School Readiness Among United States Children: Results From the 2022 National Survey of Children's Health.

OBJECTIVE: Provide the latest national and state estimates and correlates of the proportion of young children who are healthy and ready to learn (HRTL) using a revised measure from the National Survey of Children's Health (NSCH). METHODS: Data were analyzed for 11,121 children ages 3 to 5 years from the 2022 NSCH, an address-based, parent-completed survey on the health and well-being of children in the United States. A total of 27 items across 5 domains (early learning skills, social emotional development, self-regulation, motor development, and health) were used to calculate domain-specific assessments scored as "on track," "emerging," or "needs support" according to age-appropriate developmental expectations. Children "on track" in 4 to 5 domains with no domain that "needs support" were considered HRTL. RESULTS: In 2022, 63.6% of 3- to 5-year-old children were HRTL. The proportion of children "on track" ranged from just over two thirds for early learning skills and motor development to 88.9% for health. One million children, or 9.0%, needed support in multiple domains. Being HRTL was associated with child, family, community factors including participation in early childhood education, special health care needs status/type, male sex, reading/singing/storytelling by family members, adverse childhood experiences, parental mental health and education, food insufficiency, outdoor play, household language, neighborhood amenities, rural residence, medical home access. CONCLUSIONS: Nearly two thirds of young children are reported to be HRTL, meeting the Title V National Outcome Measure for School Readiness. Using a revised measure, modifiable factors are identified which offer a range of intervention opportunities at the child, family, and community levels.

Implementation of an evidence-based accidental tracheostomy dislodgement bundle in a community hospital critical care unit.

BACKGROUND: Tracheostomy dislodgment can lead to catastrophic neurological injury or death. A fresh tracheostomy amplifies the risk of such events, where an immature tract predisposes to false passage. Unfortunately, few resources exist to prepare healthcare professionals to manage this airway emergency. AIM: To create and implement an accidental tracheostomy dislodgement (ATD) bundle to improve knowledge and comfort when responding to ATD. MATERIALS & METHODS: A multidisciplinary team with expertise in tracheostomy developed a 3-part ATD bundle including (1) Tracheostomy Dislodgement Algorithm, (2) Head of Bed Tracheostomy Communication Tool and (3) Emergency Tracheostomy Kit. The team tested the bundle during the COVID-19 pandemic in a community hospital critical care unit with the engagement of nurses and Respiratory Care Practitioners. Baseline and post-implementation knowledge and comfort levels were measured using Dorton's Tracheotomy Education Self-Assessment Questionnaire, and adherence to protocol was assessed. Reporting follows the revised Standards for Quality Improvement Reporting Excellence (SQUIRE). RESULTS: Twenty-four participants completed pre-test and post-test questionnaires. The median knowledge score on the Likert scale increased from 4.0 (IQR = 1.0) pre-test to 5.0 (IQR = 1.0) post-test. The median comfort level score increased from 38.0 (IQR = 7.0) pre-test to 40.0 (IQR = 5.0) post-test). In patient rooms, adherence was 100% for the Head of Bed Tracheostomy Communication Tool and Emergency Tracheostomy Kit. The adherence rate for using the Dislodgement Algorithm was 55% in ICU and 40% in SCU. DISCUSSION: This study addresses the void of tracheostomy research conducted in local community hospitals. The improvement in knowledge and comfort in managing ATD is reassuring, given the knowledge gap among practitioners demonstrated in prior literature. The ATD bundle assessed in this study represents a streamlined approach for bedside clinicians - definitive management of ATD should adhere to comprehensive multidisciplinary guidelines. CONCLUSIONS: ATD bundle implementation increased knowledge and comfort levels with managing ATD. Further studies must assess whether ATD bundles and other standardised approaches to airway emergencies reduce adverse events. Relevance to Clinical Practice A streamlined intervention bundle employed at the unit level can significantly improve knowledge and comfort in managing ATD, which may reduce morbidity and mortality in critically ill patients with tracheostomy.

