963 resultados para Gliome de haut grade


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The angle concept is a multifaceted concept having static and dynamic definitions. The static definition of the angle refers to “the space between two rays” or “the intersection of two rays at the same end point” (Mitchelmore & White, 1998), whereas the dynamic definition of the angle concept highlights that the size of angle is the amount of rotation in direction (Fyhn, 2006). Since both definitions represent two diverse situations and have unique limitations (Henderson & Taimina, 2005), students may hold misconceptions about the angle concept. In this regard, the aim of this research was to explore high achievers’ knowledge regarding the definition of the angle concept as well as to investigate their erroneous answers on the angle concept.

104 grade 6 students drawn from four well-established elementary schools of Yozgat, Turkey were participated in this research. All participants were selected via a purposive sampling method and their mathematics grades were 4 or 5 out of 5, and. Data were collected through four questions prepared by considering the learning competencies set out in the grade 6 curriculum in Turkey and the findings of previous studies whose purposes were to identify students’ misconceptions of the angle concept. The findings were analyzed by two researchers, and their inter-rater agreement was calculated as 0.91, or almost perfect. Thereafter, coding discrepancies were resolved, and consensus was established.

The angle concept is a multifaceted concept having static and dynamic definitions.The static definition of the angle refers to “the space between two rays” or“the intersection of two rays at the same end point” (Mitchelmore & White, 1998), whereas the dynamicdefinition of the angle concept highlights that the size of angle is the amountof rotation in direction (Fyhn, 2006). Since both definitionsrepresent two diverse situations and have unique limitations (Henderson & Taimina, 2005), students may holdmisconceptions about the angle concept. In this regard, the aim of thisresearch was to explore high achievers’ knowledge regarding the definition ofthe angle concept as well as to investigate their erroneous answers on theangle concept.

104grade 6 students drawn from four well-established elementary schools of Yozgat,Turkey were participated in this research. All participants were selected via a purposive sampling method and their mathematics grades were 4 or 5 out of 5,and. Data were collected through four questions prepared by considering the learning competencies set out in the grade 6 curriculum in Turkey and the findings of previous studies whose purposes were to identify students’ misconceptions of the angle concept. The findings were analyzed by two researchers, and their inter-rater agreement was calculated as 0.91, or almost perfect. Thereafter, coding discrepancies were resolved, and consensus was established.

In the first question, students were asked to answer a multiple choice questions consisting of two statics definitions and one dynamic definition of the angle concept. Only 38 of 104 students were able to recognize these three definitions. Likewise, Mitchelmore and White (1998) investigated that less than10% of grade 4 students knew the dynamic definition of the angle concept. Additionally,the purpose of the second question was to figure out how well students could recognize 0-degree angle. We found that 49 of 104 students were unable to recognize MXW as an angle. While 6 students indicated that the size of MXW is0, other 6 students revealed that the size of MXW is 360. Therefore, 12 of 104students correctly answered this questions. On the other hand, 28 of 104students recognized the MXW angle as 180-degree angle. This finding demonstrated that these students have difficulties in naming the angles.Moreover, the third question consisted of three concentric circles with center O and two radiuses of the outer circle, and the intersection of the radiuses with these circles were named. Then, students were asked to compare the size of AOB, GOD and EOF angles. Only 36 of 104 students answered correctly by indicating that all three angles are equal, whereas 68 of 104 students incorrectly responded this question by revealing AOB<GOD< EOF. These students erroneously thought the size of the angle is related to either the size of the arc marking the angle or the area between the arms of the angle and the arc marking angle. These two erroneous strategies for determining the size of angles have been found by a few studies (Clausen-May,2008; Devichi & Munier, 2013; Kim & Lee, 2014; Mithcelmore, 1998;Wilson & Adams, 1992). The last question, whose aim was to determine how well students can adapt theangle concept to real life, consisted of an observer and a barrier, and students were asked to color the hidden area behind the barrier. Only 2 of 104students correctly responded this question, whereas 19 of 104 students drew rays from the observer to both sides of the barrier, and colored the area covered by the rays, the observer and barrier. While 35 of 104 students just colored behind the barrier without using any strategies, 33 of 104 students constructed two perpendicular lines at the both end of the barrier, and colored behind the barrier. Similarly, Munier, Devinci and Merle (2008) found that this incorrect strategy was used by 27% of students.

