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Although special education legal knowledge is central to educating students with disabilities, how two critical school professionals--special educators and school principals--garner such knowledge is unclear. This study identified gaps in the professional training for special educators and school principals by examining professional standards and common textbooks. After identifying 32 special education legal concepts, we used content analysis to determine the extent to which each concept was mentioned in professional standards and preservice textbooks (five in special education, six in principal preparation, and four in school law). Compared with special education textbooks (in which 68%-84% of special education legal concepts were mentioned), preservice principals received less information on special education law in their general textbooks (3%-13% of concepts mentioned), although gaps narrowed when examining school law textbooks (63%-81%). Special education and school law texts consistently included concepts related to the six pillars of the Individuals with Disabilities Education Improvement Act (IDEA), as well as more specific concepts, such as discipline/behavior and related services. Rarely mentioned concepts were extended school year, resolution meetings, and compensatory services. We discuss training, research, and policy implications.

This qualitative research study looks at how reflective practices support preservice teachers' professional growth and development and its impacts on their self-efficacy. This study takes place in a regionally recognized south-western Hispanic Serving Institution that serves a high needs school district. Preservice teachers were asked to reflect on their field experiences to integrate theory and practice. The common themes that emerge contend that preservice teachers with a high sense of self-efficacy maintain a better understand of classroom management with its connection to building relationships. Another significant finding indicates that preservice teacher's reflective practices lead to self-efficacy and professional growth. These finding are significant to improving teacher preparation programs.

BackgroundThe path to becoming a physician is challenging, with various barriers influencing medical student and resident physician residency and fellowship training career decisions. Studies comparing perceived obstacles at disparate training levels are limited and given these obstacles are dynamic, studies are frequently needed to evaluate perceived barriers to pursuing residency specialty or fellowship of interest for physician trainees.ObjectiveTo evaluate and compare perceived barriers to obtaining residency specialty or fellowship of choice for medical students and resident physicians, respectively.MethodsA Likert scale survey assessing perceived barriers was administered via the listservs of medical schools and organizations in 2021. Differences in the Likert scale score mean between medical students and resident physicians were measured with student t-tests (2-sided).ResultsA total of 404 medical trainees participated (301 medical students and 103 resident physicians). Medical students indicated lack of opportunity to obtain alpha omega alpha membership as the most crucial perceived barrier (mean Likert scale score ± standard deviation, 4.01±1.97), followed by USMLE Step 1 score (3.92±1.89) and lack of home program in specialty/fellowship of interest (3.62±1.85). Similarly, resident physicians implicated the lack of a home program in a specialty/fellowship of interest as the most prominent barrier (3.48±1.78), followed by lack of connections/networking (3.17±1.50) and probability of matching (3.14±1.44).ConclusionsThe lack of a home program was an important barrier to pursuing a specialty or fellowship of choice for both medical students and resident physicians, respectively, and may have been heightened during the COVID-19 pandemic. J Drugs Dermatol. 2023;22(11):e17-e20    doi:10.36849/JDD.7005e.

Abstract Background Prescribing errors put an enormous burden on health and the economy, claiming implementation of effective methods to prevent/reduce them. Polypharmacy regimens (five or more drugs) are highly prone to unacknowledged prescribing errors, since the complex network of drug-drug interactions, guidelines and contraindications is challenging to be adequately evaluated in the prescription phase, especially if different doctors are involved. Clinical decision support systems aimed at polypharmacy evaluation may be crucial to recognize and correct prescribing errors. Methods A commercial clinical decision support system (Drug-PIN®) was applied to estimate the frequency of unrecognized prescribing errors in a group of 307 consecutive patients accessing the hospital pre-admission service of the Sant’Andrea Hospital of Rome, Italy, in the period April-June 2023. Drug-PIN® is a two-step system, first scoring the risk (low, moderate or high) associated with a certain therapy-patient pair, then allowing therapy optimization by medications exchanges. We defined prescribing errors as cases where therapy optimization could achieve consistent reduction of the Drug-PIN® calculated risk. Results Polypharmacy was present in 205 patients, and moderate to high risk for medication harm was predicted by Drug-PIN® in 91 patients (29.6%). In 58 of them (63.7%), Drug-PIN® guided optimization of the therapy could be achieved, with a statistically significant reduction of the calculated therapy-associated risk score. Patients whose therapy cannot be improved have a statistically significant higher number of used drugs. Considering the overall study population, the rate of avoidable prescribing errors was 18.89%. Conclusions Results suggest that computer-aided evaluation of medication-associated harm could be a valuable and actionable tool to identify and prevent prescribing errors in polypharmacy. We conducted the study in a Hospital pre-admission setting, which is not representative of the general population but represents a hotspot to intercept fragile population, where a consistent fraction of potentially harmful polypharmacy regimens could be promptly identified and corrected by systematic use of adequate clinical decision support tools.

Purpose: This research study provides insight into students' perceptions of teaching through virtual and face-to-face clinicals in an introductory education course in a pre-education program at a minority-serving institution. Design/methodology/approach: This study took place at an urban-suburban-centered community college in the Midwestern United States and was reviewed by the higher education institutional review board (IRB). Data were collected from pre-education majors enrolled in a four-hour Introduction to Education with field experiences. Findings: The findings indicated that both virtual and face-to-face clinicals were beneficial to the development of pre-service teachers, particularly in an early introduction to education course. Research limitations/implications: The finding that virtual clinicals are significant to teacher growth is significant to teacher recruitment and preparation. Practical implications: The flexibility of a virtual clinical provides greater opportunities for low-income and marginalized populations with limited means and access. Social implications: This finding can lead to strategies to diversify teacher candidates. Originality/value: This study sought to answer the following question: how do pre-education students reflect to understand the roles and responsibilities of teaching through virtual options vs face-to-face clinicals? The interest of this research is to expand pathways into the teaching profession to nontraditional, ethnically and culturally marginalized groups and historically underrepresented groups.

In recent decades, much international research has been carried out on school climate and its relationship with learning, socioemotional, and health outcomes (Berkowitz et al., 2017; La Salle, Rocha-Neves, et al., 2021; Pizmony-Levy et al., 2019). Limited research has been carried out to investigate the relationship between school climate and educational inequalities, with particular reference to the results obtained by minoritized students. This contribution focuses on this issue, and it is organized as follows. First, The International School Climate Collaborative, which led to the cross-cultural adaptation of the Georgia School Climate Survey, is presented with normative data for the use of the survey with secondary school students in four countries: Germany, Italy, Latvia, and the United States (La Salle, Rocha-Neves, et al., 2021). Second, the theme of the relationship between School Climate and Educational Equity is focused on the basis of the most recent scientific literature. Third, the theme of the relationship between School Climate and Educational Equity is focused on comparing four countries: the United States, Germany, Italy, and Latvia. Fourth, the practical implications are investigated, focusing on three possible interventions that could be useful for improving the school climate while promoting equity and valuing cultural differences.

A diverse stakeholder partnership led to the development of a Pre-Elementary Education program through its collaboration among faculty, academic advisement, and administration across higher education institutions. Housed at an institution that serves a minority population, this collaboration led to offering an Associate of Arts degree that is fully (2 + 2) transferrable to three key transfer universities. This collaboration also created a credit hour transfer pathway to a prominent Research I institution utilizing a Mellon grant partnership between the two institutions. These collaborations are significant because pre-education is a transfer degree and requires completion of a bachelor's degree program to meet state certification requirements. This partnership emerged in 2021-2022 at a prominent Midwestern community college. This article reports on the process of building the Pre-Elementary Associate of Arts degree. The student population is considered minority status, being first-generation, lower socio-economic, coming from black and brown communities, and Middle Eastern North African descent. The lessons learned are that forging collaboration among academic advisement, faculty, and administration leads to a more successful student experience through the creation of a highly transferrable program.

This study investigates 14 digitally enhanced learning methods, shedding light on students with special educational needs (SEN) in inclusive digital learning environments. We seek to fill the gap in the literature by specifically investigating methods suitable for students with SEN. A survey among experts has been carried out to assess learning methods that are effectively applicable in inclusive digital learning environments. A mixed method: quantitative and qualitative data analysis with the use of a constant comparative method has been applied to synthesise and compare experts' answers. Quantitative data analysis showed that cooperative learning, digital problem/project-based learning, and virtual exchange are the most suitable methods for all students, whereas digital problem/project-based learning, cooperative learning, and service-learning were agreed upon as the most appropriate for students with SEN. Answers to open questions, evaluated using a qualitative approach, showed that the effectiveness of digital approaches is heavily reliant on the skills, experience, willingness, confidence, and knowledge of teachers implementing them. Employing cooperative learning and digital problem/project-based learning, particularly by experienced and highly skilled teachers, has the potential to effectively support all students, including those with SEN, in digital learning environments.

