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We have collaborated for 25 years as indigenous Māori and non-Māori researchers undertaking research with Māori families, their schools and communities. We have endeavored to meet our responsibilit...

Successful behaviour management and disciplinary practices in a school require a school-wide policy and commitment. There are important implications in Elton Report concerning changes in staff behaviour towards pupils which are required of such a team approach. The Report suggests that the effective provision for pupils with emotional and behavioural difficulties is likely to be based on support teams of specialist teachers working in mainstream schools. In New Zealand, educational psychologists are trained to take leadership roles in the areas of in-service training. Good behaviour management requires regular and frequent positive feedback on performance. A successful whole-school approach to behaviour management and discipline will make the mainstreaming of children who have special needs much easier. Wider adoption of methods such as co-operative teaching and peer tutoring may result from including special needs children among their regular classroom peers. There are implications concerning the school curriculum, concerning relationships with parents and concerning the integration of children who have special needs.

A key behavioural principle that appears to be little appreciated and greatly under-utilized in classroom teaching is the principle that learning can be facilitated and inhibited by altering the stimulus conditions or "setting events" within the physical and social context of the classroom. The concept of setting events, their identification and use is of major importance in the behavioural approach to teaching. Within the classroom environment it is known that a wide range of stimulus conditions will influence behaviour. The presence or availability of an interacting adult is a major setting event exerting a powerful influence on children's learning in the classroom. Brief periods of individual attention within the classroom context set the occasion for an important type of teacher-child interaction which rarely occurs during class or small-group instruction. When a person moves to a new environment requiring the learning of a new language, local people are usually very supportive of hesitating first attempts and very tolerant of inaccuracies.

Three bilingual (Maori and English) behavioural checklists formed part of a project designed to facilitate student, teacher and whanau collaboration in overcoming behavioural difficulties experienced by Maori students, (Hei Awhina Matua). The checklists assessed rankings by 163 students, 21 teachers and 96 whanau members of (1) contexts in which problem behaviours occur, (2) specific problem behaviours and (3) specific most valued behaviours. Data were gathered in three schools: a mainstream intermediate school with a Maori medium syndicate of three classes, a rural Kura Kaupapa Maori (Maori-controlled total immersion school) and a bilingual contributing primary school. While the three schools differed markedly in location, size, and in the proportion of Maori students enrolled, the rankings of settings and behaviours by students, teachers and whanau in each school were highly similar. The paper discusses how these data contributed to the design and development of the Hei Awhina Matua video and training manual, and provided a first step towards a collaborative student teacher and parent partnership in the management of student behaviour.

Background Regular exercise is thought to be protective against coronary artery disease. As a result, some physicians believe that the likelihood of acute coronary syndrome (ACS) in patients with acute chest pain is reduced in those who exercise regularly. We studied the association between self-reported frequency of exercising and the likelihood of ACS in patients presenting to the Emergency Department (ED) with chest pain. Methods A multi-center prospective, descriptive, cohort study design was used in ED patients to determine whether the risk of ACS was reduced in patients who self-reported regular exercise. Results There were 1093 patients enrolled. Median (interquartile range) age was 57 (48–67) years; 506 (45.7%) were female. ACS was diagnosed in 248 (22.7%) patients. Patients who did not exercise at least monthly were more likely to be diagnosed with ACS than those who did (129/466 [27.7%] vs. 119/627 [19.0%]; odds ratio 1.63, 95% CI 1.23–2.17). After adjusting for age, gender, body mass index, smoking, and prior history, limited exercise was still associated with ACS (adjusted odds ratio 1.52, 95% CI 1.10–2.10). There was no apparent association between frequency and intensity of exercise and risk of ACS. Conclusion Although self-reported frequency of exercise was significantly associated with a decrease in ACS in ED patients with chest pain, it should not be used to exclude ACS in symptomatic ED patients.

Many schools in New Zealand, the USA, and elsewhere, are searching for ways to respond positively to the educational achievement disparities that exist between majority culture students and students from minority ethnic and cultural communities. Most of the approaches and strategies that have been implemented to date have either failed, or had minimal positive influence. This paper presents the results of over five years of research, conducted collaboratively by the authors, that has been focused on developing the theory and practice of a ‘culture of care’ in schools. Using a cultural lens to interpret the findings, these replicated studies offer the promise of positively influencing the culture of schooling in the USA, New Zealand and beyond. Creating a culture of care requires schools and teachers to be cognisant of how the school and classroom values, beliefs and practices make it safe for all students to engage, to contribute, to belong and to feel confident in their own cultural identities.

