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To establish quick-reference criteria regarding the frequency of statistically rare changes in seven neuropsychological measures administered to older adults.
Method:
Data from 935 older adults examined over a two-year interval were obtained from the Alzheimer’s Disease Neuroimaging Initiative. The sample included 401 cognitively normal older adults whose scores were used to determine the natural distribution of change scores for seven cognitive measures and to set change score thresholds corresponding to the 5th percentile. The number of test scores that exceeded these thresholds were counted for the cognitively normal group, as well as 381 individuals with mild cognitive impairment (MCI) and 153 individuals with dementia. Regression analyses examined whether the number of change scores predicted diagnostic group membership beyond demographic covariates.
Results:
Only 4.2% of cognitively normal participants obtained two or more change scores that fell below the 5th percentile of change scores, compared to 10.6% of the stable MCI participants and 38.6% of those who converted to dementia. After adjusting for age, gender, race/ethnicity, and premorbid estimates, the number of change scores below the 5th percentile significantly predicted diagnostic group membership.
Conclusions:
It was uncommon for older adults to have two or more change scores fall below the 5th percentile thresholds in a seven-test battery. Higher change counts may identify those showing atypical cognitive decline.
The study aimed to describe trajectories of free sugar (FS) intake, its main sources and the associations with socio-economic status (SES) in Portuguese children/adolescents evaluated at 4, 7, 10 and 13 years of age from Generation XXI birth-cohort. Dietary intake was assessed through 3-day food diaries (n 5268). Added sugar intake was estimated following a systematic methodology, and FS was based on the WHO definition. A mixed-effects model with linear and quadratic terms for time was used to estimate FS trajectories and its association with SES, adjusting for children’s sex, age, BMI and SES. The FS mean intake (g/day) was 37, 47, 51 and 48 at 4, 7, 10 and 13 years, respectively. FS intake increased 4·6 g/year (CI 95 %: 4·20, 5·04), but velocity decreased by 0·3 g/year2 until 13 years. At all ages, the main food source was sweets. Some item’s consumption declined (sweets 25–21 % and yoghurts 22–7 %) as children grew older. Inversely, soft drink intake increased (9–18 %). Boys and children from younger mothers had higher FS intake, whereas higher maternal–SES was associated with lower children’s FS intake: occupational status (β = –3·5; 95 % CI: –4·97, –1·94), years of education (β = –3·7; 95 % CI: –4·93, –2·40) and household income (β = –4·9; 95 % CI: –6·50, –3·27). The FS trajectories were similar by SES categories but different by obesity status (interaction term β = –1·04; CI 95 % (–1·50, –0·59)). An increasing FS trajectory during childhood is mainly driven by an increasing intake of soft drinks and nectars. The FS trajectory pattern did not change according to SES categories, but children’s FS intake was always higher when their mothers had a lower SES.
Youth adversity is associated with persistence of depression and anxiety symptoms. This association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (e.g. males). Given that persistent symptoms are observed across a range of disadvantaged, minoritized, and neurodivergent groups (e.g. low compared with high socio-economic status [SES]), the intersection of individual characteristics may be an important moderator of inequality.
Methods
Data from HeadStart Cornwall (N = 4441) was used to assess the effect of youth adversity on combined symptoms of depression and anxiety (Strengths and Difficulties Questionnaire emotional problems subscale) measured at three time-points in 11–14-year-olds. Latent trajectories and regressions were estimated for eight intersectionality profiles (based on gender, SES, and hyperactivity/inattention), and moderating effects of the individual characteristics and their intersections were estimated.
Results
Youth adversity was associated with higher average depression/anxiety symptoms at baseline (11–12-years) across all intersectionality profiles. The magnitude of effects differed across profiles, with suggestive evidence for a moderating effect of youth adversity on change over time in depression/anxiety symptoms attributable to the intersection between (i) gender and SES; and (ii) gender, SES, and hyperactivity/inattention.
