49 research outputs found
How do three-year-olds use relevance inferencing to interpret indirect speech?
If a child asks a friend to play football and the friend replies “I have a cough”, the requesting child must make a ‘relevance inference’ to determine the communicative intent. Relevance inferencing is a key component of pragmatics, that is, the ability to integrate social context into language interpretation and use. We tested which cognitive skills relate to relevance inferencing. Additionally, we asked whether children’s lab-based pragmatic performance relates to children’s parent-assessed pragmatic language skills. We tested 3½- to 4-year-olds (Study 1: N = 40, Study 2: N = 32). Children were presented with video-recorded vignettes ending with an utterance requiring a relevance inference, for which children made a forced choice. Study 1 measured children’s Theory of Mind, their sentence comprehension and their real-world knowledge and found that only real-world knowledge retained significance in a regression analysis with children’s relevance inferencing as the outcome variable. Study 2 then manipulated children’s world-knowledge via priming but found this did not improve children’s performance on the relevance inferencing task. Study 2 did, however, find a significant correlation between children’s relevance inferencing and a measure of morpho-syntactic production. In both studies parents rated their children’s pragmatic language usage in daily life, which was found to relate to performance in our lab-based relevance inferencing task. This set of studies is the first to empirically demonstrate that lab-based measures of relevance inferencing are reflective of children’s pragmatic abilities ‘in the wild’. We argue that real-world knowledge is a necessary (but not sufficient) for relevance inferencing
Anxiety in children and adolescents with chronic kidney disease - multicenter national study results
Background/Aims: Chronic medical illness is a significant risk factor for the development of psychiatric disorders. The aims of the study were: to investigate the level of anxiety in children with chronic kidney disease (CKD) and to identify factors associated with the presence of that emotional problem. Methods: CKD children on hemodialysis (HD, n=22), peritoneal dialysis (PD, n=20,) and on conservative treatment (CT, n=95) were enrolled in the study. We used State-Trait Anxiety Inventory (STAI) for adolescents and STAI-C for children. Socio-demographic and physical factors were assessed. Results: There was a significantly higher level of anxiety-state among HD children (8-12 years) compared with other groups of participants of the same age and Polish population norms. The level of anxiety among adolescents (13-18 years), both anxiety-state and anxiety-trait, was significantly higher in the HD group compared with other groups, which did not differ among themselves. In the HD adolescents, there was a correlation between the anxiety-state and the duration of the disease as well as with the number of hospitalizations. PD adolescents in the mainstream education had higher levels of anxiety-state and anxiety-trait compared with home schooled patients. Conclusions: Even though children and adolescents with CKD are at risk of developing a variety of emotional disorders, the level of anxiety among the researched group, with the exception of HD patients, was not significantly different than the level of anxiety among healthy subjects. Adolescents on HD who present a high level of anxiety should undergo long-term psychological treatment
Disease-related social situation in family of children with chronic kidney disease - parents' assessment : a multicentre study
Introduction and Objective. Chronic kidney disease (CKD) in children burdens life of patients and their families. Little is
known about parents` assessment of families’ social situation. However, the knowledge of the details of a patient’s and his
family’s life standards might influence modification and optimization of applied therapy. Therefore, the main goal of the
present study was to explore the selected elements of life situation of patients suffering with CKD as well as their parents,
depending on the CKD stage and appropriate treatment.
Materials and Methods. Cross-sectional national study was conducted. A total of 203 children with CKD and 388 their
parent-proxies (196 women and 192 men) were enrolled into this study. Patient data and questionnaires filled by both
parents, concerning social-demographic parameters and assessment of changes in families after CKD diagnosis in the child,
were analysed.
Results. CKD children are being brought up in proper families whose financial situation is not good. Children need help in
process of education. Perception of current situation differed between both parents in the change of the income source,
taking care of CKD child, change in social relations and evaluating relations with medical staff. Parents do not obtain proper
support from social workers.
Conclusion. Families of CKD children require support in area of financial and educational help for school children. The
discrepancies in evaluation of family situation between mothers and fathers of ill children might be the source of conflicts
possibly resulting in worsening the outcome for CKD children
Perception of health-related quality of life in children with chronic kidney disease by the patients and their caregivers : multicentre national study results
Objective The aim of the study was to analyse the healthrelated quality of life (HRQoL) in Polish children with
chronic kidney disease (CKD) dependant on the CKD
stage, treatment modality and selected social life elements
in families of the patients. Furthermore, potential differences between self-report and parent/proxy reports and the
factors influencing them were assessed.
