Throughout the twentieth century, local control of school districts was one of the most contentious issues in American politics. As state and federal regulation attempted to standardize public ...schools, conservatives defended local prerogative as a bulwark of democratic values. Yet their commitment to those values was shifting and selective. InThe Fight for Local Control, Campbell F. Scribner demonstrates how, in the decades after World War II, suburban communities appropriated legacies of rural education to assert their political autonomy and in the process radically changed educational law.
Scribner's account unfolds on the metropolitan fringe, where rapid suburbanization overlapped with the consolidation of thousands of small rural schools. Rural residents initially clashed with their new neighbors, but by the 1960s the groups had rallied to resist government oversight. What began as residual opposition to school consolidation would transform into campaigns against race-based busing, unionized teachers, tax equalization, and secular curriculum. In case after case, suburban conservatives carved out new rights for local autonomy, stifling equal educational opportunity.
Yet Scribner also provides insight into why many conservatives have since abandoned localism for policies that stress school choice and federal accountability. In the 1970s, as new battles arose over unions, textbooks, and taxes, districts on the rural-suburban fringe became the first to assert individual choice in the form of school vouchers, religious exemptions, and a marketplace model of education. At the same time, they began to embrace tax limitation and standardized testing, policies that checked educational bureaucracy but bypassed local school boards. The effect, Scribner concludes, has been to reinforce inequalities between districts while weakening participatory government within them, keeping the worst aspects of local control in place while forfeiting its virtues.
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In this article, Campbell Scribner applies insights from history, philosophy, and reader theory to marginal inscriptions in nineteenth‐century textbooks, providing a conjectural explanation of ...student boredom during the period. He contends that boredom was a dialectic and contingent experience, based on shifting notions of childhood and education, in which students navigated between public and private space and between spontaneity and convention. Ultimately, Scribner concludes, despite difficulties in documentation, that boredom constituted a crucial element of children's self‐education.
In older age, reduction in physical function can lead to loss of independence, the need for hospital and long-term nursing or residential home care, and premature death. Home-visiting programmes for ...older people, carried out by nurses and other health-care professionals (e.g. occupational therapists and physiotherapists), aim to positively affect health and functional status, and may promote independent functioning of older people.
The main research question addressed by this assessment is 'What is the clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion intervention for older people in the UK?'
A comprehensive literature search was undertaken across 12 different databases and research registries from the year 2001 onwards (including MEDLINE, MEDLINE in Process & Other Non-Indexed Citations, EMBASE, Science Citation Index Expanded, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, NHS Health Economic Evaluation Database, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects, Cumulative Index to Nursing and Allied Health Literature). Published systematic reviews were also hand searched to identify other trials previously published.
Potentially relevant studies were sifted by one reviewer, and inclusion decisions were agreed among the broader research team. The methodological quality of included studies was assessed using the Cochrane Risk of Bias tool. The results of included studies were synthesised using narrative and statistical methods. A separate systematic search was undertaken to identify existing health economic analyses of home-based, nurse-led health promotion programmes. Included studies were critically appraised using a published checklist. Owing to resource constraints, a de novo health economic model was not developed.
Eleven studies were included in the systematic review of clinical effectiveness. There was considerable heterogeneity among the studies with respect to the nature of the intervention, the nurses delivering the programmes and the populations in which the interventions were assessed. Overall, the quality of the included studies was good: all but one of the included studies were judged to be at medium or low risk of bias. Meta-analysis of eight studies suggested a statistically significant mortality benefit for the home-based health promotion groups, whereas a meta-analysis of four studies suggested non-significant benefits in terms of fewer falls in the intervention groups than in the control groups. Positive outcomes for home-based, nurse-led health promotion interventions were also reported within individual studies across several other outcomes. Only three economic studies met the criteria for inclusion in the review of cost-effectiveness. This evidence base consists of one non-randomised cost minimisation analysis and two economic evaluations undertaken alongside randomised controlled trials. Two of these studies involved an intervention targeted specifically at patients with a known underlying incurable disease, whereas the third study examined the clinical effectiveness and cost-effectiveness of early discharge in patients with a range of conditions, including fractures, neurological conditions and cardiorespiratory conditions. Each study indicated some likelihood that home-based, nurse-led health promotion may offer cost savings to the NHS and associated sectors, such as social services. However, one study did not report any comparison of health outcomes and instead simply assumed equivalence between the intervention and comparator groups, whereas the other two studies suggested at best a negligible incremental benefit in terms of preference-based health-related quality-of-life measures.
