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BACKGROUND: Optimizing retention in human immunodeficiency virus (HIV) treatment may require sequential behavioral interventions based on patients response. METHODS: In a sequential multiple assignment randomized trial in Kenya, we randomly assigned adults initiating HIV treatment to standard of care (SOC), Short Message Service (SMS) messages, or conditional cash transfers (CCT). Those with retention lapse (missed a clinic visit by ≥14 days) were randomly assigned again to standard-of-care outreach (SOC-Outreach), SMS+CCT, or peer navigation. Those randomly assigned to SMS or CCT who did not lapse after 1 year were randomly assigned again to either stop or continue the initial intervention. Primary outcomes were retention in care without an initial lapse, return to the clinic among those who lapsed, and time in care; secondary outcomes included adjudicated viral suppression. Average treatment effect (ATE) was calculated using targeted maximum likelihood estimation with adjustment for baseline characteristics at randomization and certain time-varying characteristics at rerandomization. RESULTS: Among 1809 participants, 79.7% of those randomly assigned to CCT (n=523/656), 71.7% to SMS (n=393/548), and 70.7% to SOC (n=428/605) were retained in care in the first year (ATE: 9.9%; 95% confidence interval [CI]: 5.4%, 14.4% and ATE: 4.2%; 95% CI: -0.7%, 9.2% for CCT and SMS compared with SOC, respectively). Among 312 participants with an initial lapse who were randomly assigned again, 69.1% who were randomly assigned to a navigator (n=76/110) returned, 69.5% randomly assigned to CCT+SMS (n=73/105) returned, and 55.7% randomly assigned to SOC-Outreach (n=54/97) returned (ATE: 14.1%; 95% CI: 0.6%, 27.6% and ATE: 11.4%; 95% CI: -2.2%, 24.9% for navigator and CCT+SMS compared with SOC-Outreach, respectively). Among participants without lapse on SMS, continuing SMS did not affect retention (n=122/180; 67.8% retained) versus stopping (n=151/209; 72.2% retained; ATE: -4.4%; 95% CI: -16.6%, 7.9%). Among participants without lapse on CCT, those continuing CCT had higher retention (n=192/230; 83.5% retained) than those stopping (n=173/287; 60.3% retained; ATE: 28.6%; 95% CI: 19.9%, 37.3%). Among 15 sequenced strategies, initial CCT, escalated to navigator if lapse occurred and continued if no lapse occurred, increased time in care (ATE: 7.2%, 95% CI: 3.7%, 10.7%) and viral suppression (ATE: 8.2%, 95% CI: 2.2%, 14.2%), the most compared with SOC throughout. Initial SMS escalated to navigator if lapse occurred, and otherwise continued, showed similar effect sizes compared with SOC throughout. CONCLUSIONS: Active interventions to prevent retention lapses followed by navigation for those who lapse and maintenance of initial intervention for those without lapse resulted in best overall retention and viral suppression among the strategies studied. Among those who remained in care, discontinuation of CCT, but not SMS, compromised retention and suppression. (Funded by National Institutes of Health grants R01 MH104123, K24 AI134413, and R01 AI074345; ClinicalTrials.gov number, NCT02338739.).

The National Association for the Education of Young Children and Head Start have clearly articulated their position on the provision of high-quality instruction for the 4 million dual language learners (DLLs) enrolled in early childhood (EC) programs nationwide. Professional development (PD) provides a way for educators to increase their knowledge and skills; however, teacher practices in the classroom are strongly influenced by implicit beliefs about how children learn. This study examined the influence of 6 PD sessions related to high-quality instruction for DLLs and examined other influential factors related to beliefs and practices. Participants were 98 early childhood educators serving 3- and 4-year-old DLLs in an urban area in the Southwest US. Quantitative findings indicate educators' beliefs and practices shifted after PD. Qualitative findings suggest that educators' empathy, expectations, and external factors also influenced their beliefs and practices. Implications for PD and program design are discussed.

