MRI, CT, Results

I had an MRI of my brain, with and without contrast, on Monday, March 26th.  I was able to come to the Cancer Clinic prior to that to have my port accessed.  The MRI went fine.  I even joked with the tech: "Should I expect any bad calls about this?"  He didn't really say.  (Thanks to an amazing friend, Jenn for bringing me and keeping me company.)

The next day, Dr. Fleener called me at lunch.

The was no evidence for acute infection and no evidence for intracranial hemorrhage.  However, the MRI found two small spots of abnormal enhancement in the cerebellar vermis, at the back of my brain, around 3mm each.  Because of the size, the doctors aren't 100% sure what these spots are.  They are suspicious for early recurrent intracranial metastatic disease, but there was no swelling or other sure signs.  

Dr. F said she was going to get the opinions of Dr. Goble and Dr. Hoover, a neurosurgeon to make decide how to proceed.

The next morning, I received a call that I needed to have an appointment with Dr. Hoover.  (This is probably NOT nothing, I thought to myself......excuse the double negative, fellow teachers and grammar gurus.)

I had a scheduled CT to scan the rest of my body.  This procedure uses the *delicious* vanilla shake I just *love* so much!





I do want to add how grateful I was for the tech who took the time and truly listened to my concerns about my veins and an IV.  She searched and searched and found a winner.  Best IV experience ever!


Lunch, then another appointment.  (I forgot to mention that Dr. Fleener wanted me to remove my IUD, so I'd already done that the day before after hearing about the spots.)

I went to the appointment expecting bad news, something that would interfere with my April plans.  I was pleasantly surprised.  I liked Dr. Hoover quite a bit.  He explained that these two tiny spots, these two lesions were only discovered because this was an oncology MRI, using smaller, 1mm cuts.  The best news is that this MRI, even with the spots, is significantly better than last year.  I can attest to that, as he took me back to view them side-by-side.  Last year, my brain looked like a foggy day inside a skull.  Now, it actually looked quite normal, with a few battle scars.

Dr. hoover would not recommend any surgical options for me.  The spots are too small to biopsy.

There are two ways to proceed.  1) radiosurgery:  This involves a blast of focused radiation to those spots.  The problem lies in the unknown.  If they were to radiate these spots, and they weren't cancer, but perhaps radiation necrosis (dead cells), the spots could potentially grow, leading doctors to believe that they are cancer, and that the radio surgery was unsuccessful.  Basically, that option could lead to a false diagnosis and more damage.

2) wait, and repeat an MRI in 6-8 weeks.  This was Dr. Hoover's suggestion.  And, while we were finishing our appointment, he got a text from Dr. Goble, which said practically word-for-word what he had explained to me.



The next day, Thursday, I met with Dr. Fleener.  She went over Dr. Hoover's and Dr. Goble's recommendations, as well as some opinions of other colleagues'.   The waiting for another MRI before doing anything was unanimous.  The results from my CT came back clear.

Dr. Fleener did say that perhaps these spots were a "God thing," a reason to review my treatment.  Herceptin doesn't cross the blood-brain barrier, but estrogen does.  So, maybe we should do more to try to block that.  She gave me a sample of 2 drugs: Ibrance and Letrosole.  At some point, we will probably take away the Perjeta, since it may not be doing enough.  She would think on that and decide before my next treatment.



Overall, this news is not the best, but also not the worst.  My April plans are still on track.  I don't need to worry for 6 weeks!

Preparing teachers for 21st century challenges

By Andreas Schleicher
Director, Directorate for Education and Skills




Preparing today�s students to thrive in their society is no easy task. The skills and knowledge they�ll need to succeed in the future are constantly changing, while others are quickly being digitised, automated or outsourced.

This puts teachers in a difficult position. Not only do we expect them to have a deep and broad understanding of the subjects they teach, and to adequately prepare their students for 21st century challenges; we also expect them to be passionate, compassionate and thoughtful, and to ensure that students feel valued and included in a collaborative learning environment.

Our expectations of teachers are high and rising, yet our education systems are not keeping pace. Most schools look much the same today as they did a generation ago, and teachers themselves are often not developing the practices and skills required to meet the diverse needs of today�s learners.

So what can be done to support teachers to meet the formidable challenges of 21st century education? And how can they take advantage of new opportunities? Those questions will be at the heart of the 8th International Summit on the Teaching Profession (ISTP), which will be held this week in Lisbon. Hosted by the Portuguese Ministry of Education, with support from the OECD and Education International, the Summit brings together education ministers, union leaders and other teacher leaders to share their insights and reflect on public education policy.

