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Schools strive to respond compassionately to disadvantaged families. However, barriers to authentic home-school relationships persist because the concept of parental engagement at home is not well enough understood. Socio-cultural stereotyping still contributes to schools' fixed impressions of what parental engagement should consist of, and the abilities of disadvantaged parents to support their children's learning. This qualitative case study provides new and unique insights into learning at home. A child-centred study was undertaken in a small Primary school, in a deprived area of Scotland, exploring the importance of home learning with young children. The findings indicate the young participants had an acute understanding of the significance of home learning for their ongoing and future development.

Open educational resources (OER), including open textbooks, are free, adaptable learning resources. The integration of these materials in place of commercial textbooks allows for considerable financial savings for students and creates opportunities for more active and engaged learning. The growing interest in the use of OER at a Western Canadian university led to the chance to survey students for their feedback on using OER instead of traditional commercial textbooks. This paper focuses on the views of students in an introductory sociology course for which an instructor adopted an open textbook and otherwise left the course unchanged from when it was taught with a traditional textbook. In addition, completion rates for the offerings with the open textbook are compared to previous offerings with a commercial textbook.

Background: Marine ω-3 polyunsaturated fatty acids (PUFAs), primarily found in dark fish, may prevent colorectal cancer progression, in part through inhibition of prostaglandin-endoperoxide synthase 2 (PTGS2). However, data in humans are limited.Methods: We examined marine ω-3 PUFAs and fish intake and survival among 1,011 colon cancer patients enrolled in Cancer and Leukemia Group B 89803 between 1999 and 2001 and followed through 2009. Diet was assessed during and 6 months after chemotherapy. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for disease-free (DFS), recurrence-free (RFS), and overall survival (OS).Results: We observed 343 recurrences and 305 deaths (median follow-up: 7 years). Patients in the highest vs. lowest quartile of marine ω-3 PUFA intake had an HR for DFS of 0.72 (95% CI, 0.54-0.97; Ptrend = 0.03). Individuals who consumed dark fish ≥1/week versus never had longer DFS (HR 0.65; 95% CI, 0.48-0.87; P-value = 0.007), RFS (HR 0.61; 95% CI, 0.46-0.86; Ptrend = 0.007), and OS (HR 0.68; 95% CI, 0.48-0.96; Ptrend = 0.04). In a subset of 510 patients, the association between marine ω-3 PUFA intake and DFS appeared stronger in patients with high PTGS2 expression (HR 0.32; 95% CI, 0.11-0.95; Ptrend = 0.01) compared with patients with absent/low PTGS2 expression (HR 0.78; 95% CI, 0.48-1.27; Ptrend = 0.35; Pinteraction = 0.19).Conclusions: Patients with high intake of marine ω-3 PUFAs and dark fish after colon cancer diagnosis may have longer DFS.Impact: Randomized controlled trials examining dark fish and/or marine ω-3 PUFA supplements and colon cancer recurrence/survival are needed. Cancer Epidemiol Biomarkers Prev; 27(4); 438-45. ©2018 AACR.

BACKGROUND:The majority of patients with pancreatic cancer who undergo curative resection experience rapid disease recurrence. In previous small studies, high expression of the mismatch-repair protein mutL protein homolog 1 (MLH1) in pancreatic cancers was associated with better outcomes. The objective of this study was to validate the association between MLH1 expression and survival in patients who underwent resection of pancreatic cancer and received adjuvant chemoradiation. METHODS:Samples were obtained from the NRG Oncology Radiation Therapy Oncology Group 9704 prospective, randomized trial (clinicaltrials.gov identifier NCT00003216), which compared 2 adjuvant protocols in patients with pancreatic cancer who underwent resection. Tissue microarrays were prepared from formalin-fixed, paraffin-embedded, resected tumor tissues. MLH1 expression was quantified using fluorescence immunohistochemistry and automated quantitative analysis, and expression was dichotomized above and below the median value. RESULTS:Immunohistochemical staining was successfully performed on 117 patients for MLH1 (60 and 57 patients from the 2 arms). The characteristics of the participants who had tissue samples available were similar to those of the trial population as a whole. At the time of analysis, 84% of participants had died, with a median survival of 17 months. Elevated MLH1 expression levels in tumor nuclei were significantly correlated with longer disease-free and overall survival in each arm individually and in both arms combined. Two-year overall survival was 16% in patients who had low MLH1 expression levels and 53% in those who had high MLH1 expression levels (P

