La aplicaci��n del componente pragm��tico funcional en un manual sueco de espa��ol publicado tras el curr��culo Lgy 2011

El objetivo de esta monograf��a es el de analizar el modo en el que un manual did��ctico para la ense��anza del espa��ol en el contexto educativo sueco de bachillerato aplica y desarrolla la competencia pragm��tica funcional en sus propuestas did��cticas. Para la realizaci��n de dicho an��lisis usaremos como instrumento de medida, por una parte, las actividades de simulaci��n, escenario y role-play que propone S��nchez Sarmiento (2005), y que se dirigen a la activaci��n de la competencia pragm��tica de los estudiantes de lenguas extranjeras y, por otra, los criterios de transacciones e interacciones de colaboraci��n para el desarrollo de la competencia pragm��tica funcional que se recogen en el ��.5 del Marco Com��n Europeo de Referencia para las lenguas: aprendizaje, ense��anza, evaluaci��n (MCER, 2002). La hip��tesis de la que parte este estudio postula que el manual que analizamos (Caminando 5, Natur & Kultur, 2013), a pesar de estar compuesto de propuestas did��cticas en las que se presentan el componente pragm��tico funcional, no enuncia de forma expl��cita el trabajo con ella, no conduce ni a su activaci��n ni a su desarrollo, su frecuencia de aparici��n en el manual es irregular, y las actividades que forman parte de sus propuestas did��cticas no proponen reflexiones metapragm��ticas sobre los propios contenidos pragm��ticos de la lengua. La investigaci��n que hemos desarrollado confirma que, aunque en algunas propuestas did��cticas del manual�� se proponen actividades que activan y desarrollan algunos de los criterios de transacci��n e interacci��n colaborativa del MCER (2002), su tratamiento resulta poco exhaustivo y su explicitaci��n es escasa. Sin embargo, se puede constatar que el manual representa un acercamiento a los principios metodol��gicos de los enfoques comunicativos y que su explotaci��n did��ctica, aunque no de forma expl��cita, conduce, en parte, al trabajo con algunos de los criterios pragm��ticos funcionales que se proponen en el MCER (2002).

Aberrant protective force generation during neural provocation testing and the effect of treatment in patients with neurogenic cervicobrachial pain

Background: Observation of the occurrence of protective muscle activity is advocated in assessment of the peripheral nervous system by means of neural provocation tests. However, no studies have yet demonstrated abnormal force generation in a patient population. Objectives: To analyze whether aberrations in shoulder girdle-elevation force during neural tissue provocation testing for the median nerve (NTPTI) can be demonstrated, and whether possible aberrations can be normalized following cervical mobilization. Study Design: A single-blind randomized comparative controlled study. Setting: Laboratory setting annex in a manual therapy teaching practice. Participants: Twenty patients with unilateral or bilateral neurogenic cervicobrachial pain. Methods: During the NTPTI, we used a load cell and electrogoniometer to record continuously the shoulder-girdle elevation force in relation to the available range of elbow extension. Following randomization, we analyzed the immediate treatment effects of a cervical contralateral lateral glide mobilization technique (experimental group) and therapeutic ultrasound (control group). Results: On the involved side, the shoulder-girdle elevation force occur-red earlier, and the amount of force at the end of the test was substantially, though not significantly, greater than that on the uninvolved side at the corresponding range of motion. Together with a significant reduction in pain perception after cervical mobilization, a clear tendency toward normalization of the force curve could be observed, namely, a significant decrease in force generation and a delayed onset. The control group demonstrated no differences. Conclusions: Aberrations in force generation during neural, provocation testing are present in patients with neurogenic pain and can be normalized with appropriate treatment modalities.

A novel 3-D segmentation algorithm for anatomic liver and tumor volume calculations for liver cancer treatment planning

Three-Dimensional (3-D) imaging is vital in computer-assisted surgical planning including minimal invasive surgery, targeted drug delivery, and tumor resection. Selective Internal Radiation Therapy (SIRT) is a liver directed radiation therapy for the treatment of liver cancer. Accurate calculation of anatomical liver and tumor volumes are essential for the determination of the tumor to normal liver ratio and for the calculation of the dose of Y-90 microspheres that will result in high concentration of the radiation in the tumor region as compared to nearby healthy tissue. Present manual techniques for segmentation of the liver from Computed Tomography (CT) tend to be tedious and greatly dependent on the skill of the technician/doctor performing the task. ^ This dissertation presents the development and implementation of a fully integrated algorithm for 3-D liver and tumor segmentation from tri-phase CT that yield highly accurate estimations of the respective volumes of the liver and tumor(s). The algorithm as designed requires minimal human intervention without compromising the accuracy of the segmentation results. Embedded within this algorithm is an effective method for extracting blood vessels that feed the tumor(s) in order to plan effectively the appropriate treatment. ^ Segmentation of the liver led to an accuracy in excess of 95% in estimating liver volumes in 20 datasets in comparison to the manual gold standard volumes. In a similar comparison, tumor segmentation exhibited an accuracy of 86% in estimating tumor(s) volume(s). Qualitative results of the blood vessel segmentation algorithm demonstrated the effectiveness of the algorithm in extracting and rendering the vasculature structure of the liver. Results of the parallel computing process, using a single workstation, showed a 78% gain. Also, statistical analysis carried out to determine if the manual initialization has any impact on the accuracy showed user initialization independence in the results. ^ The dissertation thus provides a complete 3-D solution towards liver cancer treatment planning with the opportunity to extract, visualize and quantify the needed statistics for liver cancer treatment. Since SIRT requires highly accurate calculation of the liver and tumor volumes, this new method provides an effective and computationally efficient process required of such challenging clinical requirements.^

Efeito dos andr��genos na estabiliza����o da prefer��ncia manual em machos adultos de sagui comum (Callithrix jacchus)

The role of steroids hormones on the behavior of vertebrates have been described as organizational and activational effects. These actions occur in different periods of the ontogenetic development as fetal, early post natal and during puberty (organizational effect) or modifying the expression of behavioral patterns during time life (activational effects). Studies on brain lateralization in hand use in human and non-human primates have shown that sexual hormones seems to participate in the process of handedness strength that begins in the puberal period and is stabilized at the adult age. The aim of this study was to investigate in adult male Callithrix jacchus if the strength of use of the hand in common marmoset adult male is stable (organizational effect) or androgens variations could affect its stability (activational effect). The preferential use of one hand in 14 common marmoset (Callithrix jacchus was studied in two contexts: (1) spontaneous holding food and directing the food to mouth (feeding episodes), and (2) forced reaching food tests where the animal have to reach the food through a hole within a cover plate with a central hole that allow the use of one hand only to reach the food. The records were made during 5 sessions/20 bouts each during baseline totalizing 100 episodes before two treatments. Firstly it was used GnRH antagonist: a single subcutaneous injection of 100��g de Cetrotide ��� acetate of cetrorrelix (Baxter Oncology GmbH, Germany) (n=10). Secondly, a single GnRH injection of 0.2mg of GnRH (Sigma ��� Aldrich) (n= 8) was used. After injections 20 successful attempts of hand use episodes was recorded in the 1st , 2 nd, 7th, 15th and 30 th days, totalizing in the whole period 100 episodes for each context, after both treatments. Fecal sampling to measure extracted fecal androgens was performed in all days of data collection across the length of the basal and during the experimental periods. Statistical analysis by mixed model, Tukey test to compare mean values after the two treatments, and Levene test to compare mean variance were used, all for p-value < 0.05. In basal phase 6 animals used preferentially the right hand, 5 the left and 3 were ambidextrous. Mean handedness index in basal phase were different from that after both treatment starting at 7th day. Mean variance of handedness index for spontaneous and forced activities does not differs before and after both treatments but the mean values for GnRH index were higher than that observed for its antagonist. These findings suggested that androgens have an activational effect on handedness in adult male C. jacchus

Development of a learning resource manual for nurses new to thoracic surgery

Background: Patients with lung and esophageal cancer often have surgery as a means of treatment. In Newfoundland and Labrador, patients with lung and esophageal issues are cared for on Six East, the General/Thoracic Surgery unit at St. Clare���s Mercy Hospital. These patients frequently require chest tubes, which are managed and assessed by Registered Nurses (RNs) on the unit. For nurses new to thoracic surgery, fulfilling their new role and caring for chest tube systems can be daunting. Purpose: The purpose of this practicum project was to develop a learning resource manual for nurses who are new to thoracic surgery. Via self-directed learning, the manual can increase the knowledge and self-efficacy of nurses who are caring for thoracic surgery clients and assessing chest tube systems. Methods: An informal needs assessment, integrated literature review, and several consultations via in-person interviews were conducted. Results: Based on the findings from these methodologies, Knowles��� Adult Learning Theory, and Benner���s Novice to Expert Model, a learning resource manual was created. The manual was divided into chapters covering various aspects of patient and chest tube system care and assessment. Conclusion: For the purpose of this practicum project, no evaluation was conducted. However, a plan for future evaluation of the learning resource manual has been developed to determine if the manual assisted with increasing the knowledge and self-efficacy of nurses new to thoracic surgery. ���Test Your Knowledge��� questions were included at the end of each chapter in the manual as well as case study scenarios to allow for participant self-evaluation.

