Systematic review of the associations of SWPBS with exclusionary discipline and disproportionality in U.S. schools.

In response to patterns of educational inequity, many schools implement system-wide behavioral frameworks to reduce exclusionary discipline. School-wide positive behavior supports (SWPBS) is one such framework that seeks to support socially appropriate behavior by enhancing the capacity of schools to implement research-validated practices. However, there remains to be a systematic analysis of the extent to which SWPBS improves educational equity by reducing disparities in exclusionary discipline. The purpose of the systematic review was to evaluate research on the association of SWPBS with exclusionary discipline and racial discipline disproportionality. In total, 42 articles met the full inclusion criteria of a literature search conducted between 2018 and 2020. Study results were mixed regarding whether SWPBS was associated with reductions in exclusionary discipline and only a few studies provided evidence that SWPBS helps reduce exclusionary discipline disproportionality. Limitations of this research signal a need for attention to both data disaggregation and root causes of continued disproportionate discipline practices.

No "Top of the triangle kids": Toward conceptual clarity of students, behavior, and tiers in MTSS to advance social justice.

Schools have increasingly adopted multitier systems of support to address a variety of educational aims. Despite their grounding in behavioral science and the public health model of prevention, in many settings there has been a shift from a foundational focus on behavioral principles to emphasize categorization and treatment of "top of the triangle" or "Tier 3" students. Herein, we first discuss how such emphasis on situating individuals, rather than behaviors, within the continuum of supports is counter to the principles and goals of MTSS, as well as undermining efforts to support prevention and social justice. Next, we apply a critical lens to review the related literature on problem-solving, labeling, marginalization of disabled students, and discipline disparities to provide a rationale for equity-centered MTSS with corresponding recommendations for practice.

Review of State Policies and Guidance for the Identification of Culturally and Linguistically Minoritized Students With Specific Learning Disabilities.

The identification of specific learning disabilities (SLD) remains fraught with controversy and uncertainty about professionals' capacity to appropriately identify special education eligibility. For students from linguistically minoritized backgrounds, the exclusionary clause prohibits the identification of learning difficulties primarily attributable to contextual or linguistic factors. Yet the ambiguity of the federal language may hinder application, making critical states' interpretation and corresponding guidance for professional practice in eligibility determination. In this archival study, we systematically reviewed state departments' education policies and related guidance on the identification of multilingual learners with SLD, with a focus on how states have articulated policies and procedures related to the federal exclusionary clause. Our findings demonstrate variability and depth of information across states pertaining to guidance regarding the exclusionary clause. Implications for practice and policy are provided.

Bridging science and spirituality: the intersection of religion and public health in the COVID-19 pandemic.

Background: The COVID-19 pandemic has had global impacts on social interactions and religious activities, leading to a complex relationship between religion and public health policies. This article reviews impact of the COVID-19 pandemic on religious activities and beliefs in relation to the spread of the virus, as well as the potential of religious leaders and faith communities in mitigating the impact of the pandemic through public health measures and community engagement. Methods: A literature review was conducted using PubMed and Google Scholar, with search terms including "religion," "COVID-19," "pandemic," "coronavirus," and "spirituality." We included English articles published between January 2020 and September 2022, focusing on intersection of religion and COVID-19. Results: We identified two main themes emerging, with the selected 32 studies divided in 15 studies focused on the relationship between religious practices, beliefs, and the spread of COVID-19, while 17 studies explored the role of religious leaders and faith communities in coping with and mitigating the impact of COVID-19. Religious activities were found to correlate with virus spread, particularly in early days of the pandemic. The relationship between religiosity and adherence to government guidelines was mixed, with some studies suggesting increased religiosity contributed to misconceptions about the virus and resistance to restrictions. Religious beliefs were also associated with vaccine hesitancy, particularly conservative religious beliefs. On the other hand, religious leaders and communities played a crucial role in adapting to COVID-19 measures, maintaining a sense of belonging, fostering emotional resilience, and upholding compliance with public health measures. The importance of collaboration between religious leaders, institutions, and public health officials in addressing the pandemic was emphasized. Conclusions: This review highlights the essential role of religious leaders, faith-based organizations, and faith communities in promoting education, preparedness, and response efforts during the COVID-19 pandemic. Engaging with religious leaders and communities can improve pandemic control and prevention efforts. Collaboration between religious leaders, governments, and healthcare professionals is necessary to combat vaccine hesitancy and ensure successful COVID-19 vaccination campaigns. The insights from this review can guide future research, policy development, and public health interventions to minimize the impact of the pandemic and improve outcomes for individuals and communities affected.

