ABSTRACT
The novel coronavirus has had a devastating effect on the global community. This phenomenological study examines how the abrupt shift to online learning marginalized and excluded some students with disabilities across schools in Barbados. The research design is qualitative and uses case studies to investigate the narratives of three special education principals about how students, teachers, and parents managed academic and social needs during COVID-19. The research addressed two questions: (a) How did teachers adapt curriculum and instruction for online delivery at special schools? (b) How did schools support and help children cope academically and socially during COVID-19? Themes were developed to discuss the significant findings in the study. Findings revealed that teachers exhibited great creativity in their approaches to maintaining socioemotional bonding for their students, pedagogy, curriculum, and assessment during COVID-19. However, clear challenges to equity in education arose from a shortage of access to devices for students, the lack of authenticity of assessment, and the impersonal nature of online learning. Additionally, this research captures parents’ struggle to obtain proficiency with remote learning and the new technology to support online lessarning and its associated effects on their time and energy. The implications of this work are also discussed in the chapter. © 2023 Taylor and Francis.
ABSTRACT
Introduction: The COVID-19 pandemic has had far-reaching consequences for individuals with type 1 diabetes (T1D) and has laid bare inequities in health care. Objectives: We sought to examine the United States (US) trends in diabetic ketoacidosis (DKA) across the lifespan during the COVID-19 pandemic and factors associated with these trends, compared to DKA rates the year prior to the pandemic. Methods: The T1D Exchange Quality Improvement Collaborative (T1DX-QI) collected aggregate data on the incidence of DKA among children and adults with established and new-onset T1D from 7 large medical centers in the US (total T1D population >15,000). We compared DKA rates during COVID-19 Wave 1 (March-May 2020) and COVID-19 Wave 2 (August-October 2020) to the same periods in 2019. Descriptive statistics were used to summarize data. Chi-square tests were used to compare differences in patient characteristics. Results: DKA rates were higher in patients with established T1D during COVID-19 Wave 1 compared to the same period in 2019 (6.15% vs 4.71%, p=<0.001). DKA rates were also higher in patients with established T1D during COVID-19 Wave 2 compared to 2019 (5.55% vs 4.90%, p=0.02). There were no differences in rates of DKA by age or DKA severity. DKA rates were lower among individuals on insulin pumps during both COVID-19 waves compared to 2019 (Wave 1: 6.43% vs 10.25%, p=0.008;Wave 2: 8.14% vs 11.21%, p=0.03). Consistent with known T1D inequities, DKA rates were exacerbated for NH Black patients in 2020, with 18% of NH Blacks with T1D experiencing DKA compared to 6% of NH Whites. Conclusions: DKA rates rose among patients with T1D during US COVID-19 Waves 1 and 2, with the highest rates among NH Blacks. These findings highlight the urgent need for improved strategies to decrease the risk of DKA in individuals with T1D under pandemic conditions, especially among populations most affected by health inequities.