Understanding of emotions based on counterfactual reasoning in children with Autism Spectrum Disorders

The understanding of emotions based on counterfactual reasoning was studied in children with high-functioning autism spectrum disorders (n = 71) and in typically developing children (n = 71), aged 6-12 years. Children were presented with eight stories about two protagonists who experienced the same positive or negative outcome, either due to their own action or by default. Relative to the comparison group, children with high-functioning autism spectrum disorder were poor at explaining emotions based on downward counterfactual reasoning (i.e. contentment and relief). There were no group differences in upward counterfactual reasoning (i.e. disappointment and regret). In the comparison group, second-order false-belief reasoning was related to children's understanding of second-order counterfactual emotions (i.e. regret and relief), while children in the high-functioning autism spectrum disorder group relied more on their general intellectual skills. Results are discussed in terms of the different functions of counterfactual reasoning about emotion and the cognitive style of children with high-functioning autism spectrum disorder. © The Author(s) 2012

The Evaluation of More Lymph Nodes in Colon Cancer Is Associated with Improved Survival in Patients of All Ages

BACKGROUND:Improvement in survival of patients with colon cancer is reduced in elderly patients compared to younger patients. The aim of this study was to investigate whether the removal of ≥ 12 lymph nodes can explain differences in survival rates between elderly and younger patients diagnosed with colon cancer. METHODS:In a population-based cohort study, all patients (N = 41,074) diagnosed with colon cancer stage I to III from 2003 through 2010 from the Netherlands Cancer Registry were included. Age groups were defined as < 66, 66-75 and > 75 years of age. Main outcome measures were overall and relative survival, the latter as a proxy for disease specific survival. RESULTS:Over an eight years time period there was a 41.2% increase in patients with ≥ 12 lymph nodes removed, whereas the percentage of patients with the presence of lymph node metastases remained stable (35.7% to 37.5%). After adjustment for patient and tumour characteristics and adjuvant chemotherapy, it was found that for patients in which ≥ 12 lymph nodes were removed compared to patients with < 12 lymph nodes removed, there was a statistically significant higher overall survival (< 66: HR: 0.858 (95% CI, 0.789-0.933); 66-75: HR: 0.763 (95% CI, 0.714-0.814); > 75: HR: 0.734 (95% CI, 0.700-0.771)) and relative survival (< 66: RER: 0.783 (95% CI, 0.708-0.865); 66-75: RER: 0.672 (95% CI, 0.611-0.739); > 75: RER: 0.621 (95% CI, 0.567-0.681)) in all three age groups. CONCLUSIONS:The removal of ≥ 12 lymph nodes is associated with an improvement in both overall and relative survival in all patients. This association was stronger in the elderly patient. The biology of this association needs further clarification

Children’s depressive symptoms and their regulation of negative affect in response to vignette-depicted emotion-eliciting events

The present study examined the relationship between sub-clinical depressive symptoms and children's anticipated cognitive and behavioral reactions to two written vignettes depicting emotion-eliciting stressors (i.e., fight with one's best friend and failure at a roller blade contest). Participants (N = 244) ranging in age between 10 and 13 were presented each vignette and then asked to rate their anticipated utilization of each of seven emotion-regulation strategies (ERs), along with the anticipated mood enhancement effects of each strategy. In addition, ratings of participants' perceived coping efficacy to manage the stressful situation were collected. Results indicated that participants were more likely to endorse ERs for which they have greater confidence in their mood enhancement effects. Moreover, marked differences were observed between ratings for conceptually distinct cognitive ERs. Consistent with expectations, results revealed that participants displaying higher levels of depressive symptoms were more likely to endorse cognitive and behavioral ERs that are negative, passive, and/or avoidant in nature. Children's ratings of the anticipated mood enhancement effects of several ERs were inversely related to their level of depressive symptoms, as was their perceived self-efficacy to manage the stressor. © 2007 The International Society for the Study of Behavioural Development

Surgical Treatment of Diabetic Foot Ulcers Complicated by Osteomyelitis with Gentamicin-Loaded Calcium Sulphate-Hydroxyapatite Biocomposite

