Improving Quality and Achieving Equity: A Guide for Hospital Leaders

Outlines the need to address racial/ethnic disparities in health care, highlights model practices, and makes step-by-step recommendations on creating a committee, collecting data, setting quality measures, evaluating, and implementing new strategies

Teachers' classroom feedback: still trying to get it right

This article examines feedback traditionally given by teachers in schools. Such feedback tends to focus on children's acquisition and retrieval of externally prescribed knowledge which is then assessed against mandated tests. It suggests that, from a sociocultural learning perspective, feedback directed towards such objectives may limit children's social development. In this article, I draw on observation and interview data gathered from a group of 27 9- to 10-year olds in a UK primary school. These data illustrate the children's perceived need to conform to, rather than negotiate, the teacher's feedback comments. They highlight the children's sense that the teacher's feedback relates to school learning but not to their own interests. The article also includes alternative examples of feedback which draw on children's own inquiries and which relate to the social contexts within which, and for whom, they act. It concludes by suggesting that instead of looking for the right answer to the question of what makes teachers' feedback effective in our current classrooms, a more productive question might be how a negotiation can be opened up among teachers and learners themselves, about how teachers' feedback could support children's learning most appropriately

Bridging the Digital Divide in Health Care: The Role of Health Information Technology in Addressing Racial and Ethnic Disparities

Racial and ethnic disparities in health care have been consistently documented in the diagnosis, treatment, and outcomes of many common clinical conditions. There has been an acceleration of health information technology (HIT) implementation in the United States, with health care reform legislation including multiple provisions for collecting and using health information to improve and monitor quality and efficiency in health care. Despite an uneven and generally low level of implementation, research has demonstrated that HIT has the potential to improve quality of care and patient safety. If carefully designed and implemented, HIT also has the potential to eliminate disparities. Several root causes for disparities are amenable to interventions using HIT, particularly innovations in electronic health records, as well as strategies for chronic disease management. Recommendations regarding health care system, provider, and patient factors can help health care organizations address disparities as they adopt, expand, and tailor their HIT systems. In terms of health care system factors, organizations should (1) automate and standardize the collection of race/ethnicity and language data, (2) prioritize the use of the data for identifying disparities and tailoring improvement efforts, (3) focus HIT efforts to address fragmented care delivery for racial/ethnic minorities and limited-English-proficiency patients, (4) develop focused computerized clinical decision support systems for clinical areas with significant disparities, and (5) include input from racial/ethnic minorities and those with limited English proficiency in developing patient HIT tools to address the digital divide. As investments are made in HIT, consideration must be given to the impact that these innovations have on the quality and cost of health care for all patients, including those who experience disparities

RNA-Sequencing Reveals Direct Targets of Tumor Suppressor miR-203 in Human Mammary Epithelial Cells

