4 research outputs found
IMPLEMENTATION OF THE MTSS PROCESS IN KEARNEY PUBLIC SCHOOLS
To support multiple needs, districts have worked to enrich or remediate students through differentiated objectives, programs, and initiatives. The goal of a Multi-Tiered System of Supports framework is to create a system that supports all students and provides robust interventions and programs at all levels, in multiple areas of education. This cross-sectional study will investigate MTSS implementation through a self-assessment survey of school principals and teachers in Kearney Public Schools (KPS). The information collected and analyzed to support the administrative team’s planning, implementation, and measurement of effectiveness. The research will also be able to support the continued implementation of MTSS in the state of Nebraska.
Adviser: Nicholas J. Pac
Implementation of the MTSS Process in Kearney Public Schools
To support multiple needs, districts have worked to enrich or remediate students through differentiated objectives, programs, and initiatives. The goal of a Multi Tiered System of Supports framework is to create a system that supports all students and provides robust interventions and programs at all levels, in multiple areas of education. This cross sectional study will investigate MTSS implementation through a self-assessment survey of school principals and teachers in Kearney Public Schools (KPS). The information collected and analyzed to support the administrative team’s planning, implementation, and measurement of effectiveness. The research will also be able to support the continued implementation of MTSS in the state of Nebraska
Epilepsy, dissociative seizures, and mixed: Associations with time to video-EEG
PurposeVideo-electroencephalographic monitoring (VEM) is a core component to the diagnosis and evaluation of epilepsy and dissociative seizures (DS)-also known as functional or psychogenic seizures-but VEM evaluation often occurs later than recommended. To understand why delays occur, we compared how patient-reported clinical factors were associated with time from first seizure to VEM (TVEM) in patients with epilepsy, DS or mixed.MethodsWe acquired data from 1245 consecutive patients with epilepsy, VEM-documented DS or mixed epilepsy and DS. We used multivariate log-normal regression with recursive feature elimination (RFE) to evaluate which of 76 clinical factors interacting with patients' diagnoses were associated with TVEM.ResultsThe mean and median TVEM were 14.6 years and 10 years, respectively (IQR 3-23 years). In the multivariate RFE model, the factors associated with longer TVEM in all patients included unemployment and not student status, more antiseizure medications (current and past), concussion, and ictal behavior suggestive of temporal lobe epilepsy. Average TVEM was shorter for DS than epilepsy, particularly for patients with depression, anxiety, migraines, and eye closure. Average TVEM was longer specifically for patients with DS taking more medications, more seizure types, non-metastatic cancer, and with other psychiatric comorbidities.ConclusionsIn all patients with seizures, trials of numerous antiseizure medications, unemployment and non-student status was associated with longer TVEM. These associations highlight a disconnect between International League Against Epilepsy practice parameters and observed referral patterns in epilepsy. In patients with dissociative seizures, some but not all factors classically associated with DS reduced TVEM
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Factors associated with delay to video-EEG in dissociative seizures
PurposeWhile certain clinical factors suggest a diagnosis of dissociative seizures (DS), otherwise known as functional or psychogenic nonepileptic seizures (PNES), ictal video-electroencephalography monitoring (VEM) is the gold standard for diagnosis. Diagnostic delays were associated with worse quality of life and more seizures, even after treatment. To understand why diagnoses were delayed, we evaluated which factors were associated with delay to VEM.MethodsUsing data from 341 consecutive patients with VEM-documented dissociative seizures, we used multivariate log-normal regression with recursive feature elimination (RFE) and multiple imputation of some missing data to evaluate which of 76 clinical factors were associated with time from first dissociative seizure to VEM.ResultsThe mean delay to VEM was 8.4 years (median 3 years, IQR 1-10 years). In the RFE multivariate model, the factors associated with longer delay to VEM included more past antiseizure medications (0.19 log-years/medication, standard error (SE) 0.05), more medications for other medical conditions (0.06 log-years/medication, SE 0.03), history of physical abuse (0.75 log-years, SE 0.27), and more seizure types (0.36 log-years/type, SE 0.11). Factors associated with shorter delay included active employment or student status (-1.05 log-years, SE 0.21) and higher seizure frequency (0.14 log-years/log[seizure/month], SE 0.06).ConclusionsPatients with greater medical and seizure complexity had longer delays. Delays in multiple domains of healthcare can be common for victims of physical abuse. Unemployed and non-student patients may have had more barriers to access VEM. These results support earlier referral of complex cases to a comprehensive epilepsy center