bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximizing Independence for Persons Who are Developmentally Disabled: Community-Based Programs at the Waisman Center University Affiliated Facility
Authors: Karan Orv C. , Brandenburg Sara , Sauer Margaret , Yoder David E. , Mathy-Laikko Pamela , Villarruel Francisco , Dolan Terrence R.
Published: November 2015

All University Affiliated Facilities conduct interdisciplinary programs of training, education/service, research, and outreach in the area of developmental disabilities. In this article four representative programs of the Waisman Center University Affiliated Facility in Madison, Wisconsin are described. They all share the following common features: each has been designed to augment and support the independence of persons who are developmentally disabled, each is either conducted in a community-based setting or designed to train persons who will work in such settings, and each is used as a resource for the conduct of interdisciplinary training for educators and clinicians.

Included in this article are descriptions of (a) a paraprofessional training program that leads to an associate degree in community services, (b) an innovative supported employment program specifically designed for adults still living in public institutions, (c) a service/research program that provides persons who do not have speech capability with the technology and training for communicating, and (d) an evaluation/research program for promoting communication skills in persons who are mentally retarded, deaf, and blind.
Community Integration in Vermont
Authors: Williams Wes , Fox Wayne , Christie Lu , Thousand Jacque , Conn-Powers Michael , Carmichael Larry , Vogelsberg R. Timm , Hull Marc
Published: November 2015

The Center for Developmental Disabilities, a University Affiliated Facility Satellite, at the University of Vermont, has had a major role in facilitating community integration throughout the state. This article describes the development and implementation of a statewide interdisciplinary model for providing special education to learners with severe disabilities and the Center's role in facilitating systems change in early special education, recreation/leisure opportunities, vocational services, and family support.
A Competency-Based “Hands-On” Training Package for Direct-Care Staff
Authors: Burch Mary R. , Reiss Maxin L. , Bailey Jon S.
Published: November 2015

This study evaluated the effectiveness of a “hands-on” and videotape training package in teaching direct care staff in an Intermediate Care Facility to conduct daily activities for persons labeled profoundly mentally retarded. A proficiency checklist of desired staff behaviors was developed and staff were provided with hands-on competency-based training. With the use of a multiple baseline design (across two groups of staff), it was shown that staff performance in conducting the activities improved after the training was implemented, and that skills maintained at a 3-week follow-up check.
Alternative Strategies and Multiple Outcomes in the Remediation of Severe Self-Injury: Going “All Out” Nonaversively
Authors: Berkman Karen A. , Meyer Luanna H.
Published: November 2015

This case study report describes the various treatments implemented over a 3-year period in an effort to reduce and eliminate multiple and severe self-injurious behaviors in a 45-year-old man who had been institutionalized and had exhibited these behaviors for the majority of his life. After baseline, an aversive procedure (contingent mechanical restraint) had been implemented and judged a failure by institution personnel. Subsequent intervention phases introducing community involvement and performance goals that emphasized functional activities in criterion environments and situations were associated with increasingly positive behaviors. Multiple outcome data are reported, including meaningful changes in targeted self-injurious behaviors, maintenance and generalization of those changes to integrated community environments at follow-up using available staff and resources, acquisition of new alternative skills, and placement in a supported apartment in the community with full-time work in a community job site. The procedures and the results demonstrate possible outcomes when nonaversive intervention procedures and community resources are utilized comprehensively as alternatives to aversive procedures focused upon only the immediate reduction of a single target behavior.
The Implementation of Health-Related Procedures in Classrooms for Students with Severe Multiple Impairments
Authors: Mulligan-Ault Marilyn , Guess Doug , Struth Lynne , Thompson Barbara
Published: November 2015

One-hundred fifty teachers of students with severe and multiple impairments were surveyed to identify the prevalence of health-related procedures being used in the classrooms, the person(s) routinely responsible for implementing the procedure(s), and the persons the teachers felt should be responsible for implementing the procedures. In addition, the survey identified the source of the teacher's information concerning health-related procedures for individual students, types of correspondence with the school nurse and the family physician, the teachers' awareness of the availability of school policy for implementing health-related procedures, the teachers' source of training on health-related procedures, and the relationship of the classroom location to visits by the school nurse. Seventy percent of the questionnaires were returned. Teachers indicated that all but one of the procedures listed were occurring in one or more of the classrooms. The teachers ndicated that, for the most part, they were primarily responsible for implementing the procedures on a routine basis. The teachers' responses indicated that they felt they should be responsible for a specific group of procedures with the nurse and paraprofessional, or nurse and teacher in combination responsible for a different set of procedures. The family was used most often as a source of information for the health-related procedures. Contact with the school nurse was variable. Classrooms in integrated or rural settings were reported as visited less often by the school nurse than classrooms in either more segregated or urban settings. Only 21% of all the classroom teachers responding were aware of local district guidelines for the determination of who should be responsible for the implementation of health-related procedures.
A Comparison of General Case in Vivo and General Case Simulation plus in Vivo Training
Authors: McDonnell John J. , Ferguson Brad
Published: November 2015

