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This paper explores some of the basic similarities and differences between fault-based and no-fault systems of automobile accident insurance from the perspective of a U.S. state and the laws of Macedonia. The majorities of U.S. states have adopted an at-fault system of compensation and therefore share more similarities with Macedonia than the laws of a dozen U.S. states that have adopted a no-fault system. Whereas Macedonia employs a system of nearly universal health care, such is not the case in the United States. The respective states have adopted either a fault-based system or a no-fault system, but in either case issues of coverage for automobile accidents is more complicated for the lack of a nationalized health care system that at minimum acts as a safety net for treatment of injuries related to automobile accidents. It is posited that complications relating to the lack of universal health care coverage in the United States has led to significantly heightened regulatory intervention by the several states such that the similarities between the free-market approach of the states and of civil law (code) systems are greater than the differences. The paper is not based on empirical data of the legal systems or the medical systems, nor is the undeniable interrelation between a medical system and the corresponding legal system with regard to insurance coverage of primarily health-based issues considered other than to highlight how both may play a part in regulation of the automobile accident insurance industry in light the involvement of public health, safety and welfare.

Education policymakers have long sought to reduce persistent achievement disparities between students of color and White students with varying levels of success. Understanding the different needs and obstacles faced by students and families of color is important given educating all individuals for our future U.S. society is a priority. Educational policy should reflect the assumption that race matters and continues to impact educational opportunity. This paper argues that race-conscious professional teaching standards could extend the structural boundaries of teacher practice when working with racially, culturally, and linguistically diverse students. Using discourse analysis to analyze the deeper meanings of selected states' teaching standards in different sociopolitical contexts, this paper describes the challenges and opportunities for infusing race-conscious perspectives in teaching standards. Implications for how states' teaching policy language actively creates and builds teaching and learning environments are discussed.

Neuroendocrine analyses of posttraumatic stress disorder (PTSD) have generally focused on hypothalamic-pituitary-adrenal (HPA) axis alterations. In the present analyses, we examine two additional neuroendocrine factors that have been previously implicated in biological stress responses: oxytocin (OT) and arginine vasopressin (AVP). Here we examined basal neuropeptide status in military veterans clinically diagnosed with PTSD (n = 29) and in two non-traumatized comparison groups with previous stress exposure (n = 11 SWAT trainees and n = 21 ultramarathon runners). PTSD patients showed low levels of plasma OT and high levels of AVP. The ratio of AVP/OT robustly related to PTSD status, and emerged as a statistically plausible mediator of relationships between the number of personal traumatic experiences and subsequent PTSD symptom burden. Over the course of behavioral therapy for PTSD, measures of OT showed a significant but modest normalization. Plasma cortisol levels were not statistically different among the three groups. This study suggests that AVP/OT ratios may represent a neuroendocrine predictor of severe PTSD, as well as a potential treatment response biomarker.

Canadian occupational therapy (OT) university programs must teach change agent competencies. These include promoting social justice and empowering clients, which United States occupational therapists also do. Change agent competency requirements are challenging to teach and involve multidisciplinary knowledge and non-traditional skills. As few occupational therapists feel competent to act as change agents, university programs must engage in a scholarship of teaching and learning (SoTL) approach and identify areas of improvement. The aim of this study, informed by SoTL, was to document, as described by participants, the pedagogical activities related to teaching the change agent role in an OT program in Canada and explore possible curricular improvements. Two online 90-minute focus group meetings were held: one with ten teaching team members, the other with six current and past students. Participants were questioned regarding current formal and informal curricular activities, barriers that influenced competency development, and activities that could help improve it. Data were analyzed thematically. Actual informative teaching activities, such as ethics and multicultural courses, were deemed helpful but insufficient, with only one transformative course in the curriculum. Barriers such as a rigid, biomedical-based program structure also affected competency acquisition. Solutions to improve acquisition included mentorship and recognition of relevant extracurricular projects by the programs. SoTL offers a reflective lens to learn from collective experiences. This study showed the importance of involving students and faculty in program development and delivery improvements in order to better support educators and program administrators in their mission to meet the needs of vulnerable populations.

Young learners benefit from learning and engaging in nature, but nature-based outdoor learning impacts on teachers are less understood. The present study examined elementary school teachers' learning experiences with science instruction in outdoor natural settings. An Outdoor Science Education (OSE) program partnered with schools in the southeastern U.S. to provide standards-aligned outdoor science lesson expeditions for fifth-grade students. Teachers reported their participation in expeditions improved their own content knowledge in science and contributed to their confidence teaching science and teaching in the outdoors. In addition, teachers reported their perceptions of students' performance in their science classes and on standardized science tests. The teachers described their perceptions about how the expeditions improved their students' engagement for learning and behavior in outdoor settings when compared to indoor science instruction. They discussed how these changes were most obvious for students who struggled with traditional classroom instruction. Using survey and interview data, we discuss the potential for teacher learning related to outdoor science instruction.

