A multi-site case study: the effect of principal leadership on school climate and student achievement in charter schools in Los Angeles, California

This research study analyzes the effect of principal leadership practices on school climate and the resulting effect of school climate on student achievement at 4 charter schools in Los Angeles, CA. This study assesses whether teachers consider the school climate at their respective charter school as positive in nature after at least 2 years of principal leadership, going on 3 years at the current schools. It analyzes school climate as it relates to principal practices based on the leadership frameworks presented by Bolman and Deal (1991), and discusses the possible correlation of school climate and student achievement within the schools by analyzing state standardized test scores to draw a conclusive correlation. This study was quantitative in nature; two surveys were administered to teachers: The Leadership Orientation Survey (Others; See Appendix B) by Bolman and Deal (1991) was used to assess principal leadership frames and the School Climate Survey by the National Association of Secondary School Principals was used to measure school climate. The findings of this multi-site case study provided charter management organizations and other stakeholders a foundation for assessing the role of principal leadership in regards to the impact on a positive school climate and increased student achievement in a charter school setting. This research study can give insight for the school staff in future activities for continued professional development and positive growth in school climate through specific principal leadership orientations. The findings can also support other ongoing research about differences in charter school success based on these categories

Détermination de la concentration de manganèse dans l’eau potable associée à des déficits cognitifs chez l’enfant

Le manganèse (Mn) est un nutriment essentiel, mais peut induire des effets neurotoxiques lorsque l’exposition est trop élevée. En particulier, certaines études récentes ont rapporté que l’exposition au Mn dans l’eau potable était associée à une diminution des habiletés cognitives chez les enfants. Par contre, la concentration à partir de laquelle ces effets apparaissent n’a pas été estimée dans les études existantes. Par conséquent, l’objectif de mon mémoire de maîtrise était d’estimer la concentration de Mn dans l'eau potable associée à différents niveaux prédéfinis de déficit cognitif chez des enfants d’âge scolaire. Pour ce faire, les données de deux études transversales du Canada ont été poolées, résultant en un échantillon de 630 enfants âgés de 5 à 14 ans. Le quotient intellectuel (QI) de chaque enfant a été évalué et la concentration de Mn a été mesurée dans l’eau de la résidence. Au moyen du logiciel Bayesian Benchmark Dose Analysis, nous avons conduit une analyse concentration repère (benchmark concentration) pour estimer les concentrations de Mn dans l’eau associées à une diminution de 1%, 2% et de 5% de QI, ainsi que les limites inférieures des intervalles crédibles à 95% (LIIC95%). Nos résultats indiquent que la concentration de Mn dans l’eau associée à une diminution de 1% de QI était de 121 µg/L (LIIC95%, 70 µg/L), tandis que celles à une diminution de 2% et de 5% de QI étaient de 241 µg/L (LIIC95%, 141 µg/L) et 611 µg/L (LIIC95%, 367 µg/L), respectivement. Puisque les résultats suggèrent que l’association entre le Mn dans l’eau et le QI diffère entre les sexes, des analyses stratifiées ont aussi été menées. La concentration de Mn dans l’eau associée à une diminution de 1% de QI était de 169 µg/L (LIIC95%, 68 µg/L) chez les garçons et de 73 µg/L (LIIC95%, 8 µg/L) chez les filles. Il n’existe pas de recommandation actuellement au Canada sur la concentration de Mn qui devrait être permise dans l’eau potable, et ces résultats pourraient guider les décideurs dans l’élaboration d’une telle recommandation pour protéger les enfants des effets neurotoxiques de ce métal.Manganese (Mn) is an essential nutrient but can induce neurotoxic effects elevated exposure levels. Recent studies have reported that exposure to Mn in drinking water could be associated with a decrease in cognitive abilities in children. However, the concentration at which these effects appear has not been estimated in previous studies. Therefore, the objective of my master’s thesis was to estimate the concentration of Mn in drinking water associated with different predefined levels of cognitive deficits in children. To achieve this, data from two cross-sectional studies from Canada were pooled resulting in a sample of 630 children from ages 5-14 years. The intelligence quotient (IQ) of each child was assessed and the concentration of Mn was measured from the tap water of their residence. We used the software Bayesian Benchmark Dose Analysis to estimate the benchmark concentrations of water Mn associated with a 1%, 2% and 5% decrease in IQ, as well as the lower limits of the 95% credible interval (LL95%CI). Our results show that the concentration of Mn in water associated with a 1% decrease in IQ was 121 μg/L (LL95%CI, 70 μg/L), while those for a decrease of 2% and 5% points were 241 μg /L (LL95%CI, 141 μg/L) and 611 μg/L (LL95%CI, 367 μg/L) respectively. Since the results suggest that the association between Mn in water and IQ is different between the sexes, we also conducted sex-stratified analyses. The concentration of Mn in water associated with a 1% decrease in IQ was 169 μg/L (LL95%CI, 68 μg/L) in boys and 73 μg/L (LL95%CI, 8 μg/L) in girls. As there is currently no established health-based guideline for Mn in drinking water in Canada, these results can guide decision-makers in developing a guideline aimed at protecting children from neurotoxicity from this metal

