Examining Digital Proficiency Perceptions and Differences in Achievement During the Covid-19 Pandemic in a Rural Mid-Western High School

In response to the Covid-19 Pandemic, schools worldwide were forced to react quickly to meet the needs of all students in an unprecedented time of change for all facets of society. Through a mixed-method approach, this study aimed to explore the effect of hybrid learning on student achievement, as well as the effect, if any, of teachers’ perceptions of their own digital abilities on student achievement. The research also examined the thoughts of students and teachers as it pertained to teaching and learning during the global pandemic. To analyze the effect of hybrid learning on student achievement, the researcher compared English II and Government End-of-Course (EOC) scores from a year when traditional instruction took place versus a year that required hybrid instruction due to the pandemic. A representation of teachers and students completed surveys, both based on the ISTE Standards, which focused on the respective perceptions of the teachers’ digital abilities. Teachers also completed a survey that analyzed three areas of their relationship with technology use: Comfort and Confidence, Perception of Technology Use, and Technology Integration. Those survey results were tied to EOC scores, which revealed the correlation between perception and achievement. Finally, students and teachers were given an opportunity to share their thoughts concerning the challenges of teaching and learning during a pandemic by answering open-ended questions housed in Qualtrics. The intent of this study was to provide the story of a small rural school as it navigated its way through a challenging time in the world. This study also serves as a guide to comparable districts as they begin their 1:1 journey and in a time of crisis

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely