362 research outputs found

    Teacher leadership practices, supports and challenges in implementation of the common core high school math standards

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    The purpose of this qualitative phenomenological study was to explore and describe the practices of teacher leaders in a PLC content team along with the supports they received and needed as well as the challenges they encountered during implementation of the Common Core State Standards for high school mathematics in a Southern California school district. Because research shows most change initiatives require active leadership and yet are difficult to sustain there existed a need to study and describe the experiences of the teacher leaders during this curricular change to the Common Core State Standards. The experiences described by the seven teacher leaders participating in this study strengthen the practices of using collaborative content groups lead by teacher leaders. Common themes of teacher leader practices included having updated knowledge and skills about the reform through multiple trainings, honest and trusting relationships with their peers, sharing experiences and ideas, along with a shared vision and purpose, timelines and agendas. The supports received by the teacher leaders included the support of leadership through a TOSA or coach, the structure and time of the collaborative PLC content teams and on-going professional development. The challenges experienced by the teacher leaders were the need for more time and materials. The conclusions confirm that teacher leaders are the experts in their subject who practice building relationships through sharing of experiences and focusing on the goals for student improvement. Nine conclusions from this study confirm that the important practices of teacher leaders are knowledge of the change in curriculum to provide a common vision and purpose for student learning, using norms, agendas and timelines to stay focused on the goals, building trusting relationships and an environment of trying new things and sharing experiences. The leadership supports required include the PLC team time and structure including stronger administrative direction at the beginning and more choice as the work continues, the support of a TOSA or coach who advocates for the teachers and teacher leaders through communication, direction and resources and the additional support through on-going and continual professional development. The needs and challenges of the teacher leaders include more time to development, assess, adjust and improve the curriculum and the need for materials for both the teachers and students

    Association between anaesthetic technique and unplanned admission to intensive care after thoracic lung resection surgery: the second Association of Cardiothoracic Anaesthesia and Critical Care (ACTACC) National Audit

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    Unplanned intensive care admission is a devastating complication of lung resection and is associated with significantly increased mortality. We carried out a two‐year retrospective national multicentre cohort study to investigate the influence of anaesthetic and analgesic technique on the need for unplanned postoperative intensive care admission. All patients undergoing lung resection surgery in 16 thoracic surgical centres in the UK in the calendar years 2013 and 2014 were included. We defined critical care admission as the unplanned need for either tracheal intubation and mechanical ventilation or renal replacement therapy, and sought an association between mode of anaesthesia (total intravenous anaesthesia vs. volatile) and analgesic technique (epidural vs. paravertebral) and need for intensive care admission. A total of 253 out of 11,208 patients undergoing lung resection in the study period had an unplanned admission to intensive care in the postoperative period, giving an incidence of intensive care unit admission of 2.3% (95%CI 2.0–2.6%). Patients who had an unplanned admission to intensive care unit had a higher mortality (29.00% vs. 0.03%, p < 0.001), and hospital length of stay was increased (26 vs. 6 days, p < 0.001). Across univariate, complete case and multiple imputation (multivariate) models, there was a strong and significant effect of both anaesthetic and analgesic technique on the need for intensive care admission. Patients receiving total intravenous anaesthesia (OR 0.50 (95%CI 0.34–0.70)), and patients receiving epidural analgesia (OR 0.56 (95%CI 0.41–0.78)) were less likely to have an unplanned admission to intensive care after thoracic surgery. This large retrospective study suggests a significant effect of both anaesthetic and analgesic technique on outcome in patients undergoing lung resection. We must emphasise that the observed association does not directly imply causation, and suggest that well‐conducted, large‐scale randomised controlled trials are required to address these fundamental questions

    A good place to raise a family? Comparing parents, service-providers\u27, and media perspectives of the inner and outer suburban areas of Melbourne

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    In Australia, the suburbs have historically been the favoured place to raise children. However this is being challenged both by social change and government policy encouraging innerurban renewal. We examined how inner-urban areas compare with more traditional suburban locations as places to raise a family. Recognising that there are many influences on perceptions of place, we included the opinions of parents, service-providers and the media in the two locations.Research focused on two municipalities in Melbourne, one located >25km and the other <10km from the CBD. Themes were obtained and compared from in-depth interviews with parents, serviceproviders and analysis of municipality-specific and state-wide newspaper articles.Service provision was the only theme common at all levels of analysis. For all other themes, differences occurred between perspectives of service-providers, media and parents, as well as between the two residential locations. These in-depth snapshots on the challenges and rewards of raising children in different urban locations can help inform government in planning healthy neighbourhoods that better serve the needs of contemporary Australian families

    Transmembrane Peptide-Induced Lipid Sorting and Mechanism of Lα-to-Inverted Phase Transition Using Coarse-Grain Molecular Dynamics

