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In this study, the authors sought to explore superintendents' understandings of the various influences on how their districts implemented a 100% virtual learning experience for students for the 2020-2021 academic year. Understanding these influences allowed the authors to develop a framework for leading redesigns of learning systems in long-term crisis situations. In this qualitative study we conducted semi-structured interviews with fifteen superintendents in the Commonwealth of Virginia. Findings showed that districts sought to plan equitable virtual learning experiences for all students based on unintentional influences and the district's intentional responses. We found that during an educational crisis, learning plans emerged as a result of the feedback between unintentional influences (politics, availability of resources, and needs of stakeholders) and district leaders' intentional responses (leveraging relationships, communicating purposefully, and reinforcing the educational mission).

This case study describes the use of a syntax intervention with two deaf children who did not acquire a complete first language (L1) from birth. It looks specifically at their ability to produce subject-verb-object (SVO) sentence structure in American Sign Language (ASL) after receiving intervention. This was an exploratory case study in which investigators utilized an intervention that contained visuals to help teach SVO word order to young deaf children. Baseline data were collected over three sessions before implementation of a targeted syntax intervention and two follow-up sessions over 3-4 weeks. Both participants demonstrated improvements in their ability to produce SVO structure in ASL in 6-10 sessions. Visual analysis revealed a positive therapeutic trend that was maintained in follow-up sessions. These data provide preliminary evidence that a targeted intervention may help young deaf children with an incomplete L1 learn to produce basic word order in ASL. Results from this case study can help inform the practice of professionals working with signing deaf children who did not acquire a complete L1 from birth (e.g., speech-language pathologists, deaf mentors/coaches, ASL specialists, etc.). Future research should investigate the use of this intervention with a larger sample of deaf children.

Teacher leaders are valuable members of the school community. However, there is little existing research that explores how teacher leaders shape and enact their roles. In this article we explore how teacher leaders come to understand their role, as well as how principals and other school colleagues interact with teacher leaders and the ways in which those interactions support teacher leader role development. These findings have significant implications in helping us understand how to help teacher leaders develop in their role and the ways in which leaders can foster teacher leadership growth.

Speech-language pathologists (SLPs) who work with deaf students find themselves in a unique situation as deaf children often use a different language than their SLP. Providing language therapy requires high levels of fluency in the language of the client (Hoskin et al., 2023). This language proficiency is necessary to implement interventions that meet the client's needs (ASHA, n.d.b.). However, few SLPs are native signers, most SLPs are not fluent in American Sign Language (ASL), and many SLPs prioritize the use of oral language over the use of signed language with deaf children (Sanzo, 2022). Additionally, to obtain an American Speech-Language-Hearing Association (ASHA) certificate of clinical competence, an individual must have sufficient speech and hearing skills. Indeed, Cripps et al. (2016) found that SLP graduate students felt unprepared to provide language therapy to deaf students in ASL due to a lack of training in their graduate programs. This insufficient training among SLPs highlights the importance of addressing the gap in education if they are to work with deaf children (Cripps, 2019). This article examines how SLPs can work to ensure their language intervention with deaf children is effective and equitable. It also recommends SLPs should work on improving their ASL, increasing their knowledge of the Deaf community and of what it means to be a member of a marginalized group in society, and expanding their cultural

Purpose: This study aims to understand how to develop, support and utilize professional learning community (PLCs) to build organizational capacity to support teacher learning and collaboration. Although literature highlights the importance of leadership in creating a PLC, there is little research on specific actions leaders can take to create an authentic, sustainable PLC. Design/methodology/approach: We employed a multicase study approach at three school sites within the same district. Our research was guided by the following questions: (1) How are learning communities developed and sustained in school settings?; (2) What is the role of administrators in cultivating learning communities?; and (3) What factors contribute to and hinder the success of learning communities? Findings: Despite being in the same school district, the three schools' PLCs operated differently. The schools displayed characteristics of PLCs, with minimal implementation of all components. Developing a professional learning community at all three sites began with implementing structural factors and mandating specific activities such as weekly grade-level planning. Social factors were much more complex to control by administration, affecting the fidelity of learning and collaboration within the PLCs. Originality/value: Although the literature highlights the importance of leadership in creating a PLC, there is little research that supports specific actions leaders can take to create an authentic, sustainable community of practice. In addition, there is limited literature supporting how administrators use PLCs to build organizational capacity and support teacher learning. Our study contributes to building the empirical knowledge base related to these two areas.

