Brown v. Board of Education of Topeka : Sumner and Monroe Elementary Schools : management alternatives study and environmental assessment.

"March 1992."

Annual Report of the State Superintendent of Education

Mode of access: Internet.

Post-Operative Pain Scores and Level of Regional Anesthesia Expertise: Using Clinical Outcomes to Assess Procedural Proficiency

Background and Objectives: Peripheral nerve blockade requires regional anesthesia skills that trainees learn in several formats. Technical proficiency has shifted from a quota to comprehensive procedural evaluation. Successful nerve blockade is the clinical endpoint validating proficiency but patient, technical and procedural factors influence this result. The purpose of this study was to determine if procedural expertise for sciatic nerve blockade influenced postoperative pain scores and opioid requirements and if patient factors, technique and repetition influenced this outcome. Method: Sciatic nerve blockade by nerve stimulation and ultrasound guidance and training level of the resident performing the procedure were recorded. Patient obesity, trauma, chronic pain, opioid use and preoperative pain scores were compared to post-procedure pain scores and opioid analgesic requirements. Results: 102 patients received sciatic nerve blockade from 47 trainees over a 36 month interval. A significant relation between training level and improved pain scores was not demonstrated but transition from nerve stimulation to ultrasound guidance lowered scores in all groups. Nerve blockade failure was frequent with chronic opioid use and trauma. Conclusion: Analgesic outcomes should be an integral part of assessment of proficiency in regional anesthesia techniques. Evaluating outcomes of procedures throughout training will longitudinally assess technical expertise.

Oxygen sensors and energy sensors act synergistically to achieve a graded alteration in gene expression: Consequences for assessing the level of neuroprotection in response to stressors

Changes in gene expression are associated with switching to an autoprotected phenotype in response to environmental and physiological stress. Ubiquitous molecular chaperones from the heat shock protein (HSP) superfamily confer neuronal protection that can be blocked by antibodies. Recent research has focused on the interactions between the molecular sensors that affect the increased expression of neuroprotective HSPs above constitutive levels. An examination of the conditions under which the expression of heat shock protein 70 (Hsp70) was up regulated in a hypoxia and anoxia tolerant tropical species, the epaulette shark (Hemiscyllium ocellatum), revealed that up-regulation was dependent on exceeding a stimulus threshold for an oxidative stressor. While hypoxic-preconditioning confers neuroprotective changes, there was no increase in the level of Hsp70 indicating that its increased expression was not associated with achieving a neuroprotected state in response to hypoxia in the epaulette shark. Conversely, there was a significant increase in Hsp70 in response to anoxic-preconditioning, highlighting the presence of a stimulus threshold barrier and raising the possibility that, in this species, Hsp70 contributes to the neuroprotective response to extreme crises, such as oxidative stress. Interestingly, there was a synergistic effect of coincident stressors on Hsp70 expression, which was revealed when metabolic stress was superimposed upon oxidative stress. Brain energy charge was significantly lower when adenosine receptor blockade, provided by treatment with aminophylline, was present prior to the final anoxic episode, under these circumstances, the level of Hsp70 induced was significantly higher than in the pair-matched saline treated controls. An understanding of the molecular and metabolic basis for neuroprotective switches, which result in an up-regulation of neuroprotective Hsp70 expression in the brain, is needed so that intervention strategies can be devised to manage CNS pathologies and minimise damage caused by ischemia and trauma. In addition, the current findings indicate that measurements of HSP expression per se may provide a useful correlate of the level of neuroprotection achieved in the switch to an autoprotected phenotype.

Reduced hepatic extraction of palmitate in steatosis correlated to lower level of liver fatty acid binding protein

Nonalcoholic fatty liver disease is the most common of all liver diseases. The hepatic disposition [H-3]palmitate and its low-molecular-weight metabolites in perfused normal and steatotic rat liver were studied using the multiple indicator dilution technique and a physiologically based slow diffusion/bound pharmacokinetic model. The steatotic rat model was established by administration of 17alpha-ethynylestradiol to female Wistar rats. Serum biochemistry markers and histology of treated and normal animals were assessed and indicated the presence of steatosis in the treatment group. The steatotic group showed a significantly higher alanine aminotransferase-to-aspartate aminotransferase ratio, lower levels of liver fatty acid binding protein and cytochrome P-450, as well as microvesicular steatosis with an enlargement of sinusoidal space. Hepatic extraction for unchanged [H-3]palmitate and production of low-molecular-weight metabolites were found to be significantly decreased in steatotic animals. Pharmacokinetic analysis suggested that the reduced extraction and sequestration for palmitate and its metabolites was mainly attributed to a reduction in liver fatty acid binding protein in steatosis.

Sociodemographic backgrounds and career decisions of Australian and New Zealand dental students

This article describes the sociodemographic and career selection characteristics of dental students in Australia and New Zealand. A total of 672 dental students participated in the study. The survey covered age, language proficiency, type of school attended, place of residence, parental occupation, and level of education. The respondents had an average age of twenty-two years, with a range of eighteen to fifty. Fifty-six percent of respondents were female, and approximately half had completed secondary education in private schools with 44.3 percent having finished in public schools. The majority of students lived with their parents, with only a few respondents reporting a rural home address (6.8 percent). The majority of students (65.3 percent) had placed dentistry as their first career choice and had most likely made the decision after leaving high school or near the end of high school (81.4 percent), with self-motivation being the major influence on their decision. This study provides a description of the sociodemographic profile of Australian and New Zealand dental students and provides a better understanding of career decision issues. It also highlights areas for further investigation and management by educational institutions and public policy.

The effect of xylanase, phytase and lipase supplementation on the performance of broiler chickens fed a diet with a high level of rice bran.

Enzyme products did not have a significant effect (P>0.05) on weekly fed intake and weight gain of birds. But feed intake tended to drop and weight gain tended to increase in response to supplementation of the three enzymes. Weight gain of the birds was increased by 0.6% with lipase, 3.7% with phytase and 2.4% with xylanase. Xylanase had a marked effect (P