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In response to increased accountability demands placed on teacher preparation programs across the United States, some programs are using standardized teacher performance assessments, such as edTPA. In our elementary teacher preparation program, a recent state mandate stipulated that teacher candidates had to successfully complete edTPA in order to receive teacher certification. This case study used mixed methods to examine teacher candidates' (N=30) experiences and views while engaging in the assessment. Preparation for edTPA was integrated in specific courses in the program. Data were collected through a survey and individual interviews, with the analysis showing the teacher candidates felt largely ready for and supported during the edTPA completion but did not view the assessment as a fair measure of teaching effectiveness or tend to believe it improved them as neophyte teachers. The findings illuminate concerns about edTPA's use and implications for the program that could be considerations for others using edTPA, including program and curricular refinements. Keywords: elementary teacher preparation, teacher performance assessment, edTPA, Introduction Teacher effectiveness has shifted to the top of education policy agendas (Darling-Hammond, 2017), with more policies and practices directed at the standardization of teacher education. A growing approach is [...]

The title of this article very well could have been Teddy Roosevelt's other favorite slogan. That is, had he been equipped with the Administrative Procedure Act and the modern federal [...]

OBJECTIVE We evaluated the quality of periconception medical care in pregnant women with diabetes and assessed the influence of sociodemographic characteristics. RESEARCH DESIGN AND METHODS The study was based on [...]

ABSTRACTThis 5-year mathematics professional development project involves 27 elementary teachers prepared and supported as Elementary Mathematics Specialists (EMSs) in high-need, urban schools. The EMSs are a distinctive population as informal teacher leaders, with a primary responsibility of teaching students. Described here are data collected at the end of Year 1 via a survey of coaching practices, a teacher leader record, and individual and focus group interviews. The findings illuminate the variety of ways they were serving as a more knowledgeable other and practicing agency in this teacher leadership. They were agentic in their teacher leader efforts by navigating constraints through: focusing on incremental changes; developing collegial, trusting relationships with peers; and leaning into the network of teacher support in the project. The findings also provide insights into how their primary and concurrent role as teacher of students provided credibility and understanding with fellow teachers, contributing to affordances in their informal teacher leader capacity.

Background Higher rates of postoperative complication following cleft lip or palate repair have been documented in low resource settings, but their causes remain unclear. This study sought to delineate patient, surgeon, and care environment factors in cleft complications in a low-income country.Design Prospective outcomes study.Setting Comprehensive Cleft Care Center.Patients Candidate patients presenting for cleft lip or palate repair or revision.Interventions Patient anthropometric, nutritional, environmental and peri- and post-operative care factors were collected. Post-operative evaluation occurred at standard 1-week and 2-month postoperative intervals.Main Outcome Measures Complication was defined as fistula, dehiscence and/or infection.Results Among 408 patients enrolled, 380 (93%) underwent surgery, of which 208 (55%) underwent lip repair (124) or revision (84), and 178 (47%) underwent palate repair (96) or revision (82). 322 (85%) were evaluated 1 week and 166 (44%) 2 months postoperatively. 50(16%) complications were identified, including: 25(8%) fistulas, 24(7%) dehiscences, 17(5%) infections. Mid-upper arm circumference (MUAC) ≤12.5 cm was associated with dehiscence after primary lip repair (OR = 28, p = 0.02). Leukocytosis ≥11,500 on pre-operative evaluation was associated with dehiscence (OR = 2.51, p = 0.04) or palate revision fistula (OR = 64, p < 0.001). Surgeons who performed fewer previous-year palate repairs had higher likelihood of palate complications, (OR = 3.03, p = 0.01) although there was no difference in complication rate with years of surgeon experience or duration of surgery.Conclusions Multiple patient, surgeon, and perioperative factors are associated with higher rates of complication in a low-resource setting, and are potentially modifiable to reduce complications following cleft surgery.

