Search

Assistive technology (AT) is a critical in providing students with visual impairments (VI) access to classroom information. However, little is known about how the fluid and diverse experiences across core-content classrooms that impact the nature of AT use among students with VI. We conducted three classroom observations of 10 secondary-age (i.e., 6th through 12th grade) students with VI in core-content classrooms (i.e., math, English, social studies, or science). Wide variations in AT use suggest that AT needs are individualized. Additionally, writing tasks, reading tasks, and independent instructional groupings were associated with the highest rates of AT usage. However, students receive little support for using their AT in classrooms. We offer implications and recommendations for research and practice aimed at increasing AT use in core-content classrooms.

BACKGROUND: Few antiviral therapies have been studied in patients with coronavirus disease 2019 (COVID-19) and kidney impairment. Herein, the efficacy, safety, and pharmacokinetics of remdesivir, its metabolites, and sulfobutylether-β-cyclodextrin excipient were evaluated in hospitalized patients with COVID-19 and severe kidney impairment. METHODS: In REDPINE, a phase 3, randomized, double-blind, placebo-controlled study, participants aged ≥12 years hospitalized for COVID-19 pneumonia with acute kidney injury, chronic kidney disease, or kidney failure were randomized 2:1 to receive intravenous remdesivir (200 mg on day 1; 100 mg daily up to day 5) or placebo (enrollment from March 2021 to March 2022). The primary efficacy end point was the composite of the all-cause mortality rate or invasive mechanical ventilation rate through day 29. Safety was evaluated through day 60. RESULTS: Although enrollment concluded early, 243 participants were enrolled and treated (remdesivir, n = 163; placebo, n = 80). At baseline, 90 participants (37.0%) had acute kidney injury (remdesivir, n = 60; placebo, n = 30), 64 (26.3%) had chronic kidney disease (remdesivir, n = 44; placebo, n = 20), and 89 (36.6%) had kidney failure (remdesivir, n = 59; placebo, n = 30); and 31 (12.8%) were vaccinated against COVID-19. Composite all-cause mortality or invasive mechanical ventilation rates through day 29 were 29.4% and 32.5% in the remdesivir and placebo group, respectively (P = .61). Treatment-emergent adverse events were reported in 80.4% for remdesivir versus 77.5% for placebo, and serious adverse events in 50.3% versus 50.0%, respectively. Pharmacokinetic plasma exposure to remdesivir was not affected by kidney function. CONCLUSIONS: Although the study was underpowered, no significant difference in efficacy was observed between treatment groups. REDPINE demonstrated that remdesivir is safe in patients with COVID-19 and severe kidney impairment. CLINICAL TRIALS REGISTRATION: EudraCT 2020-005416-22; Clinical Trials.gov NCT04745351.

BACKGROUND: For patients with clinically node-positive (cN+) breast cancer undergoing neoadjuvant chemotherapy (NAC), retrieving previously clipped, biopsy-proven positive lymph nodes during sentinel lymph node biopsy [i.e., targeted axillary dissection (TAD)] may reduce false negative rates. However, the overall utilization and impact of clipping positive nodes remains uncertain. PATIENTS AND METHODS: We retrospectively analyzed cN+ ISPY-2 patients (2011-2022) undergoing axillary surgery after NAC. We evaluated trends in node clipping and associations with type of axillary surgery [sentinel lymph node (SLN) only, SLN and axillary lymph node dissection (ALND), or ALND only] and event-free survival (EFS) in patients that were cN+ on a NAC trial. RESULTS: Among 801 cN+ patients, 161 (20.1%) had pre-NAC clip placement in the positive node. The proportion of patients that were cN+ undergoing clip placement increased from 2.4 to 36.2% between 2011 and 2021. Multivariable logistic regression showed nodal clipping was independently associated with higher odds of SLN-only surgery [odds ratio (OR) 4.3, 95% confidence interval (CI) 2.8-6.8, p < 0.001]. This was also true among patients with residual pathologically node-positive (pN+) disease. Completion ALND rate did not differ based on clip retrieval success. No significant differences in EFS were observed in those with or without clip placement, both with or without successful clip retrieval [hazard ratio (HR) 0.85, 95% CI 0.4-1.7, p = 0.7; HR 1.8, 95% CI 0.5-6.0, p = 0.3, respectively]. CONCLUSION: Clip placement in the positive lymph node before NAC is increasingly common. The significant association between clip placement and omission of axillary dissection, even among patients with pN+ disease, suggests a paradigm shift toward TAD as a definitive surgical management strategy in patients with pN+ disease after NAC.

