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In this study, the authors explore the implementation of a statewide class-size reduction program in nine high-poverty schools. Through qualitative methods, they examined how schools used class-size reduction to change staffing patterns and instructional programs. Requiring changes in space allocation, class-size reduction was accomplished through attention to pupil:teacher ratio, with classes ranging from 15:1 to 30:2 team taught. Most partner classes used tag-team teaching, with one teacher leading and the other doing clerical work. Working without specific professional development to enhance teaching in smaller classes, it made sense that teachers continued to solo practice. Class-size reduction is both a programmatic and instructional reform, and as such, it requires specific professional development to promote change. (Contains 3 tables and 3 notes.)

Key content Cervical cancer continues to affect many women in the UK with over half under the age of 45 years at the time of diagnosis; with a trend towards starting families later in life this raises fertility concerns., While the standard treatment for stage IA2 or IB1 cervical cancer is a radical hysterectomy, radical trachelectomy has been shown to have equivalent 5-year survival and is a surgical option if there is a wish to preserve fertility., Although trachelectomies are performed by gynaecological oncologists, the management of any subsequent pregnancies falls under the remit of obstetricians who therefore require a sound knowledge of the procedure and potential obstetric sequelae., Pregnancies following trachelectomy are high risk because of the increased rate of mid-trimester miscarriage and preterm delivery, often as a consequence of preterm prelabour rupture of membranes., Delivery is by caesarean section, traditionally by classical section as a permanent isthmic suture is placed at the time of trachelectomy, but nowadays a transverse incision may be used to reduce morbidity and the implications on future fertility., Learning objectives Management of a pregnancy following radical trachelectomy., Intrapartum care of post-radical trachelectomy pregnancy and complication risks., Impact of trachelectomy and subsequent pregnancy on the woman., Ethical issues Informed consent surrounding trachelectomy and future pregnancies. [ABSTRACT FROM AUTHOR]