Philadelphia School Research Articles

Population‐based survey of the prevalence of type 1 and type 2 diabetes in school children in Philadelphia (费城学龄儿童1型与2型糖尿病患病率基于人口的调查)

AbstractBackgroundPopulation‐based (PB) registries of type 1 diabetes mellitus (T1DM) in children have been essential in determining the geographic, racial, and temporal patterns of the disease. There is a paucity of PB data on the prevalence of type 1 and type 2 diabetes (T2DM) in youth.MethodsThe prevalence of diabetes in children was determined using a PB survey of the 628 schools in Philadelphia. Data obtained included type of diabetes, date of birth, race, gender, date of diagnosis, diabetes treatment, and most recent height and weight.ResultsThe survey was completed by nurses at 510 schools (81% of schools) representing 252,896 children (70% of children in Philadelphia). Prevalence (per 1000) was computed. The survey identified 492 cases (355 T1DM, 88 T2DM, 49 type unknown). The overall prevalence of T1DM was 1.58 (0.73 White, 0.56 African American, 0.50 Hispanic); of T2DM was 0.35 (0.03 White, 0.28 African American, 0.05 Hispanic). Mean age at diagnosis was 8.6 and 11.9 years for T1DM and T2DM, respectively. The prevalence of T1DM was higher in boys‐ T2DM was higher in girls. Of children with T2DM, 25% were treated with insulin. BMI was ≥95th percentile in 20% of children weighed (10% of T1DM, 57% of T2DM).ConclusionsAlthough the Philadelphia Pediatric Diabetes Registry is the longest ongoing US registry of its kind, these are the first PB diabetes prevalence data of children in Philadelphia. PB studies in schools are able to capture children with diabetes who are diagnosed and treated in a variety of settings.

The Spillover Effects of Having a Sibling with Special Educational Needs

ABSTRACT The influence that students with special educational needs may exert on the schooling outcomes of their siblings without special educational needs has been given minimal attention in published research. Hence, the authors bring forth a unique contribution by evaluating the within-family effects of being a child without special educational needs in a family with a sibling with special educational needs. To do so, the authors utilized quasi-experimental methods on a sample of siblings in the Philadelphia School District over 6 years of observations. Because individual student data can be linked to home address information as well as classroom, school, grade, and year identifiers, the authors identified children in the same household over time and subsequently employs multilevel fixed effects models to evaluate achievement and nonachievement schooling outcomes. The results indicate that having a sibling with special educational needs is positively related to standardized achievement compared with those children whose siblings do not have special educational needs. This supports a positive spillover hypothesis. On the other hand, nonsignificance permeates the effects on nonachievement schooling results, including attendance, truancy, tardiness, and behavior.

Sleep Duration and Adolescent Obesity

Short sleep has been associated with adolescent obesity. Most studies used a cross-sectional design and modeled BMI categories. We sought to determine if sleep duration was associated with BMI distribution changes from age 14 to 18. Adolescents were recruited from suburban high schools in Philadelphia when entering ninth grade (n = 1390) and were followed-up every 6 months through 12th grade. Height and weight were self-reported, and BMIs were calculated (kg/m(2)). Hours of sleep were self-reported. Quantile regression was used to model the 10th, 25th, 50th, 75th, and 90th BMI percentiles as dependent variables; study wave and sleep were the main predictors. BMI increased from age 14 to 18, with the largest increase observed at the 90th BMI percentile. Each additional hour of sleep was associated with decreases in BMI at the 10th (-0.04; 95% confidence interval [CI]: -0.11, 0.03), 25th (-0.12; 95% CI: -0.20, -0.04), 50th (-0.15; 95% CI: -0.24, -0.06), 75th (-0.25; 95% CI: -0.38, -0.12), and 90th (-0.27; 95% CI: -0.45, -0.09) BMI percentiles. The strength of the association was stronger at the upper tail of the BMI distribution. Increasing sleep from 7.5 to 10.0 hours per day at age 18 predicted a reduction in the proportion of adolescents >25 kg/m(2) by 4%. More sleep was associated with nonuniform changes in BMI distribution from age 14 to 18. Increasing sleep among adolescents, especially those in the upper half of the BMI distribution, may help prevent overweight and obesity.

