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In the United States, over 2 million individuals openly identify with a gender that differs from their sex assigned at birth. A cancer diagnosis is physically and psychologically taxing-and, in some, traumatic. However, for transgender and gender-diverse (TGD) people, many of whom have experienced discrimination in myriad health care settings, the challenges may be even greater. These recommendations focus on how best to deliver quality cancer care to transgender men (individuals who identify as men but were assigned female sex at birth), transgender women (individuals who identify as women but were assigned male sex at birth), and people who identify somewhere beyond this gender spectrum as nonbinary or using other terms, based on the available, albeit sparse, literature. This review broaches: (1) the epidemiology of cancer in TGD individuals, including the incidence of cancer and cancer-related mortality; (2) cancer center practices that are welcoming and affirming to TGD patients; (3) the need for awareness and intentionality in the spaces of diagnosis and treatment for cancer; (4) the inevitable conclusion that gender differences exist but much more needs to be learned about the impact of gender-affirming therapy, consisting of gender-affirming surgeries and gender-affirming hormone therapy, on cancer therapy; and (5) the efficacy and perceived safety of antineoplastic therapy and gender-affirming hormone therapy.

Abstract Background The five-tiered Cambridge Prognostic Group (CPG) classification is a better predictor of prostate cancer-specific mortality than the traditional three-tiered classification (low, intermediate, and high risk). We investigated radical treatment rates according to CPG in men diagnosed with non-metastatic prostate cancer in England between 2014 and 2017. Methods Patients diagnosed with non-metastatic prostate cancer were identified from the National Prostate Cancer Audit database. Men were risk stratified according to the CPG classification. Risk ratios (RR) were estimated for undergoing radical treatment according to CPG and for receiving radiotherapy for those treated radically. Funnel plots were used to display variation in radical treatment rates across hospitals. Results A total of 61,999 men were included with 10,963 (17.7%) in CPG1 (lowest risk group), 13,588 (21.9%) in CPG2, 9452 (15.2%) in CPG3, 12,831 (20.7%) in CPG4, and 15,165 (24.5%) in CPG5 (highest risk group). The proportion of men receiving radical treatment increased from 11.3% in CPG1 to 78.8% in CGP4, and 73.3% in CPG5. Men in CPG3 were more likely to receive radical treatment than men in CPG2 (66.3% versus 48.4%; adjusted RR 1.44; 95% CI 1.36–1.53; P

The transition from expert occupational therapy practice to academic educator is stressful and complex, involving the development of a new professional identity. In 2020-21 COVID-19 created a new challenge for recently employed academics, who were in this transition process. This study utilized participatory research to explore the impact of COVID-19 on six new occupational therapy lecturers who were employed immediately before and during the pandemic. The participatory research approach simultaneously engaged participants in research processes and aimed to promote researcher development. Three focus groups were conducted to explore participants experiences before, during and after COVID-19 restrictions. Focus groups transcripts were coded and analyzed thematically. Four themes were identified: 1) Discovery 2) Turbulence 3) Survival and 4) Reflections were linked to an overarching analogy. Covid19 accelerated the transition to teaching as participants discovered effective strategies for teaching online through trial and error, with little available support. The easing of restrictions brought new challenges and anxieties for participants unfamiliar with classroom teaching. The study highlights the complexity of transitioning to academia, and the importance of peer and team support during the first two years. The participatory research process utilized in this study provided an opportunity to reflect back on the transition process while developing researcher skills and experience.

