Opportunities For Inclusion Research Articles

The Right to Play: Snakes and Ladders

This case-study will present learnings from the public art project ‘Snakes and Ladders’, a fifty metre, ground plane mural in Sydney Olympic Park, in Sydney’s western suburbs. This was a collaboration between Digby Webster, an artist with Down syndrome, and Nadia Odlum, an artist without disability who specialises in playful, large-scale public art. Snakes and Ladders was commissioned by the Sydney Olympic Parks Authority (SOPA) as a result of a community consultation and co-design process, and was supported by Accessible Arts, the peak body for advancing the rights of New South Wales artists who have disability and/or who are d/Deaf. The result was a public artwork that functions as an inclusive playspace, supporting the right to play for all people who visit or live in Sydney Olympic Park.The key achievements of this project were the meaningful inclusion of an artist with disability in a significant public art project, and the creation of an accessible and inclusive opportunity for play in public space. This case-study focuses on process, including the community consultation process that led to the commission; the role of peak body Accessible Arts in facilitating and guiding the commission; the methods used to ensure accessibility in the artwork design; and the collaborative process between Digby and Nadia, including the steps taken to support Digby’s access requirements and ensure his full participation in the commission from concept to delivery.
 
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Virtual Net-Metering Option for Bangladesh: An Opportunity for Another Solar Boom like Solar Home System Program

This study explores the virtual net-metering (VNM) option for enabling inclusive investment opportunities in renewable energy for self-consumption in Bangladesh. It focuses on consumers, such as households and businesses in multi-family and multi-story buildings, who cannot participate in traditional net-metering policy due to technical and space constraints. The study adopted the classical socket parity method to identify suitable consumers for VNM. Then it determined the consumer benefits of using VNM by calculating the net present cost (NPC) and discounted payback period. The results reveal that several consumer categories can significantly save on electricity costs through VNM. For example, commercial consumers can save more than 50% of their electricity bills by investing in a VNM-enabled remote solar power plant with a discounted payback period of fewer than six years. The discussion articulates more comprehensive benefits of VNM. It addresses challenges for renewable energy development by identifying local opportunities. Therefore, this research can help initiate policy dialogues and create momentum for citizen investments in the energy transition. The proposed approach can also be used to analyze the economic feasibility and potential of VNM in other countries.

The Latino Resident Physician Shortage: A Challenge and Opportunity for Equity, Diversity, and Inclusion.

The purpose of this study is to examine the number of Latino physicians in residency training and Latino resident physician trends in the nation's 10 largest medical specialties in the United States and in the 4 states with the largest Latino populations: California, Florida, New York, and Texas. The authors used data from the United States Census Bureau's American Community Survey to determine Latino populations and a special report from the Association of American Medical Colleges to determine rates of Latino resident physicians in the United States and in California, Florida, New York, and Texas from 2001 to 2017. Rates of Latino residents in the nation's 10 specialties with the largest number of residents were also determined. From 2001 to 2017, the United States had an average of 37 resident physicians per 100,000 population. At the national level, however, Latino residents were underrepresented, with only 14 per 100,000 Latino population. At the state level, California and Texas, the 2 states with the largest Latino populations (39.4% and 39.7% of their population, respectively), had 5 and 9 Latino residents per 100,000 Latino population, respectively. Latino residents in California, Texas, Florida, and New York were also very underrepresented in the primary care specialties examined. The findings show a severe shortage of Latino resident physicians. While a similar shortage also exists in primary care specialties, the majority of Latinos in states with large Latino populations are consistently choosing to train in primary care. Investment and greater improvement in the representation of certain population groups in medicine and for combating the inequities existing in the current educational system is needed. The authors offer recommendations to increase the number of Latinos in residency programs and for increasing the number of Spanish-speaking physicians and Latino international medical graduates in residency programs.

Comparison of sociodemographic characteristics of a phase 1 clinical trial population at an NCI-designated comprehensive cancer center in the Southeast to catchment area.

e18591 Background: Racial and ethnic minority populations are consistently under-represented in oncology clinical trials despite comprising a disproportionate share of cancer burden. Due in part to difficulties associated with participation, phase 1 trials pose a unique challenge and opportunity for minority inclusion. Here we examine the sociodemographics of phase 1 clinical trial patients at an NCI-designated Comprehensive Cancer Center compared to all patients treated at the center, patients with new cancer diagnoses in metropolitan Atlanta, and the state of Georgia (GA). Methods: Patients enrolled on phase 1 trials at the Winship Cancer Institute (WCI) from 2015-2020, identified from a data warehouse, were compared to new patient registrations at WCI from 2015-2019. Patients with cancer in metro Atlanta and GA were identified from the Surveillance, Epidemiology, and End Results (SEER) Program: Nov 2018 Submission. Covariates for the phase 1 and institutional cohort included sex, race, ECOG PS, insurance, and age at consent. Covariates for SEER patients included sex, race, and age at diagnosis. Summary statistics are reported for categorical variables using frequencies and percentages, and for continuous variables using mean, median, standard deviation, and range. One-sample proportion tests were utilized to compare observed demographic proportions on phase 1 trials with proportions calculated from new patient registrations at WCI and from SEER case data. Results: From 2015-2020, 2325 patients (43.4% F, 56.6% M) signed consent for phase 1 trials. Grouped race distribution was 70.3% White, 26.2% Black, 3.5% Other. Insurance distribution was 42.9% private, 48% government, 9.1% uninsured/other. Mean age at consent was 61.7 years (MD 63, ran 19-92). Of new patient registrations at WCI in 2015 ( N= 12358) (49.7% F, 50.3% M), grouped race distribution was 64.0% W, 28.2% B, 8% O. Atlanta 2015 SEER patients ( N= 31101) (50.3%F, 49.7%M) showed grouped race distribution 58.4% W, 37.2% B, 4.3% O. Mean age at diagnosis was 62.9. GA 2015 SEER patients ( N= 99487) (48.6%F, 51.4%M) showed grouped race distribution 71.2% W, 26.7% B, 2.1% O. Mean age at diagnosis was 64.2. The race and sex distribution of phase 1 patients was significantly different than proportions calculated from new patient registrations at WCI and SEER data from patients in Atlanta ( p< 0.001). Sex distribution was significantly different than GA SEER patients. Conclusions: Phase 1 patients were significantly more likely to be white and male, compared with patients treated at the cancer center, as well as patients with cancer in Atlanta. Race distribution was not significantly different from patients with cancer in GA. Our intent is to characterize existing disparities in order to increase representation of patients from racial and ethnic minority backgrounds in phase 1 clinical trials.

Sexual orientation and gender identity (SOGI) data in dermatologic studies and opportunities for inclusion.

Dermatologists serve a vast array of patients with unique backgrounds. The National Institutes of Health (NIH) designated members of sexual and gender minorities as underrepresented in scholarly literature. Our study examines the past 10 years of studies published in highly-cited dermatologic journals, surveying each study for common data collection of sexual orientation and gender identity (SOGI) in dermatological studies. We found representation of sexual and gender minorities to be increasing in dermatological studies but recommend that SOGI data be collected regularly just as any other common variable in dermatological patient studies.

Increasing On-Task Behavior Using Technology-Based Self-Monitoring: A Meta-Analysis of I-Connect

Self-monitoring is a promising evidence-based intervention for students who benefit from supplemental supports to stay on-task during academic periods. I-Connect, a technology-based self-monitoring intervention with a substantial body of research, allows students to discretely recognize and record their behavior on a mobile or desktop app at scheduled intervals, to improve positive behavior and increase inclusion opportunities. This meta-analytic review examined the effect of I-Connect on the on-task behavior of students with or at risk for disabilities to determine the omnibus effect of using I-Connect across students and intervention packages. Students received 20–45 minutes of training before using I-Connect and most students monitored their on-task behavior every 30-seconds during 10-minute monitoring sessions. Under these conditions, I-Connect was found to demonstrate strong functional relations, an abrupt increase in on-task behavior and consistently positive parametric effects across all 14 elementary and secondary students receiving special education.

Presenting a New Framework to Improve Engagement in Physical Activity Programs for Children and Adolescents With Social, Emotional, and Behavioral Disabilities.

Children and adolescents with psychiatric and neurodevelopmental diagnoses such as anxiety, depression, autism, and attention-deficit/hyperactivity disorder (ADHD) face enormous health disparities, and the prevalence of these disorders is increasing. Social, emotional, and behavioral disabilities (SEBD) often co-occur with each other and are associated with unique barriers to engaging in free-living physical activity (PA), community-based exercise and sports programming, and school-based physical education. Some examples of these barriers include the significantly depleted parental reserve capacity associated with SEBD in children, child dysregulation, and previous negative experiences with PA programming and/or exclusion. Importantly, most SEBD are “invisible,” so these parents and children may face more stigma, have less support, and fewer inclusive programming opportunities than are typically available for children with physical or intellectual disabilities. Children’s challenging behavioral characteristics are not visibly attributable to a medical or physical condition, and thus are not often viewed empathetically, and cannot easily be managed in the context of programming. Existing research into PA engagement barriers and facilitators shows significant gaps in existing health behavior change (HBC) theories and implementation frameworks that result in a failure to address unique needs of youth with SEBD and their parents. Addressing these gaps necessitates the creation of a simple but comprehensive framework that can better guide the development and implementation of engaging, effective, and scalable PA programming for these youth and their families. Therefore, the aim of this article is to: (1) summarize existing research into SEBD-related child and parent-level barriers and facilitators of PA evidence-based program engagement; (2) review the application of the most commonly used HBC and disability health theories used in the development of evidence-based PA programs, and implementation science frameworks used in adaptation and dissemination efforts; (3) review the SEBD-related gaps that may negatively affect engagement; and (4) describe the new Pediatric Physical Activity Engagement for Invisible Social, Emotional, and Behavioral Disabilities (PAID) Framework, a comprehensive adapted PA intervention development and implementation adaptation framework that we created specifically for youth with SEBD and their parents.

A Future for the Inland Fish and Fisheries Hidden Within the Sustainable Development Goals

The United Nations Sustainable Development Goals (SDGs) are a unifying call for change - guiding global actions at multiple levels of governance for a better planet and better lives. Consequently, achieving the “future we want” may be hindered by overlooking valuable natural resources and services that are not explicitly included in the SDGs. Not recognizing the direct, intrinsic value of some natural resources may threaten the sustainability of the services they provide and their contributions to the SDGs. Here, we use inland aquatic ecosystems, and the fish and fisheries therein, as an example to explore opportunities for recognition and inclusion of other natural resources that are missing from the SDGs. Key resources absent from the SDGs are less likely to be incorporated in global, national, and regional objectives, dialogues, and policies. We outline multiple potential pathways for better inclusion and capitalization of contributions from these overlooked natural resources during the operationalization of the SDGs and other global instruments.

MITTI Café: enabling disability inclusion in India through scalable business model

Study level/applicability The case can be used at undergraduate and postgraduate level, in management development programmes or in Executive Education programmes. Subject area Social entrepreneurship, social inclusion, business model innovation, sustainability, strategy design and strategy execution. Case overview The case explores the development of MITTI Café, an organisation that trains and employs individuals with intellectual, physical and/or psychiatric disabilities to work in inclusive kitchens and cafes in India. The protagonist is the founder of the café, Alina Alam, who has won several international awards for her work. The case highlights Alam’s approach and how she is trying to challenge societal and business perspectives relating to disability. From 2017 to 2021, Alam has scaled and operationalised the business, building her core team, leveraging several partnerships with stakeholders and putting into place offerings, processes and procedures that created a sustainable business model and blueprint.MITTI Café aligns itself with several of the Sustainable Development Goals (SDGs), with sustainability and social impact at the core of its strategy. As Alam considers the future in July 2021, what else needs to be taken into consideration to scale either within India or abroad? Expected learning outcomes Following reading and exploring the case, students should be able to identify how social exclusion and inclusion manifests in a business context, and how social entrepreneurship ventures such as MITTI Café can address this challenge; identify capabilities in the context of people with disabilities; recognise how stakeholder relationships can be leveraged as a force for good and for growth, and address SDGs through social enterprise; identify and categorise resources and capabilities within organisations; evaluate opportunities for growth and scale. Social implications The case explores how the protagonist is challenging the concept of “ability” and through her work with the differently abled providing scalable opportunities for social inclusion and dignity. Supplementary materials Teaching notes are available for educators only. Subject code CSS 11: Strategy.

A reflection of life - my tale of microdiversity, equity and inclusion in cell biology (and beyond).

A reflection of life - my tale of microdiversity, equity and inclusion in cell biology (and beyond).

Capturing instructional differentiation in educational research: investigating opportunities and challenges

ABSTRACT Background Instructional differentiation within classrooms involves educators’ adaptations of instructional elements to meet diverse learners’ needs. It is usually regarded as a crucial component of high-quality education that promotes equal and inclusive opportunities for all students. However, defining and operationalising this complex construct is challenging, and important, in efforts to better understand instructional differentiation and support learners worldwide. Purpose This paper aims to contribute to a better understanding of instructional differentiation. It discusses definitions and operationalisations of instructional differentiation in the educational research literature and argues for the inclusion of deliberateness and adaptiveness as two defining characteristics of instructional differentiation. Sources of evidence and main arguments Using theoretical arguments and illustrations from empirical research, including a small-scale study of our own, we discuss and exemplify the value of considering deliberateness and adaptiveness in empirical research on instructional differentiation. Further, we consider the challenges and opportunities for research on instructional differentiation. Conclusions Studying the deliberateness and adaptiveness of instructional variation calls for conceptual and operational alignment, and research methodologies that take into account the multiple perspectives of teachers and students. Our investigations draw attention to the conceptual complexity of instructional differentiation, challenges in practice and the need for professional development to support teachers’ embedding of instructional differentiation practices.

Three modes of inclusion of people with intellectual disability in mainstream services: mainstreaming, differentiation and individualisation

This paper examines the adjustments made to include people with intellectual disabilities in mainstream services. Drawing on in-depth interviews with both people with intellectual disabilities and mainstream service managers in four urban regions in Australia, the paper points to three modes of practice that are operationalised, to different degrees, when people with intellectual disabilities seek access to mainstream services: a commitment and adjustments to support inclusion of a wide range of marginalised people (diversity and inclusion ethos); adjustments to support inclusion of people with intellectual disabilities more specifically (differentiated adjustments); and, personal support for service users with intellectual disabilities. We argue that these three modes, at the service level, correspond in complex ways with three broader approaches to social inclusion: mainstreaming, differentiation and individualisation. Rather than contradictory modes of inclusion, our analysis suggests these approaches should be understood as complementary. Points of interest Some mainstream services that value ‘inclusion’ make adjustments to their service in order to better include people from different marginalised groups. Such adjustments have mixed outcomes for people with intellectual disability, whose specific needs are not always met. Some mainstream services operate separate activities for users with intellectual disability. This helps them manage behavioural and communication challenges, and can help people with intellectual disability experience a sense of belonging. But separate activities also limit opportunities for full inclusion in the mainstream. Often people with intellectual disability require their own personal support to be able to use mainstream services. Some mainstream services rely on such personal support as their main strategy to include people with intellectual disability. Other mainstream services work collaboratively with personal supporters to promote inclusion.

Expanding Opportunities for Work and Citizenship: Participation of People with Intellectual Disabilities in Voluntary Work

This article discusses the findings of a study into how voluntary work provides opportunities for work inclusion and citizenship for people with intellectual disabilities. The study is based on qualitative interviews with 12 people with intellectual disabilities engaged in voluntary work in Iceland and Norway. Based on collective qualitative analysis, opportunities for meaningful social relations, competence, contribution and belonging were identified as key aspects of the participants’ experiences of volunteering. The study indicates that voluntary settings offer work that recognises the diversity of preferences, expectations and skills among people with intellectual disabilities. The study’s findings point to the importance of rethinking the meaning and boundaries of work, as participation in voluntary work provides opportunities for both inclusion and citizenship in addition to the participants’ participation in other work settings.

Skin involvement in early diffuse cutaneous systemic sclerosis: an unmet clinical need.

