Search results for: parents voice in disability

Authors: Peninah Agaba, Monica Magadi, Bev Orton

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Uganda is one of the countries with high maternal mortality (336/100,000) where adolescents account for 24 percent of the total maternal deaths. Research shows that use of maternal health services may prevent some of these deaths and good provider attitudes attract adolescents to use the services. However, poor health provider’s attitudes discourage adolescents from seeking the services during the maternity period. This study explores the experiences of unmarried female adolescents at the health facilities during the maternity period. The study population is unmarried adolescent girls aged 10-19 years who were pregnant or had given birth within three years before the interview. This is a special interest group that requires attention throughout this period. Most of the pregnancies among unmarried adolescents are unwanted; as a result, many of them have been abused and neglected by parents and close family members including partners who deny fatherhood of the pregnancy/child. These adolescents hope to find comfort from health providers like being listened to during counseling, not abused and judged; unfortunately this is not the case always. The research was approved by the University of Hull, School of Education and Social Sciences ethics review committee, Mildmay Uganda Research Ethics Committee and Uganda National Council of Science and Technology. The study was carried out in Bushenyi and Kibale districts in Western Uganda. Fourteen in-depth interviews and seven focus group discussions were completed in the local languages and later transcribed to English language. Thematic analysis to identify the themes was done. Adolescents were aged 16-19 years, two had become pregnant before 15 years. Most had not completed secondary education; none had tertiary education and three of the 14 IDI adolescent participants wanted to get pregnant. Analysis shows varied experiences; most adolescents were abused verbally and physically by the health providers due to their young age of pregnancy, lack of essential items during this period (maternity dresses, children clothes, delivery kit) and fear of labour pains. Another cause for abuse was these adolescents coming for antenatal care with no partners yet the implementation of a policy on increasing male involvement in reproductive health in Uganda requires them to attend antenatal care with their partners and most of these unmarried adolescents have no partners to accompany them. Despite the above challenges, the study also identified the care some of these unmarried adolescents received during the maternity visits for example they were not abused, were provided with appropriate information and supported with child care. The study identified abuse and support the unmarried adolescents received during the maternity period. Efforts to provide adolescents with adequate information including what to expect during labour by providers and provision of basic needs are essential. Health providers should have trainings on client care especially how to embrace unmarried adolescents when they come to access maternity services. More so, the policy on improving male involvement in RH issues need to be considerate of unmarried adolescents who in most cases do not have the partners to go with to access maternity care.

Keywords: abuse, maternity care, Uganda, unmarried, adolescents

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Authors: Ayla Hoeta

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In a post-colonial Aotearoa New Zealand, solutions by rangatahi (youth) for rangatahi are essential as is civic participation and building economic agency in an increasingly tough economic climate. Upsouth was an online community crowdsourcing platform developed by The Southern Initiative, in collaboration with Itsnoon that provides rangatahi and whānau (family) a safe space to share lived experience, thoughts and ideas about local kaupapa (issues/topics) of importance to them. The target participants were Māori indigenous peoples and Pacifica groups, aged 14 - 21 years. In the Aotearoa New Zealand context, this participant group is not likely to engage in traditional consultation processes despite being an essential constituent in helping shape better local communities, whānau and futures. The Upsouth platform was active for two years from 2018-2019 where it completed 42 callups with 4300+ participants. The web platform collates the ideas, voices, feedback, and content of users around a callup that has been commissioned by a sponsor, such as Auckland Council, Z Energy or Auckland Transport. A callup may be about a pressing challenge in a community such as climate change, a new housing development, homelessness etc. Each callup was funded by the sponsor with Upsouths main point of difference being that participants are given koha (money donation) through digital wallets for their ideas. Depending on the quality of what participants upload, the koha varies between small micropayments and larger payments. This encouraged participants to develop creative and critical thinking - upskilling for future focussed jobs, enterprise and democratic skills while earning pocket money at the same time. Upsouth enables youth-led action and voice, and empowers them to be a part of a reciprocal and creative economy. Rangatahi are encouraged to express themselves culturally, creatively, freely and in a way they are free to choose - for example, spoken word, song, dance, video, drawings, and/or poems. This challenges and changes what is considered acceptable as community engagement feedback by the local government. Many traditional engagement platforms are not as consultative, do not accept diverse types of feedback, nor incentivise this valuable expression of feedback. Upsouth is also empowering for rangatahi, since it allows them the opportunity to express their opinions directly to the government. Upsouth gained national and international recognition for the way it engages with youth: winning the Supreme Award and the Accessibility and Transparency Award at Auckland Council’s 2018 Engagement Awards, becoming a finalist in the 2018 Digital Equity and Accessibility category of International Data Corporation’s Smart City Asia and Pacific Awards. This paper will fully contextualize the challenges of rangatahi and whānau civic engagement in Aotearoa New Zealand and then present a reflective case study of the Upsouth project, with examples from some of the callups. This is intended to form part of the Divided Cities 22 conference New Ground sub-theme as a critical reflection on a design intervention, which was conceived and implemented by the lead author to overcome the post-colonial divisions of Māori, Pacifica and minority ethnic rangatahi in Aotearoa New Zealand.

Keywords: rangatahi, youth empowerment, civic engagement, enabling, relating, digital platform, participation

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Authors: Mustafa Metin Donma

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Metabolic syndrome (MetS) is characterized by a series of biochemical, physiological and anthropometric indicators and is a life-threatening health problem due to its close association with chronic diseases such as diabetes mellitus, hypertension, cancer and cardiovascular diseases. The syndrome deserves great interest both in adults and children. Central obesity is the indispensable component of MetS. Particularly, children, who are morbidly obese have a great tendency to develop the disease, because they are under the threat in their future lives. Preventive measures at this stage should be considered. For this, investigators seek for an informative scale or an index for the purpose. So far, several, but not many suggestions come into the stage. However, the diagnostic decision is not so easy and may not be complete particularly in the pediatric population. The aim of the study was to develop a MetS index capable of predicting MetS, while children are at the morbid obesity stage. This study was performed on morbid obese (MO) children, which were divided into two groups. Morbid obese children, who do not possess MetS criteria comprised the first group (n=44). The second group was composed of children (n=42) with MetS diagnosis. Parents were informed about the signed consent forms, which are required for the participation of their children in the study. The approval of the study protocol was taken from the institutional ethics committee of Tekirdag Namik Kemal University. Helsinki Declaration was accepted prior to and during the study. Anthropometric measurements including weight, height, waist circumference (WC), hip C, head C, neck C, biochemical tests including fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) and blood pressure measurements (systolic (SBP) and diastolic (DBP)) were performed. Body fat percentage (BFP) values were determined by TANITA’s Bioelectrical Impedance Analysis technology. Body mass index and MetS indices were calculated. The equations for MetS index (MetSI) and advanced Donma MetS index (ADMI) were [(INS/FBG)/(HDL-C/TRG)]*100 and MetSI*[(SBP+DBP/Height)], respectively. Descriptive statistics including median values, compare means tests, correlation-regression analysis were performed within the scope of data evaluation using the statistical package program, SPSS. Statistically significant mean differences were determined by a p value smaller than 0.05. Median values for MetSI and ADMI in MO (MetS-) and MO (MetS+) groups were calculated as (25.9 and 36.5) and (74.0 and 106.1), respectively. Corresponding mean±SD values for BFPs were 35.9±7.1 and 38.2±7.7 in groups. Correlation analysis of these two indices with corresponding general BFP values exhibited significant association with ADMI, close to significance with MetSI in MO group. Any significant correlation was found with neither of the indices in MetS group. In conclusion, important associations observed with MetS indices in MO group were quite meaningful. The presence of these associations in MO group was important for showing the tendency towards the development of MetS in MO (MetS-) participants. The other index, ADMI, was more helpful for predictive purpose.

