bluuebunny/crossref_metadata_2025 huggingface dataset:
Elements of a Successful Technology-Based Distance Education Program
Authors: Tift Carolyn
Published: April 2017

This article discusses characteristics of well-designed and successful distance education programs. Distance education technologies should be selected more on a basis of what best meets local needs, rather than on the “exotic” nature of the technology. Characteristics to look for in good programs are also presented.
The ecology of integration: A descriptive rural perspective
Authors: Depaepe Jim , Walega Shawna
Published: April 2017

Many field-based teachers believe all research accomplished at universities should have direct impact on the public school environment, and transform classrooms into Utopian panaceas of reform. While it is true that there is a gap between research and practice, and many university researchers now attempt applied investigations in field-based settings, frequently the information gained can only claim reliability and rarely examines valid problems or results as prescriptions for change. This paper describes an alternative investigative process by utilizing a phenomenological approach to explain, analyze, and begin ameliorating the rural main-streaming problem that plagues special educators teaching in rural communities. Evidence contained herein indicates that main-streaming malpractice remains a highly problematic issue for the rural physical education teacher. Because most of these teachers are not qualified to teach children with special needs, and quick relief does not seem feasible, this paper is intended to offer a practical problem solving approach designed to ameliorate service deficiencies.
Project NETWORC: A distance learning model in early childhood special education
Authors: Royce Penny , Cummings Rhoda
Published: April 2017

Providing special education services to children in rural, isolated areas is an on-going problem nationwide. Project NETWORC is an innovative, cost-effective training delivery system model that uses state-of-the-art telecommunications technology to provide early childhood/special education courses to professionals living in rural areas.
Understanding the Cultural Characteristics of American Indian Families: Effective Partnerships under the Individualized Family Service Plan (IFSP)
Authors: Nelson J. Ron , Smith Deborah J. , Dodd John M.
Published: April 2017

Public Law 99–457 provides the opportunity to reshape and redirect early intervention services to infants and toddlers and their families. Effective partnerships developed under the Individualized Family Service Plan (IFSP) between families and early intervention professionals require trust, sharing and cooperation. Because a majority of American Indians receive services in rural settings, it is essential that rural early intervention professionals understand the cultural characteristics of American Indian families. Only through such understanding can the effective partnerships that are necessary to assure positive outcomes for American Indian early intervention constituents be developed. This understanding will also serve to eliminate long standing assumptions that American Indian children are deficient in their preparation for school and that their families have given them a bad start in life. Instead, it will foster a more positive view of these children and their families. While recognizing that there may be gaps in the experience of American Indian children and families, respect for their cultural background will allow professionals to build on the experience base of children and families.
Medical-Educational Liaison: A Valuable Resource for Rural Educators
Authors: Rawlins Patrice , Stephens Pat
Published: April 2017

The Medical-Educational Liaison provides a valuable resource to rural educators who, in working with special health needs children, often lack direct contact with the child's health care providers. This innovative program received three year funding from the State Department of Education. The staff is a Clinical Nurse Specialist who enhances the liaison role of the school nurse, parent and school personnel. The primary goal of the program is accurate and timely exchange of information between families, educators, and health care providers to facilitate provision of appropriate services to special needs children.
Preparation of Early Intervention Personnel in a Rural State
Authors: Rule Sarah , Fiechtl Barbara , Huntington Lisa
Published: April 2017

There is a critical need to prepare early-intervention personnel resulting from the passage of the Education of the Handicapped Act Amendments of 1986. This paper presents the results of a survey of service providers regarding the competencies they considered essential to serve young children with disabilities. It also describes the organization of a program to prepare personnel in a rural state where persons who need preparation may not have access to on-campus training.
A Model for Training Early Childhood Special Educators in Rural Settings
Authors: Watson Alma L. , Bennett Tess
Published: April 2017

This article discusses the Family Specialist Training Program, a project funded to deliver state-of-the-art training to professionals in early intervention programs in North Carolina. The training process and the training model are described with particular emphasis on the evaluation design of the project. The article gives practical recommendations for training in rural areas.
Audio Teleconferencing: Creating a Bridge between Rural Areas and the University in Early Childhood/Special Education
Authors: Shaeffer Margaret B. , Shaeffer James M.
Published: April 2017

With the enactment of P.L. 99-457, colleges and universities will need to examine and create innovative ways of providing required coursework to help early childhood/special education professionals meet state certification requirements. This paper describes the use of audio teleconferencing as one approach of offering courses to these professionals in rural areas. Specifically, the advantages of utilizing audio teleconferencing and what instructional design and teaching methods were implemented in the delivery of this course are discussed.
Replacement Behaviors: A Strategy for Teaching Social Skills to Children with Behavior Problems
Authors: Neel Richard S. , Cessna K. Kay
Published: April 2017

