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Use of electronic nicotine delivery systems (ENDS) is becoming increasingly prevalent. ENDS aerosols contain a variety of toxic components that may adversely impact health. Although exposure to traditional cigarette smoke is a risk factor for periodontal disease, the effects of ENDS on oral health have not been adequately examined. To evaluate potential oral health effects associated with ENDS use, a pilot study was performed with 14 current ENDS users and 16 never tobacco users. Participants completed questionnaires about their ENDS use and overall health. Saliva samples were assessed for differential biomarkers of inflammation, toxicity, and disease development. This included evaluation of specific inflammatory cytokines and the global assessment of alterations in metabolites. ENDS users were determined to have elevated saliva levels of interleukin-1β and tumor necrosis factor-α indicative of inflammation. Metabolite profiling determined 368 metabolites were differentially expressed in the saliva of ENDS users versus never tobacco users. Cotinine, the primary metabolite of nicotine, was the most significantly altered metabolite between the groups. Increased levels of prostaglandins and leukotrienes indicated that ENDS users exhibited increased arachidonic acid metabolism compared to never tobacco users. Additionally, a variety of other metabolites known to be involved in immune signaling such as gangliosides, ceramides, angiotensin, and others were also different between groups. Overall, our pilot study demonstrates differential saliva component profiles in current ENDS users, which may contribute to periodontal disease development. These alterations suggest specific pathways of oral disease induced by ENDS use and could be utilized as potential future biomarkers. Impact statement The use of traditional tobacco products is a known risk factor for the development of diseases including periodontal disease. To date, the potential oral health effects related to electronic nicotine delivery systems (ENDS) use is unknown. This study collected saliva from ENDS users and never tobacco users to examine differences in the oral cavity of inflammatory cytokines and metabolites. The identification and measurement of these ENDS-related changes provide insight into disease pathways potentially associated with ENDS use. The utilization of saliva samples collected from human participates enhances the application of the findings compared to the majority of studies using cell culture and animal models. In addition, these foundational findings can inform future studies to examining specific pathways identified, interventional approaches, and application of translatable biomarkers of ENDS use.

Moderate to severe fatigue occurs in 14% to 96% of oncology patients undergoing active treatment. Current interventions for fatigue are not efficacious. A major impediment to the development of effective treatments is a lack of understanding of the fundamental mechanisms underlying fatigue. In the current study, differences in phenotypic characteristics and gene expression profiles were evaluated in a sample of breast cancer patients undergoing chemotherapy (CTX) who reported low (n=19) and high (n=25) levels of evening fatigue. Compared to the low group, patients in the high evening fatigue group reported lower functional status scores, higher comorbidity scores, and fewer prior cancer treatments. One gene was identified as up-regulated and eleven genes were identified to be down-regulated in the high evening fatigue group. Gene set analysis found 24 down-regulated and 94 simultaneously up and down perturbed pathways between the two fatigue groups. Transcript Origin Analysis found that differential expression originated primarily from monocytes and dendritic cell types. Query of public data sources found 18 gene expression experiments with similar differential expression profiles. Our analyses revealed that inflammation, neurotransmitter regulation, and energy metabolism are likely mechanisms associated with evening fatigue severity; that CTX may contribute to fatigue seen in oncology patients; and that the patterns of gene expression may be shared with other models of fatigue (e.g., physical exercise, pathogen-induced sickness behavior). These results suggest that the mechanisms that underlie fatigue in oncology patients are multi-factorial.

The usual view is that truants are lost and troubled juveniles with psychological problems. While the authors agree that many well-known sociological and environmental factors promote truancy, they also confront more disconcerting causes: curriculum and pedagogy. Truancy is much too widespread to continue classifying it as the behavior of social and educational misfits. In recent years new assertions have been made that most truants aren’t social deviants; rather they’re students who become truant as a rational decision. In other words, these rational decision makers are wandering from the appointed place — the school and the classroom — because in their perceptions these places aren’t beneficial for them.