Charting a course forward will not be simple or straightforward � but it is absolutely necessary.

Over the course of two days (22-23 March), attendees will address three interrelated issues. The first session focuses on schools, and how policy-makers and the teaching profession can strengthen links between schools and their communities. Schools are vital to the social health of their local communities, and the most successful schools are often those that are at the center of their cities, towns and neighborhoods. Engaging with local communities is therefore key to success, as it is clear that no school exists in a vacuum.

The second session gets to the heart of education: pedagogy. Many teachers have a good sense of the kind of pedagogies on which 21st century learning hinges, but there is still a significant gap between intended and implemented practices. The challenge for education systems is to create conditions that will encourage teachers to initiate, share and evaluate innovative pedagogies � including new technologies -- and to anticipate any impacts such pedagogies may have on the roles of students and teachers.

In the third session, we will turn our attention to teachers themselves. There is a growing recognition that in order for teaching and learning to be most effective, teachers need to have high levels of well-being, self-efficacy and confidence. How can governments, in partnership with teachers� unions, create evidence-informed strategies on well-being, efficacy and effectiveness as part of their teacher policies?

Over the years, the ISTP has established itself of the most unique and successful education summits in the world � in part, because it explores difficult and controversial issues on the basis of sound evidence, provided by the OECD. The 8th edition of the Summit will be no different, and I am very much looking forward to the discussions and debates. Charting a course forward for teachers will not be simple or straightforward � but it is absolutely necessary. Today�s students will face vastly different challenges by the time they reach adulthood. We should do everything we can to make sure they�re prepared.

Read more

8th International Summit on the Teaching Profession
Valuing our Teachers and Raising their Status: How Communities Can Help

H&P #36

It's the first day of spring.  Here in Texas, the bluebonnets and other wildflowers are coming out!  It's one of my favorite times of year.  As I was driving in to treatment, I gave thanks for the opportunity to see these beauties for another year, for many are not so lucky.  How my heart aches for those who are fighting and still seeking for miracles in their fights, or for their families when it becomes time that the fight be over.

I often forget that beneath the beauty of these flowers, randomly sprouting up in fields and on roadsides, as well as in well kept and cultivated gardens did not begin with the colorful petals that brighten my day.  The seed and the miracle of life came first, but so did the  difficulties in reaching for the light of the sun.



Soil, freezing temperatures, strong winds and storms, pests....these are just some obstacles each flower pushes through to bring its own beauty to the world.  And, I'll keep pushing through, too.


Had another little "episode" yesterday when the words on my mind weren't the words being spoken.  Not like the times that happen often, like calling one child the wrong name or not being able to reach for a actor's name, the one on the tip of my tongue.  This was more like not having the ability to make my mouth say what was in my brain, being able to realize it was happening, not being able to fix it, and then feeling uncertainty and concern about what it all meant.  This obstacle of cancer keeps trying to stop me from reaching for and being able to remain in the sun.

Luckily for me, I have nurses who know before I mention it that somethings not right.  I have an amazing oncologist who has the ability to bring peace to my scrambled mind, reassuring me that she is not worried, while also taking my case seriously enough to push up my scans.  In addition, she never fails me in seeking out any extras that could add more to my treatment.  This time was to think about having my IUD removed, as the small traces of Estrogen probably won't make a big deal in my case, but why risk "probably?" Luckily for me, she believes in miracles and knows that God can do things that even she can't.

In addition to my angels in scrubs and white coats, I'm even more blessed.  God is there with me, as I struggle and reach and grow through the dirt and discomfort.  Luckily for all of us, the Son we reach for is even brighter than the sun.

What can education systems do to support students with immigrant backgrounds?

by Francesca Borgonovi
Senior Analyst

Large-scale migration is starting to radically alter the makeup of today�s classrooms, bringing a new wave of social, cultural and linguistic diversity to schools in destination countries. Results from the latest publication of the Strength through Diversity project, The Resilience of Students with an Immigrant Background: Factors that Shape Well-Being, reveal that in 2015, almost one in four 15-year-old students in OECD countries reported that they were either foreign-born or had at least one foreign-born parent. Indeed, in Luxembourg and Switzerland, more than one out of every two 15-year-old students reported that they were either foreign-born or had at least one parent who was; and between 2003 and 2015, the share of students who had either migrated or had a parent who migrated across international borders grew by an average of six percentage points across OECD countries.

