Characteristics of Effective Alternative Schools in Georgia: Leaders’ Perceptions

ABSTRACT Educational leaders and district decision makers are faced with the challenge of providing support for at-risk students who are failing in traditional schools and are in danger of not graduating. Alternative schools are considered options for learning for at-risk students. However, limited research is available describing the views and experiences of the administrators who lead them. Therefore, the purpose of this qualitative study was to understand leaders’ perceptions of characteristics of effective alternative schools in Georgia, as well as challenges associated with leading them. Ten face-to-face, semi-structured interviews were conducted to investigate what eight male and two female alternative school leaders in Georgia perceived to be characteristics of effective alternative schools in Georgia. The results from this qualitative study define characteristics of alternative schools that contribute to student success, explain challenges incurred by the leaders and the students in alternative schools, and describe the benefits of alternative schools. Conclusions and recommendations are included for consideration by educational leaders and decision makers who are planning new alternative schools in their districts or seek to improve practices in existing alternative schools

“It Sounds Like a Drama:” Hearing Stories of Chronic Low Back Pain Through Poetic (Re)presentation

A poetic voice develops in different ways and from different sources. In this paper, a poetic voice is brought to the experiences of patients and family members as recounted in the first phase of a UK National Health Service funded Q-methodological study, the key outcomes of which are summarized. Their stories are presented as a single poetic performance text crafted from the analysis of combined transcripts of three focus group discussions. The performance bears witness to the sadness, frustration, and resolve of those living with chronic low back pain, and offers an additional hearing to that provided by the main study

Effectiveness of Occupational Therapy Interventions for Adults with Rheumatoid Arthritis: An Evidence-Based Review

Background/Purpose: Rheumatoid arthritis (RA) is an autoimmune condition that affects the synovial membrane of the joints and is often associated with pain, fatigue, deformity, and significant limitations in meaningful occupations. This can lead to difficulty in performing activities of daily living and work duties or loss of social participation and relationships. This systematic review examined intervention studies to determine the efficacy of occupational therapy related interventions for adults with rheumatoid arthritis: What is the effectiveness of interventions within the scope of occupational therapy practice on occupational performance (function), pain, fatigue, and depression in persons with rheumatoid arthritis? Methods: This systematic review evaluated intervention studies published from 2000-2014 identified from the Medline, PsycINFO, CINAHL, OTseeker, and Ergonomics Abstracts databases. Bibliographies from included articles and relevant journals were also hand searched. Inclusion criteria required interventions be within the scope of occupational therapy practice, studies be published in English and include adults with RA, and provide Levels I, II, or III evidence. Interventions focusing solely on the upper or lower extremities were not included. Remaining studies that met the inclusion criteria were divided into two general intervention themes, reviewed by teams, and rated on bias. The final analysis included 64 studies (25 physical activity and 39 psychoeducational interventions). Results: Strong evidence was found to support the use of aerobic exercise, resistive exercise, aquatic exercise, Tai Chi, and yoga. The results for dynamic exercise interventions were mixed. For the psychoeducational interventions, strong evidence was also found to support the use of patient education and self-management, cognitive-behavioral approaches, multidisciplinary approaches, and joint protection, while little or mixed evidence supported the use of assistive technology or emotional disclosure. Conclusion: While the evidence supports interventions within the scope of occupational therapy practice, few interventions could be done within the constraints of current health care delivery models

Fatigue predicts future reduced social participation, not reduced physical function or quality of life in people with systemic sclerosis

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by a grant from the Patient Centered Outcomes Research Institute (PCORI; Poole/Khanna co-PIs) (Award CER-1310-08323 to J.L.P. and D.K.). The statements presented in this publication are solely the responsibility of the authors and do not necessarily represent the views of PCORI. Dr. Khanna’s work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at National Institutes of Health (K24-AR-063129)Peer reviewedPostprin

Fatigue and its Association with Social Participation, Functioning and Quality of Life in Systemic Sclerosis

Supported by the Patient-Centered Outcomes Research Institute (grant CER-1310-08323 to Drs. Poole and Khanna as co–principal investigators). Dr. Khanna’s work was supported by the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases grant K24-AR-063129).Peer reviewedPostprin

The Roles and Benefits of Using Undergraduate Student Leaders to Support the Work of SUMMIT-P

The article by Poole, Turner, and Maher-Boulis (2020) describes one way in which undergraduates have been used to support the SUMMIT-P goal of investigating examples of how mathematics and statistics are applied in partner discipline courses. Two other universities in the SUMMIT-P consortium, San Diego State University and Oregon State University, also use undergraduates in different ways to support the work of integrating science applications into math classes. In this article, we compare and contrast these three uses to further highlight this somewhat untapped resource

Appropriateness of admissions of children with cancer to intensive care facilities in a resource-limited setting

