the feasibility and acceptability of vDOT for adherence monitoring within a resource-limited, high TB burden setting of India.

Methods

We conducted a prospective, single-arm, pilot implementation of vDOT in Pune, India. Outcome measures included adherence (proportion of prescribed doses observed by video) and verifiable fraction (proportion of prescribed doses observed by video or verbally confirmed with the patient following an incomplete/unverifiable video submission). vDOT acceptability among patients was assessed using a posttreatment survey.

Results

A total of 25 patients enrolled. The median number of weeks on vDOT was 13 (interquartile range [IQR] 11-16). Median adherence was 74% (IQR 62%-84%), and median verifiable fraction was 86% (IQR 74%-98%). More than 90% of patients reported recording and uploading videos without difficulty.

Conclusions

We have demonstrated that vDOT may be a feasible and acceptable approach to TB treatment monitoring in India. Our work expands the evidence base around vDOT by being one of the first efforts to evaluate vDOT within a resource-limited, high TB burden setting. To our knowledge, this is the first reported use of vDOT in India.
The Preferences of Patients With Cancer Regarding Apps to Help Meet Their Illness-Related Information Needs: Qualitative Interview Study
Authors: Richards Rebecca , Kinnersley Paul , Brain Kate , Staffurth John , Wood Fiona
Published: October 2019

Background

The shift from inpatient to outpatient and community cancer care means that more patients with cancer need to manage their condition at home, without the direct supervision of their clinician. Subsequently, research has reported that many patients with cancer have unmet information needs during their illness. Mobile devices, such as mobile phones and tablet computers, provide an opportunity to deliver information to patients remotely. Before designing an app intervention to help patients with cancer to meet their information needs, in-depth qualitative research is required to gain an understanding of the views of the target users.

Objective

We aimed to develop an app intervention to help patients meet their illness-related information needs in noninpatient settings. This study explored the information needs of patients with cancer and their preferences for an app and desired app features. Specifically, the perceived acceptability of an app, desired app features, and the potential benefits and disadvantages of, and barriers to, an app were explored.

Methods

Qualitative, one-on-one semistructured interviews were conducted with patients with urological, colorectal, breast, or gynecological cancers (N=23) across two hospitals in South Wales. Interviews were audio-taped, transcribed, and analyzed using a thematic analysis.

Results

Findings indicated that barriers to information exchange and understanding in consultations, and identification of reliable information sources between consultations, appeared to contribute to patients’ unmet information needs. Consequently, app feature suggestions included a question prompt list, a glossary of cancer terms, a resources feature, and a contacts feature. Anticipated benefits of this type of app included a more informed patient, improved quality of life, decreased anxiety, and increased confidence to participate in their care. The anticipated barriers to app use are likely to be temporary or can be minimized with regard to these findings during app development and implementation.

Conclusions

This study highlights the desire of patients with cancer for an app intervention to help them meet their information needs during and between consultations with their clinicians. This study also highlights the anticipated acceptability and benefits of this type of intervention; however, further research is warranted.
A Smartphone App for Improving Clinical Photography in Emergency Departments: Comparative Study
Authors: Liu Chung-Hsien , Lin I-Chun , Lu Jui-Jen , Cai Dengchuan
Published: October 2019

Background

Digital photography is crucial for electronic medical records (EMRs), particularly for documenting dermatological diseases and traumatic wounds. In modern emergency departments (EDs), digital cameras are commonly used for photography, but the process is time-consuming. The problems of addressing patient privacy issues and that of interruptions and heavy workloads can cause archival errors when uploading photos. However, smartphones are widely available and cheap, so with a suitable app many errors could be mitigated.

Objective

The aim of this study is to design and test a smartphone app to improve the efficiency of clinical photography and improve patient privacy in the ED. The app is connected to the hospital information system to verify patient identification and enable archiving, and the app can automatically delete images after upload to the patient’s EMR.

Methods

This study enrolled 48 experienced ED nurses trained in clinical photography. Each nurse was first assigned a digital camera for photography and then a smartphone with the app preinstalled after it was launched. The time taken to upload images to a patient’s EMR was then recorded and the efficiency of the digital camera and app groups were compared.

Results

The average time taken to upload images to a patient’s EMR for the camera and app groups were 96.3 s (SD 19.3; P<.001) and 26.3 s (SD 4.7; P<.001), respectively.

Conclusions

The app effectively reduced processing time and improved clinical photography efficiency in the ED. Some issues of patient privacy in the camera group were revealed and resolved in the app group.
Amputees’ Attitudes Toward Participation in Amputee Support Groups and the Role of Virtual Technology in Supporting Amputees: Survey Study
Authors: Nathan Edward P , Winkler Sandra L
Published: October 2019

Background

Acquiring information about and living with an amputation (or limb differential) is a lifelong endeavor. Although medical institutions address the immediate medical needs of amputees, information regarding how to live life as an amputee is provided from numerous sources, one of which is amputee support groups.

Objective

This study aimed at understanding why amputees join support groups, leave support groups, and possibly return to support groups as well as how technology, specifically virtual reality, might play a role in supporting patients’ needs. The results are intended to provide data for support groups, to increase their impact on amputee participants.

