Millions Of Children, Seniors And Minorities Not Receiving Essential Dental Care, USA

4.6 million children in America in 2008 did not see a dentist because their parents did not have enough money to pay, and only 38% of seniors had dental coverage in 2006, says a new report by the Institute of Medicine (IoM) and National Research Council. The authors say that 'persistent and systemic' obstacles undermine people's access to oral health care.

These obstacles need to be removed, the authors insist, and suggest the following should occur: The funding and reimbursement for dental care should changeTraining for doctors, nurses and other non-dental professionals should be expanded so that signs of oral diseases may be better identifiedAdministrative, educational and regulatory practices should be revamped Chair of the committee that wrote the report, Frederick Rivara, said:

"The consequences of insufficient access to oral health care and resultant poor oral health - at both the individual and population levels - are far-reaching. As the nation struggles to address the larger systemic issues of access to health care, we need to ensure that oral health is recognized as a basic component of overall health."

The problem is exacerbated by a combination of cultural, geographic, structural and economic factors, the report explains. For example, 33.3 million Americans live in areas where there are not enough dentists.

People who do not look after their teeth and gums properly have a greater risk of developing: Respiratory diseaseCardiovascular diseaseDiabetes Focusing more on the prevention of oral diseases combined with more emphasis on oral health care promotion would result in improved overall public health.

Although children have to receive comprehensive dental benefits if they are enrolled in CHIP (Children's Health Insurance Program) or Medicaid from state funds, this is not the case for adults.

As underserved populations rely on publicly-funded programs as their primary source of health cover, authorities should include dental cover for all Medicaid beneficiaries as well, the authors state.

The authors wrote:

"Toward that end, the committee recommended that the Centers for Medicare and Medicaid Services fund and evaluate state-based demonstration projects that cover essential oral health benefits for adult Medicaid beneficiaries. In addition, Medicaid and CHIP reimbursement rates for providers should be increased and administrative practices need to be streamlined to increase use by both dental providers and patients."

In order to improve dental health care access, state laws should be altered so that hygienists, assistants and other dental professionals can work to their full extent in a variety of situations under suitable evidence-based supervision levels.
Even though the USA has national accreditation standards for training and education of oral health professionals, regulations regarding what they can and cannot do vary widely across states.

Dentists should be allowed to supervise work being done using current conferencing technology, the writers add.

The report explains that the geographic variations in available dentists and specializations are a "long-recognized challenge". Recently graduated dental students say they are ill-equipped to treat older patients, as well as individuals with special needs.

The authors write that:

"Efforts should be made to increase recruitment and support for dental students from minority, lower-income, and rural populations, as well as to boost the number of dental faculty with expertise caring for underserved and vulnerable populations.
In addition, the Health Resources and Services Administration should dedicate Title VII funding to aid and expand opportunities for dental residencies in community-based settings. These residencies should take place in geographically underserved areas and include clinical experiences with young children, individuals with special health care needs, and older adults.


"Improving Access to Oral Health Care for Vulnerable and Underserved Populations"
Frederick Rivara (Chair), Paul C. Erwin, Caswell Evans, Jr., Theodore G. Ganiats, Shelly Gehshan, Kathy Voigt Geurink, Paul Glassman, Jane Perkins, Margaret A. Potter, Renee Samelson, Phyllis Sharps, Linda H. Southward, Maria Rosa Watson, Barbara Wolfe
Institute of Medicine of the National Academies, National Research Council of the National Academies

Bigger Bites Means Eating Less, So Go For A Bigger Fork

The larger your fork and the bigger your bite when you eat, the less you will probably end up eating when you are in a restaurant, say researchers from the University of Utah in the Journal of Consumer Research. They used two sizes of forks in a popular Italian restaurant to measure how much people ate, and found that the participants who used the larger forks ate less than those with smaller ones.

