Improving School Improvement

PREFACEIn opening this volume, you might be thinking:Is another book on school improvement really needed?Clearly our answer is yes. Our analyses of prevailing school improvement legislation, planning, and literature indicates fundamental deficiencies, especially with respect to enhancing equity of opportunity and closing the achievement gap.Here is what our work uniquely brings to policy and planning tables:(1) An expanded framework for school improvement – We highlight that moving from a two- to a three-component policy and practice framework is essential for closing the opportunity and achievement gaps. (That is, expanding from focusing primarily on instruction and management/government concerns by establishing a third primary component to improve how schools address barriers to learning and teaching.)(2) An emphasis on integrating a deep understanding of motivation – We underscore that concerns about engagement, management of behavior, school climate, equity of opportunity, and student outcomes require an up-to-date grasp of motivation and especially intrinsic motivation.(3) Clarification of the nature and scope of personalized teaching – We define personalization as the process of matching learner motivation and capabilities and stress that it is the learner's perception that determines whether the match is a good one.(4) A reframing of remediation and special education – We formulate these processes as personalized special assistance that is applied in and out of classrooms and practiced in a sequential and hierarchical manner.(5) A prototype for transforming student and learning supports – We provide a framework for a unified, comprehensive, and equitable system designed to address barriers to learning and teaching and re-engage disconnected students and families.(6) A reworking of the leadership structure for whole school improvement --We outline how the operational infrastructure can and must be realigned in keeping with a three component school improvement framework.(7) A systemic approach to enhancing school-community collaboration – We delineate a leadership role for schools in outreaching to communities in order to work on shared concerns through a formal collaborative operational infrastructure that enables weaving together resources to advance the work.(8) An expanded framework for school accountability – We reframe school accountability to ensure a balanced approach that accounts for a shift to a three component school improvement policy.(9) Guidance for substantive, scalable, and sustainable systemic changes –We frame mechanisms and discuss lessons learned related to facilitating fundamental systemic changes and replicating and sustaining them across a district.The frameworks and practices presented are based on our many years of work in schools and from efforts to enhance school-community collaboration. We incorporate insights from various theories and the large body of relevant research and from lessons learned and shared by many school leaders and staff who strive everyday to do their best for children.Our emphasis on new directions in no way is meant to demean current efforts. We know that the demands placed on those working in schools go well beyond what anyone should be asked to do. Given the current working conditions in many schools, our intent is to help make the hard work generate better results. To this end, we highlight new directions and systemic pathways for improving school outcomes.Some of what we propose is difficult to accomplish. Hopefully, the fact that there are schools, districts, and state agencies already trailblazing the way will engender a sense of hope and encouragement to those committed to innovation.It will be obvious that our work owes much to many. We are especially grateful to those who are pioneering major systemic changes across the country. These leaders and so many in the field have generously offered their insights and wisdom. And, of course, we are indebted to hundreds of scholars whose research and writing is a shared treasure. As always, we take this opportunity to thank Perry Nelson and the host of graduate and undergraduate students at UCLA who contribute so much to our work each day, and to the many young people and their families who continue to teach us all.Respectfully submitted for your consideration,Howard Adelman & Linda Taylo

Differential Effects of Race and Poverty on Ambulatory Care Sensitive Conditions

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in high poverty areas (RR=0.97; 95% CI (0.89, 1.05)). After controlling for various indicators of area SES in multivariate analyses race differences in ACS hospitalization rates persisted. Rural neighborhoods and those with higher percent of non-high school graduates were associated with greater risk of ACS hospitalizations

Bone marrow examination in newly diagnosed Hodgkin's disease: current practice in the United Kingdom.

In the UK Hodgkin's disease is usually treated by either clinical oncologists or haematologists. A national study of the performance of bone marrow examination in newly diagnosed Hodgkin's disease was undertaken to establish current practice. A total of 620 questionnaires were despatched, and replies were received from 60% of consultants (45% of clinical oncologists and 70% of haematologists). Bone marrow examination was performed in all new cases significantly more often by haematologists than by clinical oncologists (74% vs 40%, P < 0.001). Among haematologists, there was no correlation between the number of new patients seen annually and practice, however clinical oncologists were even less likely to perform routine bone marrow biopsies if they saw more than ten patients per year (P < 0.02). Where bone marrow examination was performed selectively, the most common criteria used were peripheral blood cytopenia and advanced-stage disease. These criteria were applied in the same way by both clinical oncologists and haematologists. Bone marrow biopsy, an invasive and often painful procedure, is currently performed more frequently in Hodgkin's disease than can be recommended on the basis of recent studies in the literature and associated guidelines. There is a significant difference in practice between clinical oncologists and haematologists, and this raises the wider issue of the influence of hospital specialisation on patient management

Experiences of Improving Access to Psychological Therapy Services for Perinatal Mental Health Difficulties: a Qualitative Study of Women's and Therapists' Views

