Developing and validating a scale to measure trauma-informed practices used by teachers in inclusive schools in Ghana and the United Arab Emirates.

Research on trauma-informed practices is common in Western countries, but non-Western countries have made minimal contributions in this regard. This study aimed to develop an instrument which could be used to measure perceived competence of teachers in the implementation of trauma-informed practices for students with disabilities in Ghana and the United Arab Emirates (UAE). The Teacher Trauma Management Scale (TTMS), developed using the trauma framework by the Substance Abuse and Mental Health Services Administration was used to collect data from 514 teachers in Ghana (n 270) and the UAE (n = 244). Data were subjected to confirmatory factor analysis) and a two-way factorial analysis of variance was conducted. While one hypothesis was supported by the study findings, the other was only partially supported. The findings provided theoretical and structural support for the newly developed TTMS in a non-Western context. This study highlights the need to develop contextual trauma management training models or a curriculum for training teachers.

Competence of teachers towards managing trauma among children with disabilities in Ghana.

Background: Although trauma is one of the leading causes of behaviour problems among children with disabilities, there has been limited scholarly interest in trauma management within the discourse of implementation of inclusive education. Objectives: The Substance Abuse and Mental Health Services Administration (SAMHSA) trauma management model was used to study teachers' awareness of trauma management among students with disabilities studying in regular classrooms. Method: A total of 271 teachers were recruited from two municipalities in the central region of Ghana to complete the Teacher Trauma Management Scale developed for this study. The data were analysed using confirmatory factor analysis, mean scores, multivariate analysis of variances, and linear regression. Results: The results showed teachers' uncertainty towards trauma management, and a positive correlation was also found between the tenets of the study framework. Conclusion: The study concluded with a recommendation for contextual development of the curriculum to guide teacher training in trauma management. Contribution: Studies on trauma management within the discourse of implementation of inclusive education are scarce. This study extends the literature on inclusive education to teacher development to support trauma management among students with disabilities in regular schools.

Accessibility of nutritional services for children with autism spectrum disorder in the United Arab Emirates: Insights from special education teachers and parents.

BACKGROUND: Goal 2 of United Nation's Sustainable Development Goals exhorts countries to provide guidelines on better nutrition for all children. In response, the United Arab Emirates (UAE) government designed a national nutrition framework to encourage better eating habits. However, large body of literature has reported that children with ASD are at high risks of malnutrition and poor eating habits. Yet, in the UAE and other contexts, there is limited research on accessibility of nutritional services to adults in the lives of children with ASD. AIMS: As parents and teachers spend the most time with children with ASD, this study sought to understand their perceptions of the availability of nutritional services for such children in the UAE. METHOD AND PROCEDURES: Penchansky and Thomas' (1981) health access theory served as the theoretical framework; its five tenets (geography, finance, accommodation, resources and acceptability) informed the design of a semi-structured interview guide. Data were collected from 21 participants, comprising 6 parents and 15 teachers of children with ASD. OUTCOMES AND RESULTS: Thematic analysis revealed that participants perceived accommodation, acceptability, and human resource availability as barriers to accessibility. However, geographical and financial accessibility were not identified as challenges. CONCLUSIONS AND IMPLICATIONS: The study calls for health policymakers to formalise nutritional services as an integrated part of the UAE health system, while also extending services to children with ASD. CONTRIBUTION: This study makes a substantial contribution to the literature. First, it addresses the needs for nutritional services for children with ASD. There is a limited body of knowledge on whether children with ASD have access to the requisite nutrition for development This study sheds light on an area that has received limited scholarly insight. Second, it adds to the usage of health access theory in studies on nutritional services for children with ASD.

Nutritional needs of children with disabilities in the UAE: understanding predictors and mediators of nutritional knowledge and practices.

BACKGROUND: There is a high estimated prevalence of obesity and poor eating habits among children with disabilities. Unfortunately, the extent of parental and teachers' awareness of the dietary needs and nutritional requirements of children with disabilities has been understudied. This study aims to explore the predictors and mediators of nutritional knowledge and practices among parents and teachers of children with disabilities in the United Arab Emirates (UAE) using Nutbeam's hierarchical health literacy model as a framework to test three hypotheses. METHODS: A total of 149 parents and teachers were recruited from rehabilitation centres in two of the seven Emirates in the UAE. The revised Food and Nutritional Literacy Scale (FNLIT) was used for data collection. The revised scale was validated and its reliability was assessed using SPSS and AMOS version 28 to compute exploratory factor analysis and structural equation modelling (confirmatory factor analysis and path analysis), respectively. RESULTS: The results confirmed a four-factor structure for FNLIT, and all three hypotheses were supported by the study findings. We confirmed a relationship between understanding and practical nutritional skills (Hypothesis I), and found that two practical nutritional skills, functional and interactive, combined to predict the understanding of nutritional needs of children with disabilities (Hypothesis II). Hypothesis III was partially supported in that participant type mediated the relationship between functional, interactive, and understanding factors. The convergent and discriminant validities of the scale were confirmed, and path analysis showed the ability of practical skills to predict knowledge. CONCLUSION: The study concludes on the need for public education on nutritional needs as well as developing the capacity of teachers and parents to implement appropriate eating programmes for children with disabilities.

