984 resultados para Todd, Kim
Ryhmämuotoinen toimintaterapia visuaalisen hahmottamisen taitojen oppimisen tukena kouluympäristössä
Resumo:
Tämä opinnäytetyö on toteutettu yhteistyössä espoolaisen erityiskoulun kanssa. Opinnäytetyön tarkoituksena on tutkia ryhmämuotoista toimintaterapiaa kouluympäristössä visuaalisen hahmottamisen kehityksen tukena. Visuaalisen hahmottamisen häiriö voi olla yksi lapsen tai nuoren oppimisvaikeuksien taustalla vaikuttavista tekijöistä. Opinnäytetyön tavoitteena on selvittää, mitä mahdollisuuksia toimintaterapiaryhmä tarjoaa yksilön visuaalisen hahmottamisen kehityksen tueksi. Teoria selvittämässä visuaalista hahmottamista työssämme on Valorie Ricciardone Toddin (1993) Visuaalisen informaation analyysi -viitekehys. Tämä painottuu lapsen ja nuoren visuaalisen informaation kognitiiviseen prosessointiin, oppimiseen. Opinnäytetyön aineiston keräsimme suunnittelemalla ja toteuttamalla toimintaterapiaryhmän yhteiskumppaninamme toimivan koulun neljälle yläasteikäiselle tytölle. Toimintaterapiaryhmän tarkoituksena oli tyttöjen visuaalisen hahmottamisen taitojen oppimisen sekä näin ollen koulunkäynnin tukeminen. Teorialähtöisen aineiston analyysin avulla tarkastelimme toimintaterapiaryhmän suunnitteluun ja toteutukseen vaikuttavia tekijöitä, joita Visuaalisen informaation- analyysi (Todd 1993) viitekehys asettaa yksilön visuaalisen hahmottamisen taitojen kehittymisen ehdoiksi. Opinnäytetyön tulosten mukaan toimintaterapiaryhmä tuki ja edisti yksilön visuaalisen hahmottamisen taitojen oppimista. Toimintaterapiaryhmässä on mahdollista hyödyntää monipuolisesti erilaisia toimintoja, jotka nuori kokee mielekkääksi. Toimintaterapiaryhmä motivoi nuoren osallistumista ja suoriutumista tarkoituksenmukaisesti valittuihin toimintoihin visuaalisen hahmottamisen taitojen oppimiseksi. Toimintaterapiaryhmässä visuaalisen hahmottamisen taitojen oppimisessa ohjaajalla on suuri merkitys. Tämä edellyttää, että ohjaaja tunnistaa ryhmän jäsenten yksilölliset tarpeet ja hallitsee visuaalisen hahmottamisen taitojen oppimista edistäviä ohjausstrategioita sekä kompensatorisia menetelmiä. Yhteistyö kouluympäristössä on tärkeää ryhmän jäsenten tavoitteiden asettamisessa. Opinnäytetyömme tehtävänä on tuottaa laadullista tietoa toimintaterapiaryhmän hyödyntämisestä lasten ja nuorten kanssa, joiden visuaalisen hahmottamisen vaikeudet heijastuvat koulunkäyntiin. Opinnäytetyön tehtävänä on myös esitellä Visuaalisen informaation analyysi- viitekehys (Todd 1993) pääpiirteittäin. Opinnäytetyö tarjoaa teoritietoa visuaalisesta hahmottamisesta ja menetelmistä, joiden avulla visuaalisen hahmottamisen taitojen oppimista voidaan tukea.
