Using Community Colleges to Re-Connect Disconnected Youth

Argues that community colleges should be a major institution helping youth re-connect to education. Explores a variety of measures and reforms that community colleges would need to take to develop comprehensive and effective education programs

The First Round of Legislative Reforms in the Post-Serrano World

An overview of recent legislation in the field of educational finance reform which describes a number of similarities among the bills enacted after the Serrano decision but Before the first major reversals of some of the earlier decisions. Weaknesses common to these efforts are detailed and indications of future trends are suggested. An Appendix enumerates 1972-1973 school finance reforms in eleven different states

'Restoring Value' to the High School Diploma: The Rhetoric and Practice of Higher Standards

This policy brief examines the recent wave of commission reports that have attacked the American high school and called for its "reinvention." Two conceptions of rigor are dominant: test-based rigor, requiring higher scores on conventional tests; and course-based rigor, requiring more demanding courses. However, these conventional academic conceptions neglect several other conceptions of rigor: as depth rather than breadth; as more sophisticated levels of understanding including "higher-order skills"; and as the ability to apply learning in unfamiliar settings. With very few exceptions, both graduation requirements and exit exams replicate the conventional academic curriculum of the late nineteenth century, and they have little to say about how their imposition will enhance student performance generally. Overall, the push to enhance rigor and standards behind the high school diploma is seriously flawed. Moreover, any gains come at the expense of other goals for high school reform, including equity, curricular relevance, and student interest. A more promising approach to reshaping the high school involves pathways, structured around a coherent theme, either broadly occupational or non-occupational

The Federal Role in Vocational-Technical Education

The federal government first began to support vocational education with the Smith-Hughes Act of 1917. Its passage was controversial since there was considerable opposition to a federal role in education, which was a state responsibility. Since that time, the federal government has had constant involvement with vocational education through Smith-Hughes and its successor acts, including the Carl D. Perkins Vocational and Technical Education Act, which is currently in effect. As recent legislation has primarily focused on supporting academic achievement, it is as yet unclear what the federal government’s approach toward vocational education will be

The Federal Role in Vocational-Technical Education

The federal government first began to support vocational education with the Smith-Hughes Act of 1917. Its passage was controversial since there was considerable opposition to a federal role in education, which was a state responsibility. Since that time, the federal government has had constant involvement with vocational education through Smith-Hughes and its successor acts, including the Carl D. Perkins Vocational and Technical Education Act, which is currently in effect. As recent legislation has primarily focused on supporting academic achievement, it is as yet unclear what the federal government’s approach toward vocational education will be

Trends in surgical aortic valve replacement in pre- and post-transcatheter aortic valve replacement eras at a structural heart center

BackgroundThe advent of transcatheter aortic valve replacement (TAVR) has directly impacted the lifelong management of patients with aortic valve disease. The U.S. Food and Drug Administration has approved TAVR for all surgical risk: prohibitive (2011), high (2012), intermediate (2016), and low (2019). Since then, TAVR volumes are increasing and surgical aortic valve replacements (SAVR) are decreasing. This study sought to evaluate trends in isolated SAVR in the pre- and post-TAVR eras.MethodsFrom January 2000 to June 2020, 3,861 isolated SAVRs were performed at a single academic quaternary care institution which participated in the early trials of TAVR beginning in 2007. A formal structural heart center was established in 2012 when TAVR became commercially available. Patients were divided into the pre-TAVR era (2000–2011, n = 2,426) and post-TAVR era (2012–2020, n = 1,435). Data from the institutional Society of Thoracic Surgeons National Database was analyzed.ResultsThe median age was 66 years, similar between groups. The post-TAVR group had a statistically higher rate of diabetes, hypertension, dyslipidemia, heart failure, more reoperative SAVR, and lower STS Predicted Risk of Mortality (PROM) (2.0% vs. 2.5%, p < 0.0001). There were more urgent/emergent/salvage SAVRs (38% vs. 24%) and fewer elective SAVRs (63% vs. 76%), (p < 0.0001) in the post-TAVR group. More bioprosthetic valves were implanted in the post-TAVR group (85% vs. 74%, p < 0.0001). Larger aortic valves were implanted (25 vs. 23 mm, p < 0.0001) and more annular enlargements were performed (5.9% vs. 1.6%, p < 0.0001) in the post-TAVR era. Postoperatively, the post-TAVR group had less blood product transfusion (49% vs. 58%, p < 0.0001), renal failure (1.4% vs. 4.3%, p < 0.0001), pneumonia (2.3% vs. 3.8%, p = 0.01), shorter lengths of stay, and lower in-hospital mortality (1.5% vs. 3.3%, p = 0.0007).ConclusionThe approval of TAVR changed the landscape of aortic valve disease management. At a quaternary academic cardiac surgery center with a well-established structural heart program, patients undergoing isolated SAVR in the post-TAVR era had lower STS PROM, more implantation of bioprosthetic valves, utilization of larger valves, annular enlargement, and lower in-hospital mortality. Isolated SAVR continues to be performed in the TAVR era with excellent outcomes. SAVR remains an essential tool in the lifetime management of aortic valve disease

Study Protocol - Accurate assessment of kidney function in Indigenous Australians: aims and methods of the eGFR Study

Background: There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians