Exploring early educator burnout and process quality in a statewide sample

Building on literature linking educators' psychosocial well-being to early education and care quality, this study analyzed early educators' (N = 648) reports of burnout across a range of group-based care types in one state and examined the relation of burnout to setting quality. Confirmatory factor analysis showed the burnout measure, a self-reported emotional exhaustion scale, had a one-factor structure and adequate internal consistency among educators working in a range of early education and care settings. Measured by the scale, educators on average reported infrequent feelings of burnout. There were small but statistically significant differences in burnout scores by setting type, with Head Start educators on average reporting modestly more frequent burnout symptoms than educators in community-based centers (β=0.29,b = 0.30, SE = 0.13, p = 0.014) or family childcare settings (β=0.57,b = 0.60, SE = 0.14, p < 0.001). Only one significant association was observed between educators' self-reported burnout scores and setting quality after accounting for educator and setting characteristics: a negative association with child involvement (β =  - 0.09,b = -0.04, SE = 0.02, p = 0.03). These findings contribute to the field's understanding of burnout as a component of educator well-being and provide initial insight about targeting supports to improve educator well-being.

A randomized phase 2 study of neoadjuvant carboplatin and paclitaxel with or without atezolizumab in triple negative breast cancer (TNBC) - NCI 10013

Atezolizumab with chemotherapy has shown improved progression-free and overall survival in patients with metastatic PD-L1 positive triple negative breast cancer (TNBC). Atezolizumab with anthracycline- and taxane-based neoadjuvant chemotherapy has also shown increased pathological complete response (pCR) rates in early TNBC. This trial evaluated neoadjuvant carboplatin and paclitaxel with or without atezolizumab in patients with clinical stages II-III TNBC. The co-primary objectives were to evaluate if chemotherapy and atezolizumab increase pCR rate and tumor infiltrating lymphocyte (TIL) percentage compared to chemotherapy alone in the mITT population. Sixty-seven patients (ages 25-78 years; median, 52 years) were randomly assigned - 22 patients to Arm A, and 45 to Arm B. Median follow up was 6.6 months. In the modified intent to treat population (all patients evaluable for the primary endpoints who received at least one dose of combination therapy), the pCR rate was 18.8% (95% CI 4.0-45.6%) in Arm A, and 55.6% (95% CI 40.0-70.4%) in Arm B (estimated treatment difference: 36.8%, 95% CI 8.5-56.6%; p = 0.018). Grade 3 or higher treatment-related adverse events occurred in 62.5% of patients in Arm A, and 57.8% of patients in Arm B. One patient in Arm B died from recurrent disease during the follow-up period. TIL percentage increased slightly from baseline to cycle 1 in both Arm A (mean ± SD: 0.6% ± 21.0%) and Arm B (5.7% ± 15.8%) (p = 0.36). Patients with pCR had higher median TIL percentages (24.8%) than those with non-pCR (14.2%) (p = 0.02). Although subgroup analyses were limited by the small sample size, PD-L1-positive patients treated with chemotherapy and atezolizumab had a pCR rate of 75% (12/16). The addition of atezolizumab to neoadjuvant carboplatin and paclitaxel resulted in a statistically significant and clinically relevant increased pCR rate in patients with clinical stages II and III TNBC. (Funded by National Cancer Institute).

Executive function, self-regulation skills, behaviors, and socioeconomic status in early childhood

BACKGROUND AND OBJECTIVES

Prior research has established steep socioeconomic status (SES) disparities in children's cognitive skills at kindergarten entry. Yet, few studies have had comprehensive, multi-informant data to examine SES-related differences in foundational social and emotional skills and executive function. The objective of the current study is to systematically examine SES-related differences in young children's executive function (EF), self-regulation skills, and behaviors.

METHODS

The current study analyzed data on 2,309 young children from the Early Learning Study at Harvard (ELS@H). Multi-method (direct-assessment and reports) and multi-informant (parents and early education and care educators) information on children's executive function, self-regulation skills, and internalizing, externalizing, and adaptive behaviors were used. A parametric framework employing Ordinary Least Squares (OLS) estimation was used to quantify the size of the SES-related differences in this set of children's foundational social-emotional skills.

RESULTS

On average, there were differences of 0.24-0.45 SD for EF, 0.22-0.32 SD for self-regulation skills, and 0.27-0.54 SD for behaviors favoring children from the highest SES quartile of the distribution of SES relative to children from the lowest quartile. The SES-related differences were consistent across direct assessment, parent reports, and educator reports. Some differences were larger for older children relative to their younger counterparts.

CONCLUSIONS

Findings indicate a need for comprehensive intervention efforts well before kindergarten entry aimed at closing early disparities in children's foundational social and emotional skills and executive function.

An observational approach for exploring variability in young children's regulation-related skills within classroom contexts

Prior work has conceptualized children's executive function and self-regulation skills as relatively stable across short periods of time. Grounded in long-standing contextual theories of human development, this study introduces a new observational tool for measuring children's regulatory skills across different naturally occurring situations within early childhood classrooms. Using 460 observations of 91 children (M age = 5.54 years) in 16 socio-demographically diverse Prekindergarten and Kindergarten classrooms, we found that this tool-the Regulation-Related Skills Measure (RRSM)-reliably captured observed dimensions of young children's attention control and inhibitory control, but failed to appropriately represent more "internal" regulatory processes (e.g., working memory). Associations between the RRSM and other measures of children's executive function and self-regulation (i.e., direct assessments, adult reports) were low to moderate (r = 0.03 to 0.44), suggesting these tools are likely to be complementary in that they provide overlapping but ultimately distinct information regarding children's regulatory performance. Finally, results suggested substantial within-child variation in regulatory behaviors across different situations within the classroom, with the same children demonstrating consistently stronger attention control and inhibitory control during transitions than during either teacher- or student-directed activities. These findings underscore the situationally-dependent nature of children's self-regulatory performance, with implications for both theory and practice. Future research is needed to replicate these findings in more diverse, representative samples of children.