Defining the cellular and molecular mechanism of maternally inherited hearing loss

Mitochondrial dysfunction causes moderate to profound hearing loss both in isolation and as a feature of multi-systemic mitochondrial disease. The m.1555A>G mitochondrial DNA (mtDNA) variant is associated with a predisposition to aminoglycoside ototoxicity and maternally inherited non-syndromic deafness. However, the reasons for the highly variable penetrance of the associated hearing loss have not yet been fully resolved. Aminoglycosides are a recognised modifier factor of the hearing loss, but cannot account for all hearing impaired carriers in multi-generational pedigrees, implicating additional co-segregating genetic factors. By identifying and characterising the c.3G>A SSBP1 variant as a nuclear modifier of m.1555A>G the work detailed in this thesis extends our understanding of mitochondrial-nuclear interactions in human disease. To ascertain the frequency of the m.1555A>G variant in patients with suspected mitochondrial hearing loss we surveyed the laboratories within the United Kingdom that undertake genetic testing for this variant. We determined that the variant was not found more frequently in patients with known hearing impairment providing further evidence that m.1555A>G does not cause hearing loss in isolation. These results strengthened the case for nuclear genetic modifiers as important contributors to m.1555A>G pathogenesis. We next identified a multi-generational family that transmitted the m.1555A>G variant with variable clinical penetrance of hearing loss. In addition, a cohort of sporadic individuals carrying m.1555A>G was used to test the hypothesis that a conserved genetic mechanism accounted for the phenotype in all carriers. To this effect, we undertook whole exome sequencing in selected familial and sporadic carriers of m.1555A>G, identifying a heterozygous start loss mutation in the core mtDNA replisome protein gene, SSBP1, that co-segregated with the m.1555A>G variant and the phenotype in the family. The SSBP1 variant lead to a perturbation of mtDNA metabolism, and was associated with multiple mtDNA deletions and mtDNA depletion in skeletal muscle. Fibroblasts from these patients also showed mitochondrial network fragmentation and reduced intra-mitochondrial protein synthesis in keeping with the co-existing m.1555A>G variant, leading to reduced proliferation rates under conditions of forced mitochondrial respiration. Our findings provide an explanation for the variable clinical penetrance of the disorder within these m.1555A>G carriers and highlight the importance of trans-acting modifiers in mitochondrial disease.Wellcome Trus

A qualitative and quantitative comparison of adverse drug reaction data of anti-epileptic drugs in various sources of drug information

