Relation between active mediation,exposure to Daniel Tiger’s Neighborhood,and US preschoolers’ social and emotional development

This study explored the relationship between active mediation, exposure to Daniel Tiger’s Neighborhood, and key indicators of preschoolers’ social and emotional development. One hundred and twenty-seven children aged 2–6 either watched or did not watch 10 episodes of Daniel Tiger’s Neighborhood over a two-week period. Results revealed that preschoolers who watched the program exhibited higher levels of empathy, self-efficacy, and emotion recognition when their regular TV-watching experiences are frequently accompanied by active mediation. This was especially true for younger preschoolers and preschoolers from low-income families. Implications for policy-makers, parents, producers of prosocial programming, and educators are discussed.     

Low-dose hydrocortisone in patients with COVID-19 and severe hypoxia (COVID STEROID) trial—Protocol and statistical analysis plan

Introduction

Severe acute respiratory syndrome coronavirus-2 has caused a pandemic of coronavirus disease (COVID-19) with many patients developing hypoxic respiratory failure. Corticosteroids reduce the time on mechanical ventilation, length of stay in the intensive care unit and potentially also mortality in similar patient populations. However, corticosteroids have undesirable effects, including longer time to viral clearance. Clinical equipoise on the use of corticosteroids for COVID-19 exists.

Methods

The COVID STEROID trial is an international, randomised, stratified, blinded clinical trial. We will allocate 1000 adult patients with COVID-19 receiving ≥10 L/min of oxygen or on mechanical ventilation to intravenous hydrocortisone 200 mg daily vs placebo (0.9% saline) for 7 days. The primary outcome is days alive without life support (ie mechanical ventilation, circulatory support, and renal replacement therapy) at day 28. Secondary outcomes are serious adverse reactions at day 14; days alive without life support at day 90; days alive and out of hospital at day 90; all-cause mortality at day 28, day 90, and 1 year; and health-related quality of life at 1 year. We will conduct the statistical analyses according to this protocol, including interim analyses for every 250 patients followed for 28 days. The primary outcome will be compared using the Kryger Jensen and Lange test in the intention to treat population and reported as differences in means and medians with 95% confidence intervals.

Discussion

The COVID STEROID trial will provide important evidence to guide the use of corticosteroids in COVID-19 and severe hypoxia.

     

Comparison of blood glucose and insulin responses in non-insulin dependent diabetic patients. Studies with spaghetti and potato taken alone and as part of a mixed meal

Recently, we demonstrated that spaghetti caused significantly lower glycaemic response than rice and potato in insulin-dependent diabetic (IDDM) subjects and that this difference was also present when spaghetti and potato were taken as part of a mixed meal. We have now compared the blood glucose and insulin responses to 50 g of carbohydrate in the form of white bread, potato and white spaghetti in 6 non-insulin-dependent diabetic (NIDDM) patients. The blood glucose response after white spaghetti observed over a 3-h period was only 60 +/- 10 per cent (P less than 0.02) of that seen in response to potato (395 +/- 116 mmol/l x 180 min vs 641 +/- 108 mmol/l x 180 min) and 47 +/- 9 per cent (P less than 0.01) of that seen in response to white bread (395 +/- 116 mmol/l x 180 min vs 805 +/- 93 mmol/l x 180 min). Insulin responses showed an identical pattern reflecting the glycaemic responses. To see if the difference in the glucose responses in NIDDM patients is preserved if these carbohydrate-rich foods are taken as part of a mixed meal we looked at the blood glucose and insulin responses to 50 g of carbohydrate in the form of potato and white spaghetti when ingested together with bolognese sauce (167 g) in 7 NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Clonidine in the treatment of Tourette's syndrome exacerbation due to haloperidol withdrawal

A patient with long-standing Tourette's syndrome had a dramatic exacerbation of symptoms following the rapid withdrawal of haloperidol. Clonidine administration resulted in a disappearance of tics, which recurred 6 days later. The role of clonidine in blocking withdrawal-induced symptoms in patients with Tourette's syndrome treated with long-term neuroleptics is discussed from a clinical and neurobiological perspective. The implications of this case for the treatment of supersensitivity psychosis and tricyclic withdrawal states with clonidine are also discussed.     

Antibody levels against Streptococcus pneumoniae and Haemophilus influenzae type b in a population of splenectomized individuals with varying vaccination status.

In order to determine antibody levels against Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) in a population of splenectomized subjects, 561 persons in a Danish county, splenectomized between 1984 and 1993 were identified. Two hundred and thirty-five were alive and 149 participated in the study. Each person donated a blood sample for antibody determination by ELISA. Though vaccine coverage among the 149 persons was 91% only 52% had ''protective'' levels of pneumococcal antibodies. Despite recommendations for regular follow-up on pneumococcal antibody levels this had only been carried out in 4% of the subjects. Splenectomized subjects who needed pneumococcal revaccination were significantly more likely to have received their initial vaccination less than 14 days before or after splenectomy, as recommended, than those not requiring revaccination. Therefore, the timing of initial pneumococcal vaccination in relation to splenectomy seems to be important. All persons had Hib antibody levels higher than 0.15 microgram/ml and 60% had levels higher than 1 microgram/ml, which are the levels thought to provide short term and long term protection, respectively. In total, 37% of the 149 persons tested had pneumococcal and Hib antibody levels thought to correlate with protection from serious infections.     

Mothers' benefit of a self-care booklet and a self-care educational session at child health centres

Mothers' benefit of a mass-distributed self-care booklet and a self-care educational session about young children's minor illnesses were investigated. The following questions were studied: (1) Do mothers of infants read and benefit from a self-care booklet? (2) Is the mothers' knowledge about self-care improved more if the booklet is supplemented by a self-care educational session? 265 (92%) of 288 randomly sampled Swedish mothers whose first child was 6-12 months of age were interviewed regarding their knowledge about self-care. Shortly thereafter a self-care booklet was mailed to all households in Uppsala county and 6.5 months later a new group of 572 mothers was randomly sampled. Among the 572 mothers, 332 (58%) were randomized to a self-care session organized at child health centres and 240 (42%) were not invited to a session. Of the 572 mothers, 530 (93%) were later interviewed about the booklet, the session and their knowledge about self-care. 69% participated among the mothers randomized to the session. Among these mothers, 99% recalled the booklet and 96% had read the child care section. Among the mothers not invited to the session, 68% recalled the booklet and 60% had read the child care section. The mothers who had read the child care section would follow the recommendations about when to seek (and not to seek) medical care significantly better than those who had not read it (P less than 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)     

Epidural blood patch illustrated by CT-epidurography

Four patients, who received epidural blood patch to treat postdural puncture headache, were examined with computed tomography in order to demonstrate the distribution of the injected blood. Blood alone could not be identified, but adding 2 ml contrast agent Iohexol 180 mg J/ ml (Omnipaque®, Nycomed Imaging) to 18 ml blood gave an excellent demonstration of the distribution of the blood in the epidural space, both cranio-caudally (7–14 segments) and spatially in relation to the epidural septae. The blood-contrast media had a strong affinity to the dural sac. There was no support of the spacefilling effect of blood patch.