In Vitro Nasal Tissue Model for the Validation of Nasopharyngeal and Midturbinate Swabs for SARS-CoV-2 Testing

Large-scale population testing is a key tool to mitigate the spread of respiratory pathogens, such as the current COVID-19 pandemic, where swabs are used to collect samples in the upper airways (e.g., nasopharyngeal and midturbinate nasal cavities) for diagnostics. However, the high volume of supplies required to achieve large-scale population testing has posed unprecedented challenges for swab manufacturing and distribution, resulting in a global shortage that has heavily impacted testing capacity worldwide and prompted the development of new swabs suitable for large-scale production. Newly designed swabs require rigorous preclinical and clinical validation studies that are costly and time-consuming (i.e., months to years long); reducing the risks associated with swab validation is therefore paramount for their rapid deployment. To address these shortages, we developed a 3D-printed tissue model that mimics the nasopharyngeal and midturbinate nasal cavities, and we validated its use as a new tool to rapidly test swab performance. In addition to the nasal architecture, the tissue model mimics the soft nasal tissue with a silk-based sponge lining, and the physiological nasal fluid with asymptomatic and symptomatic viscosities of synthetic mucus. We performed several assays comparing standard flocked and injection-molded swabs. We quantified the swab pickup and release and determined the effect of viral load and mucus viscosity on swab efficacy by spiking the synthetic mucus with heat-inactivated SARS-CoV-2 virus. By molecular assay, we found that injected molded swabs performed similarly or superiorly in comparison to standard flocked swabs, and we underscored a viscosity-dependent difference in cycle threshold values between the asymptomatic and symptomatic mucuses for both swabs. To conclude, we developed an in vitro nasal tissue model that corroborated previous swab performance data from clinical studies; this model will provide to researchers a clinically relevant, reproducible, safe, and cost-effective validation tool for the rapid development of newly designed swabs.

Changes in Children's Behavioral Health and Family Well-Being During the COVID-19 Pandemic

OBJECTIVE

The coronavirus disease 2019 pandemic and associated public health measures have influenced all aspects of life for children and families. In this study, we examine changes in children's behavioral health and families' well-being at the start of the pandemic.

METHOD

We used longitudinal data on 2880 children from 1 US state collected over 3 waves to compare family and child well-being before and after a state-wide stay-at-home advisory set in March 2020. We descriptively examined levels and changes in 4 child behavioral health outcomes (externalizing, internalizing, adaptive, and dysregulated behaviors) and 4 family well-being outcomes (parental mental health, parental stress, parent-child relationship conflict, and household chaos) across the preshutdown and postshutdown periods. Fixed effects regression models were used to predict within-child and within-family differences in preshutdown and postshutdown outcomes.

RESULTS

Fixed effects analyses showed children's externalizing (0.09 points; 95% confidence interval [CI] 0.05-0.13), internalizing (0.04 points; 95% CI, 0.01-0.08), and dysregulated (0.11 points; 95% CI, 0.06-0.16) behaviors increased after the shutdown, whereas children's adaptive behaviors declined (-0.10 points; 95% CI, -0.15 to -0.05). Parental mental health issues (0.22 points; 95% CI, 0.17-0.27), parental stress (0.08 points; 95% CI, 0.03-0.12), parent-child relationship conflict (0.10 points; 95% CI, 0.04-0.16), and household chaos (0.10 points; 95% CI, 0.05-0.14) all increased relative to preshutdown levels.

CONCLUSION

Many children experienced declines in behavioral health and many families experienced declines in well-being in the early months of the public health crisis, suggesting the need for family-focused and child-focused policies to mitigate these changes.

School Learning Format and Children's Behavioral Health During the COVID-19 Pandemic

This cohort study investigates the association between US children’s behavioral health and the school learning format used during the COVID-19 pandemic.

An ecological perspective on early educator well-being at the start of the COVID-19 pandemic

Early educator well-being is increasingly understood as a critical ingredient of high-quality early education and care. The COVID-19 pandemic has threatened educator well-being by exacerbating existing stressors and introducing novel stressors to all aspects of early educators' lives, and early educators have had differential access to resources to cope with these new circumstances. Using survey data collected between April and June 2020 with a sample of 666 early educators in community-based center, family child care, Head Start, and public school prekindergarten programs across Massachusetts, we document the pandemic's initial influence on educators' sense of well-being. Adopting an ecological perspective, we consider educator-, program-, and community-level factors that may be associated with reported changes in well-being. Most educators indicated that their mental and financial well-being had been affected. These changes were not systematically associated with most contextual factors, although there was clear evidence of variability in reported impacts by provider type. These findings underscore the need to support educator well-being, as well as to create policy solutions that meet the heterogeneous needs of this essential workforce.

Evaluating the Impact of a Targeted Approach Designed to Build Executive Function Skills: A Randomized Trial of Brain Games

This paper reports results from an impact study of Brain Games (BGs), a classroom-based intervention designed to build preschool and school-aged children’s executive functions (EFs) and related self-regulation skills. The study employed a classroom-randomized, experimental design with 626 students in 36 pre-K through fourth grade classrooms in charter schools in a mid-sized urban district. In one set of models with child covariates, children in intervention classrooms showed marginal positive impacts on regulation-related behaviors, attention control and impulsivity, and negative effects on global EF and marginal increases in discipline problems. A second set of models with a smaller sample and both child and classroom covariates included indicate positive impacts of BGs on global EFs, prosocial behavior, and attention control and impulsivity. There were no significant impacts on the teacher–student relationship as reported by the teacher or on direct assessments of inhibitory control, short term and working memory, or another measure of global EF in either set of models. These promising findings offer a signal that implementation of targeted, easy to implement intervention approaches in classroom contexts can influence children’s regulation-related and prosocial outcomes, but this signal should be investigated further with larger and more tightly controlled designs.

