Students identified by the special education classification Other Health Impairment (OHI) represent the third largest group of students receiving special education services in the United States. The special education services offered these students include both academic and health related supports. The delivery of these services is enhanced when a partnership exits between the primary stakeholders; the student, parents, the school personnel, and the medical personnel. The use of Family Centered Care principles in the delivery of these services supports and maintains the partnership. Following the qualitative analysis of a series of interviews of parents whose children were classified as OHI, descriptive and inferential themes were derived from the interview data. These themes are discussed relative to the parents’ belief that the classification provided; access to appropriate special education and school-based health care allowing their children to achieve their maximum potential, parental satisfaction with the special education and school-based health care services provided, and the use of Family-Centered Care principles. Key Words: special education, health impairment, OHI, family

Adolescents with behavioral difficulties and emotional and behavior disorders (EBD) or other health impairment (OHI) have demonstrated deficits in reading, and these deficits appear to remain stable or worsen over time. Reading fluency is an essential skill for overall reading achievement, yet relatively few studies have addressed reading fluency intervention for adolescents, particularly adolescents with behavioral difficulties. This study used a multiple baseline across participants design to evaluate the effect of a repeated reading intervention on the reading fluency and comprehension skills of middle school students with reading difficulties and behavioral difficulties and EBD or OHI. The intervention involved repeated reading combined with an audio-recorded model and cues to read for comprehension. Working independently at a classroom computer, participants received six to nine minutes of daily supplemental fluency instruction over a four-week period. Instruction involved listening to an audio recording of a model reading a passage, receiving cues to read for understanding, reading the passage aloud while using the computer to record the reading, listening to the recording, and reading the passage aloud again while recording. Results indicated no functional relation between the intervention and the number of words correct per minute or the percentage of comprehension questions answered correctly. However, on-task behavior did improve during study session when compared with on-task behavior during regular classroom instruction. The findings of the study have implications for addressing the needs of adolescents with behavioral difficulties who have reading difficulties.

The main purpose of this study is to investigate the current status, demands and problems of Kaohsiung hospital bedside teaching in Kaohsiung, expecting to enhance the content and quality of hospital bedside teaching. The theory and research framework was established through literature review which acted as a basis of research tools for the design. And the survey research method and the qualitative research method are the research methods. Hospital bedside teaching teachers of compulsory education years in Kaohsiung, and students¡¦ parents were the subjects of the survey. Also, students¡¦ parents and bedside teaching teachers were the semi-structured interviewees for qualitative research. Descriptive statistical analysis was proceeded after recovering the formal questionaires, and for the data of interviews we also proceeded the process of data processing to analyze the data collected. According to the results of the analyses, the following conclusions have been reach: Firstly, the problems of hospital bedside teaching in Kaohsiung exists in three dimensions: (a) It is urgent to improve the system; (b) For bedside teaching students back to the school, there are no appropriate management measures for case counseling; (c) The rights of bedside teaching teachers are necessary to be improved. Secondly, it shows the following two aspects for the needs of Kaohsiung hospital bedside teaching: (a) the urgent needs of multi-teaching measures and curriculum for bedside teaching; (b) the services that bedside teaching teachers offer can be further enhanced. Thirdly, it proposed six dilemmas for the aspect of " It is urgent to improve the system planning aspect ": (a) lack of teacher preparation; (b) lack of teaching resources; (c) way of teacher professional education is lack; (d) hospital bedside teaching should be widely publicized; (e) the places in the hospitals to support for bedside teaching are not enough; (f) the controversy for student¡¦s GPA. Fourthly, it proposed three problems for the appropriate management measures for case counseling ": (a) it is lack to pay attention to the students of hospital besdide teaching; (b) to strengthen the assistance and concern for the students back to school and cross-education; (c) the case management system for special education students is not exactly implemented. Fifthly, two problems of the rights of bedside teaching teachers: the traffic allowance for the teachers is not corresponding for the actual needs, and the personal safety and protection of the rights and interests for bedside teaching teachers are ignored. Sixthly, for the services of bedside teaching teachers can further enhance, it proposed three items about "offering a variety of services", " strengthening transition and tracking system" and "arranging the opportunity to interact between the case students and the parents". Keywords¡GSpecial education, Itinerant service, Health Impairment, Education for the Health Impaired, Hospital bedside teaching

Underage drinking has featured prominently in both scholarly and conventional literature in recent decades as a major health and socio-economic concern in the United States. As new evidence emerges associating underage drinking with a host of negative outcomes for both the youth who drinks and society in general, a closer examination of the long-term effects of underage drinking is critical. This exploratory study was designed to examine predictor variables and their ramifications (1) using logistic regression to identify a model for underage drinking history (UDHISTORY) as a predictor of concomitant alcohol dependence and poor educational attainment (CADAPEA) among individuals aged 25 and above, and (2) obtain a better understanding of how demographic variables (age, gender, race/ethnicity) influence the prediction. The nature and strength of the effect(s) of these demographic variables on the prediction were also investigated. The 2010 National Survey on Drug Use and Health data set ICPSR 32722-0001 which is previously unexploited for this purpose is utilized in this study. The data analysis tool, SDA on SAMHSA's website and IBM SPSS were used for correlation analysis and logistic regression to test the hypothesis that currently legal age drinkers 25 years and older with UDHISTORY are more likely to experience CADAPEA than their counterparts without UDHISTORY. When considered alone, UDHISTORY was a strong and statistically significant predictor of CADAPEA. The identified bivariate logistic regression model was statistically significant, &chi2 (1, n = 60) = 13.39, Adjusted Wald F1, 60 = 13.39, p = 0.001 < .05, accounting for 1.26% (Cox and Snell R square), 1.3% (Log Likelihood Pseudo R square), to 7.9% (Nagelkerke R square) of the variance in CADAPEA. However, adding demographic variables to the model made UDHISTORY a much stronger and more statistically significant predictor. The identified final multivariable logistic regression model was statistically significant, &chi2 (6, n = 55) = 170.43, Adjusted Wald F6, 55 = 26.04, p = 0.00 < .001, accounting for 1.8% (Cox and Snell R square), 7.2% (Log Likelihood Pseudo R square) to 7.9% (Nagelkerke R square) of the variance in CADAPEA. The model also correctly classified 99.1% of cases.

Title: Paralympic classification in table tennis players with physical impairments Objectives: The aim of this work is to create systematic text by literary research follow up issue about classification in paralympic sport with focusing on table tennis players with physical impairments. Methods: In this thesis we used qualitative research methods. It is based on the analysis and synthesis of available literature resources, key organizations, and expert consultations. Results: A comprehensive text about issue of classification in the paralympic table tennis of physically disabled players was created. This work can help national table tennis classifiers of physically disabled players to classify players. In the future, research in this area needs to be carried a way that the classification is truly based on scientific evidence. Keywords: health impairment, evaluation, paralympic games, classifier, sport classes, eligibility

<p>The World Health Organisation estimates that the majority of the disabled population resides in the developing world, but most of the research on outcomes of patients originates from the developed world. In the light of the differences in healthcare structures and function, especially rehabilitation between settings and countries, it is imperative to have an understanding of the&nbsp / functioning of patients at discharge with the objective of measuring the level at which outcomes are met. The aim of this study was therefore to determine the process of rehabilitation and the&nbsp / outcome of patients following in-patient rehabilitation at a facility in the Western Cape. A quantitative research design was employed to address the objectives. Self-administered&nbsp / questionnaires were developed to collate information pertaining to the demographic-, socioeconomic- and medical profile of patients and data extraction sheets collected information relating&nbsp / to the process of rehabilitation and the impairment status of patients on admission. With regards to activity and participation, a longitudinal study design was used, which utilised standardised&nbsp / outcomes measures. The sample consisted of all patients with stroke and spinal cord injury admitted within a three-month period, and all ethical principles relating to research on human&nbsp / subjects, as stipulated in the Helsinki Declaration were adhered to during data collection, with ethical clearance obtained from relevant authorities. The SAS and the Microsoft Excel Package&nbsp / 2007 were used to analyse the quantitative data elements. Descriptive statistics using frequencies, percentages, ranges, means, and