Changing and Choosing Together: A Case Study on Improving Professional Development and Student Achievement Through a Teacher-Initiated Early Literacy Program

The purpose of this study was to ascertain teacher\u27s perceptions of the success of an early literacy professional development program designed to achieve more meaningful student assessment, facilitate observation of effective teaching practices, promote teacher-centered staff development, and encourage greater teacher collaboration. This research study also examined the extent to which teachers believed that school- and district-administrative support for this program benefited their classroom teaching practices

Penalized smoothing splines resolve the curvature identifiability problem in age-period-cohort models with unequal intervals

Age-period-cohort (APC) models are frequently used in a variety of health and demographic-related outcomes. Fitting and interpreting APC models to data in equal intervals (equal age and period widths) is nontrivial due to the structural link between the three temporal effects (given two, the third can always be found) causing the well-known identification problem. The usual method for resolving the structural link identification problem is to base a model on identifiable quantities. It is common to find health and demographic data in unequal intervals, this creates further identification problems on top of the structural link. We highlight the new issues by showing that curvatures which were identifiable for equal intervals are no longer identifiable for unequal data. Furthermore, through extensive simulation studies, we show how previous methods for unequal APC models are not always appropriate due to their sensitivity to the choice of functions used to approximate the true temporal functions. We propose a new method for modeling unequal APC data using penalized smoothing splines. Our proposal effectively resolves the curvature identification issue that arises and is robust to the choice of the approximating function. To demonstrate the effectiveness of our proposal, we conclude with an application to UK all-cause mortality data from the Human mortality database.</p

El Poder de los Padres: Volunteering in a Multicultural Parent-Child Group that Supports Language Development and Literacy Skills

Award for Best Our Husky Compact Reflection Engage as a Member of a Diverse and Multicultural World. Abstract The Greater St. Cloud Area Multicultural Parent-Child Group (El Poder de los Padres) provides intensive intervention to parents and children in the greater St. Cloud area through weekly 2-hour sessions during the academic year. Sessions include songs, activities, and crafts that facilitate the development of language and literacy skills in preschool-aged children. In addition, there is a parent education component, in which parents discuss a relevant language and/or literacy topic each week. St. Cloud State University graduate students from the Communication Sciences and Disorders program, in collaboration with a faculty advisor, create, implement, and reflect on a lesson plan for each session. The strategies in the lesson plan are based on research regarding language and literacy development. Volunteers support the group by providing individual instruction to children, assisting in group transitions, and interact with the children during free play times to foster language development. El Poder de los Padres collaborates with the ROCORI School District to empower, enrich, and educate Latino parents in Stearns County. The program is funded through a United Way of Central Minnesota Early Language/Early Literacy Grant

Estimating Subnational Under-Five Mortality Rates Using a Spatio-Temporal Age-Period-Cohort Model

Producing subnational estimates of the under-five mortality rate (U5MR) is a vital goal for the United Nations to reduce inequalities in mortality and well-being across the globe. There is a great disparity in U5MR between high-income and Low-and-Middle Income Countries (LMICs). Current methods for modelling U5MR in LMICs use smoothing methods to reduce uncertainty in estimates caused by data sparsity. This paper includes cohort alongside age and period in a novel application of an Age-Period-Cohort model for U5MR. In this context, current methods only use age and period (and not cohort) for smoothing. With data from the Kenyan Demographic and Health Surveys (DHS) we use a Bayesian hierarchical model with terms to smooth over temporal and spatial components whilst fully accounting for the complex stratified, multi-staged cluster design of the DHS. Our results show that the use of cohort may be useful in the context of subnational estimates of U5MR. We validate our results at the subnational level by comparing our results against direct estimates.Comment: 16 pages, 6 Figures, 2 Table

Referral for specialist follow-up and its association with post-discharge mortality among patients with systolic heart failure (from the National Heart Failure Audit for England and Wales)