Authors Arul Mishra, Himanshu Mishra, and Tamara M. Masters wrote:

"In this research we examined the influence of small versus large bite-sizes on overall quantity of food consumed."

They then set out to determine why their findings went against other studies that had focused on portion sizes.

The researchers wrote:

"We observe that diners visit the restaurant with a well-defined goal of satiating their hunger and because of this well-defined goal they are willing to invest effort and resources to satiate their hunger goal."

A diner is able to satisfy his/her hunger by selecting, consuming and paying for their food. All these steps require an investment of effort on their part.

Arul Mishra said:

"The fork size provided the diners with a means to observe their goal progress. The physiological feedback of feeling full or the satiation signal comes with a time lag. In its absence diners focus on the visual cue of whether they are making any dent on the food on their plate to assess goal progress."

In order to test this supposition, they altered the quantities of food. They found that when presented with a plate loaded with food, those with large forks ate considerably less than those with small ones.

However, the amount of food consumed was not influenced by fork size when they were given small servings.

When they tried this out with volunteers in a laboratory, their results were the opposite - those with small forks ate less than the ones with the larger forks. The researchers think this is because the people in the lab did not have the same hunger satiating goals as the individuals in the restaurant.

We need to have a better understanding of hunger cues if we want to avoid overeating, they added.

They wrote:

"People do not have clear internal cues about the appropriate quantity to consume. They allow external cues, such as fork size, to determine the amount they should consume."

"The Influence of Bite-size Quantity on Food Consumed: A Field Study
Arul Mishra, Himanshu Mishra, and Tamara M. Masters
Journal of Consumer Research

Schizophrenia

Schizophrenia is a psychiatric diagnosis that describes a mental disorder characterized by abnormalities in the perception or expression of reality. Distortions in perception may affect all five senses, including sight, hearing, taste, smell and touch, but most commonly manifest as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking with significant social or occupational dysfunction. Onset of symptoms typically occurs in young adulthood, with approximately 0.4–0.6% of the population affected. Diagnosis is based on the patient's self-reported experiences and observed behavior. No laboratory test for schizophrenia currently exists.

Studies suggest that genetics, early environment, neurobiology, psychological and social processes are important contributory factors; some recreational and prescription drugs appear to cause or worsen symptoms. Current psychiatric research is focused on the role of neurobiology, but no single organic cause has been found. As a result of the many possible combinations of symptoms, there is debate about whether the diagnosis represents a single disorder or a number of discrete syndromes. For this reason, Eugen Bleuler termed the disease the schizophrenias (plural) when he coined the name. Despite its etymology, schizophrenia is not the same as dissociative identity disorder, previously known as multiple personality disorder or split personality, with which it has been erroneously confused. Increased dopamine activity in the mesolimbic pathway of the brain is consistently found in schizophrenic individuals. The mainstay of treatment is antipsychotic medication; this type of drug primarily works by suppressing dopamine activity. Dosages of antipsychotics are generally lower than in the early decades of their use. Psychotherapy, and vocational and social rehabilitation are also important. In more serious cases - where there is risk to self and others - involuntary hospitalization may be necessary, although hospital stays are less frequent and for shorter periods than they were in previous times. The disorder is thought to mainly affect cognition, but it also usually contributes to chronic problems with behavior and emotion.

People with schizophrenia are likely to have additional (comorbid) conditions, including major depression and anxiety disorders; the lifetime occurrence of substance abuse is around 40%. Social problems, such as long-term unemployment, poverty and homelessness, are common. Furthermore, the average life expectancy of people with the disorder is 10 to 12 years less than those without, due to increased physical health problems and a higher suicide rate.St. Elizabeth's Hospital. Wall of room in Ward Retreat 1. Reproductions made by a patient, a disturbed case of dementia precox [praecox?]; pin or fingernail used to scratch paint from wall, top coat of paint buff color, superimposed upon a brick red coat of paint.

