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Human Anatomy and Physiology courses are "gateway" courses that students must pass with high grades in order to proceed through their program of study. However, student pass rates are often low, resulting in students attempting the course multiple times and delaying their graduation. Supplemental instruction performed by peer leaders is one mechanism that has been used to increase student success. The goal of this study was to evaluate the effectiveness of peer-led supplemental instruction by comparing predicted and actual course grades. We learned that students predicted to earn a C achieved higher grades when they utilized supplemental instruction. While those students performed better than predicted, supplemental instruction did not improve ABC rates for the class. We conclude that supplemental instruction can be of benefit for some students.

Cognitive dissonance is an important element in adult learning in that it challenges previously held ideas in favor of new knowledge. In-class simulations and game-based learning are used as innovative and effective pedagogical tools in challenging adult learners and enhancing the students' ability to think critically about larger societal needs. This paper will review the literature relevant to cognitive dissonance, adult learning, and game and simulation practices in higher education. The authors present the results of one simulation activity in a quasi-experimental non-random comparison group conducted across five universities within multiple undergraduate and graduate level social work policy courses. Findings of this research on the use of simulations in social work policy courses can be used to guide other social work programs with embedding this effective educational practice into their programs. Institutions of higher education, specifically within the discipline of social work, can play an important role in continuing the research and evaluation of this effective pedagogical practice through measuring outcomes on student critical thinking and changes in student beliefs and biases.

The impetus of this study is to investigate students' attitudes towards online language learning based on their previous academic experiences and year of study, including the decision to major or minor (i.e., motivation). A total of 975 students completed a survey questionnaire consisting of background information, Likert scale items, and open-ended questions. The quantitative data were analyzed using an exploratory factor analysis and one-way ANOVAs and were complemented with qualitative data based on students' responses. Findings indicate that students generally want consistent access to online learning, and that students with prior online-learning experience or with a desire to take an online course presented a statistically significant more positive perception of online language classes. There were also differences in perception of success in the online classes between those students who intended to major or minor in the language and those who did not. The results further revealed a decline in perception of success in online classes with the higher-level classifications (i.e., year of study). This study provides baseline attitudinal data to be built upon in future research and informs stakeholders of language programs in their curricular decisions.

Given the lack of research into native-speakerism among teachers of languages other than English (LOTEs), this qualitative study aims to bridge the gap by investigating the discriminatory and inclusive language employed in online recruitment for post-secondary institution instructors of LOTEs. The study also looks at how post-secondary institutions phrase language requirements and whether there is a difference in "native-speaker-teacher" bias depending on the language. For the purposes of this study, qualitative content analysis was used to examine 187 online job advertisements for teaching positions of different LOTEs that were posted by different post-secondary institutions across the United States. The findings of the study show that post-secondary institutions use discriminatory language such as "native" or "near-native" much more often than inclusive language such as "superior language skills," regardless of the language(s) that the position advertises for. The findings, however, show that job candidates for teaching positions of LOTEs are often required to have "native" or "near-native" proficiency in at least two languages, most commonly English plus the target language of focus.

This study explored the impact of an active project-based, aquaculture constructivist-learning program, as perceived by high school students. The purpose of this case study was to discover if participation in the program influenced students' interest, engagement, and future educational and career aspirations in science, technology, engineering, and mathematics (STEM) when integrating aquaculture in and outside the classroom. Likewise, the study also wanted to explore students' knowledge about aquaculture and skill development after their participation in the program. The study employed a qualitative methods approach to explore students' attitudes and experiences. Qualitative data were collected from post-student focus groups at three different public, rural high schools in Kentucky. Other qualitative data included teacher journal reflections (e.g., personal documents) and public newspaper articles (e.g., public documents). Four emergent themes were found: (1) Students show excitement and enthusiasm in the hands-on, aquaculture program; (2) students show attention to detail in the hands-on, aquaculture tasks, it sticks, and are more responsible; (3) students are collaboratively engaged with their peers; and (4) greater interest and confidence in STEM through practical application. Results demonstrated that the program engaged learners in real-world problem-solving and decision-making situations while working collaboratively in small works. It also appears that students gained an important life skill, responsibility, as well as self-confidence in STEM, after participating in the program.

