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PubMed2006

Teachers' perceptions of remediation possibilities of Dutch students in special education.

BACKGROUND: Research suggests that referral practices of teachers in regular education are not only affected by the level of learning difficulties but also by student behaviour and the level of students' parental involvement in education. It was hypothesized that teachers maintain a notion of the 'ideal' student, who has relatively good academic skills, is well behaved and has highly involved parents. AIMS: The main question of this study was whether special-education teachers' perceptions regarding remediation possibilities are similarly affected by student behaviour and the level of students' parental involvement. SAMPLE: Nineteen experienced Dutch school teachers in special education each evaluated four students: two with relatively high and two with relatively low academic performance. METHODS: Three questionnaires to assess learning difficulties, behavioural problems and the level of parental involvement were developed. RESULTS: Teachers' perceptions of remediation possibilities were related to the severity of the learning difficulties and academic skill. Academic skill, in turn, was strongly related to the perception of the children's behavioural problems and parental involvement, which, in turn, links the perception of remediation possibilities indirectly to children's behavioural problems and parental involvement. CONCLUSIONS: Special education teachers may also hold an image of the 'ideal' student. Students with high academic achievement levels are perceived as having fewer behavioural problems and more highly involved parents than students with low academic achievement levels. Whether this is due to justified or unjustified teachers' perceptions is a matter for future research. What is important is that stereotyping of students (justly or not) poses a serious problem for the Dutch reintegration policy.

Achievement↗

PubMed1999

Cognitive style and types of problem behaviour in boys in special schools.

BACKGROUND: The paper considers problem behaviour in the context of cognitive style with reference to both diagnosis and treatment. AIMS: The aims of the study were to investigate whether the style of pupils with behaviour problems was different to that of children with no reported problems, and also to consider how pupils of different style manifested their problem behaviours. SAMPLE: The sample comprised 131 male pupils aged 11-16 years from eight special schools. METHOD: The sample were given the Cognitive Styles Analysis to assess their positions on the Wholist-Analytic and Verbal-Imagery style dimensions. The case notes of the sample were also examined for descriptions of recent behaviours. RESULTS: When the style characteristics of the special school sample were compared with a comparison sample of 413 12-16 year-old males attending 10 secondary schools, the special school pupils had a significantly higher proportion of both Wholists and Verbalisers than the comparison group. Further, the inspection of the pupil records indicated that the types of social behaviour and behaviour problems exhibited varied with style. CONCLUSION: The results were considered to have implications for the origins and treatment of problem behaviour.

Adolescent↗

PubMed2003

Access to specialty medical care for children with mental retardation, autism, and other special health care needs.

Access to specialty medical care among children with mental retardation, autism, or other types of special health care needs was examined. Results from a national survey indicate that over a third of the children with autism, over a fifth with mental retardation, and over a fifth with other types of special health care needs had problems obtaining needed care from specialty doctors in the preceding year. The most common problems included getting referrals and finding providers with appropriate training. Children with unstable health conditions, autism, or those whose parent was in poor health were at greater risk for problems. Primary Medicaid coverage and public secondary health coverage were associated with fewer access problems. Implications for health services for children with special health care needs are discussed.

Adolescent↗

PubMed2005

Importance of experimental as well as empirical qualitative studies in special education.

In the past few decades qualitative research has increasingly appeared in special education journals. However, much of this work falls within the parameters of producing useful technical information that can be applied to the contexts where children and adults with disabilities learn, work, and live. Experimental qualitative studies that rely on postmodern or poststructural analyses, critical theory, and narrative research with subjective personal stories seem to be considered too radical, ideological, and theoretical to make it into many special education scholarly outlets. We argue that experimental qualitative designs have much to contribute to the fields of special education and disability studies and, hence, should reach those who receive or provide services to people with disabilities.

Persons with Disabilities↗

PubMed1997

Preliminary comparison of scores of special education and regular students on the Eysenck Personality Questionnaire for Children.

