72 research outputs found
The Power of Principal Supervisors: How Two Districts are Remaking an Old Role
Principals have a difficult job. It requires them to be instructional leaders, managers and mentors, all with the goal of helping every student succeed.How can school districts provide principals the support they need to excel in this challenging position? Two knowledge products—A Story From the Field and a WNET-produced video, School Leadership in Action: Principal Supervisors—explore how some school districts are responding to that question by remaking the job of the principal's supervisor.The idea—to shape a job focused squarely on helping principals improve instruction—represents a dramatic break with the conventional notion of the principal supervisor as a bureaucratic enforcer of principal compliance with regulations.The article and video profile efforts in two districts, Tulsa and Washington, D.C., that have rethought the supervisor's job, in part by giving supervisors fewer schools to oversee. The result is that supervisors now are fixtures in Tulsa and D.C. schools, doing things like classroom walkthroughs to observe what's working and what isn't—then sitting down with principals to discuss solutions. "I can't imagine doing this job without her," one novice D.C. principal says of her supervisor, who is helping her face such challenges as closing an achievement gap between African-American and white students.Changing the supervisor's job is no easy task. In addition to finding funding for the work—assigning each supervisor fewer schools means increasing the number of supervisors—district leaders face initial wariness from both principals and central office staff members. Supervisors, for their part, don't necessarily step into the job fully prepared to tackle it; so each district provides the supervisors with a considerable amount of professional development. Even with that, supervisors need to figure out how to reconcile two seemingly contradictory roles: developing a trusting relationship with principals while also being their judges in job performance evaluations.Both Tulsa and Washington, D.C., school districts receive Wallace support as part of the foundation's Principal Supervisor Initiative, which seeks to help participating districts and generate lessons for the broader field
Why do young adults in the United States have such low rates of organ donation registration?
The demand for transplantable organs has outpaced the supply. Thus, 20 Americans die
every day while waiting for an organ. Although most adults support organ donation, 42% are not
registered. The rate is even lower among young adults who are not enrolled in/never graduated
from college. The aim of this study was to use the Integrated Behavior Model (IBM) to identify factors
that predicted organ donation registration among a racially diverse sample of non-student young
adults. The study was observational and cross-sectional. Proportional allocation was used to identify
a racially diverse sample of 550 non-student, young adults from ten states in the U.S. with the lowest
registration rates. A valid and reliable survey was designed, pilot-tested, and administered. A total
of 407 young adults completed the survey (74%). Only 19% were registered donors. Caucasians were
more likely to be registered donors than racial minorities, χ
2
(3, N = 407) = 15.19, p = 0.002. Those
with more positive direct attitudes toward registration were 1.5 times more likely to be registered
than those who had negative direct attitudes. Among non-registrants, indirect descriptive norm and
direct attitude were statistically significant predictors of behavioral intention. Moreover, those who
knew someone who donated an organ and knew someone who needed a transplant were nearly three
times more likely to intend to register in the next year. The IBM proved useful in elucidating factors
that predicted intention to register among non-student young adults. The IBM should be used by
those who desire to increase registration rates
Progress in paleoclimate modeling
International audienceThis paper briefly surveys areas of paleoclimate modeling notable for recent progress. New ideas, including hypotheses giving a pivotal role to sea ice, have revitalized the low-order models used to simulate the time evolution of glacial cycles through the Pleistocene, a prohibitive length of time for comprehensive general circulation models (GCMs). In a recent breakthrough, however, GCMs have succeeded in simulating the onset of glaciations. This occurs at times (most recently, 115 kyr B.P.) when high northern latitudes are cold enough to maintain a snow cover and tropical latitudes are warm, enhancing the moisture source. More generally, the improvement in models has allowed simulations of key periods such as the Last Glacial Maximum and the mid-Holocene that compare more favorably and in more detail with paleoproxy data. These models now simulate ENSO cycles, and some of them have been shown to reproduce the reduction of ENSO activity observed in the early to middle Holocene. Modeling studies have demonstrated that the reduction is a response to the altered orbital configuration at that time. An urgent challenge for paleoclimate modeling is to explain and to simulate the abrupt changes observed during glacial epochs (i.e., Dansgaard-Oescher cycles, Heinrich events, and the Younger Dryas). Efforts have begun to simulate the last millennium. Over this time the forcing due to orbital variations is less important than the radiance changes due to volcanic eruptions and variations in solar output. Simulations of these natural variations test the models relied on for future climate change projections. They provide better estimates of the internal and naturally forced variability at centennial time scales, elucidating how unusual the recent global temperature trends are
Multi-level multi-domain statistical shape model of the subtalar, talonavicular, and calcaneocuboid joints
Traditionally, two-dimensional conventional radiographs have been the primary tool to measure the complex morphology of the foot and ankle. However, the subtalar, talonavicular, and calcaneocuboid joints are challenging to assess due to their bone morphology and locations within the ankle. Weightbearing computed tomography is a novel high-resolution volumetric imaging mechanism that allows detailed generation of 3D bone reconstructions. This study aimed to develop a multi-domain statistical shape model to assess morphologic and alignment variation of the subtalar, talonavicular, and calcaneocuboid joints across an asymptomatic population and calculate 3D joint measurements in a consistent weightbearing position. Specific joint measurements included joint space distance, congruence, and coverage. Noteworthy anatomical variation predominantly included the talus and calcaneus, specifically an inverse relationship regarding talar dome heightening and calcaneal shortening. While there was minimal navicular and cuboid shape variation, there were alignment variations within these joints; the most notable is the rotational aspect about the anterior-posterior axis. This study also found that multi-domain modeling may be able to predict joint space distance measurements within a population. Additionally, variation across a population of these four bones may be driven far more by morphology than by alignment variation based on all three joint measurements. These data are beneficial in furthering our understanding of joint-level morphology and alignment variants to guide advancements in ankle joint pathological care and operative treatments