Methods A total of 203 CKD children (on haemodialysis
(HD), peritoneal dialysis (PD) and conservative treatment
(CT)) and their 388 parent/proxies were enrolled into a
cross-sectional national study. The demographic and social
data were evaluated. We used the Paediatric Quality of Life
Inventory 4.0 Generic Core Scales to assess the HRQoL in
children.
Results Health-related quality of life scores for all CKD
groups were significantly lower in all domains compared
with population norms, the lowest one being in the HD
group. In CT children, HRQoL did not depend on the CKD
stage. Both parents assessed the HRQoL of their children
differently depending on their involvement in the care.
There are differences between the HRQoL scores of the
children and their parents
“Sure I’ll help – I’ve just been sitting around doing nothing at school all day”: cognitive flexibility and child irony interpretation
Successful peer relations in older children depend on proficiency with banter, which in turn frequently involves verbal irony. Individual differences in successful irony interpretation have traditionally been attributed to Theory of Mind. Our premise was that the key factor might in fact be cognitive flexibility, the ability to switch between different perspectives (here: on the same utterance). We also wished to extend the focus of previous irony studies, which have almost exclusively examined Simple Irony, where the literal meaning conflicts with observable physical evidence (e.g. ‘great day for a picnic’ when viewing a downpour). Therefore, we also examined how children interpreted more Complex Irony, where listeners must consider at a deeper level the common ground shared with the speakers (e.g. general knowledge / cultural common ground or information about the particular speaker). In Study 1 we found that for six- to eight-year-olds both cognitive flexibility and Theory of Mind contributed unique variance to Simple Irony interpretation, when statistically controlling for non-verbal reasoning and structural language standardised scores. Neither inhibitory control, working memory nor general knowledge correlated with irony interpretation. Six- to eight-year-olds were at floor for Complex Irony. In Study 2 we found that cognitive flexibility contributed unique variance to how ten- to twelve-year-olds interpreted Complex Irony, while controlling for non-verbal reasoning, structural language and specific knowledge required. We are the first to examine the relationship with cognitive flexibility and conclude it must be taken into account when investigating the relationship between Theory of Mind and irony interpretation
Influence of Voice Intonation on Understanding Irony by Polish-Speaking Preschool Children
The main aim of the presented study was to investigate the influence of voice intonation on the comprehension of ironic utterances in 4- to 6-year-old Polish-speaking children. 83 preschool children were tested with the Irony Comprehension Task (Banasik & Bokus, 2012). In the Irony Comprehension Task, children are presented with stories in which ironic utterances were prerecorded and read by professional speakers using an ironic intonation. Half of the subjects performed the regular Irony Comprehension Task while the other half were given a modified version of the Irony Comprehension Task (ironic content was uttered using a non-ironic intonation). Results indicate that children from the ironic intonation group scored higher on the Irony Comprehension Task than children who heard ironic statements uttered using a neutral voice. Ironic voice intonation appeared to be a helpful cue to irony comprehension
Hypertension treatment preferences in long-term dialysed children in Poland : a survey of pediatric nephrologists
Wstęp Przewlekła choroba nerek prowadzi do rozwoju nadciśnienia tętniczego u większości chorych. Leczenie nadciśnienia towarzyszącego niewydolności nerek jest utrudnione przez ograniczenia w stosowaniu wielu preparatów i brak wystarczających doświadczeń klinicznych, a ponadto istniejące obecnie rekomendacje nie obejmują w ogóle chorych ze schyłkową niewydolnością nerek. Wybór terapii hipotensyjnej ogranicza też młody wiek chorych, gdyż wielu leków nie można stosować u dzieci. Celem badania była analiza jakości leczenia przeciwnadciśnieniowego u dzieci ze schyłkową niewydolnością nerek poddawanych przewlekłej dializoterapii. Materiał i metody Analizą objęto wszystkie dzieci dializowane w Polsce w dniu 30 listopada 2004 roku (n = 134). Uzyskano informacje dotyczące grup stosowanych leków oraz dawek preparatów, a także opinie lekarzy na temat doboru leków stosowanych przy nagłym wzroście ciśnienia tętniczego oraz tych, których dzieciom dializowanym nie powinno się podawać. Wyniki Nadciśnienie tętnicze stwierdzono u 74 (55%) dzieci (47 chłopców, 27 dziewczynek). Najczęstszą przyczyną niewydolności nerek w grupie dzieci z nadciśnieniem było kłębuszkowe zapalenie nerek (27/74). W badanej grupie 65% dzieci leczono za pomocą kilku leków hipotensyjnych, 32% za pomocą jednego leku, a 3% jedynie metodami niefarmakologicznymi. Mimo aktywnego leczenia, zaledwie u 58% dializowanych dzieci prowadziło ono do obniżenia wartości ciśnienia tętniczego poniżej 95 percentyla dla wzrostu i wieku. Najmniejszą skuteczność kontroli ciśnienia tętniczego obserwowano w przypadku leczenia skojarzonego, zwłaszcza wielolekowego. Najczęściej stosowanymi lekami byli antagoniści wapnia, które podawano u ogółem 73% dzieci, w tym u 43/48 w politerapii, a 11/24 w monoterapii. Inhibitory konwertazy angiotensyny były najczęściej stosowane w monoterapii (50%). Mimo znanych kontrowersji, przy nagłym wzroście ciśnienia tętniczego stosowano najczęściej nifedipinę. Wnioski Badanie wykazało, że w Polsce odsetek dializowanych dzieci wymagających leczenia nadciśnieniowego sięga 55%, w tym większość z nich wymaga podawania kilku leków. Pomimo że zasady leczenia są podobne we wszystkich ośrodkach, skuteczność leczenia pozostaje niezadowalająca (58%).Background Chronic kidney disease is associated with the development of arterial hypertension in a vast majority of patients. The treatment of hypertension in these subjects is difficult and challenging due to a limited clinical experience with most drugs and no widely recognised recommendations for patients with end-stage renal disease. A choice of antihypertensive drugs is further narrowed by the young age of the patients since almost all drugs are not recommended in children with renal failure. The aim of this nationwide retrospective analysis was to assess the hypertension treatment patterns in the population of children with chronic kidney diseases (CKD) undergoing hemodialysis or peritoneal dialysis in Poland. Material and methods Among all 134 children dialysed on 30th November 2004 in 13 pediatric dialysis centres in Poland seventy four (55%; 47M, 27F) children were hypertensive. For each patients the treating physicians filled a questionnaire that allowed to collect the following data: the primary kidney disease, chronic dialysis treatment, diagnostic criteria of hypertension and present antihypertensive medication if any. Additionally we asked of the doctors’ preference for a therapy for the acute rise in blood pressure and suggestions which drugs, in their opinion, should not be used in dialysed children. Results In the hypertensive dialysed patients the most frequent causes of chronic kidney disease were chronic glomerulopathies (27/74). Thirty two percent of children were on monotherapy whereas 65% required combined treatment. The therapy was adequate only in 58% of subjects. The lowest rate of efficacy was detected in patients requiring a combined antihypertensive therapy. Among antihypertensive drug classes calcium channel blockers were administered most frequently (in 73% of children, in 11/24 cases in monotherapy and in 43/48 patients in combination). Angiotensin converting enzyme inhibitors were most frequently administered in monotheraphy (50%). Nifedipine was preferred in acute blood pressure rise in children. Conclusion We conclude that incidence of hypertension in dialysed children in Poland is relatively high. The pattern of the treatment was quite uniform, although the efficacy was relatively low (58%)
Hypertension treatment preferences in long-term dialysed children in Poland - a survey of pediatric nephrologists
Wstęp Przewlekła choroba nerek prowadzi do rozwoju
nadciśnienia tętniczego u większości chorych.
Leczenie nadciśnienia towarzyszącego niewydolności
nerek jest utrudnione przez ograniczenia w stosowaniu
wielu preparatów i brak wystarczających doświadczeń
klinicznych, a ponadto istniejące obecnie
rekomendacje nie obejmują w ogóle chorych ze
schyłkową niewydolnością nerek. Wybór terapii hipotensyjnej
ogranicza też młody wiek chorych, gdyż
wielu leków nie można stosować u dzieci. Celem
badania była analiza jakości leczenia przeciwnadciśnieniowego
u dzieci ze schyłkową niewydolnością
nerek poddawanych przewlekłej dializoterapii.
