Transvaginal specimen extraction in colorectal surgery: current state of the art.

Aim  Background The expected benefit of transvaginal specimen extraction is reduced incision-related morbidity. Objectives A systematic review of transvaginal specimen extraction in colorectal surgery was carried out to assess this expectation. Method  Search strategy The following keywords, in various combinations, were searched: NOSE (natural orifices specimen extraction), colorectal, colon surgery, transvaginal, right hemicolectomy, left hemicolectomy, low anterior resection, sigmoidectomy, ileocaecal resection, proctocolectomy, colon cancer, sigmoid diverticulitis and inflammatory bowel diseases. Selection criteria Selection criteria included large bowel resection with transvaginal specimen extraction, laparoscopic approach, human studies and English language. Exclusion criteria were experimental studies and laparotomic approach or local excision. All articles published up to February 2011 were included. Results  Twenty-three articles (including a total of 130 patients) fulfilled the search criteria. The primary diagnosis was colorectal cancer in 51% (67) of patients, endometriosis in 46% (60) of patients and other conditions in the remaining patients. A concurrent gynaecological procedure was performed in 17% (22) of patients. One case of conversion to laparotomy was reported. In two patients, transvaginal extraction failed. In left- and right-sided resections, the rate of severe complications was 3.7% and 2%, respectively. Two significant complications, one of pelvic seroma and one of rectovaginal fistula, were likely to have been related to transvaginal extraction. The degree of follow up was specified in only one study. Harvested nodes and negative margins were adequate and reported in 70% of oncological cases. Conclusion  Vaginal extraction of a colorectal surgery specimen shows potential benefit, particularly when associated with a gynaecological procedure. Data from prospective randomized trials are needed to support the routine use of this technique.

2013 Update in addiction medicine for the generalist.

Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for the care of patients in primary care or other generalist settings. To accomplish this aim, we selected articles in the field of addiction medicine, critically appraised and summarized the manuscripts, and highlighted their implications for generalist practice. During an initial review, we identified articles through an electronic Medline search (limited to human studies and in English) using search terms for alcohol and other drugs of abuse published from January 2010 to January 2012. After this initial review, we searched for other literature in web-based or journal resources for potential articles of interest. From the list of articles identified in these initial reviews, each of the six authors independently selected articles for more intensive review and identified the ones they found to have a potential impact on generalist practice. The identified articles were then ranked by the number of authors who selected each article. Through a consensus process over 4 meetings, the authors reached agreement on the articles with implications for practice for generalist clinicians that warranted inclusion for discussion. The authors then grouped the articles into five categories: 1) screening and brief interventions in outpatient settings, 2) identification and management of substance use among inpatients, 3) medical complications of substance use, 4) use of pharmacotherapy for addiction treatment in primary care and its complications, and 5) integration of addiction treatment and medical care. The authors discuss each selected articles' merits, limitations, conclusions, and implication to advancing addiction screening, assessment, and treatment of addiction in generalist physician practice environments.

Irish English habitual do be revisited

This article describes similarities of the Irish Gaelic present habitual aspect and traditional Irish English dialects. These observations are contrasted with differences in the Scots Gaelic aspectual system and an explanation for the deviances in present habitual marking in Scottish English and Irish English is suggested, based on differences in the Gaelic contact varieties.

Standard Specifications for Highway and Bridge Construction, 2012

When referenced, the 2012 edition of the Iowa Department of Transportation’s (Iowa DOT) Standard Specifications for Highway and Bridge Construction shall be used for contract work awarded by the Iowa DOT. They may also be incorporated by reference in other contract work on secondary, urban, local systems, or other contract work in which the Iowa DOT has an interest. As modified by the General Supplemental Specifications, these Standard Specifications represent the minimum requirements and may be modified by Supplemental Specifications, Developmental Specifications, and Special Provisions on specific contracts. These Standard Specifications have been written so the Contractor’s responsibilities are indicated by plain language using the Imperative Mood and Active Voice form. Sentences are of the form: Construct isolation joints at all points where driveways meet other walks, curbs, or fixtures in the surface. Ensure finished members are true to detailed dimensions and free from twists, bends, open joints, or other defects resulting from faulty fabrication or defective work. Personnel preparing the JMF shall be Iowa DOT certified in bituminous mix design. The Contracting Authority’s responsibilities are (with some exceptions) indicated by the use of the modal verb “will”. Sentences are of the form: The Engineer will obtain and test density samples for each lot according to Materials I.M. 204. Payment will be the contract unit price for Fabric Reinforcement per square yard (square meter). These standard specifications contain dual units of measure: the United States Standard measure (English units) and the International System of Units (SI or “metric” units). The English units are expressed first then followed by the metric units in parentheses. The measurements expressed in the two systems are not necessarily equal. In some cases the measurements in metric units is a “hard” conversion of the English measurement; i.e. the metric unit has been approximated with a rounded, rationalized metric measurement that is easy to work with and remember. The proposal form will identify whether the work was designed and shall be constructed in English or metric units.

