Program Improvement and Practice: In-Service and Pre-Service Student Teaching Reflections

A qualitative study was conducted with graduates (in-service teachers) and pre-service teacher candidates from a traditional elementary education program to explore perceptions of the student teaching process and its impact on teaching philosophy and practices. The program graduates and pre-service teachers described their experience as valuable, but believed their knowledge of pedagogy and classroom management to be deficient. The value of the internship process and implications for program improvement are discussed. Theory without practice is dead, and practice without theory is blind. — Ano

Compressive Strength of 24S-T Aluminum-alloy Flat Panels with Longitudinal Formed Hat-section Stiffeners

Results are presented for a part of a test program on 24S-T aluminum alloy flat compression panels with longitudinal formed hat-section stiffeners. This part of the program is concerned with panels in which the thickness of the stiffener materials is 0.625 times the skin thickness. The results, presented in tabular and graphical form, show the effect of the relative dimensions of the panel on the buckling stress and the average stress at maximum load. Comparative envelope curves are presented for hat-stiffened and Z-stiffened panels having the same ratio of stiffener thickness to sheet thickness. These curves provide some indication of the relative structural efficiencies of the two types of panel

Who Counsels Parents of Newborns Who Are Carriers of Sickle Cell Anemia or Cystic Fibrosis?

Our objective was to describe: 1) physicians’ knowledge of whether genetic counseling is provided to parents of newborns with sickle cell trait (SCT) or who are cystic fibrosis carriers (CFC), and 2) the prevalence of genetic counseling provided by primary care physicians. We conducted a cross‐sectional descriptive survey of 600 randomly‐sampled Michigan‐based pediatricians and family physicians, assessing physician knowledge of where and whether genetic counseling is received by parents whose newborns are carriers. Chi‐squared testing determined associations between genetic counseling location and physician demographic characteristics. Our response rate was 62 %: 298 (84 %) provided infant well care (183 pediatricians, 115 family physicians). Most respondents were non‐Hispanic White (65 %). Virtually all physicians believed parents whose newborns are carriers of either SCT or CFC should receive some genetic counseling (from the physician and/or another source), yet 20 % reported that parents of newborns with SCT did not receive counseling. Parents of infants with CFC received more counseling overall (92 % vs. 80 %; p < 0.01) and were counseled more frequently by genetic counselors or specialty centers than parents of newborns with SCT (85 % vs. 60 %; p < 0.01). Although physicians agreed that parents whose newborns are carriers should receive genetic counseling, fewer parents of newborns with SCT than with CFC received counseling from any source. This finding strongly suggests the need for further education and investigation of this apparent health disparity.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147004/1/jgc40218.pd

Parents’ Perspectives on Variants of Uncertain Significance from Chromosome Microarray Analysis

Chromosomal microarray analysis (CMA) for unexplained anomalies and developmental delay has improved diagnosis rates, but results classified as variants of uncertain significance (VUS) may challenge both clinicians and families. We explored the impact of such results on families, including parental knowledge, understanding and interpretation. Semi‐structured telephone interviews were conducted with parents (N = 14) who received genetic counseling for a VUS in their child. Transcripts were analyzed through an iterative coding process. Participants demonstrated a range of recall and personal interpretation regarding whether test results provided a causal explanation for their children’s health issues. Participants maintained contradictory interpretations, describing results as answers while maintaining that little clarification of their child’s condition had been provided. Reported benefits included obtaining medical services and personal validation. Parents described adaptation/coping processes similar to those occurring after positive test results. Recall of terminology, including “VUS” and precise CMA abnormalities, was poor. However, most demonstrated conceptual understanding of scientific uncertainty. All participants expressed intentions to return for recommended genetics follow‐up but had misconceptions about how this would occur. These results provide insight into the patient‐and‐family experience when receiving uncertain genomic findings, emphasize the importance of exploring uncertainty during the communication process, and highlight areas for potential attention or improvement in the clinical encounter.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146918/1/jgc40101.pd

Factors that Influence Teachers’ Views on Standardized Tests

The central aim of this study was to explore K-12 teachers’ (N = 183) attitudes about standardized tests as a function of experience, instructional level, student population, and type of school. The Teachers’ Views on Standardized Tests Questionnaire was developed to assess teachers’ perceptions of the impact of standardized tests on practice. All survey items were intended to measure a facet of teachers’ attitudes regarding the necessity of standardized tests and their influence on best practices. Findings from this study indicated that special education and inclusion teachers viewed standardized tests as more negatively influencing instruction than general education teachers. There were also significant differences by instructional level and type of school (i.e., public vs. independent). Compared to elementary teachers, middle and high school teachers’ views were more negative, and public school educators perceived standardized assessments as having a more negative influence on instruction than teachers in independent schools. Finally, elementary school teachers reported that the standards of learning were more appropriate in contrast to middle and high school teachers

Bivalirudin started during emergency transport for primary PCI.

BACKGROUND: Bivalirudin, as compared with heparin and glycoprotein IIb/IIIa inhibitors, has been shown to reduce rates of bleeding and death in patients undergoing primary percutaneous coronary intervention (PCI). Whether these benefits persist in contemporary practice characterized by prehospital initiation of treatment, optional use of glycoprotein IIb/IIIa inhibitors and novel P2Y12 inhibitors, and radial-artery PCI access use is unknown. METHODS: We randomly assigned 2218 patients with ST-segment elevation myocardial infarction (STEMI) who were being transported for primary PCI to receive either bivalirudin or unfractionated or low-molecular-weight heparin with optional glycoprotein IIb/IIIa inhibitors (control group). The primary outcome at 30 days was a composite of death or major bleeding not associated with coronary-artery bypass grafting (CABG), and the principal secondary outcome was a composite of death, reinfarction, or non-CABG major bleeding. RESULTS: Bivalirudin, as compared with the control intervention, reduced the risk of the primary outcome (5.1% vs. 8.5%; relative risk, 0.60; 95% confidence interval [CI], 0.43 to 0.82; P=0.001) and the principal secondary outcome (6.6% vs. 9.2%; relative risk, 0.72; 95% CI, 0.54 to 0.96; P=0.02). Bivalirudin also reduced the risk of major bleeding (2.6% vs. 6.0%; relative risk, 0.43; 95% CI, 0.28 to 0.66; P<0.001). The risk of acute stent thrombosis was higher with bivalirudin (1.1% vs. 0.2%; relative risk, 6.11; 95% CI, 1.37 to 27.24; P=0.007). There was no significant difference in rates of death (2.9% vs. 3.1%) or reinfarction (1.7% vs. 0.9%). Results were consistent across subgroups of patients. CONCLUSIONS: Bivalirudin, started during transport for primary PCI, improved 30-day clinical outcomes with a reduction in major bleeding but with an increase in acute stent thrombosis. (Funded by the Medicines Company; EUROMAX ClinicalTrials.gov number, NCT01087723.)