The evidence base for clinical effectiveness is subject to considerable heterogeneity. The UK economic evidence base is limited to three studies.
On the basis of the evidence included in this systematic review, home-based, nurse-led health promotion may offer clinical benefits across a number of important health dimensions. However, it is generally unclear from the available studies which components of this type of complex intervention contribute towards individual aspects of benefit for older people. Given the limitations of the current evidence base, it remains unclear whether or not home-based health promotion interventions offer good value for money for the NHS and associated sectors. Given the considerable uncertainties in the available evidence base, it is difficult to isolate the key areas in which future research would be valuable or the exact study design required. Although this report does not identify specific studies that should be undertaken, it does set out a number of key considerations for the design of future research in this area.
PROSPERO number: CRD42012002133.
This randomized, double‐blind, placebo‐controlled study evaluated whether lamivudine given during late pregnancy can reduce hepatitis B virus (HBV) perinatal transmission in highly viraemic mothers. ...Mothers were randomized to either lamivudine 100 mg or placebo from week 32 of gestation to week 4 postpartum. At birth, infants received recombinant HBV vaccine with or without HBIg and were followed until week 52. One hundred and fifty mothers, with a gestational age of 26–30 weeks and serum HBV DNA >1000 MEq/mL (bDNA assay), were treated. A total of 141 infants received immunoprophylaxis at birth. In lamivudine‐treated mothers, 56 infants received vaccine + HBIg (lamivudine + vaccine + HBIg) and 26 infants received vaccine (lamivudine + vaccine). In placebo‐treated mothers, 59 infants received vaccine + HBIg (placebo + vaccine + HBIg). At week 52, in the primary analyses where missing data was counted as failures, infants in the lamivudine + vaccine + HBIg group had a significant decrease in incidence of HBsAg seropositivity (10/56, 18%vs 23/59, 39%; P = 0.014) and in detectable HBV DNA (11/56, 20%vs 27/59, 46%; P = 0.003) compared to infants in the placebo + vaccine + HBIg group. Sensitivity analyses to evaluate the impact of missing data at week 52 resulting from a high dropout rate (13% in the lamivudine + vaccine + HBIg group and 31% in the placebo + vaccine + HBIg group) remained consistent with the primary analysis in that lower transmission rates were still observed in the infants of lamivudine‐treated mothers, but the differences were not statistically significant. No safety concerns were noted in the lamivudine‐treated mothers or their infants. Results of this study suggest that lamivudine reduced HBV transmission from highly viraemic mothers to their infants who received passive/active immunization.
Hub networks play an important role in many transportation and telecommunications systems. This paper introduces a new model called the hub arc location model . Rather than locate discrete hub ...facilities, this model locates hub arcs , which have reduced unit flow costs. Four special cases of the general hub arc location model are examined in detail. We provide motivation for the new models, and present examples and optimal solutions, using data for U.S. air passenger traffic. Results are used to compare optimal costs, hub locations, and hub arc locations with corresponding hub median optimal solutions. The results reveal interesting spatial patterns and help identify promising cities and regions for hubs. A companion paper (Campbell et al. 2005) presents integer programming formulations and solution algorithms for the new hub arc problems. It also provides details and computation times for these solution algorithms.
Developed and developing economies alike face increased resource scarcity and competitive rivalry. In this context, science and technology appear as an essential source of competitive and sustainable ...advantage at national and regional levels. However, the key determinant of their efficacy is the quality and quantity of entrepreneurship-enabled innovation that unlocks and captures the benefits of the science enterprise in the form of private, public or hybrid goods. Linking basic and applied research with the market, via technology transfer and commercialization mechanisms, including government-university-industry partnerships and capital investments, constitutes the essential trigger mechanism and driving force of sustainable competitive advantage and prosperity. In this volume, the authors define the terms and principles of knowledge creation, diffusion, and use, and establish a theoretical framework for their study. In particular, they focus on the "Quadruple Helix model, through which government, academia, industry, and civil society are seen as key actors promoting a democratic approach to innovation through which strategy development and decision making are exposed to feedback from key stakeholders, resulting in socially accountable policies and practices.
