Non-parental Childcare During Early Childhood and Problem Behaviour Trajectories from Ages 5 to 14 Years

Using data from the nationally representative Millennium Cohort Study, this study examined the association between age of starting and weekly hours in formal childcare between birth and 5 years with internalising and externalising behaviour trajectories from ages 5 to 14 years in England (N = 6194 children). Associations were analysed using multilevel general linear regression models, with adjustment for socio-economic position, maternal mental health, demographics, and child temperament. Later entry was associated with more internalising behaviours at age 14 years. Children who spent > 40 h per week in childcare between birth and 3 years displayed more externalising behaviour at 5 years than children who did not attend childcare. Controlling for socio-economic position and parental mental health attenuated findings.

The Detection of Environmental Influences on Academic Achievement Appears to Depend on the Analytic Approach

One long-standing analytic approach in adoption studies is to examine correlations between features of adoptive homes and outcomes of adopted children (hereafter termed 'measured environment correlations') to illuminate environmental influences on those associations. Although results from such studies have almost uniformly suggested modest environmental influences on adopted children's academic achievement, other work has indicated that adopted children's achievement is routinely higher than that of their reared-apart family members, often substantially so. We sought to understand this discrepancy. We examined academic achievement and literacy-promotive features of the home in 424 yoked adoptive/biological families participating in the Early Growth and Development Study (EGDS; i.e., adopted children, adoptive mothers, birth mothers, and biological siblings of the adopted children remaining in the birth homes) using an exhaustive modeling approach. Results indicated that, as anticipated, adopted children scored up to a full standard deviation higher on standardized achievement tests relative to their birth mothers and reared-apart biological siblings. Moreover, these achievement differences were associated with differences in the literacy-promotive features of the adoptive and birth family homes, despite minimal measured environment correlations within adoptive families. A subsequent simulation study highlighted noise in measured environmental variables as an explanation for the decreased utility of measured environment correlations. We conclude that the field's heavy focus on measured environment correlations within adoptive families may have obscured detection of specific environmental effects on youth outcomes, and that future adoption studies should supplement their measured environment analyses with mean differences between reared-apart relatives.

Trends in childhood body mass index between 1936 and 2011 showed that underweight remained more common than obesity among 398 970 Danish school children

AIM

To examine trends in all body mass index (BMI) groups in children from 1936 to 2011.

METHODS

We included 197 694 girls and 201 276 boys from the Copenhagen School Health Records Register, born between 1930 and 1996, with longitudinal weight and height measurements (6-14 years). Using International Obesity Task Force criteria, BMI was classified as underweight, normal-weight, overweight and obesity. Sex- and age-specific prevalences were calculated.

RESULTS

From the 1930s, the prevalence of underweight was stable until a small increase occurred from 1950 to 1970s, and thereafter it declined into the early 2000s. Using 7-year-olds as an example, underweight changed from 10% to 7% in girls and from 9% to 6% in boys during the study period. The prevalence of overweight plateaued from 1950 to 1970s and then steeply increased from 1970s onwards and in 1990-2000s 15% girls and 11% boys at 7 years had overweight. The prevalence of obesity particularly increased from 1980s onwards and in 1990-2000s 5% girls and 4% boys at 7 years had obesity. These trends slightly differed by age.

CONCLUSION

Among Danish schoolchildren, the prevalence of underweight was greater than overweight until the 1980s and greater than obesity throughout the period. Thus, monitoring the prevalence of childhood underweight remains an important public health issue.

Investigating robust associations between functional connectivity based on graph theory and general intelligence

Previous research investigating relations between general intelligence and graph-theoretical properties of the brain's intrinsic functional network has yielded contradictory results. A promising approach to tackle such mixed findings is multi-center analysis. For this study, we analyzed data from four independent data sets (total N > 2000) to identify robust associations amongst samples between g factor scores and global as well as node-specific graph metrics. On the global level, g showed no significant associations with global efficiency or small-world propensity in any sample, but significant positive associations with global clustering coefficient in two samples. On the node-specific level, elastic-net regressions for nodal efficiency and local clustering yielded no brain areas that exhibited consistent associations amongst data sets. Using the areas identified via elastic-net regression in one sample to predict g in other samples was not successful for local clustering and only led to one significant, one-way prediction across data sets for nodal efficiency. Thus, using conventional graph theoretical measures based on resting-state imaging did not result in replicable associations between functional connectivity and general intelligence.

What is a "Distinctive Nutritional Requirement"? A Position Paper of the Healthcare Nutrition Council

The Healthcare Nutrition Council (HNC) represents manufacturers of enteral nutrition formulas and oral nutrition supplements, including those categorized as medical foods and parenteral nutrition. HNC member companies, Abbott's Nutrition Division, Nestlé Health Science, and Nutricia North America, a subsidiary of Danone S.A., manufacture a majority of the medical foods consumed in the United States. HNC is proposing a modernized interpretation of the medical food framework to reflect the evolution of nutrition science and health care. The medical food category was first defined in 1988 as part of the Orphan Drug Act. Since then, the scientific community's understanding of nutrition and the role it can play in disease management has progressed. HNC believes that a patient-centric approach is needed to foster research and innovation and to position medical foods as a viable solution in the dietary management of disease. HNC proposes that distinctive nutritional requirements refer to the clinical need for a specific nutritional intake (compared with the intake of healthy populations), which may exist by reason of abnormal physiologic manifestation or physical impairment associated with a disease or condition. The dietary management of these diseases and conditions results in clinically meaningful improvements, including but not limited to nutritional status, health outcomes, or quality of life. HNC believes that abnormal physiologic manifestation or physical impairment would include a limited, impaired, or disturbed capacity to ingest, digest, absorb, metabolize, or excrete ordinary food or certain nutrients or metabolites or other medically determined requirements for nutrients or other food substances of biological value. HNC recommends our position be considered as we build consensus across the industry. We request that the Food and Drug Administration modify and codify the current definition to reflect this. Patients and the health care system will benefit from a strong regulatory interpretation of the medical foods framework.

