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Policy makers in the US and several other countries are recommending that more schools offer an International Baccalaureate (IB) programme. However, little is known about the challenges that IB programmes present for teaching and learning particularly those meeting national curriculum. In this study, we examined the challenges of the IB's Middle Years Programme (MYP), the least understood and researched of the IB programmes. Using a qualitative case study design, we conducted in-depth and semi-structured interviews with school leaders (n=7) and teachers (n=10) from three schools in Australia that previously offered the MYP. We used thematic analysis to generate the findings and the IB's Standards and Practice framework to organize the reporting of findings. Participants shared perceived challenges related to philosophical factors, organizational dilemmas and complexities with integrating the MYP with Australia's national curriculum. Understanding the organizational and leadership challenges that schools may face when offering the MYP can help policy makers promote the necessary conditions for successful program implementation.

BackgroundShelter-in-place orders during the COVID-19 pandemic created unmet health-related and access-related needs among older adults. We sought to understand the prevalence of these needs among community-dwelling older adults.MethodsWe performed a retrospective chart review of pandemic-related outreach calls to older adults between March and July 2020 at four urban, primary care clinics: a home-based practice, a safety net adult medicine clinic, an academic geriatrics practice, and a safety net clinic for adults living with HIV. Participants included those 60 or older at three sites, and those 65 or older with a chronic health condition at the fourth. We describe unmet health-related needs (the need for medication refills, medical supplies, or food) and access-related needs (ability to perform a telehealth visit, need for a call back from the primary care provider). We performed bivariate and multivariate analyses to examine the association between unmet needs and demographics, medical conditions, and healthcare utilization.ResultsSixty-two percent of people had at least one unmet need. Twenty-six percent had at least one unmet health-related need; 14.0% needed medication refills, 12.5% needed medical supplies, and 3.0% had food insecurity. Among access-related needs, 33% were not ready for video visits, and 36.4% asked for a return call from their provider. Prevalence of any unmet health-related need was the highest among Asian versus White (36.4% vs. 19.1%) and in the highest versus lowest poverty zip codes (30.8% vs. 18.2%). Those with diabetes and COPD had higher unmet health-related needs than those without, and there was no change in healthcare utilization.ConclusionsDuring COVID, we found that disruptions in access to services created unmet needs among older adults, particularly for those who self-identified as Asian. We must foreground the needs of this older population group in the response to future public health crises.

This study examines how access to the academic curriculum creates patterns of inequality in Australian schools. Examining students' access to the academic curriculum gives an indication of how schooling is structured to support students in pursuing higher education opportunities. To date, little research attention has been given to the opportunities schools offer students to access the academic curriculum in order to enter university. Using administrative data on students and schools, we find that there are fewer average curriculum subjects, and less complexity in the subjects offered, in schools with low levels of socio-educational advantage. We argue that curriculum differentiation across schools is a systemic constraint that students in schools with higher levels of socio-educational disadvantage face in progressing to university because these schools are less able to provide students with access to core academic curriculum subjects in the final year of secondary school. Previous research has highlighted the social differences reflected in both educational access and outcomes due to the marketisation of schools and policies of school choice. Our findings indeed demonstrate that there are relationships between access to the academic curriculum, school socio-educational advantage and the social composition of schools, and these factors have important educational policy implications.

The Programme for International Student Assessment (PISA) has become the world's largest comparative assessment of academic achievement. While hundreds of studies have examined the factors predicting student achievement in PISA, a comprehensive overview of the main predictors has yet to be completed. To address this gap, we conducted a systematic literature review of factors predicting mathematics performance in PISA. Guided by Bronfenbrenner's ecological model of human development, we synthesized the findings of 156 peer reviewed articles. The analysis identified 135 factors that fall into five broad categories: individual student, household context, school community, education systems and macro society. The analysis uncovered seven factors that are consistently associated with math achievement in PISA. Student grade level and overall family SES (socio-economic status) are consistently positively associated with math achievement while five factors are consistently negatively associated with math achievement: student absenteeism and lack of punctuality, school repeating and dropout rate, school prevalence of students' misbehavior, shortage of teachers and general staff, and student-centered instruction. Fourteen factors tend to be positively or negatively associated with math achievement. The explanatory power of many other factors, however, remain mixed. Explanations for this result include methodological differences, complex interactions across variables, and underlying patterns related to national-cultural context or other meso or macro-level variables. Implications for policy and research are discussed.