Methods

A 38-item online survey was developed based on the findings of a previous randomized trial. The survey was administered between April and September 2018 and divided into four sections: Demographics, Limb Loss History, Amputee Support Group Participation, and Technology Usage. Items used multiple-choice, drop-down menu, check-box formats with explanation boxes for open-ended responses. Descriptive analyses were performed for both qualitative (open-ended questions) and quantitative data.

Results

Of the 59 amputees enrolled, 54 completed the survey. All the respondents were aged 20-39 years, and nearly half of the older respondents thought audio and video teleconferencing or avatar-based technology would increase participation in support groups. The results suggest that an early goal for amputees who join support groups is to focus on regaining mobility and functionality in order to return to their normal life. Once achieved, the goal transitions to one of social connection with other amputees, although there is a caveat: Simply being an amputee may not provide sufficient connections for developing long-term social relationships. The strongest reason for joining a support group was to learn about living with an amputation, followed by networking and learning new skills.

Conclusions

The results suggest four key takeaways regarding amputee participation in support groups: (1) the needs of participants in amputee support groups change over time; (2) meeting content needs to be relevant to agendas primarily driven by participants; (3) support group participation is also driven by the desire to increase functionality by developing skills, become familiar with prosthetic technology, have more than amputation in common with other participants, and participate at the designated meeting time and location; and (4) the use of technology should support patients’ needs.
Use of Web Conferencing Technology for Conducting Online Focus Groups Among Young People With Lived Experience of Suicidal Thoughts: Mixed Methods Research (Preprint)
Authors: Han Jin , Torok Michelle , Gale Nyree , Wong Quincy JJ , Werner-Seidler Aliza , Hetrick Sarah E , Christensen Helen
Published: October 2019

BACKGROUND

There is an increasing interest in engaging people with lived experience in suicide prevention research. However, young people with suicidal thoughts have been described as a “hard-to-include” population due to time, distance, stigma, and social barriers.

OBJECTIVE

This study aims to investigate whether conducting synchronous Web conferencing technology–based online focus groups (W-OFGs) is a feasible method to engage young people with lived experience of suicidal thoughts in suicide prevention research.

METHODS

Young people aged between 16 and 25 years and living in Sydney, Australia, were recruited through flyers, emails, and social media advertisements. The W-OFGs were established using a Web conferencing technology called GoToMeeting. Participants’ response rate, attendance, and feedback of the W-OFGs were analyzed to determine whether the W-OFG system is feasible for suicide prevention research. Researchers’ reflections about how to effectively implement the W-OFGs were also reported as part of the results.

RESULTS

In the pre–W-OFG survey, 39 (97.5%) young people (n=40) chose to attend the online focus group. Among the 22 participants who responded to the W-OFG invitations, 15 confirmed that they would attend the W-OFGs, of which 11 participants attended the W-OFGs. Feedback collected from the participants in the W-OFG and the post–W-OFG survey suggested that online focus groups are acceptable to young people in suicide prevention research. Considerations for selecting the Web conferencing platform, conducting the mock W-OFGs, implementing the risk management procedure, inviting participants to the W-OFGs, and hosting and moderating the W-OFGs as well as a few potential ethical and pragmatic challenges in using this method are discussed in this study.

CONCLUSIONS

The Web conferencing technology provides a feasible replacement for conventional methods, particularly for qualitative research involving vulnerable populations and stigmatized topics including suicide prevention. Our results indicate that this modality is an optimal alternative to engage young people in the focus group discussion. Future studies should compare the data collected from the Web conferencing technology and conventional face-to-face methods in suicide prevention research to determine if these two methods are equivalent in data quality from a quantitative approach.
The effectiveness of clinical pathway software in inpatient settings: A systematic review (Preprint)
Authors: Askari Marjan , Tam Jasmijn , van de Klundert Joris
Published: October 2019

BACKGROUND

Various studies have assessed the effectiveness of clinical pathways (CPs) and provided systematic evidence that CPs positively affect patient outcomes and efficiency of care, thus lowering costs. In recent years, clinical pathway implementation is often combined or extended with clinical pathway software (CPS). Until now, no systematic literature review appears to exist which synthesizes the evidence on the effectiveness of CPS, especially in relation to the CPs they support in inpatient settings.

OBJECTIVE

The purpose of this study was to systematically review evidence on (perceived) effectiveness of clinical pathway software (CPS) and investigate mechanisms explaining the effects of CPS implementation on outcomes.

METHODS

We searched MEDLINE via PubMed and Scopus, for English-language original articles. Articles were included if they examined the effectiveness and/or the perceived effectiveness of CPS in the inpatient setting. They were analyzed for evidence on structure, process and outcome effects, as well as for mechanisms explaining such effects in relation to contextual factors.

RESULTS

From 2904 articles, 12 studies met our inclusion criteria. The seven studies reporting on adherence provide conclusive evidence that CPSs can improve adherence levels. We also found conclusive evidence of improvement of processes focusing on appropriate diagnostics, timeliness of care, and LOS. Evidence on costs and outcomes is weak and/or less conclusive. This holds true both for patient outcomes (e.g. mortality/patient satisfaction) and for caregiver outcomes (e,g user satisfaction). The studies presented no direct evidence on mechanisms explaining how CPS relate to process and outcome improvements.