Purpose. The purpose of this study is to examine the efficacy of the healthy lifestyle promotion program on psychosocial well-being among Chinese American adolescents. Methods. A randomized control study design was used. Adolescents in this study received 8 weekly online lessons and completed questionnaires regarding their self-competence, coping strategies, and quality of life at baseline and 2 months, 6 months, and 8 months after the baseline assessment. The primary caregiver completed questionnaires regarding parents’ demographic information at baseline. Findings. A total of 54 adolescents participated in the study (27 in the intervention and 27 in the control group). Results indicate that in contrast to the control group, adolescents in the intervention group increased their use of active coping strategies ( P = .0001) while decreasing the use of avoidance coping strategies ( P = .002), and increased their levels of competence in school ( P = .009). Physical appearance ( P = .001), conduct ( P = .001), and emotional quality of life ( P = .031) improved. Conclusions. A Web-based healthy lifestyle promotion program that incorporates coping skills training (CST) and stress management can improve psychosocial well-being in adolescents. Interventions for improving healthy lifestyles in adolescents need to incorporate information related to cognitive CST and problem-solving skills.

The purposes of this study were to describe the occurrence of chronic pain and to evaluate for differences in pain characteristics and intimate partner violence between women who reported mild compared with moderate to severe chronic pain. A convenience sample of community-based women ( N = 84) was recruited. The 77% of women who reported chronic pain were dichotomized into two groups. Women with moderate to severe pain ( n = 49) were significantly more likely to be unemployed, to be in the abusive relationship longer, to report more minor injuries and threats of violence, and to report pain in multiple locations that significantly interfered with every aspect of their lives.

Background: Clinicians use CA125, a tumor-associated antigen, primarily to monitor epithelial ovarian cancer. However, CA125 lacks the sensitivity and specificity necessary for population-based screening in healthy women. The purpose of this study was to determine if serum concentrations of CA125 differed across the three phases of the menstrual cycle in healthy, premenopausal women using two commercially available assays. Methods: Healthy, Caucasian women between the ages of 18 and 39 were enrolled using strict criteria to exclude factors known to contribute to CA125 fluctuations. Menstrual cycle regularity was determined using calendars maintained by participants for 3 months. After cycle regularity was established, blood was drawn at three time points for CA125 determination using two commercial assays (i.e., Siemens and Panomics). Results: Regardless of the assay used, CA125 values were highest during menses. The CA125 values decreased 0.2 U/ml per day from menses to the end of the same cycle, which resulted in a net decrease of 5.8 U/ml across the cycle. Conclusions: The two commercial assays for CA125 determination demonstrated good concordance in terms of reference ranges regardless of epitope differences. While CA125 levels changed over the course of the menstrual cycle, these changes may not be clinically significant in healthy women. This study is the first to control for factors known to contribute to CA125 elevations; to quantify a decrease in CA125 levels across the menstrual cycle; and to confirm concordance in the relative decreases in serum CA125 levels across the menstrual cycle between two frequently used commercial assays. © The Author(s) 2012.

Recent studies suggest that chronic psychological stress may accelerate aging at the cellular level. Telomeres are protective components that stabilize the ends of chromosomes and modulate cellular aging. Women exposed to intimate partner violence (IPV) experience chronic stress and report worse health. The purpose of this exploratory study was to examine telomeric DNA length in women who have experienced chronic stress related to IPV. We hypothesized that IPV exposure would be associated with shorter telomere length. The investigation used a cross-sectional design to study telomere length in women with a history of IPV exposure and control women who reported no prior exposure to IPV. Advertisements and public notices were used to recruit a convenience sample of healthy women. Mean leukocyte telomere length was measured in DNA samples from peripheral blood mononuclear cells (PBMCs) by a quantitative polymerase chain reaction assay (qPCR). Telomere length was significantly shorter in the 61 formerly abused women compared to the 41 controls ( t = 2.4, p = .02). Length of time in the abusive relationship and having children were associated with telomere length after controlling for age and body mass index (BMI) ( F(2, 99) = 10.23, p < .001). Numerous studies suggest that women who experience IPV have poorer overall health. It is often presumed that the stress of IPV may be causing greater morbidity. Findings from this descriptive study suggest a link between IPV exposure, duration of IPV-related stress, and telomere length molecular mechanisms that regulate cellular aging.

