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De igual manera medications ok during pregnancy order spiriva on line amex, los estudiantes demostraron dominio spa hair treatment order cheap spiriva line, de forma prбctica medicine x ed buy online spiriva, de los conceptos volumen y бrea aplicados a las figuras de cilindro y prismas rectangulares symptoms sleep apnea purchase spiriva 18mcg mastercard. Por ejemplo, en el proyecto de la muestra X, se transformу el lugar seleccionado en un centro de acopio tomando las medidas y realizando los cбlculos correspondientes. En nuestra experiencia como educadoras, los estudiantes acostumbran a hacer comentarios negativos acerca de las tйcnicas de aprendizaje formales o tradicionales. Sus reclamos giran en torno a que ellos consideran innecesario el esfuerzo que se les exige de prepararse para una evaluaciуn mediante exбmenes, pruebas cortas, tareas y otros, pues muchas veces no encuentran la pertinencia de las matemбticas a la vida diaria. Capta la atenciуn de las investigadoras cуmo el estudiante logrу valorar la experiencia vivida y transferir lo aprendido a otros escenarios. Esto se ejemplifica cuando un estudiante comenta "aprendн que todo tiene que ver con las matemбticas y que las matemбticas son necesarias para nuestra vida diaria". De manera que el solucionar problemas cotidianos con el uso de las matemбticas provee a los estudiantes de un escenario significativo que le da sentido a lo que estбn aprendiendo (Mora 2003). Las investigadoras pudieron observar cuбn recurrente fue que los estudiantes apreciaran la importancia de la aplicaciуn de los conceptos Proyecto ambiental promueve trabajo en equipo Tabla 2. Percepciуn del maestro Categorнas Aprendizaje de conceptos matemбticos: Бrea Los diseсadores demostraron conocimiento en el concepto de бrea al preparar el plano que mostraron y discutieron Est. De forma implнcita los estudiantes hacen referencia al concepto volumen: "El espacio que ocupa actualmente la basura que generamos en la escuela. Esto se al saber el volumen real de la basura evidencia en el informe acumulada (en la escuela) escrito que entregaron al final del proyecto y en el informe oral que presentaron. Yamily Colуn y Amabel Soto Anбlisis de los cuestionarios con preguntas abiertas y las observaciones reflexivas de las investigadoras. Los estudiantes pudieron encontrar aplicaciуn a los conceptos matemбticos en la realizaciуn del proyecto Est. Tambiйn reconocen ver con las matemбticas y que que para las matemбticas son necesarias para nuestra trabajar con estos conceptos la vida diaria. B y C) Limpiando y pintando el espacio en el que desarrollaran el centro de acopio. La maestra tuvo que intervenir para que llegaran a un acuerdo y negociaran la integraciуn de todos, destreza que permeу durante el resto del proyecto. Una destreza central del trabajo en equipo es la capacidad para comunicar ideas, experiencias y conocimientos adquiridos. Una estudiante, en su rol de publicista, seсalу su satisfacciуn cuando realizу su tarea en el grupo: "la tarea que mбs que me gustу fue entrevistar a las personas ya que uno puede ver la preferencia y si tienen alguna duda puedes aprovechar para hablarles del tema". Ademбs de reconocer que la comunicaciуn es necesaria para tareas como las entrevistas, las investigadoras subrayan el hecho de que la comunicaciуn fue pieza clave entre equipos. Por ejemplo, los publicistas dependнan del insumo de los otros equipos de trabajo, entre ellos los redactores, estadнsticos y diseсadores. Otra de las destrezas del trabajo en equipo que resultу relevante para el йxito de los proyectos y de la construcciуn de conocimiento, fue la planificaciуn. Los estudiantes, con certeza, hicieron uso de la misma reconociendo que era pertinente planificar para cumplir con sus responsabilidades. Por ejemplo, un estudiante seсalу que "la planificaciуn fue esencial para dividir el бrea en la cual se ubicу