standard deviations and inferential statistics using&nbsp / chi-square, student T-tests and correlation tests, for determining the predictors of functional outcome, were calculated. There were 175 patients, whereof 82 were patients with stroke and 93&nbsp / with spinal cord injury, with 143 (76 presenting with spinal cord injury and 67 with stroke) meeting the inclusion criteria on admission. The mean age of those with spinal cord injury and stroke&nbsp / was 34.14 and 52.95 years. Most of the patients with spinal cord injuries were single (73.68%), whereas the majority (53.73%) of patients with strokes were married at the time of injury. All&nbsp / patients were managed by the doctor and the nurse, with most of the patients receiving physiotherapy, occupational therapy and social assistance from the social worker. With regards to recreational activities, 46.87% of patients with spinal cord injury and 39.39% of those with stroke attended the learn to swim programme, and 29.68% of patients with spinal cord injury attended the wheelchair basketball sessions. The mean length of hospital stay for patients with spinal cord injury and stroke was 73.11 and 51. 62 days, with most of the spinal cord injured patients&nbsp / (80.26%) and stroke patients (82.08%) discharged home without follow-up rehabilitation. The most prevalent impairments on admission of the spinal cord injury cohort were muscle&nbsp / weakness (75.0%), bladder incontinence (71.1%) and reduced sensation (69.7%), whereas patients with stroke presented mostly with muscle paralysis (80.6%), abnormal tone (76.1%) and aphasia (50.8%). Functional limitations experienced by the participants included, mobility, stair climbing and transfers. The participants experienced participation restrictions in the following&nbsp / domains, leisure activities and employment. A clinical significant improvement was noted in execution of functional task of patients with spinal cord injury (p&lt / 0.0001) and stroke (p&lt / 0.0001)&nbsp / between admission and discharge. A significant statistical change was also detected for the participation elements of both stroke and spinal cord injury cohorts. Functional ability on&nbsp / admission was found to be a predictor of functional outcome of the stroke diagnostic group at discharge, whereas the multiple&nbsp / redictor model of functional outcome of the spinal cord injured cohort at discharge was significant with remaining variables of functional outcome score on admission (p&lt / 0.0001) and bladder -and bowel impairment(s) (p=0.0247). The study findings suggest that despite the significant change in activity and participation, most of the patients were discharged home without further follow-up for rehabilitation, irrespective of the activity&nbsp / limitations and participation restrictions still experienced at the time of discharge. The latter finding&nbsp / questions the duration of the length of hospital stay, which does not allow patients to be independent in all meaningful activities and participatory actions and roles by the end of inpatient rehabilitation. The study findings could assist authorities to adapt the existing rehabilitation&nbsp / programme and referral process . </p>

<p>The World Health Organisation estimates that the majority of the disabled population resides in the developing world, but most of the research on outcomes of patients originates from the developed world. In the light of the differences in healthcare structures and function, especially rehabilitation between settings and countries, it is imperative to have an understanding of the&nbsp / functioning of patients at discharge with the objective of measuring the level at which outcomes are met. The aim of this study was therefore to determine the process of rehabilitation and the&nbsp / outcome of patients following in-patient rehabilitation at a facility in the Western Cape. A quantitative research design was employed to address the objectives. Self-administered&nbsp / questionnaires were developed to collate information pertaining to the demographic-, socioeconomic- and medical profile of patients and data extraction sheets collected information relating&nbsp / to the process of rehabilitation and the impairment status of patients on admission. With regards to activity and participation, a longitudinal study design was used, which utilised standardised&nbsp / outcomes measures. The sample consisted of all patients with stroke and spinal cord injury admitted within a three-month period, and all ethical principles relating to research on human&nbsp / subjects, as stipulated in the Helsinki Declaration were adhered to during data collection, with ethical clearance obtained from relevant authorities. The SAS and the Microsoft Excel Package&nbsp / 2007 were used to analyse the quantitative data elements. Descriptive statistics using frequencies, percentages, ranges, means, and standard deviations and inferential statistics using&nbsp / chi-square, student T-tests and correlation tests, for determining the predictors of functional outcome, were calculated. There were 175 patients, whereof 82 were patients with stroke and 93&nbsp / with spinal cord injury, with 143 (76 presenting with spinal cord injury and 67 with stroke) meeting the inclusion criteria on admission. The mean age of those with spinal cord injury and stroke&nbsp / was 34.14 and 52.95 years. Most of the patients with spinal cord injuries were single (73.68%), whereas the majority (53.73%) of patients with strokes were married at the time of injury. All&nbsp / patients were managed by the doctor and the nurse, with most of the patients receiving physiotherapy, occupational therapy and social assistance from the social worker. With regards to recreational activities, 46.87% of patients with spinal cord injury and 39.39% of those with stroke attended the learn to swim programme, and 29.68% of patients with spinal cord injury attended the wheelchair basketball sessions. The mean length of hospital stay for patients with spinal cord injury and stroke was 73.11 and 51. 