Interactions and Play Behavior of Mothers of Typically Developing Infants and Infants with Disabilities: A Vygotskian Approach

This study follows a Vygotskian approach to investigate the influence and relatedness of several scaffolding behaviors for mother-infant dyads of both typically developing infants and infants with disabilities and how early intervention may influence the dyads through the home visiting process. For this primarily low-income sample, maternal participation during play did not enhance the infants\u27 play. The relation of infant level of play with maternal education, income, and the maternal involvement variables of level of play and use of scaffolding varied with the disability status of the infant. Home visitor support of mother-infant interaction did not appear to influence maternal involvement during play, except that mothers of infants with disabilities whose home visitors spent more time with just the infant played at a higher level

Preprofessional curriculum in preparation for doctor of pharmacy educational programs

The preprofessional pharmacy curriculum provides the foundation for the professional curriculum. Basic requirements are noted in the ACPE Standards and Guidelines, but there is considerable variation in the preprofessional curriculum requirements for entry into doctor of pharmacy programs in the United States. Changes in higher education, pharmacy practice, and health care continue to drive the need to evaluate the preprofessional curriculum. The objectives of this white paper were to create model preprofessional curricula that would enable students to be successful during and after entry into the professional curriculum. Using an evidence-based approach where possible, a number of factors were found to be associated with academic success during a pharmacy program and on licensing examinations. These data and other information were used to create 2 preprofessional curricular models that include the development of general and discipline-specific abilities. Challenges remain in accurately evaluating the abilities and attributes of applicants and the impact of those abilities and attributes on their success as a student and a practitioner. Colleges and schools of pharmacy should consider adopting a more consistent preprofessional curriculum on a national level. This preprofessional curriculum should be multi-dimensional, based on needs for future practice, and revised over time

Family Preservation and Healthy Outcomes for Pregnant and Parenting Teens in Foster Care: The Inwood House Theory of Change

Teens in foster care give birth at more than twice the rate of other teens in the United States. Significant challenges exist for these most vulnerable teens and their babies. To preserve teens’ families, programs and services need to be able to improve teens’ prospects for parenting success, delay subsequent pregnancies, and reduce intergenerational placement in care. The Inwood House theory of change for pregnant and parenting teens is a roadmap for providing the range and types of services that have the potential to improve outcomes for these most vulnerable families. The theory of change builds on insights and data from a demonstration project which took place in the residential program of a New York City foster care agency, with an approach that addressed the developmental needs of adolescents and the practical needs of parenting. Inwood House’s experience provided insights into the role of a theory of change focused on the development of young people, not only their protection, to improve the health and well-being of young mothers and their babies, and reduce intergenerational placement in care. Insights and data derived from this project, which reflect the challenges of research in foster care, are discussed

Financial Education Program Evaluation

This study illustrates the process of program evaluation using a logic model. Guided by the Transtheoretical Model of Change and a logic model, this study evaluated the effectiveness of a Retirement and Savings Seminar by measuring participant (n = 54) satisfaction, financial knowledge, financial confidence, and financial behavior change compared to a similar group of 134 non-participants. Participants were very satisfied with the seminar. Their financial knowledge and confidence scores significantly increased from pretest to posttest. Financial knowledge and confidence scores improved more than the comparison group while controlling for group differences in age, income, and pretest scores. Two months later, participants were more likely than the comparison group to have adopted positive financial behaviors as measured by the Financial Preparedness for Retirement Scale. Financial educators can use this study as a model for planning, conducting, and evaluating their program

Pregnant Teens in Foster Care: Concepts, Issues, and Challenges in Conducting Research on Vulnerable Populations

Teens in foster care give birth at over twice the rate of other teens. Unique challenges exist for these vulnerable teens and babies, yet research on such populations, particularly within the systems that serve them, is limited. A demonstration project at Inwood House, a residential foster care agency in New York City, from 2000 to 2005, at the same time that the Administration for Children\u27s Services was exploring policy and practice changes for this population, is described. Research design and implementation issues, descriptive data, and experiences provide lessons for improving the evidence base to meet the needs of pregnant teens in care

The not-so-sterile womb: Evidence that the human fetus is exposed to bacteria prior to birth

