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This research study considers third-level student experiences of electronic portfolio (ePortfolio) implementation during their education that occurred during the Covid-19 lockdowns. Adopting a mixed-methods approach, the purpose of this study was to identify the main challenges students face and document their experiences at an Irish higher education institution (HEI). The main challenges identified by students were a lack of time, lack of technical support, a lack of feedback received, and a dislike of information technology (IT). The key findings will provide insight about how ePortfolios can be better supported and implemented.

Tobacco surveillance in the United States is robust but cannot be quickly modified to capture newly identified tobacco products or behaviors. We present an example of a rapidly deployed nonprobability survey using social media recruitment that collected data on rapidly changing tobacco use behaviors. We recruited 15- to 17-year old current vapers from NY, USA, using targeted social media advertisements to complete the New York Adolescent Vaping Survey (NY AVS), which asked about vaping behaviors not addressed in existing probability surveillance surveys. We used the New York Youth Risk Behavior Survey (NY YRBS) to apply calibration weights to ensure that the distribution of the demographic characteristics accurately reflected the population distribution. We found systematic differences in demographic variable distributions between the probability-based NY YRBS and the convenience sample of the NY AVS that were reconciled in the weighting calibration. We found no statistically significant differences between the NY YRBS and NY AVS estimates after calibration for two outcome variables of interest. Recruiting a sample of adolescents using social media advertising to conduct a rapid survey on vaping provided valuable data that complemented traditional surveillance surveys; this approach could be used to fill future knowledge gaps in youth tobacco surveillance.

This paper is a critical exposition on three major issues related to 'interpretive research conducted by researchers who claim they engaged in mixed methods' research. First, to provide context, we demonstrate that the term 'mixed' is inappropriate for the research practices usually adopted by its exponents. Secondly, we argue, expositions in textbooks, handbooks, and journal articles are inaccurate when referring regularly to engagement in 'mixed methods' research as a relatively recent practice. Thirdly, we illustrate how the interpretive research component within mixed methods studies often display an incorrect understanding of interpretive research methodology.

BackgroundWe aimed to identify factors associated with a significant reduction in SLE disease activity over 12 months assessed by the BILAG Index.MethodsIn an international SLE cohort, we studied patients from their 'inception enrolment' visit. We also defined an 'active disease' cohort of patients who had active disease similar to that needed for enrolment into clinical trials. Outcomes at 12 months were; Major Clinical Response (MCR: reduction to classic BILAG C in all domains, steroid dose of ≤7.5 mg and SLEDAI ≤ 4) and 'Improvement' (reduction to ≤1B score in previously active organs; no new BILAG A/B; stable or reduced steroid dose; no increase in SLEDAI). Univariate and multivariate logistic regression with Least Absolute Shrinkage and Selection Operator (LASSO) and cross-validation in randomly split samples were used to build prediction models.Results'Inception enrolment' (n = 1492) and 'active disease' (n = 924) patients were studied. Models for MCR performed well (ROC AUC = .777 and .732 in the inception enrolment and active disease cohorts, respectively). Models for Improvement performed poorly (ROC AUC = .574 in the active disease cohort). MCR in both cohorts was associated with anti-malarial use and inversely associated with active disease at baseline (BILAG or SLEDAI) scores, BILAG haematological A/B scores, higher steroid dose and immunosuppressive use.ConclusionBaseline predictors of response in SLE can help identify patients in clinic who are less likely to respond to standard therapy. They are also important as stratification factors when designing clinical trials in order to better standardize overall usual care response rates.

BackgroundThis study aims to quantitatively assess use of the NSQIP surgical risk calculator (NSRC) in contemporary surgical practice and to identify barriers to use and potential interventions that might increase use.Materials and methodsWe performed a cross-sectional study of surgeons at seven institutions. The primary outcomes were self-reported application of the calculator in general clinical practice and specific clinical scenarios as well as reported barriers to use.ResultsIn our sample of 99 surgeons (49.7% response rate), 73.7% reported use of the NSRC in the past month. Approximately half (51.9%) of respondents reported infrequent NSRC use (