Keywords: body fat percentage, child, index, metabolic syndrome, obesity

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Authors: M. A. N. Rasanjalee Perera

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The world is facing several problems due to increasing elderly population. In Sri Lanka, along with the complexity of the modern society and structural and functional changes of the family, “caring for elders” seems as an emerging social problem. This situation may intensify as the county is moving into a middle income society. Seeking higher education and related career opportunities, and urban living in modern housing are new trends, through which several problems are generated. Among many issues related with elders, “lack of accessible and appropriate facilities in their houses as well as public buildings” can be identified as a major problem. This study argues that welfare facilities provided for the elderly people, particularly in the home environment, in the country are not adequate. Modern housing features such as bathrooms, pantries, lobbies, and leisure areas etc. are questionable as to whether they match with elders’ physical and mental needs. Consequently, elders have to face domestic accidents and many other difficulties within their living environments. Records of hospitals in the country also proved this fact. Therefore, this study tries to identify how far modern houses are suited with elders’ needs. The study further questioned whether “aging” is a considerable matter when people are buying, planning and renovating houses. A randomly selected sample of 50 houses were observed and 50 persons were interviewed around the Maharagama urban area in Colombo district to obtain primary data, while relevant secondary data and information were used to have a depth analysis. The study clearly found that none of the houses included to the sample are considering elders’ needs in planning, renovating, or arranging the home. Instead, most of the families were giving priority to the rich and elegant appearance and modern facilities of the houses. Particularly, to the bathrooms, pantry, large setting areas, balcony, parking slots for two vehicles, ad parapet walls with roller-gates are the main concerns. A significant factor found here is that even though, many children of the aged are in middle age and reaching their older years at present, they do not plan their future living within a safe and comfortable home, despite that they are hoping to spent the latter part of their lives in the their current homes. This fact highlights that not only the other responsible parts of the society, but also those who are reaching their older ages are ignoring the problems of the aged. At the same time, it was found that more than 80% of old parents do not like to stay at their children’s homes as the living environments in such modern homes are not familiar or convenient for them. Due to this context, the aged in Sri Lanka may have to be alone in their own homes due to current trend of society of migrating to urban living in modern houses. At the same time, current urban families who live in modern houses may have to face adding accessible facilities in their home environment, as current modern housing facilities may not be appropriate them for a better life in their latter part of life.

Keywords: aging population, elderly care, home environment, housing facilities

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Authors: Xiaoying Zhang

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Forest school – an outdoor educational experience that is undertaken in an outdoor environment with trees – becomes an emerging field of early childhood education recently. In China, the benefits of natural outdoor education to children and young people’s wellness have raised attention. Although different types of outdoor-based activities have been involved in some pre-school of China, few study and practice have been conducted in terms of the notion of forest school. To comprehend the impact of forest school for children and young people, this study aims to systematically review articles on the topic of forest school in preschool education from an ecological perspective, i.e. from individual level (e.g., behavior and mental health) to microsystem level (e.g., the relationship between teachers and children) to ecosystem level. Based on PRISMA framework flow, using the key words of “Forest School” and “Early Childhood Education” for searching in Web-of-science database, a total of 33 articles were identified. Sample participants of 13 studies were not preschool children, five studies were not on forest school theme, and two literature review articles were excluded for further analysis. Finally, 13 articles were eligible for thematic analysis. According to Bronfenbrenner's ecological systems theory, there are some fingdings, on the individual level, current forest school studies are concerned about the children behavioral experience in forest school, how these experience may relate to their achievement or to develop children’s wellbeing/wellness, and how this type of learning experience may enhance children’s self-awareness on risk and safety issues. On the microsystem/mesosystem level, this review indicated that pedagogical development for forest school, risk perception from teachers and parents, social development between peers, and adult’s role in the participation of forest school were concerned, explored and discussed most frequently. On the macrosystem, the conceptualization of forest school is the key theme. Different forms of presentation in various countries with diverse cultures could provide various models of forest school education. However, there was no study investigating forest school on an ecosystem level. As for the potential benefits of physical health and mental wellness that results from forest school, it informs us to reflect the system of preschool education from the ecological perspective for Chinese children. For instance, most Chinese kindergartens ignored the significance of natural outdoor activities for children. Preschool education in China is strongly oriented by primary school system, which means pre-school children are expected to be trained as primary school students to do different subjects, such as math. Hardly any kindergarteners provide the opportunities for children and young people to take risks in a natural environment like forest school does. However, merely copying forest school model for a Chinese preschool education system will be less effective. This review of different level concerns could inform us that the localization the idea of forest school to adapt to a Chinese political, educational and cultural background. More detailed results and profound discussions will be presented in the full paper.

Keywords: early childhood education, ecological system, education development prospects in China, forest school

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Authors: Anita Burgund Isakov, Cristina Nunes, Nevenka Zegarac, Ana Antunes

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Contemporary societies are facing a noticeable shift in family realities, urging to need for the development of new policies, service, and practice orientation that has application across different sectors who serves families with children across the world. A challenge for the field of family support is diversity in conceptual assumptions and epistemological frameworks. Since many disciplines and professionals are working in the family support field, there is a need to map and gain a deeper insight into the skills for the workforce in this field. Under the umbrella of the COST action 'The Pan-European Family Support Research Network: A bottom-up, evidence-based and multidisciplinary approach', a review of the current state of knowledge published from the European studies on family support workforce skills standards is performed. Contributing to the aim of mapping and catalogization of skills standards, key stages of literature review were identified in order to extract and systematize the data. We have considered inclusion and exclusion criteria for this literature review. Inclusion criteria were: a) families living with their children and families using family support services; different methodological approaches were included: qualitative, quantitative, mix method, literature review and theoretical reflections various topic appeared in journals like working with families that are facing difficulties or culturally sensitive practice and relationship-based approaches; b) the dates ranged from 1995 to February 2020. Articles published prior to 1995 were excluded due to modernization of family support services across world; c) the sources and languages included peer-reviewed articles published in scientific journals in English. Six databases were searched and once we have extracted all the relevant papers (n=29), we searched the list of reference in each and we found 11 additional papers. In total 40 papers have been extracted from six data basis. Findings could be summarized in: 1) only five countries emerged with production in the specific topic, that is, workforce skills to family support (UK, USA, Canada, Australia, and Spain), 2) studies revealed that diverse skills support family topics were investigated, namely the professional support skills to help families of neglected/abused children or in care; the professional support skills to help families with children who suffer from behavioral problems and families with children with disabilities; and the professional support skills to help minority ethnic parents, 3) social workers were the main targeted professionals' studies albeit other child protection workers were studied too, 4) the workforce skills to family support were grouped in three topics: the qualities of the professionals (attitudes and attributes); technical skills, and specific knowledge. The framework of analyses, literature strategy and findings with study limitations will be further discussed. As an implication, this study contributes and advocates for the structuring of a common base for cross-sectoral and interdisciplinary qualification standards for the family support workforce.

Keywords: family support, skill standards, systemic review, workforce

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Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia

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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.

Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke

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Authors: Kimberly M. Cacciato, Steven J. Singer, Allison R. Shapiro, Julianna F. Kamenakis

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This study examines the dynamics of communication among researchers and participants who have various levels of hearing, use multiple languages, have various disabilities, and who come from different social strata. This qualitative methodological study focuses on the strategies employed in an ethnographic research study examining the communication choices of six sets of parents who have Deaf-Disabled children. The participating families varied in their communication strategies and preferences including the use of American Sign Language (ASL), visual-gestural communication, multiple spoken languages, and pidgin forms of each of these. The research team consisted of two undergraduate students proficient in ASL and a Deaf principal investigator (PI) who uses ASL and speech as his main modes of communication. A third Hard-of-Hearing undergraduate student fluent in ASL served as an objective facilitator of the data analysis. The team created reflexive journals by audio recording, free writing, and responding to team-generated prompts. They discussed interactions between the members of the research team, their evolving relationships, and various social and linguistic power differentials. The researchers reflected on communication during data collection, their experiences with one another, and their experiences with the participating families. Reflexive journals totaled over 150 pages. The outside research assistant reviewed the journals and developed follow up open-ended questions and prods to further enrich the data. The PI and outside research assistant used NVivo qualitative research software to conduct open inductive coding of the data. They chunked the data individually into broad categories through multiple readings and recognized recurring concepts. They compared their categories, discussed them, and decided which they would develop. The researchers continued to read, reduce, and define the categories until they were able to develop themes from the data. The research team found that the various communication backgrounds and skills present greatly influenced the dynamics between the members of the research team and with the participants of the study. Specifically, the following themes emerged: (1) students as communication facilitators and interpreters as barriers to natural interaction, (2) varied language use simultaneously complicated and enriched data collection, and (3) ASL proficiency and professional position resulted in a social hierarchy among researchers and participants. In the discussion, the researchers reflected on their backgrounds and internal biases of analyzing the data found and how social norms or expectations affected the perceptions of the researchers in writing their journals. Through this study, the research team found that communication and language skills require significant consideration when working with multiple and complex communication modes. The researchers had to continually assess and adjust their data collection methods to meet the communication needs of the team members and participants. In doing so, the researchers aimed to create an accessible research setting that yielded rich data but learned that this often required compromises from one or more of the research constituents.