Longitudinal analyses indicate bidirectional associations between loneliness and health

OBJECTIVES

To evaluate temporal dynamics between loneliness and both objective and subjective health (i.e. functional impairment and self-rated health) in mid- to late-adulthood.

METHOD

We applied bivariate dual-change-score models to longitudinal data from 3 Swedish twin studies (N = 1,939) to explore dynamic associations between loneliness and health across 3 age ranges (50-69, 70-81, and 82+ years) to investigate whether associations between loneliness and health change with age due to increasing incidence of chronic health conditions and bereavement.

RESULTS

Results showed bidirectional associations between loneliness and both objective and subjective health, with adverse impacts of loneliness observed on subsequent subjective and objective health beginning at age 70. Associations between health and subsequent loneliness were observed after age 82 and varied for subjective and objective health, with subjective health associated with less loneliness and objective health associated with greater loneliness.

CONCLUSIONS

Our results indicate dynamic associations between loneliness and health with age in mid- to late-adulthood, with earlier impacts of loneliness on health and later impacts of health on loneliness that vary for objective and subjective measures of health. These findings suggest impacts of health on loneliness may arise later in life when worsening health or mobility interfere with social interaction.

Associations between diabetes status and grip strength trajectory sub-groups in adulthood: findings from over 16 years of follow-up in the MRC National Survey of Health and Development

BACKGROUND

Cross-sectional studies suggest a relationship between diabetes status and weaker grip strength (GS) in adulthood and limited evidence from longitudinal studies has focussed on the association with average change in GS. We aimed to investigate whether diabetes status was related to membership of distinct GS trajectories in mid-to-late adulthood in 2,263 participants in the Medical Research Council National Survey of Health and Development.

METHODS

Grip strength (kg) was measured at 53, 60-64 and 69 years. Pre-/diabetes was defined at 53 years based on HbA1c > 5.6% and/or doctor-diagnosis of diabetes. Sex-specific latent class trajectory models were developed and multinomial logistic regression was used to investigate the association between pre-/diabetes status and membership into GS trajectory classes.

RESULTS

For both males and females, a 3-class solution ('High', 'Intermediate', 'Low') provided the best representation of the GS data and the most plausible solution. There was no evidence that pre-/diabetes status was associated with class membership in either sex: e.g., adjusted odds ratios of being in the 'Low' class (vs. 'High') for males with pre-/diabetes (vs. no-diabetes) was 1.07 (95% CI:0.45,2.55).

CONCLUSION

Using a flexible data-driven approach to identify GS trajectories between 53 and 69 years, we observed three distinct GS trajectories, all declining, in both sexes. There was no association between pre-/diabetes status at 53 years and membership into these GS trajectories. Understanding the diabetes status-GS trajectories association is vital to ascertain the consequences that projected increases in pre-/diabetes prevalence's are likely to have.

Joint Consideration of Means and Variances Might Change the Understanding of Etiology

Twin and adoption studies compare the similarities of people with differing degrees of relatedness to estimate genetic and environmental contributions to trait population variance. The analytic workhorse of these kinds of variance-focused designs is the intraclass correlation, which estimates similarity between pairs of individuals. Group means, by contrast, play no overt role in estimating genetic and environmental influences. Although this focus on variance has made very important contributions to understanding psychological characteristics, we contend that the exclusion of mean effects from behavioral genetic designs may have obscured key environmental influences and impeded full appreciation of the ubiquity and nature of gene-environment interplay in human outcomes. We provide empirical examples already in the literature and a theoretical framework for thinking through the incorporation of mean effects using largely forgotten, non-Mendelian theory regarding how genes influence human outcomes. We conclude that the field needs to develop models capable of fully incorporating mean effects into twin and adoption studies.

Robust associations between white matter microstructure and general intelligence

Few tract-based spatial statistics (TBSS) studies have investigated the relations between intelligence and white matter microstructure in healthy (young) adults, and those have yielded mixed observations, yet white matter is fundamental for efficient and accurate information transfer throughout the human brain. We used a multicenter approach to identify white matter regions that show replicable structure-function associations, employing data from 4 independent samples comprising over 2000 healthy participants. TBSS indicated 188 voxels exhibited significant positive associations between g factor scores and fractional anisotropy (FA) in all 4 data sets. Replicable voxels formed 3 clusters, located around the left-hemispheric forceps minor, superior longitudinal fasciculus, and cingulum-cingulate gyrus with extensions into their surrounding areas (anterior thalamic radiation, inferior fronto-occipital fasciculus). Our results suggested that individual differences in general intelligence are robustly associated with white matter FA in specific fiber bundles distributed across the brain, consistent with the Parieto-Frontal Integration Theory of intelligence. Three possible reasons higher FA values might create links with higher g are faster information processing due to greater myelination, more direct information processing due to parallel, homogenous fiber orientation distributions, or more parallel information processing due to greater axon density.

Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

Perceived discrimination and relative deprivation in Chinese migrant adolescents: the mediating effect of locus of control and moderating effect of duration since migration

BACKGROUND

Associations between perceived discrimination and relative deprivation have been observed among both general and migrant populations. However, it is unclear how, and under what conditions, perceived discrimination relates to relative deprivation, a subjective cognition and affective experience in which individuals or groups perceive themselves as disadvantaged, compared to their peers. Therefore, this study aimed to construct a moderated mediation model to examine the roles of locus of control and duration since migration in the relationship between perceived discrimination and relative deprivation among Chinese rural-to-urban migrant adolescents.

