Using Math Vocabulary Building to Increase Problem Solving Abilities in a 5th Grade Classroom

In this action research study of my 5th grade mathematics class, I investigated how students’ understanding of math vocabulary impacts their understanding of the curriculum. I discovered math vocabulary plays an important role in a student’s ability to understand daily lessons, complete homework, discuss ideas in groups, take tests and be successful on achievement tests. A student’s ability to understand the words around him (or her) in math class seem very related to his or her ability to solve word problems. Word problems are what our national assessments are all about. I also discovered that direct instruction and support of math vocabulary increased test scores and confidence in students as test takers. As a result of this research, I plan to continue to find ways to emphasize the vocabulary used in our current math curriculum. This process will start at the beginning of the year. I will continue to look for strategies that promote math vocabulary retention in my students. And finally, I will share my findings with my colleagues, so my research can be used as part of our School Improvement Goals.

The nurse and the care to the elderly women: a social phenomenological approach

Objective: To understand how nurses see care delivery to elderly women. Methods: In this phenomenological study, ten nurses working at Primary Health Care Units were interviewed between September 2010 and January 2011. Results: In care delivery, nurses consider the elderly women's knowledge background and biographical situation, and also value the family's participation as a care mediator. These professionals have the acuity to capture these women's specific demands, but face difficulties to deliver care to these clients. Nurses expect to deliver qualified care to these women. Conclusion: The theoretical and methodological approach of social phenomenology permitted revealing that the nurse designs qualified care to elderly women, considering the possibilities in the context. This includes the participation of different social actors and health sectors, assuming collective efforts in action strategies and professional training, in line with the particularities and care needs of elderly women nurses identify.

Spray drying microencapsulation of Lippia sidoides extracts in carbohydrate blends

The microencapsulation of Lippia sidoides extracts in blends of carbohydrates was investigated. The extraction conditions were determined through a 2(2) factorial design. The effects of the plant:solvent ratio (A - 7.5:100 and 15:100 m/m) and the extraction time (B - 30 and 90 min) on thymol content of extractive solutions were evaluated, using a 2:1 (v/v) of ethanol:water at a temperature of 50 degrees C, as a solvent system. The selected extract was subjected to spray drying. Blends of maltodextrin and gum arabic at different proportions (4:1; 3:2; 2:3; 0:1) (m/m) were used as encapsulating material. The protective effects of the maltodextrin and gum arabic blends were evaluated by determination of the thymol retention in the dried product, which ranged from 70.2 to 84.2% (related to the content in the extractive solution). An increase in the gum arabic to maltodextrin (DE10) ratio has positive effect on thymol retention. L. sidoides extracts and spray-dried products showed antifungal activity against tested fungal strains (Candida albicans - ATCC 64548, Candida glabrata - ATCC 90030, Candida krusei - ATCC 6258, and Candida parapsilosis - ATCC 22019), evidencing their potential as a natural antifungal agent for medicinal, food, and cosmeceutical purposes. (C) 2012 The Institution of Chemical Engineers. Published by Elsevier B.V. All rights reserved.

Teaching of the Integrated Management of Childhood Illness strategy in undergraduate nursing programs

Objective: To describe and analyze the teaching of the Integrated Management of hildhood Illness (IMCI) strategy on Brazilian undergraduate nursing programs. Method: Integrating an international multicentric study, a cross-sectional online survey was conducted between May and October 2010 with 571 undergraduate nursing programs in Brazil Results: Responses were received from 142 programs, 75% private and 25% public. 64% of them included the IMCI strategy in the theoretical content, and 50% of the programs included IMCI as part of the students’ practical experience. The locations most used for practical teaching were primary health care units. The ‘treatment’ module was taught by the fewest number of programs, and few programs had access to the IMCI instructional manuals. All programs used exams for evaluation, and private institutions were more likely to include class participation as part of the evaluation. Teaching staff in public institutions were more likely to have received training in teaching IMCI. Conclusion: In spite of the relevance of the IMCI strategy in care of the child, its content is not addressed in all undergraduate programs in Brazil, and many programs do not have access to the IMCI teaching manuals and have not provide training in IMCI to their teaching staff.

