Ultrasound has become a widely available imaging modality for the investigation of patients with a variety of clinical conditions. Concerns have been raised by clinicians and government alike that a sizeable proportion of this imaging may be unnecessary, inappropriate or of inadequate quality for patient management. This study aims to prospectively evaluate the opinions of treating vascular clinicians as to whether the vascular ultrasound imaging studies that patients bring with them when initially referred are necessary, and technically adequate to permit clinical decision-making for the patient’s management. Vascular clinicians Australia-wide were invited to participate in the study in April 2003. They were asked to recruit their next 50 consecutive new patients, eligible to be enrolled in the study, who presented with ultrasound scans organized by their referring doctor. The clinicians were asked to fill out a two-page proforma detailing the diagnosis, if known, and their opinion regarding the study and report, whether they required further information, and what investigations they would have ordered if seeing the patient for the first time, in a primary setting. 17 vascular clinicians Australia-wide agreed to participate in the study and to recruit their next 50 patients referred to them with vascular ultrasound imaging performed prior to specialist consultation. 473 Proformas were returned for analysis. Of all studies performed, 19 percent were judged unnecessary. Studies that were considered necessary however, were, in some cases, technically inaccurately or inadequately reported in 27 percent of cases, and 67 percent of these studies were then repeated. The NATAVUS Study has demonstrated that a significant percentage of ultrasound imaging performed by referring clinicians to vascular specialists is unnecessary, and that necessary imaging does not, in a large percentage of cases, provide accurate and adequate data to allow for specialist clinical decision-making. The data from this study has the potential to develop guidelines for appropriate use of vascular ultrasound imaging for various vascular conditions. If the results of this study were to be duplicated in a larger study, development and adoption of such guidelines would have the potential to generate significant cost savings to the health system by the elimination of some unnecessary testing. This is of particular relevance with Australia’s ageing population.

Behavior Intervention Plans (BIPs) are legally binding documents required by the Individuals with Disabilities Education Act (IDEA) for students with disabilities. These plans are intended to help teachers use positive, function-based interventions to decrease problem behaviors and promote functionally-equivalent appropriate social behaviors. The Behavior Intervention Plan Quality Evaluator (BIP-QE II) identifies six components of BIP technical adequacy including behavior function, situation specificity and behavior change, reinforcement tactics, reactive team strategies, team coordination and goals and objectives. Unfortunately, in practice BIPs often lack these key components, which can lead to ineffectiveness of plans, as well as lack of communication among team members and low implementation fidelity, leading to poor student outcomes. In this study, the research team evaluated the effects of providing feedback to plan developers on the technical adequacy of BIPs, using the BIP-QE II. The study employed a waitlist control group experimental design where five participants in the treatment group received feedback immediately and four the control group received feedback after a short delay. In addition, previous research suggests that feedback is only as valuable as participants perceive it to be so. A social validity interview confirmed that feedback was valuable to participants but there was a perception that external reviewers did not appreciate some important contextual factors impacting participants' work. Feedback to support the technical adequacy of BIPs is a promising practice that appears both effective and efficient and deserves further research, refinement, and exploration.

Behavior Intervention Plans (BIPs) are used in public schools for students with disabilities, replacing target behaviors with socially appropriate behaviors using positive behavior support strategies. However, research suggests that BIPs are often poorly written or fail to be implemented as intended. One reason for the ineffectiveness of BIPs may be that the interventionist (e.g., classroom teacher or other staff member responsible for implementing the plan) and the context of his/her classroom is not considered when plans are written by specialists (e.g., school psychologist, special education teacher, etc.). The purpose of this study was to evaluate BIPs written and used for students in public schools in the intermountain west for their contextual fit, using a researcher-developed measure of contextual fit based on key concepts previously established in research and modeled after the Behavior Support Plan-Quality Evaluation, Second Edition (BSP-QE II). With the coding guide created by our research team, we coded previously collected BIPs for practicality, the skill level and competency required for the interventionist to implement, and the consideration of cultural values for both the interventionist and the student who would receive the intervention. In addition, a previous research study by a graduate student at the same university had previously coded BIPs from the four school districts in Utah for technical adequacy using the BSP-QE II and, using the results from that study, we ran a Pearson correlation to determine whether there was a statistically significant relationship between BIP quality and contextual fit. Ultimately, our study found that BIPs often failed to include all elements for contextual fit to reasonably be considered established, particularly in the cultural values of those who would implement or receive the plan. In addition, we found a moderate, positive relationship between BIP technical adequacy and contextual fit. Implications for practitioners and ideas for future research are also discussed, including: ensuring that BIPs are developed in teams that include the interventionist, creating BIP templates that are culturally and contextually appropriate, and the possibility of research that documents actual interventionist participation in BIP team meetings as a comparison to the results of our scoring guide of BIP contextual fit.

