Bounding,An Accessible Method for Estimating Principal Causal Effects,Examined and Explained

Estimating treatment effects for subgroups defined by posttreatment behavior (i.e., estimating causal effects in a principal stratification framework) can be technically challenging and heavily reliant on strong assumptions. We investigate an alternative path: using bounds to identify ranges of possible effects that are consistent with the data. This simple approach relies on fewer assumptions and yet can result in policy-relevant findings. As we show, even moderately predictive covariates can be used to substantially tighten bounds in a straightforward manner. Via simulation, we demonstrate which types of covariates are maximally beneficial. We conclude with an analysis of a multisite experimental study of Early College High Schools. When examining the program's impact on students completing the ninth grade “on-track” for college, we find little impact for ECHS students who would otherwise attend a high-quality high school, but substantial effects for those who would not. This suggests a potential benefit in expanding these programs in areas primarily served by lower quality schools.     

Integrated Reading and Writing Interventions for Students with Learning Disabilities: A Review of the Literature

In this systematic review of literature that spans 1975–2015, integrated reading and writing interventions for students with learning disabilities (LD) or students with academic difficulties were evaluated to understand the extant research, identify encouraging practices, and guide future research. Ten studies met inclusion criteria and each study was evaluated according to the relevant What Works Clearinghouse (WWC) design standards. Eight of the 10 investigations were conducted with students in grades 4–8. While only 4 of the 10 studies met WWC design with or without reservations, results from these studies are encouraging. Study findings suggest several areas for immediate future research relating to methodological and treatment variables and considerations for classroom instruction in order to respond to advanced expectations for the successful integration of reading and writing across subjects. In addition to employing stronger experimental designs and additional replications of encouraging studies, future research should explore the utility of integrated reading and writing interventions with secondary students with who have academic difficulties.     

Deficits in emotion regulation mediate the relationship between childhood abuse and later eating disorder symptoms

The present study examined the relationship of child maltreatment to both emotion dysregulation and subsequent eating pathology. In an effort to extend previous research, the authors examined the unique impact of childhood emotional abuse (CEA) on emotion dysregulation and eating disorder (ED) symptoms while controlling for the effects of sexual and physical abuse. Structural equation modeling was utilized to simultaneously examine the effects of all three abuse types on multiple dependent variables as well as examine whether deficits in emotion regulation mediated the relationship between abuse and eating pathology. Results from a survey of 1,254 female college students revealed significant paths from abuse subtypes to specific eating disorder symptoms, with CEA evidencing the strongest association with ED symptoms. Additionally, emotion dysregulation was positively associated with ED symptoms, and mediated the effects of emotional abuse on symptoms. Findings support previous research on the enduring effects of emotional abuse as well as highlight the importance of the assessment of CEA in the treatment of ED symptoms.     

Adoptive Gay Father Families: A Longitudinal Study of Children’s Adjustment at Early Adolescence

Findings are presented from the second phase of a UK longitudinal study of 33 gay father, 35 lesbian mother, and 43 heterosexual parent families when their adopted children reached early adolescence. Participants predominantly lived in urban/suburban areas and were mostly white and well-educated. Standardized interviews, observations, and questionnaires of parental mental health, parent–child relationships, and adolescent adjustment were administered to parents, children, and teachers between 2016 and 2018. There were few differences between family types. However, adjustment problems had increased in all family types, with better parenting quality and parental mental health associated with fewer adjustment problems. The findings contribute to adoption policy and practice, and to theoretical understanding of the role of parental gender in child development.     

A collaborative network for first responders: Lessons from the CapWIN case

It is increasingly important for government agencies to collaborate across jurisdictional and functional boundaries. Interorganizational systems supporting interagency collaboration must accommodate a wide range of factors from the external environment and participating organizations as part of their design and operation. This paper presents the findings from a case study of CapWIN, a collaborative network created to enable first responders to share information across jurisdictional and functional boundaries as they work together during emergencies and other critical events. The study examines how aspects of the external environment and the agency context impeded or facilitated the CapWIN collaborative network and the interorganizational system (IOS) that supports it. We identify factors affecting information sharing and collaborative processes, and describe how these factors interact to enable and constrain an IOS. The paper concludes with suggestions for further research on the interplay of environmental, organizational, and technical aspects of interagency collaboration networks as they evolve over time.     

The value and impact of information provided through library services for patient care: a systematic review

OBJECTIVE: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. METHODS: A comprehensive systematic search was undertaken of the published literature to September 2003 in ERIC, LISA, MEDLINE, PREMEDLINE, EMBASE, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twenty-eight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis. RESULTS: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10-31% on diagnosis, 20-51% on choice of tests, 27-45% on choice of therapy and 10-19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. CONCLUSIONS: Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.     

