Prefirst Placement: Parent Attitude Survey

Signs of low-achievement in kindergarten students lead to difficult decisions for parents. Often parents request that their children be pushed ahead into first grade, hoping that the child will catch up. However, studies have shown that it is rare for the child to ever be able to catch up with the rest of the class. Making children repeat kindergarten is also problematic, as children are not learning any new material, and their self-confidence may be shaken seeing their peers advance ahead of them. An alternative option is to place these children into a prefirst grade class. Prefirst grade classes have a large success rate in improving a child’s chances of succeeding in later grades, and positively impacting self-confidence. However, in spite of the success, parents often view prefirst classes as negative. In this master thesis, the author surveyed 114 parents of children enrolled in prefirst grade within the Rochester NY school district. The survey was composed of 17 questions pertaining to parent’s initial feelings of placing their children in prefirst classes, and their feelings after their children completed the class. The results show that while almost half of parents were unhappy about the initial placement, 75% of parents were happy about the placement by the end. Generally, parents found the prefirst grade to be beneficial to their child’s listening, learning, and self-esteem

Echocardiographic findings of iatrogenic septal defect during TA-AVI

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Bile analysis in heroin overdose.

Following its metabolism in the liver, morphine and its metabolites can be directly eliminated in bile. Then, they undergo the enterohepatic cycle (EHC) and mostly reappear in the circulation. We report a case showing the presence of morphine in bile (21.3 lg \u2044 mL) and hair (4.8 ng \u2044mg) but not in blood, urine or the liver of an addict who survived in hospital for about 144 h (6 days). These data would indicate that the EHC does not play any role about 144 h after the last injection, and directly confirms that gall bladder is a storage depot for morphine. They constitute the first report of a demonstration of the effect of the EHC on morphine bioavailability in an addict, and could be considered as indication, without supporting circumstantial evidence, that the morphine level in bile is related to chronic opiate use

Analisi del fenomeno della guida in stato di ebbrezza da alcool nella provincia di Macerata negli anni 2008-2009 sulla base della attivit\ue0 di controllo delle Forze dell'ordine

This study analyzes the phenomenon of driving under the influence of alcohol, based on police control data in the province of Macerata during the years 2008 and 2009. The study was carried out following the introduction of Law 160/2007 that envisages higher levels of sanctioning for drunk driving. Data utilized have concerned the alcohol concentrations found in drivers who have been subject to breathalyzer and have been sanctioned. Data analysis show differences not only between sexes but also between different age groups, with the youngest people being more sanctioned. Average alcohol levels were higher in older age groups

An esophageal lymphoma discovered by echocardiography.

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Balloon Atrial Septostomy by a Right Internal Jugular Venous Approach in a Newborn with Hypoplastic Left Heart Syndrome with a Restrictive Atrial Septum

Hypoplastic left heart syndrome with an intact or highly restrictive atrial septum requires urgent decompression of the left atrium. Catheter‐based interventions from the femoral or umbilical veins represent the standard method of atrial decompression. Restrictive atrial septal defects located at the superior portion of the fossa ovalis can be difficult to cross from these access sites. Here, we describe a successful R ashkind balloon atrial septostomy performed from an internal jugular approach.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108663/1/chd12108.pd

Pulse Fluoroscopy Radiation Reduction in a Pediatric Cardiac Catheterization Laboratory

ObjectiveTo determine if lower starting pulse fluoroscopy rates lead to lower overall radiation exposure without increasing complication rates or perceived procedure length or difficulty.SettingThe pediatric cardiac catheterization laboratory at University of Michigan Mott Children's Hospital.PatientsPediatric patients with congenital heart disease.Design/InterventionsWe performed a single‐center quality improvement study where the baseline pulse fluoroscopy rate was varied between cases during pediatric cardiac catheterization procedures.Outcome MeasuresIndirect and direct radiation exposure data were collected, and the perceived impact of the fluoroscopy rate and procedural complications was recorded. These outcomes were then compared among the different set pulse fluoroscopy rates.ResultsComparing pulse fluoroscopy rates of 15, 7.5, and 5 frames per second from 61 cases, there was a significant reduction in radiation exposure between 15 and 7.5 frames per second. There was no difference in perceived case difficulty, procedural length, or procedural complications regardless of starting pulse fluoroscopy rate.ConclusionsFor pediatric cardiac catheterizations, a starting pulse fluoroscopy rate of 7.5 frames per second exposes physicians and their patients to significantly less radiation with no impact on procedural difficulty or outcomes. This quality improvement study has resulted in a significant practice change in our pediatric cardiac catheterization laboratory, and 7.5 frames per second is now the default fluoroscopy rate.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111168/1/chd12197.pd