Implementing cooperative learning in Japanese EFL University Classrooms

13 x 13 c

Työkulttuurien jännitteitä koulutusyhteisöissä

Tarkastelemme artikkelissa jännitteitä koulutusyhteisöjen työkulttuureissa. Lähestymme aihetta opettajankoulutuksen kehittämiseen orientoituneesta koulutusmallista valmistuneiden opettajien kokemusten avulla. Tutkimuksen empiirisenä aineistona on 13 puolistrukturoitua yksilöhaastattelua, jotka kerättiin koulutusmalliin osallistuneilta opettajilta. Teoriasidonnaisessa sisällönanalyysissa keskityttiin yhteisön työkulttuuriin etsien myös sen vaikeammin havaittavia elementtejä, Scheinin (2017) sanoin perusolettamuksia. Tarkastelemme, miten yhteisöllisen ja kriittistä ammatillisuutta tukevan koulutusmallin anti on koettu ja miten sen vaikutukset ovat näyttäytyneet työelämässä. Tutkimuksemme nostaa keskiöön koulutuksen tuoman osaamisen ja työelämän käytäntöjen välisiä jännitteitä ja ristiriitoja. Merkitykselliseksi koettiin etenkin pitkäkestoinen ryhmäprosessi, joka on auttanut tiedostamaan koulutusyhteisöjen sosiaalisesti rakentuvia merkityksiä. Niiden havaitseminen, saati muuttaminen, on kuitenkin vaikeaa. Opinnoissa omaksuttu yhteisöllinen työkulttuuri opetti havainnoimaan ryhmien ja yhteisön dynamiikkaa myös työelämässä, tarkastelemaan koulukulttuuria kriittisesti ja kaipaamaan ammatillista keskustelua. Työkulttuurien erilaisten toimintamekanismien vuoksi ajatuksia ammatillisuudesta oli vaikea toteuttaa koulukulttuurissa. Koulutus voi tehdä niistä tietoiseksi, mutta tietoisuus aiheuttaa törmäyksiä työelämässä. Koulutustutkimus hyötyisi ryhmien ja yhteisöjen sekä niihin kuulumisen, liittymisen ja niissä työskentelyn syvärakenteiden tarkastelusta

Lateralization in C-11-Metomidate PET and outcome of adrenalectomy in primary aldosteronism

Introduction Subtype classification method is essential when considering adrenalectomy as a possible treatment for primary aldosteronism. We aimed to retrospectively evaluate surgical outcomes of primary aldosteronism in patients who had undergone C-11-metomidate positron emission tomography (C-11-MTO-PET) for subtype classification. Methods Postoperative clinical and biochemical cure and histopathological diagnosis from biobank samples were retrospectively evaluated in 44 patients who had all undergone preoperative C-11-MTO-PET with or without adrenal venous sampling (AVS). We compared those operated based on C-11-MTO-PET alone and those with concordant or discordant lateralization in C-11-MTO-PET and AVS studies according to postoperative immunohistochemical findings and biochemical and clinical cure. Results Adrenalectomy side was based on C-11-MTO-PET alone in 14 cases and on AVS in 30 cases of whom 42 achieved complete and two partial biochemical cures. Among those who underwent AVS and were operated according to it, the two lateralization methods were concordant in 22 cases and discordant in 8 cases. Similar immunohistochemical profiles and cure rates were seen after C-11-MTO-PET alone or AVS-based operations. Respectively, those with concordant or discordant C-11-MTO-PET and AVS lateralization did not differ in surgical outcome. Together, we found errors of lateralization diagnostics with C-11-MTO-PET in 18% and with AVS in 3% among those eligible for adrenal surgery. Conclusions Outcomes of adrenalectomy based on clinically significant lateralization in C-11-MTO-PET alone correspond to those based on C-11-MTO-PET with concordant AVS lateralization. However, our results suggest that diagnosis of unilateral PA should be performed with caution with C-11-MTO-PET in case of discordant lateralization studies.Peer reviewe

Adrenal androgens versus cortisol for primary aldosteronism subtype determination in adrenal venous sampling

