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Stroke is the third most common cause of death in the United States and is the number one cause of long-term disability. Legislative mandates, largely the result of the American Heart Association, American Stroke Association, and Brain Attack Coalition working cooperatively, have resulted in nationwide standardization of care for patients who experience a stroke. Transport to a skilled facility that can provide optimal care, including immediate treatment to halt or reverse the damage caused by stroke, must occur swiftly. Admission to a certified stroke center is recommended for improving outcomes. Most strokes are ischemic in nature. Acute ischemic stroke is a heterogeneous group of vascular diseases, which makes targeted treatment challenging. To provide a thorough review of the literature since the 2007 acute ischemic stroke guidelines were developed, we performed a search of the MEDLINE database (January 1, 2004-July 1, 2009) for relevant English-language studies. Results (through July 1, 2009) from clinical trials included in the Internet Stroke Center registry were also accessed. Results from several pivotal studies have contributed to our knowledge of stroke. Additional data support the efficacy and safety of intravenous alteplase, the standard of care for acute ischemic stroke since 1995. Due to these study results, the American Stroke Association changed its recommendation to extend the time window for administration of intravenous alteplase from within 3 hours to 4.5 hours of symptom onset; this recommendation enables many more patients to receive the drug. Other findings included clinically useful biomarkers, the role of inflammation and infection, an expanded role for placement of intracranial stents, a reduced role for urgent carotid endarterectomy, alternative treatments for large-vessel disease, identification of nontraditional risk factors, including risk factors for women, and newly published pediatric stroke guidelines. In addition, new devices for thrombolectomy are being developed, and neuroprotective therapies such as the use of magnesium, statins, and induced hypothermia are being explored. As treatment interventions become more clearly defined in special subgroups of patients, outcomes in patients with acute ischemic stroke will likely continue to improve.

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Because of an interest in the concept of opportunity to learn (OTL) in the English language arts from the perspective of students, the authors surveyed over 1,800 students in grades 9–12. OTL was defined as perceptions of access and exposure to reading and writing content, as well as curriculum tasks and materials. The findings uncovered three specific problems related to OTL that teachers and researchers should be aware of in assessing the merits of student literacy achievement. Current accounts of OTL must recognize (1) a systems problem, (2) an offerings problem, and (3) an acknowledgement problem. Knowledge of these problems underscores the need to place OTL in context when offering a clear picture of how well educators are meeting, or are positioned to meet, the goals of literacy improvement. English language arts educators and researchers are called on to restore the language of OTL in day‐to‐day dialogue. مشكلة الاعتراف. وتؤكد معرفة بهذه المشاكل الحاجة لوضع مفهوم فرصة التعلم في سياق عند تقديم صورة واضحة للدرجة التي يحقق المعلمون فيها—أو في موقف يمكنهم من تحقيق—أهدافهم لتحسين القراءة والكتابة. وقد تمت المناداة لمعلمي فنون اللغة الإنكليزية وباحثيها من أجل تجديد لغة مفهوم فرصة التعلم في الحوار اليومي.(3) مشكلة التقديمات و(2) مشكلة الأنظمة و(1) طالب في الصفوف التاسع إلى العاشر. وقد تم تعريف مفهوم فرصة التعلم كإدراكات حسية لوسيلة للقيام بالقراءة والكتابة والتعرض لمحتواهما بالإضافة إلى مواد المنهاج الدراسي وواجباته. وقد كشفت النتائج عن ثلاث مشاكل معينة متعلقة بمفهوم فرصة التعلم لا بد للمعلمين والباحثين من أن يكونوا واعين بها لدى تقييم مزايا إنجاز معرفة القراءة والكتابة عند الطلاب. إذ يجب أن تعترف البيانات الجارية بصدد مفهوم فرصة التعلم 1،800كون يوجد هنالك أهتمام بمفهوم فرصة التعلم في فنون اللغة الإنكليزية من وجهة نظر الطلبة فإن المؤلفين قاموا بمسح نيف 本文作者以学生观点出发，对学习英国语文科方面的学习机会这个概念产生兴趣，因而调查了1,800名九至十二年级的学生。学习机会的定义就是对有机会获得及接触读写内容及课程习作与教材的看法。研究结果显示出三个与学习机会有关的特有问题，而这些问题都是教师与研究者在考量学生读写能力成绩的得失时应关注的。现时对学习机会这个概念的解释必须认清：(1)系统方面的问题、(2)给予方面的问题及(3)承认方面的问题。对这些问题有所了解便会重视把学习机会置放于教学情境中的需要，从而让教育工作者清楚地看到，他们的教学是否已符合或正在设法符合改善学生读写能力的教学目标。本文作者呼吁英国语文科的教育工作者与研究者在日常对话中恢复谈论学习机会的对话。 Du fait de l'intérêt que présente le concept d'occasion d'apprentissage (OTL) en anglais du point de vue de l'élève, les auteurs ont enquêté sur plus de 1800 élèves du second degré, de la 3ème à la 1ère. On a défini l'OTL comme la perception des possibilités d'accès et de fréquentation à un contenu par la lecture et l'écriture, dans des tâches ou du matériel relatifs au programme. Les résultats ont fait apparaître trois problèmes spécifiques liés à l'OTL dont les professeurs et les chercheurs devraient être conscients quand ils évaluent la qualité des résultats des élèves en littératie. Les comptes rendus courants en OTL devraient reconnaître qu'il existe (1) un problème systémique, (2) un problème d'offre, et (3) un problème de reconnaissance. La connaissance de ces problèmes souligne le besoin qu'il y a de mettre l'OTL en contexte quand les enseignants se préoccupent, ou sont disposés à se préoccuper, des buts de l'amélioration de la littératie. On invite ...

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