A systematic review of the measurement properties of the Family Empowerment Scale.

PURPOSE: To systematically review and evaluate existing psychometric evidence for the Family Empowerment Scale (FES), which has been widely used to measure empowerment across the world. METHODS: Three databases were searched up until December 2021. Eligible studies were identified by an interdisciplinary team using the PRISMA procedure. The methodological quality of psychometrics (Risk of Bias standards) and sufficiency of each psychometric property (e.g., reliability, content validity, construct validity, responsiveness) were independently evaluated by three members, following COnsesus-based Standards for the selection of health Measurement INstruments (COSMIN). RESULTS: Twelve studies involving 3278 caregivers were included in the review. Studies reported limited information about content validity and study sample characteristics. There is sufficient evidence with moderate methodological quality to support structural validity for a four and three-bifactor structure. Sufficient evidence with good methodological quality was found for internal consistency. No studies examined responsiveness. CONCLUSIONS: Future psychometric studies of the FES should include diverse families and establish content validity following current COSMIN standards. Structural validity evidence does not support the original three-factor structure, which suggests the need to refine the theoretical measurement constructs. Responsiveness is needed prior to using FES as an instrument of change in applied research studies.Implications for RehabilitationThe evidence for the use of the Family Empowerment Scale (FES) is primarily with families of children with disabilities who identify as white, non-Hispanic, and live in the US.Across studies, evidence suggests the FES items work well together to measure family empowerment.Caution should be used when using the FES to measure changes in empowerment over time.

A translational model for early childhood intervention: developing, implementing, and scaling-up effective practices.

Early intervention (EI) researchers (i.e., those focused on children birth to age 3 and their families who experience early vulnerabilities) often engage in translational research and implementation science at the intersection of public health, pediatrics, and EI. There is currently a significant research-to-practice gap in EI despite ongoing efforts to close it. Translational research and implementation science are promising approaches to promote transdisciplinary collaborations among researchers and to move EI research into practice, thus supporting positive outcomes for young children and families. This commentary proposes a contemporary alignment of translational research phases for EI. Two literature reviews served to inform development of this alignment: (1) a narrative literature review identified existing applications of translational phases to EI; and (2) a rapid review identified examples of existing behavior-focused translational models across disciplines. Several case examples of current translational research being conducted in EI are discussed and classified according to their respective translational phase. The proposed alignment and case examples provide a basis for transdisciplinary conversations among those working across the various fields and disciplines relevant to EI research. A shift in EI research to reflect a translational and implementation focus will help bridge the research-to-practice gap and, most importantly, speed the movement of scientific evidence into real-world contexts to positively impact young children and families.

Development and Initial Psychometrics of a Generic Treatment Integrity Measure Designed to Assess Practice Elements Targeting Social, Emotional, and Behavioral Outcomes in Early Childhood Settings.

Though treatment integrity measurement is important for research intended to promote social and behavioral outcomes of children at risk for emotional and behavioral disorders (EBDs) in early childhood settings, measurement gaps exist in the field. This paper reports on the development and preliminary psychometric assessment of the treatment integrity measure for early childhood settings (TIMECS), an observational measure designed to address existing measurement gaps related to treatment integrity with tier 2 interventions in the early childhood field. To assess the preliminary score reliability (interrater) and validity (construct, discriminant) of the TIMECS, live observations (N = 650) in early childhood classrooms from 54 teachers (92.6% female, 7.4% male; 61.1% White) and 91 children (M age = 4.53 years, SD = .44; 45.1% female, 54.9% male; 45.1% Black) at risk for EBDs were scored by 12 coders using the TIMECS and an observational measure designed to assess teacher-child interactions. Teachers also self-reported on the quality of the teacher-child relationship. Interrater reliability (intraclass correlation coefficients, ICC [2,2]) for the quantity (i.e., adherence) item scores had a mean of .81 (SD = .07; range from .68 to .95), and the quality (i.e., competence) item scores had a mean of .69 (SD = .08; range from .52 to .80). Scores on the TIMECS Quantity and Quality items and scales showed evidence of construct validity, with the magnitude of the correlations suggesting that the quantity and quality items assess distinct components of treatment integrity. A TIMECS quantity scale also showed promise for intervention evaluation research by discriminating between teachers who had and had not been trained in a specific evidence-based intervention targeting social and behavioral skills in early childhood. The findings support the potential of the TIMECS to assess treatment integrity of teacher-delivered practices designed to address child social and behavioral outcomes of children at risk for EBDs in early childhood settings.