The scores were compared for 11 students from Special Education and 15 from the regular program on the Eysenck Personality Questionnaire for Children. Analysis showed that the students in Special Education obtained lower scores on Extraversion and higher ones on Neuroticism, Psychoticism, and the Lie Scale. An intervention to promote relaxation and improve self-esteem, communication, and cooperation of the students was proposed. The Special Education sample was small, so another study with a larger more representative sample was recommended.

Adolescent↗

PubMed2006

A comparison of mainstream and special education for teenagers with Down syndrome: implications for parents and teachers.

This article presents data from a research study designed to compare the achievements of teenagers with Down syndrome educated in mainstream classrooms or in special education classrooms throughout their full-time education. Progress is reported for speech and language, literacy, socialisation, daily living skills and behaviour. For all the teenagers, there is evidence of progress with age on all the measures except for communication. Communication continued to improve through teenage years for the included children but not for those in special education classrooms. There were no significant differences in overall outcomes for daily living skills or socialisation. However, there were large significant gains in expressive language and literacy skills for those educated in mainstream classrooms. Teenagers educated in mainstream classrooms showed fewer behavioural difficulties. Further, comparison with data published by these authors in an earlier study, showed no improvements in school achievements in special education over a 13 year period in the UK (1986-1999).

Activities of Daily Living↗

PubMedDate not supplied

Cognitive rehabilitation: a neuropsychological speciality comes of age.

In its first decade cognitive rehabilitation has emerged from infancy with the energy and much of the turmoil of youth. It has become an established speciality in brain-injury rehabilitation and has inspired many neuropsychologists to broaden their expertise beyond diagnosis and address their efforts to intervention. Restoration, although controversial, is an important and valid goal at the outset of cognitive rehabilitation, whereas the substitution of other means of goal achievement and environmental redesign are significant components of a comprehensive neuro-rehabilitative treatment programme. Efficacy is being demonstrated in many ways, ranging from increased patterns of use to controlled empirical studies. Few continue to raise the naive issue of whether there is any scientific basis for this neuropsychological speciality; instead, questions have become more focused on understanding the process of change to best serve human needs. In the next decade the refinement of current approaches can be anticipated, as well as the breaking of new ground. Neuropsychologists specializing in cognitive rehabilitation are likely to be turning their attention to underserved populations, such as those emerging from protracted coma, individuals suffering from 'progressive' neurological conditions, and persons whose brains were injured early in development. Scientific (theoretical, methodological and empirical) developments in cognitive psychology will help to delve more precisely into the underlying basic processes, including the sensory substrate. We will be challenged to address specific applications, such as advising people with known or suspected cognitive deficits who wish to drive.

Brain Damage, Chronic↗

PubMed1997

Twenty-one-year survival of primary hypertensive patients allocated to care in general practice or in specialized hypertension clinic. An observational study of 831 hypertensive patients.

After initial diagnostic and therapeutic assessment at a specialized hypertension clinic, 831 patients with primary hypertension were during a 15-year period allocated to continuing care management either by their general practitioner or by the out-patient department of the hypertension clinic. At a given date survival was assessed in the two groups: general practice (n = 437, 233 males, 214 females) and specialized hypertension clinic (n = 394, 208 males, 186 females). Median observation time for both groups was 11 years, the longest observation time was 21 years, 8 months. There were no significant differences between the groups concerning age at entry, pretreatment clinical status, pretreatment blood pressure or treated blood pressure level before allocation. The patients in the two groups had the same access to hospitalization when needed. Judged by a Cox regression model, no difference in survival between the two groups could be registered. No differences were found between the causes of death in the two treatment groups, the main cause of death in both groups being ischaemic heart disease. Our results indicate that after initial diagnostic assessment and adjustment, the management of treatment care in a specialized hypertension clinic offers no advantage concerning survival compared to management of care in general practice.

Cause of Death↗

PubMed2000

Enhancing geriatric nursing scholarship: specialization versus generalization.

