bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of High Costs of Care among Otolaryngology Patients
Authors: Balakrishnan Karthik , Moriarty James P. , Rosedahl Jordan , Driscoll Colin L. , Borah Bijan J. 
Published: March 2019

ObjectivesIdentify predictors of high‐cost otolaryngology care.Study DesignCross‐sectional.SettingTertiary academic multispecialty hospital.Subjects/MethodsAll patients undergoing ≥1 otolaryngologic procedures from 2011 to 2015. Encounter costs were standardized using previously described methods approximating Medicare reimbursement. Patients were stratified by adult/pediatric and inpatient/outpatient. “Outliers” were defined as total encounter costs ≥95th percentile. Logistic regression measured predictors of outlier status.ResultsIn total, 2433 adult inpatient encounters (95th percentile $57,611), 10,031 adult outpatient encounters ($10,772), 346 pediatric inpatient encounters ($84,639), and 3027 pediatric outpatient encounters ($8978) were included. For adult inpatient and outpatient, isolated head and neck oncologic procedures were the reference group. Among adult inpatients, laryngology and facial plastics procedures predicted higher odds of outlier status (odds ratio [OR] = 4.1 and 7.2). Involvement of multiple otolaryngology subspecialties increased the odds (OR = 4.7). Neck dissection and reconstructive procedures were the most common primary operations for adult inpatient outliers. For adult outpatients, several subspecialties had lower odds than head and neck (OR ≤0.44). Increased comorbidities predicted outliers for adult inpatient care (OR = 1.5); sex, age, race, and ethnicity did not. Cochlear implant was the most common primary operation among adult and pediatric outpatient outliers. Greater subspecialty involvement and increasing age predicted pediatric outpatient outliers (OR = 8.0 and 1.1); younger age and female sex predicted pediatric inpatient outliers (OR = 0.8 and 3.5). Airway procedures dominated pediatric inpatient outliers.ConclusionThis is the first large‐scale study of high‐cost otolaryngology care across multiple subspecialties. Specific procedures and subspecialties and increased comorbidities predicted high‐cost care. Contrary to previous studies, patient sex, race, and ethnicity did not.
Evaluation of simulated driving in comparison to laboratory-based tests to assess the pharmacodynamics of alprazolam and alcohol
Authors: Huizinga Coen RH , Zuiker Rob G , de Kam Marieke L , Ziagkos Dimitrios , Kuipers Jorrit , Mejia Yuri , van Gerven Joop MA , Cohen Adam F 
Published: March 2019

Rationale: Assessment of the effects of medicines on the risks of car driving must be derived from laboratory tests, simulated driving or real on-road driving tests. Relevance of tests is determined by their sensitivity and predictive ability for the probability of accidents or damage. This cannot be determined directly, but methods should be able to at least detect the effects of a positive control in dosage known to be clearly associated with increased risk. Objectives: A driving simulator was evaluated in comparison with a battery of validated tests of CNS performance, the NeuroCart®. Alcohol in a concentration exactly at the legal limit (0.5 g L−1) and well above (1.0 g L−1) as well as alprazolam (1 mg) was used as positive control. Methods: This was a randomised, cross-over study using a double dummy blinded design in 24 healthy study subjects (12 M, 12 F) aged 20–43 years. Alcohol was infused intravenously using a validated clamping protocol to obtain concentrations of 0.5 g L−1 and on another occasion 1.0 g L−1. Alprazolam was given orally. Driving tests and lab tests were done at regular time intervals during a study day. Results: Alprazolam and alcohol significantly affected the main parameters of driving in the simulator and affected scores of safe driving and alprazolam increased the odds ratio of a virtual crash. Several laboratory measurements of psychomotor performance were affected by the reference substances as expected and correlated significantly with the driving performance Conclusions: The driving simulator can detect effects of reference substances at levels that are known to negatively affect driving.
The Impact of a Childcare Food Service Intervention on Child Dietary Intake in Care: An Exploratory Cluster Randomized Controlled Trial
Authors: Yoong Sze Lin , Grady Alice , Seward Kirsty , Finch Meghan , Wiggers John , Lecathelinais Christophe , Wedesweiler Taya , Wolfenden Luke 
Published: March 2019

