647 resultados para MIA


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Són molts els estudis que avui en dia incideixen en la necessitat d’oferir un suport metodològic i psicològic als aprenents que treballen de manera autònoma. L’objectiu d’aquest suport és ajudar-los a desenvolupar les destreses que necessiten per dirigir el seu aprenentatge així com una actitud positiva i una major conscienciació envers aquest aprenentatge. En definitiva, aquests dos tipus de preparació es consideren essencials per ajudar els aprenents a esdevenir més autònoms i més eficients en el seu propi aprenentatge. Malgrat això, si bé és freqüent trobar estudis que exemplifiquen aplicacions del suport metodològic dins els seus programes, principalment en la formació d’estratègies o ajudant els aprenents a desenvolupar un pla de treball, aquest no és el cas quan es tracta de la seva preparació psicològica. Amb rares excepcions, trobem estudis que documentin com s’incideix en les actituds i en les creences dels aprenents, també coneguts com a coneixement metacognitiu (CM), en programes que fomenten l’autonomia en l’aprenentatge. Els objectius d’aquest treball son dos: a) oferir una revisió d’estudis que han utilitzat diferents mitjans per incidir en el CM dels aprenents i b) descriure les febleses i avantatges dels procediments i instruments que utilitzen, tal com han estat valorats en estudis de recerca, ja que ens permetrà establir criteris objectius sobre com i quan utilitzar-los en programes que fomentin l’aprenentatge autodirigit.

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BACKGROUND: Only a few studies have explored the relation between coffee and tea intake and head and neck cancers, with inconsistent results. METHODS: We pooled individual-level data from nine case-control studies of head and neck cancers, including 5,139 cases and 9,028 controls. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI), adjusting for potential confounders. RESULTS: Caffeinated coffee intake was inversely related with the risk of cancer of the oral cavity and pharynx: the ORs were 0.96 (95% CI, 0.94-0.98) for an increment of 1 cup per day and 0.61 (95% CI, 0.47-0.80) in drinkers of >4 cups per day versus nondrinkers. This latter estimate was consistent for different anatomic sites (OR, 0.46; 95% CI, 0.30-0.71 for oral cavity; OR, 0.58; 95% CI, 0.41-0.82 for oropharynx/hypopharynx; and OR, 0.61; 95% CI, 0.37-1.01 for oral cavity/pharynx not otherwise specified) and across strata of selected covariates. No association of caffeinated coffee drinking was found with laryngeal cancer (OR, 0.96; 95% CI, 0.64-1.45 in drinkers of >4 cups per day versus nondrinkers). Data on decaffeinated coffee were too sparse for detailed analysis, but indicated no increased risk. Tea intake was not associated with head and neck cancer risk (OR, 0.99; 95% CI, 0.89-1.11 for drinkers versus nondrinkers). CONCLUSIONS: This pooled analysis of case-control studies supports the hypothesis of an inverse association between caffeinated coffee drinking and risk of cancer of the oral cavity and pharynx. IMPACT: Given widespread use of coffee and the relatively high incidence and low survival of head and neck cancers, the observed inverse association may have appreciable public health relevance.

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Odds ratios for head and neck cancer increase with greater cigarette and alcohol use and lower body mass index (BMI; weight (kg)/height(2) (m(2))). Using data from the International Head and Neck Cancer Epidemiology Consortium, the authors conducted a formal analysis of BMI as a modifier of smoking- and alcohol-related effects. Analysis of never and current smokers included 6,333 cases, while analysis of never drinkers and consumers of < or =10 drinks/day included 8,452 cases. There were 8,000 or more controls, depending on the analysis. Odds ratios for all sites increased with lower BMI, greater smoking, and greater drinking. In polytomous regression, odds ratios for BMI (P = 0.65), smoking (P = 0.52), and drinking (P = 0.73) were homogeneous for oral cavity and pharyngeal cancers. Odds ratios for BMI and drinking were greater for oral cavity/pharyngeal cancer (P < 0.01), while smoking odds ratios were greater for laryngeal cancer (P < 0.01). Lower BMI enhanced smoking- and drinking-related odds ratios for oral cavity/pharyngeal cancer (P < 0.01), while BMI did not modify smoking and drinking odds ratios for laryngeal cancer. The increased odds ratios for all sites with low BMI may suggest related carcinogenic mechanisms; however, BMI modification of smoking and drinking odds ratios for cancer of the oral cavity/pharynx but not larynx cancer suggests additional factors specific to oral cavity/pharynx cancer.