Children with behavior problems are frustrating to teachers. Most programs for controlling behavior focus on reducing or eliminating behaviors. Instead, teaching appropriate behaviors can become part of the instructional component. Teachers can do this by evaluating the Intent of behavior and helping children achieve their intent In socially acceptable ways. The authors list steps for analyzing behavioral outcomes in order to develop teaching strategies for behavior problems.
Parental Concerns for Infants and Toddlers with Special Needs in Rural vs Urban Counties of Arizona
Authors: Sontag Joanne Curry , Schacht Robert , Horn Robert , Lenz Diane
Published: April 2017

The purpose of this study was to compare parental concerns for Infants and toddlers with special needs from rural versus urban counties in Arizona. A statewide, representative sample of 600 parents served by Arizona's key agencies were surveyed in face to face interviews with trained interviewers. Respondents were asked questions related to the nature and type of services they were receiving, their satisfaction with the services, their need for other services, financial needs, information needs, and emotional support needs. Differences were identified in relationship to the kinds of information parents from rural and urban counties need, as well as the source of information they are more likely to utilize. Parents from the largest urban area indicated that they had less help coordinating and accessing services. Parents from rural areas appeared to be enrolled at higher rates in low income family service programs and reported spending more money on travel and room and board to receive services. Overall, parents reported being highly involved in their child's services and indicated that their greatest concerns were in accessing information in order to make decisions about their child's needs.
Curriculum for Individuals with a Developmental Disability: An Overview
Authors: Palma Gloria M. , Meyers William A. , Robin Susan , Thomas Cindy , Lizar Dwayne
Published: April 2017

A curriculum that is functional for individuals who are considered developmentally disabled was developed at Tohatchi Special Education and Training Center, located within the Navajo Reservation in New Mexico. The purpose of the curriculum is to provide learning experiences for these individuals with a focus on survival skills. The curriculum is mainly divided into five parts: (a) overview of the contextual framework, (b) curriculum usage, (c) information modules, (d) gross and fine motor performance, and (e) language/communication components.
Future Special Education Teachers Perceptions of Rural Teaching Environments
Authors: Bell Teri L. , Bull Kay Sather , Barrett Jeanne M. , Montgomery Diane , Hyle Adrienne E.
Published: April 2017

For many rural communities, the recruitment and retention of special educators has emerged as a prominent concern. The purpose of this study was to assess the attitudes of future special educators regarding urban, suburban, and rural teaching environments. Specifically, research objectives focused on social, cultural, personal and professional attitudes, future career decisions, and their relationship to teaching locale.

Findings indicate that, generally, special education students had chosen their career field for altruistic reasons. The variables that drew beginning teachers to school districts were care for students, parental involvement and educational resources. Districts which could provide these should have few recruiting problems, no matter where they were located. However, if all other things are equal, the majority (60%) desired suburban placements, 23% desired rural placements and urban placements came in last.

Students who grew up in rural areas were more likely to favor returning to rural areas to teach than those from urban or suburban areas, but only 20% of rurally raised students would prefer returning to rural districts. Salaries do not seem to be an issue for any except those who want to teach in urban areas.
A Life-span Approach to Career Education for Learners with Disabilities in Rural Areas
Authors: D'alonzo Bruno J. , Giordano Gerard , Cole Jack
Published: April 2017

A life-span approach to career education suitable for learners with disabilities in rural areas is presented. This approach is designed to be inclusive to a full range of services available in communities and to be adaptable to predictable concerns of residents in rural areas. Additionally, the approach can be adapted to the characteristics of high school students in rural areas. Five levels of application for this model are reviewed: career consciousness, investigation of career aptitude, career examination, career experience, and career acquisition.
Levels of Best Practice Implementation in Classrooms for Mildly Handicapped Students in a Rural State
Authors: Daruwalla Meher E. , Whorton James E. , Richmond Mark G.
Published: April 2017

This study was designed to determine levels of implementation of identified best practices for mildly handicapped students in special education classrooms in Mississippi, a predominately rural state. It also investigated the relationship between the variables of teacher certification, level of special education teacher certification, years of teaching experience, and level of implementation of best practices. The results indicated a high level of acceptance and implementation of best practices. The variables of teacher certification and level of special education certification had an effect on implementation of only one best practice. There was a significant difference in the relationship between years of teaching experience and implementation of best practices.
Meeting the Needs of Children with Emotional Problems in a Profoundly Rural Area: A Preventive Model
Authors: Iverson Landa J. , Johnson D. Lamont , Harlow Steven D.
Published: April 2017

