Deweyan tools for inquiry and the epistemological context of critical pedagogy

This article develops the notion of resistance as articulated in the literature of critical pedagogy as being both culturally sponsored and cognitively manifested. To do so, the authors draw upon John Dewey\u27s conception of tools for inquiry. Dewey provides a way to conceptualize student resistance not as a form of willful disputation, but instead as a function of socialization into cultural models of thought that actively truncate inquiry. In other words, resistance can be construed as the cognitive and emotive dimensions of the ongoing failure of institutions to provide ideas that help individuals both recognize social problems and imagine possible solutions. Focusing on Dewey\u27s epistemological framework, specifically tools for inquiry, provides a way to grasp this problem. It also affords some innovative solutions; for instance, it helps conceive of possible links between the regular curriculum and the study of specific social justice issues, a relationship that is often under-examined. The aims of critical pedagogy depend upon students developing dexterity with the conceptual tools they use to make meaning of the evidence they confront; these are background skills that the regular curriculum can be made to serve even outside social justice-focused curricula. Furthermore, the article concludes that because such inquiry involves the exploration and potential revision of students\u27 world-ordering beliefs, developing flexibility in how one thinks may be better achieved within academic subjects and topics that are not so intimately connected to students\u27 current social lives, especially where students may be directly implicated

Comparing the costs of stroke subtypes: a cost of illness study

© 2000 Dr. Helen Margaret DeweyWorldwide, stroke is the second leading cause of death and one of the most important causes of disability. Stroke is responsible for about 4% of the total costs of disease in Australia. Apart from this study, there are no data about the patterns of health care and community resource use among distinct subtypes of stroke patients in Australia. The role of informal carers in the care of stroke survivors has not previously been investigated, and, with the exception of this study, there are no Australian data about the costs personally incurred by patients and their carers for stroke-related medical and community services. A community-based stroke incidence study conforming to 'ideal' methodology was conducted in urban Melbourne (population 133,816) during 1996 and 1997. All registered cases (380 events in 352 persons) were classified into distinct stroke subtypes. The crude annual incidence rate (first-ever strokes) was 206 per 100,000 per year. Details of stroke-related resource use during the first 12 months after stroke were obtained for 165 cases. Methods included face-to-face interviews conducted by research nurses with patients and carers. An incidence-based cost-of-illness model was developed which linked subtype-specific incidence rates, mortality rates and resource use data. The total first year costs and the present value of total lifetime costs for all first-ever-in-a-lifetime stroke cases occurring in Australia in 1997 were estimated to be $A541.3 million and$A1.3 billion respectively. The average total costs during the first year and the average present value of total costs over a lifetime following first-ever-in-a-Iifetime stroke were $18,483/case and$43,565/case respectively. The estimated total cost of inpatient rehabilitation for all first-ever-in-a-lifetime stroke cases occurring in Australia in 1997 was $A150 million. This is similar to the total cost of hospitalisation for acute stroke care and approximately twice that of a previous estimate. The 'time costs' of informal care provided by relatives and friends represented about 4% of total first year costs and 14% of total lifetime costs for first-ever-in-a-lifetime strokes. Virtually all surviving stroke cases reported 'out of pocket' costs as a consequence of stroke. The largest costs were for home modifications, private nursing care and aids and equipment. A clear relationship between stroke subtype and cost was demonstrated. During the first year after stroke, although the average cost per case was similar for cerebral infarction and intracerebral haemorrhage, large cost differences were demonstrated between subtypes of cerebral infarction. The most expensive infarct subtype was Total Anterior Cerebral Infarction (TACI) and the least expensive was Lacunar Infarction (LACI). On average, cases of TACI costed 1.8 times as much as cases of LACI. Over a lifetime, on average, cases of intracerebral haemorrhage costed 1.7 times as much as cases of cerebral infarction and cases of LACI cost two-thirds as much as TACI. This is the first comprehensive description of the patterns and costs of stroke care during the first year after stroke in Australia. Given the magnitude of the costs of stroke rehabilitation in this study, formal evaluation of the cost-effectiveness of these services needs to become a research priority

Discovery and Longitudinal Evaluation of Candidate Biomarkers for Ischaemic Stroke by Mass Spectrometry-Based Proteomics

Application of acute therapies such as thrombolysis for ischaemic stroke (IS) is constrained because of diagnostic uncertainty and the dynamic nature of stroke biology. To investigate changes in blood proteins after stroke and as a result of thrombolysis treatment we performed label-free quantitative proteomics on serum samples using high-resolution mass spectrometry and long high-performance liquid chromatography gradient (5 hours) combined with a 50-cm column to optimise the peptide separation. We identified (false discovery rate [FDR]: 1%) and quantified a total of 574 protein groups from a total of 92 samples from 30 patients. Ten patients were treated by thrombolysis as part of a randomised placebo-controlled trial and up to 5 samples were collected from each individual at different time points after stroke. We identified 26 proteins differently expressed by treatment group (FDR: 5%) and significant changes of expression over time for 23 proteins (FDR: 10%). Molecules such as fibrinogen and C-reactive protein showed expression profiles with a high-potential clinical utility in the acute stroke setting. Protein expression profiles vary acutely in the blood after stroke and have the potential to allow the construction of a stroke clock and to have an impact on IS treatment decision making

Hyperacute changes in blood mRNA expression profiles of rats after middle cerebral artery occlusion: Towards a stroke time signature.

Stroke evolution is a highly dynamic but variable disease which makes clinical decision making difficult. Biomarker discovery programs intended to aid clinical decision making have however largely ignored the rapidity of stroke evolution. We have used gene array technology to determine blood mRNA expression changes over the first day after stroke in rats. Blood samples were collected from 8 male spontaneously hypertensive rats at 0, 1, 2, 3, 6 and 24h post stroke induction by middle cerebral artery occlusion. RNA was extracted from whole blood stabilized in PAXgene tubes and mRNA expression was detected by oligonucleotide Affymetrix microarray. Using a pairwise comparison model, 1932 genes were identified to vary significantly over time (p≤0.5x10(-7)) within 24h after stroke. Some of the top20 most changed genes are already known to be relevant to the ischemic stroke physiopathology (e.g. Il-1R, Nos2, Prok2). Cluster analysis showed multiple stereotyped and time dependent profiles of gene expression. Direction and rate of change of expression for some profiles varied dramatically during these 24h. Profiles with potential clinical utility including hyper acute or acute transient upregulation (with expression peaking from 2 to 6h after stroke and normalisation by 24h) were identified. We found that blood gene expression varies rapidly and stereotypically after stroke in rats. Previous researchers have often missed the optimum time for biomarker measurement. Temporally overlapping profiles have the potential to provide a biological "stroke clock" able to tell the clinician how far an individual stroke has evolved

Island Visual Artists'82 : An Exhibition Representing the Work of Island Visual Artists

Arsenault points out the diversity of Prince Edward Island artists' work. Includes brief artists' statements and biographical notes