565 research outputs found

    Interaction Effects of Socioeconomic Status on Emerging Literacy and Literacy Skills among Pre-Kindergarten and Kindergarten Children: A Comparison Study

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    Socioeconomic differences in children’s reading and educational outcomes have been thoroughly documented throughout literature. Bobalik, Scarber, and Toon (2017) examined the link between socioeconomic status (SES) and classroom instruction on emerging literacy skills in pre-kindergarten children. The results supported the theory that children identified as belonging to a low socioeconomic status enter school with lower emerging literacy skills and benefit most from academic instruction; these children’s literacy skills substantially increased throughout the academic year, growing closer to those of their peers who were identified with a high socioeconomic status. The aim of the present study was to expand our understanding of the interaction effects of socioeconomic status and curriculum on emerging literacy and literacy skills by continuing the research into kindergarten. This study examined whether 1) differences in groups continued to grow closer to the mean or 2) the differences in groups became greater with the introduction of reading skills in kindergarten. Children (N=33) were recruited from a private school and a public school. The children from the public school who qualified for the Federal Poverty Guidelines for free/reduced lunch were assigned as having a low socioeconomic status, and children from the private school were assigned as having a high socioeconomic status. The Phonological Awareness Literacy Screening – K (PALS-K) was used to measure the literacy skills in the kindergarten children. Results of the study indicated that literacy scores between the socioeconomic groups were not significantly different at the kindergarten level, however differences between the mean scores of the pre-kindergarten and kindergarten groups were found to be significant

    Aggregation of Fine Particles at the Sediment-Water Interface

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    The presence of a bottom sediment layer agitated by mechanical stirring or by resident organisma (tubificid oligochaetes) significantly increases the rate at which fine (1 µm) cohesive particles are removed from suspension in laboratory columns. Measured rates of particle removal are equivalent to deposition velocities ranging from 0.23 m per day to 0.41 m per day. These rates are an order of magnitude faster than deposition by gravitational settling or coagulation with larger particles in the water column as observed in experimental controls. It is hypothesized that the increased removal rate is the result of aggregation in a sediment layer at the bed-water interface characterized by loosely bound (fluffy), porous material hydrodynamically coupled to the water column. According to this hypothesis particle removal occurs when motion of the overlying water or organism activity causes suspended fine particles to collide with and stick to the interfacial sediment. This new hypothesis is supported by the mass and size distribution of tracer particles recovered in cores and sediment traps at a coastal site and by theoretical estimates of interfacial aggregation rates.This work was supported by EPA grant CR-81181-01-01, by the MIT Sea Grant College Program, under NOAA Grant NA86AA-D-SG089, and by a postgraduate scholarship awarded to the second author by the Natural Sciences and Engineering Research Council of Canada.https://agupubs.onlinelibrary.wiley.com/doi/abs/10.1029/92JC0182

    Britain and the Soviet Union: The search for an interim agreement on West Berlin November 1958-May 1960.

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    This thesis analyses British and Soviet policy towards negotiations on an Interim Agreement on Berlin, from November 1958 until May 1960. It emphasises the crucial role played by the British Prime Minister, Harold Macmillan and the Soviet Premier, Nikita Khrushchev, both of whom viewed the Berlin problem within the wider context of their mutual objectives of achieving detente and disarmament. The opening chapter analyses Soviet motivation for reactivating the Berlin question, and emphasises two factors behind Soviet policy: the maintenance of the status quo in Germany and Eastern Europe, and Soviet fears of the nuclearisation of the Bundeswehr. The next two chapters reassess Britain's response to the Soviet Note of 27 November 1958, the impact of British policy on Berlin on the Western Alliance and the subsequent emergence of a British initiative on Berlin which culminated in Harold Macmillan's visit to Moscow in February 1959. Fresh insights into Soviet policy on Berlin and European Security are offered. The fourth chapter reappraises Macmillan's visits in March 1959 to Paris, Bonn and Washington to persuade his Allies of the benefits of his initiative. This chapter also deals with the British contribution both to the Allied debate on contingency planning for Berlin and to the discussions on Germany, European Security and Berlin, which took place in the Four Power Working Group from January until May 1959. The ensuing chapter analyses British and Soviet attitudes to the East-West negotiations on an Interim Agreement on West Berlin at the Geneva Foreign Ministers Conference, May-August 1959, and considers whether the British Government was correct in its perception that the Soviet Government wished to establish a modus vivendi on Berlin. Chapter six traces the evolution of Soviet and Western policies towards the forthcoming summit conference from August 1959 until May 1960. The final chapter examines Soviet and Western reactions to the U-2 Incident of 1 May 1960 and seeks to demonstrate that Khrushchev left for Paris prepared to negotiate on an Interim Agreement on Berlin, and hopeful that he would achieve the East-West Detente for which he and Macmillan had striven

