Secondary curve behavior in Lenke Type 1C adolescent idiopathic scoliosis after thoracoscopic selective anterior thoracic fusion

Study Design. Analysis of a case series of 24 Lenke 1C adolescent idiopathic scoliosis (AIS) patients receiving selective thoracoscopic anterior scoliosis correction. Objective. To report the behaviour of the compensatory lumbar curve in a group of Lenke IC AIS patients following thoracoscopic anterior scoliosis correction, and to compare the results of this study with previously published data. Summary of Background Data. Several prior studies have reported spontaneous lumbar curve correction for both anterior and posterior selective fusion in Lenke 1C/King-Moe II patients; however to our knowledge no previous studies have reported outcomes of thoracoscopic anterior correction for this curve type. Methods. All AIS patients with a curve classification of Lenke 1C and a minimum of 24 months follow-up were retrieved from a consecutive series of 190 AIS patients who underwent thoracoscopic anterior instrumented fusion. Cobb angles of the major curve, instrumented levels, compensatory lumbar curve, and T5-T12 kyphosis were recorded, as well as coronal spinal balance, T1 tilt angle and shoulder balance. All radiographic parameters were measured before surgery and at 2, 6, 12 and 24 months after surgery. Results. Twenty-four female patients with right thoracic curves had a mean thoracic Cobb angle of 53.0° before surgery, decreasing to 24.9° two years after surgery. The mean lumbar compensatory Cobb angle was 43.5° before surgery, spontaneously correcting to 25.4° two years after surgery, indicating balance between the thoracic and lumbar scoliotic curves. The lumbar correction achieved (41.8%) compares favourably to previous studies. Conclusions. Selective thoracoscopic anterior fusion allows spontaneous lumbar curve correction and achieves coronal balance of main thoracic and compensatory lumbar curves, good cosmesis and patient satisfaction. Correction and balance are maintained 24 months after surgery.

Combined VEGF and PDGF treatment reduces secondary degeneration after spinal cord injury

Trauma to the spinal cord creates an initial physical injury damaging neurons, glia, and blood vessels, which then induces a prolonged inflammatory response, leading to secondary degeneration of spinal cord tissue, and further loss of neurons and glia surrounding the initial site of injury. Angiogenesis is a critical step in tissue repair, but in the injured spinal cord angiogenesis fails; blood vessels formed initially later regress. Stabilizing the angiogenic response is therefore a potential target to improve recovery after spinal cord injury (SCI). Vascular endothelial growth factor (VEGF) can initiate angiogenesis, but cannot sustain blood vessel maturation. Platelet-derived growth factor (PDGF) can promote blood vessel stability and maturation. We therefore investigated a combined application of VEGF and PDGF as treatment for traumatic spinal cord injury, with the aim to reduce secondary degeneration by promotion of angiogenesis. Immediately after hemisection of the spinal cord in the rat we delivered VEGF and PDGF and to the injury site. One and 3 months later the size of the lesion was significantly smaller in the treated group compared to controls, and there was significantly reduced gliosis surrounding the lesion. There was no significant effect of the treatment on blood vessel density, although there was a significant reduction in the numbers of macrophages/microglia surrounding the lesion, and a shift in the distribution of morphological and immunological phenotypes of these inflammatory cells. VEGF and PDGF delivered singly exacerbated secondary degeneration, increasing the size of the lesion cavity. These results demonstrate a novel therapeutic intervention for SCI, and reveal an unanticipated synergy for these growth factors whereby they modulated inflammatory processes and created a microenvironment conducive to axon preservation/sprouting.