This paper presents a review of the literature pertaining to exam anxiety, highlighting findings from empirical studies, theoretical frameworks, and practical strategies. Exam anxiety is a pervasive issue affecting students worldwide, impacting academic performance and psychological well-being. This review explores the causes, manifestations, and consequences of exam anxiety, and evaluates existing interventions. By examining a diverse range of scholarly works, this paper seeks to contribute to a deeper understanding of exam anxiety and offers insights for educators as well as students. The paper also provides a brief list of alternative forms of summative assessment that have the potential to alleviate exam anxiety.

A simple parent request unveiled a startling revelation: The principal of Bridgforth Elementary School segregated students by race. Her attempt to establish a culturally responsive framework was met with an Office of Civil Rights (OCR) complaint of racial discrimination. This case will examine the principal's rationale for creating the framework, the parental complaint, the school community response, and two evidence-based options for increasing student outcomes for African American students and other ethnic minorities.

In the context of global concerns about teacher workload and the relationship between workload and attrition, understanding the nature, quantity and intensity of teachers' work is an essential first step in formulating robust solutions to this significant problem. Understanding teachers' work, however, is a complex undertaking, and prior attempts have largely been focused on the quantity rather than the intensity or quality of work required and undertaken. This article reports on a pilot study of the Teacher Time Use app, a bespoke tool developed by the research team to 'get inside' teachers' subjective experience of time through a focus on both workload and intensity. Our analysis shows that the app provides a simple, non-demanding way for teachers to record their work in a timely and efficient way. It also highlights the capacity of this approach to understand both the range and quantum of tasks that comprise teachers' work and consequently the nature and subjective experience of work intensification. We argue the need for a more nuanced empirical understanding of the layering and multi-tasking of teachers' work that characterises work intensity, and suggest that the Teachers' Time Use app provides an effective means for recording and representing the complex dimensions of teachers' work and time use.

Many technology acceptance models used in education were originally designed for general technologies and later adopted by education researchers. This study extends Davis' technology acceptance model to specifically evaluate educational technologies in higher education, focusing on virtual classrooms. Prior research informed the construction of the model, which contains perceived usefulness, perceived ease of use, behavioural intent, access and convenience, system attributes and self-efficacy. Education-specific constructs include cognitive engagement, feedback, instructor practice and class interaction and communication. Additionally, a new construct called comfort and well-being is introduced. A total of 427 valid responses on a 5-point Likert scale were received from university students. Exploratory factor analysis, confirmatory factor analysis and structural equation modelling were used to analyse the data. The model accounted for 78% of variance of behavioural intent, with comfort and well-being demonstrating the strongest influence. Cognitive engagement, access and convenience influenced perceived usefulness, and system attributes and self-efficacy influenced perceived ease of use. Feedback, instructor practice and class interaction and communication were not significant as educational constructs for this cohort. Based on this analysis, a final extended educational technology acceptance model (EETAM) is proposed for further use and testing.

Background: Despite emerging evidence for the effectiveness of school-based suicide prevention programmes worldwide, there are few being implemented in the United Kingdom, and their social validity (i.e., the feasibility, acceptability, and utility) is not yet known. Aims: We aimed to conduct a scoping study to determine: (1) the social validity and potential benefits of school-based suicide prevention interventions, (2) the perceived need for such interventions, and (3) barriers and facilitators to implementation. Sample and Methods: A total of 46 participants took part. Semi-structured interviews were conducted with mental health professionals (N = 8), school staff (N = 8), and parents whose children had experienced suicidal ideation/behaviours (N = 3) in England. Focus groups were also completed with children and young people (N = 27) aged 15-18 across three state secondary schools. Data were analysed using thematic framework analysis. Results: Three themes were identified: (1) the need for and importance of suicide prevention in children and young people, (2) schools as a setting for delivery, and (3) key components of suicide prevention programmes. Conclusions: Participants overwhelmingly agreed that there is a need for a greater and more consistent emphasis on school-based suicide prevention. School appears to be an acceptable location for suicide prevention, and participants felt discussions about suicide should begin at the start of secondary school. However, there are potential barriers that need to be considered, including tailoring for neurodiversity, challenging cultural/family beliefs and stigma, managing personal experiences of suicidal thoughts or previous bereavement from suicide, and a lack of existing training for school staff.

