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Although inequities are rooted across the educational ecosystem, access to high-quality learning represents a salient inroad for improving marginalized students’ educational experiences. However, preparing teachers to enact equity-centered pedagogy—that which renders high-quality learning accessible to all students—remains a multidimensional problem with a dearth of empirically supported solutions. Given special educators’ central role in supporting marginalized students’ learning, ensuring that special educator preparation supports the development of an equity-centered practice is of particular importance. Therefore, this study examines Teacher Study Groups (TSGs) as a model for building preservice special educators’ practice and, in doing so, examines the underlying processes of preservice learning that result in instructional improvements. My conceptual framework articulated communities of practice theory with empirical research on teacher learning and the conception of critically inclusive pedagogy, which cross-pollinates access- (i.e., Universal Design for Learning) and asset-based (e.g., culturally sustaining pedagogy) paradigms. To understand the underlying processes that preservice teachers’ traverse as they build capacity in critically inclusive practices, I studied preservice teachers’ participation in a course-embedded TSG. Through a convergent mixed methods design, I examined 60 preservice teachers’ instructional quality prior to and following participation, along with their knowledge, attitudes, and knowledge calibration, as well as teaching artifacts and reflections shared during weekly sessions. In alignment with a convergent approach, I first analyzed quantitative and qualitative data separately, and I then integrated data through a joint display analysis to generate meta-inferences. Results indicated that participants significantly improved practice and foregrounded salient participatory experiences that hindered and facilitated participants’ professional growth. I conclude with a discussion of implications for equity-centered teacher preparation.

Epilepsy is one of the most common neurological disorders and is characterized by the occurrence of unprovoked seizures. Temporal lobe epilepsy (TLE) is the most common form of epilepsy with focal seizures. Unfortunately, some patients will develop refractory epilepsy that is pharmaco-resistant to current antiepileptic drugs (AEDs). Current AEDs work primarily by targeting neurons directly by inhibition of glutamatergic excitatory neurotransmission or enhancement of GABAergic inhibitory neurotransmission. Non-neuronal targets are an attractive alternative approach to treat epilepsy with potentially fewer deleterious effects. Neuronal hyperexcitability is a major contributor to epilepsy but increased evidence suggests that changes in astrocytic glutamate transporters can contribute to the development of epilepsy. This proposal aims to examine the cellular and molecular mechanisms associated with glutamate transporter dysregulation and their potential as a therapeutic target in epilepsy. I hypothesize that astrocytic glutamate transporter dysregulation contributes to the development of epilepsy and therefore can be targeted for the attenuation of epilepsy. Changes in astrocytic glutamate transporters were evaluated post-kainate induced status epilepticus. Additionally, post-translational modifications (PTMs) of these transporters that have previously been determined to cause both mislocalization and dysfunction of glutamate transporters in other models of neurological disease including SUMOylation, ubiquitination and palmitoylation were examined. For the first time, whether glutamate transporter modulation reduces seizures and attenuates pathological changes observed in the IHKA model of TLE using an AAV-Gfa2-GLT1-cHA viral vector and neuregulin (NRG-1) treatment was investigated. Finally, real-time glutamate spike activity to identify whether marked glutamate spike patterns can be used to predict epileptiform activity in epileptogenesis was examined. The main findings from these studies are: 1.) Synaptosomal GLT-1 protein is downregulated at a critical time point in epileptogenesis; 2.) Overexpression of GLT-1 in astrocytes delays neuronal death and granular cell dispersion in epileptogenesis; 3.) Overexpression of GLT-1 suppresses electrographic seizures and large behavioral seizures in epileptogenesis; 4.) Exogenous NRG-1 treatment induces upregulation of glutamate transporter EAAC1 and bi-hemispheric neuroprotection in epileptogenesis; and 5.) Glutamate peak events are increased in the epileptic brain and could be used as a biomarker in TLE.

