Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography

To assess the variability in accuracy of contrast media introduction, leakage, required time and patient discomfort in four different centres, each using a different image-guided glenohumeral injection technique. Each centre included 25 consecutive patients. The ultrasound-guided anterior (USa) and posterior approach (USp), fluoroscopic-guided anterior (FLa) and posterior (FLp) approach were used. Number of injection attempts, effect of contrast leakage on diagnostic quality, and total room, radiologist and procedure times were measured. Pain was documented with a visual analogue scale (VAS) pain score. Access to the joint was achieved in all patients. A successful first attempt significantly occurred more often with US (94%) than with fluoroscopic guidance (72%). Leakage of contrast medium did not cause interpretative difficulties. With US guidance mean room, procedure and radiologist times were significantly shorter (p < 0.001). The USa approach was rated with the lowest pre- and post-injection VAS scores. The four image-guided injection techniques are successful in injection of contrast material into the glenohumeral joint. US-guided injections and especially the anterior approach are significantly less time consuming, more successful on the first attempt, cause less patient discomfort and obviate the need for radiation and iodine contrast

Mobile Collaboration for Language Learning and Cultural Learning

Locations outside the classroom represent social spaces or “settings” that offer a variety of affordances for language learning, but these opportunities will not be fully realized unless we make efforts to propose and try out new designs for learning in these settings. It is especially important to consider how learners might assemble, configure or help create learning designs that involve mobile technologies, tasks and resources corresponding to their needs, in readiness for chance encounters and for more sustained learning. Two key questions are pertinent to the issues outlined above when considering the nexus of collaboration, cultural experiences, and the interface between formal and informal learning: (1) What are the key findings from research studies and reported experiences of collaboration in mobile language learning, with particular reference to informal settings and cultural learning? (2) What do these findings mean for teacher roles, and how can learners be supported and developed to engage more effectively in collaborative and cultural mobile language learning? These two broad questions set the scene for this chapter and guide its structure. In the first part, we focus on existing studies to examine what has been tried and to establish the key findings. The existing studies include some in which we have been involved, often as lead researchers. After that, we consider teachers’ and learners’ changing roles and the foregrounding or development of competencies and skills that are important for more informal, and perhaps increasingly collaborative, mobile language learning. In the conclusion we propose a list of five areas of focus for teachers and learners to become aware that language learning with mobiles can operate across a highly‐flexible continuum from informal to formal learning and intercultural exchange