Search

This national study explored the role of digital technologies in early childhood education and care settings and whether they could contribute to quality improvement as reported by educators and assessors of quality in Australia. In this paper, data from Stage 2 of the Quality Improvement Research Project were used, which comprised 60 Quality Improvement Plans from educators linked with 60 Assessment and Rating reports from the assessors who visited early childhood centres as part of the administration of the National Quality Standards by each of Australia's State and Territory jurisdictions. Bronfenbrenner's ecological systems theory (Bronfenbrenner, U. (1995). Developmental ecology through space and time: A future perspective. In P. Moen, G.H. Elder, Jr., & K. Lüscher (Eds.), Examining lives in context: Perspectives on the ecologyof human development (pp. 619-647). American Psychological Association. https://doi.org/10.1037/10176-018; Bronfenbrenner & Ceci, Bronfenbrenner and Ceci, Psychological Review 101:568-586, 1994) was adopted to facilitate a systemic and dynamic view on the use of digital technologies in these 60 ECEC settings. References (e.g. comments/ suggestions/ examples) made by the educators about the implementation of digital technologies were counted and thematically analysed. Results revealed the strong role new technologies (e.g. documentation and management platforms, tablets, apps, etc.) play in the majority of ECEC settings and especially in relation to three of the seven Quality Areas: Educational programme and practice (Quality Area 1); Collaborative partnerships with families and communities (Quality Area 6) and Governance and leadership (Quality Area 7). Future directions for research are suggested and implications for embracing a more holistic, integrated and broad view on the use of digital technologies are discussed.

We investigated how educators, mothers and children used temporal language in reminiscing and future talk conversations. Participants initially included 40 educator-younger child dyads (27-36 months) and 45 educator-older child dyads (48-60 months) from early childhood centres in Sydney, Australia. Educators were asked to nominate and discuss four past and future events with the participating children. To determine how conversations about different events might vary, temporal focus (past/future) and event novelty (novel/familiar) were manipulated. To enable comparisons between educator-child and mother-child use of temporal language 42 mother-child dyads also completed the same tasks. Educators were noted to use timeless present references to add new information about events. With the older children, educators made significantly more future action and future hypothetical references. Educators' use of future hypothetical references was significantly greater than that of mothers. Educators used reminiscing and future talk conversations to extend children's exposure to temporal language.

When children reminisce with adults about their own past experiences, they are offered a rich forum in which to develop cognitive and socioemotional skills, build their sense of self, and form emotional bonds. Little attention has been directed to reminiscing in educational contexts, however. Our aim was to explore when, how often, and why early childhood educators engage young children in reminiscing conversations. Participants included 251 Australian educators with 1-45 years of experience. Educators completed an online survey asking them (i) the number of times per day they engaged children in reminiscing, relative to other types of talk, and (ii) the times and places these reminiscing conversations were most likely to occur. While individual differences were apparent, more than 85% of educators reporting engaging children in reminiscing multiple times per day. Popular times included arrival (67.7%), meals (65.7%) and group/circle time (58.2%). Educators' qualitative explanations suggested several important reasons to engage children in reminiscing, including to bond, establish home-centre connections, build children's socioemotional competence, reflect on 'centre life' and support intentional learning activities. Implications for research and practice are discussed.

Pedagogical documentation within early childhood centres is a key component of pedagogy and teacher accountability. In Singapore, documentation is a requirement specified under legislative policies included in the national Pre-school Accreditation Framework, with parents often perceived as the main audience. This paper reports on a study utilising Rogoff's observation on social cultural activities to focus on the interconnectedness between children, parents and teachers as stakeholders in the early childhood sector. An electronic survey was used to ascertain parents' perspectives on documentation of their child's learning and development. Analysis of this data was shared in five individual teacher interviews to explore responses to the parents' perspectives. Findings of this study affirmed that documentation varied as a process and a product of pedagogy in early childhood centres. Within a climate of assessment and accountability, these findings invite inquiry and offer possibilities for professional learning on improving pedagogical documentation across the sector.

A novel experimental method is motivated and applied in aneffort to test for effects of category learning on perceptualdiscrimination so as to clearly distinguish category boundaryeffects of expansion and compression from changes insensitivity to stimulus dimensions. The method includes acontrol group performing a task that, like category learning,requires attention to one systematically varying stimulusdimension rather than another. Discrimination accuracy istracked over time and measured using a psychophysicalstaircase procedure tailored to individual participants thatdoesn’t rely on memory. Initial results suggest improvementin discrimination accuracy over time, particularly on thedimension relevant to the categorization or control task, butno evidence of category boundary effects or effects ofcategory learning on dimension perception stronger than thoseof the control task. Possible reasons for this and directions forfurther research are briefly discussed .

