Examination and Redesign of Inclusive Special Education Service Delivery in a Rural School

In this article, we describe the self-directed change made by a rural elementary school in response to a data-based examination of its service-delivery model that revealed its lowest performing students were spending most of their time with the school’s least qualified staff. This mixed-method case study describes (a) why and how the school shifted personnel deployment and utilization, (b) factors that facilitated the shifts in service delivery, and (c) perceived effects of the changes. Findings demonstrate how implementing data-based decision-making through strong collaborative leadership led to recognizing, exploring, and modifying the school’s overreliance on paraprofessionals by increasing the availability of more highly skilled personnel to facilitate more inclusive instruction and collaboration. Participants also described challenges and perceived negative aspects related to change. We conclude with implications for practice, including how this study could inform similar change efforts in small rural schools, and suggestions for future research.

Effect of modification on the physical, mechanical and relaxation properties of the polymer - nanodispersed graphite system

The paper analyzes the physical, mechanical and relaxation properties of the polychlortrifluoroethylene (PCTFE) - modified nanodispersed graphite (TEG) system. It has been shown that the modification of the surface of conducting carbon nanoplates with ultradispersed dielectric silicon dioxide (SiO2) (30%) leads to a nontrivial effect - an increase in the electrical conductivity of the PCTFE - 2.5% TEG/30% SiO2 composite by more than two orders of magnitude in comparison with the PCTFE - TEG composites, containing unmodified carbon nanoplates. The functionalization of carbon nanoplates was carried out by treating the particle surface with an active solution of chlorosilane in an organic solvent, that in case of hydrophobization of the filler surface, leads to an increase in the system percolation threshold. It is shown that the method of hydrolyzation of the filler surface can be highly effective due to a directed change in some, in particular, shielding, properties of polymer composites based on nanocarbon. It is established that the modification of the nanofiller (dispersed thermoexpanded graphite) increases the intermolecular interaction of the filler-matrix. Depending on the concentration of the filler, the structure of the matrix and the system as a whole demonstrates dynamic transformations in the size of the heterogeneity of the structure. Ultrasonic studies of composites have shown that the smallest size of structure inhomogeneity is achieved in the range of concentrations of percolation development, and the change in the size of system structure inhomogeneity is associated with the transition from inhomogeneity as the size of crystallites activated by nanofiller at low concentrations associated with coagulation of nanoparticles at concentrations exceeding the percolation threshold. Thus, in the case of nanofillers, it is impractical to use concentrations that significantly exceed the percolation threshold, as this leads to coagulation of the filler particles and the relative loosening of the matrix.

Factors associated with failure to receive oral anticancer drugs.

41 Background: Oral anti-cancer drugs (OACDs) have become increasingly prescribed over the last 10 years and require a significant amount of care coordination. Preliminary administrative database studies have shown that 10-15% of prescriptions are never received by the patient, but the reasons behind this are poorly understood. In this study, we prospectively identified failure to receive (FR) cases in which OACD prescriptions were never received by patients, examined underlying reasons for FR, and assessed clinical and process-related factors associated with FR. Methods: We prospectively collected data on new OACD prescriptions for adult oncology patients at a large, urban academic cancer center from 1/1/2018 to 12/31/2019. We collected patient demographic, clinical, and insurance data, OACD delivery date, and interactions with payers and financial assistance groups. FR was defined as failure to receive a prescribed OACD. Reasons for FR were confirmed by manual chart review and classified into seven categories: clinical deterioration, financial access, provider-driven clinical decision making, patient-directed change, transfer of care, lost to follow up, and other. We calculated the relative proportion of each FR category and used multivariable logistic regression to identify factors associated with FR, including initiation of a prior authorization and drug class. Results: The cohort included 1,080 patients who were prescribed 1,269 new OACDs. Of these prescriptions, 13% (N=163) were categorized as FR. Among the 158 patients with FR, average patient age was 66 years, 55% identified as non-Hispanic white, 61% had any Medicare plan, 11% had Medicaid only, and 25% had commercial insurance. Overall, 18% of FR cases were attributed to clinical deterioration, 13% to financial access, 29% to provider-driven clinical decision making, 17% to patient-directed change, 13% to transfer of care, and 5% were lost to follow up. Univariate analysis showed that FR was less likely in cases where prior authorization was initiated (p < 0.001) and multivariate analysis confirmed this result (OR 0.47 [CI 0.33-0.66], p < 0.001). Conclusions: Though the majority of oncology patients prescribed OACDs received the drug, 13% of patients in our study experienced FR. FR is associated with a lack of prior authorization initiation, which may reflect barriers to access, a change in clinical decision-making, or patient choice. Ultimately, FR is multifactorial and may be appropriate in some cases. More work is needed to determine whether improved access would increase uptake in some patients. [Table: see text]

