On the heels of a campaign in which both major presidential candidates were promoting more standards, more tests, and more accountability, Linda McNeil, author of Contradictions of School Reform: Educational Costs of Standardized Testing, provides a dissenting voice. Her critical analysis is based on classroom observations in several Houston, Tex., magnet schools in the aftermath of the Texas education reforms enacted in the 1980s. She makes her views on these reforms clear in the author's preface:Accountability by standardized testing as the panacea for school reform ...is spreading like wildfire through the national debate on education....The sound bites that seduce policymakers always emphasize claims of benefits, not the actual costs.... The costs are great: a decline in the quality of what is taught and a new form of discrimination in the education of poor and minority students (xxi).

Gentamicin/azithromycin and gemifloxacin/azithromycin were highly effective for treatment of urogenital gonorrhea. Gastrointestinal adverse events may limit routine use. These non-cephalosporin-based regimens may be useful alternative options for patients who cannot be treated with cephalosporin antimicrobials. Additional treatment options for gonorrhea are needed. Clinical Trials Registration. NCT00926796.

BackgroundThis trial evaluated the safety and effectiveness of 6% cellulose sulfate vaginal gel in preventing male-to-female vaginal transmission of HIV, gonorrhea and chlamydial infection.MethodsThis Phase III, double-blind, randomized, placebo-controlled trial was conducted between November 2004 and March 2007 in Lagos and Port Harcourt, Nigeria. We enrolled 1644 HIV-antibody negative women at high risk of HIV acquisition. Study participants were randomized 1∶1 to cellulose sulfate or placebo and asked to use gel plus a condom for each act of vaginal intercourse over one year of follow-up. The participants were evaluated monthly for HIV, gonorrhea and chlamydial infection, and for adverse events.ResultsThe trial was stopped prematurely after the data safety monitoring board of a parallel trial concluded that cellulose sulfate might be increasing the risk of HIV. In contrast, we observed fewer infections in the active arm (10) than on placebo (13), a difference that was nonetheless not statistically significant (HR = 0.8, 95% CI 0.3–1.8; p = 0.56). Rates of gonorrhea and chlamydial infection were lower in the CS group but the difference was likewise not statistically significant (HR = 0.8, 95% CI 0.5–1.1; p = 0.19 for the combined STI outcome). Rates of adverse events were similar across study arms. No serious adverse events related to cellulose sulfate use were reported.ConclusionsCellulose sulfate gel appeared to be safe in the evaluated study population but we found insufficient evidence that it prevented male-to-female vaginal transmission of HIV, gonorrhea or chlamydial infection. The early closure of the trial compromised the ability to draw definitive conclusions about the effectiveness of cellulose sulfate against HIV.Trial RegistrationClinicalTrials.gov NCT00120770

Serological cure at 6 months after early syphilis treatment is associated with age, number of sex partners, Jarisch-Herxheimer reaction, and an interaction between syphilis stage and baseline RPR titer.

In the state of Texas, whose standardized, high-stakes test-based accountability system became the model for the nation's most comprehensive federal education policy, more than 135,000 youth are lost from the state's high schools every year. Dropout rates are highest for African American and Latino youth, more than 60% for the students we followed. Findings from this study, which included analysis of the accountability policy in operation in high-poverty high schools in a major urban district, analysis of student-level data for more than 271,000 students in that district 1 The authors gratefully acknowledge the contribution of Linda Darling-Hammond of Stanford University, who was the Principal Investigator on the part of the study funded by the Rockefeller Foundation. We also thank the Rice University Center for Education and Dr. Maconda Brown O'Connor for their support of this research. The authors are indebted to Laurie Hammons for her expert editing and analytical advice. The paper is stronger for the suggestions of Sherman Dorn, EPAA Editor, and the anonymous reviewers. The findings and analyses are those of the authors. Vol. 16 No. 3 2 over a seven-year period under this policy, and extensive ethnographic analysis of life in schools under the policy, show that the state's high-stakes accountability system has a direct impact on the severity of the dropout problem. The study carries great significance for national education policy because its findings show that disaggregation of student scores by race does not lead to greater equity, but in fact puts our most vulnerable youth, the poor, the English language learners, and African American and Latino children, at risk of being pushed out of their schools so the school ratings can show "measurable improvement." High-stakes, test-based accountability leads not to equitable educational possibilities for youth, but to avoidable losses of these students from our schools. Keywords: high-stakes testing; dropouts; accountability; Latino youth; African American youth. Education Policy Analysis ArchivesPerdidas evitables: Acontabilidad escolar con exámenes de alto riesgo y la crisis del abandono escolar Resumen En el estado de Texas, cuyo sistema de acontabilidad escolar se basa en la utilización de exámenes de alto riesgo y que se convirtió en el modelo a seguir para la política educativa más exhaustiva del país, cada año más de 135,000 jóvenes se pierden al dejar de estudiar en las escuelas secundarias estatales. Las tasas de abandono escolares más altas se dan entre los estudiantes afroamericanos y latinos, que configuran más del 60% de los jóvenes investigados en este trabajo. Este estudio, incluyó el análisis del sistema de acontabilidad utilizado en un distrito escolar de gran magnitud, en sus áreas de alta pobreza, análisis de datos de más que 260,000 estudiantes durante un periodo de siete años, y análisis etnográficos extensos de la vida en las escuelas permitió obtener resultados que muestran una relación causal directa entre la severidad creciente...

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Persistent nontreponemal titers after treatment are common among patients with early syphilis. We retreated 82 human immunodeficiency virus-negative early syphilis participants who were serofast at 6 months using benzathine penicillin. Only 27% exhibited serological response after retreatment and after an additional 6 months of follow-up.

In this trial, the efficacy of azithromycin at a dosage of 2.0 g administered orally was equivalent to that of benzathine penicillin G for the treatment of early syphilis in persons without HIV infection.