Exploring the Sequence of Establishing Derived Relational Responding in Children with Global Developmental Delay

The current research comprised two studies to investigate the emergence of derived relational responding in children with Global Developmental Delay (GDD). In Study 1, four children diagnosed with Autism Spectrum Disorder (ASD) and one child with Down's syndrome, were exposed to verbal assessments (the Verbal Behaviour Milestones Assessment and Placement Program, VB-MAPP; the Kaufman Brief Intelligence Test, K-BIT; and the Peabody Picture Vocabulary Test, PPVT) following which they were exposed to relational responding testing and training in the following sequence: co-ordination, distinction, comparison, opposition and hierarchy. All children demonstrated different levels of verbal and relational responding competencies however overall an intervention based on RFT was found to be successful in establishing relational responding in accordance with the targeted frames. In Study 2, four participants with ASD were exposed to a training sequence identical to that used in Study 1 however the location of comparison and opposition were alternated. Results found that participants in Study 2 demonstrated significantly better performances in the emergence of comparison relations than those in Study 1 suggesting that the manipulated sequence may have had an effect. Results also support the previously suggested developmental sequence of the emergence of derived relational responding with evidence of some relational frames emerging before others found. Furthermore results provide evidence of a relationship between relational responding and verbal ability

Wellbeing Series: Shifting the Focus to Nutrition

In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019

Eat, Sleep and be Healthy A Paramedic\u27s Guide to Healthier Shift Work

Shift work can cause adverse health effects, and the nature of paramedic work places paramedics at a higher risk of unhealthy eating and poor physical fitness. Healthier lifestyle choices, including increased physical activity and healthy eating can help to reduce the risk of adverse health effects on paramedics

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Exploring the Sequence of Establishing Derived Relational Responding in Children with Global Developmental Delay

The current research comprised two studies to investigate the emergence of derived relational responding in children with Global Developmental Delay (GDD). In Study 1, four children diagnosed with Autism Spectrum Disorder (ASD) and one child with Down's syndrome, were exposed to verbal assessments (the Verbal Behaviour Milestones Assessment and Placement Program, VB-MAPP; the Kaufman Brief Intelligence Test, K-BIT; and the Peabody Picture Vocabulary Test, PPVT) following which they were exposed to relational responding testing and training in the following sequence: co-ordination, distinction, comparison, opposition and hierarchy. All children demonstrated different levels of verbal and relational responding competencies however overall an intervention based on RFT was found to be successful in establishing relational responding in accordance with the targeted frames. In Study 2, four participants with ASD were exposed to a training sequence identical to that used in Study 1 however the location of comparison and opposition were alternated. Results found that participants in Study 2 demonstrated significantly better performances in the emergence of comparison relations than those in Study 1 suggesting that the manipulated sequence may have had an effect. Results also support the previously suggested developmental sequence of the emergence of derived relational responding with evidence of some relational frames emerging before others found. Furthermore results provide evidence of a relationship between relational responding and verbal ability

Exploring the Sequence of Establishing Derived Relational Responding in Children with Global Developmental Delay

The current research comprised two studies to investigate the emergence of derived relational responding in children with Global Developmental Delay (GDD). In Study 1, four children diagnosed with Autism Spectrum Disorder (ASD) and one child with Down's syndrome, were exposed to verbal assessments (the Verbal Behaviour Milestones Assessment and Placement Program, VB-MAPP; the Kaufman Brief Intelligence Test, K-BIT; and the Peabody Picture Vocabulary Test, PPVT) following which they were exposed to relational responding testing and training in the following sequence: co-ordination, distinction, comparison, opposition and hierarchy. All children demonstrated different levels of verbal and relational responding competencies however overall an intervention based on RFT was found to be successful in establishing relational responding in accordance with the targeted frames. In Study 2, four participants with ASD were exposed to a training sequence identical to that used in Study 1 however the location of comparison and opposition were alternated. Results found that participants in Study 2 demonstrated significantly better performances in the emergence of comparison relations than those in Study 1 suggesting that the manipulated sequence may have had an effect. Results also support the previously suggested developmental sequence of the emergence of derived relational responding with evidence of some relational frames emerging before others found. Furthermore results provide evidence of a relationship between relational responding and verbal ability

Exploring the Sequence of Establishing Derived Relational Responding in Children with Global Developmental Delay

The current research comprised two studies to investigate the emergence of derived relational responding in children with Global Developmental Delay (GDD). In Study 1, four children diagnosed with Autism Spectrum Disorder (ASD) and one child with Down's syndrome, were exposed to verbal assessments (the Verbal Behaviour Milestones Assessment and Placement Program, VB-MAPP; the Kaufman Brief Intelligence Test, K-BIT; and the Peabody Picture Vocabulary Test, PPVT) following which they were exposed to relational responding testing and training in the following sequence: co-ordination, distinction, comparison, opposition and hierarchy. All children demonstrated different levels of verbal and relational responding competencies however overall an intervention based on RFT was found to be successful in establishing relational responding in accordance with the targeted frames. In Study 2, four participants with ASD were exposed to a training sequence identical to that used in Study 1 however the location of comparison and opposition were alternated. Results found that participants in Study 2 demonstrated significantly better performances in the emergence of comparison relations than those in Study 1 suggesting that the manipulated sequence may have had an effect. Results also support the previously suggested developmental sequence of the emergence of derived relational responding with evidence of some relational frames emerging before others found. Furthermore results provide evidence of a relationship between relational responding and verbal ability

Exploring the Sequence of Establishing Derived Relational Responding in Children with Global Developmental Delay

The current research comprised two studies to investigate the emergence of derived relational responding in children with Global Developmental Delay (GDD). In Study 1, four children diagnosed with Autism Spectrum Disorder (ASD) and one child with Down\u27s syndrome, were exposed to verbal assessments (the Verbal Behaviour Milestones Assessment and Placement Program, VB-MAPP; the Kaufman Brief Intelligence Test, K-BIT; and the Peabody Picture Vocabulary Test, PPVT) following which they were exposed to relational responding testing and training in the following sequence: co-ordination, distinction, comparison, opposition and hierarchy. All children demonstrated different levels of verbal and relational responding competencies however overall an intervention based on RFT was found to be successful in establishing relational responding in accordance with the targeted frames. In Study 2, four participants with ASD were exposed to a training sequence identical to that used in Study 1 however the location of comparison and opposition were alternated. Results found that participants in Study 2 demonstrated significantly better performances in the emergence of comparison relations than those in Study 1 suggesting that the manipulated sequence may have had an effect. Results also support the previously suggested developmental sequence of the emergence of derived relational responding with evidence of some relational frames emerging before others found. Furthermore results provide evidence of a relationship between relational responding and verbal ability

Relational responding: Testing, training, and sequencing effects among children with autism and typically developing children

Relational Frame Theory (RFT) proposes that derived relational responding is crucial to the development of verbal behavior. According to RFT, typically-developing children acquire the ability to derive relations through natural language interactions. In contrast, children with autism often do not acquire these skills as readily and require interventions to target their development. Limited research has examined the optimal training context for establishing the core relational skills, such as the sequence in which the relations might be optimally trained. The current research comprised three studies to investigate the emergence of specific relational responding repertoires in typically-developing children and children with autism. The results demonstrate that the typically-developing children had a fluent repertoire of these relational skills, while those with autism demonstrated significant deficits. The results shed some light on the possible role of training sequence