Exploring the Use of the Picture Exchange Communication System (PECS) in Special Education Settings.

The Picture Exchange Communication System (PECS) is an Augmentative and Alternative Communication (AAC) system which is widely used to support children with developmental disabilities. In the present study, we surveyed individuals responsible for implementing PECS in special educational settings in the United Kingdom (N=283). We explored knowledge of and adherence to the  intervention, with a view to identifying training and support needs. Specifically, we examined participants' knowledge, implementation accuracy, training experiences, access to resources, and attitudes towards PECS. We developed hierarchical logistic regression models to explore the association between training experience and both knowledge and use of PECS. We pre-registered our methods, predictions and the analysis plan on the Open Science Framework (OSF).We found considerable variation in practitioner knowledge and implementation of PECS. Formal training predicted greater knowledge and more accurate implementation when practitioner role and the degree of setting support were accounted for. While PECS was rated by a large majority to be effective and practical, many participants identified that time and the availability of resources were barriers to implementation. We also found that the purpose of PECS was not always fully understood by practitioners, and we identified some consistent gaps in knowledge and implementation.  This study contributes new information regarding the real-world  use of PECS in educational settings and offers new insights for supporting practitioners.

Urinary Exosomal MicroRNAs as Biomarkers for Obesity-Associated Chronic Kidney Disease.

The early detection of chronic kidney disease (CKD) is key to reducing the burden of disease and rising costs of care. This need has spurred interest in finding new biomarkers for CKD. Ideal bi-omarkers for CKD should be: easy to measure; stable; reliably detected, even when interfering substances are present; site-specific based on the type of injury (tubules vs. glomeruli); and its changes in concentration should correlate with disease risk or outcome. Currently, no single can-didate biomarker fulfills these criteria effectively, and the mechanisms underlying kidney fibrosis are not fully understood; however, there is growing evidence in support of microRNA-mediated pro-cesses. Specifically, urinary exosomal microRNAs may serve as biomarkers for kidney fibrosis. In-creasing incidences of obesity and the recognition of obesity-associated CKD have increased interest in the interplay of obesity and CKD. In this review, we provide: (1) an overview of the current scope of CKD biomarkers within obese individuals to elucidate the genetic pathways unique to obesi-ty-related CKD; (2) a review of microRNA expression in obese individuals with kidney fibrosis in the presence of comorbidities, such as diabetes mellitus and hypertension; (3) a review of thera-peutic processes, such as diet and exercise, that may influence miR-expression in obesity-associated CKD; (4) a review of the technical aspects of urinary exosome isolation; and (5) future areas of research.

National climate institutions complement targets and policies.

Institutions can affect coordination, consensus, and strategy.

Physical Activity Opportunities of Low-Income Elementary School-Aged Children During the Segmented School Day.

BACKGROUND: In this study, we examined moderate-to-vigorous physical activity (MVPA) of children in a school district serving children from low-income and minority households. METHODS: This observational study was conducted in 8 rural elementary schools in South Carolina. Children (N = 719, age = 7.7 years, 48.0% girls, 88.0% African American) wore accelerometers during school hours. Physical activity was distilled into time engaged in MVPA during 4 distinct opportunities. These 4 opportunities were non-activity time (eg, class-time), extended lunch (lunch recess after eating), physical education (PE), and recess. Mixed effects linear regressions estimated MVPA on days that had no activity opportunities, extended lunch, recess, PE, and multiple activity opportunities (eg, PE and recess). RESULTS: On days with multiple activity opportunities, girls and boys accumulated 8.0 (95% CI = 4.9, 11.1) and 7.1 (95% CI = 3.6, 10.7) additional minutes of MVPA compared to a no activity day. On PE days boys accumulated 5.2 (95% CI = 0.3, 10.2) additional minutes of MVPA, whereas recess days provided girls with 3.0 (95% CI = 0.1, 6.0) additional MVPA minutes. No other activity opportunities provided statistically significant increases in school-day MVPA. CONCLUSIONS: In low-income schools it may be necessary to provide multiple physical activity opportunities during the school day to increase boys' and girls' MVPA.

