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While endorsed as critical for promoting learning, students’ interest in a topic has had minimal, if any, influence on curriculum development. Teachers thus are challenged to promote students’ interest within an established curriculum. After students demonstrated misunderstandings after reading an article about bacteria, Sarah Stallings and Samuel Miller, a 4th-grade teacher and university researcher, decided to base their instruction on students’ queries and concerns. This one lesson provided the impetus for a series of activities across the school year that allowed students to become more actively involved in choosing what they would learn and how they would learn it. What students viewed as important and interesting determined the nature and format of their daily studies.

Introduction: Patients on continuous flow left ventricular assist devices (CF-LVADs) often require CF-LVAD exchange. The purpose of this study was to investigate the incidence of infection following CF-LVAD exchange performed for non-infectious indications. Methods: An electronic literature search was performed to identify all studies of patients undergoing CF-LVAD exchange for pump thrombosis or device malfunction. Of 2,698 articles identified, 6 studies with 81 total patients met the inclusion criteria. Cohort-level data were pooled for meta-analysis. Results: Mean patient age was 60 years (95% CI: 41–78), and 74% were male (95% CI: 61–84). Pump thrombosis was the most common indication for exchange in 70% of patients (95% CI: 47–86). Other indications were driveline fracture and electrical malfunction in 21% (95% CI: 5–56) and 12% (95% CI: 4–33) of patients, respectively. Prior to exchange, 95% of patients were on HeartMate II (HM2) LVADs (95% CI: 86–98) and average duration of support for these patients was 27.1 months (95% CI: 9.3–44.8). The majority were placed on a HM2 following exchange (88% (95% CI: 45–98)) versus HM3 (12% (95% CI: 2–55)). Follow-up was an average of 16.4 months (95% CI: 6.8–26.0). Following exchange, 16 of 81 patients developed infection, with pooled mean incidence of 24% (95% CI: 14–38). 30-day mortality was 14% (95% CI: 7–26). Survival at follow-up was 65% (95% CI: 52–76). Conclusions: Infection following CF-LVAD exchange can occur at rates higher than those observed with primary implantation; therefore, effective strategies need to implemented early and consistently to help lower infections rates and help improve outcomes following exchange.

Drawing on the concept of a “complex humanitarian crisis,” this paper describes how outflows of migrants from Central America were transformed into such a crisis by intransigent immigration and border policies enacted in both Mexico and the United States. We describe the origins of the migration in U.S. Cold War interventions that created many thousands of displaced people fleeing violence and economic degradation in the region, leading to a sustained process of undocumented migration to the United States. Owing to rising levels of gang violence and weather events associated with climate change, the number of people seeking to escape threats in Central America has multiplied and unauthorized migration through Mexico toward the United States has increased. However, the securitization of migration in both Mexico and the United States has blocked these migrants from exercising their right to petition for asylum, creating a growing backlog of migrants who are subject to human rights violations and predations both by criminals and government authorities, leading migrants to label Mexican routes northward as a “corridor of death.” We draw on data from annual reports of Mexico's Red de Documentación de las Organizaciones Defensoras de Migrantes (Network for the Documentation of Migrant Defense Organizations) to construct a statistical profile of transit migrants and the threats they face as reported by humanitarian actors in Mexico. These reports allow us to better understand the practical realities of the “complex humanitarian crisis” facing undocumented migrants, both as unauthorized border crossers and as transit migrants moving between the southern frontiers of Mexico and the United States. Policy Recommendations Policy makers need to address: Governments must recognize that the humanitarian crisis facing migrants is not confined to border regions but unfolds at places of both origin and destination as well as within extended geographies of transit in-between. The current refugee protection regime and asylum system are ill-matched to the needs and vulnerabilities of today's migrants. In an era of rapid climate change, rising state failures, and escalating violence, people are not moving so much to advance economically as to escape a growing array of threats not covered by the 1951 Refugee Convention, which needs to be updated. Developed nations must honor rather than elide their obligations under international law to accept asylum applicants and fairly adjudicate their cases, Since a large fraction of the Central Americans arriving at the southern US border have relatives in the United States, creating a pathway to legal status for unauthorized US residents would relieve a lot of the pressure on the asylum system by enabling authorities to release applicants to the support and care of legally resident relatives rather than placing them in an overburdened detention system. Governments need to scale back the securitization and criminalization of migration, which have made human mobility an increasingly precarious and risk-filled activity that contributes to rather than forestalls the proliferation of crime and violence. Human rights and humanitarian agencies need to revisit their missions to derive new ways of working conjointly and in parallel with each other and with governments to better understand and meet the needs of migrants in the 21st century.

Through time-series graphs, teachers often evaluate progress monitoring data to make both low- and high-stakes decisions for students. The construction of these graphs—specifically, the presence of an aimline and the data points per x- to y-axis ratio (DPPXYR)—may impact decisions teachers make. The purpose of this study was to evaluate the impact of graph construction manipulations on pre-service teachers’ accuracy with instructional decision-making. Participants included 94 pre-service teachers enrolled in an introductory course focused on students with disabilities at two universities. Following instruction on progress monitoring, students evaluated 48 graphs representing eight data sets with six manipulations (i.e., with and without aimline; DPPXYR set at 0.05, 0.10, 0.15). Results suggest that the presence of an aimline increased accuracy, whereas the manipulation of the DPPXYR led to mixed findings. Implications for future research and practice are discussed.

