Children and young people's preferences and needs when using health technology to self-manage a long-term condition: a scoping review.

BACKGROUND: The use of patient-facing health technologies to manage long-term conditions (LTCs) is increasing; however, children and young people (CYP) may have preferences about health technologies which they interact or engage with, that influence their decision to use these technologies. AIMS: To identify CYP's reported preferences about health technologies to self-manage LTCs. METHODS: We undertook a scoping review, searching MEDLINE, PsycINFO and CINAHL in July 2021. Searches were limited to papers published between January 2015 and July 2021. We included any health technologies used to manage physical and mental LTCs. Qualitative content analysis of study data was undertaken to categorise data into themes and quantitative data were described and visually represented. We engaged CYP with LTCs to support the review design, interpretation of findings and development of recommendations. RESULTS: 161 journal articles were included, describing preferences of CYP. Most included studies were undertaken in high-income countries. CYP's main preferences and needs were: design and functionality; privacy and sharing; customisation and personalisation of the technology; and interaction options within the technology. CONCLUSIONS: This review highlights important preferences and needs that CYP may have before using technologies to self-manage their LTC. These should be considered when developing technology for this population. Future research should involve CYP throughout the development of the technologies, from identifying their unmet needs through to final design, development, evaluation and implementation of the intervention.

Are syntactic representations similar in both reading and listening? Evidence from priming in first and second languages.

It is unclear to what extent natural differences between reading and listening result in differences in the syntactic representations formed in each modality. The present study investigated the occurrence of syntactic priming bidirectionally from reading to listening, and vice versa to examine whether reading and listening share the same syntactic representations in both first language (L1) and second language (L2). Participants performed a lexical decision task in which the experimental words were embedded in sentences with either an ambiguous or a familiar structure. These structures were alternated to produce a priming effect. The modality was manipulated whereby participants (a) first read part of the sentence list and then listened to the rest of the list (reading-listening group), or (b) listened and then read (listening-reading group). In addition, the study involved two within-modality lists in which participants either read or listened to the whole list. The L1 group showed within-modal priming in both listening and reading as well as a cross-modal priming effect. Although L2 speakers showed priming in reading, the effect was absent in listening and weak in the listening-reading condition. The absence of priming in L2 listening was attributed to difficulties in L2 listening rather than to an inability to produce abstract priming.

Sleep and memory consolidation in healthy, neurotypical children, and adults: a summary of systematic reviews and meta-analyses.

This review systematically assesses the impact of sleep on memory and cognition in healthy individuals across different life stages. It specifically examines how sleep affects memory processes in children, adults, and older adults. The methodology involved a comprehensive literature search, starting with 46 known papers. Keywords and Mesh terms related to sleep and memory consolidation were derived using the Word Frequency Analysis tool in SR Accelerator and Mesh on Demand. A detailed search on PubMed yielded a large set of records. Classifier training on 4854 decisions, these were narrowed down to 1437 papers for full-text screening, culminating in 19 systematic reviews and meta-analyses. Sleep enhances memory consolidation, especially for complex declarative information. While the role of sleep in procedural memory consolidation in children remains less robust compared to declarative memory, findings suggest potential but inconsistent benefits. Sleep improves prospective memory consolidation and aids in complex associative memory tasks. Memory reactivation during sleep, specifically slow-wave sleep, and spindles are implicated in memory consolidation. Meta-analytic evidence suggests that while sleep benefits both emotional and neutral memory consolidation, there is no strong preferential effect of sleep on emotional memory in comparison to neutral memory. In older adults, there is a noticeable reduction in sleep-dependent memory consolidation, particularly for declarative memory, likely linked to a decline in slow-wave sleep. This suggests a decrease in the benefits of sleep for memory consolidation with aging. Overall, the review underscores the importance of sleep in memory processes across all ages, highlighting variations in its impact on different types of memory and across age groups. It points to future research directions for enhancing understanding and practical applications in clinical and educational settings.

Nap effects on preschool children's learning of letter-sound mappings.

This study explored whether a daytime nap aids children's acquisition of letter-sound knowledge, which is a fundamental component for learning to read. Thirty-two preschool children in Sydney, Australia (Mage  = 4 years;3 months) were taught letter-sound mappings in two sessions: one followed by a nap and the other by a wakeful period. Learning was assessed by explicit letter-sound mappings ("Which sound does this letter make?") and knowledge generalization tasks ("Here's Tav and Cav, which one is /kav/?"). Results from the knowledge generalization task showed better performance after a nap than after wake. However, no nap benefit was found for explicit letter-sound knowledge. This study provides initial evidence that naps could be beneficial for preschool children's learning of letter-sound mappings.

