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Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis (ERS), a weighted sum of the following risks: paternal age, childhood adversities, cannabis use, and ethnic minority membership; b) to explore the putative differences in specific environmental risk factors in distinguishing within patient clusters and from controls.
Methods
A univariable general linear model (GLS) compared the ERS between 1,263 community controls and clusters derived from 802 FEP patients, namely, low (n = 223) and high-cognitive-functioning (n = 205), intermediate (n = 224) and deteriorating (n = 150), from the EU-GEI study. A multivariable GLS compared clusters and controls by different exposures included in the ERS.
Results
The ERS was higher in all clusters compared to controls, mostly in the deteriorating (β=2.8, 95% CI 2.3 3.4, η2 = 0.049) and the low-cognitive-functioning cluster (β=2.4, 95% CI 1.9 2.8, η2 = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (meandifference = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (meandifference = 0.77, 95% CI 0.24 1.29) compared to the high-cognitive-functioning cluster.
Conclusions
High exposure to environmental risk factors might result in cognitive impairment and lower-than-expected functioning in individuals at the onset of psychosis. Some patients’ trajectories involved risk factors that could be modified by tailored interventions.
The association between cannabis and psychosis is established, but the role of underlying genetics is unclear. We used data from the EU-GEI case-control study and UK Biobank to examine the independent and combined effect of heavy cannabis use and schizophrenia polygenic risk score (PRS) on risk for psychosis.
Methods
Genome-wide association study summary statistics from the Psychiatric Genomics Consortium and the Genomic Psychiatry Cohort were used to calculate schizophrenia and cannabis use disorder (CUD) PRS for 1098 participants from the EU-GEI study and 143600 from the UK Biobank. Both datasets had information on cannabis use.
Results
In both samples, schizophrenia PRS and cannabis use independently increased risk of psychosis. Schizophrenia PRS was not associated with patterns of cannabis use in the EU-GEI cases or controls or UK Biobank cases. It was associated with lifetime and daily cannabis use among UK Biobank participants without psychosis, but the effect was substantially reduced when CUD PRS was included in the model. In the EU-GEI sample, regular users of high-potency cannabis had the highest odds of being a case independently of schizophrenia PRS (OR daily use high-potency cannabis adjusted for PRS = 5.09, 95% CI 3.08–8.43, p = 3.21 × 10−10). We found no evidence of interaction between schizophrenia PRS and patterns of cannabis use.
Conclusions
Regular use of high-potency cannabis remains a strong predictor of psychotic disorder independently of schizophrenia PRS, which does not seem to be associated with heavy cannabis use. These are important findings at a time of increasing use and potency of cannabis worldwide.
We present radio observations of the galaxy cluster Abell S1136 at 888 MHz, using the Australian Square Kilometre Array Pathfinder radio telescope, as part of the Evolutionary Map of the Universe Early Science program. We compare these findings with data from the Murchison Widefield Array, XMM-Newton, the Wide-field Infrared Survey Explorer, the Digitised Sky Survey, and the Australia Telescope Compact Array. Our analysis shows the X-ray and radio emission in Abell S1136 are closely aligned and centered on the Brightest Cluster Galaxy, while the X-ray temperature profile shows a relaxed cluster with no evidence of a cool core. We find that the diffuse radio emission in the centre of the cluster shows more structure than seen in previous low-resolution observations of this source, which appeared formerly as an amorphous radio blob, similar in appearance to a radio halo; our observations show the diffuse emission in the Abell S1136 galaxy cluster contains three narrow filamentary structures visible at 888 MHz, between $\sim$80 and 140 kpc in length; however, the properties of the diffuse emission do not fully match that of a radio (mini-)halo or (fossil) tailed radio source.
Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP.
Methods
We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately.
Results
Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia.
Conclusions
Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.
Symptoms and cognition are both utilized as indicators of recovery following pediatric concussion, yet their interrelationship is not well understood. This study aimed to investigate: 1) the association of post-concussion symptom burden and cognitive outcomes (processing speed and executive functioning [EF]) at 4 and 12 weeks after pediatric concussion, and 2) the moderating effect of sex on this association.
