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Evidence shows that having a drink of water can improve cognitive performance in schoolchildren. This study investigated whether water consumption would improve a range of tasks requiring both cognitive and fine motor skills. Participants were 85 children (37 boys, 48 girls, mean age 10.1 years, SD = 0.6) attending a primary school in the UK. Children completed finger-tapping, bead threading, and handwriting tasks at baseline and test. They were divided into two groups; one group was offered a 500-ml bottle of water after baseline tasks were completed and the other group was not. The drink group were given 5 min to consume the water and they could choose how much to drink. We also recorded the volume of water consumed in order to consider dose response relationships. Participants in both groups were given a 25-min break, during which they could read quietly, before repeating the tasks at test. Results showed that the participants who were given a drink, regardless of volume, had faster handwriting speed at test than those who did not. Correlations between volume drunk and changes in performance from baseline to test showed there was a positive relationship between volume drunk and improvement in finger-tapping speed. These results show that the simple intervention of giving children a drink of water has a beneficial effect on fine motor skills, and handwriting, which is an integral activity in school.

BACKGROUND Trans-thoracic echo (TTE) is a commonly performed non-invasive investigation for the cardiovascular assessment of critically ill patients in the Intensive Care Unit (ICU). Raised cardiac biomarkers are commonly cited as an indication for TTE, however the significance of these biomarker elevations in the critical care setting is unclear. PURPOSE The aim of this study was to describe findings on TTE in an Irish ICU cohort and to determine if there was any correlation between these findings and serum N-terminal pro b-type natiuretic (NT-proBNP) and high sensitivity troponin T (HsTnT) levels. METHODS Patients admitted to the ICU and who received a TTE between January 2018 and February 2019 were identified. Based on TTE findings, patients were divided into two groups: ‘Normal group’ and ‘Abnormal group’. For the purpose of this study, minor abnormalities including concentric left ventricular hypertrophy, diastolic dysfunction and hyper-dynamic left ventricular function were included in the Normal group. The Abnormal group included reductions in LV function, regional wall motion abnormalities and significant valvular heart disease. Continuous variables were expressed as medians and interquartile range. The groups were compared using the z-test for continuous variables and fishers exact test for categorical variables, with a p value of < 0.05 considered significant. RESULTS There were 358 patients admitted to the ICU during the study period. The mean age was 59.8 ± 17 years and over half of the patients (55%) were male. One hundred and fifteen patients (32%) had a reported TTE, of which 55% were normal and 22% had minor abnormalities (Normal group). The remaining 23% showed significant abnormalities (Abnormal group). The prevalence of a NT-proBNP result over 4 times the upper limit of normal (>4xULN) was not significantly different between groups (67% in Normal group vs 71% in Abnormal group, Fisher exact test statistic value is 0.7887, p < .05). However a HsTnT value >4xULN was more common in the Abnormal group than the Normal group (73% vs 46%, Fisher exact test statistic value is 0.0231, p < .05). Similarly, Median NT-proBNP did not differ significantly between the groups; (2254pg/mL; IQR: 11,758 in the Normal group vs 6428pg/mL; IQR: 5,789 in the Abnormal group, p = 0.52218) but Median HsTnT level was significantly higher in the Abnormal group than Normal group; (123ng/L ; IQR: 656 vs 51ng/L; IQR: 163.5 ,p = 0.0278). CONCLUSION TTE is performed commonly in the ICU, with one-third of ICU admissions receiving a TTE. Over 75% were reported as normal or showing only minor abnormalities. NT-Pro BNP was commonly significantly elevated but did not correlate with the subsequent diagnostic yield of significant abnormalities on echocardiography. HsTnT levels were more commonly significantly raised in patients with abnormal TTE results and the role of troponin in this setting requires further evaluation.

Transoesophageal echocardiography (TOE) is frequently performed in patients following a cryptogenic stroke or transient ischaemic attack (TIA). The aim of this single centre study was to determine the diagnostic yield of TOE in cases referred following a stroke or TIA, & to clarify whether findings differed based on evidence of an acute ischaemic cerebral event on MRI or CT. We also sought to assess the prevalence of patent foramen ovale (PFO) in this population and whether they would meet the inclusion and exclusion criteria for recent PFO closure trials. Methods We retrospectively analysed TOE cases performed in our centre for assessment of an embolic source of a stroke or TIA between November 2017 &amp November 2018. Patients who did not have cerebral imaging in our centre were excluded from this study. Baseline, demographic, clinical, & technical data were collected for all patients using our IT system & a database was formed. Significant findings on TOE were defined as left atrial appendage (LAA) thrombus, left ventricular thrombus, patent foramen ovale & grade 3–4 aortic arch atheroma. Results Our analysis included 189 TOEs during the study period, 20 of these patients were excluded due to incomplete imaging. The study includes 169 TOE cases. Baseline characteristics of the study included, mean age 60.7 years (range; 23–84), female 50.3%. 49.7% (n=84) of patients had a lesion on MRI with diffusion weighed imaging (DWI +), (DWI + MRI: 49.7% v DWI - MRI: 50.2%) (table 1). Significant findings on TOE were identified more commonly in patients with evidence of an acute lesion on MRI DWI, (47% v 31%, p value=0.01996). 1 left atrial appendage thrombus was identified in a MRI DWI+ case, this required initiation of anticoagulation. A PFO was identified in 13% of cases (n=22). Prevalence of PFO did not differ between the DWI+ and DWI - cohorts (15.4% vs 12.9%, p=NS). Only 13.6% of PFO’s identified (n=3, 1.7% of total cohort) were eligible for PFO closure based on hierarchal application of the REDUCE and CLOSE trial criteria. (Table 2). Conclusion Over half of patients referred for work-up of TOE to rule out an embolic source for a stroke/TIA do not have MRI evidence of an acute ischaemic cerebral event. As such their prior probability of relevant abnormalities being identified on TOE is decreased. Physicians should take this prior probability into account when reporting TOEs in the setting of TIA/Stroke. PFOs were identified in a smaller than expected number of patients in our cohort. Care must be taken when interpreting the significance of a PFO in these patients, particularly in those who do not meet the criteria for PFO closure. We determined a statistically significant increase in diagnostic yield and explanation for TIA/stroke aetiology on TOEs performed in patients with objective evidence of cerebral ischaemia. However TOE identified minimal findings that led to a change in patient therapeutic management.