Buildings of Pennsylvania: Philadelphia and Eastern Pennsylvania

Buildings of Pennsylvania: Philadelphia and Eastern Pennsylvania

Physical Activity Patterns of Inner-City Elementary Schoolchildren

This study aimed to objectively measure the physical activity (PA) characteristics of a racially and ethnically diverse sample of inner-city elementary schoolchildren and to examine the influence of sex, race/ethnicity, grade level, and weight status on PA. A total of 470 students in grades 4-6 from six inner-city schools in Philadelphia wore an ActiGraph GT3X+ accelerometer (Actigraph, Pensacola, FL) for up to 7 d. The resultant data were uploaded to a customized Visual Basic EXCEL macro to determine the time spent in sedentary (SED), light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA). On average, students accumulated 48 min of MVPA daily. Expressed as a percentage of monitoring time, students were sedentary for 63% of the time, in LPA 31% of the time, and in MVPA 6% of the time. Across all race/ethnicity and grade level groups, boys exhibited significantly higher levels of MVPA than girls did; fifth-grade boys exhibited significantly lower MVPA levels than fourth- and sixth-grade boys did, and sixth-grade girls exhibited significantly lower MVPA levels than fourth- and fifth-grade girls did. Hispanic children exhibited lower levels of MVPA than children from other racial/ethnic groups did, and overweight and obese children exhibited significantly lower MVPA levels than children in the healthy weight range did. Across the entire sample, only 24.3% met the current public health guidelines for PA. Physical inactivity was significantly greater among females, Hispanics, and overweight and obese students. Fewer than one in four inner-city schoolchildren accumulated the recommended 60 min of MVPA daily. These findings highlight the need for effective and sustainable programs to promote PA in inner-city youth.

Educational Courage: Resisting the Ambush of Public Education (review)

Reviewed by: Educational Courage: Resisting the Ambush of Public Education Timothy R. Conrad Nancy Schniedewind & Mara Sapon-Shevin. Educational Courage: Resisting the Ambush of Public Education. Boston: Beacon Press, 2012. 209p. As a teacher education professor, I was strongly attracted to this book because of events that have recently transpired in Ogden, Utah, where my university is located. The Ogden City School Board had just decided to bypass negotiations with teacher representatives in contract negotiations. Letters sent to all district teachers ended with the words, "Please note that should we not receive your signed contract by 4:00 p.m. on July 20, 2011, we will declare your current position open for hire." Superintendent Noel R. Zabriskie supported the new approach as a "bold" decision ("Sign or Lose Your Job," 1). One of my newly hired teacher education students showed me her letter and asked, "What do you think I should do?" This is precisely the question addressed by veteran public school educators Nancy Schniedewind and Mara Sapon-Shevin in their book Educational Courage: Resisting the Ambush of Public Education. In the preface of the book, Schniedewind introduces herself as a teacher of an innovative public school in Philadelphia, while Sapon-Shevin describes how her work as a special education teacher was frustrated because "things that I thought were best for my students were disallowed by those in positions of power" (xvi). Their points of view make for the two main thrusts of the book: the "powerful potential of public education" as experienced by Schniedewind, and the "problematic aspects of Sapon-Shevin's school experience" caused by policies instituted without honoring teachers' knowledge and understanding of their students (xiii). As co-editors, Schniedewind and Sapon-Shevin write introductions for Parts I-IV of the book. Each part is made up of chapters consisting of real-life narratives written by public-school teachers, students, and parents. In Part I, "Is This What We Call Education?" contributors focus on what they perceive to be a gradual redefinition of how schools, teachers, and students are treated by policymakers. In Chapter 1, Schniedewind traces a history of increased attacks since the Reagan administration and continuing into the Obama presidency on teachers, teacher unions, and collective bargaining. In Chapter 2, a teacher laments that her lesson plans must focus on test preparation rather than student's learning and real life experiences. In Chapter 3, a parent tells the story of her 10-year-old daughter's [End Page 91] nervous breakdown and how she tells her father, "Daddy, I'll die of another test week" (28). In Part II, eight chapters focus on stories of resistance, such as a fifth grader who refuses to take TAKS, the Texas Assessment of Knowledge and Skills (Chapter 6), a teacher who starts a teacher committee at her middle school asking that teachers be included in decision-making when the principal decides to implement "no excuses, whatever it takes," school reform based on data-driven tests and teacher evaluation (Chapter 7), and a university business student who decides to quit the "Teach for America" assignment she had won after graduation, because she discovers it is better to fight for school reform through public education (Chapter 9). Four chapters in Part III, "Working in the Cracks," include narratives of educators who decide to stay within schools "ambushed" by the new school reform movement in an attempt to teach authentically while also meeting demands for multiple high-stakes testing and scripted teacher evaluations. For example, in one of the most compelling chapters of the book, a high school teacher describes the intriguing reactions of her students to a variety of strategies she develops for a unit providing debate-oriented reading and discussion combined with test preparation for the high-stakes New York State English Language Arts Regents Exam (Chapter 13). In a final caveat, however, she warns that through the interactive activities of her course unit, "My students had the luxury to write about something they cared about and had studied—rather than the Regents approach of writing on something you may care nothing about or know nothing about, and do so for ninety minutes" (103). Part IV ends with ten...

