Objectives
To evaluate third-grade reading and math proficiency for children born to adolescent women compared with those born to non-adolescent women.
Methods
A statewide, retrospective cohort study ...was conducted in Rhode Island using third-grade year-end examination data from 2014 to 2017 as part of a statewide initiative to improve third grade reading levels. Children’s third-grade reading and math proficiencies were compared between those born to nulliparous adolescent women (age 15–19 at the time of delivery), and nulliparous women 20 years or older at delivery. Bivariate analyses were conducted to compare maternal and child characteristics between adolescent and non-adolescent groups. Multivariable logistic regression was used to examine the association between having an adolescent mother and being proficient in reading and math after adjusting for lunch subsidy, core city residence, child race/ethnicity and sex.
Results
Of the 8,248 children meeting the inclusion criteria, 20% were born to adolescent women and the remaining 80% were born to non-adolescent women. After adjusting for potential confounders, children born to adolescent women were significantly less likely to be proficient in both reading (adjusted risk ratio (aRR) 0.77, 95% confidence interval (CI): 0.71–0.83) and math (aRR 0.78, 95% CI: 0.72–0.85).
Conclusions for Practice
Children born to adolescent women had significantly lower rates of reading and math proficiency when compared with children of non-adolescent women. These children may benefit from additional resources focused on early academic performance in order to address disparities in reading and math proficiency.
Reading aloud is an important activity to prepare children to succeed in learning to read. Many Hispanic children have reading difficulties and therefore are at increased risk for school failure.
We ...conducted a prospective, randomized, controlled study to evaluate the effectiveness of a literacy promoting intervention delivered to low-income Hispanic families with infants. We consecutively enrolled 135 low-income Hispanic parents of healthy 5 to 11 month old infants. Families were randomly assigned to an intervention (n = 65) or control (n = 70) group. At enrollment and at two consecutive well-child visits, pediatricians gave intervention families: 1) an age-appropriate bilingual children's book, 2) a bilingual handout explaining the benefits of reading to children, and 3) literacy-promoting anticipatory guidance. Ten months after enrollment we reinterviewed 130 parents.
Both groups were comparable at baseline. At follow-up, intervention parents were more likely to read books with their child at least 3 days/week (intervention = 66% vs control parents = 24%) and to report that reading books was one of their three most favorite things to do with their child (intervention = 43% vs controls = 13%). Intervention families also had a greater number of children's books and total books at home. Using a multiple logistic regression model, controlling for child and parental age, reading habits, and English proficiency, we found that the odds of parents reading to their child at least 3 days/week were 10 times greater in intervention families (OR 10.1, 95% CI 4.0-25.6) compared with control families.
This simple, culturally appropriate intervention significantly increased literacy behaviors in low-income Hispanic families.
Frequent use of the emergency department (ED) is often targeted as a quality improvement metric. The objective of this study was to assess ED visit frequency by the demographic and health ...characteristics of children who visit the ED to better understand risk factors for high ED utilization.
The majority of pediatric ED services in Rhode Island are provided by a hospital network that includes the state's only children's hospital. Using 10 years of data (2005-2014) from this statewide hospital network, we examined ED use in this network for all children aged 0 to 17 years. Patients' home addresses were geocoded to assess their neighborhood characteristics.
Between 2005 and 2014, 17,844 children visited 1 or more of the network EDs at least once. In their year of maximum use, 67.8% had only 1 ED visit, 20.1% had 2 visits, 6.9% had 3 visits, and 5.2% had 4 or more visits. In the adjusted multinomial logistic regression model, age, race/ethnicity, language, insurance coverage, medical complexity, neighborhood risk, and distance to the ED were found to be significantly associated with increased visit frequency.
Risk factors for frequent ED use by children include age, race/ethnicity, language, insurance coverage, medical complexity, neighborhood risk, and distance to the hospital. To decrease frequent pediatric ED use, improved medical management of complex medical problems is needed, but it is also essential to address modifiable social determinants of health care utilization in this population.
The use of High Purity Germanium detectors operated in ionization mode at cryogenic temperatures is investigated as an external background mitigation solution for bolometers used in rare-event search ...experiments. A simple experimental setup, running a 52-g Li2WO4 bolometer sandwiched in-between two 2-cm thick High Purity Germanium cylindrical detectors in a dry cryostat, shows promising rejection to environmental gammas and atmospheric muons backgrounds. The acquired data are used together with a Monte Carlo simulation of the setup to extract the main contributions to the external backgrounds expected in an above ground experiment, such as e.g. current and future experimental efforts targeting the detection of coherent elastic neutrino-nucleus scattering at reactor facilities. Based on all these results, a 4π coverage similar veto system achieving a O(10 keV) energy threshold is expected to achieve a ≳73% and a ≳92% rejection power for gamma-like and muon-like events, respectively.
