High-stakes testing Thomas, Robert Murray
2005, 20050323, 2005-03-23, 2005-12-31
eBook, Book
The federal government's No Child Left Behind Act has thrust high-stakes testing - its goals, methods, and consequences - into the educational limelight. The four-fold purpose of this book is to 1. ...describe the nature of high-stakes testing, 2. identify types of collateral damage that have attended the testing programs, 3. analyze methods different groups of people have chosen for coping with the damage and 4. suggest lessons to be learned from the high-stakes-testing experience. The six groups of people whose coping strategies are inspected include a) politicians and their staffs, b) educational administrators and their staffs, c) parents and their public, d) test makers and test administrators, e) teachers and f) students. Importantly the author avoids aligning himself with the test-bashing rhetoric of those who oppose high-stakes testing, especially the No Child Left Behind Act. Key features of this book include 1. Illustrative cases: The book offers more than 350 cases of collateral damage from high-stakes testing (and people's coping strategies) as reported in newspapers over the 2002-2004 period; 2. Background perspectives: Part I examines the influence of high-stakes testing on 1) what schools teach, 2) how student progress is evaluated, 3) how achievement standards are set and 4) how test results are used; 3. Participant responses: Part II, which is the heart of the book, devotes a separate chapter to the coping strategies of each of the major participants in the high-stakes testing movement: politicians and their staffs, educational administrators and their staffs, parents and the public, test-makers and test-givers, teachers, and students; 4. Summary chapter: The last chapter (Lessons to learn) offers suggestions for minimizing collateral damage by adopting alternative approaches not used in the creation of our current high-stakes testing programs, particularly the federal government's No Child Left Behind Act. (DIPF/Orig.).
The human genome contains ∼30,000 CpG islands (CGIs). While CGIs associated with promoters nearly always remain unmethylated, many of the ∼9,000 CGIs lying within gene bodies become methylated during ...development and differentiation. Both promoter and intragenic CGIs may also become abnormally methylated as a result of genome rearrangements and in malignancy. The epigenetic mechanisms by which some CGIs become methylated but others, in the same cell, remain unmethylated in these situations are poorly understood. Analyzing specific loci and using a genome-wide analysis, we show that transcription running across CGIs, associated with specific chromatin modifications, is required for DNA methyltransferase 3B (DNMT3B)-mediated DNA methylation of many naturally occurring intragenic CGIs. Importantly, we also show that a subgroup of intragenic CGIs is not sensitive to this process of transcription-mediated methylation and that this correlates with their individual intrinsic capacity to initiate transcription in vivo. We propose a general model of how transcription could act as a primary determinant of the patterns of CGI methylation in normal development and differentiation, and in human disease.
Context: Short and long-acting somatostatin (SRIF) analogs are approved for clinical use in acromegaly. Recent analysis of the relative efficacy of octreotide LAR and lanreotide SR on the GH-IGF-I ...axis in acromegaly favored octreotide LAR in the secondary treatment of patients not preselected by SRIF responsiveness. A novel aqueous formulation of lanreotide, lanreotide Autogel (ATG), has recently been approved and is the predominant (and only in the United States) formulation of lanreotide used clinically.
Objective: We performed a critical review of SRIF analog treatment to establish the relative efficacy of three clinically available SRIF analog preparations, octreotide LAR, lanreotide SR, and lanreotide ATG (Somatuline depot in the United States) in control of the GH-IGF-I axis in acromegaly.
Data Sources: Data were drawn from MEDLINE and the bibliography of analyses of long-acting SRIF analogs.
Data Collection: We reviewed the largest studies of sc octreotide, octreotide LAR, and lanreotide SR, all that included biochemical end-point data for lanreotide ATG, and studies that directly compared the efficacy of octreotide LAR and lanreotide SR.
Data Synthesis: Caveats considered included differences in baseline GH and IGF-I values, patient selection, and interassay and intraassay variability, confounding the analysis. Studies comparing patients treated contiguously with lanreotide SR and octreotide LAR are fraught with methodological problems, however, are suggestive of marginally greater efficacy in control of the GH-IGF-I axis for octreotide LAR. Lanreotide ATG shows noninferiority to lanreotide SR. Five small studies directly comparing octreotide LAR and lanreotide ATG suggest no significant differences between these preparations in control of biochemical end-points.
Conclusion: Lanreotide ATG and octreotide LAR are equivalent in the control of symptoms and biochemical markers in patients with acromegaly.
Abstract
Background
Patients with adrenal insufficiency (AI) have excess mortality, in part due to the occurrence of life‐threatening adrenal crises. Infective processes, including that of the severe ...acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), are recognised as the major precipitant of adrenal crises. Adverse reactions to the ChAdOx1 SARS‐CoV‐2 vaccine occur in a significant proportion of individuals, however, are mild‐moderate in the majority of cases.
Design
Case series.
Patients & Results
We describe five cases where more severe adverse reactions to the ChAdOx1 SARS‐CoV‐2 vaccine led to actual or incipient adrenal crises requiring parenteral hydrocortisone within 24 h of receiving the first ChAdOx1 SARS‐CoV‐2 vaccination.
