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With dialogic writing assessment, teachers can scaffold students’ writing processes in ways that are flexible and responsive to students’ individual needs. Examples of teachers using this conference‐based method of classroom writing assessment illustrate how to practice assessment that is dynamic and relational rather than static and standardized, by allowing teachers to vary their support for student writers based on students’ unique needs. These examples also suggest that teachers’ epistemologies for writing instruction can influence how they practice dialogic writing assessment. The authors conclude with a discussion of how dynamic and responsive scaffolding can support an equity‐focused model for teaching academic writing and how teachers’ expertise may be a factor in how they apply dialogic writing assessment.

To positively influence students’ behavior and social relationships in the school and community settings, teachers can support students during early interventions and active conversations. Conversations held during class time that use picturebooks and restorative practice activities can be an appropriate way to support student learning and engagement. Lessons and activities can be implemented through any subject and integrated into classroom discussions to support students’ relationships, personal growth, well‐being, and behaviors. Incorporating discussions surrounding picturebooks with specific messages relating to social skills or situations in the classroom or community can support a restorative justice framework. The authors present ideas and activities relating to using picturebooks while upholding a restorative environment.

Barriers to technology integration in instruction include a lack of time, resources, and professional development. One potential approach to overcoming these barriers is through collaborative work, or professional learning communities. This article focuses on one group of teachers who leveraged their professional learning community to focus on integrating technology into their literacy instruction. Through this experience, teachers changed the way they approached technology integration. This article adds to the current literature on professional development and technology integration by exploring the perspectives of three fifth‐grade teachers working in a collaborative learning community over a period of one year. Implications from this experience suggest that using common formative assessments, providing ample time to learn together, and using a facilitator can help teachers work together effectively to integrate technology into literacy instruction.

Practitioners face many challenges when working with students who are experiencing difficulty with comprehension. The act of creating meaning with texts is complex, and comprehension is often measured in schools as a product of reading. Product assessments, such as answering questions or retelling a text, take place after reading, which makes it difficult to understand why and when a student may be experiencing difficulties. Using design-based research, the author examined the implementation of verbal protocols in classrooms as a formative assessment tool for comprehension. During this two-month study, three reading specialists drew on the landscape model of reading as a theoretical framework to better understand their students’ think-aloud statements. Findings indicated that reading specialists implemented verbal protocols as a formative assessment tool with diagnostic interpretation about their students’ reading difficulties and were able to use this information to effectively coach students on their reading processes.

This department column is a venue for thoughtful discussions of contemporary issues dealing with policy and practice, remixed in ways that generate new insights into enduring dilemmas, debates, and controversies.

In the realm of accelerated testing within controlled laboratory settings, the fidelity of the service environment assumes paramount importance. It is imperative to replicate real-world conditions while compressing the testing duration to facilitate early evaluations, thereby optimizing time and cost efficiencies. Traditional immersion protocols, reflective solely of full ballast tank conditions, inadequately expedite the corrosion process representative of an average ballast tank environment. Through the integration of immersion with fog/dry conditions, aligning the test protocol more closely with the internal conditions of an average ballast tank, heightened rates of general corrosion are achieved. This augmentation yields an acceleration factor of 7.82 times the standard test duration, under the assumption of a general corrosion rate of 0.4 mm/year for uncoated ballast tank steel, with both sides exposed. Subsequently, the fog/dry test protocol, albeit only resembling the environment of an empty ballast tank, closely trails in terms of acceleration efficacy. The fog/dry test protocol offers cost-effectiveness and replicability compared to the AMACORT CIFD-01 protocol, making it a strong competitor despite the relatively close acceleration factor.

There have been conflicting data regarding the relationship between sepsis-bundle adherence and mortality. Moreover, little is known about how this relationship may be moderated by the anatomic source of infection or the location of sepsis declaration. This was a multi-center, retrospective, observational study of adult patients with a hospital discharge diagnosis of severe sepsis or septic shock. The study included patients who presented to one of three Los Angeles County Department of Health Services (DHS) full-service hospitals January 2012 to December 2014. The primary outcome of interest was the association between sepsis-bundle adherence and in-hospital mortality. Secondary outcome measures included in-hospital mortality by source of infection, and the location of sepsis declaration. Among the 4,582 patients identified with sepsis, overall mortality was lower among those who received bundle-adherent care compared to those who did not (17.9% vs. 20.4%; p=0.035). Seventy-five percent (n=3,459) of patients first met sepsis criteria in the ED, 9.6% (n=444) in the intensive care unit (ICU) and 14.8% (n=678) on the ward. Bundle adherence was associated with lower mortality for those declaring in the ICU (23.0% adherent [95% confidence interval{CI} {16.8-30.5}] vs. 31.4% non-adherent [95% CI {26.4-37.0}]; p=0.063), but not for those declaring in the ED (17.2% adherent [95% CI {15.8-18.7}] vs. 15.1% non-adherent [95% CI {13.0-17.5}]; p=0.133) or on the ward (24.8% adherent [95% CI {18.6-32.4}] vs. 24.4% non-adherent [95% CI {20.9-28.3}]; p=0.908). Pneumonia was the most common source of sepsis (32.6%), and patients with pneumonia had the highest mortality of all other subsets receiving bundle non-adherent care (28.9%; 95% CI [25.3-32.9]). Although overall mortality was lower among those who received bundle-adherent care compared to those who did not, when divided into subgroups by suspected source of infection, a statistically significant mortality benefit to bundle-adherent sepsis care was only seen in patients with pneumonia. In a large public healthcare system, adherence with severe sepsis/septic shock management bundles was found to be associated with improved survival. Bundle adherence seems to be most beneficial for patients with pneumonia. The overall improved survival in patients who received bundle-adherent care was driven by patients declaring in the ICU. Adherence was not associated with lower mortality in the large subset of patients who declared in the ED, nor in the smaller subset of patients who declared in the ward.