BACKGROUND: Extended first-line therapy (1LT) has improved clinical outcomes in newly diagnosed multiple myeloma (NDMM). This retrospective study of NDMM patients evaluated the relationship between dose-attenuation of 1LT and duration of therapy (DOT) and DOT on outcomes. METHODS: Adults with NDMM not undergoing stem cell transplant (SCT) from January 1, 2012 toMarch 31, 2018 from the Integrated Oncology Network were included; 300 were randomly selected for chart review. 1LT DOT, time to next treatment (TTNT), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier analysis. Marginal structural models evaluated relationships between DOT and TTNT, PFS, and OS at 2 years accounting for confounders and survival bias from the time-dependent nature of DOT. RESULTS: Of 300 chart-reviewed patients, 93 were excluded for incomplete data or meeting exclusion criteria. Among 207 NDMM patients, median age was 74 years; 146 (70.5%) did not receive dose-attenuation during 1LT. Patients with short DOT were older, frailer, with a higher comorbidity burden, and a significantly lower proportion had an Eastern Cooperative Oncology Group PS = 0. As DOT increased, more patients underwent dose-attenuation (p

BACKGROUND: Lupus nephritis (LN) is a common and severe complication of systemic lupus erythematosus (SLE), with approximately 40% of patients with SLE developing LN. Even with treatment, 10%-30% of patients will progress to end-stage renal disease (ESRD). Although many studies have assessed the clinical value of low disease activity in LN, the economic implications are less defined. OBJECTIVE: To evaluate treatment utilization and health care costs associated with active disease, low disease activity, and ESRD in patients with LN. METHODS: A retrospective analysis of Optum pharmacy and medical claims data from 2015 to 2019 was performed and included patients with a diagnosis of SLE (International Classification of Diseases, Ninth Revision or Tenth Revision codes 710.0 or M32, respectively) and additional prespecified criteria for LN. Total health care payer costs for medical and pharmacy services and treatment utilization for commonly prescribed medications were determined for periods of low disease activity, active disease, or ESRD. RESULTS: A total of 21,251 patients (mean age 60.3 years; 87% female; 55% White patients and 18% Black patients) with a mean follow-up period of 30.6 months were included; the majority of patients had active disease (67.3%), followed by low disease activity (51.3%), and ESRD (10.5%). Glucocorticoids were used 2 times more often and mycophenolate mofetil was used 4 times more often in patients with active disease vs low disease activity. Glucocorticoids, mycophenolate mofetil, and tacrolimus were more commonly used in patients with ESRD vs those with low disease activity. Mean medical costs were $4,777 per month in active disease and $18,084 per month in ESRD vs $2,523 per month in low disease activity. CONCLUSIONS: Treatment burden and costs are high for patients with active disease and ESRD in LN. Treatments that allow patients to achieve and maintain low disease activity may help improve patient outcomes and reduce medication use and overall health care costs. DISCLOSURES: Maria DallEra and Kenneth Kalunian are consultants of Aurinia Pharmaceuticals. Eric Turowski, Vanessa Birardi, Neil Solomons, Simrat Randhawa, and Paola Mina-Osorio are employees and stockholders of Aurinia Pharmaceuticals. Michael Eaddy is a former employee of Xcenda, LLC. Augustina Ogbonnaya and Eileen Farrelly are employees of Xcenda, LLC, which was contracted by Aurinia Pharmaceuticals to assist in the conduct of this study and the writing of this manuscript. Aurinia Pharmaceuticals provided funding for this study and the preparation of the manuscript. Aurinia Pharmaceuticals had a role in writing the report and decision to submit for publication.

Framing education ecologically and cultivating an environmental consciousness in the way Michael Bonnett has articulated poses a fresh challenge to educators to identify the latent aspects of educational philosophy and practice that are rooted in an Enlightenment 'metaphysic of mastery'. In 'The Significance of Myth for Environmental Education' (2019), I explored the role that mythopoetic texts could serve to predispose educators and students for qualitatively richer imaginative and affective experiences in/with nonhuman nature. Exposure to these texts, I argued, could begin to effect a work of transformation in those who read them. Here I further develop my former work and make an intervention where Bonnett's more recent work has touched upon my own: the relationship between myth, poetics, phenomenology, and environmental education. Drawing on Charles Taylor's account of Western (dis)enchantment, I develop what I am calling a 'mythopoetic participation', and explore the relationship between a poet's mythic & poetic encounter with the world (that awakens a desire for fullness-in/with-the-world) and the 'artifacts' they create. I offer a phenomenological account of how reading such texts can support environmental educators.

