Assessing the Effectiveness of an In-home Training Program for Parents of Children with Autism or Related Developmental Delays: A Multiple Baseline across Parent Skills

Autism spectrum disorders (ASD) are characterized by difficulty in communication and social interaction, and repetition of behaviors, requiring focused intervention efforts over time. Research has supported the role of parents as intervention agents in improving their children’s behavior, but relatively little of this research has been conducted in the home. This study examined the effectiveness of an in-home intervention of five two-hour sessions combining positive behavior supports (PBS) with the provision of visual supports (VS). The Positive Behavior Visual Support (PBVS) curriculum was developed by the Center for Leadership in Disability at Georgia State University and was previously implemented with both individual in-home and group delivery. In the present study, we wanted to examine more closely the session-by-session acquisition of parental skills using the PBVS curriculum. A single-subject multiple baseline design was used with one family, and partially replicated with a second, to document whether parent training on PBS increased the use of specific skills and whether that, in turn, had an effect on child problem behaviors. We hypothesized that the parents who participated in the PBVS study would increase their use of the positive behavior approaches, which would be accompanied by a decrease in one or more of their children’s targeted challenging behaviors. We looked at five positive behavior parenting skills, as well as child behaviors, during parent-child interaction sessions. We also predicted that parents would report a decrease in stress and an increase in knowledge and self-efficacy. One family withdrew from the study after three sessions so no follow-up was available. Results from the multiple baseline failed to support the predicted outcomes as both parent and child behaviors were quite variable from session to session. This family did demonstrate enhanced self-efficacy and parenting knowledge following the training. The brief time frame (only five sessions), paired with the relative long in-session time spent on parenting strategies (approximately 90 minutes per session), and that the data collection occurred in the first 15 minutes of the session (no time for warm-up or reminders) may have mitigated finding more specific session-by-session changes in behavior

A comparative study of geometry curricula

In the United States, geometry has long been offered to high school students in the tenth grade. Attempts have been made in recent years to expand the role of geometry across grades Pre-K through twelve. However, based on the latest TIMSS results, although students in the United States made gains in most content areas, they still struggle with geometric concepts compared to their counterparts in other nations of the world, primarily those in certain Asian countries like Singapore and China. We argue that the structure of the curriculum and the instructional strategies used in these countries may lead to more progressive reform strategies for the United States curriculum. These strategies may provide the catalyst to push our students back to the head of the class when assessed locally, nationally, and internationally

Understanding Fetal Alcohol Spectrum Disorder (FASD) through the Stories of Nyoongar Families and how can this Inform Policy and Service Delivery

This is the first study to explore Fetal Alcohol Spectrum Disorder (FASD) in the south west region, Western Australia. The study included a mixed methods approach of qualitative and quantitative and Indigenous Standpoint theory. The project recorded the stories of families caring for Aboriginal children with FASD and explored the level of awareness of FASD amongst the Aboriginal community. The results support the baseline international evidence for families raising children with FASD

