Search

For many autistic students, to experience more successful outcomes, school processes must be restructured and given necessary resources. The probability of success can be increased by implementing a school system that integrates research-based academic and behavioral instructional support, along with collaborative data-informed decision-making routines. This paper presents an example of a transformational framework and technical assistance that were provided to six schools to reshape and increase the schools’ capacity to implement and sustain an equity-based multi-tiered system of support (MTSS) with intensified instructional decision making. Statistical analyses were used to examine the outcomes of autistic students (n = 23) who participated in a state assessment over three consecutive years in the same state. The results demonstrated an increase in academic scores, and many students transitioned to less-restrictive educational environments.

AIM: To determine the prevalence of focal lamina cribrosa (LC) defect among patients with pachychoroid disease spectrum (PDS) in the absence of peripapillary retinoschisis. METHODS: This retrospective, cross-sectional study comprised of 180 patients with PDS, including polypoidal choroidal vasculopathy (PCV), central serous chorioretinopathy, and pachychoroidal neovasculopathy. Medical records and optic nerve head evaluations conducted using spectral-domain optical coherence tomography with enhanced depth imaging were reviewed. As a control group, 236 patients who underwent ophthalmologic evaluation for vitreous floaters, without obvious ocular disease, were also included. RESULTS: The mean age of the PDS group, which included 118 male patients (65.6%), was 57.4±11.1y. There was no significant difference between the two groups in age (P=0.710) or sex (P=0.248). Six patients (3.3%) in the PDS group and none in the control group showed focal LC defect (P=0.318). Among the six patients with focal LC defect in the PDS group, four eyes had PCV, one eye was the fellow eye of a PCV eye, and one eye had pachychoroidal neovasculopathy. CONCLUSION: Focal LC defect can be defected in patients with PDS in the absence of peripapillary retinoschisis. However, the prevalence of focal LC defect was not different significantly between PDS patients and those who did not have PDS.

"AIM: To investigate clinical characteristics of asymptomatic Terson syndrome and its clinical impact in patients with aneurysmal subarachnoid hemorrhage (SAH). METHODS: This retrospective, interventional study included 31 patients with aneurysmal SAH, and the medical records were reviewed. In addition to baseline characteristics of the study population such as age, sex, and underlying medical history, multi-modal imaging analysis, including fluorescein angiography (FA), spectral domain optical coherence tomography (SD-OCT), were also reviewed. Glasgow Coma Scale (GCS), Hunt-Hess (HH) grade, and Fisher scale at the time of admission, and functional outcome by using modified Rankin Scale (mRS) at 6mo were compared. RESULTS: Of the 31 patients, 10 patients (32.3%) were diagnosed with Terson syndrome. All the patients with Terson syndrome did not report visual symptoms at the time of ophthalmologic screening. FA showed microvascular changes of retinal capillaries and varying degrees of disc leakage. SD-OCT allowed intuitive anatomical localization of multi-layered retinal hemorrhages and assessment of ellipsoid zone integrity. The patients with Terson syndrome showed significantly worse GCS (P=0.047) and HH grade (P=0.025) than those without, except Ficher scale (P=0.385). There was no significant difference in the mRS (P=0.250) at 6mo. Among baseline factors, the HH grade was the only significant factor associated with Terson syndrome (B=1.079, P=0.016). CONCLUSION: In our study, 32.3% of the patients have Terson syndrome without visual symptoms. The baseline HH grade is significantly correlated with Terson syndrome, and there is no significant difference in the functional outcome between the patients with and without Terson syndrome. Terson syndrome may develop without any visual symptoms as shown in our study, and ophthalmologic screening may be recommended to prevent further visual deterioration especially in the patients with poor HH grade at the time of aneurysmal SAH."

