Family-School Partnerships in Special Education: A Narrative Study of Parental Experiences

Thesis advisor: Curt Dudley-MarlingImproving educational outcomes for students with disabilities remains a challenge for professionals in the field of special education. With the passage of NCLB and IDEA 2004 has come the recommendation to establish higher standards for educational productivity for these students. This call to action seems warranted, especially in light of recent findings published in a report by the U.S. Department of Education (2002) entitled A New Era: Revitalizing Special Education for Children and Their Families . The report suggests that students with disabilities drop-out of high school at twice the rate of their peers and higher education enrollment rates for students with disabilities are 50 percent lower than rates for the general population. Recent literature indicates that improving educational outcomes for students with disabilities depends in large part on creating constructive partnerships between their families and schools. The present study contributes to the knowledge base on partnership-making by investigating family-school partnerships in special education from the perspective of parents. This study utilized the qualitative methodology known as narrative inquiry to investigate the following research questions: 1. What stories do parents tell regarding their personal experiences with the special education process? 2. What do these stories tell us about the family's perspective of family-school partnerships in special education? 3. What can we learn from these stories that might translate into effective policy and practice in schools? Findings from interviews with fourteen parents of students receiving special education services indicated that they were concerned about issues of teacher effectiveness, honesty and trust, and their role in securing services for their children. Knowledge derived from their experiences offer suggestions for schools, institutions of higher education, and future researchers.Thesis (PhD) — Boston College, 2009.Submitted to: Boston College. Lynch School of Education.Discipline: Teacher Education, Special Education, Curriculum and Instruction

Cost data in implementation science: categories and approaches to costing

A lack of cost information has been cited as a barrier to implementation and a limitation of implementation research. This paper explains how implementation researchers might optimize their measurement and inclusion of costs, building on traditional economic evaluations comparing costs and effectiveness of health interventions. The objective of all economic evaluation is to inform decision-making for resource allocation and to measure costs that reflect opportunity costs-the value of resource inputs in their next best alternative use, which generally vary by decision-maker perspective(s) and time horizon(s). Analyses that examine different perspectives or time horizons must consider cost estimation accuracy, because over longer time horizons, all costs are variable; however, with shorter time horizons and narrower perspectives, one must differentiate the fixed and variable costs, with fixed costs generally excluded from the evaluation. This paper defines relevant costs, identifies sources of cost data, and discusses cost relevance to potential decision-makers contemplating or implementing evidence-based interventions. Costs may come from the healthcare sector, informal healthcare sector, patient, participant or caregiver, and other sectors such as housing, criminal justice, social services, and education. Finally, we define and consider the relevance of costs by phase of implementation and time horizon, including pre-implementation and planning, implementation, intervention, downstream, and adaptation, and through replication, sustainment, de-implementation, or spread

Reframing and reacting to employees' responses to change: A focus on resistance

Background A hallmark of a leader is their ability to manage change—an ever-present feature of organisational life. Indeed, all improvement requires change, and in this context navigating employees’ responses to progress change is a key part of leadership. To support this, research and leadership development have historically focused on how leaders can reduce resistance to change. This review highlights the value of reframing classic conceptions of resistance to change as something negative. Result Widening understanding of non-acceptance responses to change supports the provision of broader, yet more meaningful advice to leaders and managers about how to engage with employees in ways that can support improvement. To do this, the article identifies why resistance is important in the contemporary context and then outlines three current broad views within research on resistance to change identified by Robyn Thomas and Cynthia Hardy. These influence how resistance is seen and therefore how it is approached. The article considers what leaders can learn and do to more effectively navigate employees’ responses to change, and how reframing resistance applies to the specific context of healthcare

Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life

Purpose of Review: To describe approaches to measuring deprescribing and associated outcomes in studies of patients approaching end of life (EOL). Recent Findings: We reviewed studies published through 2020 that evaluated deprescribing in patients with limited life expectancy and approaching EOL. Deprescribing includes reducing the number of medications, decreasing medication dose(s), and eliminating potentially inappropriate medications. Tools such as STOPPFrail, OncPal, and the Unnecessary Drug Use Measure can facilitate deprescribing. Outcome measures vary and selection of measures should align with the operationalized deprescribing definition used by study investigators. Summary: EOL deprescribing considerations include medication appropriateness in the context of patient goals for care, expected benefit from medication given life expectancy, and heightened potential for medication-related harm as death nears. Additional data are needed on how EOL deprescribing impacts patient quality of life, caregiver burden, and out-of-pocket medication-related costs to patients and caregivers. Investigators should design deprescribing studies with this information in mind

Pretreatment of Lignocellulosic Wastes to Improve Ethanol and Biogas Production: A Review

Lignocelluloses are often a major or sometimes the sole components of different waste streams from various industries, forestry, agriculture and municipalities. Hydrolysis of these materials is the first step for either digestion to biogas (methane) or fermentation to ethanol. However, enzymatic hydrolysis of lignocelluloses with no pretreatment is usually not so effective because of high stability of the materials to enzymatic or bacterial attacks. The present work is dedicated to reviewing the methods that have been studied for pretreatment of lignocellulosic wastes for conversion to ethanol or biogas. Effective parameters in pretreatment of lignocelluloses, such as crystallinity, accessible surface area, and protection by lignin and hemicellulose are described first. Then, several pretreatment methods are discussed and their effects on improvement in ethanol and/or biogas production are described. They include milling, irradiation, microwave, steam explosion, ammonia fiber explosion (AFEX), supercritical CO2 and its explosion, alkaline hydrolysis, liquid hot-water pretreatment, organosolv processes, wet oxidation, ozonolysis, dilute-and concentrated-acid hydrolyses, and biological pretreatments

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