Ζητήματα συνεργασίας στην ενταξιακή πρωτοβάθμια εκπαίδευση: Απόψεις και εμπειρίες εκπαιδευτικών γενικής εκπαίδευσης και εκπαιδευτικών παράλληλης στήριξης.

Η ετερογενής σύνθεση των τάξεων καθιστά τη συνεργασία μεταξύ των εκπαιδευτικών αναγκαία, καθώς απαιτείται η ανταλλαγή γνώσεων, απόψεων και ιδεών με στόχο την ανταπόκριση στη διαφορετικότητα και την πολυπλοκότητα των σημερινών τάξεων. H συνεργασία μεταξύ των εκπαιδευτικών μίας τάξης αποτελεί βασικό παράγοντα για την προώθηση της ενταξιακής εκπαίδευσης και τη διαμόρφωση ενταξιακής κουλτούρας με στόχο την ισότιμη πρόσβαση και συμμετοχή όλων των παιδιών στη μαθησιακή διαδικασία. Στην παρούσα εργασία διερευνώνται οι απόψεις και οι εμπειρίες εκπαιδευτικών, αναφορικά με το ζήτημα της συνεργασίας του εκπαιδευτικού ειδικής αγωγής με τον εκπαιδευτικό της τάξης. Συγκεκριμένα, πραγματοποιείται μία προσπάθεια μελέτης του ζητήματος αυτού μέσα από την επεξεργασία των αντιλήψεων των εκπαιδευτικών αναφορικά με τη νοηματοδότηση της συνεργασίας, την πρακτική εφαρμογή της και τη διερεύνηση των εμποδίων που βιώνουν στο πλαίσιο της πρωτοβάθμιας ενταξιακής εκπαίδευσης. Πρόκειται για μία ποιοτική έρευνα, ερευνητικό εργαλείο της οποίας αποτελεί η ημι-δομημένη συνέντευξη. Στην εργασία έλαβαν μέρος δέκα (10) εκπαιδευτικοί γενικής και ειδικής αγωγής & εκπαίδευσης και η επιλογή του δείγματος πραγματοποιήθηκε με βάση τη μέθοδο της βολικής δειγματοληψίας. Τα ερευνητικά δεδομένα αναλύθηκαν με τη μέθοδο της θεματικής ανάλυσης περιεχομένου. Σύμφωνα με τα συμπεράσματα της έρευνας η ανάπτυξη συνεργατικών πρακτικών προκύπτει ως αναγκαιότητα στο πλαίσιο της καθημερινής λειτουργίας του σχολείου και σχετίζεται με την κοινή λήψη αποφάσεων και το αίσθημα της κοινής ευθύνης ως προς τον σχεδιασμό, τη διδασκαλία και την αξιολόγηση της εκπαιδευτικής διαδικασίας. Παράλληλα, η ουσιαστική συνεργασία μεταξύ των εκπαιδευτικών αποτελεί τον κυριότερο παράγοντα δημιουργίας ενός ενταξιακού περιβάλλοντος μάθησης. Ωστόσο, λαμβάνοντας υπόψη τα ερευνητικά δεδομένα, συμπεραίνεται ότι παρόλο που οι εκπαιδευτικοί δίνουν έμφαση στη ισοτιμία των ρόλων στο πλαίσιο μίας ουσιαστικής και αποτελεσματικής συνεργασίας, στην πράξη διαφαίνεται ότι οι ρόλοι διαχωρίζονται. Ο ρόλος των εκπαιδευτικών της ειδικής αγωγής και εκπαίδευσης είναι συχνά επικουρικός προς τον κυρίαρχο ρόλο των εκπαιδευτικών της γενικής εκπαίδευσης στο πλαίσιο της μεταξύ τους συνεργασίας. Αναφορικά με τα εμπόδια και τις προκλήσεις που βιώνουν οι εκπαιδευτικοί ως προς την ανάπτυξη συνεργατικών πρακτικών αναδεικνύονται κυρίως η έλλειψη χρόνου και η αύξηση του φόρτου εργασίας, οι συγκρουσιακές προσωπικές σχέσεις, οι διαφορετικές προσεγγίσεις και στάσεις, η σύμβαση εργασίας του εκπαιδευτικού ειδικής αγωγής και εκπαίδευσης και ο διαχωρισμός των ρόλων ανάμεσα στους δύο εκπαιδευτικούς. Κρίνεται αναγκαία η προσπάθεια άρσης των εμποδίων με στόχο την ανάπτυξη ενταξιακών συνεργατικών πρακτικών.The heterogeneous composition of classes makes collaboration between teachers necessary, as the exchange of knowledge, opinions and ideas is required in order to respond to the diversity and complexity of today's classes. The cooperation between the teachers of a class is a key factor for the promotion of inclusive education and the formation of inclusive culture with the aim of equal access and participation of all children in the learning process. In this paper, the opinions and experiences of teachers are investigated, regarding the issue of the cooperation of the special education teacher with the classroom teacher in the context of inclusive education. Specifically, an attempt is made to study this issue through the processing of teachers' perceptions regarding the meaning of cooperation in inclusive contexts, its practical application and the investigation of the obstacles they experience. It is a qualitative research, the research tool of which is the semi-structured interview. Ten (10) general and special education & education teachers took part in the work and the selection of the sample was carried out based on the convenience sampling method. The research data were analyzed using the method of thematic content analysis. According to the conclusions of the research, the development of collaborative practices arises as a necessity in the context of the daily operation of the school and is related to joint decision-making and the feeling of joint responsibility regarding the planning, teaching and evaluation of the educational process. At the same time, the essential cooperation between teachers is the main factor in creating an inclusive learning environment. However, taking into account the research data, it is concluded that although teachers emphasize the equality of roles in the context of a meaningful and effective collaboration, in practice it appears that the roles are separated. The role of special education and education teachers is often subsidiary to the dominant role of general education teachers in the context of cooperation between them. In relation to the obstacles and challenges experienced by teachers in terms of the development of collaborative practices, the lack of time and the increase in workload, conflicting personal relationships, different approaches and attitudes, the employment contract of the special education and education teacher and the separation of roles between the two teachers. It is considered necessary to try to remove the obstacles with the aim of developing inclusive cooperative practices