The purposes of this study in children who underwent a cycle of myelosuppressive chemotherapy were to describe changes in symptom occurrence and severity during the chemotherapy cycle. Patients (N = 66) 10 to 18 years of age completed the Memorial Symptom Assessment Scale for 10- to 18-year-olds (MSAS 10-18) at the start of a chemotherapy cycle (T1) and weekly for the next 2 weeks (T2 and T3). More than 30% of children reported 10 or more symptoms at all 3 time points. Symptom occurrence trajectories were tested with multilevel logistic regression. In all, 6 symptoms (ie, fatigue, sadness, irritability, worrying, weight loss, sweating) showed a decreasing linear trend. Significant quadratic patterns of change were found for feeling drowsy, nausea, and vomiting. Changes in symptom severity over time were evaluated with multilevel negative binomial regression. No significant differences over time were found in any of the symptom severity scores on the MSAS. Children experienced a high number of symptoms at the initiation of a chemotherapy cycle that persisted over the subsequent 2 weeks.

Although associations between intimate partner violence, chronic pain, depression, posttraumatic stress disorder (PTSD), and lifetime trauma exposure are well known, previous studies are limited by their recruitment of women from shelters. These relationships were explored with a community-based sample of formerly abused women ( N = 84). Seventy-seven percent of women reported pain of >" xbd="604" xhg="581" ybd="1721" yhg="1685"/>3 months duration, and 75% had moderate to severe pain. Based on logistic regression analysis, women with moderate to severe chronic pain were significantly less likely to be employed, had more depressive symptoms, and were in the abusive relationship longer than women in mild chronic pain. Both pain severity groups had equally high levels of depressive and PTSD symptoms and multiple trauma exposures. Findings document the persistence of significant symptomatology in formerly abused women.

Although fatigue and sleep disturbance are prevalent symptoms in oncology patients and their family caregivers, little is known about the factors that contribute to interindividual variability in symptom severity ratings as well as in their underlying biological mechanisms. In this study, we sought to determine whether a functional genetic variation in a prominent proinflammatory cytokine, tumor necrosis factor-alpha (TNFA-308G>A [rs1800629] promoter polymorphism) was associated with overall ratings of sleep disturbance and fatigue as well as with the trajectories of these symptoms. Over 6 months, participants completed standardized measures of sleep disturbance and fatigue. Multiple linear regression was used to assess the effect of the TNFA genotype and other covariates on mean sleep disturbance and fatigue scores. Hierarchical linear modeling was used to determine the effect of TNFA genotype on the trajectories of these symptoms. Common allele homozygotes reported higher levels of sleep disturbance (p = .09) and morning fatigue (p = .02) than minor allele carriers. Multivariate analyses demonstrated that age and genotype were predictors of both mean symptom scores and the trajectories of these symptoms. Findings provide preliminary evidence of an association between a functional promoter polymorphism in the TNFA gene and the severity of sleep disturbance and morning fatigue in oncology patients and their family caregivers.

Union-management relationships have been filled with fear since the rise of capitalism; public education is no different. Workers fear exploitation by owners (profits depend on it) and capitalist/management has always worried that the working classes will organize and either take over the firm or strike and bring production to a screeching halt. In public education, teachers turned to collective bargaining in the 37 states that allow it to give them greater voice and power over their wages, benefits, and working conditions using collective actions through the American Federation of Teachers (AFL-CIO) and National Education Association, not unlike worker unionism in the private sector. Fear still resides beneath the surface but, since the 1990s, strikes are less common and teachers are well organized and earning better salaries and benefits than ever before. Whenever policies change, as under No Child Left Behind (NCLB) or charter school laws, teacher unions take the lead and are now even opening charter schools to guarantee that these teachers remain union members.

Supporters of public education fear attempts to privatize schools, while the private sector has always struggled against the monopolistic power of the public schools that educates almost 90% of all K-12 students. This trepidation has recently been intensified by the creation of a “third sector” that includes charter schools, voucher programs, and the increased diversity of private education. This article looks at the dynamics of fear as shaped by increased competition among public, private, and privatized schools. In fact, both public schools and their private school counterparts, fear privatization of education because it draws students and resources away from traditional schools. And recently, the opening of new “religious charter schools” has crossed the lines between church and state, and between private and public education. Thus, the politics of education have become somewhat more confused and unnerving as the distinctions between public and private education are virtually disappearing.