Behavior Intervention Plans (BIPs) are legally binding documents required by the Individuals with Disabilities Education Act (IDEA) for students with disabilities. These plans are intended to help teachers use positive, function-based interventions to decrease problem behaviors and promote functionally-equivalent appropriate social behaviors. The Behavior Intervention Plan Quality Evaluator (BIP-QE II) identifies six components of BIP technical adequacy including behavior function, situation specificity and behavior change, reinforcement tactics, reactive team strategies, team coordination and goals and objectives. Unfortunately, in practice BIPs often lack these key components, which can lead to ineffectiveness of plans, as well as lack of communication among team members and low implementation fidelity, leading to poor student outcomes. In this study, the research team evaluated the effects of providing feedback to plan developers on the technical adequacy of BIPs, using the BIP-QE II. The study employed a waitlist control group experimental design where five participants in the treatment group received feedback immediately and four the control group received feedback after a short delay. In addition, previous research suggests that feedback is only as valuable as participants perceive it to be so. A social validity interview confirmed that feedback was valuable to participants but there was a perception that external reviewers did not appreciate some important contextual factors impacting participants' work. Feedback to support the technical adequacy of BIPs is a promising practice that appears both effective and efficient and deserves further research, refinement, and exploration.

This study surveyed a national sample of school psychologists (N = 105) regarding their training and skills in function-based behavior support planning. Specifically, this study aimed to determine (a) the function-based behavior support planning competencies practicing school psychologists possess and (b) factors that are related to their level of competency (e.g., prior training). School psychologists were asked to identify strategies as function-based, neutral, or contra-indicated when provided with a brief vignette. School psychologists also reported on demographic characteristics and pre-service and post-graduate training in behavior support planning. Currently, very little is known about the function-based behavior support planning competencies school psychologists possess. This study is among the first to directly assess the ability to link the function of behavior to relevant support strategies. Results of the study indicate that an alarming proportion of school psychologists did not meet the criterion for proficiency on this measure. Interestingly, the current study did not find statistically meaningful differences of performance based on characteristics of prior training. Implications for improving function-based behavior support planning competencies of school psychologists and strategies for improving student supports are discussed.