Vasoactive intestinal peptide (VIP) interneurons in sensory cortex modulate sensory responses based on global exploratory behavior and arousal state, but their function during non-exploratory, goal-directed behavior is not well understood. In particular, whether VIP cells are activated by sensory cues, reward-seeking actions, or directly by reinforcement is unclear. We trained mice on a Go/NoGo whisker touch detection task that included a delay period and other features designed to separate sensory-evoked, action-related, and reward-related neural activity. Mice had to lick in response to a whisker stimulus to receive a variable-sized reward. Using two-photon calcium imaging, we measured ΔF/F responses of L2/3 VIP neurons in whisker somatosensory cortex (S1) during behavior. In both expert and novice mice, VIP cells were strongly activated by whisker stimuli and goal-directed actions (licking), but not by reinforcement. VIP cells showed somatotopic whisker tuning that was spatially organized relative to anatomical columns in S1, unlike lick-related signals which were spatially widespread. In expert mice, lick-related VIP responses were suppressed, not enhanced, when a reward was delivered, and the amount of suppression increased with reward size. This reward-related suppression was not seen in novice mice, where reward delivery was not yoked to licking. These results indicate that besides arousal and global state variables, VIP cells are activated by local sensory features and goal-directed actions, but not directly by reinforcement. Instead, our results are consistent with a role for VIP cells in encoding the expectation of reward associated with motor actions.

Abstract Introduction In chronic spontaneous urticaria (CSU), interleukin (IL)-4 and IL-13 may promote mast cell activation directly via IL-4 receptor expression, or indirectly via upregulated immunoglobulin E (IgE) production. Dupilumab significantly improved CSU signs and symptoms in the phase 3, randomized, placebo-controlled LIBERTY-CSU CUPID Study A. This analysis explores the impact of dupilumab on CSU signs and symptoms and serum IgE levels in patients from LIBERTY-CSU CUPID Study A with serum total IgE above and below 100 IU/mL at baseline. Methods Patients with H1-antihistamine-refractory CSU received dupilumab (n = 70) or placebo (n = 68) for 24 weeks. Efficacy endpoints were change from baseline to weeks 12 and 24 in serum total IgE levels, Itch Severity Score over 7 days (ISS7), Urticaria Activity Score over 7 days (UAS7), and Hives Severity Score over 7 days (HSS7) in dupilumab- or placebo-treated patients with serum total IgE above and below 100 IU/mL at baseline. Results Dupilumab treatment significantly reduced median (interquartile range) IgE levels at week 12 [dupilumab: −31.9% (−41.9; −22.6); placebo: −6.3% (−21.3; 14.9)] and week 24 [dupilumab: −48.2% (−56.8; − 39.5); placebo: − 6.3% (−34.5; 14.8)]. Similar IgE reductions relative to baseline were observed in dupilumab-treated patients regardless of baseline IgE level. Dupilumab treatment improved ISS7, UAS7, and HSS7 over 12 and 24 weeks, regardless of baseline serum IgE level (interaction p ≥ 0.59 for all treatment by subgroup comparisons), with weak correlations (r

Abstract Background Transient erythroblastopenia of childhood (TEC) is an acquired, self-limited pure red cell aplasia that usually occurs in children 4 years old and younger. This clinical condition has been priorly described to be linked to numerous viral and immunologic mechanisms. COVID-19, caused by the coronavirus SARS-CoV-2, was initially discovered in China in December 2019. The disease quickly spread worldwide, resulting in pandemic. Case Presentation This manuscript reports a new clinically relevant condition associated to COVID-19, describing a child with clinical and biochemical signs of Pure Red Blood cells aplasia and complete absence of erythroblasts at the bone marrow needle aspiration with signs of erythrophagocytosis, resembling morphological signs such as in hemophagocytic lymphohistiocytosis (HLH), temporally associated to SARS-CoV-2 infection. Conclusion This report highlights a newly described continuum laboratory and clinical spectrum of immune/hematological dysregulations secondary to SARS-CoV-2. SARS-CoV‐2 infection-linked TEC has never been described in literature, but, according to our findings, should be considered in all the patients with transient erythroblastopenia without congenital red blood cell abnormalities and serology negative for major infections associated with TEC. This condition must be considered in the same spectrum of MIS-C and the inter-links among the two clinical manifestations, as well as a potential interdependence among them, should be considered in the future.