Treatment Modalities for Internet Addiction in Children and Adolescents: A Systematic Review of Randomized Controlled Trials (RCTs).

BACKGROUND: In recent years, the use of the internet among children and adolescents has dramatically increased, leading to growing concerns regarding the potential risks of excessive internet use and addiction. Addressing these concerns, this systematic review aims to summarize current evidence on the effectiveness of treatment interventions for internet addiction among children and adolescents. METHOD: We performed a systematic review using PubMed, Web of Science, PsycInfo, and Google Scholar with search terms including "internet addiction", "problematic internet use", "children" or "adolescents", "treatment" and "randomized controlled trial". We found 10 Randomized Controlled Trials (RCTs) meeting the criteria and included them in this systematic review. RESULTS: This systematic review analyzed 10 randomized controlled trials focused on treatment interventions for internet addiction in adolescents and young adults. The interventions used were diverse, including cognitive-behavioral therapy (CBT), medication, electro-acupuncture (EA), and solution-focused approaches. The measures used to assess the effectiveness of the interventions also varied, but most studies reported moderate to large effect sizes for at least some outcomes. Overall, the studies suggest that interventions such as CBT and EA can be effective in reducing symptoms of internet addiction, internet gaming disorder, and unspecified internet use disorders. School-based programs and brief manualized CBT programs also show promise, though more research is needed to determine their long-term effectiveness. CONCLUSION: Promising treatment approaches for internet addiction are emerging, but inconsistencies in conceptualization, language, and diagnostic criteria present some challenges. The growing recognition of problematic internet use, as shown by the DSM-5's recognition of Internet Gaming Disorder, highlights the need for a multidisciplinary approach and standardized criteria to facilitate accurate reporting across studies. Continued research is needed to identify effective treatments and diagnostic criteria for internet addiction, with the potential to offer practical insights into effective medications and therapies.

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications.

INTRODUCTION AND OBJECTIVES: The opioid overdose epidemic is exacerbated by the emergence of Xylazine as an illicit drug adulterant. Xylazine, a veterinary sedative, can potentiate opioid effects while also causing toxic and potentially fatal side effects. This systematic review aims to assess the impact of Xylazine use and overdoses within the opioid epidemic context. METHOD: A systematic search was conducted following PRISMA guidelines to identify relevant case reports, and case series related to Xylazine use. A comprehensive literature search included databases like Web of Science, PubMed, Embase, and Google Scholar, utilizing keywords and Medical Subject Headings (MeSH) terms related to Xylazine. Thirty-four articles met the inclusion criteria for this review. RESULTS: Intravenous (IV) administration was a common route for Xylazine use among various methods, including subcutaneous (SC), intramuscular (IM), and inhalation, with overall doses ranging from 40 mg to 4300 mg. The average dose in fatal cases was 1,200 mg, compared to 525 mg in non-fatal cases. Concurrent administration of other drugs, primarily opioids, occurred in 28 cases (47.5%). Intoxication was identified as a notable concern in 32 out of 34 studies, and treatments varied, with the majority experiencing positive outcomes. Withdrawal symptoms were documented in one case study, but the low number of cases with withdrawal symptoms may be attributed to factors such as a limited number of cases or individual variation. Naloxone was administered in eight cases (13.6%), and all patients recovered, although it should not be misconstrued as an antidote for Xylazine intoxication. Of the 59 cases, 21 (35.6%) resulted in fatal outcomes, with 17 involving Xylazine use in conjunction with other drugs. The IV route was a common factor in six out of the 21 fatal cases (28.6%). CONCLUSION: This review highlights the clinical challenges associated with Xylazine use and its co-administration with other substances, particularly opioids. Intoxication was identified as a major concern, and treatments varied across the studies, including supportive care, naloxone, and other medications. Further research is needed to explore the epidemiology and clinical implications of Xylazine use. Understanding the motivations and circumstances leading to Xylazine use, as well as its effects on users, is essential for developing effective psychosocial support and treatment interventions to address this public health crisis.