METHODS

We conducted a cross-sectional study using a convenience sampling method in three coastal cities in southeast China. We recruited 625 Chinese rural-to-urban migrant adolescents, who completed a battery of questionnaires assessing perceived discrimination, relative deprivation, locus of control, and demographic variables. Regression-based statistical mediation and moderation were conducted using the PROCESS macro for SPSS.

RESULTS

After controlling for sex and age, perceived discrimination was positively associated with migrant adolescents' relative deprivation, and external locus of control partially mediated this connection. Furthermore, the mediating effect was moderated by the duration of the migration. In relatively recently migrated adolescents, perceived discrimination was significantly related to relative deprivation through a greater external locus of control; however, this indirect association was not significant for adolescents with long-term migratory duration.

CONCLUSION

The results of our analysis expand our understanding of the link between perceived discrimination and relative deprivation. Moreover, these findings may provide practical guidance for interventions among Chinese rural-to-urban migrant adolescents to raise their social status and improve their mental health by addressing the macro-social psychological causes of relative deprivation.

What’s to Come of All This Tracking “Who We Are”? The Intelligence Example

Increasingly, we are required, encouraged, and/or motivated to track our behavior, presumably to improve our life “quality.” But health and life-satisfaction trends are not cooperating: Empirical evidence for success is sorely lacking. Intelligence has been tracked for more than 100 years; perhaps this example offers some hints about tracking’s overall social impact. I suggest that Huxley’s Brave New World offers a relevant long-term extrapolation and that popular recent tracking activities will accelerate “progress” in that dystopian direction.

Relative deprivation and social anxiety among Chinese migrant children: Testing a moderated mediation model of perceived control and belief in a just world

To examine the relationship between relative deprivation and social anxiety, which affects mental health, and investigate the mediating role of perceived control and the moderating role of belief in a just world (BJW) in an understudied population in Asia, we surveyed 1573 rural-to-urban migrant children (48% female; M_age = 12.3, SD = 1.7) in southeast China. Relative deprivation was positively correlated with social anxiety; perceived control partially mediated this connection. Moreover, BJW moderated the indirect effect, which was stronger for male migrant children with lower levels of BJW. The limitations and practical implications of this study are discussed.

Telehealth e-mentoring in postgraduate musculoskeletal physiotherapy education: A mixed methods case study

BACKGROUND

Educational standards of advanced musculoskeletal physiotherapy include mentored clinical practice. Whilst traditionally delivered face-to-face, telehealth e-mentoring affords a distinctive andragogy to facilitate mentee development.

OBJECTIVE

To understand the experiences and outcomes of stakeholders participating in musculoskeletal physiotherapy telehealth e-mentoring.

DESIGN

A case study design with sequential mixed methods (quantitative patient outcome data and qualitative interviews and a focus group) of a 20-week e-mentored telehealth physiotherapy service.

METHODS

Data collection comprised 1) Patient experiences and measures of musculoskeletal health 2) Mentee semi-structured interviews 3) Mentor focus group. Data analysis included descriptive statistics (median and IQR) and the Framework Method for qualitative and quantitative data respectively. An exploratory bidirectional approach supported data integration across all participants.

RESULTS

Participants included patients (n = 90), mentees (n = 10) and mentors (n = 6). Patients reported improvements (>MCID) in MSK-HQ and Patient Specific Functional Scale, with high scores for Consultation and Relational Empathy and Patient Enablement Instruments. Main themes were a) social learning b) advanced professional practice c) learner experience and d) limitations of telehealth for mentees, and for mentors a) preparedness b) journey of development and c) challenges. Participant data integration resulted in 4 main themes 1) energising/positive experience 2) communications skills valued 3) perceptions of telehealth 4) upskilling required.

CONCLUSIONS

Telehealth e-mentoring is a valuable alternative to face-to-face mentored physiotherapy practice to support development in advanced musculoskeletal physiotherapy practice. Findings indicate that technical and professional skills are required, high levels of communication skills were valued, there is a need for reconceptualisation of musculoskeletal physiotherapeutic interventions.

Polygenic scores for smoking and educational attainment have independent influences on academic success and adjustment in adolescence and educational attainment in adulthood

Educational success is associated with greater quality of life and depends, in part, on heritable cognitive and non-cognitive traits. We used polygenic scores (PGS) for smoking and educational attainment to examine different genetic influences on facets of academic adjustment in adolescence and educational attainment in adulthood. PGSs were calculated for participants of the Minnesota Twin Family Study (N = 3225) and included as predictors of grades, academic motivation, and discipline problems at ages 11, 14, and 17 years-old, cigarettes per day from ages 14 to 24 years old, and educational attainment in adulthood (mean age 29.4 years). Smoking and educational attainment PGSs had significant incremental associations with each academic variable and cigarettes per day. About half of the adjusted effects of the smoking and education PGSs on educational attainment in adulthood were mediated by the academic variables in adolescence. Cigarettes per day from ages 14 to 24 years old did not account for the effect of the smoking PGS on educational attainment, suggesting the smoking PGS indexes genetic influences related to general behavioral disinhibition. In sum, distinct genetic influences measured by the smoking and educational attainment PGSs contribute to academic adjustment in adolescence and educational attainment in adulthood.

