Systematic assessment of HER2/neu in gynecologic neoplasms, an institutional experience.

BackgroundHER2/neu overexpression and/or amplification has been widely studied in a number of solid tumors, primarily in the breast. In gynecologic neoplasms, determination of HER2/neu status has not been well studied as a predictive biomarker in anti-HER2/neu treatment.MethodsWe systematically evaluated the HER2/neu reactions by immunohistochemistry and fluorescent in situ hybridization in malignant gynecologic neoplasms as experienced in our institution.ResultsThe HER2/neu overexpression or amplification occurred in 8 % of the cancers of the gynecological organs in our series. Majority of the HER2/neu overexpression and/or amplification occurred in clear cell (27 %) and serous (11 %) carcinomas. HER2/neu positivity was also seen in undifferentiated as well as in mixed clear cell and serous carcinomas. Discordant IHC and FISH results (positive by FISH but not IHC) was seen in 2 cases. Majority of the HER2/neu overexpression and/or amplification occurs in the endometrium rather than the ovary. Heterogeneity of the HER2/neu by IHC staining was in < 2 % of the tumors in our series.ConclusionsWe recommend the HER2/neu studies on Müllerian carcinomas of clear cell, serous, and undifferentiated types, particularly when they arise in the endometrium. Since there are some discordant IHC/FISH results, we also propose performing the HER2/neu testing by FISH when the IHC score is less than 3 + 

Secondary literacy across the curriculum: Challenges and possibilities

This paper discusses the challenges and possibilities attendant upon successfully implementing literacy across the curriculum initiatives – or ‘school language policies’ as they have come to be known - particularly at the secondary or high school level. It provides a theoretical background to these issues, exploring previous academic discussions of school language policies, and highlights key areas of concern as well as opportunity with respect to school implementation of such policies. As such, it provides a necessary conceptual background to the subsequent papers in this special issue, which focus upon the Secondary Schools’ Literacy Initiative (SSLI) – a New Zealand funded programme that aims to establish cross-curricular language and literacy policies in secondary schools

National Academy of Clinical Biochemistry and IFCC Committee for Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines: Analytical Issues for Biochemical Markers of Acute Coronary Syndromes

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Wigs, disguises and child's play : solidarity in teacher education

It is generally acknowledged that much contemporary education takes place within a dominant audit culture, in which accountability becomes a powerful driver of educational practices. In this culture both pupils and teachers risk being configured as a means to an assessment and target-driven end: pupils are schooled within a particular paradigm of education. The article discusses some ethical issues raised by such schooling, particularly the tensions arising for teachers, and by implication, teacher educators who prepare and support teachers for work in situations where vocational aims and beliefs may be in in conflict with instrumentalist aims. The article offers De Certeau’s concept of ‘la perruque’ to suggest an opening to playful engagement for human ends in education, as a way of contending with and managing the tensions generated. I use the concept to recover a concept of solidarity for teacher educators and teachers to enable ethical teaching in difficult times

Impact of Scottish vocational qualifications on residential child care : have they fulfilled the promise?

This article will present findings from a doctoral study exploring the impact of 'SVQ Care: Promoting Independence (level III)' within children's homes. The study focuses on the extent to which SVQs enhance practice and their function within a 'learning society'. A total of 30 staff were selected from seven children's homes in two different local authority social work departments in Scotland. Each member of staff was interviewed on four separate occasions over a period of 9 months. Interviews were structured using a combination of repertory grids and questions. Particular focus was given to the assessment process, the extent to which SVQs enhance practice and the learning experiences of staff. The findings suggest that there are considerable deficiencies both in terms of the SVQ format and the way in which children's homes are structured for the assessment of competence. Rather than address the history of failure within residential care, it appears that SVQs have enabled the status quo to be maintained whilst creating an 'illusion' of change within a learning society

Analytical considerations in deriving 99th percentile upper reference limits for high-sensitivity cardiac troponin assays: Educational recommendations from the IFCC committee on clinical application of cardiac bio-markers

The International Federation of Clinical Chemistry Committee on Clinical Application of Cardiac Bio-Markers provides evidence-based educational documents to facilitate uniform interpretation and utilization of cardiac biomarkers in clinical laboratories and practice. The committee’s goals are to improve the understanding of certain key analytical and clinical aspects of cardiac biomarkers and how these may interplay in clinical practice. Measurement of high-sensitivity cardiac troponin (hs-cTn) assays is a cornerstone in the clinical evaluation of patients with symptoms and/or signs of acute cardiac ischemia. To define myocardial infarction, the Universal Definition of Myocardial Infarction requires patients who manifest with features suggestive of acute myocardial ischemia to have at least one cTn concentration above the sex-specific 99th percentile upper reference limit (URL) for hs-cTn assays and a dynamic pattern of cTn concentrations to fulfill the diagnostic criteria for MI. This special report provides an overview of how hs-cTn 99th percentile URLs should be established, including recommendations about prescreening and the number of individuals required in the reference cohort, how statistical analysis should be conducted, optimal preanalytical and analytical protocols, and analytical/biological interferences or confounds that can affect accurate determination of the 99th percentile URLs. This document also provides guidance and solutions to many of the issues posed.publishedVersio

A theory of motivation and ontological enhancement: the role of disability policy in student empowerment and institutional change

As debate continues around the nature and values of education, it is important to ask the question of what factors motivate a student to engage with the ends of an educational institution. In this paper, a broad, holistic view of learner motivation, derived from Aristotelian ethics, is used to provide a model to drive institutional change. Focussing on the approach of one Higher Education institution to the particular accommodations required for students with disabilities, the paper identifies three factors which motivate students, a failure to engage with the aims and ends of the educational project, a failure to see that a particular learning aim is worth attaining, and a simple lack of will‐power to attain it. To each of these failures a social cause is identified, and a change in both the institutional culture and the individual learner's approach to their education is suggested

Critical Race Theory and Education: racism and anti-racism in educational theory and praxis

What is Critical Race Theory (CRT) and what does it offer educational researchers and practitioners outside the US? This paper addresses these questions by examining the recent history of antiracist research and policy in the UK. In particular, the paper argues that conventional forms of antiracism have proven unable to keep pace with the development of increasingly racist and exclusionary education polices that operate beneath a veneer of professed tolerance and diversity. In particular, contemporary antiracism lacks clear statements of principle and theory that risk reinventing the wheel with each new study; it is increasingly reduced to a meaningless slogan; and it risks appropriation within a reformist “can do” perspective dominated by the de-politicized and managerialist language of school effectiveness and improvement. In contrast, CRT offers a genuinely radical and coherent set of approaches that could revitalize critical research in education across a range of inquiries, not only in self-consciously "multicultural" studies. The paper reviews the developing terrain of CRT in education, identifying its key defining elements and the conceptual tools that characterise the work. CRT in education is a fast changing and incomplete project but it can no longer be ignored by the academy beyond North America

Social difference, cultural arbitrary and identity : an analysis of a new national curriculum document in a non-secular environment

This article focuses on the idea of the Curriculum as a 'selection from the cultures of society' and as a site of contestation for legitimacy and identity affirmation. The purpose is to shed some light on the nature of curricular reform being advocated in a specific context - Malta. Throughout the past four years, there has been a revamping of the National Minimum Curriculum (NMC) document in Malta, established in 1988. The 'old' National Minimum Curriculum was subject to criticism focusing on a variety of issues (echoing criticisms levelled at similar National Curricula elsewhere), including issues concerning difference and identity. The first part of the article deals briefly with the issues concerning difference raised in this criticism, focusing on the issues of class, race/ethnicity, gender and disability. The second part focuses on the long and gradual build up towards the development of the new National Curriculum document. The process centres around two documents, the preliminary Tomorrow's Schoolsdocument and the draft NMC document. The issues of equity and the affirmation of social difference, as well as the move towards de-streaming, are discussed. It is argued that this process of reform benefited from the criticism of the earlier NMC document. The process of reform involved an attempt at widespread participation by various stakeholders - parents, teachers, students, unions, women's organisations, disabled person's organisations etc. The final section focuses on the final new NMC document. In this section, the authors explore the compromises, which have been made in reaction to the draft document, indicating the interests at play. Whose cultural arbitrary is reflected in the final document? The article concludes with a discussion centring around lessons to be drawn from a process of curricular reform, involving issues related to identity and difference, carried out in a country characterised by a non-secular environment.peer-reviewe

Multicenter assessment of a hemoglobin A1c point-of-care device for diagnosis of diabetes mellitus.

ObjectiveA multisite investigation compared the analytical performance of a point-of-care (POC) HbA1c device with multiple commonly used HbA1c laboratory methods and an NGSP (National Glycohemoglobin Standardization Program) reference method.Research design and methodsThe Afinion AS100 POC device analyzed HbA1c using 618 EDTA whole blood excess patient specimens with clinically indicated HbA1c testing. Results were compared to measurements across five clinical laboratories and the NGSP reference method. Precision was evaluated over 8-10 consecutive days for low-, mid-, and high-range HbA1c specimens at all five sites.ResultsOver a wide range of HbA1c values (4.0%-15% HbA1c), 97.1% of the POC results and 94.5% of routine laboratory results fell within the target value of ±6% of the NGSP reference method results. The POC HbA1c results at 6.5% exhibited a total relative bias of -0.6% (-0.04% HbA1c) compared to the reference method while the aggregate of laboratory methods displayed a relative bias of -0.9% (-0.06% HbA1c). The total imprecision of the POC results ranged from 0.74-2.13% CV across the analytic measurement range compared to 0.81-3.23% CV for the routine laboratory methods.ConclusionsThe accuracy and precision of the Afinion POC HbA1c method was comparable to the laboratory HbA1c methods supporting the FDA's recent approval of the Afinion HbA1c Dx device for use in the diagnosis of diabetes