Contexte. Objectifs principaux : explorer l’expérience vécue vécu des neurologues et des patients des annonces de mauvaises nouvelles dans la sclérose en plaques, le vécu de la pathologie ainsi que de la qualité de leur relation dans le contexte du suivi d’un projet thérapeutique, et d’envisager la création d’un outil clinique réflexif pour les neurologues destiné à contribuer au maintien d’une relation de qualité durant l’ensemble du parcours de soins. Méthodologie. Étude qualitative multicentrique ; analyse des verbatims : 63 entretiens cliniques de recherche - 35 patients et 20 entretiens - 20 neurologues ; 3 entretiens - relecture d’items ; triangulation méthodologique ; triangulation des observateurs/résultats ; analyse IPA et analyse clinique d’orientation psychodynamique. Résultats. Les annonces de mauvaises nouvelles dans la SEP sont vécues comme des expérience anxiogènes pour la majorité des neurologues de la recherche, des situations source de frustration et parfois d’impuissance. Les impacts psychiques engendrés par les annonces de mauvaises nouvelles, la perception dans certains cas d’une relation au médecin dénuée d’empathie, le sentiment d’impuissance lié au caractère imprévisible de l’évolution de cette maladie progressivement handicapante ainsi qu’une défiance quant à l’efficacité des traitements proposés expliquent en partie la fragilité de l’alliance thérapeutique avec le neurologue et les réactions psychologiques parfois extrêmes des patients qui en découlent. Conclusion et ouverture. Résultats obtenus : engager une réflexion éthique sur les informations à transmettre au patient, et proposer une formation aux neurologues basée sur l’outil élaboré / Context. This research aims to explore the neurologist’s and patient’s lived experiences of breaking bad news in multiple sclerosis and the lived experience of this disease, to understand the basic conditions of their relationship, and to create reflective clinical tools aimed at helping neurologists to maintain the quality of their relationship with the patients. Methodology. Multicentre qualitative study presents the results obtained from the analysis of 83 clinical research interviews with 35 patients and 20 neurologists, using IPA and a clinical psychodynamic. Results. Breaking bad news (BBN) in multiple sclerosis are lived as stressful experience for the majority of the neurologists of the research, a situations lived with frustration and sometimes powerlessness. Psychic impacts engendered by the BBN, the perception in certain cases of a relation to the doctor divested of empathy, the feeling of powerlessness linked to the unpredictable character of the evolution of this gradually crippling disease as well as a mistrust as for the efficiency of the proposed treatments explain partially the fragility of the therapeutic alliance with the neurologist and sometimes the extreme psychological reactions of the patients. Conclusion and opening. Results obtained : engage an ethical reflection on the information to transmit to the patient, and to suggest training to neurologists based on the tool created in tis research

INTRODUÇÃO: No Brasil, no período compreendido entre 2013 a 2015, a terapia tripla com boceprevir (BOC) ou telaprevir (TVR) foi o tratamento padrão para pacientes infectados pelo vírus da hepatite C (VHC) genótipo 1. OBJETIVOS: Avaliar a efetividade e a segurança da terapia tripla com BOC ou TVR, no contexto de vida real, em pacientes portadores de hepatite C crônica genótipo 1 tratados em centros de referência no Brasil. Foi também objetivo deste estudo, investigar os fatores preditores para obtenção da resposta viral sustentada (RVS) e fatores preditores da ocorrência de eventos adversos sérios (EAS) associados a essa modalidade terapêutica. MÉTODOS: Trata-se de um estudo multicêntrico, observacional e retrospectivo, que incluiu pacientes monoinfectados pelo VHC genótipo 1 que iniciaram o tratamento com interferon peguilado (Peg-IFN), ribavirina e BOC ou TVR . Dados demográficos, clínicos, virológicos e eventos adversos (EA) foram coletados durante o tratamento e seguimento. A análise dos fatores preditores da RVS e de EAS foi realizada por meio do modelo de regressão de Poisson com variância robusta. RESULTADOS: Dos 715 pacientes analisados, 56,1% eram do sexo