OBJECTIVE--Diabetic women are at increased risk for adverse pregnancy outcomes that can be improved by preconception care. Our goal was to evaluate the quality of medical care in diabetic women [...]

Junior leaned back into his plastic, foldup chair, making it creak with the stress. He was watching the heat off his grandmother's cement back porch distort a thin layer of [...]

The expansion of environmental law since the 1970s has resulted in comprehensive regulatory schemes in many areas of environmental law in which federal or state programs effectively occupy the field. [...]

Background and Objective: Topical microbicides will only be effective if they are acceptable to potential users. The purpose of this study is to develop a scale to evaluate characteristics and aspects of topical microbicides that are important to adolescent girls. Study Design: Girls (n = 207) completed a questionnaire on perceptions of microbicide-like products. Results: A principal components factor analysis with a varimax rotation produced a 6-factor solution. The mean factor scores suggested that girls saw the products positively. Age was positively correlated with 'comparison to condoms' and 'comfort while using' factor scores and inversely correlated with 'negative impact on interpersonal relationships' factor score. Sexually transmitted infection (STI) history was related to higher scores on the 'health benefits' and 'pleasure' factors. Age, race/ethnicity, and STI history were not related to the other factor scores. Conclusion: The current scale shows promise in assessment of microbicide acceptability, and in general, girls expressed positive views about microbicides.

Objective: The number of older patients with chronic schizophrenia is increasing. There is a need for empirically validated psychotherapy interventions for these patients. Cognitive behavioral social skills training teaches cognitive and behavioral coping techniques, social functioning skills, problem solving, and compensatory aids for neurocognitive impairments. The authors compared treatment as usual with the combination of treatment as usual plus cognitive behavioral social skills training. Method: The randomized, controlled trial included 76 middle-aged and older outpatients with chronic schizophrenia, who were assigned to either treatment as usual or combined treatment. Cognitive behavioral social skills training was administered over 24 weekly group sessions. Blind raters assessed social functioning, psychotic and depressive symptoms, cognitive insight, and skill mastery. Results: After treatment, the patients receiving combined treatment performed social functioning activities significantly more frequently than the patients in treatment as usual, although general skill at social functioning activities did not differ significantly. Patients receiving cognitive behavioral social skills training achieved significantly greater cognitive insight, indicating more objectivity in reappraising psychotic symptoms, and demonstrated greater skill mastery. The overall group effect was not significant for symptoms, but the greater increase in cognitive insight with combined treatment was significantly correlated with greater reduction in positive symptoms. Conclusions: With cognitive behavioral social skills training, middle-aged and older outpatients with chronic schizophrenia learned coping skills, evaluated anomalous experiences with more objectivity (achieved greater cognitive insight), and improved social functioning. Additional research is needed to determine whether cognitive insight mediates psychotic symptom change in cognitive behavior therapy for psychosis.

Objective: The frequency and nature of sustained remission of schizophrenia are controversial. Method: The authors assessed the prevalence of sustained remission among 155 middle-aged and elderly outpatients living independently. They compared patients with sustained remission to symptomatic schizophrenia patients and normal comparison subjects using standardized psychopathological, cognitive, and functional measures. Results: Eight percent of the older schizophrenia patients living independently met criteria for sustained remission. Their level of psychopathology was similar to that in normal subjects and lower than that in symptomatic patients. On cognition, quality of well-being, and everyday functioning, the group with sustained remission was intermediate between the normal and symptomatic groups and differed significantly from the normal subjects. Conclusions: Sustained remission can occur even in older patients with very chronic illness, but its prevalence is lower than that in several published reports. Remission may reflect a return to premorbid functioning, consistent with neurodevelopmental hypotheses of schizophrenia.

