Longitudinal Studies

The development of imitation during the second year of life plays an important role in domains of socio-cognitive development such as language and social learning. Deficits in imitation ability in persons with autism spectrum disorder (ASD) have also been repeatedly documented from toddlerhood into adulthood, raising the possibility that early disruptions in imitation contribute to the onset of ASD and the deficits in language and social interaction that define the disorder. This study prospectively examined the development of imitation between 12 and 24 months of age in 154 infants at familial risk for ASD and 78 typically developing infants who were all later assessed at 36 months for ASD or other developmental delays. The study established a developmental measure of imitation ability, and examined group differences over time, using an analytic Rasch measurement model. Results revealed a unidimensional latent construct of imitation and verified a reliable sequence of imitation skills that was invariant over time for all outcome groups. Results also showed that all groups displayed similar significant linear increases in imitation ability between 12 and 24 months and that these increases were related to individual growth in both expressive language and ratings of social engagement, but not fine motor development. The group of children who developed ASD by age 3 years exhibited delayed imitation development compared to the low-risk typical outcome group across all time-points, but were indistinguishable from other high-risk infants who showed other cognitive delays not related to ASD.

Federal aviation regulations prohibit airline pilots from flying beyond the age of 60 years. However, the relation between pilot age and flight safety has not been rigorously assessed using empirical data. From 1987 to 1997, the authors followed a cohort of 3,306 commuter air carrier and air taxi pilots who were aged 45-54 years in 1987. During the follow-up period, the pilots accumulated a total of 12.9 million flight hours and 66 aviation crashes, yielding a rate of 5.1 crashes per million pilot flight hours. Crash risk remained fairly stable as the pilots aged from their late forties to their late fifties. Flight experience, as measured by total flight time at baseline, showed a significant protective effect against the risk of crash involvement. With adjustment for age, pilots who had 5,000-9,999 hours of total flight time at baseline had a 57% lower risk of a crash than their less experienced counterparts (relative risk = 0.43, 95% confidence interval: 0.21, 0.87). The protective effect of flight experience leveled off after total flight time reached 10,000 hours. The lack of an association between pilot age and crash risk may reflect a strong "healthy worker effect" stemming from the rigorous medical standards and periodic physical examinations required for professional pilots.

Rift Valley fever virus (RVFV) is an arthropod-borne phlebovirus reported to be circulating in most parts of Africa. Since 2009, RVFV has been suspected of continuously circulating in the Union of Comoros. To estimate the incidence of RVFV antibody acquisition in the Comorian ruminant population, 191 young goats and cattle were selected in six distinct zones and sampled periodically from April 2010 to August 2011. We found an estimated incidence of RVFV antibody acquisition of 17.5% (95% confidence interval (CI): [8.9-26.1]) with a significant difference between islands (8.2% in Grande Comore, 72.3% in Moheli and 5.8% in Anjouan). Simultaneously, a longitudinal entomological survey was conducted and ruminant traderelated information was collected. No RVFV RNA was detected out of the 1,568 blood-sucking caught insects, including three potential vectors of RVFV mosquito species. Our trade survey suggests that there is a continuous flow of live animals from eastern Africa to the Union of Comoros and movements of ruminants between the three Comoro islands. Finally, a cross-sectional study was performed in August 2011 at the end of the follow-up. We found an estimated RVFV antibody prevalence of 19.3% (95% CI: [15.6%-23.0%]). Our findings suggest a complex RVFV epidemiological cycle in the Union of Comoros with probable inter-islands differences in RVFV circulation patterns. Moheli, and potentially Anjouan, appear to be acting as endemic reservoir of infection whereas RVFV persistence in Grande Comore could be correlated with trade in live animals with the eastern coast of Africa. More data are needed to estimate the real impact of the disease on human health and on the national economy. Citation: Roger M, Beral M, Licciardi S, Soulé M, Faharoudine A, et al. (2014) Evidence for Circulation of the Rift Valley Fever Virus among Livestock in the Union of Comoros. PLoS Negl Trop Dis 8(7): e3045.

