Nurses' Perceptions of Implant Barcode Scanning in Surgical Services.

The US Food and Drug Administration's 2013 Unique Device Identification System Rule requires manufacturers to label devices with unique identifiers. Implantable devices are now shipped with unique identifiers, and many electronic health records have fields to incorporate them. Health policy changes have prompted hospital systems to assess implementation of implant barcode scanning systems to capture unique device identifiers. Project aims were to assess predictors of operating room nurses' acceptance of a new implant barcode scanning system, describe operating room nurses' perceptions of the system value, and identify operating room nurses' perceived gaps in system implementation. An online survey was disseminated to operating room nurses, and focus groups were conducted with orthopedic operating room nurses in an academic medical center that had recently implemented an implant barcode scanning system in surgical services. Predictors of barcode scanning acceptance included perceived usefulness for patient care, perceived ease of use, and perceived usefulness (self). Nurses perceived the system to be more accurate and valuable for patient safety. Perceived gaps in system implementation related to communication, completeness of the system, consistency in process, and training. Understanding nurse perceptions of new barcode scanning systems and engaging them in the implementation process are key areas for success and optimization of these systems.

Interactions among catechol-O-methyltransferase genotype, parenting, and sex predict children's internalizing symptoms and inhibitory control: Evidence for differential susceptibility.

We used sex, observed parenting quality at 18 months, and three variants of the catechol-O-methyltransferase gene (Val158Met [rs4680], intron1 [rs737865], and 3'-untranslated region [rs165599]) to predict mothers' reports of inhibitory and attentional control (assessed at 42, 54, 72, and 84 months) and internalizing symptoms (assessed at 24, 30, 42, 48, and 54 months) in a sample of 146 children (79 male). Although the pattern for all three variants was very similar, Val158Met explained more variance in both outcomes than did intron1, the 3'-untranslated region, or a haplotype that combined all three catechol-O-methyltransferase variants. In separate models, there were significant three-way interactions among each of the variants, parenting, and sex, predicting the intercepts of inhibitory control and internalizing symptoms. Results suggested that Val158Met indexes plasticity, although this effect was moderated by sex. Parenting was positively associated with inhibitory control for methionine-methionine boys and for valine-valine/valine-methionine girls, and was negatively associated with internalizing symptoms for methionine-methionine boys. Using the "regions of significance" technique, genetic differences in inhibitory control were found for children exposed to high-quality parenting, whereas genetic differences in internalizing were found for children exposed to low-quality parenting. These findings provide evidence in support of testing for differential susceptibility across multiple outcomes.

Efficacy of the Teaching Early Literacy and Language Curriculum With Preschoolers From Low-Income Families.

PURPOSE: The purpose of this study was to test the efficacy of the Teaching Early Literacy and Language (TELL) curriculum package for improving the early literacy and oral language skills of preschoolers from low-income families. METHOD: In a randomized controlled trial (RCT), TELL was implemented in 30 TELL and 28 business-as-usual classrooms. TELL is a Tier 1 whole-class curriculum package that includes a scope and sequence of instruction, lesson plans and materials, high-quality books, curriculum-based measures (CBMs), and professional development training and coaching. RESULTS: Implementation fidelity was high; however, due to COVID-19 school closures, we did not collect end-of-year data for our third cohort of teachers. Results indicated significant TELL effects on all code-related CBMs and two code-related distal measures as well as receptive and expressive vocabulary CBMs. No significant differences were found on distal measures of oral language/vocabulary or listening comprehension. CONCLUSIONS: Results of the present study, paired with findings from an earlier TELL RCT with children with developmental speech and/or language impairments, suggest that children enrolled in TELL classrooms achieve higher outcomes on a variety of code-related and vocabulary measures by the end of their final preschool year. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25345708.

An Extended GFfit Statistic Defined on Orthogonal Components of Pearson's Chi-Square.

