Promoting Social-emotional Wellbeing in Early Intervention Services: A Fifty-state View

In 2007 approximately 322,000 young children received services through the Individuals with Disabilities Act (IDEA) Part C, the Early Intervention Program for Infant and Toddlers with Disabilities. Yet research shows that only a fraction of children eligible for the program received services. Against the backdrop of this gap between need for services and service use, special concerns for young children with or at risk for social-emotional developmental delays stand in relief. Even fewer of these children received services to address their social-emotional developmental needs through Part C. In part, this state of affairs reflects the significant flexibility states have in the eligibility criteria used to identify children who will receive services under Part C. However, this flexibility results in significant differences in the number of children identified in specific states. Eligibility criteria are categorized into three groups: restricted, which includes in the determination neither clinical input nor children at-risk for developmental delay; narrow, which does include a clinical option but not at risk children; and liberal, which can include both the clinical option and at-risk children

Social-emotional Development in Early Childhood: What Every Policymaker Should Know

The early years of life present a unique opportunity to lay the foundation for healthy development. It is a time of great growth and of vulnerability. Research on early childhood has underscored the impact of the first five years of a child's life on his/her social-emotional development. Negative early experiences can impair children's mental health and effect their cognitive, behavioral, social-emotional development

Teacher-child relationships: Examining the relations among children's risk, relationships, and externalizing behaviors in Head Start

Early externalizing behaviors can have significant and persistent impacts on young children's developmental trajectories (Campbell, 1994; 1995; Moffitt, 1993). High-quality teacher-child relationships have the potential to protect children living in high-risk family environments from developing externalizing behaviors. Using Bronfenbrenner's bioecological framework, the current study explored the impact of family risks and teacher-child relationship quality on children's externalizing behaviors. Specifically, the goals of the study were to: (a) investigate the associations between family risk factors and children's externalizing behaviors, (b) examine the associations between teacher-child relationship quality and children's externalizing behaviors, (c) examine whether teacher-child relationship quality moderates the impact of family risk on children's externalizing behaviors, and (d) investigate the associations among teacher, student, and classroom characteristics and teacher-child relationship quality. Data were gathered from 100 Head Start children, their parents, and their teachers. Controlling for children's age and gender, results revealed that two family risk factors, parent-child dysfunctional interaction and family cohesion, significantly predicted child noncompliance. All of the teacher-child relationship quality variables including conflict, cohesion, dependency, and positive interactions significantly predicted children's externalizing behaviors, with conflict being the strongest and most consistent predictor. Finally, analyses on the interactions between the family risk and teacher-child relationship quality variables revealed that teacher-child conflict moderated the impact of family cohesion on child noncompliance. This finding suggested that low teacher-child conflict protects children from the impact of low family cohesion on child noncompliance, and high teacher-child conflict intensifies the impact of low family cohesion on child noncompliance. Overall, the results from this study suggest that teacher-child relationship quality may serve as both a risk and protective factor in the development of young children's externalizing behaviors. The findings presented have important implications for researchers, practitioners, and policy makers in understanding how to strengthen teacher-child relationships as a means to promote Head Start children's competence in the behavioral domain

O monitoramento de rastreadores de eventos adversos relacionados aos medicamentos como ferramenta de segurança aos pacientes da unidade de tratamento de queimados do Hospital Regional da Asa Norte, Brasília - Distrito Federal