While the relationship between school socioeconomic composition and student academic outcomes is well established, knowledge about differential effects is not extensive. In particular, little is known whether the relationship differs for students with varying levels of academic performance. We examined whether the school socioeconomic composition effect on academic achievement is stronger or weaker for high-performing students than for average- and low-performing students. Australia is a theoretically interesting case study as it has high levels of school socioeconomic segregation compared to other economically developed countries. We conducted quantile regression analysis using data from the Australia PISA 2018 sample (N = 14,273 15-year-old students). We examined the effect of school socioeconomic status (school SES) on student performance in reading, mathematical and scientific literacy. We found that the school socioeconomic composition effect is substantial and is similar for all students, regardless of their level of academic performance. The findings also show that school SES is a stronger predictor than student SES for all student performance quintiles, and the size of the school SES effect relative to the size of student SES effect is larger in lower performance quintiles. These results indicate no differential effect of school SES on reading, mathematical or scientific literacy for students of varying levels of academic performance. The relationship is similarly strong and positive for high-performing students as it is for their lower performing peers. As school SES is a strong predictor for all students regardless of their level of academic performance, we argue that equity of educational outcomes can be best achieved by policies and structures that promote socioeconomically mixed rather than segregated schools. We also call for more research that seeks to identify and understand possible differential effects of school socioeconomic composition on a range of academic and non-cognitive student outcomes.

This study examines the effect of school socioeconomic composition on student achievement growth in Australian schooling, and its relationship with academic composition utilising the National Assessment Program--Literacy and Numeracy (NAPLAN) dataset. Previous research has found that school composition predicts a range of schooling outcomes. A critique of school compositional research has been that measurement error may have biased findings of compositional effects. Prior studies have found that socioeconomic compositional effect sizes are small when models include academic composition. The relationship between socioeconomic and academic compositions has yet to be fully determined. Multi-level regressions and structural equation models were compared to estimate the degree of bias in socioeconomic compositional effects due to measurement error. Multi-level path models were used to test if academic composition mediated the relationship between socioeconomic composition and achievement growth. The results showed that measurement error did not bias compositional effects in the dataset, and academic composition mediates the relationship between socioeconomic composition and achievement growth. We argue that school value-add research should include academic composition to account for contextual effects. The socioeconomic compositional effect is of practical significance to policy makers and educational researchers due to its relative size compared to average student achievement growth. Potential reforms include ensuring public subsidies to private schools in Australia do not increase school segregation and the amelioration of the effects of residential segregation through school funding reforms.

International research has consistently found that the socioeconomic segregation of schools may worsen inequalities in schooling outcomes through the socioeconomic compositional effect. This study examines whether the socioeconomic compositional effect varies between developed countries and potential mechanisms by which national schooling systems moderate its effect. The results suggest that the socioeconomic compositional effect does vary between developed countries and that national differences in its size were partially explained by policies of tracking age and the proportion of students that attend public schools. We conclude schooling systems in developed countries would require substantial reform to reduce the detrimental effects of school composition on disadvantaged students.

Parent-generated revenue in public schools, in the form of fee-giving or fundraising, is fast developing as a robust source of financial revenue for public schools in OECD countries. In this paper we draw on a comprehensive empirical dataset of parent-generated financial revenue for public schools located in New South Wales, Australia. We draw on a census dataset of all public schools over a five-year period, examining how funding gaps are exacerbated by selective processes and school segregation. The analysis compares parent-generated financial revenue within two types of public schools, namely select-entry public schools and local comprehensive public schools. We find that select-entry public schools consistently generate more than three-times more income across different measures, and over a five-year period. Furthermore, the amount of revenue for select-entry schools annually grows, and the gap increases, suggesting that as market logics intensify, cyclical disadvantage and residualisation of comprehensive public schools increase.

In recent decades, policymakers around the globe have adopted market mechanisms such as consumer-style choice, provider autonomy and competition. Such policies may improve educational equity since families can choose options outside of their assigned local school. Yet research from multiple countries is finding a link between greater use of such policies and increases in social segregation in schooling. This comprehensive analysis is a first step in examining the specific policies and institutional and contextual factors that may alleviate or exacerbate different types of student sorting. Rather than focus only on the question of causation, we instead examine the potential pathways through which market mechanisms might impact student sorting, and highlight the role of incentives in shaping these pathways. In specifying several such pathways, we then present a framework through which further research might conceptualize and theorize the relationship between market mechanisms and student opportunity.

