72 research outputs found

    Who is responsible for transition planning? Mapping transition responsibilities amongst school professionals

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    Students with disabilities experience better postsecondary outcomes when they are engaged in high-quality transition planning and services during high school. Yet, many secondary schools fall short of their transition-related responsibilities. Delivery of effective transition practices depends upon the coordinated efforts of the personnel who implement them. Yet, we know little about the transition-related responsibilities various professionals are currently fulfilling in schools or why professionals might be conceptualizing and enacting their roles in particular ways. Thus, the purpose of this study was to examine how transition responsibilities were divided amongst professionals in one secondary school and the factors shaping the division of responsibilities. Using cultural historical activity theory as a conceptual foundation, I qualitatively analyzed interviews with 10 professionals and the cases of three focal students within one secondary school. I found that transition activities primarily focused on college admission. Guidance counselors led future planning, while special educators and the IEP process played only a limited role. Professionals tended to enact their transition-related responsibilities independently and collaborated primarily when students were struggling. Findings suggest multiple opportunities for improving transition practices at the organizational level

    Tracking Valued and Avoidant Functions With Health Behaviors: A Randomized Controlled Trial of The Acceptance and Commitment Therapy Matrix Mobile App

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    This randomized controlled trial evaluated the acceptability and additive effects of self- monitoring avoidant and valued functions of behavior, in the context of self-monitoring physical activity and dietary behavior in a mobile app. The self-monitoring approach was based on the Acceptance and Commitment Therapy (ACT) Matrix. A sample of 102 adults interested in improving their diet and physical activity were randomized to a Health Behavior Tracking app (HBT), HBT plus ACT matrix app (HBT+ACT), or waitlist condition. Online self-report assessments were completed at baseline, mid (2 weeks), and post-intervention (4 weeks). Participants reported high usability, but mixed satisfaction with both apps. About half of the prompted app check-ins were completed on average, with 14% never using the ACT app. Participants in the HBT+ACT app condition reported greater self-reported physical activity over time relative to HBT and waitlist, potentially due to protecting against a decrease over time in physical activity observed in the other two conditions. HBT and HBT+ACT conditions both improved self-reported sedentary behavior relative to waitlist. HBT+ACT improved cognitive restraint with eating more than HBT. Neither the HBT or HBT+ACT app improved other health behavior outcome measures or values processes relative to the waitlist. Overall, findings suggest some benefits of the ACT Matrix app for addressing physical activity by tracking valued/avoidant functions, but mixed findings on acceptability, outcomes, and processes of change suggests impact may be relatively limited

    Promoting quality individualized learning plans throughout the lifespan: a revised and updated ILP how to guide 2.0

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    Promoting Quality Individualized Learning Plans throughout the Lifespan: A Revised and Updated ILP How to Guide 2.0 expands upon the guidance and resources in NCWD/Youth’s earlier ILP How to Guide. ILP How to Guide 2.0 provides career development resources and examples of ILP implementation for an expanded range of age groups and settings including elementary and secondary school, postsecondary education, workforce development programs and other non-school settings. It also offers strategies for building and supporting capacity at the local level to facilitate adoption of the ILP process and provides examples of how to ensure that ILPs are implemented with quality.Published versio

    Comparison of Clinician Suspicion Versus a Clinical Prediction Rule in Identifying Children at Risk for Intra‐abdominal Injuries After Blunt Torso Trauma

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    ObjectivesEmergency department (ED) identification and radiographic evaluation of children with intra‐abdominal injuries who need acute intervention can be challenging. To date, it is unclear if a clinical prediction rule is superior to unstructured clinician judgment in identifying these children. The objective of this study was to compare the test characteristics of clinician suspicion with a derived clinical prediction rule to identify children at risk of intra‐abdominal injuries undergoing acute intervention following blunt torso trauma.MethodsThis was a planned subanalysis of a prospective, multicenter observational study of children (50% prior to knowledge of abdominal computed tomography (CT) scanning (if performed). Intra‐abdominal injuries undergoing acute intervention were defined by a therapeutic laparotomy, angiographic embolization, blood transfusion for abdominal hemorrhage, or intravenous fluid administration for 2 or more days in those with pancreatic or gastrointestinal injuries. Patients were considered to be positive for clinician suspicion if suspicion was documented as ≥1%. Suspicion ≥ 1% was compared to the presence of any variable in the prediction rule for identifying children with intra‐abdominal injuries undergoing acute intervention.ResultsClinicians recorded their suspicion in 11,919 (99%) of 12,044 patients enrolled in the parent study. Intra‐abdominal injuries undergoing acute intervention were diagnosed in 203 (2%) patients. Abdominal CT scans were obtained in the ED in 2,302 of the 2,667 (86%, 95% confidence interval [CI] = 85% to 88%) enrolled patients with clinician suspicion ≥1% and in 3,016 of the 9,252 (33%, 95% CI = 32% to 34%) patients with clinician suspicion  50% previamente a conocer la tomografía computarizada (TC) abdominal (si fue realizada). La LIA con necesidad de intervención urgente se definió como laparotomía terapéutica, embolización angiográfica, transfusión de sangre por hemorragia intrabdominal o administración de fluidos intravenosos durante 2 o más días en aquéllos con lesiones pancreáticas o gastrointestinales. Los pacientes se consideraron positivos para la sospecha clínica si la sospecha se documentó como ≥1%. La sospecha > 1% se comparó con la presencia de cualquier variable en la regla de predicción para la identificación de niños con LIA con necesidad de una intervención urgente.ResultadosLos clínicos documentaron su sospecha en 11.919 (99%) de los 12.044 pacientes incluidos en el estudio original. La LIA con necesidad de intervención urgente se diagnosticó en 203 (2%) pacientes. Las TC abdominales se obtuvieron en el SU en 2.302 de los 2.667 pacientes (86%, IC95% = 85% a 88%) incluidos con sospecha clínica ≥1%; y en 3.016 de los 9.252 pacientes (33%, IC95% = 32% a 34%) con sospecha clínica < 1%. La sensibilidad de la regla de predicción para LIA con necesidad de intervención aguda fue mayor que la sospecha clínica ≥1% (197 de 203, 97,0%, IC95% = 93,7% a 98,9%, frente a 168 de 203, 82,8%, IC95% = 76,9% a 87,7%, respectivamente; diferencia de 14,2%, IC95% = 8,6% a 20,0%). La especificidad de la regla de predicción, sin embargo, fue menor que la sospecha clínica (4,979 de los 11.716, 42,5%, IC95% = 41,6% a 43,4%, frente a 9,217 de los 11.716, 78,7%, IC95% = 77,9% a 79,4%, respectivamente; diferencia de –36,2%, IC95% = –37,3% a –35,0%). Treinta y cinco de los pacientes con sospecha clínica < 1% (0,4%, IC95% = 0,3% a 0,5%) tuvieron LIA con necesidad de intervención urgente.ConclusionesLa regla de predicción clínica derivada tuvo una sensibilidad mayor de forma significativa, pero menor especificidad que la sospecha clínica para la identificación de niños con necesidad de una intervención urgente. La mayor especificidad de la sospecha clínica, sin embargo, no se tradujo en la práctica clínica, ya que los clínicos obtuvieron más frecuentemente TC abdominales en los pacientes que consideraron de muy bajo riesgo. Si se validase, esta regla de predicción puede ayudar en la toma de decisiones clínicas sobre el uso de TC abdominal en los niños con traumatismo torácico cerrado.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113736/1/acem12739.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/113736/2/acem12739_am.pd

    A Novel Extracellular Hsp90 Mediated Co-Receptor Function for LRP1 Regulates EphA2 Dependent Glioblastoma Cell Invasion

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    Extracellular Hsp90 protein (eHsp90) potentiates cancer cell motility and invasion through a poorly understood mechanism involving ligand mediated function with its cognate receptor LRP1. Glioblastoma multiforme (GBM) represents one of the most aggressive and lethal brain cancers. The receptor tyrosine kinase EphA2 is overexpressed in the majority of GBM specimens and is a critical mediator of GBM invasiveness through its AKT dependent activation of EphA2 at S897 (P-EphA2(S897)). We explored whether eHsp90 may confer invasive properties to GBM via regulation of EphA2 mediated signaling.We find that eHsp90 signaling is essential for sustaining AKT activation, P-EphA2(S897), lamellipodia formation, and concomitant GBM cell motility and invasion. Furthermore, eHsp90 promotes the recruitment of LRP1 to EphA2 in an AKT dependent manner. A finding supported by biochemical methodology and the dual expression of LRP1 and P-EphA2(S897) in primary and recurrent GBM tumor specimens. Moreover, hypoxia mediated facilitation of GBM motility and invasion is dependent upon eHsp90-LRP1 signaling. Hypoxia dramatically elevated surface expression of both eHsp90 and LRP1, concomitant with eHsp90 dependent activation of src, AKT, and EphA2.We herein demonstrate a novel crosstalk mechanism involving eHsp90-LRP1 dependent regulation of EphA2 function. We highlight a dual role for eHsp90 in transducing signaling via LRP1, and in facilitating LRP1 co-receptor function for EphA2. Taken together, our results demonstrate activation of the eHsp90-LRP1 signaling axis as an obligate step in the initiation and maintenance of AKT signaling and EphA2 activation, thereby implicating this pathway as an integral component contributing to the aggressive nature of GBM

    The role of performance management and control systems in the implementation of public sector reforms: creating health care networks in Victoria

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    G5 - Minor Reports and Working Paper

    Mixed Methods Research in Accounting

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    Purpose The purpose of this paper is to set the scene for this special issue by synthesising the vast array of literature to examine what constitutes mixed methods research, and the associated strengths and risks attributed to this approach. Design/methodology/approach This paper takes the form of a literature review. The authors draw on extensive methods research from a diverse range of social science disciplines to identify and explore key definitions, opportunities and risks in mixed methods studies. They review a number of accounting studies that adopt mixed methods research approaches. This allows the authors to analyse variance in how mixed methods research is conceptualised across these studies and evaluate the perceived strengths and limitations of specific mixed methods design choices. Findings The authors identify a range of opportunities and challenges in the conduct of mixed methods research and illustrate these by reference to both published studies and the other contributions to this special issue. Originality/value With the exception of Modell's work, there is sparse discussion of the application and potential of mixed methods research in the extant accounting literature

    The Influence of Institutional Differences on Control Mechanisms in Alliances

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    Cross-border alliances expose firms to heightened risks, posing different governance and control challenges than domestic alliances. We examine the impact of differences in alliance partner countries’ institutional environments. Analysis of survey data supports our contention that cross-border alliances involve a greater reliance on formal controls, particularly when firms collaborate with partners in countries with a weaker institutional environment. These relations exist regardless of governance structure (i.e., equity or non-equity alliance) that prior research considers a critical choice for addressing cross-border alliance risks. Additional analyses show that four sub-dimensions of institutional characteristics (voice and accountability, regulatory quality, rule of law, and control of corruption) and one sub-dimension of formal controls (behavior controls) are the main drivers in the association between institutional distance and reliance on formal controls. These findings demonstrate the distinct impact of institutional environment as a country-level determinant of alliance control choices
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