Checking behaviours, prospective memory and executive functions

Explanations implicating memory in the causes and severity of checking symptoms have focused primarily on retrospective memory, and relatively little attention has been paid to prospective memory. Limited research has examined the relationship between prospective memory and executive functions. We assessed whether impairments in prospective memory and executive function predict checking symptoms in a sample of 106 adults. Checking symptoms were assessed using the Padua Inventory Washington State University Revision (PI-WSUR). All participants completed the prospective memory questionnaire (PMQ) and four computerised executive function tasks from the CANTAB, measuring inhibition, planning, attention set-shifting and working memory. Prospective memory and inhibition predicted checking symptom severity. Importantly, there were no correlations between internally cued prospective memory and inhibition or between prospective memory aiding strategies and inhibition. These variables appear to have an independent role in checking. The current findings highlight prospective memory and inhibition as key contributors to the checking symptom profile and provide the first evidence that these cognitive processes may independently contribute to checking symptoms. These findings have implications for a model in which memory performance is thought to be secondary to impairments in executive functions

Friendships in children with Williams syndrome : parent and child perspectives

Although children with Williams syndrome (WS) are strongly socially motivated, many have friendship difficulties. The parents of 21 children with WS and 20 of the children themselves participated in a semi-structured interview about the children's friendships. Parents reported that their child had difficulties sustaining friendships and low levels of interaction with peers. Barriers to friendships included difficulties with play and self-regulating behaviour. However, there was within-group variability, with a small number of children reported to have strong friendships. While parents reported friendship challenges, all of the children named at least one friend, and most said that they had never felt excluded by their peers. Future research is needed to determine optimal ways to support children with WS in their friendships

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

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

Is child-related training or general education a better predictor of good quality care?

The combination of education and training for caregivers provides the best preparation for ensuring high quality of care. Education makes an important difference in the way in which caregivers interact with children - a difference which is further supplemented by child-related training. However, for those with no education even small amounts of training seem to have a significant effect. The level of knowledge relating to development which is provided by education and training seems to be an important factor in their effect on adult-child interaction and children's developmental outcomes. Thus, where only relatively brief training is available to caregivers its' curriculum should be directed to the provision of the greatest amount of child development knowledge possible. The type and amount of training and education caregivers have received and how clearly these are specified varies greatly from study to study making it difficult to interpret their effects. Future research in this area needs to utilize a common method of categorizing caregivers' levels of education and training which clearly specifies the number of caregivers in each category

The effects of specialized training on caregivers and children in early-years settings: an evaluation of the foundation course in playgroup practice

This study examined the effects of a 120-hour preschool training course on caregivers' behavior and children's development in early-years settings. Sixteen caregivers attending this training course and 17 comparison caregivers were assessed on a measure of caregiver sensitivity in the child-care centers in which they were employed. Sixty-eight children, two from each center, were assessed for social and cognitive competence. Both the training and comparison caregivers and children were observed before and after the former group attended the training course. Caregivers who received training made significant gains in positive relationship and decreased in levels of detachment. The children in their care made significant gains in complex social and cognitive play from pre- to post-training. The comparison group adults and children showed no significant improvements from pre- to post-test times

Disturbed and disturbing behaviour

Children's Personal and Social Development gives an up-to-date and accessible account of work addressing an area of psychological enquiry that has grown rapidly in recent years, namely the study of children's personal and social development. One of a series of four books which form part of The Open University course Child Development. Each chapter focuses on a specific key issue or topic, for example parenting or gender identity, and discusses associated theories and research. The chapters have been prepared by leading researchers in relevant fields and members of The Open University course team

An experimental and modeling study of propene oxidation. Part 2: Ignition delay time and flame speed measurements

Journal articleExperimental data obtained in this study (Part II) complement the speciation data presented in Part I, but also offer a basis for extensive facility cross-comparisons for both experimental ignition delay time (IDT) and laminar flame speed (LFS) observables.To improve our understanding of the ignition characteristics of propene, a series of IDT experiments were performed in six different shock tubes and two rapid compression machines (RCMs) under conditions not previously studied. This work is the first of its kind to directly compare ignition in several different shock tubes over a wide range of conditions. For common nominal reaction conditions among these facilities, cross-comparison of shock tube IDTs suggests 20-30% reproducibility (2 sigma) for the IDT observable. The combination of shock tube and RCM data greatly expands the data available for validation of propene oxidation models to higher pressures (2-40 atm) and lower temperatures (750-1750 K).Propene flames were studied at pressures from 1 to 20 atm and unburned gas temperatures of 295-398 K for a range of equivalence ratios and dilutions in different facilities. The present propene-air LFS results at 1 atm were also compared to LFS measurements from the literature. With respect to initial reaction conditions, the present experimental LFS cross-comparison is not as comprehensive as the IDT comparison; however, it still suggests reproducibility limits for the LFS observable. For the LFS results, there was agreement between certain data sets and for certain equivalence ratios (mostly in the lean region), but the remaining discrepancies highlight the need to reduce uncertainties in laminar flame speed experiments amongst different groups and different methods. Moreover, this is the first study to investigate the burning rate characteristics of propene at elevated pressures (>5 atm).IDT and LFS measurements are compared to predictions of the chemical kinetic mechanism presented in Part I and good agreement is observed. (C) 2014 The Combustion Institute. Published by Elsevier Inc. All rights reserved.The Rensselaer group was supported by the U.S. Air Force Office of Scientific Research (Grant No. FA9550-11-1-0261) with Dr. Chiping Li as technical monitor. Work at the University of Connecticut and at Princeton University was supported as part of the Combustion Energy Frontier Research Center, an Energy Frontier Research Center funded by the U.S. Department of Energy, Office of Science, Office of Basic Energy Science, under Award Number DE-SC0001198. The work at Stanford University was supported by the Air Force Office of Scientific Research through AFOSR Grant No. FA9550-11-1-0217, under the AFRL Integrated Product Team, with Dr. Chiping Li as contract monitor. The work at NUI Galway was kindly supported by Saudi Aramco. The work of KAUST authors was supported by Saudi Aramco under the FUELCOM program.peer-reviewe