This article explores the relative merits of encouraging preparation of more nurses with specialization in geriatrics as compared to encouraging geriatric preparation among nurses whose major field of study is outside geriatrics. The article explores two approaches to examining capacity for geriatric nursing scholarship among nurse scholars not involved in geriatrics, and in schools of nursing with strength in research but with little geriatric research. The findings show an ongoing need to strengthen geriatric nursing as an area of specialization. Faculty prepared in geriatric nursing are underrepresented in schools of nursing, and only a small number of doctoral students specialize in geriatric nursing. Academic nursing programs with strength in geriatric nursing need ongoing support to maintain and expand current geriatric programs. Data support that encouraging individual non-geriatric nurse faculty and doctoral candidates to focus their work on areas of concern to geriatric nursing, and strengthening geriatrics in research-intensive schools of nursing that have not heavily invested in geriatric scholarship are viable options for strengthening academic geriatric nursing. Establishing mechanisms to attract nurse scholars working outside the scope of geriatric nursing to address clinical issues of concern to older adults offers promise in rapidly attracting new scholars to geriatric nursing.

Adult↗

PubMed1986

A holistic approach to specialization.

There is a growing concern that extensive specialization in occupational therapy may so fragment the profession that it may be lost in the changes taking place in the delivery and payment of health care services. The early concepts of occupation and purposeful, developmentally appropriate activities are giving way in some settings to the use of highly specialized technologies. This article examines the trend of leaving occupational behaviors and adopting activity of a more technical nature and offers a conceptual model to preserve the traditional holistic approach to the practice of occupational therapy in today's climate of specialization. The approach is seen as important to the viability of the profession in a modern competitive health care market.

Community Health Services↗

PubMed1995

Surgical referrals as evidence of a de facto podiatric medical specialization.

The authors present evidence on the patterns and correlates of surgical referrals to podiatric physicians that suggests a surgical specialty now exists in podiatric medicine. The primary factors on which surgical specialization appears to be based are residency training, hospital medical staff membership, and increased hospital podiatric practice activity. Surgically specialized podiatric physicians tend to be younger, but such specialization is not related to either the gender or race of podiatric physicians.

Adult↗

PubMed1993

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services; nonavailability statements; peer review organization program; supplemental care--DoD. Final rule.

This final rule: establishes a Specialized Treatment Services Program, under which CHAMPUS beneficiaries in need of certain highly specialized medical care will be referred to specially designated national or regional, military or civilian treatment facilities; revises a number of procedures applicable to the CHAMPUS Peer Review Organization program; and expands reliance on CHAMPUS payment rules and procedures for purposes of the supplemental care program, which applies to services provided by civilian providers to active duty members and certain other patients referred by military providers.

Economics, Medical↗

PubMed1995

Rethinking disability policy: equity in the ADA era and the meaning of specialized services for people with disabilities.

An analysis of disability policy suggests that policy-makers have pursued two strategies to treat people with disabilities equally. In one approach, categories of people with disabilities were identified and provided with specialized services. In the second, categories of services were provided to people with disabilities on a specialized basis. In both cases, the implication is that people with disabilities are so different a class of people that society should not be required to adapt to their presence. In this article, the authors suggest that the new equity standard established by the Americans with Disabilities Act makes such specialized services inappropriate and suggests a general three-prong strategy for including the needs of people with disabilities in mainstream policy-making. This strategy addresses education and training needs, health care reform, and civil rights enforcement.

Persons with Disabilities↗

PubMed1998

Virtual environments special needs and evaluative methods.

This paper presents an overview of the development of the Learning in Virtual Environments programme (LIVE), carried out in special education over the last four years. It is more precisely a project chronology, so that the reader can sense the historical development of the programme rather than giving emphasis to any one particular feature or breakthrough, which are covered in other papers and available through the authors. The project conception in a special school in Nottingham is followed by a description of the development of experiential and communicational virtual learning environments. These are followed, in turn, by the results of our testing programmes which show that experience gained in a virtual environment can transfer to the real world and that their use can encourage self-directed activity in students with severe learning difficulties. Also included is a discussion of the role of virtual learning environments (VLEs) in special education and of its attributes in the context of contemporary educational theory.

