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BackgroundSimulation modeling has frequently been used to assess interventions in complex aspects of health care, such as colorectal cancer (CRC) screening, where clinical trials are not feasible. Simulation models provide estimates of outcomes, unintended consequences, and costs of an intervention; thus offering an invaluable decision aid for policy makers and health care leaders. However, the contribution that simulation models have made to policy and health system decisions is unknown. ObjectiveThis study aims to assess if simulation modeling has supported evidence-informed decision making in CRC screening. MethodsA preliminary literature search and pilot screening of 100 references were conducted by three independent reviewers to define and refine the inclusion criteria of this systematic review. Using the developed inclusion criteria, a search of the academic and gray literature published between January 1, 2008, and March 1, 2019, will be conducted to identify studies that developed a simulation model focusing on the delivery of CRC screening of average-risk individuals. The three independent reviewers will assess the validation process and the extent to which the study contributed evidence toward informed decision making (both reported and potential). Validation will be assessed based on adherence to the best practice recommendations described by the International Society for Pharmacoeconomics and Outcomes Research-Society for Medical Decision Making (ISPOR-SMDM). Criteria for potential contribution to decision making will be defined as outlined in the internationally recognized Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision (GRADE EtD) framework. These criteria outline information that the health system and policy decision makers should consider when making an evidence-informed decision including an intervention’s resource utilization, cost-effectiveness, impact on health equity, and feasibility. Subgroup analysis of articles based on their GRADE EtD criteria will be conducted to identify methods associated with decision support capacity (ie, participatory, quantitative, or mixed methods). ResultsA database search of the literature yielded 484 references to screen for inclusion in the systematic review. We anticipate that this systematic review will provide an insight into the contribution of simulation modeling methods to informed decision making in CRC screening delivery and discuss methods that may be associated with a stronger impact on decision making. The project was funded in May 2019. Data collection took place from January 2008 to March 2019. Data analysis was completed in November 2019, and are expected to be published in spring 2020. ConclusionsOur findings will help guide researchers and health care leaders to mobilize the potential for simulation modeling to inform evidence-informed decisions in CRC screening delivery. The methods of this study may also be replicated to assess the utility of simulation modeling in other areas of complex health care decision making. International Registered Report Identifier (IRRID) DERR1-10.2196/16103 Trial RegistrationPROSPERO no. 130823; https://www.crd.york.ac.uk/PROSPERO

Students' identification with schools or universities is associated with many positive outcomes, such as increased cooperation and completion of studies. This study is a qualitative investigation of university students' experiences concerning identification. Two hundred and eleven Italian students and 226 U.S. students wrote responses to open-ended questions about a time that they either felt connected (identified) or disconnected to (not identified) with their university. In Italy, students prompted to identify with the university focused their descriptions on didactical aspects such as academic training experiences. Italian students prompted not to identify with the university often described their experiences with the university's organizational and administrative aspects. U.S. students prompted to identify or not with the university focused on the social aspects of their university experience such as their involvement with fraternities and sororities. Italian and U.S. students rarely mentioned instrumental aspects of their university experience such as how much the university matters for professional training. This close analysis of students' experiences illustrates how diverse the sources of university identification can be across different countries. These qualitative results help to fully understand the contents of the experience of university students. Policies for enhancing students' motivation and engagement in higher education should reflect all the different domains of identification, to support the full range of students' experiences.

Although special education teachers are expected to implement evidence-based practices, teachers of students with extensive support needs have reported challenges in identifying and implementing effective practices to meet the unique needs of their students. Systematic instruction has been identified as an evidence-based practice for students with extensive support needs and can be used to support students across a wide range of skill domains. We used an experimental pretest-posttest design to examine the effectiveness of two training approaches, video performance feedback and video self-monitoring, on the implementation of systematic instruction among pre-service special education teachers. Overall, both approaches resulted in improved implementation of systematic instruction by pre-service special education teachers and were viewed as socially valid. We present directions for future research and implications for practice in special education teacher preparation.