Background: The increasing intensity of treatment of paediatric malignancies has led to improved survival rates, but often necessitates intensive supportive care. The decision to admit a child to the paediatric intensive care unit (PICU) is based on the probability of both short-term and long-term survival in the context of severe resource constraints. Resource constraints in South Africa result in limited access of children with cancer to PICU facilities. Objectives: The aim of this study was to determine whether referrals by paediatric oncologists to a PICU in Johannesburg were appropriate by analysing indications for admission, underlying diagnoses, duration and costs of admissions, and overall outcomes. Methods: A retrospective review of consecutive PICU admissions over a 12-year period was performed. Data from all patients with histologically proven malignant conditions were included and analysed using descriptive statistical methods, Kaplan–Meier curves, log-rank analysis and Fisher’s exact test. Results: There were 5704 recorded admissions to PICU in the study period. Of these admissions, 120 (2.1%) were for patients with malignancies. The majority of PICU oncology admissions were for post-operative care, and the median duration of stay was 1 day (interquartile range: 1–3 days). The short-term mortality rate of oncology patients in PICU was 13.3% in comparison with 16.2% in the overall PICU population. The 4-year overall survival rate post PICU discharge was 54%. Conclusion: The documented short-term mortality rate indicates that referrals by paediatric oncologists are consistent with current PICU admission policies. Oncologists should assess the prognosis for survival before requesting admission to PICU, and, resources permitting, these patients should be accepted to PICU

Making sense of social prescribing

This booklet provides advice and guidance on all things social prescribing

Engagement of patients with scleroderma to revise an internet self-management program

Systemic sclerosis (SSc) or scleroderma is a rare connective tissue disease. Many people do not have access to education programs. A self-management program was developed several years ago based on the literature and input from people with SSc. However, new therapies and treatment options have been developed since the program was developed. The purpose of this qualitative study was to identify and remedy gaps in an internet SSc self-management program to improve the quality of critical information relevant to effective management of the disease. Six focus groups with 30 participants with SSc were conducted: 2 telephone groups and 4 face-to-face groups. Prior to the focus group meetings, participants reviewed the existing website. A semi-structured interview guide elicited participants’ responses. Gaps were expressed in affect and positive affirmation; disease and symptom management; self-advocacy; information for caregivers, families, coworkers and strangers; tracking systems; information about local support groups; pictures and information on underrepresented groups; and general format. Discussants were positive regarding the audio voice over, exercise module, current content, health logs and checklists. People with SSc identified additional content to improve the internet self-management program. Many of the suggestions were incorporated into the existing program as modifications and additions to existing modules, patient testimonials, worksheets, resources sheets, and/or links to additional websites. People with rare, chronic conditions such as SSc need education and reliable sources of information and self-management skills. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len

A nested cohort study of 6,248 early breast cancer patients treated in neoadjuvant and adjuvant chemotherapy trials investigating the prognostic value of chemotherapy-related toxicities.

BACKGROUND: The relationship between chemotherapy-related toxicities and prognosis is unclear. Previous studies have examined the association of myelosuppression parameters or neuropathy with survival and reported conflicting results. This study aims to investigate 13 common chemotherapy toxicities and their association with relapse-free survival and breast cancer-specific survival. METHODS: Chemotherapy-related toxicities were collected prospectively for 6,248 women with early-stage breast cancer from four randomised controlled trials (NEAT; BR9601; tAnGo; Neo-tAnGo). Cox proportional-hazards modelling was used to analyse the association between chemotherapy-related toxicities and both breast cancer-specific survival and relapse-free survival. Models included important prognostic factors and stratified by variables violating the proportional hazards assumption. RESULTS: Multivariable analysis identified severe neutropenia (grades ≥3) as an independent predictor of relapse-free survival (hazard ratio (HR) = 0.86; 95% confidence interval (CI), 0.76-0.97; P = 0.02). A similar trend was seen for breast cancer-specific survival (HR = 0.87; 95% CI, 0.75-1.01; P = 0.06). Normal/low BMI patients experienced more severe neutropenia (P = 0.008) than patients with higher BMI. Patients with fatigue (grades ≥3) showed a trend towards reduced survival (breast cancer-specific survival: HR = 1.17; 95% CI, 0.99-1.37; P = 0.06). In the NEAT/BR9601 sub-group analysis by treatment component, this effect was statistically significant (HR = 1.61; 95% CI, 1.13-2.30; P = 0.009). CONCLUSIONS: This large study shows a significant association between chemotherapy-induced neutropenia and increased survival. It also identifies a strong relationship between low/normal BMI and increased incidence of severe neutropenia. It provides evidence to support the development of neutropenia-adapted clinical trials to investigate optimal dose calculation and its impact on clinical outcome. This is important in populations where obesity may lead to sub-optimal chemotherapy doses