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To explore issues surrounding re-consenting youth in longitudinal studies as they reach legal adulthood interviews were conducted with 46 parents plus 13 autistic teens enrolled in the Simons Foundation Powering Autism Research for Knowledge (SPARK) study. Qualitative analysis focused on family sensitivities regarding guardianship decisions, transition concerns, and the re-consenting process. Questions regarding guardianship were difficult for parents unsure of a teen’s future status. Mothers were key facilitators of re-consenting for soon-to-be-independent teens. As legal adulthood approached, parents were willing to assist teens with re-consenting but needed support, asking for multiple contacts, transition resources, and explanatory materials from the research team. Most teens were not cognizant of SPARK but willing to continue participation once made aware.

Background Rigorous simulation-based research is essential to advance the science of nursing education. This article outlines the use of the updated Simulation Research Rubric (SRR) to assess the quality of published simulation research articles. Methods The SRR was used to rate 73 published articles in the Clinical Simulation in Nursing from 2015 to 2017. All articles were reviewed and rated by two reviewers. Results Of the 73 articles reviewed, 15 (20.5%) received a rating of excellent (76%-100%), 39 (53.4%) were rated as good (51%-75%), and 19 (26%) were rated as fair (26%-50%). Inter-rater reliability was 0.92, with a content validity index of 0.95 for the SRR. Conclusions The strengths and weaknesses of two years of published simulation-based research reports were identified. Although the SRR was not intended to be used to evaluate research itself, the rubric can be used as a framework to develop a thorough research proposal, for rating grant proposals, and for teaching students how to critique written research reports.

BACKGROUND Psychological safety, essential in high-quality simulation-based education, positively influences learning behaviors and outcomes in corporate organizations. Current assessment of psychological safety is grounded in Edmondson's work team learning model. To understand applicability of this model in nursing education, a literature review was conducted. We reviewed literature on psychological safety in nursing education to assess support for this learning model constructs. Adapting existing models and assessment instruments in different contexts is an important contribution to the profession. METHODS A structured narrative review examined psychological safety in nursing education simulation literature to identify support for Edmondson's work team learning model constructs. RESULTS Included articles (n = 13) supported the Edmondson model constructs. When faculty practiced specific leader behaviors, learners experienced psychological safety and demonstrated specific learning-oriented behaviors. CONCLUSION Psychological safety literature in nursing education supports the work team learning model constructs. This link offers promise for transfer to an assessment instrument in nursing education.

Autism spectrum disorders (ASD) significantly impact lives of affected individuals and their families. They confront daunting challenges and multiple demands in their daily life, when compared to parents of children with other disabilities or parents of typically developing children.Participants completed The Caregiver Needs Survey, the survey intended for parents or primary caregivers of children with a diagnosis of ASD. During the study, 231 parents were interviewed; 167 mothers and 64 fathers. Parents were recruited from the patient database comprised of families from the two largest cities in Serbia. All of them were contacted before the study, either via phone or at the child's regular check-in visit.Over 90 percent of the parents reported that additional support at schools, home, and improved relationships with service providers are necessary and important. The most important challenges related to care were child's communication difficulties, social interaction difficulties, and problems with daily living skills. The significant predictors of lower overall satisfaction were parent's higher education, having a first concern related to problems of the child's interaction with others or playing alone, and parent frustration with accessing services in the past 12 months. Greater overall satisfaction, on the other hand, was related to having an in-school tutor training or assistance in managing child's needs or implementing treatments, and having primary care doctor or pediatrician as a source of information on autism.Future efforts to develop ASD-related policies and services should also take the following into consideration: the low level of awareness among caregivers and health care providers about the early signs of autism; disparities in access to services; educational problems and significant levels of dissatisfaction with the overall care and stigma.

The realisation of human potential for development requires age-specific investment throughout the 8000 days of childhood and adolescence. Focus on the first 1000 days is an essential but insufficient investment. Intervention is also required in three later phases: the middle childhood growth and consolidation phase (5-9 years), when infection and malnutrition constrain growth, and mortality is higher than previously recognised; the adolescent growth spurt (10-14 years), when substantial changes place commensurate demands on good diet and health; and the adolescent phase of growth and consolidation (15-19 years), when new responses are needed to support brain maturation, intense social engagement, and emotional control. Two cost-efficient packages, one delivered through schools and one focusing on later adolescence, would provide phase-specific support across the life cycle, securing the gains of investment in the first 1000 days, enabling substantial catch-up from early growth failure, and leveraging improved learning from concomitant education investments. Refereed/Peer-reviewed

Background Debriefing is critical to learning in simulation-based education. The body of research related to debriefing is growing. However, few empirical studies exist that define specific techniques that facilitate learning during debriefing. Methods This phenomenological study investigated baccalaureate nursing students' perceptions about the characteristics of debriefing that contributed to their ability to learn. Twenty-eight students participated in focus groups after simulation experiences. Results Five themes emerged as supporting the students' abilities to learn during debriefing in simulation-based education. The themes were: Safe Environment, Debriefing to Explore Thoughts, Feedback from Multiple Perspectives, All in This Together, and Group Facilitation. Conclusions This study provides guidance to debriefing facilitators regarding specific actions that can be taken to facilitate learning during debriefing discussions. Establishing an environment of psychological safety, drawing on multiple perspectives, conducting debriefing as a reflective conversation, and use of specific facilitation techniques were identified as being critical to learning during debriefing.

Objective: To assess care-seeking behaviors, perceptions of quality, and access to health services among populations affected by the 2007 Peruvian earthquake.Methods: A stratified cluster survey design was used to allow for comparison between urban, periurban, and rural populations of the 4 provinces most affected by the earthquake. Forty-two clusters of 16 households (n = 672) were interviewed approximately 6 months after the earthquake.Results: Of all of the respondents, 38% reported that a household member sought medical care within 2 weeks after the earthquake. Earthquake-related injury, presence of a chronic medical condition, and residence in temporary housing were significantly associated with care seeking in adjusted models. Individuals experiencing earthquake-related injuries and those with chronic medical conditions, respectively, were 7.1 times (95% confidence interval [CI] 3.7–13.7) and 1.9 times (95% CI 1.3–2.9) more likely to seek medical care; temporary housing residents were 1.7 times (95% CI 1.0–2.8) more likely to seek care than those residing in permanent housing.Conclusions: Earthquake-related injury and chronic medical conditions were associated with care seeking in the first 2 weeks after the 2007 Ica earthquake. Households living in temporary housing were more likely to seek medical care than those residing in permanent structures, suggesting that displaced people are more likely to need medical attention. (Disaster Med Public Health Preparedness. 2009;3:97–103)

Introduction. More than 500 million people live within the potential exposure range of a volcano. The risk of catastrophic losses in future eruptions is significant given population growth, proximities of major cities to volcanoes, and the possibility of larger eruptions. The objectives of this review are to describe the impact of volcanoes on the human population, in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of volcanoes were compiled using two methods, a historical review of volcano events from 1900 to 2009 from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between volcano mortality and characteristics using STATA 11. Findings. There were a total of 91,789 deaths (range: 81,703-102,372), 14,068 injuries (range 11,541-17,922), and 4.72 million people affected by volcanic events between 1900 and 2008. Inconsistent reporting suggests this is an underestimate, particularly in terms of numbers injured and affected. The primary causes of mortality in recent volcanic eruptions were ash asphyxiation, thermal injuries from pyroclastic flow, and trauma. Mortality was concentrated with the ten deadliest eruptions accounting for more than 80% of deaths; 84% of fatalities occurred in four locations (the Island of Martinique (France), Colombia, Indonesia, and Guatemala). Conclusions. Changes in land use practices and population growth provide a background for increasing risk; in conjunction with increasing urbanization in at risk areas, this poses a challenge for future volcano preparedness and mitigation efforts.

