Transition Planning Research Articles

Social network support is associated with teacher’s perceptions of transition planning for their autistic students

BackgroundSchool transitions are accompanied by disruptions in routines and increased social and academic demands, creating challenges for autistic students, who often have difficulty coping with change. These transitions are also challenging for teachers, who often report feeling unprepared to guide their autistic students through the transition process. MethodsThis study examined teacher and student factors that contribute to teachers’ perceptions of transition planning for their autistic students. At four sites (Los Angeles, Philadelphia, Rochester, and Sacramento), 126 teachers responded to survey questions regarding their perception of transition planning for their autistic students, their students’ classroom behavior as they were preparing to transition, their own burnout, and a social network survey about the people they relied on to support their autistic students. ResultsTeachers reported being somewhat satisfied with their schools with the way that schools prepared their students for transition and that the transition planning was somewhat effective. Teachers also reported that they received little support from their schools during their students’ transition planning. Results of Generalized Linear Mixed Effects models indicated that teachers with positive perceptions of their students’ transition planning had larger support networks, ConclusionsThe findings of this study underscore that teachers’ support networks play an important role in helping teachers negotiate the transition process.

Methodologies and key considerations for implementing the International Classification of Diseases-11th revision morbidity coding: insights from a national pilot study in China.

The aim of this study was to disseminate insights from a nationwide pilot of the International Classification of Diseases-11th revision (ICD-11). The strategies and methodologies employed to implement the ICD-11 morbidity coding in 59 hospitals in China are described. The key considerations for the ICD-11 implementation were summarized based on feedback obtained from the pilot hospitals. Coding accuracy and Krippendorff's alpha reliability were computed based on the coding results in the ICD-11 exam. Among the 59 pilot hospitals, 58 integrated ICD-11 Coding Software into their health information management systems and 56 implemented the ICD-11 in morbidity coding, resulting in 3723959 diagnoses for 873425 patients being coded over a 2-month pilot coding phase. The key considerations in the transition to the ICD-11 in morbidity coding encompassed the enrichment of ICD-11 content, refinement of tools, provision of systematic and tailored training, improvement of clinical documentation, promotion of downstream data utilization, and the establishment of a national process and mechanism for implementation. The overall coding accuracy was 82.9% when considering the entire coding field (including postcoordination) and 92.2% when only one stem code was considered. Krippendorff's alpha was 0.792 (95% CI, 0.788-0.796) and 0.799 (95% CI, 0.795-0.803) with and without consideration of the code sequence, respectively. This nationwide pilot study has enhanced national technical readiness for the ICD-11 implementation in morbidity, elucidating key factors warranting careful consideration in future endeavors. The good accuracy and intercoder reliability of the ICD-11 coding achieved following a brief training program underscore the potential for the ICD-11 to reduce training costs and provide high-quality health data. Experiences and lessons learned from this study have contributed to WHO's work on the ICD-11 and can inform other countries when formulating their transition plan.

A Quality Improvement Initiative to Improve Health Care Transition Planning at Adolescent Well Visits

ObjectiveHealth care transition (HCT) planning supports adolescents as they move from pediatric to adult health care and is recommended for all youth. HCT planning uptake remains low, with little known about HCT in the adolescent well child check (WCC) setting. We sought to increase rates of HCT planning at WCCs by adapting best practices for HCT from specialty and chronic care. MethodsThis quality improvement initiative at 12 to 17-year-old WCCs at four Internal Medicine-Pediatrics primary care clinics, was based on the first three of the “Six Core Elements” of HCT framework and integrated into the electronic health record. Two uptake measures were assessed via chart review after three plan-do-study-act (PDSA) cycles, with two provider surveys and an implementation science analysis further informing interpretation. ResultsBy the final PDSA cycle, the percentage of 14 to 17-year-old WCCs at which HCT planning was discussed and a screening tool completed increased from 5% to 31%, and the percentage of 12 to 13-year-old WCCs at which the HCT policy was discussed increased from 6% to 47%. Provider survey results revealed endorsement of HCT goals, but time and technological barriers, which were further elucidated in the implementation science analysis. ConclusionsThis quality improvement initiative increased rates of HCT planning during adolescent WCCs. While limited to three Core Elements and Internal Medicine-Pediatrics clinics, strengths include measures capturing all WCCs, contextualized by provider surveys and an implementation science framework. Lessons from this effort can inform future tailored HCT initiatives at adolescent WCCs.

Data–driven analysis of Romania's renewable energy landscape and investment uncertainties

In recent years, there has been a significant transformation in the energy sector in the European Union as a whole. The shift towards producing renewable energy has had a significant impact on the economic development of most countries, requiring substantial investments through public procurement. This study aims to analyse the evolution of the energy sector in Romania from an economic perspective by using a data-driven approach. The data used in this research is collected from publicly available sources and pertains to energy production and public acquisitions in Romania, carried out through the Electronic Public Procurement System. By using a mixed approach, combining documentary analysis, literature review, and predictive modelling, the study reveals a shift towards more sustainable energy options. There is a significant decrease in the production of thermal power and an increase in solar and wind power. The findings provide an overview and potential scenario of Romania's electricity production levels in 2023, shedding light on the relative uncertainties associated with such a transition. The findings also suggest a clear and growing commitment in Romania towards the adoption of alternative energy sources, as reflected in the trends of public procurement. These procurement trends offer a valuable perspective on policy-making, investment planning, and progress monitoring in Romania's energy transition. Despite the inherent uncertainties in such a transition, the study demonstrates Romania's potential in terms of diverse sources for electricity production as well as the role of public procurement in achieving energy transformation.

Developing a framework for understanding policy decision-making behaviors in the transition of a HIV prevention program towards sustainability: a case study from Zambia’s voluntary medical male circumcision program

Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia’s VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0-2 months) and early-adolescent (15-17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors.

Transferring Surgical Expertise: Analyzing the Learning Curve of Robotic Cardiac Surgery Operative Time Reduction When Surgeon Moves from One Experienced Center to Another.

Robotically assisted cardiac surgery is performed in a team setting and is well known to be associated with learning curves. Surgeon and operative team learning curves are distinct entities, with total operative time representing the entire operative team (surgery, anesthesia, nursing, and perfusion) and cross-clamp time representing mainly the surgical team. Little is known about how a team learning curve evolves when an experienced surgeon transitions from one surgical center to another. This study investigates the dynamics of the team learning curve expressed as total operative time in the case of a surgeon with previous experience transitioning to a new team. A retrospective analysis was conducted on robotic cardiac surgeries performed by a surgeon who transitioned from one experienced surgical center to another. Operative time data were collected and categorized to assess the evolution of the learning curve. Statistical analysis, including learning curve modeling and linear regression analysis, was used to evaluate changes in total time in the operating room per case. 103 cases were included in Weill Cornell Medicine (2019-2023). The median patient age was 63 years, 68% were males, 90.3% of cases were repaired for degenerative mitral valve disease, and the median body mass index was 23.87. Operative time (ORT) decreased from a median of 5.00 h [95%CI: 4.76, 6.00] in the first 30 cases to 4.83 [95%CI: 4.10, 5.27] thereafter, with the apparent curve plateauing indicative of the adaptation period to the new surgical environment (p = 0.01). Subgroup analysis among mitral cases (n = 93) showed a decrease in ORT from 5.00 [95%CI: 4.71, 5.98] in the first 26 cases to 4.83 [95%CI: 4.14, 5.30] (p = 0.045). There was no difference between the initial 30 cases and subsequent cases regarding cardiopulmonary bypass time, myocardial ischemia time, reoperation for bleeding, prolonged ventilation, reintubation, renal failure, need for an intra-aortic balloon pump, readmission to the ICU, reoperation for valvular dysfunction within 30 days, pneumonia, and deep venous thrombosis. Multivariate significant predictors of longer operative time were the first 30 cases, resection-based repairs, and MAZE as a concomitant procedure. Total operative time can be expected to decrease after about 30 cases when an experienced robotic surgeon moves between centers. Complications and cross-clamp times are less susceptible to a learning curve phenomenon in such a circumstance, as these depend primarily on the operating surgeon's level of experience. Understanding these dynamics can inform the planning and management of surgical transitions, ensuring optimal patient care and continued improvement in surgical outcomes.

Identifying critical employability skills for employment success of autistic individuals: A content analysis of job postings

AbstractThis study aimed to examine the literature on the skill sets of autistic individuals and determine how these skills align with current and projected future labour market needs. Based on a literature review, researchers identified the following skill categories common to autistic individuals: visual skills, attention to detail and systemizing composite skills. Researchers then gathered aggregated data on occupations and industries from over 90 state and federal sources in the United States. Next, they collected data on the most in‐demand jobs, their industries and relevant skills by analysing hundreds of millions of online job postings. The results indicate the most viable occupations aligned with each skill category. There is minimal available research using labour market data to generate special education goals and transition plans for autistic students. By providing educators and practitioners with critical information regarding viable employment pathways, all stakeholders can more effectively and equitably prepare autistic individuals for the 21st‐century workforce.

Integrated system dynamics modeling and optimization for artisanal and small-scale gold supply chains

We address artisanal and small-scale gold mining in Peru. Using the data collected through field visits, we develop a System Dynamics (SD) model to examine the current operations of the gold supply chain, and its interplay with mercury and gas suppliers. The current mining operations cause potential health and environmental issues, due to high mercury usage, and other issues (e.g., safety issues). As a potential solution to overcome such problems, we consider incorporating a cyanide processing facility into the SD model, where we examine the amount of ore that a miner would be willing to sell to the facility under several payback scenarios. We formulate a mixed-integer programming model that prescribes the optimal transition plan of a miner from local production to selling their ore to the facility within a time horizon that maximizes a miner’s profit. The optimal solution provides a 22% improvement in the miners’ profit over that of their current operations. We also conduct a sensitivity analysis to test the sensitivity of the optimal solution to the changes in several input parameters. We discuss that the solution is most sensitive to the gold price changes and the least sensitive to the local production cost changes.

Ranking building design and operation parameters for residential heating demand forecasting with machine learning

The European Union's Energy Performance in Buildings Directive has made significant strides in enhancing building energy efficiency since its inception in 2002. However, approximately 75% of EU buildings still fall short of energy-efficient standards. Furthermore, there is a growing momentum to extend the concept of nearly zero-energy buildings to entire districts, thereby fostering Net-Zero Energy Districts. This underscores the necessity for large-scale urban building energy modelling to identify and improve underperforming buildings and energy transition planning. Given the increasing interest in black box models for building energy performance, this study aims to identify common input variables in buildings energy demand literature, analyse their influence, and develop a heating demand prediction model using different algorithms: Random Forest, XGBoost, and Extra Trees. Four large datasets generated from white-box simulation in three Spanish cities were used for training and testing the models. Four features consistently stand out as the most important for prediction: shape factor, infiltration rate, south equivalent surface, and internal gains, regardless of the training algorithm or the climatic zone. The multi-location XGBoost algorithm with an optimizer emerged as the best-performing model, with an average Mean Absolute Percentage Error value hovering around 40%. Analysis employing SHapley Additive exPlanation (SHAP) values showcases the model's ability to identify factors that drive higher heating energy demand, alongside its strong predictive performance. This suggests potential integration of the model into programmes to identify key variables to be addressed during building renovation. Additionally, results show the potential of XGBoost-based software's potential for identifying building renovation targets.

The Case for Early Transition-Planning for Students With Significant Support Needs: Implications for Policy and Practice

The period in which young adults transition from high school is accompanied with complexities they need to navigate, such as further education and training, independent living, developing their career, and achieving meaningful employment. All of these set the stage for a successful and independent life. The significance of this transition is paramount; however, in research and practice, we continue to see poor outcomes for students with disabilities, especially those with the most significant support needs. Transition planning, mandated by the Individuals with Disabilities Education Act, must begin no later than a child turning 16. Some states mandate transition activities to start as early as 14, but should we consider an even earlier age? Within this paper, we discuss the need for changes within policy and practice to begin transition activities during children’s early education years.

Rooted in Nature: The Rise, Challenges, and Potential of Organic Farming and Fertilizers in Agroecosystems

Organic farming, which is deeply rooted in traditional agricultural practices, has witnessed a profound evolution over the last century. Transitioning from a grassroots initiative resisting the industrialization of agriculture to a global industry, organic farming now plays a pivotal role in addressing contemporary challenges related to environmental health, sustainability, and food safety. Despite the growing consumer demand for organic products and market access, organic farming has its challenges. This paper discusses the origin and evolution of organic farming with an emphasis on different types of organic fertilizers, benefits, and challenges. Nutrient variability and the slow-release nature of organic fertilizer often do not meet crop demands and can substantially reduce yield. Some organic fertilizers, like manure and biosolids, can provide a higher yield benefit, but there are environmental and health risks associated with them. Weed and pest management in organic farming can be labor-intensive and increase costs. Inefficient planning of organic farming and rapid transition can also create food insecurity. This paper also gives a brief account of the current certification process for organic fertilizers and their technicalities. It showcases how the holistic approach of organic farming extends beyond production, including strategies like reducing food waste and building self-sufficient farming communities. These practices contribute to a more sustainable agricultural system, reducing environmental impacts and supporting local economies. Future technological innovations, especially in precision agriculture and bio-physicochemical models, can help in formulating targeted organic fertilizers.

Comparing the epistemic burdens of liberal transition and central planning

AbstractEpistemic burdens are ubiquitous. Whenever people act, their success largely depends on their knowledge. While epistemic burdens are widely recognised when it comes to centrally planning the economy, Scott Scheall has drawn attention to the epistemic burdens involved in transitioning to a liberal society. In this regard, Scheall raises the question of whether these epistemic burdens might actually be as high as those faced by central planners. In this paper, I examine the epistemic burdens of liberal transitions and compare them to those of central planning the economy. Also looking at empirical cases, I tentatively conclude that transitioning to a liberal society is epistemically less burdensome, primarily because the liberal society provides a relatively stable objective and because theoretical knowledge about the necessary cultural preconditions and the institutional framework already exists. However, liberal transitions are still epistemically burdensome, especially when it comes to getting to the desired societal framework. Furthermore, when the required cultural preconditions are absent, it may well be that the epistemic burdens are insurmountable.

Mapping the research field on product quality: a bibliometric analysis

PurposeThis research intends to undertake a rigorous bibliometric analysis of product quality research trends and patterns, map the intellectual and social structure of the field, identify the predominant themes and propose a transition plan for future work in this discipline.Design/methodology/approachThe procedure was carried out in a step-by-step manner. Following a specified search string, Scopus retrieved 1454 journal articles from the previous 39 years (1984–2022). To comprehend the field’s base, various techniques of performance analysis and science mapping were employed using RStudio and VOSviewer.FindingsIn light of the results, both the volume and influence of product quality studies have surged over the past four decades, with most works appearing in prestigious academic journals. A number of cross-country product quality collaborations took place in nations with little geographic, historical, or cultural proximity. Using co-citation analysis, five distinct subfields were identified within the literature on product quality. Finally, the use of co-word analysis helps understand the field’s underlying themes and concludes with a set of potential research avenues built on a content analysis of the articles from each of the five subfields.Originality/valueTo the authors' understanding, this study represents a pioneering effort to examine the research field on product quality using bibliometric analysis. Notwithstanding being rooted in scientometrics, this research’s outcomes are instructive for practitioners, academics and aspiring researchers in the field.