Methods:
This prospective, multicenter cohort study included participants aged 5.00–17.99 years with acute concussion presenting to four Emergency Departments of the Pediatric Emergency Research Canada network. Five processing speed and EF tasks and the Post-Concussion Symptom Inventory (PCSI; symptom burden, defined as the difference between post-injury and retrospective [pre-injury] scores) were administered at 4 and 12 weeks post-concussion. Generalized least squares models were conducted with task performances as dependent variables and PCSI and PCSI*sex interaction as the main predictors, with important pre-injury demographic and injury characteristics as covariates.
Results:
311 children (65.0% males; median age = 11.92 [IQR = 9.14–14.21 years]) were included in the analysis. After adjusting for covariates, higher symptom burden was associated with lower Backward Digit Span (χ2 = 9.85, p = .043) and Verbal Fluency scores (χ2 = 10.48, p = .033) across time points; these associations were not moderated by sex, ps ≥ .20. Symptom burden was not associated with performance on the Coding, Continuous Performance Test, and Color-Word Interference scores, ps ≥ .17.
Conclusions:
Higher symptom burden is associated with lower working memory and cognitive flexibility following pediatric concussion, yet these associations were not moderated by sex. Findings may inform concussion management by emphasizing the importance of multifaceted assessments of EF.
The neuropsychology of babies, toddlers, and young children is a rapidly evolving frontier within our discipline. While there is an inaccurate perception among referral sources that neuropsychological services are not useful before school-age, pediatric neuropsychologists are especially well-suited to identify delay or dysfunction in the years before school entry (Baron and Anderson, 2012). Patterns of neurodevelopmental strengths and weaknesses can be detected very early on in development and used to make inferences about brain-behavior relationships integral for guiding treatment across a number of medical and neurodevelopmental diagnoses. As such, there is a need to foster ongoing clinical interest and expertise and promote the utility of neuropsychological services within this age range. The INS BabIes, ToddlerS, and Young children (BITSY) SIG was recently developed to bring together scientists and clinicians from across the world who conduct research and provide neuropsychological services within this age range to foster collaboration and learning. A priority of the BITSY SIG is not only to promote awareness of the novel needs of this age range, but to consider historical and ongoing disparities in service access, representation in research, and neuropsychological practice. For this inaugural BITSY SIG symposium, four members of the SIG will discuss innovations in infant, toddler, and young child neuropsychological models of care. This topic was developed in direct response to survey results from the first BITSY SIG meeting held during INS 2022, indicating the need for the development and refinement of clinical approaches that incorporate diverse perspectives as well as training opportunities in models of care for very young children. As such, speakers will cover innovations in neuropsychological service models from the prenatal period to formative early years that are inclusive of diverse neurological and neurodevelopmental populations commonly served by neuropsychologists including spina bifida, prematurity, hypoxic-ischemic encephalopathy (HIE), congenital heart disease (CHD), autism (ASD) and attention-deficit/hyperactivity disorder (ADHD). The first talk will highlight the unique role of the neuropsychologist in prenatal and infant consultation, whereas the second talk will focus on the state of the field with regard to the utility of neuroimaging in neonatal populations and the integration of this tool in neuropsychological care. The third talk will discuss early screening and assessment models in a diverse range of conditions within an interdisciplinary setting. The final talk will illustrate a novel neuropsychological intervention designed with and for the empowerment of caregivers for young children impacted by neurological and neurodevelopmental conditions. The unifying theme across the talks is how unplanned discoveries and acute observations of children and families during the critical early years have led to these inclusive care models that prioritize family preferences, values, and culture. Upon conclusion of this course, learners will be able to:
1. Summarize several novel models of neuropsychological care for infants, toddlers, and young children.
2. Recognize ways in which neuropsychologists work within interdisciplinary teams to serve infants, toddlers, and young children and their families.
3. Apply these models of care to your conceptualization of the scope of neuropsychological services available for infants, toddlers, and young children.
