High-Stakes Testing and Student Achievement: Problems for the No Child Left Behind Act

Under the federal No Child Left Behind Act of 2001 (NCLB), standardized test scores are the indicator used to hold schools and school districts accountable for student achievement. Each state is responsible for constructing an accountability system, attaching consequences -- or stakes -- for student performance. The theory of action implied by this accountability program is that the pressure of high-stakes testing will increase student achievement. But this study finds that pressure created by high-stakes testing has had almost no important influence on student academic performance

Judy Nichols and Sharon Fields in a Joint Senior Piano Recital

This is the program for the joint senior piano recital of Judy Nichols and Sharon Fields. The recital took place on January 21, 1971

Provas de consequências severas e desempenho do aluno: análise atualizada de dados NAEP

The present research is a follow-up study of earlier published analyses that looked at the relationship between high-stakes testing pressure and student achievement in 25 states. Using the previously derived Accountability Pressure Index (APR) as a measure of state-level policy pressure for performance on standardized tests, a series of correlation analyses was conducted to explore relationships between high-stakes testing accountability pressure and student achievement as measured by the National Assessment for Education Progress (NAEP) in reading and math. Consistent with earlier work, stronger positive correlations between the pressure index and NAEP performance in fourth grade math and weaker connections between pressure and fourth and eighth grade reading performance were found. Policy implications and future directions for research are discussed.Este estudio da seguimiento a investigaciones ya publicadas que analizaron la relación entre las presiones de las pruebas de consecuencias severas y el rendimiento de estudiantes en 25 estados. Utilizando el Índice de Presión y Responsabilidad (APR por su sigla en inglés) como medida de presión política a nivel estatal sobre el rendimiento en los exámenes estandarizados, se realizaron una serie de análisis de correlación para explorar las relaciones entre pruebas de consecuencias severas, rendición de cuentas y rendimiento de los estudiantes, medidos por los resultados de el Instituto Nacional Evaluación para el Progreso de la Educación (NAEP por su sigla en inglés) en lectura y matemáticas. Consistente con resultados de trabajos anteriores, las correlaciones positivas más fuertes fueron entre el índice de presión y el rendimiento de la NAEP en matemáticas en cuarto grado y las conexiones más débiles entre la presión y el rendimiento de lectura en cuarto y octavo grado. El trabajo concluye con implicaciones para las políticas educativas y sugerencias para continuar investigando este tema.Este estudo prossegue uma investigação anteriormente publicada que examinou a relação entre as provas de consequências severas e o desempenho de alunos em 25 estados. Usando o Índice de Pressão e Responsabilidade (APR –  sigla em Inglês) como medida de pressão política a nível estadual sobre o desempenho em testes padronizados foram realizados uma série de correlações para explorar as relações entre provas de  consequências severas,  prestação de contas e desempenho dos alunos, medidos pelos resultados da Avaliação Nacional do Progresso educacional (NAEP –  sigla em Inglês) em leitura e matemática. Consistente com os resultados de estudos anteriores, as correlações positivas foram mais fortes entre o índice de pressão e desempenho em NAEP em matemática na quarta série e ligações mais fracas entre pressão e desempenho de leitura na quarta e oitava séries. O artigo conclui com implicações para as políticas educacionais e sugestões para futuras pesquisas nesse tema

NEPC Review: Lessons From State Performance on NAEP: Why Some High-Poverty Students Score Better Than Others

This Center for American Progress report examines whether states’ adoption of standards-based policies predicts low-income students’ NAEP achievement trends in fourth and eighth grade math and reading throughout the 2003-2013 decade. The report claims to analyze changes across five separate two-year intervals, but it only reports findings for 2009-2011, with no explanation of why or any documentation of the representativeness of that single interval. The reported finding for the selected interval is that state adoption of standards policies positively predicts fourth (but not eighth) grade math NAEP and eighth (but not fourth) grade reading NAEP. Even these selected positive results are statistically significant only at the generally unacceptable 0.10 level of significance. The report includes effect sizes but nothing about the percent of the variance explained in their model. In short, the report does not adequately describe variables or analytic methods or completely report findings, and the data and methods used do not allow for any causal findings. They use state standards adoption across grade levels and subject areas as well as selected accountability mandates as predictors but fail to assess their quality or fidelity of implementation. Yet based on these very problematic and limited analyses, the authors conclude that their analysis “strongly supports the potential of the Common Core to drive improvements in educational outcomes.” The study simply does not support this conclusion or the set of recommendations that follow

High-Stakes Testing and Student Achievement: Does Accountability Pressure Increase Student Learning?