AIM: To investigate sectoral changes in the mean peripapillary choroidal thickness (PCT) in patients with unilateral branch retinal vein occlusion (BRVO). METHODS: This retrospective, interventional study included 41 patients with acute, unilateral BRVO without macular edema. All patients completed at least a 6-month follow-up period. The PCT was measured at eight locations (temporal, superotemporal, superior, superonasal, nasal, inferonasal, inferior, and inferotemporal). In addition to calculating the average of all locations, the peripapillary choroidal area was divided into four sectors: superior (average of superotemporal PCT, superior PCT, and superonasal PCT), temporal, inferior (average of inferotemporal PCT, inferior PCT, and inferonasal PCT), and nasal. RESULTS: In the BRVO-affected eyes, the mean PCT was 177.7±69.8 μm (range, 70.1-396.0 μm) at baseline and 127.8±54.8 μm (range, 56.4-312.1 μm) at 6mo (P

PurposeWe sought to evaluate changes of mean peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) over 12 months in patients with unilateral central retinal vein occlusion (CRVO).MethodsOur retrospective, observational study included 19 patients with treatment-naïve, unilateral CRVO who completed at least 12 months of follow-up period. Mean PCT and mean SFCT in CRVO-affected eyes and unaffected contralateral eyes were measured at each follow-up visit, and then compared. Differences between baseline and 12 months (ΔSFCT and ΔPCT) and percentage changes (ΔSFCT or ΔPCT/baseline×100%) were determined. We also investigated the predictive factors for visual outcome in the CRVO-affected eyes.ResultsIn the CRVO-affected eyes, mean PCT was 146.7±41.9 μm at baseline, and 106.5±24.2 μm at 12 months (P < 0.001). Mean PCT of the contralateral eyes was 129.8±42.6 μm at baseline and 124.6±39.7 μm at 12 months (P = 0.089). Mean SFCT of CRVO-affected eyes was 225.8±77.9 μm at baseline, and 199.4±66.6 μm at 12 months (P = 0.009). Mean SFCT of the contralateral eyes was 218.4±83.0 μm at baseline, and 208.4±78.1 μm at 12 months (P = 0.089). Δ PCT was -41.6±25.3 μm in the CRVO-affected eyes, and -5.2±5.8 μm in the contralateral eyes (PConclusionBoth peripapillary and subfoveal choroidal thickness reduced significantly over 12 months in the CRVO-affected eyes, but not in the contralateral eyes. In addition, the absolute reduction amount and reduction ratio of PCT and SFCT were significantly greater in the CRVO-affected eyes than the contralateral eyes.

PURPOSE:To investigate the prevalence of focal lamina cribrosa (LC) defects in patients with unilateral branch retinal vein occlusion (BRVO) and to compare ocular characteristics between eyes with and without focal LC defect and those eyes with normal-tension glaucoma (NTG). METHODS:This retrospective, cross-sectional study included 121 patients. Thirty-nine patients had unilateral BRVO (BRVO group), 36 patients had NTG (NTG group), and 36 patients had vitreous floaters, but no other ocular diseases (control group). In addition to baseline characteristics such as age, sex, refractive errors, the ocular characteristics such as peripapillary choroidal thickness (PCT), retinal nerve fiber layer thickness, and subfoveal choroidal thickness were retrospectively analyzed. RESULTS:Focal LC defects were detected in 20 eyes of 14 patients (38.9%) in the BRVO group, 24 eyes of 15 patients (41.7%) in the NTG group, and none in the control group (P