el centro de acopio". Durante las observaciones realizadas a los estudiantes nos percatamos que cada equipo de trabajo planificу minuciosamente cada etapa del proyecto para cumplir exitosamente con las responsabilidades asignadas. Como aprendizaje adicional los estudiantes demostraron conocimientos cientнficos volumen de cilindros y prisma rectangulares a una situaciуn real, en la culminaciуn del proyecto. Mбs aъn, como se muestra en la Tabla 2, a partir de la participaciуn de los estudiantes en el proyecto emergieron cambios en las actitudes de los estudiantes hacia las matemбticas, ciencias y otros conceptos. Es de conocimiento comъn el hecho de que la educaciуn se transforma de acuerdo a los cambios generacionales. Lo que demandaba la sociedad del siglo pasado en el бmbito profesional no es igual a las exigencias de este nuevo siglo. Esto se respalda con las expresiones de los estudiantes en las cuales se destaca que su experiencia les permitiу desarrollar sus destrezas de colaboraciуn, negociaciуn, comunicaciуn y planificaciуn. De las interacciones de los estudiantes en los grupos de trabajo se hizo evidente que la colaboraciуn fue un atributo que fortaleciу el trabajo en equipo. Uno de los estudiantes lo evidencia al indicar: "para lograr hacer el proyecto escolar nos basamos principalmente en el trabajo en equipo donde todos ayudamos". Este aspecto tambiйn fue resaltado en las observaciones reflexivas donde las investigadoras identificaron que el trabajo en equipo fluyу con йxito al momento de completar el producto deseado; cada estudiante contribuyу.
According to Parsons (1936:222) symptoms viral meningitis spiriva 18mcg cheap, the story was the only widely known myth at the time in that important weaving town symptoms tuberculosis purchase spiriva visa. Sus Ley pursues the twins after they kill her husband medications used for fibromyalgia discount spiriva, a frequent theme in many versions of the sun and moon story treatment 2 go purchase 18 mcg spiriva amex. As they flee, the twins throw behind them various weaving implements belonging to the old woman, which become geographical landmarks. In one of the Trique versions (Bartolomй 1984), the twins rape the old woman after killing the deer that is her husband. When she wakes from her sleep, induced by the fruit the twins have given her, she realizes what has happened and throws her seven warping stakes, or weaving sticks, at the sun and moon. The salience of spinning and weaving in contemporary Oaxacan myths parallels the prominence of spindles, cotton puffs, and battens in the attire of precolumbian deities depicted in the Mixtee codices, as well as in the Borgia group codices and the early Central Mexican manuscripts. When couples are represented, the iconography indicates that wives and husbands shared the same status in this region, in contrast to Central Mexico. The power of women in indigenous Oaxaca is also attested by historical records of the colonial period, which refer frequently to cacicas, their property, and their privileges (Terraciano 1996). Contemporary ethnographies emphasize the central role of women in production, politics, and ritual in Oaxaca (Stephen 199la, b; Chinas 1973). The weavers of Teotitlбn del Valle interviewed by Stephen, as well as the Isthmus Zapotee merchants studied by Chinas, express womanhood, ethnicity, and creativity through textiles. C u l t u r a l P o l i t i c s and the C o n s e r v a t i o n of The x t i l e s During a recent campaign for state governor elections, a novel poster appeared in the streets of Oaxaca. Depicting an idealized, elaborately decorated textile, the poster read: "[name of the candidate], de autйntica urdimbre oaxaqueсa" [of authentic Oaxacan warp]. The candidate, representing the dominant party, boasted of his indigenous identity in the propaganda and in his speeches - even though he would not be considered indнgena by the definition of the national