In 1939, Chavasse attributed the development of amblyopia and facultative suppression to the process of adaptive inhibition in the face of dissociatio
|
|
- 骑坚 宇文
- 7 years ago
- Views:
Transcription
1 Amblyopia History of amblyopia Le Cat (1713) is credited with providing the first accurate clinical description of human amblyopia. However, credit for first describing any treatment for amblyopia is given to George Louis Leclerc, Conte De Buffon ( ) Buffon was the first to realize the two most important elements in amblyopia therapy: occlusion and full optical correction
2 In 1939, Chavasse attributed the development of amblyopia and facultative suppression to the process of adaptive inhibition in the face of dissociation. This is known as the theory of amblyopia of arrest versus amblyopia of extinction.
3 Chavasse divided amblyopia into two types: Amblyopia of arrest there is a cessation of development of vision in the involved eye that must occur before the age of 6 years. Chavasse felt that 20/20 vision is firmly established by age 6 years and amblyopia of arrest is considered irreversible. Amblyopia extinction The amblyopia could be improved, but only up to the best vision that was obtained before the onset of the anomalous visual experience.
4 Dobson and Teller ( 1978) More recent objective methods have demonstrated 20/20 VA can be obtainable by about 6 to 12 months of age with certain testing procedures. Amblyopia of arrest can only exist when the anomalous visual experience occurs before 6 months or so. consequently, the majority of amblyopia is of the extinction type and therefore potentially reversible.
5
6
7 Example 1. Onset of abnormal visual experience is at age of 1 year 2. Best VA at age 1 year: Chavasse : 20/120 Dobson and Teller: 20/20 3. Best VA now( after age 6 years and without previous treatment) : 20/200
8 Chavasse ( 1939) 20/200 to 20/120 = deficit due to extinction and therefore fully reversible 20/120 to 20/20 = deficit due to arrest and therefore nonreversible Dobson and Teller ( 1978) 20/200 to 20/20 = deficit due to extinction and therefore fully reversible
9 Definition Amblyopia is an unilaterally or bilaterally decrease of visual form sense for which no obvious structural or pathologic causes can be detected, and which is not overcome by correction of the refractive error.
10 The problem with the definition description is the no structural causes is depended on the depth of the clinical investigation. Another problem is that many cases of amblyopia are cured simply by wearing spectacles, though over a period of time. This is why recent studies have changed the clause to a visual loss resulting from an impediment or disturbance to the normal development of vision, and not directly correctable with glasses
11 Amblyopia develops in infants and very young children, beginning only during the first 6 years old. The most critical period for loss of binocularity and for the development of functional amblyopia is the first 18 months of life ( Levi 1994). Once established, it can persist for life. If treat early, its effects are completely or nearly reversible. Different visual functions have different sensitive periods: the sensitive periods for cortical visual functions are longer than for retinal functions.
12 The visual acuity of amblyopia ranges from slightly less than normal ( 20/25) to functional blind ( less than 20/200). Light perception is always maintained. There are many criterions to define amblyopia acuity. Amblyopia represents a syndrome of deficits, not just decrease of visual acuity. The depressing are including other ocular functions such as ocular motility, accommodation, contrast sensitivity, and spatial judgment.
13 The low spatial contrast sensitivity is close to normal but there is a marked loss at high spatial frequency. This loss increases with the severity of the amblyopia and does not result from optical factors, unsteady fixational eye movements or eccentric fixation( Flynn 1991). Intermediate spatial frequency is less affected than high contrast VA ( Moseley et al 2006).
14 New definition of amblyopia Unilateral ( or infrequently bilateral) condition in which the best corrected visual acuity is poorer than 20/20 in the absence of any obvious structural or pathologic anomalies but with one or more of the following conditions occurring before the age of 6 years
15 Continue 1. Amblyogenic anisometropia 2. Constant uniteral esotropia or exotropia 3. Amblyogenic bilateral isometropia 4. Amblyogenic unilateral or bilateral astigmatism 5. Image degradation
16 Prevalence of amblyopia Amblyopia is common, but it s prevalence has been difficult to assess due to: Differences in criteria Various populations Type of visual acuity test Omission of successfully treated or prevented amblyopia Incomplete examination
17 Preschool and school age children 1% to 4.8% Ophthalmic patients seeking eye care 1.7% to 5.6% Military personnel 1% to 4%
18 Incidence of amblyopia A higher incidence has been associated with prematurity, low birth weight, retinopathy of prematurity, cerebral palsy, and metal retardation. Maternal smoking and use of drugs or alcohol during pregnancy are also in high risk. Data in various sub-populations is generally not available. No difference between males and females. The relative importance of environment and genetic factors in the development of amblyopia is also unclear.
19 Etiology The sensory obstacles in the early life Retinal image degradation Cataract, lid closure, high uncorrected refractive errors Binocular mis-registration Strabismus The factors are sufficient but not necessary to produce amblyopia
20 The role of visual experience in the development of visual function Disruption of binocular input completely disrupts the pattern of cortical excitatory binocular interaction Monocular deprivation has a dramatic effect on the anatomy, physiology, and function of the striate cortex
21 The physiologic consequences of deprivation are more or less confined to the striate cortex The effects of abnormal visual experience occur only during a sensitive period early in life The physiologic consequences of deprivation can be reversed during a critical period early in life
22 Classification All amblyopia was consider either organic, or functional amblyopia. Some contend that amblyopia should be limited to functional etiologies. Organic can not truly be amblyopia because of its structural defects or the impairment of visual pathway, so that medical treatment can be considered.
23 Organic amblyopia Organic amblyopia occurs when the components of visual pathway fail to develop because of any subtle retinal or central nervous system lesion,or undetectable lesion because of metabolic or toxic disturbance. Organic amblyopia includes nutritional, toxic, retinal eye disease, and idiopathic or congenital amblopia.
24 Functional amblyopia Reduced vision was due to physical obstacles such as corneal and lens opacities, as well as strabismus due to suppression of the retinal image in the deviated eye strabismic amblyopia anisometropic amblyopia isoametropic amblyopia image degradation amblyopia Psychogenic amblyopia
25 Psychogenic amblyopia The visual loss is of emotional or psychologic rather than physiologic origin. The amblyopia is characterized by reducing visual acuity for anxiety or emotional repression. The symptoms are not under voluntary control. The diagnosis is made by exclusion of organic pathology and sensory problems. Unilateral visual loss is very rare. Direct to others questions, nearly always reveals additional symptoms such as headache, periorbital pain, photophobia, and sometimes diplopia.
26 Strabismic amblyopia Strabismic amblyopia is associated with an early-onset ( before age 7 years or so), constant, unilateral deviation at distance and at near. The cause is an active cortical inhibition from the fovea of the deviated eye. ( diplopia and confusion)
27 When mention about strabismic amblyopia, primary esotropia and not exotropia typically is associated with amblyopia. Under most condition, exotropia presents as an intermittent and/or alternating deviation rather than a constant unilateral deviation
28
29
30 If a patient presents with an exotropia and reduced unilateral VA in the absence of anisometropia or a history of retinal image degradation, the clinician should suspect organic amblyopia. Remember, there may be a functional amblyopia superimposed over the organic amblyopia, with the cause of the functional amblyopia being the secondary exotropia.
31 Anisometropic amblyopia Anisometropia is frequently considered to be the most common cause of amblyopia. This has been found to occur twice as frequently as strabismic amblyopia. (Unfortunately, fixation status was not tested. Therefore, microtropia with anisometropia would be classified as anisometropic amblyopia ) Flynn and Cassady (1978) analyzed 544 amblyopes, 48% were strabismic, 32% were strabismic and anisometropic, and 20% were purely anisometropic.
32
33 A population based study ( Attebo et al 1998) found that the relative prevalence of different types of amblyopia is anisometropic 50%, strabismic 19%, mixed strabismic and anisometropic 27%, and visual deprivation 4%. Amblyopia is more likely to be present in the left eye, and this asymmetry is exaggerated for anisometropia ( Woodruff et al 1994)
34 Coexist of strabismic and anisometropic amblyopia Although anisometropia was defined as a 1- diopter or greater difference between eyes. However, significant amblyogenic anisometrpia is different for myopia and hyperopia. For example: OD plano 20/20 OS sph. 20/100 with left esotropia This patient should be categorized under strabismic amblyopia, since the myopic anisometropia is probably not a significant amblyogenic factor.
