Readiness for Change: Evidence from a Study of Early Childhood Care and Education Centers

This study examines factors that influence staff members’ readiness for change in early childhood settings in Ireland. The introduction of a new national framework, designed to improve the quality of Early Childhood Care and Education Centers (ECCECs), has been piloted in several communities. This study measures support for this change in organizational practices using the Organizational Change Recipients’ Belief Scale and uses correlation analysis to determine how readiness for change is linked to job satisfaction and the work environment. Results show that individual staff characteristics had little impact on support for the change, while factors related to group dynamics were significantly associated with readiness for change. Specifically, a positive work environment and greater job satisfaction were associated with a lower belief that there is a need for change, but a higher belief that the staff will be supported by management if the change is introduced.

Investigating the clinical use of structured light plethysmography to assess lung function in children with neuromuscular disorders

BackgroundChildren and young people with neuromuscular disorders (NMD), such as Duchenne Muscular Dystrophy (DMD), develop progressive respiratory muscles weakness and pulmonary restriction. Pulmonary function monitoring of the decline in lung function allows for timely intervention with cough assist techniques and nocturnal non-invasive ventilation (NIV). NMD may find the measurement of lung function difficult using current techniques. Structured Light Plethysmography (SLP) has been proposed as a novel, non-contact, self-calibrating, non-invasive method of assessing lung function. The overarching aim of this study was to investigate the use of SLP as a novel method for monitoring respiratory function in children with neuromuscular disease.MethodsSLP thoraco-abdominal (TA) displacement was correlated with forced vital capacity measurements recorded by spirometry and the repeatability of the measurements with both methods examined. SLP tidal breathing parameters were investigated to assess the range and repeatability of regional right and left side TA displacement and rib cage and abdominal wall displacement.ResultsThe comparison of the FVC measured with SLP and with spirometry, while having good correlation (R = 0.78) had poor measurement agreement (95% limits of agreement: -1.2 to 1.2L) The mean relative contribution of right and left TA displacement in healthy controls was 50:50 with a narrow range. Repeatability of this measure with SLP was found to be good in healthy controls and moderate in NMD children with/without scoliosis but with a wider range. The majority of the control group displayed a predominant rib cage displacement during tidal breathing and those who displayed predominant abdominal wall displacement showed displacement of both regions close to 50:50 with similar results for the rib cage and abdomen. In comparison, children with NMD have a more variable contribution for all of these parameters. In addition, SLP was able to detect a reduction in abdominal contribution to TA displacement with age in the DMD group and detect paradoxical breathing in children with NMD. Using SLP tracings during tidal breathing we were able to identify three specific patterns of breathing amongst healthy individuals and in children with NMD.ConclusionsSLP is a novel method for measuring lung function that requires limited patient cooperation and may be especially useful in children with neuromuscular disorders. Measuring the relative contributions of the right and left chest wall and chest versus abdominal movements allows a more detailed assessment

Circulating 250HD, dietary vitamin D, PTH, and calcium associations with incident cardiovascular disease and mortality: The MIDSPAN Family Study

<p>Context: Observational studies relating circulating 25-hydroxyvitamin D (25OHD) and dietary vitamin D intake to cardiovascular disease (CVD) have reported conflicting results.</p> <p>Objective: Our objective was to investigate the association of 25OHD, dietary vitamin D, PTH, and adjusted calcium with CVD and mortality in a Scottish cohort.</p> <p>Design and Setting: TheMIDSPAN Family Study is a prospective study of 1040 men and 1298 women from the West of Scotland recruited in 1996 and followed up for a median 14.4 yr. Participants: Locally resident adult offspring of a general population cohort were recruited from 1972–1976.</p> <p>Main Outcome Measures: CVD events (n = 416) and all-cause mortality (n=100) were evaluated.</p> <p>Results: 25OHD was measured using liquid chromatography-tandem mass spectrometry in available plasma (n=2081). Median plasma 25OHD was 18.6 ng/ml, and median vitamin D intake was 3.2 µ g/d (128 IU/d). Vitamin D deficiency (25OHD<15 ng/ml) was present in 689 participants (33.1%). There was no evidence that dietary vitamin D intake, PTH, or adjusted calcium were associated with CVD events or with mortality. Vitamin D deficiency was not associated with CVD (fully adjusted hazard ratio=1.00; 95% confidence interval=0.77–1.31). Results were similar after excluding patients who reported an activity-limiting longstanding illness at baseline (18.8%) and those taking any vitamin supplements (21.7%). However, there was some evidence vitamin D deficiency was associated with all-cause mortality (fully adjusted hazard ratio=2.02; 95% confidence interval=1.17–3.51).</p> <p>Conclusion: Vitamin D deficiency was not associated with risk of CVD in this cohort with very low 25OHD. Future trials of vitamin D supplementation in middle-aged cohorts should be powered to detect differences inmortality outcomes as well as CVD.(J Clin EndocrinolMetab97: 0000 –0000, 2012)</p&gt

Readiness for change : evidence from a study of early childhood care and education centers

This study examines factors that influence staff members’ readiness for change in early childhood settings in Ireland. The introduction of a new national framework, designed to improve the quality of Early Childhood Care and Education Centers (ECCECs), has been piloted in several communities. This study measures support for this change in organizational practices using the Organizational Change Recipients’ Belief Scale and uses correlation analysis to determine how readiness for change is linked to job satisfaction and the work environment. Results show that individual staff characteristics had little impact on support for the change, while factors related to group dynamics were significantly associated with readiness for change. Specifically, a positive work environment and greater job satisfaction were associated with a lower belief that there is a need for change, but a higher belief that the staff will be supported by management if the change is introduced.Not applicabl

Readiness for change : evidence from a study of early childhood care and education centers

This study examines factors that influence staff members’ readiness for change in early childhood settings in Ireland. The introduction of a new national framework, designed to improve the quality of Early Childhood Care and Education Centers (ECCECs), has been piloted in several communities. This study measures support for this change in organizational practices using the Organizational Change Recipients’ Belief Scale and uses correlation analysis to determine how readiness for change is linked to job satisfaction and the work environment. Results show that individual staff characteristics had little impact on support for the change, while factors related to group dynamics were significantly associated with readiness for change. Specifically, a positive work environment and greater job satisfaction were associated with a lower belief that there is a need for change, but a higher belief that the staff will be supported by management if the change is introduced.Not applicabl

Preparing for Life early childhood intervention : impact evaluation report 1 : recruitment and baseline characteristics

Not applicabl

Measuring Investment in Human Capital Formation: An Experimental Analysis of Early Life Outcomes

The literature on skill formation and human capital development clearly demonstrates that early investment in children is an equitable and efficient policy with large returns in adulthood. Yet little is known about the mechanisms involved in producing these long-term effects. This paper presents early evidence on the nature of skill formation based on an experimentally designed, five-year home visiting program in Ireland targeting disadvantaged families - Preparing for Life (PFL). We examine the impact of investment between utero to 18 months of age on a range of parental and child outcomes. Using the methodology of Heckman et al. (2010a), permutation testing methods and a stepdown procedure are applied to account for the small sample size and the increased likelihood of false discoveries when examining multiple outcomes. The results show that the program impact is concentrated on parental behaviors and the home environment, with little impact on child development at this early stage. This indicates that home visiting programs can be effective at offsetting deficits in parenting skills within a relatively short timeframe, yet continued investment may be required to observe direct effects on child development. While correcting for attrition bias leads to some changes in the precision of estimates, overall the results are quite similar.Not applicable19/8/2013. SB