Pregnancy is a condition leading to an important strain on thyroid morphology and function.A normal functioning of the thyroid gland in the mother is essential for the early fetal development, since the fetal thyroid does not produce thyroid hormones until the end of the first trimester (approximately 12 to 14 weeks).The impact of thyroid dysfunction (and especially hypothyroidism) during pregnancy is well documented and has been associated with a number of obstetrical complications, such as premature delivery, low birth weight and even fetal death. In view of all changes in thyroid physiology during pregnancy the ATA (American Thyroid Association) guidelines recommend using trimester- and population-specific normality ranges, to define thyroid dysfunction. It is proposed to determine them in pregnant women without thyroid antibodies (TPO) and without severe iodine deficiency. Due to the few numbers of randomized clinical trials, there is still no consensus whether all pregnant women should be screened or only women at risk for the development of thyroid dysfunction during pregnancy.Thyroid dysfunction during pregnancy is caused in most cases by the presence of thyroid autoimmunity (TAI) and also the altered pregnancy outcomes in most studies are associated with the presence of TAI.Besides the presence of TAI, other factors might also change, influence and/or modify thyroid function. When we started our research, there were only few studies that investigated the impact of other variables, such as iron, BMI, smoking habit and/or the background of the pregnant women on the prevalence of thyroid dysfunction during the first trimester of pregnancy.The aims of the thesis were therefore, to investigate: • the association between the iron reserve status (ferritin levels), thyroid (dys)function and autoimmunity, corrected for confounders such as age, BMI, smoking habit and the time of blood sampling;• the impact of the ethnic background of the pregnant woman on thyroid function and autoimmunity, corrected for confounders such as age, BMI, smoking habit, and the time of blood sampling. Furthermore, to determine ethnic-specific reference ranges and investigate their impact on the diagnosis of thyroid dysfunction;• the impact of changes in thyroid function within the normal reference range in women free of thyroid autoimmunity on pregnancy outcomes, corrected for established covariates (age, BMI, smoking) and iron reserve as candidate new variable.• whether targeted high-risk screening for thyroid dysfunction during pregnancy could be improved with the inclusion of iron status and ethnicity to the actual risk factors defined in the ATA-GL.The results can be summarized as follows:Thyroid function during pregnancy can be influenced by variables others than thyroid antibodies such as the iron status and the ethnical background of the women. However, their impact on thyroid function is less important compared to that of thyroid antibodies. No significant impact of well-known variables (BMI, age, smoking) and others such as iron has been shown on clinical pregnancy outcomes when thyroid function remained within the normal range and no thyroid antibodies were present.We have shown that adding variables such as iron deficiency, ethnic background and obesity to the currently provided list of factors leading to a high-risk for the development of thyroid dysfunction during pregnancy, might improve the detection rate of subclinical hypothyroidism to comparable rates obtained in case of universal screening. / Doctorat en Sciences médicales (Médecine) / info:eu-repo/semantics/nonPublished

Systematic screening for social, emotional, and behavioral concerns (SEBC) identifies at-risk students and provides information to guide interventions that may prevent negative outcomes (Glover & Albers, 2006; Kauffman, 1999; Severson, Walker, Hope-Dolittle, Katochwill, & Gresham, 2007). However, the screening process may be influenced by the gender of the student (Young, Sabbah, Young, Reiser, & Richardson, 2010). This study further examined the influence of student gender on screening by assessing the congruency of gates one and two of a screening process based on student gender. Participants included 59 middle school teachers who nominated at-risk students on the Teacher Nomination Form (TNF; Davis, 2012) and then completed the Behavior Assessment System for Children, Behavioral and Emotional Screening System (BASC-2 BESS; Kamphaus & Reynolds, 2007) on each nominated student. A two-tailed z-score was calculated to see if the TNF predicted BASC-2 BESS T-scores better for one gender over the other. A z score of -0.63 (p > .05) was obtained in the internalizing category and a z score of 0.39 (p > .05) was obtained in the externalizing category; the difference between correlation coefficients for males and females was not statistically significant. While more males were nominated than females in both the internalizing and externalizing categories, the screening instrument does not measure differently for males and females according to the data analysis provided here. Disproportionate identification of males and females in the screening process may be explained by other factors that could be the focus of additional research.