Paediatric narcolepsy: a review of diagnosis and management.

Narcolepsy is a chronic disabling neurological sleep disorder that requires lifelong treatment. We have outlined the clinical features of narcolepsy, the assessment and diagnosis process and have summarised the existing treatment options for children and adolescents with narcolepsy. In the future, the approach to management of paediatric narcolepsy should ideally be in a multidisciplinary setting, involving specialists in sleep medicine, sleep physiology, neurologists and psychologists/psychiatrists. A multidisciplinary approach will help to manage the potential impact of narcolepsy on children and adolescents who are in a stage of their life that is critical to their physical, emotional and social development and their academic attainment.

Psychoeducation Intervention Effectiveness to Improve Social Skills in Young People with ADHD: A Meta-Analysis.

OBJECTIVE: Attention Deficit Hyperactivity Disorder (ADHD) can be associated with limited understanding of the condition and poor social skills. Some evidence favors a psychoeducational approach, but little is known about the effectiveness of psychoeducation. METHODS: Systematic review and meta-analysis of studies assessing psychoeducational interventions that aim to improve social skills of young people with ADHD. RESULTS: Ten studies, including 943 participants, reported across 13 papers met the inclusion criteria. Although effect sizes were small, findings suggest the included interventions significantly improved social skills in young people with ADHD. CONCLUSIONS: Results show promise for psychoeducational behavioral interventions . However, the recommendations that can be developed from existing evidence are somewhat limited by the low quality of studies. Further rigorous trials are needed. In addition, future research should consider the long-term outcomes for these interventions, they should be iteratively co-designed and research should consider the context they intend to be delivered in.

Evidence of objective sleep impairment in nonepileptic attack disorder: A naturalistic prospective controlled study using actigraphy and daily sleep diaries over six nights.

Poor sleep is reported by many with nonepileptic attack disorder (NEAD) with correlations evident between self-reported sleep quality and mood and functional impairment. However, it is contended that self-reported sleep impairment in NEAD is a subjective phenomenon, which represents a general tendency to over-report symptoms or misinterpret bodily states in those with NEAD. The present study was therefore designed to investigate the extent of subjective and objective sleep impairments in those with NEAD. Over six nights we prospectively recorded comparable nightly objective (actigraphy) and subjective (consensus sleep diary) sleep parameters in a sample of 17 people with NEAD, and an age- and gender-matched normative control group (N = 20). Participants recorded daily measures of attacks, dissociation, and mood. Alongside higher subjective sleep impairment, the NEAD group had significantly worse objective sleep on several metrics compared to the normative controls, characterized by disrupted sleep (frequent awakenings and wake after sleep onset, low efficiency). Exploratory analyses using mixed effects models showed that attacks were more likely to occur on days preceded by longer, more restful sleep. This study, which had good ecological validity, evidences the presence of objective sleep impairment in NEAD, suggesting that in patient reports of problems with sleep should be given careful consideration in clinical practice.

Impact of the novel coronavirus (COVID-19) pandemic on sleep.

BACKGROUND: The COVID-19 pandemic has led to significant changes in daily routines and lifestyle worldwide and mental health issues have emerged as a consequence. We aimed to assess the presence of sleep disturbances during the lockdown in the general population. METHODS: Cross-sectional, online survey-based study on adults living through the COVID-19 pandemic. The questionnaire included demographics and specific questions assessing the impact of the pandemic/lockdown on sleep, daytime functioning and mental health in the general population. Identification of sleep pattern changes and specific sleep-related symptoms was the primary outcome, and secondary outcomes involved identifying sleep disturbances for predefined cohorts (participants reporting impact on mental health, self-isolation, keyworker status, suspected COVID-19 or ongoing COVID-19 symptoms). RESULTS: In total, 843 participants were included in the analysis. The majority were female (67.4%), middle aged [52 years (40-63 years)], white (92.2%) and overweight to obese [BMI 29.4 kg/m2 (24.1-35.5 kg/m2)]; 69.4% reported a change in their sleep pattern, less than half (44.7%) had refreshing sleep, and 45.6% were sleepier than before the lockdown; 33.9% had to self-isolate, 65.2% reported an impact on their mental health and 25.9% were drinking more alcohol during the lockdown. More frequently reported observations specific to sleep were 'disrupted sleep' (42.3%), 'falling asleep unintentionally' (35.2%), 'difficulties falling'/'staying asleep' (30.9% and 30.8%, respectively) and 'later bedtimes' (30.0%). Respondents with suspected COVID-19 had more nightmares and abnormal sleep rhythms. An impact on mental health was strongly associated with sleep-related alterations. CONCLUSIONS: Sleep disturbances have affected a substantial proportion of the general population during the COVID-19 pandemic lockdown. These are significantly associated with a self-assessed impact on mental health, but may also be related to suspected COVID-19 status, changes in habits and self-isolation.

Consolidation of vocabulary is associated with sleep in typically developing children, but not in children with dyslexia.

Sleep is known to play an active role in consolidating new vocabulary in adults; however, the mechanisms by which sleep promotes vocabulary consolidation in childhood are less well understood. Furthermore, there has been no investigation into whether previously reported differences in sleep architecture might account for variability in vocabulary consolidation in children with dyslexia. Twenty-three children with dyslexia and 29 age-matched typically developing peers were exposed to 16 novel spoken words. Typically developing children showed overnight improvements in novel word recall; the size of the improvement correlated positively with slow wave activity, similar to previous findings with adults. Children with dyslexia showed poorer recall of the novel words overall, but nevertheless showed overnight improvements similar to age-matched peers. However, comparisons with younger children matched on initial levels of novel word recall pointed to reduced consolidation in dyslexics after 1 week. Crucially, there were no significant correlations between overnight consolidation and sleep parameters in the dyslexic group. This suggests a reduced role of sleep in vocabulary consolidation in dyslexia, possibly as a consequence of lower levels of learning prior to sleep, and highlights how models of sleep-associated memory consolidation can be usefully informed by data from typical and atypical development.

Consolidation of vocabulary during sleep: The rich get richer?

Sleep plays a role in strengthening new words and integrating them with existing vocabulary knowledge, consistent with neural models of learning in which sleep supports hippocampal transfer to neocortical memory. Such models are based on adult research, yet neural maturation may mean that the mechanisms supporting word learning vary across development. Here, we propose a model in which children may capitalise on larger amounts of slow-wave sleep to support a greater demand on learning and neural reorganisation, whereas adults may benefit from a richer knowledge base to support consolidation. Such an argument is reinforced by the well-reported "Matthew effect", whereby rich vocabulary knowledge is associated with better acquisition of new vocabulary. We present a meta-analysis that supports this association between children's existing vocabulary knowledge and their integration of new words overnight. Whilst multiple mechanisms likely contribute to vocabulary consolidation and neural reorganisation across the lifespan, we propose that contributions of existing knowledge should be rigorously examined in developmental studies. Such research has potential to greatly enhance neural models of learning.

A systematic review of cognitive function and psychosocial well-being in school-age children with narcolepsy.

In August 2010, concerns were raised about an increase in the incidence rate of narcolepsy diagnosis in children and adolescents. Narcolepsy is a chronic neurological sleep disorder characterised by excessive daytime sleepiness and attacks of muscle weakness which are often precipitated by strong emotions, known as cataplexy. We systematically examined and updated the scientific literature on the consequences of narcolepsy on cognitive function and psychosocial well-being in school-age children. Eight studies published between 2005 and 2015 were eligible for inclusion in this review. Collectively the results provide evidence to suggest that children who develop narcolepsy are at significant risk of cognitive impairment in at least one domain and emotional problems including depression, anxiety and low self-esteem. Children with narcolepsy should be monitored carefully in order to manage and reduce the impact of any impairments present. The existing literature is limited by small sample sizes, lack of appropriate controls and lack of longitudinal data. Future research should aim to address the limitations of the current work and aim to determine the underlying cause of cognitive and psychological impairments. This will enable the design of effective interventions to support children with narcolepsy so that they are able to achieve their full potential.

When the daffodat flew to the intergalactic zoo: off-line consolidation is critical for word learning from stories.

Previous studies using direct forms of vocabulary instruction have shown that newly learned words are integrated with existing lexical knowledge only after off-line consolidation (as measured by competition between new and existing words during spoken word recognition). However, the bulk of vocabulary acquisition during childhood occurs through incidental exposure to verbal material; hence, the role of consolidation may be different or limited when learning is less explicit. To address this, 40 children (ages 7-10 years) and 33 adults listened to a fictitious story that contained 12 novel words (e.g., "daffodat"). Lexical integration was measured by comparing pause detection latencies to existing competitors (e.g., "daffo_dil") and control words for which no new competitor had been encountered. Pause detection latencies were slower for existing competitors than control words (signifying increased lexical competition) 24 hr after exposure to the novel words but not immediately. Both groups recalled significantly more novel words when tested 24 hr after hearing the story than immediately. It is important that children with better expressive vocabulary knowledge showed larger consolidation effects for the novel words, both in terms of strengthening of explicit knowledge and their integration with existing knowledge. Off-line consolidation is therefore required for the integration of new and established knowledge when words are learned under relatively naturalistic conditions. Furthermore, a richer body of established vocabulary knowledge may facilitate (or benefit from) swift lexical integration of new vocabulary.