The longitudinal growth in stature for 509 males and 311 females was characterized from early childhood to adulthood. A triphasic generalized logistic (BTT) model (Bock et al. [1994] Chicago: SSI) was used through the AUXAL software program. Growth parameters were derived from the estimated distance and velocity curves for each individual. A set of estimated growth parameters, including adult stature, was selected to develop equations, through the forward stepwise regression method, for the prediction of adult stature for Japanese boys and girls. Am.

Compares conceptualizations of homelessness as a temporary state through which people pass or a permanent trait that emanates from individual characteristics. Evidence from a longitudinal study of 564 homeless families in New York City and additional secondary sources supports the view that for families, homelessness is a temporary state that is resolved by the provision of subsidized housing. Even for single individuals with severe mental disturbances, housing is a key factor in ending homelessness, although here there is more evidence that social services also contribute. Policy implications are that governments should take a more active role in reducing homelessness by providing access to subsidized housing.

results of a single neuropsychological test than when it is based on the results of more memory tests. In epidemiological studies and clinical trials the diagnosis of MCI will likely be more stable if impairment on more than one test is required for amnestic and/or nonamnestic domains.

The aim of the present study was to examine an adapted integrated psycho-social model to predict sport injury rehabilitation adherence. A longitudinal prospective design was used whereby 70 patients attending private physiotherapy clinics completed a battery of questionnaires both pre- and post-rehabilitation treatment based on the adapted framework. All participants were receiving treatment for tendonitis-related injuries. Adherence was monitored prospectively over the entire rehabilitation program using an observational measure of clinic adherence, a self-report measure of home-based adherence, in addition to monitoring attendance at rehabilitation sessions. In the initial phase of rehabilitation learning goal orientation, attitudes and perceived severity were found to predict rehabilitation intention. Intentions were also found to mediate the relationship between the aforementioned variables and clinic rehabilitation. Self-efficacy and self-motivation were predictors of clinic rehabilitation and attendance but not home rehabilitation. During the maintenance phase of rehabilitation coping ability and social support were predictors regarding all three measures of adherence. Implications for practitioners rehabilitating injured athletes are discussed.

To study incidence and distribution of deciduous molar ankylosis. study design: longitudinal retrospective study. A total of 512 consecutive subjects (aged 5 to 15 years) were examined at the Orthodontics and Paediatric Dentistry Department of the Genoa University School of Dentistry; for each subject an ortopantomography x-ray was taken. Thirty-four children were affected by deciduous molars ankylosis (6.6%). A statistically significant difference was revealed between the distributions: the lower deciduous molars were ankylosed more frequently than the upper ones (P < 0.001); the second deciduous molars were ankylosed more frequently than the first molars (P < 0.001). No statistical significance was found between sex and number of infraoccluded teeth (P = 0.74). This study found an incidence of deciduous molar ankylosis of about 6.6%; the lower deciduous molars and second deciduous molars were ankylosed more frequently (P < 0.001).

Survival rate of extremely low gestational age (ELGA) newborns has increased over 80% in the last 15 years, but its consequences on the short-and longer-term developmental competencies may be severe. The aim of this study was to describe growth trajectories of linguistic, motor and cognitive skills among ELGA children, compared to full-term (FT) peers, from the first to the third year of life, a crucial period for development. Growth curve analysis was used to examine individual and group differences in terms of initial status at 12 months and rate of growth through the second and the third year of life with five points of assessment. Twenty-eight monolingual Italian children, of whom 17 were ELGA (mean GA 25.7 weeks) and 11 were FT children, were assessed through the BSID-III at 12, 18, 24, 30 and 36 months for language skills and at 12, 24 and 30 months for motor and cognitive skills. ELGA children presented significantly lower scores than FT peers in language, motor and cognitive skills and they did not overcome their disadvantage by 3 years, even if their corrected age was taken into account. Concerning growth curves, in motor development a significant increasing divergence was found showing a Matthew effect with the preterm sample falling further behind the FT sample. In linguistic and cognitive development, instead, a stable gap between the two samples was found. In addition, great interindividual differences in rate of change were observed for language development in both samples. Our findings highlight the theoretical and clinical relevance of analyzing, through growth curve analyses, the developmental trajectories of ELGA children in language skills taking into account their inter-individual variability also across motor and cognitive domains.

