Predictors of special education referral: child characteristics and state pre-kindergarten quality

Past research has demonstrated that attending high quality early education programs is associated with the reduction of later need for special education services. However, little research has looked specifically at how different program characteristics affect these outcomes. Additionally, no research has examined such associations within the state-funded pre-kindergarten programs that have recently become more widespread. The current study aimed to add to the literature by exploring the potential benefits of state-funded prekindergarten programs for children who are at-risk for needing later special education services. More specifically, the study had three purposes: (1) to identify early social and academic skills that serve as predictors of special education referral at the end of kindergarten, among children without individualized education plans (IEPs) at entry to prekindergarten, (2) to investigate the associations between classroom quality in state-funded pre-kindergarten programs and special education status for this group of children, and (3) to examine whether classroom quality moderates the relation between young children’s skills and later special education placement. To explore these issues the present study draws from the National Center for Early Development and Learning’s (NCEDL) Multi-State Study of Pre-Kindergarten and the State-Wide Early Education Programs (SWEEP) study. Combined, these studies offer a sample of nearly 3,000 children from over 700 classrooms in state-funded pre-kindergarten programs in 11 states. Participants were followed longitudinally throughout their pre-kindergarten and kindergarten years. No study participants had an IEP at the start of pre-kindergarten. Results suggest that academic and social skills at the start of pre-kindergarten predict special education placement at the end of kindergarten. Specifically, both lower language and social skills were related to greater chance of later referral for special education services. Results did not support an association of classroom quality and special education status. Similarly, support was not found for an interaction between abilities of young children and classroom quality, and later special education. Limitations of the present study and implications for future research are discussed

Interaction of health value and perceived control in relation to outcome behaviours in a type 2 diabetes patient population in Scotland

Aim:To test the interactive effects of the constructs of Modified Social Learning Theory (MSLT) in relation to predicting health behaviour in Type 2 Diabetes. Methods: The study is mixed methods and employs an exploratory sequential design. Qualitative Phase: (N=12) Semi-structured interviews with adults with insulin-treated type 2 diabetes, explored how beliefs and values influence self-management behaviour. Interim Phase: Thematic analysis allowed development of an adapted Health Value Measure. Quantitative phase: (N=107) Valid questionnaires measured Health Value, Health Locus of Control (HLC) and Self-efficacy (SE). Health Value was measured pre and post diagnosis in order to compare any changes with time. Anxiety and depression was controlled for using the Hospital Anxiety and Depression(HAD) scale. Five subscales measured diabetes outcome behaviour: general diet, specific diet, exercise, blood sugar and foot care. Hierarchical Multiple Regression(HMR) analyses consisted of four blocks, including three two-way interaction terms and one three-way interaction term to test the interactive effects of the three-predictor variables on outcome behaviours. ANOVA’s were conducted in an effort to add support to HMR results. Results: The interviews suggest that people may hold terminal (beliefs about desired end states)/instrumental health values (beliefs about desired modes of action) pre-diagnosis but these are mainly instrumental post-diagnosis in order to meet their new needs and maintain quality of life. The qualitative data also drew attention to the way in which LOC and SE beliefs impact on behaviour. Additionally, differing dimensions of various emergent themes highlight the demands Type 2 diabetes places on a person and how this influences beliefs and values.Interim phase results resulted in the new items being removed from the adapted health value measure prior to the quantitative data analysis, as item 5 was deemed problematic.Sensitivity analysis was carried out to increase the robustness of the quantitative findings due to removing 29 cases with missing data from Dataset 1. Dataset 1 includes 78 complete cases and Dataset 2 contains 107 cases, 29 of which had missing values and were replaced using regression imputation. HMR analyses produced significant results that support MSLT when the three-way interaction variable was added to block 4. ANOVA results produced minimum support for MSLT. Conclusion: Support for MSLT has been found and can be used to inform interventions to change self-management behaviours of patients with poor diabetes control. Change in health value orientation post-diagnosis purports further investigation, as it is supported by qualitative results but not quantitative

What is the Effect of Frequent Basic Life Support Refresher Sessions on Health Care Professionals’ Retention of Cardiopulmonary Resuscitation Skills? A Systematic Review

