Peer-mentoring for first-time mothers from areas of socio-economic disadvantage: a qualitative study within a randomised controlled trial

Objective: To explore the difficulties experienced by lay-workers, women and health professionals involved in a peer-mentoring programme for first-time mothers living in socially disadvantaged areas. Design: Qualitative study; semi-structured interviews with lay-worker peer-mentoring programme participants at two separate stages of the programme (antenatal and postnatal). Setting: Community based. Participants: 11 women receiving peer-mentoring support (from first hospital antenatal visit to one year postnatal); 11 lay-workers; 2 research midwives. Results: Lay-workers had difficulty initiating contact with women and failure to establish contact affected their morale adversely. They felt that women understood their intended role poorly and attempted to develop relationships with them by sharing personal experiences and offering friendship; women who participated in the programme appreciated this. Developing a peer-mentor relationship was difficult if women lacked interest in the programme or in continuing contact. External influences on peer-mentoring uptake and delivery included family and friends who could prevent or encourage women’s participation and cause difficulties for the lay-worker both in delivering support and arranging follow-up. Lay-workers providing support to women from a different ethnic background experienced difficulties relating to both language and culture: these were perceived to affect peer-mentor relationships adversely. Major personal difficulties for lay-workers related to time constraints in reconciling mentoring requirements with demands of family and other work. Informing midwives of these difficulties helped identify solutions through training and ongoing professional support for the lay-workers. Conclusions: Lay-worker peer support is appreciated by first time mothers but difficulties in initiating contact, developing peer-mentor relationships and external influences such as family, ethnicity and time constraints are relevant to poor uptake and high staff turnover. In developing peer support programmes, awareness of potential difficulties and of how professional support can help resolve these should improve uptake and thus optimise the evaluations of their effectiveness.

Presence of arsenic in agricultural products from arsenic-endemic areas and strategies to reduce arsenic intake in rural villages

About 100 million rural people in Asia are exposed to arsenic (As)-polluted drinking water and agricultural products. Total and inorganic arsenic (t-As and i-As) intake mainly depend on the quality of drinking and cooking waters, and amounts of seafood and rice consumed. The main problems occur in countries with poor water quality where the population depends on rice for their diet, and their t-As and i-As intake is high as a result of growing and cooking rice in contaminated water. Workable solutions to remove As from water and breeding rice cultivars with low As accumulation are being sought. In the meantime, simple recommendations for processing and cooking foods will help to reduce As intake. For instance, cooking using high volumes of As-free water may be a cheap way of reducing As exposure in rural populations. It is necessary to consider the effects of cooking and processing on t-As and i-As to obtain a realistic view of the risks associated with intake of As in Asendemic areas.

Out of the wilderness? Achieving sustainable development within Scottish national parks

The introduction of national parks to Scotland represents a significant shift in the evolution of protected area management within the UK. Although the National Parks (Scotland) Act 2000 adopts the established national park aims of conservation and recreation, provisions are also made for advancing notions of sustainable development. This paper provides an assessment of the degree to which the Scottish national park model is likely to enable the realisation of multiple national park objectives. Five key areas are considered for analysis. These relate to management aims, institutional arrangements, implementation, democratic accountability and funding. The evaluation reveals that whilst management provisions have been established in accordance with international sustainable development guidelines, a number of concerns relating to operational processes remain.

High density mangrove plantation enhances surface accretion, surface elevation change, and tree survival in coastal areas susceptible to sea-level rise

Survival, growth, above ground biomass accumulation, soil surface elevation dynamics and nitrogen accumulation in accreted sediments were studied in experimental treatments planted with four different densities (6.96, 3.26, 1.93 and 0.95 seedlings m-2) of the mangrove Rhizophora mucronata in Puttalam Lagoon, Sri Lanka. Measurements were taken over a period of 1171 days and were compared with those from unplanted controls. Trees at the lowest density showed significantly reduced survival, whilst measures of individual tree growth did not differ significantly among treatments. Rates of surface sediment accretion (means ± S.E.) were 13.0 (±1.3), 10.5 (±0.9), 8.4 (±0.3), 6.9 (±0.5) and 5.7 (±0.3) mm yr-1 at planting densities of 6.96, 3.26, 1.93, 0.95, and 0 (unplanted control) seedlings m-2, respectively, showing highly significant differences among treatments. Mean (± S.E.) rates of surface elevation change were much lower than rates of accretion at 2.8 (±0.2), 1.6 (±0.1), 1.1 (±0.2), 0.6 (±0.2) and -0.3 (±0.1) mm yr-1 for 6.96, 3.26, 1.93, 0.95, and 0 seedlings m-2, respectively. All planted treatments appeared to accumulate greater nitrogen concentrations in the sediment compared to the unplanted control, and suggests one potential causal mechanism for the facilitatory effects observed; high densities of plants potentially contribute to the accretion of greater amounts of nutrient rich sediment. While this potential process needs further study, this study demonstrated how higher densities of mangroves enhance rates of sediment accretion and surface elevation, processes that may be crucial in mangrove ecosystem adaptation to sea level rise. There was no evidence that increasing plant density evoked a trade-off with growth and survival of the planted trees. Rather facilitatory effects enhanced survival at high densities, suggesting that local land managers may be able to take advantage of plantation densities to help mitigate sea-level rise effects by encouraging positive soil surface elevation increment, and perhaps even greater nutrient retention to promote mangrove growth and ameliorate nearshore eutrophication in tropical island environments.