The Rising Above the Gathering Storm report (National Academy of Sciences, 2007) emphasizes a need for improved science education in United States schools. Instruction, informed by assessment, has been repeatedly demonstrated to be effective for increasing students' performance. In particular, the use of curriculum-based measurement (CBM) to assist with making screening decisions has been shown to increase the likeliness of students meeting meaningful outcomes. While CBM tools for assisting with making screening decisions in reading, mathematics, and written language have been well examined, tools for use in content areas (e.g., science and social studies) remain in the beginning stages of research. In this study, two alternate forms of a new CBM tool, Statement Verification for Science (SV-S), for assisting with making screening decisions regarding students' science content knowledge is examined for technical adequacy. A total of 1,545 students across Grades 7 (N = 799) and 8 (N = 746) completed Forms A and B of SV-S the week prior to, and within two weeks after, a statewide high-stakes test of accountability including Science, Reading, and Mathematics. Obtained data were used in order to examine internal consistency, test-retest with alternate forms reliability, and evidence of criterion- and construct-related validity. Promising results were found for reliability, in particular internal consistency, while results related to evidence of criterion- and construct-related validity were less than desired. Such results, along with additional exploratory analyses, provide support for future research of SV-S as a CBM tool to assist teachers and other educators with making screening decisions.

The Student Risk Screening Scale—Internalizing/Externalizing (SRSS-IE) was developed to screen elementary-aged students for Emotional and Behavioral Disorders (EBD). Its use has been extended to middle schools with little evidence that it measures the same constructs as in elementary schools. Scores of a middle school population from the SRSS-IE are analyzed with Multilevel Confirmatory Factor Analysis (MCFA) to examine its factor structure, factorial invariance between females and males, and its reliability. Several MCFA models are specified, and compared, with two retained for further analysis. The first model is a single-level model with chi-square and standard errors adjusted for the clustered nature of the data. The second model is a two-level model. Both support the hypothesized structure found in elementary populations of two factors (Externalizing and Internalizing). All items load on only one factor except Peer Rejection, which loads on both. Reliability is estimated for both models using several methods, which result in reliability coefficients ranging between .89-.98. Both models also show evidence of Configural, Metric, and Scalar invariance between females and males. While more research is needed to provide other kinds of evidence of validity in middle school populations, results from this study indicate that the SRSS-IE is an effective screening tool for EBD.

Universal screening is an emerging practice in the field of education to provide at-risk students with early intervention services. Currently there is not a universal screener specifically designed for the middle school population. Therefore, the purpose of this study was to obtain junior high and middle school teachers' perspectives on behaviors exhibited by students at risk for emotional and behavioral disorders in order to develop preliminary test items. Several themes were identified from the teachers' perspectives. Teacher perspectives noted that at-risk students displayed a variety of internalizing and externalizing behaviors. These issues included difficulty maintaining peer and teacher relationships, difficulty with hygiene and sleep, challenging home and school relationships, and noncompliant behaviors. From these themes, the researcher created an initial item pool of 24 items, which can be used for future development of a screening instrument.