Pasteurized donor human milk (PDHM) is associated with a reduced incidence of necrotizing enterocolitis in very low birth weight (VLBW) infants. Absence of Medicaid and private insurance payment for PDHM use in neonatal intensive care units contributes to disparities based on state of birth and socioeconomic level. Before 2017, 5 states had policies for PDHM coverage, incorporating less than 30% of VLBW infants born nationally. In this case study, we outline the partnership of local American Academy of Pediatrics (AAP) chapters with the national AAP Section on Neonatal-Perinatal Medicine to create a PDHM Advocacy Toolkit to facilitate Medicaid PDHM coverage. Over 5 years, neonatologist-led advocacy, incentivized via AAP funds, contributed to 5 additional states providing Medicaid payment for PDHM, resulting in over 55% of VLBW infants born nationally in states with funded coverage. Partnerships with state AAP chapters, pilot grant funding with deliverables, emphasis on advocacy coaching, and modification of the generalized toolkit to suit local needs were essential in engineering Medicaid PDHM payment. Together these actions provide a template for other pediatric subspecialists to help advance niche-focused advocacy issues at the state level.

Xanthomonas spp are the causative agents of bacterial spot disease on cultivated pepper, Capsicum annuum, and tomato, Solanum lycopersicum. Although pepper and tomato are closely related in the Solanaceae, four species of xanthomonads have differing host specificities and utilize unique virulence strategies between these two crops plants. A major factor differentiating these pathogens are the Type III Effector (T3E) proteins they deploy to overcome the plant’s immune system and increase the host’s susceptibility. The genetic diversity and composition of T3E repertoires in a large sampling of field strains have yet to be explored on a genomic scale, limiting our understanding of pathogen evolution in an agricultural setting. To this end, we sequenced the genomes of sixty-seven Xanthomonas euvesicatoria (Xe), Xanthomonas perforans (Xp), and Xanthomonas gardneri (Xg) strains isolated from diseased pepper and tomato fields in the southeastern and midwestern United States. T3E repertoires were computationally predicted for each strain and whole genomic phylogenies were employed to understand better the genetic relationship of strains in the collection. From this analysis we detected a division in the Xp population that supported a model whereby a host-range expansion of Xp field strains on pepper is due, in part, to a loss of the T3E AvrBsT. Xp-host compatibility was further studied with the observation that a double deletion of the T3Es AvrBsT and XopQ allowed a gain of host range for Nicotiana benthamiana. Additionally, a single deletion of XopQ expanded the host range of Xe to N. benthamiana, while Xg was a natural pathogen of N. benthamiana. Extensive sampling of field strains and an improved understanding of effector content will aid in efforts to design plant disease resistance strategies targeted against highly conserved effectors.Xg has emerged recently as the dominant tomato pathogen in parts of the United States and South America. It is responsible for severe crop losses and causes spotting on fruits. Furthermore, Xg appears to be spreading globally. In its repertoire of Type III effectors, Xg possesses a single Transcription Activator Like (TAL) effector protein, AvrHah1, which has previously been shown to confer enhanced water soaked lesions in pepper. TAL effectors act as transcription factors that manipulate expression of target host genes to increase host susceptibility. We investigated the molecular mechanism of AvrHah1-dependent water soaking and the effects of water soaking on enhancing disease severity in tomato. We observed that water from outside the leaf was drawn into the apoplast in Xg-, but not XgΔAvrHah1-, infected tomato, and that water soaking can serve as a mechanism to “ferry” new bacteria into the apoplast. Additionally, AvrHah1 increased the bacterial population present on the surface of diseased tomato leaves. Comparing the transcriptomes of tomato infected with Xg wt vs XgΔAvrHah1 revealed that thousands of genes were differentially upregulated in the presence of AvrHah1. We identified two highly upregulated basic Helix Loop Helix (bHLH) transcription factors with predicted Effector Binding Elements (EBEs) as direct targets of AvrHah1. We mined our RNA-seq data for genes that were highly upregulated but without EBEs and identified two pectin modification genes, a pectate lyase and pectinesterase, which are expressed in response to the bHLH transcription factors and are therefore indirect targets of AvrHah1. Importantly, designer TAL effectors (dTALEs) for the bHLH transcription factors and the pectate lyase complement water soaking in XgΔAvrHah1. By modifying the plant cell wall to enhance water uptake and increase tissue damage, AvrHah1 may improve bacterial dispersal from the apoplast and thereby enhance disease transmission. Understanding lesion development may improve the design of disease tolerance in crops by reducing symptom development and overall pathogen transmission.

