Road map or maze? : one school\u27s experience of restructuring within the Massachusetts Carnegie Schools Grant Program.

Although by reputation and performance an effective school, the staff and principal of Adams School in Northtown, Massachusetts sought and won a state-funded grant for school restructuring. Seeking increased autonomy and more say, the Massachusetts Carnegie Schools Grant Program was seen as a vehicle to facilitate and legitimize the reform-type activities already in progress at the school. The complexity of the restructuring process soon became apparent. Certain staff referred to as the doubters questioned the feasibility of restructuring. Lacking a real transfer of power to the school site confirmed the doubters\u27 skepticism. Encountering numerous obstacles, the complex process of restructuring is seen as more analogous to moving though a maze than following a road map. Major elements of restructuring emerge within this school\u27s model. Grade-level teams coordinated through a central school governance team facilitate shared decision-making and planning by principal, teachers, and parents. Students are also empowered through classroom forums and a student council. Despite the auspices of a state-sponsored grant awarded to a good school with strong leadership, motivated staff, strong parental support, and a proven record of instructional effectiveness, successful restructuring is not assured. Lacking the power to effect radical change, people in this setting were limited to small scale tinkering rather than restructuring. A summary of data suggests that: (1) Cultural readiness of the community, school district and school site are critical to successful restructuring. A real transfer of power may not be possible without such readiness. (2) Restructuring involves a redefinition of roles and relationships among people--particularly that between teacher and parent; teacher and principal. (3) The opportunity for developing inter-personal relationships among roles can be a valuable by-product of the training process. (4) Inclusion of all stakeholders especially central office personnel, school board members, and less-involved parents is essential for successful restructuring. (5) Models of school restructuring developed within The Massachusetts Carnegie Schools Grant Program may be of limited value. Restructuring as a strategy for improving the effectiveness of less successful schools is not demonstrated within this model

Cavity Nest Materials of Northern Flying Squirrels, Glaucomys sabrinus, and North American Red Squirrels, Tamiasciurus hudsonicus, in a Secondary Hardwood Forest of Southern Ontario

Through deployment of artificial nest boxes, we examined the composition of cavity nest materials used by Northern Flying Squirrels (Glaucomys sabrinus) and North American Red Squirrels (Tamiasciurus hudsonicus) in a secondary hardwood forest of southern Ontario, Canada. We collected 32 nests of known species association and found that 85.7% of G. sabrinus nests and 77.8% of T. hudsonicus nests were constructed almost entirely of shredded bark from Eastern White Cedar (Thuja occidentalis). Mean nest depth across all samples was 12.2 cm and showed no significant difference between species or between spring and summer nests. We review the antiparasitic properties of T. occidentalis and suggest that the use of shredded cedar bark by G. sabrinus and T. hudsonicus to line nest cavities may be a behavioural adaptation, which reduces ectoparasite loads in the nest environment

Organizations driving positive social change:a review and an integrative framework of change processes

Academic and practitioner interest in how market-based organizations can drive positive social change (PSC) is steadily growing. This paper helps to recast how organizations relate to society. It integrates research on projects stimulating PSC – the transformational processes to advance societal well-being – which is fragmented across different streams of research in management and related disciplines. Focusing on the mechanisms at play in how organizations and their projects affect change in targets outside of organizational boundaries, we 1) clarify the nature of PSC as a process, 2) develop an integrative framework that specifies two distinct PSC strategies, 3) take stock of and offer a categorization scheme for change mechanisms and enabling organizational practices, and 4) outline opportunities for future research. Our conceptual framework differentiates between surface- and deep-level PSC strategies understood as distinct combinations of change mechanisms and enabling organizational practices. These strategies differ in the nature and speed of transformation experienced by the targets of change projects and the resulting quality (pervasiveness and durability), timing, and reach of social impact. Our findings provide a solid base for integrating and advancing knowledge across the largely disparate streams of management research on Corporate Social Responsibility, Social Entrepreneurship, and Base of the Pyramid, and open up important new avenues for future research on organizing for PSC and on unpacking PSC processes

Developing systems leadership in public health: A scoping report

This document reports the outcomes of a scoping project commissioned by Public Health England (PHE) in order to outline possibilities for developing the systems leadership capacity of public health registrars and newly appointed consultants. It has been written for those involved in the design, delivery and accreditation of training and professional development for public health registrars and consultants across the UK in order to support the upscaling of systems leadership development opportunities within the sector.The project was undertaken by a multi-disciplinary team based at the University of the West of England, drawing on the expertise of the Bristol Leadership and Change Centre and the Centre for Public Health and Wellbeing as well as a number of independent consultants with backgrounds in leadership and organisation development and public health. The methodology involved consultation and engagement with a range of stakeholders with extensive experience of the public health landscape in the UK, including 10 registrars, 2 consultants, 3 directors of public health, 3 PHE managers/board members, 3 Faculty of Public Health (FPH) managers/board members, 4 heads of school/postgraduate deans, and 4 other UK-based public health professionals, through interviews, a focus group and a co-design workshop. Building on insights from the literature review and stakeholder consultation/engagement a series of principles and concepts underpinning a systems approach to leadership development are presented, along with six levels of learning, ranging from leading self to leading team/organisation, leading collaborations/partnerships, leading local systems and leading wider system/across systems. These principles are then used to outline an indicative development framework for public health professionals through the five years of the specialty training programme (as registrar) into the years following qualification (as consultant). Three distinct phases of learning/development are outlined, along with indicative content and learning outcomes. The report concludes with a series of 18 recommended actions, grouped into four thematic areas. It is hoped that this document provides a valuable resource for those involved in the development and accreditation of public health professionals and a timely call to action