Activities of Daily Living↗

PubMed2002

[Finland launches special competence program in traffic medicine].

Postgraduate specialist training in medicine is organized in Finland by the country's five medical faculties. Training is completed with a written examination, compulsory since 1962. The recently revised programme comprises 49 specialties, 16 of which stipulate five years, and 33 six years of training. State authorization is provided after successful completion of the programme. In addition, the Finnish Medical Association (FMA) has run a complementary training programme since 1993, covering selected and often interdisciplinary branches of medicine. There are 31 such FMA-authorized training programmes leading to special competence. A training programme for special competence in traffic medicine was approved in 1997, aiming to establish a network of traffic medicine experts throughout the country. The need for doctors trained in traffic medicine is estimated to be 1:100,000 inhabitants. In addition to the seven members of the examination board, 17 doctors have received such special competence.

Accidents, Traffic↗

PubMed2003

[Role of disabled children's school as regional special education center].

The final report of the Collaborative Research Conference on Special Education in the 21th Century pointed out that supportive activities, such as education, welfare, medical care and labor should be strengthened to provide special support for disabled children, and that measures should be taken for school children requiring medical care in daily life, in response to an increasing number of children with severe and multiple disabilities and other social changes. Recent great progress in pediatric medicine has enabled these children to attend schools for the physically handicapped which provide more specialized educational support. At present, support for these children is still insufficient. This symposium discusses these problems as well as future prospects of disabled children's schools.

Child↗

PubMed2005

A national study of the relationship of care site HIV specialization to early adoption of highly active antiretroviral therapy.

BACKGROUND: Little is known about characteristics of organizations that predict early adoption of highly active antiretroviral therapy (HAART) for persons with HIV infection. OBJECTIVES: To describe characteristics of sites where HIV care is provided and to assess site characteristics that predict early adoption of HAART. DESIGN: Cross-sectional analysis of survey data from patients, HIV physicians, and medical directors. PATIENTS AND SETTING: Participants in the HIV Cost and Services Utilization Study, a national probability sample of persons with HIV who received outpatient care in the continental United States during 1996. MAIN OUTCOME MEASURE: Rates of exposure to HAART by December 1996. RESULTS: Nationally, 79% of patients were treated at sites specializing in HIV care (HIV sites). Over 90% of patients were cared for by physicians who were experts in HIV care, either infectious disease specialists (46%) or general medicine experts (45%). Adjusted rates of exposure to HAART by December 1996 varied from 0.02 to 0.79 across sites (mean rate, 0.33). In multivariable models, HIV specialization (odds ratio [OR], 3.6; P < 0.001), total patient volume of more than 20,000 visits a year (OR, 2.1; P < 0.01), and educational level of the zip code in which the site was located (OR, 1.2 for each 10% increase in college education) were associated with higher rates of exposure to HAART. These effects persisted after adjustment for physician HIV expertise. Site effects were more important than physician effects in explaining rates of exposure to HAART. CONCLUSION: In 1996 there were wide variations in rates of HAART use by site of care. Low-volume sites that do not specialize in HIV care should take measures to ensure that HIV expertise is available to their patients.

Adult↗

PubMed1992

Specialism and generalism in the future of general surgery.

The progressive specialism that has characterized the practice of medicine over the last 100 years has occurred almost entirely in a scientific context. Societal needs and social changes have had little influence. As we near the end of the 20th century the benefits of scientific specialism are being questioned. New historical studies of specialism have shown that factors other than new knowledge are the driving force for the creation of some subspecialties. The process by which a new subspecialty is established requires both a national institute and a certification examination. Certification is intended to identify those with specific knowledge and skill by inclusion, but is being perceived increasingly as a process that works by exclusion. General surgery, one of the few "generalist" disciplines, finds itself at a crossroads. Further subspecialization with certification will fragment and destroy the discipline. There are cogent arguments, based on economics and care-delivery issues, to preserve general surgery. Making this choice will commit general surgeons to accept the concept of scientific generalism and to the development of the specialty of general surgery in a social context.

Canada↗