757 resultados para Conceptions and practices


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This study was conducted under the auspices of the Subcommittee on Risk Communication and Education of the Committee to Coordinate Environmental Health and Related Programs (CCEHRP) to determine how Public Health Service (PHS) agencies are communicating information about health risk, what factors contributed to effective communication efforts, and what specific principles, strategies, and practices best promote more effective health risk communication outcomes.^ Member agencies of the Subcommittee submitted examples of health risk communication activities or decisions they perceived to be effective and some examples of cases they thought had not been as effective as desired. Of the 10 case studies received, 7 were submitted as examples of effective health risk communication, and 3, as examples of less effective communication.^ Information contained in the 10 case studies describing the respective agencies' health risk communication strategies and practices was compared with EPA's Seven Cardinal Rules of Risk Communication, since similar rules were not found in any PHS agency. EPA's rules are: (1) Accept and involve the public as a legitimate partner. (2) Plan carefully and evaluate your efforts. (3) Listen to the public's specific concerns. (4) Be honest, frank, and open. (5) Coordinate and collaborate with other credible sources. (6) Meet the needs of the media. (7) Speak clearly and with compassion.^ On the basis of case studies analysis, the Subcommittee, in their attempts to design and implement effective health risk communication campaigns, identified a number of areas for improvement among the agencies. First, PHS agencies should consider developing a focus specific to health risk communication (i.e., office or specialty resource). Second, create a set of generally accepted practices and guidelines for effective implementation and evaluation of PHS health risk communication activities and products. Third, organize interagency initiatives aimed at increasing awareness and visibility of health risk communication issues and trends within and between PHS agencies.^ PHS agencies identified some specific implementation strategies the CCEHRP might consider pursuing to address the major recommendations. Implementation strategies common to PHS agencies emerged in the following five areas: (1) program development, (2) building partnerships, (3) developing training, (4) expanding information technologies, and (5) conducting research and evaluation. ^

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Health care workers have been known to carry into the workplace a variety of judgmental and negative attitudes towards their patients. In no other area of patient care has this issue been more pronounced as in the management of patients with AIDS. Health care workers have refused to treat or manage patients with AIDS and have often treated them more harshly than identically described leukemia patients. Some health care institutions have simply refused to admit patients with AIDS and even recent applicants to medical colleges and schools of nursing have indicated a preference for schools in areas with low prevalence of HIV disease. Since the attitudes of health care workers do have significant consequences on patient management, this study was carried out to determine the differences in clinical practice in Nigeria and the United States of America as it relates to knowledge of a patient's HIV status, determine HIV prevalence and culture in each of the study sites and how they impact on infection control practices, determine the relationship between infection control practices and fear of AIDS, and also determine the predictors of safe infection control practices in each of the study sites.^ The study utilized the 38-item fear of AIDS scale and the measure of infection control questionnaire for its data. Questionnaires were administered to health care workers at the university teaching hospital sites of Houston, Texas and Calabar in Nigeria. Data was analyzed using a chi-square test, and where appropriate, a student t-tests to establish the demographic variables for each country. Factor analysis was done using principal components analysis followed by varimax rotation to simple structure. The subscale scores for each study site were compared using t-tests (separate variance estimates) and utilizing Bonferroni adjustments for number of tests. Finally, correlations were carried out between infection control procedures and fear of AIDS in each study site using Pearson-product moment correlation coefficients.^ The study revealed that there were five dimensions of the fear of AIDS in health care workers, namely fear of loss of control, fear of sex, fear of HIV infection through blood and illness, fear of death and medical interventions and fear of contact with out-groups. Fear of loss of control was the primary area of concern in the Nigerian health care workers whereas fear of HIV infection through blood and illness was the most important area of AIDS related feats in United States health care workers. The study also revealed that infection control precautions and practices in Nigeria were based more on normative and social pressures whereas it was based on knowledge of disease transmission, supervision and employee discipline in the United States, and thus stresses the need for focused educational programs in health care settings that emphasize universal precautions at all times and that are sensitive to the cultural nuances of that particular environment. ^