CONCLUSIONS

The primary effect of CPS to increase of adherence towards high levels may in turn positively impacts other processes indicators such as LOS, timeliness of care, and diagnostic effectiveness. Subsequent effects on costs, outcomes for patients, physicians and nurses remain inconclusive and call for further research. Further research should explicitly take context into account. The scarce and weak evidence-base relating CPS implementation project management to process and outcome effects needs development along the same lines.

CLINICALTRIAL

N.A.
External ambient cues to mediate the involvement of family caregivers in the management of older adults’ medications: a qualitative study (Preprint)
Authors: Rodríguez Marcela D. , Garcia-Vazquez Juan-Pablo , Andrade Angel G.
Published: October 2019

BACKGROUND

The most common reasons for the lack of adherence among older adults is the forgetfulness due to the multiple cognitive processes associated with prospective memory involved in remembering to follow a medication regimen. Problems with prospective memory increase the demands for care. Therefore, family members play an essential role in supporting patients in activities that involve: helping with medication adherence, transmitting knowledge about medications, and helping to refill their prescriptions. To address some of these medication problems, we designed a Medication Ambient Display (MAD) to support education, motivation, and measurement of medication-taking behaviors in older adults. The functionality of MAD consists of providing external cues to convey information through abstract and stylized representations of older adults’ medication adherence. Specifically, MAD is placed as a portrait in the elderly’s home. It shows a virtual birdcage to raise elders’ consciousness about their responsibility for caring for their health, in a similar way that they gladly take care of their pets

OBJECTIVE

This study aimed to assess the effect of MAD’s external cues on the involvement of family members in the management of medications for the elderly.

METHODS

We conducted a qualitative study consisting of semi-structured interviews with older adults and their relatives identified as informal caregivers. The study lasted ten (10) weeks. We visited participants weekly to collect data about: older adults’ medication problems, help received, and their perception about older adults’ medication adherence. The first five (5) weeks of the study was used to establish baseline data to understand the involvement of relatives on medication management activities. Afterward, we introduced MAD to be used for the successive five (5) weeks.

RESULTS

We found that new patterns of interaction among older adults and their relatives arose while using MAD. Participants perceived that MAD reinforced the care functions of family caregivers. For instance, it made them aware of older adults' medication adherence and encouraged youngest family members to help older adults.

CONCLUSIONS

We identified that the external cues provided through ambient displays did not overwhelm family members, but motivated their social connectedness with older adults. We conclude this paper with a set of lessons learned from this qualitative assessment, which may help designers to develop assistive technology for older adults.
REKONSTRUKSI KOTA KOLONIAL SALATIGA DAN KONTRIBUSI TEKNOLOGI GEOGRAPHICAL INFORMATION SYSTEM
Authors: Anwar Muh Khoirul
Published: October 2019

Salatiga City was located on the hillside of Merbabu Mountain and on highland has fresh air and cool climate. Salatiga City also located on the strategist area, reachable from Semarang, Solo, Ambarawa, and Magelang. Salatiga is very interesting for Europeans that live there in the Colonial Era. The implication for Modern Salatiga is to many historical buildings with classical European style in Salatiga. There is a well-preserved building, but also the same building was not preserved and destroyed. The historical building is a cultural heritage and national treasure that can be used for many good things, such as science or economics. To raise the awareness of the folk about historical buildings, we need to make publications and educate the folk about how important the historical building was. To get the publication material and education material was held historical research with a technical approach in a form of using Geographical Information System as research tools. As expected from this research can raise the awareness of the folks about how important the historical building.
An observational study of trait and state fatigue, and their relation to cognitive fatigability and saccade performance
Authors: Möller Marika C , Johansson Jan , Matuseviciene Giedre , Pansell Tony , Deboussard Catharina Nygren
Published: October 2019

Aim: Different fatigue measurements and their relation to saccadic functions were investigated in 15 patients with a mild traumatic brain injury (mTBI) and 15 orthopedic controls. Materials & methods: State fatigue was measured with the Fatigue Severity Scale and trait fatigue with the question on fatigue in the Rivermead Post Concussion Questionnaire and fatigability as decreased performance over time on a neuropsychological measure. Results: Patients with an mTBI scored significantly higher in state fatigue and showed more fatigability compared with the orthopedic controls. Among patients with mTBI, state fatigue correlated with prosaccade latency and cognitive fatigability, while trait fatigue correlated with anxiety and antisaccade latency and variability. Conclusion: This pilot study indicates that saccade measurements might, in the future, be useful in the understanding of fatigue and in the search for prognostic factors after mTBI.
Intervención educativa en embarazadas primigestas para disminuir la frecuencia de cesáreas
Authors: Torres Rodríguez Alicia Anai , Joanico Morales Baltazar , Salgado Jiménez María de los Ángeles , Juanico Morales Guillermina , Calderón Lozano Edith
Published: October 2019