35 There exists a controversy as to how one categorizes a patient having both significant anisometropia and unilateral constant strabismus, example: Patients with greater than 5 diopters of anisometropia, over two-thirds had amblyopia, a quarter of whom also had strabismus Patients with less than 2 diopters of anisometropia, about 20 % had amblyopia and only 1 % had a strabismus
36 There is some evidence that emmetropization depends on normal visual experience. In amblyopia, it was found that the refractive error developed at a different rate in the amblyopic eye than in the dominant eye, with the dominant eyes becoming more myopic while the amblyopic eyes stayed the same or became more hyperopic.(nastri et al 1984)
37 Incidence and depth of amblyopia may be dependent on the degree and type of anisometropic refractive error The incidence of amblyopia was lower in myopic than in hyperopia Myopic anisometropia occurs more frequently in the general population than does hyperopic anisometropia
38
39 Strabismic amblyopia v.s. anisometropic amblyopia The pupillary function of the eye with strabismic amblyopia is subtly different from that of eyes with anisometropic amblyopia. In anisometropic amblyopia, there is either a difference in retinal image clarity ( and contrast) or a difference in retinal image size. In strabismic amblyopia, there is a form dissimilarity of retinal images. Therefore, the suppression mechanism may be very different.
40 Anisometropic amblyopia reduces sensitivity centrally and peripherally, whereas, strabismic amblyopia losses acuity is predominantly restricted to the foveal region.
41 Isometropic Amblyopia Secondary to a significant bilateral refractive error Even when properly corrected, does not immediately result in normal vision Visual acuity usually improves once the corrective lenses have been worn for a period of time A relatively mild vision loss that is amenable to vision therapy
42 Strabismus secondary to the amblyopia is much less likely to occur Esotropia is more likely to occur in lower amounts of bilateral hyperopia and unilateral amblyopia secondary to an accommodative esotropia Strabismus will result if the AC/A ratio is high, the fusional system cannot handle the excessive vergence demand
43 Clinically, isometropic amblyopes typically exhibit VA in the range of 20/30 to 20/70 in each eye when first corrected If VA is not normalized once the proper corrective lenses are worn for a period of time, then VT is indicated
44 Myopes and astigmats show their best acuities through full correction, whereas hyperopes show better acuities when slightly undercorrected For hyperopes, a large exophoric or tropic deviation may become manifest as the full correction is gradually accepted
45 Isometropic amblyopia is generally detected and treated earlier than anisometropic amblyopia The prevalence of isometropic amblyopia is decreasing in countries where early vision care is emphasized
46 The meridional amblyopia does not develop during the first year of life, despite the high incidence of significant astigmatism during the first year of life May have dissimilar critical period timetables
47 It is difficult to determine precisely the prevalence of isometropic amblyopia It appears to be about 0.03% The effects of bilateral loss of clear form vision are not as damaging as asymmetrical visual inputs The depth of isometropic amblyopia and its resistance to therapy is less High degrees of myopia are frequently associated with retinal thinning and macular pigment abnormalities
48 Image degradation Secondary to the obstruction of sight that prevents the formation of a well focused, high contrast image on the retina Either one or both eyes take place before the 7 year of life for amblyopia to develop Time of onset The extent of the degradation Cataract, corneal opacities, congenital ptosis, and early total occlusion
49 Treatment Early surgery Before 8 weeks of age Total bilateral occlusion between operations on the fellow eye 48 hours or less Early correction of aphakia with extended wear contact lenses Within one week of surgery
50 The importance of early treatment and optical correction The effect of deprivation begins at about 4 months of age, increases rapidly up to 8 months, and the declines gradually over the first decade of life
51 Congenital cataract are often associated with organic ocular diseases: Microphthalmia, coloboma, and optic atriphy The vision is bad Rule out the possibility of functional amblyopia The concept of occlusion amblyopia in human infants is well established Even short periods( less than 1 week) of direct occlusion can result in dramatic changes in monocular acuity and a tradeoff between the two eyes
52 Clinical diagnosis and prognosis of The clinician s task: amblyopia Determine the etiology of the amblyopia Rule out any organic contributions to the VA loss Determine the prognosis and probability for success Organize a comprehensive monocular and binocular treatment strategy
53
54 History taking When did the amblyogenic anomaly begin? The later the onset, the better is the prognosis Parents are more likely to recall strabismus rather than anisometropia The anisometropia amblyope is typically first detected during a vision screen If the vision anomaly occurred after age 4 years, the prognosis is excellent Obtaining the results of the earliest vision examination
55 When was treatment initiated? If the uncorrected anomaly has existed for less than 1 year, the prognosis for success is much better There is no drastic difference in prognosis once the non-treated amblyogenic anomaly has existed for greater than 5 years
56 What did the treatment consist of and how successful was it? An amblyope left without either stereopsis or alternation of fixation after treatment is to demonstrate some regression in visual function, especially VA
57 What was the extent of compliance? Need to fully complied and monitored Any history of trauma? Is there a family history? Any diplopia? If yes, suggests recent onset or not very severe Is patient or parent motivated? Without motivation, there will be little or no success
58
59 Visual acuity Contour interaction(crowding phenomenon) Contour interaction does not begin at greater than one letter diameter separation The effect is approximately equal at threshold visual acuity levels for both normal and amblyopic eyes
60 The amblyopic eye resolve a few letters per line with no clear cutoff point to define threshold ( a sigmoid, or S-shaped, curve of acuity value) It is similar either use snellen chart or a visual acuity chart with contour interaction control The normal eye will generate a curve with a steep slop, demonstrate a sharp drop-off VA
61
62 Snellen chart versus S-chart The inter-letter separations Control for contour interaction The VA levels have large gap at the low end Letters with different degrees of difficulty Frequent re-testing of the VA can result in contamination by memorization
63 Flom s visual acuity test slide
64
65 Flom designed a VA test specially for the evaluation of amblyopic eyes Consists of a series of 21 slides Range of VA values from 20/277 to 20/9 Each slide contains a series of eight Landolt C The interletter spacing is equal to the letter diameter, and is surrounded by an equal number of contours The determination of VA use psychometric analysis The number of correct responses is plotted against letter size
66
67 A modification of the S-chart Increases contour interaction by reducing interletter spacing to half of the letter size This chart is easier and less confusing to use with children
68
69 Telescopic acuity Differential diagnosis between organic and functional amblyopia Any improvement in acuity through a telescope indicates a functional amblyopia That telescopic acuity greater than predicted by the magnification of the telescope indicates a functional amblyopia with good prognosis The pretherapy acuity through the telescope is the predicted acuity following successful therapy
70 Neutral density filter Preadapt the good eye for 5 minutes with the polarized filters Expose an S-chart of 20/42. Slowly rotate the polarizers until the patient can just begin to resolve at least five of the eight LandoltC Similarly preadapt the amblyopic eye for 5 minutes, and then quickly introduce the filter that allow the good eye to resolve Measure VA of the amblyopic eye through the filter, and compare this without the filter VA If VA is reduced considerably more in the amblyopic eye than in the good eye, then organic amblyopia should be suspected
71 Other abnormal aspects of Accommodation Reduced amplitude amblyopic eye Reduce threshold and contrast sensitivity, target fading Accommodative stimulus response Eccentric fixation Increased depth of focus Increased variability of accommodative response Abnormal fixational eye movements, increase drift and jerk nystagmus
72 Other abnormal aspects of amblyopic eye Eccentric fixation Binocularity Motor Cover test at distance and near Sensory Stereopsis, anomalous retinal correspondence
73 Visual acuity, fixation, and direction MAR = E + 1 sense MAR is minimum angular resolution E is eccentricity In 1961, Flom and Weymouth studied the eccentricity of Maxwell s spot in both normal and amblyopic eyes Monocular VA in the amblyopic eye at the point of eccentric fixation was the same as that found in the normal eye at the same eccentricity
74
75 Treatment Early detection Correction of any significant refractive error Constant Occlusion Additional active training The effects of occlusion can be enhanced or facilitated by addition of active training
76 Home and office therapy Weekly office session of approximately 45 minutes Daily home therapy lasting from 20 minutes to 2 hours The amblyopic visual system responds best to short regular periods of intense therapy
77 Patching Anywhere from ½ to 6 hours daily Most of the patching done at home Cosmetic is not a major factor
78
79 Length of treatment Last from 4 to 6 months Afterward, daily treatment duration will be gradually reduced To prevent regression of vision function Take another 2 months or so
80 Progress evaluation Perform every 8 weeks during the therapy course The goal of amblyopia treatment is to improve vision and sensorimotor function ( eye-hand coordination, focusing, navigation ability, etc.) Monitor improvement in vision function Determine when treatment should be discontinued
81 Motivation The single most important factor contributing toward a successful case Explain to the patient and encourage the patient by setting up situation that will allow the patient to be aware of progress Show the progress of evaluation to patient, have them become actively involved in the therapy process May experience headaches, eyestrain, fatigue, or diplopia during treatment
82
83 Training sequences Accommodation Stimulus, monocular to bi-ocular accommodation Eye movements Hart-chart saccades, eye-hand coordination Form recognition Recognize the simple and complex forms with either being hidden, or slightly different from a similar comparison form
84
85
86
87 Strabismus Strabismus most often develops within the first 6 ~ 7 years of life. Approximately 7% of children aged 6~7 years had strabismus. Strabismus affected approximately 1% of infants ( < 12 months).