Monografia (graduação)—Universidade de Brasília, Faculdade de Ceilândia, Curso de Farmácia, 2015.Objetivo: Identificar a ocorrência de eventos adversos por meio da aplicação de rastreadores em pacientes hospitalizados em uma unidade de tratamento de queimados em um hospital de referência. Materiais e Métodos: Trata-se de um estudo de coorte baseado na análise dos prontuários de pacientes hospitalizados na Unidade de Tratamento de Queimados do Hospital Regional da Asa Norte – Brasília – DF, nos meses de agosto, setembro e outubro de 2015. Os dados coletados foram armazenados em um banco de dados no programa EpiData 3.0 e posteriormente analisados no Statistical Package for Social Science (SPSS) 20.0. Resultados: A amostra foi composta por 32 sujeitos sendo 68,8% homens, a média de idade foi de 32,4 (±18,0) anos. As complicações durante a internação foram frequentes (65,5%) sendo as mais comuns, as infecciosas e as hematológicas. Pelo menos metade dos pacientes necessitou de hemocomponentes (56,3%). Os resultados demonstram que são pacientes polimedicados, as classes de medicamentos mais utilizadas foram os anti-infecciosos de uso sistêmico e os que atuam no sistema nervoso, foi observado o uso elevado de dois medicamentos potencialmente perigosos, o Tramadol e a Enoxaparina. Os rastreadores que mais apareceram foram: antieméticos, anti-histamínicos e redução de hemoglobina/hematócrito, 75% dos pacientes apresentaram rastreadores, porém apenas um paciente apresentou evento adverso relacionado a um rastreador. Conclusão: Observou-se alta incidência de rastreadores, contudo, o próprio problema de saúde e os procedimentos realizados com estes pacientes explicam os rastreadores identificados É necessário um acompanhamento mais longo destes pacientes para confirmar a aplicabilidade dos rastreadores na identificação de eventos adversos relacionados aos medicamentos.Objective: Identify the occurrence of adverse events applying trigger tools in hospitalized patients in the Burn Unit. Materials and Methods: This is a cohort study based on analysis of medical records of patients hospitalized in the Burn Unit of Hospital Regional da Asa Norte - Brasília - DF, in the months of August, September and October 2015. The data collected were stored in a database program EpiData 3.0 software, and then analyzed using the Statistical Package for Social Sciences (SPSS) 20.0. Results: The sample consisted of 32 subjects and 68.8% male, mean age was 32.4 (± 18.0) years. Complications during hospitalization were common (65.5 %) being the most common, infectious and hematological. Half of the patients needed blood products (56.3 %). They’re polymedicated, the most commonly used drug classes were anti -infectious for systemic use and those that act on the nervous system, the high use of two high-alert medications was noted, Tramadol and Enoxaparin. Triggers appeared that most were: antiemetics, antihistamines and reduction of hemoglobin/hematocrit, 75,0% of patients had triggers, but only one patient had adverse event related to a trigger. Conclusion: There was a high incidence of triggers, however, the very health problem and the procedures carried out with these patients explain triggers identified. It is necessary a longer follow-up of these patients to confirm the applicability of trigger tools to identify adverse events related to drugs

Characterizing the impact of smoking and lung cancer on the airway transcriptome using RNA sequencing

Thesis (M.A.)--Boston UniversityPLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at [email protected]. Thank you.Cigarette smoke creates a molecular field of injury in epithelial cells that line the respiratory tract. We hypothesized that transcriptome sequencing (RNA-seq) will enhance our understanding of the field of molecular injury in response to tobacco smoke exposure and lung cancer pathogenesis by identifying gene expression differences not interrogated or accurately measured by microarrays. We sequenced the high- molecular weight fraction of total RNA (>200 nt) from pooled bronchial airway epithelial cell brushings (n = 3 patients per pool) obtained during bronchoscopy from healthy never smoker (NS) and current smoker (S) volunteers and smokers with (C) and without ( C) lung cancer undergoing lung nodule resection surgery. RNA-seq libraries were prepared using two distinct approaches, one capable of capturing non-polyadenylated RNA (the prototype NuGEN Ovation RNA-seq protocol) and the other designed to measure only polyadenylated RNA (the standard Illumina mRNA-seq protocol) followed by sequencing generating approximately 29 million 36 nt reads per pool and approximately 22 million 75 nt paired-end reads per pool, respectively. The NuGEN protocol captured additional transcripts not detected by the Illumina protocol at the expense of reduced coverage of polyadenylated transcripts, while longer read lengths and a paired-end sequencing strategy significantly improved the number of reads that could be aligned to the genome. The aligned reads derived from the two complementary protocols were used to define the compendium of genes expressed in the airway epithelium (n = 20,573 genes). Pathways related to the metabolism of xenobiotics by cytochrome P450, retinol metabolism, and oxidoreductase activity were enriched among genes differentially expressed in smokers, whereas chemokine signaling pathways, cytokine-cytokine receptor interactions, and cell adhesion molecules were enriched among genes differentially expressed in smokers with lung cancer. There was a significant correlation between the RNA-seq gene expression data and Affymetrix microarray data generated from the same samples (P < 0.001); however, the RNA-seq data detected additional smoking- and cancer-related transcripts whose expression was were either not interrogated by or was not found to be significantly altered when using microarrays, including smoking- related changes in the inflammatory genes SIOOA8 and SIOOA9 and cancer-related changes in MUC5AC and secretoglobin (SCGB3Al). Quantitative realtime PCR confirmed differential expression of select genes and non-coding RNAs within individual samples. These results demonstrate that transcriptome sequencing has the potential to provide new insights into the biology of the airway field of injury associated with smoking and lung cancer. The measurement of both coding and non-coding transcripts by RNA-seq has the potential to help elucidate mechanisms of response to tobacco smoke and to identify additional biomarkers of lung cancer risk and novel targets for chemoprevention.2031-01-0

The early home environment and developmental outcomes for young children in the child welfare system