The finer details? The predictability of life outcomes from Big Five domains, facets, and nuances

Associations between personality traits and life outcomes are usually studied using the Big Five domains and, occasionally, their facets. But recent research suggests these associations may be driven by the items (reflecting personality nuances) chosen to measure these traits. Using a large dataset (N = 6126), we examined associations with 53 self-reported outcomes using domains, facets and items (markers for nuances), training and validating models in different sample partitions. Facets better predicted outcomes than domains (on average, 18.0% versus 16.6% of variance explained), but items provided the most accurate predictions (on average 20.9%). Removing domain and facet variance from items had no effect on their predictive validity, suggesting that outcome-related information was often in items' unique variances (i.e., nuance-specific). Item-based prediction also showed the highest discriminant validity. These observations, replicating previous findings, suggest that personality traits' valid associations with outcomes are often driven by narrow personality nuances.

Changes over time in latent patterns of childhood-to-adulthood BMI development in Great Britain: evidence from three cohorts born in 1946, 1958, and 1970

BACKGROUND

Most studies on secular trends in body mass index (BMI) are cross-sectional and the few longitudinal studies have typically only investigated changes over time in mean BMI trajectories. We aimed to describe how the evolution of the obesity epidemic in Great Britain reflects shifts in the proportion of the population demonstrating different latent patterns of childhood-to-adulthood BMI development.

METHODS

We used pooled serial BMI data from 25,655 participants in three British cohorts: the 1946 National Survey of Health and Development (NSHD), 1958 National Child Development Study (NCDS), and 1970 British Cohort Study (BCS). Sex-specific growth mixture models captured latent patterns of BMI development between 11 and 42 years. The classes were characterised in terms of their birth cohort composition.

RESULTS

The best models had four classes, broadly similar for both sexes. The 'lowest' class (57% of males; 47% of females) represents the normal weight sub-population, the 'middle' class (16%; 15%) represents the sub-population who likely develop overweight in early/mid-adulthood, and the 'highest' class (6%; 9%) represents those who likely develop obesity in early/mid-adulthood. The remaining class (21%; 29%) reflects a sub-population with rapidly 'increasing' BMI between 11 and 42 years. Both sexes in the 1958 NCDS had greater odds of being in the 'highest' class compared to their peers in the 1946 NSHD but did not have greater odds of being in the 'increasing' class. Conversely, males and females in the 1970 BCS had 2.78 (2.15, 3.60) and 1.87 (1.53, 2.28), respectively, times higher odds of being in the 'increasing' class.

CONCLUSIONS

Our results suggest that the obesity epidemic in Great Britain reflects not only an upward shift in BMI trajectories but also a more recent increase in the number of individuals demonstrating more rapid weight gain, from normal weight to overweight, across the second, third, and fourth decades of life.

Thoracic Lymph Duct Catheterization with a Venous Shunt in the Nonhuman Primate

Background: Biologic therapeutics constitute up to 30% of all drugs approved from 2010 to 2018 and represent a continuous growing market. In contrast to small molecules, biologic therapeutics (>1 kDa MW) are administered parenterally or intravenously due to poor bioavailability when administered orally. The absorption and disposition of biologics that are administered subcutaneously may be absorbed via lymphatic or blood capillaries. Methods: To understand the absorption and distribution of biotherapeutics via the lymphatic system a surgical model was developed in the cynomolgus macaque (Macaca fascicularis) to allow for frequent and chronic collection of lymph fluid. Additionally, the model allowed for the recirculation of the lymph fluid into the blood stream providing true physiologic redistribution of the biologic drug from the bloodstream back into the lymph. Results: To our knowledge, models of lymphatic duct catheterization with recirculation in the NHP have not been reported. The model consisted of two surgically implanted catheters, one in the thoracic lymph duct and one in the azygous vein. These two catheters were then exteriorized and connected to each other to allow for recirculation of lymph back into the venous blood stream. The exteriorized catheters were protected within the pocket of a jacket. Thirty-one surgical procedures were performed with an overall success rate of 70%. Unsuccessful attempts were related to anatomical differences where the lymphatic duct was either not identifiable (n = 3) or too small to catheterize (n = 6). The patency rate was 90% instrumented animals for at least 24 h, up to 168 h. Conclusion: We present the surgical technique, complications, and refinements which resulted in a reliable and reproducible model in the nonhuman primate for the chronic collection and recirculation of lymphatic fluid.

Prevalence and spatial distribution of Coxiella burnetii seropositivity in northern Australian beef cattle adjusted for diagnostic test uncertainty

Q fever is a zoonotic disease caused by infection with Coxiella burnetii transmitted from animals including, but not limited to, cattle, sheep and goats. The infection in cattle is typically sub-clinical with some evidence suggesting associated reproductive loss. There is currently limited data on the true prevalence and distribution of coxiellosis in beef cattle across northern Australia. During this study, 2,012 sera samples from beef cattle managed on commercial farms located in Queensland and the Northern Territory were tested using an indirect immunofluorescent assay (IFA) for serological evidence of IgG antibodies against C. burnetii. Bayesian latent class models were used to estimate the true prevalence, adjusted for diagnostic test sensitivity and specificity and incorporating the hierarchical structure of the cattle within farms and regions. In this study, cattle in the Northern Territory had lower estimated true prevalence than cattle within most regions of Queensland with the exception of south-east Queensland. Results from this study have described the geographic distribution and estimated the true prevalence of antibodies to C. burnetii in a sample of extensively managed beef cattle located across the tropical grazing regions of northern Australia.