88 Risk factors for strabismus Maternal cigarette smoking Neurologic disorders Use of other drugs during pregnancy Heredity Refractive errors Low birth weight( prematurity) Anatomic factors( craniofacial anomalies)
89 Classification of Heterotropia Squint or Strabismus In term of the direction and magnitude of the deviation, heterotropia is classified as either comitant or incomitant. More information are also required to have more detailed classification regarding its frequency, laterality, age of onset, influence of accommodation and cosmesis.
90 Comitant and Incomitant heterotropia The angle of deviation is constant in all direction of gaze called comitant strabismus The incomitant deviation is varies with direction of gaze. The deviation is largest when the eyes are turned in the direction of maximum action of the affected muscle. The term paralysis is used if the action of one or a group of extra-ocular muscles is completely abolished. If the action of muscle is impaired the term paresis is used.
91 Frequency Constant or intermittent Laterality Unilateral or alternating Location Patient may have a phoria at distance and have a tropia at near.
92 Direction Depend on the visual axes deviate from alignment. The tropia is noted by the non-fixating eye. Esotropia, Exotropia, Hypertropia, Hypotropia Deviation of the upper pole of the cornea result in Excyclotropia ( outward) or Incyclotropia ( inward)
93 Age of onset Congenital is the deviation that are present at birth or develop during the first few months of life. Acquired is arisen during childhood or later in life. Presence of nystagmus Should be described in terms of congenital, latent or acquired and whether pendular or jerky.
94 Refractive errors in children The management of refractive errors is of the utmost importance in children with strabismus. Hyperopia was more common in esotropia at the time of diagnosis. A few exopropic children were myopic. The strabismic eye had a greater chance of becoming anisometropic in esotropia.
95 In every child with strabismus, VA should be measured as early as possible to detect amblyopia. The vision in one eye is compared with the fellow eye. VA of 20/200 or less should raise the suspicion of anisometropic amblyopia or other ocular disease.
96 Differential diagnosis Not all monocular vision loss with a strabismic patient is secondary to amblyopia. Only after an extensive examination has been performed otherwise. Careful refraction must be performed and any refractive error corrected before it is assumed. Mild congenital optic nerve pathology as well as small lens opacities can be overlooked. The amblyopic patient has normal color vision, in contrast to the patient with optic neuropathy. Marcus Gunn pupil is rare in strabismic amblyopia
97
98 When to treat comitant strabismus There are three good reasons for treating: If they are causing problems If they are likely to deteriorate if left untreated If treatment may be required but less effective when the patient is older.
99
100
101 ( see to learn) ( learn to see)
102
103 (3~5 ) ( )
104 At what ages should children be examined All children should be seen at before the end of the first year of life. If there is a family history of strabismus, amblyopia, high refractive error, or early vision loss, the infant should be examined by 6 months of age. If the parents observe any unusual appearance of the child s eyes or visual behavior, they should be evaluated as soon as possible.
105 The child should routinely be seen again between the ages of 2.5 ~ 3.5 years, just before kindergarten, and then yearly through elementary school. This is to ensure early detection of major visual anomalies that might affect the child s general performance.
106 Practice Management Many clinical examination techniques on the young children are quite the same with older children and adults. These may require only few modification of instruction and targets to be effective with young children.
107 Environment Comfort and welcome designed office or reception area reduce the fear and anxiety Select the optimal appointment time Removing the doctor s white coat
108 Observation Hyperactive vs. shy or cautious child Communication with parents Convey clear expression and clearly outline the parent s involvement. The parents will follow the optometrist s lead and will interact with the child at the level of permitted.
109 The Problem Oriented Record The data base A problem solving approach requires the optometrist to think in terms of ensuring the major visual system or function. The data base can be subdivided into the diagnostic areas as following:
110 Examination strategy Case history Refractive status Visual acuity status Binocular status Motor Sensory Accommodative status Ocular health status Developmental perceptual motor status
111 Problem list From the results of data base evaluation the optometrist construct a problem list, which provides an overview of the patient s problems and eliminates the extensive file review prior to future visits.
112 Initial plan This serves as the basis for the plan list, consisting of the therapy and education recommendations. Progress note Used to follow up on the initial management plans and is outlined in SOAP notation
113 S ( subjective): information about course of signs and symptoms, compliance with the management plan, and new concerns. O ( objective): examination findings. A (assessment): the doctor s interpretation P (plan): any modification of the initial plan
114 Primary reason for eye examination Routine check-up Family Hx of visual problems Failed vision screening Referred by GP or teacher Signs noticed by parents Symptoms reported by child Further opinion sought
115 History
116 5~6
117
118
119
120 Visual Acuity There are several tests available for children. Response to occluding Forced-choice preferential looking ( FPL) is suitable for toddlers from 12 months of age up to 3.5 years old, and for older children with either poor communication skills or delayed development
121
