We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The assessment, diagnosis, and management of memory problems in older adults are routinely undertaken by memory assessment services (MAS) typically following referral from a GP. Mental health liaison teams (MHLT) newly identify many older people in acute hospitals with memory problems. Delirium is often diagnosed acutely and should be managed prior to any consideration of dementia diagnoses, however many of these people still have histories which also suggest underlying undiagnosed dementia. Referral policies advise of 3 months delay between delirium and MAS review to avoid misdiagnosis of dementia. MHLT therefore often request GP to refer at 3 months if still indicated. It is felt that some patients may be lost to follow-up via this route; our aim was to explore this further with a view to establishing a more robust direct referral pathway if indicated.
Methods
Electronic records of patients under the care of MHLT aged over 65 from June 2022 to June 2023 were reviewed. This excluded patients who were referred and discharged from MHLT after a single assessment. We collected retrospective data for 8 months during this 12-month period. For any patients with memory concerns, we recorded where MAS referral was recommended and whether they were subsequently referred and seen.
Results
108 patients over the age of 65 under the care of MHLT were identified. 69 patients had memory problems, 28 of whom already had established diagnoses or were already under MAS and 41 had newly identified memory problems. Of these 41 patients, 15 were felt to need MAS referral due to possible dementia. 3 were referred directly to MAS by MHLT and were seen. 5 were later referred to MAS by GP on MHLT recommendation and were seen. 7 were not later referred to MAS despite it being recommended.
Conclusion
All 3 patients whom MHLT were able to refer directly to MAS were seen, whereas 7 out of 12 (58%) patients for whom 3-month delayed referral by GP was requested were not seen. The policy of 3-month delay avoids misdiagnosis due to delirium, but in practice also leaves some patients with missed opportunities for diagnosis and management of dementia. There is a need for a more robust delayed referral pathway to memory assessment services from mental health liaison teams. We hope to use these findings to improve our local referral pathways and share this information to support other localities.
Community involvement in research is key to translating science into practice, and new approaches to engaging community members in research design and implementation are needed. The Community Scientist Program, established at the MD Anderson Cancer Center in Houston in 2018 and expanded to two other Texas institutions in 2021, provides researchers with rapid feedback from community members on study feasibility and design, cultural appropriateness, participant recruitment, and research implementation. This paper aims to describe the Community Scientist Program and assess Community Scientists' and researchers' satisfaction with the program. We present the analysis of the data collected from 116 Community Scientists and 64 researchers who attended 100 feedback sessions, across three regions of Texas including Northeast Texas, Houston, and Rio Grande Valley between June 2018 and December 2022. Community Scientists stated that the feedback sessions increased their knowledge and changed their perception of research. All researchers (100%) were satisfied with the feedback and reported that it influenced their current and future research methods. Our evaluation demonstrates that the key features of the Community Scientist Program such as follow-up evaluations, effective bi-directional communication, and fair compensation transform how research is conducted and contribute to reducing health disparities.
This concluding chapter situates developmental science in the service of children, and appraises the contributions of the brain development revolution. The question of why has brain development become the dominant lens through which we view children’s development today is answered in light of the discussions of the previous chapters. How the brain development revolution has changed public understanding of children and its practical implications are considered. Finally, the lessons of the revolution for science communication are considered in relation to the book’s three themes: science, the media, and public policy. Concerning science, the successes in the public communication of developmental brain science are contrasted with problems in messaging the science, especially the selectivity of the messaging. The chapter argues for a stronger leadership role for developmental scientists in the communication and application of the research. Concerning the media, the chapter considers the opportunities and difficulties for science communication posed by digital and social media in light of a new generation of scientists in using these tools. Concerning public policy, the chapter urges consideration of alternative policy proposals for implementing developmental science based on different value priorities and preferences to create broader coalitions of advocates for children and their families.
