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Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147810/1/art40762.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147810/2/art40762_am.pd

Graduate Preparation of School Psychologists in Serving English Language Learners

The purpose of this study was to examine the training practices of NASP accredited graduate programs in school psychology with regard to best practices in working with English Language Learners (ELLs). Training directors of school psychology programs were surveyed regarding the amount of time and the extent of instruction they provided their school psychology graduate students on the topic of ELLs. School psychology interns were also surveyed regarding both their current knowledge about serving ELLs and their perceived preparedness to serve ELLs. Results indicated that school psychology programs are not adequately preparing graduate students to serve the growing population of ELLs. Faculty members cited time as the largest barrier to increasing their instruction about ELLs, particularly the amount of time that must be devoted to other requirements per state and national standards. Interns rated themselves as feeling less than adequately prepared to serve ELLs effectively, both during their internship and for their future practice. This article also presents implications for school psychology graduate training

Performance Characteristics of Pulmonary Function Tests for the Detection of Interstitial Lung Disease in Adults With Early Diffuse Cutaneous Systemic Sclerosis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163424/2/art41415.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163424/1/art41415_am.pd

Does hand involvement in systemic sclerosis limit completion of patient-reported outcome measures?

The objective of this analysis is to examine whether the severity of systemic sclerosis (SSc)-hand involvement influences patient-reported outcome measure (PROM) completion rate in a US cohort of early disease. Participants included SSc patients with less than 5 years disease duration consented and enrolled in the Collaborative, National, Quality, and Efficacy Registry (CONQUER) between June 2018 and December 2019. Participants\u27 socio-demographics, hand clinical features (severe modified Rodnan skin score, presence of small joint contractures, acro-osteolysis, calcinosis, and digital ulcers), and completion rates of seven PROMs including a Resource Use Questionnaire were analyzed. Cohort characteristics and baseline PROM completion were evaluated. Multivariable logistic regression assessed the relationship between hand limitations and PROM incompletion at several time points using generalized estimating equations. At the time of data lock, 339 CONQUER subjects had a total of 600 visits available for analysis. Calcinosis (odds ratio [OR] 6.35, confidence interval [CI] 2.41-16.73 and acro-osteolysis OR 3.88 (1.57-9.55) were significantly associated with incomplete PROM. The Resource Use Questionnaire was the PROM most commonly not completed. Increasing age was correlated with resource use questionnaire incompletion rate. Acro-osteolysis and calcinosis were associated with lower PROM completion rates in a US SSc cohort, independent of the length of the questionnaires or the modality of administration (electronic or paper). Resource Use Questionnaires are important for understanding the economic impact and burden of chronic disease; however, in this study, it had lower completion rates than PROMs devoted to clinical variables. Key points •Multiple strategies are needed to ensure optimal completion of PROM in longitudinal cohort studies. Even if patients request electronic surveys, we have found it is important to follow up incomplete surveys with paper forms provided at the time of a clinical visit. •The Resource Utilization Questionnaire was lengthy and prone to non-completion in the younger population. •Acro-osteolysis and calcinosis were associated with reduced PROM completion rates

CONQUER Scleroderma: Association of Gastrointestinal Tract Symptoms in Early Disease With Resource Utilization

OBJECTIVES: SSc is associated with increased health-care resource utilization and economic burden. The Collaborative National Quality and Efficacy Registry (CONQUER) is a US-based collaborative that collects longitudinal follow-up data on SSc patients withparticipants. METHODS: CONQUER participants who had completed a baseline and 12-month Gastrointestinal Tract Questionnaire (GIT 2.0) and a Resource Utilization Questionnaire (RUQ) were included in this analysis. Patients were categorized by total GIT 2.0 severity: none-to-mild (0-0.49); moderate (0.50-1.00), and severe-to-very severe (1.01-3.00). Clinical features and medication exposures were examined in each of these categories. The 12-month RUQ responses were summarized by GIT 2.0 score categories at 12 months. RESULTS: Among the 211 CONQUER participants who met the inclusion criteria, most (64%) had mild GIT symptoms, 26% had moderate symptoms, and 10% severe GIT symptoms at 12 months. The categorization of GIT total severity score by RUQ showed that more upper endoscopy procedures and inpatient hospitalization occurred in the CONQUER participants with severe GIT symptoms. These patients with severe GIT symptoms also reported the use of more adaptive equipment. CONCLUSION: This report from the CONQUER cohort suggests that severe GIT symptoms result in more resource utilization. It is especially important to understand resource utilization in early disease cohorts when disease activity, rather than damage, primarily contributes to health-related costs of SSc

Screening High‐Resolution Computed Tomography of the Chest to Detect Interstitial Lung Disease in Systemic Sclerosis: A Global Survey of Rheumatologists

