Patterns of Attention and Anxiety in Predicting Arithmetic Fluency among School-Aged Children.

Although the interaction between anxiety and attention is considered crucial for learning and performance in mathematics, few studies have examined these cognitive and affective predictors in a single framework or explored the role of sustained attention in promoting children's arithmetic performance, using traditional linear analyses and latent profile analysis (LPA). In this paper, state anxieties (in a math test and in an attention test situation), general anxiety traits, sustained attention (performance-based test and attention deficit/hyperactivity disorder (ADHD) self-ratings) and math achievement of 403 fourth and fifth graders (55.8% girls) were assessed. A negative correlation between state anxiety prior to the math test and arithmetic achievements was identified, even when controlling for other non-math related state anxieties and general anxiety. Sustained attention was a strong predictor of arithmetic achievement and functioned as a moderator in the anxiety-performance link. LPA identified six distinct profiles that revealed a complex relationship with arithmetic fluency. The weakest achievement was found for a specific math anxiety subgroup. The findings highlight the important role of the interaction of anxiety and sustained attention in children's ability to perform math and enable new conclusions about the specific nature of math anxiety. Implications for future research are discussed.

Percutaneous operative treatment of fragility fractures of the pelvis may not increase the general rate of complications compared to non-operative treatment.

PURPOSE: Despite an increasing number of fragility fractures of the pelvis (FFP) over the last 2 decades, controversy persists on their therapy with special regard to potential complications. Therefore, the present study compared the complication rates and in-hospital mortality of non-operative therapy, percutaneous treatment and open reduction and internal fixation (ORIF) of pelvic fractures in elderly patients. METHODS: All consecutive patients treated for FFP between January 2013 and December 2017 aged 65 years or older were retrospectively identified from an institutional database. Demographic data and specific patient data were collected with a special focus on pre-existing comorbidities. General and surgical complications, hospital length of stay (LOS) and mortality rates were compared. RESULTS: 379 patients (81.3 ± 7.5 years; 81% female) were identified, 211 (55.7%) were treated non-operatively, 74 (19.5%) percutaneously and 94 (24.8%) with ORIF. The rate of general complications did not differ between treatment groups (non-operative: 21.8%; percutaneous: 28.4%; ORIF: 33.0%; p = 0.103). Surgery-related complications were twofold more frequent in the ORIF group as than in the percutaneously treated group (18.1% vs. 9.5%). The LOS differed significantly (non-operatively: 8.9 ± 7.1 days; percutaneous: 16.6 ± 8.2 days; ORIF: 19.3 ± 12.8 days; p < 0.001). Hospital mortality rate was higher in patients with ORIF (5.3%) than percutaneous treatment (0%) (p = 0.044). CONCLUSIONS: Complication rates and hospital mortality in elderly patients with FFPs are high and associated with long LOS. For surgical treatment of FFPs, the complication rate and mortality can be significantly reduced using percutaneous procedures compared to ORIF. Therefore, percutaneous surgery should be preferred where possible.

A latent profile analysis of math anxiety and core beliefs toward mathematics among children.

Recent findings on the negative impacts of math anxiety (MA) have raised questions for educational and clinical research regarding effective intervention programs. One basic approach for developing intervention programs in the field of cognitive behavioral therapy is to gain an in-depth understanding of the cognitive beliefs of children with a specific mental problem. By applying latent profile analysis (LPA), the present study aimed at identifying different patterns of MA and providing further insights into its cognitive phenomenology. For this purpose, trait-MA, state-MA, attitudes toward math, academic self-concepts, fixed/growth mindsets, executive functions, and math performance of 475 fourth and fifth graders (48.2% girls) were assessed. LPA indicated seven distinct profiles characterized by different dimensions and patterns of state-MA, trait-MA, and core beliefs toward math. Furthermore, the profiles showed clearly different math performances. The weakest performances were found for a profile with highest state-MA, high trait-MA, and negative cognitive beliefs toward math and a profile with average state-MA, high trait-MA, and negative cognitive beliefs toward math, whereas the highest achieving profile had no state-MA, high trait-MA, and very positive cognitive beliefs toward math. The findings underline the complexity of MA and emphasize the necessity to develop interventions with careful consideration of the heterogeneous patterns.

State- and trait-math anxiety and their relation to math performance in children: The role of core executive functions.

