Universal Adaptation: The Need to Enhance Accessibility in the Basic Course

It is well-documented that the basic course is the front porch of the communication discipline (Beebe, 2013). Regularly part of general education, the basic course introduces students who may never experience another communication course to communication-based content. Because of the prominence of the basic course in general education, the scope of participating students is vast in terms of motivation and ability. This varied population may present several challenges for basic course instructors. One oft-forgotten issue, or an afterthought in course design, is the development and implementation of accessible basic course delivery and materials for students with disabilities. We believe it is necessary that basic course administrators and instructors recognize challenges faced by students with disabilities. Using both universal design principles and computer mediated access strategies, instructors can develop and implement a classroom climate that engages students across the spectrum of academic abilities. This is especially important in light of the increasing enrollment of students with disabilities

A Five-Year Retroactive Analysis of Cut Score Impact: California’s Proposed Supervised Provisional License Program

A five-year cohort of 39,737 examinees who sat for the California Bar Exam (“CBX”) between 2014-18 was analyzed using a simulation model based on actual exam results to evaluate how the minimum passing scores (“cut score”) of 1440, 1390, 1350, 1330, and 1300, if used as qualifying scores for a provisional licensing program, would affect the number of previous examinees, by race and ethnicity, who would qualify to participate within retroactive groupings of five-year, four-year, three-year, two-year, and one-year examinee cohorts.The result of the simulation models indicated that selecting a qualifying score lower than the current California cut score of 1390 will significantly increase both the overall number of eligible participants and the diversity of the group eligible to participate in the proposed alternate licensing program.This study follows an initial study of 85,727 examinees of the CBX from 2009-18 titled, Examining the California Cut Score: An Empirical Analysis of Minimum Competency, Public Protection, Disparate Impact, and National Standards that determined maintaining a high cut score does not result in greater public protection as measured by disciplinary statistics, but does result in excluding minorities from admission to the bar and the practice of law at rates disproportionately higher than Whites

Examining the California Cut Score: An Empirical Analysis of Minimum Competency, Public Protection, Disparate Impact, and National Standards

The selection of a minimum bar exam passing score (“cut score”) shapes the representation of racial and ethnic minorities in the legal profession and the quality of access to justice in the state. California and national policy makers have not had the benefit of detailed exam performance data that analyzes the effect of the cut score on race and ethnicity. Because policy makers consider the cut score an important public protection mechanism, this study also explored whether the selection of higher cut scores better protected the public from attorneys who do not have the minimum competence to practice law. To conduct the analysis, the study used two data sets. The first data set included 85,727 examinees who sat for 21 administrations of the CBX from 2009-18 and the race and ethnicity of each examinee. The second data set included the ABA discipline data from up to 48 U.S. jurisdictions from 2013-18 and the cut scores in each jurisdiction. Using the first data set,the study determined how the selection of a minimum cut score (1) widens or narrows the racial and ethnic impacts of the bar exam and/or (2) alters the racial and ethnic composition of new attorneys joining the legal profession. Both historical actual and simulated cut scores were analyzed. Using the second data set, this study examined a third factor: the relationship, if any, between minimum cut scores and rates of attorney discipline. This analysis determined that initial and eventual passing rates differed significantly between racial and ethnic groups, and this gap was wider at higher simulated cut scores. A simulation analysis using actual examinee scores confirmed that selecting a lower cut score would have significantly narrowed the achievement gap between Whites and racial and ethnic minorities and would have increased the number of newly admitted minority attorneys in California. For example, at 1440, the achievement gap between Whites and Blacks was 27.4 percentage points. But at a simulated cut score of 1300, the achievement gap between these two groups would have been only 14.5 percentage points. This 12.9 percentage point difference in the achievement gap at 1440 and 1300 demonstrates a disparate effect of the higher cut scores. Using the second data set about disciplinary statistics, the study determined that no relationship exists between the selection of a cut score and the number of complaints, formal charges, or disciplinary actions taken against attorneys in the jurisdictions studied. California’s recent decision to lower the cut score from 1440 to 1390 moved California from having the second-highest cut score to the fourth-highest cut score in the country. However, the report data established that at 1390 California will continue to produce significantly disparate pass rates on the basis of race and ethnicity when compared to the national norm of 1350, the New York standard of 1330, and the simulated model of 1300. This study establishes that maintaining a high cut score does not result in greater public protection as measured by disciplinary statistics but does result in excluding minorities from admission to the bar and the practice of law at rates disproportionately higher than Whites

