First-rib stress fractures have been described in adolescent athletes in various sports, with only one prior case report of first-rib stress fractures in an adolescent female swimmer. There is a need for research on the cause, management, and prevention of these injuries as they lead to significant morbidity and critical time away from sport for these aspiring athletes. We aimed to describe first-rib stress fractures as a potential cause for non-specific atraumatic chronic shoulder pain in adolescent swimmers and to discuss the different presentations, unique risk factors, treatment, and potential injury prevention strategies of such fractures. We discussed two such cases which were successfully treated with activity modification with restriction of all overhead activity, gradually progressive physical therapy and a return to swimming protocol. First-rib stress fractures can vary in presentation and should be in the differential diagnosis in adolescent swimmers with chronic shoulder pain. These injuries can be successfully managed with rest from overhead activities and physical therapy. Gradual return to competitive swimming can be achieved even with non-union of a first-rib stress fracture. Emphasis on balanced strength training in different muscle groups and proper swimming technique is essential to prevent these injuries. 相似文献
The final session of the National Research Center on Learning Disabilities (NRCLD) Responsiveness-to-Intervention (RTI) Symposium, "What are alternative models to LD identification other than RTI?" included four papers that discussed concerns over the exclusive reliance on an RTI approach to learning disability identification, considerations for analyzing proposed LD identification models, and various alternatives to LD identification. The work of the participating panelists is summarized in this discussant paper, and next steps for the NRCLD in light of these presentations are suggested. 相似文献
OBJECTIVES: The study was designed to explore whether the credibility of children's statements regarding their alleged experiences of child sexual abuse could be assessed in a more valid and reliable way when investigative interviews were conducted using the NICHD protocol rather than in an unstructured manner. METHODS: Forty-two experienced Israeli youth investigators each assessed the credibility of allegations of sexual abuse made by alleged victims of sexual abuse when interviewed either with or without the protocol. Half of the alleged incidents were judged likely to have happened ("plausible") on the basis of independent evidence, while half were deemed unlikely to have happened ("implausible"). RESULTS: More non-protocol than protocol interviews were rated as "No judgment possible" rather than either credible or incredible. Allegations made in protocol interviews were more accurately rated as credible or incredible when they were either plausible or implausible, respectively, than those made in non-protocol statements. Levels of inter-rater reliability were also higher when protocol interviews were rated. The differences were significant only for plausible cases, however. CONCLUSIONS: The use of the NICHD protocol facilitated the assessment of credibility by child investigators although incredible allegations (those describing incidents that were unlikely to have happened) remained difficult to detect, even when the protocol was used. 相似文献
This article is based on data generated in an ethnographic study of gender in a Swedish preschool. Drawing on Judith Butler’s understanding of performativity and (un)doing of gender, a new theoretical concept, situated decoding of gender, is further developed by showing how the material and spatial dimension of the educational practice and the teachers’ actions contribute to establishing and maintaining this process in an early childhood educational setting. Instead of normalising the gender binary, a reverse process occurs that turns what is perceived as feminine or masculine into a gender decoded state in which gender is made less relevant, or even irrelevant. It is argued that this continuous reiterative process emerges and is maintained by three main factors: (a) the preschool’s physical environment, (b) the regular and repetitive structure of the educational practice and (c) the consistent actions of the teachers in the everyday practice. 相似文献
Science learning is inextricably tied to two aspects of students’ lives: literacy and culture. While English Learners (ELs) who speak a non-English native language are typically the focus in this line of scholarly inquiry, deaf and hard-of-hearing (DHH) students occupy a distinct space in this conversation. For DHH learners, literacy levels can be hindered by an early dependence on a more survival-based language learning model that postpones basic scientific inquiry. The vocabulary for curiosity is limited, which in turn affects the educational culture. DHH learners have a unique culture that demands an appropriate science curriculum, which thus far has not been explored or attempted for either DHH learners or their educators. Data collected consisted of interviews with teachers of DHH students, as well as observational data collected from a high-minority urban K-8 school for DHH students. The analysis revealed that, first, many of the teachers had limited preparation to teach science content. Second, DHH teachers used inconsistent instructional strategies ranging from drawing pictures to building models. Third, the modifications provided to DHH science learners were mostly limited to visual support and repetition. Implications for teacher education programs include instruction focused on specific supports for DHH students and co-teaching methods, and deeper investigation of inquiry-based science practices. Implications for classroom practices include providing hands-on, inquiry-based instruction, working closely with parents, and developing students’ and teachers’ understanding of scientific inquiry.