Preparing Teachers Who Can Effectively Assess Students with Disabilities

This qualitative interview study examined the classroom assessment knowledge and beliefs of five recent graduates of the University of New Mexico Special Education Dual License Program (SEDLP). Research questions were designed to gain an understanding in three areas. First, in what ways did recent SEDLP graduates characterize their level of competence (theoretical understanding and practical application) in assessing the progress of students with disabilities in the classroom? Second, in what ways do SEDLP graduates report that they use classroom assessment to inform classroom instruction? Third, what features of the SEDLP teacher preparation program do graduates identify as having positively or negatively impacted their ability to effectively use classroom assessments? To answer these questions, each participant was interviewed twice using a semi-structured question format and constant-comparative methodology. The results showed participant knowledge and specific practices in addressing student affective needs, broadening the application of assessments by individualizing and differentiating, meeting district requirements for assessments, using measurable assessment criteria, and using frequent informal assessment. Classroom instruction was most impacted as participants determined next steps to address knowledge gaps or intervene behaviorally. The SEDLP was characterized as positively impacting classroom assessment in the areas of providing assessment models, multiple examples of types, multiple informal assessment practice opportunities, and organizational and resource availability. It was characterized as lacking instruction in the areas of writing formal assessments and providing opportunities to learn and practice assessments in math. These results lead to implications for future practice and research that are discussed

Drug Cartels and the International Organization of Drug Trafficking in the 21st Century

This research is a brief overview of the new cartels emerging to dominate today\u27s international traffic in drugs. In terms of geographic reach, economic impact, and imperiousness to law enforcemnt, drug cartels became the dominant form of organized crime in the last two decades of the 20th century. In the 21st century drug cartels have taken advatage of the massive increases in international trade and commerce and have learned from the mistakes of the earlier cartels. The new cartels are more numerous, flexible, chameleonic in their nature, and durable than any we have seen before

Production and Purification of the Heavy Chain Fragment C of Botulinum Neurotoxin, Serotype A, Expressed in the Methylotrophic Yeast \u3ci\u3ePichia pastoris\u3c/i\u3e

A recombinant Hc fragment of botulinum neurotoxin, serotype A (rBoNTA(Hc)), has been successfully expressed in a Mutt strain of the methylotrophic yeast Pichia pastoris for use as an antigen in a proposed human vaccine. Fermentation employed glycerol batch, glycerol-fed batch, and methanol-fed batch phases to achieve high cell density. Induction times were short to maximize rBoNTA(Hc) production while minimizing proteolytic degradation. Concentration of rBoNTA(Hc) in yeast cell lysates was generally 1-2% of the total protein based on ELISA analysis. The Hc fragment was purified from cell lysates using a multistep ion-exchange (IEC) chromatographic process, including SP, Q, and HS resins. The zwitterionic detergent Chaps was included in the buffer system to combat possible interactions, such as protein-protein or protein-DNA interactions. Following IEC was a hydrophobic interaction chromatography (HIC) polishing step, using phenyl resin. The Hc fragment was purified to \u3e95% purity with yields up to 450 mg/kg cells based on ELISA and Bradford protein assay. The purified Hc fragment of serotype A was stable, elicited an immune response in mice, and was protected upon challenge with native botulinum type A neurotoxin

Parity and Components of the Metabolic Syndrome Among US Hispanic/Latina Women

BACKGROUND: Physiological adaptations occurring across successive pregnancies may increase the risk of adverse cardiovascular health outcomes in later life. METHODS AND RESULTS: The association between parity and metabolic syndrome was examined among 7467 Hispanic/Latina women of diverse backgrounds, aged 18 to 74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from 2008 to 2011. Metabolic syndrome components were defined according to American Heart Association/National Heart, Lung, and Blood Institute criteria and included abdominal obesity, elevated triglycerides, low high-density lipoprotein cholesterol, high blood pressure, and elevated fasting glucose. Logistic regression models estimated odds ratios (ORs) adjusting for sociodemographic, behavioral, and reproductive characteristics. At HCHS/SOL baseline, women reported none (21.1%), 1 (19.9%), 2 (25.7%), 3 (18.6%), 4 (8.8%), and ≥ 5 (5.9%) live births. When compared with women with 1 birth, those with 4 births had the highest odds of abdominal obesity (OR, 2.0; 95% confidence interval, 1.5-2.8) and overall metabolic syndrome (OR, 1.4; 95% confidence interval, 1.0-2.0) and those with ≥ 5 births had the highest odds of low high-density lipoprotein cholesterol (OR, 1.5; 95% confidence interval, 1.2-2.0) and elevated fasting glucose (OR, 1.6; 95% confidence interval, 1.1-2.4), after adjusting for age, background, education, marital status, income, nativity, smoking, physical activity, menopause, oral contraceptive use, hormone therapy, and field center. Further adjustment for percent body fat attenuated these associations. No associations were observed between parity and elevated triglycerides or high blood pressure. CONCLUSIONS: Higher parity is associated with an increased prevalence of selected components of the metabolic syndrome among Hispanic/Latina women in the US. High parity among Hispanics/Latinas with a high prevalence of abdominal obesity suggests high risk for metabolic dysregulation