Hearing consists of peripheral components (outer and middle ear, cochlea) and the central auditory system (cochlear nuclei to the auditory cortex). Speech perception relies on peripheral hearing abilities (i.e., pure-tone thresholds) and central auditory processing (CAP) and cognitive functioning. Specifically, working memory, executive function, attention, and verbal functioning allow for speech understanding. As a result, CAP deficits are also influenced by peripheral hearing sensitivity and cognitive functioning. Assessing CAP deficits can be difficult because of these complex interactions. Prior work has shown persons living with HIV (PWH) are at higher risk for sensorineural hearing loss compared to persons living without HIV (PWOH) after adjusting for age, sex, and noise exposure. Further, HIV is a risk factor for cognitive impairment, one example being Alzheimer's disease (AD) and its precursor, Mild Cognitive Impairment (MCI), with auditory dysfunction occurring in earlier stages of AD. Therefore, the purpose of this study was to evaluate: 1) the peripheral hearing sensitivity and CAP in PWH and PWOH; and 2) the association between cognitive function measures and CAP in PWH and PWOH.
Participants and Methods:
Participants included 59 PWH (39 men and 20 women, mean age=66.7 years [SD=4.4 years]) and 27 PWOH (13 men and 14 women, mean age=71.9 years [SD=7.1 years]). Participants completed a standard neuropsychological battery assessing the domains of learning, recall, executive function, working memory, verbal fluency, processing speed and motor. Raw scores were transformed to demographically corrected, domain T-scores. Cognitive function was normal for 39 (66.1%) PWH and 16 (59.3%) PWOH while 43 (72.9%) PWH and 17 (63.0%) PWOH were determined to have MCI. Participants with dementia were excluded. Participants also completed a hearing assessment, a portion of which consisted of pure-tone thresholds, peripheral hearing measure, and dichotic digits testing (DDT), a CAP measure. Pure-tone air-conduction thresholds were obtained at octave frequencies from 0.25 through 8 kHz, including 3 and 6 kHz. A pure-tone average (PTA) was calculated from 0.5, 1, 2, and 4 kHz thresholds for each ear. The DDT involves the presentation of numbers from 1 to 10, excluding 7, in which two different digits are presented to one ear while two other digits are simultaneously presented to the opposite ear. The outcome of DDT is percent correct.
Results:
PWH had slightly lower (i.e., better) mean PTAs in both ears compared to PWOH, but this was not statistically significant. Conversely, PWH had lower percent correct DDT results compared to PWOH, but this difference was also not statistically significant. Participants with impairment in verbal fluency, executive functioning, and working memory had significantly worse DDT results by approximately 10%, but only for right ear data.
Conclusions:
PWH in our sample had better hearing than PWOH, which can be explained by PWH having a lower mean age. PWH had poorer DDT results, however, indicative of CAP deficits rather than peripheral hearing problems. Poor right ear DDT was associated with impairments specifically in frontal-based cognitive processes with an executive component.
A common assumption to maximise cognitive training outcomes is that training tasks should be adaptive, with difficulty adjusted to the individual’s performance. This has only been tested once in adults (von Bastian & Eschen, 2016). We aimed to examine children’s outcomes of working memory training using adaptive, self-select and stepwise approaches to setting the difficulty of training tasks compared to an active control condition.
Participants and Methods:
In a randomised controlled trial (ACTRN 12621000990820), children in Grades 2-5 (7 to 11 years) were allocated to one of four conditions: adaptive working memory training, self-select working memory training, stepwise working memory training, or active control. An experimental intervention embedded in Minecraft was developed for teachers to deliver in the classroom over two weeks (10 x 20-minute sessions). The working memory training comprised two training tasks with processing demands similar to daily activities: backward span with digits and following instructions with objects. The control condition comprised creative building tasks. As part of a larger protocol, children completed at baseline and immediately post-intervention working memory measures similar to the training activities (primary outcome): backward span digits and letters versions, following instructions objects and letters versions. Primary analyses were intention-to-treat. Secondary analyses included only children who completed 10 sessions.
Results:
Of 204 children recruited into the study, 203 were randomised, with 95% retention at post-intervention. 76% of children completed all 10 training sessions. Comparisons between each working memory training condition and the active control on working memory measures were non-significant (f2 = 0.00), with one exception. Children in the self-select condition on average performed 1-point better than the controls on the following instructions objects measure (p = .02, f2 = 0.03). A pattern emerged that the self-select condition performed better on most measures.
Conclusions:
We found little evidence that an adaptive approach to setting the difficulty of training tasks maximises training outcomes for children. Findings suggest that working memory outcomes following training are limited and are not modulated by the approach to setting the difficulty of training tasks. This is consistent with findings from von Bastian & Eschen (2016), who also observed that the self-select condition (and not the adaptive condition) showed a slightly larger change in working memory performance following training than the control. It is helpful for clinicians to be aware that adaptive working memory training programs might not be superior in improving children’s working memory, and the benefits of programs are limited.