masculino, com média de idade de 54,1 ± 10,1 anos, 59% eram portadores de cirrose hepática e 67,1% tinham sido tratados previamente. Foram tratados com TVR, 557 pacientes (77,9%), e com BOC, 158 (22,1%). Pela análise de intenção de tratamento, a RVS geral foi de 56,6% (IC 95%, 52,9 - 60,3), com uma efetividade semelhante em ambos os grupos (51,9% [BOC] versus (vs.) 58% [TVR], P = 0,190). Os pacientes cirróticos tiveram uma menor taxa de RVS comparado aos não cirróticos (46,9% vs. 70,6%, P < 0,001). Na análise múltipla, a obtenção de RVS foi associada com a ausência de cirrose hepática (P < 0,001), antecedente de recidiva viral após tratamento prévio (P < 0,001), contagem de plaquetas no pré-tratamento acima de 100.000/mm3 (P < 0,001) e obtenção de resposta viral rápida (P < 0,001). A taxa de descontinuação do tratamento foi de 34,8%, sendo a ocorrência de EA (16,1%) e a falha virológica (15,9%) as principais causas. Em relação à segurança do tratamento, 90,1% dos pacientes (IC 95%, 87,6 - 92,2) apresentaram algum EA durante o tratamento, sendo que 44,2% dos pacientes (IC 95%, 40,5 - 47,9) apresentaram EAS. A anemia foi o EA mais comum em ambos os grupos (59,5% [BOC] vs. 74,5% [TVR], P < 0,001). Houve maior ocorrência de EAS nos pacientes cirróticos comparados aos não cirróticos (50,7% vs. 34,8%, P < 0,001). Sexo feminino (P < 0,001), idade acima de 65 anos (P = 0,008), diagnóstico de cirrose hepática (P = 0,019), concentração de hemoglobina pré-tratamento alterada (P < 0,001) e contagem de plaquetas abaixo de 100.000/mm3 no pré-tratamento (P < 0,001) foram associados à ocorrência de EAS. Seis óbitos (0,8%) ocorreram. CONCLUSÃO: A terapia tripla com BOC ou TVR apresentou uma taxa de RVS superior ao tratamento padrão anterior (Peg-IFN e ribavirina). Contudo, este tratamento apresentou uma alta taxa de EAS, principalmente em pacientes com doença hepática avançada / INTRODUCTION: In Brazil, from 2013 until 2015, triple therapy with boceprevir (BOC) or telaprevir (TVR) was the standard treatment for patients infected with hepatitis C virus (HCV) genotype 1. OBJECTIVES: To evaluate the effectiveness and safety of triple therapy with BOC or TVR, in real life context, in patients with chronic hepatitis C genotype 1 treated at reference centers in Brazil. It was also the objective of this study to investigate the predictive factors for obtaining sustained viral response (SVR) and factors predictive of the occurrence of serious adverse events (SAE) associated with this therapeutic modality. METHODS: This was a multicenter, observational, retrospective study that included HCV infected patients genotype 1 who started treatment with pegylated interferon, ribavirin and BOC or TVR from July 2013 until April 2014, from 15 centers of reference in Brazil. Demographic, clinical, virological, and adverse events (AE) data were collected during treatment and follow-up. The analysis of predictive factors of SVR and SAE was performed using the Poisson regression model with robust variance. RESULTS: Of the 715 patients analyzed, 56.1% were males, mean age was 54.1 ± 10.1 years, 59% had hepatic cirrhosis and 67.1% had been previously treated. They were treated with TVR, 557 patients (77.9%), and with BOC, 158 (22.1%). By intention-to-treat analysis, overall SVR was 56.6% (95%CI, 52.9 - 60.3), with similar effectiveness in both groups (51.9% [BOC] versus (vs.) 58% [TVR], P = 0.190). Cirrhotic patients had a lower SVR rate compared to non-cirrhotic patients (46.9% vs. 70.6%, P < 0.001). In the multiple analysis, SVR acquisition was associated with absence of hepatic cirrhosis (P < 0.001), previous viral relapse after previous treatment (P < 0.001), pre-treatment platelet count above 100,000/mm3 (P < 0.001) and rapid viral response (P < 0.001). The treatment discontinuation rate was 34.8%, with the occurrence of AE (16.1%) and virological failure (15.9%) being the main causes. Regarding treatment safety, 90.1% of the patients (95%CI, 87.6 - 92.2) presented some AE during treatment, and 44.2% of the patients (95%CI, 40.5 - 47,9) presented SAE. Anemia was the most common AE in both groups (59.5% [BOC] vs. 74.5% [TVR], P < 0.001). There was a higher occurrence of SAE in cirrhotic patients compared to non-cirrhotic patients (50.7% vs. 34.8%, P < 0.001). Female gender (P < 0.001), age above 65 years (P = 0.008), diagnosis of hepatic cirrhosis (P = 0.019), altered pre-treatment hemoglobin concentration (P < 0.001) and platelet count below 100,000/mm3 in the pre-treatment (P < 0.001) were associated with the occurrence of SAE. Six deaths (0.8%) occurred. CONCLUSION: Triple therapy with BOC or TVR showed a higher SVR rate than the previous standard treatment (Peg-IFN and ribavirin). However, this treatment had a high EAS rate, especially in patients with advanced liver disease