To date little literature has been published on how an alternative undergraduate teacher preparation program infuses mobile devices such as the iPad and its applications, model classrooms, and a high-tech computer lab to prepare teacher candidates. Preparing teacher candidates to generalize technological skills is most effective when it is hands on, using the varied devices and support available to them. Meaningful instruction, application and maintenance of technological usage is the key to 21st century teaching and learning but it will not occur without a designed plan of action or model. This article focuses on the prominence of the use of iPads for teacher candidates in higher education and its potential impact on the learning of students with varying backgrounds and abilities in public schools. Further, it provides conceptual, systematic, comprehensive, and ready-to-use three phases of an existing one-to-one iPad initiative model at a southeast institution of higher education in the United States of America.

The National Association for the Education of Young Childrenand Head Start have clearly articulated their position on the provision of high-quality instruction for the 4 million dual languagelearners (DLLs) enrolled in early childhood (EC) programs nationwide. Professional development (PD) provides a way for educators to increase their knowledge and skills; however, teacherpractices in the classroom are strongly influenced by implicit beliefs about how children learn. This study examined the influenceof 6 PD sessions related to high-quality instruction for DLLs andexamined other influential factors related to beliefs and practices.Participants were 98 early childhood educators serving 3- and4-year-old DLLs in an urban area in the Southwest US. Quantitative findings indicate educators’ beliefs and practices shiftedafter PD. Qualitative findings suggest that educators’ empathy, expectations, and external factors also influenced their beliefs andpractices. Implications for PD and program design are discussed.

Introduction: Psoriasis is a papulosquamous condition characterized by type 1 (T1) inflammation, while chronic rhinosinusitis (CRS) concurrent with asthma is commonly a type 2 (T2) process. Since psoriasis is predictive for higher rates of CRS, our objective was to determine whether CRS with concurrent psoriasis would share its T1 pathogenic signature. In comparison to T1 CRS, a T2 process can be predicted by presence of more extensive sinus disease via Lund-MacKay score, reduced sense of smell, and greater concurrence of purulent drainage and pain/pressure. Methods: Subjective measurements of CRS included the Sino-Nasal Outcome Test (SNOT-22) and objective measurements included Lund-MacKay sinus CT score and endoscopic scoring. Outcomes were compared with control subjects with CRS co-presenting with allergies, asthma, or aspirin-exacerbated respiratory disease (AERD). Results: A total of 62 patients (12 CRS alone, 14 CRS/psoriasis, 12 CRS/AERD, 12 CRS/allergic asthmatic, 12 CRS/non-allergic asthmatic) were included. Comparative analysis utilizing χ2 revealed no significant differences in any factor between CRS/psoriatic patients and all other groups associated with T2 presentations. Specifically, psoriatic patients had comparable reductions in smell, similar complaints of pain/pressure, negligible purulent drainage/crusting, and comparable extent of disease on their CT scan, as well as similar blood eosinophilia. The only significant difference was in lack of productivity (p < 0.05) with trends toward reduced concentration, waking up tired, and lack of sleep parameters presumably related to systemic psoriatic manifestations. Conclusions: Despite the increased prevalence of CRS in psoriasis patients, our data suggest that when present, psoriasis does not predict the presence of a T1 process in the sinuses. [ABSTRACT FROM AUTHOR]

Play is one of the essential components in proper development of first-grade students. Since the adoption by various states of the Common Core State Standards (CCSS), two outcomes have developed: (a) increased instructional time and (b) decreased public school recess periods across school districts. Given the complex nature of daily instructional practices and the lack of opportunity to engage in play (i.e. which in turn decrease the chances for first graders to interact and improve their pro-social skills), classroom teachers need to begin to model and incorporate bibliotherapy as a means to enhance pro-social interactions during daily language art lessons. The purpose of this article is to introduce first-grade teachers to a four-step guide for incorporating bibliotherapy with the "Key Ideas and Details" strand of the CCSS on reading informational text while teaching the needed pro-social skills for first-grade students.

Twenty-first-century preschool children, with and without disabilities, may be found using technology, including assistive technologies, on a daily basis in their homes, schools, and communities. Early childhood educators are exploring opportunities to integrate technology and interactive media into the present-day curriculum. The authors suggest implementing the following five-step process to support using technology in early childhood inclusive programs: (a) assessing technology knowledge of young children, (b) developing technology rules with young children, (c) applying professional judgment and program policy, (d) implementing technology into the curriculum, and (e) collecting data for decision making. Through this process, early educators may define children's background knowledge and subsequently design a curriculum approach, including instructional methods and strategies, to engage young children while fostering creative learning experiences.