Purpose: To assess the efficacy of a food service implementation intervention designed to increase provision of foods consistent with nutrition guidelines on child consumption of fruit, vegetables, breads/cereals, meat/alternatives, dairy, and diet quality in care. Design: Exploratory cluster randomized controlled trial. Setting: Twenty-five childcare centers in New South Wales, Australia. Sample: Three hundred ninety-five children aged 2 to 5 years. Intervention: Centers were randomized to the intervention or control group. Intervention development was guided by the Theoretical Domains Framework and included securing executive support, provision of group training, resources, audit and feedback, and one-on-one support. The intervention was delivered across six months and the study was conducted between March and December 2016. Measures: Child diet was assessed by educators using a validated questionnaire modified for completion in childcare center. Analysis: Data were analyzed in SAS using generalized linear mixed models adjusted for clustering. Results: Children in the intervention group consumed significantly higher number of serves of vegetables (0.4 serves; P < .001), wholegrain cereals (0.7 serves; P = .02), and meat/alternatives (0.5 serves; P < .001), and had higher diet quality scores (10.3; P < .001). Conclusions: A food service intervention targeting the provision of food significantly improved child dietary intake in care. Such findings are relevant to health promotion practitioners responsible for supporting improvements in child diet.
Evaluation of the volume-value relationship in hip fracture care using evidence-based thresholds
Authors: Navarro Sergio M , Frankel William C , Haeberle Heather S , Billow Damien G , Ramkumar Prem N 
Published: March 2019

Background: Studies have shown high-volume surgeons and hospitals deliver higher value care. The aims of this study were to establish meaningful thresholds defining high-volume surgeons and hospitals performing hip fracture surgery and to examine the relative market share of hip fracture cases using these surgeon and hospital strata. Methods: We performed a retrospective cohort study in a database of 103,935 patients undergoing hip fracture repair. We generated stratum-specific likelihood ratio (SSLR) models of a receiver operating characteristic (ROC) curve using length of stay (LOS) and cost value metrics. Volume thresholds predictive of decreased LOS and costs for surgeons and hospitals were identified. Results: Analysis of annual surgeon hip fracture volume produced two volume categories for LOS and cost: 0–30 (low) and 31+ (high). Analysis of LOS by annual hospital hip fracture volume produced strata at: 0–59 (low), 60–146 (medium), and 147 or more (high). Analysis of cost by annual hospital volume produced strata at: 0–125 (low) and 126+ (high). LOS and cost both decreased significantly ( p < 0.05) in progressively higher volume categories. Low-volume surgeons performed the majority of hip fracture cases, although they were performed at medium- or high-volume centres. Conclusions: This study demonstrates a direct relationship between volume and value, translating to improvement in hip fracture care delivery for both surgeons and hospitals. Higher volume hospitals while lower volume surgeons perform the majority of hip fracture cases, suggesting optimisation opportunities. However, systems-based practices at the hospital level likely drive value to a greater extent than individual surgeons.
Research with Children: A Rich Glimpse into the World of Childhood
Authors: Sorin Reesa 
Published: March 2019

I feel angry when my brother is hurting me and he, and I'm tired and I'm having a sleep and Jason just says ‘Matthew, Matthew, look at this’. My face gets angry. [Makes face and clenches fist]. That's when they get even pinker. That's what happens to my arms when I get angry (Matthew, age 5—name has been changed). Research in early childhood education generally involves children in some capacity, whether it be how they respond to various pedagogical initiatives, how their parents or teachers interact with them or what understandings they bring to a situation. Unfortunately, in the past, much of this research has given children limited voice; positioning them as innocent, incompetent and in need of an adult voice to confirm their place in the research. This article examines my research into young children's emotions, which suggests to me that children's voices can be powerful and possibly richer than those of adults acting on behalf of children.
Children Talk about their Early Experiences at School
Authors: Potter Gillian , Briggs Freda 
Published: March 2019

Researchers have explored the issues associated with transition policies, practices, and children's readiness for school. They have collected parents' and teachers' attitudes towards and feelings about children starting school. However, little attention has been given to the voices of children in this matter. This paper reports on the perspectives of one-hundred children aged 5–6 years on their early experiences of school. The first section explores some of the literature relevant to starting school and the emerging international research trend to giving children a voice in matters that concern them. The second discusses the research methodology and findings. These indicate that, while most children settle in well to school, many have concerns about the affective domain of the school environment, the fear of punishment, being bored, and the lack of choice. While just over half of the children liked school most of the time, 83 per cent of them said they did not like school work, which they clearly defined in their own words.
Are We Asking the Right Question When We Ask ‘Is Child Care Bad for Children?’
Authors: Sims Margaret 
Published: March 2019