Myeloperoxidase (MPO) is proposed for risk stratification in patients with suspected acute coronary syndromes (ACSs). We determined if MPO has diagnostic value in patients being evaluated for ACS.MIDAS was an 18-center prospective study enrolling suspected ACS emergency department patients who presented8 hours after symptom onset and in whom serial cardiac markers and objective cardiac perfusion testing were planned. Blinded MPO (Biosite, Inc, San Diego, CA) and troponin I (Triage Cardio 3; Biosite, Inc) were drawn at arrival, and Troponin I (TnI) was measured at 90, 180, and 360 minutes. Final diagnoses were adjudicated by the local investigator blinded to study assay.Of 1,018 patients, 54% were male, 26% black, with a mean age of 58 ± 13 years. Diagnoses were ACS in 288 (23%) and noncardiac chest pain (NCCP) in 788 (77%). Of patients with ACS, 94 (9.2%) had a myocardial infarction (MI) at presentation (69 non-ST-elevation MI, 25 ST-elevation MI), and 136 had unstable angina. Using a cutpoint of 210 ng/mL to provide 90% specificity, MPO had a sensitivity of 0.18; negative predictive value, 0.69; positive predictive value, 0.47; negative likelihood ratio, 0.91; and a positive likelihood ratio of 1.83 to differentiate ACS and NCCP. Because of the large overlap of quartiles, MPO was not clinically useful to predict serial TnI changes. The C statistics ± 95% CI for MPO differentiating ACS from NCCP and for AMI versus NCCP were 0.629 ± 0.04 and 0.666 ± 0.06, respectively.Myeloperoxidase has insufficient accuracy for decision making in patients with suspected ACS.

This paper illustrates how important changes can occur in science learning and teaching if teachers take the trouble to understand and respect the cultural worlds of Indigenous students, and incorporate something of this understanding within their teaching practice. Ten teachers participated in a specially-designed one-year university postgraduate course, which encouraged them to incorporate into their classroom learning two Māori pedagogical principles, ako and whakawhanaungatanga. Ako is a responsive and reciprocal process, through which both teaching and learning roles are shared. Whakawhanaungatanga is the process of constructing relationships in the classroom between people, between students' cultural knowledge and domain knowledge. This paper draws on co-constructed narratives from four of the teachers, two Māori and two Pākehā (New Zealanders of European descent). The teachers built trusting and respectful relationships with their Māori students by facilitating connections between Western and Māori worldviews of science. They shared their teaching role with Māori elders (kaumātua) and members of the extended family of their students (whānau). The teachers learned a great deal from their Māori students who became highly engaged and agentic in their science learning. Students took collaborative responsibility for asking learning questions, and sought information on science topics from both Western and Māori worldviews.

In this article, a group of four indigenous Māori educators and one non-Māori educator comment on a proposed amendment to the New Zealand National Curriculum Framework to replace the current separate sets of skills, values and attitudes with five generic performance-based key competencies. The paper discusses important parallels between western/European sociocultural theorizing on human development and learning (on which the key competencies seemed to be based), and the values, beliefs and preferred practices that are embodied within an indigenous Māori cultural worldview ( Te Ao Māori). A Māori worldview is characterized by an abiding concern for the quality of human relationships that need to be established and maintained if learning contexts are to be effective for Māori students, and for these relationships to balance individual learning and achievement against responsibilities for the well-being and achievement of the group. Within such a worldview, education is understood as holistic, collective, experiential and dependent upon a free exchanging of teaching and learning roles. The article describes five specific cultural constructs within this worldview that highlight Māori traditional understandings of human development and learning and teaching, and aligns and compares these constructs with the five key competencies proposed. The article argues that the worldviews of Māori people in New Zealand provide an extensive and coherent framework for theorizing about human development and education, and are able to contribute strongly and positively to the development of a national school curriculum for the benefit all students. Implications for other contexts can also be drawn.