Background  Extremely low and very low gestational age (ELGA and VLGA) constitutes a risk factor for development even in absence of cerebral damage, as an immature central nervous system is exposed to invasive and inadequate stimulation. We tested the hypothesis that GA impacts developmental outcomes and trajectories of preterms without major cerebral damage in the first 2 years of life, expecting poorer developmental outcomes and higher rate of impairment with the decreasing of GA. We also evaluated whether GA, together with developmental outcomes in the first year of life, was related to developmental outcomes at 24 months.Methods  Eighty-eight infants, divided into three GA groups (ELGA: ≤28 weeks; VLGA: 29–32 weeks; full term: >37 weeks) were assessed longitudinally at 6, 12, 18 and 24 months using the Griffiths Mental Development Scales.Results  Use of a repeated measure multivariate analysis of variance resulted in several significant findings. GA was associated with the developmental quotient (DQ) scores (P= 0.006); and locomotor (P < 0.001), eye and hand co-ordination (P= 0.016) and performance (P= 0.040) sub-scale quotient (SQ) scores; age of evaluation was also associated with DQ scores (P= 0.002), and locomotor (P < 0.001) and performance (P < 0.001) SQ scores. In particular, ELGAs exhibited lower DQ and SQ scores compared with the VLGA and full-term groups; some ELGAs showed mild, moderate or severe cognitive impairments, while few VLGAs mild impairments. Linear regression analysis showed that GA (P= 0.034) and 12-month developmental outcome (P < 0.001) were related to 24-month developmental outcome.Conclusions  Different developmental trajectories emerged in relation to GA, with poorer developmental outcomes and higher rates of impairment in ELGAs and few mild impairments in VLGAs. The relevance of taking into account both GA and repeated assessments in the first 2 years of life was shown.

We conducted a 3-wave, longitudinal study to examine the role of ethnic collective self-esteem and United States (U.S.) collective self-esteem on anxious-depressed symptoms over time among Asian and Latino immigrant-origin adolescents (n ϭ 171). Growth curve analysis revealed that anxious-depressed symptoms first decreased between 10th and 11th grade and then increased over time for both groups. Additionally higher levels of ethnic collective self-esteem were associated with lower levels of anxiousdepressed symptoms only for Asian adolescents. There was a differing pattern for U.S. collective self-esteem such that for Latino adolescents, higher U.S. collective self-esteem was associated with higher anxious-depressed symptoms, whereas for Asian adolescents there was an inverse relationship with anxious-depressed symptoms. The results expand the literature on ethnic and U.S. collective self-esteem and their link to mental health. Implications of the findings for research in general, and for counseling immigrant youth and families in particular, are discussed.

This study was meant to investigate the psychometric properties and clinical utility of the Lehrer Woolfolk Anxiety Symptom Questionnaire (LWASQ), an instrument for assessment of somatic, behavioral and cognitive aspects of anxiety. Confirmatory factor analysis on data from social phobics (n = 108), normal adults (n = 103) and normal adolescents (n = 650) showed that the three original factors were strongly replicated in each sample. The three subscales appeared to have high internal consistency, while data on convergent and divergent validity were satisfactory. In addition, the subscales did very well in discriminating between phobic patients and normals, and were able to detect treatment effects. In the discussion the instrument is compared with other self report measures of anxiety dimensions, like the Cognitive Somatic Anxiety Questionnaire (CSAQ) and the Worry-Emotionality Scale (WES). It is suggested that similar questionnaires, adjusted to the separate anxiety disorders, should be developed.

The current study, utilizing data from the National Early Head Start Research and Evaluation Project explored the relationship between biological father presence and emotion regulation over toddlerhood among children from low-income families. Conceptualizing biological father presence as a proxy for family role development, results are interpreted from a role development theoretical perspective. The latent growth curve model was compared based on child ethnoracial status (African American, Caucasian, Hispanic) and child gender. Consistent biological father presence was associated with toddlers' regulatory development across toddlerhood, and this relationship was most robust among Caucasian toddlers as compared to African American toddlers. Findings for Hispanic toddlers were not significantly different from those of Caucasian or African American families. Results bolster the literature on father presence and child outcomes. Analyses address consistency in father presence as a proxy for coherent role development and define a link between consistent father presence and children's regulatory development, demonstrating ethnoracial differences which are likely attributed to the social construction of family roles.

