The researcher examined school counselors’ and administrator’s perceptions of the readiness level to implement the American School Counseling Association (ASCA) National Model. The researcher evaluated the differences in perceived readiness, between counselors and administrators, across in each of the 7 ASCA National Model District Readiness Survey indicators (i.e., community support, leadership, guidance curriculum, school counselor’ beliefs and attitudes, school counselors’ skills, district resources, and staffing/time use). The researcher also addressed certain school and position characteristics that could be predictors of the readiness level. The predictor variables included: highest degree of education, age, student-to-counselor ratio, years of total experience in schools, years of counseling and/or administrative experience, gender, ethnicity, grade level of school, and school role. The research provided evidence that school counselors perceived their district to be ready in the areas of School Counselors’ Skills, and School Counselors’ Beliefs and Attitudes indicators. The areas where school counselors indicated they perceived their school district as minimally ready were Leadership, Community Support, and Guidance Curriculum. In the areas of Staffing/Time Use and District Resources, school counselors reported perceiving their school district as being not ready. School administrators perceived their district to be ready in the areas of Community Support, Leadership, Guidance Curriculum, School Counselors’ Beliefs and Attitudes, and School Counselors’ Skills indicators. The areas where school administrators indicated they perceived their school district as minimally ready were Staffing/Time Use and District Resources. There were no areas in which administrators reported perceiving their school district as being not ready. Based on school counselor perceptions, the “overall” readiness level of their district was minimally ready to implement the ASCA National Model. Based on school administrator perceptions, the “overall” readiness level of their district was ready to implement the ASCA National Model. The school counselor and administrator perceptions were significantly different across all 7 readiness factors of the ASCA National Model District Readiness Survey. The classification of school counselors and administrator was determined to account for 30.4% of the variance in the overall perception of district readiness level to implement the ASCA National Model.

The researcher examined school counselors? perceptions of the readiness level of school districts in Mississippi to implement the American School Counseling Association (ASCA) National Model. The researcher also addressed certain school and counselor characteristics that could be predictors of this level of readiness. The predictor variables included grade level of counselor?s school (elementary, middle, high school/vocational), number of years of counseling experience, years of experience as a classroom teacher, student-to-counselor ratio, age, race, and level of education (M.S., Ed.S., Ph.D.). The dependent variable was the school counselor?s perceived level of readiness of the school district based on their overall scores on the ASCA National Model District Readiness Survey. The researcher also examined the perceived readiness level of school districts in the State of Mississippi in each of the 7 ASCA National Model readiness indicators (i. e., community support, leadership, guidance curriculum, school counselors? beliefs and attitudes, school counselors? skills, district resources, and staffing/time use). Based on mean scores for the seven readiness indicators on the ASCA National Model District Readiness Survey, school counselors perceived two indicators as being ready to implement the ASCA National Model: School Counselors? Beliefs and Attitudes and School Counselors? Skills. School counselors perceived three indicators as being minimally ready: Community Support, Leadership, and Guidance Curriculum. School counselors perceived two indicators as being not ready to implement the ASCA National Model: District Resources and Staffing/Time Use. Based on school counselor perceptions, the ?overall? readiness level of Mississippi school districts to implement the ASCA National Model is a minimal level of readiness. For the dependent variable overall readiness level, student-to-counselor ratio and gender were the most influential predictor variables. Female school counselors perceived their school districts as being more ready to implement the ASCA National Model than male school counselors. Also, schools with lower student-to-counselor ratios perceived their school districts as more ready to implement the ASCA National Model than schools with higher student-to-counselor ratios.

