A Framework For Principals: Promoting Student Success Through Leadership And Collaboration

What’s a principal to do?  How can a principal stay on top of the demands of the job and be successful?  How can the principal construct strategies that will invite solidarity, cooperation, and shared decision-making, and yet, at the same time, focus on student achievement?  This article provides a framework in which key concepts are addressed, all geared to reckon with the demands of the principal as instructional leader. To meet these challenges, educational leaders need to address a clear vision for change, an engaging learning environment, a collegial commitment for improvement, the importance of multicultural education, and the inclusion of technology

Post‐intestine transplant graft‐versus‐host disease: Associated with inclusion of a liver graft and with a high mortality risk

Introduction This study reports the incidence, anatomic location, and outcomes of graft‐versus‐host disease (GVHD) at a single active intestine transplant center. Methods Records were reviewed for all patients receiving an intestine transplant from 2003 to 2015. Pathology reports and pharmacy records were reviewed to establish the diagnosis, location, and therapeutic interventions for GVHD. Results A total of 236 intestine transplants were performed during the study period, with 37 patients (16%) developing GVHD. The median time to onset of disease was 83 days, with 89% of affected patients diagnosed in the first year post‐transplant. Mortality for affected patients was 54% in the one‐year after GVHD diagnosis. Skin lesions were the most common manifestation of GVHD. Other sites of disease included lungs, bone marrow, oral mucosa, large intestine, and brain. The incidence of GVHD was 16% in adult patients, and slightly lower in pediatric recipients (13%). In adults, increasing graft volume (isolated versus multi‐organ) and liver inclusion were associated with increasing risk of GVHD, though this was not seen in pediatric patients. Conclusion Overall, 16% of intestine transplant recipients developed GVHD. GVHD is associated with high mortality, and disease in the lungs, brain, and bone marrow was universally fatal

How Do NYPD Officers Respond to Terror Threats?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155976/1/ecca12328.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155976/2/ecca12328_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155976/3/ecca12328-sup-0001-Appendix.pd

Steroid Free Three Drug Maintenance Regimen for Pancreas Transplant Alone: Comparison of Induction with Rabbit Antithymocyte Globulin +/- Rituximab

Graft survival following pancreas transplant alone (PTA) is inferior to other pancreas transplants. Steroid elimination is appealing, but a two drug maintenance strategy may be inadequate. Additionally, recipients tend to have diabetic nephropathy and do not tolerate nephrotoxic medications. A three‐drug maintenance strategy permits immunosuppression through different mechanisms as well as an opportunity to use lower doses of the individual medications. Induction consisted of five doses of rabbit antithymocyte globulin (1 mg/kg/dose). As of October 2007, a single dose of rituximab (150 mg/m2) was added. Maintenance consisted of tacrolimus, sirolimus and mycophenolate mofetil. From 2004 to 2017, 166 PTA were performed. Graft loss at 7‐ and 90‐ days were 4% and 5%, and one year patient and graft survival were 97% and 91%. Comparing induction without and with rituximab, there was no significant difference in 7 or 90 day graft loss, 1 year patient or graft survival or in the rate of rejection or infection. Rabbit antithymocyte globulin induction and steroid withdrawal followed by a three drug immunosuppression regimen is an excellent strategy for PTA recipients

Substance abuse and psychiatric co-morbidity as predictors of premature mortality in Swedish drug abusers a prospective longitudinal study 1970 - 2006

