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In this manuscript, we rely on practices of thinking with and through theory to situate and analyze the discourses of three neoliberal educational reform initiatives. We researched public-facing material from these initiatives to surface how commonsense language and colorblindness is often used to disguise agendas that reaffirm the racial status quo in urban schools and society. We offer strategies for educators, teacher-educators, and administrators to critically respond when they encounter such neoliberal reforms. [ABSTRACT FROM AUTHOR]

The southeastern United States Coastal Plain ecosystem contains baldcypress (Taxodium distichum) swamps and grass‐dominated marshes. These ecosystems also occurred on the exposed continental shelf during lower sea levels but are rarely preserved due to the mechanically erosive nature of transgression and regression. Two presently marine sites on the northeastern Gulf of Mexico's continental shelf contain well‐preserved woody terrestrial sediments that were the subject of previous studies. This study continues the investigation using geochemical (δ13C, δ15N, δ34S) and palynological characteristics of these formerly terrestrial sediments to determine if swamps and/or marshes existed at the time of deposition. The first site is located ∼20 km southeast of Horn Island, Mississippi (MS) and the core has terrestrial sediments radiocarbon dated to 11,066–10,228 (2σ) calibrated years BP (early Holocene). The second site is the "Alabama Underwater Forest" located ∼13 km south of Gulf Shores, Alabama (AL) and the cores have terrestrial sediments optically stimulated luminescence dated to 63 ka (±10 ka, 2σ) to 72 ka (±16 ka, 2σ) (late Pleistocene). Geochemical results for the MS sediments indicate a swamp‐to‐freshwater marsh transitional series, whereas the AL sediments indicate a swamp‐to‐saltwater marsh transitional series, both supported by palynological results. Further exploration of the geochemical results using linear discriminant analysis, trained with published geochemical data, supports the swamp and marsh interpretations. We conclude that the near‐pristine preservation of these woody deposits is not solely due to physical mechanisms, such as rapid burial, but is also coupled with anoxia‐ and euxinia‐driven biogeochemical reactions promoting wood and woody debris preservation in swamp and marsh environments. Plain Language Summary: Scientists have studied unique sites offshore of Alabama and Mississippi that contain soils, peat, wood, and tree stumps. Scientists have determined that the trees from the Alabama site are between 42,000 and 72,000 years old and were alive during the last ice age when sea levels were much lower than today. The Mississippi site contains woody peat sediments about 11,000 years old and occurred when sea levels were rapidly rising globally. These types of formally land‐based sediments are eroded as the sea level rises at the end of the glacial periods. Furthermore, wood and plant matter decay after the plant dies and become part of the soil. We investigated the chemistry of the preserved soils to understand the conditions that lead to their preservation. Chemical and pollen analyses found that these deposits are past swamp and marsh ecosystems that occurred on land similar to those occurring along the United States Gulf Coast today. Swamps and marshes have still waters with little oxygen that stop decay leading to the preservation of the wood and tree stumps. Swamps occur in depressions where water can collect and over time they fill with sediments. These preserved swamp deposits are time capsules from the past. Key Points: Multiple paleo‐terrestrial deposits containing wood and peat are preserved offshore in the northeastern Gulf of MexicoGeochemical and microfossil analyses find that these deposits are past swamp and marsh ecosystemsSwamps and marshes that are anoxic and/or euxinic promote the biogeochemical preservation of woody and organic matter [ABSTRACT FROM AUTHOR]

As rapid genomic testing technology increasingly allows for real‐time answers that could alter management for acutely ill patients, opportunities for genetic counselors to work in inpatient settings will increase. However, genetic counselors' preparedness and the training provided by graduate programs to work in inpatient settings are unknown. We conducted semi‐structured interviews with 13 genetic counselors who provided services in varied inpatient settings to assess genetic counselors' readiness for inpatient positions. We also surveyed members of the Association of Genetic Counseling Program Directors (AGCPD) about inpatient training practices of genetic counseling graduate programs. Genetic counselors were recruited through the National Society of Genetic Counselors (NSGC) Inpatient Special Interest Group listserv and graduate program faculty were recruited through the AGCPD listserv. Some challenges reported by genetic counselors in inpatient settings included working in a fast‐paced hospital environment which necessitated focused interactions with patients; collaborating with diverse providers who may not understand the role of genetic counselors; and navigating grief experiences of families and of themselves as a provider. Although genetic counselors felt that many of their skills developed in graduate school were transferrable to the inpatient setting, those who had minimal or no inpatient exposure in graduate school often described feeling unprepared for working in the inpatient setting. The majority of AGCPD respondents (23/28) indicated their program provided some type of exposure to the inpatient setting for students, the most common (22/23) being an inpatient clinical rotation, which suggests many graduate programs are already recognizing the importance of providing inpatient training. Our findings indicate that while many skills are transferrable to inpatient positions, genetic counselors face unique challenges in inpatient settings. Our results suggest that graduate exposure to the inpatient setting and professional support of inpatient genetic counselors are beneficial to support genetic counselors' preparedness to take on inpatient positions. [ABSTRACT FROM AUTHOR]