The quality of the early home environment is predictive of young children's subsequent cognitive, academic, and behavioral functioning. Limited research has focused on the effects of the early caregiving environment on the functioning of young children involved with the child welfare system. This study investigated the influence of children's home environments (i.e., number of children in the home, number of moves the child experienced, level of cognitive stimulation, and level of emotional support) during the first 2 years of life on their preschool developmental outcomes (i.e., cognition, language, social skills, and behavior problems). As anticipated, a high-quality early home environment promoted the well-being of preschool children who had entered the child welfare system as infants. Children who lived with greater numbers of children incurred more compromised cognitive, language, behavioral, and social outcomes. No significant associations emerged between the total number of placements and developmental outcomes; children who remained in the same home during infancy (typically the birth family home) had more compromised developmental outcomes in every domain except behavioral problems. Both cognitive stimulation and emotional support in the home predicted higher cognitive and language scores, decreased behavioral problems, and increased social skills. Early out-of-home placement and lack of emotional support interacted to predict children's behavioral problems. These findings are considered in the context of extant research and policy relevant to young children in the child welfare system.Home environment Preschool Infancy Developmental outcomes Child maltreatment Foster care

Measuring parenting among foster families: The development of the Foster Parent Attitudes Questionnaire (FPAQ)

Foster parents are an increasingly vulnerable population, with documented parenting difficulties. The care they provide to maltreated children plays a critical role in these children's well-being. Parenting attitudes figure largely in the quality of care any parent may provide, and may be particularly salient for foster children. The current study was designed to create and test a measure of foster parent attitudes. Following focus groups and expert item review, a measure of foster parenting attitudes was administered to 90 foster mothers in two urban settings. The measure had very good test-retest reliability and good internal reliability. Validity was established through the measure's significant positive relation to a general measure of parenting attitudes. Exploratory factor analysis yielded 7 factors, the most robust of which was attachment/commitment to the foster child. These findings are discussed in the context of current practice and research.

Molecular profiling of premalignant lesions in lung squamous cell carcinomas identifies mechanisms involved in stepwise carcinogenesis.

Lung squamous cell carcinoma (SCC) is thought to arise from premalignant lesions in the airway epithelium; therefore, studying these lesions is critical for understanding lung carcinogenesis. Previous microarray and sequencing studies designed to discover early biomarkers and therapeutic targets for lung SCC had limited success identifying key driver events in lung carcinogenesis, mostly due to the cellular heterogeneity of patient samples examined and the interindividual variability associated with difficult to obtain airway premalignant lesions and appropriate normal control samples within the same patient. We performed RNA sequencing on laser-microdissected representative cell populations along the SCC pathologic continuum of patient-matched normal basal cells, premalignant lesions, and tumor cells. We discovered transcriptomic changes and identified genomic pathways altered with initiation and progression of SCC within individual patients. We used immunofluorescent staining to confirm gene expression changes in premalignant lesions and tumor cells, including increased expression of SLC2A1, CEACAM5, and PTBP3 at the protein level and increased activation of MYC via nuclear translocation. Cytoband enrichment analysis revealed coordinated loss and gain of expression in chromosome 3p and 3q regions, respectively, during carcinogenesis. This is the first gene expression profiling study of airway premalignant lesions with patient-matched SCC tumor samples. Our results provide much needed information about the biology of premalignant lesions and the molecular changes that occur during stepwise carcinogenesis of SCC, and it highlights a novel approach for identifying some of the earliest molecular changes associated with initiation and progression of lung carcinogenesis within individual patients

Molecular profiling of premalignant lesions in lung squamous cell carcinomas identifies mechanisms involved in stepwise carcinogenesis.

Lung squamous cell carcinoma (SCC) is thought to arise from premalignant lesions in the airway epithelium; therefore, studying these lesions is critical for understanding lung carcinogenesis. Previous microarray and sequencing studies designed to discover early biomarkers and therapeutic targets for lung SCC had limited success identifying key driver events in lung carcinogenesis, mostly due to the cellular heterogeneity of patient samples examined and the interindividual variability associated with difficult to obtain airway premalignant lesions and appropriate normal control samples within the same patient. We performed RNA sequencing on laser-microdissected representative cell populations along the SCC pathologic continuum of patient-matched normal basal cells, premalignant lesions, and tumor cells. We discovered transcriptomic changes and identified genomic pathways altered with initiation and progression of SCC within individual patients. We used immunofluorescent staining to confirm gene expression changes in premalignant lesions and tumor cells, including increased expression of SLC2A1, CEACAM5, and PTBP3 at the protein level and increased activation of MYC via nuclear translocation. Cytoband enrichment analysis revealed coordinated loss and gain of expression in chromosome 3p and 3q regions, respectively, during carcinogenesis. This is the first gene expression profiling study of airway premalignant lesions with patient-matched SCC tumor samples. Our results provide much needed information about the biology of premalignant lesions and the molecular changes that occur during stepwise carcinogenesis of SCC, and it highlights a novel approach for identifying some of the earliest molecular changes associated with initiation and progression of lung carcinogenesis within individual patients