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This study described home infusion techniques and practices, measured the perceived risk of HIV and hepatitis transmission to self and others, and measured the outcome expectancy of following risk reduction guidelines for 90 hemophilia patients and/or their infusion assistants. It also assessed general knowledge of HIV and hepatitis information for the same population.^ The study subjects were hemophilia patients or their infusion assistants from the Gulf States Hemophilia Center in Houston, the El Paso Satellite Hemophilia Clinic in El Paso, or Texas members of the Women Outreach Network of the National Hemophilia Foundation (WONN) group. Each subject was interviewed either by telephone or in person. The questionnaire used was developed for the study and consisted of 60 items. These items assessed general demographics for the patients and assistants, including questions about their training to do infusions as well as the actual practices, measured perceived personal risk for the transmission of HIV or hepatitis to the assistants, perceived risk of transmission of HIV or hepatitis to others for assistants and self-infusers, and the outcome expectancy for following recommended risk reduction guidelines also for both groups.^ The theoretical framework used assumed that perceived risk and outcome expectancy would be predictive of behavior. The findings did not support this theory. Instead, the findings suggest that infusion behavior is habitual in nature; most respondents perform exactly the same behavior for every infusion. Since none of the variables selected were predictive of the compliance behavior for home infusion the teaching method should be directed towards mastery learning, or learning that will incorporate the correct behavior into a habitual pattern of home infusion. ^

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While reported prevalence rates of troubled employees vary considerably, even conservative estimates indicate a major public health problem. For example, alcohol and drug related problems alone cost U.S. industry more than 45 billion dollars annually.^ Of the alternatives available to deal with these problems, e.g., dismissal or disciplinary actions, the most viable and cost effective are employee assistance programs (EAP), designed to provide professional assistance to employees experiencing alcohol, drug, emotional or personal crisis.^ The principal component of an EAP is that of assessment and referral, and this study was developed to determine which EAP client intake variables are the most efficacious predictors of assessment and referral procedures.^ Although, specific client intake variables were statistically significant the discriminant classification analysis was demonstrably inadequate. Nevertheless, the identification of A/R procedure phases which were not efficacious, as well as EAP client populations for whom services were not effective, were extremely valuable discernments. Identifying the less efficacious components of the A/R process provided an opportunity to recommend alternatives to current program procedures and practices, which may ameliorate program effectiveness. ^

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The use of tobacco products ruins the health of millions of people around the world. On average, tobacco users die nearly seven years earlier than non-tobacco users. n1 Cigarette smoking is a particular concern in the developing countries of the Middle East and Gulf Cooperation Council (GCC) region where smoking prevalence is expected to increase. This is due to the tobacco industry's vigorous commercial and marketing activities. n3 Smoking prevalence among physicians is considered to be an effective indicator of a society's readiness to identify the smoking epidemic and its related health diseases. n4 There is a lack of detailed data on the smoking prevalence among healthcare professionals, particularly physicians, in the United Arab Emirates (UAE). This cross sectional study is the first to address smoking practices among physicians working at the Department of Health and Medical Services (DOHMS); in Dubai, UAE. ^ This study describes the cigarette smoking prevalence among DOHMS Physicians, physician attitudes towards tobacco use and tobacco bans; physician attitudes towards smoking cessation techniques (among smokers and non-smokers); and physician awareness of official anti-smoking policies. Data for the study was collected through the use of an adapted WHO standardized questionnaire, the Global Health Professionals Survey. The questionnaire was administered by the researcher to physicians (n=288) at their work place. Date was analyzed using the SPSS analytic software program. ^ Twelve percent of DOHMS physicians smoked cigarettes. Regardless of smoking status, the majority supported a tobacco ban in hospitals and public places, and a ban on tobacco advertising. There is a significant relationship between physician smoking status and discussing risks of tobacco use (p < 0.05). Non-smoking physicians reported spending more time with patients discussing hazards of smoking (p < 0.01). Non-smokers reported providing more counseling than their smoking colleagues. The majority of DOHMS physicians (63%) reported a lack of knowledge about 5As/ 5Rs. The majority of physicians also reported they are aware of hospital smoking policies that restrict smoking. Regardless of physician smoking status, DOHMS physicians are not very actively involved in smoking cessation activities. This cross sectional study is the first to address smoking programs, policies, and practices among physicians in Dubai, UAE. Findings support the need for increased physical smoking cessation training as well as the development of smoking cessation programs for tobacco control, and programs with a focus on physician participation in reducing tobacco and cigarette use among the general population.^

