Search

BackgroundGiven limited experience in applying the creatine-(methyl-D3) (D3Cr) dilution method to measure skeletal muscle mass (SMM) in young children, the feasibility of deployment in a fielding setting and performance of the method was assessed in a cohort of 4-year-old children in Dhaka, Bangladesh.MethodsFollowing D3Cr oral dose (10 mg) administration, single fasting urine samples were collected at 2-4 days (n = 100). Twenty-four-hour post-dose collections and serial spot urine samples on days 2, 3 and 4 were obtained in a subset of participants (n = 10). Urinary creatine, creatinine, D3Cr and D3-creatinine enrichment were analyzed by liquid chromatography-tandem mass spectrometry. Appendicular lean mass (ALM) was measured by dual-energy x-ray absorptiometry and grip strength was measured by a hand-held dynamometer.ResultsSMM was measured successfully in 91% of participants, and there were no adverse events. Mean ± SD SMM was greater than ALM (4.5 ± 0.4 and 3.2 ± 0.6 kg, respectively). Precision of SMM was low (intraclass correlation = 0.20; 95% CI: 0.02, 0.75; n = 10). Grip strength was not associated with SMM in multivariable analysis (0.004 kg per 100 g of SMM; 95% CI: -0.031, 0.038; n = 91).ConclusionsThe D3Cr dilution method was feasible in a community setting. However, high within-child variability in SMM estimates suggests the need for further optimization of this approach.ImpactThe D3-creatine (D3Cr) stable isotope dilution method was considered a feasible method for the estimation of skeletal muscle mass (SMM) in young children in a community setting and was well accepted among participants. SMM was weakly associated with both dual-energy x-ray absorptiometry-derived values of appendicular lean mass and grip strength. High within-child variability in estimated values of SMM suggests that further optimization of the D3Cr stable isotope dilution method is required prior to implementation in community research settings.

All children benefit from intentional interactions and instruction to become socially and emotionally competent. Over the past 30 years, evidence-based intervention tactics and strategies have been integrated to establish comprehensive, multitiered, or hierarchical systems of support frameworks to guide social-emotional interventions for young children. In this study, the authors reviewed systematically the efficacy of classroom-wide social-emotional interventions for improving the social, emotional, and behavioral outcomes of preschool children and used meta-analytic techniques to identify critical study characteristics associated with obtained effect sizes. Four electronic databases (i.e., Academic Search Premier, Educational Resource Information Center, PsycINFO, and Education Full Text) were systematically searched in December 2015 and updated in January 2018. "Snowball methods" were used to locate additional relevant studies. Effect size estimates were pooled using random-effects meta-analyses for three child outcomes, and moderator analyses were conducted. Thirty-nine studies involving 10,646 child participants met the inclusion criteria and were included in this systematic review, with 33 studies included in the meta-analyses. Random-effects meta-analyses showed (a) improvements in social competence and emotional competence, and (b) decreases in challenging behavior. For social competence and challenging behavior, moderator analyses suggested interventions with a family component had statistically significant and larger effect sizes than those without a family component. Studies in which classroom teachers served as the intervention agent produced statistically significant but smaller effect sizes than when researchers or others implemented the intervention for challenging behavior. This systematic review and meta-analysis support using comprehensive social-emotional interventions for all children in a preschool classroom to improve their social-emotional competence and reduce challenging behavior.

A non-concurrent multiple baseline design across four early intervention providers was used to examine functional relations between job-embedded professional development (PD), including practice-based coaching (PBC), and providers' fidelity of implementation of home visiting practices for embedded intervention. Four providers with one to two caregivers and their toddler with disabilities or developmental delays participated. The primary dependent measure was the number of essential home visiting practices providers implemented with fidelity. Results from visual analyses showed a functional relation between job-embedded PD and the number of essential home visiting practices implemented with fidelity for three of four providers. Provider and caregiver social validity data indicated PD and home visiting practices and embedded intervention were appropriate, feasible, and useful. Results provide promising evidence for job-embedded PD, including PBC, to support providers' fidelity of implementation of home visiting practices for embedded intervention. Implications for future research and practice are discussed. [ABSTRACT FROM AUTHOR]

