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Clearly babies come into the world remarkably receptive to its wonders. Their alertness to sights, sounds, and even abstract concepts makes them inquisitive explorers--and learners--every waking minute. Well before formal schooling begins, children's early experiences lay the foundations for their later social behavior, emotional regulation, and literacy. Yet, for a variety of reasons, far too little attention is given to the quality of these crucial years. Outmoded theories, outdated facts, and undersized budgets all play a part in the uneven quality of early childhood programs throughout our country.What will it take to provide better early education and care for our children between the ages of two and five? Eager to Learn explores this crucial question, synthesizing the newest research findings on how young children learn and the impact of early learning. Key discoveries in how young children learn are reviewed in language accessible to parents as well as educators: findings about the interplay of biology and environment, variations in learning among individuals and children from different social and economic groups, and the importance of health, safety, nutrition and interpersonal warmth to early learning. Perhaps most significant, the book documents how very early in life learning really begins. Valuable conclusions and recommendations are presented in the areas of the teacher-child relationship, the organization and content of curriculum, meeting the needs of those children most at risk of school failure, teacher preparation, assessment of teaching and learning, and more. The book discusses:Evidence for competing theories, models, and approaches in the field and a hard look at some day-to-day practices and activities generally used in preschool.The role of the teacher, the importance of peer interactions, and other relationships in the child's life.Learning needs of minority children, children with disabilities, and other special groups.Approaches to assessing young children's learning for the purposes of policy decisions, diagnosis of educational difficulties, and instructional planning.Preparation and continuing development of teachers.Eager to Learn presents a comprehensive, coherent picture of early childhood learning, along with a clear path toward improving this important stage of life for all children.

A devastatingly large number of people in America cannot read as well as they need for success in life. With literacy problems plaguing as many as four in ten children in America, this book discusses how best to help children succeed in reading. This book identifies the most important questions and explores the authoritative answers on the topic of how children can grow into readers, including: What are the key elements all children need in order to become good readers? What can parents and caregivers provide all children so that they are prepared for reading instruction by the time that they get to school? What concepts about language and literacy should be included in beginning reading instruction? How can we prevent reading difficulties starting with infants and into the early grades? What to ask school boards, principals, elected officials, and other policy makers who make decisions regarding early reading instruction. You'll find out how to help youngsters build word recognition, avoid comprehension problems, and more-with checklists of specific accomplishments to be expected at different ages: for very young children, for kindergarten students, and for first, second, and third grade students. Included are 55 activities to do with children to help them become successful readers, a list of recommended children's books, and a guide to CD-ROMs and websites. Great strides have been made recently toward identifying the best ways to teach children to read. Starting Out Right provides a wealth of knowledge based on a summary of extensive research. It is a \"must read\" for specialists in primary education as well as parents, pediatricians, child care providers, tutors, literacy advocates, policy makers, and teachers.

While most children learn to read fairly well, there remain many young Americans whose futures are imperiled because they do not read well enough to meet the demands of our competitive, technology-driven society. This book explores the problem within the context of social, historical, cultural, and biological factors. Recommendations address the identification of groups of children at risk, effective instruction for the preschool and early grades, effective approaches to dialects and bilingualism, the importance of these findings for the professional development of teachers, and gaps that remain in our understanding of how children learn to read. Implications for parents, teachers, schools, communities, the media, and government at all levels are discussed. The book examines the epidemiology of reading problems and introduces the concepts used by experts in the field. In a clear and readable narrative, word identification, comprehension, and other processes in normal reading development are discussed. Against the background of normal progress, Preventing Reading Difficulties in Young Children examines factors that put children at risk of poor reading. It explores in detail how literacy can be fostered from birth through kindergarten and the primary grades, including evaluation of philosophies, systems, and materials commonly used to teach reading.

