Αντιλήψεις και βιώματα εκπαιδευτικών, γονέων, και παιδιών προσχολικής ηλικίας κατά την περίοδο της εξ αποστάσεως εκπαίδευσης και της μετάβασης τους στην δια ζώσης.

Η παρούσα εργασία αποτελεί ποιοτική έρευνα η οποία έχει ως αντικείμενο τις προσωπικές αντιλήψεις των εκπαιδευτικών προσχολικής αγωγής, των γονέων αλλά και των μαθητών προσχολικής ηλικίας, οι όποιοι κλήθηκαν με την έναρξη της πανδημίας να συμμετάσχουν στην εξ αποστάσεως εκπαίδευση. Σκοπός της εκπόνησης της παρούσας μελέτης είναι η διερεύνηση των αντιλήψεων και των βιωμάτων εκπαιδευτικών προσχολικής αγωγής, γονέων, αλλά και παιδιών που συμμετείχαν στην διαδικασία της τηλεκπαίδευσης κατά την διάρκεια της πανδημίας COVID 19, καθώς και της μετάβασής τους στην διά ζώσης εκπαίδευση. Ειδικότερα, θα διερευνηθούν οι προσωπικές εμπειρίες και αντιλήψεις των συμμετεχόντων σχετικά με την εξ αποστάσεως διδασκαλία, την συνεργασία με τους γονείς/κηδεμόνες και αντίστοιχα με τους εκπαιδευτικούς, τις μεταξύ τους σχέσεις από την περίοδο εκείνη και μετά, πώς, αν και κατά πόσο επηρεάστηκαν. Ακόμα, θα διερευνηθούν οι δυσκολίες που κλήθηκαν να αντιμετωπίσουν κατά την διάρκεια τόσο της τηλεκπαίδευσης όσο και μετά με την επιστροφή τους στην διά ζώσης εκπαίδευση και αν τελικά συνδέονται τα βιώματα και οι δυσκολίες που αντιμετώπισε η κάθε ομάδα. Επομένως, οι στόχοι της έρευνας αυτής περιστρέφονται γύρω από την διερεύνηση των βαθύτερων αντιλήψεων, στάσεων και απόψεων τόσο των εκπαιδευτικών όσο και των γονέων αλλά και πώς αυτές μπορεί να επηρεάσουν τα παιδιά και τον τρόπο που σκέφτονται και αντιλαμβάνονται τον κόσμο. Αφού οριοθετηθεί η γενική έννοια της εκπαίδευσης στο νηπιαγωγείο αλλά και οι παιδαγωγικοί στόχοι της εν λόγω βαθμίδας, γίνεται αναφορά στην πανδημία, στα μέτρα και τις αλλαγές που ακολούθησαν με αυτήν, στον ρόλο του εκπαιδευτικού και των γονέων, καθώς επίσης και στις σχέσεις εκπαιδευτικών – γονέων – παιδιών. Συνοψίζοντας, με την ολοκλήρωση της εργασίας παρατίθενται προτάσεις για την βελτίωση της εξ αποστάσεως και της διά ζώσης εκπαίδευσης. Για την εξέταση των παραπάνω ζητημάτων αξιοποιήθηκε η ποιοτική μεθοδολογία. Συγκεκριμένα, η επεξεργασία και ανάλυση των δεδομένων έγινε με την μέθοδο ανάλυσης περιεχομένου. Η συλλογή των δεδομένων έγινε μέσα από 15 ημι-δομημένες συνεντεύξεις, 5 με εκπαιδευτικούς προσχολικής αγωγής, 5 με γονείς παιδιών προσχολική αγωγής και 5 με παιδιά Α΄-Β΄ Δημοτικού, τα οποία κατά την περίοδο της πανδημίας ήταν μαθητές νηπιαγωγείου. Όλες οι συνεντεύξεις μαγνητοφωνήθηκαν, αφού πρώτα οι συμμετέχοντες έλαβαν σχετικό έντυπο ενημέρωσης και συγκατάθεσης, το οποίο υπέγραψαν.The present study constitutes a qualitative research, which discusses the personal perceptions of preschool teachers, parents and preschool students during the COVID 19 pandemic, who were called to deal with remote education. The aim of this study is to examine the perceptions and experiences of all participants (students, teachers and parents) during this new educational process and during their transition to the classrooms in the after-COVID 19 era. Specifically, both their personal experiences and perceptions are explored, as well as the way in which their interpersonal relationships were formed and to what extend they were affected. Additionally, this study investigates the difficulties they had to face during the remote education and the reversion to the traditional one and if the experiences and difficulties faced by each group are ultimately connected. Therefore, the objectives of this research revolve around investigating the deeper perceptions, attitudes and opinions of both teachers and parents and how these may affect the children and their perception of the world. After defining the general concept of preschool education as well as the goals of the specific grade, reference is made to the pandemic, the measures and the changes that followed it, the role of the teachers and the parents and finally the relationships between teachers, parents and children. Upon completion of the study, suggestions for the improvement of distance and traditional education are listed. To examine the above, qualitative methodology was used. Specifically, the processing and analysis of the data was done using the content analysis method. The data was collected through 15 semi-structured interviews, 5 with preschool teachers, 5 with preschool children's parents and 5 with primary school grade children, who were preschool students during the pandemic. All interviews were recorded after the written consent of the participants

