Parent Interaction Between an Infant with a Cochlear Implant and Additional Disabilities

Pediatric hearing loss has many spoken language learning issues that can impact parent-infant interaction. Moreover, additional disabilities are likely to increase stress, which could have cascading effects on communication. The purpose of the study was to examine interactions between mother- and father-child dyads with and without hearing loss and/or Autism Spectrum Disorder (ASD), Cytomegalovirus (CMV), and global delay. Recordings of the parents speaking with six infants in the study were analyzed: an infant with cochlear implants and ASD (low socioeconomic status, SES), two infants with cochlear implants and normal development (high SES and low SES), one infant with a cochlear implant and CMV (average SES), one infant with a cochlear implant and global delay (average SES), and one infant who was typically developing and had normal hearing (high SES). After analyzing the results for communication measures, such as vocalization attempts, turn-taking in utterances, mean-length of utterances, and type-token ratio, it was concluded that maternal and paternal interaction was negatively affected due not only to the difficulty of the hearing loss and/or additional disability, but rather due to a combination of factors, including the disability, SES, maternal and paternal education, and the home environment

A survey and evaluation of professional literature on spelling, 1938-1948

There have been rapid changes in methods of teaching spelling. At one time spelling was restricted to a specific list of words in the curriculum for each grade, with little regard for functional use. This method has been recognized as inefficient since the mere learning of isolated lists of words is not sufficient. However the present tendency in methods of teaching spelling is toward the functional approach, and consequently spelling is being used in the modern school with the broader activity program. The old method of drilling every pupil on every word is not sufficent. Word lists are being individualized for daily instruction and individual remedial work is used. So much has been written on methods to use in the teaching of spelling that one needs to sort and evaluate them. Some of the new trends in spelling have been summarized by Gertrude Hildreth, who writes: "the routine, regimented, uniform drill which has prevailed so long proves in the end to be inefficient----Nothing is going to improve the situation except more efficient and intelligent instruction."

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

Additional file 4 of Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Additional file 4: Supplemental results.1. README. 2. Prevalence range across districts. 3. Prevalence range between sexes. 4. Prevalence range between ages. 5. Age-specific district ranges

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

International audienc