This study examined how parent-child communication regarding adolescent unsupervised activities develops over the course of adolescence. We used questionnaire data from 390 adolescents (58% girls; 90% European Canadian) who were followed from age 12 to 19. Latent growth curve modeling revealed curvilinear developmental changes that differed for boys and girls. From age 14 to 19 (but not from age 12 to 14) a linear decrease in parental control was found for both genders. For girls, parent-child communication decreased in early adolescence, as indicated by decreasing parental solicitation, decreasing adolescent disclosure, and increasing secrecy. Girls' communication with parents intensified in middle adolescence, as indicated by increasing parental solicitation, increasing adolescent disclosure, and decreasing adolescent secrecy. For boys, disclosure declined in early adolescence, but secrecy and solicitation were stable throughout adolescence. Parental knowledge decreased from age 12 to 19 for both genders but was temporarily stable for middle adolescent girls. The meaning of these developmental changes, their timing, and gender differences are discussed.

Using a sample of dental students (N=373) from four Canadian dental schools, this longitudinal study determined whether the new Canadian Dental Association (CDA) structured interview was a predictor of clinical and academic performance. The new interview predicted clinical performance in the third and fourth years of dental school, but not academic performance. The Canadian Dental Aptitude Test (DAT) continued to predict first- and second-year academic performance, but not clinical performance in the senior years. A personality factor, &quot;Conscientiousness,&quot; predicted clinical and academic performance to various degrees across the four years of dental school. A second personality factor, &quot;Openness to Experience,&quot; predicted third-year academic performance. The results suggest that a combination of scores from the DAT, a valid measure of personality, and a well-designed structured interview will provide the best prediction of those applicants who will do well in both...

Background: There is increasing recognition of the need to identify risk factors for poor mental health in pregnancy and following birth. In New South Wales, Australia, health policy mandates psychosocial assessment and depression screening for all women at the antenatal booking visit and at six to eight weeks after birth. Few studies have explored in-depth women's experience of assessment and how disclosures of sensitive information are managed by midwives and nurses. This paper describes women's experience of psychosocial assessment and depression screening examining the meaning they attribute to assessment and how this influences their response.

WADEY, R., L. EVANS, S. HANTON, and R. NEIL. Effect of Dispositional Optimism before and after Injury. Med. Sci. Sports Exerc., Vol. 45, No. 2, pp. 387-394, 2013. Purpose: This study examined the direct, moderating, and indirect effects of dispositional optimism on the prediction of, and athletes' responses to, injury. Methods: A 2-yr longitudinal design was conducted with a baseline sample of 694 asymptomatic participants (389 men, 305 women; mean T SD age = 19.17 T 1.69 yr), 104 of which subsequently became injured. Logistic regression, Pearson product-moment correlations, and a bootstrapping procedure were used to analyze the data. Results: Findings revealed a significant direct effect (i.e., as optimism increased, the likelihood of injury occurrence decreased) and a nonsignificant moderating effect for optimism before injury. Significant direct and indirect effects for optimism after injury were found. Conclusions: These findings have important implications for practitioners who have a vested interest in reducing the likelihood of injury and expediting the rate and quality of recovery from injury. Future avenues of research that include the need to embrace more objective indicators of recovery from injury are discussed.

This longitudinal research aimed to determine the utility of psychosocial and eating characteristics in early teenage years in predicting eating attitudes and behaviors in early adulthood. Self-esteem, perfectionism, family function, and eating attitudes were measured at 12 years and eating attitudes and behavior were assessed at 19 years. Sixty-three women (71.6%) remained in the study over the 7 years. Bulimic attitudes in early teenage years were related to subsequent bulimic features, while restrictive attitudes were more closely related to later purging behaviors. Self-esteem and perfectionism were only weakly linked with subsequent eating. However, different perceived family characteristics at the first stage were associated with specific aspects of eating in early adulthood. There is consistency of eating characteristics across time, but psychosocial characteristics have a more limited predictive power. Future longitudinal studies should begin earlier in childhood if psychoso...