Treatment of thromboangiitis obliterans (Buerger's disease) with bosentan

<p>Abstract</p> <p>Background</p> <p>This study assessed the effectiveness and safety of bosentan when administered to thromboangiitis obliterans (Buerger's disease) patients.</p> <p>Methods</p> <p>A clinical pilot study was designed in which patients with ulcer and/or pain at rest were treated with bosentan p.o. at a dose of 62.5 mg twice daily during the first month, which was thereafter up-titrated to 125 mg twice daily. The study endpoints were clinical improvement rate, major or minor amputation rate, haemodynamic changes, changes in endothelial function and angiographic changes.</p> <p>Results</p> <p>Seven out of 12 patients were male (58%). Median age was 39 years (range 29-49). The median follow-up was 20 months (range 11-40). All patients were smokers. With bosentan treatment, new ischaemic lesions were observed in only one patient. Overall, clinical improvement was observed in 12 of the 13 extremities (92%). Only two out of 13 extremities underwent amputation (one major and one minor) after bosentan treatment. After being assessed by digital arteriography with subtraction or angio-magnetic resonance imaging, an increase of distal flow was observed in 10 out of the 12 patients. All patients experienced a statistically significant improvement in their BAFMD values (mean: 1.8 at baseline; 6.6 at the end of the treatment; 12.7 three months after the end of the treatment; p < 0.01).</p> <p>Conclusion</p> <p>Bosentan treatment may result in an improvement of clinical, angiographic and endothelial function outcomes. Bosentan should be investigated further in the management of TAO patients. Larger studies are required to confirm these results.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01447550">NCT01447550</a></p

Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome.

BACKGROUND: Sjögren´s syndrome (SS) is an autoimmune rheumatic disease that is characterised by decreased exocrine gland function and frequent ocular symptoms associated with eye dryness. Significantly, dry eyes can lead to corneal abrasions, infection, ulceration, chronic scarring and, in severe cases, perforation. The available conventional therapies have limited efficacy and there are no biologic therapies licensed for use in SS patients. MATERIALS AND METHODS: A literature search of PubMed (MEDLINE) and EMBASE electronic data bases was performed covering the period from January 1994 to September 2014. Evidence was graded in categories I-IV and a treatment algorithm, comprising first line, second line and rescue therapies for ocular dryness associated with SS was proposed. It is based on the current evidence of efficacy of different therapies and explores their link with the pathogenesis of ocular dryness associated with SS. RESULTS: Recent developments in the understanding of the pathogenesis of SS provided evidence that the ocular dryness is associated with pathologic infiltration and dysfunction of the lacrimal glands and changes in the tear composition, together with abnormalities involving the neurosecreting circuits. There is good evidence for the efficacy of topical artificial tears, antiinflammatories and Cyclosporine, and oral Pilocarpine and Cevimeline in controlling the symptoms of ocular dryness associated with SS. CONCLUSIONS: Conventional DMARDs are not particularly effective in addressing the symptoms of ocular dryness associated with SS, despite being commonly prescribed for other SS manifestations. Emerging evidence suggests that B cell and co-stimulatory targeted therapy may play a role in the future

