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69 Psychometric Properties of the PediaTrac Social/Communication/Cognition Domain
- Michelle Lobermeier, Samantha Levick, Trivellore Raghunathan, Patricia Berglund, Seth Warschausky, Alissa Huth-Bocks, H. Gerry Taylor, Angela D Staples, Jennifer Cano, Renee Lajiness-O’Neill
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 744-745
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Objective:
Research has established the importance of early identification and intervention for children with developmental disorders and delays. In striving toward earlier recognition and treatment of developmental concerns, it is crucial to have a universal system to monitor infant and toddler development over time. This system should comprehensively assess the desired areas of development, be based on normative data from large samples, and have strong psychometric properties. While a few developmental monitoring tools are currently in use, they lack many of the aforementioned qualities. The current study reports on the cross-sectional psychometric properties of PediaTrac, which is a novel caregiver-report measure of infant and toddler development. Specifically, this study focuses on psychometric properties of PediaTrac’s social/communication/cognition (SCG) domain during the first 9 months of life.
Participants and Methods:The current sample included 571 caregiver-infant dyads recruited into term (n=331) and preterm (n=240) groups. Participants were from the PediaTrac multisite, longitudinal study and were socioeconomically (41.9% below median income) and racially (33.6% Black, 47.6% White, 11.0% multiracial/other) diverse. Data included caregiver reports of infant development from the SCG domain of PediaTrac at 5 sampling periods (newborn, 2, 4, 6, and 9 months). Item response theory (IRT) graded response modeling was used to estimate theta, an index of the latent trait, social/communication/cognition. Exploratory factor analysis (EFA) was used to further examine the underlying structure of the SCG domain.
Results:Mean theta values could be reliably estimated at all time periods and followed a linear trend consistent with development. At 9 months, theta values were statistically different between the term and preterm groups, indicating that term infants demonstrated more advanced SCG abilities. Item parameters (discrimination and difficulty) could be modeled at each time period across the range of ability. Reliability of the SCG domain ranged from 0.97 to 0.99. Results of the EFA suggested a two-factor solution (affect/emotional expression, social responsiveness) at the newborn period accounting for 43% of the variance, a three-factor solution (affect/emotional expression, social responsiveness, imitation/emerging communication) at the 2-, 4-, and 6-month periods accounting for 43%, 34%, and 34% of the variance, respectively, and a four-factor solution (affect expression, social responsiveness, imitation/communication, nonverbal/gestural communication) at the 9-month period accounting for 34% of the variance.
Conclusions:The PediaTrac SCG domain has strong psychometric properties, including reliability estimates higher than other existing caregiver-report measures of SCG abilities. EFA analyses demonstrated that the structure of affect/emotional expression and social responsiveness remains relatively stable and may reflect affective and regulatory aspects of temperament. Conversely, the quality and type of communication continually develops and becomes more differentiated throughout the time periods of interest. Notably, parents appear to be capable of observing and reliably reporting on their infants’ abilities in these areas. The use of a universal screening tool developed with rigorous psychometric methods, such as PediaTrac, could transform the way that clinicians identify infants in need of early intervention.
Complementary feeding practices and their association with adiposity indicators at 12 months of age
- Ameyalli M. Rodríguez-Cano, Jennifer Mier-Cabrera, Carolina Rodríguez-Hernández, Ana L Allegre-Dávalos, Cinthya Muñoz-Manrique, Otilia Perichart-Perera
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- Journal:
- Journal of Developmental Origins of Health and Disease / Volume 12 / Issue 5 / October 2021
- Published online by Cambridge University Press:
- 23 November 2020, pp. 780-787
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Nutrition during the first 1000 days of life represents a window of opportunity to reduce the risk of metabolic dysfunctions later in life. Exclusive breastfeeding (EBF) and adequate introduction of solid foods are essential to promote metabolic and nutritional benefits. We evaluated the association of infant feeding practices from birth to 6 months (M) with adiposity indicators at 12 M. We performed a secondary analysis of 106 healthy term infants born from a cohort of healthy pregnant women. Type of breastfeeding (exclusive or nonexclusive), the start of complementary feeding (CF) (before (<4 M) or after (≥4 M)), and adiposity (body mass index – BMI, body mass index-for-age – BMI/A, waist circumference – WC, and waist circumference–length ratio – WLR) were evaluated at 12 M using descriptive statistics, mean differences, X2, and linear regression models. During the first 6 M, 28.3% (n = 30) of the infants received EBF. Early CF (<4 M) was present in 26.4% (n = 28) of the infants. Children who started CF < 4 M were less breastfed, received added sugars as the most frequently introduced food category, and showed higher BMI, BMI/A, WC, and WLR; those who consumed added sugars early (<4 M) had a higher WC. Starting CF < 4 M was the main factor associated with a higher WC at 12 M. Unhealthy infant feeding practices, such as lack of EBF, early CF, and early introduction of sugars, may be associated with higher adiposity at 12 M.