We respond to Malatinszky and Armor's, and Marks' comments on our article recently published in this journal. We agree with Marks in the use of prior achievement to control for spurious effects in school effects research. Marks makes an incorrect statement about our article, refers to dated critiques, and presents an empirical demonstration with some problems. We agree with Malatinszky and Armor that school composition may have sufficient within-student variation to detect a potential effect on achievement growth in fixed-effects models. We argue that fixed-effects models exclude most of the variation in socioeconomic composition, are incapable of measuring the commonly defined conceptualisation of school composition and can mischaracterise the relative importance of socioeconomic composition.

Objective: To test whether a personality feedback intervention improves three domains of cancer self‐management: self‐awareness, self‐efficacy, and positive affect. Methods: From 11/2020‐02/2021, 372 adults diagnosed with cancer participated in a randomized controlled trial (RCT) of an intervention that entailed reading a brief personality‐related excerpt during an online survey. Eligibility included self‐reported age ≥ 18 years, current or past cancer diagnosis, and ability to read English. The survey included a baseline assessment with a personality questionnaire, then randomized participants to one of two groups. The intervention group (n = 184) received a personality feedback report with tailored self‐care tips, whereas the control group (n = 188) received a generic reading on personality theory. At the end of the survey, participants completed outcome measures of self‐awareness (primary), self‐efficacy for illness management, and positive affect. General linear models tested between‐group differences in changes from baseline to post‐test on each outcome. Results: There was no intervention effect on self‐awareness (primary outcome) or positive affect. However, compared to controls, intervention participants experienced a greater increase in self‐efficacy for illness management (d = 0.33, p = 0.002), including in 2 of 3 constituent domains: self‐efficacy for managing symptoms (d = 0.36, p < 0.001) and self‐efficacy for managing treatments/medication (d = 0.22, p = 0.035). Conclusion: Despite the primary outcome's null results, this was the first RCT of a personality feedback intervention to show improvements in self‐efficacy for managing chronic illness. Given the important role of self‐efficacy in self‐management, the intervention has implications for other cancer outcomes. Follow‐up studies on longer‐term outcomes such as health behaviors and quality of life should be explored. Trial Registration: NCT04625439 [ABSTRACT FROM AUTHOR]

Patients with serious illnesses often do not engage in discussions about end-of-life care decision-making, or do so reluctantly. These discussions can be useful in facilitating advance care planning and connecting patients to services such as palliative care that improve quality of life. Terror Management Theory, a social psychology theory stating that humans are motivated to resolve the discomfort surrounding their inevitable death, has been discussed in the psychology literature as an underlying basis of human decision-making and behavior. This paper explores how Terror Management Theory could be extended to seriously ill populations and applied to their healthcare decision-making processes and quality of care received. [ABSTRACT FROM AUTHOR]

Conservation of biodiversity is above all else an exercise in human persuasion. Human behavior drives all substantive threats to biodiversity; therefore, influencing it is the only path to mitigating the current extinction crisis. We review the literature across three different axes to highlight current evidence on influencing human behavior for conservation. First, we look at behavioral interventions to mitigate different threats, from pollution and climate change to invasive species and human disturbance. Next, we examine interventions focused on different stakeholders, from voters, investors, and environmental managers to consumers, producers, and extractors. Finally, we review delivery channels, ranging from mass and social media to interventions involving changes to the physical environment or carried out in person. We highlight key gaps, including the lack of scale and robust impact evaluation of most interventions, and the need to prioritize behaviors, overcome the reproducibility crisis, and deal with inequality when designing and implementing behavior change interventions. [ABSTRACT FROM AUTHOR]

While the International Baccalaureate's Middle Years Programme (MYP) is growing in popularity in Australia and across the globe, few studies have examined the benefits and challenges of this IB programme for supporting student learning. Using a qualitative case study design of three Australian schools that formerly offered the MYP, we investigated teacher and school leader perceptions of the MYP for promoting student learning. Perceived benefits included high achievement and skill development through the MYP's emphasis on inquiry-based learning and real-world relevance; criterion-referenced assessments; and a healthy balance between core and elective learning areas. Challenges for students stemmed primarily from operational difficulties and possible systems-level constraints impacting teachers, including integration of the Australian Curriculum with the MYP; ability to meet the MYP's demands; confusion about MYP terminology and grading systems; and understanding interdisciplinary units. The findings suggest that MYP Coordinators and school leaders play a critical role in ensuring that schools realise the benefits of the MYP for student learning by providing systems-level support to optimise its benefits.