This study examined the relative effectiveness and efficiency of general case in vivo and general case simulation plus in vivo training in teaching six students with moderate and severe disabilities to purchase drink and food items in fast-food restaurants. General case in vivo training consisted of instruction in three fast-food restaurants located near the students' school. General case simulation plus in vivo training alternated classroom training with training in a single restaurant. Generalization was assessed in three novel restaurants. Results indicated that both strategies led to reliable performance in nontrained settings. However, students who received general case in vivo instruction required fewer training trials to criterion, made fewer errors to criterion, and required less training time to criterion than students who received general case simulation plus in vivo training. In addition, the overall costs of general case in vivo instruction were lower than the costs of the general case simulation plus in vivo training. The results are discussed in terms of the implications for teachers in designing instructional programs to teach generalized performance of community skills.
Statistics for Small Groups: The Power of the Pretest
Authors: Cole David A.
Published: November 2015

In the area of severe-profound retardation, researchers are faced with small sample sizes. The question of statistical power is critical. In this article, three commonly used tests for treatment-control group differences are compared with respect to their relative power: the posttest-only approach, the change-score approach, and an analysis of covariance (ANCOVA) approach. In almost all cases, the ANCOVA approach is the more powerful than the other two, even when very small samples are involved. Finally, a fourth approach involving ANCOVA plus alternate rank assignments is examined and found to be superior even to the ANCOVA approach, especially in small sample cases. Use of slightly more sophisticated statistics in small sample research is recommended.
Perspectives on Pitfalls and Hassles in Single-Subject Research
Authors: Kratochwill Thomas R. , Williams Bonnie L.
Published: November 2015

Single-case research designs have emerged as a major methodological strategy in some areas of social science research. Yet, single-subject research is plagued by a number of methodological, conceptual, and philosophical problems that have a bearing on the efficacy of these strategies in applied settings. In this article we review briefly some methodological issues in single-case design, including factors such as baseline trends, variability in the data, and duration of phases. In addition, conceptual issues include the range of outcome questions that single-case designs are designed to address as well as establishing the generalizability of findings. Beyond these issues, a number of pitfalls and hassles are likely to emerge, including philosophical objections to single-case research design, replication problems, measurement paradigms that seem incompatible with design assumptions, and the integration of single-case designs into practice.
“Are You Retarded?” “No, I'm Catholic”: Qualitative Methods in the Study of People with Severe Handicaps
Authors: Biklen Sari Knopp , Moseley Charles R.
Published: November 2015

Qualitative research methods generally depend heavily on good communication between researcher and informant. When qualitative methodologists study informants with severe retardation whose use of language may be limited, what do they do?

If the researchers plan to study the world of the informant, then traditional participant observation guidelines are useful. But when the researcher wants to interview the informant, some modifications need to be made. The authors suggest several guidelines to follow.
Generations of Hope: Parental Perspectives on the Transitions of Their Children with Severe Retardation from School to Adult Life
Authors: Ferguson Philip M. , Ferguson Dianne L. , Jones David
Published: November 2015

Transitions within families are socially constructed processes that need to be understood in both their historical and their cultural context. This study explored how parents interpret the events and relationships surrounding the transition of their children with severe disabilities from school to adult life. The study used qualitative techniques to collect and analyze data from two sets of parents grouped according to their children's ages. Results indicated that the parents interviewed tended to perceive three distinct types of transition: bureaucratic, family life, and adult status. Generational patterns of parental response to these transitions are discussed in terms of professional relationships and self-reliance. A matrix of these response patterns is presented. The findings suggested several ways in which parent-professional cooperation around transition events might be improved.
Active versus Passive Programming: A Critique of IEP Objectives for Students with the Most Severe Disabilities
Authors: Downing June
Published: November 2015