Leadership practices of Kuwaiti Secondary School Principals for embedding ICT

Globalisation and the emergence of knowledge-based economies have forced many countries to reform their education system. The enhancement of human capital to meet modern day demands of a knowledge economy, and equip the new generation with the capacity to meet the challenges of the 21st Century has become a priority. This change is particularly necessary in economies typical of countries, such as Kuwait, which have been dependent on the exploitation of non-renewable natural resources. Transiting from a resource-based economy to an economy based on knowledge and intellectual skills poses a key challenge for an education system. Significant in the development of this new economy has been the expansion of Information Communication Technology (ICT). In education, in particular, ICT is a tool for transforming the education setting. However, transformation is only successful where there are effective change management strategies and appropriate leadership. At the school level, rapid changes have affected the role that principals take particularly in relation to leading the change process. Therefore, this study investigated the leadership practices of school principals for embedding ICT into schools. The case study assessed two Kuwaiti secondary schools; both schools had well established ICT programs. The mode of data collection used a mixed-methods design, to address the purpose of the study, namely, to examine the leadership practices of school principals when managing the change processes associated with embedding ICT in the context of Kuwait. A theoretical model of principal leadership, developed, from the literature, documented and analysed the practices of the respective school principals. The study used the following five data sources: (a) face to face interviews (with each school principal), and two focus group interviews (with five teachers and five students, from each school); (b) school documents (related to the implementation and embedding of ICT); (c) one survey (of all teachers in each school); (d) an open-ended questionnaire (of participating principals and teachers); and (e) the observation of ICT activities (PD ICT activities and instruction meetings). The study revealed a range of strategies used by the principals and aligned with the theoretical perspective. However, these strategies needed to be refined and selectively used to fit the Kuwait context, both culturally and organisationally. The principals of Schools A and B employed three key strategies to maximise the impact on the teaching staff incorporating ICT into their teaching and learning practices. These strategies were: (a) encouragement for teaching staff to implement ICT in their teaching; (b) support to meet the material and human needs of teaching staff using ICT; and (c) provision of instructions and guidance for teaching staff in how and why such behaviours and practices should be performed. The strategies provided the basic leadership practices required to construct a successful ICT embedded implementation process. Hence, a revised model of leadership that has applicability in the adoption of ICT in Kuwait was developed. The findings provide a better understanding of how a school principal’s leadership practices impact upon the ICT embedding process. Hence, the outcome of this study informs emerging countries, which are also undergoing major change related to ICT, for example, other members of the Cooperation Council for the Arab States of the Gulf. From an educational perspective, this knowledge has the potential to support ICT-based learning environments that will help educational practitioners to effectively integrate ICT into teaching and learning that will facilitate students’ ICT engagement, and prepare them for the ICT development challenges that are associated with the new economy; this is achieved by increasing students’ knowledge and performance. Further, the study offers practical strategies that have been shown to work for school principals leading ICT implementation in Kuwait. These strategies include how to deal with the shortage in schools’ budgets, and the promotion of the ICT vision, as well as developing approaches to build collaborative culture in the schools.

Broadening horizons : an emerging research agenda modelling design led innovation across secondary education

A re-examination of design education at all levels is needed to ensure global economic competitiveness and social and environmental sustainment. This paper presents an emerging research agenda modelling design led innovation approaches from the business sector to secondary education curriculum. To do this, a review of literature is provided and current knowledge gaps surrounding design education are detailed. A regional secondary school design immersion program is outlined as a future research case study using action research. A framework and recommendations for developing and delivering pedagogical approaches for 21st century skill outcomes in secondary education are briefly introduced and future research objectives are overviewed and discussed.

An integrated approach to professional development in secondary schools

Following the implementation of the National Professional Standards for Teachers, all teachers in Australia will be required to undertake 30 hours per year of professional development (PD) to maintain their registration. However, defining what constitutes effective PD is complex and often contested. This paper looks at a case study in Queensland, Australia, where a high school worked collaboratively with a university lecturer to deliver effective whole-school professional development. The lecturer acted as an external change agent, working closely with the principal and staff to build a relationship of trust and to develop a strategy for the delivery of PD on-site. This case highlights how partnerships between teachers and teacher educators combined with a willing school leader can provide positive opportunities for collaborative, sustainable, professional growth and learning.

Near-Wall Turbulent Pressure Diffusion Modeling and Influence in Three-Dimensional Secondary Flows

The purpose of this paper is to develop a second-moment closure with a near-wall turbulent pressure diffusion model for three-dimensional complex flows, and to evaluate the influence of the turbulent diffusion term on the prediction of detached and secondary flows. A complete turbulent diffusion model including a near-wall turbulent pressure diffusion closure for the slow part was developed based on the tensorial form of Lumley and included in a re-calibrated wall-normal-free Reynolds-stress model developed by Gerolymos and Vallet. The proposed model was validated against several one-, two, and three-dimensional complex flows.

A methodological approach to modelling design led innovation across secondary education : an Australian case study

Incorporating design thinking as a generic capability at a school level is needed to ensure future generations are empowered for business innovation and active citizenship. This paper describes the methodology of an investigation into modelling design led innovation approaches from the business sector to secondary education, as part of a larger study. It builds on a previously discussed research agenda by outlining the scope, significance and limitations of currently available research in this area, examining an action research methodology utilising an Australian design immersion program case study, and discussing implications and future work. It employs a triangulated approach encompassing thematic analysis of qualitative data collection from student focus groups, semi-structured convergent interviews with teachers and facilitators, and student journals. Eventual outcomes will be reviewed and analysed within the framework of a proposed innovation matrix model for educational growth, synthesising principles responding to 21st century student outcomes. It is anticipated this research will inform a successful design led secondary education innovation model, facilitating new engagement frameworks between tertiary and secondary education sectors, as well as providing new insight into the suitability of action research in prototyping social innovation in Australia.

