Θεωρία και πράξη της διδασκαλίας της Αγγλικής γλώσσας σε μαθητές Λυκείου: Η περίπτωση της δημιουργικής μάθησης

Περίληψη Η παρούσα εργασία επιχειρεί να συνδέσει τη θεωρία του αυτοπροσδιορισμού (Self - determination theory), η οποία ασχολείται με την ενεργοποίηση των εσωτερικών κινήτρων και την ικανοποίηση των τριών βασικών, εγγενών, ψυχολογικών αναγκών των έφηβων μαθητών / μαθητριών για επάρκεια, αυτονομία και συσχέτιση με τους άλλους, με την πράξη της διδασκαλίας της Αγγλικής ως ξένης γλώσσας στο Λύκειο, μέσα από την εργασιοκεντρική προσέγγιση (Task - based instruction), με στόχο τη διερεύνηση της δημιουργικής και πιο αποτελεσματικής μάθησής τους. Για τον σκοπό αυτό, η διδάσκουσα – ερευνήτρια χρησιμοποίησε τρεις ωριαίες δραστηριότητες – εργασίες (tasks), δύο από τις οποίες ήταν δικής της επινόησης, το παιχνίδι ρόλων Καθηγητής της Ημέρας, στην Α΄ τάξη και η παιγνιώδης δραστηριότητα Η μάγισσα και το ρολόι, στη Β΄ τάξη, ενώ στη Γ΄ τάξη, προσάρμοσε στις ανάγκες της εκπαιδευτικής διαδικασίας το παιχνίδι ρόλων Lupus in Tabula. Η έρευνα πραγματοποιήθηκε στο 1ο ΓΕΛ Καματερού, κατά το σχολικό έτος 2017-2018. Για τη συλλογή των δεδομένων, αξιοποιήσαμε τις μεθόδους της δομημένης παρατήρησης και της ημιδομημένης συνέντευξης. Οι εκπαιδευτικές παρεμβάσεις, με τα συγκεκριμένα χαρακτηριστικά της δημιουργικής μάθησης, είχαν θετικά αποτελέσματα, όσον αφορά στην ενεργοποίηση των εσωτερικών κινήτρων των συμμετεχόντων / συμμετεχουσών μαθητών / μαθητριών, όπως επίσης στη δημιουργική και πιο αποτελεσματική διδασκαλία και μάθηση της Αγγλικής ως ξένης γλώσσας στο περιβάλλον του σύγχρονου Λυκείου.Abstract The present study aims at investigating the association of Self - determination theory with creative and more effective teaching and learning English as a foreign language (EFL). More specifically, the teacher – researcher employed Task - based instruction with the particular characteristics of creative learning to activate students’ intrinsic motivation by satisfying the three basic innate psychological student needs for competence, autonomy and relatedness. The teacher – researcher implemented three tasks in three teaching hours, two of which she devised herself, namely, Teacher of the day - A class and The witch and the watch - B class, whereas for C class she adapted Lupus in Tabula. The research took place at 1o Geniko Lykeio Kamaterou (1st Senior High School of Kamatero) during the school year 2017 - 2018. The research data was collected from structured observations and semi - structured interviews. The findings revealed positive outcomes regarding both the participant students’ intrinsic motivation activation and creative and more effective teaching and learning of EFL in the modern Senior High School classroom

Efficacy and Safety of Oral Factor XIa Inhibitors in Stroke Prevention: A Systematic Review and Meta-Analysis

Anticoagulation; Factor Xia inhibitors; Ischemic strokeAnticoagulació; Inhibidors del factor Xia; Ictus isquèmicAnticoagulación; Inhibidores del factor Xia; Ictus isquémicoIntroduction: Despite preventive measures, stroke rates remain high in the primary and secondary prevention settings. Factor XIa inhibition may offer a novel, safe and effective antithrombotic option for stroke prevention. Methods: We conducted a systematic review and meta-analysis including all available randomized controlled clinical trials (RCTs) that investigated the efficacy and safety of factor XIa inhibitors versus controls in primary or secondary stroke prevention. The primary efficacy and safety outcomes of interest were symptomatic ischemic stroke (IS) and the composite of major bleeding and clinically relevant non-major bleeding. Results: Four phase II dose-finding RCTs were included, comprising a total of 4732 patients treated with factor XIa inhibitors versus 1798 controls. Treatment with factor XIa inhibitors did not reduce the risk of IS compared to controls (RR: 0.89; 95% CI: 0.67–1.17). The composite of symptomatic IS and covert infarcts on brain MRI (RR: 1.01; 95% CI: 0.87–1.18), the composite of symptomatic IS and transient ischemic attack (TIA; RR: 0.78; 95% CI: 0.61–1.01), and the composite of major adverse cardiovascular events (RR: 1.07; 95% CI: 0.87–1.31) did not differ between the treatment groups. Treatment with factor XIa inhibitors did not increase the risk of the composite of major bleeding and clinically relevant non-major bleeding (RR: 1.19; 95% CI: 0.65–2.16), major bleeding alone (RR: 1.19; 95% CI: 0.64–2.22), intracranial bleeding (RR: 0.91; 95% CI: 0.26–3.19) or all-cause mortality (RR: 1.21; 95% CI: 0.77–1.90). Conclusion: This meta-analysis provides reassuring evidence regarding the safety of factor XIa inhibitors. These findings, coupled with potential signals of efficacy in reducing IS (and TIA), underscore the importance of ongoing phase III RCTs for providing definitive data regarding the effect of factor XIa inhibition on stroke prevention

