A vision for administering schools: A reflective essay

Education can be restructured through strategic leadership, curriculum, evaluation, collaboration, vision, site-based management, technology, reflection, finance and life 1 long learning. Following are some of the points on how a personal vision on restructuring in education may be a success. This vision could be a framework that guides me and others through the many daily situations faced in schools, and it will provide direction in a less random and more thoughtful way. Barth (1990) wrote: Expanding the vision within the school house is an enterprise that will create schools with room enough for all of us to live and work and have our children learn. When we create schools that, we value, for our children and for ourselves, we will have created schools of value to others as well. (p.516) This vision will be a set of long-term planning ideas that would address what \u27should be\u27 achieved in schools based on the individual needs of the school

Chronic instability of the anterior tibiofibular syndesmosis of the ankle. Arthroscopic findings and results of anatomical reconstruction

<p>Abstract</p> <p>Background</p> <p>The arthroscopic findings in patients with chronic anterior syndesmotic instability that need reconstructive surgery have never been described extensively.</p> <p>Methods</p> <p>In 12 patients the clinical suspicion of chronic instability of the syndesmosis was confirmed during arthroscopy of the ankle. All findings during the arthroscopy were scored. Anatomical reconstruction of the anterior tibiofibular syndesmosis was performed in all patients. The AOFAS score was assessed to evaluate the result of the reconstruction. At an average of 43 months after the reconstruction all patients were seen for follow-up.</p> <p>Results</p> <p>The syndesmosis being easily accessible for the 3 mm transverse end of probe which could be rotated around its longitudinal axis in all cases during arthroscopy of the ankle joint, confirmed the diagnosis. Cartilage damage was seen in 8 ankles, of which in 7 patients the damage was situated at the medial side of the ankle joint. The intraarticular part of anterior tibiofibular ligament was visibly damaged in 5 patients. Synovitis was seen in all but one ankle joint. After surgical reconstruction the AOFAS score improved from an average of 72 pre-operatively to 92 post-operatively.</p> <p>Conclusions</p> <p>To confirm the clinical suspicion, the final diagnosis of chronic instability of the anterior syndesmosis can be made during arthroscopy of the ankle. Cartilage damage to the medial side of the tibiotalar joint is often seen and might be the result of syndesmotic instability. Good results are achieved by anatomic reconstruction of the anterior syndesmosis, and all patients in this study would undergo the surgery again if necessary.</p

Economic Inequality and Science, Technology and Innovation Policy: the cases of the United Kingdom and South Africa

There is growing evidence that technology-driven economic growth has a signficant role to play in growing inequality in industrialised countries. Examining innovation policies in South Africa (the G20 Country with the highest levels of inequality) and the UK (inequality at the G20 average), we ask whether the role of innovation in driving inequality is being addressed in STI policy, what measures might be neglected, and why innovation and distribution sensitive policies take the form they do. We find that the distributional consequences of innovation do receive attention in innovation policies in the two countries, albeit in different (and sometimes suprising) ways. However, the approaches taken are limited to a focus on the ‘firm’ as the model for technology transfer, with little evidence of moves to share assets. These differences and oversights, we argue, are the result of particular sociotechnical imaginaries shaping the role of science and innovation in national life

Interobserver and intraobserver variability in the radiological assessment of sialolithiasis using cone beam computed tomography

BACKGROUND: Data regarding the inter- and intraobserver variability in the radiological assessment of sialolithiasis using cone beam computed tomography are missing in the current literature. This study assessed the inter- and intraobserver variability in the radiological assessment of sialolithiasis using cone beam computed tomography (CBCT). MATERIAL AND METHODS: In 107 patients, 130 salivary glands (65 parotid and 65 submandibular) with clinical signs of obstruction were assessed by four independent observers; 2 residents OMFS and 2 experienced OMFS. The observers analyzed the CBCT images and determined the absence or presence of one or more salivary stones in the affected gland. This procedure was repeated after three months. RESULTS: Interobserver agreements showed kappa values of 0.84 for the parotid gland, and 0.93 for the submandibular gland. Intraobserver agreements for the whole group reported kappa values between 0.83 - 0.95. There was no significant difference between residents and experienced OMFS. CONCLUSIONS: Due to the good inter- and intraobserver agreement, CBCT appears to be a reproducible imaging modality for detecting salivary stones in patients with signs and symptoms of obstructed parotid and submandibular glands. Key words:Salivary gland calculi, cone-beam computed tomography, observer variation

