An investigation of the Bender-Gestalt as a screening technique for psychiatric disorders in children

The present study utilized three groups of children; 200 normals, 60 emotionally disturbed and 39 suffering some degree of cerebral dysfunction. Their ages ranged from 10-0 through 14-11 and their IQs from 76 to 126. Each child was administered individually the Spiral After effect Test, the writer's version of the Trail Making Test and the Bender-Gestalt Test. The Bender-Gestalt protocols were then scored by the Pascal-Suttell method. Although it was found that each of the three tests discriminated between the groups at the . 1[percent] level of confidence, they were of little value for individual prediction purposes.Two brief screening scales, Scale A (Emotional Disturbance) and Scale B (Neurological Referral) were then constructed from scorable deviations on the Bender-Gestalt Test and from parts of the Spiral Aftereffect and Trail Making Tests. When these scales were applied to the test data, they were also able to discriminate between the groups at the .1% level. The scales improved on the Pascal-Suttell method in making individual discriminations in that they misclassified fewer subjectsin both experimental groups than the Pascal-Suttell method.<p

Initial adherence of EPEC, EHEC and VTEC to host cells

Initial adherence to host cells is the first step of the infection of enteropathogenic Escherichia coli (EPEC), enterohaemorrhagic Escherichia coli (EHEC) and verotoxigenic Escherichia coli (VTEC) strains. The importance of this step in the infection resides in the fact that (1) adherence is the first contact between bacteria and intestinal cells without which the other steps cannot occur and (2) adherence is the basis of host specificity for a lot of pathogens. This review describes the initial adhesins of the EPEC, EHEC and VTEC strains. During the last few years, several new adhesins and putative colonisation factors have been described, especially in EHEC strains. Only a few adhesins (BfpA, AF/R1, AF/R2, Ral, F18 adhesins) appear to be host and pathotype specific. The others are found in more than one species and/or pathotype (EPEC, EHEC, VTEC). Initial adherence of EPEC, EHEC and VTEC strains to host cells is probably mediated by multiple mechanisms

Differential Kinetics of Immune Responses Elicited by Covid-19 Vaccines

To the Editor: Previous studies have shown that the BNT162b2 (Pfizer–BioNTech), mRNA-1273 (Moderna), and Ad26.COV2.S (Johnson & Johnson–Janssen) vaccines provide robust protective efficacy against coronavirus disease 2019 (Covid-19). Here, we report comparative kinetics of humoral and cellular immune responses elicited by the two-dose BNT162b2 vaccine (in 31 participants), the two-dose mRNA-1273 vaccine (in 22 participants), and the one-dose Ad26.COV2.S vaccine (in 8 participants). We evaluated antibody and T-cell responses from peak immunity at 2 to 4 weeks after the second immunization in recipients of the messenger RNA (mRNA) vaccines or after the first immunization in recipients of the Ad26.COV2.S vaccine to 8 months (Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org)

What Makes Retirees Happier: A Gradual or 'Cold Turkey' Retirement?

This study explores the factors that affect an individual’s happiness while transitioning into retirement. Recent studies highlight gradual retirement as an attractive option to older workers as they approach full retirement. However, it is not clear whether phasing or cold turkey makes for a happier retirement. Using longitudinal data from the Health and Retirement Study, this study explores what shapes the change in happiness between the last wave of full employment and the first wave of full retirement. Results suggest that what really matters is not the type of transition (gradual retirement or cold turkey), but whether people perceive the transition as chosen or forced

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Storytelling Comes Alive: Preschoolers’ Development of Narrative Comprehension and Academic Language Within a Participatory Oral Storytelling Intervention

