Classically, visual awareness and metacognition are thought to be intimately linked, with our knowledge of the correctness of perceptual choices (henceforth metacognition) being dependent on the level of stimulus awareness. Here we used a signal detection theoretic approach involving a Gabor orientation discrimination task in conjunction with trial-by-trial ratings of perceptual awareness and response confidence in order to gauge estimates of type-1 (perceptual) orientation sensitivity and type-2 (metacognitive) sensitivity at different levels of stimulus awareness. Data from three experiments indicate that while the level of stimulus awareness had a profound impact on type-1 perceptual sensitivity, the awareness effect on type-2 metacognitive sensitivity was far lower by comparison. The present data pose a challenge for signal detection theoretic models in which both type-1 (perceptual) and type-2 (metacognitive) processes are assumed to operate on the same input. More broadly, the findings challenge the commonly held view that metacognition is tightly coupled to conscious states.

Children and their mothers have poor quality sleep in paediatric wards. This may affect the child's behaviour, recovery and pain tolerance. Sleep deprivation adds to parental burden and stress. Sound levels are significantly raised in hospital and may contribute to poor sleep. Reduction in the level of noise might lead to an improvement in sleep, affecting the quality of stay of both parent and child.

Desaturation indices are substantially higher in young infants than older children where a DI4 over 4 is considered abnormal. These decrease by 3-4 months of age but still remain elevated compared with older children.

Study Objectives: Obstructive sleep apnea (OSA) is common in children with Down syndrome (DS) and is associated with adverse health and cognitive outcomes. Daytime clinical assessment is poorly predictive of OSA, so regular screening with sleep studies is recommended. However, sleep studies are costly and not available to all children worldwide. We aimed to evaluate the psychometric properties and predictive value of a newly developed screening questionnaire for OSA in this population.Methods: 202 children aged 6 months to 6 th birthday with DS were recruited, of whom 188 completed cardio-respiratory sleep studies to generate an obstructive apnea hypopnea index (OAHI). Parents completed the 14-item Down syndrome OSA screening questionnaire. Responses were screened, a factor analysis undertaken, internal consistency calculated and receiver operator characteristic (ROC) curves drawn to generate an area under the curve (AUC) to assess criterion related validity.Results: Of 188 children who completed cardiorespiratory sleep studies; parents completed the screening questionnaire for 186. Of this study population 15.4% had moderate to severe OSA defined by an OAHI of ≥5/h. Sixty-three (33.9%) participants were excluded due to "unsure" responses or where questions were not answered. Using the remaining 123 questionnaires a four-factor solution was found, with the 1 st factor representing breathing related symptoms, explaining a high proportion of the variance. Internal consistency was acceptable with a Cronbach alpha of 0.87. ROC curves for the