Nurses and care delivery to elderly women: a social phenomenological approach

OBJECTIVE: To understand how nurses see care delivery to elderly women. METHODS: In this phenomenological study, ten nurses working at Primary Health Care Units were interviewed between September 2010 and January 2011. RESULTS: In care delivery, nurses consider the elderly women's knowledge background and biographical situation, and also value the family's participation as a care mediator. These professionals have the acuity to capture these women's specific demands, but face difficulties to deliver care to these clients. Nurses expect to deliver qualified care to these women. CONCLUSION: The theoretical and methodological approach of social phenomenology permitted revealing that the nurse designs qualified care to elderly women, considering the possibilities in the context. This includes the participation of different social actors and health sectors, assuming collective efforts in action strategies and professional training, in line with the particularities and care needs of elderly women nurses identify.

Tutela dei minori e recupero della genitorialità: il caso dell'accoglienza in comunità

La tesi di Matteo Allodi intende analizzare alcune pratiche socio-assistenziali rivolte a minori e famiglie in difficoltà relative a progetti di accoglienza presso alcune strutture residenziali. In particolare, Matteo Allodi si sofferma su progetti di accoglienza elaborati presso alcune Comunità familiari la cui metodologia d’intervento si caratterizza per un orientamento verso un modello di lavoro sociale di tipo sussidiario nell’ottica del recupero dei legami e delle competenze genitoriali. La tesi affronta nella prima parte la dimensione teorica relativa a un approccio progettuale di intervento sociale che, mettendo al centro le relazioni dei soggetti in gioco, possa promuovere la loro attivazione in funzione della realizzazione dell’obiettivo del recupero della genitorialità. Allodi si concentra dal punto di vista teorico sulle modalità di realizzazione di un servizio alla persona guidato dal principio di sussidiarietà, ovvero orientato alla valorizzazione delle capacità riflessive degli attori. Nella seconda, parte Allodi presenta l’indagine condotta in alcune Comunità di tipo familiare di Parma. La strategia iniziale d’indagine è quella del case study. Allodi sceglie di indagare il fenomeno partendo da un’osservazione partecipata di orientamento etnometodologico integrata con interviste agli attori privilegiati. In questa fase si è proceduto a una prima ricerca qualitativa, attraverso la metodologia dello studio di caso, che ha permesso di entrare in contatto con alcune tipologie di strutture residenziali per minori al fine di completare il quadro generale del fenomeno delle Comunità familiari e impostare una prima mappatura esplorativa. La ricerca prosegue con uno studio longitudinale prospettico volto a monitorare e valutare il lavoro di rete della comunità e dei servizi, osservando principalmente la mobilitazione verso l’autonomia e l’empowerment dei soggetti (minori) e delle reti ancorate al soggetto (single case study). Si è voluto comprendere quali modalità relazionali gli attori della rete di coping mettono in gioco in funzione del “cambiamento sociale”.