Matematiken har använts i flera tusen år. Även om matematiken i sig utvecklas är det en sak som består: vi använder den i verkligheten. Att arbeta med kopplingen mellan matematiken och verkligheten är ett av matematiklärarnas uppdrag. Tidigare forskning visar att matematikundervisningen i yngre åldrar ska syfta till högre studier och ett mer krävande samhälle där matematikkunskaper, bland annat matematisk modellering, är ett krav för att få en djupare verklighetsanknytning till matematiken. Eftersom matematiken är så viktig på flera plan och lärare måste kunna motivera eleverna till att arbeta med det som lärs ut i skolan, spelar lärarnas egen syn och attityd till verklighetsanknuten matematik en stor roll. Studien utgår utifrån undervisningsteorin Realistic Mathematics Education och syftar till att bidra med kunskap om hur matematiklärare, som undervisar i årskurs 4-6, kan uppfatta verkligheten i förhållande till sin undervisning. Detta görs genom att utföra sex stycken semi-strukturerade intervjuer med lärare som undervisar matematik på mellanstadiet. För att besvara studiens syfte utgår studien ifrån fyra frågeställningar: • Vad anser lärare att matematikundervisningens roll är i skolan? • Hur använder matematiklärare verkligheten i sin undervisning? • Hur konstruerar matematiklärare en uppgift kopplad till verkligheten för sina elever? • Hur resonerar matematiklärare kring en matematisk modelleringsuppgift? Resultatet visar att lärarna är positiva till användandet av en verklighetsanknuten matematikundervisning och att det gynnar eleverna. Flera av lärarna i studien kopplade uttrycket verklighetsanknuten matematikundervisning till större arbeten eller projekt med eleverna och kunde se svårigheter med att hinna med att utföra eller planera dessa aktiviteter. Vid uppgifter som är kopplade till verkligheten läggs större fokus av lärarna på processen än det slutgiltiga svaret. Även diskussion kring uppgifterna ansågs viktigt. / Mathematics has been used for several thousands of years. Even if the mathematics progresses there is one thing that consist: we still use it in the real world. To work with the connection between the mathematics and the reality is one of the mathematics teachers’ tasks. Previous research is pointing out that the education of mathematics in lower years should aim to prepare the students for higher education studies and an increasingly more demanding society where mathematical knowledge, among them mathematical modeling, is crucial to achieve a deeper connection between the real life and the mathematics. Since the mathematics is so important on several levels and teachers need to be able to motivate their students to work with the subjects that are situated in schools, does the teachers’ own view and attitude towards real-life connected mathematics play a big part. The study emanates from the teaching theory Realistic Mathematics Education and aims to contribute with knowledge about how mathematic teachers, who teaches students aged 9-13, can perceive the reality linked to their teaching. This is done by six semi-structured interviews with teachers who are active in teaching mathematics for students aged 9-13. To answer the aim of the study, it emanates from four questions: • What do teachers regard as the role of mathematic education in school? • How do mathematic teachers use the reality in their teaching? • How do mathematic teachers design a task linked to the reality, for their students? • How do mathematic teachers reason about a mathematic modeling-task? The results shows that teachers are positive towards the use of a real-life connected education in mathematics and that they believe it benefits the students. Several of the teachers in the study associated the term real-life connected teaching in mathematics to larger tasks or projects with the students and could see difficulties in finding the time to plan and execute said activities. When working with tasks that are connected to the reality, the teachers focus more on the process than the final answer. The discussion around the tasks is also something that is also important according the teachers

Cette thèse présente des algorithmes de résolution de quatre problèmes de clique : clique de poids maximum (MVWCP), s-plex maximum (MsPlex), clique maximum équilibrée dans un graphe biparti (MBBP) et clique partition (CPP). Les trois premiers problèmes sont des généralisations ou relaxations du problème de la clique maximum, tandis que le dernier est un problème de couverture. Ces problèmes, ayant de nombreuses applications pratiques, sont NP-difficiles, rendant leur résolution ardue dans le cas général. Nous présentons ici des algorithmes de recherche locale, principalement basés sur la recherche tabou, permettant de traiter efficacement ces problèmes ; chacun de ces algorithmes emploie des composants originaux et spécifiquement adaptés aux problèmes traités, comme de nouveaux opérateurs ou mécanismes perturbatifs. Nous y intégrons également des stratégies telles que la réduction de graphe ou la propagation afin de traiter des réseaux de plus grande taille. Des expérimentations basées sur des jeux d’instances nombreux et variés permettent de montrer la compétitivité de nos algorithmes en comparaison avec les autres stratégies existantes. / This thesis considers four clique problems: the maximum vertex weight clique problem (MVWCP), the maximum s-plex problem (MsPlex), the maximum balanced biclique problem (MBBP) and the clique partitioning problem (CPP). The first three are generalization and relaxation of the classic maximum clique problem (MCP), while the last problem belongs to a clique grouping problem. These combinatorial problems have numerous practical applications. Given that they all belong to the NP-Hard family, it is computationally difficult to solve them in the general case. For this reason, this thesis is devoted to develop effective algorithms to tackle these challenging problems. Specifically, we propose two restart tabu search algorithms based on a generalized PUSH operator for MVWCP, a frequency driven local search algorithms for MsPlex, a graph reduction based tabu search as well as effective exact branch and bound algorithms for MBBP and lastly, a three phase local search algorithm for CPP. In addition to the design of efficient move operators for local search algorithms, we also integrate components like graph reduction or upper bound propagation in order to deal deal with very large real-life networks. The experimental tests on a wide range of instances show that our algorithms compete favorably with the main state-of-the-art algorithms.

The network "Developing Quality in Mathematics Education II" is a continuation of the associated project "Developing Quality in Mathematics Education" (http://www.dqime.unidortmund. de). In this project participate universities, teacher education institutions and schools from 11 European countries. Cross-cultural cooperation and exchange of ideas, materials, teachers and pupils support developing quality in mathematics education, especially in the area of mathematical modelling. The quality and application of the developed learning materials is also guaranteed by using, comparing and modifying them in eleven different countries. This comparison leads to an agreement about contents of mathematical learning and teaching in eleven European countries. Thus we want to establish a "European Curriculum for the teaching and learning of mathematics" in the 21st century. A special feature of this project is the strong connection between theory and practice and between the research and development of mathematics education. In this project our Faculty of Mathematics, Physics and Informatics of Comenius University Bratislava manage testing of translated teaching materials at the high school „Gymnazium Sturovo“. We know that using ICT and didactical software in schools is almost present and wide spread. So we try to focus on several possibilities in solving real-life tasks using this technologies, regard to the fact technologies are hard upon the young generation of students.