In this article, Janice Wearmouth, formerly professor of education at the University of Wellington, New Zealand and now at LiverpIn this article, Janice Wearmouth, formerly professor of education at the University of Wellington, New Zealand and now at Liverpool Hope University, Rawiri McKinney, an advocate for Rangatahi who has recently completed his Master of Education degree, and Ted Glynn, foundation professor of teacher education at the University of Waikato, discuss two examples of restorative justice in practice to illustrate how community norms and values can help to encourage more socially appropriate behaviour. Both examples come from a New Zealand Maori context and interventions undertaken with young men whose behaviour was of concern in school and in the local neighbourhood. The interventions operated through traditional Maori protocols to shift the focus away from individuals on to the whole community in order to focus on‘putting things right’between all those involved in the wrong-doing. These examples show how the use of traditional community conflict resolution processes was able to resolve tensions, make justice visible and re-establish harmonious relations between the individuals, the school and between members of the community. The use of restorative practices in schools is not straightforward, however. The authors of this article argue that it requires that schools do not own or completely control the process but are responsive to the local context and recognise the important sources of support that may be found in some of the families and local voluntary community groups within it for addressing problematic student behaviour.ool Hope University, Rawiri McKinney, an advocate for Rangatahi who has recently completed his Master of Education degree, and Ted Glynn, foundation professor of teacher education at the University of Waikato, discuss two examples of restorative justice in practice to illustrate how community norms and values can help to encourage more socially appropriate behaviour. Both examples come from a New Zealand Maori context and interventions undertaken with young men whose behaviour was of concern in school and in the local neighbourhood. The interventions operated through traditional Maori protocols to shift the focus away from individuals on to the whole community in order to focus on‘putting things right’between all those involved in the wrong-doing. These examples show how the use of traditional community conflict resolution processes was able to resolve tensions, make justice visible and re-establish harmonious relations between the individuals, the school and between members of the community. The use of restorative practices in schools is not straightforward, however. The authors of this article argue that it requires that schools do not own or completely control the process but are responsive to the local context and recognise the important sources of support that may be found in some of the families and local voluntary community groups within it for addressing problematic student behaviour.

In order to better understand the present trends in New Zealand’s schooling contexts, there is a clarion call for educators to develop sensitivity and sensibility towards the cultural backgrounds and experiences of Maori students. This paper reports on the work of four scholars who share research that has been undertaken in educational settings with high numbers of Maori students, and discusses the importance of creating culturally-safe schools - places that allow and enable students to be who and what they are. The theoretical frameworks drawn on are based on both a life partnership analogy as well as on a socio-cultural perspective on human development and learning. The Maori worldview presented in this paper is connected to the Treaty of Waitangi, The Educultural Wheel and the Hikairo Rationale. Data were collected from two ethnographic case studies and analysed through these frameworks. Practical suggestions are then made for using restorative practices and creating reciprocal relationships in classrooms within an environment of care. The paper reports on an evidence-based approach to creating culturally-safe schools for Maori students.

Objectives: To assess the feasibility of implementing an emergency department (ED)–based transientischemic attack (TIA) clinical pathway that uses computer-based clinical support, and to evaluate measuresof quality, safety, and efficiency.Methods: This was a prospective cohort study of adult patients presenting to a community ED withsymptoms consistent with acute TIA. Adherence to the clinical pathway served as a test of feasibility.Compliance with guideline recommendations for antithrombotic therapy and vascular imaging wereused as process measures of quality. The 90-day risk of recurrent TIA, stroke, or death provided estimatesof safety. Efficiency was assessed by measuring the rate of uneventful hospitalization, defined as a hospitaladmission that did not result in any major medical event or vascular intervention such as endarterectomyor stent placement.Results: Of the 75 subjects enrolled, physician adherence to the clinical pathway was 85.3%, and 35 patients(46.7%) were discharged home from the ED. Antithrombotic agents were prescribed to 68 (90.7%), andvascular imaging was performed in 70 (93.3%). The 90-day risk of recurrent TIA was seven out of 75(9.3%; 95% confidence interval [CI] = 4.6% to 18.0%), one patient experienced stroke (1.3%; 95% CI =0.2% to 7.2%), and three patients died (4.0%; 95% CI = 1.4% to 11.1%). Uneventful hospitalization occurredin 38 of 40 patients (95.0%).Conclusions: Implementation of a clinical pathway for the evaluation and management of TIA usingcomputer-based clinical support is feasible in a community ED setting. This pilot study in knowledgetranslation provides a design framework for further studies to assess the safety and efficiency of astructured ED-based TIA clinical pathway.ACADEMIC EMERGENCY MEDICINE 2007; 14:1114–1119 a 2007 by the Society for Academic EmergencyMedicineKeywords: TIA, transient ischemic attack, emergency department, clinical pathway