From defined polymer architectures to structure-property relationships in vivo

Makromolekulare Wirkstoffträgersysteme sind von starkem Interesse bezüglich der klinischen Anwendung chemotherapeutischer Agenzien. Um ihr klinisches Potential zu untersuchen ist es von besonderer Bedeutung das pharmakokinetische Profil in vivo zu bestimmen. Jede Veränderung der Polymerstruktur beeinflusst die Körperverteilung des entsprechenden Makromoleküls. Aufgrund dessen benötigt man detailliertes Wissen über Struktur-Eigenschaftsbeziehungen im lebenden Organismus, um das Nanocarrier System für zukünftige Anwendungen einzustellen. In dieser Beziehung stellt das präklinische Screening mittels radioaktiver Markierung und Positronen-Emissions-Tomographie eine nützliche Methode für schnelle sowie quantitative Beobachtung von Wirkstoffträgerkandidaten dar. Insbesondere poly(HPMA) und PEG sind im Arbeitsgebiet Polymer-basierter Therapeutika stark verbreitet und von ihnen abgeleitete Strukturen könnten neue Generationen in diesem Forschungsbereich bieten.rnDie vorliegende Arbeit beschreibt die erfolgreiche Synthese verschiedener HPMA und PEG basierter Polymer-Architekturen – Homopolymere, Statistische und Block copolymere – die mittels RAFT und Reaktivesterchemie durchgeführt wurde. Des Weiteren wurden die genannten Polymere mit Fluor-18 und Iod-131 radioaktiv markiert und mit Hilfe von microPET und ex vivo Biodistributionsstudien in tumortragenden Ratten biologisch evaluiert. Die Variation in Polymer-Architektur und darauffolgende Analyse in vivo resultierte in wichtige Schlussfolgerungen. Das hydrophile / lipophile Gleichgewicht hatte einen bedeutenden Einfluss auf das pharmakokinetische Profil, mit besten in vivo Eigenschaften (geringe Aufnahme in Leber und Milz sowie verlängerte Blutzirkulationszeit) für statistische HPMA-LMA copolymere mit steigendem hydrophoben Anteil. Außerdem zeigten Langzeitstudien mit Iod-131 eine verstärkte Retention von hochmolekularen, HPMA basierten statistischen Copolymeren im Tumorgewebe. Diese Beobachtung bestätigte den bekannten EPR-Effekt. Hinzukommend stellen Überstrukturbildung und damit Polymergröße Schlüsselfaktoren für effizientes Tumor-Targeting dar, da Polymerstrukturen über 200 nm in Durchmesser schnell vom MPS erkannt und vom Blutkreislauf eliminiert werden. Aufgrund dessen wurden die hier synthetisierten HPMA Block copolymere mit PEG Seitengruppen chemisch modifiziert, um eine Verminderung in Größe sowie eine Reduktion in Blutausscheidung zu induzieren. Dieser Ansatz führte zu einer erhöhten Tumoranreicherung im Walker 256 Karzinom Modell. Generell wird die Körperverteilung von HPMA und PEG basierten Polymeren stark durch die Polymer-Architektur sowie das Molekulargewicht beeinflusst. Außerdem hängt ihre Effizienz hinsichtlich Tumorbehandlung deutlich von den individuellen Charakteristika des einzelnen Tumors ab. Aufgrund dieser Beobachtungen betont die hier vorgestellte Dissertation die Notwendigkeit einer detaillierten Polymer-Charakterisierung, kombiniert mit präklinischem Screening, um polymere Wirkstoffträgersysteme für individualisierte Patienten-Therapie in der Zukunft maßzuschneidern.rn

