99 research outputs found
Interactive White Board Use in a Second Grade Classroom During Content Area Lessons
Technology is quickly finding its way into each and every aspect of our lives, including in the elementary classroom. Many students have grown accustomed to having computers in their classrooms and now newer technologies, specifically IWBs, have entered the classroom and have the potential to help them to be successful. Because technology is constantly advancing and taking on a bigger role in the classroom, I believe that it is imperative that teachers are able to effectively integrate its many uses in ways that will benefit our students. Too often in the classroom technology is used in its most basic form and students are not given ample opportunities to reach their potential through the use of technology. For example, students use the computers to play games or word process a document or teachers use a projector or document camera to simply display information rather than using the available technology to create interactive lessons. By using technology, such as IWBs, teachers can create interactive lessons and students can become a part of the lesson and gain a better understanding of the content. Conducting this study will, I anticipate, reveal the positive role technology, in the form of an IWB, can have on student engagement during content area lessons
Straight Talk From Recent Grads: Grant Writing Tips for New Investigators
There is an increasing demand and critical importance for those in academic positions to be conducting high quality research in addition to teaching well and successfully obtaining grants is often necessary to fund such scientific inquiry (Shaw, 2002). Faculty members in academic or research positions are likely to be among those spending the most time on such efforts as successful grant writing to support both research and scholarly productivity is compulsory for flourishing in these jobs (Hasche, Perron & Proctor, 2009). In fact, most job announcements in the Chronicle of Higher Education list the ability to acquire external funding as a leading factor in hiring decisions among candidates. Successful grant writing is every bit as important for keeping a new job once it has been obtained as new faculty members failing to meet a high standard of funded research and scholarship are typically released from employment after a predetermined period of time (Cater, Lew, Smith, 2008). According to Inouye and Fiellin (2005), “the competition for funds to conduct clinical research is intense, and only a minority of grant proposals receive funding” (p. 274). Adding to the difficulty and pressure to secure extramural funding in a new research position, universities are currently receiving less federal and state funding and are relying more heavily on their faculty to obtain external grant money (Toews & Yazedjian, 2007)
Tips for New Scholars on Academic Publishing
When one looks at a list of common psychology words, terms and phrases along with their definitions; and then attempt to apply these to business organizations; it is amazing how psychology applies to business organizations in a very direct manner. Let’s review some common psychology words, terms, phrases and their definitions; and apply them to business organizations. Get ready for amazement and a revelation that will create much personal thought and serious discussions with others
Increasing Access to Care by Delivering Mental Health Services in Schools: The School-Based Support Program
It is widely estimated that approximately 25% of school age youth face mental and behavioral health challenges. The vast majority of these youth are insufficiently treated, leaving them vulnerable to negative school outcomes such as attendance, behavioral, and academic problems. One common barrier to treatment is a lack of access to appropriate and consistent care including assessment and intervention. Often when students are identified in schools as potentially struggling with mental health issues, the child is referred out to the community for treatment. While well-intended, this approach is largely unsuccessful if families face challenges such as a language barrier, a lack of transportation or health insurance, or lack of flexibility with their jobs leaving them unable to make appointments. A unique school–community partnership in North Carolina attempted to overcome these obstacles by bringing mental health services to youth at the school campuses. The School-Based Support program largely mitigated problems with access to care and made a positive impact on school outcomes for youth. This report from the field describes the consequences of untreated mental health problems among children, barriers to receiving mental health treatment, and ways student mental health needs are currently addressed in schools. We then detail how the School-Based Support program was formed through a school–community partnership, the program components, evaluation results, and a case example
A Case of Metastatic Squamous Cell Carcinoma in a Patient with Recessive Dystrophic Epidermolysis Bullosa that was Responsive to Pembrolizumab, a Programmed Cell Death Protein 1 Inhibitor
A case of metastatic squamous cell carcinoma in a patient with recessive dystrophic epidermolysis bullosa that was responsive to pembrolizumab, a programmed cell death protein 1 inhibitor.
Purpose: Cutaneous squamous cell carcinomas (SCCs) are the leading cause of death in patients with recessive dystrophic epidermolysis bullosa (RDEB). Management of SCCs in these patients is challenging with higher rates of recurrence and lymph nodes metastases. Although surgery is the first-line treatment in the majority of cases, certain clinical situations, such as local recurrence, or regional or distant metastasis, may call for nonsurgical treatment such as chemotherapy. We report the complex management of SCCs in a young female patient with RDEB whose nodal disease responded successfully to programmed cell death protein 1 (PD-1) inhibitor, pembrolizumab.
Design: Patient is a 29-year-old female with a long-standing history of RDEB that has been complicated by multifocal and recurrent SCC of the skin. She initially presented in 2015, at the age of 24, for SCC of the skin that was treated with a combination of Mohs micrographic surgery (MMS), wide local excision, and laser-assisted topical delivery of aminolevulinic acid. Over the following 6 months she developed several additional invasive SCCs. Surgical resection was again attempted, however, pathology revealed positive deep and lateral margins at 2 excision sites. Computed tomography (CT) scan at this time revealed bilateral pulmonary nodules and axillary nodes concerning for early metastatic disease. Left axillary node biopsy performed however, was negative for metastatic disease and these were thought to be consistent with a reactive process. Oncology recommended off-label palliative use of cetuximab given her multifocal disease and higher risk of metastasis in RDEB patients. She completed 4 cycles of cetuximab complicated by sepsis due to group G streptococcus, likely from a cutaneous source, as well as a grade 2 EGFR-associated acneiform eruption. After 4 cycles, her CT remained stable and there was no evidence of cutaneous recurrence, so the decision was made to discontinue cetuximab at this time. However, two years following the cessation of cetuximab she developed multiple cutaneous recurrences and a surveillance CT scan showed enlargement of her left axillary lymph nodes to a mass of 3.7 x 4.0 cm in size. Nodal biospy revealed metastatic SCC and molecular testing performed showed that 100% of tumor cells (tumor proportion score) were positive for PD-L1 staining. The decision was made to start pembrolizumab as off label therapy with plans to pursue axillary node excision after she completed treatment. At the completion of 4 cycles of pembrolizumab, a repeat CT scan showed improvement in the enlarged nodes with reduction to 2.2 x 1.4 cm in size and regional lymph node resection was successfully performed.
Summary: Pembrolizumab was the first PD-1 inhibitor approved by the FDA for metastatic melanoma. Recently in clinical trials, a new PD-1 inhibitor cemiplimab showed a 50% response rate in the treatment of cutaneous SCC and became the first systemic drug in it’s class to be approved for the treatment of locally advanced or metastatic cutaneous SCC. We report the first case of metastatic SCC in a RDEB patient that responded to treatment with PD-1 inhibitor, pembrolizumab.
Conclusion: Immunotherapy with PD-1 inhibitors, such as pembrolizumab may be an alternative treatment modality for SCC in RDEB patients with late stage or metastatic disease. Further larger scale studies are warranted to determine the utility of PD-1 inhibitors in the multimodal management of these high-risk patients.https://scholarlycommons.henryford.com/merf2020caserpt/1131/thumbnail.jp
Metastatic squamous cell carcinoma in a RDEB patient treated with pembrolizumab
A case of metastatic squamous cell carcinoma in a patient with recessive dystrophic epidermolysis bullosa that was responsive to pembrolizumab, a programmed cell death protein 1 inhibitor.
Purpose: Cutaneous squamous cell carcinomas (SCCs) are the leading cause of death in patients with recessive dystrophic epidermolysis bullosa (RDEB). Management of SCCs in these patients is challenging with higher rates of recurrence and lymph nodes metastases. Although surgery is the first-line treatment in the majority of cases, certain clinical situations, such as local recurrence, or regional or distant metastasis, may call for nonsurgical treatment such as chemotherapy. We report the complex management of SCCs in a young female patient with RDEB whose nodal disease responded successfully to programmed cell death protein 1 (PD-1) inhibitor, pembrolizumab.
