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Reflective supervision/consultation (RSC) is a relationship-based form of professional development for the infant and early childhood mental health (IECMH) workforce. A critical context for effective RSC is the quality of the reflective alliance between supervisor and supervisee. Their "way of being" together is inclusive of safe, caring, and consistent relationships and serves as a source of resilience for providers. This article describes the impact of a 1-year project in which 49 IECMH supervisors participated virtually in small RSC training groups during the COVID-19 pandemic. Supervisors experienced significant improvements in positive emotions and work engagement, with concurrent decreases in ruminative thinking and negative work experiences. Supervisors reported that many factors played a role in their positive experience within RSC training, with the relationships with supervisors and fellow group members as critical to positive outcomes.

Elected representatives' place of residence can reveal information about their socioeconomic status, their likely social networks, and potential biases in the constituencies they represent. Using data on home addresses we collected from local elections offices, we investigate the geographic distribution of school board candidates', including winners', places of residence across two election cycles for 610 school districts in Ohio. We employ geographic information systems (GIS) to identify census block group and school enrollment zones associated with each candidate's residence. We document differences among block groups and schools with more and less school board representation, including a robust association between the relative affluence of a neighborhood and the likelihood of school board members residing in that area. We find that more citizens from affluent areas run for school board, and because a large proportion of school board elections feature minimal competition, these higher propensities to run explain disparities in representation.

Because polarization and demonization of the "other" are increasingly prevalent in today's America, there are limited opportunities for deep and informed engagement across lines of difference, particularly on college campuses. "Bridging the Gap: Dialogue across Difference" (BTG) is a 2-3 week January term immersive experience that teaches students, from two very different higher education settings, the skills and approach to effectively communicate, understand and solve problems across lines of difference. BTG is predicated on the belief that engagement across difference strengthens, not weakens, our identities and calls on us to practice humility and curiosity. This work requires students to develop a set of skills and practices that too often go untaught. Piloted in January 2020 with Spring Arbor University and Oberlin College, BTG used a skills-based approach that tied together relationship-building, intellectual humility, and open-mindedness among people who disagree deeply to explore important matters. This article highlights experiences from the 2020 BTG pilot program and provides an in-depth description of the BTG approach and methodology.

"Gerrymandering" is known best as a tool to manipulate boundaries for voting districts, but school districts have long used the same tool to manipulate school boundaries. The author used geospatial techniques--mapping various kinds of demographic data onto school boundaries--to examine public school attendance zones and their effect on students. The author's research yielded several key insights. Like congressional districts, school zones are highly gerrymandered; the gerrymandering of school zones serves to worsen the already severe racial segregation of public schools, but affirmative gerrymandering can effectively increase diversity and reduce racial segregation.

A review of the literature on corporate governance serves to demonstrate the applicability of many governance solutions to the university setting. Based on a review of university scandals, most of which are recent but some of which took place decades ago, it is possible to categorize them as follows: sex scandals, drugs, cheating, hazing, admissions and diplomas, on-the-job consumption, athletics, and murder. Several examples are provided in the paper, along with their impact on various stakeholders. The paper then discusses a variety of solutions designed to either preempt the activities potentially leading to scandal, to deter them or to punish perpetrators. Some of these involve structural changes, institutional policies and procedures, fines, terminations, and sanctions. The paper emphasizes the proactive safeguards which govern and monitor to make sure that universities do not suffer on the back end and that their reputations do not suffer into the future.

Purpose: The authors explore how abortion regulations in Ohio, an abortion-restrictive state in the USA, impact obstetrician-gynecologists' (OB/GYNs) training in reproductive healthcare and describe what OB/GYNs believe to be the broader impact of Ohio's regulations on skillbuilding, skills maintenance, and professional retention of reproductive healthcare providers in the state. Authors discuss how their findings foreshadow abortion training limitations in Ohio and other abortion-restrictive states now that abortion regulations have returned to the states. Methods: The authors conducted four semi-structured focus groups and five in-depth interviews between April 2019 and March 2020. Participants included OB/GYNs practicing obstetrics and gynecology in Ohio between 2010 and 2020. Thematic analysis was conducted using Atlas.ti. Results: Twenty attending physicians and 15 fellows and residents participated in the study. Participants discussed the impact of Ohio's written transfer agreement, gestational-limit, and abortion method and facility bans on training and skill-building opportunities. Participants felt that Ohio's strict abortion regulations 1) limit opportunities to observe and perform abortion procedures during training; 2) require learning the ever-changing legality of abortion provision; 3) limit the number of abortions OB/GYNs can provide, leading to the atrophy of their skills over time; and 4) may prevent prospective medical students and residents from choosing to study in Ohio and may lead to physician attrition from the state. Conclusion: Prior to the reversal of federal protections for abortion in 2022, OB/GYNs in Ohio and other abortion-hostile states experienced barriers to training in abortion care. In returning abortion regulation to the states, access to training is likely to be increasingly restricted. This research demonstrates how abortion-restrictions hamper physicians' skills needed to care for patients, particularly in emergent situations. This puts patients at risk and places physicians in precarious ethical positions. Expanding protections and reducing restrictions on abortion will ensure OB/GYNs and trainees have the skills necessary to care for patients presenting for reproductive healthcare. [ABSTRACT FROM AUTHOR]

This study sought to understand the opportunities and challenges associated with the implementation of state designed Race to the Top (RttT) funded reform networks. Drawing on a conceptual framework developed from the networked governance literature, we analyzed the 12 state RttT grantees' applications. Our analysis revealed that states designed large implementation networks with potential to bring a wide range of resources to bear on reform efforts, particularly through participation of numerous nonsystem actors. However, coordinating large and diverse networks places state education agencies (SEAs) in a new and challenging role. The extent to which networks extend state capacity to support educational improvement or further complicate the work of SEAs remains an open question. We propose a model including a set of theoretical propositions to guide future research.

Objective: To analyze obstetrician-gynecologists' (ob-gyns') experiences with, and perspectives on, how Ohio's abortion-restrictive regulatory landscape affects their health care practices.Methods: Between 2019 and 2020, we conducted qualitative interviews and focus groups with ob-gyns (N=35) who had practiced in Ohio for at least 6 months between 2010 and 2020. Discussions were recorded, transcribed, coded, and analyzed thematically using ATLAS.ti software.Results: Participants perceived Ohio abortion regulations affecting their practice in three key ways: abortion regulations framed abortion and physicians who provide abortion as separate and distinct from other medical practices and physicians; many institutional interpretations of abortion regulations undermined physician expertise and professional autonomy; and the constellation of abortion regulations, institutional interpretations, physicians' trepidation, and their perceived inability to exercise clinical judgment worked together to limit abortion access and increase risks to patients' lives and health. The combined factors left participants feeling distraught that they were unable to practice medicine in an ethical and compassionate manner.Conclusion: Ohio abortion regulations limit ob-gyns' ability to provide comprehensive reproductive health care, creating ethical dilemmas for these physicians as they attempt to care for their patients. As Ohio's abortion laws increase in number and restrictiveness, they further undermine obstetric and gynecologic ethical practice guidelines. However, medical institutions play a key role in determining abortion provision in Ohio; through their interpretation of the law, institutions can demonstrate support or further limit ob-gyns' ability to exercise clinical judgment and provide ethical, compassionate care to their patients. Considerable work remains to bring Ohio's abortion regulations, institutional interpretations, and physician practices into alignment with professional clinical practice and ethics guidelines. [ABSTRACT FROM AUTHOR]

Objective  Acute kidney injury (AKI) incidence is 30% in neonatal intensive care units (NICU). AKI is associated with increased mortality and risk of chronic kidney disease (CKD) in children. To assess follow-up and early CKD, we retrospectively reviewed outcomes of Cincinnati Children's Hospital Medical Center (CCHMC) cohort of neonates from the AWAKEN trial (2014). Study Design  Data from 81 CCHMC patients were extracted from the AWAKEN dataset. KDIGO (Kidney Disease: Improving Global Outcomes) criteria for serum creatinine (SCr) and urine output (UOP) <1 mL/kg/h, reported per 24 hours on postnatal days 2 to 7, were used to define AKI. Charts were reviewed until May 2019 for death, nephrology consult, AKI diagnosis on discharge summary, follow-up, and early CKD at >6 months of age (defined as: estimated glomerular filtration rate < 90 mL/min/1.73 m 2 , hyperfiltration, proteinuria, hypertension, or abnormal ultrasound). Patients were considered to have renal follow-up if they had ≥1 follow-up visit containing: SCr, urinalysis, or blood pressure measurement. Results  Seventy-seven patients had sufficient data to ascertain AKI diagnosis. In total 47 of 77 (61%) were AKI+ by SCr or UOP criteria (20 stage 1, 14 stage 2, 13 stage 3). Four died during their admission and five were removed from CKD analyses due to urologic anomalies. AKI-UOP alone outnumbered AKI-SCr (45 AKI+ vs 5 AKI+ for all stages). 33% of patients had <2 SCr measured while inpatient. Only 3 of 47 AKI+ patients had a nephrology consult (all stage 3 by SCr) and 2 of 47 had AKI included in discharge summary. 67% of AKI+ patients had follow-up. In total 10 of 43 (23%) AKI+ versus 12 of 25 (48%) AKI− patients had ≥1 marker of early CKD assessed after 6 months. Based on SCr, 3 of 7 (43%) AKI+ had hyperfiltration versus 0 of 7 (0%) AKI− (p  = 0.19). Conclusion  AKI is vastly under-recognized in the NICU, especially if based on SCr alone. This leads to insufficient follow-up to ascertain renal sequelae in this high-risk population. Key Points AKI is under-recognized in high-risk neonates. There is a lack of adequate follow-up. Identification of AKI by SCr alone is insufficient. [ABSTRACT FROM AUTHOR]