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Attitudes to sign languages or language policies are often not overtly discussed or recorded but they influence deaf young people's educational opportunities and outcomes. Two qualitative studies from Scotland investigate the provision of British Sign Language as accommodation in public examinations. The first explores the views of deaf pupils and staff about the official system for face-to-face interpretation of exam papers. The second investigates a centrally translated digital paper with embedded video questions. Discussion focuses on contrasts between the USA and UK approaches to accommodations, raising issues of standardized technical terms in signed languages, the right to respond in sign, and candidate choice.

This article reviews Education for Sustainability (EfS) in the secondary sector across a range of countries. Drawing on journal articles, book chapters and official reports, it identifies some of the more successful approaches to implementing EfS within the secondary sector. The authors first discuss the importance of educating for sustainability at the secondary level and then explore barriers to effective EfS in secondary schools. They go on to share their insights into contextual factors that influence EfS practices which are reported in the case studies. In particular, they discuss the influence of (a) politics and curriculum renewal, (b) alignment of curriculum, resources and teaching, (c) the perceived state of EfS and (d) teachers' professional development as determinants of EfS implementation and success.

This qualitative study investigated the perspectives of preservice teachers from the United States on the customs and practices of teaching in primary schools in England resulting from their participation in a study abroad experience. Participants were 17 teacher education candidates from a university in the southeastern United States who studied in primary schools in England for a four-week internship. Data were collected from student reflective journals, tutors' observations, and of the study abroad experience by three researchers who also serve as tutors for the programme. The researchers used a hermeneutic approach to interpret the preservice teachers' narratives of their experience and their perceptions of the customs and practices that were distinct to the English context. Emerging themes were organised into the following four categories: learner-centred and holistic approaches, planning and delivery of curriculum, the structured system with relaxed interactions and the role of the school in the community. Findings are discussed in relation to research and policy discourses in the US and the UK.

Findings from this investigation suggest that spirituality is a vital component for teacher and student success in high stress educational settings. The study investigated how experienced teachers of violent students maintained teacher efficacy through stress management in four schools in one state within the USA. Most educators consider working with these pupils very challenging, which has resulted in a shortage of experienced educators willing to teach this population. Yet some teachers maintain their effectiveness teaching these challenging students. Within this study, spirituality helped them to maintain efficacy through anxiety reduction and by functioning as a "tool" to connect with students. Some specific methods included Bible reading, meditation, prayer, Pantheism and martial arts. This study relates to the growing body of literature that indicates that spirituality benefits humans physically, psychologically and sociologically. (Contains 1 table.)

This research examines the perceptions of early childhood preservice teachers in relation to earning the techniques of pedagogic documentation with young children. Data sources are preservice teachers' written responses to questions related to using technologies associated with pedagogic documentation such as photography and video recording, as well as their thoughts on the process and purposes of pedagogic documentation in early childhood education. The data were drawn from preservice teachers who were enrolled in an upper division course in an early childhood teacher preparation program at a major University in the southern United States. Findings include preservice teachers' articulations of apprehensions related to human-technological interfaces, clear preferences for photography over video as a media for documentation in the classroom, and conceptions of documentation as a technique for children's learning as well as for their own professional development. Implications for early childhood teacher educators are discussed.

Substance abuse in the United States has reached catastrophic proportions. 23.6 million people needed treatment for an illicit drug or alcohol use problem (1). According to the National Association of Social Workers, 60% of all mental health services are carried out by social workers (3). Therefore, social workers are in a critical and unique position to address substance abuse. This study examined the education and training new social workers receive at 216 graduate programs accredited or in-candidacy for accreditation by the Council of Social Work Education. An overwhelming number did not have substance abuse courses as a requirement for all students, and a significant number did not have one course dedicated to substance abuse. These astounding deficiencies can only be described as an "institutional denial or minimization".

