As people age, they are more likely to have an increasing number of medical diagnoses and medications, as well as healthcare providers who care for those conditions. Health professionals caring for older adults understand that medical issues are not the sole factors in the phenomenon of this “care complexity.” Socioeconomic, cognitive, functional, and organizational factors play a significant role. Care complexity also affects family caregivers, providers, and healthcare systems and therefore society at large. The American Geriatrics Society (AGS) created a work group to review care to identify the most common components of existing healthcare models that address care complexity in older adults. This article, a product of that work group, defines care complexity in older adults, reviews healthcare models and those most common components within them and identifies potential gaps that require attention to reduce the burden of care complexity in older adults.

Background/Context A number of recent policies have specifically attacked immigrants and English Language Learners (ELLs), including Georgia's HB 87 (2011), Arizona's SB 1070 (2010), and Alabama's HB 56 (2011), among others. The policy focus of this study is Arizona's HB 2064 (2006), which added additional requirements that mandate tracking students by English language proficiency and separating English language instruction from subject matter for ELL students. Few scholars have considered how these broad social policies impact professional development (PD)-induced classroom change, especially in mathematics education. This sociopolitical context cannot help but affect teachers’ willingness to take on new practices in PD and thus affect educational opportunities for Latinos and English Language Learners. Yet, policies that target ELLs have not received much attention within mathematics education or PD. This exploratory study details teacher change produced by mathematics PD efforts before and after a new ELD policy was implemented in order to better understand this intersection. Purpose/Objective/Research Question/Focus of Study The teachers in this study participated in mathematics professional development focusing on Cognitively Guided Instruction (CGI). This exploratory research documents how teachers experimented in their classrooms before and after this policy was implemented and teachers’ views of HB 2064. Two research questions guided the study: 1) How did the mathematics PD affect change in teacher knowledge and classroom practice? and 2) How did the conflicting policy and PD efforts influence change in elementary mathematics instruction? Setting This research took place in the Monroe Elementary School District, an urban school district in Arizona. Three schools participated in mathematics professional development based on CGI principles. The student population was 95% Hispanic and 46% ELLs, and 89% of students received free or reduced lunch. Therefore, Arizona's policies had the potential to greatly impact the student population in this school. Population/Participants/Subjects The professional development was implemented with three groups of K–3 teachers (n=44). Across the PD, just over one fourth of participating teachers were bilingual in Spanish and English. Intervention/Program/Practice The professional development focused on the principles of CGI, combining earlier work on student strategies and problem types (Carpenter, Fennema, Franke, Levi, & Empson, 1999) with more recent work on algebraic thinking (Carpenter, Franke, & Levi, 2003) and counting (Schwerdtfeger & Chan, 2007). This model of professional development focuses teachers on the development of student thinking, problem types for various mathematical operations, and building instruction from this knowledge base. The PD consisted of monthly on-site workgroup meetings and weekly on-site visits to support teachers in their classrooms. Research Design The research team conducted a mixed methods study of teacher change across the district. The study followed teachers for two years—one year before the policy was implemented and the year it was implemented—documenting the practices teachers maintained in their elementary mathematics classrooms. The study used a mixed methods design to respond to the two research questions (Creswell, 2003). A teacher knowledge assessment was used to see if teachers were gaining new knowledge as they implemented the principles of the PD. Observations allowed for the study to look at teacher experimentation in classrooms. Finally, an interview on the policy and its impact on their classroom practices was performed to add more understanding to why teachers did or did not implement more PD practices. Findings/Results Teacher knowledge change was minimal across the professional development. However, the data on change in practice suggest that more practices were adopted before the policy was implemented than during implementation. In contrast, teachers reported that the policy had minimal effect on their mathematics instruction. This conflict, between change in practice and the perceived lack of policy impact, seemed to be due to teachers’ view of mathematics and language as fundamentally separate. It also was related to an alignment between teacher beliefs and the views embedded in the policy. Conclusions/Recommendations The findings raise concerns about the conflict between PD and policy in generating teacher change. New questions emerge from this work about taking into consideration the sociopolitical context when researching PD efforts focused on intersections between policy and subject matter. Questions also emerge about the alignment of ideology in policy with teachers’ beliefs. The authors call for work in mathematics PD that takes on the intersections between policies and PD efforts and that targets particular student populations. Additionally, more research would be beneficial for understanding the impact of the sociopolitical context on teacher change efforts.

BACKGROUND: Many older adults with limited life expectancy still receive cancer screening. One potential contributor is that primary care providers (PCP) are not trained to incorporate life expectancy in cancer screening recommendations. We describe the development and evaluation of a novel curriculum to address this need. METHODS: We developed and implemented a web-based learning module within a large Maryland group practice with PCPs for older adults. We assessed attitude, knowledge, self-efficacy, and self-reported behavior outcomes before the module, immediately after completing the module, and 6 months afterwards. RESULTS: Of 172 PCPs who were invited, 86 (50%) completed the module and of these, 50 (58.1%) completed the 6-months follow up survey. Immediately after the module, there was a significant increase in perceived importance of life expectancy (increase of 0.50 point on 10-point scale, 95% confidence intervals (CI) = 0.27-0.73), confidence in predicting life expectancy (increase of 2.32 points on 10-point scale, 95% CI = 1.95-2.70) and confidence in discussion screening cessation (increase of 1.69 points on 10-point scale, 95% CI = 1.37-2.02). Knowledge in patient-preferred communication strategies improved from 55% correct response to 97% (P < .001). However, most of these improvements dissipated by 6 months and there was no change in self-reported behavior at 6 months compared to baseline (P = .34). CONCLUSION: Although the module resulted in significant short-term improvement in attitude, knowledge, and self-efficacy, the changes were not sustained over time. Educational interventions such as this can be coupled with ongoing reinforcing strategies and/or decision support interventions to improve cancer-screening practices in older adults.

The 2011 Hearst Philippine Biodiversity Expedition was the largest ever launched by the California Academy of Sciences, and was also the largest and most diverse expedition to ever take place in the Philippines. Filipino collaboration and participation were vitally important from the outset. Scientists of both nations documented biodiversity in a variety of habitats and across multiple biological disciplines, identifying more than 500 species new to science. The expedition also modeled a new way of embedding substantial educational outreach and media coverage, and promoting conservation actions. More than 900 people attended educational events in the Philippines. Extensive television, radio, online, and print media coverage occurred both in the Philippines and in the U.S. during the expedition and after. A conference at the end shared preliminary results among scientists, educators, policy makers, and media, before the Academy team even left the country.

The SETI Institute, the California Academy of Sciences, NASA Ames Research Center, and San Francisco State University have developed standards-based curriculum materials for a one-year high school integrated science course centered on the unifying theme of evolution. Scientists, teachers, curriculum writers, and media specialists are currently finalizing six modules that integrate astronomical, geological, and biological sciences as well as the history of science and technology. The sequence of lessons in each module is designed to promote students' understanding and skills as defined by the National Science Education Standards and Benchmarks for Science Literacy. The modules cover: Cosmic Evolution, Planetary Evolution, Origin of Life, Evolution of Life, Hominid Evolution, and the Evolution of Technology. The core lessons for all six modules are provided via CD-ROM, including instructional guidelines, science background information, and additional resources (print, audiovisual, software, WWW sites, and databases). These products will be published as a complete set for use as a yearlong science course and will also be available as individual modules for use in discipline-based courses. Evolutionary change is a powerful framework for studying our world and our place therein. It is a story of epic size, capable of inspiring awe and of expanding our sense of time and place. This story is the basis of Voyages Through Time.