Guided by developmental models examining the legacy of childhood caregiving environments, we examined the longitudinal pattern of associations between harsh parenting and children's internalizing and externalizing symptoms across late childhood to late adolescence. Participants included 199 youth (48.7% female, 65.3% White, 32.2% Black, 2.5% biracial) and their mothers and fathers from a diverse range of socioeconomic backgrounds. The study utilized a multi-informant, longitudinal design including five waves of data (youths' mean ages were 9, 10, 11, 17, and 18 across waves). Harsh parenting at Age 9 predicted higher levels of (a) externalizing symptoms at Ages 11, 17, and 18 and (b) internalizing symptoms at Ages 17 and 18. Developmental sensitivity analyses revealed that the magnitude of the more distal association between early harsh parenting and later internalizing and externalizing symptoms was statistically stronger as compared to more proximal associations. Bidirectional analyses revealed that externalizing symptoms at Age 9 predicted harsh parenting at Ages 9, 10, 11, 17, and 18. Whereas links between harsh parenting and internalizing symptoms were consistent with a sleeper effects model, links between harsh parenting and externalizing symptoms provided some support for both enduring and sleeper effects models. Findings inform an understanding of youth developmental sensitivity to harsh parenting and the downstream consequences of harsh parenting. Results have important translational implications, including testing the long-term efficacy of therapeutic programs.

Longitudinal research is crucial to fully assess the putative impact of the COVID-19 pandemic on children with an intellectual disability in special school settings--ideally drawing on data pre-pandemic to be able to evaluate later impact. Data on challenging behaviour and adaptive skills were collected annually for 348 students in one special school across four time points pre-pandemic and one time point post-pandemic. Data were analysed using multilevel models with repeated observations over the five time points. There was a decrease in aggressive and destructive behaviours and a decrease in adaptive skills at the post-pandemic time point, after accounting for other important covariates. There was no evidence of a change in stereotyped or self-injurious challenging behaviours. Other research using longitudinal methods is rare, but the current findings are consistent with previous research reporting on the impact of COVID-19 on children and young people, particularly from parent reports. Future considerations for schools include adopting appropriate strategies to support learners to reintegrate back into education. Further research is needed to look at the longer-term impact of the pandemic on challenging behaviour in children with an intellectual disability.

Reading is a key gateway to learning, enabling independent access to a range of educational materials. Thus, reading difficulties leave a child particularly vulnerable to academic problems in later schooling and beyond. However, while there is good awareness of children with word reading difficulties within the education system, much less is known about the children who struggle to comprehend texts despite having adequate word reading skills. In this registered report, we investigated the later education and occupational outcomes of 947 children initially identified as having poor reading comprehension at 8-9 years from the Avon Longitudinal Study of Parents and Children, compared to peers not identified as having a specific reading difficulty (n = 4,516) and those with word reading weaknesses (n = 1,383). We observed that children with comprehension weaknesses (a) were less likely than typical readers to meet U.K. national educational targets as they progressed through education, with more marked differences for mathematics and science than English; (b) had poorer qualifications at the point of leaving compulsory education, which were comparable to children with word reading weaknesses; and (c) were the group at greatest risk of being out of employment, education and training at age 20. However, there was considerable variability in outcomes, with much of the risk shared with socio-demographic factors. The results address an important gap in knowledge regarding the functional consequences of reading comprehension difficulties in mid-childhood and inform discussions concerning the need for identification and targeted support in classroom settings.

