Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit

PubMed Central

Prasad, P; Harrison, BJ; Balasubramanian, SP

2014-01-01

Background Post-thyroidectomy hypocalcaemia is a common complication with significant short and long term morbidity. The aim of this study was to determine the incidence and predictors of post-thyroidectomy hypocalcaemia (as defined by a corrected calcium <2.1 mmol/l) in a tertiary endocrine surgical unit. Methods A total of 238 consecutive patients who underwent completion or bilateral thyroid surgery between 2008 and 2011 were included in this retrospective study. Clinical and biochemical data were obtained from electronic and hard copy medical records. Results The incidence of post-thyroidectomy hypocalcaemia on first postoperative day (POD1) was 29.0%. There was variation in the incidence of hypocalcaemia depending on the timing of measurement on the first postoperative day. At six months following surgery, 5.5% of patients were on calcium and/or vitamin D supplementation. Factors associated with post-thyroidectomy hypocalcaemia were lower preoperative corrected calcium (p=0.005) and parathyroid gland (PTG) auto-transplant (p=0.001). Other clinical factors such as central lymph node dissection, inadvertent PTG excision, ethnicity, preoperative diagnosis and Lugol’s iodine were not associated with post-thyroidectomy hypocalcaemia. Conclusion The incidence of post-thyroidectomy hypocalcaemia was underestimated by 6% when only POD1 measurements were considered. The timing of measurement on POD1 has an impact on the incidence of post-thyroidectomy hypocalcaemia. Auto-transplantation and lower preoperative calcium were associated with post-thyroidectomy hypocalcaemia. PMID:24780788

Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit.

PubMed

Edafe, O; Prasad, P; Harrison, B J; Balasubramanian, S P

2014-04-01

Post-thyroidectomy hypocalcaemia is a common complication with significant short and long term morbidity. The aim of this study was to determine the incidence and predictors of post-thyroidectomy hypocalcaemia (as defined by a corrected calcium <2.1 mmol/l) in a tertiary endocrine surgical unit. A total of 238 consecutive patients who underwent completion or bilateral thyroid surgery between 2008 and 2011 were included in this retrospective study. Clinical and biochemical data were obtained from electronic and hard copy medical records. The incidence of post-thyroidectomy hypocalcaemia on first postoperative day (POD1) was 29.0%. There was variation in the incidence of hypocalcaemia depending on the timing of measurement on the first postoperative day. At six months following surgery, 5.5% of patients were on calcium and/or vitamin D supplementation. Factors associated with post-thyroidectomy hypocalcaemia were lower preoperative corrected calcium (p=0.005) and parathyroid gland (PTG) auto-transplant (p=0.001). Other clinical factors such as central lymph node dissection, inadvertent PTG excision, ethnicity, preoperative diagnosis and Lugol's iodine were not associated with post-thyroidectomy hypocalcaemia. The incidence of post-thyroidectomy hypocalcaemia was underestimated by 6% when only POD1 measurements were considered. The timing of measurement on POD1 has an impact on the incidence of post-thyroidectomy hypocalcaemia. Auto-transplantation and lower preoperative calcium were associated with post-thyroidectomy hypocalcaemia.

Thyroid surgery for Graves' disease and Graves' ophthalmopathy.

PubMed

Liu, Zi Wei; Masterson, Liam; Fish, Brian; Jani, Piyush; Chatterjee, Krishna

2015-11-25

Graves' disease is an autoimmune disease caused by the production of auto-antibodies against the thyroid-stimulating hormone receptor, which stimulates follicular cell production of thyroid hormone. It is the commonest cause of hyperthyroidism and may cause considerable morbidity with increased risk of cardiovascular and respiratory adverse events. Five per cent of people with Graves' disease develop moderate to severe Graves' ophthalmopathy. Thyroid surgery for Graves' disease commonly falls into one of three categories: 1) total thyroidectomy, which aims to achieve complete macroscopic removal of thyroid tissue; 2) bilateral subtotal thyroidectomy, in which bilateral thyroid remnants are left; and 3) unilateral total and contralateral subtotal thyroidectomy, or the Dunhill procedure. Recent American Thyroid Association guidelines on treatment of Graves' hyperthyroidism emphasised the role of surgery as one of the first-line treatments. Total thyroidectomy removes target tissue for the thyroid-stimulating hormone receptor antibody. It controls hyperthyroidism at the cost of lifelong thyroxine replacement. Subtotal thyroidectomy leaves a thyroid remnant and may be less likely to lead to complications, however a higher rate of recurrent hyperthyroidism is expected and revision surgery would be challenging. The choice of the thyroidectomy technique is currently largely a matter of surgeon preference, and a systematic review of the evidence base is required to determine which option offers the best outcomes for patients. To assess the optimal surgical technique for Graves' disease and Graves' ophthalmopathy. We searched the Cochrane Library, MEDLINE and PubMed, EMBASE, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). The date of the last search was June 2015 for all databases. We did not apply any language restrictions. Only randomised controlled trials (RCTs) involving participants with a diagnosis of Graves' disease based on clinical features and biochemical findings of hyperthyroidism were eligible for inclusion. Trials had to directly compare at least two surgical techniques of thyroidectomy. There was no age limit to study inclusion. Two review authors independently extracted and cross-checked the data for analysis, evaluation of risk of bias and establishment of 'Summary of findings' tables using the GRADE instrument. The senior review authors reviewed the data and reconciled disagreements. We included five RCTs with a total of 886 participants; 172 were randomised to total thyroidectomy, 383 were randomised to bilateral subtotal thyroidectomy, 309 were randomised to the Dunhill procedure and 22 were randomised to either bilateral subtotal thyroidectomy or the Dunhill procedure. Follow-up ranged between six months and six years. One trial had three comparison arms. All five trials were conducted in university hospitals or tertiary referral centres for thyroid disease. All thyroidectomies were performed by experienced surgeons. The overall quality of the evidence ranged from low to moderate. In all trials, blinding procedures were insufficiently described. Outcome assessment for objective outcomes was blinded in one trial. Surgeons were not blinded in any of the trials. One trial blinded participants. Attrition bias was a substantial problem in one trial, with 35% losses to follow-up. In one trial the analysis was not carried out on an intention-to-treat basis.Total thyroidectomy was more effective than subtotal thyroidectomy techniques (both bilateral subtotal thyroidectomy and the Dunhill procedure) at preventing recurrent hyperthyroidism in 0/150 versus 11/200 participants (OR 0.14 (95% CI 0.04 to 0.46); P = 0.001; 2 trials; moderate quality evidence). Total thyroidectomy was also more effective than bilateral subtotal thyroidectomy at preventing recurrent hyperthyroidism in 0/150 versus 10/150 participants (odds ratio (OR) 0.13 (95% confidence interval (CI) 0.04 to 0.44); P = 0.001; 2 trials; moderate quality evidence). Compared to bilateral subtotal thyroidectomy, the Dunhill procedure was more likely to prevent recurrent hyperthyroidism in 20/283 versus 8/309 participants (OR 2.73 (95% CI 1.28 to 5.85); P = 0.01; 3 trials; low quality evidence). Total thyroidectomy compared with subtotal thyroidectomy conferred a greater risk of permanent hypocalcaemia/hypoparathyroidism in 8/172 versus 3/221 participants (OR 4.79 (95% CI 1.36 to 16.83); P = 0.01; 3 trials; low quality evidence). Effects of the various surgical techniques on permanent recurrent laryngeal nerve palsy and regression of Graves' ophthalmopathy were neutral. One death was reported in one study in year three of follow-up. No study investigated health-related quality of life or socioeconomic effects. Total thyroidectomy is more effective than subtotal thyroidectomy (both bilateral subtotal thyroidectomy and the Dunhill procedure) at preventing recurrent hyperthyroidism in Graves' disease. The type of surgery performed does not affect regression of Graves' ophthalmopathy. There was some evidence that total thyroidectomy compared with subtotal thyroidectomy conferred a greater risk of permanent hypocalcaemia/hypoparathyroidism, which however, was not seen in comparison with bilateral subtotal thyroidectomy. Permanent recurrent laryngeal nerve palsy did not seem to be affected by type of thyroidectomy. Health-related quality of life as a patient-important outcome measure should form a core determinant of any future trial on the effects of thyroid surgery for Graves' disease.

Lessons Learned for Improving Spacecraft Ground Operations

NASA Technical Reports Server (NTRS)

Bell, Michael; Henderson, Gena; Stambolian, Damon

2013-01-01

NASA policy requires each Program or Project to develop a plan for how they will address Lessons Learned. Projects have the flexibility to determine how best to promote and implement lessons learned. A large project might budget for a lessons learned position to coordinate elicitation, documentation and archival of the project lessons. The lessons learned process crosses all NASA Centers and includes the contactor community. o The Office of The Chief Engineer at NASA Headquarters in Washington D.C., is the overall process owner, and field locations manage the local implementation. One tool used to transfer knowledge between program and projects is the Lessons Learned Information System (LLIS). Most lessons come from NASA in partnership with support contractors. A search for lessons that might impact a new design is often performed by a contractor team member. Knowledge is not found with only one person, one project team, or one organization. Sometimes, another project team, or person, knows something that can help your project or your task. Knowledge sharing is an everyday activity at the Kennedy Space Center through storytelling, Kennedy Engineering Academy presentations and through searching the Lessons Learned Information system. o Project teams search the lessons repository to ensure the best possible results are delivered. o The ideas from the past are not always directly applicable but usually spark new ideas and innovations. Teams have a great responsibility to collect and disseminate these lessons so that they are shared with future generations of space systems designers. o Leaders should set a goal for themselves to host a set numbers of lesson learned events each year and do more to promote multiple methods of lessons learned activities. o High performing employees are expected to share their lessons, however formal knowledge sharing presentation are not the norm for many employees.

Engineering Lessons Learned and Systems Engineering Applications

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.

2005-01-01

Systems Engineering is fundamental to good engineering, which in turn depends on the integration and application of engineering lessons learned. Thus, good Systems Engineering also depends on systems engineering lessons learned from within the aerospace industry being documented and applied. About ten percent of the engineering lessons learned documented in the NASA Lessons Learned Information System are directly related to Systems Engineering. A key issue associated with lessons learned datasets is the communication and incorporation of this information into engineering processes. As part of the NASA Technical Standards Program activities, engineering lessons learned datasets have been identified from a number of sources. These are being searched and screened for those having a relation to Technical Standards. This paper will address some of these Systems Engineering Lessons Learned and how they are being related to Technical Standards within the NASA Technical Standards Program, including linking to the Agency's Interactive Engineering Discipline Training Courses and the life cycle for a flight vehicle development program.

Engineering Lessons Learned and Systems Engineering Applications

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.

2005-01-01

Systems Engineering is fundamental to good engineering, which in turn depends on the integration and application of engineering lessons learned and technical standards. Thus, good Systems Engineering also depends on systems engineering lessons learned from within the aerospace industry being documented and applied. About ten percent of the engineering lessons learned documented in the NASA Lessons Learned Information System are directly related to Systems Engineering. A key issue associated with lessons learned datasets is the communication and incorporation of this information into engineering processes. Systems Engineering has been defined (EINIS-632) as "an interdisciplinary approach encompassing the entire technical effort to evolve and verify an integrated and life-cycle balanced set of system people, product, and process solutions that satisfy customer needs". Designing reliable space-based systems has always been a goal for NASA, and many painful lessons have been learned along the way. One of the continuing functions of a system engineer is to compile development and operations "lessons learned" documents and ensure their integration into future systems development activities. They can produce insights and information for risk identification identification and characterization. on a new project. Lessons learned files from previous projects are especially valuable in risk

Lessons Learned and Technical Standards: A Logical Marriage

NASA Technical Reports Server (NTRS)

Gill, Paul; Vaughan, William W.; Garcia, Danny; Gill, Maninderpal S. (Technical Monitor)

2001-01-01

A comprehensive database of lessons learned that corresponds with relevant technical standards would be a boon to technical personnel and standards developers. The authors discuss the emergence of one such database within NASA, and show how and why the incorporation of lessons learned into technical standards databases can be an indispensable tool for government and industry. Passed down from parent to child, teacher to pupil, and from senior to junior employees, lessons learned have been the basis for our accomplishments throughout the ages. Government and industry, too, have long recognized the need to systematically document And utilize the knowledge gained from past experiences in order to avoid the repetition of failures and mishaps. The use of lessons learned is a principle component of any organizational culture committed to continuous improvement. They have formed the foundation for discoveries, inventions, improvements, textbooks, and technical standards. Technical standards are a very logical way to communicate these lessons. Using the time-honored tradition of passing on lessons learned while utilizing the newest in information technology, the National Aeronautics and Space Administration (NASA) has launched an intensive effort to link lessons learned with specific technical standards through various Internet databases. This article will discuss the importance of lessons learned to engineers, the difficulty in finding relevant lessons learned while engaged in an engineering project, and the new NASA project that can help alleviate this difficulty. The article will conclude with recommendations for more expanded cross-sectoral uses of lessons learned with reference to technical standards.

Lessons Learned in Engineering

NASA Technical Reports Server (NTRS)

Blair, J. C.; Ryan, R. S.; Schutzenhofer, L. A.

2011-01-01

This Contractor Report (CR) is a compilation of Lessons Learned in approximately 55 years of engineering experience by each James C. Blair, Robert S. Ryan, and Luke A. Schutzenhofer. The lessons are the basis of a course on Lessons Learned that has been taught at Marshall Space Flight Center. The lessons are drawn from NASA space projects and are characterized in terms of generic lessons learned from the project experience, which are further distilled into overarching principles that can be applied to future projects. Included are discussions of the overarching principles followed by a listing of the lessons associated with that principle. The lesson with sub-lessons are stated along with a listing of the project problems the lesson is drawn from, then each problem is illustrated and discussed, with conclusions drawn in terms of Lessons Learned. The purpose of this CR is to provide principles learned from past aerospace experience to help achieve greater success in future programs, and identify application of these principles to space systems design. The problems experienced provide insight into the engineering process and are examples of the subtleties one experiences performing engineering design, manufacturing, and operations.

The role of vitamin D in post-thyroidectomy hypocalcemia: Still an enigma.

PubMed

Cherian, Anish Jacob; Ponraj, Sam; Gowri S, Mahasampath; Ramakant, Pooja; Paul, Thomas V; Abraham, Deepak Thomas; Paul, M J

2016-02-01

There is conflicting evidence regarding the role of vitamin D deficiency in the development of post-thyroidectomy hypocalcemia. Recent reports show postoperative parathormone (PTH) is unreliable in predicting post-thyroidectomy hypocalcemia in vitamin D deficient patients. We conducted this study to analyze the role of vitamin D status in the development of post-thyroidectomy hypocalcemia and to evaluate its effect on the predictability of PTH as a marker for post-thyroidectomy hypocalcemia. A retrospective review of prospectively collected data of patients undergoing thyroidectomy between August 2007 to September 2013 (n = 150) was performed. Results of preoperative calcium, albumin, vitamin D, PTH and postoperative calcium, albumin, and PTH were collated. Patients were divided into 2 groups based on their vitamin D status: group A, vitamin D ≥ 20 ng/mL and group B, vitamin D < 20 ng/mL. Vitamin D deficiency was present in 80 (53.3%) patients and post-thyroidectomy hypocalcemia developed in 67 (44.7%). The incidence of postoperative hypocalcemia was similar in both the groups (48.6% and 41.3%, respectively). Vitamin D status was not associated with the development of post-thyroidectomy hypocalcemia (P = .23). Postoperative PTH of <8 pg/mL was strongly associated with the development of hypocalcemia in both the groups (P = .0002 and .0045, respectively). The area under the receiver operator characteristic curve in group B (0.68) was less than in group A (0.76; P = .41). The majority of patients were vitamin D deficient in this cohort, but this did not increase the risk of post-thyroidectomy hypocalcemia, nor did it interfere with the predictability of PTH as a marker of post-thyroidectomy hypocalcemia. Copyright © 2016 Elsevier Inc. All rights reserved.

The impact of body habitus on the surgical outcomes of transaxillary single-incision robotic thyroidectomy in papillary thyroid carcinoma patients.

PubMed

Lee, Sohee; Park, Seulkee; Lee, Cho Rok; Son, Haiyoung; Kim, Jungwoo; Kang, Sang-Wook; Jeong, Jong Ju; Nam, Kee-Hyun; Chung, Woong Youn; Park, Cheong Soo

2013-07-01

Robotic applications have achieved safe and precise thyroidectomy with notable cosmetic and functional benefits. This study was designed to document the influence of body habitus on robotic thyroidectomy in papillary thyroid carcinoma (PTC) patients. From July 2009 to February 2010, 352 patients underwent robotic thyroidectomy using a gasless, transaxillary single-incision approach at Yonsei University Health System. Body habitus was described using body mass index category (normal weight, overweight, obese), neck length, shoulder width, and shoulder width to neck length ratios. The impact of body habitus on surgical outcomes was analyzed with respect to operation time, number of retrieved central nodes, bleeding amount, and postoperative complications. Of the 352 patients, 217 underwent less than total thyroidectomy and 135 underwent total thyroidectomy. Operative variables (i.e. operation times, bleeding amounts, and numbers of retrieved central nodes) showed no significant differences between three BMI groups for less than total thyroidectomy. However, total operation and working space times were longer for obese patients during total thyroidectomy. In particular, shoulder width was positively correlated with total operation time, working space time, console time, and number of retrieved central nodes. On the other hand, postoperative complications were not significantly different in the three BMI groups and showed no significant correlation with the other indices of body habitus. Standardized robotic thyroidectomy can be performed safely and feasibly in patients with a large body habitus despite longer operation times.

Intraoperative serum parathyroid hormone level is an indicator of hypocalcaemia in total thyroidectomy patients.

PubMed

Islam, M S; Sultana, T; Paul, D; Huq, A H M Z; Chowdhury, A A; Ferdous, C; Ahmed, A N N

2012-12-01

Postoperative hypocalcaemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose or to predict hypocalcaemia immediately after total thyroidectomy for minimizing complications. A prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Microbiology & Immunology, Department of Surgery, Department of Otolaryngology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Department of Otolaryngology, Dhaka Medical College & Hospital (DMC&H), Dhaka, during the period of September 2010 to August 2011 to evaluate intraoperative (20 minutes after total thyroidectomy) parathyroid hormone (PTH) measurement as a predictor of post thyroidectomy hypocalcaemia. Total 65 patients were enrolled in this study those came for total thyroidectomy. Postoperative hypocalcaemia developed in 25 cases. Intraoperative PTH was assessed and significant correlation was found between intraoperative PTH level and development of hypocalcaemia. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of intraoperative serum PTH for prediction of post total thyroidectomy hypocalcaemia were 84.0%, 85.0%, 84.6%, 77.8%, and 89.5% respectively. Because of the high sensitivity, specificity and accuracy of intraoperative serum PTH of this study, the early prediction of hypocalcaemia could be made by single assay of intraoperative serum PTH level at 20 minutes after total thyroidectomy.

Unmanned Ground Vehicle (UGV) Lessons Learned

DTIC Science & Technology

2001-11-01

iii 1. INTRODUCTION ....................................................................................................... 1 1.1... INTRODUCTION 1.1 PURPOSE The purpose of this effort is to compile Lessons Learned from the unmanned ground vehicle (UGV) programs that could be relevant to... introduction of gunpowder, this lesson was no longer valid. Castles crumbled and new lessons had to be learned. One such lesson was that the faster

Lesson Learning at JPL

NASA Technical Reports Server (NTRS)

Oberhettinger, David

2011-01-01

A lessons learned system is a hallmark of a mature engineering organization A formal lessons learned process can help assure that valuable lessons get written and published, that they are well-written, and that the essential information is "infused" into institutional practice. Requires high-level institutional commitment, and everyone's participation in gathering, disseminating, and using the lessons

77 FR 64565 - Solicitation of Feedback and Lessons-Learned from the Pilot of the Revised Construction Reactor...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0249] Solicitation of Feedback and Lessons-Learned from... or the Commission) is soliciting feedback and lessons-learned from members of the public, licensees... constructed in accordance with the licensing basis. The NRC has applied lessons- learned from the prior plants...

Review analysis of medullary carcinoma of the thyroid: a 15-year Indian experience.

PubMed

Dorairajan, N; Siddharth, D; Kanna, Srinivasulu

2006-01-01

The aim of this study was to emphasize the importance of adequate primary surgery in cases of medullary carcinoma of the thyroid. We retrospectively reviewed 44 cases of medullary carcinoma of the thyroid treated in Government General Hospital, Chennai between 1987 and 2002. Patients who underwent total thyroidectomy with only central compartment dissection were compared with those who had undergone total thyroidectomy with meticulous triple compartment (bilateral lateral and central groups) nodal dissection. The group of total thyroidectomy with only central compartment dissection had a high rate of lymph nodal recurrence and persistent hypercalcitoninemia compared with the group with total thyroidectomy with meticulous triple compartment nodal dissection. (chi square, 4.503; P > 0.05). Primary surgery with total thyroidectomy with meticulous triple compartment dissection is superior to total thyroidectomy with central compartment dissection alone in terms of preventing nodal and local recurrences and achieving normal (basal and stimulated) serum calcitonin levels postoperatively.

Rare complication after thyroidectomy-cervical esophageal stenosis: a case report and literature review.

PubMed

Peng, Hanwei; Wang, Steven J; Li, Weixiong

2014-10-11

The most common complications after thyroidectomy are injuries associated with the recurrent laryngeal nerve and parathyroid gland. Cervical esophagus perforation is an exceptionally rare complication after thyroidectomy; it can usually be resolved by conservative care. Cervical esophageal stenosis secondary to intraoperative esophageal injury during thyroidectomy is much rarer and has not been reported in the literature to date. We report a case of esophageal stenosis following thyroidectomy performed at a peripheral hospital. The patient initially underwent a thyroidectomy for papillary thyroid carcinoma involving the cervical esophagus; esophageal perforation was noted intraoperatively, and closed using three number 4 silk sutures. Cervical esophageal stenosis subsequently developed after conservative care. The patient was successfully treated with cervical esophagectomy and reconstruction using a tubed forearm free flap after a failed attempt at endoscopic recanalization. This case is discussed in conjunction with a review of the literature.

Lessons Learned in Engineering. Supplement

NASA Technical Reports Server (NTRS)

Blair, James C.; Ryan, Robert S.; Schultzenhofer, Luke A.

2011-01-01

This Contractor Report (CR) is a compilation of Lessons Learned in approximately 55 years of engineering experience by each James C. Blair, Robert S. Ryan, and Luke A. Schutzenhofer. The lessons are the basis of a course on Lessons Learned that has been taught at Marshall Space Flight Center. The lessons are drawn from NASA space projects and are characterized in terms of generic lessons learned from the project experience, which are further distilled into overarching principles that can be applied to future projects. Included are discussions of the overarching principles followed by a listing of the lessons associated with that principle. The lesson with sub-lessons are stated along with a listing of the project problems the lesson is drawn from, then each problem is illustrated and discussed, with conclusions drawn in terms of Lessons Learned. The purpose of this CR is to provide principles learned from past aerospace experience to help achieve greater success in future programs, and identify application of these principles to space systems design. The problems experienced provide insight into the engineering process and are examples of the subtleties one experiences performing engineering design, manufacturing, and operations. The supplemental CD contains accompanying PowerPoint presentations.

Validity of early parathyroid hormone assay as a diagnostic tool for sub-total thyroidectomy related hypocalcaemia.

PubMed

Riaz, Umbreen; Shah, Syed Aslam; Zahoor, Imran; Riaz, Arsalan; Zubair, Muhammad

2014-07-01

To determine the validity of early (one hour postoperatively) parathyroid hormone (PTH) assay (² 10 pg/ml), keeping gold standard as the serum ionic calcium level, for predicting sub-total thyroidectomy-related hypocalcaemia and to calculate the sensitivity and specificity of latent signs of tetany. Cross-sectional validation study. Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad from August 2008 to August 2010. Patients undergoing sub-total thyroidectomy were included by convenience sampling. PTH assay was performed 1 hour post sub-total thyroidectomy. Serum calcium levels were performed at 24 and 48 hours, 5th day and 2 weeks after surgery. Cases that developed hypocalcaemia were followed-up for a period of 6 months with monthly calcium level estimation to identify cases of permanent hypocalcaemia. Symptoms and signs of hypocalcaemia manifesting in our patients were recorded. Data was analyzed through SPSS version 10. 2 x 2 tables were used to calculate sensitivity and specificity of PTH in detecting post-thyroidectomy hypocalcaemia. Out of a total of 110 patients included in the study, 16.36% (n=18) developed hypocalcaemia including 1.81% (n=2) cases of permanent hypoparathyroidism. The sensitivity of one hour postoperative PTH assay as a predictive tool for post-thyroidectomy related hypocalcaemia was 94.4% while its specificity was 83.6% with 53% positive predictive value and 98.7% negative predictive value. One hour post sub-total thyroidectomy PTH assay can be helpful in predicting post sub-total thyroidectomy hypocalcaemia. Moreover, it can be useful in safe discharge of day-care thyroidectomy patients.

Lessons learned from facilitating the state and tribal government working group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurstedt, H.A. Jr.

1994-12-31

Thirteen lessons learned from my experience in facilitating the State and Tribal Government Working Group for the U.S. Department of Energy have been identified. The conceptual base for supporting the veracity of each lesson has been developed and the lessons are believed to be transferable to any stakeholder group. The crux of stakeholder group success if the two-directional, two-mode empowerment required in this case. Most of the lessons learned deal with the scope of that empowerment. A few of the lessons learned deal with the operations of the group.

77 FR 14446 - Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, “Buried and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0055] Changes to the Generic Aging Lessons Learned (GALL... Aging Lessons Learned (GALL) Report,'' and the NRC staff's aging management review procedure and... into ADAMS. II. Background The NRC issues LR-ISGs to communicate insights and lessons learned and to...

Learning from Lessons: Teachers' Insights and Intended Actions Arising from Their Learning about Student Thinking

ERIC Educational Resources Information Center

Roche, Anne; Clarke, Doug; Clarke, David; Chan, Man Ching Esther

2016-01-01

A central premise of this project is that teachers learn from the act of teaching a lesson and that this learning is evident in the planning and teaching of a subsequent lesson. We are studying the knowledge construction of mathematics teachers utilising multi-camera research techniques during lesson planning, classroom interactions and…

Functional Voice Outcomes After Thyroidectomy: An Assessment of the Dsyphonia Severity Index (DSI) After Thyroidectomy

DTIC Science & Technology

2010-01-01

patients in the objective NVO group demonstrated persistent signs of recurrent laryngeal nerve paralysis. Sub- jective and objective NVO patients were...DL, Montesinos MR, Tacchi VA, Moreno JC, Falco JE, Mezzadri NA, et al. Voice changes after thyroidectomy with- out recurrent laryngeal nerve injury. J...in a cancer hospital. Otolaryngol Head Neck Surg 2005;132:490-4. 10. Roy AD, Gardiner RH, Niblock WM. Thyroidectomy and the recurrent laryngeal nerve

The Impact of Potassium Iodide on Thyroidectomy for Graves’ disease: Implications for Safety and Operative Difficulty

PubMed Central

Randle, Reese W; Bates, Maria F; Long, Kristin L; Pitt, Susan C; Schneider, David F; Sippel, Rebecca S

2017-01-01

Background Potassium iodide (KI) is often prescribed prior to thyroidectomy for Graves’ disease, but the effect of KI on the ease and safety of thyroidectomy for Graves’ is largely unknown. Methods We conducted a prospective cohort study of patients with Graves’ disease undergoing thyroidectomy. For the first 8-months no patients received KI; for the next 8-months, KI was added to the pre-operative protocol for all patients. Outcomes included operative difficulty (based on the Thyroidectomy Difficulty Scale) and complications. Results A total of 31 patients in the no-KI group and 28 in the KI group were included. According to the Thyroidectomy Difficulty Scale, gland vascularity decreased in the KI group (mean score 2.6 vs. 3.3, p=0.04), but there were no significant differences in thyroid friability, fibrosis, size, or overall difficulty (p=NS for all). Despite similar operative difficulty, patients prescribed KI were less likely to experience transient hypoparathyroidism (7.1% vs. 25.9%, p=0.018) and transient hoarseness (0% vs. 16.1%, p=0.009) compared with the no-KI group. Conclusion KI administration decreases gland vascularity but does not change the overall difficulty of thyroidectomy. However, KI was associated with less transient hypoparathyroidism and transient hoarseness, suggesting that KI improves the safety of thyroidectomy for Graves’ disease. PMID:29108701

Total Thyroidectomy for Benign Thyroid Diseases: What is the Price to be Paid?

PubMed Central

Gangappa, Rajashekara Babu; Chowdary, Prashanth Basappa; Patanki, Adithya Malolan; Ishwar, Mahalakshmi

2016-01-01

Introduction Total thyroidectomy has been used to treat patients with malignant thyroid disease. But for patients with benign thyroid disease, the safety and efficacy of total thyroidectomy is a matter of debate. Subtotal thyroidectomy that was previously the treatment of choice for benign thyroid disease has been associated with high recurrence rates. The risk of permanent complications is greatly increased in patients who undergo surgery for recurrence of benign thyroid disease. Total thyroidectomy is an operation that can be safely performed, with low incidence of permanent complications, which allows one to broaden its indications in various benign thyroid diseases, thus avoiding future recurrences and reoperations. Aim To assess the benefits of total thyroidectomy for benign thyroid diseases. Materials and Methods This randomized prospective study was conducted between Feb 2013 and Nov 2014 in the Department of General Surgery at Bangalore Medical College and Research Institute. It included 116 patients undergoing total thyroidectomy procedure for benign thyroid disease. All cases were followed-up for a period of 6 months for incidence of RLN palsy, hypoparathyroidism, disease recurrence and number of incidental malignancies detected on postoperative histological analyses of the thyroid specimens. Results Most of the patients were in the third decade of their lives. The female to male ratio was 6.7:1. Total thyroidectomy was done for 116 benign thyroid diseases with multinodular goiter as the most common diagnosis. The incidence of postoperative hypocalcaemia was 16.37% (however, only 1 patient developed permanent hypocalcaemia) and that of wound infection was 2.58% and seroma formation was 2.58%. None of the patients included in this study had haematoma formation or RLN paralysis. An incidental malignancy was identified in 11.20% patients. Conclusion Total thyroidectomy shows benefits in eradicating multinodular goiter, alleviating Grave’s opthalmopathy, treating Hashimoto’s thyroiditis and preventing recurrence. It decreases the likelihood of future operations for recurrent disease or completion thyroidectomy for incidental thyroid cancer thus decreasing the associated risks of increased morbidity associated with second operation. Therefore, for benign thyroid diseases requiring surgical management total thyroidectomy can be considered the treatment of choice. PMID:27504342

Minimally invasive video-assisted thyroid surgery: how can we improve the learning curve?

PubMed

Castagnola, G; Giulii Cappone, M; Tierno, S M; Mezzetti, G; Centanini, F; Vetrone, I; Bellotti, C

2012-10-01

Minimally invasive video-assisted thyroidectomy (MIVAT) is a technically demanding procedure and requires a surgical team skilled in both endocrine and endoscopic surgery. A time consuming learning and training period is mandatory at the beginning of the experience. The aim of our report is to focus some aspects of the learning curve of the surgeon who practices video-assisted thyroid procedures for the first time, through the analysis of our preliminary series of 36 cases. From September 2004 to April 2005 we selected 36 patients for minimally invasive video-assisted surgery of the thyroid. The patients were considered eligible if they presented with a nodule not exceeding 35 mm in maximum diameter; total thyroid volume within normal range; absence of biochemical and echographic signs of thyroiditis. We analyzed surgical results, conversion rate, operating time, post-operative complications, hospital stay, cosmetic outcome of the series. We performed 36 total thyroidectomy. The procedure was successfully carried out in 33/36 cases. Post-operative complications included 3 transient recurrent nerve palsies and 2 transient hypocalcemias; no definitive hypoparathyroidism was registered. All patients were discharged 2 days after operation. The cosmetic result was considered excellent by most patients. Advances in skills and technology have enabled surgeons to reproduce most open surgical techniques with video-assistance or laparoscopically. Training is essential to acquire any new surgical technique and it should be organized in detail to exploit it completely.

Learning from Lessons: Studying the Construction of Teacher Knowledge Catalysed by Purposefully-Designed Experimental Mathematics Lessons

ERIC Educational Resources Information Center

Clarke, Doug; Clarke, David; Roche, Anne; Chan, Man Ching Esther

2015-01-01

A central premise of this project is that teachers learn from the act of teaching a lesson and that this learning is evident in the planning and teaching of a subsequent lesson. In this project, the knowledge construction of mathematics teachers was examined utilising multi-camera research techniques during lesson planning, classroom interactions…

Brownfields City of Cleveland: Deconstruction Lessons Learned Report

EPA Pesticide Factsheets

This technical memorandum presents an overview of Cleveland’s current deconstruction initiative goals and lessons learned (in the Cleveland area) and potential strategies for addressing lessons learned.

77 FR 46127 - Interim Staff Guidance on Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2...

Federal Register 2010, 2011, 2012, 2013, 2014

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... Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, ``Buried and Underground Piping and Tanks... AMPs in NUREG-1801, Revision 2, ``Generic Aging Lessons Learned (GALL) Report,'' and the NRC staff's... issues LR-ISG to communicate insights and lessons learned and to address emergent issues not covered in...

Hypomagnesemia associated with hypocalcemia after total thyroidectomy: an observational study.

PubMed

Mahmoud, Renata Regina da Graça Lorencetti; Neto, Vergilius José Furtado de Araujo; Alves, Wellington; Lin, Chin Shien; Leite, Ana Kober Nogueira; Matos, Leandro Luongo; Filho, Vergilius José Furtado de Araujo; Cernea, Claudio Roberto

2016-06-01

Serum magnesium is frequently low in patients with hypocalcemia after total thyroidectomy. The aim of the present study was to analyze the variations in serum magnesium and calcium concentrations after total thyroidectomy, and the relationship between both ions. We conducted an observational study of 142 patients who had undergone total thyroidectomy, measuring serum calcium and magnesium levels preoperatively and on the day following surgery. The incidence of postoperative hypocalcemia was compared with that of postoperative hypomagnesemia. A total of 142, total thyroidectomies were performed: 54 patients (38%) presented with hypocalcemia on the first postoperative day. A marked decrease in blood magnesium in the group of patients with hypocalcemia was observed when compared to those with normal calcemia on the first postoperative day (mean variation respectively, 0.125 ± 0.065 mmol/L versus 0.035 ± 0.020 mmol/L; P = 0.0002). Hypomagnesemia is significantly associated with early hypocalcemia following thyroidectomy.

Predictors factors for post-thyroidectomy hypocalcaemia.

PubMed

Sousa, Alexandre de Andrade; Salles, José Maria Porcaro; Soares, João Marcos Arantes; Moraes, Gustavo Meyer de; Carvalho, Jomar Rezende; Savassi-Rocha, Paulo Roberto

2012-12-01

To evaluate the incidence and predictors of post-thyroidectomy definitive hypocalcemia and hypoparathyroidism. We assessed ionic calcium preoperatively and postoperatively (first, second and 30th day) in 333 patients undergoing thyroidectomy. In those presenting hypocalcemia, measurements were also made 90 and 180 days after surgery, when parathormone was also dosed. Patients were grouped according to the presence or absence of hypocalcemia and evaluated according to age, gender, thyroid function, thyroid volume, number of parathyroid glands identified and need to parathyroid reimplantation, type of operation, operative time, and histopathological diagnosis. The incidence of temporary hypocalcemia was 40.8% (136 patients), and of definitive hypoparathyroidism 4.2% (14 patients). Reoperation or total thyroidectomy, neck dissection, hyperthyroidism, operative time and age above 50 years were factors related to higher incidence of hypocalcemia and definitive hypoparathyroidism (p <0.05). predictors of postoperative hypocalcemia included age (> 50 years), total thyroidectomy, reoperation, neck dissection and operative time. The predictors of post-thyroidectomy definitive hypoparathyroidism included type of operation, histological diagnosis and hyperthyroidism.

Teacher Responses to Learning Cycle Science Lessons for Early Childhood Education

NASA Astrophysics Data System (ADS)

Kraemer, Emily N.

Three learning cycle science lessons were developed for preschoolers in an early childhood children's center in Costa Mesa, California. The lessons were field tested by both novice and experienced teachers with children ranging from three to five years old. Teachers were then interviewed informally to collect feedback on the structure and flow the lessons. The feedback was encouraging remarks towards the use of learning cycle science lessons for early childhood educators. Adjustments were made to the lessons based on teacher feedback. The lessons and their implications for preschool education are discussed.

After-Action Reports: Capturing Lessons Learned and Identifying Areas for Improvement. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 1, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This issue of "Lessons Learned" addresses after-action reports, which are an integral part of the emergency preparedness planning continuum and support effective crisis response. After-action reports have a threefold purpose. They…

Continuous intraoperative neuromonitoring (CIONM) of the recurrent laryngeal nerve is sufficient as the only neuromonitoring technique in thyroidectomy performed because of benign goitre.

PubMed

Adamczewski, Zbigniew; Chwałkiewicz, Michał; Lewiński, Andrzej; Brzeziński, Jan; Dedecjus, Marek

2015-01-01

Recently, intraoperative neurophysiological neuromonitoring (IONM) of recurrent laryngeal nerves (RLN) has been evolving quickly. This evolution touched many aspects of the technique, leading to continuous stimulation of the RLN with real time analysis of the electrical signal. The aim of the study was to estimate the value of continuous intraoperative neuromonitoring (CIONM) as the only technique for intraoperative neuromonitoring in thyroidectomy performed because of benign goitre. The study comprised 80 women qualified for thyroidectomy due to nodular goitre. The patients were divided into 4 groups depending on the technique used for RLN integrity verification: group 1 - thyroidectomy with CIONM; group 2 - thyroidectomy with direct, intermittent stimulation of RLN and vagus nerve (NX); group 3 - both CIONM and intermittent stimulation of RLN and NX; group 4 - thyroidectomy without any IONM. Mean operation time did not differ significantly among the groups with IONM, but was significantly longer in comparison to group 4, as well as the operation's cost. In the analysed groups there was no significant difference in complication ratio. CIONM with RLN visualization in thyroidectomy performed because of benign goitre is as safe as other methods of IONM and gives a continuous confirmation of the electrical integrity of the loop NX-RLN-vocal folds during almost the entire procedure. There is a clinical need for the development of external stimulation of NX (transdermal or trancranial), particularly for minimally invasive techniques in which access to NX is limited (i.e. transoral thyroidectomy).

Lessons from 30 Years of Flight Software

NASA Technical Reports Server (NTRS)

McComas, David C.

2015-01-01

This presentation takes a brief historical look at flight software over the past 30 years, extracts lessons learned and shows how many of the lessons learned are embodied in the Flight Software product line called the core Flight System (cFS). It also captures the lessons learned from developing and applying the cFS.

Communication and Collaboration During Natural Disasters: The Lessons Learned From Past Experience. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 2, 2008

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on the response and recovery efforts to wildfires by the San Diego County Office of Education (SDCOE) and its school and community partners. Natural disasters such as floods,…

Persistent hyperthyroidism and de novo Graves' ophthalmopathy after total thyroidectomy.

PubMed

Tay, Wei Lin; Loh, Wann Jia; Lee, Lianne Ai Ling; Chng, Chiaw Ling

2017-01-01

We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion. It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy.TSH receptor antibody may persist after total thyroidectomy and may potentially contribute to the development of de novo Graves' ophthalmopathy.

Clinical Efficacy of Intravenous Lidocaine for Thyroidectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial.

PubMed

Choi, Geun Joo; Kang, Hyun; Ahn, Eun Jin; Oh, Jong In; Baek, Chong Wha; Jung, Yong Hun; Kim, Jin Yun

2016-12-01

Systemic lidocaine has analgesic and anti-inflammatory effects. The purpose of this prospective, randomized, double-blind study was to evaluate the effects of intravenous lidocaine on pain following thyroidectomy. Fifty-eight adult patients scheduled for total thyroidectomy were randomly allocated to receive a 1.5 mg/kg lidocaine bolus followed by a 2 mg/kg/h infusion during surgery, or the same volume of normal saline (control). After thyroidectomy, we evaluated postoperative pain, nausea, fentanyl consumption, frequency of pushing the button (FPB) for patient-controlled analgesia (PCA), High-sensitivity C-reactive protein (hs-CRP) in serum, and patient satisfaction scores regarding the recovery process. Postoperative pain and nausea scores were significantly lower in the lidocaine group for the first 4 h following thyroidectomy, compared to the control group. Fentanyl consumption and FPB for the PCA were also significantly reduced in the lidocaine group for 4 h following thyroidectomy, and hs-CRP was significantly less in the lidocaine group at postoperative days 1 and 3. Furthermore, satisfaction scores were significantly higher in the lidocaine group compared to the control group. Intravenous lidocaine effectively reduced postoperative pain and nausea following thyroidectomy as well as improved the quality of recovery. Clinicaltrials.gov NCT01608360.

Co-Creation Learning Procedures: Comparing Interactive Language Lessons for Deaf and Hearing Students.

PubMed

Hosono, Naotsune; Inoue, Hiromitsu; Tomita, Yutaka

2017-01-01

This paper discusses co-creation learning procedures of second language lessons for deaf students, and sign language lessons by a deaf lecturer. The analyses focus on the learning procedure and resulting assessment, considering the disability. Through questionnaires ICT-based co-creative learning technologies are effective and efficient and promote spontaneous learning motivation goals.

Unintended knowledge learnt in primary science practical lessons

NASA Astrophysics Data System (ADS)

Park, Jisun; Abrahams, Ian; Song, Jinwoong

2016-11-01

This study explored the different kinds of unintended learning in primary school practical science lessons. In this study, unintended learning has been defined as student learning that was found to occur that was not included in the teachers learning objectives for that specific lesson. A total of 22 lessons, taught by five teachers in Korean primary schools with 10- to 12-year-old students, were audio-and video recorded. Pre-lesson interviews with the teachers were conducted to ascertain their intended learning objectives. Students were asked to write short memos after the lesson about what they learnt. Post-lesson interviews with students and teachers were undertaken. What emerged was that there were three types of knowledge that students learnt unintentionally: factual knowledge gained by phenomenon-based reasoning, conceptual knowledge gained by relation- or model-based reasoning, and procedural knowledge acquired by practice. Most unintended learning found in this study fell into the factual knowledge and only a few cases of conceptual knowledge were found. Cases of both explicit procedural knowledge and implicit procedural knowledge were found. This study is significant in that it suggests how unintended learning in practical work can be facilitated as an educative opportunity for meaningful learning by exploring what and how students learnt.

[Surgery for benign goiter in Germany: fewer operations, changed resectional strategy, fewer complications].

PubMed

Dralle, H; Stang, A; Sekulla, C; Rusner, C; Lorenz, K; Machens, A

2014-03-01

The increase of certain operations in the wake of the introduction of the German Diagnosis-Related Groups (G-DRG) system rekindled debate on the risk-benefit profile of what is widely being perceived as a too high number of thyroidectomies for benign goiter in Germany. The numbers of thyroidectomy for benign goiter from 2005-2011 were obtained from the Federal Bureau of Statistics ("Statistisches Bundesamt"). For the purpose of the study, the following operation and procedure key (OPS) codes were selected: hemithyroidectomy (OPS code 5-061); partial thyroid resection (OPS code 5-062); total thyroidectomy (OPS code 5-063); and thyroid surgeries via sternotomy (OPS code 5-064). The rates of permanent hypoparathyroidism and vocal cord palsy were calculated based on two prospective multicenter evaluation studies conducted in 1998-2001 (PETS 1) and 2010-2013 (PETS 2) in Germany. Between 2005 and 2011, the number of thyroidectomies for benign thyroid goiter decreased by 8 %, and the age-standardized surgery rate decreased by 6 % in men (2005: 599 per 1 million; 2011: 565 per 1 million) and 11 % in women (2005: 1641 per 1 million; 2011: 1463 per 1 million). At the same time, the rates of partial and subtotal thyroidectomy decreased by 59 % in men and 64 % in women, whereas the rates of hemithyroidectomy and total thyroidectomy increased by 65 % (113 %) in men and 42 % (97 %) in women. Despite a greater proportion of thyroidectomies over time, the approximated rates for postoperative hypoparathyroidism were reduced from 2.98 to 0.83 % and for postoperative vocal cord palsy from 1.06 to 0.86 %. Irrespective of that decline, either complication was more frequent after total than after subtotal thyroidectomy. The total number of thyroid surgeries due to benign goiter has decreased substantially in Germany from 2005 through 2011. Despite changes in the resectional strategy with an increase in the total number thyroidectomies and a decrease of subtotal resections, the rates for postoperative hypoparathyroidism and vocal cord palsy have decreased. The complication rates for total thyroidectomy, however, are still higher compared to subtotal resection. An individualized risk-oriented surgical approach is warranted.

Thyroidectomy Practice After Implementation of the 2015 American Thyroid Association Guidelines on Surgical Options for Patients With Well-Differentiated Thyroid Carcinoma.

PubMed

Hirshoren, Nir; Kaganov, Kira; Weinberger, Jeffrey M; Glaser, Benjamin; Uziely, Beatrice; Mizrahi, Ido; Eliashar, Ron; Mazeh, Haggi

2018-03-29

The recommended extent of surgery for well-differentiated thyroid carcinoma has been modified considerably in the updated 2015 American Thyroid Association guidelines published in January 2016. To date, the changes in clinical practice after publication of these new guidelines have not been demonstrated. The aim of this study was to evaluate clinical practice changes associated with implementation of the updated guidelines on the surgical procedure rates of total thyroidectomy, thyroid lobectomy, and completion thyroidectomy at a single tertiary medical center. This is a retrospective cohort study of 169 patients at the Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Patients with pathologically proved, well-differentiated thyroid carcinoma who underwent surgery between January 1, 2013, and December 31, 2014, were compared with patients who underwent surgery from January 1 to December 31, 2016. A total of 434 thyroidectomy procedures were performed during the study period, and 251 had pathologically proved, well-differentiated thyroid carcinoma. Patients with tumors larger than 4 cm, involved lymph nodes, or bilateral nodules were excluded. Primary outcomes were the rate of up-front total thyroidectomy vs lobectomy and the rates of completion thyroidectomy before and after the implementation of the new guidelines. Of the 169 patients in the final analysis, 118 (69.8%) were included from 2013 to 2014 and 51 (30.2%) in 2016. The mean (SD) age for the entire cohort was 44 (13.8) years, and 129 (76.3%) were women. Up-front total thyroidectomy was performed in 72 of 118 patients (61.0%) prior to the 2015 American Thyroid Association guidelines and 16 of 51 (31.4%) following their implementation (odds ratio, 0.29; 95% CI, 0.14-0.59). The rate of completion thyroidectomy also significantly decreased between these periods (73.9% vs 20.0%; odds ratio, 0.09; 95% CI, 0.04-0.19). The updated 2015 American Thyroid Association guidelines implementation was associated with a significant decrease in the rates of both up-front total thyroidectomy and completion thyroidectomy. According to these findings, only 1 of 5 patients who undergoes thyroid lobectomy will require a completion procedure.

Lessons learned from first year cistern monitoring in Camden ...

EPA Pesticide Factsheets

Invited panelist for Webinar 08/16/2016 by Office of Water : Lessons Learned from Past Green Infrastructure Projects Invited panelist for Webinar 08/16/2016 by Office of Water : Lessons Learned from Past Green Infrastructure Projects

Launch Vehicle Propulsion Life Cycle Cost Lessons Learned

NASA Technical Reports Server (NTRS)

Zapata, Edgar; Rhodes, Russell E.; Robinson, John W.

2010-01-01

This paper will review lessons learned for space transportation systems from the viewpoint of the NASA, Industry and academia Space Propulsion Synergy Team (SPST). The paper provides the basic idea and history of "lessons learned". Recommendations that are extremely relevant to NASA's future investments in research, program development and operations are"'provided. Lastly, a novel and useful approach to documenting lessons learned is recommended, so as to most effectively guide future NASA investments. Applying lessons learned can significantly improve access to space for cargo or people by focusing limited funds on the right areas and needs for improvement. Many NASA human space flight initiatives have faltered, been re-directed or been outright canceled since the birth of the Space Shuttle program. The reasons given at the time have been seemingly unique. It will be shown that there are common threads as lessons learned in many a past initiative.

Lessons Learned and Technical Standards: A Logical Marriage for Future Space Systems Design

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.; Parker, Nelson C. (Technical Monitor)

2002-01-01

A comprehensive database of engineering lessons learned that corresponds with relevant technical standards will be a valuable asset to those engaged in studies on future space vehicle developments, especially for structures, materials, propulsion, control, operations and associated elements. In addition, this will enable the capturing of technology developments applicable to the design, development, and operation of future space vehicles as planned in the Space Launch Initiative. Using the time-honored tradition of passing on lessons learned while utilizing the newest information technology, NASA has launched an intensive effort to link lessons learned acquired through various Internet databases with applicable technical standards. This paper will discuss the importance of lessons learned, the difficulty in finding relevant lessons learned while engaged in a space vehicle development, and the new NASA effort to relate them to technical standards that can help alleviate this difficulty.

77 FR 55230 - Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2012-01; Compliance With...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0068] Japan Lessons-Learned Project Directorate Interim... Commission (NRC). ACTION: Japan Lessons-Learned Project Directorate interim staff guidance; issuance. SUMMARY...-Learned Project Directorate Interim Staff Guidance (JLD-ISG), JLD-ISG-2012-01, ``Compliance with Order EA...

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2012-09-07

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0067] Japan Lessons-Learned Project Directorate Interim...-Learned Project Directorate Interim Staff Guidance; issuance. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC or the Commission) is issuing the Final Japan Lessons-Learned Project Directorate (JLD...

77 FR 55231 - Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2012-02; Compliance With...

Federal Register 2010, 2011, 2012, 2013, 2014

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... NUCLEAR REGULATORY COMMISSION [NRC-2012-0069] Japan Lessons-Learned Project Directorate Interim...-Learned Project Directorate interim staff guidance; issuance. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC or the Commission) is issuing the Final Japan Lessons-Learned Project Directorate Interim...

