Elementary Principal Leadership and Special Education: A Case Study in the United States

School districts have called upon principals to build capacity for inclusive learning environments and prioritize the needs of an increasingly diverse group of students. A principal\u27s work to effectively include students so they are part of the school community and have opportunities to achieve academically has been challenging. As the instructional leader of the school, principals have played an essential role by collaborating with teachers and specialists, removing obstacles to learning, and ensuring that teachers meet the needs of all learners in their classrooms. They have also been held accountable for knowing the laws, policies, and best practices to support students with disabilities. The purpose of my research was to explore how elementary principals make sense of their experiences when responding to the needs of students with disabilities and the increased challenge of student achievement. In this investigation, I examined the role of three elementary school principals in the United States as instructional leaders of students with disabilities. I used qualitative methods to conduct a multiple case study of three principals who were known to be leading school change efforts to develop inclusive learning environments in their schools. Based on the analysis of interview data, I identified three key themes: the principals\u27 belief that all students can learn, the essential nature of collaboration and teamwork, and the principals\u27 actions and practices that build inclusive environments for students with disabilities to ensure their success. After discussing implications of the study, I offered a set of recommendations for principals, school districts, university administrator licensing programs, and other stakeholders

Analysis of the Impact of Early Surgery on In-Hospital Mortality of Native Valve Endocarditis

Background— The impact of early surgery on mortality in patients with native valve endocarditis (NVE) is unresolved. This study sought to evaluate valve surgery compared with medical therapy for NVE and to identify characteristics of patients who are most likely to benefit from early surgery. Methods and Results— Using a prospective, multinational cohort of patients with definite NVE, the effect of early surgery on in-hospital mortality was assessed by propensity-based matching adjustment for survivor bias and by instrumental variable analysis. Patients were stratified by propensity quintile, paravalvular complications, valve perforation, systemic embolization, stroke, Staphylococcus aureus infection, and congestive heart failure. Of the 1552 patients with NVE, 720 (46%) underwent early surgery and 832 (54%) were treated with medical therapy. Compared with medical therapy, early surgery was associated with a significant reduction in mortality in the overall cohort (12.1% [87/720] versus 20.7% [172/832]) and after propensity-based matching and adjustment for survivor bias (absolute risk reduction [ARR] −5.9%, P<0.001). With a combined instrument, the instrumental-variable–adjusted ARR in mortality associated with early surgery was −11.2% (P<0.001). In subgroup analysis, surgery was found to confer a survival benefit compared with medical therapy among patients with a higher propensity for surgery (ARR −10.9% for quintiles 4 and 5, P=0.002) and those with paravalvular complications (ARR −17.3%, P<0.001), systemic embolization (ARR −12.9%, P=0.002), S aureus NVE (ARR −20.1%, P<0.001), and stroke (ARR −13%, P=0.02) but not those with valve perforation or congestive heart failure. Conclusions— Early surgery for NVE is associated with an in-hospital mortality benefit compared with medical therapy alone

Scale-up of Adhesive Transdermal Drug Delivery Systems

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41458/1/11095_2004_Article_304228.pd