Reading instruction in first-grade classrooms: Do basals control teachers?

This study describes first-grade teachers beliefs and practices about reading instruction. Drawing from interview and observational data, 16 teachers from four districts were placed on a continuum from skills-based to literature-based in relationship to their use of the basal. Only 2 teachers were found to rely solely on the basal, while 3 teachers enhanced the basal with literature, and 4 teachers used only literature in their reading instruction. Six teachers enhanced their basal use with additional skills and 1 teacher relied on skills only in her reading instruction. This diversity\u27 of teaching beliefs and practices was corroborated by questionnaire data from a larger sample of teachers. Next, a framework developed by Belenky, Clinchy, Goldberger, and Tarule (1986) was used to categorize teachers\u27 ways of knowing. The findings showed 1 teacher to be a silent knower, 6 were received knowers, 1 was a subjective knower, 7 were procedural knowers, and 1 was a connected knower. Results challenge Shannon\u27s (1987) hypothesis that basals deskill teachers while supporting Sosniak and Stodolskv\u27s (1993) view that teachers are more autonomous in their use of textbook materials

Health of War-Affected Karen Adults 5 Years Post-Resettlement

Background: An estimated 140 000 refugees from Burma have resettled to the USA since 2009, comprising 21% of total resettlement in the USA over the last decade. Our objective was to describe patterns of longitudinal health outcomes in a cohort of Karen refugees resettled in the USA for 5 years, and to translate these findings to a primary healthcare context. Methods: The study was a retrospective cohort study focused on the analysis of the first 5 years of electronic health records of a sample of 143 Karen refugees who were initially resettled between May 2011 and May 2013. Results: Through descriptive, inferential and survival statistics, we described patterns of retention in primary care, biometric trends, condition prevalence and survival probabilities. Highest prevalence health conditions documented at any point in the 5-year period included diagnoses or symptoms associated with pain (52%); gastrointestinal disturbance (41%); metabolic disorder (41%); infectious process (34%); mental health condition (31%) and central nervous system disorder (24%). Conclusions: This study is the first retrospective longitudinal analysis of patterns of health in Karen refugees originating from Burma and resettled to the USA. Findings identified in the 5-year, the post-resettlement period provided important clinical insights into the health trajectories of war-affected populations. Burden of illness was high although results did not demonstrate the extent of trauma-associated physical health conditions reported in the literature. Indicators such as significant increases in body mass index (BMI), the overall prevalence of dyslipidaemia and others suggested that the cohort may be exhibiting an early trajectory towards the development of these conditions. Authors summarize potential protective factors experienced by the cohort that promoted aspects of health frequently challenged in forced migration

Literature-based reading instruction: Problems, possibilities & polemics in the struggle to change

Concerns are being raised in both professional literature as well as in the popular press regarding certain aspects of the literature-based movement. Here we report on findings from a longitudinal study of a group of first -grade teachers who have been attempting (with varying degrees of success)to introduce literature-based teaching strategies into their classrooms. We inspect the experiences of these teachers in relation to four areas of concern that have been raised regarding literature-based teaching: 1. skills instruction; 2.guided reading strategies; 3. literature selection;and 4. thematic teaching (or curriculum integration). We describe classroom practices and the 9 problems and possibilities associated with teacher change in each of the four areas

Sensitive Species Data in Colorado’s State and Local Government Decision-Making

This report addresses the use of sensitive species data in Colorado at both the state and local levels. At the state level, this research focuses on environmental statutes and regulations, permitting authority in various state agencies, and processes for identifying and dealing with sensitive species. At the local level, the focus is on the role of sensitive species data in development proposals, as well as the varying level of detail required for considering sensitive species data in in local government decision-making. Principally, this report identifies: (1) areas where statutes and regulations require the consideration of sensitive species data; (2) areas where data could be used but are not used currently; and (3) impediments to the best data being used in decision-making. Finally, this report offers suggested best practices and recommendations for statutory and regulatory changes to ensure that decision-makers are using the best available sensitive species data. The recommendations provided in this report include statutory changes, regulatory amendments, and changes to policy documents. Ultimately, each of these recommendations serve to increase transparency in decision-making processes and improve considerations of environmental impacts. While this report recognizes that the overarching goal of more complete considerations for sensitive species may be achieved through recommendations not included in this report, the recommendations provided intend to serve as a framework to guide potential changes to the law

Patient‐friendly pathology reports for patients with breast atypias

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146318/1/tbj13061_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146318/2/tbj13061.pd

Four Kinds of Hard: An Understanding of Cancer and Death among Latino Community Leaders

