Fifty Definitions of English Learner: A Proposed Solution to Inconsistent State-by-State Systems in the United States for Classifying Students Who Speak English as a Second Language

Although nearly one in 10 U.S. students is an English Learner (or EL), the definition of the term EL varies considerably from state to state, as does the means of assessing English language proficiency and the period of time for which the label is applied to individual students. As EL populations are growing throughout the U.S., both in school systems familiar with teaching ELs and in systems that do not have such experience, it is urgent that the methods by which this population is identified and by which its needs are met in acquiring English language proficiency are backed up by evidence and, ideally, standardized at the national level. In this article, after reviewing the current decentralized climate of EL identification, classification and reclassification, we propose a new definition of English Learner that both resolves inconsistencies in current state-level practices and would include many practicing ELs who are often excluded from current state-level definitions

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Congnitive socialization and its mediatization through cultural contexts

Resumen: se integra la literatura sobre la interacción adulto-niño, uniendo los factores relacionados al Nivel Socio Económico (NSE) con las diferencias en la socialización. La primera sección delinea las preguntas teóricas y de investigación relacionadas con la influencia del NSE en los patrones de interacción adulto-niño. La segunda sección provee de un ejemplo de ambas, la dominante y los estudios Cultural-Historical Activity Theory (CHAT) respecto de la interacción adulto-niño con conexiones a las diferencias en mediación del NSE. La tercera sección se enfoca en la construcción histórica del nivel socioeconómico, junto con las diferencias del NSE y el capital cultural. Se traza un modelo que articula la relación dinámica entre los individuos y la sociedad a través de la participación en encuadres de actividad en el tiempo. En la última sección se identifican conclusiones y áreas para futura investigación.Abstract: Literature about adult-child interaction becomes integrated by connecting the factors related to the Socioeconomic Level (SEL) with the differences in socialization. The first section outlines theoretical and research questions related to SEL influence on adult-child interaction patterns. The second section supplies an example of both, the dominant one and the studies on the Cultural-Historical Activity Theory (CHAT) regarding adult-child interaction with connections to the differences in SEL mediation. The third section focuses on the historical construction of the socioeconomic level, together with SEL differences and cultural assets. A model that articulates the dynamic relationship between individuals and society is drawn by means of the participation in activity frameworks in time. In the last section, conclusions and areas for future research are identified

Comprensión de las diferencias de sexo en la adaptación de los niños al divorcio : inferencia en la práctica

Resumen: el presente trabajo trata algunos de los temas actuales con los que se enfrentan los profesionales e investigadores al comprender las diferencias en el sexo del niño que se adapta al divorcio. Las diferencias de género en la adaptación evolutiva del niño ante el divorcio se encuentran influenciadas por los procesos de desarrollo previos y posteriores al divorcio, las expectativas de los padres y la habilidad del niño para hacerle frente. Investigaciones actuales indican que los niños y las niñas se ven afectados de forma diferente por el divorcio, donde los niños experimentan un desajuste mayor a los procesos relacionados con el divorcio. Se brindan recomendaciones para los profesionales que trabajan con los niños del divorcio y sus familias en el hogar y en la escuela.Abstract: The present paper discusses some of the current issues confronting practitioners and researchers in understanding gender differences in children’s adjustment to divorce. Gender differences in children’s developmental adjustment to divorce are influenced by pre and post divorce development processes, parent expectation and children’s coping abilities. Current research indicates that boys and girls are affected differentially by divorce with boys experiencing greater maladjustment resulting from divorce related processes. Recommendations are provided for practitioners who work with children of divorce and their families in the home and school