School Counselors\u27 Perceptions about lnterventions for At-Risk Students Including Grade Retention: Implications for School Leaders

The term at-risk is used by educators and policymakers to describe a wide variety of students who struggle in schools (Kronholz, 2011). Factors associated with labeling students at-risk include minority status, poverty, language difficulties, low school attendance, and poor family support (Re~ Akpo-Sanni, Losike-Sedimo, 2012; Stockard, 2010). For many at-risk students, reading at a proficient level is a primary concern for school leaders and teachers (Allington, 2011; McAlenney & Coyne, 2011), especially with increased accountability including school sanctions for not closing reading achievement gaps (Chappell, Nunnery, Pribesh, & Hager, 2011). Although a plethora of interventions have been proposed to assist at-risk students, requiring students to repeat a grade continues to be used as a threat for students who are not proficient, despite evidence that suggests grade retention is detrimental to students on various outcomes (Battistin & Schizzerotto, 2012; Webley, 2012)

Lessons from Triadic Supervisors: Maximizing Effectiveness

Through this hermeneutic-phenomenological qualitative study, 10 supervisors of a CACREP accredited program identified emergent themes and challenges of triadic supervision: relationship dynamics, feedback, time management, contextual learning, and matching of supervisees. The researchers offer specific methods to approach these challenges within triadic supervision to maximize effectiveness

Lessons from Triadic Supervisors: Maximizing Effectiveness

Through this hermeneutic-phenomenological qualitative study, 10 supervisors of a CACREP accredited program identified emergent themes and challenges of triadic supervision: relationship dynamics, feedback, time management, contextual learning, and matching of supervisees. The researchers offer specific methods to approach these challenges within triadic supervision to maximize effectiveness

Supervision Experiences of Rural School Counselors

This qualitative study explored the needs of professional school counselors and school counselor interns located in rural areas with regard to clinical supervision, consultation, and professional growth. Four separate focus groups (n=21) were conducted. To allow for consistency across focus groups, a series of six structured interview questions were used. Results of the data analysis revealed six themes which included unique issues of rural school counselors, dynamics of rural living, supervision from school administrators, supporting development through technology, desire for increased connection through supervision, and the identification of roles and responsibilities. Implications of this study indicate a crucial need to increase supervision training opportunities for current school counselors and interns. Technology and active participation with professional organizations may provide a platform for rural school counselors to receive supervision training and offer increased professional connection to solidify their counseling identity

Validation of Nuclear Material Control and Accountability (MC&A) System Effectiveness Tool (MSEF) at Idaho National Laboratory (INL)

A Nuclear Material Control and Accountability (MC&A) Functional Model has been developed to describe MC&A systems at facilities possessing Category I or II Special Nuclear Material (SNM). Emphasis is on achieving the objectives of 144 “Fundamental Elements” in key areas ranging from categorization of nuclear material to establishment of Material Balance Areas (MBAs), controlling access, performing quality measurements of inventories and transfers, timely reporting all activities, and detecting and investigating anomalies. An MC&A System Effectiveness Tool (MSET), including probabilistic risk assessment (PRA) technology for evaluating MC&A effectiveness and relative risk, has been developed to accompany the Functional Model. The functional model and MSET were introduced at the 48th annual International Nuclear Material Management (INMM) annual meeting in July, 20071,2. A survey/questionnaire is used to accumulate comprehensive data regarding the MC&A elements at a facility. Data is converted from the questionnaire to numerical values using the DELPHI method and exercises are conducted to evaluate the overall effectiveness of an MC&A system. In 2007 a peer review was conducted and a questionnaire was completed for a hypothetical facility and exercises were conducted. In the first quarter of 2008, a questionnaire was completed at Idaho National Laboratory (INL) and MSET exercises were conducted. The experience gained from conducting the MSET exercises at INL helped evaluate the completeness and consistency of the MC&A Functional Model, descriptions of fundamental elements of the MC&A Functional Model, relationship between the MC&A Functional Model and the MC&A PRA tool and usefulness of the MSET questionnaire data collection process