Measuring state-level infant and toddler well-being in the United States: Gaps in data lead to gaps in understanding.

Children who are nurtured, protected, and supported in the first years of life tend to have better individual outcomes and are more likely to grow to become healthy, productive adults. Child well-being varies across states, yet the field lacks a comprehensive review of infant and toddler indicators measured at the state-level. This paper reviews indicators of well-being from the prenatal period to three years that meet certain a priori criteria. Most of the child-level indicators identified were in the physical health domain; relatively fewer indicators were found in the early cognition and language or social-emotional-behavioral domains. While some states are making progress toward developing integrated early childhood data systems, more work is needed to provide robust data on infant and toddler development. These results highlight the need to develop a broader range of indicators of infant and toddler well-being and improve measurement sources to better inform policies and programs advancing population health.

Healthy and Ready to Learn: Prevalence and Correlates of School Readiness among United States Preschoolers.

OBJECTIVE: To assess the national and state prevalence of being "Healthy and Ready to Learn" (HRL) and associated sociodemographic, health, family and neighborhood factors. METHODS: Cross-sectional analysis of the 2016 National Survey of Children's Health, a nationally representative parent-reported survey administered by web and paper June 2016 to February 2017. Four domains were constructed from 18 items through confirmatory factor analyses: "Early Learning Skills", "Social-Emotional Development", "Self-Regulation", and "Physical Well-being and Motor Development." Each item and domain were scored according to age-specific standards as "On-Track", "Needs Support", and "At Risk" with overall HRL defined as "On-Track" in all domains for 7565 randomly selected children ages 3 to 5 years. RESULTS: In 2016, 42.2% of children ages 3 to 5 years were considered HRL with the proportion considered "On-Track" ranging from 58.4% for Early Learning Skills to 85.5% for Physical Well-being and Motor Development"; approximately 80% of children were considered "On-Track" in Social-Emotional Development and Self-Regulation, respectively. Sociodemographic differences were mostly non-significant in multivariable analyses. Health, family, and neighborhood factors (ie, special health care needs status/type, parental mental health, reading, singing and storytelling, screen time, adverse childhood experiences, and neighborhood amenities) were associated with HRL. HRL prevalence ranged from 25.5% (NV) to 58.7% (NY), but only 4 states were significantly different from the U.S. overall. CONCLUSIONS: Based on this pilot measure, only about 4 in 10 US children ages 3 to 5 years may be considered "Healthy and Ready to Learn." Improvement opportunities exist for multiple, modifiable factors to affect young children's readiness to start school.

Mechanical regulation of photosynthesis in cyanobacteria.

Photosynthetic organisms regulate their responses to many diverse stimuli in an effort to balance light harvesting with utilizable light energy for carbon fixation and growth (source-sink regulation). This balance is critical to prevent the formation of reactive oxygen species that can lead to cell death. However, investigating the molecular mechanisms that underlie the regulation of photosynthesis in cyanobacteria using ensemble-based measurements remains a challenge due to population heterogeneity. Here, to address this problem, we used long-term quantitative time-lapse fluorescence microscopy, transmission electron microscopy, mathematical modelling and genetic manipulation to visualize and analyse the growth and subcellular dynamics of individual wild-type and mutant cyanobacterial cells over multiple generations. We reveal that mechanical confinement of actively growing Synechococcus sp. PCC 7002 cells leads to the physical disassociation of phycobilisomes and energetic decoupling from the photosynthetic reaction centres. We suggest that the mechanical regulation of photosynthesis is a critical failsafe that prevents cell expansion when light and nutrients are plentiful, but when space is limiting. These results imply that cyanobacteria must convert a fraction of the available light energy into mechanical energy to overcome frictional forces in the environment, providing insight into the regulation of photosynthesis and how microorganisms navigate their physical environment.

Casein Kinase 1δ Stabilizes Mature Axons by Inhibiting Transcription Termination of Ankyrin.

