Response to instruction and intervention: teachers\u27 perceptions of the implementation in the Beaumont Unified School District as measured by the Concerned [sic] Based Adoption Model

A school district in southern California mandated the implementation of Response to Intervention (RtI) in order to better meet the needs of all district students. RtI is a proven approach to ameliorating academic and behavioral difficulties. It provides a logical structure for allocating instructional resources to utilize research-based effective instructional practices, identify students with learning disabilities, and collaborate between general and special education to benefit all students. In order to continue to provide effective professional development for teachers and thus improve the chances of successful implementation, district administrators needed feedback about the process of implementation and concerns of teachers. The purpose of this program evaluation study was to identify the perceptions, concerns, and level of acceptance of teachers toward the implementation of RtI, in order to provide more effective professional development in the future. A survey was used to understanding the impact of this potentially significant change by measuring the user group\u27s overall perception and level of acceptance. The survey used was the Stages of Concern (SoC) survey from the Concerns Based Adoption Model (CBAM). This study was designed to investigate the following: (a) the composite Stages of Concern Questionnaire (SoCQ) profile of teachers in regard to the overall perceptions and level of acceptance by the users in the implementation of RtI; (b) the overall perceptions and level of acceptance of teachers in regard to the implementation of RtI related to selected demographic characteristics of the employees, with respect to job location (elementary site or secondary site); (c) other issues or concerns seen as significant to the teachers, as determined by the responses to the open-ended questions (see Appendix A and Appendix B). Teachers\u27 perceptions of changes taking place play a critical role in RtI implementation and its impact on student success. Considering this, understanding the impact of such potentially significant change by measuring teachers\u27 overall perception and level of acceptance could be a key component in providing guidance for future implementations. This understanding can also facilitate the development of appropriate professional development to enhance the acceptance and implementation of RtI

«CHEST PAIN» AT PRE-HOSPITAL STAGE

The article is devoted to the questions of differential diagnostics in patients with chest pain at pre-hospital stage of medical care. On the basis of literary data the principle of construction of diagnostic algorithm by the physician for this group of patients is defined. Summarized literary data allowed to reveal the tendency of mutually burdening influence of different pathology, that is accompanied with chest pain, on the pathogenesis of basic disease. The principles of medical care for the patients with chest pain at pre-hospital stage are determined

Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique

Abstract Background Systematic adaptation of evidence-informed interventions that increase retention in care and improve adherence to antiretroviral therapy (ART) are essential to ending the HIV epidemic in rural sub-Saharan Africa. We selected and adapted an adherence support worker intervention employed in Malawi for use by traditional healers in rural Mozambique. Given the levels of trust and dependence previously expressed by persons living with HIV (PLHIV) for traditional medicine, we adapted the program to engage traditional healers within the allopathic health system. Methods Adaption followed a theoretically driven approach to intervention adaption: the Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT) model. Three rounds of performance feedback, based on theater presentations of the adapted intervention for stakeholders and idea generation, were completed with 12 groups from March to July 2016 to develop the final model. We offered healer support to 180 newly diagnosed HIV-infected patients. Results Traditional healers were an acceptable group of community health workers to assist with patient adherence and retention. Traditional healers, clinicians, and interested community members suggested novel strategies to tailor the adherence support worker intervention, revealing a local culture of HIV denialism, aversion to the health system, and dislike of healthcare providers, as well as a preference for traditional treatments. Proposed changes to the intervention included modifications to the training language and topics, expanded community-based activities to support acceptability of an HIV diagnosis and to facilitate partner disclosure, and accompaniment to the health facility by healers to encourage delivery of respectful clinical care. PLHIV, healers, and clinicians deemed the intervention socially acceptable during focus groups. We subsequently recruited 180 newly diagnosed HIV-infected patients into the program: 170 (94%) accepted. Conclusions Systematic translation of interventions, even between regions with similar social and economic environments, is an important first step to successful program implementation. Efforts previously limited to community health workers can be tailored for use by traditional healers—an underutilized and often maligned health workforce. It proved feasible to use theater-based performances to demonstrate delivery of the intervention in low-literacy populations, generating discussions about social norms, community concerns, and the merits of an acceptable strategy to improve retention and adherence to ART.https://deepblue.lib.umich.edu/bitstream/2027.42/136553/1/13012_2017_Article_582.pd

The desmosome and pemphigus

Desmosomes are patch-like intercellular adhering junctions (“maculae adherentes”), which, in concert with the related adherens junctions, provide the mechanical strength to intercellular adhesion. Therefore, it is not surprising that desmosomes are abundant in tissues subjected to significant mechanical stress such as stratified epithelia and myocardium. Desmosomal adhesion is based on the Ca2+-dependent, homo- and heterophilic transinteraction of cadherin-type adhesion molecules. Desmosomal cadherins are anchored to the intermediate filament cytoskeleton by adaptor proteins of the armadillo and plakin families. Desmosomes are dynamic structures subjected to regulation and are therefore targets of signalling pathways, which control their molecular composition and adhesive properties. Moreover, evidence is emerging that desmosomal components themselves take part in outside-in signalling under physiologic and pathologic conditions. Disturbed desmosomal adhesion contributes to the pathogenesis of a number of diseases such as pemphigus, which is caused by autoantibodies against desmosomal cadherins. Beside pemphigus, desmosome-associated diseases are caused by other mechanisms such as genetic defects or bacterial toxins. Because most of these diseases affect the skin, desmosomes are interesting not only for cell biologists who are inspired by their complex structure and molecular composition, but also for clinical physicians who are confronted with patients suffering from severe blistering skin diseases such as pemphigus. To develop disease-specific therapeutic approaches, more insights into the molecular composition and regulation of desmosomes are required

Response to Instruction and Intervention: Teachers' perceptions of the implementation in the Beaumont Unified School District as measured by the Concerns Based Adoption Model

A school district in southern California mandated the implementation of Response to Intervention (RtI) in order to better meet the needs of all district students. RtI is a proven approach to ameliorating academic and behavioral difficulties. It provides a logical structure for allocating instructional resources to utilize research-based effective instructional practices, identify students with learning disabilities, and collaborate between general and special education to benefit all students. In order to continue to provide effective professional development for teachers and thus improve the chances of successful implementation, district administrators needed feedback about the process of implementation and concerns of teachers. The purpose of this program evaluation study was to identify the perceptions, concerns, and level of acceptance of teachers toward the implementation of RtI, in order to provide more effective professional development in the future. A survey was used to understanding the impact of this potentially significant change by measuring the user group's overall perception and level of acceptance. The survey used was the Stages of Concern (SoC) survey from the Concerns Based Adoption Model (CBAM). This study was designed to investigate the following: (a) the composite Stages of Concern Questionnaire (SoCQ) profile of teachers in regard to the overall perceptions and level of acceptance by the users in the implementation of RtI; (b) the overall perceptions and level of acceptance of teachers in regard to the implementation of RtI related to selected demographic characteristics of the employees, with respect to job location (elementary site or secondary site); (c) other issues or concerns seen as significant to the teachers, as determined by the responses to the open-ended questions (see Appendix A and Appendix B). Teachers' perceptions of changes taking place play a critical role in RtI implementation and its impact on student success. Considering this, understanding the impact of such potentially significant change by measuring teachers' overall perception and level of acceptance could be a key component in providing guidance for future implementations. This understanding can also facilitate the development of appropriate professional development to enhance the acceptance and implementation of RtI

Educational intervention increased referrals to allopathic care by traditional healers in three high HIV-prevalence rural districts in Mozambique.

Delayed uptake of clinical services impedes favorable clinical outcomes in Mozambique. Care is delayed among patients who initiate care with traditional healers; patients with conditions like human immunodeficiency virus (HIV) or tuberculosis are rarely referred to the health system in a timely fashion.We conducted a pre-post educational intervention with traditional healers, assessing healer referral rates and HIV knowledge in three rural districts in Zambézia Province.The median monthly referral rate prior to the intervention was 0.25 patients (interquartile range [IQR]: 0-0.54) compared with a post-intervention rate of 0.34 patients (IQR: 0-0.71), a 35% increase (p=0.046). A median HIV knowledge score of 67% (IQR: 59-78) was noted 4-months pre-intervention and a median score of 81% (IQR: 74-89) was recorded 2½ months post-intervention (p<0.001). One hundred and eleven healers referred 127 adults, 36 pregnant women, and 188 children to health facilities. Referred patients were most likely to be diagnosed with bronchopneumonia (20% adults; 13% children) and/or malaria (15% adults; 37% children). Of 315 non-pregnant persons referred, 3.5% were tested for HIV and 2.5% were tested for tuberculosis.We engaged traditional healers with some success; referral rates were low, but increased post-intervention. Once seen in the clinics, patients were rarely tested for HIV or tuberculosis, though symptoms suggested screening was indicated. We found increased referral rates through an inexpensive intervention with traditional healers, a viable, cost-effective method of directing patients to health facilities. However, quality improvement within the clinics is necessary before a substantial impact can be expected

Intérêt de l’individualisation de l’alimentation des brebis laitières par l’utilisation d’un distributeur automatique de concentrés en salle de traite

National audienc

Characteristics of 111 Traditional Healers from three rural districts in Zambézia Province, Mozambique, comparing those who referred to allopathic clinics with those who did not refer.

a<p>Continuous data are summarized as median (interquartile range).</p>b<p>To compare the distribution of study characteristics for healers with any referral, we employ chi-square tests. Similarly, we use a Wilcoxon rank sum test for continuous variables by any referral.</p