Background Patient navigation is an evidence-based intervention for reducing delays in oncology care among underserved populations. In order to address the financial sustainability of this intervention, information is needed on the cost of implementing patient navigation in diverse healthcare settings. Because patient navigation programs and care settings are highly variable, this paucity of cost data creates difficulties in identifying best practices and decisions about the feasibility of implementing navigation programs within a health care system. One barrier to collecting these cost data is the lack of assessment tools available to support patient navigation programs. These tools must be relevant to the wide variety of navigation activities that exist in health care settings, and be flexible enough to collect cost data important to stakeholders in fee-for-service and value-based care environments. Methods and results We present a novel approach and methods for assessing the cost of a patient navigation program implemented across six hospital systems to enhance timely entry and uptake of breast cancer care and treatment. These methods and tools were developed in partnership with breast oncology patient navigators and supervisors using principles of stakeholder engagement, with the goal of increasing usability and feasibility in the field. Conclusions This methodology can be used to strengthen cost analysis and assessment tools for other navigation programs for improving care and treatment for patients with chronic conditions. Trial registration NCT03514433

Objectives: Our objective was to describe and determine the factors contributing to a recent drug-resistant tuberculosis (TB) outbreak in Georgia. Methods: We defined an outbreak case as TB diagnosed from March 2008 through December 2015 in a person residing in Georgia at the time of diagnosis and for whom (1) the genotype of the Mycobacterium tuberculosis isolate was consistent with the outbreak strain or (2) TB was diagnosed clinically without a genotyped isolate available and connections were established to another outbreak-associated patient. To determine factors contributing to transmission, we interviewed patients and reviewed health records, homeless facility overnight rosters, and local jail booking records. We also assessed infection control measures in the 6 homeless facilities involved in the outbreak. Results: Of 110 outbreak cases in Georgia, 86 (78%) were culture confirmed and isoniazid resistant, 41 (37%) occurred in people with human immunodeficiency virus coinfection (8 of whom were receiving antiretroviral treatment at the time of TB diagnosis), and 10 (9%) resulted in TB-related deaths. All but 8 outbreak-associated patients had stayed overnight or volunteered extensively in a homeless facility; all these facilities lacked infection control measures. At least 9 and up to 36 TB cases outside Georgia could be linked to this outbreak. Conclusions: This article highlights the ongoing potential for long-lasting and far-reaching TB outbreaks, particularly among populations with untreated human immunodeficiency virus infection, mental illness, substance abuse, and homelessness. To prevent and control TB outbreaks, health departments should work with overnight homeless facilities to implement infection control measures and maintain searchable overnight rosters.

Data are limited regarding adverse reactions after COVID-19 vaccination in patients with a history of multisystem inflammatory syndrome in children (MIS-C). The lack of vaccine safety data in this unique population may cause hesitancy and concern for many families and health care professionals. To describe adverse reactions following COVID-19 vaccination in patients with a history of MIS-C. In this multicenter cross-sectional study including 22 North American centers participating in a National Heart, Lung, and Blood Institute, National Institutes of Health-sponsored study, Long-Term Outcomes After the Multisystem Inflammatory Syndrome in Children (MUSIC), patients with a prior diagnosis of MIS-C who were eligible for COVID-19 vaccination (age ≥5 years; ≥90 days after MIS-C diagnosis) were surveyed between December 13, 2021, and February 18, 2022, regarding COVID-19 vaccination status and adverse reactions. COVID-19 vaccination after MIS-C diagnosis. The main outcome was adverse reactions following COVID-19 vaccination. Comparisons were made using the Wilcoxon rank sum test for continuous variables and the χ2 or Fisher exact test for categorical variables. Of 385 vaccine-eligible patients who were surveyed, 185 (48.1%) received at least 1 vaccine dose; 136 of the vaccinated patients (73.5%) were male, and the median age was 12.2 years (IQR, 9.5-14.7 years). Among vaccinated patients, 1 (0.5%) identified as American Indian/Alaska Native, non-Hispanic; 9 (4.9%) as Asian, non-Hispanic; 45 (24.3%) as Black, non-Hispanic; 59 (31.9%) as Hispanic or Latino; 53 (28.6%) as White, non-Hispanic; 2 (1.1%) as multiracial, non-Hispanic; and 2 (1.1%) as other, non-Hispanic; 14 (7.6%) had unknown or undeclared race and ethnicity. The median time from MIS-C diagnosis to first vaccine dose was 9.0 months (IQR, 5.1-11.9 months); 31 patients (16.8%) received 1 dose, 142 (76.8%) received 2 doses, and 12 (6.5%) received 3 doses. Almost all patients received the BNT162b2 vaccine (347 of 351 vaccine doses [98.9%]). Minor adverse reactions were observed in 90 patients (48.6%) and were most often arm soreness (62 patients [33.5%]) and/or fatigue (32 [17.3%]). In 32 patients (17.3%), adverse reactions were treated with medications, most commonly acetaminophen (21 patients [11.4%]) or ibuprofen (11 [5.9%]). Four patients (2.2%) sought medical evaluation, but none required testing or hospitalization. There were no patients with any serious adverse events, including myocarditis or recurrence of MIS-C. In this cross-sectional study of patients with a history of MIS-C, no serious adverse events were reported after COVID-19 vaccination. These findings suggest that the safety profile of COVID-19 vaccination administered at least 90 days following MIS-C diagnosis appears to be similar to that in the general population.

