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From 2010 to 2017, the United States experienced a significant increase in maternal opioid-related diagnoses and neonatal abstinence syndrome (NAS). NAS is increasingly being referred to as neonatal opioid withdrawal syndrome (NOWS), as opioids are becoming the most common cause of neonatal withdrawal, whether alone or in the presence of other substances. A major challenge in the field is the lack of a standardized clinical definition of NAS. To address this challenge, the authors convened two modified-Delphi expert panels consisting of national experts on substance-exposed mother-infant dyads. Through these online panels, the authors solicited expert opinion to inform the development of clinical definitions of NAS and NOWS for use at the bedside as part of the U.S. Department of Health and Human Services initiative on NAS. To convene the panels, the authors used ExpertLensTM, a previously evaluated platform for conducting iterative online modified-Delphi panels. Participants provided initial responses to study questions about key components of the clinical definition of NAS and NOWS; reviewed how their responses compared to those of other participants; and revised their responses based on group feedback and discussion, if needed. Eighteen experts provided numeric ratings and free-text comments to contextualize their responses. Simple descriptive statistics, including frequency distributions, medians, interquartile ranges, as well as the RAND/UCLA Appropriateness Method Manual's approach to determining consensus in expert panels were used to analyze rating data, and the authors thematically analyzed the experts' free-text comments.

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To update its teaching and departmental review processes, Phillips Academy Andover, an independent boarding school in Massachusetts, commissioned RAND Corporation researchers to review the school's policies, conduct a literature review, interview other independent high schools, develop potential recommendations for revision of Andover's processes, and revise those recommendations after vetting them with Andover's faculty. This report summarizes their work. The report is intended primarily for Andover administrators and teachers to guide their revision of their teaching and departmental review processes, but it also provides relevant research that independent schools can use to inform their design of teaching and departmental review policies. To help readers understand how proposed changes may or may not work in different contexts, the report includes Andover teachers' reactions to initial potential recommendations, the authors' subsequent revisions to the recommendations based on teacher's feedback, and Andover administrators' reactions to the authors' final recommendations.