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This study presents the results of implementing a CLIL programme in a Catalan primary school three years after the onset of the implementation. The main objective of this investigation was to determine the effects of CLIL on students’ L2 English oral performance in terms of Complexity, Accuracy and Fluency (CAF). The results obtained suggest that CLIL learners outperform non-CLIL learners not only in fluency, but also in syntactic complexity. However, despite the encouraging results, the study concludes that further research which transcends the methodological limitations observed in the study is needed in order to confirm the results

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BACKGROUND: Greater tobacco smoking and alcohol consumption and lower body mass index (BMI) increase odds ratios (OR) for oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancers; however, there are no comprehensive sex-specific comparisons of ORs for these factors. METHODS: We analyzed 2,441 oral cavity (925 women and 1,516 men), 2,297 oropharynx (564 women and 1,733 men), 508 hypopharynx (96 women and 412 men), and 1,740 larynx (237 women and 1,503 men) cases from the INHANCE consortium of 15 head and neck cancer case-control studies. Controls numbered from 7,604 to 13,829 subjects, depending on analysis. Analyses fitted linear-exponential excess ORs models. RESULTS: ORs were increased in underweight (<18.5 BMI) relative to normal weight (18.5-24.9) and reduced in overweight and obese categories (>/=25 BMI) for all sites and were homogeneous by sex. ORs by smoking and drinking in women compared with men were significantly greater for oropharyngeal cancer (p < 0.01 for both factors), suggestive for hypopharyngeal cancer (p = 0.05 and p = 0.06, respectively), but homogeneous for oral cavity (p = 0.56 and p = 0.64) and laryngeal (p = 0.18 and p = 0.72) cancers. CONCLUSIONS: The extent that OR modifications of smoking and drinking by sex for oropharyngeal and, possibly, hypopharyngeal cancers represent true associations, or derive from unmeasured confounders or unobserved sex-related disease subtypes (e.g., human papillomavirus-positive oropharyngeal cancer) remains to be clarified.

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Scanty data are available on the incidence (i.e., the absolute risk) of second cancers of the head and neck (HN) and its pattern with age. We investigated this issue using data from a multicentric study of 13 population-based cancer registries from Europe, Canada, Australia and Singapore for the years 1943-2000. A total of 99,257 patients had a first primary HN cancer (15,985 tongue, 22,378 mouth, 20,758 pharyngeal, and 40,190 laryngeal cancer), contributing to 489,855 person-years of follow-up. A total of 1,294 of the patients (1.3%) were diagnosed with second HN cancers (342 tongue, 345 mouth, 418 pharynx and 189 larynx). Male incidence rates of first HN cancer steeply increased from 0.68/100,000 at age 30-34 to 46.2/100,000 at age 70-74, and leveled off at older age; female incidence increased from 0.50/100,000 at age 30-34 to 16.5/100,000 at age 80-84. However, age-specific incidence of second HN cancers after a first HN cancer in men was around 200-300/100,000 between age 40-44 and age 70-74 and tended to decline at subsequent ages (150/100,000 at age 80-84); in women, incidence of second HN cancers was around 200-300/100,000 between age 45-49 and 80-84. The patterns of age-specific incidence were consistent for different subsites of second HN cancer and sexes; moreover, they were similar for age-specific incidence of first primary HN cancer in patients who subsequently developed a second HN cancer. The incidence of second HN cancers does not increase with age, but remains constant, or if anything, decreases with advancing age.

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BACKGROUND: Quitting tobacco or alcohol use has been reported to reduce the head and neck cancer risk in previous studies. However, it is unclear how many years must pass following cessation of these habits before the risk is reduced, and whether the risk ultimately declines to the level of never smokers or never drinkers. METHODS: We pooled individual-level data from case-control studies in the International Head and Neck Cancer Epidemiology Consortium. Data were available from 13 studies on drinking cessation (9167 cases and 12 593 controls), and from 17 studies on smoking cessation (12 040 cases and 16 884 controls). We estimated the effect of quitting smoking and drinking on the risk of head and neck cancer and its subsites, by calculating odds ratios (ORs) using logistic regression models. RESULTS: Quitting tobacco smoking for 1-4 years resulted in a head and neck cancer risk reduction [OR 0.70, confidence interval (CI) 0.61-0.81 compared with current smoking], with the risk reduction due to smoking cessation after >/=20 years (OR 0.23, CI 0.18-0.31), reaching the level of never smokers. For alcohol use, a beneficial effect on the risk of head and neck cancer was only observed after >/=20 years of quitting (OR 0.60, CI 0.40-0.89 compared with current drinking), reaching the level of never drinkers. CONCLUSIONS: Our results support that cessation of tobacco smoking and cessation of alcohol drinking protect against the development of head and neck cancer.