Government funded mentoring programs are one strategy to address the supply crisis of early childhood teachers (ECTs) in Australia. There is little or no published research on the long-term impacts of these programs. This paper presents the findings of an evaluation survey completed 18 months after the mentoring program finished, covering the perspectives of experienced ECTs (mentors) and beginning ECTs (mentees). The participants (N = 39) reported personal and professional growth over the period of the program. Subsequently, their enriched knowledge, skills and understanding of mentoring impacted their own, other individuals and wider practices within their workplaces. Enablers to participation were a supportive director and the scheduling of the program out of hours. The predominant challenge for ongoing enactment of learnings was time constraints due to daily demands of early childhood workplaces. Recommendations for sustainability of effective mentoring practices are proffered and warrant the attention of governments, employers and the sector. [ABSTRACT FROM AUTHOR]

This study investigated the characteristics of educators' talk about decontextualised events with young children in seven early childhood long day care centres in Sydney, Australia. Educators were partnered with up to six children aged between 27 and 60 months. Across two time points, 85 educator-child dyads discussed past and future events. Educators' use of questions, contextual statements, evaluations and prompts and children's use of questions, open-ended responses, yes-no responses and spontaneous information statements were examined. Educators' evaluative statements were highly correlated and educators' questions were moderately correlated with children's open-ended responses in past event conversations. Educators' evaluative statements were highly correlated with children's open-ended responses in future event conversations and were the only significant predictor for children's talk. Given the important role of educators in scaffolding children's thinking and communication skills, the recommended strategies for educators' talk in decontextualised conversations include: sharing the conversational load, making frequent contextual statements and following the child's lead/interests.

Research findings: No research to date has compared mental state language (MSL) in conversations between children and different adult talk partners, such as mothers and educators. The aim of this study was to investigate the use of MSL (verbalization of mental states such as remembering, knowing and thinking) by children, educators, and mothers during conversations about the past and future. Eighty-five educator-child dyads from seven childcare centers in Sydney, Australia participated in eight conversations that varied by temporal (past/future) and novelty (novel/familiar) focus. Ten educators talked with 40 younger children (27-36 months), and 11 talked with 45 older children (48-60 months). A subsample of 42 mother-child dyads completed the same tasks: 20 with the younger children (27-36 months) and 22 with the older children (48-60 months). Educators used significantly more MSL than mothers. Compared to diploma-qualified educators, degree trained educators were especially likely to use more MSL. Educators' MSL was significantly associated with children's MSL for future talk conversations only. Practice or Policy: Educators' and mothers' MSL may influence children in different ways. Pre-service teacher training appears to facilitate educators' own use of MSL. More research is needed to determine why children use more MSL with their mothers than with their educators. Practice or Policy

Myeloma bone disease (MBD) affects ~90% of multiple myeloma patients, but current treatment options are suboptimal. Therefore, to successfully develop new therapies or optimize current ones, we must improve our fundamental knowledge of how myeloma affects bone microstructure and function. Here, we have investigated the osteocyte lacuno-canalicular network (LCN) in MBD, as bone porosity affects bone quality and resilience. We used the syngeneic 5TGM1-C57BL-Kalwrij and the xenograft U266-NSG models at end stage and compared them to healthy controls (naïve). Micro-computed tomography (μCT) and histomorphometry indicated the 5TGM1 and U266 models developed mild and extensive MBD, respectively, with the U266 model producing large osteolytic lesions. High-resolution synchrotron micro-CT (SR-μCT) revealed significant osteocyte lacunae changes in U266 bones but not 5TGM1, with a reduction in lacunae number and sphericity, and an increase in lacunae volume compared with naïve. Canalicular length, visualized using histological Ploton silver staining, appeared significantly shorter in 5TGM1 and U266 bones compared with naïve. Canalicular area as a proportion of the bone was also decreased by 24.2% in the U266 model. We observed significant upregulation of genes implicated in peri-lacunar remodeling (PLR), but immunohistochemistry confirmed that the osteocyte-specific protein sclerostin, a known driver of PLR, was unchanged between MBD and naïve bones. In summary, we have demonstrated evidence of PLR and altered organization of the osteocyte LCN in MBD mouse models. The next step would be to further understand the drivers and implications of PLR in MBD, and whether treatments to manipulate PLR and the LCN may improve patient outcomes. Lay Summary: Multiple myeloma is a blood cancer that causes bone damage in ~90% of patients. Currently, treatment options for myeloma bone disease (MBD) are suboptimal, leaving patients with chronic pain and increased fracture risk. Therefore, it is important that we improve our fundamental knowledge of how myeloma causes bone damage. With the development of more powerful imaging technologies, this allows us to visualize bone at the submicron level. Here, we assessed bones from two murine models of MBD (termed 5TGM1 and U266) and compared them to bones from healthy control mice (naïve). Using high-resolution imaging (SR-μCT), we found structural changes in the pores where the most abundant bone cells (osteocytes) reside, and that the orientation of their signaling network (lacuno-canalicular network, LCN) is altered in MBD compared with healthy bones. We also found differences in gene expression of key molecules in osteocytes from bones with MBD compared with healthy bones and identified a potential mechanism leading to these changes. The next step would be to use this knowledge to determine how myeloma treatments can affect the osteocyte LCN, as this may allow informed treatment decisions to be made, potentially reducing fracture risk and improving outcomes for patients with MBD. Graphical Abstract [ABSTRACT FROM AUTHOR]

