Reading Problems--Prevention Rather Than Cure

As the title suggests, there is concern among many of us that children can experience serious difficulty in learning to read. We expect to see some evidence of confusion and incomplete skill development as our pupils are learning to read. The quandry we face, however, is that some of these children do not grow beyond these stages—they continue to be confused, to not work up to their full potential. Often we have been unable to identify these children from the others in order to provide special instruction early enough to avoid compounding the learning problems that soon arise. In many schools, by the time the parents and teacher realize that the child is having serious difficulty learning to read, often the child has decided that he is stupid or that school is dumb —and we face behavior and motivation problems which compound enormously the task of remediation

Schemata for reading and reading comprehension performance

Bibliography: leaves 51-56Supported by the National Institute of Educatio

Take a Reading Vacation--Go DRP (Directed Reading Plan)

While vacationing may seem a remote thought from directing a reading program, effective implementation through daily lesson planning does require an analogous sequence of activities. Just as thoughtful preparation helps to make the trip successful, thoughtful planning for reading instruction can contribute toward more effective reading skill development with elementary level students

There is another way: The faculty-developed Idaho Comprehensive Literacy Assessment for K-8 pre-service teachers

In this era of external teacher testing with the intent of ensuring the competence of the teaching force, as well as holding students and institutions accountable for results, the Idaho Comprehensive Literacy Assessment (ICLA) stands in sharp contrast. It represents an alternative to external testing of preservice teachers, testing procured from an outside agency unconnected to preservice programs, since it has been developed and is managed by literacy faculty from Idaho’s major institutions of higher learning. This paper provides a brief history of major events in the field of literacy including teacher testing initiatives and policies, which led to the creation of the ICLA. A description of the ICLA assessment and its construction is provided, along with a report of initial performance. Implications and policy consequences of this approach are explored

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment

The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation

ObjectiveTo evaluate the impact of the Quintet Recruitment Intervention (QRI) on recruitment in challenging randomized controlled trials (RCTs) that have applied the intervention. The QRI aims to understand recruitment difficulties, and then implements ‘QRI-actions’ to address these as recruitment proceeds.Study Design and SettingA mixed-methods study, comprising: a) before-and-after comparisons of recruitment rates and numbers of patients approached, and b) qualitative case studies, including documentary analysis and interviews with RCT investigators.ResultsFive UK-based publicly-funded RCTs were included in the evaluation. All recruited to target. RCT2 and RCT5 both received up-front pre-recruitment training before the intervention was applied. RCT2 did not encounter recruitment issues and recruited above target from its outset. Recruitment difficulties, particularly communication issues, were identified and addressed through QRI-actions in RCTs 1, 3, 4 and 5. Randomization rates significantly improved post-QRI-action in RCTs 1,3, and 4. QRI-actions addressed issues with approaching eligible patients in RCTs 3 and 5, which both saw significant increases in patients approached. Trial investigators reported that the QRI had unearthed issues they had been unaware of, and reportedly changed their practices post QRI-action.ConclusionThere is promising evidence to suggest the QRI can support recruitment to difficult RCTs. This needs to be substantiated with future controlled evaluations

Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials

Background Neoadjuvant chemotherapy (NACT) for early breast cancer can make breast-conserving surgery more feasible and might be more likely to eradicate micrometastatic disease than might the same chemotherapy given after surgery. We investigated the long-term benefits and risks of NACT and the influence of tumour characteristics on outcome with a collaborative meta-analysis of individual patient data from relevant randomised trials. Methods We obtained information about prerandomisation tumour characteristics, clinical tumour response, surgery, recurrence, and mortality for 4756 women in ten randomised trials in early breast cancer that began before 2005 and compared NACT with the same chemotherapy given postoperatively. Primary outcomes were tumour response, extent of local therapy, local and distant recurrence, breast cancer death, and overall mortality. Analyses by intention-to-treat used standard regression (for response and frequency of breast-conserving therapy) and log-rank methods (for recurrence and mortality). Findings Patients entered the trials from 1983 to 2002 and median follow-up was 9 years (IQR 5–14), with the last follow-up in 2013. Most chemotherapy was anthracycline based (3838 [81%] of 4756 women). More than two thirds (1349 [69%] of 1947) of women allocated NACT had a complete or partial clinical response. Patients allocated NACT had an increased frequency of breast-conserving therapy (1504 [65%] of 2320 treated with NACT vs 1135 [49%] of 2318 treated with adjuvant chemotherapy). NACT was associated with more frequent local recurrence than was adjuvant chemotherapy: the 15 year local recurrence was 21·4% for NACT versus 15·9% for adjuvant chemotherapy (5·5% increase [95% CI 2·4–8·6]; rate ratio 1·37 [95% CI 1·17–1·61]; p=0·0001). No significant difference between NACT and adjuvant chemotherapy was noted for distant recurrence (15 year risk 38·2% for NACT vs 38·0% for adjuvant chemotherapy; rate ratio 1·02 [95% CI 0·92–1·14]; p=0·66), breast cancer mortality (34·4% vs 33·7%; 1·06 [0·95–1·18]; p=0·31), or death from any cause (40·9% vs 41·2%; 1·04 [0·94–1·15]; p=0·45). Interpretation Tumours downsized by NACT might have higher local recurrence after breast-conserving therapy than might tumours of the same dimensions in women who have not received NACT. Strategies to mitigate the increased local recurrence after breast-conserving therapy in tumours downsized by NACT should be considered—eg, careful tumour localisation, detailed pathological assessment, and appropriate radiotherapy

Teaching Children About Reading

Teaching children to read has been a central focus of our educational system for over 350 years. Despite the variety of subjects treated in school, reading usually has been viewed as the most prominent of "the three R's." Teachers, parents and interested citizens today voice similar concern for reading. Despite efforts to instill in all children the ability to read and the habit of reading, schools are under attack for an apparent decline in student reading achievement. School critics cite poor instruction, cluttered curricula and a loss of teacher professionalism as major factors. School supporters counter with the argument that the range of students who remain in school has increased, causing score averages to decline; however, the average student today is better educated and knows more about his world than his counterpart of fifty years ago. 1 Both groups also note changes in social climate, especially with the family unit, and the advent of television as major contributors to reading problems.published or submitted for publicatio