This study originated as an institutionally sponsored research residency conducted using utilization-focused evaluation (Patton, 2008) to investigate the nature of dispositional changes in candidates pursuing National Louis University's M.Ed. and Ed.S. degrees leading to educational leadership (EDL) state certification in one large urban school district in a Southern state. The EDL program organized learning objectives intending to develop a specific knowledge base, an operational competency set, and, as this study's focus, leadership dispositions related to preparing assistant principals and principals to lead effectively in chronically low-performing (CLP) schools. The inquiry cross-analyzed data at the intersection of the graduate program's disposition-related learning objectives with 13 leadership dispositions identified in The Haberman Educational Foundation Star Urban Administrator Pre-Screener. EDL program faculty administered the prescreener to EDL program candidates twice, yielding 187 matched pairs in pre-program and postprogram administrations. Statistical analyses yielded a significant difference (improvement) in overall Haberman scores at the .01 alpha level, as well as an effect size considered (Cohen, 1969) to be a medium effect size. Faculty triangulated the data with interviews of alumni and faculty with experience in leading CLP schools, who affirmed that focus on leadership dispositions serves an important developmental role in an EDL program. The study appears to validate the measurable presence and dynamic changes in EDL candidate dispositions as an element of a graduate program focused on developing effective leaders of CLP schools.

The existing research on community college faculty attrition has focused on such internal institutional factors as faculty work life and morale. Few studies have examined factors outside of an institution's control that may influence faculty attrition and no studies to date have examined such factors in a sample of rural-serving community college faculty. The present study explores the relationships of geographic issues, counterstream migration, economic concerns, and social responsibilities to attrition in a sample of full-time rural-serving community college faculty. Implications for rural and rural-serving community college human resources professionals and administrators are discussed.

This study was interested in the level of correspondence between high school students' self-perceptions of academic competence and achievement. The objectives were to (a) identify different profiles of students in terms of correspondence between perceptions of general academic competence and achievement in language arts and mathematics, (b) describe the personal and family characteristics of the students in these profiles, and (c) associate personality traits defined by the Big-Five with these profiles. A latent class analysis and a multinominal logistic regression were conducted on the data collected from 309 ninth and tenth graders. Among the most salient results, five profiles of students were identified, three of which with competence perceptions corresponding with achievement (i.e., high achievers with high self-perceived competence (SPC), average achievers with average SPC, and low achievers with lower SPC) and two with competence perceptions showing no or little correspondence with achievement (i.e., low achievers with higher SPC and average achievers with lower SPC). Also, students scoring high on openness to experience and conscientiousness were more likely to belong to the profile of high achievers with high SPC. These findings contribute to the literature on the possible reasons why students hold accurate or biased self-perceptions of competence.

Community colleges often employ measures to determine student course placement. Though much research has examined the predictive validity of placement measures such as ACT or high-school GPA, little research examines the effects of students' traditional and non-traditional status. Using data from a rural state community college, we examined the predictability of high-school GPA and ACT scores on college GPA and passing math and English courses. The results confirm previous research that finds high-school GPA to predict better than other placement measures. The results from the analyses of traditional and non-traditional students add to the placement literature by suggesting that the number of years between high-school graduation and community college attendance also affects overall success. This signifies that the number of years since a student graduated high school should be factored into placement decisions.

eSports is an increasingly visible part of our popular culture and is becoming both a financial and technological force. In higher education, community colleges are rapidly developing eSports programs for a variety of reasons, including increasing student engagement to developing alumni relationships. Although some discussion exists in sports management, economics, psychology and legal literature, there appears to be little work dedicated to eSports in the literature of community college studies. This study draws upon the small base of literature on eSports beyond community college studies and presents an example of a recently emerging eSports program at one rural community college in the mountain western U.S. A look forward on eSports is provided by noting breaking issues, trends, and proposals for a research agenda for scholars and practitioners in community college studies.

Youth with conduct problems have poorer academic outcomes than their typically developing peers. The objective of the current study was to examine how sexual minority status was associated with trajectories of teacher-rated mathematics and language arts (i.e., reading and writing) achievement in seven consecutive years across the transition to adolescence among youth with childhood histories of conduct problems (N = 383). Sexual minority status (as assessed via indicators of identity, attraction, or behavior during adolescence in the eighth year of the study) was not associated with initial mathematics or language arts performance at time 1, but was associated with declining mathematics achievement during the transition to adolescence. These findings suggest that sexual minority status is linked to change in some aspects academic achievement among youth already at risk for poorer academic achievement (i.e., youth with conduct problems).

The current study explores differences in transfer shock between veteran and non-veteran community college transfer students at a land grant institution in a rural state. Analysis includes institutional data for community college transfer students, including those who self-identified as veterans or used veteran tuition benefits from Fall 2015 to Spring 2022. Many of these students held marginalized identities in other categories such as nontraditional age. Overall, all community college transfer students in the sample experienced a decrease in mean GPA in their first university semester. Veteran and non-veteran community college transfer students did not experience significantly different levels of transfer shock. However, veteran community college transfer students showed little evidence of transfer shock overall and performed better on average than both their nontraditional and traditional nonveteran student counterparts after transferring.