census, since the indigenous language is dying out in his native village. To his discredit, there is no record of traditional textiles from his community; weaving appears to have died out in that area of Oaxaca early in the 1800s. The poster illustrates the appropriation of textiles as symbols of ethnicity for political purposes. Indigenous clothing, usually simplified and worn by young, urban, middle-class women, has become part of the protocol at state functions and political rallies in Oaxaca. That message is exalted in the Guelaguetza, a yearly festival sponsored and presided over by the state government. Named after a traditional system of reciprocal exchange of goods and labor practiced in Zapotee communities in the Valley of Oaxaca, the Guelaguetza developed in the 1950s as an event to attract tourism. It was superimposed on the Lunes del Cerro (Monday of the Mountain), a traditional celebration in the city of Oaxaca, during which families climb the hill just west of the center of town to relax and enjoy traditional foods and drinks sold there for the occasion (Gonzбlez Rнos 1993). Groups of dancers and musicians, dressed in traditional garb, are brought in to perform. Few, if any, of the young people who participate wear indigenous clothing, except during the festival. Many of the dances are specially rehearsed for the event, as they are no longer performed traditionally. The debate over the Guelaguetza reflects a deep contradiction in the relationship of the Mexican state to indigenous peoples (Nagengast and Kearney 1990). Nationalistic ideology after the 136 the U n b r o k e n Thread revolution of 1910 glorified the precolumbian past and the folkloristic expressions of contemporary indigenous cultures. This ideology led to the creation of a system of institutions funded by the state that study conserve, and promote indigenous and popular culture. At the same time, the state continues to implement policies that compromise the viability of communal forms of organization of indigenous peoples and promote migration from the countryside to the cities, facilitating cultural breakdown. Substantial resources are invested in the development of commercial farming and cattle raising, most of which take place in areas where indigenous population is minimal. Comparatively meager resources are devoted to the economic development of indigenous areas, characterized by subsistence agriculture. Legislative reform, designed to facilitate the privatization of eju)od (a system of collective land tenure that was instituted after the revolution of 1910), threatens the integrity of land and natural resources held by numerous indigenous communities.
Como casi toda actividad cientнfica medications via g-tube spiriva 18mcg overnight delivery, particularmente treatment vs cure discount 18 mcg spiriva with visa, la actividad matemбtica consiste en crear modelos treatment 2 purchase spiriva with visa. La elaboraciуn de un modelo matemбtico requiere treatment alternatives purchase spiriva 18mcg, por parte del modelador, de conocimientos tanto matemбtico como de la situaciуn. Y mбs aъn: una buena dosis de intuiciуn y creatividad para interpretar el contexto y discernir cuбles son las variables envueltas. En las ъltimas dйcadas, en diversos paнses, viene creciendo un movimiento en pro de esta metodologнa en el proceso de enseсanza de la matemбtica. En la ъltima dйcada, especialmente, se han venido realizando investigaciones que legitiman la modelizaciуn en el proceso de enseсanza de matemбtica en cualquier nivel escolar. Preocupaciones sobre quй, cуmo, cuбndo y para quй enseсar matemбtica han contribuido en el fortalecimiento de esas investigaciones en el бrea de la Educaciуn Matemбtica. La Modelizaciуn Matemбtica, originalmente, como metodologнa de enseсanza parte de un tema o asunto acerca del cual se desarrollan preguntas. Esas preguntas deberбn ser respondidas mediante el uso del conjunto