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Influenza (the flu) is a serious respiratory illness that can cause severe complications, often leading to hospitalization and even death. Influenza epidemics occur in most countries every year, usually during the winter months. Despite recommendations from the Centers for Disease Control and Prevention (CDC) and efforts by health care institutions across the United States, influenza vaccination rates among health care workers in the United States remain low. How to increase the number of vaccinated health care workers is an important public health question and is examined in two journal articles included here. ^ The first journal article evaluates the effectiveness of an Intranet intervention in increasing the proportion of health care workers (HCWs) who received influenza vaccination. Hospital employees were required go to the hospital's Intranet and select "vaccine received," "contraindicated," or "declined" from the online questionnaire. Declining employees automatically received an online pop-up window with education about vaccination; managers were provided feedback on employees' participation rates via e-mail messages. Employees were reminded of the Intranet requirement in articles in the employee newsletter and on the hospital's Intranet. Reminders about the Intranet questionnaire were provided through managers and newsletters to the HCWs. Fewer than half the employees (43.7%) completed the online questionnaire. Yet the hospital witnessed a statistically significant increase in the percentage of employees who received the flu vaccine at the hospital – 48.5% in the 2008-09 season as compared to 36.5%, 38.5% and 29.8% in the previous three years (P < 0.05). ^ The second article assesses current interventions employed by hospitals, health systems and nursing homes to determine which policies have been the most effective in boosting vaccination rates among American health care workers. A systematic review of research published between January 1994 and March 2010 suggests that education is necessary but not usually sufficient to increase vaccine uptake. Education about the flu and flu vaccines is most effective when complemented with easy access and making the vaccine free, although this combination may not be sufficient to achieve the desired vaccination levels among HCWs. The findings point toward adding incentives for HCWs to get vaccinated and requiring them to record their vaccination status on a declination/consent form – either written or electronic. ^ Based on these findings, American health care organizations, such as hospitals, nursing homes, and long-term care facilities, should consider using online declination forms as a method for increasing influenza vaccination rates among their employees. These online forms should be used in conjunction with other policies, including free vaccine, mobile distribution and incentives. ^ To further spur health care organizations to adopt policies and practices that will raise influenza vaccination rates among employees, The Joint Commission – an independent, not-for- profit organization that accredits and certifies more than 17,000 health care organizations and programs in the United States – should consider altering its standards. Currently, The Joint Commission does not require signed declination forms from employees who eschew vaccination; it only echoes the CDC's recommendations: "Health care facilities should require personnel who refuse vaccination to complete a declination form." Because participation in Joint Commission accreditation is required for Medicare reimbursement, action taken by the Joint Commission to require interventions such as mandatory declination/consent forms might result in immediate action by health care organizations to follow these new standards and lead to higher vaccination rates among HCWs.^ 1“Frequently Asked Questions for H1N1 and Seasonal Influenza.” The Joint Commission - Infection Control: http://www.jointcommission.org/PatientSafety/InfectionControl/h1n1_faq.htm. ^

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Sexual/reproductive/health and rights are crucial public health concerns that have been specifically integrated into the Millennium Development Goals to be accomplished by 2015. These issues are related to several health outcomes, including HIV/AIDS and gender-based violence (GBV) among women. The Middle East and North Africa (MENA) region comprises Algeria, Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Qatar, Saudi Arabia, Syria, Tunisia, United Arab Emirates (UAE), West Bank and Gaza (WBG), and Yemen. This region is primarily Arabic speaking (except for Israel and Iran), and primarily Muslim (except for Israel). Some traditional and cultural views and practices in this region engender gender inequalities, which manifest themselves in the economic, political and social spheres. HIV and gender-based violence in the region may be interlinked with gender inequalities which breed justification for partner violence and honour killings, and increase the chance that HIV will transform into an epidemic in the region if not addressed. A feminist framework, focused on economic, political and social empowerment for women would be useful to consider applying to sexual/reproductive health in the region.^

