Action Research

Action research is a common journey for graduate students in education and other human science fields. This book attempts to meet the needs of graduate students, in-service teachers, and any other educators interested in action research and/or self-study. The chapters of this book draw on our collective experiences as educators in a variety of educational contexts, and our roles guiding educator/researchers in various settings. All of our experiences have enabled us to question and refine our own understanding of action research as a process and means for pedagogical improvement. The primary purpose of this book is to offer clear steps and practical guidance to those who intend to carry out action research for the first time. As educators begin their action research journey, we feel it is vital to pose four questions: 1) What is action research, and how is it distinct from other educational research?; 2) When is it appropriate for an educator to conduct an action research project in their context?; 3) How does an educator conduct an action research project?; 4) What does an educator do with the data once the action research project has been conducted? We have attempted to address all four questions in the chapters of this book.https://newprairiepress.org/ebooks/1034/thumbnail.jp

Impact of Morphine Treatment on Infarct Size and Reperfusion Injury in Acute Reperfused ST-Elevation Myocardial Infarction

Current evidence regarding the effect of intravenous morphine administration on reperfusion injury and/or cardioprotection in patients with myocardial infarction is conflicting. The aim of this study was to evaluate the impact of morphine administration, on infarct size and reperfusion injury assessed by cardiac magnetic resonance imaging (CMR) in a large multicenter ST-elevation myocardial infarction (STEMI) population. In total, 734 STEMI patients reperfused by primary percutaneous coronary intervention <12 h after symptom onset underwent CMR imaging at eight centers for assessment of myocardial damage. Intravenous morphine administration was recorded in all patients. CMR was completed within one week after infarction using a standardized protocol. The clinical endpoint of the study was the occurrence of major adverse cardiac events (MACE) within 12 months after infarction. Intravenous morphine was administered in 61.8% (n = 454) of all patients. There were no differences in infarct size (17%LV, interquartile range [IQR] 8–25%LV versus 16%LV, IQR 8–26%LV, p = 0.67) and microvascular obstruction (p = 0.92) in patients with versus without morphine administration. In the subgroup of patients with early reperfusion within 120 min and reduced flow of the infarcted vessel (TIMI-flow ≤2 before PCI) morphine administration resulted in significantly smaller infarcts (12%LV, IQR 12–19 versus 19%LV, IQR 10–29, p = 0.035) and reduced microvascular obstruction (p = 0.003). Morphine administration had no effect on hard clinical endpoints (log-rank test p = 0.74) and was not an independent predictor of clinical outcome in Cox regression analysis. In our large multicenter CMR study, morphine administration did not have a negative effect on myocardial damage or clinical prognosis in acute reperfused STEMI. In patients, presenting early ( ≤120 min) morphine may have a cardioprotective effect as reflected by smaller infarcts; but this finding has to be assessed in further well-designed clinical studie