In an attempt to better meet the needs of children with emotional problems in profoundly rural areas, the Wyoming Department of Education and the University of Wyoming organized a summer institute for regular educators. The intent of this institute was to provide intensive training in theory, concepts, and techniques that would allow regular educators to work with children who were emotionally disturbed in a preventative manner. One year after the first institute was held, some of the participants were brought back to the University of Wyoming and assessment data were gathered. Questionnaire and interview data both indicate that the institute was successful and that the preventative model achieved its goals.
Using Mastery Learning to Facilitate the Full Inclusion of Students with the Most Intense Educational Needs within Rural Schools
Authors: Passaro Perry D. , Guskey Thomas R. , Zahn Gail
Published: April 2017

Often students with intense education needs or students with low incidents disabilities living in rural areas are served in more restrictive environments such as: out of district residential placement; home-bound instruction; or in isolated, one-on-one tutoring (Zeph,1991). Mastery learning is now being used in many rural schools throughout the midwest to facilitate the inclusion of students with intense educational needs into the regular classroom. The case of Stephanie, a rural South Dakota girl with Down Syndrome, verifies the success of mastery learning as a viable model for inclusion.
Toward a Positive and Effective Teacher and Paraprofessional Relationship
Authors: Palma Gloria M.
Published: April 2017

This article focuses on the importance and contributions of paraprofessionals in the teaching learning process. Tips on how to establish a positive and effective teacher and paraprofessional work relationship are also presented.
Referral, Assessment, and Placement Practices Used in Rural School Districts with Native American Students in Special Education
Authors: Gritzmacher Hal L. , Gritzmacher Sharon C.
Published: April 2017

Considerable information is available regarding the cultural bias inherent in assessment instruments and the disproportionately high placement of minority students within special education classrooms. However, little research is available regarding specific practices used in areas that have high minority representation. Because of these issues, a survey was developed to investigate the referral, assessment, and placement practices used with rural Native American students in special education. Twenty-five northern Minnesota school districts serving populations of Native American students that exceeded the state average were included in the study. Special education directors, Indian education directors, and selected special education teachers from these districts were surveyed. Their satisfaction with referral, assessment, and placement practices used with Native American students was compared, and specific information about those practices was used in an effort to determine best practices. While the scope of this survey was small, the issues raised have direct implications for all rural special education teachers in districts with high minority populations.
Supported Employment in Rural Areas: The Demographics of Job Development in South Dakota
Authors: Wheeler John J. , Hall Philip S.
Published: April 2017

A significant amount of research has examined supported employment but little has dealt with the delivery of supported employment services to persons with developmental disabilities who live in rural areas. This study investigated the relationship between demographic variables and job development of persons with developmental disabilities in South Dakota. A survey of job developers at eleven community-based adult service facilities and two major public school systems was conducted. Results are discussed pertaining to the effect of rate of unemployment, percentage of service jobs, and community size on the development of community-based jobs for persons with developmental disabilities.
Rural School APE: Are We Breaking the Law?
Authors: Benham-Deal Tami
Published: April 2017

The purpose of this study was to examine Adapted Physical Education (APE) practices in a rural state and to determine the preservice and inservice needs of APE teachers in Wyoming. Of the state's 49 school districts 38 responded to a descriptive questionnaire. Results indicated that (a) many school districts did not offer APE programs; (b) minimal, if any, specialization was required of many APE teachers; (c) larger districts tended to employ APE teachers more frequently; and (d) there is considerable need for inservice training. It was concluded that APE practices in Wyoming, as well as the preservice and inservice programs offered at the state university, need to be carefully examined.
Voices in Rural Special Education: Retrospectives, Prospectives, Possibilities
Authors: Berkeley Terry R. , Bull Kay S.
Published: April 2017

There is a richness of history, tradition, customs, and lore about rural America and rural schooling. Education in rural locales has had a significant and positive impact on education in suburban and urban areas. The same can be related about rural special education. In this article, retrospective views of the past and prospective thoughts about the future in the mix that occurs in rural education and rural special education were joined as voices to celebrate the successes and challenges confronting professional school people as they go about their daily work with students with disabilities in integrated settings and in separate classrooms.