Objetivo: evaluar el impacto de una estrategia educativa en mujeres primigestas para disminuir la frecuencia de cesáreas. Métodos: ensayo clínico no aleatorizado que se llevó a cabo de noviembre de 2017 a abril de 2018, en el Hospital General Regional no.1 Vicente Guerrero (hgr no. 1) del Instituto Mexicano del Seguro Social (imss) en Acapulco, Guerrero, México, en 172 mujeres primigestas de 18 a 35 años con embarazo de bajo riesgo. Se formaron dos grupos de 86 participantes cada uno. El grupo de intervención recibió información educativa sobre el trabajo de parto y las complicaciones asociadas a cesáreas injustificadas. Se realizó análisis de frecuencias simples y análisis bivariado. Se obtuvieron porcentajes y Riesgo Relativo (rr), así como intervalos de confianza y χ2. Resultados: la incidencia hospitalaria global de cesáreas fue de 32%, para el grupo control fue de 36% y en el grupo de intervención fue de 29%. Las pacientes mayores de 25 años tuvieron mayor riesgo de concluir su embarazo en cesárea (rr: 1.803). Conclusiones: implementar un programa de educación prenatal estandarizado podría tener un impacto positivo en la reducción de la incidencia de cesáreas.
Trastorno del espectro autista: una revisión para el médico de primer nivel de atención
Authors: Robles López Luis Ricardo , Hernández Barrios Laura Raquel , Peña Rosales Berenice , De la Rosa Arredondo Tania , Guadarrama Ortiz Parménides
Published: October 2019

El trastorno del espectro autista (tea) es un desorden del desarrollo complejo caracterizado principalmente por carencias en la comunicación y en la interacción social, así como por patrones de comportamiento, intereses o actividades repetidas y restrictivas. La prevalencia es mayor en niños. Se desconocen las causas exactas de las anomalías o irregularidades en las conexiones neuronales subyacentes a la enfermedad, pero etiológicamente el tea se considera un padecimiento multifactorial. Se han propuesto diferentes mecanismos fisiopatológicos para explicar las manifestaciones del trastorno, entre los que destaca una alteración en el balance de señales excitadoras e inhibidoras mediadas por el glutamato y el ácido gamma amino-butírico (gaba), respectivamente, en circuitos que controlan funciones cognitivas como la memoria y aprendizaje. El tratamiento del tea consiste en apoyo psicopedagógico y farmacológicos, cada caso debe ser individualizado. Esta revisión aborda aspectos relevantes de los mecanismos fisiopatológicos, características clínicas y terapéutica de este trastorno.
La autocita en artículos de investigación publicados en Scielo Chile: variación según el área de la ciencia y la experticia del autor
Authors: Meza Paulina , Ortega Gustavo
Published: October 2019

El objetivo de esta investigación fue describir el uso de la autocita en artículos de investigación publicados en Scielo Chile, de diversas áreas de la ciencia, escritos por autores con distintos niveles de experticia en el ámbito de las publicaciones científicas. A partir de una investigación inductivo-deductiva, analizamos un corpus de 182 artículos de cinco áreas de la ciencia, escritos entre 2010 y 2014 por autores noveles y consolidados. Entre los principales resultados destacamos que Humanidades lidera la frecuencia de uso de autocitación, mientras que Ciencias Médicas es la disciplina en la que la autocita es menos común. Esto podría atribuirse a que los autores de Ciencias Humanas requieren mayor difusión de sus trabajos, por lo que la autocita sería una forma simple y rápida para aumentar los índices de citación y la visibilidad de sus investigaciones. En cuanto al nivel de experticia, los autores más dados a autocitarse son los consolidados. En conclusión, creemos que la autocitación constituye una estrategia de posicionamiento del autor, ya sea para mostrar sus trabajos previos, evidenciar su línea investigativa, aumentar sus índices, lograr visibilidad o simple vanidad.
Matthew Vitz, A City on a Lake: Urban Political Ecology and the Growth of Mexico City
Authors: Soto Coloballes Natalia Verónica
Published: October 2019

Reseña sobre Matthew Vitz, A city on a lake: Urban political ecology and the growth of Mexico City, Durham, Duke University Press, 2018.
Thrombosis prevention in atrial fibrillation with concomitant cirrhosis: oral anticoagulation may not be worth the risks
Authors: Berschback Madeline
Published: October 2019

A critical appraisal and clinical application of Kuo L, Chao TF, Liu CJ, et al. Liver cirrhosis in patients with atrial fibrillation: Would oral anticoagulation have a net clinical benefit for stroke prevention? J Am Heart Assoc. 2017;6(6):e005307. doi: 10.1161/jaha.116.005307
Las avanzadas minero-auríferas en el macizo colombiano: conflicto, asociatividad y gobernanza del territorio
Authors: Cortés Landázury Raúl
Published: October 2019

Este trabajo muestra las formas de articulación de los actores sociales tras las incursiones mineras y el legado de las movilizaciones de protesta de la última parte del siglo XX (1990-2000) en el municipio de La Vega (Cauca, Colombia). Para ello, se usó el análisis documental junto a una encuesta que funge como herramienta de Análisis de Redes Sociales (ARS); se tipificaron los indicadores y valores esperados y se construyó el grafo correspondiente para rastrear el conflicto y la gobernanza. Al final se encontraron nuevas formas de tramitar el fenómeno con fuerte arraigo en las organizaciones campesinas y arreglos socio-céntricos que, si bien generan conocimiento mutuo, requieren de conexiones multiescalares que superen arreglos endogámicos virtuales.
La generación de empleo en 16 sociedades en postconflicto, implicaciones de política pública
Authors: Prieto Bustos William Orlando , Manrique Hernández Johanna Elizabeth
Published: October 2019

