PATHOLOGICAL SIGNIFICANCE OF CDH1/E-CADHERIN GERMLINE SEQUENCE VARIANTS IN BREAST CANCER PATIENTS.

BACKGROUND: Germline alterations of the CDH1 (E-cadherin) tumor suppressor gene have been reported in several epithelial malignancies like hereditary diffuse gastric cancer and lobular breast cancer. E-cadherin plays a central role in proliferation, maintenance of cell-to-cell adhesion, polarity, and epithelial-mesenchymal transition of tissue cells. It is necessary to analyze the impact of the CDH1 germline sequence variants on protein and predict its clinical significance in breast cancer (BC) progression. The aim of the current study was to evaluate the impact and association of CDH1 gene potentially pathogenic variants/likely pathogenic variants (PVs/LPVs) with the initiation and progression of BC. MATERIALS AND METHODS: In this study, the clinical data of 200 BC patients have been analyzed based on the type of BC, age, grade, stage, hormonal status, and risk factors. Blood samples from 50 healthy donors were used as a control. Furthermore, CDH1 gene molecular analysis, along with in silico analysis, was provided to assess the invasiveness and progression of BC caused by the E-cadherin protein. RESULTS: Four variants were identified by genetic screening within the CDH1 gene that included variations in exons 7, 8, 10, 11, and 13. Exon 10 had splice site mutation at position c.1337C>A, affecting the protein structure. In exon 11, there was an insertion of T base at position 1669, resulting in truncated protein compared to a normal one that can lead to the disease-causing non- sense-mediated decay and exon 13 variant c.2076T>C has already known polymorphism. In silico analysis of CDH1 showed the presence of the different variants that indicated the overall disruption of protein structure and function. CONCLUSIONS: The further functional analysis of these variants and their association with BC can be ensured by increasing the sample size and in vivo studies using mouse models.

Soluble brain homogenates from diverse human and mouse sources preferentially seed diffuse Aß plaque pathology when injected into newborn mouse hosts.

Background: Seeding of pathology related to Alzheimer's disease (AD) and Lewy body disease (LBD) by tissue homogenates or purified protein aggregates in various model systems has revealed prion-like properties of these disorders. Typically, these homogenates are injected into adult mice stereotaxically. Injection of brain lysates into newborn mice represents an alternative approach of delivering seeds that could direct the evolution of amyloid-ß (Aß) pathology co-mixed with either tau or α-synuclein (αSyn) pathology in susceptible mouse models. Methods: Homogenates of human pre-frontal cortex were injected into the lateral ventricles of newborn (P0) mice expressing a mutant humanized amyloid precursor protein (APP), human P301L tau, human wild type αSyn, or combinations thereof. The homogenates were prepared from AD and AD/LBD cases displaying variable degrees of Aß pathology and co-existing tau and αSyn deposits. Behavioral assessments of APP transgenic mice injected with AD brain lysates were conducted. For comparison, homogenates of aged APP transgenic mice that preferentially exhibit diffuse or cored deposits were similarly injected into the brains of newborn APP mice. Results: We observed that lysates from the brains with AD (Aß+, tau+), AD/LBD (Aß+, tau+, αSyn+), or Pathological Aging (Aß+, tau-, αSyn-) efficiently seeded diffuse Aß deposits. Moderate seeding of cerebral amyloid angiopathy (CAA) was also observed. No animal of any genotype developed discernable tau or αSyn pathology. Performance in fear-conditioning cognitive tasks was not significantly altered in APP transgenic animals injected with AD brain lysates compared to nontransgenic controls. Homogenates prepared from aged APP transgenic mice with diffuse Aß deposits induced similar deposits in APP host mice; whereas homogenates from APP mice with cored deposits induced similar cored deposits, albeit at a lower level. Conclusions: These findings are consistent with the idea that diffuse Aß pathology, which is a common feature of human AD, AD/LBD, and PA brains, may arise from a distinct strain of misfolded Aß that is highly transmissible to newborn transgenic APP mice. Seeding of tau or αSyn comorbidities was inefficient in the models we used, indicating that additional methodological refinement will be needed to efficiently seed AD or AD/LBD mixed pathologies by injecting newborn mice.

Biophysical characteristics of lipid-induced Aß oligomers correlate to distinctive phenotypes in transgenic mice.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that affects cognition and memory. Recent advances have helped identify many clinical sub-types in AD. Mounting evidence point toward structural polymorphism among fibrillar aggregates of amyloid-ß (Aß) to being responsible for the phenotypes and clinical manifestations. In the emerging paradigm of polymorphism and prion-like propagation of aggregates in AD, the role of low molecular weight soluble oligomers, which are long known to be the primary toxic agents, in effecting phenotypes remains inconspicuous. In this study, we present the characterization of three soluble oligomers of Aß42, namely 14LPOs, 16LPOs, and GM1Os with discreet biophysical and biochemical properties generated using lysophosphatidyl glycerols and GM1 gangliosides. The results indicate that the oligomers share some biophysical similarities but display distinctive differences with GM1Os. Unlike the other two, GM1Os were observed to be complexed with the lipid upon isolation. It also differs mainly in detection by conformation-sensitive dyes and conformation-specific antibodies, temperature and enzymatic stability, and in the ability to propagate morphologically-distinct fibrils. GM1Os also show distinguishable biochemical behavior with pronounced neuronal toxicity. Furthermore, all the oligomers induce cerebral amyloid angiopathy (CAA) and plaque burden in transgenic AD mice, which seems to be a consistent feature among all lipid-derived oligomers, but 16LPOs and GM1Os displayed significantly higher effect than the others. These results establish a correlation between molecular features of Aß42 oligomers and their distinguishable effects in transgenic AD mice attuned by lipid characteristics, and therefore help bridge the knowledge gap in understanding how oligomer conformers could elicit AD phenotypes.

Functional characterization of the cis-regulatory region for the vitellogenin gene in Plutella xylostella.

The vitellogenin gene promoter (VgP) is an essential cis-regulatory element that plays a significant role in transcription of the vitellogenin (Vg) gene, leading to the production of yolk protein in insects, including lepidopterans. However, the function of VgP is still not clear in Plutella xylostella. Here, we cloned a 5.1 kb DNA fragment of the cis-regulatory region adjacent to the 5' end of the Vg gene of P. xylostella (PxVg). We identified two promoter sites in that 5' upstream sequence of PxVg and performed in vitro analysis of two promoter sequences (PxVgP1, 4.9 kb, and PxVgP2, 2.9 kb) in the embryonic cell line of P. xylostella. PxVgP2 exhibited higher enhanced green fluorescent protein (EGFP) expression, so PxVgP2 was used for in vivo analysis. Strong EGFP fluorescence was observed in adult females and the fat body of females, with low expression in embryos. Our results suggest that PxVgP is an important stage-, tissue- and sex-specific endogenous cis-regulatory element in P. xylostella.

Disclosure of Type 1 diabetes at work among Finnish workers.

AIMS: To determine which self-management factors and psychosocial work factors were associated with disclosing diabetes to colleagues, line managers and occupational health personnel among workers with Type 1 diabetes. METHODS: A total of 767 working-aged respondents with Type 1 diabetes completed a Finnish cross-sectional survey named 'People with Type 1 Diabetes in Worklife'. Factor analysis was carried out, followed by logistic regressions to estimate the associations between self-management factors, psychosocial work factors and the likelihood of disclosure separately to colleagues, line managers and occupational health personnel. The models were adjusted for sociodemographic, diabetes-related and work-related variables. RESULTS: A total of 52% of the respondents had disclosed their diabetes to their colleagues, 45% to occupational health personnel and 28% to their line manager. Receiving social support and having good psychosocial work ability were significantly associated with disclosure to colleagues, line managers and occupational health personnel. Relations at work were associated with disclosure to colleagues and the line manager. Furthermore, opportunity to self-manage diabetes at work was associated with disclosure to colleagues. CONCLUSIONS: Line managers and colleagues have a remarkable role to play in providing workplace support to workers with Type 1 diabetes. Disclosure of Type 1 diabetes should be encouraged as line managers can provide workers with the right support, implement work adaptations and facilitate job retention. As only half of respondents disclosed their Type 1 diabetes at work, further research is required into the reasons for and consequences of not disclosing a diagnosis.

Iatrogenic Menopause After Treatment for Cervical Cancer.