This paper challenges some of the ill-informed and misleading assumptions made about Maori students and their whanau, and about Maori teachers and education professionals, in particular it examines four prominent assumptions that impact on Maori namely: We are all New Zealanders: We know all about Maori students and praise: We know what whanau needs are, and how to meet them; and we know what an effective partnership with Maori looks likeIi is argued that non-Maori need to invest more time and energy into gaining an understanding of the worldviews and lived experiences of their Maori colleague students andwhanau they work with They also need to better understand how taken-for-granted Western European worldviews impact upon Maori. Deeper understanding of both issues will enablenon-Maori to build close personal as well as professional relationships with Maori, and so avoid forming and acting upon untested assumptions about Msoni needs and how they should be met.

Background Many responses to students whose behaviour is considered unacceptable at school fail because they treat young people as isolated individuals and do not operate in the context of the community of people who know and care about them. In some parts of the world there is a move towards exploring how to support such students by moving away from retributive justice and the primacy of assigning blame and punishment to an alternative means of preventing, managing and controlling behaviour by establishing partnerships with students' home communities. One such approach is restorative justice. Purpose To examine how the process of restorative justice can make a positive response to unacceptable behaviour. Design and methods This paper draws together some of the literature associated with this approach, with a case example of restorative justice in action. It illustrates how community norms and values can help to encourage more socially appropriate behaviour. This example comes from a New Zealand Māori con...

This is an excerpt from two conversations between Professor Ted Glynn and George Middleton. Ted Glynn's contributions to education have included being Foundation Professor of Teacher Education at the University of Waikato, a Fellow of the Royal Society of New Zealand, and researcher and author. Professor Glynn was a part of the team of academics from three universities, Waikato, Auckland and Wellington, responsible for training the first teachers to become ResourcenTeachers of Learning and Behaviour (Brown et al, 2000). Ted shares part of his professional journey and how it was illuminated by his family experiences, and how he hopes to continue researching in bicultural and bilingual education.

There is much to celebrate in the greatly increased number of Māori and non-Māori students in New Zealand tertiary institutions undertaking doctoral research on issues of importance to Māori. However, in honouring their commitments to the Treaty of Waitangi, tertiary institutions need to ensure that Māori doctoral students and their Māori communities maintain their right to define their own research questions, research paradigms and methodologies. As supervisors of doctoral research students investigating issues of significance to Māori people, it is essential that we learn to position ourselves as visitors in someone else’s cultural space, as partners in the Treaty of Waitangi, and as co-constructors of knowledge and research methodology rather than as experts and gatekeepers (Berryman, SooHoo, & Nevin, 2013; Glynn, 2012). This paper was occasioned by an invitation from the organisers of the annual Kingitanga Day cultural and educational programme at the University of Waikato. The Kingitanga movement has much to teach us about how to frame and conduct research that responds to long-standing injustices that have marginalised Māori people. The Kingitanga has inspired us through the resistance, resilience, agency and humility of its leaders in asserting their right to define the effects of historic and contemporary injustices, and the right to define their own responses to these injustices. In this paper, we explore some of the relational and culturally responsive understandings we have arrived at from supervising the research of four doctoral candidates in Education (two Māori and two non-Māori). This research has been designed to promote the success and wellbeing of Māori students in mainstream schools, addressing historic and ongoing injustices experienced by Māori students and their whānau and communities.

Teachers and community in a small rural Māori-medium school in New Zealand were concerned that their students who were highly literate in Māori experienced difficulties in reading and writing in English on entry to secondary school (where English was the medium of instruction). Consequently, this school and community introduced a 10-week culturally appropriate home and school English reading and writing programme for their Year 6, 7 and 8 students. Specific tutoring procedures were implemented to assist students with their English reading, while a structured written brainstorm procedure, together with a responsive written feedback procedure, was implemented to assist with their English writing. Data demonstrate that students from all three year groups (Years 6–8) made marked gains in both reading and writing in English, and that these gains were not made at the expense of reading and writing in Māori. After 10 weeks in the programme students were able to read English at age-appropriate levels. The program...

In this study seven 10‐year‐old to 11‐year‐old students peer‐tutored seven six‐year‐old students in writing over a 10‐week period. Tutoring took place over 20‐minute sessions four times per week in the six‐year‐old students' regular classes during their usual writing time. The first author trained the tutors to assist tutees to (1) produce a writing plan, (2) use the plan to develop a piece of writing with help from the tutor, (3) proof‐read writing samples for meaning and accuracy, and (4) prompt tutees to make editing changes to their writing by asking appropriate questions. Samples of the writing of tutors and tutees were compared at baseline, intervention and follow‐up phases and the attitudes of participants towards the programme were evaluated. Unlike most peer tutoring programmes the study relied largely on intrinsic motivation for student participation, and utilised a procedure that required responsive feedback by tutors and a problem‐solving approach rather than a constrained linear methodology. ...

Diltiazem is commonly used to treat atrial fibrillation or flutter (AFF) with rapid ventricular response (RVR). Although it is very effective for rate control, up to an 18% prevalence of reported diltiazem-induced hypotension [defined by systolic blood pressure (SBP)90 mm Hg], and a mean of 9.7% hypotension have been reported from several studies totaling over 450 patients. This hypotension may complicate therapy. Our objective was to determine if calcium chloride (CaCl(2)) pre-treatment would blunt a SBP drop after i.v. diltiazem, while allowing diltiazem to maintain its efficacy. A prospective, randomized, double-blind, placebo-controlled study was conducted. Seventy-eight patients with AFF and a ventricular rate of/= 120 beats per minute were enrolled. Half received i.v. CaCl(2) pre-treatment; the other half received placebo. All patients then received i.v. diltiazem in a standard, weight-based dose. A second dose of CaCl(2) pre-treatment or placebo and diltiazem was given if clinically indicated for additional rate control. Both CaCl(2) and placebo pre-treatment groups had equal lowering of heart rate (p0.001). There were no adverse events in the calcium pre-treatment study arm. One patient in the placebo group became paradoxically more tachycardic and apneic after the diltiazem infusion. Although i.v. CaCl(2) seems to be equally safe compared to placebo as a pre-treatment in the management of AFF with RVR, we were unable to find a statistically significant blunting of SBP drop with CaCl(2) i.v. pre-treatment. Until further research determines a benefit exists, we cannot recommend i.v. CaCl(2) pre-treatment before diltiazem in the treatment of AFF with RVR.

With the implementation of Special Education 2000, a new policy on special education, New Zealand has moved to develop a world-class inclusive education system for students with mild to moderate learning and behavior needs. This article outlines a professional development program for a group of resource teachers who are implementing a major element of the policy. The authors report on the establishment of the training program through the collaboration of faculty from three universities. They also comment on the challenges to such a program, the ways in which these challenges were met through collaborative problem solving, and some outcomes to date.

In our previous article, we reported on a research project designed to improve the attending, reading, and writing behaviour of nine older low-achieving children in a special class in an urban primary school. We attempted operational definitions of important reader and tutor behaviours that occur during one-to-one oral reading, and we applied direct observational principles to coding and recording their occurrence from transcribed tapes of children's regular reading with their teacher. This provided data that served to monitor short-term and long-term change in both child and tutor (teacher) behaviour during oral reading interactions. In the present paper, we describe how these direct observational principles have contributed to the development of assessment and tutoring strategies for both adults and peers in the English language Pause Prompt Praise and the M # ori language Tatari Tautoko Tauawhi reading tutoring programs. The assessment strategies generated from observations of reader and tutor interact...

Introduction: The diagnosis of TIA is often challenging in the emergency department (ED) setting. ICD-9 discharge code 435 is often used to identify TIA cases; however, its accuracy is unclear. Our objective was to determine the sensitivity of ICD-9 code 435 to identify confirmed TIA cases treated in 4 community-based EDs. Methods: Over a 12 month period suspect TIA cases were prospectively identified using hot-pursuit mechanisms in 4 EDs. A time-based definition of TIA was used (i.e., acute onset focal unilateral symptoms with duration Results: Of 366 subjects with suspected TIA, 336 (92%) had a confirmed final diagnosis of TIA. Mean age was 66 years, 54% female, 31% non-white and 83% were hospitalized. The relative frequency of primary ICD-9 discharge codes at each of the 4 EDs are shown in the Table. The overall sensitivity of the 435 code was 64.3% (95% CI 58.9-69.4). Alternative codes used included stroke-related (8.0%), other CVD-related (2.7%), miscellaneous (8.3%) and non-specific symptoms codes (16.7%). The frequency of 435 coding varied non-significantly between sites (56% to 72%; p= 0.13); however, sites varied substantially in their use of non-specific symptoms codes (4.8% to 26.7%; p=0.002). Conclusions: In this series of confirmed TIA cases, more than 1/3 rd would not have been identified if the 435 code was used. These findings suggest that the 435 code should not be relied upon to identify TIA cases. Future studies should determine the causes of the variation in coding between sites, and also measure both sensitivity and specificity of the 435 code.