Throughout the past century, many changes in the conceptualization of the school counselor have occurred. Although most states endorse a national model developed through the American School Counseling Association (ASCA), not all school and district personnel have changed their views of the school counselor role to the most current conceptualization. The focus of this study was to gather current information on principal perceptions of appropriate and inappropriate school counselor activities based on the ASCA model. Differences were examined in principal perceptions at the elementary and secondary levels, and between appropriate and inappropriate activities to see if principals ranked appropriate activities more highly. Differences were also examined in schools with Recognized ASCA Model Program (RAMP) designation and schools without RAMP designation. Results showed differences in perception between elementary and secondary principals, with secondary principals rating all counseling activities significantly higher than elementary school principals, although there were similarities in ratings between groups. Appropriate activities were rated significantly higher than inappropriate activities by principals overall as well as the elementary principal group and secondary principal group. There were no significant differences overall in RAMP versus non-RAMP school principal perceptions. Discussion includes reviewing specific activities where perceptions differed; how these results fit with previous research; and implications for policy and practice, future research, and higher education. / Doctor of Philosophy / Throughout the past century, many changes in the conceptualization of the role of the school counselor have occurred. Although most states endorse a national model developed through the American School Counseling Association (ASCA), not all school and district personnel have changed their views of the school counselor role to the most current conceptualization. The focus of this study was to gather current information on principal perceptions of appropriate and inappropriate school counselor activities based on the ASCA model. Differences were examined in principal perceptions at the elementary and secondary levels, and between appropriate and inappropriate activities to see if principals ranked appropriate activities more highly. Differences were also examined in schools with Recognized ASCA Model Program (RAMP) designation and schools without RAMP designation. Results showed differences in perception between elementary and secondary principals, with secondary principals rating all counseling activities significantly higher than elementary school principals, although there were similarities in ratings between groups. Appropriate activities were rated significantly higher than inappropriate activities by principals overall as well as the elementary principal group and secondary principal group. There were no significant differences overall in RAMP versus non-RAMP school principal perceptions. Discussion includes reviewing specific activities where perceptions differed; how these results fit with previous research; and implications for policy and practice, future research, and higher education.

The American School Counseling Association (ASCA) created the American School Counseling National Model to guide best practices in the school setting. Professional school counselors are encouraged to implement this model in order to increase student achievement and personal/social growth through a comprehensive school counseling program. Although this is the recommended model for school counselors, many districts have failed to implement it. This study examined the relationship among beliefs, various demographic variables, and program implementation to determine the combination of variables that would best explain the variance in program implementation. Data collected through the School Counseling Program Implementation Scale (SCPIS) and School Counseling Program Component Scale (SCPCS) instruments were analyzed through hierarchical multiple regression to determine regression models that best accounted for prediction of program implementation. Based on this research, school counselor beliefs in using data for program improvement accounted for the greatest degree of variance in specific model implementation.

INTRODUCTION: The techniques currently in practice to diagnose and assess interval disease activity in patients with inflammatory bowel disease (IBD) are costly and invasive. Physicians typically rely on information derived from a combination of endoscopic, radiologic, and histologic studies to diagnose and determine the extent and severity of the two most common forms of IBD, Crohn disease (CD) and ulcerative colitis (UC). The development of noninvasive methods of assessing response to therapy is of increasing importance to pediatric healthcare providers. Previous studies have demonstrated that serum and fecal biomarkers are reliable measures of inflammation in the gastrointestinal tract. However, existing biomarkers are non-specific and their levels can be elevated in the context of either acute and chronic inflammation (IBD) or infection. As such, further studies are required to develop newer and novel biomarkers that have greater specificity for use in the diagnosis and interval assessment in children and adults with IBD. OBJECTIVES: The goal of this study is to further assess the relationship between biomarkers in the stool and serum of patients with IBD that are being treated with the anti-TNF therapy, infliximab (Remicade). To accomplish this, we will assess the changes in serum and fecal biomarker levels over the course of treatment and correlate the changes in fecal and serum biomarker levels with clinical, biochemical, and endoscopic outcome variables. METHODS: We conducted a prospective longitudinal cohort study in pediatric patients with IBD receiving long-term immunosuppressive therapy with Remicade. Pediatric patients diagnosed with either CD or UC who receive Remicade at Boston Children’s Hospital were recruited. Patients were drawn from subsets of patients that were either naïve to Remicade, had received Remicade for less than 6 months, or had received Remicade for more than one year at the time of enrollment. We collected longitudinal data over the course of their first 6 consecutive infusions following enrollment, including blood and stool samples, disease activity indexes, as well as a patient-reported outcome measure (IMPACT-III Questionnaire) at each infusion session. RESULTS: A total of 33 patients with IBD who fit our eligibility criteria and provided informed consent were enrolled to date. Of these, 20 had a CD diagnosis and 13 had a UC diagnosis. We collected baseline serum, fecal, and IMPACT-III score data and followed enrolled patients over the course of subsequent infusions. Mean baseline fecal ASCA levels from 8 CD and 6 UC patients were 0.08±0.021 OD and 0.02±0.0015 OD, respectively. At baseline, serum lactoferrin (p<0.10), calprotectin (p<0.10), ESR (p<0.05), and CRP (p<0.10) were significantly higher among CD patients. CONCLUSION: Our data demonstrate the potential for serum and fecal biomarkers to evaluate therapeutic response to Remicade. Completion of study enrollment and data collection will be necessary to determine if individual or combinations of fecal and serum biomarkers yield the most robust measures for use in the diagnosis and interval assessment of children and adults with IBD.