This research examines the experiences of elementary and early childhood pre-service teachers from the U.S. engaged in a month long study abroad internship program in England. Using data from participants written journals, we use a hermeneutic approach to interrogate their evolving sense of professional development and their understanding of cultural differences in the internship in England. Informed by a theoretical framework of consonance and dissonance (Cochran-Smith, M. (1991). Reinventing student teaching. "Journal of Teacher Education", 42(2), 104-118), the emerging themes were related to the school context, the teacher's role, the learners, the buildings, and the community. Implications are for planning and facilitation of pre-service teachers study abroad experiences are discussed. (Contains 1 table.)

The alternative education field lacks a common definition and has a major divide between the differing philosophies of alternative programs; little empirical evidence is available to identify the components necessary to create effective alternative educational programs. Tremendous growth in the availability of alternative programs in the United States over the past several decades, however, illustrates continuing demand for such programs as well as the need for research on the characteristics that constitute effective alternative programs. In this article, the authors study exemplary alternative programs in 3 racially and economically diverse communities to characterize the school climate as viewed by the students and the staff. At this relatively early stage in the field of alternative education, it is essential to examine the similarities, as well as any differences, in the social climate of highly effective alternative programs and to consider their potential relationship with student academic and behavioral success. Furthermore, it is important to recognize how these findings might be one foundation for future inquiry and research on alternative education.

The authors performed a statistical analysis to investigate whether grade inflation existed in the business school at a small private college in the northeast region of the United States. The results showed that grade inflation existed and exhibited a linear trend over a 20-year period. The authors found that grade inflation was related to faculty status with significant differences seen between mean grade point averages of students being taught by tenured and adjunct faculty and between those students taught by nontenured and adjunct faculty. They also found that average grades given by adjunct faculty were higher than those of either tenured or nontenured faculty. Thus, the results indicate the increased use of adjunct faculty exacerbates grade inflation in higher education.

Improving our knowledge of the number of incarcerated youth with disabilities can assist educators, other professionals, and policymakers to develop more effective services for youth. This article reports the findings of a national survey conducted to determine the number of youth identified as having disabilities in the juvenile corrections systems in the United States. The data show that, when compared to the national average, there is an overrepresentation of students identified as having disabilities, especially emotional disturbance, in those systems.

Nearly a quarter-million children are siblings to children living with serious illness. Intense physical, emotional, social and psychological concerns are introduced when a brother or sister is diagnosed with a serious illness or disease. Support services for siblings are critical to promote positive outcomes and decrease negative consequences and align with parents' desires to support all of their children. These include services offered to the sibling or family to provide comfort or enhance the quality of life during a child's serious illness. Despite national standards, sibling support services are often difficult for families to access. The aim of this study was to describe sibling support activities provided through teaching children's hospitals across the United States using a cross-sectional, descriptive design. Results indicate most hospitals surveyed offer sibling support services that focus on sibling education about the illness; parent education on how to anticipate the siblings needs; and activities for families to do together, yet face barriers to delivery. Services focused directly on siblings and actively supporting their adaptation were least often provided and less than half reported screening siblings for psychosocial distress. Findings suggest that sibling support services may be an important resource to minimize distress and promote adaptation for siblings. This description of current and available sibling support services is an important starting point for enhancing services, policies, and institutions that fully envelope siblings into patient- and family-centered care. [ABSTRACT FROM AUTHOR]

This pilot outcome evaluation assesses the effectiveness of an online curriculum, the Keystones of Development, aimed at improving residents' knowledge, attitudes, and reported behaviors around promoting positive parenting and childhood development in well-child visits. We used an explanatory mixed-methods approach, including a single-arm pre-posttest of intervention effects on self-reported behavioral outcomes (discussing, modeling, and praising) and secondary outcomes (knowledge, perceived barriers, attitudes, and self-efficacy). Following this, a subset of residents participated in in-depth interviews to describe participant responses to the intervention. The study was conducted at 8 pediatric residency programs across the United States with 67 pediatric residents (mean age = 29; 79% female; 57% PGY1). Within one month postintervention, there was a statistically significant increase in the behaviors that promote positive parenting: discussing (P <. 01;d = 0.73) and modeling (P <. 01;d = 0.61) but not praising (P =. 05; d = 0.3). Significant changes in the secondary outcomes: knowledge (P <. 01), perceived barriers, (P <. 01), and retrospective self-efficacy (P <. 01) were seen. Interviews revealed that integration of curriculum content into clinical practice was due to the relevance of the material to primary care and the modeling of how to apply in the clinical setting. Curriculum format, content, and clinical application helped participants weave recommendations into the well-child visit. In this study, we demonstrated that the online curriculum, Keystones of Development , increased resident behaviors, knowledge, and self-efficacy, and decreased perceived barriers to promote parenting behaviors associated with improved child development outcomes in well-child visits. These findings were observed across participants demonstrating equal success regardless of demographic characteristics or study site. [ABSTRACT FROM AUTHOR]

