Acting or Reacting?: Creating High Quality Supportive Environments to Prevent Challenging Behaviors

Presentation given at the Southern Conference on Children. All children are learning how to ride the waves of their emotions. Self-regulation, pro-social behaviors, and emotional competence are skills that we can help children develop. Participants in this session will learn how to adapt their behaviors and environments to prevent or intervene in children’s challenging behaviors

Caregiver perceptions on the effects of a therapeutic camp on well-being using the flourishing through leisure model

Literature has noted the contribution of therapeutic camping programs in enhancing overall functioning and well-being. Therapeutic camps can provide an opportunity for recreation involvement, skill development, and reduction in deficits by providing a variety of activities suited for the needs of the population. This study explores caregivers’ perceptions on the impacts of a four week therapeutic day camp program on well-being in adolescents with disabilities. Qualitative data was collected through functional profiles, treatment goals, discharge summaries, and caregiver surveys provided by Camp RAD to evaluate the outcomes of the camp through the lens of the Flourishing through Leisure Model. By providing the correct environmental supports, Camp RAD led to improvements in the physical, social, emotional, cognitive, spiritual, and leisure domains that assist participants in achieving flourishing and overall well-being. The study suggests that a therapeutic camp program is effective at enhancing skills and assisting in the achievement of well-being

Instructional Scaffolding in Internships: Supporting future professionals in Family Science

Internships are known for being a valuable, albeit time consuming, opportunity for students, supervisors, and faculty in many fields. As undergraduate programs consider their current and future internship programs, we suggest the processes an intern takes to secure and complete an internship are key to furthering their learning and increasing their career marketability. In this article, we use scaffolding and self-efficacy theories as the foundation to developing an intentional internship program in the family science field. We share the steps faculty take to prepare students for the internship, use graduated guidance to support student learning, and to assess learning during the internship. This hybrid approach combines quality online learning with on-site application and readily lends itself to replication in other disciplines

School Community Connectedness and Family Participation at School

Family involvement in a child’s education is a complex system that extends beyond the presence of partnerships between families, schools, and the community (Epstein, 2011). By measuring families’ feelings of connectedness and membership to the school community, this study explores families’ motivations for participating in their child’s learning and development at school. Results suggest that a family’s sense of connectedness to their child’s school community may be related to their level of participation. Findings are discussed in terms of implications for educational communities emphasizing the power of families’ community connectedness within the schools and expanding on the ways to enhance family involvement and participation

Suppression of Internal Wave Breaking in the Antarctic Circumpolar Current near Topography

Simultaneous full-depth microstructure measurements of turbulence and finestructure measurements of velocity and density are analyzed to investigate the relationship between turbulence and the internal wave field in the Antarctic Circumpolar Current. These data reveal a systematic near-bottom overprediction of the turbulent kinetic energy dissipation rate by finescale parameterization methods in select locations. Sites of near-bottom overprediction are typically characterized by large near-bottom flow speeds and elevated topographic roughness. Further, lower-than-average shear-to-strain ratios indicative of a less near-inertial wave field, rotary spectra suggesting a predominance of upward internal wave energy propagation, and enhanced narrowband variance at vertical wavelengths on the order of 100 m are found at these locations. Finally, finescale overprediction is typically associated with elevated Froude numbers based on the near-bottom shear of the background flow, and a background flow with a systematic backing tendency. Agreement of microstructure- and finestructure-based estimates within the expected uncertainty of the parameterization away from these special sites, the reproducibility of the overprediction signal across various parameterization implementations, and an absence of indications of atypical instrument noise at sites of parameterization overprediction, all suggest that physics not encapsulated by the parameterization play a role in the fate of bottom-generated waves at these locations. Several plausible underpinning mechanisms based on the limited available evidence are discussed that offer guidance for future studie

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Natural or Nemesis? Understanding Challenging Behaviors as Communication With Infants and Toddlers

Presentation given at the Accreditation Facilitation Project Super Saturday

Communication Disorders and Challenging Behaviors: Supporting Children’s Functional Communication Goals in the Classroom

Children with communication disorders may express frustrations through challenging behaviors such as aggressive behaviors and social withdrawal. Challenging behaviors may lead to difficulties with building social competencies including emotional regulation and peer engagement. Individualized planning of functional goals for children with communication disorders provides support for social communication to increase quality classroom interactions. Teachers, families and service providers can work together to assess the purpose of the child’s behaviors in order to create more functional ways for the child to communicate as the spoken language continues to improve. This article focuses on strategies including considerations for collaboration in initial planning, communication modifications, and peer supports

Data Collection in Qualitative Research

Presentation given at the Eagle QuaRC Biannual Conference