Introduction. Population growth and increasing urbanization in earthquake-prone areas suggest that earthquake impacts on human populations will increase in the coming decades. Recent large earthquakes affecting large populations in Japan, Haiti, Chile and New Zealand are evidence of this trend and also illustrate significant variations in outcomes such damage and mortality levels. The objectives of this review were to describe the impact of earthquakes on human populations in terms of mortality, injury and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of earthquakes were compiled using two methods, a historical review from 1980 to mid 2009 of earthquake events from multiple databases and a systematic literature review of publications, ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between earthquake mortality and characteristics using STATA 11. Findings. From 1980 through 2009, there were a total of 372,634 deaths (range 314,634-412,599), 995,219 injuries (range: 845,345-1,145,093), and more than 61 million people affected by earthquakes, and mortality was greatest in Asia. Inconsistent reporting across data sources suggests that the numbers injured and affected are likely underestimates. Findings from a systematic review of the literature indicate that the primary cause of earthquake-related death was trauma due to building collapse and, the very young and the elderly were at increased mortality risk, while gender was not consistently associated with mortality risk. Conclusions. Strategies to mitigate the impact of future earthquakes should include improvements to the built environment and a focus on populations most vulnerable to mortality and injury.

Background. Floods are the most common natural disaster and the leading cause of natural disaster fatalities worldwide. Risk of catastrophic losses due to flooding is significant given deforestation and the increasing proximity of large populations to coastal areas, river basins and lakeshores. The objectives of this review were to describe the impact of flood events on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters Methods. Data on the impact of floods were compiled using two methods, a historical review of flood events from 1980 to 2009 from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics, bivariate tests for associations and multinomial logistic regression of flood characteristics and mortality using Stata 11.0. Findings. There were 539,811 deaths (range: 510,941 to 568,680), 361,974 injuries and 2,821,895,005 people affected by floods between 1980 and 2009. Inconsistent reporting suggests this is an underestimate, particularly in terms of the injured and affected populations. The primary cause of flood-related mortality is drowning; in developed countries being in a motor-vehicle and male gender are associated with increased mortality, whereas female gender may be linked to higher mortality in low-income countries. Conclusions. Expanded monitoring of floods, improved mitigation measures, and effective communication with civil authorities and vulnerable populations has the potential to reduce loss of life in future flood events.

To quantify earthquake injury and mortality from the 2007 Ica earthquake in Peru and to assess earthquake-related risk and vulnerability.A population-based cluster survey of households in the region most affected by the earthquake. A stratified cluster survey design was used to allow for comparison between urban, periurban, and rural areas, where different outcomes were anticipated as a result of variation in building practices and access to post-earthquake assistance. A total of 42 clusters of 16 households were planned to allow for comparison between the location types and to ensure adequate spatial coverage.The four affected provinces in Southern Peru: Ica, Pisco, Chincha, and Canete.A total of 672 randomly selected households with a combined population of 3,608 individuals, of which 3,484 (97 percent) were reported as household members on the day of the earthquake.Mortality and injury rates in the four most affected provinces were estimated at 1.4 deaths/ 1,000 exposed (95 CI: 0.5-3.3) and 29 injuries/1,000 exposed (95 CI: 6-52). Older adults and members of households of lower socioeconomic status faced increased risk of injury. No significant differences in injury rates were observed between rural, urban, and peri-urban residence areas.Populations of lower socioeconomic status faced increased risk of injury; however, no differences in injury rates were observed between rural, urban, and peri-urban communities. Study findings suggest that earthquake preparedness and mitigation efforts should focus on population subgroups of lower socioeconomic in both rural and urban areas of earthquake-prone regions.

The dictum "a quart of milk a day for every child" is largely the result of an investigation by Sherman and Hawley 1 in which it was shown that the optimum amount of calcium is retained only when approximately 1 quart of milk is included in the diet. Calcium from other sources was found to be less available, lower amounts being retained when the calcium was supplied more largely from vegetables and fruits. The variations in the retentions of calcium of children who were living under comparable conditions as well as the results reported in more recent studies with both children and adults 2 suggest that the difference in the amounts of calcium retained may be due in part to the lack of uniformity in the physiologic condition of the persons studied. For example, the potentialities of growth in children or the physiologic balance in adults may have been less