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March 2019 Archives

By Andrea Silvestri

At Purnell, we specialize in creating a safe, rigorous learning environment to ensure the success of students who think differently. We are a day and boarding college preparatory school for girls with learning differences. Our students' learning challenges include ADHD, dysgraphia, dyscalculia, dyslexia, executive functioning issues, and expressive-receptive language disorder. As a Purnell faculty member, I work alongside my colleagues to design and implement curriculum that appeals to our unique student population. Our goal is to create a community that allows each student to discover her potential and strengths both in and outside of the classroom. I strive to achieve this goal through classes that appeal to my students' individual learning styles. My personal strengths as a science teacher are rooted in environmental, place-based, and experiential education. I work to create curricula that draws from my personal strengths as an educator while catering to my students' unique interests and needs. Most recently, I implemented this strategy while designing a Watershed Management course for Purnell. 

Watershed Management is a half-year elective course during which students learn what a watershed is, how they are affected by human activities, and what can be done to preserve them. The course curriculum uses several strategies to appeal to Purnell's students. The class participates in workshops at a nature preserve in coordination with a local non-profit group. The students use online tools to study the pollution status of the streams around their homes and school. They become familiar with the local flora and fauna. The class engages learners through kinesthetic, hands-on activities. Labs at local streams and ponds allow students to see and apply the concepts they learn in the classroom. Students collect macroinvertebrates, measure pH, oxygen levels, and waterflow at several sites to determine water quality. During the water use unit, the students apply the content of the course to their daily lives. They analyze their water usage while performing daily tasks that include household and consumer choices. They compare and contrast their water use to that of other people around the world and critically analyze how they can lessen their impact on the environment. Watershed Management is an experiential learning course that is highly effective because students learn through hands-on activities. Moreover, all lessons are differentiated. Each lesson can be molded and scaffolded to fit individual students' learning needs. In fact, every class at Purnell is designed and differentiated to meet the needs of our diverse group of learners.

Engaging classes are what make Purnell unique. Our student-centered model utilizes small class sizes and opportunities for one-to-one tutoring and support. Every day, teachers hold office hours and learning specialists provide support in our Learning and Enrichment Center. Purnell values community, and our faculty members advise students individually, facilitate student activity clubs, serve as dorm parents, and coach our athletic activities. We want our students to succeed both in and outside of class. Here, we enable each girl to be herself to explore her passions, discover her strengths, and find the confidence to succeed in the world beyond Purnell. #

Andrea Silvestri is a STEM faculty member at the Purnell School.



By Jason D. Kofinas MD, MSc, FACOG

Fertility Surgery is a group of procedures aimed at removing female and male barriers to natural conception. In an age where In-Vitro Fertilization (IVF) has become common and very widely used, it is easy to forget the essential role that fertility surgery can play in the ability of a couple to achieve a pregnancy. There is a big difference between non-surgical fertility treatment options and actual fertility surgery. The former--which you might also hear called "non-surgical" or simply "medical" fertility treatment--can include a wide variety of options that you choose with the guidance of your doctor, and may include ovarian stimulation medications, intrauterine insemination (IUI), or cycle monitoring and stimulation.

Fertility surgery, on the other hand, is more likely to treat more serious conditions that may prevent you from getting or staying pregnant. Some of these conditions for example include uterine fibroids, adhesions, and endometriosis. For men, repair of dilated veins in the scrotum and reversal of vasectomies can overcome anatomic barriers to male fertility. A Human Reproduction article published in 2001 showed that fibroids located in the wall of the uterine body halved the rates of successful pregnancy in assisted conception cycles.Besides decreasing the ability of couples to achieve pregnancy, fibroids are associated with miscarriage and early loss of an otherwise viable pregnancy.

Endometriosis is another reproductive condition that has profound effects on a woman's fertility and reproductive life span. Endometriosis is a condition that can cause severe pain with menses, pain with intercourse and irregular vaginal bleeding. The mechanism of pain is most likely due to significant inflammation in the uterine pelvis leading to the release of substances that can cause severe pain. The presence of endometriosis in some women versus others is a mystery although an anatomic as well as an immunologic based theory of disease is gaining significant traction. The biggest concern we fertility doctors have is how to identify those women who have endometriosis and how to best preserve their fertility and/or assist them in reproducing. A study published in Fertility and Sterility in the summer of 2018 showed that women with stage 3 or 4 endometriosis (severe) defined by the presence of an endometrioma (ovarian cyst) have a significantly higher and rapid reduction in ovarian reserve.This leads to impairment of reproductive potential at a much younger age than a healthy control population.  Endometriosis is a progressively destructive condition and can be treated effectively with fertility surgical intervention. This should restore natural fertility and decrease the progressive decline in reproductive potential.

When used appropriately, fertility surgery can be a safe and effective restoration of a couple's fertile potential. It can completely eliminate the need for IVF which is an expensive and difficult treatment that for the conditions listed above has significantly lower success rates. Proper diagnosis and treatment of a couple leads to better treatment outcomes and fertility surgery continues to play a large role. #

Dr. Jason D. Kofinas is the Director of IVF and Research at Kofinas Fertility Group.



  1. Hart R, Khalaf Y, Yeong CT, Seed P, Taylor A, Braude P. A prospective controlled study of the effect of intramural uterine fibroids on the outcome of assisted conception. Human Reproduction, Volume 16, Issue 11, 1 November 2001, Pages 2411-2417
  2. Kasapoglu I, Ata B, Uyaniklar O, Seyhan A, Orhan A, Oguz SY, Uncu G. Endometrioma-related reduction in ovarian reserve (ERROR): a prospective longitudinal study.  Fertility and Sterility, Volume 110, Issue 1, 1 July 2018, Pages 122-127.

Champions of Compassion and Peace


By Scott T. Nashimoto
I have a 16-month-old daughter. Her ancestors come from all over the world -- she's Asian, Caucasian, Native Hawaiian. She's beautiful and she's starting to show signs that she's strong-willed, caring, persevering, artistic, and much more. And I'm terrified for her because I'm not sure our society is ready to fully accept her and help her to thrive. She'll someday be a young woman of color in a society that doesn't fully respect young women of color. There's a good chance that she'll be paid less than her counterparts, that she'll be a victim of some form of violence, that she'll be bullied, that her home of Hawai`i will be ravaged by climate change or that she'll be priced out by the wealthy, that her culture will fade. I could go on and on. My wife and I have brainstormed how we can give her the utmost freedom to pursue her own interests and passions while still feeling safe and while still developing into a young woman who possesses our two non-negotiable qualities -- to be resilient and kind. And I'm terrified for ourselves because I'm not confident that we have the skills to do so. I'm able to work on both of these fears through my work with Ceeds of Peace. Ceeds of Peace is a Hawai`i-based organization founded by Dr. Kerrie Urosevich and Dr. Maya Soetoro-Ng. Over the past five years, Ceeds of Peace has reached over 7,000 community members, equipping them with the skills and inspiration to raise a generation of leaders who will create peaceful, just, and sustainable communities. Our founders define sustainable communities as communities that come together to protect their most vulnerable members, while designing and adapting socioeconomic systems to reflect the unique needs of their people and land. We offer a number of peacebuilding and action planning workshops and presentations for teachers, families, community groups, and youth. We help participants to plant and nurture essential leadership skills, including critical thinking, courage, communication, compassion, conflict resolution, commitment, collaboration, and connection. Hence our name, Ceeds of Peace. We focus on proactive peacebuilding efforts that address underlying causes and risk factors -- for example, efforts that raise compassionate children and prevent bullying rather than efforts that intervene and punish bullies. Some confuse us as a structured social emotional learning curriculum or a cure-all elixir to address bullying or violence. We are not, and this cure-all elixir doesn't exist. Our goal is to bring out the knowledgeable expert and the courageous leader in each of our participants. Our participants leave us more confident to create and implement action plans that work best for their unique selves (peace within), their own families and friends (peace with others), and their own communities (peace in community). This is the approach it'll take to build a community that fully accepts my daughter and other youth and helps them to thrive. At the same time, this is the approach it'll take to empower my wife and I, as well as other adults across the globe, to raise resilient and kind young peacebuilding leaders. #

Scott T. Nashimoto is the Executive Director of Ceeds of Peace. For more information, please visit CeedsOfPeace.org.

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