Background: Isolated growth hormone deficiency (IGHD) provides the ideal model to characterize GHD without interference from other pituitary deficiencies or their treatment. No study has addressed the question whether adult patients with IGHD differ in clinical presentation or in responsiveness to GH replacement from adult patients with multiple pituitary hormone deficiencies (MPHD) receiving conventional replacement therapy. Patients and methods: Data were retrieved from the outcomes research database KIMS (Pfizer international metabolic database). Patients with IGHD accounted for 9.6% (274/2868) of all GHD patients. Patients were separated according to the timing of onset. In the adult-onset (AO) group, 167 patients with IGHD were compared to 1992 patients with MPHD. In the childhood-onset (CO) group, 107 patients with IGHD were compared to 602 patients with MPHD. To assess the effect of GH replacement after one year, a longitudinal sub-analysis in the AO group was performed comparing 89 IGHD patients to 1234 MPHD patients. The same study was done in the CO group comparing 66 IGHD patients to 386 MPHD patients. Because IGHD patients were significantly younger than MPHD patients, data analysis was also performed after adjustment for gender and age. Results: In the AO group, non-functioning and secreting pituitary adenomas were the most common primary diagnoses in both IGHD and MPHD. Medical history revealed a high prevalence of hypertension and fractures in both subgroups, but also of non-insulin dependent diabetes mellitus. The prevalence of obesity was high and the waist circumference was elevated. The lipid profile was unfavourable in both IGHD and MPHD. IGF-I concentration and SDS were comparable in both subgroup. Quality of life assessed by QoL-AGHDA was equally poor in both IGHD and MPHD. GH replacement therapy induced favourable changes without distinction.

Objectives: 1) profile the living environments and 2) examine the social and emotional outcomes of Australian children from Indigenous and cultural and linguistically diverse (CALD) backgrounds at school entry. Method: Secondary analysis of crosssectional data collected in Wave 1 of the Longitudinal Study of Australian Children (n=4,735). Child mental-health outcomes were measured using parent report of the Strengths and Difficulties Questionnaire (SDQ). Results: Significant differences in family and neighbourhood characteristics, including parental income, maternal education, maternal parenting quality and neighbourhood safety, were found in children of Indigenous and CALD backgrounds compared to the reference group of Australian-born, English-speaking children. After controlling for family and neighbourhood characteristics, significant differences in parent-reported SDQ total difficulties were found for Indigenous children. Significant differences in emotional difficulties and peer problems subscales were found for children with overseas-born mothers regardless of English proficiency.

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn.

Context: Accurate assessment of insulin sensitivity may better identify individuals at increased risk of cardio-metabolic diseases. Objectives: To examine whether a combination of anthropometric, biochemical and imaging measures can better estimate insulin sensitivity index (ISI) and provide improved prediction of cardio-metabolic risk, in comparison to HOMA-IR. Design and participants: Healthy male volunteers (96 Chinese, 80 Malay, 77 Indian), 21 to 40 years, body mass index 18230 kg/m 2. Predicted ISI (ISI-cal) was generated using 45 randomly selected Chinese through stepwise multiple linear regression, and validated in the rest using non-parametric correlation (Kendall's tau t). In an independent longitudinal cohort, ISI-cal and HOMA-IR were compared for prediction of diabetes and cardiovascular disease (CVD), using ROC curves. Setting: The study was conducted in a university academic medical centre. Outcome measures: ISI measured by hyperinsulinemic euglycemic glucose clamp, along with anthropometric measurements, biochemical assessment and imaging; incident diabetes and CVD. Results: A combination of fasting insulin, serum triglycerides and waist-to-hip ratio (WHR) provided the best estimate of clamp-derived ISI (adjusted R 2 0.58 versus 0.32 HOMA-IR). In an independent cohort, ROC areas under the curve were 0.7760.02 ISI-cal versus 0.7660.02 HOMA-IR (p.0.05) for incident diabetes, and 0.7460.03 ISI-cal versus 0.6160.03 HOMA-IR (p,0.001) for incident CVD. ISI-cal also had greater sensitivity than defined metabolic syndrome in predicting CVD, with a four-fold increase in the risk of CVD independent of metabolic syndrome. Conclusions: Triglycerides and WHR, combined with fasting insulin levels, provide a better estimate of current insulin resistance state and improved identification of individuals with future risk of CVD, compared to HOMA-IR. This may be useful for estimating insulin sensitivity and cardio-metabolic risk in clinical and epidemiological settings.

