A doenÃa de Chagas à um dos principais problemas mÃdico-sociais do Brasil. A morte sÃbita à um dos fenÃmenos clÃnicos caracterÃsticos da doenÃa de Chagas desde suas descriÃÃes iniciais. Mais de 50% da mortalidade nos pacientes com doenÃa de Chagas sÃo atribuÃveis à morte sÃbita cardÃaca. O cardiodesfibrilador implantÃvel (CDI) tornou-se a principal estratÃgia terapÃutica para prevenÃÃo de morte sÃbita. Contudo, a eficÃcia e a seguranÃa de se tratar o paciente chagÃsico com o CDI foi avaliada em poucos estudos observacionais. O objetivo do presente trabalho foi avaliar as caracterÃsticas clÃnicas, epidemiolÃgicas e a evoluÃÃo de pacientes com cardiopatia chagÃsica crÃnica e desfibrilador cardÃaco implantÃvel no Estado do CearÃ. Delineamento, populaÃÃo e mÃtodos: estudo retrospectivo, descritivo e analÃtico. A populaÃÃo consistiu de pacientes chagÃsicos com CDI por profilaxia primÃria ou secundÃria de morte sÃbita, atendidos em Ãnico hospital universitÃrio de referÃncia. Para anÃlise comparativa, foram incluÃdos pacientes com cardiopatia isquÃmica e CDI por profilaxia primÃria ou secundÃria de morte sÃbita. Os desfechos analisados foram: terapia apropriada (choque apropriado e terapia antitaquicardia), choque apropriada, mortalidade geral e sobrevida livre de eventos (choque apropriado, terapia apropriada ou Ãbito). Resultados: foram avaliados 146 pacientes, sendo 63 (42,5%) chagÃsicos com a mediana do tempo de seguimento de 27 meses (Q1=9,0 e Q3=47) e 83 (57,5%) isquÃmicos com a mediana do tempo de seguimento de 35 meses (Q1=22 e Q3=59). A taxa de mortalidade anual, a incidÃncia de morte sÃbita, a incidÃncia de tempestade arrÃtmica e a incidÃncia de choque inapropriados foram semelhantes nos dois grupos. Os pacientes isquÃmicos eram em mÃdia 10 anos mais velhos que os chagÃsicos (p<0,001). Observou-se terapia apropriada deflagrada pelo CDI em 27 (42,9%) pacientes chagÃsicos e 14 (16,9%) isquÃmicos (p=0,001). Choque apropriado foi observado em 23 (36,5%) pacientes chagÃsicos e 14 (16,9%) isquÃmicos. A cardiopatia chagÃsica aumentou em 2,07 vezes (IC 95%: 1,02-4,17) o risco de o paciente receber terapia apropriada. A classe funcional (I a IV), a fraÃÃo de ejeÃÃo (normal ou disfunÃÃo leve à severa) e o tipo de prevenÃÃo nÃo foram preditores de choque ou terapia apropriada nos pacientes com cardiopatia chagÃsica. NÃo houve diferenÃa significativa no tempo de sobrevida entre os pacientes chagÃsicos e os isquÃmicos. A sobrevida livre de eventos (choque, terapia apropriada e Ãbito) foi similar nos dois grupos (chagÃsicos e isquÃmicos). NÃo houve nenhuma morte sÃbita durante o seguimento dos pacientes chagÃsicos. A baixa escolaridade (HR=4,6 IC 95%;1,6-13,3) e a fraÃÃo de ejeÃÃo do ventrÃculo esquerdo menor que 30% (HR=6,3 IC 95%: 1,2-31,7) estiveram associadas de forma significante com o desfecho de Ãbito. ConclusÃes: a maior frequÃncia de pacientes chagÃsicos com registro de terapia apropriada e choque apropriado à consistente com a presenÃa de um substrato arritmogÃnico mais grave nessa patologia. Apesar dessa maior frequÃncia, nÃo houve nenhuma morte sÃbita no seguimento, o que sugere a efetividade do CDI nos pacientes chagÃsicos. A ausÃncia de diferenÃa na taxa de terapia apropriada ou choque apropriado entre os chagÃsicos com e sem disfunÃÃo ventricular sugere que a FEVE nÃo deveria ser usada como critÃrio preponderante e decisivo de indicaÃÃo do cardiodesfibrilador nesses pacientes. / Chagas disease is one of the major social-medical problems of Brazil. Sudden death is one of the clinical phenomena characteristic of the Chagas disease since their initial descriptions. More than 50% of mortality in patients with Chagas disease are attributable to sudden cardiac death. The Implantable Cardioverter-defibrillator (ICD) has become the main therapeutic strategy for prevention of sudden death. However, the efficacy and safety of treating Chagas patients with CDI was assessed in a few observational studies. The aim of this paper was to evaluate the clinical, epidemiological and outcome of patients with chronic Chagas heart disease and implantable cardioverter-defibrillator in the state of CearÃ. This was retrospective, descriptive and analytical study. The population consisted of chagasic patients with ICD for primary or secondary prevention of sudden death, enrolled at a sole university hospital. For comparative analysis, we included patients with ischemic cardiomyopathy and ICD for primary or secondary prevention of sudden death. The outcomes analyzed were: appropriate therapy (shock therapy and appropriate antitachycardia), appropriate shock, mortality and event-free survival (appropriate shock, appropriate therapy or death). Results: 146 patients were evaluated, 63 (42.5%) chagasic patients with median follow-up time of 27 months (Q1 = 9.0 and Q3 = 47) and 83 (57.5%) with a median of ischemic follow-up time of 35 months (Q1 = Q3 = 22 and 59). The annual mortality rate, the incidence of sudden death, the incidence of arrhythmic storm and the incidence of inappropriate shock were similar in both groups. The ischemic patients were on average 10 years older than the Chagas patients (p <0.001). Observed appropriate therapy triggered by CDI in 27 (42.9%) chagasic patients and 14 (16.9%) ischemic (p = 0.001). Appropriate shock was observed in 23 (36.5%) chagasic patients and 14 (16.9%) ischemic. Chagas heart disease increased by 2.07 times (95% CI: 1.02 to 4.17) the risk of the patient receiving appropriate therapy. The functional class (I to IV), ejection fraction (normal or mild dysfunction to severe) and type of prevention were not predictors of shock or appropriate therapy in patients with Chagas heart disease. There was no significant difference in survival time between patients with Chagas disease and the ischemic ones. The event-free survival (shock, appropriate therapy and death) was similar in both groups (Chagas disease and ischemic). There was no sudden death during follow-up of patients with Chagas disease. The low educational level (HR = 4.6 95% CI 1.6 to 13.3) and the ejection fraction of the left ventricle less than 30% (HR = 6.3 95% CI 1.2 to 31.7) were associated significantly with the outcome of death. Conclusions: The higher frequency of appropriate shock therapy in chronic Chagas disease is consistent with the presence of an arrhythmogenic substrate. Despite this higher frequency, there was no sudden death following, which suggests the effectiveness of ICD in patients with Chagas disease. The lack of difference in the rate of appropriate therapy or appropriate shock among chagasic patients with and without ventricular dysfunction suggests that LVEF should not be used as a preponderant and decisive criterion of the defibrillator indication in these patients.

