3 research outputs found

    Constructing The Role Of The Secondary Special Educator

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    The purpose of this research is to understand the perceived roles of secondary special educators, how they developed their role perceptions, and how their role perceptions determine their job functions. This study examines how secondary special educators, who primarily serve students with high incidence or mild disabilities, perceive their professional role across six public high schools in a southeastern state. Individual perspectives regarding their professional duties, job descriptions, schedules, and other artifacts were reviewed to examine how this group of teachers constructed their professional roles.The theoretical framework guiding this research is social constructionism. Exploring the influence of the social dynamics within the educational institution and the impact of these dynamic on how this group of teachers defined and performed their professional work was paramount to this study.A qualitative multiple case study approach was used to explore the meaning secondary special educators serving students with high incidence disabilities in public schools in three geographic areas of one state in the southeastern part of the United States placed on their roles and ensuing work. These cases were bounded by similar work assignments, time, and governing policies within one state. The resulting data suggests these teachersโ€™ daily duties may vary, yet they share common role perceptions that manifested in four themes: (1) thinking about inclusion as a service, not a philosophy; (2) recognizing a disconnect between instructional practices and Individual Education Program (IEP) goals; (3) performing the job as if they are a โ€œJack of all trades, but master of noneโ€; and (4) feeling subordinate to general education colleagues. Several implications for practice were identified

    Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

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    Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1ยท00, 95% CI 0ยท93โ€“1ยท07; p=0ยท95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0ยท99, 95% CI 0ยท94โ€“1ยท03; p=0ยท57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0ยท99, 95% CI 0ยท93โ€“1ยท05; p=0ยท79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

    Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

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    Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein โ‰ฅ75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mgโ€“800 mg (depending on weight) given intravenously. A second dose could be given 12โ€“24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21โ€ˆ550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0ยท85; 95% CI 0ยท76โ€“0ยท94; p=0ยท0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1ยท22; 1ยท12โ€“1ยท33; p<0ยท0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0ยท84; 95% CI 0ยท77โ€“0ยท92; p<0ยท0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research
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