122 Children of three years to five years old The Kay picture test Recognition test, pictures of familiar objects are presented to the child
123 The Sheridan-Gardiner test Seven Snellen letters are used in this matching test
124 4~5
125 phoropter
126 Cycloplegia Cycloplegia cycloplegia
127 Near fixation retinoscopy The Mohindra technique Mohindra (1975) 50 trial lens or lens racks -1.25D
128 Mohindra technique subjective refraction cycloplegic refraction 18 ~ 48
129 Dynamic retinoscopy Dynamic retinoscopy low neutral point high neutral point NRA
130 static retinoscopy, other objective refractive and subjective refractive findings 0.50D
131 Subjective refraction
132
133
附件1:
附 件 1: 全 国 优 秀 教 育 硕 士 专 业 学 位 论 文 推 荐 表 单 位 名 称 : 西 南 大 学 论 文 题 目 填 表 日 期 :2014 年 4 月 30 日 数 学 小 组 合 作 学 习 的 课 堂 管 理 攻 硕 期 间 及 获 得 硕 士 学 位 后 一 年 内 获 得 与 硕 士 学 位 论 文 有 关 的 成 果 作 者 姓 名 论 文 答 辩 日 期 学 科 专
More information1 * 1 *
1 * 1 * taka@unii.ac.jp 1992, p. 233 2013, p. 78 2. 1. 2014 1992, p. 233 1995, p. 134 2. 2. 3. 1. 2014 2011, 118 3. 2. Psathas 1995, p. 12 seen but unnoticed B B Psathas 1995, p. 23 2004 2006 2004 4 ah
More information東吳大學
律 律 論 論 療 行 The Study on Medical Practice and Coercion 林 年 律 律 論 論 療 行 The Study on Medical Practice and Coercion 林 年 i 讀 臨 療 留 館 讀 臨 律 六 礪 讀 不 冷 療 臨 年 裡 歷 練 禮 更 老 林 了 更 臨 不 吝 麗 老 劉 老 論 諸 見 了 年 金 歷 了 年
More information度 身 體 活 動 量 ; 芬 蘭 幼 兒 呈 現 中 度 身 體 活 動 量 之 比 例 高 於 臺 灣 幼 兒 (5) 幼 兒 在 投 入 度 方 面 亦 達 顯 著 差 異 (χ²=185.35, p <.001), 芬 蘭 與 臺 灣 幼 兒 多 半 表 現 出 中 度 投 入 與 高 度
臺 灣 與 芬 蘭 幼 兒 園 室 內 自 由 遊 戲 內 涵 之 探 討 林 昭 溶 毛 萬 儀 經 國 管 理 暨 健 康 學 院 幼 兒 保 育 系 副 教 授 joyce@ems.cku.edu.tw 吳 敏 而 國 家 教 育 研 究 院 研 究 員 rozwu@mail.naer.edu.tw wanyi@ems.cku.edu.tw 摘 要 自 由 遊 戲 被 視 為 是 幼 兒 的
More informationAbstract The purpose of this study is to analyze mother s meta-emotion philosophy and children s emotional adjustment in order to understand the actual interaction between mother s meta-emotion philosophy
More information第一章 緒論
(informed consent) 6 . (Informed 23 Consent) 24 (Informed Consent) informed consent 1. 2. 7 3. 4. 5. 6.. 26 1. 8 2. 3. 4. 5. 6.. Braddock 1993 59 65 1057 (discussion of the patient s role in decision making)
More informationhks298cover&back
2957 6364 2377 3300 2302 1087 www.scout.org.hk scoutcraft@scout.org.hk 2675 0011 5,500 Service and Scouting Recently, I had an opportunity to learn more about current state of service in Hong Kong
More informationMicrosoft PowerPoint - ryz_030708_pwo.ppt
Long Term Recovery of Seven PWO Crystals Ren-yuan Zhu California Institute of Technology CMS ECAL Week, CERN Introduction 20 endcap and 5 barrel PWO crystals went through (1) thermal annealing at 200 o
More information國家圖書館典藏電子全文
i ii Abstract The most important task in human resource management is to encourage and help employees to develop their potential so that they can fully contribute to the organization s goals. The main
More information鼠 疫(Plague)
鼠 疫 (Plague) 一 疾 病 概 述 (Disease description) 存 在 囓 齒 類 及 其 跳 蚤 的 一 種 人 畜 共 通 傳 染 病, 並 藉 跳 蚤 傳 染 給 各 種 動 物 及 人 類, 其 最 初 反 應 為 跳 蚤 咬 傷 部 位 臨 近 的 淋 巴 腺 發 炎, 這 就 是 腺 鼠 疫, 經 常 發 生 於 鼠 蹊 部, 少 發 生 於 腋 下 或 頸 部,
More information國 史 館 館 刊 第 23 期 Chiang Ching-kuo s Educational Innovation in Southern Jiangxi and Its Effects (1941-1943) Abstract Wen-yuan Chu * Chiang Ching-kuo wa
國 史 館 館 刊 第 二 十 三 期 (2010 年 3 月 ) 119-164 國 史 館 1941-1943 朱 文 原 摘 要 1 關 鍵 詞 : 蔣 經 國 贛 南 學 校 教 育 社 會 教 育 掃 盲 運 動 -119- 國 史 館 館 刊 第 23 期 Chiang Ching-kuo s Educational Innovation in Southern Jiangxi and
More informationMicrosoft PowerPoint _代工實例-1
4302 動態光散射儀 (Dynamic Light Scattering) 代工實例與結果解析 生醫暨非破壞性分析團隊 2016.10 updated Which Size to Measure? Diameter Many techniques make the useful and convenient assumption that every particle is a sphere. The
More information東莞工商總會劉百樂中學
/2015/ 頁 (2015 年 版 ) 目 錄 : 中 文 1 English Language 2-3 數 學 4-5 通 識 教 育 6 物 理 7 化 學 8 生 物 9 組 合 科 學 ( 化 學 ) 10 組 合 科 學 ( 生 物 ) 11 企 業 會 計 及 財 務 概 論 12 中 國 歷 史 13 歷 史 14 地 理 15 經 濟 16 資 訊 及 通 訊 科 技 17 視 覺
More informationby mild (22.7%). Inhaled corticosteroids, systemic corticosteroids, and antibiotics were applied to 94.8% (292 cases), 74.7% (230 cases), and 90.9% (2
论 著 临 床 研 究 doi: 0.7499/j.issn.008-8830.204.2.007 郑 州 市 城 区 儿 童 哮 喘 的 流 行 病 学 调 查 及 发 病 相 关 因 素 分 析 赵 坤 宋 桂 华 古 华 倩 2 刘 爽 3 张 岩 郭 彦 荣 (. 河 南 中 医 学 院 第 一 附 属 医 院 儿 科 医 院, 河 南 郑 州 450000; 2. 杭 州 市 余 杭 区
More information10389144 2006 5 30 2006 5 30
10389144 10389144 2006 5 30 2006 5 30 ED ED IIEFEFOF SDISOS ED 10 2 2 1 10 4 1 1 4 4 IIEF SD EFOFISOS EF 2 1 1 4 1 ED ED Study on the effect of Sex Therapy for Erectile Dysfunction Patients ABSTRACT Objective
More information211 better than those in the control group, with significant difference between two groups (P < 0.05). The ocular hypertension of patients in the cont
210 毛 果 芸 香 碱 联 合 拉 坦 前 列 素 治 疗 原 发 性 急 性 闭 角 型 青 光 眼 的 疗 效 观 察 符 元 党 1, 郑 振 优 2, 林 再 雄 2, 周 吉 良 1. 昌 江 黎 族 自 治 县 中 西 医 结 合 医 院, 海 南 昌 江 572700 2. 海 南 医 学 院 附 属 医 院 眼 科, 海 南 海 口 570100 1 摘 要 : 目 的 探 讨
More information%
38 1 2014 1 Vol. 38No. 1 January 2014 51 Population Research 2010 2010 2010 65 100028 Changing Lineal Families with Three Generations An Analysis of the 2010 Census Data Wang Yuesheng Abstract In contemporary
More informationMicrosoft Word - TIP006SCH Uni-edit Writing Tip - Presentperfecttenseandpasttenseinyourintroduction readytopublish
我 难 度 : 高 级 对 们 现 不 在 知 仍 道 有 听 影 过 响 多 少 那 次 么 : 研 英 究 过 文 论 去 写 文 时 作 的 表 技 引 示 巧 言 事 : 部 情 引 分 发 言 该 生 使 在 中 用 过 去, 而 现 在 完 成 时 仅 表 示 事 情 发 生 在 过 去, 并 的 哪 现 种 在 时 完 态 成 呢 时? 和 难 过 道 去 不 时 相 关? 是 所 有
More informationPowerPoint Presentation
Decision analysis 量化決策分析方法專論 2011/5/26 1 Problem formulation- states of nature In the decision analysis, decision alternatives are referred to as chance events. The possible outcomes for a chance event
More information01 招 生 简 章 03 考 试 说 明 04 笔 试 样 题 2 emba.pbcsf.tsinghua.edu.cn
01 招 生 简 章 03 考 试 说 明 04 笔 试 样 题 2 emba.pbcsf.tsinghua.edu.cn 清 华 五 道 口 金 融 EMBA 招 生 简 章 金 融 EMBA 教 育 中 心 2012 年, 为 加 快 现 代 金 融 学 科 建 设, 培 养 高 端 金 融 人 才, 促 进 金 融 界 与 金 融 教 育 界 的 联 系, 提 高 金 融 研 究 水 平, 推
More information2015年4月11日雅思阅读预测机经(新东方版)