T-replete cord transplants give superior outcomes in high risk and relapsed/refractory paediatric myeloid malignancy

Stem cell transplant (SCT) outcomes in high-risk (HR) and relapsed/refractory (R/R) paediatric acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) have been poor historically. Cord blood allows T-cell replete transplant (TRCB), enabling enhanced graft-versus-leukaemia. We collected data from 367 consecutive patients undergoing TRCB (112 patients) or other cell source (255 patients) SCT for paediatric AML/MDS in the UK and Ireland between January 2014 and December 2021. Data was collected about patient's demographics, disease and its treatment including previous transplant, measurable residual disease (MRD) status at transplant, HLA-match, relapse, death, graft versus host disease (GvHD) and transplant-related mortality (TRM). Univariable and multivariable analyses were undertaken. There was a higher incidence of poor prognosis features in the TRCB cohort: 51.4% patients were MRD positive at transplant, 46.4% had refractory disease and 21.4% had relapsed after a previous SCT, compared with 26.1%, 8.6% and 5.1% respectively in the comparator group (all p <0.001). Within the TRCB cohort, Event Free Survival (EFS) was 64.1%, 50% in MRD positive patients and 79% in MRD negative (p= 0.009). To allow for the imbalance in baseline characteristics, a multivariable analysis was performed: the TRCB cohort had significantly improved EFS (0.57[0.35-0.91], p=0.019), time to relapse (0.46[0.26-0.81), p=0.008), and reduced chronic GVHD (HR 0.28 [95% CI 0.11-0.70]; p=0.007), with some evidence of improved Overall Survival (OS) (0.65[0.39-1.07], p = 0.088). The effect appeared similar regardless of MRD status, (interaction p-value= 0.29). CB transplant without serotherapy may be the optimal transplant option for children with myeloid malignancy

Maternal mood, anxiety and mental health functioning after combined myo-inositol, probiotics, micronutrient supplementation from preconception: findings from the NiPPeR RCT

Observational studies have reported associations between nutrition during pregnancy and mental wellbeing. As secondary outcomes, the NiPPeR double-blind randomized trial in women planning conception investigated whether a myo-inositol, probiotics and enriched micronutrients formulation (intervention) taken preconception and throughout pregnancy could improve mental wellbeing during pregnancy and post-delivery, compared with a standard micronutrient supplement (control). Mood and anxiety symptoms were ascertained (Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-state)) at preconception (baseline), 7, 28 and 34 weeks gestation, 3-weeks and 6-months post-delivery. EPDS&gt;=13 was categorised as low mood; STAI-state&gt;=45 as high anxiety. Change in mental health functioning was assessed as difference between preconception baseline and 6-month post-delivery 12-item Short-Form Health Survey (SF-12v2) mental component scores. Adjusting for site, ethnicity and baseline scores, there were no robust differences in EPDS and STAI-state scores between intervention and control groups across pregnancy (n = 630) and post-delivery (n = 532). Compared to controls, intervention group women averaged a 1.21 (95 %CI 0.04,2.39) higher change in SF-12v2 mental component score from preconception to 6-months post-delivery. Taking a myo-inositol, micronutrient and probiotic supplement during preconception/pregnancy had no effect on mood and anxiety, but there was evidence of a modest improvement in mental health functioning from preconception to 6-months post-delivery.</p

