A Reappraisal of Children’s ‘Potential’

What does it mean for a child to fulfil his or her potential? This article explores the contexts and implications of the much-used concept of potential in educational discourses. We claim that many of the popular, political and educational uses of the term in relation to childhood have a problematic blind spot: interpersonality, and the necessary coexistence for the concept to be receivable of all children’s ‘potentials’. Rather than advocating abandoning the term—a futile gesture given its emotive force—we argue that the concept of children’s potential must be profoundly rethought to be workable as a philosophical notion in education. In an era marked by the unspoken assumption that ‘unlimited potential’ is always a good thing, we argue that it might be necessary to think about the limitations of the notion of individual potential; namely, the moment when it comes into contact with other people’s projects. We propose a conceptualisation of potential as the negotiated, situated, ever-changing creation of a group of individuals, in a process marked by conflict, and which remains essentially difficult.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s11217-016-9508-

Bridging reproductive and microbial ecology: a case study in arbuscular mycorrhizal fungi

Offspring size is a key trait for understanding the reproductive ecology of species, yet studies addressing the ecological meaning of offspring size have so far been limited to macro-organisms. We consider this a missed opportunity in microbial ecology and provide what we believe is the first formal study of offspring-size variation in microbes using reproductive models developed for macro-organisms. We mapped the entire distribution of fungal spore size in the arbuscular mycorrhizal (AM) fungi (subphylum Glomeromycotina) and tested allometric expectations of this trait to offspring (spore) output and body size. Our results reveal a potential paradox in the reproductive ecology of AM fungi: while large spore-size variation is maintained through evolutionary time (independent of body size), increases in spore size trade off with spore output. That is, parental mycelia of large-spored species produce fewer spores and thus may have a fitness disadvantage compared to small-spored species. The persistence of the large-spore strategy, despite this apparent fitness disadvantage, suggests the existence of advantages to large-spored species that could manifest later in fungal life history. Thus, we consider that solving this paradox opens the door to fruitful future research establishing the relationship between offspring size and other AM life history traits

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Review of \u3ci\u3eThe Prairie Schoolhouse\u3c/i\u3e by John Martin Campbell

John Martin Campbell, in this fine book consisting of sixty black and white, well conceived photographic plates and explicative text, has created an evocative picture of the prairie schoolhouses, the age from which they sprang, their environment, and the people for whom these formulaic structures fulfilled many functions. Older folks who grew up in the largely poor, rural areas of the vast American prairies will easily identify with Tony Hillerman\u27s anecdote in the foreword, and they will surely experience a deep nostalgia and a profound sadness for the decay of the schoolhouse concept as well as the decay of the physical structures and all that they symbolized. Times were hard in an often alien and forbidding climate on the prairies, and life at best was a constant struggle for those who persisted. Even the graininess of the images becomes a metaphor for the true grit required for these prairie children to garner an education while their families struggled to survive and thrive in the face of drought, blizzard, poverty, sickness, and death. Campbell tells stories best in his images of interior details of the schoolhouses themselves. These are close-ups not just of a physical structure but of a learning structure as well: the raised teacher\u27s platform extending across the far, narrow end of the single room; the roller-mounted wall maps inviting the reader to pull one down to see how much the world of those early pupils has changed in the intervening years; the wainscoting and chair rail protecting walls against deterioration; the Palmer-method penmanship prototypes forming the upper blackboard border. Outdoors the playground equipment and outhouses, being necessary adjuncts of the time, add important elements to the story. Surprisingly, the photographs even evoke the sound of singsong recitations of the pupils and the rap of the teacher\u27s ruler calling the class to order and the shouts of children playing tag in the long grass of the schoolyard. What more might we have learned if Campbell had chosen to include excerpts of prairie schoolhouse memories in the words of some of those children now grown old? Perhaps we would better understand the sense of personal development and community-building which these structures represented and which our larger schools of today often cannot sustain. Nevertheless, Campbell\u27s photographs and accompanying text paint the prairie schoolhouses large with the love of learning

TEXTURE, PATTERN, AND COHESION IN WRITTEN TEXTS: A STUDY WITH A GRAPHIC PERSPECTIVE (PRONOUNS, DEFINITE ARTICLES, COMPUTER ANALYSIS)

