Section 504: Private College Receiving Federal Assistance Must Provide Funds for Interpreter Services for Deaf Student

Barnes v. Converse College, 436 F. Supp. 635 (D.S.C. 1977). In the 1960\u27s, a political and legal revolution began because there was a significant minority population which had to sit at the back of the bus. Today it is realized that a significant minority cannot even get on the bus. This significant minority, which has been estimated to include 20-35 million persons, are the handicapped individuals of America who have at last come forward in great numbers to demand the equal rights and protections which have been denied them for so many years. This most recent social movement has been termed a new era of civil rights by Joseph A. Califano, Jr., Secretary of the United States Department of Health, Education, and Welfare (HEW), at a recent White House Conference on Handicapped Individuals. In response to the growing outcry for an effective government mechanism to oversee enforcement of the laws and regulations passed for handicapped reform, Secretary Califano, under order from President Gerald Ford, recently signed a regulation implementing section 504 of the Rehabilitation Act of 1973, which prohibits discrimination solely on the basis of handicap against otherwise qualified handicapped individuals in programs receiving federal financial assistance. The new section 504 has already presented many unanswered questions regarding the scope of its effect and the liability of those who are subject to it. In Barnes v. Converse College, a deaf teacher has sought to enforce section 504. This case may serve as a fundamental guidepost for future litigation by demonstrating how far the courts are willing to go toward enforcement in the area of post-secondary educational aids to the handicapped

Culture, surprise, and adaptation: Examining undergraduate students’ matriculation processes

The purposes of this study were to (a) explore undergraduate students’ experiences as they transitioned to the university, (b) explore how the cultures of students’ hometowns influenced student culture at the university, and (c) provide a conceptual model which has analytical generalizability across higher education. This ethnographic research focuses on developing a cultural knowledge of hometown community culture. While previous research examined how college affects students, this research reverses the approach and investigates how the students and their hometown community values actually affect the college community. To investigate these topics, I did ethnographic observation including trips to students’ hometowns and conducted in-depth interviews with 21 diverse students to learn about their matriculation process and how hometown culture(s) affected their entry into Eastern Michigan University. To examine the hometown cultural environment and the institutional cultural environment, I used ten cultural categories including (a) demographics, (b) tasks/jobs, (c) income, (d) family structure, (e) education, (f) physical environment, safety, and security, (g) ideology, (h) activities, entertainment, and rituals, (i) schools, and (j) extracurricular activities. Comparing hometown cultural environment to institutional cultural environment resulted in either a match or a mismatch; a mismatch was termed a “surprise” for students. I discovered that students must make sense of the institutional environment when they matriculate to the university. Adaptation, how individuals construct reality and interpret situations, is a significant process for undergraduate students at the institution. Since students come from different communities in southeast Michigan and have different experiences prior to their collegiate experience, they experience different surprises and react to these surprises in different ways. This study, which examined students’ organizational entry from a hometown in southeast Michigan to EMU, found that students experience a surprise once at the institution. As a result of the surprises, students adapted in one of two ways, either behaviors which resulted in integration or segregation. The adaptation process is an ongoing process, which is initiated by incongruencies between a student’s hometown culture and the campus culture (i.e., mismatches or surprises). Overall, this research has helped me better understand the needs, perspectives, and aspirations of the students whom I serve

Phylogeography of the crown-of-thorns starfish in the Indian Ocean

Background: Understanding the limits and population dynamics of closely related sibling species in the marine realm is particularly relevant in organisms that require management. The crown-of-thorns starfish Acanthaster planci, recently shown to be a species complex of at least four closely related species, is a coral predator infamous for its outbreaks that have devastated reefs throughout much of its Indo-Pacific distribution. Methodology/Principal Findings: In this first Indian Ocean-wide genetic study of a marine organism we investigated the genetic structure and inferred the paleohistory of the two Indian Ocean sister-species of Acanthaster planci using mitochondrial DNA sequence analyses. We suggest that the first of two main diversification events led to the formation of a Southern and Northern Indian Ocean sister-species in the late Pliocene-early Pleistocene. The second led to the formation of two internal clades within each species around the onset of the last interglacial. The subsequent demographic history of the two lineages strongly differed, the Southern Indian Ocean sister-species showing a signature of recent population expansion and hardly any regional structure, whereas the Northern Indian Ocean sister-species apparently maintained a constant size with highly differentiated regional groupings that were asymmetrically connected by gene flow. Conclusions/Significance: Past and present surface circulation patterns in conjunction with ocean primary productivity were identified as the processes most likely to have shaped the genetic structure between and within the two Indian Ocean lineages. This knowledge will help to understand the biological or ecological differences of the two sibling species and therefore aid in developing strategies to manage population outbreaks of this coral predator in the Indian Ocean

