COMPETÊNCIA GLOBAL COMEÇA NA PRÉ-ESCOLA: UMA INVESTIGAÇÃO DE COMO ESTIMULAR A EMPATIA EM CRIANÇAS PEQUENAS

This collaborative action research study examines the effects of the implementation of Global Thinking Routines and Thinking Routines on the development of empathy, a global competent disposition, in preschool children. The study investigates how students are able to identify their emotions and the emotions of others, and consequently, how they attempt to manage those emotions. The Emotion Cards pre-test was applied to a sample of 44 preschoolers, who then participated in classroom learning experiences, including Visible Thinking and Global Thinking routines. Afterwards, the Emotion Cards post-test was applied. The purpose was to examine the implementation of these routines and their impact on preschoolers’ development of empathy, a component of Emotional Intelligence and global competence. A collaborative action research study approach was used, with qualitative data in the form of documentation, which included videos, pictures, notes, parents’ feedback, kindergarten teacher’s feedback, ongoing study group discussions and reflections with the researcher, the teachers and atelierista. Quantitative data with descriptive statistics were also collected, comparing the quantitative pre- and post-data. The main findings indicate that (1) preschoolers demonstrated growth in the development of empathy and (2) teachers also demonstrated the development of empathy. The findings also indicated (3) a possible change in the traditional discipline system commonly implemented in today’s classroom, with a more innovative and constructive method that could potentially decrease negative behaviors in children with behavioral challenges.Este estudio de investigación acción colaborativa, examinó los efectos de la implementación de las Rutinas de Pensamiento Global y Rutinas de Pensamiento en el desarrollo de la empatía, un componente de Competencia Global, en niños pre-escolares. El estudio investiga como estudiantes consiguen identificar las propias emociones y las emociones de los otros y, consecuentemente, como se relacionan con ellas. El pre-test Tarjetas de emociones fue aplicado a una muestra de 44 pre-escolares, que después participaron de experiencias de aprendizaje en clase, incluyendo Pensamiento Visible y rutinas de Pensamiento Global. Posteriormente, fue aplicado el pos-test Tarjetas de emociones. El objetivo era examinar la implementación de esas rutinas y sus impactos en el desarrollo de empatía en pre-escolares, un componente de Inteligencia Emocional y de Competencia Global. Fue utilizado como abordaje de estudio la investigación acción colaborativa, con documentos de datos cuantitativos, que incluyen videos, fotos, anotaciones, parecer de los padres, parecer del profesor de la pre-escuela, discusiones y reflexiones en el grupo de estudios y reflexiones con el investigador, profesores y profesores de taller. Fueron también recolectados datos cuantitativos con estatística descriptiva y fueron comparados los datos pre y pos cuantitativos. Los principales resultados indican que (1) los pre-escolares demuestran aumento en el desarrollo de la empatía y (2) los profesores también demostraron el desarrollo de la empatía. Los resultados también indicaron (3) una posibilidad de cambio en el sistema disciplinar tradicional comumente implementado en las clases de hoy, con un método más innovador y constructivo que podría disminuir los comportamientos negativos en niños con desafíos de conducta. Este estudo de pesquisa-ação colaborativa examinou os efeitos da implantação das Rotinas de Pensamento Global e Rotinas de Pensamento no desenvolvimento da empatia, um componente de Competência Global, em crianças pré-escolares. O estudo investiga como estudantes conseguem identificar as próprias emoções e as emoções dos outros e, consequentemente, como buscam lidar com elas. O pre-test Cartões das emoções foi aplicado em uma amostra de 44 pré-escolares, que depois participaram de experiências de aprendizagem em sala de aula, incluindo Pensamento Visível e rotinas de Pensamento Global. Posteriormente, foi aplicado o pós-test Cartões das emoções. O objetivo era examinar a implementação dessas rotinas e seus impactos no desenvolvimento da empatia em pré-escolares, um componente de Inteligência Emocional e de Competência Global. Foi utilizada como abordagem de estudo a pesquisa-ação colaborativa, com documentação de dados quantitativos, que incluem vídeos, fotos, anotações, parecer dos pais, parecer do professor da pré-escola, discussões e reflexões no grupo de estudos e reflexões com o pesquisador, professores e atelierista. Foram também coletados dados quantitativos com estatística descritiva e foram comparados os dados pré e pós-quantitativos. Os principais resultados indicam que (1) os pré-escolares demonstraram aumento no desenvolvimento da empatia e (2) os professores também demonstraram o desenvolvimento da empatia. Os resultados também indicaram (3) uma possibilidade para mudança no sistema disciplinar tradicional comumente implementado nas salas de aula de hoje, com um método mais inovador e construtivo que poderia diminuir os comportamentos negativos em crianças com desafios comportamentais