Abstract The KHP PCaBB was established in 2013 and recruits donors from the Urology or Oncology Departments at Guy’s Hospital in London (UK). Prostate cancer patients may be approached to give their consent for biobanking at any point in their treatment pathway, which allows residual material from their earlier diagnosis to be transferred and used by the Biobank. Currently, patients are specifically asked to donate samples of blood and surplus prostate tissue as well as permitting access to their clinical and pathological data that continues to be added throughout the course of their disease. Between 2013 and 2015, 549 prostate cancer patients gave their consent to the biobank and, the tissue repository collected 489 blood samples, 120 frozen prostate tissue samples and 1064 formalin fixed paraffin embedded diagnostic blocks. Prostate cancer has become a chronic disease in a large proportion of men, with many men receiving multiple subsequent treatments, and their treatment trajectory often spanning over decades. Therefore, this resource aims to provide an ideal research platform to explore potential variations in treatment response as well as disease markers in the different risk categories for prostate cancer. A recent audit of the KHP PCaBB revealed that between 2013 and 2015, 1796 patients were diagnosed with prostate cancer at King’s Health Partners (KHP), out of which 549 (30.6%) gave their consent to KHP PCaBB. Comparisons between demographic and clinical characteristics of patients who had consented compared to the total patient population revealed that the KHP PCaBB is demographically representative of the total prostate cancer patient population seen in Guy’s and St Thomas’ NHS Foundation Trust (GSTT). We observed no differences in distribution of ethnicity (p = 0.507) and socioeconomic status (p = 0.097). Some differences were observed in clinical characteristics, specifically with treatment type – which differed significantly between the patients who had given consent and total patient population. The KHP PCaBB has thereby amassed a rich data and tissue repository that is largely reflective of both the demographic and clinical diversity within the total prostate cancer patient population seen at KHP, making it an ideal platform for prostate cancer research.

Student Evaluation of Teaching surveys (SETs) are used at universities to inform teaching practice and subject design. However, there is increasing concern about the impact of allegations, abuse, and discrimination in survey open text components. Here we discuss the implementation of an automated screening mechanism using a combination of dictionary and machine learning approaches. We present both a process diagram detailing how the screening is performed, as well as a form of categorisation for comments that are unacceptable or indicate a potential risk of harm. Examples of real comments in each of these categories are presented to demonstrate the depth of the challenge and potential cause for concern. Ultimately, we argue that student and educator wellbeing are inextricably connected and exposing staff to abusive and discriminatory comments causes harm. Furthermore, SETs are an important channel for students to raise concerns about their own wellbeing and potentially unsafe experiences in the learning environment.

BACKGROUND: Anatomical location-dependent differences in transdermal opioid penetration are well described in human patients. Although this has been investigated in horses with fentanyl, there is no literature available on location-dependent plasma buprenorphine concentrations when administered as a transdermal matrix-type patch. OBJECTIVE: This study aims to compare the plasma concentrations achieved from the matrix-type transdermal buprenorphine patches placed at different anatomical sites (metacarpus, gaskin, and ventral tail base) in healthy adult horses. STUDY DESIGN: This is a randomized experimental study with a Latin square design. METHODS: Six adult horses were given each of three treatments with a minimum 10-day washout period. For each treatment, two 20 μg h-1 matrix-type buprenorphine patches were applied to the ventral aspect of the tail base (TailTDP), metacarpus region (MetacarpusTDP), or gaskin region (GaskinTDP). Whole blood samples (for determination of buprenorphine concentration) and physiological variables were collected before (0 h) and at 0.5, 2, 4, 6, 8, 10, 12, 16, 24, 32, 48, 56, 72, 96 and 120 h after patches were applied. The patches were removed 96 h following placement and were analyzed for residual buprenorphine content. Buprenorphine concentrations were measured in plasma by LC-MS/MS. A mixed-effects model was used to analyze the physiological variables. RESULTS: Between the three treatment groups, there was no change in physiological variables across timepoints as compared to baseline and when compared to each other in a single horse and between horses (p > 0.3). When comparing all three locations, the buprenorphine uptake was observed to be more consistent with respect to measurable plasma concentrations >0.1 ng ml-1 when applied to the ventral aspect of the tail base. In the TailTDP group, the mean plasma buprenorphine concentrations were >0.1 ng ml-1 from 2 to 32 h. The highest group mean was 0.25 ng ml-1 noted at 4 h. CONCLUSIONS: The metacarpal and gaskin regions presented more erratic and inconsistent buprenorphine uptake and plasma concentrations as compared to the ventral aspect of the tail base. Further research must be directed at investigating the optimal dose, achievable duration of analgesia, change in measurable plasma concentrations, and behavioral and systemic effects.