Conclusions
The detrimental effects of youth adversity pervade across intersectionality profiles. The extent to which these effects are moderated by intersectionality is discussed in terms of operational factors. The current results provide a platform for further research, which is needed to determine the importance of intersectionality as a moderator of youth adversity on the development of depression and anxiety symptoms in adolescence.
Although the importance of the dynamic intra-individual relationship between mother-to-infant bonding and postpartum depressive symptoms has been widely recognized, the complex interplay between them is not well understood. Furthermore, the potential role of prenatal depressive symptoms and infant temperament in this relationship remains unclear. This study aims to examine the bidirectional influence of mother-to-infant bonding on postpartum depressive symptoms within individuals and to elucidate whether prenatal depressive symptoms and infant temperament would influence deviations from stable individual states.
Methods
Longitudinal data were collected from 433 women in early pregnancy. Of these, 360 participants completed the main questionnaires measuring impaired mother-to-infant bonding and postpartum depressive symptoms at least once during the postpartum period. Data were collected at early and late pregnancy and several postpartum time points: shortly after birth and at one, four, ten, and 18 months postpartum. We also assessed prenatal depressive symptoms and infant temperament. A random-intercept cross-lagged panel model was used.
Results
Within-individual variability in mother-to-infant bonding, especially anger and rejection, significantly predicted subsequent postpartum depressive symptoms. However, the inverse relationship was not significant. Additionally, prenatal depressive symptoms and difficult infant temperament were associated with greater within-individual variability in impaired mother-to-infant bonding and postpartum depressive symptoms.
Conclusions
The present study demonstrated that the within-individual relationship between mother-to-infant bonding and postpartum depressive symptoms is likely non-bidirectional. The significance of the findings is underscored by the potential for interventions aimed at improving mother-to-infant bonding to alleviate postpartum depressive symptoms, suggesting avenues for future research and practice.
Attentional impairments are common in dementia with Lewy bodies and its prodromal stage of mild cognitive impairment (MCI) with Lewy bodies (MCI-LB). People with MCI may be capable of compensating for subtle attentional deficits in most circumstances, and so these may present as occasional lapses of attention. We aimed to assess the utility of a continuous performance task (CPT), which requires sustained attention for several minutes, for measuring attentional performance in MCI-LB in comparison to Alzheimer’s disease (MCI-AD), and any performance deficits which emerged with sustained effort.
Method:
We included longitudinal data on a CPT sustained attention task for 89 participants with MCI-LB or MCI-AD and 31 healthy controls, estimating ex-Gaussian response time parameters, omission and commission errors. Performance trajectories were estimated both cross-sectionally (intra-task progress from start to end) and longitudinally (change in performance over years).
Results:
While response times in successful trials were broadly similar, with slight slowing associated with clinical parkinsonism, those with MCI-LB made considerably more errors. Omission errors were more common throughout the task in MCI-LB than MCI-AD (OR 2.3, 95% CI: 1.1–4.7), while commission errors became more common after several minutes of sustained attention. Within MCI-LB, omission errors were more common in those with clinical parkinsonism (OR 1.9, 95% CI: 1.3–2.9) or cognitive fluctuations (OR 4.3, 95% CI: 2.2–8.8).
Conclusions:
Sustained attention deficits in MCI-LB may emerge in the form of attentional lapses leading to omissions, and a breakdown in inhibitory control leading to commission errors.
Chapter 10 discusses various characteristics of the overall developmental progression of language acquisition. We first discuss some general properties of this process and then show how it can be studied both with respect to language production and language perception. We discuss the stages and milestones that children go through for different aspects of grammar and ask whether the properties and timing of stages lend support to the Innateness Hypothesis for language. We then formulate the argument from stages. Here the idea is that a complex system like language “unfolds” in the human mind, step by step, each step occurring at more or less regular points in time, as determined by a biological clock. This process of unfolding is called maturation. Just as our body gradually changes into a mature system, so does our mind. This process of unfolding is biologically determined and largely outside the control of the organism, although external factors (“nurture“) play a role. We critically evaluate the argument from stages, asking how precisely it might support the Innateness Hypothesis.
