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Background: Understanding teachers' appraisals of student wellness services and supports during COVID-19 is essential to strengthening services and improving student health outcomes. This mixed-method study aimed to examine US PK-12 teachers' appraisals of student wellness services and supports during COVID-19. Methods: This study focuses on qualitative data from 291 teachers' open-ended responses to the question: "What do you wish your school leaders knew about this (wellness support) aspect of your work?" and whose responses described wellness services and supports. A qualitative content analysis was conducted by an interdisciplinary research team using open- and axial coding. Results: Three main themes emerged. (1) insufficient access to mental health professionals and programming at schools, (2) concern about the quality of available services, and (3) a need for teacher professional development and support on student wellness. Statistically significant differences in teacher appraisals of insufficient access to mental health professionals and programming were found based on grade level taught and percentage of immigrant students in the school. Conclusion: With amplified student wellness needs, school personnel, including school leaders, must consider ways to allocate additional resources/staffing, assess the quality of services and supports, and design professional development opportunities to support teachers' involvement in supporting student wellness needs.

Despite the common and growing use of and instruction on digital reading in schools, the ways in which reading comprehension may operate differently in paper and online environments are still underexplored. Using publicly available national datasets, we explore similarities and differences in how varied comprehension processes relate to each other in these spaces. Analyses using a Bayesian unidimensional graded response model found that paper-based reading performance involved hierarchical comprehension processes consistent with traditional theories of reading comprehension while digital hypermedia reading did not involve these same processes. This research provides usable knowledge for supporting researchers, and teachers in uncovering the unique educational benefits and challenges of online reading.

Classroom quality measures, such as the Early Childhood Environment Rating Scale, Revised (ECERS-R), are widely used in research, practice, and policy. Increasingly, these uses have been for purposes not originally intended, such as contributing to consequential policy decisions. The current study adds to the recent evidence of problems with the ECERS-R standard stop-scoring by analyzing eight studies offering 14 waves of data collection in approximately 4,000 classrooms. Our analysis, which featured the nominal response model, generalized partial credit model, partial credit model, within-category averages of total scores, and point-biserial correlations, revealed that all 36 items had categories that did not follow an ordinal progression with respect to quality. Additionally, our results showed that the category problems accumulated to the scale score. The results caution against the use of the standard raw scoring and encourage development of alternative scoring methods for the ECERS-R.

Substance Use Disorder (SUD) is a major public health concern affecting an estimated 22.5 million individuals in the United States. The primary aim of this study was to characterize psychological pain in a cohort of patients participating in outpatient treatment for SUD. A secondary aim was to determine the relationships between pre-treatment assessments of psychological pain, depression, anxiety and hopelessness with treatment retention time and completion rates. Data was analyzed from 289 patients enrolled in an outpatient community drug treatment clinic in Southern California, U.S. A previously determined threshold score on the Mee-Bunney Psychological Pain Assessment Scale (MBP) was utilized to group patients into high and low-moderate scoring subgroups. The higher pain group scored higher on measures of anxiety, hopelessness and depression compared to those in the low-moderate pain group. Additionally, patients scoring in the higher psychological pain group exhibited reduced retention times in treatment and more than two-fold increased odds of dropout relative to patients with lower pre-treatment levels of psychological pain. Among all assessments, the correlation between psychological pain and treatment retention time was strongest. To our knowledge, this is the first study to demonstrate that psychological pain is an important construct which correlates with relevant clinical outcomes in SUD. Furthermore, pre-treatment screening for psychological pain may help target higher-risk patients for clinical interventions aimed at improving treatment retention and completion rates.

The current investigation addresses critiques about motivation terminology and instrumentation by examining together three commonly used reading motivation assessments in schools. This study explores the distinctiveness and redundancies of the constructs operationalized in these reading motivation assessments with 222 middle school students, using item response theory. Results support distinctions between constructs grounded in self-determination theory, social cognitive theory, and expectancy-value theory as well as conceptual overlap, among constructs associated with competence beliefs and social sources of motivation across different theoretical traditions. Educational benefits of multidimensional and unidimensional interpretations of reading motivation constructs covered in these instruments are discussed.