Abbreviations: AED, Automated External Defibrillator; AHA, American Heart Association; BLS, Basic Life Support; CPR, Cardiopulmonary Resuscitation; EBL, Evidence Based Librarianship; IDG, Instructor Directed Group; NHMRC, National Health and Medical Research Council; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta- Analyses; RCT, Randomised Control Trial; RFST, Repetitive Sessions of Formative Self Testing; RFSTAP, Repetitive Sessions of Formative Self Testing with Additional Practice ROSC, Return of Spontaneous Circulation; SDG, Student Directed Group. Abstract Background: Cardiopulmonary resuscitation training is currently provided to health care professionals at biannual intervals to meet mandatory recertification in accordance with guidelines.  However, literature reports that resuscitation skills decline rapidly and sometimes long before recertification. Inadequate CPR may result in a decrease in the incidence of achieving return of spontaneous circulation and other devastating outcomes. Good quality training and education in cardiopulmonary resuscitation is paramount to patient survival. Brief refresher sessions may prevent skill decay among health care professionals, improving skill retention over time and improving patient outcomes. Objective: The aim of this systematic review is to determine the effect of frequent basic life support refresher sessions on health care professionals’ retention of cardiopulmonary resuscitation skills. Methods: A systematic review using narrative analysis was completed.  A database search was conducted to identify relevant studies for inclusion.  Databases searched include Medline, Embase, CINAHL and The Cochrane Library. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the review. Results: Ten of the 11 studies in this paper concluded that basic life support refresher sessions may increase retention of cardiopulmonary resuscitation skills.  Two of the included studies discussed self-perceived confidence as a secondary outcome.  One of these two studies demonstrated a significant correlation between higher self-confidence and improved retention of cardiopulmonary resuscitation skills. Conclusion: Basic life support refresher sessions can have a positive impact on cardiopulmonary resuscitation skill retention among health care professionals.  However, the most effective method of delivering refresher sessions must be further clarified.  The optimal duration of these sessions as well as the optimal timing of delivering these sessions also requires further clarification through further research

Development and psychometric evaluation of the patient knowledge of, and attitudes and behaviours towards pressure ulcer prevention instrument (KPUP)

The Patient Knowledge of, and Attitude and Behaviour towards Pressure Ulcer Prevention Instrument (KPUP) was developed and validated using a two-stage prospective psychometric instrument validation study design. In Stage 1, the instrument was designed, and it is psychometrically evaluated in Stage 2. To establish content validity, two expert panels independently reviewed each item for appropriateness and relevance. Psychometric evaluation included construct validity and stability testing of the instrument. The questionnaire was administered to a convenience sample of 200 people aged more than 65 years, living independently in the community; reliability and stability were assessed by test/retest procedures, with a 1-week interval. Mean knowledge scores at 'test' were 11.54/20 (95% CI = 11.10-11.99, SD: 3.07), and 'retest' was 12.24 (95% CI = 11.81-12.66, SD: 2.93). For knowledge, correlation between the test/retest score was positive (r=. 60), attitude section-inter-item correlations ranged from r = -.31 to r = .57 (mean intraclass correlation coefficient of r = .42), and internal consistency for the retest was the same as the test (alpha = .41 for the eight items). For health behaviours, individual inter-item correlations for test items ranged from r = -.21 to r = .41 for the 13 standardised items. Psychometric testing of the KPUP in a sample of older persons in the community provided moderate internal consistency and general high test-retest stability

Immigration in the 21st Century: Perspectives on Law and Policy

The program consisted of a keynote presentation by Linda Chavez, Chairman of the Center for Equal Opportunity, followed by a panel featuring Leticia Saucedo, Associate Professor of Law at the William S. Boyd School of Law, University of Nevada, Law Vegas; Andrea Rahal, Associate at McCandlish Holton, PC in Richmond; Robert Redmond, Jr., Partner at Williams Mullen in Richmond; Michael Hethmon, General Counsel for the Immigration Reform Law Institute; and Tim Freilich, Legal Director of the Legal Aid Justice Center\u27s Immigration Advocacy Program. Christopher Nugent, Senior Counsel at Holland & Knight, D.C. Office, served as moderator

Regulating mobility in the Peruvian Andes: road safety, social hierarchies and governmentality in Cusco's rural provinces