Innovations in Social and Emotional Learning Research and Practice: Building from Evidence and Applying Behavioral Insights to the Design of a Social and Emotional Learning Intervention in Northeast Nigeria

Recent studies suggest that social and emotional learning (SEL) programming has the potential to be effective in conflict-affected regions, yet evidence is limited, and findings to date are mixed. One hypothesis about why SEL interventions in education in emergencies (EiE) settings have not generated the anticipated results is that the SEL content and materials have not been sufficiently localized to the context, leading to poor cultural relevance or fit. A second hypothesis is that SEL program demands tend to be high and capacity for implementation is low, undermining sustainability and impact. The current study addresses these challenges by investing in locally driven SEL content and design as a way to ensure that SEL materials are grounded in local values and needs, culturally appropriate, relevant to the specific context, and feasible to implement. The study draws on the developmental and prevention sciences as well as the field of behavioral insights to test evidence-based interventions intended to encourage desired behaviors around uptake and implementation. This paper documents the activities conducted during the project’s design phase, including landscape research, creation of initial prototypes, design workshops and rapid prototyping, and field testing. Findings suggest that using local values, practices, and framing in SEL programming increases relevance and appropriateness for the Northeast Nigeria setting. Furthermore, targeted behavioral insights interventions increased the uptake, habitual and regular use, as well as correct implementation of SEL activities. The findings contribute to the emerging literature on the cultural variability of SEL and the need to consider the context when designing and implementing programs in any setting.

Getting Developmental Science Back Into Schools: Can What We Know About Self-Regulation Help Change How We Think About "No Excuses"?

Research from education, psychology, and human development indicates that social and emotional skills are essential to success in school, work, and life, and that high-quality social and emotional learning (SEL) programs can benefit students’ mental health, academic achievement, and behavioral outcomes. While many schools are adopting an SEL approach, there remains a concerning gap between SEL research and policies and practices related to discipline and behavior management. Following the No Child Left Behind Act and education reform driven by a culture of high-stakes standardized testing and accountability benchmarks, there has been an increase in elementary schools adopting a “no excuses” model of education. This model is characterized by extended time in school, highly structured in-service teacher training, frequent assessments, and “zero tolerance” policies to strictly manage and control children’s behavior. These behavior policies are problematic as they run counter to what research tells us about children’s social and emotional development. Reactive and exclusionary discipline policies inhibit children’s abilities to build and practice self-regulation skills and jeopardize the relationships between students and teachers. The developmental science perspective on children’s regulatory skills suggests that the early years of school are a central context for developing and practicing self-regulation with the support of educators and peers. Research also indicates that warm, caring, reciprocal relationships based on trust are critical to learning and development. Yet, this research base is often overshadowed by pressures to improve standardized achievement scores or misinterpreted in the form of hyper-vigilance about children’s behavior in the classroom. Finally, the “no excuses” approach to behavior management is used disproportionally in schools serving low-income students of color and thus may contribute to unequal rates of suspensions and expulsions, both of which are linked to negative developmental outcomes later in life. This is particularly true for students who have experienced trauma, in part because the act of social exclusion is often re-traumatizing. This article summarizes research on self-regulation, trauma, and developmental relationships, highlights potential consequences of “no excuses” policies and practices in schools, and presents an alternative view of learning environments which promote effective self-regulation skills in young children.

Social centrality and aggressive behavior in the elementary school: Gender segregation, social structure, and psychological factors

In this paper, we build on key findings in the sociological literature regarding different patterns of association between social centrality and overt aggressive behavior in the context of same-and-cross gender social interactions. We explore these associations in a population of urban elementary school students ( Age ^   = 8.62 , SD = 0.69, N = 848), while addressing claims that the role of psychological factors is overstated in this literature. Our results indicate that, on average, social centrality is positively associated with aggressive behavior for boys, but negatively for girls. We also find a moderating effect indicating that the proportion of male peers with whom participants are reported to hang around, as well as their own gender play a role in the association between social centrality and aggression. These findings are discussed in the context of an ecological perspective on human development in which interactions among individuals, their social groups, and key environments are viewed as central to shaping developmental pathways.

Long-term follow-up of fenestrated endovascular repair for juxtarenal aortic aneurysm

BACKGROUND

Fenestrated endovascular aneurysm repair (FEVAR) is increasingly being used for juxtarenal aortic aneurysms. The aim of this study was to review long-term results and assess the importance of changing stent-graft design on outcomes.

METHODS

This was a retrospective review of all patients who underwent FEVAR within a single unit over 12 years (February 2003 to December 2015). Kaplan-Meier analysis of survival, and freedom from target vessel loss, aneurysm expansion, graft-related endoleak and secondary intervention was performed. Comparison between outcomes of less complex grafts (fewer than 3 fenestrations) and more complex grafts (3 or 4 fenestrations) was undertaken.

RESULTS

Some 173 patients underwent FEVAR; median age was 76 (i.q.r. 70-79) years and 90·2 per cent were men. Median aneurysm diameter was 63 (59-71) mm and median follow-up was 34 (16-50) months. The adjusted primary technical operative success rate was 95·4 per cent. The in-hospital mortality rate was 5·2 per cent; there was no known aneurysm-related death during follow-up. Median survival was 7·1 (95 per cent c.i. 5·2 to 8·1) years and overall survival was 60·1 per cent (104 of 173). There was a trend towards an increasing number of fenestrations in the graft design over time. In-hospital mortality appeared higher when more complex stent-grafts were used (8 versus 2 per cent for stent-grafts with 3-4 versus fewer than 3 fenestrations; P = 0·059). Graft-related endoleaks were more common following deployment of stent-grafts with three or four fenestrations (12 of 90 versus 6 of 83; P < 0·001).

