Tadpole pupil.

Editors' Note: Dr. Egan inquires about the possibility of Tournay phenomenon in Kawasaki and Mayer's "Tadpole pupil." Dr. Charles, in reference to "Disease-modifying drugs for multiple sclerosis in pregnancy: A systematic review," suggests that it might be appropriate to continue glatiramer acetate in women trying to conceive given the lack of evidence of fetal risk. Authors Tremlett et al. advise that, at this point, each case should continue to be assessed individually.

En torno a los efectos de la edad en el aprendizaje escolar de una lengua extrangera

The purpose of this article is to treat a currently much debated issue, the effects of age on second language learning. To do so, we contrast data collected by our research team from over one thousand seven hundred young and adult learners with four popular beliefs or generalizations, which, while deeply rooted in this society, are not always corroborated by our data.Two of these generalizations about Second Language Acquisition (languages spoken in the social context) seem to be widely accepted: a) older children, adolescents and adults are quicker and more efficient at the first stages of learning than are younger learners; b) in a natural context children with an early start are more liable to attain higher levels of proficiency. However, in the context of Foreign Language Acquisition, the context in which we collect the data, this second generalization is difficult to verify due to the low number of instructional hours (a maximum of some 800 hours) and the lower levels of language exposure time provided. The design of our research project has allowed us to study differences observed with respect to the age of onset (ranging from 2 to 18+), but in this article we focus on students who began English instruction at the age of 8 (LOGSE Educational System) and those who began at the age of 11 (EGB). We have collected data from both groups after a period of 200 (Time 1) and 416 instructional hours (Time 2), and we are currently collecting data after a period of 726 instructional hours (Time 3). We have designed and administered a variety of tests: tests on English production and reception, both oral and written, and within both academic and communicative oriented approaches, on the learners' L1 (Spanish and Catalan), as well as a questionnaire eliciting personal and sociolinguistic information. The questions we address and the relevant empirical evidence are as follows: 1. "For young children, learning languages is a game. They enjoy it more than adults."Our data demonstrate that the situation is not quite so. Firstly, both at the levels of Primary and Secondary education (ranging from 70.5% in 11-year-olds to 89% in 14-year-olds) students have a positive attitude towards learning English. Secondly, there is a difference between the two groups with respect to the factors they cite as responsible for their motivation to learn English: the younger students cite intrinsic factors, such as the games they play, the methodology used and the teacher, whereas the older students cite extrinsic factors, such as the role of their knowledge of English in the achievement of their future professional goals. 2 ."Young children have more resources to learn languages." Here our data suggest just the opposite. The ability to employ learning strategies (actions or steps used) increases with age. Older learners' strategies are more varied and cognitively more complex. In contrast, younger learners depend more on their interlocutor and external resources and therefore have a lower level of autonomy in their learning. 3. "Young children don't talk much but understand a lot"This third generalization does seem to be confirmed, at least to a certain extent, by our data in relation to the analysis of differences due to the age factor and productive use of the target language. As seen above, the comparably slower progress of the younger learners is confirmed. Our analysis of interpersonal receptive abilities demonstrates as well the advantage of the older learners. Nevertheless, with respect to passive receptive activities (for example, simple recognition of words or sentences) no great differences are observed. Statistical analyses suggest that in this test, in contrast to the others analyzed, the dominance of the subjects' L1s (reflecting a cognitive capacity that grows with age) has no significant influence on the learning process. 4. "The sooner they begin, the better their results will be in written language"This is not either completely confirmed in our research. First of all, we perceive that certain compensatory strategies disappear only with age, but not with the number of instructional hours. Secondly, given an identical number of instructional hours, the older subjects obtain better results. With respect to our analysis of data from subjects of the same age (12 years old) but with a different number of instructional hours (200 and 416 respectively, as they began at the ages of 11 and 8), we observe that those who began earlier excel only in the area of lexical fluency. In conclusion, the superior rate of older learners appears to be due to their higher level of cognitive development, a factor which allows them to benefit more from formal or explicit instruction in the school context. Younger learners, however, do not benefit from the quantity and quality of linguistic exposure typical of a natural acquisition context in which they would be allowed to make use of implicit learning abilities. It seems clear, then, that the initiative in this country to begin foreign language instruction earlier will have positive effects only if it occurs in combination with either higher levels of exposure time to the foreign language, or, alternatively, with its use as the language of instruction in other areas of the curriculum.