Designing a new robust on-line secondary path modeling technique for feedforward active noise control systems

Several approaches have been introduced in the literature for active noise control (ANC) systems. Since the filtered-x least-mean-square (FxLMS) algorithm appears to be the best choice as a controller filter, researchers tend to improve performance of ANC systems by enhancing and modifying this algorithm. This paper proposes a new version of the FxLMS algorithm, as a first novelty. In many ANC applications, an on-line secondary path modeling method using white noise as a training signal is required to ensure convergence of the system. As a second novelty, this paper proposes a new approach for on-line secondary path modeling on the basis of a new variable-step-size (VSS) LMS algorithm in feed forward ANC systems. The proposed algorithm is designed so that the noise injection is stopped at the optimum point when the modeling accuracy is sufficient. In this approach, a sudden change in the secondary path during operation makes the algorithm reactivate injection of the white noise to re-adjust the secondary path estimate. Comparative simulation results shown in this paper indicate the effectiveness of the proposed approach in reducing both narrow-band and broad-band noise. In addition, the proposed ANC system is robust against sudden changes of the secondary path model.

An efficient online secondary path estimation for feedback active noise control systems

In practical cases for active noise control (ANC), the secondary path has usually a time varying behavior. For these cases, an online secondary path modeling method that uses a white noise as a training signal is required to ensure convergence of the system. The modeling accuracy and the convergence rate are increased when a white noise with a larger variance is used. However, the larger variance increases the residual noise, which decreases performance of the system and additionally causes instability problem to feedback structures. A sudden change in the secondary path leads to divergence of the online secondary path modeling filter. To overcome these problems, this paper proposes a new approach for online secondary path modeling in feedback ANC systems. The proposed algorithm uses the advantages of white noise with larger variance to model the secondary path, but the injection is stopped at the optimum point to increase performance of the algorithm and to prevent the instability effect of the white noise. In this approach, instead of continuous injection of the white noise, a sudden change in secondary path during the operation makes the algorithm to reactivate injection of the white noise to correct the secondary path estimation. In addition, the proposed method models the secondary path without the need of using off-line estimation of the secondary path. Considering the above features increases the convergence rate and modeling accuracy, which results in a high system performance. Computer simulation results shown in this paper indicate effectiveness of the proposed method.

Principals, Teachers, and Student's Perception of the Information and Communication Technology in Kuwait Secondary Schools (Rhetoric and reality)

ICT integration has been advocated to provide opportunities to improve students’ achievement and engagement through transforming the educational setting. A valuable tool that contributes in enhancing and developing students’ cognitive skills for lifelong learning, ICT integration has introduced a new educational philosophy, shifting the role of students into a more central position in the pedagogical processes. Kuwait, as with many other countries, has recently planned ICT integration to develop its citizen’s capacities. This study sought to capture the principals’, teachers’, and students’ perceptions of ICT integration in pedagogical activities, as well as how ICT is being used for learning and teaching activities in three ICT leading Kuwaiti secondary schools. Interviews with principals, teachers, and students were conducted, along with an open-ended questionnaire for the teachers, researcher observations, and document analysis. The findings revealed that ICT integration in Kuwait needed to be reinforced to accomplish the ICT integration objectives. A call for further support for teachers, and a reconsideration of the ICT integration strategies were also recommended.

The deep trauma of secondary victimisation : parents of sex offenders

The publication of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) introduced the notion that a life-threatening illness can be a stressor and catalyst for Posttraumatic Stress Disorder (PTSD). Since then a solid body of research has been established investigating the post-diagnosis experience of cancer. These studies have identified a number of short and long-term life changes resulting from a diagnosis of cancer and associated treatments. In this chapter, we discuss the psychosocial response to the cancer experience and the potential for cancer-related distress. Cancer can represent a life-threatening diagnosis that may be associated with aggressive treatments and result in physical and psychological changes. The potential for future trauma through the lasting effects of the disease and treatment, and the possibility of recurrence, can be a source of continued psychological distress. In addition to the documented adverse repercussions of cancer, we also outline the recent shift that has occurred in the psycho-oncology literature regarding positive life change or posttraumatic growth that is commonly reported after a diagnosis of cancer. Adopting a salutogenic framework acknowledges that the cancer experience is a dynamic psychosocial process with both negative and positive repercussions. Next, we describe the situational and individual factors that are associated with posttraumatic growth and the types of positive life change that are prevalent in this context. Finally, we discuss the implications of this research in a therapeutic context and the directions of future posttraumatic growth research with cancer survivors. This chapter will present both quantitative and qualitative research that indicates the potential for personal growth from adversity rather than just mere survival and return to pre-diagnosis functioning. It is important to emphasise however, that the presence of growth and prevalence of resilience does not negate the extremely distressing nature of a cancer diagnosis for the patient and their families and the suffering that can accompany treatment regimes. Indeed, it will be explained that for growth to occur, the experience must be one that quite literally shatters previously held schemas in order to act as a catalyst for change.