The relationship between school mental health service use in high school and educational outcomes of adolescents with psychiatric disorders

This study aimed to examine the relationship between school mental health service use in high school and educational outcomes of adolescents with psychiatric disorders. The sample included 2617 adolescents who were enrolled in eighth grade in a large urban school district in the United States, were enrolled in Medicaid during eighth grade, and had a mental health diagnosis. Psychiatric hospitalization, school enrollment, school absences, out-of-school suspensions, school dropouts, and school exits for negative reasons were examined as mental health and educational outcomes. Compared with adolescents who used school mental health services for 2 years following eighth grade, adolescents who did not use school mental health service during the high school years had a significantly lower annual number of days enrolled in school and higher rates of exiting school for negative reasons such as school dropout and long-term hospitalization. Our findings support the positive role of school mental health care delivery in high schools in preventing negative educational outcomes for adolescents with psychiatric disorder.

The Association of Sleep Duration with Grade Point Averages and Absences Among 9th Graders in Georgia, USA

This study aimed to examine the association between sleep measures (self-reported sleep duration and weekend catch-up sleep) and grade point average (GPA) and absences among 9th grade students from two racially and economically diverse high schools in a semi-rural county of north-central Georgia. Linear and Poisson regression models estimated the association between sleep measures and GPA and absences (separately), respectively. Analyses adjusted for gender, race/ethnicity, free/reduced-price school lunch status, and parental education. Sleep duration was significantly associated with both GPA and absences, such that for every one additional hour of sleep, GPA increased by 0.8 percentage points (b=0.8, 95% CI:0.1,1.5) while the number of absences was lower by 6% (b=-0.05; OR=0.94, 95% CI:0.91,0.98). Weekend catch-up sleep was also significantly and positively associated with absences (b=0.04; OR=1.04, 95% CI; 1.02, 1.07). Increasing sleep may be a strategy to improve GPA and reduce absences among teenagers. Future research should identify effective measures to lengthen sleep.

The paradoxical role of social class background in the educational and labour market outcomes of the children of immigrants in the UK

Despite predominantly lower social class origins, the second generation of established immigrant groups in the UK are now attaining high levels of education. However, they continue to experience poorer labour market outcomes than the majority population. These worse outcomes are often attributed in part to their disadvantaged origins, which do not, by contrast, appear to constrain their educational success. This paper engages with this paradox. We discuss potential mechanisms for second-generation educational success and how far we might expect these to be replicated in labour market outcomes. We substantiate our discussion with new empirical analysis. Drawing on a unique longitudinal study of England and Wales spanning 40 years and encompassing one per cent of the population, we present evidence on the educational and labour market outcomes of the second generation of four groups of immigrants and the white British majority, controlling for multiple measures of social origins. We demonstrate that second-generation men and women's educational advantage is only partially reflected in the labour market. We reflect on the implications of our findings for future research.

Deviations from a typical development of the cerebellum in youth are associated with psychopathology, executive functions and educational outcomes

BACKGROUND

Understanding deviations from typical brain development is a promising approach to comprehend pathophysiology in childhood and adolescence. We investigated if cerebellar volumes different than expected for age and sex could predict psychopathology, executive functions and academic achievement.

METHODS

Children and adolescents aged 6-17 years from the Brazilian High-Risk Cohort Study for Mental Conditions had their cerebellar volume estimated using Multiple Automatically Generated Templates from T1-weighted images at baseline (n = 677) and at 3-year follow-up (n = 447). Outcomes were assessed using the Child Behavior Checklist and standardized measures of executive functions and school achievement. Models of typically developing cerebellum were based on a subsample not exposed to risk factors and without mental-health conditions (n = 216). Deviations from this model were constructed for the remaining individuals (n = 461) and standardized variation from age and sex trajectory model was used to predict outcomes in cross-sectional, longitudinal and mediation analyses.

RESULTS

Cerebellar volumes higher than expected for age and sex were associated with lower externalizing specific factor and higher executive functions. In a longitudinal analysis, deviations from typical development at baseline predicted inhibitory control at follow-up, and cerebellar deviation changes from baseline to follow-up predicted changes in reading and writing abilities. The association between deviations in cerebellar volume and academic achievement was mediated by inhibitory control.

CONCLUSIONS

Deviations in the cerebellar typical development are associated with outcomes in youth that have long-lasting consequences. This study highlights both the potential of typical developing models and the important role of the cerebellum in mental health, cognition and education.

The Effectiveness of Online-Only Blended Cardiopulmonary Resuscitation Training: Static-Group Comparison Study

BACKGROUND

Basic life support (BLS) education is essential for improving bystander cardiopulmonary resuscitation (CPR) rates, but the imparting of such education faces obstacles during the outbreak of emerging infectious diseases, such as COVID-19. When face-to-face teaching is limited, distance learning-blended learning (BL) or an online-only model-is encouraged. However, evidence regarding the effect of online-only CPR training is scarce, and comparative studies on classroom-based BL (CBL) are lacking. While other strategies have recommended self-directed learning and deliberate practice to enhance CPR education, no previous studies have incorporated all of these instructional methods into a BLS course.

OBJECTIVE

This study aimed to demonstrate a novel BLS training model-remote practice BL (RBL)-and compare its educational outcomes with those of the conventional CBL model.

METHODS

A static-group comparison study was conducted. It included RBL and CBL courses that shared the same paradigm, comprising online lectures, a deliberate practice session with Little Anne quality CPR (QCPR) manikin feedback, and a final assessment session. In the main intervention, the RBL group was required to perform distant self-directed deliberate practice and complete the final assessment via an online video conference. Manikin-rated CPR scores were measured as the primary outcome; the number of retakes of the final examination was the secondary outcome.

RESULTS

A total of 52 and 104 participants from the RBL and CBL groups, respectively, were eligible for data analysis. A comparison of the 2 groups revealed that there were more women in the RBL group than the CBL group (36/52, 69.2% vs 51/104, 49%, respectively; P=.02). After adjustment, there were no significant differences in scores for QCPR release (96.9 vs 96.4, respectively; P=.61), QCPR depth (99.2 vs 99.5, respectively; P=.27), or QCPR rate (94.9 vs 95.5, respectively; P=.83). The RBL group spent more days practicing before the final assessment (12.4 vs 8.9 days, respectively; P<.001) and also had a higher number of retakes (1.4 vs 1.1 times, respectively; P<.001).

CONCLUSIONS

We developed a remote practice BL-based method for online-only distant BLS CPR training. In terms of CPR performance, using remote self-directed deliberate practice was not inferior to the conventional classroom-based instructor-led method, although it tended to take more time to achieve the same effect.

TRIAL REGISTRATION

Not applicable.

Children's Educational Outcomes and Persistence and Severity of Household Food Insecurity in India: Longitudinal Evidence from Young Lives

BACKGROUND

Food insecurity is a pressing global challenge with far-reaching consequences for health and well-being. However, little attention has focused specifically on the experiences of children and adolescents over the age of 5 y in food insecure households.

OBJECTIVES

We examine whether the persistence and severity of household food insecurity are negatively associated with children's educational outcomes.

METHODS

We used data for the younger cohort of the longitudinal Young Lives data from rounds 3 (2009), 4 (2013), and 5 (2016), when children were aged 8 y, 12 y, and 15 y, respectively. Drawing on the Household Food Insecurity and Access Scale, we used descriptive statistics, graphical analysis, and multilevel regressions to document how the persistence and severity of household food insecurity are associated with children's educational outcomes (years of education, maths, and vocabulary [PPVT] test scores). We controlled for potentially confounding sociodemographic characteristics, including children's own baseline grade attained and test scores in "value-added" models, to provide robust estimates of household food insecurity in predicting children's educational outcomes.

RESULTS

Household food insecurity generally declined between 2009 and 2016. Fewer than 50% of households were food secure across the 3 rounds of data we examined. Our robust, multivariate, value-added models show that the persistence and severity of food insecurity are negatively associated with all 3 children's educational outcomes we examined.

