Developmental progression in children’s and adolescents’ cognitive control

Background: Despite developmental progression in the ability to control behavior in service of goals during kindergarten period, little is known about cognitive control mechanisms in later childhood and adolescence. Method: The present study provides detailed insights into children’s and adolescents’ ability to flexibly and efficiently adapt their speed of responding in the context of a multiple-trial spatial conflict task. Based on the dual mechanisms of cognitive control, variability in response times, response consistency, trial-by trial adjustments surrounding errors, and developmental differences thereof were investigated. Results: Results showed that individuals become more reliable, more efficient, better adjusted, and thus of overall better in cognitive control with increasing age. Sequential adjustments of response times revealed that the participating 4th graders responded too fast when the task was running smoothly and slowed down too strongly after committing an error in comparison to 6th and 8th graders. Conclusion: The results suggest that the fine-tuning of speeded responses are key mechanisms for developmental progression in cognitive control. Furthermore, the current study attempts to increase researcher’s and practitioners’ awareness that detailed analysis of cognitive control processes in typically developing children and adolescents is needed for a better understanding when evaluating these processes in individuals with deviant cognitive development. Keywords: Cognitive Control; Error-Monitoring; Typical Developmen

Foundations for future math achievement: Early numeracy, home learning environment, and the absence of math anxiety.

BACKGROUND Mathematics achievement is pivotal in shaping children's future prospects. Cognitive skills (numeracy), feelings (anxiety), and the social environment (home learning environment) influence early math development. METHOD A longitudinal study involved 85 children (mean age T1 = 6.4 years; T2 = 7.9) to explore these predictors holistically. Data were collected on early numeracy skills, home learning environment, math anxiety, and their impact on various aspects of math. RESULTS The study found that early numeracy skills, home learning environment, and math anxiety significantly influenced math school achievement. However, they affected written computation, sequences, and comparisons differently. Early numeracy skills strongly predicted overall achievement and comparison subtest performance. CONCLUSION These findings underscore the substantial role of math anxiety and home learning environment in children's math achievement. The study emphasizes the need to consider the selective impacts of these factors in future research, shedding light on the multifaceted nature of mathematics achievement determinants

The influence of nurse characteristics on practice skills and attitudes towards working with families in critical care : a regression analysis

Objectives: The study aimed to identify nurse characteristics that influence their self-perceived practice skills in working with families and their attitudes towards engaging families in adult and neonatal intensive care units. Research methodology/Design: Secondary data analysis using a descriptive, cross-sectional design. Setting: An online survey was completed by 256 nurses from six adult intensive (73% response rate) and two neonatal intensive and one intermediate care unit (27% response rate) in a Swiss, university affiliated hospital. Main outcome measures: Nurses’ self-perceived practice skills in working with families were assessed with the “Family Nursing Practice Scale”. Attitudes towards families were measured with the “Families’ Importance in Nursing Care – Nurses’ Attitudes Scale”. Data were analysed with multiple linear regression models. Results: Prior education in family nursing significantly influenced nurses’ self-perceived practice skills in working with families. Nurses’ clinical speciality had a significant influence on their attitudes towards overall, and on the subscale “family as a burden”. Neonatal intensive care nurses showed more open attitudes towards families overall, but perceived family more often as a burden than nurses in adult intensive care. Nurses’ perceived skills and attitudes in family engagement significantly influenced each other. Conclusion: The results suggest that nurses’ prior education in family nursing and clinical speciality determine their ability to work with and engage families in critical care. Our study suggests that integration of family nursing engagement practices in critical care requires educational implementation strategies combined with culture change efforts

Impact of Age at Pediatric Stroke on Long-term Cognitive Outcome.

OBJECTIVES To investigate the impact of age at pediatric arterial ischemic stroke on long-term cognitive outcome in order to identify patients particularly at risk for the development of cognitive long-term cognitive sequelae. METHODS This cross-sectional study included patients in the chronic phase of stroke (> 2 years after stroke) previously diagnosed with neonatal or childhood arterial ischemic stroke and a control group. Participants with active epilepsy, severe learning difficulties, or behavioral problems hindering the cognitive assessment were excluded. Several cognitive domains, including intelligence, executive functions (working memory, inhibition, and cognitive flexibility), processing speed, memory, letter fluency, and visual-motor skills were assessed with neuropsychological tests. Cognitive long-term outcome was compared across patients after neonatal stroke (stroke between 0 and 28 days of life), early childhood stroke (stroke between 29 days and < 6 years) and late childhood stroke (stroke between ≥ 6 and < 16 years). RESULTS 52 patients after neonatal or childhood arterial ischemic stroke (median age: 15.3 years, IQR = 10.6 - 18.7) and 49 healthy controls (median age: 13.6 years, IQR = 9.8 - 17.2) met the inclusion criteria. Cognitive outcome was significantly worse in the pediatric stroke group compared to the control group. A non-linear effect of age at stroke (irrespective of lesion size and lesion location) was found for cognitive flexibility, processing speed, and verbal learning with early childhood stroke (29 days to < 6 years) showing significantly worse cognitive outcome compared to neonatal or late childhood stroke (p < .05, FDR-corrected). CONCLUSION Age at stroke is an important factor for post-stroke recovery and modulates long-term cognitive outcome irrespective of lesion size and lesion location. Children after early childhood stroke are at particular risk for alterations of long-term cognitive functions