Originally evolving out of a welfare model of services (Brennan, 1994; Sims & Hutchins, 1996), child care has traditionally been the underdog of early childhood programs. Child care workers remain on lower wages than early childhood teachers (Press & Hayes, 2001). Training requirements to work in child care are less, and the industry is characterised by high caregiver stress levels, high staff turnover and poor working conditions (Commonwealth Child Care Advisory Council, 2001; Press & Hayes, 2001; Sims, 2003, in press). It is no wonder child care is perceived as a ‘necessary evil’ for those parents whose needs require them to be in the workforce. The Western world is strongly influenced by an ‘Ideology of Motherhood’ (Hutchins & Sims, 1999) which implies that the ultimate achievement of womanhood is to parent children. In this context, women who ‘pass on’ their child caring role to others are judged as poor examples of womanhood. The child care industry, therefore, is seen as having a ‘…financial interest in separating infants and young children from their mothers…’ (Cook, 2002). Alternatives to child care, such as extended parental leave, are debated without challenging the fundamental assumption that children are better off in their homes, being cared for by a parent. Formal child care is often perceived as the opposite, and less desirable end of the child care continuum, with parental care at the most desirable, end. Proving child care is bad for children is often assumed to prove the converse: that parental care is the best for children. The question thus becomes imbued with all the power and emotion surrounding the whole issue of parenthood/motherhood.
Fundamental Movement Skills: Children's Perspectives
Authors: Hands Beth , Martin Marie 
Published: March 2019

Ample evidence exists about the importance of physical activity for developing and maintaining an active and healthy lifestyle. As many habits are formed when young, well-planned and effective movement programs specifically designed for young children are important. In this paper, the influence of a new teaching resource designed to support teachers in implementing a fundamental movement skill program on the children in the classes is presented using a case study approach. The case studies were constructed with teachers and children in a range of early childhood settings. The impact of the program on the children's level of confidence, knowledge of fundamental movement skills and personal physical activity level is presented. This information was gathered using direct observation methods, observation records and questionnaires. The findings indicated an increase in the children's physical activity levels, confidence and knowledge about fundamental movement skills.
East Timor: Building on the Early Years
Authors: Nyland Berenice 
Published: March 2019

When the East Timorese voted for Independence in 1999 they at least expected to have infrastructure, such as school buildings, available as they started the task of building a new nation. The post-Independence destruction also meant that unexpected priority decisions about what should be built, or rebuilt, first had to be made. In a country suffering from low literacy rates, high unemployment, trauma, poverty and food shortages, the question of an education system remains very complex. This paper explores the potential of early childhood education in the new nation of East Timor. The discussion of the early years will be framed by some of the debates that have occupied the education conversation in the early days of Independence. The question of language has been strongly debated (Lutz, 1991; Burns, 1999; Kehi, 1999; Hull, 2000) and will be a focus of this discussion. Three questions are examined in the paper: one, the extremely complex issues surrounding choices about the language(s) of education in a country where literacy levels are low and colonial rulers have used language as an overt expression of power; two, the importance of the early years; and three, the question of the role of early education in nation building.
The Tug of War: When Queer and Early Childhood Meet
Authors: DeJean William 
Published: March 2019

SEXUALITIES IN THE FIELD OF early childhood remains an abstract concept for some, yet for others it is a reality experienced from the moment one prepares to enter the field. Using a narrative ethnography, which calls for the voice of the ‘researcher’ and ‘participant’ to be made visible, this paper explores sexualities in early childhood from the perspective of one lesbian early childhood preservice teacher who must negotiate her identity within the location of university studies and early childhood placement. The paper concludes with recommendations on ways for queer teacher education to support preservice teachers entering the early childhood field. Invisibility is a dangerous and painful condition. When those who have the power to name and to socially construct reality choose not to see you or hear you … there is a moment of psychic disequilibrium, as if you looked into a mirror and saw nothing (Rich, 1986, p. 199).
The Effects of the Art Education Program on Drawing Skills of Six-Year-Old Gifted Children in the High Socio-Economic Status in Turkey
Authors: Gur Cagla , Temel Fulya 
Published: March 2019

AN ART EDUCATION PROGRAM WAS designed to develop the drawing skills of gifted children. In this study, the program was implemented with six-year-old gifted children receiving regular pre-elementary school education to investigate its impact. The main question to be answered was: Does the Art Education Program affect the drawing skills of six-year-old gifted children? The study included 26 girls and 26 boys from private preschools in Ankara, Turkey. Among these children, 26 were chosen as the experimental group and 26 were chosen as the control group. Both groups undertook the Silver Drawing Test before and after the program so any changes could be measured. The experimental group, after the pre-test, participated in an Art Education Program consisting of 18 sessions. There was a significant improvement in the drawing skills of the experimental group when compared to the control group (p < 0.001). However, the relationship between the pre-test, final test scores and years of pre-elementary education was not statistically significant at five per cent significance level.
Gender and Leadership Styles in Children's Play
Authors: Mawson Brent 
Published: March 2019