Oncology Outpatient and Provider Responses to a Computerized Symptom Assessment System

Purpose/Objectives: To assess patient and provider responses to a computerized symptom assessment system. Design: Descriptive, longitudinal study with retrospective, longitudinal medical records review. Setting: University-based National Cancer Institute-designated outpatient cancer center. Sample: 80 oncology outpatients receiving chemotherapy, 8 providers, and 30 medical records. Methods: Patients completed the computerized assessment during three chemotherapy follow-up clinic appointments (times 1, 2, and 3). Patient usability was recorded via an observer checklist (ease of use) and the computer (completion time). Patient satisfaction and impact were assessed during telephone interviews two to three days after times 1 and 3 only. Provider usability and impact were assessed at the end of the study using a questionnaire and focus groups, whereas effect on provider documentation was assessed through chart audits. Main Research Variables: Patient usability (ease of use, completion time), satisfaction, and impact; provider usability and impact. Findings: Patients reported good usability, high satisfaction, and modest impact on discussions with their providers. Providers reported modest usability, modest impact on discussions with patients, and had varied reactions as to how the system affected practice. Documentation of symptoms was largely absent before and after implementation. Conclusions: This system demonstrated good usability and satisfaction but had only a modest impact on symptom-related discussions and no impact on documentation. Implications for Nursing: A computerized system can help address barriers to symptom assessment but may not improve documentation unless it can be integrated into existing medical records systems

Rasch analysis of the long-term conditions questionnaire (LTCQ) and development of a short-form (LTCQ-8)

Background The aim of the current study was to evaluate the structural validity of the 20-item long-term conditions questionnaire (LTCQ) and to explore a potential short-form version of the scale using Rasch analysis. Methods Data were collected through postal surveys (February 2016–January 2017) from a sample of 1,211 participants diagnosed with at least one long-term condition (LTC). Identified participants were invited through either local authorities for a social care cohort (n = 294) or primary care practices for a health care cohort (n = 917). Participants were mailed a survey, including the LTCQ, demographic questions, a comorbidities measure, and other validated outcome measures. Respondents were invited to complete a follow-up survey including the LTCQ for assessment of reproducibility. Results The main assumptions of the Rasch model from the LTCQ were fulfilled, although infit and outfit indices indicated some items showed misfit. Misfitted items, items that did not have a preceding set or showed some local dependence were removed one at a time, with the remaining candidate items to form an 8-item short version, the LTCQ-8. The Rasch model for the LTCQ-8 explained 64% variance and had a reliability estimate greater than 0.80. Several items in the LTCQ showed uniform differential item function (DIF) in relation to the number of reported LTCs, age, cohort and type of LTCs, but fewer items exhibited DIF in the LTCQ-8. Spearman’s rho correlations between the LTCQ and the LTCQ-8 were strong across the total sample and various subgroups. Correlations between the LTCQ-8 and all reference measures were moderate to strong, and comparable to correlations found between the LTCQ and these measures. Conclusions The LTCQ measures a unidimensional construct, and it is therefore acceptable to use a summed total score. The LTCQ-8 also met the assumption of unidimensionality and had comparable construct validity with the LTCQ. Additional validation is required in an independent sample

A calcium channel or angiotensin converting enzyme inhibitor/angiotensin receptor blocker regime to reduced blood pressure variability in acute ischaemic stroke (CAARBS): A feasibility trial

