Ethical Issues in Response-to-Intervention: Evidence-Based Interventions

In a private learning environment, each learner's interactions with course contents are treasured clues for educators to understand the individual and collective learning process. To provide educators with evidence-based insights, this chapter intends to adopt sequential analysis method to unfold learning behavioral differences among different groups of students (grade, subject, and registration type) in a university cloud classroom system. Experimental results indicate that sophomores undertake more learning tasks than other grades. There are significant differences in task-related and self-monitoring behaviors between liberal arts and science learners. Registered learners have higher participation levels than non-registered ones. Meanwhile, a user study aiming to analyze students' learning feelings indicates that a fraction of students have dishonest behaviors for achieving a good online performance. Finally, this study discusses behavioral ethical issues emerged in cloud classroom, which deserve the attention of educators for regulating and optimizing the online learning process of students.

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Ethics in cancer care

Oxford Handbook of Cancer Nursing ◽

10.1093/med/9780198569244.003.0013 ◽

2007 ◽

pp. 169-178

Keyword(s):

End Of Life ◽

Cancer Care ◽

Ethical Issues ◽

Moral Values ◽

Evidence Based ◽

Life Care ◽

Ethical Guidance ◽

Life Issues ◽

End Of Life Issues ◽

Participation In Research

Introduction and overview of ethical guidance 170 End of life issues 172 Withdrawing and withholding treatment 176 Ethical and moral values affect all aspects of cancer care, including treatment, management of symptoms, end of life care and participation in research. With advancing medical technology and developing evidence-based practice, ethical issues in cancer care are increasingly complex....

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Implementation of Evidence-Based Literacy Practices in Middle School Response to Intervention

Learning Disability Quarterly ◽

10.1177/0731948714566120 ◽

2015 ◽

Vol 39 (1) ◽

pp. 44-57 ◽

Cited By ~ 14

Author(s):

Stephen Ciullo ◽

Erica S. Lembke ◽

Abigail Carlisle ◽

Cathy Newman Thomas ◽

Marilyn Goodwin ◽

...

Keyword(s):

Middle School ◽

Response To Intervention ◽

Reading Instruction ◽

Performance Feedback ◽

Literacy Practices ◽

Strategy Instruction ◽

Future Research ◽

Evidence Based ◽

Independent Practice ◽

Middle School Reading

The authors report findings from a systematic observational study of middle school educators (Grades 6–8) in two states who provided reading interventions within Tier 2 and Tier 3 of a Response to Intervention (RTI) framework. Intervention sessions were coded and analyzed to understand (a) the frequency and type of evidence-based strategies implemented for students with learning disabilities and reading difficulties, and (b) whether observed practices within secondary and tertiary intervention settings align with researcher recommendations regarding middle school reading instruction based on extant research. The findings indicated that more than 12% of time was devoted to logistical and non-academic activities, and evidence-based interventions including explicit instruction, cognitive strategy instruction, content enhancements, and independent practice opportunities were reported infrequently, although instructional differences across sites were demonstrated. Encouraging findings include evidence of peer-mediated reading and explicit performance feedback. Implications for teacher preparation, professional development, and future research for RTI are discussed.

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Ethical Practice of Cognitive Behavior Therapy

10.1093/oxfordhb/9780198732372.013.35 ◽

2015 ◽

Cited By ~ 1

Author(s):

Debbie Sookman

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Ethical Issues ◽

Complex Interventions ◽

Initial Assessment ◽

Evidence Based ◽

Cognitive Behavior ◽

Ethical Practice ◽

Psychotherapeutic Treatment ◽

Specific Symptoms

Contemporary cognitive behavior therapy (CBT) comprises complex interventions that have demonstrated efficacy and/or are currently the evidence-based psychotherapeutic treatment of choice for many psychiatric disorders. This chapter discusses management of ethical issues that may arise during evidence-based CBT: initial assessment, informed consent, exposure-based therapy, out of office sessions, management of boundaries, homework, and risk management. The patient-therapist relationship and conceptualization of resistance during CBT are discussed. A crucial requirement of ethical mental health care is additional dissemination of CBT expertise. In this current era of specialization, interventions that target disorder specific symptoms and related difficulties (American Psychiatric Association,2013) show special promise. It is the ethical responsibility of clinicians regardless of orientation to be guided by current empirical research and their own specific areas of competence when making treatment recommendations. A priority for clinical research is further examination of the specific therapeutic ingredients that impact outcome and optimize recovery.

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The treatment of bipolar disorder in the elderly

10.1093/med/9780198748625.003.0022 ◽

2017 ◽

Author(s):

Gilberto Sousa Alves ◽

Felipe Kenji Sudo ◽

Johannes Pantel

Keyword(s):

Bipolar Disorder ◽

Gold Standard ◽

Atypical Antipsychotics ◽

Extended Release ◽

Ethical Issues ◽

The Elderly ◽

Evidence Based ◽

Pharmacological Interventions ◽

First Line ◽

Evidence Based Guidelines

Bipolar disorder (BD) is an extremely disabling condition characterized by mood switches, and cognitive and functional impairment. The current chapter discusses the updated review on pharmacological and non-pharmacological interventions targeting BD in the elderly. The risk of concurrent medical diseases (eg, metabolic syndrome) and relatively lower tolerability than young BD make the patient safety a major concern in most cases. Evidence-based guidelines, although useful for promoting rational and effective therapy, are generally lacking in elderly BD. Current recommendations for acute mania include atypical antipsychotics, careful use of lithium, and election of valproate as the gold-standard therapy. In acute BD depression, first-line agents in monotherapy may include lithium, lamotrigine, quetiapine, and quetiapine extended release (XR). Electroconvulsive therapy may be an option for severe/refractory cases. Family members or caregivers should be encouraged to support the patient, since potential ethical issues involving patrimony or profession may arise during the treatment.

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Response to Intervention

Oxford Research Encyclopedia of Education ◽

10.1093/acrefore/9780190264093.013.1187 ◽

2020 ◽

Author(s):

Evelyn S. Johnson

Keyword(s):

Response To Intervention ◽

General Education ◽

Progress Monitoring ◽

Instructional Program ◽

Evidence Based ◽

Tier 2 ◽

Academic Challenges ◽

Essential Components ◽

Tier 1 ◽

Tier 2 Intervention

Response to intervention (RTI) is a framework that can help ensure the academic strengths and needs of students are met effectively and efficiently. Patterned on a public health model of prevention, the focus of RTI is on preventing and intervening for academic challenges through a system of increasingly intensive supports, where the least intensive but most effective option is the most desirable. RTI models consist of the key essential components of effective inclusive instruction, universal screening, progress monitoring, data-based instructional decision-making, tiered levels of evidence-based and culturally responsive interventions, and fidelity of implementation. When the RTI framework is well implemented, most students are successful in the general education environment. In the general education classroom, teachers provide quality core, or Tier 1, instruction for all students. Even with high-quality instruction, however, not all students will be successful. Between 10 and 15% of the student population will likely need more intensive academic support at some point during their schooling, typically referred to as Tier 2 intervention. Tier 2 provides a system of evidence-based intervention, designed to meet the needs of most students at risk for poor academic outcomes. Tier 2 interventions are meant to be short in duration, focused on improving skill deficits that interfere with students’ success, and comprised of systematic approaches to providing student support. For some students whose needs cannot be met through Tier 1 or 2 instruction, an even more intensive level of intervention will be required. Tier 3 consists of specially designed interventions to support the needs of students who require a more individualized, intensive instructional program. Through this multi-leveled prevention system, the RTI framework provides supports to students that are appropriate to their needs within an environment of equity, efficiency, and accountability. With a well-structured, rigorous implementation of RTI, schooling becomes much more fluid and responsive to meet student needs.

