Partnering With Latino/a Caregivers and Community Stakeholders to Understand Priorities and Needs Prior to Implementing an Early Literacy Program.

PURPOSE: Latino/a children disproportionately experience academic vulnerabilities, including in reading. Caregiver-mediated interventions can be leveraged to support the bilingual language development of young Latino/a children to prevent these well-documented disparities in reading. However, in leveraging these programs, it is important to weigh Latino cultural values surrounding education, family connection, and learning alongside the barriers and inequities experienced by Latino families. In response to this need, this study used a community-partnered approach to (a) understand caregivers' needs related to the language and literacy development of their young children and (b) understand perspectives for how best to implement a culturally adapted and culturally responsive caregiver-mediated program. METHOD: A total of 101 caregivers completed a needs assessment of sociodemographic information, child development and needs, and family needs. Subsequently, nonprofit staff and caregivers completed semistructured interviews or focus groups about the development and implementation of a birth-to-5 program supporting early language development. RESULTS: Thirty-five percent of families reported having at least one child with delayed language. Furthermore, 60.3% of respondents reported desiring strategies to support their child's early reading. Deductive content analysis revealed that both staff and caregivers desired a birth-to-5, caregiver-mediated program. Staff described family-level characteristics to consider for an early language program, community strengths, specific inequities faced by Latino families, and suggestions about culturally responsive early language and literacy program content and structure. Caregivers described barriers and inequities that they have faced related to their children's learning and development and how a birth-to-5 program could be responsive to their needs and values. CONCLUSIONS: Staff and caregiver emphasized the resilience of Latino families and their strong values surrounding educational involvement. At the same time, participants also reported barriers and inequities rooted in systemic racism that have prevented families from being involved in certain aspects of the children's education. Together, these results revealed the importance of an early literacy program that is responsive to the structural inequities experienced by families.

Crime and Inequality in Academic Achievement Across School Districts in the United States.

This study investigates the effect of violent crime on school district-level achievement in English language arts (ELA) and mathematics. The research design exploits variation in achievement and violent crime across 813 school districts in the United States and seven birth cohorts of children born between 1996 and 2002. The identification strategy leverages exogenous shocks to crime rates arising from the availability of federal funds to hire police officers in the local police departments where the school districts operate. Results show that children who entered the school system when the violent crime rate in their school districts was lower score higher in ELA by the end of eighth grade, relative to children attending schools in the same district but who entered the school system when the violent crime rate was higher. A 10% decline in the violent crime rate experienced at ages 0-6 raises eighth-grade ELA achievement in the district by 0.03 standard deviations. Models that estimate effects by race and gender show larger impacts among Black children and boys. The district-wide effect on mathematics achievement is smaller and statistically nonsignificant. These findings extend our understanding of the geography of educational opportunity in the United States and reinforce the idea that understanding inequalities in academic achievement requires evidence on what happens inside as well as outside schools.

Association of Primary Language and Hospitalization for Ambulatory Care Sensitive Conditions.

BACKGROUND: Limited English proficiency is associated with decreased access to ambulatory care, however, it is unclear if this disparity leads to increased use of emergency departments (EDs) for low severity ambulatory care sensitive conditions (ACSCs). OBJECTIVE: We sought to determine the association between the patient's preferred language and hospital utilization for ACSCs. RESEARCH DESIGN: We conducted a retrospective cohort study of all ED visits in New Jersey in 2013 and 2014. The primary outcome was hospital admission for acute ACSCs, chronic ACSCs, and fractures (a nonambulatory care sensitive control condition). Secondary outcomes included intensive care unit (ICU) utilization and length of stay. Mixed-effect regression models estimated the association between preferred language (English vs. non-English) and study outcomes, controlling for demographics, comorbidities, and hospital characteristics. RESULTS: We examined 201,351 ED visits for acute ACSCs, 251,193 visits for chronic ACSCs, and 148,428 visits for fractures, of which 13.5%, 11.1%, and 9.9%, respectively, were by non-English speakers. In adjusted analyses, non-English speakers were less likely to be admitted for acute ACSCs [-3.1%; 95% confidence interval (CI), -3.6% to -2.5%] and chronic ACSCs (-2.3%; 95% CI, -2.8% to -1.7%) but not fractures (0.4%; 95% CI, -0.2% to 1.0%). Among hospitalized patients, non-English speakers were less likely to receive ICU services but had no difference in length of stay. CONCLUSIONS: These findings suggest non-English-speaking patients may seek ED care for lower acuity ACSCs than English-speaking patients. Efforts to decrease preventable ED and increase access to ambulatory care use should consider the needs of non-English-speaking patients.

Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study.

OBJECTIVES: The life course determinants of midlife and later life cognitive function have been studied using longitudinal population-based cohort data, but far less is known about whether the pattern of these pathways is similar or distinct for clinically relevant cognitive state. We investigated this for Addenbrooke's Cognitive Examination third edition (ACE-III), used in clinical settings to screen for cognitive impairment and dementia. DESIGN: Longitudinal birth cohort study. SETTING: Residential addresses in England, Wales and Scotland. PARTICIPANTS: 1762 community-dwelling men and women of European heritage, enrolled since birth in the Medical Research Council (MRC) National Survey of Health and Development (the British 1946 birth cohort). PRIMARY OUTCOME: ACE-III. RESULTS: Path modelling estimated direct and indirect associations between apolipoprotein E (APOE) status, father's social class, childhood cognition, education, midlife occupational complexity, midlife verbal ability (National Adult Reading Test; NART), and the total ACE-III score. Controlling for sex, there was a direct negative association between APOE ε4 and the ACE-III score (ß=-0.04 [-0.08 to -0.002], p=0.04), but not between APOE ε4 and childhood cognition (ß=0.03 [-0.006 to 0.069], p=0.10) or the NART (ß=0.0005 [-0.03 to 0.03], p=0.97). The strongest influences on the ACE-III were from childhood cognition (ß=0.20 [0.14 to 0.26], p<0.001) and the NART (ß=0.35 [0.29 to 0.41], p<0.001); educational attainment and occupational complexity were modestly and independently associated with the ACE-III (ß=0.08 [0.03 to 0.14], p=0.002 and ß=0.05 [0.01 to 0.10], p=0.02, respectively). CONCLUSIONS: The ACE-III in the general population shows a pattern of life course antecedents that is similar to neuropsychological measures of cognitive function, and may be used to represent normal cognitive ageing as well as a screen for cognitive impairment and dementia.

Instrumento de avaliação de linguagem na perspectiva da Comunicação Suplementar e Alternativa: elaboração e validação de conteúdo / Script for language assessment on Augmentative and Alternative Communication perspective: construction and content validation

RESUMO Objetivo Desenvolver e validar o conteúdo de instrumento de avaliação de linguagem pautado na Comunicação Suplementar e Alternativa (CSA). Métodos O instrumento foi elaborado a partir de revisão bibliográfica, em conjunto com a experiência clínica da pesquisadora. Em seguida, foi avaliado por juízes especialistas na área e uma nova versão foi construída, incorporando as colaborações dos juízes. Resultados O instrumento foi elaborado em 4 eixos de conteúdo, com instruções e sugestão de contextos e símbolos gráficos. A partir da avaliação dos juízes, o instrumento foi aprimorado e proposto, em sua versão final. Conclusão O instrumento denominado CSA_Linguagem se mostrou operacional, de fácil e rápida aplicação e baixo custo. Contudo, esta pesquisa tem limitações, na medida em que não há instrumentos de avaliação de linguagem padronizados, que considerem a utilização de símbolos gráficos como possibilidade de comunicação.

ABSTRACT Purpose Content development and validation of a language assessment instrument lined on Augmentative and Alternative Communication (AAC). Methods The instrument was elaborated from a bibliographic review, along with the clinical experience of the researcher. Then, It was evaluated by expert judges in the area and a new final version was constructed, with computed collaboration. Results The Instrument was developed in four content axes, with instructions and suggestion of contexts and graphic symbols. Based on the evaluation of judges, the instrument was improved and the final version was proposed. Conclusion The instrument, named CSA_Linguagem, was proved to be operational, easy, of rapid application and low cost. However, this research has limitations, there are no standardized language assessment tools that consider the use of graphic symbols as communication possibilities.

