Ensuring an independent future for young people with special educational needs and disabilities (SEND): a critical examination of the impact of education,health and care plans in England

This article examines the implications of the new education, health and care (EHC) planning process for career professionals in England. The new process comes in the wake of a succession of legislation relating to young people with special educational needs and disabilities (SEND) in England. There is much to recommend the new process as it represents a shift to a more holistic and person-centred approach. However, there are four main criticisms which can be made of the new process: (1) the policy has an excessive focus on paid work as an outcome which is unrealistic (for some young people); (2) the resourcing in local authorities is too limited to successfully operationalise the policy; (3) there is a lack of clarity about the professional base delivering EHC planning (especially in relation to the career elements); and (4) the policy is too narrowly targeted. While the new legislation offers some major opportunities, realising these will be difficult. In this paper, questions are raised about the resources required to deliver these services; the responsibilities relevant to such services; and the role and scope of these services in supporting the transitions of vulnerable young people into learning and work in an environment where universal careers provision has been substantially diminished.     

Balance of blood pressure equivalents as a new quantitative scale for identifying cardiac versus vascular reactor: Comparisons with Gregg, Matyas and James' (2002) hemodynamic profile scale

Abstract:  A quantitative scale for identifying cardiac versus vascular reactor, balance of blood pressure equivalents ( BE ), was newly advocated and compared with a very recently advocated one, hemodynamic profile ( HP ), by Gregg, Matyas and James (2002). BE was defined as " (Δ Q/Q ₀) P ₀'  − ( Δ R/R ₀ )P ₀." Here, P ₀ , Q ₀, and R ₀ were mean blood pressure ( P ), cardiac output ( Q ), and total peripheral resistance ( R ) during baseline, and Δ Q and Δ R were the difference scores of Q and R from baseline to stress, respectively. This was named as BE because the two terms in the formula indicated changes in Q and R in their blood pressure equivalents. Comparisons of the BE and HP scales were carried out, theoretically, in a newly introduced pressor space, on orthogonality with the extent of elevation of P (Δ P ); and then, practically, by using hypothetical data. In summary, it was shown that data points in the neighborhood in the pressor space can be judged as having not so different hemodynamic balance whether the BE or HP scale was used. As a merit, the BE scale seemed helpful to an intuitive understanding of the hemodynamics during stress. As a demerit, it cannot maintain the quasi-orthogonal relationship with Δ P when Q or R changes profoundly in the face of stress.