Measuring children's behavioral regulation in the preschool classroom: An objective, sensor-based approach.

Children's abilities to regulate their behaviors are critical for learning and development, yet researchers lack an objective, precise method for assessing children's behavioral regulation in their everyday environments such as their classrooms. This study tested a sensor-based approach to assess preschool children's behavioral regulation objectively, precisely, and naturalistically. Children wore accelerometer devices as they engaged in center-based play in their preschool classrooms for roughly 45 min (N = 50 children, 48% female, mean age = 4.5 years). Set to record data each second, these devices collected information about children's movement (N = 140,564 observations). From these data, the authors extracted concrete behaviors hypothesized to index behavioral regulation and compared them with teacher and observer ratings of the same. Initiating movement more frequently, staying seated in activities for shorter amounts of time, and spending a greater amount of time in motion were related to lower ratings of attention and inhibitory control by teachers and by observers of classroom group time, median r = .45, p < .01. These same objectively measured behaviors showed only weak associations with children's performance on assessments of cognitive regulation, median r = .11, p = .47. The findings indicate that ambulatory accelerometers can capture movement-based indicators of children's behavioral regulation in the classroom setting and that performance on measures of cognitive regulation does not strongly predict children's behavior in the classroom. As an unobtrusive and objective measure, actigraphy may become an important tool for studying children's behavioral regulation in everyday contexts.

Atypical presentations in the hospitalised older adult testing positive for SARS-CoV-2: a retrospective observational study in Glasgow, Scotland.

Introduction: Understanding of how SARS-CoV-2 manifests itself in older adults was unknown at the outset of the pandemic. We undertook a retrospective observational analysis of all patients admitted to older people's services with confirmed COVID-19 in one of the largest hospitals in Europe. We detail presenting symptoms, prognostic features and vulnerability to nosocomial spread. Methods: We retrospectively collected data for each patient with a positive SARSCoV-2 RT PCR between 18th March and the 20th April 2020 in a department of medicine for the elderly in Glasgow. Results: 222 patients were included in our analysis. Age ranged from 56 to 99 years (mean = 82) and 148 were female (67%). 119 patients had a positive swab for SARS-CoV-2 within the first 14 days of admission, only 32% of these patients presented with primarily a respiratory type illness. 103 patients (46%) tested positive after 14 days of admission - this was felt to represent likely nosocomial infection. 95 patients (43%) died by day 30 after diagnosis. Discussion: This data indicates that older people were more likely to present with non-respiratory symptoms. High clinical frailty scores, severe lymphopenia and cumulative comorbidities were associated with higher mortality rates. Several contributing factors will have led to nosocomial transmission.

Advocating zoster vaccination in a community pharmacy through use of personal selling.

OBJECTIVE: To evaluate whether the use of personal selling, in combination with other promotional techniques, could improve patient commitment to receive the targeted intervention of herpes zoster vaccine (Zostavax-Merck). SETTING: Two locally owned grocery store chain pharmacies in the Kansas City, MO, metropolitan area (Price Chopper Pharmacy 11 [PC11] and Price Chopper Pharmacy 36 [PC36]). PRACTICE DESCRIPTION: Price Chopper Pharmacy employs pharmacists who are able to administer vaccinations to patients within the dispensing workflow. PRACTICE INNOVATION: Passive signage promoting zoster vaccine was placed at both PC11 and PC36. Personal selling by pharmacy staff to targeted patients was implemented at PC36, where patients were encouraged to receive zoster vaccine at prescription pick up and/or by personalized letter. MAIN OUTCOME MEASURES: Primary measures included comparison of the number committing to receive zoster vaccine at either pharmacy, comparison of patient perceptions regarding each pharmacy's promotion of zoster vaccine, and pharmacy staff time spent identifying targeted patients and performing personal selling activities. RESULTS: 90 of 745 targeted patients (12.1%) at PC36 made commitments to receive zoster vaccine compared with 9 of 614 (1.5%) at PC11 (P < 0.001). The barrier of "Dr. hasn't told me I need it" was reduced for PC36 patients (P < 0.05). Patients receiving vaccination had a more favorable attitude toward receiving zoster vaccine than unvaccinated patients (P < 0.01). Among unvaccinated patients, those at PC36 had a more favorable attitude toward receiving zoster vaccine after interacting with a pharmacist (P < 0.05). CONCLUSION: Personal selling increased patient commitment to receiving a targeted intervention significantly. By using personal selling, pharmacists resolved barriers to immunization.

