Promoting toddlers' self-regulation and healthy eating habits among families living in poverty: A randomized controlled trial of Recipe 4 Success.

The Recipe 4 Success preventive intervention targeted multiple factors critical to the health and well-being of toddlers living in poverty. This randomized controlled trial, which was embedded within Early Head Start home visits for 12 weeks, included 242 racially and ethnically diverse families (51% girls; toddler mean age = 2.58 years; data collected 2016-2019). Compared to parents in usual practice home visits, parents in Recipe 4 Success displayed greater sensitive scaffolding of toddlers' learning and more responsive food parenting practices (Cohen's d = .21-.30). Toddlers in Recipe 4 Success exhibited greater self-regulation and had healthier eating habits (Cohen's d = |.16-.35|). Results highlight the value of Recipe 4 Success in promoting parent and toddler behavior change that could have life-long benefits.

Elaboration of parents' schemas of their children: Unique relations to sensitivity and learning support among families living in poverty.

This study examined how distinct aspects of parents' schemas of their children are related to caregiving behaviors. It included 242 families with toddlers and young children, most of whom were living in poverty (37% White, 25% Black, 19% Latine, 17% Multiracial, and 2% Asian; child age = 21-39 months; median family income = $1,555 per month). The elaboration and emotional valence of parents' schemas were coded from brief responses to open-ended questions about children's personality; observations of parents' sensitivity and learning support were assessed in structured and unstructured settings. Results of regression equations controlling for multiple family, parent, and child characteristics revealed that both greater elaboration and positive emotional valence were uniquely related to parents' sensitivity (standardized ß = .15, p = .05, and ß = .13, p = .04, respectively), but only elaboration was uniquely related to learning support (ß = .35, p < .001). This study highlights the special importance of the elaboration of parents' schemas in understanding caregiving behaviors among families living in poverty and the potential value of enhancing elaboration in family-focused preventive interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Heterogeneous Effects of Depression on Parenting Competence and Child Behavior Among Families Living in Poverty.

This study examined how depression and psychosocial protective factors, such as self-efficacy and conscientiousness, were related to parenting competence and child behavior among families living in poverty. The sample included 238 families (37% White, 25% Black, 19% Latinx, 17% Multiracial, and 2% Asian; 42% of parents reporting clinically significant symptoms of depression) with young children (mean age = 31 months, 51% female). Latent profile analysis identified five distinct subgroups of parents who differed on levels of depression and psychosocial protective factors. A small group of parents who had high levels of depression and low levels of protective factors displayed the least parenting competence and had children with lower levels of adjustment. At the same time, parents in two other profiles had high levels of depression, but moderate or high levels of protective factors, and displayed average parenting competence and had children who displayed average or above average levels of adjustment. In this study, depression appeared less predictive of parenting competence and child behavior than the psychosocial protective factors. This study suggests that many parents, despite having depression and living in poverty, exhibit psychosocial protective factors that are associated with high levels of parenting competence and rear children who are doing well.

What kind of parenting is associated with early self-control among toddlers living in poverty? The importance of learning support.

The present study examined what kind of parenting best supports toddlers' self-control in the context of poverty. Parents and toddlers (52% female; Mage = 2.60 years) in 117 families (35% White, 25% Black, 22% Latinx, 15% Multiracial, and 3% Asian; M family income = $1,845/month) engaged in structured interaction tasks, and toddlers completed a snack delay task concurrently and after 6 months. Latent profile analysis based on eight observed parenting behaviors representing learning support and responsiveness/sensitivity (e.g., teaching, technical scaffolding, teamwork, instructions, choices, language use, specific praise, and warmth) identified four parenting profiles: Lower Learning Support/Lower Responsiveness, Moderate Learning Support/Moderate Responsiveness, High Responsiveness, and High Learning Support. Toddlers with parents in the High Learning Support profile demonstrated the greatest self-control 6 months later, compared with toddlers of parents in the other three profiles, and there were no statistically significant differences in self-control among toddlers of parents in those other three profiles. Results were robust even after controlling for initial levels of self-control, as well as multiple other child, parent, and family characteristics. These study findings highlight the importance of parents' learning support in understanding the early development of toddlers' self-control in the context of poverty and reinforce the need to create and refine preventive interventions in this area. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A systematic review of clinical and laboratory parameters of 3,000 COVID-19 cases.