BackgroundWith its high and increasing lifetime prevalence, back pain represents a contemporary challenge for patients and healthcare providers. Monitored exercise therapy is a commonly prescribed treatment to relieve pain and functional limitations. However, the benefits of exercise are often gradual, subtle, and evaluated by subjective self-reported scores. Back pain pathogenesis is interlinked with epigenetically mediated processes that modify gene expression without altering the DNA sequence. Therefore, we hypothesize that therapy effects can be objectively evaluated by measurable epigenetic histone posttranslational modifications and proteome expression. Because epigenetic modifications are dynamic and responsive to environmental exposure, lifestyle choices—such as physical activity—can alter epigenetic profiles, subsequent gene expression, and health traits. Instead of invasive sampling (e.g., muscle biopsy), we collect easily accessible buccal swabs and plasma. The plasma proteome provides a systemic understanding of a person's current health state and is an ideal snapshot of downstream, epigenetically regulated, changes upon therapy. This study investigates how molecular profiles evolve in response to standardized sport therapy and non-controlled lifestyle choices.ResultsWe report that the therapy improves agility, attenuates back pain, and triggers healthier habits. We find that a subset of participants' histone methylation and acetylation profiles cluster samples according to their therapy status, before or after therapy. Integrating epigenetic reprogramming of both buccal cells and peripheral blood mononuclear cells (PBMCs) reveals that these concomitant changes are concordant with higher levels of self-rated back pain improvement and agility gain. Additionally, epigenetic changes correlate with changes in immune response plasma factors, reflecting their comparable ability to rate therapy effects at the molecular level. We also performed an exploratory analysis to confirm the usability of molecular profiles in (1) mapping lifestyle choices and (2) evaluating the distance of a given participant to an optimal health state.ConclusionThis pre-post cohort study highlights the potential of integrated molecular profiles to score therapy efficiency. Our findings reflect the complex interplay of an individual's background and lifestyle upon therapeutic exposure. Future studies are needed to provide mechanistic insights into back pain pathogenesis and lifestyle-based epigenetic reprogramming upon sport therapy intervention to maintain therapeutic effects in the long run.

Abstract Background The COVID-19 pandemic substantially affected the lives of persons with inherited neuromuscular disorders (INMD), causing disruption in clinical and support services. While several studies have investigated mental health, distress and psychosocial resources in the general population during the pandemic, little is known about the experience of persons with INMD. Methods This study was aimed to fill this gap by jointly investigating both psychopathological symptoms and psychosocial resources – specifically, resilience and perceived social support – among persons with INMD during the pandemic, taking into account demographic and clinical factors. Between April and December 2020, 59 participants with INMD (aged 15–59, 71.2% M) completed a questionnaire collecting demographic and clinical data, the Multidimensional Scale of Perceived Social Support, the Resilience Scale for Adults, and the Achenbach System of Empirically Based Assessment. Results Overall, participants showed good levels of resilience and perceived social support. A minority of participants reported clinically relevant psychopathological symptoms, 28.81% for anxiety and depression. Most psychopathological symptoms were negatively correlated with resilience (-0.347

Purpose The purpose of this study was to explore the personal stroke and rehabilitation experiences of older adults with chronic stroke living in a mid-sized Northwestern Ontario city in Canada during the COVID-19 pandemic. Methods A qualitative descriptive approach with a constructivist worldview was used. In addition, a semi-structured interview guide was used to gather the participants’ perspectives on their experiences throughout stroke recovery. Ten participants were interviewed, including six males and four females. The interviews were completed, transcribed, and analysed using inductive and deductive content analysis. Multiple steps were taken to enhance data trustworthiness. Results Six main themes and eight related subthemes emerged. These included: getting help is complex, the effects of stroke are multifaceted, losing rehabilitation services during the COVID-19 pandemic, overcoming hardships but not alone, “If you don’t use it, you lost it”: rehabilitative success is based on one’s actions, and “look at me now”: the importance of taking pride in one’s successes. Conclusions One unique finding was that the participants used this study as an opportunity to teach and advocate for future stroke survivors which is not often seen in qualitative stroke rehabilitation research. Future stroke research should place emphasis on both the positive and negative experiences of this population.

Impulsivity undergoes a normative developmental trajectory from childhood to adulthood and is thought to be driven by maturation of brain structure. However, few large-scale studies have assessed associations between impulsivity, brain structure, and genetic susceptibility in children. In 9112 children ages 9–10 from the ABCD study, we explored relationships among impulsivity (UPPS-P impulsive behavior scale; delay discounting), brain structure (cortical thickness (CT), cortical volume (CV), and cortical area (CA)), and polygenic scores for externalizing behavior (PGSEXT). Both higher UPPS-P total scores and more severe delay-discounting had widespread, low-magnitude associations with smaller CA in frontal and temporal regions. No associations were seen between impulsivity and CV or CT. Additionally, higher PGSEXT was associated with both higher UPPS-P scores and with smaller CA and CV in frontal and temporal regions, but in non-overlapping cortical regions, underscoring the complex interplay between genetics and brain structure in influencing impulsivity. These findings indicate that, within large-scale population data, CA is significantly yet weakly associated with each of these impulsivity measures and with polygenic risk for externalizing behaviors, but in distinct brain regions. Future work should longitudinally assess these associations through adolescence, and examine associated functional outcomes, such as future substance use and psychopathology.