Este documento discute la generación de empleo como instrumento para la reinserción de la población víctima durante el posconflicto, a partir de la política pública. Se busca validar la hipótesis según la cual existen dos etapas: el fortalecimiento institucional y los ajustes económicos subsecuentes. Se basa en un modelo conceptual propuesto por el Banco Mundial para la implementación de alternativas sostenibles de paz y estudios de caso en los cuales se resalta la importancia de factores que contribuyen a la inclusión productiva de la población víctima, tales como: el fortalecimiento institucional, seguridad, inversión (social y en infraestructura), generación de capacidad individual y social, y mejora en el sistema educativo en búsqueda de impactos de largo plazo en el mercado de trabajo.
Financiamiento especulativo de la vivienda en Colombia: un análisis de la dinámica de los precios, 2000-2016
Authors: Cómbita Mora Gonzalo , Pérez Rodríguez Oscar Eduardo , Ramos Barrera María Gabriela
Published: October 2019

El presente trabajo estudia la dinámica de los precios de la vivienda en Colombia para el periodo 2000 a 2016. Se presentan los fundamentos teóricos no-convencionales para la determinación del precio, junto con dos estrategias cuantitativas: 1) un estudio descriptivo del mercado y la posible fragilidad financiera que ha permitido el incremento de los precios de la vivienda nueva; y 2) un modelo econométrico VEC que captura los determinantes de corto y largo plazo del precio. Se concluye que la dinámica del precio de la vivienda está influenciada por el crédito hipotecario y los costos de construcción, y presenta una fuerte relación de largo plazo entre el comportamiento actual y previo de los precios, evidentes en los escenarios financieros especulativos.
Premedical Student Exposure to Pharmaceutical Marketing: Too Much, Too Soon?
Authors: Keys Toby , Ryan Mark H. , Dobie Sharon , Satin David , Evans David V.
Published: October 2019

Background and Objectives: Direct pharmaceutical marketing to physicians by pharmaceutical representatives is effective in changing behavior of health care providers, resulting in less evidence-based prescribing. Although much has been written about pharmaceutical marketing exposures among medical students, less is known about direct marketing exposures before students matriculate. This study examined the types of pharmaceutical representative direct marketing exposures for premedical students and where they occurred.
Methods: From June to August of 2017, researchers surveyed students who accepted admission to US public medical schools. These prematriculated students completed our survey just prior to matriculation. The survey inquired about whether the students were exposed to pharmaceutical marketing directly from pharmaceutical salespeople, the types of marketing they observed or received, and where these interactions occurred.
Results: Survey participants included 911 prematriculated students from 14 of the 188 medical schools invited to participate. Seventy-one percent (646) of the participants received or observed someone receiving pharmaceutical marketing gifts, small meals or snacks, articles, or samples. The two most common contexts for direct pharmaceutical marketing exposures were during shadowing experiences (54%, 346) and during employment (50%, 323).
Conclusions: The findings suggest that it may be common for medical students to have interacted directly with pharmaceutical salespeople or observed other health professionals in these interactions before they matriculate in medical school. Because many of these interactions occur during clinical experiences required by institutions for admission, medical schools and premedical associations should consider delivering conflict-of-interest education early in medical school education or before students matriculate.
Identifying and Remediating Quality Issues at Clinical Teaching Sites: A CERA Clerkship Directors Survey
Authors: Drowos Joanna , Sairenji Tomoko , Watson Kristen Hood , Diaz Vanessa A. , Pinckney Jasmine , Cook Ronald , Chessman Alexander W.
Published: October 2019

Background and Objectives: Family medicine clerkship directors must secure an adequate number of teaching sites while maintaining or improving the quality of teaching. This survey details how family medicine clerkship directors identify community-based clinical sites with performance challenges, types of challenges, and whether a remediation option exists for struggling clinical sites or preceptors. This study also investigates the relationship between clerkship structure and problems with maintaining high-quality teaching sites.
Methods: Data were gathered and analyzed as part of the 2018 Council of Academic Family Medicine’s (CAFM) Educational Research Alliance (CERA) survey of family medicine clerkship directors.
Results: There was a significant relationship between ease/difficulty of identifying clinical sites and paying preceptors (P=.032). A lower proportion of sites where a system is in place for remediation reported it being difficult to identify clinical sites (70.0% vs 92.2%, respectively, P=.011). Having a remediation system in place was also associated with less removal of sites (2.5% removed three or more sites vs 25% removed three or more sites, respectively, P=.005).
Conclusions: Medical education leaders can explore payment to incentivize community-based preceptors in schools where identifying clinical sites is a challenge. Offering centralized preceptor development activities from medical schools, geared toward the importance of evaluations, balancing learners and opportunities for student engagement, may overcome some of the identified challenges. Medical schools may also consider providing additional time and support for clerkship directors to assist with tracking teaching quality at sites, and to assist struggling preceptors prior to removing them from teaching.
What Are the Characteristics of Fourth-Year Medical Students With Higher Levels of Resilience?
Authors: Park Sey , Porter Maribeth , Park Ki , Bielick Lauren , Rooks Benjamin J. , Mainous Arch G. , Datta Susmita , Carek Peter J.
Published: October 2019