BackgroundObservational studies suggest that higher levels of 25-hydroxyvitamin D3 (25(OH)D) are associated with a reduced risk of colorectal cancer and improved survival of colorectal cancer patients. However, the influence of vitamin D status on cancer recurrence and survival of patients with stage III colon cancer is unknown.Patients and methodsWe prospectively examined the influence of post-diagnosis predicted plasma 25(OH)D on outcome among 1016 patients with stage III colon cancer who were enrolled in a National Cancer Institute-sponsored adjuvant therapy trial (CALGB 89803). Predicted 25(OH)D scores were computed using validated regression models. We examined the influence of predicted 25(OH)D scores on cancer recurrence and mortality (disease-free survival; DFS) using Cox proportional hazards.ResultsPatients in the highest quintile of predicted 25(OH)D score had an adjusted hazard ratio (HR) for colon cancer recurrence or mortality (DFS) of 0.62 (95% confidence interval [CI], 0.44-0.86), compared with those in the lowest quintile (Ptrend = 0.005). Higher predicted 25(OH)D score was also associated with a significant improvement in recurrence-free survival and overall survival (Ptrend = 0.01 and 0.0004, respectively). The benefit associated with higher predicted 25(OH)D score appeared consistent across predictors of cancer outcome and strata of molecular tumor characteristics, including microsatellite instability and KRAS, BRAF, PIK3CA, and TP53 mutation status.ConclusionHigher predicted 25(OH)D levels after a diagnosis of stage III colon cancer may be associated with decreased recurrence and improved survival. Clinical trials assessing the benefit of vitamin D supplementation in the adjuvant setting are warranted.Clinicaltrials.gov identifierNCT00003835.

The poverty-related attainment gap is an internationally recognised problem. It resides within a culture of performativity in which international comparators, underpinned by neo-liberal ideology, drive national policy. This conceptual paper interrogates the relationship between poverty, attainment and children's mental health and wellbeing to inform public policy and practice in Scotland and beyond. A key theme identified from the analysis of the literature is the nature, quality and strength of social and support networks around schools, families and children. This is contextualised within a discussion of the nature of childhood poverty and mental health in children in Scotland and the response of the Scottish Government. A focus on educational policy and schools alone will not in itself address the poverty-related attainment gap. What is required is a holistic focus on public policy, informed by interdisciplinary research, and a focus on building a strong infrastructure of support around schools, families and communities.

This article discusses how we are living through unprecedented times and times which will test leadership capacities at all levels of the system to the full. This crisis needs to be understood from a global perspective and within broader social parameters--the quest for social justice, amongst other imperatives. This article discusses why it is important to recognise that COVID-19 restrictions were experienced differentially by children and young people (CYP) and that it presents not only as a time of challenge but also as a time of opportunity and for learning. Leadership programmes, and headship programmes in particular, have always stressed the need for emotionally intelligent leaders. The pandemic has provided an opportunity to stand back, take stock, to identify what is really important to the school community, and to consider what can be learned and built upon in the future.

