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Advocacy for inclusive education has been connected with the United Nations' global poverty alleviation guidelines, the Sustainable Development Goals, which appeal to countries to extend universal access to education, from primary to secondary schooling. In the Ghanaian context, the implementation of inclusive education in secondary schools has been under-explored. In this study, we adopted Ajzen's theory of planned behaviour as a framework to explore demographic variables which could impact on teachers' intentions to practise inclusive education in secondary schools. We recruited 457 teachers from five districts in one region in Ghana. "T"-test and analysis of variance were used to ascertain the association between demographic variables and intentions. We found no significant differences between participants based on school resourcing or location. However, participants in private schools had attitudes that were more positive, they felt they received more support, had higher self-efficacy, and were more willing to include children with disabilities in their classrooms than teachers in public schools. Also, we found a difference between participants on units of study taken in inclusive education during pre-service training and their level of confidence to practise inclusive education. The need for teacher educators to embed more inclusive teaching practices in all courses at teacher training institutions is discussed, as well as other study implications.

Many teachers are sporadic in using evidence-based practice (EBP) concerning students with autism spectrum disorder (ASD). Numerous reasons have been posited for this. However, no single study has worked to understand the relative importance of identified criteria in the EBP decision-making processes of teachers. Through the development of a new survey tool, the Evidence-Based Practice Innovation Survey (EBPIAS), an exploration of the decision-making process of Australian teachers in their adoption and cessation of EBP was undertaken. Teachers rated the perception that an EBP would meet the needs of their students as the most important criteria in determining their use of EBP. Conversely, the judgement that an EBP did not meet the needs of their student was the most important criteria in their decision to cease use. In comparing the relevant importance of identified criteria, teachers rated the perception of training as the second-lowest consideration in their decision to adopt and cease using EBP. Consequently, there may need to be greater promotion of, or information concerning, the training required by teachers for effective implementation supporting a more balanced and holistic approach in assessing criteria impacting the adoption of EBP by teachers in the first instance, potentially lowering cessation rates.

The intention of teachers towards adopting inclusive practices is vital to determining teaching behaviour in classrooms. Although some previous studies have reported that variables such as attitudes, subjective norms and self-efficacy combine to predict intention of teachers, such studies are sparse in sub-Saharan Africa and mainly limited to primary school teachers. In this study, the Theory of Planned Behaviour (TPB) was adopted as a framework to study the predictors of intentions of teachers towards inclusive education in secondary schools in Ghana. Four scales, developed to reflect the elements of TPB, were used to collect data from 457 secondary school teachers. Only the two determinants, attitude and self-efficacy, combined to significantly predict the intention of teachers towards practising inclusive education. Interestingly, there was no relationship between subjective norms and intention towards inclusive education. The need for teacher educators to prioritise the two variables, in attempt to promote inclusive practices in secondary schools in Ghana, is also discussed.

Flexible learning programs (FLPs) provide a place for students who have disengaged and disconnected from mainstream schools. Despite the legislative framework in Australia supporting the participation of students with disability in their local mainstream schools wherever possible, very little research focusing on whether students with disability are being excluded from, or dropping out of, mainstream schools into these FLPs has been conducted. In this paper, we report on the findings of an online cross-sectional survey of FLP leaders about their student populations, with a focus on the 10 most prevalent disabilities among Australian children. Data from the 22 participants who completed all items of the survey were analysed. The participants' (n = 22) schools represented a total enrolment of 2,383 students in FLPs across Australia: Tasmania (n = 3), Victoria (n = 5), New South Wales (n = 5), Queensland (n = 4), Western Australia (n = 3), and South Australia (n = 2). We found that while there was an apparent overrepresentation of students with certain types of disabilities in FLPs, others were not overrepresented at all. The findings of this preliminary study are discussed, with an exploration of issues relating to why students with some disabilities may be more likely to disengage, or be excluded, from mainstream schooling while others are not, as well as recommendations for future research.

For the past 15 years (2003-2018), Ghana has followed international frameworks and taken steps to implement inclusive education. This has triggered research that seeks to assess effectiveness of practices by documenting the perspectives and experiences of key stakeholders such as parents and other educators. This study took stock of the research evidence to appraise the effectiveness of inclusive education practices, identify gaps in the literature and draw attention to areas that policymakers could strengthen to advance those practices. Adopting Ainscow and Miles's (2009. "Developing Inclusive Education Systems: How Can We Move Policies Forward." https://pdfs.semanticscholar.org/e849/cf5de98a03304867093fff0a5d8265a6e20e.pdf) inclusive education measurement indicators as a conceptual framework, we reviewed empirical studies that have been conducted on inclusive education in Ghana since the policy was formally incorporated into the education system. Ten databases, along with manual searches in journals and the reference lists of selected articles, yielded a total of 426 studies, of which 35 satisfied the pre-determined inclusion and quality-assessment criteria. We found barriers to inclusive practices at all levels of education. Teachers in particular have not been adequately informed and supported to teach students with disabilities in regular classrooms. The implications of the findings for policymaking and future research are discussed in detail.

The theory of planned behaviour (TPB) captures important individual beliefs (attitudes, subjective norms and perceived behaviour control), which influence people's intentions towards performing a given behaviour. Due to the successful application of TPB to a number of areas of human activity, it has been adopted as a framework in a number of studies assessing teachers' intentions towards implementing inclusive education. However, little work has been done to synthesise these studies. In this study, we reviewed published studies on inclusive education (2007 to 2019), which used the TPB as a framework to understand reporting trends and identify research gaps. We followed the guidelines for the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Five keywords were used to search for studies in nine databases, which resulted in the identification of 604 papers, of which 22 satisfied the pre-set inclusion and quality assessment criteria. Although the findings from some studies confirm the ability of TPB to predict teachers' intentions, the link between the predictors and actual behaviour was unclear. Moreover, there was divergence between the findings of the qualitative and quantitative studies. Limitations, recommendations for future studies and implications for inclusive practice are discussed.

Intestinal production of endocannabinoid and oleoylethanolamide (OEA) is impaired in high-fat diet/obese rodents, leading to reduced satiety. Such diets also alter the intestinal microbiome in association with enhanced intestinal permeability and inflammation; however, little is known of these effects in humans. This study aimed to 1) evaluate effects of lipid on plasma anandamide (AEA), 2-arachidonyl- sn-glycerol (2-AG), and OEA in humans; and 2) examine relationships to intestinal permeability, inflammation markers, and incretin hormone secretion. Twenty lean, 18 overweight, and 19 obese participants underwent intraduodenal Intralipid infusion (2 kcal/min) with collection of endoscopic duodenal biopsies and blood. Plasma AEA, 2-AG, and OEA (HPLC/tandem mass spectrometry), tumor necrosis factor-α (TNFα), glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic peptide (GIP) (multiplex), and duodenal expression of occludin, zona-occludin-1 (ZO-1), intestinal-alkaline-phosphatase (IAP), and Toll-like receptor 4 (TLR4) (by RT-PCR) were assessed. Fasting plasma AEA was increased in obese compared with lean and overweight patients ( P < 0.05), with no effect of BMI group or ID lipid infusion on plasma 2-AG or OEA. Duodenal expression of IAP and ZO-1 was reduced in obese compared with lean ( P < 0.05), and these levels related negatively to plasma AEA ( P < 0.05). The iAUC for AEA was positively related to iAUC GIP ( r = 0.384, P = 0.005). Obese individuals have increased plasma AEA and decreased duodenal expression of ZO-1 and IAP compared with lean and overweight subjects. The relationships between plasma AEA with duodenal ZO-1, IAP, and GIP suggest that altered endocannabinoid signaling may contribute to changes in intestinal permeability, inflammation, and incretin release in human obesity.

The unique traits and behaviours of students with autism spectrum disorder (ASD) often present a range of barriers to their educational experiences and development. The present study investigated collaborative partnerships between 3 stakeholders that often support students with ASD: teachers, parents, and allied health professionals (AHPs). With current literature on collaboration between teachers, parents, and AHPs involved in the education of students with ASD predominantly relating to specific skill or knowledge acquisition, there was an insufficient understanding of 'collaborative processes' and the factors that benefit or limit effective practice. In the present study, the researchers explored the experiences, processes, and opinions of parents, teachers, and AHPs supporting students with ASD in mainstream Australian primary schools. A total of 129 responses were recorded (41 teachers, 44 parents, and 44 AHPs) through an online survey, and thematic data analysis was used to qualitatively interpret the open-ended questions. The findings highlight the current opportunities and challenges faced by key stakeholders in this important process.