The Surgeon and the Abolitionist: William Chancellor and Anthony Benezet

Anthony Benezet and William Chancellor might, at first, seem strange collaborators. They both arrived in Philadelphia at about the same time: Chancellor by birth in 1730, the eldest son of an Anglican father who was a politically connected sailmaker; Benezet by ship in 1731, the eighteen-year-old son of a French Huguenot emigre. From that coincidental starting point, Benezet’s and Chancellor’s lives diverged in significant ways. Benezet renounced the life of business after an unsuccessful early trial and became a pioneering schoolteacher, first in Germantown and then, more famously, at Penn Charter School in Philadelphia. He went on to establish and teach in a school for girls and a school for blacks, both among the first of their kind in America. Partly through his adopted Quaker faith, partly through his native humane disposition, and partly through his acquaintance with enslaved and free blacks in Philadelphia, he became a staunch campaigner against slavery and the slave trade, writing and publishing some of the most influential abolitionist tracts to appear before the American Revolution. Chancellor, by contrast, became a doctor of physic, selling medicines that he imported from London at his apothecary shop on Philadelphia’s Market Street. As a young man he sailed out of New York on a slave ship, using his medical skills to evaluate the health of potential slaves, either captured or purchased, and to keep them alive and healthy at sea so they could be sold at a profit in New York on the ship’s return.It seems unlikely that the paths of these two would cross, or that the ardent abolitionist Benezet would choose to collaborate with a doctor who abetted the slave trade through his practice. Yet evidence suggests strongly that the two did work together, in a way—that Benezet used the slave physician’s testimony to powerful effect as he composed his first antislavery tract for public dissemination in 1759. In order to ascertain the probable nature of the relationship between the two men, how Chancellor came to share his experiences with the abolitionist, and what the consequences were of their collaboration, we must look first at Benezet to see what he might have desired from Chancellor, then follow the course of Chancellor’s background and life to evaluate the experiences that might have led him to aid Benezet. In the process we get a snapshot of Philadelphia mercantile society in the decades leading up to the separation from England and of the forces that shaped disparate responses to the institution of African slavery in America.

