A systematic review of cognitive functioning among young people who have experienced homelessness, foster care, or poverty

Young people who have experienced homelessness, foster care, or poverty are among the most disadvantaged in society. This review examines whether young people who have these experiences differ from their non-disadvantaged peers with respect to their cognitive skills and abilities, and whether cognitive profiles differ between these three groups. Three electronic databases were systematically searched for articles published between 1 January 1995 and 1 February 2015 on cognitive functioning among young people aged 15 to 24 years who have experienced homelessness, foster care, or poverty. Articles were screened using pre-determined inclusion criteria, then the data were extracted, and its quality assessed. A total of 31 studies were included. Compared to non-disadvantaged youth or published norms, cognitive performance was generally found to be impaired in young people who had experienced homelessness, foster care, or poverty. A common area of difficulty across all groups is working memory. General cognitive functioning, attention, and executive function deficits are shared by the homeless and poverty groups. Creativity emerges as a potential strength for homeless young people. The cognitive functioning of young people with experiences of impermanent housing and poverty has been relatively neglected and more research is needed to further establish cognitive profiles and replicate the findings reviewed here. As some aspects of cognitive functioning may show improvement with training, these could represent a target for intervention

An investigation of changes in children′s mental health in Wales between 2007/2008 and 2012/2013

Improving children’s mental well-being is a recognised public health priority, but evidence on recent trends is lacking. This study updates evidence on differences in child mental health since 2008 by comparing two nationally representative cohorts in Wales, UK. Parents of 4-12 year old children completed the Strength and Difficulties Questionnaire (SDQ). No significant differences were seen for younger girls between 2007/2008 and 2012/2013. There was a decrease in conduct, hyperactivity and total difficulties symptom scores and an increase in prosocial scores for boys’ and older girls. These findings suggest that rates of child mental health problems are stable or falling

Executive functions in homeless young people: working memory impacts on short-term housing outcomes

Most homeless young people have experienced multiple adversities, with potential implications for the development of Executive Functions (EFs), higher-order cognitive processes important for adaptation. EFs have been identified as putative contributors to the capacity to exit homelessness, however, little research has investigated EFs in homeless young people. To address gaps in current knowledge, this study compared executive function performance between homeless and housed young people. Relationships between EFs and short-term housing outcomes were also explored. Sixty-eight homeless young people (16–19 years) and 37 age-matched housed young people participated in this study. Computerized EF tasks spanned the domains of working memory, set shifting/flexibility, planning, impulsivity/risky decision making, selective attention/inhibition, and verbal fluency. Homeless young people demonstrated worse performance than housed youth on several EF tasks, particularly working memory and impulsivity/risky decision making. Working memory predicted progression into more independent accommodation; those with longer working memory spans were twice as likely to have progressed to more independent housing rather than maintained their current housing status after six months. Poorer EFs are associated with youth homelessness and also with an individual’s ability to progress towards independence. As such, EFs should not continue to be overlooked by researchers and service providers. Emerging adulthood, as a sensitive period for EF development, is an opportune time for intervention to increase the likelihood of positive housing outcomes in homeless young people

Incidence and prevalence of lumbar stress fracture in English County Cricket fast bowlers, association with bowling workload and seasonal variation

Objectives Since much of the previous epidemiological research into lumbar stress fracture was conducted, there has been a marked increase in the amount of cricket being played. The aims were to determine the incidence and prevalence of lumbar stress fracture in English County Cricket fast bowlers between 2010 and 2016, determine the association with match bowling workload and observe seasonal variation in workload and injury. Methods Lumbar stress fracture incidence and prevalence rates were calculated using new international methods for epidemiology in 368 professional English fast bowlers from 2010 to 2016. Workload variables were compared between lumbar stress fracture case and non-injured control groups, before entry in a logistic regression. Results Fifty-seven lumbar stress fractures (mean age 22.81) were reported. Injury was most common in July and September. Match incidence was 0.16 lumbar stress fractures per 10 000 deliveries, annual incidence was 2.46 lumbar stress fractures per 100 fast bowlers and annual prevalence of lumbar stress fractures was 1.67% of squad days. Significant workload variables were observed between cases and controls. A peak 7-day workload of greater than 234 deliveries significantly increased the odds of sustaining a lumbar stress fracture 11-fold compared with bowling fewer than 197 deliveries. Conclusion Lumbar stress fractures are common in young fast bowlers possibly due to immaturity of the lumbar spine. The condensed early and late-season schedule may be causing periods of overuse, resulting in an increase in incidence of lumbar stress fracture. Reduction of workload in young fast bowlers is needed to reduce incidence