This paper uses phylogenetic modeling to investigate the evolutionary mechanisms responsible for the maintenance of sound symbolism in the world's languages. Applying our model to sound-meaning correspondences reported in the literature, we find that many previously established associations are weaker than expected when analyzed using our framework. This is possibly because certain sound-meaning associations are artifacts of slow-changing vocabulary items rather than specific preferences for certain sounds in words with certain meanings. For sound-meaning associations for which we find evidence, the maintenance of sound symbolism appears to be due to a tendency to preserve words in certain meanings if certain sounds are present.

BACKGROUND: Matrix type transdermal buprenorphine patches have not been investigated in horses and may provide an effective means of providing continuous pain control for extended period and eliminating venous catheterization. OBJECTIVE: Assessment of the physiological variables (heart rate, respiratory rate, body temperature) and thermal nociceptive threshold testing, and describing the pharmacokinetic profile of transdermal buprenorphine matrix-type patch (20 μg h-1 and 40 μg h-1 dosing) in healthy adult horses. STUDY DESIGN: Randomised experimental study with a Latin-square design. METHODS: Six adult healthy horses received each of the three treatments with a minimum 10 day washout period. BUP0 horses did not receive a patch (control). BUP20 horses received one patch (20 μg h-1) applied on the ventral aspect of the tail base resulting in a dose of 0.03-0.04 μg kg-1 h-1. BUP40 horses received two patches placed alongside each other (40 μg h-1) on the tail base resulting in a dose of 0.07-0.09 μg kg-1 h-1. Whole blood samples (for determination of buprenorphine concentration), physiological variables and thermal threshold testing were performed before (0 h) and at 2, 4, 8, 12, 16, 24, 32, 40, 48, 56, 64, 72, and 96 h after patch application. The patches were removed 72 h following placement and were analyzed for residual buprenorphine content. RESULTS: Between the three groups, there was no change in physiological variables across timepoints as compared to baseline (p > 0.1). With the higher dose, there was a significant increase in thermal thresholds from baseline values from 2 h until 48 h and these values were significantly higher than the group receiving the lower patch dose for multiple timepoints up to 40 h. 40 μg h-1 patch led to consistent measurable plasma concentrations starting at 2 h up to 96 h, with the mean plasma concentrations of > 0.1 ng/ml from 4 h to 40 h. CONCLUSIONS: 20 μg h-1 and 40 μg h-1 patch doses were well tolerated by all horses. At higher dose, plasma buprenorphine concentrations were more consistently measurable and blunted thermal thresholds for 48 h vs. 32 h with 20 μg h-1 dosing as compared to control.

For decades, racially and ethnically minoritized youth have been subject to unequal distributions of access and opportunity in school, leading to inequities in academic outcomes. Educators require knowledge and skills to provide relevant instruction and create a more supportive, effective classroom environment. This systematic review includes 24 qualitative and quantitative studies in which researchers investigated a culturally responsive classroom intervention or practice to promote academic outcomes for racially and ethnically minoritized youth. Within these studies, authors described several approaches to promote academic success: (a) developing authentic partnerships with families, (b) using effective pedagogy with students' culture infused, and (c) accessing rigorous professional development. In addition, studies were assessed for methodological quality, and qualitative works met design standards more often than the quantitative studies reviewed. Implications include the need for additional research to inform comprehensive support for educators to design effective instructional environments for all students, especially those who have historically encountered systemic barriers in school.