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Systematic review of randomized controlled trials in the treatment of dry eye disease in Sjogren syndrome

Primary Sjögren’s syndrome is an autoimmune disease characterized by dry eye and dry mouth. We systematically reviewed all the randomized controlled clinical trials published in the last 15 years that included ocular outcomes. We found 22 trials involving 9 topical, 10 oral, 2 intravenous and 1 subcutaneous modalities of treatment. Fluoromethalone eye drops over 8 weeks were more effective than topical cyclosporine in the treatment of dry eye symptoms and signs; similarly, indomethacin eye drops over 1 month were more efficacious than diclofenac eye drops. Oral pilocarpine 5 mg twice daily over 3 months was superior to use of lubricants or punctal plugs for treating dry eye, but 5% of participants had gastrointestinal adverse effects from pilocarpine, though none discontinued treatment. In contrast, etanercept, a TNF-alpha blocking antibody, administered as subcutaneous injections twice weekly, did not improve dry eye significantly compared to placebo injections. In conclusion, topical corticosteroids have been shown to be effective in dry eye associated with Sjögren’s syndrome. As some topical non-steroidal anti-inflammatory drugs may be more effective than others, these should be further evaluated. Systemic secretagogues like pilocarpine have a role in Sjögren’s syndrome but the adverse effects may limit their clinical use. It is disappointing that systemic cytokine therapy did not produce encouraging ocular outcomes but participants should have assessment of cytokine levels in such trials, as those with higher baseline cytokine levels may respond better.published_or_final_versio

Safety and efficacy of recombinant γ interferon in the of treatment of systemic sclerosis

Objective - To evaluate the safety and efficacy of recombinant γ interferon (rIFNγ) in the treatment of patients with systemic sclerosis. Methods - Sixteen patients with systemic sclerosis were treated with r-IFNγ, 60 μg m-2 low dose, n = 10) and 150 μg m-2 (high dose, n = 6), three times weekly in an open phase I/II trial of eight months duration. The patients were stratified in low and high dose according to the severity and the extent of scleroderma; the two groups were comparable. Results - The treatment was well tolerated. The most common side effects, almost certainly related to r-IFNγ, were fever, chills, dizziness, headache, and severe flu-like syndrome with decreasing intensity with the time of treatment. Severe aphthous stomatitis (n = 1), ventricular tachycardia (n = 1), severe oesophageal ulcers due to gastro-oesophageal reflux (n = 1), disease exacerbation alone with frank arthritis and slight pericardial effusion (n = 1), and inability to conform to the requirements of the study (n = 1) were the reasons for discontinuing treatment. Side effects and degree of response were evident during the first five months of treatment. A significant decrease in mean skin thickness score was observed and was higher in the high dose group. Reactive oxygen species of peripheral neutrophils and soluble interleukin-α receptor serum concentrations were higher than those of normal individuals at study entry and decreased in parallel with clinical improvement. Conclusions - Treatment of systemic sclerosis patients with r-IFNγ was relatively safe and well tolerated for doses as high as 150 μg m-2 three times weekly. Side effects and the degree of response can be seen during the first months of therapy and can be used as predictors of ultimate toxicity or response. The drug seems to be effective in treating cutaneous scleroderma