剑 桥 雅 思 10 第 一 时 间 解 析 阅 读 部 分 1 剑 桥 雅 思 10 整 体 内 容 统 计 2 剑 桥 雅 思 10 话 题 类 型 从 以 上 统 计 可 以 看 出, 雅 思 阅 读 的 考 试 话 题 一 直 广 泛 多 样 而 题 型 则 稳 中 有 变 以 剑 桥 10 的 test 4 为 例 出 现 的 三 篇 文 章 分 别 是 自 然 类, 心 理 研 究 类,
More information我国原奶及乳制品安全生产和质量安全管理研究
密 级 论 文 编 号 中 国 农 业 科 学 院 硕 士 学 位 论 文 我 国 原 奶 及 乳 制 品 质 量 安 全 管 理 研 究 Study on Quality and Safety Management of Raw Milk and Dairy Products in China 申 请 人 : 段 成 立 指 导 教 师 : 叶 志 华 研 究 员 张 蕙 杰 研 究 员 申 请
More informationMicrosoft Word - 第四組心得.doc
徐 婉 真 這 四 天 的 綠 島 人 權 體 驗 營 令 我 印 象 深 刻, 尤 其 第 三 天 晚 上 吳 豪 人 教 授 的 那 堂 課, 他 讓 我 聽 到 不 同 於 以 往 的 正 義 之 聲 轉 型 正 義, 透 過 他 幽 默 熱 情 的 語 調 激 起 了 我 對 政 治 的 興 趣, 願 意 在 未 來 多 關 心 社 會 多 了 解 政 治 第 一 天 抵 達 綠 島 不 久,
More informationAbstract Due to the improving of living standards, people gradually seek lighting quality from capacityto quality. And color temperature is the important subject of it. According to the research from aboard,
More information2005 5,,,,,,,,,,,,,,,,, , , 2174, 7014 %, % 4, 1961, ,30, 30,, 4,1976,627,,,,, 3 (1993,12 ),, 2
3,,,,,, 1872,,,, 3 2004 ( 04BZS030),, 1 2005 5,,,,,,,,,,,,,,,,, 1928 716,1935 6 2682 1928 2 1935 6 1966, 2174, 7014 %, 94137 % 4, 1961, 59 1929,30, 30,, 4,1976,627,,,,, 3 (1993,12 ),, 2 , :,,,, :,,,,,,
More information南華大學數位論文
南 華 大 學 教 育 社 會 學 研 究 所 碩 士 論 文 高 職 智 能 障 礙 學 生 性 教 育 課 程 之 行 動 研 究 Action research of sex education for students with intellectual disability in a vocational school 研 究 生 : 蘇 淑 惠 指 導 教 授 : 林 昱 瑄 博 士 中
More information天 主 教 輔 仁 大 學 社 會 學 系 學 士 論 文 小 別 勝 新 婚? 久 別 要 離 婚? 影 響 遠 距 家 庭 婚 姻 感 情 因 素 之 探 討 Separate marital relations are getting better or getting worse? -Exp
天 主 教 輔 仁 大 學 社 會 學 系 學 士 論 文 小 別 勝 新 婚? 久 別 要 離 婚? 影 響 遠 距 家 庭 婚 姻 感 情 因 素 之 探 討 Separate marital relations are getting better or getting worse? -Explore the impact of emotional factors couples do not
More informationMicrosoft PowerPoint - ATF2015.ppt [相容模式]
Improving the Video Totalized Method of Stopwatch Calibration Samuel C.K. Ko, Aaron Y.K. Yan and Henry C.K. Ma The Government of Hong Kong Special Administrative Region (SCL) 31 Oct 2015 1 Contents Introduction
More informationVocabulary Development in Armenian Children Attending Armenian-English Bilingual Preschools
Vocabulary Development in Armenian Children Attending Armenian-English Bilingual Preschools Alice Hovsepian, Ph.D. Candidate Carla J. Johnson, Ph.D. Department of Speech-Language Pathology University of
More information124 第十三期 Conflicts in the Takeover of the Land in Taiwan after the Sino-Japanese War A Case in the Change of the Japanese Names of the Taiwanese Peopl
123 戰後初期臺灣土地接收的糾紛 以更改日式姓名的臺人遭遇為例 124 第十三期 Conflicts in the Takeover of the Land in Taiwan after the Sino-Japanese War A Case in the Change of the Japanese Names of the Taiwanese People Abstract By Ho Fung-jiao
More information大 綱 癌 痛 發 生 率 病 因 評 估 癌 痛 及 分 級 癌 症 治 療 常 見 副 作 用 與 癌 痛 處 理 策 略 中 醫 護 理 面 對 癌 痛 可 發 揮 之 作 用 與 醫 倫 問 題 中 醫 療 法 病 案 2009/10/15 2
中 醫 診 療 與 癌 痛 三 軍 總 醫 院 中 醫 部 蔡 運 寧 醫 師 2008 年 7 月 31 日 大 綱 癌 痛 發 生 率 病 因 評 估 癌 痛 及 分 級 癌 症 治 療 常 見 副 作 用 與 癌 痛 處 理 策 略 中 醫 護 理 面 對 癌 痛 可 發 揮 之 作 用 與 醫 倫 問 題 中 醫 療 法 病 案 2009/10/15 2 Incidence Affects
More informationMicrosoft Word - ??????-2.doc
伃 University of South California University of North Texas 99.12.07~99.12.04 100.02.16 2 2 3 4 6...6...9..11..13 -..14 3 4 5 - (USC University Hospital) Norris (USC Norris Cancer Hospital) 1991 PMV (Passy
More information: 23 S00017242 1 -----------------------------------------------------------------------------1 -----------------------------------------------------------------------------3 -------------------------------------------------------------------7
More informationMicrosoft PowerPoint - STU_EC_Ch08.ppt
樹德科技大學資訊工程系 Chapter 8: Counters Shi-Huang Chen Fall 2010 1 Outline Asynchronous Counter Operation Synchronous Counter Operation Up/Down Synchronous Counters Design of Synchronous Counters Cascaded Counters
More information國立中山大學學位論文典藏
I II III IV The theories of leadership seldom explain the difference of male leaders and female leaders. Instead of the assumption that the leaders leading traits and leading styles of two sexes are the
More informationOA-253_H1~H4_OL.ai
WARNINGS Note: Read ALL the following BEFORE using this product. Follow all Guidelines at all times while using this product. CAUTION This warning indicates possibility of personal injury and material
More information病因及其推断
(Causes of Disease) ( ) ( ) ( ) 19 19 (Koch ) ) Koch Postulates Robert Koch established the relationship between the tubercule bacillus and tuberculosis. Developed the following three postulates The pathogen
More information广 州 市 花 都 区 公 务 员 培 训 需 求 分 析 的 研 究 A STUDY OF TRAINING NEEDS ANALYSIS ON CIVIL SERVANTS OF HUADU DISTRICT IN GUANGZHOU 作 者 姓 名 : 黄 宁 宁 领 域 ( 方 向 ): 公
广 州 市 花 都 区 公 务 员 培 训 需 求 分 析 的 研 究 分 类 号 :C93 单 位 代 码 :10183 研 究 生 学 号 :201223A022 密 级 : 公 开 研 吉 林 大 学 硕 士 学 位 论 文 ( 专 业 学 位 ) 黄 宁 宁 广 州 市 花 都 区 公 务 员 培 训 需 求 分 析 的 研 究 A STUDY OF TRAINING NEEDS ANALYSIS
More information<4D F736F F D20342DBA63ADB5BBD9C3AAA8E0B5A3B1B5A8FCA743B14BB6B0A9CABB79A8A5AA76C0F8A4A7B5B2AA475FA4FDB7D4A86B5F5F32372D33345F2E646F63>
27 原 著 構 音 障 礙 兒 童 接 受 低 密 集 性 語 言 治 療 之 結 果 王 煜 男 鄭 美 麗 李 雅 雯 張 筱 君 秀 傳 醫 療 社 團 法 人 秀 傳 紀 念 醫 院 復 健 科 構 音 障 礙 (articulation disorder) 是 發 展 中 兒 童 常 見 的 障 礙 之 一, 學 齡 前 及 學 齡 兒 童 約 10% 有 構 音 障 礙 的 問 題 本
More informationD A
2015 4 D822.333 A 0452 8832 2015 4 0014-12 14 The Second ASEAN Regional Forum: The ASEAN Regional Forum, A Concept Paper, in ASEAN Regional Forum Documents Series 1994-2006, ASEAN Secretariat, Jakarta,
More informationBC04 Module_antenna__ doc
http://www.infobluetooth.com TEL:+86-23-68798999 Fax: +86-23-68889515 Page 1 of 10 http://www.infobluetooth.com TEL:+86-23-68798999 Fax: +86-23-68889515 Page 2 of 10 http://www.infobluetooth.com TEL:+86-23-68798999
More informationMicrosoft Word - 24217010311110028谢雯雯.doc
HUAZHONG AGRICULTURAL UNIVERSITY 硕 士 学 位 论 文 MASTER S DEGREE DISSERTATION 80 后 女 硕 士 生 择 偶 现 状 以 武 汉 市 七 所 高 校 为 例 POST-80S FEMALE POSTGRADUATE MATE SELECTION STATUS STUDY TAKE WUHAN SEVEN UNIVERSITIES
More informationThe Development of Color Constancy and Calibration System