Children with Developmental Language Disorder (DLD) often experience co-occurring psychosocial difficulties, the developmental trajectories of which are still not fully understood. This study sought to explore the manifestation of such difficulties during childhood, through first-hand accounts of those with DLD and their close relatives. Individual semi-structured interviews were conducted with 11 mothers of children with DLD (aged 6-12 years old) and were analysed alongside the secondary data from interviews of five adults with DLD. Interviews were conducted online; all participants resided in Europe and were fluent in spoken and written English. A process of interpretive phenomenological analysis resulted in the development of five overall themes: experiencing anxiety, social frustrations, maintaining factors, childhood strengths and the parenting experience. Cognitive appraisals appeared particularly important during childhood in both escalating and maintaining anxiety, low self-esteem, emotion dysregulation and social frustrations. High levels of isolation and stress were experienced by all mothers. The findings suggest parents in the United Kingdom and Ireland require more support and guidance at the point of diagnosis than is currently provided. Emphasis was given to the link between children's experience of anxiety and social behaviours, such as withdrawal, as well as their intolerance of uncertainty. Internalising symptoms were a prioritisation for intervention during childhood by both parents and adults with DLD.

To explore the benefits of a brief autism education intervention on peer engagement and inclusion of autistic children at day camps. A convergent, parallel, two-arm (intervention/no intervention), non-randomized, mixed-methods design was used. The individualized, peer-directed, 5--10 min intervention included four components: (1) diagnostic label, (2) description and purpose of unique behaviors, (3) favorite activities and interests, and (4) strategies to engage. A timed-interval behavior-coding system was used to evaluate engagement between each autistic camper and their peers based on videos taken at camp (days 1, 2, 5). Interviews with campers and camp staff explored why changes in targeted outcomes may have occurred. Percent intervals in which the autistic campers were jointly engaged with peers improved in the intervention group (n = 10) and did not change in the control group (n = 5). A large between group intervention effect occurred by day 5 (Z = - 1.942, [eta-squared] = 0.29). Interviews (5 autistic campers, 34 peers, 18 staff) done on the last day of camp in the intervention group garnered three themes: (1) "Changed behavioral attribution," (2) "Knowledge facilitates understanding and engagement," and (3) "(Mis)perceptions of increased inclusion." A brief educational intervention that includes individualized explanatory information and strengths-based strategies might improve peers' understanding of and social engagement with autistic children in community programs such as camps.

The dorsal stream vulnerability hypothesis posits that the dorsal stream, responsible for visual motion and visuo-motor processing, may be particularly vulnerable during neurodevelopment. Consistent with this, autism spectrum disorder (ASD) has been associated with deficits in global motion integration, though deficits in ventral stream tasks, such as form identification, have also been reported. In the current study, we examined whether a similar pattern of results is found in a cohort of 381 children born with neurodevelopmental risk factors and exhibiting a wide spectrum of caregiver-reported autistic traits. Methods: We examined the associations between global motion perception, global form perception, fine motor function, visual-motor integration, and autistic traits (autism spectrum quotient, AQ) using linear regression, accounting for possible interactions with sex and other factors relevant to neurodevelopment. Results: All assessments of dorsal stream function were significantly associated with AQ such that worse performance predicted higher AQ scores. We also observed a significant sex interaction, with worse global form perception associated with higher AQ in boys (n = 202) but not girls (n = 179). Conclusion: We found widespread associations between dorsal stream functions and autistic traits. These associations were observed in a large group of children with a range of AQ scores, demonstrating a range of visual function across the full spectrum of autistic traits. In addition, ventral function was associated with AQ in boys but not girls. Sex differences in the associations between visual processing and neurodevelopment should be considered in the designs of future studies.