Comparing measures of free-living sleep in school-aged children.

OBJECTIVE/BACKGROUND: Recent technological advances and emerging commercially-available consumer-friendly sleep assessment products affords researchers with a host of tools to consider for capturing free-living sleep in children. The purpose of this study was to compare free-living sleep characteristics (duration and bed/wake times) across different measures in children. METHODS: Elementary school-aged children (N = 30, mean age 7.2 years, 63% boys, 87% non-Hispanic white) wore an ActiGraph GT9X Link© and Fitbit Charge HR© on the non-dominant wrist, with a Beddit 3 Sleep Monitor© affixed to their mattress for two consecutive weekend nights of free-living sleep. Parents completed a sleep log of bed and wake times. Absolute differences in bed and wake times were examined and Bland Altman plots assessed the level of agreement across sleep measures. RESULTS: Across the four sleep measures, total sleep time (TST) ranged from 458 min/night (ActiGraph GT9X Link©) to 613 min/night (Parent report). Mean bed and wake times ranged from 8:46PM to 9:03PM, and 6:52AM to 7:16AM, respectively. Pearson correlation coefficients were moderate between all four sleep measures (range r = 0.30-0.71). Bland-Altman plots indicated the highest level of agreement for TST was between Beddit 3 Sleep Monitor© and Fitbit Charge HR© (mean difference -11.7, limits of agreement: 119.0, -142.4 min). CONCLUSIONS: The findings from this study show a high level of agreement of when a child goes to sleep and wakes up across a variety of sleep measures; however, more work is needed to classify TST once the sleep period has commenced.

"The caterpillar": a novel reading passage for assessment of motor speech disorders.

PURPOSE: A review of the salient characteristics of motor speech disorders and common assessment protocols revealed the need for a novel reading passage tailored specifically to differentiate between and among the dysarthrias (DYSs) and apraxia of speech (AOS). METHOD: "The Caterpillar" passage was designed to provide a contemporary, easily read, contextual speech sample with specific tasks (e.g., prosodic contrasts, words of increasing length and complexity) targeted to inform the assessment of motor speech disorders. Twenty-two adults, 15 with DYS or AOS and 7 healthy controls (HC), were recorded reading "The Caterpillar" passage to demonstrate its utility in examining motor speech performance. CONCLUSION: Analysis of performance across a subset of segmental and prosodic variables illustrated that "The Caterpillar" passage showed promise for extracting individual profiles of impairment that could augment current assessment protocols and inform treatment planning in motor speech disorders.

Public health educators' participation in teams: implications for preparation and practice.

Collaboration among public health organizations is essential to ensuring the health of the public. Much of the day-to-day work of public health educators is done in groups or teams or in consultation with others. This study examined the extent of health educators' work in teams as a proxy for collaboration. Health educators participated in an average of four teams per individual; three of these were interorganizational teams. Moreover, 40% of the respondents participated in five or more teams. Health educators supervised by other health educators were more likely to work in interorganizational teams than were those supervised by other professionals. Certified Health Education Specialists were more likely to participate in intraorganizational teams. Curricula in academic programs should reflect the extensive teamwork in which health educators are involved. Employers need to provide health educators with grounding in organizational priorities and support to carry out their collaborative work.

Assessment of public health educator practice: health educator responsibilities.

This study presents a method for better understanding how practicing health educators in local health departments spend their time. The purpose of this study was to document the daily practice of health educators in the 10 areas of responsibility as defined by a competency-based framework for graduate-level health educators. The results of the current study present the average percentage of time health educators spent carrying out each area of responsibility and the percentage of health educators that did not carry out activities related to a specific area of responsibility. For example, the greatest percentage of time was spent implementing programs (21.2%), and approximately 60% of the health educators in the sample did not conduct research nor did they participate in activities to advance the profession. These findings have implications for the professional preparation of health educators and for their continuing education. The current study contains several suggestions for future research in this area.