    The Effects of a Web-Based Tool for Parents of Children With Juvenile Idiopathic Arthritis: Randomized Controlled Trial

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    Background: Juvenile idiopathic arthritis (JIA) is a group of autoinflammatory diseases that cause pain and disability if not controlled by treatment. Parenting a child with JIA is stressful for parents, who express concerns about their child’s treatment and may experience anxiety and powerlessness concerning their child’s illness. Parenting stress is greater in parents of children with chronic illness than in those with healthy children and is related to poorer psychological adjustment in both parents and children. It is therefore important to develop interventions to support parents. This paper reports the evaluation of a web-based tool that provides information and practical skills to help increase parents’ confidence in managing their child’s illness and reduce parenting stress. Objective: The aim of this study is to evaluate the benefits of a web-based tool (WebParC) for parents of children with recently diagnosed JIA. Methods: A multicentered randomized controlled trial was conducted at pediatric rheumatology centers in England. We recruited parents of children aged ≤12 years who had been diagnosed with JIA within the previous 6 months. They were randomized to the intervention (WebParC access plus standard care) or the control (standard care alone) and followed up 4 months and 12 months after randomization. Where both parents participated, they were randomized by household to the same trial arm. The WebParC intervention consists of information about JIA and its treatment plus a toolkit, based on cognitive behavioral therapy, to help parents develop skills to manage JIA-related issues. The primary outcome was the self-report Pediatric Inventory for Parents measure of illness-related parenting stress. The secondary outcomes were parental mood, self-efficacy, coping, effectiveness of participation in their child’s health care, satisfaction with health care, and child’s health-related quality of life. Results: A total of 203 households comprising 220 parents were randomized to the intervention (100/203, 49.3%) or control (103/203, 50.7%) arm. Follow-up assessments were completed by 65.5% (133/203) of the households at 4 months (intervention 60/100, 60%, and control 73/103, 70.9%) and 61.1% (124/203) of the households at 12 months (intervention 58/100, 58%, and control 66/103, 64.1%). A main effect of the trial arm was found on the Pediatric Inventory for Parents: the intervention participants reported less frequency (subscales communication F1,120627=5.37; P=.02, and role function F1,27203=5.40; P=.02) and difficulty (subscales communication F1,2237=7.43; P=.006, medical care F1,2907=4.04; P=.04, and role function F1,821=4.37, P=.04) regarding illness-related stressful events than the control participants. Conclusions: The WebParC website for parents of children with JIA reduced illness-related parenting stress. This web-based intervention offers a feasible preventive approach for parents of children with JIA and potentially could be adapted and evaluated for parents of children with other chronic illnesses. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN) 13159730; http://www.isrctn.com/ISRCTN1315973

    Does the Method of Biopsy Affect the Incidence of Sentinel Lymph Node Metastases?

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    More detailed examination of the sentinel lymph node (SLN) in breast cancer has raised concerns about the clinical significance of micrometastases, specifically isolated tumor cells detected only through immunohistochemical (IHC) staining. It has been suggested that these cells do not carry the same biologic implications as true metastatic foci and may represent artifact. A retrospective institutional review board-approved review was conducted on clinically node-negative breast cancer patients who underwent SLN biopsy (SLNB) between 1997 and 2003. Retrospective analysis of tumor characteristics and the method of the initial diagnostic biopsy were correlated with the presence and nature of metastatic disease in the SLN. Of 537 SLNBs, 123 (23%) were hematoxylin-eosin (H&E) positive. SLN positivity strongly correlated with tumor size (p < 0.001) and tumor grade (p = 0.025), but not with the method of biopsy (needle versus excisional biopsy). Prior to July 2002, we routinely evaluated H&E-negative SLNs with IHC ( n  = 381). Of the 291 H&E-negative patients, 26 had IHC-only detected micrometastases (9%). The likelihood of detecting IHC-only metastases did not correlate with tumor size or grade, but was significantly higher in patients undergoing excisional biopsy than core needle biopsy. While the method of biopsy has no demonstrable effect on the likelihood of finding metastases in the SLN by routine serial sectioning and H&E staining, it may significantly impact the likelihood of finding micrometastases by IHC. IHC should not be used routinely in the evaluation of the SLN and caution should be used when basing treatment decisions (completion axillary lymph node dissection or adjuvant therapy) on IHC-only detected micrometastases.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72849/1/j.1075-122X.2006.00179.x.pd