Total thyroidectomy: is morbidity higher for Graves' disease than nontoxic goiter?

PubMed

Welch, Kellen C; McHenry, Christopher R

2011-09-01

Total thyroidectomy for treatment of Graves' disease is controversial and much of the debate centers on the concern for complications. The purpose of this study was to evaluate the morbidity of total thyroidectomy for Graves' disease and determine if it is different than for patients with nontoxic nodular goiter. The rates of life threatening neck hematoma, recurrent laryngeal nerve (RLN) injury, transient hypocalcemia, and hypoparathyroidism were determined for consecutive patients with Graves' disease treated with total thyroidectomy from 1996 to 2010. Results were compared with patients who underwent total thyroidectomy for nontoxic nodular goiter during the same period, matched for the weight of the excised thyroid gland. Total thyroidectomy was performed in 111 patients with Graves' disease (group I) and 283 patients with nontoxic nodular goiter (group II). Parathyroid autotransplantation was performed in 31(28%) patients in group I and 98 (35%) patients in group II (P = NS). Comparative analysis of morbidity revealed no significant difference in neck hematoma, 0(0%) (I) versus 3(1%) (II); permanent RLN injury, 0(0%) (I) versus 2(1%) (II); and permanent hypoparathyroidism in 1(1%) (I) versus 1 (0.4%) (II) (P = NS). Transient hypocalcemia was more common in patients with Graves' disease, 80(72%) (I) versus 170 (60%) (II) (P < 0.05), but not when matched for thyroid weight. Total thyroidectomy can be performed with low morbidity in patients with Graves' disease; only transient hypocalcemia occurred more often than in patients with nodular goiter. Total thyroidectomy should be presented as a therapeutic option for all patients with Graves' disease. Copyright © 2011 Elsevier Inc. All rights reserved.

[Thyroid cancer in patients with Grave's Disease].

PubMed

Mssrouri, R; Benamr, S; Essadel, A; Mdaghri, J; Mohammadine, El H; Lahlou, M-K; Taghy, A; Belmahi, A; Chad, B

2008-01-01

To evaluate the incidence of thyroid carcinoma in patients operated on for Graves' disease, to identify criteria which may predict malignancy, and to develop a practical approach to determine the extensiveness of thyroidectomy. Retrospective study of all patients who underwent thyroidectomy for Graves' disease between 1995 and 2005. 547 patients underwent subtotal thyroidectomy for Graves' disease during this period. Post-operative pathology examination revealed six cases of thyroid cancer (1.1%). All six cases had differentiated thyroid carcinoma (papillary carcinoma in 3 cases, follicular carcinoma in 2 cases and papillo-follicular carcinoma in 1 case). The indication for initial thyroidectomy was a palpable thyroid nodule in 3 cases (50%), failure of medical treatment for Grave's disease in 2 cases (33%), and signs of goiter compression in 1 case (17%). Five patients underwent re-operative total thyroidectomy. This study shows that while malignancy in Grave's disease is uncommon, the presence of thyroid nodule(s) in patients with Grave's disease may be considered as an indication for radical surgery. The most adequate radical surgery in this situation is to perform a total thyroidectomy.

Incidental parathyroidectomy during thyroidectomy increases the risk of postoperative hypocalcemia.

PubMed

Lin, Yann-Sheng; Hsueh, Chuen; Wu, Hsin-Yi; Yu, Ming-Chin; Chao, Tzu-Chieh

2017-09-01

The correlation between incidental parathyroidectomy (IP) during thyroidectomy and postoperative hypocalcemia remains controversial. Our aim was to investigate the incidence of IP, risk factors, and impact on patient outcomes. Retrospective cohort study. This was a retrospective observational study including 3,186 consecutive patients who underwent thyroidectomy between January 2007 and December 2014. The patients were divided into two groups: the IP group and the non-IP. Numerous clinical parameters were collected and analyzed. The overall incidence of incidentally excised parathyroid glands during thyroidectomy was 6.4%. Patients with IP had significantly higher incidences of postoperative hypocalcemia and hypoparathyroidism than those without IP (P < 0.001). Intrathyroidal parathyroid glands presented only 2.2% of all removed parathyroid glands. Total thyroidectomy, central compartment lymph node dissection, and reoperation were independent risk factors for IP. Incidental parathyroidectomy during thyroidectomy is associated with the increased likelihood of postoperative hypocalcemia. All independent risk factors examined in the study for IP are surgery-related. Surgeons should perform meticulous dissection with the intention of avoiding IP and resultant hypocalcemia. 4. Laryngoscope, 127:2194-2200, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Minimally invasive video-assisted thyroidectomy compared with conventional thyroidectomy in a general surgery department.

PubMed

Dobrinja, Chiara; Trevisan, Giuliano; Makovac, Petra; Liguori, Gennaro

2009-10-01

We retrospectively evaluated a series of patients who underwent minimally invasive video-assisted thyroidectomy (MIVAT) to define its advantages or disadvantages. Between May 2005 and March 2008, 68 patients underwent MIVAT. Sixty-nine patients who underwent conventional thyroidectomy (CT) during the period before the introduction of the MIVAT technique in our department-chosen with the same inclusion criteria used for MIVAT-served as matched controls. The eligibility criteria for both groups was thyroid nodules < or = 35 mm, thyroid volume < 25 ml, no thyroiditis, and no previous surgery. Forty-five MIVAT and 43 CT patients underwent hemithyroidectomy. Twenty-three MIVAT and 26 CT patients underwent total thyroidectomy. No differences were found in terms of complications, operative time, and radicality of the procedure. Patients who underwent MIVAT experienced significantly less pain, better cosmetic results, and shorter hospital stay than patients who underwent conventional surgery The MIVAT technique, in selected patients, seems to be a valid option for thyroidectomy and even preferable to conventional surgery because of its significant advantages, especially in terms of cosmetic results, postoperative pain, and postoperative recovery.

Pre-operative serum alkaline phosphatase as a predictive indicator of post-operative hypocalcaemia in patients undergoing total thyroidectomy.

PubMed

Miah, M S; Mahendran, S; Mak, C; Leese, G; Smith, D

2015-11-01

This study aimed to evaluate whether a pre-operative elevated serum alkaline phosphatase level is a potential predictor of post-operative hypocalcaemia after total thyroidectomy. Data was retrospectively collected from the case notes of patients who had undergone total thyroidectomy. Patients were divided into Graves' disease and non-Graves' groups. Pre-operative and post-operative biochemical markers, including serum calcium, alkaline phosphatase and parathyroid hormone levels, were reviewed. A total of 225 patients met the inclusion criteria. Graves' disease was the most common indication (n = 134; 59.5 per cent) for thyroidectomy. Post-operative hypocalcaemia developed in 48 patients (21.3 per cent) and raised pre-operative serum alkaline phosphatase was noted in 94 patients (41.8 per cent). Raised pre-operative serum alkaline phosphatase was significantly associated with post-operative hypocalcaemia, particularly in Graves' disease patients (p < 0.05). Pre-operative serum alkaline phosphatase measurements help to predict post-thyroidectomy hypocalcaemia, especially in patients who do not develop hypoparathyroidism. Ascertaining the pre-operative serum alkaline phosphatase level in patients undergoing total thyroidectomy may help surgeons to identify at-risk patients.

Laryngeal and vocal alterations after thyroidectomy.

PubMed

Iyomasa, Renata Mizusaki; Tagliarini, José Vicente; Rodrigues, Sérgio Augusto; Tavares, Elaine Lara Mendes; Martins, Regina Helena Garcia

2017-09-21

Dysphonia is a common symptom after thyroidectomy. To analyze the vocal symptoms, auditory-perceptual and acoustic vocal, videolaryngoscopy, the surgical procedures and histopathological findings in patients undergoing thyroidectomy. Prospective study. Patients submitted to thyroidectomy were evaluated as follows: anamnesis, laryngoscopy, and acoustic vocal assessments. Moments: pre-operative, 1st post (15 days), 2nd post (1 month), 3rd post (3 months), and 4th post (6 months). Among the 151 patients (130 women; 21 men). Type of surgery: lobectomy+isthmectomy n=40, total thyroidectomy n=88, thyroidectomy+lymph node dissection n=23. Vocal symptoms were reported by 42 patients in the 1st post (27.8%) decreasing to 7.2% after 6 months. In the acoustic analysis, f0 and APQ were decreased in women. Videolaryngoscopies showed that 144 patients (95.3%) had normal exams in the preoperative moment. Vocal fold palsies were diagnosed in 34 paralyzes at the 1st post, 32 recurrent laryngeal nerve (lobectomy+isthmectomy n=6; total thyroidectomy n=17; thyroidectomy+lymph node dissection n=9) and 2 superior laryngeal nerve (lobectomy+isthmectomy n=1; Total thyroidectomy+lymph node dissection n=1). After 6 months, 10 patients persisted with paralysis of the recurrent laryngeal nerve (6.6%). Histopathology and correlation with vocal fold palsy: colloid nodular goiter (n=76; palsy n=13), thyroiditis (n=8; palsy n=0), and carcinoma (n=67; palsy n=21). Vocal symptoms, reported by 27.8% of the patients on the 1st post decreased to 7% in 6 months. In the acoustic analysis, f0 and APQ were decreased. Transient paralysis of the vocal folds secondary to recurrent and superior laryngeal nerve injury occurred in, respectively, 21% and 1.3% of the patients, decreasing to 6.6% and 0% after 6 months. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

INDUCTION OF NEOPLASMS IN THYROID GLANDS OF RATS BY SUBTOTAL THYROIDECTOMY AND BY THE INJECTION OF ONE MICROCURIE OF I$sup 13$$sup 1$

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldberg, R.C.; Lindsay, S.; Nichols, C.W. Jr.

1964-01-01

Female Long-Evans rats were subjected to subtotal thyroidectomy, subtotal thyroidectomy plus injection of 1 mu e of I/sup 131/, subtotal thyroidectomy plus injection of 1 mu c of I/sup 131/ plus feeding of a diet containing desiccated thyroid, subtotal thyroidectomy plus feeding of a diet containing desiccated thyroid, injection of 1 mu c of I/sup 131/, feeding of a diet containing desiccated thyroid, and injection of 1 mu c of I/sup 131/ plus feeding of a diet containing desiccated thyroid. Single and multiple adenomas were found in rats subjected to subtotal thyroidectomy and in those subtotally thyroidectomized and given injectionsmore » of 1 mu c of I/sup 131/. In rats subjected to these same treatments but, in addition, fed the thyroid-containing diet, significantly fewer adenomas were encountered. Four papillary carcinomas and one follicular carcinoma were found in rats subjected to subtotal thyroidectomy and/or given injections of 1 mu c I/sup 131/. No carcinoma was observed in control rats. Two papillary carcinomas were found in glands following subtotal thyroidectomy alone, a finding suggesting that thyrotropic hormone stimulation may cause the development of both benign and malignant thyroid neoplasms. One papillary and one follicular carcinoma developed in the intact thyroid glands of rats that received only 1 mu c of I/sup 131/. These malignant neoplasms were possibly induced solely by the I/sup 131/ irradiation. One papillary carcinoma developed in a rat that had been subjected to subtotal thyroidectomy, given an injection of 1 mu c of I/sup 131/, and fed the desiccated thyroid-containing diet. This neoplasm appeared to be the result of either prolonged thyrotropic hormone stimulation or I/sup 131/ irradiation. (auth)« less

DT&E Forum for Best Practices and Lessons Learned

DTIC Science & Technology

2013-05-01

E A N A L Y S E S IDA Paper P-4975 DT&E Forum for Best Practices and Lessons Learned L. B. Scheiber, Project Leader...and accessing from the DT&E Forum website. A. Collection of Lessons Learned and Best Practices We began the effort by reviewing approximately 30...Forum’s Home Page 1. Searching for BPLL Documents The DT&E Forum website contains DT&E Best Practice and Lessons Learned (BPLL) documents along with the

Sublingual pyramidal lobe. Complications of subtotal thyroidectomy for Graves' disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sternberg, J.L.

1986-11-01

A potential complication of subtotal thyroidectomy where a large pyramidal lobe is present is described. The pyramidal lobe normally is immobilized inferiorly by its attachment to the thyroidal isthmus. When the isthmus is removed and the pyramidal lobe is left in situ during subtotal thyroidectomy its superior attachments will allow the pyramidal lobe to become situated sublingually. This may produce gagging and nausea. To avoid the complication, it is recommended that the pyramidal lobe be removed during subtotal thyroidectomy. If the patient also is thyrotoxic, I-131 can be used to treat this complication successfully.

Papermaking and Poetry. ArtsEdge Curricula, Lessons and Activities.

ERIC Educational Resources Information Center

Withroe, J.

In this lesson, designed to be taught within a unit on China, primary-grade students will learn about the history of papermaking and its origins in China and even learn how to make their own paper. After learning about Chinese art and culture in the lesson, students will write their own "cinquain" poem about China. The lesson presents an…

Planning to Serve: Using Backwards Planning to Design Service-Learning Lesson Plans in the Preservice Curriculum

ERIC Educational Resources Information Center

Stiler, Gary

2009-01-01

The author describes how the Understanding by Design (backwards planning) lesson plan format was used by his preservice K-12 students to develop service-learning lesson plans. Preservice teachers in a multicultural education course were given an assignment to develop service-learning lesson plans using the Understanding by Design planning process.…

Learning from Lessons: studying the structure and construction of mathematics teacher knowledge in Australia, China and Germany

NASA Astrophysics Data System (ADS)

Chan, Man Ching Esther; Clarke, David J.; Clarke, Doug M.; Roche, Anne; Cao, Yiming; Peter-Koop, Andrea

2018-03-01

The major premise of this project is that teachers learn from the act of teaching a lesson. Rather than asking "What must a teacher already know in order to practice effectively?", this project asks "What might a teacher learn through their activities in the classroom and how might this learning be optimised?" In this project, controlled conditions are created utilising purposefully designed and trialled lesson plans to investigate the process of teacher knowledge construction, with teacher selective attention proposed as a key mediating variable. In order to investigate teacher learning through classroom practice, the project addresses the following questions: To what classroom objects, actions and events do teachers attend and with what consequence for their learning? Do teachers in different countries attend to different classroom events and consequently derive different learning benefits from teaching a lesson? This international project combines focused case studies with an online survey of mathematics teachers' selective attention and consequent learning in Australia, China and Germany. Data include the teacher's adaptation of a pre-designed lesson, the teacher's actions during the lesson, the teacher's reflective thoughts about the lesson and, most importantly, the consequences for the planning and delivery of a second lesson. The combination of fine-grained, culturally situated case studies and large-scale online survey provides mutually informing benefits from each research approach. The research design, so constituted, offers the means to a new and scalable vision of teacher learning and its promotion.

Parathyroid hormone levels 1 hour after thyroidectomy: an early predictor of postoperative hypocalcemia

PubMed Central

AlQahtani, Awad; Parsyan, Armen; Payne, Richard; Tabah, Roger

2014-01-01

Background Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total or completion thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. A simple, reliable indicator to identify patients at risk would permit earlier pharmacologic prophylaxis to avoid these adverse outcomes. We examined the role of intact parathormone (PTH) levels 1 hour after surgery as a predictor of post-thyroidectomy hypocalcemia. Methods We prospectively reviewed the cases of consecutive patients undergoing total or completion thyroidectomy. Ionized calcium (Ca2+) and intact PTH levels were measured preoperatively and at 1-, 6- and 24-hour intervals postoperatively. The specificity, sensitivity, negative and positive predictive values of the 1-hour PTH serum levels (PTH-1) in predicting 24-hour post-thyroidectomy hypocalcemia and eucalcemia were determined. Results We reviewed the cases of 149 patients. Biochemical hypocalcaemia (Ca2+ < 1.1 mmol/L) developed in 38 of 149 (25.7%) patients 24 hours after thyroidectomy. The sensitivity, specificity, positive and negative predictive values of a low PTH-1 were 89%, 100%, 97% and 100%, respectively. Conclusion We found that PTH-1 levels were predictive of symptomatic hypocalcemia 24 hours after thyroidectomy. Routine use of this assay should be considered, as it could prompt the early administration of calcitriol in patients at risk of hypocalcemia and allow for the safe and timely discharge of patients expected to remain eucalcemic. PMID:25078927

Parathyroid hormone levels 1 hour after thyroidectomy: an early predictor of postoperative hypocalcemia.

PubMed

AlQahtani, Awad; Parsyan, Armen; Payne, Richard; Tabah, Roger

2014-08-01

Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total or completion thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. A simple, reliable indicator to identify patients at risk would permit earlier pharmacologic prophylaxis to avoid these adverse outcomes. We examined the role of intact parathormone (PTH) levels 1 hour after surgery as a predictor of post-thyroidectomy hypocalcemia. We prospectively reviewed the cases of consecutive patients undergoing total or completion thyroidectomy. Ionized calcium (Ca(2+)) and intact PTH levels were measured preoperatively and at 1-, 6- and 24-hour intervals postoperatively. The specificity, sensitivity, negative and positive predictive values of the 1-hour PTH serum levels (PTH-1) in predicting 24-hour post-thyroidectomy hypocalcemia and eucalcemia were determined. We reviewed the cases of 149 patients. Biochemical hypocalcaemia (Ca(2+) < 1.1 mmol/L) developed in 38 of 149 (25.7%) patients 24 hours after thyroidectomy. The sensitivity, specificity, positive and negative predictive values of a low PTH-1 were 89%, 100%, 97% and 100%, respectively. We found that PTH-1 levels were predictive of symptomatic hypocalcemia 24 hours after thyroidectomy. Routine use of this assay should be considered, as it could prompt the early administration of calcitriol in patients at risk of hypocalcemia and allow for the safe and timely discharge of patients expected to remain eucalcemic.

Considerations for implementing an organizational lessons learned process.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fosshage, Erik D

2013-05-01

This report examines the lessons learned process by a review of the literature in a variety of disciplines, and is intended as a guidepost for organizations that are considering the implementation of their own closed-loop learning process. Lessons learned definitions are provided within the broader context of knowledge management and the framework of a learning organization. Shortcomings of existing practices are summarized in an attempt to identify common pitfalls that can be avoided by organizations with fledgling experiences of their own. Lessons learned are then examined through a dual construct of both process and mechanism, with emphasis on integrating intomore » organizational processes and promoting lesson reuse through data attributes that contribute toward changed behaviors. The report concludes with recommended steps for follow-on efforts.« less

Lesson Study and Teachers Knowledge Development: Collaborative Critique of a Research Model and Methods.

ERIC Educational Resources Information Center

Lewis, Catherine; Perry, Rebecca; Murata, Aki

During "lesson study" teachers formulate long-term goals for student learning and development, collaboratively work on "research lessons" to bring these goals to life, document and discuss student responses to these lessons, and revise the lessons in response to student learning. This document summarizes the content of a…

A Checklist of Artillery Organizational Histories; A Compilation.

DTIC Science & Technology

1982-03-08

Artillery. 3d Battalion. Ab Operational reports - Lessons learned. ( 3d ) 1966- . (Vietnam n.p.) APO 96318. 1. Vietnamese Conflict, 1961- I. Title. 11...1973. A631 U.S. Army. 18th Artillery. 3d Bn. A18 Operational report(s) - Lessons learned. ( 3d ) (Vietnam, n.p.) 1966- nos. 1. Vietnamese Conflict, 1961...1973. I. Title. II. T: Lessons learned. *DS557 Vietnamese Conflict, 1961-1973 A63A]8 ’U.S. Army. 18th Artillery. 3d Bn. Lessons learned. (Vietnam, n.p

Improving the primary school science learning unit about force and motion through lesson study

NASA Astrophysics Data System (ADS)

Phaikhumnam, Wuttichai; Yuenyong, Chokchai

2018-01-01

The study aimed to develop primary school science lesson plan based on inquiry cycle (5Es) through lesson study. The study focused on the development of 4 primary school science lesson plans of force and motion for Grade 3 students in KKU Demonstration Primary School (Suksasart), first semester of 2015 academic year. The methodology is mixed method. The Inthaprasitha (2010) lesson study cycle was implemented in group of KKU Demonstration Primary School. Instruments of reflection of lesson plan developing included participant observation, meeting and reflection report, lesson plan and other document. The instruments of examining students' learning include classroom observation and achievement test. Data was categorized from these instruments to find the issues of changing and improving the good lesson plan of Thai primary school science learning. The findings revealed that teachers could develop the lesson plans through lesson study. The issues of changing and improving were disused by considering on engaging students related to societal issues, students' prior knowledge, scientific concepts for primary school students, and what they learned from their changing. It indicated that the Lesson Study allowed primary school science teachers to share ideas and develop ideas to improve the lesson. The study may have implications for Thai science teacher education through Lesson Study.

Learning to Lead, Leading to Learn: How Facilitators Learn to Lead Lesson Study

ERIC Educational Resources Information Center

Lewis, Jennifer M.

2016-01-01

This article presents research on how teacher developers in the United States learn to conduct lesson study. Although the practice of lesson study is expanding rapidly in the US, high-quality implementation requires skilled facilitation. In contexts such as the United States where this form of professional development is relatively novel, few…

Solid-State Lighting: Early Lessons Learned on the Way to Market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sandahl, Linda J.; Cort, Katherine A.; Gordon, Kelly L.

2013-12-31

The purpose of this report is to document early challenges and lessons learned in the solid-state lighting (SSL) market development as part of the DOE’s SSL Program efforts to continually evaluate market progress in this area. This report summarizes early actions taken by DOE and others to avoid potential problems anticipated based on lessons learned from the market introduction of compact fluorescent lamps and identifies issues, challenges, and new lessons that have been learned in the early stages of the SSL market introduction. This study identifies and characterizes12 key lessons that have been distilled from DOE SSL program results.

Lessons Learned Study Final Report for the Exploration Systems Mission Directorate

NASA Technical Reports Server (NTRS)

Van Laak, Jim; Brumfield, M. Larry; Moore, Arlene A.; Anderson, Brooke; Dempsey, Jim; Gifford, Bob; Holloway, Chip; Johnson, Keith

2004-01-01

This report is the final product of a 90-day study performed for the Exploration Systems Mission Directorate. The study was to assemble lessons NASA has learned from previous programs that could help the Exploration Systems Mission Directorate pursue the Exploration vision. It focuses on those lessons that should have the greatest significance to the Directorate during the formulation of program and mission plans. The study team reviewed a large number of lessons learned reports and data bases, including the Columbia Accident Investigation Board and Rogers Commission reports on the Shuttle accidents, accident reports from robotic space flight systems, and a number of management reviews by the Defense Sciences Board, Government Accountability Office, and others. The consistency of the lessons, findings, and recommendations validate the adequacy of the data set. In addition to reviewing existing databases, a series of workshops was held at each of the NASA centers and headquarters that included senior managers from the current workforce as well as retirees. The full text of the workshop reports is included in Appendix A. A lessons learned website was opened up to permit current and retired NASA personnel and on-site contractors to input additional lessons as they arise. These new lessons, when of appropriate quality and relevance, will be brought to the attention of managers. The report consists of four parts: Part 1 provides a small set of lessons, called the Executive Lessons Learned, that represent critical lessons that the Exploration Systems Mission Directorate should act on immediately. This set of Executive Lessons and their supporting rationale have been reviewed at length and fully endorsed by a team of distinguished NASA alumni; Part 2 contains a larger set of lessons, called the Selected Lessons Learned, which have been chosen from the lessons database and center workshop reports on the basis of their specific significance and relevance to the near-term work of the Exploration Directorate. These lessons frequently support the Executive lessons but are more general in nature; Part 3 consists of the reports of the center workshops that were conducted as part of this activity. These reports are included in their entirety (approximately 200 pages) in Appendix G and have significance for specific managers; Part 4 consists of the remainder of the lessons that have been selected by this effort and assembled into a database for the use of the Explorations Directorate. The database is archived and hosted in the Lessons Learned Knowledge Network, which provides a flexible search capability using a wide variety of search terms. Finally, a spreadsheet lists databases searched and a bibliography identifies reports that have been reviewed as sources of lessons for this task. NASA has been presented with many learning opportunities. We have conducted numerous programs, some extremely successful and others total failures. Most have been documented with a formal lessons learned activity, but we have not always incorporated these learning opportunities into our normal modes of business. For example, the Robbins Report of 2001 clearly indicates that many project failures of the past two decades were the result of violating well documented best practices, often in direct violation of management instructions and directives. An overarching lesson emerges: that disciplined execution in accordance with proven best practices is the greatest single contributor to a successful program. The Lessons Learned task team offers a sincere hope that the lessons presented herein will be helpful to the Exploration Systems Directorate in charting and executing their course. The success of the Directorate and of NASA in general depends on our collective ability to move forward without having to relearn the lessons of those who have gone before.

Utilization of Lesson Analysis as Teacher Self Reflection to Improve the Lesson Design on Chemical Equation Topic

NASA Astrophysics Data System (ADS)

Edyani, E. A.; Supriatna, A.; Kurnia; Komalasari, L.

2017-02-01

The research is aimed to investigate how lesson analysis as teacher’s self-reflection changes the teacher’s lesson design on chemical equation topic. Lesson Analysis has been used as part of teacher training programs to improve teacher’s ability in analyzing their own lesson. The method used in this research is a qualitative method. The research starts from build lesson design, implementation lesson design to senior high school student, utilize lesson analysis to get information about the lesson, and revise lesson design. The revised lesson design from the first implementation applied to the second implementation, resulting in better design. This research use lesson analysis Hendayana&Hidayat framework. Video tapped and transcript are employed on each lesson. After first implementation, lesson analysis result shows that teacher-centered still dominating the learning because students are less active in discussion, so the part of lesson design must be revised. After second implementation, lesson analysis result shows that the learning already student-centered. Students are very active in discussion. But some part of learning design still must be revised. In general, lesson analysis was effective for teacher to reflect the lessons. Teacher can utilize lesson analysis any time to improve the next lesson design.

Review analysis of medullary carcinoma thyroid--15-year Indian experience.

PubMed

Dorairajan, N; Saravanakumar, P; Karthikeyan, S; Siddharth, D; Kanna, Srinivasulu

2005-08-01

To emphasize the importance of adequate primary surgery in cases of medullary carcinoma of the thyroid, 44 cases of treated medullary carcinoma of thyroid were retrospectively reviewed in Government General Hospital, Chennai between 1987 and 2002. Patients who underwent total thyroidectomy with only central compartment dissection were compared with those who had undergone total thyroidectomy with meticulous triple compartment (bilateral lateral and central groups) nodal dissection. The group of total thyroidectomy with only central compartment dissection had high rate of lymph nodal recurrence and persistent hypercalcitoninaemia when compared with the group of total thyroidectomy with meticulous triple compartment nodal dissection. (Chi square value 4.503 with p<0.05).

Hypocalcaemia after total thyroidectomy: incidence, control and treatment.

PubMed

Herranz González-Botas, Jesús; Lourido Piedrahita, Diana

2013-01-01

Hypocalcaemia, although usually transitory, is the most frequent complication after total thyroidectomy. To identify factors associated with a higher risk of hypoparathyroidism and related to aetiology and surgical procedure. A total of 254 total thyroidectomies were analysed for the incidence of transitory or permanent hypocalcaemia based on the relationship with etiological and surgical factors. Transient hypocalcaemia was present in 29.1% of the cases and permanent hypocalcemia was present in 4.7%. Postoperative hypocalcaemia was lower in patients with completion thyroidectomy than in patients that underwent total thyroidectomy in a single operation, 12% vs. 31%. Patients with Graves-Basedow disease developed postoperative hypocalcaemia in 50% of the cases. Mean recovery time of parathyroid function was 5.2 months, with 72.2% of the patients recovering before 6 months. Postoperative hypocalcaemia is a frequent complication of total thyroidectomy, but it is seldom permanent. Patients with Graves-Basedow disease have a higher incidence of postoperative hypocalcaemia and need closer follow-up. Postoperative calcium level analysis at 24 and 48 h after surgery is not useful for rapid identification of patients at high risk of hypocalcaemia. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Lesson Study: Evaluation Report and Executive Summary

ERIC Educational Resources Information Center

Murphy, Richard; Weinhardt, Felix; Wyness, Gill; Rolfe, Heather

2017-01-01

Lesson Study is a popular approach to teacher professional development used widely in Japan. It involves a small group of teachers co-planning a series of lessons based on a shared learning goal for the pupils, with one teacher leading the co-constructed lesson and their colleagues invited to observe pupil learning in the lesson. The team then…

Solid-State Lighting. Early Lessons Learned on the Way to Market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sandahl, L. J.; Cort, K. A.; Gordon, K. L.

2014-01-01

Analysis of issues and lessons learned during the early stages of solid-state lighting market introduction in the U.S., which also summarizes early actions taken to avoid potential problems anticipated based on lessons learned from the market introduction of compact fluorescent lamps.

Lesson Closure: An Important Piece of the Student Learning Puzzle

ERIC Educational Resources Information Center

Ganske, Kathy

2017-01-01

As we seek ways to improve literacy teaching and learning, we need to be careful not to overlook lesson closure as an opportunity to solidify student learning. This Teaching Tip describes the importance of taking time at the ends of lessons, days, and weeks to revisit what students have learned as a means for helping them synthesize and assimilate…

Parathyroid hormone and serum calcium levels measurements as predictors of postoperative hypocalcemia in total thyroidectomy

PubMed Central

Algarni, Mohammed; Dionigi, Gianlorenzo; Hadi, Al-Hakami; AlSubayea, Haia

2017-01-01

Background The rules of quantitative measures such as parathyroid hormone (PTH) levels in the first hours following total thyroidectomy have since been validated repeatedly. Such measures play an integral rule in identifying patients at significant risk for hypocalcaemia and have allowed for earlier supplementation of these patients with calcium with or without vitamin D. Methods A retrospective analysis was conducted of 40 consecutive patients with well differentiated thyroid cancer (WDTC) who underwent total thyroidectomy without central neck dissection (CND) as an initial surgery and no comorbidity at King Abdulaziz Medical City (National Guard hospital), between July 2011 and July 2012. A blood testing protocol was applied for all patients that measured serum calcium PTH at 6 hours postoperatively. Results Following total thyroidectomy, women were found to experience transient hypocalcaemia in 12.5% of cases (4/32), whereas no men cases encountered this postoperative complication (0/8). However, most probably due to small sample size, this difference was not statistically significant. PTH level was significantly associated with post thyroidectomy hypocalcaemia (43.7±39.3 versus 13.40±24.9 ng/L), P=0.014. Only negligible differences in the length of hospital stay were observed with and without post-thyroidectomy hypocalcaemia. Conclusions Using post-thyroidectomy PTH levels to predict hypocalcaemia has been confirmed in the current study. So, the use of PTH levels allows for early risk stratification of our patients and we feel this has resulted in better patient satisfaction. PMID:29142830

Mechanisms behind Post-Thyroidectomy Hypocalcemia: Interplay of Calcitonin, Parathormone, and Albumin-A Prospective Study.

PubMed

Chisthi, Meer M; Nair, Rakhi S; Kuttanchettiyar, Krishnakumar G; Yadev, Induprabha

2017-08-01

Hypocalcemia after thyroidectomy is attributed to injury or ischemia to parathyroid glands. Transient hypocalcemia in thyroidectomy when parathyroids are preserved is not adequately explained. Release of calcitonin and hypoalbuminemia are two proposed reasons. Primary objective of this study was to find the change in calcitonin in the postoperative period after total thyroidectomy. Secondarily, hypocalcemia and its correlation with calcitonin, albumin, and parathormone were also studied. This Cohort study was carried out at the general surgical department of a tertiary level teaching institution from April 2015 to December 2015. One hundred adult patients undergoing total thyroidectomy, with at least three parathyroids being preserved were included. Changes in calcium, calcitonin, albumin, and parathormone were studied based on preoperative levels and the values at 1, 6, 24, and 48 hr after surgery. Calcitonin increased at one hour after thyroidectomy and fell below preoperative levels subsequently. Parathormone showed a mild rise at one hour and normalized subsequently. Total calcium, corrected calcium, and albumin showed decline at one hour and recovered gradually over the next two days. At preoperative level, calcium had significant correlation with parathormone alone. Calcium levels at one hour had significant correlation with calcitonin. All post-operative calcium levels had significant correlation with parathormone and the number of parathyroids preserved in situ without auto-transplantation. There is significant hypocalcemia within the first 24 hr after thyroidectomy, caused by calcitonin release and hypoalbuminemia. Preservation of maximum number of parathyroids in-situ can counter and normalize this hypocalcemia.

Robotic Thyroidectomy: Comparison of a Postauricular Facelift Approach with a Gasless Unilateral Axillary Approach.

PubMed

Sung, Eui Suk; Ji, Yong Bae; Song, Chang Myeon; Yun, Bo Ram; Chung, Won Sang; Tae, Kyung

2016-06-01

Robotic thyroidectomy using remote access approaches has gained popularity with patients seeking to avoid neck scarring and enhanced cosmetic satisfaction. The aim of this study was to compare the efficacy and advantages of a postauricular facelift approach vs a gasless unilateral axillary (GUA) approach in robotic thyroidectomy. Case series with chart review. University tertiary care hospital. We retrospectively analyzed the data of 65 patients who underwent robotic thyroidectomy with or without central neck dissection using a GUA approach (45 patients) or a postauricular facelift approach (20 patients) between September 2013 and December 2014. We excluded patients who underwent simultaneous lateral neck dissection or completion thyroidectomy. Robotic procedures were completed without being converted to an open procedure in all patients. There were no significant differences in terms of patient and tumor characteristics, extent of thyroidectomy and central neck dissection, operative time, complications, and postoperative pain between the 2 approaches, except the higher female ratio in the GUA approach group (female ratio, 95.6% vs 75%, P = .042). Cosmetic satisfaction evaluated by a questionnaire was not significantly different between the 2 groups, and most patients of both groups (85.7%) were satisfied with postoperative cosmesis. Both GUA and postauricular facelift approaches are feasible, with no significant adverse events in patients, and result in excellent cosmesis. However, a GUA approach seems to be superior when performing total thyroidectomy using a unilateral incision based on the preliminary result. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Voice changes after thyroidectomy without recurrent laryngeal nerve injury.

PubMed

Sinagra, Diego L; Montesinos, Manuel R; Tacchi, Verónica A; Moreno, Julio C; Falco, Jorge E; Mezzadri, Norberto A; Debonis, Daniel L; Curutchet, H Pablo

2004-10-01

Injury of the inferior laryngeal nerve is not the only cause of voice alteration after thyroidectomy; many patients notice minimal changes immediately after operation, without evidence of inferior laryngeal nerve damage. We hypothesized that there may be other causes for voice modification, such as injuries of the superior laryngeal nerve, prethyroid strap muscles, and cricothyroid muscles. We describe voice changes after total thyroidectomy, without inferior laryngeal nerve injury, using a computer program to objectively compare different patterns of voice. Forty-six consecutive patients who underwent total thyroidectomy were studied between March 1997 and December 1999. Acoustic voice analysis was performed preoperatively and at the second, fourth, and sixth postoperative months using a microphone adapted to a personal computer. Parameters measured were intensity of the voice (Shimmer) and fundamental frequency (Fo). No complications occurred during operation or in the postoperative period. Voice fatigue during phonation was the most common symptom after thyroidectomy. Forty patients (87%) stated that their voices had changed since the operation, and common complaints were voice alteration while speaking loudly, changes in voice pitch, and voice disorder while singing. Changes in the Fo and Shimmer values in smokers versus nonsmokers were similar (Fo overall, p = 0.56; Shimmer overall, p = 0.66), as were the same parameters in benign and malignant pathologies (Fo overall, p = 0.66; Shimmer overall, p = 0.67). Voice changes after uncomplicated thyroidectomy occur and can be objectively measured. This is important in the preoperative counseling of patients before thyroidectomy, for ethical and legal purposes.

Lesson Study as Professional Development within Secondary Physics Teacher Professional Learning Communities

NASA Astrophysics Data System (ADS)

Collins, Tonya Monique Nicki

Two Professional Learning Communities of physics teachers from different high schools voluntarily participated in Lesson Study as a means of professional development. The five teacher-participants and one participant-researcher partook of two Lesson Study cycles, each of which focused on student physics misconceptions. The Lesson Study resulted in two topics of physics: projectiles and gravitation. The researcher aimed to determine what happens to secondary physics teachers who undergo Lesson Study through this phenomenological case study. Specifically, (1) What is the process of Lesson Study with secondary physics teachers? and (2) What are the teacher-reported outcomes of Lesson Study with secondary physics teachers? Overall, Lesson Study provided an avenue for secondary physics teachers to conduct inquiry on their students in an attempt to better understand student thinking and learning. As a result, teachers collaborated to learn how to better meet the needs of their students and self-reported growth in many areas of teaching and teacher knowledge. The study resulted in twelve hypotheses to be tested in later research centering on idealizing the process of Lesson Study and maximizing secondary physics teacher growth.

Integrating Instruments of Power and Influence: Lessons Learned and Best Practices

DTIC Science & Technology

2008-01-01

practices developed by ACT’s Joint Analysis and Lessons Learned Centre in Monsanto , Portugal. Summary xix European Union An increasing European role in...oversees the Joint Analysis and Lessons Learned Centre in Monsanto , Por- tugal, the mission of which is critical for the purposes of this report. These

Human Spaceflight Conjunction Assessment: Lessons Learned

NASA Technical Reports Server (NTRS)

Smith, Jason T.

2011-01-01

This viewgraph presentation reviews the process of a human space flight conjunction assessment and lessons learned from the more than twelve years of International Space Station (ISS) operations. Also, the application of these lessons learned to a recent ISS conjunction assessment with object 84180 on July 16, 2009 is also presented.

NASA's Lessons Learned and Technical Standards: A Logical Marriage

NASA Technical Reports Server (NTRS)

Gill, Paul; Vaughan, William W.; Garcia, Danny; Weinstein, Richard

2001-01-01

Lessons Learned have been the basis for our accomplishments throughout the ages. They have been passed down from father to son, mother to daughter, teacher to pupil, and older to younger worker. Lessons Learned have also been the basis for NASA's accomplishments for more than forty years. Both government and industry have long recognized the need to systematically document and utilize the knowledge gained from past experiences in order to avoid the repetition of failures and mishaps. Lessons Learned have formed the foundation for discoveries, inventions, improvements, textbooks, and Technical Standards.

Selected Lessons Learned in Space Shuttle Orbiter Propulsion and Power Subsystems

NASA Technical Reports Server (NTRS)

Hernandez, Francisco J.; Martinez, Hugo; Ryan, Abigail; Westover, Shayne; Davies, Frank

2011-01-01

Over its 30 years of space flight history, plus the nearly 10 years of design, development test and evaluation, the Space Shuttle Orbiter is full of lessons learned in all of its numerous and complex subsystems. In the current paper, only selected lessons learned in the areas of the Orbiter propulsion and power subsystems will be described. The particular Orbiter subsystems include: Auxiliary Power Unit (APU), Hydraulics and Water Spray Boiler (WSB), Mechanical Flight Controls, Main Propulsion System (MPS), Fuel Cells and Power Reactant and Storage Devices (PRSD), Orbital Maneuvering System (OMS), Reaction Control System (RCS), Electrical Power Distribution (EPDC), electrical wiring and pyrotechnics. Given the complexity and extensive history of each of these subsystems, and the limited scope of this paper, it is impossible to include most of the lessons learned; instead the attempt will be to present a selected few or key lessons, in the judgment of the authors. Each subsystem is presented separate, beginning with an overview of the hardware and their function, a short description of a few historical problems and their lessons, followed by a more comprehensive table listing of the major subsystem problems and lessons. These tables serve as a quick reference for lessons learned in each subsystem. In addition, this paper will establish common lessons across subsystems as well as concentrate on those lessons which are deemed to have the highest applicability to future space flight programs.

Importance of latency and amplitude values of recurrent laryngeal nerve during thyroidectomy in diabetic patients.

PubMed

Ozemir, Ibrahim Ali; Ozyalvac, Ferman; Yildiz, Gorkem; Eren, Tunc; Aydin-Ozemir, Zeynep; Alimoglu, Orhan

2016-11-01

Diabetes mellitus may cause degeneration in the myelin and/or axonal structures of peripheral nerves. The aim of this study was to investigate the effects of diabetic neuropathy on intraoperative neuromonitoring findings such as latency and amplitude values of the recurrent laryngeal nerves during thyroidectomy. To our knowledge this is the first study to report comparison of the electrophysiologic features of diabetic and non-diabetic patients. One-hundred-and-eleven consecutive patients who received neuromonitoring during thyroidectomy between 2013 and 2015 were included to study. The patients were divided into two groups according to the presence of diabetes mellitus. Pre-thyroidectomy and post thyroidectomy motor response latency and amplitude values of recurrent laryngeal nerves were compared between groups. Neuromonitoring findings, demographic data and postoperative complications were evaluated. The diabetic group consisted of 29 (26.1%) patients while 82 (73.9%) patients were in non-diabetic group. The mean post-thyroidectomy amplitude values (millivolts-mV) of the recurrent laryngeal nerve were significantly lower in diabetic group (0.51 ± 0.26 mV vs. 0,70 ± 0,46 mV, p < 0.05), whereas the latency values were significantly higher (2.50 ± 0.86 ms vs. 1.85 ± 0.59 ms, p < 0.01) compared to non-diabetic group. Additionally, post-thyroidectomy latency values were significantly increased compared to the pre-thyroidectomy latency values (2.50 ± 0.86 ms vs. 2.02 ± 0.43 ms) in diabetic group patients (p < 0.05). Although postoperative complication rates were higher in diabetic group (10.3% vs. 5.9%), there were no statistical significance differences. Prolonged latency and decreased amplitude values in recurrent laryngeal nerves of diabetic patients show that diabetic neuropathy of the recurrent laryngeal nerves develop similarly to the peripheral nerves. Increased post-thyroidectomy latency values reveal that the recurrent laryngeal nerve is more susceptible to surgical trauma in diabetic patients. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Key Events in Student Leaders' Lives and Lessons Learned from Them

ERIC Educational Resources Information Center

Sessa, Valerie I.; Morgan, Brett V.; Kalenderli, Selin; Hammond, Fanny E.

2014-01-01

This descriptive study used an interview protocol developed by the Center for Creative Leadership with 50 college student leaders to determine what key developmental events young college leaders experience and the leadership lessons learned from these events. Students discussed 180 events and 734 lessons learned from them. Most events defined by…

75 FR 80857 - Notice of Availability of NUREG-1800, Revision 2; “Standard Review Plan for Review of License...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

..., Revision 2; ``Generic Aging Lessons Learned (GALL) Report'' AGENCY: Nuclear Regulatory Commission (NRC... Nuclear Power Plants'' and NUREG-1801, Revision 2; ``Generic Aging Lessons Learned (GALL) Report... Lessons Learned (GALL) Report.'' These revised documents describe methods acceptable to the NRC staff for...

Reinventing Teacher Professional Norms and Identities: The Role of Lesson Study and Learning Communities

ERIC Educational Resources Information Center

Lieberman, Joanne

2009-01-01

The present article addresses how lesson study can facilitate changing traditional norms of individualism, conservatism and presentism that constrain American teachers from learning from one another. The article investigates how lesson study can serve as a vehicle for developing teacher learning communities by developing or redeveloping teachers'…

Impact of postoperative magnesium levels on early hypocalcemia and permanent hypoparathyroidism after thyroidectomy.

PubMed

Garrahy, Aoife; Murphy, Matthew S; Sheahan, Patrick

2016-04-01

Postoperative hypocalcemia is a common complication of thyroidectomy. Magnesium is known to modulate serum calcium levels and hypomagnesemia may impede correction of hypocalcemia. The purpose of this study was to investigate whether hypomagnesemia after thyroidectomy has any impact on early hypocalcemia and/or permanent hypoparathyroidism. We conducted a retrospective review of prospectively maintained databases. Inclusion criteria were total or completion total thyroidectomy with postoperative magnesium levels available. The incidence of postoperative hypocalcemia was correlated with postoperative hypomagnesemia and other risk factors. Two hundred one cases were included. Twenty-six patients (13%) developed postoperative hypomagnesemia. Hypomagnesemia (p = .002), cancer diagnosis (p = .01), central neck dissection (p = .02), and inadvertent parathyroid resection (p = .02) were significantly associated with hypocalcemia. On multivariate analysis, only hypomagnesemia (p = .005) remained significant. Hypomagnesemia was also a significant predictor of permanent hypoparathyroidism (p = .0004). Hypomagnesemia is significantly associated with early hypocalcemia and permanent hypoparathyroidism after thyroidectomy. Magnesium levels should be closely monitored in patients with postthyroidectomy hypocalcemia. © 2015 Wiley Periodicals, Inc.

Economic analysis of routine neuromonitoring of recurrent laryngeal nerve in total thyroidectomy.

PubMed

Sanabria, Álvaro; Ramírez, Adonis

2015-01-01

Thyroidectomy is a common surgery. Routine searching of the recurrent laryngeal nerve is the most important strategy to avoid palsy. Neuromonitoring has been recommended to decrease recurrent laryngeal nerve palsy. To assess if neuromonitoring of recurrent laryngeal nerve during thyroidectomy is cost-effective in a developing country. We designed a decision analysis to assess the cost-effectiveness of recurrent laryngeal nerve neuromonitoring. For probabilities, we used data from a meta-analysis. Utility was measured using preference values. We considered direct costs. We conducted a deterministic and a probabilistic analysis. We did not find differences in utility between arms. The frequency of recurrent laryngeal nerve injury was 1% in the neuromonitor group and 1.6% for the standard group. Thyroidectomy without monitoring was the less expensive alternative. The incremental cost-effectiveness ratio was COP$ 9,112,065. Routine neuromonitoring in total thyroidectomy with low risk of recurrent laryngeal nerve injury is neither cost-useful nor cost-effective in the Colombian health system.

Minimally invasive thyroidectomy (MIT): indications and results.

PubMed

Docimo, Giovanni; Salvatore Tolone, Salvatore; Gili, Simona; d'Alessandro, A; Casalino, G; Brusciano, L; Ruggiero, Roberto; Docimo, Ludovico

2013-01-01

To establish if the indication for different approaches for thyroidectomy and the incision length provided by means of pre-operative assessment of gland volume and size of nodules resulted in safe and effective outcomes and in any notable aesthetic or quality-of-life impact on patients. Ninehundred eightytwo consecutive patients, undergoing total thyroidectomy, were enrolled. The thyroid volume and maximal nodule diameter were measured by means of ultrasounds. Based on ultrasounds findings, patients were divided into three groups: minimally invasive video assisted thyroidectomy (MIVAT), minimally invasive thyroidectomy (MIT) and conventional thyroidectomy (CT) groups. The data concerning the following parameters were collected: operative time, postoperative complications, postoperative pain and cosmetic results. The MIVAT group included 179 patients, MIT group included 592 patients and CT group included 211 patients. Incidence of complications did not differ significantly in each group. In MIVAT and MIT group, the perception of postoperative pain was less intense than CT group. The patients in the MIVAT (7±1.5) and MIT (8±2) groups were more satisfied with the cosmetic results than those in CT group (5±1.3) (p= <0.05). The MIT is a technique totally reproducible, and easily convertible to perform surgical procedures in respect of the patient, without additional complications, increased costs, and with better aesthetic results.

Predictors of Hypocalcemia after Thyroidectomy: Results from the Nationwide Inpatient Sample

PubMed Central

Baldassarre, Randall L.; Chang, David C.; Brumund, Kevin T.; Bouvet, Michael

2012-01-01

Hypocalcemia is a common complication following thyroidectomy. However, the incidence of postoperative hypocalcemia varies widely in the literature, and factors associated with hypocalcemia after thyroid surgery are not well established. We aimed to identify incidence trends and independent risk factors of postoperative hypocalcemia using the nationwide inpatient sample (NIS) database from 1998 to 2008. Overall, 6,605 (5.5%) of 119,567 patients who underwent thyroidectomy developed hypocalcemia. Total thyroidectomy resulted in a significantly higher increased incidence (9.0%) of hypocalcemia when compared with unilateral thyroid lobectomy (1.9%; P < .001). Thyroidectomy with bilateral neck dissection, the strongest independent risk factor of postoperative hypocalcemia (odds ratio, 9.42; P < .001), resulted in an incidence of 23.4%. Patients aged 45 years to 84 years were less likely to have postoperative hypocalcemia compared with their younger and older counterparts (P < .001). Hispanic (P = .003) and Asian (P = .027) patients were more likely, and black patients were less likely (P = .003) than white patients to develop hypocalcemia. Additional factors independently associated with postoperative hypocalcemia included female gender, nonteaching hospitals, and malignant neoplasms of thyroid gland. Hypocalcemia following thyroidectomy resulted in 1.47 days of extended hospital stay (3.33 versus 1.85 days P < .001). PMID:22844618

Effect of central compartment neck dissection on hypocalcaemia incidence after total thyroidectomy for carcinoma.

PubMed

Mitra, I; Nichani, J R; Yap, B; Homer, J J

2011-05-01

Central compartment neck dissection is increasingly performed as part of surgical management of differentiated thyroid carcinoma. However, elective central neck dissection remains controversial due to complications and lack of evidence of survival benefit. To investigate and compare rates of transient and permanent hypocalcaemia following total thyroidectomy alone, compared with total thyroidectomy with central neck dissection, for differentiated thyroid carcinoma. Retrospective study of 127 consecutive patients referred with differentiated thyroid carcinoma, 2004-2006; 78 patients had undergone total thyroidectomy (group one) and 49 total thyroidectomy with central compartment node dissection (group two). Surgery was performed in various hospitals by both otolaryngologists and endocrine surgeons. In groups one and two, the incidence of transient hypocalcaemia was 18 per cent (14/78) and 51 per cent (25/49) (p < 0.001), and the incidence of permanent hypocalcaemia 1 per cent (one of 77) and 12 per cent (six of 49) (p < 0.01), respectively. Most patients undergoing central neck dissection had evidence of pathological level six lymphadenopathy (29/49). Total thyroidectomy combined with central neck dissection for the treatment of differentiated thyroid carcinoma is more likely to result in transient (51 per cent) and permanent (12 per cent) hypocalcaemia. Elective neck dissection should be performed selectively, with a high expectation of post-operative hypocalcaemia.

