WORKING MEMORY AND LEARNING DIFFICULTIES: COEXISTENCE OR A STRONG RELATIONSHIP?

This research paper addressed the relationship between Learning Difficulties and Working Memory of a sample of primary students in 10 schools at 4 cities of Cyprus. Students with poor working memory have a low academic achievement, facing difficulties in reading and mathematical thinking. The main objective of the current research is to investigate the possibility of a causative interaction between working memory and the occurrence of learning difficulties in primary school students. Evaluating working memory in students with SLD, the analysis showed that it was significantly lower (p=,000), indicating a strong correlation between working memory and learning difficulties. Specifically, the analysis revealed a statistically significant correlation (p≤.001) between working memory and the variables of digit span, picture memory, pattern memory, grapheme discrimination, phoneme discrimination, and phoneme composition. Adding to the research, the current study stress that in students with learning difficulties the deficits in working memory are in a strong relationship with difficulties in specific types of both Sequence Working Memory and Grapheme-phoneme’s Awareness.  Article visualizations

The role of phonological awareness and working memory in the learning of reading of primary school students, with learning difficulties, in a diglossic environment

Students with learning difficulties (LD) show a wide range of difficulties in individual areas of written language, which are due to a variety of factors. In the field of reading, poor decoding and word recognition skills, limited vocabulary, limited perceptions of the structure of the text, ineffective approach strategies lead to poor comprehension of the text and consequently to the impossibility of mastering the reading. Today, a large number of studies confirm the importance of the integrity of the phonological system and the proper functioning of the processing of this information, which is stored in a well-categorized way and helps in the good decoding of written words. It also confirms that Working Memory is inextricably linked to the ability to read and understand texts, and whatever the state of decoding, Working Memory allows information to be stored for use when and if there is a comprehension problem. The main purpose of the present study was to study and highlight the correlation between Phonological Awareness and Working Memory with the reading ability of primary school students with Learning Disabilities in a bilingual educational environment. In addition, the main issue was the extraction of correct results and appropriate conclusions, which in a sequence of similar findings in the international literature will help to raise concerns for further research on the factors that affect the level of reading ability of students with Learning Disabilities. Appropriately weighted psychometric tools for data collection were provided to a satisfactory sample of primary school students and parents and teachers in schools in Cyprus. The results of data processing showed a statistically significant correlation between phonological awareness and working memory in Cypriot students with learning disabilities. Evaluating the findings of the present research, it is considered important their contribution on the one hand to the understanding of the complex interactions of the above factors in the manifestation of learning difficulties and on the other hand, to the application of appropriate forms of intervention in educational practice.Οι μαθητές με μαθησιακές δυσκολίες (ΜΔ) εκδηλώνουν μεγάλο εύρος δυσκολιών σε επιμέρους τομείς του γραπτού λόγου, οι οποίες οφείλονται σε ποικίλους παράγοντες. Αναφορικά με τον τομέα της ανάγνωσης, οι φτωχές δεξιότητες αποκωδικοποίησης και αναγνώρισης λέξεων, το περιορισμένο λεξιλόγιο, οι περιορισμένες αντιλήψεις σχετικά με τη δομή του κειμένου, οι αναποτελεσματικές στρατηγικές προσέγγισης οδηγούν σε ελλειπή κατανόηση κειμένου και κατ’ επέκταση στην αδυναμία κατάκτησης της αναγνωστικής δεξιότητας. Σήμερα, μεγάλος αριθμός ερευνών επιβεβαιώνει τη σημασία της ακεραιότητας του φωνολογικού συστήματος και της σωστής λειτουργίας της επεξεργασίας αυτών των πληροφοριών, που είναι αποθηκευμένες με ένα καλά κατηγοριοποιημένο τρόπο και βοηθούν στην καλή αποκωδικοποίηση των γραπτών λέξεων. Εξίσου, επιβεβαιώνεται ότι με την ικανότητα ανάγνωσης και την κατανόηση των κειμένων συνδέεται άρρηκτα η Εργαζόμενη Μνήμη, καθώς όποια και αν είναι η κατάσταση της αποκωδικοποίησης, η Εργαζόμενη Μνήμη επιτρέπει τη διατήρηση πληροφοριών, ώστε να χρησιμοποιηθούν όταν και εφόσον παρουσιαστεί κάποιο πρόβλημα κατά την κατανόηση. Κύριο σκοπό της παρούσας έρευνας αποτέλεσε η μελέτη και ανάδειξη συσχέτισης της Φωνολογικής Ενημερότητας και της Εργαζόμενης Μνήμης με την αναγνωστική ικανότητα μαθητών πρώτης σχολικής ηλικίας με Μαθησιακές Δυσκολίες σε δίγλωσσο εκπαιδευτικό περιβάλλον. Επιπρόσθετα, κύριο ζητούμενο αποτέλεσε η εξαγωγή ορθών αποτελεσμάτων και κατάλληλων συμπερασμάτων, τα οποία σε ακολουθία ανάλογων ευρημάτων της διεθνούς βιβλιογραφίας θα συμβάλουν ώστε να τεθούν προβληματισμοί για περαιτέρω έρευνα των παραγόντων που επηρεάζουν το επίπεδο αναγνωστικής ικανότητας των μαθητών με Μαθησιακές Δυσκολίες. Για την συλλογή των δεδομένων κατάλληλα σταθμισμένα ψυχομετρικά εργαλεία χορηγήθηκαν σε ένα ικανοποιητικό δείγμα μαθητών πρώτης σχολικής ηλικίας και γονέων και εκπαιδευτικών, σε σχολεία της Κύπρου.Τα αποτελέσματα της επεξεργασίας των δεδομένων ανέδειξαν στατιστικά σημαντική συσχέτιση μεταξύ της φωνολογικής ενημερότητας και της εργαζόμενης μνήμης σε Κύπριους μαθητές με μαθησιακές δυσκολίες. Αξιολογώντας τα ευρήματα της παρούσας έρευνας, κρίνεται σημαντική η συμβολή τους αφενός στην κατανόηση των σύνθετων αλληλεπιδράσεων των παραπάνω παραγόντων στην εκδήλωση των μαθησιακών δυσκολιών και αφετέρου, στην εφαρμογή κατάλληλων μορφών παρέμβασης στην εκπαιδευτική πράξη