Trabalho de pesquisa quantitativo realizado com 42 discentes de uma instituição pública de ensino superior, utilizando-se a técnica do Toque Terapêutico - Método Krieger-Kunz e aplicação de um questionário validado no Brasil para avaliar a ansiedade durante três sessões. Os sujeitos foram alocados em dois grupos: experimental (1), em que receberam a terapia complementar; e controle (2), em que foram submetidos a imitação da técnica sem intenção terapêutica. O objetivo foi identificar a influência gradativa desta terapia complementar de saúde no que se refere ao estado de ansiedade dos estudantes. A análise dos dados revelou uma redução estatisticamente significativa do estado de ansiedade em ambos os grupos, com pd&quot; 0,05.

IMPORTANCE The requirement of a childhood onset has always been a key criterion for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults, but recently this requirement has become surrounded by controversy. OBJECTIVE To investigate whether impaired young adults with ADHD symptoms always have a childhood-onset disorder in a population-based longitudinal study. DESIGN, SETTING, AND PARTICIPANTS Participants belonged to the 1993 Pelotas Birth Cohort Study, including 5249 individuals born in Pelotas, Brazil, in 1993. They were followed up to 18 to 19 years of age, with 81.3% retention. The data analysis was performed between August 8, 2015, and February 5, 2016. MAIN OUTCOMES AND MEASURES The ADHD status was first ascertained at 11 years of age using a screening instrument (hyperactivity subscale of the Strength and Difficulties Questionnaire) calibrated for a DSM-IV ADHD diagnosis based on clinical interviews with parents using the Development and Well-Being Assessment. At 18 to 19 years of age, ADHD diagnosis was derived using DSM-5 criteria, except age at onset. We estimated the overlap between these groups assessed at 11 and 18 to 19 years of age and the rates of markers of impairment in these 2 groups compared with those without ADHD. RESULTS At 11 years of age, childhood ADHD (C-ADHD) was present in 393 individuals (8.9%). At 18 to 19 years of age, 492 individuals (12.2%) fulfilled all DSM-5 criteria for young adult ADHD (YA-ADHD), except age at onset. After comorbidities were excluded, the prevalence of YA-ADHD without comorbidities decreased to 256 individuals (6.3%). Children with C-ADHD had a male preponderance not observed among children without ADHD (251 [63.9%] vs 1930 [47.9%] male, P < .001), whereas the YA-ADHD group had a female preponderance (192 [39.0%] vs 1786 [50.4%] male, P < .001). Both groups had increased levels of impairment in adulthood, as measured by traffic incidents, criminal behavior, incarceration, suicide attempts, and comorbidities. However, only 60 children (17.2%) with ADHD continued to have ADHD as young adults, and only 60 young adults (12.6%) with ADHD had the disorder in childhood. CONCLUSIONS AND RELEVANCE The findings of this study do not support the assumption that adulthood ADHD is necessarily a continuation of childhood ADHD. Rather, they suggest the existence of 2 syndromes that have distinct developmental trajectories.

The parietal lobe (PL) supports cognitive domains, including attention and memory, which are impaired in bipolar disorder (BD). Although cross-sectional voxel-based morphometry studies found reduced PL grey matter (GM) in BD, none has longitudinally focused on PL anatomy in BD, relating it to patients&#39; functioning. Thirty-eight right-handed BD patients and 42 matched healthy subjects (HS) underwent a Magnetic Resonance Imaging (MRI) scan at baseline. Seventeen BD patients and 16 matched HS underwent a follow-up MRI. PL white matter (WM) and GM volumes were measured. The trajectory of parietal volumes over time and the possible relation with the global functioning were investigated in both BD patients and HS. At baseline, BD patients showed significant reduced PL WM and GM and different WM laterality compared with HS. Furthermore, smaller PL WM volumes predicted lower global functioning in BD, but not in HS. At follow-up, although BD patients reported reduced PL WM compared with ...