Predictors of thyroid gland involvement in hypopharyngeal squamous cell carcinoma.

PubMed

Chang, Jae Won; Koh, Yoon Woo; Chung, Woong Youn; Hong, Soon Won; Choi, Eun Chang

2015-05-01

Decision to perform concurrent ipsilateral thyroidectomy on patients with hypopharyngeal cancer is important, and unnecessary thyroidectomy should be avoided if oncologically feasible. We hypothesized that concurrent ipsilateral thyroidectomy is not routinely required to prevent occult metastasis. This study aimed to determine the prevalence of histological thyroid invasion in patients with hypopharyngeal cancer, and to refine the indications for prophylactic ipsilateral thyroidectomy in patients with hypopharyngeal cancer. A retrospective review of the medical records from the Department of Otolaryngology at Yonsei University College of Medicine was conducted from January 1994 to December 2009. A total of 49 patients underwent laryngopharyngectomy with thyroidectomy as a primary treatment of hypopharyngeal cancer. The incidence of thyroid gland involvement was 10.2%. The most common route of invasion was direct extension through the thyroid cartilage. Thyroid cartilage invasion (p=0.034) was the most significant factor associated with thyroid invasion. Disease-specific survival at 5 years was lower in patients with than without thyroid gland invasion (26.7% vs. 55.2%, respectively; p=0.032). Disease-free survival at 5 years was also lower in patients with than without thyroid gland invasion (20.0% vs. 52.1%, respectively; p=0.024). Ipsilateral thyroidectomy in combination with total laryngopharyngectomy is indicated when invasion of the thyroid cartilage is suspected in patients with hypopharyngeal cancer.

Prevention of Thyroidectomy Scars in Asian Adults With Low-Level Light Therapy.

PubMed

Park, Young Joon; Kim, Sang Jin; Song, Hyo Sang; Kim, Sue Kyoung; Lee, Jeonghun; Soh, Euy Young; Kim, You Chan

2016-04-01

Abnormal wound-healing after thyroidectomy with a resulting scar is a common dermatologic consultation. Despite many medical and surgical approaches, prevention of postoperative scars is challenging. This study validated the efficacy and safety of low-level light therapy (LLLT) using an 830/590 nm light-emitting diode (LED)-based device for prevention of thyroidectomy scars. Thirty-five patients with linear surgical suture lines after thyroidectomy were treated with 830/590 nm LED-LLLT. Daily application of 60 J/cm (11 minutes) for 1 week starting on postoperative day 1 was followed by treatment 3 times per week for 3 additional weeks. The control group (n = 15) remained untreated. Scar-prevention effects were evaluated 1 and 3 months after thyroidectomy with colorimetric evaluation using a tristimulus-color analyzer. The Vancouver Scar Scale (VSS) score, global assessment, and a subjective satisfaction score (range: 1-4) were also determined. Lightness (L*) and chrome values (a*) decreased significantly at the 3-month follow-up visit in the treatment group compared with those of controls. The average VSS and GAS scores were lower in the treatment group, whereas the subjective score was not significantly different. Light-emitting diode based LLLT treatment suppressed the formation of scars after thyroidectomy and could be safely used without noticeable adverse effects.

Leveraging Lesson Learning in Tactical Units

DTIC Science & Technology

1997-01-01

then it may be a lesson, but as Vetock points out, determining useful lessons requires analysis. Discovery of the wrong lesson can be as bad as not...34lesson learning is a very dangerous business.൘ Distinguishing a good" lesson from a " bad " one requires experience, a good grasp of doctrine, and...section - - boasted 3 cigarette lighters, 1 bar of soap, 2 wallets, 40 bottles, 1 suspender, and 11 French toothpaste .55 49 As Vetock points out, the

Serum phosphate predicts temporary hypocalcaemia following thyroidectomy.

PubMed

Sam, Amir H; Dhillo, W S; Donaldson, M; Moolla, A; Meeran, K; Tolley, N S; Palazzo, F F

2011-03-01

Temporary hypocalcaemia occurs in up to 40% of patients following a total thyroidectomy. Serum calcium and parathyroid hormone (PTH) measurements are currently used to predict post-thyroidectomy hypocalcaemia. However, immediate access to PTH measurement is expensive and not widely available. Serum phosphate responds rapidly to changes in circulating PTH levels, and its measurement is readily available in all hospitals. We evaluated the use of serum phosphate to predict temporary hypocalcaemia post-thyroidectomy. We retrospectively assessed 111 consecutive patients who had total or completion thyroidectomy. Patients had serum calcium and phosphate measured preoperatively, on the evening of surgery (day 0), on the morning of day 1 and over the following week as clinically indicated. Serum PTH was measured on the morning of day 1. Vitamin D levels were measured preoperatively. Seventy-six patients did not develop treatment-demanding hypocalcaemia. In these patients, the mean serum phosphate concentration was lower on the morning of day 1 compared to that on the evening of surgery. Seventeen patients with a vitamin D>25 nmol/l developed hypocalcaemia requiring treatment from day 1 onwards. All had an overnight rise in serum phosphate to >1.44 mmol/l (100% sensitivity and specificity for predicting hypocalcaemia). Twelve patients who had a vitamin D<25 nmol/l also developed hypocalcaemia but had an attenuated rise in serum phosphate. Serum phosphate is a reliable biochemical predictor of post-thyroidectomy hypocalcaemia in patients without vitamin D deficiency. The use of serum phosphate may facilitate safe day 1 discharge of patients undergoing thyroidectomy. © 2011 Blackwell Publishing Ltd.

Improving the quality of learning in science through optimization of lesson study for learning community

NASA Astrophysics Data System (ADS)

Setyaningsih, S.

2018-03-01

Lesson Study for Learning Community is one of lecturer profession building system through collaborative and continuous learning study based on the principles of openness, collegiality, and mutual learning to build learning community in order to form professional learning community. To achieve the above, we need a strategy and learning method with specific subscription technique. This paper provides a description of how the quality of learning in the field of science can be improved by implementing strategies and methods accordingly, namely by applying lesson study for learning community optimally. Initially this research was focused on the study of instructional techniques. Learning method used is learning model Contextual teaching and Learning (CTL) and model of Problem Based Learning (PBL). The results showed that there was a significant increase in competence, attitudes, and psychomotor in the four study programs that were modelled. Therefore, it can be concluded that the implementation of learning strategies in Lesson study for Learning Community is needed to be used to improve the competence, attitude and psychomotor of science students.

Postoperative hypocalcemia after thyroidectomy for Graves' disease.

PubMed

Pesce, Catherine E; Shiue, Zita; Tsai, Hua-Ling; Umbricht, Christopher B; Tufano, Ralph P; Dackiw, Alan P B; Kowalski, Jeanne; Zeiger, Martha A

2010-11-01

It is believed that patients who undergo thyroidectomy for Graves' disease are more likely to experience postoperative hypocalcemia than patients undergoing total thyroidectomy for other indications. However, no study has directly compared these two groups of patients. The aim of this study was to determine whether there was an increased incidence or severity of postoperative hypocalcemia in patients who underwent thyroidectomy for Graves' disease. An institutional review board-approved database was created of all patients who underwent thyroidectomy from 1998 to 2009 at the Johns Hopkins Hospital. There were a total of 68 patients with Graves' disease who underwent surgery. Fifty-five patients who underwent total thyroidectomy were randomly selected and served as control subjects. An analysis was conducted that examined potential covariates for postoperative hypocalcemia, including age, gender, ethnicity, preoperative alkaline phosphatase level, size of goiter, whether parathyroid tissue or glands were present in the specimen, and the reason the patient underwent surgery. Specific outcomes examined were calcium levels on postoperative day 1, whether or not patients experienced symptoms of hypocalcemia, whether or not Rocaltrol was required, the number of calcium tablets prescribed upon discharge, whether or not postoperative tetany occurred, and calcium levels 1 month after discharge. Each outcome was analyzed using a logistic regression. Graves' disease patients had a significantly (p-value < 0.001) higher odds of greater number of calcium tablets prescribed upon discharge. Further, 6 of 68 patients with Graves' disease and no patient in the control group were readmitted with tetany (p = 0.033). There was a trend, though not significant, toward patients with Graves' disease having a higher prevalence of hypocalcemia the day after thyroidectomy and 1 month later. Patients with Graves' disease are more likely to require increased dosages of calcium as well as experience tetany postoperatively than patients undergoing total thyroidectomy for other indications. This suggests that patients operated upon for Graves' disease warrant close followup as both inpatients and outpatients for signs and symptoms of hypocalcemia.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, the Apollo, Challenger, Columbia Lessons Learned Program manager, far right, is pictured with panelists from the Apollo 1 Lessons Learned event in the Training Auditorium at NASA's Kennedy Space Center in Florida. In the center, are Ernie Reyes, retired, former Apollo 1 senior operations manager; and John Tribe, retired, former Apollo 1 Reaction and Control System lead engineer. At far left is Zulie Cipo, the Apollo, Challenger, Columbia Lessons Learned Program event support team lead. The theme of the program was "To there and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Responding To School Walkout Demonstrations. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 1, 2008

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue examines the incidence of student walkout demonstrations and the various ways in which administrators, school staff, law enforcement, and the community at large can help keep youths…

Lessons Learned from School Crises and Emergencies, Vol. 1, Issue 2, Fall 2006

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. School and student names have been changed to protect identities. Information for this publication was gathered through a series of interviews with school stakeholders involved in the actual incident. This "Lessons Learned" issue…

75 FR 27838 - Notice of Availability of Draft NUREG-1800, Revision 2; “Standard Review Plan for Review of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

... Draft NUREG-1801, Revision 2; ``Generic Aging Lessons Learned (GALL) Report'' AGENCY: Nuclear Regulatory... Applications for Nuclear Power Plants ''and draft NUREG-1801, ``Generic Aging Lessons Learned (GALL) Report... Power Plants'' (SRP-LR); and the revised NUREG-1801, ``Generic Aging Lessons Learned (GALL) Report'' for...

77 FR 21813 - Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, “Buried and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0055] Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, ``Buried and Underground Piping and Tanks'' AGENCY: Nuclear Regulatory... NUREG-1801, Revision 2, ``Generic Aging Lessons Learned (GALL) Report,'' and the NRC staff's aging...

Teaching from Objects and Stories: Learning about the Bering Sea Eskimo People. Smithsonian in Your Classroom.

ERIC Educational Resources Information Center

Smigielski, Alan

The three lesson plans in this issue feature the Eskimos of the Bering Sea and their culture. The lesson plans are: (1) "Learning about a Culture from Its Objects"; (2) "Learning about a Culture from a Story"; and (3) "Everyday Objects." Each lesson cites student objectives; lists materials needed; gives subjects…

Value pricing pilot program : lessons learned

DOT National Transportation Integrated Search

2008-08-01

This "Lessons Learned Report" provides a summary of projects sponsored by the Federal Highway Administration's (FHWA's) Congestion and Value Pricing Pilot Programs from 1991 through 2006 and draws lessons from a sample of projects with the richest an...

[Total thyroidectomy in patients with amiodarone-induced hyperthyroidism: when does the risk of conservative treatment exceed the risk of surgery?].

PubMed

Meerwein, C; Vital, D; Greutmann, M; Schmid, C; Huber, G F

2014-02-01

Amiodarone plays a pivotal role in the treatment of ventricular and supraventricular arrhythmias. However, amiodarone-induced hyperthyroidism (AIH) is one of the most feared complications, which necessitates interdisciplinary treatment and careful balancing of the risks of conservative treatment against those of total thyroidectomy. In this article we discuss the pharmacological aspects of amiodarone and its diverse effects on the thyroid. Furthermore, we present diagnostic and therapeutic strategies and report our positive experiences with total thyroidectomy in patients with AIH. Particularly in patients for whom continuation of amiodarone treatment is compulsory, a well-timed total thyroidectomy is a reliable therapeutic option, with minimal complication rates and immediate amelioration of symptoms.

[The rational application of Da Vinci surgical system in thyroidectomy].

PubMed

He, Q Q

2017-08-01

Da Vinci surgical system is the most advanced minimally invasive surgical platform in the world, and this system has been widely used in cardiac surgery, urology surgery, gynecologic surgery and general surgery. Although the application of this system was relatively late in thyroid surgery, the number of thyroidectomy with Da Vinci surgical system is increasing quickly. Having reviewed recent studies and summarized clinical experience, compared with traditional open operation, the robotic thyroidectomy has the same surgical safety and effectiveness in selective patients with thyroid cancer. In this paper, several aspects on this novel operation were demonstrated, including surgical indications and contraindications, the approaches, surgical procedures and postoperative complications, in order to promote the rational application of Da Vinci surgical system in thyroidectomy.

[Pay attention to the prevention of intraoperative complications of total thyroidectomy].

PubMed

Tian, Wen

2015-03-01

The incidence of thyroid cancer has increased sharply year by year. Thyroid cancer ranked from the 14th in 2003 to the 4th in 2012 most common cancers in female in Beijing. Surgery is still main solution for thyroid cancer, there are two operative procedure for thyroid cancer: total thyroidectomy, lateral lobectomy and isthmus resection. The surgeon must pay attention to intraoperative recurrent laryngeal nerve and parathyroid injury, with particular emphasis on the prevention of total thyroidectomy complications. Precise dissection of thyroid capsule, intraoperative recurrent laryngeal nerve monitoring and application of lymphatic mapping to recognize and protect negative stained parathyroid by using carbon nanoparticles tracer is prone to reduce the incidence of recurrent laryngeal nerve and parathyroid injury in the total thyroidectomy.

Lessons Learned from the Node 1 Temperature and Humidity Control Subsystem Design

NASA Technical Reports Server (NTRS)

Williams, David E.

2010-01-01

Node 1 flew to the International Space Station (ISS) on Flight 2A during December 1998. To date the National Aeronautics and Space Administration (NASA) has learned a lot of lessons from this module based on its history of approximately two years of acceptance testing on the ground and currently its twelve years on-orbit. This paper will provide an overview of the ISS Environmental Control and Life Support (ECLS) design of the Node 1 Temperature and Humidity Control (THC) subsystem and it will document some of the lessons that have been learned to date for this subsystem and it will document some of the lessons that have been learned to date for these subsystems based on problems prelaunch, problems encountered on-orbit, and operational problems/concerns. It is hoped that documenting these lessons learned from ISS will help in preventing them in future Programs. 1

Lessons Learned from Ares I Upper Stage Structures and Thermal Design

NASA Technical Reports Server (NTRS)

Ahmed, Rafiq

2012-01-01

The Ares 1 Upper Stage was part of the vehicle intended to succeed the Space Shuttle as the United States manned spaceflight vehicle. Although the Upper Stage project was cancelled, there were many lessons learned that are applicable to future vehicle design. Lessons learned that are briefly detailed in this Technical Memorandum are for specific technical areas such as tank design, common bulkhead design, thrust oscillation, control of flight and slosh loads, purge and hazardous gas system. In addition, lessons learned from a systems engineering and vehicle integration perspective are also included, such as computer aided design and engineering, scheduling, and data management. The need for detailed systems engineering in the early stages of a project is emphasized throughout this report. The intent is that future projects will be able to apply these lessons learned to keep costs down, schedules brief, and deliver products that perform to the expectations of their customers.

Welcome to Lotus 1-2-3 Advanced. Learning Activity Packets.

ERIC Educational Resources Information Center

Mills, Steven; And Others

This learning activity packet (LAP) contains five self-paced study lessons that allow students to study advanced concepts of Lotus 1-2-3 at their own pace. The lessons used in the LAP are organized in the following way: lesson name, lesson number, objectives, completion standard, performance standard, required materials, unit test, and exercises.…

Skylab lessons learned as applicable to a large space station, 1967-1974. Ph.D. Thesis - Catholic Univ. of Am.

NASA Technical Reports Server (NTRS)

Schneider, W. C.

1976-01-01

This report records some of the lessons learned during Skylab development. The approach taken is to list lessons which could have wide application in the development of a large space station. The lessons are amplified and explained in light of the background and experiences of the Skylab development.

Lessons Learned JSC Micro-Wireless Instrumentation Systems on Space Shuttle and International Space Station CANEUS 2006

NASA Technical Reports Server (NTRS)

Studor, George

2007-01-01

A viewgraph presentation on lessons learned from NASA Johnson Space Center's micro-wireless instrumentation is shown. The topics include: 1) Background, Rationale and Vision; 2) NASA JSC/Structural Engineering Approach & History; 3) Orbiter Wing Leading Edge Impact Detection System; 4) WLEIDS Confidence and Micro-WIS Lessons Learned; and 5) Current Projects and Recommendations.

Orbiter Water Dump Nozzles Redesign Lessons Learned

NASA Technical Reports Server (NTRS)

Rotter, Hank

2017-01-01

Hank Rotter, NASA Technical Fellow for Environmental Control and Life Support System, will provide the causes and lessons learned for the two Space Shuttle Orbiter water dump icicles that formed on the side of the Orbiter. He will present the root causes and the criticality of these icicles, along with the redesign of the water dump nozzles and lessons learned during the redesign phase.

2000 Worldwide Joint Lessons Learned Conference. Forging a Future Joint Lessons Learned System. (Joint Center for Lessons Learned Special Bulletin. Volume 3, Special Issue 1, January 2001)

DTIC Science & Technology

2001-01-01

Management System (JTIMS) followed, and generated spirited discussion regarding the respective roles of JTIMS and the JLLP. The discussion concluded...waiting for the Director, Joint Staff�s signature and should be in official distribution by January 2001. An update on the Joint Training Information

Epidemiology of Vocal Fold Paralyses After Total Thyroidectomy for Well-Differentiated Thyroid Cancer in Medicare Population

PubMed Central

Francis, David O.; Pearce, Elizabeth C.; Ni, Shenghua; Garrett, C. Gaelyn; Penson, David F.

2014-01-01

Objectives Population-level incidence of vocal fold paralysis after thyroidectomy for well-differentiated thyroid carcinoma (WDTC) is not known. This study aimed to measure longitudinal incidence of post-operative vocal fold paralyses and need for directed interventions in the Medicare population undergoing total thyroidectomy for WDTC. Study Design Retrospective Cohort Study Setting United States Population Subjects Medicare Beneficiaries Methods SEER-Medicare data (1991 – 2009) were used to identify beneficiaries who underwent total thyroidectomy for WDTC. Incident vocal fold paralyses and directed interventions were identified. Multivariate analyses were used to determine factors associated with odds of developing these surgical complications. Results Of 5,670 total thyroidectomies for WDTC, 9.5% were complicated by vocal fold paralysis [8.2% unilateral vocal fold paralysis (UVFP); 1.3% bilateral vocal fold paralysis (BVFP)]. Rate of paralyses decreased 5% annually from 1991 to 2009 (OR 0.95, 95% CI 0.93 – 0.97; p<0.001). Overall, 22% of patients with vocal fold paralysis required surgical intervention (UVFP 21%, BVFP 28%). Multivariate logistic regression revealed odds of post-thyroidectomy paralysis increased with each additional year of age, with non-Caucasian race, particular histologic types, advanced stage, and in particular registry regions. Conclusions Annual rates of post-thyroidectomy vocal fold paralyses are decreasing among Medicare beneficiaries with WDTC. High incidence in this aged population is likely due to a preponderance of temporary paralyses, which is supported by the need for directed intervention in less than a quarter of affected patients. Further population-based studies are needed to refine the population incidence and risk factors for paralyses in the aging population. PMID:24482349

Transient and permanent hypocalcemia after total thyroidectomy: Early predictive factors and long-term follow-up results.

PubMed

Seo, Sung Tae; Chang, Jae Won; Jin, Jun; Lim, Young Chang; Rha, Ki-Sang; Koo, Bon Seok

2015-12-01

Post-thyroidectomy hypocalcemia is among the most common complications of total thyroidectomy. The purpose of this study was to evaluate early predictive factors and long-term changes in intact parathyroid hormone (iPTH) levels in patients with transient and permanent hypocalcemia after total thyroidectomy. A total of 349 consecutive patients who underwent total thyroidectomy with or without neck dissection between 2009 and 2011 were reviewed. PTH, total calcium (Ca), and ionized Ca (iCa) levels were evaluated at 1 hour, and 1, 3, 5, and 7 days, and 1, 3, 6, and 12 months postoperatively. Biochemical profiles at 1 hour after total thyroidectomy in patients with transient and permanent hypocalcemia were compared. Patients with postoperative hypocalcemia were followed for 12 months. Lesser preoperative serum levels of Ca and more extensive surgery were significantly associated with postoperative hypocalcemia (P < .05). The absolute level and relative decline (%) in iPTH at 1 hour were the most reliable predictors of postoperative hypocalcemia according to the receiver operating characteristics curve, with a threshold of 10.42 pg/mL and 70%. Sensitivity and specificity of the predictors were 83.4% (95% CI, 76.4-89.1), 100% (95% CI, 84.6-100.0), 84.1 (95% CI, 77.2-89.7), and 95.5% (95% CI, 77.2-99.9), respectively. Parathyroid function recovered in the first month after total thyroidectomy in 78 of 99 patients (79%) with transient hypocalcemia. However, 46 of 61 patients (74%) with a subnormal iPTH level at 3 months after surgery had permanent hypocalcemia. Mean postoperative PTH level and the mean relative decline in PTH measured 1 hour postoperatively were the most reliable predictors of postoperative or permanent hypocalcemia. Copyright © 2015 Elsevier Inc. All rights reserved.

Hypocalcaemia after total thyroidectomy: could intact parathyroid hormone be a predictive factor for transient postoperative hypocalcemia?

PubMed

Puzziello, Alessandro; Gervasi, Rita; Orlando, Giulio; Innaro, Nadia; Vitale, Mario; Sacco, Rosario

2015-02-01

Hypocalcemia, the most common complication of thyroidectomy, is a transient condition in up to 27% of patients and a permanent condition approximately 1% of patients. The aim of this prospective study was to evaluate reliability of postoperative intact parathyroid hormone (iPTH) assessment for predicting clinically relevant postthyroidectomy hypocalcemia for a safe early discharge of patients with no overtreatment. Seventy-five consecutive patients (age 51 ± 13 years [mean ± SD]) undergoing total or completion thyroidectomy with no concomitant parathyroid diseases or renal failure were included in the present study. Serum iPTH level was determined before and 2 hours after thyroidectomy. Serum calcium concentration was determined 1 day before and 2 days postoperatively. The occurrence of postoperative hypocalcemia was correlated both with the absolute and relative iPTH decrease, determined as a ratio of the preoperative value (P < .0001). There was a greater difference in relative decrease in iPTH between patients remaining normocalcemic and those with hypocalcemia present on the second postoperative day. Hypocalcemic patients on the second postoperative day had a 62% relative decrease in iPTH 2 hours after thyroidectomy. The relative decrease in serum iPTH was greater in patients with hypocalcemia arising on the second postoperative day rather than in patients who remained normocalcemic. The relative decrease in iPTH determined 2 hours after total thyroidectomy together with the serum calcium concentration 24 hours after thyroidectomy proved to be useful predictors of sustained hypocalcemia and might change the clinical management of patients after thyroid surgery to support a longer hospitalization in these selected patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Better consenting for thyroidectomy: who has an increased risk of postoperative hypocalcaemia?

PubMed

Harris, Andrew S; Prades, Eduardo; Tkachuk, Olena; Zeitoun, Hisham

2016-12-01

Hypocalcaemia is the most common complication following thyroidectomy. This study aimed to establish the factors associated with increased risk of hypocalcaemia on day 1 following thyroidectomy. All patients who underwent thyroidectomy under a single consultant during a 5-year period were included. A multivariate analysis was undertaken to ascertain which variables had the most effect on the risk of hypocalcaemia. A prognosis table was constructed to allow risk to be predicted for individual patients based on these factors. Included in the analysis were 210 procedures and 194 patients. Eighty-two percent of patients had no calcium derangement postoperatively. Fourteen point nine percent were categorised as early hypocalcaemia, 1 % had protracted hypocalcaemia and 2.1 % had permanent hypocalcaemia. For hemi-thyroidectomies 2.8 % had postoperative hypocalcaemia and 0.9 % had permanent hypocalcaemia. The multivariate analysis revealed total thyroidectomy (risk ratio 26.5, p < 0.0001), diabetes (risk ratio 4.8, p = 0.07) and thyrotoxicosis (risk ratio 3.1, p = 0.04) as statistically significant variables for early postoperative hypocalcaemia. Gender as an isolated factor did not reach significance but was included in the model. The p value for the model was p < 1 × 10 -12 . Total thyroidectomy increases risk of early hypocalcaemia when compared to hemithyroidectomy. Gender, diabetes and thyrotoxicosis were also been found to influence the risk. All of these factors are available pre-operatively and can therefore be used to predict a more specific risk for individual patients. It is hoped that this can lead to better informed consent, prevention and better resource allocation.

Minimally invasive, nonendoscopic thyroidectomy: a cosmetic alternative to robotic-assisted thyroidectomy.

PubMed

Govednik, Cara M; Snyder, Samuel K; Quinn, Courtney E; Saxena, Saurabh; Jupiter, Daniel C

2014-10-01

The desire to improve cosmesis has driven the introduction of robotic-assisted and video-assisted thyroidectomy techniques. We report on minimally invasive thyroidectomy (MIT) through a 2-cm incision without the added need for video assistance and hypothesize similar clinical results to standard open thyroidectomy. Between May 2012 and December 2013, 62 nonendoscopic MIT were evaluated for demographics, clinical outcomes, and patient satisfaction on a 1-10 scale. The results were compared with a case-matched control group who underwent conventional open thyroidectomy by the same surgeon. The 124 study patients demonstrated no differences between groups for demographics or clinical outcomes except a smaller thyroid lobe in the MIT group (9.2 vs 11.7 g; P = .05). There were longer operative times in the MIT group (135.4 vs 119.6 minutes; P = .07) that were not equivalent by equivalence testing (P = .534). In MIT patients, transient recurrent laryngeal nerve injury occurred per nerves at risk (1.1% vs 3.4%; P = .62) with no permanent injuries in either group. There was no difference in symptomatic hypocalcemia (9.7% vs 11.3%; P = .77) and postoperative hematoma (0% vs 3.2%; P = .50). On follow-up, the measured MIT scar was significantly shorter (2.22 vs 3.98 cm; P < .00001), which resulted in significantly improved cosmetic satisfaction ratings (9.56 vs 8.66; P = .03). In selected patients, MIT through a 2-cm incision without endoscopic assistance is a safe alternative to standard open thyroidectomy in the hands of an experienced endocrine surgeon. The operating time is slightly increased, but clinical results are equivalent and patient satisfaction is significantly improved. Copyright © 2014 Elsevier Inc. All rights reserved.

Developing Noticing of Reasoning through Demonstration Lessons

ERIC Educational Resources Information Center

Bragg, Leicha A.; Vale, Colleen

2014-01-01

Observation of fellow educators conducting demonstration lessons is one avenue for teachers to develop sensitivity to noticing students' reasoning. We examined teachers' noticing of children's learning behaviours in one demonstration lesson of the "Mathematical Reasoning Professional Learning Research Program" (MRPLRP). The observations…

Lessons Learned from the NASA Plum Brook Reactor Facility Decommissioning

NASA Technical Reports Server (NTRS)

2010-01-01

NASA has been conducting decommissioning activities at its PBRF for the last decade. As a result of all this work there have been several lessons learned both good and bad. This paper presents some of the more exportable lessons.

The advantages of subtotal thyroidectomy and suppression of TSH in the primary treatment of papillary carcinoma of the thyroid

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crile, G. Jr.; Antunez, A.R.; Esselstyn, C.B. Jr.

1985-06-01

Patients between the ages of 6 and 45 years with distant metastases from papillary carcinoma of the thyroid can be treated as effectively by subtotal thyroidectomy and suppressive doses of thyroid hormone as by total thyroidectomy followed by treatment with iodine 131 (/sup 131/I). Moreover, distant metastases can be treated by either /sup 131/I or suppression as effectively after they are apparent on x-ray as they can be when treated in a subclinical stage. Therefore, in patients younger than 45 years old it is rarely necessary to perform a total thyroidectomy or to do frequent postoperative scans. In patients oldermore » than 44 or younger than 7 who have distant metastases or extensive involvement of both lobes, total or almost total thyroidectomy is justified if it can be done with minimal morbidity. In patients of this age group whose tumors fail to respond to suppressive doses of thyroid, /sup 131/I should be used. In view of the importance of diagnostic related groups (DRG) to the economy of hospitals, we note that the cost of total thyroidectomy, ablation by /sup 131/I, and intermittent body scans is at least three times that of less radical procedures which, in conjunction with suppression by thyroid feeding, give the same survival with less morbidity.« less

Predictors of Thyroid Gland Involvement in Hypopharyngeal Squamous Cell Carcinoma

PubMed Central

Chang, Jae Won; Koh, Yoon Woo; Chung, Woong Youn; Hong, Soon Won

2015-01-01

Purpose Decision to perform concurrent ipsilateral thyroidectomy on patients with hypopharyngeal cancer is important, and unnecessary thyroidectomy should be avoided if oncologically feasible. We hypothesized that concurrent ipsilateral thyroidectomy is not routinely required to prevent occult metastasis. This study aimed to determine the prevalence of histological thyroid invasion in patients with hypopharyngeal cancer, and to refine the indications for prophylactic ipsilateral thyroidectomy in patients with hypopharyngeal cancer. Materials and Methods A retrospective review of the medical records from the Department of Otolaryngology at Yonsei University College of Medicine was conducted from January 1994 to December 2009. A total of 49 patients underwent laryngopharyngectomy with thyroidectomy as a primary treatment of hypopharyngeal cancer. Results The incidence of thyroid gland involvement was 10.2%. The most common route of invasion was direct extension through the thyroid cartilage. Thyroid cartilage invasion (p=0.034) was the most significant factor associated with thyroid invasion. Disease-specific survival at 5 years was lower in patients with than without thyroid gland invasion (26.7% vs. 55.2%, respectively; p=0.032). Disease-free survival at 5 years was also lower in patients with than without thyroid gland invasion (20.0% vs. 52.1%, respectively; p=0.024). Conclusion Ipsilateral thyroidectomy in combination with total laryngopharyngectomy is indicated when invasion of the thyroid cartilage is suspected in patients with hypopharyngeal cancer. PMID:25837190

Initial impressions from the Northern California 2008 lightning siege: A report by a Wildland Fire Lessons Learned Center Information Collection Team

Treesearch

Jonetta T. Holt; David Christenson; Anne Black; Brett Fay; Kim Round

2009-01-01

This event in NorCal is another of the major events we have experienced in fire management. In line with our desire to learn, we ought to line up a team to help us capture lessons learned from this event." This statement, and a regional delegation, was the impetus for an information collection team from the Wildland Fire Lessons Learned Center to visit with...

Learning To Serve, Serving To Learn: A View from Higher Education. Integrating Service-Learning into Curriculum: Lessons Learned. Teacher Education Consortium in Service-Learning.

ERIC Educational Resources Information Center

2003

This collection of papers includes lessons learned from a 3-year collaboration among faculty who had pursued a scholarly inquiry of service-learning, integrated service-learning into their curricula, altered their teaching, forged partnerships with community based organizations, and developed measures and methodologies for assessing results. The…

Neonatal hyperthyroidism: neonatal clinical course of two brothers born to a mother with Graves-Basedow disease, before and after total thyroidectomy.

PubMed

Zuppa, A A; Sindico, P; Savarese, I; D'Andrea, V; Fracchiolla, A; Cota, F; Romagnoli, C

2007-04-01

About 1-2% of infants born to mothers with Graves' disease or Hashimoto's thyroiditis develop neonatal hyperthyroidism because of transplacental passage of IgG stimulating TSH receptors (TRAb). To evaluate the effect of maternal total thyroidectomy on neonatal clinical course. We describe two brothers born to a mother with Graves' disease, before and after total thyroidectomy. The first child showed persistent tachycardia, the presence of TRAb and a laboratory pattern of hyperthyroidism. Lugol's solution was started and then propylthiouracil was added. Digitalis, furosemide and diazepam were necessary for treatment of heart failure, hypertension and irritability. On the 70th day of life, hormone serum levels normalized and treatment was interrupted. TRAb normalized by the third month of life. The second infant was born 2 years after the mother underwent total thyroidectomy. In spite of a laboratory pattern of hyperthyroidism and positivity to TRAb, he showed only considerable weight loss, and no therapy was required. TRAb may persist after total thyroidectomy: clinical and instrumental follow-up of the newborn is recommended.

Solo-Surgeon Retroauricular Approach Endoscopic Thyroidectomy.

PubMed

Lee, Doh Young; Baek, Seung-Kuk; Jung, Kwang-Yoon

2017-01-01

This study aimed to evaluate the feasibility and efficacy of solo-surgeon retroauricular thyroidectomy. For solo-surgery, we used an Endoeye Flex Laparo-Thoraco Videoscope (Olympus America, Inc.). A Vitom Karl Storz holding system (Karl Storz GmbH & Co.) composed of several bars connected by a ball-joint system was used for fixation of endoscope. A snake retractor and a brain-spoon retractor were used on the sternocleidomastoid. Endoscopic thyroidectomy using the solo-surgeon technique was performed in 10 patients having papillary thyroid carcinoma. The mean patient age was 36.0 ± 11.1 years, and all patients were female. There were no postoperative complications such as vocal cord paralysis and hematoma. When compared with the operating times and volume of drainage of a control group of 100 patients who underwent surgery through the conventional retroauricular approach between May 2013 and December 2015, the operating times and volume of drainage were not significantly different (P = .781 and .541, respectively). Solo-surgeon retroauricular thyroidectomy is safe and feasible when performed by a surgeon competent in endoscopic thyroidectomy.

Defining a risk-informed framework for whole-of-government lessons learned: A Canadian perspective.

PubMed

Friesen, Shaye K; Kelsey, Shelley; Legere, J A Jim

Lessons learned play an important role in emergency management (EM) and organizational agility. Virtually all aspects of EM can derive benefit from a lessons learned program. From major security events to exercises, exploiting and applying lessons learned and "best practices" is critical to organizational resilience and adaptiveness. A robust lessons learned process and methodology provides an evidence base with which to inform decisions, guide plans, strengthen mitigation strategies, and assist in developing tools for operations. The Canadian Safety and Security Program recently supported a project to define a comprehensive framework that would allow public safety and security partners to regularly share event response best practices, and prioritize recommendations originating from after action reviews. This framework consists of several inter-locking elements: a comprehensive literature review/environmental scan of international programs; a survey to collect data from end users and management; the development of a taxonomy for organizing and structuring information; a risk-informed methodology for selecting, prioritizing, and following through on recommendations; and standardized templates and tools for tracking recommendations and ensuring implementation. This article discusses the efforts of the project team, which provided "best practice" advice and analytical support to ensure that a systematic approach to lessons learned was taken by the federal community to improve prevention, preparedness, and response activities. It posits an approach by which one might design a systematic process for information sharing and event response coordination-an approach that will assist federal departments to institutionalize a cross-government lessons learned program.

Unintended Learning in Primary School Practical Science Lessons from Polanyi's Perspective of Intellectual Passion

ERIC Educational Resources Information Center

Park, Jisun; Song, Jinwoong; Abrahams, Ian

2016-01-01

This study explored, from the perspective of intellectual passion developed by Michael Polanyi, the unintended learning that occurred in primary practical science lessons. We use the term "unintended" learning to distinguish it from "intended" learning that appears in teachers' learning objectives. Data were collected using…

Seizing the Moment: State Lessons for Transforming Professional Learning

ERIC Educational Resources Information Center

Learning Forward, 2013

2013-01-01

Explore this first look at lessons learned through Learning Forward's ongoing initiative to develop a comprehensive system of professional learning that spans the distance from the statehouse to the classroom. This policy brief underscores the importance of a coordinated state professional learning strategy, the adoption of professional learning…

Robotic and endoscopic transoral thyroidectomy: feasibility and description of the technique in the cadaveric model.

PubMed

Kahramangil, Bora; Mohsin, Khuzema; Alzahrani, Hassan; Bu Ali, Daniah; Tausif, Syed; Kang, Sang-Wook; Kandil, Emad; Berber, Eren

2017-12-01

Numerous new approaches have been described over the years to improve the cosmetic outcomes of thyroid surgery. Transoral approach is a new technique that aims to achieve superior cosmetic outcomes by concealing the incision in the oral cavity. Transoral thyroidectomy through vestibular approach was performed in two institutions on cadaveric models. Procedure was performed endoscopically in one institution, while the robotic technique was utilized at the other. Transoral thyroidectomy was successfully performed at both institutions with robotic and endoscopic techniques. All vital structures were identified and preserved. Transoral thyroidectomy has been performed in animal and cadaveric models, as well as in some clinical studies. Our initial experience indicates the feasibility of this approach. More clinical studies are required to elucidate its full utility.

Planning and scheduling lessons learned study, executive summary

NASA Technical Reports Server (NTRS)

Robinson, Toni

1990-01-01

The study was performed to document the lessons on planning and scheduling activities for a number of missions and institutional facilities in such a way that they can be applied to future missions; to provide recommendations to both projects and Code 500 that will improve the end-to-end planning and scheduling process; and to identify what, if any, mission characteristics might be related to certain lessons learned. The results are a series of recommendations of both a managerial and technical nature related to the underlying lessons learned.

Providing Community Education: Lessons Learned from Native Patient Navigators

PubMed Central

Burhansstipanov, Linda; Krebs, Linda U.; Harjo, Lisa; Watanabe-Galloway, Shinobu; Pingatore, Noel; Isham, Debra; Duran, Florence Tinka; Denny, Loretta; Lindstrom, Denise; Crawford, Kim

2014-01-01

Native Navigators and the Cancer Continuum (NNACC) was a community-based participatory research study among five American Indian organizations. The intervention required lay Native Patient Navigators (NPNs) to implement and evaluate community education workshops in their local settings. Community education was a new role for the NPNs and resulted in many lessons learned. NPNs met quarterly from 2008 through 2013 and shared lessons learned with one another and with the administrative team. In July 2012, the NPNs prioritized lessons learned throughout the study that were specific to implementing the education intervention. These were shared to help other navigators who may be including community education within their scope of work. The NPNs identified eight lessons learned that can be divided into three categories: NPN education and training, workshop content and presentation, and workshop logistics and problem-solving. A ninth overarching lesson for the entire NNACC study identified meeting community needs as an avenue for success. This project was successful due to the diligence of the NPNs in understanding their communities’ needs and striving to meet them through education workshops. Nine lessons were identified by the NPNs who provided community education through the NNACC project. Most are relevant to all patient navigators, regardless of patient population, who are incorporating public education into navigation services. Due to their intervention and budget implications, many of these lessons also are relevant to those who are developing navigation research. PMID:25087698

Coping with Multiple Suicides among Middle School Students. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 2

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue addresses the experience of a school district where three middle school students hung themselves within a three-week timeframe. Although deaths were apparently unconnected, the school district is part of a…

Managing an Infectious Disease Outbreak in a School. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 3

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an infectious disease incident, which resulted in the death of a student, closure of area schools and the operation of an on-site school vaccine clinic. The report highlights the critical need…

Learning with and about Advertising in Chemistry Education with a Lesson Plan on Natural Cosmetics--A Case Study

ERIC Educational Resources Information Center

Belova, Nadja; Eilks, Ingo

2015-01-01

This paper describes a case study on the chemistry behind natural cosmetics in five chemistry learning groups (grades 7-11, age range 13-17) in a German comprehensive school. The lesson plan intends to promote critical media literacy in the chemistry classroom and specifically emphasizes learning with and about advertising. The lessons of four…

Real-Time Meteorological Battlespace Characterization in Support of Sea Power 21

DTIC Science & Technology

2011-02-04

32  5.3  LESSONS LEARNED ....................................................................................... 44  6.  FUTURE WORK...problem with the SWR alignment, which is sometimes re- set during SWR maintenance (see Section 6 ‘Lessons Learned ’ for a case in point). Fig...ground clutter present (discussed in Section 6 ‘Lessons Learned ’), along with the lowest-tilt, quality controlled velocity. Bottom panel shows the

Effects of Providing a Rationale for Learning a Lesson on Students' Motivation and Learning in Online Learning Environments

ERIC Educational Resources Information Center

Shin, Tae Seob

2010-01-01

This study examined whether providing a rationale for learning a particular lesson influences students' motivation and learning in online learning environments. A mixed-method design was used to investigate the effects of two types of rationales (former student vs. instructor rationales) presented in an online introductory educational psychology…

University Educators' Instructional Choices and Their Learning Styles within a Lesson Framework

ERIC Educational Resources Information Center

Mazo, Lucille B.

2017-01-01

Research on learning styles often focuses on the learning style of the student; however, the learning style of the educator may affect instructional choices and student learning. Few studies have addressed the lack of knowledge that exists in universities with respect to educators' learning styles and a lesson framework (development, delivery, and…

Use of after action reports (AARs) to promote organizational and systems learning in emergency preparedness.

PubMed

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D

2012-08-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The "lessons-learned" approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the "Lessons Learned Information Sharing (LLIS.gov)" system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strove to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed.

Hybrid-type endoscopic thyroidectomy (HET: Tori's method) for differentiated thyroid carcinoma including invasion to the trachea.

PubMed

Tori, Masayuki

2014-03-01

Endoscopic thyroidectomy (ET) or robotic thyroidectomy is yet to be applied to thyroid carcinoma invasive to the trachea and to wide lymph node node metastasis. On the other hand, small-incision thyroidectomy lacks sufficient working space and clear vision. The author has newly developed hybrid-type endoscopic thyroidectomy (HET) to overcome these problems. From March 2011 to February 2012, HET was performed for 85 patients. Clinicopathologic characteristics were analyzed. To evaluate the superiority of HET for malignancy representatively, conventional lobectomy with central compartment node dissection (CCND) performed 1 year previously was compared with HET. In lobectomy and node dissection, a single skin incision (1.5 cm) is made above the clavicle, with a port incision (5 mm) made 3 cm below the clavicle. Then CCND is performed directly through the incision by lifting up the isthmus. To obtain sufficient working space for the lobectomy, the strap muscles are taped and pulled toward the head, then hung by the cradle. The thyroid lobe is retracted to the midline with a retractor, followed by isolation of the inferior laryngeal nerve and transection of the inferior thyroid vessels with the monitor of the scope. Lateral lymph nodes dissection can be performed at the same time, if necessary. In total thyroidectomy, the same procedure is performed at the opposite side. The scalpel can be used to shave through each incision in case of tracheal invasion. Of the 85 cases, 62 were malignant, involving papillary thyroid carcinoma (PTC), and 23 were benign. Total thyroidectomy was performed for 22 of the PTC cases and CCND for 49 of the cases. Shaving for tracheal invasion was performed for eight patients. No mortality, complications, recurrence, or metastasis was found 1-2 years after the operation. Compared with conventional thyroidectomy, HET was superior in blood loss, visual analog scale, and postoperative hospital stay. The author's method (Tori's method) might be less invasive, cosmetically excellent, and moreover, safe and feasible for differentiated thyroid carcinoma including invasion to the trachea.

Impact of Extent of Surgery on Survival for Papillary Thyroid Cancer Patients Younger Than 45 Years

PubMed Central

Abdelgadir Adam, Mohamed; Pura, John; Goffredo, Paolo; Dinan, Michaela A.; Hyslop, Terry; Reed, Shelby D.; Scheri, Randall P.; Sosa, Julie A.

2015-01-01

Context: Papillary thyroid cancer (PTC) patients <45 years old are considered to have an excellent prognosis; however, current guidelines recommend total thyroidectomy for PTC tumors >1.0 cm, regardless of age. Objective: Our objective was to examine the impact of extent of surgery on overall survival (OS) in patients <45 years old with stage I PTC of 1.1 to 4.0 cm. Design, Setting, and Patients: Adult patients <45 years of age undergoing surgery for stage I PTC were identified from the National Cancer Data Base (NCDB, 1998–2006) and the Surveillance, Epidemiology, and End Results dataset (SEER, 1988–2006). Main Outcome Measure: Multivariable modeling was used to compare OS for patients undergoing total thyroidectomy vs lobectomy. Results: In total, 29 522 patients in NCDB (3151 lobectomy, 26 371 total thyroidectomy) and 13 510 in SEER (1379 lobectomy, 12 131 total thyroidectomy) were included. Compared with patients undergoing lobectomy, patients having total thyroidectomy more often had extrathyroidal and lymph node disease. At 14 years, unadjusted OS was equivalent between total thyroidectomy and lobectomy in both databases. After adjustment, OS was similar for total thyroidectomy compared with lobectomy across all patients with tumors of 1.1 to 4.0 cm (NCDB: hazard ratio = 1.45 [confidence interval = 0.88–2.51], P = 0.19; SEER: 0.95 (0.70–1.29), P = 0.75) and when stratified by tumor size: 1.1 to 2.0 cm (NCDB: 1.12 [0.50–2.51], P = 0.78; SEER: 0.95 [0.56–1.62], P = 0.86) and 2.1 to 4.0 cm (NCDB: 1.93 [0.88–4.23], P = 0.10; SEER: 0.94 [0.60–1.49], P = 0.80). Conclusions: After adjusting for patient and clinical characteristics, total thyroidectomy compared with thyroid lobectomy was not associated with improved survival for patients <45 years of age with stage I PTC of 1.1 to 4.0 cm. Additional clinical and pathologic factors should be considered when choosing extent of resection. PMID:25337927

Multimedia Principle in Teaching Lessons

ERIC Educational Resources Information Center

Kari Jabbour, Khayrazad

2012-01-01

Multimedia learning principle occurs when we create mental representations from combining text and relevant graphics into lessons. This article discusses the learning advantages that result from adding multimedia learning principle into instructions; and how to select graphics that support learning. There is a balance that instructional designers…

Lessons learned and their application to program development and cultural issues

NASA Technical Reports Server (NTRS)

Roth, Gilbert L.

1991-01-01

The main objectives of space product assurance are, in effect, the same as those of Total Quality Management (TQM) or its many variants. The most significant ingredients are the lessons learned and their application to ongoing and future programs as they are affected by changes in the cultural environment. The cultural issues which affect almost everything done in technical programs and projects are considered. Understanding the lessons learned and the synergism which results from this combination of knowledge, culture, and lessons learned is identified as crucial. A brief discussion of the closed loop linkage that should exist between the world of hands on activities and that of educational institutions is presented.

Lessons learned from the Space Flyer Unit (SFU) mission.

PubMed

Kuriki, Kyoichi; Ninomiya, Keiken; Takei, Mitsuru; Matsuoka, Shinobu

2002-11-01

The Space Flyer Unit (SFU) system and mission chronology are briefly introduced. Lessons learned from the SFU mission are categorized as programmatic and engineering lessons. In the programmatic category are dealt with both international and domestic collaborations. As for the engineering lessons safety design, orbital operation, in-flight anomaly, and post flight analyses are the major topics reviewed. c2002 Elsevier Science Ltd. All rights reserved.

Workplace Wisdom: What Educators Can Learn from the Business World

ERIC Educational Resources Information Center

Williams, Sheri S.; Williams, John W.

2014-01-01

In many schools and businesses today, the pressure to produce results is far greater than attention to employee learning. If continued learning impacts service for business customers and their communities, then what lessons can be learned from business to support and advocate for educator learning? This article is a collection of lessons learned…

Logistics Lessons Learned in NASA Space Flight

NASA Technical Reports Server (NTRS)

Evans, William A.; DeWeck, Olivier; Laufer, Deanna; Shull, Sarah

2006-01-01

The Vision for Space Exploration sets out a number of goals, involving both strategic and tactical objectives. These include returning the Space Shuttle to flight, completing the International Space Station, and conducting human expeditions to the Moon by 2020. Each of these goals has profound logistics implications. In the consideration of these objectives,a need for a study on NASA logistics lessons learned was recognized. The study endeavors to identify both needs for space exploration and challenges in the development of past logistics architectures, as well as in the design of space systems. This study may also be appropriately applied as guidance in the development of an integrated logistics architecture for future human missions to the Moon and Mars. This report first summarizes current logistics practices for the Space Shuttle Program (SSP) and the International Space Station (ISS) and examines the practices of manifesting, stowage, inventory tracking, waste disposal, and return logistics. The key findings of this examination are that while the current practices do have many positive aspects, there are also several shortcomings. These shortcomings include a high-level of excess complexity, redundancy of information/lack of a common database, and a large human-in-the-loop component. Later sections of this report describe the methodology and results of our work to systematically gather logistics lessons learned from past and current human spaceflight programs as well as validating these lessons through a survey of the opinions of current space logisticians. To consider the perspectives on logistics lessons, we searched several sources within NASA, including organizations with direct and indirect connections with the system flow in mission planning. We utilized crew debriefs, the John Commonsense lessons repository for the JSC Mission Operations Directorate, and the Skylab Lessons Learned. Additionally, we searched the public version of the Lessons Learned Information System (LLIS) and verified that we received the same result using the internal version of LLIS for our logistics lesson searches. In conducting the research, information from multiple databases was consolidated into a single spreadsheet of 300 lessons learned. Keywords were applied for the purpose of sorting and evaluation. Once the lessons had been compiled, an analysis of the resulting data was performed, first sorting it by keyword, then finding duplication and root cause, and finally sorting by root cause. The data was then distilled into the top 7 lessons learned across programs, centers, and activities.