Emerging adults discontinue behavioral health treatment at rates ranging from 30% to 50%. This study explored dropout using semi-structured interviews ( N = 20). Participants were engaged in a group therapy program, Healthy Transitions. Findings revealed the lack of therapeutic relationship and logistical issues such as cost, transportation, and conflicting work schedules contributed to dropout. Participants indicated that alleviating logistical barriers and feeling a connection to their peers and group leader prevented dropout. This program was free, transportation was provided, and sessions were in the evening. Participants expressed peer educators made them feel less judged and/or stigmatized than a one-on-one therapy appointment. These findings reinforce logistical issues and lack of a therapeutic relationship contribute to dropout and highlight the benefits of flexible scheduling and reinforce the importance of a therapeutic relationship in preventing dropout.

Purpose: The purpose of the study was to examine factors associated with food insecurity among Medicare beneficiaries with type 2 diabetes. Methods: The 2019 Medicare Current Beneficiary Survey Public Use File of beneficiaries ≥65 years old with type 2 diabetes (n = 1343) was analyzed. A binary variable was created to represent food insecurity (1 = food insecurity, 0 = without food insecurity) with ≥2 affirmative responses adapting an established algorithm of the United States Department of Agriculture food insecurity questionnaire. A survey-weighted logistic model was performed to examine factors (ie, sociodemographic characteristics, health status, and insurance coverage) associated with food insecurity. Results: Approximately 11.6% of study Medicare beneficiaries with type 2 diabetes reported food insecurity. Non-Hispanic Black beneficiaries were more likely to report food insecurity than non-Hispanic White beneficiaries. Beneficiaries with incomes Conclusions: Sociodemographic disparities in food insecurity were observed among Medicare beneficiaries with type 2 diabetes. Implementation of screening protocols, interventions related to social determinants of health, and the diabetes care continuum may mitigate the prevalence of food insecurity in this demographic.

Firearm-related injuries are the leading cause of death among youth in the United States, and rates of firearm-related suicide in rural youth are more than double those in urban youth. Although safe firearm storage has been shown to reduce firearm injuries, little is known about how to culturally tailor such interventions for rural families in the United States. Informed by community-based participatory methods, focus groups and key informant interviews were conducted to design a safe storage prevention strategy for rural families. Participants included a broad array of community stakeholders ( n = 40; 60% male, 40% female; age 15–72, M = 36.9, SD = 18.9) who were asked to identify acceptable messengers, message content, and delivery mechanisms that were perceived as respectful to the strengths of rural culture. Independent coders analyzed qualitative data using an open coding technique. Emerging themes included (1) community norms, values, and beliefs about firearms; (2) reasons for ownership; (3) firearm safety; (4) storage practices; (5) barriers to safe storage; and (6) suggested intervention components. Firearms were described as a “way of life” and family tradition in rural areas. Owning firearms for hunting and protection influenced family storage decisions. Intervention strategies that use respected firearm experts as messengers, refer to locally derived data, and that reflect community pride in firearm safety and responsible ownership may improve the acceptability of prevention messages in rural areas.

Objective: This study examined whether fathers’ prebirth pregnancy intentions were associated with fathers’ involvement with his child 15 months later. Method: Propensity score matching was used to assess the effects of fathers’ pregnancy intentions (self-reported before the birth of the child) on three measures of father involvement (residency with child, engagement in caregiving activities, and engagement in social cognitive play) in a large sample of young, diverse, and low-income fathers ( N = 2,008). Results: In this sample matched on sociodemographic and interpersonal factors, fathers reporting an intended pregnancy had significantly higher levels of social and cognitive play with their child, compared to fathers reporting an unintended pregnancy. However, intentions were not significantly associated with fathers’ residency with child or caregiving activities. Conclusion: Results suggest that fathers’ pregnancy intentions are predictive of certain types of father involvement and emphasize the importance of controlling for factors associated with both fathers’ intentions and involvement.

Purpose: This quasi-experimental pilot study evaluated the preliminary efficacy of training designed to increase child welfare workers’ ( N = 156) knowledge, attitudes, and behaviors related to communicating with youth involved in the child welfare system about sexual and reproductive health (SRH). Method: Preintervention and 3-month follow-up survey data were collected from intervention participants ( n = 69) who registered for a sexual health training and comparison participants ( n = 87) who registered for other child welfare trainings. Results: Participants in the SRH training showed more positive behavioral beliefs, self-efficacy, and knowledge of SRH compared to date- and region-matched comparison participants at the 3-month follow-up; there was no difference between the groups on intentions or past month communication with clients regarding SRH. Conclusion: Findings suggest that although SRH training may be effective in changing child welfare workers’ attitudes about SRH, additional efforts may be needed to alter intentions and behaviors.