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Las concepciones en torno a la normatividad en la didáctica constituyen el problema de investigación central de esta tesis y cobran relevancia al postular que la didáctica es una teoría acerca de la enseñanza con posibilidades de influir en el mejoramiento de las prácticas. Se propone indagar, desde una perspectiva histórica, cómo se ha ido resolviendo la cuestión de la normatividad, o más específicamente, cómo aparece planteada la normatividad en la producción teórica de la didáctica entre los años 1960 y 1990 en la Argentina. Asimismo, se incluyen las relaciones entre la didáctica y el curriculum. Se parte de dos supuestos principales: el primero de ellos se refiere a que la didáctica ha incorporado en su estructura disciplinar la teoría curricular ocasionando que desde ella se definan los temas, problemas y orientaciones de la producción curricular, y que "en parte por esto" el curriculum no posee un desarrollo autónomo en nuestro país, al menos en el período aquí estudiado. El segundo supuesto se refiere a un comportamiento disímil que cada una de estas disciplinas evidencia en torno a la normatividad. Por otra parte, esta forma de entender la didáctica conduce a introducirse en teorías epistemológicas y metodológicas con una doble intención: en primer lugar, para indagar en problemas y esquemas interpretativos que con respecto a la normatividad aparecen en la reflexión epistemológica y metodológica en las ciencias sociales, para luego con ellos enriquecer el análisis en la disciplina de base. En segundo lugar, porque parece evidente que una investigación como la que se realiza no es posible sin contar con categorías que habiliten un análisis metateórico. A su vez, la didáctica ha ido atravesando por diferentes momentos históricos en su constitución y los mismos pueden analizarse desde una particular configuración integrada por conocimiento, normas, valores y prácticas. Construcción histórica que se enriquece en su comparación con el recorrido realizado por teorías epistemológicas y metodológicas. La construcción de conocimientos que se propone para esta tesis se realiza en el diálogo entre el marco conceptual referencial antes delineado y el análisis de un corpus empírico integrado por diez (10) obras de didáctica y de curriculum seleccionadas en base a cuatro criterios centrales. El primer criterio permite seleccionar obras de Imídeo Nérici y Hans Aebli para dar cuenta de las características de la didáctica general que se conoció en Argentina en las décadas del '50 y del '60. El segundo criterio se refiere a considerar obras de la teoría curricular norteamericana y que se difundieron en nuestro país desde principios de los '70, específicamente se analizan trabajos de Ralph Tyler, Hilda Taba y Clifton Chadwick. El tercer criterio permite considerar textos de Susana Avolio, Susana Barco, Gloria Edelstein y Azucena Rodríguez, ya que dan cuenta de las características del pensamiento local en el área de didáctica general en los años '70. Por último, el cuarto criterio se refiere a obras de curriculum de Joseph Schwab y Lawrence Stenhouse que se conocieron en la Argentina en la década del '80 y que impactaron en la didáctica

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Las concepciones en torno a la normatividad en la didáctica constituyen el problema de investigación central de esta tesis y cobran relevancia al postular que la didáctica es una teoría acerca de la enseñanza con posibilidades de influir en el mejoramiento de las prácticas. Se propone indagar, desde una perspectiva histórica, cómo se ha ido resolviendo la cuestión de la normatividad, o más específicamente, cómo aparece planteada la normatividad en la producción teórica de la didáctica entre los años 1960 y 1990 en la Argentina. Asimismo, se incluyen las relaciones entre la didáctica y el curriculum. Se parte de dos supuestos principales: el primero de ellos se refiere a que la didáctica ha incorporado en su estructura disciplinar la teoría curricular ocasionando que desde ella se definan los temas, problemas y orientaciones de la producción curricular, y que "en parte por esto" el curriculum no posee un desarrollo autónomo en nuestro país, al menos en el período aquí estudiado. El segundo supuesto se refiere a un comportamiento disímil que cada una de estas disciplinas evidencia en torno a la normatividad. Por otra parte, esta forma de entender la didáctica conduce a introducirse en teorías epistemológicas y metodológicas con una doble intención: en primer lugar, para indagar en problemas y esquemas interpretativos que con respecto a la normatividad aparecen en la reflexión epistemológica y metodológica en las ciencias sociales, para luego con ellos enriquecer el análisis en la disciplina de base. En segundo lugar, porque parece evidente que una investigación como la que se realiza no es posible sin contar con categorías que habiliten un análisis metateórico. A su vez, la didáctica ha ido atravesando por diferentes momentos históricos en su constitución y los mismos pueden analizarse desde una particular configuración integrada por conocimiento, normas, valores y prácticas. Construcción histórica que se enriquece en su comparación con el recorrido realizado por teorías epistemológicas y metodológicas. La construcción de conocimientos que se propone para esta tesis se realiza en el diálogo entre el marco conceptual referencial antes delineado y el análisis de un corpus empírico integrado por diez (10) obras de didáctica y de curriculum seleccionadas en base a cuatro criterios centrales. El primer criterio permite seleccionar obras de Imídeo Nérici y Hans Aebli para dar cuenta de las características de la didáctica general que se conoció en Argentina en las décadas del '50 y del '60. El segundo criterio se refiere a considerar obras de la teoría curricular norteamericana y que se difundieron en nuestro país desde principios de los '70, específicamente se analizan trabajos de Ralph Tyler, Hilda Taba y Clifton Chadwick. El tercer criterio permite considerar textos de Susana Avolio, Susana Barco, Gloria Edelstein y Azucena Rodríguez, ya que dan cuenta de las características del pensamiento local en el área de didáctica general en los años '70. Por último, el cuarto criterio se refiere a obras de curriculum de Joseph Schwab y Lawrence Stenhouse que se conocieron en la Argentina en la década del '80 y que impactaron en la didáctica