Diabetic foot ulcers, complicated by osteomyelitis, can be treated by surgical resection, dead space filling with gentamicin-loaded calcium sulphate-hydroxyapatite (CaS-HA) biocomposite, and closure of soft tissues and skin. To assess the feasibility of this treatment regimen, we conducted a multicenter retrospective cohort study of patients after failed conventional treatments. From 13 hospitals we included 64 patients with forefoot (n = 41 (64%)), midfoot (n = 14 (22%)), or hindfoot (n = 9 (14%)) ulcers complicated by osteomyelitis. Median follow-up was 43 (interquartile range, 20-61) weeks. We observed wound healing in 54 patients (84%) and treatment success (wound healing without ulcer recurrence) in 42 patients (66%). Treatment failures (no wound healing or ulcer recurrence) led to minor amputations in four patients (6%) and major amputations in seven patients (11%). Factors associated with treatment failures in univariable Cox regression analysis were gentamicin-resistant osteomyelitis (hazard ratio (HR), 3.847; 95%-confidence interval (CI), 1.065-13.899), hindfoot ulcers (HR, 3.624; 95%-CI, 1.187-11.060) and surgical procedures with gentamicin-loaded CaS-HA biocomposite that involved minor amputations (HR, 3.965; 95%-CI, 1.608-9.777). In this study of patients with diabetic foot ulcers, complicated by osteomyelitis, surgical treatment with gentamicin-loaded CaS-HA biocomposite was feasible and successful in 66% of patients. A prospective trial of this treatment regimen, based on a uniform treatment protocol, is required

Negative emotions in children with newly diagnosed epilepsy.

Purpose: To understand the emotional predicament in children with recently diagnosed idiopathic or cryptogenic epilepsy. Methods: We used the well-tried method of structured projection for the first time in children with epilepsy. Thirty-six children with epilepsy, aged 7-15 years (mean age, 9.5 years) and in 35 control children aged 7-15 years (mean age, 9.4 years), attributed shame and guilt in relation to three types of situation (non- illness related, illness related, and epilepsy related). Children were evaluated twice: shortly after diagnosis, before antiepileptic drug (AED) use and after an interval of 3 months. Results: Children with epilepsy and healthy controls were similar in their way of attributing shame and guilt. However, the type of situation was of influence: Both children with epilepsy and healthy children attributed more shame to incompetence due to epilepsy than to incompetence due to other illnesses. Conclusions: Increased affective problems in childhood epilepsy cannot be explained by excessive attribution of shame and guilt, affects known to be important precursors of psychopathology, yet both healthy children and children with epilepsy attribute more shame to epilepsy than to other illnesses. Epilepsy is not like any other disease

Making New "New AI" Friends : Designing a Social Robot for Diabetic Children from an Embodied AI Perspective

Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Robin is a cognitively and motivationally autonomous affective robot toddler with "robot diabetes" that we have developed to support perceived self-efficacy and emotional wellbeing in children with diabetes by providing them with positive mastery experiences of diabetes management in a playful but realistic and natural interaction context. Underlying the design of Robin is an "Embodied" (formerly also known as "New") Artificial Intelligence approach to robotics. In this paper we discuss the rationale behind the design of Robin to meet the needs of our intended end users (both children and medical staff), and how "New AI" provides a suitable approach to developing a friendly companion that fulfills the therapeutic and affective requirements of our end users beyond other approaches commonly used in assistive robotics and child-robot interaction. Finally, we discuss how our approach permitted our robot to interact with and provide suitable experiences of diabetes management to children with very different social interaction styles.Peer reviewedFinal Published versio

Developmental differences in children’s interpersonal emotion regulation

Previous research on interpersonal emotion regulation (ER) in childhood has been rather unsystematic, focusing mainly on children’s prosocial behaviour, and has been conducted in the absence of an integrative emotion theoretical framework. The present research relied on the interpersonal affect classification proposed by Niven, Totterdell, and Holman (2009) to investigate children’s use of different interpersonal ER strategies. The study drew on two samples: 180 parents of children aged between 3 and 8 years reported about a situation where their child was able to change what another person was feeling in order to make them feel better. In addition, 126 children between 3- and 8-years old answered two questions about how they could improve others’ mood. Results from both samples showed age differences in children’s use of interpersonal ER strategies. As expected, ‘affective engagement’ (i.e., focusing on the person or the problem) and ‘cognitive engagement’ (i.e., appraising the situation from a different perspective) were mainly used by 7-8 years-old, whereas ‘attention’ (i.e., distracting and valuing) was most used by 3-4 and 5-6 years-old. ‘Humor’ (i.e., laughing with the target) remained stable across the different age groups. The present research provides more information about the developmental patterns for each specific interpersonal emotion regulation strategy