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In this study, we investigated the impact of teaming school-based instructional coaches with science or mathematics middle school teachers to build a community of practice around inquiry instruction. This professional development model began with a 2-week summer institute and continued with four follow-up sessions during the academic school year for the teacher and instructional coach participants. The teachers' participation in this professional development program with (1) content instruction through inquiry lessons, (2) practice teaching to middle school students, and (3) coach-led reflection improved their understanding of inquiry-based practices and the quality of their classroom inquiry implementation. Professional development experiences that prepare teachers and coaches simultaneously in inquiry and content may help build a shared language for reform and accelerate inquiry instructional changes.

Objective: Sinonasal malignancies are uncommon neoplasms with several histological subtypes, most commonly treated with surgery and postoperative radiotherapy. The aim of this study was to evaluate complications and survival, focusing on differences between elderly and younger patients undergoing surgery., Study Design: Historical cohort based on medical records., Setting: Tertial referral center., Subjects and Methods: Medical charts of 103 surgically treated patients (71 patients younger than 70 years and 32 patients aged 70 years and older) in a tertiary referral center with sinonasal malignancy were retrospectively analyzed. Comorbidity was scored according to the Adult Comorbidity Evaluation 27 system. Treatment outcomes were analyzed by collecting treatment-related complications scores and survival data., Results: Although comorbidity was more common in elderly patients, no significant differences were recorded in complications. In multivariate analysis, length of surgery was the only predictor for complication. Furthermore, no significant differences were seen in disease-specific survival and recurrence in young and elderly patients. Young patients with malignant epithelial tumors and melanoma had worse overall survival than patients with other histological subtypes. However, in elderly patients, no significant differences were seen in survival between histological subtypes., Conclusion: For complications, survival, and recurrence, no differences were seen between young and elderly patients. Based on this study, surgery can also be safely performed in elderly sinonasal cancer patients after careful preoperative evaluation and patient selection.

The presence of paratracheal lymph node (PTLN) metastasis harbours a worse prognosis. Uniform guidelines on PTLN dissection are missing, mainly because of the value of diagnostic techniques for the detection of PTLN metastasis are not clear. This study is performed to identify CT and MRI criteria for detection of PTLN metastasis. 149 patients who underwent laryngectomy and a PTLN dissection between 1990 and 2010 were included. Patient, tumour, treatment and follow up data were collected. On computed tomography (CT) and magnetic resonance imaging (MRI) different test criteria were examined. Considering PTLN with a maximal axial diameter of ≥5 mm as positive predicts PTLN metastasis best: sensitivity and specificity 70% and 36% (CT) and 50% and 71% (MRI). Other risk factors for PTLN metastasis were subglottic extension of the tumour (sensitivity is 45%) and clinical positive neck status (sensitivity is 59%). When at least one of these risk factors was present and the status of PTLN was considered positive, a high sensitivity (90% for CT and 100% for MRI) and a lower specificity (19% for CT and 32% for MRI) was found. If at least one of the risk factors such as subglottic extension, clinical positive neck and PTLN with a maximal axial diameter of ≥5 mm is present, sensitivity and negative predictive value for the prediction of PTLN metastasis are high, but the specificity is low. These risk factors can be used to select laryngectomy patients for PTLN dissection., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Treatment choice in elderly pharyngeal cancer patient is disputed. This study was aimed to asses association of co-morbidity, complications and survival in different treatment modalities of pharyngeal cancer patients. Retrospective analysis of pharyngeal cancer patients, diagnosed between 1997 and 2007 in a tertiary referral hospital was performed. Patients 75years and older (n=42), were matched with two control patients 64years and younger (n=84). Co-morbidity (ACE-27), treatment related complications and survival data were assessed and analyzed. Frequency of co-morbidity was similar in both age groups, although discarding alcohol abuse resulted in higher incidence of co-morbidity in the elderly group. Complication rate was not significantly different. In a multivariate analysis only stage found to be a significant predictor of complications. Survival estimates adjusted to sex, age and birth cohort revealed co-morbidity to be a significant predictor for survival in elderly and young patients. No evidence has been found to treat elderly pharyngeal cancer patients differently than younger ones. Treatment related complications are not predicted by co-morbidities in young and elderly patients; however survival is predicted by comorbidity. Therefore thorough pre-treatment evaluation and care necessary in the elderly population., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The standard treatment of elderly head and neck patients is controversial. The goal of this study was to evaluate the relationship between co-morbidity and complications in elderly laryngeal cancer patients treated with different modalities. Retrospective analysis of patients 75 years old and older with laryngeal cancer (n=139) and patients 65 years old and younger as a reference control group (n=289) diagnosed in our department between 1997 and 2007 has been performed. Pretreatment co-morbidity (ACE-27), treatment-related complications and one- and six-month death rates have been analyzed. Co-morbidity rate was more pronounced in the elderly group, but did not result in more complications. Correlation has been found between co-morbidity and complication in the whole patients group, but not in the elderly group. By multivariate analysis, in all age groups radiation therapy (vs. total laryngectomy) and tumor stage were predictors of complications but co-morbidity and age were not. According to our study there is no reason to treat elderly laryngeal cancer patients differently. The weaker relation between co-morbidity and complications emphasizes the importance of careful pre-treatment evaluation in elderly., (Copyright © 2010 Elsevier Ltd. All rights reserved.)