Identifying and Tracking Gas Suicides in the U.S. Using the National Violent Death Reporting System, 2005–2012

IntroductionIdentifying the source and specific type of gas used in suicides is difficult using most data systems owing to limitations in ICD-10 coding. The National Violent Death Reporting System (NVDRS), with its rich collection of both coded and free-text variables, has the potential to overcome these limitations. This study used a multipronged approach to identify gas-specific suicides in NVDRS and to track the incidence of these suicides over time.MethodsUsing suicide cases from the 16 NVDRS states that participated throughout 2005–2012, free-text and code searches were conducted for four types of variables—incident narratives, coroner/medical examiner cause-of-death statements, cause-of-death codes, and substance names—to identify suicides by carbon monoxide, helium, hydrogen sulfide, and four other gases. All analyses were conducted in 2015.ResultsApproximately 4% (3,242 of 80,715) of suicides recorded in NVDRS over the study period were the result of gas inhalation. Of these, the majority (73%) were carbon monoxide suicides (almost exclusively from motor vehicle exhaust and charcoal burning). Other types of gas (most notably helium), once rare, are now more common: At the start of the study period non–carbon monoxide gas suicides represented 15% of all gas suicides; at the end of the study period, they represented 40%.ConclusionsPublic health policies to reduce a suicidal person’s access to more lethal suicide methods require a reliable source of surveillance data on specific methods used in suicide. Small changes to NVDRS could make it an efficient and nimble surveillance system for tracking these deaths

Improving Data Infrastructure to Reduce Firearms Violence

In the fall of 2020, Arnold Ventures, a philanthropy dedicated to maximizing opportunity and minimizing injustice, and NORC at University of Chicago, an objective nonpartisan research institution, released the Blueprint for a US Firearms Infrastructure (Roman, 2020). The Blueprint is the consensus report of an expert panel of distinguished academics, trailblazing practitioners, and government leaders. It describes 17 critical reforms required to modernize how data about firearms violence of all types (intentional, accidental, and self-inflicted) are collected, integrated and disseminated. This project, which is also supported by Arnold Ventures, takes the conceptual priorities described in the Blueprint and proposes specific new steps for implementation.The first step in building a better firearms data infrastructure is to acknowledge where we currently stand. In The State of Firearm Data in 2019 (Roman, 2019), the expert panel found that while there are a substantial number of data sources that collect data on firearms violence, existing datasets and data collections are limited, particularly around intentional injuries. There is some surveillance data, but health data on firearms injuries are kept separately from data on crimes, and there are few straightforward ways to link those data. Data that provide context for a shooting--where the event took place, and what the relationship was between victim and shooter--are not available alongside data on the nature of injuries. Valuable data collections have been discontinued, data are restricted by policy, important data are not collected, data are often difficult to access, and contemporary data are often not released in a timely fashion or not available outside of specialized settings. As a result, researchers face vast gaps in knowledge and are unable to leverage existing data to build the evidence base necessary to adequately answer key policy questions and inform firearms policymaking.In the Blueprint, the expert panel developed a set of recommendations organized around a reconceptualization of how data are collected and who collects data. The broad themes from the Blueprint are as follows:Almost all surveillance data in health and criminal justice is generated locally. It is a high priority to provide information, technical assistance, implementation supports, and funding to state and local governments to improve their collections.Comprehensive monitoring of all federal data collections is needed to ensure that important data elements are being collected, data gaps are being addressed, and quality issues are quickly resolved.Timely dissemination of key data is important, including the development of guidelines to ensure consistency across collections and that resources are made available to speed reporting for collections with historical delays.Improvement is needed in strategic communication about the purpose and use of data to federal agencies, researchers and to the general public.The current report builds on the Blueprint by developing implementation guidance for key recommendations. Where the Blueprint included actionable recommendations, such as naming discontinued surveys that should be resurrected, this report develops specific recommendations for implementation. The report is centered on three topics that were the highest priority for the expert panel but that required additional research before guidance could be disseminated. The research findings from that additional investigation are reported here, and recommendations to facilitate implementation are described. The three topic areas are as follows:The creation of a nonfatal firearms injury databaseIncreasing the quality, availability, and usefulness of firearms data for research and policyPractical steps for building state capacity and infrastructure to use data for evidence-based decision-makin

Le Certificat de compétence additionnelle en médecine familiale : une enquête descriptive sur le point de vue des médecins de famille sur les pratiques d'amélioration des compétences au Canada