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Made available in DSpace on 2016-06-02T19:16:32Z (GMT). No. of bitstreams: 1 4408.pdf: 1810645 bytes, checksum: 0fd4606e328847a6c924081001222134 (MD5) Previous issue date: 2011-02-07 / Universidade Federal de Minas Gerais / The current society presents sharp inequalities, based on competition and individualistic values. Aiming to break up with such values which result in unemployment, poor working conditions and social exclusion, the solidarity economy brings elements such as solidarity, cooperation, self-management. Given this reality, we highlighted a class of informal workers, called waste pickers , responsible for collecting about 90% of the waste directed to recycling plants in Brazil. Besides having a role in the economy, the waste pickers have specific knowledge and skills necessary to identify, collect, sort, add value and sell that waste. This case study, focused on the Coopervida, a waste pickers cooperative of São Carlos-SP, adopted a qualitative approach and intended to identify according to the view of the waste pickers, what elements are transformers and what are obstacles for the autonomy in the work of the Cooperative, with a focus on self-management, the development of social technologies and on the process of socio-technical adequacy. According with the referenced theory in science and technology, the critical communicative methodology was used, with the realization of communicative groups as a technique for collecting primary data. The interaction between the researcher and the research subjects (one male and two female members of the cooperative) happened through the establishment of an intersubjective dialogue in which they participated from the point of defining the research question to the data analysis. As one of the results achieved we identified as the main transforming element, the recognition by the workers of the importance of cooperation, solidarity, participation in the activities of formation and adding value to waste to the self-management practices and the advance towards the Cooperative autonomy. The workers development of social technologies and the socio-technical adequacy process was also found to be an important transforming element for the autonomy in the work of Coopervida. In contrast, the lack of cooperation of some workers, the sometimes truncated communication between them, along with the difficulty in breaking up with the division of manual and intellectual work, expressed in the dichotomy between production and management, are the main obstacles to the Cooperative autonomy, since such actions are not directed towards the values of self-management that the venture is proposing to accomplish. We related the themes investigated with Science, Technology and Society field, through the participation of the research subjects in the production of knowledge and in the adequation of technologies with the objective of overcoming social inequality and in favor of the historically marginalized classes. / A sociedade atual apresenta nítidas desigualdades, baseando-se na competição e em valores individualistas. Com a proposta de romper com tais valores que resultam no desemprego, em más condições de trabalho e na exclusão social, a economia solidária traz elementos como a solidariedade, a cooperação, a autogestão. Diante desta realidade, destacamos uma classe de trabalhadores/as informais, os/as catadores/as de resíduos, responsáveis pela coleta de cerca de 90% dos resíduos que alimentam as indústrias de reciclagem no Brasil. Além de terem um papel na economia, possuem conhecimentos específicos e habilidades necessárias para identificar, coletar, separar, agregar valor e vender esses resíduos. Este estudo de caso, que abordou a Coopervida, Cooperativa de catadores e catadoras do município de São Carlos-SP, adotou uma abordagem qualitativa e pretendeu, na perspectiva dos/as catadores/as, identificar quais elementos são transformadores e quais são obstáculos para a autonomia no trabalho da cooperativa, com foco na prática da autogestão, no desenvolvimento de tecnologias sociais e no processo de adequação sociotécnica. Em acordo com o referencial teórico apresentado sobre ciência e tecnologia, foi utilizada a metodologia comunicativa crítica, com a realização de grupos comunicativos como técnica de coleta de dados primários. A interação entre o pesquisador e os sujeitos da pesquisa (um cooperado e duas cooperadas) aconteceu pelo estabelecimento do diálogo intersubjetivo em que estes participaram desde a definição da pergunta de pesquisa até a análise dos dados. Como um dos resultados alcançados, identificamos como principal elemento transformador o reconhecimento pelos/as trabalhadores/as da importância da cooperação, da solidariedade, da participação em atividades de formação e da agregação de valor aos resíduos para as práticas autogestionárias e para o avanço da cooperativa rumo à sua autonomia. O desenvolvimento de tecnologias sociais e do processo de adequação sociotécnica pelos/as cooperados/as também foi verificado como um importante elemento transformador para a autonomia no trabalho da Coopervida. Em contraponto, a falta de cooperação de alguns/algumas trabalhadores/as, a comunicação entre os/as cooperados/as que às vezes é truncada, juntamente com a dificuldade em romper com a divisão do trabalho manual e intelectual, expressada na dicotomia entre produção e gestão, são os principais obstáculos para a autonomia da cooperativa, uma vez que tais ações não estão indo ao encontro dos valores da autogestão a que o empreendimento está se propondo a realizar. Relacionamos os temas investigados com o campo Ciência, Tecnologia e Sociedade, por meio da participação dos sujeitos da pesquisa na produção de conhecimentos e na adequação de tecnologias, com o objetivo de superar as desigualdades sociais e a favor das classes historicamente marginalizadas.