A INTERNACIONALIZAÇÃO DA FILOSOFIA EDUCACIONAL REGGIO EMILIA

This article presents the history and framework of the Reggio Emilia philosophy, an educational approach to early childhood education that places children as the main participants and protagonists of the curriculum. It also showcases the growing influence of the Reggio Emilia philosophy around the world, through key regional and national organizations. The association of the Emilia fundamental values of the Reggio Emilia with the globally competent soft skills helps this philosophy to overcome the growing need worldwide. Ultimately, the internationalization of this approach has inspired teaching practices all over the world. Within different nations, organizations that advocate the application of Reggio Emilia principles in various schools has grown, prompting a need to educate children to that they will develop emotionally and cognitively, in making thinking visible.Este artículo presenta la historia y la estructura de la filosofía Reggio Emilia. Es un enfoque educacional para la educación infantil que coloca a los niños como los principales participantes y protagonistas del currículo. El artículo también muestra la creciente influencia de la filosofía de Reggio Emilia en todo el mundo por medio de organizaciones clave regionales y nacionales. La asociación de los valores fundamentales de Reggio Emilia trabaja con habilidades sensibles globalmente competentes, lo que contribuye para que esta filosofía satisfaga las necesidades crecientes en todo el mundo. En último análisis, la internacionalización de este abordaje inspiró prácticas educativas en todo el mundo. Las organizaciones que defienden la aplicación de Reggio Emilia en las escuelas han crecido en diversos países, mostrando la necesidad de educar a los niños para desarrollarse emocionalmente y cognitivamente en el hacer y pensar visible. Este artigo apresenta a história e a estrutura da filosofia Reggio Emilia. É uma abordagem educacional para a educação infantil, a qual coloca as crianças como os principais participantes e protagonistas do currículo. O artigo também mostra a crescente influência da filosofia de Reggio Emilia em todo o mundo por meio de organizações regionais e nacionais. A associação dos valores fundamentais de Reggio Emilia lida com habilidades sensíveis globalmente competentes, o que contribui para que esta filosofia supra as necessidades crescentes em todo o mundo. Em última análise, a internacionalização desta abordagem inspirou práticas de ensino em todo o mundo. Dentro de diferentes nações, organizações que defendem a aplicação de Reggio Emilia em várias escolas têm crescido, solicitando a necessidade de educar as crianças para se desenvolver emocionalmente e cognitivamente no fazer pensar visível.

A beautiful stroke? A side note on the 75th anniversary of the spectacular death of the French organist and composer Louis Vierne (1870-1937)

The great French organist and composer Louis Vierne (1870-1937) died while performing an organ recital at Notre Dame cathedral in Paris - right in front of the console. This historical article provides insights into the biography of a highly talented musician who was challenged by disability and diseases throughout his career. A special focus is placed on the circumstances of Vierne’s remarkable death. Until now, both a primary cerebrovascular event and a "heart attack" are discussed in reference books and encyclopedias as the immanent causes of death. From the perspective of a stroke neurologist, a reappraisal of Vierne’s medical history and the events that happened during his last concert is presented. Copyright (C) 2012 S. Karger AG, Base

Accompanying injuries in tibial shaft fractures: how often is there an additional violation of the posterior malleolus and which factors are predictive? A retrospective cohort study

