Supporting the Professional Needs of Alternatively Certified Secondary Education Teachers

The reliance on alternative teacher certification to address teacher quality and quantity is an educational issue worthy of study because non-traditionally prepared teachers fill the nation\u27s classrooms. This qualitative case study explored the experiences of secondary education teachers with no preservice training who earned a professional educator certificate in Alabama through the alternative baccalaureate-level program. The central research questions of this study related to the professional needs of alternatively certified teachers and how educational leaders supported those professional needs. The conceptual framework of this project study included the National Research Center for Career and Technical Education\u27s differentiated induction model based on technical pedagogy and collegial support to address teacher quality and attrition. The qualitative data were gathered through a series of interviews with 6 alternatively certified secondary education teachers using specific protocols. Transcribed data were coded for a priori themes aligned to the research questions, and coded data were analyzed for trends and patterns. The results indicated that the participants perceived support from administrators and teacher leaders as important to their professional development and effectiveness. As a result of this study, a professional development training program was developed for the study site to assist educational leaders in providing an induction program. Implications for positive social change include for school and district administrators to have a better understanding of the challenges that alternatively certified teachers face; they may also appreciate the importance of providing administrator support to improve teacher effectiveness, retention, and ultimately student achievement

Key Topics on End-of-Life Care for African Americans

Racial classifications of human populations are politically and socially determined. There is no biological or genetic basis for these racial classifications. Health behaviors may be influenced by culture and poverty. Disparities in health outcomes, sometimes resulting in higher mortality rates for African-Americans appear to influence end of life decision-making attitudes and behaviors. To improve the quality of end of life care in African-American communities, health care professionals must better understand and work to eliminate disparities in health care, increase their own skills, knowledge and confidence in palliative and hospice care, and improve awareness of the benefits and values of hospice and palliative care in their patients and families

“What if There's Something Wrong with Her?”‐How Biomedical Technologies Contribute to Epistemic Injustice in Healthcare

While there is a steadily growing literature on epistemic injustice in healthcare, there are few discussions of the role that biomedical technologies play in harming patients in their capacity as knowers. Through an analysis of newborn and pediatric genetic and genomic sequencing technologies (GSTs), I argue that biomedical technologies can lead to epistemic injustice through two primary pathways: epistemic capture and value partitioning. I close by discussing the larger ethical and political context of critical analyses of GSTs and their broader implications for just and equitable healthcare delivery

Molecular identification of Trypanosoma theileri (Laveran, 1902) in cattle from two slaughterhouses in Ecuador and its relation with other haemotropic agents.

peer reviewedTrypanosoma theileri is a worldwide distributed haemoparasite that has been reported throughout the American continent in various species, including bovines, buffaloes and bats. In bovines, high incidence of T. theileri can be harmful when associated with other infections or under stress situations. There is little information on this hemoflagellate in Ecuador, which prompted the study and molecular identification of the trypanosomes collected in two slaughtering centers. Between February and April 2021, a total of 218 samples of bovine blood were collected in abattoirs located in the Andean region of Quito (n = 83) and in the coastal region, in Santo Domingo (n = 135). Quito public Slaughterhouse is the biggest in Ecuador, and for that, they receive animals from all country; on the other hand, Santo Domingo's Slaughterhouse is a small one where mainly females from the region are sacrificed and some males. The samples were evaluated using two molecular tests, the PCR cathepsin L-like (CatL) specific for T. theileri and for the positive samples, a Nested PCR that targets the ITS of the 18S gene. The corresponding PCR products were sequenced, analyzed by BLAST/NCBI and the sequences were used to build a concatenated phylogenetic tree, using the MEGA XI software. Overall, 34 out of the 218 samples, (15.6%) were positive to T. theileri by PCR CatL, resulting from 20/83 (24.1%) positives from the Quito abattoir and 14/135 (10.4%) from the Santo Domingo slaughterhouse. These prevalence rates were found to be significantly different (p = 0.006). According to the phylogenetic tree based on the CatL and ITS concatenated sequences (n = 13), the two novel Equatorial T. theileri isolates, ThI (n = 7) and ThII (n = 6) are closely related and associated to the IC, IB and IIB genotypes, present in Brazil, Venezuela and Colombia. Thirty-one out of the thirty-four T. theileri-positive bovines were co-infected with other haemotropic pathogens, Anaplasma marginale Babesia spp and T. vivax. This coinfection could be responsible for additional pathologies and harmful effects on the affected cattle. This study presents the molecular identification and genotypification of T. theileri isolated from cattle in Ecuador through the analysis of CAtL and ITS sequences, and the high frequency of coinfection of this hemoflagellate with other blood haemotropic organisms

