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1.
There is overwhelming evidence that hypertension is an important risk factor for both macrovascular and microvascular complications in patients with diabetes, but the problem remains to identify appropriate goals for preventive therapies. A number of guidelines (the European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) 2007, the Joint National Committee (JNC)-VII 2003, the American Diabetes Association (ADA) 2011) have for example advocated a blood pressure goal of less than 130/80 mmHg, but this suggestion has been challenged by findings in recent trials and meta-analyses (2011). The European Society of Hypertension (ESH) therefore recommends a systolic blood pressure goal of “well below” 140 mmHg. Based on evidence from both randomized controlled trials (hypertension optimal treatment (HOT), action in diabetes and vascular disease: preterax and diamicron MR controlled evaluation (ADVANCE), action to control cardiovascular risk in diabetes (ACCORD)) and observational studies (ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET), international verapamil-trandolapril study (INVEST), treat to new targets (TNT), and the National Diabetes Register (NDR)), it has been shown that the benefit for stroke reduction remains even at lower achieved blood pressure levels, but the risk of coronary events may be uninfluenced or even increased at lower systolic blood pressure levels. In a recent meta-analysis, it was therefore concluded that the new recommended goal should be 130–135 mmHg systolic blood pressure for most patients with type 2 diabetes. Other risk factors should also be controlled with a more ambitious strategy applied in the younger patients with shorter diabetes duration, but a more cautious approach in the elderly and frail patients with a number of vascular or non-vascular co-morbidities. In patients from East Asia, such as China, the stroke risk is relatively higher than the risk of coronary events. This must also be taken into consideration for individualized goal setting in relation to total risk, for example in patients from stroke-prone families. In conclusion, the current strategy is to have a more individualized approach to risk factor control in patients with type 2 diabetes, also relevant for blood pressure control.  相似文献   

2.
Structural equation modelling is used to measure the existence of a response style (in particular, acquiescence) behind three balanced Likert scales measuring different concepts in a questionnaire for student evaluation of teaching in higher education. Exploration with one sample (n = 1125) and confirmation in a second sample (n = 710) from a different population (different students, different courses) shows the existence of a common factor behind these scales. However, the weak correlation with the variable ‘sum of agreements’ does not support the idea of acquiescence in student evaluation of teaching. Instead, the common factor could be interpreted as a halo factor influencing different scales in the questionnaire. The implications of this exploratory study for future research on acquiescence in student evaluations of teaching are discussed.  相似文献   

3.
This paper measures and decomposes socioeconomic-related inequality in mathematics achievement in 15 European Union member states. Data is taken from the 2003 wave of the OECD Programme for International Student Assessment (PISA). There is socioeconomic-related inequality in mathematics achievement, favoring the higher socioeconomic groups in each country. There are important differences among countries. The inequality is higher in Germany, Greece, Great Britain, Belgium, and Portugal and is lower in Sweden and Finland. Socioeconomic factors represent between 14.9% and 34.6% of the overall inequality in education.  相似文献   

4.
For over a decade, all three‐year‐olds in England have been entitled to a free part‐time early education place. One aim of this policy is to close developmental gaps between higher‐income and low‐income children. However, the success of the initiative depends on children accessing the places. Using the National Pupil Database, we examine all autumn‐born four‐year‐olds attending in January 2011, and ask whether they started attending when first eligible, in January 2010. One in five children did not access their free place from the beginning, and the proportion is much higher among children from families with persistently low incomes. We also find differences by ethnicity and home language, but these factors explain only a small share of the income gradient. We go on to explore associations between non‐take‐up and local area factors. In areas with higher child poverty rates, take‐up is lower overall, but the gap between low‐income and other families is smaller. There are also various associations between take‐up and local proportions of different provider types (maintained, private, voluntary, Sure Start). In particular, the voluntary sector seems to have more flexibility than maintained provision to offer places in January, and more success than private providers in reaching children from lower‐income backgrounds. The analysis also highlights how take‐up overall is relatively high and the gap by income level is smaller in areas with more Sure Start provision. This suggests that aspects of Sure Start facilitated access among low‐income families, and could perhaps be replicated as implementation of the free entitlement continues to be expanded.  相似文献   