Thermionic energy converters are solid‐state heat engines that have the potential to produce electricity with efficiencies of over 30% and area‐specific power densities of 100 Wcm−2. Despite this ...prospect, no prototypes reported in the literature have achieved true efficiencies close to this target, and many of the most recent investigations report power densities on the order of mWcm−2 or less. These discrepancies stem in part from the low‐temperature (<1300 K) test conditions used to evaluate these devices, the large vacuum gap distances (25–100 µm) employed by these devices, and material challenges related to these devices' electrodes. This review will argue that, for feasible electrode work functions available today, efficient performance requires generating output power densities of >1 Wcm−2 and employing emitter temperatures of 1300 K or higher. With this result in mind, this review provides an overview of historical and current design architectures and comments on their capacity to realize the efficiency and power potential of thermionic energy converters. Also emphasized is the importance of using standardized efficiency metrics to report thermionic energy converter performance data.
Thermionic energy converters transform heat into electricity using no moving parts. This review highlights recent developments that have the potential to achieve high power density outputs at high efficiencies for commercial operation. Also emphasized are two standardized efficiency metrics to evaluate converter performance.
Background
Autoimmune pancreatitis (AIP) is an uncommon form of chronic pancreatitis. Whilst being corticosteroid responsive, AIP often masquerades radiologically as pancreatic neoplasia. Our aim is ...to appraise demographic, radiological and histological features in our cohort in order to differentiate AIP from pancreatic malignancy.
Methods
Clinical, biochemical, histological and radiological details of all AIP patients 1997–2016 were analysed. The initial imaging was re-reviewed according to international guidelines by three blinded independent radiologists to evaluate features associated with autoimmune pancreatitis and pancreatic cancer.
Results
There were a total of 45 patients: 25 in type 1 (55.5%), 14 type 2 (31.1%) and 6 AIP otherwise not specified (13.3%). The median (IQR) age was 57 (51–70) years. Thirty patients (66.6%) were male. Twenty-six patients (57.8%) had resection for suspected malignancy and one for symptomatic chronic pancreatitis. Three had histologically proven malignancy with concurrent AIP. Two patients died from recurrent pancreatic cancer following resection. Multidisciplinary team review based on radiology and clinical history dictated management. Resected patients (vs. non-resected group) were older (64 vs. 53,
p
= 0.003) and more frequently had co-existing autoimmune pathologies (22.2 vs. 55.6%,
p
= 0.022). Resected patients also presented with less classical radiological features of AIP, which are halo sign (0/25 vs. 3/17,
p
= 0.029) and loss of pancreatic clefts (18/25 vs. 17/17,
p
= 0.017). There were no differences in demographic features other than age.
Conclusion
Despite international guidelines for diagnosing AIP, differentiation from pancreatic cancer remains challenging. Resection remains an important treatment option in suspected cancer or where conservative treatment fails.
In this paper, we consider the design of large-scale multiple allocation hub-and-spoke transportation networks in a competitive environment. We adopt a generic hub arc location model that locates ...arcs with discounted transport costs connecting pairs of hub facilities. Two firms compete for customers in a Stackelberg framework where the leader firm locates hub arcs to maximize its revenue, given that the follower firm will subsequently locate its own hub arcs to maximize its own revenue. We present an optimal solution algorithm that allocates traffic between the two firms based on the relative utility of travel via the competing hub networks. Results for each competing firm with up to three hub arcs show the important role of competition in designing hub-based transportation systems.
Here, we use a mouse model (DBA/2J) to readdress the location of insult(s) to retinal ganglion cells (RGCs) in glaucoma. We localize an early sign of axon damage to an astrocyte-rich region of the ...optic nerve just posterior to the retina, analogous to the lamina cribrosa. In this region, a network of astrocytes associates intimately with RGC axons. Using BAX-deficient DBA/2J mice, which retain all of their RGCs, we provide experimental evidence for an insult within or very close to the lamina in the optic nerve. We show that proximal axon segments attached to their cell bodies survive to the proximity of the lamina. In contrast, axon segments in the lamina and behind the eye degenerate. Finally, the Wlds allele, which is known to protect against insults to axons, strongly protects against DBA/2J glaucoma and preserves RGC activity as measured by pattern electroretinography. These experiments provide strong evidence for a local insult to axons in the optic nerve.
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