Intergenerational continuity and discontinuity in cognitive ability: the first offspring of the British 1946 birth cohort

Cognitive development in childhood is a key factor affecting adult life chances, including educational and occupational success. Intergenerational continuity in cognitive ability is often observed. Thus the persistence of poor cognitive outcomes across generations may lead to a ‘cycle of disadvantage’ that is difficult to break. In this thesis, intergenerational associations in cognitive ability between parents and first-born offspring were examined longitudinally. 1,690 members of the British 1946 birth cohort with at least one offspring constituted the study sample. Cognitive ability was measured at age eight years in parents and offspring. Social mobility and parenting practices were examined for their affects on the transmission of cognitive ability across generations. Offspring of parents who improved upon the occupational social class of their own fathers by the time they were aged 26, as well as offspring of parents who remained in a non-manual class, had higher cognitive scores than those whose parents remained in a manual social class, or who showed negative intergenerational mobility. Upwardly mobile and stable non-manual parents were also more likely to use positive parenting practices. Four measures of parenting were shown to mediate part of the intergenerational relationship in cognitive ability. The intellectual home environment, parental aspirations and cognitive stimulation were positively related with cognitive outcomes in the second generation, while coercive discipline was negatively associated with offspring ability. Path analyses revealed that maternal education, but not occupation, was an important predictor of offspring cognition. The educational attainment of fathers indirectly influenced the cognitive development of the next generation through its effect on occupational social class. For those parents with the lowest and highest ability scores, the quality of the intellectual environment enabled their offspring to ‘escape’ or replicate parental cognitive ability respectively. Cognitive stimulation and paternal aspirations helped offspring to avoid repeating the poor cognitive outcomes of their parents. These data add to the relatively few studies that examine intergenerational continuity and discontinuity in cognitive ability. The results provide a basis for understanding some of the processes by which parenting practices may influence intergenerational relationships

Pathways to "opportunity and excellence": collaborative curriculum innovation in South Yorkshire

This paper reports on two aspects of a large-scale curriculum project currently taking place in four LEAs in South Yorkshire. The first of these is concerned with the positive and negative influences on effective curriculum innovation and is addressed from the perspective of the LEA project managers who are managing the delivery of the project in the region's schools. The second aspect considers what the pupils (Year 10, age 14-15) think about the new learning opportunities. The project is set in the context of regional regeneration. The paper concludes that the extremely positive responses from the sample of pupils in all three strands of the programme indicate that the greater emphasis on vocational work and work experience in schools is having a strong motivational effect on pupils who are responding with improved attendance, behaviour and achievement.</p

Exploring Cold War Religious Persecution Using the Rank-Order Approach

This lesson explores religious persecution in East Germany. Students must decide plausible actions to take against the Protestant Church to diminish power. Acting as a member of The East German Secret Police, students, evaluate, rank, and justify decisions to minimalize Christianity in an atheist society

Enhanced Safety Surveillance of Influenza Vaccines in General Practice, Winter 2015-16: Feasibility Study

BACKGROUND: The European Medicines Agency (EMA) requires vaccine manufacturers to conduct enhanced real-time surveillance of seasonal influenza vaccination. The EMA has specified a list of adverse events of interest to be monitored. The EMA sets out 3 different ways to conduct such surveillance: (1) active surveillance, (2) enhanced passive surveillance, or (3) electronic health record data mining (EHR-DM). English general practice (GP) is a suitable setting to implement enhanced passive surveillance and EHR-DM. OBJECTIVE: This study aimed to test the feasibility of conducting enhanced passive surveillance in GP using the yellow card scheme (adverse events of interest reporting cards) to determine if it has any advantages over EHR-DM alone. METHODS: A total of 9 GPs in England participated, of which 3 tested the feasibility of enhanced passive surveillance and the other 6 EHR-DM alone. The 3 that tested EPS provided patients with yellow (adverse events) cards for patients to report any adverse events. Data were extracted from all 9 GPs' EHRs between weeks 35 and 49 (08/24/2015 to 12/06/2015), the main period of influenza vaccination. We conducted weekly analysis and end-of-study analyses. RESULTS: Our GPs were largely distributed across England with a registered population of 81,040. In the week 49 report, 15,863/81,040 people (19.57% of the registered practice population) were vaccinated. In the EPS practices, staff managed to hand out the cards to 61.25% (4150/6776) of the vaccinees, and of these cards, 1.98% (82/4150) were returned to the GP offices. Adverse events of interests were reported by 113 /7223 people (1.56%) in the enhanced passive surveillance practices, compared with 322/8640 people (3.73%) in the EHR-DM practices. CONCLUSIONS: Overall, we demonstrated that GPs EHR-DM was an appropriate method of enhanced surveillance. However, the use of yellow cards, in enhanced passive surveillance practices, did not enhance the collection of adverse events of interests as demonstrated in this study. Their return rate was poor, data entry from them was not straightforward, and there were issues with data reconciliation. We concluded that customized cards prespecifying the EMA's adverse events of interests, combined with EHR-DM, were needed to maximize data collection. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2016-015469

