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The SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) trial showed the safety but not efficacy of the Symplicity system (Medtronic, Santa Rosa, CA, USA) at 6 months follow-up in patients with treatment-resistant hypertension. This final report presents the 36-month follow-up results.SYMPLICITY HTN-3 was a single-blind, multicentre, sham-controlled, randomised clinical trial, done in 88 centres in the USA. Adults aged 18-80 years, with treatment-resistant hypertension on stable, maximally tolerated doses of three or more drugs including a diuretic, who had a seated office systolic blood pressure of 160 mm Hg or more and 24 h ambulatory systolic blood pressure of 135 mm Hg or more were randomly assigned (2:1) to receive renal artery denervation using the single electrode (Flex) catheter or a sham control. The original primary endpoint was the change in office systolic blood pressure from baseline to 6 months for the renal artery denervation group compared with the sham control group. Patients were unmasked after the primary endpoint assessment at 6 months, at which point eligible patients in the sham control group who met the inclusion criteria (office blood pressure ≥160 mm Hg, 24 h ambulatory systolic blood pressure ≥135 mm Hg, and still prescribed three or more antihypertensive medications) could cross over to receive renal artery denervation. Changes in blood pressure up to 36 months were analysed in patients in the original renal artery denervation group and sham control group, including those who underwent renal artery denervation after 6 months (crossover group) and those who did not (non-crossover group). For comparisons between the renal artery denervation and sham control groups, follow-up blood pressure values were imputed for patients in the crossover group using their most recent pre-crossover masked blood pressure value. We report long-term blood pressure changes in renal artery denervation and sham control groups, and investigate blood pressure control in both groups using time in therapeutic blood pressure range analysis. The primary safety endpoint was the incidence of all-cause mortality, end stage renal disease, significant embolic event, renal artery perforation or dissection requiring intervention, vascular complications, hospitalisation for hypertensive crisis unrelated to non-adherence to medications, or new renal artery stenosis of more than 70% within 6 months. The trial is registered with ClinicalTrials.gov, NCT01418261.From Sep 29, 2011, to May 6, 2013, 1442 patients were screened, of whom 535 (37%; 210 [39%] women and 325 [61%] men; mean age 57·9 years [SD 10·7]) were randomly assigned: 364 (68%) patients received renal artery denervation (mean age 57·9 years [10·4]) and 171 (32%) received the sham control (mean age 56·2 years [11·2]). 36-month follow-up data were available for 219 patients (original renal artery denervation group), 63 patients (crossover group), and 33 patients (non-crossover group). At 36 months, the change in office systolic blood pressure was -26·4 mm Hg (SD 25·9) in the renal artery denervation group and -5·7 mm Hg (24·4) in the sham control group (adjusted treatment difference -22·1 mm Hg [95% CI -27·2 to -17·0]; p≤0·0001). The change in 24 h ambulatory systolic blood pressure at 36 months was -15·6 mm Hg (SD 20·8) in the renal artery denervation group and -0·3 mm Hg (15·1) in the sham control group (adjusted treatment difference -16·5 mm Hg [95% CI -20·5 to -12·5]; p≤0·0001). Without imputation, the renal artery denervation group spent a significantly longer time in therapeutic blood pressure range (ie, better blood pressure control) than patients in the sham control group (18% [SD 25·0] for the renal artery denervation group vs 9% [SD 18·8] for the sham control group; p≤0·0001) despite a similar medication burden, with consistent and significant results with imputation. Rates of adverse events were similar across treatment groups, with no evidence of late-emerging complications from renal artery denervation. The rate of the composite safety endpoint to 48 months, including all-cause death, new-onset end-stage renal disease, significant embolic event resulting in end-organ damage, vascular complication, renal artery re-intervention, and hypertensive emergency was 15% (54 of 352 patients) for the renal artery denervation group, 14% (13 of 96 patients) for the crossover group, and 14% (10 of 69 patients) for the non-crossover group.This final report of the SYMPLICITY HTN-3 trial adds to the totality of evidence supporting the safety of renal artery denervation to 36 months after the procedure. From 12 months to 36 months after the procedure, patients who were originally randomly assigned to receive renal artery denervation had larger reductions in blood pressure and better blood pressure control compared with patients who received sham control.Medtronic.