To examine how food insecurity in childhood up to adolescence relates to eating habits and weight status in young adulthood.
Design:
A longitudinal study design was used to derive trajectories of household food insecurity from age 4·5 to 13 years. Multivariable linear and logistical regression analyses were performed to model associations between being at high risk of food insecurity from age 4·5 to 13 years and both dietary and weight outcomes at age 22 years.
Setting:
A birth cohort study conducted in the Province of Quebec, Canada.
Participants:
In total, 698 young adults participating in the Québec Longitudinal Study of Child Development.
Results:
After adjusting for sex, maternal education and immigrant status, household income and type of family, being at high risk (compared with low risk) of food insecurity in childhood up to adolescence was associated with consuming higher quantities of sugar-sweetened beverages (ßadj: 0·64; 95 % CI (0·27, 1·00)), non-whole-grain cereal products (ßadj: 0·32; 95 % CI (0·07, 0·56)) and processed meat (ßadj: 0·14; 95 % CI (0·02, 0·25)), with skipping breakfast (ORadj: 1·97; 95 % CI (1·08, 3·53)), with eating meals prepared out of home (ORadj: 3·38; 95 % CI (1·52, 9·02)), with experiencing food insecurity (ORadj: 3·03; 95 % CI (1·91, 4·76)) and with being obese (ORadj: 2·01; 95 % CI (1·12, 3·64)), once reaching young adulthood.
Conclusion:
Growing up in families experiencing food insecurity may negatively influence eating habits and weight status later in life. Our findings reinforce the importance of public health policies and programmes tackling poverty and food insecurity, particularly for families with young children.
Choosing an appropriate electronic data capture system (EDC) is a critical decision for all randomized controlled trials (RCT). In this paper, we document our process for developing and implementing an EDC for a multisite RCT evaluating the efficacy and implementation of an enhanced primary care model for individuals with opioid use disorder who are returning to the community from incarceration.
Methods:
Informed by the Knowledge-to-Action conceptual framework and user-centered design principles, we used Claris Filemaker software to design and implement CRICIT, a novel EDC that could meet the varied needs of the many stakeholders involved in our study.
Results:
CRICIT was deployed in May 2021 and has been continuously iterated and adapted since. CRICIT’s features include extensive participant tracking capabilities, site-specific adaptability, integrated randomization protocols, and the ability to generate both site-specific and study-wide summary reports.
Conclusions:
CRICIT is highly customizable, adaptable, and secure. Its implementation has enhanced the quality of the study’s data, increased fidelity to a complicated research protocol, and reduced research staff’s administrative burden. CRICIT and similar systems have the potential to streamline research activities and contribute to the efficient collection and utilization of clinical research data.
We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI).
Design:
Prospective cohort study with assessments every 2 years (for up to 6 years).
Setting:
Community, Sydney, Australia.
Participants:
Four hundred and eighty one people were classified into three groups: those with MCI at baseline and MCI or dementia at follow-up assessments (n = 92); those who fluctuated between cognitively normal and MCI throughout follow-up (cognitively fluctuating) (n = 157), and those who were cognitively normal at baseline and all reassessments (n = 232).
Measurements:
Cognitive and physical function measured over 2–6 years follow-up. Falls in the year following participants’ final assessment.
Results:
In summary, 27.4%, 38.5%, and 34.1% of participants completed 2, 4, and 6 years follow-up of cognitive and physical performance, respectively. The MCI and cognitive fluctuating groups demonstrated cognitive decline, whereas the cognitively normal group did not. The MCI group had worse physical function than the cognitively normal group at baseline but decline over time in physical performance was similar across all groups. Decline in global cognitive function and sensorimotor performance were associated with multiple falls in the cognitively normal group and decline in mobility (timed-up-and-go test) was associated with multiple falls across the whole sample.
