Aristotle\u27s Doctrine of Elements

In his studies of nature, Aristotle pursues a series of connected inquiries. He elicits a series of sets of elements; none of the steps is abandoned in favor of later ones. Each set of elements discovers primary constituents of an appropriate sort. Substratum, form, and privation are the most fundamental for the study of generable objects

Meeting Yourself Without Rose Colored Glasses: An Urban Charter

Abstract The impact of a culturally relevant professional development series on classroom teacher’s cultural lens was determined. Fifty teachers from two different school districts participated in 16 hours of professional development in an attempt to impact their understanding of how culture and instruction are connected. During the professional development, participants took part in activities, dialogues and reflections designed to impact their cultural competency. The content of the four professional development sessions included (a) videos on culturally relevant teaching; (b) discussion of cultural identity of participants and how it surfaces in the classroom; (c) discussion of the culture, values, and beliefs of the students in the classroom; (d) completion of written reflections after each session; and (e) participation of selected teachers in a semi-structured interview. After administering the four professional development sessions, the results indicated that the cultural lenses of teachers were impacted. Professional educators indicated an increased level of self-awareness and a better understanding of cultural diversity and the impact that culture has on instruction

Counting Nilpotent Pairs in Finite Groups: Some Conjectures

The number of nilpotent pairs is determined for a number of small groups

Innovative and Community-Guided Evaluation and Dissemination of a Prostate Cancer Education Program for African-American Men and Women

African Americans (AA) are more likely to develop and die from cancer than any other racial or ethnic group. The aims of this research were to (1) evaluate current education materials being implemented in a community-based prostate cancer education program for AA communities, (2) refine materials based on findings from aim 1, (3) share updated materials with participants from aim 1 for additional improvements, and (4) disseminate and evaluate the improved education program through a statewide videoconference with AA men and women. AA individuals evaluated the current education program through a mail survey (n = 32) and community forum (n = 38). Participants reported that the existing prostate cancer education program content could be understood by lay persons, but recommendations for improvement were identified. They included the following: defining unknown and/or scientific terminology, increasing readability by increasing font size and enlarging images, and including more recent and relevant statistics. Following refinement of the education materials based on survey and forum feedback, a statewide videoconference was implemented. Following the videoconference, participants (25 men; 3 women) reported that they would encourage others to learn more about prostate cancer, talk to their doctor about whether or not to get screened for prostate cancer, and recommend the conference to others. There is great potential for using this type of iterative approach to education program development with community and clinical partners for others conducting similar work

Building Telehealth Teams of the Future Through Interprofessional Curriculum Development: A Five-Year Mixed Methodology Study

Building the next generation of telehealth enabled professionals requires a mixture of team-based, interprofessional practice with novel technologies that connect providers and patients. Effective telehealth education is critical for the development of multidisciplinary training curricula to ensure workforce preparedness. In this study, we evaluated the impact of a formal telehealth education curriculum for interprofessional students through an online elective. Over 12 semesters, 170 students self-selected to enroll in the 3-credit hour interprofessional elective and took part in structured didactic, experiential and interprofessional learning opportunities. Mixed-method assessments show significant knowledge and confidence gains with students reflecting on their roles as future healthcare providers. The results from five years’ worth of course data shows not only an opportunity to advance the individual knowledge of trainees, but a larger movement to facilitate changes in practice toward population health goals. Recent global health events have further highlighted the need for a rapid response to public health emergencies by highly trained provider teams who are able to utilize technology as the cornerstone for the continuity of care

Intentional left subclavian artery coverage during thoracic endovascular aortic repair for traumatic aortic injury