Moderating Effects of Personality on the Genetic and Environmental Influences of School Grades Helps to Explain Sex Differences in Scholastic Achievement

Girls consistently achieve higher grades than boys despite scoring lower on major standardized tests and not having higher IQs. Sex differences in non-cognitive variables such as personality might help to account for sex differences in grades. Utilizing a large sample of 17 year-old twins participating in the Minnesota Twin Family Study (MTFS), we examined the roles of Achievement Striving, Self-Control, and Aggression on sex differences in grade point average (GPA). Each personality trait was a significant predictor of GPA, with sex differences in Aggression accounting for one-half the sex difference in GPA and genetic variance accounting for most of the overlap between personality and GPA. Achievement Striving and Self-Control moderated the genetic and environmental influences on GPA. Specifically, for girls but not boys, higher Achievement Striving and Self-Control were associated with less variability in GPA and greater genetic and environmental overlap with GPA. For girls, certain personality traits operate to shape a context yielding uniformly higher GPA, a process that seems absent in boys.

Bottom Up Construction of a Personality Taxonomy

Abstract. In pursuit of a more systematic and comprehensive framework for personality assessment, we introduce procedures for assessing personality traits at the lowest level: nuances. We argue that constructing a personality taxonomy from the bottom up addresses some of the limitations of extant top-down assessment frameworks (e.g., the Big Five), including the opportunity to resolve confusion about the breadth and scope of traits at different levels of the organization, evaluate unique and reliable trait variance at the item level, and clarify jingle/jangle issues in personality assessment. With a focus on applications in survey methodology and transparent documentation, our procedures contain six steps: (1) identification of a highly inclusive pool of candidate items, (2) programmatic evaluation and documentation of item characteristics, (3) test-retest analyses of items with adequate qualitative and quantitative properties, (4) analysis of cross-ratings from multiple raters for items with adequate retest reliability, (5) aggregation of ratings across diverse samples to evaluate generalizability across populations, (6) evaluations of predictive utility in various contexts. We hope these recommendations are the first step in a collaborative effort to identify a comprehensive pool of personality nuances at the lowest level, enabling subsequent construction of a robust hierarchy – from the bottom up.

Cognitive aging and verbal labeling in continuous visual memory

The decline of working memory (WM) is a common feature of general cognitive decline, and visual and verbal WM capacity appear to decline at different rates with age. Visual material may be remembered via verbal codes or visual traces, or both. Souza and Skóra, Cognition, 166, 277-297 (2017) found that labeling boosted memory in younger adults by activating categorical visual long-term memory (LTM) knowledge. Here, we replicated this and tested whether it held in healthy older adults. We compared performance in silence, under instructed overt labeling (participants were asked to say color names out loud), and articulatory suppression (repeating irrelevant syllables to prevent labeling) in the delayed estimation paradigm. Overt labeling improved memory performance in both age groups. However, comparing the effect of overt labeling and suppression on the number of coarse, categorical representations in the two age groups suggested that older adults used verbal labels subvocally more than younger adults, when performing the task in silence. Older adults also appeared to benefit from labels differently than younger adults. In younger adults labeling appeared to improve visual, continuous memory, suggesting that labels activated visual LTM representations. However, for older adults, labels did not appear to enhance visual, continuous representations, but instead boosted memory via additional verbal (categorical) memory traces. These results challenged the assumption that visual memory paradigms measure the same cognitive ability in younger and older adults, and highlighted the importance of controlling differences in age-related strategic preferences in visual memory tasks.

Strategy mediation in working memory training in younger and older adults

Working memory (WM) training with the N-Back task has been argued to improve cognitive capacity and general cognitive abilities (the Capacity Hypothesis of training), although several studies have shown little or no evidence for such improvements beyond tasks that are very similar to the trained task. Laine et al. demonstrated that instructing young adult participants to use a specific visualisation strategy for N-back training resulted in clear, generalised benefits from only 30 min of training (Strategy Mediation Hypothesis of training). Here, we report a systematic replication and extension of the Laine et al. study, by administering 60 younger and 60 older participants a set of WM tasks before and after a 30-min N-back training session. Half the participants were instructed to use a visualisation strategy, the others received no instruction. The pre-post test battery encompassed a criterion task (digit N-back), two untrained tasks N-back tasks (letters and colours), and three structurally different WM tasks. The instructed visualisation strategy significantly boosted at least some measures of N-back performance in participants of both age groups, although the strategy generally appeared more difficult to implement and less beneficial for older adults. However, the strategy did not improve performance on structurally different WM tasks. We also found significant associations between N-back performance and the type and level of detail of self-generated strategies in the uninstructed participants, as well as age group differences in reported strategy types. WM performance appeared to partly reflect the application of strategies, and Strategy Mediation should be considered to understand the mechanisms of WM training. Claims of efficient training should demonstrate useful improvement beyond task-specific strategies.

The Contribution of Cognitive and Noncognitive Skills to Intergenerational Social Mobility

We investigated intergenerational educational and occupational mobility in a sample of 2,594 adult offspring and 2,530 of their parents. Participants completed assessments of general cognitive ability and five noncognitive factors related to social achievement; 88% were also genotyped, allowing computation of educational-attainment polygenic scores. Most offspring were socially mobile. Offspring who scored at least 1 standard deviation higher than their parents on both cognitive and noncognitive measures rarely moved down and frequently moved up. Polygenic scores were also associated with social mobility. Inheritance of a favorable subset of parent alleles was associated with moving up, and inheritance of an unfavorable subset was associated with moving down. Parents' education did not moderate the association of offspring's skill with mobility, suggesting that low-skilled offspring from advantaged homes were not protected from downward mobility. These data suggest that cognitive and noncognitive skills as well as genetic factors contribute to the reordering of social standing that takes place across generations.