Atmospheric/Space Environment Support Lessons Learned Regarding Aerospace Vehicle Design and Operations

NASA Technical Reports Server (NTRS)

Vaughan, William W.; Anderson, B. Jeffrey

2005-01-01

In modern government and aerospace industry institutions the necessity of controlling current year costs often leads to high mobility in the technical workforce, "one-deep" technical capabilities, and minimal mentoring for young engineers. Thus, formal recording, use, and teaching of lessons learned are especially important in the maintenance and improvement of current knowledge and development of new technologies, regardless of the discipline area. Within the NASA Technical Standards Program Website http://standards.nasa.gov there is a menu item entitled "Lessons Learned/Best Practices". It contains links to a large number of engineering and technical disciplines related data sets that contain a wealth of lessons learned information based on past experiences. This paper has provided a small sample of lessons learned relative to the atmospheric and space environment. There are many more whose subsequent applications have improved our knowledge of the atmosphere and space environment, and the application of this knowledge to the engineering and operations for a variety of aerospace programs.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, at left, the Apollo, Challenger, Columbia Lessons Learned Program manager, presents a certificate to John Tribe, retired, Apollo 1 Reaction and Control System lead engineer, during the Apollo 1 Lessons Learned presentation in the Training Auditorium at NASA's Kennedy Space Center in Florida. The theme of the program was "To there and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, the Apollo, Challenger, Columbia Lessons Learned program manager, at left, presents a certificate to Ernie Reyes, retired, former Apollo 1 senior operations manager, during the Apollo 1 Lessons Learned presentation in the Training Auditorium at NASA's Kennedy Space Center in Florida. The theme of the program was "To there and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Responding To and Recovering From an Active Shooter Incident That Turns Into a Hostage Situation. Lessons Learned From School Crises and Emergencies, Volume 2, Issue 6, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an active shooter situation that escalated to a hostage situation that required multiple law enforcement agencies and other first responders and agencies to coordinate response and recovery…

Responding To Infectious Disease: Multiple Cases of Staph Infections in a Rural School District. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 3, 2008

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an incident involving several cases of Methicillin-resistant Staphylococcus aureus (MRSA) at a rural high school. MRSA is a specific strain of Staphylococcus aureus bacteria (often called staph)…

Safety and Mission Assurance for In-House Design Lessons Learned from Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Anderson, Joel M.

2011-01-01

This viewgraph presentation identifies lessons learned in the course of the Ares I Upper Stage design and in-house development effort. The contents include: 1) Constellation Organization; 2) Upper Stage Organization; 3) Presentation Structure; 4) Lesson-Importance of Systems Engineering/Integration; 5) Lesson-Importance of Early S&MA Involvement; 6) Lesson-Importance of Appropriate Staffing Levels; 7) Lesson-Importance S&MA Team Deployment; 8) Lesson-Understanding of S&MA In-Line Engineering versus Assurance; 9) Lesson-Importance of Close Coordination between Supportability and Reliability/Maintainability; 10) Lesson-Importance of Engineering Data Systems; 11) Lesson-Importance of Early Development of Supporting Databases; 12) Lesson-Importance of Coordination with Safety Assessment/Review Panels; 13) Lesson-Implementation of Software Reliability; 14) Lesson-Implementation of S&MA Technical Authority/Chief S&MA Officer; 15) Lesson-Importance of S&MA Evaluation of Project Risks; 16) Lesson-Implementation of Critical Items List and Government Mandatory Inspections; 17) Lesson-Implementation of Critical Items List Mandatory Inspections; 18) Lesson-Implementation of Test Article Safety Analysis; and 19) Lesson-Importance of Procurement Quality.

Thyroidectomy

MedlinePlus

... via an incision high in the neck. The robotic approach allows a thyroidectomy to be performed while avoiding an incision in the center of your neck. After the procedure After surgery, you're moved to a recovery room where ...

Robotic and endoscopic transoral thyroidectomy: feasibility and description of the technique in the cadaveric model

PubMed Central

Kahramangil, Bora; Mohsin, Khuzema; Alzahrani, Hassan; Bu Ali, Daniah; Tausif, Syed; Kang, Sang-Wook; Kandil, Emad

2017-01-01

Background Numerous new approaches have been described over the years to improve the cosmetic outcomes of thyroid surgery. Transoral approach is a new technique that aims to achieve superior cosmetic outcomes by concealing the incision in the oral cavity. Methods Transoral thyroidectomy through vestibular approach was performed in two institutions on cadaveric models. Procedure was performed endoscopically in one institution, while the robotic technique was utilized at the other. Results Transoral thyroidectomy was successfully performed at both institutions with robotic and endoscopic techniques. All vital structures were identified and preserved. Conclusions Transoral thyroidectomy has been performed in animal and cadaveric models, as well as in some clinical studies. Our initial experience indicates the feasibility of this approach. More clinical studies are required to elucidate its full utility. PMID:29302476

Bilateral benign multinodular goiter: What is the adequate surgical therapy? A review of literature.

PubMed

Mauriello, Claudio; Marte, Gianpaolo; Canfora, Alfonso; Napolitano, Salvatore; Pezzolla, Angela; Gambardella, Claudio; Tartaglia, Ernesto; Lanza, Michele; Candela, Giancarlo

2016-04-01

Benign multinodular goiter (BMNG) is the most common endocrine disease requiring surgery. During the last few years a more aggressive approach has become the trend for bilateral BMNG treatment. Randomized clinical trials of any size that compared bilateral subtotal resection, Dunhill procedure and total thyroidectomy for benign multinodular goiter, published between January 2000 and the end of March 2015, were reviewed. Total thyroidectomy can be considered the most reliable approach in preventing recurrence. The Dunhill procedure is related to a higher rate of recurrence, but rarely recurrences after Dunhill procedure lead to reoperation. Total thyroidectomy avoid completion thyroidectomy for incidental carcinoma and its related risks. Recurrent laryngeal nerve (RLN) palsy becomes less common as surgical experience increases. Transient and permanent hypoparathyroidism is strictly related to the extent of neck dissection. In the risk-cost analysis we must consider the type of patient candidated to surgery and the impact of the surgical protocol we apply. When thyroid surgery is taken in consideration, specific complication rates of different procedures in each hospital must be analyzed accordingly to patient-specific risk factors and local expertise. The Dunhill procedure seems to be a good compromise between radicality and prevention of complications, avoiding reoperation for recurrence or completion thyroidectomy for incidental thyroid carcinoma. More follow-up studies and prospective studies are necessary to better evaluate, definitively, whether to prefer total thyroidectomy or Dunhill procedure in case of benign goiter surgery. Copyright © 2015. Published by Elsevier Ltd.

Association between Decreased Serum Parathyroid Hormone after Total Thyroidectomy and Persistent Hypoparathyroidism

PubMed Central

Wang, Jian-Biao; Sun, Hai-Li; Song, Chun-Yi; Gao, Li

2015-01-01

Background Postoperative hypocalcemia caused by hypoparathyroidism is one of the most common morbidities of total thyroidectomy. The aim of this study was to analyze the kinetics and factors affecting PTH levels after total thyroidectomy and central neck dissection (CND). Material/Methods We performed a retrospective study in 438 consecutive patients who underwent total thyroidectomy between January 2007 and December 2010. No patient had a history of thyroid or neck surgery. PTH and calcium levels were recorded 1 day before the operation, during the first 5 days, and during follow-up (2 weeks and 2, 6, and 12 months). Results PTH levels declined to 41.90% of its initial value on the first day after the operation. After surgery, PTH was correlated positively with calcium and inversely with phosphate levels from postoperative day 1 to 14. Based on clinical observation, using a PTH threshold of <7 ng/L on postoperative day 1 was predictive of persistent hypoparathyroidism, with sensitivity and negative predictive value 100%, but poor specificity (70.19%). CND increased the risk of transient hypoparathyroidism compared with total thyroidectomy alone. Patients with thyroiditis had an increased risk of permanent hypoparathyroidism compared with those without thyroiditis. Iatrogenic removal of the parathyroid glands increased the risk of permanent hypoparathyroidism compared with those without iatrogenic parathyroidectomy. Conclusions PTH declined on the first day after thyroidectomy. PTH levels <7 ng/L on the first day after surgery might be associated with persistent hypoparathyroidism. CND, thyroiditis, and iatrogenic parathyroidectomy increased the risk of hypoparathyroidism. PMID:25923249

Nerve sparing sutureless total thyroidectomy. Preliminary study.

PubMed

Parmeggiani, Domenico; De Falco, Massimo; Avenia, Nicola; Sanguinetti, Alessandro; Fiore, Andrea; Docimo, Giovanni; Ambrosino, Pasquale; Madonna, Imma; Peltrini, Roberto; Parmeggiani, Umberto

2012-01-01

In the present study the authors assess the advantages of new technologies in thyroid surgery: to prevent nerve injury by using an intra-operative continuous nerve-monitoring techniques and to compare the real advantages of advanced coagulation devices. Among a series of 440 thyroidectomies (jan 2004-feb 2006) the Authors reviewed charts from two groups: (1) 240 total thyroidectomies performed using the traditional monopolar electrocautery, non-absorbable stitches for the principal vascular pedicles. (2) 140 total thyroidectomies performed using dedicated small bipolar electro thermal coagulator (ligasure-precise). (3) Since 2006 in a double blind group selection of 70, we've performed sutureless thyroidectomy with continuous intraoperative nerve monitoring using dedicated endotracheal tube. Mean operative time, post-operative bleeding, post-operative stay, incidence of transient or definitive laryngeal nerve lesions, incidence of permanent or transient hypocalcaemia, costs of the procedures were analyzed. Major complications in the first two groups compared with the data of the literature are absolutely over-imposable, except a reduction of incidence of transient hypocalcaemia in the Precise group, but if we compare data of the 3rd group (NIM), we find a significative reduction of transient and permanent laryngeal nerve palsy incidence. This new technology offers several advantages: (1) atraumatic; (2) easy to use; (3) continuous monitoring and audio feedback to the surgeon (4) works outside the operation field (5) high sensitiveness. Cost-analysis confirm that NIM + ligasure have same or less cost and time and probably less complications than traditional Total Thyroidectomy.

Kinesthetic Astronomy: Significant Upgrades to the Sky Time Lesson that Support Student Learning

NASA Astrophysics Data System (ADS)

Morrow, C. A.; Zawaski, M.

2004-12-01

This paper will report on a significant upgrade to the first in a series of innovative, experiential lessons we call Kinesthetic Astronomy. The Sky Time lesson reconnects students with the astronomical meaning of the day, year, and seasons. Like all Kinesthetic Astronomy lessons, it teaches basic astronomical concepts through choreographed bodily movements and positions that provide educational sensory experiences. They are intended for sixth graders up through adult learners in both formal and informal educational settings. They emphasize astronomical concepts and phenomenon that people can readily encounter in their "everyday" lives such as time, seasons, and sky motions of the Sun, Moon, stars, and planets. Kinesthetic Astronomy lesson plans are fully aligned with national science education standards, both in content and instructional practice. Our lessons offer a complete learning cycle with written assessment opportunities now embedded throughout the lesson. We have substantially strengthened the written assessment options for the Sky Time lesson to help students translate their kinesthetic and visual learning into the verbal-linguistic and mathematical-logical realms of expression. Field testing with non-science undergraduates, middle school science teachers and students, Junior Girl Scouts, museum education staff, and outdoor educators has been providing evidence that Kinesthetic Astronomy techniques allow learners to achieve a good grasp of concepts that are much more difficult to learn in more conventional ways such as via textbooks or even computer animation. Field testing of the Sky Time lesson has also led us to significant changes from the previous version to support student learning. We will report on the nature of these changes.

Lessons Learned from the Advanced Topographic Laser Altimeter System

NASA Technical Reports Server (NTRS)

Garrison, Matt; Patel, Deepak; Bradshaw, Heather; Robinson, Frank; Neuberger, Dave

2016-01-01

The ICESat-2 Advanced Topographic Laser Altimeter System (ATLAS) instrument is an upcoming Earth Science mission focusing on the effects of climate change. The flight instrument passed all environmental testing at GSFC (Goddard Space Flight Center) and is now ready to be shipped to the spacecraft vendor for integration and testing. This presentation walks through the lessons learned from design, hardware, analysis and testing perspective. ATLAS lessons learned include general thermal design, analysis, hardware, and testing issues as well as lessons specific to laser systems, two-phase thermal control, and optical assemblies with precision alignment requirements.

Japanese Lesson Study Comes to California

ERIC Educational Resources Information Center

Jetter, Madeleine; Hancock, Gwen

2012-01-01

Japanese lesson study--Jugyou kenkyuu--which is a cornerstone of Project DELTA (Developing Educators Learning to Teach Algebraically), adds a new twist: the teachers take turns publicly teaching the collaboratively planned lessons with their own students for the rest of the team to observe and then analyze, based on the students' learning. Lesson…

Credit: A Teaching Unit.

ERIC Educational Resources Information Center

Clanton, Brandolyn; And Others

Intended for teachers of secondary school students, five lessons on consumer credit are presented. In the first lesson students identify and evaluate sources of credit, compare some of the costs and benefits of credit, and learn to apply criteria used in evaluating applications for credit. In the second lesson, students learn about two basic types…

More Lessons from Bhutan: 6 Years Later, Change Takes Root and Flourishes

ERIC Educational Resources Information Center

Telsey, Alison; Levine, Laurie

2015-01-01

In April 2011, the Journal of Staff Development (JSD) published "Lessons from Bhutan: Embrace cultural differences to effect change" (Levine, Telsey, & McCormack, 2011), which described the experiences of several U.S. educators who learned their own transformative lessons while leading professional learning in special education…

New Horizons Risk Communication Strategy, Planning, Implementation, and Lessons Learned

NASA Technical Reports Server (NTRS)

Dawson, Sandra A.

2006-01-01

This paper discusses the risk communication goals, strategy, planning process and product development for the New Horizons mission, including lessons from the Cassini mission that were applied in that effort, and presents lessons learned from the New Horizons effort that could be applicable to future missions.

Comment Data Mining to Estimate Student Performance Considering Consecutive Lessons

ERIC Educational Resources Information Center

Sorour, Shaymaa E.; Goda, Kazumasa; Mine, Tsunenori

2017-01-01

The purpose of this study is to examine different formats of comment data to predict student performance. Having students write comment data after every lesson can reflect students' learning attitudes, tendencies and learning activities involved with the lesson. In this research, Latent Dirichlet Allocation (LDA) and Probabilistic Latent Semantic…

Use of After Action Reports (AARs) to Promote Organizational and Systems Learning in Emergency Preparedness

PubMed Central

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D.

2012-01-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The “lessons-learned” approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the “Lessons Learned Information Sharing (LLIS.gov)” system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strived to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed. PMID:23066408

Using Cooperative Learning To Improve Reading and Writing in Science.

ERIC Educational Resources Information Center

Nesbit, Catherine R.; Rogers, Cynthia A.

1997-01-01

Presents several cooperative learning lessons that integrate science, reading and writing. Notes that sample lessons involve six methods of cooperative learning drawn from four prominent developers and researchers, David Johnson, Roger Johnson, Robert Slavin, and Spencer Kagan. Describes the cooperative learning method to illustrate how to use it…

Teachers' Self-Regulated Learning Lesson Design: Integrating Learning from Problems and Successes

ERIC Educational Resources Information Center

Michalsky, Tova; Schechter, Chen

2018-01-01

Teachers' design of a lesson is critical for helping their students develop academically effective forms of self-regulating learning (SRL) in classrooms. Using a quasi-experimental design, the researchers integrated systematic collaborative learning from problematic and successful experiences into teachers' preparatory programs and examined how…

Hypocalcaemia following total thyroidectomy: An analysis of 806 patients.

PubMed

Nair, C Gopalakrishnan; Babu, Misha J C; Menon, Riju; Jacob, Pradeep

2013-03-01

Permanent hypocalcaemia following thyroidectomy causes considerable morbidity. This prospective observational study aims to define the factors likely to predict hypocalcaemia following total thyroidectomy. Patients who were subjected to total thyroidectomy during January 2005 to December 2009 were followed up for a minimum period of 1 year. Efficacy of an intraoperative parathyroid hormone assay to predict hypocalcaemia was validated. Overall incidence of hypocalcaemia was 23.6% (n = 190) and that of permanent hypocalcaemia was 1.61% (n = 13). Onset was delayed up to 3(rd) postoperative day in 13 patients. Hypocalcaemia was significantly associated with thyroidectomy for Grave's Disease (P = 0.001), Hashimoto's thyroiditis (P = 0.003), and with incidental parathyroidectomy (P = 0.006). The intraoperative assay of parathyroid hormone showed low sensitivity (0.5) and satisfactory specificity (0.9) in predicting hypocalcemia. Hypocalcemia could manifest late in the immediate postoperative period and this may explain latent hypocalcemia. High incidence of hypocalcaemia noted in Grave's Disease could be due to the autoimmunity since same feature was noted associated with Hashimoto's thyroiditis and the incidence of hypocalcaemia was not high in the subgroup with toxic nodular goiter. The incidence of hypocalcemia was not affected by age or sex.

Hypocalcaemia following total thyroidectomy: An analysis of 806 patients

PubMed Central

Nair, C. Gopalakrishnan; Babu, Misha J. C.; Menon, Riju; Jacob, Pradeep

2013-01-01

Background: Permanent hypocalcaemia following thyroidectomy causes considerable morbidity. This prospective observational study aims to define the factors likely to predict hypocalcaemia following total thyroidectomy. Materials and Methods: Patients who were subjected to total thyroidectomy during January 2005 to December 2009 were followed up for a minimum period of 1 year. Efficacy of an intraoperative parathyroid hormone assay to predict hypocalcaemia was validated. Results: Overall incidence of hypocalcaemia was 23.6% (n = 190) and that of permanent hypocalcaemia was 1.61% (n = 13). Onset was delayed up to 3rd postoperative day in 13 patients. Hypocalcaemia was significantly associated with thyroidectomy for Grave's Disease (P = 0.001), Hashimoto's thyroiditis (P = 0.003), and with incidental parathyroidectomy (P = 0.006). The intraoperative assay of parathyroid hormone showed low sensitivity (0.5) and satisfactory specificity (0.9) in predicting hypocalcemia. Conclusion: Hypocalcemia could manifest late in the immediate postoperative period and this may explain latent hypocalcemia. High incidence of hypocalcaemia noted in Grave's Disease could be due to the autoimmunity since same feature was noted associated with Hashimoto's thyroiditis and the incidence of hypocalcaemia was not high in the subgroup with toxic nodular goiter. The incidence of hypocalcemia was not affected by age or sex. PMID:23776907

"Minimally invasive video-assisted thyroidectomy. Initial experience in a general surgery department".

PubMed

Dobrinja, Chiara; Trevisan, Giuliano; Liguori, Gennaro

2009-03-01

The aim of this study is to analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and demonstrate the feasibility of MIVAT also in non-referral centers. We report our initial experience based on a series of 47 patients selected for MIVAT at General Surgery Department of University of Trieste during a period from May 2005 to February 2007. The eligibility criteria were rigorously observed. Age, goiter volume, major diameter of the dominant nodule, operative times, pathologic findings, postoperative pain, length of hospital stay, cosmetic results, and complications were retrospectively analyzed. Thyroid lobectomy was successfully accomplished in 33 cases, total thyroidectomy in 14. Conversion to standard cervicotomy was required in three patients (6%). Mean operative time of lobectomy was 82.6 min and 118.7 for total thyroidectomy. Postoperative complications included 11 (23.4%) transient hypocalcemias, 2 (4.2%) hematomas, and 2 (4.2%) temporary laryngeal nerve palsies. None-recurrent nerve palsies was observed. The cosmetic result was excellent in most cases. Our experience demonstrates that MIVAT, after adequate training, is feasible and safe, with results comparable to conventional thyroidectomy, also in a General Surgery Department, from a dedicated team, with a sufficient and specific activity volume.

Efficacy of a Home-Based Exercise Program After Thyroidectomy for Thyroid Cancer Patients.

PubMed

Kim, Kyunghee; Gu, Mee Ock; Jung, Jung Hwa; Hahm, Jong Ryeal; Kim, Soo Kyoung; Kim, Jin Hyun; Woo, Seung Hoon

2018-02-01

The objective of this study was to determine the effect of a home-based exercise program on fatigue, anxiety, quality of life (QoL), and immune function of thyroid cancer patients taking thyroid hormone replacement after thyroidectomy. This quasi-experimental study with a non-equivalent control group included 43 outpatients taking thyroid hormone replacement after thyroidectomy (22 in the experimental group and 21 in the control group). After education about the home-based exercise program, subjects in the experimental group underwent 12 weeks of aerobic, resistance, and flexibility exercise. A comparative analysis was conducted between the two groups. Patients in the experimental group were significantly less fatigued or anxious (p < 0.01). They reported significantly improved QoL (p < 0.05) compared to those in the control group. Natural killer cell activity was significantly higher in the exercise group compared to that in the control group (p < 0.05). A home-based exercise program is effective in reducing fatigue and anxiety, improving QoL, and increasing immune function in patients taking thyroid hormone replacement after thyroidectomy. Therefore, such a home-based exercise program can be used as an intervention for patients who are taking thyroid hormone replacement after thyroidectomy.

Mobile Learning vs. Traditional Classroom Lessons: A Comparative Study

ERIC Educational Resources Information Center

Furió, D.; Juan, M.-C.; Seguí, I.; Vivó, R.

2015-01-01

Different methods can be used for learning, and they can be compared in several aspects, especially those related to learning outcomes. In this paper, we present a study in order to compare the learning effectiveness and satisfaction of children using an iPhone game for learning the water cycle vs. the traditional classroom lesson. The iPhone game…

Rescuing Joint Personnel Recovery: Using Air Force Capability to Address Joint Shortfalls

DTIC Science & Technology

2011-06-01

of an IP, the IP is not successfully reintegrated or the lessons learned are not incorporated into other operations. Adversaries will benefit from...Washington, D.C.: Office of Air Force History , United States Air Force, 1980, 117. 47 Durant , Michael J. In the Company of Heroes, Penguin Group... Lessons Learned, 22 September 2005, 3. 2 US Joint Task Force Katrina. The Federal Response to Hurricane Katrina Lessons Learned, February 2006, 54

Implementing a lessons learned process at Sandia National Laboratories

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fosshage, Erik D.; Drewien, Celeste A.; Eras, Kenneth

2016-01-01

The Lessons Learned Process Improvement Team was tasked to gain an understanding of the existing lessons learned environment within the major programs at Sandia National Laboratories, identify opportunities for improvement in that environment as compared to desired attributes, propose alternative implementations to address existing inefficiencies, perform qualitative evaluations of alternative implementations, and recommend one or more near-term activities for prototyping and/or implementation. This report documents the work and findings of the team.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, at left, the Apollo, Challenger, Columbia Lessons Learned Program manager, presents a certificate to Charlie Duke, former Apollo 16 astronaut and member of the Apollo 1 Emergency Egress Investigation Team, during the Apollo 1 Lessons Learned presentation in the Training Auditorium at NASA's Kennedy Space Center in Florida. The program's theme was "To There and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Lessons learned applying CASE methods/tools to Ada software development projects

NASA Technical Reports Server (NTRS)

Blumberg, Maurice H.; Randall, Richard L.

1993-01-01

This paper describes the lessons learned from introducing CASE methods/tools into organizations and applying them to actual Ada software development projects. This paper will be useful to any organization planning to introduce a software engineering environment (SEE) or evolving an existing one. It contains management level lessons learned, as well as lessons learned in using specific SEE tools/methods. The experiences presented are from Alpha Test projects established under the STARS (Software Technology for Adaptable and Reliable Systems) project. They reflect the front end efforts by those projects to understand the tools/methods, initial experiences in their introduction and use, and later experiences in the use of specific tools/methods and the introduction of new ones.

The experience of gasless endoscopic-assisted thyroidectomy via the anterior chest approach for Graves' disease.

PubMed

Hong, Yun; Yu, Shi-Tong; Cai, Qian; Liang, Fa-Ya; Han, Ping; Huang, Xiao-Ming

2016-10-01

The aim of this study was to evaluate the safety, feasibility, effectiveness, and cosmesis of a gasless endoscopic-assisted thyroidectomy via the anterior chest in patients with Graves' disease. We retrospectively reviewed 38 patients with Graves' disease treated with thyroidectomy from November 2007 to June 2015. We analyzed clinical characteristics of patients, type of operation, operative indications, operative duration, length of postoperative hospital stay, and postoperative complications. The thyroidectomies were classified as total thyroidectomy (n = 12) or near-total thyroidectomy with a remnant of <1 g (n = 26). Surgical indications were recurrence after antithyroid drugs (ATDs) and unwillingness to undergo radioiodine therapy (n = 27), local compressive symptoms (n = 2), adverse drug reactions to ATDs (n = 5), and patient's preference (n = 4). Mean resection weight was 71.7 ± 16.2 g (range 44-109 g), mean operative duration 87.7 ± 17.3 min (range 66-136 min), intraoperative blood loss 70.6 ± 11.3 mL (range 43-92 mL), and drainage was 42.0 ± 8.5 mL (range 20-62 mL). Temporary postoperative recurrent laryngeal nerve palsy and temporary hypoparathyroidism occurred in 3 cases (7.89 %) each. Mean hospital stay was 2.5 ± 0.3 days (range 2-4 days). There was no recurrence of hyperthyroidism over the follow-up period of for 68.1 ± 5.6 months (range 6-89 months). All patients were satisfied with their cosmetic results. Gasless endoscopic-assisted thyroidectomy via the anterior chest approach for Graves' disease is a safe, feasible, and effective and provides an excellent cosmetic outcome procedure. It is a valid option in appropriately selected patients.

Late effect of subtotal thyroidectomy and radioactive iodine therapy on calcitonin secretion and bone mineral density in women treated for Graves' disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lowery, W.D.; Thomas, C.G. Jr.; Awbrey, B.J.

1986-12-01

This study was designed to evaluate the effect of subtotal thyroidectomy and/or radioactive iodine therapy on plasma immunocalcitonin (iCT) levels and bone densities in patients treated for Graves' disease. Forty-eight women whose ages ranged from 29 to 79 years (mean, 55 years) were evaluated. All were at least 10 years beyond treatment. Fourteen patients had undergone subtotal thyroidectomy, 22 had received radioactive iodine therapy, and 12 had received both. Serum calcitonin levels were measured with the patient fasting and at 30 minutes and 2 hours after the ingestion of 15 mg of calcium in orange juice. Single photon absorptiometry wasmore » used to measure bone mineral density of the middle and distal radius. The mean fasting plasma levels of iCT for patients undergoing subtotal thyroidectomy was 27 +/- 2 mumol/L; women treated with radioactive iodine, 26 +/- 2; women undergoing subtotal thyroidectomy followed by radioactive iodine, 24 +/- 2, and for normal control women, 48.5 +/- 4.7. The mean stimulated iCT level of each of the patient groups was significantly lower than that of the normal controls (p = 0.01). There were no significant differences among the groups. Although there was an increased loss of bone mineral density in postmenopausal patients, with age and race as covariates, the bone densities of the distal radius in women undergoing subtotal thyroidectomy and/or receiving radioactive iodine were not significantly lower than those of normal control subjects (p greater than 0.05). These findings are consistent with other observations that patients treated by thyroidectomy and/or radioactive iodine for Graves' disease have lower basal levels of calcitonin and decreased calcitonin response to a provocative stimulus. Whether this loss of calcitonin reserve is a significant factor in development of postmenopausal osteoporosis remains unanswered.« less

Robotic thyroidectomy for benign thyroid diseases: a stepwise strategy to the adoption of robotic thyroidectomy (gasless, transaxillary approach).

PubMed

Giannopoulos, George; Kang, Sang-Wook; Jeong, Jong J; Nam, Kee-Hyun; Chung, Woong Y

2013-06-01

Thyroid surgery for benign diseases mainly involves young women, and thus, cosmetic considerations have motivated the development of "no scar to the neck" procedures. Endoscopic techniques are often strenuous, and therefore, discouraging to adopt. However, the recent incorporation of robotic technology proposes a feasible, safe, extracervical approach that alleviates most of the technical difficulties associated with endoscopy. Here, the authors present a series of robotic thyroidectomies performed to treat benign thyroid diseases and detail the key issues of initial patient selection. From November 2007 to December 2010, 44 patients with benign thyroid disease were operated upon using a robotic procedure. Indications were follicular/Hürthle cell lesions smaller than 5 cm, nodules with an indefinite/suspicious cytology, or Graves disease. All patients underwent robotic gasless, transaxillary thyroidectomy using the da Vinci S system. Thirty-nine of the 44 patients were women, and the overall mean age was 38.2 years (range, 16 to 60 y). The most common pathology was adenomatous hyperplasia (20 lesions) followed by follicular adenoma (10 lesions). Seven patients had Graves disease. The mean tumor size was 1.68 cm (range, 0.3 to 5 cm). Thirty-nine patients underwent less than total thyroidectomy and 5 underwent total or near total thyroidectomy. The mean total operative time was 129.8 minutes (range, 75 to 242 min) and the mean duration of postoperative hospital stay was 3.1 days (range, 2 to 5 d). Postoperative complications were 1 transient hoarseness, 1 transient hypocalcemia, and 1 permanent recurrent laryngeal nerve injury. Robotic thyroidectomy, although novel and sophisticated, has already been used to treat over 4000 thyroid cancer patients in Korea. Female patients with a small to average build, with a follicular lesion and concerned about neck scarring, seem to be the best candidates. Patients with small suspicious nodules without severe thyroiditis are also a rational choice. In contrast, patients with Graves disease should be reserved, unless significant experience has been gained.

Is There a Minimum Number of Thyroidectomies a Surgeon Should Perform to Optimize Patient Outcomes?

PubMed

Adam, Mohamed Abdelgadir; Thomas, Samantha; Youngwirth, Linda; Hyslop, Terry; Reed, Shelby D; Scheri, Randall P; Roman, Sanziana A; Sosa, Julie A

2017-02-01

To determine the number of total thyroidectomies per surgeon per year associated with the lowest risk of complications. The surgeon volume-outcome association has been established for thyroidectomy; however, a threshold number of cases defining a "high-volume" surgeon remains unclear. Adults undergoing total thyroidectomy were identified from the Health Care Utilization Project-National Inpatient Sample (1998-2009). Multivariate logistic regression with restricted cubic splines was utilized to examine the association between the number of annual total thyroidectomies per surgeon and risk of complications. Among 16,954 patients undergoing total thyroidectomy, 47% had thyroid cancer and 53% benign disease. Median annual surgeon volume was 7 cases; 51% of surgeons performed 1 case/y. Overall, 6% of the patients experienced complications. After adjustment, the likelihood of experiencing a complication decreased with increasing surgeon volume up to 26 cases/y (P < 0.01). Among all patients, 81% had surgery by low-volume surgeons (≤25 cases/y). With adjustment, patients undergoing surgery by low-volume surgeons were more likely to experience complications (odds ratio 1.51, P = 0.002) and longer hospital stays (+12%, P = 0.006). Patients had an 87% increase in the odds of having a complication if the surgeon performed 1 case/y, 68% for 2 to 5 cases/y, 42% for 6 to 10 cases/y, 22% for 11 to 15 cases/y, 10% for 16 to 20 cases/y, and 3% for 21 to 25 cases/y. This is the first study to identify a surgeon volume threshold (>25 total thyroidectomies/y) that is associated with improved patient outcomes. Identifying a threshold number of cases defining a high-volume thyroid surgeon is important, as it has implications for quality improvement, criteria for referral and reimbursement, and surgical education.

Cardiovascular morbidity and mortality in surgically treated hyperthyroidism - a nation-wide cohort study with a long-term follow-up.

PubMed

Ryödi, Essi; Salmi, Jorma; Jaatinen, Pia; Huhtala, Heini; Saaristo, Rauni; Välimäki, Matti; Auvinen, Anssi; Metso, Saara

2014-05-01

Previous studies suggest that patients with hyperthyroidism remain at an increased risk of cardiovascular morbidity even after restoring euthyroidism. The mechanisms of the increased risk and its dependency on the different treatment modalities of hyperthyroidism remain unclear. The aim of this long-term follow-up study was to compare the rate of hospitalizations for cardiovascular causes and the mortality in hyperthyroid patients treated surgically with an age- and gender-matched reference population. A population-based cohort study was conducted among 4334 hyperthyroid patients (median age 46 years) treated with thyroidectomy in 1986-2007 in Finland and among 12,991 reference subjects. Firstly, the hospitalizations due to cardiovascular diseases (CVD) were analysed until thyroidectomy. Secondly, the hazard ratios for any new hospitalization due to CVDs after the thyroidectomy were calculated in Cox regression analysis adjusted with the prevalent CVDs at the time of thyroidectomy. The risk of hospitalization due to all CVDs started to increase already 5 years before the thyroidectomy, and by the time of the operation, it was 50% higher in the hyperthyroid patients compared to the controls (P < 0·001). After the thyroidectomy, the hospitalizations due to all CVDs (HR 1·15), hypertension (HR 1·23), heart failure (HR 1·17) and valvular diseases or cardiomyopathies (HR 1·55) remained more frequent among the patients than among the controls for 20 years after thyroidectomy. The increased morbidity was not clearly related to the aetiology of hyperthyroidism. Despite the increased CVD morbidity among the patients, there was no difference in cardiovascular mortality. The present study shows that hyperthyroidism increases the risk of hospitalization due to CVDs and the risk is sustained up to two decades after effective surgical treatment. However, there was no excess CVD mortality in the middle-aged patient cohort studied. © 2013 John Wiley & Sons Ltd.

Should Subtotal Thyroidectomy Be Abandoned in Multinodular Goiter Patients From Endemic Regions Requiring Surgery?

PubMed Central

Yoldas, Tayfun; Makay, Ozer; Icoz, Gokhan; Kose, Timur; Gezer, Gulten; Kismali, Erkan; Tamsel, Sadık; Ozbek, Sureyya; Yılmaz, Mustafa; Akyildiz, Mahir

2015-01-01

The most convenient surgical procedure for benign thyroid diseases is still controversial. The aim of this study is to determine the recurrence rate and risk factors for recurrence after different thyroidectomy procedures in multinodular goiter patients. Patients were separated into two groups according to the detection of a recurrent nodule or not after thyroidectomy. Of the 748 patients, 216 (29%) had recurrence, while 532 had no recurrent nodule. The difference between surgical procedures described as subtotal (ST), near total (NT) and total thyroidectomy (TT) was statistically significant. Transient hypoparathyroidism was significantly higher in NT and TT, when compared to ST patients (P < 0.05). Young age, bilateral multinodular goiter and insufficient surgery are risk factors affecting recurrence for benign nodular thyroid disease. Currently, subtotal procedures should be discontinued and total or near total procedures should be preferred. Meanwhile, the probability of a higher risk of hypoparathyroidism should be kept in mind. PMID:25594634

A paired comparison analysis of third-party rater thyroidectomy scar preference.

PubMed

Rajakumar, C; Doyle, P C; Brandt, M G; Moore, C C; Nichols, A; Franklin, J H; Yoo, J; Fung, K

2017-01-01

To determine the length and position of a thyroidectomy scar that is cosmetically most appealing to naïve raters. Images of thyroidectomy scars were reproduced on male and female necks using digital imaging software. Surgical variables studied were scar position and length. Fifteen raters were presented with 56 scar pairings and asked to identify which was preferred cosmetically. Twenty duplicate pairings were included to assess rater reliability. Analysis of variance was used to determine preference. Raters preferred low, short scars, followed by high, short scars, with long scars in either position being less desirable (p < 0.05). Twelve of 15 raters had acceptable intra-rater and inter-rater reliability. Naïve raters preferred low, short scars over the alternatives. High, short scars were the next most favourably rated. If other factors influencing incision choice are considered equal, surgeons should consider these preferences in scar position and length when planning their thyroidectomy approach.

Postoperative day 1 levels of parathyroid as predictor of occurrence and severity of hypocalcaemia after total thyroidectomy.

PubMed

Karatzanis, Alexander D; Ierodiakonou, Despo P; Fountakis, Emmanuel S; Velegrakis, Stylianos G; Doulaptsi, Maria V; Prokopakis, Emmanuel P; Daraki, Vasiliki N; Velegrakis, George A

2018-05-01

Hypocalcaemia is a common and serious complication after thyroidectomy. The purpose of this study is to assess the effectiveness of first postoperative day parathyroid hormone (PTH) measurement in order to predict the presence and severity of postthyroidectomy hypocalcaemia. One hundred consecutive cases undergoing total thyroidectomy in a tertiary referral center were prospectively assessed. Preoperative measurements of PTH were compared with postoperative levels in the first morning after surgery. All cases of hypocalcaemia were recorded and evaluated with regard to preoperative and postoperative levels of PTH. A decrease of 56% of PTH levels on the first postoperative day could accurately predict postoperative hypocalcaemia with a sensitivity and specificity of 80%. Serum PTH levels on the first postoperative day may be used as a reliable predictive marker for calcium supplementation need and even prolonged hospitalization in cases undergoing total thyroidectomy. © 2018 Wiley Periodicals, Inc.

Post- thyroidectomy haematoma causing severe supraglottic oedema and pulmonary oedema - a case report.

PubMed

Parate, Leena Harshad; Pujari, Vinayak Seenappa; Anandaswamy, Tejesh C; Vig, Saurabh

2014-08-01

Large, long standing goiters present multiple challenges to anaesthesiologist. Post thyroidectomy haematoma is a rare but life threatening complication of thyroid surgery leading to airway obstruction. We report a case of huge goiter that underwent near total thyroidectomy and developed post thyroidectomy haematoma. Within no time it resulted in near fatal airway obstruction, pulmonary oedema and cardiac arrest. The haematoma was evacuated immediately and patient was resuscitated successfully. Pulmonary oedema was further worsened by subsequent aggressive fluid resuscitation. She was electively ventilated with PEEP and was extubated after five days. Except for right vocal cord palsy her postoperative stay was uneventful. This is unique case where a post thyoidectomy haematoma has resulted in fatal supraglottic oedema and pulmonary oedema. Early recognition, immediate intubation and evacuation of haematoma are the key to manage this complication. We highlight on the pathophysiology of haematoma and discuss the strategies to prevent similar events in future.

Engaging the Deaf American sign language community: lessons from a community-based participatory research center.

PubMed

McKee, Michael; Thew, Denise; Starr, Matthew; Kushalnagar, Poorna; Reid, John T; Graybill, Patrick; Velasquez, Julia; Pearson, Thomas

2012-01-01

Numerous publications demonstrate the importance of community-based participatory research (CBPR) in community health research, but few target the Deaf community. The Deaf community is understudied and underrepresented in health research despite suspected health disparities and communication barriers. The goal of this paper is to share the lessons learned from the implementation of CBPR in an understudied community of Deaf American Sign Language (ASL) users in the greater Rochester, New York, area. We review the process of CBPR in a Deaf ASL community and identify the lessons learned. Key CBPR lessons include the importance of engaging and educating the community about research, ensuring that research benefits the community, using peer-based recruitment strategies, and sustaining community partnerships. These lessons informed subsequent research activities. This report focuses on the use of CBPR principles in a Deaf ASL population; lessons learned can be applied to research with other challenging-to-reach populations.

Professional Learning through the Collaborative Design of Problem-Solving Lessons

ERIC Educational Resources Information Center

Wake, Geoff; Swan, Malcolm; Foster, Colin

2016-01-01

This article analyses lesson study as a mode of professional learning, focused on the development of mathematical problem solving processes, using the lens of cultural-historical activity theory. In particular, we draw attention to two activity systems, the classroom system and the lesson-study system, and the importance of making artefacts…

Marine Hydrokinetic Energy Regulators Workshop: Lessons from Wind

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baring-Gould, E. Ian

2015-09-03

Ian Baring-Gould presented these lessons learned from wind energy to an audience of marine hydrokinetic regulators. Lessons learned spanned the areas of technology advances, using collaborative approaches to involve key stakeholders; using baseline studies to measure and prioritize wildlife impacts, and look at avoidance and mitigation options early in the process.

Does the Modality Principle for Multimedia Learning Apply to Science Classrooms?

ERIC Educational Resources Information Center

Harskamp, Egbert G.; Mayer, Richard E.; Suhre, Cor

2007-01-01

This study demonstrated that the modality principle applies to multimedia learning of regular science lessons in school settings. In the first field experiment, 27 Dutch secondary school students (age 16-17) received a self-paced, web-based multimedia lesson in biology. Students who received lessons containing illustrations and narration performed…

Automatic Dance Lesson Generation

ERIC Educational Resources Information Center

Yang, Yang; Leung, H.; Yue, Lihua; Deng, LiQun

2012-01-01

In this paper, an automatic lesson generation system is presented which is suitable in a learning-by-mimicking scenario where the learning objects can be represented as multiattribute time series data. The dance is used as an example in this paper to illustrate the idea. Given a dance motion sequence as the input, the proposed lesson generation…

Mining Mathematics in Textbook Lessons

ERIC Educational Resources Information Center

Ronda, Erlina; Adler, Jill

2017-01-01

In this paper, we propose an analytic tool for describing the mathematics made available to learn in a "textbook lesson". The tool is an adaptation of the Mathematics Discourse in Instruction (MDI) analytic tool that we developed to analyze what is made available to learn in teachers' lessons. Our motivation to adapt the use of the MDI…

Challenge Activities for the Physical Education Classroom: Affective Learning Outcomes

ERIC Educational Resources Information Center

McKenzie, Emily; Symonds, Matthew L.; Fink, Kevin; Tapps, Tyler

2017-01-01

The purpose of this article is to share three challenge-based lesson plans that can be implemented by physical educators in their classroom. Each of the lesson examples addresses the three learning domains: psychomotor, cognitive and affective. Additionally, each lesson is aligned with SHAPE America's National Standards for K-12 Physical…

Japanese Lesson Study Sustaining Teacher Learning in the Classroom Context

ERIC Educational Resources Information Center

Loose, Crystal Corle

2014-01-01

The purposes of this action research study were first to explore teacher perceptions of Japanese lesson study as a method of professional development, and second to take teachers through an action research process as they observed the implementation of a literacy lesson in the classroom. Situated Learning Theory, particularly related to teacher…

Teachers' Professional Growth through Engagement with Lesson Study

ERIC Educational Resources Information Center

Widjaja, Wanty; Vale, Colleen; Groves, Susie; Doig, Brian

2017-01-01

Lesson study is highly regarded as a model for professional learning, yet remains under-theorised. This article examines the professional learning experiences of teachers and numeracy coaches from three schools in a local network of schools, participating in a lesson study project over two research cycles in 2012. It maps the interconnections…

Implementation of lesson study in physics teaching by group of teachers in Solok West Sumatera

NASA Astrophysics Data System (ADS)

Yurnetti, Y.

2018-04-01

This article based of collaborative classroom action research with science teachers group or MGMP at Solok West Sumatera; based on their willingness to implementation of lesson study by this group. The study started by discussing some problems according to the implementation of the lesson study, establishing the teaching materials, developing learning tools, defining the model teachers, conducting classroom activities, and reflecting by discussions. The preparation of this study includes some learning material according to temperature and heat; the observation form that led by observer teachers; teachers’s model impression and open questionnaire implementation of lesson study that applied to the students and teachers. This research got some information about the strengths and weaknesses of learning using lesson study from the students involved. To conclude, the implementation of lesson study should be able to support the principle of collaborative in learning. The challenge of this study is how to make a condition to gather some teachers in one school at a certain time because they have the schedule at their own school.

American Thyroid Association Statement on Remote-Access Thyroid Surgery

PubMed Central

Bernet, Victor; Fahey, Thomas J.; Kebebew, Electron; Shaha, Ashok; Stack, Brendan C.; Stang, Michael; Steward, David L.; Terris, David J.

2016-01-01

Background: Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. Methods: A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Results: Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillo-breast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Conclusions: Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery. PMID:26858014

American Thyroid Association Statement on Remote-Access Thyroid Surgery.

PubMed

Berber, Eren; Bernet, Victor; Fahey, Thomas J; Kebebew, Electron; Shaha, Ashok; Stack, Brendan C; Stang, Michael; Steward, David L; Terris, David J

2016-03-01

Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillo-breast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery.

Providing Simulated Online and Mobile Learning Experiences in a Prison Education Setting: Lessons Learned from the PLEIADES Pilot Project

ERIC Educational Resources Information Center

Farley, Helen; Murphy, Angela; Bedford, Tasman

2014-01-01

This article reports on the preliminary findings, design criteria and lessons learned while developing and piloting an alternative to traditional print-based education delivery within a prison environment. PLEIADES (Portable Learning Environments for Incarcerated Distance Education Students), was designed to provide incarcerated students with…

The Effect of Cooperative Learning Method and Systematic Teaching on Students' Achievement and Retention of Knowledge in Social Studies Lesson

ERIC Educational Resources Information Center

Korkmaz Toklucu, Selma; Tay, Bayram

2016-01-01

Problem Statement: Many effective instructional strategies, methods, and techniques, which were developed in accordance with constructivist approach, can be used together in social studies lessons. Constructivist education comprises active learning processes. Two active learning approaches are cooperative learning and systematic teaching. Purpose…

Experiential Learning: Lessons Learned from the UND Business and Government Symposium

ERIC Educational Resources Information Center

Harsell, Dana Michael; O'Neill, Patrick B.

2010-01-01

The authors describe lessons learned from a limited-duration experiential learning component of a Master's level course. The course is open to Master's in Business and Master's in Public Administration students and explores the relationships between government and business. A complete discussion of the Master's in Business and Master's in Public…

Reflections on Designing a MPA Service-Learning Component: Lessons Learned

ERIC Educational Resources Information Center

Roman, Alexandru V.

2015-01-01

This article provides the "lessons learned" from the experience of redesigning two sections (face-to-face and online) of a core master of public administration class as a service-learning course. The suggestions made here can be traced to the entire process of the project, from the "seed idea" through its conceptualization and…

Sustaining Student Engagement in Learning Science

ERIC Educational Resources Information Center

Ateh, Comfort M.; Charpentier, Alicia

2014-01-01

Many students perceive science to be a difficult subject and are minimally engaged in learning it. This article describes a lesson that embedded an activity to engage students in learning science. It also identifies features of a science lesson that are likely to enhance students' engagement and learning of science and possibly reverse students'…

Applying ergonomics to systems: some documented "lessons learned".

PubMed

Hendrick, Hal W

2008-07-01

Based on evidence accumulated during the author's 45 years of professional experience, the author presents 23 important "lessons learned" regarding applying ergonomics to systems. Documented results from reported cases or other evidence are presented to validate each of these practical learning points.

Extension Learning Exchange: Lessons from Nicaragua

ERIC Educational Resources Information Center

Treadwell, Paul; Lachapelle, Paul; Howe, Rod

2013-01-01

There is a clear need to support global professional development, international education, and collaborative learning opportunities in Extension. The program described here established an international learning exchange in Nicaragua to lead to global professional development and future international collaboration. The primary lessons and outcomes…

Planning Mars Memory: Learning from the MER Mission

NASA Technical Reports Server (NTRS)

Charlotte, Linde

2004-01-01

This viewgraph presentation discusses ways in which the lessons learned from a mission can be systematically remembered, retained, and applied by individuals and by an organization as a whole. The presentation cites lessons learned from the Mars Exploration Rover (MER) Mission as examples.

Commercial Orbital Transportation Services (COTS) Program Lessons Learned

NASA Technical Reports Server (NTRS)

Lindenmoyer, Alan; Horkachuck, Mike; Shotwell, Gwynne; Manners, Bruce; Culbertson, Frank

2015-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the COTS Program. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

The Impact of Toxic Agent Training on Combat Readiness

DTIC Science & Technology

1992-03-24

Desert Storm veterans, as well as Lessons Learned from the use of toxic chemicals in World War I. Conclusions reached arei (1) Live agent training is...Department of the Army staff. The report of our findings and conclusions is attached. After reviewing this report and the lessons learned from Desert Storm...analysis of feedback from soldiers in the grades of PVl to General, input from Desert Storm veterans, as well as lessons learned from the use of toxic

Prophylactic thyroidectomy for asymptomatic 3-year-old boy with positive multiple endocrine neoplasia type 2A mutation (codon 634).

PubMed

Jesić, Maja D; Tancić-Gajić, Milina; Jesić, Milos M; Zivaljević, Vladan; Sajić, Silvija; Vujović, Svetlana; Damjanović, Svetozar

2014-01-01

The multiple endocrine neoplasia type 2A (MEN 2A) syndrome, comprising medullary thyroid carcinoma (MTC), pheochromocytoma and primary hyperparathyroidism (PHPT) is most frequently caused by codon 634 activating mutations of the RET (rearranged during transfection) proto-oncogene on chromosome 10. For this codon-mutation carriers, earlier thyroidectomy (before the age of 5 years) would be advantageous in limiting the potential for the development of MTC as well as parathyroid adenomas. This is a case report of 3-year-old boy from the MEN 2A family (the boy's father and grandmother and paternal aunt) in which cysteine substitutes for phenylalanine at codon 634 in exon 11 of the RET proto-oncogene, who underwent thyroidectomy solely on the basis of genetic information. A boy had no thyromegaly, thyroidal irregularities or lymphadenopathy and no abnormality on the neck ultrasound examination. The pathology finding of thyroid gland was negative for MTC. Two years after total thyroidectomy, 5-year-old boy is healthy with permanent thyroxine replacement. His serum calcitonin level is < 2 pg/ml (normal < 13 pg/ml), has normal serum calcium and parathyroid hormone levels and negative urinary catecholamines. Long-term follow-up of this patient is required to determine whether very early thyroidectomy improves the long-term outcome of PHPT. Children with familial antecedents of MEN 2A should be genetically studied for the purpose of determining the risk of MTC and assessing the possibilities of making prophylactic thyroidectomy before the age of 5 years.

Unintentional parathyroidectomy and postoperative hypocalcaemia. Conventional thyroidectomy versus miniinvasive thyroidectomy.