English language proficiency and physical activity among Mexican-origin women in South Texas and South Carolina.

OBJECTIVES: To examine the relationship between English language proficiency (ELP), physical activity, and physical activity-related psychosocial measures (i.e., exercise self-efficacy, exercise social support, perceptions of environmental supports) among Mexican-origin women in South Carolina and Texas. DESIGN: Adjusted robust regression and interaction modeling to evaluate baseline questionnaire data on self-reported ELP with CHAMPS leisure-time moderate-to-vigorous physical activity (MVPA), accelerometry data, Physical Activity Self-Efficacy, Physical Activity Social Support, and Environmental Support for Physical Activity in 118 Mexican-origin women. RESULTS: The adjusted regression revealed a significant association between ELP and perceived physical activity self-efficacy (ß = 234.2, p = .004), but not with physical activity social support. In South Carolina, CHAMPS leisure-time MVPA (411.4 versus 114.3 minutes, p < .05) was significantly different between women in the high ELP quartile and those in the very low quartile. Among high ELP Mexican-origin women, participants in Texas reported significantly higher MVPA measured by accelerometry (p = .042) than those in South Carolina. CONCLUSION: Our findings indicate that ELP was associated with physical activity and that contextual factors may also play a role.

Assessment of dispositional and contextual variables in educational settings: IEPA and AYES scales.

BACKGROUND: Despite the fact that there are a few instruments designed to measure dispositional and contextual variables in educational contexts, the goal of this study is to elaborate and validate two questionnaires to measure learning interest, effort and progression as dispositional (IEPA) and contextual (AYEs) variables in secondary education students. METHOD: An initial version of both scales was developed. They were reviewed by a panel of experts and tested on two pilot studies. The final versions were administered to the described sample and their psychometric properties were tested. Factor analyses (exploratory and confirmatory) were conducted on three sets of data: Mathematics (n = 290), Spanish Language and Literature (n = 283), and Physical Education (n = 289). RESULTS: Both final scales had three dimensions with four items in each dimension. All standardized loads and critical values of t were overwhelmingly positive, while alpha coefficients ranged from .85 to .91. Both scales showed adequate construct validity, convergent validity, discriminant validity and concurrent validity. CONCLUSIONS: Results showed that these new scales have adequate psychometric properties, allowing a valid and reliable assessment.

Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort.

CONTEXT: Severe iodine deficiency (ID) during gestation is associated with neurocognitive sequelae. The long-term impact of mild ID, however, has not been well characterized. OBJECTIVE: The purpose of this study was to determine whether children born to mothers with urinary iodine concentrations (UICs) <150 µg/L during pregnancy have poorer educational outcomes in primary school than peers whose mothers did not have gestational ID (UIC ≥150 µg/L). DESIGN: This was a longitudinal follow-up (at 9 years old) of the Gestational Iodine Cohort. Pregnancy occurred during a period of mild ID in the population, with the children subsequently growing up in an iodine-replete environment. SETTING AND PARTICIPANTS: Participants were children whose mothers attended The Royal Hobart Hospital (Tasmania) antenatal clinics between 1999 and 2001. MAIN OUTCOME MEASURES: Australian national curriculum and Tasmanian state curriculum educational assessment data for children in year 3 were analyzed. RESULTS: Children whose mothers had UIC <150 µg/L had reductions of 10.0% in spelling (-41.1 points, 95% confidence interval [CI], -68.0 to -14.3, P = .003), 7.6% in grammar (-30.9 points, 95% CI, -60.2 to -1.7, P = .038), and 5.7% in English-literacy (-0.33 points, 95% CI, -0.63 to -0.03, P = .034) performance compared with children whose mothers' UICs were ≥150 µg/L. These associations remained significant after adjustment for a range of biological factors (maternal age at birth of child, gestational length at time of birth, gestational age at time of urinary iodine collection, birth weight, and sex). Differences in spelling remained significant after further adjustment for socioeconomic factors (maternal occupation and education). CONCLUSIONS: This study provides preliminary evidence that even mild iodine deficiency during pregnancy can have long-term adverse impacts on fetal neurocognition that are not ameliorated by iodine sufficiency during childhood.