CONCLUSION

Fenestrated endovascular aneurysm repair for juxtarenal aneurysm is associated with few aneurysm-related deaths in the long term. Significant numbers of secondary interventions are required, but the majority of these can be performed using an endovascular approach.

Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Background

The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.

Methods

Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).

Results

Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.

Conclusion

Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

Disentangling the “whys” from the “whats” of aggressive behaviour

We examined the validity of a measurement system for the study of aggression that distinguishes among four principle dimensions of aggressive behaviour: overt and relational aggression (i.e., the “whats”) and instrumental and reactive aggression (i.e., the “whys”). The sample comprised 1723 adolescents (Grades 5 through 10) from Berlin, Germany. The internal validity of the measurement system was strongly supported, revealing four discrete dimensions of aggression: two overriding forms (overt and relational) and two underlying functions (instrumental and reactive). The differential and unique patterns of criterion-related validity strongly supported the distinctions among the constructs. The importance of disentangling these dimensions in understanding the development of aggressive behaviour is discussed.

Measuring psychosocial environments using individual responses: an application of multilevel factor analysis to examining students in schools

Interest in understanding how psychosocial environments shape youth outcomes has grown considerably. School environments are of particular interest to prevention scientists as many prevention interventions are school-based. Therefore, effective conceptualization and operationalization of the school environment is critical. This paper presents an illustration of an emerging analytic method called multilevel factor analysis (MLFA) that provides an alternative strategy to conceptualize, measure, and model environments. MLFA decomposes the total sample variance-covariance matrix for variables measured at the individual level into within-cluster (e.g., student level) and between-cluster (e.g., school level) matrices and simultaneously models potentially distinct latent factor structures at each level. Using data from 79,362 students from 126 schools in the National Longitudinal Study of Adolescent to Adult Health (formerly known as the National Longitudinal Study of Adolescent Health), we use MLFA to show how 20 items capturing student self-reported behaviors and emotions provide information about both students (within level) and their school environment (between level). We identified four latent factors at the within level: (1) school adjustment, (2) externalizing problems, (3) internalizing problems, and (4) self-esteem. Three factors were identified at the between level: (1) collective school adjustment, (2) psychosocial environment, and (3) collective self-esteem. The finding of different and substantively distinct latent factor structures at each level emphasizes the need for prevention theory and practice to separately consider and measure constructs at each level of analysis. The MLFA method can be applied to other nested relationships, such as youth in neighborhoods, and extended to a multilevel structural equation model to better understand associations between environments and individual outcomes and therefore how to best implement preventive interventions.

School Climate, Teacher-Child Closeness, and Low-Income Children’s Academic Skills in Kindergarten

In this study we used data on a sample of children in the Chicago Public Schools in areas of concentrated poverty-related disadvantage to examine associations between school climate and low-income children’s language/literacy and math skills during the transition to kindergarten. We also explored whether teacher-child closeness moderated these associations. Multilevel modeling analyses conducted using a sample of 242 children nested in 102 elementary schools revealed that low adult support in the school was significantly associated with children’s poorer language/literacy and math skills in kindergarten. Teacher-child closeness predicted children’s higher language/literacy and math scores and moderated the association between low adult support and children’s academic skills. Among children who were high on closeness with their teacher, those in schools with high levels of adult support showed stronger language/literacy and math skills. There were no significant associations between adult support and the academic skills of children with medium or low levels of teacher-child closeness. Results shed light on the importance of adult support at both school and classroom levels in promoting low-income children’s academic skills during the transition to kindergarten.

The Influence of Conduct Problems and Callous-Unemotional Traits on Academic Development Among Youth

The present study attempted to address developmental differences within the large group of youth with conduct problems through an examination of the relationship between callous-unemotional traits and academic outcomes in an effort to expand the field's understanding of heterogeneity in outcomes associated with behavior problems. Data were collected from a cohort of 3rd grade students (N = 942; 51 % female; 45.6 % Hispanic/Latino, 41.1 % Black/African American, 4.7 % Non-Hispanic White; mean age = 8.07 years) in eighteen public elementary schools, as well as their parents and teachers. Hierarchical linear modeling revealed that callous-unemotional traits were associated with lower quality student-teacher relationships and worse performance on standardized math and reading exams over and above the effects of conduct problems. These findings suggest that school-based interventions may be particularly effective in ameliorating some of the deficits noted within this subset of youth exhibiting conduct problems. This finding has important policy implications as the field of developmental science attempts to design and enrich programs that focus on improving social-emotional learning.

Social and Emotional Learning Services and Child Outcomes in Third Grade: Evidence from a Cohort of Head Start Participants

A variety of universal school-based social and emotional learning (SEL) programs have been designed in the past decades to help children improve social-emotional and academic skills. Evidence on the effectiveness of SEL programs has been mixed in the literature. Using data from a longitudinal follow-up study of children (n = 414) originally enrolled in a clustered randomized controlled trial (RCT) when they were in Head Start, we examined whether universal SEL services in third grade were associated with the development of children from disadvantaged families. We took advantage of pairwise matching in the RCT design to compare children who had similar family background and preschool experiences but received different doses of SEL services in third grade. The results showed that the frequent (i.e., weekly to daily) exposure to SEL opportunities was associated with favorable social-emotional and academic development in third grade, including increased social skills, student-teacher relationship, and academic skills, as well as reduced impulsiveness.

