The Impact of Principal Preparation on Student Outcomes

The purpose of this study was to understand the role of principal preparation on first-year principals\u27 ability to positively impact student outcomes. The study sought to understand key learning experiences that contributed to first-year principals\u27 success upon completion of their preparation program. Using the case study method for this qualitative research study, I interviewed first-year principals to gather data on their perceptions of the learning experiences that led to their success. The research question that guided my qualitative research study was: How does one district-led principal preparation program in a large urban city increase first-year principals\u27 capacity to effectively lead a campus and produce positive outcomes? The study highlighted six best practices that all university-based preparation programs and alternative principal pipelines should implement to enhance its participants\u27 learning experiences and their ability to successfully impact student outcomes within their first academic year of the principalship. The themes that emerged from the study as compelling learning experiences to build instructional leadership that impacted student outcomes were data analysis, observation and feedback, and professional learning communities. Themes based on unexpected challenges during their first year as principals serve as gaps in their learning that would enhance all preparation programs. Those themes were: non-instructional systems related to campus operations, soft skills, and transitioning to the principalship. Based on the theoretical framework created from the literature, field-experience and on-the-job support served as meaningful experiences for the preparation of aspiring leaders. Because principals play a crucial role in a campus\u27s success or failure, aspiring leaders must be adequately prepared to lead a campus. Thus, this study contributes to the literature on principal preparation programs

Integrating Students into Interdisciplinary Health and Health Disparities Research Teams

Major initiatives by the U.S. Department of Health and Human Services as well as the World Health Organization have produced a large and compelling body of evidence on how to reduce health disparities, which entails having a clear understanding of how social factors shape health and healthcare outcomes. Specifically, there is a need for healthcare professionals to understand social determinants of health (e.g., low socioeconomic status, lack of health insurance, and poor education) and how these lead to disparities in health for people of minority racial and ethnic groups. Little is known about how students are developed as health disparities researchers or how their research experiences impact their views about addressing social determinants of health as a career goal. The purpose of this paper is to describe how health and human sciences students were integrated into three minority HIV prevention and testing projects using the lifelong learning for health professionals (LLHP) principles and activities framework, which entails a focus on: (a) education, (b) community, and (c) organization in the planning, development, implementation, and evaluation of interdisciplinary research

Integrating students into interdisciplinary health and health disparities research teams

Major initiatives by the U.S. Department of Health and Human Services as well as the World Health Organization have produced a large and compelling body of evidence on how to reduce health disparities, which entails having a clear understanding of how social factors shape health and healthcare outcomes. Specifically, there is a need for healthcare professionals to understand social determinants of health (e.g., low socioeconomic status, lack of health insurance, and poor education) and how these lead to disparities in health for people of minority racial and ethnic groups. Little is known about how students are developed as health disparities researchers or how their research experiences impact their views about addressing social determinants of health as a career goal. The purpose of this paper is to describe how health and human sciences students were integrated into three minority HIV prevention and testing projects using the lifelong learning for health professionals (LLHP) principles and activities framework, which entails a focus on: (a) education, (b) community, and (c) organization in the planning, development, implementation, and evaluation of interdisciplinary research

Evaluation Findings: School and Workplace Strategies 2005-2007

This report is an evaluation developed to provide updates on the progress of the Missouri Foundation for Health’s Tobacco Prevention and Cessation Initiative (TPCI). The report provides an overview of the activities and outcomes regarding school and workplace strategies that occurred between 2005 and 2007.https://openscholarship.wustl.edu/cphss/1099/thumbnail.jp

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

The Impact of Principal Preparation on Student Outcomes

The purpose of this study was to understand the role of principal preparation on first-year principals\u27 ability to positively impact student outcomes. The study sought to understand key learning experiences that contributed to first-year principals\u27 success upon completion of their preparation program. Using the case study method for this qualitative research study, I interviewed first-year principals to gather data on their perceptions of the learning experiences that led to their success. The research question that guided my qualitative research study was: How does one district-led principal preparation program in a large urban city increase first-year principals\u27 capacity to effectively lead a campus and produce positive outcomes? The study highlighted six best practices that all university-based preparation programs and alternative principal pipelines should implement to enhance its participants\u27 learning experiences and their ability to successfully impact student outcomes within their first academic year of the principalship. The themes that emerged from the study as compelling learning experiences to build instructional leadership that impacted student outcomes were data analysis, observation and feedback, and professional learning communities. Themes based on unexpected challenges during their first year as principals serve as gaps in their learning that would enhance all preparation programs. Those themes were: non-instructional systems related to campus operations, soft skills, and transitioning to the principalship. Based on the theoretical framework created from the literature, field-experience and on-the-job support served as meaningful experiences for the preparation of aspiring leaders. Because principals play a crucial role in a campus\u27s success or failure, aspiring leaders must be adequately prepared to lead a campus. Thus, this study contributes to the literature on principal preparation programs

InternalBrace has biomechanical properties comparable to suture button but less rigid than screw in ligamentous lisfranc model

PurposeThe aim of this study was to investigate the biomechanical properties of the InternalBrace for lisfranc injuries.MethodsA Sawbone model was developed comparing screw, suture button and InternalBrace.ResultsWhen loaded in axial tension at 0.5 mm/s, the screw was stiffest (2,240 N/mm), while the InternalBrace (200 N/mm) was stiffer than the suture button (133 N/mm). Cyclic loading with 10,000 cycles of 69 N, 138 N, and 207 N showed the InternalBrace maintained stiffness, but fatigued earlier than the suture button.ConclusionThe mechanical properties of the InternalBrace support clinical use, but further studies are needed regarding early weight bearing