Objective We examined if measurement of adrenal androgens adds to subtype diagnostics of primary aldosteronism (PA) under cosyntropin-stimulated adrenal venous sampling (AVS). Design A prospective pre-specified secondary endpoint analysis of 49 patients with confirmed PA, of whom 29 underwent unilateral adrenalectomy with long-term follow-up. Methods Concentrations of androstenedione, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEAS) were measured during AVS in addition to aldosterone and cortisol. Subjects with lateralisation index (LI) of >= 4 were treated with unilateral adrenalectomy, and the immunohistochemical subtype was determined with CYP11B2 and CYP11B1 stains. The performance of adrenal androgens was evaluated by receiver operating characteristics (ROC) curve analyses in adrenalectomy and medical therapy groups. Results During AVS, the correlations between cortisol and androstenedione, DHEA and DHEAS for LI and selectivity index (SI) were highly significant. The right and left side SIs for androstenedione and DHEA were higher (p < .001) than for cortisol. In ROC analysis, the optimal LI cut-off values for androstenedione, DHEA and DHEAS were 4.2, 4.5 and 4.6, respectively. The performance of these LIs for adrenal androgens did not differ from that of cortisol. Conclusions Under cosyntropin-stimulated AVS, the measurement of androstenedione and DHEA did not improve the cannulation selectivity. The performance of cortisol and adrenal androgens are confirmatory but not superior to cortisol-based results in lateralisation diagnostics of PA.Peer reviewe

Lateralization in 11C-Metomidate PET and outcome of adrenalectomy in primary aldosteronism

IntroductionSubtype classification method is essential when considering adrenalectomy as a possible treatment for primary aldosteronism. We aimed to retrospectively evaluate surgical outcomes of primary aldosteronism in patients who had undergone 11C-metomidate positron emission tomography (11C-MTO-PET) for subtype classification.MethodsPostoperative clinical and biochemical cure and histopathological diagnosis from biobank samples were retrospectively evaluated in 44 patients who had all undergone preoperative 11C-MTO-PET with or without adrenal venous sampling (AVS). We compared those operated based on 11C-MTO-PET alone and those with concordant or discordant lateralization in 11C-MTO-PET and AVS studies according to postoperative immunohistochemical findings and biochemical and clinical cure.ResultsAdrenalectomy side was based on 11C-MTO-PET alone in 14 cases and on AVS in 30 cases of whom 42 achieved complete and two partial biochemical cures. Among those who underwent AVS and were operated according to it, the two lateralization methods were concordant in 22 cases and discordant in 8 cases. Similar immunohistochemical profiles and cure rates were seen after 11C-MTO-PET alone or AVS-based operations. Respectively, those with concordant or discordant 11C-MTO-PET and AVS lateralization did not differ in surgical outcome. Together, we found errors of lateralization diagnostics with 11C-MTO-PET in 18% and with AVS in 3% among those eligible for adrenal surgery.ConclusionsOutcomes of adrenalectomy based on clinically significant lateralization in 11C-MTO-PET alone correspond to those based on 11C-MTO-PET with concordant AVS lateralization. However, our results suggest that diagnosis of unilateral PA should be performed with caution with 11C-MTO-PET in case of discordant lateralization studies.</p

Influenza virus NS1 protein binds cellular DNA to block transcription of antiviral genes

Influenza NS1 protein is an important virulence factor that is capable of binding double-stranded (ds) RNA and inhibiting dsRNA-mediated host innate immune responses. Here we show that NS1 can also bind cellular dsDNA. This interaction prevents loading of transcriptional machinery to the DNA, thereby attenuating IAV-mediated expression of antiviral genes. Thus, we identified a previously undescribed strategy, by which RNA virus inhibits cellular transcription to escape antiviral response and secure its replication. (C) 2016 Elsevier B.V. All rights reserved.Peer reviewe

Dyslipidemiat : KÄYPÄ HOITO -SUOSITUS (Päivitystiivistelmä)

Käypä hoito -suositus. Päivitystiivistelm