Homeschooling has developed from a small, isolated, parent-led effort to a vibrant national movement to lobby for and legalize K-12 education at home in all 50 states. Although a majority of homeschool families are Evangelical Christians, the others come from a variety of religious and nonreligious backgrounds, giving homeschooling a broad national political and social base. Homeschool families have organized regional and national associations, gained children’s access to after-school and even during-school classes and activities in local public schools, and increasingly gained entry to college. About 1.35 million children in the country are being officially home-schooled, making it a vital and expanding form of private education and political force in U.S. society.

Principals play an important role in determining the quality of their schools by the selection of teachers. A preponderance of evidence from the economic and education policy literature indicates that teachers with stronger academic backgrounds produce better student outcomes. This article hypothesizes that school principals with certain attributes are likely to favor teachers with similar attributes to their own. This study uses the Schools and Staffing Surveys from 1993 to 1994 to test whether school administrators who attended more selective universities are more or less likely to hire teachers who attended more selective undergraduate institutions. Findings suggest that principals’undergraduate background matters when it comes to their recruitment, selection, and perhaps retention of teachers with strong academic undergraduate backgrounds, especially in high-poverty schools. Principals in high-poverty schools who attended highly or the most selective undergraduate institutions were 3.3 times more likely to hire teachers who attended similar institutions.

Teacher supervision and evaluation are fundamental responsibilities of the principal. Yet principals and teachers find their supervisory interactions to be difficult and unsatisfying experiences. This article explores the micropolitical context in which supervision and evaluation take place. Highlighting specific examples in New York City, the article argues that the environment in which teacher-principal interactions occur is shaped by union contracts, state and district personnel policies, and precedents set by local experiences with teacher dismissals. These historical and structural factors and others converge to create three traps of supervision.

Objectives The primary objective of the IDEAL study is to determine whether the timing of dialysis initiation has an effect on survival in subjects with end-stage renal disease (ESRD). The secondary objectives are to determine the impact of “early start” versus “late start” dialysis on nutritional and cardiac morbidity, quality of life, and economic cost. Design Prospective multicenter randomized controlled trial. Patients are randomized to commence dialysis at a glomerular filtration rate (by Cockcroft–Gault) of either 10 – 14 mL/minute/1.73 m2 (“early start”) or 5 – 7 mL/min/1.73 m2 (“late start”), with stratification for dialysis modality (hemodialysis vs peritoneal dialysis), study center, and the presence or not of diabetes mellitus. Setting Dialysis units throughout Australia and New Zealand. Patients Patients with ESRD commencing chronic dialysis therapy. Outcome Measures Three years from randomization, all-cause mortality, morbidity, and economic impact; structural and functional cardiac status, nutritional state, and quality of life will be assessed. Results To date, 388 patients of a minimum 800 patients have been entered and randomized into the study. Current recruitment rates suggest sufficient patients will be enrolled by December 2004 and follow-up completed by December 2007. Conclusions The IDEAL study will provide evidence for the optimal time to commence dialysis.

Fifty preschool children with varying amounts of visitation with their previously violent fathers were studied to determine if the amount of father visitation was related to their behavioral functioning. The possible association of the severity of violence witnessed and the quality of the mother-child relationship on child behaviors was also assessed. There was a significant negative relationship between internalizing and externalizing behaviors, as measured by the Child Behavior Checklist, and frequency of father visitation. Children who saw their fathers less frequently evidenced higher internalizing and externalizing scores. More severe levels of violence perpetrated by the father significantly predicted increased externalizing behavior scores but not internalizing scores. Severity of violence was more predictive of externalizing behaviors than frequency of father visitation.

← ObjectiveTo determine the effect of renal function at the commencement of dialysis on nutritional state.← DesignRetrospective cohort study.← SettingUniversity tertiary referral hospital.← PatientsPatients with end-stage renal disease commencing renal replacement therapy over 8.5 years.← Main Outcome MeasuresTotal body nitrogen assessment using in vivo neutron activation analysis, expressed as nitrogen index (NI = observed total body nitrogen/predicted total body nitrogen); serum albumin measurement and creatinine clearance estimation, using the Cockcroft– Gault equation, at the start of dialysis. “Early” start group = creatinine clearance > 10 mL/minute ( n = 26). “Late” start group = creatinine clearance ≤ 10 mL/min ( n = 108).← ResultsMean NI was significantly lower [95% confidence interval (CI) 6% – 30%, p < 0.0001] in the late start group (NI = 88%) compared to the early start group (NI = 106%). The late start group also had a significantly lower (95% CI 0.06 – 0.47 g/dL, p = 0.02) mean serum albumin level (3.66 g/dL) compared to that of the early start group (3.93 g/dL)A. positive independent correlation existed between renal function and total body nitrogen ( r2= 0.21, p < 0.0001). No other clinical or demographic variable at the start of dialysis was found to predict nutritional state.← ConclusionsPatients that start dialysis with low levels of renal function are likely to be significantly malnourished. Whether this translates into a survival advantage requires prospective study.

This article presents the findings of a random national sample of 1,719 superintendents, using a 67-item survey instrument called the Superintendents’ Professional Expectations and Advancement Review (SPEAR), which measures superintendents’ occupational perceptions, career satisfaction, and job mobility. The study's major findings include that superintendents perceive the quantity of applicants for the superintendency to have decreased in recent years and are concerned about high turnover of superintendents. However, superintendents are less worried about the quality of applicants for vacancies. Contrary to popular perception, superintendents report significant career satisfaction, particularly in the nation's largest districts. The study concludes by offering possible explanations for the widespread public perception of a crisis in the superintendency.

This study examines the longevity in office of superintendents in 292 school districts, using data from the period 1975-99. Random samples of districts from across the United States, as well as all school districts from North Carolina, were studied. Data were analyzed by survival analysis techniques, using information on superintendents, districts, and school boards as predictors. Superintendent tenure has not changed significantly since 1975-79, averaging 6–7 years over the whole period. Significantly related to survival in office were level of school board involvement in management, support for needed construction, merger of school systems, district poverty level, and superintendent postgraduate education.

The term "rubric" is used widely in education. In the classroom, rubric may mean a set of categories, criteria for assessment, and the gradients for presenting and evaluating learning. When grading a student's essay, for example, a teacher may apply a rubric for its quality of organization, giving a 3 for Advanced Proficient, 2 for Proficient, and a 1 for Partially Proficient. Other criteria that could be rubrics include the use of examples, paragraph structure, grammar, and overall quality. Yet, like many terms in education, the meaning of rubric is confusing. For example, Wiggins defines a rubric as "one of the basic tools in the assessor's kit ... telling us what elements matter most" (1998, p. 153). Schmoker states that a rubric "simply means a rule or guide ... by which students' performance or product is judged. It nails down the criteria, making them available to schools, teachers, parents, and students and providing clear direction and focus" (2006, pp. 70-71). And Guskey explains that rubrics "are specific guidelines that can be used to describe students' work in reading, writing, mathematics, and other content areas" (1994, p. 25). The term, apparently, can refer to almost anything: rule, guide, criterion, or description that is used to assess the progress of students in their academic subjects, as well as the grading system for assessing each criterion. The term rubric has been used in English since the 1400s, making it as old as it is interesting. The root of rubric refers to the color red or red earth. The Oxford English Dictionary gives an example of the term used in 1607: "this marrow of a deer in sheep's milk with rubric and soft pitch, drunk every day, helps the digestion and obstructions." Another meaning, closer to how it is currently used in education, is the heading of a chapter or division of a book, written or printed in red ink or underlined in red for emphasis. In 1658, Phillips stated that a rubric is "a noted Sentence of any Book marked with red Letters." The Catholic Church has long employed the term for the directions for conducting the Mass, which are printed in red and inserted into liturgical books. Foxe in 1583 explained that a rubric is part of "the whole Canon of the Masse, with the Rubricke thereof, as it standeth in the Masse/booke." John Wesley, the founder of the Methodist church, stated that "as a Minister, I teach her Doctrines. I use her Offices. I conform to her Rubricks." And in law, a rubric is a heading or title of a statute or section of a legal code (again, originally printed in red ink). In 1634, Kirk explained that "When this Act came to be heard in open Parliament, his Majestie gave orders to read only the rubricks of it." Red delineations, headings, and divisions--the term rubric has a long and interesting history. APPLYING RUBRICS Educators today use rubric to refer to a category of behavior that can be used to evaluate performance. The term is currently so popular that no one writing a funding proposal would ignore laying out the rubric for evaluating the program's success. Today's rubrics involve creating a standard and a descriptive statement that illustrates how the standard is to be achieved. For example, a rubric for judging an essay would list everything a student needs to include to receive a certain grade on that essay. Generally, the rubric also would specify what is needed to achieve different levels of performance, such as what is needed for an A, a B, etc. In addition to helping students know what they need to do to achieve a certain grade, rubrics have other benefits: 1. A rubric can help teachers think carefully and critically about what they are teaching and what students need to learn. The rubric is a predetermined set of categories. Whatever the subject or project for which it's used, a rubric will help teachers consider what's important for them to teach and how to determine the level at which students have learned what's been taught. …