Understanding Child-Directed Speech Around Book Reading in Toddler Classrooms: Evidence From Early Head Start Programs.

Child-directed speech (CDS), which can help children learn new words, has been rigorously studied among infants and parents in home settings. Yet, far less is known about the CDS that teachers use in classrooms with toddlers and children's responses, an important question because many toddlers, particularly in high-need communities, attend group-care settings. This exploratory study examines the linguistic environment during teacher-led book readings in American Early Head Start classrooms serving 2-year-olds from households in poverty. Seven teachers in four classrooms were trained to emphasize target words while reading story and informational books. We first analyzed the nature and quality of their book readings from a macro-level, exploring global instructional quality [Classroom Assessment Scoring System (CLASS)] and linguistic complexity [i.e., diversity of vocabulary (D) and sophistication of syntax (MLU-w)], and we also examined micro-level teacher-child talk strategies and use of target words. Compared to prior research, these classrooms had similar global quality and syntactic complexity, although less lexical diversity. Exploratory results also revealed three distinct teacher talk patterns-teachers who emphasized (1) comments, (2) questions, and (3) a balance of the two. Question-focused teachers had more adult and child talk during reading, as well as more repetitions of target words, and stronger CLASS Engaged Support for Learning. However, comment-focused teachers used more diverse vocabulary and had stronger CLASS Emotional and Behavioral Support. Results illuminate the nature and quality of CDS in toddler classrooms, particularly in the context of an intervention emphasizing target vocabulary words, and highlight applications for professional development and questions for further research.

Development and Validation of a Questionnaire to Measure Chinese Preschool Teachers' Implementation of Social-Emotional Practices.

We describe the development and validation of the Social-Emotional Teaching Practices Questionnaire-Chinese (SETP-C), a self-report instrument designed to gather information about Chinese preschool teachers' implementation of social-emotional practices. Initially (study 1), 262 items for the SETP-C were generated. Content validation of these items was conducted separately with Chinese practice experts, research experts, and preschool teachers. Significant revisions were made to items based on theoretical evidence and empirical findings from initial content validation activities, which led to a 70-item version of the SETP-C. In study 2, preliminary psychometric integrity evidence and item characteristics of the SETP-C were gathered based on the data from a sample of 1,599 Chinese preschool teacher respondents. Results from confirmatory factor analyses suggested a seven-factor measurement model, and high internal consistency score reliability was documented for each dimension of the SETP-C. Results of item response theory graded response models further indicated adequate psychometric properties at the item level.

A Systematic Review of Caregiver-Implemented Functional Analyses.

The purpose of this systematic review was to systematically locate and analyze the research on caregiver-implemented functional analyses and subsequent function-based interventions. We included 36 studies and examined multiple features of the studies, including participant demographics, functional analysis characteristics, intervention characteristics, procedural fidelity, risks of bias, and social validity. Overall, the studies showed that caregivers were able to implement functional analyses that yielded differential responding, although few studies reported procedural fidelity data. Caregivers were also able to implement function-based interventions that led to socially significant changes in challenging behavior. Implications for practice and future research are discussed.

Simulation for Clinical Preparedness in Pediatric Emergencies: A Pilot Study.

Positive outcomes for pediatric in-hospital cardiopulmonary arrest remain low with little change in mortality rates. Infrequently used clinical knowledge and skills decline quickly, contributing to poor quality of resuscitation. The aim of this pilot study exploring the outcomes of repeated pediatric mock code simulations with structured debriefing demonstrated statistically significant differences in participants' knowledge of pediatric emergencies, with no significant decline in resuscitation skills. This provides an evidence-based approach for professional development educators working with nurses on pediatric emergencies.

Examining young children's social competence using functional ability profiles.

PURPOSE: To explore the use of International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) based profiles of children's functional abilities in relation to their social competence. Subgroups based on shared profiles of functional ability were investigated as an alternative or complement to subgroups defined by disability categories. METHODS: Secondary analysis of a nationally representative data set of young children identified for special education services in the United States was used for the present study. Using five subgroups of children with shared profiles of functional ability, derived from latent class analysis in previous work, regression analyses were used to examine the relationships between social competence and functional abilities profile subgroup membership. Differences among the subgroups were examined using standardized effect sizes. R2 values were used to examine explained variance in social competence in relation to subgroup membership, disability category, and these variables in combination. RESULTS: Functional ability profile subgroup membership was moderately related to children's social competence outcomes: social skills and problem behaviors. Effect sizes showed significant differences between subgroups. Subgroup membership accounted for more variance in social competence outcomes than disability category. CONCLUSIONS: The results provide empirical support for the importance of functional ability profiles when examining social competence within a population of young children with disabilities. Implications for Rehabilitation The extent to which children with disabilities experience difficulty with social competence varies by their functional characteristics. Functional ability profiles can provide practitioners and researchers working young children with disabilities important tools to examine social competence and to inform interventions.