BACKGROUND: Perinatal mental health difficulties are highly prevalent. In England, the Improving Access to Psychological Therapy (IAPT) programme provides evidence-based psychological treatment, predominantly in the form of brief manualized cognitive behavioural therapy (CBT), to people with mild to moderate depression or anxiety. Yet little is known about the experiences of women referred to IAPT with perinatal mental health difficulties. AIMS: The aim of this qualitative study was to investigate how women view IAPT support for perinatal mental health. We also gained the perspective of IAPT therapists. METHOD: Semi-structured interviews were conducted with twelve women who had been referred to and/or received therapy from IAPT during the perinatal period. Additionally, fourteen IAPT therapists participated in two focus groups. Thematic analysis was used. RESULTS: Key themes centred on barriers to access and the need to tailor support to (expectant) mothers. Women and therapists suggested that experiences could be improved by supporting healthcare professionals to provide women with more help with referrals, better tailoring support to the perinatal context, improving perinatal-specific training, supervision and resources, and offering a more individualized treatment environment. CONCLUSIONS: Overall, women reported positive experiences of support offered by IAPT for perinatal mental health difficulties. However, services should seek to facilitate access to support and to enable therapists to better tailor treatment

Effects of Open Marsh Water Management on Numbers of Larval Salt Marsh Mosquitoes

Open marsh water management (OMWM) is a commonly used approach to manage salt marsh mosquitoes than can obviate the need for pesticide application and at the same time, partially restore natural functions of grid-ditched marshes. OMWM includes a variety of hydrologic manipulations, often tailored to the specific conditions on individual marshes, so the overall effectiveness of this approach is difficult to assess. Here, we report the results of controlled field trials to assess the effects of two approaches to OMWM on larval mosquito production at National Wildlife Refuges (NWR). A traditional OMWM approach, using pond construction and radial ditches was used at Edwin B. Forsythe NWR in New Jersey, and a ditch-plugging approach was used at Parker River NWR in Massachusetts. Mosquito larvae were sampled from randomly placed stations on paired treatment and control marshes at each refuge. The proportion of sampling stations that were wet declined after OMWM at the Forsythe site, but not at the Parker River site. The proportion of samples with larvae present and mean larval densities, declined significantly at the treatment sites on both refuges relative to the control marshes. Percentage of control for the 2 yr posttreatment, compared with the 2 yr pretreatment, was \u3e90% at both treatment sites

Hubble Space Telescope Imaging of the Expanding Nebular Remnant of the Recurrent Nova RS Ophiuchi (2006)

We report Hubble Space Telescope imaging obtained 155 days after the 2006 outburst of RS Ophiuchi. We detect extended emission in both [O III] and [Ne V] lines. In both lines, the remnant has a double ring structure. The E-W orientation and total extent of these structures (580+-50 AU at d=1.6kpc) is consistent with that expected due to expansion of emitting regions imaged earlier in the outburst at radio wavelengths. Expansion at high velocity appears to have been roughly constant in the E-W direction (v_{exp} = 3200+-300 km/s in the plane of the sky), with tentative evidence of deceleration N-S. We present a bipolar model of the remnant whose inclination is consistent with that of the central binary. The true expansion velocities of the polar components are then v = 5600+-1100 km/s. We suggest that the bipolar morphology of the remnant results from interaction of the outburst ejecta with a circumstellar medium that is significantly denser in the equatorial regions of the binary than at the poles. This is also consistent with observations of shock evolution in the X-ray and the possible presence of dust in the infrared. Furthermore, it is in line with models of the shaping of planetary nebulae with close binary central systems, and also with recent observations relating to the progenitors of Type Ia supernovae, for which recurrent novae are a proposed candidate. Our observations also reveal more extended structures to the S and E of the remnant whose possible origin is briefly discussed.Comment: 13 pages, 2 figures, accepted for publication in ApJ

Tenofovir disoproxil fumarate for prevention of HIV infection in women: a phase 2, double-blind, randomized, placebo-controlled trial.

ObjectivesThe objective of this trial was to investigate the safety and preliminary effectiveness of a daily dose of 300 mg of tenofovir disoproxil fumarate (TDF) versus placebo in preventing HIV infection in women.DesignThis was a phase 2, randomized, double-blind, placebo-controlled trial.SettingThe study was conducted between June 2004 and March 2006 in Tema, Ghana; Douala, Cameroon; and Ibadan, Nigeria.ParticipantsWe enrolled 936 HIV-negative women at high risk of HIV infection into this study.InterventionParticipants were randomized 1:1 to once daily use of 300 mg of TDF or placebo.Outcome measuresThe primary safety endpoints were grade 2 or higher serum creatinine elevations (&gt;2.0 mg/dl) for renal function, grade 3 or 4 aspartate aminotransferase or alanine aminotransferase elevations (&gt;170 U/l) for hepatic function, and grade 3 or 4 phosphorus abnormalities (&lt;1.5 mg/dl). The effectiveness endpoint was infection with HIV-1 or HIV-2.ResultsStudy participants contributed 428 person-years of laboratory testing to the primary safety analysis. No significant differences emerged between treatment groups in clinical or laboratory safety outcomes. Study participants contributed 476 person-years of HIV testing to the primary effectiveness analysis, during which time eight seroconversions occurred. Two were diagnosed in participants randomized to TDF (0.86 per 100 person-years) and six in participants receiving placebo (2.48 per 100 person-years), yielding a rate ratio of 0.35 (95% confidence interval = 0.03-1.93), which did not achieve statistical significance. Owing to premature closures of the Cameroon and Nigeria study sites, the planned person-years of follow-up and study power could not be achieved.ConclusionDaily oral use of TDF in HIV-uninfected women was not associated with increased clinical or laboratory adverse events. Effectiveness could not be conclusively evaluated because of the small number of HIV infections observed during the study