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    AbstractMolecular dynamics results are presented for a coarse-grain model of 1,2-di-n-alkanoyl-sn-glycero-3-phosphocholine, water, and a capped cylindrical model of a transmembrane peptide. We first demonstrate that different alkanoyl-length lipids are miscible in the liquid-disordered lamellar (Lα) phase. The transmembrane peptide is constructed of hydrophobic sites with hydrophilic caps. The hydrophobic length of the peptide is smaller than the hydrophobic thickness of a bilayer consisting of an equal mixture of long and short alkanoyl tail lipids. When incorporated into the membrane, a meniscus forms in the vicinity of the peptide and the surrounding area is enriched in the short lipid. The meniscus region draws water into it. In the regions that are depleted of water, the bilayers can fuse. The lipid headgroups then rearrange to solvate the newly formed water pores, resulting in an inverted phase. This mechanism appears to be a viable pathway for the experimentally observed Lα-to-inverse hexagonal (HII) peptide-induced phase transition

    Analysis of incidence and prognostic factors for ipsilateral breast tumour recurrence and its impact on disease-specific survival of women with node-negative breast cancer: a prospective cohort study

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    INTRODUCTION: This study had three aims: to establish the incidence of ipsilateral breast tumour recurrence (IBTR) in a community treatment setting, to evaluate known factors – in particular younger age (< 40 years) – predictive for local recurrence, and to assess the impact of local recurrence on disease-specific survival (DSS). METHODS: A consecutive series of 1,540 women with node-negative breast cancer, diagnosed between the ages of 18–75 years, were prospectively accrued between September 1987 and September 1999. All had undergone a resection of the primary breast cancer with clear margins, an axillary lymph node dissection with a minimum of four sampled nodes, and breast-conserving surgery (of any type). RESULTS: During the study follow-up period, 98 (6.4%) IBTRs and 117 (7.6%) deaths from or with breast cancer were observed. The median time to IBTR was 3.1 years and to death from or with disease was 4.3 years. In the multivariate Cox proportional hazards (PH) regression model for IBTR with adjuvant therapy factors, independent risk factors included age < 40 years (relative risk (RR) = 1.89, 95% confidence interval (CI) of 1.00 – 3.58), presence of intraductal disease (RR = 1.81, 95% CI = 1.15–2.85) and histological grade ('G2' or G3 versus G1: RR = 1.59, 95% CI = 0.87–2.94). In the multivariate Cox PH regression model for DSS with adjuvant therapy factors, independent risk factors included previous IBTR (RR = 2.58, 95% CI = 1.41–4.72), tumor size (1–2 cm versus < 1 cm: RR = 1.95, 95% CI = 1.05–3.64, > 2 cm versus < 1 cm: RR = 2.94, 95% CI = 1.56–5.56), progesterone receptor status (negative or equivocal versus positive or unknown: RR = 2.15, 95% CI = 1.36–3.39), lymphatic invasion (RR = 1.78, 95% CI = 1.17–2.72), and histological grade ('G2' or G3 versus G1: RR = 8.59, 95% CI = 2.09–35.36). The effects of competing risks could be ignored. CONCLUSION: The Cox PH analyses confirmed the importance of known risk factors for IBTR and DSS in a community treatment setting. This study also revealed that the early occurrence of an IBTR is associated with a relatively poor five-year survival rate

    A Continuum of Cell States Spans Pluripotency and Lineage Commitment in Human Embryonic Stem Cells

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    Background: Commitment in embryonic stem cells is often depicted as a binary choice between alternate cell states, pluripotency and specification to a particular germ layer or extraembryonic lineage. However, close examination of human ES cell cultures has revealed significant heterogeneity in the stem cell compartment. Methodology/Principal Findings: We isolated subpopulations of embryonic stem cells using surface markers, then examined their expression of pluripotency genes and lineage specific transcription factors at the single cell level, and tested their ability to regenerate colonies of stem cells. Transcript analysis of single embryonic stem cells showed that there is a gradient and a hierarchy of expression of pluripotency genes in the population. Even cells at the top of the hierarchy generally express only a subset of the stem cell genes studied. Many cells co-express pluripotency and lineage specific genes. Cells along the continuum show a progressively decreasing likelihood of self renewal as their expression of stem cell surface markers and pluripotency genes wanes. Most cells that are positive for stem cell surface markers express Oct-4, but only those towards the top of the hierarchy express the nodal receptor TDGF-1 and the growth factor GDF3. Significance: These findings on gene expression in single embryonic stem cells are in concert with recent studies of early mammalian development, which reveal molecular heterogeneity and a stochasticity of gene expression in blastomeres. Our work indicates that only a small fraction of the population resides at the top of the hierarchy, that lineage priming (co-expression of stem cell and lineage specific genes) characterizes pluripotent stem cell populations, and that extrinsic signaling pathways are upstream of transcription factor networks that control pluripotency
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