Statistical or sequential learning (SL) involves comprehending environmental patterns in which some items precede other items with a given likelihood. SL is thought to occur without attention or consciousness (or explicit knowledge) of the learned patterns and thus is sometimes considered to be implicit learning. However, this assumption is still debatable (Daltrozzo & Conway, 2014). We examined the role of selective attention and pattern consciousness (PC) in SL using event-related potentials (ERP) with healthy adults. Thirty-four participants (27 females, 18-49 years) performed a Flanker task to assess their level of selective attention, followed by a visual SL task while ERPs were recorded. Participants’ level of PC was assessed via a questionnaire. In the SL task, participants viewed a sequence of different stimuli on the screen and were instructed to press a button as fast as possible, when they saw a target stimulus. They were unaware that: 1.) two predictor items were embedded in the sequence and 2.) the items predicted target occurrence with high or low probability. ERPs were timelocked to predictor onsets. The mean ERP between 200 and 700ms post-predictor onset revealed an interaction between target occurrence probability, PC, attention, and two scalp topographic factors. Post-hoc tests indicated that higher attention was related to a more rostral left lateralized effect under high PC and a left lateralization of SL ERP effects under low PC. These neural findings suggest that both attention and PC modulate SL.

A growing body of research suggests that individuals withdevelopmental dyslexia perform below typical readers onnon-linguistic cognitive tasks involving the learning andencoding of statistical-sequential patterns. However, theneural mechanisms underlying such a deficit have not beenwell examined. The aim of the present study was toinvestigate the ERP correlates of sequence processing in asample of children diagnosed with dyslexia using aprobabilistic visual serial learning paradigm. The behavioralresults revealed that whereas age-matched typicallydeveloping children (n=12) showed learning in the task asreflected by their response times, the children with dyslexia(n=8) likely showed difficulty in learning. In conjunction withthese behavioral results, the ERPs of the typically developingchildren showed a P300-like response indicative of thisparadigm (Jost et al., 2015); whereas, the children diagnosedwith a reading disorder showed no such ERP effects. Thesefindings are consistent with the idea that differences instatistical-sequential learning ability might underlie thereading deficits observed in developmental dyslexia.

Objective

To estimate traumatic brain injuries (TBIs) and acute care costs due to sports activities.

Methods

A planned secondary analysis of 7799 children from 5 years old to <18 years old with head injuries enrolled in a prospective multicentre study between 2011 and 2014. Sports-related TBIs were identified by the epidemiology codes for activity, place and injury mechanism. The sports cohort was stratified into two age groups (younger: 5-11 and older: 12-17 years). Acute care costs from the publicly funded Australian health system perspective are presented in 2018 pound sterling (£).

Results

There were 2903 children (37%) with sports-related TBIs. Mean age was 12.0 years (95% CI 11.9 to 12.1 years); 78% were male. Bicycle riding was associated with the most TBIs (14%), with mean per-patient costs of £802 (95% CI £644 to £960) and 17% of acute costs. The highest acute costs (21%) were from motorcycle-related TBIs (3.8% of injuries), with mean per-patient costs of £3795 (95% CI £1850 to £5739). For younger boys and girls, bicycle riding was associated with the highest TBIs and total costs; however, the mean per-patient costs were highest for motorcycle and horse riding, respectively. For older boys, rugby was associated with the most TBIs. However, motorcycle riding had the highest total and mean per-patient acute costs. For older girls, horse riding was associated with the most TBIs and highest total acute costs, and motorcycle riding was associated with the highest mean per-patient costs.

Conclusion

Injury prevention strategies should focus on age-related and sex-related sports activities to reduce the burden of TBIs in children.

Trial registration number

ACTRN12614000463673.

Objective: This study determined if the caregivers of children in the emergency department (ED) have the same COVID-19 vaccination status as the child, the reasons they chose to not vaccinate the child, and self-identified barriers to vaccination to determine if the ED is appropriate for vaccination intervention.

Methods: A survey was administered to caregivers of pediatric ED patients at four Children’s Hospitals in: Augusta, GA, Buffalo, NY, Madison, WI, and Sacramento, CA. Participants were asked about their and the child’s demographics, vaccination status, and barriers to vaccination. We used descriptive statistics, Cohen's kappa, and logistic regression to analyze responses.

Results: 941 caregivers were considered for enrollment, and 800 consented to participation. Participants were 75% women with a mean age of 40.9 ± 8.9 years. 51% (409) of the pediatric ED patients were COVID-19 vaccinated, as were 74% (591) of the caregivers. There was variation across sites, but overall, 15% of caregivers of unvaccinated children wanted the child tobe vaccinated with the most common barriers to vaccination identified as safety data (25%), time availability (20%), and ability to obtain an appointment (13%). The most common reason for not wanting the child COVID-19 vaccinated was concern the vaccine didn’t work or had too many side effects.

Conclusion: A small but clinically important group of pediatric ED patients are not COVID-19 vaccinated but their caregivers want them to be vaccinated, indicating that consideration should be given to offering vaccination in the ED. Reasons for avoiding COVID-19 vaccination were primarily concerns with efficacy and side effects.

INTRODUCTION: Sepsis affects 25.2 million children per year globally and causes 3.4 million deaths, with an annual cost of hospitalisation in the USA of US$7.3 billion. Despite being common, severe and expensive, therapies and outcomes from sepsis have not substantially changed in decades. Variable case definitions, lack of a reference standard for diagnosis and broad spectrum of disease hamper efforts to evaluate therapies that may improve sepsis outcomes. This landscape analysis of community-acquired childhood sepsis in Australia and New Zealand will characterise the burden of disease, including incidence, severity, outcomes and cost. Sepsis diagnostic criteria and risk stratification tools will be prospectively evaluated. Sepsis therapies, quality of care, parental awareness and understanding of sepsis and parent-reported outcome measures will be described. Understanding these aspects of sepsis care is fundamental for the design and conduct of interventional trials to improve childhood sepsis outcomes. METHODS AND ANALYSIS: This prospective observational study will include children up to 18 years of age presenting to 12 emergency departments with suspected sepsis within the Paediatric Research in Emergency Departments International Collaborative network in Australia and New Zealand. Presenting characteristics, management and outcomes will be collected. These will include vital signs, serum biomarkers, clinician assessment of severity of disease, intravenous fluid administration for the first 24 hours of hospitalisation, organ support therapies delivered, antimicrobial use, microbiological diagnoses, hospital and intensive care unit length-of-stay, mortality censored at hospital discharge or 30 days from enrolment (whichever comes first) and parent-reported outcomes 90 days from enrolment. We will use these data to determine sepsis epidemiology based on existing and novel diagnostic criteria. We will also validate existing and novel sepsis risk stratification criteria, characterise antimicrobial stewardship, guideline adherence, cost and report parental awareness and understanding of sepsis and parent-reported outcome measures. ETHICS AND DISSEMINATION: Ethics approval was received from the Royal Childrens Hospital of Melbourne, Australia Human Research Ethics Committee (HREC/69948/RCHM-2021). This included incorporated informed consent for follow-up. The findings will be disseminated in a peer-reviewed journal and at academic conferences. TRIAL REGISTRATION NUMBER: ACTRN12621000920897; Pre-results.