Teaching, working, writing, and living in a rural locale either for part of one's life or for all of one's life adds a degree of realism and practicality no matter how much one can be influenced by city life. In particular, for the one author while in the city, I always feel that I am from away, and while in New Hampshire, the country, I never feel that I am here enough. For both of the authors of this article, rural roots, deep or not as firm, color our appreciation and caring for a way of life too few people speak about and too few other people know about. It is in this spirit that we hope these thoughts are considered.
Participation of Rural Students with Disabilities and Rural Gifted Students in Open Enrollment
Authors: Delaney Thomas J. , Lange Cheryl M. , Ysseldyke James E.
Published: April 2017

Minnesota has an open enrollment program which allows students the opportunity to attend a school in any school district of their choice. The authors examined the survey responses on open enrollment of 82 parents of rural students with disabilities and rural students who are gifted. The purpose of the data analysis was to focus on transferring students' demographic characteristics, sources of information about open enrollment, and reasons for transfer. The majority of students with disabilities using open enrollment have been categorized as having a learning disability. Most of these open enrollment students and their parents gather information about the availability of open enrollment from the media. The most important reason parents of rural children with special needs apply for open enrollment is because programs available in alternative districts are thought to be better able to meet the educational requirements of these children.
Distance Training in Gifted/Talented Education: Description of a Collaborative Working Model
Authors: Van Ert Heidi , Wolf Joan S.
Published: April 2017

This article describes a two-year staff development project in which teachers in rural areas of Utah were introduced to basic concepts about and strategies for gifted students. The collaborative training with the Utah State Office of foundation was designed to have a multiplier effect as the participants were encouraged to return to their respective schools and districts and become a resource to colleagues on issues related to serving the gifted.
Managing Scarce Resources for Students with Learning Disabilities: Factors Affecting Resource Allocation in Wyoming
Authors: Yocom Dorothy Jean , Beglau Monica
Published: April 2017

Wyoming has often been described as a small town with very long streets. With a sparse population scattered across vast geographical distances, special education teachers in Wyoming have a unique challenge for providing an appropriate education to students with disabilities. This survey study was designed to establish a perspective about how decisions regarding the allocation of resources for special education are made in Wyoming's rural school districts. Several interesting implications can be drawn from the findings, most notably that the type of service delivery model selected by Wyoming school district administrators appears to have the greatest impact on resource allocation decisions.
Special Education and Home Schooling: How Laws Interact with Practice
Authors: Reinhiller Noell , Thomas Gloria Jean
Published: April 2017

Home schooling has been part of the American education system since this country's beginning. In reviewing the history of home schooling and accompanying legislative action, there is a definite trend by state legislatures to liberalize laws related to home schooling. Students with disabilities, however, pose significantly greater challenges for parents who choose home schooling and have created a new area of litigation in the last 20 years. After summarizing statutes in the rural states of North Dakota and Minnesota, this article discusses several cases to illustrate the refinement of the interpretation of the intersection of home schooling and special education. Implications and recommendations for practice are included.
Regional Program, School District, and College: Collaborating to Provide an Educational Program for One Deaf Child
Authors: Schirmer Barbara R.
Published: April 2017

One rural school district in central Oregon addressed the challenges of providing a quality, inclusive education for one deaf child by bringing together professionals from the district, the regional program for deaf children, and the college with a teacher preparation program in deaf education. The teacher educator conducted an assessment of the child and used the results of the assessment as the basis for an staff development workshop designed to enable the school district to provide an appropriate education for the child at present and to offer a foundation of knowledge for the district to make future decisions.
Exploring the Personal Cultures of Rural Deaf/Hard of Hearing Students
Authors: Fletcher-Carter R. , Páez Doris
Published: April 2017

For teachers of deaf or hard-of -hearing students, knowledge of their students' cultures can serve as an aid in their approach to teaching. A student, particularly one who is deaf or hard of hearing, attending school in a rural community of the United States belongs to or is influenced by at least four cultural groups: (a) family, (b) neighborhood/vicinity, (c) community, and (d) school. To understand the world of each student requires that educators explore the child's uniqueness or “personal culture.” A framework for exploring the personal cultures of rural, deaf or hard of hearing students, strategies for gathering cultural information, and a means for applying the cultural information in curricular adaptations are presented in this article.
Preparing Native American Special Education Teachers: Lessons Learned from the Rural Special Education Project
Authors: Delany-Barmann Gloria , Prater Greg , Minner Sam
Published: April 2017

Twelve Navajo preservice teachers in the Rural Special Education Project on the Navajo Nation in Kayenta, Arizona, shared their perceptions regarding the factors which enabled them and constrained them as they completed a special education teacher preparation program. Several themes emerged during the process of interviewing the students including the importance of cultural teachings and family support; the influence of language factors, financial constraints, and cultural responsibilities; and the lack of availability of educational opportunities on the Navajo Nation. Each of these factors is discussed in this article and recommendations are made for others interested in establishing successful teacher preparation programs for Native American students.
The Effectiveness of Regional Center Cooperatives and Regional Education Cooperatives in Providing Special Education Services to Rural New Mexico
Authors: Sauble Tara L. , Rhodes Robert L.
Published: April 2017