Science literacy has many personal and societal benefits that allows for better informed decision-making. Although the importance of science literacy is recognized globally, there are many challenges associated with its promotion. Scientists are more frequently engaging with nonscientific audiences through public outreach activities and with increasing support from institutions and professional societies. This is especially true regarding microbiologists and other related professionals since the start of the global 2019 coronavirus disease pandemic heightened the need to convey novel and rapidly evolving scientific information to lay audiences. The means by which professionals engage with these audiences affect the efficacy of the relay of scientific information. One method of engagement is the "ambassador approach," which aims to establish dialogue among different groups of people and scientists. In this perspective article, we discuss this approach, highlighting activities for the promotion of science literacy organized by the American Society for Microbiology Ambassador Program and similar programs of other scientific societies. We discuss the benefits and challenges of implementing an ambassador approach, propose potential improvements that could be made to existing programs promoting science literacy, and ultimately advocate for increased implementation of science ambassador programs. [This article was written on behalf of the Young Leaders Circle of the American Society for Microbiology.]

This quantitative survey study aimed to identify differences between school counselors' and administrators' perceptions of the school counselors' role and if demographic criteria of years of experience, years in education, enrollment size, and grade level impacted these perceptions. Currently employed school counselors and administrators in Alabama with at least one year of experience were recruited to participate in this study. The School Counseling Activity Rating Scale (SCARS) (Scarborough, 2005b) and SCARS Modified (Lane et al., 2020) instruments were utilized. Results were analyzed by comparing descriptive statistics and performing a factorial ANOVA and multiple regression. Results of the ANOVA suggest that discrepancies exist between how school counselors and administrators view the preferred role of the school counselor but were not statistically significant in how the groups perceive the fundamental role of the school counselor. The results of the multiple regression were inconclusive and suggested additional research. Implications for school counselors and administrators aim toward opportunities for advocacy and leadership through professional development, training, and collaboration.

Despite the long-term negative outcomes associated with restraining and secluding students, these practices are frequently used in schools, with disproportionate use on students with disabilities. Based on recent guidance from the U.S. Justice Department's Civil Rights Division, misusing these practices violates student rights under the Americans with Disabilities Act. This policy document aligns with research findings that seclusion and physical restraint should only be used in emergencies and only as a last resort. This article intends to provide three systems-level changes to reduce or eliminate the use of restraint and seclusion in schools: implement schoolwide positive behavior intervention and supports, support students in crisis, and include families in an ongoing collaboration process.

A transition-age youth with an Individualized Education Program (IEP) has the right to a free, appropriate public education that includes postsecondary transition planning and services. Because students with emotional-behavioral disorders (EBD) experience adverse outcomes during and after high school, they may benefit from a transition-focused IEP. With the support of multiple practitioners, these students can be more involved in their education program. This article demonstrates how to use transition tasks to promote a student with EBD's involvement in their IEP in four areas: assessment tasks, evaluation tasks, IEP meeting preparation, and IEP meeting participation.

A transition-aged youth with an individualized education program has the right to free, appropriate public education that includes postsecondary transition planning and services. The documented transition supports need to meet both procedural and substantive requirements. While many court cases have included transition components, few have been decided at the appellate court level. In "Gibson v. Forest Hills" (2016), Chloe Gibson, a transition-aged youth with intellectual and developmental disabilities, was provided inadequate postsecondary transition planning and services. According to the U.S. Court of Appeals for the Sixth Circuit, Chole's right to a free, appropriate public education was violated due to procedural errors related to inviting her to individualized education program (IEP) meetings, conducting age-appropriate transition assessments, and including programming leading to supported competitive employment in a community setting. This decision supports the federal requirements of including a transition-aged student's strengths, interests, preferences, and needs when planning their life after high school.