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This Article challenges the orthodoxy that First Amendment speech rights can bind only the state. I argue that the primary justification for the freedom of speech is to protect fundamental interests like autonomy, democracy, and knowledge from the kind of extraordinary power over speech available to the state. If so, this justification applies with nearly equal force to any private agents with power over speech rivaling that of the state. Such a class of private agents, which I call quasi-state agents, turns out to be a live possibility once we recognize that state power is more limited than it seems and can be broken down into multiple, equally threatening parts. Quasistate agents might include a limited set of corporations, from the largest social media platforms to powerful private employers. However, because quasi-state agents are not exactly like state agents but pursue important private aims that the state cannot, I argue that the First Amendment might bind them slightly differently (and less demandingly) than it does the state. Drawing on examples from American state and comparative constitutional law, I offer several analytical models for understanding this differential application. [ABSTRACT FROM AUTHOR]

The intersection of bibliographic control and information behavior is explored in 237 issues of CCQ literature published from 1980–2023 using a combination of expanded searches within three prominent journal databases and frequency analysis of the terms "user", "seek", and "behavior" in the approximately 2,391 published items. The database searches, while inconsistent, produced a set of 43 articles (approx. 2%). Frequency and mention rates analysis using Voyant provided unique insight into both high and low occurrences of the terms. Cross-referencing both data sets produced a set of 37 volumes/issues with two prominent clusters between the years of 2009 and 2017. [ABSTRACT FROM AUTHOR]

The article discusses the importance of embracing and preserving our "wildness" in education and research. It highlights the resistance to taming our natural state and the forces that attempt to control and limit our wildness. The authors of the article explore various topics, such as anti-colonialism, speculative civic literacies, and playfully studious teaching, to challenge traditional approaches and promote a more equitable and diverse perspective in teaching and learning. The authors emphasize the need to be aware of the forces that try to steal our wildness and to strive for a better way of living and learning. [Extracted from the article]

INTRODUCTION: We evaluated the associations between celiac disease (CD) prevalence and regional sociodemographic variables in the United States. METHODS: The outcome was CD relative prevalence, defined as number of patients with CD among those in a Medicare registry per 3-digit ZIP code. Linear regression models assessed associations between relative prevalence of CD and sociodemographic variables. RESULTS: CD relative prevalence was positively correlated with median income, urban area, and proximity to a CD specialty center and negatively correlated with Black race, Latino/Hispanic ethnicity, and median social deprivation index score (P < 0.01, all). DISCUSSION: CD relative prevalence is associated with indicators of economic advantage. [ABSTRACT FROM AUTHOR]