Underrepresentation among those identified for gifted programs has been a concern in the field of gifted education for over a century, affecting students of color, students with disabilities, English language learners, and economically disadvantaged students. Universal screening has emerged as a possible strategy to increase referrals of students from underrepresented populations and to produce gifted population demographics more reflective of total student enrollment. The purpose of this study was to investigate the influence of universal screening measures on the diversity of students found eligible for gifted education services. The study examined the following research questions: 1. What is the relationship between a referral source and the gifted identification of elementary school students? 2. To what extent do universal screening measures influence the diversity of students eligible for gifted education services? This study used existing referral and eligibility data of elementary school students in a medium-sized school district who were administered a universal screening measure during the 2019-2020 school year. Pearson chi-square tests with Yates' continuity correction were used to determine the existence of possible associations between referral source and gifted identification status, and Cramér's V was used as a measure of effect size. Referral rates, accuracy, and effectiveness of referral sources were also computed. Across all demographic groups, universal screeners referred more students than any other referral source, and the highest number of students identified gifted after the full gifted evaluation came from universal screener referrals. Teacher referrals and universal screener referrals produced the most diverse identified gifted results after evaluation. Universal screeners displayed the highest referral rates and were the most accurate and effective referral source across all demographic groups. This study provides the field of gifted education further research on universal screening, and the findings of this study provide educational leaders data to inform practice. Implications for school and district leaders involve multiple stakeholders and address different areas to promote diversity among the gifted student population. The implications center on parent and community engagement, professional learning, best practices in gifted education, and evaluation of gifted identification processes. / Doctor of Education / Historically, students of color, students with disabilities, English language learners, and economically disadvantaged students have been underrepresented in gifted programs. Universal screening has emerged as a potential practice to refer more students from underrepresented populations and consequentially identify a more diverse gifted population, but few studies exist to support adoption of the practice and to justify the financial expense and amount of instructional time devoted to administering the assessments. This study used existing data of elementary school students in a medium-sized school district who were administered a universal screening measure to investigate the influence of universal screening measures on the diversity of students found eligible for gifted education services. Possible associations between referral source and gifted status were determined, and referral rates, accuracy and identification rates, and effectiveness of various referral sources were calculated. Across demographic groups, universal screeners referred more students than any other referral source, and the highest number of students identified gifted after the full gifted evaluation resulted from these referrals. Teacher referrals and universal screener referrals were found to produce the most diverse identified gifted populations after evaluation; universal screeners displayed the highest referral rates and were the most accurate and effective referral source across all demographic groups. This study adds further research on universal screening to the field of gifted education, and the findings of this study provide educational leaders information regarding the effectiveness of universal screening to translate into institutional practice.

This research study examined the psychometric properties of the Student Risk Screening Scale for Internalizing and Externalizing Behaviors (SRSS-IE) using Item Response Theory (IRT) methods among a sample of 2,122 middle school students. The SRSS-IE is a recently revised screening instrument aimed at identifying students who are potentially at risk for emotional and behavioral disorders (EBD). There are two studies included in this research. Study 1 utilized the Nominal Response and Generalized Partial Credit models of IRT to evaluate items from the SRSS-IE in terms of the degree to which the response options for each item functioned as intended by the scale developers and how well those response options discriminated among students who exhibited varying levels of EBD risk. Results from this first study indicated that the four response option configurations of the items on the SRSS-IE may not adequately discriminate among the frequency of externalizing and internalizing behaviors demonstrated by middle school students. Recommendations for item response option revisions or scale scoring revisions are discussed in this study. In study 2, differential item functioning (DIF) and differential step functioning (DSF) methods were used to examine differences in item and response option functioning according to student gender variables. Additionally, test information functions (TIFs) were used to determine whether preliminary recommendations for cut scores differ by gender. Results of this second study indicate that two of the items on the SRSS-IE systematically favor males over females and one item systematically favors females over males. Additionally, examination of TIFs demonstrated different degrees of measurement precision at various levels of theta for males and females on both the externalizing and internalizing constructs. Implications of these results are discussed in relation to possible revisions of the SRSS-IE items, cut scores, or scale scoring procedures.

