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Ongoing validation work has continued with the 2017 and 2018 NSCH, including the addition of new items to the survey, and subsequently to the measure. The measure requires additional pilot testing to establish validity (meaning the degree to which the tool measures what it is intended to measure in the real world).

Data from HRTL pilot measures indicate that the measure is a promising tool that can contribute useful information regarding the well-being and school readiness of young children in the years leading up to their kindergarten entry. First, preliminary analyses with the pilot measure using 2017-2018 NSCH data indicate robust patterns of association between the HRTL pilot measure and correlates of kindergarten readiness, including exposure to early adversity, parental education, and family strengths (forthcoming in 2020). Second, estimates of the percentage of children who are On Track with the HRTL measure do not differ greatly from some kindergarten readiness or entrance assessments used by states. The commonalities are promising, given the differences between teacher-reported and parent-reported measures of development. Finally, as a population monitoring tool embedded within a very large, annual, and nationally representative survey that provides rich data on the context and conditions of child development and well-being within the United States, the HRTL measure is poised to serve as a key indicator of well-being.

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Within spinal surgery CAS is typically used for placement of instrumentation. A recent survey among AOSpine surgeons (Hrtl, et al, unpublished 2010) showed that CAS is particularly helpful in three areas: complex spinal surgery, such as deformity and revision surgery; minimally invasive spinal surgery (MIS); and surgery in challenging anatomy, such as thoracic and cervical instrumentation.

A better understanding of these reasons would be essential in order to determine the current deficits of navigation and how these can be addressed. Therefore, the previous Access and Navigation Expert Group decided to perform an internet-based survey among AOSpine surgeons in order to better understand current attitudes towards spinal navigation (Hrtl, et al, unpublished 2010).

678 out of 3,348 contacted spine surgeons (20%) responded to a 12-item questionnaire that assessed the experiences with CAS and their current attitudes towards its use in spine surgery (Fig 10). The results showed that while 35% of overall surgeons actually had CAS available at their institution only few used CAS routinely. Despite an even more widespread distribution of navigation systems in North America and Europe only 11% used it routinely. Surgeons performing a high volume of spinal fusions are more likely to use CAS than surgeons performing a lower volume of spinal fusions, indicating that high-volume users may have integrated CAS more effectively into their workflow. This goes against previous thoughts that navigation may be used by surgeons who are not that familiar with instrumentation and would rely on CAS to facilitate procedures in the OR. Routine users considered its accuracy, the potential of facilitating complex surgery, and the reduction in radiation exposure as the main advantages of CAS. Routine users identified the increase in OR time associated with CAS as the main reason why they did not use CAS more frequently. The lack of equipment, inadequate training, and high costs were quoted by the majority of the nonusers as the main reasons for not using CAS. The survey also showed that 42% of surgeons felt positively about CAS and that 37% had strong and very strong positive beliefs about the benefits of navigation. Overall, neurological surgeons and surgeons with a busy MIS practice were more likely to use CAS. In summary, the survey demonstrated that the majority of responding surgeons had positive beliefs about navigation.

Industry analysts see this M&A wave continuing. Further, according to a Definitive Healthcare survey just released, industry consolidation was listed as the most important trend of the year, leading the way with 25.2% of the votes.

Module 1BackgroundUnit 1Introduction Unit 2How to use this playbook Module 2PartnershipsUnit 1What is the role of partnerships in information sharing? Unit 2What strategies can be used to identify and engage partners? Unit 3Talking points for engaging partners and identifying champions Module 3Proposed indicatorsUnit 1Indicator summary Module 4School attendanceUnit 1Definition Unit 2Domains to assess school attendance Unit 3Data on school attendance Unit 4Examples of school attendance to monitor trends Module 5School disciplinary actionsUnit 1Definition Unit 2Domains to assess school disciplinary actions Unit 3Data on school disciplinary actions Module 6School readinessUnit 1Definition Unit 2Domains to assess school readiness Unit 3Data on school readiness Module 7Next stepsUnit 1Next steps Module 8AppendicesUnit 1Appendix A: Key terms Unit 2Appendix B. School disciplinary action scenario workflows Unit 3Appendix C: School readiness assessment tools Unit 4Appendix D: Legal considerations Unit 5Appendix E. Additional data sharing information, resources and considerations Unit 6Appendix F. User stories Unit 7Feedback survey Module 9ReferencesUnit 1References be457b7860