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Adopting an anti-bullying programme for UK special schools
Bullying is a public health priority but to date, there is a lack of evidence-based anti-bullying programmes or interventions designed for use in special schools. KiVa is a successful anti-bullying programme for mainstream schools currently used in 23 countries. This brief paper outlines the co-development and adaptation of two KiVa lessons into KiVa-SEND lessons and their implementation in two special schools in the UK. One school supports pupils with a primary need of Autism, the other supports pupils with severe and complex learning disabilities. Engagement with the lessons was high from both pupils and staff; the content was perceived as acceptable by staff, complementing the curriculum and perceived as suitable for their pupils. Minor adjustments need to be made to ensure all pupils can comprehend and access the concepts. Further development of the KiVa-SEND programme and testing its potential effectiveness to reduce bullying and associated negative outcomes in special schools is now warranted.
Cost-effectiveness of therapist-assisted internet-delivered psychological therapies for PTSD differing in trauma focus in England: an economic evaluation based on the STOP-PTSD trial.
BACKGROUND: Although there are effective psychological treatments for post-traumatic stress disorder (PTSD), they remain inaccessible for many people. Digitally enabled therapy is a way to overcome this problem; however, there is little evidence on which forms of these therapies are most cost effective in PTSD. We aimed to assess the cost-effectiveness of the STOP-PTSD trial, which evaluated two therapist-assisted, internet-delivered cognitive behavioural therapies: cognitive therapy for PTSD (iCT-PTSD) and a programme focusing on stress management (iStress-PTSD). METHODS: In this health economic evaluation, we used data from the STOP-PTSD trial (n=217), a single-blind, randomised controlled trial, to compare iCT-PTSD and iStress-PTSD in terms of resource use and health outcomes. In the trial, participants (aged ≥18 years) who met DSM-5 criteria for PTSD were recruited from primary care therapy services in South East England. The interventions were delivered online with therapist support for the first 12 weeks, and three telephone calls over the next 3 months. Participants completed questionnaires on symptoms, wellbeing, quality of life, and resource use at baseline, 13 weeks, 26 weeks, and 39 weeks after randomisation. We used a cost-effectiveness analysis to assess cost per quality-adjusted life year (QALY) at 39 weeks post-randomisation, from the perspective of the English National Health Service (NHS) and personal social services and on the basis of intention-to-treat for complete cases. Treatment modules and the platform design were developed with extensive input from service users: service users also advised on the trial protocol and methods, including the health economic measures. This is a pre-planned analysis of the STOP-PTSD trial; the trial was registered prospectively on the ISRCTN Registry (ISRCTN16806208). FINDINGS: NHS costs were similar across treatment groups, but clinical outcomes were superior for iCT-PTSD compared with iStress-PTSD. The incremental cost-effectiveness ratio for NHS costs and personal social services was estimated as £1921 per QALY. iCT-PTSD had an estimated 91·6% chance of being cost effective at the £20 000 per QALY threshold. From the societal perspective, iCT-PTSD was cost saving compared with iStress-PTSD. INTERPRETATION: iCT-PTSD is a cost-effective form of therapist-assisted, internet-delivered psychological therapy relative to iStress-PTSD, and it could be considered for clinical implementation. FUNDING: Wellcome Trust and National Institute of Health Research Oxford Health Biomedical Research Centre.
VERBS OF PERCEPTION: A QUANTITATIVE TYPOLOGICAL STUDY
Previous studies have proposed that the lexicalization of perception verbs is constrained by a biologically grounded hierarchy of the senses. Other research traditions emphasize conceptual and communicative factors instead. Drawing on a balanced sample of perception verb lexicons in 100 languages, we found that vision tends to be lexicalized with a dedicated verb, but that nonvisual modalities do not conform to the predictions of the sense-modality hierarchy. We also found strong asymmetries in which sensory meanings colexify. Rather than a universal hierarchy of the senses, we suggest that two domain-general constraints—conceptual similarity and communicative need— interact to shape lexicalization patterns.