Developing a proactive treatment program for human bites in the occupational health setting can be a challenging task for the occupational health nurse. One of the challenges is that work-related injuries are characteristically underreported and undertreated. Complications of wound infection, joint deformity, loss of function, and transmission of acute disease from exposure to bodily fluids can be minimized by accurate early assessment and proper evidence-based treatment and surveillance. This poster identified occupations at risk for human bites and discussed the role of the occupational health nurse in early reporting, administering immediate wound care, and initiating hepatitis B and tetanus immunizations. This poster was the result of an extensive literature review of human bites in the occupational setting. It is estimated that Australian health care workers sustain more than 18,500 needlestick injuries per year (Murphy, 2008). Inherently preventable, these injuries cause significant personal, social, and economic distress for health care workers and have an economic impact to Western Australia (WA) Health via lost productivity and treatment and recovery costs. In February 2008, research was conducted by the product liaison officer into the use of safety engineered medical devices (SEMDs) in Australia, finding that no states mandated their use. In April 2009, a WA Safety Sharps Forum was initiated by the Occupational Safety & Health (OSH) Nursing team with the aim of developing a strategy whereby SEMDs would be mandated, extending with time to all WA Health Care Units. At the same time, the state government of WA issued a 7% cut in spending across all agencies. Agencies reacted by restricting new programs. Despite this, OSH Nursing continued to implement the SEMDs, commencing with a pilot trial completely substituting standard sharps devices in five acute clinical areas. The outcome was a significant downward trend of needlestick injuries, which continues, to below the Australian Council on Healthcare needlestick injury national benchmark. This study validates this program's success in reducing the incidence of needlestick injuries among health care workers. Although hypertension is highly prevalent, associated with serious health consequences, but treatable, fewer than half of those with hypertension have achieved hypertension control (Centers for Disease Control and Prevention, 2011). Epidemiological evidence supports the claim that psychological factors such as job satisfaction, life satisfaction, perceived stress, and perceived health status can mediate and negatively influence health behaviors associated with hypertension (Blanchflower & Oswald, 2008; Kulkarni, Farrel, Erasi, & Kochar, 1998; Walcott-McQuigg, 2000). However, few have studied how these factors affect hypertension control. Given the significant influence of workers' health on their overall well-being and work productivity, it is important to understand the impact these factors have on blood pressure control. Opportunities for intervention exist if psychological factors, which may place individuals with high blood pressure at risk for poor pressure control, can be identified. This proposed study will examine the role of perceived stress, job satisfaction, life satisfaction, and perceived health status in the development of uncontrolled hypertension among municipal employees of the city of Birmingham, Alabama. This study is a secondary analysis of cross-sectional data collected in a health screening questionnaire by The Good Health Program, which conducts regularly scheduled health screenings. Findings from the study should lead to future targeted interventions designed to increase hypertension control (and thereby reduce cardiovascular morbidity) among municipal workers. This poster described basic rabies facts, including incidence, prevention, symptoms, and postexposure prophylaxis. The poster emphasized exposure among deployed personnel and incidence in current theaters of operation. The poster also provided a case study of a soldier who died of rabies presumably after being bitten by a dog in theater. The poster described the Army National Guard's execution of a potential rabies exposure screening task from the Public Health Command, including challenges, successes, and issues unique to the Army National Guard. Changes in swine production methods during the past 25 years have resulted in an environment that increases workers' exposure to airborne ammonia and particulate matter. A task-associated analysis of ammonia and particulate matter concentrations was conducted on swine farms in breeding and gestation barns. The purpose of this study was to determine if specific tasks performed by workers increased concentrations of ammonia and particulate matter. A convenient sample of 8 workers was selected from all breeding and gestation workers (n = 24). Data collection occurred in the morning at each of the eight farms and continued until