By Practitioners, For Practitioners: Informing and Empowering Practice Through Practitioner Research

The National Youth-At-Risk Journal was developed to provide meaningful information and resources for professionals who work with youth placed at risk. In order to further this goal, we are calling on practitioners to communicate directly with their colleagues via the journal. We are especially interested in publishing practitioner reports on effective programs, strategies, or interventions that improve both the practice and well-being of youth. The editors provide an overview of practitioner research, describe three approaches to practitioner research, outline the process for conducting practitioner research, and emphasize the role of practitioner-researchers as agents of change. Resources are provided to assist practitioners in conducting research and in reporting their experiences and outcomes

Making the American Dream a Reality for All Youth: Introduction to the First Issue of the \u3ci\u3eNational Youth-At-Risk Journal\u3c/i\u3e

This editorial provides an introduction to the first issue of the National Youth-At-Risk Journal. Information highlighted regarding the journal includes its mission, historical background and inspiration, and holistic aims and scope. Biased and realistic uses of the phrase “at risk” are also addressed. The editorial also introduces the journal editors and presents a preview of issue content

Educating Students in Poverty: Building Equity and Capacity with a Holistic Framework and Community School Model

Educators are often blamed for the achievement gap between low-income and higher income students. We propose to replace the divisive “blame game” with a holistic framework for collaborative action between schools, families, and communities. This 5H Holistic Framework (5HHF) is composed of the 5H protective factors (Health, Hands, Heart, Head, Home). These protective factors holistically address the educational needs and capacities of all students—especially students in poverty—for physical/mental health (Health), safety/security (Hands), social-emotional care (Heart), cognitive development (Head), and family/community support (Home). The 5HHF is used to identify and organize best educational practices and to recommend the community school model to reduce the income-based achievement gap and promote student well-being. The 5HHF of best practices and community school model expands the collective capacity of schools, families, and communities to meet equitably the educational needs of students in poverty and to enhance their opportunities for a quality education. Furthermore, we show how the 5HHF and community school model are aligned with and supported by the Every Student Succeeds Act (ESSA)

The Every Student Succeeds Act (ESSA): What It Means for Educators of Students at Risk

This editorial perspective examines some ways that the Every Student Succeeds Act (ESSA), which becomes operational in the 2017–2018 school year, may enhance the capacity of educators to help students and schools at risk of underperforming. It also addresses some of the challenges that educators will face under ESSA in ensuring success for all students. We highlight aspects of ESSA that may be of most interest to our readers including the broadened definition of academic success, expansion of subgroups for data reporting, emphasis on evidence-based research and practice, focus on continuous improvement, and need for increased educator understanding of research and evaluation. Resources are included that provide information for educators on how to use evidence, locate research findings on existing interventions, and access funding opportunities

Multi-site and multi-depth near-infrared spectroscopy in a model of simulated (central) hypovolemia: lower body negative pressure

Purpose: To test the hypothesis that the sensitivity of near-infrared spectroscopy (NIRS) in reflecting the degree of (compensated) hypovolemia would be affected by the application site and probing depth. We simultaneously applied multi-site (thenar and forearm) and multi-depth (15-2.5 and 25-2.5 mm probe distance) NIRS in a model of simulated hypovolemia: lower body negative pressure (LBNP). Methods: The study group comprised 24 healthy male volunteers who were subjected to an LBNP protocol in which a baseline period of 30 min was followed by a step-wise manipulation of negative pressure in the following steps: 0, -20, -40, -60, -80 and -100 mmHg. Stroke volume and heart rate were measured using volume-clamp finger plethysmography. Two multi-depth NIRS devices were used to measure tissue oxygen saturation (StO2) and tissue hemoglobin index (THI) continuously in the thenar and the forearm. To monitor the shift of blood volume towards the lower extremities, calf THI was measured by single-depth NIRS. Results: The main findings were that the application of LBNP resulted in a significant reduction in stroke volume which was accompanied by a reduction in forearm StO2 and THI. Conclusions: NIRS can be used to detect changes in StO2 and THI consequent upon central hypovolemia. Forearm NIRS measurements reflect hypovolemia more sensitively than thenar NIRS measurements. The sensitivity of these NIRS measurements does not depend on NIRS probing depth. The LBNP-induced shift in blood volume is reflected by a decreased THI in the forearm and an increased THI in the calf

Genome-Wide Association Study in BRCA1 Mutation Carriers Identifies Novel Loci Associated with Breast and Ovarian Cancer Risk

BRCA1-associated breast and ovarian cancer risks can be modified by common genetic variants. To identify further cancer risk-modifying loci, we performed a multi-stage GWAS of 11,705 BRCA1 carriers (of whom 5,920 were diagnosed with breast and 1,839 were diagnosed with ovarian cancer), with a further replication in an additional sample of 2,646 BRCA1 carriers. We identified a novel breast cancer risk modifier locus at 1q32 for BRCA1 carriers (rs2290854, P = 2.7×10-8, HR = 1.14, 95% CI: 1.09-1.20). In addition, we identified two novel ovarian cancer risk modifier loci: 17q21.31 (rs17631303, P = 1.4×10-8, HR = 1.27, 95% CI: 1.17-1.38) and 4q32.3 (rs4691139, P = 3.4×10-8, HR = 1.20, 95% CI: 1.17-1.38). The 4q32.3 locus was not associated with ovarian cancer risk in the general population or BRCA2 carriers, suggesting a BRCA1-specific associat

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

The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation

ObjectiveTo evaluate the impact of the Quintet Recruitment Intervention (QRI) on recruitment in challenging randomized controlled trials (RCTs) that have applied the intervention. The QRI aims to understand recruitment difficulties, and then implements ‘QRI-actions’ to address these as recruitment proceeds.Study Design and SettingA mixed-methods study, comprising: a) before-and-after comparisons of recruitment rates and numbers of patients approached, and b) qualitative case studies, including documentary analysis and interviews with RCT investigators.ResultsFive UK-based publicly-funded RCTs were included in the evaluation. All recruited to target. RCT2 and RCT5 both received up-front pre-recruitment training before the intervention was applied. RCT2 did not encounter recruitment issues and recruited above target from its outset. Recruitment difficulties, particularly communication issues, were identified and addressed through QRI-actions in RCTs 1, 3, 4 and 5. Randomization rates significantly improved post-QRI-action in RCTs 1,3, and 4. QRI-actions addressed issues with approaching eligible patients in RCTs 3 and 5, which both saw significant increases in patients approached. Trial investigators reported that the QRI had unearthed issues they had been unaware of, and reportedly changed their practices post QRI-action.ConclusionThere is promising evidence to suggest the QRI can support recruitment to difficult RCTs. This needs to be substantiated with future controlled evaluations