Background Takotsubo Cardiomyopathy (TCM) is an acute cardiac condition independent of epicardial coronary obstruction, mimicking an acute coronary syndrome and is characterised by acute heart failure with reversible ventricular wall motion abnormalities. It is associated with a wide variety of physical, psychological and emotional stressors. Patients admitted to the intensive care unit (ICU) are exposed to significant stressors and so may be at an increased risk of developing TCM. There are limited data outlining the prevalence of TCM in the ICU. As a result the quoted figures vary considerably in the literature, with reported prevalences ranging from 0.9 to 28%. In this study, we sought to define the prevalence of regional wall motion abnormalities consistent with TCM in patients admitted to the ICU in our centre. Methods A retrospective cross sectional study was performed in our centre. This included all patients admitted to the Intensive Care Unit in Tallaght University Hospital over a 13 month period: January 2018 - February 2019. Baseline, demographic, clinical, laboratory and technical data was collected for all patients using our IT system and a database was formed. An independent cardiologist retrospectively reviewed all echocardiograms performed within the study period. Results There were 358 patients admitted to the ICU during the study period. The mean age was 59.8±17 years, over half of the patients (55%) were male. One hundred and fifteen patients (32%) had a reported transthoracic echocardiogram on our system. Of these echocardiograms 58 (50%) were reported as completely normal and 27 (23%) had minor abnormalities, including concentric left ventricular (LV) hypertrophy, n=12; hyper-dynamic LV function, n=6; diastolic dysfunction, n=9. Significant abnormalities were identified in 25 cases (22%). These included moderate-severe reductions in LV function, n=9; and LV hypokinesia/akinesia/dyskinesia, n=16. Of the 16 patients with LV hypokinesia/akinesia/dyskinesia, 10 had new regional wall motion abnormalities (RWMA) potentially consistent with TCM. Indications for ICU admission within this group included: urosepsis, respiratory sepsis, ischemic bowel, acute pancreatitis and seizures. Only 3 of these patients (0.84% of total ICU admissions) had a repeat echocardiogram confirming recovery of RWMA consistent with TCM. The majority of these patients had no follow up echocardiogram (N=7). Of note, 50% of this cohort did not survive to discharge. Of the 10 patients with potential or confirmed TCM, the ICU length of stay was longer when compared to all other ICU admissions for the same period (Median 17.36 days, IQR 15.83 vs 3.79 days, IQR 7.13, p=0.00694). The rate of survival to hospital discharge rate was numerically lower in this cohort but this did not reach statistical significance (50% vs 68%, p=0.169). Conclusion Echocardiography was performed on one-third of patients admitted to the ICU. Of these echocardiograms, 73% of studies were reported as normal or showing only minor abnormalities. Wall motion abnormalities potentially consistent with TCM were identified in 3% of all patients admitted to the intensive care unit. Two-thirds of patients with new or indeterminate RWMA in the ICU did not receive follow up investigations. As such, RWMA consistent with TCM were confirmed in only 3 patients, resulting in a prevalence of 0.84% in our study population. A more standardised approach may help determine the true prevalence of this condition.

Introduction The use of subcutaneous implantable cardioverter defibrillators (S-ICD) in patients at risk of sudden cardiac death is increasing. S-ICDs were designed to avoid the potential morbidity and mortality associated with transvenous pacing leads. The ESC guidelines recommend a class IIa indication for S-ICD to be considered as an alternative to transvenous ICD, in patients with an indication for an ICD, when pacing therapy for bradycardia support, cardiac resynchronization or antitachycardia pacing is not needed. Currently, 64% of US centres are using general anaesthetic (GA) for these procedures. Using GA increases the risk of complications both during and after implantation and also presents a resource issue, necessitating an anaesthetist for the duration of the procedure. In this abstract, we report the anaesthesia approach and safety for S-ICD implantation in our centre. 10 S-ICDs have been successfully implanted in our centre between February 2016 and April 2019. The majority of these were male (80%) with an average age of 46.5±12.54 years. Six patients underwent implantation with a combination of conscious sedation with Midazolam and Fentanyl and local anaesthetic. Four patients received regional anaesthesia, provided by our anaesthetics colleagues. Two patients required GA for defibrillation testing (DT). Six patients were successfully discharged on the day of the procedure. Two patients were kept for observation and pain control and both patients who received S-ICDs as inpatients for secondary prevention remained admitted. Conclusion The experience from our centre is that the majority of patients tolerate S-ICD with a combination of local anaesthetic and conscious sedation with or without regional anaesthesia. This minimizes potential complications related to GA and avoids the necessity of having an anaesthetist present for the duration of the procedure, optimizing the use of hospital resources.

Even in infancy children from low-SES backgrounds differ in frontal cortex functioning and, by the start of pre-school, they frequently show poor performance on executive functions including attention control. These differences may causally mediate later difficulties in academic learning. Here, we present a study to assess the feasibility of using computerized paradigms to train attention control in infants, delivered weekly over five sessions in early intervention centres for low-SES families. Thirty-three 12-month-old infants were recruited, of whom 23 completed the training. Our results showed the feasibility of repeat-visit cognitive training within community settings. Training-related improvements were found, relative to active controls, on tasks assessing visual sustained attention, saccadic reaction time, and rule learning, whereas trend improvements were found on assessments of short-term memory. No significant improvements were found in task switching. These results warrant further investigation into the potential of this method for targeting ‘at-risk’ infants in community settings.

Background: \ud Past research suggests children with Down syndrome often lack awareness of their disability despite the visibility of their condition.\ud \ud Method: \ud This study used novel tasks to investigate their insight. Twenty‐eight young people with Down syndrome (aged 8–17 years) were recruited, along with control groups of 67 typically developing young people. Three tasks explored the children's awareness of Down syndrome: (a) choice of partner for social activities, (b) sorting photographs and (c) attributing positive or negative descriptors to photographs.\ud \ud Results: \ud All participants expressed a preference to engage in social activities with typically developing peers. Most participants with Down syndrome identified with the typically developing person. Even though all participants attributed more positive descriptors to the photographs of the typically developing individuals, they remained positive about themselves.\ud \ud Conclusion: \ud The early awareness of difference shown by young people with Down syndrome suggests this may play an important role in their developing identities.

Public expenditure on large events such as the London 2012 Olympic Games is often justified by the potential legacy of urban regeneration and its associated health and well-being benefits for local communities. In the Olympic Regeneration in East London Study, we examined whether there was an association between urban regeneration related to the 2012 Games and improved mental health in young people. Adolescents aged 11-12 years attending schools in the Olympic host borough of Newham in London or in 3 adjacent comparison London boroughs completed a survey before the 2012 Games and 6 and 18 months after the Games (in 2013 and 2014, respectively). Changes in depressive symptoms and well-being between baseline and each follow-up were examined. A total of 2,254 adolescents from 25 randomly selected schools participated. Adolescents from Newham were more likely to have remained depressed between baseline and the 6- and 18-month follow-up surveys (for 6-month follow-up, relative risk = 1.78, 95% confidence interval: 1.12, 2.83; for 18-month follow-up, relative risk = 1.93, 95% confidence interval: 1.01, 3.70) than adolescents from the comparison boroughs. No differences in well-being were observed. There was little evidence that urban regeneration had any positive influence on adolescent mental health and some suggestion that regeneration may have been associated with maintenance of depressive symptoms. Such programs may have limited short-term impact on the mental health of adolescents.