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Value-based decisions often involve comparisons between benefits and costs that must be retrieved from memory. To investigate the development of value-based decisions, 9- to 10-year olds (N = 30), 11- to 12-year olds (N = 30), and young adults (N = 30) first learned to associate gain and loss magnitudes with symbols. In a subsequent decision task, participants rapidly evaluated objects that consisted of combinations of these symbols. All age groups achieved high decision performance and were sensitive to gain–loss magnitudes, suggesting that required core cognitive abilities are developed early. A cognitive-modeling analysis of performance revealed that children were less efficient in object evaluation (drift rate) and had longer nondecision times than adults. Developmental differences, which emerged particularly for objects of high positive net value, were linked to mnemonic and numerical abilities.  相似文献   

7.
Der Wegfall einer Berufungsm?glichkeit, mangels entsprechender übergangsbestimmungen, beseitigt nicht den Anspruch auf bescheidf?rmige Erledigung. Aus den Aufsichtregelungen des UG 2002 ist abzuleiten, dass der Bundesminister für Wissenschaft und Forschung sachlich in Betracht kommende Oberbeh?rde gegenüber den Organen der Universit?t ist.  相似文献   

8.
The teacher–student relationship is viewed as integral to successful teaching and learning but, outside of a few exceptions, ethical boundary issues in this relationship have not been explored. The purpose of this study was to examine teachers' perspectives of their relationships with their students as well as how they described and negotiated relationship boundaries. Findings were organised into a typology of 11 categories of boundaries. The balance between demonstrating care while maintaining a healthy, productive level of control in the classroom was a recurring theme when discussing the boundaries.  相似文献   

9.
10.
In the face of the worldwide ecological crisis, ecocriticism, “the study of the relationship between literature and the physical environment” as “an earth-centered approach to literary studies” has become an important part of contemporary literary theory (Glotfelty in The Ecocriticism Reader: Landmarks in Literary Ecology, 1996, p. xviii). Since many traditional Native American lifestyles were based on ecological or ecocentric thinking—the need to live in harmony with the natural world—scholars have turned to the Native American literature that shares this ecocentric focus, which includes writing by Chickasaw poet Linda Hogan, Acoma Pueblo poet Simon Ortiz, and Laguna Pueblo novelist Paula Gunn Allen, among others. Native American children’s literature has been less examined. Even the acclaimed poet and novelist Louise Erdrich, one of the best-known authors of the second wave of the Native American Renaissance, has received less academic attention for her children’s books. This article aims to explore ecocentrism in Erdrich’s award-winning children’s book Chickadee (2012), the fourth book in her Birchbark House series, consulting discourses on ecocentrism and anthropocentrism, the importance of children’s literature in education, as well as the significance of animals and shamanism in Chickadee, placing the book within the context of traditional Native American culture.  相似文献   

11.
The number of students who are ‘at risk’ including those with special education needs and or disabilities is increasing rapidly worldwide in all schools. This has prompted widespread debate regarding the impact of initiatives in Curriculum, Assessment and Reporting for this group of students. Teachers, parents and administrators need to have further information to enable them to contribute to the development of content, assessment and reporting processes in the curriculum that are inclusive, relevant, reliable and valid. This paper explores some of the issues and dilemmas raised by recent policy discussions regarding the inception of a first national Australian Curriculum. It draws purposively on literature relating to developments in England and Wales, where national curriculum provision has existed for over 25 years, as well as the responses of a group of stakeholders (teachers and leaders) from both England/Wales and Australian schools and settings. These data highlight both tension and opportunity in this area of work.  相似文献   

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The need for education to help every child has become more important for policy in the US and the UK. Remedial programmes are often difficult to evaluate because participation is usually based on pupil characteristics that are largely unobservable to the analyst. We evaluate programmes for children with ‘Special Educational Needs’ in England. We show that the decentralized design of the policy generates much stronger differences across schools in access to remediation resources for children with moderate learning difficulties than for children with either no difficulties or severe difficulties. However, these differences are not reflected in subsequent educational attainment – suggesting that the programme is ineffective for children with moderate learning difficulties. Also, we use demographic variation within schools to consider the effect of the programme on whole year groups. Our analysis is consistent with no overall effect on account of the combined direct and indirect (spillover) effects.  相似文献   