LEARNING PATHS AND LEARNING STYLES IN DYSLEXIA: POSSIBILITES AND EFFECTIVENESS - CASE STUDY OF TWO ELEMENTARY SCHOOL STUDENTS AGED 7 YEARS OLD

The difficulty in reading and writing, spelling mistakes and poor speech are considered as the main elements that characterize students with dyslexia. If one thinks that most of the things in a class are based on writing and reading, then the importance of such a learning difficulty is that it is recognized as soon as possible and with appropriate strategies that people with dyslexia can be helped in their progress. The main aim of the current study was to stress the contribution of early diagnosis of dyslexia to the creation of effective learning environments based on individual learning difficulties, learning styles, and learning paths. To this end, were studied different difficulties in the domains of memory, phonology, grammar, and syntax differentiated the learning styles as well as the strategies of each case, resulting to the implementation of multisensory individualized teaching approaches. Conclusively, early diagnosis of dyslexia as well as multisensory intervention approaches were considered as the most effective factors in the improvement of the two cases learning achievement

The Cost and the Value of Stroke Care in Greece: Results from the SUN4P Study

The aim of this study was to measure the one-year total cost of strokes and to investigate the value of stroke care, defined as cost per QALY. The study population included 892 patients with first-ever acute strokes, hemorrhagic strokes, and ischemic strokes, (ICD-10 codes: I61, I63, and I64) admitted within 48 h of symptoms onset to nine public hospitals located in six cities. We conducted a bottom-up cost analysis from the societal point of view. All cost components including direct medical costs, productivity losses due to morbidity and mortality, and informal care costs were considered. We used an annual time horizon, including all costs for 2021, irrespective of the time of disease onset. The average cost (direct and indirect) was extrapolated in order to estimate the national annual burden associated with stroke. We estimated the total cost of stroke in Greece at EUR 343.1 mil. a year in 2021, (EUR 10,722/patient or EUR 23,308 per QALY). Out of EUR 343.1 mil., 53.3% (EUR 182.9 mil.) consisted of direct healthcare costs, representing 1.1% of current health expenditure in 2021. Overall, productivity losses were calculated at EUR 160.2 mil. The mean productivity losses were estimated to be 116 work days with 55.1 days lost due to premature retirement and absenteeism from work, 18.5 days lost due to mortality, and 42.4 days lost due to informal caregiving by family members. This study highlights the burden of stroke and underlines the need for stakeholders and policymakers to re-organize stroke care and promote interventions that have been proven cost-effective

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London