Isolated disturbance of written language-acquisition as an initial symptom of epileptic aphasia in a 7-year-old child - a 3-year follow-up-study

A 7-year-old right-handed girl developed partial complex seizures with a left-sided onset. A brief period of post-ictal aphasia of the conduction type was documented before seizure control and complete normalization of oral language were obtained. We also found that she had a history of previous unexplained difficulty with written language acquisition that had occurred prior to the clinically recognized epilepsy and a subsequent loss of this ability. This rapidly improved with control of the epilepsy. The evolution of written language were been followed for 3 years, and continued improvement has occurred with fluctuations related to her epilepsy. This observation adds support to the growing body of data indicating that specific cognitive disturbances can be due to epilepsy in young children. It shows the vulnerability of skills which are in a period of active development, and the possibility that oral/written language can be differentially involved by cerebral dysfunction in the young child.

Keep on moving from English to Catalan : El determinisme lingüístic en la traducció del moviment

El propòsit d'aquest treball és fixar, basant-nos en l'anàlisi tipològica, les diferències lingüístiques en la construcció de les expressions de moviment de l'anglès i el català. Partim de la hipòtesi que en funció de l'origen de la llengua, s'apliquen solucions diferents a determinats problemes lingüístics que apareixen a l'hora de traduir un discurs. Analitzarem, doncs, el grau de fidelitat de la traducció quant a l'expressió del trajecte i de la manera. Per consegüent, estudiarem si hi ha cap pèrdua d'informació, de qualitat o de genuïnitat en relació amb el text original servint-nos de la comparació d'ambdós estils narratius.

English grammar games in primary education

The purpose of this study was to analyse pupils’ English grammar acquisition from competitive and cooperative approaches. After searching a wide range of authors’ contribution to English language learning, grammar acquisition, classroom environment and language games. A hundred and twenty pupils from three schools; two from Ripoll and one from Campdevànol were enrolled in a specific grammar games intervention. This was imparted in three different phases: first of all, I interviewed the three teachers from the three schools, then I put into practice my competitive and cooperative games which I designed especially for this study (all the sessions were carried, assessed and registered by myself); finally, all pupils answered a questionnaire related to their experiences in my grammar games intervention. Analysis of teaching interventions showed that, in terms of English language acquisition, pupils used different strategies to show up understanding and achieve the objective of the game such as: recalling their background knowledge, expressing sentences influenced by their internal language and their mother tongue. Data collected revealed that most difficulties were founded in team work, even more in competitive games. The results also showed that team work is something which has to be developed step by step in order to achieve language learning and all pupils’ active participation successfully.

Materials and supplementary materials used to teach vocabulary in the English class

This study is based on the analysis of the use of supplementary materials to teach vocabulary by second language teachers in Primary Education. The study consists of two analyses: the first one is a quantitative analysis based on 33 questionnaires answered by different second language teachers of Primary Education. The other, is a qualitative analysis in which the teacher’s subjective opinion on vocabulary learning techniques is presented. The study covers these main aspects: material use, effectiveness, children’s motivation, main criteria to teach vocabulary and the children’s role in their vocabulary learning.

Speaking in the CLIL classroom: to what extent do teachers and students use english in the classroom?

L'objectiu principal d'aquesta investigació va ser determinar els efectes del CLIL en els professors i estudiants en les seves produccions orals. El punt de partida de la meva investigació era de la teoria de Dalton-Puffer (2007), que estableix que la funció de parlar en les classes CLIL és mínima, la meva recerca s'ha basat en la recopilació recollir informació des de diferents fonts, amb la finalitat de veure si aquest fet també passa a les nostres escoles. Eventualment, he planejat algunes estratègies i activitats per incrementar la quantitat d’oportunitats per parlar en llengua anglesa els alumnes.

Oral English in different school settings

Hi ha molts tipus d’escoles diferents, i fins i tot, podem constatar que cada escola és diferent de les altres. Per aquesta raó, quan parlem sobre l’aprenentatge de l’anglès, no podem generalitzar una manera de fer-ho, perquè cada una d’elles tracta aquesta llengua de manera diferent. A més, pel que fa a l’aprenentatge d’una llengua, hi ha diferents habilitats involucrades, i entre totes aquestes, he centrat aquest projecte en l’habilitat oral. Aquesta recerca esta basada en l’observació de tres exemples de tipus d’escoles, i per ser més precisos, té l’objectiu d’aprofundir com tracten l’Anglès. D’aquesta manera, el principal objectiu d’aquest projecte és comparar l’habilitat oral dels alumnes d’aquestes escoles, tot considerant les seves diferències. Així doncs, amb el desenvolupament d’aquesta recerca, vaig voler descobrir si hi havien alguns alumnes amb millors habilitats orals que d’altres, i trobar-ne la possible raó.

Do real books help the learning of english in P4?

The purpose of this study is to answer the principal question, Do Real Books help the learning of English in P4?, and create a useful document to English teachers in Infant Education that are interested in working through stories. Previous to the development of the work, it has been necessary a research work and a theoretical documentation, performed using a literature review. This process has served to establish the basis of the study and to develop the subsequent didactic intervention. This second part of the study, the didactic intervention, contains all the information about how it was planned, carried to term and evaluated. There are three different ‘real books’ used as a reference in which the reader can see how to choose the correct story, how to adapt the text to the children, the daily planning, and how to evaluate the activities.

Observations sur les articles IX & X du titre III du projet de décret du comité ecclésiastique sur la Constitution du clergé ([Reprod.]) / par un député à l'Assemblée nationale

Collection : Les archives de la Révolution française ; 8.167