Consequently, we found that although the participants in this study were high achievers, they still held several misconceptions on the angle concept and had difficulties in adapting the angle concept to real life.

Keywords: the angle concept;misconceptions; erroneous answers; high achievers

References

Clausen-May, T. (2008). AnotherAngle on Angles. Australian Primary Mathematics Classroom, 13(1),4–8.

Devichi, C., & Munier, V.(2013). About the concept of angle in elementary school: Misconceptions andteaching sequences. The Journal of Mathematical Behavior, 32(1),1–19. http://doi.org/10.1016/j.jmathb.2012.10.001

Fyhn, A. B. (2006). A climbinggirl’s reflections about angles. The Journal of Mathematical Behavior, 25(2),91–102. http://doi.org/10.1016/j.jmathb.2006.02.004

Henderson, D. W., & Taimina,D. (2005). Experiencing geometry: Euclidean and non-Euclidean with history(3rd ed.). New York, USA: Prentice Hall.

Kim, O.-K., & Lee, J. H.(2014). Representations of Angle and Lesson Organization in Korean and AmericanElementary Mathematics Curriculum Programs. KAERA Research Forum, 1(3),28–37.

Mitchelmore, M. C., & White,P. (1998). Development of angle concepts: A framework for research. MathematicsEducation Research Journal, 10(3), 4–27.

Mithcelmore, M. C. (1998). Youngstudents’ concepts of turning and angle. Cognition and Instruction, 16(3),265–284.

Munier, V., Devichi, C., &Merle, H. (2008). A Physical Situation as a Way to Teach Angle. TeachingChildren Mathematics, 14(7), 402–407.

Wilson, P. S., & Adams, V.M. (1992). A Dynamic Way to Teach Angle and Angle Measure. ArithmeticTeacher, 39(5), 6–13.

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Several different acquired resistance mechanisms of EGFR mutant lung adenocarcinoma to EGFR-tyrosine kinase inhibitor (TKI) therapy have been described, most recently transformation to small cell lung carcinoma (SCLC). We describe the case of a 46-year-old female with relapsed EGFR exon 19 deletion lung adenocarcinoma treated with erlotinib, and on resistance, cisplatin-pemetrexed. Liver rebiopsy identified an afatinib-resistant combined SCLC and non-small cell carcinoma with neuroendocrine morphology, retaining the EGFR exon 19 deletion. This case highlights acquired EGFR-TKI resistance through transformation to the high-grade neuroendocrine carcinoma spectrum and that that such transformation may not be evident at time of progression on TKI therapy.

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A consistent use of the target language during English lessons is beneficial for pupils’ linguistic development, but also challenging for both teachers and pupils. The main purpose for pupils to learn English is to be able to use it in communication, which requires that they develop the ability to comprehend input, produce output and use language strategies. Several researchers claim that a consistent use of the target language is necessary in order to develop these abilities. Therefore, the aim of this study is to examine the target language use during English lessons in Swedish grades 4-6, and what pupils’ opinions regarding target language use are. The methods used to collect data consisted of a pupil questionnaire with 42 respondents and an observation of two teachers’ English lessons during a week’s time. The results from the observations show that the teachers use plenty of target language during lessons, but the first language as well to explain things that pupils might experience difficult to understand otherwise. The results from the questionnaire mainly show that the pupils seem to enjoy English and like to both speak and hear the target language during lessons. The main input comes from listening to a CD with dialogues and exercises in the textbook and the workbook, and from the teacher speaking. The results also show that a majority of the pupils use the target language in their spare time. A conclusion that can be drawn from this study is that the TL should be used to a large extent in order to support pupils’ linguistic development. However, teachers may sometimes need to use L1 in order to facilitate understanding of the things that many pupils find difficult, for example grammar. Suggestions for further research in this area include similar studies conducted on a larger scale.