EXPLORING BIOGRAPHIES: THE EDUCATIONAL JOURNEY TOWARDS BECOMING INCLUSIVE EDUCATORS OF CHILDREN WITH DISABILITIES

The current study explored the formative processes of twelve student teachers constructing role understandings in the context of their experiences and interactions with people with disabilities. In particular, it examined the participants’ changing notions of self-as-teacher and their unfolding perceptions of an inclusive educator’s role in teaching children with disabilities. The research aimed to investigate personal and professional forms of knowledge linked with the prior subjective life experiences of the student teachers and those arising from their interactions in situated learning experiences in community settings. The contextual framework of the study focused on the development of the student teachers’ unique understandings and awareness of people with disabilities through processes of biographical situated learning. The investigation examined participants’ voluntary out-ofcourse experiences with people with disabilities across three community settings for the ways in which these experiences facilitated the participants’ emerging role understandings. These settings included respite experiences in families’ homes of young children with disabilities receiving early intervention, an after-school recreational program for primary and secondary aged children and adolescents with disabilities, and an independent living centre providing post-school options and activities for adults with disabilities. ii Two groups participated in the current study, each consisted of six student teachers in the Bachelor of Education Course at the Bathurst campus of Charles Sturt University. Group One participants were in the second year compulsory inclusive education subject and Group Two participants were in the third year elective early intervention subject. The investigation examines the nature of reflexive and reflective processes of the student teachers from subjective, conflict realities in an attempt to link community experiences with real-life issues affecting inclusive educational practices. The voluntary community experiences engaged the research participants in multi-faceted interactions with people with disabilities, providing thought-provoking contexts for their reflections on observations, responses and reactions to situations, such as critical incidents. The participants engaged in reflexive and reflective processes in records made in learning journals and in semi-structured interviews conducted throughout the investigation. Results were analysed from a constructivist research paradigm to investigate their emerging role understandings. Prior to this study there had been few practical components in the compulsory undergraduate inclusive education subject which meant that previously student teachers gained theoretical knowledge without the opportunity to apply their learning. Many student teachers had expressed their feelings of anxiety and uneasiness about what they should do and say to a person with a disability. Thus, the community experiences were selected in order to give a specific context for student teachers’ learning and to provide participants with expanded opportunities to consider their professional identity, social awareness and acceptance of people with disabilities. iii An analysis of the data demonstrated the centrality of reflection within a situated teaching and learning framework. Understandings of prior experiences and motivation were shown to interact with the outcomes of the community experiences through an on-going process of reflection and reflexivity. This reconstructing process encouraged learners to reflect on past, present and projected future experiences and reframe actions from multiple perspectives as a way of exploring alternatives within broader contexts. The data reveal the participants’ engagement in the community experiences facilitated their awareness of wider socio-cultural educational issues, while focusing their attention on more appropriate inclusive teaching and learning strategies. The reflective inquiry process of identifying diverse issues led participants to consider other possible alternatives to current community practices for better ways to support their changing perspectives on ideal inclusive classroom practices. The dialogic nature of participants’ on-going deliberations contributed to the construction of their deeper understandings of an inclusive educator’s role. The findings of the study identified external environmental and internal personal factors as contributing biographical influences which shaped the student teachers’ emerging role understandings. The results emphasised the value of contextual influences in promoting desirable personal and professional qualities in student teachers. Importantly, situated learning enhanced participants’ unique interpretations of their prospective roles. As a result of analysing their insights from interactions in community contexts, the student teachers had increased their personal and professional understandings of individuals with disabilities and broadened their perceptions of their roles as inclusive educators. Thus, the study found that encouraging a biographical reflexive and reflective orientation in participants was conducive iv to facilitating changes in their understandings. Overall, the outcomes had benefits for student teachers and teacher educators in finding innovative ways for integrating biographical perspectives into situated teaching and learning approaches. The study showed that contextual influences facilitated deeper understanding of role identity and produced new ideas about the nature of reflexivity and reflection in guiding student teachers’ learning. (Note: Appendices not included in digital version of thesis

Developing Methods to Support Collaborative Learning and Co-creation of Resilient Healthcare—Tips for Success and Lessons Learned From a Norwegian Hospital Cancer Care Study