18 F-Click-Radiomarkierung polymerer Trägersysteme zur ex vivo- und in vivo-Evaluierung

Die Positronen-Emissions-Tomographie (PET) ist ein leistungsstarkes, nicht-invasives, bildgebendes Verfahren in der Nuklearmedizin und hat darüber hinaus zunehmende Bedeutung in der Arzneistoffentwicklung. Zur Verbesserung des therapeutischen Index von niedermolekularen Pharmaka werden vermehrt Wirkstofftransportsysteme eingesetzt. Eine Klasse dieser Wirkstofftransportsysteme sind Liposomen. Die Weiterentwicklung der klassischen Liposomen sind sogenannte „Stealth“-Liposomen, die eine Polyethylenglykol (PEG)-Korona zur Herabsetzung der Erkennung und Ausscheidung tragen. Zur (Weiter-)Entwicklung und deren in vivo-Evaluierung bietet die PET die Möglichkeit, die Auswirkungen von strukturellen Anpassungen auf die pharmakokinetischen Eigenschaften solcher Transportsysteme zu untersuchen. Zur Evaluierung neuartiger, cholesterolverankerter, linear-hyperverzweigter Polyglycerole (Ch-PEG-hbPG) als sterisch stabilisierende Polymere in Liposomen wurden diese im Rahmen dieser Arbeit mit der prosthetischen Gruppe 18F-TEG-N3 über kupferkatalysierte Alkin-Azid Cycloaddition (CuAAC) in sehr hohen Ausbeuten radiomarkiert. Zum systematischen Vergleich des in vivo-Verhaltens wurde ebenfalls ein cholesterolbasiertes lineares PEG (Ch-PEG) mit CuAAC nahezu quantitativ radiomarkiert. Als drittes Element wurde die Direktmarkierung von Cholesterol mit [18F]F- entwickelt. Diese drei Verbindungen wurden zuerst separat als Einzelkomponenten und anschließend, in Liposomen formuliert, in Tierstudien an Mäusen hinsichtlich ihrer initialen Pharmakokinetik und Biodistribution untersucht. Dabei zeigte sich ein ähnliches Verhalten der neuartigen Ch-PEG-hbPG-Derivate zu den bekannten Ch-PEG, mit dem Vorteil der Multifunktionalität an den hyperverzweigten Strukturen. Die liposomalen Strukturen mit der neuartigen sterischen Stabilisierung wiesen eine erhöhte Blutzirkulationszeit und vorteilhafte Blut-zu-Leber- und Blut-zu-Lunge-Verhältnisse im Vergleich zu den linear stabilisierten Analoga auf.rnEine weitere Klasse von Wirkstofftransportsystemen sind polymere Trägersysteme wie pHPMA. Alkinfunktionalisierte Polymere konnten in zwei verschiedenen Größen (~12 und 60 kDa) mittels CuAAC in sehr hohen Ausbeuten mit der prosthetischen Gruppe 18F-TEG-N3 radiomarkiert werden. Bicyclononinderivate der gleichen Größen konnten ohne Kupferkatalyse über ringspannungsvermittelte Alkin-Azid-Cycloaddition (SPAAC) mikrowellengestützt markiert werden und stehen somit zur in vivo-Untersuchung hinsichtlich des Einflusses der Markierungsart zur Verfügung.

Early mortality and loss to follow-up in HIV-infected children starting antiretroviral therapy in Southern Africa

Many HIV-infected children in Southern Africa have been started on antiretroviral therapy (ART), but loss to follow up (LTFU) can be substantial. We analyzed mortality in children retained in care and in all children starting ART, taking LTFU into account.

Male-biased reproductive effort in a long-lived seabird.

Background: In dimorphic seabirds, the larger sex tends to provision more than the smaller sex. In contrast, monogamy and biparental care are often associated with equal effort between the sexes. However, the few studies that have tested sex-specific effort in monomorphic seabirds have primarily examined the details of foraging at sea. Hypotheses: Parental effort is also sex-biased in a monomorphic seabird mating system for one of two reasons: (1) If females enter the period of parental care less able to invest in care due to the cost of egg production, male-biased effort may be necessary to avoid reproductive failure. (2) Alternatively, female-biased effort may occur due to the initial disparity in gamete size, particularly in species with internal fertilization. Organism: Leach’s storm-petrel (Oceanodroma leucorhoa), a monomorphic seabird with true monogamy and obligate biparental care. Site: A breeding colony of Oceanodroma leucorhoa at the Bowdoin Scientific Station on Kent Island, Bay of Fundy, New Brunswick, Canada. Methods: Across multiple breeding seasons, we assessed incubation behaviour and chickrearing behaviour through one manipulative and multiple observational studies. We assessed energetic investment by inducing feather replacement and measuring the resulting rate of feather growth during both the incubation and chick-rearing phases of parental care. Conclusions: We observed male-biased effort. Males incubated the egg for a greater proportion of time than did females and, when faced with an egg that would not hatch, males continued to incubate past the point when females abandoned it. Males made a higher percentage of total food deliveries to chicks than did females, resulting in greater mean daily food provisioning by males than by females. During chick rearing, males grew replacement feathers more slowly than did females, indicating that males were more likely to reduce their own nutritional condition while raising chicks than were females. These results support the hypothesis that females enter the period of parental care at a nutritional deficit and males must compensate to avoid reproductive failure.

