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The benefit of surveillance colonoscopy in older adults is not well described. To quantify the detection of colorectal cancer (CRC) and advanced polyps during surveillance colonoscopy in older adults with a history of colon polyps. We conducted a systematic review (MEDLINE, Cochrane Library, Web of Science, and Embase) for all published studies through May 2020 in adults age > 70 undergoing surveillance colonoscopy. The main outcome was CRC and advanced polyps detection. We performed meta-analysis to pool results by age (>70 vs. 50–70). The search identified 6239 studies, of which 569 underwent full-text review and 64 data abstraction, of which 19 were included. The risk of detecting CRC (N = 11) was higher in those >70 compared to 50–70 (risk ratio 1.5 (95% CI 1.1–2.2); risk difference 0.8% (95% CI −0.2%–1.8%)). Similarly, the risk of detecting advanced polyps (N = 8) was higher in those >70 compared to 50–70 (risk ratio 1.3 (95% CI 1.2–1.3), risk difference 2.7% (95% CI 1.3%–4.0%)). Most studies did not stratify results by baseline polyp risk. The detection of CRC and advanced polyps during surveillance colonoscopy in older individuals was higher than in younger controls; however, the absolute risk increase for both was small. These differences must be weighed against competing medical problems and limited life expectancy in older adults when making decisions about surveillance colonoscopy. More primary data on the risks of CRC and advanced polyps accounting for number of past colonoscopies, prior polyp risk, and duration of time since last polyp are needed.

The benefit of surveillance colonoscopy in older adults is not well described.To quantify the detection of colorectal cancer (CRC) and advanced polyps during surveillance colonoscopy in older adults with a history of colon polyps.We conducted a systematic review (MEDLINE, Cochrane Library, Web of Science, and Embase) for all published studies through May 2020 in adults age 70 undergoing surveillance colonoscopy. The main outcome was CRC and advanced polyps detection. We performed meta-analysis to pool results by age (70 vs. 50-70).The search identified 6239 studies, of which 569 underwent full-text review and 64 data abstraction, of which 19 were included. The risk of detecting CRC (N = 11) was higher in those70 compared to 50-70 (risk ratio 1.5 (95% CI 1.1-2.2); risk difference 0.8% (95% CI -0.2%-1.8%)). Similarly, the risk of detecting advanced polyps (N = 8) was higher in those70 compared to 50-70 (risk ratio 1.3 (95% CI 1.2-1.3), risk difference 2.7% (95% CI 1.3%-4.0%)). Most studies did not stratify results by baseline polyp risk.The detection of CRC and advanced polyps during surveillance colonoscopy in older individuals was higher than in younger controls; however, the absolute risk increase for both was small. These differences must be weighed against competing medical problems and limited life expectancy in older adults when making decisions about surveillance colonoscopy. More primary data on the risks of CRC and advanced polyps accounting for number of past colonoscopies, prior polyp risk, and duration of time since last polyp are needed.

Meeting the instructional needs of exceptional students in general education classrooms is a complex process. The typical, traditional curriculum used in general education classrooms may not address these students' unique needs, particularly in the areas of behavioral and social skills. This article presents a model for teaching social and behavioral skills in the context of the general curriculum and presents the Violence is Preventable infusion approach. Teachers familiar with curriculum and thematic integration may feel comfortable including skills and content from social and behavioral areas within their regular instructional units.

Classroom management in middle school is a challenge—this article shows you how

The Systematic Screening for Behavior Disorders (SSBD) (Walker & Severson, in press) procedure was further evaluated. Two studies are reported in which validation, replication, and normative questions were addressed. Study I was conducted in a suburban Oregon school district in which 15 elementary schools and their teachers participated. Study 2 was conducted in two school districts, one urban and one suburban, in the state of Washington. The primary focus of Study I was upon normative and validity questions (factorial, criterion-related, and discriminant): the primary focus of Study 2 was upon replication and reliability questions. The results of Study I produced evidence of the SSBD's validity, as indicated by powerful subject group differences and criterion-related validity coefficients between SSBD measures and archival school record profiles. The results of Study 2 closely replicated those of Study I and extended the results of Study 1 in two respects. Study 2 included test-retest estimates of SSBD Stage 1 and 2 measures for 40 participating teachers, and an empirical verification of the SSBD system's sensitivity to the behavioral characteristics of previously certified severely emotionally disturbed (SED) students who were main-streamed into the participating teachers' classrooms. Future research plans and school applications of the SSBD system and the measures it comprises are also discussed.