Cost-Minimization Analysis of the Treatment of Patients With Metastatic Colorectal Cancer in Greece

Background: In 2008, colorectal cancer was the fourth most common cause of cancer-related death worldwide. Monotherapy with monoclonal antibodies directed against the epidermal growth factor receptor, such as cetuximab and panitumumab, has recently been introduced in the management of metastatic colorectal cancer (mCRC) patients. Objective: The aim of this study was to conduct a cost-minimization analysis comparing panitumumab with cetuximab in the treatment of patients with epidermal growth factor receptor expressing mCRC with nonmutated (wild-type) Kirsten rat sarcoma viral oncogene homolog in Greece. The perspective of analysis was that of payers (Social Security Sickness Fund) and the country’s National Health Service (NHS). Methods: The model was designed to contain probabilistic parameters to account for uncertainty and variation in these parameters. All resources consumed in local hospitals in the management of patients in each case were evaluated. Two analyses were performed: 1 evaluating cost per milligram and another evaluating cost per vial. Results: From a payer perspective, the mean 20-week total cost per patient for panitumumab and cetuximab was: (1) per-milligram analysis: (sic)16,349 and (sic)18,242, respectively; and (2) per-vial analysis: (sic)18,808 and (sic)19,701. From the NHS perspective, the mean total costs per patient were slightly higher; however, the use of panitumumab was associated with a 17.7% and 12.4% cost reduction in per-milligram and per-vial analysis, respectively. The results of probabilistic models confirmed those of the deterministic analyses. Conclusion: In the Greek NHS and Social Security Sickness Fund setting, panitumumab monotherapy potentially constitutes a cost-saving option (versus cetuximab monotherapy) in the management of patients with mCRC and no mutation of Kirsten rat sarcoma viral oncogene homolog. (Clin Ther. 2012; 34:2132-2142) (C) 2012 Elsevier HS Journals, Inc. All rights reserved

Bilateral non-bifurcating carotid arteries in a patient with recurrent cerebrovascular events.

INTRODUCTION: Among congenital anomalies of the carotid artery circulation, the presence of a non-bifurcating carotid artery is extremely rare. Relevant cases with unilateral non-bifurcating carotid artery have scarcely been described in the literature. After extensive literature review, only one case with asymptomatic bilateral non-bifurcating carotid arteries associated with persistent proatlantal artery was identified. METHODS: We present the case of a 40-year-old man with recurrent cerebrovascular events presenting non-bifurcating carotid arteries bilaterally. RESULTS: A 40-year-old man presented in the emergency department with a transient ischemic attack. Past medical history included prior ischemic stroke of unknown etiology in the distribution of the left middle cerebral artery, untreated hyperlipidemia and tobacco use. Complete work-up in order to identify the underlying mechanism of the patient's recurrent cerebrovascular events was negative, except for the finding of non-bifurcating carotid arteries bilaterally, associated with an extensive intracranial anastomosing arterial network. Long-term antiplatelet therapy and statins were administered as secondary stroke prevention therapy. DISCUSSION: Previous reports suggest that non-bifurcating carotid arteries may be associated with atherosclerotic plaque formation in symptomatic cases due to shear stress, tortuosity or other local factors. However, in the absence of atherosclerosis, the pathogenic association of bilateral non-bifurcating carotid arteries with cerebrovascular events remains questionable, but may be considered when other stroke etiologies are excluded

Periodic Limb Movements during Sleep in Acute Stroke: Prevalence, Severity and Impact on Post-Stroke Recovery