This article undertakes a critical appraisal of learning design and its relation to ethical ideas of care. We give an account of three personae of near future learning designers, developed using speculative methods, seeded with real-world data comprising job advertisements and validated with learning designers. The personae illustrate conflicts about the role of learning designers within the teaching and research missions of the academy and issues of care or lack thereof for these workers. The disembodied skills of learning designer job advertisements are contrasted with the bodies of (more than) real people that can suffer and care. We finish by contributing elements of a speculative job advertisement for a learning designer, who will help shape educational spaces of the near future by entangled care and unencumbered attentiveness.

Nine experienced university pre-service teacher educators used a collaborative autoethnography method to reflect on what they say to students on the first day of new classes and how their performance sets up the semester. Our group exchanges provided an opportunity to express long-developing values and practices embedded in individual's teaching craft. The exchanges were often revelatory to other participants unfamiliar with the performative day-one interactions for start-of-semester classes that their colleagues had developed in different teaching specialities. Narratives of practice, experience and philosophies of class management are present in these conversations about applying pedagogical strategies. The shared accounts revealed skills developed experimentally over many semester-starts to achieve successful class management. The accounts demonstrated a range of interwoven practices individual pre-service teacher educators emphasised in engaging students: what the educators said and how they positioned their opening statements and actions for students at the start of each new semester.

Children's experience of harm and abuse has a profound impact on their health and well-being. In response, school-based prevention programmes have been developed and delivered by external organisations with the aim of improving children's awareness and understanding of forms of harm and abuse which may affect them, encouraging them to seek help if needed. In September 2020, Relationships Education became statutory within the primary school curriculum in England and this ratification is likely to increase demand for externally delivered classroom-based programmes, which address the broad range of topics to be covered within this field. However, evidence is required to understand the impact and acceptability of such programmes. This paper presents qualitative findings from a larger mixed-methods study. Focus group discussions with 29 children explored their responses to one Healthy Relationships programme delivered to primary school children aged 10 and 11 in England. Analysis focuses specifically on responses to the topics of sexual abuse prevention and help-seeking. Children's widespread support for the programme indicates that topics are relevant and the opportunity to explore these issues is valued. However, for effective programme implementation, schools and parents need to be prepared, and prevention messages should continue to be embedded throughout children's school lives.

Cannabis legalization has rapidly spread throughout the United States and is associated with multiple public health outcomes, including driving under the influence of cannabis (DUIC). To improve understanding of the relationship between legalization and DUIC, we tested two potential mediators of this relationship: perceived safety and perceived legality of driving high. We analyzed data from 1,236 current (past 30-day) cannabis users who were recruited from states with recreational, medical only, or no legal cannabis between 2016 and 2017 using address-based and social media samples. Using a generalized linear model and adjusting for cannabis legalization, demographics, living in a state with a cannabis-specific drugged driving law, frequency of cannabis use, and weights, we found that perceived safety (risk ratio [RR] = 2.60, 95% CI [1.88, 3.58]), but not perceived legality (RR = 0.96, 95% CI [0.67, 1.37]), was significantly associated with DUIC. Perceived safety mediated the relationship between legalization and DUIC (Coeff: -0.12, 95% CI [-0.23, -0.01]). Models stratified by frequency of cannabis use yielded results consistent with those of pooled models except that, for frequent users, cannabis-specific driving laws were associated with a significantly lower risk of DUIC (RR = 0.64, 95% CI [0.44, 0.92]). Agencies developing cannabis-focused drugged driving educational campaigns should consider the potential role of perceived safety of driving high in DUIC campaigns.

