Toward instituting a chaperone policy in outpatient pediatric clinics

ObjectivesWe sought to evaluate child, parent and medical provider preferences for chaperones for outpatient encounters and to evaluate the acceptability and frequency of utilization following institution of a chaperone policy. Secondarily, we sought to understand what medical history and examinations teens consider “sensitive.”DesignWe conducted an observational study 1 month before and 1 month after institution of outpatient clinic chaperone policy. Post clinic questionnaires were used for patients ≥12 years old, parents, and clinicians. A research assistant observed chaperone use.SettingAdolescent Medicine, Urology, and Rehabilitation Clinics at a regional, tertiary-care pediatric hospital, in a major metropolitan area were studied.ParticipantsConvenience sample: 117 clinic patients during control period and 119 after policy implementation.Main outcome measuresPreferences for and satisfaction with chaperone use were documented.ResultsAlthough non-parent chaperones were usually declined (99.6%), offers were appreciated. Non-parent chaperone use increased modestly (5.3–18.1%).Most patients preferred not to have non-parent chaperones. This preference was greater among older patients (88%), than early teens (52%). After experiencing sensitive examinations, more young adolescent patients (89%) wished their parent had been present than older patients (38%). Patients’ opinions about what constitutes “sensitive” questions and examinations and chaperone preferences varied widely. Providers often did not recognize issues patients and parents considered sensitive questioning (21% agreement), but recognized sensitive physical examinations better (74% agreement). Providers felt chaperones had been a detriment to examination and exams would have gone better without one only 1% of the time.ConclusionsAlthough usually declined, offers of chaperones were appreciated and use of non-parent chaperones increased modestly. Offering chaperones for sensitive examinations may remind providers about appropriate, respectful patient encounters. Implications for children's hospitals’ patient safety and satisfaction, and institutional staff protection and costs are significant.Practice implicationsQuestions and examinations which patients consider sensitive vary widely. Asking patients for their preferences for examination chaperones may reassure them about the appropriateness of examinations, remind staff to conduct respectful examinations and protect providers from accusations of impropriety. Since most chaperone offers are declined, the cost of asking is likely to be minimal.     

Are there positive effects of having a sibling with special needs? Empathy and prosociality of twins of children with non-typical development

This study examined whether typically developing (TD) twins of non-TD children demonstrate enhanced empathy and prosociality. Of 778 Hebrew-speaking Israeli families who participated in a twin study, 63 were identified to have a non-TD child with a TD twin, and 404 as having both twins TD. TD twins of non-TD children (27% males) were compared to the rest of the cohort of TD children (46% males) on measures of empathy and prosociality. Participants were 11 years old. TD twins of non-TD children scored significantly higher than TD twins of TD children in a measure of cognitive empathy (d = .43). No differences were found in emotional empathy and prosociality. The specificity of the positive effect on cognitive empathy is discussed.     

Understanding Heterogeneity in the Impact of Public Preschool Programs

We examine the North Carolina Pre-K (NC Pre-K) program to test the hypothesis that observed variation in effects resulting from exposure to the program can be attributed to interactions with other environmental factors that occur before, during, or after the pre-k year. We examine student outcomes in 5th grade and test interaction effects between NC's level of investment in public pre-k and moderating factors. Our main sample includes the population of children born in North Carolina between 1987 and 2005 who later attended a public school in that state, had valid achievement data in 5th grade, and could be matched by administrative record review (n = 1,207,576; 58% White non-Hispanic, 29% Black non-Hispanic, 7% Hispanic, 6% multiracial and Other race/ethnicity). Analyses were based on a natural experiment leveraging variation in county-level funding for NC Pre-K across NC counties during each of the years the state scaled up the program. Exposure to NC Pre-K funding was defined as the per-4-year-old-child state allocation of funds to a county in a year. Regression models included child-level and county-level covariates and county and year fixed effects. Estimates indicate that a child's exposure to higher NC Pre-K funding was positively associated with that child's academic achievement 6 years later. We found no effect on special education placement or grade retention. NC Pre-K funding effects on achievement were positive for all subgroups tested, and statistically significant for most. However, they were larger for children exposed to more disadvantaged environments either before or after the pre-k experience, consistent with a compensatory model where pre-k provides a buffer against the adverse effects of prior negative environmental experiences and protection against the effects of future adverse experiences. In addition, the effect of NC Pre-K funding on achievement remained positive across most environments, supporting an additive effects model. In contrast, few findings supported a dynamic complementarity model. Instrumental variables analyses incorporating a child's NC Pre-K enrollment status indicate that program attendance increased average 5th grade achievement by approximately 20% of a standard deviation, and impacts were largest for children who were Hispanic or whose mothers had less than a high school education. Implications for the future of pre-k scale-up and developmental theory are discussed.     

Relations among academic enablers and academic achievement in children with and without high levels of parent‐rated symptoms of inattention,impulsivity, and hyperactivity

This study examined the relationships among academic enablers (i.e., engagement, interpersonal skills, motivation, study skills) and academic achievement in children with and without high levels of parent‐rated symptoms of inattention, impulsivity, and hyperactivity (Symptoms of IIH Group). The study included 69 participants (29 [42%] in the IIH Group and 40 [58%] in the Comparison Group), with 33 boys and 36 girls in the third through fifth grades. The researchers found significant differences on the measure of academic enablers, including engagement, interpersonal skills, motivation, and study skills, in which participants in the Comparison Group received higher scores. In addition, several academic enablers mediated the relationship between symptoms of inattention, impulsivity, and hyperactivity and the academic outcomes of reading and teachers' ratings of total academic skills. © 2011 Wiley Periodicals, Inc.     

Fake News as a Critical Incident in Journalism

This study examines how American newspapers made sense of the issue of fake news. By analysing newspaper editorials and considering the problem of fake news as a critical incident confronting journalism, this study found that news organizations in the US recognize fake news as a social problem while acknowledging the challenge in defining it. They generally considered fake news as a social media phenomenon thriving on political polarization driven by mostly ideological, but sometimes also financial, motivations. Therefore, they assigned blame for the rise of fake news to the current political environment, to technological platforms Google and Facebook, and to audiences.     

INTERGENERATIONAL SHARING SEMINARS: THEIR IMPACT ON YOUNG ADULT COLLEGE STUDENTS AND SENIOR GUEST STUDENTS

A 3‐month intergenerational program was developed on the premise that it is important for young adults, who are in the formative period of career development and direction, to experience the benefits of positive interaction with older persons. Program evaluation findings showed that participation not only influenced the young adults’ interest in gerontology, but also increased their willingness to accept older persons on social and academic levels. Positive changes were documented for the Senior Guest students and included more favorable attitudes toward young adult family members as well as toward the younger generation of college students in general.     

Bottom line: A seat at the table that I set: Beyond social justice allies

Toby Jenkins argues for including the roles of advocates and agents in higher education's conversation about social justice.