The Pearson and likelihood ratio statistics are commonly used to test goodness of fit for models applied to data from a multinomial distribution. The goodness-of-fit test based on Pearson's Chi-squared statistic is sometimes considered to be a global test that gives little guidance to the source of poor fit when the null hypothesis is rejected, and it has also been recognized that the global test can often be outperformed in terms of power by focused or directional tests. For the cross-classification of a large number of manifest variables, the GFfit statistic focused on second-order marginals for variable pairs i, j has been proposed as a diagnostic to aid in finding the source of lack of fit after the model has been rejected based on a more global test. When data are from a table formed by the cross-classification of a large number of variables, the common global statistics may also have low power and inaccurate Type I error level due to sparseness in the cells of the table. The sparseness problem is rarely encountered with the GFfit statistic because it is focused on the lower-order marginals. In this paper, a new and extended version of the GFfit statistic is proposed by decomposing the Pearson statistic from the full table into orthogonal components defined on marginal distributions and then defining the new version, [Formula: see text], as a partial sum of these orthogonal components. While the emphasis is on lower-order marginals, the new version of [Formula: see text] is also extended to higher-order tables so that the [Formula: see text] statistics sum to the Pearson statistic. As orthogonal components of the Pearson [Formula: see text] statistic, [Formula: see text] statistics have advantages over other lack-of-fit diagnostics that are currently available for cross-classified tables: the [Formula: see text] generally have higher power to detect lack of fit while maintaining good Type I error control even if the joint frequencies are very sparse, as will be shown in simulation results; theoretical results will establish that [Formula: see text] statistics have known degrees of freedom and are asymptotically independent with known joint distribution, a property which facilitates less conservative control of false discovery rate (FDR) or familywise error rate (FWER) in a high-dimensional table which would produce a large number of bivariate lack-of-fit diagnostics. Computation of [Formula: see text] statistics is also computationally stable. The extended [Formula: see text] statistic can be applied to a variety of models for cross-classified tables. An application of the new GFfit statistic as a diagnostic for a latent variable model is presented.

Increasing Registered Nurse Hours Per Resident Day for Improved Nursing Home Residents' Outcomes Using a Longitudinal Study.

The purpose of this study was to estimate how much resident outcomes can improve with an increase in hours per resident day (HPRD) of registered nurses (RNs) staffing. Nursing home (NH) staff in Korea have serious problems with inappropriate nurse staffing standards and poor working conditions, which lead to poor quality of care for NH residents. This study used a longitudinal survey design. A quota sampling was used with a total of several repeated survey measurement from 2017 to 2020 (n = 74). The independent variable was the amount of nurse staffing HPRD and the outcome variable was the compiled outcome of 15 quality-of-care indicators. Data were directly collected from all participating NHs. A longitudinal, multilevel model was used for analysis. An increase of one unit of RN HPRD (60 min) corresponded to a decrease of about 10.5% of residents with deteriorated quality of care outcomes. This study emphasized that increasing RN HPRD decreased residents' deteriorated outcomes in NHs. This suggests that professional RNs must be secured to an appropriate level to improve the quality of care for NH residents.

Relations among maternal socialization, effortful control, and maladjustment in early childhood.

In a sample of 18-, 30-, and 42-month-olds, the relations among parenting, effortful control (EC), and maladjustment were examined. Parenting was assessed with mothers' reports and observations; EC was measured with mothers' and caregivers' reports, as well as a behavioral task; and externalizing and internalizing symptoms were assessed with parents' and caregivers' reports. Although 18-month unsupportive (vs. supportive) parenting negatively predicted EC at 30 months, when the stability of these variables was taken into account, there was no evidence of additional potentially causal relations between these two constructs. Although EC was negatively related to both internalizing and externalizing problems within all three ages as well as across 1 year, EC did not predict maladjustment once the stability of the constructs and within time covariation between the constructs were taken into account. In addition, externalizing problems at 30 months negatively predicted EC at 42 months, and internalizing problems at 30 months positively predicted EC at 42 months, but only when the effects of externalizing on EC were controlled. The findings are discussed in terms of the reasons for the lack of causal relations over time.