Interactive readings of children's literature in day care: Microgenetic analysis of the semiopictorial construction.

In line with educational issues involved in emergent literacy practices in preschool, in particular those concerning comprehension processes, this paper focuses on picture-based narrative comprehension during an interactive reading session of a wordless picture book, involving a group of children aged three and their teacher. Children are asked to make inferences about the meaning and outcome of the story, a procedure which gradually elicits their responses on how events link together, thus enhancing their capacity to use prior and implicit knowledge to build the story meaning. Moreover, this study highlights the importance of interaction for developing comprehension. Data collected was analysed following didactic microgenesis, an analytical approach showing that knowledge built during interaction depends on the joint construction of a zone of common meaning by which teacher and children try to adjust to each other. In order to help the process of merging different meanings of the story built online, a text written by researchers, following the narrative structure of the story, was read by the teacher after the picture-based reading. This led us to examine through interactional analysis which semiotic cues were used during recall on the following day, as an additional measure of knowledge construction.

Improvement of cardiovascular risk prediction: time to review current knowledge, debates, and fundamentals on how to assess test characteristics.

Cardiovascular risk assessment might be improved with the addition of emerging, new tests derived from atherosclerosis imaging, laboratory tests or functional tests. This article reviews relative risk, odds ratios, receiver-operating curves, posttest risk calculations based on likelihood ratios, the net reclassification improvement and integrated discrimination. This serves to determine whether a new test has an added clinical value on top of conventional risk testing and how this can be verified statistically. Two clinically meaningful examples serve to illustrate novel approaches. This work serves as a review and basic work for the development of new guidelines on cardiovascular risk prediction, taking into account emerging tests, to be proposed by members of the 'Taskforce on Vascular Risk Prediction' under the auspices of the Working Group 'Swiss Atherosclerosis' of the Swiss Society of Cardiology in the future.

Embodying feminist research: learning from action research, political practices, diffractions and collective knowledge.

In the past three decades, feminists and critical theorists have discussed and argued the importance of deconstructing and problematizing social science research methodology in order to question normalized hierarchies concerning the production of knowledge and the status of truth claims. Nevertheless, often, these ideas have basically remained theoretical propositions not embodied in research practices. In fact there is very little published discussion about the difficulties and limits of their practical application. In this paper we introduce some interconnected reflections starting from two different but related experiences of embodying 'feminist activist research'. Our aim is to emphasise the importance of attending to process, making mistakes and learning during fieldwork, as well as experimenting with personalized forms of analysis, such as the construction of narratives and the story-telling process.

Embodying feminist research: learning from action research, political practices, diffractions and collective knowledge.

In the past three decades, feminists and critical theorists have discussed and argued the importance of deconstructing and problematizing social science research methodology in order to question normalized hierarchies concerning the production of knowledge and the status of truth claims. Nevertheless, often, these ideas have basically remained theoretical propositions not embodied in research practices. In fact there is very little published discussion about the difficulties and limits of their practical application. In this paper we introduce some interconnected reflections starting from two different but related experiences of embodying 'feminist activist research'. Our aim is to emphasise the importance of attending to process, making mistakes and learning during fieldwork, as well as experimenting with personalized forms of analysis, such as the construction of narratives and the story-telling process.

