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BACKGROUND: Low-value use of screening colonoscopy is wasteful and potentially harmful to patients. Decreasing low-value colonoscopy prevents procedural complications, saves patient time and reduces patient discomfort, and can improve access by reducing procedural demand. The objective of this study was to develop and validate an electronic measure of screening colonoscopy overuse using International Classification of Diseases, Tenth Edition codes and then apply this measure to estimate facility-level overuse to target quality improvement initiatives to reduce overuse in a large integrated healthcare system. METHODS: Retrospective national observational study of US Veterans undergoing screening colonoscopy at 119 Veterans Health Administration (VHA) endoscopy facilities in 2017. A measure of screening colonoscopy overuse was specified by an expert workgroup, and electronic approximation of the measure numerator and denominator was performed (electronic measure). The electronic measure was then validated via manual record review (n=511). Reliability statistics (n=100) were calculated along with diagnostic test characteristics of the electronic measure. The measure was then applied to estimate overall rates of overuse and facility-level variation in overuse among all eligible patients. RESULTS: The electronic measure had high specificity (99%) and moderate sensitivity (46%). Adjusted positive predictive value and negative predictive value were 33% and 95%, respectively. Inter-rater reliability testing revealed near perfect agreement between raters (k=0.81). 269 572 colonoscopies were performed in VHA in 2017 (88 143 classified as screening procedures). Applying the measure to these 88 143 screening colonoscopies, 24.5% were identified as potential overuse. Median facility-level overuse was 22.5%, with substantial variability across facilities (IQR 19.1%-27.0%). CONCLUSIONS: An International Classification of Diseases, Tenth Edition based electronic measure of screening colonoscopy overuse has high specificity and improved sensitivity compared with a previous International Classification of Diseases, Ninth Edition based measure. Despite increased focus on reducing low-value care and improving access, a quarter of VHA screening colonoscopies in 2017 were identified as potential low-value procedures, with substantial facility-level variability.

Art and movement are motivating forces in, through, and beyond education. As populations age, there is an increasing need to support physical and social well-being. Yet, since the onset of the COVID-19 pandemic, there has been a reported exponential increase in feelings of loneliness across generations. Complex challenges require trans-disciplinary solutions, and this paper represents a joint effort within and across disciplines, communities and cultures to find ways to ameliorate this silent epidemic. In this paper, we propose a cross-disciplinary conceptual framework where Aboriginal Artists and Knowledge Holders, Teacher Educators, and Physical and Occupational Therapists come together to explore theoretical and pedagogical insights that encompass intergenerational art-moving-well-being practices, reducing feelings of loneliness and improving social connections across generations. There are two main aims of this paper; first, to better understand current studies that report on integrating art-moving-well-being practices, and the effect this has on health and well-being of intergenerational participants (under 10-year-olds, 20+ year olds and 50+ year olds). Second, based on community needs, the long-term aim is to propose a flexible art-moving-well-being conceptual model that is scalable, sustainable and based on social and relational support systems. We propose a model that is flexible and adaptable within and across our local community and beyond. We argue that feelings of loneliness are unique to each individual, and there is a need to connect specific intergenerational programmes with art-moving-well-being practices that readily engage and integrate varied communities and cultures in sustainable ways and thus, contribute to thriving communities.

In this summer program, preservice teachers are recruited to work with children from the community and are mentored closely by two faculty members who are literacy education professors. This allows the candidates to learn from faculty mentors and their peers, a proven model for effective field experiences. Despite the research being done on remote learning due to COVID-19, the factors dictating the necessity of caring classrooms--such as systemic inequities and mental health's impact on student achievement--are more prevalent than ever and missing from the literature. The findings of the qualitative case study indicate the need for intentional work in preservice programs on creating caring digital classrooms. The findings also indicate the immediacy of the mental health concerns for children learning digitally due to COVID-19.