Identifying Common Practice Elements to Improve Social, Emotional, and Behavioral Outcomes of Young Children in Early Childhood Classrooms.

Educators are increasingly being encouraged to implement evidence-based interventions and practices to address the social, emotional, and behavioral needs of young children who exhibit problem behavior in early childhood settings. Given the nature of social-emotional learning during the early childhood years and the lack of a common set of core evidence-based practices within the early childhood literature, selection of instructional practices that foster positive social, emotional, and behavioral outcomes for children in early childhood settings can be difficult. The purpose of this paper is to report findings from a study designed to identify common practice elements found in comprehensive intervention models (i.e., manualized interventions that include a number of components) or discrete practices (i.e., a specific behavior or action) designed to target social, emotional, and behavioral learning of young children who exhibit problem behavior. We conducted a systematic review of early childhood classroom interventions that had been evaluated in randomized group designs, quasi-experimental designs, and single-case experimental designs. A total of 49 published articles were identified, and an iterative process was used to identify common practice elements. The practice elements were subsequently reviewed by experts in social-emotional and behavioral interventions for young children. Twenty-four practice elements were identified and classified into content (the goal or general principle that guides a practice element) and delivery (the way in which a teacher provides instruction to the child) categories. We discuss implications that the identification of these practice elements found in the early childhood literature has for efforts to implement models and practices.

Evaluation of urinary corticosterone as a biomarker of stress in rats using fenitrothion as a chemical stressor.

Regulatory guidelines for pharmaceutical toxicity studies recommend using one dose near the maximum tolerated. At that level significant toxicities may occur, leading to systemic stress and secondary immune suppression which can be difficult to differentiate from a primary drug effect. Therefore, there is a need for a biomarker of stress applicable to toxicity studies. This study evaluated urinary corticosterone as a biomarker, using as a pharmacologic stressor fenitrothion, which was previously shown not to cause primary immune suppression. Rats were administered fenitrothion orally at 20 and 30 mg/kg daily for 2 or 8 days, with matched vehicle controls (n = 6/group). Urine was collected for 6 and 24 h, before treatment and on Day 2 and Day 8. Urine was assayed for corticosterone, separately for the first 6 h of collection and for the whole 24 h sample. Animals were euthanized on Day 3 or Day 9 and lymphoid tissue samples were collected, weighed and examined histologically. Treated rats showed neurologic signs following treatment. Findings also included time- and dose-dependent decreases in body weight and spleen and thymus weight decreases supra-proportional to body weight on Day 9. Histologic changes were mild at a dose of 20 mg/kg, but significant at 30 mg/kg, consisting of lymphocytolysis at Day 3 and lymphoid depletion at Day 9. Urine corticosterone levels were increased on Day 2 and Day 8, in the 6-h samples, but not the 24-h ones, at both dose levels. Based on the results, urine corticosterone appears to be a sensitive biomarker of systemic stress caused by fenitrothion. Other chemical stressors should be evaluated in a similar manner in order to fully validate urine corticosterone measurement as a stress biomarker.

Unusual Helicobacter pylori in gastric resection specimens: an old friend with a new look.

Immunohistochemical staining is useful in the diagnosis of Helicobacter pylori-induced gastritis. The authors encountered gastric resection specimens with an unusual pattern of reactivity on H pylori immunostains where the typical morphology of the organism was not recognizable, but the characteristic chronic gastritis associated with infection was present. The authors sought to explore this phenomenon by retrospectively reviewing and immunostaining 28 gastric resection specimens for H pylori. Six cases with large clumps of immunohistochemically positive but morphologically unrecognizable material were identified on light microscopy, corresponding on electron microscopy to clusters of predominantly coccoid H pylori, some located intracellularly. Such organisms were not identifiable without immunohistochemistry, and the phenomenon was not encountered in gastric biopsies. The authors conclude that this staining pattern reflects true H pylori infection that is not diagnosable without immunohistochemistry. Based on its occurrence only in resections, it may be the result of hypoxic or other stress induced when the mucosa is not promptly fixed.