INTRODUCTION: An undislocated fracture of the posterior malleolus is a common concomitant injury in tibial shaft spiral fractures. Nevertheless, these accompanying injuries cannot always be reliably assessed using conventional X-rays. Thus, the aim of the study is to evaluate how often a fracture of the posterior malleolus occurs with tibial shaft fractures (AO:42A/B/C and AO:43A) and which factors—identifiable in conventional X-rays—are predictive. METHODS: Retrospective evaluation of X-ray and CT images revealed a total of 103 patients with low-energy tibial shaft fractures without direct joint involvement. Proximal fractures and fractures involving the knee were excluded. Basic data on injury, the trauma mechanism, the path of the fracture, bony avulsions of the posterior syndesmosis and the procedures performed were evaluated. RESULTS: Thirty-nine fractures were located in the middle third of the tibia, 64 in the distal third. In 65 cases, a spiral fracture (simple or wedge fracture) was found. In 31/103 fractures, an additional osseous avulsion of the posterior syndesmosis could be detected, 5 (16.1%) of them were not recognized preoperatively due to an absence of CT imaging. In three of these patients, a fracture of the posterior malleolus was only recognized postoperatively, and an additional surgery was necessary. The spiral fractures were classified in the a.p. X-ray according to their path from lateral proximal to medial distal (Type A) or from medial proximal to lateral distal (Type B). A Pearson chi-square test and Fisher’s exact test showed a highly significant accumulation of accompanying posterior malleolus fractures for type A fractures (p = 0.001), regardless of the location of the fracture. In addition, the fractures with involvement of the posterior malleolus had a significantly higher proportion in the fractures of the distal third (p = 0.003). There was no statistically significant relationship between the height of the fracture and the path of the fracture (type A or B). These two factors seem to be independent factors for participation of the posterior malleolus. CONCLUSION: In 40.6% of the tibial shaft fractures in the distal third, in 56.9% of the type A spiral fractures and in 67.6% of the type A fractures in the distal third, the ankle joint is involved with bony avulsion of the posterior syndesmosis, which is not always recognized in conventional X-rays. To avoid complications such as additional operations, instability and post-traumatic arthrosis, we recommend preoperative imaging of the ankle using CT for these fractures. LEVEL OF EVIDENCE: III, retrospective cohort study. TRAIL REGISTRATION NUMBER: DRKS00024536

Circulating Factor Seven Activating Protease (FSAP) in the Hyperacute Phase of Stroke

Background. Factor VII activating protease (FSAP) is a circulating serine protease that could be involved in the pathophysiology of stroke. We analyzed the temporal changes in FSAP antigen and FSAP activity after acute cerebral ischemia (ACI) and tested if FSAP could be used to differentiate between stroke subtypes in the hyperacute phase (<4.5 hours after symptom onset). Methods. Of the 118 suspected stroke patients enrolled, 76 had ACI; of which 20 suffered from large vessel occlusion (LVO), 19 had intracerebral hemorrhage (ICH), and 23 had stroke mimics. Median time from symptom onset to the two plasma sample collections, <4.5 hours, were 66 and 107 minutes for the entire study population. Additional samples were collected up to 90 days post stroke in a subset of ACI patients (). FSAP antigen, FSAP activity, FSAP-α2-antiplasmin-complex (FSAP-AP complex), and nucleosomes were measured by activity assays or ELISA. Results. ACI patients treated with tissue plasminogen activator (tPA) had elevated FSAP hours () that subsequently normalized after 6 hours. FSAP-AP complex levels decreased significantly from <4.5 hours () to 6 hours after symptom onset. tPA did not increase FSAP activity significantly in plasma in vitro. FSAP antigen significantly hours after symptom onset in LVO () and ICH () patients. FSAP could not differentiate ACI from ICH or strokes (ACI and ICH) from stroke mimics. FSAP did not correlate with stroke severity. Conclusion. LVO and ICH seem to influence FSAP levels in the hyperacute phase of stroke, but FSAP does not differentiate between stroke subtypes in a hyperacute setting.publishedVersio

Warfarin Anticoagulation Exacerbates the Risk of Hemorrhagic Transformation after rt-PA Treatment in Experimental Stroke: Therapeutic Potential of PCC

