Between Mandates and Molding Minds: The Challenge of Teacher Autonomy Today

In recent years, Texas schools have witnessed a significant decline in teacher autonomy, attributable primarily to three factors: an increased emphasis on standardized testing, the prevalence of top-down leadership and bureaucracy, and the adoption of third-party curricula and commercialized content. These elements have collectively constrained educators\u27 ability to adapt and innovate according to the unique needs of their students. Additionally, this issue has had profound ripple effects on families and communities in several ways. Possible solutions for increasing teacher autonomy will be provided that offer multiple benefits to the education system, teachers, students, and the broader community

Short Interval Occurance of Papillary Thyroid Carcinoma Following Radiotherapy for Hodgkin’s Disease: a Case Report

Introduction: Hodgkin’s disease (HD) is a common pediatric malignancy that is treated with a combination of chemotherapy and radiation. Although cure rates are very high (~90%), secondary malignancies are not uncommon and radiation has been shown to be a risk factor for their development. Secondary malignant neoplasms (SMNs) of the thyroid gland are common solid tumors found in patients treated for HD. Current literature shows that these SMNs generally appear an average of 5-15 years later, even in patients under surveillance.Presentation of Case: We present 16 year old patient with secondary thyroid papillary carcinoma four years after completion of radiotherapy.Conclusion: This case may have implications for the future management and post radiation care of these patients

Framework for Classifying Compliance and Medical Immediacy among Low-Acuity Presentations at an Urban Trauma Center

Background: This research offers two exploratory frameworks for medical regimen compliance and medical immediacy. The first classifies compliance awareness, compliance mitigation, and financial limitation for those patients that exhibit nonadherence with a medical regimen. The second classifies medical immediacy and characterizes avoidable utilization. Methods: Representative sampling of adult patients presenting at an emergency department (62,000/ppy) triaged as low acuity; emergency department physician assessment of noncompliance with medical regimen for those patients with a complaint related to a chronic condition; and emergency department physician assessment of medical immediacy and avoidable utilization. Results: Physicians report 48.3% (95% confidence interval (CI) 43.5% to 53.1%) of patients with at least a single chronic condition are presenting with symptoms or complaint related a chronic condition, and 39.6% (CI 31.7% to 47.4%) of these exhibit noncompliance with the medical regimen associated with that chronic condition. 16.4% (CI 6.6% to 26.1%) of the patients exhibit pseudo compliance, a belief that the medical regimen is in compliance when in fact it is not. If the patient had been in compliance, 85.9% (CI 77.0% to 94.8%) of the presenting conditions may have been mitigated. Noncompliance cases (34.5% (CI 22.0% to 47.1%)) are partly attributable to financial constraints. Further, 19.1% (CI 15.7% to 22.5%) are assessed as requiring no medical intervention and 3.4% (CI 1.8% to 4.9%) require immediate stabilization. Conclusions: A large portion of low-acuity presentations are related to a chronic condition and noncompliance with the associated medical regimen contributes to the need to seek medical services. Interventions addressing literacy and financial constraints may increase compliance and decrease utilization

Impact of Pneumococcal Conjugate Vaccines on Pneumonia Hospitalizations in High- and Low-Income Subpopulations in Brazil.

BackgroundPneumococcal conjugate vaccines (PCVs) are being used worldwide. A key question is whether the impact of PCVs on pneumonia is similar in low- and high-income populations. However, most low-income countries, where the burden of disease is greatest, lack reliable data that can be used to evaluate the impact. Data from middle-income countries that have both low- and high-income subpopulations can provide a proxy measure for the impact of the vaccine in low-income countries.MethodsWe evaluated the impact of PCV10 on hospitalizations for all-cause pneumonia in Brazil, a middle-income country with localities that span a broad range of human development index (HDI) levels. We used complementary time series and spatiotemporal methods (synthetic controls and hierarchical Bayesian spatial regression) to test whether the decline in pneumonia hospitalizations associated with vaccine introduction varied across the socioeconomic spectrum.ResultsWe found that the declines in all-cause pneumonia hospitalizations in children and young and middle-aged adults did not vary substantially across low and high HDI subpopulations. Moreover, the estimated declines seen in infants and young adults were associated with higher levels of uptake of the vaccine at a local level.ConclusionsThese results suggest that PCVs have an important impact on hospitalizations for all-cause pneumonia in both low- and high-income populations

