Abstract
Introduction
Increasing attention to the importance of sleep among children raises questions about how to implement accessible, effective interventions. Part of answering those questions ...rests in determining interest in and demand for programming. Pajama Program (PJP), a 501(c)(3), works with nearly 4,000 community-based organizations (CBOs) nationally that work with children exposed to adversity, including: foster care/child welfare; shelters; low-income schools, after-school, and early care and education programs; and social-service providers. Anticipating its launch of sleep health education programs, PJP and its Good Night Advisory Council of sleep experts designed a CBO needs assessment.
Methods
The survey was distributed electronically to staff at 3,911 CBOs; 1,635 organizations responded (42%).
Results
Across respondents, 65% work with children birth to 18 in settings that were non-residential (39%), residential (18%), or both (43%); most (91%) worked with participants for over one month. CBOs included child welfare/foster care (20.6% of respondents); transitional housing/shelter (20.5%); social services (15.6%); and early care and education (12.7%). Interest in sleep health education was high across all program types: 80 to 89% of programs within each type wanted information for staff and/or caregivers, specifically handouts (among 93% of programs), articles (88%), videos (85%), and workshops (70%). At least 90% of respondents who provided early care and education, parenting, and crisis services were interested in sleep health education for program staff. These program types also had high interest in sleep health education for caregivers, as did child welfare/foster care, school/after school, and shelters (all at least 90% of respondents).
Conclusion
The CBOs in this sample recognize sleep is an issue among the children they serve, but most did not have access to information on sleep health. These results establish the need for sleep health education and suggest preferred modalities. The project is a model for partnerships involving researchers, nonprofits, and community-based organizations.
Support
Funding for this project was provided by Pajama Program, a national 501(c)(3) non-profit.
Abstract
Introduction
Children exposed to adversity (e.g., homelessness, poverty) are at risk of poor sleep. Community settings that serve these children, both residential (e.g., foster care group ...homes, shelters) and non-residential (e.g., early care and education, schools), hold important understandings to the barriers to sleep they experience. We surveyed a heterogeneous national sample of community-based organizations (CBOs) in our Pajama Program sample to explore these barriers.
Methods
Pajama Program, a national 501(c)(3) nonprofit, administered an online needs assessment in May 2016 to staff at 3,911 CBOs. This poster reports on qualitative responses to the question, What are the primary barriers to sleep and bedtime among children your organization serves? Responses from residential and non-residential CBOs were analyzed separately. Two trained coders independently used the constant comparative method to analyze transcripts.
Results
Survey respondents (1,635) provided services in non-residential (42%), residential (18%) and combined (43%) settings. Organizations provided child welfare/foster care (20.6% of programs); transitional housing/shelter (20.5%); social services (15.6%); and early care and education (12.7%) services. Responses to the target open-ended item were from 127 non-residential and 55 residential programs. Sleep barriers common to both settings included: late/irregular bedtimes; no bedtime routine; lack of sleep education; housing/food insecurity; stress; disrupted/uncomfortable sleep; and adapting to new environments. Trauma was a barrier among residential (vs. non-residential) programs. Non-residential providers noted unstable family situations, bedding insecurity, and poor sleep hygiene.
Conclusion
Our research highlights barriers to sleep among children exposed to adversity, a largely understudied yet high risk group. Barriers reported by residential and non-residential CBOs were more similar than different. was Across program types and settings, CBOs expressed a need for sleep health education interventions for children and caregivers.
Support
Funding for this project was provided by Pajama Program, a national 501(c)(3) non-profit.
Will Fifty Cooks Spoil the Broth? Ripple, Carol H; Gilliam, Walter S; Chanana, Nina ...
The American psychologist,
05/1999, Volume:
54, Issue:
5
Journal Article
Peer reviewed
Many researchers and policymakers recognize the importance of preschool education, particularly for low-income children, and the role of state governments has become increasingly prominent in ...providing services. At the same time, some policy analysts have urged that Head Start should be shifted from federal to state control. Others, however, believe this is inadvisable. We sought to inform the debate over whether entrusting Head Start to the states would be a sound policy decision by examining extant state preschool programs. Our survey of 31 programs that matched our criteria suggested that state-funded initiatives vary widely in design, implementation, and quality. There are some common areas of strength and weakness: States tend to be strong in domains such as classroom quality, but are weak on providing comprehensive services. Overall, we find reason for serious concern regarding Head Start devolution from federal to state control at this time.
