A descriptive study of school discipline referrals in first grade

School discipline referrals (SDRs) may be useful in the early detection and monitoring of disruptive behavior problems to inform prevention efforts in the school setting, yet little is known about the nature and validity of SDRs in the early grades. For this descriptive study, SDR data were collected on a sample of first grade students who were at risk for developing disruptive behavior problems (n = 186) and a universal sample (n = 531) from 20 schools. Most SDRs were given for physical aggression and the predominant consequence was time out. As expected, boys and at-risk students were more likely to receive an SDR and to have more SDRs than were girls and the universal sample. A large difference between schools regarding the delivery of SDRs was found. A zero-inflated Poisson model clustered by school tested the prediction of school-level variables. Students in schools that had a systematic way of tracking SDRs were more likely to receive one. Also, schools with more low-income students and larger class sizes gave fewer SDRs. SDRs predicted teacher ratings, and to a lesser extent, parent ratings of disruptive behavior at the end of first grade. Practitioners and researchers must examine school-level influences whenever first grade discipline referrals are used to measure problem behavior for the purpose of planning and evaluating interventions

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Promoting self-regulation in young children: The role of parenting interventions

Self-regulation is a foundational skill in childhood and underpins various positive and negative outcomes throughout childhood, adolescence and into adulthood. Parents and the way they parent their children play a key role in the development of young children’s self-regulatory capacity. However, there is limited evidence for the effectiveness of parenting interventions on child self-regulatory outcomes. This paper provides an overview of the role of parenting in the development of child self-regulation and a summary of the evidence base for parenting interventions to promote self-regulation in children under age eight, focusing on infancy, the toddler/preschooler period, and early school-age. We conclude by examining the gaps in this field of research and providing directions for future research

Diffusion of Adolescent Marijuana Use in School Environments Following Recreational Legalization

Aim: To identify the mechanisms by which social interactions with classmates influence marijuana use in the transition into adolescence. Design: Using four waves of longitudinal social network data collected quarterly during the school year from the spring of 8th grade to the spring of 9th grade (2014-2016), we examine how friendship ties relate to marijuana use. Participants: 1075 adolescents were included in the present analysis. An implicit consent procedure was used: all students whose parents did not opt out of the study were eligible to participate. Setting: Participants were drawn from 12 schools with 8th graders, from five rural and two nonrural school districts in Western Oregon. Measurements: At each assessment wave participants reported on their marijuana use in the past 30 days. Using stochastic actor-oriented modeling, we examined whether classmates with similar marijuana use were more likely to select each other as friends, and if a classmate’s marijuana use was influenced by friends’ use. Findings: Past 30-day marijuana use increased in prevalence across 9th grade. Classmates with similar marijuana use were more likely to select each other as friends, and classmates were more likely to adopt similar patterns of marijuana use as their friends. This influence effect did not depend on the friend’s popularity or closeness; best friends had no more influence on marijuana use than less-close friends. Conclusion: In the transition into high school, adolescents tend to select friends who report similar recent marijuana use, and are also more likely to adopt the marijuana use patterns of their friends regardless of how close or popular they are

A longitudinal study of e-cigarette, cigarette, and marijuana use sequence in youth.

OBJECTIVE: There is evidence linking youth use of electronic (e-) cigarettes to subsequent cigarette and marijuana use, raising public health concerns. We examined the sequence of use of e-cigarettes, conventional cigarettes, and marijuana in a longitudinal sample of adolescents, to determine if use of e-cigarettes often preceded use of other substances. METHODS: We collected self-reports from 1123 Oregon adolescents (52% female; 37% Hispanic) longitudinally from 8 to 11 grade (8 total surveys) regarding their lifetime (ever use) and current use (last 30 days) of e-cigarettes, cigarettes, and marijuana. If applicable, students also reported the delivery method of their current marijuana use. RESULTS: Almost 10% of adolescents reported using e-cigarettes prior to use of cigarettes or marijuana, and the majority of these youth initiated use of marijuana, cigarettes, or both by 11 grade. More youth transitioned from e-cigarette use to marijuana use then from e-cigarettes to use of conventional cigarettes. Participants who were co-using e-cigarettes and marijuana in 11 grade had an increased likelihood of consuming marijuana via vaping, dabbing, and edibles, compared to those who were only using marijuana. DISCUSSION: E-cigarettes were often the first substance used in this longitudinal sample, and more of these youth subsequently used marijuana compared to cigarettes. While research has focused on the progression from e-cigarettes to cigarettes in youth, these findings indicate that more attention should be focused on the subsequent initiation of marijuana

Emulating real-life situations with a play task to observe parenting skills and child behaviors

Play tasks that use standardized procedures and materials are a practical way to assess parenting skills, child behaviors, and the ways in which parents and children interact. We describe a systematic process for developing the parent-child play task (PCPT) to assess mother-child interactions for a randomized controlled trial of a video-based parenting program. Participants were 307 mothers and their 3- to 6-year-old children who presented oppositional and disruptive behavior challenges. The validity of the PCPT was investigated by testing (a) the extent to which the tasks elicited the specific parent and child behaviors of interest, (b) the consistency of individuals' behavior across the play tasks, an

Parenting support in an early childhood learning context

Early childhood education and child care settings have the potential to support parents and promote children’s cognitive, social, and emotional development, with likely long-term positive impacts well beyond school readiness. This chapter describes the development and pilot testing of a parallel program to Triple P, the Positive Early Childhood Education Program, a professional development and learning program designed for early childhood educators and carers. Key considerations in applying such programs in the early education setting are discussed, including awareness of local regulations, fit with early learning philosophies, and developing an environment that promotes partnerships between educators and parents. Parameters for professional development in the sector are also explored, such as online learning and opportunities for practice and coaching in the context of a busy early learning setting