Quality leadership is a critical variable in the effort to promote school improvement. Professional development programs for experienced and prospective school principals represent a powerful strategy that links leaders with the ultimate objective of student achievement. To be more effective, the training of school administrators must revolve around a core of recognized leadership standards that provide leaders with a framework for effective practice. This article offers a descriptive review of professional development programs for school leaders in the United States and in England.

In most states, lieutenant governors operate as built-in governors-in-waiting. But in the early days of the United States, relatively few lieutenant governors existed--and in the states without them, governors were usually succeeded by legislative, or quasi-legislative, officers. The adoption of lieutenant governorships, which primarily took place during the nineteenth century, reflects the culmination of a long trend in state constitutional law toward the democratization of state institutions. The story of gubernatorial succession is primarily the story of how lieutenant governors were created. But it is more than that-- it is the story of how state separation-of-powers systems evolved over time, how legislators lost their perch in the line of gubernatorial succession, how other state officers were created and positioned as gubernatorial successors, and how small features of state constitutional law became polarizing issues in constitutional development. It is also a story of incompletion. Many states today lack lieutenant governors, or provide for a method of lieutenant-gubernatorial election that defies the logic for establishing such an office in the first place. This Article tells each of these stories, recounting in detail the history of gubernatorial succession, using that history to extract a narrative of democratization, and arguing that there remain undemocratic vestiges in current gubernatorial succession provisions that ought to be reformed. [ABSTRACT FROM AUTHOR]

Background: Although controversial, early administration of tranexamic acid (TXA) has been shown to reduce mortality in adult patients with major trauma. Tranexamic acid has also been successfully used in elective pediatric surgery, with significant reduction in blood loss and transfusion requirements. There are limited data to guide its use in pediatric trauma patients. We sought to determine the current practices for TXA administration in pediatric trauma patients in the United States. Methods: A survey was conducted of all the American College of Surgeons-verified Level I and II trauma centers in the United States. The survey data underwent quantitative analysis. Results: Of the 363 Level I and II qualifying centers, we received responses from 220 for an overall response rate of 61%. Eighty of 99 verified pediatric trauma centers responded for a pediatric trauma center response rate of 81%. Of all responding centers, 148 (67%) reported they care for pediatric trauma patients, with an average of 513 pediatric trauma patients annually. The pediatric trauma centers report caring for an average of 650 pediatric trauma patients annually. Of all centers caring for pediatric trauma, 52 (35%) report using TXA, with the most common initial dosing being 15 mg/kg (68%). A follow-up infusion was utilized by 45 (87%) of the programs, most commonly dosed at 2 mg/kg/hr × 8 hr utilized by 24 centers (54%). Conclusion: Although the clinical evidence for TXA in pediatric trauma patients is limited, we believe that consideration should be given for use in major trauma with hemodynamic instability or significant risk for ongoing hemorrhage. If available, resuscitation should be guided by thromboelastography to identify candidates who would most benefit from antithrombolytic administration. This represents a low-cost/low-risk and high-yield therapy for pediatric trauma patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Our Cooling to Help Injured Lungs (CHILL) trial of therapeutic hypothermia in ARDS includes neuromuscular blockade (NMB) as an inclusion criterion to avoid shivering. NMB has been used to facilitate mechanical ventilation in ARDS and was shown to reduce mortality in the ACURASYS trial. To assess the feasibility of a multi-center CHILL trial, we conducted a survey of academic intensivists about their NMB use in patients with ARDS. METHODS: We distributed via email a 16-question survey about NMB use in patients with ARDS including frequency, indications, and dosing strategy. RESULTS: 212 (24.3%) of 871 respondents completed the survey: 94.7% were board-certified in internal medicine, 88% in pulmonary and critical care; 90.3% practiced in academic medical centers, with 87% working in medical ICUs; 96.6% of respondents who treat ARDS use NMB, and 39.7% use NMB in ≥ 50% of these patients. Of 4 listed indications for initiating NMB in ARDS, allowing adherence with lung-protective ventilator strategies and patient--ventilator synchrony were cited as the most important reasons, followed by the results of the ACURASYS trial and facilitating prone positioning. CONCLUSIONS: We conclude that NMB is frequently used by academic intensivists to facilitate mechanical ventilation in patients with moderate to severe ARDS. [ABSTRACT FROM AUTHOR]

