Having their say: Parents of high-achieving African American elementary students talk about the home-school relationship

Having Their Say: Parents of High-Achieving African American Elementary Students Talk About the Home-School Relationship describes a qualitative research study that explored parents\u27 perceptions of their role in education and how these perceptions translate into specific parent involvement practices both at home and at school. It also identifies the concerns that African American parents have about their children\u27s schooling and offers their suggestions for improvement; Twelve parents of African American students identified as high-achieving and of varying socioeconomic levels participated in either a focus group discussion or in an individual in-depth interview about parent involvement in education. Epstein\u27s theoretical model of overlapping spheres of influence and typology of parent involvement practices were used as the bases for formulating the questioning route; Interview data revealed that parent participants were able to distinguish between the responsibilities of families and the responsibilities of schools in the education of children but also recognized that families and schools must work together to insure student success. Parents perceived their responsibilities as teaching their children the value of education, instilling a strong work ethic, and supporting learning at home. Parents reported that the school\u27s primary responsibility is to teach students the content and skills appropriate for each grade level and to use a variety of instructional approaches; In describing their parent involvement practices, parents reported being actively involved in three types of activities: (1) communicating with the school; (2) supporting learning at home; and (3) volunteering and/or attending school events. Parents talked about their concerns with the racial identity development of their children and expressed their views on Black History Month and the recruitment of minority teachers. However, parents did not view teacher race as a critical factor related to their children\u27s racial identity development; instead, they described their concerns with the teacher placement policies of large urban school districts and how these policies can shortchange students in at-risk schools; Finally, parents made suggestions for improving home-school relationships that have implications for all parents, teachers, school administrators, human resources departments of school districts, and teacher educators interested in parent involvement and multicultural issues in education. The findings of this study identify the need for more staff development in these areas. They add to the growing body of literature that suggests family environment is more predictive of student achievement than status variables such as race or social class

Six versus 12 months' adjuvant trastuzumab in patients with HER2-positive early breast cancer: the PERSEPHONE non-inferiority RCT

Background The addition of adjuvant trastuzumab to chemotherapy has significantly improved outcomes in human epidermal growth factor receptor 2 (HER2) positive early, potentially curable breast cancer. Twelve months’ trastuzumab tested in the registration trials was adopted for standard adjuvant treatment in 2006. Subsequently similar outcomes were demonstrated using 9 weeks trastuzumab. Shorter durations were therefore tested for non-inferiority. Objectives To establish whether 6 months’ adjuvant trastuzumab is non-inferior to 12 months in HER2-positive early breast cancer using a primary endpoint of 4-year disease-free-survival (DFS). Design Phase III randomised, controlled, non-inferiority trial. Setting 152 NHS Hospitals. Participants 4088 patients with HER2-positive early breast cancer planned to receive both chemotherapy and trastuzumab. Intervention Randomisation (1:1) between six months’ or twelve months’ trastuzumab. Main outcomes Primary endpoint was DFS four years after diagnosis. Secondary endpoints were overall survival (OS), cost effectiveness, and cardiac function during trastuzumab. Assuming a 4-year DFS rate of 80% with 12 months, 4000 patients were required to demonstrate non-inferiority of 6-months (5% 1-sided significance, 85% power), defining the non-inferiority limit as no worse than 3% below the standard arm. Costs and quality-adjusted life years (QALYs) were estimated by within-trial analysis and a lifetime decision-analytic model. Results Between 4th October 2007 and 31st July 2015, 2045 patients were randomised to 12-months’ trastuzumab and 2043 to 6-months. Sixty-nine percent had ER-positive disease; 90% received anthracyclines (49% with taxanes; 41% without taxanes); 10% received taxanes without anthracyclines; 54% had trastuzumab sequentially after chemotherapy; 85% received adjuvant chemotherapy (58% were node negative). At 6.1 years median follow-up with 389 (10%) deaths, and 566 (14%) DFS events, 4-year DFS rates for the 4088 patients were 89.5% (95% CI, 88.1-90.8) in the 6-month group and 90.3% (95% CI 88.9- 91.5) in the 12-month group (Hazard Ratio 1.10; 90% CI 0.96–1.26, non-inferiority p=0.01), demonstrating non-inferiority of 6-months’ trastuzumab. Congruent results were found for OS (non-inferiority p=0.0003), and landmark analyses 6 months from starting trastuzumab (non-inferiority p=0.03 (DFS) and p=0.006 (OS)). 6-months’ trastuzumab resulted in fewer patients reporting adverse events of severe grade (365/1929 (19%) versus 460/1935 (24%) 12-month patients, p=0.0003) or stopping early because of cardiotoxicity (61/1977 (3%) versus 146/1941 (8%) 12-month patients, p<0.0001). Health economic analysis showed significantly lower lifetime costs and similar lifetime QALYs, and thus a high probability that 6 months is cost-effective compared to 12 months. Patient reported experiences on the trial highlighted fatigue, and aches and pains most frequently. Limitations The type of chemotherapy and timing of trastuzumab changed through the recruitment phase of the study as standard practice altered. Conclusions PERSEPHONE demonstrated that in HER2-positive early breast cancer 6 months’ adjuvant trastuzumab was non-inferior to 12 months. There was significantly less cardiac toxicity and fewer severe adverse events with 6 months’ treatment. Future work On-going translational work investigates patient and tumour genetic determinants of toxicity, and trastuzumab efficacy. An individual patient data meta-analysis with PHARE and other trastuzumab duration trials is planned. Trial registration ISRCTN 52968807 Funding National Institute for Health Research, Health Technology Assessment Programme (HTA Project: 06/303/98).National Institute for Health Research, Health Technology Assessment Programme (HTA Project: 06/303/98)