The effects of linear order in category learning: Some replications of Ramscar et al., (2010) and their implications for replicating training studies
Ramscar, Yarlett, Dye, Denny and Thorpe (2010) showed how, consis tent with the predictions of error-driven learning models, the order in which stimuli are presented in training can affect category learning. Specifically, learners exposed to artificial language input where objects preceded their labels learned the discriminating features of categories better than learners exposed to input where labels preceded objects. We sought to replicate this finding in two online experiments employing the same tests used originally: A four pictures test (match a label to one of four pictures) and a four labels test (match a picture to one of four labels). In our study, only findings from the four pictures test were consistent with the original result. Additionally, the effect sizes observed were smaller, and participants over-generalized high frequency category labels more than in the original study. We suggest that although Ramscar et al. [2010] feature-label order predictions were derived from error-driven learning, they failed to consider that this mechanism also predicts that perfomance in any training paradigm must inevitably be influ enced by participant prior experience. We consider our findings in light of these factors, and discuss implications for the generalizability and replication of training studies
Onomatopoeia, gestures, actions and words: How do caregivers use multimodal cues in their communication to children?
Most research on how children learn the mapping between words and world has assumed that language is arbitrary, and has investigated language learning in contexts in which objects referred to are present in the environment. Here, we report analyses of a semi-naturalistic corpus of caregivers talking to their 2-3 year-old. We focus on caregivers' use of non-arbitrary cues across different expressive channels: both iconic (onomatopoeia and representational gestures) and indexical (points and actions with objects). We ask if these cues are used differently when talking about objects known or unknown to the child, and when the referred objects are present or absent. We hypothesize that caregivers would use these cues more often with objects novel to the child. Moreover, they would use the iconic cues especially when objects are absent because iconic cues bring to the mind's eye properties of referents. We find that cue distribution differs: all cues except points are more common for unknown objects indicating their potential role in learning; onomatopoeia and representational gestures are more common for displaced contexts whereas indexical cues are more common when objects are present. Thus, caregivers provide multimodal non-arbitrary cues to support children's vocabulary learning and iconicity - specifically - can support linking mental representations for objects and labels.
Learning: Statistical Mechanisms in Language Acquisition
The grammatical structure of human languages is extremely complex, yet children master this complexity with apparent ease. One explanation is that we come to the task of acquisition equipped with knowledge about the possible grammatical structures of human languages—so-called “Universal Grammar”. An alternative is that grammatical patterns are abstracted from the input via a process of identifying reoccurring patterns and using that information to form grammatical generalizations. This statistical learning hypothesis receives support from computational research, which has revealed that even low level statistics based on adjacent word co-occurrences yield grammatically relevant information. Moreover, even as adults, our knowledge and usage of grammatical patterns is often graded and probabilistic, and in ways which directly reflect the statistical makeup of the language we experience. The current chapter explores such evidence and concludes that statistical learning mechanisms play a critical role in acquisition, whilst acknowledging holes in our current knowledge, particularly with respect to the learning of ‘higher level’ syntactic behaviours. Throughout, I emphasize that although a statistical approach is traditionally associated with a strongly empiricist position, specific accounts make specific claims about the nature of the learner, both in terms of learning mechanisms and the information that is primitive to the learning system. In particular, working models which construct grammatical generalizations often assume inbuilt semantic abstractions.
Poststroke Executive Function in Relation to White Matter Damage on Clinically Acquired CT Brain Imaging.
BACKGROUND: Executive function (EF) impairments are prevalent post stroke and are associated with white matter (WM) damage on MRI. However, less is known about the relationship between poststroke EF and WM damage on CT imaging. OBJECTIVE: To investigate the relationship between poststroke EF and WM damage associated with stroke lesions and WM hypointensities (WMHs) on clinically acquired CT imaging. METHOD: This study analyzed data from the Oxford Cognitive Screening Program, which recruited individuals aged ≥18 years with a confirmed stroke from an acute stroke unit. The individuals completed a follow-up assessment 6 months post stroke. We included individuals with a CT scan showing a visible stroke who completed follow-up EF assessment using the Oxford Cognitive Screen-Plus rule-finding task. We manually delineated stroke lesions and quantified then dichotomized WM damage caused by the stroke using the HCP-842 atlas. We visually rated then dichotomized WMHs using the Age-Related White Matter Changes Scale. RESULTS: Among 87 stroke survivors (M age = 73.60 ± 11.75; 41 female; 61 ischemic stroke), multivariable linear regression showed that stroke damage to the medial lemniscus ( B = -8.86, P < 0.001) and the presence of WMHs ( B = -5.42, P = 0.005) were associated with poorer EF 6 months post stroke after adjusting for covariates including age and education. CONCLUSION: Poorer EF was associated with WM damage caused by stroke lesions and WMHs on CT. These results confirm the importance of WM integrity for EF post stroke and demonstrate the prognostic utility of CT-derived imaging markers for poststroke cognitive outcomes.
