Does Child Care Works Work? An Exploration of Pennsylvania’s Child Care Subsidy Program

This article explores the theory and implementation behind Child Care Works, Pennsylvania\u27s child care subsidy program. The article then studies and evaluates the policy through three criterion: effectiveness in providing families with low cost but high quality child care, efficiency in how it uses resources dedicated to childcare in the state, and the equitable distribution of access to childcare. Child Care Works has the potential to increase access to childcare and employment in Pennsylvania, but the current budget does not allot enough money to the program for it to be as helpful as it could be

Skills Acquired Through Personal Narrative Writing Instruction

This study was focused on personal narrative writing instruction in the elementary grades. The purpose of this study was to determine the skills that students acquire during personal narrative writing instruction. The study was conducted in a rural fifth grade classroom and included six students of varying ability levels as well as the classroom teacher. samples. Data was collected through classroom observation, interviews, and student work The results of this study suggested that personal narrative writing instruction teaches students how to effectively organize a writing piece, include proper mechanics, vary word choice, and how to edit and revise. Educators need to be aware that a variety of teaching strategies should be used to successfully teach these skills to students

Software support for environmental evidence synthesis

Ecological research is central to efforts to ensure the provision of critical societal needs such as clean water, carbon abatement, and to avert the loss of biodiversity. The amount of research published on these subjects has increased enormously in recent ears, yet this research is not always used to improve environmental management or policy4. This ‘research-implementation gap’ is sustained by many factors including low access to scientific research outside of academia, a lack of flexible decision-making structures to incorporate new information, and mismatches between management and scientific priorities. A key step towards bridging the research-implementation gap, however, is to gather insights from the entire body of available evidence to ensure that scientific advice is as consistent and accurate as possible. This requires evidence synthesis; work by individuals or teams that take scientific outputs (articles and reports) and use them to understand the effectiveness of an intervention in a range of contexts. Consequently, applied synthesis has become indispensable to the application of scientific information to socio-ecological problems

A feasibility study of indocyanine green fluorescence mapping for sentinel lymph node detection in cutaneous melanoma

Objectives: Sentinel lymph node biopsy (SLNB) is standard of care for staging regional LN in AJCC stage IB-IIC melanoma; using dual localization with radiolabelled colloid and blue dye. Combining these gives optimal accuracy; drawbacks include cumulative radiation exposure for healthcare workers, coordination between disciplines and anaphylaxis. An alternative tracer agent is indocyanine green (ICG); an optical enhancer that fluoresces in the near infrared range. This prospective cohort study assesses the feasibility of using ICG as a tracer agent to detect SLN in cutaneous melanoma. Methods: Primary melanoma patients diagnosed with pT1b-pT4b tumours undergoing SLNB were recruited over a 6-month period at a tertiary referral centre. All underwent standard preoperative lymphoscintigraphy (LSG) using 20-40MBq of Tc99radiolabelled nanocolloid plus intraoperative Patent Blue dye (PBD). ICG was administered as a third tracer agent intraoperatively. Results: 62 patients (33M/29F) were recruited; median age was 61 years. Median melanoma Breslow thickness was 1.6mm. 144 specimens containing 135 SLN were excised. Concordance rate for all 3 tracer agents was 88.1%(119/135 LN); that for radioisotope/PBD was 88.2%(95%CI:82.2,93.7). There were no discordance pairs between radioisotope/PBD compared to radioisotope/PBD/ICG. Radioisotope/ICG significantly increased the sensitivity of detecting SLN to 98.5%(95%CI:94.8,99.8); p<0.00001 compared to radioisotope/PBD. Concordance rate of intraoperative ICG drainage pattern with LSG was 22.6%. Conclusion: ICG utilization showed comparable sensitivity with gold standard. Technical challenges e.g. ICG leakage into biopsy field, poor concordance with LSG limits its efficacy in melanoma SLNB. We therefore do not recommend replacing current practice with ICG alone or by using a combination with TC99