Objective:A syndemic of violence exposure, substance misuse, and mental health problems (i.e., depression, anxiety, posttraumatic stress disorder) is associated with increased unprotected anal sex and number of sexual partners in young men who have sex with men (YMSM). However, few studies have examined multiple forms of violence—including childhood abuse, intimate partner violence, and community violence—and identified which factors are significant predictors of HIV risk for YMSM when controlling for all other factors. Accordingly, this study examined the additive and independent influence of different forms of violence, substance misuse, and mental health problems associated with sexual risk behaviors in YMSM who used HIV prevention services. Method:A convenience sample of 168 (97 Black or multiethnic Black, 71 white) YMSM ages 18–34 completed computer-assisted personal interviews assessing syndemic factors and HIV risk behaviors. We conducted Spearman correlations and negative binomial regressions to describe syndemic relationships and identify the significant independent predictors of HIV risk. Results:A syndemic of violence exposure, substance use, and mental health problems was observed in the sample. Also, participants with depression, drug abuse in the clinical range, and polydrug use reported significantly higher frequencies of sexual risk behaviors. Violence exposure did not uniquely predict sexual risk. Conclusions:Depression, drug abuse, and polydrug use should be targets for HIV prevention among YMSM using HIV prevention services.

Background: The majority of research to understand the risk factors of nonsyndromic orofacial clefts (NSOFCs) has been conducted in high-income populations. Although patients with NSOFCs in low- and middle-income countries (LMICs) are at the highest risk of not receiving care, global health infrastructure allows innovative partnerships to explore the etiologic mechanisms of cleft and targets for prevention unique to these populations.Methods: The International Family Study (IFS) is an ongoing case–control study with supplemental parental trio data designed to examine genetic, environmental, lifestyle, and sociodemographic risk factors for NSOFCs in 8 LMICs (through August 2020). Interview and biological samples are collected for each family. The interview includes demographics, family history of cleft, diet and water sources, maternal pregnancy history, and other lifestyle and environmental factors.Results: Seven of 8 countries are currently summarized (2012-2017) for a total of 2955 case and 2774 control families with 11 946 unique biological samples from Vietnam, Philippines, Honduras, Madagascar, Morocco, Democratic Republic of the Congo, and Nicaragua. The phenotype distribution was 1641 (55.5%) cases with cleft lip and palate, 782 (26.5%) with cleft lip (CL), and 432 (14.6%) with cleft palate (CP).Discussion: The International Family Study is the largest case set of NSOFCs with an associated biobank in LMICs currently assembled. The biobank, family, and case–control study now include samples from 8 LMICs where local health care infrastructure cannot address the surgical burden of cleft or investigate causal mechanisms. The International Family Study can be a source of information and may collaborate with local public health institutions regarding education and interventions to potentially prevent NSOFCs.

OBJECTIVE -- This study evaluated the 3-month follow-up data of the Eat Well, Live Well Nutrition Program, a culturally specific, peer-led dietary change program designed to reduce the risk of [...]

Objective: To identify factors associated with late cleft repair at a US tertiary children’s hospital.Design: Retrospective study of children with CL/P using Children’s Hospital Los Angeles (CHLA) records.Setting: US tertiary children’s hospital.Patients/Participants: Patients undergoing primary CL or CP repair at CHLA from 2009 to 2018.Main Outcome Measures: Proportion of children who had delayed primary CL repair or CP repair using CHLA and American Cleft Palate-Craniofacial Association (ACPA) guidelines and factors associated with late surgery.Results: In total, 805 patients—503 (62.5%) who had CL repair, 302 (37.5%) CP repair—were included. Using CHLA protocol, 14.3% of patients seeking CL repair had delayed surgery. Delay was significantly associated with female gender, non-Hispanic ethnicity, Spanish primary language, government insurance, bilateral cleft, cleft lip and palate (CLP), and syndromic diagnosis. Using ACPA guidelines, 5.4% had delayed surgery. Female gender and syndromic diagnosis were significantly associated with delay and remained significant after adjustment for confounders in multivariate models. For CP repair, 60.3% of patients had delayed surgery using CHLA protocol. Cleft lip and palate diagnosis, complete cleft, syndromic diagnosis, and longer travel distance were significantly associated with delay. Using ACPA guidelines, 28.5% had delayed surgery; however, significant association with patient variables was not consistently observed.Conclusions: Delay in cleft surgery occurs most often for patients seeking CP repair and is associated with female gender, non-Hispanic ethnicity, Spanish language, government insurance, and bilateral CL, CLP, or syndromic diagnoses. Initiatives should aim to optimize cleft surgery delivery for these subpopulations.