tasks were completed (4 hours). The results suggested a significant interactive effect for the type of confinement barn and the type of tasks the workers were performing. The workers' risk of exposure to particulate matter depended on the type of task they performed in a particular barn. Agricultural occupational health nurses can use this information to implement interventions appropriate to minimize worker exposures. Exposure could be reduced if workers were informed of conditions that require the use of personal protective equipment. When personal protective equipment is recommended, the occupational health nurse can ensure the proper selection and fit-testing of appropriate equipment. As one of the largest industries in the United States, health care employs a diverse and aging population. Health care personnel face a multitude of risks, both physical and emotional, that could result in occupational injuries. Health care is considered high risk for occupational injuries due to the variety of hazards present in the workplace. Hazards faced each day by health care personnel include biological, chemical, radiological, and ergonomic hazards, needlesticks, lasers, stress (including emotional/psychological and physical/musculoskeletal), and workplace violence. Left unchecked, workers' compensation costs could rise out of control, placing a financial burden on the industry due to lost time, escalating health care costs, and lost productivity during this time of health care reform. An effective and successful workers' compensation program must include strategies around injury prevention and control. Elements of prevention include commitment from leadership and key stakeholders, effective policies and procedures, ongoing data analysis, and effective interventions targeted at high-risk hazards. Controlling access to timely evidence-based care and disciplined oversight of health care and claims processes are necessary. Using a standardized, methodical approach to prevent and control work-related injuries in the health care setting can result in a 54% reduction in claims frequency, a 74% reduction in workers' compensation costs for wages, a 58% reduction in lost time, and a 65% reduction in incurred costs. More than 100 million American workers, 7 million workplaces, and 945,000 hazardous chemical products are covered by the Hazard Communication Standard (HCS). The Occupational Safety and Health Administration (OSHA) established the HCS to ensure that workers are informed of the hazardous chemicals with which they work, yet OSHA representatives admit that many adults may have difficulty reading hazard communication materials. Only 12% of adults surveyed in the United States demonstrated proficient health literacy; this poses a serious problem for hazard communication. The purpose of this study was to examine literacy levels as a hypothesized moderator of test scores of employees presenting to a local occupational health clinic for physical examination, immunization, drug screening, or a monitoring appointment. Comprehensibility was measured by a test based on seven separate Material Safety Data Sheets (MSDSs) for sodium hypochlorite. Literacy levels were measured using the Short Test of Functional Health Literacy in Adults (STOFHLA). The readability level of the written material was measured using the Simplified Measure of Gobbledygook (SMOG) and the Flesch-Kincaid Grade Level (FKGL). Age, highest grade level completed, native language, and job category were measured by a demographic survey. The results indicated a significant positive correlation between the total STOFHLA scores and the total scores on the MSDS test. Findings comparing the readability of the MSDS examples to the participant's overall MSDS score were inconclusive. However, the format of the MSDSs, specifically the number of lines per sentence and number of words three syllables or more, may influence comprehension. According to the World Health Organization, hypertension is the leading cause of death in the world and is a primary reason that individuals seek health care. Combined interventions to promote adherence have been promising, but further research is needed to understand which behaviors to target. The frequency of self-monitoring of blood pressure among workers is unknown and information about assessing hypertensive individuals' readiness and confidence to engage in medication adherence is limited in the literature. The purpose of this study was to determine the prevalence of medication adherence, readiness, self-efficacy, self-monitoring of blood pressure, and blood pressure control in a specific group of workers, municipal employees. The study population (N = 149) was participants in a wellness program established more than 20 years earlier to promote health and safety in a large municipal work force in the southeastern United States. The majority of the study participants (75.70%) demonstrated controlled blood pressure, reported adheren