This study examines the alignment between Arizona public high school Administrators' expectations of professional school counselors, the ASCA National Model (2005), and the instruments used in Arizona to evaluate professional school counselors. Participants included ten principals and assistant principals, and 103 of the 111 public school districts with at least one high school in Arizona. Data was obtained through semistructured interviews, document, and content analysis. Organizational Role Theory and Leader-Member Exchange Theory guided the qualitative and quantitative analysis. Findings indicate that administrators' expectations of professional school counselors align 62% with the ASCA National Model, while the instruments used in Arizona to evaluate professional school counselors align 13% with administrators' expectations of professional school counselors and 21% with the ASCA National Model. The best predictor of alignment was school district use of a school counselor-specific evaluation instrument. Recommendations focused on the need for clearer communication of role expectations between administrators and counselors, and for more meaningful evaluation practices that align with counseling standards.

Submitted by Pós Imunologia (ppgimicsufba@gmail.com) on 2017-06-05T19:24:17Z No. of bitstreams: 1 Dissertação Taiana final corrigida 16.02.2017 (1).pdf: 1211793 bytes, checksum: a20533e20682931dfb2ee45359c2edcf (MD5) / Approved for entry into archive by Delba Rosa (delba@ufba.br) on 2017-06-07T14:02:20Z (GMT) No. of bitstreams: 1 Dissertação Taiana final corrigida 16.02.2017 (1).pdf: 1211793 bytes, checksum: a20533e20682931dfb2ee45359c2edcf (MD5) / Made available in DSpace on 2017-06-07T14:02:20Z (GMT). No. of bitstreams: 1 Dissertação Taiana final corrigida 16.02.2017 (1).pdf: 1211793 bytes, checksum: a20533e20682931dfb2ee45359c2edcf (MD5) / Capes / INTRODUÇÃO: O lúpus eritematoso sistêmico é uma doença reumática autoimune caracterizada por múltiplas manifestações clínicas e laboratoriais, entre estas, a dislipidemia. Contudo, a imunopatogenia desta alteração metabólica no LES ainda não é bem conhecida. OBJETIVO: O presente estudo investigou o envolvimento de anticorpos na patogênese da doença obstrutiva coronária crônica de pacientes portadores de LES de um serviço de reumatologia de Salvador-Bahia. Especificamente, investigou a presença de anticorpos IgA anti-β2GPI e IgG anti-Saccharomyces cerevisiae em pacientes lúpicos e buscou associar a soropositividade para estes anticorpos com achados clínicos e laboratoriais indicadores de doença obstrutiva coronária crônica e história de acidente cardiovascular. MATERIAL E MÉTODOS: Cento e cinquenta mulheres portadoras de LES foram incluídas no estudo e classificadas para dislipidemia a partir dos seus lipidogramas. A atividade do LES foi avaliada com o SLEDAI-2K. Foram determinados os seguintes índices aterogênicos de risco cardiovascular: razão apoB/apoA, índices I e II de Castelli (CT/HDL-C e LDL-C/HDL-C, respectivamente) e a razão TG/HDL-C. Anticorpos antinucleares foram detectados por IFI, enquanto anticorpos contra autoantígenos, anti-S. cerevisiae (ASCA) e IgA anti-β2GPI foram detectados por testes de ELISA indiretos. RESULTADOS: Cento e dezesseis de 151 pacientes (76,8%) eram dislipidêmicas. Destas, 13 tinham relato de evento cardiovascular (AVC = 12 e IAM = 01). Uma importante proporção dessas pacientes tinha atividade lúpica moderada a alta (69/116, 59,5%), observando-se nas mesmas, níveis baixos de HDL-C e índices aterogênicos de risco cardiovascular mais elevados. Os