A number of recent studies have found that objects are named more slowly in the context of same-category items than in the context of items from various semantic categories. Several experiments reported here indicated that this semantic effect is relatively persistent because it was essentially unaffected by the presence of interspersed filler items. The authors suggest that the effect is specific to the retrieval of lexical-semantic codes and characterize mechanisms that could support the effect at this processing level, such as incremental learning in the links between conceptual and lexical codes and the temporary increase of lexical resting levels. The results underscore the necessity of incorporating mechanisms of long-term adaptation into current models of spoken production.

Our findings indicate that a significant minority of school-aged children admitted to PICU are at risk for reduced mental and physical well-being in the short term. Symptoms of poor mental well-being were linked to both vulnerability factors and critical illness factors.

Objective: To assess short-term neuropsychological function and academic performance in school children following admission to intensive care and to explore the role of critical neurological and systemic infection.Design: A prospective observational case-control study.Setting: Two Paediatric Intensive Care Units (PICUs).Subjects: A consecutive sample of 88 children aged 5-16 years (Mdn age = 10.00, IQR = 6.00-13.00) admitted to PICU between 2007 and 2010 with meningo-encephalitis, septic illness, or other critical illnesses were assessed three to six months following discharge and performance compared with 100 healthy controls. Patients were without prior neurological or neuro-developmental disorder.Interventions: None.Measurements and Main Results: Data encompassing demographic and critical illness details were obtained and children were assessed using tests of intellectual function, memory, and attention. Questionnaires addressing academic performance were returned by teachers. After adjusting for co-variates, the PICU admitted children significantly underperformed on neuropsychological measures in comparison to the healthy controls (ps<.02). Teachers deemed more PICU children than controls as performing educationally worse and having problems with school work (ps=.001), as well as performing below average on aspects of executive function and attention (ps<.04). Analysis of the effect of illness type on outcome revealed that aspects of 3 neuropsychological function, such as memory function, and teacher-rated academic performance were most reduced in children with meningo-encephalitis and septic illness. In the PICU group, multivariable linear regression revealed that worse performance on a composite score of neuropsychological impairment was more prevalent when children were younger, from a lower social class, and had experienced seizures during their admission (ps<.02).Conclusions: Admission to PICU is followed by deficits in neuropsychological performance and educational difficulties, with more severe difficulties noted following meningo-encephalitis and septic illness. These results highlight the importance of future studies on cognition and educational outcome incorporating type of illness as a moderating factor.

ObjectiveTo assess feasibility and pilot a supported psychoeducational tool to improve parent and child mental health following discharge from a paediatric intensive care unit (PICU), in preparation for a large randomised controlled trial (RCT).DesignFeasibility assessment and single-centre, parallel group, pilot RCT. A concealed computer generated list was used to randomise participants, with an allocation of 2:1 in favour of the intervention.SettingA PICU in an acute care hospital in London, UK.Participants31 parents of children aged 4–16 years-old admitted to PICU.InterventionParents received a psychoeducational tool supported by a telephone call. The psychoeducational tool outlined the possible psychological reactions in children and parents alongside management advice. The telephone call addressed each family's postdischarge experience, reinforced the psychoeducational material and encouraged parents to put into practice the advice given.Main outcome measuresThe primary outcome was the number of feasibility criteria successfully met (linked to the intervention and the study design). Secondary outcomes were questionnaire data collected at 3–6-month follow-up assessing mental health in parents and children.Results31 parents were randomised (intervention n=22; treatment as usual, TAU n=9). 23 parents were included in the analysis of secondary outcomes (intervention n=17; TAU n=6). 3 (of 6) intervention and 1 (of 6) study design feasibility criteria were fully met. All unmet criteria could be addressed with minor or significant modifications to the protocol. At follow-up there was a tendency for parents who received the intervention to report lower post-traumatic stress symptoms in themselves and fewer emotional and behavioural difficulties in their children than TAU parents. This needs to be explored in a fully powered trial.ConclusionsThis feasibility and pilot RCT provided valuable information on the intervention and trial design for a full RCT.Trials registration numberNCT01737021; Results.