The coronavirus disease 2019 (COVID-19) has spread worldwide. It is still a pandemic and poses major health problem across the globe. In our review, clinical characteristics and laboratory parameters of COVID-19 patients were compiled systematically, with special reference to pregnant women in order to understand the disease course. An extensive literature search on various scientific databases for relevant manuscripts was conducted, which yielded 7 manuscripts for final analysis. The most common symptoms were fever (85%), cough (70.63%), chest tightness (37.36%), expectoration (33.27%), fatigue (32%), dyspnea (31.95%), and shortness of breath (31.19%), while hemoptysis (1.0%) was the least common. The associated comorbidities were hypertension (21.6%) and diabetes (10.0%). In terms of hematological parameters, lower total leukocyte counts were observed in 65% of cases and biochemical parameters, patients demonstrated elevated levels of albumin (53.72%), lactate dehydrogenase (45.71%), and natriuretic peptide (34.84%); however, total bilirubin was elevated in only 8% of cases. In the acute inflammatory cytokine profile, C-reactive protein (59.0%), tumor necrosis factor (58.0%), erythrocyte sedimentation rate (57.0%), interleukin-2 (IL- 2, 54.0%), and IL-6 (52.0%) levels were increased, while prolactin levels (6.5%) were minimally elevated. The recovery rate was approximately 41%, and mortality was about 6.5%. The study also concluded that the clinical symptoms of COVID-19 were similar among pregnant and non-pregnant women. There was no evidence of vertical transmission of COVID-19 infection. This review critically analyzed COVID-19 as a public health hazard in order to help policy makers, health care givers, and primary physicians to promote early diagnosis and prevention.

Improving Toddlers' Healthy Eating Habits and Self-regulation: A Randomized Controlled Trial.

OBJECTIVES: In this study, we tested whether Recipe 4 Success, a preventive intervention featuring structured food preparation lessons, was successful in improving the following 4 protective factors related to overweight and obesity among families living in poverty: toddlers' healthy eating habits, toddlers' self-regulation, parents' responsive feeding practices, and parents' sensitive scaffolding. METHODS: This randomized controlled trial was open to families enrolled in Early Head Start home visits and included 73 parents and their toddlers aged 18 to 36 months. Multimethod assessments were conducted at baseline and posttreatment. RESULTS: Compared with toddlers in usual practice Early Head Start, toddlers in Recipe 4 Success consumed healthier meals and snacks (d = 0.57; P < .03; 95% confidence interval [CI]: 0.08-1.06) and displayed better self-regulation (d = 0.95; P < .001; 95% CI: 0.43-1.45). Compared with parents in usual practice Early Head Start, parents in Recipe 4 Success engaged in more responsive feeding practices (d = 0.87; P < .002; 95% CI: 0.34-1.40) and were better able to sensitively scaffold their toddlers' learning and development (d = 0.58; P < .04; 95% CI: 0.07-1.09). CONCLUSIONS: This randomized controlled trial revealed medium to large intervention effects on 4 important protective factors that are related to overweight and obesity but are often compromised by living in poverty.

Mechanical prophylaxis, early mobilisation and risk stratification: as effective as drugs for low risk patients undergoing primary joint replacement. Results in 13,384 patients.

