The relationship between language and executive function (EF) and their development in children have been the focus of recent debate and are of theoretical and clinical importance. Exploration of these functions in children with a peripheral hearing loss has the potential to be informative from both perspectives. This study compared the EF and language skills of 8- to 12-year-old children with cochlear implants (n = 22) and nonimplanted deaf children (n = 25) with those of age-matched hearing controls (n = 22). Implanted and nonimplanted deaf children performed below the level of hearing children on tests assessing oral receptive language, as well as on a number of EF tests, but no significant differences emerged between the implanted and nonimplanted deaf groups. Language ability was significantly positively associated with EF in both hearing and deaf children. Possible interpretations of these findings are suggested and the theoretical and clinical implications considered.

In recent years, the number of children receiving cochlear implants who have significant disabilities in addition to their deafness has increased substantially. However, in comparison with the extensive literature on speech, language, and communication outcomes following pediatric implantation in children without complex needs, the available literature for this special group of children is relatively sparse. This article reviews the available research on outcomes, grouping studies according to the nature of the additional disabilities and specific etiologies of deafness. The methodological problems relating to outcome research in this field are outlined, followed by some tentative conclusions drawn from the literature base while bearing these problems in mind. The remainder of the article focuses on the challenges for clinical practice, from a psychological perspective, of implanting deaf children with complex needs. Two groups of children are considered, those whose additional disabilities have been identified prior to implantation and those whose difficulties become apparent at some point afterward, sometimes many years later. A case example describing the psychological assessment of a deaf-blind child being considered for implantation is presented.

This paper reports the development and validation of the Pain Beliefs Questionnaire (PBQ). This is a 20-item questionnaire covering beliefs about the cause and treatment of pain. It was administered to 294 subjects, comprising 100 chronic pain patients and 194 controls. An exploratory factor analysis revealed 2 factors accounting for 68.15% of the variance. From the final solution 2 scales were derived: the first called Organic Beliefs and the second Psychological Beliefs scale, comprising 8 and 4 items, respectively. The construct validity of the questionnaire was assessed in 2 ways. First, the responses of chronic pain patients and non-patient controls were compared: a significant difference (F(1,236) = 53.04, P < 0.0001) between these 2 groups emerged such that chronic pain patients were more likely to endorse the Organic Beliefs scale items, whereas non-patients were more likely to endorse the Psychological Beliefs scale items. Secondly, as predicted significant associations were observed between scores on the Organic Beliefs scale and scores on the Chance and Powerful Others scales of the Multidimensional Health Locus of Control (MHLC), and also between the Psychological Beliefs and Internal scales of the MHLC. No relationship, however, emerged between these scales and measures of pain intensity. The implications of these findings for the assessment and management of chronic pain patients, and in the understanding of the development of chronic pain, are discussed.

Cirrhotic portal hypertension is characterised by development of the decompensating events of ascites, encephalopathy, portal hypertensive bleeding and hepatorenal syndrome, which arise in a setting of cirrhosis-associated immune dysfunction (CAID) and define morbidity and prognosis. CAID describes the dichotomous observations that systemic immune cells are primed and display an inflammatory phenotype, while failing to mount robust responses to pathogen challenge. Bacterial infections including spontaneous bacterial peritonitis are common complications of advanced chronic liver disease and can precipitate variceal haemorrhage, hepatorenal syndrome and acute-on-chronic liver failure; they frequently arise from gut-derived organisms and are closely linked with dysbiosis of the commensal intestinal microbiota in advanced chronic liver disease.Here, we review the links between cirrhotic dysbiosis, intestinal barrier dysfunction and deficits of host-microbiome compartmentalisation and mucosal immune homoeostasis that occur in settings of advanced chronic liver disease. We discuss established and emerging therapeutic strategies targeted at restoring intestinal eubiosis, augmenting gut barrier function and ameliorating the mucosal and systemic immune deficits that characterise and define the course of decompensated cirrhosis.

Mood congruity effects in induced mood states and affective disorders are well established. Recent evidence suggests that a similar process occurs in chronic pain patients, although the extent to which the memory bias is a consequence of the affective or sensory state of the subject in this group is unknown. In this study selective memory for sensory and affective pain-related information was investigated in depressed and non-depressed chronic pain patients and depressed psychiatric patients. A recall test comprising sensory, affective and neutral adjectives matched for frequency was followed by a recognition task, where the words of the recall test were randomized with an equal number of new adjectives matched for word type and frequency. Comparison of the three patient groups with normal controls revealed specific recall biases directly related to pain and depression in both chronic pain groups and the controls. Contrary to expectations, the depressed psychiatric patients failed to show a recall bias for affective adjectives: the possibility of cognitive avoidance as an explanation for this is discussed. Signal detection analysis of the recognition results suggested that selective memory in chronic pain and depression may to some extent be accounted for by differences in 'true memory', the contribution of response bias remaining less clear.

Hearing impairment has been associated with cognitive deficits. It is not yet clear whether cochlear implants enable children to reduce or overcome these deficits. This study examined whether hearing impaired children with cochlear implants differed from hearing impaired children without cochlear implants or from hearing children. The three age-matched groups were compared on a non-verbal measure of cognition, the Leiter International Performance Scale-Revised (LIPS-R), and a measure of behaviour, the Child Behaviour Checklist (CBCL). Apart from their scores on the Attention Sustained Subtest of the LIPS-R, the performance of the implanted group and the hearing group closely corresponded, while the hearing impaired children without cochlear implants performed below the level achieved by both these groups. There were no differences between any groups on the CBCL. It was concluded that hearing impaired children with cochlear implants were able to perform at the same non-verbal cognitive level as hearing children.

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