Forum : Populism, Identity Politics, and the Archaeology of Europe

SSR gratefully acknowledges M.J. Walsh, J.-L. Renaud, and another anonymous col- league for comments on this manuscript. MB would like to thank P. Pavúk, N. Vlhová, and M. Havlíková for reading and commenting on his paper. KK grate- fully acknowledges the editorial help of his friend Sappho Haralambous-Howe. Naturally, the views and opinions expressed here are those of the authors and do not reflect the official policy or position of other agencies.Peer reviewedPublisher PD

Reward processing electrophysiology in schizophrenia : effects of age and illness phase

Background: Reward processing abnormalities may underlie characteristic pleasure and motivational impairments in schizophrenia. Some neural measures of reward processing show age-related modulation, highlighting the importance of considering age effects on reward sensitivity. We compared event-related potentials (ERPs) reflecting reward anticipation (stimulus-preceding negativity, SPN) and evaluation (reward positivity, RewP; late positive potential, LPP) across individuals with schizophrenia (SZ) and healthy controls (HC), with an emphasis on examining the effects of chronological age, brain age (i.e., predicted age based on neurobiological measures), and illness phase. Methods: Subjects underwent EEG while completing a slot-machine task for which rewards were not dependent on performance accuracy, speed, or response preparation. Slot-machine task EEG responses were compared between 54 SZ and 54 HC individuals, ages 19 to 65. Reward-related ERPs were analyzed with respect to chronological age, categorically-defined illness phase (early; ESZ versus chronic schizophrenia; CSZ), and were used to model brain age relative to chronological age. Results: Illness phase-focused analyses indicated there were no group differences in average SPN or RewP amplitudes. However, a group x reward outcome interaction revealed that ESZ differed from HC in later outcome processing, reflected by greater LPP responses following loss versus reward (a reversal of the HC pattern). While brain age estimates did not differ among groups, depressive symptoms in SZ were associated with older brain age estimates while controlling for negative symptoms. Conclusions: ESZ and CSZ did not differ from HC in reward anticipation or early outcome processing during a cognitively undemanding reward task, highlighting areas of preserved functioning. However, ESZ showed altered later reward outcome evaluation, pointing to selective reward deficits during the early illness phase of schizophrenia. Further, an association between ERP-derived brain age and depressive symptoms in SZ extends prior findings linking depression with reward-related ERP blunting. Taken together, both illness phase and age may impact reward processing among SZ, and brain aging may offer a promising, novel marker of reward dysfunction that warrants further study

An inflammation based score can optimize the selection of patients with advanced cancer considered for early phase clinical trials.

Background: Adequate organ function and good performance status (PS) are common eligibility criteria for phase I trials. As inflammation is pathogenic and prognostic in cancer we investigated the prognostic performance of inflammation-based indices including the neutrophil (NLR) and platelet to lymphocyte ratio (PLR). Methods: We studied inflammatory scores in 118 unselected referrals. NLR normalization was recalculated at disease reassessment. Each variable was assessed for progression-free (PFS) and overall survival (OS) on uni- and multivariate analyses and tested for 90 days survival (90DS) prediction using receiving operator curves (ROC). Results: We included 118 patients with median OS 4.4 months, 23% PS>1. LDH 65450 and NLR 655 were multivariate predictors of OS (p<0.001). NLR normalization predicted for longer OS (p<0.001) and PFS (p<0.05). PS and NLR ranked as most accurate predictors of both 90DS with area under ROC values of 0.66 and 0.64, and OS with c-score of 0.69 and 0.60. The combination of NLR+PS increased prognostic accuracy to 0.72. The NLR was externally validated in a cohort of 126 subjects. Conclusions: We identified the NLR as a validated and objective index to improve patient selection for experimental therapies, with its normalization following treatment predicting for a survival benefit of 7 months. Prospective validation of the NLR is warranted. Copyright: \ua9 2014 Pinato et al