Fashion involves more than material garments. It is extended to the settings surrounding it. We wear and dress in more than clothes, we do it in scents and lights, in objects and images. Today, when fashion mostly is consumed in pictures - a representation of the physical garment - there is a need for a shifted view of what fashion design is and potentially can become. This work aims to explore and extend the domain of fashion by using text titles as a catalyst for creative activity and seek to move beyond traditional outlets of fashion. Each title becomes a project in itself. Together they form a collection of products in the widest sense that informs the logics of my practice and pose as a suggestion for an alternative approach to collection making as well as to what contemporary fashion design can incorporate.

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Studies have documented challenges in meeting No Child Left Behind (NCLB) expectations as well as gender differences that contribute to the achievement gaps between boys and girls. In response to increased NCLB accountability and achievement gaps between boys and girls, several experts have promoted single-sex education as a possible strategy to improving student achievement. The purpose of this study was to examine data that were gathered from an economically disadvantaged Title I federally-assisted upper elementary school with respect to the implementation of single-gender classrooms. This study was guided by the following two research questions: First, what were the perspectives from teachers, students, and parents with the initial year of implementation of single-gender classrooms? Second, what school level data could be analyzed and summarized with respect to student behaviors during the initial year of implementation? Unlike previous studies, which focused on private or parochial schools at the secondary school level, this study focused on an economically disadvantaged school within an upper elementary setting. In addition, limited previous research has examined the perspectives of teachers, students, and parents. As research continues to show an ever-increasing achievement gap between students in poverty and those who are not, many educators seek alternative ways to educate students in economically disadvantaged schools. While single-gender classrooms are by no means a cure-all for the adversity faced by disadvantaged students in public schools, an analysis of the aforementioned research data indicated salient benefits for such students in that they can provide a learning environment where affective and cognitive learning outcomes could be realized. The results from this study revealed that teachers and parents considered single-gender classrooms provide a positive learning environment for students. Teachers, students, and parents emphasized that single-gender classrooms allowed students to be more productive, removed the largest distractions for male and female students, and allowed them to concentrate on their schoolwork. In addition, the data revealed that single-gender classrooms had a positive impact on girls as viewed by teachers, female students, and parents of female students in terms of feeling comfortable enough to ask questions when they did not understand something.