The Development of Color Constancy and Calibration System The Development of Color Constancy and Calibration System LabVIEW CCD BMP ii Abstract The modern technologies develop more and more faster, and
More informationMicrosoft Word - D-2°w¶Ë¬ì¹ï¤U�Iµh®{¤âÀˬd¬yµ{_¬x°ö�×__P.329-335_.doc
針 傷 科 對 下 背 痛 徒 手 檢 查 流 程 329 針 傷 科 對 下 背 痛 徒 手 檢 查 流 程 洪 培 修 1 張 晉 賢 2 張 世 良 3 1 嘉 義 基 督 教 醫 院 中 醫 科 系 2 長 庚 紀 念 醫 院 中 醫 醫 院 基 隆 分 院 暨 長 庚 大 學 醫 學 院 3 中 國 醫 藥 大 學 中 醫 院 學 針 灸 研 究 所 摘 要 前 言 腰 痛 或 下 背 痛
More informationPneumonia - Traditional Chinese
Pneumonia When you have pneumonia, the air sacs in the lungs fill with infection or mucus. Pneumonia is caused by a bacteria, virus or chemical. It is not often passed from one person to another. Signs
More information: ( ),,
Case Discussion: ( ), RN, ScD, MPH : 24,,,,,,, ( ) ) ( ), : ( ),, randomized controlled trial (RCT). minimization program,,,, : : ; Apgar score > 7 ;, : ; ; ; ; (BT180/min; 2, 83,50 (60.2%).,
More informationMicrosoft PowerPoint - Relationships Among locus of Control, Psychology Status
Shu-Ming Marine Chen FooyingUniversityID: 65452 The Burden of Diabetes in Taiwan The prevalence of Type II diabetes is between 5-10%, and over 45 years old is higher at 11% (Department of Health, Taiwan,
More informationA VALIDATION STUDY OF THE ACHIEVEMENT TEST OF TEACHING CHINESE AS THE SECOND LANGUAGE by Chen Wei A Thesis Submitted to the Graduate School and Colleg
上 海 外 国 语 大 学 SHANGHAI INTERNATIONAL STUDIES UNIVERSITY 硕 士 学 位 论 文 MASTER DISSERTATION 学 院 国 际 文 化 交 流 学 院 专 业 汉 语 国 际 教 育 硕 士 题 目 届 别 2010 届 学 生 陈 炜 导 师 张 艳 莉 副 教 授 日 期 2010 年 4 月 A VALIDATION STUDY
More information國立中山大學學位論文典藏.PDF
I II III The Study of Factors to the Failure or Success of Applying to Holding International Sport Games Abstract For years, holding international sport games has been Taiwan s goal and we are on the way
More informationap15_chinese_interpersoanal_writing_ _response
2015 SCORING GUIDELINES Interpersonal Writing: 6 EXCELLENT excellence in 5 VERY GOOD Suggests excellence in 4 GOOD 3 ADEQUATE Suggests 2 WEAK Suggests lack of 1 VERY WEAK lack of 0 UNACCEPTABLE Contains
More informationMicrosoft PowerPoint - talk8.ppt
Adaptive Playout Scheduling Using Time-scale Modification Yi Liang, Nikolaus Färber Bernd Girod, Balaji Prabhakar Outline QoS concerns and tradeoffs Jitter adaptation as a playout scheduling scheme Packet
More information硕 士 专 业 学 位 论 文 论 文 题 目 无 锡 市 区 机 关 公 务 员 健 身 锻 炼 现 状 研 究 The Study on Physical Exercises of Civil Servants in Wuxi 研 究 生 姓 名 张 征 指 导 教 师 姓 名 陆 阿 明 教 授 专 业 名 称 研 究 方 向 论 文 提 交 日 期 体 育 教 育 训 练 学 体 育 健 身
More informationMicrosoft Word - 刘藤升答辩修改论文.doc
武 汉 体 育 学 院 硕 士 学 位 论 文 ( 全 日 制 硕 士 ) 社 会 需 求 视 角 下 武 汉 体 院 乒 乓 球 硕 士 研 究 生 就 业 状 况 研 究 研 究 生 : 刘 藤 升 导 师 : 滕 守 刚 副 教 授 专 业 : 体 育 教 育 训 练 学 研 究 方 向 : 乒 乓 球 教 学 训 练 理 论 与 方 法 2015 年 5 月 分 类 号 : G8 学 校 代
More information考試學刊第10期-內文.indd
misconception 101 Misconceptions and Test-Questions of Earth Science in Senior High School Chun-Ping Weng College Entrance Examination Center Abstract Earth Science is a subject highly related to everyday
More informationMaster CAM Abstract With the great progress on the transition of mankind's living type attitude and medical science, mankind's present average life span is all in the extension year by year, increasing
More information2005 4,,,,,,,,,,,,, (2001 ) ;() ( 1997 ) ; ( 1997 ) ; () (1996 ) ;,: ( 1995 ) ; (1995 ),,,, (J13) (J9) (J10), (J19) (J17) 58
,,,, 44 %,,,,,,,,,,,, 57 2005 4,,,,,,,,,,,,, (2001 ) ;() ( 1997 ) ; ( 1997 ) ; () (1996 ) ;,: ( 1995 ) ; (1995 ),,,, (J13) (J9) (J10), (J19) (J17) 58 ,,,,,,,,,,, 1945 11 5,, ( ) : ; 1945 11,,,,,:, 1987,802,
More informationuntitled
20 90 1998 2001 1 Abstract Under the environment of drastic competitive market, risk and uncertainty that the enterprise faces are greater and greater, the profit ability of enterprise assets rises and
More information南華大學數位論文
I II Abstract This study aims at understanding and analysing the general situation and predicament of current educational development in Savigi tribe and probing the roles played by the school, the family
More informationhas become a rarity. In other words, the water resources that supply the needs in Taiwan depend crucially on the reservoirs built at least more than t
臺 灣 水 利 第 64 卷 第 1 期 民 國 105 年 3 月 出 版 Taiwan Water Conservancy Vol. 64, No. 1, March 2016 論 台 灣 水 資 源 開 發 的 必 要 性 The Essentiality of Water Resource Development in Taiwan * 虞 國 興 GWO-HSING YU 淡 江 大 學
More information一段“蝶蝶”上休的生命教育故事
一 段 蝶 蝶 不 休 的 生 命 教 育 故 事 幼 兒 園 生 命 教 育 之 實 踐 歷 程 幼 兒 教 保 研 究 期 刊 2010 第 4 期 李 麗 娟 姚 維 芬 陳 宜 君 陳 萱 蔡 佩 其 劉 秋 燕 鄭 莉 君 四 季 藝 術 兒 童 教 育 機 構 教 研 中 心 四 季 藝 術 幼 稚 園 摘 要 本 研 究 以 做 中 學 之 蝴 蝶 飼 養 教 學 實 踐 活 動, 探
More information(baking powder) 1 ( ) ( ) 1 10g g (two level design, D-optimal) 32 1/2 fraction Two Level Fractional Factorial Design D-Optimal D
( ) 4 1 1 1 145 1 110 1 (baking powder) 1 ( ) ( ) 1 10g 1 1 2.5g 1 1 1 1 60 10 (two level design, D-optimal) 32 1/2 fraction Two Level Fractional Factorial Design D-Optimal Design 1. 60 120 2. 3. 40 10
More informationencourages children to develop rich emotions through close contact with surrounding nature. It also cultivates a foundation for children s balanced de
* ** *** **** The Instruction of a Sense of Seasons in the Field Environment through the Comparison of Kindergartens in Germany, Australia and Japan Kazuyuki YOKOIKimihiko SAITOKatsushi ONO Koichi EBIHARA
More information864 现 代 药 物 与 临 床 Drugs & Clinic 第 31 卷 第 6 期 2016 年 6 月 of apoptosis related factors, decrease the incidence of adverse reactions, which is of great
现 代 药 物 与 临 床 Drugs & Clinic 第 31 卷 第 6 期 2016 年 6 月 863 曲 妥 珠 单 抗 联 合 多 西 紫 杉 醇 治 疗 Her-2 阳 性 乳 腺 癌 的 临 床 研 究 * 周 永 安, 刘 训 碧 黄 石 市 中 心 医 院 ( 普 爱 院 区 ) 乳 腺 肿 瘤 外 科, 湖 北 黄 石 435000 摘 要 : 目 的 探 析 注 射 用 曲
More information03 年 8 月 Vol.5 No.8 支 气 管 哮 喘 ( 简 称 哮 喘 ) 是 儿 童 时 期 最 常 见 的 慢 性 呼 吸 道 疾 病 之 一 近 年 来, 随 着 人 类 文 明 的 发 展 社 会 化 进 程 的 加 快 经 济 水 平 的 提 高 和 科 技 的 进 步, 环 境
03 年 8 月 Vol.5 No.8 DOI:0.7499/j.issn.008-8830.03.08.003 论 著 临 床 研 究 成 都 地 区 0~4 岁 城 乡 儿 童 哮 喘 流 行 病 学 调 查 对 比 分 析 李 敏 张 琼 时 维 娟 李 兰 李 艳 庞 英 姚 兵 蒋 虹 (. 四 川 省 医 学 科 学 院 / 四 川 省 人 民 医 院 儿 科, 四 川 成 都 6007;.
