Teachers\u27 Perceptions of Their Preparation to Choose and Implement Effective Methods for Teaching Emergent Readers.

Reading is not an easily learned skill for most students. I chose to look at the methodology being used by teachers in East Tennessee to instruct emerging readers. Through my review of literature, I researched reading approaches implemented in American classrooms in the last 150 years. I compared and contrasted data to determine current researchers\u27 findings concerning the most effective techniques for teaching reading and how teachers have implemented this knowledge base into their teaching strategies. Teachers cannot teach what they do not know. Therefore, I also researched literature addressing the growing concern among educators with teachers\u27 preparation and professional development opportunities as well as the amount of specific preparation teachers received regarding the reading methods they are using. After compiling the data from my interviews with 30 East Tennessee first-grade teachers, I found that most said they did not feel adequately prepared to teach emergent readers. These teachers reported they had not had instruction that provided foundations in a wide range of research-based approaches to reading. The professional development offerings for teachers already in the classroom were often sporadic and did not compensate for their lack of preparation in college. There is a need for colleges and universities to re-evaluate the current teacher preparation programs. School systems should strive to provide quality inservice opportunities for instructors of emergent readers as well as hiring reading coaches or specialists to assist the reading instructors

Postnatal parental smoking: an important risk factor for SIDS

Background: Sudden infant death syndrome (SIDS) is the unexpected death of an infant that remains unexplained after a thorough investigation of the circumstances, family history, paediatric investigation and complete autopsy. In Western society, it is the leading cause of post-neonatal death below 1 year of age. In the Netherlands, the SIDS incidence is very low, which offers opportunities to assess the importance of old and new environmental risk factors. For this purpose, cases were collected through pathology departments and the working group on SIDS of the Dutch Paediatrician Foundation. A total of 142 cases were included; these occurred after the parental education on sleeping position (1987), restricted to the international age criteria and had no histological explanation. Age-matched healthy controls (N∈=∈2,841) came from a survey of the Netherlands Paediatric Surveillance Unit, completed between November 2002 and April 2003. A multivariate analysis was performed to determine the risk factors for SIDS, including sleeping position, antenatal maternal smoking, postnatal parental smoking, premature birth, gender, lack of breastfeeding and socio-economic status. Postnatal smoking was identified as an important environmental risk factor for SIDS (OR one parent∈=∈2.5 [1.2, 5.0]; both parents∈=∈5.77 [2.2, 15.5]; maternal∈=∈2.7 [1.0, 6.4]; paternal∈=∈2.4 [1.3, 4.5] ) as was prone sleeping (OR put prone to sleep∈=∈21.5 [10.6, 43.5]; turned prone during sleep∈=∈100 [46, 219]). Premature birth was also significantly associated with SIDS (OR∈=∈2.4 [1.2, 4.8]). Conclusion: Postnatal parental smoking is currently a major environmental risk factor for SIDS in the Netherlands together with the long-established risk of prone sleeping

Measurement of detector-corrected observables sensitive to the anomalous production of events with jets and large missing transverse momentum in pp collisions at √s=13 TeV using the ATLAS detector

Observables sensitive to the anomalous production of events containing hadronic jets and missing momentum in the plane transverse to the proton beams at the Large Hadron Collider are presented. The observables are defined as a ratio of cross sections, for events containing jets and large missing transverse momentum to events containing jets and a pair of charged leptons from the decay of a Z/γ ∗ boson. This definition minimises experimental and theoretical systematic uncertainties in the measurements. This ratio is measured differentially with respect to a number of kinematic properties of the hadronic system in two phase-space regions; one inclusive single-jet region and one region sensitive to vectorboson- fusion topologies. The data are found to be in agreement with the Standard Model predictions and used to constrain a variety of theoretical models for dark-matter production, including simplified models, effective field theory models, and invisible decays of the Higgs boson. The measurements use 3.2 fb−1 of proton–proton collision data recorded by the ATLAS experiment at a centre-of-mass energy of 13TeV and are fully corrected for detector effects, meaning that the data can be used to constrain new-physics models beyond those shown in this paper

Significant benefits of AIP testing and clinical screening in familial isolated and young-onset pituitary tumors

Context Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene are responsible for a subset of familial isolated pituitary adenoma (FIPA) cases and sporadic pituitary neuroendocrine tumors (PitNETs). Objective To compare prospectively diagnosed AIP mutation-positive (AIPmut) PitNET patients with clinically presenting patients and to compare the clinical characteristics of AIPmut and AIPneg PitNET patients. Design 12-year prospective, observational study. Participants & Setting We studied probands and family members of FIPA kindreds and sporadic patients with disease onset ≤18 years or macroadenomas with onset ≤30 years (n = 1477). This was a collaborative study conducted at referral centers for pituitary diseases. Interventions & Outcome AIP testing and clinical screening for pituitary disease. Comparison of characteristics of prospectively diagnosed (n = 22) vs clinically presenting AIPmut PitNET patients (n = 145), and AIPmut (n = 167) vs AIPneg PitNET patients (n = 1310). Results Prospectively diagnosed AIPmut PitNET patients had smaller lesions with less suprasellar extension or cavernous sinus invasion and required fewer treatments with fewer operations and no radiotherapy compared with clinically presenting cases; there were fewer cases with active disease and hypopituitarism at last follow-up. When comparing AIPmut and AIPneg cases, AIPmut patients were more often males, younger, more often had GH excess, pituitary apoplexy, suprasellar extension, and more patients required multimodal therapy, including radiotherapy. AIPmut patients (n = 136) with GH excess were taller than AIPneg counterparts (n = 650). Conclusions Prospectively diagnosed AIPmut patients show better outcomes than clinically presenting cases, demonstrating the benefits of genetic and clinical screening. AIP-related pituitary disease has a wide spectrum ranging from aggressively growing lesions to stable or indolent disease course