UC-15 Malware Analysis Using Reverse Engineering

The motivation for this project is driven by evaluation of the different tools on the market that allow for breaking down executables or binary files, and understanding what the malware is doing. By reverse-engineering the malware, we can understand its impact and how to protect against it. Our focus is to understand where different tools are stronger than others, as well as understand the evolving landscape of malware and security overall. For this capstone project, we utilized two different tools and many sample malware files. The methods used to debug the malware are detailed in our milestone two report and will be expanded upon in our final presentation. At this point, we\u27ve found the tool WinDbg to be the most versatile for binary and executable debugging. We also evaluated IDA Pro, and understand the many ways in which its graphical display of data and relationships, equips a researcher with the necessary tools and information to walk through an executable. Our focus in milestone 3 is to expand our documentation and guide on malware debugging to the point that it provides a user the full breadth of information and steps needed to start from scratch and end with a broken apart piece of malware. We provided much of this as part of the milestone 2 presentation and report, but we will continue to build on it so it\u27s a useful how-to guide for anyone trying to debug a piece of malicious code.Advisors(s): Dr. Ying Xie [email protected](s): SecurityIT 498

Social and Psychological Factors Associated with Health Care Transition for Young Adults Living with Sickle Cell Disease

Introduction: Due to advances in disease management, mortality rates in children with sickle cell disease (SCD) have decreased. However, mortality rates for young adults (YA) increased, and understanding of social and psychological factors is critical. The aim of this study was to explore factors associated with health care transition experiences for YA with SCD. Method: This was a qualitative descriptive study. A 45-minute semistructured interview was conducted with 13 YA (M = 21.5 years, SD = 1.73). Results: Results suggest that social and psychological factors and self-management experiences influence health care transition. Eight themes emerged: “need for accessible support”; “early assistance with goal setting”; “incongruence among expectations, experiences, and preparation”; “spiritual distress”; “stigma”; “need for collaboration”; “appreciation for caring providers”; and “feeling isolated.” Discussion: Consideration of cultural contexts will guide nurses in supporting health care transition. Designing culturally relevant interventions that address unique needs for YA living with SCD is warranted

Seasonal Migration and Home Ranges of Female Elk in the Black Hills of South Dakota and Wyoming

Understanding the movement and dispersion patterns of elk (Cervus elaphus) on public lands and the underlying factors that affect each will facilitate elk management and help resolve conflicts between management that benefit elk and other uses of land resources. Consequently, there is a need to identify and examine the movement and dispersion patterns of elk in the Black Hills of South Dakota and Wyoming. Our study quantified seasonal movements, determined home ranges of female elk in two areas of the Black Hills, and examined underlying factors associated with each. Elk in the northern area did not demonstrate seasonal migration patterns. Rather, winter ranges in the northern area were contained mostly within the boundaries of the summer range. Elk in the southern area exhibited a north-south migration pattern that coincided with seasonal patterns of snowfall. These elk migrated to winter range in late November and returned to summer range in late April. Home ranges of elk in the southern area were larger (P \u3c 0.01) than home ranges in the northern area. Landscape characteristics with marginally-significant correlations to elk home range area included road density (P = 0.10), and forage:cover ratio (P = 0.08); density of primary and secondary roads and average slope were significantly correlated with elk home range area (P \u3c 0.01). Managers can use this information to develop strategies that meet population goals and reduce conflicts between management for elk and with other resources

MR diffusion changes in the perimeter of the lateral ventricles demonstrate periventricular injury in post-hemorrhagic hydrocephalus of prematurity

OBJECTIVES: Injury to the preterm lateral ventricular perimeter (LVP), which contains the neural stem cells responsible for brain development, may contribute to the neurological sequelae of intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus of prematurity (PHH). This study utilizes diffusion MRI (dMRI) to characterize the microstructural effects of IVH/PHH on the LVP and segmented frontal-occipital horn perimeters (FOHP). STUDY DESIGN: Prospective study of 56 full-term infants, 72 very preterm infants without brain injury (VPT), 17 VPT infants with high-grade IVH without hydrocephalus (HG-IVH), and 13 VPT infants with PHH who underwent dMRI at term equivalent. LVP and FOHP dMRI measures and ventricular size-dMRI correlations were assessed. RESULTS: In the LVP, PHH had consistently lower FA and higher MD and RD than FT and VPT (p\u3c.050). However, while PHH FA was lower, and PHH RD was higher than their respective HG-IVH measures (p\u3c.050), the MD and AD values did not differ. In the FOHP, PHH infants had lower FA and higher RD than FT and VPT (p\u3c.010), and a lower FA than the HG-IVH group (p\u3c.001). While the magnitude of AD in both the LVP and FOHP were consistently less in the PHH group on pairwise comparisons to the other groups, the differences were not significant (p\u3e.050). Ventricular size correlated negatively with FA, and positively with MD and RD (p\u3c.001) in both the LVP and FOHP. In the PHH group, FA was lower in the FOHP than in the LVP, which was contrary to the observed findings in the healthy infants (p\u3c.001). Nevertheless, there were no regional differences in AD, MD, and RD in the PHH group. CONCLUSION: HG-IVH and PHH results in aberrant LVP/FOHP microstructure, with prominent abnormalities among the PHH group, most notably in the FOHP. Larger ventricular size was associated with greater magnitude of abnormality. LVP/FOHP dMRI measures may provide valuable biomarkers for future studies directed at improving the management and neurological outcomes of IVH/PHH