Challenging the Assumption of Rationality in Performance-Based Accountability Systems: A Comparative Case Study of School and District Decision-Making Approaches

CHALLENGING THE ASSUMPTION OF RATIONALITY IN PERFORMANCE-BASED ACCOUNTABILITY SYSTEMS: A COMPARATIVE CASE STUDY OF SCHOOL AND DISTRICT DECISION-MAKING APPROACHES Jessica K. Beaver Richard M. Ingersoll Performance-based accountability systems provide schools and districts with detailed student performance data on the front end and demand that schools meet rigorous minimum proficiency thresholds on the back end or face a set of sanctions that ratchet up year after year. The process by which schools and districts make decisions for improvement in order to meet these requirements, however, is opaque at best. Each district is like an island unto itself, with its own political context, financial constraints, demographic and economic makeup, human capital, and social dynamics. Especially given the immense amount of money spent every year in improvement grants to districts, as well as the plethora of vendors touting new products, there is a clear imperative to understand how schools and districts select particular programs or strategies for improvement above other options. In this dissertation study, I apply the literature on search and decision-making in other disciplines to the field of public elementary and secondary education, paying particular attention to schools and districts under pressure to improve from performance-based accountability systems. I employ a comparative case study approach, using three consecutive years of data from a stratified random sample of eight schools (nested within their districts) in Pennsylvania. I find that schools and districts are under immense pressure to demonstrate student achievement gains, and that this pressure extends to all phases of the decision-making process, including problem identification, search, and the decision point. Despite this pressure, I find that schools do not descend into chaos when making decisions for improvement - they generally approach the decision-making process in a linear manner and let building-level administrators employ a middle-out approach to decision-making. But on the other hand, schools are far from purely rational organizations, as there are forces internal and external to the school or district that constrain decision-making processes. Although these constraints affect all stages of the decision-making process, they have the most severe influence on the search phase. Finally, I create a framework that advances the literature on decision-making in education by establishing four distinct typologies of decision-making approaches

Measuring School Capacity, Maximizing School Improvement

Given the nearly ubiquitous use of the term capacity in education policy discourse, this policy brief offers a common framework for analyzing capacity that educators, policymakers, and researchers alike can apply and understand with consistency. Drawing data from a larger three-year CPRE study of school responses to accountability in Pennsylvania, the authors\u27 goal is not to provide an easy, new, one-sentence definition, but rather to create a shared language that can be applied to research and improvement efforts in schools. To accomplish this, the authors break capacity down into component parts, explaining how each one builds off the next and contributes to theoverall concept

Learning From NCLB: School Responses to Accountability Pressure and Student Subgroup Performance

Much has been written in the last decade about the spotlight that the No Child Left Behind Act (NCLB) shines on schoolperformance. Proponents and opponents alike are quick to discuss the law’s rigid definitions of school performance— exemplified by the classification of schools as making Adequate Yearly Progress (AYP) or not making AYP based largely on annual tests in reading and mathematics, disaggregating school performance by student subgroups, and requiring that all schools reach 100% proficiency. Yet for all its rigidity, the law has offered schools little guidance on how to make use of the performance data that the new systems provide or how to design improvement efforts. As policymakers discuss ways to change NCLB or design new federal education policies targeted at improving academic achievement, we present new research findings that can help to inform those discussions. In this CPRE Policy Brief, we examine the extent to which the assumptions in the law manifest themselves in the actions that school leaders take. This brief asks and answers the question: How do school leaders—administrators and teachers— respond to the results of state assessment systems and the pressure of performance-based accountability? And do those responses seem to matter to achievement outcomes

CSF Inflammatory Markers Differ in Gram-Positive Versus Gram-negative Shunt Infections.

BACKGROUND: Cerebrospinal fluid (CSF) shunt placement is frequently complicated by bacterial infection. Shunt infection diagnosis relies on bacterial culture of CSF which can often produce false-negative results. Negative cultures present a conundrum for physicians as they are left to rely on other CSF indices, which can be unremarkable. New methods are needed to swiftly and accurately diagnose shunt infections. CSF chemokines and cytokines may prove useful as diagnostic biomarkers. The objective of this study was to evaluate the potential of systemic and CSF biomarkers for identification of CSF shunt infection. METHODS: We conducted a retrospective chart review of children with culture-confirmed CSF shunt infection at Children\u27s Hospital and Medical Center from July 2013 to December 2015. CSF cytokine analysis was performed for those patients with CSF in frozen storage from the same sample that was used for diagnostic culture. RESULTS: A total of 12 infections were included in this study. Patients with shunt infection had a median C-reactive protein (CRP) of 18.25 mg/dL. Median peripheral white blood cell count was 15.53 × 10 CONCLUSIONS: This pilot study is the first to characterize the CSF cytokine profile in patients with CSF shunt infection and supports the distinction of chemokine and cytokine profiles between gram-negative and gram-positive infections. Additionally, it demonstrates the potential of CSF chemokines and cytokines as biomarkers for the diagnosis of shunt infection