The ability of societies to preserve and promote social cohesion in the presence of large migration flows depends on their capacity to integrate immigrants. While migration flows can create difficulties for host communities, they also represent an opportunity for countries with ageing native-born populations that face labour and skills shortages. Effective education and social policies are essential for successfully integrating migrant children into society and unlocking the potential benefits of migration.

Schools often act as an early point of contact between young immigrants and their host societies, helping to determine their ability to participate in the labour markets of host countries, contribute to welfare arrangements, and feel part of their communities. This new OECD report is the first of its kind because it examines the overall resilience � �resilience� being the ability to thrive academically, socially and emotionally in adverse circumstances � of students with an immigrant background as they integrate into education systems. The report identifies both the risk factors that prevent immigrant students from successfully integrating and the protective factors that enable these students to flourish.

Many students with an immigrant background fail to achieve the academic, social and emotional outcomes that are comparable to those achieved by their native peers.

Despite the adversities they face, many students with an immigrant background actually overcome the various disadvantages that often accompany displacement, and display high levels of academic, social, emotional and motivational resilience. For example, as much as 49% of first-generation and 61% of second-generation immigrant students achieve at least baseline levels of proficiency in the three core PISA (Programme for International Student Assessment) subjects of reading, mathematics and science; and as much as 59% of first-generation and 63% of second-generation immigrant students report feeling a strong sense of belonging at school. Crucially, many students with an immigrant background appear to be motivated to make the most of their educational opportunities: 71% of both first- and second-generation immigrant students report high levels of achievement motivation.

But many students with an immigrant background fail to achieve the academic, social and emotional outcomes that are comparable to those achieved by their native peers; they struggle to overcome socio-economic disadvantages, language barriers and the difficulty of forging a new identity.

Education systems play a key role in enabling students with an immigrant background to reach their academic potential, feel part of their communities and be satisfied with their lives. Findings from this new report suggest that when education systems adequately support students with an immigrant background, other students can benefit too. The growing diversity that arises from international migration can be a great opportunity for education systems, forcing teachers to rethink their pedagogical approaches and teaching styles. Doing so will better equip them to cater to the needs of each student, whether the student has an immigrant background or not. At the same time, if teachers and educators do not have the right support, they may not be able to adapt to these changes, and all students may suffer as a result.

Schools in many communities are already working to promote the resilience of students with an immigrant background, often jointly with other social service providers and civil society, and with direct financial and logistical support from national, regional or local governments. The Strength through Diversity project has been facilitating dialogue among countries through its dedicated Policy Forum series, but more can be done. This new OECD report can help educators build the resilience, and ease the integration, of all students with an immigrant background.

Read more

Strength through Diversity: The Integration of Immigrants and Refugees in School and Training Systems
The Resilience of Students with an Immigrant Background. Factors that Shape Well-being

Photo credit: @Shutterstock

Why schools should pay more attention to students� mental health and well-being

by Anna Choi 
Analyst, Economist/Analyst at CFE/LESI (Local employment, skills, and social innovation)

The notion of well-being and happiness has increasingly taken centre stage in our societies over the recent years. As Nobel Prize Economist Daniel Kahneman puts it, "there is a huge wave of interest in happiness among researchers. There is a lot of happiness coaching. Everybody would like to make people happier."

In addition to physical health, it has become clear that emotional health is vital for our overall well-being. Children who are in a good state of emotional well-being have higher odds of growing into adults who are happy, confident, and enjoy healthy lifestyles, consequently contributing towards a better society and improving the overall well-being of the population.

Perhaps this emphasis on well-being may reflect the increasing prevalence of emotional ill-being and mental health problems. Across OECD countries, almost one in four adults report experiencing more anger, worry and sadness than enjoyment, restedness and smiling or laughter every day. What is more alarming is that around 10-20% of children and adolescents around the world suffer from mental health problems, and an increasing number of children and adolescents have reported experiencing anxiety, depression, and difficulties sleeping over the recent decades. Emotional well-being during childhood and adolescence is particularly important as nearly one in two mental health problems among adults begin by age 14. A just released Trends Shaping Education Spotlight looks at this in more detail.

Given the importance of emotional well-being in early life, these trends are quite worrying for researchers, policy makers, teachers, and parents worldwide. This is perhaps reflected in the fact that schools and education systems around the world are increasingly concerned with their students' well-being. Since children and adolescents spend most of their time in schools, their learning environments can have a significant impact on their emotional well-being, in addition to the things they experience outside of school.