The poverty-related attainment gap is an internationally recognised problem. There is growing recognition that it cannot either be understood or addressed without taking cognisance of children's mental health and wellbeing. The focus of this conceptual article is to examine the impact of social inequality and poverty on the mental health and wellbeing and attainment of children and young people in Scotland through the lens of resilience. While not a 'state of the art' literature review, a systematic approach was adopted in the selection of the literature and in the identification of themes to emerge from it. A range of risk and protective factors at the individual, social, societal and political levels emerged as impacting on the mental health and wellbeing and attainment of children living in poverty, and three important mediating variables are the negative impact of social stratification and adverse childhood experiences and the positive impact of a supportive adult. Schools alone cannot solve the problem. The findings revealed that there is a need to build a strong infrastructure around families and schools and to examine how economic, social, health and educational policy interact with each other as a starting point in addressing the problem, supported by inter-disciplinary research.

The COVID-19 pandemic caused a worldwide health- and societal crisis. Youth were exposed to enduring stressors. We examined types and load of stressors faced by youth, and their use of coping strategies. A population-based sample within Bergen municipality, Norway (N = 1031, 11–19 years) completed the Response to Stress Questionnaire 9 months into the pandemic. Social stressors were most frequent, with secondary control engagement being the most used coping strategy. Stress and coping strategies differed depending on sex, age, and socioeconomic status. Heightened stress were associated with primary and secondary control engagement, and disengagement. Thus, youth employed a range of coping strategies to an increasing degree with heightened levels of COVID-19 stress. The frequency of secondary control engagement aligns with the enduring uncontrollable nature of the outbreak. For future health crises, authorities should focus on social stressors experienced by youth, especially among girls, older youth, and youth with low socioeconomic status. [ABSTRACT FROM AUTHOR]

Audio feedback has been shown to be popular and well received by students. However, there is little published work to indicate how effective audio feedback is in improving student performance. Sixty students from a first year science degree agreed to take part in the study; thirty were randomly assigned to receive written feedback on coursework, thirty students received their feedback via audio files. Mean marks awarded for the coursework for each group were not significantly different. The end of module test included questions that specifically assessed topics from the coursework. Overall test results were not significantly different for the two groups, nor were marks for the coursework-specific questions. Samples of the tutor feedback were analysed and the language categorised. The mean word counts for audio feedback were significantly higher than word counts for written feedback. Analysis of the language used in feedback (measured by word count) indicated significantly higher word counts for audio feedback in the following categories, "explaining misunderstandings" and "demonstration of good practice." Since word counts for audio feedback might be expected to include a number of "filler" words, the number of comments made under different categories was also compared for audio and written feedback. Significantly more comments were made using audio feedback in the categories "giving praise," "explaining misunderstandings," "demonstration of good practice" and "justifying marks." Under the heading "suggesting approaches to future work" more comments were made using written feedback than audio, although the mean number of comments in both forms of feedback in this category was very low. Whilst marks may not be improved for those students receiving audio rather than written feedback, the feedback given is much richer.

BackgroundCarboplatin (C) and paclitaxel (P) are standard treatments for carcinoma of unknown primary (CUP). Everolimus, an mTOR inhibitor, exhibits activity in diverse cancer types. We did a phase II trial combining everolimus with CP for CUP. We also evaluated whether a gene expression profiling (GEP) test that predicts tissue of origin (TOO) could identify responsive patients.Patients and methodsA tumor biopsy was required for central confirmation of CUP and GEP. Patients with metastatic, untreated CUP received everolimus (30 mg weekly) with P (200 mg/m(2)) and C (area under the curve 6) every 3 weeks. The primary end point was response rate (RR), with 22% needed for success. The GEP test categorized patients into two groups: those having a TOO where CP is versus is not considered standard therapy.ResultsOf 45 assessable patients, the RR was 36% (95% confidence interval 22% to 51%), which met criteria for success. Grade ≥3 toxicities were predominantly hematologic (80%). Adequate tissue for GEP was available in 38 patients and predicted 10 different TOOs. Patients with a TOO where platinum/taxane is a standard (n = 19) tended to have higher RR (53% versus 26%) and significantly longer PFS (6.4 versus 3.5 months) and OS (17.8 versus 8.3 months, P = 0.005), compared with patients (n = 19) with a TOO where platinum/taxane is not standard.ConclusionsEverolimus combined with CP demonstrated promising antitumor activity and an acceptable side-effect profile. A tumor biomarker identifying TOO may be useful to select CUP patients for specific antitumor regimens.ClinicaltrialsgovNCT00936702.

