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Family science literature has documented the benefits of studying abroad on students' overall development. However, research has focused less on the challenges that students experience while studying abroad. This study aimed to explore the challenges family science students experienced in a semester-long study abroad program. Qualitative data were collected from 80 students participating in the Semester at Sea study abroad program. Participants responded to an open-ended survey question. Researchers used qualitative content analysis techniques to analyze data and identify common themes. Six major themes emerged from the data. Students experienced: 1) cognitive challenges; 2) social challenges; 3) academic challenges; 4) cultural challenges; 5) logistical challenges, and 6) emotional challenges. Students reported challenges across a variety of domains during the study abroad voyage. Understanding these challenges experienced by students may help family science faculty know where study abroad students can be further supported. Faculty should emphasize students' cognitive preparations and support students in processing their experiences throughout their study abroad program. Faculty should also prepare students to return home and manage the guilt they may experience.

Objectives The psychological impact of the COVID-19 pandemic on doctors is a significant concern. Due to the emergence of multiple pandemic waves, longitudinal data on the impact of COVID-19 are vital to ensure an adequate psychological care response. The primary aim was to assess the prevalence and degree of psychological distress and trauma in frontline doctors during the acceleration, peak and deceleration of the COVID-19 first wave. Personal and professional factors associated with psychological distress are also reported.Design A prospective online three-part longitudinal survey.Setting Acute hospitals in the UK and Ireland.Participants Frontline doctors working in emergency medicine, anaesthetics and intensive care medicine during the first wave of the COVID-19 pandemic in March 2020.Primary outcome measures Psychological distress and trauma measured using the General Health Questionnaire-12 and the Impact of Events-Revised.Results The initial acceleration survey distributed across networks generated a sample of 5440 doctors. Peak and deceleration response rates from the original sample were 71.6% (n=3896) and 56.6% (n=3079), respectively. Prevalence of psychological distress was 44.7% (n=1334) during the acceleration, 36.9% (n=1098) at peak and 31.5% (n=918) at the deceleration phase. The prevalence of trauma was 23.7% (n=647) at peak and 17.7% (n=484) at deceleration. The prevalence of probable post-traumatic stress disorder was 12.6% (n=343) at peak and 10.1% (n=276) at deceleration. Worry of family infection due to clinical work was the factor most strongly associated with both distress (R2=0.06) and trauma (R2=0.10).Conclusion Findings reflect a pattern of elevated distress at acceleration and peak, with some natural recovery. It is essential that policymakers seek to prevent future adverse effects through (a) provision of vital equipment to mitigate physical and psychological harm, (b) increased awareness and recognition of signs of psychological distress and (c) the development of clear pathways to effective psychological care.Trial registration number ISRCTN10666798.

Collaboration has become an important way for organizations to leverage human resources to create shared organizational goals. Schools, as organizations, thrive on positive collegial partnerships among educators, with effective educator collaborations linked to improved school effectiveness and student outcomes. However, not all collaborations are successful. The current study draws heavily from Coleman's (1988) social capital framework to understand with whom educators choose to interact and how patterns of interaction facilitate educators' social capital development. Using an equal status, sequential mixed methods design, K-12 educators' interview and survey data were iteratively analyzed to explore how educators describe their school-based collaborations, how collaborations reveal distinct social network structures, and how school-based collaborations and network structures lead to educators' social capital. Findings illuminated four distinct profiles of collaboration that emerged as educators described their school-based collaboration, which were linked to different social network structures and qualities of social capital. These results can be used to inform professional development practices for school administrators and human resources teams through consideration of profiles that may inform responsive school-based collaborations. We discuss additional implications for educator hiring and retention as well as policy around PK-12 teacher standards.