PurposeTo investigate long-term treatment response after intravitreal bevacizumab injections (IVBIs) for central serous chorioretinopathy (CSC).MethodsThis retrospective, interventional study investigated the medical records of 45 eyes of 44 patients with CSC who underwent IBVIs and completed at least 2-year follow-up period. Complete resolution (CR) was defined as complete resolution of subretinal fluid at least 3 months after the last IVBI. Thick-choroid CSC was defined as mean subfoveal choroidal thickness more than 300.0 μm. The main outcome measure was long-term treatment outcome after IVBIs in patients with CSC.ResultsThirty-five patients (79.5%) were male, and their mean age was 45.5 ± 9.6 years. The mean follow-up period was 35.1 ± 11.5 months. Twenty-two eyes (48.9%) had acute CSC, and 40 eyes (88.9%) achieved CR. Twenty eyes (50.0%) developed recurrence, the mean number of IVBIs to achieve the first CR was not significantly different between eyes with and without recurrences (2.6 ± 1.6 vs. 2.9 ± 1.9; P = 0.658). Thick-choroid CSC was significantly difference between the eyes with and without recurrence (17 eyes, 85.0% vs. eyes, 50.0%; P = 0.020). Among the baseline characteristics, serous pigment epithelial detachment (B = - 2.580, P = 0.032) and thick-choroid (B = 1.980, P = 0.019) were significantly associated with recurrence.ConclusionEyes with CSC treated with IVBI and achieving complete resolution of subretinal fluid have 50% chance of recurrence in the long term. Thinner choroid and serous pigment epithelial detachment appear protective for recurrences.

PURPOSE:To evaluated the changes in choroidal vasculature in patients with ocular ischemic syndrome (OIS) and in the ipsilateral eyes of patients with symptomatic carotid artery stenosis (CAS). METHOD:A total of 50 patients (15 patients with OIS, 10 patients with symptomatic CAS, 25 patients of age-and sex-matched control group) were included, and the medical records were retrospectively reviewed. The mean subfoveal choroidal thickness (SFCT) of each eye was measured, and binary images of the choroid were evaluated to compare the mean choroidal area and the luminal area. RESULTS:The mean SFCT was 170.5±75.3 μm in the eyes with OIS, 154.8±62.9 μm in the ipsilateral eyes with symptomatic CAS, and 277.5±73.2 μm in the right eyes of the control group patients (P

This paper empirically analyzed how electronic health records (EHR) systems impacted hospital operations. This study examined the merits of implementing EHR in operational efficiency, profitability, and service quality delivered to patients. Therefore, this research tested three hypotheses postulating overall positive associations of EHR implementation for the three areas, respectively. This paper used the 2015 American Hospital Association U. S. Hospital Survey dataset and the Hospital Consumer Assessment of Healthcare Providers and Systems dataset. To measure each hospital’s efficiency, this study developed a data envelopment analysis model with four inputs including beds, doctors, nurses, and total operating expenses, and three outputs including outpatient visits, inpatient days, and total patient revenues. This research used the operating margin to measure the hospital profitability, while patient experience ratings and readmission rates were used to measure the hospital quality. Results indicated that EHR implementing hospitals outperformed non-EHR implementing hospitals in operational efficiency, profitability, and quality. [ABSTRACT FROM AUTHOR]

Inclusive educational practices are rooted in a body of research indicating that when students in need of support through special education are meaningfully included in schools, academic and social outcomes improve for all students. To realize this promise of better outcomes, traditional schools with separate classrooms and even schools designated to exclusively serve various learner subgroups (e.g., students identified for special education) will require reorganized systems, structures, and resources. A school with a fully integrated educational framework is better positioned to meet the needs of all students, including those who live in poverty, who experience high mobility, who benefit from an accelerated curriculum, or who struggle to learn for other reasons. This paper describes an example of a transformational framework and technical assistance provided to a whole interlocking education systems (i.e., state, district, school) to reshape and increase school capacity to implement and sustain an equity-based, inclusive multi-tiered system of support. Statistical analyses that compared academic achievements of students with Individualized Education Programs (IEPs, i.e., disability) in schools reflecting early stages of transformation with that of students with IEPs in schools reflecting advanced transformation. The extent of school transformation to the framework significantly predicted improved outcomes for students with IEPs. [ABSTRACT FROM AUTHOR]