In the Crossfire: Marcus Foster and the Troubled History of American School Reform by John P. Spencer (review)

Reviewed by: In the Crossfire: Marcus Foster and the Troubled History of American School Reform by John P. Spencer Dionne Danns In the Crossfire: Marcus Foster and the Troubled History of American School Reform. By John P. Spencer. Philadelphia: University of Pennsylvania Press. 2012. Those who study the history of education realize that there are no quick fixes for providing equal educational opportunity for all. Throughout America’s educational history, some groups (Whites and European immigrants) were given increased participation in public schooling while others groups (people of color, women and non-European immigrants) continually faced limitations. After more than a century of limited schooling opportunities for African Americans nationwide, and shortened efforts to address inequality, a new breed of school reformers believe that addressing the achievement gap, devoid of lessons from the 1960s will be the cure all for the problems of urban school reform. John P. Spencer poses the biographical experiences of Marcus Foster as a “cautionary lesson” for current school reformers. In Marcus Foster, author John Spencer writes, “we see that problems of access, of achievement, of resources, of responsibility, were more complicated than they appeared to be in polarized public debates over who was to blame” (3). Furthermore, Foster’s story provides a sense of what is possible with school reform while confronting the restrictions of that same reform. In the Crossfire chronicles the school leadership experiences of Marcus Foster. As the principal of three Philadelphia schools and the superintendent of Oakland Public Schools, Foster was able to turn around schools others considered a failure. With compensatory funding, Foster targeted teacher expectations, student and parental attitudes and involvement, as well as community and business support to revitalize the educational environments of the schools and district he led. His charming personality as well as his ability to bring diverse people together to solve school problems served as an asset in fulfilling his goals. Unlike Foster, current school reformers have taken a more adversarial approach by demonizing teachers and unions rather than working with them to solve problems. Each time Foster became a principal at school, he gave teachers and other groups a seat at the table in determining how they would reform the school. This inspired the teachers and gave them buy-in for the changes that would be necessary at each school. Spencer argues convincingly that liberals in the post-World War II period expressed conflicting views about school problems. Some blamed the school system and racist society for problems students experienced in schools. Others used cultural deprivation arguments to determine that situations beyond the schools led to the problems by blaming the lack of abilities on students and their families. Marcus Foster’s leadership bridged this ideological divide among liberals. Foster took a more holistic approach to solving the problems in urban schools, recognizing both the societal and familial difficulties his students faced. [End Page 120] This book is an important contribution to the debates currently occurring around school reform. The push for excellence, and high stakes testing as the solution to narrowing the achievement gap without a concerted effort to provide additional funding for the schools with the most need, is simplistic. As Spencer rightly demonstrated, Foster made great strides in the schools he revitalized because he had additional compensatory funding to provide tutoring for students, outreach for communities, and additional services to improve the education of his students. It is doubtful his efforts would have been as effective without the additional aid. This book is well written and researched. Foster’s experiences are well situated in the context of the times, and Spencer superbly incorporates Foster’s work in the crossfire of the arguments around schooling in the 1960s. Spencer also recognizes that the traditions of equality and of excellence have been long a part of the Black community’s cultural ethos and Foster comes from that tradition. There are only a few minor critiques that can be made of an otherwise excellent book. First, the book is very repetitive, particularly with Spencer’s constantly rehashing his arguments. He left no doubt in readers’ minds about what he was arguing. To a lesser extent, on a couple of occasions Spencer called nontraditional families...

Theory and Creativity Woven Together: An Interview With Dr. LeoNora Cohen

LeoNora M. Cohen is an emeritus associate professor in the College of Education at Oregon State University. She began the Mentally Gifted Program for Philadelphia Schools, founded the Conceptual Fo...

Remembering my mentor, Dr. Irena Koprowska

Remembering my mentor, Dr. Irena Koprowska

Peer Effects in Urban Schools

This study evaluates the effects of classroom peers on standardized testing achievement for all third- and fourth-grade students in the Philadelphia School District over 6 school years. With a comprehensive individual- and multilevel data set of all students matched to teachers, classrooms, and schools, two empirical strategies are employed. The first relies on the observable distribution of students among classrooms within a particular grade and school in any given year. As a test of robustness, a second strategy is employed, which depends on the idiosyncratic variation in classroom composition based on the random assignment of students entering the school at abnormal times during the academic year. Based on these empirical strategies, this study finds statistically significant classroom peer effects on standardized achievement, though the degree to which they impact performance differs based on peer characteristics.

