Should iterative spinal surgeries be performed? A case report.

The number of spinal surgeries performed is increasing. Along with this comes an increase in iterative surgeries. Each surgery that a patient undergoes has an increased risk of complication and a decreased success rate compared to the last. We present a case of a 51-year-old female who continues to experience debilitating low back pain following three double fusions performed over four years. The patient describes that she is in more pain now than before any previous surgical intervention. Following these surgeries, the patient has been forced to take early retirement, frequently uses a wheelchair and requires assistance with daily activities. The role of iterative surgery in healthcare needs to be re-assessed. The poor outcomes, especially following tertiary and quaternary surgery, question the use of iterative surgery entirely.

The unequal impact of Covid-19 on the lives and rights of the children of modern slavery survivors, children in exploitation and children at risk of entering exploitation.

This article discusses the unequal impact of Covid-19 on the lives of the children of survivors of modern slavery, child victims of exploitation and children at risk of exploitation in the UK. It draws on research that has analysed the risks and impacts of Covid-19 on victims and survivors of modern slavery. It explores how pandemic responses may have hindered these children's rights to education, food, safety, development and participation and representation in legal processes. It suggests that the pandemic should be used as an impetus to address inequalities that existed pre-Covid-19 and those that have been exacerbated by it.

The strategies used by chimpanzees (Pan troglodytes) and children (Homo sapiens) to solve a simple coordination problem.

One of the challenges of collaboration is to coordinate decisions with others, and recent theories have proposed that humans, in particular, evolved skills to address this challenge. To test this hypothesis, we compared the coordination abilities of 4-year-old children and chimpanzees with a simple coordination problem. To retrieve a reward from a "puzzle box," pairs of individuals were simply required to choose the same 1 of 4 options. If successful, they each received the same reward, so there were no conflicts of interest. Individuals were paired with multiple partners over time. Both species were able to coordinate, but there were marked differences in the way they did so. Children were able to coordinate quickly and flexibly, adjusting easily to new partners, suggesting an understanding of the coordination process. In contrast, chimpanzees took time to converge on a single solution with each new partner, with no gains across partners, suggesting that their coordination was based only on repeating successful past choices. Together, these results support the hypothesis that humans have evolved unique skills for coordinating decisions and actions with others in the pursuit of common interests. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

"I know you don't know I know " children use second-order false-belief reasoning for peer coordination.

Numerous studies have investigated children's abilities to attribute mental states, but few have examined their ability to recruit these abilities in social interactions. Here, 6-year-olds (N = 104) were tested on whether they can use first- and second-order false-belief understanding to coordinate with peers. Children adjusted their decisions in a coordination game in response to either their partner's erroneous belief or their partner's erroneous belief about their own belief-a result that contrasts with previous findings on the use of higher order "theory of mind" (TOM) reasoning at this age. Six-year-olds are thus able to use their higher order TOM capacities for peer coordination, which marks an important achievement in becoming competent social collaborators.

Children use salience to solve coordination problems.

Humans are routinely required to coordinate with others. When communication is not possible, adults often achieve this by using salient cues in the environment (e.g. going to the Eiffel Tower, as an obvious meeting point). To explore the development of this capacity, we presented dyads of 3-, 5-, and 8-year-olds (N = 144) with a coordination problem: Two balls had to be inserted into the same of four boxes to obtain a reward. Identical pictures were attached to three boxes whereas a unique--and thus salient--picture was attached to the fourth. Children either received one ball each, and so had to choose the same box (experimental condition), or they received both balls and could get the reward independently (control condition). In all cases, children could neither communicate nor see each other's choices. Children were significantly more likely to choose the salient option in the experimental condition than in the control condition. However, only the two older age groups chose the salient box above chance levels. This study is the first to show that children from at least age 5 can solve coordination problems by converging on a salient solution.

Conforming to coordinate: children use majority information for peer coordination.

Humans are constantly required to coordinate their behaviour with others. As this often relies on everyone's convergence on the same strategy (e.g., driving on the left side of the road), a common solution is to conform to majority behaviour. In this study, we presented 5-year-old children with a coordination problem: To retrieve some rewards, they had to choose the same of four options as a peer partner--in reality a stooge--whose decision they were unable to see. Before making a choice, they watched a video showing how other children from their partner's peer group had behaved; a majority chose the same option and a minority chose a different one. In a control condition, children watched the same video but could then retrieve the reward irrespective of their partner's choice (i.e., no coordination was necessary). Children followed the majority more often when coordination was required. Moreover, conformers mostly justified their choices by referring to the majority from the video demonstration. This study is the first to show that young children are able to strategically coordinate decisions with peers by conforming to the majority.

Coordination strategies of chimpanzees and human children in a Stag Hunt game.

Much of human cooperation takes place in mutualistic contexts in which the main challenge for individuals is how to coordinate decisions. In the current studies, we compared the abilities of chimpanzees and young children to coordinate with a partner in two versions of a Stag Hunt game. When risks were low (the hare was of low value) and information was cheap (the partner's behaviour was readily observable), partners of both species were able to successfully coordinate on the higher value stag more than 90% of the time. By contrast, when the risks were raised and observing the partner was more difficult, the chimpanzees became less successful, whereas the children compensated, and so remained highly successful, by communicating more often and more specifically. This pattern of results is consistent with the hypothesis that humans evolved unique skills of coordination and communication in the context of especially risky coordination problems.

Young children understand multiple pretend identities in their object play.

This set of studies examined the ability of 3-year-olds to conceptualize multiple pretend identities with objects. Rather than relying on verbal response measures, as has been done in the past, children's creative and inferential pretend actions were used as indicators of their understanding. The common structure to all four studies was that children were confronted with one pretend scenario, moved to a second pretend scenario and then back again to the first. Children proficiently tailored their pretence to an object whose pretend identity changed between scenarios despite being less able to name each identity. Thus, using an inferential action methodology, these studies provide early and particularly convincing evidence that children can track the multiple pretend identities of objects.