A 73-year-old woman underwent deformity correction surgery (anterior lumbar interbody fusion of L2-L3-L4-L5-S1, pedicle subtraction osteotomy at L4, and posterior screw fixation from T10 to the pelvis) due to lumbar degenerative flat-back. Following the operation, the patient experienced pain in her back and buttocks, for which she regularly took medications. She reported frequently feeling a heavy and stretched sensation of pain after the operation in those areas, which made her regret undergoing the operation. However, at 33 months postoperatively, she reported that one day, while getting up from a chair, she felt a crack in her back, which was followed by an improvement in her back and buttock pain; thereafter, she stopped taking pain medications. Follow-up radiography revealed a bilateral rod fracture at the L4-5 level on the right side and at the L3-4 level on the left side. The overall pelvic parameters, except pelvic incidence, slightly changed after the rod fracture. Therefore, the broken rod was replaced and another rod was added to the broken rod area; however, the changed pelvic parameters were not corrected further during the reoperation. Following the reoperation, the patient showed improvements and she no longer required pain medication. [ABSTRACT FROM AUTHOR]

Background Percutaneous endoscopic lumbar diskectomy is a good treatment modality for lumbar disk herniation. However, when a patient complains of bilateral lower limb radicular pain with severe disk protrusion at the L5-S1 level, the transforaminal approach is often unable to resolve both lesions owing to anatomical limitations. It is also very difficult to resolve both lesions in an ipsilateral direction using the percutaneous interlaminar approach. We report our surgical technique and clinical results using a ventral dural approach of percutaneous endoscopic interlaminar lumbar diskectomy for L5-S1 herniated nucleus pulposus (HNP) in patients with bilateral radiculopathy due to a severe disk protrusion. Methods Twenty-seven patients with severe L5-S1 HNP complaining of back pain and bilateral lower limb pain were included in the study. The unilateral ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy technique was used. The visual analog scale (VAS) and Macnab criteria were used for clinical evaluation. All assessments were completed 1 day before surgery, 1 week after surgery, 6 months after surgery, and at final follow-up after surgery. Results The mean preoperative back and leg pain VAS scores decreased from 5.67 ± 0.78 and 7.81 ± 0.83 to 2.44 ± 0.58 and 2.26 ± 0.53 at 1 week, 1.78 ± 0.51 and 1.52 ± 0.58 at 6 months, and 1.56 ± 0.70 and 1.67 ± 0.96, respectively, at the final follow-up after surgery. With respect to the Macnab criteria, 51.85% of the results were excellent, 44.44% were good, and 3.70% were fair. Four cases recurred: three patients underwent conservative treatment and one patient operated with percutaneous endoscopic interlaminar lumbar diskectomy. Conclusion According to the results of this study, the ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy in patients with L5-S1 HNP associated with bilateral lower limb pain due to a severely protruded HNP is a good option for a minimally invasive surgical approach. [ABSTRACT FROM AUTHOR]

Background Bertolotti syndrome is characterized by an abnormal enlargement of the transverse process of the most caudal lumbar vertebra. Most of the time it is asymptomatic, but when it is symptomatic it is associated with low back pain, radiating leg pain, or both. There is no consensus regarding management of this pathology. Open to minimal invasive tubular resection techniques are described in the literature, but a full endoscopic resection technique has not yet been described. Endoscopic technique is a less invasive target-oriented iliolumbar ligament preserving technique. We report our percutaneous full endoscopic technique for the treatment of symptomatic Bertolotti syndrome. Method We have treated three symptomatic cases of Bertolotti syndrome with the percutaneous endoscopic technique. We review the feasibility of this technique and the outcomes. Result Full endoscopic resection of Bertolotti syndrome is feasible and safe with comparable good outcomes and the added benefits of minimal invasive surgery. Conclusion We believe this novel percutaneous full endoscopic technique will yield good results in the hands of expert endoscopic spine surgeons and can be an alternative treatment method in cases of symptomatic Bertolotti syndrome. To our knowledge this is the first report of percutaneous full endoscopic treatment of Bertolotti syndrome in the world. [ABSTRACT FROM AUTHOR]