Simple Precision Teaching-based probes were used in a regular kindergarten class to identify pupils who might be at risk for demonstrating potentially serious learning problems. Two, one-minute probes were completed with each pupil to assess their performances in six basic skill areas targeted for instruction in the kindergarten curriculum and listed on the kindergarten report card: see-say letter names from ordered and random lists, see-say letter sounds from ordered and random lists, seewrite (copy) numbers from a random list, and see-say colors. The probe on seelsay letter sounds from a random list proved to discriminate most easily among students who had already mastered the skill and those who had not yet mastered it, so it was selected as the instructional target for a special remedial program. The nine lowest performing students on that skill were provided 15 minutes of small group direct instruction for three days each week over an eleven week period. During the course of the remedial program, six of the students mastered the skill, but three did not. Those students were therefore considered at risk of potentially serious learning problems, and in need of more highly individualized instructional attention. Implications for practice and the continued development of procedures for identifying children in need of more individualized instruction are discussed. If they are identified as having learning difficulties early in their school years, students might be helped before their problems multiply (Epstein, Kauffman, & Cullinan, 1985; Wallace & Larsen, 1986). The Precise Identification and Remediation for Learning (PIRL) project was established to accomplish this goal of early identification using procedures that could be implemented easily in a regular education kindergarten.

Escape of photoelectrons from the Jovian ionosphere produces only a meager source of thermal plasma for the inflated centrifugally unstable magnetosphere and is unable to account for the 100 eV thermal plasma temperatures of the magnetosphere. Since the Jovian magnetosphere is well populated with highly energetic electrons, the creation of secondaries and the energy degradation of the primaries precipitating into the lower ionosphere provide additional sources of magnetospheric thermal plasma as well as of the energy for further elevating the plasma temperatures in the top side ionosphere. The efficiencies with which escaping electrons are created by precipitating electrons with energies up to several MeV are computed using energetic electron transport and thermalization codes. The more energetic incident fluxes are far less efficient in creating escaping electrons than the lower energy fluxes with only 0.001% of the secondaries escaping for a 1 MeV source versus 3% for a 1 keV source. Incident fluxes of the order of 10 to 100 per sq cm per sec per eV between 100 eV and 100 keV are required to produce 50 eV escape fluxes comparable to those generated by solar EUV.

This paper describes a multiple gating screening procedure for the identification of elementary-aged pupils who are at risk for serious behavior disorders. This procedure, entitled Systematic Screening for Behavior Disorders (SSBD), consists of three interrelated assessment stages with teacher judgment as the primary information source in screening Stages 1 and 2 and direct behavioral observations as the primary source in Stage 3. The SSBD is designed to improve the quality of referrals to multidisciplinary teams and to provide each pupil in regular classroom settings with an equal chance to be identified for both externalizing and internalizing behavior problems. The paper reviews some of the myriad problems associated with the definition, classification, assessment, and referral of pupils with behavior disorders. A rationale for the SSBD is presented; its operation is described and initial research conducted in its development and trial testing is presented and discussed. A year-long, formal test of the SSBD within an elementary school is also described. Results of this study indicated that the SSBD correctly classified 89.47% of pupils who had been identified as externalizers, internalizers, or normals by their respective teachers in screening Stage 1. The psychometric characteristics of the instruments in SSBD Stages 1, 2, and 3 are judged acceptable by the authors for their intended assessment purposes. Practical implications and uses of the SSBD are discussed, as is future planned research.