Language acquisition: hesitations in the question/answer dialogic pair / Aquisição da linguagem: hesitações no par dialógico pergunta/resposta

PURPOSE: (1) To verify the existence (or not) of hesitation marks in the beginning of utterances in children's discourse; and (2) to determine to what extent the presence/absence of these marks could be explained by retrievable facts in the production conditions of their discourses. METHODS: Interview situations with four children aged 5-6 years attending Kindergarten level II in a public preschool at the time of the data collection were analyzed. The interviews were recorded on audio and video, inside a soundproof booth, with high fidelity equipment. Afterwards, the recordings were transcribed by six transcribers that were specially trained for this task. Transcription rules that prioritized the analyses of hesitations were used. For the analysis of retrievable facts in the production conditions of children's discourse, the dialogic pair question-answer was adopted. RESULTS: A correlation between presence/absence of hesitation in the beginning of utterances in children and type of question (open/closed) made by the collocutor was observed. When the question was closed ended, the utterances were preferably initiated without hesitation marks, and when the question was open ended, the utterances were preferably initiated with hesitation marks. CONCLUSION: The presence/absence of hesitation marks in the beginning of utterances in children was found to be dependent on the production conditions of their discourses. .

OBJETIVOS: (1) Verificar a existência (ou não) de marcas hesitativas no início de enunciados no discurso de crianças; e (2) verificar em que medida a presença/ausência dessas marcas se explicaria por fatos recuperáveis na produção de seus discursos. MÉTODOS: Foram analisadas situações de entrevistas de quatro crianças com 5-6 anos de idade que frequentavam o nível II de uma escola pública de Educação Infantil na época da coleta dos dados. As entrevistas foram gravadas, em áudio e em vídeo, no interior de uma cabine acústica, com material de alta fidelidade. Posteriormente, as gravações foram transcritas por seis transcritores treinados para essa tarefa. Foram utilizadas normas de transcrição que priorizavam a análise das hesitações. Para a análise de fatos recuperáveis das condições de produção dos discursos das crianças, foi adotado o par dialógico pergunta-resposta. RESULTADOS: Foi observada correlação entre presença/ausência de hesitação em início de enunciados das crianças e tipo de pergunta (aberta/fechada) feita pelo interlocutor. Quando a pergunta era do tipo fechada, os enunciados iniciaram-se, preferencialmente, sem marca hesitativa; já quando a pergunta era do tipo aberta, os enunciados iniciaram-se, preferencialmente, com marcas hesitativas. CONCLUSÃO: A presença/ausência de marcas hesitativas em início de enunciados das crianças mostrou-se como dependente das condições de produção de seus discursos. .

Explanatory digital video disc with patients undergoing diagnostic cardiac catheterization / Digital video disc explicativo em pacientes submetidos ao cateterismo cardíaco diagnóstico / Disco digital explicativo para pacientes sometidos al cateterismo cardiaco diagnóstico

The aim of this study was to evaluate knowledge of patients before outpatient diagnostic cardiac catheterization after viewing an explanatory Digital Video Disc, in a cardiology reference hospital. This cross-sectional study was carried out with patients undergoing their first cardiac catheterization and was performed from May to June 2009 in the hemodynamic sector. An instrument was used with questions (12) regarding the patients' understanding of the procedure. The intervention was a five-minute video prepared by the researchers. The sample was composed of 94 patients, divided into an intervention group (45) and a control group (49), with a mean age of 55±9 years and predominantly male. The patients of the IG had a higher rate of correct answers (74.6±17.1) compared to the CG (31.6±18.8), P=.000. The results demonstrated the efficacy of the presentation of a guidance video for patients undergoing a hemodynamic procedure.

O objetivo deste estudo foi avaliar o conhecimento dos pacientes pré-cateterismo cardíaco com diagnóstico ambulatorial, após digital video disc explicativo, em um hospital de referência em cardiologia. Usou-se o estudo transversal como metodologia, com pacientes submetidos ao primeiro cateterismo cardíaco, realizado de maio a junho de 2009, no setor de hemodinâmica. Foi utilizado instrumento com questões (12) referentes ao entendimento dos pacientes sobre o procedimento. A intervenção foi um vídeo com duração de cinco minutos, elaborado pelos pesquisadores. A amostra foi constituída por 94 pacientes, divididos em grupo intervenção-GI (45) e grupo controle-GC (49), com idade média de 55±9 anos e predominância do sexo masculino. Pacientes do GI apresentaram maior índice de acertos (74,6±17,1), quando comparados ao GC (31,6±18,8), p=0,000. Pode-se concluir, por meio dos resultados, que houve eficácia da apresentação de um vídeo de orientações para pacientes submetidos ao procedimento hemodinâmico.