The present investigation examines the schoolwide applications model (SAM) as a potentially effective school reform model for increasing equity-based inclusive education practices while enhancing student reading and math achievement for all students. A 3-year quasi-experimental comparison group analysis using latent growth modeling (LGM) was used with seven urban elementary or elementary/middle schools and seven matched comparison schools in the same district. Results suggest significantly larger growth for experimental school students in math and no statistically significant difference in reading score growth between experimental and comparison schools. However, reading score growth for experimental schools was statistically significant in a post hoc analysis of selected schools. Additional descriptive analysis is presented for three schools that implemented the model with the highest measured fidelity; these schools made improvements on both reading and math scores while those of matching comparison schools decreased. [ABSTRACT FROM AUTHOR]

Background and aims There is a paucity of data in the literature on the surgical management of conjunctival dermolipoma. In this study, we report outcomes of a partial mass excision technique (excision of the portion visible when eyes open) and free conjunctival autograft. Methods Medical records of 13 patients with dermolipoma who had undergone partial mass excision at Seoul National University Hospital from January 1999 to May 2014 were retrospectively reviewed. After resection of the visible part of tumour, including the overlying thick surface conjunctiva, the conjunctival defects were reconstructed with free conjunctival autograft harvested from the contralateral superior bulbar area. Results The median postoperative follow-up period was 5 months (range 1-84 months). The cosmetic surgical results were satisfactory in all 13 patients. Three patients showed thick texture on the grafted surgical area postoperatively, but there was no significant scar formation resulting in restrictive symblepharon or eye movement limitation. There were no other significant complications, such as blepharoptosis, diplopia or keratoconjunctivitissicca during the follow-up period. Conclusions Partial mass (visible part only) excision, including that of the overlying thick conjunctiva, and free conjunctival autograft from the opposite eye, is a relatively simple and effective technique for the surgical management of conjunctival dermolipoma. [ABSTRACT FROM AUTHOR]

With the increase in the interest of producing natural gas from methane hydrates as well as potential risks of massive hydrate dissociation in the context of global warming, studies have recently shifted from pure hydrate crystals to hydrates in sediments. Such a research focus shift requires a series of innovative laboratory devices that are capable of investigating various properties of hydrate-bearing sediments (HBS). This study introduces a newly developed high pressure testing chamber, i.e., multi-property characterization chamber (MPCC), that allows simultaneous investigation of a series of fundamental properties of HBS, including small-strain stiffness (i.e., P- and S-waves), shear strength, large-strain deformation, stress-volume responses, and permeability. The peripheral coolant circulation system of the MPCC permits stable and accurate temperature control, while the core holder body, made of aluminum, enables X-ray computer tomography scanning to be easily employed for structural and morphological characterization of specimens. Samples of hydrate-bearing sediments are held within a rubber sleeve inside the chamber. The thick sleeve is more durable and versatile than thin membranes while also being much softer than oedometer-type chambers that are incapable of enabling flow tests. Bias introduced by the rubber sleeve during large deformation tests are also calibrated both theoretically and experimentally. This system provides insight into full characterization of hydrate-bearing sediments in the laboratory, as well as pressure core technology in the field. [ABSTRACT FROM AUTHOR]