The ever-improving prognosis of women diagnosed with cervical cancer has meant that survivorship and treatment-related sequelae are being brought more into the spotlight in an attempt to try to reduce morbidity and improve women's long-term health. However, there are many issues surrounding an iatrogenic menopause in cervical cancer, a variety of potential management options and barriers to treatment. Women who have become menopausal under the age of 45 years as a result of cervical cancer are significantly less likely to start hormone replacement therapy (HRT) or continue it long term as compared with those who have undergone a surgical menopause for a benign reason. High profile media reports raising concerns about the safety of HRT use have left many women reluctant to consider HRT as a therapeutic option for menopausal symptoms and many are seeking to use complementary/alternative medicine, including non-pharmacological interventions, to alleviate symptoms. The benefits of HRT in this population have been shown to reduce these effects, although adherence to treatment regimens is a challenge due to poor compliance, which is in part due to the fear of a second malignancy. The development of non-HRT-based interventions to ameliorate menopausal symptoms and reduce the long-term health consequences are needed for women who choose not to take HRT.

Providing NHS staff with height-adjustable workstations and behaviour change strategies to reduce workplace sitting time: protocol for the Stand More AT (SMArT) Work cluster randomised controlled trial.

BACKGROUND: High levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health. With high levels of sitting widespread in desk-based office workers, office workplaces are an appropriate setting for interventions aimed at reducing sedentary behaviour. This paper describes the development processes and proposed intervention procedures of Stand More AT (SMArT) Work, a multi-component randomised control (RCT) trial which aims to reduce occupational sitting time in desk-based office workers within the National Health Service (NHS). METHODS/DESIGN: SMArT Work consists of 2 phases: 1) intervention development: The development of the SMArT Work intervention takes a community-based participatory research approach using the Behaviour Change Wheel. Focus groups will collect detailed information to gain a better understanding of the most appropriate strategies, to sit alongside the provision of height-adjustable workstations, at the environmental, organisational and individual level that support less occupational sitting. 2) intervention delivery and evaluation: The 12 month cluster RCT aims to reduce workplace sitting in the University Hospitals of Leicester NHS Trust. Desk-based office workers (n = 238) will be randomised to control or intervention clusters, with the intervention group receiving height-adjustable workstations and supporting techniques based on the feedback received from the development phase. Data will be collected at four time points; baseline, 3, 6 and 12 months. The primary outcome is a reduction in sitting time, measured by the activPAL(TM) micro at 12 months. Secondary outcomes include objectively measured physical activity and a variety of work-related health and psycho-social measures. A process evaluation will also take place. DISCUSSION: This study will be the first long-term, evidence-based, multi-component cluster RCT aimed at reducing occupational sitting within the NHS. This study will help form a better understanding and knowledge base of facilitators and barriers to creating a healthier work environment and contribute to health and wellbeing policy. TRIAL REGISTRATION: ISRCTN10967042 . Registered 2 February 2015.

Psychosocial work environment and leisure-time physical activity: the Stormont study.

BACKGROUND: Research findings on the relationship between the psychosocial work environment and leisure-time physical activity (LTPA) are equivocal. This might partly be due to studies having focused on a restricted set of psychosocial dimensions, thereby failing to capture all relevant domains. AIMS: To examine cross-sectional associations between seven psychosocial work environment domains and LTPA in a large sample of UK civil servants and to profile LTPA and consider this in relation to UK government recommendations on physical activity. METHODS: In 2012 Northern Ireland Civil Service employees completed a questionnaire including measures of psychosocial working conditions (Management Standards Indicator Tool) and LTPA. We applied bivariate correlations and linear regression analyses to examine relations between psychosocial working conditions and LTPA. RESULTS: Of 26000 civil servants contacted, 5235 (20%) completed the questionnaire. 24% of men and 17% of women reported having undertaken 30min or more of physical activity on five or more days in the past week. In men, job control (-0.08) and peer support (-0.05) were weakly but significantly negatively correlated with LTPA, indicating that higher levels of exposure to these psychosocial hazards was associated with lower levels of LTPA. Job role (-0.05) was weakly but significantly negatively correlated with LTPA in women. These psychosocial work characteristics accounted for 1% or less of the variance in LTPA. CONCLUSIONS: Longitudinal research to examine cause-effect relations between psychosocial work characteristics and LTPA might identify opportunities for psychosocial job redesign to increase employees' physical activity during leisure time.

Overweight and obesity in UK firefighters.