Provision of rapid and specific ex vivo diagnosis of central nervous system lymphoma from rodent xenograft biopsies by a fluorescent aptamer.

OBJECTIVE: Differentiating central nervous system (CNS) lymphoma from other intracranial malignancies remains a clinical challenge in surgical neuro-oncology. Advances in clinical fluorescence imaging contrast agents and devices may mitigate this challenge. Aptamers are a class of nanomolecules engineered to bind cellular targets with antibody-like specificity in a fraction of the staining time. Here, the authors determine if immediate ex vivo fluorescence imaging with a lymphoma-specific aptamer can rapidly and specifically diagnose xenografted orthotopic human CNS lymphoma at the time of biopsy. METHODS: The authors synthesized a fluorescent CNS lymphoma-specific aptamer by conjugating a lymphoma-specific aptamer with Alexa Fluor 488 (TD05-488). They modified human U251 glioma cells and Ramos lymphoma cells with a lentivirus for constitutive expression of red fluorescent protein and implanted them intracranially into athymic nude mice. Three to 4 weeks postimplantation, acute slices (biopsies, n = 28) from the xenografts were collected, placed in aptamer solution, and imaged with a Zeiss fluorescence microscope. Three aptamer staining concentrations (0.3, 1.0, and 3.0 µM) and three staining times (5, 10, and 20 minutes) followed by a 1-minute wash were tested. A file of randomly selected images was distributed to neurosurgeons and neuropathologists, and their ability to distinguish CNS lymphoma from negative controls was assessed. RESULTS: The three staining times and concentrations of TD05-488 were tested to determine the diagnostic accuracy of CNS lymphoma within a frozen section time frame. An 11-minute staining protocol with 1.0-µM TD05-488 was most efficient, labeling 77% of positive control lymphoma cells and less than 1% of negative control glioma cells (p < 0.001). This protocol permitted clinicians to positively identify all positive control lymphoma images without misdiagnosing negative control images from astrocytoma and normal brain. CONCLUSIONS: Ex vivo fluorescence imaging is an emerging technique for generating rapid histopathological diagnoses. Ex vivo imaging with a novel aptamer-based fluorescent nanomolecule could provide an intraoperative tumor-specific diagnosis of CNS lymphoma within 11 minutes of biopsy. Neurosurgeons and neuropathologists interpreted images generated with this molecular probe with high sensitivity and specificity. Clinical application of TD05-488 may permit specific intraoperative diagnosis of CNS lymphoma in a fraction of the time required for antibody staining.

Positive and negative emotionality: trajectories across six years and relations with social competence.

The goals of the present study were to examine (1) the mean-level stability and differential stability of children's positive emotional intensity, negative emotional intensity, expressivity, and social competence from early elementary school-aged to early adolescence, and (2) the associations between the trajectories of children's emotionality and social functioning. Using four waves of longitudinal data (with assessments 2 years apart), parents and teachers of children (199 kindergarten through third grade children at the first assessment) rated children's emotion-related responding and social competence. For all constructs, there was evidence of mean-level decline with age and stability in individual differences in rank ordering. Based on age-centered growth-to-growth curve analyses, the results indicated that children who had a higher initial status on positive emotional intensity, negative emotional intensity, and expressivity had a steeper decline in their social skills across time. These findings provide insight into the stability and association of emotion-related constructs to social competence across the elementary and middle school years.

Longitudinal relations of children's effortful control, impulsivity, and negative emotionality to their externalizing, internalizing, and co-occurring behavior problems.

