A Comparison of the Frequency of Print Focused Strategies Implemented By Preschoolteachers During Story Time Reading Across Classroom Type and Book Type

The purpose of this study was to compare the frequency of print-focused strategies that preschool teachers implemented when reading to their class during story time. In particular, comparing the frequency across classrooms types and between book types. Eight preschools were studied, four of them for children at-risk and four for children not-at risk. The results indicate that there is no significant difference in the number of print-focused strategies based on classroom type. But teachers produced significantly more print-focused prompts when reading alphabet books compared to picture books

Boom and Bust: a Study Employing Principal Agency to Investigate the Behavior of Borrowers, Lenders, and Investors That Led to the Mortgage Crisis in 2007

In the biggest economic downturn since the Great Depression, the financial collapse of 2007 was a result of many economic factors. In particular, risky mortgage lending has been widely deemed the root cause of the financial crisis. In this research, borrower-lender and investor lender relationships are investigated using the Principal Agent Theory. It is hypothesized that a drastic increase in loan originations combined with deteriorating lending standards caused the eventual failure across the financial industry. Upon statistical analysis, this study provides evidence supporting the hypothesis based on data measured across one hundred metropolitan areas in 2010

Partial versus full sternotomy for aortic valve replacement.

BACKGROUND: Recent trends suggest that smaller incisions reduce postoperative morbidity. This study tests the hypothesis that a partial upper sternotomy improves patient outcome for aortic valve replacement. METHODS: A group of 50 patients who underwent aortic valve surgery through a partial upper sternotomy (group I) were compared to 50 patients who underwent aortic valve replacement through a median sternotomy during the same time period (group II). The mean age (60+/-2 versus 63+/-2 years; mean +/- SEM) and preoperative ejection fractions (53+/-2 versus 54+/-2) were similar. Operations were performed with central cannulation, and antegrade/retrograde blood cardioplegia. RESULTS: There was one death in each group. No differences were found in aortic occlusion time, mediastinal drainage, transfusion incidence, narcotic requirement, length of stay, or cost. The incidence of pleural and pericardial effusions was increased (18.4% versus 3.9%, p \u3c 0.03), and the need for postoperative inotropic support was higher (38.7% versus 19.6%, p \u3c 0.03) in the partial sternotomy group. CONCLUSIONS: Aortic valve replacement can be performed through a partial sternotomy with results comparable to full sternotomy. The partial sternotomy offers a cosmetic benefit, but does not significantly reduce postoperative pain, length of stay, or cost

Strategies and outcomes of cardiac surgery in Jehovah\u27s Witnesses.

BACKGROUND: Jehovah\u27s Witnesses (JW) are a Christian faith, with an estimated 1.1 million members in the United States, well recognized for their refusal of blood and blood products. JW may not be considered for cardiac surgery due to perceived higher risks of morbidity and mortality. This study reviews our contemporary strategies and experience with JW undergoing routine and complex cardiac surgery. METHODS: From November 2001 to April 2010, 40 JW were referred for cardiac surgery at a single quaternary referral institution. A retrospective analysis of demographic data, perioperative management, and clinical outcomes was examined. Published validated clinical risk calculator and model for prediction of transfusion were used to identify high-risk patients (risk of mortality \u3e6% or probability of transfusion \u3e0.80). RESULTS: The mean age was 70 (± 9.5) years with 21 men and 19 women. Patients were classified as high risk (45%, n = 18) and low risk (55%, n = 22) with demographics and comorbidities listed in Table 2. Operative procedures included: isolated coronary artery bypass grafting (CABG) (n = 19), isolated valve replacement/repair (n = 7), valve/CABG (n = 7), reoperative valve replacement (n = 4), reoperative CABG (n = 2), valve/ascending aorta replacement (n = 1), and CABG/ascending aorta replacement (n = 1). All JW were evaluated by The Department of Bloodless Medicine to individually define acceptable blood management strategies. The mean preoperative hemoglobin was 14.1 g/dL (±1.6). Overall mortality was 5% (n = 2) all of which were in the high-risk group. DISCUSSION: Using a multidisciplinary approach to blood management, JW can safely undergo routine and complex cardiac surgery with minimal morbidity and mortality

Recent Clinical Experience With Left Heart Bypass Using a Centrifugal Pump for Repair of Traumatic Aortic Transection

OBJECTIVE: To analyze the indications, results, and limitations of using left atrial to femoral artery (LA-FA) bypass to provide distal perfusion during repair of traumatic aortic injuries. SUMMARY BACKGROUND DATA: There is no consensus about the best method for repair of traumatic aortic transection. Distal aortic perfusion with LA-FA bypass and a centrifugal pump has been the authors’ preferred technique for injuries to the aortic isthmus and descending thoracic aorta. METHODS: From 1988 to 1998, the authors operated on 30 patients with traumatic aortic transection using LA-FA bypass. The mean age of the group was 36 ± 2 years. The mechanism of injury was from a motor vehicle accident in 97% of the cases. Distal aortic perfusion was maintained at 50 to 75 mm Hg with flow rates of 1.5 and 3 L/min. The mean aortic cross-clamp time was 38 ± 2 minutes, and the mean bypass time was 49 ± 2 minutes. RESULTS: No complications related to cannulation, arterial thromboembolism, renal failure, mesenteric ischemia, or hepatic insufficiency occurred. There were no cases of postoperative paraplegia and no deaths. CONCLUSION: Left atrial to femoral artery bypass is a safe, simple, and effective adjunct to the repair of traumatic injuries to the thoracic aorta. Active distal aortic perfusion preserves spinal cord, mesenteric, and renal blood flow and eliminates the potential catastrophic consequence of spinal cord ischemia from an unexpectedly prolonged aortic cross-clamp time