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111.
Objective
(1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries.Methods
We present a case series of 4 female adolescent patients seen at a children's hospital over a period of 6 months. Each patient developed significant vaginal bleeding after sexual intercourse, and 3 of the patients presented to the emergency department with vital signs consistent with compensated shock.Results
Each patient was evaluated by pediatric surgery, and found to have a laceration of the vagina. Three of the patients described consensual intercourse prior to the onset of bleeding, and had lacerations of the vaginal fornices; these patients were determined to have injuries resulting from consensual sexual intercourse. The fourth patient reported sexual assault as the cause of her injuries, and was treated for longitudinal lacerations of the vaginal wall.Conclusions
Lacerations of the upper vagina are not frequently reported in forced vaginal intercourse, but are occasionally reported as injuries sustained during consensual coitus. In the absence of reported sexual assault, a severe vaginal fornix laceration is consistent with the diagnosis of coital injury from consensual intercourse. Diagnosis and treatment of this injury can be delayed due to the sensitive nature of these injuries. Bleeding can be profuse, leading to hemorrhagic shock, and these injuries may require transfusion of blood products and surgical repair in some cases. Complications may include hemoperitoneum, pneumoperitoneum, or retroperitoneal hematoma, even in the absence of complete vaginal perforation.Practice implications
Knowledge of the consensual sexual injuries that may occur in adolescent patients can guide diagnosis, treatment, and counseling for the patient and her family, preventing long-term medical complications and legal consequences. 相似文献112.
Nancy Arthur Sarah Flynn 《International Journal for Educational and Vocational Guidance》2011,11(3):221-237
This research focused on the career decision and planning needs of a unique group of migrants: international students who
are completing their studies as temporary immigrants and who are embarking on the career journey of employment and permanent
immigration. A semi-structured interview employing a Critical Incident Technique was used to assess the career influences
of 19 undergraduate and graduate international students at a Canadian university. Data were analyzed using a constant comparison
method and critical incident protocol. Students were motivated to remain in Canada due to enhanced job opportunities and high
standard of living. Barriers to migration included the fear of not securing employment and cultural and linguistic barriers.
International students would like to see campus and career services specified to the needs of international and graduate students
to help them realize their goal of pursuing employment as the key to permanent immigration. 相似文献
113.
Khan Sarah Kambris Mona El Kouatly Alfalahi Hamda 《Education and Information Technologies》2022,27(3):4141-4169
Education and Information Technologies - Owing to COVID-19 the Ministry of Education in the United Arab Emirates mandated educational institutions to shift to remote learning. In this study the... 相似文献
114.
Research supports an explicit-reflective approach to teaching about nature of science (NOS), but little is reported on teachers’ journeys as they attempt to integrate NOS into everyday lessons. This participatory action research paper reports the challenges and successes encountered by an in-service teacher, Sarah, implementing NOS for the first time throughout four units of a community college biology course (genetics, molecular biology, evolution, and ecology). Through the action research cycles of planning, implementing, and reflecting, Sarah identified areas of challenge and success. This paper reports emergent themes that assisted her in successfully embedding NOS within the science content. Data include weekly lesson plans and pre/post reflective journaling before and after each lesson of this lecture/lab combination class that met twice a week. This course was taught back to back semesters, and this study is based on the results of a year-long process. Developing pedagogical content knowledge (PCK) for NOS involves coming to understand the overlaps and connections between NOS, other science subject matter, pedagogical strategies, and student learning. Sarah found that through action research she was able to grow and assimilate her understanding of NOS within the biology content she was teaching. A shift in orientation toward teaching products of science to teaching science processes was a necessary shift for NOS pedagogical success. This process enabled Sarah’s development of PCK for NOS. As a practical example of putting research-based instructional recommendations into practice, this study may be very useful for other teachers who are learning to teach NOS. 相似文献
115.
Ubiquitous “sex tips” in popular media evidence an unquenchable public interest in learning how to experience “great sex,” and studies confirm that a great sexual relationship correlates to general relationship satisfaction, which in turn correlates to overall happiness. While studies of great sex or “optimal sexuality” are few, enough is known to conclude that the paths to great sex depicted in popular media are largely dead ends. This lesson plan will help educators (a) dispel inaccurate information about optimal sexuality disseminated in the popular media and (b) inform students about the components of optimal sexuality. 相似文献
116.