14.
This study of 241 parent–child dyads from the United Kingdom (= 120, Mage = 3.92, SD = 0.53) and Hong Kong (= 121, Mage = 3.99, SD = 0.50) breaks new ground by adopting a cross‐cultural approach to investigate children's theory of mind and parental mind‐mindedness. Relative to the Hong Kong sample, U.K. children showed superior theory‐of‐mind performance and U.K. parents showed greater levels of mind‐mindedness. Within both cultures parental mind‐mindedness was correlated with theory of mind. Mind‐mindedness also accounted for cultural differences in preschoolers’ theory of mind. We argue that children's family environments might shed light on how culture shapes children's theory of mind.  相似文献   

15.
We describe, discuss and illustrate a metaphoric parallel between the history of the most famous Spanish liqueur, “Anís del Mono” (Anís of the Monkey), and the evolution of living organisms in the light of Darwinian theory and other biological hypotheses published subsequent to Charles Darwin’s Origin of Species. Also, we report the use of a caricature of a simian Darwin with a positive connotation, perhaps the only one ever produced. We conclude that, like some species in the natural world, Anís of the Monkey has evolved, adapted, survived and become the fittest and most successful anís in the Spanish market and possibly the world. We hope this paper will contribute a new useful metaphor for the teaching of biological evolution.  相似文献   

16.
Teacher actions can influence how students engage at school, making it relevant to understand their conceptions of student engagement and how to facilitate it. Reviews of existing literature suggested that a distinction between engagement in schooling and engagement in learning might help differentiate between social and academic outcomes.Data from a phenomenographic study of 20 Australian teachers were analysed to show how teacher thinking related to this distinction. While some teachers held complex conceptions centred on promoting cognitive engagement and student learning, others aligned with engagement in schooling, focusing on generating participation and emphasising positive student affective experiences.  相似文献   

17.
Educational Studies in Mathematics - Designers in out-of-school spaces often negotiate the meaning of mathematics as part of the design process, determining what to include in classes and exhibits...  相似文献   

18.
Korean‐learning infants’ categorization of two spatial categories, one consistent and one inconsistent with the Korean semantic category of “kkita,” was examined. Infants of 10 months (= 32) and 18 months (= 49) were tested on their categorization of containment or tight fit spatial relations. At 10 months, infants only formed a category of containment, but at 18 months, their categorization of tight fit was significantly stronger than containment. The results suggest that Korean infants benefit from their language environment in forming a category of tight fit when the exemplars are perceptually diverse. In particular, infants’ language environment may bolster their ability to generalize across diverse exemplars to form abstract categorical representations of spatial relations.  相似文献   

19.
A person who everyday looks upon a beautiful picture, reads a page from some good book, and hears a beautiful piece of music will soon become a transformed person – one born again [Labour, 1997]. Across the world, music audiences are being eroded by an array of domestic electronic attractions. Habitual concertgoers fear to venture into the inner city after dark, or get deterred by traffic jams and parking restrictions. A new generation raised on television soundbites and instant hamburgers has been jaggedly desensitised to the stately magniloquence of an hour-long symphony. The sharing of music within families has been blighted by the decline of the nuclear family. Music teaching, insofar as it is still provided in public school systems, has been rendered almost worthless by a politically correct tendency to treat all musics as equal – the primitive with the refined, the commercial with the spiritual [Lebrecht, 1996].  相似文献   

20.
This study explores how students' learning styles influence their learning while solving complex problems when a case‐based e‐learning environment is implemented in a conventional lecture‐oriented classroom. Seventy students from an anaesthesiology class at a dental school participated in this study over a 3‐week period. Five learning‐outcome tests and two course‐satisfaction surveys were implemented during the case‐based instruction using a blended approach (online and face‐to‐face). The results of one‐way ANOVAs with repeated measures revealed that the four learning styles (active–reflective, sensing–intuitive, visual–verbal, sequential–global) did not influence students' learning experience and learning outcomes during the implementation of case‐based e‐learning. However, the pattern of the students' performance graph and further analysis with a liberal approach implied that the active–reflective learning style may influence learning outcomes slightly at an earlier time during the case‐based learning implementation; however, as time passed, this learning style no longer influenced their learning at all. Thus, learning styles may not be considered important or may be considered only during the early stages of instructional implementation in order to facilitate the students' transition to the new case‐based learning environment. It is more efficient to encourage students to adapt to different learning environments than to design adaptive systems in order to embrace diverse learning styles.  相似文献   

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