BackgroundThoracic endovascular aortic repair (TEVAR) is widely used for treatment of traumatic aortic injury (TAI). Stent graft coverage of the left subclavian artery (LSA) may be required in up to 40% of patients. We evaluated the long-term effects of intentional LSA coverage (LSAC) on symptoms and return to normal activity in TAI patients compared with a similarly treated group whose LSA was uncovered (LSAU).MethodsPatients were identified from a prospective institutional trauma registry between September 2005 and July 2012. TAI was confirmed using computed tomography angiography. The electronic medical records, angiograms, and computed tomography angiograms were reviewed in a retrospective fashion. In-person or telephone interviews were conducted using the SF-12v2 (Quality Metrics, Lincoln, RI) to assess quality of life. An additional questionnaire was used to assess specific LSA symptoms and the ability to return to normal activities. Data were analyzed by Spearman rank correlation and multiple linear and logistic regression analysis with appropriate transformations using SAS software (SAS Institute, Cary, NC).ResultsDuring the study period, 82 patients (57 men; mean age 40.5 ± 20 years, mean Injury Severity Score, 34 ± 10.0) underwent TEVAR for treatment of TAI. Among them, LSAC was used in 32 (39.5%) and LSAU in 50. A group of the LSAU patients (n = 22) served as matched controls in the analysis. We found no statistically significant difference in SF-12v2 physical health scores (ρ = −0.08; P = .62) between LSAC and LSAU patients. LSAC patients had slightly better mental health scores (ρ = 0.62; P = .037) than LSAU patients. LSAC patients did not have an increased likelihood of experiencing pain (ρ = −0.0056; P = .97), numbness (ρ = −0.12; P = .45), paresthesia (ρ = −0.11; P = .48), fatigue (ρ = −0.066; P = .69), or cramping (ρ = −0.12; P = .45). We found no difference between groups in the ability to return to activities. The mean follow-up time was 3.35 years. Six LSAC patients (19%) died during the follow-up period of unrelated causes.ConclusionsIntentional LSAC during TEVAR for TAI appears safe, without compromising mental or physical health outcomes. Furthermore, LSAC does not increase the long-term risk of upper extremity symptoms or impairment of normal activities

Outcomes after endovascular repair of arterial trauma

BackgroundEndovascular repair of peripheral arterial trauma using covered stent grafts is a minimally invasive alternative to open surgery in selected patients. Although the technical feasibility of endovascular repair has been established, there are a paucity of data regarding outcomes. The purpose of this study was to evaluate the short-term outcomes of endovascular repair in patients with peripheral arterial trauma.MethodsA review of a prospectively collected institutional trauma registry captured all patients with peripheral arterial injury who underwent endovascular repair from August 2004 to June 2012. Data collected included demographics, Injury Severity Score (ISS), mechanism, location and type of injury, imaging modality, intervention type, complications and reintervention, length of stay, and follow-up. Descriptive statistics were used for analysis.ResultsDuring the study period, we performed endovascular repair in 28 patients with peripheral arterial injuries. There were 20 male patients (71%) with a median age of 39 years (range, 13-88 years). The mean ISS was 17.2 (range, 9-41). The mechanism of injury was penetrating in 21 (75%) and blunt in seven (25%). The anatomic locations of the 28 arterial injuries were carotid (3 [11%]), subclavian (7 [25%]), axillary (6 [22%]), iliac (3 [11%]), and femoral/popliteal (9 [32%]). Findings consistent with injury on imaging included pseudoaneurysms (9 [32%]), extravasations (9 [32%]), occlusions (6 [22%]), and arteriovenous fistulas (4 [14%]). Technical success was achieved in all patients. The overall complication rate was 21%, with six patients requiring a secondary procedure. Two patients underwent a planned, elective conversion to open repair during the initial hospitalization. Four patients required conversion secondary to stent graft thrombosis. Three conversions were early (<30 days) and one was late (>30 days). The mean length of stay was 18.4 ± 22.9 days (range, 1-93 days), with a median follow-up of 13 months (range, 1-60 months). The overall limb salvage rate was 92% at 45 days and 79% at 93 days.ConclusionsThe present study outlines our early experience with endovascular repair of peripheral arterial injuries in a variety of anatomic locations. Overall complication rates are appreciable but can be effectively detected and managed with additional intervention. The inclusion of endovascular modalities in algorithms of trauma care holds considerable promise. The need to better define optimal algorithms for utilization and determine long-term outcomes of intervention requires significant additional study