Although item response theory (IRT) models such as the bifactor, two-tier, and between-item-dimensionality IRT models have been devised to confirm complex dimensional structures in educational and psychological data, they can be challenging to use in practice. The reason is that these models are multidimensional IRT (MIRT) models and thus are highly parameterized, making them only suitable for data provided by large samples. Unfortunately, many educational and psychological studies are conducted on a small scale, leaving the researchers without the necessary MIRT models to confirm the hypothesized structures in their data. To address the lack of modeling options for these researchers, we present a general Bayesian MIRT model based on adaptive informative priors. Simulations demonstrated that our MIRT model could be used to confirm a two-tier structure (with two general and six specific dimensions), a bifactor structure (with one general and six specific dimensions), and a between-item six-dimensional structure in rating scale data representing sample sizes as small as 100. Although our goal was to provide a general MIRT model suitable for smaller samples, the simulations further revealed that our model was applicable to larger samples. We also analyzed real data from 121 individuals to illustrate that the findings of our simulations are relevant to real situations.

Multilevel bifactor item response theory (IRT) models are commonly used to account for features of the data that are related to the sampling and measurement processes used to gather those data. These models conventionally make assumptions about the portions of the data structure that represent these features. Unfortunately, when data violate these models' assumptions but these models are used anyway, incorrect conclusions about the cluster effects could be made and potentially relevant dimensions could go undetected. To address the limitations of these conventional models, a more flexible multilevel bifactor IRT model that does not make these assumptions is presented, and this model is based on the generalized partial credit model. Details of a simulation study demonstrating this model outperforming competing models and showing the consequences of using conventional multilevel bifactor IRT models to analyze data that violate these models' assumptions are reported. Additionally, the model's usefulness is illustrated through the analysis of the Program for International Student Assessment data related to interest in science.

Psychological pain is a relatively understudied and potentially important construct in the evaluation of suicidal risk. Psychological pain also referred to as 'mental pain' or 'psychache' can be defined as an adverse emotional reaction to a severe trauma (e.g., the loss of a child) or may be associated with an illness such as depression. When psychological pain levels reach intolerable levels, some individuals may view suicide as the only and final means of escape. To better understand psychological pain, we previously developed and validated a brief self-rating 10-item scale, Mee-Bunney Psychological Pain Assessment Scale [MBP] in depressed patients and non-psychiatric controls. Our results showed a significant increase in psychological pain in the depressed patients compared to controls. We also observed a significant linear correlation between psychological pain and suicidality in the depressed patient cohort. The current investigation extends our study of psychological pain to a diagnostically heterogeneous population of 57 US Veterans enrolled in a suicide prevention program. In addition to the MBP, we administered the Columbia Suicide Severity Rating Scale (C-SSRS), Beck Depression Inventory (BDI-II), Beck Hopelessness Scale (BHS), and the Barratt Impulsiveness Scale (BIS-11). Suicidal patients scoring above a predetermined threshold for high psychological pain also had significantly elevated scores on all the other assessments. Among all of the evaluations, psychological pain accounted for the most shared variance for suicidality (C-SSRS). Stepwise regression analyses showed that impulsiveness (BIS) and psychological pain (MBP) contributed more to suicidality than any of the other combined assessments. We followed patients for 15 months and identified a subgroup (24/57) with serious suicide events. Within this subgroup, 29% (7/24) had a serious suicidal event (determined by the lethality subscale of the C-SSRS), including one completed suicide. Our results build upon our earlier findings and recent literature supporting psychological pain as a potentially important construct. Systematically evaluating psychological pain along with additional measures of suicidality could improve risk assessment and more effectively guide clinical resource allocation toward prevention.

Advancements in item response theory (IRT) have led to models for dual dependence, which control for cluster and method effects during a psychometric analysis. Currently, however, this class of models does not include one that controls for when the method effects stem from two method sources in which one source functions differently across the aspects of another source (i.e., a nested method-source interaction). For this study, then, a Bayesian IRT model is proposed, one that accounts for such interaction among method sources while controlling for the clustering of individuals within the sample. The proposed model accomplishes these tasks by specifying a multilevel trifactor structure for the latent trait space. Details of simulations are also reported. These simulations demonstrate that this model can identify when item response data represent a multilevel trifactor structure, and it does so in data from samples as small as 250 cases nested within 50 clusters. Additionally, the simulations show that misleading estimates for the item discriminations could arise when the trifactor structure reflected in the data is not correctly accounted for. The utility of the model is also illustrated through the analysis of empirical data.