For patients admitted with worsening heart failure, early follow-up after discharge is recommended. Whether outcomes can be improved when follow-up is done by cardiologists is uncertain. We aimed to determine the association between cardiology follow-up and risk of death for patients with heart failure discharged from hospital. Using data from the National Heart Failure Audit (England &amp; Wales), we investigated the effect of referral to cardiology follow-up on 30-day and one-year mortality in 68 772 patients with heart failure and a reduced left ventricular ejection fraction (HFREF) discharged from 185 hospitals between 2007 to 2013. The primary analyses used instrumental variable analysis complemented by hierarchical logistic and propensity matched models. At the hospital level, rates of referral to cardiologists varied from 6% to 96%. The median odds ratio (OR) for referral to cardiologist was 2.3 (95% confidence interval [CI] 2.1, 2.5), suggesting that, on average, the odds of a patient being referred for cardiologist follow-up after discharge differed approximately 2.3 times from one randomly selected hospital to another one. Based on the proportion of patients (per region) referred for cardiology follow-up, referral for cardiology follow-up was associated with lower 30-day (OR 0.70; CI 0.55, 0.89) and one-year mortality (OR 0.81; CI 0.68, 0.95) compared with no plans for cardiology follow-up (i.e., standard follow-up done by family doctors). Results from hierarchical logistic models and propensity matched models were consistent (30-day mortality OR 0.66; CI 0.61, 0.72 and 0.66; CI 0.58, 0.76 for hierarchical and propensity matched models, respectively). For patients with HFREF admitted to hospital with worsening symptoms, referral to cardiology services for follow-up after discharge is strongly associated with reduced mortality, both early and late

Does in utero HIV exposure and the early nutritional environment influence infant development and immune outcomes? Findings from a pilot study in Pretoria, South Africa