Shifts in data distribution across time can strongly affect early classification of time-series data. When decoding behavior from neural activity, early detection of behavior may help in devising corrective neural stimulation before the onset of behavior. Recurrent Neural Networks (RNNs) are common models for sequence data. However, standard RNNs are not able to handle data with temporal distributional shifts to guarantee robust classification across time. To enable the network to utilize all temporal features of the neural input data, and to enhance the memory of an RNN, we propose a novel approach: RNNs with time-varying weights, here termed Time-Varying RNNs (TV-RNNs). These models are able to not only predict the class of the time-sequence correctly but also lead to accurate classification earlier in the sequence than standard RNNs. In this work, we focus on early sequential classification of brain-wide neural activity across time using TV-RNNs applied to a variety of neural data from mice and humans, as subjects perform motor tasks. Finally, we explore the contribution of different brain regions on behavior classification using SHapley Additive exPlanation (SHAP) value, and find that the somatosensory and premotor regions play a large role in behavioral classification.

One’s own speech can be affected when communicating with a speaker with a different accent. Despite the strength of anecdotal evidence for perception-production transfer, the nature of transfer has remained elusive. Results have been highly variable both regarding the acoustic properties that transfer between speakers and the characteristics of the speakers who show transfer. The current study investigates perception-production transfer through the lens of dimension-based statistical learning. Participants passively listened to a short sequence of acoustically variable minimal pair (beer/pier) speech segments conveying either an accent or typical English acoustics, made a perceptual judgment to an ambiguous Test stimulus and then repeated the Test stimulus. In the Canonical condition, F0 and voice onset time (VOT) of /b/ and /p/ covaried according to their usual pattern in English. In the Reverse condition, the correlation was reversed to create an ’accent’ with speech input regularities atypical of English. Perceptual categorization showed down-weighting of F0 in the Reverse vs. the Canonical condition. Critically, this down-weighting transferred to production, with systematic changes to F0 when speakers repeated the Test stimulus in the Reverse vs. the Canonical condition. Both findings were robust in male and female participants. These results indicate that the mapping of acoustics to speech categories is rapidly adjusted by short-term input regularities experienced across passive listening and that these adjustments transfer robustly to speech production, regardless of sex.

This article explores the connection between teaching effectiveness and participation in teacher learning communities (TLCs) in the context of a second-level co-educational urban school. In particular, it examines the role of educational leadership in their development and concomitantly toward the enhancement of teaching and learning. Seven teachers contributed to the research across two existing TLCs at the site school. It emerged that relationships and respect amongst the participants are pivotal to their effectiveness. It also transpired that both learning communities that were the focus of this study are characterized by a democratic style of leadership. Such however was possibly largely on account of the leadership style that this study found to be present in the school. Particular importance was attached to the significance of “professional relationships” for effective TLCs. It is recognized that further research on the nature of these relationships in the context of a constantly developing and changing education system will be beneficial and of the concomitant leadership styles that will provide the optimum context for these relationships to flourish.

This article adopts a phenomenological-oriented approach to explore the perceptions of a small cohort of teachers about teacher pedagogical well-being (TPWB), the experience of which is intimately ...

With the rise of network governance, and its concomitant fragmentation of public education systems across Europe, international studies have recommended teacher collaboration as a means to bring educational stakeholders together. Yet, despite some agreement over the potential benefits to student, professional and organisational learning, there is limited comparative research into the policy response of national governments to this recommendation and the discourses in which any initiatives might be embedded. Such inquiry is important during a time of decreased public investment in education when policymakers might seek to encourage ‘alternative’ forms of collaboration. Employing Fairclough’s three-dimensional framework to Critical Discourse Analysis, this article compares dominant policy discourses on collaboration in England, the Netherlands and the Republic of Ireland. Our findings reveal restricted discourses on teacher collaboration in these national contexts. Rather, in line with a global modernisation agenda for education, organisational collaboration and private actor engagement support the shift towards network governance while developing new forms of hierarchical and market control. Future research might therefore consider the impact of these reforms on teachers’ individual and collective practices at the school level and on public education more generally.

International Perspectives on Teacher Well-being and Diversity: Portals into Innovative Classroom Practice offers a suite of practical methods and research approaches to promote educator well-being in responding respectfully, ethically, and in a strength-based way to growing student diversity. Several themes emerged throughout the book, including the potential of teacher collaboration, the impact of the neo-liberal turn in education, the need for culturally responsive pedagogies, the importance of dialogue with parents, the critical factor of school leadership, and the inter-connection between teacher well-being and pupil well-being. Each of the themes identified above are obvious topics for further research, and the chapter concludes with a consideration of such opportunities.