INTRODUCTION: Current NICE Guidelines state that all patients undergoing total hip and knee arthroplasty should be given both mechanical and chemical prophylaxis. At our institution, a targeted thromboprophylaxis policy has been in place since October 1999. The aim of this study was to calculate our venous thromboembolism rates and compare these to published rates in the literature. METHODS: All patients are pre-operatively assessed for their VTE risk. Patients are stratified into high or low risk: all patients received mechanical thromboprophylaxis and the higher risk patients now receive chemical and mechanical thromboprophylaxis post op. Patients are reviewed at 2, 6 and 52 weeks and with annual postal questionnaires and clinical and radiological review at 5 and 10yrs. RESULTS: 13,384 primary THA and TKAs were entered into the database. The overall rate of clinically apparent DVT and overall PE rates of 0.48% and 0.42% respectively. 86.16% of our patients were low risk, of these 23.3% of patients were on Aspirin/Clopidogrel with mechanical thromboprophylaxis and 76.7% of patients had mechanical prophylaxis alone. There was no statistical difference between the DVT or PE rates in the low risk groups. CONCLUSION: Our results show that use of early mobilisation and mechanical prophylaxis within an Enhanced Recovery Programme results in comparable VTE rates to chemical prophylaxis for all, which is reflected in the literature. Our results question the need for chemical thromboprophylaxis or extended use of mechanical thromboprophylaxis in "lower risk" patients if a risk stratification policy is used in the context of modern surgical approaches.

Parent Engagement in a Head Start Home Visiting Program Predicts Sustained Growth in Children's School Readiness.

This study examined three components of parent engagement in an enriched Head Start home visiting program: intervention attendance, the working alliance between parents and home visitors, and parents' use of program materials between sessions. The study identified those family and child characteristics that predicted the different components of parent engagement, and the study tested whether those components predicted sustained growth in children's school readiness skills across four years, from preschool through second grade. Ninety-five low-income parents with four year-old children attending Head Start (56% white; 26% black; 20% Latino; 44% girls) were randomly assigned to receive the home visiting program. Assessments included home visitor, parent, and teacher ratings, as well as interviewer observations and direct testing of children; data analyses relied on correlations and hierarchical multiple regression equations. Results showed that baseline family characteristics, like warm parent-child interactions, and child functioning predicted both working alliance and use of program materials, but only race/ethnicity predicted intervention attendance. The use of program materials was the strongest predictor of growth in children's literacy skills and social adjustment at home during the intervention period itself. In contrast, working alliance emerged as the strongest predictor of growth in children's language arts skills, attention skills, and social adjustment at school through second grade, two years after the end of the home visiting intervention. To maximize intervention effectiveness across school readiness domains over time, home visiting programs need to support multiple components of parent engagement, particularly working alliance and the use of program materials between sessions.

Dosimetric and volumetric changes in the rectum and bladder in patients receiving CBCT-guided prostate IMRT: analysis based on daily CBCT dose calculation.

Delivered dose can be calculated by transferring the planned treatment beams onto the daily CBCT. Bladder and rectum volumetric doses were calculated and cor-related to the daily bladder and rectum fullness. Patients for this study underwent hypofractionated prostate IMRT to 70 Gy in 28 fractions. Daily CBCT was utilized for image guidance. A clinically acceptable plan was created using a CTV-to-PTV uniform margin of 5 mm. Image fusion was performed to transfer the bladder and rectum contours onto each CBCT. Contours were then edited to match the anatomy of each CBCT. Using the daily treatment isocenter, the planned beams were transferred onto the CBCT and daily and cumulative DVHs calculated. For the results a total of 168 daily CBCTs were evaluated. The bladder was found to be smaller for 74.7% of the 168 daily CBCTs accessed in this study. This reduction in volume correlated to an increase in the cumulative bladder V70 Gy from 9.47% on the planning CT to 10.99% during treatment. V70Gy for the rectum was 7.27% on the planning CT, when all six patients were averaged, and increased to 11.56% on the average of all daily treatment CBCTs. Increases in volumetric rectum dose correlated with increases in rectal volume. For one patient, the rectum and blad-der absolute V70 Gy, averaged over the course of treatment, increased by 295% and 61%, respectively. Larger variations in the daily bladder and rectal volume were observed and these correlated to large deviations from the volumetric dose received by these structures. In summary, bladder and rectum volume changes during treatment have an effect on the cumulative dose received by these organs. It was observed that the volumetric dose received by the bladder decreases as the volume of the bladder increases. The inverse was true for the rectum.

Determination of optimal PTV margin for patients receiving CBCT-guided prostate IMRT: comparative analysis based on CBCT dose calculation with four different margins.