Feasibility of Electromyography-Triggered Neuromuscular Stimulation as an Adjunct to Constraint-Induced Movement Therapy

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT). Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient\u27s weaker arm for one half of the CIMT training hours. Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements were paralleled by a change in the size and location of the extensor digitorum communis muscle representation in the primary motor cortex, as measured by transcranial magnetic stimulation mapping. Discussion. These changes suggest that using EMG-stim as an adjunct to CIMT should be further investigated in individuals who have low functional abilities following stroke

An efficient assay for identification and quantitative evaluation of potential polysialyltransferase inhibitors

YesThe polysialyltransferases (polySTs) catalyse the polymerisation of polysialic acid, which plays an important role in tumour metastasis. While assays are available to assess polyST enzyme activity, there is no methodology available specifically optimised for identification and quantitative evaluation of potential polyST inhibitors. The development of an HPLC-fluorescence-based enzyme assay described within includes a comprehensive investigation of assay conditions, including evaluation of metal ion composition, enzyme, substrate and acceptor concentrations, temperature, pH, and tolerance to DMSO, followed by validation using known polyST inhibitors. Thorough analysis of each of the assay components provided a set of optimised conditions. Under these optimised conditions, the experimentally observed Ki value for CMP, a competitive polyST inhibitor, was strongly correlated with the predicted Ki value, based on the classical Cheng-Prusoff equation [average fold error (AFE) = 1.043]. These results indicate that this assay can provide medium-throughput analysis for enzyme inhibitors with high accuracy, through determining the corresponding IC50 values with substrate concentration at the KM, without the need to perform extensive kinetic studies for each compound. In conclusion, an in vitro cell-free assay for accurate assessment of polyST inhibition is described. The utility of the assay for routine identification of potential polyST inhibitors is demonstrated, allowing quantitative measurement of inhibition to be achieved, and exemplified through assessment of full competitive inhibition. Given the considerable and growing interest in the polySTs as important anti-metastatic targets in cancer drug discovery, this is a vital tool to enable preclinical identification and evaluation of novel polyST inhibitors.Yorkshire Cancer Research, Wellcome Trus

Shielding, hospital admission and mortality among 1216 people with total laryngectomy in the UK during the COVID-19 pandemic: A cross-sectional survey from the first national lockdown

BackgroundPeople with a total laryngectomy (PTL) rely on a permanent opening in their neck (stoma) to breathe. This altered anatomy may increase susceptibility to contracting and transmitting SARS-CoV-2.AimsTo report on (1) the frequency and characteristics of PTL who tested positive for COVID-19, (2) the receipt of advice regarding shielding and patient self-reports of shielding, (3) hospital admissions and length of stay, and (4) mortality rates in this group during the first UK national lockdown.Methods & proceduresThis is a cross-sectional survey and case note review. National Health Service (NHS) centres providing care to PTL were invited to participate via the Royal College of Speech and Language Therapists' (RCSLT) Head & Neck Clinical Excellence Networks and through social media. PTL were reviewed by their speech and language therapist either in person or via telehealth between 30 March and 30 September 2020. Data were collected within the time frame covered by the Control of Patient Information (COPI) notice issued for COVID-19 and included information on COVID-19 testing, shielding, hospital admissions, length of stay and deaths. Information was submitted to the lead NHS site using a custom designed data-capture worksheet. Analysis was performed using descriptive statistics, including proportions and frequency counts. Pearson's Chi squared tests were used to compare categorical data using a 5% significance level.Outcomes & resultsData were obtained from 1216 PTL from 26 centres across the UK. A total of 81% were male; mean age was 70 years (28-97 years). Of the total group, 12% received a COVID-19 test. A total of 24 (2% of total sample) tested positive for COVID-19. Almost one-third of PTL (32%) received a government letter or were advised to shield by a healthcare professional. During the data collection time frame, 12% had a hospital admission (n = 151) with a median length of stay of 1 day (1-133 days), interquartile range (IQR) = 17 days. A total of 20 of these admissions (13%) had tested positive for COVID-19 with a median length of stay of 26 days, IQR = 49 days. The overall mortality was 4% (41 patients), with eight deaths occurring within 28 days of testing positive for COVID-19.Conclusions & implicationsThis study highlighted the lack of routine national data for neck-breathers with which to compare the current findings. Greater testing in the community is necessary to understand the prevalence of COVID-19 in PTL and if this group is indeed more susceptible. The potential for nasopharyngeal and tracheal aspirates to show differing results when testing for COVID-19 in neck-breathers requires further investigation.What this paper addsWhat is already known on the subject? People with total laryngectomy (PTL) have an altered anatomy for breathing and speaking. The presence of a neck stoma poses an additional virus entry point aside from the nose, mouth and conjunctiva. This could increase the susceptibility to COVID-19 for PTL. What this paper adds? This is the first national audit to provide data on shielding, hospital admissions and mortality for patients with total laryngectomy in the UK over the pandemic. The overall mortality in PTL over the first lockdown did not appear to be higher than the "best case" estimates from previous years. However, one in three PTL who acquired COVID-19 and were admitted to hospital, died within 28 days of testing positive. These findings are relevant to the current care and management of PTL over the pandemic but also highlights important knowledge gaps. What are the potential or actual clinical implications of this work? This study highlights gaps in the collection of baseline information on hospital admissions, length of stay and mortality for people with laryngectomy in the UK, restricting comparisons between the current data and historical data. The need for further research on whether neck-breathers should be tested via both nasopharyngeal and tracheal aspirates is important not just currently, but also in case of any future respiratory epidemics

Brief for the United States as Amicus Curiae in Support of Neither Party

Amicus ("friend of the court") brief written by the United States in support of petitioners in AMP v. Myriad Genetics (Supreme Court Case Docket No. 12-398)