After axon outgrowth and synapse formation, the nervous system transitions to a stable architecture. In C. elegans, this transition is marked by the appearance of casein kinase 1δ (CK1δ) in the nucleus. In CK1δ mutants, neurons continue to sprout growth cones into adulthood, leading to a highly ramified nervous system. Nervous system architecture in these mutants is completely restored by suppressor mutations in ten genes involved in transcription termination. CK1δ prevents termination by phosphorylating and inhibiting SSUP-72. SSUP-72 would normally remodel the C-terminal domain of RNA polymerase in anticipation of termination. The antitermination activity of CK1δ establishes the mature state of a neuron by promoting the expression of the long isoform of a single gene, the cytoskeleton protein Ankyrin.

Parent-Teen Communication about Sexual and Reproductive Health: Cohort Differences by Race/Ethnicity and Nativity.

Parent-teen discussions about sexual and reproductive health (SRH) are associated with delayed sex and higher contraceptive use among teens. Using the National Survey of Family Growth, we conducted bivariate and multivariate analyses of different types of parent-teen SRH discussions among two cohorts of teens. We describe differences in patterns for males and females by race/ethnicity and nativity, and test for racial/ethnic interactions within each cohort. Analyses found that the prevalence of parent-teen discussions about SRH increased across cohorts. For males and females, there were increases in parent-teen discussions about condoms, and for males only, there were increases in any SRH discussions and discussions about contraception and STIs. Based on interactions, parent-teen discussions and STI discussions increased most for Hispanic females, and among Hispanics, increased most for the foreign-born. These data indicate increases in different types of parent-teen SRH discussions, particularly for males and foreign-born teens overall, and for Hispanic teen females regarding condom use. Future research should examine what factors are driving these changes, including changes in the structure of U.S. Hispanic communities and expansion of evidence-based teen pregnancy prevention programs.

Degradation of Blos1 mRNA by IRE1 repositions lysosomes and protects cells from stress.

Cells respond to stress in the ER by initiating the widely conserved unfolded protein response. Activation of the ER transmembrane nuclease IRE1 leads to the degradation of specific mRNAs, but how this pathway affects the ability of cells to recover from stress is not known. Here, we show that degradation of the mRNA encoding biogenesis of lysosome-related organelles 1 subunit 1 (Blos1) leads to the repositioning of late endosomes (LEs)/lysosomes to the microtubule-organizing center in response to stress in mouse cells. Overriding Blos1 degradation led to ER stress sensitivity and the accumulation of ubiquitinated protein aggregates, whose efficient degradation required their independent trafficking to the cell center and the LE-associated endosomal sorting complexes required for transport. We propose that Blos1 regulation by IRE1 promotes LE-mediated microautophagy of protein aggregates and protects cells from their cytotoxic effects.

Commentary: Positive Youth Development Goes Mainstream.

Evidence has accumulated that confirms the success of a positive youth development (PYD) approach. Importantly, a positive development approach is just that-an approach. It is not a particular program or curriculum but a set of practices designed to achieve one or more positive outcomes. As such, PYD practices can be added onto other programs to make positive outcomes more likely. For example, a tutoring program can work hard to hire and train staff to work with students in a trusting, respectful relationship. Camp counselors can be encouraged to build rapport and positive bonds among the campers.

Degradation of Gadd45 mRNA by nonsense-mediated decay is essential for viability.

The nonsense-mediated mRNA decay (NMD) pathway functions to degrade both abnormal and wild-type mRNAs. NMD is essential for viability in most organisms, but the molecular basis for this requirement is unknown. Here we show that a single, conserved NMD target, the mRNA coding for the stress response factor growth arrest and DNA-damage inducible 45 (GADD45) can account for lethality in Drosophila lacking core NMD genes. Moreover, depletion of Gadd45 in mammalian cells rescues the cell survival defects associated with NMD knockdown. Our findings demonstrate that degradation of Gadd45 mRNA is the essential NMD function and, surprisingly, that the surveillance of abnormal mRNAs by this pathway is not necessarily required for viability.

State policy and teen childbearing: a review of research studies.

