The Effects of Explicit Adult Guided Instruction on Vocabulary Acquisition of Three to Four Year old Children with Disabilities

This research study examined the effects of explicit adult guided instruction on vocabulary acquisition in preschoolers with disabilities through daily interventions and an environment in which the participants were immersed in the vocabulary. The research question guiding this study was: What are the effects of explicit adult guided instruction on vocabulary acquisition in preschoolers with disabilities? Seven children ages 3 to 4 were selected to participate in a four week intervention with 7-10 minute daily literacy interventions combined with an immersive vocabulary classroom setting that revisited the target vocabulary words. Eight vocabulary words were introduced throughout the intervention: four nouns representing animals and four verbs that corresponded to how those animals moved. Two words, one noun and one verb, were explicitly taught per week through various multimodal activities including: scientific book read aloud, videos, kinesthetic movement of the verbs, fine motor activities, and music. The results demonstrated that all participants made gains in verbal and nonverbal language use involving the eight target vocabulary words. Based on the results of the study, it is recommended that children with disabilities be given vocabulary instruction using adult guided multimodal lessons

Organizational Fragmentation and Care Quality in the U.S. Health Care System

Many goods and services can be readily provided through a series of unconnected transactions, but in health care close coordination over time and within care episodes improves both health outcomes and efficiency. Close coordination is problematic in the US health care system because the financing and delivery of care is distributed across a variety of distinct and often competing entities, each with its own objectives, obligations and capabilities. These fragmented organizational structures lead to disrupted relationships, poor information flows, and misaligned incentives that combine to degrade care quality and increase costs. We illustrate our argument with examples taken from the insurance and the hospital industries, and discuss possible responses to the problems resulting from organizational fragmentation.

Unhealthy Insurance Markets: Search Frictions and the Cost and Quality of Health Insurance

We analyze the role of search frictions in the market for commercial health insurance. Frictions increase the cost of insurance by enabling insurers to set price above marginal cost, and by creating incentives for inefficiently high levels of marketing. Frictions also lead to price dispersion for identical products and, as a consequence, to increases in the rate of insurance turnover. Our empirical analysis indicates that frictions increase prices enough to transfer 13.2% of consumer surplus from employer groups to insurers (approximately $34.4 billion in 1997), and increase employer group turnover by 64% for the average insurance policy. This heightened turnover reduces insurer incentives to invest in the future health of their policy holders. Our analysis also suggests that a publicly-financed insurance option might improve private insurance markets by reducing distortions induced by search frictions.

Presynaptic Nrxn3 is essential for ribbon-synapse maturation in hair cells.

Hair cells of the inner ear and lateral-line system rely on specialized ribbon synapses to transmit sensory information to the central nervous system. The molecules required to assemble these synapses are not fully understood. We show that Nrxn3, a presynaptic adhesion molecule, is crucial for ribbon-synapse maturation in hair cells. In both mouse and zebrafish models, the loss of Nrxn3 results in significantly fewer intact ribbon synapses. We show in zebrafish that, initially, Nrxn3 loss does not alter pre- and postsynapse numbers but, later, synapses fail to pair, leading to postsynapse loss. We also demonstrate that Nrxn3 subtly influences synapse selectivity in zebrafish lateral-line hair cells that detect anterior flow. Loss of Nrxn3 leads to a 60% loss of synapses in zebrafish, which dramatically reduces pre- and postsynaptic responses. Despite fewer synapses, auditory responses in zebrafish and mice are unaffected. This work demonstrates that Nrxn3 is a crucial and conserved molecule required for the maturation of ribbon synapses. Understanding how ribbon synapses mature is essential to generating new therapies to treat synaptopathies linked to auditory or vestibular dysfunction

Pamięć przyszłości. Analiza ryzyka dla zarządzania kryzysowego

Zakres, w jakim uda się nam ograniczyć własną niepewność oraz osiągnąć oczekiwany poziom bezpieczeństwa, jest wprost proporcjonalny do pracy, jaką włożymy w proces planowania i przygotowania. Niemniej sam wysiłek nie gwarantuje jeszcze powodzenia realizowanych przedsięwzięć. Czynnikiem decydującym jest wiedza i umiejętności tych, którym przyjdzie zmierzyć się z problemem zarządzania ryzykiem. Czy są to jednak wystarczające predyspozycje, by podjąć trud zmierzenia się z zarządzaniem ryzykiem? Albert Einstein zapytany o przyczyny naukowych osiągnięć zwykł mawiać: Gdy przyglądam się sobie i moim metodom rozumowania, dochodzę do wniosku, że wyobraźnia odgrywa w moim życiu większą rolę niż talent do przyswajania wiedzy obiektywnej. W obszarach nauki, które posiłkują się metodami antycypacyjnymi, to wyobraźnia zaczyna odgrywać dziś decydującą rolę. Nauka coraz częściej bazuje na tzw. pamięci przyszłości (memories of the future) – czyli wskazaniu prawdopodobnych zdarzeń i przygotowaniu już dziś różnych przyszłości.Elżbieta MuszyńskaNCBi

Health plan administrative records versus birth certificate records: quality of race and ethnicity information in children

<p>Abstract</p> <p>Background</p> <p>To understand racial and ethnic disparities in health care utilization and their potential underlying causes, valid information on race and ethnicity is necessary. However, the validity of pediatric race and ethnicity information in administrative records from large integrated health care systems using electronic medical records is largely unknown.</p> <p>Methods</p> <p>Information on race and ethnicity of 325,810 children born between 1998-2008 was extracted from health plan administrative records and compared to birth certificate records. Positive predictive values (PPV) were calculated for correct classification of race and ethnicity in administrative records compared to birth certificate records.</p> <p>Results</p> <p>Misclassification of ethnicity and race in administrative records occurred in 23.1% and 33.6% children, respectively; the majority due to missing ethnicity (48.3%) and race (40.9%) information. Misclassification was most common in children of minority groups. PPV for White, Black, Asian/Pacific Islander, American Indian/Alaskan Native, multiple and other was 89.3%, 86.6%, 73.8%, 18.2%, 51.8% and 1.2%, respectively. PPV for Hispanic ethnicity was 95.6%. Racial and ethnic information improved with increasing number of medical visits. Subgroup analyses comparing racial classification between non-Hispanics and Hispanics showed White, Black and Asian race was more accurate among non-Hispanics than Hispanics.</p> <p>Conclusions</p> <p>In children, race and ethnicity information from administrative records has significant limitations in accurately identifying small minority groups. These results suggest that the quality of racial information obtained from administrative records may benefit from additional supplementation by birth certificate data.</p