The author argues that collective bargaining procedures and relationships bewteen labor and management must reflect less conflict and more cooperation as the nation's economy struggles to meet international competition and domestic needs. (Author/SSH)

Finns are proud of their uniformly high-quality schools. Unlike in the United States, where parents fret about getting their children into "good" and often private schools with restrictive enrollment, virtually all schools are public, and most Finnish parents send their children to the school closest to their home. Teaching is a desirable profession in Finland, albeit not very highly paid, and also largely female. Teaching is seen as comparable to information technology employment; it is considered exciting and contemporary work. The master's-level degree program for teachers is free, as is all education in Finland. The government also provides a monthly allowance, housing, meals, and free health care. Once employed, teachers enjoy a good deal of respect, autonomy, and responsibility, and the benefits of strong union representation. Teachers and professors are part of the same union, and even teacher education students have a union. In this article, the author reflects on her experiences in Finland.

The central purpose of scientific research and emerging dental health technologies is to improve care for patients and achieve health equity. The Impact of Scientific Technologies and Discoveries on Oral Health Globally workshop conducted joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, highlighted innovative technologies and scientific discoveries to support personalized dental care in an academic and clinical setting. The 2019 workshop built upon the new ideas and way forward identified in the 2017 ADEE-ADEA joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education II held in London. During the most recent workshop the approach was to explore the "Teaching Clinic of the Future". Participants applied ideas proposed by keynote speakers, Dr. Walji and Dr. Vervoorn to educational models (Logic Model) in an ideal dental education setting. It is only through this continuous improvement of our use of scientific and technological advances that dental education will be able to convey to students the cognitive skills required to continually adapt to the changes that will affect them and consequently their patients throughout their career. This workshop was a valuable experience for highlighting opportunities and challenges for all stakeholders when aiming to incorporate new technologies to facilitate patient care and students' education. [ABSTRACT FROM AUTHOR]