Schools and education systems around the world are increasingly concerned with their students' well-being.

Different factors can be conducive or detrimental to students' well-being, and many of these factors are interrelated. Stable emotional support and positive relationships with parents can act as a protective buffer during difficulties in life such as chronic stress, exposure to bullying, anxiety, and depression. Similarly, happier students tend to report having good relationships with their teachers, and those who receive high levels of support from their teachers tend to handle stress better at school. Outside of school, engaging in other activities such as volunteering can help foster co-operation and interpersonal trust. Socialising with friends outside of school is also positively associated with life satisfaction, sense of belonging at school, happiness and self-esteem.

While it is difficult to isolate a single winning strategy to enhance children�s and adolescents' emotional well-being, effective prevention programmes for depression, anxiety and suicide tend to all have something in common at their core: cognitive-behavioural therapy (CBT). The behavioural component within CBT focuses on coping strategies, social problem-solving skills, and interpersonal relationships, as well as the cognitive component involved in helping adolescents identify and gain control over thought processes and patterns in order to be more optimistic.  Similarly, CBT programmes targeted towards lowering anxiety have a related behavioural component that helps participants block avoidance behaviour, and a cognitive therapy component that emphasises the monitoring of feelings and behaviours and efforts towards cognitive restructuring to change anxious thoughts and processes.

It is important to involve and collaborate with different actors�schools, teachers, and parents�to improve the effectiveness of different prevention programs and thus enhance children�s and adolescents� well-being. An open line of communication between teachers and parents can raise the awareness of the problem as some children may be reluctant to openly discuss the challenges and emotional difficulties they are going through, whether it be depression, anxiety, or bullying. It is also important to provide support and training to teachers and parents to monitor and detect children's symptoms and behaviours early on (including depression, bullying, chronic stress, and other behavioural problems).

If not properly addressed, issues of mental health and well-being may not only impact individuals at the school level, but also have far-reaching effects on the society at large.

Links

Trends Shaping Education Spotlight 14 - Good vibrations: Students� well-being 

OECD Centre for Educational Research and Innovation 

How's Life? Measuring Well-being
Emotional well-being of children and adolescents. Recent trends and relevant factors
PISA 2015 Results. Student's Well-Being

Photo credit: @Shutterstock

How Japan�s Kosen schools are creating a new generation of innovators

By Andreas Schleicher
Director, Directorate for Education and Skills

Photo credit: Jun Takai

Innovation and problem solving depend increasingly on the ability to synthesise disparate elements to create something different and unexpected. This involves curiosity, open-mindedness and making connections between ideas that previously seemed unrelated. It also requires knowledge across a broad range of fields. If we spend our entire lives in the silo of a single discipline, we will not gain the imaginative skills necessary to connect the dots and develop the next life-changing invention.

For schools, then, the challenge is to remain true to disciplines while encouraging interdisciplinary learning and building students�capacity to see problems through multiple lenses. Some countries have been trying to develop cross-curricular capabilities. Japan�s network of Kosen schools is a unique example.

Its president, Isao Taniguchi, showed me around the Tokyo campus last week, and it was one of my most inspiring school visits. At first sight, the campus looks like a vocational school, since much of the learning is hands-on, collaborative and project-based. But for those who may associate hands-on learning with an academically less-rigorous curriculum, Kosen is profoundly different.

What makes the Kosen schools different is their unique blend of classroom-based and hands-on, project-based learning.

In fact, the 51 Kosen schools are among Japan�s most selective high schools and colleges, and the curriculum is as much focused on liberal arts as it is technical and scientific studies. Some 40% of graduates will continue studying at university, and those who choose to directly enter the labour market can expect an average of 20 job offers as Japan�s most sought-after innovators and engineers. None of the students I met knew anyone who had dropped out of this demanding programme.

What makes the Kosen schools different is their unique blend of classroom-based and hands-on, project-based learning. At Kosen schools, learning is both cross-curricular and student-centred, and teachers are mainly coaches, mentors, facilitators and evaluators. This is not one of those contrived, one-week projects that have now become quite fashionable in many schools around the world; on the contrary, Kosen students will typically work for several years on developing and realising their big ideas.

Toshiki Tomihira, a student specialising in electrical engineering, invited me to an amazing virtual reality experience of wild water rafting. Daisuke Suzuki, a chemistry student, is working on a low-cost solution to purify soil from heavy metal pollution. And unlike most other school projects, the fruits of the work of Kosen students typically end up not in a bin, but in an incubator where they find their way to market as one of Japan�s many innovations.

