An Examination of Disproportionality in One School District Using a Response to Intervention Model

Disproportionality in special education has been an ongoing discussion and cause for concern at the district, state, and federal levels for the past 45 years. Due to legislative changes and a shifting attitude in public education away from a wait to fail service delivery model, may states now require the use of Response to Intervention (RTI), or a multi-tiered system of support (MTSS) for students who do not meet grade level academic standards or behavioral expectations. This study examined the presence of disproportionality among race/ethnicity, gender, and ELL status for students who received targeted and intensive interventions across two consecutive school years. Descriptive statistics, tests of proportion, and regression analyses were conducted to measure disproportionality within RTI and examine predictors of student outcome at the end of each year. Results indicated that for both school years Other/Multi-racial students were under-represented and in the second year, White/Caucasian students were overrepresented. For both school years, males were significantly overrepresented, females were underrepresented, and English Language Learners were proportionately represented. Hispanic/Latino(a) students who received RTI interventions were about four times more likely to be placed into special education in the first school year than White/Caucasian students and about half as likely to continue RTI interventions for that same year. Gender was a significant predictor in the second school year, with females being about half as likely to be placed in special education than males. Results from this study emphasize the need for providing strong leadership, professional development, and resources to support best practices in RTI implementation for all schools. Implications for future research, limitations to the study, and reflections on current educational practices are also discussed

Cytogenomic array detects a subset of myelodysplastic syndrome with increased risk that is invisible to conventional karyotype

Conventional karyotyping is essential standard practice in the initial evaluation of myelodysplastic syndrome (MDS) and is the most impactful single component of the Revised International Prognostic Scoring System (IPSS‐R). While single nucleotide polymorphism array (SNP‐A) has demonstrated the ability to detect chromosomal defects with greater sensitivity than conventional karyotype, widespread adoption is limited by the unknown additional prognostic impact of SNP‐A analysis. Here, we investigate the significance of additional SNP‐A abnormalities in the setting of MDS and demonstrate differences in survival of patients with additional abnormalities, even those initially characterized as relatively lower risk either by cytogenetic score or IPSS‐R. Our findings identify specific abnormalities, particularly KMT2A partial tandem duplication, that are invisible to conventional karyotype and potentially contribute to the poor prognosis of MDS patients. Furthermore, these results demonstrate the added value of SNP‐A analysis in identifying patients who may benefit from more aggressive therapy, particularly those who would otherwise be classified into lower risk categories.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151357/1/gcc22783_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151357/2/gcc22783.pd

Branching on multi-aggregated variables

open5siopenGamrath, Gerald; Melchiori, Anna; Berthold, Timo; Gleixner, Ambros M.; Salvagnin, DomenicoGamrath, Gerald; Melchiori, Anna; Berthold, Timo; Gleixner, Ambros M.; Salvagnin, Domenic

Rising rural body-mass index is the main driver of the global obesity epidemic in adults [Letter]

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories

Long-term and recent trends in hypertension awareness, treatment and control in twelve high-income countries: an analysis of 123 nationally representative surveys

Background: Antihypertensive medicines are effective in reducing adverse cardiovascular events. Our aim was to compare hypertension awareness, treatment and control, and how they have changed over time, in high-income countries. Methods: We used data on 526,336 participants aged 40-79 years in 123 national health examination surveys from 1976 to 2017 in twelve high-income countries: Australia, Canada, Finland, Germany, Ireland, Italy, Japan, New Zealand, South Korea, Spain, the UK, and the USA. We calculated the percent of participants with hypertension – defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or being on pharmacological treatment for hypertension – who were aware of their condition, who were treated, and whose hypertension was controlled (i.e. lower than 140/90 mmHg). Findings: Canada, South Korea, Australia and the UK have the lowest prevalence of hypertension, and Finland the highest. In the 1980s and early 1990s, treatment rates were at most 40% and control rates were below 25% in most countries and age-sex groups. Over time, hypertension awareness and treatment increased and control rate improved in all twelve countries, with South Korea and Germany experiencing the largest improvements. Most of the increase occurred in the 1990s and early-mid 2000s, having plateaued since in most countries. Canada, Germany, South Korea and the USA have the highest rates of awareness, treatment and control, while Finland, Ireland, Japan and Spain the lowest. Even in the best performing countries, treatment coverage was at most 80% and control rates were below 70%. Interpretation: Hypertension awareness, treatment and control have improved substantially in high-income countries since the 1980s and 1990s. However, control rates have plateaued in the past decade, at levels lower than those in high-quality hypertension programmes. There is substantial variation across countries in the rates of hypertension diagnosis, treatment an

Safety and efficacy of direct- acting oral anticoagulants versus warfarin in kidney transplant recipients: a retrospective single- center cohort study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155941/1/tri13599.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155941/2/tri13599_am.pd