This study examines inequalities of school funding as exclusively generated by the parent community in urban public schools, and potentially illuminates a secondary impact of between-school segregation. For schools that are largely understood as free, the substantial injections of private financing into public schools indicate a concerning tension for fairness and equity. Using a census dataset of all public schools in one Australian capital city (n = 150), we compare reported parent 'contributions, fees and charges' and how they are patterned by measures of school disadvantage and advantage. We found a statistically significant relationship between private financing and measures of school-based advantage or disadvantage, over a four-year period. Advantaged schools generate up to six times greater income in comparison to disadvantaged schools over a four-year period, and we argue that the substantial gaps function as another form of 'compounded disadvantage' for residualised public schools and a tiered effect of segregation.

International Baccalaureate Middle Years Programme (MYP) is recognized for its rigor, inquiry-based learning, and development of academic skills. While it is growing in popularity worldwide, some schools have discontinued the program. Literature on the reasons why schools discontinue the MYP is limited. Using a qualitative case study design, we examined the perspectives of school leaders, former MYP coordinators, and experienced MYP teachers at three private and public Australian schools to find out why they discontinued the MYP. Our findings add to the limited literature base on the topic--they reveal schools discontinued the program due to challenges from various systems-level constraints, leadership issues, school organizational structures, and individual teacher challenges. Although our small sample prevents generalizability, our findings generate novel insights and hypotheses that can inform school decision making and future research about the sustainability of the MYP.

Parent involvement in their child's schooling is routinely celebrated and emphasised in government education policy in many countries. We take a critical lens to examining parent involvement by investigating voluntary parent fees in public secondary schools, and how these fees are patterned by school socioeconomic status (SES). In Australia, where this study is located, public schools may request 'voluntary' fees from parents to enhance education programmes and facilities. As public schools are increasingly situated in a competitive market, this has arguably augmented pressure for schools and their communities to generate funds. Our findings show large inequalities between public schools, with high-SES schools enjoying more than four times parent-generated income than low-SES schools. Parent financial contributions are a form of structural inequality that benefits socially advantaged students and schools, potentially serving as both a cause and consequence of socially segregated schooling. We conclude with recommendations for policy.

Increased social and academic segregation are known side effects of school choice policies in market-driven environments that facilitate competition amongst schools. Aiming at complementing foundational knowledge in quantifying segregation, this study first defines school markets (i.e., geographical context) based on student transitions from primary school to secondary school in Hamburg, Germany. Second, genuine spatial measures of segregation are applied to generate differentiated in-situ insights. In general, social segregation appears evident between school markets, school types, and individual schools and, thus, shapes social compositions of secondary schools. The pattern of student transfers across the city confirms that parents are selecting particular schools for their children, resulting in different schools servicing different composition of students and so markets. Furthermore, the findings suggest that school markets in both very affluent and very deprived areas are spatially isolated and hence persistently reproduce wealth and affluence as well as poverty and disadvantage.

School socio-economic compositional (SEC) effects have been influential in educational research predicting a range of outcomes and influencing public policy. However, some recent studies have challenged the veracity of SEC effects when applying residualised-change and fixed effects models and simulating potential measurement errors in hierarchical regression models. We review the residualised change and fixed effects methods in critical studies and find limitations in their capacity to demonstrate null compositional effects. We show this with an adjusted residualised change model finding significant SEC effects. We show structural equation models can address concerns that measurement errors inflate SEC effects by comparing hierarchical regression models to structural equation models. We find that structural equation models can detect SEC effects free from measurement error. We conclude that the reviewed critiques of SEC effects were due to methods unlikely to detect compositional effects. Future research would benefit from the identification of mediators of SEC effects.