ObjectiveNo randomized controlled trials (RCTs) for adults have compared the effectiveness of a well-specified psychotherapy and a culturally adapted version of the same treatment. This study evaluated the effectiveness of cognitive-behavioral therapy (CBT) and culturally adapted CBT (CA-CBT) in treating depressed Chinese-American adults.MethodsThis RCT treated 50 Chinese Americans who met criteria for major depression and sought treatment at community mental health clinics. Screening of participants began in September 2008, and the last assessment was conducted in March 2011. Participants were stratified by whether they were already taking antidepressants when they first came to the clinic and randomly assigned to 12 sessions of CBT or CA-CBT. The study did not influence regular prescription practices. The primary outcomes were dropout rates and Hamilton Depression Rating Scale scores at baseline, session 4, session 8, and session 12.ResultsParticipants in CA-CBT demonstrated a greater overall decrease in depressive symptoms compared with participants in CBT, but the groups had similarly high depression rates at week 12. Differences in dropout rates for the two groups approached, but did not meet, statistical significance (7%, CA-CBT; 26%, CBT).ConclusionsChinese Americans entered this study with very severe depression. Participants in both CBT and CA-CBT demonstrated significant decreases in depressive symptoms, but the majority did not reach remission. Results suggest that these short-term treatments were not sufficient to address such severe depression and that more intensive and longer treatments may be needed. Results also indicate that cultural adaptations may confer additional treatment benefits.

Objectives: Many congenital hydronephroses spontaneously resolve. This study evaluated a long‐term follow‐up of more than 4 years of patients with congenital hydronephrosis at a single center. Methods: In total, 215 patients (286 kidneys) with congenital hydronephrosis were included. Hydronephrosis outcomes (resolution, improvement, and persistence) and time‐to‐outcome were evaluated. Results: Fourteen patients underwent early surgical intervention until the age of 2 years. A total of 189 congenital hydronephrosis cases (66%) showed resolution at a median of 16 months (interquartile range: 7–21 months) and 169 (80%) of 210 kidneys with grade I to II hydronephrosis showed resolution at a median of 14 months (interquartile range: 6–23 months). Of 76 kidneys with grade III to IV hydronephrosis, 24 (32%) showed resolution at a median of 29 months (interquartile range: 24–41 months), and 56 (74%) showed improvement to grade II or less at a median of 12 months (interquartile range: 5–23 months). Of the 76 kidneys with grade III to IV hydronephrosis, five required delayed pyeloplasty at a median of 66 months (interquartile range: 42–89 months). One patient was asymptomatic, with a marked worsening of hydronephrosis and decreased renal function 6 years after the resolution of hydronephrosis. Conclusions: None of the patients with grade I to II hydronephrosis required surgical treatment, and a shorter follow‐up may be sufficient. Grade III to IV severe hydronephrosis should be considered for a longer and more careful follow‐up, given the possibility of asymptomatic exacerbation of hydronephrosis. [ABSTRACT FROM AUTHOR]

Item response theory (IRT) models are often compared with respect to predictive performance to determine the dimensionality of rating scale data. However, such model comparisons could be biased toward nested-dimensionality IRT models (e.g., the bifactor model) when comparing those models with non-nested-dimensionality IRT models (e.g., a unidimensional or a between-item-dimensionality model). The reason is that, compared with non-nested-dimensionality models, nested-dimensionality models could have a greater propensity to fit data that do not represent a specific dimensional structure. However, it is unclear as to what degree model comparison results are biased toward nested-dimensionality IRT models when the data represent specific dimensional structures and when Bayesian estimation and model comparison indices are used. We conducted a simulation study to add clarity to this issue. We examined the accuracy of four Bayesian predictive performance indices at differentiating among non-nested- and nested-dimensionality IRT models. The deviance information criterion (DIC), a commonly used index to compare Bayesian models, was extremely biased toward nested-dimensionality IRT models, favoring them even when non-nested-dimensionality models were the correct models. The Pareto-smoothed importance sampling approximation of the leave-one-out cross-validation was the least biased, with the Watanabe information criterion and the log-predicted marginal likelihood closely following. The findings demonstrate that nested-dimensionality IRT models are not automatically favored when the data represent specific dimensional structures as long as an appropriate predictive performance index is used. [ABSTRACT FROM AUTHOR]

Objectives: Cryptorchidism (CO) diagnosis by palpation is challenging. Patients with suspected CO are primarily referred to pediatric urologists by general pediatricians and urologists. Currently, surgical treatment for CO is recommended earlier than in previous guidelines. In this study, we evaluated factors that lead to diagnosis discordance and delayed orchidopexy in patients referred with suspected CO in addition to timing of initial screening. Methods: In total, 731 patients (1052 testes) with suspected CO were included. Risk factors for diagnostic discrepancy in CO diagnosis by pediatric urologists and risk of delayed orchiopexy were evaluated. Results: Herein, 659 (90%) patients were diagnosed during routine public health checkups for infants and young children, and 419 (57%) patients were referred by pediatric practitioners. Of 1052 testes, 374 (36%) were diagnosed with CO by pediatric urologists. In multivariate analysis, risk factors of diagnostic discrepancy for CO diagnosis by pediatric urologists were bilateral testis (odds ratio [OR] = 9.17, p < 0.0001), >6 months old at initial diagnosis (OR = 1.036, p < 0.0001), and pediatric referral (OR = 4.60, p < 0.0001). In total, 296 patients underwent orchiopexy for CO. In multivariate analysis, risk factors for delayed orchiopexy were presence of comorbidities (OR = 3.43, p = 0.003) and >10 months old at referral (OR = 12.62, p < 0.0001). Conclusions: Pediatric referral is a risk factor for discordant CO diagnostics, and late age at referral brings a risk of delayed orchiopexy. It is necessary to enlighten pediatricians, who are mainly responsible for routine health checkups, in teaching CO diagnostic techniques to ensure early referral. [ABSTRACT FROM AUTHOR]

The Early Childhood Environment Rating Scale-Revised (ECERS-R) is widely used to associate child care quality with child development, but its validity for this purpose is not well established. We examined the validity of the ECERS-R using the multidimensional Rasch partial credit model (PCM), factor analyses, and regression analyses with data from the Early Childhood Longitudinal Study Birth Cohort. The PCM identified rating category disordering, indicating previously unrecognized problems with the scale's response process validity. Factor analyses identified neither a single factor nor the ECERS-R six subscales, replicating prior research regarding the scale's structural validity. Criterion validity results were mixed, with small effect sizes for regressions predicting child outcomes and moderate effect sizes for regressions predicting teacher-reported quality. Our results lend empirical support to recent critiques of the ECERS-R, and we discuss implications for its future use and for the development of future measures. (Contains 5 tables, 1 figure and 6 footnotes.)

The Arnett Caregiver Interaction Scale (CIS) has been widely used in research studies to measure the quality of caregiver-child interactions. The scale was modeled on a well-established theory of parenting, but there are few psychometric studies of its validity. We applied factor analyses and item response theory methods to assess the psychometric properties of the Arnett CIS in a national sample of toddlers in home-based care and preschoolers in center-based care from the Early Childhood Longitudinal Study-Birth Cohort. We found that a bifactor structure (one common factor and a second set of specific factors) best fits the data. In the Arnett CIS, the bifactor model distinguishes a common substantive dimension from two methodological dimensions (for positively and negatively oriented items). Despite the good fit of this model, the items are skewed (most teachers/caregivers display positive interactions with children) and, as a result, the Arnett CIS is not well suited to distinguish between caregivers who are "highly" versus "moderately" positive in their interactions with children, according to the items on the scale. Regression-adjusted associations between the Arnett CIS and child outcomes are small, especially for preschoolers in centers. We encourage future scale development work on measures of child care quality by early childhood scholars. (Contains 8 tables.)

Objective: Knowledge of acculturative processes and their impact on immigrant families remains quite limited. Acculturative family distancing (AFD) is the distancing that occurs between immigrant parents and their children and is caused by breakdowns in communication and cultural value differences. It is a more proximal and problem-focused formulation of the acculturation gap and is hypothesized to increase depression via family conflict. Method: Data were collected from 105 Chinese American high school students and their mothers. Rasch modeling was used to refine the AFD measure, and structural equation modeling was used to determine the effects of AFD on youth and maternal depression. Results: Findings indicate that greater AFD was associated with higher depressive symptoms and risk for clinical depression. Family conflict partially mediated this relation for youths, whereas for mothers, AFD directly increased risk for depression. Greater mother-child heritage enculturation discrepancies were associated with greater mother and child AFD. Mainstream acculturation discrepancies and language gaps between mothers and youths were not significantly associated with any of the primary outcome variables. Conclusions: Results highlight the need for better understanding of how AFD and other acculturation-gap phenomena affect immigrant mental health. They also underscore the need for prevention and intervention programs that target communication difficulties and intergenerational cultural value differences. (Contains 2 tables and 1 figure.)

To understand the process of radiocaesium uptake in salmonids after the Fukushima Dai-ichi Nuclear Power Plant accident, a lake caging experiment and two captive-rearing experiments with controlled radiocaesium concentrations of [...]