The primary-secondary transition presents both opportunities and challenges for children. For some, it may represent a 'critical period' which impacts their future mental health and well-being. This article focuses on identifying the affordances and constraints of a group-work approach to support children with social, emotional and behavioural needs (SEBN) across the transition with a specific focus on the socio-emotional aspects of transition. This evaluative, mixed-methods case study took place in six clusters of primary/secondary schools in Scotland involving 63 pupils who participated within support groups for around twenty 1-hour sessions. It focuses on the accounts of Support group Leaders, drawing from focus group discussions held within each cluster and a Likert-type scale questionnaire. A wide range of facilitators and barriers to implementation and to pupil progress were identified. Facilitators related principally to the quality of relationships and pedagogy which the support group afforded and the quality of support for the project. Barriers related principally to organisational and resource constraints and more general concerns around how behaviour support is perceived. The article argues that supporting the transition for pupils with SEBN is complex and there is no 'magic bullet'. Building a supportive infrastructure from the outset is key to success.

PurposeObservational studies have demonstrated increased colon cancer recurrence in states of relative hyperinsulinemia, including sedentary lifestyle, obesity, and increased dietary glycemic load. Greater coffee consumption has been associated with decreased risk of type 2 diabetes and increased insulin sensitivity. The effect of coffee on colon cancer recurrence and survival is unknown.Patients and methodsDuring and 6 months after adjuvant chemotherapy, 953 patients with stage III colon cancer prospectively reported dietary intake of caffeinated coffee, decaffeinated coffee, and nonherbal tea, as well as 128 other items. We examined the influence of coffee, nonherbal tea, and caffeine on cancer recurrence and mortality using Cox proportional hazards regression.ResultsPatients consuming 4 cups/d or more of total coffee experienced an adjusted hazard ratio (HR) for colon cancer recurrence or mortality of 0.58 (95% CI, 0.34 to 0.99), compared with never drinkers (Ptrend = .002). Patients consuming 4 cups/d or more of caffeinated coffee experienced significantly reduced cancer recurrence or mortality risk compared with abstainers (HR, 0.48; 95% CI, 0.25 to 0.91; Ptrend = .002), and increasing caffeine intake also conferred a significant reduction in cancer recurrence or mortality (HR, 0.66 across extreme quintiles; 95% CI, 0.47 to 0.93; Ptrend = .006). Nonherbal tea and decaffeinated coffee were not associated with patient outcome. The association of total coffee intake with improved outcomes seemed consistent across other predictors of cancer recurrence and mortality.ConclusionHigher coffee intake may be associated with significantly reduced cancer recurrence and death in patients with stage III colon cancer.

This conceptual paper provides a critical analysis of the current convergence of major policy initiatives in Scotland to improve learning and teaching, promote greater equity and close the attainment gap through systems level leadership and change. It is neither an empirical study nor a literature review but synthesises across a range of fields -- social justice, poverty, social mobility, school improvement, leadership and policy -- in order to cast light on the problem and to inform public policy and practice. However system level leadership is not unproblematic, with, as argued by Boylan, the terms system and leadership seen as malleable concepts, nor can it be seen as a panacea for all ills. The paper argues that educational policy needs to be seen as residing within wider social policy. Without recourse to addressing systemic inequalities in society and building the infrastructure and support structures around schools, schools, on their own, are unlikely to rise to the challenge. The paper argues for a melding of distributive leadership (with emancipatory intent and purpose) with systems leadership, characterised by meaningful collaboration and partnerships from 'within -- to between -- and beyond' schools (as suggested by Chapman), imbued with moral purpose.