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This paper describes a new reliable method, based on modal interval analysis (MIA) and set inversion (SI) techniques, for the characterization of solution sets defined by quantified constraints satisfaction problems (QCSP) over continuous domains. The presented methodology, called quantified set inversion (QSI), can be used over a wide range of engineering problems involving uncertain nonlinear models. Finally, an application on parameter identification is presented

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Tutkimuksen tarkoituksena oli selvittää passiivisen mobilisaation vaikutusta ylemmän nilkkanivelen liikelaajuuteen ja siinä mahdollisesti esiintyvään kipuun. Lisäksi tavoitteena oli lisätä manuaalisen terapian tunnettuutta yhtenä jalkaterapian hoitomenetelmänä. Tutkimusmenetelmä oli kokeellinen yksittäistapaustutkimus. Tutkimuseen valittiin harkinnanvaraisesti neljä (n=4) henkilöä, joilla oli ainakin toisen ylemmän nilkkanivelen liikelaajuus dorsaalifleksioon alle 10̊. Lisäksi nivelessä saattoi esiintyä kipua. Passiivista mobilisaatiota annettiin kaksi kertaa viikossa kolmen viikon ajan. Perustasonmittaukset suoritettiin neljä kertaa ennen hoitojaksoa kahden viikon aikana ja kolme kertaa seurantajakson (6 viikkoa) aikana kahden viikon välein. Tiedonhankintamenetelminä olivat kysely- ja tutkimuslomake, kivun ja haitan arviointilomake. Ylemmän nilkkanivelen liikelaajuuden mittaus tehtiin Ficherin goniometrillä. Perustasonmittauksissa nilkkanivelten liikelaajuuden vaihtelu oli 3̊̊-14̊ polvi suorana ja polvi koukussa 5̊- 16̊. Kyselyn mukaan kahdella tutkittavalla esiintyi kipua ainakin toisessa ylemmässä nilkkanivelessä. Hoitojakson aikana kaikien tutkittavien liikelaajuus lisääntyi 3̊- 8̊ polvi suorana ja polvi koukussa 2̈̊- 9̊. Kolme henkilöä saavutetti normaalin kävelyn vaativan liikelaajuuden, 10̊ polvi suorana ja 15̊ polvi koukussa. Seurantavaiheessa liikelaajuudet lisääntyivät alkumittauksiin verratuna kolmella henkilöllä. Yhdellä henkilöllä saavutettu liikelaajuus säilyi seurantavaiheen loppuun asti. Mobilisaatio ei vaikuttanut merkittävästi ylemmän nilkkanivelen kipuun. Koska tämä oli yksittäistapaustutkimus ja tutkimusjoukko oli pieni (N=4), tutkimustuloksia ei voida yleistää. Tutkimustulokset ovat kuitenkin lupaavia ja ne antavat viitteen siitä, että passiivisella mobilisaatiolla voidaan lisätä ylemmän nilkkanivelen liikelaajuutta. Tutkimus antaa lisää näyttöä jalkaterapian alaraajoja tukevista hoitomenetelmistä ja erityisesti nivelen passiivisen mobilisaation vaikutuksesta ylemmän nilkkanivelen liikerajoitukseen. Mobilisaatio on tehokas hoitomenetelmä ja hyvä vaihtoehto perinteisille pehmytkudosperäisen jäykän nilkan hoitomuodoille. Tutkimusta ja sen tuloksia voivat hyödyntää kaikki terveysalan ammattilaiset, jotka työssään käyttävät passiivista mobilisaatiota. Tutkimuksen avulla jalkaterapeutit voivat parantaa omaa kriittistä työotettaan, työnsä seurantaa sekä hoitotulosten dokumentointia.

