The effects of the Healthy Steps for Young Children Program: results from observations of parenting and child development

The Healthy Steps for Young Children Program (HS) is designed to provide support for new parents through the pediatrician's office. We present findings of the effect of HS on the quality of mother–child interaction, security of attachment, and child behavior using observational data from two of the HS sites that utilized a randomized treatment design. Results indicated that mothers participating in Healthy Steps were more likely to interact sensitively and appropriately than mothers in the comparison group at the second assessment point (age 34–37 months) but not at the first assessment point (age 16–18 months). There were no differences in child outcomes at either time point when the cross-sectional data were analyzed. However, the results of the longitudinal analysis (which included families who participated in the home observations at both Time 1 and Time 2) indicated that Healthy Steps participation was associated with greater security of attachment and fewer child behavior problems.     

Strategies for incorporating cultural competence into childbirth education curriculum

Cultural competence affects all interactions with prospective parents and families. Childbirth educators need to assess their own cultural competence, beginning with an understanding of their own background and how it affects interactions with families. The purpose of this article is to enhance the incorporation of cultural competency, cultural awareness, and cultural sensitivity into the childbirth education curricula. Methods for enhancing cultural competence in a multicultural global society are discussed. Strategies are also presented to address the challenges of assessing parents and families of diverse cultures and their beliefs, traditions, and special needs in the plan of care.     

Making the Critical Appraisal for Summaries of Evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence

Objectives:

Standards for evaluating evidence-based medicine (EBM) point-of-care (POC) summaries of research are lacking. The authors developed a “Critical Appraisal for Summaries of Evidence” (CASE) worksheet to help assess the evidence in these tools. The authors then evaluated the reliability of the worksheet.

Methods:

The CASE worksheet was developed with 10 questions covering specificity, authorship, reviewers, methods, grading, clarity, citations, currency, bias, and relevancy. Two reviewers independently assessed a random selection of 384 EBM POC summaries using the worksheet. The responses of the raters were then compared using a kappa score.

Results:

The kappa statistic demonstrated an overall moderate agreement (κ = 0.44) between the reviewers using the CASE worksheet for the 384 summaries. The 3 categories of evaluation questions in which the reviewers disagreed most often were citations (κ =  0), bias (κ = 0.11), and currency (κ = −0.18).

Conclusions:

The CASE worksheet provided an effective checklist for critically analyzing a treatment summary. While the reviewers agreed on worksheet responses for most questions, variation occurred in how the raters navigated the tool and interpreted some of the questions. Further validation of the form by other groups of users should be investigated.

Highlights

• Few critical appraisal tools have been evaluated with inter-rater reliability testing.
• The ways that users of evidence-based medicine (EBM) point-of-care (POC) tools interpret how to appraise an evidence summary—particularly when defining the grading of evidence, currency, and bias—may vary even when a standard evaluation sheet is used.
• The Critical Appraisal for Summaries of Evidence (CASE) worksheet had a moderate level of inter-rater reliability, similar to previous evaluative studies of critical appraisals tools.

Implications

• Medical librarians can develop tools useful for librarians, students, and clinicians to guide them in appraising clinical evidence summaries.
• The CASE worksheet can be a valuable tool to consider the quality of individual evidence summaries and to see patterns of overall quality in EBM POC tools.

     

The application of archival concepts to a data-intensive environment: working with scientists to understand data management and preservation needs

The collection, organization, and long-term preservation of resources are the raison d??être of archives and archivists. The archival community, however, has largely neglected science data, assuming they were outside the bounds of their professional concerns. Scientists, on the other hand, increasingly recognize that they lack the skills and expertise needed to meet the demands being placed on them with regard to data curation and are seeking the help of ??data archivists?? and ??data curators.?? This represents a significant opportunity for archivists and archival scholars but one that can only be realized if they better understand the scientific context.     

Meme Engineers: children as producers of musical culture

This paper examines the ways in which young children construct and negotiate musical meaning as song-makers in a post-modern consumerist musical world. A critical analysis of the presentation of music in two popular Australian children's television programmes (Play School and Hi-5) and the ways in which such media impact upon children's constructions of music and musical understanding is presented. This analysis provides a context for the examination of tensions that exist between a modernist account of what constitutes musical understanding in the young child, and an account that is cognisant of post-modern aesthetics. The implications of this concerning views of children's musical development and curriculum decision making are discussed and a view of the child as an active agent in the construction of her musical worlds is illustrated through an examination of the musical narratives of a 4-year-old child.