BACKGROUND: Obesity among firefighters can present a hindrance to operational effectiveness. In North American studies, 80% of US firefighters are overweight or obese. No studies have explored obesity among firefighters in the UK, and it is unclear whether obesity is a problem among UK firefighters. AIMS: To establish the prevalence of obesity among a large sample of firefighters in the UK and to explore changes in body mass index (BMI) over a 3-year period. METHODS: The BMI and body composition of 735 male firefighters from a UK county fire and rescue service were assessed in 2008 and 2011. RESULTS: In 2008, 65% of the firefighters were either overweight (54%) or obese (11%). In 2011, slightly fewer firefighters were overweight (53%), but the proportion classified as obese increased significantly to 13%. Those classified as normal weight in 2008 were more likely to have gained weight by 2011 in comparison with those categorized as obese at baseline. A lower proportion of firefighters were classified as high risk for obesity based on their waist circumference in 2008. CONCLUSIONS: The proportion of firefighters who are either overweight or obese is lower in this UK sample than that found in US studies. Nevertheless, the proportion of UK firefighters classed as overweight was higher than that found in the general population samples from England. Given the negative implications of obesity for performance, there is a need for further investment in theory-based, sector-specific health promotion research and practice.

The impact of colorectal cancer and self-efficacy beliefs on work ability and employment status: a longitudinal study.

We examined how colorectal cancer patients' treatment and symptom management impacted perceptions of work ability and subsequent work decisions. Fifty patients completed questionnaires at baseline (post-surgery/pretreatment), 3 months and 6 months. Questionnaires assessed fatigue, depression, quality-of-life (QoL), cancer self-efficacy, job self-efficacy (JSE) and work ability. Factors related to perceived work ability were occupation (ß= 0.31, P= 0.0005) and QoL (ß= 0.42, P= 0.01) at baseline, treatment type (ß=-0.19, P= 0.05) at 3 months, and JSE at 3 months (ß= 0.57, P= 0.0005) and 6 months (ß= 0.50, P= 0.006). Factors related to being on sick leave were lower levels of JSE (OR = 2.20, 95% CI: 1.17-4.13) at baseline and being employed in a manual occupation (OR = 0.03, 95% CI: 0.00-0.86), and perceived work ability (OR = 3.05, 95% CI: 1.00-12.80) at 6 months. Along with self-assessed work ability at baseline (ß= 0.67, P= 0.0005), receiving chemotherapy or a combination of treatments (ß=-0.24, P= 0.05) were the strongest predictors of poorer perceptions of follow-up work ability. Self-efficacy beliefs may add to understanding and should be considered in future research.

Developing occupational health services for active age management.

AIMS: To review current occupational health (OH) approaches aimed at maintaining the health and workability of older workers. METHODS: A literature review was undertaken to identify articles on OH interventions focused on maintaining the health of older workers (published since 2000). The inclusion criteria included studies that reported interventions aimed specifically at older workers. RESULTS: A limited number of interventions targeting older workers were identified. A second literature search was therefore conducted that identified types of workplace interventions that, if used with older workers, may benefit their health, well-being and workability. CONCLUSIONS: Very few OH interventions have addressed the health and workability of older workers and there is considerable scope for developing OH provision, which accounts for the needs of the older workforce.

The role of communication and support in return to work following cancer-related absence.

OBJECTIVE: Many cancer survivors experience difficulties returning to work. However, there have been relatively few attempts to understand why problems with employer support and work adjustment occur. This paper aims to extend previous work in two ways: first, through exploring the way in which communication and support at work effect cancer survivors on their return to work and during the post-return period; and second, by drawing on a research sample working in the United Kingdom. METHODS: In all, 26 cancer survivors took part in a semi-structured telephone interview. Interviews were transcribed and analysed using thematic analysis. RESULTS: The analysis revealed three key findings. First, the central role of communication and support from (and between) occupational health, line managers, and colleagues was highlighted. Second, two discrete processes or periods of return to work were identified: the experience of return to work during the initial period of return and the experiences of post-return to work. Third, during the post-return period, the importance of the delayed impact of cancer on the ability to work, the lack of follow-up and monitoring, and the wear-off effect of empathy and support were highlighted as contributing to return-to-work difficulties. CONCLUSIONS: This qualitative study highlights the importance of communication within the workplace with regard to the return-to-work process and the need to provide better support and guidance to cancer survivors, line managers and colleagues. Research is required in delineating how employers without occupational health or human resources support manage the return-to-work process.