Reframing Retention: New Evidence from within the Elementary School Classroom on Post-Retention Performance

This study contributes a novel perspective on grade retention by empirically examining how classroom composition relates to the standardized-testing performance of grade-retained students in their post-retained years. This evaluation employed a sample of entire cohorts of urban elementary school children in the Philadelphia School District over 6 years of observations. For the approximate 21% of students retained in the sample, the results demonstrate that as retained students are placed in classrooms with higher average and greater standard deviation in peer ability, they tend to achieve lower testing outcomes in their post-retention years compared to their continuously promoted counterparts. Further investigation also shows that these relationships are not solely driven by having low levels of achievement. Implications are discussed.

Asthma Prevalence in Philadelphia: Description of Two Community-Based Methodologies to Assess Asthma Prevalence in an Inner-City Population

Objectives. Local asthma prevalence, especially in high-risk areas, may vary greatly from those estimated by national or regional data and targeted, community-specific approaches may be needed to assess the burden of childhood asthma. The Philadelphia Merck Childhood Asthma Network project sought to understand the local prevalence of asthma in Philadelphia communities and schools of low-income, disadvantaged children utilizing a grassroots approach that would access traditionally hard-to-reach families. Methods. Two asthma-screening methodologies were implemented using the Brief Pediatric Asthma Screen. Door-to-door screening was conducted in disadvantaged neighborhoods by community health workers. School screening was implemented in each class through partnership with the school principals and teachers in disadvantaged neighborhoods within the same target area. Results. A total of 2368 children were screened through door-to-door methodology and 5563 children were screened in the schools. Door-to-door screening revealed asthma prevalence of 21.7%, with an additional 4.9% reporting symptoms consistent with asthma. School screening results revealed a higher prevalence with more than a quarter (27.5%) of the students screened positive for asthma. An additional 16.7% had symptoms indicative of asthma. Conclusions. Both methods were able to successfully identify children with asthma in hard-to-reach populations. These methods can easily be replicated in other cities and the results can be used to inform programs, services, and policy developments.

Technical Skills Acquisition in Surgery-Bound Senior Medical Students: An Evaluation of Student Assertiveness

To prepare students pursuing surgical careers, we devised a senior subinternship curriculum supplement that focused on the acquisition of technical skills required of surgical residents. We hypothesized that more assertive students, those that accomplished more of the curriculum, would perform better on a technical skills Objective Structured Clinical Examination (OSCE). Senior medical students rotating on their first general surgery subinternship were administered a 6-station OSCE on the first day of their subinternship and again during the final week of the month-long rotation. A self-directed, 38-task "scavenger hunt" representing common intern level clinical skills, procedures, and patient care activities was provided to each student. The study was performed at Jefferson Medical College, a large, private medical school in Philadelphia, PA. Forty-nine senior students completed surgical subinternships between July 2009 and September 2010, and participated both in the pre-/post-OSCEs and the scavenger hunt. Students performed significantly better on the post-rotation OSCE than on the pre-rotation OSCE; 70.2% ± 8.1% vs. 60.4% ± 12.0%, p < 0.0001. Assertiveness scores from the "scavenger hunt" did not correlate with final OSCE scores (r = -0.328, p = 0.25), and were negatively correlated with the change between pre- and post-OSCE scores (r = -0.573, p < 0.04). Individual student assertiveness scores were determined by the number of tasks completed over the course of the rotation. As surgical education becomes more streamlined with evolving work hour restrictions, medical school education is playing an increasingly pivotal role in preparing students for internship. In our study, individual assertiveness in completing structured self-directed learning tasks did not directly predict the acquisition of proficiency in technical skills. We feel assertiveness is overshadowed by other factors that may carry more weight in terms of technical skills acquisition. Further studies are required to delineate these factors and ultimately enhance technical skills acquisition during medical school.

