The roles of prosody in Chinese-English reading comprehension

Background: Despite being an essential component of children’s oral reading fluency, prosodic reading, which involves expressive changes in pitch patterns and pause durations, has not been explored in Cantonese-English bilingual children, whose first language (L1) is tonal, non-alphabetic, and whose second language (L2) is non-tonal, alphabetic. Aims: This study examined the development of prosodic reading and its within- and cross-language associations with reading comprehension among Cantonese-English bilingual children from second to third grade. Sample: One hundred and twenty-one 7-to 8-year-old Cantonese-English bilingual children completed initial testing in grade 2, with 52 tested in grade 3. Methods: Prosodic reading was assessed using one Chinese and one English passage, each comprising six types of syntactic structures: declaratives, clause-final commas, yes-no questions, wh- questions, complex adjectival phrases, and quotatives. Word-reading efficiency, oral passage-reading fluency, and reading comprehension in Chinese and English were also measured. Results: Spectrographic analyses revealed that these children were aware of language-independent functions and language-specific manifestations of pitch and pause cues within and across their L1 Chinese and L2 English. Wh question pitch contours emerged as the most robust link to reading comprehension across both languages, while a crossover effect occurred from Cantonese pitch to English reading comprehension. Shorter pauses for English declarative quotative sentences and phrase-final commas were concurrently associated with greater English reading comprehension. Conclusions: These findings are interpreted within a new reading framework, the Prosodic Catalysing Hypothesis (PCH), which proposes that pitch and pause production can bridge prosody and syntax to facilitate reading comprehension

The development of gaze following in monolingual and bilingual infants: A multi-lab study

Determining the meanings of words requires language learners to attend to what other people say. However, it behooves a young language learner to simultaneously attend to what other people attend to, for example, by following the direction of their eye gaze. Sensitivity to cues such as eye gaze might be particularly important for bilingual infants, as they encounter less consistency between words and objects than monolinguals, and do not always have access to the same word learning heuristics (e.g., mutual exclusivity). In a pre-registered study, we tested the hypothesis that bilingual experience would lead to a more pronounced ability to follow another’s gaze. We used the gaze-following paradigm developed by Senju and Csibra (2008) to test a total of 93 6–9 month-old and 229 12–15 month-old monolingual and bilingual infants, in 11 labs located in 8 countries. Monolingual and bilingual infants showed similar gaze-following abilities, and both groups showed age-related improvements in speed, accuracy, frequency and duration of fixations to congruent objects. Unexpectedly, bilinguals tended to make more frequent fixations to onscreen objects, whether or not they were cued by the actor. These results suggest that gaze sensitivity is a fundamental aspect of development that is robust to variation in language exposure

The Development of gaze following in monolingual and bilingual infants: A multi‐laboratory study

Determining the meanings of words requires language learners to attend to what other people say. However, it behooves a young language learner to simultaneously encode relevant non-verbal cues, for example, by following the direction of their eye gaze. Sensitivity to cues such as eye gaze might be particularly important for bilingual infants, as they encounter less consistency between words and objects than monolingual infants, and do not always have access to the same word-learning heuristics (e.g., mutual exclusivity). In a preregistered study, we tested the hypothesis that bilingual experience would lead to a more pronounced ability to follow another's gaze. We used a gaze-following paradigm developed by Senju and Csibra (Current Biology, 18, 2008, 668) to test a total of 93 6- to 9-month-old and 229 12- to 15-month-old monolingual and bilingual infants, in 11 laboratories located in 8 countries. Monolingual and bilingual infants showed similar gaze-following abilities, and both groups showed age-related improvements in speed, accuracy, frequency, and duration of fixations to congruent objects. Unexpectedly, bilinguals tended to make more frequent fixations to on-screen objects, whether or not they were cued by the actor. These results suggest that gaze sensitivity is a fundamental aspect of development that is robust to variation in language exposure.Individual participatin laboratories acknowledge funding support from: the Natural Sciences and Engineering Research Council of Canada (402470-2011; 2018-04390); the National Science Foundation (BCS-155719); the UK Economic and Social Research Council (ESRC ES/L008955/1); the European Research Council Advanced Grant, UNDER CONTROL (323961); the European Research Council Marie Sklodowska-Curie grant (798658); the Leverhulme Trust (ECF-2015-009); the National Institute of Child Health and Human Development (R01HD083312); the European Research Council Synergy Grant (SOMICS 609819); the Early Career Research Grant & Start-up Grant, Western Sydney University; Research Manitoba University of Manitoba, Children's Hospital Research Institute of Manitoba; and the ODPRT funds, National University of Singapore

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

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

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