In the development of this chapter, the authors paid particular attention to what is referred to in the literature as ‘teacher pedagogical well-being’ (TPWB) (Soini et al., Teachers and Teaching: Theory and Practice, 16:735–751, 2010). It is constructed ‘in the core processes of teachers’ work that is, carrying out and developing teaching–learning process, including, for example, planning classroom activities, interacting with pupils, making evaluations, and choosing and developing instructional tools’ (2010, p. 737). The chapter authors comprised of academics from the University of Limerick together with teachers from the site school involved in the research. The latter was a disadvantaged second-level school in an urban environment in the mid-west region of Ireland. The research was conducted in two phases. In phase one, a focus group was conducted with a convenience sample of teachers to explore their views and perceptions on TPWB. A principal finding which emerged was the conviction that opportunities for the teachers to engage in safe dialogic spaces about their pedagogic work as classroom practitioners were very beneficial towards both supporting and nurturing their experiences of teacher pedagogical well-being. This finding informed the second phase of the research. A focus group was conducted with two existing groups of teachers who met regularly at the school, one for literacy and one for numeracy. It was intended that this phase of the research would identify characteristics to maximise the potential of Teacher Learning Communities (TLCs) to enhance and nurture TPWB.

Teacher research has been identified as a transformative model of CPD. However, as illustrated in the OECD’s TALIS study, while teachers recognise the benefits of classroom enquiry for their own wo...

Much research has been done on how best teachers' professional development can be supported. However, for it to be effective, CPD provision needs to target the right content areas or topics. Planning for such provision is normally undertaken by providers with a role in supporting professional development across both sectors, i.e., primary and post-primary. It raises the question as to what differences and similarities may exist between the priorities of teachers across both sectors. The current study shows that certain commonalities exist across both sectors - pedagogical content knowledge, technology, and assessment. However, the study also reveals some sectoral differences.

After deep venous thrombosis (DVT), many patients have impaired quality of life (QOL). We aimed to assess whether pharmacomechanical catheter-directed thrombolysis (PCDT) improves short-term or long-term QOL in patients with proximal DVT and whether QOL is related to extent of DVT.The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial was an assessor-blinded randomized trial that compared PCDT with no PCDT in patients with DVT of the femoral, common femoral, or iliac veins. QOL was assessed at baseline and 1 month, 6 months, 12 months, 18 months, and 24 months using the Venous Insufficiency Epidemiological and Economic Study on Quality of Life/Symptoms (VEINES-QOL/Sym) disease-specific QOL measure and the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary general QOL measures. Change in QOL scores from baseline to assessment time were compared in the PCDT and no PCDT treatment groups overall and in the iliofemoral DVT and femoral-popliteal DVT subgroups.Of 692 ATTRACT patients, 691 were analyzed (mean age, 53 years; 62% male; 57% iliofemoral DVT). VEINES-QOL change scores were greater (ie, better) in PCDT vs no PCDT from baseline to 1 month (difference, 5.7; P = .0006) and from baseline to 6 months (5.1; P = .0029) but not for other intervals. SF-36 PCS change scores were greater in PCDT vs no PCDT from baseline to 1 month (difference, 2.4; P = .01) but not for other intervals. Among iliofemoral DVT patients, VEINES-QOL change scores from baseline to all assessments were greater in the PCDT vs no PCDT group; this was statistically significant in the intention-to-treat analysis at 1 month (difference, 10.0; P .0001) and 6 months (8.8; P .0001) and in the per-protocol analysis at 18 months (difference, 5.8; P = .0086) and 24 months (difference, 6.6; P = .0067). SF-36 PCS change scores were greater in PCDT vs no PCDT from baseline to 1 month (difference, 3.2; P = .0010) but not for other intervals. In contrast, in femoral-popliteal DVT patients, change scores from baseline to all assessments were similar in the PCDT and no PCDT groups.Among patients with proximal DVT, PCDT leads to greater improvement in disease-specific QOL than no PCDT at 1 month and 6 months but not later. In patients with iliofemoral DVT, PCDT led to greater improvement in disease-specific QOL during 24 months.