Keywords: American Sign Language, complex communication, deaf-disabled, methodology

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Authors: Carina Hermansson

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This presentation focuses a development project aiming at developing and documenting the steps taken at a multilingual, multicultural K-5 school, with the aim to improve the achievement levels of the pupils by focusing language and literacy development across the schedule in a digital classroom, and in all units of the school. This pre-formulated aim, thus, may be said to adhere to neoliberal educational and accountability policies in terms of its focus on digital learning, learning results, and national curriculum standards. In particular the project aimed at improving the collaboration between the teachers, the leisure time unit, the librarians, the mother tongue teachers and bilingual study counselors. This is a school environment characterized by cultural, ethnic, linguistic, and professional pluralization. The overarching aims of the research project were to scrutinize and analyze the factors enabling and obstructing the implementation of the Language Policy in a digital classroom. Theoretical framework: We apply multi-level perspectives in the analyses inspired by Uljens’ ideas about interactive and interpersonal first order (teacher/students) and second order(principal/teachers and other staff) educational leadership as described within the framework of discursive institutionalism, when we try to relate the Language Policy, educational policy, and curriculum with the administrative processes. Methodology/research design: The development project is based on recurring research circles where teachers, leisure time assistants, mother tongue teachers and study counselors speaking the mother tongue of the pupils together with two researchers discuss their digital literacy practices in the classroom. The researchers have in collaboration with the principal developed guidelines for the work, expressed in a Language Policy document. In our understanding the document is, however, only a part of the concept, the actions of the personnel and their reflections on the practice constitute the major part of the development project. One and a half years out of three years have now passed and the project has met with a row of difficulties which shed light on factors of importance for the progress of the development project. Field notes and recordings from the research circles, a survey with the personnel, and recorded group interviews provide data on the progress of the project. Expected conclusions: The problems experienced deal with leadership, curriculum, interplay between aims, technology, contents and methods, the parents as customers taking their children to other schools, conflicting values, and interactional difficulties, that is, phenomena on different levels, ranging from school to a societal level, as for example teachers being substituted as a result of the marketization of schools. Also underlying assumptions from actors at different levels create obstacles. We find this study and the problems we are facing utterly important to share and discuss in an era with a steady flow of refugees arriving in the Nordic countries.

Keywords: early childhood education, language policy, multicultural school, school development project

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Authors: Lillian M. Seo, Curtis L. Petersen, Ryan J. Halter, David Kotz, John A. Batsis

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Background: Resistance-based exercises effectively enhance muscle strength, which is especially important in older populations as it reduces the risk of disability. Our group developed a Bluetooth-enabled handle for resistance exercise bands that wirelessly transmits relative force data through low-energy Bluetooth to a local smartphone or similar device. The system has the potential to measure home-based exercise interventions, allowing health professionals to monitor compliance. Its feasibility has already been demonstrated in both clinical and field-based settings, but it remained unclear whether the system’s usability persisted upon repeated use. The current study sought to assess the usability of this system and its users’ satisfaction with repeated use by deploying the device among younger adults to gather formative information that can ultimately improve the device’s design for older adults. Methods: A usability study was conducted in which 32 participants used the above system. Participants executed 10 repetitions of four commonly performed exercises: bicep flexion, shoulder abduction, elbow extension, and triceps extension. Each completed three exercise sessions, separated by at least 24 hours to minimize muscle fatigue. At its conclusion, subjects completed an adapted version of the usefulness, satisfaction, and ease (USE) questionnaire – assessing the system across four domains: usability, satisfaction, ease of use, and ease of learning. The 20-item questionnaire examined how strongly a participant agrees with positive statements about the device on a seven-point Likert scale, with one representing ‘strongly disagree’ and seven representing ‘strongly agree.’ Participants’ data were aggregated to calculate mean response values for each question and domain, effectively assessing the device’s performance across different facets of the user experience. Summary force data were visualized using a custom web application. Finally, an optional prompt at the end of the questionnaire allowed for written comments and feedback from participants to elicit qualitative indicators of usability. Results: Of the n=32 participants, 13 (41%) were female; their mean age was 32.4 ± 11.8 years, and no participants had a physical impairment. No usability questions received a mean score < 5 of seven. The four domains’ mean scores were: usefulness 5.66 ± 0.35; satisfaction 6.23 ± 0.06; ease of use 6.25 ± 0.43; and ease of learning 6.50 ± 0.19. Representative quotes of the open-ended feedback include: ‘A non-rigid strap-style handle might be useful for some exercises,’ and, ‘Would need different bands for each exercise as they use different muscle groups with different strength levels.’ General impressions were favorable, supporting the expectation that the device would be a useful tool in exercise interventions. Conclusions: A simple usability assessment of a Bluetooth-enabled resistance exercise band supports a consistent and positive user experience among young adults. This study provides adequate formative data, assuring the next steps can be taken to continue testing and development for the target population of older adults.

Keywords: Bluetooth, exercise, mobile health, mHealth, usability

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Authors: Julia Kapr, Andrea Rossi, Haribaskar Ramachandran, Marius Pollet, Ilka Egger, Selina Dangeleit, Katharina Koch, Jean Krutmann, Ellen Fritsche

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It is widely acknowledged that animal models do not always represent human disease. Especially human brain development is difficult to model in animals due to a variety of structural and functional species-specificities. This causes significant discrepancies between predicted and apparent drug efficacies in clinical trials and their subsequent failure. Emerging alternatives based on 3D in vitro approaches, such as human brain spheres or organoids, may in the future reduce and ultimately replace animal models. Here, we present a human induced pluripotent stem cell (hiPSC)-based 3D neural in a vitro disease model for the Cockayne Syndrome B (CSB). CSB is a rare hereditary disease and is accompanied by severe neurologic defects, such as microcephaly, ataxia and intellectual disability, with currently no treatment options. Therefore, the aim of this study is to investigate the molecular and cellular defects found in neural hiPSC-derived CSB models. Understanding the underlying pathology of CSB enables the development of treatment options. The two CSB models used in this study comprise a patient-derived hiPSC line and its isogenic control as well as a CSB-deficient cell line based on a healthy hiPSC line (IMR90-4) background thereby excluding genetic background-related effects. Neurally induced and differentiated brain sphere cultures were characterized via RNA Sequencing, western blot (WB), immunocytochemistry (ICC) and multielectrode arrays (MEAs). CSB-deficiency leads to an altered gene expression of markers for autophagy, focal adhesion and neural network formation. Cell migration was significantly reduced and electrical activity was significantly increased in the disease cell lines. These data hint that the cellular pathologies is possibly underlying CSB. By induction of autophagy, the migration phenotype could be partially rescued, suggesting a crucial role of disturbed autophagy in defective neural migration of the disease lines. Altered autophagy may also lead to inefficient mitophagy. Accordingly, disease cell lines were shown to have a lower mitochondrial base activity and a higher susceptibility to mitochondrial stress induced by rotenone. Since mitochondria play an important role in neurotransmitter cycling, we suggest that defective mitochondria may lead to altered electrical activity in the disease cell lines. Failure to clear the defective mitochondria by mitophagy and thus missing initiation cues for new mitochondrial production could potentiate this problem. With our data, we aim at establishing a disease adverse outcome pathway (AOP), thereby adding to the in-depth understanding of this multi-faced disorder and subsequently contributing to alternative drug development.

Keywords: autophagy, disease modeling, in vitro, pluripotent stem cells

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Authors: Doris C. C. K. Kowaltowski, Marcella S. Deliberador

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The architectural design process, in general, is becoming more complex, as new technical, social, environmental, and economical requirements are imposed. For school buildings, this scenario is also valid. The quality of a school building depends on known design criteria and professional knowledge, as well as feedback from building performance assessments. To attain high-performance school buildings, a design process should add a multidisciplinary team, through an integrated process, to ensure that the various specialists contribute at an early stage to design solutions. The participation of stakeholders is of special importance at the programming phase when the search for the most appropriate design solutions is underway. The composition of a multidisciplinary team should comprise specialists in education, design professionals, and consultants in various fields such as environmental comfort and psychology, sustainability, safety and security, as well as administrators, public officials and neighbourhood representatives. Users, or potential users (teachers, parents, students, school officials, and staff), should be involved. User expectations must be guided, however, toward a proper understanding of a response of design to needs to avoid disappointment. In this context, appropriate tools should be introduced to organize such diverse participants and ensure a rich and focused response to needs and a productive outcome of programming sessions. In this paper, different stakeholder in a school design process are discussed in relation to their specific contributions and a tool in the form of a card game is described to structure the design debates and ensure a comprehensive decision-making process. The game is based on design patterns for school architecture as found in the literature and is adapted to a specific reality: State-run public schools in São Paulo, Brazil. In this State, school buildings are managed by a foundation called Fundação para o Desenvolvimento da Educação (FDE). FDE supervises new designs and is responsible for the maintenance of ~ 5000 schools. The design process of this context was characterised with a recommendation to improve the programming phase. Card games can create a common environment, to which all participants can relate and, therefore, can contribute to briefing debates on an equal footing. The cards of the game described here represent essential school design themes as found in the literature. The tool was tested with stakeholder groups and with architecture students. In both situations, the game proved to be an efficient tool to stimulate school design discussions and to aid in the elaboration of a rich, focused and thoughtful architectural program for a given demand. The game organizes the debates and all participants are shown to spontaneously contribute each in his own field of expertise to the decision-making process. Although the game was specifically based on a local school design process it shows potential for other contexts because the content is based on known facts, needs and concepts of school design, which are global. A structured briefing phase with diverse stakeholder participation can enrich the design process and consequently improve the quality of school buildings.