More information國小三年級閱讀理解教學行動研究
國 小 中 年 級 弱 勢 低 成 就 學 童 閱 讀 理 解 補 救 教 學 行 動 歷 程 之 個 案 研 究 國 小 中 年 級 弱 勢 低 成 就 學 童 閱 讀 理 解 補 救 教 學 行 動 歷 程 之 個 案 研 究 林 素 秋 國 立 屏 東 教 育 大 學 附 設 實 驗 國 民 小 學 教 師 兼 研 究 主 任 中 文 摘 要 本 研 究 是 以 兒 童 讀 書 會 進 行 閱
More information168 健 等 木醋对几种小浆果扦插繁殖的影响 第1期 the view of the comprehensive rooting quality, spraying wood vinegar can change rooting situation, and the optimal concent
第 31 卷 第 1 期 2013 年 3 月 经 济 林 研 究 Nonwood Forest Research Vol. 31 No.1 Mar. 2013 木醋对几种小浆果扦插繁殖的影响 健 1,2 杨国亭 1 刘德江 2 (1. 东北林业大学 生态研究中心 黑龙江 哈尔滨 150040 2. 佳木斯大学 生命科学学院 黑龙江 佳木斯 154007) 摘 要 为了解决小浆果扦插繁殖中生根率及成活率低等问题
More information内容 Outline 1 中国机动化进程及其影响 Motorization and its effects 2 中国道路交通安全发展及形势 Road traffic development and trends 3 中国客车特大事故特征及政策回顾 Fatal crash analysis and s
城市交通发展中的道路安全研讨会 唐琤琤博士/研究员 张建军副研究员 胡晗副研究员 交通运输部公路科学研究院 交通运输部公路交通安全工程研究中心 交通运输部公路交通安全技术行业重点实验室 2013年12月19日 内容 Outline 1 中国机动化进程及其影响 Motorization and its effects 2 中国道路交通安全发展及形势 Road traffic development and
More informationMicrosoft Word - KSAE06-S0262.doc
Stereo Vision based Forward Collision Warning and Avoidance System Yunhee LeeByungjoo KimHogi JungPaljoo Yoon Central R&D Center, MANDO Corporation, 413-5, Gomae-Ri, Gibeung-Eub, Youngin-Si, Kyonggi-Do,
More informationMicrosoft Word doc
中 考 英 语 科 考 试 标 准 及 试 卷 结 构 技 术 指 标 构 想 1 王 后 雄 童 祥 林 ( 华 中 师 范 大 学 考 试 研 究 院, 武 汉,430079, 湖 北 ) 提 要 : 本 文 从 结 构 模 式 内 容 要 素 能 力 要 素 题 型 要 素 难 度 要 素 分 数 要 素 时 限 要 素 等 方 面 细 致 分 析 了 中 考 英 语 科 试 卷 结 构 的
More informationMicrosoft Word - HC20138_2010.doc
Page: 1 of 7 Date: April 26, 2010 WINMATE COMMUNICATION INC. 9 F, NO. 111-6, SHING-DE RD., SAN-CHUNG CITY, TAIPEI, TAIWAN, R.O.C. The following merchandise was submitted and identified by the vendor as:
More information( s y s t e m ) ( s t r e s s ) (stress model) ( s y s t e m ) [ ] [ 5 ] C o x [ 3 ] 1 [ 1, 2 ] [ 6-8 ] [ 9 ] Tw Fam Med Res 2003 Vol.1 No.1 23
1, 4 1, 2 3 1 4 1, 2 1977 E n g e l 1999 5 1 ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) 2003 1 2 2-32 stress model, stress analysis [ 1 ] ( p s y c h o g e n e s i s ) (holism) (biomedical model) ( r e d u c t i o
More informationMicrosoft Word - 24.doc
水 陸 畢 陳 晚 明 飲 食 風 尚 初 探 蕭 慧 媛 桃 園 創 新 技 術 學 院 觀 光 與 休 閒 事 業 管 理 系 摘 要 飲 食 是 人 類 維 持 與 發 展 生 命 的 基 礎 之 一, 飲 食 風 尚 會 隨 著 社 會 地 位 物 質 條 件 以 及 人 為 因 素 轉 移, 不 同 階 層 的 飲 食 方 式, 往 往 標 誌 著 他 們 的 社 會 身 分, 甚 至 反
More informationUntitled-3
SEC.. Separable Equations In each of problems 1 through 8 solve the given differential equation : ü 1. y ' x y x y, y 0 fl y - x 0 fl y - x 0 fl y - x3 3 c, y 0 ü. y ' x ^ y 1 + x 3 x y 1 + x 3, y 0 fl
More informationAbstract Today, the structures of domestic bus industry have been changed greatly. Many manufacturers enter into the field because of its lower thresh
SWOT 5 Abstract Today, the structures of domestic bus industry have been changed greatly. Many manufacturers enter into the field because of its lower threshold. All of these lead to aggravate drastically
More information096STUT DOC
i YouTube was established in 2005 until now only more than 3 years. Although it was established just more than 3 years, it has already become the one of multitudinous video shares website that most people
More information南華大學數位論文
南 華 大 學 生 死 學 研 究 所 碩 士 論 文 屏 東 地 區 孕 婦 實 施 胎 教 的 經 驗 歷 程 之 探 討 An Enquiry into Pregnant Women s Pre-natal Training Experiences at Pintung Area 研 究 生 : 莊 秀 全 撰 指 導 教 授 : 許 秀 月 博 士 中 華 民 國 九 十 四 年 十 二 月
More information问 她! 我 们 把 这 只 手 机 举 起 来 借 着 它 的 光 看 到 了 我 老 婆 正 睁 着 双 眼 你 在 干 什 么 我 问, 我 开 始 想 她 至 少 是 闭 着 眼 睛 在 yun 酿 睡 意 的 我 睡 不 着 她 很 无 辜 地 看 着 我 我 问 她 yun 酿 的 yu
果 皮 云 写 作 NO.6: 响 水 不 滚 滚 水 不 响 时 间 :2011 年 12 月 25 日 主 编 : 乌 青 作 者 : 秦 留, 新 a, 伊 文 达, 乌 青, 张 墩 墩, 娜 娜, 女 斑 马 王, 马 其 顿 荒 原, 尼 码, 萨 尔 卡, 傀 儡 尫 仔, 东 成, 二 天, 老 马 迷 途, 曾 骞, 郑 在, 柚 子, 以 下 简 称 刘 某, 大 棋, 张 维,
More information目 录 8.3 NOC 医 疗 服 务 声 明 执 业 注 册 申 请 表 医 疗 器 械 入 境 申 请 表 药 物 入 境 申 请 表 17
目 录 1 概 述 1 2. 相 关 政 策 2 2.1 代 表 团 随 队 医 生 执 业 备 案 2 2.2 代 表 团 医 疗 专 业 人 员 保 险 2 2.3 代 表 团 药 物 和 医 疗 器 械 进 出 境 2 2.4 代 表 团 随 队 医 生 药 房 服 务 及 处 方 权 3 2.5 运 动 员 治 疗 用 药 豁 免 (TUE) 3 2.6 医 疗 费 用 政 策 4 2.7
More informationUTI (Urinary Tract Infection) - Traditional Chinese
UTI (Urinary Tract Infection) Urinary tract infection, also called UTI, is an infection of the bladder or kidneys. Urethra Kidney Ureters Bladder Vagina Kidney Ureters Bladder Urethra Penis Causes UTI
More information<4D6963726F736F667420576F7264202D20ECFAD0C0D0C0C2DBCEC4CCE1BDBB6F7665722E646F63>
硕 士 专 业 学 位 论 文 论 文 题 目 鲍 温 病 临 床 病 理 特 征 和 几 种 治 疗 方 法 比 较 的 分 析 研 究 研 究 生 姓 名 指 导 教 师 姓 名 禚 欣 欣 康 定 华 专 业 名 称 皮 肤 性 病 学 研 究 方 向 皮 肤 肿 瘤 与 皮 肤 病 理 论 文 提 交 日 期 2013 年 4 月 I 鲍 温 病 临 床 病 理 特 征 和 几 种 治 疗
More information<4D6963726F736F667420576F7264202D20B0EAA5DFC170A658A46ABEC7A764ACFCAA4BBAD3A468B2A6B77EBDD7A4E53130312E31315FABC8A965B77CA7B9A6A8AAA95F312E646F636D>
國 立 聯 合 大 學 客 家 語 言 與 傳 播 研 究 所 碩 士 論 文 語 言 使 用 與 客 家 認 同 關 係 之 研 究 - 以 三 義 鯉 魚 潭 村 為 例 A study of correlation between Language Use and Hakka Identity A case of Li Yu Tan Village in San Yi Town 研 究 生 :
More informationTA-research-stats.key
Research Analysis MICHAEL BERNSTEIN CS 376 Last time What is a statistical test? Chi-square t-test Paired t-test 2 Today ANOVA Posthoc tests Two-way ANOVA Repeated measures ANOVA 3 Recall: hypothesis testing
More informationC o n t e n t s...7... 15 1. Acceptance... 17 2. Allow Love... 19 3. Apologize... 21 4. Archangel Metatron... 23 5. Archangel Michael... 25 6. Ask for
Doreen Virtue, Ph.D. Charles Virtue C o n t e n t s...7... 15 1. Acceptance... 17 2. Allow Love... 19 3. Apologize... 21 4. Archangel Metatron... 23 5. Archangel Michael... 25 6. Ask for a Sign... 27 7.