de herramientas matemбticas y de la investigaciуn sobre el tema. Se trata, es lуgico, de una forma placentera de investigar el tema que es capaz de llevar al alumno a construir conocimientos significativos, ya sea en forma de conceptos matemбticos, o sobre el tema que se estudia. La idea de muchos defensores es la de que cada alumno pueda escoger un tema o asunto de alguna бrea de su interйs, hacer una investigaciуn al respecto, proponer preguntas y, bajo la orientaciуn del profesor, elaborar un modelo matemбtico. El aprendizaje se vuelve mбs rico, considerando que el alumno no sуlo aprende matemбtica inserta en el contexto de otra бrea del conocimiento, sino que tambiйn despierta su sentido crнtico y creativo. La modelizaciуn matemбtica, por tanto, es un mйtodo de enseсanza y de investigaciуn que se vale de la esencia de la modelizaciуn. Con su aplicaciуn, se espera propiciar en el alumno: que integre la matemбtica con otras бreas del conocimiento; se interese por la matemбtica frente a su aplicabilidad; mejore el aprendizaje de los conceptos matemбticos; se estimule su creatividad en la formulaciуn y resoluciуn de problemas; desarrolle habilidad en el uso de mбquinas (ej. Dicho estбndar indica: "El estudiante es capaz de entender, interpretar, analizar y construir modelos de diversas funciones y sus representaciones. Esto incluye las descripciones verbales, tablas y ecuaciones y grбficas para hacer predicciones y analizar las relaciones al solucionar problemas matemбticos complejos de la vida diaria" (Departamento de Educaciуn 2014). Especнficamente se abordaron dos expectativas de dicho estбndar: · Escribe una funciуn que describa una relaciуn entre dos cantidades. Determina una expresiуn explнcita, un proceso recursivo o pasos para un cбlculo a partir de un contexto. Las guнas que proveen estos dos grupos de autores para realizar intervenciones de este tipo se utilizaron para planificar la intervenciуn. En primera instancia se presentу una situaciуn motivadora que sirviera de contexto al proyecto a ser desarrollado. Dicha situaciуn fue el problema de crisis alimentaria que se avecina en el mundo en los prуximos cincuenta aсos. Mediante los videos se intentу llevar a los estudiantes a los niveles mбs altos de razonamiento y pensamiento crнtico para viabilizar la bъsqueda de soluciones a dicho problema. Los estudiantes luego hicieron una bъsqueda de posibles ideas y soluciones para prevenir la crisis alimentaria. Los estudiantes, tras un torbellino de ideas, determinaron llevar a cabo un proyecto agrнcola. Se formaron grupos, como mбximo de 2 alumnos, y cada Aprendizaje basado en proyectos grupo eligiу un asunto de su interйs para llevar a cabo una actividad del Proyecto que incluнa la investigaciуn cientнfica. Una vez elegido el asunto, el maestro propuso que obtuvieran informaciуn mediante bibliografнa especializada y/o especialistas. Antes de comenzar el proyecto, para propуsitos de la investigaciуn acciуn, se aplicу una preprueba para explorar los niveles de conocimientos sobre modelos de funciones polinуmicas y no polinуmicas de los estudiantes. Estas actividades sirvieron para que los estudiantes se familiarizaran con el modelaje matemбtico y practicaran el uso de dichas tecnologнas, lo que servirнa de preparaciуn para el desarrollo del Proyecto. Estas actividades iniciales tuvieron los siguientes objetivos: a) resolver problemas de aplicaciуn que se pueden modelar por medio de una funciуn, b) encontrar funciones de potencia para modelar un conjunto de datos y c) explicar los parбmetros del modelo. Componente de Acciуn Para diseсar las actividades del Proyecto, los grupos elaboraron una serie de preguntas y una sнntesis de la investigaciуn a realizar las cuales el maestro revisу para ayudarles a delimitar y precisar las mismas. Se plantearon asн las preguntas de investigaciуn y se establecieron los procedimientos a seguir para realizar las actividades del Proyecto.