Conclusions:
Cognitive declines were not associated with falls in people with MCI and fluctuating cognition. Declines in physical function were similar between groups and decline in mobility was associated with falls in the whole sample. As exercise has multiple health benefits including maintaining physical function, it should be recommended for all older people. Programs aimed at mitigating cognitive decline should be encouraged in people with MCI.
The objective was to characterize the progression of sleep complaints in 115 dystrophy type 1 (DM1) patients who filled out a sleep questionnaire twice at a 9-year interval. Daytime napping (22.1% vs. 34.5%, p < 0.05), early awakenings (11.4% vs 21.1%, p < 0.05), nonrestorative sleep (39.5% vs 51.8%, p < 0.05), stimulant use (7.0% vs 19.3%, p < 0.01), breathing cessation (10.7% vs 23.2%, p < 0.01), and nighttime urination (42.5% vs 54.9%, p < 0.05) increased between Time 1 and Time 2. Sleep-related complaints are prominent and augment rapidly in DM1 patients. Physicians need to better identify and treat them to help alleviate the burden they impose on patients and their caregivers.
This chapter introduces the Conway–Maxwell–Poisson regression model, along with adaptations of the model to account for zero-inflation, censoring, and data clustering. Section 5.1 motivates the consideration and development of the various COM–Poisson regressions. Section 5.2 introduces the regression model and discusses related issues including parameter estimation, hypothesis testing, and statistical computing in R. Section 5.3 advances that work to address excess zeroes, while Section 5.4 describes COM–Poisson models that incorporate repeated measures and longitudinal studies. Section 5.5 focuses attention on the R statistical packages and functionality associated with regression analysis that accommodates excess zeros and/or clustered data as described in the two previous sections. Section 5.6 considers a general additive model based on COM–Poisson. Finally, Section 5.7 informs readers of other statistical computing softwares that are also available to conduct COM–Poisson regression, discussing their associated functionality. The chapter concludes with discussion.
Infants’ difficulty, typically characterized as proneness to negative emotionality, is commonly considered a risk for future maladaptive developmental trajectories, mostly because it often foreshadows increased parental power assertion, typically linked to future negative child outcomes. However, growing evidence of divergent developmental paths that unfold from infant difficulty has invigorated research on causes of such multifinality. Kochanska et al. (2019) proposed that parent and child Internal Working Models (IWMs) of each other are key, with the parent’s IWM of the child moderating the link between child difficulty and parental power assertion, and the child’s IWM of the parent moderating the link between power assertion and child outcomes. In Children and Parents Study (200 community mothers, fathers, and children), child difficulty was observed at 8 months, parents’ power assertion at 16 months, and children’s outcomes rated by parents at age 3. Parents’ IWMs were assessed with a mentalization measure at 8 months and children’s IWMs were coded from semi-projective narratives at age 3. The cascade from infant difficulty to maternal power assertion to negative child outcomes was present only when both the mother’s and the child’s IWMs of each other were negative. We did not support the model for father-child dyads.
Bilateral Ménière's disease is classified according to the time of appearance of symptoms in each ear into synchronous and metachronous types. A descriptive longitudinal study, involving 59 bilateral Ménière's disease patients, was carried out to assess the two forms of bilateral Ménière's disease.
Method
Data on symptomatic chronology in each ear, auditory evolution and evolution of vertiginous crisis, among other aspects, were obtained, analysed and compared. Possible risk factors for Ménière's disease becoming bilateral were analysed after conducting nested case–control studies in a cohort.
Results
The metachronous form was seen in 76.3 per cent of cases, and the time it took for the disease to become bilateral took a median time of seven years. The symptomatic triad was the most frequent symptomatic debut for the first ear in both forms. Synchronous debut presented a greater average hearing loss. Suffering from migraine and a symptomatic onset with a greater number of symptoms appear to be possible predictors of conversion to bilateral Ménière's disease.
Conclusion
Bilateral Ménière's disease temporal models presented differences. The study of them helps to better understand, prevent and predict the behaviour of these patients.