Assessing invariance across sex and race/ethnicity in measures of youth psychopathic characteristics

The aim of this study was to assess the measurement invariance of 2 commonly used measures of youth psychopathic characteristics across sex and racial/ethnic groups. Among a community sample of Hispanic and Black adolescents (N = 355; 50.5% female; mean age = 15.09) and their parents, this study tested the configural and metric invariance of the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Fitzpatrick, & Kiehl, 1995) and the parent-report version of the Inventory of Callous-Unemotional Traits (Frick, 2004). Preliminary analyses indicated that the adolescents in the present study reported similar rates of psychopathic characteristics as those reported by other studies of adolescents and young adults. Results of the multigroup invariance analyses indicated that these measures are invariant across sex and between Hispanic and Black youth. In addition, further analyses assessing associations between these measures and a number of behavioral and emotional characteristics indicated that scores on the LSRP Scale and Callous-Unemotional Traits demonstrate good convergent and discriminant validity with few differences by sex or race/ethnicity. To date, research on psychopathy has focused predominantly on samples of White males. Therefore, it is important that research examines the equivalence of measures of psychopathic characteristics across different populations, so that accurate assessments can be made to inform intervention and treatment efforts.

Implications of different methods for specifying classroom composition of externalizing behavior and its relationship to social-emotional outcomes

In this paper, we examine common methods for using individual-level data to represent classroom composition by examining exemplary studies that thoughtfully incorporate such measures. Building on these studies, and using data from the Chicago School Readiness Project (CSRP), this paper examines theoretical and analytical implications of a set of different transformations of individual ratings of child externalizing behaviors in order to examine and compare the influence of these representations of classroom composition on Kindergarten internalizing behaviors, social competence, and attention/impulsivity problems. Results indicate that each Kindergarten outcome is influenced by distinct aspects of classroom composition of externalizing behaviors. Kindergarten internalizing behaviors are positively associated with the proportion of children in the Head Start classroom who started with externalizing scores above the 75th percentile regardless of the average value of externalizing behaviors in the classroom. In contrast, Kindergarten social competence is predicted by three aspects of the classroom distribution of externalizing behaviors in the fall of Head Start-the classroom mean, standard deviation, and skew. Finally, Kindergarten attention/impulsivity problems were not associated with any aspect of classroom composition of externalizing behavior examined in this paper.

Growth trajectories of early aggression, overactivity, and inattention: Relations to second-grade reading

The link between behavior problems and low academic achievement is well established, but few studies have examined longitudinal relations between early externalizing behaviors before school entry and low academic achievement following transition to formal schooling. Early inattention has been particularly overlooked, despite strong associations between inattention and reading difficulties later in development. Trajectories of infant and toddler aggression, overactivity, and inattention, developed from parent reports about 1- to 3-year-old children, were examined as predictors of direct assessments of 2nd-grade reading in an at-risk epidemiological study subsample (N = 359). Reports of inattentive and overactive behaviors at ages 1-3 years and changes in inattention through toddlerhood predicted reading achievement in 2nd grade. A parallel process model suggested that the effects of early inattention on reading appear to be most robust. Findings underscore the contribution of social-emotional development to school readiness and the importance of early identification of children with externalizing problems, as early interventions designed to reduce externalizing problems may improve later reading skills.

OS-9 facilitates turnover of nonnative GRP94 marked by hyperglycosylation

ER quality control factors GRP94 and OS-9 associate not for the disposal of ERAD substrates but instead because OS-9 sequesters and degrades aberrant forms of GRP94, which are hyperglycosylated at cryptic acceptor sites and have altered structure and activity. This highlights a novel mechanism of quality control of an ER-resident chaperone.

The tight coupling of protein folding pathways with disposal mechanisms promotes the efficacy of protein production in the endoplasmic reticulum (ER). It has been hypothesized that the ER-resident molecular chaperone glucose-regulated protein 94 (GRP94) is part of this quality control coupling because it supports folding of select client proteins yet also robustly associates with the lectin osteosarcoma amplified 9 (OS-9), a component involved in ER-associated degradation (ERAD). To explore this possibility, we investigated potential functions for the GRP94/OS-9 complex in ER quality control. Unexpectedly, GRP94 does not collaborate with OS-9 in ERAD of misfolded substrates, nor is the chaperone required directly for OS-9 folding. Instead, OS-9 binds preferentially to a subpopulation of GRP94 that is hyperglycosylated on cryptic N-linked glycan acceptor sites. Hyperglycosylated GRP94 forms have nonnative conformations and are less active. As a result, these species are degraded much faster than the major, monoglycosylated form of GRP94 in an OS-9–mediated, ERAD-independent, lysosomal-like mechanism. This study therefore clarifies the role of the GRP94/OS-9 complex and describes a novel pathway by which glycosylation of cryptic acceptor sites influences the function and fate of an ER-resident chaperone.

Translating multilevel theory into multilevel research: challenges and opportunities for understanding the social determinants of psychiatric disorders

INTRODUCTION

The observation that features of the social environment, including family, school, and neighborhood characteristics, are associated with individual-level outcomes has spurred the development of dozens of multilevel or ecological theoretical frameworks in epidemiology, public health, psychology, and sociology, among other disciplines. Despite the widespread use of such theories in etiological, intervention, and policy studies, challenges remain in bridging multilevel theory and empirical research.

METHODS

This paper set out to synthesize these challenges and provide specific examples of methodological and analytical strategies researchers are using to gain a more nuanced understanding of the social determinants of psychiatric disorders, with a focus on children's mental health. To accomplish this goal, we begin by describing multilevel theories, defining their core elements, and discussing what these theories suggest is needed in empirical work. In the second part, we outline the main challenges researchers face in translating multilevel theory into research. These challenges are presented for each stage of the research process. In the third section, we describe two methods being used as alternatives to traditional multilevel modeling techniques to better bridge multilevel theory and multilevel research. These are (1) multilevel factor analysis and multilevel structural equation modeling; and (2) dynamic systems approaches.