Thisdiagnosisshouldbemadeonlyinassociation withaspecifiedphysicaldisorder medications hyponatremia buy spiriva visa,andshouldnotbemadeinthepresenceofany of the mental or behavioural disorders classified to F10F99 symptoms diabetes type 2 generic spiriva 18mcg with visa. The disorder may precede medications not covered by medicare discount spiriva online visa, accompany or follow a wide variety of infections and physical disorders treatment laryngomalacia infant buy cheap spiriva 18 mcg online, both cerebral and systemic, but direct evidence of cerebral involvement is not necessarilypresent. Organic: · pseudopsychopathicpersonality · pseudoretardedpersonality Syndrome: · frontal lobe · limbic epilepsy personality · lobotomy · postleucotomy Excl. Identification of the psychoactive substance should be based on as many sources of information as possible. Only in cases in which patterns of psychoactive substance-taking are chaotic and indiscriminate,orinwhichthecontributionsofdifferentpsychoactivesubstancesare inextricablymixed,shouldthediagnosisofdisordersresultingfrommultipledruguse (F19. When organic factors are also considered to play a role in the etiology, the condition shouldbeclassifiedtoF05. The disorder is characterized by hallucinations(typicallyauditory,butofteninmorethanonesensorymodality), perceptual distortions, delusions (often of a paranoid or persecutory nature), psychomotor disturbances (excitement or stupor) and an abnormal affect, which mayrangefromintensefeartoecstasy. Immediate recall is usually preserved and recent memory is characteristically more disturbed than remote memory. Disturbances of time sense and ordering of events are usually evident, as are difficulties in learning newmaterial. Onset of the disorder should be directly related to the use of the psychoactivesubstance. Flashbacks may be distinguished from psychotic state partly by their episodic nature, frequently of very short duration, and by their duplication of previousalcohol-orotherpsychoactive-substance-relatedexperiences. F20 Schizophrenia the schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception, and affects that are inappropriateorblunted. The diagnosis of schizophrenia should not be made in the presence of extensive depressive or manic symptoms unless it is clear that schizophrenic symptoms antedate the affective disturbance. The mood is shallow and inappropriate, thought is disorganized, and speech is incoherent. If the patient no longer has any schizophrenic symptoms, a depressive episode should be diagnosed (F32. If schizophrenic symptoms are still florid and prominent, thediagnosisshouldremainthatoftheappropriateschizophrenicsubtype(F20. Thesymptomsmayincludeacoldor inappropriateaffect;anhedonia;oddoreccentricbehaviour;atendencytosocial withdrawal;paranoidorbizarreideasnotamountingtotruedelusions;obsessive ruminations; thought disorder and perceptual disturbances; occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations anddelusion-likeideas,usuallyoccurringwithoutexternalprovocation. However, the presence of occasional or transitory auditory hallucinations, particularly in elderly patients, does not rule out this diagnosis, providedthattheyarenottypicallyschizophrenicandformonlyasmallpartofthe overallclinicalpicture. Paranoia Paranoid: · psychosis · state Paraphrenia(late) Sensitiverbeziehungswahn Excl. Acuteonsetisdefinedasacrescendo development of a clearly abnormal clinical picture in about two weeks or less. Complete recovery usually occurs within a few months, often within a fewweeksorevendays. Acute(undifferentiated)schizophrenia Briefschizophreniform: · disorder · psychosis Oneirophrenia Schizophrenicreaction Excl. This category should be used for both a single episode and a recurrent disorderinwhichthemajorityofepisodesareschizoaffective,manictype. The mood change is usually accompanied by a change in the overall level of activity; most of theothersymptomsareeithersecondaryto,oreasilyunderstoodinthecontextof,the changeinmoodandactivity. F30 Manic episode All the subdivisions of this category should be used only for a single episode. Hypomanicormanicepisodesinindividualswhohavehadoneormoreprevious affective episodes (depressive, hypomanic, manic or mixed) should be coded as bipolaraffectivedisorder(F31. Increased sociability, talkativeness, over-familiarity, increased sexualenergyandadecreasedneedforsleepareoftenpresentbutnottotheextent thattheyleadtoseveredisruptionofworkorresultinsocialrejection. Irritability, conceit and boorish behaviour may take the place of the more usual euphoric sociability. The disturbances of mood and behaviour are not accompanied by hallucinationsordelusions. Loss of normal social inhibitions may result in behaviour that is reckless, foolhardy or inappropriatetothecircumstances,andoutofcharacter. Maniawith: · mood-congruentpsychoticsymptoms · mood-incongruentpsychoticsymptoms Manicstupor F30.