The purpose of the study was to examine the relations of effortful control (EC), impulsivity, and negative emotionality to at least borderline clinical levels of symptoms and change in maladjustment over four years. Children's (N = 214; 77% European American; M age = 73 months) externalizing and internalizing symptoms were rated by parents and teachers at 3 times, 2 years apart (T1, T2, and T3) and were related to children's adult-rated EC, impulsivity, and emotion. In addition, the authors found patterns of change in maladjustment were related to these variables at T3 while controlling for the T1 predictor. Externalizing problems (pure or co-occurring with internalizing problems) were associated with low EC, high impulsivity, and negative emotionality, especially anger, and patterns of change also related to these variables. Internalizing problems were associated with low impulsivity and sadness and somewhat with high anger. Low attentional EC was related to internalizing problems only in regard to change in maladjustment. Change in impulsivity was associated with change in internalizing primarily when controlling for change in externalizing problems.

Predictors of withdrawal: possible precursors of avoidant personality disorder.

Relations of avoidant personality disorder (AvPD) with shyness and inhibition suggest that a precursor of AvPD is withdrawal. Using a sample of 4.5- to 7-year-olds studied four times, 2 years apart, four and three classes of children differing in trajectories of mother- and teacher-reported withdrawal, respectively, were identified. Mothers and teachers generally did not agree on children's trajectories but the pattern of findings in the two contexts did not differ markedly. The mother-identified high and declining withdrawal class, in comparison with less withdrawn classes, and the teacher-identified high and declining class compared with low withdrawal classes, were associated with relatively high levels of anger and low levels of attentional control and resiliency. The mother-identified moderate and increasing withdrawal class was distinguished from less problematic withdrawal classes by higher anger, lower resiliency, and sometimes, lower attentional control. The teacher-identified low and increasing withdrawal class was distinguished from less problematic withdrawal classes by lower resiliency and lower attentional control. Findings are discussed in terms of the developmental precursors to social withdrawal and avoidant behavior.

Does chronic classroom peer rejection predict the development of children's classroom participation during the grade school years?

A sample of 398 children was followed up from ages 5 to 12 to investigate the relation between peer group rejection and classroom participation. The participation trajectories of individuals and groups of children who were rejected for differing periods of time were examined both during and after rejection using piecewise growth curve analyses. The results showed that whereas during periods of rejection, children exhibited negative or negligible growth in participation, when nonrejected, they manifested positive growth. These findings corroborated the hypothesis that (a) peer rejection creates constraints that inhibit children's classroom participation and (b) the cessation of rejection enables children to become more active and cooperative participants in classroom activities.

Understanding mother-adolescent conflict discussions: concurrent and across-time prediction from youths' dispositions and parenting.

Adolescence is often thought of as a period during which the quality of parent-child interactions can be relatively stressed and conflictual. There are individual differences in this regard, however, with only a modest percent of youths experiencing extremely conflictual relationships with their parents. Nonetheless, there is relatively little empirical research on factors in childhood or adolescence that predict individual differences in the quality of parent-adolescent interactions when dealing with potentially conflictual issues. Understanding such individual differences is critical because the quality of both parenting and the parent-adolescent relationship is predictive of a range of developmental outcomes for adolescents. The goals of the research were to examine dispositional and parenting predictors of the quality of parents' and their adolescent children's emotional displays (anger, positive emotion) and verbalizations (negative or positive) when dealing with conflictual issues, and if prediction over time supported continuity versus discontinuity in the factors related to such conflict. We hypothesized that adolescents' and parents' conflict behaviors would be predicted by both childhood and concurrent parenting and child dispositions (and related problem behaviors) and that we would find evidence of both parent- and child-driven pathways. Mothers and adolescents (N5126, M age513 years) participated in a discussion of conflictual issues. A multimethod, multireporter (mother, teacher, and sometimes adolescent reports) longitudinal approach (over 4 years) was used to assess adolescents' dispositional characteristics (control/ regulation, resiliency, and negative emotionality), youths' externalizing problems, and parenting variables (warmth, positive expressivity, discussion of emotion, positive and negative family expressivity). Higher quality conflict reactions (i.e., less negative and/or more positive) were related to both concurrent and antecedent measures of children's dispositional characteristics and externalizing problems, with findings for control/regulation and negative emotionality being much more consistent for daughters than sons. Higher quality conflict reactions were also related to higher quality parenting in the past, positive rather than negative parent-child interactions during a contemporaneous nonconflictual task, and reported intensity of conflict in the past month. In growth curves, conflict quality was primarily predicted by the intercept (i.e., initial levels) of dispositional measures and parenting, although maintenance or less decrement in positive parenting, greater decline in child externalizing problems, and a greater increase in control/regulation over time predicted more desirable conflict reactions. In structural equation models in which an aspect of parenting and a child dispositional variable were used to predict conflict reactions, there was continuity of both type of predictors, parenting was a unique predictor of mothers' (but not adolescents') conflict reactions (and sometimes mediated the relations of child dispositions to conflict reactions), and child dispositions uniquely predicted adolescents' reactions and sometimes mothers' conflict reactions. The findings suggest that parent-adolescent conflict may be influenced by both child characteristics and quality of prior and concurrent parenting, and that in this pattern of relations, child effects are more evident than parent effects.