Academic achievement and relations to externalizing behavior: Much ado about nothing?

Some of the worst long-term outcomes of children are associated with the presence of externalizing behavior and low academic achievement. However, the nature of the causal and predictive relationship between these two domains remains contested due to inconsistent findings in previous literature. Leveraging a nationally representative sample (N = 7330) from the Early Childhood Longitudinal Study (ECLS)-Kindergarten Cohort of 2011, we used latent class growth analysis and machine learning cross validation techniques to analyze the association of early math and reading achievement with the development of externalizing behavior trajectories in elementary school. Several theoretically and empirically important covariates were utilized to develop a profile of learners in each trajectory. Results indicated stable teacher ratings of behavior across kindergarten to fifth grade and three primary trajectories, consisting of (1) higher persistent, (2) low persistent, and (3) no problem behavior. Importantly, teacher rated early inattention and approaches to learning behaviors, rather than direct standardized measures of academic achievement, were the strongest malleable predictors to trajectory membership. Student demographics, including being a boy and identifying as Black, contributed to these students being almost twice as likely to belong to the higher problem behavior trajectory as compared to girls and White peers. Educational implications for intervention, as well as the influence of implicit bias and structural racism in the role of teacher ratings, are discussed.

Academic training of authors publishing in high-impact epidemiology and clinical journals.

BACKGROUND: To inform training program development and curricular initiatives, quantitative descriptions of the disciplinary training of research teams publishing in top-tier clinical and epidemiological journals are needed. Our objective was to assess whether interdisciplinary academic training and teamwork of authors publishing original research in 15 top-tier journals varied by year of publication (2000/2010/2020), type of journal (epidemiological/general clinical/specialty clinical), corresponding author gender, and time since the corresponding author completed formal training relative to the article publication date (<5/≥5 years). METHODS AND FINDINGS: We invited corresponding authors of original research articles to participate in an online survey (n = 103; response rate = 8.3% of 1240 invited authors). In bivariate analyses, year of publication, type of journal, gender, and recency of training were not significantly associated with interdisciplinary team composition, whether a co-author with epidemiological or biostatistical training was involved in any research stage (design/analysis/interpretation/reporting), or with participants' confidence in their own or their co-authors epidemiological or biostatistical expertise (p > 0.05 for each comparison). Exceptions were participants with more recent epidemiological training all had co-author(s) with epidemiological training contribute to study design and interpretation, and participants who published in 2020 were more likely to report being extremely confident in their epidemiological abilities. CONCLUSIONS: This study was the first to quantify interdisciplinary training among research teams publishing in epidemiological and clinical journals. Our quantitative results show research published in top-tier journals generally represents interdisciplinary teamwork and that interdisciplinary training may provide publication type options. Our qualitative results show researchers view interdisciplinary training favorably.

Addressing TB-related mortality in adults living with HIV: a review of the challenges and potential solutions.

Tuberculosis (TB) is the leading cause of death in people living with HIV (PLHIV) globally, causing 208,000 deaths in PLHIV in 2019. PLHIV have an 18-fold higher risk of TB, and HIV/TB mortality is highest in inpatient facilities, compared with primary care and community settings. Here we discuss challenges and potential mitigating solutions to address TB-related mortality in adults with HIV. Key factors that affect healthcare engagement are stigma, knowledge, and socioeconomic constraints, which are compounded in people with HIV/TB co-infection. Innovative approaches to improve healthcare engagement include optimizing HIV/TB care integration and interventions to reduce stigma. While early diagnosis of both HIV and TB can reduce mortality, barriers to early diagnosis of TB in PLHIV include difficulty producing sputum specimens, lower sensitivity of TB diagnostic tests in PLHIV, and higher rates of extra pulmonary TB. There is an urgent need to develop higher sensitivity biomarker-based tests that can be used for point-of-care diagnosis. Nonetheless, the implementation and scale-up of existing tests including molecular World Health Organization (WHO)-recommended diagnostic tests and urine lipoarabinomannan (LAM) should be optimized along with expanded TB screening with tools such as C-reactive protein and digital chest radiography. Decreased survival of PLHIV with TB disease is more likely with late HIV diagnosis and delayed start of antiretroviral (ART) treatment. The WHO now recommends starting ART within 2 weeks of initiating TB treatment in the majority of PLHIV, aside from those with TB meningitis. Dedicated TB treatment trials focused on PLHIV are needed, including interventions to improve TB meningitis outcomes given its high mortality, such as the use of intensified regimens using high-dose rifampin, new and repurposed drugs such as linezolid, and immunomodulatory therapy. Ultimately holistic, high-quality, person-centered care is needed for PLHIV with TB throughout the cascade of care, which should address biomedical, socioeconomic, and psychological barriers.