425 Background: Artificial Intelligence (AI) has potential benefits in medicine, including improving patient education, but its use in mitigating financial toxicity faced by patients with cancer is unknown. We aimed to investigate the accuracy of ChatGPT, an open access AI, responses to common financial concerns among patients with cancer. Methods: ChatGPT, an open access AI platform, was used to query 50 questions developed using oncologic society websites. These questions encompassed medical (n=25, concerns related to treatment costs) and non-medical financial (n=25, questions related to financial assistance) questions focused on breast, endometrial, lung, colon, and prostate cancers. The responses were scored by two financial toxicity experts with the scale: 1) correct and comprehensive, 2) correct but not comprehensive, 3) some correct, some incorrect components and 4) completely incorrect. Score discrepancies were resolved with a third reviewer. In secondary analysis, all questions were queried 3 times to assess if ChatGPT gave different/improved responses. The proportion of responses earning each score were calculated overall, within each category, and by disease site. Results: Overall, in the first queries, 84% of questions were scored as correct but not comprehensive (n=42/50) and 6% (n=3/50) of questions were scored as having both correct and incorrect components. Approximately 28% (n=14/50) of questions had discrepant scores that required third party review, and 10% (n=5/50) of questions never achieved a consensus. All non-medical questions were scored as correct but not comprehensive (n=25/25) with a concordance rate of 96% (n=24/25), with only 1 question sent to a third reviewer. Additional queries of non-medical questions did not yield different answers. For the medical questions, approximately 68% (n=17/25) of questions were scored as correct but not comprehensive and 12% (n=3/25) were scored as having correct and incorrect components. 52% (n=13/25) of questions were sent to a third reviewer, and 20% (n=5/25) of questions never achieved a consensus score. While additional queries of medical questions yielded different answers, the quality of the responses did not improve. For each disease site, prostate cancer questions had the highest number of discordant questions with 40% (n=4/10) that were sent to a third reviewer for scoring but a 100% (n=10/10) of responses had a score that showed correct but not comprehensive answers. Reviewer feedback was universal that ChatGPT responses did not provide helpful information to patients, even in the situations in which there was technically no inaccurate information. Conclusions: ChatGPT does not consistently provide accurate or helpful answers to financial toxicity concerns commonly asked by patients with cancer. Additional input from experts is necessary to aid in AI learning before this resource should be used by patients facing financial toxicity. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy (HCM) is a common hereditary condition affecting approximately 1 in 500 adults. It is characterized by marked clinical heterogeneity with individuals experiencing minimal to no symptoms, while others may have more severe outcomes including heart failure and sudden cardiac death. Genetic testing for HCM is increasingly available due to advances in DNA sequencing technologies and reduced costs. While a diagnosis of HCM is a well-supported indication for genetic testing and genetic counseling, incorporation of genetic services into the clinical setting is often limited outside of expert centers. As genetic counseling and testing have become more accessible and convenient, optimal integration of genomic data into the clinical care of individuals with HCM should be instituted, including delivery via genetic counseling. Drawing on recommendations from recent disease guidelines and systematic evidence reviews, we highlight key recommendations for HCM genetic testing and counseling. This practice resource provides a comprehensive framework to guide healthcare providers in the process of genetic test selection, variant classification, and cascade testing for genetic evaluation of HCM., (© 2024 The Author(s). Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.)

Genetic counseling is an important component of pediatric cardiac care. The financial costs and benefits of this care have yet to be defined in the literature. Downstream revenue (DSR) analysis can be used to assess the economic impact of genetic counselors (GCs) at their institution beyond the initial patient contact. Previous literature has reported DSR generated by oncology GCs, but there is no published DSR data from a cardiac GC setting. This study measured the DSR generated at a private hospital following a cardiac GC appointment. A chart review identified patients seen by a cardiac GC between 2018 and 2022. The study population included patients and their pediatric relatives who had not previously seen a cardiologist. Patients were included if they were affected with or at-risk for long QT syndrome, hypertrophic cardiomyopathy, dilated cardiomyopathy, or familial thoracic aortic aneurysm at the time of the GC visit. We recorded the frequency of common cardiac services and calculated the reimbursement for all cardiology services for 1 year following the initial GC appointment. The cohort included 121 participants from 61 families. Most individuals were at-risk for (n = 114, 94.3%) rather than affected by an inherited cardiac condition and presented for screening. The total DSR was $247,592.27, with an annual median of $1819.50 per patient (IQR $0, $3761.33). Revenue was similar among individuals who had undergone genetic testing and those who had not. Among participants, 72 (59.5%) had subsequent cardiology services. Most frequently, a patient who presented for subsequent care had an EKG, an echocardiogram, and a cardiology appointment. While the economic contributions of GC services do not speak to the broader value of GC involvement in patient care, they are important metrics for sustainability. This study outlines an approach to evaluating DSR and establishes a baseline understanding of DSR related to cardiac GC services., (© 2024 The Author(s). Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.)