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This is a report on data raised through research, which has already finished, about Identification references in adolescents . Objetives : To analyze and reflect upon the collected data, adolescents' representations about the work field and their projects for future work. To conceptualize about the crises of social significances which produce and order sense and, therefore, organize our perceptions of work through social discourses and practices which have an impact on the subjectivity of adolescents and young adults. Methodology: Brief presentation of the concepts which frame the qualitative research in this area. Reading and analysis of fragments from adolescents' accounts, obtained in focal groups at different state secondary schools. Conclusions: The adolescents researched portray a self-image full of uncertainty and skepticism as regards their future possibilities. The impact produced by the fall of work as an ideal of doing and being is made evident in their accounts. Only some of them link their future project with an invested and valuable activity, even if this is not associated with economic safety and wellbeing. Others present themselves as incapable to modify the state of things, which offers a field connected with consumerist values and with the idea that "you are worth what you have (in material things)".

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This paper explores the relation between society, family, and learning. In particular, it addresses the features of home literacy environments in low income families and their impact on children's pre-literacy skills and knowledge. Sixty-two four/five-year-old children and their mothers were randomly selected for this study. The mothers were interviewed using an adaptation of a family literacy environment survey (Whitehurst, 1992). The children were assessed with specific tests to examine the scope of their 'early literacy'. The results revealed significant variability in the features and practices of home literacy environments as well as in the children's emerging pre-literacy skills and knowledge. The correlation between the two variables shows low to moderate statistical significance. The implications of such findings are discussed. Additionally, the purpose of isolating relevant features of the children and their home environments is to identify specific indicators related to the literacy fostering process. Ultimately, the goal is to design adequate, timely, and systematic intervention strategies aimed at preventing difficulties related to written language learning in children that could be considered at risk.

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En este artículo se presentan las investigaciones que venimos desarrollando sobre concepciones de niñas, niños y adultos acerca de las personas con diversidad funcional. Se trata de indagaciones descriptivas y exploratorias que recogen los puntos de vista de diferentes actores en el ámbito educativo. Las conceptualizaciones sobre la diversidad funcional resultan de construcciones sociales, culturales y científicas, siendo interpretadas por los individuos como modelos que implican valoraciones, actitudes, pensamientos y prácticas hacia el colectivo "personas con discapacidades", el que se visualiza como diferente y diverso. Desde el campo de la Ética y los Derechos Humanos la consideración de la discapacidad en la educación se concentra en el tema de la igualdad y de la equiparación de oportunidades, propiciando ambientes inclusivos. Nuestras investigaciones, centradas inicialmente en niñas, niños y adolescentes, y recientemente en docentes, intentan realizar aportes y brindar insumos para la reflexión que merece este problema en el marco de la escuela como parte de una sociedad más equitativa y justa

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Las concepciones en torno a la normatividad en la didáctica constituyen el problema de investigación central de esta tesis y cobran relevancia al postular que la didáctica es una teoría acerca de la enseñanza con posibilidades de influir en el mejoramiento de las prácticas. Se propone indagar, desde una perspectiva histórica, cómo se ha ido resolviendo la cuestión de la normatividad, o más específicamente, cómo aparece planteada la normatividad en la producción teórica de la didáctica entre los años 1960 y 1990 en la Argentina. Asimismo, se incluyen las relaciones entre la didáctica y el curriculum. Se parte de dos supuestos principales: el primero de ellos se refiere a que la didáctica ha incorporado en su estructura disciplinar la teoría curricular ocasionando que desde ella se definan los temas, problemas y orientaciones de la producción curricular, y que "en parte por esto" el curriculum no posee un desarrollo autónomo en nuestro país, al menos en el período aquí estudiado. El segundo supuesto se refiere a un comportamiento disímil que cada una de estas disciplinas evidencia en torno a la normatividad. Por otra parte, esta forma de entender la didáctica conduce a introducirse en teorías epistemológicas y metodológicas con una doble intención: en primer lugar, para indagar en problemas y esquemas interpretativos que con respecto a la normatividad aparecen en la reflexión epistemológica y metodológica en las ciencias sociales, para luego con ellos enriquecer el análisis en la disciplina de base. En segundo lugar, porque parece evidente que una investigación como la que se realiza no es posible sin contar con categorías que habiliten un análisis metateórico. A su vez, la didáctica ha ido atravesando por diferentes momentos históricos en su constitución y los mismos pueden analizarse desde una particular configuración integrada por conocimiento, normas, valores y prácticas. Construcción histórica que se enriquece en su comparación con el recorrido realizado por teorías epistemológicas y metodológicas. La construcción de conocimientos que se propone para esta tesis se realiza en el diálogo entre el marco conceptual referencial antes delineado y el análisis de un corpus empírico integrado por diez (10) obras de didáctica y de curriculum seleccionadas en base a cuatro criterios centrales. El primer criterio permite seleccionar obras de Imídeo Nérici y Hans Aebli para dar cuenta de las características de la didáctica general que se conoció en Argentina en las décadas del '50 y del '60. El segundo criterio se refiere a considerar obras de la teoría curricular norteamericana y que se difundieron en nuestro país desde principios de los '70, específicamente se analizan trabajos de Ralph Tyler, Hilda Taba y Clifton Chadwick. El tercer criterio permite considerar textos de Susana Avolio, Susana Barco, Gloria Edelstein y Azucena Rodríguez, ya que dan cuenta de las características del pensamiento local en el área de didáctica general en los años '70. Por último, el cuarto criterio se refiere a obras de curriculum de Joseph Schwab y Lawrence Stenhouse que se conocieron en la Argentina en la década del '80 y que impactaron en la didáctica

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This is a report on data raised through research, which has already finished, about Identification references in adolescents . Objetives : To analyze and reflect upon the collected data, adolescents' representations about the work field and their projects for future work. To conceptualize about the crises of social significances which produce and order sense and, therefore, organize our perceptions of work through social discourses and practices which have an impact on the subjectivity of adolescents and young adults. Methodology: Brief presentation of the concepts which frame the qualitative research in this area. Reading and analysis of fragments from adolescents' accounts, obtained in focal groups at different state secondary schools. Conclusions: The adolescents researched portray a self-image full of uncertainty and skepticism as regards their future possibilities. The impact produced by the fall of work as an ideal of doing and being is made evident in their accounts. Only some of them link their future project with an invested and valuable activity, even if this is not associated with economic safety and wellbeing. Others present themselves as incapable to modify the state of things, which offers a field connected with consumerist values and with the idea that "you are worth what you have (in material things)".

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This paper explores the relation between society, family, and learning. In particular, it addresses the features of home literacy environments in low income families and their impact on children's pre-literacy skills and knowledge. Sixty-two four/five-year-old children and their mothers were randomly selected for this study. The mothers were interviewed using an adaptation of a family literacy environment survey (Whitehurst, 1992). The children were assessed with specific tests to examine the scope of their 'early literacy'. The results revealed significant variability in the features and practices of home literacy environments as well as in the children's emerging pre-literacy skills and knowledge. The correlation between the two variables shows low to moderate statistical significance. The implications of such findings are discussed. Additionally, the purpose of isolating relevant features of the children and their home environments is to identify specific indicators related to the literacy fostering process. Ultimately, the goal is to design adequate, timely, and systematic intervention strategies aimed at preventing difficulties related to written language learning in children that could be considered at risk.