This position paper from the American College of Physicians (ACP) presents a review of current performance measures for major depressive disorder (MDD) to inform physicians, payers, and policymakers about their quality and appropriateness for use in various measurement programs. The paper also highlights challenges related to developing performance measures that address MDD management. Major depressive disorder (MDD) is a severe mood disorder that affects at least 8.4% of the adult population in the United States. Characteristics of MDD include persistent sadness, diminished interest in daily activities, and a state of hopelessness. The illness may progress quickly and have devastating consequences if left untreated. Eight performance measures are available to evaluate screening, diagnosis, and successful management of MDD. However, many performance measures do not meet the criteria for validity, reliability, evidence, and meaningfulness. The American College of Physicians (ACP) embraces performance measurement as a means to externally validate the quality of care of practices, medical groups, and health plans and to drive reimbursement processes. However, a plethora of performance measures that provide low or no value to patient care have inundated physicians, practices, and systems and burdened them with collecting and reporting of data. The ACP's Performance Measurement Committee (PMC) reviews performance measures using a validated process to inform regulatory and accreditation bodies in an effort to recognize high-quality performance measures, address gaps and areas for improvement in performance measures, and help reduce reporting burden. Out of 8 performance measures, the PMC found only 1 measure (suicide risk assessment) that was valid at all levels of attribution. This paper presents a review of MDD performance measures and highlights opportunities to improve performance measures addressing MDD management. [ABSTRACT FROM AUTHOR]

Students who enrol in a Bachelor of Education (Early Childhood Education) at the Institute of Early Childhood, Macquarie University, with a Diploma in Children's Services attained from a Technical and Further Education (TAFE) institution or a Registered Training Organisation (RTO) often experience challenges in their first professional experience unit. Utilising a phenomenological approach to understand the students' previous knowledge and experiences as they navigated through their first professional experience unit, this qualitative study identified factors including institutional structures and course content as challenging to the diploma student. To ensure diploma students can successfully transition to and participate in their first professional experience unit at university, all stakeholders including the university, the academics teaching the students, and the students themselves need to commit to a multilevel support programme. Key findings from this study support the previous research on this student cohort.

The Population Health and Medical Science Committee of the American College of Physicians (ACP) updates the living, rapid practice points on the treatment of adults with COVID-19 in an outpatient setting. Practice points are based on a living, rapid review done by the ACP Center for Evidence Reviews at Cochrane Austria at the University for Continuing Education Krems. Description: Evidence for the use of outpatient treatments in adults with confirmed COVID-19 continues to evolve with new data. This is version 2 of the American College of Physicians (ACP) living, rapid practice points focusing on 22 outpatient treatments for COVID-19, specifically addressing the dominant SARS-CoV-2 Omicron variant. Methods: The Population Health and Medical Science Committee (formerly the Scientific Medical Policy Committee) developed this version of the living, rapid practice points on the basis of a living, rapid review done by the ACP Center for Evidence Reviews at Cochrane Austria at the University for Continuing Education Krems (Danube University Krems). This topic will be maintained as living and rapid by continually monitoring and assessing the impact of new evidence. Practice Point 1: Consider molnupiravir to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease. Practice Point 2: Consider nirmatrelvir–ritonavir combination therapy to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease. Practice Point 3: Do not use ivermectin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting. Practice Point 4: Do not use sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting. [ABSTRACT FROM AUTHOR]

Several performance measures have been developed to assess and improve osteoporosis screening, diagnosis, and treatment. These performance measures vary in quality but are often used in accountability, public reporting, and/or payment programs. This article evaluates 6 osteoporosis performance measures relevant to internal medicine physicians to inform physicians, payers, and policy makers in their selection and interpretation of performance measures for this condition. Primary osteoporosis is characterized by decreasing bone mass and density and reduced bone strength that leads to a higher risk for fracture, especially hip and spine fractures. The prevalence of osteoporosis in the United States is estimated at 12.6% for adults older than 50 years. Although it is most frequently diagnosed in White and Asian females, it still affects males and females of all ethnicities. Osteoporosis is considered a major health issue, which has prompted the development and use of several performance measures to assess and improve the effectiveness of screening, diagnosis, and treatment. These performance measures are often used in accountability, public reporting, and/or payment programs. However, the reliability, validity, evidence, attribution, and meaningfulness of performance measures have been questioned. The purpose of this paper is to present a review of current performance measures on osteoporosis and inform physicians, payers, and policymakers in their selection of performance measures for this condition. The Performance Measurement Committee identified 6 osteoporosis performance measures relevant to internal medicine physicians, only 1 of which was found valid at all levels of attribution. This paper also proposes a performance measure concept to address a performance gap for the initial approach to therapy for patients with a new diagnosis of osteoporosis based on the current American College of Physicians guideline. [ABSTRACT FROM AUTHOR]