BACKGROUND: Magseed technology is a recently introduced localisation technique for impalpable breast lesions with possible advantages over traditional techniques. These include improved theatre logistics, flexibility in incision placement and improved patient experience. This multicentre study evaluates the experience of introducing Magseed technology into routine surgical practice. METHODS: A prospective multicentre study of Magseed localised procedures was performed. Insertion data were recorded by the radiologist including lesion characteristics and Magseed insertion accuracy. The surgical team recorded time from insertion to operation, operating time and surgical satisfaction. Pathology results were reviewed for specimen weight and margins. RESULTS: Between February 2019 and June 2020, 100 patients were enrolled. Magseed localised procedures included 18 excisional biopsies, 23 wide local excisions (WLE), 50 WLE with axillary surgery and four cases of Magseed localised breast WLE with Magseed localised axillary surgery. There were three therapeutic mammoplasties and two cases of Magseed localised targeted axillary node dissection alone. A total of 90% of Magseeds were radiologically placed within 5 mm of the target lesion/node. Time between incision and specimen removal was 17 min (range 6-40 min). All breast and axillary Magseeds were successfully identified and retrieved during surgery. The target lesion was identified in the specimen in all cases. A total of 10% of cases required further surgery for pathologically positive margins. Overall, surgeons reported that Magseed localisation was "easy" or "very easy" in 77% of cases. CONCLUSION: Magseed is a reliable, safe and accurate surgical technique that provides logistical advantages and flexibility of surgical approach. The method was well-accepted by all users.

In a large academic children's hospital ambulatory clinic, the increasing demand for Spanish interpretation exceeds the Interpreting Services Department capacity, necessitating telephone interpretation. By adding a dedicated Spanish interpreter in the otolaryngology clinic, we aimed to decrease visit times for Spanish-speaking patients and increase satisfaction. Additional aims explored if dedicated Spanish interpreters could increase patients seen per session.A quality improvement initiative investigated baseline state compared to 2 tests of change using video interpretation and dedicated, in-person interpretation. Time permitting, interpreters contacted patients before the visit to decrease missed appointments and late arrivals. Measures included clinic visit times, late arrivals, missed appointments, and family/employee satisfaction scores. Actuarial statistics forecasted if on-site Spanish interpreters would affect patients seen per session and the potential addition of sessions.In-person interpretation reduced visit times for Spanish-speaking patients from 55 to 48 minutes (Implementing dedicated Spanish interpreters may increase productivity and enhance family experience.Reducing patient visit time by 9 minutes permits 2 additional patients per clinic session (1560 visits, 390 surgeries per year). Applied institution-wide, the intervention could create 29% more capacity in the ambulatory schedule (31,000 additional visits) and reduce actuarial need for ambulatory sessions in the same clinic space.

Today, low-income students and students of color are also more likely to attend schools with high teacher turnover (Boyd, Hamilton, Loeb, & Wyckoff, 2005; Clotfelter et al., 2006; Ingersoll & Connor, 2009). This is known in the literature as the “teacher quality gap.” In this study, I seek to capitalize on a recent policy development – the reauthorization of the Elementary and Secondary Education Act (ESEA) known as the Every Student Succeeds Act (ESSA) – to understand how state education agency officials frame the teacher quality gap. This study uses an approach called discourse analysis to unpack the discourses or narratives that state education officials put forth about the teacher quality gap in these documents. To guide my analysis of the discourses used by state education agency officials to discuss the teacher quality gap, I relied upon Rochefort and Cobb’s (1993) anatomy of problem description (Figure 1) as my conceptual and analytic framework. This framework summarizes and builds upon bodies of work from other scholars from the agenda setting and issue framing traditions (Baumgartner, 1989; Cobb & Elder, 1983; Elder & Cobb, 1984; Ellwood, 1989; Jones & Baumgartner, 1989; Lipsky & Smith, 1989; Schneider & Ingram, 1990; Stone, 1988, 1989; Weiss, 1989) and provides a coherent framework for understanding and analyzing how policymakers define the problem, put forth a narrative about how the problem came to be, characterize the population of children most affected by these inequities, and describe the nature of the proposed solutions. The findings from this study suggest that education agencies in many states frame the teacher quality gap as a highly complex and longstanding problem, but without serious consequences and without a clear role for the state, although there are notable exceptions.