Objective Trauma care provides value to the critically injured. Our aim was to assess whether trauma team involvement adds value to the care of minimally injured patients and to define its costs. Methods Minimally injured patients admitted to a trauma center were propensity matched and compared by involvement versus no involvement of the trauma service (TS). Demographics, injury severity, complications, length of emergency department stay, mortality, and hospital costs and charges were studied. Results A total of 1253 patients were enrolled, with 308 propensity matched to the following groups: TS (n = 102) and no TS (n = 206). TS demonstrated a 30% increase in total charges and costs with no difference in complications. TS did demonstrate decreased time in the emergency department but had an increased delay to operation. Findings were similar when stratified for only lower extremity injuries. Conclusions TS involvement for minimally injured patients does not increase value. Reducing TS involvement while avoiding trauma undertriage may reduce costs to the healthcare system without affecting outcomes.

The ability to control the proliferation and cell death by inhibiting specific target kinase offers the opportunity to apply targeted therapies in the treatment of cancer. It has been found that (S)-valine-thiazole-derived compounds such as NEOS-223 are effective inhibitors of one or more of these kinases. NEOS 223 was developed, synthesized, and tested in the NCI 60 human tumor cell-screening panel demonstrating inhibition of colon (-53%), melanoma (-41%), and breast cancers (-9%). Microsomal clearance was determined in mouse, rat, dog, and human, and analyzed by LC-MS/MS by percent of parent material. IC50 values for CYP inhibition of >10 μM were calculated for 1A2, 2C19, and 3A4 with IC50 values of 4.86, 4.31, and 7.84 μM for 2C9 and 2D6. Microsomal clearance was high in all species with clearance rates ranging from 69-136 mL/min/kg. Plasma protein binding was determined by Rapid Equilibrium Dialysis in mice, rats, dogs, and humans. High plasma protein binding (>70%) was observed across all species. Based on the NCI results several cell lines were assayed in an MTT assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl- tetrazolium bromide) to determine cell viability in the presence of NEOS-223 resulting in in vivo efficacy resulted in inhibition of growth of multiple cell line. As a novel effective structure possibly targeting multiple kinases and transporters in one hybrid molecule, NEOS-223 may be a preferred monotherapy or combined therapy for multiple cancers. If upon further development, this drug is effective in humans, it would advance clinical practice and could improve current therapy significantly. Citation Format: Sumathi Chittamuru, Timothy M. Murphy, Sara A. Little, Andrew A. Taylor, Roseanne Wexler, Laxman Desai. Pre-clinical evaluation of NEOS-223, an (S)-valine-thiazole derived peptidomimetic N-heterocycle, as an anticancer agent and P-glycoprotein inhibitor [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr P39.

Background and Overview Although dental anesthetic needle fractures remain an uncommon occurrence, there is a lack of consensus on the management of the treatment of this complication. Complications could include trismus, dysphagia, or infection that may lead to more deleterious results. Case Description In this case study, a 47-year-old man underwent a routine dental extraction at a private office. During administration of the inferior alveolar nerve block, a dental anesthetic needle fractured. The general dental practitioner dismissed the patient and reassured him that no retrieval of the needle was needed. Several weeks later, the patient sought care for severe, acute pain and dysphagia. Traditional retrieval techniques were unsuccessful, and the authors consulted the neurosurgery team. The patient underwent endovascular surgery with digital subtraction angiography for retrieval of the needle from the right internal carotid artery. Conclusions and Practical Implications Most authors in the literature agree that proper technique and equipment are paramount in avoiding fractures of dental anesthetic needles. Although needle fracture is a rare complication, immediate referral and retrieval of the broken needle by an appropriately trained surgeon is essential for optimal outcomes. This case demonstrates an example of a broken needle that migrated and transected the internal carotid artery at the jugular foramen. All dental practitioners must be cognizant of the potentially serious complications associated with a retained broken needle.