Medical training has become a global phenomenon, and the Physician's Charter (PC), as a missionary document, is key to training those outside the Global North. Undergraduate and postgraduate students in the medical profession are sometimes trained in contexts foreign to their social and ontological backgrounds. This might lead to confusion and blunders, creating an impression of what might look and feel unprofessional to those unfamiliar with the local context. Understanding the cultural backgrounds of the trainees is crucial, and the reverse is also as important. It is essential for clinicians and trainees to understand the cultural backgrounds of their patients to avoid miscommunication. In this phenomenological study, we recruited participants in 2020 who were in their first to fourth year of study of medical training during the #FeesMustFall protests. We used data from this extensive study looking at students' experiences during their training amidst protest and social upheavals in a South African tertiary institution. For this paper, we examined what professionalism means to the student participants using an African Ubuntu lens. Ubuntu and the Collective Finger theory were used to investigate what professionalism means to participants. The Ubuntu philosophy was compared to the PC. In the findings, the clinical space is hierarchical, silencing and the opposite of what Ubuntu means. In comparison to the PC, respect is overarching while compassion and responsibility are the most comparable to the Charter. This study adds an African voice to the professionalism discourse while showing African elements that could be aligned to the PC to challenge the current global discourses.

This article offers a content analysis of technical and professional communication articles related to user experience (TPC-UX) published between 2013 and 2022 in six TPC scholarly journals. This analysis reveals that TPC-UX primarily focuses on product and process topics and illustrates the terminological comingling of "user experience" and "usability." Specific TPC-UX topics identified include "theory," "multimodality," "health and medicine," "localization," "web design," "mobile applications," "accessibility," and "content strategy." These topics suggest that TPC-UX's key affordances are its attunement to networked power dynamics, its theoretically rich treatment of multimodality, and its strategies for navigating contextual complexities.

Objective: The goal of this study was to report on the development and early usability of a new interactive mHealth app for reducing cardiovascular risk in primary care patients of low socioeconomic status attending clinics in Chile. Design: Mixed-methods design with qualitative and quantitative components. Setting: Three Chilean primary care clinics located in one urban (Santiago) and two rural areas (San Clemente and Chiguayante). Each clinic serves a population of about 24,000 people of generally low socioeconomic status with an average of 8.5 years of education. Methods: A qualitative co-design participatory framework was used to develop the "Mi Salud-APS" mHealth app. Three iterations of virtual workshops were held with healthcare providers and patient participants to develop the new app. Once developed, the usability phase identified, invited and followed up for 3 months a sample of primary care patients with moderate (N = 119) or high (N = 329) cardiovascular risk. Results: A total of 24 healthcare providers and 24 patients participated in the developmental workshops. Three emergent categories represented the core attributes for the mHealth app design: 'Friendly', 'Interactive' and 'Pertinent'. In the usability phase of the sample of 448 patients, 98% downloaded the app, and 64.6% of them logged in and used it for an average of 1.46 (0.5-10) times weekly. Conclusion: Findings suggest that patient and healthcare provider contributions to the development of the mHealth app accurately reflect the interests and experiences of both groups and together helped achieve the high usability levels observed among primary care patients enrolled in clinics in underserved communities.

The experiences of autistic parents when interacting with statutory services for their autistic children is not well understood. This study investigates the experiences of autistic parents' interactions with statutory services, including education and healthcare, in relation to their autistic children. Interpretative Phenomenological Analysis was used to investigate their experiences. Ten autistic mothers of autistic children in mainstream education completed semi-structured interviews, which were co-developed with autistic parents. Two superordinate themes were developed: (1) The wider system is the problem and (2) Feeling judged and stigmatised. While Theme 1 demonstrates some similarities in the experiences of autistic parents to that of non-autistic parents in previous studies, theme 2 is unique to autistic parents who may feel that they are being treated differently. These themes indicate the importance of training encouraging a strength-based rather than deficit-based understanding of autism. Participants highlighted the wider system is the problem rather than individual professionals, and that it places some families at a disadvantage.

Background: Youth mental health has declined since the COVID-19 pandemic began. Health coaching and mindfulness-based intervention may support therapeutic processes that promote resilience in the face of risk factors for adverse mental health outcomes. Building Resilience for Healthy Kids (HK) is a school-based intervention designed to support mental health through targeting these processes. Objective: In this study, we tested HK in a pilot randomized controlled trial. Specifically, we examined intervention effects on the theoretically-informed therapeutic processes of emotion regulation, mindfulness, self-efficacy, and resilience and the clinical outcomes of depression and anxiety symptoms. The trial took place between April and June 2021, offering an opportunity to assess the impact of HK in the context of COVID-19. Methods: Participants were early adolescents (N = 230), randomized to HK or assessment-only. Participants in the intervention condition received weekly one-on-one sessions with health coaches. All youth completed validated self-report measures at baseline and post-intervention. Results: Linear mixed effects models indicated that participants who received HK had a greater reduction in emotion regulation difficulties, relative to assessment-only controls (d = 0.84, large effect). Follow-up analyses revealed that youth who endorsed negative affectivity at baseline experienced more benefits than those who did not, and youth who attended more HK sessions increased in self-efficacy, in addition to improved emotion regulation. Intervention effects did not reach significance for other outcomes. Conclusions: Findings suggest that HK may support youth in reducing difficulties in emotion regulation, which are precursors to the development of mental health concerns in adolescence.

Background: Previous evidence has suggested a strong association between school exclusion and health outcomes. However, as health risks are themselves related to the risk of experiencing a school exclusion, it has been challenging to determine the extent to which school exclusion impacts later health outcomes, as opposed to reflecting a marker for pre-existing risks. Aim: The aim of the current study was to address this challenge in estimating the medium-to-long-term impact of school exclusion of health and well-being outcomes. Methods: To this end, we used an inverse propensity weighting approach in the Next Steps data set (N = 6534, from wave 1, 2014, to wave 8, 2015). Results: We found that after weighting for propensity of treatment scores estimated based on a wide range of factors, including previous health indicators, there was a significant effect of school exclusion on a wide range of health and well-being outcomes. Discussion: These results provide some of the most robust evidence to date that school exclusion harms long-term health outcomes. Conclusion: The findings suggest that policies should aim to reduce exclusion and ensure access to preventative health support for those who experience a school exclusion.

The revised two-factor Study Process Questionnaire and the Approaches and Study Skills Inventory for Students are two instruments commonly used to measure student learning approach. Although they are designed to measure similar constructs, it is unclear whether the metrics they provide differ in terms of their real-world classification of learning approach. The purpose of this study is to compare outcomes of these two inventories in a study population from an undergraduate (baccalaureate) human anatomy course. The three central goals of this study are to compare the inventories in terms of 1) how students are classified, 2) the relationship between examination performance, time spent studying, and learning approach, and 3) instrument reliability. Results demonstrate that student classifications of corresponding scales of each inventory are significantly correlated, suggesting they measure similar constructs. Although the inventories had similar reliability, neither was consistently strong in predicting examination performance or study habits. Overall, these results suggest that the two inventories are comparable in terms of how they measure learning approach, but the lack of correspondence between learning approach scores and measurement outcomes questions their validity as tools that can be used universally in classrooms.

There is a well-documented interdependency between destructive interparental conflict (IPC) and parenting difficulties (i.e., spillover effect), yet little is known about the mechanisms that "carry" spillover between IPC and parenting. Guided by a cascade model framework, the current study used a longitudinal, multimethod, multi-informant design to examine a process model of spillover that tested whether parental executive functioning (working memory, cognitive flexibility, inhibitory control) served as a mediator of the prospective associations between IPC and subsequent changes in parenting over a 2-year period. Mothers and fathers were separated into differentiated models and multiple domains of parenting were examined (i.e., authoritarian discipline and scaffolding behavior). Participants included 231 families (both mothers and fathers of preschoolers). Race was reported as White (62%), Black (21%), Mixed (8%), Asian (3%), or Other (6%) and 14% considered their ethnicity to be Hispanic/Latino. Median household income was $65,000. Results indicated that for fathers, IPC indirectly predicted domain-general parenting difficulties (increased authoritarian parenting and decreased scaffolding) via deficits in paternal cognitive flexibility (but not inhibitory control or working memory). In mothers, IPC directly predicted domain-specific parenting difficulties (decreased scaffolding only) that did not operate via maternal executive functions. Notably, these effects occurred over and above the influence of parental socioeconomic status. This study constitutes a first step toward documenting parental executive functioning as a mechanism underlying the spillover of IPC to the parent-child relationship. Family interventions intended to interrupt IPC spillover should emphasize father involvement and consider targeting parental executive functions as change mechanisms.

Individuals with deaf-blindness and co-occurring diagnoses, such as intellectual and developmental disabilities, may experience difficulty with independence, specifically with communication. One behavior-analytic procedure that may be useful for increasing independence and teaching communication to this population is the behavior-chain interruption strategy (BCIS). The current study examined the use of the BCIS to teach a 65-year-old deaf-blind participant with severe intellectual disability to use a SadoTech Elderly Monitoring Pager to notify others in the environment when help was needed. The researcher alternated between establishing operation (EO; help needed, items missing, or inoperable) and abolishing operation (AO; help not needed, items present, and operable) trials for three previously mastered daily living routines. The results demonstrated that following intervention, the participant used the device independently during EO trials and never used it during AO trials across behavior chains, and similar results were obtained during a treatment-extension phase. Limitations and implications for applied practice are discussed.

Indonesian physicians working in rural and remote areas must be equipped not only with generic competencies but also with the attributes and skills necessary to provide health care services without compromising quality. This study sought to reach a consensus on the attributes and competencies that are viewed as essential and important for working effectively as an early career doctor in rural and remote practice in Indonesia. A two-round Delphi study was conducted by reference to 27 consenting physicians working in rural and remote Indonesia. Forty-three items covering 9 attributes and 34 competencies were sent to these physicians to be rated on a Likert scale ranging from 1 to 5 in terms of their importance for effective rural and remote practice. Nine attributes and 29 competencies progressed to Round 2. All nine attributes and 29 competencies were identified as essential or important for junior physicians' ability to be effective in their practice. The essential attributes included professional quality related to prioritising the rural community. The essential competencies included medical skills, professional behaviour, interprofessional skills, health promotion and connection to the rural community. The consensus thus reached on these essential and important attributes and competencies can inform curriculum development for the undergraduate and postgraduate training of junior rural and remote physicians.

Medical students' feedback orientation (their attitudes about and preferences for feedback from preceptors) may change over the course of the third year of medical school and is likely influenced by identity-related factors. This study proposed that both how students view themselves personally (i.e., impostor syndrome) and how they view themselves in relation to the group (i.e., identification with the profession) are identity factors related to related to feedback orientation during clinical rotations. 177 third-year medical students enrolled in a four-phase longitudinal survey study beginning at the start of clinical rotations and continuing every twelve weeks of the academic year thereafter. Feedback orientation was conceptualized and measured as comprising aspects of utility (i.e., feedback is valuable and useful), sensitivity (i.e., feeling intimidated or threatened by corrective feedback), confidentiality (i.e., public/private context of feedback), and retention (i.e., feedback remembered). Results indicated that these aspects of feedback orientation did not significantly change during the third year. Instead, impostor syndrome was at least marginally, significantly associated with all aspects of feedback orientation across phases. Group identity was associated with feedback utility and retention, and female-identifying students reported significantly greater feedback confidentiality and feedback retention. Interventions may be needed to improve medical students' attitudes about feedback, particularly for those who experience impostor syndrome. Fostering group cohesion among medical students may influence how well students remember feedback and find it useful.

Background: While barriers to participation in physical activity are well documented, there is no consolidated evidence on strategies promoting participation of people with intellectual disability in physical activities. Methods: We conducted a scoping review to examine initiatives used to facilitate the inclusion of people with intellectual disability in community-based sporting and recreation activities. We searched Medline, Embase, CINAHL+ and PsycINFO for articles published in English between 2000 and 2022. Results: Eight articles were included. Initiatives included: (1) building knowledge, awareness and attitudinal change (2) organisational alliances/partnerships (3) relationship-building (4) modifications/adaptions to activities/environment (5) organisational policy (6) engagement with people with disability. Initiatives were implemented through international collaborations, in local fitness/recreational facilities and public spaces, and targeted athletes, coaches, volunteers and organisational leaders. Conclusion: While some increase in awareness and inclusion of people with intellectual disability was reported, no longitudinal data reported on the impact of initiatives on sustained social inclusion for people with intellectual disability.