62 days, with most of the spinal cord injured patients&nbsp / (80.26%) and stroke patients (82.08%) discharged home without follow-up rehabilitation. The most prevalent impairments on admission of the spinal cord injury cohort were muscle&nbsp / weakness (75.0%), bladder incontinence (71.1%) and reduced sensation (69.7%), whereas patients with stroke presented mostly with muscle paralysis (80.6%), abnormal tone (76.1%) and aphasia (50.8%). Functional limitations experienced by the participants included, mobility, stair climbing and transfers. The participants experienced participation restrictions in the following&nbsp / domains, leisure activities and employment. A clinical significant improvement was noted in execution of functional task of patients with spinal cord injury (p&lt / 0.0001) and stroke (p&lt / 0.0001)&nbsp / between admission and discharge. A significant statistical change was also detected for the participation elements of both stroke and spinal cord injury cohorts. Functional ability on&nbsp / admission was found to be a predictor of functional outcome of the stroke diagnostic group at discharge, whereas the multiple&nbsp / redictor model of functional outcome of the spinal cord injured cohort at discharge was significant with remaining variables of functional outcome score on admission (p&lt / 0.0001) and bladder -and bowel impairment(s) (p=0.0247). The study findings suggest that despite the significant change in activity and participation, most of the patients were discharged home without further follow-up for rehabilitation, irrespective of the activity&nbsp / limitations and participation restrictions still experienced at the time of discharge. The latter finding&nbsp / questions the duration of the length of hospital stay, which does not allow patients to be independent in all meaningful activities and participatory actions and roles by the end of inpatient rehabilitation. The study findings could assist authorities to adapt the existing rehabilitation&nbsp / programme and referral process . </p>

Background: There is a strong association between exposure to intimate partner violence (IPV) and the development of negative mental health (MH) outcomes among women and their children. Given the high prevalence of IPV in low and lower-middle income countries (LLMICs) and its relationship with varying MH issues, it is essential to identify evidence-based interventions that reduce MH challenges, including interventions that remain effective under LLMIC resource, implementation, and scalability constraints. Objective: The proposed study involves a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating psychosocial interventions compared to a) no intervention, b) alternatively specified interventions, or c) waitlisted services to reduce MH impairment among women and children with IPV exposure and who live in LLMICs relative to those living in high income countries (HICs). Methods: Our methods and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched eight electronic databases for RCTs reporting the effects of psychosocial interventions on the well-being of women, and/or their children, who were exposed to IPV and who were living in LLMICs or HICs. Searches were completed on April 10, 2022. We implemented forward citation searching on February 19th, 2023, of the included studies to capture any missed or recently published papers. Title, abstract, full-text screening, and data extraction were completed independently, using Covidence. Primary and secondary outcome data extracted and analyzed from the included studies were: (a) MH disorder (depressive disorder, anxiety disorder, post-traumatic stress disorder (PTSD)), (b) clinical symptoms of mental illness (stress, emotion dysregulation, self-efficacy, self-esteem, externalizing symptoms, and suicidal thoughts and ideation) and (c) parent and child relationship and quality of life. Pooled effect estimates of the outcomes were synthesized on Comprehensive Meta-Analysis (CMA) and were reported using Hedge’s g. Risk of bias was also assessed, in duplicate, using the Clarity Risk of Bias Tool and the certainty of the available evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE). Where at least five studies were available for an outcome, three a priori subgroup analyses were completed for women and children on the basis of : 1) psychosocial intervention type (empowerment and advocacy, trauma-focused therapy, non-trauma focused therapy, counselling, and cognitive behavioural therapy (CBT), and parenting), income setting (LLMIC and HIC), and 3) length of follow-up (post-intervention, < 12-months follow-up, and ≥ 12-months follow-up). Lastly, sensitivity