The presented dissertation encompasses three distinct investigations into novel complexes with diverse applications. Firstly, a Europium-based complex, K[Eu(hfa)4], exhibits remarkable potential for detecting dissolved CO2 in an ethylene glycol medium, offering a low limit of detection, rapid response times, and high signal-to-noise ratios. This complex demonstrates promise for quantifying CO2 concentrations and finds utility in sugar fermentation monitoring. Secondly, an innovative ratiometric optical sensor, Eu(tta)3([4,4'-(t-bu)2-2,2'-bpy)], showcases exceptional sensitivity and selectivity in detecting aluminum ions, making it suitable for environmental and biological applications. It exhibits reliable quantification in both methanol and aqueous samples, with remarkable accuracy validated by ICP-OES. Lastly, modifications to the Au3Pz3 complex synthesis enable the development of a silver ion sensor, paving the way for detecting silver ion leaching in real-life scenarios, such as silver nanoparticle-embedded bandages. The research extends to the synthesis of silver nanoparticles using various methods and foresees expanded in vitro and in vivo studies. These investigations collectively offer insights into the development of advanced sensing technologies with significant implications for a wide range of practical applications.

La lombalgie compte parmi les causes principales d’incapacité chez des membres des Forces armées canadiennes (FAC). Une prise en charge efficace de cette condition est donc primordiale afin de maintenir des forces opérationnelles. Les études randomisées contrôlées réalisées auprès de la population générale suggèrent que la direction préférentielle (DP) est efficace pour guider la prise en charge de la lombalgie. Toutefois, aucune étude n’a investigué l’efficacité d’une telle approche en contexte réel ou auprès de la population militaire. L’objectif de ce mémoire était d’évaluer, dans le contexte réel de la pratique clinique, l’efficacité d’une prise en charge guidée par la DP parmi des membres des FAC souffrant de lombalgie. Pour ce faire, une étude observationnelle de cohorte incluant 44 membres consentant des FAC a été réalisée. Les patients du groupe exposé (n=22) ont reçu des interventions guidées par la DP. Les patients du groupe non-exposé (n=22) ont reçu les soins usuels, soit des interventions déterminées par leur physiothérapeute, mais pas d’approche guidée par la DP. Les données ont été colligées et comparées entre les deux groupes au début de l’étude, à 1 mois, et à 3 mois grâce à un questionnaire autoadministré concernant la douleur (intensité, localisation, fréquence), l’incapacité perçue, la consommation de médicaments, et l’effet global perçu (douleur, fonctionnement et état général). La perte de productivité et l’utilisation de soins de santé ont été mesurées à 3 mois grâce au dossier médical électronique. Des différences statistiquement significatives en faveur du groupe exposé à une prise en charge guidée par la DP ont été observées pour l’intensité de la douleur (Δ à 1 mois : 1,9/10; Δ à 3 mois : 1,3/10), l’incapacité perçue (Δ 1 mois : 4,3/24; Δ 3 mois : 3,5/24), l’amélioration de l’effet global perçu à 1 mois (douleur : 86,4 % vs 57,1 %; fonctionnement : 81,8 % vs 47,6 %; état général : 86,4 % vs 57,1 %) et à 3 mois (douleur : 95,5 % vs 71,1 %; état général : 95,5 % vs 66,7 %), et l’amélioration du statut au travail à 3 mois (54,5 % vs 23,8 %). Malgré les limites de notre étude, nos résultats suggèrent qu’en conditions réelles de pratique, la prise en charge guidée par la DP est plus efficace que les soins usuels pour réduire la douleur et l’incapacité chez les membres des FAC souffrant de lombalgie. / Abstract : Low back pain (LBP) is a leading cause for disability in Canadian Armed Forces (CAF) members. Efficacious and cost-effective management for LBP is thus essential to maintaining operational capabilities. In randomized controlled trials among the general population, directional preference (DP) was shown useful to guide treatment of LBP, but no studies have investigated this in real-life settings or in military personnel. The purpose of this study was to evaluate, in real-life clinical practice, the effectiveness of DP to guide management of LBP in CAF members when compared to usual care. To that purpose, we conducted a cohort study including 44 consenting CAF members with LBP. Patients in the exposed group (n=22) were assessed for DP and received matching interventions. Patients in the non-exposed group (n=22) received interventions as determined by their treating physiotherapist, excluding any DP-guided treatments. Data were collected and compared between groups at baseline, at 1-month and at 3-month follow-up using self-administered questionnaires regarding pain (intensity, location, frequency), perceived disability, medication, and perceived global effect (pain, function, overall status). Work loss and health care utilization were measured at 3 months using electronic health records. Statistically significant differences, favoring