By U. Mannig. Hardin-Simmons University.

Educating the reflective practitioner:toward a new design for teaching and learning in the professions discount 60 caps serpina free shipping. The word curriculum has its roots in the Latin word for track or race course buy serpina 60 caps online. From there it came to mean course of The planned curriculum study or syllabus. Today the definition is much wider and • What is intended by the designers includes all the planned learning experiences of a school or educational institution. Thecurriculummustbeinaformthatcanbe communicated to those associated with the learning institution, The delivered curriculum should be open to critique, and should be able to be readily • What is organised by the administrators transformed into practice. The curriculum exists at three levels: • What is taught by the teachers what is planned for the students, what is delivered to the students, and what the students experience. It is underpinned by a set of values and beliefs about what students The experienced curriculum should know and how they come to know it. The curriculum of • What is learned by the students any institution is often contested and problematic. Some people may support a set of underlying values that are no longer relevant. This is the so called sabretoothed curriculum, which is Three levels of a curriculum based on the fable of the cave dwellers who continued to teach about hunting the sabretoothed tiger long after it became extinct. In contemporary medical education it is argued that the curriculum should achieve a “symbiosis” with the health services and communities in which the students will serve. The values that underlie the curriculum should enhance health service provision. The curriculum must be responsive to changing values and expectations in education if it is to remain useful.

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Lamotrigine and vigabatrin are effective in some patients and exacerbate seizures in others discount 60 caps serpina amex. The efficacy of com- plementary medications is reported using a change in global neurological function (not seizure frequency) for outcome cheap serpina 60 caps on-line. Conclusions about efficacy are limited by the paucity of interpretable results. SUMMARY The most common disorders which belong to the progressive myoclonic epilepsies are Unverricht–Lundborg disease, mitochondrial epilepsy with ragged red fibers (MERRF), Lafora body disease, neuronal ceroid lipofuscinosis (NCL), and Sialido- sis (cherry-red spot myoclonus syndrome). A definitive diagnosis can be made in Unverricht–Lundborg disease, Lafora body disease, and Sialidosis, and a presump- 102 Conry tive diagnosis (by electron microscopy, respiratory chain enzyme analysis, or chro- mosomal linkage) can be made in some cases of MERRF and NCL. Unfortunately, a definitive diagnosis cannot be made in many patients who fall into the PME spec- trum. In view of the fact that most cases of clearly diagnosed PME are either autosomal recessive or mitochondrially (maternally) transmitted genetic disorders, a definitive diagnosis for genetic counsel- ing is essential even in those patients who are declining rapidly. In: Progressive Myoclonic Epilepsies in Epilepsy: A Comprehensive Textbook. Treatment strategies for myoclonic seizures and epilepsy syndromes with myoclonic seizures. INTRODUCTION In both community practices and academic centers caring for children with epilepsy, it is not uncommon for 10–30% of patients to have seizures that defy control with standard anticonvulsant drugs. In a study by Berg, intract- able seizures occurred more commonly in patients with cryptogenic or symptomatic generalized syndromes (e. In addition, the presence of focal slowing on electroencephalogram (EEG), high initial seizure frequency, and either acute symptomatic or neonatal status epilepticus were positively correlated with an increased likelihood of having intractable epilepsy. The definition varies, but most definitions in the literature describe those patients who fail to respond to two or more antiepileptic drugs at maximally tolerated doses.

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