The Resource Teachers Learning and Behaviour (RTLB) program is a unique special education development in New Zealand. The aim of this program is the creation of a nation-wide network of more than 700 RTLB operating as itinerant consulting teachers providing support in inclusive classrooms. The principles underlying the program are described and an outline provided of the curriculum and methods of delivery. The program also acknowledges the need to address the important bi-cultural elements of New Zealand society. The paper reports on RTLB demographic profiles and the initial responses of teachers to their training. Preliminary indices of program effectiveness are also presented. The paper indicates ways in which the RTLB initiative is likely to develop and notes issues within the New Zealand education system that will both strengthen and constrain the overall development of the program.

A recent study of five research projects demonstrated how a group of researchers, both Maori and non‐Maori, had been re‐positioned within new ‘story‐lines’ that addressed the contradictory nature of the traditional researcher/researched relationship. The language used by the researchers contains the key to the new story‐lines; metaphor and imagery that are located within the research participant's domain. The researchers either were or have moved to become part of this domain. In the narratives developed in this research project, the researchers demonstrated how they had been re‐positioned by the use of contextually constituted metaphor within the domain where others can constitute themselves as agentic. Within this domain there are discursive practices that provide the researchers with positions that enable them to carry through their negotiated lines of action. An examination of the language used by the researchers demonstrated researcher reflection on their somatic involvement in the research ...

OBJECTIVES: To determine the sensitivity, specificity, and accuracy of a point-of-care method for identifying Rh(D) phenotype. METHODS: Rh(D) was determined using preserved whole blood via standard laboratory methods. Comparison testing was conducted using the HealthTEST Rh(D) card (Akers Laboratories, Thorofare, NJ). Results of the card test were visually interpreted and recorded. To achieve sensitivity and specificity of 99% (95% confidence interval [CI] = 98% to 100%), 380 Rh-positive and 380 Rh-negative samples were required. During card testing, convenience sampling was used. Card results were compared with official results, and statistical analysis was conducted. RESULTS: In identifying Rh(D)-positive phenotype, the card had a sensitivity of 98.9% and a specificity of 99.7% (95% CI = 0.99 +/- 0.01). For Rh(D)-negative phenotype, the card had a sensitivity of 99.7% and a specificity of 98.9% (95% CI = 0.99 +/- 0.01). CONCLUSIONS: In identifying type D (Rh positive or Rh negative), the card achieves sensitivity, specificity, and accuracy to warrant further study.

The expert contributors to this book make sense of the different approaches to understanding pupil behavior in schools, providing a comprehensive overview thorough discussion of key topics. The book covers: * Cultural issues such as ethnic diversity and the underachievement of boys * Psychological perspectives, including a range of behavioral models * Medical conditions, including AD/HD and autism * Sociological issues, specifically the challenges of including pupils whose behavior is hard to manage.

Providng an overview of the issues crucial to understanding inclusion and behavior management in schools, this book discusses: * Policy at national, local authority and school level * Inclusive practices in mainstream settings * Issues such as race, ethnicity school disciplines and exclusion

The challenges posed by the behavior of some pupils can only be properly addressed if support is extended beyond the classroom. Linking theory and practice, this book outlines a range of assessment and intervention techniques at: * District and community level * School level * Classroom level * Individual level