Schools are important in nurturing social skills and behaviours. Research consistently demonstrates that movement into/out of school (transience/mobility) disrupts positive social skill development, especially for students who frequently move. The impact of attending a highly transient school on "non-mobile" students is not as well-known. The current study explored the impact of values and life skill-based programme, Kiwi Can, on social development and the classroom climate for non-mobile children. Researchers administered surveys to students attending 15 intervention (i.e. Kiwi Can programme; n = 763) and 9 control (n = 456) schools in Aotearoa New Zealand. We examined the impact of programme participation by school transience level (high, middle, low) and length of school participation (new, experienced). The results indicate that students attending highly transient schools struggled to build social relationships, feel connected, demonstrate care and compassion to others, and behave in prosocial ways. They also felt less safe at their schools. Students participating in Kiwi Can for more than two years (experienced schools) showed fewer negative effects of transience on social development than less experienced schools. This research highlights the plight of students who are 'left behind.'

Objectives To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores.Design Cross-sectional electronic survey.Setting Emergency departments (EDs) (n=112) in the UK and Ireland.Participants Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019.Main outcome measure NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery.Results The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5–90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%–50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%–75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%–100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9).Conclusion Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible.

Objectives Informing research participants of the results of studies in which they took part is viewed as an ethical imperative. However, there is little guidance in the literature about how to do this. The Fluoxetine Or Control Under Supervision trial randomised 3127 patients with a recent acute stroke to 6 months of fluoxetine or placebo and was published in the Lancet on 5 December 2018. The trial team decided to inform the participants of the results at exactly the same time as the Lancet publication, and also whether they had been allocated fluoxetine or placebo. In this report, we describe how we informed participants of the results.Design In the 6-month and 12-month follow-up questionnaires, we invited participants to provide an email address if they wished to be informed of the results of the trial. We re-opened our trial telephone helpline between 5 December 2018 and 31 March 2019.Setting UK stroke services.Participants 3127 participants were randomised. 2847 returned 6-month follow-up forms and 2703 returned 12-month follow-up forms; the remaining participants had died (380), withdrawn consent or did not respond.Results Of those returning follow-up questionnaires, a total of 1845 email addresses were provided and a further 50 people requested results to be sent by post. Results were sent to all email and postal addresses provided; 309 emails were returned unrecognised. Seventeen people replied, of whom three called the helpline and the rest responded by email.Conclusion It is feasible to disseminate results of large trials to research participants, though only around 60% of those randomised wanted to receive the results. The system we developed was efficient and required very little resource, and could be replicated by trialists in the future.Trial registration number ISRCTN83290762; Post-results.

The teacher is key to reforming K-12 science, technology, engineering, and mathematics (STEM) education for all students (Powell et al., 2018) in the United States, and a catalyst for a competitive workforce and economic development. Reports based on Free or Reduced-Price Lunch (FRPL) and percent schools offering STEM courses, along with FRPL and per pupil expenditure in science adjusted for inflation, show disparity between the highest and lowest quartiles (U.S. Government Accountability Office, 2018; Banilower et al., 2018). Strategies to promote STEM for All and turn STEM education into a dependable human resource pipeline for a competitive workforce and economic development are discussed. The strategies include, promoting diversity and inclusion towards STEM for All, providing adequate STEM teacher training, increasing teacher retention in STEM subjects, and building a supportive environment for STEM teachers and teachers in general. These strategies are essential to connecting K-12 STEM education, a competitive workforce, and economic development.

Policies of dispersal are increasingly favoured internationally for the resettlement of refugees and asylum seekers. With forty percent of the world's forcibly displaced people being school-aged children, the dispersal of refugee-background people into regional areas means that rural schools are central sites of community response to refugees. Little is known in published research about how rural schools engage in refugee education within the policy context of 'dispersal'. This review of relevant literature examines the educational dimensions of dispersal policies, drawing on research in Australia, Canada, the United Kingdom, the United States and Sweden. Research linking refugee resettlement, refugee education and rurality shows a complex interplay between histories of exclusion and contemporary challenges in both the construction of rural spaces, and the deployment of humanitarian dispersal policies at national and international levels. This literature is thematically organised to show that in refugee education within a policyscape of dispersal, rural schools may be 1) operating in racialised community contexts; 2) working within poorly resourced infrastructure; 3) unfamiliar with refugee-background students; and, despite these challenges, they may become 4) key sites of resistance, creativity and support for refugee-background students and their families.