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial

Background High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains unclear. We investigated whether transdermal glyceryl trinitrate (GTN; also known as nitroglycerin), a nitric oxide donor, might improve outcome when administered very early after stroke onset. Methods We did a multicentre, paramedic-delivered, ambulance-based, prospective, randomised, sham-controlled, blinded-endpoint, phase 3 trial in adults with presumed stroke within 4 h of onset, face-arm-speech-time score of 2 or 3, and systolic blood pressure 120 mm Hg or higher. Participants were randomly assigned (1:1) to receive transdermal GTN (5 mg once daily for 4 days; the GTN group) or a similar sham dressing (the sham group) in UK based ambulances by paramedics, with treatment continued in hospital. Paramedics were unmasked to treatment, whereas participants were masked. The primary outcome was the 7-level modified Rankin Scale (mRS; a measure of functional outcome) at 90 days, assessed by central telephone follow-up with masking to treatment. Analysis was hierarchical, first in participants with a confirmed stroke or transient ischaemic attack (cohort 1), and then in all participants who were randomly assigned (intention to treat, cohort 2) according to the statistical analysis plan. This trial is registered with ISRCTN, number ISRCTN26986053. Findings Between Oct 22, 2015, and May 23, 2018, 516 paramedics from eight UK ambulance services recruited 1149 participants (n=568 in the GTN group, n=581 in the sham group). The median time to randomisation was 71 min (IQR 45–116). 597 (52%) patients had ischaemic stroke, 145 (13%) had intracerebral haemorrhage, 109 (9%) had transient ischaemic attack, and 297 (26%) had a non-stroke mimic at the final diagnosis of the index event. In the GTN group, participants’ systolic blood pressure was lowered by 5·8 mm Hg compared with the sham group (p<0·0001), and diastolic blood pressure was lowered by 2·6 mm Hg (p=0·0026) at hospital admission. We found no difference in mRS between the groups in participants with a final diagnosis of stroke or transient ischaemic stroke (cohort 1): 3 (IQR 2–5; n=420) in the GTN group versus 3 (2–5; n=408) in the sham group, adjusted common odds ratio for poor outcome 1·25 (95% CI 0·97–1·60; p=0·083); we also found no difference in mRS between all patients (cohort 2: 3 [2–5]; n=544, in the GTN group vs 3 [2–5]; n=558, in the sham group; 1·04 [0·84–1·29]; p=0·69). We found no difference in secondary outcomes, death (treatment-related deaths: 36 in the GTN group vs 23 in the sham group [p=0·091]), or serious adverse events (188 in the GTN group vs 170 in the sham group [p=0·16]) between treatment groups. Interpretation Prehospital treatment with transdermal GTN does not seem to improve functional outcome in patients with presumed stroke. It is feasible for UK paramedics to obtain consent and treat patients with stroke in the ultraacute prehospital setting. Funding British Heart Foundation

Increased Dietary Protein to Energy Ratio in Pre-Weaning Lambs Increases Average Daily Gain and Cortical Bone Thickness in the Tibia

The objective of this study was to examine if diets differing in crude protein (CP) to metabolizable energy (ME) ratio (CP:ME) pre-weaning altered peripheral quantitative computed tomography (pQCT) measures of bone mass and strength in lambs. The left hind leg of lambs were available at the completion of a trial designed to examine the effect that altering the CP:ME ratio in milk replacer had on growth and body composition of pre-weaned lambs reared artificially. Treatments consisted of either normal commercial milk replacer (CMR, n = 10) containing 240 g/kg CP and 21.89 MJ/kg ME, high protein milk replacer (HPM, n = 9) containing CMR with additional milk protein concentrate to reach 478.7 g/kg CP and 19.15 MJ/kg ME or a mix of normal milk replacer and milk protein concentrate adjusted twice-weekly to match optimal CP:ME requirements (MB, n = 8) based on maintenance plus 300 g/d liveweight gain. At 22 kg live weight, lambs were euthanized and the tibia including the surrounding muscle was collected and scanned using pQCT at the mid-diaphysis. Lambs on the HPM and MB diets had a greater average daily gain (p &lt; 0.01). There were limited differences in bone morphology and muscle mass, though notably the higher protein diets (MB and HPM) were associated with greater cortical thickness (p &lt; 0.05) and, therefore, potentially greater peak bone mass at maturity This finding demonstrates that pre-weaning diets, and the protein content in particular, may influence the developmental potential of long bones and attainment of peak bone mass at maturity