Trends in recreational computer use among Latino children in California.

In this study we examine differential trends in recreational computer use among Latino and white children in California. We analyzed data from the children's sample (age 4-11) of the 2001 and 2009 California Health Interview Survey. Multivariate analysis was used to estimate the impact of language spoken at home, income and parental education, on recreational computer use. Latino children had substantially lower recreational computer use in 2001, compared to whites, but by 2009 the gap had almost disappeared. Among Latinos, compared to families where English is spoken exclusively, recreational computer use was substantially lower in families where Spanish is spoken exclusively. Parental education and income were significantly associated with recreational computer use, but only among Latinos, and the association with parental education changed from 2001 to 2009, explaining some of the difference in trend between Latino and white children.

Reliability and validity of a Thai version of assessment of chronic illness care (ACIC).

BACKGROUND: The Assessment Chronic Illness Care (ACIC), developed in the United States, is a quality-improvement tool used to help organization evaluate the strengths and weaknesses of their delivery of care for chronic illness in six areas, community linkages, self-management support, decision support, delivery system design, information systems, and organization of care. These areas of care are influenced by the Chronic Care Model. The questionnaire scale ranges from 0 to 11. OBJECTIVE: Translate in Thai language and validate the ACIC as a practical tool to measure the quality of chronic illness care in Thailand. MATERIAL AND METHOD: In a cross-sectional study, the content validity was examined by public health experts. The original ACIC was translated into Thai with permission from The MacColl Institute for Healthcare Innovation at Group Health's Center for Health Studies. The translation process followed the World Health Organization (WHO) process of translation and adaptation of instruments, including forward translation, expert panel and synthesis of the translation, back translation, pre-testing, and cognitive interviewing. The pre-testing was done by distributing the questionnaire to a sample of 12 organizations with cognitive interviewing, followed by revision and finalization of the questionnaire. The reliability and validity of the translated version was then examined by distributing the questionnaire to 172 organizations (84 district hospitals and 88 community health center primary care units within the upper northern part of Thailand)focusing on care of cerebrovascular disease. RESULTS: The response rate was approximately 70% or 120 organizations. The results from these organizations 'self-assessment showed that the Thai version of ACIC achieved good levels of reliability and validity, with the range of Cronbach's alpha coefficients being 0.846 to 0.972 in each aspect of ACIC. However ACIC inablility to detect statistical significant difference in score for each dimension though the self-management support and decision support are the two relatively low score rating. CONCLUSION: The Thai translation of the ACIC can be used as an organization self-assessment instrument to evaluate the quality of chronic care in Thailand Further explanatory research of association between ACIC assessment and organization change as well as clinical outcomes is needed.

[The movement to represent Francophone minority groups: the future of health services in French]. / Le mouvement de santé en français en contexte linguistique minoritaire: les représentations des acteurs sur l'avenir des services.

The Action Plan for Official Languages launched in 2003 intends to revitalize the country's linguistic duality. Among the priority areas, health is the focus in order to ensure the training of health professionals to serve official language minority communities and to network the main actors concerned about the organization of services in the minority language. The aim of this paper is to report representations of Francophones in minority with respect to the future of health services in French. The study is based on a participatory methodology: concept mapping to identify the conceptual universe of a given problem.

Scientific English: a program for addressing linguistic barriers of international research trainees in the United States.

Within the international research environment, English is indisputably the lingua franca, and thus, the majority of the world's scientists must adapt to a second language. Linguistic barriers in science affect not only researchers' career paths but institutional productivity and efficiency as well. To address these barriers, we designed and piloted a specialized course, Scientific English. The pedagogical approach is based on English for specific purposes methodology in which curriculum and content are driven by the types of daily language used and interactions which occur in the participants' occupation, in this case, cancer research. The 11-week program was organized into three sections: presentation skill, meeting and discussion skills, and writing skills. Effectiveness of the course was measured by the number of participants able to produce the presentations and written products with a score of at least 75 of 100 possible points. From January to December 2008, participant scores averaged 90.4 for presentation and 86.8 for written products. The authors provide insights and recommendations on the development and delivery of the program.