With the ability and the funds to implement programs on a national level, federal policy is a potentially potent tool in primary prevention. Despite the U.S. government's history of ambivalence ...toward intervening in child rearing and limited national support for primary prevention, several initiatives have been implemented for children and families with some measure of success. The successes, however, are mitigated by limitations of the initiatives themselves and by the inconclusive nature of much of the evaluation data. This review of 5 federal policy-based initiatives for children and families provides the backdrop for discussing aspects of federal prevention program design, implementation, policy, and research.
We present three cases of fatal dog maulings of infants placed in mobile infant swings, a phenomenon not previously described in the literature. In each case, the victim was left in a mobile swing, ...unsupervised by an adult, and the attacking dog was a family pet. Case 1 involved an 18‐day‐old male infant attacked by a pit bull; Case 2 involved a 3‐month‐old male infant attacked by a Chow Chow and/or a Dachshund, and Case 3 involved an 18‐day‐old female infant attacked by a Labrador–pit bull mix. These cases not only underscore the importance of not leaving young children unattended in the presence of pet dogs, but also raise the possibility that mobile swings may trigger a predatory response in dogs and thus may represent an additional risk factor for dog attack.
In this 3-year prospective study, we explored antecedents of school-based adjustment among 134 inner-city high-school students. We examined the role of freshman-year risk and protective factors in ...relation to dropout status and senior-year adjustment indices among those who remained in school, including academic performance, psychological symptoms, and drug use. Although each single attribute included in this study has been linked to poor academic performance in previous investigations, the primary goal in this study was to determine which attributes were strongly related to academic problems when considered together. In addition, we sought to establish whether risk factors associated with dropout were the same as those that predicted academic problems among students who remained in school. Findings indicated that freshman-year attendance and demographic indices were most strongly predictive of dropout. Among adolescents who remained in school, freshman academic success was robustly linked to senior-year competence. Implications for identifying inner-city high-school students at high risk for academic problems are discussed.
Abstract Background and Aims The optimal type of stent for the palliation of malignant biliary obstruction in patients with pancreatic adenocarcinoma undergoing neoadjuvant chemoradiotherapy with ...curative intent is not known. We performed a prospective trial comparing 3 types of biliary stents—fully covered self-expandable metal stents (fcSEMSs), uncovered self-expandable metal stents (uSEMSs), and plastic stents—to determine which best optimized cost effectiveness and important clinical outcomes. Methods In this prospective, randomized trial, consecutive patients with malignant biliary obstruction from newly diagnosed pancreatic adenocarcinoma who were to start neoadjuvant chemoradiotherapy were randomized to receive fcSEMSs, uSEMSs, or plastic stents during index ERCP. The primary outcomes were time to stent occlusion, attempted surgical resection, or death after the initiation of neoadjuvant therapy and the secondary outcomes were total patient costs associated with the stent, including the index ERCP cost, downstream hospitalization cost due to stent occlusion, and the cost associated with procedural adverse event. Results A total of 54 patients were randomized and reached the primary endpoint; 16 patients in the fcSEMS group, 17 in the uSEMS group, and 21 in the plastic group. No baseline demographic or tumor characteristic differences were noted between groups. fcSEMSs had a longer time to stent occlusion compared with uSEMSs and plastic stents (219 vs. 88 and 75 days, p<0.01), although the groups had equivalent rates of stent occlusion, attempted surgical resection, and death. Although SEMS placement cost more during index ERCP (uSEMS = $24,874 and fcSEMS = $22,729 vs plastic = $18,701, p <0.01), they resulted in higher procedural adverse event costs per patient (uSEMS $5521 and fcSEMS=$12,701 vs plastic = $0, p<0.01). Conversely, plastic stents resulted in a $11,458 hospitalization cost per patient due to stent occlusion, compared with $2301 for uSEMSs and $0 for fcSEMSs (p<0.01). The total cost of the index ERCP, procedural adverse events associated with the index ERCP