Significant developments in road safety regulation have taken place in Peru during recent years, reflecting international efforts to reduce worldwide fatalities and injuries. A series of measures has sought to bring about transformations in governmentality among passengers on public transport. Seen ethnographically, these have had uneven success on the ground. In rural provinces of Cusco, situated histories and sociologies of mobility have sometimes led to ambivalence, unobtrusive resistance or reinforcement of discriminatory attitudes. This article explores how reception of the regulations has been refracted through class, ethnic and geographical divisions within Peruvian society, and argues for both the applied and theoretical utility of anthropological study of road safety governance

Type II-P Supernovae from the SDSS-II Supernova Survey and the Standardized Candle Method

We apply the Standardized Candle Method (SCM) for Type II Plateau supernovae (SNe II-P), which relates the velocity of the ejecta of a SN to its luminosity during the plateau, to 15 SNe II-P discovered over the three season run of the Sloan Digital Sky Survey - II Supernova Survey. The redshifts of these SNe - 0.027 < z < 0.144 - cover a range hitherto sparsely sampled in the literature; in particular, our SNe II-P sample contains nearly as many SNe in the Hubble flow (z > 0.01) as all of the current literature on the SCM combined. We find that the SDSS SNe have a very small intrinsic I-band dispersion (0.22 mag), which can be attributed to selection effects. When the SCM is applied to the combined SDSS-plus-literature set of SNe II-P, the dispersion increases to 0.29 mag, larger than the scatter for either set of SNe separately. We show that the standardization cannot be further improved by eliminating SNe with positive plateau decline rates, as proposed in Poznanski et al. (2009). We thoroughly examine all potential systematic effects and conclude that for the SCM to be useful for cosmology, the methods currently used to determine the Fe II velocity at day 50 must be improved, and spectral templates able to encompass the intrinsic variations of Type II-P SNe will be needed.Comment: Accepted for publication by ApJ; data used in this paper can be downloaded from http://sdssdp47.fnal.gov/sdsssn/photometry/SNIIp.tgz; citation errors correcte

PTF10iya: A short-lived, luminous flare from the nuclear region of a star-forming galaxy

We present the discovery and characterisation of PTF10iya, a short-lived (dt ~ 10 d, with an optical decay rate of ~ 0.3 mag per d), luminous (M_g ~ -21 mag) transient source found by the Palomar Transient Factory. The ultraviolet/optical spectral energy distribution is reasonably well fit by a blackbody with T ~ 1-2 x 10^4 K and peak bolometric luminosity L_BB ~ 1-5 x 10^44 erg per s (depending on the details of the extinction correction). A comparable amount of energy is radiated in the X-ray band that appears to result from a distinct physical process. The location of PTF10iya is consistent with the nucleus of a star-forming galaxy (z = 0.22405 +/- 0.00006) to within 350 mas (99.7 per cent confidence radius), or a projected distance of less than 1.2 kpc. At first glance, these properties appear reminiscent of the characteristic "big blue bump" seen in the near-ultraviolet spectra of many active galactic nuclei (AGNs). However, emission-line diagnostics of the host galaxy, along with a historical light curve extending back to 2007, show no evidence for AGN-like activity. We therefore consider whether the tidal disruption of a star by an otherwise quiescent supermassive black hole may account for our observations. Though with limited temporal information, PTF10iya appears broadly consistent with the predictions for the early "super-Eddington" phase of a solar-type star disrupted by a ~ 10^7 M_sun black hole. Regardless of the precise physical origin of the accreting material, the large luminosity and short duration suggest that otherwise quiescent galaxies can transition extremely rapidly to radiate near the Eddington limit; many such outbursts may have been missed by previous surveys lacking sufficient cadence.Comment: 18 pages, 8 figures; revised following referee's comment

Human vaccination against RH5 induces neutralizing antimalarial antibodies that inhibit RH5 invasion complex interactions.

