EZ-IO intraosseous device implementation in a pre-hospital emergency service : a prospective study and review of the literature

Introduction : La prise en charge des patients critiques nécessite dans la majorité des situations l'obtention rapide d'un accès vasculaire, afin d'administrer des médicaments, des solutés de remplissage, ou des produits sanguins. La mise en place d'un accès vasculaire peut s'avérer difficile chez ces patients. En cas d'échec de pose d'une voie veineuse périphérique, des abords vasculaires alternatifs existent. Il s'agit essentiellement de la pose d'une voie veineuse centrale, la réalisation d'une dénudation veineuse, ou la pose d'une voie intra-osseuse. Depuis le développement de dispositifs d'insertion « semi-automatique » à la fin des années 90, la voie intra-osseuse, traditionnellement réservée aux cas pédiatriques, est de plus en plus fréquemment utilisée chez les patients adultes. Le Service des Urgences du CHUV a introduit en 2009 les dispositifs d'insertion d'aiguilles intra-osseuses de type EZ-IO® (perceuse électrique), en salle de réanimation des urgences vitales (déchoquage), ainsi qu'au sein du secteur préhospitalier pour les interventions du SMUR de Lausanne et de l'hélicoptère REGA de la base de Lausanne. Par cette étude, nous voulions mettre en évidence les aspects épidémiologiques des patients ayant dû être perfusés par cet abord dans un contexte préhospitalier, ainsi que les circonstances cliniques ayant justifié un tel usage, le taux de succès, les éventuelles complications, les médicaments perfusés et la mortalité des patients ayant bénéficié de ce dispositif. Méthode: Chaque patient ayant bénéficié de la mise en place d'une voie intra-osseuse par EZ-IO® du 1er janvier 2009 au 31 décembre 2011 a été inclus. Les données récoltées étaient l'âge, le sexe, l'indication à la mise en place de l'intra-osseuse, la localisation, le taux de succès, les médicaments et fluides administrés, les complications, la mortalité à 48 heures et à la sortie de l'hôpital. Tous les articles mentionnant l'utilisation de ΙΈΖ-ΙΟ® dans des situations cliniques ont également été analysés par une revue de littérature structurée exhaustive, afin de comparer nos résultats avec les données de la littérature. Résultats : Cinquante-huit patients, représentant 60 intra-osseuses EZ-IO®, ont été inclus. Leur âge moyen (47 ans), le taux de succès (90%), les indications, la localisation de l'aiguille (98% au niveau du tibia proximal) et le taux de complications (0%) correspondent aux valeurs trouvées dans la littérature. Le taux de survie de nos patients est de 38% à 48 heures et de 29% à la sortie de l'hôpital. De nombreux médicaments ou solutés de perfusion ont été administrés; l'adrénaline restant le médicament le plus fréquemment administré par cette voie. Dans 7 cas, les patients ont bénéficié d'une induction d'anesthésie par voie intra-osseuse. La revue de littérature a permis de compiler 30 études distinctes, représentant un total de 1603 accès vasculaires de type EZ-IO®. Conclusion : La voie intra-osseuse s'avère fiable et rapide pour obtenir un accès vasculaire, avec un taux de complications très faible et permet l'administration d'un grand nombre de substances. D'autres études sont nécessaires pour évaluer l'impact de la voie intra osseuse, notamment en termes de mortalité, de complications tardives, ainsi que d'analyse coût/bénéfice de ce matériel.

An Empirical Study on Faculty Perceptions and Teaching Practices of Wikipedia

Some faculty members from different universities around the world have begun to use Wikipedia as a teaching tool in recent years. These experiences show, in most cases, very satisfactory results and a substantial improvement in various basic skills, as well as a positive influence on the students' motivation. Nevertheless and despite the growing importance of e-learning methodologies based on the use of the Internet for higher education, the use of Wikipedia as a teaching resource remains scarce among university faculty.Our investigation tries to identify which are the main factors that determine acceptance or resistance to that use. We approach the decision to use Wikipedia as a teaching tool by analyzing both the individual attributes of faculty members and the characteristics of the environment where they develop their teaching activity. From a specific survey sent to all faculty of the Universitat Oberta de Catalunya (UOC), pioneer and leader in online education in Spain, we have tried to infer the influence of these internal and external elements. The questionnaire was designed to measure different constructs: perceived quality of Wikipedia, teaching practices involving Wikipedia, use experience, perceived usefulness and use of 2.0 tools. Control items were also included for gathering information on gender, age, teaching experience, academic rank, and area of expertise.Our results reveal that academic rank, teaching experience, age or gender, are not decisive factors in explaining the educational use of Wikipedia. Instead, the decision to use it is closely linked to the perception of Wikipedia's quality, the use of other collaborative learning tools, an active attitude towards web 2.0 applications, and connections with the professional non-academic world. Situational context is also very important, since the use is higher when faculty members have got reference models in their close environment and when they perceive it is positively valued by their colleagues. As far as these attitudes, practices and cultural norms diverge in different scientific disciplines, we have also detected clear differences in the use of Wikipedia among areas of academic expertise. As a consequence, a greater application of Wikipedia both as a teaching resource and as a driver for teaching innovation would require much more active institutional policies and some changes in the dominant academic culture among faculty members.