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Evidence-based policies, nudge theory and Nancy Cartwright: a search for causal principles

Behavioural Public Policy ◽

10.1017/bpp.2020.55 ◽

2020 ◽

pp. 1-20

Author(s):

ALEJANDRO HORTAL

Keyword(s):

Public Policy ◽

Randomized Controlled Trials ◽

Ethical Issues ◽

Controlled Trials ◽

Evidence Based ◽

Randomized Controlled ◽

Policy Interventions ◽

Nancy Cartwright ◽

Instrumental View

Abstract Nancy Cartwright argues that evidence-based policies should not only rely on randomized controlled trials (RCTs) to test their effectiveness – they should also use horizontal and vertical searches to find support factors and causal principles that help define how those policies work. This paper aims at analyzing Cartwright's epistemology regarding evidence-based policies and their use of RCTs while applying her findings to current research involving nudges as behavioral public policy interventions. Holding a narrowly instrumental view of rationality, nudge theory tends to neglect other expressive components. Policymakers, in their quest for causal principles, should consider the expressive rationality of individuals in their research. This inclusion would not only increase the effectiveness of nudges, but also address some ethical issues related to people's autonomy when targeted by these interventions.

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Rethinking placebo in psychiatry: the range of placebo effects

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.112.010397 ◽

2013 ◽

Vol 19 (3) ◽

pp. 162-170 ◽

Cited By ~ 6

Author(s):

Daniel McQueen ◽

Sarah Cohen ◽

Paul St John-Smith ◽

Hagen Rampes

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Ethical Issues ◽

Additive Models ◽

Evidence Based ◽

Placebo Effects ◽

Evidence Based Treatments ◽

Basic Facts ◽

Broad Overview

SummaryThis article, the first of two on placebo effects, provides a broad overview of placebo in the field of medicine. A brief conceptual history is followed by some basic facts about placebos. Problems of definition are identified. Additive and non-additive models of treatment effects, and problems of measurement of placebo effects are described. The role of placebo in the pharmacotherapy of depression and complementary and alternative medicine is discussed. The ‘efficacy paradox’ (that placebo treatments can have larger effects than ‘evidence-based treatments’) is introduced. Finally, ethical issues are discussed.

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Prisoners' insomnia: to treat or not to treat? Medical decision-making in places of detention

Medicine Science and the Law ◽

10.1258/rsmmsl.48.4.307 ◽

2008 ◽

Vol 48 (4) ◽

pp. 307-316 ◽

Cited By ~ 6

Author(s):

Bernice S. Elger

Keyword(s):

Decision Making ◽

Medical Decision Making ◽

Ethical Issues ◽

Public Health Problem ◽

Medical Decision ◽

Evidence Based ◽

Correctional Institutions ◽

Efficient Treatment ◽

Adequate Evaluation ◽

Insomnia Treatment

Insomnia is a frequent reason for medical and psychiatric consultation in prisons. Medical decision-making in correctional health care should be based on the same principles as outside correctional institutions. In places of detention, principles should be balanced according to the same criteria as outside correctional institutions, while taking into account the unique harm-benefit ratios related to the specific context. The aim of this paper was to examine the existing attitudes and ethical issues related to decision-making about insomnia evaluation and treatment in places of detention. An analysis of the ethical issues and an evidence-based review of the consequences of different attitudes and treatments with regard to prison medicine were carried out. Insomnia is a public health problem and requires adequate evaluation and treatment to avoid more serious health consequences both within and outside correctional institutions. Insomnia treatment in places of detention is an ethical dilemma, but there is no evidence-based reason to avoid benzodiazepines in prison completely and to use only neuroleptics and antidepressants, which might represent more dangerous and less efficient treatment. In prison medicine, should we even treat insomnia? Widely accepted ethical strategies of decision-making indicate that we should. Institutional guidelines on insomnia should be based on ethically sound decision-making that takes into account the available evidence.

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