Preschoolers, Parents, and Teachers (PPT): A Preventive Intervention with an At-Risk Population

The importance of early intervention with children who are at risk for mental health problems is widely recognized. Relationships with significant adults (parents, other caregivers, and teachers) are critically important in young children\u27s lives and can make a tremendous difference in the trajectory of a child\u27s future. This study utilized a waiting-control group design to examine the effects on student behavior and parent stress of play-based interventions designed to improve the relationships between parents and their children (i.e., Filial Therapy), and teachers and their students (i.e., Kinder Training). To incorporate the benefits of group work, the eight-week intervention was delivered to parents in a small-group format. Teachers participated in a one-day group training with weekly coaching and dyadic consultation for on-going support. Results at post-intervention indicated that teachers perceived children in the intervention group to exhibit significantly less problem behavior than students in the waiting-control group. Although results suggest that the intervention had no demonstrable effect on parent stress, qualitative results indicate otherwise. Implications for practice and research are discussed

A Novel Modelling Process in Chemistry: Merging Biological and Mathematical Perspectives to Develop Modelling Competences

Models are essential in science and therefore in scientific literacy. Therefore, pupils need to attain competency in the appropriate use of models. This so-called model–methodical competence distinguishes between model competence (the conceptual part) and modelling competence (the procedural part), wherefrom a definition follows a general overview of the concept of models in this article. Based on this, modelling processes enable the promotion of the modelling competence. In this context, two established approaches mainly applied in other disciplines (biology and mathematics) and a survey among chemistry teachers and employees of chemistry education departments (N = 98) form the starting point for developing a chemistry modelling process. The article concludes with a description of the developed modelling process, which by its design, provides an opportunity to develop students’ modelling competence

Age-stratified heritability estimation in the Framingham Heart Study families

The Framingham Heart Study provides a unique source of longitudinal family data related to CVD risk factors. Age-stratified heritability estimates were obtained over three age groups (31–49 years, 50–60 years, and 61–79 years), reflecting the longitudinal nature of the data, for four quantitative traits. Age-adjusted heritability estimates were obtained at a single common time point for the same four quantitative traits. The importance of these groups is that they consist of the same individuals. The highest age-stratified heritability estimate (h(2 )= 0.88 (± 0.06)) was for height in the model adjusting for gender over all three age groups. SBP gave the lowest heritability estimate (h(2 )= 0.15 (± 0.11)) for the 70 age group in the model adjusting for gender, height, BMI, smoker, and drinker. BMI had slightly higher estimates (h(2 )= 0.64 (± 0.11)) in the 40 age group than previously published. The highest age-adjusted heritability estimate (h(2 )= 0.90 (± 0.06)) was for height in the model adjusting for gender. SBP gave the lowest heritability estimate (h(2 )= 0.38 (± 0.09)) for unadjusted model. These results indicate that some common, complex traits may vary little in their genetic architecture over time and suggest that a common set of genes may be contributing to observed variation for these longitudinally collected phenotypes

Overcoming the Challenges to Clinical Development of X-Linked Retinitis Pigmentosa Therapies: Proceedings of an Expert Panel

UNLABELLED: X-linked retinitis pigmentosa (XLRP) is a rare inherited retinal disease manifesting as impaired night vision and peripheral vision loss that progresses to legal blindness. Although several trials of ocular gene therapy for XLRP have been conducted or are in progress, there is currently no approved treatment. In July 2022, the Foundation Fighting Blindness convened an expert panel to examine relevant research and make recommendations for overcoming the challenges and capitalizing on the opportunities in conducting clinical trials of RPGR-targeted therapy for XLRP. Data presented concerned RPGR structure and mutation types known to cause XLRP, RPGR mutation-associated retinal phenotype diversity, patterns in genotype/phenotype relationships, disease onset and progression from natural history studies, and the various functional and structural tests used to monitor disease progression. Panel recommendations include considerations, such as genetic screening and other factors that can impact clinical trial inclusion criteria, the influence of age on defining and stratifying participant cohorts, the importance of conducting natural history studies early in clinical development programs, and the merits and drawbacks of available tests for measuring treatment outcomes. We recognize the need to work with regulators to adopt clinically meaningful end points that would best determine the efficacy of a trial. Given the promise of RPGR-targeted gene therapy for XLRP and the difficulties encountered in phase III clinical trials to date, we hope these recommendations will help speed progress to finding a cure. TRANSLATIONAL RELEVANCE: Examination of relevant data and recommendations for the successful clinical development of gene therapies for RPGR-associated XLRP

