A study of the certification requirements for teachers of the social studies in secondary schools in the United States

Thesis (M.A.)--Boston University, 1949. This item was digitized by the Internet Archive

Case series of elective instrumented posterior lumbar spinal fusions demonstrating a low incidence of venous thromboembolism

Introduction: Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in orthopaedic surgery. While specific guidelines exist for hip and knee arthroplasty, there is wide variation in VTE prophylaxis in complex spinal surgery. This study sought to determine the incidence of VTE, and risk factors associated with VTE, in patients undergoing elective instrumented posterior lumbar spinal fusion. Methods: In a single-centre case series study, 107 consecutive patients undergoing elective lumbar spinal fusion were evaluated for VTE by lower limb duplex ultrasonography and/or clinical observation, and where indicated, computed tomography pulmonary angiogram (CTPA). The Caprini model for thrombosis risk factor assessment was retrospectively applied to grade levels of VTE risk, which were compared with overall VTE incidence. Results: All patients were operated on a spinal frame and received mechanical prophylaxis (thromboembolic deterrent stockings and sequential calf-compression devices). Thirty-seven percent also received chemoprophylaxis with low molecular weight heparin (LMWH). There was no significant relationship between LMWH use and protection from VTE. Risk scores ³3 (high/highest risk categories) were observed in 96.2% of patients. Four (3.7%) patients encountered a VTE complication (all with no chemoprophylaxis), either deep vein thrombosis (1.9%) or pulmonary embolism (1.9%). No patient sustained an epidural haematoma. Conclusion: Although patients undergoing elective instrumental posterior lumbar spinal fusion are at high risk of developing VTE, the actual incidence of VTE in these patients is low. Our data support the use of mechanical prophylaxis with thromboembolic deterrent stockings and sequential calf-compression devices to prevent VTE in these patients

A comparison of computational and experimental lift-off heights of coflow laminar diffusion flames

As a sensitive marker of changes in flame structure, the number densities of excited-state CH (denoted CH*), and excited-state OH (denoted OH*) are imaged in coflow laminar diffusion flames. Measurements are made both in normal gravity and on the NASA KC-135 reduced-gravity aircraft. The spatial distribution of these radicals provides information about flame structure and lift-off heights that can be directly compared with computational predictions. Measurements and computations are compared over a range of buoyancy and fuel dilution levels. Results indicate that the lift-off heights and flame shapes predicted by the computations are in excellent agreement with measurement for both normal gravity (1g) and reduced gravity flames at low dilution levels. As the fuel mixture is increasingly diluted, however, the 1g lift-off heights become underpredicted. This trend continues until the computations predict stable flames at highly dilute fuel mixtures beyond the 1g experimental blow-off limit. To better understand this behavior, an analysis was performed, which indicates that the lift-off height is sensitive to the laminar flame speed of the corresponding premixed mixture at the flame edge. By varying the rates of two key "flame speed" controlling reactions, we were able to modify the predicted lift-off heights so as to be in closer agreement with the experiments. The results indicate that reaction sets that work well in low dilution systems may need to be modified to accommodate high dilution flames

Chinese immigrant parents' vaccination decision making for children: A qualitative analysis

Background: While immunization coverage rates for childhood routine vaccines in Hong Kong are almost 100%, the uptake rates of optional vaccines remain suboptimal. Understanding parental decision-making for children's vaccination is important, particularly among minority groups who are most vulnerable and underserved. This study explored how a subsample of new immigrant mothers from mainland China, a rapidly-growing subpopulation in Hong Kong, made decisions on various childhood and adolescent vaccines for their offspring, and identified key influences affecting their decision making. Methods. Semi-structured in-depth interviews were conducted with 23 Chinese new immigrant mothers recruited by purposive sampling. All interviews were audio-taped, transcribed and analyzed using a Grounded Theory approach. Results: Participants' conversation revealed five underlying themes which influenced parents' vaccination decision-making: (1) Institutional factors, (2) Insufficient vaccination knowledge and advice, (3) Affective impacts on motivation, (4) Vaccination barriers, and (5) Social influences. The role of social norms appeared overwhelmingly salient influencing parents' vaccination decision making. Institutional factors shaped parent's perceptions of vaccination necessity. Fear of vaccine-targeted diseases was a key motivating factor for parents adopting vaccination. Insufficient knowledge about vaccines and targeted diseases, lack of advice from health professionals and, if provided, suspicions regarding the motivations for such advice were common issues. Vaccination cost was a major barrier for many new immigrant parents. Conclusions: Social norms play a key role influencing parental vaccination decision-making. Insight gained from this study will help inform healthcare providers in vaccination communication and policymakers in future vaccination programme. © 2014 Wang et al.; licensee BioMed Central Ltd.Link_to_subscribed_fulltex