Efficacy of Preoperative Chemotherapy in Treatment of Children With Wilms��� Tumor: A Meta-Analysis

Context: To assess the efficacy of preoperative chemotherapy in Wilms��� tumor patients and explore its true value for specific subgroups. Objectives: In the presence of these controversies, a meta-analysis that examines the efficacy of preoperative chemotherapy in Wilms��� tumor patients and specific subgroups is needed to clarify these issues. The objective of this meta-analysis is to assess the efficacy of preoperative chemotherapy in Wilms��� tumor patients and explore its true value for specific subgroups. Data Sources: Computer-based systematic search with ���preoperative chemotherapy���, ���Neoadjuvant Therapy��� and ���Wilms��� tumor��� as search terms till January 2013 was performed. Study Selection: No language restrictions were applied. Searches were limited to randomized clinical trials (RCTs) or retrospective studies in human participants under 18 years. A manual examination of references in selected articles was also performed. Data Extraction: Relative Risk (RR) and their 95% Confidence Interval (CI) for Tumor Shrinkage (TS), total Tumor Resection (TR), Event-Free Survival (EFS) and details of subgroup analysis were extracted. Meta-analysis was carried out with the help of the software STATA 11.0. Finally, four original Randomized Clinical Trials (RCTs) and 28 retrospective studies with 2375 patients were included. Results: For preoperative chemotherapy vs. up-front surgery (PC vs. SU) group, the pooled RR was 9.109 for TS (95% CI: 5.109 - 16.241; P &lt; 0.001), 1.291 for TR (95% CI: 1.124 - 1.483; P &lt; 0.001) and 1.101 for EFS (95% CI: 0.980 - 1.238; P = 0.106). For subgroup short course vs. long course (SC vs. LC), the pooled RR was 1.097 for TS (95% CI: 0.784 - 1.563; P = 0.587), 1.197 for TR (95% CI: 0.960 - 1.493; P = 0.110) and 1.006 for EFS (95% CI: 0.910 - 1.250; P = 0.430). Conclusions: Short course preoperative chemotherapy is as effective as long course and preoperative chemotherapy only benefits Wilms��� tumor patients in tumor shrinkage and resection but not event-free survival.

State agency resource manual

Many state agencies provide beneficial services for minorities. However, many minorities and some agencies that serve minorities are not aware of these services. This Resource Manual provides a listing of programs and services various state agencies offer. These programs and services include alcohol and substance abuse treatment, victim assistance, financial services, educational services, disabilities and special needs, insurance services, youth programs, business enterprise development, etc.

Mechanochemical treatment of kaolinite

Kaolinite surfaces were modified by mechanochemical treatment for periods of time up to 10 h. X-ray diffraction shows a steady decrease in intensity of the d(001) spacing with mechanochemical treatment, resulting in the delamination of the kaolinite and a subsequent decrease in crystallite size with grinding time. Thermogravimetric analyses show the dehydroxylation patterns of kaolinite are significantly modified. Changes in the molecular structure of the kaolinite surface hydroxyls were followed by infrared spectroscopy. Hydroxyls were lost after 10 h of grinding as evidenced by a decrease in intensity of the OH stretching vibrations at 3695 and 3619 cm���1 and the deformation modes at 937 and 915 cm���1. Concomitantly an increase in the hydroxyl stretching vibrations of water is found. The water-bending mode was observed at 1650 cm���1, indicating that water is coordinating to the modified kaolinite surface. Changes in the surface structure of the OSiO units were reflected in the SiO stretching and OSiO bending vibrations. The decrease in intensity of the 1056 and 1034 cm���1 bands attributed to kaolinite SiO stretching vibrations were concomitantly matched by the increase in intensity of additional bands at 1113 and 520 cm���1 ascribed to the new mechanically synthesized kaolinite surface. Mechanochemical treatment of the kaolinite results in a new surface structure.