CONCLUSIONS

Through its review of multilevel theory, assessment of existing strategies, and examination of emerging methodologies, this paper offers a framework to evaluate and guide empirical studies on the social determinants of child psychiatric disorders as well as health across the life course.

Unpacking the Black Box of the CSRP Intervention: The Mediating Roles of Teacher-child Relationship Quality and Self-regulation

This study examines the theory of change of the Chicago School Readiness Project (CSRP), testing a sequence of theory-derived mediating mechanisms including the quality of teacher-child relationships and children's self-regulation. The CSRP is a multi-component teacher- and classroom-focused intervention, and its cluster-randomized efficacy trial was conducted in 35 Head Start-funded classrooms. A series of increasingly complex and conservative structural equation models indicate that the CSRP carries its effects on children's academic and behavioral outcomes through changes in teacher-child relationship quality and children's self-regulation.

Does a Preschool Social and Emotional Learning Intervention Pay Off for Classroom Instruction and Children's Behavior and Academic Skills? Evidence From the Foundations of Learning Project

This article tests the hypothesis that children's learning environment will improve through a social and emotional learning (SEL) intervention that provides preschool teachers with new skills to manage children's disruptive behavior by reporting results from the Foundations of Learning (FOL) Demonstration, a place-randomized, experimental evaluation conducted by MDRC. Research Findings: Findings demonstrate that the FOL intervention improved teachers' ability to address children's behavior problems and to provide a positive emotional climate in their classrooms. Importantly, the FOL intervention also improved the number of minutes of instructional time, although the quality of teachers' instruction was not improved. Finally, FOL benefited children's observed behavior in classrooms, with lower levels of conflictual interactions and, at the trend level, higher levels of engagement in classrooms activities, relative to similar students randomly assigned to control classrooms. Practice or Policy: This study is one of an emerging body of research on the efficacy of SEL programs for preschool children living in poverty. Understanding the value-added of these programs (e.g., in increased instructional time and increased classroom engagement) as well as their limitations (e.g., in teachers' instructional quality and children's academic skills) will help us design the next set of more effective interventions for low-income children.

The role of HIF in cobalt-induced ischemic tolerance

Understanding the endogenous survival pathways induced by ischemic tolerance may yield targets for neuroprotection from stroke. One well-studied pathway reported to be evoked by preconditioning stimuli is the transcription factor HIF (hypoxia-inducible factor). However, whether HIF induction by ischemic insults is neuroprotective or toxic is still unclear. We examined the ability of three prolyl-hydroxylase inhibitors, which induce HIF, to protect hippocampal cultures from oxygen-glucose deprivation. Hippocampal cultures were exposed to ischemic preconditioning or various concentrations of cobalt chloride, deferoxamine (DFO) or dimethyloxylalyglycine (DMOG), prior to lethal oxygen-glucose deprivation (OGD). Cell survival of neurons and astrocytes was determined with dual-label immunocytochemistry. The induction of HIF targets was assessed in mixed as well as astrocyte-enriched cultures. Ischemic preconditioning, as well as low concentrations of cobalt and DFO, enhanced the survival of neurons following OGD. However, DMOG exacerbates OGD-induced neuronal death. At low concentrations, all three prolyl-hydroxylase (PHD) inhibitors increased the survival of astrocytes. Neuroprotective concentrations of cobalt induced the transcription of the cytokine erythropoietin (EPO) in astrocyte cultures. In addition, pretreatment with recombinant human erythropoietin (rH-EPO) also protected neurons from OGD. Our data suggest that HIF-induced EPO, released from astrocytes, protects neurons from OGD. However, the three PHD inhibitors each exhibited different neuroprotective profiles at low concentrations, suggesting that not all PHD inhibitors are created equal. The protective effects at low doses is reminiscent of HIF involvement in ischemic tolerance, in which sub-lethal insults induce HIF pathways resulting in neuroprotection, whereas the high-dose toxicity suggests that over-activation of HIF is not always protective. Therefore, the choice of inhibitor and dose may determine the clinical utility of these compounds. Deferoxamine exhibited little toxicity even at higher doses, and therefore appears a promising candidate for clinical use.

TEACHING THROUGH INTERACTIONS: Testing a Developmental Framework of Teacher Effectiveness in over 4,000 Classrooms

Validating frameworks for understanding classroom processes that contribute to student learning and development is important to advance the scientific study of teaching. This article presents one such framework, Teaching through Interactions, which posits that teacher-student interactions are a central driver for student learning and organizes teacher-student interactions into three major domains. Results provide evidence that across 4,341 preschool to elementary classrooms (1) teacher-student classroom interactions comprise distinct emotional, organizational, and instructional domains; (2) the three-domain latent structure is a better fit to observational data than alternative one- and two-domain models of teacher-student classroom interactions; and (3) the three-domain structure is the best-fitting model across multiple data sets.