CONCLUSIONS

We add to a small but growing literature exploring how household food insecurity is associated with children's educational outcomes in the Global South. Our findings on severity of food insecurity highlight the importance of understanding food insecurity along the severity continuum rather than as a dichotomous state, as previously done in existing literature. Addressing household food insecurity in childhood and adolescence may be a key factor to improve children's educational outcomes.

Ensuring Doctor of Pharmacy Graduates Have the Essential Competencies for Innovative Practice

As the pharmacy profession continues to evolve from product oriented to patient centered, pharmacy programs have been transitioning from a traditional pharmacy curriculum to a competency-based education pedagogy. Competency-based education has been developed to instill the required clinical competencies in graduates to better meet the contemporary role of pharmacists in accordance with the latest scientific knowledge and evidence-based practices in an ever-evolving health care landscape. While these ideas have helped shape the new Accreditation Council for Pharmacy Education (ACPE) Standards and Center for the Advancement of Pharmacy Education (CAPE) Educational Outcome domains, recent publications have indicated that it is integral for these Standards to include public health emergency preparedness and response. Updated Standards and Educational Outcomes must be integrated longitudinally in pharmacy curricula to ensure that graduates will be practice-ready health care professionals. This commentary highlights the strategic use of workforce development of population health based on two perspectives: emergency preparedness and response and digital health.

Learning outcomes measured in zoo and aquarium conservation education

Communicating the topic of conservation to the public and encouraging proenvironmental behaviors can mitigate loss of biodiversity. Thus, the evaluation of educational efforts is important to ascertain the educational effects and provide high-quality conservation education. The learning outcomes of conservation education are diverse (e.g., attitudes, knowledge, and behavior). Considering the specific characteristics of these different outcomes and the factors that influence them is crucial to delivering successful conservation education. We reviewed 29 peer-reviewed articles published in English from January 2011 to April 2020 on empirical studies of learning outcomes of on-site conservation education in zoos and aquaria, institutions that seek to educate the public about conservation. We examined the range of learning outcomes, their definitions, and factors that influenced them. Cognitive outcomes were most frequently investigated (37%) in comparison with other outcomes (e.g., affective outcomes, 31%). The articles did not use explicit definitions for learning outcomes, and implicit or explorative definitions provided were inconsistent. Outcomes were influenced by various factors (e.g., prior experiences, staff interaction, animal behavior). Our results suggest the agenda of conservation education research should be broadened by examining all learning outcomes relevant to behavior change. Educational and behavior change theories should be used as a background for conservation education research to ensure clear and consistent definitions, derive appropriate instruments to measure learning outcomes, and relate learning outcomes to influencing factors. We recommend conservation education researchers and practitioners to treat conservation education holistically and acknowledge its learning outcomes' full complexity.

Bibliometric analyses of social media for educational purposes over four decades

The unexpected outbreak of COVID-19 pandemic has led students to frequently use social media to receive education, which brought about both positive and negative learning outcomes (Oliveira et al., 2022). To address the issue of integrating social media into education, this study conducted both quantitative and qualitative studies using VOSviewer and CitNetExplorer. The qualitative study through CitNetExplorer, involving 1780 publications, concluded that while social media might have gained popularity in education based on the classic theoretical framework of the zone of proximal development, there might be many challenges such as teacher resistance, data privacy, costs, and ethical and social issues. Besides, this study conducted bibliometric analyses using VOSviewer (N = 1841) to identify the top cited authors, organizations, documents, references, sources, countries, and keywords with high occurrences based on the citation networks. In the future, researchers could enhance the studies on how to guide students and teachers to properly integrate social media into education.

School age educational outcomes of infants born with congenital diaphragmatic hernia

BACKGROUND

To compare academic proficiency among children with congenital diaphragmatic hernia (CDH) versus controls and identify predictors of academic performance among children with CDH.

METHODS

Infants born with CDH in Arkansas, 2000-2005, were identified from the Arkansas Reproductive Health Monitoring System. For each case, two controls were selected from birth certificate data and matched for hospital and month of birth, sex, and race/ethnicity. Data on re-hospitalization within the first 5 years and payer data were collected from the Arkansas Hospital Inpatient Discharge database. Surviving cases and controls were linked to the Arkansas Department of Education database. Primary outcomes were odds of proficiency on fourth grade literacy and mathematics achievement tests. Multivariable logistic regression models evaluated the association between study characteristics and academic proficiency.

RESULTS

The final study cohort included 25 surviving CDH cases and 31 controls who were linked to their education data. After adjusting for differences in characteristics (5-min Apgar score and associated congenital anomalies) between cases and controls, there were no statistically significant differences in literacy (72% vs. 84%, p = .93) or mathematics (64% vs. 81%, p = .98) test proficiency between the two groups. In multivariable analyses, among CDH cases, oxygen at discharge and Medicaid payer/longer hospital stay were associated with worse fourth grade literacy and mathematics proficiency, respectively.

CONCLUSIONS

Oxygen at discharge, Medicaid payer, and longer hospital stay were associated with lower academic performance among CDH cases.

Combined interprofessional education and system intervention to improve screening older adults for dementia and falls

The objective of this study was to increase screening for falls and dementia by improving interprofessional (IP) providers' and staffs' knowledge and attitudes toward the care of older patients and team-based care. An intervention, including education about screening and an electronic health record (EHR) flowsheet, was rolled-out across eight Federally Qualified Health Centers (FQHC). Participants were 262 IP health providers who served 6670 patients ≥ age 65 > age 65 . An EHR flowsheet with two-item screeners for falls and dementia triggered automatically for patients ≥ age 65. Documentation of screening for falls and dementia was abstracted from the EHR for the year prior to and the year after the interventions began. Baseline screening rates for falls and dementia were flat; from the start of education intervention until EHR live date, screening rates increased significantly; after EHR live date, the screening rates continued increasing significantly. A combined education-system intervention can improve screening for falls and dementia in FQHC.

An integrative review of the potential of wireless assistive technologies and internet of things (IoT) to improve accessibility to education for students with disabilities

This research paper seeks to examine the challenges and opportunities for wireless technologies and the Internet of Things (IoT) to improve access to education for students with disabilities (SwDs). As technology integration into educational content and learning environments occurs, it becomes paramount for scholars to consider how the needs of students with disabilities are incorporated into these learning spaces. This paper synthesizes existing literature via an integrative review that explores barriers to accessing technology-mediated learning and the classroom. It also assesses the potential for technology-mediated learning to progress forward over the last five years. Finally, this article provides targeted recommendations for actualizing wireless technologies' potential on improving students with disabilities' educational outcomes.

Consistency between Household and County Measures of Onsite Schooling during the COVID-19 Pandemic

The academic, socioemotional, and health impacts of school policies throughout the COVID-19 pandemic have been a source of many questions that require accurate information about the extent of onsite schooling occurring. This article investigates school operational status datasets during the pandemic, comparing (1) self-report data collected nationally on the household level through a Facebook-based survey, (2) county-level school policy data, and (3) a school-level closure status dataset based on phone GPS tracking. The percentage of any onsite instruction within states and counties are compared across datasets from December 2020 to May 2021. Sources were relatively consistent at the state level and for large counties, but key differences were revealed between units of measurement, showing differences between policy and household decisions surrounding children's schooling experiences. The consistency levels across sources support the usage of each of the school policy sources to answer questions about the educational experiences, factors, and impacts related to K-12 education across the nation during the pandemic, but it remains vital to think critically as to which unit of measurement is most relevant to targeted research questions.

Early childhood educational outcomes of children associated with vaginal birth after cesarean delivery

BACKGROUND

Rates of vaginal birth after cesarean delivery have decreased and cesarean delivery rates have increased in the last 2 decades. Evidence on short-term neonatal outcomes is available, but data on long-term childhood outcomes following vaginal birth after cesarean delivery are insufficient. Long-term childhood outcome data are essential in decision-making regarding mode of delivery.