An influential approach to public communication focuses on changing the preexisting frames of understanding the public brings to issues or introducing new frames to strengthen message acceptance. This chapter explores this approach to communicating developmental science in the work of the FrameWorks Institute together with the National Scientific Council on the Developing Child. The application of “strategic frame analysis” is described to show how an influential messaging strategy was developed by FrameWorks, and the example of framing child mental health illustrates this process. Questions are raised about this approach, including how to define the target audience(s) and the media that influence them, balancing scientific accuracy and policy advocacy in the communication goal(s), and whether there are long-term effects of FrameWorks messaging. The work of the National Scientific Council on the Developing Child is profiled as an implementation of strategic frame analysis to communicating developmental science. The development of the core story of early childhood development and the use of metaphors such as toxic stress, serve and return, and brain architecture are discussed. The chapter concludes with questions and cautions about the framing of developmental science and the influence of values in science communication.
This chapter continues the story of the preceding chapter with a wider lens to discuss advocacy efforts of various kinds for children in the years following the brain development campaign. These include California’s Proposition 10 campaign for a cigarette tax that has provided millions of dollars in funding for early childhood programs through First 5 California, the work of James Heckman and Rolnick and Grunewald using economic principles to argue for early childhood investments as a means of improving workplace productivity through the developing brain, the Pew Charitable Trusts’ ten-year campaign for prekindergarten education, the development of advocacy efforts for early childhood within the business community, confused and constructive applications of developmental neuroscience to education, and other initiatives. The results of these efforts were some real wins for young children, such as advances in child health care access and affordability and early childhood education. But there have been disappointments, including lack of improvement in child care and parental leave, and inattention to brain development for children in poverty. The chapter documents the evolving brain development message as new voices and priorities entered and the problems of overpromising results from proposed programs for children.
The I Am Your Child campaign in 1997 introduced the public to early brain development and shaped public understanding of the developing brain. In its design and impact, it illustrates “campaign journalism” that mobilizes public engagement through a large-scale communications strategy that weds science and advocacy and creates media momentum. This approach bypasses traditional science journalism and foreshadowed the current era of advocacy through viral social media messaging. This chapter documents the events leading up to the campaign, its planning and central themes, the events, its impact on parents, and the reactions of commentators. The chapter profiles how developmental scientists responded both critically and constructively, and describes the report of a federal blue-ribbon committee formed in response, From Neurons to Neighborhoods: The Science of Early Childhood Development. In assessing the campaign and its impact, the chapter shows how the messaging integrated neuroimaging studies with research on children’s behavioral development in ways that were both helpful and misleading to public understanding; how cultural frames shaped how the messaging was received and accepted; and the problems deriving from the selectivity of the campaign’s messaging, including insufficient attention to prenatal development, brain growth after early childhood, and the effects of poverty.
Two stories of brain development are described. The first is from the perspective of developmental neuroscience, describing the core story of developing neurons, synapses, and neural networks, and showing how these create the brain’s developing capacities for memory, language, self-regulation, and other abilities. The second story is from the perspective of developmental science, summarizing the large literature on developing concepts and reasoning skills and the influence of early relationships in their growth. The two stories are then compared to reveal how complementary they are (as we should expect, since they both concern the developing child), but how their integration is still a work in progress, especially because the stories of brain and mind have somewhat different perspectives on development deriving from different research methods, levels of analysis, vocabulary, and concepts. The last section describes overlooked topics in the brain development story that was publicly messaged: the effects of poverty, fetal brain “programming,” and adolescence as a period of renewed brain plasticity and growth. The chapter shows how the science of brain development is constantly evolving, how the interaction of mind and brain is only slowly becoming understood, and the selectivity of the public communication of developmental brain science.
This introductory chapter previews the major themes of the book. The chapter discusses how brain development has become incorporated into parents’ thinking about early child development, educators’ concerns with early childhood education, legislators’ initiatives supporting young children and their families, businesses’ marketing of commercial products for young children, and other features of the climate of early child development for the past twenty years. It discusses how ideas from philosophy and later psychological science have historically created images and metaphors to convey new understanding of the developing child, and how brain development has become the most recent and influential of these scientific accounts because of its novelty, its technological sophistication, and a concerted public engagement campaign in 1997 to promote public understanding of the developing brain. The view that “science does not speak for itself” highlights that scientists are trusted sources but not trusted communicators. This raises the problem of how best to convey this scientific account to an interested public, and alternative ways of translating developmental research findings into “usable knowledge” for parents and practitioners are considered. The chapter concludes with an outline of the chapters and the issues they discuss.
