Assistance Models in Reading Instruction

There is general agreement that it is not possible within the constraints of undergraduate programs and the limited time frame for preservice teaching experience to train highly professional teachers before the first year of teaching (McDonald, 1980). Thus, professional education should be considered a continuous process (Feiman-Nemser, 1983)

Variability in the practice of fertility preservation for patients with cancer

Fertility is important to women and men with cancer. While options for fertility preservation (FP) are available, knowledge regarding the medical application of FP is lacking. Therefore we examined FP practices for cancer patients among reproductive endocrinologists (REs). A 36 item survey was sent to board-certified REs. 98% of respondents reported counseling women with cancer about FP options. Oocyte and embryo cryopreservation were universally offered by these providers, but variability was noted in reported management of these cases-particularly for women with breast cancer. 86% of the respondents reported using letrozole during controlled ovarian stimulation (COS) in patients with estrogen receptor positive (ER+) breast cancer to minimize patient exposure to estrogen. 49% of respondents who reported using letrozole in COS for patients with ER+ breast cancer reported that they would also use letrozole in COS for women with ER negative breast cancer. Variability was also noted in the management of FP for men with cancer. 83% of participants reported counseling men about sperm banking with 22% recommending against banking for men previously exposed to chemotherapy. Overall, 79% of respondents reported knowledge of American Society for Clinical Oncology FP guidelines-knowledge that was associated with providers offering gonadal tissue cryopreservation (RR 1.82, 95% CI 1.14-2.90). These findings demonstrate that RE management of FP in cancer patients varies. Although some variability may be dictated by local resources, standardization of FP practices and communication with treating oncologists may help ensure consistent recommendations and outcomes for patients seeking FP

Efeitos da Redução da Gordura Epicárdica na Duração da Onda P de Obesos Mórbidos Submetidos à Cirurgia Bariátrica

Introdução: A gordura epicárdica (GE) é biologicamente ativa e, por meio de seu efeito parácrino, interage com o miocárdio atrial e pode estar envolvida no remodelamento atrial observado em obesos. A duração da onda P (DOP) é um marcador não invasivo do tempo de condução atrial e reflete alterações relacionadas ao remodelamento atrial. Os efeitos da redução da GE induzida pela cirurgia bariátrica sobre a DOP ainda não foram definidos. Métodos: Recrutamos prospectivamente 22 obesos mórbidos sem outras comorbidades na Unidade de Cirurgia Bariátrica do Hospital das Clínicas da Universidade de São Paulo. Os pacientes foram submetidos a avaliações clínica e laboratorial, além de eletrocardiograma (ECG) de 12 derivações, ecocardiograma bidimensional e Holter de 24 h. A mesma avaliação foi realizada 12 meses após a cirurgia bariátrica. A fim de que as variáveis contínuas fossem comparadas, foram utilizados os testes T pareado e de Wilcoxon. Já para avaliar a associação entre variáveis independentes foi utilizado um modelo de regressão para medidas repetidas. Resultados: Ao todo, 20 pacientes completaram o protocolo (idade: 36,35 ± 10,26 anos, 18 mulheres). Houve uma redução significativa da DOP, do índice de massa corporal (IMC) e da GE após cirurgia bariátrica (p<0,05). Houve também redução média de 11,55 ± 8,49 ms na DOP. Na análise de regressão múltipla, foi observada associação entre a redução da DOP e a redução da GE e do IMC. Conclusões: Em obesos mórbidos sem outras comorbidades, a redução da GE após cirurgia bariátrica foi associada a melhora do remodelamento atrial, indicada por uma redução significativa da DOP

Endocrine disruptors and obesity: a current review on environmental obesogens

Obesity represents an important public health concern because it substantially increases the risk of multiple chronic diseases and thereby contributing to a decline in both quality of life and life expectancy. Besides unhealthy diet, physical inactivity and genetic susceptibility, environmental pollutants also contribute to the rising prevalence of obesity epidemic. An environmental obesogen is defined as a chemical that can alter lipid homeostasis to promote adipogenesis and lipid accumulation whereas an endocrine disrupting chemical (EDC) is defined as a synthetic chemical that can interfere with the endocrine function and cause adverse health effects. Many obesogens are EDCs that interfere with normal endocrine regulation of metabolism, adipose tissue development and maintenance, appetite, weight, and energy balance. An expanding body of scientific evidence from animal and epidemiological studies has begun to provide links between exposure to EDCs and obesity. Despite the significance of environmental obesogens in the pathogenesis of metabolic diseases, the contribution of synthetic chemical exposure to obesity epidemic remains largely unrecognised. Hence, the purpose of this review is to provide a current update on the evidences from animal and human studies on the role of fourteen environmental obesogens in obesity, a comprehensive view of the mechanisms of action of obesogens and current green and sustainable chemistry strategies to overcome chemical exposure to prevent obesity. Designing of safer version of obesogens through green chemistry approaches requires a collaborative undertaking to evaluate the toxicity of endocrine disruptors using appropriate experimental methods, which will help in developing a new generation of inherently safer chemicals

Febre sem sinais de localizacao clinica: aspectos clinicos e laboratoriais

BV UNIFESP: Teses e dissertaçõe

One-handed golf for hemiplegics

There seems to be a strong assumption among people who have suffered a stroke and who have become paralyzed on one side that it would no longer be possible to enjoy the leisure activity of playing golf. Such an assumption was found to prevail in a personal survey of twenty-five members of the Palms Springs Stroke Resocialization Club in California. Of the twenty-five people questioned, thirteen said that they had played golf prior to their stroke, but they did not know how it would be possible to resume the activity again. No materials have been found by this writer which addresses the ???how??? of playing gold after a person has become a hemiplegic because of having had a stroke. This writer, prior to sustaining a stroke which left him a hemiplegic, was a professional golf teacher for four years. With the belief that a person need not be totally incapacitated because of having sustained a stroke, he began to investigate how best to adapt to the new procedures that needed to be implemented to play the game of golf. Based upon his empirical knowledge of how to play the game with the new restrictions, he prepared a manual which will show those who had previously enjoyed golf how they might resume the game on a one ???hand basis. The manual explains relevant matters such as equipment that is necessary, gripping the club, addressing the ball, swinging the club, and the approach???sand and hazard shots. The manual describes putting and general procedures to follow in various regulation games. Also addressed is the matter of understanding one???s capabilities and how to exercise properly. Photographs are included in the manual which are simple and descriptive; they illustrate the written guidelines in a forthright manner. The recommendation is given in this project that further evaluative studies be made in the future when this book has been distributed to people who have had stroke and have begun to attempt to follow its guidelines