Economía de palabras con la propuesta de un término / Economy of words with the proposal of a term

Se propone el uso de un sustantivo derivado de siglas, con vista a economizar 7 de 8 palabras al referirse a especialistas de primer o segundo grado en medicina general integral.

The use of a noun derived from acronyms was proposed to economize 7 of 8 words when referring to first o second degree specialists in General Comprehensive Medicine.

Identification of the class characteristics in the handwriting of Polish people writing in English.

An investigation was carried out to identify the class characteristics of Polish people writing in English and to specifically identify those characteristics that separate Polish handwriting from English handwriting. In the first stage, 40 Polish and 40 English handwriting samples were collected and systematically examined. In total, 31 features were identified that occurred in ≥25% of the Polish handwriting samples and therefore considered class characteristics. Of these, chi-square analyses identified 21 class characteristics that occurred significantly more in Polish compared to English handwriting. Twenty-one of the class characteristics in the Polish handwriting had similar constructions to the copybook pattern thus supporting the theory that class characteristics frequently stem from the taught writing system. In the second stage, an algorithm was developed using seventeen of the class characteristics that successfully discriminated between a further 13 Polish and 12 English handwriting samples.

Serviços substitutivos de saúde mental e inclusão noterritório: contradições e potencialidades / Mental health substitutive services and inclusion in the territory:contradictions and potentialities / Servicios sustitutivos de salud mental e inclusión en el territorio:contradicciones y potencialidades

Este estudo pretende analisar o discurso de trabalhadores de saúde mental sobre a implantação dos serviçossubstitutivos no território. Objetiva-se apontar, no discurso, contradições e potencialidades da proposta, de modoa poder-se avançar nas discussões sobre o processo de consolidação da reforma psiquiátrica brasileira. Ocorpus deste trabalho constitui-se de entrevistas aplicadas a 17 dos 25 profissionais de saúde mental quetrabalham em um serviço substitutivo de uma cidade da Região Sul do Brasil. O dispositivo metodológico quesubsidiou a sistematização dos dados foi o “diagrama axiológico-discursivo”, construído a partir dos pressupostosteóricos da Análise Crítica do Discurso. Os resultados mostram que os trabalhadores parecem tentar evitar ofechamento do serviço sobre si mesmo, apesar dos movimentos contrários que reforçam a tendência aoisolamento, ao encolhimento e ao esvaziamento do território. Esperamos que este estudo possa ajudar naproblematização do movimento de reforma psiquiátrica no contexto brasileiro.

This study aims to analyze the discourse of mental health workers on the deployment of substitutive services inthe territory. The aim is to point out, in discourse, contradictions and potentialities of the proposal, in order toadvance the discussions on the consolidation process of the Brazilian psychiatric reform. The corpus of this workconsists in interviews applied to 17 of 25 mental health workers in a substitutive service of a city in southernBrazil. The methodological device which subsidized the systematization of the data was the "axiologicaldiscursivediagram", constructed from the Critical Discourse Analysis theoretical framework. The results show thatworkers seem to try to prevent the end of the service by itself, despite the contrary movements that reinforce thetendency to isolation, the reduction and a loss of territory. We hope this study can help in questioning themovement of psychiatric reform in the Brazilian context.

Este estudio pretende analizar el discurso de los trabajadores de salud mental sobre la implantación de losservicios sustitutivos en el territorio. Se busca apuntar, en el discurso, contradicciones y potencialidades de lapropuesta, para poder avanzar en las discusiones sobre el proceso de consolidación de la reforma psiquiátricabrasileña. El corpus es compuesto por entrevistas aplicadas a 17 de los 25 profesionales de salud mental quetrabajan en un servicio sustitutivo de una ciudad de la Región Sur de Brasil. El dispositivo metodológico quesubsidió la sistematización de los datos fue el “diagrama axiológico-discursivo”, construido a partir de lospresupuestos teóricos del Análisis Crítico de Discurso. Los resultados muestran que los trabajadores parecenintentar evitar el cierre del servicio sobre sí mismo, aunque haya movimientos contrarios que refuerzan latendencia al aislamiento, al encogimiento y al vaciamiento del territorio. Esperamos que este estudio puedaayudar en la problematización del movimiento de reforma psiquiátrica en el contexto brasileño.