Teen childbearing is affected by many individual, family, and community factors; however, another potential influence is state policy. Rigorous studies of the relationship between state policy and teen birth rates are few in number but represent a body of knowledge that can inform policy and practice. This article reviews research assessing associations between state-level policies and teen birth rates, focusing on five policy areas: access to family planning, education, sex education, public assistance, and access to abortion services. Overall, several studies have found that measures related to access to and use of family planning services and contraceptives are related to lower state-level teen birth rates. These include adolescent enrollment in clinics, minors' access to contraception, conscience laws, family planning expenditures, and Medicaid waivers. Other studies, although largely cross-sectional analyses, have concluded that policies and practices to expand or improve public education are also associated with lower teen birth rates. These include expenditures on education, teacher-to-student ratios, and graduation requirements. However, the evidence regarding the role of public assistance, abortion access, and sex education policies in reducing teen birth rates is mixed and inconclusive. These conclusions must be viewed as tentative because of the limited number of rigorous studies that examine the relationship between state policy and teen birth rates over time. Many specific policies have only been analyzed by a single study, and few findings are based on recent data. As such, more research is needed to strengthen our understanding of the role of state policies in teen birth rates.

Regulation of sumo mRNA during endoplasmic reticulum stress.

The unfolded protein response (UPR) is a collection of pathways that maintains the protein secretory pathway during the many physiological and pathological conditions that cause stress in the endoplasmic reticulum (ER). The UPR is mediated in part by Ire1, an ER transmembrane kinase and endoribonuclease that is activated when misfolded proteins accumulate in the ER. Ire1's nuclease initiates the cytosolic splicing of the mRNA encoding X-box binding protein (Xbp1), a potent transcription factor that then upregulates genes responsible for restoring ER function. This same nuclease is responsible for the degradation of many other mRNAs that are localized to the ER, through Regulated Ire1 Dependent Decay (RIDD). Here we show that Smt3, a homolog of small ubiquitin-like modifier (sumo), is a non-canonical RIDD target in Drosophila S2 cells. Unlike other RIDD targets, the sumo transcript does not stably associate with the ER membrane, but instead relies on an Xbp1-like stem loop and a second UPR mediator, Perk, for its degradation during stress.

The unfolded protein response in secretory cell function.

The endoplasmic reticulum (ER) controls many important aspects of cellular function, including processing of secreted and membrane proteins, synthesis of membranes, and calcium storage. Maintenance of ER function is controlled through a network of signaling pathways collectively known as the unfolded protein response (UPR). The UPR balances the load of incoming proteins with the folding capacity of the ER and allows cells to adapt to situations that disrupt this balance. This disruption is referred to as ER stress. Although ER stress often arises in pathological situations, the UPR plays a central role in the normal development and function of cells specializing in secretion. Many aspects of this response are conserved broadly across eukaryotes; most organisms use some subset of a group of ER transmembrane proteins to signal to the nucleus and induce a broad transcriptional upregulation of genes involved in ER function. However, new developments in metazoans, plants, and fungi illustrate interesting variations on this theme. Here, we summarize mechanisms for detecting and counteracting ER stress, the role of the UPR in normal secretory cell function, and how these pathways vary across organisms and among different tissues and cell types.

Positive child well-being: an index based on data for individual children.

Data from the 2007 National Survey of Children's Health are used to develop an index of positive child well-being that has several innovative and important characteristics. It distinguishes child well-being from contexts of child development; it is built with rich micro-data (rather than population-level macro-data) to create unique measures of well-being for individual children; and it focuses on positive, rather than negative, aspects of development. These data can be aggregated to provide a perspective on the proportions of children in the population who are doing well on all, some, or no developmental domains. Based on child development theory and research, the index is constructed within a framework of four conceptually distinct developmental domains, each of which is comprised of three sub-domains. The index distinguishes among children in predicted directions, by poverty level and parental education. White children tend to do better than Hispanic or black children in all domains, though neither minority subgroup is consistently better or worse off than the other subgroup. Girls score slightly higher than boys on the index. About three in four children score positively on three or four domains. The index provides a composite, multidimensional view of positive child well-being that can be useful to researchers and policy analysts, and which addresses some weaknesses of other similar indices.