Objective—This paper aims to review findings from a longitudinal study of prenatal methylenedioxymethamphetamine (MDMA, “ecstasy”) on infant development. Methods—In a prospective, longitudinal cohort design, we followed 28 MDMA-exposed and 68 non-MDMA-exposed infants from birth to 2 years of age. Women recruited voluntarily into a study of recreational drug use during pregnancy were interviewed to obtain type, frequency, and amount of recreational drug use. Their children were followed for a 2-year period after birth. A large number of drug and environmental covariates were controlled. Infants were seen at 1, 4, 12, 18, and 24 months using standardized normative tests of mental and motor development. Results—There were no differences between MDMA-exposed and non-MDMA-exposed infants at birth except that MDMA-exposed infants were more likely to be male. Motor delays were evident in MDMA infants at each age and amount of MDMA exposure predicted motor deficits at 12 months in a dose-dependent fashion. Conclusions—Prenatal MDMA exposure is related to fine and gross motor delays in the first 2 years of life. Follow-up studies are needed to determine long-term effects.

Background. Research shows that school environment impacts significantly on students’ mental health, future aspirations and feelings of school connectedness, which in turn can improve academic outcomes. The UK has seen rising numbers of academy schools in recent years which have been scrutinised for academic performance but overlooked in terms of important aspects of school environment. Aim. This study compares outcomes for mental health, school connectedness and future aspirations in low-socioeconomic status adolescents attending academy and non-academy schools. Sample. Data came from 1,284 11-16yr olds attending one of 67 academy or non-academy schools from areas of deprivation in London. 639 complete cases were analysed. Method. Self-reported measures of school connectedness, future aspirations and mental health, including self-esteem, were analysed and compared using linear regression clustered at school level, adjusting for the effects of gender, ethnicity, school year and affluence. Results. Adolescents attending academies were found to have significantly higher levels of school connectedness than those at non-academy schools. No direct effect of academies on mental health or aspirations was found, however school connectedness had a significant, mediating effect on pro-social mental health scores. Academies in this sample can therefore be said to indirectly increase levels of mental health by increasing levels of school connectedness. Conclusion. These findings highlight the importance of school connectedness for adolescent wellbeing and suggest that academies can be more successful in promoting levels of school connectedness which can then impact positively on individual mental health. More work needs to be done on identifying the structures and processes at work.

BackgroundPreterm birth may leave the brain vulnerable to dysfunction. Knowledge of future neurodevelopmental delay in children born with various degrees of prematurity is needed to inform practice and policy. ObjectiveTo quantify the long-term cognitive, motor, behavioural and academic performance of children born with different degrees of prematurity compared with term-born children. Search strategyPubMed and Embase were searched from January 1980 to December 2016 without language restrictions. Selection criteriaObservational studies that reported neurodevelopmental outcomes from 2 years of age in children born preterm compared with a term-born cohort. Data collection and analysisWe pooled individual estimates of standardised mean differences (SMD) and odds ratios (OR) with 95% confidence intervals using a random effects model. Main resultsWe included 74 studies (64 061 children). Preterm children had lower cognitive scores for FSIQ (SMD: -0.70; 95% CI: -0.73 to -0.66), PIQ (SMD: -0.67; 95% CI: -0.73 to -0.60) and VIQ (SMD: -0.53; 95% CI: -0.60 to -0.47). Lower scores for preterm children in motor skills, behaviour, reading, mathematics and spelling were observed at primary school age, and this persisted to secondary school age, except for mathematics. Gestational age at birth accounted for 38-48% of the observed IQ variance. ADHD was diagnosed twice as often in preterm children (OR: 1.6; 95% CI: 1.3-1.8), with a differential effect observed according to the severity of prematurity (I-2 = 49.4%, P = 0.03). ConclusionsPrematurity of any degree affects the cognitive performance of children born preterm. The poor neurodevelopment persists at various ages of follow up. Parents, educators, healthcare professionals and policy makers need to take into account the additional academic, emotional and behavioural needs of these children. Tweetable abstractAdverse effect of preterm birth on a child's neurodevelopment persists up to adulthood. Tweetable abstract Adverse effect of preterm birth on a child's neurodevelopment persists up to adulthood

This article reports findings among adolescents of the impact of Well London, a program of wellbeing interventions delivered across 20 deprived neighbourhoods of London using a community engagement model. Twelve hundred and fifty-four adolescents were surveyed from matched intervention and control areas. There was no significant intervention effect on the main outcome measures: unhealthy eating, physical activity, and mental health. Factors influencing the results may include the possibility that the communities defined by the cluster randomized controlled trial (CRCT) were not an accurate reflection of the adolescent’s natural community, and interactions within the school environment in particular could have led to a dilution of effect.

In this paper, we describe the measures of intervention exposure used in the cluster randomised trial of the Well London programme, a public health intervention using community engagement and community-based projects to increase physical activity, healthy eating and mental health and well-being in 20 of the most deprived neighbourhoods in London.10 No earmarked resources to support the development of these measures and associated data collection were provided to either the research team or to those delivering the interventions on the ground. Instead, these were derived from contractually specified performance management information reported quarterly by partners and by inclusion of questions seeking information about participation in the follow-up questionnaires used to measure the main trial outcomes. The exposure measures are consequently considerably less sophisticated than those used in the US studies, where earmarked funding was available.

Objective The illicit recreational drug 3,4-methylenedioxymethamphetamine (MDMA) or Ecstasy has strong neurohormonal effects. When taken by recreational users at dance clubs and raves, it can generate an 800% increase in the stress hormone cortisol, whereas drug-free users show chronically raised levels of cortisol. The aim here is to critically debate this neurohormonal influence for the children of pregnant MDMA-using mothers. Methods High levels of cortisol are known to be damaging for neuropsychobiological well-being in adult humans. MDMA can damage foetal development in laboratory animals, and the prospective Drugs and Infancy Study was established to monitor the effects of MDMA taken recreationally by pregnant women. Results The Drugs and Infancy Study revealed that young mothers, who took MDMA during the first trimester of pregnancy, gave birth to babies with significant gross psychomotor retardation . These mothers would have experienced high levels of cortisol due to Ecstasy/MDMA use, and since cortisol can cross the placenta, this is likely to have also occurred in the foetus. Conclusions In terms of causation, the developmental problems may reflect a combination of neurotransmitter and neurohormonal effects on the hypothalamic–pituitary–adrenal axis, with serotonergic activity being influenced by the high levels of cortisol. Copyright © 2014 John Wiley & Sons, Ltd. key words—Ecstasy; MDMA; cortisol; stress; hormone; pregnancy

Young infants are capable of integrating auditory and visual information and their speech perception can be influenced by visual cues, while 5-month-olds detect mismatch between mouth articulations and speech sounds. From 6 months of age, infants gradually shift their attention away from eyes and towards the mouth in articulating faces, potentially to benefit from intersensory redundancy of audiovisual (AV) cues. Using eye tracking, we investigated whether 6- to 9-month-olds showed a similar age-related increase of looking to the mouth, while observing congruent and/or redundant versus mismatched and non-redundant speech cues. Participants distinguished between congruent and incongruent AV cues as reflected by the amount of looking to the mouth. They showed an age-related increase in attention to the mouth, but only for non-redundant, mismatched AV speech cues. Our results highlight the role of intersensory redundancy and audiovisual mismatch mechanisms in facilitating the development of speech processing in infants under 12 months of age.

