The Impact of Instructional Coaching on Efficacy in General Education Teachers in Inclusion Classrooms

The purpose of this quantitative, causal-comparative study was to determine if there was a difference in teacher efficacy between general education teachers who are coached by a special education instructional coach and general education teachers who have not been coached by a special education instructional coach. Federal mandates, such as the Every Student Succeeds Act and Individuals with Disabilities Education Act, guarantee that students with disabilities are included in the general education classroom. General education teachers need to be qualified to teach in an inclusive classroom, yet research overwhelmingly demonstrates that they do not feel prepared or effective. Currently, very little information exists on special education instructional coaching. Student achievement is directly impacted by teacher efficacy; therefore, the results of this study were necessary for considering strategies ensuring as many students as possible achieve at a high rate. Bandura’s social cognitive theory and the central tenet of self-efficacy in that theory informed this research. This study utilized a causal-comparative design to examine the Teacher Efficacy for Inclusive Practices (TEIP) Scale scores. A random sample of 137 general education teachers was surveyed through an online version of the TEIP. An independent-samples t-test was used to analyze the scores for overall self-efficacy as well as collaboration. The Wilcoxon test was used to analyze scores for inclusive pedagogy and classroom management because they did not follow a normal distribution. The results indicated that there was no significant difference in aggregate efficacy or the subfactors of inclusive pedagogy, classroom management, and collaboration

Creation of a Decision Support Tool for Expectant Parents Facing Threatened Periviable Delivery: Application of a User-Centered Design Approach

Background Shared decision-making (SDM) is optimal in the context of periviable delivery, where the decision to pursue life-support measures or palliation is both preference sensitive and value laden. We sought to develop a decision support tool (DST) prototype to facilitate SDM by utilizing a user-centered design research approach. Methods We convened four patient and provider advisory boards with women and their partners who had experienced a surviving or non-surviving periviable delivery, pregnant women who had not experienced a prior preterm birth, and obstetric providers. Each 2-h session involved design research activities to generate ideas and facilitate sharing of values, goals, and attitudes. Participant feedback shaped the design of three prototypes (a tablet application, family story videos, and a virtual reality experience) to be tested in a final session. Results Ninety-five individuals (48 mothers/partners; 47 providers) from two hospitals participated. Most participants agreed that the prototypes should include factual, unbiased outcomes and probabilities. Mothers and support partners also desired comprehensive explanations of delivery and care options, while providers wanted a tool to ease communication, help elicit values, and share patient experiences. Participants ultimately favored the tablet application and suggested that it include family testimonial videos. Conclusion Our results suggest that a DST that combines unbiased information and understandable outcomes with family testimonials would be meaningful for periviable SDM. User-centered design was found to be a useful method for creating a DST prototype that may lead to improved effectiveness, usability, uptake, and dissemination in the future, by leveraging the expertise of a wide range of stakeholders

Phase I of the Detecting and Evaluating Childhood Anxiety and Depression Effectively in Subspecialties (DECADES) Study: Development of an Integrated Mental Health Care Model for Pediatric Gastroenterology

Background: Children with gastrointestinal symptoms have a very high rate of anxiety and depression. Rapid identification of comorbid anxiety and depression is essential for effective treatment of a wide variety of functional gastrointestinal disorders. Objective: The objective of our study was to determine patient and parent attitudes toward depression, anxiety, and mental health screening during gastroenterology (GI) visits and to determine patient and parent preferences for communication of results and referral to mental health providers after a positive screen. Methods: We augmented standard qualitative group session methods with patient-centered design methods to assess patient and parent preferences. We used a variety of specific design methods in these sessions, including card sorting, projective methods, experience mapping, and constructive methods. Results: Overall, 11 families (11 patients and 14 parents) participated in 2 group sessions. Overall, patients and their parents found integrated mental health care to be acceptable in the subspecialty setting. Patients’ primary concerns were for the privacy and confidentiality of their screening results. Patients and their parents emphasized the importance of mental health services not interfering with the GI visit and collaboration between the GI physician, psychologist, and primary care provider. Conclusions: Patients and their families are open to integrated mental health care in the pediatric subspecialty clinic. The next phase of the DECADES study will translate patient and parent preferences into an integrated mental health care system and test its efficacy in the pediatric GI office. [J Participat Med 2018;10(3):e10655

Assessing Needs and Experiences of Preparing for Medical Emergencies Among Children with Cancer and Their Caregivers

