The effect of Universal Teacher-Child Interaction Training on Hispanic teachers' sense of self-efficacy in early childhood education and care settings.

Disparities exist in the availability of high-quality early childhood education and care settings (ECEC) across communities within the United States. Teachers have an imperative role in fostering children's socioemotional development; however, when the classroom climate deteriorates due to disruptive behavior, meeting these emotional and learning needs becomes more difficult. Dealing with challenging behaviors can lead to emotional exhaustion which is directly linked to a decrease in teacher sense of efficacy. Teacher-Child Interaction Training-Universal (TCIT-U) targets teachers' skills to provide quality interactions and decrease child behavior problems. Despite evidence that teacher sense of self-efficacy can inhibit negative teaching practices, a lack of research has explored this construct as related to TCIT-U. The current study is a randomized, wait-list control study measuring the change of teachers' sense of self-efficacy after participating in TCIT-U, and the first known of its kind. The study included mostly Hispanic (96.4%) teachers (N = 84) of ECEC programs across 13 unique sites serving 900 children ages 2-5 years from low-income, urban areas. Results from inferential statistics and hierarchical linear regression tests demonstrated TCIT-U as an effective intervention to improve teachers' sense of efficacy in classroom management, instructional strategies, and student engagement. In addition, this study contributes to the effectiveness of TCIT-U as an in-service training which targets teacher communication skills for teachers with diverse backgrounds in ECEC settings with mostly dual language learners.

Presurgical Perspective and Postsurgical Evaluation of Tibial Pilon Fractures.

Tibial pilon fractures represent only a small percentage of all fractures of the lower limb. But they are a feared entity, both for the interpreting radiologist and the treating surgeon and, ultimately, for the patient because they involve the weight-bearing area of the joint and often have associated soft tissue injury. These factors make them technically challenging, with poor clinical and functional results in many patients, even when a perfect joint reduction is achieved. Presurgical evaluation with computed tomography and individualized staged management is critical for the prognosis, a definitive treatment strategy, and the prevention of future complications.

Preferences for the research use of electronic health records among young adults with fragile X syndrome or autism spectrum disorder.

BACKGROUND: Health researchers are increasingly using electronic health records (EHRs) to study the health care needs of people with neurodevelopmental disorders (NDDs). However, little is known about the preferences of people with NDDs for sharing EHRs for research. OBJECTIVE: To explore preferences for sharing EHRs for research among young adults ages 18-40 who make their own legal decisions and who have autism spectrum disorder (ASD), fragile X syndrome (FXS), or no NDDs. METHODS: We conducted a qualitative study with seven focus groups: 2 ASD groups, 3 FXS groups, and 2 no-NDD groups. We asked participants about factors that could affect their willingness to share their EHRs for research: type of organization, type of information, study purpose, duration, contact frequency, return of results, benefits, and risks. We analyzed the qualitative data using directed content analysis. RESULTS: Participants with NDDs valued personally relevant and directly beneficial EHR research. Participants with NDDs expressed willingness to share sensitive data if the study was personally relevant. Most participants wanted to receive results, but only participants with FXS indicated it would affect their willingness to participate. Participants were concerned about privacy risks, discrimination, researcher misconduct, and financial conflicts of interest. CONCLUSION: This study provides initial evidence suggesting that young adults with NDDs prefer EHR research that is personally relevant, benefits themselves and their communities, and is conducted in the context of trusting, reciprocal participant-researcher relationships. The findings point to the need for researchers to improve the informed consent process and to better engage individuals with NDDs in research.

"Just tell me what's going on": The views of parents of children with genetic conditions regarding the research use of their child's electronic health record.

OBJECTIVE: The purpose of this study was to understand the ethical, legal, and social issues described by parents of children with known or suspected genetic conditions that cause intellectual and developmental disabilities regarding research use of their child's electronic health record (EHR). MATERIALS AND METHODS: We conducted 4 focus groups with parents of children with a known (n = 12) or suspected (n = 11) genetic condition, as well as 2 comparison groups with parents who had a child with no known genetic condition (n = 15). Focus group transcripts were coded and analyzed using directed content analysis. RESULTS: After weighing the risks and benefits, parents of children with known or suspected genetic conditions were willing to share their child's EHR for research studies under certain conditions. Preferences were for studies conducted by universities or nonprofits that might benefit their child or others with the same condition. Parents also valued return of research results. DISCUSSION: Trust, transparency, altruism, and concerns about privacy emerged as factors that affect parents' willingness to allow research use of their child's EHR. CONCLUSION: Researchers should consider how to build trust with parents by increasing transparency of the research process and explaining specifically how they will ensure the confidentiality of EHR data.