Pictures symbolize events in patient's past life and represent a mild state of mental regression. Undated, but likely early 20th century. Schizophrenia occurs equally in males and females, although typically appears earlier in men - the peak ages of onset are 20–28 years for males and 26–32 years for females. Onset in childhood is much rarer, as is onset in middle- or old age. The lifetime prevalence of schizophrenia - the proportion of individuals expected to experience the disease at any time in their lives - is commonly given at 1%. However, a 2002 systematic review of many studies found a lifetime prevalence of 0.55%. Despite the received wisdom that schizophrenia occurs at similar rates worldwide, its prevalence varies across the world, within countries, and at the local and neighbourhood level. One particularly stable and replicable finding has been the association between living in an urban environment and schizophrenia diagnosis, even after factors such as drug use, ethnic group and size of social group have been controlled for. Schizophrenia is known to be a major cause of disability. In a 1999 study of 14 countries, active psychosis was ranked the third-most-disabling condition after quadriplegia and dementia and ahead of paraplegia and blindness.

Accounts of a schizophrenia-like syndrome are thought to be rare in the historical record prior to the 1800s, although reports of irrational, unintelligible, or uncontrolled behavior were common. There has been an interpretation that brief notes in the Ancient Egyptian Ebers papyrus may imply schizophrenia, but other reviews have not suggested any connection.

A review of ancient Greek and Roman literature indicated that although psychosis was described, there was no account of a condition meeting the criteria for schizophrenia. Bizarre psychotic beliefs and behaviors similar to some of the symptoms of schizophrenia were reported in Arabic medical and psychological literature during the Middle Ages. In The Canon of Medicine, for example, Avicenna described a condition somewhat resembling the symptoms of schizophrenia which he called Junun Mufrit (severe madness), which he distinguished from other forms of madness (Junun) such as mania, rabies and manic depressive psychosis. However, no condition resembling schizophrenia was reported in Şerafeddin Sabuncuoğlu's Imperial Surgery, a major Islamic medical textbook of the 15th century. Given limited historical evidence, schizophrenia (as prevalent as it is today) may be a modern phenomenon, or alternatively it may have been obscured in historical writings by related concepts such as melancholia or mania.A detailed case report in 1797 concerning James Tilly Matthews, and accounts by Phillipe Pinel published in 1809, are often regarded as the earliest cases of schizophrenia in the medical and psychiatric literature. Schizophrenia was first described as a distinct syndrome affecting teenagers and young adults by Bénédict Morel in 1853, termed démence précoce (literally 'early dementia').

The term dementia praecox was used in 1891 by Arnold Pick to in a case report of a psychotic disorder. In 1893 Emil Kraepelin introduced a broad new distinction in the classification of mental disorders between dementia praecox and mood disorder (termed manic depression and including both unipolar and bipolar depression). Kraepelin believed that dementia praecox was primarily a disease of the brain, and particularly a form of dementia, distinguished from other forms of dementia, such as Alzheimer's disease, which typically occur later in life. Kraepelin's classification slowly gained acceptance. There were objections to the use of the term "dementia" despite cases of recovery, and some defence of diagnoses it replaced such as adolescent insanity.The word schizophrenia - which translates roughly as "splitting of the mind" and comes from the Greek roots schizein (σχίζειν, "to split") and phrēn, phren- (φρήν, φρεν-, "mind") - was coined by Eugen Bleuler in 1908 and was intended to describe the separation of function between personality, thinking, memory, and perception. Bleuler described the main symptoms as 4 A's: flattened Affect, Autism, impaired Association of ideas and Ambivalence.

Bleuler realized that the illness was not a dementia as some of his patients improved rather than deteriorated and hence proposed the term schizophrenia instead.The term schizophrenia is commonly misunderstood to mean that affected persons have a "split personality". Although some people diagnosed with schizophrenia may hear voices and may experience the voices as distinct personalities, schizophrenia does not involve a person changing among distinct multiple personalities.

The confusion arises in part due to the meaning of Bleuler's term schizophrenia (literally "split" or "shattered mind"). The first known misuse of the term to mean "split personality" was in an article by the poet T. S. Eliot in 1933.In the first half of the twentieth century schizophrenia was considered to be a hereditary defect, and sufferers were subject to eugenics in many countries. Hundreds of thousands were sterilized, with or without consent - the majority in Nazi Germany, the United States, and Scandinavian countries. Along with other people labeled "mentally unfit", many diagnosed with schizophrenia were murdered in the Nazi "Action T4" program.In the early 1970s, the diagnostic criteria for schizophrenia was the subject of a number of controversies which eventually led to the operational criteria used today. It became clear after the 1971 US-UK Diagnostic Study that schizophrenia was diagnosed to a far greater extent in America than in Europe. This was partly due to looser diagnostic criteria in the US, which used the DSM-II manual, contrasting with Europe and its ICD-9. David Rosenhan's 1972 study, published in the journal Science under the title On being sane in insane places, concluded that the diagnosis of schizophrenia in the US was often subjective and unreliable. These were some of the factors in leading to the revision not only of the diagnosis of schizophrenia, but the revision of the whole DSM manual, resulting in the publication of the DSM-III in 1980. Since the 1970s more than 40 diagnostic criteria for schizophrenia have been proposed and evaluated.

In the Soviet Union the diagnosis of schizophrenia has also been used for political purposes. The prominent Soviet psychiatrist Andrei Snezhnevsky created and promoted an additional sub-classification of sluggishly progressing schizophrenia. This diagnosis was used to discredit and expeditiously imprison political dissidents while dispensing with a potentially embarrassing trial. The practice was exposed to Westerners by a number of Soviet dissidents, and in 1977 the World Psychiatric Association condemned the Soviet practice at the Sixth World Congress of Psychiatry. Rather than defending his theory that a latent form of schizophrenia caused dissidents to oppose the regime, Snezhnevsky broke all contact with the West in 1980 by resigning his honorary positions abroad.Social stigma has been identified as a major obstacle in the recovery of patients with schizophrenia. In a large, representative sample from a 1999 study, 12.8% of Americans believed that individuals with schizophrenia were "very likely" to do something violent against others, and 48.1% said that they were "somewhat likely" to.

Over 74% said that people with schizophrenia were either "not very able" or "not able at all" to make decisions concerning their treatment, and 70.2% said the same of money management decisions. The perception of individuals with psychosis as violent has more than doubled in prevalence since the 1950s, according to one meta-analysis.

Sourced and Abstracted from information found at NIAMS, CDC, NIH, FDA, Wikipedia

Schizophrenia Has More New Genetic Mutations

New genetic mutations that are not inherited from one's parents appear to happen more frequently in people with schizophrenia than might normally be expected in healthy individuals said a team of scientists led by Dr Guy A Rouleau from the University of Montreal in Canada. The team hopes their discovery, which includes genes not linked to schizophrenia before, will provide a list of genes for researching how the disease develops, and also lead to new treatments.

Rouleau and colleagues found the new or de novo mutations, that is genetic errors present in a person that are not present in their biological parents, when they examined about 20,000 genes in the "exomes" of 14 patients with schizophrenia and their unaffected parents. They write about their discovery in this week's issue of Nature Genetics.

It can be very expensive to analyze the genetic code of all the genes in a human being, the "genome", so many scientists looking for new genes behind diseases have settled on a more cost-effective method, they analyze just the "exome", that part of the genome that expresses the genes responsible for making proteins and developing the individual as he or she grows from a fertilized egg. The exome is thought to represent less than 2% of the total genome.

The researchers note in their paper that:

"We identified 15 de novo mutations (DNMs) in eight probands [patients], which is significantly more than expected considering the previously reported DNM rate. In addition, 4 of the 15 identified DNMs are nonsense mutations, which is more than what is expected by chance."

Rouleau, who is also Director of the Centre Hospitalier Universitaire Sainte-Justine Research Center in Montreal, told the press their discovery that de novo mutations appear to occur more frequently in people with schizophrenia may explain the high worldwide incidence of the disease.

"Our results not only open the door to a better understanding of schizophrenia. They also give us valuable information about the molecular mechanisms involved in human brain development and function," said Rouleau.

Simon Girard, a student at the University of Montreal Hospital Research Centre, where Rouleau also does research, carried out the main experiments behind the discovery. He explained that:

"Because the mutations are located in many different genes, we can now start to establish genetic networks that would define how these gene mutations predispose to schizophrenia."

"Most of the genes identified in this study have not been previously linked to schizophrenia, thereby providing new potential therapeutic targets," he added.

In 2006, Rouleau proposed that de novo mutations might play a big part in autism, schizophrenia, and other diseases that arise from factors affecting brain development.

Schizophrenia is a major mental disorder with a wide range of symptoms including disorganized speech and thinking, paranoid delusions, hallucinations, and deterioration of emotional responsiveness and social behaviours.

The World Health Organization (WHO) estimates there are 24 million people with schizophrenia worldwide, and more than 50% of them are not getting the treatment they need.

Much of the funding for the study came from Genome Canada and Génome Québec, with additional support from the Canadian Institutes of Health Research (CIHR) and the Brain and Behavior Research Foundation (formerly NARSAD, the National Alliance for Research on Schizophrenia and Depression) and the University of Montreal.

"Increased exonic de novo mutation rate in individuals with schizophrenia."
Simon L Girard, Julie Gauthier, Anne Noreau, Lan Xiong, and others.
Nature Genetics, Published online: 10 July 2011 | doi:10.1038/ng.886.
Link to Abstract.

Additional source : University of Montreal.

No Scientific Basis For Hypoallergenic Dogs Having Less Allergen

Contrary to popular belief, so-called hypoallergenic dogs do not have lower household allergen levels than other dogs.

That's the conclusion of a study by Henry Ford Hospital researchers who sought to evaluate whether hypoallergenic dogs have a lower dog allergen in the home than other dogs. Hypoallergenic dogs are believed to produce less dander and saliva and shed less fur.

The findings are to be published online this month in the American Journal of Rhinology and Allergy.

"We found no scientific basis to the claim hypoallergenic dogs have less allergen," says Christine Cole Johnson, Ph.D., MPH, chair of Henry Ford's Department of Public Health Sciences and senior author of the study.

"Based on previous allergy studies conducted here at Henry Ford, exposure to a dog early in life provides protection against dog allergy development. But the idea that you can buy a certain breed of dog and think it will cause less allergy problems for a person already dog-allergic is not borne out by our study."

This is believed to be the first time researchers measured environmental allergen associated with hypoallergenic dogs. Previous studies analyzed hair samples from only a handful of dogs in a small number of breeds.

Henry Ford researchers analyzed dust samples collected from 173 homes one month after a newborn was brought home. The dust samples were collected from the carpet or floor in the baby's bedroom and analyzed for the dog allergen Can f 1. Only homes with one dog were involved in the study. Sixty dog breeds were involved in the study, 11 of which are considered hypoallergenic dogs.

Based on public web site claims of hypoallergenic breeds, dogs were classified as hypoallergenic using one of four "schemes" based on their breed for comparing allergen levels. Scheme A compared purebred hypoallergenic dogs to purebred non-hypoallergenic dogs; Scheme B compared purebred and mixed breed dogs with at least one hypoallergenic parent to purebred non-hypoallergenic dogs; Scheme C compared purebred and mixed breed dogs with at least one hypoallergenic parent to purebred and mixed breed dogs with no known hypoallergenic component; Scheme D compared only purebred dogs identified as hypoallergenic by the American Kennel Club to all other dogs.

Researchers found that the four schemes yielded no significant differences in allergen levels between hypoallergenic dogs and non-hypoallergenic dogs. In homes where the dog was not allowed in the baby's bedroom, the allergen level for hypoallergenic dogs was slightly higher compared to allergen levels of non-hypoallergenic dogs.

While researchers acknowledged limitations in their study - the amount of time the dog spent in the baby's bedroom was not recorded and the size of its sample did not allow looking at specific breeds - they say parents should not rely on dog breeds classified as hypoallergenic.

Source:
David Olejarz
Henry Ford Health System

Blacks, Hispanics And Asians In Nursing Homes Increases As Their Share Of Elderly In The Total Population Increases, But Not Whites

Nursing homes in the United States are shrinking and their residents are becoming proportionately more black, more Hispanic, more Asian, and less white, according to a new study by Brown University researchers. The nationwide trend, reflected in metropolitan areas from New York to Los Angeles, results from changing demographics and disparities in what people can afford. The study is published in the July edition of Health Affairs.

In the last decade, minorities have poured into nursing homes at a time when whites have left in even greater numbers, according to a new Brown University study that suggests a racial disparity in elder care options in the United States.

At first blush the analysis, published July 7 in the journal Health Affairs, suggests that elderly blacks, Hispanics, and Asians are gaining greater access to nursing home care. But the growing proportion of minorities in nursing homes is coming about partly because they do not have the same access to more desirable forms of care as wealthier whites do, said the study's lead author Zhanlian Feng, assistant professor of community health in the Warren Alpert Medical School of Brown University.

"Seemingly, we are closing the gap in terms of minority access to nursing home beds, but I don't think that is something to celebrate," Feng said. "They are really the last resort. Most elders would rather stay in their homes, or some place like home, but not a nursing home unless they have to."

The new analysis shows that between 1999 and 2008 the nation's nursing home population shrank by 6.1 percent to just over 1.2 million people. In that time period the number of whites in nursing homes decreased by 10.2 percent nationwide, while the number of blacks rose 10.8 percent, the number of Hispanics rose by 54.9 percent and the number of Asians rose by 54.1 percent. The study also looked at nursing home population changes in the top 10 metropolitan areas for each minority.

Prior research has shown that the nursing homes in predominately minority areas are often of lower quality and are more likely to close, while assisted living facilities are more likely to be built in areas where residents have high incomes. The result, reflected in the figures in the new Health Affairs paper, is a disparity that plays out not only economically and geographically, but also racially, Feng said.

"We know those alternatives are not equally available, accessible, or affordable to everybody, certainly not to many minority elders," he said.

As policymakers look to "rebalance" elder care from nursing homes to other forms of care, for instance with shifts in Medicaid funding to support home and community-based services, they should account for these disparities, Feng said. As it is, whites are clearly more likely to be using more desirable alternatives; more concerted efforts may be required to promote minority elders' use of them too, he said.
"Rebalancing is a recognition of most people's preferences for long-term care," Feng said. "For that effort to be successful you have to consider who is using what."

To determine the figures, Feng and his co-authors used the federally mandated Minimum Data Set, which tracks the population of nursing home users and assesses their care needs on a routine basis, because they receive substantial Medicare and Medicaid funding. Similar data is not available for other kinds of elder care, which is predominantly paid for with private insurance dollars.

Metropolitan shifts

One way Feng and his co-authors have quantified the disparity in eldercare is by grouping metropolitan areas into quartiles based on the proportion of whites, blacks, Hispanics or Asians 65 or older in each area. The researchers found that the representation of blacks, Hispanics and Asians in nursing homes increased as their share of elderly in the total population increased. That correlation did not hold for whites, who did not appear to be obliged to choose nursing homes as they age.