Masters of Art / Intimate partner violence (IPV) has reached epidemic proportions in South Africa, prompting the government to pass the Domestic Violence Act 116 (1998). However, numerous scholars still believe that legislation is lacking due to inadequate implementation of protocol in the healthcare sector. In the healthcare setting, nurses are usually the first people that abused women make contact with and so they are in an excellent position to identify IPV victims and prevent further abuse. Routine universal screening in the healthcare setting is recommended as a means to identify women who suffer in abusive relationships. However, several problems have been encountered with the attempts to implement screening practices. In this study the various perceived barriers to IPV screening among nursing students were examined by use of a descriptive survey approach. The research participants were 103 nursing students from the University of the Western Cape. Data were collected by means of a selfadministered questionnaire and analysed using descriptive as a means to uncover the relationship between perceived barriers and the screening practices of the participants. The aim of this study was to identify the barriers that will discourage a nurse from routinely screening for intimate partner violence in a healthcare practice. The present study’s results indicated that the majority of variance in routinely screening for IPV can be explained by barriers related to HCP knowledge of managing IPV disclosure; the perceived responses of patients to screening; the privatisation of abuse; and whether HCP regard IPV as a healthcare issue. Information, regarding the beliefs of healthcare providers (HCP) with regard to IPV as well as the barriers they perceive toward screening, will be helpful in designing curricula that will successfully teach HCP how to screen for IPV and it will also be useful in making positive changes to the screening conditions in healthcare settings.

Emotional and Behavioral Disorders (EBD) directly influence learning, relationships, mood, and overall scholastic experiences. Research provides evidence that early intervention and prevention efforts can address the needs of students with EBD (Allen-DeBoer, Malmgren, & Glass, 2006; Cook, et al. 2008; Lien-Thorne & Kamps, 2005; Regan, Mastropieri, & Scruggs, 2005; Rivera, Al-Otiba, & Koorland, 2006), but in order to identify these at-risk youth, a screening system is needed to broadly consider Social, Emotional, and Behavioral Concerns (SEBC).This dissertation evaluated the alignment of a teacher nomination process (Teacher Nomination Form (TNF)) and a normative screener of EBD risk (BASC-2 Behavioral and Emotional Screening System (BESS), Kamphaus & Reynolds, 2007). Teacher nominations and rankings were significantly correlated to the BESS in the internalizing (.177), externalizing (.246), and combined categories (.304) groups. Multiple teacher nominations were not significantly related to BESS scores. Social validity evidence was gathered and interpreted.

The use of Response to Intervention, more commonly referred to as RTI has become more prevalent as school systems look to find ways of bridging the opportunity gap and provide support those students who are not successful in their attempts to access the general education curriculum. More research is needed in order to have a better understanding of not only how schools implement RTI, but also how they utilize data, monitor student progress and help to ensure fidelity of implementation. The purpose of this study was to examine and explain how one elementary school with a high quality RTI program implemented Response to Intervention while keeping all three essential components in consideration. The findings demonstrate that the subject elementary school combined several elements of Response to Intervention and in turn, created their own version of a hybrid RTI model that utilized components from both the standard protocol model and the problem-solving model. In order to monitor student progress, universal screeners were utilized several times throughout the year for both reading and math. Reading was also monitored through running records, PALS Quick Checks, Orton Gillingham assessments, and exit tickets, whereas Math utilized formative assessments, anecdotal notes, and exit tickets to track student progress. Each math and reading CLT met weekly to engage in dialogue around student data. An important finding is that the subject elementary school made RTI implementation decisions around what was best for their students, which allowed for a more flexible and adaptable approach. The system utilized targeted individual student needs and helped to ensure that ALL students had access to the necessary supports that would help to ensure student success. / Doctor of Education / As schools continue to face increasing demands, including how to meet the needs of students with diverse academic backgrounds, they have been charged with exploring new ways and methods of ensuring that students are successful in their attempts to access the general education curriculum. Response to Intervention, more commonly referred to as RTI, has become more widely used in school systems as they continue to work to ensure student success for all. RTI is seen as a tool to help accurately identify students who have a learning disability (Ciolfi and Ryan, 2011), however more research is needed in order to have a better understanding of how schools implement RTI, as well as how they utilize the data collected and monitor student progress. This qualitative case study analyzes how one subject elementary school implemented RTI, how they utilized data, as well as how they monitored the progress of their students.