    Social Competence Treatment after Traumatic Brain Injury: A Multicenter, Randomized, Controlled Trial of Interactive Group Treatment versus Non-Interactive Treatment

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    Objective To evaluate the effectiveness of a replicable group treatment program for improving social competence after traumatic brain injury (TBI). Design Multicenter randomized controlled trial comparing two methods of conducting a social competency skills program, an interactive group format versus a classroom lecture. Setting Community and Veteran rehabilitation centers. Participants 179 civilian, military, and veteran adults with TBI and social competence difficulties, at least 6 months post-injury. Experimental Intervention Thirteen weekly group interactive sessions (1.5 hours) with structured and facilitated group interactions to improve social competence. Alternative (Control) Intervention Thirteen traditional classroom sessions using the same curriculum with brief supplemental individual sessions but without structured group interaction. Primary Outcome Measure Profile of Pragmatic Impairment in Communication (PPIC), an objective behavioral rating of social communication impairments following TBI. Secondary Outcomes LaTrobe Communication Questionnaire (LCQ), Goal Attainment Scale (GAS), Satisfaction with Life Scale (SWLS), Post-Traumatic Stress Disorder Checklist – (PCL-C), Brief Symptom Inventory 18 (BSI-18), Scale of Perceived Social Self Efficacy (PSSE). Results Social competence goals (GAS) were achieved and maintained for most participants regardless of treatment method. Significant improvements in the primary outcome (PPIC) and two of the secondary outcomes (LCQ and BSI) were seen immediately post-treatment and at 3 months post-treatment in the AT arm only, however these improvements were not significantly different between the GIST and AT arms. Similar trends were observed for PSSE and PCL-C. Conclusions Social competence skills improved for persons with TBI in both treatment conditions. The group interactive format was not found to be a superior method of treatment delivery in this study

    Using the behaviour change wheel and person-based approach to develop a digital self-management intervention for patients with adrenal insufficiency: the Support AI study protocol

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    Introduction: Most patients with Adrenal insufficiency (AI) require lifelong glucocorticoid replacement. They need to increase glucocorticoids during physical illness or major stressful situations and require parenteral hydrocortisone in the event of an adrenal crisis. Patients with AI have impaired quality of life and high mortality; approximately 1 in 6-12 patients are hospitalised at least once/year from a potentially preventable adrenal crisis. Adoption of self-management behaviours are crucial; these include adherence to medication, following “sick day rules” and associated behaviours that aid prevention and treatment of adrenal crisis such as symptom monitoring, having extra tablets, carrying a medical-alert ID and injection kit, and self-injecting when necessary. Current patient education is ineffective at supporting self-management behaviour change or reducing adrenal crisis-related hospitalisations. This research study aims to gain an in-depth understanding of the barriers and enablers to self-management for patients with AI and to develop an evidence-based digital self-management behaviour change intervention. / Methods: The study is conducted in accordance with the MRC Framework for developing complex interventions. Underpinned by the Behaviour Change Wheel (BCW), the Theoretical Domains Framework (TDF), and the Person-Based Approach, this research will be conducted in two phases: Phase 1 will involve a sequential qualitative/quantitative mixed-methods study involving focus group interviews followed by a cross-sectional survey with patients with AI recruited from patient advocacy groups and endocrine clinics in the UK. Phase 2 will develop the Support AI, a website-based digital behaviour change intervention (DBCI) informed by Phase 1 findings to support self-management for patients with AI. The most appropriate behaviour change techniques (BCTs) will be selected utilising a nominal group technique with an Expert Panel of 10-15 key stakeholders. The design of the Support AI website will be guided by the Person-Based Approach using an Agile iterative “think-aloud” technique with 12-15 participants over 3 usability testing iterations. / Conclusion: A theory- and evidence-based digital behaviour change intervention will be developed which will be tested in a feasibility randomised trial following completion of this study. The projected benefit includes cost-effective health care service (reduced hospitalisations and demand for specialist services) and improved health outcomes and quality of life for patients with AI

    Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients

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    There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children’s Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology
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