Puppets in Education

Introduction: •Autism spectrum disorders (ASD) are a group of related brain-based disorders that affect a child\u27s behavior, social and communication skills. •In 2009, approximately 1,000 Vermont students received special educational services for ASD. •Puppets in Education (PiE) is a non-profit group that teaches kids how to keep themselves safe and healthy and to appreciate each other’s differences. •PiE’sFriend 2 Friend Program (F2F) addresses ASD in fun and interactive puppet and workshop presentations, promoting empathy for individuals on the autism spectrum by modeling, labeling, explaining and normalizing differences, and teaching prosocial communication and friendship skills. •Last year, UVM COM students collaborated with PiE to determine how the use of puppets could best educate the community regarding ASD. •This year our goals were to elicit: --the perceived effectiveness of current ASD education in the classroom --the perceived effectiveness of including children with ASD in the classroom; and --the most important aspects of ASD to address in the Puppets in Education (PiE) curriculumhttps://scholarworks.uvm.edu/comphp_gallery/1059/thumbnail.jp

Maximizing success in single-session EUS-directed transgastric ERCP: a retrospective cohort study to identify predictive factors of stent migration

BACKGROUND AND AIMS: EUS-directed transgastric ERCP (the EDGE procedure) is a simplified method of performing ERCP in Roux-en-Y gastric bypass patients. The EDGE procedure involves placement of a lumen-apposing metal stent (LAMS) into the excluded stomach to serve as a conduit for passage of the duodenoscope for pancreatobiliary intervention. Originally a multistep process, urgent indications for ERCP have led to the development of single-session EDGE (SS-EDGE) with LAMS placement and ERCP performed in the same session. The goal of this study was to identify predictive factors of intraprocedural LAMS migration in SS-EDGE. METHODS: We conducted a multicenter retrospective review that included 9 tertiary medical centers across the United States. Data were collected and analyzed from 128 SS-EDGE procedures. The primary outcome was intraprocedural LAMS migration. Secondary outcomes were other procedural adverse events such as bleeding and perforation. RESULTS: Eleven LAMS migrations were observed in 128 procedures (8.6%). Univariate analysis of clinically relevant variables was performed, as was a binary logistic regression analysis of stent diameter and stent dilation. This revealed that use of a smaller (15 mm) diameter LAMS was an independent predictor of intraprocedural stent migration (odds ratio, 5.36; 95% confidence interval, 1.29-22.24; P = .021). Adverse events included 3 patients who required surgery and 2 who experienced intraprocedural bleeding. CONCLUSIONS: Use of a larger-diameter LAMS is a predictive factor for a nonmigrated stent and improved procedural success in SS-EDGE. Although larger patient cohorts are needed to adequately assess these findings, performance of LAMS dilation and fixation may also decrease risk of intraprocedural LAMS migration and improve procedural success