Early classroom reading gains moderate shared environmental influences on reading comprehension in adolescence

BACKGROUND

Reading is important for children's success in school and beyond, yet many adolescents fail to reach expected levels of proficiency. This highlights the need to better understand the factors that influence reading effectiveness over time, including genes and environment. Greater expression of genetic influence on first- and second-grade reading fluency has been observed in higher quality classroom reading environments. To what degree this early environment continues to influence genetic and other environmental influences on later reading is unknown and was tested in this study.

METHODS

The quality of the early classroom reading environment was approximated by gains in oral reading fluency (ORF) across the school year among first- or second-grade classmates of 546 MZ and 1,016 DZ twin children (mean age = 7.13 years; SD = 0.45) who had reading comprehension scores from a state-wide mandatory test in school year 2013-2014 when most twin pairs were in seventh to tenth grade (mean age = 14.41; SD = 1.13) in a variable called Class ORF Gain. Biometrical models were fit to the data to assess whether Class ORF Gain moderated the genetic, shared environmental and/or nonshared environmental variance associated with adolescent reading comprehension.

RESULTS

Class ORF Gain moderated shared environmental influences on reading comprehension 6-9 years later. When early classroom reading gains were poor, variability in reading comprehension in adolescence was high and was associated largely with shared environmental influences. When early classroom reading gains were good, overall and shared environmentally influenced variability in adolescent reading comprehension was lower so that genetic influences were most relevant in explaining that variability.

CONCLUSIONS

Our findings suggested that classroom reading environment experienced when children were learning to read had a lasting influence on the factors underlying variability in later reading effectiveness.

Part I: A Quantitative Study of Social Risk Screening Acceptability in Patients and Caregivers

INTRODUCTION

Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening.

METHODS

This was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019.

RESULTS

Screening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07).

CONCLUSIONS

A strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier.

SUPPLEMENT INFORMATION

This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

Part II: A Qualitative Study of Social Risk Screening Acceptability in Patients and Caregivers

INTRODUCTION

This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.

METHODS

As part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes.

RESULTS

Fifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks.

CONCLUSIONS

Despite gaps in the availability of social risk-related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams.

SUPPLEMENT INFORMATION

This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

Framework for developing a national surgical, obstetric and anaesthesia plan

Background

Emergency and essential surgical, obstetric and anaesthesia (SOA) care are now recognized components of universal health coverage, necessary for a functional health system. To improve surgical care at a national level, strategic planning addressing the six domains of a surgical system is needed. This paper details a process for development of a national surgical, obstetric and anaesthesia plan (NSOAP) based on the experiences of frontline providers, Ministry of Health officials, WHO leaders, and consultants.

Methods

Development of a NSOAP involves eight key steps: Ministry support and ownership; situation analysis and baseline assessments; stakeholder engagement and priority setting; drafting and validation; monitoring and evaluation; costing; governance; and implementation. Drafting a NSOAP involves defining the current gaps in care, synthesizing and prioritizing solutions, and providing an implementation and monitoring plan with a projected cost for the six domains of a surgical system: infrastructure, service delivery, workforce, information management, finance and governance.

Results

To date, four countries have completed NSOAPs and 23 more have committed to development. Lessons learned from these previous NSOAP processes are described in detail.

Conclusion

There is global movement to address the burden of surgical disease, improving quality and access to SOA care. The development of a strategic plan to address gaps across the SOA system systematically is a critical first step to ensuring countrywide scale‐up of surgical system‐strengthening activities.

Changes in Food Consumption of WIC-Participating Infants and Children, 2008 vs. 2016 (P11-066-19)

Objectives

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritionally at-risk low-income pregnant women, infants and children up to 5 years of age with foods tailored to their nutritional needs, along with nutrition education. In 2009, USDA made major revisions to WIC food packages to better conform to expert dietary guidance. Notable changes included increased fruits and vegetables, and lower-fat milk for children 2 years and older. This study uses data from the 2008 and 2016 Feeding Infants and Toddlers Study (FITS) to compare foods consumed by children participating in WIC to foods consumed by children not participating in WIC before and after the food package changes.

Methods

FITS 2008 (n = 3273) and 2016 (n = 3235) are cross-sectional nationally-representative surveys of caregivers of children < 4 years living in the U.S. Trained telephone interviewers collected 24-hour dietary data. Tests of interaction were used to determine whether the trends in consumption of select foods between 2008 and 2016 differed between children who participate in WIC compared to those who do not, while controlling for income and household size.

Results

The percentage of WIC infants (6-11.9 months) eating vegetables increased from 2008 to 2016, but the % eating fruit (including 100% juice) was unchanged. WIC infants shifted from being less likely than non-WIC infants to eat babyfood fruits and vegetables in 2008 to being more likely to eat them in 2016; at the same time, the % of WIC participants consuming non babyfood fruit and vegetables declined. The percentage of WIC children (12-23.9 months) drinking whole milk increased and drinking reduced fat (2%) milk decreased in 2016 compared to 2008; whereas older WIC children (24-47.9 months) were more likely to drink low or nonfat milk and less likely to drink reduced-fat milk.

Conclusions

Babyfood fruits and vegetables, added to the WIC food package in 2009, have become important contributors to WIC infants’ fruit and vegetable intakes. In 2016, WIC children were more likely to follow expert advice to shift to lower fat milks at ages 2 and above. Significant changes in the relationship of these food patterns to WIC participation between 2008 and 2016 suggest an important public health role of the revised WIC food packages.

Funding Sources

FITS 2008 and 2016 supported by Nestlé Research Center, Lausanne Switzerland.