Predicting Airborne Infection Risk: Association Between Personal Ambient Carbon Dioxide Level Monitoring and Incidence of Tuberculosis Infection in South African Health Workers.

BACKGROUND: High rates of tuberculosis (TB) transmission occur in hospitals in high-incidence countries, yet there is no validated way to evaluate the impact of hospital design and function on airborne infection risk. We hypothesized that personal ambient carbon dioxide (CO2) monitoring could serve as a surrogate measure of rebreathed air exposure associated with TB infection risk in health workers (HWs). METHODS: We analyzed baseline and repeat (12-month) interferon-γ release assay (IGRA) results in 138 HWs in Cape Town, South Africa. A random subset of HWs with a baseline negative QuantiFERON Plus (QFT-Plus) underwent personal ambient CO2 monitoring. RESULTS: Annual incidence of TB infection (IGRA conversion) was high (34%). Junior doctors were less likely to have a positive baseline IGRA than other HWs (OR, 0.26; P = .005) but had similar IGRA conversion risk. IGRA converters experienced higher median CO2 levels compared to IGRA nonconverters using quantitative QFT-Plus thresholds of ≥0.35 IU/mL (P < .02) or ≥1 IU/mL (P < .01). Median CO2 levels were predictive of IGRA conversion (odds ratio [OR], 2.04; P = .04, ≥1 IU/mL threshold). Ordinal logistic regression demonstrated that the odds of a higher repeat quantitative IGRA result increased by almost 2-fold (OR, 1.81; P = .01) per 100 ppm unit increase in median CO2 levels, suggesting a dose-dependent response. CONCLUSIONS: HWs face high occupational TB risk. Increasing median CO2 levels (indicative of poor ventilation and/or high occupancy) were associated with higher likelihood of HW TB infection. Personal ambient CO2 monitoring may help target interventions to decrease TB transmission in healthcare facilities and help HWs self-monitor occupational risk, with implications for other airborne infections including coronavirus disease 2019.

The role of counselling in tuberculosis diagnostic evaluation and contact tracing: scoping review and stakeholder consultation of knowledge and research gaps.

BACKGROUND: Tuberculosis (TB) care cascade analyses show large gaps at early stages, including care-seeking and diagnostic evaluation, where promising interventions to decrease attrition are urgently needed. Person-centered care is prioritized in the World Health Organization's End TB strategy; yet little is known about how it is delivered and can be optimized. Recommendations for counselling, a core component of person-centered care, are largely limited to its role in improving TB treatment adherence. The role of counselling to close key diagnostic gaps in the care cascade is poorly understood. METHODS: We conducted a scoping review to identify evidence on the use of counselling at TB diagnosis, for both people with presumptive TB and index patients to promote patient retention and contact tracing. Using search terms for TB, diagnosis and counselling, we systematically searched PubMed, EMBASE and Web of Science. Two independent reviewers screened all abstracts, full-texts, extracted data and conducted a quality assessment. We used thematic analysis to identify key themes. RESULTS: After screening 1785 articles, we extracted data from 15 studies and determined that the major themes best corresponded to the following gaps in the TB care cascade: care-seeking, pre-diagnosis, and pre-treatment. Studies were conducted across varied settings including pharmacies, primary health centres, and clinics, primarily in high TB incidence countries. No study directly evaluated the impact of counselling on outcomes such as treatment initiation or retention in care. Included studies suggested counselling may play an important role in improving the uptake of diagnostic testing and contact tracing. Barriers to counselling included time and personnel requirements. Stakeholder consultation emphasized the importance of high-quality counselling as a core tenet of TB care. CONCLUSION: Data on the impact of counselling to improve TB case detection are absent from the literature. The shift towards person-centred care for TB presents an opportunity to incorporate counselling during earlier stages of the TB care cascade; however, evidence-based approaches are needed. Implementation research is needed to operationalize and evaluate counselling to strengthen high-quality TB care delivery.