Variations in daily setup and rectum/bladder filling lead to uncertainties in the delivery of prostate IMRT. The purpose of this study is to determine the optimal PTV margin for CBCT-guided prostate IMRT based on daily CBCT dose calculations using four different margins. Five patients diagnosed with low-risk prostate cancer were treated with prostate IMRT to 70 Gy in 28 fractions using daily CBCT for image guidance. The prostate CTV and OARs were contoured on all CBCTs. IMRT plans were created using 1 mm, 3 mm, 5 mm, and 7 mm CTV to PTV expansions. For each delivered fraction, dose calculations were generated utilizing the pretreatment CBCT translational shifts performed and dosimetric analysis was performed. One hundred and forty total treatment fractions (CBCT sessions) were evaluated. The planned prostate CTV V100% was 100% for all PTV margins. Based on CBCT analysis, the actual cumulative CTVs V100% were 96.55% ± 2.94%, 99.49% ± 1.36%, 99.98% ± 0.26%, and 99.99% ± 0.05% for 1, 3, 5, and 7 mm uniform PTV margins, respectively. Delivered rectum and bladder doses were different as compared to expected planned doses, with the magnitude of differences increasing with PTV margin. Daily setup variation during prostate IMRT yields differences in the actual vs. expected doses received by the prostate CTV, rectum, and bladder. The magnitude of these differences is significantly affected by the PTV margin utilized. It was found that when daily CBCT was used for soft-tissue alignment of the prostate, a 3 mm PTV margin allowed for CTV to be covered for 99% of cases.

Effects of Head Start REDI on children's outcomes 1 year later in different kindergarten contexts.

One year after participating in the Research-based, Developmentally Informed (REDI) intervention or "usual practice" Head Start, the learning and behavioral outcomes of 356 children (17% Hispanic, 25% African American; 54% girls; Mage  = 4.59 years at initial assessment) were assessed. In addition, their 202 kindergarten classrooms were evaluated on quality of teacher-student interactions, emphasis on reading instruction, and school-level student achievement. Hierarchical linear analyses revealed that the REDI intervention promoted kindergarten phonemic decoding skills, learning engagement, and competent social problem-solving skills, and reduced aggressive-disruptive behavior. Intervention effects on social competence and inattention were moderated by kindergarten context, with effects strongest when children entered schools with low student achievement. Implications are discussed for developmental models of school readiness and early educational programs.

Promoting Children's Social-Emotional Skills in Preschool Can Enhance Academic and Behavioral Functioning in Kindergarten: Findings from Head Start REDI.

This study examined processes of change associated with the positive preschool and kindergarten outcomes of children who received the Head Start REDI intervention, compared to "usual practice" Head Start. In a large-scale randomized-controlled trial (N = 356 children, 42% African American or Latino, all from low-income families), this study tests the logic model that improving preschool social-emotional skills (e.g., emotion understanding, social problem solving, and positive social behavior) as well as language/emergent literacy skills will promote cross-domain academic and behavioral adjustment after children transition into kindergarten. Validating this logic model, the present study finds that intervention effects on three important kindergarten outcomes (e.g., reading achievement, learning engagement, and positive social behavior) were mediated by preschool gains in the proximal social-emotional and language/emergent literacy skills targeted by the REDI intervention. Importantly, preschool gains in social-emotional skills made unique contributions to kindergarten outcomes in reading achievement and learning engagement, even after accounting for the concurrent preschool gains in vocabulary and emergent literacy skills. These findings highlight the importance of fostering at-risk children's social-emotional skills during preschool as a means of promoting school readiness. The REDI (Research-Based, Developmentally-Informed) enrichment intervention was designed to complement and strengthen the impact of existing Head Start programs in the dual domains of language/emergent literacy skills and social-emotional competencies. REDI was one of several projects funded by the Interagency School Readiness Consortium, a partnership of four federal agencies (the National Institute of Child Health and Human Development, the Administration for Children and Families, the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services, and the Office of Special Education and Rehabilitation Services in the Department of Education). The projects funded through this partnership were designed to assess how integrative early interventions for at-risk children could promote learning and development across multiple domains of functioning. In addition, the projects were charged with examining processes of change and identifying mechanisms of action by which the early childhood interventions fostered later school adjustment and academic achievement. This study examined such processes of change, with the goal of documenting hypothesized cross-domain influences on kindergarten outcomes. In particular, this study tested whether gains in the proximal language/emergent literacy and social-emotional competencies targeted during Head Start would mediate the REDI intervention effects on kindergarten academic and behavioral outcomes. In addition, it tested the hypothesis that gains in social-emotional competencies during preschool would make unique contributions to intervention effects on both academic and behavioral outcomes, even after accounting for the effects of preschool gains in language and emergent literacy skills.