Factors influencing critical care nurses' family engagement practices: An international perspective

Background: Family engagement positively impacts patient and family members' experiences of care and health outcomes. While partnering with families denotes best practice in intensive care units (ICUs), its full adoption requires improvement. A better understanding of the factors that influence the implementation of family engagement practices is necessary. Aim: To investigate the factors that enable or hinder adult ICU nurse-family engagement and to explore potential international variations. Study design: Descriptive, cross-sectional survey. Nurses from 10 countries completed the 'Questionnaire on Factors that Influence Family Engagement' (QFIFE), including five open-ended questions. We performed descriptive statistics on quantitative data and content analysis for open-ended questions, and then integrated the findings according to influencing factors and geographical patterns. This was part of a larger qualitative study where 65 nurses participated from adult intensive care units. Results: Sixty-one nurses completed the questionnaire, making a response rate of 94%. Overall, patient acuity (Md = 5.0) and nurses' attitudes (Md = 4.6) seemed to be the most influential facilitator, followed by nurse workflow (Md = 4.0) and ICU environment (Md = 3.1) (score 1-6 most influential). The open-ended question data showed a more nuanced picture of the complexity of family engagement in care around these four determinants. Adding a fifth determinant, namely Families are complex structures that respond uniquely to the ICU and patient, revealed that difficult family dynamics, miscommunication and family having difficulty in understanding the situation or health literacy, hindered family engagement. Exploring geographical variations, Africa/Middle East consistently differed from others on three of the four QFIFE subscales, showing lower median levels. Conclusions: Some determinants are perceived to be more influential than others, becoming barriers or enablers to nurse-family engagement in adult ICU. Research that investigates contextual determinants and which compares implementation and improvement initiatives tailored to address family engagement practices barriers and enablers are needed. Relevance to clinical practice: Knowledge of this international study expands our understanding of enablers and barriers in family engagement that may inform family engagement practice improvement efforts around the world. Keywords: communication; critical care nursing; family nursing; intensive care unit; social factor

The influence of nurse characteristics on practice skills and attitudes towards working with families in critical care: A regression analysis

Objectives: The study aimed to identify nurse characteristics that influence their self-perceived practice skills in working with families and their attitudes towards engaging families in adult and neonatal intensive care units. Research methodology/design: Secondary data analysis using a descriptive, cross-sectional design. Setting: An online survey was completed by 256 nurses from six adult intensive (73% response rate) and two neonatal intensive and one intermediate care unit (27% response rate) in a Swiss, university affiliated hospital. Main outcome measures: Nurses' self-perceived practice skills in working with families were assessed with the "Family Nursing Practice Scale". Attitudes towards families were measured with the "Families' Importance in Nursing Care - Nurses' Attitudes Scale". Data were analysed with multiple linear regression models. Results: Prior education in family nursing significantly influenced nurses' self-perceived practice skills in working with families. Nurses' clinical speciality had a significant influence on their attitudes towards overall, and on the subscale "family as a burden". Neonatal intensive care nurses showed more open attitudes towards families overall, but perceived family more often as a burden than nurses in adult intensive care. Nurses' perceived skills and attitudes in family engagement significantly influenced each other. Conclusion: The results suggest that nurses' prior education in family nursing and clinical speciality determine their ability to work with and engage families in critical care. Our study suggests that integration of family nursing engagement practices in critical care requires educational implementation strategies combined with culture change efforts. Keywords: Adults; Critical care; Family engagement; Family nursing; Neonates; Nurse’ characteristics; Practice skills; Practitioners’ attitudes

Foundations for future math achievement: early numeracy, home learning, and the absence of math anxiety

Mathematics achievement is an important predictor of later life and career prospects. Therefore, it is highly relevant to identify early determinants of math achievement. Recently, non-cognitive aspects such as home learning environment (home numeracy) and math anxiety were observed to significantly predict mathematics achievement beyond domain- specific early numerical skills. However, these aspects have hardly been considered jointly in one study. Therefore, this longitudinal study evaluated the predictive power of early numeracy skills, home learning environment, and math anxiety assessed at the end of kindergarten for mathematics achievement at the beginning of second grade in a normative sample of 85 children. Correlations and regression analyses indicated that early numeracy skills, home environment, and math anxiety have a unique and essential influence on math school achievement. It is, however, important to note that predictions seemed selective for different components of math achievement such as written computation, sequences, and comparisons. Results indicated that home numeracy only predicted performance on sequences, whereas math anxiety seemed to affect written computation. Overall achievement as well as performance on the equation’s subtest were best predicted by early numeracy skills. Taken together, these results suggest that non-cognitive aspects of home numeracy and math anxiety significantly influence children’s future math achievement. Importantly, however, results also argue for selective influences that should be considered in future studies