Resumo:
We and others have reported mutations in LONP1, a gene coding for a mitochondrial chaperone and protease, as the cause of the human CODAS (cerebral, ocular, dental, auricular and skeletal) syndrome (MIM 600373). Here, we delineate a similar but distinct condition that shares the epiphyseal, vertebral and ocular changes of CODAS but also included severe microtia, nasal hypoplasia, and other malformations, and for which we propose the name of EVEN-PLUS syndrome for epiphyseal, vertebral, ear, nose, plus associated findings. In three individuals from two families, no mutation in LONP1 was found; instead, we found biallelic mutations in HSPA9, the gene that codes for mHSP70/mortalin, another highly conserved mitochondrial chaperone protein essential in mitochondrial protein import, folding, and degradation. The functional relationship between LONP1 and HSPA9 in mitochondrial protein chaperoning and the overlapping phenotypes of CODAS and EVEN-PLUS delineate a family of "mitochondrial chaperonopathies" and point to an unexplored role of mitochondrial chaperones in human embryonic morphogenesis.
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Sacroiliíte é o processo inflamatório não-infeccioso das articulações sacroilíacas, sendo critério diagnóstico das espondiloartropatias soronegativas. O diagnóstico desta enfermidade requer confirmação pelos métodos de imagem. O presente trabalho faz um revisão de casos do arquivo didático e de artigos da literatura para ilustrar a anatomia, a técnica e os principais achados de imagem na radiografia, tomografia computadorizada e ressonância magnética, na determinação do diagnóstico de sacroiliíte, abordando inclusive os seus principais diagnóstico diferenciais.
Influence of M. tuberculosis lineage variability within a clinical trial for pulmonary tuberculosis.
Resumo:
Recent studies suggest that M. tuberculosis lineage and host genetics interact to impact how active tuberculosis presents clinically. We determined the phylogenetic lineages of M. tuberculosis isolates from participants enrolled in the Tuberculosis Trials Consortium Study 28, conducted in Brazil, Canada, South Africa, Spain, Uganda and the United States, and secondarily explored the relationship between lineage, clinical presentation and response to treatment. Large sequence polymorphisms and single nucleotide polymorphisms were analyzed to determine lineage and sublineage of isolates. Of 306 isolates genotyped, 246 (80.4%) belonged to the Euro-American lineage, with sublineage 724 predominating at African sites (99/192, 51.5%), and the Euro-American strains other than 724 predominating at non-African sites (89/114, 78.1%). Uneven distribution of lineages across regions limited our ability to discern significant associations, nonetheless, in univariate analyses, Euro-American sublineage 724 was associated with more severe disease at baseline, and along with the East Asian lineage was associated with lower bacteriologic conversion after 8 weeks of treatment. Disease presentation and response to drug treatment varied by lineage, but these associations were no longer statistically significant after adjustment for other variables associated with week-8 culture status.
Resumo:
Xantomatose cerebrotendínea é rara condição de natureza genética, na qual se observa redução na atividade da enzima hepática 27-hidroxilase, envolvida no metabolismo e excreção do colesterol. Consequentemente, depósitos de material lipídico (colesterol/colestanol) acumulam-se em diferentes regiões do organismo, principalmente tendões, sistema nervoso central e cristalino. Relatamos dois casos da doença em duas irmãs, mostrando os principais achados de imagem.
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OBJECTIVE: To review and update the conceptual framework, indicator content and research priorities of the Organisation for Economic Cooperation and Development's (OECD) Health Care Quality Indicators (HCQI) project, after a decade of collaborative work. DESIGN: A structured assessment was carried out using a modified Delphi approach, followed by a consensus meeting, to assess the suite of HCQI for international comparisons, agree on revisions to the original framework and set priorities for research and development. SETTING: International group of countries participating to OECD projects. PARTICIPANTS: Members of the OECD HCQI expert group. RESULTS: A reference matrix, based on a revised performance framework, was used to map and assess all seventy HCQI routinely calculated by the OECD expert group. A total of 21 indicators were agreed to be excluded, due to the following concerns: (i) relevance, (ii) international comparability, particularly where heterogeneous coding practices might induce bias, (iii) feasibility, when the number of countries able to report was limited and the added value did not justify sustained effort and (iv) actionability, for indicators that were unlikely to improve on the basis of targeted policy interventions. CONCLUSIONS: The revised OECD framework for HCQI represents a new milestone of a long-standing international collaboration among a group of countries committed to building common ground for performance measurement. The expert group believes that the continuation of this work is paramount to provide decision makers with a validated toolbox to directly act on quality improvement strategies.