The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe

The preponderance of matter over antimatter in the early Universe, the dynamics of the supernova bursts that produced the heavy elements necessary for life and whether protons eventually decay --- these mysteries at the forefront of particle physics and astrophysics are key to understanding the early evolution of our Universe, its current state and its eventual fate. The Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed plan for a world-class experiment dedicated to addressing these questions. LBNE is conceived around three central components: (1) a new, high-intensity neutrino source generated from a megawatt-class proton accelerator at Fermi National Accelerator Laboratory, (2) a near neutrino detector just downstream of the source, and (3) a massive liquid argon time-projection chamber deployed as a far detector deep underground at the Sanford Underground Research Facility. This facility, located at the site of the former Homestake Mine in Lead, South Dakota, is approximately 1,300 km from the neutrino source at Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino charge-parity symmetry violation and mass ordering effects. This ambitious yet cost-effective design incorporates scalability and flexibility and can accommodate a variety of upgrades and contributions. With its exceptional combination of experimental configuration, technical capabilities, and potential for transformative discoveries, LBNE promises to be a vital facility for the field of particle physics worldwide, providing physicists from around the globe with opportunities to collaborate in a twenty to thirty year program of exciting science. In this document we provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess.Comment: Major update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figure

Emergency Department Activation of Interventional Cardiology to Reduce Door-to-Balloon Time

