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The prevalence of autism spectrum disorder (ASD) has continued to rise each year. This fact has significance in the area of education. The rise in prevalence of autism means an increase of students with autism in schools. Educators have the need to be prepared to provide an appropriate education for these students but may not have training or resources to be effective. Rural communities may have even more concerns about education for students with ASD due to geographic isolation and the lack of available educators in their area trained to support the specific needs of these students. To determine the best use of available resources and identify critical needs, a study of stakeholder perceptions of the needs of students with ASD was conducted in a rural Utah community of approximately 15,000 people. Key stakeholders were provided an opportunity to respond to an online needs assessment questionnaire regarding the educational interventions and services available in the rural school district, as well as rate the effectiveness of the above-mentioned services. Key stakeholders included: parents and caregivers of children with ASD, the rural school district’s educators, community care providers, and individuals 12 years and older who have been classified as having an ASD in the rural school district. Further, upon completion of the online needs assessment, the participants were invited, if they wished to elaborate further, to meet by phone or in person in an interview format with the researcher to discuss their perceptions in more detail than was possible in the online needs assessment questionnaire. Mixed methods were used to analyze the data. Quantitative data were first analyzed using descriptive statistics to characterize patterns in responses between groups. The qualitative data from open-ended questions in the survey and the in-person interviews were analyzed using consensual qualitative research methods. Results showed that all stakeholders believe that better communication from the school district and more training are needed for educators and related professionals. These results have implications for the school district as they plan their use of available resources to better meet the needs of students with ASD. Pursuit of targeted training options for educators may be one of the most effective use of available resources to meet these needs.

This study was undertaken to determine adherence rates to side effect monitoring guidelines of second-generation antipsychotics (SGAs) approximately 10 years after their publication to assess the quality of care being provided to patients with mental illness at an urban community mental health center located in the Southeast United States. Results indicated an initial combined collection of fasting blood glucose (FBG) and fasting lipid profile (FLP) of 30%. At the 3-month time point, 20% of FBG and FLP were checked and at 1 year 14%. Study results suggest there is a need for practice improvements to increase quality of care.

This study aimed to provide information about the quality of the evidence on reading fluency instruction for at-risk students and students with reading/learning disabilities as a way to evaluate whether an instructional strategy is evidence-based and has potential for classroom use. An extensive search process with inclusion and exclusion criteria yielded a total of 18 studies to be included in the present study: 12 group design studies and six single-subject design studies. The quality indicators proposed by Gersten et al. (Except Child 71:149–164, 2005) and Horner et al. (Except Child 71:165–179, 2005) were applied to evaluate the quality of selected fluency intervention studies. Results revealed that (a) most group design studies provided little information about the intervention and agent for the comparison group, (b) internal and social validity were not clearly stated in single-subject design studies, and (c) procedural fidelity in assessment and intervention implementation was inadequately addressed in both group design and single-subject design studies. Lack of methodological rigor, which hampers determinations of the effectiveness of fluency instruction, the current status of intervention studies, and future directions are discussed.

The Long March is a review of the origins and development of the Physical Therapy profession in the United States since the beginning of the 20th century. It shows the evolution experienced since that time of its professional profile, name and academic training received. It is shown how the relationship between the physical therapist and physician has grown and evolved into a relationship of mutual respect and of improvement in the professional practice.On the other hand, the principal milestones in the long march of the physical therapy profession from the time of its birth as a profession that was totally dependent on the physician to its current status as a profession with professionals having a deep science base and high university level training who are able to practice and freely govern their profession without external control are presented.

Objectives: To show forgiveness to be a central component in substance abuse and recovery and to encourage the empirical investigation of such realtionships. Methods: Literature reviewed and synthesized to support the role of forgiveness in addiction and recovery and to justify its empirical investigation. Results: The construct and process of forgiveness are present in 12-Step Facilitation Therapy, Motivational Enhancement Therapy, and Cognitive Behavioral Coping Skills Therapy, and other psychotherapies applicable to the treatment of substance abuse. Nevertheless, few studies exist to provide empirical support for these relationships. Conclusions: Religion and spirituality can have a salutary effect on substance use disorders. However, little is known regarding the effects of specific manifestations of religiosity and spirituality. Forgiveness, decreasing negative responses to offense irrespective of interaction with the offender, has been argued to be highly relevant to problematic substance use. Although the process of forgiveness is conceptually found in empirically validated forms of treatment for alcohol problems, little quantitative evidence exists to verify and illuminate the relationships between forgiveness and substance abuse. Empirical investigation into the basic, indirect, contextual, and interventional relationships between forgiveness and substance use disorders, including development, maintenance, and recovery, is warranted and encouraged.

At the project site in New Jersey, eligible patients were leaving the hospital without receiving the influenza or pneumococcal vaccine. The field site has an established, evidence-based, nurse-driven protocol. The purpose of this project was to increase adherence to the current influenza and pneumococcal nurse-driven protocol on one medical-surgical unit. This unit had experienced low adherence rates to the nurse-driven protocol for vaccines, not reaching the New Jersey state target of 96% administration prior to discharge. The practice-focused question was: Will increasing awareness of evidence-based practice increase adherence to the influenza and pneumococcal vaccine protocol? A quality improvement plan was developed to address a gap in practice using the plan-do-study-act model. Internal vaccination data was the source of evidence used to drive this project. Baseline data was used from 2 months prior to the December 2017 start of the project. Once the quality improvement plan was implemented, data were collected and analyzed weekly with the quality improvement team. Findings for the pneumococcal vaccine demonstrated reaching 96% or higher while the influenza vaccine exceeded the state target reaching 100% of discharged patients being vaccinated. Implementing large surveillance boards into clinical rounds promoted increased adherence to the protocol, achieving a positive social change. Leadership worked directly with the staff to use evidence-based practice and promote nursing autonomy to administer the vaccines. An increased number of vaccinated patients leaving the medical-surgical unit was achieved.

Asthma is a chronic airway inflammatory disease that is characterized by reversible airway obstruction due to hyper-responsiveness of the tracheobronchial tree. The condition disproportionately affects male children, females, and the aged globally, and its prevalence keeps rising despite being a preventable condition in terms of relapse. Most asthmatic patients receive care in primary care settings. Various health agencies have developed asthma management guidelines to improve the quality of asthma care; however, in some cases, adherence to these guidelines is substandard. The overarching aim of this study was to determine whether primary care providers manage asthma in line with the available guidelines. A qualitative systematic review was conducted by searching for journal articles published between 2005 and 2016 relating to guideline use in primary care management of asthma. Twenty-nine primary studies evaluating adherence to asthma management guidelines were included. The collected data were analyzed through thematic data analysis techniques, and various themes emerged with regard to the research questions. Generally, the findings suggest that there is a mismatch between what is needed by patients/caregivers and what is currently provided by primary care providers (PCPs) in primary care settings and that asthma management guidelines are only partially followed or not used. Emerging themes were classified into 3 main categories: physician-, patient-, and institution-related barriers. The study provides recommendations on how adherence to asthma management can be improved.

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