and adverse events from stent occlusion were similar between stent types (fcSEMSs = $41,112; uSEMSs = $41,475; and plastic = $39,955; p=1.00). There was no difference between groups in terms of number of days hospitalized for index ERCP adverse event and/or stent occlusion, although fcSEMSs resulted in fewer total days (3) of neoadjuvant treatment delay than uSEMSs (39) or plastic stents (79) (p<0.01). Conclusions In a prospective trial comparing fcSEMSs, uSEMSs, and plastic stents for malignant biliary obstruction in patients undergoing neoadjuvant therapy with curative intent for pancreatic adenocarcinoma, no stent type was superior in optimizing cost effectiveness, although fcSEMS resulted in fewer days of neoadjuvant treatment delay and a longer time to stent occlusion. (ClincialTrials.gov, number NCT01038713)
Acoustic deterrent devices (ADDs) are used in attempts to mitigate pinniped depredation on aquaculture sites through the emission of loud and pervasive noise. This study quantified spatio-temporal ...changes in underwater ADD noise detections along western Scotland over 11 years. Acoustic point data (‘listening events’) collected during cetacean line-transect surveys were used to map ADD presence between 2006 and 2016. A total of 19,601 listening events occurred along the Scottish west coast, and ADD presence was recorded during 1371 listening events. Results indicated a steady increase in ADD detections from 2006 (0.05%) to 2016 (6.8%), with the highest number of detections in 2013 (12.6%), as well as substantial geographic expansion. This study demonstrates that ADDs are a significant and chronic source of underwater noise on the Scottish west coast with potential adverse impacts on target (pinniped) and non-target (e.g. cetaceans) species, which requires further study and improved monitoring and regulatory strategies.
•ADDs are being used to mitigate pinniped depredation in Scottish aquaculture.•Over the last decade underwater noise from ADDs has markedly increased.•ADDs are an important source of chronic underwater noise in western Scotland.
Research on familial factors in illicit drug abuse has been approached from the perspectives of psychiatric epidemiology, which aims to assess familial clustering of disorders, and clinical ...psychiatry, which focuses on intrafamilial dynamics. To date, however, these two research traditions have existed in relative isolation from each other, and there has been little consideration given to enhancing the understanding of familial factors in drug abuse by combining these approaches. The intention of this article is to critically review the literature in these two areas and to offer suggestions as to how the strengths from each could be applied in a comprehensive research approach.
Infrared stellar photometry from the Two Micron All-Sky Survey (2MASS) and spectral line imaging observations of 12CO and 13CO J = 1-0 line emission from the Five College Radio Astronomy Observatory ...(FCRAO) 14-m telescope are analysed to assess the variation of the CO abundance with physical conditions throughout the Orion A and Orion B molecular clouds. Three distinct A
v
regimes are identified in which the ratio between the 13CO column density and visual extinction changes corresponding to the photon-dominated envelope, the strongly self-shielded interior, and the cold, dense volumes of the clouds. Within the strongly self-shielded interior of the Orion A cloud, the 13CO abundance varies by 100 per cent with a peak value located near regions of enhanced star formation activity. The effect of CO depletion on to the ice mantles of dust grains is limited to regions with A
v
> 10 mag and gas temperatures less than ∼20 K as predicted by chemical models that consider thermal evaporation to desorb molecules from grain surfaces.
Values of the molecular mass of each cloud are independently derived from the distributions of A
v
and 13CO column densities with a constant 13CO-to-H2 abundance over various extinction ranges. Within the strongly self-shielded interior of the cloud (A
v
> 3 mag), 13CO provides a reliable tracer of H2 mass with the exception of the cold, dense volumes where depletion is important. However, owing to its reduced abundance, 13CO does not trace the H2 mass that resides in the extended cloud envelope, which comprises 40-50 per cent of the molecular mass of each cloud. The implied CO luminosity to mass ratios, M/L
CO, are 3.2 and 2.9 for Orion A and Orion B, respectively, which are comparable to the value (2.9), derived from γ-ray observations of the Orion region. Our results emphasize the need to consider local conditions when applying CO observations to derive H2 column densities.
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