Students who have severe to profound mental retardation, sensory impairments, medical problems, and severe physical disabilities are often the recipients of passive programming and instruction. These students typically are individuals who have difficulty manipulating their physical and social environments and communicating their intent. This study investigated the quality of programming for students with the most severe disabilities to determine whether physical disabilities that prevent voluntary movement is a discriminating factor affecting the type of programming (i.e., active or passive). The IEPs of 35 students with severe multiple disabilities from six states were evaluated to determine the number of age-inappropriate and nonfunctional objectives, criterion-referenced objectives, and passive versus active objectives. Students were grouped according to their ability to manipulate their physical environment. Findings from this preliminary investigation suggest that both groups of students engage in a considerable number of age-inappropriate and nonfunctional objectives, and that students with very little voluntary movement received more passive instruction than students who were more physically able.
Natural Supports in the Workplace: A Reexamination of Supported Employment
Authors: Nisbet Jan , Hagner David
Published: November 2015

The purpose of this article is to examine some of the basic premises of supported employment initiatives. In particular, the role of agency-sponsored job coaches in supporting employees with severe disabilities in integrated work environments is discussed. A broader concept of supported employment is proposed, based on studies of the supports and informal interactions characteristic of natural work environments. Alternative support options, entitled the Mentor Option, the Training Consultant Option, the Job Sharing Option, and the Attendant Option, which involve the active participation of supervisors and co-workers, are presented with suggestions for implementation.
Visual Analysis of Student Evaluation Data: A Qualitative Analysis of Teacher Decision Making
Authors: Grigg Nancy C. , Snell Martha E. , Loyd Brenda
Published: November 2015

Visual analysis of graphically displayed data typically is used by teachers of persons with severe disabilities to evaluate the effectiveness of educational interventions. Although the use of this process is widely advocated as a desirable educational practice, recent research indicates that levels of interrater agreement are unacceptably low. To examine the variables that influence the decisions made during visual appraisal in classroom settings, qualitative interviews were conducted with special education teachers. The implications of these results for teachers who collect and analyze student performance data in a classroom setting are discussed.
Promoting Social Interaction through Teaching Generalized Play Initiation Responses to Preschool Children with Autism
Authors: Haring Thomas G. , Lovinger Laurie
Published: November 2015

Two experiments were conducted to investigate the effects of play initiation training on subsequent social interactions between students with severe disabilities and their nonhandicapped peers within play contexts. In both studies, five nonhandicapped peers were used as training confederates, and generalization probes were conducted within unstructured free-play situations with a larger number of peers who did not participate in training. In Experiment 1, a preschool student with autistic behaviors was integrated into a regular preschool The effects of two treatment conditions were compared: (a) providing an awareness activity plus rewards for the nonhandicapped peers who initiated interactions and (b) teaching initiations and play behaviors to the student with severe disabilities. The results indicated that although the awareness activity plus reward condition increased the frequency of peer initiations, peer responsivity to the initiations by the student with severe disabilities remained low. When the student with severe disabilities was taught to initiate interactions and play appropriately, the level of initiation by the student increased and the level of responsivity by the peers toward his initiations also increased. In Experiment 2, we replicated this effect with two students who were integrated into a kindergarten class. The effects of competent social interaction skills on shaping environments that are responsive to the social initiations of students with severe disabilities are discussed.
The Desegregation of America's Special Schools: Strategies for Change
Authors: McDonnell Andrea P. , Hardman Michael L.
Published: November 2015

There is strong philosophical, legal, and empirical support for integrated educational programs for students with severe disabilities. In spite of this support, significant numbers of students with severe handicaps continue to be educated in segregated special schools. This article briefly reviews the support for integration and presents a framework for planned educational change, based on the extant racial desegregation literature. This report includes a discussion of the logistical issues facing school administrators and an analysis of effective leadership roles in the change process.
Teaching Generalized Communicative Behaviors within Interrupted Behavior Chain Contexts
Authors: Alwell Morgen , Hunt Pam , Goetz Lori , Sailor Wayne
Published: November 2015

Three students with severe disabilities were taught to request items or events within interrupted behavior chain contexts. The interrupted behavior chain strategy involved inserting a typical instructional trial into the midst of an ongoing predictable sequence of behaviors such as getting a jacket and going outside or obtaining and operating a simple toy. Additionally, generalization probes were conducted in a variety of nontraining settings to determine whether responses taught within interrupted routines would generalize to “out-of-routine” contexts in which the child requested items to begin, rather than to resume, an activity. The results demonstrated that for each of the three students the responses acquired within interrupted chains of behavior generalized to a variety of naturally occurring, out-of-routine contexts and are discussed in relation to teaching self-initiated communicative behaviors.
Establishing Communicative Alternatives to the Emission of Socially Motivated Excess Behavior: A Review
Authors: Doss Scott , Reichle Joe
Published: November 2015