ObjectivesFew surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.DesignCross-sectional survey using four validated instruments.SettingSixty-two sites in Canada and the United States.SubjectsAttending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.InterventionNone.Measurements and main resultsWe analysed 431 questionnaires (43.3% response rate) from 25 states and eight provinces. Respondents were predominantly male (229 [55.6%]) and in practice for 11.8 ± 9.8 years. Compared with prepandemic, respondents reported significant intrapandemic increases in days worked/mo, ICU bed occupancy, and self-reported moral distress (240 [56.9%]) and burnout (259 [63.8%]). Of the 10 top-ranked items that incited moral distress, most pertained to regulatory/organizational ( n = 6) or local/institutional ( n = 2) issues or both ( n = 2). Average moral distress (95.6 ± 66.9), professional fulfilment (6.5 ± 2.1), and burnout scores (3.6 ± 2.0) were moderate with 227 physicians (54.6%) meeting burnout criteria. A significant dose-response existed between COVID-19 patient volume and moral distress scores. Physicians who worked more days/mo and more scheduled in-house nightshifts, especially combined with more unscheduled in-house nightshifts, experienced significantly more moral distress. One in five physicians used at least one maladaptive coping strategy. We identified four coping profiles (active/social, avoidant, mixed/ambivalent, infrequent) that were associated with significant differences across all wellness measures.ConclusionsDespite moderate intrapandemic moral distress and burnout, physicians experienced moderate professional fulfilment. However, one in five physicians used at least one maladaptive coping strategy. We highlight potentially modifiable factors at individual, institutional, and regulatory levels to enhance physician wellness.

Many institutions have found the strength to name racism and seek space for curriculum and other systemic changes. We argue this is happening against a backdrop of curriculum, regulatory and policy changes in education, and particularly initial teacher education and training (ITE/T), which are de-racialised. We propose that a 'pocket of possibility' lies within such divergences, and present research leading to the creation of an anti-racism framework for ITE/T to support action against this emergent landscape. The paper documents each aspect of the research and snapshots of the findings of a global literature review of anti-racism in initial teacher education, which demonstrated the need for an embedded approach to anti-racism, informed by critical understandings of whiteness and racism. We share some of the complexities, obstacles, and effective anti-racism practices revealed in the review. The findings of the review led to the creation and analysis of a survey for ITE/T providers in England, which provided encouraging evidence of useful practice alongside needs of the profession. We conclude with a statement of intent and hope to maximise of the minimum entitlement of the Core Content Framework (CCF) by a purposeful undoing of the perpetual de-racialisation of education.

Using Parker Palmer's "The Courage to Teach," and in particular the notion of the undivided life, to guide reflections through the process of collaborative autoethnography, we reflect on our lived experiences with the Scholarship of Teaching and Learning (SoTL). The central question being: How does Palmer's idea of the undivided life enable SoTL scholars to explore notions of identity and integrity that are intertwined with our academic practice? Ultimately, we found that Palmer's insights provoked us to think deeply about our identities, and while perhaps we did not always see ourselves on the paths he illuminates, his work, and our collaborative ethnographic process, helped us to illuminate our own paths. More specifically, we share five themes arising from our collaborative autoethnography related to the importance of context and positionality, defining a SoTL scholar, the power to diminish, the importance of relationships and community, and collaborative autoethnography as method and process. Our stories highlight the need for us to see our community as complex, messy, and deeply human, and we remind readers of the need to think about the ethics of all methods and the power in our everyday practice to include or exclude.

The Race Disparity Audit (RDA) was published in 2017 by the then Conservative government of the UK. The proclaimed aims were to 'reveal racial disparities and to help end the injustices that many people experience'. This paper adopts a critical discourse analysis approach to analysing the RDA and associated webpages, to critically examine the government's purported aims. The linguistic analysis reveals a pernicious form of political doublespeak which effects a maintenance of the status quo. In excluding racism as a cause of disparities, the audit acts to de-legitimise anti-racism as part of the solution, thereby preventing actions with the potential to end racial injustices. The analysis is explained by reference to Feagin's (2013. "The White racial frame. Centuries of racial framing and counter-framing" (2nd ed.). New York, NY: Routledge) White racial frame in institutional operation. The paper concludes by exposing the ramifications of this for future policy development by reference to an education policy development borne from the RDA.

