The Clinical and Classroom Utility of the Inventory of Reading Occupations: An Assessment Tool of Children’s Reading Participation

Background: The aim of this study was to determine the initial clinical and classroom utility of the Inventory of Reading Occupations (IRO), a new tool to assess children’s reading participation. Method: The study used phenomenological qualitative and descriptive methods. The participants included 38 occupational therapists, speech-language pathologists, classroom teachers, and parents who completed or reviewed responses of children on the IRO. To provide triangulation, 20 of the children who completed the IRO were interviewed. Data were thematically analyzed and then categorized using a central Strengths-Weaknesses-Opportunities-Threats premise. Results: The majority of the participants indicated favorable response to the clinical and classroom utility of the tool. Common themes were (a) the IRO is a user-friendly and engaging assessment that allows students to reflect on their reading participation; (b) the IRO is more suitable for children who engage in more structured reading; (c) the IRO can be adapted for older children; and (d) there is a need to identify whether the IRO is better as a screening or a full assessment tool. Conclusion: The study provided useful perspectives on how the tool can be further improved as a measure of the reading participation of school-aged children

Validity of self-reported versus actual age in Nepali children and young people

• Self-reported age is a potential source of misclassification bias in International Surveys. • We compare objectively recorded age with self-reported age at mean age 11.5 years in 3943 children in rural Nepal. • There was high agreement between actual and self-reported age with an error rate of 7%

Determining the Internal Validity of the Inventory of Reading Occupations: An Assessment Tool of Children’s Reading Participation

The Inventory of Reading Occupations (IRO) is an assessment tool of children’s reading participation. In this study, we used Rasch methods to determine the internal validity of the IRO. Participants included 192 typical and struggling readers from kindergarten to third grade from five different states in the United States. We analyzed the fit of each of the items in the 17 reading categories, the test items in the three dimensions of reading participation, and the contexts of reading in the IRO. Analysis indicated that the IRO items support the Rasch model of unidimensionality. Analysis also indicated that 1 of the 30 test items can be revised to strengthen test validity. Moreover, the analysis also suggested that the IRO is more useful for first- to third-grade students. This study provides evidence of internal validity of a useful tool to assess children’s reading participation

Epigenetic regulation of POMC; implications for nutritional programming, obesity and metabolic disease.

Proopiomelanocortin (POMC) is a key mediator of satiety. Epigenetic marks such as DNA methylation may modulate POMC expression and provide a biological link between early life exposures and later phenotype. Animal studies suggest epigenetic marks at POMC are influenced by maternal energy excess and restriction, prenatal stress and Triclosan exposure. Postnatal factors including energy excess, folate, vitamin A, conjugated linoleic acid and leptin may also affect POMC methylation. Recent human studies suggest POMC DNA methylation is influenced by maternal nutrition in early pregnancy and associated with childhood and adult obesity. Studies in children propose a link between POMC DNA methylation and elevated lipids and insulin, independent of body habitus. This review brings together evidence from animal and human studies and suggests that POMC is sensitive to nutritional programming and is associated with a wide range of weight-related and metabolic outcomes

Interval Outcomes of a Lifestyle Weight-Loss Intervention in Early Adolescence

We undertook a feasibility study to reassess metabolic outcomes in young people with early onset obesity who attended a hospital-based lifestyle weight-loss intervention during adolescence. Comparisons of metabolic assessments, including body mass index standard deviation scores (BMI–SDSs), blood pressure (BP), oral glucose tolerance tests (OGTTs), lipid profile, and alanine transaminase (ALT), before and after treatment were made. Twenty-five subjects (10 males) with median ages (interquartile range, IQR) of 14.5 (12.6–15.4) years at the beginning of intervention and 18.2 (17.2–18.9) years at reassessment and who were 3.5 (2.4–6.5) years post-intervention were recruited. Twenty-eight percent had a ≥0.25 reduction in BMI–SDS from baseline (responders). Responders demonstrated significantly lower BMI–SDS, systolic BP, and glucose disposal at reassessment compared with baseline. They also showed significantly lower total fat percentage SDSs, trunk fat percentages, 120 min insulin, and ALT, as well as higher insulin sensitivity index (ISIcomp) than non-responders. Male gender and younger age at the initiation of intervention showed a non-significant trend towards greater success in weight loss. Long-term benefits were demonstrated in around one-quarter of obese adolescents after lifestyle modification treatment, with associated improvements in body composition and metabolic parameters

