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Improving Schools to Promote Upward Mobility: The Promise and Limits of School Finance Reforms
No full textAs part of the Brookings Scholar Lecture Series, Brookings Mountain West presents a lecture titled, Improving Schools to Promote Upward Mobility: The Promise and Limits of School Finance Reforms by Brookings senior fellow in economic studies, Sarah Reber.
Systematic differences in access to high-quality schools by race, income, and other characteristics perpetuate inequality across generations. Local property tax financing of schools is often identified as a key cause of unequal educational opportunity. While the consensus of rigorous research supports the common intuition that, on average, “money matters” in improving educational outcomes, questions about how much, and under what conditions, school funding affects performance remain unresolved. To improve schools, should policymakers and advocates focus primarily on increasing funding, or are other reforms equally (or more) important?
In this lecture, Brookings Cabot Family Fellow in Economic Studies Sarah Reber explains how schools in the United States are funded, how that has changed over time, which schools have the least (and most) funding, and what it means for inequality and economic mobility
Opting out of AI”: Exploring Perceptions, Reasons, and Concerns Behind Faculty Resistance to Generative AI
No full textResearch on Generative Artificial Intelligence (GAI) in higher education primarily focuses on faculty use and experiences, with limited attention given to why some abstain from using it. Drawing from Innovation Resistance Theory, this study aims to address this gap by exploring the perceptions of both faculty users and non-users of GAI, identifying the reasons and concerns why they avoid GAI. A survey of 294 full-time higher education faculty from two mid-size U.S. public universities was conducted. Using qualitative and quantitative analysis, results show that over one-third of the faculty members opted out of using GAI for five primary reasons: not ready/not now, no perceived value, identity in tension, threat to human intelligence, and future fears and present risks. While both groups expressed concerns about academic dishonesty, non-users associate GAI with broader negative societal consequences, whereas users viewed it as related to innovation and potential benefits. For non-users, top concerns included a perceived lack of originality and accountability, while users were primarily concerned with accuracy. Surprisingly, general comfort with technology emerged as a significant predictor of non-user faculty’s behavioral intention to use GAI. This research contributes to understanding faculty resistance to GAI, emphasizing the need to balance its benefits with drawbacks in higher education
A Case Series: Effectiveness of Nintendo Ring Fit in Improving Balance and Stability Deficits after Recovery from ACL Reconstruction
No full textTopics in Exercise Science and Kinesiology Volume 6: Issue 1, Article 10, 2025. This study aimed to assess the effectiveness of a gaming system in improving balance, strength, and power after recovery from an anterior cruciate ligament reconstruction (ACLR). Existing bilateral deficits were also assessed among patients.
Four participants between the ages of 18-24 years were recruited for this case-control study. Participants must have had an ACLR in the last 2 years, been discharged from formal physical therapy, and have a continued history of participating in physical activity at least three times a week. Participants were assigned to either the experimental or control groups using counterbalancing. The two experimental participants were asked to complete six weeks of guided programming on a Nintendo Ring Fit at home. Balance and stability (functional movement screen), strength (handheld dynamometry), and power (triple hop) were assessed and compared pre and post the intervention, in addition to a basic analysis of current activity level and injury details. Minimal improvements in strength were witnessed for the experimental (3.11 ± 2.23% change) whereas the control group declined (-14.11 ± 5.67% change). Improvements for the involved limb were found in ankle closed-chain dorsiflexion range of motion (38.11 + 5.02% change) and triple hop performance (27.62 + 5.18% change) for the experimental group. Participants in the experimental group also made improvements toward the functional pass criterion of the Functional Movement System Motor Control Screen (9.31 + 10.40% change). The involved limb within the experimental group (19.78 + 7.76 % change) improved by +3.74% more than the involved limb in the control group (16.04 + 8.21% change) in the crossover hop test. The Nintendo Ring Fit may be effective in improving balance, stability, and power following ACLR. Further research is needed to assess its effectiveness across all measures
The Role of Prediction Error in Episodic Memory
No full textPredictions play an important role in our everyday lives. We make predictions (whether conscious or unconscious) about what we will encounter. However, we will also experience discrepancies between predictions and observed outcomes (i.e., prediction error; PE). There are inconsistencies in the literature regarding how PE affects memory. Several studies find that PE facilitates memory (e.g., Greve et al., 2019), while others find that it harms memory (Kim et al., 2013). The aim of the present study was to determine which conditions may lead to PE facilitating memory and which conditions may lead to worse memory. We tested two PE models, The Predictive Interactive Multiple Memory Signals model (PIMMS) and The Schema Linked Interactions between Medial Prefrontal and Medial Temporal Lobe model (SLIMM). PIMMS argues the larger PEs will result in better memory compared to small PEs. In experiment 1, we tested this assumption by manipulating the frequency of PE. The High Certainty condition had few PEs while the Low Certainty condition contained many PEs. We predicted that PE would facilitate memory in the High certainty condition compared to no PE. We did not predict a difference in memory between PE and no PE in the Low certainty condition. However, we found memory was worse for PE items compared to no PE items, in the Low Certainty condition only. In experiment 2, we manipulated the strength of PE such that PE was either, high, moderate or low. SLIMM predicts a U-shape function such that High PE and Low PE should both be facilitated. However, we found no significant difference between the three levels of PE. Thus, our predictions based on PIMMS and SLIMM were not supported
Patient Engagement and Treatment Adherence in End-Stage Renal Disease Hemodialysis Patients
No full textIntroduction: Chronic hemodialysis patients have a significant treatment-related burden due to the physical and emotional challenges associated with disease management. The physical side effects of hemodialysis treatment, such as pain, muscle cramps, hypotension, nausea, vomiting, fatigue, and pruritus, often contribute to significant emotional challenges, such as depression and anxiety, experienced by 15-45% of patients. These challenges affect their ability to manage the chronic nature of hemodialysis, including lifestyle modifications such as frequently scheduled appointments and changes in functional status, which affect adherence to treatment and treatment outcomes. The present study aimed to examine the association between patient engagement and adherence to HD guidelines and whether the patient engagement level correlates with patient adherence. Engagement was defined as the developmental process of psychological and emotional adaptation to chronic disease, influencing a person’s ability to play an active role in chronic disease management. Adherence was defined as how a person’s behavior compares to the recommendations of the National Kidney Disease Quality Initiative (NKDQI) guidelines of treatment time and fluid restriction. Methods This was a cross-sectional, descriptive study. The final analyses included two hundred and four hemodialysis patients from five Fresenius Medical Care community in-center units. While undergoing hemodialysis treatment, each participant answered a demographic survey and two engagement surveys. Treatment data was obtained from the electronic medical record. Patient engagement was measured using the Patient Health Engagement Scale® (PHE-S®) and Patient Activation Measure® (PAM-13® survey). Adherence was defined as 1) they had interdialytic weight gain (IDWG) \u3c 2.5 kg and 2) their time on the dialysis treatment was within 15 minutes of the recommended prescribed treatment time (taking into consideration specific reasons for changes in treatment time). To answer the study questions, Pearson’s correlation and Spearman’s correlation, t-test, Mann-Whitney U test, chi-square, and multivariate binomial logistic regression analyses were used to answer the research questions. Results: Univariate analyses identified four factors associated with adherence: age, race, employment status, and length of time on HD. In both multivariate models, Model 1(PHE-S®) and Model 2 (PAM-13®), there was no independent association between adherence and engagement after adjusting for demographic, disease-related, and substance use factors. However, in model 2, using the PAM-13®, increasing age was associated with increased odds of being adherent. Discussion: Adherence is multifaceted, especially in chronic hemodialysis care, requiring continuous patient and family engagement. Adherent patients to fluid restriction and treatment time had higher engagement scores; though not statistically significant, the findings had clinical relevance. The innovative aim of this study was to see if there was a relationship between the psychological and emotional adaptation to chronic disease, influencing a person’s ability to play an active role in chronic disease management (engagement) and adherence after adjusting for demographic, disease-related, and substance use factors. The first model that included the PHE-S® did not identify any significant findings. However, white patients had increased odds of being adherent. The second model that included the PAM-13® identified age as the only significant variable associated with adherence. Participants with a level three or four on the PAM-13® had increased odds of being adherent; However, the result was not statistically significant in the current study. A broader Nursing perspective of nonadherent patients should consider the importance of age and race in developing research to improve engagement interventions and adherence
Machine Learning Methods and Transcranial Direct Current Stimulation for the Understanding and Treatment of Parkinson’s Disease
No full textParkinson’s disease (PD) affects over 10 million people and its prevalence is projected to double by 2040 worldwide. Current pharmacological or surgical options provide only symptomatic relief. Anodal transcranial direct‑current stimulation (tDCS) of the primary motor cortex (M1) is a promising, inexpensive adjunct treatment modality that could be efficacious in PD. However, its optimal stimulation parameters remain unknown, and the rapidly expanding trial literature makes it challenging to interrogate manually. To address these issues, we built a large‑language‑model pipeline that automatically extracted, cleaned and tagged every PD and tDCS record on ClinicalTrials.gov. This resulted in 64 trials, double the count of a standard keyword search, with perfect inter‑model agreement on core stimulation parameters. In addition, two experimental studies were completed to compare different tDCS parameters of stimulation on motor skill, transfer of motor skill, and cortical excitability in PD.Chapter 1 provides a comprehensive overview of the history, evolution, mechanisms, theories, and specific applications of non-invasive brain stimulation, and introduces relevant motor learning principles to establish a foundation of essential knowledge. The chapter is intentionally written in a clear, non-technical style to ensure that readers can grasp the technical content presented in chapters two through four, regardless of their initial understanding of brain stimulation and motor learning. Chapter 2 aimed to determine whether a parallel‑LLM extraction pipeline (GPT‑4, Claude 3.5 Sonnet, Llama 3.1 70B) can retrieve and structure ClinicalTrials.gov data on tDCS in PD more completely and efficiently than conventional keyword‑based searches. The secondary purpose was to compare the three LLMs’ relative strengths and limitations in parsing clinical‑trial protocols, quantify their agreement on key elements (e.g., stimulation parameters, anatomical targets, treatment duration), and identify where human oversight is still required. The study method was an automated, API‑driven, single‑dataset, parallel‑processing implementation in which sixty‑four PD‑tDCS trials (identified with API queries plus regex filtering) were fed in parallel to the three LLMs under an identical, JSON‑constrained prompt. Each model’s output was schema‑validated and logged; discrepancies were analyzed with percent agreement, Cohen’s κ, ICC, and error metrics. The final outcomes included total trials captured versus baseline search (64 vs 28), inter‑model reliability for simple (κ \u3e 0.90) and complex (κ ≈ 0.60) attributes, and numeric‑parameter concordance (intensity ICC = 1.0; duration ICC = 0.35). Pairwise comparisons showed substantial agreement among language models, with the highest concordance seen for identifying brain stimulation presence (97.9%) and non-invasive classifications (96.8%); reliability varied across models and extracted parameters. While large language models exhibit strong potential for automating trial protocol analysis, their varied performance on complex extraction tasks highlights the continued need for human oversight and multi-model ensemble approaches to ensure accuracy and reliability. Chapter 3 investigated the impact of tDCS applied before versus during motor practice on motor skill acquisition in PD. The secondary purpose was to determine the influence of tDCS on the transfer of motor skill in PD. The study employed a single-blind, SHAM-controlled, within-subjects design, and 12 individuals with PD completed a SHAM condition, a tDCS before motor practice condition (BEFORE), and a tDCS during motor practice condition (DURING) in three separate experimental sessions. The practice task was a complex visuomotor isometric precision grip task (PGT). In addition, motor skill transfer tasks and transcranial magnetic stimulation (TMS) measures of cortical excitability were performed pre- and post- each practice and stimulation period in the three conditions. The force error in the PGT was significantly lower in the BEFORE condition compared to the SHAM condition (p = 0.031). Force error was also lower in the DURING condition compared to the SHAM condition, but this difference was not statistically significant (p = 0.15). Furthermore, neither tDCS condition significantly enhanced performance in any of the motor skill transfer tasks. Similarly, there was no significant effect of tDCS on measures of cortical excitability. Collectively, these results indicate that tDCS of M1 applied before practice enhances motor skill acquisition in PD, but tDCS does not lead to significant increases in the transfer of motor skill or cortical excitability. Finally, in Chapter 4, the primary purpose of this study was to determine the influence of tDCS intensity on motor skill acquisition in individuals with PD. The secondary purpose was to examine the effects of tDCS intensity on motor skill transfer in PD. The study utilized a SHAM-controlled, single-blind, within-subjects crossover experimental design. A total of 15 individuals with PD performed three experimental sessions (SHAM, 1 mA tDCS, and 2 mA tDCS conditions) that involved practice of a complex visuomotor isometric precision grip task (PGT). Furthermore, assessments of motor skill transfer and transcranial magnetic stimulation (TMS) metrics of cortical excitability were administered prior to and following each practice and stimulation session in all three experimental conditions. Although, the force error in the PGT was lower in both the 1 mA and 2 mA tDCS conditions compared with the SHAM condition, a one-way ANOVA revealed that these differences failed statistical significance (p = 0.075; ηp2 = 0.169). Similarly, transfer task motor performance was not significantly improved and cortical excitability was not increased following either of the two tDCS conditions compared to the SHAM condition. The findings of this study collectively suggest that acute single session applications of tDCS at two commonly used stimulation intensities do not produce considerable enhancements in motor skill acquisition, motor skill transfer, or cortical excitability in PD
The Effects of Blood Flow Restriction and Body Weight Support Treadmill Walking on Electromyographic Activity in Lower Limb Muscles
No full textBlood flow restriction (BFR) is an emerging rehabilitation modality shown to enhance muscle activation and elicit strength gains comparable to high-intensity training at lower loads (Cognetti et al.,2019). Body weight support (BWS) treadmill walking is another modality that has gained popularity due to the effect it has on lowering muscle activation with increasing support levels (Jensen et al.,2016). However, to date no research has looked at electromyographic (EMG) activity utilizing both modalities concurrently. This study investigated if stride frequency (SF) and muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) and gastrocnemius (GA) would be influenced by an interaction between BWS and BFR. Seven healthy participants (3 men and 4 women; age: 23.71 3.01yrs; height: 171.27 6.91 cm; body mass: 64.38 4.94 kg; body fat percentage: 18.76 5.44 %) completed four walking conditions at 0% & 50% BWS with and without 80% occlusion pressure of BFR at a self-selected speed. EMG activity was recorded for 30s during each condition. Results revealed that EMG activity was not influenced by an interaction between BWS and BFR for SF (P=.345), RF (P=.845), BF (P=.684), TA (P=.761) and GA (P=.129). Additionally, BFR alone did not influence EMG activity across muscles (SF (P=.161);RF (P=.639); BF (P=.684);TA (P=.479);GA (P=.404)), nor did BWS ( SF (P=.740); RF(P=.675); BF (P=.900); TA (P=.102), except for GA (P=.039). These finding suggest that BFR did not influence EMG activity regardless of BWS. Thus, suggesting that further research is needed to further explore the neuromuscular effects of BFR under varying levels of BWS and walking speeds
Biomechanical Accommodation: Learning to Move in The Lower Body Positive Pressure Treadmill
No full textIn 2022, 31% of the global population were considered physically inactive. Running and walking are two forms of natural human locomotion that are both sufficient and easily accessible ways to meet the physical activity guidelines. Running is a popular activity; however, many individuals who participate are faced with overuse injuries. These injuries are caused by repetitive ground reaction forces (vGRF) applied with each foot-strike. Evidence has reported that runners who get injured do not replace running with another form of physical activity. This causes a cycle of physical inactivity to develop that is difficult to break out from. When considering populations that are currently inactive, walking is an approachable form of improving health and fitness. Walking has lower vGRFs associated, but for those who are currently inactive, walking can cause overloading issues at their lower extremity. Discomfort and low self-confidence have been reported to be reasons for early physical activity program dropouts. For both running and walking, providing bodyweight support can minimize potential discomfort and be supplemented in training programs. The Lower body positive pressure treadmill (LBPPT) is a tool that works to provide air pressure and reduce the vGRFs that during both running and walking. However, the LBPPT is a novel environment for many participants, and many previous investigations have focused on short trials. The disagreements regarding LBPPT findings may be attributed to the lack of consideration of this effect, or an accommodation period. Therefore, the purpose of this dissertation was to investigate the presence of an accommodation period during LBPPT running and walking across two populations. The series of studies assessed the effect of prolonged running and walking on the LBPPT to understand the influence on devices on gait. The LBPPT causes changes to preferred movement patterns that cause inconsistencies in both running and walking gait. We were able to identify the point of accommodation during both exercises and provide a framework for utilizing the LBPPT for training
\u27We Owe, You Know, the World Our Perfection\u27: How the Neurodiversity Paradigm Informs Autistic Women\u27s Self-Perceptions
No full textThis qualitative, phenomenological study examines how autistic women characterize and interpret their experiences, beliefs, and self-perceptions within the framework of the neurodiversity paradigm. Guided by a social constructivist epistemology, this study explores the complex intersections between autistic women’s experiences of diagnostic processes, gendered socialization, and identity formation in autistic women. Through semi-structured interviews with ten autistic women, themes emerged around gender differences between autistic men and women, external versus internal self-perception, diagnostic age and self-perception, sensory overload and its consequences, and the journey from feeling othered to finding one’s place socially. Findings suggest that delayed diagnosis and persistent societal pressures to conform to normative feminine roles significantly distorted self-perception and hinder authentic self-concept development. However, exposure to neurodiversity-affirming discourses—including stimming destigmatization, the use of identity-first language, and the reconceptualization of autism as a strength—has the potential to radically reshape autistic women’s internal narratives. Participants who engaged with neurodiversity frameworks described increased self-compassion, existential clarity, and a reclaimed sense of personal empowerment. This study addresses critical gaps in the literature by amplifying underrepresented voices and synthesizing three previously siloed domains: autistic self-perception, neurodiversity orientation, and women’s gendered experiences of autism. Ultimately, these findings highlight a need for more aware diagnostic practices, increased autistic representation in practitioner roles, and the widespread adoption of neurodiversity-affirming frameworks to support the flourishing of autistic women
Balanced Artistry: Integrating The Methods of Michael Chekhov and Body Mapping for the Versatile Singing Actor
No full textThis document explores the integration of movement-based techniques in vocal performance training by focusing on integrating Michael Chekhov’s acting method and Body Mapping. It examines how these methodologies enhance expressive freedom, technical efficiency, and injury prevention in singers. By providing a framework for performers to embody characters with greater authenticity, this document contextualizes exercises from both Body Mapping and Chekhov’s technique through an interdisciplinary approach that enhances student achievement of technical vocal and acting proficiency. Synthesizing principles from Body Mapping, such as inclusive awareness and the dynamic points of balance, with key elements of Michael Chekhov’s acting technique, including crossing the threshold, archetypal gesture, and qualities of movement, this work presents strategies for incorporating movement into the modern voice studio and opera workshop space. Examples of lesson plans, exercises, and modalities of execution will be shown. This research contributes to a growing body of work advocating for a holistic approach to vocal training and emphasizes the inseparable connection between body, breath, and artistic expression