This study investigates 14 digitally enhanced learning methods, shedding light on students with special educational needs (SEN) in inclusive digital learning environments. We seek to fill the gap in the literature by specifically investigating methods suitable for students with SEN. A survey among experts has been carried out to assess learning methods that are effectively applicable in inclusive digital learning environments. A mixed method: quantitative and qualitative data analysis with the use of a constant comparative method has been applied to synthesise and compare experts’ answers. Quantitative data analysis showed that cooperative learning, digital problem/project-based learning, and virtual exchange are the most suitable methods for all students, whereas digital problem/project-based learning, cooperative learning, and service-learning were agreed upon as the most appropriate for students with SEN. Answers to open questions, evaluated using a qualitative approach, showed that the effectiveness of digital approaches is heavily reliant on the skills, experience, willingness, confidence, and knowledge of teachers implementing them. Employing cooperative learning and digital problem/project-based learning, particularly by experienced and highly skilled teachers, has the potential to effectively support all students, including those with SEN, in digital learning environments.

Abstract Background Value-based healthcare (VBHC) is an approach that focuses on delivering the highest possible value for patients while driving cost efficiency in health services. It emphasizes improving patient outcomes and experiences while optimizing the use of resources, shifting the healthcare system’s focus from the volume of services to the value delivered. Our study assessed the effectiveness of implementing a VBHC-principled, tailored preoperative evaluation in enhancing patient care and outcomes, as well as reducing healthcare costs. Methods We employed a quality improvement, before-and-after approach to assessing the effects of implementing VBHC strategies on the restructuring of the preoperative evaluation clinics at Humanitas Research Hospital. The intervention introduced a VBHC-tailored risk matrix during the postintervention phase (year 2021), and the results were compared with those of the preintervention phase (2019). The primary study outcome was the difference in the number of preoperative tests and visits at baseline and after the VBHC approach. Secondary outcomes were patient outcomes and costs. Results A total of 9722 patients were included: 5242 during 2019 (baseline) and 4,480 during 2021 (VBHC approach). The median age of the population was 63 (IQR 51–72), 23% of patients were classified as ASA 3 and 4, and 26.8% (2,955 cases) were day surgery cases. We found a considerable decrease in the number of preoperative tests ordered for each patient [6.2 (2.5) vs 5.3 (2.6) tests, p

Among the pathophysiological correlates of schizophrenia, recent research suggests a potential role for the Hedgehog (Hh) signalling pathway, which has been traditionally studied in embryonic development and oncology. Its dysregulation may impact brain homeostasis, neuroplasticity, and potential involvement in neural processes. This systematic review provides an overview of the involvement of Hh signalling in the pathophysiology of schizophrenia and antipsychotic responses. We searched the PubMed and Scopus databases to identify peer-reviewed scientific studies focusing on Hh and schizophrenia, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, finally including eight studies, including three articles focused on patients with schizophrenia, two animal models of schizophrenia, two animal embryo studies, and one cellular differentiation study. The Hh pathway is crucial in the development of midbrain dopaminergic neurons, neuroplasticity mechanisms, regulating astrocyte phenotype and function, brain-derived neurotrophic factor expression, brain glutamatergic neural transmission, and responses to antipsychotics. Overall, results indicate an involvement of Hh in the pathophysiology of schizophrenia and antipsychotic responses, although an exiguity of studies characterises the literature. The heterogeneity between animal and human studies is another main limitation. Further research can lead to better comprehension and the development of novel personalised drug treatments and therapeutic interventions.

Objective: To assess the prevalence of chronic neutropenia (CN) and the clinical profile of patients with CN aged up to 18 years, followed in the pediatric hematology, rheumatology, or immunology outpatient clinic of a tertiary medical center from May 1, 2018, to 30 April 2019. Methods: Retrospective observational study carried out by collecting data from the patient's medical charts. CN was defined as absolute neutrophil count (ANC) below 1.5 × 109/L lasting over three months. Autoimmune neutropenia (AIN) was defined by clinical criteria and an over twofold increase in ANC after glucocorticoid stimulation. AIN was considered secondary when associated with autoimmune or immunoregulatory disorders. Wilcoxon and Fisher's exact tests were used to compare variables; the significance level was 5 %. Results: A total of 1,039 patients were evaluated; 217 (20 %) presented CN. Twenty-one (2 %) had AIN, classified as primary in 57 % of the cases. The average age at the onset of symptoms was 38.6 months. During follow-up, patients had 4.2 infections on average; frequency was higher among patients with secondary AIN (p = 003). Isolated neutropenia occurred in 43 % of the patients with AIN. Neutropenia resolved in eight (38 %) of the 21 patients with AIN within 19.6 months on average. Eight patients with secondary AIN met the criteria for Inborn Errors of Immunity. Conclusion: AIN prevalence was 2 %. Most cases were first evaluated by a pediatric immunologist or rheumatologist rather than a pediatric hematologist. This study highlights the need for a multidisciplinary approach involving a pediatric immunologist, rheumatologist, and hematologist.