Meaningful Progress Research Articles

Teaching and Assessing Systems Thinking in First-Year Chemistry

Powerful arguments have been made recently to advocate for the introduction of systems thinking in chemistry education to equip graduates to address sustainability challenges. This contribution describes systems thinking activities and an assessment tool that enables meaningful learning in first-year organic chemistry as students engage with the molecular-level foundation and real-world implications of the system under consideration. The activity incorporates concept maps and systems-oriented concept mapping extensions (SOCMEs) as visualization tools to scaffold the development of systems thinking skills. A rubric based on the SOLO taxonomy was designed and used to assess evidence of systems thinking skills demonstrated on SOCMEs. The activity was implemented in a small and a large group of 18 and 219 participants respectively, where findings from both groups are presented. The grading of six SOCMEs by three independent raters proved to be inconsistent at higher thinking SOLO levels, where rater experience was flagged as an area for future improvement to ensure raters are proficient in assessing systems thinking. However, meaningful progress was made to assess the quality of learning. The rubric was an effective tool for formative and low-stakes assessment to drive the teaching and learning of systems thinking in chemistry.

Beyond a seat at the table: imagining educational equity through critical inclusion

ABSTRACT Interlocking mechanisms of exclusion function as gatekeepers to high-quality learning in schools, which perpetuate oppressive conceptions of ability, learning, and intelligence. Across educational ecosystems, these intersecting forms of oppression—including but not limited to racism, ableism, and colonialism—are reified through exclusionary practices that hoard learning opportunities. In this paper, we contend that learning-access disparities are at the crux of educational inequalities, and that theoretical fragmentation across educational disciplines has limited our understanding of entrenched patterns of exclusion and potential solutions. This fragmentation has led to siloed equity conversations and solutions; therefore, we articulate a conceptual framework for inclusive education: Critical Inclusion (InCrit). In doing so, we first engage in a critical-historical review of educational inclusion, including how it has been theorised and operationalised in both research and praxis. We next describe the cross-pollination of the foundational theories on which the conceptual framework stands to emphasise intersectionality and emancipatory education in relation to the vast scholarship on critical inclusion. We then present the framework’s core components, which represent connectors between theory and practice, and illustrative examples. We conclude with a discussion of the cross-systems change required to make meaningful progress toward emancipatory education for all students and achieve critical inclusion in practice.

Challenging Case: Leveraging Community Partnerships to Address Barriers to Care for Students with Autism.

Sam is an 11-year-old young boy with autism spectrum disorder (ASD), unspecified anxiety disorder, and attention-deficit/hyperactivity disorder, combined presentation. He was initially diagnosed with ASD at 6 years of age after evaluation by a developmental-behavioral (DB) pediatrician. He presents to the DB pediatrics clinic to reestablish care. He established care with psychiatry 5 months ago after his school referred him to a hospital-school-community telepartnership bridge program following statements of self-harm and numerous concerns with his behavior, including elopement.Sam currently receives special education support under the classifications of "Emotional Disturbance" and "Speech Impairment." His parents report significant challenges with having his medical diagnosis of autism recognized by the school, which has impeded him receiving educational support as a student with autism. This has resulted in Sam being penalized for challenging behaviors related to his neurodevelopmental disorder. He is not currently making meaningful progress in the school setting. Sam currently demonstrates avoidance, physical and verbal aggression, and difficulty adapting to change across settings. In addition to difficulties advocating for more individualized support at school, Sam has never received applied behavior analysis (ABA) therapy because of challenges obtaining insurance approval. There are no additional barriers to accessing care, such as language, geographic, or socioeconomic factors.Sam's visit to reestablish care with DB pediatrics consisted of an individual clinician evaluation model. The Childhood Autism Rating Scale, Second Edition, (CARS-2) and Vineland Adaptive Behavior Scales, Third Edition (Vineland-3), were administered, and Sam continued to meet DSM-5 criteria for ASD following re-evaluation. A new referral for ABA therapy was submitted. Shortly afterward, his family received an insurance denial letter specifying that additional developmental testing was needed before ABA therapy would be approved. His clinician called the insurance company to appeal this decision but was unsuccessful. Sam was then seen by the DB pediatrics embedded psychologist, who completed additional testing, including assessment of cognitive functioning, administration of the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and autism-specific rating scales. This process led to further delays in access to ABA services. Throughout this process, the parents reported feeling helpless and frustrated given the barriers faced in receiving appropriate services. What are your next steps to advocate for supports through the school and insurance company?

Logical fallacies persist in invasion biology and blaming the messengers will not improve accountability in this field: a response to Frank et al.

We analyze the “Logical fallacies and reasonable debates in invasion biology: a response to Guiaşu and Tindale” article by Frank et al., and also discuss this work in the context of recent intense debates in invasion biology, and reactions by leading invasion biologists to critics of aspects of their field. While we acknowledge the attempt by Frank et al., at least in the second half of their paper, to take into account more diverse points of view about non-native species and their complex roles in ecosystems, we also find the accusations of misrepresenting invasion biology, for instance by “cherry-picking” and “constructing ‘straw people’”, directed at the Guiaşu and Tindale study to be unwarranted. Despite the sometimes harsh responses by leading invasion biologists to critics of their field, we believe that persistent and fundamental problems remain in invasion biology, and we discuss some of these problems in this article. Failing to recognize these problems, and simply dismissing or minimizing legitimate criticisms, will not advance the cause, or enhance the general appeal, of invasion biology and will prevent meaningful progress in understanding the multiple contributions non-native species can bring to various ecosystems worldwide. We recommend taking a more open-minded and pragmatic approach towards non-native species and the novel ecosystems they are an integral part of.

Controlled generation of a vapor bubble representative of nucleate boiling conditions using transient focused laser heating

Nucleate boiling is a phenomenon of significant importance in a broad range of industries. Increasing boiling performance parameters could lead to more efficient power plants and better electronics thermal management. However, difficulties associated with studying this extremely complex phenomenon have prevented a meaningful progress in the area of boiling heat transfer enhancement. In this paper, we implement a laser-based controlled bubble generation technique to enable accurate phenomenological studies of the boiling process. We present details of the transient focused-laser heating mechanism used to nucleate a microscale vapor embryo on the boiling surface. We present high-speed optical imaging data showing how this vapor embryo grows into a bubble using electrically applied background heat flux. Unlike the currently available artificial bubble generation approaches, which either generate unphysical bubbles or are extremely difficult to implement, we show that the laser-nucleated controlled single bubble demonstrates bubble ebullition characteristics closely representative of naturally occurring bubbles in nucleate pool boiling.

Moving from i-frame to s-frame focus in equity, diversity, and inclusion research, practice, and policy.

Meaningful and long-lasting progress in equity, diversity, and inclusion (EDI) continue to elude academics, practitioners, and policymakers. Extending Chater & Loewenstein's arguments to the EDI space, we argue that, despite conventional focus on individual-level solutions (i-frame), increasing EDI also requires a systemic focus (s-frame). We thus call for the design, testing, and implementation of multipronged s-frame interventions.

Notes from the Editors, January 2023

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 This month’s “Notes from the Editors” marks the 30-year anniversary of the United Nations Framework Convention on Climate Change. The abject failure of this framework to enact meaningful progress on the planetary crisis continued to be on full display in 2022, including at November’s COP27 in Egypt.

Planning for Future Is Critical to Protecting Our Profession and Americans’ Mental Health

Planning for Future Is Critical to Protecting Our Profession and Americans’ Mental Health

A PUBLIC HEALTH APPROACH TO ALZHEIMER’S DISEASE RISK REDUCTION: WHERE WE ARE AND WHERE WE’RE HEADED

Abstract A growing body of evidence has identified potential modifiable risk factors for Alzheimer’s disease and related dementias (ADRD). In 2021, the National Plan to Address Alzheimer's Disease (National Plan) included a new goal to promote healthy aging and address risk factors to help delay onset or slow progression of ADRD. Applying a robust public health approach to ADRD risk reduction can help achieve meaningful progress at the population level. The activities outlined in the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L. 115-406) are designed to create a uniform national public health infrastructure with a focus on various issues including risk reduction. The purpose of this session is to illustrate a public health approach to ADRD risk reduction, including its current status along with future directions and priorities. An overview of the National Plan’s new goal regarding ADRD risk reduction (McGuire) and data highlighting the current burden of key modifiable risk factors in the United States along with important disparities (Omura) will be presented. Holt will describe how ADRD risk reduction is integrated into the work of BOLD funding recipients, and Head will present experiences implementing public health activities that support ADRD risk reduction in the field along with successes and lessons learned. Finally, priorities and future directions for a public health approach to ADRD risk reduction will be presented from the perspective of the CDC’s Building Our Largest Dementia Infrastructure Public Health Center of Excellence on Dementia Risk Reduction (Baumgart).

Improved Outcomes Following a Care Guideline Implementation: Part 1 of an Analysis of 12 355 Patients After Total Knee Arthroplasty.

OBJECTIVE: To describe the application and examine the influence of a continuous quality improvement intervention, which had a goal of standardizing care to reduce the proportion of patients who do not have a meaningful improvement in patient-reported outcomes following total knee arthroplasty (TKA). DESIGN: Continuous quality improvement. METHODS: A physical therapy (PT) care guideline was initiated in 2013 for patients following TKA. The Knee Outcome Survey - Activities of Daily Living (KOS-ADL) was measured at every visit, and scores were extracted from a clinical outcomes database to calculate the proportion of patients who did not achieve a minimal clinically important difference. Based on logistic regression analysis, we compared the proportion of patients who did not progress on the KOS-ADL in a non-care guideline group (2008-2012) to a care guideline (CG) group (2014-2019). RESULTS: This study included 12 355 patients (aged 18-92 years) following TKA incurring at least 3 PT visits from 2008 to 2019. The percentage of patients who did not progress in the non-care guideline group was 25.8% and in the care guideline group 14.3% (P<0.001). The relationship between care guideline adherence and lack of progression on the KOS-ADL was statistically significant, X2 (df = 1) = 148.7, P<.001. CONCLUSION: The percentage of patients who did not achieve meaningful progress on the KOS-ADL declined significantly in the 6 years after implementing a TKA care guideline without an increase in the number of clinical visits. The standardized care guideline was associated with meaningful improvements for patients following TKA when applied in conjunction with PT access to outcome data, feedback through audits, performance goals, and financial incentives. J Orthop Sports Phys Ther 2023;53(3):143-150. Epub: 12 December 2022. doi:10.2519/jospt.2022.11369.

The Drive for Health Equity - The Need to Use Technology to Reduce Healthcare Disparities in Orthopedics

Health and healthcare disparities occur across a range of dimensions—including socioeconomic status, age, geographical location, language, and gender—and are reflected in variable rates of disease, disability, and death, as well as life expectancy. Members of disadvantaged groups are more likely to have poor health status in addition to more limited means and ability to access healthcare services. Within orthopedic care, existing literature has long identified various health and healthcare disparities, including significantly lower rates of total hip arthroplasty (THA) and total knee arthroplasty (TKA) among Black and Hispanic patients, as well as higher amputation rates among Black and Mexican American diabetic patients. While such studies have for decades identified the presence and impact of healthcare disparities among minority and disadvantaged populations, action to improve health equity in orthopedics has been scarce. To make meaningful progress on health equity, health systems and Ambulatory Surgery Centers will first need to identify existing barriers to care that impact their own patient populations, particularly as new legislation will require organizations to document how they screen patients for social determinants of health, analyze patient data, and address healthcare disparities. Digital care management, remote monitoring, and messaging platforms can help health systems and ASCs improve the quality, consistency, and availability of the care they deliver. As orthopedic care can potentially improve the health and well-being of so many Americans, it is crucial that we commit to resolving disparities in orthopedic care access, utilization, and outcomes for disadvantaged populations. With greater knowledge of each patient’s challenges, risks, and motivations, providers can more easily address barriers to care and support the best possible outcomes for each and every patient.

MIGRATED SOCIAL STRUCTURES, PREBENDALISM AND INSTABILITY IN PLURAL SOCIETIES: EXPERIENCES IN NIGERIA

Every society desires peace, cohesion, order, fairness, and stability. Without these, there would be no meaningful progress, and development. The quest for social order, in plural societies, therefore depends on the level of stability. Post-colonial African societies today are experiencing varying levels of instabilities which has hindered peace, and security. This paper therefore sought to examine the role of migrated social structures on the prevalence of prebendalism and instability in a plural society. Attempts have been made to understand the causes of these instabilities. Instabilities in post-colonial Africa resulted from cultural contact with Europeans. The objective of this paper is to examine the effects of migrated social structures on the prebendal behaviour and instabilities in plural societies like Nigeria. The prebendalist theory by Richard (1986) was used to anchor the arguments of this paper. This paper argues that as a way of stemming the growing prebendalism and instability in Nigeria, serious efforts should be made to encourage meritocracy and inclusiveness which would help reduce the incidences of instability occasioned by exclusionism and prebendalism which has led to ethnicity as different nationalities engage in unhealthy competition, rivalry, and lack of trust.