PubMed

Del Rio, Paolo; De Simone, Belinda; Viani, Lorenzo; Arcuri, Maria Francesca; Sianesi, Mario

2014-01-01

Hypocalcemia and unintentional parathyroidectomy would be associated as cause of post-thyroidectomy hypocalcemia. We analysed the cases treated with total thyroidectomy by two experienced endocrine surgeons from January 2010 to December 2011 at the Unit of General Surgery and Organ Transplantation of the University Hospital of Parma. These cases were divided in two groups: "Group A" included patients for whom a histological report was made that was negative for a parathyroid avulsion, and "Group B" included patients for whom an inadvertent avulsion of the intracapsular parathyroid glands had occurred. In total, 538 patients were treated with a total thyroidectomy from January 2010 to December 2011. In 26 cases, the histological report highlighted the presence of an intracapsular parathyroid gland. The values of pre-operative calcaemia in group A and group B were 9.204 ± 0.2703 mg/dl versus 9.283 ± 0.401 mg/dl, respectively (p=0.32). The values of post-operative calcaemia were 8.039 ± 0.596 mg/dl for group A versus 7.569 ± 0.618 mg/dl for group B (p=0.0002) In Group A, 91/512 patients were treated with the minimally invasive video-assisted thyroidectomy (MIVAT) technique (17,7%), while 1/26 patients in group B was treated with a MIVAT (3,8%). Unintentional parathyroidectomies can occur with experienced surgeons, but this complication is not related to a substantial difference in the incidence of hypocalcemia. MIVAT can helps the endocrine surgeon in the detection of the parathyroids glands, but when the parathyroid is intracapsular, is difficult to preserve it, during surgical dissection.

Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma.

PubMed

Huang, Jian-Kang; Ma, Ling; Song, Wen-Hua; Lu, Bang-Yu; Huang, Yu-Bin; Dong, Hui-Ming

2016-01-01

Endoscopic thyroidectomy for minimally invasive thyroid surgery has been widely applied in the past decade. The present study aimed to evaluate the effects of single-port access transaxillary totally endoscopic thyroidectomy on the postoperative outcomes and functional parameters, including quality of life and cosmetic result in patients with papillary thyroid carcinoma (PTC). Seventy-five patients with PTC who underwent endoscopic thyroidectomy via a single-port access transaxillary approach were included (experimental group). A total of 123 patients with PTC who were subjected to conventional open total thyroidectomy served as the control group. The health-related quality of life and cosmetic and satisfaction outcomes were assessed postoperatively. The mean operation time was significantly increased in the experimental group. The physiological functions and social functions in the two groups were remarkably augmented after 6 months of surgery. However, there was no significant difference in the scores of speech and taste between the two groups at the indicated time of 1 month and 6 months. In addition, the scores for appearance, satisfaction with appearance, role-physical, bodily pain, and general health in the experimental group were better than those in the control group at 1 month and 6 months after surgery. The single-port access transaxillary totally endoscopic thyroidectomy is safe and feasible for the treatment of patients with PTC. The subjects who underwent this technique have a good perception of their general state of health and are likely to participate in social activities. It is worthy of being clinically used for patients with PTC.

Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study

PubMed Central

TARTAGLIA, F.; GIULIANI, A.; SGUEGLIA, M.; PATRIZI, G.; DI ROCCO, G.; BLASI, S.; RUSSO, G.; TORTORELLI, G.; GIANNOTTI, D.; REDLER, A.

2014-01-01

Summary Wanting to find a way of identifying patients suitable for early discharge after thyroidectomy, we set out to establish whether ionized calcium concentration is a better predictor of post-surgical hypocalcemia than total serum calcium. Data were analyzed to establish whether serum ionized calcium concentrations are correlated with total serum calcium levels and symptomatic hypocalcemia after thyroidectomy. Sixty-two patients undergoing total thyroidectomy at the Department of Surgical Sciences of the “Sapienza” University of Rome, Italy, in 2010. Ionized calcium was measured before (day 0) and after surgery (days 1, 2 and 60) in all the patients. These measurements were compared with preoperative (day 0) and postoperative total serum calcium levels (days 1, 2 and 60). The preoperative ionized calcium levels differed from the ionized calcium levels recorded on days 1 and 2; this pattern was not observed for the total calcium concentrations. Conversely, total calcium on days I and II correlated significantly with the various ionized calcium measurements. The presence of parathyroid glands in the surgical specimen did not seem to affect suitability for discharge. The statistical analysis showed that ionized calcium measurements are more reliable than total calcium measurements in the immediate and long-term follow-up of total thyroidectomy patients. Applying a 95% confidence interval we established reference values for both total serum calcium and ionized calcium, below which all patients develop postoperative symptomatic hypocalcemia. In conclusion, measurement of ionized calcium, as opposed to total calcium, should be strongly recommended in the immediate and long-term follow-up of total thyroidectomy patients. PMID:24690338

Evolution in the profile of thyroid cancer cases treated in an oncology reference service: what changed in the last 20 years.

PubMed

Lira, Renan Bezerra; Carvalho, Genival Barbosa de; Gonçalves Filho, João; Kowalski, Luiz Paulo

2014-01-01

To evaluate the characteristics of thyroid carcinoma cases treated at a reference hospital for cancer between 2008 and 2010. we studied 807 cases and analyzed the following clinicopathologic variables: symptoms, risk factors, diagnostic tests, staging, histological type, treatment performed and complications. Females were more affected, with 660 cases (82%). The average age at diagnosis was 44.5 years. Prior exposure to ionizing radiation was reported by 22 (3%) patients, a family history of thyroid cancer by 89 (11%), and 289 (36%) individuals reported other types of cancer in the family. The fine needle aspiration biopsy was the main parameter for surgical indication and was suggestive of carcinoma in 463 patients (57%). Papillary carcinoma was the most common histological type, with 780 cases (96.6%). There were 728 (90%) total thyroidectomies, 43 (5.3%) reoperations or partial thyroidectomies followed by totalization, 23 (2.8%) extended thyroidectomies and only 13 (1.6%) partial thyroidectomies (lobectomy with isthmectomy). Neck dissection associated with thyroidectomy was done in 158 patients (19.5%). We observed a predominance of tumors classified as T1 in 602 (74.6%) patients. Transient hypocalcemia was the most frequent complication. The results show that the worldwide increase in the incidence of thyroid cancer has changed the profile of patients seen at a referral service. In addition, there were changes in the type of surgical treatment used, with increased use of total thyroidectomy in relation to partial and subtotal ones, and decreased use of elective neck dissections.

Total thyroidectomy: safe and adequate treatment for papillary microcarcinoma of the thyroid gland.

PubMed

Uhliarova, B; Hajtman, A

2016-08-01

Total thyroidectomy: safe and adequate treatment for papillary microcarcinoma of the thyroid gland. The purpose of this study was to evaluate the incidence of and surgical approach in patients with papillary thyroid microcarcinoma (PTMC; thyroid cancer s10 mm) when these patients underwent surgery for presumed benign thyroid conditions. Between January 2006 and December 2013, 1460 adult patients underwent partial or total thyroidectomy for presumed benign thyroid conditions in the Department of Otorhinolaryngology, Head and Neck Surgery, Comenius University, Jessenius Faculty of Medicine, University Hospital in Martin, Slovakia. Of this population, 78 patients with incidental PTMC were further studied. Incidental papillary microcarcinoma was more frequently detected in patients with multinodular goitre (P = 0.034) or Hashimoto's thyroiditis (P=0.00 13) than in patients with other thyroid diseases. Multifocal and bilateral occurance of PTMC was identified in 26% and 18% of patients, respectively. The initial surgical procedure was -hemithyroidectomy in 23% of patients. All patients initially treated with hemithyroidectomy underwent completion thyroidectomy 10-32 days (median 19 ±7 days) after initial surgery. There were no significant differences in postoperative complications (recurrent laryngeal nerve injury, hypoparathyroidism) between patients with hemithyroidectomy and patients with total thyroidectomy at the first operation (P = 0.647). Completion surgery in patients with hemithyroidectomy was not followed by a significant increase in the incidence of complications (P=0.228). Incidental PTMC is more often detected in patients that undergo surgery for multinodular goitre and Hashimoto's thyroiditis. Total thyroidectomy constitutes a safe and adequate surgical approach in patients with PTMC.

Constellation Program: Lessons Learned. Volume 1; Executive Summary

NASA Technical Reports Server (NTRS)

Rhatigan, Jennifer L. (Editor)

2011-01-01

This document (Volume I) provides an executive summary of the lessons learned from the Constellation Program. A companion Volume II provides more detailed analyses for those seeking further insight and information. In this volume, Section 1.0 introduces the approach in preparing and organizing the content to enable rapid assimilation of the lessons. Section 2.0 describes the contextual framework in which the Constellation Program was formulated and functioned that is necessary to understand most of the lessons. Context of a former program may seem irrelevant in the heady days of new program formulation. However, readers should take some time to understand the context. Many of the lessons would be different in a different context, so the reader should reflect on the similarities and differences in his or her current circumstances. Section 3.0 summarizes key findings developed from the significant lessons learned at the program level that appear in Section 4.0. Readers can use the key findings in Section 3.0 to peruse for particular topics, and will find more supporting detail and analyses in Section 4.0 in a topical format. Appendix A contains a white paper describing the Constellation Program formulation that may be of use to readers wanting more context or background information. The reader will no doubt recognize some very similar themes from previous lessons learned, blue-ribbon committee reviews, National Academy reviews, and advisory panel reviews for this and other large-scale human spaceflight programs; including Apollo, Space Shuttle, Shuttle/Mir, and the ISS. This could represent an inability to learn lessons from previous generations; however, it is more likely that similar challenges persist in the Agency structure and approach to program formulation, budget advocacy, and management. Perhaps the greatest value of these Constellation lessons learned can be found in viewing them in context with these previous efforts to guide and advise the Agency and its stakeholders.

Constellation Program Lessons Learned. Volume 2; Detailed Lessons Learned

NASA Technical Reports Server (NTRS)

Rhatigan, Jennifer; Neubek, Deborah J.; Thomas, L. Dale

2011-01-01

These lessons learned are part of a suite of hardware, software, test results, designs, knowledge base, and documentation that comprises the legacy of the Constellation Program. The context, summary information, and lessons learned are presented in a factual format, as known and described at the time. While our opinions might be discernable in the context, we have avoided all but factually sustainable statements. Statements should not be viewed as being either positive or negative; their value lies in what we did and what we learned that is worthy of passing on. The lessons include both "dos" and "don ts." In many cases, one person s "do" can be viewed as another person s "don t"; therefore, we have attempted to capture both perspectives when applicable and useful. While Volume I summarizes the views of those who managed the program, this Volume II encompasses the views at the working level, describing how the program challenges manifested in day-to-day activities. Here we see themes that were perhaps hinted at, but not completely addressed, in Volume I: unintended consequences of policies that worked well at higher levels but lacked proper implementation at the working level; long-term effects of the "generation gap" in human space flight development, the need to demonstrate early successes at the expense of thorough planning, and the consequences of problems and challenges not yet addressed because other problems and challenges were more immediate or manifest. Not all lessons learned have the benefit of being operationally vetted, since the program was cancelled shortly after Preliminary Design Review. We avoid making statements about operational consequences (with the exception of testing and test flights that did occur), but we do attempt to provide insight into how operational thinking influenced design and testing. The lessons have been formatted with a description, along with supporting information, a succinct statement of the lesson learned, and recommendations for future programs and projects that may be placed in similar circumstances.

Why undertake a pilot in a qualitative PhD study? Lessons learned to promote success.

PubMed

Wray, Jane; Archibong, Uduak; Walton, Sean

2017-01-23

Background Pilot studies can play an important role in qualitative studies. Methodological and practical issues can be shaped and refined by undertaking pilots. Personal development and researchers' competence are enhanced and lessons learned can inform the development and quality of the main study. However, pilot studies are rarely published, despite their potential to improve knowledge and understanding of the research. Aim To present the main lessons learned from undertaking a pilot in a qualitative PhD study. Discussion This paper draws together lessons learned when undertaking a pilot as part of a qualitative research project. Important methodological and practical issues identified during the pilot study are discussed including access, recruitment, data collection and the personal development of the researcher. The resulting changes to the final study are also highlighted. Conclusion Sharing experiences of and lessons learned in a pilot study enhances personal development, improves researchers' confidence and competence, and contributes to the understanding of research. Implications for practice Pilots can be used effectively in qualitative studies to refine the final design, and provide the researcher with practical experience to enhance confidence and competence.

Reconstructing High School Chemical Reaction Lessons to Motivate and Support Conceptual Learning

NASA Astrophysics Data System (ADS)

Ndiforamang, Nathan Moma

The primary focus of this education leadership portfolio is to reconstruct lessons on chemical reaction concepts for teachers to use and reach all learners of chemistry in Cecil County Public Schools. As a high school chemistry teacher, I have observed that student enrollment in chemistry is relatively low, and students show little enthusiasm about being successful in chemistry compared to other science subjects. To understand these issues, I researched conceptual learning, misconceptions, and best practices; prepared open-ended questions in a survey for chemistry teachers in my district; distributed the survey; received their responses; and processed the information received. I analyzed the data using qualitative techniques, and the results revealed that many of the tools provided in the district's curriculum guide for chemistry were not effective in class. I used the data to search for learning tools and classroom resources that could improve students understanding of chemistry concepts. I then reconstructed eight lessons on chemical reaction concepts utilizing those tools and resources. I redistributed the reconstructed lessons to teachers who had volunteered to review the lessons and provide professional feedback. The teachers' feedback revealed that the tools and resources incorporated in the reconstructed lessons included interactive activities that would excite students. The teachers indicated that the lessons were technology rich and included a variety of learning strategies. They also noted that the lessons included too many activities to cover within a day's lesson, and some of the recommended weblinks had technical issues. Most of the suggestions received were used to improve the quality of the reconstructed lessons and will serve as a resource for future fine-tuning of the lessons.

MC-1 Engine Valves, Lessons Learned

NASA Technical Reports Server (NTRS)

Laszar, John

2003-01-01

Many lessons were learned during the development of the valves for the MC-1 engine. The purpose of this report is to focus on a variety of issues related to the engine valves and convey the lessons learned. This paper will not delve into detailed technical analysis of the components. None of the lessons learned are new or surprising, but simply reinforce the importance of addressing the details of the design early, at the component level. The Marshall Space Flight Center (MSFC), Huntsville, Alabama developed the MC-1 engine, a LOX / FW-1, 60,000 pound thrust engine. This engine was developed under the Low Cost Boost Technology office at MSFC and proved to be a very successful project for the MSFC Propulsion team and the various subcontractors working the development of the engine and its components.

The roles of lesson study in the development of mathematics learning instrument based on learning trajectory

NASA Astrophysics Data System (ADS)

Misnasanti; Dien, C. A.; Azizah, F.

2018-03-01

This study is aimed to describe Lesson Study (LS) activity and its roles in the development of mathematics learning instruments based on Learning Trajectory (LT). This study is a narrative study of teacher’s experiences in joining LS activity. Data collecting in this study will use three methods such as observation, documentations, and deep interview. The collected data will be analyzed with Milles and Huberman’s model that consists of reduction, display, and verification. The study result shows that through LS activity, teachers know more about how students think. Teachers also can revise their mathematics learning instrument in the form of lesson plan. It means that LS activity is important to make a better learning instruments and focus on how student learn not on how teacher teach.

Active Learning Institute: Energizing Science and Math Education. A Compilation of Lesson Plans.

ERIC Educational Resources Information Center

Cuyahoga Community Coll. - East, Cleveland, OH.

The middle school and high school lessons featured in this collection were crafted by science and math teachers who participated in a week-long seminar sponsored by the Eisenhower Professional Development Program administered by the Ohio Board of Regents. The lessons showcase a variety of active learning strategies from using hands-on, low-tech…

Teacher Perspectives about Lesson Study in Secondary School Departments: A Collaborative Vehicle for Professional Learning and Practice Development

ERIC Educational Resources Information Center

Cajkler, Wasyl; Wood, Phil; Norton, Julie; Pedder, David; Xu, Haiyan

2015-01-01

Two departments in a secondary school in England participated in "lesson study" projects over a five-month period to explore its usefulness as a vehicle for professional development. Through a cycle of two research lessons, conducted separately in each department, teachers identified challenges that inhibited the learning of their…

Data storage: Retrospective and prospective

NASA Technical Reports Server (NTRS)

Speliotis, Dennis E.

1993-01-01

We study history to learn from its lessons so we don't repeat the mistakes. Ironically, however, sometimes it seems that the lessons we learn from history is how to repeat the mistakes more precisely. A brief discussion about the history of magnetic recording is presented, and the lessons of the past are used to look into the future.

Deaf Children's Science Content Learning in Direct Instruction Versus Interpreted Instruction

ERIC Educational Resources Information Center

Kurz, Kim B.; Schick, Brenda; Hauser, Peter C.

2015-01-01

This research study compared learning of 6-9th grade deaf students under two modes of educational delivery--interpreted vs. direct instruction using science lessons. Nineteen deaf students participated in the study in which they were taught six science lessons in American Sign Language. In one condition, the lessons were taught by a hearing…

Five Important Lessons I Learned during the Process of Creating New Child Care Centers

ERIC Educational Resources Information Center

Whitehead, R. Ann

2005-01-01

In this article, the author describes her experiences of developing new child care sites and offers five important lessons that she learned through her experiences which helped her to create successful child care centers. These lessons include: (1) Finding an appropriate area and location; (2) Creating realistic financial projections based on real…

Conceptualizing and Describing Teachers' Learning of Pedagogical Concepts

ERIC Educational Resources Information Center

González, María José; Gómez, Pedro

2014-01-01

In this paper, we propose a model to explore how teachers learn pedagogical concepts in teacher education programs that expect them to become competent in lesson planning. In this context, we view pedagogical concepts as conceptual and methodological tools that help teachers to design a lesson plan on a topic, implement this lesson plan and assess…

Lessons Learned and Lessons To Be Learned: An Overview of Innovative Network Learning Environments.

ERIC Educational Resources Information Center

Jacobson, Michael J.; Jacobson, Phoebe Chen

This paper provides an overview of five innovative projects involving network learning technologies in the United States: (1) the MicroObservatory Internet Telescope is a collection of small, high-quality, and low-maintenance telescopes operated by the Harvard-Smithsonian Center for Astrophysics (Massachusetts), which may be used remotely via the…

From the Games Industry: Ten Lessons for Game-Based Learning

ERIC Educational Resources Information Center

Hollins, Paul; Whitton, Nicola

2011-01-01

This paper draws on lessons learned from the development process of the entertainment games industry and discusses how they can be applied to the field of game-based learning. This paper examines policy makers and those wishing to commission or develop games for learning and highlights potential opportunities as well as pitfalls. The paper focuses…

Systems Engineering Lessons Learned from Solar Array Structures and Mechanisms Deployment

NASA Technical Reports Server (NTRS)

Vipavetz, Kevin; Kraft, Thomas

2013-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the Engineering Directorate at LaRC. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

The Beaverton School District Arts for Learning (A4L) Lessons Project, an Investing in Innovation (i3) Development Grant: Student Impact Findings from Years 1, 2, and 3

ERIC Educational Resources Information Center

Nakamoto, Jonathan; Sobolew-Shubin, Sandy; Orland, Martin

2015-01-01

The purpose of this study was to assess the impact of the Arts for Learning (A4L) Lessons Project on the literacy and life skills of students in grades 3, 4, and 5. A4L Lessons is a supplementary literacy curriculum designed to blend the creativity and discipline of the arts with learning science to raise student achievement in reading and…

Heritage Adoption Lessons Learned: Cover Deployment and Latch Mechanism

NASA Technical Reports Server (NTRS)

Wincentsen, James

2006-01-01

Within JPL, there is a technology thrust need to develop a larger Cover Deployment and Latch Mechanism (CDLM) for future missions. The approach taken was to adopt and scale the CDLM design as used on the Galaxy Evolution Explorer (GALEX) project. The three separate mechanisms that comprise the CDLM will be discussed in this paper in addition to a focus on heritage adoption lessons learned and specific examples. These lessons learned will be valuable to any project considering the use of heritage designs.

Weapon System Management to Directorate of Logistics Management Systems Requirements (XRB) DCS/Plans and Programs Air Force Logistics Command Wright-Patterson AFB, Ohio 45433.

DTIC Science & Technology

1982-05-14

Attachment 2 contains the reports and lessons learned which resulted from the Level II Weapon System Management activities. Attachment 3 contains the reports...and lessons learned which resulted from the Level III Weapon System Management activities. _____ r. Air Force Logistics Command Attn: Col. McConnell 2...May 14, 1982 Attachment 4 contains the plans and lessons learned which resulted from the RCC Evaluation activities. I am pleased to deliver these

An Interview with Joe McMann: Lessons Learned from Fifty Years of Observing Hardware and Human Behavior

NASA Technical Reports Server (NTRS)

McMann, Joe

2011-01-01

Pica Kahn conducted "An Interview with Joe McMann: Lessons Learned in Human and Hardware Behavior" on August 16, 2011. With more than 40 years of experience in the aerospace industry, McMann has gained a wealth of knowledge. This presentation focused on lessons learned in human and hardware behavior. During his many years in the industry, McMann observed that the hardware development process was intertwined with human influences, which impacted the outcome of the product.

The lift-fan powered-lift aircraft concept: Lessons learned

NASA Technical Reports Server (NTRS)

Deckert, Wallace H.

1993-01-01

This is one of a series of reports on the lessons learned from past research related to lift-fan aircraft concepts. An extensive review is presented of the many lift-fan aircraft design studies conducted by both government and industry over the past 45 years. Mission applications and design integration including discussions on manifolding hot gas generators, hot gas dusting, and energy transfer control are addressed. Past lift-fan evaluations of the Avrocar are discussed. Lessons learned from these past efforts are identified.

Space Shuttle Reusable Solid Rocket Motor Program Overview and Lessons Learned

NASA Technical Reports Server (NTRS)

Graves, Stan R.; McCool, Alex (Technical Monitor)

2001-01-01

An overview of the Space Shuttle Reusable Solid Rocket Motor (RSRM) program is provided with a summary of lessons learned since the first test firing in 1977. Fifteen different lessons learned are discussed that fundamentally changed the motor's design, processing, and RSRM program risk management systems. The evolution of the rocket motor design is presented including the baseline or High Performance Solid Rocket Motor (HPM), the Filament Wound Case (FWC), the RSRM, and the proposed Five-Segment Booster (FSB).

Lessons Learned: The Pale Horse Bioterrorism Response Exercise

DTIC Science & Technology

2003-12-01

to define what the professional and personal liability of private health care providers is for Table 1. Participants in Pale Horse Tabletop Planning...Lessons Learned Lessons Learned: The “Pale Horse ” Bioterrorism Response Exercise Col. David Jarrett, MD, FACEP The city of San Antonio, Texas, and...Editorial, see p. 98 And I looked, and behold, a pale horse : and his name that sat on him was Death, and Hell followed with him. Book of Revelation 6:8 I n

The current status of robotic transaxillary thyroidectomy in the United States: an experience from two centers.

PubMed

Zaidi, Nisar; Daskalaki, Despoina; Quadri, Pablo; Okoh, Alexis; Giulianotti, Pier Cristoforo; Berber, Eren

2017-08-01

Few studies exist regarding the state of robotic transaxillary thyroidectomy (RT) and its outcomes at high-volume institutions. Eighty-nine patients underwent RT between January 2009 and September 2015 at two tertiary centers. Data were collected from prospectively-maintained IRB-approved databases. Patient demographic and clinical data, and trends were evaluated. Indications for RT included biopsy-proven or suspicion for malignancy in 20.2%, atypical cells or follicular neoplasm in 27.7%, multinodular goiter in 26.6%, thyrotoxicosis in 8.5%, need for completion thyroidectomy in 5.3%, and non-diagnostic FNA in 3.2%. 56% underwent total thyroidectomy and 44% lobectomy. Operative time (OT) was 153.5 minutes for lobectomies and 192.6 minutes for total thyroidectomy. The complication rate was 11.7%: temporary RLN neuropraxia in 2 patients, permanent hypoparathyroidism in 1 patient, temporary hypoparathyroidism in 6 patients, flap seroma in 1 patient, and flap hematoma in 1 patient. Pathology showed malignancy in 43 patients. At a mean follow-up of 31.9 months, there were no recurrences. Since 2013, the number of RTs performed has risen. The number of out-of-state patients increased from 18% to 37% after 2011. RT was performed without compromising outcomes in selected patients. There remains interest among patients seeking this procedure in expert centers.

Long-term esophageal motility changes after thyroidectomy: associations with aerodigestive disorders.

PubMed

Scerrino, G; Inviati, A; Di Giovanni, S; Paladino, N C; Di Giovanni, S; Paladino, N C; Di Paola, V; Raspanti, C; Melfa, G I; Cupido, F; Mazzola, S; Porrello, C; Bonventre, S; Gullotta, G

2017-01-01

Patients undergoing thyroidectomy often complain aerodigestive disorders. In a previous study we showed the associations between voice impairment and proximal acid reflux, swallowing impairment and Upper Esophageal Sphyncter (UES) incoordination and the decrease in UES pressure in thirty-six patients observed before and soon afterwards uncomplicated thyroidectomy. This study investigated the state of post-thyroidectomy esophageal motility changes and its associations with these disorders after 18-24 months. The thirty-six patients prospectively recruited according to selection criteria (thyroid volume ≤60 ml, benign disease, age 18-65 years, previous neck surgery, thyroiditis, pre- or postoperative vocal cord palsy) underwent voice (VIS) and swallowing (SIS) impairment scores, esophageal manometry and pH monitoring once again. After 18-24 months, both VIS and SIS recovered (respectively: p=0,022; p=0,0001); UES pressure increased (p=0,0001) nearing the preoperative values. The persistence of swallowing complaints were associated with the persistence of esophageal incoordination (p=0,03); the association between voice impairment and proximal acid reflux was confirmed (p<0,001). Our study confirms that aerodigestive disorders after uncomplicated thyroidectomy, largely transient, are strictly connected with upper esophageal motility changes. In this viewpoint, the innervation of upper aerodigestive anatomical structures (larynx, pharynx, upper esophagus) and its variations should be focused.

Hypocalcaemia following thyroidectomy for treatment of Graves' disease: implications for patient management and cost-effectiveness.

PubMed

Hughes, O R; Scott-Coombes, D M

2011-08-01

No consensus exists on optimal treatment for Graves' disease once anti-thyroid medication fails to induce remission. Total thyroidectomy is a more cost-effective treatment than radioactive iodine or life-long anti-thyroid medication, but hypocalcaemia is an important complication, leading to longer hospital admissions and increased prescription costs. This study aimed to compare the relative risk of hypocalcaemia requiring medical treatment for patients with Graves' disease. Prospective cohort study of patients undergoing total thyroidectomy for Graves' disease and for multinodular goitre, calculating serum calcium levels 24-hours post-operatively and prescription rates. Mean corrected calcium concentrations 24 hours post-operatively were 2.05 mmol/l for Graves' disease patients and 2.14 mmol/l for multinodular goitre patients (p = 0.003). Biochemical hypocalcaemia developed in 92 per cent (n = 34) of Graves' disease patients and 71 per cent (n = 43) of multinodular goitre patients (p = 0.012). Graves' disease patients were more likely to be prescribed calcium supplementation pre-discharge (p = 0.037). Total thyroidectomy for Graves' disease carries an increased risk of hypocalcaemia at 24 hours, and of calcium supplementation pre-discharge. Graves' disease patients should be informed of the increased risk of hypocalcaemia associated with total thyroidectomy, and this risk must be factored into future cost-effectiveness analysis.

A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

PubMed

Mohan, Vinuta; Lind, Robert

2016-01-01

Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

Higher Education ERP: Lessons Learned.

ERIC Educational Resources Information Center

Swartz, Dave; Orgill, Ken

2001-01-01

Shares experiences and lessons learned by chief information officers of large universities about enterprise resource planning (ERP). Specifically, provides a framework for approaching an ERP that could save universities millions of dollars. (EV)

A study: Effect of Students Peer Assisted Learning on Magnetic Field Achievement

NASA Astrophysics Data System (ADS)

Mueanploy, Wannapa

2016-04-01

This study is the case study of Physic II Course for students of Pathumwan Institute of Technology. The purpose of this study is: 1) to develop cooperative learning method of peer assisted learning (PAL), 2) to compare the learning achievement before and after studied magnetic field lesson by cooperative learning method of peer assisted learning. The population was engineering students of Pathumwan Institute of Technology (PIT’s students) who registered Physic II Course during year 2014. The sample used in this study was selected from the 72 students who passed in Physic I Course. The control groups learning magnetic fields by Traditional Method (TM) and experimental groups learning magnetic field by method of peers assisted learning. The students do pretest before the lesson and do post-test after the lesson by 20 items achievement tests of magnetic field. The post-test higher than pretest achievement significantly at 0.01 level.

Development of short Indonesian lesson plan to improve teacher performance

NASA Astrophysics Data System (ADS)

Yulianto, B.; Kamidjan; Ahmadi, A.; Asteria, P. V.

2018-01-01

The developmental research was motivated by the results of preliminary study through interviews, which revealed almost all of the teachers did not create lesson plan themselves. As a result of this load, the performance of the real learning in the classroom becomes inadequate. Moreover, when lesson plan was not made by teachers themselves, the learning process becomes ineffective. Therefore, this study designed to develop a prototype of the short lesson plan, in particular, Indonesian language teaching, and to investigate its effectiveness. The participants in the study were teachers who were trained through lesson study group to design short model’s lesson plan. Questionnaires and open-ended questions were used, and the quantitative and qualitative data obtained were analyzed accordingly. The analysis of the quantitative data, aided with SPSS, were frequency, percentage, and means, whereas the qualitative data were analyzed descriptively. The results showed that the teachers liked the model, and they were willing to design their own lesson plan. The observation data revealed that the classroom learning process became more interactive, and classroom atmosphere was more engaging and natural because the teachers did not stick to the lesson plan made by other teachers.

Shaping Interpersonal Learning in the Jazz Improvisation Lesson: Observing a Dynamic Systems Approach

ERIC Educational Resources Information Center

de Bruin, Leon Rene

2018-01-01

Music institutions predominantly utilize the one-to-one lesson in developing and supporting music students' learning of skill and knowledge. This article explores the effect that interpersonal interaction plays in shaping pedagogical applications between teacher and student. Observing the learning of improvisation within this individualized social…

Applying Universal Design for Learning to Instructional Lesson Planning

ERIC Educational Resources Information Center

McGhie-Richmond, Donna; Sung, Andrew N.

2013-01-01

Universal Design for Learning is a framework for developing inclusive instructional lesson plans. The effects of introducing Universal Design for Learning Principles and Guidelines in a university teacher education program with pre-service and practicing teachers were explored in a mixed methods approach. The results indicate that the study…

Lessons Learned from Introducing Social Media Use in Undergraduate Economics Research

ERIC Educational Resources Information Center

O'Brien, Martin; Freund, Katarina

2018-01-01

The research process and associated literacy requirements are often unfamiliar and daunting obstacles for undergraduate students. The use of social media has the potential to assist research training and encourage active learning, social inclusion and student engagement. This paper documents the lessons learned from developing a blended learning…

"Periscope": Looking into Learning in Best-Practices Physics Classrooms

ERIC Educational Resources Information Center

Scherr, Rachel E.; Goertzen, Renee Michelle

2018-01-01

"Periscope" is a set of lessons to support learning assistants, teaching assistants, and faculty in learning to notice and interpret classroom events the way an accomplished teacher does. "Periscope" lessons are centered on video episodes from a variety of best-practices university physics classrooms. By observing, discussing,…

Blended Learning of Programming in the Internet Age

ERIC Educational Resources Information Center

Djenic, S.; Krneta, R.; Mitic, J.

2011-01-01

This paper presents an advanced variant of learning programming by the use of the Internet and multimedia. It describes the development of a blended learning environment, which, in addition to classroom (face-to-face) lessons, introduces lessons delivered over the Internet: the use of multimedia teaching material with completely dynamic…

Integrating the Core Curriculum through Cooperative Learning. Lesson Plans for Teachers.

ERIC Educational Resources Information Center

Winget, Patricia L., Ed.

Cooperative learning strategies are used to facilitate the integration of multicultural and multi-ability level students into California regular education classrooms. This handbook is a sampling of innovative lesson plans using cooperative learning activities developed by teachers to incorporate the core curriculum into their instruction. Three…

Webinar Presentation: Phthalates Exposures through Diet: Lessons Learned

EPA Pesticide Factsheets

This presentation, Phthalates Exposures through Diet: Lessons Learned, was given at the NIEHS/EPA Children's Centers 2015 Webinar Series: Phthalates in the Diet and in our Homes held on June 10, 2015.

Web Cast on Arsenic Demonstration Program: Lessons Learned

EPA Science Inventory

Web cast presentation covered 10 Lessons Learned items selected from the Arsenic Demonstration Program with supporting information. The major items discussed include system design and performance items and the cost of the technologies.

Best Practices and Lessons Learned In LANL Approaches to Transportation Security

DOE Office of Scientific and Technical Information (OSTI.GOV)

Drypolcher, Katherine Carr

Presentation includes slides on Physical Protection of Material in Transit; Graded Approach for Implementation Controls; Security Requirements; LANL Lessons Learned; Shipping Violation; Unmonitored Shipment; Foreign shipment; and the Conclusion.

Lessons Learned from the Node 1 Atmosphere Control and Storage and Water Recovery and Management Subsystem Design

NASA Technical Reports Server (NTRS)

Williams, David E.

2010-01-01

Node 1 flew to the International Space Station (ISS) on Flight 2A during December 1998. To date the National Aeronautics and Space Administration (NASA) has learned a lot of lessons from this module based on its history of approximately two years of acceptance testing on the ground and currently its twelve years on-orbit. This paper will provide an overview of the ISS Environmental Control and Life Support (ECLS) design of the Node 1 Atmosphere Control and Storage (ACS) and Water Recovery and Management (WRM) subsystems and it will document some of the lessons that have been learned to date for these subsystems based on problems prelaunch, problems encountered on-orbit, and operational problems/concerns. It is hoped that documenting these lessons learned from ISS will help in preventing them in future Programs.

Lessons Learned from the Node 1 Atmosphere Control and Storage and Water Recovery and Management Subsystem Design

NASA Technical Reports Server (NTRS)

Williams, David E.

2011-01-01

Node 1 flew to the International Space Station (ISS) on Flight 2A during December 1998. To date the National Aeronautics and Space Administration (NASA) has learned a lot of lessons from this module based on its history of approximately two years of acceptance testing on the ground and currently its twelve years on-orbit. This paper will provide an overview of the ISS Environmental Control and Life Support (ECLS) design of the Node 1 Atmosphere Control and Storage (ACS) and Water Recovery and Management (WRM) subsystems and it will document some of the lessons that have been learned to date for these subsystems based on problems prelaunch, problems encountered on-orbit, and operational problems/concerns. It is hoped that documenting these lessons learned from ISS will help in preventing them in future Programs.

Importance Of Quality Control in Reducing System Risk, a Lesson Learned From The Shuttle and a Recommendation for Future Launch Vehicles

NASA Technical Reports Server (NTRS)

Safie, Fayssal M.; Messer, Bradley P.

2006-01-01

This paper presents lessons learned from the Space Shuttle return to flight experience and the importance of these lessons learned in the development of new the NASA Crew Launch Vehicle (CLV). Specifically, the paper discusses the relationship between process control and system risk, and the importance of process control in improving space vehicle flight safety. It uses the External Tank (ET) Thermal Protection System (TPS) experience and lessons learned from the redesign and process enhancement activities performed in preparation for Return to Flight after the Columbia accident. The paper also, discusses in some details, the Probabilistic engineering physics based risk assessment performed by the Shuttle program to evaluate the impact of TPS failure on system risk and the application of the methodology to the CLV.

Iterating between lessons on concepts and procedures can improve mathematics knowledge.

PubMed

Rittle-Johnson, Bethany; Koedinger, Kenneth

2009-09-01

Knowledge of concepts and procedures seems to develop in an iterative fashion, with increases in one type of knowledge leading to increases in the other type of knowledge. This suggests that iterating between lessons on concepts and procedures may improve learning. The purpose of the current study was to evaluate the instructional benefits of an iterative lesson sequence compared to a concepts-before-procedures sequence for students learning decimal place-value concepts and arithmetic procedures. In two classroom experiments, sixth-grade students from two schools participated (N=77 and 26). Students completed six decimal lessons on an intelligent-tutoring systems. In the iterative condition, lessons cycled between concept and procedure lessons. In the concepts-first condition, all concept lessons were presented before introducing the procedure lessons. In both experiments, students in the iterative condition gained more knowledge of arithmetic procedures, including ability to transfer the procedures to problems with novel features. Knowledge of concepts was fairly comparable across conditions. Finally, pre-test knowledge of one type predicted gains in knowledge of the other type across experiments. An iterative sequencing of lessons seems to facilitate learning and transfer, particularly of mathematical procedures. The findings support an iterative perspective for the development of knowledge of concepts and procedures.

Encouraging Problem-Solving Disposition in a Singapore Classroom

ERIC Educational Resources Information Center

Leong, Yew Hoong; Yap, Sook Fwe; Quek, Khiok Seng; Tay, Eng Guan; Tong, Cherng Luen; Ong, Yao Teck; Chia, Alexander Stanley Foh Soon; Zaini, Irni Karen Mohd; Khong, Wee Choo; Lock, Oi Leng; Zhang, Qiao Tian Beatrice; Tham, Yi Hui; Noorhazman, Nur-Illya Nafiza Mohamed

2013-01-01

In this article, we share our learning experience as a Lesson Study team. The Research Lesson was on Figural Patterns taught in Year 7. In addition to helping students learn the skills of the topic, we wanted them to develop a problem-solving disposition. The management of these two objectives was a challenge to us. From the lesson observation and…

Learning Study: Helping Teachers to Use Theory, Develop Professionally, and Produce New Knowledge to Be Shared

ERIC Educational Resources Information Center

Pang, Ming Fai; Ling, Lo Mun

2012-01-01

The lesson study approach is a systematic process for producing professional knowledge about teaching by teachers, and has spread rapidly and extensively in the United States. The learning study approach is essentially a kind of lesson study with an explicit learning theory--the variation theory of learning. In this paper, we argue that having an…

Academic-Community Partnership for Medical Missions: Lessons Learned and Practical Guidance for Global Health Service-Learning Experiences.

PubMed

Dang, Yen H; Nice, Frank J; Truong, Hoai-An

2017-01-01

To facilitate an academic-community partnership for sustainable medical mis-sions, a 12-step process was created for an interprofessional, global health educational, and service-learning experience for students and faculty in a school of pharmacy and health professions. Lessons learned and practical guidance are provided to implement similar global health opportunities.

Community Learning Campus: It Takes a Simple Message to Build a Complex Project

ERIC Educational Resources Information Center

Pearson, George

2012-01-01

Education Canada asked Tom Thompson, president of Olds College and a prime mover behind the Community Learning Campus (CLC): What were the lessons learned from this unusually ambitious education project? Thompson mentions six lessons he learned from this complex project which include: (1) Dream big, build small, act now; (2) Keep a low profile at…

Perceived Advantages of 3D Lessons in Constructive Learning for South African Student Teachers Encountering Learning Barriers

ERIC Educational Resources Information Center

de Jager, Thelma

2017-01-01

Research shows that three-dimensional (3D)-animated lessons can contribute to student teachers' effective learning and comprehension, regardless of the learning barriers they experience. Student teachers majoring in the subject Life Sciences in General Subject Didactics viewed 3D images of the heart during lectures. The 3D images employed in the…

Engaging the Deaf American Sign Language Community: Lessons From a Community-Based Participatory Research Center

PubMed Central

McKee, Michael; Thew, Denise; Starr, Matthew; Kushalnagar, Poorna; Reid, John T.; Graybill, Patrick; Velasquez, Julia; Pearson, Thomas

2013-01-01

Background Numerous publications demonstrate the importance of community-based participatory research (CBPR) in community health research, but few target the Deaf community. The Deaf community is understudied and underrepresented in health research despite suspected health disparities and communication barriers. Objectives The goal of this paper is to share the lessons learned from the implementation of CBPR in an understudied community of Deaf American Sign Language (ASL) users in the greater Rochester, New York, area. Methods We review the process of CBPR in a Deaf ASL community and identify the lessons learned. Results Key CBPR lessons include the importance of engaging and educating the community about research, ensuring that research benefits the community, using peer-based recruitment strategies, and sustaining community partnerships. These lessons informed subsequent research activities. Conclusions This report focuses on the use of CBPR principles in a Deaf ASL population; lessons learned can be applied to research with other challenging-to-reach populations. PMID:22982845

Lesson Plans: Road Maps for the Active Learning Classroom.

PubMed

Moore-Cox, Annie

2017-11-01

Lesson planning is a documentation process used extensively in education from kindergarten through 12th grade, but rarely in higher education, including undergraduate, prelicensure nursing education. Lesson plans help teachers plan what will happen during a class period from moment to moment. Trends in nursing education, such as the incorporation of active learning strategies in the classroom, make lesson plans a timely addition to the nurse educator's toolkit. This article describes the components of a lesson plan and offers an author-developed template for use in nursing education. Using the template helps nurse educators map out activities for all class participants, such as students, student pairs and teams, and faculty. The lesson plan enables faculty to plot out the many dynamic components of an active learning class period. It also serves as a road map for subsequent faculty, which is an important feature as the profession faces a wave of retirements in the coming decade. [J Nurs Educ. 2017;56(11):697-700.]. Copyright 2017, SLACK Incorporated.

Quality of information available on the World Wide Web for patients undergoing thyroidectomy: review.

PubMed

Muthukumarasamy, S; Osmani, Z; Sharpe, A; England, R J A

2012-02-01

This study aimed to assess the quality of information available on the World Wide Web for patients undergoing thyroidectomy. The first 50 web-links generated by internet searches using the five most popular search engines and the key word 'thyroidectomy' were evaluated using the Lida website validation instrument (assessing accessibility, usability and reliability) and the Flesch Reading Ease Score. We evaluated 103 of a possible 250 websites. Mean scores (ranges) were: Lida accessibility, 48/63 (27-59); Lida usability, 36/54 (21-50); Lida reliability, 21/51 (4-38); and Flesch Reading Ease, 43.9 (2.6-77.6). The quality of internet health information regarding thyroidectomy is variable. High ranking and popularity are not good indicators of website quality. Overall, none of the websites assessed achieved high Lida scores. In order to prevent the dissemination of inaccurate or commercially motivated information, we recommend independent labelling of medical information available on the World Wide Web.

A misdiagnosed Riedel's thyroiditis successfully treated by thyroidectomy and tamoxifen.

PubMed

Wang, Chih-Jung; Wu, Ta-Jen; Lee, Chung-Ta; Huang, Shih-Ming

2012-12-01

Riedel's thyroiditis, known as invasive fibrous thyroiditis, is a very rare form of chronic thyroiditis. It is hard to make the diagnosis without surgical biopsy. We present a case of Riedel's thyroiditis in a 52-year-old female with past history of Hashimoto's thyroiditis. She suffered from bilateral neck pain, which radiated to both lower jaws. The erythrocyte sedimentation rate was 125 mm/hour. Subacute thyroiditis superimposed on Hashimoto's thyroiditis was diagnosed and treated with steroid. However the response was poor and she had a history of severe peptic ulcer. To avoid inducing the peptic ulcer by steroid, she received bilateral subtotal thyroidectomy. During surgery, the thyroid had severe adhesion to surrounding soft tissue and the pathology showed Riedel's thyroiditis. The neck pain improved after thyroidectomy. Tamoxifen has been given for 8 months and the size of remnant thyroid decreased to 8 mm. We concluded that combined thyroidectomy and tamoxifen successfully cured a patient with Riedel's thyroiditis. Copyright © 2012. Published by Elsevier B.V.

A Case of Type 2 Amiodarone-Induced Thyrotoxicosis That Underwent Total Thyroidectomy under High-Dose Steroid Administration

PubMed Central

Hashimoto, Koshi; Ota, Masaki; Irie, Tadanobu; Takata, Daisuke; Nakajima, Tadashi; Kaneko, Yoshiaki; Tanaka, Yuko; Matsumoto, Shunichi; Nakajima, Yasuyo; Kurabayashi, Masahiko; Oyama, Tetsunari; Takeyoshi, Izumi; Mori, Masatomo; Yamada, Masanobu

2015-01-01

Amiodarone is used commonly and effectively in the treatment of arrhythmia; however, it may cause thyrotoxicosis categorized into two types: iodine-induced hyperthyroidism (type 1 amiodarone-induced thyrotoxicosis (AIT)) and destructive thyroiditis (type 2 AIT). We experienced a case of type 2 AIT, in which high-dose steroid was administered intravenously, and we finally decided to perform total thyroidectomy, resulting in a complete cure of the AIT. Even though steroid had been administered to the patient (maximum 80 mg of prednisolone), the operation was performed safely and no acute adrenal crisis as steroid withdrawal syndrome was found after the operation. Few cases of type 2 AIT that underwent total thyroidectomy with high-dose steroid administration have been reported. The current case suggests that total thyroidectomy should be taken into consideration for patients with AIT who cannot be controlled by medical treatment and even in those under high-dose steroid administration. PMID:25664188

Management of the thyroid gland during laryngectomy.

PubMed

Li, S X; Polacco, M A; Gosselin, B J; Harrington, L X; Titus, A J; Paydarfar, J A

2017-08-01

This study aimed to: describe the incidence of thyroid gland involvement in advanced laryngeal cancer, analyse patterns of spread to the thyroid and elucidate predictors of thyroid involvement. A retrospective review was performed on patients who underwent laryngectomy from 1991 to 2015 as a primary or salvage treatment for squamous cell carcinoma of the larynx, hypopharynx or base of tongue. The incidence of thyroidectomy during total laryngectomy, type of thyroidectomy, incidence of gland involvement, route of spread, and positive predictors of spread were analysed and reported. A total of 188 patients fit the inclusion criteria. Of these, 125 (66 per cent) underwent thyroidectomy. The thyroid was involved in 10 of the 125 patients (8 per cent), 9 by direct extension and 1 by metastasis. Cartilage invasion was a predictor of thyroid gland involvement, with a positive predictive value of 26 per cent. There is a low incidence of thyroid gland involvement in laryngeal carcinoma. Most cases of gland involvement occurred by direct extension. Thyroidectomy during laryngectomy should be considered for advanced stage tumours with cartilage invasion.

[Surgical aspects of radicalism in the treatment of the thyroid gland cancer].

PubMed

Sterniuk, Iu M; Niederle, B

2007-07-01

The results of surgical treatment of 149 patients, suffering differentiated cancer of the thyroid gland (CTG) and 89--with medullar pathology were analyzed. In differentiated CTG the recurrence after performance of subtotal resection of the organ had occurred in (41.2 +/- 12.3)% observations, after thyroidectomy performance without cervical lymph nodes (LN) dissection--in (31.1 +/- 5.9)%, after thyroidectomy with LN dissection--in (11.3 +/- 3.8)%. The operation radicalism for differentiated CTG secures, as minimum, by application of thyroidectomy with central LN dissection. For optimization of indications for dissection of lateral and mediastinal LN diagnostic lymphadenectomy is performed or the process stage is analyzed. Radicalism of surgical intervention for medullar cancer necessitates as minimal procedure thyroidectomy, dissection of central and also, for prophylaxis, lateral LN during the first stage of the operation, securing in 60% of patients the treatment radicalism. While application of radical surgical tactics only during performance of subsequent (for recurrence) operations the essential lowering of calcitonin level is observed only in 17.6% of patients.

Role of prophylactic thyroidectomy in RET 790 familial medullary thyroid carcinoma.

PubMed

Bihan, Hélène; Baudin, Eric; Meas, Taly; Leboulleux, Sophie; Al Ghuzlan, Abir; Hannoteaux, Véronique; Travagli, Jean-Paul; Valleur, Patrice; Guillausseau, Pierre-Jean; Cohen, Régis

2012-04-01

We describe a family harboring RET 790 mutation and review the role of prophylactic thyroidectomy for medullary thyroid carcinoma. We evaluated in detail both clinical and biological follow-up and reviewed literature reports. Among 86 family members, 15 of 22 members screened harbored the 790 mutation. Abnormal calcitonin levels were found in 8/15. Total thyroidectomy with lymph node dissection cured the 5 operated patients (range, 45-76 years). Tumor staging was pT1N0M0. Among 10 carriers who did not undergo surgery, 3 patients had abnormal calcitonin levels. For the others, calcitonin levels remained <30 pg/mL. Two asymptomatic carriers were older than 70 years. Four subjects were lost to follow-up. In RET codon 790 mutations families, a case-by-case decision instead of systematic prophylactic thyroidectomy should be discussed. Difficulties of follow-up should be taken into account and represent the main challenge. Copyright © 2011 Wiley Periodicals, Inc.

Bee SAFE, a Skill-Building Intervention to Enhance CAM Health Literacy: Lessons Learned.

PubMed

Shreffler-Grant, Jean; Nichols, Elizabeth G; Weinert, Clarann

2018-05-01

The purpose is to describe a feasibility study of a skill-building intervention to enhance health literacy about complementary and alternative (CAM) therapies among older rural adults and share lessons learned. A study was designed to examine the feasibility of an intervention to enhance CAM health literacy. The theme was "Bee SAFE" for Be a wise user of CAM, Safety, Amount, From where, and Effect. Modules were presented face to face and by webinar with older adults at a senior center in one small rural community. The team achieved its purpose of designing, implementing, and evaluating the intervention and assessing if it could be implemented in a rural community. The implementation challenges encountered and lessons learn are discussed. By improving CAM health literacy, older rural adults with chronic health conditions can make well-reasoned decisions about using CAM for health promotion and illness management. The goal is to implement the Bee SAFE intervention in other rural communities; thus team members were attentive to lessons to be learned before investing time, effort, and expense in the larger intervention. It is hoped that the lessons learned can be instructive to others planning projects in rural communities.

University Hospital Struck Deaf and Silent by Lightning: Lessons to Learn.

PubMed

Dami, Fabrice; Carron, Pierre-Nicolas; Yersin, Bertrand; Hugli, Olivier

2015-08-01

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident.

Retrieval Lesson Learned from NAST-I Hyperspectral Data

NASA Technical Reports Server (NTRS)

Zhou, Daniel K.; Smith, William L.; Liu, Xu; Larar, Allen M.; Mango, Stephen A.

2007-01-01

The retrieval lesson learned is important to many current and future hyperspectral remote sensors. Validated retrieval algorithms demonstrate the advancement of hyperspectral remote sensing capabilities to be achieved with current and future satellite instruments.

Lesson Study-Building Communities of Learning Among Pre-Service Science Teachers

NASA Astrophysics Data System (ADS)

Hamzeh, Fouada

Lesson Study is a widely used pedagogical approach that has been used for decades in its country of origin, Japan. It is a teacher-led form of professional development that involves the collaborative efforts of teachers in co-planning and observing the teaching of a lesson within a unit for evidence that the teaching practices used help the learning process (Lewis, 2002a). The purpose of this research was to investigate if Lesson Study enables pre-service teachers to improve their own teaching in the area of science inquiry-based approaches. Also explored are the self-efficacy beliefs of one group of science pre-service teachers related to their experiences in Lesson Study. The research investigated four questions: 1) Does Lesson Study influence teacher preparation for inquiry-based instruction? 2) Does Lesson Study improve teacher efficacy? 3) Does Lesson Study impact teachers' aspiration to collaborate with colleagues? 4) What are the attitudes and perceptions of pre-service teachers to the Lesson Study idea in Science? The 12 participants completed two pre- and post-study surveys: STEBI- B, Science Teaching Efficacy Belief Instrument (Enochs & Riggs, 1990) and ASTQ, Attitude towards Science Teaching. Data sources included student teaching lesson observations, lesson debriefing notes and focus group interviews. Results from the STEBI-B show that all participants measured an increase in efficacy throughout the study. This study added to the body of research on teaching learning communities, professional development programs and teacher empowerment.

Tracking voice change after thyroidectomy: application of spectral/cepstral analyses.

PubMed

Awan, Shaheen N; Helou, Leah B; Stojadinovic, Alexander; Solomon, Nancy Pearl

2011-04-01

This study evaluates the utility of perioperative spectral and cepstral acoustic analyses to monitor voice change after thyroidectomy. Perceptual and acoustic analyses were conducted on speech samples (sustained vowel /α/ and CAPE-V sentences) provided by 70 participants (36 women and 34 men) at four study time points: prior to thyroid surgery and 2 weeks, 3 months and 6 months after thyroidectomy. Repeated measures analyses of variance focused on the relative amplitude of the dominant harmonic in the voice signal (cepstral peak prominence, CPP), the ratio of low-to-high spectral energy, and their respective standard deviations (SD). Data were also examined for relationships between acoustic measures and perceptual ratings of overall severity of voice quality. Results showed that perceived overall severity and the acoustic measures of the CPP and its SD (CPPsd) computed from sentence productions were significantly reduced at 2-week post-thyroidectomy for 20 patients (29% of the sample) who had self-reported post-operative voice change. For this same group of patients, the CPP and CPPsd computed from sentence productions improved significantly from 2-weeks post-thyroidectomy to 6-months post-surgery. CPP and CPPsd also correlated well with perceived overall severity (r = -0.68 and -0.79, respectively). Measures of CPP from sustained vowel productions were not as effective as those from sentence productions in reflecting voice deterioration in the post-thyroidectomy patients at the 2-week post-surgery time period, were weaker correlates with perceived overall severity, and were not as effective in discriminating negative voice outcome (NegVO) from normal voice outcome (NormVO) patients as compared to the results from the sentence-level stimuli. Results indicate that spectral/cepstral analysis methods can be used with continuous speech samples to provide important objective data to document the effects of dysphonia in a post-thyroidectomy patient sample. When used in conjunction with patient's self-report and other general measures of vocal dysfunction, the acoustic measures employed in this study contribute to a complete profile of the patient's vocal condition.

Lessons Learned from Optical Payload for Lasercomm Science (OPALS) Mission Operations

NASA Technical Reports Server (NTRS)

Sindiy, Oleg V.; Abrahamson, Matthew J.; Biswas, Abhijit; Wright, Malcolm W.; Padams, Jordan H.; Konyha, Alexander L.

2015-01-01

This paper provides an overview of Optical Payload for Lasercomm Science (OPALS) activities and lessons learned during mission operations. Activities described cover the periods of commissioning, prime, and extended mission operations, during which primary and secondary mission objectives were achieved for demonstrating space-to-ground optical communications. Lessons learned cover Mission Operations System topics in areas of: architecture verification and validation, staffing, mission support area, workstations, workstation tools, interfaces with support services, supporting ground stations, team training, procedures, flight software upgrades, post-processing tools, and public outreach.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, the Apollo, Challenger, Columbia Lessons Learned Program manager, welcomes participants to the Apollo 1 Lessons Learned presentation in the Training Auditorium at NASA’s Kennedy Space Center in Florida. The program's theme was "To There and Back Again." Guest panelists included Charlie Duke, former Apollo 16 astronaut and member of the Apollo 1 Emergency Egress Investigation Team; Ernie Reyes, retired, Apollo 1 senior operations engineer; and John Tribe, retired, Apollo 1 Reaction and Control System lead engineer. The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Biomimicry as a route to new materials: what kinds of lessons are useful?

PubMed

Reed, Emily J; Klumb, Lisa; Koobatian, Maxwell; Viney, Christopher

2009-04-28

We consider the attributes of a successful engineered material, acknowledging the contributions of composition and processing to properties and performance. We recognize the potential for relevant lessons to be learned from nature, at the same time conceding both the limitations of such lessons and our need to be selective. We then give some detailed attention to the molecular biomimicry of filamentous phage, the process biomimicry of silk and the structure biomimicry of hippopotamus 'sweat', in each case noting that the type of lesson now being learned is not the same as the potential lesson that originally motivated the study.

Hypocalcaemia following thyroidectomy unresponsive to oral therapy.

PubMed

Etheridge, Zac C; Schofield, Christopher; Prinsloo, Peter J J; Sturrock, Nigel D C

2014-01-01

Hypocalcaemia due to hypoparathyroidism following thyroidectomy is a relatively common occurrence. Standard treatment is with oral calcium and vitamin D replacement therapy; lack of response to oral therapy is rare. Herein we describe a case of hypoparathyroidism following thyroidectomy unresponsive to oral therapy in a patient with a complex medical history. We consider the potential causes in the context of calcium metabolism including: poor adherence, hungry bone syndrome, malabsorption, vitamin D resistance, bisphosphonate use and functional hypoparathyroidism secondary to magnesium deficiency. Malabsorption due to intestinal hurry was likely to be a contributory factor in this case and very large doses of oral therapy were required to avoid symptomatic hypocalcaemia.

E-Learning and Development: Lessons from Multi-Disciplinary Capacity Strengthening

ERIC Educational Resources Information Center

Babu, Suresh Chandra

2014-01-01

This paper documents the experience and lessons from implementing an e-learning program aimed at creating multidisciplinary research capacity. It presents a case study of bringing together a multidisciplinary group of professionals on-line to learn the skills needed to be a successful researcher in the context of HIV/AIDS and food security…

Effects of Detailed Illustrations on Science Learning: An Eye-Tracking Study

ERIC Educational Resources Information Center

Lin, Yu Ying; Holmqvist, Kenneth; Miyoshi, Kiyofumi; Ashida, Hiroshi

2017-01-01

The eye-tracking method was used to assess the influence of detailed, colorful illustrations on reading behaviors and learning outcomes. Based on participants' subjective ratings in a pre-study, we selected eight one-page human anatomy lessons. In the main study, participants learned these eight human anatomy lessons; four were accompanied by…

Assessment and Program Accountability in Early Childhood Education: Lessons Learned in Ohio

ERIC Educational Resources Information Center

Boat, Mary; Zorn, Debbie; Austin, James T.

2005-01-01

Ensuring that children, especially those from disadvantaged backgrounds, start school ready to learn is an important goal. This paper presents lessons learned from the state of Ohio's multi-year program to develop a standards-based assessment system for programs delivering state-funded early childhood education (ECE) through programs receiving…

The Cispus Experience: A Curriculum Guide for the Cispus Learning Center.

ERIC Educational Resources Information Center

Association of Washington School Principals, Olympia.

This curriculum guide presents lesson plans for outdoor and environmental education at the Cispus Learning Center, a camp in Randle, Washington. Objectives for the Cispus experience cover student learning of content, socialization as a team member, development of aesthetic awareness of nature and art, and increased physical wellness. Lesson plans…

Creating Teacher Communities of Inquiry through Lesson Study

ERIC Educational Resources Information Center

Widjaja, Wanty

2013-01-01

Opportunities for teachers to engage in collaborative learning to examine and reflect on their practice are vital for sustained professional learning. Lesson Study centres on teachers coming together with colleagues to plan, observe, and reflect on classroom teaching and learning as a Community of Inquiry. In this project, six teachers from three…

Novice Teachers' Perspectives on Learning in Lesson Rehearsals in Second Language Teacher Preparation

ERIC Educational Resources Information Center

Troyan, Francis John; Peercy, Megan Madigan

2016-01-01

Although scholars working in core practices have put forth lesson rehearsals as central to novice teachers' learning and development, there is little work on how novice teachers experience rehearsals. This qualitative research investigated learning opportunities for novice teachers of language learners during rehearsals. The analysis examines two…

The Effects of Variations in Lesson Control and Practice on Learning from Interactive Video.

ERIC Educational Resources Information Center

Hannafin, Michael J.; Colamaio, MaryAnne E.

1987-01-01

Discussion of the effects of variations in lesson control and practice on the learning of facts, procedures, and problem-solving skills during interactive video instruction focuses on a study of graduates and advanced level undergraduates learning cardiopulmonary resuscitation (CPR). Embedded questioning methods and posttests used are described.…

What Positive Lessons Have You Learned from English Class about Working with Other People?

ERIC Educational Resources Information Center

Cook, Bailey; Keefe, Bailey; Gray, Angela; Li, Justin; Miller, Kevin

2010-01-01

This article provides a forum for students to share their experiences and lessons learned from English class about working with other people. The first author thinks it is a good idea to have split-level classes because it opens up new opportunities to meet people and teaches one many good lessons about working with other people. The second author…

E-Learning and the iNtegrating Technology for InQuiry (NTeQ) Model Lesson Design

ERIC Educational Resources Information Center

Flake, Lee Hatch

2017-01-01

The author reflects on the history of technology in education and e-learning and introduces the iNtegrating Technology for inQuiry (NTeQ) model of lesson design authored by Morrison and Lowther (2005). The NTeQ model lesson design is a new pedagogy for academic instruction in response to the growth of the Internet and technological advancements in…

The use of high impact practices (HIPs) on chemistry lesson design and implementation by pre-service teachers

NASA Astrophysics Data System (ADS)

Chamrat, Suthida; Apichatyotin, Nattaya; Puakanokhirun, Kittaporn

2018-01-01

The quality of lesson design is essential to learning effectiveness. Research shows some characteristics of lessons have strong effect on learning which were grouped into "High Impact Practices or HIPs. This research aims to examine the use of HIPs on chemistry lesson design as a part of Teaching Science Strand in Chemistry Concepts course. At the first round of lesson design and implementing in classroom, 14 chemistry pre-services teachers freely selected topics, designed and implemented on their own ideas. The lessons have been reflected by instructors and their peers. High Impact Practices were overtly used as the conceptual framework along with the After-Action Review and Reflection (AARR). The selected High Impact practice in this study consisted of 6 elements: well-designed lesson, vary cognitive demand/academic challenge, students center approach, opportunity of students to reflect by discussion or writing, the assignment of project based learning or task, and the lesson reflects pre-service teachers' Technological Pedagogical Content Knowledge (TPACK). The second round, pre-service teachers were encouraged to explicitly used 6 High Impact Practices in cooperated with literature review specified on focused concepts for bettering designed and implemented lessons. The data were collected from 28 lesson plans and 28 classroom observations to compare and discuss between the first and second lesson and implementation. The results indicated that High Impact Practices effect on the quality of delivered lesson. However, there are some elements that vary on changes which were detailed and discussed in this research article.

Learning from Lessons: Studying the Structure and Construction of Mathematics Teacher Knowledge in Australia, China and Germany

ERIC Educational Resources Information Center

Chan, Man Ching Esther; Clarke, David J.; Clarke, Doug M.; Roche, Anne; Cao, Yiming; Peter-Koop, Andrea

2018-01-01

The major premise of this project is that teachers learn from the act of teaching a lesson. Rather than asking "What must a teacher already know in order to practice effectively?", this project asks "What might a teacher learn through their activities in the classroom and how might this learning be optimised?" In this project,…

Project-Based Learning Using Discussion and Lesson-Learned Methods via Social Media Model for Enhancing Problem Solving Skills

ERIC Educational Resources Information Center

Jewpanich, Chaiwat; Piriyasurawong, Pallop

2015-01-01

This research aims to 1) develop the project-based learning using discussion and lesson-learned methods via social media model (PBL-DLL SoMe Model) used for enhancing problem solving skills of undergraduate in education student, and 2) evaluate the PBL-DLL SoMe Model used for enhancing problem solving skills of undergraduate in education student.…

The Implementation of Lesson Study to Strengthen Students: Understanding Participation and Application Capabilities in History Education Research Method on Topic Research and Development

ERIC Educational Resources Information Center

Towaf, Siti Malikhah

2016-01-01

Learning can be observed from three-dimensions called: effectiveness, efficiency, and attractiveness of learning. Careful study carried out by analyzing the learning elements of the system are: input, process, and output. Lesson study is an activity designed and implemented as an effort to improve learning in a variety of dimensions. "Lesson…

Improving the redistribution of the security lessons in healthcare: An evaluation of the Generic Security Template.

PubMed

He, Ying; Johnson, Chris

2015-11-01

The recurrence of past security breaches in healthcare showed that lessons had not been effectively learned across different healthcare organisations. Recent studies have identified the need to improve learning from incidents and to share security knowledge to prevent future attacks. Generic Security Templates (GSTs) have been proposed to facilitate this knowledge transfer. The objective of this paper is to evaluate whether potential users in healthcare organisations can exploit the GST technique to share lessons learned from security incidents. We conducted a series of case studies to evaluate GSTs. In particular, we used a GST for a security incident in the US Veterans' Affairs Administration to explore whether security lessons could be applied in a very different Chinese healthcare organisation. The results showed that Chinese security professional accepted the use of GSTs and that cyber security lessons could be transferred to a Chinese healthcare organisation using this approach. The users also identified the weaknesses and strengths of GSTs, providing suggestions for future improvements. Generic Security Templates can be used to redistribute lessons learned from security incidents. Sharing cyber security lessons helps organisations consider their own practices and assess whether applicable security standards address concerns raised in previous breaches in other countries. The experience gained from this study provides the basis for future work in conducting similar studies in other healthcare organisations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Implementing the Japanese Problem-Solving Lesson Structure

ERIC Educational Resources Information Center

Groves, Susie

2013-01-01

While there has been worldwide interest in Japanese Lesson Study as a model for teacher professional learning, there has been less research into authentic implementation of the problem-solving lesson structure that underpins mathematics research lessons in Japan. Findings from a Lesson Study project involving teachers from three Victorian primary…

The current status of robotic transaxillary thyroidectomy in the United States: an experience from two centers

PubMed Central

Zaidi, Nisar; Daskalaki, Despoina; Quadri, Pablo; Okoh, Alexis; Giulianotti, Pier Cristoforo

2017-01-01

Background Few studies exist regarding the state of robotic transaxillary thyroidectomy (RT) and its outcomes at high-volume institutions. Methods Eighty-nine patients underwent RT between January 2009 and September 2015 at two tertiary centers. Data were collected from prospectively-maintained IRB-approved databases. Patient demographic and clinical data, and trends were evaluated. Results Indications for RT included biopsy-proven or suspicion for malignancy in 20.2%, atypical cells or follicular neoplasm in 27.7%, multinodular goiter in 26.6%, thyrotoxicosis in 8.5%, need for completion thyroidectomy in 5.3%, and non-diagnostic FNA in 3.2%. 56% underwent total thyroidectomy and 44% lobectomy. Operative time (OT) was 153.5 minutes for lobectomies and 192.6 minutes for total thyroidectomy. The complication rate was 11.7%: temporary RLN neuropraxia in 2 patients, permanent hypoparathyroidism in 1 patient, temporary hypoparathyroidism in 6 patients, flap seroma in 1 patient, and flap hematoma in 1 patient. Pathology showed malignancy in 43 patients. At a mean follow-up of 31.9 months, there were no recurrences. Since 2013, the number of RTs performed has risen. The number of out-of-state patients increased from 18% to 37% after 2011. Conclusions RT was performed without compromising outcomes in selected patients. There remains interest among patients seeking this procedure in expert centers. PMID:28861379

Effectiveness of an i-PTH Measurement in Predicting Post Thyroidectomy Hypocalcemia: Prospective Controlled Study

PubMed Central

Kim, Jin Pyeong; Park, Jung Je; Son, Hee Young; Kim, Rock Bum; Kim, Ho Youp

2013-01-01

Purpose Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. Materials and Methods We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. Results 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. Conclusion We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy. PMID:23549808

Prospective study of the changes in thyrotropin binding inhibitory immunoglobulins in Graves' disease treated by subtotal thyroidectomy or radioactive iodine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teng, C.S.; Yeung, R.T.T.; Khoo, R.K.K.

1980-06-01

The effects of subtotal thyroidectomy and radioactive iodine on thyroid-stimulating immunoglobulins, as measured by a receptor assay, more appropriately termed TSH binding inhibitory immunoglobulins (TBII), were studied in 74 patients with Graves' disease. Fourty-four patients received radioactive iodine therapy, while 30 were subjected to subtotal thyroidectomy. After radioactive iodine, more patients were TBII-positive (90.5% vs 81.8%) than before treatment, and the mean TBII index decreased dramatically, the maximum decrease being 3 months. The mean TBI index subsequently returned gradually to the pretreatment level. Subtotal thyroidectomy had a different effect on TBII activity. TBII indices were positive in 89.3% of thesemore » patients before any treatment but were positive in only 40% (12 patients) after antithyroid drugs had been given before surgery. After surgery, TBII indices remained positive in 7 patients, while the remaining 5 patients became TBII negative. Seventeen patients (56.7%) were TBII negative before operation and remained so after surgery. One patient who was TBII negative before operation became TBII positive 2 months after operation. Interestingly, postoperative relapse of hyperthyroidism occurred in 3 patients who were TIBII positive, while hypothyroidism occurred in patients who were TBII negative. Thus, the TBII activity after subtotal thyroidectomy might be an important factor in determining the outcome of surgery.« less

Development of concept-based physiology lessons for biomedical engineering undergraduate students.

PubMed

Nelson, Regina K; Chesler, Naomi C; Strang, Kevin T

2013-06-01

Physiology is a core requirement in the undergraduate biomedical engineering curriculum. In one or two introductory physiology courses, engineering students must learn physiology sufficiently to support learning in their subsequent engineering courses and careers. As preparation for future learning, physiology instruction centered on concepts may help engineering students to further develop their physiology and biomedical engineering knowledge. Following the Backward Design instructional model, a series of seven concept-based lessons was developed for undergraduate engineering students. These online lessons were created as prerequisite physiology training to prepare students to engage in a collaborative engineering challenge activity. This work is presented as an example of how to convert standard, organ system-based physiology content into concept-based content lessons.

Lessons Learned and Flight Results from the F15 Intelligent Flight Control System Project

NASA Technical Reports Server (NTRS)

Bosworth, John

2006-01-01

A viewgraph presentation on the lessons learned and flight results from the F15 Intelligent Flight Control System (IFCS) project is shown. The topics include: 1) F-15 IFCS Project Goals; 2) Motivation; 3) IFCS Approach; 4) NASA F-15 #837 Aircraft Description; 5) Flight Envelope; 6) Limited Authority System; 7) NN Floating Limiter; 8) Flight Experiment; 9) Adaptation Goals; 10) Handling Qualities Performance Metric; 11) Project Phases; 12) Indirect Adaptive Control Architecture; 13) Indirect Adaptive Experience and Lessons Learned; 14) Gen II Direct Adaptive Control Architecture; 15) Current Status; 16) Effect of Canard Multiplier; 17) Simulated Canard Failure Stab Open Loop; 18) Canard Multiplier Effect Closed Loop Freq. Resp.; 19) Simulated Canard Failure Stab Open Loop with Adaptation; 20) Canard Multiplier Effect Closed Loop with Adaptation; 21) Gen 2 NN Wts from Simulation; 22) Direct Adaptive Experience and Lessons Learned; and 23) Conclusions

Lessons learned for improving spacecraft ground operations

NASA Astrophysics Data System (ADS)

Bell, Michael; Stambolian, Damon; Henderson, Gena

NASA has a unique history in processing the Space Shuttle fleet for launches. Some of this experience has been captured in the NASA Lessons Learned Information System (LLIS). This tool provides a convenient way for design engineers to review lessons from the past to prevent problems from reoccurring and incorporate positive lessons in new designs. At the Kennedy Space Center, the LLIS is being used to design ground support equipment for the next generation of launch and crewed vehicles. This paper describes the LLIS process and offers some examples.

Lessons Learned for Improving Spacecraft Ground Operations

NASA Technical Reports Server (NTRS)

Bell, Michael A.; Stambolian, Damon B.; Henderson, Gena M.

2012-01-01

NASA has a unique history in processing the Space Shuttle fleet for launches. Some of this experience has been captured in the NASA Lessons Learned Information System (LLIS). This tool provides a convenient way for design engineers to review lessons from the past to prevent problems from reoccurring and incorporate positive lessons in new designs. At the Kennedy Space Center, the LLIS is being used to design ground support equipment for the next generation of launch and crewed vehicles. This paper describes the LLIS process and offers some examples.

Lessons Learned in the D.C. Public Schools. Hearing before the Subcommittee on Oversight of Government Management, Restructuring, and the District of Columbia of the Committee on Governmental Affairs. United States Senate, One Hundred Fifth Congress. Second Session (March 9, 1998).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

The focus of this hearing was on lessons learned in the District of Columbia public schools in the year preceding the hearing. In his opening remarks, Senator Brownback (Kansas) remarked that one of the first lessons is that the academic quality of the schools is not good enough and is in dire need of improvement. A second set of lessons focuses…

A theory-based approach to teaching young children about health: A recipe for understanding

PubMed Central

Nguyen, Simone P.; McCullough, Mary Beth; Noble, Ashley

2011-01-01

The theory-theory account of conceptual development posits that children’s concepts are integrated into theories. Concept learning studies have documented the central role that theories play in children’s learning of experimenter-defined categories, but have yet to extensively examine complex, real-world concepts such as health. The present study examined whether providing young children with coherent and causally-related information in a theory-based lesson would facilitate their learning about the concept of health. This study used a pre-test/lesson/post-test design, plus a five month follow-up. Children were randomly assigned to one of three conditions: theory (i.e., 20 children received a theory-based lesson); nontheory (i.e., 20 children received a nontheory-based lesson); and control (i.e., 20 children received no lesson). Overall, the results showed that children in the theory condition had a more accurate conception of health than children in the nontheory and control conditions, suggesting the importance of theories in children’s learning of complex, real-world concepts. PMID:21894237

CYGNSS: Lessons We are Learning from a Class D Mission

NASA Technical Reports Server (NTRS)

Tumlinson, Jessica

2015-01-01

CYGNSS: Lessons Learned from NASA Class D Mission and how they selected their parts for the program to include balance between cost, risk, schedule and technology available as well as balancing cost restraints with mission risk profile.

Notification: Lessons Learned from Implementing the American Recovery and Reinvestment Act of 2009 (Recovery Act)

EPA Pesticide Factsheets

Project #OA-FY12-0360, March 5, 2012. The Recovery Funds Working Group of the Recovery Accountability and Transparency Board has initiated a project to capture lessons learned from Recovery Act implementation.

IVHS Institutional Issues and Case Studies, Analysis and Lessons Learned, Final Report

DOT National Transportation Integrated Search

1994-04-01

This 'Analysis and Lessons Learned' report contains observations, conclusions, and recommendations based on the performance of six case studies of Intelligent Vehicle-Highway Systems (IVHS) projects. Information to support the development of the case...

Multi-Modal Traveler Information System - Lessons Learned

DOT National Transportation Integrated Search

1997-05-19

The purpose of this working paper is to provide an information base of lessons learned from activities similar to the design of the Gary Chicago Milwaukee (GCM) Corridor Architecture and the Gateway Traveler Information System (TIS). Many similar act...

"Lessons learned" : evaluation of intelligent transportation systems (ITS) implementation at Santee Wateree Regional Transportation Authority.

DOT National Transportation Integrated Search

2002-06-01

The purpose of this lessons learned is to document the experience with Intelligent Transportation Systems (ITS) : implementation at the Santee Wateree Regional Transportation authority (SWRTA). SWRTA is a public : transportation provider servin...

Lessons learned on the Skylab program

NASA Technical Reports Server (NTRS)

1974-01-01

Lessons learned in the Skylab program and their application and adaptation to other space programs are summarized. Recommendations and action taken on particular problems are described. The use of Skylab recommendations to identify potential problems of future space programs is discussed.

Gemini Observatory base facility operations: systems engineering process and lessons learned

NASA Astrophysics Data System (ADS)

Serio, Andrew; Cordova, Martin; Arriagada, Gustavo; Adamson, Andy; Close, Madeline; Coulson, Dolores; Nitta, Atsuko; Nunez, Arturo

2016-08-01

Gemini North Observatory successfully began nighttime remote operations from the Hilo Base Facility control room in November 2015. The implementation of the Gemini North Base Facility Operations (BFO) products was a great learning experience for many of our employees, including the author of this paper, the BFO Systems Engineer. In this paper we focus on the tailored Systems Engineering processes used for the project, the various software tools used in project support, and finally discuss the lessons learned from the Gemini North implementation. This experience and the lessons learned will be used both to aid our implementation of the Gemini South BFO in 2016, and in future technical projects at Gemini Observatory.

Periscope: Looking into Learning in Best-Practices Physics Classrooms

NASA Astrophysics Data System (ADS)

Scherr, Rachel E.; Goertzen, Renee Michelle

2018-02-01

Periscope is a set of lessons to support learning assistants, teaching assistants, and faculty in learning to notice and interpret classroom events the way an accomplished teacher does. Periscope lessons are centered on video episodes from a variety of best-practices university physics classrooms. By observing, discussing, and reflecting on teaching situations similar to their own, instructors practice applying lessons learned about teaching to actual teaching situations and develop their pedagogical content knowledge. Instructors also get a view of other institutions' transformed courses, which can support and expand the vision of their own instructional improvement and support the transfer of course developments among faculty. Periscope is available for free to educators at http://physport.org/periscope.

Applying lessons learned in communities to programs and policies at the federal level.

PubMed

Chang, Debbie I

2006-01-01

As solutions to the problems of the uninsured are debated, there are lessons to be learned from community-based initiatives. Such efforts can provide information on different models as well as key political lessons. Defining the specific role that community efforts play is also critical. Actively involving community stakeholders of such community initiatives in health care policy debates will result in more workable policies.

The Role of Lesson Analysis in Pre-Service Teacher Education: An Empirical Investigation of Teacher Learning from a Virtual Video-Based Field Experience

ERIC Educational Resources Information Center

Santagata, Rossella; Zannoni, Claudia; Stigler, James W.

2007-01-01

A video-based program on lesson analysis for pre-service mathematics teachers was implemented for two consecutive years as part of a teacher education program at the University of Lazio, Italy. Two questions were addressed: What can preservice teachers learn from the analysis of videotaped lessons? How can preservice teachers' analysis ability,…

Allosteric Learning Model in English Lesson: Teachers' Views, the Instructions of Curriculum and Course Book, a Sample of Daily Lesson Plan

ERIC Educational Resources Information Center

Berkant, Hasan Güner; Baysal, Seda

2017-01-01

The changes which occur during the learning process have been explained by many teaching-learning models and theories. One of these models is allosteric learning model (ALM) which was developed by André Giordan in 1989. This model was derived from a biological metaphor related to proteins. The interaction between individual and environment in a…

Managing Differences in Stakeholder Relationships and Organizational Cultures in E-Learning Development: Lessons from the UK eUniversity Experience

ERIC Educational Resources Information Center

Conole, Grainne; Carusi, Annamaria; de Laat, Maarten; Wilcox, Pauline; Darby, Jonathan

2006-01-01

This paper presents some of the initial findings of a series of studies documenting the UK eUniversity (UKeU) approach to and experience of e-learning. It will focus on the experiences and lessons learned of members of the learning technology team within the UKeU or people working closely with them. Our particular interest is to describe the…

Preparing for the Worst: Psychological Excellence of First Responders - A Katrina Lessons Learned Study

DTIC Science & Technology

2008-01-01

cases on human cognition and performance. For instance, when you learn to fly an airplane, you will be instructed to use a simple rule to avoid...Existing Training Technologies; First Responders; Katrina; Lesson Learned 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER... student . Based in Maryland, the training institute prepares first responders using online learning courses or training exercises. Such topics

Examining Teachers' Understanding of the Mathematical Learning Progression through Vertical Articulation during Lesson Study

ERIC Educational Resources Information Center

Suh, Jennifer; Seshaiyer, Padmanabhan

2015-01-01

This study examines elementary- and middle-grade teachers' understanding of the mathematical learning progression as they participated in a 6-month professional learning project. Teachers participated in a professional development project that consisted of a 1-week summer content-focused institute with school-based follow-up Lesson Study cycles in…

From Lessons Learned the Hard Way to Lessons Learned the Harder Way

ERIC Educational Resources Information Center

Schwegler, Andria Foote

2013-01-01

My departure from traditional methods of teaching and assessment (i.e., lecture and close-ended exams) was prompted years ago by a "gut feeling" that has morphed into an explicit examination of my teaching practice and students' reactions to it. The scholarly approach and empirical evidence in "Teachers and Learning"…

Pre-Service Teachers' Cognitive Competencies to Use the Approaches in Mathematics Teaching: Discovery Learning

ERIC Educational Resources Information Center

Yilmaz, Rezan

2014-01-01

This study aims to present the cognitive competences of the pre-service teacher about discovery learning approach in mathematical education. The study was conducted with 37 mathematics pre-service teachers who study Special Teaching Methods lesson in a state university in Turkey. Throughout the lesson, the approaches used in learning were examined…

Let's Cooperate! Integrating Cooperative Learning Into a Lesson on Ethics.

PubMed

Reineke, Patricia R

2017-04-01

Cooperative learning is an effective teaching strategy that promotes active participation in learning and can be used in academic, clinical practice, and professional development settings. This article describes that strategy and provides an example of its use in a lesson about ethics. J Contin Nurs Educ. 2017;48(4):154-156. Copyright 2017, SLACK Incorporated.

Commissioning MMS: Challenges and Lessons Learned

NASA Technical Reports Server (NTRS)

Wood, Paul; Gramling, Cheryl; Reiter, Jennifer; Smith, Patrick; Stone, John

2016-01-01

This paper discusses commissioning of NASA's Magnetospheric MultiScale (MMS) Mission. The mission includes four identical spacecraft with a large, complex set of instrumentation. The planning for and execution of commissioning for this mission is described. The paper concludes by discussing lessons learned.

The lift-fan aircraft: Lessons learned

NASA Technical Reports Server (NTRS)

Deckert, Wallace H.

1995-01-01

This report summarizes the highlights and results of a workshop held at NASA Ames Research Center in October 1992. The objective of the workshop was a thorough review of the lessons learned from past research on lift fans, and lift-fan aircraft, models, designs, and components. The scope included conceptual design studies, wind tunnel investigations, propulsion systems components, piloted simulation, flight of aircraft such as the SV-5A and SV-5B and a recent lift-fan aircraft development project. The report includes a brief summary of five technical presentations that addressed the subject The Lift-Fan Aircraft: Lessons Learned.

Report from the School of Experience: Lessons-Learned on NASA's EOS/ICESat Mission

NASA Technical Reports Server (NTRS)

Anselm, William

2003-01-01

Abstract-NASA s Earth Observing System EOS) Ice, Cloud, and Land Elevation Satellite (ICESat) mission was one of the first missions under Goddard Space Flight Center s (then-) new Rapid Spacecraft Development Office. This paper explores the lessons-learned under the ICESat successful implementation and launch, focusing on four areas: Procurement., Management, Technical, and Launch and Early Operations. Each of these areas is explored in a practical perspective of communication, the viewpoint of the players, and the interactions among the organizations. Conclusions and lessons-learned are summarized in the final section.

Looking within and beyond the community: lessons learned by researching, theorising and acting to address urban poverty and health.

PubMed

Hodgetts, Darrin; Chamberlain, Kerry; Tankel, Yadena; Groot, Shiloh

2014-01-01

Urban poverty and health inequalities are inextricably intertwined. By working in partnership with service providers and communities to address urban poverty, we can enhance the wellness of people in need. This article reflects on lessons learned from the Family100 project that explores the everyday lives, frustrations and dilemmas faced by 100 families living in poverty in Auckland. Lessons learned support the need to bring the experiences and lived realities of families to the fore in public deliberations about community and societal responses to urban poverty and health inequality.

The effectiveness of CCDSR learning model to improve skills of creating lesson plan and worksheet science process skill (SPS) for pre-service physics teacher

NASA Astrophysics Data System (ADS)

Limatahu, I.; Sutoyo, S.; Wasis; Prahani, B. K.

2018-03-01

In the previous research, CCDSR (Condition, Construction, Development, Simulation, and Reflection) learning model has been developed to improve science process skills for pre-service physics teacher. This research is aimed to analyze the effectiveness of CCDSR learning model towards the improvement skills of creating lesson plan and worksheet of Science Process Skill (SPS) for pre-service physics teacher in academic year 2016/2017. This research used one group pre-test and post-test design on 12 pre-service physics teacher at Physics Education, University of Khairun. Data collection was conducted through test and observation. Creating lesson plan and worksheet SPS skills of pre-service physics teacher measurement were conducted through Science Process Skill Evaluation Sheet (SPSES). The data analysis technique was done by Wilcoxon t-test and n-gain. The CCDSR learning model consists of 5 phases, including (1) Condition, (2) Construction, (3) Development, (4) Simulation, and (5) Reflection. The results showed that there was a significant increase in creating lesson plan and worksheet SPS skills of pre-service physics teacher at α = 5% and n-gain average of moderate category. Thus, the CCDSR learning model is effective for improving skills of creating lesson plan and worksheet SPS for pre-service physics teacher.

Lessons Learned from Developing a Patient Engagement Panel: An OCHIN Report.

PubMed

Arkind, Jill; Likumahuwa-Ackman, Sonja; Warren, Nate; Dickerson, Kay; Robbins, Lynn; Norman, Kathy; DeVoe, Jennifer E

2015-01-01

There is renewed interest in patient engagement in clinical and research settings, creating a need for documenting and publishing lessons learned from efforts to meaningfully engage patients. This article describes early lessons learned from the development of OCHIN's Patient Engagement Panel (PEP). OCHIN supports a national network of more than 300 community health centers (CHCs) and other primary care settings that serve over 1.5 million patients annually across nearly 20 states. The PEP was conceived in 2009 to harness the CHC tradition of patient engagement in this new era of patient-centered outcomes research and to ensure that patients were engaged throughout the life cycle of our research projects, from conception to dissemination. Developed by clinicians and researchers within our practice-based research network, recruitment of patients to serve as PEP members began in early 2012. The PEP currently has a membership of 18 patients from 3 states. Over the past 24 months, the PEP has been involved with 12 projects. We describe developing the PEP and challenges and lessons learned (eg, recruitment, funding model, creating value for patient partners, compensation). These lessons learned are relevant not only for research but also for patient engagement in quality improvement efforts and other clinical initiatives. © Copyright 2015 by the American Board of Family Medicine.

Lessons Learned from the Wide Field Camera 3 TV1 and TV2 Thermal Vacuum Test Campaigns

NASA Technical Reports Server (NTRS)

Peabody, Hume; Stavely, Richard; Bast, William

2008-01-01

The Wide Field Camera 3 (WFC3) instrument has undergone two complete thermal vacuum tests (TV1 and TV2), during which valuable lessons were learned regarding test configuration, test execution, model capabilities, and modeling practices. The very complex thermal design of WFC3 produced a number of challenging aspects to ground testing with numerous ThermoElectric Coolers and heat pipes, not all of which were functional. Lessons learned during TV1 resulted in significant upgrades to the model capabilities and a change in the test environment approach for TV2. These upgrades proved invaluable during TV2 when pretest modeling assumptions proved to be false. Each of the lessons learned relate to one of two following broad statements: 1. Ensure the design can be tested and that the effect of non-flight like conditions is well understood, particularly with respect to non passive devices (TECs, Heat Pipes, etc) 2. Ensure that the model is sufficiently detailed and is capable of predicting off-nominal behavior and the power dissipation of any thermal devices, especially TECs This paper outlines a number of the lessons learned over these two test campaigns with respect to the thermal design, model, and test configuration and presents recommendations for future tests.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, Charles Frederick

Lessons learned are more in vogue today than at any time in our history. You can’t tune into a news broadcast without hearing a reference to the concept – and for good reason. People are finally accepting the idea that they may be able to benefit from the experiences of others. Corporations, government departments, and even the military are actively using lessons learned information to help them to achieve their varied goals. The Department of Energy is one of the government departments that has a Lessons Learned Program and requires its contractors to develop a program of their own. Unfortunately,more » adequate guidance is not available to enable contractors to design a fully mature program (i.e., a program that will immediately meet their every need) and to ensure that it is implemented such that it will be deemed acceptable during subsequent assessments. The purpose of this paper is to present the reader with information that might help him or her better plan and develop a new or upgraded Lessons Learned Program. The information is based on the actual development and implementation of a “second generation” lessons learned program and is presented as a chronicle of the steps taken to build the rudimentary system and the subsequent events and problems that led to the programs present-day configuration.« less

Unintended Learning in Primary School Practical Science Lessons from Polanyi's Perspective of Intellectual Passion

NASA Astrophysics Data System (ADS)

Park, Jisun; Song, Jinwoong; Abrahams, Ian

2016-03-01

This study explored, from the perspective of intellectual passion developed by Michael Polanyi, the unintended learning that occurred in primary practical science lessons. We use the term `unintended' learning to distinguish it from `intended' learning that appears in teachers' learning objectives. Data were collected using video and audio recordings of a sample of twenty-four whole class practical science lessons, taught by five teachers, in Korean primary schools with 10- to 12-year-old students. In addition, video and audio recordings were made for each small group of students working together in order to capture their activities and intra-group discourse. Pre-lesson interviews with the teachers were undertaken and audio-recorded to ascertain their intended learning objectives. Selected key vignettes, including unintended learning, were analysed from the perspective of intellectual passion developed by Polanyi. What we found in this study is that unintended learning could occur when students got interested in something in the first place and could maintain their interest. In addition, students could get conceptual knowledge when they tried to connect their experience to their related prior knowledge. It was also found that the processes of intended learning and of unintended learning were different. Intended learning was characterized by having been planned by the teacher who then sought to generate students' interest in it. In contrast, unintended learning originated from students' spontaneous interest and curiosity as a result of unplanned opportunities. Whilst teachers' persuasive passion comes first in the process of intended learning, students' heuristic passion comes first in the process of unintended learning. Based on these findings, we argue that teachers need to be more aware that unintended learning, on the part of individual students, can occur during their lesson and to be able to better use this opportunity so that this unintended learning can be shared by the whole class. Furthermore, we argue that teachers' deliberate action and a more interactive classroom culture are necessary in order to allow students to develop, in addition to heuristic passion, persuasive passion towards their unintended learning.

Blended learning: strengths, challenges, and lessons learned in an interprofessional training program.

PubMed

Lotrecchiano, G R; McDonald, P L; Lyons, L; Long, T; Zajicek-Farber, M

2013-11-01

This field report outlines the goals of providing a blended learning model for an interdisciplinary training program for healthcare professionals who care for children with disabilities. The curriculum blended traditional face-to-face or on-site learning with integrated online interactive instruction. Credit earning and audited graduate level online coursework, community engagement experiences, and on-site training with maternal and child health community engagement opportunities were blended into a cohesive program. The training approach emphasized adult learning principles in different environmental contexts integrating multiple components of the Leadership Education in Neurodevelopmental and Related Disabilities Program. This paper describes the key principles adopted for this blended approach and the accomplishments, challenges, and lessons learned. The discussion offers examples from training content, material gathered through yearly program evaluation, as well as university course evaluations. The lessons learned consider the process and the implications for the role of blended learning in this type of training program with suggestions for future development and adoption by other programs.

Tracking Voice Change after Thyroidectomy: Application of Spectral/Cepstral Analyses

ERIC Educational Resources Information Center

Awan, Shaheen N.; Helou, Leah B.; Stojadinovic, Alexander; Solomon, Nancy Pearl

2011-01-01

This study evaluates the utility of perioperative spectral and cepstral acoustic analyses to monitor voice change after thyroidectomy. Perceptual and acoustic analyses were conducted on speech samples (sustained vowel /[alpha]/ and CAPE-V sentences) provided by 70 participants (36 women and 34 men) at four study time points: prior to thyroid…

Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer.

PubMed

Yu, Hea Min; Park, Soon Hyun; Lee, Jae Min; Park, Kang Seo

2013-09-01

Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

Value of intra-operative neuromonitoring of the recurrent laryngeal nerve in total thyroidectomy for benign goitre.

PubMed

Page, C; Cuvelier, P; Biet, A; Strunski, V

2015-06-01

This study aimed to evaluate the impact of intra-operative neuromonitoring of the recurrent laryngeal nerve during total thyroidectomy for benign goitre. A single-centre retrospective study using historical controls was conducted for a 10-year period, comprising a series of 767 patients treated by total thyroidectomy for benign goitre. Of these, 306 had intra-operative neuromonitoring of the recurrent laryngeal nerve and 461 did not. Post-operative laryngeal mobility was assessed in all patients by direct laryngoscopy before hospital discharge and at post-operative follow-up visits. In all, 6 out of 461 patients (1.30 per cent) in the control group and 6 out of 306 patients (1.96 per cent) in the intra-operative neuromonitoring group developed permanent recurrent laryngeal nerve palsy. No statistically significant difference was observed between the two patient groups. Intra-operative neuromonitoring does not appear to affect the post-operative recurrent laryngeal nerve palsy rate or to reliably predict post-operative recurrent laryngeal nerve palsy. However, it can accurately predict good nerve function after thyroidectomy.

Applications of Evolving Robotic Technology for Head and Neck Surgery.

PubMed

Sharma, Arun; Albergotti, W Greer; Duvvuri, Umamaheswar

2016-03-01

Assess the use and potential benefits of a new robotic system for transoral radical tonsillectomy, transoral supraglottic laryngectomy, and retroauricular thyroidectomy in a cadaver dissection. Three previously described robotic procedures (transoral radical tonsillectomy, transoral supraglottic laryngectomy, and retroauricular thyroidectomy) were performed in a cadaver using the da Vinci Xi Surgical System. Surgical exposure and access, operative time, and number of collisions were examined objectively. The new robotic system was used to perform transoral radical tonsillectomy with dissection and preservation of glossopharyngeal nerve branches, transoral supraglottic laryngectomy, and retroauricular thyroidectomy. There was excellent exposure without any difficulties in access. Robotic operative times (excluding set-up and docking times) for the 3 procedures in the cadaver were 12.7, 14.3, and 21.2 minutes (excluding retroauricular incision and subplatysmal elevation), respectively. No robotic arm collisions were noted during these 3 procedures. The retroauricular thyroidectomy was performed using 4 robotic ports, each with 8 mm instruments. The use of updated and evolving robotic technology improves the ease of previously described robotic head and neck procedures and may allow surgeons to perform increasingly complex surgeries. © The Author(s) 2015.

Chinese Lessons from Other Peoples’ Wars

DTIC Science & Technology

2011-11-01

have a unified center for lessons learned (key U.S. examples are the Joint Center for Operational Analy- 8 sis, the Center for Army Lessons Learned...complete publicly available docu- mentary and analytical record in Chinese on the wars might present. Readers are advised to bear these chal- lenges...guided missiles (PGM). Indeed, there are 14 many PLA studies about the PGM and its employment in the U.S. joint and integrated operations in the

Meeting the Informal Learning Challenges of the Free Agent Learner: Drawing Insights from Research-Based Lessons Learned. Innovative Session 1. [Concurrent Innovative Session at AHRD Annual Conference, 2000.

ERIC Educational Resources Information Center

Marsick, Victoria J.; Volpe, F. Marie; Brooks, Ann; Cseh, Maria; Lovin, Barbara Keelor; Vernon, Sally; Watkins, Karen E.; Ziegler, Mary

The concept of the free agent learner, which has roots in self-directed and informal learning theory, has recently emerged as a factor important to attracting, developing, and keeping knowledge workers. The literature on free agent learning holds important lessons for today's free agent learners, human resource developers, and work organizations.…

76 FR 81516 - Homeland Security Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

... security; and provide information on the threat of an electromagnetic pulse attack and its associated... Operational Update. Electromagnetic Pulse (EMP) Threat--Lessons Learned and Areas of Vulnerability, and... and the potential threat of an electromagnetic pulse attack. Both will include lessons learned and...

The Status of Ubiquitous Computing.

ERIC Educational Resources Information Center

Brown, David G.; Petitto, Karen R.

2003-01-01

Explains the prevalence and rationale of ubiquitous computing on college campuses--teaching with the assumption or expectation that all faculty and students have access to the Internet--and offers lessons learned by pioneering institutions. Lessons learned involve planning, technology, implementation and management, adoption of computer-enhanced…

Lessons Learned on Implementing Fault Detection, Isolation, and Recovery (FDIR) in a Ground Launch Environment

NASA Technical Reports Server (NTRS)

Ferell, Bob; Lewis, Mark; Perotti, Jose; Oostdyk, Rebecca; Goerz, Jesse; Brown, Barbara

2010-01-01

This paper's main purpose is to detail issues and lessons learned regarding designing, integrating, and implementing Fault Detection Isolation and Recovery (FDIR) for Constellation Exploration Program (CxP) Ground Operations at Kennedy Space Center (KSC).

Impact of Chess Training on Mathematics Performance and Concentration Ability of Children with Learning Disabilities

ERIC Educational Resources Information Center

Scholz, Markus; Niesch, Harald; Steffen, Olaf; Ernst, Baerbel; Loeffler, Markus; Witruk, Evelin; Schwarz, Hans

2008-01-01

The aim of this study is to evaluate the benefit of chess in mathematics lessons for children with learning disabilities based on lower intelligence (IQ 70-85). School classes of four German schools for children with learning disabilities were randomly assigned to receive one hour of chess lesson instead of one hour of regular mathematics lessons…

Evaluating Primary School Student's Deep Learning Approach to Science Lessons

ERIC Educational Resources Information Center

Ilkörücü Göçmençelebi, Sirin; Özkan, Muhlis; Bayram, Nuran

2012-01-01

This study examines the variables which help direct students to a deep learning approach to science lessons, with the aim of guiding programmers and teachers in primary education. The sample was composed of a total of 164 primary school students. The Learning Approaches to Science Scale developed by Ünal (2005) for Science and Technology lessons…

Lessons that Last: Former Youth Organizers' Reflections on What and How They Learned

ERIC Educational Resources Information Center

Conner, Jerusha

2014-01-01

This study examines the learning outcomes and learning environment of a youth organizing program that has been effective in promoting individual as well as social change. Drawing on interviews with 25 former youth organizers from the program, this study explores the lessons that stay with them as they transition to young adulthood and the factors…

Dynamic Lesson Planning in EFL Reading Classes through a New e-Learning System

ERIC Educational Resources Information Center

Okada, Takeshi; Sakamoto, Yasunobu

2015-01-01

This paper illustrates how lesson plans, teaching styles and assessment can be dynamically adapted on a real-time basis during an English as a Foreign Language (EFL) reading classroom session by using a new e-learning system named iBELLEs (interactive Blended English Language Learning Enhancement system). iBELLEs plays a crucial role in filling…

Lessons Learned from Lessons Learned: The Fit between Online Education "Best Practices" and Small School Reality

ERIC Educational Resources Information Center

Lovvorn, Al S.; Barth, Michael M.; Morris, R. Franklin, Jr.; Timmerman, John E.

2009-01-01

Schools of all types and sizes are exploring the merits and facets of online learning approaches; but, the online delivery literature has focused on "best practices" generated primarily through the experiences of larger schools that are on the leading edge of this innovation. Small public schools, on the other hand, are faced with unique…

The Measurement of Causes of Patient Satisfaction and Dissatisfaction within Clinics at an Army Medical Treatment Facility

DTIC Science & Technology

1984-05-01

Satisfaction Measures Between Clinics.... 39 Lessons Learned From the Pilot Studies ...................... 42 Telephonic Versus Clinic Survey...Between Clinics. 63 Comments from Survey Participants ....................... 64 Lessons Learned from the Study ............................. 67...attempted to apply principles learned from a review of the multitude of studies conducted in the area of patient satisfaction. Validated dimensions of

Students' Learning Experiences When Using a Dynamic Geometry Software Tool in a Geometry Lesson at Secondary School in Ethiopia

ERIC Educational Resources Information Center

Denbel, Dejene Girma

2015-01-01

Students learning experiences were investigated in geometry lesson when using Dynamic Geometry Software (DGS) tool in geometry learning in 25 Ethiopian secondary students. The research data were drawn from the used worksheets, classroom observations, results of pre- and post-test, a questionnaire and interview responses. I used GeoGebra as a DGS…

How Is the Learning Environment in Physics Lesson with Using 7E Model Teaching Activities

ERIC Educational Resources Information Center

Turgut, Umit; Colak, Alp; Salar, Riza

2017-01-01

The aim of this research is to reveal the results in the planning, implementation and evaluation of the process for learning environments to be designed in compliance with 7E learning cycle model in physics lesson. "Action research", which is a qualitative research pattern, is employed in this research in accordance with the aim of the…

Open Distance Learning for Development: Lessons from Strengthening Research Capacity on Gender, Crisis Prevention, and Recovery

ERIC Educational Resources Information Center

Babu, Suresh Chandra; Ferguson, Jenna; Parsai, Nilam; Almoguera, Rose

2013-01-01

This paper documents the experience and lessons from implementing an e-learning program aimed at creating research capacity for gender, crisis prevention, and recovery. It presents a case study of bringing together a multidisciplinary group of women professionals through both online and face-to-face interactions to learn the skills needed to be a…

Lessons Learned (3 Years of H2O2 Propulsion System Testing Efforts at NASA's John C. Stennis Space Center)

NASA Technical Reports Server (NTRS)

Taylor, Gary O.