Introduction As part of the Milestones Initiative of the Accreditation Council for Graduate Medical Education (ACGME), residents in neurosurgery are expected to participate in either clinical research or basic science research. Therefore, each neurosurgical training program must offer the support and opportunity to achieve this goal. In 2012, a structured effort to promote a resident culture of research was introduced into the authors' neurosurgery residency training curriculum. This study reviews this experience over the last decade. Methods Data were collected from the authors' departmental neurosurgery website and Scopus to create a database of neurosurgical residents who graduated 10 years before and after 2012 and their publication output. Bibliometric measures were collected for all articles published by residents. Results were compared between residents who graduated before and after the introduction of the research initiative. Results A total of 127 publications were analyzed from 37 residents, constituting 174 authorships. There was a statistically significant increase in the number of publications per resident (P < 0.001), citation number per author (P = 0.002), and author h-index (P < 0.001) after implementing the initiative. There were no significant differences in the pre-residency and baseline demographic variables between the two groups. Conclusion This study relates the experience of initiating a research culture at the authors' neurosurgery training program, which did not emphasize scholarly productivity historically. The effort focused on creating a culture of curiosity as opposed to formal requirements. The results provided evidence that this strategy yielded a significant increase in academic output and impact. These findings have important implications for neurosurgical training programs., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Motiwala et al.)

Background: Community pharmacists are often the most accessible member of the healthcare team to many patients and can play a key role in managing their chronic conditions, such as diabetes or heart disease, through enhanced pharmacy services. Despite their accessibility, pharmacy services are often underutilized due, in part, to a lack of adequate reimbursement models that comprehensively encapsulate all elements of those pharmacy services. While routine documentation of services does collect certain qualitative data, they do not always indicate the nuance of the full scope of services with resulting robust impact and value of those services for the patient and healthcare system. Objective: To develop and pilot an online reporting tool for pharmacist documentation of high impact patient intervention "stories" that includes the nuances of care provision processes in outpatient pharmacy settings that promote positive outcomes. Methods: An online Patient Stories Reporting Tool (PRST) was developed to allow outpatient pharmacists to document details on distinct direct patient care encounters, or "stories", that they felt showcased their value. Documentation through PSRT included limited quantitative data and qualitative data with a focus on a free response narrative for the "story". In a pilot, the PSRT was distributed to 18 pharmacists across 16 practice sites from one partnering pharmacy organization. Qualitative data, the focus of the included analysis, was collected, assessed by project team members, and organized by intervention types. Results: Forty-seven stories involving 17 pharmacists across 13 practice sites from August 2021 to March 2023 were reported. Three types of key intervention stories were identified including General Patient Education (7 stories), Medication Optimization (20 stories), and Cost Reduction (20 stories). Given the nature and scope of this initial pilot, one story for each of the three most prevalent intervention types was identified as exemplifying the types of stories the tool can collect and are subsequently discussed in detail. Conclusions: The three selected stories help to characterize the services pharmacists provide, the critical components of pharmacist-patient interactions, and the value of sharing these stories utilizing tools such as the PSRT. Through these stories, the PSRT also begins to record the nuances of pharmacist interventions and the impact they can make in a patient's healthcare journey. Potential applications of the tool are multivarious including supporting improvements in the perception of pharmacists' roles on the healthcare team and justifying expansion of reimbursement models., (© Individual authors.)

Background: Student-completed course evaluations are often included in university faculty promotion and tenure packets but may not be the best metrics for student learning. This juxtaposition creates a challenge - the metric faculty first want to improve is student learning rather than student perception, but course changes improving student learning do not always result in higher course evaluation scores. Additionally, making course changes can be time consuming for faculty. The objective of this project was to assess the changes made to a course, the time spent making those changes, and the impact of the changes on course evaluation scores and student performance., Educational Activity: A single course focused on management with a business plan as the primary course project was revised in Fall 2023; the goal of revisions was to address poor course evaluation scores and negative student perceptions of the course in as little faculty time as possible while maintaining quality of student work. Primary changes centered around the business plan project and a shift in course communication. Evaluation of the changes occurred through mid-semester survey and discussion and end-of-semester survey for the 2023 cohort, and comparing course evaluations and student work products between the 2022 and 2023 cohorts., Critical Analysis of the Educational Activity: Course evaluation scores were improved and student feedback was more positive for the revised Fall 2023 course. The implemented changes did not negatively affect student performance as quality of the business plan project was maintained across both semesters. Instructor transparency and responsiveness through the mid-semester survey and discussion may have positively influenced course evaluations scores. Overall, the course changes did not take a significant amount of faculty time, but the desired outcome of improving course evaluation scores was recognized., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest. The authors have no funding sources to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)