Introduction: Burnout during medical training, including medical school, has gained attention in recent years. Resiliency may be an important characteristic for medical students to have or obtain. The aim of this study was to examine the level of resiliency in fourth-year medical students and whether certain characteristics were associated with students who have higher levels of resiliency.
Methods: Subjects were fourth-year medical students who completed a survey during a required end-of-year rotation. The survey collected subjects’ demographic information including age, gender, race, ethnicity, marital status, and chosen specialty. They were also asked to complete the Brief Resilience Scale (BRS) and answer questions that assessed personal characteristics.
Results: The response rate was 92.4%. Most respondents had personal time for themselves after school (92.6%), exercise or participate in physical activity for at least 30 minutes most days of the week (67.2%), were able to stop thinking about medical school after leaving for the day (58.2%), and had current financial stress (51.6%). No differences were noted in demographic information among students across specialty categories. A higher BRS score was associated with being male and having the ability to stop thinking about school.
Conclusions: BRS scores in medical students are associated with specific demographic characteristics and the ability to stop thinking about school. Addressing the modifiable activities may assist students with increasing their resiliency and potentially decreasing their risk of burnout.
A LITERATURA COMPARADA NO BRASIL
Authors: Bittencourt Gilda
Published: October 2019

Comparatism followed the steps of Brazilian literatureinvestigation even before the establishment of Comparative Literature as asistematic study, for it was a spontaneous practice which was present in thecritical essays by different scholars. Comparative Literature has beenintroduced in Brazilian University from the 30's onwards. The name ofAntonio Candido de Mello e Souza has contributed to its development andconsolidation, mainly through his renewed ideas of the concept of influence.His critical discourse was the starting point for the search of a decolonizedcomparativist model. The establishment of graduate courses in ComparativeLiterature on a regular basis has given a great impetus to the field in Brazil,producing in-depth studies which have shown the interliterary relationsthrough a new point of view, breaking with the tradicional concepts of debtsand influences. The ripening of Comparative Literature in Brazil can bemeasured by the creation of the National Association (ABRALIC) in 1986,and by the realization of four National Conferences.
O MODO DE NARRAR DO CONTO MACHADIANO: MACHADO, AVESSO DE POE
Authors: Flores da Cunha Patrícia Lessa
Published: October 2019

The purpose of the essay is to discuss the peculiarities of Machado de Assis' own way of writing up the short story as confronted with the issues formerly enunciated by Edgar A. Poe in his so-called "theory of the prose tale". In this respect, analogies and marks of differentiation with the Impressionism and its assumptions are searched out with the final aim of stating the very originality of Machado de Assis' mode of narration. The ideas from Ricardo Piglia's "Teses Sobre o Conto" are also indicated so that the mood of duplicity and ambiguity which is spread throughout Machado de Assis' short stories could succesfully be argued.
GUIMARÃES, Eduardo. Os limites do sentido: um estudo histórico e enunciativo da linguagem. Campinas, Pontes, 1995, 91p.
Authors: Zandwais Ana
Published: October 2019

Resenhado por Ana Zandwais
CARVALHAL, Tania Franco (org.). O discurso crítico na América Latina
Authors: Tiburski João
Published: October 2019

Resenhado por João Carlos Tiburski
UM NOVO OLHAR PARA O TEXTO DISCUTINDO A AVALIAÇÃO
Authors: Kauer Maria Alice , Favero Teresinha Oliveira
Published: October 2019

This article will present a research project that deals with theory and practice ofportuguese language teaching - PROPEL. The group investigates, among others subjects,criterias usually used in valuation process of pupil's texts at school. It will be related anexpierence realized with two different groups: the first group consists of 42 professionalteachers of a public school at Porto Alegre/ Rio Grande do Sul; the second group is compoundof 28 scholars of the University of Rio Grande do Sul/Brasil who will be teachers very soon.The searchers have two goals with this expierence: 1º) they want to know how much linguisticsknowledge affects the process; 2º) they have interess too in knowing what kind of expectationdo the teachers have about theirs pupil productions.
LES LIMITES DE LA GRAMMAIRE
Authors: Auroux Sylvain
Published: October 2019

Neste artigo, o autor perpassa o pensamento humano sobre a linguagem - suanatureza, estrutura e funcionamento - e aponta, em cada modelo lingüístico, seus limites. Comisso, conclui que, qualquer que seja a gramática por eles construída, em determinadomomento, ela se mostrará inadequada para explicar fenômenos produzidos pelos sujeitosfalantes, fazendo-se, assim, necessário pensar uma outra gramática que seja capaz de explicálos,determinando, pois, a elaboração de um novo modelo.
MAYER, Marc; MIRÓ, Mònica; VELAZA, Javier. Litterae in titulis, tituli in litteris. Elements per a l'estudi de la interacció entre Epigrafia i Literatura en el món romà. Barcelona, Edicions Universitat de Barcelona, 1998. 104p.
Authors: Funari Pedro Paulo
Published: October 2019

MAYER, Marc; MIRÓ, Mònica; VELAZA, Javier. Litterae in titulis, tituli in litteris.Elements per a l'estudi de la interacció entre Epigrafia i Literatura en el món romà.Barcelona, Edicions Universitat de Barcelona, 1998. 104p.Resenhado por: Pedro Paulo A. Funari
O DISCURSO PROFÉTICO: CONDIÇÕES DE FORMAÇÃO DAS RELAÇÕES HEGEMÔNICAS ENTRE O POVO JUDEU, A PARTIR DE ENUNCIAÇÕES DO VELHO TESTAMENTO
Authors: Zandwais Ana
Published: October 2019

