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Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.Cross-sectional survey using four validated instruments.Sixty-two sites in Canada and the United States.Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.None.We 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.Despite 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.

This article takes Viviana Zelizer’s (1985) Pricing the Priceless Child to the new millennium. Zelizer documented the transformation between the 19th and 20th century from an “economically useful” to an “emotionally priceless” child. She observed that by the 1930s, American children were practically economically worthless but invested with significant emotional value. What has happened to this emotionally priceless child at the dawn of the new millennium? Has there been a new transformation in the social value of children, and, if so, what might have such a transformation entailed? To address these questions, we examine overtime trends that point to increasing devotion of resources and time to children’s education, a key input in the exceedingly influential human capital theory, which connects investment into children’s human capital with their future market value. Therefore, we argue that the priceless child 2.0 is a useful-to-be human capital investment child. We use four empirical examples of overtime growth in children’s human capital investment: (a) enrollments in early childhood education, (b) federal spending on early education, (c) federal spending on K-12 programs, and (d) parental spending on child care, education and extracurricular activities. In the conclusion, we discuss some potential consequences and concerns about raising children as human capital investment.

Evidence-based and culturally relevant parenting programs strengthen adults’ capacity to support children’s health and development. Optimizing parent participation in programs implemented at scale is a prevailing challenge. Our collaborative team of program developers, implementers, and researchers applied insights from the field of behavioral economics (BE) to support parent participation in ParentCorps—a family-centered program delivered as an enhancement to pre-kindergarten—as it scaled in a large urban school district. We designed a bundle of BE-infused parent outreach materials and successfully showed their feasibility in site-level randomized pilot implementation. The site-level study did not show a statistically significant impact on family attendance. A sub-study with a family-level randomization design showed that varying the delivery time of BE-infused digital outreach significantly increased the likelihood of families attending the parenting program. Lessons on the potential value of a BE-infused approach to support outreach and engagement in parenting programs are discussed in the context of scaling up efforts. Supplementary Information The online version contains supplementary material available at 10.1007/s11121-021-01249-0.

High-quality early care and education is increasingly viewed as a path toward narrowing socioeconomic gaps in children’s school readiness and development. Features of early childhood education envi...

We use novel information about fixture-specific water lead levels (WLLs) in Portland, Oregon schools to explore inequalities in students’ potential for exposure to lead in drinking water at school. We find that Black and Hispanic students were in classrooms with higher WLLs than white students primarily because they attended different schools. The elevated exposure of students with non-English first languages was also largely driven by sorting into different schools, although there were marginally significant differences between students within the same school. Our findings underscore the importance of broadly targeted remediation efforts like those implemented in Portland to address environmental injustices.