The Relationship Between Study Quality and the Effects of Supplemental Reading Interventions: A Meta-Analysis.

Empirical studies investigating supplemental reading interventions for students with or at-risk for reading disabilities in the early elementary grades have demonstrated a range of effect sizes. Identifying the findings from high quality research can provide greater certainty of findings related to the effectiveness of supplemental reading interventions. This meta-analysis investigated how four variables of study quality (study design, statistical treatment, Type I error, and fidelity of implementation) were related to effect sizes from standardized measures of foundational reading skills and language/comprehension. The results from 88 studies indicated that year of publication was a significant predictor of effect sizes for both standardized measures of foundational reading skills and language/comprehension, with more recent studies demonstrating smaller effect sizes. Results also demonstrated that with the exception of research design predicting effect sizes on foundational reading skills measures, study quality was not related to the effects of supplemental reading interventions. Implications for research and practice are discussed.

Heterogeneity in Reading Achievement and Mindset of Readers with Reading Difficulties.

Recent research has focused on evaluating the relation between mindset and reading achievement. We used exploratory factor mixture models (E-FMMs) to examine the heterogeneity in reading achievement and mindset of 650 fourth graders with reading difficulties. To build E-FMMs, we conducted confirmatory factor analyses to examine the factor structure of scores of (a) mindset, (b) reading, and (c) mindset/reading combined. Our results indicated (a) a 2-factor model for mindset (General Mindset vs. Reading Mindset), (b) a 2-factor model for reading (Word Reading vs. Comprehension; four covariances), and (c) a combined model with significant correlations across mindset and reading factors. We ran E-FMMs on the combined model. Overall, we found three classes of students. We situate these results within the existing literature and discuss implications for practice and research.

Randomized Trial of Stand-Alone Use of the Antimicrobial Envelope in High-Risk Cardiac Device Patients.

BACKGROUND: Cardiac implantable electronic device (CIED) infection has a high mortality. Previous investigations showed reduced postoperative infections using skin preparation with chlorhexidine, preoperative intravenous antibiotics, and a TYRX-a antibacterial envelope. The additional benefit of antibiotic pocket wash and postoperative antibiotics has not been systematically studied. METHODS: The ENVELOPE trial (A Randomized trial of Stand-Alone Use of the Antimicrobial Envelope in High-Risk Cardiac Device Patients) was a prospective, multicenter, randomized, controlled trial enrolling patients undergoing CIED procedures with ≥2 risk factors for infection. The control arm received standard chlorhexidine skin preparation, intravenous antibiotics, and the TYRX-a antibiotic envelope. The study arm received pocket wash (500 mL antibiotic solution) and postoperative antibiotics for 3 days along with the prophylactic control measures. The primary end point was CIED infection and system removal at 6 months. RESULTS: One thousand ten subjects (505 per arm) were enrolled and randomized. Patients were seen in person for a wound check with digital photo 2 weeks postimplant and at 3 and 6 months. CIED infection rate was low in both groups (1.0% control arm and 1.2% study arm, P=0.74). In the 11 subjects with infection and system removal, the time to study end point was 107±92 days with a PADIT (Prevention of Arrhythmia Device Infection Trial) score of 7.4 and a 64% 1-year mortality. Prior history of CIED infection independently predicted CIED system removal at 6 months in all subjects (odds ratio, 9.77, P=0.004). Of 11 infections requiring system removal, 5 were in the setting of pocket hematoma. CONCLUSIONS: The use of antibiotic pocket irrigation and postoperative oral antibiotics provides no additional benefit to the prophylactic measures of chlorhexidine skin preparation, preoperative intravenous antibiotics, and an antibiotic envelope in reducing CIED infection. Postoperative hematoma is a major risk factor for infection, driven by the use of antiplatelet and anticoagulant medications. The strongest predictor of CIED removal at 6 months, regardless of intervention, was prior CIED infection. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02809131.

Effects of Reading Interventions Implemented for Upper Elementary Struggling Readers: A Look at Recent Research.