Urban teachers unions, as mature institutions, face three dilemmas. First, they struggle to maintain their ranks through an active role in the preparation/recruitment of new teachers while raising standards (limiting supply) and thus raising demand and salaries. Second, unions seek to become a more powerful national voice for teachers (by attempting to merge the American Federation of Teachers and the National Education Assocation while serving the local district needs of their membership. And finally, and most complexly, unions strive to preserve large, monopolistic public education while being aware of the need to reform, restructure, and even privatize schools to drive improvement.

Research in education is a value-free, unbiased, neutral, social scientific pursuit of truth, using the best methods, and models available—or so we were told when we were learning the craft. The past 30 years have witnessed dramatic changes in how we view research and education. Traditional paradigms of research of methodology now compete with a variety of qualitative approaches and critical theory has unmasked the neutrality of education. This article provides an introduction to these issues and concerns of the politics of research on education as well as an outline of each chapter.

The objective of this study was to see whether outcome of infants of larger birth weight (1,000-1,499 grams) has changed with advances in neonatology. The outcome of infants born in a recent time period (1989-1991) was compared with that of infants born previously, in 1984-1986 and 1979-1981. Univariate analyses were conducted on the association of medical risk factors and date of birth with outcome. More than 90% of infants in each time period were neurologically normal and more than 80% were cognitively normal. Predictor variables were intracranial hemorrhage for poor neurologic outcome and days on oxygen for poor cognitive outcome. We found that neurodevelopmental outcome was stable over three time periods.

An after-school program encourages at-risk teens to stay in school by providing tutoring, therapy, and enrichment.

Families play a vital role in supporting school improvement—especially par ents, who are critical in inculcating personal values and civic virtues in their children; in teaching basic life skills; in helping schools as parent vol unteers and as decisionmakers; in selecting schools for their own chil dren ; and as advocates for all children.

