The School Principal and Teacher Retention

This report comes from the MERC Teacher Retention study. This study was designed to identify patterns of teacher retention in the MERC region and to determine the school and system-level factors driving them. The study also provides an overview of state and regional policies and programs relevant to teacher retention, and includes evaluations of existing policies and initiatives to determine efficacy and cost benefit. This policy brief examines the role of leadership, and specifically the school principal, in retaining teachers. The brief includes a review of studies that used survey scales to measure leadership and then disaggregate and re-aggregate the items in those scales into a handful of common themes. The purpose of this policy brief is to review the foundational literature on the role of the principal in order to develop a set of focus areas for principals who want to improve teacher retention

The Effect of High School Racial Demographics on Cultural Competence in College Students

Originally coined by nursing professor Madeleine Leininger in the 1960’s, “cultural competence” describes how well individuals communicate and collaborate across cultures. Amongst college students, cultural competence is associated with numerous positive outcomes including improved behavioral records and higher overall college satisfaction (Bowman and Denson, 2012, p. 420; Schwarzenthal et al., 2020, p. 326). Studies have also shown that exposure to racial diversity can foster cultural competence, particularly during adolescence (Raabe & Beelmann, 2011). Despite this, few studies have examined the relationship between exposure to racial diversity in high school and cultural competence in college. This analysis seeks to address this gap by examining cultural competence in three key facets of college life: collaboration, discussion, and friendship. Results suggest that college students from diverse high schools were noticeably more proficient than college students from segregated high schools in four cultural competencies: “being aware of within-group difference,” “acknowledging the importance of difference,” “accepting ambiguity,” and “being curious.

Perceived Barriers and facilitators for Physical activity in South African patients with axial spondyloarthritis : An explanatory sequential mixed methods approach with the transtheoretical model as a conceptual framework

Background: Physical activity (PA) for individuals with axial spondyloarthritis (axSpA) is highly recommended for the management of the disease. However, maintaining physical activity is challenging for individuals with axSpA.Aim: The aim was to explore perceived facilitators and barriers to PA in relation to stages of change (SOC) in individuals living with axSpA in South Africa. Methods: A mixed method design involving 65 participants with axSpA was used. A web-based survey assessed facilitators and barriers with the Inflammatory Arthritis Facilitators and Barriers questionnaire, SOC, and demographic data. 10 participants were contacted for follow-up interviews and data were analysed with content analysis. Results: Knowledge about the PA benefits to health (69,2%) and mood (60%) were predominant facilitators and levels of symptoms (66.2%) and lack of mindset (64.5%) were barriers indicated in the survey. Lower levels of education were associated with higher barriers. The interview analysis uncovered four barriers: interaction of symptoms, inappropriate care, unsupportive external environment, mindset and three facilitators: mental strength, symptom relief and supportive external environment. Conclusion: There is a complex interplay between physical symptoms, psychological, interpersonal, and environmental barriers and facilitators to physical activity. Since physical activity in axSpA is important for management, future research should involve behavioural medicine approaches

Perceived Barriers and facilitators for Physical activity in South African patients with axial spondyloarthritis : An explanatory sequential mixed methods approach with the transtheoretical model as a conceptual framework

Background: Physical activity (PA) for individuals with axial spondyloarthritis (axSpA) is highly recommended for the management of the disease. However, maintaining physical activity is challenging for individuals with axSpA.Aim: The aim was to explore perceived facilitators and barriers to PA in relation to stages of change (SOC) in individuals living with axSpA in South Africa. Methods: A mixed method design involving 65 participants with axSpA was used. A web-based survey assessed facilitators and barriers with the Inflammatory Arthritis Facilitators and Barriers questionnaire, SOC, and demographic data. 10 participants were contacted for follow-up interviews and data were analysed with content analysis. Results: Knowledge about the PA benefits to health (69,2%) and mood (60%) were predominant facilitators and levels of symptoms (66.2%) and lack of mindset (64.5%) were barriers indicated in the survey. Lower levels of education were associated with higher barriers. The interview analysis uncovered four barriers: interaction of symptoms, inappropriate care, unsupportive external environment, mindset and three facilitators: mental strength, symptom relief and supportive external environment. Conclusion: There is a complex interplay between physical symptoms, psychological, interpersonal, and environmental barriers and facilitators to physical activity. Since physical activity in axSpA is important for management, future research should involve behavioural medicine approaches

Efficacy of Care and Antibiotic Use for Chalazia and Hordeola.

ObjectivesTo evaluate whether use of an antibiotic improves the efficacy of care for a chalazion or hordeolum.MethodsA cross-sectional retrospective review was performed. All patients treated for a newly diagnosed chalazion or hordeolum at the University of California, San Francisco from 2012 to 2018 were identified. Patients were excluded when clinical notes were inaccessible or there was inadequate documentation of treatment modality or outcome. Patient demographics, setting of initial presentation, treatment modalities, antibiotic use, and outcomes were analyzed.ResultsA total of 2,712 patients met inclusion criteria. Management with an antibiotic was observed in 36.5% of patients. An antibiotic was 1.53 times (95% confidence interval [CI], 1.06-2.22, P=0.025) more likely to be prescribed in emergency or acute care setting for a chalazion. Older age was associated with a higher risk of receiving an antibiotic for a hordeolum (adjusted RR 1.07 per decade, 95% CI, 1.05-1.11, P<0.001). The addition of an antibiotic to conservative measures for a chalazion (adjusted RR, 0.97, 95% CI, 0.89-1.04, P=0.393) or hordeolum (adjusted RR, 0.99, 95% CI, 0.96-1.02, P=0.489) was not associated with an increased likelihood of treatment success.ConclusionAlthough frequently prescribed, an antibiotic is unlikely to improve the resolution of a chalazion or hordeolum

Association of body-mass index and outcomes in patients with metastatic melanoma treated with targeted therapy, immunotherapy, or chemotherapy: a retrospective, multicohort analysis.

BACKGROUND:Obesity has been linked to increased mortality in several cancer types; however, the relation between obesity and survival outcomes in metastatic melanoma is unknown. The aim of this study was to examine the association between body-mass index (BMI) and progression-free survival or overall survival in patients with metastatic melanoma who received targeted therapy, immunotherapy, or chemotherapy. METHODS:This retrospective study analysed independent cohorts of patients with metastatic melanoma assigned to treatment with targeted therapy, immunotherapy, or chemotherapy in randomised clinical trials and one retrospective study of patients treated with immunotherapy. Patients were classified according to BMI, following the WHO definitions, as underweight, normal, overweight, or obese. Patients without BMI and underweight patients were excluded. The primary outcomes were the associations between BMI and progression-free survival or overall survival, stratified by treatment type and sex. We did multivariable analyses in the independent cohorts, and combined adjusted hazard ratios in a mixed-effects meta-analysis to provide a precise estimate of the association between BMI and survival outcomes; heterogeneity was assessed with meta-regression analyses. Analyses were done on the predefined intention-to-treat population in the randomised controlled trials and on all patients included in the retrospective study. FINDINGS:The six cohorts consisted of a total of 2046 patients with metastatic melanoma treated with targeted therapy, immunotherapy, or chemotherapy between Aug 8, 2006, and Jan 15, 2016. 1918 patients were included in the analysis. Two cohorts containing patients from randomised controlled trials treated with targeted therapy (dabrafenib plus trametinib [n=599] and vemurafenib plus cobimetinib [n=240]), two cohorts containing patients treated with immunotherapy (one randomised controlled trial of ipilimumab plus dacarbazine [n=207] and a retrospective cohort treated with pembrolizumab, nivolumab, or atezolizumab [n=331]), and two cohorts containing patients treated with chemotherapy (two randomised controlled trials of dacarbazine [n=320 and n=221]) were classified according to BMI as normal (694 [36%] patients), overweight (711 [37%]), or obese (513 [27%]). In the pooled analysis, obesity, compared with normal BMI, was associated with improved survival in patients with metastatic melanoma (average adjusted hazard ratio [HR] 0·77 [95% CI 0·66-0·90] for progression-free survival and 0·74 [0·58-0·95] for overall survival). The survival benefit associated with obesity was restricted to patients treated with targeted therapy (HR 0·72 [0·57-0·91] for progression-free survival and 0·60 [0·45-0·79] for overall survival) and immunotherapy (HR 0·75 [0·56-1·00] and 0·64 [0·47-0·86]). No associations were observed with chemotherapy (HR 0·87 [0·65-1·17, pinteraction=0·61] for progression-free survival and 1·03 [0·80-1·34, pinteraction=0·01] for overall survival). The association of BMI with overall survival for patients treated with targeted and immune therapies differed by sex, with inverse associations in men (HR 0·53 [0·40-0·70]), but no associations observed in women (HR 0·85 [0·61-1·18, pinteraction=0·03]). INTERPRETATION:Our results suggest that in patients with metastatic melanoma, obesity is associated with improved progression-free survival and overall survival compared with those outcomes in patients with normal BMI, and that this association is mainly seen in male patients treated with targeted or immune therapy. These results have implications for the design of future clinical trials for patients with metastatic melanoma and the magnitude of the benefit found supports further investigation of the underlying mechanism of these associations. FUNDING:ASCO/CCF Young Investigator Award, ASCO/CCF Career Development Award, MD Anderson Cancer Center (MDACC) Melanoma Moonshot Program, MDACC Melanoma SPORE, and the Dr Miriam and Sheldon G Adelson Medical Research Foundation