Under-representation of males in the early years: the challenges leaders face

This article investigates why there appears to be an under-representation of males in comparison to their female colleagues in the Early Years (EY) sector, and the perception of male teachers progressing more quickly to leadership positions when they do enter this context. Using case studies of final year male students on an Initial Teacher Training (ITT) undergraduate degree course at one university, we attempt to analyse data on male under-representation in Early Years against contemporary theories of identity, power and leadership. Questionnaires and interviews were conducted with the male sample group and male senior leaders in primary schools to gain an overview as to the leadership support they needed and provided. Our tentative findings suggested that male trainees are happy to work in an Early Years context and take leadership positions, but the challenge for leaders is that male trainees require strong leadership mentoring processes to help overcome perceived contextual barriers

Proliferation Index: A Continuous Model to Predict Prognosis in Patients with Tumours of the Ewing's Sarcoma Family

The prognostic value of proliferation index (PI) and apoptotic index (AI), caspase-8, -9 and -10 expression have been investigated in primary Ewing's sarcoma family of tumours (ESFT). Proliferating cells, detected by immunohistochemistry for Ki-67, were identified in 91% (91/100) of tumours with a median PI of 14 (range 0–87). Apoptotic cells, identified using the TUNEL assay, were detected in 96% (76/79) of ESFT; the median AI was 3 (range 0–33). Caspase-8 protein expression was negative (0) in 14% (11/79), low (1) in 33% (26/79), medium (2) in 38% (30/79) and high (3) in 15% (12/79) of tumours, caspase-9 expression was low (1) in 66% (39/59) and high (3) in 34% (20/59), and caspase-10 protein was low (1) in 37% (23/62) and negative (0) in 63% (39/62) of primary ESFT. There was no apparent relationship between caspase-8, -9 and -10 expression, PI and AI. PI was predictive of relapse-free survival (RFS; p = 0.011) and overall survival (OS; p = <0.001) in a continuous model, whereas AI did not predict outcome. Patients with tumours expressing low levels of caspase-9 protein had a trend towards a worse RFS than patients with tumours expressing higher levels of caspase-9 protein (p = 0.054, log rank test), although expression of caspases-8, -9 and/or -10 did not significantly predict RFS or OS. In a multivariate analysis model that included tumour site, tumour volume, the presence of metastatic disease at diagnosis, PI and AI, PI independently predicts OS (p = 0.003). Consistent with previous publications, patients with pelvic tumours had a significantly worse OS than patients with tumours at other sites (p = 0.028); patients with a pelvic tumour and a PI≥20 had a 6 fold-increased risk of death. These studies advocate the evaluation of PI in a risk model of outcome for patients with ESFT

Anatomical considerations and biomechanics in distal humeral hemiarthroplasty: are custom-made implants essential?

Distal humerus hemiarthroplasty is a somewhat debated and relatively new therapeutic option for distal humerus fractures, their sequelae, and other humeral degenerative conditions associated with a preserved radioulnar compartment. The anatomical variability of the distal humerus is the main issue that remains to be solved, particularly in view of the limited modularity of the only implant currently available. The clinical relevance of the mismatch between the native joint and the replacement joint has yet to be clearly demonstrated in the long term, though biomechanical studies have highlighted marked ulnar cartilage wear associated with such implants. Clinical studies are needed to understand whether custom-made implants can improve the results yielded by the implant available at present

Anatomy of the elbow and how It affects implant design

The elbow is considered a complex joint because it is composed of three closely connected articulations: the ulnohumeral joint, the radiohumeral joint, and the proximal radioulnar joint. A thorough knowledge of the morphology of the elbow has important implications on implant design. Indeed, the advancement in our understanding of the anatomy and biomechanics of the elbow in recent years has led to an improvement in the design of prostheses, which has in turn increased the indications and clinical results associated with such implants. The aim of this chapter is to provide a detailed description of the morphology of the distal humerus, proximal radius, and proximal ulna, which is critical to the design of an anatomical implant

Indications and surgical technique of primary elbow linked arthroplasty

Since the introduction of total elbow arthroplasty (TEA), the continual evolution of biomaterials and increasing knowledge of the anatomy of the elbow has raised awareness among orthopedic surgeons of the potential of TEA and has extended the indications for this kind of surgery. Regardless of the diagnosis that leads to surgery, there are some common key steps concerning the surgical technique that need to be followed regardless of the type of implant used. In this chapter the main indications for linked TEA, along with the surgical technique for the correct positioning of linked total elbow prosthesis, will be analyzed