Background/ContextThis study examines the implementation of an academic and social-emotional learning innovation called Personalization for Academic and Social Emotional Learning, or PASL. The innovation was designed, tested, and implemented using a continuous continuous-improvement model. The model emphasized a top-and-bottom process in which implementers played a central role in the innovation design, and adaptations were planned, tested, and refined based on local school contexts.PurposeThis study sought to understand what implementation integrity looked like in three high schools participating in a continuous continuous-improvement process that promoted deliberate, planned adaptations to PASL, and as well as to uncover factors that may explain differences in the integrity of PASL implementation across the three schools.Research DesignWe conducted embedded, qualitative case studies of three large, racially-, ethnically-, and linguistically- diverse urban high schools. Data collected and analyzed included interviews with school innovation design design-team members, student focus groups, and observations of teachers implementing PASL.FindingsEach school made site-specific adaptations to the PASL innovation before and during implementation. However, there was variation in the extent to which the schools demonstrated integrity to the PASL design and their own adaptations. A combination of local contextual factors helped explain differences in implementation integrity across the schools. These factors included the availability of resources and ongoing technical support, the will of local implementers, and perceptions about policy alignment.Conclusions/RecommendationsWhile PASL was implemented across the three school sites, the degree of implementation integrity varied, suggesting that encouraging program adaptation alone may not solve longstanding challenges associated with achieving depth of implementation. This is the first study of its kind in education, however, and more research is clearly warranted.

Background The value of population-based mammographic screening has been questioned by those who believe that the reduction in mortality from earlier diagnosis is outweighed by harms including overdiagnosis and overtreatment. Much of these commentaries assume that all Early-Stage Breast Cancer (ESBC) is treated the same way after diagnosis; with extensive therapies including surgery, radiotherapy and chemotherapy being standard. Intensity of treatment received is rarely mentioned in the debate. We hypothesised that those diagnosed through a screening program (Active Screeners (AS)) would receive less extensive surgical treatment and less intense adjuvant therapies than those not recently screened (NRS). If demonstrated, these differences would form an important component of the debate over the role of mammographic screening. Methods Retrospective analysis of a consecutive cohort of female patients aged 50-69 and managed for ESBC (invasive or DCIS) during 2007-2013 within a large metropolitan Breast Service, diagnosed either via a population screening program (AS) or outside of the program (NRS). Data on patient characteristics, symptoms, mode of detection, tumour pathology, surgical intervention and adjuvant treatment recommendations were derived from prospectively collected Multi-Disciplinary Meeting (MDM) records. Patients with metastatic disease or prior treatment for breast cancer were excluded. Results 791 cases were identified (569 with screen-detected cancer, 53 with interval cancers and 169 cancers diagnosed in women not recently screened). Invasive cancers in the AS group were much smaller than in the NRS group – mean 17mm versus 26mm. The AS group had lower grade invasive cancer – grade 1, 2 and 3 were 27%, 42%, 31% - compared with 10%, 39% and 52% in the NRS group. The AS group were more likely to have ER+ve cancers (88% vs 80%) and less likely to have nodal involvement (26% vs 48%). For invasive breast cancer, the NRS group were more than twice as likely to undergo mastectomy than cancers in the AS group (35% vs 16%). Axillary dissections were more common in the NRS than the AS group (43% vs 19%). Adjuvant chemotherapy was recommended more frequently for the NRS group compared to the AS group (65% vs 37%), as was post mastectomy radiotherapy (58% vs 39%). Endocrine therapy was less often recommended to the NRS group (86% versus 77%). Conclusion Women diagnosed with early stage breast cancer who are participating in a population based screening program are less likely to receive mastectomy and/or axillary dissection, less likely to receive adjuvant chemotherapy and less likely to receive post-mastectomy radiotherapy. These differences in treatment intensity should be considered in the debate surrounding mammographic screening. Citation Format: Elder KJ, Nickson C, Cooke S, Machalek D, Rose A, Mou A, Collins JP, Park A, De Boer R, Phillips C, Pridmore V, Farrugia H, Mann GB. Benefits to breast screening beyond mortality reduction [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD2-13.

BACKGROUND: Adjuvant therapy for breast cancer is routinely discussed and recommended in multi-disciplinary meetings (MDMs). Current literature explores how treatments received by patients differ from national guidelines; however, it does not explore whether treatment is concordant with MDMs. This study provides an Australian perspective on the uptake of MDM recommendations and reasons for non-concordance. METHODS: A retrospective cohort study of patients with breast cancer presented at The Royal Melbourne Hospital MDM in 2010 and 2014 to investigate the concordance between MDM recommendations and treatment received. RESULTS: The study group comprised 441 patients (161 from 2010 and 280 from 2014). A total of 375 patients were included in the analyses. Overall, 82% of patients had perfect concordance between recommended and received treatment for all modes of adjuvant therapy. Concordance to endocrine therapy was higher for invasive cancers than ductal carcinoma in situ (97% versus 81%, P

This article describes a model for continuous improvement that guides the work of the National Center on Scaling Up Effective Schools, or NCSU. NCSU is a research and development center funded by the Institute for Education Sciences, the research arm of the United States Department of Education. At the core of the Center's work is an innovative process to bring to scale practices that have been shown to improve student achievement in high schools in Broward County, Florida, and Fort Worth, Texas. To do so, the Center's model of improvement relies on three core principles. First, a prototype is built to reflect the core elements of programs or practices that have been shown to be effective locally. Second, rapid-cycle testing is used to allow the prototype to be revised in ways that adapt it to a particular school context. Third, a researcher–practitioner partnership is employed that strives to both take advantage of and build local ownership and expertise. In so doing, the continuous improvement model addresses well-known challenges faced by those attempting to scale up educational innovations, challenges such as building teacher buy-in and attending to the organizational context in which innovations are to be enacted.

Background and Aim The role of staging breast magnetic resonance imaging (MRI) of apparently localised breast cancer is controversial. Some recommend MRI in selected ‘high risk’ situations, while others suggest it has little or no role. Few studies demonstrate improved outcomes associated with MRI. ANZ 1002 : Post-operative Radiotherapy Omission in Selected Patients with Early breast Cancer Trial (PROSPECT) is a prospective single-arm study using preoperative MRI to identify a group of patients with early breast cancer in whom radiotherapy might be safely omitted. Inclusion criteria include nil/minimal or mild Background Parenchymal Enhancement (BPE), unifocal pT1N0 invasive cancer, not TNBC, no LVI. Since September 2011, 443 patients have undergone MRI and 201 have had radiotherapy omitted. Primary analysis of ipsilateral local recurrence is due in May 2021. Here we report imaging, subsequent biopsy findings for occult lesions and mastectomy rates. Methods All patients who underwent PROSPECT MRI in addition to mammogram (MMG) and ultrasound (US) were included. Imaging findings on MMG, US and MRI were documented. Breast Imaging-Reporting and Data System (BIRADS) 4 or higher lesions on MRI were subject to biopsy under US if possible, or MRI or surgical biopsy if not. Pathologic results of lesions identified by MRI were described and the extent of surgery was documented. Results: Over 8 years, 443 patients were identified; mean age 63 years (range: 50 to 84), median index tumour size 13mm (range: 2 to 111), grade 1 (188), grade 2 (212) or grade 3 (38). MRI showed nil/minimal or mild BPE in 336 patients and moderate or marked BPE in 107. A total of 189 occult BIRADS>3 lesions were identified in 140 (32%) patients; 135 (71%) were ipsilateral; 36 (19%) could be identified and biopsied with MRI-directed, US-guided biopsy, while 63 (33%) underwent MRI-guided biopsy, 82 (43%) surgical biopsy after MRI-guided hook needle localisation, 1 underwent a stereotactic biopsy and 7 were not biopsied due to proximity to the index lesion. A total of 51 occult malignant lesions were identified in 40 patients (9% of the total patient cohort). 36 were invasive cancer and 15 were DCIS. There were 17 invasive and 14 DCIS ipsilateral occult lesions in 26 patients (6% of total cohort) and 19 invasive and 1 DCIS contralateral lesions in 18 patients (4% of total cohort) An additional 16 lesions in 9 patients were malignant but considered part of the primary cancer. There were 3 ‘at risk’ lesions: 1 LCIS and 2 ADH. There were a total of 112 benign biopsies in 95 patients. 9 patients in the cohort (2%) underwent total mastectomy due to pathological extent of disease of the index cancer (4), multicentric cancer (3) or patient choice (2). A higher proportion of patients with moderate/marked BPE had occult lesions (29% vs. 39%, p=0.09) and occult malignant lesions (8% vs. 13%, p=0.09) compared to those with less BPE. Conclusion Breast MRI in selected, low risk patients over 50 years old with low risk apparently unifocal cancer identified an occult breast cancer in 9% of patients. Only 2% underwent total mastectomy. Primary analysis of PROSPECT in 2021 will help define the clinical utility of these findings. Background Parenchymal EnhancementNil/Mild (n=336)Mod/Marked (n=107)p-valueNo occult lesions237 (71%)66 (62%)0.09Occult lesions99 (29%)41 (38%)No occult malignant lesions310 (92%)93 (87%)0.09Occult malignant lesions26 (8%)14 (13%)Age 65144 (43%)42 (39%) Citation Format: Allison Rose, Arlene Mou, John Collins, Anita Skandarajah, Janemary Hughes, Heath Badger, Helen Braggett, Nicholas Zdenkowski, Rebecca Asher, Andrew Spillane, Boon Chua, Gregory Bruce Mann. Prospect trial MRI findings: High incidence of occult cancers in apparently low risk cases [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr PD9-01.