Translational research

Nemours Research Lung Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Department of Physiology Temple University School of Medicine Philadelphia, PA; and Department of Pediatrics Jefferson Medical College/Thomas Jefferson University Philadelphia, PA Department of Physiology, Temple University School of Medicine, Philadelphia, PA; and Departments of Physiology, Pediatrics, and Medicine, Temple University School of Medicine; and The Center for Inflammation, Translational, and Clinical Lung Research, Philadelphia, PA *See also p. e187. The authors have four patents for liquid ventilation.

A 3-year-old girl with vomiting and diarrhea

Division of Infectious Diseases, Department of Pediatrics, Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 9104, United States Clinical Virology Laboratory, Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, hiladelphia, PA 19104, United States

Varicella Zoster Virus Transmission in the Vaccine Era: Unmasking the Role of Herpes Zoster

Varicella (chickenpox) is a highly contagious disease caused by varicella zoster virus (VZV). After infection, the virus remains dormant in sensory dorsal root ganglia. Reactivation of latent VZV is associated with cutaneous disease occurring in $1 dermatomes, termed herpes zoster (HZ). Historically, HZ has been considered significantly less infectious than varicella and has not been thought to play an important role in person-to-person transmission. Since the licensure of the varicella vaccine in 1995 and the more recent recommendation that a second dose of vaccine be given to children aged 4–6 years [1], the epidemiology of pediatric varicella infection has shifted dramatically [2]. Efforts to quantify the burden of varicella in the community since vaccine licensure have been hindered by the absence of mandatory case-based reporting in most jurisdictions [3]. The article by Viner et al in this issue of the journal [4] provides important new insights into the epidemiology and transmissibility of VZV in a highly immunized, healthy pediatric population. The authors analyzed data obtained through a combination of active and passive surveillance for both varicella and HZ in Philadelphia schools and day care centers during 7 academic years. Cases were linked to the Philadelphia Department of Public Health immunization registry for ascertainment of vaccine status. Through this comprehensive surveillance system, 2296 cases of VZVassociated infection were identified, with 28% categorized as secondary varicella. Much of what is known about VZV transmission dynamics in the community comes from outbreak investigations at elementary schools or day care centers. In these settings, varicella attack rates among children who had previously received a single dose of varicella vaccine ranged from 12%–42% [5–7]. A recent report found that prior receipt of a second dose of vaccine did not appreciably decrease the attack rate during a school outbreak [8]. In contrast, in an elementary school outbreak during which the second dose of vaccine was given as an intervention for outbreak control, the attack rate was reduced from 43% among children who had received only a single vaccination to 5% among 2-dose recipients [9]. Large-scale, school-based varicella outbreaks such as these serve as important sentinel events but may not be representative of the true burden and infectivity of VZV in the community. In the study by Viner et al, .80% of epidemiologically linked transmissions involved ,4 secondary cases and, in the absence of a dedicated varicella surveillance system, would be unrecognized and unreported. Despite the continued documentation of outbreaks among immunized school children, the varicella vaccine epitomizes a public health success story. In the prevaccine era, varicella was an almost universal disease of childhood. After the widespread implementation of pediatric vaccination in the United States, incidences of VZV-related infection, hospitalization, and death have all markedly declined [10, 11]. In the present study, .90% of children who developed secondary varicella had received $1 doses of vaccine before the onset of infection, representing vaccine failures. However, even in these breakthrough cases, the benefits of vaccination are evident. As has been reported elsewhere [12, 13], .70% of breakthrough varicella cases had mild disease characterized by ,50 skin lesions. Vaccinated varicella cases were associated with a significantly lower proportion of secondary cases compared with unvaccinated cases, presumably related to lower virus burden and shorter duration of viral shedding. Finally, there was a significant decline in the incidence of all VZV-related infections in Philadelphia schools beginning in 2007, Received 9 December 2011; accepted 12 December 2011; electronically published 27 March 2012. Correspondence: Karen C. Bloch, MD, MPH, Division of Infectious Diseases, Vanderbilt University Medical Center, A-2200, Medical Center North, Nashville, TN 37232 (karen.bloch@vanderbilt.edu). The Journal of Infectious Diseases 2012;205:1331–3 The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals. permissions@oup.com DOI: 10.1093/infdis/jis214

