Perceptual Other-Race Training Reduces Implicit Racial Bias

Background: Implicit racial bias denotes socio-cognitive attitudes towards other-race groups that are exempt from conscious awareness. In parallel, other-race faces are more difficult to differentiate relative to own-race faces – the ‘‘Other-Race Effect.’ ’ To examine the relationship between these two biases, we trained Caucasian subjects to better individuate other-race faces and measured implicit racial bias for those faces both before and after training. Methodology/Principal Findings: Two groups of Caucasian subjects were exposed equally to the same African American faces in a training protocol run over 5 sessions. In the individuation condition, subjects learned to discriminate between African American faces. In the categorization condition, subjects learned to categorize faces as African American or not. For both conditions, both pre- and post-training we measured the Other-Race Effect using old-new recognition and implicit racial biases using a novel implicit social measure – the ‘‘Affective Lexical Priming Score’ ’ (ALPS). Subjects in the individuation condition, but not in the categorization condition, showed improved discrimination of African American faces with training. Concomitantly, subjects in the individuation condition, but not the categorization condition, showed a reduction in their ALPS. Critically, for the individuation condition only, the degree to which an individual subject’s ALPS decreased was significantly correlated with the degree of improvement that subject showed in their ability to differentiate African American faces

Feature Articles Pediatric Critical Care Medicine Pediatric Delirium and Associated Risk Factors: A Single-Center Prospective Observational Study*

Objective: To describe a single-institution pilot study regarding prevalence and risk factors for delirium in critically ill children. Design: A prospective observational study, with secondary analysis of data collected during the validation of a pediatric delirium screening tool, the Cornell Assessment of Pediatric Delirium. Setting: This study took place in the PICU at an urban academic medical center. Patients: Ninety-nine consecutive patients, ages newborn to 21 years. Intervention: Subjects underwent a psychiatric evaluation for delirium based on the Diagnostic and Statistical Manual IV criteria. Measurements and Main Results: Prevalence of delirium in this sample was 21%. In multivariate analysis, risk factors associated with the diagnosis of delirium were presence of developmental delay, need for mechanical ventilation, and age 2-5 years. Conclusions: In our institution, pediatric delirium is a prevalent problem, with identifiable risk factors. Further large-scale prospective studies are required to explore multi-institutional prevalence, modifiable risk factors, therapeutic interventions, and effect on long-term outcomes. (Pediatr Crit Care Med 2015; 16:303-309) Key Words: critical care; delirium; pediatric critical care; pediatrics; prevalence; risk factor D elirium is the behavioral manifestation of acute cerebral dysfunction associated with serious underlying medical illness. It presents as an acute and fluctuating change in mental status, with disordered attention and cognition (1). It is a well-known and prevalent problem in adult intensive care, linked to short-and long-term morbidity (2), increased mortality (3), and astronomical healthcare costs (4). The pathophysiology of ICU delirium is complex and multifactorial. It is the end result of diffuse cerebral metabolic abnormality. Broadly, alterations in neurotransmission, cerebral blood flow, energy metabolism, and disordered cellular homeostasis all play a role (5-7). Although it can occasionally be traced to a single etiology (e.g., alcohol toxicity or delirium tremens), in the ICU, it is frequently a result of three synergistic events: the underlying disease process, side-effects of treatment, and the highly abnormal critical care unit environment (8, 9). As an example, let us consider the patient admitted to the ICU with pneumonia and associated acute hypoxemic respiratory failure. The inflammatory process associated with the infection and hypoxia predisposes the patient to delirium. The benzodiazepine prescribed to facilitate patient-ventilator synchrony is itself deliriogenic. The prolonged period of immobilization in the ICU bed, the presence of invasive catheters and monitors, and the disruption of the patient's sleep-wake cycle all contribute to the evolving delirium (9, 10). It is important to recognize that delirium is a medical diagnosis and not simply a constellation of symptoms. Delirium is not untreated pain, oversedation, sleep deprivation, or withdrawal (although any of these may contribute to the development of delirium) Epidemiology and risk factors for pediatric delirium are not yet well described, due in part to the absence of widespread screening, underrecognition, and lack of evidence-based dat

Annexin A2 Loss After Cardiopulmonary Bypass and Development of Acute Postoperative Respiratory Dysfunction in Children