Background: Caregivers of children with cancer can experience stress when seeking care in the emergency department (ED). We sought to assess how caregivers prepare for and manage a medical emergency that arises in the community setting. Methods: A qualitative evaluation of ED visit preparations taken by children with cancer and their caregivers using self-reported interactive toolkits. Eligible participants included children with cancer (age: 11 to 21 y) currently receiving therapy for cancer diagnosis with an ED visit (besides initial diagnosis) within the previous 2 months and caregivers of same. Participants received a paper toolkit, which were structured as experience maps with several generative activities. Toolkits were transcribed, thematically coded, and iteratively analyzed using NVivo 12.0 software. Results: A total of 25 toolkits were received (7 children, 18 caregivers), with about three quarters of participants living >1 hour from the treating institution. Several important common themes and areas for improvement emerged. Themes included struggles with decision-making regarding when and where to seek ED care, preparing to go to the ED, waiting during the ED visit, repetition of information to multiple providers, accessing of ports, and provider-to-provider and provider-to-caregiver/patient communication. Conclusions: The information gained from this study has the potential to inform a tool to support this population in planning for and managing emergent medical issues. This tool has the potential to improve patient and caregiver satisfaction, patient-centered outcomes, and clinical outcomes

Bone marrow-derived and resident liver macrophages display unique transcriptomic signatures but similar biological functions

Abstract: Background and aims: Kupffer cells (KCs), the resident tissue macrophages of the liver, play a crucial role in the clearance of pathogens and other particulate materials that reach the systemic circulation. Recent studies have identified KCs as a yolk sac-derived resident macrophage population that is replenished independently of monocytes in the steady state. Although it is now established that following local tissue injury, bone-marrow derived monocytes may infiltrate the tissue and differentiate into macrophages, the extent to which newly differentiated macrophages functionally resemble the KCs they have replaced has not been extensively studied. Methods and results: Here we show using intravital microscopy, morphometric analysis and gene expression profiling that bone marrow derived “KCs” accumulating as a result of genotoxic injury resemble, but are not identical to their yolk-sac (YS) counterparts. An ion homeostasis gene signature, including genes associated with scavenger receptor function and extracellular matrix deposition, allows discrimination between these two KC populations. Reflecting the differential expression of scavenger receptors, YS-derived KCs were more effective at accumulating Ac-LDL, whereas surprisingly they were poorer than BM-derived KCs when assessed for uptake of a range of bacterial pathogens. The two KC populations were almost indistinguishable in regard to i) response to LPS challenge, ii) phagocytosis of effete RBCs and iii) their ability to contain infection and direct granuloma formation against Leishmania donovani, a KC-tropic intracellular parasite. Conclusions: BM-derived KCs differentiate locally to resemble YS-derived KC in most but not all respects, with implications for models of infectious diseases, liver injury and bone marrow transplantation. In addition, the gene signature we describe adds to the tools available for distinguishing KC subpopulations based on their ontology

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

ONE ENVIRONMENT, ONE HEALTH

Nebraska’s place as an international agricultural epicenter is important for feeding a hungry world, but the work that makes that position possible is truly incredible. Thanks to research conducted at the University of Nebraska–Lincoln by many of the world’s finest scientists, discoveries are being made that improve the health of all kingdoms – plant, animal, human and the natural environment. The UNL Institute of Agriculture and Natural Resources scientists are Growing a Healthy Future through their work in laboratories on campus and in the laboratories of the world – fields, rivers, pastures, feedlots, swine facilities, hen houses, zoos and public health clinics. They are the pioneers who are learning to prevent and cure plant, animal and human diseases and protect the biodiversity of the natural environment. We are fortunate to have outstanding programs and facilities in addition to outstanding people, among them: the Nebraska Center for Virology; Nebraska Center for Prevention of Obesity Diseases; UNL Center for Biotechnology; Doctor of Plant Health program; Gut Function Initiative; Great Plains Veterinary Educational Center; School of Veterinary Medicine and Biomedical Sciences; and the Nebraska Veterinary Diagnostic Center. The scientists in these programs and facilities are protecting the health and well-being of all. University of Nebraska scientists from all four campuses and the Nebraska College of Technical Agriculture, as well as other educational institutions are reaching out to one another, bringing in scientists from around the world and working together to learn more about the biology shared by all living things. They are using that knowledge to grow a healthier future for all of us. In this 2015 Strategic Discussions for Nebraska publication, you will find stories that explain the importance of One Environment, One Health: Animals, Plants and Us. Many stories refer to the concept of One Health, which was first articulated in the early 2000s by the United States veterinary community. Concern that animal disease might jump from animal to human initiated the One Health concept, which explains that all kingdoms are interlinked. As you read this publication, you will learn about astounding progress in solving the puzzles of disease, saving crops, lives and billions of dollars in economic activity. A friend’s daughter had a third-grade teacher who taped a memorable phrase to the wall of the classroom: “Through hard work and perseverance, you have the potential to achieve excellence.” That’s quite a goal for a class of eight-year-olds, but here at the University of Nebraska–Lincoln, our hard work and perseverance are reaping excellence that is improving the health of the environment, plants, animals – and us