Exploring the patient experience of remote hypertension management in Scotland during COVID-19: a qualitative study

ObjectivesThe aim of this study was to understand how patients experienced hypertension management, with or without BP telemonitoring, during the COVID-19 pandemic. Design, Methods, participants, and settingThis qualitative study conducted between April and November 2022 consisted of 43 semi-structured telephone interviews (23 men and 20 women) from six primary care practices in one area of Scotland. Results From the views of 25 participants with experience of using the Connect Me telemonitoring service and 18 participants without such experience, five themes were developed. These were: (1) Navigating access to services. There were challenges to gaining timely and/or in-person access to services and a reluctance to attend clinical settings because participants were aware of their increased risk of contracting the COVID-19 virus. (2) Adapting NHS services. All six practices had adapted care provision in response to potential COVID-19 transmission, however, these adaptations disrupted routine management of in-person primary care hypertension, diabetes and/or asthma checks. (3) Telemonitoring feedback. Telemonitoring reduced the need to attend in-person primary care practices and supported access to remote healthcare monitoring and feedback. (4) Self-management. Many non-telemonitoring participants were motivated to use self-management strategies to track their blood pressure using home monitoring equipment. Also, participants were empowered to self-manage lifestyle and hypertension medication. (5) Experience of having COVID-19. Some participants contracting the COVID-19 virus experienced an immediate increase in their BP whilst a few experienced ongoing increased BP readings. ConclusionsThe COVID-19 pandemic disrupted routine in-person care for hypertension patients. Both telemonitoring and some non-telemonitoring patients were motivated to self-manage hypertension, including self-adjusting medication, however only those with access to telemonitoring had increased access to hypertension monitoring and feedback. Blood pressure telemonitoring permitted routine care to continue for participants in this study and may offer a service useful in pandemic proofing hypertension healthcare in the future

A Phase I and Pharmacologic Study of Weekly Gemcitabine in Combination with Infusional 5-fluorodeoxyuridine and Oral Calcium Leucovorin

Purpose: Since preclinical studies have shown more than additive cytotoxicity and DNA damage with the combination of gemcitabine and 5-fluoro-2′-deoxyuridine (FUDR), we studied this combination in a phase I trial. Methods: Gemcitabine alone was given in cycle 1 as a 24-h, 2-h or 1-h i.v. infusion weekly for 3 of 4 weeks; if tolerated, a 24-h i.v. infusion of FUDR was added with oral leucovorin. The cycle was aborted for grade 3 thrombocytopenia, grade 4 neutropenia, and grade 2 or worse nonhematologic toxicity. Results: During cycle 1, six of eight patients who received 150 or 100 mg/m2 over 24 h had dose-limiting neutropenia, thrombocytopenia, fatigue or mucositis. Six of seven patients treated with 1000 mg/m2 over 2 h required a gemcitabine dose reduction for cycle 2 (thrombocytopenia, neutropenia, fatigue). Of 25 assessable patients who received gemcitabine 1000 mg/m2 over 1 h, 7 did not complete cycle 1 due to thrombocytopenia (n = 6) or diarrhea (n = 1). Of 42 patients entered, 27 received at least one course of gemcitabine/FUDR (5-19.5 mg/m2 over 24 h) without appreciable toxicity. Due to a shortage of FUDR, the protocol was closed early. Gemcitabine plasma concentrations averaged 0.061 μM (24 h), 16.3 μM (2 h), and 31.9 μM (1 h). In 21 paired bone marrow mononuclear cell samples obtained before treatment and during FUDR infusion, thymidylate synthase ternary complex was only seen during FUDR infusion. Conclusions: Gemcitabine 100-150 mg/m2 over 24 h was poorly tolerated, whereas toxicity was acceptable with 800-1000 mg/m2 over 1 h. Inhibition of the target enzyme was demonstrated at all FUDR doses