analyses explored the impact of the following on the outcomes (1) high-risk of bias ratings; (2) missing data, and (3) reporting on feasibility and pilot data. Results: A total of 33,257 articles were identified via database searches; 12,057 were removed using deduplication, resulting in 21, 200 articles for title and abstract screening. A total of 581 articles underwent full-text screening, of which 55 unique studies were included in the review. Across the included studies, enough data was available to analyze seven outcomes within the meta-analysis; this included the primary outcomes of depressive disorder, anxiety disorder, PTSD, and the secondary outcomes, stress, self-esteem, self-efficacy, and quality of life. Thirteen studies were completed in LLMIC settings, with 42 studies focused on HICs. Ten studies focused on women and children exposed to IPV, 43 studies focused strictly on women, and two studies focused strictly on children. With respect to the outcomes, the majority of studies examined intervention impacts on depression (k = 33, 60%), anxiety (k = 11, 20%), and PTSD (k = 26, 47%). After performing the meta-analyses, very uncertain evidence suggests that psychosocial interventions may lead to reductions in maternal depression (g = -0.222; 95% CI -0.353 to -0.090) maternal anxiety (g = -0.541; 95% CI -0.953 to -0.129), and child PTSD (g = -0.314; 95% CI -0.602 to -0.026). Additionally, very uncertain evidence suggests that psychosocial interventions may have little to no effect on child depression (g = 0.085; 95% CI -0.519 to 0.690), maternal PTSD (g = -0.193; 95% CI -0.339 to -0.047), maternal stress (g = -0.188; 95% CI -0.454 to 0.078), and maternal self-efficacy (g = 0.187; 95% CI -0.096, 0.469). As well, moderate certainty of evidence indicates that psychosocial interventions are likely to result in little to no difference in self-esteem (g = 0.196; 95% CI -0.009 to 0.401), and a low certainty of evidence indicates that psychosocial interventions may result in little to no difference in maternal quality of life (g = 0.121; 95% CI -0.090, 0.332), relative to controls. However, when considering these outcomes, trauma-focused therapy showed significant improvements in maternal depression in HICs and LLMICs, while maternal anxiety and PTSD showed significant improvements in LLMICs. Non-trauma focused therapy resulted in significant improvements in maternal stress specifically in LLMICs. Parenting psychosocial interventions were also effective in significantly improving child PTSD in LLMICs. Conclusion: The systematic review and meta-analysis found that psychosocial interventions may not be more beneficial compared to control groups for addressing MH outcomes amongst women and children exposed to IPV within LLMICs and HICs. While trauma-focused therapy, non-trauma focused therapy, and parenting interventions demonstrated significant positive impacts for maternal depression, anxiety, PTSD, stress and child PTSD, the evidence available was deemed to be uncertain. This review underscores the importance of equal resource distribution, fair research practices, investing in longer follow-up studies, comprehensive data analysis, and clear reporting. Future research should prioritize well-designed trials to understand the effects of specific psychosocial interventions. / Thesis / Master of Science (MSc) / Women's exposure to intimate partner violence (IPV) is a serious public health problem that often occurs in the presence of children and is linked to poor mental health; this is especially true among women and children living in low and lower-middle income countries (LLMIC) (Barada et al., 2021; García-Moreno et al., 2013; Silva et al., 2019). Given that intervening early can help reduce the mental health (MH) impacts of IPV exposure, there is an urgency to identify and disseminate evidence-based interventions in LLMIC settings. Here, we systematically review the literature evaluating psychosocial interventions that aim to reduce MH impairment among women and children exposed to IPV in LLMIC settings and examine how these findings compare to psychosocial interventions that reduce MH impairment among those living in high-income country (HIC) settings. In total, 55 unique studies were included in the systematic review. Findings are varied; however, overall, trauma-focused therapy, non-trauma focused therapy, and parenting psychosocial interventions significantly improved specific mental health outcomes within specific settings. In HICs, trauma-focused therapy demonstrated improvements in maternal depression. In LLMICs, trauma-focused therapy was effective in reducing maternal depression, anxiety, and post-traumatic stress disorder (PTSD). In addition, in LLMICs, only, non-trauma focused therapy improved maternal stress and parenting interventions improved child PTSD. We also narratively and statistically discuss factors specific to the psychosocial interventions that may improve MH following IPV exposure. Intervention factors include mechanism, type, delivery, setting, and modality, which should be targets for future evaluation. In sum, our review emphasizes the importance of tailoring interventions to address the unique needs of survivors in particular settings and calls for balanced, larger, and well-designed trials to better understand the effects of psychosocial interventions within and across contexts.