The effectiveness of different minimally invasive epiphysiodesis techniques in the management of paediatric leg length discrepancies: a systematic review

Paediatric leg length discrepancies (LLDs) are more common than might be expected with the literature reporting that between 0.1 and 7% of the paediatric population has a LLD of >2 cm. Causes can be subdivided into congenital and acquired aetiologies. LLDs greater than 2 cm can lead to functional complications such as altered gait kinetics and abnormal loading of joints. For children predicted to have a LLD of 2-5 cm, minimally invasive epiphysiodesis (MIE) is the current management of choice. Presently, there are four MIE techniques commonly used throughout the world, however, no systematic reviews have compared these techniques. The objective of this thesis was to conduct a systematic review to synthesise the best available evidence on the use of MIE for the management of paediatric LLD. The effectiveness of four different techniques was compared: percutaneous epiphysiodesis using transphyseal screws (PETS); physeal drilling and curettage (PDC); physeal stapling; and guided growth with eight-Plates. Studies that evaluated two or more of the interventions or those that investigated a single intervention were considered for inclusion. Primary outcomes for the review included absolute LLD at skeletal maturity; rate of correction; percentage of correction; and incidence of long term complications. This review found that all techniques were sufficient at reducing the burden of a LLD with the mean final LLD of each being calculated to be <2 cm. Despite this, the rate of complications was higher in the eight-Plates and staples groups than the PDC and PETS groups. The PETS cohort had a reported failure of growth plate arrest (GPA) of 2.5% compared with 6% in the PDC and staples groups and 14% in the eight-Plate groups. The rate of inadequate correction (i.e. over or under correction), were also higher in the eight-Plate and staples groups (15% and 23%, respectively) than the PETS and PDC groups (8% and 13%, respectively). The incidence of angular deformities was much higher in the staples cohort (33%) than in the other groups (PDC 2%; PETS 9%; and eight-Plates 5%). The incidence of acute complications, such as haematoma, infection and acute knee pain, was similar across all techniques. Unfortunately, the overall level of evidence was low, due to the suboptimal and heterogeneous nature of the study designs included in this systematic review, and thus, treatment guidelines could not be developed. Notwithstanding this, the available evidence showed that all the evaluated techniques can adequately reduce a LLD, although PDC and PETS appear to be more effective at this. Further research is required to substantiate these claims; for now, all techniques remain an acceptable technique for addressing LLDs of 2-5 cm.Thesis (MClinSc) -- University of Adelaide, Adelaide Medical School, 201

Learning in Context: Women in Transition from Situations of Domestic Violence

This empirical study explores learning among women in a transitional housing program for women and children who have experienced domestic violence. It situates this learning in the context of the women\u27s lives, the program structure, and larger socioeconomic factors

The Effect of Different Training Regimens on Improved Sound Frequency Discrimination in Wistar Rats

Rat subjects were randomly assigned to one of three groups. The rats were presented with differing patterns of target and non-target frequencies, with the target remaining constant between groups while the non-target varied between groups. The rats were rewarded with food for successful bar presses while the target tone was playing, and no reinforcement was delivered for presses that occurred during the non-target tone. The groups were labeled as Control, Rapid, and Gradual. The control group experienced a silence in the place of non-target tone, while the rapid and gradual groups received the same tone in the beginning, but the rate of tone change differed throughout the training process. The test phase involved all three groups experiencing a multitude of different tones, with correct versus incorrect responses monitored. Researchers hypothesized that the rats that received the intensive training provided by the gradual method would exhibit a greater attunement in discriminative ability when compared to both the rapid and control groups

Children's processing and comprehension of complex sentences containing temporal connectives:the influence of memory on the time course of accurate responses

In a touch screen paradigm, we recorded 3- to 7-year-olds’ (N = 108) accuracy and response times to assess their comprehension of two-clause sentences containing before and after. Children were influenced by order: performance was most accurate when the presentation order of the two clauses matched the chronological order of events: ‘She drank the juice, before she walked in the park’ (chronological order) vs ‘Before she walked in the park, she drank the juice’ (reverse order). Differences in response times for correct responses varied by sentence type: accurate responses were made more speedily for sentences that afforded an incremental processing of meaning. An independent measure of memory predicted this pattern of performance. We discuss these findings in relation to children’s knowledge of connective meaning and the processing requirements of sentences containing temporal connectives

Targeted STR and SNP in-field sequencing by Oxford Nanopore MinION™ for the identification of an individual in a military scenario

The requirement for DNA evidence in forensics has increased, meaning the demand for DNA typing has also increased. Current analytical processes for DNA evidence are known to be costly and time-consuming and traditionally occur at a centralised laboratory which can impact on the amount of time from sample collection to DNA profile generation. Therefore, research has focused on creating technologies that are capable of in-field analysis. Oxford Nanopore Technologies developed MinION™, a portable, cost-effective nanopore sequencer that is capable of in-field analysis. The development of in-field sequencing technologies is favourable for isolated and remote communities where traditional laboratory environments are not feasible. Furthermore, the development of these processes is favourable as backlogs and costs with traditional methods can be reduced. In-field sequencing also has the potential to be used in a range of disciplines including personal healthcare, pathogen identification and disaster victim identification. With the advancement of sequencing technologies research has also focused on how to increase the discriminatory power of DNA typing with the selection of alternative markers specific for human identification. This review will investigate current sequencing technologies and techniques as well as evaluating current targets for DNA analysis

Looking Back in Order to Move Forward: Lessons from COVID-19 for Teacher Education

This article provides critical perspectives on education technology integration in a teacher education context in a post-pandemic world. The authors—two early career teachers, one in a pre-school and one in an elementary school, and two elementary teacher education faculty members at a mid-sized public university—use the U.S. Department of Education’s 2016 guiding principles for educational technology in teacher education for analysis. The commentary evolves directly from and reflects the authors’ collective experience across the P-20 spectrum in education technology, with close attention paid to what was learned during the onset of the COVID-19 pandemic and subsequent pivot to remote learning in spring 2020, which altered the teacher education landscape in significant ways. This article makes curricular and pedagogical suggestions for P-20 educators, and concludes with recommendations for future research at the intersection of technology integration and teacher education