This article discusses literature related to the use of communication intervention for reducing excess behavior in persons with severe disabilities and speculates upon unresolved issues in research and intervention. Operant conditioning and pragmatics are discussed in terms of their joint application to excess behavior. The intervention literature is reviewed, and a comprehensive list of possible pragmatic intents of excess behavior is developed. Finally, recommendations regarding important lines of research and intervention are presented.
The Relationship of Staff Contact and Activity to the Stereotypy of Children with Multiple Disabilities
Authors: Brusca Rita M. , Nieminen Gayla S. , Carter Russell , Repp Alan C.
Published: November 2015

This study was a descriptive analysis of the role that staff-resident interaction, content of activity, and presence of teaching staff played on the stereotypy of three children with severe mental retardation and dual sensory impairments. The study also examined several characteristics of the instructional setting, including time allocation to various activities and percentage of staff interaction relative to the type of activity. Results indicated that staff-resident interaction was associated with dramatic reductions in the stereotypy of each child, that the type of activity was associated with differential responses across children, and that the presence of certified teaching staff was associated with reductions in stereotypy. Results also indicated an extremely low level of staff-resident interaction despite adequate staff-resident ratio.
A Survey of Nondisabled Employees' Attitudes toward Supported Employees with Mental Retardation
Authors: Shafer Michael S. , Rice Martha Larus , Metzler Helen M. D. , Haring Michael
Published: November 2015

A survey was administered to 212 co-workers of supported employees with mental retardation. The purpose of the survey was to assess the perceptions and experiences of nondisabled employees with co-workers with mental retardation. Results suggest that contact in the workplace does not significantly affect the attitudes of nondisabled employees regarding the social and vocational competence of individuals with mental retardation. Results also indicate that the attitudes of nondisabled employees are not significantly affected by the level of mental retardation experienced by their supported employment co-workers. The results also suggest that the majority of contact between nondisabled employees and supported employees concentrated on task performance; very little contact between employees was reported during breaks at work and after work hours. These results are discussed in light of their implications for supported employment providers.
The Application of a Self-Management Program on Instruction-Following Skills
Authors: Agran Martin , Fodor-Davis Julie , Moore Stephen , Deer Marlene
Published: November 2015

The effects of a multicomponent self-management program on the instruction-following behaviors of five students with moderate to severe intellectual disabilities are investigated in a vocational skills training program that included self-generated verbal prompts, picture cues, double instructions, and reinforcement. Training components for individual participants were added as needed to facilitate task performance. The percentage of appropriate responses to both trained and untrained instructions was evaluated within a multiple baseline design. Results demonstrated that training was effective in teaching the students to respond appropriately to instructions. Furthermore, the findings suggested that the students learned to respond to novel instructions. Suggestions for using flexible self-management programs, in which training components are established as effective for individual participants, are discussed.
Supporting Families of Children with Severe Disabilities
Authors: Cohen Shirley , Agosta John , Cohen Judith , Warren Rachel
Published: November 2015

This article addresses the issue of how best to provide families of children who have severe disabilities with the support services they need to maintain their well-being. Relevant federal and state programs for family-related services are analyzed, and current service themes are discussed. Principles for program design are presented, and recommendations for policy are offered.
Partners in Policymaking: Empowering People
Authors: Zirpoli Thomas J. , Hancox David , Wieck Colleen , Skarnulis Edward R.
Published: November 2015

Advocacy for people with disabilities and their families has evolved from the provision of public protective services to private and independent advocacy service groups, and finally to self-advocacy. This article describes one empowerment and self-advocacy training program for parents of young children and individuals with disabilities. An overview of the Partners in Policymaking program and the participants is provided along with Year 1 outcomes. The benefits of self-advocacy and the need for additional training programs are stressed.
The Effects of Preference on Spontaneous Verbal Requests in Individuals with Autism
Authors: Dyer Kathleen
Published: November 2015