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Tämä opinnäytetyö liittyy Helsingin kaupungin Akuuttisairaalaosaston ja Helsingin ammattikorkeakoulun Stadian tutkimus- ja kehittämishankkeeseen "Kuntoutumista ja selviytymistä edistävän hoitotyön kehittäminen". Opinnäytetyö tehtiin yhteistyössä Helsingin kaupungin terveyskeskuksen Laakson sairaalan osasto 2 kanssa. Opinnäytetyön tarkoituksena oli kehittää Laakson sairaala osasto 2 ravitsemushoitoa. Tarkoituksena oli kartoittaa potilaan ravitsemushoidon toteutumista osastolla ja laatia kehittämisehdotuksia ravitse-mushoidon toteuttamiseen osastolla. Opinnäytetyön tutkimusmenetelminä käytettiin ruokailun seurantalomaketta ja strukturoitua haastattelulomaketta. Opinnäytetyön ruokailun seurantaan osallistui 10 potilasta, joiden ruokailua hoitajat ha-vainnoivat kahden päivän ajan. Strukturoituun haastatteluun osallistui 18 potilasta, joista nuorin oli 40-vuotias ja vanhin 98-vuotas. Aineisto analysoitiin SPSS for Windows 14.0 -ohjelmalla. Ruokailun seurantalomakkeella arvioituna potilaat söivät viljatuotteita liian vähän ja maitotuotteiden nauttiminen saattaa olla liian vähäistä. Aterioiden annoskoot olivat liian suuria. Haastatteluosuudessa selvisi, että yli puolella potilaista oli alhainen BMI ja kalkki- ja D-vitamiinivalmisteiden käyttö oli vähäistä. Osa potilaista oli sitä mieltä, että ruoka ei ollut riittävän lämmintä ja ateriat olivat suolattomia. Ilta-päiväkahvin tarjoilua huoneisiin ja ruokalistasta tiedottamista ennakkoon toivottiin myös. Kolmanneksella potilaista oli ainakin joskus huono ruokailuasento. Kaikki potilaat olivat omasta mielestään omatoimisia ruokailun suhteen, eikä heillä ollut syömisvaikeuksia. Tulokset osoittavat, että tulevaisuudessa olisi aihetta kiinnittää enemmän huomiota osastohoidossa olevien potilaiden ravitsemukseen liittyviin tekijöihin. Hyvä ravitsemustila parantaa elämänlaatua ja edesauttaa toimintakyvyn säilymistä. Huono ravitsemustila aiheuttaa monilta osin terveydellisiä ongel-mia, pitkittää kuntoutumista ja lisää ikääntyneiden hoidon kustannuksia.

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Os mecanismos de formação de frases relativas restritivas têm sido amplamente analisados na literatura sobre o português europeu (PE) e o português brasileiro (PB) (e.g. Tarallo 1985; Brito 1991; Kato 1993; Peres & Móia 1995; Kato et al. 1996; Alexandre 2000, Kenedy 2007), focando em particular se há ou não aplicação da operação Move. No entanto, os estudos sobre construções-Q, concretamente sobre relativas restritivas, em variedades (emergentes) do português em África são ainda escassos e restringem-se essencialmente ao português de Moçambique (PM), onde se observa um processo de mudança linguística que parece privilegiar a estratégia resumptiva (Chimbutane 1996; Gonçalves 1996; Gonçalves & Stroud 1998; Brito 2001), como em Nesta comunicação, alargaremos o estudo das frases relativas ao português falado em Cabo Verde e em S. Tomé e Príncipe, baseando-nos em corpora do Centro de Linguística da Universidade de Lisboa (CLUL) descritos na secção 3. O nosso objetivo é mostrar que, nestas variedades, a estratégia canónica de piedpiping (2) convive com diversas estratégias consideradas agramaticais à luz da norma, designadamente a estratégia cortadora (3), que é particularmente comum, e as estratégias resumptiva (4) e de cópia defetiva (5), que ocorrem com menor frequência. Esta última estratégia foi apenas encontrada nos dados do POST.4 (2) Não, houve uma ocasião em que havia muita cólera, ... (POST) (3) a. Esse jornalista Ø que estamos aqui a falar, isento, objectivo... (POCV) b. Depois cheguei um momento Ø que eu vi que era vazio... (POST) (4) Meu filho foi baptizado no católico e a mulher que eu vivo com ela também é católica. (POST) (5) A própria escola que eu estudei nele. (POST) Defenderemos que a preferência pela estratégia cortadora poderá estar relacionada com a reestruturação das grelhas argumentais dos verbos no POST (R. Gonçalves 2010) e que tal facto constitui um contraste com o POCV (assim como com o PE e o PB), variedade em que a presença de relativas cortadoras não está, tipicamente, relacionada com a alteração dessas propriedades nos verbos.

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BACKGROUND: A history of diabetes is associated with an increased risk of several types of cancers. Whether diabetes is a risk factor for head and neck cancer (HNC) has received little attention. METHODS: We pooled data from 12 case-control studies including 6,448 cases and 13,747 controls, and estimated odds ratios (OR) and 95% confidence intervals (CI) for the associations between diabetes and HNC, adjusted for age, education level, sex, race/ethnicity, study center, cigarette smoking, alcohol use and body mass index (BMI). RESULTS: We observed a weak association between diabetes and the incidence of HNC overall (OR, 1.09; 95% CI, 0.95-1.24). However, we observed a modest association among never smokers (OR, 1.59; 95% CI, 1.22-2.07), and no association among ever smokers (OR, 0.96; 95% CI, 0.83-1.11); likelihood ratio test for interaction p=0.001. CONCLUSIONS: A history of diabetes was weakly associated with HNC overall, but we observed evidence of effect modification by smoking status, with a positive association among those who never smoked cigarettes. Impact: This study suggests that glucose metabolism abnormalities may be a HNC risk factor in subgroups of the population. Prospective studies incorporating biomarkers are needed to improve our understanding of the relationship between diabetes and HNC risk, possibly providing new strategies in the prevention of HNC.

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