OBJECTIVE

This study aimed to evaluate the association between delivery mode and long-term educational outcomes of the children of pregnant individuals with a previous cesarean delivery.

STUDY DESIGN

This was a retrospective cohort study linking Rhode Island third-grade education data from 2014 to 2017 to birth certificate data. Data were obtained from a statewide database using Department of Education data, and were linked to Department of Health birth certificate data. Participants were children of multiparous women who were term, singleton births without congenital anomalies. Children delivered by primary cesarean delivery were excluded. The exposure was mode of delivery classified as vaginal birth after cesarean delivery, repeated cesarean delivery, or repeated vaginal birth. The primary outcome was children's third-grade reading and math proficiency. Bivariate analyses were conducted to assess differences in demographic variables. Bivariable and multivariable log-binomial regression was used to examine the association between subject proficiency and predictors including mode of delivery, maternal education, sex, child race or ethnicity, and lunch subsidy.

RESULTS

Of the 10,923 children who met the inclusion criteria, 2.0% were delivered by vaginal birth after cesarean delivery, 22.0% by repeated cesarean delivery, and 76.0% by repeated vaginal delivery. After adjustment for confounders, there was no difference in reading proficiency (adjusted risk ratio, 0.98; 95% confidence interval, 0.84-1.15) or math proficiency (adjusted risk ratio, 0.99; 95% confidence interval, 0.84-1.15) between those born by vaginal birth after cesarean delivery and those born by repeated cesarean delivery. There was no difference found in either proficiency between children born by repeated vaginal birth and those born by repeated cesarean delivery (reading: adjusted risk ratio, 0.97; 95% confidence interval, 0.93-1.01; math: adjusted risk ratio, 0.97; 95% confidence interval, 0.92-1.02).

CONCLUSION

In comparison with repeated cesarean delivery, both vaginal birth after cesarean delivery and repeated vaginal birth were not associated with differences in educational outcomes. This may aid in counseling about long-term safety outcomes regarding vaginal birth after cesarean delivery and may assist in shared decision-making when selecting between trial of labor after cesarean delivery and repeated cesarean delivery.

Best Practices of the World Health Organization Collaborating Centres (WHOCCs) in the Eastern Mediterranean Region

BACKGROUND

World Health Organization Collaborating Centres (WHOCCs) cooperate with the WHO on a range of strategic areas such as nursing, nutrition, mental health, chronic diseases, education, and health technologies, depending on their speciality areas. As of 2021, WHO has 47 CCs in the Eastern Mediterranean Region (EMR) collaborating on diverse areas. Four CCs in the EMR located in Egypt, Kingdom of Bahrain, Sudan, and Pakistan focus primarily on medical education (ME).

OBJECTIVE

The objective of this review of the literature is to describe the best practices in ME based on published research from the four WHOCCs in EMR. The secondary objective is to classify them based on the level of Kirkpatrick's model (KM) of educational outcomes.

METHODS

The contributions of WHOCCs are categorised in to five domains namely "Curriculum Development and Course Design", "Student Assessment", "Quality, Accreditation, and Program Evaluation", "Teaching and Learning" and "Innovation in Medical Education". Initial extraction yielded 96 articles for review, while the second level of analysis reduced the number of publications to 37 based on the date of publication within the last 5 years. Numerous best practices in ME emerged from the recently published works of these WHOCCs in the areas of learning and teaching, curriculum development, innovations in medical education, quality, and assessments in medical education. Literature from the WHOCCs on assessment and curriculum design are limited, possibly indicating opportunities for additional research.

CONCLUSION

The researchers conclude that the WHOCCs in the EMR show transformational impact on all principal areas of research and at multiple levels.

Celebrating Diverse Voices in Neuroscience: Introducing Project DiViNe

Institutions of higher education are meant to provide opportunities for the growth and development of their students. As student bodies have become more diverse it would seem to follow that institutional efforts to satisfy this obligation would likewise need to change. Despite increases in the numbers of historically underrepresented students entering higher education, the proportion of these students who graduate continues to lag behind that of students who are not historically underrepresented. As others have suggested, we believe the disparity between rates of matriculation and graduation parallels a disconnect between diversity and inclusion. Whereas the former is a relatively simple matter of access and demographic accounting, the latter concerns the lived experiences of students within our programs. Evidence suggests that the degree to which students feel valued within their programs can predict students' success, persistence, and graduation from these programs. Here, in an effort to promote greater inclusion, we propose a new pedagogical resource designed to share the personal stories and scientific contributions of neuroscientists from historically underrepresented or marginalized groups. After providing some context for why these interventions are so important, we describe the general expectations of these profiles and, in an accompanying article in this same issue, provide a number of examples. By incorporating these stories into our curricula we would hope to increase the sense of belonging of historically underrepresented or marginalized students and to increase awareness of disciplinary diversity among their peers. Ultimately, by challenging a colorblind approach to science in general and to neuroscience in particular, we hope to change our collective assumptions about who neuroscientists are and can be.

An Online, Modular Curriculum Enhances Surgical Education and Improves Learning Outcomes in East, Central, and Southern Africa: A Mixed-Methods Study

Objective

We aimed to determine the impact of a standardized curriculum on learning outcomes for surgical trainees in East, Central, and Southern Africa (ECSA).

Background

As surgical education expands throughout ECSA, there is a recognized need for a standardized curriculum. We previously described the design of a novel, large-scale, flipped-classroom, surgical curriculum for trainees in ECSA.

Methods

In January 2020, the first year of curricular content for trainees of the College of Surgeons of ECSA was released, containing 11 monthly thematic topics, each with 2 to 5 weekly modular subtopics. We aimed to evaluate 3 outcomes utilizing data sources incorporated into the curriculum structure. Learner engagement was assessed by the number of trainees completing curriculum topics. User experience was evaluated using quantitative and qualitative feedback responses to embedded surveys for each content week. Curriculum impact on trainee examination performance was assessed by comparing certification examination scores stratified by the number of curricular topics each trainee completed.

Results

Two hundred seventy-one trainees (96%) in 17 countries accessed at least 1 weekly module. Trainees completed a median of 9 topics (interquartile range: 6-10). The feedback survey response rate was 92% (5742/6233). Quantitative and qualitative responses were positive in overall module value (93.7% + 2.6%), amount of learning experienced (97.9% + 1.4%), confidence in achieving learning objectives (97.1% + 2.4%), and ease of use of the module (77.6% + 5.98%). Topic-related certification examination performance improved significantly with increased completion of thematic topics.

Conclusions

A standardized surgical curriculum in ECSA demonstrated excellent trainee usage, positive feedback, and improved examination scores.

Special health care needs during childhood and academic achievement in secondary school

BACKGROUND

Secondary education has lifelong implications for wellbeing. We evaluated associations between the duration and timing of special health care needs (SHCN) across childhood and academic achievement in secondary school.

METHODS

Cohort design. The structured modelling approach was used to evaluate life-course models for associations between the duration and timing of SHCN (measured using a two-item SHCN screener across ages 4-5, 6-7, 8-9 and 10-11 years) and Grade 7 (median age 12.5 years) reading and numeracy achievement. Linear regressions were fitted for each life-course model: four critical period models (each including SHCN exposure in one period), one sensitive period model (including SHCN exposure in all periods) and two strict accumulation models (including the duration of SHCN exposure in linear form then categorical form). Interactions of SHCN with child sex and family socio-economic status (SES) were examined.

RESULTS

Of 3734 children, 1845 were female. The number of children with SHCN was 434 (11.7%), 458 (12.9%), 534 (14.7%), 551 (15.4%) at 4-5, 6-7, 8-9 and 10-11 years respectively. For both outcomes, the linear strict accumulation model fitted best, and interactions of SHCN with sex and SES were non-significant. The average decrease in school achievement z score (95% confidence interval) per period of having SHCN was 0.04 (-0.07 to -0.02) for reading and 0.08 (-0.11 to -0.05) for numeracy.

