Social Participation of Students with Special Educational Needs in Mainstream Seventh Grade

AbstractThis study addresses the social participation of students with special educational needs (SEN) in mainstream 7th grade in Flanders (Belgium). Social participation (i.e., social interactions, peer acceptance, friendships, and social self-concept) was assessed by means of questionnaires among 86 students with autism spectrum disorder (ASD), 61 students with motor and/or sensory disabilities (MOTSENS) and 1926 normally developing classmates. Seventh grade students with ASD scored less favorably in all aspects. Girls with MOTSENS scored less favorably on some aspects of social participation than typically expected of their peers. The social participation of students with ASD and students with MOTSENS did not differ significantly

Blood DCs activated with R848 and poly(I:C) induce antigen-specific immune responses against viral and tumor-associated antigens

Monocyte-derived Dendritic cells (DCs) have successfully been employed to induce immune responses against tumor-associated antigens in patients with various cancer entities. However, objective clinical responses have only been achieved in a minority of patients. Additionally, generation of GMP-compliant DCs requires time- and labor-intensive cell differentiation. In contrast, Blood DCs (BDCs) require only minimal ex vivo handling, as differentiation occurs in vivo resulting in potentially better functional capacities and survival. We aimed to identify a protocol for optimal in vitro activation of BDCs including the three subsets pDCs, cDC1s, and cDC2s. We evaluated several TLR ligand combinations and demonstrated that polyinosinic:polycytidylic acid poly(I:C) and R848, ligands for TLR3 and TLR7/8, respectively, constituted the optimal combination for inducing a positive co-stimulatory profile in all BDC subsets. In addition, TLR3 and TLR7/8 activation led to high secretion of IFN-α and IL-12p70. Simultaneous as opposed to separate tailored activation of pDCs and cDCs increased immunostimulatory capacities, suggesting that BDC subsets engage in synergistic cross-talk during activation. Stimulation of BDCs with this protocol resulted in enhanced migration, high NK-cell activation, and potent antigen-specific T-cell induction.We conclude that simultaneous activation of all BDC subsets with a combination of R848 + poly(I:C) generates highly immunostimulatory DCs. These results support further investigation and clinical testing, as standalone or in conjunction with other immunotherapeutic strategies including adoptive T-cell transfer and checkpoint inhibition

Predisposing and Precipitating Risk Factors for Delirium in Elderly Patients Admitted to a Cardiology Ward: An Observational Cohort Study in 1,042 Patients.

Aim: Although the risk factors for delirium in general medicine are well-established, their significance in cardiac diseases remains to be determined. Therefore, we evaluated the predisposing and precipitating risk factors in patients hospitalized with acute and chronic heart disease. Methods and Results: In this observational cohort study, 1,042 elderly patients (≥65 years) admitted to cardiology wards, 167 with and 875 without delirium, were included. The relevant sociodemographic and cardiac- and medical-related clusters were assessed by simple and multiple regression analyses and prediction models evaluating their association with delirium. The prevalence of delirium was 16.0%. The delirious patients were older (mean 80 vs. 76 years; p < 0.001) and more often institutionalized prior to admission (3.6 vs. 1.4%, p = 0.05), hospitalized twice as long (12 ± 10 days vs. 7 ± 7 days; p < 0.001), and discharged more often to nursing homes (4.8 vs. 0.6%, p < 0.001) or deceased (OR, 2.99; 95% CI, 1.53-5.85; p = 0.003). The most relevant risk factor was dementia (OR, 18.11; 95% CI, 5.77-56.83; p < 0.001), followed by history of stroke (OR, 6.61; 95% CI 1.35-32.44; p = 0.020), and pressure ulcers (OR, 3.62; 95% CI, 1.06-12.35; p = 0.040). The predicted probability for developing delirium was highest in patients with reduced mobility and institutionalization prior to admission (PP = 31.2%, p = 0.001). Of the cardiac diseases, only valvular heart disease (OR, 1.57; 95% CI, 1.01-2.44; p = 0.044) significantly predicted delirium. The patients undergoing cardiac interventions did not have higher rates of delirium (OR, 1.39; 95% CI 0.91-2.12; p = 0.124). Conclusion: In patients admitted to a cardiology ward, age-related functional and cognitive impairment, history of stroke, and pressure ulcers were the most relevant risk factors for delirium. With regards to specific cardiological factors, only valvular heart disease was associated with risk for delirium. Knowing these factors can help cardiologists to facilitate the early detection and management of delirium

De ontwikkeling van een procedure voor de evaluatie van de kwaliteit van leven en de kwaliteit van ondersteuning geboden aan personen met ernstige meervoudige beperkingen

Het thema van ‘kwaliteit van leven’ is zeer actueel in onderzoek met betrekking tot personen met een handicap. Het wordt beschouwd als een ‘sensitizing’ concept dat de hulpverlening aan deze groep van personen leidt in de richting van meer participatie, respect en waardering, keuze en controle, competentie en verbondenheid in relaties. Aspecten van kwaliteit van leven worden vaak gebruikt als persoonsgerichte indicatoren waaraan de kwaliteit van de geboden ondersteuning afgemeten wordt. Personen met ernstige meervoudige beperkingen vereisen een bijzondere ondersteuning omwille van hun zeer specifieke en complexe hulpvragen. Het zijn personen met zowel ernstige cognitieve alsook ernstige motorische functiestoornissen veelal in combinatie met sensorische beperkingen en/of medische problemen. In de hantering van het concept ‘kwaliteit van leven’ bij deze groep van personen worden we geconfronteerd met twee problemen. Een eerste probleem heeft betrekking op de operationalisering van het concept. Er is in de literatuur een tekort aan conceptuele modellen van kwaliteit van leven die op het niveau van de indicatoren aangepast zijn aan de groep van personen met ernstige meervoudige beperkingen. Een tweede probleem is het tekort aan betrouwbare en valide instrumenten om de kwaliteit van leven van deze specifieke doelgroep te evalueren. Met dit doctoraatsonderzoek trachten we aan beide problemen tegemoet te komen. De algemene doelstelling van dit doctoraatsonderzoek is het ontwikkelen van een valide en betrouwbare procedure voor het evalueren van de kwaliteit van leven van en de kwaliteit van ondersteuning geboden aan personen met ernstige meervoudige beperkingen. Om deze doelstelling te bereiken ondernemen we vier stappen. In een eerste onderzoeksfase ontwikkelen we een conceptueel kader dat de grondlijnen uitzet voor de ontwikkeling van de procedure. Vervolgens genereren we in een tweede onderzoeksfase een itemverzameling. Hiervoor bevragen we ouders en directe begeleiders van personen met ernstige meervoudige beperkingen door middel van semi-gestructureerde interviews over domeinen en factoren die zij belangrijk achten voor de kwaliteit van leven van en de kwaliteit van ondersteuning geboden aan deze personen. Deze itemverzameling wordt in een derde onderzoeksfase in de vorm van een Delphi-format voorgelegd aan een expertgroep. Deze expertgroep beoordeelt de itemverzameling met betrekking tot inhoud, formulering, indeling en antwoordmogelijkheden en verzamelt voorstellen voor een afnameprocedure. Op basis van deze beoordeling wordt de evaluatieprocedure geconstrueerd. Tot slot worden in een vierde onderzoeksfase de toepassingsmogelijkheden, de bruikbaarheid en de psychometrische eigenschappen van deze evaluatieprocedure nagegaan door middel van twee soorten van pilootstudies. In een eerste deelstudie gaan we de bruikbaarheid van de evaluatieprocedure na door middel van twaalf meervoudige gevalsstudies in een sequentieel design. In een tweede deelstudie toetsen we de validiteit en de betrouwbaarheid van de evaluatieprocedure door middel van een schriftelijke bevraging bij de ouders, begeleiders en orthopedagogen van honderd cliënten met ernstig meervoudige beperkingen in dagcentra of residentiële voorzieningen in Vlaanderen en Nederland.status: publishe

How do children with a chronic or long-term illness perceive their school re-entry after a period of homebound instruction?

Background A considerable number of children are confronted with a chronic or long-term illness in their lives. For these children, absenteeism is problematic, because education plays a major role in stimulating their cognitive development and in promoting a sense of normalcy and psychosocial well-being. In the literature, a great deal of attention has been paid to school reintegration programmes, which try to counter the barriers that these children may face when they return to school. Another way of surmounting these barriers is through the use of homebound instruction, in which the educational process for the child is continued during the period of absence. Despite the growing awareness of the necessity of education for these children, there is still little empirical research available addressing programmes that facilitate school re-entry. Methods The major goal of this study is to investigate how parents and their children with a chronic or long-term illness perceive school re-entry after a period of homebound instruction, by using a descriptiveâ explorative, multi-informant research design. Participants were 60 children and their parents who filled in a self-constructed questionnaire. Results Both parents and children perceived the period of homebound instruction, as well as their school re-entry, predominantly positively.Most of the children stated that they had been able to keep up with their subjects, and that they had good contact with their peers when they returned to school. According to parents, homebound instruction made a positive contribution to the school re-entry of their child. Conclusions The current study is one of the first to explore the school re-entry of children with a chronic or long-term illness. According to both parents and children, the school re-entry process passed off positively. However, more research is needed with regard to the quality of education and the programmes aimed at facilitating school re-entry.status: publishe

Onderwijs- en examenfaciliteiten voor studenten hoger onderwijs met ASS

status: publishe

Psychometric evaluation of a questionnaire to measure the quality of life of people with profound multiple disabilities (QOL-PMD)

Because of a shortage of valid instruments to measure the QOL of people with profound multiple disabilities (PMD), the QOL-PMD was developed. In the present study, possibilities for item reduction as well as the psychometric properties of the questionnaire were examined. One hundred and forty-seven informants of people with PMD participated in the study. Fifty items were removed from the questionnaire on the basis of preset criteria. Internal consistency was good for the total questionnaire as well as for the subscales. Evidence of the construct validity of the questionnaire was found. Correspondence between the groups of informants was moderate. The results of this preliminary analysis of the psychometric properties of the QOL-PMD are encouraging, but further validation of the measure is warranted.status: publishe