Theory of Enunciation researches can explain questions concerning theroles of subjectivity in language, as well as descontinuities found betweendiscoursive and linguistic objects. In this paper we analyse the formativeconditions of the Jewish social hegemony, by investigating an historical discoursetaken from the Old Testament: a profecy against the king Jeroboam (Book of theKings). Considering the intersection of voices in statements of discourse and thecathegories of distance, opacity, tension and modality, we try to describe how theeffects of senses produced by that voices can represent relations of power in theancient Jewish society.
À PROPOS DE ON EN FRANÇAIS: RESTRICTIONS DISCURSIVES ET INTERPRÉTATION
Authors: Mazière Francine
Published: October 2019

A análise do discurso, em sua exigência de leitura da história, apoia-sesobre a língua. Este trabalho questiona diacronicamente a constituição dainterpretação lexical do pronome on, em francês, através de sua fixação morfosemânticae discursiva nos primeiros dicionários. Analisando os discursos sobreon e os discursos produzidos com on, percebe-se uma semantização histórica dapartícula, legível no dicionário, instrumento lingüístico cujo objeto não seja,talvez, a língua da gramática, mas a da normatividade cultural.
PRECONCEITO E SEPARATISMO NO DISCURSO: UM DISCURSO SEPARATISTA GAÚCHO
Authors: De Barros Diana Luz Pessoa
Published: October 2019

Ce texte examine la construction du récit et du discours séparatiste, àpartir de la théorie sémiotique. On analyse surtout le chapitre 10 “O país dosgaúchos - Manifesto do povo gaúcho”, du livre d’Irton Marx, Vai nascer um novopaís: República do Pampa Gaúcho. D’après l’analyse du texte, on peut conclureque le discours séparatiste se présente comme un discours raciste, à double sens.Le discours séparatiste s’appuie sur le discours du racisme communautairecontemporain (de la différence) et aussi sur le racisme universaliste oudiscriminatoire (de l’inégalité ou de la supériorité), qui a présidé à la formationdes empires coloniaux ou des systèmes d’esclavage.
ENGANO E DESENGANO: OS TEXTOS DA IRONIA NA FÁBULA
Authors: Lopes Edward , Trigo Helenice
Published: October 2019

This article shows us the fable as a manipulation discourse, embeddingthree texts: a) a deceptive text, settled up by a polemic dialogue between theaddresser (a trickster) and the addressee of a verbal manipulation; b) an ironictext, which — concerning the narrator and/or the manipulated actant viewpoint —operates the countermanipulation of the deceptive text (a), by means of both a“desmythical” discourse (the deception revealed) and of a “ridicularization”process (the laughing negative sanction provoked by the deception exhibition): atlast, c) an exemplar text which provides a sort of moralization to the story told by(a) plus (b) — and by doing so converts itself in the starting point to a new processof manipulation: of the fable readers now.
O AMOR MUDOU DE ENDEREÇO: UMA ANÁLISE DAS TRANSFORMAÇÕES DO CONCEITO DE AMOR NO DISCURSO CINEMATOGRÁFICO
Authors: Duarte Elizabeth Bastos
Published: October 2019

Dans ce travail l’auteur fait une analyse sémiotique destransformations, du point de vue narratif, du concept d’amour, pedant ce siècle. Lecorpus appartient au discours cinématographique sonore, découpé par desdécades. L’interprétation de ces transformations a été faite en utilisant des apportsinterdisciplinaires provenant de la philosophie, de la psycanalyse et de lasociologie.
O TEXTO: CONSTRUÇÃO DE SENTIDOS
Authors: Koch Ingedore
Published: October 2019

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Apresentação
Authors: Kreiger Maria Da Graça
Published: October 2019

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UNIDADES FRASEOLÓGICAS ESPECIALIZADAS: NOVAS PERSPECTIVAS PARA SUA IDENTIFICAÇÃO E TRATAMENTO
Authors: Bevilacqua Cleci Regina
Published: October 2019

This paper presents Specialised Phraseologic Units, within the framework of theTerminology’s Communicative Theory (TCT) proposed by Cabré (1998, 1999). First, we will brieflyintroduce the basic theoretic principles of this theory; we will then discuss the implications of theiracceptance for the analysis and treatment of specialised phraseology. Finally, we will mention some ofthe consequences of this new approach for terminological research in the context of Mercosul.
PENSAR LA NARRATIVA LATINOAMERICANA
Authors: Bolanos Aimée Gonzalez
Published: October 2019

With two main questions in mind - «the hegemonic tendencies of theLatin-American narrative in its relationship with the high modernity culture» and«the development of the Latin America narrative poetics in its modernization process,from the late 20’s to our times» - this paper intends to offer a diacronic vision ofnarrative, searching the key-points for a reflexive interpretation of the polemicaltopic of our identity in writing. Confrontations, confluences, opening to the world,renewed humanism are references to this discussion, specifically focused on the roleof Brazilian narrative in Latin-American narrative system.
OS HETERÔNIMOS (POSSÍVEIS) EM MACHADO DE ASSIS
Authors: Coelho Robson
Published: October 2019