in this study the authors describe the investigation of a 1992 outbreak of green tobacco sickness, a form of nicotine poisoning from dermal exposure, among 47 tobacco workers in a five-county region of central and south-central Kentucky. Cases were identified through medical record searches at participating hospitals, as well as from reports submitted to the Occupational Health Nurses in Agricultural Communities program. A case-control study was undertaken to assess risk factors for green tobacco sickness. In a 20-min telephone interview, 40 cases and 83 controls responded to questions contained in a questionnaire. in 1992, 47 persons (3 were under age 16 y) in the study region sought medical treatment for green tobacco sickness. Twelve persons were hospitalized and 2 required intensive-care treatment. The crude incidence in 1 992 was 10.0/1 000 tobacco workers. in 1993, 66 cases (7 were under age 16 y) of green tobacco sickness were identified in the study region (i.e., annual incidence of 14.0/1 000). A case-control study demonstrated that ill workers were younger, and were more likely to have worked in wet conditions, compared with workers who were not ill. Green tobacco sickness is a common problem among tobacco workers that may be prevented by avoiding work in wet tobacco or by use of protective clothing. Children younger than 16 y of age represented 9% of the green tobacco sickness cases in 1992 and 1993. Current occupational safety and health laws do not address protection of tobacco workers with respect to green tobacco sickness., Green tobacco sickness (GTS) is a form of nicotine poisoning that affects tobacco workers who have direct contact with tobacco plants during cultivation and harvesting. More than 20 y ago, [...]

A case report of epithelioid adrenal angiosarcoma is presented. Tumor cells showed expression of cytokeratin, Factor VIII-related antigen, Ulex europaeus agglutinin-I, and vimentin. The patient also was found to have mesenteric fibromatosis (abdominal desmoid tumor) and an elevated serum level of estradiol. The authors discuss the unique appearance of these rare tumors, their relationship to hyperestrinism, and review the recent data in the literature showing cytokeratin expression by malignant epithelioid vascular tumors. Cancer 1992; 69:1808-1812.

About 41% of total energy consumption in the U.S. of year 2014 is used for heating and air conditioning, that is about 40 quadrillion (40×1015) British thermal units (BTU). Despite the fact that people have been working on on fault detection and diagnosis (FDD) for Heating, Ventilation, and Air Conditioning (HVAC) systems for a long time, very few publications have focused on scalability and low cost. In order to address this challenge, we will propose an approach which focuses on control-system data. Several machine learning algorithms are introduced for data exploration and analysis, a control-system data focused model free approach is presented as well, and finally, FDD is carried out by implementing anomaly algorithms. A simulation model is used to evaluate the performance of the various algorithms.