El objetivo de este estudio fue evaluar el conocimiento de los pacientes sometidos a cateterismo cardiaco tipo diagnóstico en ambulatorio después de ser presentado un DVD explicativo, en un hospital de referencia en cardiología. Se trata de un estudio transversal, con pacientes sometidos al primer cateterismo cardiaco, realizado de mayo a junio de 2009, en el sector de hemodinámica. Fue utilizado un instrumento con 12 preguntas referentes a la atención de los pacientes sobre el procedimiento. La intervención fue un vídeo con duración de cinco minutos elaborado por los investigadores. La muestra constituida de 94 pacientes, fue dividida en grupo intervención (45) y grupo control (49); la edad promedio fue de 55±9 años con predominancia del sexo masculino. Los pacientes del GI presentaron un mayor índice de aciertos (74,6±17,1), cuando comparados al GC (31,6±18,8), P=0,000. Los resultados demostraron la eficacia de la presentación de un vídeo de orientaciones para pacientes sometidos al procedimiento hemodinámico.

Efeito na Ressuscitação Cardiopulmonar utilizando treinamento teórico versus treinamento teórico-prático / Effects of the use of theoretical versus theoretical-practical training on Cardiopulmonary Resuscitation / Efecto en la Resucitación Cardiopulmonar utilizando entrenamiento teórico versus entrenamiento teórico-prático

FUNDAMENTO: O conhecimento teórico e a habilidade de realizar ressuscitação cardiopulmonar (RCP) de qualidade são essenciais para a sobrevida do paciente vítima de morte súbita. OBJETIVO: Determinar se o ensino apenas teórico é capaz de promover o ensino da RCP de boa qualidade e conhecimento em profissionais da área da saúde comparado com curso teórico-prático de suporte básico de vida. MÉTODOS: Vinte enfermeiras voluntárias participaram do treinamento teórico de RCP e desfibrilação externa automática (DEA) utilizando aula teórica e vídeo usado nos cursos de Suporte Básico de Vida da American Heart Association (BLS-AHA; grupo A). Foram comparadas com 26 alunos profissionais da saúde que participaram de um curso regular teórico-prático de BLS-AHA (grupo B). Após os cursos, os participantes foram submetidos à avaliação teórica e prática como recomendado nos cursos do BLS-AHA. As avaliações práticas foram gravadas e posteriormente pontuadas por três instrutores experientes. A avaliação teórica foi um teste de múltipla escolha usada nos cursos regulares do BLS-AHA. RESULTADOS: Não houve diferença na avaliação teórica (p = ns), entretanto a avaliação prática foi consistentemente pior no grupo A, evidenciado pelos três examinadores (p < 0,05). CONCLUSÃO: A Utilização de vídeos de RCP e aulas teóricas não melhoraram a capacidade psicomotora em realizar RCP de boa qualidade, entretanto pode melhorar a capacidade cognitiva (conhecimento). Áreas críticas de atuação são o ABCD primário e o correto uso do DEA.

BACKGROUND: Theoretical knowledge and skill to perform good quality cardiopulmonary resuscitation (CPR) are essential for the survival of patients with sudden death. OBJECTIVE: To determine whether a theoretical course alone is sufficient to promote good quality CPR training and knowledge for health professionals in comparison to a theoretical-practical basic life support training. METHODS: Twenty volunteer nurses participated in the theoretical CPR and automated external defibrillation (AED) training by means of a theoretical class and video used in the Basic Life Support Training of the American Heart Association (BLS-AHA; group A). They were compared to other 26 health professionals who attended regular theoretical-practical BLS-AHA training (group B). After the training, the participants took theoretical and practical tests as recommended in BLS-AHA courses. The practical tests were recorded and were later scored by three experienced instructors. The theoretical test was a multiple choice test used in regular BLS-AHA courses. RESULTS: No difference was observed in the theoretical tests (p = ns). However, the practical tests were consistently worse in group A, as evaluated by the three examiners (p < 0.05). CONCLUSION: The use of CPR videos and theoretical training did not improve the individuals' psychomotor ability to perform good quality CPR; however, it may improve their cognitive ability (knowledge). Critical areas of intervention are the primary ABCD and the correct use of AED.

