Writer\u27s Workshop in Kindergarten: A Study of Writing Mechanics, Attitudes, and Behaviors

The purpose of this study was to explore the impact of the writer\u27s workshop approach in a kindergarten classroom, given the confines of Reading First. The goal was to use this information to more effectively assist kindergarten students in developing their writing skills. This study was designed to highlight the importance of writing instruction at this level and to explore one particular writing approach, writer\u27s workshop. Furthermore, it could prove to be informative to other teachers at my school who are struggling to include writing instruction while also meeting all the requirements of Reading First. Thus, my research questions were as follows: • What impact can writer\u27s workshop have on kindergarten students? • How can writer\u27s workshop affect students\u27 writing mechanics? • What impact can writer\u27s workshop have on students\u27 writing attitudes and behaviors? In order to explore the impact of writer\u27s workshop in my classroom, I selected three of my students for case studies. I chose students about whom I wished to learn more and students with a range of abilities. I selected a student who struggled in writing, one who excelled, and a student who was more average in her writing skills. In this way, I was able to consider in what ways the writer\u27s workshop approach was or was not effectively meeting each student\u27s individual needs. I used rubrics weekly to collect data. I used the Kindergarten Writing Rubric to analyze writing samples and assess the writing conventions used. This rubric analyzed language use, spelling, legibility, directionality, spacing, punctuation, and capitalization. I selected the Kindergarten Writing Rubric, because it was the rubric used in my district for grading the fall, winter, and spring writing benchmarks. Thus, it corresponded with my district\u27s writing standards. I also observed student behaviors during writer\u27s workshop time and used the Writing Workshop Rubric to determine my students\u27 writing attitudes and behaviors. I adapted this Writing Workshop Rubric from Lucy Calkins, using her categories and adding my own indicators. This rubric analyzed student attitude, confidence, planning, independence, and productivity. I also conducted interviews with the three participants at the beginning and conclusion of the study using questions I developed

The maximum contraceptive prevalence ‘demand curve’: guiding discussions on programmatic investments [version 1; referees: 1 approved, 2 approved with reservations]

Most frameworks for family planning include both access and demand interventions. Understanding how these two are linked and when each should be prioritized is difficult. The maximum contraceptive prevalence ‘demand curve’ was created based on a relationship between the modern contraceptive prevalence rate (mCPR) and mean ideal number of children to allow for a quantitative assessment of the balance between access and demand interventions. The curve represents the maximum mCPR that is likely to be seen given fertility intentions and related norms and constructs that influence contraceptive use. The gap between a country’s mCPR and this maximum is referred to as the ‘potential use gap.’ This concept can be used by countries to prioritize access investments where the gap is large, and discuss implications for future contraceptive use where the gap is small. It is also used within the FP Goals model to ensure mCPR growth from access interventions does not exceed available demand

EFFECT OF PRACTICAL LOSSES ON OPTIMAL DESIGN OF BATCH RO SYSTEMS

Batch reverse osmosis (BRO) systems may enable a significant reduction in energy consumption for desalination and water reuse. BRO systems operate with variable pressure, by applying only slightly more pressure than is needed to overcome the osmotic pressure and produce reverse water flux. This study explains, quantifies, and optimizes the energy-saving performance of realistic batch designs implemented using pressure exchangers and unpressurized tanks. The effects of additional design parameters such as feed tank volume at the end of the cycle, volume of water in the pipes, per-pass recovery, cycle operating time, and cycle reset time on the performance of BRO are captured. Loss mechanisms including hydraulic pressure drop and concentration polarization as well as friction and mixing in the energy recovery devices are considered. At low cycle-reset time (10% of productive time) and low piping volumes (12% of volume inside membrane elements), about 13% energy savings is possible compared to a continuous system operating at the same overall pure water productivity. Under these conditions, we also show that the ideal per-pass recovery is close to 50%, similar to single-stage RO. This recovery reduces the need for system redesign with additional pressure vessels in parallel, contrary to predictions in the literature. The projected savings in terms of the overall cost of water is around 3%. Additionally, advanced ultra-permeable membranes, such as those based on graphene or graphene oxide, are expected to lead to more significant energy savings in BRO than in single-stage RO