Using a content analysis methodology, we examined 15 peer-reviewed articles published between 2009 and 2019 that used qualitative and mixed methods approaches to explore how college and university students experience food insecurity. Concerningly, there was limited variety in the methods employed across these articles and more discussion of methodology was needed. Despite this, our analysis of student statements in these articles yielded three common themes: (1) co-occurring basic needs; (2) academic, physical, psychological, and social effects of food insecurity; and (3) institutional satisfaction and/or critique. We include implications for research and practice.Context and implicationsRationale for the studyFew qualitative studies centre students' food insecurity experiences in the United States. We examined available research to unearth commonalities across student narratives while connecting food insecurity to broader social class inequality in higher education.Why the new findings matterOur findings underscore the urgent need for additional qualitative food insecurity scholarship that foregrounds student voices. Future researchers examining food insecurity should consider: (a) the nuances of on-campus food insecurity, (b) the impact of food insecurity on student success, and (c) the linkages between food insecurity and social class in higher education.Implications for policy makersCampus leaders and policy makers can help address campus food insecurity by building holistic wraparound systems to support the multi-faceted needs of students facing food insecurity. To do this, policy makers and leaders must begin to understand food insecurity as more than a statistic and acknowledge the human experiences of those it affects.

Purpose: This study examined speech changes induced by deep-brain stimulation (DBS) in speakers with Parkinson's disease (PD) using a set of auditory-perceptual and acoustic measures. Method: Speech recordings from nine speakers with PD and DBS were compared between DBS-On and DBS-Off conditions using auditory-perceptual and acoustic analyses. Auditory-perceptual ratings included voice quality, articulation precision, prosody, speech intelligibility, and listening effort obtained from 44 listeners. Acoustic measures were made for voicing proportion, second formant frequency slope, vowel dispersion, articulation rate, and range of fundamental frequency and intensity. Results: No significant changes were found between DBS-On and DBS-Off for the five perceptual ratings. Four of six acoustic measures revealed significant differences between the two conditions. While articulation rate and acoustic vowel dispersion increased, voicing proportion and intensity range decreased from the DBS-Off to DBS-On condition. However, a visual examination of the data indicated that the statistical significance was mostly driven by a small number of participants, while the majority did not show a consistent pattern of such changes. Conclusions: Our data, in general, indicate no-to-minimal changes in speech production ensued from DBS stimulation. The findings are discussed with a focus on large interspeaker variability in PD in terms of their speech characteristics and the potential effects of DBS on speech.

African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings.

Children with autism spectrum disorder (ASD) who are also minimally verbal may require specialized interventions to promote the development of vocalizations. Preliminary research supports an innovative procedure called response contingent stimulus-stimulus pairing (SSP) as a potentially effective procedure to promote vocalizations. The primary aim of this study was to demonstrate the feasibility of delivering a randomized trial comparing response contingent SSP to a control condition. Secondary aims were to demonstrate the feasibility of deploying to the home environment the Digital Language Processor (DLP), a voice recorder by LENA®, and to examine preliminary efficacy of the intervention. Sixteen minimally verbal children with ASD (ages 2.0 to 3.9 years) were randomly assigned to the intervention or control condition with access to delayed treatment. Feasibility metrics were met in that 14 participants (88%) finished the study and attendance to all assessment time points and treatment sessions was over 90%. The research team conducted treatment sessions with 99% fidelity and collected 83.3% of voice recorder data. Nine of 16 caregiver satisfaction surveys were returned, and scores averaged 5.68 out of a possible 6.00 across all participants. Preliminary treatment data results showed that 8/14 participants (57%) showed significant improvement in target sounds and participants receiving the intervention were 3.5 times as likely to improve compared to control.