Materiał i metody Analizą objęto wszystkie dzieci dializowane
w Polsce w dniu 30 listopada 2004 roku (n = 134).
Uzyskano informacje dotyczące grup stosowanych leków
oraz dawek preparatów, a także opinie lekarzy na
temat doboru leków stosowanych przy nagłym wzroście
ciśnienia tętniczego oraz tych, których dzieciom
dializowanym nie powinno się podawać.
Wyniki Nadciśnienie tętnicze stwierdzono u 74 (55%)
dzieci (47 chłopców, 27 dziewczynek). Najczęstszą
przyczyną niewydolności nerek w grupie dzieci z nadciśnieniem
było kłębuszkowe zapalenie nerek (27/74).
W badanej grupie 65% dzieci leczono za pomocą kilku
leków hipotensyjnych, 32% za pomocą jednego
leku, a 3% jedynie metodami niefarmakologicznymi.
Mimo aktywnego leczenia, zaledwie u 58% dializowanych
dzieci prowadziło ono do obniżenia wartości
ciśnienia tętniczego poniżej 95 percentyla dla wzrostu
i wieku. Najmniejszą skuteczność kontroli ciśnienia
tętniczego obserwowano w przypadku leczenia skojarzonego,
zwłaszcza wielolekowego.
Najczęściej stosowanymi lekami byli antagoniści
wapnia, które podawano u ogółem 73% dzieci, w tym
u 43/48 w politerapii, a 11/24 w monoterapii. Inhibitory konwertazy angiotensyny były najczęściej stosowane
w monoterapii (50%). Mimo znanych kontrowersji,
przy nagłym wzroście ciśnienia tętniczego stosowano
najczęściej nifedipinę.
Wnioski Badanie wykazało, że w Polsce odsetek dializowanych
dzieci wymagających leczenia nadciśnieniowego
sięga 55%, w tym większość z nich wymaga
podawania kilku leków. Pomimo że zasady leczenia
są podobne we wszystkich ośrodkach, skuteczność
leczenia pozostaje niezadowalająca (58%).Background Chronic kidney disease is associated with the
development of arterial hypertension in a vast majority of
patients. The treatment of hypertension in these subjects is
difficult and challenging due to a limited clinical experience
with most drugs and no widely recognised recommendations
for patients with end-stage renal disease. A choice of
antihypertensive drugs is further narrowed by the young age
of the patients since almost all drugs are not recommended
in children with renal failure. The aim of this nationwide
retrospective analysis was to assess the hypertension treatment
patterns in the population of children with chronic
kidney diseases (CKD) undergoing hemodialysis or peritoneal
dialysis in Poland.
Material and methods Among all 134 children dialysed on
30th November 2004 in 13 pediatric dialysis centres in Poland
seventy four (55%; 47M, 27F) children were hypertensive.
For each patients the treating physicians filled a questionnaire
that allowed to collect the following data: the primary
kidney disease, chronic dialysis treatment, diagnostic
criteria of hypertension and present antihypertensive medication
if any. Additionally we asked of the doctors’ preference
for a therapy for the acute rise in blood pressure and
suggestions which drugs, in their opinion, should not be
used in dialysed children. Results In the hypertensive dialysed patients the most frequent
causes of chronic kidney disease were chronic
glomerulopathies (27/74). Thirty two percent of children
were on monotherapy whereas 65% required combined treatment.
The therapy was adequate only in 58% of subjects.
The lowest rate of efficacy was detected in patients requiring
a combined antihypertensive therapy.
Among antihypertensive drug classes calcium channel blockers
were administered most frequently (in 73% of children, in 11/24 cases in monotherapy and in 43/48 patients in combination).
Angiotensin converting enzyme inhibitors were most
frequently administered in monotheraphy (50%). Nifedipine
was preferred in acute blood pressure rise in children.
Conclusion We conclude that incidence of hypertension
in dialysed children in Poland is relatively high. The pattern
of the treatment was quite uniform, although the efficacy
was relatively low (58%)