Learning new vocabulary during childhood: effects of semantic training on lexical consolidation and integration.

Research suggests that word learning is an extended process, with offline consolidation crucial for the strengthening of new lexical representations and their integration with existing lexical knowledge (as measured by engagement in lexical competition). This supports a dual memory systems account, in which new information is initially sparsely encoded separately from existing knowledge and integrated with long-term memory over time. However, previous studies of this type exploited unnatural learning contexts, involving fictitious words in the absence of word meaning. In this study, 5- to 9-year-old children learned real science words (e.g., hippocampus) with or without semantic information. Children in both groups were slower to detect pauses in familiar competitor words (e.g., hippopotamus) relative to control words 24h after training but not immediately, confirming that offline consolidation is required before new words are integrated with the lexicon and engage in lexical competition. Children recalled more new words 24h after training than immediately (with similar improvements shown for the recall and recognition of new word meanings); however, children who were exposed to the meanings during training showed further improvements in recall after 1 week and outperformed children who were not exposed to meanings. These findings support the dual memory systems account of vocabulary acquisition and suggest that the association of a new phonological form with semantic information is critical for the development of stable lexical representations.

Online lexical competition during spoken word recognition and word learning in children and adults.

Lexical competition that occurs as speech unfolds is a hallmark of adult oral language comprehension crucial to rapid incremental speech processing. This study used pause detection to examine whether lexical competition operates similarly at 7-8 years and tested variables that influence "online" lexical activity in adults. Children (n = 20) and adults (n = 17) were slower to detect pauses in familiar words with later uniqueness points. Faster latencies were obtained for words with late uniqueness points in constraining compared with neutral sentences; no such effect was observed for early unique words. Following exposure to novel competitors ("biscal"), children (n = 18) and adults (n = 18) showed competition for existing words with early uniqueness points ("biscuit") after 24 hr. Thus, online lexical competition effects are remarkably similar across development.

Graphic imagery is not sufficient for increased attention to cigarette warnings: the role of text captions.

AIMS: The present study aims to assess the extent to which attention to UK cigarette warnings is attributable to the graphic nature of the content. DESIGN: A visual dot probe task was utilised, with the warnings serving as critical stimuli that were manipulated for the presence of graphic versus neutral image content, and the accompanying text caption. This mixed design yielded image content (graphic versus neutrally-matched images) and presence (versus absence) of text caption as within subjects variables and smoking status as a between-participants variable. SETTING: The experiment took place within the laboratories of a UK university. PARTICIPANTS: Eighty-six psychology undergraduates (51% smokers, 69% female), predominantly of Caucasian ethnicity took part. MEASUREMENTS: Reaction times towards probes replacing graphic images relative to probes replacing neutral images were utilised to create an index of attentional bias. FINDINGS: Bias scores (M = 10.20 ± 2.56) highlighted that the graphic image content of the warnings elicited attentional biases (relative to neutral images) for smokers. This only occurred in the presence of an accompanying text caption [t (43) = 3.950, P < 0.001] as opposed to when no caption was present [t (43) = 0.029, P = 0.977]. Non-smokers showed no biases in both instances. CONCLUSIONS: Graphic imagery on cigarette packets increases attentional capture, but only when accompanied by a text message about health risks.

Consolidation of vocabulary is associated with sleep in children.

Although the acquisition of a novel word is apparently rapid, adult research suggests that integration of novel and existing knowledge (measured by engagement in lexical competition) requires sleep-associated consolidation. We present the first investigation of whether a similar time-course dissociation characterizes word learning across development. Consistent with previous research but counter to adults, 7-12-year-olds showed sleep-associated consolidation effects in declarative but not procedural memory. Nevertheless, the relationship between sleep and word learning in children was remarkably similar to the pattern for adults. Following exposure to nonword competitors (e.g. biscal) in the a.m. or p.m., children's ability to recognize and recall the nonwords improved only after sleep (after approximately 12-hrs for the p.m. group and 24-hrs for the a.m. group), with performance stable 1 week later. Novel nonwords only induced lexical competition effects after sleep. These findings suggest that children utilize a dual memory system when acquiring and integrating new vocabulary and highlight sleep as integral to this process. A video abstract of this article can be viewed at http://www.youtube.com/watch?feature=youtube_gdata&v=2UNuKCAakOk&gl=GB.