Why does the science of brain development have such compelling influence on our thinking about children’s development? This question is explored in relation to an important Supreme Court decision concerning adolescent responsibility in which the findings of developmental neuroscience were influential but misleading. In considering this case, the chapter explores the concepts of neurorealism (i.e., brain images provide “visual proof” of the brain’s influence on mental processes) and neuroessentialism (i.e., brain processes are the material basis for mental processes). Then the chapter describes why we are – but should not be – neurodeterminists by showing how the brain and mind are mutually influential in development and that both are affected by experience. The chapter also describes the difficulties of attributing specific mental processes to particular areas of the brain, and considers the importance of context and culture in the development of brain and mind. The chapter shows that without due consideration of the multiple influences on the developing brain and mind, and careful examination of the contexts in which they develop, mistaken applications of developmental brain science are more likely. The clear and accurate communication of the science is thus crucial to public understanding and responsible policy applications.
Ross A. Thompson is Distinguished Professor of Psychology at the University of California, Davis, where he directs the Social and Emotional Development Lab. Thompson studies the psychological development of young children, parent-child relationships, and the applications of developmental science to public policy problems such as early childhood mental health, child poverty, maltreatment prevention, and early education. His work integrates understanding of the developing brain with early experiences in both typical and at-risk children, and he consults extensively with legislative committees, public agencies, and private foundations.
The science of human development informs our thinking about children and their development. The Brain Development Revolution asks how and why has brain development become the major lens for understanding child development, and its consequences. It describes the 1997 I Am Your Child campaign that engaged public attention through a sophisticated media communications effort, a White House conference, and other events. It explores the campaign's impact, including voter initiatives to fund early childhood programs and a national campaign for prekindergarten education, but also several missed opportunities. The study examines why brain development compels our attention, why we are – but shouldn't be – neurodeterminists, and the challenges of communicating developmental brain science. This book examines the framing of the brain development story, the selectivity of the messaging, and overpromising the results of early programs. Lastly, it discusses proposals for how science communication can be improved to better serve children and the public.
Emotion motivates prosocial behavior, and interest in this topic usually focuses on empathy. This chapter explores other emotions that can also motivate prosocial action and the research directions and practical implications that follow. It opens with consideration of two perspectives on the association of emotions and prosocial behavior offered by Malti and Thompson, and then proceeds to discuss research concerning the following prosocial emotions: happiness derived from assisting another, moral pride derived from prosociality, indignation over observed harm, empathy and sympathy, and gratitude. Guilt as a moral and possibly prosocial emotion is also discussed. The shared element of these prosocial emotions is that they derive from a personal connection between an observer and another’s emotional experience. An overview of the research on emotional development and emotion regulation follows to explore how this connection emerges developmentally. The conclusion summarizes much-needed areas for further research along with the implications of these ideas.
Cetaceans in the eastern South Atlantic Ocean are poorly studied. We present results from a 2 week ship-based survey from Cape Town to Vema Seamount (980 km to the west) during October–November 2019, including visual and towed-hydrophone observations from the vessel, and 10 days of acoustic monitoring on the seamount. Fifty-two hours of visual surveys resulted in 39 encounters of whale groups including seven of humpback, six of fin and one sei whale, as well as four unidentified baleen whales, 18 unidentified balaenopterid whales and four unidentified odontocetes. Two humpback whales at the seamount were engaged in possible feeding behaviour. A large aggregation of mostly fin whales was observed near the continental shelf edge (22 encounters over a 70 × 50 km2 area, six fin, one sei whale, 15 not confirmed to species), an historic whaling ground for both fin and sei whales. Towed-hydrophone data (78.7 h) detected five groups of sperm whales, 45 of delphinids, one beaked whale and no Kogiids. Acoustic data from the seamount detected calls from several baleen whale species including humpback whale non-song calls, Antarctic minke ‘bioduck’ calls, sei whale down-sweep calls and a likely Bryde's whale call. Two call types could not be assigned to species, including the most detected – a simple frequency-modulated call with peak power around 130 Hz. This study contributes to an improved understanding of cetacean occurrence in the eastern South Atlantic Ocean and highlights the need for more research to improve identification of cetacean vocalizations in the region.