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Language barriers make it difficult for surgical teams to engage in the discussion of important aspects of pre- and post-operative patient care with patients who are non-Englishspeakers.

Understanding the emotions experienced by higher education instructors related to assessment feedback, how instructors understand student emotions, and how instructors might manage these emotions positively, can help to secure the educational benefits of feedback. In this research, we aimed to explore the emotional responses that instructors experienced through the giving and receiving of assessment feedback. We undertook qualitative data collection, carrying out individual semi-structured interviews with instructors from three universities who had administered a dialogic feed-forward intervention on one of their teaching units. The full interview transcripts were analysed inductively using thematic analysis. Five main themes emerged from the interview data: 1. Summative written feedback aroused largely negative emotions in instructors because they felt distanced from their students; 2. Instructors experienced a broad range of emotions related to dialogic feedforward encounters, emerging from their proximity to students; 3. Dialogic feed-forward, as an affective encounter, was emotionally challenging for instructors; 4. Dialogic feed-forward built strong learning relationships between students and instructors, strengthening students' sense of belonging; 5. Dialogic feed-forward was transformational for instructors as educators. We consider the implications of our findings for instructors and wider assessment and feedback practices, including emotional labour, promotional reward, and instructor professional development.

The goal of the study is to overcome two main drawbacks of traditional science, technology, engineering, and math (STEM) pedagogical strategies using PBL - lack of student engagement and students who are not prepared for more complex problems. PBL teaching strategies practiced in an introductory class are assessed. Classroom observations and student surveys are used to determine at what level does the PBL affect students' problem-solving skills. For the first half of the semester of the course, traditional lectures were used, during the second half, students are divided into experimental (PBL strategy) and control groups. The results of the survey and student grades are analyzed to determine a statistically significant difference between pre/post-study results. From the students' perspective, there is a significant mean difference between their confidence level in solving problems before and after using PBL and the students earned higher grades compared to the students in the control group.

Lung cancer is the leading cause of cancer related deaths in the US, with 85% of cases classified as non-small cell lung cancer (NSCLC). 20-25% of patients with NSCLC present with resectable disease.

Background: Few studies have considered policies which underpin the promotion of positive behaviour support (PBS). The present study examined policy beliefs about PBS and their relationship to restrictive practices. Methods: Discourse network analysis (a combination of critical discourse analysis and social network analysis) was used. Results: A total of 11 policies were examined from which 38 belief statements were coded. One cluster was identified which promoted 13 dominant beliefs. Dominant discourses related to law, safety and the environment were evident. A conceptual representation of the shared PBS beliefs demonstrated contradictions in PBS policy. Conclusions: There is evidence that PBS policies have become informal rules for using restrictive practices, not reducing them. They are also acting as surrogates to debate conflicts between political, personal and bureaucratic interests. Three recommendations for improved PBS policy are provided.

Assessment feedback should be an integral part of learning in higher education, but students can find this process emotionally and cognitively challenging. Instructors need to consider how to manage students' responses to feedback so that students feel capable of improving their work and maintaining their wellbeing. In this paper, we examine the role of instructor-student relational feed-forward, enacted as a dialogue relating to ongoing assessment, in dissipating student anxiety, enabling productive learning attitudes and behaviours, and supporting wellbeing. We undertook qualitative data collection within two undergraduate teaching units that were adopting a relational feed-forward intervention over the 2019-2020 academic year. Student responses were elicited via small group, semi-structured interviews and personal reflective diaries, and were analysed inductively using thematic analysis. The results demonstrate that relational feed-forward promotes many elements of student feedback literacy, such as appreciating the purpose and value of feedback, judging work against a rubric, exercising volition and agency to act, and managing affect. Students were keen for instructors to help them manage their emotions related to assessment, believing this would promote their wellbeing. We conclude by exploring academic strategies and pedagogies that position relational instructor feedforward as an act of care, and we summarize the key characteristics of emotionally resonant relational feed-forward meetings.

Summative assessments tend to be viewed as high-stakes episodes by students, directly exposing their capabilities as learners. As such, receiving feedback is likely to evoke a variety of emotions that may interact with cognitive engagement and hence the ability to learn. Our research investigated the emotions experienced by undergraduate students in relation to assessment feedback, exploring if these emotions informed their learning attitudes and behaviours. Respondents were drawn from different years of study and subject/major. A qualitative approach was adopted, using small group, semi-structured interviews and reflective diaries. Data were analysed thematically and they revealed that receiving feedback was inherently emotional for students, permeating their wider learning experience positively and negatively. Many students struggled to receive and act upon negative feedback, especially in early years, when it was often taken personally and linked to a sense of failure. Negative emotional responses tended to reduce students' motivation, self-confidence, and self-esteem. Some students, especially in later years of study, demonstrated resilience and engagement in response to negative feedback. By contrast, positive feedback evoked intense but fleeting emotions. Positive feedback made students feel cared about, validating their self-worth and increasing their confidence, but it was not always motivational. The paper concludes with recommendations for instructors, highlighting a need to communicate feedback carefully and to develop student and staff feedback literacies.

Despite research investment and a growing body of diverse evidence there has been no comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those in medicine and other public health fields. The National Academies of Sciences, Engineering, and Medicine convened an ad hoc committee to develop and use methods for grading and synthesizing diverse types of evidence to create a single certainty of intervention-related evidence to support recommendations for Public Health Emergency Preparedness and Response Research. A 13-step consensus building method was used. Experts were first canvassed in public meetings, and a comprehensive review of existing methods was undertaken. Although aspects of existing review methodologies and evidence grading systems were relevant, none adequately covered all requirements for this specific context. Starting with a desire to synthesize diverse sources of evidence not usually included in systematic reviews and using GRADE for assessing certainty and confidence in quantitative and qualitative evidence as the foundation, we developed a mixed-methods synthesis review and grading methodology that drew on (and in some cases adapted) those elements of existing frameworks and methods that were most applicable. Four topics were selected as test cases. The process was operationalized with a suite of method-specific reviews of diverse evidence types for each topic. Further consensus building was undertaken through stakeholder engagement and feedback The NASEM committee's GRADE adaption for mixed-methods reviews will further evolve over time and has yet to be endorsed by the GRADE working group.