“This paper when considering Man’s manifestations, Author and Narrator,in Machado de Assis, intends to verify them as ethical-aesthetic components. Suchcomponents, articulate, expose the base of the production literary machadiana andthey reveal an implicit intention of, more than to write to the people, to inform themabout the real world in that live.”
MACHADO DE ASSIS: “UMA EXCURSÃO MILAGROSA”
Authors: Salomoni Rosane Saint-Denis
Published: October 2019

The purpose of this work is to present a view about Machado’s shortstory “O país das Quimeras”, that was rewrote few years later as “Uma excursãomilagrosa” and reveal some aspects of the narrative that includes narrator’s strategiesand his characteristics. I also established hipertextual relations according to evidencessupported by Machado’s way of writing
POESIA, HISTÓRIA E RAZÃO CRÍTICA: DE ITABIRA PARA O VASTO MUNDO
Authors: Sapiecinski Marlise
Published: October 2019

Dans l’ouvre de Carlos Drummond de Andrade, poésie, histoire et raisoncritique s’entremêlent et donnent le ton d’une lyrique profondément refléchie, qui, àses meilleurs moments, comme c’est le cas dans Claro Enigma (1951), a atteint l’unionharmonieuse entre la raison et la sensibilité. Comme le savait déjà Aristote, l’intuitionpoétique, bien qu’elle corresponde à un mode sui generis d’appréhension du monde– qui exige, évidemment, une attitude qui ne peut être à peine intellectuelle -, nerépond pas à une modèle d’habilité étrangère à l’homme – d’inspiration divine, commedisait Platon, non sans ironie – mais comprend sa dose particulière de raison enagissant conformément à la sensation. Toutes les deux reposent, par conséquent, surune base à la fois affective et intellectuelle. Irrémédiablement seul, et en même tempsolidaire de toutes les créatures, toujours réticente par rapport à la communicabilitéde l’expérience poétique: voici le grand conflit réfléchit dans tout son art. C’est dansce conflit que s’instaure et s’étend, de différentes manières, dans toute sa trajectoire,le profond “sentiment social” de sa poésie.
ALINHAVOS PARA UMA COSTURA: “BOITEMPO”
Authors: Souza Raquel
Published: October 2019

The autobiographical poetry of Carlos Drummond de Andrade, the threevolumes os Boitempo, Boitempo II (the old boy) and Boitempo III (forget to remember),point to the moderns autobiographic person constitution as a dialectical tensionbetween the contraries. Following the oximoro the poet builds his possiblesidentities to arrive at the self knowledge.
VILA RICA: A EPOPÉIA DAS MINAS
Authors: Stroparo Sandra Mara
Published: October 2019

Cláudio M. da Costa a écrit en 1772 un long poème intitulé “Vila Rica”.Avec des prétensions épiques, l’auteur s’étend sur des références historiques et insistesur la documentation, soit dans une longue introduction, soit dans des nombreusesnotes ajoutées au texte. À la fin du XVIIIème, quand l’Histoire n’avait pasencore un discours autonome, le poète finit par construire un texte ambigu qui offre,cependant, l’intuition d’une identité.
CLÁUDIO OU A DIALÉTICA DO BUCOLISMO
Authors: Sarmatz Leandro
Published: October 2019

This is a reading on Cláudio Manuel da Costa’s sonnets which aims atdetecting tensions between culture and rusticity, tradition and lack of history. It intendsto unfold the idea of a “Brazilian bucolic” - retake of the historical patrimonyto trace the limits of the New World tradition - the interior of Cláudio Manoel daCosta´s poetry.
ONDULAÇÕES DA FICÇÃO PORTUGUESA PÓS-74: A RENOVAÇÃO DA LITERATURA DE SARAMAGO
Authors: Remédios Maria Luíza
Published: October 2019

This essay is centered on José Saramago’s novel História do cerco deLisboa (1989). It discusses the clear approximation and the intermingling of historyand fiction, pointing out the dialectic process of this mimetic relationship. In order todo so, the novelist makes use of resources such as alterity, intertextuality andmetafiction, revealing the text’s literariness as poetic work on discourse.
VARIAÇÃO NO USO DO INFINITIVO PESSOAL
Authors: Gorski Edair
Published: October 2019

This paper investigates the variable use of the infinitive in oralBrazilian Portuguese considering both the verb morphology and the formalrepresentation of the subject. The analysis of sociolinguistic interviews shows thatthe speakers prefer both the non-finite verb form of the infinitive (92%) and nosubject expressed (71%). These results display a tendency for a regularization ofthe infinitive as an impersonal form. Empirical results also point out a correlationbetween finite verb form and formal representation of the subject, which are highlymarked constructions. The independent variables subject coreferentiality, semantic(in)determination of the subject and syntactic coding of the clause are statisticallysignificant for the expression of the subject.
LEANDRO FERREIRA, Maria Cristina. Da ambigüidade ao equívoco: da resistência da língua nos limites da sintaxe e do discurso. Porto Alegre, Ed. da UFRGS, 2000, 126p.
Authors: Souza Pedro
Published: October 2019

LEANDRO FERREIRA, Maria Cristina. Da ambigüidade ao equívoco: daresistência da língua nos limites da sintaxe e do discurso. Porto Alegre, Ed. daUFRGS, 2000, 126p.Resenhado por: Pedro de Souza