State and national standards call for teaching evolution concepts as early as kindergarten, which provides motivation to continue developing science instruction and curriculum for young learners. The importance of addressing students' folk theories regarding science justifies teaching evolution early in K-12 education. In this project, we developed, implemented, and researched standards-based lessons to teach elements of evolution (speciation and adaption) to kindergarteners and second graders. Our lessons attended to the students' prior knowledge, and utilized inquiry and modeling to teach and assess their ability to recognize patterns of similarity and differences among organisms. Using their products and comments as evidence, it was apparent the students were able to communicate recognition of patterns and effectively apply their knowledge in near transfer activities, indicating they achieved our learning objectives. This provides support for teaching evolution concepts in the early grades and evidence of the ability for young children to effectively engage in supported inquiry and modeling for learning science. ). Yet, there are mixed perspectives of how and when various aspects of science, e.g. evolution, should be included in the elementary curriculum (NRC 2000). There is a range of pedagogical and philosophical perspectives influencing how to approach teaching evolution to early elementary students (Metz 1995). The range of perspectives of early childhood science education raises the question of how effectively early elementary students can learn from lessons structured to teach evolution. We address this question by assessing kindergarten and second grade students' learning in response to biological similarities and differences, concepts that are fundamental to the evolutionary concepts of adaption and speciation. Teaching Science in Early Elementary GradesRegardless of mandates to improve science education for early elementary students, the efforts may not be widely embraced by educators. Eshach and Fried (2005) report reluctance to include scientific concepts in early elementary courses based on the belief that these concepts are too abstract for younger Evo Edu Outreach (2009) 2:458-473
Typical atrial flutter is a common atrial tachyarrhythmia. Symptoms are typically related to the rate of ventricular response. Although atrial flutter with 1:1 atrioventricular conduction is rare, it is important to recognize because it may precipitate rapid hemodynamic compromise. The authors present a case of exercise-induced 1:1 atrioventricular conduction in a patient with typical atrial flutter.
Renal involvement in systemic lupus erythematosus (SLE) is usually immune complex mediated and may have multiple different presentations. Pauci-immune necrotizing and crescentic glomerulonephritis (NCGN) refers to extensive glomerular inflammation with few or no immune deposits that may result in rapid decline in renal function. We report a case of a 79-year-old Hispanic male with a history of secondary membranous nephropathy (diagnosed by renal biopsy 15 years previously) who was admitted with acute kidney injury and active urinary sediment. P-ANCA titers and anti-myeloperoxidase antibodies were positive. The renal biopsy was diagnostic for NCGN superimposed on a secondary membranous nephropathy. A previous diagnosis of SLE based on American College of Rheumatology criteria was discovered via Veteran's Administration records review after the completion of treatment for pauci-immune NCGN. ANCAs are detected in 20–31% of patients with SLE. There may be an association between SLE and ANCA seropositivity. In patients with lupus nephritis and biopsy findings of necrotizing and crescentic glomerulonephritis, without significant immune complex deposition, ANCA testing should be performed. In patients with secondary membranous nephropathy SLE should be excluded.
Acute interstitial nephritis (AIN) is characterized by inflammation of the renal interstitium and usually occurs in a temporal relationship with the medication. We present a case of an Asian male who had nephrotic range proteinuria and presented with acute kidney injury. The patient reported an acute change in physical appearance and symptomatology after the ingestion of a single dose of sildenafil. Renal biopsy was notable for minimal change disease (MCD) with acute and chronic interstitial nephritis. Renal replacement and glucocorticoid therapy were initiated. Renal recovery within six weeks permitted discontinuation of dialysis. AIN superimposed on MCD is a known association of NSAID induced nephropathy. The temporal association and the absence of any new drugs suggest that the AIN was most likely due to the sildenafil. NSAIDs are less likely to have caused the AIN given their remote use. The ease of steroid responsiveness would also suggest another cause as NSAID induced AIN is often steroid resistant. The MCD was most likely idiopathic given the lack of temporal association with a secondary cause. As the number of sildenafil prescriptions increases, more cases of AIN may be identified and physician awareness for this potential drug disease association is necessary.
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