Pediatric do-not-attempt-resuscitation orders and public schools: a national assessment of policies and laws

Some children living with life-shortening medical conditions may wish to attend school without the threat of having resuscitation attempted in the event of cardiopulmonary arrest on the school premises. Despite recent attention to in-school do-not-attempt-resuscitation (DNAR) orders, no assessment of state laws or school policies has yet been made. We therefore sought to survey a national sample of prominent school districts and situate their policies in the context of relevant state laws. Most (80%) school districts sampled did not have policies, regulations, or protocols for dealing with student DNARs. A similar majority (76%) either would not honor student DNARs or were uncertain about whether they could. Frequent contradictions between school policies and state laws also exist. Consequently, children living with life-shortening conditions who have DNARs may not have these orders honored if cardiopulmonary arrest were to occur on school premises. Coordinated efforts are needed to harmonize school district, state, and federal approaches in order to support children and families' right to have important medical decisions honored.     

A Population-Based Study of Children’s Well-Being and Health: The Relative Importance of Social Relationships,Health-Related Activities,and Income

This study investigated how various risk and protective factors interface with child health and well-being at the population level. Specifically, we examined the association of income, social-contextual variables, and indicators of health-related habits and activities to children’s life satisfaction and perceived overall health. Child data were collected via a self-report survey, the Middle Years Development Instrument, which was administered in three demographically diverse Canadian school districts to 5026 grade 4 students (83 % of the students had complete data and were included in the analyses). Multiple regression and mediation analyses were conducted to examine the joint associations of social relationships with adults and peers, nutrition and sleep habits, and after school sports activities with children’s satisfaction with life and perceived health. Results indicate that peer belonging and relationships with adults at home and school were the strongest predictors of life satisfaction. Furthermore, the (small) association between income and life satisfaction was mediated by social relationship variables. Child reports of perceived health were predicted by peer belonging, adult relationships (home, school, neighborhood), after-school team sports, and nutrition habits. The (small) association between income and health was mediated by social relationships and team sports participation. Findings are discussed in light of previous research on social determinants and socio-economic gradients of children’s health and life satisfaction.     

Using confirmatory factor analysis to understand executive control in preschool children: I. Latent structure

Although many tasks have been developed recently to study executive control in the preschool years, the constructs that underlie performance on these tasks are poorly understood. In particular, it is unclear whether executive control is composed of multiple, separable cognitive abilities (e.g., inhibition and working memory) or whether it is unitary in nature. A sample of 243 normally developing children between 2.3 and 6 years of age completed a battery of age-appropriate executive control tasks. Confirmatory factor analysis was used to compare multiple models of executive control empirically. A single-factor, general model was sufficient to account for the data. Furthermore, the fit of the unitary model was invariant across subgroups of children divided by socioeconomic status or sex. Girls displayed a higher level of latent executive control than boys, and children of higher and lower socioeconomic status did not differ in level. In typically developing preschool children, tasks conceptualized as indexes of working memory and inhibitory control in fact measured a single cognitive ability, despite surface differences between task characteristics.     

Framing Persuasive Appeals: Episodic and Thematic Framing, Emotional Response, and Policy Opinion

Those seeking to frame political issues to their advantage recognize the power of emotional appeals. Yet the study of framing has focused mainly on the cognitive effects of framing rather than on its emotional effects. This study presents the results of two experiments designed to explore the effect of episodic and thematic framing on emotional response and policy opinion. Participants were randomly assigned to read a column arguing against mandatory minimum sentencing that employed either a thematic or one of two episodic frames featuring a woman who received a harsh sentence under the policy. Episodic framing was more emotionally engaging. Furthermore, the specific emotions elicited by the episodic frame—sympathy and pity for the woman featured in the column—were associated with increased opposition to mandatory minimum sentencing. Yet the thematic frame was actually more persuasive once this indirect effect of frame on emotional response was taken into account. The results are consistent with the conclusion that framing effects on policy opinion operate through both affective and cognitive channels. The theoretical and practical implications of the study are discussed.     

Anxiety and Depression in Children: A Preliminary Examination of the Utility of the PANAS-C

Recent research has questioned the validity of identifying depression and anxiety as separate constructs in children. The current investigation examined the usefulness of the Positive and Negative Affect Schedule for Children (PANAS-C) in differentiating between anxiety and depression in children while also providing needed reliability and validity data on the PANAS-C. In addition, the relationship between positive and negative affect and coping was examined. Subjects included 110 third through fifth graders from a semirural public school setting. Children completed the PANAS-C, as well as self-report measures of depression, anxiety, and coping strategies. Moderate item–total correlations and high internal consistency indicated that the PANAS-C has good reliability. Validity results were mixed: a two-factor solution resembled previous studies, and negative affect was associated with avoidance coping strategies whereas positive affect was associated with approach coping strategies, as expected. However, correlations of positive and negative affect, anxiety, and depression scales suggest that positive and negative affectivity are negatively related in children as opposed to separate and independent constructs. Results of the present investigation question the validity of the use of the PANAS-C for differentiating anxiety and depression with this age group and lend support to the possibility that high overlap between anxiety and depression in this age group may be specific for childhood depression.     

