Neuropsychological Assessment of Children With Reading Disabilities From 8 to 10 Years Old: An Exploratory Portuguese Study

Abstract Reading disabilities are one of the most significant causes of school failure and may result from different causes and cognitive processes. A comprehensive battery of neuropsychological tests was applied to a control group of 102 children (46 girls, 56 boys) with no history of learning disabilities and 32 children (13 girls, 19 boys) with poor reading achievement (PRA) to characterize their cognitive profile. A principal component analysis of the cognitive measures was undertaken to identify cognitive domains. Age-adjusted normative data were computed from controls for verbal and visuospatial abilities, psychomotor skills, executive functions, and a total score. Significant differences were found between the 2 groups. Although single tests could not identify children with PRA, measures of oral and written language, immediate and working memory, calculation, and verbal learning discriminated the 2 groups. A logistic regression model using these factors allowed us to identify 91.2% of healthy children and 96.9% of children with PRA. PRA may result from different patterns of cognitive difficulties, and it is more common in children with oral language and working-memory deficits. Wide-range cognitive testing is necessary to identify strong and weak areas to plan personalized intervention program

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology