The thought processes of administrators as they review and make evaluative judgment of a second-year teacher portfolio: A qualitative study

This qualitative study explored the thought processes of administrators as they reviewed and judged second-year teacher artifacts (a portfolio) relative to the Iowa teaching standards and criteria (ITS/criteria). In addition, data was collected pertaining to the tools principals used as they conducted portfolio evaluation and the amount of bearing the portfolio had on a licensure decision. Data for the study was gathered via a think-aloud process in combination with guided interview questions. Nine principals participated in the study; three each from elementary, middle, and high school. The nine principals were also representative of rural, suburban, and urban geographic/demographic regions. The think-alouds and ensuing interviews were audio-recorded and then transcribed. The resulting verbal reports (comments) were analyzed and categorized using the constant comparative method. The comment counts were used to report the accumulated data and make comparisons between academic level and between geographic/demographic regions. The verbal reporting data revealed that the thought processes of the principals were similar. Each review consisted of three distinct phases. Within in each phase, the principals attended to processing activities, judgment activities, and coaching activities. In addition, the principals identified two critical pieces of teacher evaluation as teacher reflection and principal\u27 s observation of teacher. Findings also made clear the impact of the Iowa Evaluator Training Program (IEATP) on the consistency of evaluation. Principals across academic level and geographic/demographic region used a similar four-step rhythm as they judged artifacts. In addition, a distinct consistency existed in the kinds of artifacts the principals identified as valid evidence of the ITS/criteria. Further, the leadership style of the principals was indicative of the formative nature of the portfolio. Six distinct tools that principals used while they evaluated were identified and described in the study. In addition, it was evident that, while value was placed on the portfolio, the principals put more emphasis on observation. Principals indicated that the portfolio review would account for roughly 30% of a licensure decision. The findings from this study were relevant to consistency in evaluation across academic level and geographic/demographic region. The information may help inform continuing efforts relative to teacher evaluation across the state

Messiness of forest governance:How technical approaches suppress politics in REDD+ and conservation projects

Reduction of Emissions from Deforestation and Forest Degradation (REDD+) was originally conceived to address the global problem of climate change by reducing deforestation and forest degradation at national and subnational levels in developing countries. Since its inception, REDD+ proponents have increasingly had to adapt global ideas to local demands, as the rollout process was met with on-the-ground realities, including suspicion and protest. As is typical in aid or ‘development’ projects conceived in the global North, most of the solutions advanced to improve REDD+ tend to focus on addressing issues of justice (or ‘fairness’) in distributive terms, rather than addressing more inherently political objections to REDD+ such as those based on rights or social justice. Using data collected from over 700 interviews in five countries with both REDD+ and non-REDD+ cases, we argue that the failure to incorporate political notions of justice into conservation projects such as REDD+ results in ‘messiness’ within governance systems, which is a symptom of injustice and illegitimacy. We find that, first, conservation, payment for ecosystem services, and REDD+ project proponents viewed problems through a technical rather than political lens, leading to solutions that focused on procedures, such as ‘benefit distribution.’ Second, focusing on the technical aspects of interventions came at the expense of political solutions such as the representation of local people's concerns and recognition of their rights. Third, the lack of attention to representation and recognition justices resulted in illegitimacy. This led to messiness in the governance systems, which was often addressed in technical terms, thereby perpetuating the problem. If messiness is not appreciated and addressed from appropriate notions of justice, projects such as REDD+ are destined to fail

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

A successful physician training program in cholesterol screening and management

Method. Thirty-six resident physicians received a blood cholesterol training program which included training in blood cholesterol screening using a fingerstick method and a desktop analyzer, diet assessment and counseling, and a management protocol for follow-up diet and drug treatment. The program also included feedback to residents about their blood cholesterol screening activity, incentives, and biweekly articles in the department newsletter. Results. Between 1986-1987 (baseline) and 1987-1988 (intervention), the percentage of the target patient population (ages 20-65 years, nonpregnant, not screened in the previous year) that was screened for hypercholesterolemia in this primary care practice increased from 16.2 to 23.2% [rate difference (RD) = 7.0; 95% confidence interval (CI) = 4.75-9.25]. The mean value of the screening tests decreased from 5.36 mmol/liter (207.2 mg/dl) to 5.08 mmol/liter (196.6 mg/dl; t = 2.98, P = 0.003) and the percentage of the population screened needing further evaluation decreased from 36.8 to 27.6% (RD 9.2; CI = 2.00-14.00). In the intervention year, compared with the baseline year, patients with a borderline blood cholesterol and cardiovascular risk factors were more likely to have a follow-up test (28.8% vs 11.9%, RD = 16.9; 95% CI = 0.80-33.00) and the low-density lipoprotein cholesterol test was used less for screening (8.2% vs 19.4%, P \u3c 0.0001). Conclusion. We conclude that this program was effectively integrated into a busy primary care practice, leading to improvement in blood cholesterol screening and management practices. © 1991