Courtroom sentencing, as part of the judicial process, is a long-standing norm in the justice system of the United States. But this basic criminal law precept is currently under quiet attack. This is because some states are now allowing parole boards to step in to decide criminal penalties without first affording defendants lawful judicial branch sentencing proceedings and sentences. These outside-of-court punishment decisions are occurring in the cases of youthful offenders entitled to sentencing relief under Miller v. Alabama, which outlawed automatic life-without-parole sentences for children. Thus, some Miller-impacted defendants are being sentenced by paroleboards as executive branch agents, rather than by the judicial branch of government. Parole board punishments serve as a somewhat shocking turn of events, particularly since the right to be sentenced in a courtroom, rather than some other government-run venue, seems so unquestionable. But quite surprisingly, that right is not contained in the text of the U.S. Constitution. Nor has the matter been squarely addressed by legal scholars or the Supreme Court. Instead, both the Court and respected commentators have been writing around the issue for years. Nevertheless, allowing executive branch bodies to become sole deciders of penalty terms-- up to and including life without parole--is more than highly unusual. It is deeply problematic as a matter of law, policy, and precedent. Failing to take action to rein in this emerging practice could result in serious consequences, not just in Miller matters, but beyond. As executive branch agencies, the parole boards have not been called upon to entirely displace the judicial branch to serve both as front-end penalty adjudicators responsible for proportionality, narrowing, and mitigation assessments, as well as early-release gatekeepers evaluating reform and risk for reoffending. In fact, parole-grant determinations are seen as highly informal proceedings, made behind closed doors, without court-level due process protections or even involvement of defense counsel. And the interests, roles, and experiences of parole agency officials are far different from the legally trained judiciary who oversee court-based penalty processes. For all these reasons, permitting parole board displacement of sentencing courts in Miller matters, or otherwise, is not just inadvisable, but highly injudicious. This article, therefore, calls for recommitment to the right of court-centered sentencing practices for Miller cases and beyond. It is the first scholarly account of why this is the constitutionally required path in cases involving the punishment of imprisonment as well as the preferred policy given contemporary parole board practices and culture. [ABSTRACT FROM AUTHOR]

Background: Evidence indicates that fewer non-Hispanic black versus non-Hispanic white youths with type 1 diabetes are meeting treatment goals for optimal glycemic outcomes, predisposing them to risks for cardiovascular (CV) morbidity and mortality in adulthood. Purpose: We sought to assess the association of sex and race with heart rate variability (HRV) and cardiorespiratory fitness in adolescents with type 1 diabetes. The association between the HRVand cardiorespiratory outcomes with glucose control was also examined. Methods: A secondary data analysis of 95 adolescents with type 1 diabetes (n = 66 non-Hispanic white n = 29 non-Hispanic black) was used. Using 24-hour Holter recordings, spectral and time domain measures of HRV were obtained. Cardiorespiratory fitness using a graded exercise test was completed. Descriptive statistics and Pearson correlation coefficients were used to assess associations between glucose control and study outcomes, and general linear models were applied to explore and quantify associations of sex and race with HRV and cardiorespiratory fitness. Results: Body mass index (mean [standard deviation]) was similar between non-Hispanic black (23.5 [3.9]) and non-Hispanic white (22.7 [3.8]) adolescents. Females and non-Hispanic black adolescents had significantly lower HRV and cardiorespiratory fitness levels. Moderate associations were found between lower HRV and poorer glycemic control (HbA1c). Recent HbA1c was significantly higher in non-Hispanic black (9.7 [1.8]) than non-Hispanic white (8.2 [1.2]). Conclusion: Findings support the importance of early identification of CV health risks in adolescents with type 1 diabetes, particularly for non-Hispanic black adolescents. Interventions focused on overall improvement in glycemic control for adolescents with type 1 diabetes are a priority for minimizing future CV complications. [ABSTRACT FROM AUTHOR]

Most US hospitals conduct patient experience surveys by mail or telephone after discharge to assess patient/family centeredness of care. Pediatric response rates are usually very low, especially for black, Latino, and low-income respondents. We investigated whether day of discharge surveying using tablets improves response rates and respondent representativeness. This was a quasi-experimental study of parents of patients discharged from 4 units of a children's hospital. Parents were assigned to receive the Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) via an audio-enabled tablet before discharge or via mail at approximately 1 week postdischarge. Intervention and control conditions alternated by week. We compared response rates, child/respondent characteristics, and mean top-box scores between tablet and mail only arms. Administering Child HCAHPS on a tablet was administratively feasible and did not interfere with the discharge process (median completion time, 12.4 minutes). The response rate was 71.1% (424 of 596) for tablet versus 16.3% (96 of 588) for mail only. Although the tablet response rate was higher in every subgroup, tablet respondents were more likely to be fathers (20.4% vs 6.4%; P =.006), more likely to have a high school education or less (17.5% vs 8.4%; P =.002), less likely to be white (56.8% vs 71.9%; P =.006), and more likely to be publicly insured (31.4% vs 19.8%; P =.02). Tablet scores were significantly higher than mail only scores for 3 of 17 measures. The response rate for day of discharge tablet survey administration was >4-fold higher than with single-wave mail-only administration, with greater participation of hard-to-reach groups. These findings suggest tablet administration before discharge shows great promise for real-time feedback and QI and may transform the field of inpatient survey administration. [ABSTRACT FROM AUTHOR]