PURPOSE: The surrogacy of biochemical recurrence (BCR) for overall survival (OS) in localized prostate cancer remains controversial. Herein, we evaluate the surrogacy of BCR using different surrogacy analytic methods. MATERIALS AND METHODS: Individual patient data from 11 trials evaluating radiotherapy dose escalation, androgen deprivation therapy (ADT) use, and ADT prolongation were obtained. Surrogate candidacy was assessed using the Prentice criteria (including landmark analyses) and the two-stage meta-analytic approach (estimating Kendalls tau and the R2). Biochemical recurrence-free survival (BCRFS, time from random assignment to BCR or any death) and time to BCR (TTBCR, time from random assignment to BCR or cancer-specific deaths censoring for noncancer-related deaths) were assessed. RESULTS: Overall, 10,741 patients were included. Dose escalation, addition of short-term ADT, and prolongation of ADT duration significantly improved BCR (hazard ratio [HR], 0.71 [95% CI, 0.63 to 0.79]; HR, 0.53 [95% CI, 0.48 to 0.59]; and HR, 0.54 [95% CI, 0.48 to 0.61], respectively). Adding short-term ADT (HR, 0.91 [95% CI, 0.84 to 0.99]) and prolonging ADT (HR, 0.86 [95% CI, 0.78 to 0.94]) significantly improved OS, whereas dose escalation did not (HR, 0.98 [95% CI, 0.87 to 1.11]). BCR at 48 months was associated with inferior OS in all three groups (HR, 2.46 [95% CI, 2.08 to 2.92]; HR, 1.51 [95% CI, 1.35 to 1.70]; and HR, 2.31 [95% CI, 2.04 to 2.61], respectively). However, after adjusting for BCR at 48 months, there was no significant treatment effect on OS (HR, 1.10 [95% CI, 0.96 to 1.27]; HR, 0.96 [95% CI, 0.87 to 1.06] and 1.00 [95% CI, 0.90 to 1.12], respectively). The patient-level correlation (Kendalls tau) for BCRFS and OS ranged between 0.59 and 0.69, and that for TTBCR and OS ranged between 0.23 and 0.41. The R2 values for trial-level correlation of the treatment effect on BCRFS and TTBCR with that on OS were 0.563 and 0.160, respectively. CONCLUSION: BCRFS and TTBCR are prognostic but failed to satisfy all surrogacy criteria. Strength of correlation was greater when noncancer-related deaths were considered events.

Heart failure (HF) leads to brain injury in autonomic, respiratory, mood, and cognitive control sites, revealed as tissue volume loss, altered metabolites, and impaired diffusion tissue properties. The extent of myelin changes in HF and variations within sexes are unclear. Our aim was to examine regional brain subcortical and white matter myelin integrity in HF patients over control subjects, as well as differences between sexes using T1- and T2-weighted clinical images. We acquired T1- and T2-weighted images from 63 HF patients and 129 controls using a 3.0-Tesla MRI scanner. Using T1- and T2-weighted images, ratio maps were computed, normalized to a common space, smoothed, and compared between groups (ANCOVA; covariates: age and sex; SPM12, false discovery rate, p

This study investigates how individual-level factors contribute to classroom engagement variations of boys and girls across the elementary school years. Classroom engagement was assessed four times between the ages of 7 and 12 years in a large, representative population-based sample (N = 877) using latent growth modeling. Predictors included the sex of the child, the family income, and the mother's educational attainment when the child was 5 months old, along with the child's early receptive vocabulary, numeracy, motor and attentional skills, motivation to learn, and internalizing and externalizing behaviors measured at age 6 years. On average, classroom engagement progressively improved over time. Child vocabulary skills, attention, intrinsic motivation, and externalizing behaviors predicted initial levels of classroom engagement. Child classroom engagement also showed slower progression over time when receptive vocabulary and attentional skills were high. This trend was slightly different when the analyses were conducted separately for boys and girls. Girls with higher attentional skills and fewer externalizing behaviors at age 6 showed slower improvement in classroom engagement throughout elementary school, while boys did not significantly improve in their classroom engagement. Overall, these results suggest that several individual-level factors contribute to classroom engagement. Children with lower levels of receptive vocabulary, attentional skills, and motivation to learn, and those displaying externalizing behavior may benefit from additional help to boost their classroom engagement.

This study investigated the contribution of fine and gross motor skills to academic and attentional performance at school entry among 832 boys and girls. Children were tested on their fine and gross motor skills (locomotor, object control) and their academic performance in receptive vocabulary, number knowledge, and attentional skills at 6 to 7 years old. Results from ordinary least square models adjusted for family income, maternal education attainment, and early cognitive skills at 41 to 48 months revealed that fine motor skills significantly predicted receptive vocabulary, number knowledge, and attention skills. The associations between fine motor skills with receptive vocabulary and attention were stronger for girls than boys. Better performance in locomotor also significantly predicted higher levels of receptive vocabulary while object control was positively associated with attentional skills among girls only. Children with better motor abilities, especially fine motor skills, are more likely to be successful in the areas requiring language, numeracy, and attentional skills. Thus, motor skills should be a focus of interest for increasing academic and attentional skills level at school entry, particularly in girls.