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Research has shown orthographic neighbourhood size effects (ONS) in the left visual field (LVF) but not in the right visual field (RVF). An earlier study examined the combined effects of ONS and font distortion in the LVF and RVF, but did not find an interaction. The current lexical decision experiment re-examined the interaction between ONS and format distortion at fixation and in the LVF and RVF with the addition of several methodological improvements. Main results replicated previous findings and extended them by indicating that (a) ONS effects in the LVF are immune to the putatively disruptive effects of format distortion, (b) format distortion revealed ONS effects in the RVF and (c) large orthographic neighbourhood size slowed pseudoword rejections regardless of format distortion or visual field presentation. Results are discussed within the context of relevant literature on the visual field laterality of visuoperceptual-orthographic processing.

Aim: Tonsillectomy procedures are a core element of paediatrics; however, perioperative management differs. This study aimed to describe tonsillectomy management, including the burden of pain, nausea and delayed recovery.Methods: A prospective cohort study was undertaken through an audit of tonsillectomy perioperative practice and recovery and survey interviews with family members 7-14 days post-surgery. The study was undertaken at an Australian tertiary referral paediatric hospital between June and September 2016.Results: The audit included 255 children undergoing tonsillectomy, with 127 family members interviewed. Most participants underwent adenotonsillectomy (n = 216; 85%), with a primary diagnosis of obstructive sleep apnoea (n = 205; 80%) and a mean age of 7 years (standard deviation; 3.9). A variety of intra-operative pain relief and antiemetics was administered. Pain was present in 29% (n = 26) of participants at ward return, increasing to 32-45% at 4-20 h and decreasing to 21% (n = 15) at discharge. A third of the children (32%; n = 41) had moderate to severe pain at post-discharge interview, and 30% (n = 38) experienced nausea at home. Most parents (82%; n = 104) were still giving regular paracetamol at 7 days post-operatively, and 31% (n = 39) had finished their oxycodone. Of the participants, 14% (n = 26) presented to the emergency department within 7 days of discharge; 8% (n = 20) of the total cohort were re-admitted.Conclusions: There was variety in perioperative and post-discharge care. Pain scores were infrequently documented post-tonsillectomy, and parents are generally dissatisfied with the management of post-operative pain and nausea. Further research is needed to provide a more consistent approach to perioperative management to promote recovery. [ABSTRACT FROM AUTHOR]

Persistent pain is a global health care issue affecting more than 30% of children and young people. mHealth applications delivered using smartphones, are an innovative method to engage children in pain self-management. This article outlines the evidence concerning the development, implementation, and evaluation of mHealth apps for these children in terms of feasibility, acceptability, and impact on important pain outcomes such as quality of life and health care utilization. [ABSTRACT FROM AUTHOR]

Research has shown orthographic neighbourhood size effects (ONS) in the left visual field (LVF) but not in the right visual field (RVF). An earlier study examined the combined effects of ONS and font distortion in the LVF and RVF, but did not find an interaction. The current lexical decision experiment re-examined the interaction between ONS and format distortion at fixation and in the LVF and RVF with the addition of several methodological improvements. Main results replicated previous findings and extended them by indicating that (a) ONS effects in the LVF are immune to the putatively disruptive effects of format distortion, (b) format distortion revealed ONS effects in the RVF and (c) large orthographic neighbourhood size slowed pseudoword rejections regardless of format distortion or visual field presentation. Results are discussed within the context of relevant literature on the visual field laterality of visuoperceptual-orthographic processing. [ABSTRACT FROM AUTHOR]