Concurrent validity and reliability of the Alberta Infant Motor Scale in infants at dual risk for motor delays.

Concurrent validity of scores for the Alberta Infant Motor Scale (AIMS) and the Peabody Developmental Gross Motor Scale-2 (PDGMS-2) was examined with a sample of 35 infants at dual risk for motor delays or disabilities. Dual risk was defined as low birthweight ( 9 months of age. Novice examiners' scores on both measures closely approximated those of experienced examiners (ICC range = .98 to .99). The results support concurrent validity of the AIMS and PDGMS-2 for infants at dual risk and have implications for using the AIMS in high-risk follow-up programs, particularly in relation to evaluating functional components of motor performance and ease of administration.

Using cooperative learning in clinical laboratory science education.

OBJECTIVE: To compare performance of students instructed by cooperative learning (CL) activities with those taught by lecture. A secondary objective was to assess students' perceptions about their ability to work in teams before and after their exposure to these instructional approaches. DESIGN/SETTING/PARTICIPANTS: CL was incorporated into the immunology/serology course of a university-based clinical laboratory science (CLS) program. Twenty-two students participated in a 4-week study and were randomly assigned to one of two study groups. INTERVENTION: One group received the course material by CL activities, and the other group was exposed to the material through lecture. MAIN OUTCOMES MEASURE: Mean examination scores for CL and lecture groups were compared using an independent samples t-test. Teamwork knowledge, skills, and attitude (KSA) assessment rated students' perceptions of their ability to work in a team environment pre and post tests were compared using a 2 x 2 repeated measures ANOVA. RESULTS: No significant difference was found between mean examination scores of students who acquired their knowledge by CL activities (85.09%) and those taught by lecture (82.18%). Teamwork KSA means scores pre and post tests (22.5, 22.6 CL; 22.7, 21.6 lecture) were not significantly different. CONCLUSION: Results suggest that the incorporation of CL activities did not reduce the students' academic performance or self-perceptions of their ability to work in teams. The use of CL in the classroom, student laboratory, or clinical setting may help prepare students for the role they will be expected to perform as laboratory professionals.

Pacing as a treatment technique for transitional sucking patterns.

OBJECTIVE: To ascertain whether the implementation of a paced feeding protocol in a sample of preterm infants with respiratory diagnoses will result in the development of more efficient sucking patterns, increased weight gain, decreased incidence of bradycardia during feeding, and shorter length of hospital stay. METHOD: A total of 36 premature infants were enrolled into a nonrandomized clinical trial conducted in a neonatal intensive care unit (NICU). The first 18 infants were traditionally bottle-fed. Following this cohort's discharge from NICU, nursing staff completed continuing education on implementing a paced feeding protocol and the next 18 infants were delivered paced feedings. RESULTS: The two cohorts were equivalent at the initiation of oral feedings on gestational age, birth weight, 1 and 5 minute Apgar scores, weight, and postconceptual age. The paced infants demonstrated statistically and clinically significant decreases in bradycardic incidences during feeding and gains in development of more efficient sucking patterns at discharge. Discharge and average weekly weight gain did not differ between the two groups. CONCLUSIONS: The incorporation of pacing into NICU care practices appears to be beneficial for preterm infants with respiratory disease.

How the CATCH eat smart program helps implement the USDA regulations in school cafeterias.

This article describes the implementation of the U.S. Department of Agriculture's National School Lunch Program (NSLP) standards in school lunch menus in 56 intervention and 20 control schools from the Child and Adolescent Trial for Cardiovascular Health (CATCH) 5 years after the main trial, compared with 12 schools previously unexposed to CATCH. School food service personnel completed questionnaires to assess CATCH guideline implementation, demographic data, behavioral constructs, training, program material use, and participation in competing programs. Five days of menus and recipes were collected from school cafeteria staff, averaged, and compared to USDA School Meal Initiative (SMI) standards. Significant differences between intervention and unexposed schools were found for training and knowledge of CATCH and in mean percentage energy from fat and carbohydrates. Intervention schools most closely met USDA SMI recommendations for fat. Thus, the CATCH Eat Smart Program assisted school cafeterias in meeting USDA guidelines 5 years postimplementation.

Maintenance of effects of the eat smart school food service program: results from the CATCH-ON study.