Educational leadership preparation programs increasingly rely on adjunct faculty to teach aspiring leaders. Although the percentage of adjunct faculty serving as instructors continues to grow relative to full-time, tenured faculty, the role of part-time instructors/K-12 practitioners remains confined to instruction. This study explored how one educational leadership preparation program attempted to include adjunct faculty in roles beyond teaching to include course and curriculum development, program redesign, and recruitment and marketing. Informed by the communities of practice literature, this study illustrates ways that programs can foster meaningful professional community among full- and part-time faculty in ways that contribute to program quality. In this study we found that fostering a professional community not only contributes to positive program outcomes, but also creates formal and informal learning opportunities and a powerful professional network for adjunct faculty. The implications for program practice are discussed in light of these findings.

We apply a utilization-focused evaluation [UFE] approach to an evaluation of Virginia's latest comprehensive accountability policy--the Standards of Accreditation (SOA). Our study focuses on the implementation experiences of district and high school level administrators in four urban districts. This study is significant in two important ways. First it provides an example of UFE approaches to policy analysis and evaluation. The literature on UFE supports the approach's application to policy analysis, but its use in this arena has been limited. Second, our study provides important insights for evaluation stakeholders formulating and implementing complex accountability policy, particularly in early phases of implementation. Our findings explore how and why local level administrators understand each of the new standards, what factors shape those understandings, and then how the case districts and schools respond to each of the SOA. Our findings illustrate how, along one dimension, stakeholders' understandings of the standards are related to factors that influence their sense of implementation efficacy. Along a second compliance-continuous improvement dimension, administrators' leadership experience and change-oriented mindsets appeared to determine how they responded to the new policy regime. We present conclusions and recommendations for key stakeholders and other students of policy analysis and evaluation.

Resumen: Objetivo: Principales: determinar la prevalencia y las características de los pacientes con COVID-19, y la incidencia del trastorno mental asociado a la infección y los factores de riesgo. Secundarios: conocer la prevalencia y las características de los afectados de COVID persistente. Diseño: Estudio de incidencia del trastorno mental en los pacientes diagnosticados de COVID-19, y estudio de casos y controles del síndrome de COVID persistente en la submuestra de pacientes diagnosticados de COVID-19, sin antecedente de trastorno mental. Emplazamiento: Atención Primaria de la Región Sanitaria de Lleida. Participantes: Se incluyeron 46.258 pacientes diagnosticados de COVID-19 sin antecedente de trastorno mental. Mediciones principales: La variable dependiente fue el desarrollo de trastorno mental (ansiedad, trastorno del estado de ánimo, trastorno adaptativo e insomnio) en el periodo de estudio (11/03/2020 a 11/03/2022) y las independientes variables clínicas y sociofamiliares. Se analizó su asociación con el desarrollo del trastorno mental mediante el cálculo de las hazard ratio ajustadas a un modelo de regresión logística. Resultados: La edad media ± desviación estándar de los 46.258 pacientes incluidos fue de 43 ± 17,9 años. El 47% eran mujeres. El 3,46% desarrollaron algún trastorno mental (59,20% ansiedad). El síndrome de «COVID persistente» se manifestó más en las mujeres de edad mayor, sin hábitos tóxicos, con obesidad y comorbilidad asociada. Conclusiones: La COVID-19 ha generado impacto en la salud mental de los pacientes. Conocer los factores de riesgo para los trastornos mentales y para el síndrome de «COVID persistente» permitiría al clínico identificar a los pacientes susceptibles de recibir medidas preventivas y evitar su aparición. Abstract: Objective: To determine the prevalence of COVID-19 and the characteristics of infected patients, as well as the prevalence of mental disorders associated with the infection and the associated risk factors. Secondary: to know the prevalence of the long COVID syndrome and the characteristics of this cohort. Design: Incidence study of mental disorder in patients diagnosed with COVID-19 and case-control study of long COVID syndrome in the subsample of patients diagnosed with COVID-19 without a history of mental disorder. Site: Primary care setting in Lleida. Participants: The 46,258 patients diagnosed of COVID-19 without a history of mental disorder were followed for 2 years. Main measurements: The dependent variable was the mental disorder in the period 03/11/2020 to 03/11/2022; and the independent variables were clinical and social variables. Its association with mental disorder was analyzed by calculating the adjusted hazard ratio using a logistic regression model. Results: The average age of 46,258 patients at the beginning of the study was 43 ± 17.9 years. 47% were women. The mental disorder rate for all period was 3.46% (59.20% anxiety). A predictive score was elaborated. The long COVID syndrome was more common in older women, without toxic habits, with obesity and associated comorbidity. Conclusions: COVID-19 has had an impact on the mental health of patients. Knowing the risk factors for developing these mental disorders and the long COVID syndrome would allow the clinician to be able to identify patients at risk in order to establish preventive measures and avoid their appearance.