the exposed group, were observed for pain intensity (Δ at 1 month: 1.9/10; CI 95%; 0.97 – 2.89; Δ at 3 months: 1.3/10; CI 95%: 0.35 – 2.31), disability (Δ at 1 month: 4.3/24; CI 95%: 2.12 – 6.38; Δ at 3 months: 3.5/24; CI 95%; 1.59 – 5.33), perceived global effect at 1 month (pain: 86.4% vs 57.1%; function: 81.8% vs 47.6%; overall status: 86.4% vs 57.1%) and at 3 months (pain: 95.5% vs 71.1%; overall status: 95.5% vs 66.7%) with p-values <.05, and improvement in work status (3 months: 54.5% vs 23.8%). Our data suggest that DP-guided management is more effective than usual care physiotherapy to reduce pain and improve function in CAF members with LBP. Our findings are useful to inform clinicians and policy makers to improve management strategies for CAF members.

In our presentation we will show how technology enables us to improve the teaching and learning of linear functions at the middle school level. Through various classroom activities that involve technology such as dynamic geometry software, graphing calculators and Excel, students explore functions and discover basic facts about them on their own. Students then work with real life data and on real life problems to draw graphs and form linear models that correspond to given situations as well as draw inferences based on their models. Participants will receive complete classroom materials for the unit on linear functions.

Cette thèse de sociologie cherche à montrer la relation ambivalente que des personnes handicapées visuelles, aveugles ou malvoyantes, nouent avec leur agglomération, ici l’agglomération chambérienne. Dans un premier temps, elle montre que l’espace urbain est pour ces personnes handicapées un espace de fermeture : sa lecture, sa connaissance, son utilisation sont restreintes,  soumises à des impératifs comme la canne, la technique de locomotion, l’utilisation d’outils mis à leur intention dans la ville. La vie dans l’espace privé n’échappe à de multiples contraintes. La perte de vue malmène la sécurité ontologique, altérée par la souffrance et souvent la solitude. Et pourtant, l’espace urbain est l’espace où les personnes handicapées visuelles peuvent vivre et se déplacer en autonomie. Cette autonomie est l’œuvre de deux types d’acteurs : d’une part la ville, qui réalise les aménagements urbains d’accessibilité, des chaines d’accessibilité prévus par la loi, parfois antérieurement à la loi, comme c’est le cas de la ville de Chambéry, récompensée pour son action en faveur des personnes handicapées et d’autre part les personnes handicapées elles-mêmes qui doivent conquérir leur autonomie au prix d’un travail personnel exigeant. ‘’Il faut apprendre mon métier le personne handicapée’’, a dit l’une des personnes interviewées. La conquête de son autonomie s’apparente au ‘’cas de la chose réelle’’. Cette conquête ne considère pas seulement le côté environnemental et situationnel du handicap, mais place la personne aveugle ou malvoyante dans une spécificité vis à vis de l’espace urbain. L’extension à l’analyse sociologique de la théorie écologique de Gibson relative à la perception propose de considérer les personnes handicapées visuelles dans une relation spécifique avec l’espace urbain, qui évoque le concept de niche écologique. / This thesis in sociology aims at describing the ambivalent relationship that visually impaired persons, whether they are blind or partially sighted, develop with their urban area, here that of Chambery.First, it shows that, for these disabled persons, urban space is a space where they feel locked in : the reading, the knowledge, the use of this space are restricted, submitted to imperatives such as the walking stick, the locomotion technique, the use of tools provided for them by the city. Living in the private space is also subject to many constraints. The loss of eyesight reduces ontological safety, which is altered by pain and often by loneliness.And yet urban space is the space where visually impaired persons can live and move self- autonomously. Their autonomy is made possible by two actors: on the one hand, the city which carries out urban improvements in its accessibility to conform to the law- sometimes even before the bill was passed as is the case with the city of Chambery which was rewarded for its achievements in favour of disabled persons ; on the other hand, the disabled persons themselves who need to conquer their autonomy at the expense of demanding personal efforts. “ I have to learn my job as a disabled person”, said one of them in an interview. Conquering one’s autonomy shows similarities to ‘’the real-life situation’’…. This conquest not only takes into account the environmental and situational aspect of the handicap, but it also places the blind or partially impaired person in a specific position with regard to urban space. An extension to the sociological analysis of Gibson’s ecological theory relating to perception proposes to consider visually impaired persons in a specific relationship with urban space, conjuring up the concept of ecological niche.

