Some Practical Considerations for Providing Access to the Postsecondary Environment

Whether initiating the design and development of new programs/or modifying existing programs/those who seek to support deaf/hard-of-hearing students in mainstreamed environments must carefully consider the nature and needs of both the academic environment and the student. Developing systems of support which are effective, cost-effective, and relevant to faculty and students requires dose examination of the broader questions of organization/ administration and resources/ as well as specific attention to details of classroom d3mamics and thoughtful analysis of students\u27 academic/and personal-social needs. Recognition of the interaction among these various elements is critical and suggests that efforts towards planning, development, and evaluation should include joint participation of administrators, faculty, support providers, and students to ensure that all critical needs are identified and addressed

An Approach for Developing National Guidelines for Postsecondary Support Services Programs

This paper presents a case for developing standards for specialized support programs serving deaf students in postsecondary institutions. A step-by-step plan for producing standards for the evaluation, development, and accreditation of these programs is outlined. Criteria for forming flexible standards which (1) account for variations in program size and type and (2) enhance support services which make postsecondary education more accessible for deaf students are clarified. The importance of teamwork between postsecondary specialists and generalists to link standards for special service programs to the process of accrediting regular institutions of higher education is emphasized. An example of accrediting a special college for deaf students is discussed. Results from a process of setting priorities for future actions in developing program standards which emerged from a professional conference are reported. Expected benefits of these standards to enhancing program quality are described

Attitudes of Deaf and Hearing Adults in Israel Toward Deaf People’s Career Suitability

This study investigated the expressed attitudes of deaf adults as well as hearing parents and teachers of deaf children in Israel toward career choices for deaf and hearing people by asking the participants to rate the suitability of 14 professions for deaf and hearing people. The results, in general, were consistent with those of other studies in the United States, England, Italy, South Africa and India with hearing teachers and parents of deaf children, which indicated that the hearing status of imagined advisees selectively influenced attitudes toward the suitability of certain professions. Deaf adults in Israel gave significantly lower ratings for deaf advisees on 10 out of 14 professions and did not find any of the professions to be more suitable for a deaf advisee when compared to a hearing advisee. These results are in contrast to those found by Parasnis, Samar and Mandke (1996) with deaf adults in India. Implications of these findings are discussed

Guidelines for the Development of Comprehensive Care Centers for Congenital Adrenal Hyperplasia: Guidance from the CARES Foundation Initiative

Patients with rare and complex diseases such as congenital adrenal hyperplasia (CAH) often receive fragmented and inadequate care unless efforts are coordinated among providers. Translating the concepts of the medical home and comprehensive health care for individuals with CAH offers many benefits for the affected individuals and their families. This manuscript represents the recommendations of a 1.5 day meeting held in September 2009 to discuss the ideal goals for comprehensive care centers for newborns, infants, children, adolescents, and adults with CAH. Participants included pediatric endocrinologists, internal medicine and reproductive endocrinologists, pediatric urologists, pediatric surgeons, psychologists, and pediatric endocrine nurse educators. One unique aspect of this meeting was the active participation of individuals personally affected by CAH as patients or parents of patients. Representatives of Health Research and Services Administration (HRSA), New York-Mid-Atlantic Consortium for Genetics and Newborn Screening Services (NYMAC), and National Newborn Screening and Genetics Resource Center (NNSGRC) also participated. Thus, this document should serve as a “roadmap” for the development phases of comprehensive care centers (CCC) for individuals and families affected by CAH

Guidelines for the Development of Comprehensive Care Centers for Congenital Adrenal Hyperplasia: Guidance from the CARES Foundation Initiative

Patients with rare and complex diseases such as congenital adrenal hyperplasia (CAH) often receive fragmented and inadequate care unless efforts are coordinated among providers. Translating the concepts of the medical home and comprehensive health care for individuals with CAH offers many benefits for the affected individuals and their families. This manuscript represents the recommendations of a 1.5 day meeting held in September 2009 to discuss the ideal goals for comprehensive care centers for newborns, infants, children, adolescents, and adults with CAH. Participants included pediatric endocrinologists, internal medicine and reproductive endocrinologists, pediatric urologists, pediatric surgeons, psychologists, and pediatric endocrine nurse educators. One unique aspect of this meeting was the active participation of individuals personally affected by CAH as patients or parents of patients. Representatives of Health Research and Services Administration (HRSA), New York-Mid-Atlantic Consortium for Genetics and Newborn Screening Services (NYMAC), and National Newborn Screening and Genetics Resource Center (NNSGRC) also participated. Thus, this document should serve as a “roadmap” for the development phases of comprehensive care centers (CCC) for individuals and families affected by CAH

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Guidelines for the Development of Comprehensive Care Centers for Congenital Adrenal Hyperplasia: Guidance from the CARES Foundation Initiative

Abstract Patients with rare and complex diseases such as congenital adrenal hyperplasia (CAH) often receive fragmented and inadequate care unless efforts are coordinated among providers. Translating the concepts of the medical home and comprehensive health care for individuals with CAH offers many benefits for the affected individuals and their families. This manuscript represents the recommendations of a 1.5 day meeting held in September 2009 to discuss the ideal goals for comprehensive care centers for newborns, infants, children, adolescents, and adults with CAH. Participants included pediatric endocrinologists, internal medicine and reproductive endocrinologists, pediatric urologists, pediatric surgeons, psychologists, and pediatric endocrine nurse educators. One unique aspect of this meeting was the active participation of individuals personally affected by CAH as patients or parents of patients. Representatives of Health Research and Services Administration (HRSA), New York-Mid-Atlantic Consortium for Genetics and Newborn Screening Services (NYMAC), and National Newborn Screening and Genetics Resource Center (NNSGRC) also participated. Thus, this document should serve as a "roadmap" for the development phases of comprehensive care centers (CCC) for individuals and families affected by CAH

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Some Practical Considerations for Providing Access to the Postsecondary Environment

Whether initiating the design and development of new programs/or modifying existing programs/those who seek to support deaf/hard-of-hearing students in mainstreamed environments must carefully consider the nature and needs of both the academic environment and the student. Developing systems of support which are effective, cost-effective, and relevant to faculty and students requires dose examination of the broader questions of organization/ administration and resources/ as well as specific attention to details of classroom d3mamics and thoughtful analysis of students\u27 academic/and personal-social needs. Recognition of the interaction among these various elements is critical and suggests that efforts towards planning, development, and evaluation should include joint participation of administrators, faculty, support providers, and students to ensure that all critical needs are identified and addressed

An Approach for Developing National Guidelines for Postsecondary Support Services Programs

This paper presents a case for developing standards for specialized support programs serving deaf students in postsecondary institutions. A step-by-step plan for producing standards for the evaluation, development, and accreditation of these programs is outlined. Criteria for forming flexible standards which (1) account for variations in program size and type and (2) enhance support services which make postsecondary education more accessible for deaf students are clarified. The importance of teamwork between postsecondary specialists and generalists to link standards for special service programs to the process of accrediting regular institutions of higher education is emphasized. An example of accrediting a special college for deaf students is discussed. Results from a process of setting priorities for future actions in developing program standards which emerged from a professional conference are reported. Expected benefits of these standards to enhancing program quality are described