In order to realise career and personal goals, as well as financial autonomy and security, many women are pursuing higher education alongside the role of motherhood. Student-mothers face many challenges when engaging in higher education, and many fail to complete their studies. This phenomenological study applies a feminist lens to the choices, motivations and barriers experienced by student-mothers. Data from two focus groups were analysed inductively through a feminist lens to identify emerging themes. The three main themes emerging from the data were: (1) student-mothers' considerations for engaging in blended online learning; (2) the challenges for student-mothers studying through blended online learning; and (3) self-actualisation through blended online higher education. This research makes an important contribution to the literature by illuminating the study-work-life conflict experienced by student-mothers engaging in blended online learning. The findings of this research have implications for both higher education providers and policy makers. The findings highlight the barriers and facilitators facing mothers' return to study via blended online learning and provide key insights for addressing these. Future research would benefit from exploring these issues with a larger and more diverse sample considering the perspectives of mothers from different language, socioeconomic and cultural backgrounds.

ObjectiveThe aim of this study was to identify independent predictors of hospital readmission for patients undergoing lobectomy for lung cancer.Summary background dataHospital readmission after lobectomy is associated with increased mortality. Greater than 80% of the variability associated with readmission after surgery is at the patient level. This underscores the importance of using a data source that includes detailed clinical information.MethodsUsing the Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD), we conducted a retrospective cohort study of patients undergoing elective lobectomy for lung cancer. Three separate multivariable logistic regression models were generated: the first included preoperative variables, the second added intraoperative variables, and the third added postoperative variables. The c statistic was calculated for each model.ResultsThere were 39,734 patients from 277 centers. The 30-day readmission rate was 8.2% (n = 3237). In the final model, postoperative complications had the greatest effect on readmission. Pulmonary embolus {odds ratio [OR] 12.34 [95% confidence interval (CI),7.94-19.18]} and empyema, [OR 11.66 (95% CI, 7.31-18.63)] were associated with the greatest odds of readmission, followed by pleural effusion [OR 7.52 (95% CI, 6.01-9.41)], pneumothorax [OR 5.08 (95% CI, 4.16-6.20)], central neurologic event [OR 3.67 (95% CI, 2.23-6.04)], pneumonia [OR 3.13 (95% CI, 2.43-4.05)], and myocardial infarction [OR 3.16 (95% CI, 1.71-5.82)]. The c statistic for the final model was 0.736.ConclusionsComplications are the main driver of readmission after lobectomy for lung cancer. The highest risk was related to postoperative events requiring a procedure or medical therapy necessitating inpatient care.

BackgroundCurrent smokers undergoing lobectomy are at greater risk of complications than are former smokers. The Society of Thoracic Surgeons (STS) composite score for rating program performance for lobectomy adjusts for smoking status, a modifiable risk factor. This study examined variability in the proportion of current smokers undergoing lobectomy among STS database participants. Additionally, the study determined whether each participant's rating changed if smoking was excluded from the risk adjustment model.MethodsThis is a retrospective analysis of the STS cohort used to develop the composite score for rating program performance for lobectomy. The study summarized the variability among STS database participants for performing lobectomy on current smokers and compared star ratings developed from models with and without smoking status.ResultsThere were 24,912 patients with smoking status data: 23% current smokers, 62% former smokers, and 15% never smokers. There was significant variability among participants in the proportion of current smokers undergoing lobectomy (3% to 48.6%; P < .001). Major morbidity or mortality (composite) was greater in current smokers (12.1%) than in former smokers (8.6%) and never smokers (4.2%) (P < .001). Using the current risk adjustment model, participant star ratings were as follows: 1 star, n = 6 (3.2%); 2 stars, n = 170 (91.4%); and 3 stars, n = 10 (5.4%). When smoking status was excluded from the model, 1 participant shifted from a 2-star to a 3-star program.ConclusionsThere is substantial variability among STS database participants with regard to the proportion of current smokers undergoing lobectomy. However, exclusion of smoking status from the model did not significantly affect participant star rating.

IntroductionMycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, can lead to disfiguring lesions, debilitating pruritus and frequent skin infections. This study assessed response to brentuximab vedotin in patients with MF in the phase III ALCANZA study.MethodsBaseline CD30 levels and large-cell transformation (LCT) status were centrally reviewed in patients with previously-treated CD30-positive MF using ≥2 skin biopsies obtained at screening; eligible patients required ≥1 biopsy with ≥10% CD30 expression. Patients were categorised as CD30min

Background: Little is known about networks for positive behaviour support (PBS) in disability services. This study explores a PBS network to identify influential persons in its promotion and communication. Methods: Quantitative sociometric methods were used to identify persons who occupy positions of either boundary spanning (those that link people and groups) and/or opinion leadership (those that are sought for advice). Results: Nineteen persons were identified. Boundary spanners met all criteria for the position while opinion leaders did not. Conclusions: This is the first published study of a PBS network in disability services and provides insights into persons involved in its systemic promotion. Boundary spanners are effectively bridging the PBS network, yet persons seeking information about PBS are doing so from opinion leaders that do not display a requisite characteristic for this role. These results have implications for the wider utility of PBS within disability service systems.