Prediction of Children's Academic Competence From Their Effortful Control, Relationships, and Classroom Participation.

The authors examined the relations among children's effortful control, school relationships, classroom participation, and academic competence with a sample of 7- to 12-year-old children (N = 264). Parents and children reported on children's effortful control, and teachers and children reported on children's school relationships and classroom participation. Children's grade point averages (GPAs) and absences were obtained from school-issued report cards. Significant positive correlations existed between effortful control, school relationships, classroom participation, and academic competence. Consistent with expectations, the teacher-child relationship, social competence, and classroom participation partially mediated the relation between effortful control and change in GPA from the beginning to the end of the school year. The teacher-child relationship and classroom participation also partially mediated the relation between effortful control and change in school absences across the year.

Goodness-of-fit testing using components based on marginal frequencies of multinomial data.

The goodness-of-fit test based on Pearson's chi-squared statistic is sometimes considered to be an omnibus test that gives little guidance to the source of poor fit when the null hypothesis is rejected. It has also been recognized that the omnibus test can often be outperformed by focused or directional tests of lower order. In this paper, a test is considered for a model on a data table formed by the cross-classification of q dichotomous variables, and a score statistic on overlapping cells that correspond to the first- through qth-order marginal frequencies is presented. Then orthogonal components of the Pearson-Fisher statistic are defined on marginal frequencies. The orthogonal components may be used to form test statistics, and a log-linear version of an item response model is used to investigate the order and dilution of a test based on these components, as well as the projection of components onto the space of lower-order marginals. The advantage of the components in terms of power and detection of the source of poor fit is demonstrated. Overcoming the adverse effects of sparseness provides another motive for using components based on marginal frequencies because an asymptotic chi-squared distribution will be more reliable for a statistic formed on overlapping cells if expected frequencies in the joint distribution are small.

The developmental trajectories of attention focusing, attentional and behavioral persistence, and externalizing problems during school-age years.

The developmental trajectories of attention focusing (by parents' and teachers' reports) and attentional and behavioral persistence (observed during a laboratory task)--2 indexes of effortful control--and externalizing problems from ages 5 to 10 years were examined for 356 children combined from a pair of 3-wave (2 years apart) longitudinal studies. The authors identified clusters of children with distinct trajectories for these variables and examined the links between the effortful control trajectories and the externalizing problem trajectories. Although attention focusing remained relatively stable, attentional and behavioral persistence continued to show mean-level changes (especially among the children with lower levels of persistence). Children with high and stable trajectories of effortful control tended to exhibit low and stable trajectories of externalizing problems, whereas those with lower and/or less stable trajectories of effortful control showed more elevated and/or fluctuating trajectories of externalizing problems.

The Relations of Effortful Control and Impulsivity to Children's Sympathy: A Longitudinal Study.