Sustaining High Quality Teaching and Evidence-based Curricula: Follow-up Assessment of Teachers in the REDI Project.

Recent research has validated the power of evidence-based preschool interventions to improve teaching quality and promote child school readiness when implemented in the context of research trials. However, very rarely are follow-up assessments conducted with teachers in order to evaluate the maintenance of improved teaching quality or sustained use of evidence-based curriculum components after the intervention trial. In the current study, we collected follow-up assessments of teachers one year after their involvement in the REDI research trial to evaluate the extent to which intervention teachers continued to implement the REDI curriculum components with high-quality, and to explore possible pre-intervention predictors of sustained implementation. In addition, we conducted classroom observations to determine whether general improvements in the teaching quality of intervention teachers (relative to control group teachers) were sustained. Results indicated sustained high-quality implementation of some curriculum components (the PATHS curriculum), but decreased implementation of other components (the language-literacy components). Sustained intervention effects were evident on most aspects of general teaching quality targeted by the intervention. Implications for practice and policy are discussed.

Chemically stable proton conducting doped BaCeO3 -no more fear to SOFC wastes.

Development of chemically stable proton conductors for solid oxide fuel cells (SOFCs) will solve several issues, including cost associated with expensive inter-connectors, and long-term durability. Best known Y-doped BaCeO3 (YBC) proton conductors-based SOFCs suffer from chemical stability under SOFC by-products including CO2 and H2O. Here, for the first time, we report novel perovskite-type Ba0.5Sr0.5Ce0.6Zr0.2Gd0.1Y0.1O3-δ by substituting Sr for Ba and co-substituting Gd + Zr for Ce in YBC that showed excellent chemical stability under SOFC by-products (e.g., CO2 and H2O) and retained a high proton conductivity, key properties which were lacking since the discovery of YBCs. In situ and ex- situ powder X-ray diffraction and thermo-gravimetric analysis demonstrate superior structural stability of investigated perovskite under SOFC by-products. The electrical measurements reveal pure proton conductivity, as confirmed by an open circuit potential of 1.15 V for H2-air cell at 700°C, and merits as electrolyte for H-SOFCs.

Wound problems following hip arthroplasty before and after the introduction of a direct thrombin inhibitor for thromboprophylaxis.

In the United Kingdom, national guidelines have stated that patients undergoing elective hip surgery are at increased risk for venous thromboembolic events (VTE) following surgery and have recommended thromboprophylaxis for 28-35 days (1, 2). Studies of direct thrombin inhibitors have hitherto concentrated on major bleeding. We prospectively assessed wound discharge in patients who underwent hip arthroplasty and who received oral dabigatran postoperatively between March 2010 and April 2010 (n=56). We compared these results to a retrospective matched group of patients who underwent similar operations six months earlier, at which time all patients were given subcutaneous dalteparin routinely postoperatively until discharge, and then discharged home on 150 mg aspirin daily for 6 weeks (n=67). Wound discharge after 5 days was significantly higher in the patients taking dabigatran (32% dabigatran n=18, 10% dalteparin n=17, p=0.003) and our rate of delayed discharges due to wound discharge significantly increased from 7% in the dalteparin group (n=5) to 27% for dabigatran (n=15, p=0.004). Patients who received dabigatran were more than five times as likely to return to theatre with a wound complication compared with those who received dalteparin (7% dabigatran n=4, vs. 1% dalteparin n=1), but this was not statistically significant (p=0.18). We now administer dalteparin until the wound is dry and then start dabigatran. Our study demonstrates the need for further clinical studies regarding wound discharge and direct thrombin inhibitors.

