TEACHER SELF-EFFICACY IN A MULTICULTURAL ALTERNATIVE EDUCATION PROGRAM

As the United States embraces cultural diversity, educators need to feel a sense of preparedness to effectively master culturally responsive teaching which is vital to students’ academic growth and development. Drawing on the interpretivist- constructive paradigm and self-efficacy theory, this narrative inquiry study, examined teacher’s beliefs, attitudes and perceptions, with regards to their culturally relevant pedagogy and the impact on their multicultural students’ academic achievement and social success. Eight teacher candidates, seven females and one male (Caucasian), who teach at a multicultural alternative education program in New York State participated in two interviews, one face to face and the other a follow-up through email. NVivo transcription service was used to transcribe the data. Hand coding and analytic memos assisted in analyzing the rich, thick experiences of the teachers in their multicultural classrooms. Six major themes emerged from the analysis of the data, cultural proficiency, cultural challenges, educational attributes, instructional strategies, cultural beliefs and cultural competence. The findings revealed that teacher participants believe they would have accomplished a greater level of self-efficacy in their multicultural classrooms, if the challenges that inhibit their performance, were non-existent and that they value their students shared cultural knowledge, experiences, accomplishments developed despite of the challenges. This study proved to be purposeful and meaningful because it highlighted how the teachers’ self-efficacy is being challenged due to the numerous issues shared in the findings. This research could help other alternative education teachers learn how to better withstand the challenges they might face while implementing their best practices. The study shared the limitations, delimitations, recommendations for future research, and recommendations for practice

Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients

Prior research strongly implicates gastric acid and bile acids, two major components of the gastroesophageal refluxate, in the development of Barrett’s esophagus (BE) and its pathogenesis. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been shown to protect esophageal cells against oxidative stress induced by cytotoxic bile acids. We conducted a pilot clinical study to evaluate the clinical activity of UDCA in patients with BE. Twenty-nine BE patients received UDCA treatment at a daily dose of 13–15 mg/kg/day for six months. The clinical activity of UDCA was assessed by evaluating changes in gastric bile acid composition and markers of oxidative DNA damage (8-hydroxydeoxyguanosine, 8OHdG), cell proliferation (Ki67), and apoptosis (cleaved caspase 3, CC3) in BE epithelium. The bile acid concentrations in gastric fluid were measured by liquid chromatography-mass spectrometry. At baseline, UDCA (sum of unchanged and glycine/taurine conjugates) accounted for 18.2% of total gastric bile acids. Post UDCA intervention, UDCA increased significantly to account for 93.39% of total gastric bile acids (p<0.0001). The expression of markers of oxidative DNA damage, cell proliferation, and apoptosis was assessed in the BE biopsies by immunohistochemistry. The selected tissue biomarkers were unchanged after 6 months of UDCA intervention. We conclude that high dose UDCA supplementation for six months resulted in favorable changes in gastric bile acid composition but did not modulate selected markers of oxidative DNA damage, cell proliferation, and apoptosis in the BE epithelium

Elevated lactate level predicts intensive care unit admissions, endoscopies and transfusions in patients with acute gastrointestinal bleeding

Manish P Shrestha,1 Mark Borgstrom,2 Eugene Abraham Trowers3 1Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA; 2Research Computing Group of University Information Technology Services, University of Arizona, Tucson, AZ, USA; 3Division of Gastroenterology, University of Arizona College of Medicine, Tucson, AZ, USA Background and aims: Initial clinical management decision in patients with acute gastrointestinal bleeding (GIB) is often based on identifying high- and low-risk patients. Little is known about the role of lactate measurement in the triage of patients with acute GIB. We intended to assess if lactate on presentation is predictive of need for intervention in patients with acute GIB. Patients and methods: We performed a single-center, retrospective, cross-sectional study including patients &ge;18&nbsp;years old presenting to emergency with acute GIB between January 2014 and December 2014. Intensive care unit (ICU) admission, inpatient endoscopy (upper endoscopy and/or colonoscopy), and packed red blood cell (PRBC) transfusion were assessed as outcomes. Analyses included univariate and multivariate logistic regression analyses. Results: Of 1,237 patients with acute GIB, 468 (37.8%) had venous lactate on presentation. Of these patients, 165 (35.2%) had an elevated lactate level (&gt;2.0&nbsp;mmol/L). Patients with an elevated lactate level were more likely to be admitted to ICU than patients with a normal lactate level (adjusted odds ratio [AOR] 2.96, 95% confidence interval [CI] 1.74&ndash;5.01; p&lt;0.001). Patients with an elevated lactate level were more likely to receive PRBC transfusion (AOR 3.65, 95% CI 1.76&ndash;7.55; p&lt;0.001) and endoscopy (AOR 1.64, 95% CI 1.02&ndash;2.65; p=0.04) than patients with a normal lactate level. Conclusion: Elevated lactate level predicts the need for ICU admissions, transfusions, and endoscopies in patients with acute GIB. Lactate measurement may be a useful adjunctive test in the triage of patients with acute GIB. Keywords: venous lactate, ICU admissions, endoscopy, acute gastrointestinal bleedin

Simple and effective: transvaginal vesico-vaginal fistula repair with a modified Latzko technique

The incidence of vesico-vaginal fistulas after hysterectomies for benign indications in developed countries is less than one percent. The objective of this video is to demonstrate an easy-to-follow, step-by-step approach to repairing a small, uncomplicated vesico-vaginal fistula transvaginally using a modified Latzko technique. In this video, we present a case of a 46-year-old woman who developed a simple, uncomplicated vesico-vaginal fistula after a total abdominal hysterectomy. To correct her fistula, we used a modified Latzko technique, which is a transvaginal approach to vesico-vaginal fistula repair that involves mobilizing the vaginal mucosa around the fistula and then closing the pubo-vesical fascia and vaginal mucosa in layers. The patient had successful surgical correction of her vesico-vaginal fistula without recurrence of the fistula. For small, uncomplicated vesico-vaginal fistulas, a transvaginal approach has an equivalent success rate to that of other approaches with less invasiveness and faster recovery times. Therefore, it is reasonable to use a modified Latzko technique to help restore the quality of life to women affected by small, uncomplicated vesico-vaginal fistulas.12 month embargo; published online: 07 September 2017This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Elevated lactate level predicts intensive care unit admissions, endoscopies and transfusions in patients with acute gastrointestinal bleeding

Open Access Article. UA Open Access Publishing Fund.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]