Feasibility, acceptability and effectiveness data of a virtual adaptation of the WHO Caregiver Skills Training (CST; n = 25) were compared with those of a pilot RCT of CST delivered in person (n = 43) against treatment as usual (TAU; n = 43). Virtual CST was delivered with high levels of integrity, but received lower ratings in some caregiver- and facilitator-rated acceptability and feasibility dimensions. Qualitative analysis identified both benefits (flexibility, convenience, clinical usefulness) and challenges, (technological issues, distraction from family members, emotional distance). Virtual and in-person CST improved significantly more on caregiver competence than TAU; there were no other significant effects. Potential for use of virtual CST as a clinical response in contexts where in-person delivery is not possible is discussed.

Single-case research design is a useful methodology to investigate counseling treatment effects through a time-series graph. A systematic review of 42 counseling journals was conducted, yielding 50 studies, including 272 graphs. Most graphs did not meet recommended guidelines. How graphs impact visual analysis and suggestions to enhance interpretability are discussed.

Approximately 30% of students who enter the postsecondary education system do so through 2-year colleges. The majority of these students intend to earn a bachelor's degree, but most leave college before earning a diploma from a 4-year institution. The discrepancy between bachelor's degree aspirations and degree attainment rates of students who enter through 2-year colleges suggests that vertical transfer students--those who transfer from 2- to 4-year colleges--face unique obstacles to academic performance and retention that affect their likelihood of earning a bachelor's degree. Similar barriers exist for economically disadvantaged students, who may be more likely to enter the postsecondary education system through 2-year colleges. This scoping review synthesizes the literature on factors influencing economically disadvantaged vertical transfer students' academic performance in the first year posttransfer and retention between the first and second year posttransfer. Implications for 2- and 4-year institutions and recommendations for future research are discussed.

An individual participant data meta-analysis was conducted to test pre-registered hypotheses about how the configuration of attachment relationships to mothers and fathers predicts children's language competence. Data from seven studies (published between 1985 and 2014) including 719 children (M[subscript age]: 19.84 months; 51% female; 87% White) were included in the linear mixed effects analyses. Mean language competence scores exceeded the population average across children with different attachment configurations. Children with two secure attachment relationships had higher language competence scores compared to those with one or no secure attachment relationships (d = 0.26). Children with two organized attachment relationships had higher language competence scores compared to those with one organized attachment relationship (d = 0.23), and this difference was observed in older versus younger children in exploratory analyses. Mother-child and father-child attachment quality did not differentially predict language competence, supporting the comparable importance of attachment to both parents in predicting developmental outcomes. [This article was written by the Collaboration on Attachment to Multiple Parents and Outcomes Synthesis.]

In this paper, we utilize the concepts of "racial knowledge" and "subjective understanding" to demonstrate how the metaphor of surrogacy encodes a racialized discourse via the epistemic authority of social science research. Taken together, we demonstrate how the pervasive use of surrogacy as a metaphor reflects the subjective understanding of Black male teachers produced through the racial knowledge of social science discourse. We argue that the metaphor of surrogacy has become so unquestioningly ubiquitous throughout education and popular culture that it has become the default conceptual framework regarding all reforms for Black young men and boys.

Dispositional employability can be understood as a psychosocial process that facilitates the enactment of behaviors directed toward career self-management. This investigation aimed to test the validity of a measure of dispositional employability to predict salient career outcomes in university students. Two studies using distinct samples of students at a multi-campus university in Australia deployed surveys containing measures of dispositional employability, career adaptability, and job search self-efficacy. The measures' properties were tested using principal axis factoring in Study 1 and confirmatory factor analysis in Study 2. Furthermore, hierarchical regression analyses in Study 2 found that dispositional employability has distinctive relations with measures of career adaptability and job search self-efficacy. Our findings inform recommendations for higher education institutions to measure the psychosocial aspects of employability.