Children with autism are characterized by the absence of functional spontaneous speech. This study assessed whether the type of stimulus materials (preferred versus nonpreferred) would affect the frequency of spontaneous verbal requests in these children. The results of the repeated reversals analysis revealed that the frequency of spontaneous verbal requests was higher in the preferred materials condition than in the nonpreferred materials condition. The results are discussed in relation to issues involving motivation and the development of naturalistic, context-appropriate speech training procedures.
Social Contacts of Adults with Severe Disabilities Living in the Community: A Descriptive Analysis of Relationship Patterns
Authors: Kennedy Craig H. , Horner Robert H. , Newton J. Stephen
Published: November 2015

Social integration and social support are critical elements in determining a person's quality of life. To date, however, very little descriptive information is available on patterns of social contact between persons with severe disabilities and typical members of local communities. This report presents information on the social interaction patterns of 23 adults with severe disabilities across a 2 1/2-year time period. The staff in small, community-based residential programs collected continuous counts of the activities performed by residents and the people (companions) with whom activities were performed. Only those contacts that occurred with people other than people paid to provide support or other residents in the program were counted. The results indicate great variability in the social contact patterns across the 23 people observed, but that on the average they had contact with 63.5 different companions across the 30 months of observation. Social contacts occurred on the average of once every 2 days, and the durability of social contacts indicated that companions seldom continued the relationship beyond a 12-month period, except for family members or someone perceived as a “best friend.” Examination of the final year of observation indicates that the 23 people met about 17 new individuals across the 12-month period. The report offers implications of these results for further research on social contacts and the development of support strategies for building and maintaining social relationships.
The McGill Action Planning System (MAPS): A Strategy for Building the Vision
Authors: Vandercook Terri , York Jennifer , Forest Marsha
Published: November 2015

The McGill Action Planning System (MAPS) is a planning process that places primary emphasis on the integral involvement of learners with disabilities in the school community (i.e., regular classes and other typical school environments and activities). The seven key questions that comprise the MAPS process provide a structure that assists teams of adults and children to creatively dream, scheme, plan, and produce results that will further the inclusion of individual children with labels into the activities, routines, and environments of their same-age peers in their school community. This article provides a detailed description of the MAPS process, including the structure used, content covered, and the underlying assumptions of the process. An example of MAPS planning for an elementary age child with severe disabilities is provided, along with suggested modifications that have been used for secondary age students. The final discussion addresses practical considerations for using MAPS, including how it complements an ecological approach to curriculum development and areas requiring further development and evaluation.
Acquisition and Maintenance of Toothbrushing Skills by Students with Cerebral Palsy and Mental Retardation
Authors: Snell Martha E. , Patrice A. , Houghton Ann
Published: November 2015

Although partial participation is used widely within educational programs for persons having severe mental or motor disabilities, there are few studies that target partial participation of a task rather than independent performance. One variation of partial participation requires that caregivers perform the task components that are not motorically feasible for a person, while teaching the student to perform the remaining components. In this study, three toothbrushing tasks (brushing teeth, rinsing, and wiping mouth) were analyzed into steps, some which the teacher performed and others that were taught to the student. The participants were 3 elementary-aged students with quadriplegic cerebral palsy and severe to profound mental retardation. Intervention procedures included time delay to fade physical prompts, reinforcement, and error correction. Instruction occurred daily in a self-contained public school classroom over a single school year, with follow-up probes conducted during the subsequent 2 years. A multiple probe design across tasks was employed to evaluate treatment effects. Daily training data and probes of performance indicated that 2 of the 3 students reached criterion on all three tasks, while 1 student reached criterion on one task. All students maintained performance on one or more tasks when measured 4 and 19 months following intervention.
User-Friendly Measures of Meaningful Outcomes: Evaluating Behavioral Interventions
Authors: Meyer Luanna , Janney Rachel
Published: November 2015

This article describes principles and practices of data collection to evaluate the attainment of meaningful outcomes in educational services for students with severe disabilities and serious behavior problems. In contrast to a limited outcome such as a temporary change in one target behavior in a controlled clinical setting, an expanded definition of effectiveness would require evidence of a range of more meaningful outcomes for child, school, family, and community. Several user-friendly measures to document such outcomes are described, which were field-tested in an educational consultation project serving students with severe disabilities and challenging behaviors in integrated schools. The article concludes with a discussion of the advantages of an emphasis upon both meaningful outcomes and the use of measurement strategies that blend well and have high utility for typical schools while simultaneously increasing programmatic rigor and general school responsibility for what happens to students.
Supported Employment: Promises Deferred for Persons with Severe Disabilities
Authors: Kregel John , Wehman Paul
Published: November 2015