Mediation and spillover effects in group-randomized trials: a case study of the 4Rs educational intervention

Peer influence and social interactions can give rise to spillover effects in which the exposure of one individual may affect outcomes of other individuals. Even if the intervention under study occurs at the group or cluster level as in group-randomized trials, spillover effects can occur when the mediator of interest is measured at a lower level than the treatment. Evaluators who choose groups rather than individuals as experimental units in a randomized trial often anticipate that the desirable changes in targeted social behaviors will be reinforced through interference among individuals in a group exposed to the same treatment. In an empirical evaluation of the effect of a school-wide intervention on reducing individual students' depressive symptoms, schools in matched pairs were randomly assigned to the 4Rs intervention or the control condition. Class quality was hypothesized as an important mediator assessed at the classroom level. We reason that the quality of one classroom may affect outcomes of children in another classroom because children interact not simply with their classmates but also with those from other classes in the hallways or on the playground. In investigating the role of class quality as a mediator, failure to account for such spillover effects of one classroom on the outcomes of children in other classrooms can potentially result in bias and problems with interpretation. Using a counterfactual conceptualization of direct, indirect and spillover effects, we provide a framework that can accommodate issues of mediation and spillover effects in group randomized trials. We show that the total effect can be decomposed into a natural direct effect, a within-classroom mediated effect and a spillover mediated effect. We give identification conditions for each of the causal effects of interest and provide results on the consequences of ignoring "interference" or "spillover effects" when they are in fact present. Our modeling approach disentangles these effects. The analysis examines whether the 4Rs intervention has an effect on children's depressive symptoms through changing the quality of other classes as well as through changing the quality of a child's own class.

Evidence of pathway-specific basophil anergy induced by peanut oral immunotherapy in peanut-allergic children

BACKGROUND

In Westernized countries, over 1% of the population is allergic to peanuts or tree nuts, which carries a risk of severe allergic reactions. Several studies support the efficacy of peanut oral immunotherapy (OIT) for reducing the clinical sensitivity of affected individuals; however, the mechanisms of this effect are still being characterized. One mechanism that may contribute is the suppression of effector cells, such as basophils. Basophil anergy has been characterized in vitro as a pathway-specific hyporesponsiveness; however, this has not been demonstrated to occur in vivo.

OBJECTIVE

To evaluate the hypothesis that basophil anergy occurs in vivo due to chronic allergen exposure in the setting of a clinical oral immunotherapy trial.

METHODS

Samples of peripheral blood were obtained from subjects during a placebo-controlled clinical trial of peanut OIT. Basophil reactivity to in vitro stimulation with peanut allergen and controls was assessed by the upregulation of activation markers, CD63 and CD203c, measured by flow cytometry.

RESULTS

The upregulation of CD63 following stimulation of the IgE receptor, either specifically with peanut allergen or non-specifically with anti-IgE antibody, was strongly suppressed by active OIT. However, OIT did not significantly suppress this response in basophils stimulated by the distinct fMLP receptor pathway. In the subset of subjects with egg sensitization, active peanut OIT also suppressed CD63 upregulation in response to stimulation with egg allergen. Allergen OIT also suppressed the upregulation of CD203c including in response to stimulation with IL-3 alone.

CONCLUSION

Peanut OIT induces a hyporesponsive state in basophils that is consistent with pathway-specific anergy previously described in vitro. This suggests the hypothesis that effector cell anergy could contribute to clinical desensitization.

Academic Performance of Subsequent Schools and Impacts of Early Interventions: Evidence from a Randomized Controlled Trial in Head Start Settings

The role of subsequent school contexts in the long-term effects of early childhood interventions has received increasing attention, but has been understudied in the literature. Using data from the Chicago School Readiness Project (CSRP), a cluster-randomized controlled trial conducted in Head Start programs, we investigate whether the intervention had differential effects on academic and behavioral outcomes in kindergarten if children attended high- or low-performing schools subsequent to the preschool intervention year. To address the issue of selection bias, we adopt an innovative method, principal score matching, and control for a set of child, mother, and classroom covariates. We find that exposure to the CSRP intervention in the Head Start year had significant effects on academic and behavioral outcomes in kindergarten for children who subsequently attended high-performing schools, but no significant effects on children attending low-performing schools. Policy implications of the findings are discussed.

A school-randomized clinical trial of an integrated social-emotional learning and literacy intervention: impacts after 1 school year

OBJECTIVE

To report experimental impacts of a universal, integrated school-based intervention in social-emotional learning and literacy development on change over 1 school year in 3rd-grade children's social-emotional, behavioral, and academic outcomes.

METHOD

This study employed a school-randomized, experimental design and included 942 3rd-grade children (49% boys; 45.6% Hispanic/Latino, 41.1% Black/African American, 4.7% non-Hispanic White, and 8.6% other racial/ethnic groups, including Asian, Pacific Islander, Native American) in 18 New York City public elementary schools. Data on children's social-cognitive processes (e.g., hostile attribution biases), behavioral symptomatology (e.g., conduct problems), and literacy skills and academic achievement (e.g., reading achievement) were collected in the fall and spring of 1 school year.

RESULTS

There were main effects of the 4Rs Program after 1 year on only 2 of the 13 outcomes examined. These include children's self-reports of hostile attributional biases (Cohen's d = 0.20) and depression (d = 0.24). As expected based on program and developmental theory, there were impacts of the intervention for those children identified by teachers at baseline with the highest levels of aggression (d = 0.32-0.59) on 4 other outcomes: children's self-reports of aggressive fantasies, teacher reports of academic skills, reading achievement scaled scores, and children's attendance.

CONCLUSIONS

This report of effects of the 4Rs intervention on individual children across domains of functioning after 1 school year represents an important first step in establishing a better understanding of what is achievable by a schoolwide intervention such as the 4Rs in its earliest stages of unfolding. The first-year impacts, combined with our knowledge of sustained and expanded effects after a second year, provide evidence that this intervention may be initiating positive developmental cascades both in the general population of students and among those at highest behavioral risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Two-year impacts of a universal school-based social-emotional and literacy intervention: an experiment in translational developmental research

This study contributes to ongoing scholarship at the nexus of translational research, education reform, and the developmental and prevention sciences. It reports 2-year experimental impacts of a universal, integrated school-based intervention in social-emotional learning and literacy development on children's social-emotional, behavioral, and academic functioning. The study employed a school-randomized, experimental design with 1,184 children in 18 elementary schools. Children in the intervention schools showed improvements across several domains: self-reports of hostile attributional bias, aggressive interpersonal negotiation strategies, and depression, and teacher reports of attention skills, and aggressive and socially competent behavior. In addition, there were effects of the intervention on children's math and reading achievement for those identified by teachers at baseline at highest behavioral risk. These findings are interpreted in light of developmental cascades theory and lend support to the value of universal, integrated interventions in the elementary school period for promoting children's social-emotional and academic skills.