In this study, we conducted a review of reading intervention research (1988-2019) for upper elementary struggling readers and examined intervention area (e.g., foundational, comprehension, or multicomponent) and intensity (e.g., hours of intervention, group size, and individualization) as possible moderators of effects. We located 33 studies containing 49 treatment-comparison contrasts, found small effects for foundational reading skills (g = 0.22) and comprehension (g = 0.21), and decreased effects when considering standardized measures only. For intervention area, only multicomponent interventions predicted significant effects for both comprehension and foundational outcomes. For intensity, we did not find systematic evidence that longer or individualized interventions were associated with larger effects. However, interventions implemented in very small groups predicted larger comprehension outcomes. Overall, more research examining the quality of school provided reading instruction and how the severity of reading difficulties may impact effects of more intensive interventions is needed.

Comparing the Effects of Reading Intervention Versus Reading and Mindset Intervention for Upper Elementary Students With Reading Difficulties.

The primary purpose of this study was to examine the effects of providing mindset intervention in addition to reading intervention compared with only reading intervention for fourth graders with reading difficulties. Reading intervention was provided daily in 45 min sessions throughout the school year. Mindset intervention occurred in small groups for 24-30 min lessons. Multilevel structural equation modeling (SEM) via n-level SEM was used to account for the latent variable representation of constructs, and the complex nesting and cross-classification structure of the data. Students in the reading intervention plus mindset condition significantly outperformed the business as usual condition on nonword reading (d = 0.35) as did students in the reading intervention condition (d = 0.20), who also outperformed the business as usual condition on phonological processing (d = 0.28). There were no significant differences among students in the three conditions on nonword reading, word reading, phonological processing, reading comprehension, or growth mindset. Initial reading achievement, mindset, and problem behavior did not generally moderate these findings.

Overnight transfusions in New Zealand hospitals: potential risk to patients.

AIMS: This audit aimed to assess how frequently overnight transfusions were taking place and compare it to the previous 2004 audit. METHOD: All red cell units transfused between 20:00 and 08:00 hours in low acuity areas over 4 weeks in 2010 in 8 of New Zealand's largest public hospitals were identified prospectively, followed by review of clinical notes and laboratory results by the hospital Transfusion Nurse Specialist (TNS). RESULTS: 535 red cell units were transfused overnight, or 9% of the total units administered over the study period. Indications for transfusion were symptomatic anaemia, active bleeding or haemolysis (66%), but 16% of patients were asymptomatic. Of the non-urgent overnight transfusions (OTs), 42% were assessed as non-essential during the night. 49% of post-transfusion haemoglobin (Hb) levels were >100 g/L indicating a liberal transfusion practice. Although frequently cited as a reason for OT, only 16% of patients were discharged the following day. The median interval from pre-transfusion haemoglobin testing and starting the OT was approximately 9 hours, far exceeding the time needed to obtain routine full blood results. Adherence to recommended best transfusion practice was poor at night, with 12% of transfusions exceeding the 4 hour recommendation. End of transfusion observations fell to less than 80%, with the lowest compliance rate (69%) occurring at 06:00 hours. In addition to the 4 adverse reactions reported to the Haemovigilance programme, another 9 unreported reactions were identified by the auditors from the clinical notes. CONCLUSIONS: This audit has shown an improvement from 22% to 9% in the rate of OT compared to the 2004 audit. Nevertheless, 42% of transfusions were not considered appropriate based on current guidelines, and there is therefore room for improvement. A mean delay of 9 hours from haemoglobin sampling to transfusion suggests that reasons for this delay could be explored to help optimise transfusion start time. Some aspects of OT were worse than previously, with 12% of the OT exceeding 4 hours duration, double the rate of the previous audit. Results showing poor documentation and a high rate of unreported transfusion reactions (69% of reactions) suggest if an adverse transfusion reaction occurs overnight, there is a significant risk that it is less likely to be recognised, treated and/or reported.