Right ventricular outflow reconstruction with cryopreserved homografts in pediatric patients: Intermediate-term follow-up with serial echocardiographic assessment

AbstractObjectives. This study was performed to assess by echocardiography the intermediate-term outcome of cryopreserved homografts employed in pulmonary outflow reconstruction in children and to validate the reliability of Doppler echocardiography in their evaluation.Background. Cryopreserved homografts have become the most widely used pulmonary conduits. Previous reports have shown the occurrence of homograft regurgitation in the immediate postoperative period and the propensity of regurgitation to progress. Although Doppler echocardiography has been useful in assessing extracardiac valved conduit stenosis, its reliability in assessing a large series of cryopreserved homografts has not been documented.Methods. Echocardiograms of 41 patients (43 homografts) who underwent operations between December 1986 and October 1992 were retrospectively reviewed. The median age of patients at operation was 37.5 months (range 3 to 333), and the median duration of follow-up was 28.5 months (range 1 to 68). Homograft regurgitation was classified on a scale of 0 to 4+. Pressure gradients across the homografts measured in 23 catheterizations were correlated with corresponding echocardiographic gradients.Results. Regurgitation: Homograft regurgitation occurred in 100% of patients at follow-up. Progression of severity >2 grades occurred during follow-up in 35% and was associated with operation before age 18 months (p < 0.002) and stenosis progression (p < 0.05) but not with homograft type (aortic or pulmonary). These data predict that 50% of patients operated on before 18 months of age will have severe regurgitation by 15 months postoperatively compared with only 15% operated on after 18 months. Stenosis: At follow-up, 51% of homografts had a stenotic gradient ≥25 mm Hg predominantly at the distal anastomosis, and stenosis progression was related to young age at operation (<18 months, p < 0.005) and small conduit size (p < 0.01). Fifty percent of conduits implanted before age 18 months could be predicted to stenose by 21.8 months compared with only 5% of those implanted after age 18 months. The gradient measured from Doppler echocardiography correlated well with the catheterization gradient (r = 0.86).Conclusions. Cryopreserved homograft dysfunction is frequent and progressive. Young age at operation (<18 months) predicts more rapid deterioration. Doppler echocardiography is reliable in assessing the systolic gradients across homografts. Serial echocardiographic assessment in the follow-up of these patients accurately characterizes these problems

Quantifying errors in 3D CME parameters derived from synthetic data using white-light reconstruction techniques