That some entity called \u27text\u27 exists has rarely been questioned, but because of its complexity, the synergistic nature of such texts is little understood. This synergism is the dynamic product of reader processing which is more than, but dependent on, the physical text produced by a writer. One aspect of this synergism is \u27texture\u27 which is caused by an overlaying, as it were, of numerous text patterns, including cohesion. This study provides an insight into the rudiments of texture, and hence synergism, by analyzing the patterns of three types of cohesion in thirty-five published texts representing five genres. The patterns of cohesion for these types--definite articles, pronouns, and agent displacements--were computer-analyzed for frequency of occurrence. The statistical results demonstrate that these types occur with some degree of regularity in all texts in all genres, but they also show that some linguistic signals for cohesion are ambiguous or unfulfilled. Furthermore, when abstracted locationally and drawn graphically on the computer as \u27maps\u27 of cohesive networks, these patterns uncover aspects of cohesion that the numerical data cannot. That is, as the number of cohesive elements per cohesive node varies and as the lengths of the cohesive ties vary, so will the relative cohesiveness of the texts vary. An index of cohesion developed to show this variability reveals that the personal essay genre is the most cohesive while the nonfiction genre is the least cohesive. Because the mind of the reader must simultaneously manage all types of cohesion (as well as other text components), the processing of texts is extremely complex. In order to describe this complexity for patterns of cohesion, a set of maps showing the networks of each of the three types of cohesion was transferred to colored transparencies. These maps, when overlaid, suggest not only the complexity of the processing required to read a text, but also the multidimensionality of textual synergism

Situation, Background, Assessment, Recommendation (SBAR) Education for Health Care Students: Assessment of a Training Program

Introduction Interprofessional communication failures are estimated to be a factor in two-thirds of serious health care–related accidents. Using a standardized communication protocol during transfer of patient information between providers improves patient safety. An interprofessional education (IPE) event for first-year health professions students was designed using the Situation, Background, Assessment, Recommendation (SBAR) tool as a structured communication framework. IPE literature, including a valid measurement tool specifically tailored for SBAR, was utilized to design the Interprofessional Team Training Day (ITTD) and evaluate learner gains in SBAR skills. Methods Learners from six educational programs participated in ITTD, which consisted of didactics, small-group discussion, and role-play using the SBAR protocol. Individual learners were assessed using the SBAR Brief Assessment Rubric for Learner Assessment (SBAR-LA) on SBAR communication skills before and after the ITTD event. Learners received a written clinical vignette and submitted video recordings of themselves simulating the use of SBAR to communicate to another health care professional. Pre- and postrecordings were scored using the SBAR-LA rubric. Normalized gain scores were calculated to estimate the improvement attributable to ITTD. Results SBAR-LA scores increased for 60% of participants. For skills not demonstrated before the event, the average learner acquired 44% of those skills from ITTD. Learners demonstrated statistically significant increases for five of 10 SBAR-LA skills. Discussion The value to patient safety of utilizing structured communication between health care providers is proven; however, evaluating IPE teaching of communication skills effectiveness is challenging. Using SBAR-LA, communication skills were shown to improve following ITTD

Referral Gridlock: Primary Care Physicians and Mental Health Services

BACKGROUND: Patients' barriers to mental health services are well documented and include social stigma, lack of adequate insurance coverage, and underdiagnosis by primary care physicians. Little is known, however, about challenges primary care physicians face arranging mental health referrals and hospitalizations. OBJECTIVE: To examine how practice setting and environment influence primary care physicians' ability to refer patients for medically necessary mental health services. DESIGN: Cross-sectional analysis using nationally representative survey data from the 1998 to 1999 Community Tracking Study physician survey. The overall survey response rate was 61%. PARTICIPANTS: A 1998 to 1999 telephone survey of 6,586 primary care physicians. MEASUREMENTS: Primary care physicians' report of whether they could obtain medically necessary referrals to high-quality mental health specialists or psychiatric admissions. RESULTS: Overall, 54% of primary care physicians reported problems obtaining psychiatric hospital admissions, and 54% reported problems arranging outpatient mental health referrals. Primary care physicians practicing in staff and group model HMOs were much less apt to report difficulties than physicians in solo and small-group practices (P < .001). Reports of inadequate time with patients (P < .001) and smaller numbers of psychiatrists in a market area (P < .01) also were associated with problems obtaining mental health referrals. Pediatricians were more apt to report problems than general internists (P < .001). CONCLUSIONS: Primary care physicians face greater hurdles obtaining mental health services than other medical services. Primary care is an important entry point for mental health services, yet inadequate referral systems between medical and mental health services may be hampering access