Extensive bodies of literature examining child language acquisition and early literacy development indicate that the language and literacy opportunities young children have at home and in school settings, including the nature of their language interactions with adults and their exposure to books and stories, are consequential for mastery of conventional literacy and long-term academic success (Burchinal &amp; Forestieri, 2011; Catts et al., 2001; Cunningham &amp; Stanovich, 1997; Fernald &amp; Weisleder, 2015). Research reports indicating numerous common and distinct benefits to book reading (e.g., Elley, 1989; Lonigan &amp; Whitehurst, 1998; Neuman, 1999; Becher, 1985) and storytelling (e.g., Isbell et al., 2004; Trostle &amp; Hicks, 1998) for emergent and beginning readers and writers would suggest that children learning in settings where both activities are implemented would be poised to receive the best of both worlds. This study investigated the affordances for the development of narrative comprehension and academic language that arise when young children participate in both read aloud and storytelling lessons. I conducted an ethnographic case study of an ongoing arts-integrated storytelling program for preschoolers, Language and Learning Through Oral Storytelling, that was collaboratively implemented by a community arts organization and a Head Start agency in four preschool classrooms at a single Head Start site serving large numbers of emergent bilingual students and children diagnosed with disabilities. Two teaching artists with professional backgrounds in theater and dance, one seasoned and one new to the storytelling program, delivered over a period of several months in two classrooms each 12 participatory storytelling sessions organized into four units that were designed to promote understanding of narrative. I recorded, transcribed, and analyzed storytelling sessions to investigate and compare the repertoire of language-promoting pedagogical tools that each teaching artist used to promote the narrative register, academic language, and comprehension for stories. In addition, I served as a participant observer in the four classrooms, a role that allowed me informally observe the typical read aloud practices of the classroom teachers as well as to record, transcribe, and analyze their read aloud lessons for the focal picture books that anchored each storytelling unit. A fifth preschool classroom located at second nearby Head Start site served as a no treatment control to permit me to examine teacher read aloud practices in a setting outside the influence of the storytelling program. I compared the read aloud practices of the storytelling teachers to each other and to the control teacher to investigate the language-promoting pedagogical tools they used to promote students’ control of the narrative register, academic language, and comprehension for stories during read aloud lessons. Finally, I asked how the affordances of these two learning contexts—storytelling and reading aloud—complemented and contrasted with one another.Findings indicate that the teaching artists’ pedagogical repertoires were more complex and diverse than those used by the classroom teachers for reading aloud due the wider array of activities used within the storytelling program. The classroom contexts into which the storytelling program was implemented, and the roles played by individual classroom teachers were found to be important contributors to how the storytelling sessions were enacted and experienced in each classroom. The two teaching artists overall used a similar repertoire of language-promoting practices, but the more seasoned artist’s prior experience working with preschoolers in the storytelling program appeared to assist her in designing and teaching heavily scaffolded lessons that minimized misunderstandings with students whereas the new artists’ more relaxed implementation of the storytelling lesson framework and her high expectations for preschool students’ capacity for mature reasoning led to communication problems with students somewhat more frequently. They both strongly emphasized building common knowledge and student observation of and performance of acts of storytelling. The performance orientation placed considerable demands on students’ cognitive, linguistic, motor, and social capacities, while at the same time offering a highly engaging and often exciting forum in which to build understanding of story. This is an important finding given the scope of extant literature on storytelling; in no other study was the storytelling intervention led by professional teaching artists, and in no other study was fully embodied participation by students so emphasized.The classroom teachers shared many commonalities in their read aloud practices, including the finding that many of the language-promoting practices under analysis occurred only occasionally and sometimes not at all during their read aloud lessons. A major unexpected finding was the low frequency of read aloud lessons and sometimes circumscribed nature of those lessons in the four storytelling classrooms as the result of broader professional, instructional, and social forces that shaped the context for instruction at this site. In contrast, the control classroom was found have a particularly vibrant and effective program of reading instruction due operating under substantially different professional, instructional, and social forces. Students at this site enjoyed listening to and talking about books and at times engaged in emergent independent and partner reading. This finding supports existing literature on reading aloud, which indicates that children who find listening to and talking about books to be pleasurable activities are more likely to read independently once they learn to read (Bus, 2002; Cunningham &amp; Zibulsky, 2011) which can have consequential impacts on their success in school and available life choices, as volume of reading is strongly correlated with general knowledge and reading achievement (Cervetti &amp; Hiebert, 2015; Sparks et al., 2014; Stanovich &amp; Cunningham, 1993)

Storytelling Comes Alive: Preschoolers’ Development of Narrative Comprehension and Academic Language Within a Participatory Oral Storytelling Intervention