Using tactile imagery to teach geometry to students with visual impairments in the United Arab Emirates.

Learning geometry is difficult for students with visual impairments (VIs). However, tactile imagery, the process of constructing mental images of physical objects with certain shapes, may help them make sense of geometrical shapes. Thus, discussions have centred on interventions to promote the participation of students with VIs in the learning of shapes. This study explored tactile imagery connecting physical touch to memory as an approach to teaching shapes to students with VIs. Eleven students, five with VIs and six sighted students took part in this experimental design study. A tactile imagery test and intervention lessons were developed for this study. Four tactile imagery domains (tactile discrimination, tactile memory 2D, tactile memory 3D and pattern recall), each made up of 10 tests, guided the design of the tests and training lessons. The students' scores from the pre-test and post-test were subjected to mean computations, Mann-Whitney U tests and the Wilcoxon signed-rank test. The post-test results revealed that students with VIs performed better than their sighted peers. The study concludes with a discussion of the need for teacher educators to consider using tactile imagery as a way of teaching geometry to students with VIs.

The combined effect of ketamine and remifentanil infusions as total intravenous anesthesia for scoliosis surgery in children.

BACKGROUND: This study was designed to assess the effect of combination of ketamine and remifentanil infusions as total intravenous anesthesia (TIVA) during scoliosis surgery in children. METHODS: Thirty two children, 8-14 yr of age, scheduled for posterior spinal fusion, were randomly allocated into two equal groups to receive either remifentanil infusion in a dose of 0.2 microg/kg/minutes or same dose of remifentanil infusion combined with ketamine infusion in a dose of 1 microg/kg/minutes after induction of general anesthesia. During surgery, hemodynamics, surgical bleeding, and electrophysiology monitors were recorded. After completion of surgery, recovery score, recovery time and rescue analgesia were assessed in post-anesthesia care unit (PACU) for 24 hours. RESULTS: The two groups were similar for age, weight, duration of surgery, and time to extubation. Intraoperative heart rate and arterial blood pressure were significantly decreased in remifentanil group when compated to remifentanil-ketamine group. The surgical bleeding and electrophysiological monitoring were not significantly affected by remifentanil-ketamine combination in second group. Recovery score and recovery time were not significantly increased in remifentanil-ketamine group. First pain scores recordings in arrival to (PACU) were significantly less in remifentanil-ketamine group than remifentanil group and the time passed to first patient controlled analgesia (PCA) demand dose was increased in remifentanil-ketamine group. The first 24 h morphine consumption was 38 +/- 17 and 28 +/- 10 mg (mean +/- SD) in remifentanil and remifentanil-ketamine groups, respectively. CONCLUSIONS: These data demonstrate that during posterior spinal fusion surgery in children, the combination of ketamine and remifentanil infusions as TIVA may provide hemodynamic stability, satisfactory surgical requirements with reliable electrophysiological monitoring and adequate post operative pain relief supplemented by PCA morphine.

Pegylated interferon alpha-2b plus ribavirin in patients with genotype 4 chronic hepatitis C: The role of rapid and early virologic response.

UNLABELLED: In patients chronically infected with hepatitis C virus (HCV) genotype 4, the optimum duration of therapy and the predictors of sustained virologic response (SVR) have not been adequately determined. In this study, 358 patients with chronic hepatitis C genotype 4 were randomly assigned to pegylated interferon (PEG-IFN) alpha-2b (1.5 mug/kg/week) plus oral ribavirin (10.6 mg/kg/day) for a fixed duration of 48 weeks (control group, n = 50) or for a variable duration (n = 318). In the variable-duration group, patients with undetectable HCV RNA at week 4 were treated for 24 weeks (group A, n = 69), patients with undetectable HCV RNA at week 12 were treated for 36 weeks (group B, n = 79), and the rest of the patients were treated for 48 weeks (group C, n = 160). The primary endpoint was SVR (undetectable HCV RNA 24 weeks after treatment cessation). Groups A-C and the control group had SVR rates of 86%, 76%, 56%, and 58%, respectively. After the study was controlled for predictors, a low baseline histologic grade and stage were associated with SVR (P < 0.029) in all groups. In addition, among patients in group C, older age (P = 0.04), a higher baseline body mass index (P = 0.013), and low baseline HCV RNA (P < 0.001) were also associated with SVR attainment. The incidence of adverse events and the rate of discontinuation were higher in patients in the variable-duration and fixed-duration groups treated for 48 weeks. CONCLUSION: In patients with chronic hepatitis C genotype 4 and undetectable HCV RNA at weeks 4 and 12, treatment with PEG-IFN alpha-2b and ribavirin for 24 weeks and 36 weeks, respectively, is sufficient.