CONCLUSIONS

A longer duration of SHCN from age 4-11 years has small-sized cumulative associations with poorer Grade 7 reading and numeracy achievement. Each period of SHCN between 4 and 5 and 10-11 years was associated with nearly 0.05 and 0.1 of a standard deviation reduction in Grade 7 reading and numeracy scores respectively, and these associations did not appear to differ across sex or SES. These findings suggest that children with persistent SHCN are at risk of academic deficits and should receive focused interventions.

Developing the "Upstreamist" through Antiracism Teaching in Pharmacy Education

Objective. To present antiracism teaching as a key modality and an upstream approach to addressing health disparities in pharmacy education. Relevant theoretical frameworks and pedagogical strategies used in other health disciplines will be reviewed to present how antiracism curricula can be integrated into pharmacy educational outcomes.Findings. Various disciplines have incorporated antiracism pedagogy in their respective programs and accreditation standards. While challenges to implementation are acknowledged, structural racism continues to compromise health outcomes and should be centralized when addressing health disparities.Summary. Pharmacy curricula has explored and implemented cultural competency as a means to address the social determinants of health. By intentionally addressing racism in the context of health disparities, student pharmacists will further acknowledge racism as a public health issue and a systemic barrier to patient-centered care.

Bayesian variable selection for understanding mixtures in environmental exposures

Social and environmental stressors are crucial factors in child development. However, there exists a multitude of measurable social and environmental factors-the effects of which may be cumulative, interactive, or null. Using a comprehensive cohort of children in North Carolina, we study the impact of social and environmental variables on 4th end-of-grade exam scores in reading and mathematics. To identify the essential factors that predict these educational outcomes, we design new tools for Bayesian linear variable selection using decision analysis. We extract a predictive optimal subset of explanatory variables by coupling a loss function with a novel model-based penalization scheme, which leads to coherent Bayesian decision analysis and empirically improves variable selection, estimation, and prediction on simulated data. The Bayesian linear model propagates uncertainty quantification to all predictive evaluations, which is important for interpretable and robust model comparisons. These predictive comparisons are conducted out-of-sample with a customized approximation algorithm that avoids computationally intensive model refitting. We apply our variable selection techniques to identify the joint collection of social and environmental stressors-and their interactions-that offer clear and quantifiable improvements in prediction of reading and mathematics exam scores.

Socioeconomic Status During Childhood and Academic Achievement in Secondary School

OBJECTIVE

Secondary education has lifelong implications for well-being. We evaluated associations between the timing and duration of low socioeconomic status (SES) during childhood and academic achievement in secondary school.

METHODS

Cohort design. The structured modeling approach was used to evaluate life-course models for associations between the duration and timing of low SES (across ages 4-5, 6-7, 8-9, 10-11 years) and Grade 7 (median age 12.5 years) reading and numeracy achievement. Linear regressions were fitted for 4 critical period models (each including low SES at 1 age), 1 sensitive period model (including low SES at all ages), and 2 strict accumulation models (including low SES duration in linear/categorical form).

RESULTS

Of 3734 children, 1718 (46.1%), 1749 (48.6%), 1797 (49.3%), and 1779 (49.8%) experienced low SES at 4 to 5, 6 to 7, 8 to 9, and 10 to 11 years, respectively. For reading, the sensitive period model fitted best. Reading z-score coefficients for low SES (reference: high SES) at 4 to 5, 6 to 7, 8 to 9, and 10 to 11 years were: -0.20, -0.18, -0.02, and -0.22. For numeracy, the categorical strict accumulation model, with SES-by-sex interaction, fitted best. Numeracy z-score coefficients for 1, 2, 3, and 4 periods of low SES (reference: 0 periods) were: -0.38, -0.42, -0.54, and -0.77 for boys, and -0.23, -0.34, -0.42, and -0.54 for girls.

CONCLUSIONS

Low SES at all ages studied except 8 to 9 years has cumulative associations with poorer Grade 7 reading. Longer duration of low SES from 4 to 11 years is associated with poorer Grade 7 numeracy, with stronger associations for boys than girls. Academic interventions should be targeted toward children with persistently low SES.

School Mental Health Providers’ Perspectives on the Impact of COVID-19 on Racial Inequities and School Disengagement

School disengagement is a critical factor that will likely exacerbate long-standing racial inequities in educational outcomes during the aftermath of the coronavirus disease (COVID-19) pandemic. Due to their training and contact with at-risk students, school social workers and other school-based mental health professionals (SMHP) are in an ideal position to understand the impact of COVID-19 and virtual learning on K–12 students. To that end, this study reports on findings from a survey of SMHP about the differential impact that the COVID-19 outbreak is having on students and their families. The findings suggest that COVID-19 has had a tremendous impact on families overall, especially among populations who were experiencing hardships before the current outbreak. In addition, several barriers were noted for student learning, with many students—particularly students of color—completely disengaging from school during spring 2020. However, SMHP reported several important insights on how to support students and their families—some requiring immediate action on the part of school districts and others requiring greater community-level investment into the economic, social, emotional, and overall health of families. Findings are discussed in light of addressing disengagement and educational inequities for students of color.

Educational and health outcomes of children and adolescents receiving antidepressant medication: Scotland-wide retrospective record linkage cohort study of 766 237 schoolchildren

Background

Childhood depression is relatively common, under-researched and can impact social and cognitive function and self-esteem.

Methods

Record linkage of routinely collected Scotland-wide administrative databases covering prescriptions [prescribing information system (PIS)], hospitalizations (Scottish Morbidity Records 01 and 04), maternity records (Scottish Morbidity Records 02), deaths (National Records of Scotland), annual pupil census, school absences/exclusions, special educational needs (Scottish Exchange of Educational Data; ScotXed), examinations (Scottish Qualifications Authority) and (un)employment (ScotXed) provided data on 766 237 children attending Scottish schools between 2009 and 2013 inclusively. We compared educational and health outcomes of children receiving antidepressant medication with their peers, adjusting for confounders (socio-demographic, maternity and comorbidity) and explored effect modifiers and mediators.

Results

Compared with peers, children receiving antidepressants were more likely to be absent [adjusted incidence rate ratio (IRR) 1.90, 95% confidence interval (CI) 1.85–1.95] or excluded (adjusted IRR 1.48, 95% CI 1.29–1.69) from school, have special educational needs [adjusted odds ratio (OR) 1.77, 95% CI 1.65–1.90], have the lowest level of academic attainment (adjusted OR 3.00, 95% CI 2.51–3.58) and be unemployed after leaving school (adjusted OR 1.88, 95% CI 1.71–2.08). They had increased hospitalization [adjusted hazard ratio (HR) 2.07, 95% CI 1.98–2.18] and mortality (adjusted HR 2.73, 95% CI 1.73–4.29) over 5 years’ follow-up. Higher absenteeism partially explained poorer attainment and unemployment. Treatment with antidepressants was less common among boys than girls (0.5% vs 1.0%) but the associations with special educational need and unemployment were stronger in boys.

Conclusions

Children receiving antidepressants fare worse than their peers across a wide range of education and health outcomes. Interventions to reduce absenteeism or mitigate its effects should be investigated.

Educational outcomes among children with type 1 diabetes: Whole-of-population linked-data study

BACKGROUND

Challenges with type 1 diabetes (T1D) blood glucose management and illness-related school absences potentially influence children's educational outcomes. However, evidence about the impact of T1D on children's education is mixed. The objectives were to estimate the effects of T1D on children's educational outcomes, and compare time since T1D diagnosis (recent diagnosis [≤2 years] and 3 to 10 years long exposure) on educational outcomes.

METHODS

This whole-of-population study used de-identified, administrative linked-data from the South Australian Early Childhood Data Project. T1D was identified from hospital ICD-10-AM diagnosis codes (E10, ranging E101 to E109), from 2001 to 2014. Educational outcomes were measured in grade 5 by the National Assessment Program-Literacy and Numeracy (NAPLAN, 2008-2015) for children born from 1999 to 2005. Analyses were conducted using augmented inverse probability of treatment weighting. Multiple imputations was used to impute missing data.