Diffuse cutaneous systemic sclerosis (dcSSc) is associated with high mortality resulting from early internal-organ involvement. Clinicians therefore tend to focus on early diagnosis and treatment of potentially life-threatening cardiorespiratory and renal disease. However, the rapidly progressive painful, itchy skin tightening that characterizes dcSSc is the symptom that has the greatest effect on patients’ quality of life, and there is currently no effective disease-modifying treatment for it. Considerable advances have been made in predicting the extent and rate of skin-disease progression (which vary between patients), including the development of techniques such as molecular analysis of skin biopsy samples. Risk stratification for progressive skin disease is especially relevant now that haematopoietic stem-cell transplantation is a treatment option, because stratification will inform the balance of risk versus benefit for each patient. Measurement of skin disease is a major challenge. Results from clinical trials have highlighted limitations of the modified Rodnan skin score (the current gold standard). Alternative patient-reported and other potential outcome measures have been and are being developed. Patients with early dcSSc should be referred to specialist centres to ensure best-practice management, including the management of their skin disease, and to maximize opportunities for inclusion in clinical trials.

Opportunities for Inclusion and Engagement in the Transition of Autistic Youth from Pediatric to Adult Healthcare: A Qualitative Study

Transitioning autistic youth from pediatric to adult healthcare requires coordination of multiple stakeholders, including youth, caregivers, and pediatric and adult care providers, whose interests at times overlap but often differ. To understand barriers and facilitators to inclusive transition experiences, we conducted thematic analysis of interviews with 39 stakeholders from the same large, integrated healthcare system. We identified three major themes: (1) Navigating the healthcare transition without guidance, (2) Health consequences of a passive healthcare transition, and (3) Strategies for inclusion and continuous engagement. Facilitators included gradual transition planning, a warm handoff between providers, and support of shared healthcare decision-making. Providers also sought clinical tools and logistical supports such as care coordinators and longer transition-specific visit types to enhance patient-centered care.

Remembering New Vocationalism: Reinforcing the Future of Workforce and Professional Development in the Community College

ABSTRACT The concept of new vocationalism reached its height in the 1990s and 2000s as views evolved regarding how community colleges should provide relevant vocational education for students. The concept of new vocationalism is here brought into the present moment by mapping theoretical lineages and emphasizing the current and future practical implications at the nexus of the community college sector and a post-COVID-19 economy. Reforms centered around the principles of new vocationalism have led to more inclusive opportunities for learners from varied diverse and marginalized backgrounds, though the influence within career development and community colleges often goes unrecognized. Implications for educational leaders are discussed, including refocusing outcomes on the needs of diverse learners and bridging the gap between students’ academic and vocational educations. Specific considerations are also provided to further solidify new vocationalism principles in workforce and professional development programs within community college and career development contexts. Consideration first needs to be given to building programming that develops students’ professional identity with a willingness (from both student and educator) to push back against exclusionary ideas of professional, professionalism, and industry practices that are not focused on employee inclusion. Further, equity and access should remain foundational to all programs if these structures are to remain relevant. Specific recommendations are given for incorporating the equity-mindedness approach when developing workforce and professional development programs and curriculum, with increased consideration being given regarding the reality of how well workforce and professional development programs are currently preparing students for life-long career success, growth, and adaptability.

Unraveling the Threads: A Comprehensive Analysis of Government Policies on Unemployment, Worker Empowerment, and Labor Market Dynamics

This research delves into the multifaceted landscape of government policies addressing unemployment and worker empowerment, offering a comprehensive analysis of their implications for policymakers, employers, and workers. The study illuminates both the commendable strides and nuanced challenges associated with existing policies, emphasizing the need for adaptability, inclusivity, and sustainability in the ever-evolving labor market. For policymakers, the research underscores the importance of informed decision-making, adaptive policy design, and global collaboration. Insights gleaned from the study call for a holistic approach that considers long-term sustainability, environmental impacts, and the creation of inclusive opportunities across diverse demographic groups. Employers are called upon to invest not only in workforce productivity but also in holistic employee development. Balancing technological integration with employee well-being emerges as a key theme, alongside the imperative of fostering diversity and inclusion initiatives within the workplace. Individual workers are encouraged to embrace adaptability and lifelong learning as central tenets of navigating the evolving world of work. The study underscores the significance of advocating for equal access, participating in creating inclusive workplaces, and safeguarding worker rights in the face of technological disruptions.In conclusion, this research serves as a guiding compass for stakeholders, highlighting the complex interplay of economic, technological, and societal forces. The implications are clear: collaborative efforts are requisite to address identified challenges, and a collective commitment to fostering inclusive, adaptive, and environmentally conscious practices is essential. The study posits that the trajectory of the labor market is inseparable from the choices and actions of policymakers, employers, and workers, emphasizing a collective ethos that values the dignity, diversity, and continuous growth of every individual within the workforce

Recovery Compromised: Tracing the Structural Conditions that Perpetuate and Maintain Social Exclusion in Assertive Community Treatment

Concerns have been raised regarding the extent to which the services provided through the Assertive Community Treatment (ACT) model are based on an understanding of recovery as primarily a clinical phenomenon rather than a journey that is fundamentally about self-determination, social inclusion, citizenship and civil rights. Until recently, the limited degree of social inclusion experienced by users of ACT has been assumed to result from individual functioning or inadequate practitioner training. These explanations negate the role of organizing conditions in shaping a systematic approach to everyday practice that diminishes opportunities for inclusion. The current study identifies key areas where practices consistent with the current recovery vision and theories of social inclusion are superseded by accepted and legitimized forms of practice that are aligned with a medical model approach. The study explicates both how and why this happens in the course of everyday practice.

Don\u2019t change who we are but give us a chance: confronting the potential of community health worker certification for workforce recognition and exclusion

BackgroundFor community health workers (CHWs) and promotores de salud (CHWs who primarily serve Latinx communities and are grounded in a social, rather than a clinical model of care), the process of certification highlights the tension between developing a certified workforce with formal requirements (i.e., certified CHWs) and valuing CHWs, without formal requirements, based on their roles, knowledge, and being part of the communities where they live and work (i.e., non-certified CHWs). California serves as an ideal case study to examine how these two paths can coexist. California’s CHW workforce represents distinct ideologies of care (e.g., clinical CHWs, community-based CHWs, and promotores de salud) and California stakeholders have debated certification for nearly twenty years but have not implemented such processes.MethodsWe employed purposive sampling to interview 108 stakeholders (i.e., 66 CHWs, 11 program managers, and 31 system-level participants) to understand their perspectives on the opportunities and risks that certification may raise for CHWs and the communities they serve. We conducted focus groups with CHWs, interviews with program managers and system-level participants, and observations of public forums that discussed CHW workforce issues. We used a thematic analysis approach to identify, analyze, and report themes.ResultsSome CHW participants supported inclusive certification training opportunities while others feared that certification might erode their identity and undermine their work in communities. Some program managers and system-level participants acknowledged the opportunities of certification but also expressed concerns that certification may distance CHWs from their communities. Program managers and system-level participants also highlighted that certification may not address all challenges related to integrating CHWs into health care systems. CHWs, program managers, and system-level participants agreed that CHWs should be involved in certification discussions and decision making.ConclusionsTo address participant concerns, our findings recommend California stakeholders build a voluntary certification process structured with multiple pathways to overcome entry barriers of traditional certification processes, maintain CHW identity, and protect diversity within the workforce. Positioning CHWs as decision makers will be critical when designing state certification processes.

Who’s striking, and who’s not? Avoiding and acknowledging bias in youth climate activism research

AbstractThe School Strike 4 Climate is a timely opportunity for education and research sectors to support youth stories in climate change policy, and foster impactful relationships between researchers, teachers and students. But much research in this space has inherent selection biases where youth representation in research is limited by place (such as attendance at a protest), snowball sampling (often within already engaged groups) or through education channels (such as private or independent schools), ultimately leading to unrepresentative response samples. This comment explores the challenges and opportunities for equitable inclusion of teenage voices in environmental research, including some practical approaches (such as inclusion of public schools) to ensure more diverse samples are represented. Implications for how the existing body of research should be viewed is discussed, highlighting an existing lack of representation of students that do not overtly engage with climate activism or School Strikes.