Background: Oral anticoagulant therapy (OAT) with warfarin is the standard of stroke prevention in patients with atrial fibrillation. Approximately 30% of patients with cardioembolic strokes are on OAT at the time of symptom onset. We investigated whether warfarin exacerbates the risk of thrombolysis-associated hemorrhagic transformation (HT) in a mouse model of ischemic stroke. Methods: 62 C57BL/6 mice were used for this study. To achieve effective anticoagulation, warfarin was administered orally. We performed right middle cerebral artery occlusion (MCAO) for 3 h and assessed functional deficit and HT blood volume after 24 h. Results: In non-anticoagulated mice, treatment with rt-PA (10 mg/kg i.v.) after 3 h MCAO led to a 5-fold higher degree of HT compared to vehicle-treated controls (4.0±0.5 µl vs. 0.8±0.1, p<0.001). Mice on warfarin revealed larger amounts of HT after rt-PA treatment in comparison to non-anticoagulated mice (9.2±3.2 µl vs. 2.8±1.0, p<0.05). The rapid reversal of anticoagulation by means of prothrombin complex concentrates (PCC, 100 IU/kg) at the end of the 3 h MCAO period, but prior to rt-PA administration, neutralized the exacerbated risk of HT as compared to sham-treated controls (3.8±0.7 µl vs. 15.0±3.8, p<0.001). Conclusion: In view of the vastly increased risk of HT, it seems to be justified to withhold tPA therapy in effectively anticoagulated patients with acute ischemic stroke. The rapid reversal of anticoagulation with PCC prior to tPA application reduces the risk attributed to warfarin pretreatment and may constitute an interesting therapeutic option

Iatrogenic injury of the popliteal artery in orthopedic knee surgery: clinical results and development of a therapeutic algorithm

PURPOSE: Intraoperative injury to the popliteal artery is a rare complication of orthopedic surgery, however, it can have serious consequences, including major amputation. Recommendations for a standard approach are lacking. The aim of this study was to develop an interdisciplinary therapeutic algorithm to assist in complication management. METHODS: From 01/11 to 12/20, 16 arterial injuries after knee surgery were analyzed in a retrospective single-center study. Four cases involved recurrent orthopedic surgery. Procedures performed included eleven total knee arthoplasties (TKA), two TKA replacements, one arthroscopy, and two high tibial osteotomies. Clinical presentation of patients was hemorrhage (n = 2), ischemia (n = 7), the combination of both (n = 4), or pseudoaneurysm formation (n = 3). RESULTS: Ten patients underwent endovascular treatment, some as combined procedures: (stent)-PTA (n = 6), aspiration thrombectomy (n = 5), thrombin injection (n = 1), and embolization (n = 1). Six patients were treated surgically: four with bypass/interposition and one with a patch plasty and one as a hybrid procedure, respectively. Only autologous great saphenous vein was used. All extremities could be preserved. Functional impairment remained in six cases. CONCLUSION: Both endovascular and surgical procedures can be used to treat arterial injuries after knee surgery. Efficient standardized diagnosis and the involvement of vascular expertise are essential to prevent functional impairment or limb loss, as suggested in the algorithms

Rare and common epilepsies converge on a shared gene regulatory network providing opportunities for novel antiepileptic drug discovery

Background The relationship between monogenic and polygenic forms of epilepsy is poorly understood, and the extent to which the genetic and acquired epilepsies share common pathways is unclear. Here, we use an integrated systems-level analysis of brain gene expression data to identify molecular networks disrupted in epilepsy. Results We identify a co-expression network of 320 genes (M30), which is significantly enriched for non-synonymous de novo mutations ascertained from patients with monogenic epilepsy, and for common variants associated with polygenic epilepsy. The genes in M30 network are expressed widely in the human brain under tight developmental control, and encode physically interacting proteins involved in synaptic processes. The most highly connected proteins within M30 network are preferentially disrupted by deleterious de novo mutations for monogenic epilepsy, in line with the centrality-lethality hypothesis. Analysis of M30 expression revealed consistent down-regulation in the epileptic brain in heterogeneous forms of epilepsy including human temporal lobe epilepsy, a mouse model of acquired temporal lobe epilepsy, and a mouse model of monogenic Dravet (SCN1A) disease. These results suggest functional disruption of M30 via gene mutation or altered expression as a convergent mechanism regulating susceptibility to epilepsy broadly. Using the large collection of drug-induced gene expression data from Connectivity Map, several drugs were predicted to preferentially restore the down-regulation of M30 in epilepsy toward health, most notably valproic acid, whose effect on M30 expression was replicated in neurons. Conclusions Taken together, our results suggest targeting the expression of M30 as a potential new therapeutic strategy in epilepsy