The development of a highly effective vaccine remains a key strategic goal to aid the control and eventual eradication of Plasmodium falciparum malaria. In recent years, the reticulocyte-binding protein homolog 5 (RH5) has emerged as the most promising blood-stage P. falciparum candidate antigen to date, capable of conferring protection against stringent challenge in Aotus monkeys. We report on the first clinical trial to our knowledge to assess the RH5 antigen - a dose-escalation phase Ia study in 24 healthy, malaria-naive adult volunteers. We utilized established viral vectors, the replication-deficient chimpanzee adenovirus serotype 63 (ChAd63), and the attenuated orthopoxvirus modified vaccinia virus Ankara (MVA), encoding RH5 from the 3D7 clone of P. falciparum. Vaccines were administered i.m. in a heterologous prime-boost regimen using an 8-week interval and were well tolerated. Vaccine-induced anti-RH5 serum antibodies exhibited cross-strain functional growth inhibition activity (GIA) in vitro, targeted linear and conformational epitopes within RH5, and inhibited key interactions within the RH5 invasion complex. This is the first time to our knowledge that substantial RH5-specific responses have been induced by immunization in humans, with levels greatly exceeding the serum antibody responses observed in African adults following years of natural malaria exposure. These data support the progression of RH5-based vaccines to human efficacy testing

Photobiomodulation in the management of oral mucositis for adult head and neck cancer patients receiving irradiation: the LiTEFORM RCT.

BackgroundOral mucositis is a debilitating and painful complication of head and neck cancer irradiation that is characterised by inflammation of the mucous membranes, erythema and ulceration. Oral mucositis affects 6000 head and neck cancer patients per year in England and Wales. Current treatments have not proven to be effective. International studies suggest that low-level laser therapy may be an effective treatment.ObjectivesTo assess the clinical effectiveness and cost-effectiveness of low-level laser therapy in the management of oral mucositis in head and neck cancer irradiation. To identify barriers to and facilitators of implementing low-level laser therapy in routine care.DesignPlacebo-controlled, individually randomised, multicentre Phase III superiority trial, with an internal pilot and health economic and qualitative process evaluations. The participants, outcome assessors and therapists were blinded.SettingNine NHS head and neck cancer sites in England and Wales.ParticipantsA total of 87 out of 380 participants were recruited who were aged ≥ 18 years and were undergoing head and neck cancer irradiation with ≥ 60 Gy.InterventionRandom allocation (1 : 1 ratio) to either low-level laser therapy or sham low-level laser therapy three times per week for the duration of irradiation. The diode laser had the following specifications: wavelength 660 nm, power output 75 mW, beam area 1.5 cm2, irradiance 50 mW/cm2, exposure time 60 seconds and fluence 3 J/cm2. There were 20-30 spots per session. Sham low-level laser therapy was delivered in an identical manner.Main outcome measureThe mean Oral Mucositis Weekly Questionnaire-Head and Neck Cancer score at 6 weeks following the start of irradiation. Higher scores indicate a worse outcome.ResultsA total of 231 patients were screened and, of these, 87 were randomised (low-level laser therapy arm, n = 44; sham arm, n = 43). The mean age was 59.4 years (standard deviation 8.8 years) and 69 participants (79%) were male. The mean Oral Mucositis Weekly Questionnaire-Head and Neck Cancer score at 6 weeks was 33.2 (standard deviation 10) in the low-level laser therapy arm and 27.4 (standard deviation 13.8) in the sham arm.LimitationsThe trial lacked statistical power because it did not meet the recruitment target. Staff and patients willingly participated in the trial and worked hard to make the LiTEFORM trial succeed. However, the task of introducing, embedding and sustaining new low-level laser therapy services into a complex care pathway proved challenging. Sites could deliver low-level laser therapy to only a small number of patients at a time. The administration of low-level laser therapy was viewed as straightforward, but also time-consuming and sometimes uncomfortable for both patients and staff, particularly those staff who were not used to working in a patient's mouth.ConclusionsThis trial had a robust design but lacked power to be definitive. Low-level laser therapy is relatively inexpensive. In contrast with previous trials, some patients found low-level laser therapy sessions to be difficult. The duration of low-level laser therapy sessions is, therefore, an important consideration. Clinicians experienced in oral cavity work most readily adapt to delivering low-level laser therapy, although other allied health professionals can be trained. Blinding the clinicians delivering low-level laser therapy is feasible. There are important human resource, real estate and logistical considerations for those setting up low-level laser therapy services.Future workFurther well-designed randomised controlled trials investigating low-level laser therapy in head and neck cancer irradiation are needed, with similar powered recruitment targets but addressing the recruitment challenges and logistical findings from this research.Trial registrationThis trial is registered as ISRCTN14224600.FundingThis project was funded by the National Institute for Health and Care Research ( NIHR ) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 46. See the NIHR Journals Library website for further project information