The need for metrics to measure progress on racial equity in global public health and medicine

The need for metrics to measure progress on racial equity in global public health and medicine

Economic Disparities in the Outcomes of Sickle Cell Disease-Related Admissions over a Decade

Background: According to the CDC, Sickle Cell Disease (SCD) occurs in 1 out of every 365 African American births and 1 out of every 16,300 Hispanic American births. It is an inherited disorder caused secondary to a mutation in the hemoglobin beta subunit and has complex phenotypes. The disease is characterized by recurrent hemolysis, vaso-occlusion leading to pain episodes, and chronic organ damage due to ischemia. A comprehensive care management team is not well established for this disease. There is sparse information regarding the trends in outcomes of SCD admissions in the past decade where rapid advances have been made in treatment including the evolving hematopoietic stem cell transplant. In this study, we sought to analyze the trends and outcomes of SCD admissions in the United States from 2011- 2019 and the influence of socioeconomic status. Methods: The National Inpatient Sample (NIS) database was queried to identify adult patients admitted with a principal diagnosis of Sickle Cell Disease using the International Classification of Disease (ICD-9) and ICD-10 codes. Trends for primary in-hospital outcomes including mortality, length of stay (LOS), and total hospitalization charges (THC) were assessed. The impact of economic status on these outcomes was also studied. Statistics were performed using STATA and multivariate linear and logistic regression analysis was used to adjust for confounders. Results: The rate of hospitalizations for SCD remained stable from 2010 to 2019. Women constituted 53.99% and the majority of patients were young adults (86.62%) and Black (90.36%) as expected. Many patients belonged to the low-income quartile group and were admitted to hospitals with a large bed size and urban teaching hospitals. The overall mortality rate among adult SCD hospitalizations from 2010 to 2019 decreased by an odds ratio of 0.96 (p=0.008) after adjusting for age, sex, and race and is reassuring. However, on subgroup analysis, this trend was replicated for those belonging to a higher income quartile group whereas there was no statistically significant decrease in the mortality rate trend for those belonging to the lower income quartile group. After adjusting for confounders there was an increase in the total charges in all subgroups (p<0.001). The mean LOS decreased for the total population and most subgroups (p<0.001). Conclusion: Despite the advances in the understanding of SCD and its treatment, its benefits have not reached all the people affected. Access to healthcare and the treatment costs associated could be one among the possible reasons why the lower income quartile group have not yet benefited. Meaningful progress in healthcare is not achievable unless these economic disparities are addressed. It is imperative to develop economic policies to address these inequities. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The Molecular Mechanism of Natural Products Activating Wnt/β-Catenin Signaling Pathway for Improving Hair Loss.

Hair loss, or alopecia, is a dermatological disorder that causes psychological stress and poor quality of life. Drug-based therapeutics such as finasteride and minoxidil have been clinically used to treat hair loss, but they have limitations due to their several side effects in patients. To solve this problem, there has been meaningful progress in elucidating the molecular mechanisms of hair growth and finding novel targets to develop therapeutics to treat it. Among various signaling pathways, Wnt/β-catenin plays an essential role in hair follicle development, the hair cycle, and regeneration. Thus, much research has demonstrated that various natural products worldwide promote hair growth by stimulating Wnt/β-catenin signaling. This review discusses the functional role of the Wnt/β-catenin pathway and its related signaling molecules. We also review the molecular mechanism of the natural products or compounds that activate Wnt/β-catenin signaling and provide insights into developing therapeutics or cosmeceuticals that treat hair loss.

Development as Liberation.

At a point in history where the worlds social and ecological boundaries are at a true testing point, this article presents some thoughts and questions around the tensions between reformist and revolutionary actions and ends in presenting dreaming as a tool towards emancipation. Through these thoughts, collective action is a central cog towards meaningful progress.