Impact of Obesity in Patients with Candida Bloodstream Infections: A Retrospective Cohort Study

© 2020, The Author(s). Background: Candida species are responsible for 15% of bloodstream infections, leading to prolonged hospitalizations and increased mortality. With the rise in obesity, antifungal dosing is unclear. The purpose of this study was to determine differences in clinical outcomes between obese versus non-obese patients with Candida bloodstream infections. Methods: This retrospective cohort included adult patient’s first episode of Candida bloodstream infection treated with ≥ 48 h of antifungal therapy between 1 June 2013 and 31 August 2019. Patients were excluded for: dual systemic antifungal therapy, polymicrobial infections, or chronic candidiasis. The primary outcome was infection-related length of stay. Secondary outcomes included: time to candidemia resolution, 30-day readmission rates, and in-hospital mortality. Results: Eighty patients were included (28 obese; 52 non-obese). Most were male (55%); median age was 54 years. Median BMI and weight were 36.3 kg/m2 and 103 kg versus 20.4 kg/m2 and 61 kg, respectively (p \u3c 0.01). Baseline characteristics were comparable. C. albicans was isolated in 37.5% of cultures and C. glabrata in 30%. Micafungin was utilized empirically in 72.5% of patients; obese patients received definitive micafungin more frequently (57.1% vs. 21.2%; p \u3c 0.01) and were treated longer (13 versus 10 days; p = 0.04). Infection-related length of stay was 19 days in the obese patients and 13 days in the non-obese patients (p = 0.05). Non-obese patients had a shorter duration of candidemia (5 versus 6 days; p = 0.02). In-hospital mortality was numerically higher in obese patients (21.4% versus 13.5%; p = 0.36). There were no differences in 30-day readmissions between groups. Conclusions: Worse clinical outcomes were observed for obese versus non-obese patients. Further clinical research is warranted

The Gathering Storm: Infectious Diseases and Human Rights in Burma

Documents how decades of repressive rule, civil war, and poor governance in Burma have contributed to the spread of HIV/AIDS, tuberculosis, malaria, and other infectious diseases

Assessment of Antimicrobial Pharmacokinetics Curricula Across Schools and Colleges of Pharmacy in the United States

Introduction Advances in technology and understanding of pharmacokinetic/pharmacodynamic relationships have prompted guideline updates and advances in precision dosing, but the role of clinical pharmacokinetics (PK) in pharmacy education remains inconsistent. Previous surveys of pharmacy school PK curricula revealed large variations in content, integration, and teaching tools but did not focus on antimicrobials or details of andragogy used. Objective Identify how antimicrobial PK is taught in pharmacy curricula across the United States, as well as instructor perceptions of current practices. Methods An online survey was distributed to 118 pharmacy programs across the United States in 2018. This 30-minute questionnaire covered curriculum content, teaching strategies, assessment modalities, and perceptions. Results Completed surveys were received from 53 programs (45% response rate) via relevant course coordinators. Among 35 traditional progressive curriculum programs (TPC), antimicrobial PK was taught in basic science (33, 94%), clinical PK (15, 43%), pharmacology (8, 23%), therapeutics (28, 80%), and skills lab courses (21, 65%). Among 18 integrated block curriculum programs (IBC), it was taught in foundations/principles (17, 94%), organ systems (12, 67%), and skills lab courses (9, 50%). On average, TPC programs had more courses with antimicrobial PK than IBC programs. Vancomycin and aminoglycosides were the most common antimicrobials taught (100%), while didactic lecturing was the predominant andragogy. Multiple choice was the primary assessment modality, being frequently used in 64% of TPC and 68% of IBC courses, respectively. Among respondents, 72% believed more time was needed to teach PK and 53% believed students were adequately prepared at the start of APPEs. Conclusion Antimicrobial PK instruction remains highly inconsistent in U.S. pharmacy schools and colleges. IBC programs may provide less opportunity for antimicrobial PK instruction, which conflicts with the desire for more instruction time. As clinical applications of antimicrobial PK change and expand, it is crucial that pharmacy education prioritizes PK education appropriately

FAS promoter polymorphism: outcome of childhood acute myeloid leukemia. A children's oncology group report.