This study investigated a set of online reading courses at the undergraduate and graduate levels in a university's college of education. The courses were thought to integrate culturally relevant pedagogy (CRP), and the study's intent was to determine the extent to which they actually did so. The goals of the study were to determine whether CRP was emphasized in course descriptions, informational materials, activities, assessments, and rubrics, and to determine whether there was alignment between CRP-related descriptions, activities, assessments, and rubrics. Findings indicate that CRP was not strongly emphasized or well aligned in most courses. Indeed, across most or all courses, we found the following: a lack of emphasis on democratic classrooms; a lack of alignment between CRP objectives, assignments, and rubrics; a lack of evidence that depth of CRP knowledge was required across courses; problems with course design; and a lack of emphasis on identity and cultural competence. The study's findings highlight the importance of a fully developed syllabus for adjunct/part-time faculty who rely heavily on the syllabus; emphasize the importance of strong syllabi for curriculum and course integrity (particularly when programs move fully online); and indicate that alignment between assessment and objectives and a detailed syllabus are critical in creating culturally relevant online courses. This study also introduces a tool for evaluating the extent to which CRP is emphasized in a course, which may be valuable to colleges wishing to implement CRP more deeply and consistently. In addition, the study's evaluation process demonstrates that faculty working in teams increases the success of program revision.

Research indicates the need for children performing below grade level in reading to receive additional support in summer months. However, little research has been done related to utilizing preservice teachers during those months in the form of a supplemental field experience. Investigating the experiences of undergraduate students majoring in education is critical to understanding the strengths and weaknesses of these summer programs serving as supplemental field experiences. In the present article, I describe experiences of undergraduate students working in a summer literacy program. The present study was conducted using case study. The data sources included reflection journals, researcher journals, and observations. Thematic analysis assisted by Atlas.ti software was used in order to determine important themes. Findings suggest tutors display many positive teaching traits despite experiencing mental health burdens while teaching.

This article focuses on practice architectures of international schools that create affective atmosphere for the professional learning and becoming of international-hire and local-hire teachers. We use the concept of precarious labour to explore relational tensions and their effects on the professional learning of teachers and school leaders. Empirical data are drawn from two case study schools located in two major countries that offer international education. The data sets include interviews with school leaders and international and 'local' teachers. The analysis focuses on relational tensions experienced by teachers in these schools. The article argues that the affective atmosphere of teacher workplaces produces a force -- a sense of precariousness -- that envelopes teachers and oppresses them. At the same time, it also provides the very conditions for their professional learning in international workplaces. From this practice-ontological perspective, therefore, it is important to recognise the primacy of affect in the professional learning of teachers.

This study explored Master of Teaching pre-service teachers' (PSTs') feelings of comfort and more broadly, their emotional experience as they prepare to work in classrooms with LGBTIQ students. Within the context of a broader mixed methods research project, PSTs were surveyed, and data were combined with a focus group (total participants n = 42). This paper reports on the qualitative data collected. Theoretically, Vygotsky's cultural-historical approach was used to elicit information about the PSTs' emotional experience (perezhivanie). Important findings indicate that PSTs' past experiences influence their understanding of LGBTIQ content and their willingness to transform their developing pedagogy. Systemic tensions around language and context contributed to challenging emotional experiences when PSTs were unable to mitigate the issues. It is argued that comfort is an initial starting point, but "perezhivanie" provides a lens to examine and support a broader understanding of the institutional structures which constrain PSTs when working with LGBTIQ students.

The study explores inter-professional collaboration between a teacher educator (TE), and preservice teachers (PSTs) and a co-teacher (CT). The co-teacher is a practising schoolteacher employed part-time by the university due to expert skills in managing challenging behaviours. The main aim of the study was to answer Master of Teaching PSTs anonymised survey responses indicating the need for support when working with students in school classrooms displaying challenging behaviours. The concepts of 'relational expertise', 'common knowledge' and 'relational agency' (Edwards 2017) have been drawn upon to understand ways practitioners from intersecting practices can expand their understanding of a problem by using their specialist expertise and working together to inform joint goals and future directed actions (Rickinson & Edwards, 2021).

A novel way to support change and development in a country's education system is to send teachers abroad on a professional learning program, so that they become immersed in a different culture, language and education system. The focus of this study was to investigate the supports and tensions created during a professional learning and leadership development program, in which teachers from the Kingdom of Saudi Arabia (KSA) (n = 45) lived in Australia for one year. A multiple case study approach was used to report on the analysis of individual interviews with the KSA teachers (n = 5) and their capstone projects. Drawing on the 2019 study of McChesney and Aldridge,, we report on findings related to the teachers' evolving Science, Technology, Engineering and Mathematics (STEM) integration and leadership skills. Findings indicated that there were both tensions and supports for the KSA teachers. Tensions existed as the teachers were developing their English language proficiency and learned more pedagogical ideas about the integration of STEM into the curriculum. Furthermore, the KSA teachers benefitted from mentor teachers' support in schools and modelling of leadership practices with respect to planning and through completion of a capstone project. Implications concerning an international immersion program are discussed.