RESULTS

Among 61 445 children born in South Australia who had undertaken NAPLAN assessments, 162 had T1D. There were negligible differences in the educational outcomes of children with and without T1D, and between recently diagnosed and those with longer exposure. For example, the mean reading score was 482.8 ± 78.9 for children with T1D and 475.5 ± 74.3 for other children. The average treatment effect of 6.8 (95% CI - 6.3-19.9) reflected one-tenth of a SD difference in the mean reading score of children with and without T1D.

CONCLUSION

Children with T1D performed similarly on literacy and numeracy in grade 5 (age ~ 10-years) compared to children without T1D. This could be due to effective T1D management.

A BEME realist synthesis review of the effectiveness of teaching strategies used in the clinical setting on the development of clinical skills among health professionals: BEME Guide No. 61

Background: Literature describing the effectiveness of teaching strategies in the clinical setting is limited. This realist synthesis review focuses on understanding the effectiveness of teaching strategies used in the clinical setting.Methods: We searched ten databases for English language publications between 1 January 1970 and 31 May 2017 reporting effective teaching strategies, used in a clinical setting, of non-procedural skills. After screening, we used consensus to determine inclusion and employed a standardised instrument to capture study populations, methodology, and outcomes. We summarised what strategies worked, for whom, and in what settings.Results: The initial search netted 53,642 references after de-duplication; 2037 were retained after title and abstract review. Full text review was done on 82 references, with ultimate inclusion of 25 publications. Three specific teaching strategies demonstrated impact on educational outcomes: the One Minute Preceptor (OMP), SNAPPS, and concept mapping. Most of the literature involves physician trainees in an ambulatory environment. All three have been shown to improve skills in the domains of medical knowledge and clinical reasoning.Discussion/conclusions: Apart from the OMP, SNAPPS, and concept mapping, which target the formation of clinical knowledge and reasoning skills, the literature establishing effective teaching strategies in the clinical setting is sparse.

Educational attainment in childhood cancer survivors: a meta-analysis

OBJECTIVE

To assess differences across educational outcomes in survivors of childhood cancer (CCS) compared with peers.

DESIGN

Systematic review and meta-analysis of observational studies.

DATA SOURCES AND STUDY SELECTION

Medline, EMBASE, ERIC, CINAHL and PsycInfo from inception to 1st August 2018. Any peer reviewed, comparative study with a population of any survivor of childhood cancer, from high-economy countries, reporting outcomes on educational attainment, were selected.

RESULTS

26 studies representing 28 434 CCS, 17 814 matched controls, 6582 siblings and six population studies from 11 high-income countries, which have similar access to education and years of mandatory schooling as reported by the Organisation for Economic Cooperation and Development, were included. CCS were more likely to remain at compulsory level (OR 1.36, 95% CI 1.26 to 1.43) and less likely to complete secondary (OR 0.93, 95% CI 0.87 to 1.0) and tertiary level education (OR 0.87, 95% CI 0.78 to 0.98). They were more likely to require special educational needs (OR 2.47, 95% CI 1.91 to 3.20). Subgroup analyses revealed that survivors, irrespective of central nervous system (CNS) involvement, were less likely to progress onto secondary level compared with cancer-free peers (OR 1.77. 95% CI 1.46 to 2.15; OR 1.19, 95% CI 1.00 to 1.42, respectively). This, however, changed at tertiary level where those with CNS involvement continued to perform worse (OR 0.61, 95% CI 0.55 to 0.68) but those without appeared to perform similarly to their peers (OR 1.12, 95% CI 1.0 to 1.25).

CONCLUSIONS

Compared with controls, we have elucidated significant differences in educational attainment in survivors. This is sustained across different countries, making it an international issue. CNS involvement plays a key role in educational achievement. Clinicians, teachers and policymakers should be made aware of differences and consider advocating for early educational support for survivors.

Beyond the Classroom: The Intergenerational Effect of Incarceration on Children's Academic and Nonacademic School-Related Outcomes in High School

The author uses strategic comparison regression and the Longitudinal Study of Adolescent to Adult Health (n = 11,767) to explore the effect of parental incarceration on academic and nonacademic outcomes in high school. This method compares youth whose parents were incarcerated before the outcomes are measured with those whose parents will be incarcerated after. The author examines most recent grades and a range of nonacademic outcomes, such as truancy, involvement in school activities, and suspension. Results indicate that the associations between parental incarceration and grades are largely accounted for by selection, but associations between parental incarceration and nonacademic processes persist. Maternal incarceration holds particular importance for behavioral outcomes (fighting and truancy), and paternal incarceration holds particular importance for behavioral, connectedness, and disciplinary outcomes. Researchers examining the intergenerational consequences of incarceration should examine school contexts beyond the classroom and explore the pathways through which this disadvantage occurs.

Educational and Career Development Outcomes Among Undergraduate Summer Research Interns: A Pipeline for Pathology, Laboratory Medicine, and Biomedical Science

Nurturing undergraduate students’ interest in careers in science, technology, engineering, and medicine is important to developing the future health-care workforce. Summer research internships provide experiential learning that is important to sustaining students’ interest in science, technology, engineering, and medicine careers and inspiring higher educational goals. The Edmondson Summer Research Internship is a mentored program for undergraduate students in University of California Davis Health’s Department of Pathology and Laboratory Medicine. To evaluate intern satisfaction, perceptions on the program’s influence on their career development, and higher educational outcomes, 102 former interns from a 15-year period were invited to participate in an online survey. Responses were received by 58 (57%) of 102 respondents. Not all respondents answered every question. Overall satisfaction was very high/high in 55 (95%) of 58. Ninety-three percent (54/58) strongly agreed/agreed that the internship was an important part of their career development. Almost all who applied to career/professional opportunities strongly agree/agreed that they perceived the internship to be advantageous (96%, 46/48). Forty-four percent (25/57) received additional education after completing their undergraduate degree, with 25% (14/57) receiving a doctoral degree. Few reported prior experience with a clinical laboratory (8/48, 17%), pathologist (10/48, 21%), or clinical laboratory scientist (12/48, 25%). Based on their internship experience, 55% (32/58) strongly agree/agreed that they positively considered pathology or laboratory medicine as a career choice. The Edmondson Summer Research Internship is seen as important to higher educational goals and career development, increases exposure to pathology and laboratory medicine, and demonstrates the value of hosting a mentored research program for undergraduates.

University students with attention deficit hyperactivity disorder (ADHD): a literature review

OBJECTIVES

To review existing literature about university students with Attention Deficit Hyperactivity Disorder (ADHD).

METHODS

A framework for scoping studies and content analysis were used to source and review selected publications from PubMed, ScienceDirect, Google Scholar and relevant bibliographies.

RESULTS

Seventy-four publications were reviewed and key findings were categorised under six core themes that represent the issues germane to university students with ADHD. These themes are: academic, social and psychological functioning, giftedness, new media technologies, treatment, substance misuse and the non-medical use of prescription stimulants, and malingering.

CONCLUSION

In Ireland and the United Kingdom (UK) young people with ADHD are unlikely to enrol into further education, and of those who do go to university, few will graduate at the same time as their non-ADHD peers. ADHD is associated with poor educational outcomes and it may be a hidden disability within institutions of higher education (e.g. universities). Surprisingly, in this topic area, there is a paucity of research in Ireland and the UK. Most studies originate from North America were research activity in the field has been ongoing since the 1990s. These studies however, tend to use relatively small samples of college (university) students recruited at a single institution. It is difficult to generalise the findings of these studies to student populations in North America, let alone in Ireland and the UK. At the very least, these North American studies provide insights into key areas of concern. This topic area straddles education and psychiatry. This means an inter-disciplinary approach is required to examine, better understand and address the impact of ADHD on the educational outcomes of university students. The philosophies of difference, equity and self-realisation can offer a conceptual framework for conducting further research and/or developing services to deliver more personalised learning support for university students with ADHD.