Total Play Time Needed for Preschoolers to Reach Recommended Amount of Non-Sedentary Activity.

Health guidelines suggest that caregivers provide preschoolers with opportunities to be physically active for 3 h per day (roughly 15 min per waking hour), but because children are not continuously active, it is unclear what amount of time is needed to reach this goal. This naturalistic study enrolled 67 children (M = 4.5 years, 46% female) who wore accelerometers to measure their activity during indoor and outdoor free -play (N = 315,061 s). An hour of indoor play was insufficient for most children to reach 15 min of physical activity. When outside, most children reached 15 min of physical activity after slightly more than 30 min. Children engaged in outdoor activity sporadically (1.7 starts/stops per minute). Most physical activity occurred in bouts shorter than 20 s. Indoor free-play does not, on its own, provide sufficient opportunity for preschoolers to engage in physical activity consistent with health guidelines. As a result, outdoor play for at least 30 min at a time has a key role in meeting these guidelines.

Preschoolers' executive functions following indoor and outdoor free play.

BACKGROUND: Children's executive functions develop rapidly during the preschool years and are critical for attending to lessons and meeting classroom expectations. Engaging in periods of outdoor play that have lower regulatory requirements and that provide opportunities for physical activity may help children maintain control over their behavior when they are back in settings with higher regulatory requirements. However, little work has formally examined this proposition in early childhood. METHODS: This study used a quasi-experimental design to examine preschoolers' executive functions following indoor compared to outdoor play. A total of 72 children (mean age = 4.5 years, 46% female, 73% non-Hispanic White) participated in task-based assessments of attention shifting and inhibitory control and in classroom observations of attention and inhibitory control. A subsample of the children (n = 51) was assessed for physical activity using accelerometry to examine the extent to which young children's physical activity during outdoor play predicted their subsequent executive functions better than their physical activity during indoor play. RESULTS: Children showed greater attention during classroom circle time following outdoor play compared to after indoor play (d = .34). Children's non-sedentary activity during indoor play was not related to their subsequent task-based executive functions but showed negative associations with their subsequent classroom-based executive functions. Children's percentage of time spent in non-sedentary physical activity during outdoor play showed a quadratic association with subsequent task-based inhibitory control but linear associations with subsequent classroom-based attention and inhibitory control during circle time. CONCLUSION: Periods of outdoor play that involve recommended amounts of physical activity may help young children engage executive functions when they return to the classroom.

Ambient Temperature Increases and Preschoolers' Outdoor Physical Activity.

This cross-sectional study evaluates the association of high outdoor temperatures with children's engagement in physical activity during play.

Credentialing of pharmacy technicians in the USA.

OBJECTIVE: This review will compare the USA and UK regarding pharmacy technicians' roles, it will summarize the current roles and responsibilities of pharmacy technicians in the USA, public perception of pharmacy technicians, pharmacy organizations' perspectives on pharmacy technician credentialing, academic programmes for pharmacy technicians, accreditation of pharmacy technician programmes, pharmacy technician certification exams and differing perspectives on the push for standardized technician training. It will conclude with observations regarding the importance of standardized pharmacy technician training. METHODS: Articles were identified via searches of PubMed and IPA from inception to November 2010 related to credentialing of pharmacy technicians. Search terms included pharmacy technician, pharmacy technician certification, pharmacy registration, technician education and technician requirements. Articles describing the roles and responsibilities of a technician, public perception of technicians, demographics, certification processes and the future of technician roles were included. An Internet search was also performed to identify articles in the lay press related to this topic. KEY FINDINGS: Providing a pharmacy technician with proper training and education is necessary for operating a successful pharmacy. In the USA, mandating a national standardized training programme is the source of the debate. Current rules and regulations regarding the training and education needed for a pharmacy technician vary from state to state in the USA. Attitudes of technicians towards standardized training may be difficult to change. CONCLUSION: This paper provides a review of pharmacy technicians' roles and responsibilities across different pharmacy settings. Although the literature provides some insight, more studies are needed to assess the value and impact of the knowledge and skills possessed by certified pharmacy technicians with standardized training compared with technicians with site-specific or limited training.