An Investigation of Conceptual Knowledge: Urban African American Middle School Students\u27 Use of Fraction Representations and Fraction Computations in Performance-Based Tasks

A relatively large number of 8th-grade public middle school students in the United States, particularly in urban communities, are not performing at acceptable levels in mathematics. One concept that poses significant difficulty for these students and negatively affects their overall mathematics achievement is fractions. Many researchers have attributed these difficulties primarily to traditional fraction instruction that emphasizes procedural rather than conceptual knowledge. Therefore this study was designed to investigate how students use their computational and conceptual knowledge and fraction representations to solve fraction-related performance-based mathematical tasks. Social constructivism was used as the theoretical framework in examining conceptual knowledge related to learning fractions. This qualitative study was implemented in an urban middle school in the southeast. It involved an initial sample of 37, 8th-grade, African American pre-algebra students who completed a fraction interest questionnaire and two fraction pretests. During the implementation period, 34 students in the researcher’s pre-algebra class completed three performance-based tasks, three reflection logs, and participated in an interview after completing each task. Of the 34 students who completed all tasks, three were purposefully selected as the informants for the study. In addition, observations, field notes, and artifacts (student work) were utilized to facilitate triangulation of the data. The findings of the study indicated the informants could compute fractions with an average of 85% of mastery but could conceptualize fractions only to a small extent. This validated prior findings and led to the conclusion that student deficiency with fractions results primarily from their level of conceptual knowledge. In the investigation of the ways in which 8th-grade students use fraction representations, this study found the informants used representations to develop a visual map of their mathematical thinking and reasoning and to check the accuracy of their computations. Therefore, this study suggests, when students’ mathematical learning experiences relative to fractions have not emphasized the use of representations to develop conceptual knowledge, they may not be comfortable with the accuracy of the solutions demonstrated in their fractions models

Shadow smoke: A nonfiction collection on memories lost, taken, and storied

Shadow Smoke investigates the neuroscientific nature of memory and memory’s role/ authority in creative nonfiction as an illustration of how the genre lays the process of memory bare and accurately models the mind’s process of memory. The scholarship as well as body of creative works revolve around the understanding and tension of memory being a creative process which is explored through genre discussions, neuroscientific studies, and individual creative works. Shadow Smoke consists of four braided nonfiction essays and five nonfiction vignettes to form a collection on memories lost, taken, and storied framed by a critically researched introduction assessing the collection’s alignment and originality in the genre at large. Each of the four creative nonfiction essays imagines those traces of stories that are not really ours, but can be, and should be and the neuroscientific backing of storytelling culture. Although self-contained, all four essays are connected thematically through their overlapping themes and focuses on family, region (West Virginia), memory, memory loss, storytelling, identity, and trauma. Lyric in nature, but research driven at their core each creative nonfiction piece focuses on the process of finding, but more so understanding, how to engage with the remnants of the Appalachian region’s and my family’s oral traditions. As the subtitle to the collection represents the represented essays: “Remembering Sophia Jane,” “Homeplace,” “Stories of the Broom Sage,” and the title essay, “Shadow Smoke” each grapple with the research and experience of memories lost, taken, and storied. Stories and writing are not functional. They are creative, expressive, flawed, and thankfully free from the pressure to capture exactly what happened. Free to imagine what happened and what those memories, or lack thereof, can mean

Unit costs of health and social care

Includes bibliographical referencesAvailable from British Library Document Supply Centre- DSC:9090. 785418(2002) / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Oral Manifestations of Syphilis: a Review of the Clinical and Histopathologic Characteristics of a Reemerging Entity with Report of 19 New Cases

Background Syphilis is a sexually-transmitted infectious disease caused by Treponema pallidum. Cases of primary and secondary syphilis are on the rise in the United States, with a 14.4% increase in new cases noted from 2017 to 2018 and an escalation of 71% between the years 2014 and 2018. Fulfilling its nickname of “the great imitator,” oral manifestations of syphilis may mimic a variety of infectious, neoplastic, or immune-mediated processes, both clinically and histopathologically. This large spectrum of appearances can create a diagnostic challenge to the clinician and/or pathologist, leading to delay in diagnosis or misdiagnosis. Methods A database of oral syphilis cases was created from archives at the University of Kentucky, University of Pittsburgh, LIJMC, Columbia University MC, and University of Tennessee. The age, sex, race, location, duration, and clinical description were recorded. Cases without positive reaction upon immunohistochemistry or serologic tests were excluded. Results We identified 19 new cases of oral syphilis (17 males, one female, and one case unknown sex) and described the clinical and histopathological features of this re-emerging and potentially fatal disease. All cases demonstrated dense lymphoplasmacytic inflammation, often with inflammatory exocytosis or ulceration at the surface, and perivascular inflammation. Conclusions Early recognition of the histopathologic and clinical manifestations of oral syphilis is imperative for prompt diagnosis, improved patient outcomes, and disease prevention

Challenges and opportunities in designing dementia-friendly communities with local governments