Science in Western Islam. The circulation of knowledge in Mediterranean region

La Mediterrània ha estat gresol de la circulació d¿idees i persones des de fa mil·lennis. Durant l¿edat mitjana, però, el moviment més rellevant va ser, tal vegada, el que es va produirentre l¿Orient (Maixriq) i l¿Occident (Magrib) islàmics. Els viatges d¿estudis, íntimament units a les prescripcions religioses,varen convertir els científics musulmans en membres especialment actius en la difusió dels coneixements i dels avenços ques¿anaven adquirint a la capital de l¿imperi, Bagdad. Lluny de ser mers «transportistes» de la ciència, el nivell cultural assolit durantl'edat d'or abbassí els va convertir en un dels clímaxs intel·lectuals de la història. Al principi, tot i restar en un discret segonpla, els científics del nord d¿Àfrica i, especialment, els científicsd'al-Andalus varen tenir un paper essencial en la transmissióde la ciència oriental cap a una Europa que en va recollir el testimoni.Per això l¿aportació de la cultura araboislàmica és un esglaó sense el qual és impossible entendre la ciència posterior.Els camps conreats foren diversos: medicina, agronomia,òptica... però l¿àmbit que presidí la ciència fou, sens dubte,l¿astronomia (relacionada, al seu torn, amb les matemàtiques i la geografia). Els noms dels astrònoms més rellevants (desd¿al-Khwarizmi fins a Azarquiel) i les fites que varen assolir justifiquen que fossin coneguts per un públic ampli. Malgrat tot, continuen essent uns grans desconeguts.

Implementation of guidelines on delirium in a General Hospital: a before-after study of their impact on caregivers' knowledge and clinical skills

INTRODUCTION: Delirium is a highly prevalent disorder, with serious consequences for the hospitalised patient. Nevertheless, it remains under-diagnosed and under-treated. We developed evidence-based clinical practice guidelines (CPGs) focusing on prevention, screening, diagnosis, and treatment of delirium in a general hospital. This article presents the implementation process of these CPGs and a before-after study assessing their impact on healthcare professionals' knowledge and on clinical practice. METHODS: CPGs on delirium were first implemented in two wards (Neurology and Neurosurgery) of the Lausanne university hospital. Interactive one-hour educational sessions for small groups of nurses and physicians were organised. Participants received a summary of the guidelines and completed a multiple choice questionnaire, assessing putative changes in knowledge, before and three months after the educational session. Other indicators such as "diagnosis of delirium" reported in the discharge letters, and mean duration of patients' hospital stay before and after implementation were compared. RESULTS: Eighty percent of the nurses and physicians from the Neurology and Neurosurgery wards attended the educational sessions. Both nurses and physicians significantly improved their knowledge after the implementation (+9 percentage-points). Other indicators were not modified by the intervention. CONCLUSION: A single interactive intervention improved both nurses' and physicians' knowledge on delirium. Sustained and repeated interventions are probably needed to demonstrate changes in clinical practice.

The INTERNORM Project: Bridging Two Worlds of Expert- and Lay-Knowledge in Standardization

This paper presents a pilot project to reinforce participatory practices in standardization. The INTERNORM project creates an interactive knowledge center based on the sharing of academic skills and experiences accumulated by the civil society, especially consumer associations, environmental associations and trade unions to strengthen the participatory process of standardization. The first objective of the project is action-oriented: INTERNORM provides a common knowledge pool supporting the participation of civil society actors to international standard-setting activities by bringing them together with academic experts in working groups and providing logistic and financial support to their participation in meetings of national and international technical committees. The second objective is analytical: the standardization action provides a research field for a better understanding of the participatory dynamics underpinning international standardization. This paper presents three incentives that explain civil society (non-)involvement in standardization that overcome conventional resource-based hypotheses: an operational incentive related to the use of standards in the selective goods provided by associations to their membership; a thematic incentive provided by the setting of priorities by strategic committees created in some standardization organization; and a rhetorical incentive related to the discursive resource that civil society concerns offers to the different stakeholders.

Disorders of the pupil.

The pupil is one objective marker of vision and autonomic pathways. A good understanding of its anatomy and careful examination techniques are the essential tools for proper clinical diagnosis of pupillary disorders.

Crisis Kit for Teacher and Administrators, January 17, 2012

Whether it’s tornadoes, flooding, winter storms or an act of terrorism, emergencies can occur quickly and without warning. Although we cannot prevent emergencies, we can prepare for them. Teachers and administrators need to take special care as they are responsible for the students in their care. Putting together and having on hand a crisis kit can be invaluable in times of emergency.