The Relationships Among Caregiver Training, Mentoring, and Turn-Taking Between Caregiver and Child in Family Child Care

Basic communication skills are foundational for children\u27s success in school and are dependent largely on their language experiences early in life. The purpose of this study was to examine two professional development models and family child care providers\u27 use of turn-taking strategies that promote language in young children. The first professional development model consisted of a 10-hour nonformal training focused on supporting early language development. The second included the nonformal training and on-site mentoring. The 48 family child care programs were randomly assigned to one of the professional development models or a control group. Hierarchical linear modeling was used to examine the average increase in the frequency of providers\u27 use of turn-taking strategies over three observations. Results indicate that both forms of professional development support increased use of language promoting turn-taking strategies as compared to a control group. Professional development that includes on-site mentoring support appears to be related to greater increases in providers\u27 use of informational talk and didactic utterances over training only

Investigation of Social Supports for Parents of Children with Autism

There has been an increase of children being identified with autism in the United States (Center for Disease Control, 2009), leading to an increased concern of how to best meet the needs of children with autism and their families. In response to each reauthorization of the Individuals with Disabilities in Education Act (2004), in which the roles of families have been strengthened in planning their child\u27s education and professionals have had more input, the field has tried to uncover the \u27best\u27 ways to support parents. Recommended practice suggests that parents are best able to identify their own support needs, with assistance from professionals in identifying supports to assist with these needs (Murray et al., 2007). The focus of this study was to identify the forms of social support that parents of children recently diagnosed with autism perceive as being important. Twenty parents of children recently diagnosed with autism participated in this study. These parents completed a Q-sort using the forms of social support, which allowed for a ranking from most to least important. Statistically significant correlations were found on five support items. Factor analysis was conducted to explore groups of participants with similar rankings of the Q sort items

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

Training and Mentoring: Family Child Care Providers\u27 Use of Linguistic Inputs in Conversations with Children

The purpose of this study was to examine the effectiveness of two professional development models in increasing family child care providers’ frequency of linguistic inputs in conversations with young children. The first professional development model consisted of a 10-h in-service training focused on supporting early language development. The second included the same 10-h in-service training program and mentoring. Providers and children at 48 family child care programs participated in this study. The family child care programs were randomly assigned to one of the two professional development models (i.e., training or training with mentoring) or to a control group. Audio recordings of the language environment were collected prior to the in-service training, at the completion of the in-service training, and at the completion of the mentoring. Hierarchical linear modeling was used to examine the average increase in the frequency of providers’ use of linguistic inputs over three observations, conducted before training, immediately at the end of training, and 6 weeks after training. Results indicate that both forms of professional development increased linguistically stimulating inputs as compared to the control group. The professional development model including mentoring support was related to greater increases in providers’ use of informational talk and teaching utterances over in-service training without mentoring

An Ecological Momentary Assessment of Burnout, Rejuvenation Strategies, Job Satisfaction, and Quitting Intentions in Childcare Teachers

Guided by affective events theory, the purpose of this study was to examine the temporal aspects of childcare teacher burnout, particularly as to how feelings of exhaustion throughout the day relate to perceptions of end-of-day job satisfaction and quitting intentions. A secondary purpose of the study was to explore the frequency and type of rejuvenation strategies childcare teachers use to relieve perceived stress throughout the day. Ecological momentary assessment procedures were employed for 1 week to assess exhaustion levels (3 times/day), frequencies and types of rejuvenation strategies (3 times/day), and end-of-day job satisfaction perceptions and quitting intentions (1 time/day) among 50 childcare teachers. Results indicated that childcare teachers’ quitting intentions were positively predicted by emotional exhaustion (β = 0.52) and negatively predicted by overall job satisfaction (β = −0.28). Short (≤15 min), infrequently used (one to two times/day) physical or cognitive health reprieve strategies were reported by 86 % of teachers as the most effective for reducing daily stress. Findings suggest that daily accounts of burnout and quitting intentions have both exhaustive and restorative properties

Implication of LRRC4C and DPP6 in neurodevelopmental disorders

We performed whole-genome sequencing on an individual from a family with variable psychiatric phenotypes that had a sensory processing disorder, apraxia, and autism. The proband harbored a maternally inherited balanced translocation (46,XY,t(11;14)(p12;p12)mat) that disrupted LRRC4C, a member of the highly specialized netrin G family of axon guidance molecules. The proband also inherited a paternally derived chromosomal inversion that disrupted DPP6, a potassium channel interacting protein. Copy Number (CN) analysis in 14,077 cases with neurodevelopmental disorders and 8,960 control subjects revealed that 60% of cases with exonic deletions in LRRC4C had a second clinically recognizable syndrome associated with variable clinical phenotypes, including 16p11.2, 1q44, and 2q33.1 CN syndromes, suggesting LRRC4C deletion variants may be modifiers of neurodevelopmental disorders. In vitro, functional assessments modeling patient deletions in LRRC4C suggest a negative regulatory role of these exons found in the untranslated region of LRRC4C, which has a single, terminal coding exon. These data suggest that the proband’s autism may be due to the inheritance of disruptions in both DPP6 and LRRC4C, and may highlight the importance of the netrin G family and potassium channel interacting molecules in neurodevelopmental disorders

An Ecological Momentary Assessment of Burnout, Rejuvenation Strategies, Job Satisfaction, and Quitting Intentions in Childcare Teachers

Guided by affective events theory, the purpose of this study was to examine the temporal aspects of childcare teacher burnout, particularly as to how feelings of exhaustion throughout the day relate to perceptions of end-of-day job satisfaction and quitting intentions. A secondary purpose of the study was to explore the frequency and type of rejuvenation strategies childcare teachers use to relieve perceived stress throughout the day. Ecological momentary assessment procedures were employed for 1 week to assess exhaustion levels (3 times/day), frequencies and types of rejuvenation strategies (3 times/day), and end-of-day job satisfaction perceptions and quitting intentions (1 time/day) among 50 childcare teachers. Results indicated that childcare teachers’ quitting intentions were positively predicted by emotional exhaustion (β = 0.52) and negatively predicted by overall job satisfaction (β = −0.28). Short (≤15 min), infrequently used (one to two times/day) physical or cognitive health reprieve strategies were reported by 86 % of teachers as the most effective for reducing daily stress. Findings suggest that daily accounts of burnout and quitting intentions have both exhaustive and restorative properties