Across many academic disciplines visualisation and notation systems are used for modelling data and developing theory, but in child development visual models are not widely used; yet researchers and students of developmental difficulties may benefit from a visualisation and notation system which can clearly map developmental outcomes and trajectories, and convey hypothesised dynamic causal pathways. Such a system may help understanding of existing accounts and be a tool for developing new theories. We first present criteria that need to be met in order to provide fully nuanced visualisations of development, and discuss strengths and weaknesses of the visualisation system proposed by Morton. Secondly, we present a tool we have designed to give more precise accounts of development while also being accessible, intuitive and visually appealing. We have called this an Accessible Cause-Outcome Representation and Notation System (ACORNS). This system provides a framework for clear mapping and modelling of developmental sequences, illustrating more precisely how functions change over time, how factors interact with the environment, and the absolute and relative nature of causal outcomes. We provide a new template, a set of rules for the appropriate use of boxes and arrows, and a set of visually accessible indicators that can be used to show more precisely relative rates, degrees and variance of functioning over different capacities at different time points. We have designed ACORNS to give a precise and clear visualisation of how development unfolds; allowing the representation of less 'static' and more transactional models of developmental difficulties. We hope ACORNS will help students, clinicians and theoreticians across disciplines to better represent nuances of debates, and be a seed for the development of new theory.

Background Many measures of infants' early cognitive development, including the BSID-II (The Bayley Scales of Infant Development), mix together test items that assess a number of different developmental domains including language, attention, motor functioning and social abilities, and some items contribute to the assessment of more than one domain. Consequently, the scales may lead to under- or over-estimates of cognitive abilities in some clinical samples and may not be the best measure to use for matching purposes.\ud Method To address this issue we created a modified form of the BSID-II (the BSID-M) to provide a ‘purer’ assessment of the general cognitive capacities in infants with Down syndrome (DS) from 6 to 18 months of age. We excluded a number of items that implicated language, motor, attentional and social functioning from the original measure. This modified form was administered to 17 infants with Down syndrome when 6, 12 and 18 months old and to 41 typically developing infants at 4, 7 and 10 months old. \ud Results The results suggested that the modified form continued to provide a meaningful and stable measure of cognitive functioning and revealed that DS infants may score marginally higher in terms of general cognitive abilities when using this modified form than they might when using the standard BSID-II scales. \ud Conclusions This modified form may be useful for researchers who need a ‘purer’ measure with which to match infants with DS and other infants with intellectual disabilities on cognitive functioning.

There has been limited study of how the constitutional characteristics of infants with Down syndrome (DS) influence the patterning of their relations with caregivers. To assess natural and perturbed interactions between infants with DS and their mothers, we tested ten 6-month-old infants with DS and 20 typically developing (TD) 4-month-old of similar mental age. Participants were videotaped with their mothers in a natural face-to-face interaction, a brief period when the mothers adopted a still-face, and a subsequent reengagement phase. There was little to distinguish the infants in the initial phase of natural interaction, but the mothers of infants with DS were more likely to show assertive warmth, and unlike in the case of mothers of TD infants, high maternal directiveness tended to be associated with lower levels of infant looking and lack of fussing. During the still-face episode, infants of both groups showed reduced looking and smiling, although infants with DS tended to show lower levels of fussing and fewer in this group showed fussing in the reengagement phase. Therefore DS infants were somewhat similar to TD infants of comparable mental age in being responsive to the still-face procedure, but showed indications of group differences in intense emotional reactivity.

Recent work suggests that differences in functional brain development are already identifiable in 6- to 9-month-old infants from low socio-economic status (SES) backgrounds. Investigation of early SES-related differences in neuro-cognitive functioning requires the recruitment of large and diverse samples of infants, yet it is often difficult to persuade low-SES parents to come to a university setting. One solution is to recruit infants through early intervention children’s centres (CCs). These are often located in areas of high relative deprivation to support young children. Given the increasing portability of eye-tracking equipment, assessment of large clusters of infants could be undertaken in centres by suitably trained early intervention staff. Here, we report on a study involving 174 infants and their parents, carried out in partnership with CCs, exploring the feasibility of this approach. We report the processes of setting up the project and participant recruitment. We report the diversity of sample obtained on the engagement of CC staff in training and the process of assessment itself. We report the quality of the data obtained, and the levels of engagement of parents and infants. We conclude that this approach has great potential for recruiting large and diverse samples worldwide, provides sufficiently reliable data and is engaging to staff, parents and infants.

Infant sleep undergoes significant re-organization throughout the first 12 months of life, with sleep quality having significant consequences for infant learning and cognitive development. While there has been great interest in the neural basis and developmental trajectories of infant sleep in general, relatively little is known about individual differences in infant sleep and the socio-economic and cultural sources of that variability. We investigated this using questionnaire sleep data in a large, unique multi-ethnic sample of 6–7 month-olds (n = 174), with families from South Asian ethnic groups in the UK (Indian, Pakistani and Bangladeshi) being especially well represented. Consistent with previous data from less variable samples, no effects of SES on sleep latency or nocturnal sleep duration emerged. However, perinatal risk factors and ethnic differences did predict daytime sleep, sleep fragmentation and sleep-onset time. While these results should be interpreted with caution due to several limitations, they likely demonstrate that even when socio-economic status and ethnicity are much less confounded than in previous studies, they have a surprisingly limited impact on individual differences in sleep patterns in young infants.