More information240 生 异 性 相 吸 的 异 性 效 应 [6] 虽 然, 心 理 学 基 础 研 [7-8] 究 已 经 证 实 存 在 异 性 相 吸 异 性 相 吸 是 否 存 在 于 名 字 认 知 识 别 尚 无 报 道 本 实 验 选 取 不 同 性 别 的 名 字 作 为 刺 激 材 料, 通
2011 年 Journal of Capital Medical University 4月 第2 期 Apr 2011 Vol 32 No 2 基础研究 doi: 10 3969 / j issn 1006-7795 2011 02 015 人脑识别不同性别名字反应时的差异研究 高迎霄 陈昭燃 * 张明霞 ( 首都医科大学神经生物系高级脑功能中心) 摘要 目的 探讨男女对不同性别名字认知加工速度是否存在差异
More information前 言 一 場 交 換 學 生 的 夢, 夢 想 不 只 是 敢 夢, 而 是 也 要 敢 去 實 踐 為 期 一 年 的 交 換 學 生 生 涯, 說 長 不 長, 說 短 不 短 再 長 的 路, 一 步 步 也 能 走 完 ; 再 短 的 路, 不 踏 出 起 步 就 無 法 到 達 這 次
壹 教 育 部 獎 助 國 內 大 學 校 院 選 送 優 秀 學 生 出 國 研 修 之 留 學 生 成 果 報 告 書 奧 地 利 約 翰 克 卜 勒 大 學 (JKU) 留 學 心 得 原 就 讀 學 校 / 科 系 / 年 級 : 長 榮 大 學 / 財 務 金 融 學 系 / 四 年 級 獲 獎 生 姓 名 : 賴 欣 怡 研 修 國 家 : 奧 地 利 研 修 學 校 : 約 翰 克 普
More information2005 3,, :,,,, (),,,,, [],,,,,,,,,,, (),, (,, ),,,,,,,,,,,,,,,,,,,,,,,,,( ),, :,,, :,?,,, :,1999,
(), 70,,,,,, :,31, 1555,;18,,, ;,, (1895),, 1 2005 3,, :,,,, (),,,,, [],,,,,,,,,,, (),, (,, ),,,,,,,,,,,,,,,,,,,,,,,,,( ),, :,,, :,?,,, :,1999,24 25 2 (),,,,,,, 1970,,,,,, ;,; :,,?? 1988,,, 1987 1990,,,
More information% % % % % % ~
1001-5558 2015 03-0021-16 2010 C91 A 2014 5 2010 N. W. Journal of Ethnology 2015 3 86 2015.No.3 Total No.86 2010 2010 2181.58 882.99 40.47% 1298.59 59.53% 2013 2232.78 847.29 37.95% 1385.49 62.05% 1990
More informationLH_Series_Rev2014.pdf
REMINDERS Product information in this catalog is as of October 2013. All of the contents specified herein are subject to change without notice due to technical improvements, etc. Therefore, please check
More information天 主 教 輔 仁 大 學 社 會 學 系 學 士 論 文 百 善 孝 為 先? 奉 養 父 母 與 接 受 子 女 奉 養 之 態 度 及 影 響 因 素 : 跨 時 趨 勢 分 析 Changes in attitude toward adult children's responsibilit
天 主 教 輔 仁 大 學 社 會 學 系 學 士 論 文 指 導 老 師 : 翁 志 遠 百 善 孝 為 先? 奉 養 父 母 與 接 受 子 女 奉 養 之 態 度 及 影 響 因 素 : 跨 時 趨 勢 分 析 Changes in attitude toward adult children's responsibility to financially support and to live
More information東方設計學院文化創意設計研究所
東 方 設 計 學 院 文 化 創 意 設 計 研 究 所 碩 士 學 位 論 文 應 用 德 爾 菲 法 建 立 社 區 業 餘 油 畫 課 程 之 探 討 - 以 高 雄 市 湖 內 區 為 例 指 導 教 授 : 薛 淞 林 教 授 研 究 生 : 賴 秀 紅 中 華 民 國 一 o 四 年 一 月 東 方 設 計 學 院 文 化 創 意 設 計 研 究 所 碩 士 學 位 論 文 Graduate
More informationKnowledge and its Place in Nature by Hilary Kornblith
Deduction by Daniel Bonevac Chapter 7 Quantified Natural Deduction Quantified Natural Deduction As with truth trees, natural deduction in Q depends on the addition of some new rules to handle the quantifiers.
More information13-4-Cover-1
106 13 4 301-323 302 2009 2007 2009 2007 Dewey 1960 1970 1964 1967 303 1994 2008 2007 2008 2001 2003 2006 2007 2007 7 2013 2007 2009 2009 2007 2009 2012 Kendall 1990 Jacoby 1996 Sigmon 1996 1 2 3 20062000
More information第三章 国内外小组合作学习的应用情况
摘 要 论 文 题 目 : 小 组 合 作 学 习 在 上 海 高 中 信 息 科 技 教 学 中 的 应 用 专 业 : 现 代 教 育 技 术 学 位 申 请 人 : 朱 翠 凤 指 导 教 师 : 孟 琦 摘 要 小 组 合 作 学 习 是 目 前 世 界 上 许 多 国 家 普 遍 采 用 的 一 种 富 有 创 意 的 教 学 理 论 与 策 略, 其 在 培 养 学 生 的 合 作 精
More information摘 要 互 联 网 的 勃 兴 为 草 根 阶 层 书 写 自 我 和 他 人 提 供 了 契 机, 通 过 网 络 自 由 开 放 的 平 台, 网 络 红 人 风 靡 于 虚 拟 世 界 近 年 来, 或 无 心 插 柳, 或 有 意 噱 头, 或 自 我 表 达, 或 幕 后 操 纵, 网 络
上 海 外 国 语 大 学 硕 士 学 位 论 文 论 文 题 目 从 偶 像 符 号 的 消 解 到 消 费 符 号 的 建 构 网 络 红 人 的 形 象 变 迁 研 究 学 科 专 业 传 播 学 届 别 2013 届 姓 名 孙 清 导 师 王 玲 宁 I 摘 要 互 联 网 的 勃 兴 为 草 根 阶 层 书 写 自 我 和 他 人 提 供 了 契 机, 通 过 网 络 自 由 开 放 的
More information中國文化大學政治學研究所
中 國 文 化 大 學 社 會 科 學 院 政 治 學 系 碩 士 論 文 Department of Political Science College of Social Sciences Chinese Culture University Master Thesis 台 灣 中 小 企 業 赴 大 陸 投 資 風 險 及 其 因 應 之 道 Investment Risks and its
More information穨control.PDF
TCP congestion control yhmiu Outline Congestion control algorithms Purpose of RFC2581 Purpose of RFC2582 TCP SS-DR 1998 TCP Extensions RFC1072 1988 SACK RFC2018 1996 FACK 1996 Rate-Halving 1997 OldTahoe
More informationA Study of Su Hsuei-Lin s Painting Based on the Literati Painting Prototype Wu Rong-Fu Assistant Professor, Department of Chinese Literature, National
2007 4 131-170 prototype theory 131 A Study of Su Hsuei-Lin s Painting Based on the Literati Painting Prototype Wu Rong-Fu Assistant Professor, Department of Chinese Literature, National Cheng Kung University
More information南華大學數位論文
-- Managing Traditional Temples A Case Study of Representative Temples in CHIA-YI i Abstract This research used the methodology of field study historical comparative research, and qualitative interview
More informationMicrosoft Word - A200810-897.doc
基 于 胜 任 特 征 模 型 的 结 构 化 面 试 信 度 和 效 度 验 证 张 玮 北 京 邮 电 大 学 经 济 管 理 学 院, 北 京 (100876) E-mail: weeo1984@sina.com 摘 要 : 提 高 结 构 化 面 试 信 度 和 效 度 是 面 试 技 术 研 究 的 核 心 内 容 近 年 来 国 内 有 少 数 学 者 探 讨 过 基 于 胜 任 特 征
More information