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Esitys Kirjastoverkkopäivillä 25.10.2012 Helsingissä

Induction practices : experiences of newly qualified teachers

The thesis consists of four studies (articles I–IV) and a comprehensive summary. The aim is to deepen understanding and knowledge of newly qualified teachers’ experiences of their induction practices. The research interest thus reflects the ambition to strengthen the research-based platform for support measures. The aim can be specified in the following four sub-areas: to scrutinise NQTs’ experiences of the profession in the transition from education to work (study I), to describe and analyse NQTs’ experiences of their first encounters with school and classroom (study II), to explore NQTs’ experiences of their relationships within the school community (study III), to view NQTs’ experiences of support through peer-group mentoring as part of the wider aim of collaboration and assessment (study IV). The overall theoretical perspective constitutes teachers’ professional development. Induction forms an essential part of this continuum and can primarily be seen as a socialisation process into the profession and the social working environment of schools, as a unique phase of teachers’ development contributing to certain experiences, and as a formal programme designed to support new teachers. These lines of research are initiated in the separate studies (I–IV) and deepened in the theoretical part of the comprehensive summary. In order to appropriately understand induction as a specific practice the lines of research are in the end united and discussed with help of practice theory. More precisely the theory of practice architectures, including semantic space, physical space-time and social space, are used. The methodological approach to integrating the four studies is above all represented by abduction and meta-synthesis. Data has been collected through a questionnaire survey, with mainly open-ended questions, and altogether ten focus group meetings with newly qualified primary school teachers in 2007–2008. The teachers (n=88 in questionnaire, n=17 in focus groups), had between one and three years of teaching experience. Qualitative content analysis and narrative analysis were used when analysing the data. What is then the collected picture of induction or the first years in the profession if scrutinising the results presented in the articles? Four dimensions seem especially to permeate the studies and emerge when they are put together. The first dimension, the relational ˗ emotional, captures the social nature of induction and teacher’s work and the emotional character intimately intertwined. The second dimension, the tensional ˗ mutable, illustrates the intense pace of induction, together with the diffuse and unclear character of a teacher’s job. The third dimension, the instructive ˗ developmental, depicts induction as a unique and intensive phase of learning, maturity and professional development. Finally, the fourth dimension, the reciprocal ˗ professional, stresses the importance of reciprocity and collaboration in induction, both formally and informally. The outlined four dimensions, or integration of results, describing induction from the experiences of new teachers, constitute part of a new synthesis, induction practice. This synthesis was generated from viewing the integrated results through the theoretical lens of practice architecture and the three spaces, semantic space, physical space-time and social space. In this way, a more comprehensive, refined and partially new architecture of teachers’ induction practices are presented and discussed.

Open abdomen management: single institution experience

OBJECTIVE: to evaluate the outcome of abdominal wall integrity of both techniques. METHODS: a retrospective study was carried out at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, identifying the patients undergoing temporary abdominal closure (TAC) from January 2005 to December 2011. Data were collected through the review of clinical charts. Inclusion criteria were indication of TAC and survival to definitive abdominal closure. In the post-operative period only a group of three surgeons followed all patients and performed the reoperations. RESULTS: Twenty eightpatients were included. The difference in primary closure rates and mean time for fascial closure did not reach statistical significance (p=0.98 and p=0.23, respectively). CONCLUSION: VAC and Bogota Bag do not differ significantly regarding the outcome of abdominal wall integrity, due to the monitoring of a specific team and the adoption of progressive closure

Comparison between open and laparoscopic elective cholecystectomy in elderly, in a teaching hospital

Objective: to analyze the differences in mortality rates, length of hospital stay, time of surgery and the conversion rate between elective open cholecystectomies (OC) and laparoscopic ones (LC) in elderly patients. Methods : we evaluated medical records of patients 65 years of age or older undergoing open or laparoscopic cholecystectomy at the Hospital Regional de Mato Grosso do Sul between January 2008 and December 2011. We excluded individuals operated in non-elective scenarios or who underwent intraoperative cholangiography. Results : we studied 113 patients, of whom 38.1% were submitted to the OC and 61.9%, to LC. Women accounted for 69% of patients and men, for 31%. The conversion rate was 2.9%. The mean age and duration of the procudure was 70.1 and 84 minutes, respectively, with no significant difference between OC and LC. Patients undergoing LC had shorter hospital stays (2.01 versus 2.95 days, p=0.0001). We identified operative complications in sixpatients (14%) after OC and in nine (12%) after LC, with no statistical difference. Conclusion : there was no difference in morbidity and mortality when comparing OC with LC. The laparoscopic approach led to shorter hospital stay. Operative time did not differ between the two access routes. The conversion rate was similar to other studies.

Enhanced muscle strength with carbohydrate supplement two hours before open cholecystectomy: a randomized, double-blind study

Objective: to investigate the effects of preoperative fasting abbreviation with oral supplementation with carbohydrate in the evolution of grip strength in patients undergoing cholecystectomy by laparotomy. Methods : we conducted a clinical, randomizeddouble blind study with adult female patients, aged 18-60 years. Patients were divided into two groups: Control Group, with fasting prescription 6-8h until the time of operation; and Intervention Group, which received prescription of fasting for solids 6-8h before surgery, but ingested an oral supplement containing 12.5% carbohydrate, six (400ml) and two (200ml) hours before theprocedure. The handgrip strength was measured in both hands in both groups, at patient's admission (6h before surgery), the immediate pre-operative time (1h before surgery) and 12-18h postoperatively. Results : we analyzed 27 patients, 14 in the intervention group and 13 in the control group. There was no mortality. The handgrip strength (mean [standard deviation]) was significantly higher in the intervention group in the three periods studied, in at least one hand: preoperatively in the dominant hand (27.8 [2.6] vs 24.1 [3.7] kg; p=0.04), in the immediate preoperative in both hands, and postoperatively in the non-dominant hand (28.5 [3.0] vs 21.3 [5.9] kg; p=0.01). Conclusion : the abbreviation of preoperative fasting to two hours with drink containing carbohydrate improves muscle function in the perioperative period.

Open Door International Summer School at Mlada Boleslav, Czechoslovakia, July 31st – August 4th, 1933

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