Objective: This study aimed to examine some common problems observed during school recess and translate findings to evidence-based, practical solutions that can be applied within schools on a more systematic level. Design: Observational study. Setting: Elementary schools in the USA. Method: Data were collected from 112 school recess periods at 25 public elementary schools in three distinct geographical regions of the USA (Midwest, Northwest, Southwest). The Great Recess Framework–Observational Tool (GRF-OT) guided observations and field notes. The GRF-OT measures safety and structure, student behaviour, adult supervision and engagement, transitions, and physical activity. Following data collection, inductive and deductive content analysis examined patterns in the data. Results: Analyses revealed how poorly designed and inadequately maintained schoolyard spaces contribute to common safety issues. A combination of insufficient play space planning and maintenance, lack of play equipment and game availability, and limited adult involvement in the schoolyard reinforced social hierarchies, leading to exclusionary practices. While recess is often deemed a child-led portion of the school-day, results highlighted the important role that adults play in recess. Conclusion: The following evidence-based solutions should be considered by school administrators and policy makers to mitigate problems observed during recess: (1) assess the schoolyard landscape, (2) assess patterns of play, (3) plan an intentional recess and (4) address the social climate. A high-quality recess promotes equitable access to play opportunities.

Background: High-speed running is commonly implicated in the genesis of hamstring injury. The success of hamstring injury management is typically quantified by the duration of time loss or reinjury rate. These metrics do not consider any loss in performance after returning to play from hamstring injury. It is not known to what extent high-speed running is altered on return to play after such injury. Hypothesis: Match high-speed running distance will change after returning from hamstring injury. Study Design: Non-randomized cohort. Level of Evidence: Level 3. Methods: Match high-speed running distance in highest level professional football (soccer, Rugby League, Rugby Union, and Australian Rules) were examined for a minimum of 5 games prior and subsequent to hamstring strain injury for individual differences using a linear regression models approach. A total of 22 injuries in 15 players were available for analysis. Results: Preinjury cumulative high-speed running distances were strongly correlated for each individual ( r2 = 0.92-1.0; P < 0.0001). Pre- and postinjury high-speed running data were available for a median of 15 matches (range, 6-15). Variance from the preinjury high-speed running distance was significantly less ( P = 0.0005) than the post injury values suggesting a suppression of high-speed running distance after returning from injury. On return to play, 7 of the 15 players showed a sustained absolute reduction in preinjury high-speed running distance, 7 showed no change, and 1 player (only) showed an increase. Analysis of subsequent (second and third injury) return to play showed no differences to return from the index injury. Conclusion: Return to play was not associated with return to high-speed running performance for nearly half of the players examined, although the same number showed no difference. Persisting deficits in match high-speed running may exist for many players after hamstring strain injury. Clinical Relevance: Returning to play does not mean returning to (high-speed running) performance for nearly half of the high-level professional football players examined in this study. This suggests that successful return to play metrics should be expanded from simple time taken and recurrence to include performance.

This study tested the contrarian proposition that market-driven newspapers value rank-and-file newsworkers as human capital assets. Data from a national survey of U.S. daily newspaper editors partially support the proposition. Newspapers see positive value in the know-how and abilities of their newsworkers, but they do not see enough of it to invest in training and rewards for them.

Objectives: Schools can provide an optimal environment for promoting children’s health behaviours. The Whole School, Whole Community, Whole Child (WSCC) model addresses 10 aspects of the school environment that can be used to promote student health behaviours and academic outcomes: namely, Health Education; Nutrition Environment and Services; Employee Wellness; Social and Emotional School Climate; Physical Environment; Health Services; Counselling, Psychological and Social Services; Community Involvement; Family Engagement; and Physical Education and Physical Activity. Design: Guidelines for practical use of the WSCC model for school professionals are limited, impeding potential impact on school health promotion. Accordingly, in this article, we seek to demonstrate an application of the WSCC model to a specific school-based practice: recess. Setting: School recess. Results: An overview of literature and evidence-informed practices details how recess can facilitate WSCC adoption and initial implementation. Areas requiring further empirical research prior to making additional recommendations are also discussed. Conclusion: Strategies to enhance learning and health are described, attempting to bridge the gap between research and practice in school settings using the WSCC model.

Background: There is evidence that patients and physicians are frequently misaligned in their perspectives on psoriatic arthritis (PsA) treatment priorities, which may be associated with increased disease activity, greater disability, and poorer health-related quality of life of PsA patients. Objective: To identify factors associated with patient–physician misalignment in satisfaction with PsA disease control. Methods: In a cross-sectional survey of physicians and their patients with PsA from the United States and Europe, satisfaction with disease control was examined and classified as satisfied, neutral, or dissatisfied. Bivariate and multivariate regression analyses explored alignment in satisfaction between physicians and patients. Results: There were 656 PsA patient–physician pairs included in the analysis. Misalignment occurred in 20.6% of cases. Greater disease impact, worse physician-reported disease severity, and lower patient-reported involvement in treatment decisions were associated with misalignment. Conclusion: Greater patient–physician engagement may improve satisfaction, alignment, and outcomes in PsA disease control.