Pattern of Maternal Knowledge and Its Implications for Diarrhoea Control in Southern Malawi: Multilevel Thresholds of Change Analysis

A survey was conducted in Southern Malawi to examine the pattern of mothers’ knowledge on diarrhoea. Diarrhoea morbidity in the district is estimated at 24.4%, statistically higher than the national average at 17%. Using hierarchically built data from a survey, a multilevel threshold of change analysis was used to determine predictors of knowledge about diarrhoeal aetiology, clinical features, and prevention. The results show a strong hierarchical structured pattern in overall maternal knowledge revealing differences between communities. Responsible mothers with primary or secondary school education were more likely to give more correct answers on diarrhoea knowledge than those without any formal education. Responsible mothers from communities without a health surveillance assistant were less likely to give more correct answers. The results show that differences in diarrhoeal knowledge do exist between communities and demonstrate that basic formal education is important in responsible mother’s understanding of diseases. The results also reveal the positive impact health surveillance assistants have in rural communities

A four-month gatifloxacin-containing regimen for treating tuberculosis.

BACKGROUND: Shortening the course of treatment for tuberculosis would be a major improvement for case management and disease control. This phase 3 trial assessed the efficacy and safety of a 4-month gatifloxacin-containing regimen for treating rifampin-sensitive pulmonary tuberculosis. METHODS: We conducted a noninferiority, randomized, open-label, controlled trial involving patients 18 to 65 years of age with smear-positive, rifampin-sensitive, newly diagnosed pulmonary tuberculosis in five sub-Saharan African countries. A standard 6-month regimen that included ethambutol during the 2-month intensive phase was compared with a 4-month regimen in which gatifloxacin (400 mg per day) was substituted for ethambutol during the intensive phase and was continued, along with rifampin and isoniazid, during the continuation phase. The primary efficacy end point was an unfavorable outcome (treatment failure, recurrence, or death or study dropout during treatment) measured 24 months after the end of treatment, with a noninferiority margin of 6 percentage points, adjusted for country. RESULTS: A total of 1836 patients were assigned to the 4-month regimen (experimental group) or the standard regimen (control group). Baseline characteristics were well balanced between the groups. At 24 months after the end of treatment, the adjusted difference in the risk of an unfavorable outcome (experimental group [21.0%] minus control group [17.2%]) in the modified intention-to-treat population (1356 patients) was 3.5 percentage points (95% confidence interval, -0.7 to 7.7). There was heterogeneity across countries (P=0.02 for interaction, with differences in the rate of an unfavorable outcome ranging from -5.4 percentage points in Guinea to 12.3 percentage points in Senegal) and in baseline cavitary status (P=0.04 for interaction) and body-mass index (P=0.10 for interaction). The standard regimen, as compared with the 4-month regimen, was associated with a higher dropout rate during treatment (5.0% vs. 2.7%) and more treatment failures (2.4% vs. 1.7%) but fewer recurrences (7.1% vs. 14.6%). There was no evidence of increased risks of prolongation of the QT interval or dysglycemia with the 4-month regimen. CONCLUSIONS: Noninferiority of the 4-month regimen to the standard regimen with respect to the primary efficacy end point was not shown. (Funded by the Special Program for Research and Training in Tropical Diseases and others; ClinicalTrials.gov number, NCT00216385.)

Linear Stability Analysis for Plane-Poiseuille Flow of an Elastoviscoplastic fluid with internal microstructure

We study the linear stability of Plane Poiseuille flow of an elastoviscoplastic fluid using a revised version of the model proposed by Putz and Burghelea (Rheol. Acta (2009)48:673-689). The evolution of the microstructure upon a gradual increase of the external forcing is governed by a structural variable (the concentration of solid material elements) which decays smoothly from unity to zero as the stresses are gradually increased beyond the yield point. Stability results are in close conformity with the ones of a pseudo-plastic fluid. Destabilizing effects are related to the presence of an intermediate transition zone where elastic solid elements coexist with fluid elements. This region brings an elastic contribution which does modify the stability of the flow