Background: Trials of lowering blood pressure in patients with acute ischaemic stroke not undergoing thrombolysis have not demonstrated improved outcomes with intervention. Rather than absolute levels, it may be that blood pressure variability is important. However, there are no prospective randomised trials investigating the benefit of reducing blood pressure variability in this patient group. Aims: The primary aim of this trial was to determine the feasibility of recruitment to a randomised trial investigating the effect of different antihypertensive medications on blood pressure variability. Methods: CAARBS was a multi-centre, open-label, randomised parallel group controlled feasibility trial. Adults with a first mild-moderate ischaemic stroke or transient ischaemic attack, requiring antihypertensive therapy for secondary prevention, were randomised to a calcium channel blocker or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. Blood pressure and variability were measured at baseline, three weeks, and three months. Compliance with measurements and treatment was monitored. Results: Fourteen patients were recruited to the trial (0.6% of those screened), nine of whom completed follow-up. The majority of patients screened (98.1%) were ineligible. Compliance with the intervention was good, as were measurement completion rates (88.9% or higher in all cases except ambulatory measurements). No major adverse events were recorded. Conclusions: Recruitment to the trial was difficult due to patient ineligibility, suggesting that the current protocol is unlikely to be successful if scaled for a definitive trial. However, the intervention was safe, and compliance was good, suggesting a future trial with modified eligibility criteria could be successful. Trial registration: ISRCTN10853487

Genetic variation in prostaglandin E2 synthesis and signaling, prostaglandin dehydrogenase, and the risk of colorectal adenoma.

BACKGROUND: Prostaglandins are important inflammatory mediators; prostaglandin E2 (PGE2) is the predominant prostaglandin in colorectal neoplasia and affects colorectal carcinogenesis. Prostaglandins are metabolites of omega-6 and omega-3 polyunsaturated fatty acids; their biosynthesis is the primary target of nonsteroidal anti-inflammatory drugs (NSAID), which reduce colorectal neoplasia risk. METHODS: We investigated candidate and tagSNPs in PGE2 synthase (PGES), PGE2 receptors (EP2 and EP4), and prostaglandin dehydrogenase (PGDH) in a case-control study of adenomas (n = 483) versus polyp-free controls (n = 582) and examined interactions with NSAID use or fish intake, a source of omega-3 fatty acids. RESULTS: A 30% adenoma risk reduction was observed for EP2 4950G>A (intron 1; OR(GA/AA vs. GG), 0.71; 95% confidence interval, 0.52-0.99). For the candidate polymorphism EP4 Val294Ile, increasing fish intake was associated with increased adenoma risk among those with variant genotypes, but not among those with the Val/Val genotype (P(interaction) = 0.02). An interaction with fish intake was also observed for PGES -664A>T (5' untranslated region; P(interaction) = 0.01). Decreased risk with increasing fish intake was only seen among those with the AT or TT genotypes (OR(>2 t/wk vs. A (intron 1) and PGDH 343C>A (intron 1). However, none of the observed associations was statistically significant after adjustment for multiple testing. We investigated potential gene-gene interactions using the Chatterjee 1 degree of freedom Tukey test and logic regression; neither method detected significant interactions. CONCLUSIONS: These data provide little support for associations between adenoma risk and genetic variability related to PGE(2), yet suggest gene-environment interactions with anti-inflammatory exposures

No reduction in C-reactive protein following a 12-month randomized controlled trial of exercise in men and women.

Low-grade systemic inflammation is suggested to play a role in the development of several chronic diseases including cancer. Higher levels of physical activity and lower adiposity have been associated with reduced levels of markers of systemic inflammation, such as C-reactive protein (CRP); however, reductions in CRP have not been observed consistently in randomized controlled trials of exercise. Purpose: To examine the effect of a 12-month aerobic exercise intervention on CRP levels in men and women. Methods: 102 men and 100 women, sedentary and aged 40-75 years, mean BMI of 29.9 and 28.7 kg/m2, respectively, were randomly assigned to a 12-month moderate-to-vigorous aerobic exercise intervention (6 d/wk, 60 min/d, 60-85% maximum heart rate) or control group. Fasting blood samples were collected at baseline and at 12-months. CRP levels were measured by high-sensitivity latex-enhanced nephelometry. Results: At baseline, CRP was 1.16 mg/L and 2.11 for men and women, respectively, and CRP was correlated with percent body fat (r=0.48, p ≤0.001), BMI (r=0.37, p ≤0.001) and aerobic fitness (r=-0.49, p ≤0.001). No intervention effects were observed for CRP in men or women, or when stratified by baseline BMI (< 30 kg/m2 vs. ≥ 30 kg/m2) , baseline CRP (< 3 mg/L vs. ≥ 3 mg/L) or change in body weight, body composition or aerobic fitness. Conclusion: A 12 month moderate-to-vigorous aerobic exercise intervention did not affect CRP levels in previously sedentary men or women with average-risk CRP values at baseline