Staphylococcus aureus sarA regulates inflammation and colonization during central nervous system biofilm formation

Infection is a frequent and serious complication following the treatment of hydrocephalus with CSF shunts, with limited therapeutic options because of biofilm formation along the catheter surface. Here we evaluated the possibility that the sarA regulatory locus engenders S. aureus more resistant to immune recognition in the central nervous system (CNS) based on its reported ability to regulate biofilm formation. We utilized our established model of CNS catheter-associated infection, similar to CSF shunt infections seen in humans, to compare the kinetics of bacterial titers, cytokine production and inflammatory cell influx elicited by wild type S. aureus versus an isogenic sarA mutant. The sarA mutant was more rapidly cleared from infected catheters compared to its isogenic wild type strain. Consistent with this finding, several pro-inflammatory cytokines and chemokines, including IL-17, CXCL1, and IL-1β were significantly increased in the brain following infection with the sarA mutant versus wild type S. aureus, in agreement with the fact that the sarA mutant displayed impaired biofilm growth and favored a planktonic state. Neutrophil influx into the infected hemisphere was also increased in the animals infected with the sarA mutant compared to wild type bacteria. These changes were not attributable to extracellular protease activity, which is increased in the context of SarA mutation, since similar responses were observed between sarA and a sarA/protease mutant. Overall, these results demonstrate that sarA plays an important role in attenuating the inflammatory response during staphylococcal biofilm infection in the CNS via a mechanism that remains to be determined

Bacteria Commonly Associated with Central Nervous System Catheter Infections Elicit Distinct CSF Proteome Signatures

Background: Cerebrospinal fluid (CSF) shunt infection is a common and devastating complication of the treatment of hydrocephalus. Timely and accurate diagnosis is essential as these infections can lead to long-term neurologic consequences including seizures, decreased intelligence quotient (IQ) and impaired school performance in children. Currently the diagnosis of shunt infection relies on bacterial culture; however, culture is not always accurate since these infections are frequently caused by bacteria capable of forming biofilms, such as Staphylococcus epidermidis, Cutibacterium acnes, and Pseudomonas aeruginosa resulting in few planktonic bacteria detectable in the CSF. Therefore, there is a critical need to identify a new rapid, and accurate method for diagnosis of CSF shunt infection with broad bacterial species coverage to improve the long-term outcomes of children suffering from these infections. Methods: To investigate potential biomarkers that would discriminate S. epidermidis, C. acnes and P. aeruginosa central nervous system (CNS) catheter infection we leveraged our previously published rat model of CNS catheter infection to perform serial CSF sampling to characterize the CSF proteome during these infections compared to sterile catheter placement. Results: P. aeruginosa infection demonstrated a far greater number of differentially expressed proteins when compared to S. epidermidis and C. acnes infection and sterile catheters, and these changes persisted throughout the 56-day time course. S. epidermidis demonstrated an intermediate number of differentially expressed proteins, primarily at early time points that dissipated over the course of infection. C. acnes induced the least amount of change in the CSF proteome when compared to the other pathogens. Conclusions: Despite the differences in the CSF proteome with each organism compared to sterile injury, several proteins were common across all bacterial species, especially at day 5 post-infection, which are candidate diagnostic biomarkers

Comprehensive Molecular Characterization of Pheochromocytoma and Paraganglioma

SummaryWe report a comprehensive molecular characterization of pheochromocytomas and paragangliomas (PCCs/PGLs), a rare tumor type. Multi-platform integration revealed that PCCs/PGLs are driven by diverse alterations affecting multiple genes and pathways. Pathogenic germline mutations occurred in eight PCC/PGL susceptibility genes. We identified CSDE1 as a somatically mutated driver gene, complementing four known drivers (HRAS, RET, EPAS1, and NF1). We also discovered fusion genes in PCCs/PGLs, involving MAML3, BRAF, NGFR, and NF1. Integrated analysis classified PCCs/PGLs into four molecularly defined groups: a kinase signaling subtype, a pseudohypoxia subtype, a Wnt-altered subtype, driven by MAML3 and CSDE1, and a cortical admixture subtype. Correlates of metastatic PCCs/PGLs included the MAML3 fusion gene. This integrated molecular characterization provides a comprehensive foundation for developing PCC/PGL precision medicine

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant