Approaches consistent with a Response to Intervention (RTI) framework are becoming increasingly prominent. The present study is a preliminary investigation aimed at gaining a greater understanding of ...educators' knowledge of RTI and application of RTI principles. It serves as the first step toward understanding educators' preparation to implement these mandated changes. Educators (308) completed an online study to assess their knowledge of tasks inherent in RTI procedures. Respondents were asked to rate their familiarity with RTI principles. Then, respondents were asked to interpret graphical data that were consistent with RTI screening and progress monitoring approaches. Overall, results indicated that the majority of educators perceived themselves as having the knowledge to implement RTI practices. However, when asked to apply RTI-consistent principles, not all were successful. Specifically, school psychologists were better at interpreting and making decisions based on graphical data relative to general and special education teachers. There may be a disconnect between the expectations inherent in an RTI model and teachers' ability to meet these expectations. School psychologists may be positioned to support teachers in this area. The implications of these results for implementing RTI practices and developing professional development programs for general and special educators in elementary schools are discussed.
"Occupational engagement" is a term often used within occupational science and occupational therapy literature. However, it has yet to be clearly and consistently described, resulting in a lack of ...clarity in the use and definition of this term. This paper is derived from a larger piece of research, which used social constructionism to explore occupational engagement for five men living in a secure mental health unit from an occupational perspective. This research required the development of a clear description of occupational engagement. Following an exploration and critical review of the literature, the process of developing a new description of occupational engagement is outlined. Occupational engagement cannot be considered in isolation, so within this paper it is positioned within a descriptive framework of values and consequences. The development of the framework returned to the etymology of relevant terms, considering both the value and consequences of occupational experiences. This is the first published holistic description of this term, as the framework fully acknowledges the negative as well as positive dimensions of occupation. The paper concludes with consideration of how this new framework could be useful to occupational science.
The shortage of teachers in classrooms across the country is not a new problem, and research suggests that this issue has only worsened in recent years. The struggle to find and keep highly qualified ...teachers in our schools makes it vital to better understand what motivates teachers to remain in and thrive in the profession. The purpose of this narrative inquiry study was to explore participants’ experiences with shared decision-making and their perceptions of organizational citizenship behavior, as well as how each of these relates to their intention to remain on their campuses and in the field of education. This qualitative study included the perspectives of a sample of secondary teachers in a large suburban district in north central Texas and was conducted in two phases. In Phase 1, the researcher collected survey data from 72 participants. For the next phase, nine participants were randomly selected from the list of Phase I participants who volunteered to be included in Phase II interviews. In Phase II, the researcher dove into the narrative experiences and perspectives of participants with semi-structured, one-on-one interviews.Findings of this study indicated that teachers’ experiences with shared decision-making yielded two emergent themes: campus structures and principal leadership. Teachers' perceptions of organizational citizenship behavior centered on three themes that emerged: (a) commitment behavior, (b) influence of the principal, and (c) motivation. When asked about their intention to continue in their positions, participants’ responses had three themes emerge: (a) connection to the campus, (b) connection to the principal, and (c) intention to stay. The researcher made several recommendations for further research: (a) consider a different approach to sampling to gain the perspectives of a more diverse sample, (b) include both teacher and administers’ voices to the study, and (c) conduct a study to explore the influence of the principal on teachers’ sense of organizational citizenship behavior.
In most patients with small-cell lung cancer (SCLC)-a metastatic, aggressive disease-the condition is initially chemosensitive but then relapses with acquired chemoresistance. In a minority of ...patients, however, relapse occurs within 3 months of initial treatment; in these cases, disease is defined as chemorefractory. The molecular mechanisms that differentiate chemosensitive from chemorefractory disease are currently unknown. To identify genetic features that distinguish chemosensitive from chemorefractory disease, we examined copy-number aberrations (CNAs) in circulating tumor cells (CTCs) from pretreatment SCLC blood samples. After analysis of 88 CTCs isolated from 13 patients (training set), we generated a CNA-based classifier that we validated in 18 additional patients (testing set, 112 CTC samples) and in six SCLC patient-derived CTC explant tumors. The classifier correctly assigned 83.3% of the cases as chemorefractory or chemosensitive. Furthermore, a significant difference was observed in progression-free survival (PFS) (Kaplan-Meier P value = 0.0166) between patients designated as chemorefractory or chemosensitive by using the baseline CNA classifier. Notably, CTC CNA profiles obtained at relapse from five patients with initially chemosensitive disease did not switch to a chemorefractory CNA profile, which suggests that the genetic basis for initial chemoresistance differs from that underlying acquired chemoresistance.
Purpose
Facilitation of genuine occupational engagement rather than a more superficial level of participation that has minimal therapeutic benefit is a challenge within secure mental health settings. ...The purpose of this paper is to develop, pilot and evaluate therapeutic tools based on a framework of occupational engagement.
Design/methodology/approach
The study used action research with occupational therapists from two secure residential units. Focus group discussions gathered participants’ views of how the occupational engagement framework could be used to inform a therapeutic tool. Following the development and piloting of the subsequent tools, focus groups were again used to review their usefulness in practice. Discussions were audio recorded and thematically analysed.
Findings
Three tools were designed and piloted. Evaluation revealed a number of benefits and different ways in which the tools could be used in practice.
Research limitations/implications
This research has indicated that the occupational engagement framework has potential for increasing understanding of the relationship between the value and consequences of participating in occupations. The limited timescale of the research restricted the opportunity to fully explore the tools’ potential effectiveness as outcome measures.
Practical implications
The clinical tools developed within this research have provided some information to the clinical teams which has contributed to their understanding of how service users experience participating in occupations.
Originality/value
The occupational engagement framework and resulting tools have the potential to enhance understanding of occupational engagement within secure settings.
It is argued that the way in which we view a person with dementia can have a significant effect on the level of disability and wellbeing of the person. There is a divergence between a belief that the ...self disintegrates, leaving a non-person, and a belief that the self remains but is misplaced and can be maintained with the appropriate approach from others. This article seeks to examine the differing approaches to self and personhood in dementia care, and establish ways of approaching care for the person with dementia which may limit the extent of disability in the face of cognitive decline.
This is the first multicenter randomized controlled trial to evaluate the effectiveness and safety of Zephyr Endobronchial Valve (EBV) in patients with little to no collateral ventilation out to 12 ...months.
To evaluate the effectiveness and safety of Zephyr EBV in heterogeneous emphysema with little to no collateral ventilation in the treated lobe.
Subjects were enrolled with a 2:1 randomization (EBV/standard of care SoC) at 24 sites. Primary outcome at 12 months was the ΔEBV-SoC of subjects with a post-bronchodilator FEV
improvement from baseline of greater than or equal to 15%. Secondary endpoints included absolute changes in post-bronchodilator FEV
, 6-minute-walk distance, and St. George's Respiratory Questionnaire scores.
A total of 190 subjects (128 EBV and 62 SoC) were randomized. At 12 months, 47.7% EBV and 16.8% SoC subjects had a ΔFEV
greater than or equal to 15% (P < 0.001). ΔEBV-SoC at 12 months was statistically and clinically significant: for FEV
, 0.106 L (P < 0.001); 6-minute-walk distance, +39.31 m (P = 0.002); and St. George's Respiratory Questionnaire, -7.05 points (P = 0.004). Significant ΔEBV-SoC were also observed in hyperinflation (residual volume, -522 ml; P < 0.001), modified Medical Research Council Dyspnea Scale (-0.8 points; P < 0.001), and the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index (-1.2 points). Pneumothorax was the most common serious adverse event in the treatment period (procedure to 45 d), in 34/128 (26.6%) of EBV subjects. Four deaths occurred in the EBV group during this phase, and one each in the EBV and SoC groups between 46 days and 12 months.
Zephyr EBV provides clinically meaningful benefits in lung function, exercise tolerance, dyspnea, and quality of life out to at least 12 months, with an acceptable safety profile in patients with little or no collateral ventilation in the target lobe. Clinical trial registered with www.clinicaltrials.gov (NCT 01796392).
Abstract We have investigated the effect of cloretazine (VNP40101M or Laromustine), a novel sulfonylhydrazine alkylating agent with significant antileukaemic activity, alone, or combined with ...cytarabine or daunorubicin, on the proliferation, viability and apoptosis of cell lines and acute myeloid leukaemia blast cells in vitro. Cloretazine alone induced a concentration-dependent inhibition of proliferation, reduction in cell viability and an increase in apoptosis in all samples tested. Combinations of cloretazine with varying concentrations of cytarabine or daunorubicin further enhanced these inhibitory effects, suggesting VNP40101M may have a role in combined low dose chemotherapy regimes especially in the elderly.
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