Aim: To evaluate insulin and glucagon sensitivity in Han Chinese women with and without gestational diabetes mellitus (GDM). Methods: In total, 81 women with GDM and 81 age‐matched healthy controls were evaluated with a 75 g oral glucose tolerance test (OGTT) at gestational weeks 24‐28. Plasma glucose concentrations were measured at fasting and 1 h and 2 h post‐OGTT. Fasting plasma insulin, glucagon and amino acids were also measured. Insulin and glucagon sensitivity were assessed by the homeostatic model assessment of insulin resistance (HOMA‐IR) and glucagon‐alanine index, respectively. Results: As expected, plasma glucose concentrations were higher at fasting and 1 h and 2 h post‐OGTT in GDM participants (p <.001 each). Both the HOMA‐IR and the glucagon‐alanine index were higher in GDM participants. There was a weak positive correlation between HOMA‐IR and glucagon‐alanine index (r = 0.24, p =.0024). Combining the HOMA‐IR and the glucagon‐alanine index yielded better capacity (area under the curve = 0.878) than either alone (area under the curve = 0.828 for HOMA‐IR and 0.751 for glucagon‐alanine index, respectively) in differentiating GDM from healthy participants. While the majority of GDM participants (64%) exhibited both reduced insulin and glucagon sensitivity, a third of them presented either reduced insulin (20%) or glucagon (14%) sensitivity alone. HOMA‐IR and glucagon‐alanine index correlated differentially with fasting glucose, triglycerides, low‐density lipoprotein cholesterol, sum of amino acids and hepatic steatosis index. Conclusions: Impairments of both insulin and glucagon sensitivity occur frequently in Chinese women with GDM, which may, individually or together, drive metabolic derangements in GDM. These observations provide new insights into the pathophysiology of GDM and support the need to target insulin or glucagon resistance, or both, in the management of GDM. [ABSTRACT FROM AUTHOR]

Aim: To perform a direct, double‐blind, randomised, crossover comparison of subcutaneous and intravenous glucagon‐like peptide‐1 (GLP‐1) in hyperglycaemic subjects with type 2 diabetes naïve to GLP‐1‐based therapy. Materials and Methods: Ten fasted, hyperglycaemic subjects (1 female, age 63 ± 10 years [mean ± SD], glycated haemoglobin 73.5 ± 22.0 mmol/mol [8.9% ± 2.0%], both mean ± SD) received subcutaneous GLP‐1 and intravenous saline, or intravenous GLP‐1 and subcutaneous saline. Infusion rates were doubled every 120 min (1.2, 2.4, 4.8 and 9.6 pmol·kg−1·min−1 for subcutaneous, and 0.3, 0.6, 1.2 and 2.4 pmol·kg−1·min−1 for intravenous). Plasma glucose, total and intact GLP‐1, insulin, C‐peptide, glucagon and gastrointestinal symptoms were evaluated over 8 h. The results are presented as mean ± SEM. Results: Plasma glucose decreased more with intravenous (by ~8.0 mmol/L [144 mg/dL]) than subcutaneous GLP‐1 (by ~5.6 mmol/L [100 mg/dL]; p < 0.001). Plasma GLP‐1 increased dose‐dependently, but more with intravenous than subcutaneous for both total (∆max 154.2 ± 3.9 pmol/L vs. 85.1 ± 3.8 pmol/L; p < 0.001), and intact GLP‐1 (∆max 44.2 ± 2.2 pmol/L vs. 12.8 ± 2.2 pmol/L; p < 0.001). Total and intact GLP‐1 clearance was higher for subcutaneous than intravenous GLP‐1 (p < 0.001 and p = 0.002, respectively). The increase in insulin secretion was greater, and glucagon was suppressed more with intravenous GLP‐1 (p < 0.05 each). Gastrointestinal symptoms did not differ (p > 0.05 each). Conclusions: Subcutaneous GLP‐1 administration is much less efficient than intravenous GLP‐1 in lowering fasting plasma glucose, with less stimulation of insulin and suppression of glucagon, and much less bioavailability, even at fourfold higher infusion rates. [ABSTRACT FROM AUTHOR]

Aim: To evaluate sex differences in gastric emptying and the glycaemic response to a glucose drink and a high carbohydrate meal in type 2 diabetes (T2D). Methods: In cohort 1, 70 newly diagnosed, treatment‐naïve Chinese patients with T2D (44 men) recruited from a diabetes outpatient clinic ingested a 75‐g glucose drink containing 150 mg 13C‐acetate. In cohort 2, 101 Australian patients with T2D (67 male) recruited from the community, managed by diet and/or metformin monotherapy, ingested a semi‐solid mashed potato meal, labelled with 100 μl 13C‐octanoic acid. Breath samples were collected over 3 and 4 h, respectively, for assessment of gastric emptying, and venous blood was sampled for evaluation of glycaemia (with and without adjustment for each participant's estimated total blood volume). Results: Gastric emptying was slower in female than male subjects in both cohorts (both p <.01). Multiple linear regression analyses revealed that gastric emptying was independently associated with sex (both p <.05). Without adjustment for blood volume, the glycaemic responses to oral glucose and the mixed meal were greater in female subjects (both p <.001). However, after adjustment for blood volume, the glycaemic responses were greater in men (both p <.05). Conclusions: Gastric emptying is slower in women than men with T2D, associated with a reduced blood volume‐adjusted glycaemic response to oral glucose and a mixed meal in women. These observations highlight the sex difference in postprandial glucose handling, which is relevant to the personalized management of postprandial glycaemia in T2D. [ABSTRACT FROM AUTHOR]

Aim: To evaluate gastric emptying (GE) and the glycaemic response to a 75‐g oral glucose load in newly diagnosed, treatment‐naïve Han Chinese with type 2 diabetes (T2D) before insulin pump therapy, after 4 weeks of insulin pump therapy, and 12–15 months after insulin pump therapy. Materials and Methods: Twenty participants with T2D (baseline glycated haemoglobin [± SD] 10.7% [± 1.2%] 93 [± 10] mmol/mol) ingested a 75‐g glucose drink containing 150 mg 13C‐acetate, to determine the gastric half‐emptying time, and underwent assessment of plasma glucose and serum insulin, C‐peptide and glucagon‐like peptide‐1 (GLP‐1) over 180 min before and after 4 weeks of insulin pump therapy (discontinued for 48 h before re‐assessment). Data were compared to those in 19 healthy participants matched for sex and age. After 12–15 months, GE was re‐measured in 14 of the T2D participants. Results: At baseline, participants with T2D exhibited substantially augmented fasting and post‐glucose glycaemia, diminished insulin secretion, and more rapid GE (p < 0.05 each), but comparable GLP‐1, compared to healthy participants. Following insulin pump therapy, insulin secretion increased, GLP‐1 secretion was attenuated, fasting and post‐glucose glycaemia were lower, and GE was slowed (p < 0.05 each). The slowing of GE in T2D participants was sustained over 12–15 months of follow‐up. Conclusions: In newly diagnosed Han Chinese with T2D, GE is often accelerated despite poor glycaemic control and is slowed by short‐term insulin pump therapy. The effect on GE is maintained for at least 12 months. [ABSTRACT FROM AUTHOR]

Sport and physical activity contexts are entrenched with ableist perspectives which view disability as abnormal or negative. Consequently, those who deviate from cultural norms may experience inequity, exclusion, stigmatisation, non-accidental violence and maltreatment. Despite the commitment to ensuring sport and physical activity is safe and inclusive through policies and programmes, more knowledge is needed about the welfare-related experiences of persons with a disability in sport and physical activity to better protect them. This research used collaborative autoethnography and Goffman's theory of stigma to explore two mothers' experiences in a sport and physical activity context, including what they saw, what they felt and what they perceived their children with a disability experienced. This research shows both mothers experienced stigma (e.g. enacted, courtesy, affiliate) due to their immersion and the actions of others in these contexts. Further, both mothers also perceived that their children with a disability experienced the same types of stigma in these contexts as well as the negative consequences related to this stigma (e.g. bullying, social isolation, exclusion, judgement, labelling, anxiety). These acts of stigmatisation positioned both them and their children as outsiders within the stories. This collaborative autoethnography highlights the lack of provisions for disabled children and their families in sport and physical activity contexts, and the persistence of ableist views.