Teacher stress is at an all-time high, negatively impacting the quality of education and student outcomes. In recent years, mindfulness-based interventions have been shown to promote wellbeing and reduce stress among healthy adults. In particular, mindfulness-based interventions enhance emotion regulation and reduce psychological distress. One such program specifically designed to address teacher stress is Cultivating Awareness and Resilience in Education (CARE). The present study examined teachers' self-reported data collected at three time points over two consecutive school years as part of a randomized controlled trial of CARE. The study involved 224 teachers in 36 elementary schools in high poverty areas of New York City. Teachers were randomly assigned within schools to receive CARE or to a waitlist control group. This study builds on previous experimental evidence of the impacts of CARE on teacher self-reported outcomes for this sample of teachers within one school year (Jennings et al., 2017). Results indicate that at the third assessment point (9.5 months after participating in the program), CARE teachers showed continued significant decreases in psychological distress, reductions in ache-related physical distress, continued significant increases in emotion regulation and some dimensions of mindfulness. Findings indicate that teachers who participated in mindfulness-based professional development through CARE reported both sustained and new benefits regarding their well-being at a follow-up assessment almost one-year post-intervention compared to teachers in the control condition. Implications for further research and policy are discussed.

In this paper we designed a STEM outreach program with a modular tissue engineering education tool (we refer to as "modular cyclic-stretch device") to engage high school students in STEM hands-on activities. Using simple machines such as gears and rotating cams, students were able to build a custom device to apply cyclic stretch to biomaterials. With the help of this hands-on activity, our outreach program helped students grasp tendon tissue biomechanics and understand the importance of applying biomechanical force to regenerate tendon tissue in a laboratory setting. The two-day outreach program comprised: (1) pre- and post-tests; (2) lectures; (3) laboratory sessions, including the microscopic examination of stained tissue sections and a hands-on group activity employing the modular cyclic-stretch device; and (4) homework. Assessment results suggest that our program supports improved student awareness and interest in tissue engineering as a future profession. The program elevated students' confidence in their ability to apply engineering principles to tasks such as building a modular cyclic-stretch device and measuring the mechanical properties of biological tissues. Building an educational bioreactor improved students' understanding of the dynamic nature of the human body and the importance of tissue engineering as an emerging discipline towards replacing or regenerating damaged organs. We propose that our modular device has great outreach potential to introduce tissue engineering concepts to high school and potentially college freshmen engineering students.

While formative assessments (FAs) can facilitate learning within undergraduate STEM courses, their impact likely depends on many factors, including how instructors implement them, whether students buy-in to them, and how students utilize them. FAs have many different implementation characteristics, including what kinds of questions are asked, whether questions are asked before or after covering the material in class, how feedback is provided, how students are graded, and other logistical considerations. We conducted 38 semi-structured interviews with students from eight undergraduate biology courses to explore how various implementation characteristics of in-class and out-of-class FAs can influence student perceptions and behaviors. We also interviewed course instructors to provide context for understanding student experiences. Using thematic analysis, we outlined various FA implementation characteristics, characterized the range of FA utilization behaviors reported by students, and identified emergent themes regarding the impact of certain implementation characteristics on student buy-in and utilization. Furthermore, we found that implementation characteristics have combined effects on student engagement and that students will tolerate a degree of "acceptable discomfort" with implementation features that contradict their learning preferences. These results can aid instructor reflection and guide future research on the complex connections between activity implementation and student engagement within STEM disciplines.

