In patients with atrial fibrillation of unknown or prolonged duration who are not receiving long-term anticoagulation, atrial thrombi are detected by transesophageal echocardiography in only a small minority (13 percent in our study). Our preliminary data suggest that if transesophageal echocardiography excludes the presence of thrombi, early cardioversion can be performed safely without the need for prolonged oral anticoagulation before the procedure.
Balloon mitral valvuloplasty as a treatment for selected patients with mitral stenosis has good long-term results. The long-term outcome after this procedure can be predicted on the basis of patients' base-line characteristics.
Intracoronary enalaprilat at a dosage that did not cause systemic neurohormonal activation improved LV diastolic chamber distensibility and regional relaxation and filling in patients with LV hypertrophy due to aortic stenosis. In contrast, these effects of intracoronary enalaprilat on diastolic function were not observed in patients with dilated cardiomyopathy who did not have concentric hypertrophy. These observations support the hypothesis that the cardiac renin-angiotensin system is activated in patients with concentric pressure-overload hypertrophy and that this activation may contribute to impaired diastolic function.
This study describes how a culturally responsive school leader promoted equity in a racially and linguistically diverse school. The authors shadowed Faith, an assistant principal, and did follow-up interviews with her after each day of shadowing. They observed teachers in their classrooms, conducted multiple interviews with teachers and parents, and gathered artifacts from administrative offices, classrooms, and common areas. The authors found that Faith practiced culturally responsive leadership on three levels: personal, environmental, and curricular. Faith's culturally responsive leadership included six themes: caring, building relationships, being persistent and persuasive, being present and communicating, modeling cultural responsiveness, and fostering cultural responsiveness among others.
The Texas Assessment of Academic Skills (TAAS) is a classic case of the high-stakes test, accompanied by rewards for high performing schools and sanctions for lower performing schools. In this study, over 100 teachers from Texas school districts completed open-ended surveys on how they prepare students for TAAS and the effects of the test on students, teachers, and schools. Twenty of the survey respondents engaged in interviews to gather in-depth data on their perceptions of TAAS. Results provide preliminary indications that, for many schools, high-stakes testing has become the object rather than the measure of teaching and learning, with negative side effects on curriculum, teacher decision making, instruction, student learning, school climate, and teacher and student self-concept and motivation.
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