Do we really need a new definition of dyslexia? A commentary.
We provide a commentary on current debates about the definition of dyslexia. We agree with others that dyslexia is best thought of as a dimensional disorder with the best established causal risk factor being a deficit in phonological processing. Dyslexia is particularly common in children from families with a history of dyslexia and in children with preschool language difficulties. We argue that definitions may differ depending upon their purpose. Traditional discrepancy definitions may be useful for research purposes, but when considering the provision of educational services discrepancy definitions are not useful since all children with reading difficulties require reading intervention regardless of their level of IQ.
Leveraging transportation providers to deploy lay first responder (LFR) programs in three sub-Saharan African countries without formal emergency medical services: Evaluating longitudinal impact and cost-effectiveness.
INTRODUCTION: In 2019, the World Health Assembly declared emergency care essential to achieve the 2030 Sustainable Development Goals. Few sub-Saharan African (SSA) countries have developed robust approaches to sustainably deliver emergency medical services (EMS) at scale, as high-income country models are financially impractical. Innovative reassessment of EMS delivery in resource-limited settings is necessary as timely emergency care access can substantially reduce mortality. MATERIALS AND METHODS: We developed the Lay First Responder (LFR) program by training 1,291 pre-existing motorcycle taxi drivers, a predominant form of short-distance transport in sub-Saharan Africa, to provide trauma care and transport for road traffic injuries. Three pilot programs were launched in staggered fashion between 2016 and 2019 in West, Central, and East Africa and a 5.5 h curriculum was iteratively developed to train first responders. Longitudinal data on patient impact (patient demographics, injury characteristics, and treatment rendered), emergency care knowledge acquisition/retention, and social/financial effects of LFR training were collected and pooled across three sites for collective analysis. Novel cost-effectiveness ratios were calculated based on prospective cost data from each site. Previously projected aggregate disability-adjusted life years (DALYs) addressable by LFRs were used to inform cost-effectiveness ratios($USD cost per DALY averted). Cost-effectiveness ratios were then compared against African per capita gross domestic product (GDP), following WHOCHOICE guidelines, which state ratios less than GDP per capita are "very cost-effective." RESULTS: In 2,171 total patient encounters across all three pilot sites, LFRs most frequently provided hemorrhage control in 61 % of patient encounters and patient transport by motorcycle in 98.5 %. Median pre-/post-test scores improved by 34.1 percentage points (39.5% vs.73.6 %, p < 0.0001) with significant knowledge retention at six months. 75 % of initial participants remain voluntarily involved 3 years post-course, reporting increased local stature and customer acquisition(income 32.0 % greater than non-trained counterparts). Locally sourced first-aid materials cost $6.54USD/participant. Cost-effectiveness analysis demonstrated cost per DALY averted=$51.65USD. CONCLUSION: LFR training is highly cost-effective according to WHOCHOICE guidelines and expands emergency care access. The LFR program may be an alternative approach to formal ambulance-reliant EMS that are cost-prohibitive in resource-limited, sub-Saharan African settings. A novel social/financial mechanism appears to incentivize long-term voluntary LFR involvement, which may sustain programs in resource-limited settings.
Acknowledging religion in cognitive behavioural therapy: The effect on alliance, treatment expectations and credibility in a video-vignette study.