<p>Abstract</p> <p>Background</p> <p>Few longitudinal cohort studies have focused on the impact of substances abused and psychiatric disorders on premature mortality. The aim of the present study was to identify predictors of increased risk of drug related death and non drug related death in substance abusers of opiates, stimulants, cannabis, sedatives/hypnotics, hallucinogens and alcohol over several decades.</p> <p>Methods</p> <p>Follow-up study of a consecutive cohort of 561 substance abusers, admitted to a detoxification unit January 1970 to February 1978 in southern Sweden, and followed up in 2006. Demographic and clinical data, substance diagnoses and three groups of psychiatric diagnoses were identified at first admission. Causes of death were coded according to ICD-10 and classified as drug related deaths or non drug related deaths. To identify the incidence of some probable risk factors of drug related premature death, the data were subjected to a competing risks Cox regression analysis.</p> <p>Results</p> <p>Of 561 patients in the cohort, 11 individuals had either emigrated or could not be located, and 204/561 patients (36.4%) were deceased by 2006. The cumulative risk of drug related death increased more in the first 15 years and leveled out later on when non drug related causes of death had a similar incidence. In the final model, male gender, regular use of opiates or barbiturates at first admission, and neurosis were associated with an increased risk of drug related premature death, while cannabis use and psychosis were associated with a decreased risk. Neurosis, mainly depression and/or anxiety disorders, predicted drug related premature death while chronic psychosis and personality disorders did not. Chronic alcohol addiction was associated with increased risk of non drug related death.</p> <p>Conclusions</p> <p>The cohort of drug abusers had an increased risk of premature death to the age of 69. Drug related premature death was predicted by male gender, the use of opiates or barbiturates and depression and anxiety disorders at first admission. The predicted cumulative incidence of drug related death was significantly higher in opiate and barbiturate abusers over the observed period of 37 years, while stimulant abuse did not have any impact. Alcohol contributed to non drug related death.</p

Impact of a nitrogen emission control area (NECA) on the future air quality and nitrogen deposition to seawater in the Baltic Sea region

Air pollution due to shipping is a serious concern for coastal regions in Europe. Shipping emissions of nitrogen oxides (NOx) in air over the Baltic Sea are of similar magnitude (330&thinsp;kt yr−1) as the combined land-based NOx emissions from Finland and Sweden in all emission sectors. Deposition of nitrogen compounds originating from shipping activities contribute to eutrophication of the Baltic Sea and coastal areas in the Baltic Sea region. For the North Sea and the Baltic Sea a nitrogen emission control area (NECA) will become effective in 2021; in accordance with the International Maritime Organization (IMO) target of reducing NOx emissions from ships. Future scenarios for 2040 were designed to study the effect of enforced and planned regulation of ship emissions and the fuel efficiency development on air quality and nitrogen deposition. The Community Multiscale Air Quality (CMAQ) model was used to simulate the current and future air quality situation. The meteorological fields, the emissions from ship traffic and the emissions from land-based sources were considered at a grid resolution of 4×4&thinsp;km2 for the Baltic Sea region in nested CMAQ simulations. Model simulations for the present-day (2012) air quality show that shipping emissions are the major contributor to atmospheric nitrogen dioxide (NO2) concentrations over the Baltic Sea. In the business-as-usual (BAU) scenario, with the introduction of the NECA, NOx emissions from ship traffic in the Baltic Sea are reduced by about 80&thinsp;% in 2040. An approximate linear relationship was found between ship emissions of NOx and the simulated levels of annual average NO2 over the Baltic Sea in the year 2040, when following different future shipping scenarios. The burden of fine particulate matter (PM2.5) over the Baltic Sea region is predicted to decrease by 35&thinsp;%–37&thinsp;% between 2012 and 2040. The reduction in PM2.5 is larger over sea, where it drops by 50&thinsp;%–60&thinsp;% along the main shipping routes, and is smaller over the coastal areas. The introduction of NECA is critical for reducing ship emissions of NOx to levels that are low enough to sustainably dampen ozone (O3) production in the Baltic Sea region. A second important effect of the NECA over the Baltic Sea region is the reduction in secondary formation of particulate nitrate. This lowers the ship-related PM2.5 by 72&thinsp;% in 2040 compared to the present day, while it is reduced by only 48&thinsp;% without implementation of the NECA. The effect of a lower fuel efficiency development on the absolute ship contribution of air pollutants is limited. Still, the annual mean ship contributions in 2040 to NO2, sulfur dioxide and PM2.5 and daily maximum O3 are significantly higher if a slower fuel efficiency development is assumed. Nitrogen deposition to the seawater of the Baltic Sea decreases on average by 40&thinsp;%–44&thinsp;% between 2012 and 2040 in the simulations. The effect of the NECA on nitrogen deposition is most significant in the western part of the Baltic Sea. It will be important to closely monitor compliance of individual ships with the enforced and planned emission regulations.</p