Implementation Quality: Lessons Learned in the Context of the Head Start REDI Trial.

This study uses data collected in the intervention classrooms (N = 22) of Head Start REDI (Research-based, Developmentally Informed), a randomized clinical trial testing the efficacy of a comprehensive preschool curriculum targeting children's social-emotional competence, language, and emergent literacy skills delivered by teachers who received weekly coaching support. Multiple dimensions of implementation (Dosage, Fidelity, Generalization, and Child Engagement) were assessed across curriculum components. Results indicated that REDI Trainers perceived significant growth in teacher implementation quality over time but that patterns differed by implementation dimension. Dosage and Fidelity of all intervention components were high at the beginning of the year and remained so over time while Generalization was low at baseline but increased significantly across the year. Variation in implementation was associated with variation on several child outcome measures in the social-emotional domain but not in the language and literacy domains.

Ethnic awareness, prejudice, and civic commitments in four ethnic groups of American adolescents.

The role of prejudice and ethnic awareness in the civic commitments and beliefs about the American social contract of 1,096 (53% female) adolescents (11-18 year olds, Mean = 15) from African-, Arab-, Latino-, and European-American backgrounds were compared. Ethnic awareness was higher among minority youth and discrimination more often reported by African- and Arab-Americans. Parental admonitions against discrimination were heard by all but African Americans, Latinos and those who reported prejudice heard that it could pose a barrier. Adolescents' beliefs that America is an equal opportunity society were negatively associated with experiences of discrimination and African-Americans were least likely to believe that the government was responsive to the average person. With respect to civic goals, all youth endorsed patriotism but ethnic minorities and ethnically aware youth were more committed to advocating for their ethnic group and European-Americans were less committed than were African Americans to improving race relations.

Fostering High-Quality Teaching with an Enriched Curriculum and Professional Development Support: The Head Start REDI Program.

This randomized controlled trial tested whether teaching quality in Head Start classrooms could be improved with the addition of evidence-based curriculum components targeting emergent language/literacy and social-emotional development and the provision of associated professional development support. Participants were lead and assistant teachers in 44 Head Start classrooms. Teachers received 4 days of workshop training along with weekly in-class support from a mentor teacher. End-of-year observations indicated that, compared to the control group, intervention teachers talked with children more frequently and in more cognitively complex ways, established a more positive classroom climate, and used more preventive behavior management strategies. Results supported the conclusion that enriched curriculum components and professional development support can produce improvements in multiple domains of teaching quality.

Individual Factors Associated with Professional Development Training Outcomes of the Head Start REDI Program.

This study examined factors associated with process and content outcomes of the training provided in the context of Head Start REDI (Research based Developmentally-informed), a preschool curriculum designed to enhance the quality of interactions (social-emotional and language-literacy) between teachers and children. REDI professional development included 4 days of training and weekly coaching. Data for 22 intervention teaching pairs (N = 44) were used in the study. With the exception of years of education and emotional exhaustion, distal teacher factors (i.e., professional characteristics, personal resources and perceptions of the work environment) were unrelated to end-of-year implementation fidelity while openness to consultation showed a significant association. The findings emphasize the importance of teacher engagement in the training process for program effectiveness.

Promoting academic and social-emotional school readiness: the head start REDI program.

Forty-four Head Start classrooms were randomly assigned to enriched intervention (Head Start REDI-Research-based, Developmentally Informed) or "usual practice" conditions. The intervention involved brief lessons, "hands-on" extension activities, and specific teaching strategies linked empirically with the promotion of: (a) social-emotional competencies and (b) language development and emergent literacy skills. Take-home materials were provided to parents to enhance skill development at home. Multimethod assessments of three hundred and fifty-six 4-year-old children tracked their progress over the course of the 1-year program. Results revealed significant differences favoring children in the enriched intervention classrooms on measures of vocabulary, emergent literacy, emotional understanding, social problem solving, social behavior, and learning engagement. Implications are discussed for developmental models of school readiness and for early educational programs and policies.