Background:\ud Recreational use of 3,4 methylenedioxymethamphetamine (ecstasy, MDMA) is increasing worldwide. Its use by pregnant women causes concern due to potentially harmful effects on the developing fetus. MDMA, an indirect monoaminergic agonist and reuptake inhibitor, affects the serotonin and dopamine systems. Preclinical studies of fetal exposure demonstrate effects on learning, motor behavior, and memory. In the first human studies, we found prenatal MDMA exposure related to poorer motor development in the first year of life. In the present study we assessed the effects of prenatal exposure to MDMA on the trajectory of child development through 2 years of age. We hypothesized that exposure would be associated with poorer mental and motor outcomes.\ud \ud Materials and Methods:\ud The DAISY (Drugs and Infancy Study, 2003–2008) employed a prospective longitudinal cohort design to assess recreational drug use during pregnancy and child outcomes in the United Kingdom. Examiners masked to drug exposures followed infants from birth to 4, 12, 18, and 24 months of age. MDMA, cocaine, alcohol, tobacco, cannabis, and other drugs were quantified through a standardized clinical interview. The Bayley Scales (III) of Mental (MDI) and Motor (PDI) Development and the Behavior Rating Scales (BRS) were primary outcome measures. Statistical analyses included a repeated measures mixed model approach controlling for multiple confounders.\ud \ud Results:\ud Participants were pregnant women volunteers, primarily white, of middle class socioeconomic status, average IQ, with some college education, in stable partner relationships. Of 96 women enrolled, children of 93 had at least one follow-up assessment and 81 (87%) had ≥ two assessments. Heavier MDMA exposure (M = 1.3 ± 1.4 tablets per week) predicted lower PDI (p < .002), and poorer BRS motor quality from 4 to 24 months of age, but did not affect MDI, orientation, or emotional regulation. Children with heavier exposure were twice as likely to demonstrate poorer motor quality as lighter and non-exposed children (O.R. = 2.2, 95%, CI = 1.02–4.70, p < .05).\ud \ud Discussion:\ud Infants whose mothers reported heavier MDMA use during pregnancy had motor delays from 4 months to two years of age that were not attributable to other drug or lifestyle factors. Women of child bearing age should be cautioned about the use of MDMA and MDMA-exposed infants should be screened for motor delays and possible intervention.

Adolescents from areas of high deprivation are often assumed to have low aspirations for the future. However, recent research has suggested otherwise and there have been calls for more substantial investigation into the relationship between poverty and aspiration. This article reports levels and variation in aspiration from 1214 adolescents (49.5 % male; 50.5 % female) living in areas of high deprivation across 20 London boroughs. A strength of this study is our large and diverse population of low socio-economic status (SES) adolescents, comprising of white British (22 %), black African (21 %), black Caribbean (9 %), Indian/Pakistani/Bangladeshi/Other Asian (24 %), mixed ethnicity (9 %), and 15 % defining themselves as Other. Our measures indicated a high group level of reported aspiration with notable variations. Females reported higher educational (but not occupational) aspirations than males; white British students reported lower educational and occupational aspirations than other ethnic groups; and black African children reported the highest educational aspirations. Perceived parental support for education had the largest positive association with aspirations. In contrast to previous findings from studies carried out in the United States, aspirations were found to be negatively associated with perceptions of school and school peer environment. These measures explored feelings of safety, happiness and belonging within the school environment and school peer group. We discuss possible explanations for this unexpected finding within our population of adolescents from UK state schools and how it might affect future policy interventions. This study makes an important contribution to the literature on adolescent aspirations because of the unique nature of the data sample and the multiple domains of functioning and aspiration measured.

This study aimed to explore the perception of different components of biological movement in individuals with autism and Asperger syndrome. The ability to recognize a person's actions, subjective states, emotions, and objects conveyed by moving point-light displays was assessed in 19 participants with autism and 19 comparable typical control participants. Results showed that the participants with autism were as able as controls to name point-light displays of non-human objects and human actions. In contrast, they were significantly poorer at labeling emotional displays, suggesting that they are specifically impaired in attending to emotional states. Most studies have highlighted an emotional deficit in facial expression perception; our results extend this hypothesized deficit to the perception and interpretation of whole-body biological movements.

This paper brings together extensive data from 257 children to explore the relative importance of social-environmental factors during critical periods of children's musical development. The paper also presents preliminary findings from a follow-up of 20 of the most musically successful children 8 years later to determine which childhood factors predict differences in success as adult performers. Those children who continued to play an instrument started at an early age, had higher parental support in lessons, and had first teachers who were friendly but not too technically able. However, these factors alone were not sufficient to predict relative success in childhood. Successful childhood musicians also appear to need teachers who are 'not too relaxed' and also 'not too pushy' and they also need to do substantial amounts of practice. The follow-up study suggested, though, that successful adult performers were not those who did the most practice; rather, the successful adults were those who took part in more concert activities in childhood, did more improvisation, and who had mothers at home in their early years. The results are discussed in relation to theories of musical development and the changing influences of parents, teachers and peers.

Children's understanding of properties of the earth was investigated by interviewing Asian and white British classmates aged 4-8 years (N = 167). Two issues were explored: whether they held mental models of the earth (Vosniadou & Brewer, 1992) or instead had fragmented knowledge (di Sessa, 1988); and the influence of the children's different cultural backgrounds. Children selected from a set of plastic models and answered forced-choice questions. Using this methodology, there were no significant differences in the overall performance of Asian and white children after language skills were partialled out. Even young children showed an emerging knowledge of some properties of the earth, but the distributions of their combinations of responses provided no evidence that they had mental models. Instead, these distributions closely resembled those that would be expected if children's knowledge in this domain were fragmented Possible reasons for the differences between these findings and those of previous research are discussed.

Background:\ud Populations living in urban areas experience greater health inequalities as well as higher absolute burdens of illness. It is well-established that a range of social and environmental factors determine these differences. Less is known about the relative importance of these factors in determining adolescent health within a super diverse urban context.\ud \ud Methods:\ud A cross-sectional sample of 3,105 adolescent participants aged 11 to 12 were recruited from 25 schools in the London boroughs of Newham, Tower Hamlets, Hackney and Barking & Dagenham. Participants completed a pseudo-anonymised paper-based questionnaire incorporating: the Warwick-Edinburgh Mental Well-being Scale used for assessing positive mental well-being, the Short Moods and Feelings Questionnaire based on the DSM III-R criteria for assessment of depressive symptoms, the Youth-Physical Activity Questionnaire and a self-assessment of general health and longstanding illness. Prevalence estimates and unadjusted linear models estimate the extent to which positive well-being scores and time spent in physical/sedentary activity vary by socio-demographic and environmental indicators. Logistic regression estimated the unadjusted odds of having fair/(very)poor general health, a long standing illness, or depressive symptoms. Fully adjusted mixed effects models accounted for clustering within schools and for all socio-demographic and environmental indicators.\ud \ud Results:\ud Compared to boys, girls had significantly lower mental well-being and higher rates of depressive symptoms, reported fewer hours physically active and more hours sedentary, and had poorer general health after full adjustment. Positive mental well-being was significantly and positively associated with family affluence but the overall relationship between mental health and socioeconomic factors was weak. Mental health advantage increased as positive perceptions of the neighbourhood safety, aesthetics, walkability and services increased. Prevalence of poor health varied by ethnic group, particularly for depressive symptoms, general health and longstanding illness suggesting differences in the distribution of the determinants of health across ethnic groups.\ud \ud Conclusions:\ud During adolescence perceptions of the urban physical environment, along with the social and economic characteristics of their household, are important factors in explaining patterns of health inequality.