CSRP's Impact on low-income preschoolers' preacademic skills: self-regulation as a mediating mechanism

Based on theoretically driven models, the Chicago School Readiness Project (CSRP) targeted low-income children's school readiness through the mediating mechanism of self-regulation. The CSRP is a multicomponent, cluster-randomized efficacy trial implemented in 35 Head Start-funded classrooms (N = 602 children). The analyses confirm that the CSRP improved low-income children's self-regulation skills (as indexed by attention/impulse control and executive function) from fall to spring of the Head Start year. Analyses also suggest significant benefits of CSRP for children's preacademic skills, as measured by vocabulary, letter-naming, and math skills. Partial support was found for improvement in children's self-regulation as a hypothesized mediator for children's gains in academic readiness. Implications for programs and policies that support young children's behavioral health and academic success are discussed.

CSRP's Impact on low-income preschoolers' preacademic skills: self-regulation as a mediating mechanism

Based on theoretically driven models, the Chicago School Readiness Project (CSRP) targeted low-income children's school readiness through the mediating mechanism of self-regulation. The CSRP is a multicomponent, cluster-randomized efficacy trial implemented in 35 Head Start-funded classrooms (N = 602 children). The analyses confirm that the CSRP improved low-income children's self-regulation skills (as indexed by attention/impulse control and executive function) from fall to spring of the Head Start year. Analyses also suggest significant benefits of CSRP for children's preacademic skills, as measured by vocabulary, letter-naming, and math skills. Partial support was found for improvement in children's self-regulation as a hypothesized mediator for children's gains in academic readiness. Implications for programs and policies that support young children's behavioral health and academic success are discussed.

Dosage effects on school readiness: evidence from a randomized classroom-based intervention

Variations in the dosage of social interventions and the effects of dosage on program outcomes remain understudied. This study examines the dosage effects of the Chicago School Readiness Project, a randomized, multifaceted classroom-based intervention conducted in Head Start settings. Using a principal score matching method to address the issue of selection bias, the study finds that high-dosage levels of teacher training and mental health consultant class visits have larger effects on children's school readiness than the effects estimated through intention-to-treat (ITT) analyses. Low-dosage levels of treatment are found to have effects that are smaller than those estimated in ITT analyses or to have no statistically significant program effects. Moreover, individual mental health consultation services provided to high-risk children are found to have statistically significant effects on their school readiness. The study discusses the implications of these findings for research and policy.

Phasing rectangular apertures

Several techniques have been developed to phase apertures in the context of astronomical telescopes with segmented mirrors. Phasing multiple apertures, however, is important in a wide range of optical applications. The application of primary interest in this paper is the phasing of multiple short pulse laser beams for fast ignition fusion experiments. In this paper analytic expressions are derived for parameters such as the far-field distribution, a line-integrated form of the far-field distribution that could be fit to measured data, enclosed energy or energy-in-a-bucket and center-of-mass that can then be used to phase two rectangular apertures. Experimental data is taken with a MEMS device to simulate the two apertures and comparisons are made between the analytic parameters and those derived from the measurements. Two methods, fitting the measured far-field distribution to the theoretical distribution and measuring the ensquared energy in the far-field, produced overall phase variance between the 100 measurements of less than 0.005 rad(2) or an RMS displacement of less than 12 nm.

Setting up a store‐and‐forward telemedicine service for acute trauma in a hospital trust

Telemedicine is a valuable, but as yet underused, resource for the delivery of health-care to patients. This paper describes the development of a new store-and-forward telemedicine service at the Queen Victoria Hospital, which is a tertiary referral centre for plastic surgery in the United Kingdom. The practical requirements of such a system, and the technical and legal difficulties experienced during the initial stages, are also discussed.

Activation of the tonic GABAC receptor current in retinal bipolar cell terminals by nonvesicular GABA release

Within the second synaptic layer of the retina, bipolar cell (BC) output to ganglion cells is regulated by inhibitory input to BC axon terminals. GABA(A) receptors (GABA(A)Rs) mediate rapid synaptic currents in BC terminals, whereas GABA(C) receptors (GABA(C)Rs) mediate slow evoked currents and a tonic current, which is strongly regulated by GAT-1 GABA transporters. We have used voltage-clamp recordings from BC terminals in goldfish retinal slices to determine the source of GABA for activation of these currents. Inhibition of vesicular release with concanamycin A or tetanus toxin significantly inhibited GABA(A)R inhibitory postsynaptic currents and glutamate-evoked GABA(A)R and GABA(C)R currents but did not reduce the tonic GABA(C)R current, which was also not dependent on extracellular Ca(2+). The tonic current was strongly potentiated by inhibition of GABA transaminase, under both normal and Ca(2+)-free conditions, and was activated by exogenous taurine; however inhibition of taurine transport had little effect. The tonic current was unaffected by GAT-2/3 inhibition and was potentiated by GAT-1 inhibition even in the absence of vesicular release, indicating that it is unlikely to be evoked by reversal of GABA transporters or by ambient GABA. In addition, GABA release does not appear to occur via hemichannels or P2X(7) receptors. BC terminals therefore exhibit two forms of GABA(C)R-mediated inhibition, activated by vesicular and by nonvesicular GABA release, which are likely to have distinct functions in visual signal processing. The tonic GABA(C)R current in BC terminals exhibits similar properties to tonic GABA(A)R and glutamate receptor currents in the brain.