Abstract Both intra-pore hydrate morphology and inter-pore hydrate distribution influence the physical properties of hydrate-bearing sediments, yet there has been no pore-scale observations of hydrate habit under pressure in preserved pressure core samples so far. We present for the first time a pore-scale micro-CT study of natural hydrate-bearing cores that were acquired from Green Canyon Block 955 in UT-GOM2-1 Expedition and preserved within hydrate pressure–temperature stability conditions throughout sub-sampling and imaging processes. Measured hydrate saturation in the sub-samples, taken from units expected to have in-situ saturation of 80% or more, ranges from 3 ± 1% to 56 ± 11% as interpreted from micro-CT images. Pore-scale observations of gas hydrate in the sub-samples suggest that hydrate in silty sediments at the Gulf of Mexico is pore-invasive rather than particle displacive, and hydrate particles in these natural water-saturated samples are pore-filling with no evidence of grain-coating. Hydrate can form a connected 3D network and provide mechanical support for the sediments even without cementation. The technical breakthrough to directly visualize particle-level hydrate pore habits in natural sediments reported here sheds light on future investigations of pressure- and temperature-sensitive processes including hydrate-bearing sediments, dissolved gases, and other biochemical processes in the deep-sea environment.

Schoolwide positive behavior support (SWPBS) exemplifies a longitudinal research program originating in the fields of special education and school psychology that has produced an extensive national database encompassing an evidence-based set of practices applicable to general education as well as special education students including those with severe disabilities. Schoolwide applications of evidence-based practices, however, are at some risk of falling victim to the ongoing bifurcation of education into the general and special education parallel and often noninteractive, professional systems of instruction. One potential solution to bifurcated practice is to embed (or contextualize) SWPBS in a broader, universal school reform agenda that coordinates and evaluates all educational intervention services and supports for the benefit of all students. A structural school reform process called the Schoolwide Applications Model (SAM) is described, which includes SWPBS as 1 of 15 critical features. Results from a 3-year, ongoing research project in a low-income, multicultural, urban school district in Northern California suggests that SWPBS, with its three levels of student support, guided by teams of general as well as special educators, can be an important contributor to academic as well as social achievement among students with and without disabilities and, as grounded within systematic school reform, can help to mitigate against the bifurcation of general and special education practices. [ABSTRACT FROM AUTHOR]

Objective Percutaneous endoscopic lumbar discectomy (PELD) has several advantages, but it is not used routinely due to early relapse and steep learning curve. We have studied the factors associated with early relapse in patients who underwent posterolateral PELD at or above the L4-5 level. Methods In this retrospective study, we have enrolled 200 cases and divided them into 4 groups (A, B, C, and D) with 50 patients in each group, that had undergone PELD by 2 different techniques (inside-out and outside-in with or without anti-adhesive agent) and operated by 2 different surgeons between May 2009 and November 2010. The factors studied were - Age, gender, disc (degeneration grade, location, level), associated adjacent level herniated nucleus pulposus (HNP), episode (first or recurrent), anti-adhesive agent, annulus preservation, approach, disc height and segmental dynamic motion (discrepancy in flexion and extension). Statistical analysis was done by Pearson’s chi-square test and p value (significance). The clinical results were evaluated by visual analogue scale (VAS). Results The mean age and mean follow-up period was comparable in all four groups. The overall recurrence rate was 9.5% (19/200). Average early relapse time was 3.26 months. Factors like Age of the patient, multilevel HNP and degeneration grade showed significant correlation with relapse rate. The change in VAS pre-operatively to post-operatively was significant across all groups (p

Objective The optimal treatment methods for thoracolumbar burst fracture with intact neurology are not established yet. Spinal canal integrity, sagittal balance and anterior column intactness are very important for successful outcome in this type of injury. There is no study analyzing restoration of these parameters by low pressure restoration using postural pillow reduction and lordotic posterior column compressive percutaneous transpedicular screw fixation and this study analyzes canal remodeling, spinal balance and anterior column intactness after this procedure. Methods The surgical procedure included three different elements: (1) preoperative postural pillow reduction for 1-2 days, (2) augmentation of fractured vertebra by polymethylmethacrylate (PMMA) in osteoporotic bone or by non-PMMA materials in non-osteoporotic bone, and (3) lordotic, posterior column compressive, percutaneous transpedicular screw fixation. We measured anterior vertebral height, canal size and lordotic angle preoperatively, immediate postoperatively and after 6 months in 34 patients treated with this technique and were analyzed. Results Of 34 patients 17 were male. The mean age was 52.03±12.51 years. They were followed for 30.68±11.67 months on average. At 6 months, preoperative canal stenosis of 44% remodeled to 12%, preoperative anterior vertebral height of 44% increased to 77% and preoperative average kyphosis of 14 degrees corrected to 3.4 degrees No neurological deterioration noted. Functionally all patients returned to their previous status. Conclusion The postural pillow reduction and lordotic posterior column compressive percutaneous screw fixation in patients with neurologically intact thoracolumbar burst fracture is effective and safe.