Objective: To evaluate characteristics of congenital heart disease (CHD) in patients with cleft lip and/or palate (CL/P) and assess potential associations with cleft outcomes.Design: Retrospective review of all patients with CL/P who underwent primary cleft treatment from 2009 to 2015.Setting: Children’s Hospital Los Angeles, a tertiary hospital.Patients: Exclusion criteria included microform cleft lip diagnosis, international patients, and patients presenting for secondary repair or revision after primary repair at another institution.Main Outcomes Measured: Patient demographics, prenatal and birth characteristics, CL/P characteristics, syndromic status, postoperative complications, and other outcomes were analyzed relative to CHD diagnoses and management. Patients with CL/P with (+CHD) were compared to those without (−CHD) CHD using χ2tests and analysis of variance.Results: Among 575 patients with CL/P, 83 (14.4%) had CHD. Congenital heart disease rates were significantly higher in patients with cleft palate (CP) compared to other cleft types (χ2, P= .009). Eighty-one (97.6%) out of 83 +CHD patients were diagnosed prior to initial CL/P surgical assessment. Twenty-three (27.7%) +CHD patients required surgical repair of 10 cardiac anomalies prior to cleft care. Congenital heart disease was associated with delayed CP repair and increased rates of fistula in isolated patients with CP.Conclusions: Congenital heart disease is known to be more prevalent in patients with CL/P. These data suggest the condition is particularly increased in patients with CP. Severe forms of CHD are diagnosed and treated prior to cleft care however postoperative fistula may be more common in patients with CHD. Therefore, careful attention is required for patient optimization and palatal flap dissection in patients with coexisting CHD and CL/P.

The abuse of power, said the artist Jenny Holzer, comes as no surprise, and it certainly never has to me. I spent my childhood beneath the omnipotent thumb of the [...]

When I was a child, my mother told me that everyone in the world hated me. They hated me, she said, because I was a Jew. So? I asked. So [...]

It is almost Thanksgiving, and so my wife and I are making plans. We are making calls. Unfortunately, we discover, the Xs, with whom we often share the holiday dinner, [...]

Byline: PHOTOGRAPHS BY TONY KELLY MY HARD-CORE OBSESSION Threesomes, fishnets, dirty talkthose are the vanilla sorts of fantasies we admit to. Then there's the truly filthy porn we actually watch [...]

And so we arrive, once again, at that hallowed time of the year when man bows his head to the Lord, trembling in fear, pounding his chest in regret and [...]

I'm going to propose a constitutional amendment here, and I want you to stay with me for a moment before rejecting it out of hand: Henceforth, every adult citizen of [...]

For a number of reasons, I've never been a fan of testicles. Not my own, not those of others. They're ridiculous-looking, lazily conceived; they seem to me as if God [...]

I have a great idea for a holiday. It's called Fuck-Off Day. One day a year, every year, everyone in the country stays home. No get-togethers, no barbecues, no nothing. [...]

For Sons [non-translatable text] Hear our voice, Hashem our God, pity and be compassionate to us, and deliver us, Oh Father in Heaven, from our mothers here on Earth. Bring [...]

Byline: Shalom Auslander It was 2002, and the city had been irreparably -Giulianified. Everything was gorgeous, and I hated it. The parks were gorgeous, the streets were gorgeous, even Times [...]

Jonathon Rosen Bad news, folks. I'm afraid John Calvin may have been right: Things suck, and they're not going to get better, because you suck, too. I'm paraphrasing. Slightly. Of [...]

The Tallis Revolution: Ultra-Orthodox Jews in Brooklyn take up arms against the scantily clad bicyclists who ride through their neighborhoods. 'No Biblically Ordained Modesty, No Peace,' they will chant. Might [...]

I had this idea for a story. I won't tell you what it was, but it was good. Really good. It was great. Maybe not great, but good. It was [...]

Jonathon Rosen Day 27, 7 a.m. My editor wakes up and has much to do before the day begins, none of which includes reading the manuscript I sent him almost [...]

Mid-June. A pleasant summer morning. 11 a.m.: Shalom, are you going to mow the lawn? I hate mowing the fucking lawn. The Andersons will be here soon. Goddamit. All Frog [...]

The history of geniusand let's face it, I am a geniusis a long and storied one. Some of the most beloved stories are of seemingly divine revelation: ideas, plots, concepts, [...]

Margarita Korol/Tablet Magazine 'Hey, Shalom, how are you doing?' I am at a teacher-parent function at my son's school, and the manlet's call him K is smiling broadly as he [...]

CREDIT: Jonathon Rosen I don't know, this just isn't working. You're being too hard on yourself, Dear. It feels obvious. What's obvious about it? I feel like I've heard it [...]