Early integration of palliative care after a diagnosis of cancer improves outcomes, yet such care for Latino populations is lacking in rural regions of the United States. We used a participatory action research design with Latino community leaders from emerging immigrant communities in North Carolina to explore sociocultural perspectives on cancer and death. Thematic analysis was conceptualized as Four Kinds of Hard represented by four themes: Receiving an Eviction Notice, Getting in the Good Book, Talking is (Sometimes) Taboo, and Seeing Their Pain Makes us Suffer. These themes captured fears of deportation, coping with cancer through faithfulness, ambivalence about advance care planning, and a desire to spare families from suffering. Findings suggest strategies to improve conversations about end-of-life wishes when facing advanced illness and death. This study demonstrates the importance of training Latino community leaders to improve palliative care and bridge service gaps for Latino families living in emerging rural communities.OA publication support through Carolina Consortium agreement with Sag

Effectiveness of Stroke Early Supported Discharge: Analysis From a National Stroke Registry

BackgroundImplementation of stroke early supported discharge (ESD) services has been recommended in many countries’ clinical guidelines, based on clinical trial evidence. This is the first observational study to investigate the effectiveness of ESD service models operating in real-world conditions, at scale.Methods AND RESULTSUsing historical prospective data from the United Kingdom Sentinel Stroke National Audit Programme (January 1, 2016–December 31, 2016), measures of ESD effectiveness were “days to ESD” (number of days from hospital discharge to first ESD contact; n=6222), “rehabilitation intensity” (total number of treatment days/total days with ESD; n=5891), and stroke survivor outcome (modified Rankin scale at ESD discharge; n=6222). ESD service models (derived from Sentinel Stroke National Audit Programme postacute organizational audit data) were categorized with a 17-item score, reflecting adoption of ESD consensus core components (evidence-based criteria). Multilevel modeling analysis was undertaken as patients were clustered within ESD teams across the Midlands, East, and North of England (n=31). A variety of ESD service models had been adopted, as reflected by variability in the ESD consensus score. Controlling for patient characteristics and Sentinel Stroke National Audit Programme hospital score, a 1-unit increase in ESD consensus score was significantly associated with a more responsive ESD service (reduced odds of patient being seen after ≥1 day of 29% [95% CI, 1%–49%] and increased treatment intensity by 2% [95% CI, 0.3%–4%]). There was no association with stroke survivor outcome measured by the modified Rankin Scale.ConclusionsThis study has shown that adopting defined core components of ESD is associated with providing a more responsive and intensive ESD service. This shows that adherence to evidence-based criteria is likely to result in a more effective ESD service as defined by process measures

Effectiveness of stroke early supported discharge

Background Implementation of stroke early supported discharge (ESD) services has been recommended in many countries’ clinical guidelines, based on clinical trial evidence. This is the first observational study to investigate the effectiveness of ESD service models operating in real-world conditions, at scale. Methods AND RESULTS Using historical prospective data from the United Kingdom Sentinel Stroke National Audit Programme (January 1, 2016–December 31, 2016), measures of ESD effectiveness were “days to ESD” (number of days from hospital discharge to first ESD contact; n=6222), “rehabilitation intensity” (total number of treatment days/total days with ESD; n=5891), and stroke survivor outcome (modified Rankin scale at ESD discharge; n=6222). ESD service models (derived from Sentinel Stroke National Audit Programme postacute organizational audit data) were categorized with a 17-item score, reflecting adoption of ESD consensus core components (evidence-based criteria). Multilevel modeling analysis was undertaken as patients were clustered within ESD teams across the Midlands, East, and North of England (n=31). A variety of ESD service models had been adopted, as reflected by variability in the ESD consensus score. Controlling for patient characteristics and Sentinel Stroke National Audit Programme hospital score, a 1-unit increase in ESD consensus score was significantly associated with a more responsive ESD service (reduced odds of patient being seen after ≥1 day of 29% [95% CI, 1%–49%] and increased treatment intensity by 2% [95% CI, 0.3%–4%]). There was no association with stroke survivor outcome measured by the modified Rankin Scale. Conclusions This study has shown that adopting defined core components of ESD is associated with providing a more responsive and intensive ESD service. This shows that adherence to evidence-based criteria is likely to result in a more effective ESD service as defined by process measures. REGISTRATION: URL: http://www.isrctn.com/ ; Unique identifier: ISRCTN15568163

The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial [ISRCTN87413556]

BACKGROUND: The management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects [1,2]. Intervention with Virtual Reality (VR) games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation. METHODS: This study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5–18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses. RESULTS: The average pain scores (from the Faces Scale) for pharmacological analgesia only was, 4.1 (SD 2.9), while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8) CONCLUSION: The study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain

So What\u27s New in the New Basals? A Focus on First Grade

The authors examine the first grade materials in five new basal programs submitted for the 1993 Texas state adoption. These series are compared with program materials currently in use in the state (Copyright 1986/1987). The analysis focuses on features of the pupil texts(e.g., total number of words, number of unique words, readability levels, literary quality) and features of the teachers\u27 editions (e.g., program design, organization, tone). Results of the analysis indicate substantial changes in the more recent series.The findings are interpreted in terms of historical trends as well as recent developments in the literature-based and whole language movements.Implications for future research are identified that relate to the study of the implementation and effects of these new programs