Using Medical Students to Enhance Curricular Integration of Cross-Cultural Content
We hypothesized that an interested medical student group would be helpful in reviewing tutorial cases and giving relevant feedback on the curricular integration of cross-cultural content using case triggers in a preclinical gastrointestinal pathophysiology course. Self-selected student leaders (n = 9) reviewed pre-existing problem-based learning tutorial cases (n = 3) with cross-cultural triggers, and provided narrative feedback to course faculty. The cases were modified and used for the entire class in the following 2 years. Participating course students' comments and teaching faculty feedback were also noted. Outcomes were a change in case content, student global evaluations of the course, and self-reported faculty comfort with teaching the cases. All three tutorial cases were reviewed by a separate group of 2–3 students. Major and minor revisions were made to each case based on the student feedback. These cases were used in 2007 and 2008 and were the major change to the course during that time. Overall course evaluation scores improved significantly from 2006 to 2008 (p = 0.000). Tutors (n = 22 in 2007; n = 23 in 2008) expressed relief during tutor meetings that students had reviewed the cases. A general framework for eliciting student feedback on problem-based cases was developed. Student feedback, consisting of self-selected students' case reviews and solicited course and tutor comments, added value to a curricular reform to improve the integration of cross-cultural content into a problem-based learning curriculum. Our study underscores the fundamental link between teachers and students as partners in curricular development
Levetiracetam-loaded biodegradable polymer implants in the tetanus toxin model of temporal lobe epilepsy in rats
Approximately one-third of people with epilepsy receive insufficient benefit from currently available anticonvulsant medication, and some evidence suggests that this may be due to a lack of effective penetration into brain parenchyma. The current study investigated the ability of biodegradable polymer implants loaded with levetiracetam to ameliorate seizures following implantation above the motor cortex in the tetanus toxin model of temporal lobe epilepsy in rats. The implants led to significantly shorter seizures and a trend towards fewer seizures for up to 1 week. The results of this study indicate that drug-eluting polymer implants represent a promising evolving treatment option for intractable epilepsy. Future research is warranted to investigate issues of device longevity and implantation site
Comparison of Outcomes of antibiotic Drugs and Appendectomy (CODA) trial: a protocol for the pragmatic randomised study of appendicitis treatment.
INTRODUCTION: Several European studies suggest that some patients with appendicitis can be treated safely with antibiotics. A portion of patients eventually undergo appendectomy within a year, with 10%-15% failing to respond in the initial period and a similar additional proportion with suspected recurrent episodes requiring appendectomy. Nearly all patients with appendicitis in the USA are still treated with surgery. A rigorous comparative effectiveness trial in the USA that is sufficiently large and pragmatic to incorporate usual variations in care and measures the patient experience is needed to determine whether antibiotics are as good as appendectomy.
OBJECTIVES: The Comparing Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial for acute appendicitis aims to determine whether the antibiotic treatment strategy is non-inferior to appendectomy.
METHODS/ANALYSIS: CODA is a randomised, pragmatic non-inferiority trial that aims to recruit 1552 English-speaking and Spanish-speaking adults with imaging-confirmed appendicitis. Participants are randomised to appendectomy or 10 days of antibiotics (including an option for complete outpatient therapy). A total of 500 patients who decline randomisation but consent to follow-up will be included in a parallel observational cohort. The primary analytic outcome is quality of life (measured by the EuroQol five dimension index) at 4 weeks. Clinical adverse events, rate of eventual appendectomy, decisional regret, return to work/school, work productivity and healthcare utilisation will be compared. Planned exploratory analyses will identify subpopulations that may have a differential risk of eventual appendectomy in the antibiotic treatment arm.
ETHICS AND DISSEMINATION: This trial was approved by the University of Washington\u27s Human Subjects Division. Results from this trial will be presented in international conferences and published in peer-reviewed journals.
TRIAL REGISTRATION NUMBER: NCT02800785
Data Descriptor: An open resource for transdiagnostic research in pediatric mental health and learning disorders
Technological and methodological innovations are equipping researchers with unprecedented capabilities for detecting and characterizing pathologic processes in the developing human brain. As a result, ambitions to achieve clinically useful tools to assist in the diagnosis and management of mental health and learning disorders are gaining momentum. To this end, it is critical to accrue large-scale multimodal datasets that capture a broad range of commonly encountered clinical psychopathology. The Child Mind Institute has launched the Healthy Brain Network (HBN), an ongoing initiative focused on creating and sharing a biobank of data from 10,000 New York area participants (ages 5–21). The HBN Biobank houses data about psychiatric, behavioral, cognitive, and lifestyle phenotypes, as well as multimodal brain imaging (resting and naturalistic viewing fMRI, diffusion MRI, morphometric MRI), electroencephalography, eyetracking, voice and video recordings, genetics and actigraphy. Here, we present the rationale, design and implementation of HBN protocols. We describe the first data release (n =664) and the potential of the biobank to advance related areas (e.g., biophysical modeling, voice analysis
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