Design: Patient is a 29-year-old female with a long-standing history of RDEB that has been complicated by multifocal and recurrent SCC of the skin. She initially presented in 2015, at the age of 24, for SCC of the skin that was treated with a combination of Mohs micrographic surgery (MMS), wide local excision, and laser-assisted topical delivery of aminolevulinic acid. Over the following 6 months she developed several additional invasive SCCs. Surgical resection was again attempted, however, pathology revealed positive deep and lateral margins at 2 excision sites. Computed tomography (CT) scan at this time revealed bilateral pulmonary nodules and axillary nodes concerning for early metastatic disease. Left axillary node biopsy performed however, was negative for metastatic disease and these were thought to be consistent with a reactive process. Oncology recommended off-label palliative use of cetuximab given her multifocal disease and higher risk of metastasis in RDEB patients. She completed 4 cycles of cetuximab complicated by sepsis due to group G streptococcus, likely from a cutaneous source, as well as a grade 2 EGFR-associated acneiform eruption. After 4 cycles, her CT remained stable and there was no evidence of cutaneous recurrence, so the decision was made to discontinue cetuximab at this time. However, two years following the cessation of cetuximab she developed multiple cutaneous recurrences and a surveillance CT scan showed enlargement of her left axillary lymph nodes to a mass of 3.7 x 4.0 cm in size. Nodal biopsy revealed metastatic SCC and molecular testing performed showed that 100% of tumor cells (tumor proportion score) were positive for PD-L1 staining. The decision was made to start pembrolizumab as off label therapy with plans to pursue axillary node excision after she completed treatment. At the completion of 4 cycles of pembrolizumab, a repeat CT scan showed improvement in the enlarged nodes with reduction to 2.2 x 1.4 cm in size and regional lymph node resection was successfully performed.
Summary: Pembrolizumab was the first PD-1 inhibitor approved by the FDA for metastatic melanoma. Recently in clinical trials, a new PD-1 inhibitor cemiplimab showed a 50% response rate in the treatment of cutaneous SCC and became the first systemic drug in it’s class to be approved for the treatment of locally advanced or metastatic cutaneous SCC. We report the first case of metastatic SCC in a RDEB patient that responded to treatment with PD-1 inhibitor, pembrolizumab.
Conclusion: Immunotherapy with PD-1 inhibitors, such as pembrolizumab may be an alternative treatment modality for SCC in RDEB patients with late stage or metastatic disease. Further larger scale studies are warranted to determine the utility of PD-1 inhibitors in the multimodal management of these high-risk patients.https://scholarlycommons.henryford.com/merf2020caserpt/1006/thumbnail.jp
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Adolescent Substance Use in the U.S.: Facts for Policymakers
Adolescence is an important period of physical, social, psychological, and cognitive growth. No longer children and not yet adults, adolescents make significant choices about their health and develop attitudes and health behaviors that continue into adulthood. Substance use disorders among adolescents can impede the attainment of important developmental milestones, including the development of autonomy, the formation of intimate interpersonal relationships, and general integration into adult society. Similarly, the use of alcohol and illicit substances by youth often leads to adverse health outcomes. Because heightened peer influence and a tendency towards risk taking are normal developmental changes in adolescence, experimentation with substances during this period is common. However, using drugs and alcohol at a young age increases the risk of dependency and addiction, and early onset of drinking increases the likelihood of alcohol-related injuries, motor vehicle crash involvement, unprotected intercourse, and interpersonal violence. The more risk an adolescent is exposed to, the more likely it is he or she will abuse substances. Some risk factors, such as peer influence, may be more powerful during adolescence, and likewise some protective factors, such as a strong sense of school belonging and a meaningful positive adult presence, can have a greater positive impact during this period. An important goal of substance abuse prevention is to reduce risk and increase protective factors in the lives of all adolescents, and particularly among disadvantaged youth
Miscarriage, Preterm Delivery, and Stillbirth: Large Variations in Rates within a Cohort of Australian Women