Benjamin D. Plummer Brian M. Galla Amy S. Finn Sarah D. Patrick David Meketon Julia Leonard Calvin Goetz Elizabeth Fernandez‐Vina Sara Bartolino Rachel E. White Angela L. Duckworth 《Mind, Brain, and Education》2014,8(1):15-20
Schools are an important context for both basic and applied scientific research. Unlike the laboratory, however, the physical and social conditions of schools are not under the exclusive control of scientists. In this article, we liken collecting data in schools to putting on a theatrical production. We begin by describing the large cast of characters whose collaborative efforts make school‐based research possible. Next, we address the critics, including the university Institutional Review Board (IRB) and school administrators, whose feedback often improves the final study design. We then turn our attention to set building, stage directions, and rehearsals—key steps in the iterative process of refining study procedures. We end with a discussion of the day of data collection itself and activities that take place after the curtain drops. Throughout, we make recommendations based on our recent experience collecting data at several high schools. 相似文献
117.
Enhancement of anatomical learning and developing clinical competence of first‐year medical and allied health profession students
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Sarah A. Keim Janssen Stephane P. VanderMeulen Valerie K. Shostrom Carol S. Lomneth 《Anatomical sciences education》2014,7(3):181-190
Hands‐on educational experiences can stimulate student interest, increase knowledge retention, and enhance development of clinical skills. The Lachman test, used to assess the integrity of the anterior cruciate ligament (ACL), is commonly performed by health care professionals and is relatively easy to teach to first‐year health profession students. This study integrated teaching the Lachman test into a first‐year anatomy laboratory and examined if students receiving the training would be more confident, competent, and if the training would enhance anatomical learning. First‐year medical, physician assistant and physical therapy students were randomly assigned into either the intervention (Group A) or control group (Group B). Both groups received the course lecture on knee anatomy and training on how to perform the Lachman test during a surface anatomy class. Group A received an additional 15 minutes hands‐on training for the Lachman test utilizing a lightly embalmed cadaver as a simulated patient. One week later, both groups performed the Lachman test on a lightly embalmed cadaver and later completed a post‐test and survey. Students with hands‐on training performed significantly better than students with lecture‐only training in completing the checklist, a post‐test, and correctly diagnosing an ACL tear. Students in Group A also reported being more confident after hands‐on training compared to students receiving lecture‐only training. Both groups reported that incorporating clinical skill activities facilitated learning and created excitement for learning. Hands‐on training using lightly embalmed cadavers as patient simulators increased confidence and competence in performing the Lachman test and aided in learning anatomy. Anat Sci Educ 7: 181–190. © 2013 American Association of Anatomists. 相似文献
118.
The purpose of this study was to investigate the effectiveness of an iPad to increase work related behaviors for one adult with disabilities in a vocational setting. A multiple baseline across behaviors single subject research design was used to determine if an iPad helped to increase independence in three identified behaviors, which included setting up a workstation for maximum efficiency, managing time accurately, and identifying faces and names of coworkers. Results indicate that the subject was able to use the iPad to achieve independence in the work setting, thus making him less reliant on site staff and his vocational trainer and making him potentially employable. The results of the study prove to be important because little research has been conducted on how technological devices such as the iPad can help individuals with disabilities in the vocational setting. 相似文献
119.
The Access to Research project is a collaboration between scholarly publishers and librarians to provide free licensed access to research journals via terminals in public libraries. The project is an element of the ‘balanced package’ proposed by the Finch Working Group on how to expand access to published research in the UK, which reported its recommendations to the UK government in June 2012. We describe the setting up of the project and the findings from a three‐month technical pilot prior to the launch of a two‐year national pilot in February 2014. The project has already attracted support from the major scholarly publishers, with about 8,400 journal titles now available. The access platform has been shown to be usable by public librarians and library patrons. We are now addressing the challenge of understanding how the public will make use of the system and exploring how best to provide training and education for librarians and users. 相似文献
120.
Sarah J. Skinner 《Journal of Cultural Economics》2006,30(2):109-125
This paper addresses the evaluation of real growth forecasts made by impact studies. Intervention analysis is used to estimate the ex post impact of blockbuster exhibits on economic growth in Jackson, Mississippi (chosen because state and local governments provide regular subsidies to finance the exhibitions). Non-farm employment measures real economic growth and dummy variables capture the occurrence of the exhibitions. Univariate time series techniques identify and estimate a stationary process after filtering the data for seasonal and cyclical effects. The analysis estimates the short run impact on Jackson’s filtered employment series due to the blockbuster exhibitions as approximately 700 jobs. 相似文献