BackgroundEnd stage renal disease (ESRD) is associated with elevated fibrinogen levels and fibrinolysis inhibition. However, there is a paucity of data on how renal transplantation impacts coagulation. we hypothesize that renal transplantation recipients with good functioning grafts will have improved fibrinolytic activity following surgery.MethodsKidney recipients were analyzed pre-operatively and on post-operative day 1(POD1) using three different TEG assays with and without two concentration of tissue-plasminogen activator (t-PA). TEG indices and percent reduction in creatinine from pre-op to POD1 were measured, with >50% defining "good" graft function. Follow up was done at 6, 12, and 24 months.ResultsPercent lysis(LY30) on POD1 the t-PA TEG was significantly correlated to change creatinine from pre-op to POD-1(p = 0.006). A LY30 ≥ 23% was associated with good early graft function, and lower creatinine at 24-months(p = 0.028) compared to recipients with low POD1 LY30.ConclusionsPost-operative tPA-TEG LY30 is associated with favorable early and late outcomes in kidney transplant.

Early in 2016, the Council on Accreditation of Educator Providers (CAEP) (caepnet.org, 2016) published a new set of standards that called for increased collaboration of university-school partners by means of coconstruction clinical experiences. In designing the new models, pre-service co-teaching, conducted by the teacher candidate and collaborating teacher, emerged as a promising practice in teacher education (Arshavskaya, 2014; Perry, 2016). However, even with the current enthusiasm for the establishing the new practices, a working definition of pre-service co-teaching remains elusive. Thus, the study of the voices of educators who are involved in co-teaching is essential as universities make the transition from single-taught to co-taught clinical experiences. This study presents a discourse analysis of the voices of 21 teacher candidates who were enrolled in a year-long, co-taught clinical experience, along with the voices of 29 mentor teachers. The findings of this study describe the terms and language used by our candidates and mentor teachers to describe their relationships and practices. The implications for these findings are discussed in terms of our new understandings of the nuances of co-teaching and how they may be used to shape a common definition of pre-service co-teaching.

Rigorous scientific practice relies on the tenet of transparency. However, despite regular transparency in areas such as data availability and methodological practice, the influence of personal and professional values in research design and dissemination is often not disclosed or discussed in conservation science. Conservation scientists are increasingly driven to work in collaboration with communities where their work takes place, which raises important questions about the research process, especially as the field remains largely represented by a Western scientific worldview. The process of reflexivity, and the creation of positionality statements as one form of a reflexive practice, is an important component of transparency, rigor, and best practice in contemporary conservation science. In our own professional practices, however, we have found that guidance on how to produce positionality statements and maintain reflexivity throughout the lifecycle of research is too often lacking. In response, we build on existing literature and our own experience to offer a primer as a starting point to the practice of reflexivity. Rather than being prescriptive, we seek to demonstrate flexible approaches that researchers may consider when communicating reflexive practice to enhance research transparency. We explore the challenges and potential pitfalls in a reflexive practice and offer considerations and advice based on our collective professional experience. [ABSTRACT FROM AUTHOR]

It has been reported that in cross-cultural contexts, Western science content is often not used in everyday practice, and the learning of science is often viewed as difficult and having no social meaning (e.g., Aikenhead & Michell, 2011). It is suggested that the cultural relevance of everyday family practices and Western constructions of science concepts may be worlds apart, requiring new forms of brokering between schools and communities. But this expansive cross-cultural work says very little about everyday family life for supporting the cultural learning of science for the birth to five year period. In this paper we report on how everyday and abstract scientific concepts are meaningfully constructed in the context of culturally relevant life events (Vygotsky, 1987) for the early childhood period. We analyse the science concepts involved in the process of a South Sudan Dinka wedding in Australia, and explore these concepts through science related games with families who in turn introduce the concepts to their children as part of their playgroup activities. The results of the study indicate that finding Dinka words to name Western science concepts was challenging, and conceptualising everyday routines and cultural practices with scientific lenses amplified emotional engagement in science and generated new family discourses between children and their extended families. The study contributes to better understanding the relations between everyday cultural practices and Western science learning in the early childhood period.

The increasing trend of world trade that supports globalisation has expanded the movement of families across countries (Thomas & Kearney, 2008). There is limited research exploring the everyday settings at home and school as families' experience new countries due to one or both parent's employment with international companies. One area that has not been theorised is the way very young expatriate children form friendships. Hedegaard, Fleer, Bang, and Hviid (2008) propose a methodology supported by cultural-historical principles. This methodology has been used to explore the complexity of friendship formation in a sub section of the expatriate population. A multiple case study approach was used to research five families with 13 children in total (aged 3 to 7 years), transitioning to and from Malaysia. Data collected were 90 hours of digital video recording, interviews, field notes, and photographic documentation to capture the everyday lives of families. Findings reveal that Western parents place priority on their children's social interaction when entering a new country. Play dates are used as vehicles to support the formation of social interaction and potential friendships. It is argued that Vygotsky's (1987, 1994) theoretical framework and specifically the concept of the ideal and real form, which is an integral part of perezhivanie, are valuable for theorising friendship formation. These concepts provide a different perspective on initiating friendships as participants enter new social situations in a new country.

Fostering the development of the required knowledge, skills, and dispositions needed for teachers to be successful in the classroom is a complex task. Teacher candidates must develop the skills needed to make 'professional decisions that lead to favorable student outcomes' (Warren, 2018, p. 169). There are many moments within a school day when teachers must make decisions quickly about instructional methods, behaviour interventions, and student supports. It is of the utmost importance that in assessing a 'teacher disposition', the empathy of the teacher candidate at minimum is investigated (Warren, 2018). Empathy allows teachers to place themselves in the positions of their students in order to navigate their own positionality and privilege, whether in terms of power, race, economics, or some combination of all of those. If there is no quantitative measure to determine if a candidate is able to work with children without causing harm, how can teacher preparation programmes ensure that those who enter the workforce are ready to teach? One suggestion has been the development of supplemental field experiences where faculty can work more closely with teacher candidates as they develop the skills to make professional decisions (Hopkins et al., 2018). These field experiences have the potential to better prepare teacher candidates through practice based experiences; Pre-Service Techers (PSTs) are able to work with K-12 students and practice what they are learning in their courses while being mentored closely by faculty (Maxwell et al., 2018). These experiences might be in university clinical settings, in schools, or some other configuration (Braden et al., 2019; Jinhee & Koeun, 2020). The data shared in this article is related to several critical incidents that occurred during summer of 2019 during a summer literacy programme where tutors worked with elementary age students in a university literacy centre. Each incident adds to learning by PSTs on professional behaviour. The paper is thematically organised across four critical incidents. The first two involved conflict between three tutors, broadly. In one, a student was involved as the tutors engaged in personal conflict. In the second, the tutors alone were involved, however, the escalation of the situation occurred quite quickly. In the third narrative, the authors re-story a critical incident that involved the researchers and one of the teacher candidates across multiple moments in the programme. In the final narrative, model behaviour by two tutors was exhibited when handling mandated reporting.

In this article, we offer an analysis of how institutions of higher education have responded to occurrences related to racism in educational contexts and the larger society. Since the initial drafting of this manuscript, continued police brutality and racially motivated tragedies have prompted protests and uprising across the US and the world, specifically after the killings of Ahmaud Arbery in Georgia, Breona Taylor in Kentucky, and George Floyd in Minnesota. This social unrest reflects the ways in which people respond when enough is enough. In addition, a number of schools across the P-20 landscape are engaging in discussions around equity and racism and responding in ways that address racist systems and policies. We conclude this article with a discussion of what institutions of higher education should aspire to in order to humanize the educational contexts for a more equitable and anti-racist society. We hope this discussion around past incidents provide a lens of possibilities for meaningful change; because as we knew when writing the initial draft, and as we still know, lives depend on it.

