Barriers to Full Participation in the Individualized Education Program for Culturally and Linguistically Diverse Parents

The Individuals with Disabilities Education Improvement Act (2004) mandates that schools facilitate parent participation in planning the Individual Education Program (IEP). However, culturally and linguistically diverse parents are less likely to feel fully included in the IEP process. In this article we examine three sources of cross-cultural communication difficulties: verbal and non-verbal communication styles, bureaucratic procedures, and cultural assumptions about disability and intervention. We conclude by suggesting schools use an empathetic approach to improve communication in the IEP process

Short Communication: A Simple Method for Performing Worm-Egg Counts on Sodium Acetate Formaldehyde-Preserved Samples

The Kato Katz method is the most common way of performing worm-egg counts on human faecal samples, but it must be done in the field using freshly collected samples. This makes it difficult to use in remote, poorly accessible situations. This paper describes a simple method for egg counts on preserved samples collected in the field and sent to a central location for further processing

Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models.

BACKGROUND: New WHO guidelines recommend ART initiation for HIV-positive persons with CD4 cell counts ≤500 cells/µL, a higher threshold than was previously recommended. Country decision makers must consider whether to further expand ART eligibility accordingly. METHODS: We used multiple independent mathematical models in four settings-South Africa, Zambia, India, and Vietnam-to evaluate the potential health impact, costs, and cost-effectiveness of different adult ART eligibility criteria under scenarios of current and expanded treatment coverage, with results projected over 20 years. Analyses considered extending eligibility to include individuals with CD4 ≤500 cells/µL or all HIV-positive adults, compared to the previous recommendation of initiation with CD4 ≤350 cells/µL. We assessed costs from a health system perspective, and calculated the incremental cost per DALY averted ($/DALY) to compare competing strategies. Strategies were considered 'very cost-effective' if the$/DALY was less than the country's per capita gross domestic product (GDP; South Africa: $8040, Zambia:$1425, India: $1489, Vietnam:$1407) and 'cost-effective' if $/DALY was less than three times per capita GDP. FINDINGS: In South Africa, the cost per DALY averted of extending ART eligibility to CD4 ≤500 cells/µL ranged from$237 to $1691/DALY compared to 2010 guidelines; in Zambia, expanded eligibility ranged from improving health outcomes while reducing costs (i.e. dominating current guidelines) to$749/DALY. Results were similar in scenarios with substantially expanded treatment access and for expanding eligibility to all HIV-positive adults. Expanding treatment coverage in the general population was therefore found to be cost-effective. In India, eligibility for all HIV-positive persons ranged from $131 to$241/DALY and in Vietnam eligibility for CD4 ≤500 cells/µL cost $290/DALY. In concentrated epidemics, expanded access among key populations was also cost-effective. INTERPRETATION: Earlier ART eligibility is estimated to be very cost-effective in low- and middle-income settings, although these questions should be revisited as further information becomes available. Scaling-up ART should be considered among other high-priority health interventions competing for health budgets. FUNDING: The Bill and Melinda Gates Foundation and World Health Organization

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Short communication: a simple method for performing worm-egg counts on sodium acetate formaldehyde-preserved samples

The Kato Katz method is the most common way of performing worm-egg counts on human faecal samples, but it must be done in the field using freshly collected samples. This makes it difficult to use in remote, poorly accessible situations. This paper describes a simple method for egg counts on preserved samples collected in the field and sent to a central location for further processing

Short Communication: A Simple Method for Performing Worm-Egg Counts on Sodium Acetate Formaldehyde-Preserved Samples

The Kato Katz method is the most common way of performing worm-egg counts on human faecal samples, but it must be done in the field using freshly collected samples. This makes it difficult to use in remote, poorly accessible situations. This paper describes a simple method for egg counts on preserved samples collected in the field and sent to a central location for further processing

Make/Use: : A System for Open Source, User-Modifiable, Zero Waste Fashion Practice

This paper discusses Make/Use, a multi-disciplinary research project exploring “User Modifiable Zero Waste Fashion”. In particular, it addresses the use of textile print and a parametric matrix to facilitate the cognitive and creative processes involved in the transformation from two-dimensional (2D) to three-dimensional (3D) form. The Make/Use project centers on the development and testing of an embedded navigational system by which users can formulate a functional understanding of the form and construction of a garment and its opportunities for manipulation. It questions how the encoding of navigational clues and markers into a garment might aid in its facility for creation and modification by the user, aiming to enhance emotional investment and connection, and extending its functional life by providing embedded opportunities for alteration and visible repair.The research for this work took place while I was a researcher at Massey University, the article was published while an employee at the University of Borås.</p

Effect of lens care systems on silicone hydrogel contact lens hydrophobicity

Purpose: To analyze changes in wettability of hydrogel and silicone hydrogel contact lenses (CLs) when preserved in different lens care systems. Methods: In this research, four silicone hydrogel CLs (senofilcon A, balafilcon A, comfilcon A, and lotrafilcon B) and one conventional CL (etafilcon A) and appropriate lens care solutions (ReNu MultiPlus, Biotrue, OPTI-FREE PureMoist, and AOSept Plus) were used. Lenses were immersed in each lens care system for 12 hr and then CL hydrophobicity was determined through water contact angle (CA) measurements using the OCA 20 instrument (DataPhysics). Results: Mean CA values obtained when CLs were removed from blisters (baseline value) were lower for etafilcon A (49.6°63.0°) and comfilcon A (48.0°62.8°) and higher for senofilcon A (78.9°62.5°), lotrafilcon B (82.6°61.7°), and balafilcon A (91.5°60.7°). Depending on CL and lens care combination, it was detected a statistically significant reduction by 70% of the 20 combinations studied and any significant increase in the CA. When compared to baseline values, CA varied between etafilcon A: 2° and 11°, comfilcon A: 1° and 7°, senofilcon A: 2° and 28°, lotrafilcon B: 14° and 31°, and balafilcon A: 18° and 29°. Comfilcon A was the most stable lens material presenting only one significant decrease in CA. Conclusions: This study reveals the existence of interactions between CL material and lens solutions that can play an important role in CL surface wettability. The major changes were obtained in lenses with higher baseline CA, which showed significant changes with each of the solutions. These differences can be positive, because in almost all of the combinations, the lenses became more wettable