Patterns and Predictors of UTI Treatment Practices in Nursing Homes
- James H. Ford II, Dee Heller, Kathi Selle, Susan Nordman-Oliveira, Jennifer Robinson, Sally Jolles, Daniela Uribe-cano, Christopher Crnich
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, p. s345
- Print publication:
- October 2020
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Background: Suspicion of urinary tract infection (UTI) is the most common justification for prescribing antibiotics in nursing homes. More than half of antibiotic prescriptions for treatment of UTI in nursing homes are either unnecessary or inappropriate. Achieving a better understanding of the factors that underlie UTI treatment decisions is necessary to improve the quality of antibiotic prescribing in nursing homes. An ongoing hybrid type 2 effectiveness-implementation cluster randomized trial of a recently developed nursing home UTI recognition and management tool kit provided us with an opportunity to explore the influence of organizational, clinical, and staff attributes on UTI antibiotic prescribing practices in nursing homes. Methods: Data on antibiotic starts for suspected UTIs were collected in 29 nursing homes over a 9-month period. Antibiotic practices evaluated included total antibiotic starts per 1,000 resident days, % antibiotic starts with treatment duration >7 days, % antibiotic starts in which the initial antibiotic choice was a fluoroquinolone, and % antibiotic starts meeting UTI tool-kit criteria of appropriateness. Prior research and bivariate analyses were used to select clinical and organizational attributes as well as individual nursing staff-level retention rates for inclusion in a stepwise linear regression model for each antibiotic practice outcome. Results: In total, 602 UTI antibiotic events were evaluated. Four associations were identified for antibiotic starts including nursing home urine culture rate, ICP status, nonprofit and part-time LPN retention. Nursing homes with higher full-time LPN retention had a lower rate of antibiotic treatment duration >7 days. Full-time CNAs and part-time LPNs retention and for-profit status was associated with the proportion of fluoroquinolone antibiotic starts. No attributes influenced the proportion of antibiotic starts meeting appropriateness criteria (Fig. 1). Urine culture rates are driving overall nursing home antibiotic prescribing. Conclusions: Urine culture practices was strongly associated with UTI treatment rates in nursing homes. A variety of organizational characteristics were also associated with UTI treatment rates as well as other UTI antibiotic prescribing practices. Some of these associations appear paradoxical but may reflect increasing resident acuity and increased capacity to standardize practices through organizational centralization.
Funding: Support for the project provided by the Wisconsin Partnership Program.
Disclosures: None
Contributors
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- By Charles E. Argoff, Gerard A. Banez, Samantha Boris-Karpel, Barbara K. Bruce, Alexandra S. Bullough, Annmarie Cano, Victor T. Chang, Elizabeth A. Clark, Daniel J. Clauw, June L. Dahl, Tam K. Dao, Amber M. Davis, Courtney L. Dixon, Michael H. Ebert, Robin M. Gallagher, Gerald W. Grass, Carmen R. Green, Jay Gunkelman, Bradford D. Hare, Jennifer A. Haythornthwaite, Jaclyn Heller Issner, W. Michael Hooten, Mark P. Jensen, Mark E. Jones, Robert D. Kerns, Raphael J. Leo, Morris Maizels, Mary E. Murawski, Brooke Myers-Sorger, Akiko Okifuji, Renata Okonkwo, John D. Otis, Stacy C. Parenteau, Laura E. Pence, Donald B. Penzien, Donna B. Pincus, Ellyn Poltrock Stein, Wendy J. Quinton, Jeanetta C. Rains, M. Carrington Reid, Thomas J. Romano, Jeffrey D. Rome, Robert L. Ruff, Suzanne S. Ruff, Steven H. Sanders, Ingra Schellenberg, John J. Sellinger, Howard S. Smith, Brenda Stoelb, Jon Streltzer, Mark D. Sullivan, Kimberly S. Swanson, Gabriel Tan, Stephen Thielke, Beverly E. Thorn, Cynthia O. Townsend, Dennis C. Turk, Stephanie C. Wallio, Lawrence J. Weinberger, David A. Williams, Hilary Wilson
- Edited by Michael H. Ebert, Yale University, Connecticut, Robert D. Kerns, Yale University, Connecticut
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- Book:
- Behavioral and Psychopharmacologic Pain Management
- Published online:
- 10 January 2011
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- 25 November 2010, pp ix-xii
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