PURPOSE: FAS is a cell surface receptor involved in apoptotic signal transmission. Deregulation of this pathway results in down-regulation of apoptosis and subsequent persistence of a malignant clone. A single nucleotide polymorphism resulting in guanine-to-adenine transition in the FAS promoter region (position -1377) is thought to reduce stimulatory protein 1 transcription factor binding and decrease FAS expression. Previous work has shown increased risk of developing acute myeloid leukemia (AML) in adult patients with a variant allele at this site. The same authors have shown that the presence of an adenine residue rather than a guanine residue at -1,377 bp significantly attenuates transcription factor stimulatory protein 1 binding and may contribute to a reduction in FAS expression and ultimately to the enrichment of apoptosis-resistant clones in AML. We hypothesized that FAS genotype by altering susceptibility to apoptosis might affect outcome of childhood AML therapy. EXPERIMENTAL DESIGN: Four hundred forty-four children treated for de novo AML on a uniform protocol were genotyped for FAS 1377. RESULTS: There were no significant differences in overall survival, event-free survival, treatment-related mortality, or relapse rate between patients with FAS 1377GG genotype versus 1377GA/1377AA genotypes. CONCLUSIONS: FAS 1377 genotype does not alter outcome of de novo AML in children

Naomi: a new modelling tool for estimating HIV epidemic indicators at the district level in sub-Saharan Africa.

INTRODUCTION: HIV planning requires granular estimates for the number of people living with HIV (PLHIV), antiretroviral treatment (ART) coverage and unmet need, and new HIV infections by district, or equivalent subnational administrative level. We developed a Bayesian small-area estimation model, called Naomi, to estimate these quantities stratified by subnational administrative units, sex, and five-year age groups. METHODS: Small-area regressions for HIV prevalence, ART coverage and HIV incidence were jointly calibrated using subnational household survey data on all three indicators, routine antenatal service delivery data on HIV prevalence and ART coverage among pregnant women, and service delivery data on the number of PLHIV receiving ART. Incidence was modelled by district-level HIV prevalence and ART coverage. Model outputs of counts and rates for each indicator were aggregated to multiple geographic and demographic stratifications of interest. The model was estimated in an empirical Bayes framework, furnishing probabilistic uncertainty ranges for all output indicators. Example results were presented using data from Malawi during 2016-2018. RESULTS: Adult HIV prevalence in September 2018 ranged from 3.2% to 17.1% across Malawi's districts and was higher in southern districts and in metropolitan areas. ART coverage was more homogenous, ranging from 75% to 82%. The largest number of PLHIV was among ages 35 to 39 for both women and men, while the most untreated PLHIV were among ages 25 to 29 for women and 30 to 34 for men. Relative uncertainty was larger for the untreated PLHIV than the number on ART or total PLHIV. Among clients receiving ART at facilities in Lilongwe city, an estimated 71% (95% CI, 61% to 79%) resided in Lilongwe city, 20% (14% to 27%) in Lilongwe district outside the metropolis, and 9% (6% to 12%) in neighbouring Dowa district. Thirty-eight percent (26% to 50%) of Lilongwe rural residents and 39% (27% to 50%) of Dowa residents received treatment at facilities in Lilongwe city. CONCLUSIONS: The Naomi model synthesizes multiple subnational data sources to furnish estimates of key indicators for HIV programme planning, resource allocation, and target setting. Further model development to meet evolving HIV policy priorities and programme need should be accompanied by continued strengthening and understanding of routine health system data