Introduction: The College of Family Physicians of Canada (CFPC) offers the Certificate of Added Competence (CAC) program to designate a family physician with enhanced skills. In 2015, the College expanded its program to introduce enhanced certification in four new domains: Palliative Care, Care of the Elderly, Sports and Exercise Medicine, and Family Practice Anesthesia. In this study, we elicited perceptions from Canadian family physicians with and without the CAC on practice impacts associated with the program. Methods: Active family physicians in Canada with and without CACs were surveyed between November 2019 to January 2020. Descriptive statistics were generated to describe the perceptions of family physicians regarding the CAC program and its impacts on practice. Results: Respondents agreed with several benefits of the program including enhancing the capacity to deliver comprehensive care, alleviating the burden of patient travel by increasing the availability of care in rural and remote communities, and providing opportunities to engage in various collaborative care models and new leadership roles. All respondents perceived CAC holders to pursue the certificate to meet both professional interests and community needs. Conclusions: There is a need for strong and continued investment in systemic practice improvements that incentivize the delivery of comprehensive family medicine practice.Introduction : Le certificat de compétence additionnelle (CCA) accordé par le Collège des médecins de famille du Canada (CMFC) vise à reconnaître un haut niveau de compétences chez un médecin de famille. En 2015, le Collège a élargi le titre de compétences additionnelles à quatre nouveaux domaines : soins palliatifs, soins aux personnes âgées, médecine du sport et de l'exercice, et anesthésie en médecine familiale. Dans cette étude, nous avons recueilli les perceptions de médecins de famille titulaires et non titulaires d’un CCA sur l’influence de pratiques associées au programme de certification. Méthodes : Des médecins de famille actifs au Canada, titulaires et non titulaires du CCA, ont été interrogés entre novembre 2019 et janvier 2020. Des statistiques descriptives ont été générées pour décrire leurs perceptions concernant le Certificat et ses impacts sur la pratique. Résultats : Les répondants s’entendaient pour reconnaître au CCA plusieurs avantages, notamment le fait d'améliorer la capacité des médecins à fournir des soins complets, de leur offrir la possibilité de s'engager dans divers modèles de soins collaboratifs et de nouveaux rôles de leadership, et d'alléger le fardeau des déplacements des patients en augmentant la disponibilité des soins dans les populations rurales et éloignées. Tous les répondants estiment que les médecins recherchent l’obtention de ce titre de compétence pour répondre à la fois à leurs intérêts professionnels et aux besoins de la collectivité. Conclusions : Il faut investir de manière importante et continue dans des améliorations systémiques qui favoriseront une pratique holistique de la médecine familiale

United by Neurodiversity : Postgraduate Research in a Neurodiverse Context

Peer reviewedPublisher PD

Prevalence and impacts of upper limb morbidity after treatment for breast cancer: a cross-sectional study of lymphedema and function.

A cross-sectional study screened lymphedema, impaired upper limb function (ULF) and quality of life (QOL) in women post-breast cancer. Women attending review appointments who had completed surgery, chemotherapy and radiotherapy, were without recurrence, and could complete questionnaires in English were invited. Medical records were reviewed and questionnaires completed: the Morbidity Screening Tool (MST), Disability of the Arm, Shoulder and Hand questionnaire (DASH), and Functional Assessment of Cancer Therapy for breast cancer QOL questionnaire (FACTB+4). The vertical perometer (400T) measured percentage upper limb volume difference (%LVD), with 10% or greater difference diagnosed as lymphedema. Of 617 participants (mean age 62.3y, SD 10.0; mean time since treatment 63.0 months, SD 46.6), sufficient questionnaire data were available for 613 and perometry data for 417. Using the MST, 21.9% self-reported impaired ULF, 19.8% lymphedema, and 9.2% both. Based on %LVD, 26.5% had lymphedema. Histogram analysis for individuals in the first eight twelve-month intervals after treatment found impaired ULF prevalence peaked at three to five years and lymphedema at three years. Significantly worse function (DASH) and QOL (FACT B+4) resulted for those with morbidity (p<0.000). This provides evidence that impaired ULF and lymphedema negatively affect QOL years after treatment and are not necessarily linked.sch_phy1pub3633pub

Connections: the power of learning together to improve healthcare in the United Kingdoms

An edited collection of chapters from international experts on patient engagement. Chapter 6.Connections: The Power of Learning Together to Improve Healthcare in the United Kingdom. A research review of patient engagement, with consideration of practical techniques to teach and support patient engagement. The voices of patients are strong with pieces written by twelve patients on their experiences of involvement

Comparison of breast cancer-related lymphedema (Upper Limb Swelling) prevalence estimated using objective and subjective criteria and relationship with quality of life

This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling); percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference); and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4). Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95-10.03) and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema. 2013 Catherine Bulley et al.sch_phy2013pub3233pub80756