At what age do normal weight Canadian children become overweight adults? Differences according to sex and metric

BACKGROUND

The prevalence of overweight and obesity doubles between adolescence and young adulthood; however, the exact age, and appropriate metric to use to identify when overweight develops is still debated.

AIM

To examine the age of onset of overweight by sex and four metrics: body mass index (BMI), fat mass (%FM), waist circumference (WC) and waist-to-height ratio (WHtR).

SUBJECTS AND METHODS

Between 1991 and 2017, serial measures of body composition were taken on 237 (108 males) individuals (aged 8-40 years of age). Hierarchical random effects models were used to develop growth curves. Curves were compared to BMI, %FM and WC overweight age- and sex-specific cut-points.

RESULTS

In males, the BMI growth curve crossed the cut-point at 22.0 years, compared to 23.5 and 26.5 years for WHtR and %FM, respectively; WC cut-off was not reached until 36 years. In females, the BMI growth curve crossed the overweight cut-point at 21.5 years, compared to 14.2 years for %FM and 21.9 and 27.5 years for WC and WHtR, respectively.

CONCLUSION

In summary, overweight onset occurs during young adulthood with the exception of WC in males. BMI in males and %FM in females were the metrics identifying overweight the earliest.

SES-of-Origin and BMI in Youth: Comparing Germany and Minnesota

Increasing obesity is a world-wide health concern. Its most commonly used indicator, body mass index (BMI), consistently shows considerable genetic and shared environmental variance throughout life, the latter particularly in youth. Several adult studies have observed less total and genetically influenced variance with higher attained SES. These studies offer clues about sources of the 'obesity epidemic' but analogous youth studies of SES-of-origin are needed. Genetic and environmental influences and moderating effects of SES may vary in countries with different health policies, lifestyles, and degrees/sources of social inequality, offering further clues to the sources of the obesity epidemic. We examined SES-of-origin moderation of BMI variance in the German TwinLife study's cohorts assessed around ages 5, 11, 17, and 23-24, and in the Minnesota Twin Family Study's (MTFS) 11- and 17-year-old birth cohorts assessed longitudinally around ages 11, 17, and 23-24, comparing male and female twins and their parents. Age for age, both sexes' means and variances were greater in MTFS than in TwinLife. We observed that SES generally moderated genetic influences, more strongly in females, similar to most adult studies of attained-SES moderation of BMI. We interpreted differences in our SES-of-origin observations in light of inevitably-missing covariance between SES-of-origin and BMI in the models, mother-father and parent-offspring BMI correlations, and parental attained-SES-BMI correlations. We suggest that one source of the present obesity epidemic is social change that amplifies expression of genes both constraining SES attainment and facilitating weight gain.

Have Standard Formulas Correcting Correlations for Range Restriction Been Adequately Tested?: Minor Sampling Distribution Quirks Distort Them

Most study samples show less variability in key variables than do their source populations due most often to indirect selection into study participation associated with a wide range of personal and circumstantial characteristics. Formulas exist to correct the distortions of population-level correlations created. Formula accuracy has been tested using simulated normally distributed data, but empirical data are rarely available for testing. We did so in a rare data set in which it was possible: the 6-Day Sample, a representative subsample of 1,208 from the Scottish Mental Survey 1947 of cognitive ability in 1936-born Scottish schoolchildren (70,805). 6-Day Sample participants completed a follow-up assessment in childhood and were re-recruited for study at age 77 years. We compared full 6-Day Sample correlations of early-life variables with those of the range-restricted correlations in the later-participating subsample, before and after adjustment for direct and indirect range restriction. Results differed, especially for two highly correlated cognitive tests; neither reproduced full-sample correlations well due to small deviations from normal distribution in skew and kurtosis. Maximum likelihood estimates did little better. To assess these results' typicality, we simulated sample selection and made similar comparisons using the 42 cognitive ability tests administered to the Minnesota Study of Twins Reared Apart, with very similar results. We discuss problems in developing further adjustments to offset range-restriction distortions and possible approaches to solutions.

Attained SES as a moderator of adult cognitive performance: Testing gene-environment interaction in various cognitive domains

We examined whether attained socioeconomic status (SES) moderated genetic and environmental sources of individual differences in cognitive performance using pooled data from 9 adult twin studies. Prior work concerning SES moderation of cognitive performance has focused on rearing SES. The current adult sample of 12,196 individuals (aged 27-98 years) allowed for the examination of common sources of individual differences between attained SES and cognitive performance (signaling potential gene-environment correlation mechanisms, rGE), as well as sources of individual differences unique to cognitive performance (signaling potential gene-environment interaction mechanisms, G × E). Attained SES moderated sources of individual differences in 4 cognitive domains, assessed via performance on 5 cognitive tests ranging 2,149 to 8,722 participants. Attained SES moderated common sources of influences for 3 domains and influences unique to cognition in all 4 domains. The net effect was that genetic influences on the common pathway tended to be relatively more important at the upper end of attained SES indicating possible active rGE, whereas, genetic influences for the unique pathway were proportionally stable or less important at the upper end of attained SES. As a noted exception, at the upper end of attained SES, genetic influences unique to perceptual speed were amplified and genetic influences on the common pathway were dampened. Accounting for rearing SES did not alter attained SES moderation effects on cognitive performance, suggesting mechanisms germane to adulthood. Our findings suggest the importance of gene-environment mechanisms through which attained SES moderates sources of individual differences in cognitive performance. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Body size trajectories and cardio-metabolic resilience to obesity