While project-based learning has only recently gained widespread traction, the Kosen schools have been in operation since the early 1960s, demonstrating to the world that this is not just a promising approach, but a proven one, as well.


Learn more about Japan's efforts to help students develop critical thinking and problem-solving skills:    

Why access to quality early childhood education and care is a key driver of women�s labour market participation

  by Eric Charbonnier, Analyst, Directorate for Education and Skills

We are in 1961. JF Kennedy is president and has just designated Eleanor Roosevelt as chairwoman of the new US Commission on the Status of Women: "We want to be sure that women are used as effectively as they can to provide a better life for our people, in addition to meeting their primary responsibility, which is in the home." Fifty-seven years ago, women had to make a choice between pursuing a career or having children. Back then, access to early childhood education and care (ECEC) services was reserved for the elite and was not considered a policy priority; maternity leave was rare, while paternity leave was unheard of. This may seem strange now, but just try to think of society in the 1960s. Just think how far we have come since then: In 1961, only 38 % of women were employed in the United States. In 2015, this figure was at 70%.

Don�t be fooled by the upbeat statistics though. Two generations later, inequalities still exist.  Although women are more engaged in the labour market, they are still three times more likely to be employed in part-time positions than men. They are also less likely to be employed in higher-paid occupations, and less likely to progress in their careers. However, mindsets have evolved, and combining a career and a family for women is no longer the heresy it used to be.  As a recent example, the current Prime Minister of New Zealand, Jacinda Ardern, announced some months ago both her first pregnancy and her husband�s paternity leave: "I�ll be Prime Minister AND a mum, and Clarke will be �first man of fishing� and stay- at- home dad." The news was generally well--received, a stark contrast to 1961 when low provision of early childhood services and other work-family provision would have made such a decision virtually impossible.

This month�s Education Indicators in Focus brief takes a closer look at how provision of early childhood education and care has affected the participation of women in the labour market over the years. In the last half century, women�s labour force participation has increased dramatically in most countries. The rise in ECEC provision over this period has greatly contributed to this change, particularly for mothers with a child under the age of 3. As shown in the figure above, both components are strongly associated. However, there are substantial cross-country differences. In countries where mothers� labour market participation rates are the highest, the proportions of very young children enrolled in early childhood services are also the highest (see quadrant on the top-right). By contrast, combining childrearing and employment is most difficult in some eastern  European countries (the Czech Republic, Estonia, Hungary, the Slovak Republic), as well as in Mexico (see quadrant on the bottom-left), partly because these services are under-developed in those countries.

The availability of early childhood services plays a key role in the increased labour force participation rates among women. This in turn has public benefits in terms of higher contributions to society and to economic growth.  But having a good access to such services is not sufficient. The number of ECEC hours per week available to young children is paramount to increasing the full-time participation of mothers in the labour market. For that reason, many OECD countries have recently increased the number of free hours of ECEC entitlements, or shifted from half-day to full-day kindergartens. However, here again, wide variations among countries still exist. Countries with both high levels of participation in early childhood education and care and greater intensity of participation (in hours per week), such as Nordic countries, are in general those in which most mothers work full-time.

Women�s participation in work does not only make economic sense for a nation, but the benefits of early childhood services towards better learning for the children themselves are also now widely acknowledged. In this context, it is not surprising that ECEC has experienced a surge of policy attention in the last fifteen years. However, despite many initiatives over this period to increase access, equity and quality of these services across OECD countries, affordability remains a key challenge in most of them. It is true (and a positive step) that governments often provide various schemes to help reduce the cost of early childhood services for poorer families (including cash transfers, rebates and tax reductions), but these efforts are still insufficient. Thus, children under the age of 3 in most countries are more likely to be enrolled in ECEC if they come from relatively advantaged socio-economic backgrounds or if their mother has completed a tertiary education degree.

Society has progressed a lot in fifty-seven years. Who would have thought in 1961 that someday women would no longer have to make a choice between their career and raising a family? Stronger access and provision to early childhood education and care services has greatly contributed to more equity in the workforce, but more is needed to ensure fully equal participation of men and women, whether at work or at home. Hopefully we will not have to wait another half century to see that happen.

Links
Education Indicators in Focus No. 59 - How does access to early childhood education services affect the participation of women in the labour market?
OECD Early Childhood Education and Care
Starting Strong 2017: Key OECD Indicators on Early Childhood Education and Care