Similarities in Reentry Planning of Students Involved in the Juvenile Justice System and Postsecondary Transition Planning for Students with Disabilities

The field of special education has developed evidence-based practices (EBPs) to promote positive postsecondary outcomes for youth with disabilities. Postsecondary transition planning is comparable to the planning processes needed for reentry of previously incarcerated youth to educational and community settings. Common practices for transitioning students with disabilities and for those returning to the community setting include career/technical/vocational education, interagency collaboration, career assessment and exploration, student-centered planning, high expectations, real-life problem solving, and assessment-driven goals. Transition planning has the potential to reduce recidivism, the key measurement of successful programs and interventions in the carceral setting. There is little empirical evidence of best practices in correctional education; however, there are some programs and resources within special education transition literature that may be useful in the development of prerelease planning for adjudicated youth. Programs focused on improving self-determination skills such as being aware of abilities, needs and preferences, problem-solving, self-control, cognitive reasoning to address problems, self-efficacy, and self-advocacy can increase the level of preparation youth have for returning to the community. Other efforts geared at systemic change can be beneficial, as well, including improvement of interagency collaboration, enrollment/re-enrollment requirements, training for educators and administrators to prevent stigma, and hiring one person in charge of the prerelease planning and records. Resources and suggested applications are included in summary.

JOB READINESS AND WORK PLACEMENT PROGRAM FOR LEARNERS WITH SPECIAL EDUCATIONAL NEEDS

This study sheds light on the obstacles that these students confront, aiming to bridge the informational void regarding their career development journey. Furthermore, it offers strategies and optimal approaches to facilitate a smooth transition for these students into the professional sphere. Youth with disabilities must be college and career-ready to be prepared for adult life. Parallel to the emergence of college and career readiness (CCR), transition planning and service requirements have promoted successful transitions to post school education, employment, and community living. 
 This study primarily aimed to find the difference in the level of functioning in the Pizza Making Program as part of the Job Readiness and Work Placement Program of high school learners with special educational needs in terms of their cognitive skills, functional skills, behavioral skills, and daily life skills. The majority of high school students with special educational needs in the pre-evaluation had a rarely observed and practiced level of functioning in terms of cognitive, functional, behavioral, and daily life skills. 
 There was a significant difference between the pre-test and post-test in the four skills: cognitive, functional, behavioral, and daily life skills. This indicates that utilizing the program and giving more constant exposure to it would help the learner with special educational needs reach the highest level of functioning, which is always observing and practicing the skills needed in order to have a successful transition to college and in obtaining and maintaining integrated and inclusive employment.

133. Health Literacy in Foster Care Transition Planning: Perspectives of Adolescents and Young Adults Formerly in Foster Care and Stakeholders on Barriers to Care

133. Health Literacy in Foster Care Transition Planning: Perspectives of Adolescents and Young Adults Formerly in Foster Care and Stakeholders on Barriers to Care

Differentiated Assessments for Learners with Neurodevelopmental Disabilities in Inclusive Elementary Schools in Tanzania

Differentiated Instructions and modifications in curriculum and assessments are considered a prerequisite for the successful inclusion of learners with disabilities in general education. This qualitative study assessed the current provisions and the aspired changes in the curriculum, assessments, and transition plans for learners with Neurodevelopmental Diversities such as Autism in Tanzania. A total of 21 participants partaken in this study. The participants were obtained through purposive and snowball sampling methods. Data collection methods included in-depth interviews, documentary reviews and non-participant observation. Data were analyzed thematically, aided by the vivo 12. Participants were of the opinion that there is a limited provision with regard to only time (an additional twenty minutes in every hour for mathematics and ten minutes in each hour for other subjects) within the subsidiary legislation of the Examination regulations released by the National Examination Council of Tanzania (NECTA) in 2016. The provision, however, does not mention any neurodevelopmental disabilities in the categories of disabilities and the special provisions entitled to them. Lack of reasonable accommodations in the type and structure of questions, rigid modality of responses to the examination questions for learners with learning disabilities and limited flexibility in time and room arrangements have been mentioned as barriers to proper assessments for such learners. The study concludes that there is a need to embrace the evidence-based practices of responsive education, instead of the “one-size-fits-all” kind of education. This will help to improve the curriculum for all learners instead of the approach to “fix” the deficits of learners with neurodevelopmental disabilities.

Energy transition plans: How municipalities face the energy transition

Energy transition plans: How municipalities face the energy transition Municipalities need tools to manage and achieve the local energy transition, according to Gerard Laguna Benet, Researcher at BEE Group – CIMNE. The European Union (EU) takes significant steps towards decarbonisation,aiming to be climate-neutral by 2050. To reach this ambitious target, the EU introduced a roadmap which set a 55% reduction of greenhouse gas emissions, above 32% share of renewable energy and at least 32.5% of energy efficiency improvement by 2030.In this context, the municipalities have a significant role as the energy transition pushes Europe to a decentralised and local energy generation framework.On one side, municipalities have a role to play in taking exemplary action to reduce energy consumption in their buildings. On the other side, to lead Europe towards climate neutrality, it’s essential to make efforts at the local level, considering each region’s specific characteristics and challenges. Therefore, municipalities have a vital role in the European energy transition.

Discovering ME: An innovative planning tool for students with significant disabilities

BACKGROUND: The Individuals with Disabilities Act (IDEA) requires transition plans for students with disabilities to be based on high-quality, age-appropriate transition assessments. However, educators struggle to garner reliable assessment results for students with significant disabilities, because so few assessments are designed or validated for students with these barriers. OBJECTIVE: The purpose of this practice brief is to share details on the process, called Discovering ME, which provides an effective transition assessment and planning tool that is critical to increasing students’ employment outcomes, especially for those who face the most significant barriers to employment. METHODS: Sixty-one students across rural, urban, and suburban school districts participated in Discovering ME. Data were collected across five years, including demographic information and examples of students’ top career cluster areas for future employment. In addition, a statewide survey was conducted with educators participating in Discovering ME on the effectiveness of this early career planning process. RESULTS: The Discovering ME process provides career-related opportunities for students with significant barriers in the home, school, and community in a variety of career clusters based on their expressed interests. Educators report that the focus of this process on students and their interests helped to create positive experiences for them by creating opportunities for success. CONCLUSION: The Discovering ME process provides students with disabilities with authentic, coordinated career awareness and development activities and the building of self-determination, work readiness, and community integration skills.

Using the independent monitoring for quality (IM4Q) program to examine employment in integrated settings in the community for people with IDD over time

BACKGROUND: Community-based employment is a key step for many adults with intellectual and developmental disabilities (IDD), a group prone to high unemployment, poverty, and dependency. It is also important in order to avoid poverty and progress toward economically stable and independent lifestyles. Increases in community-based employment for individuals with IDD meet the expectations of the HCBS final rule as well as state-wide transition planning requirements and other compliance indicators. OBJECTIVE: The current study explores changes in employment over time before and after the final rule was issued and other initiatives (e.g., Employment First policy) were adopted. This method provides an important way to detect if the effort is impacting service users with IDD as intended. By comparing three waves of data from the state of Pennsylvania (2013, 2016, and 2019), we can gain insight into changes in employment rates over time among HCBS service users with IDD in light of policy initiatives. METHODS: We used three waves of IM4Q data to compare the growth in employment among 9,486 individual service users with IDD in the state of Pennsylvania. Repeated measures regression using generalized estimating equations (GEEs) was used to examine employment in an integrated setting in the community over time after controlling for age, support needs, residence type, and community type. RESULTS: Controlling for the effects of demographic and environmental characteristics, there was a significant increase in community-based employment among IDD service users in Pennsylvania between 2013 and 2019. Other variables were also associated with employment. CONCLUSION: This study was the first to our knowledge to consider changes in community-based employment across three waves of data for individuals with IDD. The data wave collection periods in Pennsylvania coincided with significant policy changes relevant to service users with IDD. These changes in policy may be effective and warrant both continued exploration of its effects and ways to maximize policy to further integrate adults with IDD into the community.