Inclusive education is now advocated as best practice in schools. However, the extent to which adolescents with severe disabilities access the abundant social and academic experiences available in general education classes remains uncertain. We conducted multiple observations of 146 U.S. high school students with severe disabilities (including intellectual disability, autism, or multiple disabilities), who were enrolled in at least one general education class. Peer interactions with classmates tended to be very infrequent for most students with severe disabilities. Moreover, rates of peer interaction were the lowest during large-group instruction and when students were sitting next to paraprofessionals or special educators rather than with their peers. Academic engagement also varied across students and was highest during small-group instruction, during 1-on-1 work with adults, and when students sat near their peers. Observations of a comparison sample of peers attending these same classes revealed striking overall differences in social and academic participation. We offer recommendations for research and practice aimed at bolstering inclusive education in high schools.

BACKGROUND: Since 2005, highly pathogenic avian influenza A H5N1 viruses have spread from Asia worldwide, infecting poultry, humans and wild birds. Subsequently, global interest in avian influenza (AI) surveillance increased. OBJECTIVES: Mongolia presents an opportunity to study viruses in wild birds because the country has very low densities of domestic poultry and supports large concentrations of migratory water birds. METHODS: We conducted AI surveillance in Mongolia over two time periods, 2009-2013 and 2016-2018, utilizing environmental fecal sampling. Fresh fecal samples were collected from water bird congregation sites. Hemagglutinin (HA) and neuraminidase (NA) subtypes of positive samples were identified through viral isolation or molecular assays, with pathogenicity determined by HA subtype or sequencing the HA cleavage site. RESULTS: A total of 10,222 samples were collected. Of these, 7,025 fecal samples were collected from 2009 to 2013, and 3,197 fecal samples were collected from 2016 to 2018. Testing revealed 175 (1.7%) positive samples for low-pathogenicity influenza A, including 118 samples from 2009 to 2013 (1.7%) and 57 samples from 2016 to 2018 (1.8%). HA and NA subtyping of all positives identified 11 subtypes of HA and nine subtypes of NA in 29 different combinations. Within periods, viruses were detected more frequently during the fall season than in the early summer. CONCLUSION: Mongolias critical wild bird habitat is positioned as a crossroad of multiple migratory flyways. Our work demonstrates the feasibility of using an affordable environmental fecal sampling approach for AI surveillance and contributes to understanding the prevalence and ecology of low-pathogenicity avian influenza viruses in this important location, where birds from multiple flyways mix.

BACKGROUND: Axillary surgery after neoadjuvant chemotherapy (NAC) is becoming less extensive. We evaluated the evolution of axillary surgery after NAC on the multi-institutional I-SPY2 prospective trial. METHODS: We examined annual rates of sentinel lymph node (SLN) surgery with resection of clipped node, if present), axillary lymph node dissection (ALND), and SLN and ALND in patients enrolled in I-SPY2 from January 1, 2011 to December 31, 2021 by clinical N status at diagnosis and pathologic N status at surgery. Cochran-Armitage trend tests were calculated to evaluate patterns over time. RESULTS: Of 1578 patients, 973 patients (61.7%) had SLN-only, 136 (8.6%) had SLN and ALND, and 469 (29.7%) had ALND-only. In the cN0 group, ALND-only decreased from 20% in 2011 to 6.25% in 2021 (p = 0.0078) and SLN-only increased from 70.0% to 87.5% (p = 0.0020). This was even more striking in patients with clinically node-positive (cN+) disease at diagnosis, where ALND-only decreased from 70.7% to 29.4% (p < 0.0001) and SLN-only significantly increased from 14.6% to 56.5% (p < 0.0001). This change was significant across subtypes (HR-/HER2-, HR+/HER2-, and HER2+). Among pathologically node-positive (pN+) patients after NAC (n = 525) ALND-only decreased from 69.0% to 39.2% (p < 0.0001) and SLN-only increased from 6.9% to 39.2% (p < 0.0001). CONCLUSIONS: Use of ALND after NAC has significantly decreased over the past decade. This is most pronounced in cN+ disease at diagnosis with an increase in the use of SLN surgery after NAC. Additionally, in pN+ disease after NAC, there has been a decrease in use of completion ALND, a practice pattern change that precedes results from clinical trials.

AimGuideline-directed medical therapy (GDMT) is designed to improve clinical outcomes. The study aim was to assess GDMT prescribing rates and prescribing-persistence predictors in patients with diabetes and chronic kidney disease (CKD) from the Center for Kidney Disease Research, Education, and Hope Registry.Materials and methodsData were obtained from adults ≥18 years old with diabetes and CKD between 1 January 2019 and 31 December 2020 (N = 39 158). Baseline and persistent (≥90 days) prescriptions for GDMT, including angiotensin converting enzyme (ACE) inhibitor/angiotensin receptor blocker (ARB), sodium-glucose cotransporter-2 (SGLT2) inhibitor and glucagon-like peptide 1 (GLP-1) receptor agonist were assessed.ResultsThe population age (mean ± SD) was 70 ± 14 years, and 49.6% (n = 19 415) were women. Baseline estimated glomerular filtration rate (2021 CKD-Epidemiology Collaboration creatinine equation) was 57.5 ± 23.0 ml/min/1.73 m2 and urine albumin/creatinine 57.5 mg/g (31.7-158.2; median, interquartile range). Baseline and ≥90-day persistent prescribing rates, respectively, were 70.7% and 40.4% for ACE inhibitor/ARB, 6.0% and 5.0% for SGLT2 inhibitors, and 6.8% and 6.3% for GLP-1 receptor agonist (all p

Aim: To evaluate treatment effects of eteplirsen among patients with Duchenne muscular dystrophy. Methods: Using real-world claims and electronic medical record data, this retrospective comparative analysis assessed eteplirsen-treated and control cohorts matched by age, disease progression state, and pre-index period healthcare resource utilization. Poisson regression was used to evaluate eteplirsen effects on healthcare resource utilization outcomes. Results: Eteplirsen was associated with statistically significant reductions in rates of hospital encounters (31%), emergency room visits (31%), need for pulmonary management (33%), cardiac management (21%), tracheostomy (86%), and assisted ventilation (39%) versus the control group. Other assessed outcomes favored eteplirsen numerically but did not all reach statistical significance. Conclusion: Eteplirsen-treated patients had reduced rates of multiple healthcare resource utilization measures versus matched controls.

Quantitative methodology was utilized to assess factors influencing veteran school counselors' decisions to report suspected child abuse. Veteran school counselors were defined as having 6 or more years of experience working as a school counselor within a public or private school. This study is a focused examination of the responses of veteran school counselors from a larger data set. The results of the analysis revealed that academic setting, number of students within the school, and students' engagement in the free or reduced lunch program were significantly correlated with higher reporting among veteran school counselors. Moreover, veteran school counselors' self-efficacy levels were moderately correlated with their decision to report. Highly rated reasons for choosing to report suspected child abuse included professional obligation, following school protocol, and concern for the safety of the child. The highest rated reason for choosing not to report was lack of evidence. Implications for training and advocacy for veteran school counselors are discussed.

A National Science Foundation-funded Mathematics and Science Partnership program, Leadership for Educators: Academy for Driving Economic Revitalization in Science (LEADERS), aimed to develop science teacher leaders who would influence the quality of science teaching in their respective schools. To fulfill a need to evaluate leadership abilities of teachers within LEADERS, a Teacher Leadership Instrument was developed based on our previous work. This paper examines the performance of teachers as outlined in the Teacher Leader Model (TLM) Standards following their enrollment in three teacher leadership courses aligned with these Standards. The study employed a qualitative approach to analyze peer professional development sessions provided by teacher leaders, and to rate leadership behaviours and practices. Results indicate that 31 of the 37 functions were exhibited by the teacher leaders, with most observations occurring at a developing level. Behaviours related to effective presentation and facilitation were observed most frequently, but the teacher leaders also incorporated research-based practices, information about assessments, and links to the community in their sessions. Further, these behaviours linked back to the intended outcomes of the three leadership courses. The results demonstrate one manner in which teacher leaders perform the functions of the TLM Standards in the context of professional development sessions.