Background: It is essential to spread awareness about known adverse drug reactions (ADRs) for identification, prevention and their proper management. The aim of this study is to assess disparities in documented ADRS of antiepileptic drugs in various sources of drug information.Methods: An observational, cross sectional study was done to compare different drug information sources for ADRs. Six sources of information namely: National Formulary India (2011), Drug Today (2018), Current index of medical specialties (CIMS), and some textbooks like Lippincott’s illustrated reviews: Pharmacology (2012), Brenner and Stevens' Pharmacology (2018) and George and Goodman and Gilman's (GG): The pharmacological basis of therapeutics (2018) were critically analysed for ADRs of a total of 34 drugs. Prototype drugs and most commonly prescribed antiepileptic drugs, were chosen for study. They were categorized according to therapeutic classification and guidelines by Indian Society of Epilepsy. ADRs were categorized according to various body systems, and serious and life threatening ADRs, then were tabulated and compared. Qualitative and quantitative analysis of this data was also done.Results: None of analysed sources mentioned all antiepileptic drugs. GG contained information for maximum number of drugs studied (76.4%) and National Formulary of India gave information for (52.9%) drugs only. There was wide variability among various resources while listing ADRs. CIMS listed maximum number of ADRs (85.5%) while minimum was included in Brenner and Stevens' Pharmacology (13%) for all antiepileptic drugs. The quality of data though limited was relatively better in CIMS, but none of sources studied were found to be complete.Conclusions: No source of information provided complete information about adverse effects of all 34 anti-epileptic drugs. Academicians and policymakers can work towards providing complete ADR information in all sources of information and updating it from time to time. Thus, making drug use safer in patients of epilepsy

Primary hepatic embryonal sarcoma masquerading as metastatic ovarian cancer

<p>Abstract</p> <p>Background</p> <p>Hepatic embryonal sarcoma (HES) is a rare but aggressive primary tumor of the liver occurring most frequently in childhood.</p> <p>Case presentation</p> <p>We report a case of a 52 year old woman having previously undergone treatment for ovarian serous papillary carcinoma who subsequently presented with a large solitary mass in the liver. Initially this was presumed to be metastasis from the ovarian primary however, on further examination it was shown to be a primary hepatic embryonal sarcoma.</p> <p>Conclusion</p> <p>Primary liver tumors should be considered in differential diagnoses in patients with ovarian cancer who subsequently present with liver tumors. This is particularly important when there is no direct evidence of recurrence of ovarian cancer.</p

Emergency endovascular management of peripheral artery aneurysms and pseudoaneurysms - a review.

Endovascular stenting has been successfully employed in the management of aortic aneurysms; however, its use in managing peripheral arterial conditions remains questionable. We review the utility of endovascular technique in the management of peripheral arterial conditions like aneurysms, pseudoaneurysms and arterio-venous fistulas in the emergency setting. Though long term data about graft patency rates is not yet available, the endovascular approach appears to be a useful minimally invasive technique in situations where open repair is either difficult or not feasible.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey

Infection control; Multidrug resistance; StewardshipControl de infección; Resistencia a múltiples fármacos; AdministraciónControl d'infecció; Resistència a múltiples fàrmacs; AdministracióWe explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases–International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%−90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs’ implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted

Next-Generation Sequencing Supports Targeted Antibiotic Treatment for Culture Negative Orthopedic Infections

The isolation of an infective pathogen can be challenging in some patients with active, clinically apparent infectious diseases. Despite efforts in the microbiology lab to improve the sensitivity of culture in orthopedic implant-associated infections, the clinically relevant information often falls short of expectations. The management of peri-prosthetic joint infections (PJI) provides an excellent example of the use and benefits of newer diagnostic technologies to supplement the often-inadequate yield of traditional culture methods as a substantial percentage of orthopedic infections are culture-negative. Next-generation sequencing (NGS) has the potential to improve upon this yield. Bringing molecular diagnostics into practice can provide critical information about the nature of the infective organisms and allow targeted therapy in these otherwise challenging situations. This review article describes the current state of knowledge related to the use and potential of NGS to diagnose infections, particularly in the setting of PJIs