School exclusion,substance misuse and use of weapons: an interpretative phenomenological analysis of interviews with children

The study presents data drawn from semi-structured interviews with five young people permanently excluded from schools in North East England. The research aimed to investigate the risk factors that lead to the children using illegal drugs, to determine the drivers and implications for drug misuse and the carrying of knives into school. The research also hoped to elicit from the young people, the solutions that could have prevented their exclusion from school. The interviews were analysed using interpretative phenomenological analysis to understand how a homogenous sample made sense of their lived experiences. The findings highlight the importance of prompt identification and support for children with learning and subsequent mental health needs as the evidence suggests they lead to perceived negative behaviours by teachers. The research provides further evidence that behaviour sanctions in mainstream schools such as detention and isolation booths do not improve behaviour but make it worse. Original to this research is the finding that children are consuming drugs before school to cope with their inability to access the learning, to aid their concentration and to medicate themselves to reduce the likelihood of being sanctioned by teachers.     

Geriatric Expertise among Medical School Faculty: Preparing for the Challenges of an Aging Population

This study examined non-geriatrician physicians' experiences in a geriatrics-focused faculty development program, and effects of the program on their geriatrics knowledge and their teaching and practice. In-depth interviews were conducted with all physicians (n = 26) participating in the Dean's Faculty Scholars in Aging program. Most participants reported substantial gains in geriatric knowledge, and in the knowledge that older people are a distinct group with special needs. Most reported substantial changes in the way they care for older patients. Most reported incorporating notably more geriatrics content into their teaching. The program may serve as a process to address the growing need for physicians with geriatric knowledge.     

Modern dietary guidelines for healthy pregnancy; maximising maternal and foetal outcomes and limiting excessive gestational weight gain

Abstract

Maternal dietary habits influence maternal and foetal health, representing a pathway for intervention to maximise pregnancy outcomes. Advice on energy intake is provided on a trimester basis, with no additional calories required in the first trimester and an additional 340?kcal?d^?1 and 452?kcal?d^?1 needed for the second and third trimesters. Energy intake depends on pre-gravid body mass index (BMI); underweight women are recommended an increase of 150, 200 and 300?kcal?d^?1 during the first, second and third trimester, normal weight women an increase of 0, 350 and 500?kcal?d^?1 and obese women an increase of 0, 450 and 350?kcal?day^?1. The recommendations for carbohydrate and protein intake are 175?g?d^?1 and 0.88–1.1?g?kgBM?d^?1, with no change to fat intake. The number of pre-gravid obese women is rising; therefore, we need to regulate weight in women of childbearing age and limit gestational weight gain to within the recommended ranges [overweight women 6.8–11.3?kg and obese women 5.0–9.1?kg]. This can be achieved using nutritional interventions, as dietary changes have been shown to help with gestational weight management. As pregnancy has been identified as a risk factor for the development of obesity, normal weight women should gain 11.5–16.0?kg during pregnancy. While some research has shown that dietary interventions help to regulate gestational weight gain and promote postpartum weight loss to some extent, future research is needed to provide safe and effective guidelines to maximise these effects, while benefitting maternal and foetal health.     

Designing a search strategy to identify and retrieve articles onevidence-based health care using MEDLINE

Thepractice of evidence-based health care requires that information on methodology be identifiedfrom databases such as MEDLINE. Up until this year there have been no designated medicalsubject headings (MeSH) for evidence-based health care. ‘EVIDENCE-BASEDMEDICINE’ appears as a MeSH term from 1997. The absence of designated MeSH forthis concept prior to 1997 provides a challenge to the searcher. This paper describes the creationof a MEDLINE search strategy to retrieve articles on the methods of evidence-based health carepublished prior to the introduction of the new term, where an optimal combination of free-textand MeSH terms is required to identify relevant material. The study examines both free-text andsubject heading searching and attempts an optimal balance of sensitivity and specificity. It beginsby examining separate free-text and subject heading searches. Sensitivity of the subject headingsearch was 33% and specificity 80%, while the free-text search produced asensitivity of 50% and a specificity of 67%. The final strategy, combining bothapproaches, was more successful with sensitivity reaching between 82 and 90% andspecificity 83%. It is therefore possible to devise a search strategy to retrieve articles on themethods of evidence-based health care with relatively successful rates of sensitivity andspecificity. The limitations of MEDLINE, however, necessitate the use of additional approachesin identifying articles on the methods of evidence-based health care.