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The purpose of this experiment was to explore whether listening positions (close or distant location from the sound source) in the classroom, and classroom reverberation, influence students' score on a test for second-language (L2) listening comprehension (i.e., comprehension of English in Swedish speaking participants). The listening comprehension test administered was part of a standardized national test of English used in the Swedish school system. A total of 125 high school pupils, 15 years old, participated. Listening position was manipulated within subjects, classroom reverberation between subjects. The results showed that L2 listening comprehension decreased as distance from the sound source increased. The effect of reverberation was qualified by the participants' baseline L2 proficiency. A shorter reverberation was beneficial to participants with high L2 proficiency, while the opposite pattern was found among the participants with low L2 proficiency. The results indicate that listening comprehension scores-and hence students' grade in English-may depend on students' classroom listening position.

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Les déficits cognitifs sont centraux à la psychose et sont observables plusieurs années avant le premier épisode psychotique. L’atteinte de la mémoire épisodique est fréquemment identifiée comme une des plus sévères, tant chez les patients qu’avant l’apparition de la pathologie chez des populations à risque. Chez les patients psychotiques, l’étude neuropsychologique des processus mnésiques a permis de mieux comprendre l’origine de cette atteinte. Une altération des processus de mémoire de source qui permettent d’associer un souvenir à son origine a ainsi été identifiée et a été associée aux symptômes positifs de psychose, principalement aux hallucinations. La mémoire de source de même que la présence de symptômes sous-cliniques n’ont pourtant jamais été investiguées avant l’apparition de la maladie chez une population à haut risque génétique de psychose (HRG). Or, leur étude permettrait de voir si les déficits en mémoire de source de même que le vécu d’expériences hallucinatoires sont associés à l’apparition de la psychose ou s’ils en précèdent l’émergence, constituant alors des indicateurs précoces de pathologie. Afin d’étudier cette question, trois principaux objectifs ont été poursuivis par la présente thèse : 1) caractériser le fonctionnement de la mémoire de source chez une population HRG afin d’observer si une atteinte de ce processus précède l’apparition de la maladie, 2) évaluer si des manifestations sous-cliniques de symptômes psychotiques, soit les expériences hallucinatoires, sont identifiables chez une population à risque et 3) investiguer si un lien est présent entre le fonctionnement en mémoire de source et la symptomatologie sous-clinique chez une population à risque, à l’instar de ce qui est documenté chez les patients. Les résultats de la thèse ont permis de démontrer que les HRG présentent une atteinte de la mémoire de source ciblée à l’attribution du contexte temporel des souvenirs, ainsi que des distorsions mnésiques qui se manifestent par une fragmentation des souvenirs et par une défaillance de la métacognition en mémoire. Il a également été observé que les expériences hallucinatoires sous-cliniques étaient plus fréquentes chez les HRG. Des associations ont été documentées entre certaines distorsions en mémoire et la propension à halluciner. Ces résultats permettent d’identifier de nouveaux indicateurs cliniques et cognitifs du risque de développer une psychose et permettent de soulever des hypothèses liant l’attribution de la source interne-externe de l’information et le développement de la maladie. Les implications empiriques, théoriques, méthodologiques et cliniques de la thèse sont discutées.

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Summaries of the data gathered for this project.