Background While population mammographic screening identifies early-stage breast cancers (ESBCs; ductal carcinoma in situ [DCIS] and invasive disease stages 1–3A), commentaries suggest that harms from overdiagnosis and overtreatment may outweigh the benefits. Apparent benefits to patients with screen-detected cancers may be due to selection bias from exclusion of interval cancers (ICs). Treatment intensity is rarely discussed, with an assumption that all ESBCs are treated similarly. We hypothesized that women diagnosed while in a screening program would receive less-intense treatment than those never or not recently screened (NRS). Methods This was a retrospective analysis of all women aged 50–69 years managed for ESBC (invasive or DCIS) during the period 2007–2013 within a single service, comparing treatment according to screening status. Data on demographics, detection, pathology, and treatment were derived from hospital, cancer registry, and screening service records. Results Overall, 622 patients were active screeners (AS) at diagnosis (569 screen-detected and 53 ICs) and 169 patients were NRS. AS cancers were smaller (17 mm vs. 26 mm, p

There is growing concern among researchers and governmental officials that knowing what works in education is important, but not enough for school improvement. Sound evidence alone is not sufficient for large-scale, sustainable change, both because practitioners may consider it irrelevant to their own problems of practice or run into challenges when they try to implement. Failed attempts at replicating positive outcomes in new (or simply expanded) settings underscore the need for a different relationship between research and practice, one that takes a systemic perspective on improvement and transforms the role for research. In this article, we describe the new science of improvement and where it sits in the evolution of research on education policy implementation. We discuss the roots of the approach as well as its key features. We explain how the work differs from that of traditional research and end with illustrations of this difference from our experiences with the National Center on Scaling Up Effective Schools.

INTRODUCTION: Women at very high risk of breast cancer are recommended to undertake enhanced surveillance with annual MRI in addition to mammography. We aimed to review the performance of breast MRI as a screening modality over its first 5 years at our institution. METHODS: The study used a retrospective review using prospectively collected data from a consecutive series of women at high risk of developing breast cancer undergoing surveillance MRI. RESULTS: Two hundred twenty-three women had at least one screening MRI. The median age was 42 years old. Sixty-nine (30.9%) were confirmed genetic mutation carriers. The remaining 154 (69.1%) women were classified as high risk based on family history, without a confirmed genetic mutation. Three hundred forty screening MRI studies were performed. Of these, 69 patients (20.3%) were recalled for further assessment. There was a significant reduction in the recall rate throughout the study for prevalent screens, from 50% (17/34) in 2008 to 14% (9/54) in 2011 (P = 0.004). The overall biopsy rate was 39 in 340 screens (11.5%). Four cancers were identified. Three were in confirmed BRCA1/BRCA2 mutation carriers, and one was found to be a carrier after the cancer was diagnosed. All four were identified as suspicious on MRI, with two having normal mammography. The cancer detection rate of MRI was 1.2% (4/340 screens). The overall positive predictive value was 7.0%, 6.7% for prevalent screens and 7.1% for subsequent screens. CONCLUSIONS: Breast MRI as a screening modality for malignant lesions in women with high hereditary risk is valuable. The recall rate, especially in the prevalent round, improved with radiologist experience.

