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Supplemental instruction using peer leaders can assist student learning in undergraduate STEM courses, but optional sessions are not well attended. This study compared attendance in peer leader sessions, nonproductive grade rates, and student evaluation data across two Human Anatomy and Physiology I courses in two different years. One course included peer leader session times that were posted at the start of the semester along with course schedules and incentives for attendance. In the other course, peer leader session times were scheduled after the start of the course without additional incentives for attendance. Incentivizing students and pre-planning peer leader sessions was associated with 70.4% of students attending at least ten weeks of peer leader sessions and a modest decrease in nonproductive grades. By comparison, 9.6% of students attended peer leader sessions in the course that lacked pre-scheduled sessions and student incentives. Future planning should include assessments of student learning and critical thinking associated with the peer leader program.

The goal of the current study was to examine the complex links among anxious solitude, classroom climate, engagement, achievement, and gender. In particular, drawing upon the differential susceptibility hypothesis (Belsky, 1997), we investigated if children high in anxious solitude were particularly sensitive and responsive to the classroom environment. Participants were N = 712 children in Grade 3, drawn from the National Institute of Child and Human Development (NICHD) Study of Early Child Care and Youth Development data set. Classroom climate and engagement were assessed using the Classroom Observation Scale (NICHD, 1998). Teachers completed the "Teacher Report Form" (Achenbach, 1991) as a measure of anxious solitude and the "Academic Rating Scale" (NICHD, 2010) as a measure of achievement. Hypothesized associations among variables were tested by way of a moderated-mediation model. Among the results, engagement was found to "mediate" the relation between classroom climate and achievement. In addition, anxious solitude and gender were found to "moderate" the relation between classroom climate and engagement. Support for the differential susceptibility hypothesis was found, suggesting that children high in anxious solitude may be more reactive (both positively and negatively) to elements of the classroom environment. In addition, gender differences were observed, indicating that boys may be more responsive to the classroom environment as compared with girls. Implications for future research and educational policies are discussed. Impact and Implications: This study suggests that a classroom environment can foster engagement and achievement among students, however the classroom environment may be particularly influential for students who display anxious behaviors and for boys. Positive classrooms may be especially beneficial for vulnerable students, whereas negative environments may be especially detrimental for vulnerable students. [This study was conducted by the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network supported by NICHD through a cooperative agreement that calls for scientific collaboration between the grantees and the NICHD staff.]

UnlabelledWHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Multiple treatment alternatives exist for localised prostate cancer, with few high-quality studies directly comparing their comparative effectiveness and costs. The present study is the most comprehensive cost-effectiveness analysis to date for localised prostate cancer, conducted with a lifetime horizon and accounting for survival, health-related quality-of-life, and cost impact of secondary treatments and other downstream events, as well as primary treatment choices. The analysis found minor differences, generally slightly favouring surgical methods, in quality-adjusted life years across treatment options. However, radiation therapy (RT) was consistently more expensive than surgery, and some alternatives, e.g. intensity-modulated RT for low-risk disease, were dominated - that is, both more expensive and less effective than competing alternatives.ObjectiveTo characterise the costs and outcomes associated with radical prostatectomy (open, laparoscopic, or robot-assisted) and radiation therapy (RT: dose-escalated three-dimensional conformal RT, intensity-modulated RT, brachytherapy, or combination), using a comprehensive, lifetime decision analytical model.Patients and methodsA Markov model was constructed to follow hypothetical men with low-, intermediate-, and high-risk prostate cancer over their lifetimes after primary treatment; probabilities of outcomes were based on an exhaustive literature search yielding 232 unique publications. In each Markov cycle, patients could have remission, recurrence, salvage treatment, metastasis, death from prostate cancer, and death from other causes. Utilities for each health state were determined, and disutilities were applied for complications and toxicities of treatment. Costs were determined from the USA payer perspective, with incorporation of patient costs in a sensitivity analysis.ResultsDifferences across treatments in quality-adjusted life years across methods were modest, ranging from 10.3 to 11.3 for low-risk patients, 9.6-10.5 for intermediate-risk patients and 7.8-9.3 for high-risk patients. There were no statistically significant differences among surgical methods, which tended to be more effective than RT methods, with the exception of combined external beam + brachytherapy for high-risk disease. RT methods were consistently more expensive than surgical methods; costs ranged from $19 901 (robot-assisted prostatectomy for low-risk disease) to $50 276 (combined RT for high-risk disease). These findings were robust to an extensive set of sensitivity analyses.ConclusionsOur analysis found small differences in outcomes and substantial differences in payer and patient costs across treatment alternatives. These findings may inform future policy discussions about strategies to improve efficiency of treatment selection for localised prostate cancer.

UnlabelledWHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Multiple treatment alternatives exist for localised prostate cancer, with few high-quality studies directly comparing their comparative effectiveness and costs. The present study is the most comprehensive cost-effectiveness analysis to date for localised prostate cancer, conducted with a lifetime horizon and accounting for survival, health-related quality-of-life, and cost impact of secondary treatments and other downstream events, as well as primary treatment choices. The analysis found minor differences, generally slightly favouring surgical methods, in quality-adjusted life years across treatment options. However, radiation therapy (RT) was consistently more expensive than surgery, and some alternatives, e.g. intensity-modulated RT for low-risk disease, were dominated - that is, both more expensive and less effective than competing alternatives.ObjectiveTo characterise the costs and outcomes associated with radical prostatectomy (open, laparoscopic, or robot-assisted) and radiation therapy (RT: dose-escalated three-dimensional conformal RT, intensity-modulated RT, brachytherapy, or combination), using a comprehensive, lifetime decision analytical model.Patients and methodsA Markov model was constructed to follow hypothetical men with low-, intermediate-, and high-risk prostate cancer over their lifetimes after primary treatment; probabilities of outcomes were based on an exhaustive literature search yielding 232 unique publications. In each Markov cycle, patients could have remission, recurrence, salvage treatment, metastasis, death from prostate cancer, and death from other causes. Utilities for each health state were determined, and disutilities were applied for complications and toxicities of treatment. Costs were determined from the USA payer perspective, with incorporation of patient costs in a sensitivity analysis.ResultsDifferences across treatments in quality-adjusted life years across methods were modest, ranging from 10.3 to 11.3 for low-risk patients, 9.6-10.5 for intermediate-risk patients and 7.8-9.3 for high-risk patients. There were no statistically significant differences among surgical methods, which tended to be more effective than RT methods, with the exception of combined external beam + brachytherapy for high-risk disease. RT methods were consistently more expensive than surgical methods; costs ranged from $19 901 (robot-assisted prostatectomy for low-risk disease) to $50 276 (combined RT for high-risk disease). These findings were robust to an extensive set of sensitivity analyses.ConclusionsOur analysis found small differences in outcomes and substantial differences in payer and patient costs across treatment alternatives. These findings may inform future policy discussions about strategies to improve efficiency of treatment selection for localised prostate cancer.

This article compares the effects of family background and school resources on fourth-grade students' math achievement, using data from the 2011 Trends in International Mathematics and Science Study (TIMSS). In order to ameliorate potential floor effects, it uses relative risk and population attributable risk to examine the effects of family background and low levels of school resources. Four findings stand out: (1) the percentage of vulnerable students decreases as GDP increases, but this relationship weakens at higher levels of GDP; (2) the relative risk associated with low socioeconomic status is positively related to GDP, but the relative risk associated with low school resources is unrelated to GDP; (3) the population attributable risk associated with some of the family and school risk factors tends to fall with rising GDP, but varies considerably amongst countries; and (4) family background effects are stronger than school resource effects in low- and high-income countries.