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OBJETIVO: Descrever os achados de imagem de RM no hemangioma hepático com realce perilesional. MATERIAIS E MÉTODOS: Realizou-se uma pesquisa no banco de dados da unidade de RM para identificar todos os casos de hemangioma hepático com realce perilesional entre março de 2008 e julho de 2009. Todos os pacientes foram submetidos a RM pré-contraste em imagens ponderadas em T1 e T2 e em imagens dinâmicas após injeção de gadolínio. Características do hemangioma e do realce perilesional foram avaliadas nas imagens de RM. RESULTADOS: Sete hemangiomas em sete pacientes (cinco homens, duas mulheres; faixa etária entre 41-69 anos; média de 57 anos) foram incluídos no presente estudo. O tamanho das lesões variou de 7 a 20 mm (média de 12,4 mm). Na fase dominante arterial hepática, todos os sete hemangiomas mostraram realce perilesional cuneiforme que se atenuou nas imagens dois minutos após injeção de gadolínio. Quatro dessas lesões demonstraram realce capsular adjacente. CONCLUSÃO: Todos os hemangiomas hepáticos com realce perilesional eram lesões capsulares medindo menos que 2 cm. Tal localização sugere que esses hemangiomas podem recrutar vasos capsulares responsáveis pelo realce perilesional
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BACKGROUND: Several distributions of country-specific blood pressure (BP) percentiles by sex, age, and height for children and adolescents have been established worldwide. However, there are no globally unified BP references for defining elevated BP in children and adolescents, which limits international comparisons of the prevalence of pediatric elevated BP. We aimed to establish international BP references for children and adolescents by using 7 nationally representative data sets (China, India, Iran, Korea, Poland, Tunisia, and the United States). METHODS AND RESULTS: Data on BP for 52 636 nonoverweight children and adolescents aged 6 to 19 years were obtained from 7 large nationally representative cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. BP values were obtained with certified mercury sphygmomanometers in all 7 countries by using standard procedures for BP measurement. Smoothed BP percentiles (50th, 90th, 95th, and 99th) by age and height were estimated by using the Generalized Additive Model for Location Scale and Shape model. BP values were similar between males and females until the age of 13 years and were higher in males than females thereafter. In comparison with the BP levels of the 90th and 95th percentiles of the US Fourth Report at median height, systolic BP of the corresponding percentiles of these international references was lower, whereas diastolic BP was similar. CONCLUSIONS: These international BP references will be a useful tool for international comparison of the prevalence of elevated BP in children and adolescents and may help to identify hypertensive youths in diverse populations.
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Ticks transmit more pathogens to humans and animals than any other arthropod. We describe the 2.1 Gbp nuclear genome of the tick, Ixodes scapularis (Say), which vectors pathogens that cause Lyme disease, human granulocytic anaplasmosis, babesiosis and other diseases. The large genome reflects accumulation of repetitive DNA, new lineages of retro-transposons, and gene architecture patterns resembling ancient metazoans rather than pancrustaceans. Annotation of scaffolds representing ∼57% of the genome, reveals 20,486 protein-coding genes and expansions of gene families associated with tick-host interactions. We report insights from genome analyses into parasitic processes unique to ticks, including host 'questing', prolonged feeding, cuticle synthesis, blood meal concentration, novel methods of haemoglobin digestion, haem detoxification, vitellogenesis and prolonged off-host survival. We identify proteins associated with the agent of human granulocytic anaplasmosis, an emerging disease, and the encephalitis-causing Langat virus, and a population structure correlated to life-history traits and transmission of the Lyme disease agent.