Employment and the common cancers: correlates of work ability during or following cancer treatment.

AIMS: To provide an in-depth review of the impact of cancer and cancer-related issues on work ability for those working during or following cancer treatment. METHODS: Of total, 19 papers published between 1999 and 2008 on cancer and work ability were reviewed. RESULTS: Studies have shown that most types of cancers result in decreased work ability compared to healthy controls or those with other chronic conditions. Some cancer types have more decreased work ability than other types. Decreased work ability is associated with type of treatment (chemotherapy), treatment-related side-effects (e.g. fatigue) and co-morbidity with other health conditions. For most cancers, work ability improves over time irrespective of age. CONCLUSIONS: More longitudinal research is required to fully determine the impact of cancer and its treatment on work ability, occupational health services can help such employees make a full recovery and maintain employment by regularly assessing work ability and working hours so that work adjustment and support can be appropriately tailored.

Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer.

The experience of returning to work following cancer is a largely unknown area of cancer research. This preliminary study aimed to explore the factors that influence decisions about return to work either during or after cancer treatment and to identify the important aspects of returning to work. Qualitative data were collected using individual interviews (n = 19) and two focus groups (n = 4, n = 6), predominantly with breast cancer survivors. Patterns of returning to work were diverse and a variety of reasons influenced work decisions, including financial concerns and regaining normality. Participants also discussed their ability to work, health professionals' advice, side effects, support and adjustments, and attitudes towards work. Although the majority adapted well, a few encountered difficulties on their return. It is evident that more advice is required from health professionals about returning to work, along with reasonable support and adjustments from employers to ensure that cancer survivors are able to successfully reintegrate back into the workforce.

Theory of mind deficits in children with fragile X syndrome.

BACKGROUND: Given the consistent findings of theory of mind deficits in children with autism, it would be extremely beneficial to examine the profile of theory of mind abilities in other clinical groups such as fragile X syndrome (FXS) and Down syndrome (DS). Aim The aim of the present study was to assess whether boys with FXS are impaired in simple social situations that require them to understand their own and others' mental states - in essence: do they have a 'theory of mind'? METHOD: Well-standardized tasks of theory of mind, the location change false belief task and the appearance-reality tasks were employed to examine whether any impairment might be specific to the FXS or part of a more generalized developmental deficit. RESULTS: The results suggest that children with FXS do have impairment in theory of mind that is comparable to the deficit reported in other groups with learning disabilities such as DS. However, closer inspection of the impairment between these groups revealed qualitative differences in error types (realist vs. phenomenist), suggestive of atypical development that goes beyond general cognitive delay. CONCLUSION: The findings are discussed in terms of the teasing apart of different components of social cognition in order to identify syndrome-specific deficiencies and proficiencies.

Dealing with self-management of chronic illness at work: predictors for self-disclosure.

This paper explores the role of self-management of chronic illness at work, as a predictor for self-disclosure. The study reports findings from a survey sent to all staff at a UK university, of which 610 employees reported managing a chronic illness: arthritis, musculoskeletal pain, diabetes, asthma, migraine, heart disease, irritable bowel syndrome and depression. The study found that discrete self-management factors predicted different levels of disclosure: partial self-disclosure (employees informing line managers about the presence of a chronic illness) and full self-disclosure (employees informing line managers how that chronic illness affected them at work). For partial disclosure, a greater reported experience of chronic illness by employees was positively associated with self-disclosure. For full-disclosure, employees were more likely to report disclosure to line managers if they had already disclosed to colleagues, and if they perceived receiving support from their line managers in relation to their chronic illness as important. Except for academics who were least likely to disclose, occupational groups did not emerge as significant predictors for either partial or full disclosure. Except for diabetes, chronic illness itself was not a significant predictor or barrier to self-disclosure. Our findings suggest that chronically ill employees adopt a disclosure strategy specifically related to different self-management needs of chronic illness at work.

Annotation: Deconstructing the attention deficit in fragile X syndrome: a developmental neuropsychological approach.