Although healthy ecosystems are vital to sustaining human society, the Brazilian Cerrado and Atlantic Forest biomes have suffered from disorderly human development and the intense use of natural resources. Thus, cost-effective studies are needed to develop tools to assess environmental conservation and the integrity of water courses to inform decisions for ensuring their recovery where ecosystem maintenance is deficient. This study sought to develop a methodology in which the Watershed Habitat Evaluation and Biotic Integrity Protocol (WHEBIP) and Rapid Assessment Protocol for Habitat Diversity (RAP) could be used in an integrated, adaptive manner to evaluate the Water Ecosystem Integrity (WEI) in courses of rivers and streams in tropical regions of the Brazilian Cerrado–Atlantic Forest interface undergoing intense agricultural exploitation. Accordingly, a spatial assessment using geographic information systems was followed by a field visit to apply the methodology. A preliminary assessment of the soil conditions in the Lobo Reservoir Hydrographic Basin was conducted, identifying stretches of rivers and streams that were suitable for payment for environmental services and for recovery from the impact of anthropic activities. Such activities were present in 50.23% of the basin’s total area, and intensive degradation was found in stretches of the water courses, primarily where the head springs of the Itaqueri River and Lobo Stream, the principal tributaries of the Lobo Reservoir, lie. Native vegetation, Brazilian Cerrado, and reforestation occupy a total of 38.5% of the basin, comprising areas of intense conservation activity by the Brazilian government.

The American College of Emergency Physicians guidelines recommend more aggressive workup beyond imaging alone in patients with a high pretest probability (PTP) of pulmonary embolism (PE). However, the ability of multiple tests to safely rule out PE in high PTP patients is not known. We sought to measure the ability of negative computed tomography pulmonary angiography (CTPA) negative D-dimer to rule out PE in these high-risk patients. We analyzed data from a previous prospective observational study conducted in 12 emergency departments (ED). Wells score criteria were entered by providers before final PE testing. PE was diagnosed by imaging on the index ED visit, or within 45 days, demonstrating either PE or deep vein thrombosis (DVT), or if the patient died of PE during the 45-day, follow-up period. Testing threshold was set at 1.8%. A total of 7,940 patients were enrolled and tested for PE, and 257 had high PTP (Wells >6). Sixteen of these high-risk patients had negative CTPA negative D-dimer, of whom two were positive for PE (12.5% [95% confidence interval {2.2%-40.0%}]). One of these patients had a DVT on CT venogram and the other was diagnosed at follow-up. Our analysis suggests that in patients with high PTP of PE, neither negative CTPA by itself nor a negative CTPA negative D-dimer are sufficient to rule out PE. More aggressive workup strategies may be required for these patients.

Although bronchiolitis is a common reason for infant hospitalization, significant heterogeneity persists in its management. The American Academy of Pediatrics currently recommends that inhaled albuterol not be used in routine care of children with bronchiolitis. Our objective was to identify factors associated with pre-admission (e.g., emergency department or primary care) use of albuterol among infants hospitalized for bronchiolitis. We analyzed data from a 17-center observational study of 1,016 infants (age <1 year) hospitalized with bronchiolitis between 2011-2014. Pre-admission albuterol use was ascertained by chart review, and data were available for 1,008 (99%) infants. We used multivariable logistic regression to identify infant characteristics independently associated with pre-admission albuterol use. Half of the infants (n=508) received at least one albuterol treatment before admission. Across the 17 hospitals, pre-admission albuterol use ranged from 23-84%. In adjusted analysis, independent predictors of albuterol use were the following: age ≥2 months (age 2.0-5.9 months [odds ratio (OR) 2.09, 95% confidence interval (CI) {1.45-3.01}] and age 6.0-11.9 months [OR 2.89, 95% CI {1.99-4.19}]); prior use of a bronchodilator (OR 1.89, 95% CI [1.24-2.90]); and presence of wheezing documented in pre-admission chart (OR 3.94, 95% CI [2.61-5.93]). By contrast, albuterol use was less likely among those with ≥7 days since the start of breathing problem (OR 0.66, 95% CI [0.44-1.00]) and parent-reported fever (OR 0.75, 95% CI [0.58-0.96]). Variation in pre-admission albuterol use suggests that local practice had a strong influence on use, but that patient characteristics also influenced the decision. While we agree with current guidelines in recommending against albuterol for all infants with bronchiolitis, our understanding of possible subgroups of responders may improve through investigation of infants with the identified characteristics.