Keywords: architectural program, design process, school building design, stakeholder

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Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul

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Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.

Keywords: children, diabetes, metabolic control, periodontal therapy

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Authors: Orkide Donma, Mustafa M. Donma, Muhammet Demirkol, Murat Aydin, Tuba Gokkus, Burcin Nalbantoglu, Aysin Nalbantoglu, Birol Topcu

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Obesity in childhood establishes a ground for adulthood obesity. Especially morbid obesity is an important problem for the children because of the associated diseases such as diabetes mellitus, cancer and cardiovascular diseases. In this study, body mass index (BMI), body fat ratios, anthropometric measurements and ratios were evaluated together with different laboratory indices upon evaluation of obesity in morbidly obese (MO) children. Children with nutritional problems participated in the study. Written informed consent was obtained from the parents. Study protocol was approved by the Ethics Committee. Sixty-two MO girls aged 129.5±35.8 months and 75 MO boys aged 120.1±26.6 months were included into the scope of the study. WHO-BMI percentiles for age-and-sex were used to assess the children with those higher than 99^th as morbid obesity. Anthropometric measurements of the children were recorded after their physical examination. Bio-electrical impedance analysis was performed to measure fat distribution. Anthropometric ratios, body fat ratios, Index-I and Index-II as well as insulin sensitivity indices (ISIs) were calculated. Girls as well as boys were binary grouped according to homeostasis model assessment-insulin resistance (HOMA-IR) index of <2.5 and >2.5, fasting glucose to insulin ratio (FGIR) of <6 and >6 and quantitative insulin sensitivity check index (QUICKI) of <0.33 and >0.33 as the frequently used cut-off points. They were evaluated based upon their BMIs, arms, legs, trunk, whole body fat percentages, body fat ratios such as fat mass index (FMI), trunk-to-appendicular fat ratio (TAFR), whole body fat ratio (WBFR), anthropometric measures and ratios [waist-to-hip, head-to-neck, thigh-to-arm, thigh-to-ankle, height/2-to-waist, height/2-to-hip circumference (C)]. SPSS/PASW 18 program was used for statistical analyses. p≤0.05 was accepted as statistically significance level. All of the fat percentages showed differences between below and above the specified cut-off points in girls when evaluated with HOMA-IR and QUICKI. Differences were observed only in arms fat percent for HOMA-IR and legs fat percent for QUICKI in boys (p≤ 0.05). FGIR was unable to detect any differences for the fat percentages of boys. Head-to-neck C was the only anthropometric ratio recommended to be used for all ISIs (p≤0.001 for both girls and boys in HOMA-IR, p≤0.001 for girls and p≤0.05 for boys in FGIR and QUICKI). Indices which are recommended for use in both genders were Index-I, Index-II, HOMA/BMI and log HOMA (p≤0.001). FMI was also a valuable index when evaluated with HOMA-IR and QUICKI (p≤0.001). The important point was the detection of the severe significance for HOMA/BMI and log HOMA while they were evaluated also with the other indices, FGIR and QUICKI (p≤0.001). These parameters along with Index-I were unique at this level of significance for all children. In conclusion, well-accepted ratios or indices may not be valid for the evaluation of both genders. This study has emphasized the limiting properties for boys. This is particularly important for the selection process of some ratios and/or indices during the clinical studies. Gender difference should be taken into consideration for the evaluation of the ratios or indices, which will be recommended to be used particularly within the scope of obesity studies.

Keywords: anthropometry, childhood obesity, gender, insulin sensitivity index

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Authors: Suhrita Saha

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Barbie is a fashion doll manufactured by the American toy company Mattel Inc and it made debut at the American International Toy Fair in New York in 9 March 1959. From being a fashion doll to a symbol of fetishistic commodification, Barbie has come a long way. A Barbie doll is sold every three seconds across the world, which makes the billion dollar brand the world’s most popular doll for the girls. The 11.5 inch moulded plastic doll has a height of 5 feet 9 inches at 1/6 scale. Her vital statistics have been estimated at 36 inches (chest), 18 inches (waist) and 33 inches (hips). Her weight is permanently set at 110 pounds which would be 35 pounds underweight. Ruth Handler, the creator of Barbie wanted a doll that represented adulthood and allowed children to imagine themselves as teenagers or adults. While Barbie might have been intended to be independent, imaginative and innovative, the physical uniqueness does not confine the doll to the status of a play thing. It is a cultural icon but with far reaching critical implications. The doll is a commodity bearing more social value than practical use value. The way Barbie is produced represents industrialization and commodification of the process of symbolic production. And this symbolic production and consumption is a standardized planned one that produce stereotypical ‘pseudo-individuality’ and suppresses cultural alternatives. Children are being subject to and also arise as subjects in this consumer context. A very gendered, physiologically dissected sexually charged symbolism is imposed upon children (both male and female), childhood, their social worlds, identity, and relationship formation. Barbie is also very popular among Indian children. While the doll is essentially an imaginative representation of the West, it is internalized by the Indian sensibilities. Through observation and questionnaire-based interview within a sample population of adolescent children (primarily female, a few male) and parents (primarily mothers) in Kolkata, an Indian metropolis, the paper puts forth findings of sociological relevance. 1. Barbie creates, recreates, and accentuates already existing divides between the binaries like male- female, fat- thin, sexy- nonsexy, beauty- brain and more. 2. The Indian girl child in her associative process with Barbie wants to be like her and commodifies her own self. The male child also readily accepts this standardized commodification. Definition of beauty is thus based on prejudice and stereotype. 3. Not being able to become Barbie creates health issues both psychological and physiological varying from anorexia to obesity as well as personality disorder. 4. From being a plaything Barbie becomes the game maker. Barbie along with many other forms of simulation further creates a consumer culture and market for all kind of fitness related hyper enchantment and subsequent disillusionment. The construct becomes the reality and the real gets lost in the play world. The paper would thus argue that Barbie from being an innocuous doll transports itself into becoming social construct with long term and irreversible adverse impact.

Keywords: barbie, commodification, personality disorder, sterotype

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Authors: Nadeesha Sewwandi, Dilini Shashikala, R. Kanapathy, S. Viyasan, R. M. S. Kumara, Duminda Guruge

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Early childhood development is important to the emotional, social, and physical development of young children and it has a direct effect on their overall development and on the adult they become. Play is so important to optimal child developments including skill development, social development, imagination, creativity and it fulfills a baby’s inborn need to learn. So, health promotion approach empowers people about the development of early childhood. Play area is a new concept and this study focus how this play areas helps to the development of early childhood of children in rural villages in Sri Lanka. This study was conducted with a children society in a rural village called Welankulama in Sri Lanka. Survey was conducted with children society about emotional, social and physical development of young children (Under age eight) in this village using questionnaires. It described most children under eight years age have poor level of emotional, social and physical development in this village. Then children society wanted to find determinants for this problem and among them they prioritized determinants like parental interactions, learning environment and social interaction and address them using an innovative concept called play area. In this village there is a common place as play area under a big tamarind tree. It consists of a playhouse, innovative playing toys, mobile library, etc. Twice a week children, parents, grandparents gather to this nice place. Collective feeding takes place in this area once a week and it was conducted by several mothers groups in this village. Mostly grandparents taught about handicrafts and this is a very nice place to share their experiences with all. Healthy competitions were conducted in this place through playing to motivate the children. Happy calendar (mood of the children) was marked by children before and after coming to the play area. In terms of results qualitative changes got significant place in this study. By learning about colors and counting through playing the thinking and reasoning skills got developed among children. Children were widening their imagination by means of storytelling. We observed there were good developments of fine and gross motor skills of two differently abled children in this village. Children learn to empathize with other people, sharing, collaboration, team work and following of rules. And also children gain knowledge about fairness, through role playing, obtained insight on the right ways of displaying emotions such as stress, fear, anger, frustration, and develops knowledge of how they can manage their feelings. The reading and writing ability of the children got improved by 83% because of the mobile library. The weight of children got increased by 81% in the village. Happiness was increased by 76% among children in the society. Playing is very important for learning during early childhood period of a person. Health promotion interventions play a major role to the development of early childhood and it help children to adjust to the school setting and even to enhance children’s learning readiness, learning behaviors and problem solving skills.

