The Absence of Asterisks: The Inclusive Church and Children With Disabilities

Congregations are called to be communities of belonging. Yet, many churches struggle to meaningfully include children with disabilities and their families in all aspects of parish life. This article addresses 10 dimensions of belonging and their relevance to the inclusion of individuals with disabilities in their faith communities. To belong involves being present, invited, welcomed, known, accepted, cared for, supported, befriended, needed, and loved (Carter, Biggs, & Boehm, 2016). I address the importance of each of these areas, highlight relevant research, and suggest areas for reflection and response

Paraprofessional involvement in self-determination instruction for students with high-incidence disabilities

This is the publisher's version, also found here: http://cec.metapress.com/content/lq6v516h2rn178ut/?p=f618223ce7404c508a820fb0873297e2&pi=5Although enhancing students' self-determination is advocated as a central element of high-quality special education and transition services, little is known about the ways in which paraprofessional are involved in promoting self-determination or the extent to which they share teachers' views regarding its importance. The authors surveyed 223 paraprofessional from 115 randomly selected public school to examine their perspectives on promoting self-determination among students with high-incidence disabilities. Overall, paraprofessional attributed high ievel of importance to each of the 7 component elements of self-determination (i.e., choice making, decision making, problem solving, goal setting and attainment, self-advocacy and leadership, self-management and self-regulation, and self-awareness and self-knowledge). The extent to which paraprofessional reported providing instruction addressing each of the 7 components of self determination was moderate, with average ratings all slightly above the midpoint of the scale. This article presents implications for the involvement of paraprofessional in supporting the development of self-determination among students with high-incidence disabilities, along with recommendations for future research

Self-Determination Skills and Opportunities of Transition-Age Youth With Emotional Disturbance and Learning Disabilities

This is the publisher's version, also found here: http://cec.metapress.com/content/l5vq400577228810/?p=7708b4ddb79e4484ae1a1fc3d5bafcb6&pi=4This study examined the self-determination of adolescents with emotional disturbance (ED) and learning disabilities (LD)from the perspectives of special educators, parents, and the students themselves. Differences in self-determination ratings were associated with both disability group and respondent Specifically, adolescents with ED were found to have lower ratings of selfdetermination than students with LD, with the most pronounced differences evident from the teacher perspective. Eurthermore, students with ED identified infrequent opportunities at school and home for engaging in self-determined behavior, whereas educators and parents differed in their assessments of opportunities in each setting. Implications regarding increasing the self-determination skills and opportunities of adolescents with disabilities are discussed

Promoting self-determination for transition-age youth: Views of high school general and special educators

This is the published version, also found here: http://cec.metapress.com/content/m5781621105k3332/?p=a26d6505487b4343b14b0042308735be&pi=2Recent developments in policy and practice have emphasized the importance of promoting self-determination and supporting access to the general curriculum for youth with disabilities. To understand how these trends align, we examined the efforts of 340 general and special educators to promote student self-determination in high school classrooms. Educators attached considerable importance to providing instruction in skills related to self-determination and reported addressing these skills with moderate to high frequency in their classrooms. Although opportunities for students with disabilities to learn skills that promote self-determination were reported to be available across the curriculum, there were some differences across teachers and curricular area. We discuss avenues for promoting student self-determination within the general curriculum, as well as offer recommendations for future research

Partnerships in Employment: What Matters Most: Research on Elevating Parent Expectations, TASH Town Hall, December 2014

The brief goes into detail about the most powerful force in changing transition outcomes for young people with significant disabilities. This brief explains this force is not ultimately found in the transition plans we craft, the educational services we offer, the instruction we provide, or the systems we build, but rather in the expectations and aspirations individual parents hold for their sons and daughters

Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis

OBJECTIVE: To evaluate the impact of sharing electronic health records (EHRs) with patients and map it across six domains of quality of care (ie, patient-centredness, effectiveness, efficiency, timeliness, equity and safety). DESIGN: Systematic review and meta-analysis. DATA SOURCES: CINAHL, Cochrane, Embase, HMIC, Medline/PubMed and PsycINFO, from 1997 to 2017. ELIGIBILITY CRITERIA: Randomised trials focusing on adult subjects, testing an intervention consisting of sharing EHRs with patients, and with an outcome in one of the six domains of quality of care. DATA ANALYSIS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Title and abstract screening were performed by two pairs of investigators and assessed using the Cochrane Risk of Bias Tool. For each domain, a narrative synthesis of the results was performed, and significant differences in results between low risk and high/unclear risk of bias studies were tested (t-test, p<0.05). Continuous outcomes evaluated in four studies or more (glycated haemoglobin (HbA1c), systolic blood pressure (SBP) and diastolic blood pressure (DBP)) were pooled as weighted mean difference (WMD) using random effects meta-analysis. Sensitivity analyses were performed for low risk of bias studies, and long-term interventions only (lasting more than 12 months). RESULTS: Twenty studies were included (17 387 participants). The domain most frequently assessed was effectiveness (n=14), and the least were timeliness and equity (n=0). Inconsistent results were found for patient-centredness outcomes (ie, satisfaction, activation, self-efficacy, empowerment or health literacy), with 54.5% of the studies (n=6) demonstrating a beneficial effect. Meta-analyses showed a beneficial effect in effectiveness by reducing absolute values of HbA1c (unit: %; WMD=-0.316; 95% CI -0.540 to -0.093, p=0.005, I 2=0%), which remained significant in the sensitivity analyses for low risk of bias studies (WMD= -0.405; 95% CI -0.711 to -0.099), and long-term interventions only (WMD=-0.272; 95% CI -0.482 to -0.062). A significant reduction of absolute values of SBP (unit: mm Hg) was found but lost in sensitivity analysis for studies with low risk of bias (WMD= -1.375; 95% CI -2.791 to 0.041). No significant effect was found for DBP (unit: mm Hg; WMD=-0.918; 95% CI -2.078 to 0.242, p=0.121, I 2=0%). Concerning efficiency, most studies (80%, n=4) found either a reduction of healthcare usage or no change. A beneficial effect was observed in a range of safety outcomes (ie, general adherence, medication safety), but not in medication adherence. The proportion of studies reporting a beneficial effect did not differ between low risk and high/unclear risk studies, for the domains evaluated. DISCUSSION: Our analysis supports that sharing EHRs with patients is effective in reducing HbA1c levels, a major predictor of mortality in type 2 diabetes (mean decrease of -0.405, unit: %) and could improve patient safety. More studies are necessary to enhance meta-analytical power and assess the impact in other domains of care. PROTOCOL REGISTRATION: http://www.crd.york.ac.uk/PROSPERO (CRD42017070092)

Census-derived migration data as a tool for informing malaria elimination policy

Background: Numerous countries around the world are approaching malaria elimination. Until global eradication is achieved, countries that successfully eliminate the disease will contend with parasite reintroduction through international movement of infected people. Human-mediated parasite mobility is also important within countries near elimination, as it drives parasite flows that affect disease transmission on a subnational scale.Methods: Movement patterns exhibited in census-based migration data are compared with patterns exhibited in a mobile phone data set from Haiti to quantify how well migration data predict short-term movement patterns. Because short-term movement data were unavailable for Mesoamerica, a logistic regression model fit to migration data from three countries in Mesoamerica is used to predict flows of infected people between subnational administrative units throughout the region.Results: Population flows predicted using census-based migration data correlated strongly with mobile phone-derived movements when used as a measure of relative connectivity. Relative population flows are therefore predicted using census data across Mesoamerica, informing the areas that are likely exporters and importers of infected people. Relative population flows are used to identify community structure, useful for coordinating interventions and elimination efforts to minimize importation risk. Finally, the ability of census microdata inform future intervention planning is discussed in a country-specific setting using Costa Rica as an example.Conclusions: These results show long-term migration data can effectively predict the relative flows of infected people to direct malaria elimination policy, a particularly relevant result because migration data are generally easier to obtain than short-term movement data such as mobile phone records. Further, predicted relative flows highlight policy-relevant population dynamics, such as major exporters across the region, and Nicaragua and Costa Rica’s strong connection by movement of infected people, suggesting close coordination of their elimination efforts. Country-specific applications are discussed as well, such as predicting areas at relatively high risk of importation, which could inform surveillance and treatment strategies.<br/

Inline dynamometry provides reliable measurements of quadriceps strength in healthy and ACL-reconstructed individuals and is a valid substitute for isometric electromechanical dynamometry following ACL reconstruction.

BackgroundQuadriceps strength testing is recommended to guide rehabilitation and mitigate the risk of second injury following anterior cruciate ligament (ACL) reconstruction. Hand-held dynamometry is a practical alternative to electromechanical dynamometry but demonstrates insufficient reliability and criterion validity in healthy and ACL-reconstructed participants respectively. The purpose of this study is to investigate the reliability and concurrent validity of inline dynamometry for measuring quadriceps strength. The hypotheses are that intra-class correlation coefficient (ICC) values will be >0.90 for reliability and concurrent validity.MethodsThis was a cross sectional study using a within-participant, repeated measures design. Isometric quadriceps testing was performed at 60° knee flexion in 50 healthy and 52 ACL-reconstructed participants. Interrater reliability, intrarater reliability, and concurrent validity of inline dynamometry was investigated through calculation of ICCs, Bland-Altman analysis, linear regression, standard error of measurement (SEM) and minimal detectable change (MDC).ResultsThe lower bounds of the 95% confidence intervals were >0.90 for all reliability and validity ICCs in healthy and ACL-reconstructed participants, except for intrarater reliability in healthy participants using absolute scores (ICC = 0.936 [95% CI 0.890-0.963]). In ACL-reconstructed participants, Bland-Altman bias was 0.01 Nm/kg for absolute and average scores, limits of agreement were -11.74% to 12.59% for absolute scores, the SEM was 0.13Nm/kg (95% CI 0.10-0.17) and the MDC was 0.36Nm/kg (95% CI 0.28 - 0.47).ConclusionInline dynamometry is a reliable and economical alternative to electromechanical dynamometry for the assessment of quadriceps strength following ACL-reconstruction.Clinical trial registration numberClinicalTrials.gov (NCT05109871)