Conclusion
In individuals with adrenal insufficiency, adverse reactions to the initial dose of the ChAdOx1 SARS‐CoV‐2 vaccination can precipitate adrenal crises. We recommend that patients with AI should immediately increase their maintenance glucocorticoid dosage 2–3 fold on experiencing any symptoms in the initial 24 h following vaccination.
Summary
Objective
Mortality from primary and secondary adrenal insufficiency (AI; PAI and SAI, respectively) is 2‐3‐fold higher than in the general population. Mortality relates to cardiovascular ...disease, acute adrenal crisis (AC), cancer and infections; however, there has been little further characterization of patients who have died.
Design/Methods
We analysed real‐world data from 2034 patients (801 PAI, 1233 SAI) in the European Adrenal Insufficiency Registry (EU‐AIR; NCT01661387). Baseline clinical and biochemical data of patients who subsequently died were compared with those who remained alive.
Results
From August 2012 to June 2017, 26 deaths occurred (8 PAI, 18 SAI) from cardiovascular disease (n = 9), infection (n = 4), suicide (n = 2), drug‐induced hepatitis (n = 2), and renal failure, brain tumour, cachexia and AC (each n = 1); cause of death was unclear in 5 patients. Patients who died were significantly older at baseline than alive patients. Causes of AI were representative of patients with SAI; however, 3‐quarters of deceased patients with PAI had undergone bilateral adrenalectomy (3 with uncontrolled Cushing's disease, 3 with metastatic renal cell cancer). There were no significant differences in body mass index, blood pressure, low‐density lipoprotein cholesterol, total cholesterol or electrolytes between deceased and alive patients. Deceased patients with SAI were more frequently male individuals, were receiving higher daily doses of hydrocortisone (24.0 ± 7.6 vs 19.3 ± 5.7 mg, P = .0016) and experienced more frequent ACs (11.1 vs 2.49/100 patient‐years, P = .0389) than alive patients.
Conclusions
This is the first study to provide detailed characteristics of deceased patients with AI. Older, male patients with SAI and frequent AC had a high mortality risk.
Fruit and vegetables (F&V) have been a cornerstone of healthy dietary recommendations; the 2015-2020 U.S. Dietary Guidelines for Americans recommend that F&V constitute one-half of the plate at each ...meal. F&V include a diverse collection of plant foods that vary in their energy, nutrient, and dietary bioactive contents. F&V have potential health-promoting effects beyond providing basic nutrition needs in humans, including their role in reducing inflammation and their potential preventive effects on various chronic disease states leading to decreases in years lost due to premature mortality and years lived with disability/morbidity. Current global intakes of F&V are well below recommendations. Given the importance of F&V for health, public policies that promote dietary interventions to help increase F&V intake are warranted. This externally commissioned expert comprehensive narrative, umbrella review summarizes up-to-date clinical and observational evidence on current intakes of F&V, discusses the available evidence on the potential health benefits of F&V, and offers implementation strategies to help ensure that public health messaging is reflective of current science. This review demonstrates that F&V provide benefits beyond helping to achieve basic nutrient requirements in humans. The scientific evidence for providing public health recommendations to increase F&V consumption for prevention of disease is strong. Current evidence suggests that F&V have the strongest effects in relation to prevention of CVDs, noting a nonlinear threshold effect of 800 g per day (i.e., about 5 servings a day). A growing body of clinical evidence (mostly small RCTs) demonstrates effects of specific F&V on certain chronic disease states; however, more research on the role of individual F&V for specific disease prevention strategies is still needed in many areas. Data from the systematic reviews and mostly observational studies cited in this report also support intake of certain types of F&V, particularly cruciferous vegetables, dark-green leafy vegetables, citrus fruits, and dark-colored berries, which have superior effects on biomarkers, surrogate endpoints, and outcomes of chronic disease.
Savoring Sweet Murray, Robert D.
Annals of nutrition and metabolism,
01/2017, Volume:
70, Issue:
Suppl. 3
Journal Article
Peer reviewed
Open access
During the first years of life, the sweetness of sugars has a capacity to hinder or to help in laying a strong nutritional foundation for food preferences that often extend over a lifetime. Aside ...from supplying 4 g/kcal of energy, sugars are non-nutritive. However, sugars have a powerful attribute, sweetness, which strongly influences human food preference. A child’s first relationship with sweet taste begins even before birth and continues to evolve throughout complementary feeding. The sweetness of breastmilk encourages consumption and soothes the neonate. Conversely, inappropriate introduction of non-milk solids and beverages that are sweet at 0–4 months of age raises the newborn’s risk for later obesity and may discourage the acceptance of other bitter or sour foods. Although cereals, fruits, 100% fruit juices, and some grains have naturally occurring sugars that impart sweet flavor notes, there is no clear role for added sugars beem repeatedly to challenging tastes and flavors. The transitional year, as breast milk and infant formula are withdrawn, is a time when nutritional needs are high and diet quality often precarious. Rapid growth, along with brain and cognitive development, demand high-quality nutrition. Snacks are necessary both for energy and valuable nutrients. However, the selection of snack foods often exposes toddlers to items that offer concentrated energy with low nutrient value. Recent trends suggest a rapid fall in added sugars among infants and toddlers. Parenting practices that use small amounts of sugars to promote nutrient-rich foods from all 5 food groups can enhance rather than hinder their child’s emerging dietary pattern.
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