Underrepresentation of female students and specific racial/ethnic groups persists in STEM despite decades of intervention. Evidence suggests a need to encourage interest in STEM fields at the middle-school level. Adolescent career aspirations are influenced by exposure to role models and mindsets, such as a sense of perceived personal capacity. The purpose of this study was to measure how exposure to role models and work-based microbadging affects students' mindsets related to pursuit of STEM careers. Middle school students rated their intent to pursue a STEM career before and after completing a series of Quest-Challenge pairs featuring role models, including a biomedical engineer, in the Couragion application, along with their confidence, motivation, and enjoyment through in-app surveys. Data from students in well-represented and underrepresented STEM demographics were compared. Intent to pursue a STEM career increased after Couragion app intervention. Divided into demographic groups, increases were observed in students from underrepresented racial/ethnic groups and female students. Students reported increased confidence, motivation, and enjoyment after interacting with the app. Additionally, students reported confidence in STEM career success and motivation to apply themselves academically. This study showed increased intent, confidence, motivation, and enjoyment in middle school students related to STEM careers. The Couragion app intervention effectively improved metrics that inform students' future academic and professional decisions. Widely implementing this type of intervention during middle school could help narrow the representation gap in STEM fields.

Current use of vaping products has increased in recent years among youth in the United States. We conducted cross-sectional surveys of vaping product users aged 15-17 in New York in 2017 and 2019 to assess vaping frequency, reported nicotine content of vaping products used, risk perceptions of vaping and openness to vaping cannabis (2019 survey only). Between 2017 and 2019, the proportion of youth vapers who were frequent vaping product users increased from 16.8% to 26.2% (P < 0.05). The proportion of youth vapers who usually used high-nicotine vaping products also increased, from 12.6% to 40.0% (P < 0.05). In both years, the use of high-nicotine vaping products was positively associated with frequent use (P < 0.05). The perceived likelihood of harm from vaping increased (P < 0.05), but respondents' perception of harm from using tobacco-flavored vaping products remained higher than that from using menthol/mint or sweet flavors. In 2019, 60.6% of respondents reported having tried vaping cannabis. Results suggest shifts in youth vaping behavior toward more frequent use and use of higher nicotine vaping products, support previous findings about youth misperceptions about health risks of flavored vaping products and highlight openness to vaping cannabis among youth vaping product users.

Background: As of September 2020, more than 300 state and local jurisdictions restrict the sales of flavored tobacco, with some including menthol. Aims: To evaluate the impact of local ordinances restricting the sale of flavored tobacco, we surveyed Californians regarding policy support and perceived access to flavored tobacco. Methods: In 2019, we conducted an online survey of 3,075 California youth and young adults recruited via social media, about half of whom lived in a policy jurisdiction. Logistic regressions assessed differences on propensity score--weighted outcomes, policy support, and perceived access. Results Most respondents indicated agreement with almost all policy support statements. Although policy respondents were less likely than rest-of-California respondents to report perceived difficulty in buying flavored cigars, flavored vape users in policy jurisdictions were more likely than those in the rest of California to report perceived difficulty in buying flavored e-liquid. Regardless of jurisdiction, certain priority subgroups were significantly more likely to report perceived difficulty in accessing flavored cigars, flavored vaping products, flavored e-liquid, and menthol cigarettes. Discussion: With some exceptions, these findings demonstrate that among vape users in policy jurisdictions and priority subgroups, there is a higher likelihood of reporting perceived difficulty to access flavored tobacco products. Conclusions: Findings might be an early indication of shifts in social norms about flavored tobacco products in California, which could gain traction as local sales restriction ordinances proliferate throughout the state and a statewide flavored-tobacco sales restriction goes into effect.

Introduction: Undergraduate psychology programs offer opportunities for the development of knowledge and specialized skills in order to equip students to work with diverse populations. Statement of the Problem: It is crucial for psychology clinicians and other human service providers to understand and be responsive to the scope of cultural diversity. To be effective, they must demonstrate cultural humility through an anti-bias approach. Literature Review: We review research pertaining to cultural diversity, cultural humility, and the social and pedagogical implications associated with these constructs. Teaching Implications: We offer one approach for fostering the development of cultural humility through a 6-week Cultural Humility Learning Module that capitalizes on the principles of diversity, privilege and bias, cultural humility, fairness, and social justice. Conclusion: Through piloting and refining the learning module in our own classrooms, we believe that this approach shows promise of transformational learning. We offer the reader potential ways to assess the effectiveness of the module.