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Medicaid can improve beneficiary health and help sustain its own future by embracing payment for outcomes. Good precedents exist from states such as Florida, Maryland, Minnesota, New York, Ohio, Pennsylvania, and Texas. Medicaid outcome measures include preventable admissions, readmissions, emergency department visits, and inpatient complications; early elective deliveries; infant and child mortality; patient-reported outcomes, satisfaction, and confidence; and reduction in low-value care. Criteria to prioritize initiatives include potential savings, availability of established models, impact on health status, and Medicaid's ability to effect change. We offer 5 principles for success, emphasizing clinically credible initiatives that generate actionable information for clinicians. [ABSTRACT FROM AUTHOR]

In this brief, recent actions related to school discipline, discipline disparities in schools, the school-to-prison pipeline, and the added costs of suspending students in the U.S. are explored. The recommendations offered focus on how school leaders and policy makers can address disparities and how school cultures can be changed to reduce the number of detentions, suspensions, and expulsions. [ABSTRACT FROM AUTHOR]

Importance: Motor vehicle crashes (MVCs) are a major public health problem. Research has demonstrated that individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely to experience MVCs, but the effect of ADHD medication treatment on the risk of MVCs remains unclear.Objective: To explore associations between ADHD medication use and risk of MVCs in a large cohort of patients with ADHD.Design, Setting, and Participants: For this study, a US national cohort of patients with ADHD (n = 2 319 450) was identified from commercial health insurance claims between January 1, 2005, and December 31, 2014, and followed up for emergency department visits for MVCs. The study used within-individual analyses to compare the risk of MVCs during months in which patients received ADHD medication with the risk of MVCs during months in which they did not receive ADHD medication.Exposures: Dispensed prescription of ADHD medications.Main Outcomes and Measures: Emergency department visits for MVCs.Results: Among 2 319 450 patients identified with ADHD, the mean (SD) age was 32.5 (12.8) years, and 51.7% were female. In the within-individual analyses, male patients with ADHD had a 38% (odds ratio, 0.62; 95% CI, 0.56-0.67) lower risk of MVCs in months when receiving ADHD medication compared with months when not receiving medication, and female patients had a 42% (odds ratio, 0.58; 95% CI, 0.53-0.62) lower risk of MVCs in months when receiving ADHD medication. Similar reductions were found across all age groups, across multiple sensitivity analyses, and when considering the long-term association between ADHD medication use and MVCs. Estimates of the population-attributable fraction suggested that up to 22.1% of the MVCs in patients with ADHD could have been avoided if they had received medication during the entire follow-up.Conclusions and Relevance: Among patients with ADHD, rates of MVCs were lower during periods when they received ADHD medication. Considering the high prevalence of ADHD and its association with MVCs, these findings warrant attention to this prevalent and preventable cause of mortality and morbidity. [ABSTRACT FROM AUTHOR]

A review of the article "The Power of Positive Publishing: How Self-Help Ate America" by Boris Kachka is presented.

As Medicaid expands in scope and influence, it is evolving toward being a “purchaser” of quality health care. This commentary discusses measurement and incentivization of clinical outcomes in Medicaid. Advantages and disadvantages of outcome versus process measures are discussed. Distinctions are drawn between the roles of Medicare and Medicaid, including the implications of the growth in Medicaid managed care. Medicaid's influence is particularly notable for obstetric, pediatric, newborn, and long-term care. We provide data on 3 Medicaid outcomes: potentially preventable hospital admissions, readmissions, and complications. The commentary concludes with suggestions for choosing and implementing outcome-oriented value-based purchasing initiatives in Medicaid. [ABSTRACT FROM AUTHOR]