On the basis of a new model of motivation, we examined the effects of 3 dimensions of teacher (n = 14) behavior (involvement, structure, and autonomy support) on 144 children's (Grades 3-5) behavioral and emotional engagement across a school year. Correlational and path analyses revealed that teacher involvement was central to children's experiences in the classroom and that teacher provision of both autonomy support and optimal structure predicted children's motivation across the school year. Reciprocal effects of student motivation on teacher behavior were also found. Students who showed higher initial behavioral engagement received subsequently more of all 3 teacher behaviors. These findings suggest that students who are behaviorally disengaged receive teacher responses that should further undermine their motivation. The importance of the student-teacher relationship, especially interpersonal involvement, in optimizing student motivation is highlighted. What are the factors that motivate children to learn? Educators and parents value motivation in school for its own sake as well as for its long-term contribution to children's learning and self-esteem. Highly motivated children are easy to identify: They are enthusiastic, interested, involved, and curious; they try hard and persist; and they actively cope with challenges and setbacks. These are the children who should stay in school longer, learn more, feel better about themselves, and continue their education after high school. Recent research has borne this out (

Abstract:Background. Actinomycotic infections of the cervicofacial region are uncommon. Most major medical centers report approximately one case per year. Presenting clinical manifestations are confusing because they often mimic other disease processes. Diagnosis may be difficult due to a general lack of familiarity with the disease and the fastidious nature of the organism in culture. The cervicofacial manifestations of actinomycosis are varied, and a high index of suspicion is required to make an accurate and timely diagnosis.Methods. Retrospective chart review with the presentation of four unusual cases of actinomycosis were performed.Results. Two patients were initially seen with dysphagia from a tongue base mass. The third patient was initially seen with a 3-week history of worsening hoarseness and stridor. Examination revealed an ulcerative lesion of the left hemilarynx and pyriform sinus. All three patients were thought to have a neoplastic process. Diagnosis was made on histologic examination of a tissue biopsy. The fourth patient was initially seen with a buccal space mass that was draining externally. Culture of the purulent drainage revealed Actinomyces. In all four cases, symptoms resolved after appropriate antimicrobial therapy.Conclusions. Actinomycosis of the head and neck, although rare, is an important entity to the otolaryngologist. A confusing clinical presentation combined with the fastidious nature of the organism make for a difficult diagnosis. A high index of suspicion is required to make an accurate diagnosis and institute the appropriate antibiotic therapy.

No abstract

Prophylactic antibiotics are used routinely in otolaryngology. Little objective data exist concerning their use in sinonasal procedures. We wished to determine the practice patterns of otolaryngologists regarding prophylactic antibiotics for septoplasty patients. A survey of 743 (60.3% responded) members of the American Rhinologic Society was used to get information about their practice habits and rationale for using antibiotics after septoplasty. Sixty-six percent of respondents routinely used antibiotics. Postoperative infection and toxic shock syndrome (TSS) were the primary indications. Forty-four percent of respondents used some form of packing and 38% used a splint. There was no relationship between the annual number of procedures and the reasons for using antibiotics. Doctors who performed more than 50 cases a year were less likely to use packing or splints (p < 0.001). Older surgeons used less younger surgeons a packing/splints (p < 0.001). Respondents who used packing/ splints were more likely to use antibiotics (p = 0.008). Older respondents used packing whereas younger respondents used splints (p = 0.002). The rationale for antibiotics varied by age; re more concerned with TSS and older physicians were more concerned with infection (p = 0.005). This survey shows great variability in the usage and rationale for antibiotics after septoplasty.

We propose that most patients with posterior epistaxis can be treated in specialized ENT wards. This can be done without increasing complications and with significantly decreased costs.