Colostomy closure: how to avoid complications

Purpose: Colostomy is an operation frequently performed in pediatric surgery. Despite its benefits, it can produce significant morbidity. In a previous publication we presented our experience with the errors and complications that occurred during cases of colostomy creation. We now have focused in the morbidity related to the colostomy closure. The technical details that might have contributed to the minimal morbidity we experienced are described. Methods: The medical records of 649 patients who underwent colostomy closure over a 28-year period were retrospectively reviewed looking for complications following these procedures. Our perioperative protocol for colostomy closure consisted in: clear fluids by mouth and repeated proximal stoma irrigations 24 h prior to the operation. Administration of IV antibiotics during anesthesia induction and continued for 48 h. Meticulous surgical technique that included: packing of the proximal stoma, plastic drape to immobilize the surgical field, careful hemostasis, emphasis in avoiding contamination, cleaning the edge of the stomas to allow a good 2-layer, end-to-end anastomosis with separated long-term absorbable sutures, generous irrigation of the peritoneal cavity and subsequent layers with saline solution, closure by layers to avoid dead space, and avoidance of hematomas. No drains and no nasogastric tubes were used. Oral fluids were started the day after surgery and patients were discharged 48-72 h after the operation. Results: The original diagnoses of the patients were: anorectal malformation (583), Hirschsprung\u27s disease (53), and others (13). 10 patients (1.5%) had complications: 6 had intestinal obstruction (5 due to small bowel adhesions, 1 had temporary delay of the function of the anastomosis due to a severe size discrepancy between proximal and distal stoma with a distal microcolon) and 4 incisional hernias. There were no anastomotic dehiscences or wound infection. There was no bleeding, no anastomotic stricture and no mortality. Conclusion: Based on this experience we believe that colostomy closure can be performed with minimal morbidity provided a meticulous technique is observed. © 2010 The Author(s)

Breeding productivity, nest-site selection and conservation needs of the endemic Turkestan Ground-jay Podoces panderi

The Turkestan Ground-jay Podoces panderi, a corvid endemic to the deserts of Central Asia, is both understudied and under-protected. Using standardised nest-monitoring protocols and nest cameras, we estimated its breeding productivity for the first time as 0.586 fledglings per nesting attempt (inter-quartile range, IQR 0.413‒0.734), strongly constrained by a diverse set of predator species (accounting for 88% of failures), supporting the broad pattern that a wide spectrum of nest predators operate in arid environments. The probability of nest success for the 35 days from the start of incubation to fledging was low, 0.186 ± 0.06 se (N = 37), with no influence of season date, nest height or nest shrub species. However, pervasive shrub harvest severely limited availability of taller shrubs for nest-site selection, and thus our ability to detect any effect of height on nest survival. Mean clutch size was 4.8 ± 0.8 sd while hatching probability of an egg from a clutch surviving incubation was 0.800 ± 0.050 se and fledging probability was 0.824 ± 0.093 se for individual chicks in successful nests (i.e. that fledged one or more chicks). Two shrub genera, saxaul Haloxylon spp. and Calligonum spp., were used for nesting more frequently than expected (χ152 = 784.02, P < 0.001), highlighting their importance to breeding habitat suitability. This near-sole reliance on these taller shrub genera, both targeted for illegal cutting, indicates that habitat degradation may lead to increased predation and declines in productivity. Habitat conservation is, therefore, likely to be the most important management strategy for the species and other components of desert systems, as management of so diverse a set of nest predators would be both impractical and inappropriate

Hidden expectations: Scaffolding subject specialists' genre knowledge of the assignments they set

Subject specialists’ knowledge of academic and disciplinary literacy is often tacit. We tackle the issue of how to elicit subject specialists’ tacit knowledge in order to develop their pedagogical practices and enable them to communicate this knowledge to students. Drawing on theories of genre and metacognition, a professional development activity was designed and delivered. Our aims were to (1) build participants’ genre knowledge and (2) scaffold metacognitive awareness of how genre knowledge can enhance their pedagogical practices. The findings reveal that participants built a genre-based understanding of academic literacy and that the tasks provided them with an accessible framework to articulate and reflect upon their knowledge of disciplinary literacy. Participants gained metacognitive awareness of misalignments between what they teach and what they expect from students, their assumptions about students’ prior learning and genre-based strategies to adapt their practice to students’ needs. Our approach provides a theoretically grounded professional development tool for the HE sector

Preface for the IJSME Special Issue: Metacognition for Science and Mathematics Learning in Technology-Infused Learning Environments

The final publication is available at Springer via http://dx.doi.org/10.1007/s10763-016-9727-9

The learning styles neuromyth:when the same term means different things to different teachers

Alexia Barrable - ORCID: 0000-0002-5352-8330 https://orcid.org/0000-0002-5352-8330Although learning styles (LS) have been recognised as a neuromyth, they remain a virtual truism within education. A point of concern is that the term LS has been used within theories that describe them using completely different notions and categorisations. This is the first empirical study to investigate education professionals’ conceptualisation, as well as means of identifying and implementing LS in their classroom. A sample of 123 education professionals were administered a questionnaire consisting both closed- and open-ended questions. Responses were analysed using thematic analysis. LS were found to be mainly conceptualised within the Visual-Auditory-(Reading)-Kinaesthetic (VAK/VARK) framework, as well as Gardner’s multiple intelligences. Moreover, a lot of education professionals confused theories of learning (e.g., behavioural or cognitive theories) with LS. In terms of identifying LS, educators reported using a variety of methods, spanning from observation and everyday contact to the use of tests. The ways LS were implemented in the classroom were numerous, comprising various teaching aids, participatory techniques and motor activities. Overall, we argue that the extended use of the term LS gives the illusion of a consensus amongst educators, when a closer examination reveals that the term LS is conceptualised, identified and implemented idiosyncratically by different individuals. This study aims to be of use to pre-service and in-service teacher educators in their effort to debunk the neuromyth of LS and replace it with evidence-based practices.https://doi.org/10.1007/s10212-020-00485-236pubpub

Physical Methods for the Preparation of Hybrid Nanocomposite Polymer Latex Particles

In this chapter, we will highlight conceptual physical approaches towards the fabrication of nanocomposite polymer latexes in which each individual latex particle contains one or more "hard" nanoparticles, such as clays, silicates, titanates, or other metal(oxides). By "physical approaches" we mean that the "hard" nanoparticles are added as pre-existing entities, and are not synthesized in situ as part of the nanocomposite polymer latex fabrication process. We will narrow our discussion to focus on physical methods that rely on the assembly of nanoparticles onto the latex particles after the latex particles have been formed, or its reciprocal analogue, the adhesion of polymer onto an inorganic nanoparticle. First, will discuss the phenomenon of heterocoagulation and its various driving forces, such as electrostatic interactions, the hydrophobic effect, and secondary molecular interactions. We will then address methods that involve assembly of nanoparticles onto or around the more liquid precursors (i.e., swollen/growing latex particles or monomer droplets). We will focus on the phenomenon of Pickering stabilization. We will then discuss features of particle interaction with soft interfaces, and see how the adhesion of particles onto emulsion droplets can be applied in suspension, miniemulsion, and emulsion polymerization. Finally, we will very briefly mention some interesting methods that make use of interface-driven templating for making well-defined assembled clusters and supracolloidal structures