Background: Breast cancer is the leading cause of cancer-related mortality in women worldwide. Since a significant portion of cases present with or progress to metastatic disease, furthering our understanding of metastasis is critical to develop better treatments. Epithelial cells maintain contact with the extracellular matrix (ECM) predominantly via integrin engagement, a process required for tissue integrity and barrier function. In non-transformed cells, loss of ECM adhesion promotes a specialized form of programmed cell death, anoikis. In order for efficient metastasis to occur, breast tumor cells must evade anoikis. miR-203, known to be down-regulated in several cancers, was found by our lab to be induced ten-fold 24 hours following detachment in breast epithelial cells, but not invasive triple negative breast cancer (TNBC) cells, suggesting that miR-203 may participate in promoting anoikis. Interestingly, more invasive breast cancer cell lines have been shown to express miR-203 at significantly lower levels than those of less invasive lines. Objectives: Since restoration of miR-203 expression ectopically is not feasible in a clinical setting, we sought to identify and characterize miR-203 target genes in order to provide a pharmaceutical platform for restoration of anoikis sensitivity in metastatic breast cancer. Methods: We performed traditional RNA-sequencing (RNA-Seq) coupled with immunoprecipitation of the RNA-induced silencing complex (RISC; Ago2 RIP-Seq) in MCF-10A, an immortalized, but non-transformed breast epithelial cell line, overexpressing precursor miR-203 or an empty vector control. MDA-MB-231, triple negative ductal carcinoma cells, were used as our invasive comparison cell line. Results: Here we show that miR-203 induction in detached MCF-10A cells is due to loss of integrin signaling. Our coupled RNA-Seq and Ago2 RIP-Seq approach revealed 72 potential candidates, 42 of which were predicted miR-203 targets based on the TargetScan algorithm. We subjected the candidates to stringent characterization and found 9 bona-fide miR-203 targets that promote cell death when inhibited. Among these, WDR69, PRKAB1, PRPS2, and HBEGF were significantly elevated in TNBC tumor samples, as determined by RNA-Seq analysis in The Cancer Genome Atlas (TCGA). Conclusion: Understanding the mechanisms by which cells evade anoikis during tumor dissemination is crucial to developing more effective therapies in breast cancer. miR-203, which is expressed at very low levels in more invasive breast cancers, is a positive regulator of anoikis that is upregulated in response to loss of contact with the ECM. Our combined RNA-sequencing screen revealed 42 direct miR-203 targets. Inhibition of 9 bona-fide targets promoted cell death, suggesting that they are negative regulators of anoikis. WDR69, PRKAB1, PRPS2, and HBEGF were all significantly elevated in TNBC tumor samples relative to less invasive samples, likely a consequence of low miR-203 expression. The identified genes represent potential pharmaceutical targets for novel breast cancer therapies

The lesbian, gay, bisexual and transgender community online: discussions of bullying and self-disclosure in YouTube videos

Computer-mediated communication has become a popular platform for identity construction and experimentation as well as social interaction for those who identify as lesbian, gay, bisexual or transgender (LGBT). The creation of user-generated videos has allowed content creators to share experiences on LGBT topics. With bullying becoming more common amongst LGBT youth, it is important to obtain a greater understanding of this phenomenon. In our study, we report on the analysis of 151 YouTube videos which were identified as having LGBT- and bullying-related content. The analysis reveals how content creators openly disclose personal information about themselves and their experiences in a non-anonymous rhetoric with an unknown public. These disclosures could indicate a desire to seek friendship, support and provide empathy

Town of Colonial Beach Survey of Central and Castlewood Beaches

The Town of Colonial Beach occupies a peninsula between the Potomac River and Monroe Bay. Approximately 2.5 miles of the shoreline is publicly-owned. Two areas on the Potomac River have been enhanced as recreational beaches for swimming and sunbathing. Central Beach is located just south of the Town Pier and is the main recreational beach. Castlewood Beach is south of Central Beach near the entrance to Monroe Bay

Stabilization of Extra Dimensions at Tree Level

By considering the effects of string winding and momentum modes on a time dependent background, we find a method by which six compact dimensions become stabilized naturally at the self-dual radius while three dimensions grow large.Comment: 15 pages, 2 figures, minor typos correcte

Lithium in strong magnetic fields

The electronic structure of the lithium atom in a strong magnetic field 0 <= gamma <= 10 is investigated. Our computational approach is a full configuration interaction method based on a set of anisotropic Gaussian orbitals that is nonlinearly optimized for each field strength. Accurate results for the total energies and one-electron ionization energies for the ground and several excited states for each of the symmetries ^20^+, ^2(-1)^+, ^4(-1)^+, ^4(-1)^-, ^2(-2)^+, ^4(-2)^+, $^4(-3)^{+}$ are presented. The behaviour of these energies as a function of the field strength is discussed and classified. Transition wave lengths for linear and circular polarized transitions are presented as well.Comment: 12 pages, 13 figures, accepted for publication in Phys. Rev.

The effects of graded levels of calorie restriction : IV. Non-linear change in behavioural phenotype of mice in response to short-term calorie restriction

We would like to acknowledge the BSU staff for their invaluable help with caring for the animals. The work was supported by the UK Biotechnology and Biological Sciences Research Council BBSRC (BB/G009953/1 and BB/J020028/1).Peer reviewedPublisher PD