The challenge of assisted reproduction for conservation of wild felids - A reality check

Threats to the Earth's biodiversity are increasing exponentially, driven by human population growth and resource consumption. As many as one million wildlife species may disappear within the next few decades due to this human-induced extinction event. This represents our current reality and has profound implications for wildlife conservation. Within this context, application of assisted reproductive technology (ART) to conservation management is unlikely to mitigate broad-scale species loss, but for select species, such as wild cats, ART may determine if populations survive or disappear. In North American and European zoos, 20 of the world's 38 wild felid species are managed within structured breeding programs, but most are not sustainable with natural breeding alone. Zoo-based breeding programs are facing tenuous futures due to triage-based responses to this growing sustainability crisis. Theoretically, ART could benefit conservation management, but only by recognizing and addressing its present challenges. The application of ART to wildlife has been rarely successful, with only 62 mammal species (including 15 cat species) ever propagated by AI, and just 35 of these species (6 cats) reproduced following frozen semen AI. Even this most basic form of ART has a minimal impact on wildlife sustainability. The drivers of this deficit include lack of species-specific reproductive knowledge and limited access to animals for study, but also is exacerbated by a science-conservation disconnect that attempts to apply advanced reproductive technologies to species in which basic ART remains unproven. For a few felid species, these scientific challenges have been overcome and AI with frozen semen is becoming feasible as a practical management tool; for other felids, further research is needed. Non-scientific issues also impair our ability to use ART to implement global management plans. Political dysfunction, regulatory barriers and societal indifference create inertia that interferes with achieving meaningful progress in applying ART to wildlife. Collectively, these challenges may seem insurmountable but human resiliency is essential if we are to resolve these issues in a systematic manner. It will require expanding collaborative efforts substantially and intensifying efforts to conserve wildlife species that are literally running out of time. Our goal is to create a new reality that includes a sustainable future for wild felids and other imperiled wildlife species.

Revisiting Cancel Culture

The combination of English letters that spells "cancel culture" is common and divisive. More people now say they are aware of this phrase, but its meaning, implication, and impact are still heavily debated. In this paper, I revisit cancel culture and discuss its impacts. I end this paper by urging application of cancel culture that reflect its root meaning and function, critical self-reflection, and restorative conversations if we are to make meaningful progress with cancel culture.

Legal Requirements for Progress Monitoring Under the IDEA: What Do the Courts Say?

ABSTRACT The special education literature has included a continuing line of articles and chapters that have translated for practitioners the legal meaning of the progress monitoring provisions in the successive versions of the Individuals with Disabilities Education Act (IDEA). This article examines this line of publications in light of the language of the applicable statutory framework and the parallel line of judicial rulings specific to progress monitoring under the IDEA. These judicial rulings, which are the centerpiece of this analysis and which span the period from 1990 to 2021, form a continuous and consistent pattern that is severely discrepant with the characterization in the publications to date. For example, in these progress-monitoring rulings, the courts have applied the relatively relaxed analyses of either the procedural or implementation – not the substantive – category of the IDEA’s “free appropriate public education” (FAPE) obligation. Similarly, rather than treating progress monitoring as an “absolutely essential” priority for IEPs based on objective measures and high frequency, the vast majority of the rulings have been in favor of districts despite evidence of progress monitoring provisions that are either entirely absent in the IEP or do not meet such rigorous standards. Consequently, based on overlapping criteria of completeness, accuracy, and transparency, the conclusion is that the legal quality of these special education publications warrants improvement to be commensurate with their impressive level of legal quantity. The suggested improvements include not only clear differentiation between, but also a solid foundation for, legal requirements and professional recommendations. Their purpose is not just monitoring but achieving meaningful progress in the legal literacy and professional practice in educating students with disabilities.

Global trends of cropland phosphorus use and sustainability challenges.

To meet the growing food demand while addressing the multiple challenges of exacerbating phosphorus (P) pollution and depleting P rock reserves1-15, P use efficiency (PUE, the ratio of productiveP output to P input in a defined system) in crop production needs to be improved. Although many efforts have been devoted to improving nutrient management practices on farms, few studies have examined the historical trajectories of PUE and their socioeconomic and agronomic drivers on a national scale1,2,6,7,11,16,17. Here we present a database of the P budget (the input and output of the crop production system) and PUE by country and by crop type for 1961-2019, and examine the substantial contribution of several drivers for PUE, such as economic development stages and crop portfolios. To address the P management challenges, we found that global PUE in crop production must increase to 68-81%, and recent trends indicate some meaningful progress towards this goal. However, P management challenges and opportunities in croplands vary widely among countries.