A Validation of the Tactile Edition of the Boehm-3 Preschool

The purpose of this research was to conduct a validation study of the Boehm-3 Preschool tactile version, which was designed to allow young children with visual impairment and who use their tactile abilities as their primary modality to discover and interpret the world to demonstrate knowledge of concept understanding. It is well established that concept understanding is one of the most important skills a young child with visual impairment should master. The progression of concept development and haptic understanding of two-dimensional representation in young children with visual impairment was a focus of this research to inform parents, practitioners, and researchers. Just as young sighted children visually (a) discriminate shape, sizes, and length for early mathematic literacy, (b) recognize salient features of letters, and (c) demonstrate knowledge of early literacy book skills and direction following, young children with visual impairment learn about their world in a tactual experiential manner though independent movement. The current lack of any formal tactual assessments that address the understanding of academic performance left a significant gap in the measurement alternatives for those wishing to conduct second-generation research to establish evidence-based practices or to determine if classroom interventions are effective. This study was designed to build unified validity components for the Boehm-3 Preschool tactile version. Validity was established using (a) an exploratory factor analysis for unidimensionality; (b) a non-parametric Mokken analysis to provide evidence of a developmental scale; and (c) ranked Spearman correlations to show construct validity with a Smyth Developmental Rating Scale created by the investigator to assess the children’s fine-motor and cognitive functional skills. One hundred and twenty scores from young children with visual impairment (ages 3 years to 5 years, 11months) across the United States were analyzed. Statistical procedures using an Item Response Theory methodology was implemented to match the unique characteristics of this low-prevalence population. Evidence was obtained to successfully build validity components for the Boehm-3 Preschool tactile version, with the result that it is the first validated tactile assessment available for young children with visual impairment

How health visitors from one healthcare organisation in the north of England endeavour to meet the perceived needs to Pakistani mothers living with violence and abuse and the challenges they encounter in keeping such women safe

Domestic abuse is a public health issue with long term health and social consequences for its victims. The prevalence of domestic abuse among women seeking healthcare is higher than in the general UK population and often begins or worsens in pregnancy. Health visitors, because of their role with pregnant women and mothers are in a key position to offer both supportive interventions and to play a preventative role in domestic abuse. The aim of this research is to improve understanding of issues health visitors face when working with Pakistani mothers living with domestic abuse. The study is set in the north of Britain in an area that has experienced chain migration and settlement from the Mirpur and Faisalabad regions of Pakistan since the 1970s. Taking a qualitative approach and informed by a critical realist perspective, first-hand accounts from health visitors working in the area are used. The findings of the study confirm that domestic abuse perpetrated against some Pakistani mothers is a complex aspect of health visiting practice compounded by deep rooted cultural and social practices within many Pakistani families. The key challenge health visitors face appears to be non-disclosure of abuse by many Pakistani women and the main approach taken by health visitors in this situation is predominantly one of harm minimisation. Inconsistencies in practice were however noted. Three overarching themes were found from the analysis of the data which depict the challenges health visitors face and the endeavours they take to keep women safe. The theme of Presence depicts a range of actions linked to ‘seeing’ or ‘being with’ women and includes carrying out repeated enquiry into abuse. Role Strain describes how the health visitors express difficulty in fulfilling the various demands and expectations of the role. The term Covert Actions encompasses a range of seemingly hidden or concealed activities undertaken by health visitors in an endeavour to maintain Presence. The study provides useful insight into the forms of evidence many health visitors deem can legitimately inform their clinical interventions when working with this population group and succeeds in extending current understanding of the types of knowledge health visitors draw from to inform their decisions in this specific area of practice. It also provides awareness of the wider challenges health visitors can encounter when working more generally among collectivist and honour-based communities and raises questions about some of the philosophical assumptions usually associated with Western models of healthcare. Implications for practice are that mainstream domestic abuse interventions should be used with sensitivity to the different cultural contexts in which many Pakistani mothers live, and attempts should be made to develop appropriate interventions that derive from those contexts. This includes holistic assessment tools that are flexible enough to allow clinical judgements to be informed by the more subjective elements of evidence gathering and which take into consideration the impact of the multiple oppressions some women encounter. Recommendations for service providers are that they should take a broader view of domestic violence that recognises ‘difference’ and therefore enables health visiting interventions to be flexible and responsive to differing need. This includes considering more community-based interventions among certain population group

Social inequalities in wheezing in children: findings from the UK Millennium Cohort Study

Wheezing in childhood is socially patterned, but it is unclear what factors explain the social differences.Regression analysis of the UK Millennium Cohort Study, based on 11 141 singleton children who participated at ages 9 months and 3, 5 and 7 years. Relative risk ratios (RRR) for early and persistent/relapsing wheeze were estimated using multinomial regression, according to measures of socioeconomic circumstances. Maternal, antenatal and early-life characteristics were assessed as potential mediators.Children of mothers with no educational qualifications were more likely to have both wheeze types, compared to children of mothers with degree-level qualifications (RRR 1.53, 95% CI 1.26-1.86 for early wheeze; 1.32 95% CI 1.04-1.67 for persistent/relapsing wheeze). Controlling for maternal age, smoking during pregnancy and breastfeeding removed the elevated risk of wheezing. Male sex, maternal age, body mass index, atopy, smoking during pregnancy, preterm birth, breastfeeding, exposure to other children and furry pets were independently associated with wheezing, but the pattern of association varied between wheezing types.In this representative UK cohort, adjustment for maternal smoking during pregnancy and breastfeeding removed the socioeconomic inequalities in common wheezing phenotypes. Policies to reduce the social gradient in these risk factors may reduce inequalities in wheezing and asthma

Monitoring SARS-CoV-2 in Wastewater During New York City\u27s Second Wave of COVID-19: Sewershed-level Trends and Relationships to Publicly Available Clinical Testing Data

New York City\u27s wastewater monitoring program tracked trends in sewershed-level SARS-CoV-2 loads starting in the fall of 2020, just before the start of the city\u27s second wave of the COVID-19 outbreak. During a five-month study period, from November 8, 2020 to April 11, 2021, viral loads in influent wastewater from each of New York City\u27s 14 wastewater treatment plants were measured and compared to new laboratory-confirmed COVID-19 cases for the populations in each corresponding sewershed, estimated from publicly available clinical testing data. We found significant positive correlations between viral loads in wastewater and new COVID-19 cases. The strength of the correlations varied depending on the sewershed, with Spearman\u27s rank correlation coefficients ranging between 0.38 and 0.81 (mean = 0.55). Based on a linear regression analysis of a combined data set for New York City, we found that a 1 log10 change in the SARS-CoV-2 viral load in wastewater corresponded to a 0.6 log10 change in the number of new laboratory-confirmed COVID-19 cases per day in a sewershed. An estimated minimum detectable case rate between 2–8 cases per day/100 000 people was associated with the method limit of detection in wastewater. This work offers a preliminary assessment of the relationship between wastewater monitoring data and clinical testing data in New York City. While routine monitoring and method optimization continue, information on the development of New York City\u27s wastewater monitoring program may provide insights for similar wastewater-based epidemiology efforts in the future