Background: Despite American College of Cardiology (ACC) and American Heart Association (AHA) guidelines, many hospitals have door-to-balloon times in excess of 90 minutes. Emergency Department (ED) activation of interventional cardiology has been described as an important strategy to reduce door-to-balloon time. However, prior studies on ED activation have been in suburban hospitals with door-to-balloon times near the ACC/AHA targeted times.Objective: To determine if ED activation of interventional cardiology could significantly improve reperfusion times and reach the ACC/AHA target of 90 minutes or less in a safety net hospital, a Level I trauma center and teaching hospital served as a primarily uninsured and underinsured patient population with door-to-balloon times ranking in the lowest quartile of United States hospitals.Methods: In this study, door-to balloon times before and after implementation of ED activation were compared by retrospective chart review.Results: Eighty patients were included in the study, 48 before and 32 after ED activation of interventional cardiology. Median door-to-balloon time decreased from 163.5 minutes before to 130 minutes after ED activation, a significant difference of 33.5 minutes (p=0.028). Door-to-balloon time on nights, weekends and holidays decreased from a median of 165.5 minutes to 130 minutes, a reduction of 35.5 minutes, which also reached statistical significance (p=0.029).Conclusion: ED activation of interventional cardiology produced a statistically significant reduction in door-to-balloon time. However, the reduction was not enough to achieve a door-to-balloon time of less than 90 minutes. Safety net hospitals with door-to-balloon times in the lowest quartile nationally may require multiple strategies to achieve targeted myocardial reperfusion times. [West J Emerg Med. 2010; 11(4):363-366.

Emergency Department Activation of Interventional Cardiology to Reduce Door-to-Balloon Time

Background: Despite American College of Cardiology (ACC) and American Heart Association (AHA) guidelines, many hospitals have door-to-balloon times in excess of 90 minutes. Emergency Department (ED) activation of interventional cardiology has been described as an important strategy to reduce door-to-balloon time. However, prior studies on ED activation have been in suburban hospitals with door-to-balloon times near the ACC/AHA targeted times.Objective: To determine if ED activation of interventional cardiology could significantly improve reperfusion times and reach the ACC/AHA target of 90 minutes or less in a safety net hospital, a Level I trauma center and teaching hospital served as a primarily uninsured and underinsured patient population with door-to-balloon times ranking in the lowest quartile of United States hospitals.Methods: In this study, door-to balloon times before and after implementation of ED activation were compared by retrospective chart review.Results: Eighty patients were included in the study, 48 before and 32 after ED activation of interventional cardiology. Median door-to-balloon time decreased from 163.5 minutes before to 130 minutes after ED activation, a significant difference of 33.5 minutes (p=0.028). Door-to-balloon time on nights, weekends and holidays decreased from a median of 165.5 minutes to 130 minutes, a reduction of 35.5 minutes, which also reached statistical significance (p=0.029).Conclusion: ED activation of interventional cardiology produced a statistically significant reduction in door-to-balloon time. However, the reduction was not enough to achieve a door-to-balloon time of less than 90 minutes. Safety net hospitals with door-to-balloon times in the lowest quartile nationally may require multiple strategies to achieve targeted myocardial reperfusion times. [West J Emerg Med. 2010; 11(4):363-366.

Material surfaces affect the protein expression patterns of human macrophages: A proteomics approach

Monocyte-derived macrophages (MDM) are key inflammatory cells and are central to the foreign body response to implant materials. MDM have been shown to exhibit changes in actin cytoskeleton, multinucleation, cell size, and function in response to small alterations in polycarbonate-urethane (PCNU) surface chemistry. Although PCNU chemistry has an influence on de novo protein synthesis, no assessments of the protein expression profiles of MDM have yet been reported. The rapid emerging field of expression proteomics facilitates the study of changes in cellular protein profiles in response to their microenvironment. The current study applied proteomic techniques, 2-dimensional electrophoresis (2-DE) combined with MALDI-ToF (matrix assisted laser desorption ionization-time of flight) mass spectrometry, to determine differences in MDM protein expression influenced by PCNU. Results indicated that MDM responded to material chemistry by modulation of structural proteins (i.e. actin, vimentin, and tubulin). Additionally, intracellular protein modulation which requires proteins responsible for trafficking (i.e. chaperone proteins) and protein structure modification (i.e. bond rearrangement and protein folding) were also altered. This study demonstrated for the first time that a proteomics approach was able to detect protein expression profile changes in MDM cultured on different material surfaces, forming the basis for utilizing further quantitative proteomics techniques that could assist in elucidation of the mechanisms involved in MDM-material interaction. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res, 200