DISTANCE RUNNERS IN APPALACHIA: A SURVEY OF INJURIES, TRAINING, AND DIETARY HABITS

Objectives: The purpose was to examine characteristics of an Appalachian population of runners. The primary aim was to examine risk factors for running related injury (RRI), including mileage per week, experience, and use of applications/training programs. A second aim was to characterize dietary habits among runners. Methods: This study was conducted in September 2015 in North Central Appalachian West Virginia. The Morgantown Marathon consists of three races offered every September: an 8K, half marathon, and full marathon. Surveys were offered to runners ages 18 and older during packet pick-up. For this survey study, questions consisted of multiple choice and open-ended responses, including demographics, injury history, nutrition habits, and training questions. Results: In September 2015, 444 runners completed the survey. Runners with moderate experience (2-5 years) and running moderate weekly mileage (21-30 miles) had higher RRI. Reported RRI was similar for runners using an app, online program, or local or online coaching (20-29%). In our study, most runners reported following a balanced diet or eating “whatever”. Runners following a vegan diet reported the lowest RRI (0%) while those following gluten free diets reported the highest (45%). Conclusions: Increasing weekly running mileage and use of a training program did not appear to be associated with RRI. Most runners followed a balanced diet or eating “whatever,” while those following a vegan diet appeared to have lower reported RRI. Additional larger studies are needed to better characterize these findings and to identify trends in this population

Pastoral Neolithic Settlement at Luxmanda, Tanzania

The later Holocene spread of pastoralism throughout eastern Africa profoundly changed socio-economic and natural landscapes. During the Pastoral Neolithic (ca. 5000–1200 B.P.), herders spread through southern Kenya and northern Tanzania—areas previously occupied only by hunter-gatherers—eventually developing the specialized forms of pastoralism that remain vital in this region today. Research on ancient pastoralism has been primarily restricted to rockshelters and special purpose sites. This paper presents results of surveys and excavations at Luxmanda, an open-air habitation site located farther south in Tanzania, and occupied many centuries earlier, than previously expected based upon prior models for the spread of herding. Technological and subsistence patterns demonstrate ties to northerly sites, suggesting that Luxmanda formed part of a network of early herders. The site is thus unlikely to stand alone, and further surveys are recommended to better understand the spread of herding into the region, and ultimately to southern Africa

Profiling depression in childhood and adolescence: the role of conduct problems

Background Depression is typically more common in females and rates rise around puberty. However, studies of children and adolescents suggest that depression accompanied by conduct problems may represent a different subtype not characterised by a female preponderance, with differing risk factors and genetic architecture compared to pure-depression. This study aimed to identify aetiologically distinct profiles of depressive symptoms, distinguished by the presence or absence of co-occurring conduct problems. Methods Latent profile analysis was conducted on a school sample of 1648 children (11–12 years) and replicated in a sample of 2006 twins (8–17 years). Results In both samples pure-depressive and conduct-depressive profiles were identified. The pure-depressive profile was associated with female gender, while the conduct-depressive profile was associated with lower cognitive ability but not with gender. Twin analyses indicated possible differences in genetic aetiology. Conclusions There was evidence for aetiologically heterogeneous depression symptom profiles based on the presence or absence of co-occurring conduct problems

Profiling depression in childhood and adolescence: the role of conduct problems

Background: Depression is typically more common in females and rates rise around puberty. However, studies of children and adolescents suggest that depression accompanied by conduct problems may represent a different subtype not characterised by a female preponderance, with differing risk factors and genetic architecture compared to pure-depression. This study aimed to identify aetiologically distinct profiles of depressive symptoms, distinguished by the presence or absence of co-occurring conduct problems. Methods: Latent profile analysis was conducted on a school sample of 1648 children (11-12 years) and replicated in a sample of 2006 twins (8-17 years). Results: In both samples pure-depressive and conduct-depressive profiles were identified. The pure-depressive profile was associated with female gender, while the conduct-depressive profile was associated with lower cognitive ability but not with gender. Twin analyses indicated possible differences in genetic aetiology. Conclusions: There was evidence for aetiologically heterogeneous depression symptom profiles based on the presence or absence of co-occurring conduct problems

How to do it: the neurological consultation with an autistic patient

Autism is a neurodevelopmental condition with a very heterogeneous presentation. Autistic people are more likely to have unmet healthcare needs, making it essential that healthcare professionals are ‘autism-aware’. In this article, we provide an overview of how autism presents and use case studies to illustrate how a neurological consultation in an outpatient clinic environment could prove challenging for a autistic person. We suggest how to improve communication with autistic patients in clinic and highlight the importance of a patient-centred and flexible approach