Correcting mortality for loss to follow-up: a nomogram applied to antiretroviral treatment programmes in sub-Saharan Africa

Background The World Health Organization estimates that in sub-Saharan Africa about 4 million HIV-infected patients had started antiretroviral therapy (ART) by the end of 2008. Loss of patients to follow-up and care is an important problem for treatment programmes in this region. As mortality is high in these patients compared to patients remaining in care, ART programmes with high rates of loss to follow-up may substantially underestimate mortality of all patients starting ART. Methods and Findings We developed a nomogram to correct mortality estimates for loss to follow-up, based on the fact that mortality of all patients starting ART in a treatment programme is a weighted average of mortality among patients lost to follow-up and patients remaining in care. The nomogram gives a correction factor based on the percentage of patients lost to follow-up at a given point in time, and the estimated ratio of mortality between patients lost and not lost to follow-up. The mortality observed among patients retained in care is then multiplied by the correction factor to obtain an estimate of programme-level mortality that takes all deaths into account. A web calculator directly calculates the corrected, programme-level mortality with 95% confidence intervals (CIs). We applied the method to 11 ART programmes in sub-Saharan Africa. Patients retained in care had a mortality at 1 year of 1.4% to 12.0%; loss to follow-up ranged from 2.8% to 28.7%; and the correction factor from 1.2 to 8.0. The absolute difference between uncorrected and corrected mortality at 1 year ranged from 1.6% to 9.8%, and was above 5% in four programmes. The largest difference in mortality was in a programme with 28.7% of patients lost to follow-up at 1 year. Conclusions The amount of bias in mortality estimates can be large in ART programmes with substantial loss to follow-up. Programmes should routinely report mortality among patients retained in care and the proportion of patients lost. A simple nomogram can then be used to estimate mortality among all patients who started ART, for a range of plausible mortality rates among patients lost to follow-up.

The Effects of Prenatal Exposure to Altered Melatonin Levels on Hippocampal Gene Expression in the Male Rat

The stability of the circadian rhythm for mammals depends on the levels of serotonin and melatonin, neurohormones that signal for lightness and darkness, respectively. Disruption in the stability of neurohormones has been shown to be a critical factor in psychopathological disorders in humans. For example, altering levels of melatonin in utero through administration of melatonin or the melatonin receptor antagonist, luzindole, has been shown to cause changes in developmental growth and adult behavior in the male rat. Analysis of relative adult hippocampal gene expression with RT-PCR revealed differences in ARNTL expression that suggested abnormality in clock gene expression of the rats that were prenatally exposed to altered levels of melatonin. Differences in the degree of plasticity as suggested by previous behavior testing did not result in differences in gene expression for GABA receptors or NMDA receptors. Morevoer, growth associated protein 43, GAP-43, a protein that is necessary for neuronal growth cones as well as long term learning has been found to be critical for axon and presynaptic terminal formation and retention in other studies, but hippocampal gene expression in our study showed no significant alteration after exposure to various maternal melatonin levels. However, ARNTL is a key regulatory component of clock genes and the circadian cycle so that alterations in the expression of thi critical gene may lead to critical changes in neuronal growth and plasticity. Our data support the conclusion that the manipulation of maternal melatonin levels alters the brain development and the circadian cycles that may lead to physiological and behavioral abnormalities in adult offspring.