A breeding program to develop rootstocks with resistance to Xiphinema index, the dagger nematode vector of grapevine fanleaf virus (GFLV), has been underway for many years at UC Davis. A mapping ...population (0705) derived from 161-49C x R8916-22 was created in 2007 to develop an SSR-based linkage map for X. index resistance. 161-49C is a commercial rootstock susceptible to X. index feeding and R8916-22 is a heterozygous resistant cross originating from b40-14, a form of Vitis arizonica. Preliminary results suggest a 1:1 resistant:susceptible segregation ratio for X. index under greenhouse conditions. Previous studies showed that X. index resistance was controlled by a single homozygous locus. To date, 190 of 400 SSR markers were polymorphic, with coverage on all 19 linkage groups. These markers and others are being applied to the entire 0705 population to complete a genetic map of this excellent source of X. index resistance.
Objective: The objective of this study was to examine the relationship between healthcare use and children's healthcare needs as assessed from the perspectives of children themselves, parents, and ...healthcare practitioners. Research Design: We conducted a prospective cohort study in which service use was monitored for the 12 months before and after administration of a health survey. Subjects: We studied 384 parents and children aged 6 to 11 years enrolled for 2 years in a northern California health maintenance organization or a Medicaid managed care program in Rhode Island. Measures: Child and parent perspectives on needs were determined using the Child Health and Illness Profile, Child Edition (CHIP-CE). Plan administrative data were used to develop a treated morbidity index, which was based on diagnosis codes recorded by practitioners during the year before the survey and to obtain prospective measures of service use. Results: For both child- and parent-respondents, low satisfaction and comfort scale scores from the CHIP-CE were significant predictors of number of visits. CHIP-CE domain scales unrelated to future use were risk avoidance, resilience, and achievement. Multivariable regression using CHIP-CE information collected from children explained more variation in total physician visits than models that used parent-respondent data. The treated morbidity index was a weaker predictor of physician visits than the CHIP-CE scale scores. None of the domain scales were significant predictors of any emergency department use or any specialist use; however, the treated morbidity index was associated with any specialist use. Conclusions: A child's sense of well-being and burden of symptoms predict future use. Perceived healthcare needs, as assessed by the CHIP-CE, is a better predictor of children's service use than evaluated needs as assessed by physician-diagnosed disorders. Our results support the validity of using the responses of children aged 6 to 11 years as a measure of need for future health care.
Medicaid managed care allows Medicaid beneficiaries to receive services through contractual relationships between managed care organizations and state Medicaid offices. Medicaid offices monitor ...quality of care, and many states encourage or require plans to adopt quality management practices. This research examines quality management in Medicaid managed care from the perspectives of Medicaid officials, managed care plan representatives, and providers through 25 qualitative interviews in one Northeastern state. Plan representatives described quality management efforts as robust and discussed strategies targeting providers and beneficiaries. Medicaid officials indicated motivations for plans to be responsible for quality management. Providers were unaware of plan efforts or reported them to be counterproductive since performance data were thought to be inaccurate or limited, and modest incentive programs presented excessive administrative burden. Providers’ general skepticism about managed care plans’ quality improvement efforts may hinder their effectiveness, cause frustration, and lead to administrative burden that may harm care quality.
Dans le seuil du Cotentin, l' etude a privilegie les prairies marecageuses gerees individuellement par les eleveurs, qui representent la plus grosse part des marais. Elle s' est deroulee de 1982 a ...1986, avec des observations complementaires en 1991 et 1992. Elle a concerne, pour tel ou tel aspect particulier, une vingtaine de communes (les resultats relates dans le present ouvrage ont surtout trait aux communes de Marchezieux et Catteville). Description de la zone et perspective historique. Methodes d' etude des prairies marecageuses par indicateurs floristiques adaptes a ce milieu particulier; ceci a permis d' etablir une typologie fonctionnelle dans le cadre du systeme d' elevage des exploitations agricoles, avec prise en compte synchrone de la vegetation, du milieu et des pratiques agricoles. Valeur alimentaire des fourrages issus des prairies marecageuses. Mise en relief des diverses fonctions que remplissent ces prairies dans les exploitations d' elevage, ce qui permet des conjectures a propos des moyens de piloter l' evolution possible de la zone.
Etude de l' evolution de l' elevage, de l' avant-guerre a nos jours, d' une region constituee par 4 departements: Calvados, Manche, Mayenne, Orne. C' est un vaste ensemble de prairies generalement ...bocagees, interrompu par quelques plaines aux champs ouverts. Ces 4 departements ont aussi comme caracteristique commune d' avoir, jusque dans les annees 60, une economie fondee sur les secteurs agricoles et para-agricoles. Description du contexte historique, tradition ancienne de l' elevage, desindustrialisation rurale,vague herbagere et specialisation vers l' elevage de plein-air. Donnees statistiques depuis 1938, avec plusieurs types de variables: orientation des productions, facteurs de production, productivite. Explication des principaux enseignements fournis par les etudes statistiques. Un essai se synthese presente les traits communs aux 4 departements, resume la dynamique des 50 dernieres annees, apprecie la dynamique actuelle et les problemes en emergence. Deux annexes presentent les industries agro-alimentaires de la region etudiee.
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