Transitions represent an important milestone for children and are experienced differentially. For some children, transitions represent a critical period that can have a long-term impact on their lives. This paper examines the socio-emotional aspects of the transition through an exploration of the findings derived from an evaluative case study of a group-work intervention to support children with Social, Emotional and Behavioural Needs across the Primary-Secondary transition, seen through the eyes of an adolescent boy and related stakeholders. The study took place in two local authorities in Scotland. The intervention is informed by the 'Teaching for Understanding Framework' (Project Zero, Harvard University) and 'Multiple Intelligence Theory.' The study examines the impact of the intervention on participating pupils, in the process exploring the variables that impacted on pupil progress both internal and external to the intervention. The findings highlight the importance of: building trustful and respectful relationships between adults and children; creating a safe environment in which children will be listened to and cared for; high quality pedagogy and continuity and progression across the transition; and understanding the complexity of factors which may impact on the transition for individual children, particularly for those who may be at greater risk across it.

BackgroundMutations in RPE65 cause Leber's congenital amaurosis, a progressive retinal degenerative disease that severely impairs sight in children. Gene therapy can result in modest improvements in night vision, but knowledge of its efficacy in humans is limited.MethodsWe performed a phase 1-2 open-label trial involving 12 participants to evaluate the safety and efficacy of gene therapy with a recombinant adeno-associated virus 2/2 (rAAV2/2) vector carrying the RPE65 complementary DNA, and measured visual function over the course of 3 years. Four participants were administered a lower dose of the vector, and 8 were administered a higher dose. In a parallel study in dogs, we investigated the relationship among vector dose, visual function, and electroretinography (ERG) findings.ResultsImprovements in retinal sensitivity were evident, to varying extents, in six participants for up to 3 years, peaking at 6 to 12 months after treatment and then declining. No associated improvement in retinal function was detected by means of ERG. Three participants had intraocular inflammation, and two had clinically significant deterioration of visual acuity. The reduction in central retinal thickness varied among participants. In dogs, RPE65 gene therapy with the same vector at lower doses improved vision-guided behavior, but only higher doses resulted in improvements in retinal function that were detectable with the use of ERG.ConclusionsGene therapy with rAAV2/2 RPE65 vector improved retinal sensitivity, albeit modestly and temporarily. Comparison with the results obtained in the dog model indicates that there is a species difference in the amount of RPE65 required to drive the visual cycle and that the demand for RPE65 in affected persons was not met to the extent required for a durable, robust effect. (Funded by the National Institute for Health Research and others; ClinicalTrials.gov number, NCT00643747.).

Background: In colon cancer patients, obesity, sedentary lifestyle, and high dietary glycemic load have been associated with increased risk of cancer recurrence. High sugar-sweetened beverage intake has been associated with obesity, diabetes, and cardio-me

Gordon syndrome (GS), or distal arthrogryposis type 3, is a rare, autosomal-dominant disorder characterized by cleft palate and congenital contractures of the hands and feet. Exome sequencing of five GS-affected families identified mutations in piezo-type mechanosensitive ion channel component 2 (PIEZO2) in each family. Sanger sequencing revealed PIEZO2 mutations in five of seven additional families studied (for a total of 10/12 [83%] individuals), and nine families had an identical c.8057G>A (p.Arg2686His) mutation. The phenotype of GS overlaps with distal arthrogryposis type 5 (DA5) and Marden-Walker syndrome (MWS). Using molecular inversion probes for targeted sequencing to screen PIEZO2, we found mutations in 24/29 (82%) DA5-affected families and one of two MWS-affected families. The presence of cleft palate was significantly associated with c.8057G>A (Fisher's exact test, adjusted p value < 0.0001). Collectively, although GS, DA5, and MWS have traditionally been considered separate disorders, our findings indicate that they are etiologically related and perhaps represent variable expressivity of the same condition.