The Relationship of Special Education Placement and Student Academic Outcomes

This study investigates the academic outcomes of a special education student cohort in the state of Indiana placed in high and low inclusion settings. Student scores in these two settings from the Indiana State Test of Educational Progress (ISTEP+ English/Language Arts and math) were compared from fourth grade in 2014 through the eighth grade in 2018. Results of this study show that students with disabilities who spent 80% or more of their time in a general education inclusive classroom did significantly better in both reading and math assessment than their peers who spent more time in separate special education classrooms

Evaluations of the effectiveness of a web-based graduate epidemiology course

An online epidemiology course was developed, implemented, and evaluated for graduate nursing students through the collaborative efforts of nursing faculty and information, education, and instructional design staff of the library at a health sciences university. This epidemiology course is a core curriculum course for graduate nursing students. The course was piloted with 14 students (one student in Romania); the initial online offering ran concurrently with a traditional classroom section. Extensive evaluation data were collected and analyzed to compare the effectiveness of the classroom and distance-learning formats. Areas of evaluation included objective measures, such as midterm and final examination scores and content analysis comparisons, as well as subjective ratings by the students of time commitments, course objectives, technical aspects of the web-based course, areas of satisfaction or dissatisfaction, and self-confidence regarding epidemiology and computer skills. Recommendations for course development, implementation, and evaluation for similar distance-learning courses will be included

Time periods of altered risk for severe injection drug use-associated skin and soft-tissue infections: protocol for a self-controlled case series in New South Wales, Australia, 2001-2018

Injection drug use-associated bacterial and fungal infections (e.g., skin and soft-tissue infections, endocarditis, osteomyelitis, etc.) are common health problems among people who inject drugs, associated with pain, disability, and death. The incidence of these infections is rising, and better understanding of the social and environmental factors that shape individual injecting practices and risk for injecting-related infections is urgently needed. Using a self-controlled study design, the aim of this proposed study is to quantify the risks of injecting-related skin and soft-tissue infections associated with initiation of, exposure to, and discontinuation of incarceration and OAT among a sample of people with opioid use disorder

Sociopolitical Participation Among Marginalized Youth: Do Political Identification and Ideology Matter?

Engaging youth in the political system has promise for creating social change and ensuring the future of our democracy. Sociopolitical participation—individual and/or collective action to facilitate change—may be biased towards more liberal or Democratic views, which emphasize reform to create social equity. The aim of this study is to test if youth who vary in political ideology (i.e., conservative, liberal) and political identification (i.e., Republican, Democrat) participate at different levels and whether this measurement of sociopolitical participation is in fact biased. These issues were examined among 237 youth attending a large Midwestern high school who generally identified with historically marginalized groups. Results suggest that youth identifying as Republican exhibited slightly higher levels of participation, and that items were not biased by political ideology or identification. Further, political ideology and identification explained less than 5% of the variance in sociopolitical action, suggesting it is largely independent of political leaning

Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin

To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak-associated illness was $96.2 million:$31.7 million in medical costs and $64.6 million in productivity losses. The average total costs for persons with mild, moderate, and severe illness were$116, $475, and$7,808, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies

Independent Predictors of Repeat Emergency Room Presentations: Insights from a Cohort of 1066 Consecutive Patients with Non-Cardiac Chest Pain Generating 4770 Repeat Presentations