Abstract 211: Cardiopulmonary Resuscitation/Automated External Defibrillator Olympic Competition Enhances Resuscitation Skills in High School Students

Introduction: Bystander cardiopulmonary resuscitation (CPR) rates are 15-30%. We aimed to help students develop innovative CPR/AED (automated external defibrillator) training programs in Philadelphia high schools and to assess their efficacy. Hypothesis: Harnessing adolescent characteristics of teamwork, competitiveness, and creativity will produce novel and effective methods of learning resuscitation skills. Methods: Health education classes in 15 Philadelphia School District high schools were selected, with 1 control and 1 study intervention group per school. Both groups completed CPR/AED pre- and post-tests to assess cognitive knowledge and psychomotor skills. After pre-tests, both groups were taught CPR skills and AED use by their health teacher. Study groups developed innovative programs to learn, teach, and retain CPR/AED skills. The study culminated with the CPR/AED Olympic event in a sports stadium with study group students from 12 schools competing in multiple CPR/AED skills events including a Mock Code and CPR/AED program presentations. Outcomes included post-tests, Mock Code (17 performance factors), and presentation scores with analysis using paired student's t tests. Results: Students' cognitive and psychomotor skills improved with standard classroom education programs (p&lt;0.0001). Competition with other schools at the CPR/AED Olympics and the development of their own student-directed education programs resulted in further remarkable improvements. Participants averaged 93.1% on the Mock Code with 10 of 12 schools ≥94%. Conclusion: Students who developed creative and novel methods of teaching and learning resuscitation skills showed outstanding application of these skills in a Mock Code. Harnessing adolescent characteristics of teamwork, competitiveness, and creativity produced novel and effective methods of teaching resuscitation skills, potentially empowering a new generation of effectively trained CPR bystanders.

Student Input Improves Behavior, Fosters Leadership

A Philadelphia school teaches democratic practices by including students in formal decision making.

Delivery and Evaluation of Synchronous Online Reading Tutoring to Students At-Risk of Reading Failure

In a technological society, demands for higher literacy are ever increasing, creating grievous consequences for those who fail to meet these demands (National Research Council, 1998). Both legislative mandates, such as NCLB, and developments in the provision of reading instruction, such as RtI, have increased the demand for high quality tutoring services. However, the U.S. Department of Education (USDOE, 2005) and state officials (Richard, 2005) report that access to intensive supplemental tutoring may be limited in rural areas due to limited availability of qualified providers. One way to overcome this obstacle is to supplement classroom instruction with live systematic, comprehensive, and explicit online reading tutoring. The purpose of this manuscript is to describe and discuss a preliminary investigation of the effects of live online reading tutoring on 4th grade students in a high minority, high poverty school in Philadelphia, PA. Although this study was not conducted in a rural location, the implications are great for rural schools where qualified tutors may be nonexistent or inaccessible. Using a distance teleconferencing system, trained and supervised undergraduate students located at Utah State University delivered tutoring. The researchers employed a multiple-baseline across participants design to determine, the effects of 1:1 online reading tutoring on reading fluency scores for 3 students. In addition, they compared data on tutors' face-to-face and online tutoring behaviors. Data collected from parents, teachers, tutees, and tutors evaluating the effectiveness, efficiency, and feasibility of online tutoring for remediating students' skill deficiencies are presented and discussed.