BACKGROUND : As mother-to-child transmission of HIV decreases, and the population of infants who are born HIV-exposed, but uninfected (HEU) continues to rise, there is a growing need to understand the development and health outcomes of infants who are HEU to ensure that they have the healthiest start to life. METHODS : In a prospective cohort pilot study at Kalafong Hospital, Pretoria, South Africa, we aimed to determine if we could recruit new mothers living with HIV on antiretrovirals (ART; n = 20) and not on ART (n = 20) and new mothers without HIV (n = 20) through our clinics to study the effects of HEU on growth and immune- and neurodevelopment in infants in early life, and test the hypothesis that infants who were HEU would have poorer health outcomes compared to infants who were HIV-unexposed, uninfected (HUU). We also undertook exploratory analyses to investigate relationships between the early nutritional environment, food insecurity and infant development. Infant growth, neurodevelopment (Guide for Monitoring Child Development [GMCD]) and levels of monocyte subsets (CD14, CD16 and CCR2 expression [flow cytometry]) were measured in infants at birth and 12 weeks (range 8–16 weeks). RESULTS : We recruited 33 women living with HIV on ART and 22 women living without HIV within 4 days of delivery from June to December 2016. Twenty-one women living with HIV and 10 without HIV returned for a follow-up appointment at 12 weeks postpartum. The high mobility of this population presented major challenges to participant retention. Preliminary analyses revealed lower head circumference and elevated CCR2+ (% and median fluorescence intensity) on monocytes at birth among infants who were HEU compared to HUU. Maternal reports of food insecurity were associated with lower maternal nutrient intakes at 12 weeks postpartum and increased risk of stunting at birth for infants who were HEU, but not infants who were HUU. CONCLUSIONS : Our small feasibility pilot study suggests that HEU may adversely affect infant development, and further, infants who are HEU may be even more vulnerable to the programming effects of suboptimal nutrition in utero and postnatally. This pilot and preliminary analyses have been used to inform our research questions and protocol in our ongoing, full-scale study.Additional file 1: Supplementary Figure S1. Sequential gating approach for the measurement of CCR2 expression by CD14+ monocytes. The sequential gating approached used was as follows: First, the viable (7-AAD negative; region ‘Viable”) cells were identified using a 7-AAD vs SS Log density plot. A “Viable” region was created around the 7-AAD negative cells. Gated on the “Viable”cells, a SSLog vs FS plot was used to capture intact cells in the “E” region. CD14+ monocytes were identified (“CD14+” region) using a CD14 vs SS Log density plot that were gated on viable, intact cells (“E” region). CD14+ monocytes that express CCR2 were quantified using a CD192 (CCR2) vs SS Log plot. The proportion of CD14+/CCR2+ cells were captured in the “CD14+ CCR2+” region. The gating strategy followed to quantify CCR2 expression by CD16+ neutrophils was similar to what was described for CD14+ monocytes, but instead of identifying CD14+ monocytes, CD16+ neutrophils were identified (“CD16+” region) using a CD16 vs SS Log density plot that were gated on viable, intact cells (“E” region). CD16+ neutrophils that express CCR2 were quantified using a CD192 (CCR2) vs SS Log plot. The proportion of CD14+/CCR2+ cells was captured in the “CD16+ CCR2+” region.Additional file 2: Supplementary Figure S2. Sequential gating approach for the measurement of CCR2 expression by monocyte subpopulations. Doublets and debris were removed (Region ‘K’) using a FS Area vs FS Height density plot. A 7-AAD vs SS Log density plot, gated on ‘K’ was used to exclude all non-viable cells. Viable cells were captured in region ‘Viable’. Viable CD14+ monocytes were identified (Region ‘CD14+ Monocytes’) using a CD14 APC vs SS Log density plot. Monocyte sub-populations were identified using a CD16 FITC vs CD14 PE density plot gated on viable, CD14+ monocytes. Four monocyte sub-populations were identified: CD14+/CD16-; CD14++/CD16-; CD14+/CD16+; and CD14++/CD16+. The percentage CCR2+ monocytes present in each of the respective monocyte sub-populations were identified using CD195 (CCR2) PE vs SS Log two-parameter plots gated on the respective subpopulations. The overlay plots within the black bordered square indicates the strategy used to determine CCR2 expression of the different monocyte subsets. The negative/positive staining boundaries were determined based on the negative expression of CCR2 by CD16++/CD14- neutrophils (indicated in red in the overlay plots). The CCR2+ populations are indicated in blue.Additional file 3: Supplementary Figure S3. Maternal intake of estimated average requirements for macronutrients, vitamins and minerals for mothers who report on household food security circumstances. Maternal reports of food insecurity did not associate with intake levels of macronutrients or minerals. Maternal reports of experiencing food runout or inability to afford balanced meals associated with lower intake of vitamin B12 (p=0.01; p=0.04). Many women, irrespective of food security reports, are at risk of inadequate macronutrient, vitamin and mineral intakes. Percent intake of EARs for 36 nutrients were calculated for lactating women 14-18, 19-30 or 31-50 years of age [37]. Calculations for EAR for total protein considered maternal weight at time of dietary recall. Data are % intake of EAR reported in maternal dietary recall for macronutrients, *p<0.05 [ANOVA for normal distribution/ equal variance; Kruskal-Wallis/Wilcoxon test for nonparametric data; or Welch’s test for normal data/unequal variance]). CHO = carbohydrates.Additional file 4: Supplementary Figure S4. Cooccurrence of maternal HIV and food insecurity may increase risk of stunting at birth. Amongst infants whose mothers report worrying about food runout, risk of stunting at birth is greater for HEU compared to HUU infants (e; RR=4.90 [0.76, 31.5], ARD=0.56 [0.17, 0.94], p=0.0498). The red line represents the proportion of infants who had stunting at birth or 12 weeks PP. Mosaic plots are proportion (%) of HUU or HEU infants who have stunting (<-2 SD length-for-age standardised according to WHO child growth standards [28]) at birth and 12 weeks old. HUU = HIV-unexposed, uninfected infant; HEU = HIV-exposed, uninfected infant. RR = Relative risk. ARD = Absolute risk difference.Additional file 5: Supplementary Figure S5. Food insecurity may associate with low attainment of GMCD milestones for HUU and HEU infants. Infants whose mothers reported household food insecurity did not attain 1-3 month GMCD milestones (A, C, E) for receptive language, large movement, relating and response behaviour or play activities, or 3-5 month GMCD milestones (B, D, F) for fine movement or relating and response behaviour in the same proportion as the international standardization sample. Maternal reports of food insecurity did not associate with risk of not attaining all 1-3 month or 3-5 month GMCD milestones (A-F, [p>0.05], Fisher’s exact 2-Tail). Data are proportion (%) of infants who attained all age-appropriate GMCD milestones. The horizontal dotted line represents the GMCD standardised international sample proportion (85%) of infants who attained all milestones in that age category, when they were in that age range. The numbers underneath the bars represent the number of infants attaining all milestones for each milestone. GMCD = Guide for monitoring child development; HUU = HIVunexposed, uninfected infant; HEU = HIVexposed, uninfected infant.Additional file 6: Supplementary Table S1. Flow cytometry reagent list (including lasers and detectors used). Supplementary Table S2. Flow cytometry compensation matrix. Supplementary Table S3. Maternal nutrient intakes from one 24-hour dietary recall for mothers with and without HIV who attended follow up. Supplementary Table S4. Maternal nutrient intake from one 24-hour dietary recall for mothers who report experiencing food insecurity compared to those who do not experience food insecurity.The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER); the Faculty of Science, Carleton University; the Canadian Institutes of Health Research (CIHR); a Canadian Graduate Scholarship-Master’s and a Michael Smith Foreign Study Supplement from CIHR.https://pilotfeasibilitystudies.biomedcentral.comam2021ImmunologyObstetrics and GynaecologyPaediatrics and Child Healt