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Since the passage of Public Law 94-142, federal law has prioritized the education of students with disabilities with their non-disabled peers in the context of the general education classroom. This chapter examines the progress, and often lack thereof, with regard to educating students with extensive and pervasive support needs in inclusive settings. We examine current trends in placement, factors that contribute to those placement practices, and what IDEA says about the education of students with extensive and pervasive support needs. We examine what the research suggests happens in substantially segregated settings and then, in contrast, examine impacts and outcomes for students with extensive and pervasive support needs who are educated in inclusive settings. We also examine trends resulting from changing paradigms of disability that provide new opportunities for re-invigorating efforts to educate students with extensive and pervasive support needs in inclusive classrooms.

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

In The Great Derangement, the Indian writer Amitav Ghosh examines the present inability to understand and represent the scale and violence of the environmental crisis. The book is a passionate awakening call for collective action to drive change, with Ghosh clearly identifying the limits of the present framework of values, which inhibits politicians, industrialists and economists from moving towards a truly sustainable civilization. In the Anthropocene, non-human and post-human factors are raising questions about the concept of a silent Nature that can be domesticated for human advantage and the perspective of continuous progress – both of which have dominated the modern age. Nevertheless, the detailed scientific analysis of the violation of the planet’s limited capacities continues to be refuted, triggering irrational, short-term utilitarian behaviours which are preventing the fundamental changes required for the transition to sustainable development. Artists, philosophers and writers can play an invaluable role in reframing our ways of thinking, filling the gap between scientific knowledge and emotional perception. Pioneering artistic experiments are appearing all over the world, from both well-established and emerging artists, and through collective processes, and this cultural movement is setting the scene for a new wave of eco-entrepreneurs driven by the altruistic mission of saving the planet. As has happened in many previous crises, it is again in the hands of artists to redefine how we perceive ourselves and so to support the emergence of new ideas, new learning, and finally to shape society and the economy around a renewed sense of the future for humankind on Earth.