Lewy bodies and neuronal loss in subcortical areas and disability in non-demented older people: a population based neuropathological cohort study.

BACKGROUND: Functional disability, the loss of ability to carry out daily tasks unaided, is a major adverse outcome more common with increasing age. The potential contribution of neuropathological changes in subcortical areas of the brain associated with normal ageing may be a contributing factor to this loss of function. This study investigates the clinicopathological relationship between functional ability during life and pathological correlates identified at post mortem in an UK population of older people (66-102 years).The aim is to examine the clinicopathological correlates of functional disability in subcortical neuronal populations of non-demented elderly individuals. METHODS: 156 non-demented participants in the brain donation programme of the Medical Research Council Cognitive Function and Ageing Study (MRC-CFAS) were included in this study. Neuropathological examination was based on the CERAD protocol; pathologies of interest were amyloid plaques, neurofibrillary tangles, Lewy bodies, vascular disease and neuronal loss. Self-reported functional ability was scored according to a combined activities of daily living and instrumental activities of daily living scale. RESULTS: Functional disability was equally common in men and women over 65 years, and in both sexes disability was more common at older ages. Neuronal loss in several subcortical regions elevated the risk of functional disability by three-fold (95% CI 1.3-6.6). There was evidence for a relationship between Lewy bodies in the SN and functional disability. CONCLUSION: Neuronal loss in subcortical regions is associated with functional disability in the older population. The causal relationships are not defined and require further investigation

Psychometric properties of the five-level EuroQoL-5 dimension and Short Form-6 dimension measures of health-related quality of life in a population of pregnant women with depression

BACKGROUND: Although evidence suggests that the EuroQoL-5 dimension (EQ-5D) and Short Form-6 dimension (SF-6D) have equivalent psychometric properties in people with depression, there is some evidence that the EQ-5D may lack responsiveness in certain populations with depression. AIMS: To examine the psychometric properties of the five-level EQ-5D (EQ-5D-5L) and SF-6D measures of health-related quality of life in a representative sample of pregnant women with depression. METHOD: Data were taken from a cohort of pregnant women identified at or soon after the first antenatal care contact and followed-up at 3 months postpartum. Health-related quality of life was measured using both the EQ-5D-5L and the SF-6D at baseline and follow-up. We examined acceptability and conducted psychometric validation in the aspects of concurrent validity, convergent validity, known-group validity and responsiveness in 421 women with available data. RESULTS: The EQ-5D-5L and SF-6D have similarly high levels of acceptability. However, concurrent validation shows a lack of concordance between the EQ-5D-5L and SF-6D. The EQ-5D-5L tends to be higher than the SF-6D in individuals with better health states. The SF-6D tends to be higher than EQ-5D-5L in individuals with poorer health states. Convergent and known-group validity are comparable between the two utility measures. Longitudinally, women who recovered show larger increase in SF-6D utilities than those who did not recover at follow-up. With the EQ-5D-5L, this is not the case. Additionally, the ceiling effects were more apparent in the EQ-5D-5L. CONCLUSIONS: The effectiveness of perinatal mental health interventions may be better captured by the SF-6D than the EQ-5D-5L but this needs to be cross-validated in more studies. DECLARATION OF INTEREST: L.M.H. chaired the National Institute for Health and Care Excellence CG192 guidelines development group on antenatal and postnatal mental health in 2012-2014. L.M.H. reports grants from NIHR, MRC, Nuffield and the Stefanou Foundation, UK. K.T., M.H. and S.B. report funding by NIHR and the Stefanou Foundation, UK