Six versus 12 months' adjuvant trastuzumab in patients with HER2-positive early breast cancer: the PERSEPHONE non-inferiority RCT

Background The addition of adjuvant trastuzumab to chemotherapy has significantly improved outcomes in human epidermal growth factor receptor 2 (HER2) positive early, potentially curable breast cancer. Twelve months’ trastuzumab tested in the registration trials was adopted for standard adjuvant treatment in 2006. Subsequently similar outcomes were demonstrated using 9 weeks trastuzumab. Shorter durations were therefore tested for non-inferiority. Objectives To establish whether 6 months’ adjuvant trastuzumab is non-inferior to 12 months in HER2-positive early breast cancer using a primary endpoint of 4-year disease-free-survival (DFS). Design Phase III randomised, controlled, non-inferiority trial. Setting 152 NHS Hospitals. Participants 4088 patients with HER2-positive early breast cancer planned to receive both chemotherapy and trastuzumab. Intervention Randomisation (1:1) between six months’ or twelve months’ trastuzumab. Main outcomes Primary endpoint was DFS four years after diagnosis. Secondary endpoints were overall survival (OS), cost effectiveness, and cardiac function during trastuzumab. Assuming a 4-year DFS rate of 80% with 12 months, 4000 patients were required to demonstrate non-inferiority of 6-months (5% 1-sided significance, 85% power), defining the non-inferiority limit as no worse than 3% below the standard arm. Costs and quality-adjusted life years (QALYs) were estimated by within-trial analysis and a lifetime decision-analytic model. Results Between 4th October 2007 and 31st July 2015, 2045 patients were randomised to 12-months’ trastuzumab and 2043 to 6-months. Sixty-nine percent had ER-positive disease; 90% received anthracyclines (49% with taxanes; 41% without taxanes); 10% received taxanes without anthracyclines; 54% had trastuzumab sequentially after chemotherapy; 85% received adjuvant chemotherapy (58% were node negative). At 6.1 years median follow-up with 389 (10%) deaths, and 566 (14%) DFS events, 4-year DFS rates for the 4088 patients were 89.5% (95% CI, 88.1-90.8) in the 6-month group and 90.3% (95% CI 88.9- 91.5) in the 12-month group (Hazard Ratio 1.10; 90% CI 0.96–1.26, non-inferiority p=0.01), demonstrating non-inferiority of 6-months’ trastuzumab. Congruent results were found for OS (non-inferiority p=0.0003), and landmark analyses 6 months from starting trastuzumab (non-inferiority p=0.03 (DFS) and p=0.006 (OS)). 6-months’ trastuzumab resulted in fewer patients reporting adverse events of severe grade (365/1929 (19%) versus 460/1935 (24%) 12-month patients, p=0.0003) or stopping early because of cardiotoxicity (61/1977 (3%) versus 146/1941 (8%) 12-month patients, p<0.0001). Health economic analysis showed significantly lower lifetime costs and similar lifetime QALYs, and thus a high probability that 6 months is cost-effective compared to 12 months. Patient reported experiences on the trial highlighted fatigue, and aches and pains most frequently. Limitations The type of chemotherapy and timing of trastuzumab changed through the recruitment phase of the study as standard practice altered. Conclusions PERSEPHONE demonstrated that in HER2-positive early breast cancer 6 months’ adjuvant trastuzumab was non-inferior to 12 months. There was significantly less cardiac toxicity and fewer severe adverse events with 6 months’ treatment. Future work On-going translational work investigates patient and tumour genetic determinants of toxicity, and trastuzumab efficacy. An individual patient data meta-analysis with PHARE and other trastuzumab duration trials is planned. Trial registration ISRCTN 52968807 Funding National Institute for Health Research, Health Technology Assessment Programme (HTA Project: 06/303/98).National Institute for Health Research, Health Technology Assessment Programme (HTA Project: 06/303/98)