Keywords: early childhood development, health promotion approach, play and learning, working with children

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity is a low-grade inflammatory disease and may lead to health problems such as hypertension, dyslipidemia, diabetes. It is also associated with important risk factors for cardiovascular diseases. This requires the detailed evaluation of obesity, particularly in children. The aim of this study is to enlighten the potential associations between lipid ratios and obesity indices and to introduce those with discriminating features among children with obesity and metabolic syndrome (MetS). A total of 408 children (aged between six and eighteen years) participated in the scope of the study. Informed consent forms were taken from the participants and their parents. Ethical Committee approval was obtained. Anthropometric measurements such as weight, height as well as waist, hip, head, neck circumferences and body fat mass were taken. Systolic and diastolic blood pressure values were recorded. Body mass index (BMI), diagnostic obesity notation model assessment index-II (D2 index), waist-to-hip, head-to-neck ratios were calculated. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDLChol), low-density lipoprotein cholesterol (LDLChol) analyses were performed in blood samples drawn from 110 children with normal body weight, 164 morbid obese (MO) children and 134 children with MetS. Age- and sex-adjusted BMI percentiles tabulated by World Health Organization were used to classify groups; normal body weight, MO and MetS. 15^th-to-85^th percentiles were used to define normal body weight children. Children, whose values were above the 99th percentile, were described as MO. MetS criteria were defined. Data were evaluated statistically by SPSS Version 20. The degree of statistical significance was accepted as p≤0.05. Mean±standard deviation values of BMI for normal body weight children, MO children and those with MetS were 15.7±1.1, 27.1±3.8 and 29.1±5.3 kg/m², respectively. Corresponding values for the D2 index were calculated as 3.4±0.9, 14.3±4.9 and 16.4±6.7. Both BMI and D2 index were capable of discriminating the groups from one another (p≤0.01). As far as other obesity indices were considered, waist-to hip and head-to-neck ratios did not exhibit any statistically significant difference between MO and MetS groups (p≥0.05). Diagnostic obesity notation model assessment index-II was correlated with the triglycerides-to-HDL-C ratio in normal body weight and MO (r=0.413, p≤0.01 and r=0.261, (p≤0.05, respectively). Total cholesterol-to-HDL-C and LDL-C-to-HDL-C showed statistically significant differences between normal body weight and MO as well as MO and MetS (p≤0.05). The only group in which these two ratios were significantly correlated with waist-to-hip ratio was MetS group (r=0.332 and r=0.334, p≤0.01, respectively). Lack of correlation between the D2 index and the triglycerides-to-HDL-C ratio was another important finding in MetS group. In this study, parameters and ratios, whose associations were defined previously with increased cardiovascular risk or cardiac death have been evaluated along with obesity indices in children with morbid obesity and MetS. Their profiles during childhood have been investigated. Aside from the nature of the correlation between the D2 index and triglycerides-to-HDL-C ratio, total cholesterol-to-HDL-C as well as LDL-C-to- HDL-C ratios along with their correlations with waist-to-hip ratio showed that the combination of obesity-related parameters predicts better than one parameter and appears to be helpful for discriminating MO children from MetS group.

Keywords: children, lipid ratios, metabolic syndrome, obesity indices

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Authors: Sana Fatima, Paul Sadler, Jon Cooper, David Mendel, Ayesha Jameel

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Background: Neurodiversity refers to intrinsic differences between human minds and encompasses dyspraxia, dyslexia, attention deficit hyperactivity disorder, dyscalculia, autism spectrum disorder, and Tourette syndrome. There is increasing recognition of neurodiversity in relation to disability/diversity in medical education and the associated impact on training, career progression, and personal and professional wellbeing. In addition, documented and anecdotal evidence suggests that medical educators and training providers in all four nations (UK) are increasingly concerned about understanding neurodiversity and identifying and providing support for neurodivergent trainees. Summary of Work: A national Neurodiversity Task and Finish group were established to survey Health Education England local office Professional Support teams about insights into infrastructure, training for educators, triggers for assessment, resources, and intervention protocols. This group drew from educational leadership, professional and personal neurodiverse expertise, occupational medicine, employer human resource, and trainees. An online, exploratory survey was conducted to gather insights from supervisors and trainers across England using the Professional Support Units' platform. Summary of Results: This survey highlighted marked heterogeneity in the identification, assessment, and approaches to support and management of neurodivergent trainees and highlighted a 'deficit' approach to neurodiversity. It also demonstrated a paucity of educational and protocol resources for educators and supervisors in supporting neurodivergent trainees. Discussions and Conclusions: In phase one, we focused on faculty development. An educational repository for all supervising trainees using a thematic approach was formalised. This was guided by our survey findings specific for neurodiversity and took a triple 'A' approach: awareness, assessment, and action. This is further supported by video material incorporating stories in training as well as mobile workshops for trainers for more immersive learning. The subtle theme from both the survey and Task and finish group suggested a move away from deficit-focused methods toward a positive holistic, interdisciplinary approach within a biopsychosocial framework. Contributions: 1. Faculty Knowledge and basic understanding of neurodiversity are key to supporting trainees with known or underlying Neurodiverse conditions. This is further complicated by challenges around non-disclosure, varied presentations, stigma, and intersectionality. 2. There is national (and international) inconsistency in the approach to how trainees are managed once a neurodiverse condition is suspected or diagnosed. 3. A carefully constituted and focussed Task and Finish group can rapidly identify national inconsistencies in neurodiversity and implement rapid educational interventions. 4. Nuanced findings from surveys and discussion can reframe the approach to neurodiversity; from a medical model to a more comprehensive, asset-based, biopsychosocial model of support, fostering a cultural shift, accepting 'diversity' in all its manifestations, visible and hidden.

Keywords: neurodiversity, professional support, human considerations, workplace wellbeing

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Authors: Joy Chadwick

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There is no doubt that classrooms of today are more complex and diverse than ever before. Preparing teacher candidates to meet these challenges is essential to ensure the retention of teachers within the profession and to ensure that graduates begin their teaching careers with the knowledge and understanding of how to effectively meet the diversity of students they will encounter. Creating inclusive classrooms requires teachers to have a repertoire of effective instructional skills and strategies. Teachers must also have the mindset to embrace diversity and value the uniqueness of individual students in their care. This qualitative study analyzed teacher candidates' experiences as they completed a fourteen-week teaching practicum while simultaneously completing a university course focused on inclusive pedagogy. The research investigated the challenges and successes teacher candidates had in navigating the translation of theory related to inclusive pedagogy into their teaching practice. Applying threshold concept theory as a framework, the research explored the troublesome concepts, liminal spaces, and transformative experiences as connected to inclusive practices. Threshold concept theory suggests that within all disciplinary fields, there exists particular threshold concepts that serve as gateways or portals into previously inaccessible ways of thinking and practicing. It is in these liminal spaces that conceptual shifts in thinking and understanding and deep learning can occur. The threshold concept framework provided a lens to examine teacher candidate struggles and successes with the inclusive education course content and the application of this content to their practicum experiences. A qualitative research approach was used, which included analyzing twenty-nine course reflective journals and six follow up one-to-one semi structured interviews. The journals and interview transcripts were coded and themed using NVivo software. Threshold concept theory was then applied to the data to uncover the liminal or stuck spaces of learning and the ways in which the teacher candidates navigated those challenging places of teaching. The research also sought to uncover potential transformative shifts in teacher candidate understanding as connected to teaching in an inclusive classroom. The findings suggested that teacher candidates experienced difficulties when they did not feel they had the knowledge, skill, or time to meet the needs of the students in the way they envisioned they should. To navigate the frustration of this thwarted vision, they relied on present and previous course content and experiences, collaborative work with other teacher candidates and their mentor teachers, and a proactive approach to planning for students. Transformational shifts were most evident in their ability to reframe their perceptions of children from a deficit or disability lens to a strength-based belief in the potential of students. It was evident that through their course work and practicum experiences, their beliefs regarding struggling students shifted as they saw the value of embracing neurodiversity, the importance of relationships, and planning for and teaching through a strength-based approach. Research findings have implications for teacher education programs and for understanding threshold concepts theory as connected to practice-based learning experiences.