This study explored the psychometric characteristics of the Alcohol Use Disorders Identification Test (AUDIT) on a sample of 414 university undergraduate students (M age = 19.07, SD = 0.95). Internal consistency ([alpha] = 0.83), external divergent validity, and internal structural validity were adequate; the 2-factor model provided the best fit to the data.

The Social Justice Scale (SJS) and various subscales were studied on a sample of 414 human services university undergraduates. Internal consistency ([alpha] = 0.93), discriminant validity, and response bias were adequate. The 4-factor model demonstrated an excellent fit. Implications were discussed for use of the SJS in practice and research.

In 2015-2016, the Levine Museum of the New South in Charlotte, North Carolina, featured "¡Nuevolution! Latinx and the New South," an interactive exhibit that explored the bidirectional ways Latinx and the US South influence one another. To strengthen the exhibit's impact, LMNS launched a dialogue program aimed at enhancing attendees' cultural competence, as measured through relevant gains in knowledge, acceptance, appreciation, and skills. Sixty-six group dialogs took place with 863 individuals. Results demonstrate evidence of increased knowledge of Latinx in the US South, some appreciation of different cultures, yet fewer proficiencies further along the cultural competence spectrum. Data show a need for additional cultural competence skill building. We see great potential for museums and other cultural institutions to offer carefully constructed programming that pairs exhibits and community dialogue as a tool to build a foundation upon which deeper cultural awareness and competency can grow.

IntroductionInfants with SCID are treated with hematopoietic cell transplantation (HCT) or gene therapy (GT). Caregiver perceptions of pre-treatment counseling and understanding of durability of HCT/GT are poorly understood.MethodsA survey was designed and distributed to families of patients with SCID. Topics in the questionnaire included SCID genotype and treatment, family recollections of pre-treatment counseling and present clinical status.Results151 surveys were analyzed. 132 were treated with HCT, 19 with GT. From counseling received, 37% expected HCT/GT would lead to "cure"; 43% expected HCT/GT would last a lifetime. Of 136 living patients, 59% reported overall good health but 65% reported some persistent health challenges.ConclusionsFor some, interpretation of the word "cure" varied, leading to misunderstanding regarding need for continued medical evaluations and additional therapies. Clear communication regarding the importance of lifelong follow-up, no matter the treatment outcome, will help to optimize good health and quality of life.

This paper explores the effects of implementing Learning Express-Ways as an instructional communication tool between students and faculty in courses that are part of a special education teacher preparation program and apprenticeship. Findings suggest that using Learning Express-Ways contributed to the development of learning relationships with faculty and this instructional communication tool may be helpful in creating a partnership-focused approach in special education teacher preparation program.

Statisticians and data scientists have been called upon to increase the impact they have through their collaborative projects. Statistics and data science practitioners and their educators can achieve and enable greater impact by learning how to create shared understanding with their collaborators as well as teaching this concept to their students, colleagues, and mentees. In this article, we explore and explain the concepts of common knowledge and shared understanding, which is the basis for action to accomplish greater impacts. We also explore related concepts of misunderstanding and doubtful understanding. We describe a process for teaching oneself and others how to create shared understanding. We conclude that incorporating the concept of shared understanding into one's practice of statistics or data science and following the steps described will result in having more impact on projects and throughout one's career.

Responses to the Generalized Anxiety Disorder (GAD-7) scale displayed high score reliability ([alpha] = 0.91) and adequate convergent and divergent validity for college undergraduates. The data provided an adequate to excellent fit to the unidimensional model. Measurement invariance was demonstrated for gender and race.