This study examined the relationship between high-stakes testing pressure and student achievement across 25 states. Standardized portfolios were created for each study state. Each portfolio contained a range of documents that told the “story” of accountability implementation and impact in that state. Using the “law of comparative judgments,” over 300 graduate-level education students reviewed one pair of portfolios and made independent evaluations as to which of the two states’ portfolios reflected a greater degree of accountability pressure. Participants’ judgments yielded a matrix that was converted into a single rating system that arranged all 25 states on a continuum of accountability “pressure” from high to low. Using this accountability pressure rating we conducted a series of regression and correlation analyses. We found no relationship between earlier pressure and later cohort achievement for math at the fourth- and eighth-grade levels on the National Assessment of Educational Progress tests. Further, no relationship was found between testing pressure and reading achievement on the National Assessment of Education Progress tests at any grade level or for any ethnic student subgroup. Data do suggest, however, that a case could be made for a causal relationship between high-stakes testing pressure and subsequent achievement on the national assessment tests—but only for fourth grade, non-cohort achievement and for some ethnic subgroups. Implications and directions for future studies are discussed

Cefepime Neurotoxicity in an Adolescent Cystic Fibrosis Patient with Aminoglycoside-Induced Acute Kidney Injury

Objective: To describe a case of cefepime neurotoxicity in an adolescent with cystic fibrosis and aminoglycoside-associated acute kidney injury (AKI). Case Summary: A 15-year-old, 46-kg male with cystic fibrosis (CF) and chronic sinusitis was admitted to the hospital for CF exacerbation. The patient was subsequently discharged to complete home antibiotic therapy with intravenous gentamicin and cefepime. Thirteen days after discharge, while still receiving intravenous antibiotics, the patient presented to an outside hospital complaining of vomiting, fatigue, decreased appetite, and decreased urine output. The patient was diagnosed with AKI and was transferred to our institution, where he displayed signs and symptoms consistent with encephalopathy. Encephalopathy was thought to be consistent with cefepime-associated neurotoxicity. After 2 hemodialysis sessions, the encephalopathy resolved. Over the course of admission, the patient\u27s renal function improved. Discussion: This patient experienced neurotoxicity thought to be secondary to cefepime in the setting of AKI. Aminoglycoside therapy most likely led to the AKI. We believe that our patient represents the fourth pediatric patient with cefepime-associated encephalopathy described in the literature and the second without chronic renal dysfunction. Conclusions: Children receiving cefepime should be monitored for AKI. In the presence of AKI, cefepime doses may need to be adjusted and the patient should be monitored for signs and symptoms of neurotoxicity

Psychological Symptoms Among 2032 Youth Living with HIV: A Multisite Study

This study determined the prevalence and patterns of psychological symptoms in adolescents and young adults living with HIV (YLWH) in medical care and relationships between psychological symptoms, route and duration of infection, and antiretroviral treatment (ART). A clinic-based sample of 2032 YLWH (mean age 20.3 years), recruited from 20 adolescent medicine HIV clinics, completed a cross-sectional survey of health behaviors and psychological symptoms using the Brief Symptom Inventory (BSI). Overall, 17.5% of youth reported psychological symptoms greater than the normative threshold on the Global Severity Index. A wide variety of symptoms were reported. The prevalence of clinical symptoms was significantly greater in youth with behaviorally acquired HIV compared to those with perinatally acquired infection (20.6% vs. 10.8%, OR=2.06 in Multiple Logistic Regression (MLR)), and in those not taking ART that had been prescribed (29. 2% vs. 18.8%, OR=1.68 in MLR). Knowing one's HIV status for more than one year and disclosure of HIV status were not associated with fewer symptoms. A large proportion of YLWH have psychological symptoms and the prevalence is greatest among those with behaviorally acquired infection. The high rate of psychological symptoms for youth not taking ART that is prescribed is a cause for concern. Symptoms do not appear to be a transient reaction to diagnosis of HIV.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140176/1/apc.2014.0113.pd

Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention

Background: Trauma patients with penetrating vascular injuries have a higher rate of venous thromboembolism (VTE). The objective of this study was to determine the risk of VTE formation in penetrating femoral and popliteal vascular injuries and the effects of endovascular management of these injuries. Methods: A retrospective study of Pennsylvania Trauma Outcome Study registry was conducted during a 5-year period (2013-2017). All adult patients with a penetrating mechanism with femoral/popliteal vascular injuries were studied. Primary outcome was incidence of VTE in patients with isolated arterial injuries versus combined arterial/venous injuries. Secondary endpoints were intensive care unit (ICU) length of stay (LOS), hospital LOS and mortality. Statistical comparisons were accomplished using Fisher\u27s exact tests, and parametric two-sample t-tests or non-parametric Wilcoxon rank-sum tests for categorical and continuous variables, respectively. Results: Of the 865 patients with penetrating extremity vascular injuries, 207 had femoral or popliteal artery injuries. Patients with isolated arterial injuries (n=131) had a significantly lower deep venous thrombosis (DVT) rate compared with those with concurrent venous injuries (n=76) (3.1% vs. 13.2%, p=0.008). There were 14 patients in the study who developed DVTs. Among the four patients with isolated femoral or popliteal arterial injuries who had developed DVTs, three had an open repair. Among patients with isolated arterial injuries, those with DVT spend significantly more time on the ventilator (median=2 vs. 0, p=0.0020) compared with patients without DVT. Patients with DVT also had longer stay in the hospital (median=17.5 vs. 8, p=0.0664) and in the ICU (median=3 vs. 1, p=0.0585). Conclusions: Risk of DVT exists in patients with penetrating isolated femoral and popliteal artery trauma. Open repair was associated with significantly higher DVT rates in isolated arterial injuries. Level of evidence: Level IV therapeutic care/management

Integrating Behavioral Health & Primary Care in New Hampshire: A Path Forward to Sustainable Practice & Payment Transformation

New Hampshire residents face challenges with behavioral and physical health conditions and the interplay between them. National studies show the costs and the burden of illness from behavioral health conditions and co-occurring chronic health conditions that are not adequately treated in either primary care or behavioral health settings. Bringing primary health and behavioral health care together in integrated care settings can improve outcomes for both behavioral and physical health conditions. Primary care integrated behavioral health works in conjunction with specialty behavioral health providers, expanding capacity, improving access, and jointly managing the care of patients with higher levels of acuity In its work to improve the health of NH residents and create effective and cost-effective systems of care, the NH Citizens Health Initiative (Initiative) created the NH Behavioral Health Integration Learning Collaborative (BHI Learning Collaborative) in November of 2015, as a project of its Accountable Care Learning Network (NHACLN). Bringing together more than 60 organizations, including providers of all types and sizes, all of the state’s community mental health centers, all of the major private and public insurers, and government and other stakeholders, the BHI Learning Collaborative built on earlier work of a NHACLN Workgroup focused on improving care for depression and co-occurring chronic illness. The BHI Learning Collaborative design is based on the core NHACLN philosophy of “shared data and shared learning” and the importance of transparency and open conversation across all stakeholder groups. The first year of the BHI Learning Collaborative programming included shared learning on evidence-based practice for integrated behavioral health in primary care, shared data from the NH Comprehensive Healthcare Information System (NHCHIS), and work to develop sustainable payment models to replace inadequate Fee-for-Service (FFS) revenues. Provider members joined either a Project Implementation Track working on quality improvement projects to improve their levels of integration or a Listen and Learn Track for those just learning about Behavioral Health Integration (BHI). Providers in the Project Implementation Track completed a self-assessment of levels of BHI in their practice settings and committed to submit EHR-based clinical process and outcomes data to track performance on specified measures. All providers received access to unblinded NHACLN Primary Care and Behavioral Health attributed claims data from the NHCHIS for provider organizations in the NH BHI Learning Collaborative. Following up on prior work focused on developing a sustainable model for integrating care for depression and co-occurring chronic illness in primary care settings, the BHI Learning Collaborative engaged consulting experts and participants in understanding challenges in Health Information Technology and Exchange (HIT/HIE), privacy and confidentiality, and workforce adequacy. The BHI Learning Collaborative identified a sustainable payment model for integrated care of depression in primary care. In the process of vetting the payment model, the BHI Learning Collaborative also identified and explored challenges in payment for Substance Use Disorder Screening, Brief Intervention and Referral to Treatment (SBIRT). New Hampshire’s residents will benefit from a health care system where primary care and behavioral health are integrated to support the care of the whole person. New Hampshire’s current opiate epidemic accentuates the need for better screening for behavioral health issues, prevention, and treatment referral integrated into primary care. New Hampshire providers and payers are poised to move towards greater integration of behavioral health and primary care and the Initiative looks forward to continuing to support progress in supporting a path to sustainable integrated behavioral and primary care