Title IX’s legislation has been in place since 1972 and has affected female participation in a positive form towards gender equity. However many institution sill have difficulty complying with the standards mandated by Title IX. Gender equity is established by meeting substantial proportionality, continued expansion, or full accommodations prongs mandated by Title IX for an institution to be in compliance. The purpose of this study was to determine the perceptions of the athletic directors of the 15 public community and junior colleges in Mississippi regarding Title IX compliance and determine if their respective institutions are in compliance with the substantial proportionality (SP) prong of Title IX. The study identified the perceptions of the athletic directors regarding their institutions’ Title IX compliance, as well as the effective strategies and barriers toward meeting the requirements to comply with Title IX within their programs. In addition, the study revealed whether or not the institutions complied with the SP prong of Title IX. Athletic directors (N=15; 53% response rate) from the public community and junior colleges from Mississippi completed the Two-Year College Title IX Survey. Results revealed that overall the athletic directors perceived that their institutions were in compliance with Title IX. However, the athletic directors perceived that the listed strategies were not effective and the barriers listed were not perceived barriers to Title IX compliance. However, the Equity in Athletics Disclosure Act data revealed that none of the institutions complied with the SP prong of Title IX. From a practical perspective, the study revealed that while the athletic directors perceived that their institutions met the SP prong, EADA data revealed that none of the institutions in the state met that prong. Consequently, this finding indicates that there is a need for more education regarding Title IX compliance at the institutions. This information could serve as a starting point for an in-depth institutional study on Title IX. From a theoretical perspective, the study provided information that gives leaders at the public community and junior colleges in Mississippi a unique look at diversity within their athletic departments.

The purpose of the study was to determine if there is a difference in mathematics mean scale score growth on the MCT2 mathematics assessment between students taught by national board certified teachers (NBCTs) and those taught by non-NBCTs in a low socioeconomic, high minority, Title I school. For this study, a causal-comparative research design and a statistical analysis procedure of ANCOVA were used to answer two research questions: First, is there a statistically significant difference in mathematics mean scale score growth on the MCT2 mathematics assessment between fourth grade African American and Caucasian students taught by NBCTs and those taught by non-NBCTs, while controlling socioeconomic status and 3rd grade MCT2 mathematics scale scores? Second, is there a statistically significant difference in mathematics mean scale score growth on the MCT2 mathematics assessment between fourth grade students by socioeconomic status based on eligibility for free/reduced or full pay lunch taught by NBCTs and those taught by non-NBCTs, while controlling race and 3rd grade MCT2 mathematics scale scores? The results of the analysis for research question one indicated that there was not a statistically significant difference in mathematics mean score growth on the MCT2 mathematics assessment between students by race taught by NBCTs and those taught by non-NBCT. African American and Caucasian students taught by NBCTs had a comparable mathematics mean scale score growth with African American and Caucasian students taught by non-NBCTs. The results of the analysis for research question two indicated that there was a statistically significant difference in mathematics mean score growth on the MCT2 mathematics assessment between students by socioeconomic status based on eligibility for full pay lunch taught by NBCTs and those students taught by non-NBCTs. Students identified as full pay lunch taught by NBCTs had a higher mathematics mean scale score growth than those students identified as full pay lunch taught by non-NBCTs. Students identified as free/reduced lunch status taught by non-NBCTs had comparable mean scale score growth with those students identified as free/reduced lunch status taught by NBCTs, but not statistically significant.

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Child abuse and neglect in the United States resulted in 676,569 reports in 2011 (U.S. Dept. of Health and Human Services, 2012). Workers in this field struggle with low pay, high caseloads, inadequate training and supervision, and risk of violence, all of which contribute to worker burnout and poor worker retention rates. Worker self- efficacy is predictive of worker retention, job performance, and persistence in this difficult field. This paper reports the development of a new measure of self-efficacy from a sample of 395 child welfare workers. Factor analysis revealed two domains of self- efficacy, direct practice and indirect practice, which can be modestly predicted by worker characteristics upon hire and the training program the workers attend. Worker self- efficacy can be used to identify vulnerable workers who may be especially in need of strong supervisory support as well as understand who to target for recruitment. A review of the literature of self-efficacy in child welfare workers is included.

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