Up-regulating positive emotions in everyday life: Strategies, individual differences, and associations with positive emotion and well-being

This research aimed to identify strategies people use to up-regulate positive emotions, and examine associations with personality, emotion regulation, and trait and state positive experience. In Study 1, participants reported use of 75 regulation strategies and trait emotional experience. Principal component analysis revealed three strategy domains: engagement (socializing, savoring), betterment (goal pursuit, personal growth), and indulgence (substance use, fantasy). In Study 2, participants reported state-level regulation and emotional experience. Engagement correlated with greater state and trait positive emotion, and overall greater well-being. Betterment correlated with less state, but greater trait, positive emotion. Indulgence correlated with greater state, but less trait positive emotion and overall lower well-being. This research suggests trade-offs between short-term and long-term emotional consequences of different strategies.     

Religiosity, Spirituality, and the Subjective Quality of African American Men's Friendships: An Exploratory Study

The present study fills a crucial gap in literature surrounding the lives of African American men by exploring factors that shape the quality of these men's friendships. Drawing on data from a sample of 171 African American men, the study examines the relative utility of subjective religiosity, subjective spirituality, advice exchange, and affective sharing as predictors of the level of perceived support from male and female friends. Findings reveal age differences in subjective religiosity, subjective spirituality, and in level of advice and affective exchange in men's same-sex as well as cross-sex friendships. Age differences emerged in men's perceptions of the supportiveness of their friendships with women but not with men. Age was not a predictor of perceived supportiveness of same-sex or cross-sex friendships. Subjective religiosity did not predict support in same-sex or cross-sex friendships. Subjective spirituality positively predicted perceived support in men's same-sex friendships but not in cross-sex friendships. Implications of these findings are discussed.     

Computer scoring of the Levels of Emotional Awareness Scale

The Levels of Emotional Awareness Scale (LEAS; Lane, Quinlan, Schwartz, Walker, & Zeitlan, 1990) is the most commonly used measure of differentiation and complexity in the use of emotion words and is associated with important clinical outcomes. Hand scoring the LEAS is time consuming. Existing programs for scoring open-ended responses cannot mimic LEAS hand scoring. Therefore, Leaf and Barchard (2006) developed the Program for Open-Ended Scoring (POES) to score the LEAS. In this article, we report a study in which the reliability and validity of POES scoring were examined. In the study, we used three participant types (adult community members, university students, children), three LEAS versions (paper based, computer based, and the LEAS for children), and a diverse set of criterion variables. Across this variety of conditions, the four POES scoring methods had internal consistencies and validities that were comparable to hand scoring, indicating that POES scoring can be used in clinical practice and other applied settings in which hand scoring is impractical.     

Alpha to Omega: A Neurological Analysis of Marital Conflict in a Pilot Study

Although the linkage between health and marriage has been noted (e.g., Hayward and Gorman in Demography 41:87–107. doi:10.1353/dem.2004.0005, 2004; Kaplan and Kronick in J Epidemiol Community Health 60:760–765. doi:10.1136/jech.2005.037606, 2006; Schoenborn in Marital status and health: United States, 1999–2002. Advance data from vital and health statistics. National Center for Health Statistics, Hyattsville, MD, 2004), understanding the connection between neurological and behavioral phenomena in marital relationships has yet to be tackled. This pilot study attempted to address this limitation by analyzing electrical brain activity during a conflict interaction between married couples. Results generally supported the work of Lazarus (Emotion and adaptation. Oxford University Press, Oxford, 1991) and Harmon-Jones et al. (J Pers Soc Psychol 82:610–618. doi:10.1037//0022-3514.82.4.610, 2002); individuals that felt like they were in an action-possible situation revealed relatively higher left hemispheric activity in the frontal region of the brain.     

A Picture-Based Activity Schedule Intervention to Teach Adults with Mild Intellectual Disability to Use an iPad During a Leisure Activity

Individuals with developmental disabilities have limited opportunities to participate in leisure activities, frequently due to lack of skills. The purpose of the current study was to teach three adults diagnosed with mild intellectual disability to use an iPad in the context of playing the video game Angry Birds. We used an adapted multiple baseline across participants research design to teach the task, which included opening the cover of the iPad, unlocking the device, opening Angry Birds, playing the game, and putting the iPad away. Instruction took place during breaks in a private room at a sheltered workshop. During intervention, participants had access to an activity schedule to aid in completion of the task. In some cases, extra prompts were provided to increase attention to the activity schedule. All three participants showed improvement in the target skill with intervention and gains were sustained during the maintenance phase.