The Child and Adolescent Trial for Cardiovascular Health (CATCH) Eat Smart Program targeted the food service of the 56 CATCH intervention elementary schools to effect positive changes in the total fat and saturated fat content of school lunch. Maintenance of the food service intervention in former intervention (n = 56) and control (n = 20) schools was evaluated 5 years postintervention. After 5 years of follow-up and no further intervention, the former CATCH intervention schools not only maintained prior levels but also had further decreases in the mean percentage of calories from total and saturated fat to 31% and 10.4%, respectively. Significant decreases in these nutrients were also observed in the former CATCH control schools; however, the former intervention schools more closely approached the Eat Smart goal for total fat Overall, sodium levels rose in both school conditions and did not differ significantly at follow-up.

Practitioners' reading patterns, attitudes, and use of research reported in occupational therapy journals.

Occupational therapists are encouraged to use research-based evidence to guide practice. In this study, we investigated whether members of the American Occupational Therapy Association read their flagship journal, the American Journal of Occupational Therapy (AJOT, or other scholarly journals. Therapists' attitudes about research, their reading patterns, and their use of research in clinical practice were also explored. A proportional, random sample of 626 therapists from five states was mailed a questionnaire; 52% were returned. Of the 328 respondents, 85% reported reading AJOT: For those who did not read AJOT, barriers cited included time constraints, difficulty interpreting results, lack of clinical information, and too much scientific information. Attitudes about research generally were positive, although ratings regarding the usefulness of research to inform clinical practices were less favorable. Attitudes about and use of research ratings were not strongly related to practice settings, educational degree level, years of experience, or state of residence. Results suggest education and clinical practice changes may be necessary to support therapists' use of empirical evidence in practice contexts.

Nutrient Intakes of Third Graders: Results from the Child and Adolescent Trial for Cardiovascular Health (CATCH) Baseline Survey.

The purpose of this article is to report on baseline intakes of 1874 third-grade children representing a subsample of the Child and Adolescent Trial for Cardiovascular Health (CATCH) cohort. Intakes were assessed using a single, food record-assisted, 24-hour recall. The sample is unique in that it is drawn from four states and includes students from various ethnic backgrounds. Nutrients of interest include total energy, sodium, dietary cholesterol, and percent of energy from total fat and saturated fat. At baseline, third-grade students were consuming above nationally recommended levels of energy from fat, saturated fat, and sodium. The CATCH findings show a mean energy intake of 2031 kcal with significant differences by sex. Significant differences by site were seen for percent of energy from total fat, saturated fat, and dietary cholesterol. Children from Minnesota consumed the lowest proportion of energy from total fat and saturated fat while children from Texas had the highest proportion of energy from total fat and saturated fat. Intake of dietary cholesterol was lowest in Minnesota and highest in Louisiana. Nutrient differences by ethnic group were seen only for energy, with African Americans having the highest energy intake and Hispanics having the lowest energy intake. The number of meals consumed from school food service significantly influenced children's nutrient, intake; children consuming two meals from school food service had significantly greater intakes of energy, saturated fat, and dietary cholesterol compared to students consuming one or no meals from school food-service. The results are compared to other national nutritional surveys of children.

Thermal Destruction of Listeria monocytogenes in Ground Pork Prepared with and without Soy Hulls.

D-values and z-values were determined for Listeria monocytogenes Scott A cells heated in raw ground pork prepared with and without soy hulls and in a soy hull/water mixture. Products inoculated with ca. 107 colony-forming units (CFU) per g were sealed in glass vials, immersed in a water bath, and held at 50, 55, 60, or 62°C for predetermined times. Survival was determined by testing heated samples with McBride listeria agar. The D-values for L. monocytogenes cells at 50, 55, and 60°C were 108.81, 9.80, and 1.14 min, respectively, when heating was in ground pork and 113.64, 10.19, and 1.70 min, respectively, when heating in ground pork with added soy hulls. At 62°C L. monocytogenes cells were inactivated too rapidly to permit determination of the D-value. The D-values for L. monocytogenes in the soy hull/water mixture at 50 and 55°C were 19.84 and 3.94 min, respectively. L. monocytogenes cells were inactivated too quickly to determine the D-value at 60°C. The z-values for L. monocytogenes in ground pork prepared with and without soy hulls were 5.45 and 5.05°C, respectively. If ground pork naturally contains 102 L. monocytogenes cells per g and if we want to assure safety with a 4-D Listeria cook (reducing the L. monocytogenes population by four orders of magniatude), then according to results of this study, ground pork must be heated to an internal temperature of 60°C for at least 4.6 min and ground pork with added soy hulls for at least 6.8 min.