Deciding when to update parameter file or floorplan yield assumptions is key to minimizing the cost impact associated with a yield excursion. Applying a yield degrade too soon creates excess inventory and applying a yield degrade too late increases the probability of missing shipments. A simulated case study is presented to aid product engineers, manufacturing engineers, and program managers in the determination of supply impacts as a function of when the yield degrade is applied. Impact is explored for both high volume and low volume products.

Purpose. Examine the association of work and home smoking bans with quitting behaviors among employed female smokers in the United States. Design. Secondary analyses using cross-sectional data from the 2006/2007 Tobacco Use Supplement to the Current Population Survey. Subjects. Nationally representative sample of 7610 U.S. employed female smokers, aged 18 to 64 years, who reported working indoors. Setting. N/A. Methods. Multivariate logistic regression analyses were conducted to examine the association of smoking ban policies (complete work and home bans, complete work ban only, complete home ban only, and no complete work or home ban) with intention to quit in the next 30 days, at least one quit attempt in the past year, and sustained abstinence of at least 3 months in the past year. Results. Twenty-nine percent of women reported complete work and home smoking bans. Smoking bans were not associated with intention to quit and were marginally associated with sustained abstinence. Regardless of intention to quit, women with complete work and home bans were significantly more likely than those without complete work and home bans to report quit attempts. Among women with no intention to quit, the odds of having a quit attempt were significantly higher among women who had a complete home ban only compared with women without complete work and home bans. Conclusions. Efforts to promote quitting behaviors among employed female smokers may be facilitated by increasing rates of complete smoking bans at both work and home settings.

Using a school-based sample of fifth graders (mean age = 10.38, SD = 0.66) and their parents ( N = 408) from Washington, D.C., the authors examine associations of pubertal development with early adolescents’ sexual and nonsexual risk behaviors and their caregivers’ parenting behaviors and of these risk behaviors with parenting behaviors. Results indicate that youths reporting signs of pubertal development were more likely to engage in these risk behaviors than were students reporting no signs. Pubertal development is not related to parenting behaviors; however, parents of youths who reported multiple nonsexual risk behaviors reported more parent–child communication about sexual topics. These results highlight the need to begin risk prevention efforts early, prior to pubertal development. Research is needed to understand how parents can help youths better cope with pubertal development to avoid involvement in sexual and nonsexual risk behaviors.

US adolescents initiate sex at increasingly younger ages, yet few pregnancy prevention interventions for children as young as 10-12 years old have been evaluated. Sixteen Washington, DC schools were randomly assigned to intervention versus control conditions. Beginning in 2001/02 with fifth-grade students and continuing during the sixth grade, students completed pre-intervention and post-intervention surveys each school year. Each year, the intervention included 10-13 classroom sessions related to delaying sexual initiation. Linear hierarchical models compared outcome changes between intervention and control groups by gender over time. Results show the intervention significantly decreased a rise over time in the anticipation of having sex in the next 12 months among intervention boys versus control boys, but it had no other outcome effects. Among girls, the intervention had no significant outcome effects. One exception is that for both genders, compared with control students, intervention students increased their pubertal knowledge. In conclusion, a school-based curriculum to delay sexual involvement among fifth-grade and sixth-grade high-risk youths had limited impact. Additional research is necessary to outline effective interventions, and more intensive, comprehensive interventions may be required to counteract adverse circumstances in students' lives and pervasive influences toward early sex.ClinicalTrials. gov identifier: NCT00341471.