IMPORTANCE AND OBJECTIVES:. The primary objective of this study was to determine whether expression of the multifunctional and adherens junction-regulating protein, annexin A2 (A2), is altered following cardiopulmonary bypass (CPB). A secondary objective was to determine whether depletion of A2 is associated with post-CPB organ dysfunction in children. DESIGN:. In a prospective, observational study conducted over a 1-year period in children undergoing cardiac surgery requiring CPB, we analyzed A2 expression in peripheral blood mononuclear cells at different time points. We then assessed the relationship of A2 expression with organ function at each time point in the early postoperative period. SETTING:. Twenty-three-bed mixed PICU in a tertiary academic center. PARTICIPANTS:. Patients 1 month to 18 years old undergoing cardiac surgery requiring CPB. MEAN OUTCOME MEASUREMENTS AND RESULTS:. We analyzed A2 expression in 22 enrolled subjects (n = 9, 1–23 mo old; n = 13, 2–18 yr old) and found a proteolysis-mediated decline in intact A2 immediately after bypass (p = 0.0009), reaching a median of 4% of baseline at 6 hours after bypass (p < 0.0001), and recovery by postoperative day 1. The degree of A2 depletion immediately after bypass in 1–23-month-olds correlated strongly with the extent of organ dysfunction, as measured by PICU admission Vasoactive-Ventilation-Renal (p = 0.004) and PEdiatric Logistic Organ Dysfunction-2 (p = 0.039) scores on postoperative day 1. A2 depletion immediately after bypass also correlated with more protracted requirement for both respiratory support (p = 0.007) and invasive ventilation (p = 0.013) in the 1–23-month-olds. CONCLUSIONS AND RELEVANCE:. The degree of depletion of A2 following CPB correlates with more severe organ dysfunction, especially acute respiratory compromise in children under 2 years. These findings suggest that loss of A2 may contribute to pulmonary microvascular leak in young children following CPB

The role of explicit and implicit self-esteem in peer modeling of palatable food intake: A study on social media interaction among youngsters

Contains fulltext : 116712.pdf (publisher's version ) (Open Access)Objective: This experimental study investigated the impact of peers on palatable food intake of youngsters within a social media setting. To determine whether this effect was moderated by self-esteem, the present study examined the roles of global explicit self-esteem (ESE), body esteem (BE) and implicit self-esteem (ISE). Methods: Participants (N = 118; 38.1% boys; M age 11.14 +/-.79) were asked to play a computer game while they believed to interact online with a same-sex normal-weight remote confederate (i.e., instructed peer) who ate either nothing, a small or large amount of candy. Results: Participants modeled the candy intake of peers via a social media interaction, but this was qualified by their self-esteem. Participants with higher ISE adjusted their candy intake to that of a peer more closely than those with lower ISE when the confederate ate nothing compared to when eating a modest (beta = .26, p = .05) or considerable amount of candy (kcal) (beta = .32, p = .001). In contrast, participants with lower BE modeled peer intake more than those with higher BE when eating nothing compared to a considerable amount of candy (kcal) (beta = .21, p = .02); ESE did not moderate social modeling behavior. In addition, participants with higher discrepant or "damaged" self-esteem (i.e., high ISE and low ESE) modeled peer intake more when the peer ate nothing or a modest amount compared to a substantial amount of candy (kcal) (beta = -.24, p = .004; beta= -.26, p < .0001, respectively). Conclusion: Youngsters conform to the amount of palatable food eaten by peers through social media interaction. Those with lower body esteem or damaged self-esteem may be more at risk to peer influences on food intake.11 p

The role of explicit and implicit self-esteem in peer modeling of palatable food intake: A study on social media interaction among youngsters

Contains fulltext : 116712.pdf (publisher's version ) (Open Access)Objective: This experimental study investigated the impact of peers on palatable food intake of youngsters within a social media setting. To determine whether this effect was moderated by self-esteem, the present study examined the roles of global explicit self-esteem (ESE), body esteem (BE) and implicit self-esteem (ISE). Methods: Participants (N = 118; 38.1% boys; M age 11.14 +/-.79) were asked to play a computer game while they believed to interact online with a same-sex normal-weight remote confederate (i.e., instructed peer) who ate either nothing, a small or large amount of candy. Results: Participants modeled the candy intake of peers via a social media interaction, but this was qualified by their self-esteem. Participants with higher ISE adjusted their candy intake to that of a peer more closely than those with lower ISE when the confederate ate nothing compared to when eating a modest (beta = .26, p = .05) or considerable amount of candy (kcal) (beta = .32, p = .001). In contrast, participants with lower BE modeled peer intake more than those with higher BE when eating nothing compared to a considerable amount of candy (kcal) (beta = .21, p = .02); ESE did not moderate social modeling behavior. In addition, participants with higher discrepant or "damaged" self-esteem (i.e., high ISE and low ESE) modeled peer intake more when the peer ate nothing or a modest amount compared to a substantial amount of candy (kcal) (beta = -.24, p = .004; beta= -.26, p < .0001, respectively). Conclusion: Youngsters conform to the amount of palatable food eaten by peers through social media interaction. Those with lower body esteem or damaged self-esteem may be more at risk to peer influences on food intake.11 p

The prion hypothesis: from biological anomaly to basic regulatory mechanism

Prions are unusual proteinaceous infectious agents that are typically associated with a class of fatal degenerative diseases of the mammalian brain. However, the discovery of fungal prions, which are not associated with disease, suggests that we must now consider the effect of these factors on basic cellular physiology in a different light. Fungal prions are epigenetic determinants that can alter a range of cellular processes, including metabolism and gene expression pathways, and these changes can lead to a range of prion-associated phenotypes. The mechanistic similarities between prion propagation in mammals and fungi suggest that prions are not a biological anomaly but instead could be a newly appreciated and perhaps ubiquitous regulatory mechanism