Background: Previously, the nature of teacher-child relationships (TCRs) has been explored through dimensions of close, conflicted, and dependent. However, this "variable-centred" approach is limited, as many relationships can be characterized by more than one characteristic or trait. A "person-centred" approach would allow for a greater understanding of the types of relationships that are formed and improved interpretation of the students' socio-emotional outcomes associated with that relationship. Aims: The primary goal of this study was to examine the socio-emotional functioning of young children who formed distinct types of TCRs. Sample: Participants were n = 202 kindergarten children (98 girls, 104 boys, M[subscript age] = 64.12 months, SD = 4.86). Method: Multi-source assessment was employed with data collected from parent ratings, teacher reports, child interviews, and naturalistic observations in the classroom. Using quartile cut-offs, we identified children who formed conflicted, dependent, and "combined" (conflicted and dependent) TCRs. Results: Results indicated distinct patterns of socio-emotional functioning for each TCR group. For example, whereas children in conflicted TCRs evidenced greater externalizing difficulties, children with dependent TCRs had greater internalizing difficulties. Children who evidenced high levels of both conflicted and dependent TCRs displayed the most pervasive socio-emotional difficulties. Conclusions: Children who form TCRs characterized by high levels of both conflict and dependency displayed the most pervasive adjustment difficulties. Further investigation is needed to improve our understanding of this group and to assess the plausibility of early intervention strategies.

The primary goal of the present study was to examine elementary teachers' strategies, attitudes, and beliefs regarding hypothetical shy (i.e., quiet), exuberant (i.e., overly talkative), and average (i.e., typical) children. We explored whether these strategies and beliefs varied as a function of the gender of the hypothetical child as well as teachers' own shyness. Participants were 275 elementary school teachers (241 women, 34 men) ranging in age from 23 to 64 years (M = 40.97, SD = 10.02). Teachers were presented with vignettes depicting hypothetical children displaying shy/quiet, exuberant/talkative, or average/typical behaviors in the classroom and responded to follow-up questions assessing their strategies and beliefs. Teachers also completed a self-report measure of shyness. Among the results, teachers were more likely to respond to exuberant/talkative children with high-powered and social learning strategies and to employ peer-focused and indirect strategies for shy/quiet children. Teachers also believed that shy/quiet children were less intelligent and would do more poorly academically than would exuberant/talkative children. However, some of these findings were moderated by teachers' own level of shyness. Results are discussed in terms of their educational implications for the social and academic functioning of shy and exuberant children. (Contains 1 footnote, 1 table and 3 figures.)

This study explored teachers' perceptions of shy children in the classroom during the elementary school grades. Seven teachers (1 male, 6 female) from elementary schools located in geographically diverse areas of Canada participated in semistructured telephone interviews that explored their perceptions of and experiences with shy children in the classroom. Transcripts were analyzed for emerging themes about teachers' conceptions of shy children and teacher-shy child interactions. Findings suggest that shyness and social communication may influence elementary schoolteachers' classroom practices and the teacher-child relationship. Teachers' roles in shy children's socio-emotional functioning and academic success are discussed.

The goal of the current study was to explore the relations between shyness, academic engagement, and academic achievement in childhood. Participants were (n = 125) children (aged 9-13 years) attending public school boards in Canada. Children completed self reports of shyness and were administered a test of nonverbal IQ. Academic achievement was assessed through both teacher ratings and standardized tests of reading comprehension and mathematics. As well, a new teacher-rated measure of academic engagement was created to assess student participation and on-task behavior in the classroom. Among the results, shyness was negatively related to teacher-rated achievement but not related to standardized test scores. Academic engagement was significantly and negatively related to shyness, and positively related to all measures of achievement. Finally, academic engagement partially mediated the relation between shyness and teacher ratings of achievement. These findings suggest that poorer teacher-rated academic performance in shy children may be partially accounted for by a lack of academic engagement in the classroom. Future studies are needed to explore "why" shy children are less likely to be engaged in the classroom. (Contains 2 footnotes, 3 tables, and 1 figure.)