Background: Communities that do not accommodate the needs and preferences of people with dementia can exacerbate disability and isolation. Although dementia-friendly communities (DFCs) were established to foster understanding and acceptance of dementia, the built environment remains underexplored. We identified the challenges and opportunities for fostering dementia-enabling environments among community planners. Method: This study is set in South-West Sydney, Australia, where a DFC is being established. The policies of seven local governments were analysed for actions that aligned with Dementia Australia’s 41 DFC recommendations: 13 for social, 14 for outdoor, and 14 for indoor environments. An online workshop was then held with 30 community planners to raise awareness for dementia-enabling environments. Participants were surveyed about their dementia beliefs and attitudes. Facilitated discussions identified challenges and opportunities for designing DFCs. Qualitative and quantitative data across all sources were triangulated. Result: Although none of the local government policies specifically mentioned dementia, up to 20/41 DFC actions were met. Most of these were in social engagement (with ≤10/13 recommendations met by each local government). Less action was taken on outdoor and indoor environments (with ≤9/14 outdoor and ≤4/14 indoor recommendations met by up to six local governments). Although beliefs and attitudes about dementia among planners were generally positive, only 48% indicated that they had a good understanding of it and nearly 80% noted they would feel anxious and depressed about a diagnosis. Key DFC challenges included a lack of awareness and conflicting priorities between government bodies. Opportunities included engaging with universities to conduct demographically relevant awareness raising, facilitate multisectoral collaboration, developing an evidence-base, and involving service providers to engage with the dementia community. Conclusion: This study triangulated data to identify gaps in community planning efforts, confirming that more action is required to design dementia-friendly communities. We are now leading a multisectoral collaboration to educate community planners and the public, and are advocating for the recognition of dementia-friendly environments in government plans. This study provides practical guidance to assist planners with DFC designs

Cardiovascular Hospitalizations and Resource Use Following Atrial Fibrillation Ablation

Background Over the next few years, atrial fibrillation (AF)–related morbidity and costs will increase significantly. Thus, it is prudent to examine the impact of AF treatment on health care resource use. This study examined the impact of AF ablation on hospitalization, length of stay, and resource use for patients undergoing AF ablation in a multihospital system. Methods and Results In an observational analysis, outcomes of total, cardiovascular, and AF hospitalizations, emergency department visits, and length of stay were compared for 3417 patients between 12 months before and 24 months following AF ablation. Use of electrical cardioversions and antiarrhythmic use were also compared 1 year before to 2 years after AF ablation. There were fewer total (0.7±1.3 versus 0.3±0.7; P<0.001), cardiovascular (0.7±1.2 versus 0.2±0.6; P<0.001), and AF (0.6±1.1 versus 0.1±0.3; P<0.001) hospitalizations and emergency department visits (0.8±2.1 versus 0.4±0.9; P<0.001) per patient‐year for the 2 years following AF ablation compared with 1 year before. Average length of stay per patient‐year (1.4±7.9 versus 3.6±5.3 days; P<0.0001), the percentage of patients on antiarrhythmic therapy (21.2% versus 58.5%; P<0.0001), and those undergoing electrical cardioversions (16.1% versus 28.1%; P<0.0001) were lower 2 years following AF ablation versus 1 year before. Conclusions We noted a decrease in total, cardiovascular, and AF hospitalizations and health care resource use during the 2‐year period after index AF ablation, compared with the 1 year before. AF ablation may portend a decline in patient morbidity and health care costs

How to co-create a multicultural dementia education initiative

Background: Culturally and linguistically diverse (CALD) people affected by dementia have poorer health outcomes and experience greater social exclusion than their non-CALD counterparts. These disparities are worsened by: linguistic barriers; inaccessible and culturally inappropriate education about dementia and relevant support services; and stigma. This is especially prominent in the multicultural South Western Sydney region, where over 12,500 residents are already living with dementia, and dementia prevalence is forecast to increase at the highest rate in NSW by 2050: up to 460 % in some local government areas. Culturally sensitive education about dementia is needed, but no such programs exist here. Objective: We aimed to co-create a dementia education initiative that was accessible, culturally sensitive, and tailored to meet the needs of English, Arabic, Vietnamese, Chinese, and Greek-speaking communities. Methods: We established a Dementia Alliance comprising representatives from the local dementia support group, council, university, and multicultural service providers. Through a series of co-creation workshops with English, Arabic, Vietnamese, Chinese, and Greek-speaking alliance members, we mapped out the education program’s content, structure, format, and evaluation methods to suit all cultural groups. This research discusses the barriers and enablers of disseminating useable and accessible dementia information. Findings: The Dementia Alliance adapted the global Dementia Friends initiative for multicultural delivery. The co-creation workshops revealed the following barriers to uptake of information: the stigmatised translations of ‘dementia’; lengthy duration (>2 hrs); online delivery; and long, high-literacy evaluation surveys. The key enablers were: advertising the education program as a ‘memory information session’; using trained bilingual educators along with an academic co-facilitator; acknowledging stigma; durations <2 hrs; in-person, oral delivery; and using plain language paper-based evaluation surveys with <30 items. Conclusion: Co-creating a multicultural dementia education program with information that is useable and accessible by CALD communities and service providers is feasible through partnerships. This work offers practical insights into knowledge mobilisation in multicultural settings and can be applied to other areas of health where disparities exist