Visualisation and notation systems are widely used in science to provide a tool with which to map, compare and debate models and theories. Visualisation aids understanding by representing, specifying and simplifying what is complex or unseen. This in turn can make conceptual frameworks easier to understand and may bring new rigour to a discipline by ensuring a greater level of precision in theoretical debate. Furthermore, an engaging and accessible form of visualisation can help disciplines communicate complexity to a wider public audience in an engaging and accessible way. One well-known example of a visualisation tool is the ball-and-stick model used in chemistry. This provides a universal framework for representing bonds between atoms and modelling the physical structure of molecules. This system is not simply descriptive, but provides a theory-neutral tool to map, compare and propose a range of structures, starting positions and outcomes of reactions under a variety of diff erent conditions. It is hard to imagine how chemistry could function without this universal visualisation system, and how limited scientifi c and pedagogical understanding would be if chemists did not have this tool. Notation is the use of icons, symbols, letters and numbers as a means of providing additional information over multiple dimensions, linked with the other components of the visualisation. Notation is used in chemistry but is most widely encountered in music, which uses a score to represent time and pitch; variations in the form of a musical note (open, block, tailed) to indicate diff erent numbers of beats, clusters of notes to represent chords, and linked letters and symbols to indicate dimensions such as volume or attack.

Background: We report the main results, among adults, of a cluster-randomised-trial of Well London, a community engagement programme promoting healthy eating, physical activity and mental well-being in deprived neighbourhoods. The hypothesis was that benefits would be neighbourhood-wide, and not restricted to intervention participants.The trial was part of a multi-component process/outcome evaluation which included non-experimental components (self-reported behaviour change amongst participants, case studies and evaluations of individual projects) which suggested health, well-being and social benefits to participants.\ud Methods: Twenty matched pairs of neighbourhoods in London were randomised to intervention/control condition. Primary outcomes (five portions fruit/vegetables/day; 5x30 min of moderate intensity physical activity/week, abnormal General Health Questionnaire (GHQ)-12 score and Warwick–Edinburgh Mental Well-being Scale (WEMWBS) score) were measured by post-intervention questionnaire survey, among 3986 adults in a random sample of households across neighbourhoods.\ud Results: There was no evidence of impact on primary outcomes: healthy eating (relative risk [RR] 1.04, 95% CI 0.93 to 1.17); physical activity (RR:1.01, 95% CI 0.88 to 1.16); abnormal GHQ12 (RR:1.15, 95% CI 0.84 to 1.61); WEMWBS (mean difference [MD]: −1.52, 95% CI −3.93 to 0.88). There was evidence of impact on some secondary outcomes: reducing unhealthy eating-score (MD: −0.14, 95% CI −0.02 to 0.27) and increased perception that people in the neighbourhood pulled together (RR: 1.92, 95% CI 1.12 to 3.29).\ud Conclusions: The trial findings do not provide evidence supporting the conclusion of non-experimental components of the evaluation that intervention improved health behaviours, well-being and social outcomes. Low participation rates and population churn likely compromised any impact of the intervention. Imprecise estimation of outcomes and sampling bias may also have influenced findings. There is a need for greater investment in refining such programmes before implementation; new methods to understand, longitudinally different pathways residents take through such interventions and their outcomes, and new theories of change that apply to each pathway.

This study is an investigation of the role of some key characteristics of teachers in the development of students' musical ability. Interviewing 257 children who differed in the extent of their instrumental mastery, we discovered that the most successful learners regarded their teachers differently from those children who ceased music study. The more successful learners rated their first teacher higher than did other learners on personal dimensions such as friendliness, and rated their current teacher higher than did other learners on task-oriented professional dimensions such as pushiness. Additionally, the highly successful learners studied, on average, with more teachers than did the other learners; these learners also generally received more individual instruction than did the children who eventually ceased lessons. These findings confirm the importance of matching teacher characteristics to the changing requirements of learners in enabling the development of high levels of musical expertise. © 1998 by Music Educators National Conference.

Background: The recreational drug MDMA (3,4-methylenedioxymethamphetamine) or ‘Ecstasy’ is associated with heightened psychiatric distress and feelings of depression. The Drugs and Infancy Study (DAISY) monitored the psychiatric symptom profiles of mothers who used Ecstasy/MDMA while pregnant, and followed them over the first year post-partum. Methods: We compared 28 young women whom took MDMA during their pregnancy with a polydrug control group of 68 women who took other psychoactive drugs while pregnant. The Brief Symptom Inventory (BSI) was completed for several periods: The first trimester of pregnancy; and 1, 4 and 12 months after childbirth. Recreational drug use was monitored at each time point. Results: During the first trimester of pregnancy, MDMA-using mothers reported higher depression scores than the polydrug controls. At 1 year after childbirth, their BSI depression scores were significantly lower, now closer to the control group values. At the same time point, their self-reported use of MDMA became nearly zero, in contrast to their continued use of Cannabis/marijuana, nicotine and alcohol. We found significant symptom reductions in those with BSI obsessive-compulsive and interpersonal sensitivity, following Ecstasy/MDMA cessation. Conclusions: The findings from this unique prospective study of young recreational drug-using mothers are consistent with previous reports of improved psychiatric health after quitting MDMA.

This study is an attempt to analyse whether there may be separable components to the human ability to perceive people as people who engage in actions and who have attitudes. We adopted the approach of developmental psychopathology. Matched groups of typically developing, autistic and non-autistic retarded (MR) children and adolescents were tested for the ability to recognize videotaped representations of 'a person', a persons actions and a person's emotion-related attitudes and allied subjective states as manifest in moving point-light images of people. Autistic and non-autistic MR participants d d not differ in the ability to recognize that a person was represented in very brief exposures of a walking point-light display; autistic, MR and typically developing participants were equally able to recognize a person's actions. Non-autistic MR and typically developing participants were also similar in their propensity to notice a person's attitudes vis-a-vis the person's actions, and in their abilities to recognize actions and attitudes when specifically asked to do so. By comparison, however, autistic participants were specifically impaired in attending to and discriminating people's attitudes and states. The results are discussed in relation to current debates on the nature of basic person-perceptual abilities that may underpin typically developing children's understanding of persons with minds ('theory of mind'). We also consider their relevance for controversies over the primary deficits in autism.

Socioeconomic status (SES) impacts on both structural and functional brain development in childhood, but how early its effects can be demonstrated is unknown. In this study we measured resting baseline EEG activity in the gamma frequency range in awake 6–9-month-olds from areas of East London with high socioeconomic deprivation. Between-subject comparisons of infants from low- and high-income families revealed significantly lower frontal gamma power in infants from low-income homes. Similar power differences were found when comparing infants according to maternal occupation, with lower occupational status groups yielding lower power. Infant sleep, maternal education, length of gestation, and birth weight, as well as smoke exposure and bilingualism, did not explain these differences. Our results show that the effects of socioeconomic disparities on brain activity can already be detected in early infancy, potentially pointing to very early risk for language and attention difficulties. This is the first study to reveal region-selective differences in functional brain development associated with early infancy in low-income families.