This study examines the factors that shape secondary schools' offerings of academic curricula. While academic curricula provide many benefits to individuals and the larger society, inequalities in opportunities to study these subjects may exist between schools, even in comprehensive secondary education systems. We examine the Australian case as a vehicle for developing a theoretical framework about the causes of stratified and unequal access to academic curricula in comprehensive secondary education systems. We interviewed 17 school leaders from a range of secondary schools about their curricular offerings. All school leaders reported that curricular offerings are based on student choice and that subjects with sufficient demand are financially sustainable. But regardless of student choices, some schools offered academic curricula to maintain their reputation and competitive advantage in the education marketplace. School leaders of low socioeconomic public schools reported the most resource constraints in offering academic curricula, and all school leaders acknowledged systemic constraints related to the large number of curricula that could be offered. The findings highlight how marketisation dynamics combine with curriculum policies to shape schools' curricular offerings in ways that provide unequal access for different types of students.

Patients receiving palliative care experience stigma associated with their illness, personal identity, and healthcare utilization. These stigmas can occur at any stage of the disease process. Varying stigmas combine to cause palliative care patients to feel misunderstood, contribute to treatment barriers, and further negative stereotypes held by clinicians. Stigma surrounding palliative care patients stems from complex intersections of varied access to resources, familial and physical environment, socioeconomic status, mental health and disorders, and identity characteristics. This article examines the relationship between the stigmatization of mental health and palliative care through three pathways: stigma and barriers existing within healthcare, the tendency of this stigma to undermine social support, and patient deferral of treatment-seeking in response to stigma. Recommendations to address and diminish stigmatization are presented, including advocacy, increased research and assessment, and contextual and intersectional awareness. Clinicians are also encouraged to turn to their colleagues for peer support and team-based care. [ABSTRACT FROM AUTHOR]

Purpose: Much justification for third sector involvement in education advances from the notion that attributes from business and non-profit fields could benefit state-run public schools. The purpose of this paper is to explore this issue by examining theoretical underpinnings and expectations for third sector participation in public education systems, particularly with respect to educational innovations and improvements, and the structural opportunities, incentives, and impediments for such innovation. Design/methodology/approach: The question is how third sector participation shapes the rate, nature, and types of innovations in education as schools interact in response to competitive pressures. This conceptual analysis of the third sector examines the political-economic features and structures of the sector in fostering innovation, with reference to the US sector that was specifically positioned to enhance the innovative capacity of publicly funded education. Findings: The analysis indicates that educational innovations are not necessarily more prevalent in or because of the third sector, and that there are obstacles to their creation and diffusion. Moreover, schools often respond to competitive incentives in ways unanticipated by policymakers, such as school marketing rather than instructional improvement, sometimes in ways detrimental to goals set out for public education, such as social sorting. In fact, instead of the third sector simply developing or incentivizing innovations, there is evidence that this sector has adopted innovations developed in the state sector. Originality/value: The analysis suggests that a third sector based more on a professional, as opposed to a competitive, model may better facilitate the development of innovative capacity in education.

Objectives: We tested whether generalized beliefs that the world is safe, abundant, pleasurable, and progressing (termed "primal world beliefs") are associated with several objective measures of privilege. Methods: Three studies (N = 16,547) tested multiple relationships between indicators of privilege—including socioeconomic status, health, sex, and neighborhood safety—and relevant world beliefs, as well as researchers and laypeople's expectations of these relationships. Samples were mostly from the USA and included general population samples (Study 2) as well as focused samples of academic researchers (Study 1) and people who had experienced serious illness or trauma (Study 3). Results: Studies 1–2 found mostly negligible relationships between world beliefs and indicators of privilege, which were invariably lower than researcher predictions (e.g., instead of the expected r = 0.33, neighborhood affluence correlated with Abundant world belief at r = 0.01). Study 3 found that people who had experienced serious illness (cancer, cystic fibrosis) only showed modest differences in beliefs from controls. Conclusions: While results do not preclude that some individuals' beliefs were meaningfully affected by life events, they imply that such changes are smaller or less uniform than widely believed and that knowing a person's demographic background may tell us relatively little about their beliefs (and vice versa). [ABSTRACT FROM AUTHOR]

