Patella intraosseous blood flow disturbance during a medial or lateral arthrotomy in total knee arthroplasty: a laser Doppler flowmetry study

Patella complications are recognized sequelae of total knee arthroplasty (TKA). Disruption of blood flow to the patella and adjacent soft tissues during surgery may contribute to reduced viability of the bone and patella ligament tissue. The effect on genicular blood flow to the medial and lateral patella was compared for a medial (MA) and lateral arthrotomy (LA) during TKA. Laser Doppler flowmetry was used to measure both baseline and postarthrotomy flow in vivo for 16 primary TKA patients. Flow in the lateral patella was reduced approximately 20% for both MA and LA. Conversely, the use of MA resulted in substantial reduction in flow to the medial patella (53%) compared to the lateral approach (27%). A large standard deviation of scores was evident in all cases. Although there was a tendency for LA to disturb the patellar blood flow less, the difference was not significant. It was concluded that neither approach is superior regarding the blood flow preservation to the patella. Hence, a lateral approach might only have an advantage in knee joints that are likely to need a lateral release in combination with an MA—e.g., a valgus deformity or preoperative patella maltrackin

An Examination of Teachers’ Perceptions of the Literacy By 3 Reading Program

Literacy By 3 (LB3) was created by administrators in a Southeastern U.S. school district to address 3rd graders’ low reading achievement. Little was understood about experiences, instructional practices, and perceptions of LB3 reading literacy teachers and coaches. The purpose of this basic qualitative study was to explore teachers’ and coaches’ experiences, instructional practices, and perceptions with LB3. The conceptual framework was based on Cooperrider’s and Srivastva’s concept of appreciative inquiry that defines organization’s progress contingent on development of its successes. Research questions focused on teachers’ and coaches’ experiences, instructional practices, and perceptions using LB3 to improve reading literacy and what elements of the program linked to improved reading literacy. Purposive sampling was used to select eight reading teachers and four reading coaches, who taught LB3 for at least one year, to participate in semistructured interviews. Emergent coding analysis revealed that participants perceived LB3 to work well, although some program components were not used at times. Teachers and coaches reported that LB3 facilitated improved differentiated instructional practices and reading literacy through phonics, read-alouds, guided and independent reading, and writing instruction. Teachers expressed the need to see LB3 instruction modeled by trainers during professional development sessions. Coaches stated that successful teachers should serve as these models. Findings helped to create a 3-day LB3 district-wide training. Results could contribute to positive social change by guiding teachers’ and coaches’ efforts to improve reading curricula which could contribute to a better quality of life for students through the increase of reading literacy skills

“I’ve Devoted My Entire Life to My Daughter—and She Knows It”: Exploration of Identity Development Among Now-Adult Navajo Native American Adolescent Mothers

n 1992 (n = 21) and 1995 (n = 8), the principal investigator collected data from 29 reservation-residing Navajo Native American teenage mothers. A primary goal of the 1992 and 1995 investigations (Time 1) was to examine the identity status of the young women in relation to commitment to the maternal role using Marcia’s (1980) framework. Results revealed that an approximately equal number of participants could be classified as achieved, moratorium, foreclosed, and diffused (see Dalla, 2000). In 2007 (Time 2), the principal investigator returned to collect follow-up data at the Navajo Reservation, where she interviewed 21 (72%) of the original 29 women. Using a qualitative research strategy, the primary goal of this investigation was to examine developmental trajectories of participants’ identity status in relation to four significant life domains (i.e., maternity, intimate relationships, work/ occupation, and culture). The frequencies of the identity achievement status were higher at Time 2 than at Time 1, and this identity status was also more stable than the other statuses. Findings supported the expectation that presence in the identity achievement status would be positively associated with well-being, whereas the identity diffusion status has a negative association with such functioning. The authors discuss suggestions for continued research and application of findings

Introducing the Medical Ethics Bowl

Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula

Teacher perceptions of factors influencing middle school student achievement

The purpose of this case study was to examine an urban middle school demonstrating increased student academic achievement gains and success in helping adolescent students prepare for high school. The research also set out to identify key programs, practices, and instructional strategies that teachers in the study site identified as having a positive impact on student academic, social development, and high school preparedness. Furthermore, this study sought to uncover themes emerging from the examination the programs, practices and instructional strategies identified at the case study school associated with raising student achievement. The focus of the study was narrowed to three key factors associated with student academic success including school-wide programs school-wide practices, and instructional practices. The school selected for this case study was an excellent exemplar of a successful urban middle school dedicated to increasing student achievement for several reasons. Being a part of the relatively large urban district, the school is located in a primarily low socioeconomic neighborhood. The school demonstrates high success in increasing student achievement as can be seen in a three-year trend in academics as measured by the North Carolina Standardized Testing and Reporting Program. has met or exceeded the criteria set for this study defining it as a high performing school for the last three academic years, having made steady academic performance improvement over the past several years as measured by the California Standardized Testing and Reporting Program. The inquiry method employed for this study was the case study approach. Documents were reviewed, observational field notes of site visits were taken, and structured, open-ended interview questions were utilized to uncover factors positively affecting student achievement. A total of nine teachers, one administrator and one curriculum facilitator participated in the interview process. To ensure effective triangulation of the research data, a quantitative survey was used to support the principals' and teachers' interview responses. A total of 12 teachers at the case study school completed the questionnaire surveys. Data analysis uncovered three major themes associated with increasing student achievement, including a culture of support for students, the setting of high academic expectations for students, and the establishment of school-wide systems and structures. Use of Bolman and Deal's four frames paradigm provided the theoretical support for the analysis, interpretation of the data gathered at the case study school, and identification of implications for further study

BELEID VIR MIDDELMISBRUIK IN HOËRSKOLE

Substance abuse amongst the youth is a growing concern in South Africa. There is also a need for schools to formulate a policy and to design programmes to deal with substance abuse in schools. The aim of this paper is to present some of the perceptions of learners on the relevance of formulating a policy for substance abuse in a school. The rest of the paper is devoted to a problem-solving model which can be used in the process of policy formulation. Recommendations are made that can be used by schools when formulating a policy for substance abus