NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT Comprehensive Strategic Plan for Health Disparities Research

To identify the most appropriate scientific areas to address in this plan, the Institute drew from its existing research portfolio aimed at eliminating health disparities. Reflecting the Institute’s mission, the unifying concept of the plan is development, starting before conception and continuing throughout the lifespan and across generations. The Institute’s long experience investigating the complex biological and environmental interactions that drive developmental processes is invaluable when clarifying the causes of racial, ethnic, and even community-based disparities. By focusing and coordinating research on gestation and the early years of life, including the transitions into and out of adolescence and young adulthood, the NICHD can address not only the development of health disparities, but the critical timing of preventive and therapeutic strategies

State of India development evaluation

The study provides an overview of the status of development evaluation in India informed by interviews of officials, both of state and central governments, rural development institutes and research organizations conducted across 13 states of India. As there was increasing concern that government departments do not fully cooperate with external evaluators, results demonstrate a need for better training and sensitization of staff, as well as augmenting capacity of evaluation systems and stakeholders. A dedicated Evaluation Policy may be one of the ways to institutionalize the process and facilitate effective evaluation

Extending and institutionalising social protection in Asia : a regional policy-research and network building program; report

Social Protection in Asia (SPA) research contributes to networking activities among Asian institutions working on Social Protection, leading to future collaborations within a strong regional network for research and policy advocacy, and helping develop an institutional presence that can engage in policy dialogue and advocacy with national governments and international institutions. This paper reviews activities, conferences, research and other outputs during the reporting period

Chameleon Effects in Homework Research: The Homework-Achievement Association Depends on the Measures Used and the Level of Analysis Chosen

Using a data set specifically tailored to homework research, with a sample of 1,275 students from 70 classes in Switzerland, the association between homework and achievement in French as a second language was tested at three levels (class level, between-student level, within-student level). The strength and direction of the homework-achievement association depended on the homework indicator chosen and differed to some degree across analytical levels. At the class level, achievement was higher in classes set frequent homework assignments and in classes where students reported low overall levels of negative emotions when doing homework. At the between-student level, high homework effort and low levels of negative homework emotions predicted favorable developments in French achievement, whereas high homework time predicted lower achievement. At the intraindividual level, high homework effort, high homework time, and low levels of negative homework emotions were statistically significantly associated with positive student evaluations of the specific assignment

Advantages of Bayesian monitoring methods in deciding whether and when to stop a clinical trial: an example of a neonatal cooling trial.

BackgroundDecisions to stop randomized trials are often based on traditional P value thresholds and are often unconvincing to clinicians. To familiarize clinical investigators with the application and advantages of Bayesian monitoring methods, we illustrate the steps of Bayesian interim analysis using a recent major trial that was stopped based on frequentist analysis of safety and futility.MethodsWe conducted Bayesian reanalysis of a factorial trial in newborn infants with hypoxic-ischemic encephalopathy that was designed to investigate whether outcomes would be improved by deeper (32 °C) or longer cooling (120 h), as compared with those achieved by standard whole body cooling (33.5 °C for 72 h). Using prior trial data, we developed neutral and enthusiastic prior probabilities for the effect on predischarge mortality, defined stopping guidelines for a clinically meaningful effect, and derived posterior probabilities for predischarge mortality.ResultsBayesian relative risk estimates for predischarge mortality were closer to 1.0 than were frequentist estimates. Posterior probabilities suggested increased predischarge mortality (relative risk > 1.0) for the three intervention groups; two crossed the Bayesian futility threshold.ConclusionsBayesian analysis incorporating previous trial results and different pre-existing opinions can help interpret accruing data and facilitate informed stopping decisions that are likely to be meaningful and convincing to clinicians, meta-analysts, and guideline developers.Trial registrationClinicalTrials.gov NCT01192776 . Registered on 31 August 2010

Infant Attachment Security and the Timing of Puberty: Testing an Evolutionary Hypothesis

Life-history theories of the early programming of human reproductive strategy stipulate that early rearing experience, including that reflected in infant-parent attachment security, regulates psychological, behavioral, and reproductive development. We tested the hypothesis that infant attachment insecurity, compared with infant attachment security, at the age of 15 months predicts earlier pubertal maturation. Focusing on 373 White females enrolled in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, we gathered data from annual physical exams from the ages of 9½ years to 15½ years and from self-reported age of menarche. Results revealed that individuals who had been insecure infants initiated and completed pubertal development earlier and had an earlier age of menarche compared with individuals who had been secure infants, even after accounting for age of menarche in the infants’ mothers. These results support a conditional-adaptational view of individual differences in attachment security and raise questions about the biological mechanisms responsible for the attachment effects we discerned

The quality of different types of child care at 10 and 18 months. A comparison between types and factors related to quality.

The quality of care offered in four different types of non-parental child care to 307 infants at 10 months old and 331 infants at 18 months old was compared and factors associated with higher quality were identified. Observed quality was lowest in nurseries at each age point, except that at 18 months they offered more learning activities. There were few differences in the observed quality of care by child-minders, grandparents and nannies, although grandparents had somewhat lower safety and health scores and offered children fewer activities. Cost was largely unrelated to quality of care except in child-minding, where higher cost was associated with higher quality. Observed ratios of children to adults had a significant impact on quality of nursery care; the more infants or toddlers each adult had to care for, the lower the quality of the care she gave them. Mothers' overall satisfaction with their child's care was positively associated with its quality for home-based care but not for nursery settings

Improving outcomes after pediatric cardiac arrest – the ICU-Resuscitation Project: study protocol for a randomized controlled trial

Background Quality of cardiopulmonary resuscitation (CPR) is associated with survival, but recommended guidelines are often not met, and less than half the children with an in-hospital arrest will survive to discharge. A single-center before-and-after study demonstrated that outcomes may be improved with a novel training program in which all pediatric intensive care unit staff are encouraged to participate in frequent CPR refresher training and regular, structured resuscitation debriefings focused on patient-centric physiology. Methods/design This ongoing trial will assess whether a program of structured debriefings and point-of-care bedside practice that emphasizes physiologic resuscitation targets improves the rate of survival to hospital discharge with favorable neurologic outcome in children receiving CPR in the intensive care unit. This study is designed as a hybrid stepped-wedge trial in which two of ten participating hospitals are randomly assigned to enroll in the intervention group and two are assigned to enroll in the control group for the duration of the trial. The remaining six hospitals enroll initially in the control group but will transition to enrolling in the intervention group at randomly assigned staggered times during the enrollment period. Discussion To our knowledge, this is the first implementation of a hybrid stepped-wedge design. It was chosen over a traditional stepped-wedge design because the resulting improvement in statistical power reduces the required enrollment by 9 months (14%). However, this design comes with additional challenges, including logistics of implementing an intervention prior to the start of enrollment. Nevertheless, if results from the single-center pilot are confirmed in this trial, it will have a profound effect on CPR training and quality improvement initiatives. Trial registration ClinicalTrials.gov, NCT02837497. Registered on July 19, 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2590-y) contains supplementary material, which is available to authorized users