The "Assessment of Culturally and Contextually Relevant Supports" (ACCReS) was developed in response to the need for well-constructed instruments to measure teachers' cultural responsiveness and guide decision-making related to professional development needs. The current study sought to evaluate the presence of differential item functioning (DIF) in ACCReS items and the magnitude of DIF, if detected. With a national sample of 999 grade K-12 teachers in the United States, we examined measurement invariance of ACCReS items in relation to responses from (a) racially and ethnically minoritized (REM) youth and white teachers (teacher race), (b) teachers in schools with 0-50% and 51-100% REM youth (student race), and (c) teachers with <1-5 years of teaching experience and teachers with >5 years of experience. Findings suggested that ACCReS items exhibited negligible levels of DIF. The lack of DIF found provides additional evidence for the validity of scores from the ACCReS to assess teachers' cultural responsiveness. Furthermore, descriptive analyses revealed that teachers were more likely to agree with items pertaining to their own classroom practice than items related to access to adequate training and support. Results inform implications for future educational and measurement research.

Food allergies affect approximately two children per average-sized classroom, and prevalence has increased in recent decades (Gupta et al., 2011; Pawankar et al., 2013). This increase has important implications for school psychologists and counselors because allergies can impact various psychosocial aspects of students' lives (Vale et al., 2015). Unfortunately, psychosocial considerations related to allergy management are often treated as peripheral in school food allergy policy development (Behrmann, 2010a). The purpose of the current review was to examine the availability of state-level guidelines and to evaluate available guidelines according to research supported practices for students including those impacting psychosocial facets of students' lives. Guideline documents identified varied in size and form and when available tended to provide limited coverage of social and emotional factors. Our review provides insight into scope of attention to psychosocial facets of well-being in state-level allergy policy guidelines and concludes with implications for practice across multiple tiers of support.

DESTINY-Breast01 (NCT03248492) evaluated trastuzumab deruxtecan (T-DXd; DS-8201) in patients with heavily pretreated HER2-positive metastatic breast cancer (mBC). We present a subgroup of 24 patients with a history of treated brain metastases (BM), a population with limited treatment options. In patients with BMs, the confirmed objective response rate (cORR) was 58.3% [95% confidence interval (CI), 36.6%-77.9%], and the median progression-free survival (mPFS) was 18.1 months (95% CI, 6.7-18.1 months). In patients without BMs (n = 160), cORR was 61.3% and mPFS was 16.4 months. Eight patients (47.1%) experienced a best overall intracranial response of partial response or complete response. Seven patients (41.2%) had a best percentage change in brain lesion diameter from baseline consistent with stable disease. Two patients (8.3%) with BMs and two (1.3%) without BMs experienced progression in the brain. The safety profile of T-DXd was consistent with previous studies. The durable clinical activity of T-DXd in this population warrants further investigation.SignificanceAdvances in treating HER2-positive metastatic breast cancer have greatly improved patient outcomes, but intracranial progression remains an important risk for which few therapeutic options are currently available. T-DXd demonstrated durable efficacy in patients with stable, treated BMs. This article is highlighted in the In This Issue feature, p. 2711.

When students require support to improve outcomes in a variety of domains, educators provide youth with school-based intervention. When educators require support to improve their professional practice, school leaders and support personnel (e.g., school psychologists) provide teachers with professional development (PD), consultation, and coaching. This multi-study article describes how the Assessment of Culturally and Contextually Relevant Supports (ACCReS) was developed with the purpose of assessment driving intervention for teachers in need of support to engage in culturally responsive practice. Items for the ACCReS were created via a multi-step process including review by both expert and practitioner panels. Then, results of an exploratory factor analysis with a national sample of U.S. teachers (N = 500) in Study 1 yielded three subscales. A confirmatory factor analysis conducted with a separate sample of teachers (N = 400) in Study 2 produced adequate model fit. In Study 3, analyses with another final sample of teachers (N = 99) indicated preliminary evidence of convergent validity between the ACCReS and two measures of teacher self-efficacy of culturally responsive practice. Data from the ACCReS can shape the content of educator intervention (e.g., PD) and promote more equitable student outcomes for youth.