Tailored implementation of evidence-informed family end-of-life and BEreavement SupporT (BEST for Family) in acute palliative care: A mixed-methods study with health professionals and family members

Background: Family caregiving followed by the loss of the close other are stressful, incisive experiences that may impact negatively on physical and mental health. Evidence-based, health-promoting bereavement care is insufficiently adopted and inconsistently delivered in Swiss palliative care services. Objectives: The aims of this implementation research project are first, to adopt the evidence to local conditions and tailor implementation to barriers / enablers, and second, to evaluate the ability to ensure full integration of this evidence-based BEreavement SupporT services for families (= BEST for Family) through a set of co-developed implementation strategies in palliative care by investigating implementation, service, and health outcomes from health professionals’ and bereaved families’ perspectives. Setting and Participants: Implementation and evaluation of BEST for Family will be carried out in two specialized palliative care inpatient services in two large Swiss hospitals. Health professionals, namely, nurses, physicians, chaplains, social workers, psychologists, and other palliative staff members working in the services, and bereaved family members receiving the support will be included. Methods: The study includes a preparation, implementation and evaluation phase with five work packages. First, evidence-based recommendations will be identified through a literature review and adapted to the Swiss context through practice partner workshops, resulting in the BEST for Family service. Second, implementation strategies will be developed in collaboration with practice partners through contextual analysis focus groups guided by the Updated Consolidated Framework for Implementation Research (CFIR 2.0). Third, BEST for Family will be implemented and delivered. Fourth, using a pre-mid-post survey study with embedded qualitative interviews, implementation process and outcomes will be evaluated with health professionals. Fifth, using mixed-methods, service and health outcomes will also be assessed with families. Expected outcomes: The evidence available on how to best support bereaved families according to their individual needs and risks requires better translation into specialized palliative care in Switzerland. Therefore, this study addresses a significant know-do gap in palliative care by using implementation science knowledge and methods. Study findings will provide important knowledge on implementation processes and outcomes of family care, which will inform scalability to other palliative care services and settings in Switzerland and ensure improved and equitable access to evidence-informed, health-promoting engagement and support to families at the end-of-life and in bereavement

Factors influencing critical care nurses’ family engagement practices: An international perspective

Aim: To investigate the factors that enable or hinder adult ICU nurse-family engagement and to explore potential international variations. Background: Family engagement positively impacts patient and family members’ experiences of care and health outcomes. While partnering with families denotes best practice in intensive care units (ICUs), its full adoption requires improvement. A better understanding of the factors that influence the implementation of family engagement practices is necessary. Design: Descriptive, cross-sectional survey. Methods: Nurses from ten countries completed the ´Questionnaire on Factors that Influence Family Engagement´ (QFIFE), including five open-ended questions. We performed descriptive statistics on quantitative data and content analysis for open-ended questions, and then integrated the findings according to influencing factors and geographical patterns. This was part of a larger qualitative study where 65 nurses participated from adult intensive care units. Results: Sixty-one nurses completed the questionnaire, making a response rate of 94%. Overall, patient acuity (Md =5.0) and nurses’ attitudes (Md = 4.6) seemed to be the most influential facilitator, followed by nurse workflow (Md = 4.0) and ICU environment (Md=3.1) (score 1-6 most influential). The open-ended question data showed a more nuanced picture of the complexity of family engagement in care around these four determinants. Adding a fifth determinant, namely Families are complex structures who respond uniquely to the ICU and patient, revealed that difficult family dynamics, miscommunication and family having difficulty in understanding the situation or health literacy, hindered family engagement. Exploring geographical variations, Africa/Middle East consistently differed from others on three of the four QFIFE subscales, showing lower median levels. Conclusions: Some determinants are perceived to be more influential than others, becoming barriers or enablers to nurse-family engagement in adult ICU. Research that investigates contextual determinants and which compares implementation and improvement initiatives tailored to address family engagement practices barriers and enablers, is needed. Relevance to clinical practice: Knowledge of this international study expands our understanding of enablers and barriers in family engagement that may inform family engagement practice improvement efforts around the world

Supplementary information files for Foundations for future math achievement: Early numeracy, home learning environment, and the absence of math anxiety

© The Authors, CC BY 4.0Supplementary files for article Foundations for future math achievement: Early numeracy, home learning environment, and the absence of math anxietyBackgroundMathematics achievement is pivotal in shaping children's future prospects. Cognitive skills (numeracy), feelings (anxiety), and the social environment (home learning environment) influence early math development.MethodA longitudinal study involved 85 children (mean age T1 = 6.4 years; T2 = 7.9) to explore these predictors holistically. Data were collected on early numeracy skills, home learning environment, math anxiety, and their impact on various aspects of math.ResultsThe study found that early numeracy skills, home learning environment, and math anxiety significantly influenced math school achievement. However, they affected written computation, sequences, and comparisons differently. Early numeracy skills strongly predicted overall achievement and comparison subtest performance.ConclusionThese findings underscore the substantial role of math anxiety and home learning environment in children's math achievement. The study emphasizes the need to consider the selective impacts of these factors in future research, shedding light on the multifaceted nature of mathematics achievement determinants.</p