FUNDAMENTO: El conocimiento teórico y la habilidad de realizar resucitación cardiopulmonar (RCP) de calidad son esenciales para la sobrevida del paciente víctima de muerte súbita. OBJETIVO: Determinar si la enseñanza sólo teórica es capaz de promover la enseñanza de la RCP de buena calidad y conocimiento en profesionales del área de salud comparado con curso teórico-práctico de soporte básico de vida. MÉTODOS: Veinte enfermeras voluntarias participaron del entrenamiento teórico de RCP y desfibrilación externa automática (DEA) utilizando clase teórica y video usado en los cursos de Soporte Básico de Vida de la American Heart Association (BLS-AHA; grupo A). Fueron comparadas con 26 alumnos profesionales de la salud que participaron de un curso regular teórico-práctico de BLS-AHA (grupo B). Después de los cursos, los participantes fueron sometidos a evaluación teórica y práctica como es recomendado en los cursos del BLS-AHA. Las evaluaciones prácticas fueron grabadas y posteriormente puntuadas por tres instructores experimentados. La evaluación teórica fue un test de multiple choice usado en los cursos regulares del BLS-AHA. RESULTADOS: No hubo diferencia en la evaluación teórica (p = ns), mientras tanto la evaluación práctica fue consistentemente peor en el grupo A, evidenciado por los tres examinadores (p < 0,05). CONCLUSIÓN: La utilización de videos de RCP y aulas teóricas no mejoraron la capacidad psicomotora para realizar RCP de buena calidad, en cambio puede mejorar la capacidad cognitiva (conocimiento). Áreas críticas de actuación son el ABCD primario y el correcto uso del DEA.

[Comparative study of the effects of education using VCD and booklet in two different times on pre-operative anxiety]

Nowadays, CABG is classified among the most common and risky surgeries. Since heart is a vital organ, patients confronting this kind of surgery, experience more anxiety than the patients having other surgeries. The purpose of this study was to determine the effects of education using VCD and booklet on pre-operative anxiety of CABG candidates in two different times, in Tehran Heart Center-year 2006. In this clinical trial study, one hundred and twenty 45-65 years old CABG candidates were recruited consecutively and randomly assigned in 4 groups, each including 30 patients. All patients completed demographic data sheet and Spiel Berger questionnaire in their admission day and the day of surgery. Every other one patient assigned in two groups of education either by VCD or booklet one day before surgery. After completing patient in two group and one week pause, this procedure was repeated for two other groups of education 6 days before surgery. The findings showed that state and trait anxiety of 4 studied groups reduced after education, when compared with pre-education time. The results of analysis of variance [ANOVA] indicated a statistically significant difference between means of state anxiety before and after education in 4 group [P= 0.004]. Scheffe test indicated that education using VCD, 6 days before surgery has had the most effect and meanwhile, education using booklet, 6 day before surgery has had the least effect on reducing the state anxiety of participants. Regarding the results of this study, education using VCD, 6 days before CABG and booklet, one day before CABG has the most effect on reducing pre-operative anxiety

Demonstration of nasogastric intubation using video compact disc as an adjunct to the teaching processes.

BACKGROUND: An in-house produced video compact disc (VCD) demonstrating nasogastric intubation was introduced to the medical curriculum at Buddhachinaraj Hospital, Clinical Teaching Centre, Phitsanulok in 2005. OBJECTIVE: The present study aimed to qualitatively evaluate the effect of the VCD on our medical students' procedural skills. MATERIAL AND METHOD: The 6th year medical students were randomly allocated into two groups; one group viewed the VCD (test, n = 30), and the other group did not (control, n = 31). After 2 months, the authors examined all students by asking them to perform the procedure using a manikin and a checklist. The examiners were blind to the allocations at the time of examination. Unpaired t-tests and Chi-square tests were used Data are expressed as mean and SD. RESULTS: Total checklist's score was 20. There was no diference in terms of age or gender between the two groups. Thirty of 61 medical students who had watched the VCD got an average score of 15.9 +/-1.86, while the control group's average score was 13.2+/-1.94. Statistical analyses showed that the difference was significant (p < 0.0001). CONCLUSION: The medical students were able to self-improve their procedural skills of nasogastric intubation after viewing the VCD. Application of this method to other basic procedures may be useful.