2001-01-01

John C. Stennis Space Center continues to support the Propulsion community in an effort to validate High-Test Peroxide as an alternative to existing/future oxidizers. This continued volume of peroxide test/handling activity at Stennis Space Center (SSC) provides numerous opportunities for the SSC team to build upon previously documented 'lessons learned'. SSC shall continue to strive to document their experience and findings as H2O2 issues surface. This paper is intended to capture all significant peroxide issues that we have learned over the last three years. This data (lessons learned) has been formulated from practical handling, usage, storage, operations, and initial development/design of our systems/facility viewpoint. The paper is intended to be an information type tool and limited in technical rational; therefore, presenting the peroxide community with some issues to think about as the continued interest in peroxide evolves and more facilities/hardware are built. These lessons learned are intended to assist industry in mitigating problems and identifying potential pitfalls when dealing with the requirements for handling high-test peroxide.

Profile of patients with completion thyroidectomy and assessment of their suitability for outpatient surgery.

PubMed

Wu, Gaosong; Pai, Sara I; Agrawal, Nishant; Richmon, Jeremy; Dackiw, Alan; Tufano, Ralph P

2011-11-01

Outpatient thyroid surgery for thyroid lobectomy has been shown to be safe and feasible. The safety of outpatient completion thyroidectomy in patients who have previously undergone thyroid lobectomy has not been extensively evaluated in the medical literature to date. The authors sought to evaluate postoperative complications associated with completion thyroidectomy in their institution to determine if it would be safe and feasible to perform as an outpatient procedure. Case series with chart review. Tertiary care teaching hospital. Two hundred four consecutive patients, who underwent completion thyroidectomy after previous thyroid lobectomy from January 2000 to June 2010, comprised the study population. Medical records were reviewed for preoperative and postoperative serum calcium levels, preoperative and postoperative fiber-optic laryngoscopic examination of vocal fold mobility, associated comorbidities, length of hospital stay, drain use, seroma or hematoma formation, final thyroid pathology, and postoperative follow-up. Overall, 9 patients (4.4%) developed postoperative complications, including transient symptomatic hypocalcemia in 4 patients (2.0%), transient laboratory hypocalcemia in 3 patients (1.5%), seroma formation in 1 patient (0.5%), and hematoma development in 1 patient (0.5%). There were no cases with permanent or temporary vocal fold paralysis. No significant difference was found in the overall complication rate before and after 4 hours of observation (P = .50). Selected patients who undergo completion thyroidectomy after previous thyroid lobectomy can be safely discharged after 4 hours of postoperative observation with appropriate instructions.

Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis.

PubMed

Cabot, Jennifer C; Lee, Cho Rok; Brunaud, Laurent; Kleiman, David A; Chung, Woong Youn; Fahey, Thomas J; Zarnegar, Rasa

2012-12-01

This study presents a cost analysis of the standard cervical, gasless transaxillary endoscopic, and gasless transaxillary robotic thyroidectomy approaches based on medical costs in the United States. A retrospective review of 140 patients who underwent standard cervical, transaxillary endoscopic, or transaxillary robotic thyroidectomy at 2 tertiary centers was conducted. The cost model included operating room charges, anesthesia fee, consumables cost, equipment depreciation, and maintenance cost. Sensitivity analyses assessed individual cost variables. The mean operative times for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were 121 ± 18.9, 185 ± 26.0, and 166 ± 29.4 minutes, respectively. The total cost for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were $9,028 ± $891, $12,505 ± $1,222, and $13,670 ± $1,384, respectively. Transaxillary approaches were significantly more expensive than the standard cervical technique (standard cervical/transaxillary endoscopic, P < .0001; standard cervical/transaxillary robotic, P < .0001; and transaxillary endoscopic/transaxillary robotic, P = .001). The transaxillary and standard cervical techniques became equivalent in cost when transaxillary endoscopic operative time decreased to 111 minutes and transaxillary robotic operative time decreased to 68 minutes. Increasing the case load did not resolve the cost difference. Transaxillary endoscopic and transaxillary robotic thyroidectomies are significantly more expensive than the standard cervical approach. Decreasing operative times reduces this cost difference. The greater expense may be prohibitive in countries with a flat reimbursement schedule. Copyright © 2012 Mosby, Inc. All rights reserved.

Stressing the recurrent laryngeal nerve during thyroidectomy.

PubMed

Serpell, Jonathan W; Lee, James C; Chiu, Wing K; Edwards, Glenn

2015-12-01

In thyroidectomy, little has been reported on the differential recurrent laryngeal nerve (RLN) palsy rates between the left and right sides. Even less is known about the potential differences causing these differential rates. This study reports the left versus right RLN palsy rates of total thyroidectomy cases in a single institution, relating them to the comparative stiffness of the left and right porcine RLNs. Computed stress modelling was also used to estimate the differential levels of tension within each RLN. For the comparison of the left and right RLN palsy rates, 1926 cases of total thyroidectomy (between 2007 and 2013) from the Monash University Endocrine Surgery Unit were included. Stiffness of porcine RLNs was experimentally determined by measuring nerve extension against incremental increase in load. Additionally, the tension of intraoperatively stretched RLNs was estimated by computer modelling. The left RLN had a palsy rate of 0.9% (18/1926), which was significantly lower (P = 0.025) than the right RLN palsy rate of 1.8% (34/1926). The left porcine RLN was 22% stiffer than the right RLN (P = 0.004). The stress modelling estimated that at the apex of the artificial RLN genu during anteromedial rotation of the thyroid lobe, the right RLN experiences twice the tension experienced by the left RLN. The stiffer left RLN and the higher tension generated in the right RLN during thyroidectomy may jointly contribute to the higher right RLN palsy rate. © 2015 Royal Australasian College of Surgeons.

Role of Postoperative Vitamin D and/or Calcium Routine Supplementation in Preventing Hypocalcemia After Thyroidectomy: A Systematic Review and Meta-Analysis

PubMed Central

Alhefdhi, Amal; Mazeh, Haggi

2013-01-01

Background. Transient hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia. We performed a systematic review to assess the effectiveness of this intervention. The primary aim was to evaluate the efficacy of routine postoperative oral calcium and vitamin D supplementation in preventing symptomatic post-thyroidectomy hypocalcemia. The second aim was to draw clear guidelines regarding prophylactic calcium and/or vitamin D therapy for patients after thyroidectomy. Methods. We identified randomized controlled trials comparing the administration of vitamin D or its metabolites to calcium or no treatment in adult patients after thyroidectomy. The search was performed in PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Google Scholar, and Web of Knowledge databases. Patients with a history of previous neck surgery, calcium supplementation, or renal impairment were excluded. Results. Nine studies with 2,285 patients were included: 22 in the vitamin D group, 580 in the calcium group, 792 in the vitamin D and calcium group, and 891 in the no intervention group, with symptomatic hypocalcemia incidences of 4.6%, 14%, 14%, and 20.5%, respectively. Subcomparisons demonstrated that the incidences of postoperative hypocalcemia were 10.1% versus 18.8% for calcium versus no intervention and 6.8% versus 25.9% for vitamin D and calcium versus no intervention. The studies showed a significant range of variability in patients' characteristics. Conclusions. A significant decrease in postoperative hypocalcemia was identified in patients who received routine supplementation of oral calcium or vitamin D. The incidence decreased even more with the combined administration of both supplements. Based on this analysis, we recommend oral calcium for all patients following thyroidectomy, with the addition of vitamin D for high-risk individuals. PMID:23635556

Validation of 1-hour post-thyroidectomy parathyroid hormone level in predicting hypocalcemia

PubMed Central

2014-01-01

Background Prior work by our group suggested that a single one hour post-thyroidectomy parathyroid hormone (1 hr PTH) level could accurately stratify patients into high and low risk groups for the development of hypocalcemia. This study looks to validate the safety and efficacy of a protocol based on a 1 hr PTH threshold of 12 pg/ml. Study design Retrospective analysis of consecutive cohort treated with standardized protocol. Methods One hundred and twenty five consecutive patients underwent total or completion thyroidectomy and their PTH level was drawn 1-hour post operatively. Based on our previous work, patients were stratified into either a low risk group (PTH < 12 pg/ml) or a high risk group (PTH ≥ 12 pg/ml). Patients in the high risk group were immediately started on prophylactic calcium carbonate (5–10 g/d) and calcitriol (0.5-1.0 mcg/d). The outcomes were then reviewed focusing mainly on how many low risk patients developed hypocalcemia (false negative rate), and how many high risk patients failed prophylactic therapy. Results Thirty one patients (25%) were stratified as high risk, and 94 (75%) as low risk. Five (16%) of the high risk patients became hypocalcemic despite prophylactic therapy. Two of the low risk group became hypocalcemic, (negative predictive value = 98%). None of the hypocalcemic patients had anything more than mild symptoms. Conclusions A single 1-hour post-thyroidectomy PTH level is a very useful way to stratify thyroidectomy patients into high and low risk groups for development of hypocalcemia. Early implementation of oral prophylactic calcium and vitamin D in the high risk patients is a very effective way to prevent serious hypocalcemia. Complex protocols requiring multiple calcium and PTH measurements are not required to guide post-thyroidectomy management. PMID:24476535

Ambulatory thyroidectomy: an anesthesiologist's perspective.

PubMed

Murray, Benjamin; Tandon, Sankalap; Dempsey, Ged

2017-01-01

Thyroidectomy has been performed on an inpatient basis because of concerns regarding postoperative complications. These include cervical hematoma, bilateral recurrent laryngeal nerve injury and symptomatic hypocalcemia. We have reviewed the current available evidence and aimed to collate published data to generate incidence of the important complications. We performed a literature search of Medline, EMBASE and the Cochrane database of randomized trials. One hundred sixty papers were included. Twenty-one papers fulfilled inclusion criteria. Thirty thousand four hundred fifty-three day-case thyroid procedures were included. Ten papers were prospective and 11 retrospective. The incidences of complications were permanent vocal cord paralysis 7/30259 (0.02%), temporary hypocalcemia 129/4444 (2.9%), permanent hypocalcemia 405/29203 (1.39%), cervical hematoma 145/30288 (0.48%) and readmission rate 105/29609 (0.35%). Analysis of cervical hematoma data demonstrated that in only 3/14 cases the hematoma presented as an inpatient, and in the remaining 11/14, it occurred late, with a range of 2-9 days. There is a paucity of data relating to anesthetic techniques associated with ambulatory thyroidectomy. Cost comparison between outpatient and inpatient thyroidectomy was reported in three papers. Cost difference ranged from $676 to $2474 with a mean saving of $1301 with ambulatory thyroidectomy. There is a body of evidence that suggests that ambulatory thyroidectomy in the hands of experienced operating teams within an appropriate setting can be performed with acceptable risk profile. In most circumstances, this will be limited to hemithyroidectomies to reduce or avoid the potential for additional morbidity. We have found little evidence to support the use of one anesthetic technique over another. The rates of hospital admission and readmission related to anesthetic factors appear to be low and predominantly related to pain and postoperative nausea and vomiting. A balanced anesthetic technique incorporating appropriate analgesic and antiemetic regimens is essential to avoid unnecessary hospital admission/readmission.

Virtual Learning Simulations in High School: Effects on Cognitive and Non-cognitive Outcomes and Implications on the Development of STEM Academic and Career Choice.

PubMed

Thisgaard, Malene; Makransky, Guido

2017-01-01

The present study compared the value of using a virtual learning simulation compared to traditional lessons on the topic of evolution, and investigated if the virtual learning simulation could serve as a catalyst for STEM academic and career development, based on social cognitive career theory. The investigation was conducted using a crossover repeated measures design based on a sample of 128 high school biology/biotech students. The results showed that the virtual learning simulation increased knowledge of evolution significantly, compared to the traditional lesson. No significant differences between the simulation and lesson were found in their ability to increase the non-cognitive measures. Both interventions increased self-efficacy significantly, and none of them had a significant effect on motivation. In addition, the results showed that the simulation increased interest in biology related tasks, but not outcome expectations. The findings suggest that virtual learning simulations are at least as efficient in enhancing learning and self-efficacy as traditional lessons, and high schools can thus use them as supplementary educational methods. In addition, the findings indicate that virtual learning simulations may be a useful tool in enhancing student's interest in and goals toward STEM related careers.

Teachers' learning on the workshop of STS approach as a way of enhancing inventive thinking skills

NASA Astrophysics Data System (ADS)

Ngaewkoodrua, Nophakun; Yuenyong, Chokchai

2018-01-01

To improve science teachers to develop the STS lesson plans for enhancing the students' inventive thinking skills, the workshop of improving science teachers to develop the STS lesson plans for enhancing the Inventive thinking skills were organized. The paper aimed to clarify what teachers learn from the workshop. The goal of the activity of the workshop aimed to: 1) improve participants a better understanding of the relationship between the Inquiry based learning with STS approach, 2) understand the meaning and importance of the STS approach and identify the various stages of Yuenyong (2006) STS learning process, 3) discuss what they learned from the examples of Yuenyong (2006) lesson plan, 4) develop some activities for each stage of Yuenyong (2006) STS approach, and 5) ideas of providing STS approach activities for enhancing inventive thinking skills. Participants included 3 science teachers who work in Khon Kaen, Thailand. Methodology regarded interpretive paradigm. Teachers' learning about pedagogy of enhancing the students' inventive thinking skills will be interpreted through participant observation, teachers' tasks, and interview. The finding revealed that all participants could demonstrate their ideas how to generate the STS lesson plans as a way of enhancing inventive thinking skills. Teachers could mention some element of inventive thinking skills which could be generated on their STS learning activities.

Virtual Learning Simulations in High School: Effects on Cognitive and Non-cognitive Outcomes and Implications on the Development of STEM Academic and Career Choice

PubMed Central

Thisgaard, Malene; Makransky, Guido

2017-01-01

The present study compared the value of using a virtual learning simulation compared to traditional lessons on the topic of evolution, and investigated if the virtual learning simulation could serve as a catalyst for STEM academic and career development, based on social cognitive career theory. The investigation was conducted using a crossover repeated measures design based on a sample of 128 high school biology/biotech students. The results showed that the virtual learning simulation increased knowledge of evolution significantly, compared to the traditional lesson. No significant differences between the simulation and lesson were found in their ability to increase the non-cognitive measures. Both interventions increased self-efficacy significantly, and none of them had a significant effect on motivation. In addition, the results showed that the simulation increased interest in biology related tasks, but not outcome expectations. The findings suggest that virtual learning simulations are at least as efficient in enhancing learning and self-efficacy as traditional lessons, and high schools can thus use them as supplementary educational methods. In addition, the findings indicate that virtual learning simulations may be a useful tool in enhancing student’s interest in and goals toward STEM related careers. PMID:28611701

Early Predictors of Hypocalcemia After Total Thyroidectomy

PubMed Central

Noureldine, Salem I.; Genther, Dane J.; Lopez, Michael; Agrawal, Nishant; Tufano, Ralph P.

2015-01-01

IMPORTANCE Postoperative hypocalcemia is common after total thyroidectomy, and perioperative monitoring of serum calcium levels is arguably the primary reason for overnight hospitalization. Confidently predicting which patients will not develop significant hypocalcemia may allow for a safe earlier discharge. OBJECTIVE To examine associations of patient characteristics with hypocalcemia, duration of hospitalization, and postoperative intact parathyroid hormone (IPTH) level after total thyroidectomy. DESIGN, SETTING, AND PARTICIPANTS Retrospective study of consecutive patients who underwent total thyroidectomy by a single high-volume surgeon between February 1, 2010, and November 30, 2012. Postoperative serum 25-hydroxyvitamin D (vitamin D), calcium, and IPTH levels were tested within 6 to 8 hours after surgery. Mild hypocalcemia was defined as any postoperative serum calcium level of less than 8.4 to 8.0 mg/dL. Significant hypocalcemia was defined as any postoperative serum calcium level of less than 8.0 mg/dL or the development of hypocalcemia-related symptoms. INTERVENTIONS Total thyroidectomy. MAIN OUTCOMES AND MEASURES Associations of patient demographic and clinical characteristics and laboratory values with postoperative mild and significant hypocalcemia were examined using univariate analysis, and independent predictors of hypocalcemia, duration of hospitalization, and IPTH level were determined using multivariate analysis. RESULTS Overall, 304 total thyroidectomies were performed. Mild and significant hypocalcemia occurred in 68 (22.4%) and 91 (29.9%) patients, respectively, of which the majority were female (P = .003). The development of significant hypocalcemia was associated with postoperative IPTH level (P < .001). On multivariate analysis, males had a decreased risk of developing mild (odds ratio, 0.37 [95% CI, 0.16–0.85]) and significant (odds ratio, 0.57 [95% CI, 0.09–0.78]) hypocalcemia. Every 10-pg/mL increase in postoperative IPTH level predicted a 43% decreased risk of significant hypocalcemia (P < .001) and an 18% decreased risk of hospitalization beyond 24 hours (P = .03). Presence of malignant neoplasm carried a 27% risk of mild hypocalcemia (P = .02). There was a progressively increasing risk of lower IPTH levels for each parathyroid gland inadvertently resected or autotransplanted. Male sex and African American race were independently predictive of higher IPTH levels. CONCLUSIONS AND RELEVANCE Low postoperative IPTH level, female sex, and presence of malignant neoplasm are all significant, independent predictors of hypocalcemia after total thyroidectomy. Clinicians should consider these variables when deciding how to best manage or prevent postoperative hypocalcemia. PMID:25321339

GAUGING THE EXTENT OF THYROIDECTOMY FOR INDETERMINATE THYROID NODULES: AN ONCOLOGIC PERSPECTIVE.

PubMed

Schneider, David F; Cherney Stafford, Linda M; Brys, Nicole; Greenberg, Caprice C; Balentine, Courtney J; Elfenbein, Dawn M; Pitt, Susan C

2017-04-02

Increasing emphasis is being placed on appropriateness of care and avoidance of over- and under-treatment. Indeterminate thyroid nodules (ITNs) present a particular risk for this problem because cancer found via diagnostic lobectomy (DL) often requires a completion thyroidectomy (CT). However, initial total thyroidectomy (TT) for benign ITN results in lifelong thyroid hormone replacement. We sought to measure the accuracy and factors associated with the extent of initial thyroidectomy for ITN. We queried a single institution thyroid surgery database for all adult patients undergoing an initial operation for ITN. Multivariate logistic regression identified factors associated with either oncologic under- or overtreatment at initial operation. There were 639 patients with ITN. The median age was 52 (range, 18 to 93) years, 78.4% were female, and final pathology revealed a cancer >1 cm in 24.7%. The most common cytology was follicular neoplasm (45.1%) followed by Hürthle cell neoplasm (20.2%). CT or initial oncologic undertreatment was required in 58 patients (9.3%). Excluding those with goiters, 19.0% were treated with TT for benign final pathology. Multivariate analysis failed to identify any factor that independently predicted the need for CT. Female gender was associated with TT in benign disease (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0 to 4.5; P = .05). Age >45 years predicted correct initial use of DL (OR, 2.6; 95% CI, 1.2 to 5.7; P = .02). Suspicious for papillary thyroid carcinoma (OR, 5.7; 95% CI, 2.1 to 15.3; P<.01) and frozen section (OR, 9.7; 95% CI, 2.5 to 38.6; P<.01) were associated with oncologically appropriate initial TT. The highest frequency of CT occurred in patients with follicular lesion of undetermined significance (11.6%). TT for benign final pathology occurred most frequently in patients with a Hürthle cell neoplasm (24.8%). In patients with ITN, nearly 30% received an inappropriate extent of initial thyroidectomy from an oncologic standpoint. Tools to pre-operatively identify both benign and malignant disease can assist in the complex decision making to gauge the proper extent of initial surgery for ITN. ATA = American Thyroid Association AUS = atypia of undetermined significance CI = confidence interval CT = completion thyroidectomy FLUS = follicular lesion of undetermined significance ITN = indeterminate thyroid nodule OR = odds ratio PTC = papillary thyroid carcinoma TT = total thyroidectomy.

Novice High School Science Teachers: Lesson Plan Adaptations

ERIC Educational Resources Information Center

Scharon, Aracelis Janelle

2013-01-01

The Next Generation Science Standards (NRC, 2013) positions teachers as responsible for necessary decision making about how their intended science lesson plan content supports continuous student science learning. Teachers interact with their instructional lesson plans in dynamic and constructive ways. Adapting lesson plans is complex. This process…

The Promise of Collaboration

ERIC Educational Resources Information Center

Bauml, Michelle

2016-01-01

Whether a teacher loves it or dreads it, lesson planning is a crucial step in the teaching process. Done effectively, collaborative lesson planning--in which teachers work together to design lessons--leads to increased professional learning, higher job satisfaction for teachers, and better lesson plans. The process poses challenges for both…

Life After Being a Pathology Department Chair II: Lessons Learned.

PubMed

Bailey, David N; Lipscomb, Mary F; Gorstein, Fred; Wilkinson, David; Sanfilippo, Fred

2017-01-01

The 2016 Association of Pathology Chairs annual meeting featured a discussion group of Association of Pathology Chairs senior fellows (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) that focused on how they decided to transition from the chair, how they prepared for such transition, and what they did after the transition. At the 2017 annual meeting, the senior fellows (encompassing 481 years of chair service) discussed lessons they learned from service as chair. These lessons included preparation for the chairship, what they would have done differently as chair, critical factors for success as chair, factors associated with failures, stress reduction techniques for themselves and for their faculty and staff, mechanisms for dealing with and avoiding problems, and the satisfaction they derived from their service as chair. It is reasonable to assume that these lessons may be representative of those learned by chairs of other specialties as well as by higher-level academic administrators such as deans, vice presidents, and chief executive officers. Although the environment for serving as a department chair has been changing dramatically, many of the lessons learned by former chairs are still valuable for current chairs of any length of tenure.

Teaching Inquiry using NASA Earth-System Science: Lessons Learned for Blended, Scaffolded Professional Development

NASA Astrophysics Data System (ADS)

Ellis, T. D.; TeBockhorst, D.

2013-12-01

Teaching Inquiry using NASA Earth-System Science (TINES) is a NASA EPOESS funded program exploring blended professional development for pre- and in-service educators to learn how to conduct meaningful inquiry lessons and projects in the K-12 classroom. This project combines trainings in GLOBE observational protocols and training in the use of NASA Earth Science mission data in a backward-faded scaffolding approach to teaching and learning about scientific inquiry. It also features a unique partnership with the National Science Teachers Association Learning Center to promote cohort building and blended professional development with access to NSTA's collection of resources. In this presentation, we will discuss lessons learned in year one and two of this program and how we plan to further develop this program over the next two years.

Online Conferencing: Lessons Learned.

ERIC Educational Resources Information Center

Green, Lyndsay

This guide summarizes lessons learned from the author's experience of organizing and moderating five non-pedagogical online conferences that use World Wide Web-based conferencing software, whether synchronous or asynchronous. Seven sections cover the following topics: (1) the pros and cons of online conferencing; (2) setting objectives; (3)…

The Virginia Generalist Initiative: Lessons Learned in a Statewide Consortium.

ERIC Educational Resources Information Center

Morse, R. Michael; Plungas, Gay S.; Duke, Debra; Rollins, Lisa K.; Barnes, H. Verdain; Brinson, Betsy K.; Martindale, James R.; Marsland, David W.

1999-01-01

To increase supply of generalist physicians, three state-supported Virginia medical schools formed a partnership with governmental stakeholders in the Generalist Physician Initiative. Lessons learned concerning stakeholder participation in planning, shared philosophical commitment, support for risk-taking, attitudes toward change, and trust are…

MINE WASTE TECHNOLOGY PROGRAM: RECENT RESULTS: LESSONS LEARNED AND FUTURE OPPORTUNITIES

EPA Science Inventory

In the EPA sponsored AML workshop, a number of Mine Waste Technology Program (MWTP) projects will be presented in order to highlight the most successful technology demonstrations. Recent results, lesson learned and future opportunities will be presented. The MWTP projects includ...

Research Administration: Lessons Learned.

ERIC Educational Resources Information Center

Dummer, George H.

1995-01-01

The ways in which accountability issues have affected federal-university relationships, particularly in the area of academic research, are examined. Lessons university administrators have learned since issuance of Office of Management and Budget Circular A-21 in 1958, Congressional hearings on the operations of the National Institutes of Health…

Two Approaches to Distance Education: Lessons Learned.

ERIC Educational Resources Information Center

Sedlak, Robert A.; Cartwright, G. Phillip

1997-01-01

Outlines lessons learned by the University of Wisconsin-Stout in implementing two distance education programs, a technology program using interactive television and a hospitality program using Lotus Notes to deliver courses. Topics discussed include program concept vs. technology as stimulus for innovation, program planning/administration,…

Process Improvement for Next Generation Space Flight Vehicles: MSFC Lessons Learned

NASA Technical Reports Server (NTRS)

Housch, Helen

2008-01-01

This viewgraph presentation reviews the lessons learned from process improvement for Next Generation Space Flight Vehicles. The contents include: 1) Organizational profile; 2) Process Improvement History; 3) Appraisal Preparation; 4) The Appraisal Experience; 5) Useful Tools; and 6) Is CMMI working?

LESSONS LEARNED AND NEXT STEPS FOR BUILDING KNOWLEDGE ABOUT TRIBAL MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING.

PubMed

Whitmore, Corrie B; Sarche, Michelle; Ferron, Cathy; Moritsugu, John; Sanchez, Jenae G

2018-05-16

Authors in this Special Issue of the Infant Mental Health Journal shared the work of the first three cohorts of Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees funded by the Administration for Children and Families. Since 2010, Tribal MIECHV grantees have served families and children prenatally to kindergarten entry in American Indian and Alaska Native (AI/AN) communities across the lower 48 United States and Alaska. Articles highlighted challenges and opportunities that arose as grantees adapted, enhanced, implemented, and evaluated their home-visiting models. This article summarizes nine lessons learned across the articles in this Special Issue. Lessons learned address the importance of strengths-based approaches, relationship-building, tribal community stakeholder involvement, capacity-building, alignment of resources and expectations, tribal values, adaptation to increase cultural and contextual attunement, indigenous ways of knowing, community voice, and sustainability. Next steps in Tribal MIECHV are discussed in light of these lessons learned. © 2018 Michigan Association for Infant Mental Health.

The role of failure/problems in engineering: A commentary of failures experienced - lessons learned

NASA Technical Reports Server (NTRS)

Ryan, R. S.

1992-01-01

The written version of a series of seminars given to several aerospace companies and three NASA centers are presented. The results are lessons learned through a study of the problems experienced in 35 years of engineering. The basic conclusion is that the primary cause of problems has not been mission technologies, as important as technology is, but the neglect of basic principles. Undergirding this is the lack of a systems focus from determining requirements through design, verification, and operations phases. Many of the concepts discussed are fundamental to total quality management (TQM) and can be used to augment this product enhanced philosophy. Fourteen principles are addressed with problems experienced and are used as examples. Included is a discussion of the implication of constraints, poorly defined requirements, and schedules. Design guidelines, lessons learned, and future tasks are listed. Two additional sections are included that deal with personal lessons learned and thoughts on future thrusts (TQM).

Lessons learned in the development of the STOL intelligent tutoring system

NASA Technical Reports Server (NTRS)

Seamster, Thomas; Baker, Clifford; Ames, Troy

1991-01-01

Lessons learned during the development of the NASA Systems Test and Operations Language (STOL) Intelligent Tutoring System (ITS), being developed at NASA Goddard Space Flight Center are presented. The purpose of the intelligent tutor is to train STOL users by adapting tutoring based on inferred student strengths and weaknesses. This system has been under development for over one year and numerous lessons learned have emerged. These observations are presented in three sections, as follows. The first section addresses the methodology employed in the development of the STOL ITS and briefly presents the ITS architecture. The second presents lessons learned, in the areas of: intelligent tutor development; documentation and reporting; cost and schedule control; and tools and shells effectiveness. The third section presents recommendations which may be considered by other ITS developers, addressing: access, use and selection of subject matter experts; steps involved in ITS development; use of ITS interface design prototypes as part of knowledge engineering; and tools and shells effectiveness.

The surgical learning and instructional portfolio: what residents at a single institution are learning.

PubMed

Webb, Travis P; Merkley, Taylor R

2011-03-01

The Accreditation Council for Graduate Medical Education (ACGME) Learning Portfolio is recommended as a tool to develop and document reflective, practice-based learning and improvement. There is no consensus regarding the appropriate content of a learning portfolio in medical education. Studying lessons selected for inclusion in their learning portfolios by surgical trainees could help identify useful subject matter for this purpose. Each month, all residents in our surgery residency program submit entries into their individual Surgical Learning and Instructional Portfolio (SLIP). The SLIP entries from July 2008 to 2009 (n = 420) were deidentified and randomized using a random number generator. We conducted a thematic content analysis of 50 random portfolio entries to identify lessons learned. Two independent raters analyzed the "3 lessons learned" portion of the portfolio entries and identified themes and subthemes using the constant comparative method used in grounded theory. The collaborative coding process resulted in theme saturation after the identification of 7 themes and their subthemes. Themes in decreasing order of frequency included complications, disease epidemiology, disease presentation, surgical management of disease, medical management of disease, operative techniques, and pathophysiology. Junior residents chose to focus on a broad array of foundational topics including disease presentation, epidemiology, and overall management of diseases, whereas postgraduate year-4 (PGY-4) and PGY-5 residents most frequently chose to focus on complications as learning points. Lessons learned reflect perceived needs of the trainees based on training year. When given a template to follow, junior and senior residents choose to reflect on different subject matter to meet their learning goals.

Deterrence & Influence in Counterterrorism. A Component in the War on al Qaeda

DTIC Science & Technology

2002-02-01

13, 2001). Summary xv There is a lesson to learn from this for he who wishes to learn . . . . The Soviet Union entered Afghanistan in the last week of...subject needs urgent attention. Placing at Risk What the Terrorists Hold Dear: Convincing Regional Allies to Act One of the lessons learned from...formal reviews of the draft manuscript by Jerrold Green and Ambassador L. Paul Bremer. Although we learned a great deal from interactions with our

Government Accountability Office Bid Protests in Air Force Source Selections: Evidence and Options

DTIC Science & Technology

2012-01-01

chapter, we focus on the sustained protests and lessons that can be learned from them. Th is chapter does not off er complete case histories of these...resulting research project, “Air Force Source Selections: Lessons Learned and Best Practices,” which was conducted within the Resource Management...Program of PAF in fiscal year (FY) 2009. This project studied the Air Force’s recent experience with bid protests before GAO and documented lessons that

Music: Comprehensive Musicianship Program. Grade 6.

ERIC Educational Resources Information Center

Burton, Leon H., Ed.; Thomson, William, Ed.

Forty-nine music lessons for use in sixth grade classes are presented. A number of these lessons feature songs and musical instruments from or about Hawaii, and lessons stress learning about tempos, accents, meters, notes, and rhythm patterns. The lessons introduce the history of instruments such as the ukulele, recorder, rhythm instruments, and…

Amazing Animals

ERIC Educational Resources Information Center

Al-Kuwari, Najat Saad

2007-01-01

"Animals" is a three-part lesson plan for young learners with a zoo animal theme. The first lesson is full of activities to describe animals, with Simon Says, guessing games, and learning stations. The second lesson is about desert animals, but other types of animals could be chosen depending on student interest. This lesson teaches…

Inductive & Deductive Science Thinking: A Model for Lesson Development

ERIC Educational Resources Information Center

Bilica, Kim; Flores, Margaret

2009-01-01

Middle school students make great learning gains when they participate in lessons that invite them to practice their developing scientific reasoning skills; however, designing developmentally appropriate, clear, and structured lessons about scientific thinking and reasoning can be difficult. This challenge can be met through lessons that teach…

[Variation of extralaryngeal furcation of the recurrent laryngeal nerve in total thyroidectomy].

PubMed

Fan, Zhe; Zhang, Lin; Zhang, Yingyi

2015-12-01

To explore the extralaryngeal furcation variation of the recurrent laryngeal nerve (RLN) in total thyroidectomy. The clinical data of 216 RLNs from 108 patients undergone total thyroidectomy were retrospectively analyzed. RLN was found during every operation and exposed in whole course until access into larynx. Twenty (9.26%) pieces of RLNs showed bifurcated or trifurcated RLNs before access into larynx. Ratio of furcation is lower than that reported before internationally. Bifurcations of RLNs on the left were more than that on the right. The protection of RLN is important for thyroid operation, especially in total thyroidetomy. Variation of extralaryngeal furcation of RLN usually leads to injury of RLN. Understanding of variation of RLN could decrease nerve function related complication.

Post thyroidectomy suture granuloma: a cytological diagnosis.

PubMed

Javalgi, Anita P; Arakeri, Surekha U

2013-04-01

There are known post thyroidectomized complications, a suture granuloma being less frequent, with its late complication mimicking recurrent thyroid cancer. A suture granuloma is a benign, granulomatous inflammatory reaction that occurs due to the use of non absorbable suture. It constitutes one of the late complications which altogether make up less than 2% of its incidence. A suture granuloma is similar to a foreign body reaction and it usually develops slowly as a painless, palpable asymptomatic mass over the years. It mimics a cancer recurrence or a lymph node metastasis. Here, we are reporting a case of a post thyroidectomy suture granuloma in a 46 years old lady who presented with a painless swelling in the lateral neck, with a past history of thyroidectomy 5 years back.

SOCAP: Lessons learned in applying SIPE-2 to the military operations crisis action planning domain

NASA Technical Reports Server (NTRS)

Desimone, Roberto

1992-01-01

This report describes work funded under the DARPA Planning and Scheduling Initiative that led to the development of SOCAP (System for Operations Crisis Action Planning). In particular, it describes lessons learned in applying SIPE-2, the underlying AI planning technology within SOCAP, to the domain of military operations deliberate and crisis action planning. SOCAP was demonstrated at the U.S. Central Command and at the Pentagon in early 1992. A more detailed report about the lessons learned is currently being prepared. This report was presented during one of the panel discussions on 'The Relevance of Scheduling to AI Planning Systems.'

Teaching Self-Determination and Arizona Standards for K-12 Students with Disabilities Lesson Plan Portfolio.

ERIC Educational Resources Information Center

Libby, Amanda

This document presents eight lesson plans designed to teach self-determination and Arizona academic standards to students with disabilities in grades K-12. The lesson plans include: (1) an oral language lesson plan for students with learning disabilities in grades 1-2; (2) a reading acquisition lesson that teaches color words to students with…

Hunter-Killer Teams: Attacking Enemy Safe Havens

DTIC Science & Technology

2010-01-01

previous practitioners through the venue of lessons learned passed on generationally. U.S. Army operations against the Southwest Indians, the Texas...much had been learned by the Office of Strategic Services (OSS) conducting guerrilla warfare activities. Prior to the Vietnam War, it was the...type formations throughout U.S. history to derive the advantages and disadvantages of their use, to capture key lessons learned about their

Building Bridges between Technology and Content Literacy in Special Education: Lessons Learned from Special Educators' Use of Integrated Technology and Perceived Benefits for Students

ERIC Educational Resources Information Center

Ciampa, Katia

2017-01-01

This single-site case study describes the outcomes and lessons learned from the implementation of a technology professional development initiative aimed at helping three special education teachers from an urban elementary school learn how to infuse technology in their content literacy instruction. Three types of qualitative data were collected:…

Lift-fan aircraft: Lessons learned-the pilot's perspective

NASA Technical Reports Server (NTRS)

Gerdes, Ronald M.

1993-01-01

This paper is written from an engineering test pilot's point of view. Its purpose is to present lift-fan 'lessons learned' from the perspective of first-hand experience accumulated during the period 1962 through 1988 while flight testing vertical/short take-off and landing (V/STOL) experimental aircraft and evaluating piloted engineering simulations of promising V/STOL concepts. Specifically, the scope of the discussions to follow is primarily based upon a critical review of the writer's personal accounts of 30 hours of XV-5A/B and 2 hours of X-14A flight testing as well as a limited simulator evaluation of the Grumman Design 755 lift-fan aircraft. Opinions of other test pilots who flew these aircraft and the aircraft simulator are also included and supplement the writer's comments. Furthermore, the lessons learned are presented from the perspective of the writer's flying experience: 10,000 hours in 100 fixed- and rotary-wing aircraft including 330 hours in 5 experimental V/STOL research aircraft. The paper is organized to present to the reader a clear picture of lift-fan lessons learned from three distinct points of view in order to facilitate application of the lesson principles to future designs. Lessons learned are first discussed with respect to case histories of specific flight and simulator investigations. These principles are then organized and restated with respect to four selected design criteria categories in Appendix I. Lastly, Appendix Il is a discussion of the design of a hypothetical supersonic short take-off vertical landing (STOVL) fighter/attack aircraft.

[Looking back but facing ahead: implementing lessons learned from the 2nd Lebanon War].

PubMed

Adini, Bruria; Laor, Danny; Lev, Boaz; Israeli, Avi

2010-07-01

The medical system utilizes a structured culture for learning lessons in order to improve the supply of services. Various tools are utilized to evaluate performance. The aim of the article is to describe the processes for learning lessons which were carried out following the Second Lebanon War and the major lessons that were identified and implemented. Three processes were performed: a process of learning Lessons of the heaLthcare system, initiated and led by the Supreme HeaLth Authority (SHA); After action review (AAR), initiated and led by the military Medical Corps and; at a later stage, a critique, initiated and led by the State Comptroller, that examined the performance of the medical system, as part of a critique on the preparedness of the home front. The following elements were defined as highly prioritized for improvement to elevate the preparedness for a future war: (1) deployment of unified clinics in conflict areas; (2) supply of medical services to the population in shelters; (3) deploying emergency medicine services, including the relationship between the Ministry of Health (MOH) and the Home Front Command (HFC); (4) defining the relationships between the MOH and HFC in deploying the community health services in emergencies; (5) protecting medical facilities and personal protection equipment for medical teams and; (6) treating acute stress reactions. The AAR, critique and learning lessons signify three different processes that can sometimes be contradictory. Nevertheless, it is possible to achieve organizational improvement white integrating between these three processes, as was displayed by the SHA.

Lessons learned from public health campaigns and applied to anti-DWI norms development

DOT National Transportation Integrated Search

1995-05-01

The purpose of this study was to examine norms development in past public health campaigns to direct lessons learned from those efforts to future anti-DNN'l programming. Three campaigns were selected for a multiple case study. The anti-smoking, anti-...

The CanMars Analogue Mission: Lessons Learned for Mars Sample Return

NASA Astrophysics Data System (ADS)

Osinski, G. R.; Beaty, D.; Battler, M.; Caudill, C.; Francis, R.; Haltigin, T.; Hipkin, V.; Pilles, E.

2018-04-01

We present an overview and lessons learned for Mars Sample Return from CanMars — an analogue mission that simulated a Mars 2020-like cache mission. Data from 39 sols of operations conducted in the Utah desert in 2015 and 2016 are presented.

Global Consultation Processes: Lessons Learned from Refugee Teacher Consultation Research in Malaysia

ERIC Educational Resources Information Center

O'Neal, Colleen R.; Gosnell, Nicole M.; Ng, Wai Sheng; Clement, Jennifer; Ong, Edward

2018-01-01

The process of global consultation has received little attention despite its potential for promoting international mutual understanding with marginalized communities. This article details theory, entry, implementation, and evaluation processes for global consultation research, including lessons learned from our refugee teacher intervention. The…

Beyond the Comfort Zone: Lessons of Intercultural Service

ERIC Educational Resources Information Center

Urraca, Beatriz; Ledoux, Michael; Harris, James T., III

2009-01-01

This article describes an international service-learning project in Bolivia undertaken by faculty and students from Widener University. The authors examine characteristics of the student group, trip preparation, and lessons learned from the experience. The article discusses the American cultural biases that emphasize personal comfort and…

San Antonio's Medical Center Corridor: Lessons Learned From The Metropolitan Model Deployment Initiative: Reducing Delay Through Integrated Freeway & Arterial Management

DOT National Transportation Integrated Search

2000-10-01

This report demonstrates the benefits and potential pitfalls of deploying and operating an integrated freeway and arterial management system. In particular, it discusses the lessons learned about the Medical Center Corridor (MCC) Project deployed in ...

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case

DTIC Science & Technology

1992-10-01

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case. This study... management information system to automate manual Naval aviation maintenance tasks-NALCOMIS. With the use of a fourth-generation programming language

Movement and Learning in Elementary School

ERIC Educational Resources Information Center

Lindt, Suzanne F.; Miller, Stacia C.

2017-01-01

Incorporating movement into elementary school lessons in reading, math, and other subjects can boost students' interest and academic learning while also helping them meet recommendations for daily involvement in physical activity. In a recent study, researchers found that students in classrooms where movement was integrated into regular lessons,…

Observation Skills - Tuning Up the Five Senses.

ERIC Educational Resources Information Center

Mason, Fred J.

Lesson plans designed to increase the observation skills for intermediate elementary students and provide them with a variety of sensory experiences in learning situations are presented in this document. Lesson plans include objectives, outlines for both indoor and outdoor learning experiences, materials and equipment needed, and evaluation…

Testing the Tester: Lessons Learned During the Testing of a State-of-the-Art Commercial 14nm Processor Under Proton Irradiation

NASA Technical Reports Server (NTRS)

Szabo, Carl M., Jr.; Duncan, Adam R.; Label, Kenneth A.

2017-01-01

Testing of an Intel 14nm desktop processor was conducted under proton irradiation. We share lessons learned, demonstrating that complex devices beget further complex challenges requiring practical and theoretical investigative expertise to solve.

Lessons Learned from Developing and Operating the Kepler Science Pipeline and Building the TESS Science Pipeline

NASA Technical Reports Server (NTRS)

Jenkins, Jon M.

2017-01-01

The experience acquired through development, implementation and operation of the KeplerK2 science pipelines can provide lessons learned for the development of science pipelines for other missions such as NASA's Transiting Exoplanet Survey Satellite, and ESA's PLATO mission.

Lessons Learned: Reflections of a University President

ERIC Educational Resources Information Center

Bowen, William G.

2010-01-01

"Lessons Learned" gives unprecedented access to the university president's office, providing a unique set of reflections on the challenges involved in leading both research universities and liberal arts colleges. In this landmark book, William Bowen, former president of Princeton University and of the Andrew W. Mellon Foundation, and…

Hydrogen Fuel Cell Analysis: Lessons Learned from Stationary Power Generation Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Scott E. Grasman; John W. Sheffield; Fatih Dogan

2010-04-30

This study considered opportunities for hydrogen in stationary applications in order to make recommendations related to RD&D strategies that incorporate lessons learned and best practices from relevant national and international stationary power efforts, as well as cost and environmental modeling of pathways. The study analyzed the different strategies utilized in power generation systems and identified the different challenges and opportunities for producing and using hydrogen as an energy carrier. Specific objectives included both a synopsis/critical analysis of lessons learned from previous stationary power programs and recommendations for a strategy for hydrogen infrastructure deployment. This strategy incorporates all hydrogen pathways andmore » a combination of distributed power generating stations, and provides an overview of stationary power markets, benefits of hydrogen-based stationary power systems, and competitive and technological challenges. The motivation for this project was to identify the lessons learned from prior stationary power programs, including the most significant obstacles, how these obstacles have been approached, outcomes of the programs, and how this information can be used by the Hydrogen, Fuel Cells & Infrastructure Technologies Program to meet program objectives primarily related to hydrogen pathway technologies (production, storage, and delivery) and implementation of fuel cell technologies for distributed stationary power. In addition, the lessons learned address environmental and safety concerns, including codes and standards, and education of key stakeholders.« less

A qualitative content analysis of global health engagements in Peacekeeping and Stability Operations Institute's stability operations lessons learned and information management system.

PubMed

Nang, Roberto N; Monahan, Felicia; Diehl, Glendon B; French, Daniel

2015-04-01

Many institutions collect reports in databases to make important lessons-learned available to their members. The Uniformed Services University of the Health Sciences collaborated with the Peacekeeping and Stability Operations Institute to conduct a descriptive and qualitative analysis of global health engagements (GHEs) contained in the Stability Operations Lessons Learned and Information Management System (SOLLIMS). This study used a summative qualitative content analysis approach involving six steps: (1) a comprehensive search; (2) two-stage reading and screening process to identify first-hand, health-related records; (3) qualitative and quantitative data analysis using MAXQDA, a software program; (4) a word cloud to illustrate word frequencies and interrelationships; (5) coding of individual themes and validation of the coding scheme; and (6) identification of relationships in the data and overarching lessons-learned. The individual codes with the most number of text segments coded included: planning, personnel, interorganizational coordination, communication/information sharing, and resources/supplies. When compared to the Department of Defense's (DoD's) evolving GHE principles and capabilities, the SOLLIMS coding scheme appeared to align well with the list of GHE capabilities developed by the Department of Defense Global Health Working Group. The results of this study will inform practitioners of global health and encourage additional qualitative analysis of other lessons-learned databases. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

[A Study on the Cognitive Learning Effectiveness of Scenario-Based Concept Mapping in a Neurological Nursing Course].

PubMed

Pan, Hui-Ching; Hsieh, Suh-Ing; Hsu, Li-Ling

2015-12-01

The multiple levels of knowledge related to the neurological system deter many students from pursuing studies on this topic. Thus, in facing complicated and uncertain medical circumstances, nursing students have diffi-culty adjusting and using basic neurological-nursing knowledge and skills. Scenario-based concept-mapping teaching has been shown to promote the integration of complicated data, clarify related concepts, and increase the effectiveness of cognitive learning. To investigate the effect on the neurological-nursing cognition and learning attitude of nursing students of a scenario-based concept-mapping strategy that was integrated into the neurological nursing unit of a medical and surgical nursing course. This quasi-experimental study used experimental and control groups and a pre-test / post-test design. Sopho-more (2nd year) students in a four-year program at a university of science and technology in Taiwan were convenience sampled using cluster randomization that was run under SPSS 17.0. Concept-mapping lessons were used as the intervention for the experimental group. The control group followed traditional lesson plans only. The cognitive learning outcome was measured using the neurological nursing-learning examination. Both concept-mapping and traditional lessons significantly improved post-test neurological nursing learning scores (p < .001), with no significant difference between the two groups (p = .51). The post-test feedback from the control group mentioned that too much content was taught and that difficulties were experienced in understanding mechanisms and in absorbing knowledge. In contrast, the experimental group held a significantly more positive perspective and learning attitude with regard to the teaching material. Furthermore, a significant number in the experimental group expressed the desire to add more lessons on anatomy, physiology, and pathology. These results indicate that this intervention strategy may help change the widespread fear and refusal of nursing students with regard to neurological lessons and may facilitate interest and positively affect learning in this important subject area. Integrating the concept-mapping strategy and traditional clinical-case lessons into neurological nursing lessons holds the potential to increase post-test scores significantly. Concept mapping helped those in the experimental group adopt views and attitudes toward learning the teaching material that were more positive than those held by their control-group peers. In addition, while 59% of the experimental group and 49% of the control group submitted opinions related to learning attitude in the open-ended questions, positive feedback was greater in the experimental group than in the control group.

Involving users with learning difficulties in health improvement: lessons from inclusive learning disability research.

PubMed

Walmsley, Jan

2004-03-01

In this paper the author considers the lessons to be drawn from what is termed "inclusive" learning disability research for user involvement around health improvement. Inclusive learning disability research refers to research where people with learning difficulties (intellectual disability) are involved as active participants, as opposed to passive subjects. There is by now a considerable body of such research, developed over the past 25 years. From the review, the author draws attention to areas which can inform practice in involvement of users in a way that adds value.

The Surgical Learning and Instructional Portfolio: What Residents at a Single Institution Are Learning

PubMed Central

Webb, Travis P; Merkley, Taylor R

2011-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) Learning Portfolio is recommended as a tool to develop and document reflective, practice-based learning and improvement. There is no consensus regarding the appropriate content of a learning portfolio in medical education. Studying lessons selected for inclusion in their learning portfolios by surgical trainees could help identify useful subject matter for this purpose. Methods Each month, all residents in our surgery residency program submit entries into their individual Surgical Learning and Instructional Portfolio (SLIP). The SLIP entries from July 2008 to 2009 (n = 420) were deidentified and randomized using a random number generator. We conducted a thematic content analysis of 50 random portfolio entries to identify lessons learned. Two independent raters analyzed the “3 lessons learned” portion of the portfolio entries and identified themes and subthemes using the constant comparative method used in grounded theory. Results The collaborative coding process resulted in theme saturation after the identification of 7 themes and their subthemes. Themes in decreasing order of frequency included complications, disease epidemiology, disease presentation, surgical management of disease, medical management of disease, operative techniques, and pathophysiology. Junior residents chose to focus on a broad array of foundational topics including disease presentation, epidemiology, and overall management of diseases, whereas postgraduate year-4 (PGY-4) and PGY-5 residents most frequently chose to focus on complications as learning points. Conclusions Lessons learned reflect perceived needs of the trainees based on training year. When given a template to follow, junior and senior residents choose to reflect on different subject matter to meet their learning goals. PMID:22379531

Lessons learned after three years of legalized, recreational marijuana: The Colorado experience.

PubMed

Ghosh, Tista S; Vigil, Daniel I; Maffey, Ali; Tolliver, Rickey; Van Dyke, Mike; Kattari, Leonardo; Krug, Heather; Reed, Jack K; Wolk, Larry

2017-11-01

In November 2012 Colorado voters approved legalized recreational marijuana. On January 1, 2014 Colorado became the first state to allow legal sales of non-medical marijuana for adults over the age of 21. Since that time, the state has been monitoring potential impacts on population health. In this paper we present lessons learned in the first three years following legal sales of recreational marijuana. These lessons pertain to health behaviors and health outcomes, as well as to health policy issues. Our intent is to share these lessons with other states as they face the prospect of recreational marijuana legalization. Copyright © 2017 Elsevier Inc. All rights reserved.