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Les caractéristiques physiques d’un site de nidification peuvent influencer la probabilité qu’il soit utilisé et l’issue des tentatives de nidification. La buse pattue (Buteo lagopus) construit un imposant nid, qui peut être réutilisé plusieurs années, en bordure des falaises et des versants en Arctique. Ces habitats escarpés sont perturbés par des mouvements de masse pouvant entraîner la destruction de sites critiques pour la reproduction des buses. Nous avons d’abord examiné l’effet de plusieurs variables environnementales et de la réutilisation d’un nid sur la reproduction de la buse pattue. Ensuite, nous avons évalué la vulnérabilité des nids aux mouvements de masse et identifié les facteurs environnementaux associés à la persistance des nids. L’étude s’est déroulée à l’île Bylot (Nunavut) de 2007 à 2015. La probabilité qu’un nid soit utilisé par un couple augmentait avec la distance du nid actif le plus proche, la présence d’un surplomb au-dessus du nid et la densité des lemmings. Les nids accessibles aux renards et orientés vers le nord étaient associés à un moins bon succès reproducteur. Celui-ci était aussi positivement relié à la densité estivale de lemmings et négativement relié aux précipitations. Nos résultats suggèrent que les caractéristiques physiques du site de nidification offrant un microclimat favorable et une protection contre les prédateurs reflètent des sites de haute qualité. Le succès reproducteur était similaire entre les nouveaux nids et ceux préexistants, suggérant que la construction d’un nid n’entraîne pas de coût sur la reproduction à court terme. Parmi les 82 nids connus, près du tiers ont été détruits par des mouvements de masse et parmi ceux encore intacts, la majorité sont à risque modéré et haut de l’être. La probabilité de destruction était élevée pour les nids construits sur des sédiments non consolidés et positivement associée aux fortes précipitations. La hausse anticipée des précipitations due aux changements climatiques est susceptible d’augmenter la vulnérabilité des nids aux mouvements de masse ce qui pourrait ultimement réduire la disponibilité de sites appropriés pour la reproduction de ce rapace.

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La transplantation de cellules souches hématopoïétiques (CSH) constitue une avenue thérapeutique potentiellement curative pour plusieurs cancers hématologiques comme la leucémie. L’utilisation d’une thérapie immunosuppressive pour prévenir la maladie du greffon contre l’hôte (GvHD) est un déterminant majeur du succès de la greffe. Malgré tout, cette complication survient chez 25 à 50% des transplantés et est une cause majeure de mortalité. L’optimisation du régime d’immunosuppression est un facteur facilement modifiable qui pourrait améliorer le pronostic des patients. Particulièrement, les polymorphismes du génome du donneur ou du receveur dans les voies pharmacogénomiques des immunosuppresseurs pourraient influencer l’exposition et l’action de ces médicaments, de même que le pronostic du patient. Le profilage de 20 pharmacogènes prioritaires chez des paires de donneurs-receveurs en greffe de CSH a permis d’identifier des variations génétiques liées au risque de la GvHD aiguë. Principalement, le statut génétique du receveur pour les protéines ABCC1 et ABCC2, impliquées dans le transport du méthotrexate (MTX), ainsi que des cibles moléculaires de ce médicament (ATIC et MTHFR) ont été associées au risque de GvHD aiguë. Similairement, le NFATc1, codant pour une cible moléculaire de la cyclosporine, augmentait lui aussi le risque de la maladie. Les porteurs de deux génotypes à risque et plus étaient particulièrement prédisposés à développer cette complication. Par surcroît, le statut génétique du donneur influençait également le pronostic du receveur après la greffe. Entre autres, des allèles protecteurs ont été identifiés dans les voies liées au transport (SLC19A1) et à l’action du MTX (DHFR). Inversement, NFATc2 a été associé à une augmentation du risque de GvHD aiguë. Afin de mieux comprendre les associations observées entre ces marqueurs génétiques et le risque de GvHD aiguë, une étude prospective innovante est en cours chez des greffés de CSH. Cette étude permettra d’étudier comment la génétique du patient ou du donneur peut influencer la pharmacocinétique et la pharmacodynamie des immunosuppresseurs, de même que leurs liens avec la GvHD aiguë. Ces paramètres sont quantifiés grâce à des approches analytiques que nous avons mises au point afin de répondre aux besoins spécifiques et uniques de cette étude. Les approches proposées dans cette thèse sont complémentaires aux méthodes classiques de suivi des immunosuppresseurs et pourraient aider à optimiser la pharmacothérapie du patient. Une meilleure identification des patients à haut risque de GvHD aiguë avant la greffe, basée sur des marqueurs pharmacogénomiques identitaires, pourrait guider le choix de la prophylaxie immunosuppressive, et ainsi améliorer l’issue clinique de la greffe.