Aim: To investigate whether children with autistic spectrum disorder (ASD) have bowel symptoms consistent with underlying enterocolitis. Methods: Information on children's stool patterns and gut symptoms collected by questionnaire at 4 weeks and at 6, 18, 30 and 42 months of age were available for

In this review we summarize the epidemiological, cross-sectional, and interventional studies examining the association between physical activity and brain volume, function, and risk for Alzheimer's disease. The epidemiological literature provides compelling evidence that greater amounts of physical activity are associated with a reduced risk of dementia in late life. In addition, randomized interventions using neuroimaging tools have reported that participation in physical activity increases the size of prefrontal and hippocampal brain areas, which may lead to a reduction in memory impairments. Consistent with these findings, longitudinal studies using neuroimaging tools also find that the volume of prefrontal and hippocampal brain areas are larger in individuals who engaged in more physical activity earlier in life. We conclude from this review that there is convincing evidence that physical activity has a consistent and robust association with brain regions implicated in age-related cognitive decline and Alzheimer's disease. In addition to summarizing this literature we provide recommendations for future research on physical activity and brain health.

In the US, it is currently estimated that 3% of pregnant women have chronic hypertension, or more than 100,000 pregnant women each year. The aim of our study was to investigate the adaptation of autonomic control during pregnancy based on heart rate variability analysis and to determine whether chronic hypertension during pregnancy has an impact on this adaptation. Sixteen pregnant women with chronic hypertension (CH group; mean age, 30 years; range, 25-33 years) and 35 healthy pregnant women serving as controls (CON group; mean age, 28 years; range, 24-30 years) were recruited for this longitudinal study. Beginning at the 20th week of pregnancy, the women were monitored every 4th week until delivery. For the analysis of heart rate variability, Portapres signals (200 Hz) were recorded for 30 min under resting conditions. Women in the CH group had significantly elevated blood pressure compared to controls (CON, 111 mmHg [105-132]; CH, 140 mmHg [132-148]; p <0.001). An increased heart rate was found in both groups during the second half of pregnancy. Consequently, decreased heart rate variability was observed, but was more pronounced in the CON group. There was a shift in the frequency bands indicated by an elevation of the low-to-high frequency ratio (LF/HF) in both groups due to a decrease in HF, and thus a significant increase in LFn (LF power in normalized units). However, VLF (power of very low frequency range) increased exclusively in the CON pregnancies. Our data showed no significant difference in heart rate variability between the subjects of the CH and CON groups. Longitudinal variations were detectable in normal pregnancies and also, albeit to a lesser degree, in chronic hypertensive pregnant women. Thus, our data indicate that patients with long-term hypertension are still able to respond to the physiological changes occurring during pregnancy.

for the Lifeways Cross-generation Cohort Study Steering Group BACKGROUND/OBJECTIVES: Animal models have demonstrated that maternal overnutrition during pregnancy influences offspring adiposity. Few human studies of normal pregnancy have replicated these findings. We examined the association between child body mass index at age 5 years and maternal nutrient intake during pregnancy and 5 years postpartum. SUBJECTS/METHODS: Five-year-old children (n ¼ 585) and their mothers were recruited during pregnancy from two maternity hospitals in Ireland. Data are from the Lifeways Cross-Generation Cohort study with detailed dietary information obtained during pregnancy and postpartum using a food frequency questionnaire. Nutrient intake was adjusted for energy intake (EI) and expressed in quartiles. Heights and weights were measured when the children were aged 5 years. We performed multivariate logistic regression analyses to examine the independent associations of macronutrients (protein, fat and carbohydrate) and their components (saturated fatty acid (SFA)/monounsaturated fatty acid/polyunsaturated fatty acid and sugar/starch) with child overweight/obesity. Associations were examined for nutrient intake during pregnancy (T1), at 5 years postpartum (T2) and the change in nutrient intake between T1 and T2. RESULTS: Total mean (s.d.) EI was significantly higher during pregnancy (2548 ± 1239 kcal) than 5 years postpartum (2084±718 kcal). Increased odds of overweight/obesity were found in mothers with higher intakes of sugar at T1 (Q4 odds ratio (OR): 4.57, 95% confidence interval (CI): 1.01-20.69) and high intakes of SFA at T2 (Q4 OR: 3.35, 95% CI: 0.97-11.57). Mothers with persistently high intakes of SFA and those who reduce their sugar intake between T1 and T2 were more likely to have overweight/ obese children. CONCLUSION: Maternal prenatal sugar and pre/postnatal SFA was associated with offspring adiposity.