The extent of supported employment participation by individuals with severe or profound disabilities was investigated through an analysis of the employment histories and functional characteristics of 1,411 individuals involved in supported employment programs in eight states. Results indicated that individuals currently participating in supported employment possessed very limited previous employment experience, yet did not possess functional characteristics indicative of individuals with severe or profound disabilities. Persons with severe or profound disabilities were found to be minimally represented in current supported employment efforts, representing less than 8% of all individuals investigated. Based upon the results of the study, recommendations are offered to enhance the opportunities of individuals with severe or profound disabilities to benefit from the national supported employment initiative, including the need for further research and demonstration activities and the necessity of immediate modification of federal and state supported employment policies.
Conducting a Functional Assessment of Problem Behavior in Applied Settings
Authors: Lennox David B. , Miltenberger Raymond G.
Published: November 2015

Researchers have recently called for a greater emphasis on the use of functional assessment procedures in the selection of treatment strategies for problem behavior in persons with mental retardation. In applied settings there are several methods available for conducting a functional assessment. This article identifies and describes three methods that have been used in applied behavior analysis research: informant assessment (e.g., behavioral interviews, rating scales, and questionnaires), direct observation assessment, and experimental analysis. Although experimental analysis provides the most conclusive information regarding controlling variables for a behavior problem, less rigorous methods of assessment also yield important information with which to select and evaluate treatment strategies. This article reviews the strengths and weaknesses of each functional assessment method and provides a case example to illustrate the use of the various assessment procedures.
Evaluation of Community-Based Support Services for Families of Persons with Developmental Disabilities
Authors: Singer George H. S. , Irvin Larry K. , Irvine Blair , Hawkins Nancy , Cooley Elizabeth
Published: November 2015

This article presents an evaluation of a multi-element parent and family support intervention for parents of school-aged persons with severe disabilities. Using an experimental design, we compared two randomly assigned groups of parents: one group received a modest level of support consisting of respite care and case management, and the second group received an intensive intervention that consisted of stress management and parenting skills training, support groups, and additional community-based respite care. Separate MANCOVA analyses were conducted for mothers and fathers. Mothers showed significant improvement on measures of depression and anxiety. Further analysis of the data revealed that a significantly greater number of intensive support group members also achieved clinically significant improvement on measures of anxiety and depression. Fathers participated in smaller numbers than mothers. A power analysis revealed large treatment effects for fathers as well as mothers although, due to the small sample size, the results for fathers were significant at p = 0.07. Analyses of 1-year follow-up data revealed that treatment gains maintained for mothers. We discuss the results and limitations of this study in light of current efforts to create family support services nationwide.
Communication Options for Persons with Severe and Profound Disabilities: State of the Art and Future Directions
Authors: Mirenda Pat , Iacono Teresa , Williams Robert
Published: November 2015

This article reviews the literature related to issues of communication augmentation for individuals with severe and profound intellectual disabilities within the framework of the “Participation Model” (Rosenberg & Beukelman, 1987). This model consists of a communication opportunity strand and a communication access strand. The opportunity strand is discussed briefly in terms of the knowledge and attitudinal barriers that may limit communication, with suggestions for remediation of these problems. The access strand is discussed in detail, beginning with a review of current methods of assessing capability in relevant domains. The relevant literature related to the learning characteristics of both unaided and aided communication techniques is reviewed next, followed by a discussion of potential external constraints that may affect the range of options for consideration. This information facilitates the next step of selecting communication options with a view to the current and future needs and capabilities of the individual. Following this, a review is presented of vocabulary selection and effective instructional techniques in augmentative communication interventions. Finally, evaluation issues are discussed in relation to level of disability.
Analysis of Co-Worker Involvement in Relation to Level of Disability versus Placement Approach among Supported Employees
Authors: Rusch Frank R. , Johnson John R. , Hughes Carolyn
Published: November 2015

This study describes patterns of co-worker involvement among 264 supported employees in relation to level of disability versus placement approach (i.e., individual, clustered, crew). Results indicated that supported employees extensively associate with their nonhandicapped co-workers, followed by co-workers evaluating and training these same supported employees. Supported employees who were members of mobile work crews, however, experienced far less co-worker involvement than their colleagues who were employed in clustered or individual placements. Differences in levels of co-worker involvement provided were observed to relate less to level of disability than to type of placement.
The Use of High-Probability Requests to Increase Compliance with Instructions to Take Medication
Authors: Harchik Alan E. , Putzier Valerie S.
Published: November 2015