OBJECTIVES: Developing mental health services which are accessible and acceptable to those from minority backgrounds continues to be a priority. In the United Kingdom, individuals who identify with a religion are underrepresented in Talking Therapies services as compared to those with no religion. This necessitates an understanding of how therapy is perceived. This online study explored the impact of explicitly acknowledging religion on anticipated alliance, treatment credibility and expectations of therapy in a non-clinical sample of British Muslims. METHODS: A video-vignette experimental design was used in which participants who self-reported as either high or low in religiosity were randomly allocated to receiving information about cognitive behavioural therapy either with or without an explicit mention of religion as a value in the therapeutic process. RESULTS: One hundred twenty-nine British Muslim adults aged 18-70+ years from various ethnic backgrounds participated in the study. Between-subjects ANOVAs showed that scores on the perceived credibility of therapy and treatment expectations were significantly higher when religion was explicitly mentioned by the 'therapist', but that acknowledging religion did not impact upon anticipated alliance. CONCLUSIONS: These findings suggest that mentioning religion as a value to be considered in therapy has some positive impacts upon how therapy is perceived by British Muslims. Although video vignettes do not provide insight into the complexity of actual therapeutic encounters, acknowledging religion in mental health services more broadly remains an important consideration for improving equity of access and may bear relevance to other minoritized groups.
Sonic branding: A narrative review at the intersection of art and science
AbstractThe field of sonic branding/marketing has grown rapidly in recent years, as has commercial interest in more science‐based approaches to the practice, particularly as more brands and agencies look for qualitative and quantitative evidence to support the efficacy of sonic branding. In this research note, we explore the ways in which the design and execution (i.e., the “art”) of sonic branding initiatives can be informed by overlapping approaches and techniques drawn from the sciences, namely psychoacoustics, semiotics, music/auditory cognition, and crossmodal research. We explore whether the rapid growth of generative AI may represent the next major evolution in the design, creation, and assessment of sonic assets, where science and art are used to train AI tools that could one day augment (and potentially disrupt) the work of human sound designers and composers. These developments notwithstanding, it is argued that sonic branding will likely remain as much an art as a science, though basing one's approach on the emerging scientific literature ought to at least tilt the odds of success in the creative's favor.
Nuclei-specific hypothalamus networks predict a dimensional marker of stress in humans.
The hypothalamus is part of the hypothalamic-pituitary-adrenal axis which activates stress responses through release of cortisol. It is a small but heterogeneous structure comprising multiple nuclei. In vivo human neuroimaging has rarely succeeded in recording signals from individual hypothalamus nuclei. Here we use human resting-state fMRI (n = 498) with high spatial resolution to examine relationships between the functional connectivity of specific hypothalamic nuclei and a dimensional marker of prolonged stress. First, we demonstrate that we can parcellate the human hypothalamus into seven nuclei in vivo. Using the functional connectivity between these nuclei and other subcortical structures including the amygdala, we significantly predict stress scores out-of-sample. Predictions use 0.0015% of all possible brain edges, are specific to stress, and improve when using nucleus-specific compared to whole-hypothalamus connectivity. Thus, stress relates to connectivity changes in precise and functionally meaningful subcortical networks, which may be exploited in future studies using interventions in stress disorders.
A Computational Account of the Role of Cochlear Nucleus and Inferior Colliculus in Stabilizing Auditory Nerve Firing for Auditory Category Learning.
It is well known that auditory nerve (AN) fibers overcome bandwidth limitations through the volley principle, a form of multiplexing. What is less well known is that the volley principle introduces a degree of unpredictability into AN neural firing patterns that may be affecting even simple stimulus categorization learning. We use a physiologically grounded, unsupervised spiking neural network model of the auditory brain with spike time dependent plasticity learning to demonstrate that plastic auditory cortex is unable to learn even simple auditory object categories when exposed to the raw AN firing input without subcortical preprocessing. We then demonstrate the importance of nonplastic subcortical preprocessing within the cochlear nucleus and the inferior colliculus for stabilizing and denoising AN responses. Such preprocessing enables the plastic auditory cortex to learn efficient robust representations of the auditory object categories. The biological realism of our model makes it suitable for generating neurophysiologically testable hypotheses.