Background The acute assessment of patients with suspected ischemic stroke remains challenging. The use of brain biomarker assays may improve the early diagnosis of ischemic stroke. The main goal of the study was to evaluate whether the NR2 peptide, a product of the proteolytic degradation of N-methyl-D-aspartate (NMDA) receptors, can differentiate acute ischemic stroke (IS) from stroke mimics and persons with vascular risk factors/healthy controls. A possible correlation between biomarker values and lesion sizes was investigated as the secondary objective. Methods and Findings A total of 192 patients with suspected stroke who presented within 72 h of symptom onset were prospectively enrolled. The final diagnosis was determined based on clinical observations and radiological findings. Additionally gender- and age-matched healthy controls (n = 52) and persons with controlled vascular risk factors (n = 48) were recruited to compare NR2 peptide levels. Blinded plasma was assayed by rapid magnetic particles (MP) ELISA for NR2 peptide within 30 min and results for different groups compared using univariate and multivariate statistical analyses. There was a clinical diagnosis of IS in 101 of 192 (53%) and non-stroke in 91 (47%) subjects. The non-stroke group included presented with acute stroke symptoms who had no stroke (n = 71) and stroke mimics (n = 20). The highest NR2 peptide elevations where found in patients with IS that peaked at 12 h following symptom onset. When the biomarker cut off was set at 1.0 ug/L, this resulted in a sensitivity of 92% and a specificity of 96% to detect IS. A moderate correlation (rs = 0.73) between NR2 peptide values and acute ischemic cortical lesions (

In interview with Dr Peter Stanley, Professor Glynn reflects on how he became involved in special education, and on his work with the Pause Prompt Praise reading strategy, the Mangere Guidance and Learning Unit (which gave rise to Guidance and Learning Units nationally), and Glenburn Residential Centre, which was an innovative study of child behaviour management across multiple settings. Professor Glynn also talks about his time training psychologists on both the Auckland and Otago Diploma in Educational Psychology programmes and about his involvement in training Resource Teachers of Learning and Behaviour. Glynn advocates for inclusion, and for regular class teachers to be principally responsible for working with students with special needs. He also contends that much greater attention should be given to the cultural experiences of children in special and mainstream education.

The HEART score and North American Chest Pain Rule (NACPR) are decision rules designed to identify acute chest pain patients for early discharge without stress testing or cardiac imaging. This study compares the clinical utility of these decision rules combined with serial troponin determinations.A secondary analysis was conducted of 1005 participants in the Myeloperoxidase In the Diagnosis of Acute coronary syndromes Study (MIDAS). MIDAS is a prospective observational cohort of Emergency Department (ED) patients enrolled from 18 US sites with symptoms suggestive of acute coronary syndrome (ACS). The ability to identify participants for early discharge and the sensitivity for ACS at 30 days were compared among an unstructured assessment, NACPR, and HEART score, each combined with troponin measures at 0 and 3h. ACS, defined as cardiac death, acute myocardial infarction, or unstable angina, occurred in 22% of the cohort. The unstructured assessment identified 13.5% (95% CI 11.5-16%) of participants for early discharge with 98% (95% CI 95-99%) sensitivity for ACS. The NACPR identified 4.4% (95% CI 3-6%) for early discharge with 100% (95% CI 98-100%) sensitivity for ACS. The HEART score identified 20% (95% CI 18-23%) for early discharge with 99% (95% CI 97-100%) sensitivity for ACS. The HEART score had a net reclassification improvement of 10% (95% CI 8-12%) versus unstructured assessment and 19% (95% CI 17-21%) versus NACPR.The HEART score with 0 and 3 hour serial troponin measures identifies a substantial number of patients for early discharge while maintaining high sensitivity for ACS.

Effective applied behavioural intervention in teaching and learning settings requires a knowledge and skill base in human development, school curriculum, and cultural issues, as well as competence in the principles of applied behaviour analysis. Simple applications of operant principles to increasing on-task behaviour and work output have been very effective. However, behavioural practitioners in education now require a broader perspective on the interactive social contexts in which teaching and learning take place. This paper reviews a range of intervention strategies in the area of literacy learning which have been devised within this perspective, namely (a) antecedent discussion of context, (b) explicit modelling of competent performance, (c) responsive written feedback, (d) incidental teaching, (e) errors as contexts for learning, (f) Pause, Prompt, Praise, (g) reciprocal learning and peer tutoring. In conclusion, some of the implications for the training of educational professionals are examined.

Two and a half years after the initial funding allocation for teacher release hours to establish Support Teacher positions in New Zealand schools, 63 (91%) of the schools with a Support Teacher funding allocation completed a questionnaire on the establishment of the position in the school. Information derived from the questionnaire included qualifications and experience of teachers appointed to the role of Support Teacher, and detail regarding the establishment, practice, and degree of adherence to the Support Team model of operation. Significant difficulties with Support Team establishment and program adherence are reported, notably in selection, training, organizational support, and form of service delivery. The results are discussed in terms of the speed of drift from the model, differences between primary and secondary schools in implementation of the program, the importance of training, and the presence of an active Support Team Management Committee in ensuring effective service delivery.