Keywords: inclusion, inclusive education, liminal space, teacher education, threshold concepts, troublesome knowledge

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Authors: Michael J. Haslip

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Character strength application improves performance and well-being in adults across industries, but the potential impact of character strength training among early childhood educators is mostly unknown. To explore how character strengths are applied by early childhood educators at work, a qualitative study was completed alongside professional development provided to a group of in-service teachers of children ages 0-5 in Philadelphia, Pennsylvania, United States. Study participants (n=17) were all female. The majority of participants were non-white, in full-time lead or assistant teacher roles, had at least ten years of experience and a bachelor’s degree. Teachers were attending professional development weekly for 2 hours over a 10-week period on the topic of social and emotional learning and child guidance. Related to this training were modules and sessions on identifying a teacher’s character strength profile using the Values in Action classification of 24 strengths (e.g., humility, perseverance) that have a scientific basis. Teachers were then asked to apply their character strengths to help resolve current workplace challenges. This study identifies which character strengths the teachers reported using most frequently and the nature of the workplace challenges being resolved in this context. The study also reports how difficult these challenges were to the teachers and their success rate at resolving workplace challenges using a character strength application plan. The study also documents how teachers’ own use of character strengths relates to their modeling of these same traits (e.g., kindness, teamwork) for children, especially when the nature of the workplace challenge directly involves the children, such as when addressing issues of classroom management and behavior. Data were collected on action plans (reflective templates) which teachers wrote to explain the work challenge they were facing, the character strengths they used to address the challenge, their plan for applying strengths to the challenge, and subsequent results. Content analysis and thematic analysis were used to investigate the research questions using approaches that included classifying, connecting, describing, and interpreting data reported by educators. Findings reveal that teachers most frequently use kindness, leadership, fairness, hope, and love to address a range of workplace challenges, ranging from low to high difficulty, involving children, coworkers, parents, and for self-management. Teachers reported a 71% success rate at fully or mostly resolving workplace challenges using the action plan method introduced during professional development. Teachers matched character strengths to challenges in different ways, with certain strengths being used mostly when the challenge involved children (love, forgiveness), others mostly with adults (bravery, teamwork), and others universally (leadership, kindness). Furthermore, teacher’s application of character strengths at work involved directly modeling character for children in 31% of reported cases. The application of character strengths among early childhood educators may play a significant role in improving teacher well-being, reducing job stress, and improving efforts to model character for young children.

Keywords: character strengths, positive psychology, professional development, social-emotional learning

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Authors: Tanya Anand, Arun Kandasamy, L. N. Suman

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Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.

Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews

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Authors: Tholaine Matadi

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South Africa is a democratic country with a historical record of racially-motivated marginalisation and exclusion of the majority. During the apartheid era the country was run along pieces of legislation and policies based on racial segregation. The system held a tight clamp on interracial mixing which forced people to remain in segregated areas. For example, a citizen from the Indian community could not own property in an area allocated to white people. In this way, a great majority of people were denied basic human rights. Now, there is a supreme constitution with an entrenched justiciable Bill of Rights founded on democratic values of social justice, human dignity, equality and the advancement of human rights and freedoms. The Constitution also enshrines the values of non-racialism and non-sexism. The Constitutional Court has the power to declare unconstitutional any law or conduct considered to be inconsistent with it. Now, more than two decades down the line, despite the abolition of apartheid, there is evidence that South Africa still experiences hate crimes which violate the entrenched right of vulnerable groups not to be discriminated against on the basis of race, sexual orientation, gender, national origin, occupation, or disability. To remedy this mischief parliament has responded by drafting the Prevention and Combatting of Hate Crimes and Hate Speech Bill. The Bill has been disseminated for public comment and suggestions. It is intended to combat hate crimes and hate speech based on sheer prejudice. The other purpose of the Bill is to bring South Africa in line with international human rights instruments against racism, racial discrimination, xenophobia and related expressions of intolerance identified in several international instruments. It is against this backdrop that this paper intends to analyse the impact of the Bill on the rights to human dignity, equality, and freedom. This study is significant because the Bill was highly contested and creates a huge debate. This study relies on a qualitative evaluative approach based on desktop and library research. The article recurs to primary and secondary sources. For comparative purpose, the paper compares South Africa with countries such as Australia, Canada, Kenya, Cuba, and United Kingdom which have criminalised hate crimes and hate speech. The finding from this study is that despite the Bill’s expressed positive intentions, this draft legislation is problematic for several reasons. The main reason is that it generates considerable controversy mostly because it is considered to infringe the right to freedom of expression. Though the author suggests that the Bill should not be rejected in its entirety, she notes the brutal psychological effect of hate crimes on their direct victims and the writer emphasises that a legislature can succeed to combat hate-crimes only if it provides for them as a separate stand-alone category of offences. In view of these findings, the study recommended that since hate speech clauses have a negative impact on freedom of expression it can be promulgated, subject to the legislature enacting the Prevention and Combatting of Hate-Crimes Bill as a stand-alone law which criminalises hate crimes.

Keywords: freedom of expression, hate crimes, hate speech, human dignity

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Authors: M. Saard, A. Kolk, K. Sepp, L. Pertens, L. Reinart, C. Kööp

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Introduction: Social competence is often impaired in children with acquired brain injury (ABI), but evidence-based rehabilitation for social skills has remained undeveloped. Modern technology-based methods create effective and safe learning environments for pediatric social skills remediation. The aim of the study was to implement our structured model of neuro rehab for socio-cognitive deficit using multitouch-multiuser tabletop (MMT) computer-based platforms and virtual reality (VR) technology. Methods: 40 children aged 8-13 years (yrs) have participated in the pilot study: 30 with ABI -epilepsy, traumatic brain injury and/or tic disorder- and 10 healthy age-matched controls. From the patients, 12 have completed the training (M = 11.10 yrs, SD = 1.543) and 20 are still in training or in the waiting-list group (M = 10.69 yrs, SD = 1.704). All children performed the first individual and paired assessments. For patients, second evaluations were performed after the intervention period. Two interactive applications were implemented into rehabilitation design: Snowflake software on MMT tabletop and NoProblem on DiamondTouch Table (DTT), which allowed paired training (2 children at once). Also, in individual training sessions, HTC Vive VR device was used with VR metaphors of difficult social situations to treat social anxiety and train social skills. Results: At baseline (B) evaluations, patients had higher deficits in executive functions on the BRIEF parents’ questionnaire (M = 117, SD = 23.594) compared to healthy controls (M = 22, SD = 18.385). The most impaired components of social competence were emotion recognition, Theory of Mind skills (ToM), cooperation, verbal/non-verbal communication, and pragmatics (Friendship Observation Scale scores only 25-50% out of 100% for patients). In Sentence Completion Task and Spence Anxiety Scale, the patients reported a lack of friends, behavioral problems, bullying in school, and social anxiety. Outcome evaluations: Snowflake on MMT improved executive and cooperation skills and DTT developed communication skills, metacognitive skills, and coping. VR, video modelling and role-plays improved social attention, emotional attitude, gestural behaviors, and decreased social anxiety. NEPSY-II showed improvement in Affect Recognition [B = 7, SD = 5.01 vs outcome (O) = 10, SD = 5.85], Verbal ToM (B = 8, SD = 3.06 vs O = 10, SD = 4.08), Contextual ToM (B = 8, SD = 3.15 vs O = 11, SD = 2.87). ToM Stories test showed an improved understanding of Intentional Lying (B = 7, SD = 2.20 vs O = 10, SD = 0.50), and Sarcasm (B=6, SD = 2.20 vs O = 7, SD = 2.50). Conclusion: Neurorehabilitation based on the Structured Model of Neurorehab for Socio-Cognitive Deficit in children with ABI were effective in social skills remediation. The model helps to understand theoretical connections between components of social competence and modern interactive computerized platforms. We encourage therapists to implement these next-generation devices into the rehabilitation process as MMT and VR interfaces are motivating for children, thus ensuring good compliance. Improving children’s social skills is important for their and their families’ quality of life and social capital.