Diagnoses of autism spectrum disorder (ASD) have risen dramatically in the last 10 years, with recent estimates at one in every 100 children within Australia. This has resulted in considerable increases in the number of students with ASD entering mainstream education. Teachers' attitudes towards inclusion have been recognised as a key indicator for students' successful inclusion. The main factors posited for determining teachers' attitudes towards the inclusion of students with disabilities, consists of the amount of specialist training received and the length of specific ASD teaching experience. Utilising the Autism Attitude Scale for Teachers for the first time in Australia, we examined 107 primary school teachers' attitudes towards the inclusion of students with ASD within their classrooms. The resulting scores were then analysed to examine the correlations, if any existed, between the amount of specialised training and years of ASD-specific teaching on teachers' attitude scores. While teachers' attitudes were found to be highly positive, contrary to previous studies, low correlation coefficients were reported between their attitudes and ASD-specific teaching experience, and their attitudes and the number of ASD-specific professional development courses they attended. Findings of this study are discussed in the context of the sample population and explore the notion of a sociological and philosophical shift, attributed to the positive promotion efforts of the inclusive education movement, as one possible reason for the divergence in the findings from past research in the field.

There is increasing evidence linking bitter taste receptor (BTR) signaling to gut hormone secretion and glucose homeostasis. However, its effect on islet hormone secretion has been poorly characterized. This study investigated the effect of the bitter substance, denatonium benzoate (DB), on hormone secretion from mouse pancreatic islets and INS-1 832/13 cells. DB (0.5-1 mM) augmented insulin secretion at both 2.8 mM and 16.7 mM glucose. This effect was no longer present at 5 mM DB likely due to the greater levels of cellular apoptosis. DB-stimulated insulin secretion involved closure of the KATP channel, activation of T2R signaling in beta-cells, and intraislet glucagon-like peptide-1 (GLP-1) release. DB also enhanced glucagon and somatostatin secretion, but the underlying mechanism was less clear. Together, this study demonstrates that the bitter substance, DB, is a strong potentiator of islet hormone secretion independent of glucose. This observation highlights the potential for widespread off-target effects associated with the clinical use of bitter-tasting substances. [ABSTRACT FROM AUTHOR]

Many pre-service teachers feel under-prepared to teach students with a diverse range of needs and abilities and continue to be concerned about classroom behaviour management when undertaking practicum experiences. In order to address these concerns, teacher educators have explored alternative pedagogical approaches, including computer based simulations and immersion in virtual worlds. This paper reports on the results of a pilot study conducted with eight pre-service teachers who operated avatars in a virtual classroom created within Second Life (SL)[TM]. The pre-service teachers were able to role-play students with a diverse range of behaviours and engage in reflective discussion about their experiences. The results showed that the pre-service teachers appreciated the opportunity to engage in an authentic classroom experience without impacting on "real" students, but that the platform of SL proved limiting in enacting certain aspects of desired teaching pedagogy. The findings of this pilot study are discussed in relation to improving the preparation of pre-service teachers for practicum. (Contains 2 figures, 1 table and 1 footnote.)

The article discusses the effects of glucagon-like peptide-1 (GLP-1) receptor agonists on blood pressure. GLP-1 receptor agonists have been shown to have cardiovascular and renal protective effects, independent of their glucose-lowering properties. While these drugs have been found to reduce systolic blood pressure in hypertensive individuals, they have little effect on diastolic blood pressure or normotensive individuals. The article also highlights the importance of accurately measuring blood pressure, including postprandial blood pressure, and suggests that further research is needed to optimize the assessment of the effects of GLP-1 receptor agonists on blood pressure. [Extracted from the article]