Apollo Lesson Sampler: Apollo 13 Lessons Learned

NASA Technical Reports Server (NTRS)

Interbartolo, Michael A.

2008-01-01

This CD-ROM contains a two-part case study of the Apollo 13 accident. The first lesson contains an overview of the electrical system hardware on the Apollo spacecraft, providing a context for the details of the oxygen tank explosion, and the failure chain reconstruction that led to the conditions present at the time of the accident. Given this background, the lesson then covers the tank explosion and immediate damage to the spacecraft, and the immediate response of Mission Control to what they saw. Part 2 of the lesson picks up shortly after the explosion of the oxygen tank on Apollo 13, and discusses how Mission Control gained insight to and understanding of the damage in the aftermath. Impacts to various spacecraft systems are presented, along with Mission Control's reactions and plans for in-flight recovery leading to a successful entry. Finally, post-flight vehicle changes are presented along with the lessons learned.

Task-Based Language Learning: Old Approach, New Style. A New Lesson to Learn (Aprendizaje basado en tareas: un antiguo enfoque, un nuevo estilo. Una nueva lección para aprender)

ERIC Educational Resources Information Center

Rodríguez-Bonces, Mónica; Rodríguez-Bonces, Jeisson

2010-01-01

This paper provides an overview of Task-Based Language Learning (TBL) and its use in the teaching and learning of foreign languages. It begins by defining the concept of TBL, followed by a presentation of its framework and implications, and finally, a lesson plan based on TBL. The article presents an additional stage to be considered when planning…

The Effect of Lesson Structures on Predication and Inference.

ERIC Educational Resources Information Center

Li, Tiancheng; Jonassen, David H.

Theories of situated learning attempt to overcome the ill-structured nature of some domains of learning, and to use students' tendencies to construct knowledge representation on context and prior experience. Success comes when students apply abstract principles to real life. This study compares the effectiveness of two different lesson structures…

Developing Coherent Conceptual Storylines: Two Elementary Challenges

ERIC Educational Resources Information Center

Hanuscin, Deborah; Lipsitz, Kelsey; Cisterna-Alburquerque, Dante; Arnone, Kathryn A.; van Garderen, Delinda; de Araujo, Zandra; Lee, Eun Ju

2016-01-01

The "conceptual storyline" of a lesson refers to the flow and sequencing of learning activities such that science concepts align and progress in ways that are instructionally meaningful to student learning of the concepts. Research demonstrates that when teachers apply lesson design strategies to create a coherent science content…

DSCOVR Contamination Lessons Learned

NASA Technical Reports Server (NTRS)

Graziani, Larissa

2015-01-01

The Triana observatory was built at NASA GSFC in the late 1990's, then placed into storage. After approximately ten years it was removed from storage and repurposed as the Deep Space Climate Observatory (DSCOVR). This presentation outlines the contamination control program lessons learned during the integration, test and launch of DSCOVR.

Stifling Student Expression: A Lesson Taught, A Lesson Learned.

ERIC Educational Resources Information Center

Eveslage, Thomas E.

1995-01-01

Substantive student publications can bring the democratic process to life in high schools. The article presents examples of student censorship by high school teachers and advisors, noting that the attempt to inhibit students' written expression may short-circuit a useful learning tool that can prepare students for productive citizenship. (SM)

Finishing and Special Motifs: Lessons Learned from CRISPR Analysis Using Next-Generation Draft Sequences (7th Annual SFAF Meeting, 2012)

ScienceCinema

Campbell, Catherine

2018-01-22

Catherine Campbell on "Finishing and Special Motifs: Lessons learned from CRISPR analysis using next-generation draft sequences" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

Learning about Posterior Probability: Do Diagrams and Elaborative Interrogation Help?

ERIC Educational Resources Information Center

Clinton, Virginia; Alibali, Martha Wagner; Nathan, Mitchel J.

2016-01-01

To learn from a text, students must make meaningful connections among related ideas in that text. This study examined the effectiveness of two methods of improving connections--elaborative interrogation and diagrams--in written lessons about posterior probability. Undergraduate students (N = 198) read a lesson in one of three questioning…

Plastics in Our Environment: A Jigsaw Learning Activity

ERIC Educational Resources Information Center

Hampton, Elaine; Wallace, Mary Ann; Lee, Wen-Yee

2009-01-01

In this lesson, a ready-to-teach cooperative reading activity, students learn about the effects of plastics in our environment, specifically that certain petrochemicals act as artificial estrogens and impact hormonal activities. Much of the content in this lesson was synthesized from recent medical research about the impact of xenoestrogens and…

Urban partnership agreement and congestion reduction demonstration programs : lessons learned on congestion pricing from the Seattle and Atlanta household travel behavior surveys.

DOT National Transportation Integrated Search

2014-04-01

This paper presents lessons learned from household traveler surveys administered in Seattle and Atlanta as part of the evaluation of the Urban Partnership Agreement and Congestion Reduction Demonstration Programs. The surveys use a two-stage panel su...

Art & Music Appreciation. A to Z Active Learning Series.

ERIC Educational Resources Information Center

Forte, Imogene; Schurr, Sandra

This workbook includes high-interest activities, lessons, and projects to further students' interest in and understanding of important exploratory and enrichment topics essential to a balanced middle grades program. The workbook includes lessons and activities that encourage students to learn more about the arts. Instructional strategies are…

Lessons from the Past Look to the Future.

ERIC Educational Resources Information Center

Howden, Hilde

2000-01-01

Technological advances and many other changes in society change how and what students learn. Indicates the need to learn lessons from the past in order to be more mathematically literate and broaden the mathematics curriculum to a mathematical sciences curriculum that incorporates 21st century mathematics. (Contains 14 references.) (ASK)

Advanced warning for railroad delays in San Antonio : lessons learned from the Metropolitan Model Deployment Initiative : providing enhanced information to the public

DOT National Transportation Integrated Search

This report demonstrates the benefits of deploying and operating an integrated highway/rail system, along with the potential barriers to implementation. In particular, it discusses the lessons learned associated with the Advanced Warning to Avoid Rai...

Wilson and the United States Entry into the Great War.

ERIC Educational Resources Information Center

Stark, Matthew J.

2002-01-01

Presents a lesson plan that enables students to learn how to analyze primary sources, while they also learn why the United States entered into World War I. States that this lesson can be used as an introduction to World War I. Includes handouts that feature primary materials. (CMK)

Implementation of the Generic Safety Analysis Report - Lessons Learned

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blanchard, A.

1999-06-02

The Savannah River Site has completed the development, review and approval process for the Generic Safety Analysis Report (GSAR) and implemented this information in facility SARs and BIOs. This includes the yearly revision of the GSAR and the facility-specific SARs. The process has provided us with several lessons learned.

Selected Distance Education Disaster Planning Lessons Learned from Hurricane Katrina

ERIC Educational Resources Information Center

McLennan, Kay L.

2006-01-01

This paper details one institution's experience developing post disaster online instructional capability without access to the institution's courseware platform and help desk services. In turn, the post disaster distance education lessons learned include the possible need for all institutions to: prearrange an interruption of service agreement…

Achieving Balance: Lessons Learned from University and College Presidents

ERIC Educational Resources Information Center

Havice, Pamela A.; Williams, Frankie K.

2005-01-01

This study investigated strategies used by college and university presidents in balancing their professional and personal lives. The conceptual framework for this study comes from the work of Schein (1985, 1992). Lessons learned and words of wisdom from these presidents can enhance leadership effectiveness at all levels in higher education.

Perspectives on Blended Learning through the On-Line Platform, LabLessons, for Chemistry

ERIC Educational Resources Information Center

Jihad, Teeba; Klementowicz, Edward; Gryczka, Patrick; Sharrock, Chappel; Maxfield, MacRae; Lee, Yongjun; Montclare, Jin Kim

2018-01-01

The effectiveness of blended learning was evaluated through the integration of an online chemistry platform, LabLessons. Two modules, "Formation of Hydrogen" and "Titration," were designed by college mentors alongside classroom chemistry teachers to engage and allow high school students to better comprehend these scientific…

Lessons Learned Planning a Statewide Conference: "Alabama's Choice--Tobacco or Health?"

ERIC Educational Resources Information Center

Geiger, Brian F.

This paper describes lessons learned while planning a statewide conference to increase the knowledge of tobacco control advocates and promote implementation of the Alabama Comprehensive Tobacco Use Prevention and Control Plan (Plan) within the state. The Plan has three overall goals: preventing youth from becoming tobacco users; promoting…

Writing Learning Outcomes for English Language Lessons in Multilingual Schools

ERIC Educational Resources Information Center

Jones, Sally Ann

2016-01-01

This article proposes a pedagogic innovation in teacher education by articulating a method for writing learning outcomes for English language lessons in multilingual school contexts. The argument for this approach is founded on curriculum studies; however, the practice also draws specifically on applied psycholinguistic and sociolinguistic…

Finishing and Special Motifs: Lessons Learned from CRISPR Analysis Using Next-Generation Draft Sequences (7th Annual SFAF Meeting, 2012)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Campbell, Catherine

Catherine Campbell on "Finishing and Special Motifs: Lessons learned from CRISPR analysis using next-generation draft sequences" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

Developing and Sustaining Partnerships: Lessons Learned.

ERIC Educational Resources Information Center

Wills, Joan L.; Kaufmann, Barbara A.

This paper reports on a study that examined skill standards pilot programs to identify lessons learned in the selection and involvement of representatives from the various stakeholder communities and the potential for sustaining the efforts of the pilot programs. Data were gathered through structured conversations with staff and committee members…

Teachers' Considerations of Students' Thinking during Mathematics Lesson Design

ERIC Educational Resources Information Center

Amador, Julie M.

2016-01-01

Teachers' abilities to design mathematics lessons are related to their capability to mobilize resources to meeting intended learning goals based on their noticing. In this process, knowing how teachers consider Students' thinking is important for understanding how they are making decisions to promote student learning. While teaching, what teachers…

Infusing Alcohol and Drug Prevention with Existing Classroom Study Units: Miscellaneous.

ERIC Educational Resources Information Center

Valencia Community Coll., Orlando, FL.

This curriculum module, one of seven developed by the "Infusion Project," offers information and miscellaneous lessons on drug use prevention for integration into an existing seventh-grade middle school curriculum. The module, based on a type of interactive learning called infusion learning contains seven lessons each providing…

Lessons learned in applying ecosystem goods and services to community decision making

EPA Science Inventory

This report is intended to describe lessons learned from the application of FEGS-based research in a series of PBS conducted by EPA’s Office of Research and Development (ORD) and make this information available and useful for planning future research into local decision sup...

Extended Mnemonic Instruction with Learning Disabled Students.

ERIC Educational Resources Information Center

Tolfa, Debra; And Others

Sixty-four learning disabled sixth, seventh, and eighth grade students were assigned to 24 small instructional groups which were in turn assigned at random to mnemonic and control conditions. Instructional groups were then given three daily lessons on dinosaurs in counterbalanced order. The lessons involved dinosaur vocabulary, attributes of…

Keeping Kids Smokefree: Lessons Learned on Community Participation

ERIC Educational Resources Information Center

Charlier, N.; Glover, M.; Robertson, J.

2009-01-01

Community participation in program decision-making and implementation is an ideal that community and academic stakeholders aspire to in participatory research. This ideal, however, can be difficult to achieve. We describe lessons learned about community participation from a quasi-experimental trial aimed at reducing the uptake of smoking among…

"Hey, I'm Learning This"

ERIC Educational Resources Information Center

Bragg, Leicha A.

2006-01-01

Mathematics games are often used in the classroom as a reward or warm-up activity before the "real" learning takes place. Many teachers have witnessed how useful games are for tuning-in students to the impending mathematics lesson. However, have teachers considered playing games as the central part of the lesson? This article explores…

78 FR 64202 - Meeting To Discuss Lessons Learned From Commerce Spectrum Management Advisory Committee Working...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

....'' \\2\\ \\2\\ Memorandum for Heads of Executive Departments and Agencies, Expanding America's Leadership in...-leadership-wireless-innovatio . Matters To Be Considered: At this meeting, NTIA will facilitate a forum for the CSMAC Working Group participants to discuss lessons learned from the collaborative efforts within...

Non-technical impediments to maglev development : a lesson learned study of the Florida Maglev Demonstration Project

DOT National Transportation Integrated Search

1994-04-01

The objective of this paper is to study lessons learned, to date, from the Orlando experience. Particular attention will be given to the economics of competing modes in the private and public section. That objective will entail identifying the groups...

Effects of Learning about Historical Gender Discrimination on Early Adolescents' Occupational Judgments and Aspirations

ERIC Educational Resources Information Center

Pahlke, Erin; Bigler, Rebecca S.; Green, Vanessa A.

2010-01-01

To examine the consequences of learning about gender discrimination, early adolescents (n = 121, aged 10-14) were randomly assigned to receive either (a) standard biographical lessons about historical figures (standard condition) or (b) nearly identical lessons that included information about gender discrimination (discrimination condition).…

TBAL: Technology-Based Active Learning in Higher Education

ERIC Educational Resources Information Center

Ghilay, Yaron; Ghilay, Ruth

2015-01-01

In many institutions of higher education worldwide, faculty members manage lessons based on information transfer whereas their students become passive listeners. According to international research, passive learning has disadvantages mainly because students do not engage in the lesson. The study introduces a new model for higher education called…

Lesson Study and Pedagogic Literacy in Initial Teacher Education: Challenging Reductive Models

ERIC Educational Resources Information Center

Cajkler, Wasyl; Wood, Phil

2016-01-01

This paper argues that teacher learning is not reducible to lists of "performative" standards. Funded by the Society for Educational Studies, we used "lesson study" as a vehicle to develop new teacher expertise, following which we concluded that conceptualising "learning to teach" as acquisition of standards is…

Teaching Africa's Cities through Meja Mwangi's Novels

ERIC Educational Resources Information Center

Smiley, Sarah L.

2009-01-01

This article presents a lesson plan used to teach about African urbanization using Kenyan novels. Specifically, three urban novels written by Meja Mwangi are used. Based on a qualitative survey of student preference and learning, this lesson plan uses these novels alongside more traditional academic texts to achieve effective student learning.…

Special nuclear materials cutoff exercise: Issues and lessons learned. Volume 3

DOE Office of Scientific and Technical Information (OSTI.GOV)

Libby, R.A.; Segal, J.E.; Stanbro, W.D.

1995-08-01

This document is appendices D-J for the Special Nuclear Materials Cutoff Exercise: Issues and Lessons Learned. Included are discussions of the US IAEA Treaty, safeguard regulations for nuclear materials, issue sheets for the PUREX process, and the LANL follow up activity for reprocessing nuclear materials.

Lessons learned in crisis management.

PubMed

Olson, Chris

2014-01-01

This paper will explore lessons learned following a series of natural and man-made disasters affecting the Massachusetts Mutual Life Insurance Company and/or its subsidiaries. The company employs a team of certified continuity professionals who are charged with overseeing resilience on behalf of the enterprise and leading recovery activities wherever and whenever necessary.

Lesson Plan--Online Games to Teach Vocabulary to Young Learners

ERIC Educational Resources Information Center

Okaz, Abeer Ali

2014-01-01

This article describes how teachers can use online learning games to enhance young learners' language skill learning. Children love all sorts of games, therefore, implementing games (particularly online ones) are a useful aspect of lessons. Games are an indispensable tool while teaching, especially if employed effectively. The online activities…

Lessons learned from a pilot project of an automatic vehicle location system in an urban winter maintenance operations setting.

DOT National Transportation Integrated Search

2002-01-01

This report documents the lessons learned during the evolution of the Virginia Department of Transportation's pilot project to use an automatic vehicle location (AVL) system during winter maintenance operations in an urban setting. AVL is a technolog...

Lessons Learned from Accelerating Opportunity. Lessons Learned Series

ERIC Educational Resources Information Center

Wilson, Randall

2015-01-01

The Accelerating Opportunity initiative helps our nation's lowest-skilled adults earn college credentials and enter higher-wage jobs faster by combining the Adult Basic Education and career and technical training they need into one integrated curriculum. Based on four years of designing and managing Accelerating Opportunity, Jobs for the Future…

Ride through SaFIRES : lessons learned from SaFIRES - an APTS operational test in Prince William County, Virginia.

DOT National Transportation Integrated Search

2002-06-01

This interim report documents the lessons learned to date from the Smart Flex-route Integrated Real-time Enhancement System (SaFIRES) operational test in Prince William County, Virginia. This route deviation service has proven to be popular with Coun...

Doing Philosophy Effectively: Student Learning in Classroom Teaching

PubMed Central

2015-01-01

An important aim of teaching philosophy in Dutch secondary schools is to learn about philosophy (i.e., the great philosophers) by doing philosophy. We examined doing philosophy and focused specifically on the relationship between student learning activities and teacher behavior; in doing so, a qualitative cross-case analysis of eight philosophy lessons was performed. The effectiveness of doing philosophy was operationalized into five learning activities comprising rationalizing, analyzing, testing, producing criticism, and reflecting, and scored by means of qualitative graphical time registration. Using CA we find a quantitative one-dimensional scale for the lessons that contrasts lessons that are more and less effective in terms of learning and teaching. A relationship was found between teaching by teachers and doing philosophy by students. In particular we found students to produce a higher level of doing philosophy with teachers who chose to organize a philosophical discussion with shared guidance by the teacher together with the students. PMID:26379267

Doing Philosophy Effectively: Student Learning in Classroom Teaching.

PubMed

Kienstra, Natascha; Imants, Jeroen; Karskens, Machiel; van der Heijden, Peter G M

2015-01-01

An important aim of teaching philosophy in Dutch secondary schools is to learn about philosophy (i.e., the great philosophers) by doing philosophy. We examined doing philosophy and focused specifically on the relationship between student learning activities and teacher behavior; in doing so, a qualitative cross-case analysis of eight philosophy lessons was performed. The effectiveness of doing philosophy was operationalized into five learning activities comprising rationalizing, analyzing, testing, producing criticism, and reflecting, and scored by means of qualitative graphical time registration. Using CA we find a quantitative one-dimensional scale for the lessons that contrasts lessons that are more and less effective in terms of learning and teaching. A relationship was found between teaching by teachers and doing philosophy by students. In particular we found students to produce a higher level of doing philosophy with teachers who chose to organize a philosophical discussion with shared guidance by the teacher together with the students.

Learning and change in a community mental health setting.

PubMed

Mancini, Michael A; Miner, Craig S

2013-10-01

This article offers methodological reflections and lessons learned from a three-year university-community partnership that used participatory action research methods to develop and evaluate a model for learning and change. Communities of practice were used to facilitate the translation of recovery-oriented and evidence-based programs into everyday practice at a community mental health agency. Four lessons were drawn from this project. First, the processes of learning and organizational change are complex, slow, and multifaceted. Second, development of leaders and champions is vital to sustained implementation in an era of restricted resources. Third, it is important to have the agency's values, mission, policies, and procedures align with the principles and practices of recovery and integrated treatment. And fourth, effective learning of evidence-based practices is influenced by organizational culture and climate. These four lessons are expanded upon and situated within the broader literature and implications for future research are discussed.

Parathyroid hormone measurement in prediction of hypocalcaemia following thyroidectomy.

PubMed

Mehrvarz, Shaban; Mohebbi, Hassan Ali; Kalantar Motamedi, Mohammad Hosein; Khatami, Seyed Masoud; Rezaie, Ramzanali; Rasouli, Hamid Reza

2014-02-01

To determine the risk of postthyroidectomy hypocalcaemia by measuring parathyroid hormone (PTH) level after thyroidectomy. Cross-sectional study. Baqiyatallah Hospital, Tehran, Iran, from March 2008 to July 2010. All included patients were referred for total or near bilateral thyroidectomy. Serum Calcium (Ca) and PTH levels were measured before and 24 hours after surgery. In low Ca cases or development of hypocalcaemia symptoms, daily monitoring of Ca levels were continued. Data were analyzed using SPSS 20 software (SPSS, Chicago, IL, USA). A p-value less than 0.05 were considered statistically significant. To assess the standard value of useful predictive factors, we used receiver operating characteristic (ROC) curves. Of total 99 patients who underwent bilateral thyroidectomy, 47 patients (47.5%) developed hypocalcaemia, out of them, 12 (25.5%) became symptomatic while 2 patients developed permanent hypoparathyroidism. After surgery, mean rank of PTH level within the normocalcaemic and hypocalcaemic patients was 55.34 and 44.1 respectively, p=0.052. Twenty four hours after surgery, 62% drop in PTH was associated with 83.3% of symptomatic hypocalcaemic. For diagnosis of symptomatic hypocalcaemia, 62% PTH drop had sensitivity and specificity were 83.3% and 90.80%. The area under the ROC curve for the PTH postoperative and PTH drop for diagnostic symptomatic hypocalcaemia were 0.835 and 0.873 respectively. Measuring PTH levels after 24 hours postthyroidectomy is not reliable factor for predicting hypocalcaemia itself. For predicting the risk of hypocalcaemia after thyroidectomy it is more reliable to measure the serum PTH level before and after operation and compare the reduction level of percentage of PTH drop for predicting the risk of hypocalcaemia.

Comparison of Bilateral Axillo-Breast Approach Robotic Thyroidectomy with Open Thyroidectomy for Graves' Disease.

PubMed

Kwon, Hyungju; Yi, Jin Wook; Song, Ra-Yeong; Chai, Young Jun; Kim, Su-jin; Choi, June Young; Lee, Kyu Eun

2016-03-01

There is an ongoing debate about whether robotic thyroidectomy (RT) is appropriate for Graves' disease. The aim of this study was to compare the safety of bilateral axillo-breast approach (BABA) RT with that of open thyroidectomy (OT) in patients with Graves' disease. From January 2008 to June 2014, 189 (44 BABA RT and 145 OT) patients underwent total thyroidectomy for Graves' disease. Recurrence of Graves' disease, intraoperative blood loss, hospital stay, and complication rates including recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism were analyzed between BABA RT and OT groups, after propensity score matching according to age, gender, body mass index, surgical indication, the extent of operation, excised thyroid weight, and follow-up period. No patient experienced recurrence of Graves' disease after median follow-up of 35.0 months. Intraoperative blood loss (151.8 ± 165.4 mL vs. 134.5 ± 75.4 mL; p = 0.534) and hospital stay (3.4 ± 0.7 day vs. 3.3 ± 0.7 day; p = 0.564) were not different between BABA RT and OT groups. Complication rates including transient RLN palsy (11.4 vs. 11.4%; p = 1.000), transient hypoparathyroidism (18.2 vs. 20.5%; p = 0.787), permanent RLN palsy (0 vs. 2.3%; p = 0.315), and permanent hypoparathyroidism (2.3 vs. 2.3%; p = 1.000) were also comparable between groups. BABA RT for Graves' disease showed comparable surgical completeness and complications to conventional OT. BABA RT can be recommended as an alternative surgical option for patients with Graves' disease who are concerned about cosmesis.

[Surgical assessment of complications after thyroid gland operations].

PubMed

Dralle, H

2015-01-01

The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.

The Role of Magnesium in Post-thyroidectomy Hypocalcemia.

PubMed

Cherian, Anish Jacob; Gowri, Mahasampath; Ramakant, Pooja; Paul, Thomas V; Abraham, Deepak Thomas; Paul, Mazhuvanchary Jacob

2016-04-01

The purpose of this study was to determine the prevalence of hypomagnesemia in patients undergoing thyroidectomy and evaluate the relationship of hypomagnesemia with transient and severe hypocalcemia. This was a prospective observational study of 50 patients undergoing thyroidectomy. Blood samples were collected pre- and postoperatively for calcium, albumin, magnesium, phosphorous and parathormone (PTH). Signs, symptoms of hypocalcemia and volume of intravenous fluids used perioperatively were documented. The statistical analysis was performed using STATA I/C 10.1. Preoperatively, twelve patients (24 %) had hypomagnesemia and one (2 %) hypocalcemia. On the first postoperative day, hypomagnesemia was seen in 70 % and hypocalcemia in 30 %. A similar trend was observed in the fall and rise of postoperative calcium and magnesium values (p = 0.41). Severe hypocalcemia was present in three patients (6 %). All three patients had a very low postoperative PTH (<2 pg/ml). Among them, two patients (66 %) had hypomagnesemia and their hypocalcemia responded to intravenous magnesium correction. Significant risk factors for postoperative hypocalcemia include a higher volume of fluid used perioperatively and low postoperative PTH (<8 pg/ml) (p = 0.01 and 0.03, respectively). Preoperative hypomagnesemia (24 %) was prevalent in this cohort of patients. Postoperative hypomagnesemia is a common event (70 %) following total thyroidectomy, and magnesium levels tend to mimic the calcium levels postoperatively. The cause of hypocalcemia post-thyroidectomy in this study is mainly a factor of parathyroid function and fluid status. Severe hypocalcemia is a rare event, and hypomagnesemia is associated in the majority of these patients. The role of magnesium correction to alleviate severe hypocalcemia needs to be further studied.

A short-stay unit for thyroidectomy patients increases discharge efficiency.

PubMed

Vrabec, Sara; Oltmann, Sarah C; Clark, Nicholas; Chen, Herbert; Sippel, Rebecca S

2013-09-01

Patients traditionally recover overnight on a general surgery ward after a thyroidectomy; however, these units often lack the efficiency and focus for rapid discharge, which is the goal of a short-stay (SS) unit. Using an SS unit for thyroidectomy patients, who are often discharged in <24 h, may reduce the duration of hospital stay and subsequently decrease associated costs and increase hospital bed and resource availability. A retrospective review of 400 patients undergoing thyroidectomy at a single academic hospital. We analyzed postoperative discharge information and hospital cost data. Adult patients who stayed a single night in the hospital were included. We compared patients staying on a designated SS unit versus a general surgery (GS) ward. A total of 223 patients were admitted to SS, and 177 to GS. Trends of admission location were blocked based on time period, with most patients per time period going to the same location. Discharge times were significantly quicker for patients admitted to SS (P < 0.001). A total of 70% of SS patients were discharged before noon, versus 40% of GS patients (P < 0.001). Many variances were identified to account for these differences. Direct costs were significantly lower with SS, owing to savings in pharmacy, recovery room, and nursing expenses (all P < 0.01). A designated short-stay hospital unit is an effective model for increasing the efficiency of discharge for thyroidectomy patients compared with those admitted to a general surgery ward. It also serves to increase bed availability, which decreases hospital cost and may improve patient flow. Copyright © 2013 Elsevier Inc. All rights reserved.

Thyroid surgery at a volunteer program in Sub-Saharan Africa.

PubMed

Pereira Pérez, Fernando; Calvo Espino, Pablo; Sánchez Arteaga, Alejandro; Muñoz Rodriguez, Joaquín Manuel; Nges, Lionel W; Kemmoe, Mireille; Vidal Fernández, Mercedes; Blázquez, Francisco Javier; Vives Espejo-Saavedra, Teresa; Picón Maroñas, Marina; Varela de Ugarte, Andrés

2016-01-01

The aim of this study is to demonstrate our experience at a volunteer surgical program in Cameroon, which is of special interest given to the inability to adopt international treatment guidelines for thyroid surgery in areas of limited resources due to the lack of preoperative testing and to the difficulty to obtain sustitutive hormonal treatment. This is a prospective observational study that includes 16 cases of thyroid surgery in Dschang (Cameroon) during June 2015. The patients were previously selected by a local medical team. All patients were black, 15 women and one man, with a mean age of 41 years. The surgical technique used for the removal of unilateral disease was hemithyroidectomy with isthmectomy and bilateral subtotal thyroidectomy for bilateral disease. Five subtotal thyroidectomies, 9hemithyroidectomies and 2isthmectomies were performed. Prethyroid muscles were divided only in one case. We visualized 86% of the parathyroid glands and 84% of the recurrent laryngeal nerves. The main complications observed were one symptomatic cervical haematoma that required reoperation and 2surgical wound infections. There were no clinical episodes of hypocalemia or recurrent nerve lesion. The mean length of stay was 2.3 days. At follow-up, all bilateral thyroidectomies developed high TSH levels. Thyroid surgery is safe in developing countries adopting protocols and techniques we use in our environment (avoiding total thyroidectomy). Bilateral thyroidectomies should not be performed unless functional studies are available in the follow-up and a thyroid hormone supplement stock guaranteed whenever necessary. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Tissue-engineered thyroid cell sheet rescued hypothyroidism in rat models after receiving total thyroidectomy comparing with nontransplantation models.

PubMed

Arauchi, Ayumi; Shimizu, Tatsuya; Yamato, Masayuki; Obara, Takao; Okano, Teruo

2009-12-01

For hormonal deficiency caused by endocrine organ diseases, continuous oral hormone administration is indispensable to supplement the shortage of hormones. In this study, as a more effective therapy, we have tried to reconstruct the three-dimensional thyroid tissue by the cell sheet technology, a novel tissue engineering approach. The cell suspension obtained from rat thyroid gland was cultured on temperature-responsive culture dishes, from which confluent cells detach as a cell sheet simply by reducing temperature without any enzymatic treatment. The 8-week-old Lewis rats were exposed to total thyroidectomy as hypothyroidism models and received thyroid cell sheet transplantation 1 week after total thyroidectomy. Serum levels of free triiodothyronine (fT(3)) and free thyroxine (fT(4)) significantly decreased 1 week after total thyroidectomy. On the other hand, transplantation of the thyroid cell sheets was able to restore the thyroid function 1 week after the cell sheet transplantation, and improvement was maintained for 4 weeks. Moreover, morphological analyses showed typical thyroid follicle organization, and anti-thyroid-transcription-factor-1 antibody staining demonstrated the presence of follicle epithelial cells. The presence of functional microvessels was also detected within the engineered thyroid tissues. In conclusion, our results indicate that thyroid cell sheets transplanted in a model of total thyroidectomy can reorganize histologically to resemble a typical thyroid gland and restore thyroid function in vivo. In this study, we are the first to confirm that engineered thyroid tissue can repair hypothyroidism models in rats and, therefore, cell sheet transplantation of endocrine organs may be suitable for the therapy of hormonal deficiency.

Midcervical scar satisfaction in thyroidectomy patients.

PubMed

Best, Amy R; Shipchandler, Taha Z; Cordes, Susan R

2017-05-01

Assess long-term patient satisfaction with conventional thyroidectomy scars and the impact of thyroidectomy scars on patient quality of life. Validated survey administration and retrospective review of clinical and demographic data. Patients who underwent conventional thyroidectomy through years 2000 to 2010 were identified and administered the validated Patient Scar Assessment Questionnaire. Mean satisfaction, appearance and scar-consciousness scores were determined. Thirty-seven patients also measured the length of their current scar. Patient demographic and operative data were collected retrospectively from the medical record. Data were analyzed with one-way analysis of variance and independent samples t testing. Sixty of 69 patients perceived the appearance of their scar to be "good" or "excellent." Sixty-three patients (91.3%) were satisfied with all scar outcomes; 67 (97.1%) were satisfied with the overall appearance of their scar. Mean total satisfaction score was 17.3 (<26 indicates a high level of satisfaction). Fifty-six (81.2%) were "not at all" self-conscious of their scar; 65 (94.2%) reported no attempt to hide their scar. Seven patients (10.1%) indicated any likelihood of pursuing scar revision. Females had significantly higher total satisfaction scores, consciousness scores, and satisfaction with appearance scores. The effect of perceived scar length was significant for scar-consciousness, not patient satisfaction. The majority of patients were satisfied with their thyroidectomy scar appearance. Few patients reported a desire to hide the scar or pursue revision. Women were more likely to be dissatisfied than men. Length may play a role in scar consciousness. 4 Laryngoscope, 127:1247-1252, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

What Happens at the Lesson Start?

ERIC Educational Resources Information Center

Saloviita, Timo

2016-01-01

Transitional periods, such as lesson starts, are necessary steps from one activity to another, but they also compete with time for actual learning. The aim of the present study was to replicate a previous pilot study on lesson starts and explore possible disturbances. In total, 130 lesson starts in Finnish basic education in grades 1-9 were…

Transition to Science Teacher Educator: Tensions Experienced While Learning to Teach Lesson Sequencing

ERIC Educational Resources Information Center

Wiebke, Heidi; Park Rogers, Meredith

2014-01-01

This self-study investigated the tensions that I (Heidi) encountered when teaching elementary preservice teachers how to develop a coherent sequence of five science lessons. Four lesson planning components guided me in developing a series of lessons to support the preservice teachers with this exercise. Employing self-study methodology, data…

Starting Strong

ERIC Educational Resources Information Center

Curran, Ben

2016-01-01

Planning a lesson that sets all students up to learn successfully involves making a great many decisions about what to do throughout the lesson. To make this planning less overwhelming, the author focuses on a part of lesson planning that doesn't always get much attention: the first 10 to 15 minutes of a lesson. He walks readers through key…

Lesson Study: Researching Learning about Teaching from Research Mathematics Lessons

ERIC Educational Resources Information Center

Corcoran, Dolores

2009-01-01

Lesson study is a form of teacher professional development that is intrinsic to the Japanese educational system in first and second level schools and in teacher education. Lesson study has been credited with the success of Japanese pupils in international comparative tests of mathematics achievement (Stigler and Hiebert, 1999). It is gaining…

Lesson Study with Mathematical Resources: A Sustainable Model for Locally-Led Teacher Professional Learning

ERIC Educational Resources Information Center

Lewis, Catherine; Perry, Rebecca

2014-01-01

Teams of educators conducted lesson study independently, supported by a resource kit that included mathematical tasks, curriculum materials, lesson videos and plans, and research articles, as well as protocols to support lesson study. The mathematical resources focused on linear measurement interpretation of fractions. This report examines the…

Demonstration Lessons in Mathematics Education: Teachers' Observation Foci and Intended Changes in Practice

ERIC Educational Resources Information Center

Clarke, Doug; Roche, Anne; Wilkie, Karina; Wright, Vince; Brown, Jill; Downton, Ann; Horne, Marj; Knight, Rose; McDonough, Andrea; Sexton, Matthew; Worrall, Chris

2013-01-01

As part of a teacher professional learning project in mathematics education, university mathematics educators taught demonstration lessons in project primary schools. These lessons were part of a "pre-brief, teaching, and debrief" process, in which up to eight teachers observed each lesson. Using brief questionnaires completed in advance of the…

Lesson Imaging in Math and Science: Anticipating Student Ideas and Questions for Deeper STEM Learning

ERIC Educational Resources Information Center

Stephan, Michelle; Pugalee, David; Cline, Julie; Cline, Chris

2016-01-01

Help turn students into problem solvers. With lesson imaging, teachers anticipate how chosen activities will unfold in real time--what solutions, questions, and misconceptions students might have and how teachers can promote deeper reasoning. When lesson imaging occurs before instruction, students achieve lesson objectives more naturally and…

Lessons from Our Kissing Cousins: Third Culture Kids and Gifted Children

ERIC Educational Resources Information Center

Sheard, Wenda

2008-01-01

This article describes characteristics shared by "third culture kids" (TCKs) and gifted children and summarizes lessons to be learned from the two communities. Some of the lessons are from TCKs themselves; the article includes quotes from students the author has taught in recent years. Pedagogical lessons for raising the global awareness…

The Relationship between Pre-Service Mathematics Teachers' Focus on Student Thinking in Lesson Analysis and Lesson Planning Tasks

ERIC Educational Resources Information Center

Taylan, Rukiye Didem

2018-01-01

This study explored whether pre-service teachers' (PSTs') lesson analysis skills during a teacher education course in the country of Turkey were related to their skills of lesson planning. PSTs' lesson analysis skills during fieldwork were assessed by their attention to and interpretation of student thinking and learning, and how it is influenced…

Message in a Battle: An Analysis of Presidential Communication Since 9/11

DTIC Science & Technology

2013-03-01

Rumsfeld as quoted in Michael Jacobson, “ Learning Counter-Narrative Lessons from Cases of Terrorist Dropouts,” Countering Violent Extremist Narratives...October 29. 2012, http://www.cfr.org/terrorism/improving-us-public-diplomacy-campaign-war-against-terrorism/p4215. 21 Michael Jacobson, “ Learning Counter...States Government as potential new perspectives are introduced through which lessons can be learned regarding the construction and expression of a

Defense Management: DOD’s Conference Policy Is Generally Consistent with OMB’s Requirements

DTIC Science & Technology

2014-01-01

of conference costs and updated it in November 2013, citing lessons learned from implementing the September 2012 policy, among other things. The...memorandum accompanying the November 2013 policy, updates were based upon lessons learned from implementation of the September 2012 policy, the budget...higher learning or professional licensure or certification, or other training entities. However, events are not exempt simply because they offer

National Intelligence University’s Role in Interagency Research: Recommendations from the Intelligence Community

DTIC Science & Technology

2013-01-01

outreach, and (4) social science and historical research/lessons learned . In some instances, the research entity fit into more than one category. We...Bureau of Intelligence and Research (INR) and the Analytic Outreach Initiative (AOI) at ODNI. Social science and historical research/lessons learned ...its coordination efforts, CSIR was interested in learning more about potential interagency research partners and how collaboration could be improved

Collaboration Technology in Military Operations: Lessons Learned from the Corporate Domain

DTIC Science & Technology

2006-02-01

Learned from the Corporate Domain Topics: Social Domain Issues, Cognitive Domain Issues, C2 Experimentation Authors: Stacey D. Scott, M. L. Cummings, David...AFRL-HE-WP-TP-2006-0029 AIR FORCE RESEARCH LABORATORY Collaboration Technology in Military Operations: Lessons Learned from the Corporate Domain...OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response , including the time for

The Joint Lessons Learned System and Interoperability

DTIC Science & Technology

1989-06-02

Learned: 1988-1989 As mentioned in the introduction to this chaoter, the Organizacion of the JcinC Chiefs cf Staff .OJCS) ueren significant transformatioi...Organization and Functions Manual . Washington, D.C.: HQDA, Office of the Deputy Chief 0f Staff for Operations and Plans, June 1984. ’..S. Army. Concept...U.S. Department of Defense. Joint Universal Lessons Learned System (JULLS) User’s Manual . Orlando, Florida: University of Central Florida, Institute

The effect of intra-operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy.

PubMed

Park, C; Choi, J B; Lee, Y-S; Chang, H-S; Shin, C S; Kim, S; Han, D W

2015-04-01

Posterior neck pain following thyroidectomy is common because full neck extension is required during the procedure. We evaluated the effect of intra-operative transcutaneous electrical nerve stimulation on postoperative neck pain in patients undergoing total thyroidectomy under general anaesthesia. One hundred patients were randomly assigned to one of two groups; 50 patients received transcutaneous electrical nerve stimulation applied to the trapezius muscle and 50 patients acted as controls. Postoperative posterior neck pain and anterior wound pain were evaluated using an 11-point numerical rating scale at 30 min, 6 h, 24 h and 48 h following surgery. The numerical rating scale for posterior neck pain was significantly lower in the transcutaneous electrical nerve stimulation group compared with the control group at all time points (p < 0.05). There were no significant differences in the numerical rating scale for anterior wound pain at any time point. No adverse effects related to transcutaneous electrical nerve stimulation were observed. We conclude that intra-operative transcutaneous electrical nerve stimulation applied to the trapezius muscle reduced posterior neck pain following thyroidectomy. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

Hypocalcaemia following total thyroidectomy: early post-operative parathyroid hormone assay as a risk stratification and management tool.

PubMed

Islam, S; Al Maqbali, T; Howe, D; Campbell, J

2014-03-01

To develop a practical, efficient and predictive algorithm to manage potential or actual post-operative hypocalcaemia after complete thyroidectomy, using a single post-operative parathyroid hormone assay. This paper reports a prospective study of 59 patients who underwent total or completion thyroidectomy over a period of 24 months. Parathyroid hormone levels were checked post-operatively on the day of surgery, and all patients were evaluated for hypocalcaemia both clinically and biochemically with serial corrected calcium measurements. No patient with an early post-operative parathyroid hormone level of 23 ng/l or more (i.e. approximately twice the lower limit of the normal range) developed hypocalcaemia. All the patients who initially had post-operative hypocalcaemia but had an early parathyroid hormone level of 8 ng/l or more (i.e. approximately two-thirds of the lower limit of the normal range) had complete resolution of their hypocalcaemia within three months. Early post-operative parathyroid hormone measurement can reliably predict patients at risk of post-thyroidectomy hypocalcaemia, and predict those patients expected to recover from temporary hypocalcaemia. A suggested post-operative management algorithm is presented.

Robotic Thyroid Surgery: Current Perspectives and Future Considerations.

PubMed

Aidan, Patrick; Arora, Asit; Lorincz, Balazs; Tolley, Neil; Garas, George

2018-05-22

Robotic transaxillary thyroidectomy, pioneered in South Korea, is firmly established throughout the Far East but remains controversial in Western practice. This relates to important population differences (anthropometry and culture) compounded by the smaller mean size of thyroid nodules operated on in South Korea due to a national thyroid cancer screening programme. There is now level 2 evidence (including from Western World centres) to support the safety, feasibility, and equivalence of the robotic approach to its open counterpart in terms of recurrent laryngeal nerve injury, hypoparathyroidism, haemorrhage, and oncological outcomes for differentiated thyroid cancer. Moreover, robotic thyroidectomy has been shown to be superior to open surgery for certain patient-reported outcome measures, namely scar cosmesis and pain. Downsides include its high cost, longer operative time, and risk of complications not encountered in open thyroidectomy (brachial plexus neurapraxia). Careful patient selection is paramount as this procedure is not for every patient, surgeon, or hospital. It should only be undertaken by high-volume surgeons operating as part of a multidisciplinary robotic team in specialised centres. Novel robotic approaches utilising the retroauricular and transoral routes for thyroidectomy have recently been described but further studies are required to establish their respective role in modern thyroid surgery. © 2018 S. Karger AG, Basel.

Comparison of the incidence of postoperative hypocalcemia following total thyroidectomy vs completion thyroidectomy.

PubMed

Merchavy, Shlomo; Marom, Tal; Forest, Veronique-Isabelle; Hier, Michael; Mlynarek, Alex; McHugh, Tobial; Payne, Richard

2015-01-01

To study the rate of postoperative hypocalcemia following completion thyroidectomy (CT), in comparison with the hypocalcemia rate following total thyroidectomy (TT). A retrospective study, performed at the McGill University Thyroid Cancer Center, Montreal, Quebec, Canada, from 2007 to 2012. Medical records of adult patients undergoing CT and TT operated by a single surgeon were reviewed. Data were extracted for demographics, postoperative calcium levels, surgical logs, and final surgical pathology. Hypocalcemia was defined as corrected serum calcium level ≤ 1.90 mmol/L, with concurrent serum parathyroid hormone <8 ng/L, and/or any signs or symptoms of hypocalcemia. There were 68 CTs and 146 TTs. Transient hypocalcemia occurred in 1 of 68 (1.5%) and 18 of 146 (12.5%) patients in the CT and TT groups, respectively. The rate of hypocalcemia was significantly lower in the CT compared with the TT group (P = .02). In both groups, there were no cases of permanent hypocalcemia. The risk of transient of hypocalcemia in patients undergoing CT is significantly lower than the rate of hypocalcemia in patients undergoing TT. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: our initial experience.

PubMed

Lee, Kyu Eun; Rao, Jaideepraj; Youn, Yeo-Kyu

2009-06-01

Robotic surgery is useful in areas with difficult access like the pelvis. The ideal indications for robotic surgery are still to be established. The neck area, especially the thyroid gland poses a difficult challenge for many endoscopic surgeons. Robotic surgery is useful in this area due to its excellent magnification and endowrist function. We present our initial experience with robotic endoscopic thyroidectomy using the bilateral axillary breast approach (BABA). Between March and May 2008, 15 patients diagnosed with papillary thyroid cancer underwent robotic-assisted endoscopic thyroidectomy using the BABA technique. The mean operating time was 218 minutes. There was a steady decrease in operative time from the initial case to the 15th case. The blood loss was minimal. The recurrent laryngeal nerve and parathyroid glands were identified in great detail with ease and preserved in all cases. There were no postoperative complications in any case. Robotic endoscopic thyroidectomy using the BABA technique is a feasible procedure and can be performed safely. It provides an excellent operative field view enabling easy identification of vital structures. It also gives the desired cosmetic results and minimal postoperative pain similar to conventional endoscopic thyroid surgery using the BABA technique.

Epidemiologic methods lessons learned from environmental public health disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina.

PubMed

Svendsen, Erik R; Runkle, Jennifer R; Dhara, Venkata Ramana; Lin, Shao; Naboka, Marina; Mousseau, Timothy A; Bennett, Charles

2012-08-01

Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA). We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters.

Student reflections on learning with challenging tasks: `I think the worksheets were just for practice, and the challenges were for maths'

NASA Astrophysics Data System (ADS)

Russo, James; Hopkins, Sarah

2017-09-01

The current study considered young students' (7 and 8 years old) experiences and perceptions of mathematics lessons involving challenging (i.e. cognitively demanding) tasks. We used the Constant Comparative Method to analyse the interview responses ( n = 73) regarding what work artefacts students were most proud of creating and why. Five themes emerged that characterised student reflections: enjoyment, effort, learning, productivity and meaningful mathematics. Overall, there was evidence that students embraced struggle and persisted when engaged in mathematics lessons involving challenging tasks and, moreover, that many students enjoyed the process of being challenged. In the second section of the paper, the lesson structure preferences of a subset of participants ( n = 23) when learning with challenging tasks are considered. Overall, more students preferred the teach-first lesson structure to the task-first lesson structure, primarily because it activated their cognition to prepare them for work on the challenging task. However, a substantial minority of students (42 %) instead endorsed the task-first lesson structure, with several students explaining they preferred this structure precisely because it was so cognitively demanding. Other reasons for preferring the task-first structure included that it allowed the focus of the lesson to be on the challenging task and the subsequent discussion of student work. A key implication of these combined findings is that, for many students, work on challenging tasks appeared to remain cognitively demanding irrespective of the structure of the lesson.

WHY CAN'T WE LEARN FROM OUR MISTAKES LEARN THE LESSON TELL THE STORY

DOE Office of Scientific and Technical Information (OSTI.GOV)

LANGSTAFF, D.C.

2005-02-03

Tell the story well and people can learn from the lesson. The United States Department of Energy (DOE) Office of Environmental Management (EM) and its contractors are pursuing environmental remediation at the Hanford Site. This endeavor has been underway for a number of years, both at Hanford and at other sites across the DOE complex. Independently, the occurrence of two fatalities on two Sites at opposite ends of the country within two weeks raised the question, ''What is going on in the Field?'' Corporate EM management communicated directly with Field Office Managers to answer the question. As a result ofmore » this intense interest and focused communication, EM identified four areas that need additional exploration. One of those is, ''EM's ability to learn from its mistakes.'' The need to cultivate the ability to learn from our mistakes is not unique to DOE. A quick review of EM Lessons Learned reports shows that most of the reports in the EM system originate at the sites with the largest budgets doing the most work. A second look, however, reveals that many reports are repetitive, that many people might consider many reports trivial, and that reports on some of the more significant events sometimes take a long time to get distributed across the DOE Complex. Spot checks of event reports revealed frequent identification of symptoms rather than root causes. With a high percentage of identified root causes in the questionable category, it is highly unlikely that the real root causes of many events are being corrected, thus leading to recurrences of events. To learn the lesson from an event, people need to be aware of the root causes of the event. Someone has to tell a story the reader can learn from, i.e., include all the information needed to understand what happened and why it happened. Most importantly, they need to understand the lesson to be learned.« less

Post Thyroidectomy Suture Granuloma: A Cytological Diagnosis

PubMed Central

Javalgi, Anita P.; Arakeri, Surekha U.

2013-01-01

There are known post thyroidectomized complications, a suture granuloma being less frequent, with its late complication mimicking recurrent thyroid cancer. A suture granuloma is a benign, granulomatous inflammatory reaction that occurs due to the use of non absorbable suture. It constitutes one of the late complications which altogether make up less than 2% of its incidence. A suture granuloma is similar to a foreign body reaction and it usually develops slowly as a painless, palpable asymptomatic mass over the years. It mimics a cancer recurrence or a lymph node metastasis. Here, we are reporting a case of a post thyroidectomy suture granuloma in a 46 years old lady who presented with a painless swelling in the lateral neck, with a past history of thyroidectomy 5 years back. PMID:23730655

Transoral robotic thyroidectomy: a preclinical feasibility study using the da Vinci Xi platform.

PubMed

Russell, Jonathon O; Noureldine, Salem I; Al Khadem, Mai G; Chaudhary, Hamad A; Day, Andrew T; Kim, Hoon Yub; Tufano, Ralph P; Richmon, Jeremy D

2017-09-01

Transoral thyroid surgery allows the surgeon to conceal incisions within the oral cavity without significantly increasing the amount of required dissection. TORT provides an ideal scarless, midline access to the thyroid gland and bilateral central neck compartments. This approach, however, presents multiple technical challenges. Herein, we present our experience using the latest generation robotic surgical system to accomplish transoral robotic thyroidectomy (TORT). In two human cadavers, the da Vinci Xi surgical system (Intuitive Surgical, Sunnyvale, CA, USA) was used to complete TORT. Total thyroidectomy and bilateral central neck dissection was successfully completed in both cadavers. The da Vinci Xi platform offered several technologic advantages over previous robotic generations including overhead docking, narrower arms, and improved range of motion allowing for improved execution of previously described TORT techniques.

Development of X-33/X-34 Aerothermodynamic Data Bases: Lessons Learned and Future Enhancements

NASA Technical Reports Server (NTRS)

Miller, C. G.

1999-01-01

A synoptic of programmatic and technical lessons learned in the development of aerothermodynamic data bases for the X-33 and X-34 programs is presented in general terms and from the perspective of the NASA Langley Research Center Aerothermodynamics Branch. The format used is that of the aerothermodynamic chain, the links of which are personnel, facilities, models/test articles, instrumentation, test techniques, and computational fluid dynamics (CFD). Because the aerodynamic data bases upon which the X-33 and X-34 vehicles will fly are almost exclusively from wind tunnel testing, as opposed to CFD, the primary focus of the lessons learned is on ground-based testing.