As increasing numbers of families migrate from a range of countries into communities where Western science is viewed as valued curriculum content, a need for understanding the cultural nature of teaching Western science has become more urgent. The study reported in this paper sought to investigate pedagogical responses to everyday and scientific learning of pre-school children from a group of Dinka (South Sudanese) families now living in a large Australian city. Adopting a cultural-historical methodology, we analyzed 42 h of digital video observations of 34 children, one teacher and 22 parents during their participation in a regular play group in their community. We identified four pedagogical approaches being used to support children's learning. The videos capture how the use of observational pedagogy, physically helping pedagogy [in the spirit of Barbra Rogoff's (Hum Dev 57:69-81, 2014. 10.1159/000356757) "pitching in"], verbally helping pedagogy, and embedded scientific narratives, supported new forms of cultural knowledge production by the children. The study suggests that together these relational dimensions of the pedagogy in the playgroup are "transformative" because they support genuine access and participation to other forms of cultural knowledge, such as Western science.

Purpose: Public schools are spaces where capital-T transformation in teachers is needed (Guillory, 2012). To shift schools to places where all communities are valued, teacher education programs must create spaces where shifts in beliefs and practice can occur. This study aims to describe how the use of a social justice curriculum framework impacted teacher candidates by creating such a space. Design/methodology/approach: This is an ethnographic study. Qualitative ethnography is appropriate when "the study of a group provides an understanding of a larger issue" (Creswell, 2015, p. 466). In this case, studying the impact of a social justice framework on the children and teacher candidates in the program allows the researchers to capture the relationships developed during the course of the program and study. Findings: The framework created valuable experiences for both teacher candidates and elementary age participants. Data were collected to determine the impact of the program on all participants. The authors discuss implications for practitioners planning a social justice curriculum and for teacher educators planning field experiences for teacher candidates. Research limitations/implications: The need for shifting beyond culturally relevant pedagogy has been well documented in the field (Cho, 2017; Guillory, 2012; Paris, 2012). Moving toward--culturally sustaining pedagogy, multicultural social justice curriculum, critically conscious teachers--must be a priority in teacher education (Banks, 2013; Convertino, 2016). This has been explored in other studies, particularly in studies of merging--or emphasizing--multicultural and social justice education and curricula (Cho, 2017; Lawyer, 2018; Sleeter, 2018). What sets this study apart, and what needs further exploration diverse, is how to set up multicultural social justice education projects involving culturally and economically teacher education candidates and students working together (Cammarota, 2016; Lawyer, 2018; Valenzuela, 2016). Originality/value: The questions that arise from this study make it new in the field. These include how to set up these diverse field experiences, including how to increase recruitment and retention of culturally and economically marginalized students in teacher education programs (Cammarota, 2016; Castaneda, Kambutu and Rios, 2006). These are important questions to consider in designing research and recruitment projects in colleges of teacher education. Exploring how to push multicultural education into multicultural social justice education deserves additional attention and exploration (Cammarota, 2016; Lawyer, 2018; Sleeter, 2018; Valenzuela, 2016).

This paper explores internationally mobile global middle class families (GMCF) in terms of how they rationalise moving away from their home country, select schools and reimagine their young children's futures in an international setting. Building on Appadurai's notion of 'the future as a cultural fact' and Anagnost's concept of 'life-making in neoliberal times' we analyse how the search for escaping the past is dialectically related to seeking better futures. For GMCFs, the search for better futures within current neoliberal times leads to them discursively constructing spatial-temporal movements across international boundaries. The term 'futurescaping' is introduced and used to understand the act of imagining futures that are shaped by a person's past and present experience. We argue that futurescaping is more than simply transnational mobility, but is a multidimensional act, which is dynamic, culturally value-ladened, historically embedded, futuristic and provides a unique view into the everyday lives of internationally mobile GMCF.

Multiple myeloma is a rare haematological malignancy characterised by the clonal proliferation of plasma cells within the bone marrow. Typical manifestations include bone pain, fatigue and monoclonal protein elevation in serum and urine. Less than 1% of cases develop myelomatous pleural effusion, a severe complication indicative of advanced disease and a very poor prognosis. Here, we present a case of a woman with a new diagnosis of multiple myeloma complicated by bilateral myelomatous pleural effusions as the initial presentation. This case underscores the diverse clinical spectrum of multiple myeloma, the significance of timely diagnosis and the threatening implications associated with myelomatous pleural effusions. [ABSTRACT FROM AUTHOR]