The relations of children's (n = 214 at Time 1; M age = 6 years at Time 1) dispositional sympathy to adult-reported and behavioral measures of effortful control (EC) and impulsivity were examined in a longitudinal study including five assessments, each two years apart. Especially for boys, relatively high levels of EC and growth in EC were related to high sympathy. Teacher-reported impulsivity was generally modestly negatively related to measures of teacher-reported sympathy for boys, and a decline in impulsivity was linked to boys' sympathy. Some findings suggested a positive association between impulsivity and children's self-reported sympathy. EC, especially when reported by teachers, was more often a unique predictor of sympathy than was impulsivity. Results generally support the argument that sympathetic individuals, especially boys, are high in EC and that EC is a more consistent predictor of sympathy than impulsivity.

Preschoolers' academic readiness: What role does the teacher-child relationship play?

We examined the role of the teacher-child relationship quality (close, dependent, and conflictive) on preschoolers' (N = 95) academic readiness for kindergarten, and we tested children's prosocial and aggressive behavior and peer group exclusion as mediators of this relation. A unique feature of this study is the ethnically and socio-economically diverse preschool-aged sample. The association between close teacher-child relationships and academic readiness was partially mediated by prosocial behavior and peer group exclusion. There was also evidence of a transactional association between close teacher-child relationships and children's behavior. Additionally, children's behavior and peer group exclusion mediated the relation between negative teacher-child relationships (dependent and conflictive) and academic readiness. The findings suggest that teacher training, education, and support for establishing close teacher-child relationships may maximize preschoolers' academic readiness by promoting social adaptation.

Relations among mothers' expressivity, children's effortful control, and their problem behaviors: a four-year longitudinal study.

Longitudinal relations between mothers' expressivity, children's effortful control, and their problem behaviors were examined when children (N = 181) were 6.5-10 years old (T2) and again 2 (T3) and 4 (T4) years later. Mothers reported on their expression of positive and negative dominant emotion. Mothers and teachers reported on children's effortful control and externalizing and internalizing problem behaviors. In structural equation models, variables exhibited consistency over time. Further, the relation between mothers' expressivity (positive minus negative dominant emotion) at T2 and children's externalizing problems at T4 was mediated by T3 effortful control. The same process of mediation was significant for teacher- but not mother-reported internalizing problems. The results provide one explanation for how emotion-related socializing behaviors influence children's problem behaviors.

Relation of emotion-related regulation to children's social competence: a longitudinal study.

The differential relations of children's emotion-related regulation (i.e., effortful control and impulsivity) to their personality resiliency, adult-rated popularity, and social competence were examined in children who were 4.5-7.9 years old and who were remeasured 2 years later. Parents and teachers reported on all constructs, and children's attentional persistence was observed. Structural equation modeling was used to test the mediating role of resiliency on the relations between regulation/control and popularity using two-wave longitudinal data. The results provide some evidence of the mediating role of resiliency in the relations between effortful control and popularity, provide some evidence of bidirectional effects, and also buttress the view that emotional regulation should be differentiated into effortful and reactive forms of control.

The relations of problem behavior status to children's negative emotionality, effortful control, and impulsivity: concurrent relations and prediction of change.

The relations of children's internalizing and externalizing problem behaviors to their concurrent regulation, impulsivity (reactive undercontrol), anger, sadness, and fearfulness and these aspects of functioning 2 years prior were examined. Parents and teachers completed measures of children's (N = 185; ages 6 through 9 years) adjustment, negative emotionality, regulation, and behavior control; behavioral measures of regulation also were obtained. In general, both internalizing and externalizing problems were associated with negative emotionality. Externalizers were low in effortful regulation and high in impulsivity, whereas internalizers, compared with nondisordered children, were low in impulsivity but not effortful control. Moreover, indices of negative emotionality, regulation, and impulsivity with the level of the same variables 2 years before controlled predicted stability versus change in problem behavior status.