This article discusses the impact of mandated step therapy (MST) on the use of dupilumab, a systemic therapy for atopic dermatitis (AD). The study found that MST for dupilumab resulted in a delay in treatment initiation, with an average delay of 4.6 months and 1.4 additional appointments. The MST group was younger and more likely to have Medicaid-based insurance. Despite the delay, the majority of patients eventually received dupilumab. The study suggests that MST disproportionately affects younger individuals and those on Medicaid, leading to prolonged symptoms and increased healthcare costs. However, further research is needed to validate these findings in a larger sample. [Extracted from the article]

Background: Optimizing retention in human immunodeficiency virus (HIV) treatment may require sequential behavioral interventions based on patients' response. Methods: In a sequential multiple assignment randomized trial in Kenya, we randomly assigned adults initiating HIV treatment to standard of care (SOC), Short Message Service (SMS) messages, or conditional cash transfers (CCT). Those with retention lapse (missed a clinic visit by ≥14 days) were randomly assigned again to standard-of-care outreach (SOC-Outreach), SMS+CCT, or peer navigation. Those randomly assigned to SMS or CCT who did not lapse after 1 year were randomly assigned again to either stop or continue the initial intervention. Primary outcomes were retention in care without an initial lapse, return to the clinic among those who lapsed, and time in care; secondary outcomes included adjudicated viral suppression. Average treatment effect (ATE) was calculated using targeted maximum likelihood estimation with adjustment for baseline characteristics at randomization and certain time-varying characteristics at rerandomization. Results: Among 1809 participants, 79.7% of those randomly assigned to CCT (n=523/656), 71.7% to SMS (n=393/548), and 70.7% to SOC (n=428/605) were retained in care in the first year (ATE: 9.9%; 95% confidence interval [CI]: 5.4%, 14.4% and ATE: 4.2%; 95% CI: -0.7%, 9.2% for CCT and SMS compared with SOC, respectively). Among 312 participants with an initial lapse who were randomly assigned again, 69.1% who were randomly assigned to a navigator (n=76/110) returned, 69.5% randomly assigned to CCT+SMS (n=73/105) returned, and 55.7% randomly assigned to SOC-Outreach (n=54/97) returned (ATE: 14.1%; 95% CI: 0.6%, 27.6% and ATE: 11.4%; 95% CI: -2.2%, 24.9% for navigator and CCT+SMS compared with SOC-Outreach, respectively). Among participants without lapse on SMS, continuing SMS did not affect retention (n=122/180; 67.8% retained) versus stopping (n=151/209; 72.2% retained; ATE: -4.4%; 95% CI: -16.6%, 7.9%). Among participants without lapse on CCT, those continuing CCT had higher retention (n=192/230; 83.5% retained) than those stopping (n=173/287; 60.3% retained; ATE: 28.6%; 95% CI: 19.9%, 37.3%). Among 15 sequenced strategies, initial CCT, escalated to navigator if lapse occurred and continued if no lapse occurred, increased time in care (ATE: 7.2%, 95% CI: 3.7%, 10.7%) and viral suppression (ATE: 8.2%, 95% CI: 2.2%, 14.2%), the most compared with SOC throughout. Initial SMS escalated to navigator if lapse occurred, and otherwise continued, showed similar effect sizes compared with SOC throughout. Conclusions: Active interventions to prevent retention lapses followed by navigation for those who lapse and maintenance of initial intervention for those without lapse resulted in best overall retention and viral suppression among the strategies studied. Among those who remained in care, discontinuation of CCT, but not SMS, compromised retention and suppression. (Funded by National Institutes of Health grants R01 MH104123, K24 AI134413, and R01 AI074345; ClinicalTrials.gov number, NCT02338739.) [ABSTRACT FROM AUTHOR]

Includes five articles that discuss publishers' metadata hyperlinks with Digital Object Identifiers (DOIs) on the Internet; the Santa Fe Convention of the Open Archives initiative (Oai) that promotes author self-archiving; the Universal Preprint Service; costs of digital, microfiche, and print access; and an online database of old print advertisements. (LRW)