títulos de ANA foram mais altos nos pacientes dislipidêmicos, enquanto a prevalência e os níveis dos autoanticorpos contra autoantígenos, de C3, C4 e PCR foram semelhantes entre pacientes sem dislipidemia e dislipidêmicas. Existiu uma maior prevalência de ASCA nas pacientes lúpicas em relação às mulheres sem LES, mas não foram observadas diferenças na prevalência e níveis destes anticorpos nos dois grupos de lúpus. Anticorpos IgA anti-β2GPI foram também detectados de forma similar nestes grupos. Não existiram correlações entre ASCA e anticorpos IgA anti-β2GPI e SLEDAI, índices aterogênicos e níveis de PCR. CONCLUSÕES: A maioria das pacientes lúpicas dislipidêmicas apresenta índices aterogênicos de risco cardiometabólico elevados, sugerindo alta predisposição aos eventos cardiovasculares. Existe uma importante produção de anticorpos IgG anti-S. cerevisiae no LES, mas sem relação com dislipidemia ou atividade da doença, sugerindo uma homologia estrutural entre a manana da levedura e autoantígenos. / INTRODUCTION: Systemic lupus erythematosus is an autoimmune rheumatic disease characterized by multiple clinical manifestations, among them, dyslipidemia. However, the immunopathogenesis of this metabolic alteration in SLE is still not well known. OBJECTIVE: The present study investigated the involvement of antibodies in the pathogenesis of chronic obstructive coronary disease in female patients with SLE from a rheumatology service in Salvador-Bahia. Specifically, it examined the presence of anti-β2GPI IgA and anti-Saccharomyces cerevisiae IgG antibodies (ASCA) in lupus patients and sought to associate seropositivity to these antibodies with clinical and laboratory findings indicative of chronic obstructive coronary disease and history of a cardiovascular event. MATERIAL AND METHODS: One hundred and fifty-one women with SLE were included in the study and classified for dyslipidemia from their blood lipid profile. The SLEDAI-2K protocol measured the SLE activity. The following atherogenic indexes of cardiovascular risk were determined: apoB / apoA ratio, Castelli indexes I and II (CT / HDL-C and LDL-C / HDL-C, respectively) and TG / HDL-C ratio. Antinuclear antibodies were detected by an indirect fluorescent antibody test. Indirect ELISAs detected autoantigen antibodies, ASCA and anti-β2GPI IgA antibodies. RESULTS: One hundred and sixteen patients (76.8%) were dyslipidemic. Of these, 13 had a previous cardiovascular event (stroke = 12 and AMI = 01). A significant proportion of these patients had moderate to high lupus activity (69/116, 59.5%), with high levels of non-HDL-C and higher atherogenic cardiovascular risk rates. ANA titers were higher in dyslipidemic patients, while the prevalence and levels of autoantibodies against autoantigens and of C3, C4, and C-reactive protein were similar among patients with and without dyslipidemia. There was a higher prevalence of ASCA in lupus patients compared to women without SLE, but both lupus patients had similar prevalence and levels of these antibodies. Anti-β2GPI IgA antibodies were also detected similarly in these SLE groups. There was no correlation between SLEDAI and either ASCA and IgA anti-β2GPI antibodies, atherogenic indexes and CRP levels. CONCLUSIONS: The majority of dyslipidemic lupus patients present elevated atherogenic cardiometabolic risk, suggesting a high predisposition to cardiovascular events. There is a significant production of ASCA in SLE, but it is unrelated to dyslipidemia or disease activity, suggesting a structural homology between S. cerevisiae mannan and autoantigens.

