Referencing and borrowing from other systems: the Hong Kong education reforms

BACKGROUND: This paper analyses the role of, and approach to, policy referencing and borrowing in Hong Kong’s recent reforms that culminated in the creation of its New Academic Structure and the Hong Kong Diploma of Secondary Education. MAIN ARGUMENT: It argues that Hong Kong has gone further than most jurisdictions not just in responding to global influences on education reform, but in taking explicit steps to internationally benchmark its curriculum and assessment, and in involving the global community at multiple levels in the process of education policy planning and implementation. SOURCES OF EVIDENCE AND METHOD: The paper is based on the documentary analysis of policy documents in Hong Kong, and 23 interviews with key stakeholders in the policy network, including policy-makers, practitioners and community leaders. DISCUSSION AND CONCLUSIONS: While policy referencing and borrowing in the Hong Kong context can, in part, be traced to a colonial legacy, the Special Administrative Region of China demonstrates a collaborative approach to education reform involving local and international engagement that may be relevant to other systems. Its approach was informed by a measured use of policy referencing that involved ‘horizon scanning’ of other systems’ policies and practices; international benchmarking; and engaging international expertise to facilitate implementation

Long-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acute lymphoblastic leukemia

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldAnalysis of 2668 children with acute lymphoblastic leukemia (ALL) treated in two successive Nordic clinical trials (Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL-92 and ALL-2000) showed that 75% of all patients are cured by first-line therapy, and 83% are long-term survivors. Improvements in systemic and intrathecal chemotherapy have reduced the use of central nervous system (CNS) irradiation to <10% of the patients and provided a 5-year risk of isolated CNS relapse of 2.6%. Improved risk stratification and chemotherapy have eliminated the previous independent prognostic significance of gender, CNS leukemia and translocation t(1;19)(q23;p13), whereas the post-induction level of minimal residual disease (MRD) has emerged as a new risk grouping feature. Infant leukemia, high leukocyte count, T-lineage immunophenotype, translocation t(4;11)(q21;q23) and hypodiploidy persist to be associated with lower cure rates. To reduce the overall toxicity of the treatment, including the risk of therapy-related second malignant neoplasms, the current NOPHO ALL-2008 protocol does not include CNS irradiation in first remission, the dose of 6-mercaptopurine is reduced for patients with low thiopurine methyltransferase activity, and the protocol restricts the use of hematopoietic stem cell transplantation in first remission to patients without morphological remission after induction therapy or with high levels of MRD after 3 months of therapy

PISA, policymaking and political pantomime: education policy referencing between England and Hong Kong

Since the mid-1980s, a number of East Asian societies have consistently performed well in international tests, and their education systems have emerged as models of ‘best practice’, including Hong Kong, which has been extensively referenced by politicians and their advisers in England. In parallel, local dissatisfaction with the education system in Hong Kong has prompted major education reforms. This mismatch between the perceptions of the Hong Kong education system of the two policy communities is explored using documentary analysis and interviews with policymakers and other key stakeholders. We analyse the ways in which features of Hong Kong’s education system are reconstructed and projected in policymaking in England and argue that the referencing to Hong Kong in England is akin to a form of political theatre, reminiscent of a pantomime, with stereotyped villains, heroes and fairy godmothers, narratives of good conquering evil, and comical set-pieces. We argue that these elements provide the means for both constructing and validating simple causal claims and their associated policy actions

Dic(9;20)(p13;q11) in childhood acute lymphoblastic leukaemia is related to low cellular resistance to asparaginase, cytarabine and corticosteroids.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldDic(9;20)(p13;q11) was first described as a nonrandom chromosome abnormality in B-cell precursor acute lymphoblastic leukaemia (BCP ALL) in the mid 1990s,1, 2 and 71 dic(9;20)-positive cases have since then been reported.3, 4, 5 Approximately 90% of these cases were children or adolescents, with dic(9;20) occurring in about 2% of childhood BCP ALL.6 The recent review by Forestier et al.5 describes that dic(9;20)-leukaemias are of B-cell precursor immunophenotype, never have a high hyperdiploid modal number, show a female predominance, and have a significant age incidence peak at 3 years. Most patients are allocated to non-standard risk treatment arms due to high WBC (median 24 109/l) and a relatively high frequency of CNS disease or other extra-medullary leukaemia (EML) at diagnosis. The prognostic implications of dic(9;20) are to a large extent unknown. A relatively large proportion of the relapses reported in the literature have been extra-medullary, and post-relapse treatment including block therapy has been successful in several patients, as illustrated by a p-EFS of 0.62 and a predicted overall survival of 0.82 at 5 years for the 24 Nordic cases.