Mentoring, Bullying, and Educational Outcomes Among US School-Aged Children 6-17 Years

BACKGROUND

Ensuring the optimum development of all children and their attainment of age-appropriate educational outcomes is of great interest to public health researchers and professionals. Bullying and mentoring have opposite effects on child development and educational attainment. Mentoring exerts protective effects on youths against risky behaviors; however, the protective effects of community-oriented natural or informal mentoring on educational outcomes and bullying are largely underexplored. We examine associations between mentoring, bullying, and educational outcomes among US school-aged children 6-17 years.

METHODS

We analyzed the 2011-2012 National Survey of Children's Health (N = 65,593) to estimate prevalence and odds of repeating a grade in school, lower school engagement, and bullying perpetration according to mentoring receipt and sociodemographic characteristics.

RESULTS

Overall, 5.4% of US school-aged children without a mentor perpetrated bullying against other children; 11.4% repeated more than one grade in school; and 23.0% had low school engagement. Children without mentors had 2.1 and 1.3 times higher adjusted odds, respectively, of bullying other children and low school engagement than those with mentors. Proportion of children who bullied others or repeated grades was higher among minority children.

CONCLUSIONS

Findings indicate that mentoring may be a pathway for providing programs that prevent bullying and improve educational outcomes among school-aged children.

School Nurses and Student Academic Outcomes: An Integrative Review

The empirical evidence from previous studies has demonstrated that school nurses are effective in assisting children and families to address health concerns, reduce absenteeism, and provide children with the opportunity to reach their potential academically. Impoverished children and those with disabilities and chronic illness are at risk of school failure. An integrative review was undertaken to critique the research between 2002 and 2018 that addressed the influence of school nurses on academic outcomes such as absenteeism, missed class time, grades, and test scores. The findings of the review suggest that the presence of a school nurse is associated with reduced absenteeism and missed class time but not with academic achievement. Overall, the research in this area is weak and future research using more rigorous study designs, examining broader school nurse roles, and long-term academic outcomes is indicated to evaluate the impact of school nurses on educational outcomes.

Long-term psychological and educational outcomes for survivors of neuroblastoma: A report from the Childhood Cancer Survivor Study

BACKGROUND

Neuroblastoma survivors may be at elevated risk for psychological impairments because of their young age at diagnosis and neurotoxic treatment, but this is not well described.

METHODS

A total of 859 ≥5-year survivors of neuroblastoma younger than 18 years (diagnosed in 1970-1999), who had a median age at diagnosis of 0.8 years (range: 0.0-7.3 years) and a median follow-up of 13.3 years (range: 8.0-17.9 years), were compared with 872 siblings of childhood cancer survivors who were younger than 18 years with the parent-reported Behavior Problem Index (BPI) for psychological functioning. Age- and sex-adjusted multivariate log-binomial models were used to identify factors associated with impairment in BPI domains (scores worse than the sibling 10th percentile). The impact of psychological impairment on educational outcomes was examined among survivors.

RESULTS

Compared with siblings, neuroblastoma survivors had an increased prevalence of impairment in the domains of anxiety/depression (19% vs 14%; P = .003), headstrong behavior (19% vs 13%; P < .001), attention deficits (21% vs 13%; P < .001), peer conflict/social withdrawal (26% vs 17%; P < .001), and antisocial behavior (16% vs 12%; P = .01). Common treatment exposures (vincristine, cisplatin, and retinoic acid) were not associated with impairment. Having 2 or more chronic health conditions predicted impairment in 4 domains (P < .001). Specifically, pulmonary disease predicted impairment in all 5 domains (P ≤ .004). Endocrine disease (P ≤ .004) and peripheral neuropathy (P ≤ .02) each predicted impairment in 3 domains. Psychological impairment was associated with special education service usage and educational attainment less than college.

CONCLUSIONS

Neuroblastoma survivors are at elevated risk for psychological impairment, which is associated with special education service usage and lower adult educational attainment. Those with chronic health conditions may represent a high-risk group for targeted screening and intervention. Cancer 2018. © 2018 American Cancer Society.

Clinically Prepared Veterinary Students: Enhancing Veterinary Student Hands-on Experiences and Supporting Hospital Caseload Using Shelter Medicine Program

Referral-level medicine is important in the veterinary curriculum, however veterinary students also need a solid base knowledge of clinically relevant, routine surgical and diagnostic skills to be clinically prepared after graduation. Exposure to a referral-only, or primarily referral caseload, does not always provide veterinary students with the routine hands-on experiences and competencies expected by the American Veterinary Medical Association Council on Education, the Royal College of Veterinary Surgeons, the Australian Veterinary Boards Council, or prospective employers. The aim of this descriptive study was to assess how a shelter medicine program can fill the companion animal caseload gap and create the necessary hands-on experiences considered essential in the veterinary curriculum. Pedagogical frameworks, course curriculum and design, student experiences, and student assessments were described for three core curricular areas (surgery, medical days, population medicine) of the Shelter Medicine Program at Mississippi State University. The shelter surgery experience provided a high-quality, high-volume spay/neuter environment where fourth-year students averaged 65 sterilization surgeries in two weeks and demonstrated a quantifiable decrease in surgical time. The shelter surgery experience added on average 9,000 small animal cases per year to the overall hospital caseload. Shelter medical days, where students provide veterinary care during on-site shelter visits, created opportunities for third-year students to directly interact with shelter animals by performing physical examinations and diagnostic testing, and to gain experience in developing treatment protocols and recommendations for commonly encountered problems. The shelter medical days experience averaged over 700 small animal cases per year and over 1,500 diagnostic procedures. Finally, students participated in 15 onsite shelter consultations where they obtained a working knowledge of biosecurity at a population level, including how to minimize the risk of infectious diseases spreading to healthy populations. Despite several challenges, results from this curricular program assessment support the aim that animal shelters and humane organizations offer opportunities that can be mutually beneficial for both animal organizations and veterinary students. The primary care caseload for the teaching institution was positively impacted, and students were better prepared to meet potential employers’ expectations and fulfill required core competencies in veterinary medical education.

Early academic achievement in children with isolated clefts: a population-based study in England

OBJECTIVES

We used national data to study differences in academic achievement between 5-year-old children with an isolated oral cleft and the general population. We also assessed differences by cleft type.

METHODS

Children born in England with an oral cleft were identified in a national cleft registry. Their records were linked to databases of hospital admissions (to identify additional anomalies) and educational outcomes. Z-scores (signed number of SD actual score is above national average) were calculated to make outcome scores comparable across school years and across six assessed areas (personal development, communication and language, maths, knowledge of world, physical development andcreative development).

RESULTS

2802 children without additional anomalies, 5 years old between 2006 and 2012, were included. Academic achievement was significantly below national average for all six assessed areas with z-scores ranging from -0.24 (95% CI -0.32 to -0.16) for knowledge of world to -0.31 (-0.38 to -0.23) for personal development. Differences were small with only a cleft lip but considerably larger with clefts involving the palate. 29.4% of children were documented as having special education needs (national rate 9.7%), which varied according to cleft type from 13.2% with cleft lip to 47.6% with bilateral cleft lip and palate.

CONCLUSIONS

Compared with national average, 5-year-old children with an isolated oral cleft, especially those involving the palate, have significantly poorer academic achievement across all areas of learning. These outcomes reflect results of modern surgical techniques and multidisciplinary approach. Children with a cleft may benefit from extra academic support when starting school.