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Bragança and Morais Massifs are part of the mega-klippen ensemble of NW Iberia, comprising a tectonic pile of four allochthonous units stacked above the Central-Iberian Zone autochthon. On top of this pile, the Upper Allochthonous Terrane (UAT) includes different high-grade metamorphic series whose age and geodynamic meaning are controversial. Mafic granulites provided U–Pb zircon ages at 399±7 Ma, dating the Variscan emplacement of UAT. In contrast,U–Pb zircon ages of ky- and hb-eclogites, felsic/intermediate HP/HT-granulites and orthogneisses (ca. 500–480 Ma) are identical to those of gabbros (488 ± 10 Ma) and Grt-pyroxenites (495 ± 8 Ma) belonging to a mafic/ultramafic igneous suite that records upper mantle melting and mafic magma crustal underplating at these times. Gabbros intrude the high-grade units of UAT and did not underwent the HP metamorphic event experienced by eclogites and granulites. These features and the zircon dates resemblance among different lithologies, suggest that extensive age resetting of older events may have been correlative with the igneous suite emplacement/crystallisation. Accordingly, reconciliation of structural, petrological and geochronological evidence implies that the development and early deformation of UAT high-grade rocks should be ascribed to an orogenic cycle prior to ≈500 Ma. Undisputable dating of this cycle is impossible, but the sporadic vestiges of Cadomian ages cannot be disregarded. The ca. 500–480 Ma time-window harmonises well with the Lower Palaeozoic continental rifting that trace the VariscanWilson Cycle onset and the Rheic Ocean opening. Subsequent preservation of the high heat-flowregime, possibly related to the Palaeotethys back-arc basin development (ca. 450–420 Ma), would explain the 461 ± 10 Ma age yielded by some zircon domains in felsic granulites, conceivably reflecting zircon dissolution/ recrystallisation till Ordovician times, long before the Variscan paroxysm (ca. 400–390 Ma). This geodynamic scenario suggests also that UAT should have been part of Armorica before its emplacement on top of Iberia after Palaeotethys closure.

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In this article empirical findings from interviews with teachers of three classes of 12-year-old pupils are presented, together with questionnaire-responses from these 54 pupils. The interviews focus on teaching aims for Religious Education (RE), a subject that in Sweden, besides dealing with religion, also explores other kinds of beliefs, ethics and life questions. In the questionnaire the pupils are asked to solve four RE tasks with content that is central from a Swedish curriculum perspective. The research involves pupils at the beginning of the sixth grade and the purpose of this article is to look at the teachers’ aims and the pupils’ responses, and consider what these may indicate about conditions for teaching and learning RE in these classes. The findings show that the perspectives of the pupils at the beginning of the sixth grade seem to be rather far from the expectations of the RE syllabus. The pupils’ statements are rather vague with regard to religion as a phenomenon and there are few examples of pupils interpreting religious symbols in a way that is useful in further analysis. While existential and ethical plots, messages and point of views are comparatively easy to describe, it is harder to express multiple perspectives, reasons, comparisons and questions. A problem for the teachers in developing the perspectives of their pupils is that they find it hard to say what kind of general difficulties pupils have in RE, a fact that makes it hard to direct the teaching. Another challenge is that the teachers’ RE-aims are rather overarching and primarily related to fostering fundamental values. What improves the conditions for teaching and learning is the teachers’ concern for the pupils and their relationships with the teacher and with each other, a factor which is of vital importance for learning and which can also be used as a specific teaching method in subject matter education.