Interaction of Chemistry, Turbulence, and Shock Waves in Hypervelocity Flow

Significant progress was made in the third year of an interdisciplinary experimental, numerical and theoretical program to extend the state of knowledge and understanding of the effects of chemical reactions in hypervelocity flows. The program addressed the key problems in aerothermochemistry that arise from.the interaction between the three strongly nonlinear effects: Compressibility; vorticity; and chemistry. Important new results included: • New data on transition in hypervelocity carbon dioxide flows • New method of free-piston shock tunnel operation for lower enthalpy • Accurate new method for computation of self-similar flows • New experimental data on flap-induced separation at high enthalpy • Insight into mechanisms active in reacting shear layers from comparison of experiment and computation • Extensive new data from Rayleigh scattering diagnostics of supersonic shear layer • Comparison of new experiments and computation of hypervelocity double-wedge flow yielded important differences • Further first-principles computations of electron collision cross-sections of CO, N_2 and NO • Good agreement between EFMO computation and experiment of flow over a cone at high incidence • Extension of LITA diagnostics to high temperature

Electromagnetic Reduction of Plasma Density During Atmospheric Reentry and Hypersonic Flights

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76341/1/AIAA-32147-259.pd

Treatment adherence and BMI reduction are key predictors of HbA1c one year after diagnosis of childhood Type 2 Diabetes in UK

Background/Objective: Type 2 Diabetes (T2DM) is increasing in childhood especially among females and South-Asians. Our objective was to report outcomes from a national cohort of children and adolescents with T2DM 1 year following diagnosis. Methods: Clinician reported, 1-year follow-up of a cohort of children (<17 years) diagnosed with T2DM reported through the British Paediatric Surveillance Unit (BPSU) (April 2015-April 2016). Results: One hundred (94%) of 106 baseline cases were available for review. Of these, five were lost to follow up and one had a revised diagnosis. Mean age at follow up was 15.3 years. Median BMI standard deviation scores (SDS) was 2.81 with a decrease of 0.13 SDS over a year. HbA1c <48 mmol/mol (UK target) was achieved in 38.8%. logHbA1c was predicted by clinician reported compliance and attendance concerns (β = 0.12, P = <0.0001) and change in body mass index (BMI) SDS at 1-year (β = 0.13, P=0.007). In over 50%, clinicians reported issues with compliance and attendance. Mean clinic attendance was 75%. Metformin was the most frequently used treatment at baseline (77%) and follow-up (87%). Microalbuminuria prevalence at 1-year was 16.4% compared to 4.2% at baseline and was associated with a higher HbA1c compared to those without microalbuminuria (60 vs 49 mmol/mol, P = 0.03). Conclusions: Adherence to treatment and a reduction in BMI appear key to better outcomes a year after T2DM diagnosis. Retention and clinic attendance are concerning. The prevalence of microalbuminuria has increased 4-fold in the year following diagnosis and was associated with higher HbA1c

The PACT Study: results of a time series study investigating the impact, acceptability and cost of an integrated model for psychosocial screening, care and treatment of patients with urological and head and neck cancers

Background: The significant psychosocial morbidity experienced by cancer patients is often undetected and untreated. Despite international priority given to psychosocial care for cancer patients, implementation of psychosocial programs into routine cancer care is limited. We developed, implemented, and assessed the impact, acceptability, and cost of an integrated, patient-centered Psychosocial Assessment, Care and Treatment (PACT) model of care for cancer patients within a general hospital setting. Methods: A time series research design was implemented to test the PACT model of care, newly introduced in an Australian tertiary hospital. System-level impact on systematic distress screening and management was assessed through audit of the medical records of three cross-sectional samples of 141 patients, at baseline and at 12 and 24 months post-baseline. The impact of the model on patient experience and health care professionals’ (HCPs) knowledge and confidence was assessed via surveys. The acceptability of the intervention was assessed through HCP interviews at 24 months. The cost of the intervention was assessed by PACT staff recording the time spent on care provision, training, and intervention administration, and associated costs were calculated using staff payment rates adjusted for superannuation and leave. Results: Across the 24 months of implementation, formal distress screening increased from 0% at baseline to 29% of patients at 12 months and 31% of patients at 24 months, with an associated decrease in informal screening as formal screening increased. There was no notable change in distress management (ie, development of care plans) across the time period. Baseline patient experience was already high (mean score = 46.85/55) and did not change significantly over the course of the study. In both general and specific areas of addressing patient psychosocial concerns, HCP knowledge and confidence was moderate and remained largely unchanged over the course of the study. HCPs perceived the PACT model as highly beneficial and instrumental in bringing about significant changes to staff's knowledge, practices and awareness of psychosocial issues. The estimated total labor cost (including on-costs) was AUD$119,239 (over the 2 years); with a declining cost over the lifetime of the intervention reflecting the higher initial set-up costs. Conclusions: Although the PACT model was associated with an increase in distress screening, staff workloads, high turnover, and administrative barriers may have restricted the translation into distress management. Future research exploring effective avenues to engage staff at a management level and ensure that staff view distress management as a valuable component of their role may assist to embed strategies into the general hospital culture and lead to more sustainable changes