The term "rubric" is used widely in education. In the classroom, rubric may mean a set of categories, criteria for assessment, and the gradients for presenting and evaluating learning. When grading a student's essay, for example, a teacher may apply a rubric for its quality of organization, giving a 3 for Advanced Proficient, 2 for Proficient, and a 1 for Partially Proficient. Other criteria that could be rubrics include the use of examples, paragraph structure, grammar, and overall quality. Yet, like many terms in education, the meaning of rubric is confusing. For example, Wiggins defines a rubric as "one of the basic tools in the assessor's kit ... telling us what elements matter most" (1998, p. 153). Schmoker states that a rubric "simply means a rule or guide ... by which students' performance or product is judged. It nails down the criteria, making them available to schools, teachers, parents, and students and providing clear direction and focus" (2006, pp. 70-71). And Guskey explains that rubrics "are specific guidelines that can be used to describe students' work in reading, writing, mathematics, and other content areas" (1994, p. 25). The term, apparently, can refer to almost anything: rule, guide, criterion, or description that is used to assess the progress of students in their academic subjects, as well as the grading system for assessing each criterion. The term rubric has been used in English since the 1400s, making it as old as it is interesting. The root of rubric refers to the color red or red earth. The Oxford English Dictionary gives an example of the term used in 1607: "this marrow of a deer in sheep's milk with rubric and soft pitch, drunk every day, helps the digestion and obstructions." Another meaning, closer to how it is currently used in education, is the heading of a chapter or division of a book, written or printed in red ink or underlined in red for emphasis. In 1658, Phillips stated that a rubric is "a noted Sentence of any Book marked with red Letters." The Catholic Church has long employed the term for the directions for conducting the Mass, which are printed in red and inserted into liturgical books. Foxe in 1583 explained that a rubric is part of "the whole Canon of the Masse, with the Rubricke thereof, as it standeth in the Masse/booke." John Wesley, the founder of the Methodist church, stated that "as a Minister, I teach her Doctrines. I use her Offices. I conform to her Rubricks." And in law, a rubric is a heading or title of a statute or section of a legal code (again, originally printed in red ink). In 1634, Kirk explained that "When this Act came to be heard in open Parliament, his Majestie gave orders to read only the rubricks of it." Red delineations, headings, and divisions--the term rubric has a long and interesting history. APPLYING RUBRICS Educators today use rubric to refer to a category of behavior that can be used to evaluate performance. The term is currently so popular that no one writing a funding proposal would ignore laying out the rubric for evaluating the program's success. Today's rubrics involve creating a standard and a descriptive statement that illustrates how the standard is to be achieved. For example, a rubric for judging an essay would list everything a student needs to include to receive a certain grade on that essay. Generally, the rubric also would specify what is needed to achieve different levels of performance, such as what is needed for an A, a B, etc. In addition to helping students know what they need to do to achieve a certain grade, rubrics have other benefits: 1. A rubric can help teachers think carefully and critically about what they are teaching and what students need to learn. The rubric is a predetermined set of categories. Whatever the subject or project for which it's used, a rubric will help teachers consider what's important for them to teach and how to determine the level at which students have learned what's been taught. …

Purpose For some critically ill children, no attempts at resuscitation are made because further therapy is judged inappropriate. Most pediatric deaths involve withdrawal of life support (WDS); however, do not resuscitate (DNR) orders remain infrequent in this population. We studied DNR orders and WDS decisions for children with life-limiting illnesses. Methods We randomly selected 57 hospital records from all 120 in-patient pediatric deaths that occurred in 1 year at an academic children9s hospital. Demographics, end-of-life patient care conferences with parents, DNR orders, WDS, and time intervals between conferences and death were abstracted. Results Of 57 pediatric in-patient deaths, median age at death was 29 days. Median length of stay for terminal hospitalization was 10 days. Median time from first patient care conference with parents to the child9s death was 2 days. 95% of deaths occurred in intensive care settings. 11 patients did not have support withdrawn or a DNR. 23 patients had a written DNR order, while 42 patients had WDS. Of 19 with both DNR and WDS support, 16 had the DNR written within 48 hours of WDS. DNR orders were more common when patients died ≥ 2 days vs. ≤ 2 days (p=0.01) after the first parent conference. DNR orders did not significantly differ by age at death, length of stay, race, or unit at death, although sample size was small. Differences among primary diagnoses (oncologic, infectious, prematurity, non-cardiac anomalies, cardiac, respiratory and CNS conditions) were not statistically correlated with DNR status. Conclusions Most pediatric deaths still occur in intensive care settings. Many patients have neither WDS nor a DNR order and die receiving maximal therapy. Almost 50% of patients in whom life-support is withdrawn do not have a written DNR order. DNR orders do not appear to be a common first step in limiting treatment, but are written with the expectation of WDS and imminent death. Finally, earlier patient care conferences significantly increased the probability of having a DNR order. Given the short interval from poor prognosis to death, we may need to redefine palliative care practices to fit the realities of how and where children die.

Schools and parents together will be far better at educating than the schools by themselves. In New York City, "PIP," "POP," and "PLAN" assure joint efforts.