Health Improvement and Educational Attainment in Secondary Schools: Complementary or Competing Priorities? Exploratory Analyses From the School Health Research Network in Wales

Background. Implementing health improvement is often perceived as diverting resource away from schools’ core business, reflecting an assumption of a “zero-sum game” between health and education. There is some evidence that health behaviors may affect young people’s educational outcomes. However, associations between implementation of school health improvement and educational outcomes remains underinvestigated. Methods. The study linked school-level data on free school meal (FSM) entitlement, educational outcomes, and school attendance, obtained from government websites, with data from the School Environment Questionnaire (SEQ) on health improvement activity collected in Wales (2015/2016). Spearman’s rank correlation coefficients and linear regression models tested the extent of association between health improvement activity and attendance and educational outcomes. Results. SEQ data were provided by 100/115 network schools (87%), of whom data on educational performance were obtained from 97. The percentage of pupils entitled to FSM predicted most of the between-school variance in achievement and attendance. Linear regression models demonstrated significant positive associations of all measures of health improvement activity with attainment at Key Stage (KS) 3, apart from mental health education in the curriculum and organizational commitment to health. Student and parent involvement in planning health activities were associated with improved school attendance. There were no significant associations between health improvement and KS4 attainment. Conclusion. Implementing health improvement activity does not have a detrimental effect on schools’ educational performance. There is tentative evidence of the reverse, with better educational outcomes in schools with more extensive health improvement policies and practices. Further research should investigate processes by which this occurs and variations by socioeconomic status.

Reduced Educational Outcomes Persist into Adolescence Following Mild Iodine Deficiency in Utero, Despite Adequacy in Childhood: 15-Year Follow-Up of the Gestational Iodine Cohort Investigating Auditory Processing Speed and Working Memory

There is increasing evidence that even mild gestational iodine deficiency (GID) results in adverse neurocognitive impacts on offspring. It's unclear, however, if these persist long-term and whether they can be ameliorated by iodine sufficiency in childhood. We followed a unique cohort (Gestational Iodine Cohort, n = 266) where gestation occurred during a period of mild population iodine deficiency, with children subsequently growing-up in an iodine replete environment. We investigated whether associations between mild GID and reductions in literacy outcomes, observed at age 9-years, persisted into adolescence. Comparisons were made between offspring of mothers with gestational urinary iodine concentrations (UICs) ≥ 150 μg/L and < 150 μg/L. Educational outcomes were measured using Australian National Assessment Program-Literacy and Numeracy (NAPLAN) tests. Children whose mothers had UICs < 150 μg/L exhibited persistent reductions in spelling from Year 3 (10%, -41.4 points (95% Confidence Interval -65.1 to -17.6, p = 0.001)) to Year 9 (5.6%, -31.6 (-57.0 to -6.2, p = 0.015)) compared to children whose mothers had UICs ≥ 150 μg/L. Associations remained after adjustment for biological factors, socioeconomic status and adolescent UIC. Results support the hypothesis that mild GID may impact working memory and auditory processing speed. The findings have important public health implications for management of iodine nutrition in pregnancy.

Education Outcomes of Immigrant Youth: The Role of Parental Engagement

Using the 2009-2012 waves of the High School Longitudinal Survey, this article examines the role of parental engagement on academic achievement in the United States. Specifically, we examine the influence of parental engagement while also investigating the academic trajectories of racial/ethnic and immigrant groups, controlling for other standard factors. Results suggest that the progression of students' academic performance varies substantially by race/ethnicity and by immigrant generational status. After controlling for 9th grade test scores and family and other school-level characteristics, we find that first-generation immigrant youth generally have higher 11th grade test scores and lower probability of dropping out compared to native-born students who are second or third generation. Greater levels of parental engagement predict superior test scores and lower rates of dropout for youth of various racial and immigrant generation backgrounds, even in the presence of a variety of controls.

Parenting, the other oldest profession in the world - a cross-sectional study of parenting and child outcomes in South Africa and Malawi

BACKGROUND

Parenting quality is important in child development. In the presence of HIV poverty and life stress, parenting may be challenged and child development affected.

METHODS

This study examines cross-sectional associations of situational factors such as poverty, mental health, HIV status, living with a biological parent, and stigma with good parenting and child outcomes (n=989; age=4-13 years) within the Child Community Care study (South Africa and Malawi). A parenting measure was created from 10 variables comprising 6 child and 4 parent ratings. These were highly correlated. Total parenting score was generated on a 10 point continuous scale, with a good parenting cut off then defined as >=8 out of a possible 10.

RESULTS

Five factors were associated with good parenting. Positively associated with good parenting were being the biological parent of the child, parental mental health and dwelling in households with multiple adults. Poverty and stigma were negatively associated with good parenting. Using multiple mediation analysis, a positive direct effect of good parenting was found on child self-esteem, child behaviour and educational risks with a partial mediation via child depression and trauma.

CONCLUSIONS

These data highlight possible intervention points. Influences on parenting could be seen through being the biological parent, parental mental health, poverty and stigma. In these challenging environments, health, nutrition, mental health, education, and treatment to keep parents alive are all clearly identified as potential pathways to ensure child well-being.

Evidence of Criterion Validity for One Pharmacy School's Progress Examination Program

Objective. To provide evidence that the progress examination program accurately assesses student failure to demonstrate competence. Methods. A progress examination program aligned with each grade level was locally developed and administered annually to 289 PharmD students in the spring of their first year - fourth year. Correlations and linear regressions were performed to compare the examination scores to performance on national licensing examinations and cumulative didactic grade point average (GPA). Odds ratio analysis was run to determine the ability of the passing scores of the progress examination to identify students at increased risk of failing to graduate on time, earn a GPA below 3.0, and fail the licensing examinations on their first attempt. Results. Progress examination scores were strongly correlated to GPA and national licensing examination scores and weakly correlated to jurisprudence examination scores. Regression analysis indicated a significant linear relationship between examination scores and both GPA and the licensing examinations. Students who performed poorly on the progress examinations were more likely fail the national licensing examination, more likely to fail to graduate on time, and more likely to earn a cumulative didactic GPA below 3.0. Conclusions. The second-year examination program strongly predicts students at risk for failure to graduate on time or achieve a GPA below 3.0, while all four examinations identify students at risk of failing the national licensing examination on their first attempt.

Educational Implications of Preterm Birth: A National Sample of 8- to 11-Year-Old Children Born Prematurely and Their Full-Term Peers

INTRODUCTION

Preterm birth remains a significant public health issue, with children born prematurely experiencing health and educational difficulties throughout childhood. The specific aim of this study was to evaluate the educational implications of actual or potential health risks of premature birth for children in middle childhood compared with children of the same age who were born at term.

METHODS

This descriptive study is a secondary analysis of the 2011/2012 National Survey of Children's Health, specifically an 8- to 11-year-old subset, comparing children identified as being born premature and those born at term. Educational and health outcome variables were explored.

RESULTS

Preterm birth negatively affects the educational experience of children born prematurely. Logistic modeling provides insight into predicting risk.

DISCUSSION

Collaboration between primary care providers, educators, and families is recommended to improve care coordination and address educational need of children born premature.

Mixed tenure communities as a policy instrument for educational outcomes in a deprived urban context?

This article considers mixed community strategies, enacted through planning and regeneration policies, as a policy approach to the improvement of educational outcomes in schools. Analysis is undertaken of educational outcomes across secondary schools in Glasgow. The level of owner occupation in the catchment is positively associated with both examination results at S4 and positive destinations post-school, particularly at the more deprived end of the school spectrum. The results suggest that tenure mix may be both directly and indirectly related to school performance, with neighbourhood context effects not being entirely mediated through the school context.

How Children's Educational Outcomes and Criminality Vary by Duration and Frequency of Paternal Incarceration

Existing studies of the consequences of paternal incarceration for children treat paternal incarceration as a dichotomous event (a child either experiences paternal incarceration or does not), although effects could accumulate with both the frequency and duration of paternal incarcerations. In this article I use register data on Danish children from birth cohort 1991, some of whom experienced paternal incarceration before age 15, to show how educational outcomes and criminality up to age 20 vary by frequency and total duration of paternal incarceration. The high quality of Danish register data also allows me to distinguish between paternal arrest and paternal incarceration and to show results for the total duration of paternal incarcerations conditioned on frequency of paternal incarceration. Results show that educational outcomes and criminality indeed correlate with duration and frequency of paternal incarceration, indicating that treating paternal incarceration as a dichotomous event blurs important heterogeneity in the consequences of paternal incarceration.

