Promoting Leadership in the Ongoing Professional Development of Teachers: Responding to Globalization and Inclusion

This paper explores the need for innovative leadership in teacher education in the Canadian context, with a particular call for renewed professional development of current teachers. Within a country defined as multicultural, recent demographic shifts, interregional migration, growing ethnic diversity, and the emergence of a paradigm of inclusion, contemporary classrooms are evolving at a pace faster than projected. While inclusive education emerged from the growth of services for children with disabilities, it is now a concept much broader than initially con-ceived. Expanded concepts of learner differences are necessitating an urgent need for leadership in redeveloping effective training for current teachers. This paper argues that ongoing professional development must be characterized by six focus areas in order to empower teachers with pragmatic skills to balance the needs of their diverse classes. The authors conclude that a first step in this process is training for administrators who lead professional development in schools

Becoming Inclusive Teacher Educators: Self-Study as a Professional Learning Tool

This article describes a self-study inquiry project designed and conducted by a self-study group at a Faculty of Education in an Atlantic Canadian University. The seven-member group engaged in a collaborative self-study inquiry while adopting Universal Design for Learning (UDL) principles in their teacher education practices and documented their professional learning. This yearlong self-study inquiry project encompassed several data collection methods to examine inclusive practices of self-study group members, including personal reflections, minutes of weekly meetings, artifacts, and field notes. This article focuses on how UDL provided a means for three group members to critically examine their inclusive practices at the beginning, during, and following the collaborative self-study inquiry. Using a case study methodology, self-study cases of these three faculty members—Angela, Ryan, and Sarah (Pseudonyms)—were developed. The cases reported on the journey of these faculty members in improving their inclusive practice through their engagement in self-study

The Preemptive Nature of Quality Early Child Education on Special Educational Needs in Children

Given the growth of scholarship in early child education (ECE), as well as the rapid emergence of the sector as an area of academic inquiry, a team of special education/mental health scholars opted to explore its preemptive nature. Despite long and distinguished careers in childhood special educational needs (SEN), ECE has never been an area of attention for them, and they proceeded with unbiased perspectives to answer: Does participation in quality ECE lessen SEN and insulate children against requiring supports later in their school experience? Inclusive education is now an international standard for all children and the recent Canadian bilateral agreements between the federal and provincial/territorial governments strive to increase access to ECE for all children, including those with diverse needs. How inclusive is ECE and will access lessen the amount of support required by children with identified SEN, allowing them a smoother school start and ensuring better educational outcomes? Particular attention was given to children with specific needs: those with autism spectrum disorder (ASD) who typically struggle with starting school and usually require intensive supports; and those with mental health concerns. An extensive review of the literature, with particular attention to longitudinal studies, was undertaken by the team. Additionally, the Effective Pre-school, Primary and Secondary Education Project study in the UK was re-examined by Dr. Edward Melhuish to track the SEN of children across their full school experience. Public data from a representative number of Canadian provinces was also examined to help answer the questions above and illuminate the nature of inclusion in ECE programs. Surprisingly, while the literature was rich on the preemptive nature of ECE, provincial/ territorial data on inclusion during the early years was scant. Poor and inconsistent data collection processes, and an absence of policy to mandate it, sabotages the sector and leads to uninformed public policy. While all regions report policies supporting inclusive ECE programs, the absence of data and inclusive practice creates an illusion of inclusion during the early years. What emerges is significant, especially for the discipline of special education which traditionally views early identification and intervention as beginning at age six. By examining the impact of quality ECE with a common lens, both the ECE sector and the K-12 system obtain startling findings that poses an opportunity to develop earlier identification and intervention to alter the trajectory of the lives of vulnerable children. A continuum of evidence, from multiple studies in multiple countries unanimously converge on the preemptive nature of ECE on SEN. Inclusive, high quality ECE reduces SEN in young children and improves developmental outcomes, especially for vulnerable children and those with complex needs. The need for intervention is both removed for some children and reduced for others. Front loading interventions during the early years is wise public policy. Educators, parents, policy makers and governments could benefit from these findings

The Journey Between There and Here: Stories of a Faculty Writing Group

Reflecting, sharing, and producing knowledge about the process of writing and collaboration in a writing group is the focus of this qualitative project, in which we explore a complex weaving of knowledge, subjectivity, and representation. In this group are eight women faculty, all of whom are individually working on writing projects in their own areas of expertise. Using a method of writing as inquiry, each person was asked to keep a reflective journal; an autoethnographic account of their experiences of writing during a three-month period. The group met weekly and each individual shared their reflections and writing experiences. In this project, our intention is to decentre notions of the alienated, isolated academic by writing and constructing knowledge as a collective. Using the metaphor of here and there, we ask how can a relational culture grow out of writing? How can competitive, hidden barriers be broken down and replaced by open, encouraging spaces

Research objectives and general considerations for pragmatic clinical trials of pain treatments: IMMPACT statement

Many questions regarding the clinical management of people experiencing pain and related health policy decision-making may best be answered by pragmatic controlled trials. To generate clinically relevant and widely applicable findings, such trials aim to reproduce elements of routine clinical care or are embedded within clinical workflows. In contrast with traditional efficacy trials, pragmatic trials are intended to address a broader set of external validity questions critical for stakeholders (clinicians, healthcare leaders, policymakers, insurers, and patients) in considering the adoption and use of evidence-based treatments in daily clinical care. This article summarizes methodological considerations for pragmatic trials, mainly concerning methods of fundamental importance to the internal validity of trials. The relationship between these methods and common pragmatic trials methods and goals is considered, recognizing that the resulting trial designs are highly dependent on the specific research question under investigation. The basis of this statement was an Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) systematic review of methods and a consensus meeting. The meeting was organized by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership. The consensus process was informed by expert presentations, panel and consensus discussions, and a preparatory systematic review. In the context of pragmatic trials of pain treatments, we present fundamental considerations for the planning phase of pragmatic trials, including the specification of trial objectives, the selection of adequate designs, and methods to enhance internal validity while maintaining the ability to answer pragmatic research questions

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial

Background Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects. Methods FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762. Findings Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months. Interpretation Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function. Funding UK Stroke Association and NIHR Health Technology Assessment Programme

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Qualitative Investigation of School-Related Issues Affecting Individuals Diagnosed with Autism Spectrum Disorder and Co-occurring Anxiety and/or Depression

This qualitative study investigated the experiences of adolescents and young adults (16 to 21 years old) diagnosed with an autism spectrum disorder (ASD) and co-occurring depression and/or anxiety disorders. The study was conducted with 9 parents of individuals with ASD and 4 individuals diagnosed with ASD and co-occurring anxiety and/or depression. The study used open-ended, online and face-to-face interviews and yielded rich data associated with a number of broad categories. This paper focuses on associated school-related issues; medical and initial diagnosis and community services. The participants provided valuable information about navigating school environments, programming needs, prevention of victimization, and mental health issues in individuals with ASD. The results suggest the need for mindful planning and programming for individuals diagnosed with ASD, as well as the need for awareness of the characteristics and programming associated with autism

Writing Relationships: Collaboration In A Faculty Writing Group

Our faculty writing group in the Faculty of Education at Memorial University of Newfoundland, Canada began in 2009 and over the past three years it has grown into a successfully publishing community of practice. When we have presented papers on the writing group at conferences, we have found that the first question asked tends to be: How did you get the writing group to work? It is a deceptively simple question but the answer taps into many issues surrounding the difficulty of faculty writing and publishing in academic contexts. For many academics, the challenge of navigating the competitive discourse demands of conducting research and publishing journal articles, while at the same time navigating teaching and administrative loads, often leads to anxiety and stress. Situated within the literature on writing groups and research productivity, we contribute by narrating and analysing the evolving story of our group. The purpose of this paper is to explore why members continue to participate and why we have been able to successfully write and publish both individually and as a group. This study used ‘the self as data’, a qualitative methodology particularly relevant in the analysis of writing processes and groups. The data collected consisted of weekly written reflections, additional written narratives by each group member, and recordings of meeting discussions. We analysed the data qualitatively using the constant comparison method of analysis to generate themes. Results indicate that members attended the group because they were looking for a place to get support for research and writing and to cope with negotiating academic cultures. We argue that the ethos of a ‘non-competitive environment’ and ‘relationships-first’ were crucial in fostering collaboration and productivity despite diverse individual differences. We offer this analysis of our experiences, not only in terms of practicalities but also as an alternative way of working in the academy

Exploring the Impact of Quality Early Child Education on Special Education: Can We Prevent Placement in Special Education?

This article examines the research literature to determine whether the provision of quality early childhood education (ECE) lowers the risk of a child developing special education needs (SEN) and mediates the intensity of support for children with an identified exceptionality. Schools play a crucial role in reducing developmental gaps assessed at school entry, but their success comes with great expense in special education and related costs. Research indicates that ECE could narrow these gaps and better prepare children for success in school, and this realization is slowly being reflected in public policy. Based on our literature review, we describe the benefits of quality ECE in lowering special education expenses. Specific play-based learning pedagogical strategies support all children in optimizing academic progress, language development, social skills, and emotional-behavioural regulation. Professional learning for early childhood educators can build capacity to embed effective pedagogy into daily practice. The provision of quality ECE that makes a difference depends on the knowledge and skills of this workforce