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Organized System (organized + system)
Selected AbstractsClinical features of testicular tumors in childrenINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2004SATORU KANTO Abstract Aim:, Testicular tumors are not common pediatric solid tumors, especially in Asian children. There have been few reviews of cases in Japan to date. We present the clinical features of 14 pediatric testicular tumor patients. Methods:, Clinical features of 14 testicular tumor patients, such as chief complaints, age at diagnosis, pathology, stages, treatments and prognosis, were examined from medical records. Two patients had their semen tested at adolescence. Results:, Of the 14 prepubescent patients, 12 (85.7%) patients were diagnosed before 3 years of age. Ten cases (71.4%) were diagnosed as yolk sac tumors, three (21.4%) as mature teratomas and one case as an epidermoid cyst. Nine cases (90.0%) among the 10 cases of yolk sac tumor were diagnosed as stage I and one case was stage IV. One stage I yolk sac tumor patient developed lung metastasis later. Eventually, two yolk sac tumor patients died, despite chemotherapy. While all the cases with a diagnosis before 2 years of age survived, 67% (2/3) of cases with a diagnosis after the age of 2 died of tumors. Semen analysis in two patients showed normospermia. Conclusion:, In the present study, the most common testicular tumors were yolk sac tumors and the patients diagnosed before 2 years of age showed favorable results. Age could be a relapse risk factor in yolk sac tumors. Guidelines for handling testicular tumors in children is not yet well established in Japan. An organized system seems necessary to gather and accumulate the results of the cases in Japan in order to develop better guidelines for treatment. [source] Toward implementing distributed scaffolding: Helping students learn science from designJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 2 2005Sadhana Puntambekar In this article, we present two studies that helped us understand the kinds of support that students need to learn science successfully from design activities. Both were enacted in the context of an approach to learning science from design called learning by design (LBD). In our first study, we designed and integrated a paper-and-pencil scaffolding tool, the design diary, into an LBD unit to support students' design-related activities. We learned two important lessons from the first study. First, we refined our understanding of the processes involved in designing and the ways we might present those processes to students. Second, and more important, we observed that in the dynamic, complex environment of the classroom, not all of the scaffolding could be provided with any one tool or agent. We found that students need multiple forms of support and multiple learning opportunities to learn science successfully from design activities. In our next study, we provided additional support through an organized system of tools and agents. Our analysis of data from the second study leads us to believe that supporting multiple students in a classroom requires us to rethink the notion of scaffolding as it applied to groups of learners in a classroom. We put forth the notion of distributed scaffolding as an approach to supporting hands-on inquiry learning in a classroom. © 2005 Wiley Periodicals, Inc. J Res Sci Teach 42: 185,217, 2005 [source] Perceived barriers to adherence among adolescent renal transplant candidatesPEDIATRIC TRANSPLANTATION, Issue 3 2008Nataliya Zelikovsky Abstract:, Non-adherence to medical regimens is a ubiquitous hindrance to quality health care among adolescent transplant recipients. Identification of potentially modifiable barriers to adherence when patients are listed for organ transplant would help with early intervention efforts to prepare adolescents for the stringent medication regimen post-transplant. Fifty-six adolescents listed for a kidney transplant, mean age 14.27 (s.d. = 2.2; range 11,18 yr), 73.2% male, 62.5% Caucasian participated in a semi-structured interview, the Medical Adherence Measure, to assesses the patient's knowledge of the prescribed regimen, reported adherence (missed and late doses), the system used to organized medications, and who holds the primary responsibility over medication management. Better knowledge of the medication regimen was associated with fewer missed doses (r = ,0.48, p < 0.001). Patients who perceived more barriers had more missed (r = 0.38, p = 0.004) and late (r = 0.47, p < 0.001) doses. Patients who endorsed "just forget," the most common barrier (56.4%), reported significantly more missed (z = ,4.25, p < 0.001) and late (z = ,2.2, p = 0.02) doses. Only one-third of the transplant candidates used a pillbox to organize medications but these patients had significantly better adherence, z = ,2.2, p = 0.03. With regard to responsibility over managing the regimens, adolescents missed fewer doses when their parents were in charge than when they were solely responsible, z = ,2.1, p = 0.04. Interventions developed to prepare transplant candidates for a stringent post-transplant regimen need to focus on ensuring accurate knowledge of as simple a regimen as possible. Use of an organized system such as a pillbox to establish a routine and facilitate tracking of medications is recommended with integration of reminders that may be appealing for this age group. Although individuation is developmentally normative at this age, parent involvement seems critical until the adolescent is able to manage the responsibility more independently. [source] The use of multivariate statistics to elucidate patterns of floodplain sedimentation at different spatial scalesEARTH SURFACE PROCESSES AND LANDFORMS, Issue 5 2007Martin C. Thoms Abstract Floodplains are depositional features of riverine landscapes that display complex sedimentation patterns that are amenable to multi-scale approaches. We examined sedimentation in the Lower Balonne floodplain, Queensland, Australia, at three different spatial scales: the channel (103 km), floodplain process zone (10 km) and geomorphic unit (102 m) scales, and compared scale-related patterns evident from stratigraphy with those evident from quantitative multivariate analysis. Three stratigraphic sequences were found in the Lower Balonne floodplain: generally fining upward, episodic fining upward, and mud-dominated. Stratigraphical analysis revealed the detailed character of sedimentary sequences embedded within the scale patterns derived from multivariate analysis. Multivariate statistical analyses of a range of textural and geochemical data revealed different patterns of floodplain sedimentation at each scale. At the channel scale, sediment texture and geochemistry were more heterogeneous in the Culgoa River than in Briarie Creek. At the floodplain process zone scale clear patterns of sediment texture and geochemistry were observed along the upper, mid and lower floodplain process zones of Briarie Creek, but not along the Culgoa River. At the geomorphic unit scale, clear patterns of sediment texture and geochemistry were observed among the bank, buried channel and flat floodplain units of the Culgoa River, but were not as clear in Briarie Creek. Recognition of rivers as hierarchically organized systems is an emerging paradigm in river science. Our study supports this paradigm by demonstrating that different sedimentation patterns occur at different scales to reveal a hierarchically organized floodplain environment. Copyright © 2006 John Wiley & Sons, Ltd. [source] Alcohol screening and brief intervention: dissemination strategies for medical practice and public healthADDICTION, Issue 5 2000Thomas F. Babor This paper introduces the concept of risky drinking and considers the potential of alcohol screening and brief intervention (SBI) to reduce alcohol-related problems in medical practice and in organized systems of health care. The research evidence behind this approach is reviewed. Potential strategies for the dissemination of SBI to systems of health care are then discussed within the context of a public health model of clinical preventive services. There is an emerging consensus that SBI should be promoted in general healthcare settings, but further research is needed to determine the best ways to achieve widespread dissemination. In an attempt to provide an integrative model that is relevant to SBI, dissemination strategies are discussed for three target groups: (1) individual patients and practitioners; (2) health care settings and health systems; and (3) the communities and the general population. Dissemination strategies are considered from the fields of social change, social science, commercial marketing and education in terms of their potential for translating SBI innovations into routine clinical practice. One overarching strategy implicit in the approaches reviewed in this article is to embed alcohol SBI in the more general context of preventive health services, the utility of which is becoming increasingly recognized as a critical supplement to more traditional clinical medicine. [source] | ||||||||||