Infants’ high negative affectivity often initiates maladaptive parent-child relational processes that may involve both the parent’s and the child’s sides of the relationship. We proposed that infants’ high negative affectivity triggers distinct sequelae in dyads classified as avoidant, resistant, and disorganized, compared to secure dyads. In 200 community families, at 8 months, we observed infants’ negative affectivity; at 16 months, we assessed attachment organization and collected observations and reports of parent-related (responsiveness, resentment of child, power assertion, and intrusiveness) and child-related (social-emotional competence, opposition, and anger) constructs. In mother-child avoidant dyads, infants’ high negative affectivity was a significant precursor of mothers’ higher resentment and intrusiveness and children’s lower social-emotional competence. Those associations were significantly different than in secure dyads (in which none were significant). In father-child disorganized dyads, infants’ high negative affectivity was a significant precursor of fathers’ lower responsiveness and higher resentment; there were no association in secure dyads. Regardless of infants’ negative affectivity, compared to secure dyads, parents in resistant dyads expressed more resentment of child, and avoidant and resistant children were more oppositional to their fathers. The study illustrates multifinality in parent- and child-related processes that characterize unfolding early relational dynamics in dyads differing in just-emerging attachment.
Changes between diet quality and health-related quality of life (HR-QoL) over 12 years were examined in men and women, in 2844 adults (46 % males; mean age 47·3 (sd 9·7) years) from the Australian Diabetes, Obesity and Lifestyle study with data at baseline, 5 and 12 years. Dietary intake was assessed with a seventy-four-item FFQ. Diet quality was estimated with the Dietary Guideline Index, Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurological Delay Index (MIND) and Dietary Inflammatory Index. HR-QoL in terms of global, physical component summary (PCS) and mental component summary (MCS) was assessed with the Short-Form Health Survey-36. Fixed effects regression models adjusted for confounders were performed. Mean MCS increased from baseline (49·0, sd 9·3) to year 12 (50·7, sd 9·1), whereas mean PCS decreased from baseline (51·7, sd 7·4) to year 12 (49·5, sd 8·6). For the total sample, an improvement in MIND was associated with an improvement in global QoL (β = 0·28, 95 % CI (0·007, 0·55)). In men, an improvement in MIND was associated with an improvement in global QoL (β = 0·28, 95 % CI (0·0004, 0·55)). In women, improvement in MIND was associated with improvements in global QoL (β = 0·62 95 % CI (0·38, 0·85)), MCS (β = 0·75, 95 % CI (0·29, 1·22)) and PCS (β = 0·75, 95 % CI (0·29, 1·22)). Positive changes in diet quality were associated with broad improvements in HR-QoL, and most benefits were observed in women when compared to men. These findings support the need for strategies to assist the population in consuming healthy dietary patterns to lead to improvements in HR-QoL.
The chapter explains the basic principles of linguistic change from a sociolinguistic variationist perspective. It begins with an explanation of the inextricable relationship between linguistic variation and change, and proceeds to demonstrate how language change can be observed, investigated, and explained. Sociolinguists can document and analyse language change using either the real-time method or the apparent-time construct; these methods and their advantages and pitfalls are explained and exemplified.
There is a paucity of long-term treatment outcome studies among children and adolescents after natural disasters. This chapter summarizes findings from three long-term studies among severely traumatized early adolescents after the 1988 Spitak earthquake in Armenia, including a twenty-five-year follow-up that represents the most extended prospective treatment outcome study to date after a disaster. School-based trauma-grief-focused psychotherapy was provided at 1.5 years post-earthquake. The intervention addressed trauma and loss experiences due to the earthquake; post-trauma distress reactions, including PTSD and grief; current problems and adversities; trauma and loss reminders, interpersonal conflicts, and developmental progression. The findings showed significant long-term benefits of treatment in reducing PTSD and depressive symptoms. We also present findings regarding differences in recovery trajectories among treated and not treated subjects and risk and protective factors associated with PTSD and depression. Despite the improvements, a sub-group of the students continued to experience earthquake-related chronic PTSD and depressive symptoms at twenty-five-year follow-up, indicating the need for ongoing surveillance of severely traumatized survivors. The findings underscore the benefit of post-disaster therapeutic intervention, social support by family members and friends, and the need for assistance by governmental and non-governmental agencies to mitigate post-disaster adversities that contributed significantly to the chronicity of symptoms.