An empirical study on faculty perceptions and teaching practices of Wikipedia

Peer-reviewed

Integrating environmental education in primary school education in Tanzania : teachers’ perceptions and teaching practices

The study focuses on primary school teachers’ perceptions of environmental education, its integration into primary school education and teachers’ teaching practices in Tanzania. The thesis is based on empirical research. The theoretical underpinnings of the study are based on Palmer’s (1998) model of environmental education. According to the model, meaningful environmental education should include education about, in or through and for the environment. The study is supported by national and international literature from research done on environmental education and education for sustainable development and policy statements. The study is qualitative in nature, adopting phenomenography and phenomenology as points of departure. The empirical data was collected from four primary schools in Morogoro region in Tanzania. The study sample consisted of 31 primary school teachers. Data was collected through interviews and lesson observations. According to the results of the study, primary school teachers expressed variations in their perceptions of environmental education and education for sustainable development. Most of the teachers focused on the aspect of knowledge acquisition. According to Tanzanian education and training policy, environmental education has to be integrated into all subjects. Although there is environmental education in the primary school curriculum, it is not integrated on an equal footing in all subjects. Some subjects like science, social studies and geography have more environmental content than other subjects. Teachers claim that the approach used to integrate environmental education into the school curriculum was not favoured because many claimed that what is to be taught as environmental education in the various subjects is not shown clearly. As a result, many teachers suggested that to ensure that it is taught properly it should be included in the curriculum as an independent subject or as specific topics. The study revealed that teachers’ teaching practices in integrating environmental education varied from one subject to another. Although most of the teachers said that they used participatory methods, lesson observations showed that they limited themselves to question and answer and group discussion. However, the teachers faced a number of barriers in the teaching of environmental education, some of which include lack of teaching and learning resources, time and large class size. The role of teachers in the implementation of environmental education in developing an environmentally literate citizenry is of great significance. The responsibility of the government in developing a curriculum with clear goals and content, developing teachers’ capacity in the teaching of environmental education and provision of teaching and learning materials needs to be taken seriously by the government in educational plans and programs.

The association of faculty's teaching philosophy and teaching behaviour, and critical thinking and self- direction in learning

The intent in this study was to investigate in what ways teachers· beliefs about education and teaching are expressed in the specific teaching behaviours they employ, and whether teaching behaviours, as perceived by their students, are correlated with students· critical thinking and self-directed learning. To this end the relationships studied were: among faCUlty members· philosophy of teaching, locus of control orientation, psychological type, and observed teaching behaviour; and among students· psychological type, perceptions of teaching behaviour, self-directed learning readiness, and critical thinking. The overall purpose of the study was to investigate whether the implicit goals of higher education, critical thinking and self-direction, were actually accounted for in the university classroom. The research was set within the context of path-goal theory, adapted from the leadership literature. Within this framework, Mezirow·s work on transformative learning, including the influences of Habermas· writings, was integrated to develop a theoretical perspective upon which to base the research methodology. Both qualitative and quantitative methodologies were incorporated. Four faCUlty and a total of 142 students participated in the study. Philosophy of teaching was described through faCUlty interviews and completion of a repertory grid. Faculty completed a descriptive locus of control scale, and a psychological type test. Observations of their teaching behaviour were conducted. Students completed a Teaching Behaviour Assessment Scale, the Self-Directed Learning Readiness Scale, a psychological type test, and the Watson-Glaser Critical Thinking Appraisal. A small sample of students were interviewed. Follow-up discussions with faculty were used to validate the interview, observation, teaching behaviour, and repertory grid data. Results indicated that some discrepancies existed between faculty's espoused philosophy of teaching and their observed teaching behaviour. Instructors' teaching behaviour, however, was a function of their personal theory of practice. Relationships were found between perceived teaching behaviour and students· self-directed learning and critical thinking, but these varied across situations, as would be predicted from path-goal theory. Psychological type of students and instructor also accounted for some of the variability in the relationships studied. Student psychological type could be shown as a partial predictor of self-directed learning readiness. The results were discussed in terms of theory development and implications for further research and practice.