This study examines the interplay of state- and trait-math anxiety (MA) and core executive functions (CEF) on math achievement in children. According to attention control theory, MA affects the CEF by triggering the inhibition function, so that some working memory (WM) is blocked, thus reducing task processing capacity. However, research on the interplay between MA and CEF in children is rare, and the findings in the literature are inconsistent. In this paper, state- and trait-MA, math achievement, CEF (inhibition, cognitive flexibility, working memory capacity, global index of CEF) and self-ratings of ADHD symptoms (attention deficits, hyperactivity, impulsiveness) of 646 fourth and fifth grade students (48.1% girls) are assessed. CEF were evaluated with a tablet-based test. The data revealed negative correlations between state-MA and math achievement for all CEF levels and cognitive processes. However, inhibition control functioned as a moderator of the relation between state-MA and math achievement. Children with higher inhibition abilities showed more pronounced negative relations. No moderation effects were identified for working memory capacity and the CEF global index. The findings highlight the importance of distinguishing between these three CEF and raise questions for future research on the interplay between cognitive and affective factors as predictors of math achievement.

Relation of attention deficit hyperactivity disorder (ADHD) to basic number skills and arithmetic fact retrieval in children.

Although research has provided evidence for a clear association of core executive function (CEF) to math performance, fewer studies have been carried out on arithmetic fact retrieval in relation to the symptoms of attention deficit hyperactivity disorder (ADHD). The present study assessed mathematical achievement on a basic number skill test and on an arithmetic fact retrieval task. Besides math achievement, self-ratings of ADHD symptoms (attention deficits, hyperactivity, impulsivity), core executive functions (inhibition, cognitive flexibility, working memory capacity, global index) and state anxiety in 646 fourth and fifth grade students (48.1 % girls) were measured. CEF was evaluated by means of a tablet-based test. Regression analysis showed different predictors for both math abilities. While all CEF measures, inattention and impulsivity self-ratings predicted basic number skills, only inhibition, WMC and inattention self-rating were predictors of arithmetic fact retrieval. On the basis of a cluster analysis of ADHD self-ratings and CEF performance, three different groups were identified: 1: low ADHD, average CEF; 2: high ADHD, low CEF; 3: moderate ADHD, high CEF. Cluster 2 showed scores below the mean in both math scores, whereas cluster 3 exhibited performances above the mean in both math scores. No math differences were found between cluster 1 and 3. The data yield evidence that the association between CEF and math achievement depends on the specific math skill and test type. The results underline the importance of differentiating between CEF components and specific math abilities. Implications for future research on the associations between mathematics, ADHD and CEF are discussed.

Time-to-treatment is a risk factor for the development of pressure ulcers in elderly patients with fractures of the pelvis and acetabulum.

INTRODUCTION: Fractures of the pelvis and acetabulum are associated with pain and immobilization and, hence, pose the risk of developing a pressure ulcer - especially in elderly patients. In the literature, information on risk factors for the occurrence of pressure ulcers related to geriatric pelvic or acetabulum fractures is missing. METHODS: Consecutive in-hospital patients aged 55 years or older treated for closed pelvis and/or acetabulum fractures between 2013 and 2017 were retrospectively identified from an institutional prospective database. Epidemiologic characteristics and patient specifics with special focus on the time from admission to treatment, duration of hospitalization and comorbidities were retrospectively assessed by chart review. RESULTS: During the evaluated interval, 407 patients with isolated fractures of the pelvis or acetabulum (mean age 78 years, range 55 to 101 years, 69,3% female) were treated. A new pressure ulcer that developed during the hospitalization was observed in 46/407 patients (11.3%). This included pressure ulcers of stage 1 in 18/46 cases (39%), stage 2 in 24/46 cases (52%), and stage 3 in 4/46 cases (9%). No stage 4 ulcers were seen in this cohort. The mean duration of hospitalization was longer in patients with a pressure ulcer (25 days, SD 17) than in patients with no ulcers (12 days, SD 9; p < .001). Patients who developed a pressure ulcer, had waited significantly longer for treatment of their pelvis/acetabulum fracture when compared to patients without an ulcer (5 days, SD 5 vs. 3 days SD 4, p = =.001). A logistic regression analysis confirmed "time to treatment" as an independent risk factor for the occurrence of a pressure ulcer during hospitalization. In an analysis adjusted for the confounders age, male gender, diabetes and malignancy, the odds ratio to develop a pressure ulcer remained 1.10 (CI 1.03 to 1.19; c-value = 0.774, p = .008) for each day of waiting treatment. CONCLUSION: "Time to treatment" is an independent risk factor for the occurrence of a pressure ulcer during hospitalization after a pelvis/acetabulum fracture in elderly patients. Each day of waiting treatment increases the risk of developing a pressure ulcer by 10%.