Importance: Catheter dislodgement is a common complication for children with tunneled or peripherally inserted noncuffed central venous catheters (CVCs). A subcutaneous anchor securement system (SASS) may reduce this risk compared with traditional adhesive securement., Objective: To compare dislodgement of noncuffed CVCs secured with SASS with dislodgement of noncuffed CVCs secured with sutureless securement devices (SSDs)., Design, Setting, and Participants: The SECURED (Securing Central Venous Catheters to Prevent Dislodegment) trial was a pragmatic, multicenter, superiority randomized clinical trial with an internal pilot and was conducted from August 5, 2020, to August 30, 2022, at 2 Australian quaternary pediatric hospitals. Data analysis was performed in January 2023. Patients aged 0 to 18 years requiring a noncuffed CVC (≥3F catheter) were eligible for inclusion. Follow-up duration was 8 weeks or until device removal., Interventions: Patients were randomly assigned 1:1 to receive an SASS or SSD, stratified by hospital and catheter type. Only 1 catheter was studied per patient., Main Outcomes and Measures: The primary outcome was dislodgement (partial or total), defined as movement of the catheter tip by greater than 1 cm (change in external catheter length) at any point during catheter dwell. Dislodgement, reported as a risk ratio (RR), was estimated using a generalized linear model with binomial family and log link. Secondary outcomes were reported as incidence rate ratios and were analyzed using Poission regression. Outcomes reported as mean differences (MDs) were analyzed using linear regression., Results: Of 310 randomized patients, 175 patients (56.5%) were male and median (IQR) patient age was 48 (16-120) months. A total of 307 patients had a catheter device inserted, of which 153 (49.8%) were SASS and 154 (50.2%) were SSD, and were included in the intention-to-treat (ITT) analysis. Device dislodgement was lower with SASS (8 dislodgements in 153 patients [5.2%]) compared with SSD (35 dislodgements in 154 patients [22.7%]) (RR, 0.23; 95% CI, 0.11-0.48; P < .001). The per-protocol analysis was consistent with the ITT analysis. Partial dislodgement accounted for most dislodgement events, including 6 partial dislodgements in the SASS group (3.9%) and 30 partial dislodgements in the SSD group (19.5%) (RR, 0.18; 95% CI, 0.08-0.42). This contributed to fewer complications during dwell in the SASS group (37 reported complications [24.2%]) vs the SSD group (60 reported complications [39.0%]) (RR, 0.62; 95% CI, 0.44-0.87). Staff reported greater difficulty removing devices anchored with SASS vs SSD (mean [SD], 29.1 [31.3] vs 5.3 [17.0], respectively; MD, 23.8; 95% CI, 16.7-31.0). However, use of SASS resulted in reduced per-participant health care costs of A$36.60 (95% credible interval, 4.25-68.95; US $24.36; 95% credible interval, 2.83-45.89)., Conclusions and Relevance: In the SECURED trial, noncuffed CVCs secured with SASS had fewer dislodgements compared with SSDs, with a lower cost per patient and an acceptable safety profile. Future efforts should be directed at SASS implementation at the health service level., Trial Registration: anzctr.org.au Identifier: ACTRN12620000783921.

It is well known that epilepsy patients often exhibit material-specific deficits in memory for verbal versus nonverbal material. However, it is also apparent that such deficits are not always discernible, and that numerous factors may potentially moderate the degree to which fractionation between verbal and nonverbal material is evident. Using confirmatory factor analysis, we compared the relative fit of one-factor (general) and two-factor (material-specific) models of memory in data from 330 patients with intractable seizure disorder. Data from verbal and nonverbal selective reminding tests, as well as Logical Memory and Visual Reproduction (immediate and delayed recall indices), were used in analyses. The one-factor model fit the data poorly in the full sample, whereas the two-factor model fit the data significantly better. We then assessed the invariance of these two models using multiple-group modeling across subsamples of patients with left versus right sided seizure focus, earlier versus later age of seizure onset, lower versus higher Full Scale IQ, fewer versus more years of education, younger versus older patients, and male versus female patients. In all cases, the two-factor model comprised of verbal and nonverbal memory factors fit the data better than a one-factor (general) model. These findings indicate robust consistency of verbal and nonverbal memory constructs in the epilepsy population, which remain viable in this patient group despite considerable heterogeneity in other respects.