Rural schools have often encountered difficulty implementing special education programs designed for larger, urban settings. Regional cooperatives have emerged as a solution for many rural schools in order to meet the needs of their special education populations. In this study, the directors of each of the 10 regional cooperatives in New Mexico, along with special education directors of 27 selected rural schools throughout the state, were surveyed regarding their perception of the effectiveness of regionalized services. The results of this study suggest that the regional cooperative approach utilized in New Mexico provides services and personnel that the schools would have difficulty maintaining individually. Although both respondent groups identified many benefits to the current service delivery model, areas of concern were also identified. Results of the study are discussed in light of historical limitations faced by rural special education personnel and programs.
Effective Collaboration between Professionals and Paraprofessionals
Authors: Demchak Maryann , Morgan Carl R.
Published: April 2017

In rural districts the use of paraprofessionals provides a valuable resource that is often essential to the success of educational programs. Unfortunately, variables exist that can lead to ineffective collaboration between professionals and paraprofessionals. This article provides concrete strategies to lead to more effective professional-paraprofessional collaboration: (a) clarifying roles and responsibilities, (b) discussing job expectations, (c) daily scheduling, (d) on-going communication, and (e) providing regularly scheduled training.
Concerning Inclusion: Perceptions of Middle School Students, Their Parents, and Teachers
Authors: Ritter Carol L. , Michel Charles S. , Irby Beverly
Published: April 2017

This ethnographic study addressed the perceptions of rural fifth and sixth grade students with learning disabilities who have participated in an inclusion special education programs at the middle school level and who had previously participated in a more traditional special education program in fourth grade. The perceptions of their parents, as well as their regular education teachers, were also included in this study. Five predominant themes were found through analysis of the transcribed parent and student interviews. They were: (a) increased self confidence, (b) camaraderie, (c) support of the teachers, (d) poor self esteem in the special education classes, and (e) high expectations. While some of the themes which rose out of the teacher focus groups were similar to those found in the student and parent interviews there were also some which were unrelated. The themes discovered through the analysis of the focus groups transcriptions were: (a) increased student confidence, (b) interventions to accommodate learning and teaching “made all the difference”, and (c) improved academic progress of students with special needs. The impact of this inclusion program upon the school experience of these students is reflected in the analysis of the perceptions of the parents, students and teachers who participated in this study.
Alaska's Rural Early Intervention Preservice Training Program
Authors: Ryan Susan
Published: April 2017

Effective educational practices for infants and toddlers with disabilities demand personnel with appropriate training. In almost all states, qualified personnel currently are not available to staff programs designed for young children (Burke, McLaughlin, & Valdivieso, 1988; Hanson & Lovett, 1992). The lack of trained and qualified personnel working in rural areas is an even greater problem confounded by difficulties with staff recruitment and retention. The purpose of this article is to describe a Master's level training program for early intervention personnel currently providing services in rural Alaska to infants and toddlers and preschoolers with disabilities and their families. This article addresses how to implement current best practice in early intervention via distance education to programs and personnel who are geographically distanced from the places and resources where available training occurs.
Life beyond the Large City: A Distance Education Program in Learning Disabilities at the University of North Carolina at Charlotte
Authors: Jordan Luann , Spooner Fred , Calhoun Mary Lynne , Beattie John , Algozzine Bob , Galloway Tara
Published: April 2017

Continuing shortages of qualified personnel in special education is a relatively well-known phenomenon, and delivery of teacher education in rural areas is especially problematic. First, students live a far distance from the university campus. Second, they may be “learning on the run,” that is, beginning their career in special education with little preparation for their job. Finally, these students may have family responsibilities that make attending classes that much more difficult. The distance education program at the University of North Carolina (UNC) at Charlotte serves rural areas around the metropolitan area of Charlotte, NC. UNC-Charlotte offers a series of courses through the interactive fiber optic North Carolina Information Highway (NCIH). Because of this program, students from the Charlotte area and surrounding counties have access to professional preservice preparation that will improve their teaching skills and the quality of services provided by teachers who are teaching “out of field.” This paper describes the distance education project at UNC-Charlotte in terms of background of the project, technology used, and faculty and student training for using the distance education technology. Initial evaluation data also are presented. Implications for program development are discussed.
So You're a Distance Learner? Tips and Suggestions for Rural Special Education Personnel Involved in Distance Education
Authors: Collins Belva C. , Schuster John W. , Grisham-Brown Jennifer
Published: April 2017

Distance education technology is rapidly becoming a means for delivering both preservice and inservice courses and content for rural teachers, paraprofessionals, related service personnel, and others involved in special education. Yet, learning at a distance can be both intimidating and challenging. This article is designed to be distributed to distance education students by distance education instructors and describes how persons who find themselves involved in distance learning can break down barriers that inhibit learning and make the most of the experience. The tips and suggestions offered are based on the experience of instructors and participants who have been involved in university distance education courses and activities since 1989 and on suggestions from publications stemming from special education programs in distance education.
The microbiome in respiratory medicine: current challenges and future perspectives
Authors: Faner Rosa , Sibila Oriol , Agustí Alvar , Bernasconi Eric , Chalmers James D. , Huffnagle Gary B. , Manichanh Chaysavanh , Molyneaux Philip L. , Paredes Roger , Pérez Brocal Vicente , Ponomarenko Julia , Sethi Sanjay , Dorca Jordi , Monsó Eduard
Published: April 2017

The healthy lung has previously been considered to be a sterile organ because standard microbiological culture techniques consistently yield negative results. However, culture-independent techniques report that large numbers of microorganisms coexist in the lung. There are many unknown aspects in the field, but available reports show that the lower respiratory tract microbiota: 1) is similar in healthy subjects to the oropharyngeal microbiota and dominated by members of the Firmicutes, Bacteroidetes and Proteobacteria phyla; 2) shows changes in smokers and well-defined differences in chronic respiratory diseases, although the temporal and spatial kinetics of these changes are only partially known; and 3) shows relatively abundant non-cultivable bacteria in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis and bronchiectasis, with specific patterns for each disease. In all of these diseases, a loss of diversity, paralleled by an over-representation of Proteobacteria (dysbiosis), has been related to disease severity and exacerbations. However, it is unknown whether dysbiosis is a cause or a consequence of the damage to bronchoalveolar surfaces.

Finally, little is known about bacterial functionality and the interactions between viruses, fungi and bacteria. It is expected that future research in bacterial gene expressions, metagenomics longitudinal analysis and host–microbiome animal models will help to move towards targeted microbiome interventions in respiratory diseases.
Aspirin Use and Colorectal Cancer Survival According to Tumor CD274 (Programmed Cell Death 1 Ligand 1) Expression Status
Authors: Hamada Tsuyoshi , Cao Yin , Qian Zhi Rong , Masugi Yohei , Nowak Jonathan A. , Yang Juhong , Song Mingyang , Mima Kosuke , Kosumi Keisuke , Liu Li , Shi Yan , da Silva Annacarolina , Gu Mancang , Li Wanwan , Keum NaNa , Zhang Xuehong , Wu Kana , Meyerhardt Jeffrey A. , Giovannucci Edward L. , Giannakis Marios , Rodig Scott J. , Freeman Gordon J. , Nevo Daniel , Wang Molin , Chan Andrew T. , Fuchs Charles S. , Nishihara Reiko , Ogino Shuji
Published: April 2017

Purpose

Blockade of the programmed cell death 1 (PDCD1, PD-1) immune checkpoint pathway can improve clinical outcomes in various malignancies. Evidence suggests that aspirin (a widely used nonsteroidal anti-inflammatory drug) not only prolongs colorectal cancer survival, but can also activate T cell–mediated antitumor immunity and synergize with immunotherapy through inhibition of prostaglandin E2 production. We hypothesized that the survival benefit associated with aspirin might be stronger in colorectal carcinoma with a lower CD274 (PDCD1 ligand 1, PD-L1) expression level that resulted in lower signaling of the immune checkpoint pathway.

Patients and Methods

Using data from 617 patients with rectal and colon cancer in the Nurses’ Health Study and the Health Professionals Follow-Up Study, we examined the association of postdiagnosis aspirin use with patient survival in strata of tumor CD274 expression status measured by immunohistochemistry. We used multivariable Cox proportional hazards regression models to control for potential confounders, including disease stage, microsatellite instability status, CpG island methylator phenotype, long interspersed nucleotide element-1 methylation, cyclooxygenase-2 (PTGS2), and CDX2 expression, and KRAS, BRAF, and PIK3CA mutations.

Results

The association of postdiagnosis aspirin use with colorectal cancer–specific survival differed by CD274 expression status ( Pinteraction < .001); compared with aspirin nonusers; multivariable-adjusted hazard ratios for regular aspirin users were 0.16 (95% CI, 0.06 to 0.41) in patients with low CD274 and 1.01 (95% CI, 0.61 to 1.67) in patients with high CD274. This differential association seemed consistent in patients with microsatellite-stable or PIK3CA wild-type disease and in strata of PTGS2 expression, CDX2 expression, tumor-infiltrating lymphocytes, or prediagnosis aspirin use status.

Conclusion

The association of aspirin use with colorectal cancer survival is stronger in patients with CD274-low tumors than CD274-high tumors. Our findings suggest a differential antitumor effect of aspirin according to immune checkpoint status.
Predictors and Prevalence of Pain and Its Management in Four Regional Cancer Hospitals in India
Authors: Doyle Katherine E. , El Nakib Shatha K. , Rajagopal M.R. , Babu Sunil , Joshi Geeta , Kumarasamy Vidya , Kumari D. Priya , Chaudhuri Prabir , Mohanthy Sumita , Jatua Debasish , Lohman Diederik , Amon Joseph J. , Palat Gayatri
Published: April 2017

Purpose

More than 1 million new occurrences of cancer are diagnosed in India annually. Among patients with cancer, pain is a common and persistent symptom of the disease and its treatment. However, few studies to date have evaluated the prevalence of pain and the adequacy of pain management in Indian hospitals. This cross-sectional study aimed to assess the prevalence and sociodemographic patterns of cancer pain and pain management among a sample of inpatients and newly registered outpatients at four large regional cancer centers in India.

Methods

A sample of 1,600 patients with cancer who were current inpatients or newly registered outpatients were recruited and administered a questionnaire that was based on the Brief Pain Inventory. The survey tool included questions on demographics, medical history, and extent of clinical pain experienced. In addition, a pain management index score was created to link the severity of cancer pain with medication prescribed to treat it.

Results

A total of 88% of patients reported pain in the past 7 days, and approximately 60% reported that their worst pain was severe. Several demographic and medical characteristics of the study population predicted severe pain, including the following: lower educational level, outpatient status, and debt incurred as a result of illness. A total of 67% of patients were inadequately treated with analgesics. Inadequate pain management was associated with both treatment hospital and patient type, and patients who reported debt as a result of their illness were more likely to have inadequate pain management.

Conclusion

A majority of Indian patients with cancer experience significant pain and receive inadequate pain management. Improvement of pain management for Indian patients with cancer is needed urgently.
Shared Decision-Making in Patients With Prostate Cancer in Japan: Patient Preferences Versus Physician Perceptions
Authors: Schaede Ulrike , Mahlich Jörg , Nakayama Masahiko , Kobayashi Hisanori , Takahashi Yuriko , Saito Katsuhiko , Uemura Hiroji , Tokumitsu Masayuki , Yoshizawa Kazutake
Published: April 2017

This article adds the Japanese perspective to our knowledge of shared decision-making (SDM) preferences by surveying patients with prostate cancer (PCA) and physicians in Japan. In 2015, 103 Japanese patients with PCA were asked about their SDM preferences by using an Internet-based 5-point-scale questionnaire. Concurrently, 127 Japanese physicians were surveyed regarding their perceptions of patient preferences on SDM. Drivers of preferences and perceptions were analyzed using univariable ordinal logistic regression and graphing the fitted response probabilities. Although 41% of both patients and physicians expressed and expected a desire for active involvement in treatment decisions (a higher rate than in a similar study for the United States in 2001), almost half the Japanese patients preferred SDM, but only 33% of physicians assumed this was their choice. That is, 29% of Japanese physicians underestimated patients’ preference for involvement in making treatment decisions. Patients with lower health-related quality of life (as measured by the Functional Assessment of Cancer Therapy-Prostate [FACT-P]) expressed a stronger preference for SDM. The study shows that the worse the medical situation, the more patients with PCA prefer to be involved in the treatment decision, yet physicians tend to underestimate the preferences of their patients. Perhaps in contrast to common assumptions, Japanese patients are as interested in being involved in decision making as are patients in the United States.
Gel-State Dependencies of Brown Patterns of Mn–Fe-Based Prussian Blue Analogues Studied by Combined X-ray Spectroscopies
Authors: Hayashi Hisashi , Abe Hitoshi
Published: April 2017

The gel-state dependencies of brown patterns of Mn–Fe-based Prussian blue analogues (PBAs) formed in water-glass gels by reaction–diffusion (RD) processes have been studied by using X-ray fluorescence and X-ray absorption near-edge structure spectroscopies. Three tubes containing admixtures of 0.25 M [Fe(CN)6]3− and 0.30 M acetic acid (A and B) or boric acid (C) in water-glass (9.1 (A) and 7.4 (B and C) mass%) were brought into contact with 0.20 M MnSO4 solution. Tube A formed periodic (but not genuine Liesegang) bands, whereas tubes B and C formed light-brown bands in the turbid zone (TZ). A lowered amount of water-glass (A → B) resulted in a more fluctuant distribution of the PBAs. [Mn(H2O)6]2+ ions were also present in the TZ of tube B and their content increased with distance from the gel-junction after stopping the RD process. Addition of boric acid (C) suppressed the RD processes in the gel, slowing down the formation of PBAs. It is likely that the areas of low PBA content in the TZ of tubes B and C generate the light-brown bands. FEFF calculations suggest that the most likely local structures of the predominant PBAs in tubes A/B and C are Mn(NCFe)2O4K2 and Mn(NCFe)2O4, respectively.
Selective vulnerabilities and biomarkers in neurocognitive aging
Authors: Reagh Zachariah , Yassa Michael
Published: April 2017

As the world’s population continues to age, an understanding of the aging brain becomes increasingly crucial. This review focuses on several recent ideas and findings in the study of neurocognitive aging, specifically focusing on episodic memory, and discusses how they can be considered and used to guide us moving forward. Topics include dysfunction in neural circuits, the roles of neurogenesis and inhibitory signaling, vulnerability in the entorhinal cortex, individual differences, and comorbidities. These avenues of study provide a brief overview of promising themes in the field and together provide a snapshot of what we believe will be important emerging topics in selective vulnerabilities in the aging brain.
Globalized Robust Optimization for Nonlinear Uncertain Inequalities
Authors: Ben-Tal Aharon , Brekelmans Ruud , den Hertog Dick , Vial Jean-Philippe
Published: April 2017

Robust optimization is a methodology that can be applied to problems that are affected by uncertainty in their parameters. The classical robust counterpart of a problem requires the solution to be feasible for all uncertain parameter values in a so-called uncertainty set and offers no guarantees for parameter values outside this uncertainty set. The globalized robust counterpart (GRC) extends this idea by allowing controlled constraint violations in a larger uncertainty set. The constraint violations are controlled by the distance of the parameter from the original uncertainty set. We derive tractable GRCs that extend the initial GRCs in the literature: our GRC is applicable to nonlinear constraints instead of only linear or conic constraints, and the GRC is more flexible with respect to both the uncertainty set and distance measure function, which are used to control the constraint violations. In addition, we present a GRC approach that can be used to provide an extended trade-off overview between the objective value and several robustness measures.
Reflections from the Application of Different Type of Activities: Special Training Methods Course
Authors: Karadeniz Mihriban Hacisalihoglu
Published: April 2017

The aim of this study is to reveal the benefits gained from “Special Training Methods II” course and the problems prospective mathematics teachers encountered with it. The case study method was used in the study. The participants in the study were 34 prospective mathematics teachers studying at a Primary School Mathematics Education Department. The data collection tools were a form composed of open-ended questions and semi-structured interviews. Descriptive analysis of the quantitative data was carried out. In the “Special Teaching Methods II” course, beginning in the spring term of the 2015-2016 academic year, teaching activities on “multiple intelligences”, “discovery”, “group work”, “problem-solving”, “history of mathematics” and “computer-assisted teaching” were developed and implemented. It was concluded that these activities helped students like mathematics more, understand the importance of helping each other and cooperation and have more enjoyable lessons, as well as aiding their cognitive, social and emotional development. It was also found that through these activities participants improved their belief in themselves and increased their confidence regarding teaching mathematics. The participants also faced with some difficulties during the application process. They mostly mentioned that preparing worksheets was time-consuming, finding a school to perform the activity was hard and students were reluctant.
Engaging creativity: Employing assessment feedback strategies to support confidence and creativity in graphic design practice
Authors: Visser Irene , Chandler Lisa , Grainger Peter
Published: April 2017

Creativity is valued in graphic design practice. However, in design education, it is often hindered by assessment processes when students focus on grade outcomes or become attached to a limited set of concepts drawn from pre-existing knowledge. This article presents a case study from an Australian university, drawing on surveys, focus-group discussions and reflections to examine the implications of assessment feedback on creativity in graphic design pedagogy. Curriculum design and assessment strategies that support student confidence in experimentation and creative capacity, as well as the roles of both educators and students, were considered. The study highlights the benefits of face-to-face feedback throughout the assessment process but recognizes the challenges around the practice. It is suggested that, by rethinking how this form of feedback can be effectively incorporated to support graphic design pedagogy, these challenges can be overcome.
Reflective didactic strategy to integrate semiotic theory and creative practice in graphic design education
Authors: de la Cruz L. Arturo , Mejía G. Mauricio
Published: April 2017

Educators generally accept that semiotics theory should be taught in design; however, there is need of more evidence and documented practices about how to incorporate semiotics into design education. Existing references propose techniques to use semiotics as source of inspiration and as an analysis tool. In this study, the authors examined how a reflective didactic strategy, one that uses semiotic theoretical reflection in several analytical and creative activities, stimulates learning and bridges semiotic theory and design practice. Even though students’ theoretical knowledge about semiotics increased modestly, they were more aware about how design artefacts convey meaning to the audience, which is the main reason semiotics are part of the design curriculum. This study shows that a reflective didactic strategy supports learning applied semiotics, which helps students to understand the central role of theory for a legitimized design practice.