The human microbiome includes trillions of bacteria, many of which play a vital role in host physiology. Numerous studies have now detected bacterial DNA in first-pass meconium and amniotic fluid samples, suggesting that the human microbiome may commence in utero. However, these data have remained contentious due to underlying contamination issues. Here, we have used a previously described method for reducing contamination in microbiome workflows to determine if there is a fetal bacterial microbiome beyond the level of background contamination. We recruited 50 women undergoing non-emergency cesarean section deliveries with no evidence of intra-uterine infection and collected first-pass meconium and amniotic fluid samples. Full-length 16S rRNA gene sequencing was performed using PacBio SMRT cell technology, to allow high resolution profiling of the fetal gut and amniotic fluid bacterial microbiomes. Levels of inflammatory cytokines were measured in amniotic fluid, and levels of immunomodulatory short chain fatty acids (SCFAs) were quantified in meconium. All meconium samples and most amniotic fluid samples (36/43) contained bacterial DNA. The meconium microbiome was dominated by reads that mapped to Pelomonas puraquae. Aside from this species, the meconium microbiome was remarkably heterogeneous between patients. The amniotic fluid microbiome was more diverse and contained mainly reads that mapped to typical skin commensals, including Propionibacterium acnes and Staphylococcus spp. All meconium samples contained acetate and propionate, at ratios similar to those previously reported in infants. P. puraquae reads were inversely correlated with meconium propionate levels. Amniotic fluid cytokine levels were associated with the amniotic fluid microbiome. Our results demonstrate that bacterial DNA and SCFAs are present in utero, and have the potential to influence the developing fetal immune system

The biological embedding of early-life socioeconomic status and family adversity in children's genome-wide DNA methylation.

AimTo examine variation in child DNA methylation to assess its potential as a pathway for effects of childhood social adversity on health across the life course.Materials & methodsIn a diverse, prospective community sample of 178 kindergarten children, associations between three types of social experience and DNA methylation within buccal epithelial cells later in childhood were examined.ResultsFamily income, parental education and family psychosocial adversity each associated with increased or decreased DNA methylation (488, 354 and 102 sites, respectively) within a unique set of genomic CpG sites. Gene ontology analyses pointed to genes serving immune and developmental regulation functions.ConclusionFindings provided support for DNA methylation as a biomarker linking early-life social experiences with later life health in humans

Managing anxiety disorders in adults

The GP has a key role in identifying patients presenting with anxiety symptoms and ensuring appropriate acute and long-term management. There are two key messages for GPs to follow: once you have made a diagnosis of an anxiety disorder, tell the patient you have a treatment for it. Second, do not let your anxiety lead you to prescribe inappropriately or overinvestigate for all possible differential diagnoses

Encouraging Communication and Community Through Making Books About Shared Experiences

Classroom Storytelling to Enhance Language and Literacy Skills (C-SHELLS) is a guide for helping preschool children “write” books. C-SHELLS is designed to promote communication by using storytelling and book making activities to promote child language and literacy skills and community by helping culturally and linguistically diverse children engage with peers, understand classroom routines, and develop socially appropriate and regulated behaviors. C-SHELLS helps teachers engage children, get them talking, help them make friends, and increase their school readiness. C-SHELLS activities do this by helping children work together to make picture books based on shared classroom experiences. C-SHELLS uses a simple, fun, and engaging approach. In our previous work, parents receiving home visits have used this approach to improve the language skills of children who are English language learners and children who have language delays or related disabilities. Preschool teachers can use this approach with children in their classrooms. C-SHELLS incorporates evidence-based practices that promote children’s language, literacy, and social development. C-SHELLS activities are designed to build preschool children’s communication and behavioral skills within their preschool community. As children learn to organize and talk about experiences, they are learning skills important for later reading and understanding what is read. The C-SHELLS process for creating books is straightforward, and many preschool teachers have made books with young children. However, the benefit of making books depends on children’s engagement, conversation, and participation. A 3-part process is recommended. First, share experiences by encouraging children’s conversation about and interest in an activity. Second, make books by writing down what children say about photos or drawings of the shared experience and organizing words and pictures into a book. Finally, use the books by reading and talking about the books together again and again