Background: Shared decision making (SDM) is the process by which patients and clinicians exchange information and preferences to come to joint healthcare decisions. Clinical dashboards can support SDM by collecting, distilling, and presenting critical information, such as patient-reported outcomes (PROs), to be shared at points of care and in between appointments. We describe the implementation strategies and outcomes of a multistakeholder collaborative process known as "co-design" to develop a PRO-informed clinical dashboard to support SDM for patients with advanced cancer or chronic kidney disease (CKD). Methods: Across 14 sessions, two multidisciplinary teams comprising patients, care partners, clinicians, and other stakeholders iteratively co-designed an SDM dashboard for either advanced cancer (N = 25) or CKD (N = 24). Eligible patients, care partners, and frontline clinicians were identified by six physician champions. The co-design process included four key steps: (1) define "the problem", (2) establish context of use, (3) build a consensus on design, and (4) define and test specifications. We also evaluated our success in implementing the co-design strategy using measures of fidelity, acceptability, adoption, feasibility, and effectiveness which were collected throughout the process. Results: Mean (M) scores across implementation measures of the co-design process were high, including observer-rated fidelity and adoption of co-design practices (M = 19.1 on a 7–21 scale, N = 36 ratings across 9 sessions), as well as acceptability based on the perceived degree of SDM that occurred during the co-design process (M = 10.4 on a 0 to 12 adapted collaboRATE scale). Capturing the feasibility and adoption of convening multistakeholder co-design teams, min–max normalized scores (ranging from 0 to 1) of stakeholder representation demonstrated that, on average, 95% of stakeholder types were represented for cancer sessions (M = 0.95) and 85% for CKD sessions (M = 0.85). The co-design process was rated as either "fully" or "partially" effective by 100% of respondents, in creating a dashboard that met its intended objective. Conclusions: A co-design process was successfully implemented to develop SDM clinical dashboards for advanced cancer and CKD care. We discuss key strategies and learnings from this process that may aid others in the development and uptake of patient-centered healthcare innovations. [ABSTRACT FROM AUTHOR]

Patients with chronic and serious illnesses experience significant quality of life concerns. More research is needed to understand the impact of financial burden on patients with COPD, heart failure, and kidney failure. Patients with COPD, heart failure, or kidney failure completed a cross-sectional online survey using validated measures of financial burden (general financial strain as well as financial toxicity attributable to treatment), physical quality of life (symptom burden and perceived health), and emotional quality of life (anxiety, depression, and suicidal ideation). ANCOVA was used to examine whether financial strain and financial toxicity were associated with physical and emotional quality of life, while accounting for key covariates. Among 225 participants with COPD (n = 137), heart failure (n = 48), or kidney failure (n = 40), 62.2% reported general financial strain, with 34.7% experiencing financial toxicity attributable to treatments. Additionally, 68.9% rated their health as fair or poor, experiencing significant symptom burden including fatigue, dyspnea, and chest pain. Participants also reported clinically relevant levels of anxiety (55.1%), depression (52.0%), and suicidal ideation (21.8%). In the total sample, financial strain was associated with worse physical and emotional quality of life on all measures (all Ps <.001). Financial toxicity attributable to treatment was not associated with quality of life in the total sample or subsamples. Patients with COPD, heart failure, and kidney failure face significant financial, physical, and emotional burdens. Financial strain appears to undermine physical and emotional quality of life. Our study highlights the demand for interventions aimed at mitigating financial strain and toxicity experienced by individuals with chronic illnesses. [ABSTRACT FROM AUTHOR]

This study proposes a more nuanced understanding of the elements constituting refugees' cultural and social capital to help education providers and policymakers develop a non-deficit view of refugees. Such an understanding, informed by empirical research, ought to shape the type of support that is offered to this cohort to facilitate successful participation in higher education. This paper deploys the concepts of cultural and social capital, habitus and field as articulated within Bourdieu's theory of practice. The findings of this study favour an 'asset view' of refugees within the higher educational context. Using a qualitative research design, 20 participants who come from a refugee background were interviewed. It was found that cultural identity and embeddedness within community has a varied influence on the higher educational experience of people from a refugee background in Australia. Additionally, diverse learning environments and, even, generic support structures, help provide a positive higher educational experience for refugees. These findings complement current research suggesting that people who come from a refugee background possess a range of cultural and social capital which can be assets to their higher educational endeavours. [ABSTRACT FROM AUTHOR]