Multiple risk behaviours (MRBs), typically beginning in adolescence, are associated with increased risk of adverse health and social outcomes. The association between autism and MRBs is little understood.
Methods
Data were from the Avon Longitudinal Study of Parents and Children, an UK-based longitudinal, birth cohort study. Exposures were diagnosed autism and four autistic traits: social communication difficulties, pragmatic language, repetitive behaviours and reduced sociability. Outcomes were participation in up to 14 risk behaviours, including alcohol consumption, smoking, risky sexual behaviours and physical inactivity. Outcome data were collected at ages approximately 12, 14, 16 and 18.
Results
Up to 4300 participants were included in latent basis growth curve analyses with adjustment for confounders. Social communication difficulties were associated with an above average level of MRBs engagement at ~12 years (mean difference β 0.26; 95% CI 0.13–0.40), and above average rate of engagement from ages ~12–18 (β 0.08; 95% CI 0.02–0.13). Repetitive behaviours were associated with above average levels of engagement in MRBs at ~12 years (β 0.24; 95% CI 0.09–0.38). Contrastingly, reduced sociability was associated with a reduced rate of engagement in MRBs from ages ~12–18 (β −0.06; 95% CI −0.11 to −0.02). In sex-specific analyses, persisting differences in MRB engagement patterns from ages ~12–18 were observed in males with social communication difficulties and females with reduced sociability temperament.
Conclusions
Having elevated levels of some autistic traits appear to have differentiated effects on MRB engagement patterns. These findings could reflect difficulties fitting in and/or coping mechanisms relating to difficulties with fitting in.
Ultra-processed foods (UPF) have been associated with cardiometabolic outcomes, but the literature has still not reported their association with the incidence of dyslipidaemias, one of the most important risk factors for the occurrence of CVD. The objective of this study was to verify the association between consumption of UPF and incidence of dyslipidaemia in Brazilian civil servants at a 4-year follow-up. The study used data from 5275 participants at baseline and on the first follow-up visit in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We applied a FFQ at baseline and identified UPF from NOVA classification of foods as to the extent and purpose of processing. The proportion (weight) of UPF in the total diet was calculated for each participant and categorised in tertiles, corresponding to low (first tertile), medium (second tertile) and high (third tertile) consumption. A mixed-effects logistic model was used to obtain the incidence of dyslipidaemia associated with the consumption of UPF. Individuals with medium and high consumption of UPF showed increases in the risks of development of isolated hypercholesterolaemia by 12 % (OR = 1·12, CI 1·00, 1·27) and 28 % (OR = 1·28, CI 1·12, 1·47), of isolated hypertriacylglycerolaemia by 14 % (OR = 1·14, CI 1·03, 1·26) and 30 % (OR = 1·30, CI 1·17–1·45), of mixed hyperlipidaemia by 21 % (OR = 1·21, CI 1·05, 1·39) and 38 % (OR = 1·38, CI 1·18, 1·62), and of low-HDL by 12 % (OR = 1·12, CI 1·00–1·24) and 18 % (OR = 1·18, CI 1·05, 1·32), respectively, compared with participants who consumed less UPF. Our findings showed important cardiovascular risk associated with the consumption of UPF and a gradient in the consumption’s effect, so these products should be discouraged.
This chapter explains how to design experiments to study black-box corporate surveillance systems. The chapter first examines the kinds of research questions that can be asked about corporate surveillance systems. Then, it describes different high-level study designs for transparency research, followed by a look at longitudinal studies and how they can be conducted. After examining the challenges that transparency researchers face in designing these experiments, the chapter focuses on input variables that are influenced and varied during an experiment, variables that are outside the experimenter's influence, and variables that are measured (response or output variables).