Asynchronous development of memory integration and differentiation influences temporal memory organization.

Adults remember items with shared contexts as occurring closer in time to one another than those associated with different contexts, even when their objective temporal distance is fixed. Such temporal memory biases are thought to reflect within-event integration and between-event differentiation processes that organize events according to their contextual similarities and differences, respectively. Within-event integration and between-event differentiation are hypothesized to differentially rely on binding and control processes, which may develop at different ages. To test this hypothesis, 5- to 12-year-olds and adults (N = 134) studied quartets of image pairs that contained either the same scene (same-context) or different scenes (different-context). Participants remembered same-context items as occurring closer in time by older childhood (7-9 years), whereas different-context items were remembered as occurring farther apart by early adolescence (10-12 years). The differential emergence of these temporal memory biases suggests within-event integration and between-event differentiation emerge at different ages. RESEARCH HIGHLIGHTS: Children are less likely than adults to use contextual information (e.g., location) to organize their continuous experience in memory, as indicated by temporal memory biases. Biases reflecting within-event integration (i.e., remembering elements with a shared context as occurring closer together in time) emerged in late childhood. Biases reflecting between-event differentiation (i.e., remembering elements from different contexts as occurring farther apart in time) emerged in early adolescence. The differential emergence of biases reflecting within-event integration and between-event differentiation suggests they are distinct, yet complementary, processes that support developmental improvements in event memory organization.

Studying the Development of Navigation Using Virtual Environments.

Research on spatial navigation is essential to understanding how mobile species adapt to their environments. Such research increasingly uses virtual environments (VEs) because, although VE has drawbacks, it allows for standardization of procedures, precision in measuring behaviors, ease in introducing variation, and cross-investigator comparability. Developmental researchers have used a wide range of VE testing methods, including desktop computers, gaming consoles, virtual reality, and phone applications. We survey the paradigms to guide researchers' choices, organizing them by their characteristics using a framework proposed by Girard (2022) in which navigation is reactive or deliberative, and may be tied to sensory input or not. This organization highlights what representations each paradigm indicates. VE tools have enriched our picture of the development of navigation, but much research remains to be done, e.g., determining retest reliability, comparing performance on different paradigms, validating performance against real-world behavior and open sharing. Reliable and valid assessments available on open-science repositories are essential for work on the development of navigation, its neural bases, and its implications for other cognitive domains.

Developmental differences in temporal schema acquisition impact reasoning decisions.

Schemas capture patterns across multiple experiences, accumulating information about common event structures that guide decision making in new contexts. Schemas are an important principle of leading theories of cognitive development; yet, we know little about how children and adolescents form schemas and use schematic knowledge to guide decisions. Here, we show that the ability to acquire schematic knowledge based on the temporal regularities of events increases during childhood and adolescence. Furthermore, we show that temporally mediated schematic knowledge biases reasoning decisions in an age-dependent manner. Participants with greater temporal schematic knowledge were more likely to infer that temporally related items shared other, non-temporal properties, with adults showing the greatest relationship between schema knowledge and reasoning choices. These data indicate that the mechanisms underlying schema formation and expression are not fully developed until adulthood and may reflect the ongoing maturation of hippocampus and prefrontal cortex through adolescence.

Converting U-500 regular insulin to insulin detemir and insulin lispro in a patient undergoing dietary changes in preparation for bariatric surgery.

PURPOSE: The safe and effective conversion of human regular U-500 insulin (U-500R) to basal and bolus U-100 (insulin detemir and insulin lispro, respectively) in a patient undergoing a significant dietary change in preparation for bariatric surgery is described. SUMMARY: Conversion from U-100 to U-500R insulin has been described in the literature. There is, however, a paucity of information describing the reverse conversion (i.e., from U-500R to U-100 insulin). Whether converting to or from U-500R, patient safety is a primary concern. A 51-year-old Caucasian woman with a 10-year history of type 2 diabetes mellitus, hypertension, and gastroparesis who was scheduled to undergo bariatric surgery was converted from U-500R to insulin detemir and insulin lispro preoperatively while undergoing significant diet changes. The patient's blood glucose values, diet, and activity levels were closely monitored daily by the interprofessional team over a 10-day preoperative period during which her regular diet was changed to a very low-calorie, high-protein diet; insulin doses were adjusted accordingly. Throughout this process, the patient did not experience any major hypoglycemic episodes. Close collaboration among interprofessional team members and a strong partnership with the patient were considered key factors in the successful conversion of insulin therapy. CONCLUSION: Subcutaneous insulin therapy in a woman preparing for bariatric surgery was safely converted from U-500R to basal therapy with U-100 insulin detemir and with as-needed boluses of U-100 insulin lispro. This occurred as the patient switched from a regular diet to a low-calorie, high-protein diet.

Effectiveness of an alcohol-based hand hygiene programme in reducing nosocomial infections in the Urology Ward of Binh Dan Hospital, Vietnam.

OBJECTIVES: To determine the effectiveness of hand hygiene in a developing healthcare setting in reducing nosocomial infections (NIs). METHOD: Prospective study measuring NI rates in a urology ward in Ho Chi Minh City, Vietnam, before and after implementation of a hand hygiene programme with an alcohol-based decontaminant, and compliance rates of medical staff and carers with hand hygiene using standardised observation sheets. RESULTS: Incidence of NIs fell by 84%, from 13.1% to 2.1%, after implementation of the hand hygiene programme. Extended-spectrum beta-lactamase production was detected in 38.2%-50% of Enterobacteriaceae isolated from clinical samples. Length of patient stay and cost to the patient for antibiotics were reduced after implementation of the hand hygiene programme. CONCLUSION: The hand hygiene programme was effective in reducing incidence of NIs, leading to shorter inpatient stays and reduced treatment costs. Such programmes with measurable outcomes can be implemented at minimal cost in developing health contexts and should be promoted in all healthcare settings.