BACKGROUND: Pediatric patients with Inflammatory Bowel Disease (IBD) undergo costly and invasive investigations to diagnose and treat their chronic disease. To that end, it is important for researchers and physicians to continue to work to find novel tools to improve diagnosis and treatment processes. One of the main challenges is differentiating between the two main forms of IBD, Crohn disease (CD) and ulcerative colitis (UC). Physicians currently rely on a combination of endoscopic evaluations, mucosal biopsies, radiology studies, and biochemical testing to assess for the presence and extent of inflammation in the gastrointestinal (GI) tract. Serologic biomarkers can be useful to some extent, but changes in these markers do not typically reflect disease specific to the GI tract, or the state of inflammation related to a patient's IBD. In contrast, fecal biomarkers have the unique potential to provide specific information about inflammation in the GI tract. While serum antibody levels have been well studied for use in the diagnosis of patients with IBD, fecal antibody levels and anti-saccharomyces cerevisiae antibody (ASCA) in particular, have not been extensively evaluated. In this study, we will assess the dynamic range of fecal ASCA levels in acute and convalescent fecal samples collected from children and adolescents with CD and UC. METHODS: We recruited pediatric patients from inpatient and ambulatory settings at the Gastroenterology Program at Boston Children's Hospital. Patients had a diagnosis of either CD or UC. We collected baseline stool samples during a point of active disease, and follow-up samples three to six months later during a point of inactive disease. Samples were analyzed for fecal ASCA as well as lactoferrin (FLA), another marker of inflammation that can be measured in the stool. RESULTS: In patients with CD, fecal ASCA levels were significantly higher during active disease than during inactive disease. Additionally, fecal ASCA levels were higher in patients with CD than in patients with UC, regardless of disease activity. When compared to FLA, ASCA was shown to differentiate between CD and UC, with greater changes in the level of fecal ASCA (active - inactive) correlating with a diagnosis of CD. In patients with CD, FLA levels were significantly higher in the context of active disease than in inactive disease. However, FLA did not differentiate between CD and UC. CONCLUSIONS: Our results suggest that fecal ASCA may be a new marker of inflammation in the GI tract. Unlike FLA, changes in fecal ASCA levels appear more dynamic in patients with CD. Future studies are required to further demonstrate both how changes in fecal ASCA may help physicians distinguish between different forms of IBD as well as how measurement of fecal ASCA may help assess disease activity and response to therapy in patients with CD.

No description available.

Professional School Counselors (PSCs) have been called to be leaders for educational reform to support the academic, career, and personal/social development of all students through the coordination and facilitation of their comprehensive, developmental school counseling program (American School Counselor Association , 2005; National Model). The primary purpose of this study was to investigate the contributions of PSCs' values and leadership practices to their programmatic service delivery (counseling, coordinating, consulting, and curriculum). The three constructs and instruments investigated in this study were: (a) Schwartz Value Theory (the Schwartz Value Survey ; Schwartz, 1992), (b) the Leadership Challenge Theory (the Leadership Practices Inventory ; Posner & Kouzes, 1988), and (c) school counselors' programmatic service delivery (the School Counselors Activity Rating Scale ; Scarborough, 2005). The findings of this study contribute to the school counseling, counselor education, and leadership literature. The sample size for this study was 249 certified, practicing school counselors (elementary school, n = 83; middle school, n = 76; high school, n = 74; multi-level, n = 8) in the state of Florida (35% response rate). The participants completed an on-line surveys including a general demographic questionnaire, the SVS (Schwartz, 1992), the LPI (Posner & Kouzes, 1988), and the SCARS (Scarborough, 2005). The statistical procedures used to analyze the data included (a) structural equation modeling (path Analysis), (b) confirmatory factor analysis, (c) simultaneous multiple regression, (d) Pearson product-moment (2-tailed), and (e) Analysis of variance (ANOVA). The primary research hypothesis for the study was that practicing school counselors' values and leadership practice scores would contribute to their levels of programmatic service delivery. The statistical analyses of these data identified several significant findings. The path analysis models testing the contribution of school counselors' values and leadership practices on their service delivery did fit for these data. Specifically, the results indicated that values contributed minimally to the model fit (less than 1%); however, leadership practices made a significant contribution (39%) to the school counselors' service delivery. Additionally, 31% of the participants reported that their current school counseling program was consistent with how they perceive a successful school counseling program should be implemented, yet only 29% of the school counselors reported feeling comfortable in challenging their involvement in non-counseling related duties. Further, although these data indicated that the majority of the school counselors valued self-transcendence (accepting of rules and appreciating others); structural equation modification re-specification procedures revealed that the model fit supported the value type, self-enhancement (self-direction and personal success) as a more significant contributor in promoting leadership practices and effective service delivery. Implications for professional school counseling and counselor education are presented, along with areas for future investigation.