Intravenous dopamine antagonists medicine zoloft buy 18mcg spiriva free shipping, often combined with intravenous diphenhydramine (to limit or eliminate possible dystonic reactions) and hydration medicine 5113 v discount spiriva 18 mcg amex, may be helpful medicine runny nose purchase 18mcg spiriva with mastercard. Intravenous preparations of ketorolac and sodium valproic acid are also quite useful symptoms 8 days after iui generic spiriva 18mcg line, and the addition of a single dose of dexamethasone seems to reduce recurrence. Behavioral approaches provide headache relief without the risk for adverse drug effects. Antiemetics provide symptomatic relief of nausea and can facilitate the use of oral analgesics for migraine pain relief. Propranolol, timolol, divalproex sodium, and topiramate have the strongest evidence of effectiveness in preventing episodic migraine. Patients should generally be reevaluated after treatment of no fewer than 3 attacks. Patients should keep a record of headache severity, associated disability, and response to treatments. These diaries and the need for preventive therapy should be reviewed at follow-up. Preventive therapy is indicated if there is poor response to treatment or frequent need for rescue medication, which puts the patient at risk for analgesic overuse or "rebound" headache. Increasing dose or changing agents should be considered if headache frequency has not improved after 3 months of preventive treatment. Most clinicians recommend a 6- to 12-month maintenance phase after a response (often defined as a 50% reduction in headache frequency) has been achieved, followed by a tapering phase with the aim to discontinue if there is no relapse. As migraine symptoms change over time and preventive treatment may no longer be needed, this may avoid the risks and costs associated with unnecessary drug therapy. Consult a neurologist or headache specialist to determine an appropriate further diagnostic workup in patients with possible ophthalmic, basilar, atypical, or complicated migraine. Consult a neuro-ophthalmologist or an ophthalmologist when headache is associated with visual changes other than typical aura. A significant change in visual acuity or fields or elevated intraocular pressure, especially with eyecentered pain, may indicate acute glaucoma that must be treated promptly to preserve vision. Newonset visual symptoms in persons older than 50 years may indicate giant cell arteritis. Consult an obstetrician when pregnant women have headaches associated with peripheral edema or hypertension (diastolic blood pressure 90 mm Hg) because these patients may have preeclampsia (45). Patient education about the goals, use, and expectations of migraine preventive therapies is crucial in maximizing the chances of therapeutic success. The patient must understand that although these therapies may reduce the frequency or severity of attacks, improve the efficacy of acute medications, and assist in the management of comorbid conditions, they rarely result in complete headache eradication. Approximately one half of recurrent headache sufferers do not adhere properly to drug treatment regimens, with as many as two thirds of patients neglecting to make optimal use of rescue medications. Treatment can be improved by developing a plan for self-management that all parties acknowledge and accept. The plan should identify all treatment methods used, including those for coexisting conditions and limits on dosing, rescue medication, and a plan for how and when to contact a health care provider. Practice Improvement Patients should be encouraged to identify and avoid lifestyle-related factors that may contribute to headaches, including too little or too much sleep, lack of exercise, and stress. Modifications in diet, exercise, and sleep regulation have a significant effect on headache response and affective distress (47). Enhancing the effectiveness of abortive therapy: a controlled evaluation of self-management training. They must be user-friendly and measure attack frequency, severity, duration, disability, type of treatment, treatment response, and adverse effects of medication. Also includes information on diagnostic tests and criteria and quality-of-care guidelines. Mild-to-moderate migraine without vomiting or nausea · Acetaminophen and nonsteroidal anti-inflammatory drugs, such as aspirin. Other treatments · Behavioral therapy, such as relaxation training or cognitive-behavioral therapy. Severe migraine · Prescription migraine medications, such as triptans, dihydroergotamine, or ergotamine. The patient describes recurrent attacks of pulsatile pain on one side of her head that last 1 or 2 days and are often accompanied by nausea, vomiting, and disability.
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