To examine associations between executive function (EF) domains (attentional control, information processing, cognitive flexibility, and goal setting) and math computation performance at 7 and 13 years in children born very preterm (VP; <30 weeks' gestation), and secondly, to investigate the associations of 7-year EF with change in math performance from 7 to 13 years.
Participants and Methods:
In the prospective, longitudinal Victorian Infant Brain Studies (VIBeS) cohort of children born VP, assessment of EF and math performance was undertaken at 7 (n = 187) and 13 years (n = 174). Univariable and multivariable regression models (including all domains of EF) were used to examine associations between EF domains at both timepoints with math performance, as well as associations between EF at 7 years with change in math from 7 to 13 years.
Results:
At 7 and 13 years, all EF domains were positively associated with concurrent math performance, with multivariable models finding information processing, cognitive flexibility and goal setting independently contributed to math performance at both ages. All EF domains were positively associated with improvement in math performance from 7 to 13 years, with multivariable models finding that goal setting contributed unique variance to improvement in math over this period.
Conclusions:
This study provides evidence for a strong, consistent association between EF and math performance in children born VP and emphasizes the importance of goal setting capacity for later improvement in math performance.
Most food retailers display foods in prominent locations as a marketing strategy (i.e. ‘placement promotions’). We examined the extent to which households with children change their food and beverage purchases in response to these promotions.
Design:
We analysed a novel dataset of all products promoted in two supermarkets from 2016 to 2017, including promotion dates and locations (e.g. aisle endcaps and front registers). We linked promotions to all purchases from the supermarkets from 2016 to 2017 by a cohort of households with children. We calculated the number of weekly promotions in each of thirteen food and beverage groups (e.g. bread; candy) and used fixed effects regressions to estimate associations between number of weekly promotions and households’ weekly food purchases, overall and by Supplemental Nutrition Assistance Program (SNAP) participation.
Setting:
Two large supermarkets in Maine, USA.
Participants:
Eight hundred and twenty-one households with children.
Results:
Most promotions (74 %) were for less healthy foods. The most promoted food groups were sweet and salty snacks (mean = 131·0 promotions/week), baked goods (mean = 68·2) and sugar-sweetened beverages (mean = 41·6). Households generally did not change their food group purchases during weeks when they were exposed to more promotions for those groups, except that a 1-sd increase in endcap candy promotions (about 1 promotion/week) was associated with $0·19/week (about 14·5 %) increase in candy purchases among SNAP nonparticipants (adjusted P < 0·001).
Conclusions:
In-store placement promotions for food groups were generally not associated with purchases of promoted food groups, perhaps because exposure to unhealthy food marketing was consistently high. Substantial changes to in-store food marketing may be needed to promote healthier purchases.
Adam, bishop of Orkney, to Archibald Napier of Merchiston.
Darrest brother, efter all hartle recommendation, pleis wit I ressavit ane wreting of youris fra James King, be the quhilk ye schew me ye haid wretin dyvers tymes to me, and mervalet that ye haid gottin na anser. Trewle other na that wreting I gat naine fra you this gryt quhyill, quhairfor think not onkuith that I wreit na anser of that thing I ressavit not. As to the knawlege of my being quhilk ye war desyrus of, it hes bene in continuall trawell and labour of bodye and mynd and evill helth thairthrow continualle sene my cumming in this cuntray, as this berar can reherss and informe yow sufficientle. Alsua quhat cummeris sume frendis hes sterit oup unto us, and how the samin standis with us presentle, James Meinyes will reherss yow. Prayand yow hartle to rekkin, that all the cummer that can be maid me sall not caus me to geif ouer that thing suld be my supple in tyme of neid, and that otheris weill deserving suld bruik efter me: bot gif thais that hes done me plesuir will resaiff sic thankfulnes of me as of thankfull mynd I am willing and glaid to do thame, I sall be abowt to do thame mair plesuir, and acquyt the benifet done to me mair thankfulle than ony in Scotland that ever ressavit sic guid deid. Prayand yow, that gif ye cum in commonyng with ony man thairanent, schaw how I haif offeret the justice clerk, haiffand upone this benefice xi hundreth merk of pension yeirle to be geiffin owt of the quantite of xx chailder beyr, quhilk is mair than I haif to sustene me one behind, and gif the victuall com to sic pryces as it hes bene guid chaip within this schort spaice, I wald not haif sua mekil behind my pensionis as other mycht pay that or susteine my selff. Quhairfor pray him to be ressonable and ramember him that he that wald haif all, all is able to tyne.