Keywords: acquired brain injury, children, social skills deficit, technology-based neurorehabilitation

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Authors: Swati Vohra

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A genuine economic and social transformation requires equal contribution and participation from both men and women; however, achieving this gender parity is a global concern. In the patriarchal societies around the world, women have been silenced, oppressed, and subjugated. Girls and women comprise half of the world’s population. This, however, must not be the lone reason for recognizing and providing equal opportunities to them. Every individual has a right to develop through opportunities without the biases of gender, caste, race, or ethnicity. The world today is confronted by pressing issues of climate change, economic crisis, violence against women and children, escalating conflicts, to name a few. Achieving gender parity is thus an essential component in meeting this wide array of challenges in order to create just, robust and inclusive societies. In 2015, The United Nation enunciated achieving 17 Sustainable Development Goals by 2030, one of which is SGD#5- Gender Equality, that is not merely a stand-alone goal. It is central to the achievement of all 17 SDG’s. Without progress on gender equality, the global community will not only fail to achieve the SDG5, but it will also lose the impetus towards achieving the broad 2030 agenda. This research is based on a hypothesis that aims to connect the targets laid by the UN under SDG#5 - 5.4 (Recognize and value unpaid care and domestic work) and 5.5 (Ensure women participation for leadership at all levels of decision-making). The study evaluates the impact of unpaid household responsibilities on women’s leadership in India. In Indian society, women have experienced a low social status for centuries, which is reflected throughout the Indian history with preference of a male child and common occurrences of female infanticides that are still prevalent in many parts of the country. Insistence on the traditional gender roles builds patriarchal inequalities into the structure of Indian society. It is argued that a burden of unpaid labor on women is placed, which narrows the opportunities and life chances women are given and the choices they are able to make, thereby shutting them from shared participation in public and economic leadership. The study investigates theoretical framework of social construction of gender, unpaid labor, challenges to women leaders and peace theorist perspective as the core components. The methodology used is qualitative research of comprehensive literature, accompanied by the data collected through interviews of representatives of women leaders from various fields within Delhi-National Capital Region (NCR). The women leaders interviewed had the privilege of receiving good education and a conducive family support; however, post marriage and children it was not the case and the social obligations weighed heavy on them. The research concludes by recommending the importance of gender-neutral parenting and education along with government ratified paternal leaves for at least six months and childcare facilities available for both the parents at workplace.

Keywords: gender equality, gender roles, peace studies, sustainable development goals, social construction, unpaid labor, women’s leadership

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Authors: Mustafa Metin Donma, Orkide Donma

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Childhood obesity is an important clinical problem because it may lead to chronic diseases during the adulthood period of the individual. Obesity is a metabolic disease associated with low-grade inflammation. The liver occurs at the center of metabolic pathways. Adropin, fibroblast growth factor-21 (FGF-21), and fetuin-A are hepatokines. Due to the immense participation of the liver in glucose metabolism, these liver-derived factors may be associated with insulin resistance (IR), which is a phenomenon discussed within the scope of obesity problems. The aim of this study is to determine the concentrations of adropin, FGF-21, and fetuin-A in childhood obesity, to point out possible differences between the obesity groups, and to investigate possible associations among these three hepatokines in obese and morbidly obese children. A total of one hundred and thirty-two children were included in the study. Two obese groups were constituted. The groups were matched in terms of mean ± SD values of ages. Body mass index values of obese and morbidly obese groups were 25.0 ± 3.5 kg/m² and 29.8 ± 5.7 kg/m², respectively. Anthropometric measurements including waist circumference, hip circumference, head circumference, and neck circumference were recorded. Informed consent forms were taken from the parents of the participants. The ethics committee of the institution approved the study protocol. Blood samples were obtained after overnight fasting. Routine biochemical tests, including glucose- and lipid-related parameters, were performed. Concentrations of the hepatokines (adropin, FGF-21, fetuin A) were determined by enzyme-linked immunosorbent assay. Insulin resistance indices such as homeostasis model assessment for IR (HOMA-IR), alanine transaminase-to aspartate transaminase ratio (ALT/AST), diagnostic obesity notation model assessment laboratory index, diagnostic obesity notation model assessment metabolic syndrome index as well as obesity indices such as diagnostic obesity notation model assessment-II index, and fat mass index were calculated using the previously derived formulas. Statistical evaluation of the study data as well as findings of the study was performed by SPSS for Windows. Statistical difference was accepted significant when p is smaller than 0.05. Statistically significant differences were found for insulin, triglyceride, high-density lipoprotein cholesterol levels of the groups. A significant increase was observed for FGF-21 concentrations in the morbidly obese group. Higher adropin and fetuin-A concentrations were observed in the same group in comparison with the values detected in the obese group (p > 0.05). There was no statistically significant difference between the ALT/AST values of the groups. In all of the remaining IR and obesity indices, significantly increased values were calculated for morbidly obese children. Significant correlations were detected between HOMA-IR and each of the hepatokines. The highest one was the association with fetuin-A (r=0.373, p=0.001). In conclusion, increased levels observed in adropin, FGF-21, and fetuin-A have shown that these hepatokines possess increasing potential going from obese to morbid obese state. Out of the correlations found with the IR index, the most affected hepatokine was fetuin-A, the parameter possibly used as the indicator of the advanced obesity stage.

Keywords: adropin, fetuin A, fibroblast growth factor-21, insulin resistance, pediatric obesity

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Authors: Qudsiya Baig

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Empathy yields an unparalleled therapeutic value within patient physician interactions. Medical research is inundated with evidence to support that a physician’s ability to empathise with patients leads to a greater willingness to report symptoms, an improvement in diagnostic accuracy and safety, and a better adherence and satisfaction with treatment plans. Furthermore, the Institute of Medicine states that empathy leads to a more patient-centred care, which is one of the six main goals of a 21st century health system. However, there is a paradox between the theoretical significance of empathy and its presence, or lack thereof, in clinical practice. Recent studies have reported that empathy declines amongst students and physicians over time. The three most impactful contributors to this decline are: (1) disagreements over the definitions of empathy making it difficult to implement it into practice (2) poor consideration or regulation of empathy leading to burnout and thus, abandonment altogether, and (3) the lack of diversity in the curriculum and the influence of medical culture, which prioritises science over patient experience, limiting some physicians from using ‘too much’ empathy in the fear of losing clinical objectivity. These issues were investigated by conducting a fully inductive thematic narrative analysis of patient narratives in the UK to evaluate the behaviours and attitudes that patients associate with empathy. The principal enquiries underpinning this study included uncovering the factors that affected experience of empathy within provider-patient interactions and to analyse their effects on patient care. This research contributes uniquely to this discourse by examining the phenomenon of empathy directly from patients’ experiences, which were systematically extracted from a repository of online patient narratives of care titled ‘CareOpinion UK’. Narrative analysis was specifically chosen as the methodology to examine narratives from a phenomenological lens to focus on the particularity and context of each story. By enquiring beyond the superficial who-whatwhere, the study of narratives prescribed meaning to illness by highlighting the everyday reality of patients who face the exigent life circumstances created by suffering, disability, and the threat of life. The following six themes were found to be the most impactful in influencing the experience of empathy: dismissive behaviours, judgmental attitudes, undermining patients’ pain or concerns, holistic care and failures and successes of communication or language. For each theme there were overarching themes relating to either a failure to understand the patient’s perspective or a success in taking a person-centred approach. An in-depth analysis revealed that a lack of empathy was greatly associated with an emotive-cognitive imbalance, which disengaged physicians with their patients’ emotions. This study hereby concludes that competent providers require a combination of knowledge, skills, and more importantly empathic attitudes to help create a context for effective care. The crucial elements of that context involve (a) identifying empathy clues within interactions to engage with patients’ situations, (b) attributing a perspective to the patient through perspective-taking and (c) adapting behaviour and communication according to patient’s individual needs. Empathy underpins that context, as does an appreciation of narrative, and the two are interrelated.

Keywords: empathy, narratives, person-centred, perspective, perspective-taking

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Authors: A. Kourou, A. Ioakeimidou, S. Hadjiefthymiades, V. Abramea

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During the last decades, the task of engaging governments, communities and citizens to reduce risk and vulnerability of the populations has made variable progress. Experience has demonstrated that lack of awareness, education and preparedness may result in significant material and other losses both on the onset of the disaster. Schools play a vital role in the community and are important elements of values and culture of the society. A proper school education not only teaches children, but also is a key factor in the promotion of a safety culture into the wider community. In Greece School Earthquake Safety Initiative has been undertaken by Earthquake Planning and Protection Ogranization with specific actions (seminars, lectures, guidelines, educational material, campaigns, national or EU projects, drills etc.). The objective of this initiative is to develop disaster-resilient school communities through awareness, self-help, cooperation and education. School preparedness requires the participation of Principals, teachers, students, parents, and competent authorities. Preparation and earthquake readiness involves: a) learning what should be done before, during, and after earthquake; b) doing or preparing to do these things now, before the next earthquake; and c) developing teachers’ and students’ skills to cope efficiently in case of an earthquake. In the above given framework this paper presents the results of a survey aimed to identify the level of education and preparedness of school community in Greece. More specifically, the survey questionnaire investigates issues regarding earthquake protection actions, appropriate attitudes and behaviors during an earthquake and existence of contingency plans at elementary and secondary schools. The questionnaires were administered to Principals and teachers from different regions of the country that attend the EPPO national training project 'Earthquake Safety at Schools'. A closed-form questionnaire was developed for the survey, which contained questions regarding the following: a) knowledge of self protective actions b) existence of emergency planning at home and c) existence of emergency planning at school (hazard mitigation actions, evacuation plan, and performance of drills). Survey results revealed that a high percentage of teachers have taken the appropriate preparedness measures concerning non-structural hazards at schools, emergency school plan and simulation drills every year. In order to improve the action-planning for ongoing school disaster risk reduction, the implementation of earthquake drills, the involvement of students with disabilities and the evaluation of school emergency plans, EPPO participates in E-PreS project. The main objective of this project is to create smart tools which define, simulate and evaluate all hazards emergency steps customized to the unique district and school. The project comes up with a holistic methodology using real-time evaluation involving different categories of actors, districts, steps and metrics. The project is supported by EU Civil Protection Financial Instrument with a duration of two years. Coordinator is the Kapodistrian University of Athens and partners are from four countries; Greece, Italy, Romania and Bulgaria.