Background and importanceChest pain (CP) is one of the most frequent presentations to the emergency department (ED), a large proportion of which is non-cardiac chest pain (NCCP). Repeat attendances to ED are common and impose considerable burden to overstretched departments.ObjectiveOur aim was to determine drivers for repeat ED presentations using NCCP as the primary cause of index presentation.Design, setting and participantsThis was a retrospective cohort study of 1066 consecutive presentations with NCCP to a major urban hospital ED in North England. Index of Multiple Deprivation (IMD), a postcode-derived validated index of deprivation, was computed. Charlson comorbidity index (CCI) was determined by reference to known comorbidity variables. Repeat presentation to ED to any national hospital was determined by a national linked database (population 53.5 million). Independent predictors of ED representation were computed using logistic regression analysis.ResultsMedian age was 43 (IQR 28-59), and 50.8% were male. Furthermore, 27.8%, 8.1% and 3.8% suffered from chronic obstructive pulmonary disease (COPD), hypertension and diabetes mellitus, respectively. The most frequent diagnoses, using ICD-10 coding, were non-cardiac chest pain (55.1%), followed by respiratory conditions (14.7%). One-year incidence of adjudicated myocardial infarction, urgent or emergency coronary revascularisation and all-cause death was 0.6%, 2% and 5.3%, respectively. There was a total of 4770 ED repeat presentations 1 year prior to or following index presentation with NCCP in this cohort. Independent (multivariate) predictors for frequent re-presentation (defined as ≥2 representations) were a history of COPD (OR [odds ratio] 2.06, p = 0.001), previous MI (OR3.6, p = 0.020) and a Charlson comorbidity index ≥1 (OR 1.51, p = 0.030). The frequency of previous MI was low as only 3% had sustained a previous MI.ConclusionsThis analysis indicates that COPD and complex health care needs (represented by high CCI), but not socio-economic deprivation, should be health policy targets for lessening repeat ED presentations. What is already known on this topic: Repeat presentations with non-ischaemic chest pain are common, placing a considerable burden on emergency departments.What this study addsCOPD and complex health care needs, denoted by Charlson comorbidity index, are implicated as drivers for repeat presentation to accident and emergency department. Socio-economic deprivation was not an independent predictor of re-presentation. How might this study affect research, practice, or policy: Community-based support for COPD and complex health care needs may reduce frequency of ED attendance

The effect of amblyopia treatment on stereoacuity

Purpose: To explore how stereoacuity changes in patients while they are being treated for amblyopia. Methods: The Monitored Occlusion Treatment for Amblyopia Study (MOTAS) comprised 3 distinct phases. In the first phase, baseline, assessments of visual function were made to confirm the initial visual and binocular visual deficit. The second phase, refractive adaptation, now commonly termed “optical treatment,” was an 18-week period of spectacle wear with measurements of logMAR visual acuity and stereoacuity with the Frisby test at weeks 0, 6, 12, and 18. In the third phase, occlusion, participants were prescribed 6 hours of patching per day. Results: A total of 85 children were enrolled (mean age, 5.1 ± 1.5 years). In 21 children amblyopia was associated with anisometropia; in 29, with strabismus; and in 35, with both. At study entry, poor stereoacuity was associated with poor visual acuity (P < 0.001) in the amblyopic eye and greater angle of strabismus (P < 0.001). Of 66 participants, 25 (38%) who received refractive adaptation and 19 (29%) who received occlusion improved by at least one octave in stereoacuity, exceeding test–retest variability. Overall, 38 (45%) improved one or more octaves across both treatment phases. Unmeasureable stereoacuity was observed in 56 participants (66%) at study entry and in 37 (43%) at study exit. Conclusions: Stereoacuity improved for almost one half of the study participants. Improvement was observed in both treatment phases. Factors associated with poor or nil stereoacuity at study entry and exit were poor visual acuity of the amblyopic eye and large-angle strabismus