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BACKGROUND: Reliable bundle performance is the mainstay of central line-associated bloodstream infections (CLABSI) prevention despite an unclear relationship between bundle reliability and outcomes. Our primary objective was to evaluate the correlation between reported bundle compliance and CLABSI rate in the Solutions for Patient Safety network. The secondary objective was to identify which hospital and process factors impact this correlation. METHODS: We examined data on bundle compliance and monthly CLABSI rates from January 11 to December 21 in 159 hospitals. The correlation (adjusting for temporal trend) between CLABSI rates and bundle compliance was done at the network level. Negative binomial regression was done to detect the impact of hospital type, central line audit rate, and adoption of a comprehensive safety culture program on the association between bundle compliance and CLABSI rates. RESULTS: During the study, hospitals reported 27 196 CLABSI on 20 274 565 line days (1.34 CLABSI/1000 line days). Out of 2 460 133 observed bundle opportunities, 2 085 700 (84%) were compliant. There was a negative correlation between the monthly bundle reliability and monthly CLABSI rate (-0.35, P <.001). After adjusting for the temporal trend, the partial correlation was -0.25 (P = .004). On negative binomial regression, significant positive interaction was only noted for the hospital type, with Hospital Within Hospital (but not freestanding children's hospitals) revealing a significant association between compliance ≥95% and lower CLABSI rates. CONCLUSIONS: Adherence to best practice guidelines is associated with a reduction in CLABSI rate. Hospital-level factors (hospitals within hospitals vs freestanding), but not process-related (central line audit rate and safety culture training), impact this association.
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Infecciones Relacionadas con Catéteres , Cateterismo Venoso Central , Infección Hospitalaria , Niño , Humanos , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/prevención & control , Reproducibilidad de los Resultados , Cateterismo Venoso Central/efectos adversos , Adhesión a Directriz , Hospitales Pediátricos , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Control de InfeccionesRESUMEN
This meta-analysis study aims to quantify the group differences in reading skills between children with cochlear implants and their hearing peers and between children with cochlear implants and children with hearing aids (aged between 3 and 18 years old). Of the 5,642 articles screened, 47 articles met predetermined inclusion criteria (published between 2002 and 2019). The robust variance estimation based meta-analysis models were used to synthesize all the effect sizes. Children with cochlear implants scored significantly lower than their hearing peers in phonological awareness (g = -1.62, p < 0.001), vocabulary (g = -1.50, p < 0.001), decoding (g = -1.24, p < 0.001), and reading comprehension (g = -1.39, p < 0.001), but not for fluency (g = -0.67, p = 0.054). Compared to children with hearing aids, children with cochlear implants scored significantly lower in phonological awareness (g = -0.30, p = 0.028). The percentage of unilateral cochlear implant negatively impacts the group difference between children with cochlear implants and their hearing peers. Findings from this study confirm a positive shift in reading outcomes for profoundly deaf children due to cochlear implantation. Some children with cochlear implants may need additional supports in educational settings.
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Implantación Coclear , Implantes Cocleares , Sordera , Audífonos , Adolescente , Niño , Preescolar , Humanos , Lectura , VocabularioRESUMEN
Reading comprehension tests vary in format and characteristics, which may influence the extent to which component skills are involved in test performance. With students in Grades 6 to 8 with reading difficulties, dominance analyses examined the differential importance of component reading and language skills (word- and text-reading fluency, vocabulary, listening comprehension, and working memory) on several standardized tests of reading comprehension: The Gates-MacGinitie Reading Test, 4th edition (GMRT), Group Reading Assessment and Diagnostic Evaluation, Gray Oral Reading Test, 5th edition (GORT-5), and the Test of Silent Reading Efficiency and Comprehension (TOSREC). Students' word- and text-reading fluency skills were generally the most dominant predictors of performance on most reading comprehension tests, especially those with a time limit (GMRT and TOSREC). Listening comprehension was most important on the GORT-5, a test in which students read passages orally and listen to questions read by an examiner. Working memory was the least important component skill across the reading comprehension tests. Overall, results were consistent with previous work indicating that reading comprehension measures vary with regard to the skills or knowledge sources that are most important for test performance and extend these findings to struggling adolescent readers. Implications for research and practice are discussed.