Risky behaviors in late adolescence: co-occurrence, predictors, and consequences.

PURPOSE: Advances in research have broadened our understanding of the risky behaviors that significantly threaten adolescent health and well-being. Advances include: using person-centered, rather than behavior-centered approaches to examine how behaviors co-occur; greater focus on how environmental factors, such as family, or peer-level characteristics, influence behavior; and examination of how behaviors affect well-being in young adulthood. Use of nationally representative, longitudinal data would expand research on these critical relationships. METHODS: Using data from the National Longitudinal Survey of Youth, 1997 cohort, a nationally representative sample of adolescents who are being followed over time, the present study: (1) identifies profiles of risky behaviors, (2) investigates how environmental characteristics predict these profiles of risky behaviors (e.g., delinquency, smoking, drug use, drinking, sexual behavior, and exercise), and (3) examines how these profiles of risky behaviors relate to positive and negative youth outcomes. RESULTS: Four "risk profiles" were identified: a high-risk group (those who report high levels of participation in numerous behaviors), a low-risk group (those who engage in very few risky behaviors), and two moderate risk-taking groups. We found that profiles with any negative behaviors were predictive of negative outcomes. CONCLUSIONS: It is important for practitioners to examine health behaviors in multiple domains concurrently rather than individually in isolation. Interventions and research should not simply target adolescents engaging in high levels of risky behavior but also adolescents who are engaging in lower levels of risky behavior.

Food security during infancy: implications for attachment and mental proficiency in toddlerhood.

OBJECTIVE: This study examined the associations between household food security (access to sufficient, safe, and nutritious food) during infancy and attachment and mental proficiency in toddlerhood. METHODS: Data from a longitudinal nationally representative sample of infants and toddlers (n = 8944) from the Early Childhood Longitudinal Study-9-month (2001-2002) and 24-month (2003-2004) surveys were used. Structural equation modeling was used to examine the direct and indirect associations between food insecurity at 9 months, and attachment and mental proficiency at 24 months. RESULTS: Food insecurity worked indirectly through depression and parenting practices to influence security of attachment and mental proficiency in toddlerhood. CONCLUSIONS: Social policies that address the adequacy and predictability of food supplies in families with infants have the potential to affect parental depression and parenting behavior, and thereby attachment and cognitive development at very early ages.

Polymorphic microsatellite markers for the striped skunk, Mephitis mephitis, and other mephitids.

We report 10 polymorphic microsatellite loci primers developed for striped skunks (Mephitis mephitis), a widespread mesocarnivore in North America. Numbers of alleles in these loci ranged from seven to 14 and the observed heterozygosity ranged from 0.76 to 1.0. These primers will be useful for studying population dynamics of skunks where rabies is endemic and will be useful to estimate genetic relatedness among females sharing winter dens. Most of these primers amplify across species within the Mephitidae.

High-Risk Subsequent Births Among Co-Residential Couples: The Role of Fathers, Mothers, and Couples.

This study examines predictors of a cumulative measure of high-risk births, rather than single risks separately, as in prior research. Using the Early Childhood Longitudinal Study-Birth Cohort survey, we incorporate data from fathers and mothers to assess characteristics associated with births subsequent to a focal child's birth within high-risk circumstances. Components of a high-risk birth include: high-parity, very closely-spaced, or births to unmarried couples, unhappy couples, or couples in high-conflict relationships. Both fathers' and mothers' pregnancy intentions affect whether couples have a subsequent high-risk birth. The odds of a high-risk subsequent birth, relative to no birth and to a low-risk birth, are more than twice as high if only the father intended the birth of the previous child rather than if the child was intended by both the mother and father. High-risk subsequent births are much more likely among couples where the prior child was high risk and where family income was low, and lower where both father and mother had lived with both biological parents. Findings highlight the importance of father data in fertility research.