Background There is a growing attention on the role of patients and stakeholders in resilience, but there is lack of knowledge and methods on how to support collaborative learning between stakeholders and co-creation of resilient healthcare. The aim of this article was to demonstrate how the methodological process of a consensus process for exploring aspects of next of kin involvement in hospital cancer care can be replicated as an effort to promote resilient healthcare through co-creation with multiple stakeholders in hospitals. Methods The study applied a modified nominal group technique process developed by synthesizing research findings across 4 phases of a research project with a mixed-methods approach. The process culminated in a 1-day meeting with 20 stakeholder participants (5 next of kin representatives, 10 oncology nurses, and 5 physicians) from 2 Norwegian university hospitals. Results The consensus method established reflexive spaces with collective sharing of experiences between the 2 hospitals and between the next of kin and healthcare professionals. The method promoted collaborative learning processes including identification and reflection upon new ideas for involvement, and reduction of the gap between healthcare professionals’ and next of kin experiences and expectations for involvement. Next of kin were considered as important resources for resilient performance, if involved with a proactive approach. The consensus process identified both successful and unsuccessful collaborative practices and resulted in a co-designed guide for healthcare professionals to support next of kin involvement in hospital cancer care. Conclusions This study expands the body of knowledge on methods development that is relevant for collaborative learning and co-creation of resilient healthcare. This study demonstrated that the consensus methods process can be used for creating reflexive spaces to support collaborative learning and co-creation of resilience in cancer care. Future research within the field of collaborative learning should explore interventions that include a larger number of stakeholders.publishedVersio

Places and stories : mapping Ngaanyatjarra art-making practices (Nintilu Kulira Palyaratjaku Ngayuku-Lampatju Ngurrawanalu)

University of Technology Sydney. Faculty of Arts and Social Sciences.In the past four decades Australian Aboriginal art has achieved national and international recognition, and has come to occupy a significant space in the Australian cultural environment. The success of Aboriginal art has found its counterpart in a wealth of studies, both by academics in diverse disciplines and museum professionals. This literature shows how art production is part of a specific cultural and social context and how it is connected to specific Aboriginal epistemologies. However, references to Aboriginal art’s connections to everyday life are scant. This thesis aims to fill this gap, arguing that art-making needs to be located in the fine-grained relational complexities of everyday life, particularly in the material, social, cultural and epistemological specifics of daily life in remote Aboriginal communities. I develop this argument by providing a detailed record based on a rich ethnography of daily life at the Papulankutja Artists art centre. Papulankutja is a community of approximately 160 residents who are predominantly from the Ngaanyatjarra and Pitjantjatjara language groups, situated between the Western and Victorian Deserts in the Ngaanyatjarra Lands Western Australia. I spent several periods in Papulankutja between July 2011 and February 2016, working at the art centre and forming firm relationships with both artists and the art centre’s manager. To illuminate the daily flow of life in the art centre and the associated sites connected to art-making practices, I use ethnographic vignettes that illustrate the social, emplaced and multisensory aspects of art production. I read the art centre through the organising principle of ‘place’, as a collection of trajectories and stories, through what I call a storied environment. This thesis adds to our understanding of commercial art production and everyday life in the Ngaanyatjarra Lands. My findings demonstrate that art production itself is shown to be fundamentally enmeshed in socio-cultural practices and storied environments

Chemokines in the balance: Maintenance of homeostasis and protection at CNS barriers

In the adult central nervous system (CNS), chemokines and their receptors are involved in developmental, physiological and pathological processes. Although most lines of investigation focus on their ability to induce the migration of cells, recent studies indicate that chemokines also promote cellular interactions and activate signaling pathways that maintain CNS homeostatic functions. Many homeostatic chemokines are expressed on the vasculature of the blood brain barrier including CXCL12, CCL19, CCL20, and CCL21. While endothelial cell expression of these chemokines is known to regulate the entry of leukocytes into the CNS during immunosurveillance, new data indicate that CXCL12 is also involved in diverse cellular activities including adult neurogenesis and neuronal survival, having an opposing role to the homeostatic chemokine, CXCL14, which appears to regulate synaptic inputs to neural precursors. Neuronal expression of CX3CL1, yet another homeostatic chemokine that promotes neuronal survival and communication with microglia, is partly regulated by CXCL12. Regulation of CXCL12 is unique in that it may regulate its own expression levels via binding to its scavenger receptor CXCR7/ACKR3. In this review, we explore the diverse roles of these and other homeostatic chemokines expressed within the CNS, including the possible implications of their dysfunction as a cause of neurologic disease

Patient and clinician engagement with health information in the primary care waiting room: A mixed methods case study