Current efforts in space weather forecasting of CMEs have been focused on predicting their arrival time and magnetic structure. To make these predictions, methods have been developed to derive the true CME speed, size, position, and mass, among others. Difficulties in determining the input parameters for CME forecasting models arise from the lack of direct measurements of the coronal magnetic fields and uncertainties in estimating the CME 3D geometric and kinematic parameters after eruption. White-light coronagraph images are usually employed by a variety of CME reconstruction techniques that assume more or less complex geometries. This is the first study from our International Space Science Institute (ISSI) team “Understanding Our Capabilities in Observing and Modeling Coronal Mass Ejections”, in which we explore how subjectivity affects the 3D CME parameters that are obtained from the Graduated Cylindrical Shell (GCS) reconstruction technique, which is widely used in CME research. To be able to quantify such uncertainties, the “true” values that are being fitted should be known, which are impossible to derive from observational data. We have designed two different synthetic scenarios where the “true” geometric parameters are known in order to quantify such uncertainties for the first time. We explore this by using two sets of synthetic data: 1) Using the ray-tracing option from the GCS model software itself, and 2) Using 3D magnetohydrodynamic (MHD) simulation data from the Magnetohydrodynamic Algorithm outside a Sphere code. Our experiment includes different viewing configurations using single and multiple viewpoints. CME reconstructions using a single viewpoint had the largest errors and error ranges overall for both synthetic GCS and simulated MHD white-light data. As the number of viewpoints increased from one to two, the errors decreased by approximately 4° in latitude, 22° in longitude, 14° in tilt, and 10° in half-angle. Our results quantitatively show the critical need for at least two viewpoints to be able to reduce the uncertainty in deriving CME parameters. We did not find a significant decrease in errors when going from two to three viewpoints for our specific hypothetical three spacecraft scenario using synthetic GCS white-light data. As we expected, considering all configurations and numbers of viewpoints, the mean absolute errors in the measured CME parameters are generally significantly higher in the case of the simulated MHD white-light data compared to those from the synthetic white-light images generated by the GCS model. We found the following CME parameter error bars as a starting point for quantifying the minimum error in CME parameters from white-light reconstructions: Δθ (latitude)=6°-3°+2°, Δϕ (longitude)=11°-6°+18°, Δγ (tilt)=25°-7°+8°, Δα(half-angle)=10°-6°+12°, Δh (height)=0.6-0.4+1.2 R⊙, and Δκ (ratio)=0.1-0.02+0.03.Fil: Verbeke, Christine. Royal Observatory Of Belgium (rob);Fil: Mays, M. Leila. NASA Goddard Space Flight Center. Heliophysics Science Division; Estados UnidosFil: Kay, Christina. NASA Goddard Space Flight Center. Heliophysics Science Division; Estados Unidos. The Catholic University of America; Estados UnidosFil: Riley, Pete. Predictive Science Inc.; Estados UnidosFil: Palmerio, Erika. Predictive Science Inc.; Estados UnidosFil: Dumbović, Mateja. University of Zagreb; CroaciaFil: Mierla, Marilena. Institute of Geodynamics of the Romanian Academy; Rumania. Royal Observatory of Belgium; BélgicaFil: Scolini, Camilla. University of New Hampshire; Estados Unidos. University Corporation for Atmospheric Research; Estados UnidosFil: Temmer, Manuela. University of Graz; AustriaFil: Paouris, Evangelos. George Mason University; Estados Unidos. University Johns Hopkins; Estados UnidosFil: Balmaceda, Laura Antonia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Instituto de Ciencias Astronómicas, de la Tierra y del Espacio. Universidad Nacional de San Juan. Instituto de Ciencias Astronómicas, de la Tierra y del Espacio; Argentina. George Mason University; Estados Unidos. NASA Goddard Space Flight Center; Estados UnidosFil: Cremades Fernandez, Maria Hebe. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza; Argentina. Universidad de Mendoza; ArgentinaFil: Hinterreiter, Jürgen. University of Graz; Austri

Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes

AbstractIn response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described

Carbohydrate Intake in the Etiology of Crohn's Disease and Ulcerative Colitis

Background: Diet may have a role in the etiology of inflammatory bowel disease. In previous studies, the associations between increased intakes of carbohydrates, sugar, starch, and inflammatory bowel disease are inconsistent. However, few prospective studies have investigated the associations between these macronutrients and incident Crohn's disease (CD) or ulcerative colitis (UC). Methods: A total of 401,326 men and women were recruited between 1991 and 1998. At recruitment, dietary intakes of carbohydrate, sugar, and starch were measured using validated food frequency questionnaires. The cohort was monitored identifying participants who developed incident CD or UC. Cases were matched with 4 controls, and odds ratios were calculated for quintiles of total carbohydrate, sugar, and starch intakes adjusted for total energy intake, body mass index, and smoking. Results: One hundred ten participants developed CD, and 244 participants developed UC during follow-up. The adjusted odds ratio for the highest versus the lowest quintiles of total carbohydrate intake for CD was 0.87, 95% CI = 0.24 to 3.12 and for UC 1.46, 95% CI = 0.62 to 3.46, with no significant trends across quintiles for either (CD, Ptrend = 0.70; UC, Ptrend = 0.41). Similarly, no associations were observed with intakes of total sugar (CD, Ptrend = 0.50; UC, Ptrend = 0.71) or starch (CD, Ptrend = 0.69; UC, Ptrend = 0.17). Conclusions: The lack of associations with these nutrients is in agreement with many case–control studies that have not identified associations with CD or UC. As there is biological plausibility for how specific carbohydrates could have an etiological role in inflammatory bowel disease, future epidemiological work should assess individual carbohydrates, although there does not seem to be a macronutrient effect