A participação escolar de alunos com deficiência na percepção de seus professores School participation of students with disabilities from the perception of their teachers

A identificação do nível de participação escolar do aluno com deficiência é fundamental para o monitoramento do processo educacional inclusivo. Requer o uso de instrumentos de medida que contemplem a funcionalidade perante demandas escolares específicas e que possam, ao mesmo tempo, motivar o professor a uma reflexão sobre o seu julgamento acerca do desempenho desse aluno. A School Function Assessment (SFA) é um instrumento que favorece a identificação de necessidades especiais do aluno com deficiência sob parâmetros de funcionalidade e participação. Nessa perspectiva, este estudo teve como objetivo analisar a influência da aplicação da SFA no julgamento do professor sobre a participação escolar do seu aluno com deficiência. Participaram do estudo oito professores que responderam sobre a participação escolar de seus nove alunos, por meio da SFA e de roteiro de entrevista. Os resultados demonstraram que, para cinco professores, a SFA favoreceu a percepção da participação com foco na demanda de atividades e propiciou reflexões que abrangeram os seguintes destaques: necessidade de avaliação da participação fora da sala de aula, relação entre o grau de deficiência e a participação, entendimento de especificidades do desempenho, importância do recurso adaptado para neutralizar a incapacidade e importância do desvio do foco de atenção da deficiência para a funcionalidade.<br>The identification of the level of school participation of disabled students is crucial for monitoring the inclusive educational process. It requires the use of measuring instruments that provide functionality before school specific demands, and that at the same time can motivate the teacher to reflect on his judgment about the performance of students with disabilities. School Function Assessment (SFA) is a tool that helps recognize the special needs of students with disabilities according to parameters of functionality and participation. Thus, this study analyzed the influence of the use of SFA on the teacher's judgment of student participation and performance. Eight teachers responded regarding the participation of nine students with disabilities through the use of the SFA and a questionnaire. The results indicated that, for five teachers, SFA helped with the perception of the student's participation, focusing on the activity demand and brought reflections on: the need of evaluation not just in the classroom, co-relation between the degree of disability and the participation of the student, understanding of the specificities of the performance, importance of the adaptation to neutralize incapacity and the importance of the focus deviation from the disability toward functionality

Neoadjuvant atezolizumab plus chemotherapy in gastric and gastroesophageal junction adenocarcinoma: the phase 2 PANDA trial.

Gastric and gastroesophageal junction (G/GEJ) cancers carry a poor prognosis, and despite recent advancements, most patients die of their disease. Although immune checkpoint blockade became part of the standard-of-care for patients with metastatic G/GEJ cancers, its efficacy and impact on the tumor microenvironment (TME) in early disease remain largely unknown. We hypothesized higher efficacy of neoadjuvant immunotherapy plus chemotherapy in patients with nonmetastatic G/GEJ cancer. In the phase 2 PANDA trial, patients with previously untreated resectable G/GEJ tumors (n = 21) received neoadjuvant treatment with one cycle of atezolizumab monotherapy followed by four cycles of atezolizumab plus docetaxel, oxaliplatin and capecitabine. Treatment was well tolerated. There were grade 3 immune-related adverse events in two of 20 patients (10%) but no grade 4 or 5 immune-related adverse events, and all patients underwent resection without treatment-related delays, meeting the primary endpoint of safety and feasibility. Tissue was obtained at multiple time points, allowing analysis of the effects of single-agent anti-programmed cell death ligand 1 (PD-L1) and the subsequent combination with chemotherapy on the TME. Twenty of 21 patients underwent surgery and were evaluable for secondary pathologic response and survival endpoints, and 19 were evaluable for exploratory translational analyses. A major pathologic response (≤10% residual viable tumor) was observed in 14 of 20 (70%, 95% confidence interval 46-88%) patients, including 9 (45%, 95% confidence interval 23-68%) pathologic complete responses. At a median follow-up of 47 months, 13 of 14 responders were alive and disease-free, and five of six nonresponders had died as a result of recurrence. Notably, baseline anti-programmed cell death protein 1 (PD-1) &lt;sup&gt;+&lt;/sup&gt; CD8 &lt;sup&gt;+&lt;/sup&gt; T cell infiltration was significantly higher in responders versus nonresponders, and comparison of TME alterations following anti-PD-L1 monotherapy versus the subsequent combination with chemotherapy showed an increased immune activation on single-agent PD-1/L1 axis blockade. On the basis of these data, monotherapy anti-PD-L1 before its combination with chemotherapy warrants further exploration and validation in a larger cohort of patients with nonmetastatic G/GEJ cancer. ClinicalTrials.gov registration: NCT03448835