Escaping the fate of Sisyphus: assessing resistome hybridization baits for antimicrobial resistance gene capture.

Finding, characterizing and monitoring reservoirs for antimicrobial resistance (AMR) is vital to protecting public health. Hybridization capture baits are an accurate, sensitive and cost-effective technique used to enrich and characterize DNA sequences of interest, including antimicrobial resistance genes (ARGs), in complex environmental samples. We demonstrate the continued utility of a set of 19 933 hybridization capture baits designed from the Comprehensive Antibiotic Resistance Database (CARD)v1.1.2 and Pathogenicity Island Database (PAIDB)v2.0, targeting 3565 unique nucleotide sequences that confer resistance. We demonstrate the efficiency of our bait set on a custom-made resistance mock community and complex environmental samples to increase the proportion of on-target reads as much as >200-fold. However, keeping pace with newly discovered ARGs poses a challenge when studying AMR, because novel ARGs are continually being identified and would not be included in bait sets designed prior to discovery. We provide imperative information on how our bait set performs against CARDv3.3.1, as well as a generalizable approach for deciding when and how to update hybridization capture bait sets. This research encapsulates the full life cycle of baits for hybridization capture of the resistome from design and validation (both in silico and in vitro) to utilization and forecasting updates and retirement.

A call to action for school psychology to address COVID-19 health disparities and advance social justice.

The health, economic, and social challenges associated with coronavirus disease 2019 (COVID-19) present a range of threats to students' well-being, psychoeducational experiences, and outcomes, spurring fears for a "lost generation." In this article, we present COVID-19 as a large-scale multisystemic disaster causing massive disruptions and losses, with adversities moderated by the intersectional nature of systemic inequity. We first synthesize the broad effects of COVID-19 as they relate to equity and social justice, followed by the major implications for students and schools, with a focus on intersectional systemic issues. We then propose foundational considerations and resources intended to usher a paradigm shift in how school psychologists' roles and activities are conceptualized in the years to come, ending with key imperatives for practice and graduate education in school psychology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Agricultural development addresses food loss and waste while reducing greenhouse gas emissions.

Food loss and waste (FLW) reduce food available for consumption and increase the environmental burden of production. Reducing FLW increases agricultural and value-chain productivity and may reduce greenhouse gas emissions associated with feeding the global population. Although studies of interventions that reduce FLW exist, almost no research systematically investigates FLW interventions across multiple value chains or countries, most likely due to challenges in collecting and synthesizing data and estimates, let alone estimating greenhouse gas emissions. Our research team investigated changes in FLW in projects supported by the United States Agency for International Development's (USAID) global hunger and food security initiative, Feed the Future. This was a unique opportunity to conduct ex-ante estimates of the impacts of FLW interventions across 20 value chains in 12 countries, based on project documents and interviews with USAID and project staff. This paper describes specific interventions in each value chain and country context, providing insight to interventions that decrease FLW at multiple points along food value chains, from upstream producer-dominated stages to downstream consumer-dominated stages. Amongst the sub-sectors studied, FLW interventions directed at extensive dairy systems could decrease FLW by 4-10%, providing meaningful greenhouse gas mitigation, since these systems are both emission-intensive and experience high FLW. More modest emissions reductions were found for other key agricultural products, including maize, rice, vegetables, fruits and market goods.

Are school psychologists' special education eligibility decisions reliable and unbiased?: A multi-study experimental investigation.

Nearly 50 years of research show persistent racial disproportionality in the identification of special education disabilities, but the underlying mechanisms for these disparities remain largely unexplored. Because ambiguous regulations defining disabilities may allow subjectivity and unlawful differential treatment (i.e., racial bias or discrimination) in the special education eligibility process, an important target of study is disparate treatment of students by race in evaluations required to determine eligibility. School psychologists have long been recognized as highly influential in this process and in schools' resultant decisions. We used a 3 × 2 mixed factorial experimental design in three studies with simulated case report data to measure the influence of race and assessment data on school psychologists' perceptions of students' eligibility for special education in cases centering on emotional disturbance, intellectual disability, or autism, respectively. Participants included 302 practicing school psychologists in three states across the three experiments. There was little evidence of racial disparity, but participants tended to render decisions unsupported by, and even contrary to, evaluation data. Implications for research, practice, and professional development are discussed.