Research on audiovisual speech integration has reported high levels of individual variability, especially among young infants. In the present study we tested the hypothesis that this variability results from individual differences in the maturation of audiovisual speech processing during infancy. A developmental shift in selective attention to audiovisual speech has been demonstrated between 6 and 9 months with an increase in the time spent looking to articulating mouths as compared to eyes (Lewkowicz & Hansen-Tift. (2012) Proc. Natl Acad. Sci. USA, 109, 1431–1436; Tomalski et al. (2012) Eur. J. Dev. Psychol., 1–14). In the present study we tested whether these changes in behavioural maturational level are associated with differences in brain responses to audiovisual speech across this age range. We measured high-density event-related potentials (ERPs) in response to videos of audiovisually matching and mismatched syllables /ba/ and /ga/, and subsequently examined visual scanning of the same stimuli with eye-tracking. There were no clear age-specific changes in ERPs, but the amplitude of audiovisual mismatch response (AVMMR) to the combination of visual /ba/ and auditory /ga/ was strongly negatively associated with looking time to the mouth in the same condition. These results have significant implications for our understanding of individual differences in neural signatures of audiovisual speech processing in infants, suggesting that they are not strictly related to chronological age but instead associated with the maturation of looking behaviour, and develop at individual rates in the second half of the first year of life.

Interviews were conducted with 257 children and their parents; all of the children had studied a musical instrument but differed in the extent of their mastery. The purpose of the study was to investigate the role of parents in the development of musical ability. It was discovered that the most successful children had parents who were the most highly involved in lessons and practice in the earliest stages of learning. These successful music learners often had parents who were involved with music themselves. Parental involvement in music typically took the form of listening to music rather than performing it, and tended to increase over the child's learning period. The children who failed to continue with lessons had parents who were, on average, less interested in music and who did not change their own degree of involvement with music over their child's learning period. Overall, the most musically able children had the highest levels of parental support.

A sample of 257 young people aged between eight and 18 who had undertaken individual instrumental tuition were interviewed in depth about their performing history from the start of playing. A subset of 94 of these individuals also kept a practice diary for a 42-week period. The data collected allowed estimates to be calculated of the amount of time devoted to various types of practice and other activities. The sample was selected in order to encompass a wide range of levels of musical achievement, from pupils at a highly selective specialist music school through to individuals who had abandoned instrumental study after less than a year of formal instruction. Data about formal examination successes confirmed the very wide range of achievement in the sample. It was discovered that there was a strong relationship between musical achievement and the amount of formal practice undertaken. Weaker relationships were discovered between achievement and amount of informal playing. There was no evidence that high achievers were able to gain a given level of examination success on less practice than low achievers. High achievers tended to be more consistent in their pattern of practice from week to week, and tended to concentrate technical practice in the mornings. These data lend strong support to the theory that formal effortful practice is a principal determinant of musical achievement. © The British Pschological Society.

INTRODUCTION: The objectives of this study were to examine relationships between neighbourhood-level and individual-level characteristics and physical activity in deprived London neighbourhoods. METHODS: In 40 of the most deprived neighbourhoods in London (ranked in top 11% in London by Index of Multiple Deprivation) a cross-sectional survey (n = 4107 adults aged > = 16 years), neighbourhood audit tool, GIS measures and routine data measured neighbourhood and individual-level characteristics. The binary outcome was meeting the minimum recommended (CMO, UK) 5 × 30 mins moderate physical activity per week. Multilevel modelling was used to examine associations between physical activity and individual and neighbourhood-level characteristics. RESULTS: Respondents living more than 300 m away from accessible greenspace had lower odds of achieving recommended physical activity levels than those who lived within 300 m; from 301-600 m (OR = 0.7; 95% CI 0.5-0.9) and from 601-900 m (OR = 0.6; 95% CI 0.4-0.8). There was substantial residual between-neighbourhood variance in physical activity (median odds ratio = 1.7). Other objectively measured neighbourhood-level characteristics were not associated with physical activity levels. CONCLUSIONS: Distance to nearest greenspace is associated with meeting recommended physical activity levels in deprived London neighbourhoods. Despite residual variance in physical activity levels between neighbourhoods, we found little evidence for the influence of other measured neighbourhood-level characteristics.

The parents of 257 children who had all studied a musical instrument but who differed in the extent of their mastery were interviewed in order to investigate the claim that unusual musical expertise is often preceded by early signs in the form of spontaneous musical behaviours. Of the possible early signs that were investigated, only one, singing by the child, was observed at an earlier age in those children who later became the most accomplished young musicians than in the other children. With the other four early signs examined in this study, the age at which the behaviours first occurred did not differ between the most and least competent musicians. The age at which parent and child first listened to music together tended to be lower for the most successful children, and these were more likely than the others to have had a keyboard instrument in their home from an early age.

A wide range of psychological processes have been analyzed in terms of the mind's representational and central processing capacities. For example, person perception is supposed to entail that an individual infers meanings from the perception of bodily and facial cues. An alternative account is that certain basic forms of perceptual processing may not depend on the efficiency of central cognitive processing (IQ), but instead be domain specific or modular, and relatively direct in nature. In order to investigate this issue, we compared the performance of matched groups of mentally retarded and nonretarded children and adolescents on perceptual tasks involving the presentation of videotaped point-light displays of people and objects, and on a standard inspection time task. Whereas performance on the inspection time task was related to IQ, this was not the case for performance on tests involving the perception of point-light displays. We note some theoretical implications of such evidence for IQ-independent perceptual abilities.

Introduction Recent systematic reviews suggest that there is a dearth of evidence on the effectiveness of large-scale urban regeneration programmes in improving health and well-being and alleviating health inequalities. The development of the Olympic Park in Stratford for the London 2012 Olympic and Paralympic Games provides the opportunity to take advantage of a natural experiment to examine the impact of large-scale urban regeneration on the health and well-being of young people and their families. Design and methods A prospective school-based survey of adolescents (11–12 years) with parent data collected through face-to-face interviews at home. Adolescents will be recruited from six randomly selected schools in an area receiving large-scale urban regeneration (London Borough of Newham) and compared with adolescents in 18 schools in three comparison areas with no equivalent regeneration (London Boroughs of Tower Hamlets, Hackney and Barking & Dagenham). Baseline data will be completed prior to the start of the London Olympics (July 2012) with follow-up at 6 and 18 months postintervention. Primary outcomes are: pre–post change in adolescent and parent mental health and well-being, physical activity and parental employment status. Secondary outcomes include: pre–post change in social cohesion, smoking, alcohol use, diet and body mass index. The study will account for individual and environmental contextual effects in evaluating changes to identified outcomes. A nested longitudinal qualitative study will explore families’ experiences of regeneration in order to unpack the process by which regeneration impacts on health and well-being. Ethics and dissemination The study has approval from Queen Mary University of London Ethics Committee (QMREC2011/40), the Association of Directors of Children's Services (RGE110927) and the London Boroughs Research Governance Framework (CERGF113). Fieldworkers have had advanced Criminal Records Bureau clearance. Findings will be disseminated through peer-reviewed publications, national and international conferences, through participating schools and the study website (http://www.orielproject.co.uk).