Purpose: To evaluate the efficacy and safety of a novel in situ cancer vaccination method for the treatment of aggressive solid tumors, with an initial focus on metastatic prostate cancer (PCa). Procedure: 27 consecutive patients with metastatic cancers (21 with PCa and 6 with other cancers), were treated by in situ cryosurgical lysis of tumor tissue followed by injection of ipilimumab, pembrolizumab or nivolumab, and sargramostim directly into the zone of lysis. This was followed by 30 daily s.c. injections of sargramostim. Patients received 1 to 3 cycles of the above therapy at intervals of ≥ 1 month. Responses to therapy were assessed by RECIST v.1.1 and for patients with PCa, serum PSA levels. This IRB-approved study, Shulman IRB Protocol #00027107, is a retrospective analysis (with prospective follow-up) of the practice of medicine of two physicians. All patients signed informed consent. Results: 21 patients with progressive metastatic PCa and 6 with other metastatic cancers (2 bladder, 1 pancreatic, 1 colon, 1 melanoma, and 1 unknown) were treated. RECIST responses for 2 patients (both with PCa) could not be evaluated due to a lack of follow-up imaging. Among the remaining 25 patients, CRs were seen in 9 (36%) patients and a PR in 1 (4%), for an ORR of 40%. SD was seen in 8 (32%) patients, and progression was seen in 7 (28%). Among the 19 evaluable PCa patients, there were 9 (47%) CRs and no PRs, for an ORR of 47%. 5 (26%) patients showed SD, and 5 (26%) progressed. 13/21 (62%) of patients had post-therapy PSA reductions of >50%. 12 PCa patients were ADT-naïve (11 evaluable by RECIST) and there were 9 with mCRPC (8 evaluable by RECIST), and positive responses were seen in both groups, with ORRs of 55% and 38%, respectively, and PSA reductions of > 50% in 75% and 44% of patients, respectively. These antitumor responses have been durable in many patients, with CRs to date ranging from 1 to over 4.5 years post-treatment. Encouragingly, this durability of response was observed both in ADT-naïve patients and in those with mCRPC. Therapy was well tolerated, with AEs in 19/27 (70%) of patients. 24 grade 1-2 AEs were seen in 19 (70%) patients, and 8 grade 3-4 AEs were seen in 5 (19%) patients. Notably, AEs included liver enzyme elevations, hyperthyroidism and hypothyroidism, all of which are associated with autoimmune responses to immunotherapy. One death that was possibly treatment-related, 4 disease-related deaths, and 2 unrelated deaths occurred. Conclusions: This report describes a novel therapeutic modality utilizing local cryosurgical tumor cell lysis and intratumorally-delivered immunotherapy to treat metastatic prostate cancer and other aggressive solid tumor cancers. Its combination of striking efficacy and good tolerability supports additional formal clinical studies. Citation Format: Gary Onik, David Bostwick, David J. Vaughan, Donald L. Trump, Zurizaday Vega, Timothy Murphy, James Miessau, Marlene Wright-Barton, Danielle Hobbs, Charles J. Link, Jon H. Condra. Regression of metastatic cancer and abscopal effects following in situ vaccination by cryosurgical tumor cell lysis and intratumoral immunotherapy: A case series [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6540.

This paper addresses the potential for engaged learning among final-year undergraduate Education Studies students at a new, post-1992. It discusses a case study analysis of a ‘Directed Experiential Learning’ (DEL) intervention in the final year of an education studies degree designed to engage and motivate students and emphasise the links between theory and practice for them. Implementation took place in 2012–2013 with a cohort of 37 students and quantitative and qualitative analysis was performed afterwards to investigate the perspectives of students (online questionnaire and interview with 2 students) and tutors (4 individual interviews) on the DEL approach applied. The study described should be of particular interest to those teaching on and designing third level education studies programmes as well as related disciplines that might participate in integrated working arrangements in practice (e.g. nursing, social care).

This chapter documents an innovative pedagogical application of a service-learning oriented approach, pioneered by academics at a University in the North of England (UNEUK). Referred to as directed experiential learning, the core ethos of this approach connected forms of close-to-practice research, critical reflection, and community engagement and as such brought about a radical reworking of the final year of study for an existing undergraduate program – a BA (Hons) Education Studies. Responding to a broadening professional context within UK schools, this program prepared nascent professional educators and through their studies, invited them to engage in university–community partnerships where their learning and contributions to practice were inextricably conjoined.