Linear-linear piecewise growth mixture models with unknown random knots: A primer for school psychology.

Studying change over time requires rigorous and sometimes novel statistical methods that can support increasingly complex applied research questions. In this article, we provide an overview of the potential of piecewise growth mixture models. This type of longitudinal model can be used to advance our understanding of group and individual growth that may follow a segmented, or disjointed, pattern of change, and where the data come from a mixture of two or more latent classes. We then demonstrate the practical utility of piecewise growth mixture models by applying it to a subsample of students from the Early Childhood Longitudinal Study - Kindergarten Cohort of 1998 (ECLS-K) to ascertain whether mathematics achievement is characterized by one or two latent classes akin to students with and without mathematics difficulties. We discuss the applicability for school psychological research and provide supplementary online files that include an instructional sample dataset and corresponding R routine with explanatory annotations to assist in understanding the R routine before applying this approach in novel applications (https://doi.org/10.1016/j.jsp.2019.03.004).

The need for mapping personal goals to exercise dosage in community-based exercise programs for people with Parkinson's disease.

Purpose: Community-based exercise can support long-term management of Parkinson's disease, although it is not known if personal goals are met in these programs. The objectives of this study were to: (1) examine the goals of community based exercise programs from the participant and instructor perspectives; (2) establish the extent to which these programs meet self-described exercise outcomes; and (3) explore participant and instructor perspectives on barriers to meeting exercise expectations. Materials and Methods: This study explores the experiences of people with Parkinson's disease participating in a structured exercise program at six community sites. A mixed-methods approach was used, including participant and instructor interviews, assessment of exercise intensity, and mapping of exercise dosage to participant goals. Twenty-four exercise participants provided interview, quality of life, and exercise intensity data. Results: Twenty-one participants exercised for primary management of their Parkinson's disease. None met the exercise dosage necessary to meet this primary objective, although 60% met exercise dosage required to prevent disuse deconditioning. Participants and instructors did not describe similar goals for the community-based exercise program. Conclusions: Community-based exercise programs could be optimized by better aligning participant goals and exercise intensity.

Patterns and predictors of childcare subsidies for children with and without special needs.

One goal of childcare subsidies is to increase access to quality childcare for families of low-income, thus supporting child and family wellbeing, but subsidies may not equally benefit children with and without special needs. This study examined patterns and predictors of subsidy use among children with disabilities or delays relative to children without special needs. A nationally representative sample of approximately 4,050 young children from families of low-income was drawn from the Early Childhood Longitudinal Study-Birth Cohort. We examined subsidized care receipt at ages nine months, two years, and four years using descriptive analyses and multivariate logistic regression. Results suggest young children with special needs utilize childcare subsidies at significantly lower rates than their peers without disabilities. Mothers' marital status, work status, education, and age, along with child's race and number of siblings were significant predictors of subsidy use. We discuss implications for policy implementation and multisector collaboration to support the early care and education of young children with special needs.

Childcare Type and Quality among Subsidy Recipients with and without Special Needs.

Low-income children, particularly those with special needs, may have limited access to high quality early care experiences. Child care subsidies are intended to increase families' access to quality care, but little is known about subsidy use by children with special needs. Using a nationally representative sample of 4,000 young children who participated in the Early Childhood Longitudinal Study - Birth Cohort, we examined the types and quality of childcare received by children with and without special needs who came from subsidy eligible families. We also investigated the extent to which subsidy use and child and family sociodemographic characteristics predicted care type and quality among young children with special needs who used childcare subsidies at nine months, two years, and four years. Findings indicated that subsidies increased the use of non-parental care, mainly center-based care, as well as home-based care to a lesser extent among children with special needs relative to peers without special needs and relative to peers with special needs who did not use subsidies. However, use of subsidy did not consistently result in families with children with special needs accessing higher quality care. Sociodemographic characteristics of children, families and their context were differentially predictive of type and quality care. We discuss implications for practice and policy to foster quality early care and education of young children with special needs who are receiving subsidies.