Background The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT). The baseline survey data are reported here. Methods The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs); ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. Results There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of physical activity were higher in the Well London adult population but this is likely to be due to the different measurement tools used in the two surveys. Conclusions Randomization of social interventions such as Well London is acceptable and feasible and in this study the intervention and control arms are well-balanced with respect to the primary outcomes and key sociodemographic characteristics. The matched design has improved the statistical efficiency of the study amongst adults but less so amongst adolescents. Follow-up data collection will be completed 2012. Trial registration Current Controlled Trials ISRCTN68175121

OBJECTIVE: A widely used illicit recreational drug among young adults, 3,4-methylenedioxymethamphetamine (MDMA) or ecstasy, is an indirect monoaminergic agonist/reuptake inhibitor affecting the serotonin system. Preclinical studies found prenatal exposure related to long-term learning and memory impairments. There are no studies of sequelae of prenatal MDMA exposure in humans, despite potential harmful effects to the fetus. METHODS: A total of 96 women in the United Kingdom (28 MDMA users; 68 non-MDMA) were interviewed about recreational drug use during pregnancy. Their infants were seen at 12 months using standardized assessments of cognitive, language, and motor development (Preschool Language Scale, Bayley Mental and Motor Development and Behavior Rating Scales [Mental Development Index, Psychomotor Development Index, Behavioral Rating Scale]). Mothers completed the Child Domain Scale of the Parenting Stress Index, The Home Observation of the Environment Scale (in interview), the Brief Symptom Inventory, and the Drug Abuse Screening Test. Women were primarily middle class with some university education, in stable partner relationships, and polydrug users. MDMA and other drug effects were assessed through multiple regression analyses controlling for confounding variables, and analysis of covariance comparing heavier versus lighter and nonexposed groups. RESULTS: Amount of prenatal MDMA exposure predicted poorer infant mental and motor development at 12 months in a dose-dependent manner. Heavily exposed infants were delayed in motor development. Lighter-exposed infants were comparable to nonexposed infants. There were no effects on language, emotional regulation, or parenting stress. CONCLUSIONS: Findings document persistent neurotoxic effects of heavier prenatal MDMA exposure on motor development through the first year of life.

While recreational drug use in UK women is prevalent, to date there is little prospective data on patterns of drug use in recreational drug-using women immediately before and during pregnancy. A total of 121 participants from a wide range of backgrounds were recruited to take part in the longitudinal Development and Infancy Study (DAISY) study of prenatal drug use and outcomes. Eighty-six of the women were interviewed prospectively while pregnant and/or soon after their infant was born. Participants reported on use immediately before and during pregnancy and on use over their lifetime. Levels of lifetime drug use of the women recruited were high, with women reporting having used at least four different illegal drugs over their lifetime. Most users of cocaine, 3,4-methylenedioxy-N-methylamphetamine (MDMA) and other stimulants stopped using these by the second trimester and levels of use were low. However, in pregnancy, 64% of the sample continued to use alcohol, 46% tobacco and 48% cannabis. While the level of alcohol use reduced substantially, average tobacco and cannabis levels tended to be sustained at pre-pregnancy levels even into the third trimester (50 cigarettes and/or 11 joints per week). In sum, while the use of ‘party drugs’ and alcohol seems to reduce, levels of tobacco and cannabis use are likely to be sustained throughout pregnancy. The data provide polydrug profiles that can form the basis for the development of more realistic animal models.

Background In London and the rest of the UK, diseases associated with poor diet, inadequate physical activity and mental illness account for a large proportion of area based health inequality. There is a lack of evidence on interventions promoting healthier behaviours especially in marginalised populations, at a structural or ecological level and utilising a community development approach. The Well London project financed by the Big Lottery 'Wellbeing' Fund and implemented by a consortium of London based agencies led by the Greater London Authority and the London Health Commission is implementing a set of complex interventions across 20 deprived areas of London. The interventions focus on healthy eating, healthy physical activity and mental health and wellbeing and are designed and executed with community participation complementing existing facilities and services. Methods/Design The programme will be evaluated through a cluster randomised controlled trial. Forty areas across London were chosen based on deprivation scores. Areas were characterised by high proportion of Black and Minority Ethnic residents, worklessness, ill-health and poor physical environments. Twenty areas were randomly assigned to the intervention arm of Well London project and twenty 'matched' areas assigned as controls. Measures of physical activity, diet and mental health are collected at start and end of the project and compared to assess impact. The quantitative element will be complemented by a longitudinal qualitative study elucidating pathways of influence between intervention activities and health outcomes. A related element of the study investigates the health-related aspects of the structural and ecological characteristics of the project areas. The project 'process' will also be evaluated. Discussion The size of the project and the fact that the interventions are 'complex' in the sense that firstly, there are a number of interacting components with a wide range of groups and organisational levels targeted by the intervention, and secondly, a degree of flexibility or tailoring of the intervention, makes this trial potentially very useful in providing evidence of the types of activities that can be used to address chronic health problems in communities suffering from multiple deprivation. Trial Registration Current Controlled Trials ISRCTN68175121

While five-month-old infants show orientation-specific sensitivity to changes in the motion and occlusion patterns of human point-light displays, it is not known whether infants are capable of binding a human representation to these displays. Furthermore, it has been suggested that infants do not encode the same physical properties for humans and material objects. To explore these issues we tested whether infants would selectively apply the principle of solidity to upright human displays. In the first experiment infants aged six and nine months were repeatedly shown a human point-light display walking across a computer screen up to 10 times or until habituated. Next, they were repeatedly shown the walking display passing behind an in-depth representation of a table, and finally they were shown the human display appearing to pass through the table top in violation of the solidity of the hidden human form. Both six- and nine-month-old infants showed significantly greater recovery of attention to this final phase. This suggests that infants are able to bind a solid vertical form to human motion. In two further control experiments we presented displays that contained similar patterns of motion but were not perceived by adults as human. Six- and nine-month-old infants did not show recovery of attention when a scrambled display or an inverted human display passed through the table. Thus, the binding of a solid human form to a display in only seems to occur for upright human motion. The paper considers the implications of these findings in relation to theories of infants' developing conceptions of objects, humans and animals.