A simple, positive procedure was used to increase the number of times that a woman with severe disabilities complied with requests to take prescribed oral medication. The procedure involved asking the woman to follow a number of requests with which she typically complied, reinforcing her compliance with these requests, and then presenting the request to take the medication. The procedure was implemented by direct-care staff during their daily ongoing responsibilities and was functionally related to increases in the number of times that she complied with the request to take her medication.
Playing for Fun, Training for War
Authors: Sparrow Robert , Harrison Rebecca , Oakley Justin , Keogh Brendan
Published: November 2015

In the cultural controversy surrounding “violent video games,” the manufacturers and players of games often insist that computer games are a form of harmless entertainment that is unlikely to influence the real-world activities of players. Yet games and military simulations are used by military organizations across the world to teach the modern arts of war, from how to shoot a gun to teamwork, leadership skills, military values, and cultural sensitivity. We survey a number of ways of reconciling these apparently contradictory claims and argue that none of them are ultimately successful. Thus, either military organizations are wrong to think that games and simulations have a useful role to play in training anything other than the most narrowly circumscribed physical skills or some recreational digital games do, in fact, have the power to influence the real-world behavior and dispositions of players in morally significant ways.
Problematic Mobile Gameplay Among the World’s Most Intense Players
Authors: Seok Soonhwa , DaCosta Boaventura
Published: November 2015

This study investigated problematic mobile gameplay. Adopting Diagnostic and Statistical Manual of Mental Disorders-style criteria for pathological gambling to identify cases of problematic play, the study compared the mobile gaming habits, preferences, and demographics of problematic and nonproblematic game players. Of the 1,950 mobile players sampled, 3% ( n = 58) demonstrated signs of possible pathological behavior. The nonproblematic players showed characteristics identifiable with the casual mobile game player, who plays as a quick distraction to pass time when waiting or out of boredom. By comparison, the problematic players were found to play as a means of avoiding responsibilities and as a possible distraction from pain and discomfort. The findings help substantiate claims that mobile gameplay is a casual activity at least for the majority of individuals. However, for some, mobile gaming can interfere with different aspects of life and, in worst cases, may lead to pathological dependence.
TB or not TB? Diagnostic difficulties in HIV-positive versus HIV-negative tuberculosis patients with an immigration background in Germany
Authors: Ennemoser Kerstin , Singh Daman Deep , Hüttig Falk , MacKenzie Colin , Müller-Stöver Irmela , Holtmann Henrik , Kocheril Sunil José , Holtfreter Martha C , Richter Joachim
Published: November 2015

Patients immigrated or born to immigrated parents constitute an increasing proportion of TB in Germany. This study aimed to assess the clinical presentation and outcome of immigrated TB-monoinfected (TB/HIV–) patients versus TB patients with an HIV coinfection (TB/HIV+). Ninety-three patients (36 boys/men, 57 girls/women; age range, 2–59 years) were investigated of whom 47 were TB/HIV+ and 46 TB/HIV–. TB/HIV+ patients more frequently had an African background (76.6% [36/47], P <0.001), TB/HIV– patients (63.0% [29/46]) more often had an East-European or Asian background ( P <0.001). Most common symptoms included lymphadenopathy (37.6% [35/93]) and weight loss (35.5% [33/93]). In TB/HIV+ patients acute presentation was more frequent including fever (57.4% [27/47]), gastrointestinal (44.7% [21/47]), and respiratory symptoms (36.2% [17/47]). TB skin test was highly positive in all performed cases (20/20), IGRA was positive in 98.2% (55/56) cases applied. Pulmonary involvement was relatively rare (51/93 [54.8%]), especially in TB/HIV– patients (36.10% [17/46]) vs. TB/HIV+ (70.23% [36/47]; P <0.001). An infectious etiology was suspected in only 43.5% (20/46) TB/HIV– vs. 72.3% (34/47) TB/HIV+ patients ( P ⩽0.005); a malignancy was suspected in (21/46 [45.7%] TB/HIV– patients vs. 12/47 [25.5%] TB/HIV+; P ⩽0.043). The diagnostic delay between first presentation to a doctor and TB diagnosis was long in all cases, especially in TB/HIV– patients (range, 0–336 weeks; median, 8 weeks vs. TB/HIV+ patients; range, 0–288 weeks; median, 0 weeks; P <0.05). TB, especially in young immigrated HIV– patients frequently presents as an atypic extrapulmonary disease, which may end up in a delayed diagnosis of up to several years.
Neutrophil proteolytic activation cascades: a possible mechanistic link between chronic periodontitis and coronary heart disease
Authors: Alfakry Hatem , Malle Ernst , Koyani Chintan N , Pussinen Pirkko J , Sorsa Timo
Published: November 2015

Cardiovascular diseases are chronic inflammatory diseases that affect a large segment of society. Coronary heart disease (CHD), the most common cardiovascular disease, progresses over several years and affects millions of people worldwide. Chronic infections may contribute to the systemic inflammation and enhance the risk for CHD. Periodontitis is one of the most common chronic infections that affects up to 50% of the adult population. Under inflammatory conditions the activation of endogenous degradation pathways mediated by immune responses leads to the release of destructive cellular molecules from both resident and immigrant cells. Matrix metalloproteinases (MMPs) and their regulators can activate each other and play an important role in immune response via degrading extracellular matrix components and modulating cytokines and chemokines. The action of MMPs is required for immigrant cell recruitment at the site of inflammation. Stimulated neutrophils represent the major pathogen-fighting immune cells that upregulate expression of several proteinases and oxidative enzymes, which can degrade extracellular matrix components (e.g. MMP-8, MMP-9 and neutrophil elastase). The activity of MMPs is regulated by endogenous inhibitors and/or candidate MMPs (e.g. MMP-7). The balance between MMPs and their inhibitors is thought to mirror the proteolytic burden. Thus, neutrophil-derived biomarkers, including myeloperoxidase, may activate proteolytic destructive cascades that are involved in subsequent immune-pathological events associated with both periodontitis and CHD. Here, we review the existing studies on the contribution of MMPs and their regulators to the infection-related pathology. Also, we discuss the possible proteolytic involvement and role of neutrophil-derived enzymes as an etiological link between chronic periodontitis and CHD.
Using the Behaviour Change Wheel in infection prevention and control practice
Authors: Atkins Lou
Published: November 2015

The Centre for Behaviour Change at University College London (UCL) is a new venture that has grown out of the work that we have been doing in the Health Psychology Research Group at UCL and seeks to harness the different pockets of behaviour change work in different disciplines across UCL. A lot of our work in health focuses on the adoption of evidence-based guidelines in practice; not just designing and evaluating interventions, but also developing usable tools for people who are tasked with changing behaviours. These tools aim to enable those who do not necessarily have a background in behavioural science to understand the behaviours they are trying to change and design appropriate interventions.
Power and Categorization
Authors: Smith Pamela K. , Smallman Rachel , Rucker Derek D.
Published: November 2015

Across three experiments, participants formed a larger number of categories when in a state of high, compared to low, psychological power. Moreover, in contrast to prior categorization research, which suggests forming more categories is tantamount to reduced breadth of categorization, high-power participants also formed a larger number of superordinate (i.e., more abstract) categories than low-power participants. The present findings enhance the understanding of power in relation to categorization and simultaneously highlight the distinction between number and abstraction as fundamental aspects of categorization.
Crystal structure and chemistry of natural kutinaite from Černý Důl, Krkonoše, Czech Republic
Authors: Bindi Luca , Makovicky Emil
Published: November 2015

We have characterized the crystal structure of natural kutinaite, a rare mineral from the ores of Černý Důl, Czech Republic, by single-crystal X-ray diffraction and chemical analysis. We found that the structure of natural kutinaite is not identical to that of synthetic Cu14Ag6As7, previously reported to be cubic, space group Pm3m. Although topologically similar, the structure of natural kutinaite is indeed tetragonal, space group P4/mmm, with cell parameters: a = 11.789(2), c = 11.766(2) Å, V = 1635.5(4) Å3 and Z = 4. Electron microprobe analyses pointed to the (K,Tl)0.25Cu14Ag6As6.75 stoichiometry (Z = 4), or (K, Tl)Cu56Ag24As27 with Z = 16. The crystal structure of an untwinned crystal has been refined to R1 = 2.61%. It consists of clusters of eight edge-sharing tetrahedra of Cu, which alternate in a 3D chess-board manner with octahedral clusters of six Ag atoms. The latter are surrounded by triangularly coordinated copper in eight faces of a cuboctahedron. The last structure components are large cavities containing partly occupied (K,Tl) sites, coordinated by 18 Ag and As ligands. The structure is full of direct metal-metal contacts although As plays the role of anion, associating especially with copper.