An international multicentre evaluation of treatment strategies for combined hepatocellular-cholangiocarcinoma

BACKGROUND & AIMS: Management of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is not well-defined. Therefore, we evaluated the management of cHCC-CCA using an online hospital-wide multicentre survey sent to expert centres. METHODS: A survey was sent to members of the European Network for the Study of Cholangiocarcinoma (ENS-CCA) and the International Cholangiocarcinoma Research Network (ICRN), in July 2021. To capture the respondents\u27 contemporary decision-making process, a hypothetical case study with different tumour size and number combinations was embedded. RESULTS: Of 155 surveys obtained, 87 (56%) were completed in full and included for analysis. Respondents represented Europe (68%), North America (20%), Asia (11%), and South America (1%) and included surgeons (46%), oncologists (29%), and hepatologists/gastroenterologists (25%). Two-thirds of the respondents included at least one new patient with cHCC-CCA per year. Liver resection was reported as the most likely treatment for a single cHCC-CCA lesion of 2.0-6.0 cm (range: 73-93%) and for two lesions, one up to 6 cm and a second well-defined lesion of 2.0 cm (range: 60-66%). Nonetheless, marked interdisciplinary differences were noted. Surgeons mainly adhered to resection if technically feasible, whereas up to half of the hepatologists/gastroenterologists and oncologists switched to alternative treatment options with increasing tumour burden. Fifty-one (59%) clinicians considered liver transplantation as an option for patients with cHCC-CCA, with the Milan criteria defining the upper limit of inclusion. Overall, well-defined cHCC-CCA treatment policies were lacking and management was most often dependent on local expertise. CONCLUSIONS: Liver resection is considered the first-line treatment of cHCC-CCA, with many clinicians supporting liver transplantation within limits. Marked interdisciplinary differences were reported, depending on local expertise. These findings stress the need for a well-defined multicentre prospective trial comparing treatments, including liver transplantation, to optimise the therapeutic management of cHCC-CCA. IMPACT AND IMPLICATIONS: Because the treatment of combined hepatocellular-cholangiocarcinoma (cHCC-CCA), a rare form of liver cancer, is currently not well-defined, we evaluated the contemporary treatment of this rare tumour type through an online survey sent to expert centres around the world. Based on the responses from 87 clinicians (46% surgeons, 29% oncologists, 25% hepatologists/gastroenterologists), representing four continents and 25 different countries, we found that liver resection is considered the first-line treatment of cHCC-CCA, with many clinicians supporting liver transplantation within limits. Nonetheless, marked differences in treatment decisions were reported among the different specialties (surgeo

Institutional work as a key ingredient of food innovation success: The case of plant-based proteins

In this paper, we use the theory of institutional work to understand how plant-based meat substitutes emerge and successfully diffuse in the context of a dominant meat regime in the United States (US). We observe that institutional factors such as norms, habits, values, and beliefs play a more vital role than previously identified. Therefore, we utilize institutional work theory combined with insights from technological innovation systems to create a holistic understanding of this transition. We study the American plant-based protein industry from 1978 to 2019. We conduct a qualitative event-history analysis based on 2345 events from the Nexis Uni database. We observe that by strategically deploying institutional work strategies aimed at creating, maintaining, and disrupting institutions and innovation system-building strategies, innovation system actors created a favorable environment in which meat alternatives can flourish