Aim: To test whether an audit and feedback‐based intervention improved HbA1c 12 months after transfer to type 1 diabetes adult care. Methods: Multi‐centre, quasi‐experimental pre‐post study of an AF‐based intervention targeting paediatric diabetes teams, which encouraged the implementation of an evidence‐informed structured transition process at five paediatric diabetes centres in Ontario, Canada. Participants entered the study at their final paediatric visit. A parallel control cohort was ascertained using population‐based administrative datasets. The primary outcome was HbA1c 12 months after transfer. The main exposure was the study period: pre‐implementation (June 2018–May 2019); early‐implementation (June 2019–September 2020); and late‐implementation (October 2020–September 2021). Multivariable linear regression models were fit separately in each cohort. Results: There were 449 and 2844 individuals in the intervention and control cohorts, respectively. Twelve months after transfer, participants in the late‐implementation intervention cohort had an HbA1c that was, on average, 0.41% lower than participants in the pre‐implementation period (p = 0.016). Among the control cohort, there was no significant difference in the HbA1c 12 months after transfer between study periods. Conclusions: We found an effect of the intervention on glycaemic management one year following transfer to adult care. Future work will focus on refining and testing the effectiveness of the intervention in an expanded number of study sites and in collaboration with adult diabetes care providers. [ABSTRACT FROM AUTHOR]

Native American faculty in science, technology, engineering, and mathematics (NAF‐STEM) disciplines are historically underrepresented. Creating inclusive academia for Indigenous people that typically live and thrive in rural communities requires insights into their personal, relational, and collective experiences. This study was guided by the Six Rs: relationship, respect, responsibility, relevance, representation, and reciprocity, and was informed by Indigenous Research Methodologies. Twelve NAF‐STEM from tribal colleges and non‐tribal institutions were asked to share their perspectives and experiences in seven Research Circles. NAF‐STEM joined sequential hybrid workshops over seven weeks on how to conduct qualitative data analysis. Authors conducted analysis on the transcripts of Research Circles for themes associated with the professional satisfaction and success of NAF‐STEM. Results of the study identified the importance of holistic support systems that remain mindful of both the opportunities and challenges facing NAF‐STEM and emphasize the significance of balancing the need for respectful relationships, adequate representation, shared responsibility, relevance of diversity, and reciprocity in STEM. Through implementation of the Six Rs throughout the research process, the study identified successes, support systems, and challenges of NAF‐STEM at both tribal and non‐tribal colleges and universities. These outcomes can inform institutions to create an equitable and inclusive environment for NAF‐STEM. [ABSTRACT FROM AUTHOR]

Our purpose is to develop and propose a conceptual framework based on respect, relationship, representation, relevance, responsibility, and reciprocity (the Six Rs), to be applied in studies using Indigenous research methodologies (IRMs). This conceptual framework builds upon the extensive work of numerous Indigenous scholars who brought this conversation into the literature and research enterprise. Our goal is to synthesize the Six Rs, describe how they complement and inform one another, and explain our process for their implementation and interpretation as a framework to develop and answer research questions. The Six Rs provide a representative research framework and can be a powerful guideline.

OBJECTIVE: Technology use in type 1 diabetes (T1D) is impacted by socioeconomic status (SES). This analysis explored relationships between SES, glycemic outcomes, and technology use. RESEARCH DESIGN AND METHODS: A cross-sectional analysis of HbA1c data from 2,822 Australian youth with T1D was undertaken. Residential postcodes were used to assign SES based on the Index of Relative Socio-Economic Disadvantage (IRSD). Linear regression models were used to evaluate associations among IRSD quintile, HbA1c, and management regimen. RESULTS: Insulin pump therapy, continuous glucose monitoring, and their concurrent use were associated with lower mean HbA1c across all IRSD quintiles (P < 0.001). There was no interaction between technology use and IRSD quintile on HbA1c (P = 0.624), reflecting a similar association of lower HbA1c with technology use across all IRSD quintiles. CONCLUSIONS: Technology use was associated with lower HbA1c across all socioeconomic backgrounds. Socioeconomic disadvantage does not preclude glycemic benefits of diabetes technologies, highlighting the need to remove barriers to technology access. [ABSTRACT FROM AUTHOR]

Persons testing positive for Clostridium difficile by molecular methods might not always haveC. difficile disease. Up to 10% of hospitalized patients carry toxigenicC. difficile; carriage rates of 35%-50% have been [...]