In New York, a top 10 metropolitan area for blacks, Hispanics and Asians, nursing home residents from these groups increased 22 percent, 84 percent and 40 percent, respectively. In Los Angeles/Long Beach, the increases were 1 percent for blacks, 41 percent for Hispanics and 56 percent among Asians.

With different rates in different cities, the challenge facing policymakers is not only national, but also local, the researchers said.

"Efforts to reduce disparities should target both communities and facilities with high concentrations of minority residents," they wrote in Health Affairs.

In addition to Feng, the paper's other authors at Brown are Mary Fennell, professor of sociology; Denise Tyler, gerontology researcher; Melissa Clark, associate professor of community health; and Vincent Mor, the Florence Pirce Grant Professor of Health Services, Policy, and Practice.

The National Institute on Aging supported the research.

Source:
David Orenstein
Brown University

Research Highlights Failings Within The Education System

Pupils with special needs and teachers in mainstream schools in the UK are often the victims of a "one size fits all" approach to schooling and education, a leading academic has claimed.

Professor Paul Cooper, a chartered psychologist and professor of education at the University of Leicester, said pupils with social, emotional and behavioural problems (SEBD) are at particular risk of under-achieving because schools are frequently ill-equipped to handle their problems.

Teachers need better training in the appropriate skills and methods for supporting pupils with special needs, while the children themselves require a more diverse range of provision to meet those needs both within and beyond mainstream schools.

In a new study, Professor Cooper and co-author Barbara Jacobs, also of the University of Leicester's School of Education, argue that it is not children with special needs that present the problems for schools and teachers -- but failings within the education system.

Professor Cooper, whose study also examines classroom strategies and approaches that have been found to be effective, said that too often "blanket assumptions" are made about pupils' needs, and teachers frequently lack the skills and knowledge to be able to support them.

He said: "There should be a diverse range of educational facilities so that children can move between one or another as needs arise. Everyone should have the right to go to their local school, but they also have a right to be educated in accordance with their needs and aspirations.

"It is patently obvious that many of our schools experience difficulties in catering for the needs of all students, and demanding that they do so in the absence of appropriate training and resources is disheartening for teachers and disastrous for students -- especially those who are most vulnerable.

Teachers are as much victims of this muddled approach as children, Professor Cooper argues.

"Initial teacher training has not changed sufficiently to accommodate the inclusion policy, leaving most teachers lacking in the skills required to deal with children with serious difficulties.

"This failure means that the most vulnerable pupils often do not tend to achieve educational success. There is also a knock on effect from this, whereby teachers facing the most challenging circumstances find themselves locked into a fire fighting role, which has a negative effect on the learning experience of all students."

The situation is not helped by some academics who get bogged down in ideological discourse rather than conducting useful research, Professor Cooper adds.

"Too much time is spent by some educationalists navel-gazing and fiddling around with concepts that fail to tackle the nuts and bolts of interaction in the classroom," he said. It's no wonder that policy makers and teachers pay little attention to what academics have to say, given the misguided nature of the discourse which too often vilifies specialist knowledge and skills and equates inclusion with where children are located rather than the quality of their educational engagement."

Notes:

The study also examines the definition of the term 'inclusion'. Professor Cooper argues that this lacks a clear operational definition and, as a result, is interpreted in different ways by different people.

In these confused circumstances there is a tendency towards a default position which defines inclusion in relation to the location of the student. It follows that the success of the inclusion policy is measured in terms of the numbers of children who are located in non-mainstream provision (i.e. excluded) and the numbers of children who are located in mainstream schools (i.e. included). Such crude judgements underplay the importance of the quality of social-emotional and educational engagement experienced by the individual student.

Professor Cooper argues, however, that it is precisely this notion of quality of engagement that should reside at the heart of educational policy and practice. This view recognises that an appropriate educational setting is defined in terms of the extent to which it caters for the needs of the individual student, and not in relation to geographical location.

Source:
Professor Paul Cooper
University of Leicester