[Hypertension therapy in patients with renal artery stenosis]

Renovascular hypertension is due to reduced renal parenchymal perfusion. The correct diagnosis can be difficult. It is important to note that the demonstration of renal artery stenosis in a patient with hypertension does not necessarily constitute renovascular hypertension. Often, clinically nonsignificant and asymptomatic renal artery stenosis are found in patients with essential hypertension, or renal failure of other origin. Renovascular disease is a complex disorder with various clinical presentations. In patients with significant renovascular hypertension plasma renin is increased. For this reason the therapy aims to block the renin-angiotensin-aldosterone system. Bilateral renal artery stenosis causes renal sodium retention. In this situation a diuretic drug has to be added to the therapy. Endovascular or surgical therapy has to be considered in patients with flash pulmonary edema or fibromuscular dysplasia. The control of cardiovascular risk factors is important.

Maternal tobacco smoking and decreased leukocytes, including dendritic cells, in neonates

Maternal smoking in pregnancy is associated with respiratory diseases in the offspring, possibly due to prenatal influences on the developing immune system. We investigated whether maternal smoking in pregnancy was associated with cord blood leukocyte numbers, including precursor dendritic cells, adjusting for concomitant factors. In a prospective healthy birth cohort study, total leukocyte counts were reduced in neonates of smoking mothers [10.7 (8.4-13.0), n=14] compared with nonexposed infants [14.7 (13.7-15.7), n=74, p=0.002] [geometric mean cells x 10(3)/microL (95% confidence interval)]. All leukocyte subsets were decreased, most prominently segmented neutrophils [4.3 (2.8-5.7) versus 6.2 (5.5-6.8), p=0.021], lymphocytes [3.8 (2.9-4.8) versus 5.0 (4.5-5.6), p=0.036], and myeloid precursor dendritic cells [12.7 cells/microL (9.1-17.8) versus 18.3 (15.8-21.2), p=0.055]. These differences persisted after adjustment for possible confounders. Predictors of myeloid precursor dendritic cell numbers in multivariable models were maternal smoking (-5.1 cells/microL, p=0.042), age (-0.5 cells/microL/y, p=0.035), and, marginally, asthma (+8.1 cells/microL, p=0.075). The decrease of all leukocytes in neonates of smoking mothers could be clinically significant and suggests a decreased cell production, increased peripheral recruitment, or retention in bone marrow. Given the importance of dendritic cells in early immune responses, their decrease might reflect an impact of maternal smoking on the developing fetal immune system.

Substitutions due to antiretroviral toxicity or contraindication in the first 3 years of antiretroviral therapy in a large South African cohort

INTRODUCTION: The patterns and reasons for antiretroviral therapy (ART) drug substitutions are poorly described in resource-limited settings. METHODS: Time to and reason for drug substitution were recorded in treatment-naive adults receiving ART in two primary care treatment programmes in Cape Town. The cumulative proportion of patients having therapy changed because of toxicity was described for each drug, and associations with these changes were explored in multivariate models. RESULTS: Analysis included 2,679 individuals followed for a median of 11 months. Median CD4+ T-cell count at baseline was 85 cells/microl. Mean weight was 59 kg, mean age was 32 years and 71% were women. All started non-nucleoside reverse transcriptase inhibitor-based ART (60% on efavrienz) and 75% started on stavudine (d4T). After 3 years, 75% remained in care on-site, of whom 72% remained on their initial regimen. Substitutions due to toxicity of nevirapine (8% by 3 years), efavirenz (2%) and zidovudine (8%) occurred early. Substitutions on d4T occurred in 21% of patients by 3 years, due to symptomatic hyperlactataemia (5%), lipodystrophy (9%) or peripheral neuropathy (6%), and continued to accumulate over time. Those at greatest risk of hyperlactataemia or lipodystrophy were women on ART > or =6 months, weighing > or =75 kg at baseline. DISCUSSION: A high proportion of adult patients are able to tolerate their initial ART regimen for up to 3 years. In most instances treatment-limiting toxicities occur early, but continue to accumulate over time in patients on d4T. Whilst awaiting other treatment options, the risks of known toxicities could be minimized through early identification of patients at the highest risk.