Connections between neurons are affected within 3 min of stroke onset by massive ischemic depolarization and then delayed cell death. Some connections can recover with prompt reperfusion; others associated with the dying infarct do not. Disruption in functional connectivity is due to direct tissue loss and indirect disconnections of remote areas known as diaschisis. Stroke is devastating, yet given the brain’s redundant design, collateral surviving networks and their connections are well-positioned to compensate. Our perspective is that new treatments for stroke may involve a rational functional and structural connections-based approach. Surviving, affected, and at-risk networks can be identified and targeted with scenario-specific treatments. Strategies for recovery may include functional inhibition of the intact hemisphere, rerouting of connections, or setpoint-mediated network plasticity. These approaches may be guided by brain imaging and enabled by patient- and injury-specific brain stimulation, rehabilitation, and potential molecule-based strategies to enable new connections.

This paper reviews Duane Friesen’s version of pacifism, particularly his realist approach, his demand for political engagement, and his proactive peacemaking stance. Second, it demonstrates his connections with process thought, especially around notions of ordered novelty and contrasts, the nonviolence of God, and eschatological openness. It provides three areas of critique and suggests alternatives, specifically concerning Friesen’s Christology, his notion of revelation, and his commitment to religious pluralism. This paper offers a form of pacifism for radical mainline Christians who would otherwise be hesitant concerning some of Friesen’s theological presuppositions. The paper endeavors to show Friesen’s general compatibility with process philosophical commitments, thus furthering the conversation with process theologians who remain skeptical of pacifist commitments.

This article examines the role of Black and womanist theologies as critiques of capitalism. Arguing that capitalism is the economic structural context for Black people's experiences of subordination, I examine how engagement with capitalism interacts with categories of theological sources, understandings of sin, and the meaning of salvation. Comparing classic Black and womanist theologians with Cornel West's model of democratic socialism, I conclude that Albert Cleage comes the closest to rising to West's challenge, and that future Black and womanist theologies should follow their lead in order to explicitly connect current manifestations of racism with economic exploitation.

‘Morality’ and ‘ethics’ are rarely distinguished but, when they are, it is sometimes said that morality addresses the question, in the context of a set of codified norms, ‘What must I do?’, whereas ethics addresses the broader question, ‘How should I live?’1 Even in these formulations, which are controversial and expressed differently in different writers, it is clear that both morality and ethics refer to the domain of individual deliberation and choice. It is always the individual who faces moral or ethical questions such as, ‘Should I pay my taxes?’ ‘Should I have an abortion?’ ‘Should I torture this prisoner?’ These questions are related to but distinguishable from questions of political philosophy, which also involve deliberation and choice but in which the decision-making relates to the collective affairs of the polis: Is the taxation system just? Should there be an entitlement to choose whether or not to have an abortion? Should torture by state actors be permitted on some occasions? Obviously, given that individuals live in society, there is overlap and interdependence between the individual and collective domains, but an important distinction in normative philosophy remains.

e14509Background: Cyclin dependent kinases (CDK) play a vital role in cell cycling and proliferation. Altered expression of these kinases in malignant cells results in deregulation of cell cycle ac...

Drawing upon the writings of Maxine Greene and Paolo Freire, this article explores the necessary conditions for the advancement of education for democracy in the context of modern post-industrial societies, with a focus on schooling in the Republic of Ireland. The article charts a general topography of the Republic of Ireland in relation to the democratic project. For that purpose, particular attention will be paid to the changing influence of ‘theocentric’ and ‘mercantile’ ideologies of education. Educators are keenly aware of the relationality that exists between particular schooling practices and the flourishing of education for democracy. Conversely, they are also very conscious of the fact that certain schooling practices can severely impede the democratic project in society. In order to situate the study in teacher education practices, the article examines the potential of ‘service-learning’ to advance the project of education, especially with respect to its democratic remit.

Dr Timothy Murphy Senior Lecturer Carnegie Faculty of Sport and Education Leeds Metropolitan University Headingley Campus Beckett Park Leeds LS6 3QS Introduction In a recent publication, Fitzgerald (2003) inquired if the educational system in the Republic of Ireland was catering adequately for the less able learners and/or those from disadvantaged backgrounds. This paper responds to the question by providing an overview of educational inequality in the Irish context with a particular focus on what are referred to as critical transition points, at which particular cohorts of students are perceived to be in danger of dropping out of the system. It will also provide an examination of the explanations that are typically put forward to explain the persistence of educational inequality in the Republic of Ireland. Such persistence is all the more glaring when one considers the amount of investment that has been allocated to it, particularly since the middle of the 1960s. The concluding section will highlight specific strategies for tackling the vitally important question of educational disadvantage in the Irish context.