The editors of this work first encountered this run of correspondence in the course of their different researches into the history of Orkney and Shetland, John Ballantyne in his work with Brian Smith on Shetland documents, and Peter Anderson in his studies of the two Stewart earls of Orkney. The first of these earls, as Lord Robert Stewart, features prominently in the letters. Peter Anderson had already made basic transcriptions of the letters for research purposes, but it was John Ballantyne who provided independently the rigorous versions which now form the subject of this work.
There are four main sources for this material: in the National Library of Scotland are Advocates’ Manuscripts Adv. Mss 22.3.14 and 54.1.6, and manuscript Ms 1707. In the Roxburghe Muniments in Floors Castle are bundles 1104 and 1634. Those in Adv. Ms 54.1.6 are printed in Mark Napier, Memoirs of John Napier of Merchiston, 63–71, which also contains printed versions of nos. 7, 9 and 10 in the transcription, the original sources for which are unknown.
There are a variety of writers and recipients and none of the letters is in answer to any of the others, though other letters are mentioned, which do not survive. Despite this, and despite the variety of provenances, taken together each surviving epistle contributes to a coherent whole narrative. The run of correspondence, from 1560 to 1582, seems to form an almost continuous chronological sequence. There are gaps in the chronology – in particular, the last in line is separated from the rest by ten years – but most of these are at least partly explicable, with good reasons, other than simple loss, for interruptions in the action. They seem pauses rather than absences, in an ongoing account of a coherent, if contentious, body of affairs. Although of necessity telling only one side of the discussion, each letter tends to contain enough clues to infer the nature of replies and other points of view.
Pivotal to the story is the character of Sir John Bellenden of Auchnoull (1520?–76). He, despite the name of this collection, in fact writes none of the letters, but is rather the recipient of the greater part of them, and is a commanding presence throughout the correspondence, even when he is neither writer nor recipient.
Mr George Bellenden was a younger brother of Sir John and Sir Patrick Bellenden. He appears to have been illegitimate, though documents place him in line of succession after Sir John and Sir Patrick. He had an early interest in the north. In 1561 he granted a tack of the vicarage of Dunrossness to Ola Sinclair of Havera for three years from Lammas 1560; he was appointed chanter of Glasgow in 1564. He was in Scotland in March–June 1564, but by 17 October of that year he was writing from Paris describing his life there, as outlined in the letter below. This fascinating missive explicitly designates him as a brother of Sir John. Already a graduate, he had gone to France for further study. He sought to improve his Latin and French, and also heard lectures in Greek from ‘P Ramus’, the notable renaissance scholar who had had Lords John and James (the later regent) under his tutelage. It is not known whether he returned to Scotland as the only subsequent reference to him is on 21 March 1569 when Sir John Bellenden was granted a gift of the escheat of his goods, as he had died unlegitimated without lawful heirs of his body or disposition of his goods. The following letter, though not part of the main body of the correspondence, gives an interesting perspective on the whole, on the Bellendens’ part in it, and a picture of the times.
Paris, 17 October 1564
Mr George Bellenden to Sir John Bellenden, his brother.
My lord, efter my humble commendatioun of serwice. Althoe I have writtin at lenth to your lordship with the Scottis merchauntis quhom with I come in thir partis quhatsoever thing at this present I had to wrytt, yit remembering on your lordships commands quhilk was that I suld nevir lippin your lordship suld ressave ony wrytting that I wrytt, and that with sindry handis I suld evir wryttthe sammyn think. And understanding also that this berar was cummit of court and bound to Scotland in poist, and that he suld prevene our merchantis, I thocht gude to assure your lordship of your lordships cousing Williamis gude helth and weilfair, and of his placeing in Rowane,7 quhilk I understude your lordship was maist earnest with the first to knaw.