A Universal Mathematical Methodology in Characterization of Materials for Tailored Design of Porous Surfaces

Understanding adsorption phenomena is essential to optimize and customize the energy transformation in numerous industrial and environmental processes. The complex and heterogeneous structure of the adsorbent surface and the distinct interaction of adsorbent-adsorbate pairs are attributed to the diverse response of adsorption phenomena, measured by the state diagrams of adsorption uptake known as adsorption isotherms. To understand various forms of adsorption isotherms, the surface characteristics of the adsorbent surface with the heterogeneity of adsorption energy sites must be analyzed so that they can be modified for the tailored response of the material. Conventionally, such material synthesis is based on chemical recipes or post-treatment. However, if the adsorbent's surface characteristics and heterogeneity are known, then a directed change in the material structure can be planned for the desired results in the adsorption processes. In this paper, a theoretical and mathematical methodology is discussed to analyze the structure of various adsorbents in terms of the distribution of their adsorption energy sites. The change in their surface is then analyzed, which results in the tailored or customized response of the material.

General regularities in the development Gzhelian-Asselian conodonts

Subject of study. The features of the evolutionary changing of Gzhelian-Asselian conodonts are examined. Materials. The data on Ural and North American conodonts are used. Results. The cyclic type of change of the Pa-element morphology in the process of the evolutionary development of the representatives of the genus Streptognathodus is established. Morphological evolutionary trends of gradual development alternate with the periods of the rapid appearance of a group of the forms of original constitution. The species of this group are characterized by wide distribution and short lifetime. Such species are used as the markers of the boundaries of stratigraphic subdivisions. Lower boundary of Gzhelian is determined by the appearance of species of the group simulator; the species of group isolatus mark lower boundary of Asselian. Model of the ensemble evolution of the related species is used for explaining the directed change in the morphology of conodonts. The saltational appearance of the determined indication is explained by the phenomenon of evolutionary oscillations. Conclusion. We can make conclusion about the sexual multiplication of this group of the organisms according the established alternation of the periods of the slow and rapid morphological evolution of conodonts.

BARIUM AND STRONTIUM FERRITS SYNTHESIZED IN THE SUN FURNACE

Magnetic materials synthesized from a melt in a solar furnace were studied. It is shown that melts consist of crystallites of a metastable structure and an amorphous phase. This state contributes to a directed change in structurally sensitive properties (electrical, magnetic, and optical). It has been revealed that the magnetization values of barium and strontium ferrites synthesized from a melt in a stream of concentrated solar radiation increase 1.8 times in comparison with materials synthesized from solid-phase reactions. KEYWORDS- ferrites, magnetic material, solar furnace, structural defects, magnetization.

FEATURES OF AUTONOMIC REGULATION OF THE CARDIOVASCULAR SYSTEM IN HUMAN LATE ONTOGENESIS

С помощью метода артериальной пьезопульсометрии выполнены статистический и спектральный анализы вариабельных параметров ( VPP и TNN ) пульсовых волн АД крови у пациентов 18-85 лет. С высокой точностью оценены индивидуальные особенности автономной (вегетативной и нейроэндокринной) регуляции мышечных эффекторов (МЭ) сердечно-сосудистой системы (ССС) у пожилого мужчины (75 лет) и молодой женщины (20 лет). Эти данные, а также результаты сравнительного исследования пациентов разного возраста позволили выявить определенную закономерность направленного изменения симпатоадреналовой регуляции МЭ ССС в онтогенезе человека. Сделан вывод, что у людей в процессе жизни происходит перестройка физиологического механизма автономной регуляции МЭ ССС, направленная на замену краткосрочной симпатической регуляции у молодых людей на более эффективную и устойчивую регуляцию гуморальными катехоламинами у пожилых людей. Using the method of arterial piezopulsometry, statistical and spectral analyzes of variable parameters ( VPP and TNN ) of pulse waves of blood pressure in patients aged 18 to 85 years were performed. The individual characteristics of the autonomous (vegetative and neuroendocrine) regulation of the muscular effectors (ME) of the cardiovascular system (CVS) in an elderly man (75 years old) and a young woman (20 years old) were estimated with high accuracy. These data, as well as the results of a comparative study of patients of different ages, made it possible to identify a certain pattern of directed change in the sympathoadrenal regulation of ME CVS in human ontogenesis. It is concluded that in the course of their lives, people undergo a restructuring of the physiological mechanism of the autonomous regulation of their ME CVS, aimed at replacing short-term sympathetic regulation in young people with more effective and more stable regulation by humoral catecholamines in elderly.