Teaching evaluation is deeply entrenched in institutional quality assurance and is a feature of a range of policies including academic recruitment, promotion, and performance management. Universities must ensure that evaluation practices meet regulatory requirements, while balancing student voice and wellbeing. There is extensive literature examining the validity, reliability, and bias of student surveys, but limited focus on institutional evaluation strategies and what constitutes best practice. This study analyses and reports on the teaching evaluation strategies and practices of Australian and New Zealand universities. All 29 participating institutions use standardised and centrally deployed surveys to evaluate teaching and participated in external student experience surveys to benchmark nationally. Comparisons are provided between the strategic intent of evaluation; survey practices, technology, analysis, and reporting; and the use of other nonsurvey methods. The study informs higher education institutions' evaluation strategy, policies, and practice and provides an agenda for reframing approaches to evaluation of teaching.

Learning and teaching is no longer the exclusive domain of teaching academics and is increasingly reliant on third-space professionals, in particular learning designers. The sharing of the design of the learning and teaching space is underlined by the increasing collaboration between teaching academics and learning designers. This qualitative study explores how these two key stakeholders understand learning technology, which is critical to shaping the teaching and learning process in contemporary higher education. Foucauldian discourse and power were employed as the theoretical lens to analyse semistructured interviews with 12 teaching academics and 5 learning designers at a large Australian university. Although learning designers and teaching academics share a mutual interest in improving the learning and teaching process, the findings also revealed five discourses where practice was contested: centralisation, surveillance, institutional homogenisation, responsibility, and efficiency. This article calls for a new focus on the collaborative aspect of the learning design and teaching process that is constantly (re)negotiated between these two main stakeholders.

Global membership of the HEA fellowship scheme is increasing. Despite the focus by academic developers on supporting staff to achieve fellowship, there is limited research that examines whether it improves teaching and the learning experience. Our detailed survey of educators in the UK and Australia indicates perceptions of impact on individuals, practice, and community. Importantly for academic developers, the reflective act of developing a fellowship has potential to shape the student learning experience. However, some staff are frustrated and disillusioned by their experience. We call for institutions to design development and recognition that maximise impact and acknowledge the benefits valued by educators.

Student evaluation of teaching (SET) surveys are the most widely used tool for collecting higher education student feedback to inform academic quality improvement, promotion and recruitment processes. Malicious and abusive student comments in SET surveys have the potential to harm the wellbeing and career prospects of academics. Despite much literature highlighting abusive feedback in SET surveys, little research attention has been given to methods for screening student comments to identify and remove those that may cause harm to academics. This project applied innovative machine learning techniques, along with a dictionary of keywords to screen more than 100,000 student comments made via a university SET during 2021. The study concluded that these methods, when used in conjunction with a final stage of human checking, are an effective and practicable means of screening student comments. Higher education institutions have an obligation to balance the rights of students to provide feedback on their learning experience with a duty to protect academics from harm by pre-screening student comments before releasing SET results to academics.

School discipline disproportionality has long been documented in educational research, primarily impacting Black/African American and non-White Hispanic/Latinx students. In response, federal policymakers have encouraged educators to change their disciplinary practice, emphasizing that more proactive support is critical to promoting students' social and behavioral outcomes in school. Results from a literature review conducted nearly a decade ago indicated that there was, at that point, a paucity of empirical research related to considering students' culture (e.g., race, ethnicity) and supporting school behavior. The purpose of this study is to replicate and expand the previous review to summarize the characteristics of the most recent school-based quantitative research addressing interventions to promote social and behavioral outcomes for racially and ethnically minoritized youth. We screened 1687 articles for inclusion in the review. Upon coding 32 eligible research studies, we found that intervention and implementer characteristics within these studies varied, but noted strong intervention effects in studies that included established evidence-based practices, adapted interventions, as well as new practices piloted with student participants. Results inform recommendations to continue to study interventions that promote positive social and behavioral outcomes for racially and ethnically minoritized students to disrupt a long history of subjection to exclusionary discipline disproportionately. [For the grantee submission, see ED616596.]