Objectives We aimed to use simple clinical questions to group women and provide their specific rates of miscarriage, preterm delivery, and stillbirth for reference. Further, our purpose was to describe who has experienced particularly low or high rates of each event. Methods Data were collected as part of the Australian Longitudinal Study on Women's Health, a national prospective cohort. Reproductive histories were obtained from 5806 women aged 31–36 years in 2009, who had self-reported an outcome for one or more pregnancy. Age at first birth, number of live births, smoking status, fertility problems, use of in vitro fertilisation (IVF), education and physical activity were the variables that best separated women into groups for calculating the rates of miscarriage, preterm delivery, and stillbirth. Results Women reported 10,247 live births, 2544 miscarriages, 1113 preterm deliveries, and 113 stillbirths. Miscarriage was correlated with stillbirth (r = 0.09, P<0.001). The calculable rate of miscarriage ranged from 11.3 to 86.5 miscarriages per 100 live births. Women who had high rates of miscarriage typically had fewer live births, were more likely to smoke and were more likely to have tried unsuccessfully to conceive for ≥12 months. The highest proportion of live preterm delivery (32.2%) occurred in women who had one live birth, had tried unsuccessfully to conceive for ≥12 months, had used IVF, and had 12 years education or equivalent. Women aged 14–19.99 years at their first birth and reported low physical activity had 38.9 stillbirths per 1000 live births, compared to the lowest rate at 5.5 per 1000 live births. Conclusion Different groups of women experience vastly different rates of each adverse pregnancy event. We have used simple questions and established reference data that will stratify women into low- and high-rate groups, which may be useful in counselling those who have experienced miscarriage, preterm delivery, or stillbirth, plus women with fertility intent
Presence of 5-hydroxyguaiacyl units as native lignin constituents in plants as seen by Py-GC/MS
Instituto de Recursos Naturales y AgrobiologĂa de Sevilla, CSIC, P.O. Box 1052, 41080-Seville, Spain
2Centro de Investigaciones BiolĂłgicas, CSIC, Ramiro de Maeztu 9, E-28040 Madrid, Spain
E-mail address: [email protected] (J.C. del RĂo)The presence of 5-hydroxyguaiacyl moieties in the lignin from several plants has been assessed by Py-GC/MS. Different woody (eucalypt) and nonwoody (flax, hemp, kenaf, jute, sisal and abaca) angiosperms were selected for this study. The pyrolysis of whole fibers released lignin-derived products with p-hydroxyphenyl, guaiacyl and syringyl structures. Indeed, a series of compounds having a 5-hydroxyguaiacyl nuclei, including 3-methoxycatechol, 5-vinyl-3-methoxycatechol and 5-propenyl-3-methoxycatechol, were detected and identified in all samples, although in lower amounts than the normal guaiacyl and syringyl compounds. The analysis of the lignins isolated from the same plants also indicated the presence of 5-hydroxyguaiacyl moieties in the isolated lignins. These compounds are supposed to arise from the pyrolysis of 5-hydroxyguaiacyl moieties, which are supposed to be native constituents of lignin in plants forming benzodioxane substructures.This study has been supported by the Spanish Ministerio de Ciencia y TecnologĂa (MCyT) and FEDER funds (project AGL2005-01748) and the EU project BIORENEW (NMP2-CT-2006-026456). We thank CELESA S.A. (Tortosa, Spain) for providing the nonwoody plant samples, and ENCE for providing the eucalypt wood sample.Peer reviewe
Federal Policing Structures - Mexico and Comparisons, ID: DipLab1927216
This report examines Mexico’s drug and police culture while analyzing police cultures in similarly organized countries. Drugs and cartels have a long and violent history within Mexico and the problem is spilling over the border into the United States. With corrupt and insufficiently trained police forces, the ability to effectively fight the drug war is extremely limited. Both the United States and Mexico have worked together to try to combat these connected issues, but more needs to be done. Key recommendations were found by analyzing the bipartite structures in Brazil and South Africa with a focus on Armenia. These recommendations include the following:
- Prioritize the interests of the people
- Standardized training
- Distinguish a disciplinary authority to investigate human rights violations
- Practice community-based policing using well-trained officers
- Senior National Guard positions not to be reserved for friends of political appointees
- Improve communication and information sharing
- U.S. Technology and systems recommendations
- Appoint a cabinet level Drug Czar
* Limitations to this research include the use of only online materials and database articles and journals
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