Traditional open and microscopic approaches for lumbar discectomy in cauda equina syndrome are associated with retraction of thecal sac and nerve root which was already compromised. Our study looks upon a case of cauda equina syndrome due to massive disc herniation which was operated by percutaneous endoscopic transforaminal lumbar discectomy (PETLD) using outside in technique. The procedure is done under local anesthesia with minimal soft tissue damage and allows early rehabilitation with the better aesthetic outcome. PETLD is a safe and effective alternative to emergently decompress the lumbar spine with prompt recovery.

Background. Chronic low back pain (CLBP) arising from degenerative disc disease continues to be a challenging clinical and diagnostic problem whether treated with nonsurgical, pain intervention, or motion-preserving stabilization and arthrodesis. Methods. Fourteen patients with CLBP, greater than 6 months, unresponsive to at least 4 months of conservative care were enrolled. All patients were treated successfully following screening using MRI findings of Modic type I or II changes and positive confirmatory provocative discography to determine the affected levels. All patients underwent ablation of the basivertebral nerve (BVN) using 1414 nm Nd:YAG laser-assisted energy guided in a transforaminal epiduroscopic approach. Macnab’s criteria and visual analog scale (VAS) score were collected retrospectively at each follow-up interval. Results. The mean age was 46 ± 9.95 years. The mean symptoms duration was 21.21 ± 21.87 months. The mean follow-up was 15.3 ± 2.67 months. The preoperative VAS score of 7.79 ± 0.97 changed to 1.92 ± 1.38, postoperatively (P

2A major goal of positive behavior support (PBS) is to produce broad-based, long-term improvements in adaptive behavior; however, the empirical base, at present, is mainly composed of relatively short-term studies carried out in circumscribed contexts. Therefore, a need exists for reliable data that can inform the field regarding the comprehensive lifestyle effects of PBS implementation in natural community contexts over extended periods of time. The current investigation was conducted to provide a descriptive analysis of PBS with diverse participants and broad measurement strategies over multiple years. Using extensive data portfolios for 21 participants, we employed rating scales to quantify changes in key variables from baseline through 2 years of intervention. The data revealed variable levels of intervention integrity, generalized reductions in problem behavior with occasional relapses, and encouraging enhancements across six domains of quality of life. This study represents an initial attempt to understand the processes and outcomes of behavioral support by documenting behavioral patterns across full days, entire years, and all environments. We discuss the need to consider new conceptual and methodological frameworks for further study of efficacious and sustainable behavior support. [ABSTRACT FROM AUTHOR]

A pre-postassessment, single-subject, pilot study was implemented, testing the hypothesis that positive behavior support (PBS) would improve family quality-of-life outcomes by reducing parental stress and challenging behaviors of preschool children who are culturally and linguistically diverse and reside in urban, disadvantaged communities. Six participants attended parent-training workshops designed to empower them to use PBS child behavior management strategies and enhance their own mental health outcomes via a functional parent-child relationship. Parental stress levels were measured and anecdotal reports of child outcomes obtained. Findings corroborate outcomes from preceding research supporting PBS as a socially valid, culturally responsive intervention effective at producing results acceptable to participants. Future research and suggestions are provided for closing the gap between research and practice. [ABSTRACT FROM AUTHOR]