Abstract Background The traditional approach for occipital migraine surgery encompasses three separate surgical incisions in the posterior neck to decompress the greater occipital nerves (GON), lesser occipital nerves (LON), and third occipital nerves (TON). Other incisions have been investigated, including singular transverse incisions. We sought to evaluate a single, vertical midline incision approach for decompression of all six occipital nerves. Methods Using 10 cadaveric hemi-sides (5 fresh cadaver head and necks). Anatomic landmarks and the location of the bilateral GON, LON, and TON were marked according to previous anatomic studies. A single, midline 9-cm incision was made, and lateral skin flaps were raised to decompress or avulse all six nerves. Results Through the midline incision, the GON and TON were identified at 3.5 and 6.2 cm, respectively, inferior to a line bisecting the external auditory canal (EAC) and 1.5 cm lateral to the midline. The LON was identified as 6-cm inferior and 6.5-cm medial to a line bisecting the EAC in the plane just above the investing layer of the deep cervical fascia until the posterior border of the sternocleidomastoid was encountered. The LON had the greatest amount of variation but was identified lateral to the posterior border of the SCM. Conclusions A single midline incision approach allows for successful identification and decompression of all six occipital nerves in migraine surgery.

Abstract The rising rate of preprints and publications, combined with persistent inadequate reporting practices and problems with study design and execution, have strained the traditional peer review system. Automated screening tools could potentially enhance peer review by helping authors, journal editors, and reviewers to identify beneficial practices and common problems in preprints or submitted manuscripts. Tools can screen many papers quickly, and may be particularly helpful in assessing compliance with journal policies and with straightforward items in reporting guidelines. However, existing tools cannot understand or interpret the paper in the context of the scientific literature. Tools cannot yet determine whether the methods used are suitable to answer the research question, or whether the data support the authors’ conclusions. Editors and peer reviewers are essential for assessing journal fit and the overall quality of a paper, including the experimental design, the soundness of the study’s conclusions, potential impact and innovation. Automated screening tools cannot replace peer review, but may aid authors, reviewers, and editors in improving scientific papers. Strategies for responsible use of automated tools in peer review may include setting performance criteria for tools, transparently reporting tool performance and use, and training users to interpret reports.

Abstract Background Empathic erosion and burnout represent crises within medicine. Psychological training has been used to promote empathy and personal resilience, yet some training useful within adjacent fields remain unexplored, e.g., Stoic training. Given recent research within psychology suggesting that Stoic training increases emotional wellbeing, exploring this type of training within health professions education is important. We therefore asked: What impact would a Stoicism informed online training package have on third year medical students’ resilience and empathy? Methods 24 third year medical students took part in 12 days of online training (SeRenE), based on Stoic philosophy, and co-developed with psychotherapists. A mixed-methods study was conducted to evaluate impact. Pre- and post-SeRenE students completed the Stoic Attitudes and Behaviours Scale (SABS), Brief Resilience Scale (BRS) and Jefferson Scale of Empathy (JSE). All students completed semi-structured interviews following training and 2 months post-SeRenE. Thematic analysis was employed to analyse qualitative data, whilst within subjects t-tests and correlational analyses were conducted on quantitative data. Results Quantitatively, stoic ideation, resilience and empathy increased post-training, with correlational analyses suggesting resilience and empathy increase in tandem. Qualitatively, four themes were identified: 1. Negative visualisation aids emotional and practical preparedness; 2. Stoic mindfulness encourages students to think about how they think and feel; 3. Stoic reflection develops the empathic imagination; and 4. Evaluating the accessibility of SeRenE. Conclusions Our data lend support to the ability of Stoic-based psychological training to positively influence resilience and empathy. Although, quantitatively, results were mixed, qualitative data offers rich insight. The practice of negative visualisation, promoted by SeRenE, encourages student self-efficacy and planning, domains of resilience associated with academic success. Further, this study demonstrates a connection between Stoic practice and empathy, which manifests through development of the empathic imagination and a sense of empathic bravery.

Mitochondrial metabolism has been associated with tumourigenesis in acute myeloid leukaemia (AML) and currently considered as a potential therapeutic target. Here, the authors show, in patients with AML, that germline mutations in mitochondrial complex I are mutually exclusive with somatic mutations in the metabolic enzyme IDH1, and find IDH1 mutant cells have increased sensitivity to complex I inhibitors.