Reforming Preschools and Schools

Compared with their higher-income counterparts, children growing up in low-income families in the United States typically complete less schooling, report worse health, and work and earn less in adulthood. Moreover, changes in the American economy over the last 40 years have raised the level of skills and qualifications that children need to obtain a good middle-class job, as well as making it much more difficult for children from low-income families to attend schools that support their learning of these skills. We first review strategies used in the past to improve K-12 schooling-including investing more money, introducing more accountability, and putting in place new governance structures (eg, charter schools)-and show why these strategies have been relatively ineffective. Drawing on the research literature and case studies, we then describe education reform strategies for prekindergarten programs and for elementary, middle, and high schools that may help meet these challenges. All of the initiatives described in our case studies provide ample opportunities for teachers and school leaders to improve their skills through coaching and other professional development activities; incorporate sensible systems of accountability, including requiring teachers to open their classrooms to the scrutiny of colleagues and school leaders and to work with their colleagues to improve their teaching practices; and incorporate high academic standards, such as those described in the Common Core State Standards. By focusing directly on improving teaching and promoting learning, these successful initiatives have boosted the achievement of low-income children. They show that it is indeed possible to make a real difference in the life chances of low-income children.

Implementation and Use of the Pharmacy Curriculum Outcomes Assessment at US Schools of Pharmacy

OBJECTIVE

To describe how schools and colleges of pharmacy use the Pharmacy Curriculum Outcomes Assessment (PCOA) in relation to student assessment and curricular feedback.

METHODS

A survey was distributed to all programs that have implemented the PCOA. The survey was designed to assess 3 domains regarding the use of the PCOA: rationale for use, logistics of administration, and performance data review and distribution.

RESULTS

A 79% response rate (41/52) was obtained. The mix of responses was 93% current PCOA users and 7% past users. The most common reasons for PCOA use were for programmatic assessment and benchmarking. The examination was most frequently administered during the P3 year, with minimal stakes attached to performance. Significant differences in responses based on public vs private institution were seen with respect to length of accreditation of current PCOA users, messaging to students regarding performance, inclusion of results in student advising, and distribution of results to stakeholders.

CONCLUSION

Programs were using the PCOA primarily as an assessment in the P3 year for reasons related to programmatic and curricular assessment. Some differences existed between public and private institutional PCOA use and examination-related processes and results distribution.

Placing students at the center: the Whole School, Whole Community, Whole Child model

BACKGROUND

Students are the heart of the Whole School, Whole Community, Whole Child (WSCC) model. Students are the recipients of programs and services to ensure that they are healthy, safe, engaged, supported, and challenged and also serve as partners in the implementation and dissemination of the WSCC model.

METHODS

A review of the number of students nationwide enjoying the 5 Whole Child tenets reveals severe deficiencies while a review of student-centered approaches, including student engagement and student voice, appears to be one way to remedy these deficiencies.

RESULTS

Research in both education and health reveals that giving students a voice and engaging students as partners benefits them by fostering development of skills, improvement in competence, and exertion of control over their lives while simultaneously improving outcomes for their peers and the entire school/organization.

CONCLUSIONS

Creating meaningful roles for students as allies, decision makers, planners, and consumers shows a commitment to prepare them for the challenges of today and the possibilities of tomorrow.

A Methodology for Assessing Skill-Based Educational Outcomes in a Pharmacy Course

Objective. To develop a methodology for assessing skill development in a course while providing objective evidence of success and actionable data to improve instructional effectiveness. Design. Course objectives were recast as skills to be demonstrated. Confidence in these skills was surveyed before and after the course. Student skills were demonstrated using 4 work products and a multiple-choice examination. Assessment. The change from precourse survey to postcourse survey was analyzed with a paired t test. Quality of the student work product was assessed using scoring guides. All students demonstrated skill mastery by scoring 70% or above on the work product, and 87/88 demonstrated individual progress on the surveyed skills during the 15-week course. Conclusion. This assessment strategy is based on sound design principles and provides robust multi-modal evidence of student achievement in skill development, which is not currently available using traditional student course evaluation surveys.

Using curriculum mapping to engage faculty members in the analysis of a pharmacy program

OBJECTIVE

To develop a curriculum mapping process that supports continuous analysis and evidence-based decisions in a pharmacy program.

DESIGN

A curriculum map based on the national educational outcomes for pharmacy programs was created using conceptual frameworks grounded in cognitive learning and skill acquisition.

ASSESSMENT

The curriculum map was used to align the intended curriculum with the national educational outcomes and licensing examination blueprint. The leveling and sequencing of content showed longitudinal progression of student learning and performance. There was good concordance between the intended and learned curricula as validated by survey responses from employers and graduating students.

CONCLUSION

The curriculum mapping process was efficient and effective in providing an evidence-based approach to the continuous quality improvement of a pharmacy program.

Assessing achievement in nephrology training: using clinic chart audits to quantitatively screen competency

BACKGROUND

Entrustable professional activities (EPAs) are complex tasks representing vital physician functions in multiple competencies, used to demonstrate trainee development along milestones. Managing a nephrology outpatient clinic has been proposed as an EPA for nephrology fellowship training.

STUDY DESIGN

Retrospective cohort study of nephrology fellow outpatient clinic performance using a previously validated chart audit tool.

SETTING & PARTICIPANTS

Outpatient encounter chart audits for training years 2008-2009 through 2012-2013, corresponding to participation in the Nephrology In-Training Examination (ITE). A median of 7 auditors (attending nephrologists) audited a mean of 1,686±408 (SD) charts per year. 18 fellows were audited; 12, in both of their training years.

PREDICTORS

Proportion of chart audit and quality indicator deficiencies.

OUTCOMES

Longitudinal deficiency and ITE performance.

MEASUREMENTS & RESULTS

Among fellows audited in both their training years, chart audit deficiencies were fewer in the second versus the first year (5.4%±2.0% vs 17.3%±7.0%; P<0.001) and declined between the first and second halves of the first year (22.2%±6.4% vs 12.3%±9.5%; P=0.002). Most deficiencies were omission errors, regardless of training year. Quality indicator deficiencies for hypertension and chronic kidney disease-associated anemia recognition and management were fewer during the second year (P<0.001). Yearly audit deficiencies ≥5% were associated with an ITE score less than the 25th percentile for second-year fellows (P=0.03), with no significant association for first-year fellows. Auditor-reported deficiencies declined between the first and second halves of the year (17.0% vs 11.1%; P<0.001), with a stable positive/neutral comment rate (17.3% vs 17.8%; P=0.6), suggesting that the decline was not due to auditor fatigue.

LIMITATIONS

Retrospective design and small trainee numbers.

CONCLUSIONS

Managing a nephrology outpatient clinic is an EPA. The chart audit tool was used to assess longitudinal fellow performance in managing a nephrology outpatient clinic. Failure to progress may be quantitatively identified and remediated. The tool identifies deficiencies in all 6 competencies, not just medical knowledge, the primary focus of the ITE and the nephrology subspecialty board examination.

Center for the Advancement of Pharmacy Education 2013 educational outcomes

An initiative of the Center for the Advancement of Pharmacy Education (formerly the Center for the Advancement of Pharmaceutical Education) (CAPE), the CAPE Educational Outcomes are intended to be the target toward which the evolving pharmacy curriculum should be aimed. Their development was guided by an advisory panel composed of educators and practitioners nominated for participation by practitioner organizations. CAPE 2013 represents the fourth iteration of the Educational Outcomes, preceded by CAPE 1992, CAPE 1998 and CAPE 2004 respectively. The CAPE 2013 Educational Outcomes were released at the AACP July 2013 Annual meeting and have been revised to include 4 broad domains, 15 subdomains, and example learning objectives.