Enhanced recognition and recall of new words in 7- and 12-year-olds following a period of offline consolidation.

Recent studies of adults have found evidence for consolidation effects in the acquisition of novel words, but little is known about whether such effects are found developmentally. In two experiments, we familiarized children with novel nonwords (e.g., biscal) and tested their recognition and recall of these items. In Experiment 1, 7-year-olds were then retested on either the same day or the following day to examine changes in performance after a short delay compared with a longer delay that included sleep. Experiment 2 used two age groups (7- and 12-year-olds), with all participants being retested 24h later. The 12-year-olds accurately recognized the novel nonwords immediately after exposure, as did the 7-year-olds in Experiment 2 (but not in Experiment 1), suggesting generally good initial rates of learning. Experiment 1 revealed improved recognition of the novel nonwords after both short (3- to 4-h) and longer (24-h) delays. In contrast, recall was initially poor but showed improvements only when children were retested 24h later, not after a 3- to 4-h delay. Similar improvements were observed in both age groups despite better overall performance in 12-year-olds. We argue that children, like adults, exhibit offline consolidation effects on the formation of novel phonological representations.

The role of working memory and contextual constraints in children's processing of relative clauses.

An auditory sentence comprehension task investigated the extent to which the integration of contextual and structural cues was mediated by verbal memory span with 32 English-speaking six- to eight-year-old children. Spoken relative clause sentences were accompanied by visual context pictures which fully (depicting the actions described within the relative clause) or partially (depicting several referents) met the pragmatic assumptions of relativization. Comprehension of the main and relative clauses of centre-embedded and right-branching structures was compared for each context. Pragmatically appropriate contexts exerted a positive effect on relative clause comprehension, but children with higher memory spans demonstrated a further benefit for main clauses. Comprehension for centre-embedded main clauses was found to be very poor, independently of either context or memory span. The results suggest that children have access to adult-like linguistic processing mechanisms, and that sensitivity to extralinguistic cues is evident in young children and develops as cognitive capacity increases.

The kindergarten path effect revisited: children's use of context in processing structural ambiguities.

Research with adults has shown that ambiguous spoken sentences are resolved efficiently, exploiting multiple cues--including referential context--to select the intended meaning. Paradoxically, children appear to be insensitive to referential cues when resolving ambiguous sentences, relying instead on statistical properties intrinsic to the language such as verb biases. The possibility that children's insensitivity to referential context may be an artifact of the experimental design used in previous work was explored with 60 4- to 11-year-olds. An act-out task was designed to discourage children from making incorrect pragmatic inferences and to prevent premature and ballistic responses by enforcing delayed actions. Performance on this task was compared directly with the standard act-out task used in previous studies. The results suggest that young children (5 years) do not use contextual information, even under conditions designed to maximize their use of such cues, but that adult-like processing is evident by approximately 8 years of age. These results support and extend previous findings by Trueswell and colleagues (Cognition (1999), Vol. 73, pp. 89-134) and are consistent with a constraint-based learning account of children's linguistic development.

Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions.

BACKGROUND: Controversy over the measles, mumps, and rubella (MMR) vaccine has reduced uptake, raising concerns of a future disease epidemic. AIMS: To explore parents' accounts of decision making relating to the MMR vaccine controversy, identifying uptake determinants and education needs. DESIGN OF STUDY: Qualitative interviews analysed using the 'framework' approach. SETTING: Five general practices in the Leeds area, 2002-2003. METHOD: Sixty-nine interviews conducted with parents of children aged between 4 and 5 years, and 12 interviews with primary care practitioners, managers and immunisation coordinators serving participating sites. Participants were interviewed one-to-one in a place of their choice. RESULTS: The vaccination decision is primarily a function of parental assessments of the relative acceptability and likelihood of possible outcomes. For most parents the evidence of science and medicine plays little role in the decision. Although local general practitioners and health visitors are trusted information sources, the influence of primary care providers on the vaccination decision is limited by concerns over consultation legitimacy, discussion opportunity, and perceptions of financial and political partiality. Parents and practitioners identify a need for new approaches to support decisions and learning when faced with this and similar healthcare controversies. These include new collaborative approaches to information exchange designed to transform rather than supplant existing parent knowledge as part of an ongoing learning process. CONCLUSION: The study identified new ways in which parents and practitioners need to be supported in order to increase understanding of medical science and secure more informed decisions in the face of health controversy.