BACKGROUND: Fragile X syndrome is one of the world's leading hereditary causes of developmental delay in males. The past decade has witnessed an explosion of research that has begun to unravel the condition at its various levels: from the genetic and brain levels to the cognitive level, and then to the environmental and behavioural levels. Our aim in this review is to attempt to integrate some of the extensive body of knowledge to move the research a step closer to understanding how the dynamics of atypical development can influence the specific cognitive and behavioural end-states frequently observed in children and adolescents with fragile X syndrome. METHODS: We conducted a review of the current neuropsychological and neuropsychiatric approaches that have attempted to delineate the pattern of 'spared' and 'impaired' functions associated with the phenotype. RESULTS: The profile of findings suggests that fragile X syndrome should not be viewed merely as a catalogue of spared and impaired cognitive functions or modules. Instead, there appears to be a process of almost gradual modularisation whereby cognitive mechanisms become domain specific as a function of development itself (Karmiloff-Smith, 1992). The results of a decade of intense research point towards an early weakness in one or more components of executive control rather than single, static higher-level deficits (e.g., spatial cognition, speech processing). This weakness affects both the development of more complex functions and current performance. CONCLUSIONS: The prevailing tendency to interpret developmental disorders in terms of fixed damage to distinct modular functions needs to be reconsidered. We offer this review as an example of an alternative approach, attempting to identify an initial deficit and its consequences for the course of development. Through better definition of the cognitive and behavioural phenotype, in combination with current progress in brain imaging techniques and molecular studies, the next decade should continue to hold exciting promise for fragile X syndrome and other neurodevelopmental disorders.

Perfil neuropsicológico y conductual de los déficit de atención en el síndrome X frágil / A neuropsychological and behavioural profile of attention deficits in fragile X syndrome

Introducción. El síndrome X frágil es una bien reconocida causa de retraso del desarrollo en niños y algo menos en niñas. El objetivo del presente estudio es presentar un detallado análisis cognitivo y de conducta del núcleo de los trastornos de atención frecuentemente asociados al X frágil. Pacientes y métodos. Se llevaron a cabo dos estudios complementarios. El estudio 1 examina la gravedad y rango de los problemas de conducta en un grupo de 25 niños con síndrome X frágil comparándolo con cinco grupos control: un grupo con retraso mental (con síndrome de Down-trisomía 21) y cuatro grupo de niños con desarrollo normal. Se utilizaron dos escalas validadas como medida de conducta. El estudio 2 examina la realización, en estos mismos grupos, de una nueva tarea computarizada de atención que mide la capacidad de inhibir respuestas irrelevantes. Resultados. Los hallazgos del estudio 1 revelaron que los niños con X frágil eran significativamente más hiperactivos, desatentos e impulsivos comparándolos con los niños con síndrome de Down, pero no lo eran más que los niños de los grupos control con déficit de atención. Los resultados del estudio 2 revelaron que la mayor dificultad en el X frágil era la inhibición de la repetición de respuestas correctas y la atención dividida de un tipo de respuesta a otra en una secuencia, haya sido o no correcta. Conclusiones. La evidencia que emerge de este estudio apoya la hipótesis de que el déficit fundamental en el X frágil es controlar el flujo de secuencias de input y output. Se sugiere que este control requiere inhibición en varias vías y que la naturaleza y gravedad de este déficit parece ser específica de esta entidad. Se discuten las implicaciones clínicas y educacionales de estos hallazgos (AU)

The nature of attentional differences between groups of children differentiated by teacher ratings of attention and hyperactivity.

Two groups of children, one with good attention and low hyperactivity and the other with poor attention and high hyperactivity, were formed on the basis of teachers' ratings. The groups were tested on a large number of tests of attentional performance, covering selective attention, divided attention, sustained attention and executive function. Analysis of group differences, with verbal and non-verbal intelligence controlled statistically, indicated that the groups demonstrated significant differences on a variety of measures. Principal components analysis of the tests of attention isolated two components, one of which significantly distinguished the two groups. It is suggested that this component reflected aspects of executive control of attention. The measures which discriminated the groups most clearly were efficiency of visual search involving two targets in alternation, the number of correct responses on a specially devised version of the Wisconsin Card Sorting Task and a task measuring the ability to inhibit a dominant response. It is suggested that all these tasks required a combination of selective attention and executive control. It was also noted that the poor attention group produced bigger individual differences on all measures, indicating that this group may include a variety of weaknesses which require more precise analysis to distinguish them.