Introduction. Approches d'un genre hybride, le film sur l'art

Introduction dressant un bilan tout à la fois historique, théorique et bibliographique sur la question du film sur l'art et ses relations avec l'histoire de l'art

'Choosing shoes': a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients

Background: Footwear has been accepted as a therapeutic intervention for the foot affected by rheumatoid arthritis (RA). Evidence relating to the objective assessment of footwear in patients with RA is limited. The aims of this study were to identify current footwear styles, footwear characteristics, and factors that influence footwear choice experienced by patients with RA. Methods: Eighty patients with RA were recruited from rheumatology clinics during the summer months. Clinical characteristics, global function, and foot impairment and disability measures were recorded. Current footwear, footwear characteristics and the factors associated with choice of footwear were identified. Suitability of footwear was recorded using pre-determined criteria for assessing footwear type, based on a previous study of foot pain. Results: The patients had longstanding RA with moderate-to severe disability and impairment. The foot and ankle assessment demonstrated a low-arch profile with both forefoot and rearfoot structural deformities. Over 50% of shoes worn by patients were opentype footwear. More than 70% of patients’ footwear was defined as being poor. Poor footwear characteristics such as heel rigidity and sole hardness were observed. Patients reported comfort (17%) and fit (14%) as important factors in choosing their own footwear. Only five percent (5%) of patients wore therapeutic footwear. Conclusions: The majority of patients with RA wear footwear that has been previously described as poor. Future work needs to aim to define and justify the specific features of footwear that may be of benefit to foot health for people with RA

On behalf of the Nordic Society of Paediatric Haematology and Oncology (NOPHO)

Myelotoxicity during thiopurine therapy is enhanced in patients, who because of single nucleotide polymorphisms have decreased activity of the enzyme thiopurine methyltransferase (TPMT) and thus more thiopurine converted into 6-thioguanine nucleotides. Of 601 children with acute lymphoblastic leukemia (ALL) who were treated by the NOPHO ALL-92 protocol, 117 had TPMT genotype determined, whereas for 484 patients only erythrocyte TPMT activity was available. The latter were classified as heterozygous, if TPMT activity was o14 IU/ ml, or deficient (o1.0 IU/ml). 526 patients had TPMT wild type, 73 were presumed heterozygous, and two were TPMT deficient. Risk of relapse was higher for the 526 TPMT wild type patients than for the remaining 75 patients (18 vs 7%, P ¼ 0.03). In cox multivariate regression analysis, sex (male worse; P ¼ 0.06), age (higher age worse, P ¼ 0.02), and TPMT activity (wild type worse; P ¼ 0.02) were related to risk of relapse. Despite a lower probability of relapse, patients in the low TPMT activity group did not have superior survival (P ¼ 0.82), possibly because of an excess of secondary cancers among these 75 patients (P ¼ 0.07). These data suggest that children with ALL and TPMT wild type might have their cure rate improved, if the pharmacokinetics/-dynamics of TPMT low-activity patients could be mimicked without a concurrent excessive risk of second cancers

Reply to Bastien et al.

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Multi-modality image simulation with the Virtual Imaging Platform: Illustration on cardiac echography and MRI

International audienceMedical image simulation is useful for biological modeling, image analysis, and designing new imaging devices but it is not widely available due to the complexity of simulators, the scarcity of object models, and the heaviness of the associated computations. This paper presents the Virtual Imaging Platform, an openly-accessible web platform for multi-modality image simulation. The integration of simulators and models is described and exemplified on simulated cardiac MRIs and ultrasonic images

High modal number and triple trisomies are highly correlated favorable factors in childhood B-cell precursor high hyperdiploid acute lymphoblastic leukemia treated according to the NOPHO ALL 1992/2000 protocols.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Between 1992 and 2008, 713 high hyperdiploid acute lymphoblastic leukemias in children aged 1-15 years were diagnosed and treated according to the Nordic Society for Pediatric Hematology and Oncology acute lymphoblastic leukemia 1992/2000 protocols. Twenty (2.8%) harbored t(1;19), t(9;22), der(11q23), or t(12;21). The median age of patients with "classic" high hyperdiploidy was lower than that of patients with translocation-positive high hyperdiploidy (P53/55 (P=0.020/0.024). In multivariate analyses, modal number and triple trisomies were significantly associated with superior event-free survival in separate analyses with age and white blood cell counts. When including both modal numbers and triple trisomies, only low white blood cell counts were significantly associated with superior event-free survival (P=0.009). We conclude that high modal chromosome numbers and triple trisomies are highly correlated prognostic factors and that these two parameters identify the same subgroup of patients characterized by a particularly favorable outcome.Swedish Childhood Cancer Foundation Swedish Cancer Society Swedish Research Counci