The aim of this 10-year clinical trial was to evaluate the treatment outcome (condition of hard and soft peri-implant tissues, patient satisfaction, surgical and prosthetic aftercare) of mandibular overdentures supported by two or four implants. Materials and methods: Sixty edentulous patients with a mandibular height between 12 and 18 mm participated. Thirty patients were treated with an overdenture supported by two IMZ implants (group A) and 30 patients were treated with an overdenture supported by four IMZ implants (group B). Standardised clinical and radiographic parameters were evaluated 6 weeks after completion of the prosthetic treatment and after 1, 5 and 10 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period, as well as patient satisfaction. Results: There were no statistically significant differences with regard to any of the studied clinical or radiographic parameters of the peri-implant tissues between the groups. In addition, no differences in satisfaction and aftercare were observed between the groups. Conclusion: There is no difference in the clinical and radiographical state of patients treated with an overdenture on two or four implants during a 10-year evaluation period. Patients of both groups were evenly satisfied with their overdentures and received the same amount of aftercare. For reasons of cost-effectiveness, a two-implant overdenture is advised for patients with a Cawood classes IV-VI resorption of the mandible and complaints concerning retention and stability of the lower denture.

Changes in body morphology of anorectic girls during illness as well as during the treatment period were studied using data on 23 anthropometric traits. The sample consisted of 20 adolescent girls, aged 16.05 +/- 2.21 years. Girls with shorter duration of anorexia nervosa have larger amounts of fat and muscle tissue on the upper arm, as well as thicker subcutaneous fat tissue of the trunk, than the girls with longer duration of illness. These differences remain even after the treatment period. Growth rate of girls with longer duration of illness has been decreased. Slight changes in the latent structure of body morphology in anorectic girls at the end of hospitalisation in comparison with those at the beginning of hospitalisation were observed. The above-mentioned changes could have resulted from greater relative increase of fat than muscular tissue mass during hospitalisation and possible difference in the sequence of fat gain between the trunk and the extremities. Further studies ...

Diabetes" and related "Health Beliefs Concerning Diabetes" (Bradley's questionnaires, 1984), a fully randomized short-of structured outpatient education for Functional Insulin Treatment (FIT: selective insulin dosages for eating, fasting or term controlled Study 1 (four weeks, 32 patients), and longterm uncontrolled pilot Study 2 (three years, 68 patients) were correcting hyperglycaemia) on perceived control over diabetes and related health beliefs. FIT was thought to influence the performed. Results: The short-term study revealed that FIT induced the feeling of independence from situational control perception of self-efficacy in diabetes, in contrast to conventional treatment, based on scheduled, rigid food intake and while self-managing diabetes. In the long-term study, the patients were increasingly freed from the feeling of being under insulin delivery-it allows flexible eating, provided independent control of glycemia. Methods: Structured, comprehen-the control of physician and treatment-related restrictions, which-together with higher perceived self-efficacy-con-sive, outpatient group training in FIT for selective use of insulin either for eating, fasting or correction included practi-tributed to the feeling of "empowerment." This was associated with high treatment satisfaction and significant improvement cal "insulin games." The FIT program focused on everyday criteria for choices of insulin dosages and thus on the patient's of glycemic control. Conclusion: Structured out-patient group training for FIT results in measurable improvement of pa-ability to execute his/her newly gained flexible treatment to his/her everyday life while preventing acute and late complica-tients' perceived control over diabetes and self-efficacy.

Objective. To investigate the clinical features of idiopathic headache with early onset, whose presence is probably underestimated by parents and physicians and the influence of environmental and psychological factors on headache in children.

Background and Objectives: Prior research suggests that parents' monitoring behaviors are related to the conduct problems of children but not to the conduct problems of children with callous-unemotional traits. However, these studies have been cross-sectional. The present short-term longitudinal study investigates the bidirectional influences of parental monitoring and youth problem behaviors, while also examining the potential moderating influence of callous-unemotional traits.

AIM To develop an algorithmic approach to identify item sets of the 66-item version of the Gross Motor Function Measure (GMFM-66) to be administered to individual children, and to examine the validity of the algorithm for obtaining a GMFM-66 score.