Individuals with obesity do not represent a single homogenous group in terms of cardio‐metabolic health prospects. The concept of metabolically healthy obesity is a crude way of capturing this heterogeneity and has resulted in a plethora of research linking to future outcomes to show that it is not a benign condition. By contrast, very few studies have looked back in time and modelled the life course processes and exposures that explain the heterogeneity in cardio‐metabolic health and morbidity and mortality risk among people with the same body mass index (BMI) (or waist circumference or percentage body fat). The aim of the Medical Research Council New Investigator Research Grant (MR/P023347/1) ‘Body size trajectories and cardio‐metabolic resilience to obesity in three United Kingdom birth cohorts’ is to reveal the body size trajectories, pubertal development patterns and other factors (e.g. early‐life adversity) that might attenuate the positive associations of adulthood obesity makers (e.g. BMI) with cardio‐metabolic disease risk factors and other outcomes, thereby providing some degree of protection against the adverse effects of obesity. This work builds on the Principle Investigator's previous research as part of the Cohort and Longitudinal Studies Enhancement Resources initiative and focuses on secondary data analysis in the nationally representative UK birth cohort studies (initiated in 1946, 1958 and 1970), which have life course body size and exposure data and a biomedical sweep in adulthood. The grant will provide novel evidence on the life course processes and exposures that lead to some people developing a cardio‐metabolic complication or disease or dying while other people with the same BMI do not. This paper details the grant's scientific rationale, research objectives and potential impact.

The positive association of infant weight gain with adulthood body mass index has strengthened over time in the Fels Longitudinal Study

BACKGROUND

Infant weight gain is positively related to adulthood body mass index (BMI), but it is unknown whether or not this association is stronger for individuals born during (compared with before) the obesity epidemic.

OBJECTIVES

The aim of the study was to examine how the infant weight gain-adulthood BMI association might have changed across successive birth year cohorts spanning most of the 20th century.

METHODS

The sample comprised 346 participants in the Fels Longitudinal Study. Confounder-adjusted regression models were used to test the associations of conditional weight-for-length Z-score, capturing weight change between ages 0-2 years, with young adulthood BMI and blood pressure, including cohort [1933-1949 {N = 137}, 1950-1969 {N = 108}, 1970-1997 {N = 101}] as an effect modifier.

RESULTS

Conditional weight-for-length Z-score was positively related to adulthood BMI, but there was significant effect modification by birth year cohort such that the association was over two times stronger in the 1970-1997 cohort (β 2.31; 95% confidence interval 1.59, 3.03) compared with the 1933-1949 (0.98; 0.31, 1.65) and 1950-1969 (0.87; 0.21, 1.54) cohorts. A similar pattern was found for systolic blood pressure.

CONCLUSIONS

The infant weight gain-adulthood BMI association was over two times stronger among a cohort born during the obesity epidemic era compared with cohorts born earlier in the 20th century.

Development of an indirect ELISA for detection of antibody to wobbly possum disease virus in archival sera of Australian brushtail possums (Trichosurus vulpecula) in New Zealand

AIMS

To develop an indirect ELISA based on recombinant nucleocapsid (rN) protein of wobbly possum disease (WPD) virus for investigation of the presence of WPD virus in Australian brushtail possums (Trichosurus vulpecula) in New Zealand.

METHODS

Pre- and post-infection sera (n=15 and 16, respectively) obtained from a previous experimental challenge study were used for ELISA development. Sera were characterised as positive or negative for antibody to WPD virus based on western-blot using WPD virus rN protein as antigen. An additional 215 archival serum samples, collected between 2000-2016 from five different regions of New Zealand, were also tested using the ELISA. Bayesian modelling of corrected optical density at 450 nm (OD₄₅₀) results from the ELISA was used to obtain estimates of receiver operating characteristic (ROC) curves to establish cut-off values for the ELISA, and to estimate the prevalence of antibody to WPD virus.

RESULTS

Western blot analysis showed 5/14 (36%) pre-infection sera and 11/11 (100%) post-infection sera from experimentally infected possums were positive for antibodies to WPD virus. Bayesian estimates of the ROC curves established cut-off values of OD₄₅₀≥0.41 for samples positive, and OD₄₅₀<0.28 for samples negative for antibody to WPD virus, for sera diluted 1:100 for the ELISA. Based on the model, the estimated proportion of samples with antibodies to WPD virus was 0.30 (95% probability interval=0.196-0.418). Of the 230 archival serum samples tested using the ELISA, 48 (20.9%) were positive for antibody to WPD virus, 155 (67.4%) were negative and 27 (11.7%) equivocal, using the established cut-off values. The proportion of samples positive for WPD virus antibody differed between geographical regions (p<0.001).

CONCLUSION

The results suggested that WPD virus or a related virus has circulated among possums in New Zealand with differences in the proportion of antibody-positive samples from different geographical regions. Antibodies to WPD virus did not seem to protect possums from disease following experimental infection, as one third of possums from the previous challenge study showed evidence of pre-existing antibody at the time of challenge. These results provide further support for existence of different pathotypes of WPD virus, but the exact determinants of protection against WPD and epidemiology of infection in various regions of New Zealand remain to be established.

CLINICAL RELEVANCE

Availability of the indirect ELISA for detection of WPD virus antibody will facilitate prospective epidemiological investigation of WPD virus circulation in wild possum populations in New Zealand.

A Tempest in A Ladle: The Debate about the Roles of General and Specific Abilities in Predicting Important Outcomes

The debate about the roles of general and specific abilities in predicting important outcomes is a tempest in a ladle because we cannot measure abilities without also measuring skills. Skills always develop through exposure, are specific rather than general, and are executed using different strategies by different people, thus tapping into varied specific abilities. Relative predictive validities of measurement formats depend on the purpose: the more general and long-term the purpose, the better the more general measure. The more specific and immediate the purpose, the better the closely related specific measure.