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144265/1/art40441.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144265/2/art40441_am.pd

Nephrogenic systemic fibrosis: a systemic fibrosing disease resulting from gadolinium exposure

Nephrogenic systemic fibrosis (NSF) is an iatrogenic fibrosing disorder that primarily affects individuals with chronic kidney disease (CKD) following exposure to gadolinium-based contrast agents (GBCAs) during imaging procedures. NSF is characterised by skin thickening, tethering and hyperpigmentation; flexion contractures of joints; and extracutaneous fibrosis. This article reviews the history, clinical manifestations, epidemiology, histopathology and pathophysiology of this disabling disease

Baseline absolute monocyte count predicts lung function decline among patients with systemic sclerosis-associated interstitial lung disease: A post hoc analysis from the focuSSced trial

OBJECTIVE: Interstitial lung disease (ILD) is the leading cause of death in adults with systemic sclerosis (SSc). The identification of biomarkers to predict progression of SSc-ILD is an important unmet need. The purpose of this study was to determine whether an elevated baseline absolute monocyte count (AMC) is associated with a decline in forced vital capacity (FVC) at 48 weeks among participants with SSc-ILD enrolled in the phase 3 focuSSced trial. METHODS: We performed a post-hoc analysis of the focuSSced trial, a multicenter, double-blind, randomized, placebo-controlled trial of adults with diffuse cutaneous SSc for ≤ 60 months. Participants received subcutaneous tocilizumab 162 mg or placebo weekly for 48 weeks. We examined the relationship between baseline AMC and FVC at 48 weeks using a General Linear Model adjusted for potential confounders. RESULTS: The 136 participants with SSc-ILD in focuSSced were included in this study. Among participants assigned to the placebo group, there was a statistically significant inverse association between baseline AMC and change in FVC from baseline at week 48 in both unadjusted (β coefficient -0.539, 95 % CI -1.032 to -0.047, p-value=0.032) and multivariable-adjusted (β coefficient -0.573, 95 % CI -1.086 to -0.060, p-value=0.029) models. Among participants with SSc-ILD assigned to the tocilizumab group, there was no statistically significant association between baseline AMC and change in FVC from baseline at week 48 in unadjusted or fully adjusted models. CONCLUSION: AMC may be a biomarker of disease progression in SSc-ILD, especially in those with early SSc with elevated circulating inflammatory markers. These results should be validated in other SSc-ILD cohorts

Childhood Fears, Phobias, and Related Anxieties

In this chapter, we have reviewed prevalence information, assessment considerations, and four general categories of empirically supported treatment methods for reducing children\u27s (and adolescent\u27s) fears, phobias and related anxieties. In addition, variations of each method were discussed as was research supporting the relative effectiveness and efficacy of these methods. Reinforced practice and participant modeling procedures have been found to have the most empirical support, followed by systematic desensitization, modeling and cognitive behavior therapy approaches. Of key importance is the recent emphasis on guidelines for treatment efficacy. Interest in this topic has increased considerably not only among researchers and practitioners, but also policymakers, the insurance industry, and the general public. The ubiquity of the evidence-based designation, however, has engendered considerable debate. For example, Kazdin and Weisz (2003) noted that \u27...treatments must use replicable procedures (e.g., treatments codified in manuals), must be evaluated in well-controlled experiments, and must show replication of effects so there are assurances that any seemingly wonderful outcome or effect in fact can be reproduced... (p. xiii). In addition, the APA Presidential Task Force on Evidence-Based Practice (APA, 2005) adopted the following definition of the term: Evidence-based practice in psychology is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences (APA, 2005). Although there is little question about the relative effectiveness of the treatment procedures discussed in this chapter in comparison to no treatment control conditions, little comparison outcome research has been published on the relative efficacy of these methods in, for example, school settings--especially in relation to an attention placebo and wait-list control condition. In addition, many of the effectiveness studies which have been published have excluded participants who have various comorbid emotional, behavioral, and/or learning problems, when it could be argued that such participants may, in fact, be more representative of those individuals whom clinicians see on a regular basis within the clinic, school, private practice, or hospital setting. Assuming that this is the case, it would be important for future research to examine the relative contribution of various comorbid psychiatric or psychoeducational conditions to the outcome of each of these latter treatment methods. Research is also needed that examines the conditions under which these fear and anxiety reduction approaches, in particular, are effective. In addition, research is needed on the relative contribution of various relationship variables on the outcome of treatment using these therapy procedures. Furthermore, research efforts should be focused on the prevention of anxiety disorders in children and adolescents. Implementing intervention programs, for example in a school setting, within a three-tiered prevention framework has potential benefits for reaching a significant number of youth suffering from anxiety. Use of this model may help to reduce the overall incidence of anxiety as well as the long-term consequences associated with these disorders