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The aim of this double blind randomized clinical trial was to compare the short-term and long-term outcomes of stapled haemorrhoidopexy (SH group) performed using a circular stapler with that of the Milligan-Morgan haemorrhoidectomy (MMH group). A total of 79 consecutive patients with grade III haemorrhoids were randomized into two groups treated with SH (n. 39) and MMH (n. 40). The outcomes of the procedures were evaluated postoperatively and over a follow-up period of minimum 2 years. Patients undergoing the SH procedure showed greater short term advantages than MMH group with reduced pain, shorter length of hospital stay, earlier return to work and high patient satisfaction. Long-term follow-up has indicated more favourable results in MMH group in terms of resumption of symptoms with absence of residual prolapse and risk of recurrence of prolapse. At two years follow-up recurrent prolapse was confirmed in six patients of SH group (13%) whereas in none of the MMH group. At six months follow-up there weren’t significant difference in the mean satisfaction score for the two groups. At two years the mean satisfaction score was higher in the MMH group vs SH group. Seven patients in the SH group needed a reoperation whereas none in MMH group. From January 2009, in our Surgery Unit the patients are always informed about a higher recurrence rate of SH and we perform this technique only when the patient choices to accept this risk to take advantage of the short-term benefits of this procedure.

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The +Contigo Project is a longitudinal research project based on a multilevel network intervention aimed at promoting mental health and well-being and preventing suicidal behaviors. Students participate in social skills training sessions on the stigma of mental disorders, adolescence, self-esteem, problem-solving skills, and wellbeing. Problem statement: To identify the qualitative impact of the +Contigo Project. Objectives: To identify the importance of the project for students, the problem situations which it helped to solve, and its impact on an individual level. Research methods: Content analysis (Bardin, 2009) with a posteriori categorical identification. Semi-structured interview guide with 5 questions. A convenience sample of 16 students, from three schools of one school cluster in the Center Region of Portugal, was used. The ethical aspects of parental consent, voluntary participation and data confidentiality were addressed. Findings: Fourteen categories emerged from the data analysis. The answers to Question 4 'How was this project important to you?' were particularly relevant. Students mentioned that it improved their self-esteem by increasing self-confidence and interpersonal skills, and that it increased their reflection and awareness on problems with which they learned how to cope during the sessions. Conclusions: All interviewees considered that the +Contigo project helped them to solve problems, improve their interpersonal skills and cope with the adolescence period. Students improved their self-esteem and self-knowledge, and were able to apply what they had learned in the sessions in their daily lives. We concluded that the project had a positive impact on the students' mental health.

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Abstract The purpose of this study was to examine how four high schools used an Early Warning Indicator Report (EWIR) to improve ninth grade promotion rates. Ninth grade on-time promotion is an early predictor of a student’s likelihood to graduate (Bornsheuer, Polonyi, Andrews, Fore, & Onwuegbuzie, 2011; Leckrone & Griffith, 2006; Roderick, Kelley-Kemple, Johnson, & Beechum, 2014; Zvoch, 2006). The analysis revealed both similarities and differences in the ways that the four schools used the EWIR. The research took place in a large urban school district in the Mid-Atlantic. Sixteen participants from four high schools and the district’s central office voluntarily participated in face-to-face interviews. The researcher utilized a qualitative case study method to examine the implementation of the EWIR system in Wyatt School District. The interview data was transcribed and analyzed, along with district documents, to identify categories in this cross case analysis. Three primary themes emerged from the data: (1) targeted school structures for EWIR implementation, (2) the EWIR identified necessary supports for students, and (3) the central office support for school staff. The findings revealed the various ways that the target schools implemented the EWIR in their buildings and the level of support that they received from the central office that aided them in using the EWIR to improve ninth grade promotion rates. Based on the findings of this study, the researcher provided a number of key recommendations: (1) Districts should provide professional development to schools to ensure that schools have the support they need to implement the EWIR successfully; (2) There should be increased accountability from the central office for schools using the EWIR to identify impactful interventions for ninth graders; and (3) The district needs to assign dedicated central office staff to support the implementation of the EWIR in high schools across the district. As schools continue to face the challenge of improving ninth grade promotion rates, effective use of an Early Warning Indicator Report is recommended to provide school and district staff with data needed to impact overall student performance.