Background. Primary care waiting rooms can be sites of health promotion and health literacy development through the provision of readily accessible health information. To date, few studies have considered patient engagement with televised health messages in the waiting room, nor have studies investigated whether patients ask their clinicians about this information. The aim of this study was therefore to examine patient (or accompanying person) and clinician engagement with waiting room health information, including televised health messages. Design and methods. The mixed methods case study was undertaken in a regional general practice in Victoria, Australia, utilising patient questionnaires, waiting room observations, and clinician logbooks and interviews. The qualitative data were analysed by content analysis; the questionnaire data were analysed using descriptive statistics. Results. Patients engaged with a range of health information in the waiting room and reportedly received health messages from this information. 44% of the questionnaire respondents (33 of 74) reported watching the television health program, and half of these reported receiving a take home health message from this source. Only one of the clinicians (N=9) recalled a patient asking about the televised health program. Conclusions. The general practice waiting room remains a site where people engage with the available health information, with a televised health ‘infotainment’ program receiving most attention from patients. Our study showed that consumption of health information was primarily passive and tended not to activate patient discussions with clinicians. Future studies could investigate any link between the health infotainment program and behaviour change.N/

The implications of the fourth industrial revolution on diplomacy

Abstract: Diplomacy has succeeded historical events and industrial revolutions. However, the impacts of the fourth industrial revolution (4IR) threaten to be more wide-spanning and destructive than any other industrial revolution. The study explores the implications of 4IR on the theory and practice of diplomacy. The study is guided by three research questions: how does 4IR impact diplomacy; what technologies trigger a change in diplomacy; and do costs act as a barrier to states? Making use of qualitative methods, through the exploration of primary and secondary data, the study explores 4IR’s implications on diplomacy. The implications are categorized into five pillars which are considered integral aspects of diplomatic theory and practice. The pillars are communication, interdependence, domestic and international frameworks, new ‘new’ diplomacy and diplomatic functions. The study concludes that diplomacy may be impacted by 4IR in all five pillars of diplomacy. 4IR may not diminish the practice of diplomacy but rather complement it. A highly digitized diplomacy with cyber tools may result in a more efficient and effective type of diplomacy. Technologies such as artificial intelligence, big data and information and communication technologies are the key drivers of change in diplomacy...M.A. (Politics and International Relations

Do large-scale hospital- and system-wide interventions improve patient outcomes: a systematic review

BackgroundWhile health care services are beginning to implement system-wide patient safety interventions, evidence on the efficacy of these interventions is sparse. We know that uptake can be variable, but we do not know the factors that affect uptake or how the interventions establish change and, in particular, whether they influence patient outcomes. We conducted a systematic review to identify how organisational and cultural factors mediate or are mediated by hospital-wide interventions, and to assess the effects of those factors on patient outcomes.MethodsA systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Database searches were conducted using MEDLINE from 1946, CINAHL from 1991, EMBASE from 1947, Web of Science from 1934, PsycINFO from 1967, and Global Health from 1910 to September 2012. The Lancet, JAMA, BMJ, BMJ Quality and Safety, The New England Journal of Medicine and Implementation Science were also hand searched for relevant studies published over the last 5 years. Eligible studies were required to focus on organisational determinants of hospital- and system-wide interventions, and to provide patient outcome data before and after implementation of the intervention. Empirical, peer-reviewed studies reporting randomised and non-randomised controlled trials, observational, and controlled before and after studies were included in the review.ResultsSix studies met the inclusion criteria. Improved outcomes were observed for studies where outcomes were measured at least two years after the intervention. Associations between organisational factors, intervention success and patient outcomes were undetermined: organisational culture and patient outcomes were rarely measured together, and measures for culture and outcome were not standardised.ConclusionsCommon findings show the difficulty of introducing large-scale interventions, and that effective leadership and clinical champions, adequate financial and educational resources, and dedicated promotional activities appear to be common factors in successful system-wide change