THIS ARTICLE COMPARES AND CONTRASTS the leadership styles evident in children's spontaneous collaborative play in two early childhood settings. The first site, in 2007, was a long day care centre and involved 22 three- and four-year-old children. The second site, in 2008, was the morning session of a kindergarten and involved 47 children. A strong factor in beginning and maintaining a play episode was the leadership role of individual children. There were clear gender differences in leadership style. Two key roles were those of dictator and director. The dictator was invariably male and more autocratic and less able or likely to resolve inter-group conflict. The director, on the other hand, was usually female and had a more democratic approach to conflict and was more ready to compromise to keep the play episode going. Mixed-gender play was more prevalent in the long day care centre and allowed boys to experience leadership roles and styles not normally available in boys-only play.
Finding a Voice for Child Participants within Doctoral Research: Experiences from the Field
Authors: Harwood Debra 
Published: March 2019

Grown-ups never understand anything for themselves, and it is tiresome for children to be always and forever explaining things to them. -de Saint-Exupéry, A. (2000) CHILDREN HAVE A LONG HISTORY of being the object of study across several research disciplines (psychology, education, sociology). Typically, studies on children have tended to assess concepts, experimental approaches, theories or interventions with little consideration given to children's voices within that research (Hill, Laybourn, & Borland, 1996; Scott, 2008). Increasingly, within the various research communities, there has been a shift toward conducting research with children rather than on children to gain insight into what is meaningful and significant to children themselves (Clark, 2005; Clark 2007). As such, several scholars acknowledge four perspectives in conducting research on children: child as object, child as subject, child as social actor, and child as participant or co-participant (Alderson, 2008; Christensen & Prout, 2002; Christensen & James, 2008). Yet, despite recent research trends of including children's perspectives, many academic disciplines are steeped in a traditional approach of perceiving the child as object, a dependent and vulnerable being in need of protection. This article discusses the methodological choices and tensions I experienced as an early childhood education doctoral student as I endeavoured to negotiate a participatory role for young children's voices within a research agenda that focused on sibling teasing (Harwood, 2008a).
Curriculum Guidelines for Early Literacy: A Comparison of New Zealand and England
Authors: Blaiklock Ken 
Published: March 2019

THE DEVELOPMENT OF EARLY literacy knowledge is generally seen as an important aspect of early childhood education. The way early literacy learning is promoted, however, varies greatly in different national curriculum frameworks. This article compares the approach taken in the New Zealand early childhood curriculum (Te Whāriki) with the approach outlined in the curriculum for young children in England (The Early Years Foundation Stage or EYFS). The curricula are compared in relation to (1) the description of literacy-related learning outcomes; (2) guidance for teachers on how to foster literacy learning; and (3) guidance on formative and summative assessment. The EYFS contains more detailed information in each area of comparison. The article suggests that the lack of information on literacy in Te Whāriki may mean that children are provided with an inadequate range of literacy experiences in New Zealand early childhood centres.
Defining and Assessing the School Readiness of Indigenous Australian Children
Authors: McTurk Nicholas , Lea Tess , Robinson Gary , Nutton Georgie , Carapetis Jonathan R. 
Published: March 2019

THE RESEARCH EVIDENCE THAT underpins the school readiness of Indigenous Australian children is reviewed in this article, followed by identification of issues requiring research attention. Two key questions are considered: 1. How is school readiness defined and how applicable are definitions to Indigenous contexts? 2. What methods of school readiness assessment are applied to Indigenous children and are the tools appropriate or effective? General definitions of school readiness are outlined. An ecological view defines school readiness as ready services, schools, communities and families. This view is scrutinised in detail to consider whether services, schools and communities are ready to promote Indigenous children's education. Extended families are pivotal social constructions in many Indigenous contexts. The extent to which this is recognised in the ecological view of school readiness is assessed. Thereafter, the methods of assessing children's school readiness are reviewed, highlighting the shortfall in techniques specifically designed and validated for Indigenous Australians and the variable applicability of the techniques currently in use.
Observing Young Children's Rough-and-Tumble Play
Authors: Tannock Michelle 
Published: March 2019

THIS RESEARCH INVESTIGATED THE rough-and-tumble play of 17 five-year-old children in two early childhood settings. The study resulted in an increased understanding of the forms of rough-and-tumble play displayed by young children. This study demonstrates that both boys and girls are engaged in a variety of rough-and-tumble play behaviours. Twenty-seven distinct rough-and-tumble play behaviours were exhibited during the observation period. They included eight components identified as rough-and-tumble play in previous research and also 19 behaviours not previously identified as elements of such. These elements indicate pre-operational forms of rough-and-tumble play. The results of this study have implications for the understanding of child development. It suggests that rough-and-tumble play evolves as children age; that children move into more complex play behaviours as they mature.