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Background: Neonates and infants requiring anaesthesia are at risk of physiological instability and complications, but triggers for peri-anaesthetic interventions and associations with subsequent outcome are unknown. Methods: This prospective, observational study recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. The primary aim was to identify thresholds of pre-determined physiological variables that triggered a medical intervention. The secondary aims were to evaluate morbidities, mortality at 30 and 90 days, or both, and associations with critical events. Results: Infants (n¼5609) born at mean (standard deviation [SD]) 36.2 (4.4) weeks postmenstrual age (35.7% preterm) underwent 6542 procedures within 63 (48) days of birth. Critical event(s) requiring intervention occurred in 35.2% of cases, mainly hypotension (>30% decrease in blood pressure) or reduced oxygenation (SpO 2 <85%). Postmenstrual age influenced the incidence and thresholds for intervention. Risk of critical events was increased by prior neonatal medical conditions, congenital anomalies, or both (relative risk [RR]¼1.16; 95% confidence interval [CI], 1.04e1.28

This study examined the quality of the classroom climate and dyadic teacher-child relationships as predictors of self-regulation in a sample of socially disadvantaged preschool children (N = 206; 52% boys). Children's self-regulation was observed in Running head: PROCESS QUALITY AND SELF-REGULATION 2 preschool at the beginning and at the end of the school year. At the middle of the preschool year, classroom observations of interactions were conducted by trained observers and teachers rated the quality of dyadic teacher-child relationships. Results from multilevel analyses revealed that teacher-child closeness predicted improvements in observed self-regulation skills. Children showed larger gains in self-regulation when they experienced closer teacher-child relationships. Moreover, a moderating effect between classroom instructional quality and observed selfregulation was found such that children with low initial self-regulation skills benefit the most from classrooms with higher classroom quality. Findings have implications for understanding the role of classroom social processes on the development of selfregulation.Keywords: Teacher-child relationships; Classroom interactions; Self-regulation; Early education and care; Socially disadvantaged children Running head: PROCESS QUALITY AND SELF-REGULATION 3 Classroom interactions, dyadic teacher-child relationships, and self-regulation in socially disadvantaged young children There has been a recent increase in universal early childhood services in many Western countries, based on a vast literature highlighting the preschool years as a critical period for the development of social, language and cognitive skills (Leseman, 2009). Increasing numbers of children are currently attending preschool throughout many countries (OECD, 2013). However, many children, especially from socially disadvantaged backgrounds, start school lacking critical skills for a successful transition to school, namely self-regulation (Blair & Razza, 2007). A growing number of studies have shown that self-regulation is linked to academic skills, such as literacy and mathematics, and to social competence (Blair & Razza, 2007;McClelland et al., 2007). Thus, identifying specific aspects of the environment that can contribute to the development of self-regulation becomes of crucial importance.An emergent literature suggests that emotionally-close, sensitive, well-organized, and cognitively stimulating interactions in the classroom are related to young children's development of social and academic outcomes (Burchinal, PeisnerFeinberg, Bryant, & Clifford, 2000;Hamre & Pianta, 2005). Classroom process quality refers to the quality of children's direct experiences and includes both the quality of teacher-child relationships and the overall classroom climate . To date, however, the links between classroom process quality and children's development of self-regulation have been largely overlooked. The current study investigates whether different facets of classroom process quality, namely the quality o...

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