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Comprensión , Lectura , Adolescente , Cognición , Humanos , Memoria a Corto Plazo , VocabularioRESUMEN
Family obligation values have been described as an important element of collectivistic cultures that are related to the development of positive emotional well-being and motivation in high school and college students. The present study tested the hypothesis that culture moderates the relationship between family obligation values and the outcomes of Korean (n = 249) and European American (n = 251) college students. The results provided support for this hypothesis. Specifically, for Koreans, family obligation values were significantly and positively correlated with descriptions of parents as being more supportive of the self-determination of their children, which was found to mediate the relationship between family obligation values and student outcomes. Furthermore, family obligation values were more strongly associated with the motivation, self-esteem, and depression of Koreans than European Americans. European American students expressed lower family obligation values and the intensity of these values were unrelated to their emotional well-being. Family obligation values were positively correlated with reports of self-determined motivation for Korean students, and negatively correlated with reports of self-determined motivation for European American students. The results are discussed in terms of cultural moderation and self-determination theory.
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Fluency with skills that operate below the word level (i.e., sublexical), such as phonemic awareness and alphabetic knowledge, may ease the acquisition of decoding skills (Ritchey & Speece, 2006). Measures of sublexical fluency such as phoneme segmentation fluency (PSF), letter naming fluency (LNF), and letter sound fluency (LSF) are widely available for monitoring kindergarten reading progress, but less is known about the relative importance of growth in each skill across the early months of formal reading instruction and their relation to subsequent decoding acquisition. With a sample of kindergarten students at risk for reading difficulties, this study investigated the extent to which initial status and growth in PSF, LNF, and LSF, administered on a progress-monitoring basis during the fall of kindergarten, were differentially predictive of word reading fluency skills at mid-year and growth across the second half the school year. We used two different fluency-based progress monitoring measures of word reading across the spring, one consisting entirely of phonetically regular consonant-vowel-consonant words, and the other that included phonetically regular and irregular words that varied in length. Results indicated that although initial status and fall growth in all sublexical fluency measures were positively associated with subsequent word reading, LSF across the fall of kindergarten was the strongest overall predictor of mid-year level and growth on both word reading measures, and unique in its prediction over the effects of LNF and PSF. Results underscore the importance of letter-sound knowledge for word reading development, and provide additional evidence for LSF as a key index of progress for at-risk learners across the early months of formal reading instruction.
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Aprendizaje , Fonética , Lectura , Preescolar , Evaluación Educacional/métodos , Femenino , Humanos , MasculinoRESUMEN
This study presents a meta-analysis of the relation between language and mathematics. A moderate relation between language and mathematics was found in 344 studies with 393 independent samples and more than 360,000 participants, r = .42, 95% CI [.40, .44]. Moderation and partial correlation analyses revealed the following: (a) more complicated language and mathematics skills were associated with stronger relations between language and mathematics; after partialing out working memory and intelligence, rapid automatized naming showed the strongest relation to numerical knowledge; (b) the relation between language and mathematics was stronger among native language speakers than among second-language learners, but this difference was not found after partialing out working memory and intelligence; (c) working memory and intelligence together explained over 50% of the variance in the relation between language and mathematics and explained more variance in such relations involving complex mathematics skills; (d) language and mathematics predicted the development of one another even after controlling for initial performance. These findings suggest that we may use language as a medium to communicate, represent, and retrieve mathematics knowledge as well as to facilitate working memory and reasoning during mathematics performance and learning. With development, the use of language to retrieve mathematics knowledge may be more important for foundational mathematics skills, which in turn further strengthens linguistic thought processes for performing more advanced mathematics tasks. Such use of language may boost the mutual effects of cognition and mathematics across development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).