Background: Periodic Limb Movements during Sleep (PLMS) have been described to be frequently present in stroke patients. We aimed to evaluate the prevalence and severity of PLMS in acute stroke patients and clarify the association between PLMS and coexisting Sleep Disordered Breathing (SDB). Additionally, we focused on identifying variables that could independently predict the presence of PLMS in patients with acute stroke. The potential impact of PLMS on stroke outcome at three months was investigated as well. Methods: In this study, we performed overnight polysomnography on consecutive stroke patients within 72 h from symptom onset. Data regarding clinical and imaging characteristics were prospectively collected. National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and Epworth-Sleepiness Scale (ESS) were used to evaluate stroke severity on admission, stroke outcome at three months and history of daytime sleepiness, respectively. We documented PLMS and SDB using standard polysomnography criteria. Results: We prospectively assessed 126 patients with acute stroke [109 with ischemic and 17 with hemorrhagic stroke, mean age 60 ± 11 years, 68% men, median NIHSS score on admission: 3 (IQR: 2–7)]. The overall rate of PLMS in our cohort was 76%, and the rate of SDB among patients with PLMS was 83%. PLMS detection rates differed significantly (p-value: p-value: 0.001) predict the presence of PLMS in the acute stroke phase in multivariable analyses adjusting for potential confounders. Moreover, baseline stroke severity (NIHSS-score increase in per-1 point: OR: 0.819, 95% CI: 0.737–0.895, p-value p-value = 0.015) were significantly associated with the likelihood of excellent functional outcome (mRS-scores: 0–1) at 3 months. Conclusion: The common presence of mostly severe PLMS in patients with acute stroke and their negative effect on stroke outcomes point out the necessity for early PLMS detection and treatment

Delayed Leucoencephalopathy as a Complication after Endovascular Therapy of Intracranial Aneurysms—A Case Series

We describe the clinical presentation, radiological findings, treatment and outcomes of three patients with delayed leukoencephalopathy occurring after endovascular treatment (EVT) for cerebral aneurysms—a rare, albeit recurring, complication. The symptoms occurred 6 to 12 months following the EVT of the cerebral aneurysm. Characteristic imaging findings included high-signal changes on T2 images in the white matter without diffusion restriction predominantly at the distribution of the vascular territory of the catheterized arteries, coupled with patchy gadolinium enhancement or low susceptibility weighted imaging (SWI) signals within the white-matter lesions. Steroid pulse therapy is the treatment of choice and promptly improves clinical and imaging findings. Tapering or cessation of steroids may result in clinical and imaging relapses; close- and long-term follow-up for patients presenting this complication is warranted

Nocebo-Prone Behavior Associated with SARS-CoV-2 Vaccine Hesitancy in Healthcare Workers

Among healthcare workers (HCWs), SARS-CoV-2 vaccine hesitancy may be linked to a higher susceptibility to nocebo effects, i.e., adverse events (AEs) experienced after medical treatments due to negative expectations. To investigate this hypothesis a cross-sectional survey was performed with a self-completed questionnaire that included a tool (Q-No) for the identification of nocebo-prone individuals. A total of 1309 HCWs (67.2% women; 43.4% physicians; 28.4% nurses; 11.5% administrative staff; 16.6% other personnel) completed the questionnaires, among whom 237 (18.1%) had declined vaccination. Q-No scores were ≥15 in 325 participants (24.8%) suggesting nocebo-prone behavior. In a multivariate logistic regression model with Q-No score, age, gender, and occupation as independent variables, estimated odds ratios (ORs) of vaccination were 0.43 (i.e., less likely, p < 0.001) in participants with Q-No score ≥ 15 vs. Q-No score < 15, 0.58 in females vs. males (p = 0.013), and 4.7 (i.e., more likely) in physicians vs. other HCWs (p < 0.001), independent of age, which was not significantly associated with OR of vaccination. At least one adverse effect (AE) was reported by 67.5% of vaccinees, mostly local pain and flu-like symptoms. In a multivariate logistic regression model, with Q-No score, age, gender, and occupation as independent variables, estimated ORs of AE reporting were 2.0 in females vs. males (p < 0.001) and 1.47 in physicians vs. other HCWs (p = 0.017) independently of age and Q-No score, which were not significantly associated with OR of AE. These findings suggest that nocebo-prone behavior in HCWs is associated with SARS-CoV-2 vaccination hesitancy indicating a potential benefit of a campaign focused on nocebo-prone people