Social adaptation and communicative competence in children in care

This paper analyses the communicative competence and the degree of social adaptation of children in care. It provides further knowledge of the relationship between the children's social and linguistic skill and analyses the presence of difficulties in the different components of language (morphology, syntaxis, semantics and pragmatics). The research was carried out in children's homes in Extremadura (Spain). The sample consists of 74 children between 6 and 18 years of age. The study illustrates that the children's linguistic development is below what is considered to be normal for their chronological age. They have greater difficulties in pragmatics and morphology than in syntaxis and semantics. The relationship between the level of dominion in morphology, syntaxis and semantics and the children's degree of social maladjustment is evident. We call attention to such important aspects as intentionality in communication and the context in which the children's language is developed.Child care Residential care Social adaptation Linguistic skills Child abuse Neglect Language development Family

Pragmatic language development and educational style in neglected children

This paper analyzes the pragmatic competence of children in residential care and the relation between the parents' educational style and the level of pragmatic dominion of 74 children aged between 6 and 18 in 4 residential child care centers in Extremadura. We apply the 'Objective Language Criteria Test' (BLOC-Screening) to evaluate their linguistic development and the 'Autoevaluative Multifactorial Child Adaptation Test' (TAMAI) to determine educational style. The presence of difficulties in pragmatics is evident. The children with a low dominion of pragmatics perceive a more restrictive and punitive style in the mother and a high affective rejection in the father. The children have difficulties empathizing with others, especially when they are interacting with adults; they have very little skill in showing disagreement before an authority figure; and they use their previous experience to make inferences about the actions or intentions of other people. We verify the need to implant programs designed to stimulate and reorganize the children's language.Child abuse Language development Pragmatics Neglect Psycholinguistic skills

High PEEP with recruitment maneuvers versus Low PEEP During General Anesthesia for Surgery -a Bayesian individual patient data meta-analysis of three randomized clinical trials

Background: The influence of high positive end-expiratory pressure (PEEP) with recruitment maneuvers on the occurrence of postoperative pulmonary complications after surgery is still not definitively established. Bayesian analysis can help to gain further insights from the available data and provide a probabilistic framework that is easier to interpret. Our objective was to estimate the posterior probability that the use of high PEEP with recruitment maneuvers is associated with reduced postoperative pulmonary complications in patients with intermediate-to-high risk under neutral, pessimistic, and optimistic expectations regarding the treatment effect. Methods: Multilevel Bayesian logistic regression analysis on individual patient data from three randomized clinical trials carried out on surgical patients at Intermediate-to-High Risk for postoperative pulmonary complications. The main outcome was the occurrence of postoperative pulmonary complications in the early postoperative period. We studied the effect of high PEEP with recruitment maneuvers versus Low PEEP Ventilation. Priors were chosen to reflect neutral, pessimistic, and optimistic expectations of the treatment effect. Results: Using a neutral, pessimistic, or optimistic prior, the posterior mean odds ratio (OR) for High PEEP with recruitment maneuvers compared to Low PEEP was 0.85 (95% Credible Interval [CrI] 0.71 to 1.02), 0.87 (0.72 to 1.04), and 0.86 (0.71 to 1.02), respectively. Regardless of prior beliefs, the posterior probability of experiencing a beneficial effect exceeded 90%. Subgroup analysis indicated a more pronounced effect in patients who underwent laparoscopy (OR: 0.67 [0.50 to 0.87]) and those at high risk for PPCs (OR: 0.80 [0.53 to 1.13]). Sensitivity analysis, considering severe postoperative pulmonary complications only or applying a different heterogeneity prior, yielded consistent results. Conclusion: High PEEP with recruitment maneuvers demonstrated a moderate reduction in the probability of PPC occurrence, with a high posterior probability of benefit observed consistently across various prior beliefs, particularly among patients who underwent laparoscopy