Lesión Renal Aguda y Cuidados Críticos: Avances en la Detección Temprana.

Introduction: Acute renal injury, defined as a sharp deterioration of glomerular filtration, in hours or days, which is manifested by an increase in the blood of nitrogenates such as urea and creatinine, is a frequent complication in intensive care unit, Its early prediction is urgent and is a major diagnostic challenge. Objectives: Review literature on acute kidney injury and critical care: advances in early detection. Materials and Methods: A descriptive study was carried out, 42 articles from the last 5 years were selected, clinical cases, review studies, meta-analysis, systematic literature review, guidelines, observational studies, Descriptive, retrospective and expert opinions on: acute renal injury and critical care: advances in early detection. Results: Acute renal injury in critical care is associated with poor short- and long-term outcomes, so early detection is paramount, although 10% to 30% of LRA survivors may still need dialysis after hospital discharge. Conclusions: Early prediction of acute renal injury with biomarkers, renal ultrasound studies and development of nomogram models, represent an alternative for patients at high risk of developing acute renal injury and who can be diagnosed earlyIntroducción: La lesión Renal Aguda, se define como un brusco deterioro del filtrado glomerular, en horas o días, que se manifiesta por un aumento en la sangre de nitrogenados como urea y creatinina. Es una complicación frecuente en Unidad de Cuidados Intensivos, su predicción temprana es urgente y es un gran desafío diagnóstico. Objetivos: Realizar una revisión de la literatura sobre lesión renal aguda y cuidados críticos: avances en la detección temprana. Materiales y Métodos:  Se realizó una revisión sistemática, se seleccionaron 42 artículos de los últimos 5 años en su gran mayoría con, casos clínicos, estudios de revisión, metaanálisis, revisión sistemática, guías, estudios observacionales, descriptivos, retrospectivos sobre el tema: lesión renal aguda y cuidados críticos: avances en la detección temprana. Resultados: La lesión renal aguda en cuidados críticos, está asociada con malos resultados a corto y largo plazo, por lo que, su detección precoz es algo primordial, no obstante, el 10 % al 30 % de los sobrevivientes de LRA, aún pueden necesitar diálisis después del alta hospitalaria. Conclusiones: La predicción temprana de lesión renal aguda con biomarcadores, estudios de ecografía renal y desarrollo de modelos de nomogramas, representan una alternativa para pacientes con riesgo elevado de desarrollar lesión renal aguda y que pueden ser diagnosticados tempranamente

Trombólisis y trombectomía mecánica en el accidente cerebrovascular isquémico de grandes vasos. Artículo de revisión.

Introduction: Ischemic stroke is a medical emergency, with a high impact on the quality of life of patients suffering from it. Globally, only 5% of stroke patients receive thrombolysis or thrombectomy, despite being the second leading cause of disability and death worldwide. Objectives: to review the literature on thrombolysis and mechanical thrombectomy in acute stroke. Materials and methods: a bibliographic review of 36 scientific articles, including clinical cases, meta-analysis, guidelines, and observational studies, was carried out in the databases Pubmed, International Stroke Treatment Registry, IntechOpen, Google Scholar, among others. The search was conducted under the following topics: thrombolysis and mechanical thrombectomy in ischemic stroke. Discussion: Mechanical thrombectomy is beneficial until 24 hours after the onset of stroke in proximal occlusions of large vessels. According to the studies reviewed, in patients with stroke with basilar artery occlusion, middle cerebral artery and anterior arterial circulation, treated with thrombectomy and/or thrombolysis at 4.5 hours, 6 hours and 24 hours respectively, After the onset of symptoms, there was no significant difference between the use of thrombectomy alone or combined with thrombolysis. In Ecuador, a study has been reported that includes 96 patients, who underwent mechanical thrombectomy, whose effectiveness was evaluated with the modified Rankin scale, showing that, with the use of mechanical thrombectomy, the results are encouraging, suggesting a reduction in disability due to neurological sequelae. Conclusions: The early use of fibrinolysis during the first 4.5 hours, in patients with ischemic brain event of large vessels, is effective alone or accompanied by thrombectomy, however, after 4.5 hours, the greatest benefit is observed with mechanical thrombectomy regardless of the use of previous thrombolysis.Introducción: El accidente cerebrovascular isquémico o ictus isquémico, es una emergencia médica, con un alto impacto sobre la calidad de vida de los pacientes que lo padecen. A nivel mundial solo el 5% de los afectados con stroke recibe trombólisis o trombectomía, a pesar de ser la segunda causa de discapacidad y muerte en todo el mundo. Objetivos: realizar una revisión de la literatura sobre trombólisis y trombectomía mecánica en el accidente cerebrovascular agudo.  Materiales y métodos: se realizó una revisión bibliográfica de 36 artículos científicos, incluyendo casos clínicos, metaanálisis, guías y estudios observacionales, en las bases de datos Pubmed, International Stroke Treatment Registry, IntechOpen, Google académico, entre otras. La búsqueda se realizó bajo los siguientes temas: trombólisis y trombectomía mecánica en el accidente cerebrovascular isquémico. Discusión: La trombectomía mecánica es beneficiosa hasta 24 horas después del inicio del accidente cerebrovascular en oclusiones proximales de grandes vasos. Según los estudios revisados, en los pacientes con accidente cerebrovascular con oclusión de la arteria basilar, arteria cerebral media y circulación arterial anterior, tratados con trombectomía y/o trombólisis a las 4,5 horas, 6 horas   y 24 horas respectivamente, después del inicio de los síntomas, no se evidenció diferencia significativa entre, el uso de trombectomía sola o combinada con trombólisis.  En Ecuador se ha reportado un estudio que incluye 96 pacientes, a los cuales se les realizó trombectomía mecánica, cuya efectividad fue evaluada con la escala de Rankin modificada, evidenciándose que, con el uso de la trombectomía mecánica, los resultados son alentadores, sugiriendo una reducción en la incapacidad por secuelas neurológicas. Conclusiones: La utilización temprana de fibrinolisis durante las primeras 4,5 horas, en pacientes con evento cerebro vascular isquémico de grandes vasos, es efectiva sola o acompañada de trombectomía, no obstante, transcurrido las 4.5 horas, el mayor beneficio se observa con la trombectomía mecánica independientemente del uso de la trombólisis previa

African-specific alleles modify risk for asthma at the 17q12-q21 locus in African Americans

BACKGROUND: Asthma is the most common chronic disease in children, occurring at higher frequencies and with more severe disease in children with African ancestry. METHODS: We tested for association with haplotypes at the most replicated and significant childhood-onset asthma locus at 17q12-q21 and asthma in European American and African American children. Following this, we used whole-genome sequencing data from 1060 African American and 100 European American individuals to identify novel variants on a high-risk African American-specific haplotype. We characterized these variants in silico using gene expression and ATAC-seq data from airway epithelial cells, functional annotations from ENCODE, and promoter capture (pc)Hi-C maps in airway epithelial cells. Candidate causal variants were then assessed for correlation with asthma-associated phenotypes in African American children and adults. RESULTS: Our studies revealed nine novel African-specific common variants, enriched on a high-risk asthma haplotype, which regulated the expression of GSDMA in airway epithelial cells and were associated with features of severe asthma. Using ENCODE annotations, ATAC-seq, and pcHi-C, we narrowed the associations to two candidate causal variants that are associated with features of T2 low severe asthma. CONCLUSIONS: Previously unknown genetic variation at the 17q12-21 childhood-onset asthma locus contributes to asthma severity in individuals with African ancestries. We suggest that many other population-specific variants that have not been discovered in GWAS contribute to the genetic risk for asthma and other common diseases