Abstract The study describes and analyses the implementation and development of the real-life-oriented pedagogical action process as a method of work to intervene in exclusion from education from the viewpoints of the teacher, pupils and various interest groups. The actual group of subjects consisted of 74 Oulu pupils in the Tuomontupa class in the years 1992–1998. The pupils aged 15 to 17 had dropped out or were about to do so and had been moved to a special class for education for the maladjusted. 23 of the students were girls and 51 were boys. The number of boys was more than double that of girls. The research site was the Tuomontupa class that functioned in a learning environment that was not school-like in the town's work training centre. The actual purpose of the study was to describe the RLO pedagogical action process implemented in special class teaching among young people aged 15–17 who were threatened by exclusion from education. In addition to this, the realization and development of real-life-oriented pedagogical action in the case of young people near exclusion was also studied. From the theoretical and educational philosophical points of view, the research analysed the connections of the real-life-oriented pedagogical action process to social pedagogical thinking and tradition of action and to reform pedagogy. The study was carried out as a social pedagogical action study in which the data was gathered using various research methods. The methods included ethnographic observation and interpretation as well as social pedagogical participatory action research. Field data consisted of interview data, pupil transfer documents and other documents, participatory observation, pupils' essays, meeting memoranda and comparative statistical data on the pupils' school performance. Triangulation was used in an attempt to observe the research object in a comprehensive manner. The research results show that a real-life-oriented pedagogical action process can have an impact on young people's exclusion from education. The real-life-oriented process helped to produce educational and pedagogical experiences that were felt to be positive by the young people, reinforcing the subjects' ability to think and act in the same way in similar situations in the future. The pupils' absences were reduced remarkably, and their grade averages improved. 63 pupils out of 74 in the research sample managed to complete the targets set for lower secondary education in one year, while 11 needed a longer time to complete school. Out of the 63 pupils who completed lower secondary education, 46 or 73% were subsequently selected to a senior secondary program. The research data also reveals the three critical phases when to intervene in exclusion from education. The first critical phase was attachment to education, while the second phase was the corrective phase and the third phase was constituted by the linking phase. It was also possible to fail in any of these phases of intervention. The research showed that it is possible to intervene in exclusion from education, and it does not require an enormous amount of special resources, provided that the various administrative units are called together to co-operate in a tangible way. Pupils in need of special support need flexible, comprehensive and individual opportunities to meet the school's requirements. Diversified and developing special class teaching still has a well-justified position in this work as one of the ways in which the school works. The study shows that a comprehensive real-life-oriented pedagogical action process is connected with social pedagogical working practices