The value of using short-format podcasts to enhance learning and teaching

This paper presents the findings of a podcasting trial held in 2007-2008 within the Faculty of Economics and Business at the University of Sydney, Australia. The trial investigates the value of using short-format podcasts to support assessment for postgraduate and undergraduate students. A multi-method approach is taken in investigating perceptions of the benefits of podcasting, incorporating surveys, focus groups and interviews. The results show that a majority of students believe they gained learning benefits from the podcasts and appreciated the flexibility of the medium to support their learning, and the lecturers felt the innovation helped diversify their pedagogical approach and support a diverse student population. Three primary conclusions are presented: (1) most students reject the mobile potential of podcasting in favour of their traditional study space at home; (2) what students and lecturers value about this podcasting design overlap; (3) the assessment-focussed, short-format podcast design may be considered a successful podcasting model. The paper finishes by identifying areas for future research on the effective use of podcasting in learning and teaching.

LMS software study and a practical application in language and literature didactics. 'Aplicación práctica en Didáctica de la lengua y la literatura del software LMS'.

Resumen en español

English and English literature : complete study and revision guide.

Guía actualizada de acuerdo con las modificaciones del contenido curricular. Contiene todo lo que los estudiantes necesitan saber para lograr superar el General Certificate of Secundary Education (GCSE) de inglés y literatura inglesa. Ha sido escrito por un examinador para ayudar en el aprendizaje de los alumnos y orientar su revisión. Su contenido se puede utilizar como obra de referencia, para apoyar el estudio a lo largo del curso, o como para una revisión para la preparación de los exámenes. El estudio de textos de teatro, novelas y cuentos se centra en antes y después de mil novecientos catorce. Ofrece comentarios en el margen de algunas páginas para llamar la atención del estudiante sobre puntos importantes que de otro modo podría perder. Al final de cada sección hay ejemplos de preguntas GCSE y preguntas de examen práctico. Las respuestas a las preguntas de examen, simulacros de exámenes e índice de documentos se encuentran al final de la publicación.

A word study unit on Latin and Greek prefixes, roots and derivations

This paper contains an outline of study for hearing impaired children to learn language through the study of Latin and Greek roots, derivatives and prefixes.

Learning by Reading : A literature study on the use of authentic texts in the EFL upper elementary classroom

The English language is widely used throughout the world and has become a core subject in many countries, especially for students in the upper elementary classroom. While textbooks have been the preferred EFL teaching method for a long time, this belief has seemingly changed within the last few years. Therefore, this study looks at what prior research says about the use of authentic texts in the EFL upper elementary classroom with an aim to answer research questions on how teachers can work with authentic texts, what the potential benefits of using authentic texts are and what teachers and students say about the use of authentic texts in the EFL classroom. While this thesis is written from a Swedish perspective, it is recognized that many countries teach EFL. Therefore, international results have also been taken into consideration and seven previous research studies have been analyzed in order to gain a better understanding of the use of authentic texts in the EFL classroom. Results indicate that the use of authentic texts is beneficial in teaching EFL. However, many teachers are still reluctant to use these, mainly because of time constraints and the belief that such texts are too difficult for their students. Since these findings are mainly focused on areas outside of Sweden, additional research is needed before conclusions can be drawn on the use of authentic texts in the Swedish upper elementary EFL classroom.

English as the target language : A literature study on teachers’ and L2 learners’ language use in the upper elementary classroom

Even though English is a subject where Swedish pupils do well compared to pupils in other countries, research indicates that pupils are not always motivated to learn in the English classroom. Therefore, the aim of this study is to find research relating to the use of the target language in classrooms for pupils at the upper elementary level, particularly language learners in Sweden. The focus of this thesis is to find out what benefits and challenges accompany the use of the target language during English lessons, as well as what pupils’ opinions are on the consistent use of the target language in the classroom. This literature review of five research articles shows that it is beneficial for pupils’ language development to have lessons where mainly the target language is used. It is for example beneficial for pupils’ ability to speak, their pronunciation, vocabulary and ability to use language strategies. The results show that there are challenges as well, especially for the teachers, since use of the target language presumes that the teacher has good language skills and is capable of scaffolding each pupil at their individual level and in their zone of proximal development. Furthermore, there are challenges like differences in pupils’ skill level, creating tasks that both motivate and stimulate, and creating a safe learning environment. Even though the results in this thesis are limited, it is still obvious that it is an important area, where more research is necessary in order to assist teachers in how to teach English as effectively as possible.

Borrelia in granuloma annulare, morphea and lichen sclerosus: a PCR-based study and review of the literature

Morphea, granuloma annulare (GA) and lichen sclerosus et atrophicans (LSA) have also been suggested to be linked to Borrelia infection. Previous studies based on serologic data or detection of Borrelia by immunohistochemistry and polymerase chain reaction (PCR) reported contradictory results. Thus, we examined skin biopsies of morphea, GA and LSA by PCR to assess the prevalence of Borrelia DNA in an endemic area and to compare our results with data in the literature.