Peripartum outcomes after combined myo-inositol, probiotics, micronutrient supplementation from preconception: NiPPeR RCT

Background: evidence that nutritional supplementation before and during pregnancy improves peripartum outcomes is sparse. In the Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health (NiPPeR) trial, we previously reported that a combined myo-inositol, probiotics, and micronutrient supplement started at preconception showed no difference in the primary outcome of gestational glycemia, but did reduce the risk of preterm delivery, preterm prelabor rupture of membranes, and major postpartum hemorrhage.Objective: this study aimed to examine the hypothesis that a reduction in major postpartum hemorrhage following a combined nutritional (myo-inositol, probiotics, and micronutrients) intervention is linked with promotion of labor progress and reduced operative delivery.Study design: this double-blind randomized controlled trial recruited 1729 women from the United Kingdom, Singapore, and New Zealand, aged 18 to 38 years, and planning conception between 2015 and 2017. The effects of the nutritional intervention compared with those of a standard micronutrient supplement (control), taken at preconception and throughout pregnancy, were examined for the secondary outcomes of peripartum events using multinomial, Poisson, and linear regression adjusting for site, ethnicity, and important covariates.Results: of the women who conceived and progressed beyond 24 weeks’ gestation with a singleton pregnancy (n=589), 583 (99%) provided peripartum data. Between women in the intervention (n=293) and control (n=290) groups, there were no differences in rates of labor induction, oxytocin augmentation during labor, instrumental delivery, perineal trauma, and intrapartum cesarean delivery. Although duration of the first stage of labor was similar, the second-stage duration was 20% shorter in the intervention than in the control group (adjusted mean difference, −12.0 [95% confidence interval, −22.2 to −1.2] minutes; P=.029), accompanied by a reduction in operative delivery for delayed second-stage progress (adjusted risk ratio, 0.61 [0.48–0.95]; P=.022). Estimated blood loss was 10% lower in the intervention than in the control group (adjusted mean difference, −35.0 [−70.0 to −3.5] mL; P=.047), consistent with previous findings of reduced postpartum hemorrhage.Conclusion: supplementation with a specific combination of myo-inositol, probiotics, and micronutrients started at preconception and continued in pregnancy reduced the duration of the second stage of labor, the risk of operative delivery for delay in the second stage, and blood loss at delivery

Peripartum Outcomes After Combined Myo-inositol, Probiotics, Micronutrient Supplementation from Preconception: NiPPeR RCT.

BackgroundEvidence that nutritional supplementation before and during pregnancy improves peripartum outcomes is sparse. In the Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health (NiPPeR) trial we previously reported that a combined myo-inositol, probiotics and micronutrient supplement starting preconception showed no difference in the primary outcome of gestational glycemia, but did reduce the risk of preterm delivery, preterm pre-labor rupture of membranes and major postpartum hemorrhage.ObjectiveTo examine the hypothesis that a reduction in major postpartum hemorrhage following a combined nutritional (myo-inositol, probiotics and micronutrient) intervention is linked with promotion of labor progress and reduced operative delivery.Study designThis double-blind randomized controlled trial recruited from the community 1729 UK, Singapore and New Zealand women aged 18-38 years planning conception between 2015-2017. Here, the effects of the nutritional intervention compared with a standard micronutrient supplement (control), taken preconception and throughout pregnancy, on the secondary outcomes of peripartum events were examined using multinomial, Poisson and linear regression adjusting for site, ethnicity and important covariates.ResultsOf the women who conceived and progressed beyond 24 weeks' gestation with a singleton pregnancy (n=589), 583 (99%) provided peripartum data. Between women in the intervention (n=293) and control (n=290) groups, there were no differences in rates of labor induction, oxytocin augmentation during labor, instrumental delivery, perineal trauma and intrapartum cesarean section. While duration of the first stage of labor was similar, the second-stage duration was 20% shorter in the intervention group compared with controls [adjusted mean difference -12.0 (95%CI -22.2, -1.2) minutes, p=0.029], accompanied by a reduction in operative delivery for delayed second-stage progress [adjusted risk ratio 0.61 (0.48, 0.95); p=0.022]. Estimated blood loss was 10% less with intervention compared with control [adjusted mean difference -35.0 (-70.0, -3.5) ml, p=0.047], consistent with previous findings of reduced postpartum hemorrhage.ConclusionSupplementation with a specific combination of myo-inositol, probiotics and micronutrients starting preconception and continued in pregnancy reduced both the duration of the second stage of labor and the risk of operative delivery for delay in the second stage, and reduced blood loss at delivery