as a form of interventive action against exclusion from education. / Tiivistelmä Tutkimuksessa kuvataan ja analysoidaan reaalipedagogisen toimintaprosessin toteutumista ja kehitystä koulutukselliseen syrjäytymiseen puuttuvana interventiivisena työmuotona tarkasteltuna opettajan, oppilaiden ja eri sidosryhmien näkökulmista. Tutkimuksen varsinaisen kohderyhmän muodosti 74 oululaista, Tuomontupa-luokkaa vuosina 1992–1998 käynyttä oppilasta. Oppilaat olivat 15–17-vuotiaita, koulunsa keskeyttäneitä tai keskeyttämässä olevia nuoria, jotka oli siirretty erityisluokalle sopeutumattomien opetukseen. Oppilaista oli tyttöjä 23 ja poikia 51. Poikien määrä oli yli kaksinkertainen verrattuna tyttöjen määrään. Tutkimuspaikan muodosti Tuomontupa-luokka, joka toimi kaupungin työvalmennuskeskuksessa, ei koulumaisessa opiskeluympäristössä. Tutkimuksen varsinaisena tehtävänä oli kuvata koulutuksesta syrjäytymässä olevien 15–17-vuotiaiden nuorten erityisluokkaopetuksessa toteutettua reaalipedagogista toimintaprosessia. Tämän lisäksi tutkittiin reaalipedagogisen toiminnan toteutumista ja kehittymistä koulutuksesta syrjäytymässä olevien nuorten kohdalla. Teoreettisesti ja kasvatusfilosofisesti ajateltuna tutkimuksessa jäsennettiin reaalipedagogisen toimintaprosessin yhteyttä sosiaalipedagogiseen ajatteluun ja toimintaperinteeseen sekä reformipedagogiikkaan. Tutkimus toteutettiin sosiaalipedagogisena toimintatutkimuksena, jossa käytettiin eri tutkimusmenetelmiä tiedon keruuseen. Tutkimusmetodeina käytettiin etnografista havainnointia ja tulkintaa sekä sosiaalipedagogista osallistuvaa toimintatutkimusta. Kenttämateriaali muodostui haastatteluaineistosta, oppilaiden siirtoasiakirjoista ja dokumenteista, osallistuvasta havainnoinnista, oppilaiden kirjoitelmista, kokousmuistioista ja oppilaiden koulusuoritusten tilastollisesta vertailuaineistosta. Toteutetun triangulaation avulla pyrittiin hahmottamaan kokonaisvaltaisesti tutkittavaa kohdetta. Tutkimustulokset osoittavat, että reaalipedagogisen toimintaprosessin avulla voidaan puuttua nuorten koulutukselliseen syrjäytymiseen. Reaalipedagogisen toimintaprosessin avulla luotiin nuorille myönteisiä kasvatuksellisia ja pedagogisia kokemuksia, jotka vahvistivat tutkittavien nuorten kykyä ajatella ja toimia samankaltaisissa tilanteissa tulevaisuudessa samoin. Oppilaiden poissaolot vähenivät merkittävästi ja keskiarvot paranivat. Tutkimusaineiston oppilaista 63 oppilasta 74:stä pystyi yhden vuoden aikana suoriutumaan peruskoulun oppitavoitteista ja 11 tarvitsi pitemmän ajan koulusta suoriutumiseen. Peruskoulunsa suorittaneista 63 oppilaasta pääsi jatkokoulutukseen 46 eli 73 %. Tutkimusaineisto osoittaa myös koulutuksellisen syrjäytymisen intervention kolme kriittistä vaihetta. Ensimmäisen kriittisen vaiheen muodosti koulutukseen kiinnittämisvaihe, toisen kriittisen vaiheen muodosti korjaava vaihe ja kolmannen kriittisen vaiheen muodosti niveltämisvaihe. Kaikissa edellisissä intervention vaiheissa oli myös mahdollista epäonnistua. Tutkimuksen mukaan koulutukselliseen syrjäytymiseen voidaan puuttua ja se ei vaadi suunnattomia erillisiä resursseja, kun yhdistetään eri hallintokunnat tekemään konkreettista yhteistyötä. Erityistä tukea tarvitsevat oppilaat tarvitsevat joustavia, kokonaisvaltaisia ja yksilöllisiä mahdollisuuksia suoriutua koulun tavoitteista. Tässä työssä monimuotoisella ja kehittyvällä erityisluokkaopetuksella on edelleen perusteltu sijansa koululaitoksen yhtenä toimintamuotona. Tutkimus osoittaa kokonaisvaltaisen reaalipedagogisen toimintaprosessin liittyvän sosiaalipedagogiseen työkäytäntöön koulutuksellisen syrjäytymiseen puuttuvana interventiivisenä toimintana.