Extensive bodies of literature examining child language acquisition and early literacy development indicate that the language and literacy opportunities young children have at home and in school settings, including the nature of their language interactions with adults and their exposure to books and stories, are consequential for mastery of conventional literacy and long-term academic success (Burchinal &amp; Forestieri, 2011; Catts et al., 2001; Cunningham &amp; Stanovich, 1997; Fernald &amp; Weisleder, 2015). Research reports indicating numerous common and distinct benefits to book reading (e.g., Elley, 1989; Lonigan &amp; Whitehurst, 1998; Neuman, 1999; Becher, 1985) and storytelling (e.g., Isbell et al., 2004; Trostle &amp; Hicks, 1998) for emergent and beginning readers and writers would suggest that children learning in settings where both activities are implemented would be poised to receive the best of both worlds. This study investigated the affordances for the development of narrative comprehension and academic language that arise when young children participate in both read aloud and storytelling lessons. I conducted an ethnographic case study of an ongoing arts-integrated storytelling program for preschoolers, Language and Learning Through Oral Storytelling, that was collaboratively implemented by a community arts organization and a Head Start agency in four preschool classrooms at a single Head Start site serving large numbers of emergent bilingual students and children diagnosed with disabilities. Two teaching artists with professional backgrounds in theater and dance, one seasoned and one new to the storytelling program, delivered over a period of several months in two classrooms each 12 participatory storytelling sessions organized into four units that were designed to promote understanding of narrative. I recorded, transcribed, and analyzed storytelling sessions to investigate and compare the repertoire of language-promoting pedagogical tools that each teaching artist used to promote the narrative register, academic language, and comprehension for stories. In addition, I served as a participant observer in the four classrooms, a role that allowed me informally observe the typical read aloud practices of the classroom teachers as well as to record, transcribe, and analyze their read aloud lessons for the focal picture books that anchored each storytelling unit. A fifth preschool classroom located at second nearby Head Start site served as a no treatment control to permit me to examine teacher read aloud practices in a setting outside the influence of the storytelling program. I compared the read aloud practices of the storytelling teachers to each other and to the control teacher to investigate the language-promoting pedagogical tools they used to promote students’ control of the narrative register, academic language, and comprehension for stories during read aloud lessons. Finally, I asked how the affordances of these two learning contexts—storytelling and reading aloud—complemented and contrasted with one another.Findings indicate that the teaching artists’ pedagogical repertoires were more complex and diverse than those used by the classroom teachers for reading aloud due the wider array of activities used within the storytelling program. The classroom contexts into which the storytelling program was implemented, and the roles played by individual classroom teachers were found to be important contributors to how the storytelling sessions were enacted and experienced in each classroom. The two teaching artists overall used a similar repertoire of language-promoting practices, but the more seasoned artist’s prior experience working with preschoolers in the storytelling program appeared to assist her in designing and teaching heavily scaffolded lessons that minimized misunderstandings with students whereas the new artists’ more relaxed implementation of the storytelling lesson framework and her high expectations for preschool students’ capacity for mature reasoning led to communication problems with students somewhat more frequently. They both strongly emphasized building common knowledge and student observation of and performance of acts of storytelling. The performance orientation placed considerable demands on students’ cognitive, linguistic, motor, and social capacities, while at the same time offering a highly engaging and often exciting forum in which to build understanding of story. This is an important finding given the scope of extant literature on storytelling; in no other study was the storytelling intervention led by professional teaching artists, and in no other study was fully embodied participation by students so emphasized.The classroom teachers shared many commonalities in their read aloud practices, including the finding that many of the language-promoting practices under analysis occurred only occasionally and sometimes not at all during their read aloud lessons. A major unexpected finding was the low frequency of read aloud lessons and sometimes circumscribed nature of those lessons in the four storytelling classrooms as the result of broader professional, instructional, and social forces that shaped the context for instruction at this site. In contrast, the control classroom was found have a particularly vibrant and effective program of reading instruction due operating under substantially different professional, instructional, and social forces. Students at this site enjoyed listening to and talking about books and at times engaged in emergent independent and partner reading. This finding supports existing literature on reading aloud, which indicates that children who find listening to and talking about books to be pleasurable activities are more likely to read independently once they learn to read (Bus, 2002; Cunningham &amp; Zibulsky, 2011) which can have consequential impacts on their success in school and available life choices, as volume of reading is strongly correlated with general knowledge and reading achievement (Cervetti &amp; Hiebert, 2015; Sparks et al., 2014; Stanovich &amp; Cunningham, 1993)