Radiographers' involvement in research activities and opinions on radiography research: A Nordic survey

Introduction: Radiographers' engagement in research is important for the development of evidence-based practice in radiography; however, radiographers' interest in research has rarely been reported. This study sought to ascertain radiographers' opinions about radiography research and investigate their involvement in research activities in four Nordic countries.Methods: This study was conducted in Denmark, Finland, Norway and Sweden. A study-specific questionnaire was developed in English and adapted to each language of the study sample, and the content and face validity of the adaptations were evaluated. An online tool was used to collect the study data. The questionnaire link was distributed in September 2019 to radiographers working in clinical settings in four Nordic countries (n = 4572).Results: The overall response rate was 14% (n = 662/4572). Research involvement was reported by 33% of the respondents; data collection was the main type of contribution. Radiographers who contributed to research were more likely to be male, have longer work experience, hold a master's or doctoral degree, work as managers and be employed in university hospitals. Nearly all agreed that radiography research is needed to promote the radiography profession and provide the evidence base for radiographic practice. However, only 14% were aware of the current research evidence regarding their professional field of specialisation, and 19% indicated that they developed current practices based on research evidence.Conclusion: The findings indicate that, although radiographers had positive attitudes towards radiography research, their involvement in research and utilisation of research evidence in practice is low.</p

Is Fairtrade in commercial farms justifiable?: its impact on commercial and small-scale producers in South Africa

Fairtrade initially was limited to improving the lives of small-scale and peasant farmers, but later on it embraced commercial farmers, which attracted criticism. While there are a number of justifications for the Fairtrade organization's decision, there are authors who feel that meaningful “fair trade” cannot be achieved with the inclusion of commercial farms. This paper investigates the impact of Fairtrade on commercial farms and small-scale farmer cooperatives in South Africa. Fairtrade on South African commercial farms embraces a number of policy concerns related to land reform, BEE and sustainable development. The results of the study show that when commercial farms are included in the Fairtrade model, communities in which these farmers live benefit from developmental projects. In addition, in some instances, farm workers gain shares in the commercial farms, and benefit from the farm owners’ knowledge and capital

Shared socio-economic pathways extended for the Baltic Sea: exploring long-term environmental problems

Long-term scenario analyses can be powerful tools to explore plausible futures of human development under changing environmental, social, and economic conditions and to evaluate implications of different approaches to reduce pollution and resource overuse. Vulnerable ecosystems like the Baltic Sea in North-Eastern Europe tend to be under pressure from multiple, interacting anthropogenic drivers both related to the local scale (e.g. land use change) and the global scale (e.g. climate change). There is currently a lack of scenarios supporting policy-making that systematically explore how global and regional developments could concurrently impact the Baltic Sea region. Here, we present five narratives for future development in the Baltic Sea region, consistent with the global Shared Socioeconomic Pathways (SSPs) developed for climate research. We focus on agriculture, wastewater treatment, fisheries, shipping, and atmospheric deposition, which all represent major pressures on the Baltic Sea. While we find strong links between the global pathways and regional pressures, we also conclude that each pathway may very well be the host of different sectoral developments, which in turn may have different impacts on the ecosystem state. The extended SSP narratives for the Baltic Sea region are intended as a description of sectoral developments at regional scale that enable detailed scenario analysis and discussions across different sectors and disciplines, but within a common context. In addition, the extended SSPs can readily be combined with climate pathways for integrated scenario analysis of regional environmental problems.Peer reviewe