Keywords: drills, earthquake, emergency plans, E-PreS project

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Authors: Abdalla Ahmed Abdrabou Emam Eldeib

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For more than a century, the Hague Conference has tackled issues in the most challenging areas of private international law, including family law. Its actions in the realm of international child abduction have been remarkable in two ways during the last two decades. First, on October 25, 1980, the Hague Convention on the Civil Aspects of International Child Abduction (the Convention) was promulgated as an unusually inventive and powerful tool. Second, the Convention is rapidly becoming more prominent in the development of international child law. By that time, overseas travel had grown more convenient, and more couples were marrying or travelling across national lines. At the same time, parental separation and divorce have increased, leading to an increase in international child custody battles. The convention they drafted avoids legal quagmires and addresses extra-legal issues well. It literally restores the kid to its place of usual residence by establishing that the youngster was unlawfully abducted from that position or, alternatively, was wrongfully kept abroad after an allowed visit. Legal custody of a child of a contested parent is usually followed by the child's abduction or unlawful relocation to another country by the non-custodial parent or other persons. If a child's custodial parent lives outside of Egypt, the youngster may be kidnapped and brought to Egypt. It's natural to ask what laws should apply and what legal norms should be followed while hearing individual instances. This study comprehensively evaluates and estimates the relevant Hague Child Abduction Convention and the current situation in Egypt and which law is applicable for child custody. In addition, this research emphasis, detail, and focus on the position of Cross-border parental child abductions in Egypt. Moreover, examine the Islamic law compared to the Hague Convention on Child Custody in detail, as well as mentioning the treatment of Islamic countries in this matter in general and Egypt's treatment of this matter in particular, as well as the criticism directed at Egypt regarding the application and implementation of child custody issues. The present research backs up this method by using non-doctrinal techniques, including surveys, interviews, and dialogues. An important objective of this research is to examine the factors that contribute to parental child abduction. In this case, family court attorneys and other interested parties serve as the target audience from whom data is collected. A survey questionnaire was developed and sent to the target population in order to collect data for future empirical testing to validate the identified critical factors on Parental Child Abduction. The main finding in this study is breaking the reservations of many Muslim countries to join the Hague Convention with regard to child custody., Likewise, clarify the problems of implementation in practice in cases of kidnapping a child from one of the parents and traveling with him outside the borders of the country. Finally, this study is to provide suggestions for reforming the current Egyptian Family Law to make it an effective and efficient for all dispute's resolution mechanism and the possibility of joining The Hague Convention.

Keywords: egyptian family law, Hague child abduction convention, child custody, cross-border parental child abductions in egypt

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Authors: LouAnne Boyd

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From the perspective of self-advocates, the biggest unaddressed problem is not the symptoms of an autism spectrum diagnosis but the social stigma that accompanies autism. This societal perspective is in contrast to the focus on the majority of interventions. Autism interventions, and consequently, most innovative technologies for autism, aim to improve deficits that occur within the person. For example, the most common Human-Computer Interaction research projects in assistive technology for autism target social skills from a normative perspective. The premise of the autism technologies is that difficulties occur inside the body, hence, the medical model focuses on ways to improve the ailment within the person. However, other technological approaches to support people with autism do exist. In the realm of Human Computer Interaction, there are other modes of research that provide critique of the medical model. For example, critical design, whose intended audience is industry or other HCI researchers, provides products that are the opposite of interventionist work to bring attention to the misalignment between the lived experience and the societal perception of autism. For example, parodies of interventionist work exist to provoke change, such as a recent project called Facesavr, a face covering that helps allistic adults be more independent in their emotional processing. Additionally, from a critical disability studies’ perspective, assistive technologies perpetuate harmful normalizing behaviors. However, these critical approaches can feel far from the frontline in terms of taking direct action to positively impact end users. From a critical yet more pragmatic perspective, projects such as Counterventions lists ways to reduce the likelihood of perpetuating ableism in interventionist’s work by reflectively analyzing a series of evolving assistive technology projects through a societal lens, thus leveraging the momentum of the evolving ecology of technologies for autism. Therefore, all current paradigms fall short of addressing the largest need—the negative impact of social stigma. The current work introduces a new paradigm for technologies for autism, borrowing from a paradigm introduced two decades ago around changing the narrative related to eating disorders. It is the shift from reprimanding poor habits to celebrating positive aspects of eating. This work repurposes Celebratory Technology for Neurodiversity and intended to reduce social stigma by targeting for the public at large. This presentation will review how requirements were derived from current research on autism social stigma as well as design sessions with autistic adults. Congruence between these two sources revealed three key design implications for technology: provide awareness of the autistic experience; generate acceptance of the neurodivergence; cultivate an appreciation for talents and accomplishments of neurodivergent people. The current pilot work in Celebratory Technology offers a new paradigm for supporting autism by shifting the burden of change from the person with autism to address changing society’s biases at large. Shifting the focus of research outside of the autistic body creates a new space for a design that extends beyond the bodies of a few and calls on all to embrace humanity as a whole.

Keywords: neurodiversity, social stigma, accessibility, inclusion, celebratory technology

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Authors: Brandy Yee, Dianne Yee

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Through the exploration of the lived experiences, beliefs and values of instructional leaders, teachers and students in Finland, Germany and Canada, we investigated the factors which contribute to developmentally responsive, intellectually engaging middle-level learning environments for early adolescents. Student-centred leadership dimensions, effective instructional practices and student agency were examined through the lens of current policy and research on middle-level learning environments emerging from the Canadian province of Manitoba. Consideration of these three research perspectives in the context of early adolescent learning, placed against an international backdrop, provided a previously undocumented perspective on leading, teaching and learning in the middle years. Aligning with a social constructivist, qualitative research paradigm, the study incorporated collective case study methodology, along with constructivist grounded theory methods of data analysis. Data were collected through semi-structured individual and focus group interviews and document review, as well as direct and participant observation. Three case study narratives were developed to share the rich stories of study participants, who had been selected using maximum variation and intensity sampling techniques. Interview transcript data were coded using processes from constructivist grounded theory. A cross-case analysis yielded a conceptual framework highlighting key factors that were found to be significant in the establishment of developmentally responsive, intellectually engaging middle-level learning environments. Seven core categories emerged from the cross-case analysis as common to all three countries. Within the visual conceptual framework (which depicts the interconnected nature of leading, teaching and learning in middle-level learning environments), these seven core categories were grouped into Essential Factors (student agency, voice and choice), Contextual Factors (instructional practices; school culture; engaging families and the community), Synergistic Factors (instructional leadership) and Cornerstone Factors (education as a fundamental cultural value; preservice, in-service and ongoing teacher development). In addition, sub-factors emerged from recurring codes in the data and identified specific characteristics and actions found in developmentally responsive, intellectually engaging middle-level learning environments. Although this study focused on 12 schools in Finland, Germany and Canada, it informs the practice of educators working with early adolescent learners in middle-level learning environments internationally. The authentic voices of early adolescent learners are the most important resource educators have to gauge if they are creating effective learning environments for their students. Ongoing professional dialogue and learning is essential to ensure teachers are supported in their work and develop the pedagogical practices needed to meet the needs of early adolescent learners. It is critical to balance consistency, coherence and dependability in the school environment with the necessary flexibility in order to support the unique learning needs of early adolescents. Educators must intentionally create a school culture that unites teachers, students and their families in support of a common purpose, as well as nurture positive relationships between the school and its community. A large, urban school district in Canada has implemented a school cohort-based model to begin to bring developmentally responsive, intellectually engaging middle-level learning environments to scale.

Keywords: developmentally responsive learning environments, early adolescents, middle level learning, middle years, instructional leadership, instructional practices, intellectually engaging learning environments, leadership dimensions, student agency

Procedia PDF Downloads 287