A systematic review of systematic reviews to improve maternal mental health and well-being

Objective: to identify non-invasive interventions in the perinatal period that could enable midwives to offer effective support to women within the area of maternal mental health and well-being.

Methods: a total of 9 databases were searched: MEDLINE, PubMed, EBSCO (CINAHL/British Nursing Index), MIDIRS Online Database, Web of Science, The Cochrane library, CRD (NHS EED/DARE/HTA), Joanne Briggs Institute and EconLit. A systematic search strategy was formulated using key MeSH terms and related text words for midwifery, study aim, study design and mental health. Inclusion criteria were articles published from 1999 onwards, English language publications and articles originating from economically developed countries, indicated by membership of the Organisation for Economic Co-operation and Development (OECD). Data were independently extracted using a data collection form, which recorded data on the number of papers reviewed, time frame of the review, objectives, key findings and recommendations. Summary data tables were set up outlining key data for each study and findings were organised into related groups. The methodological quality of the reviews was assessed based on predefined quality assessment criteria for reviews.

Findings: 32 reviews were identified as examining interventions that could be used or co-ordinated by midwives in relation to some aspect of maternal mental health and well-being from the antenatal to the postnatal period and met the inclusion criteria. The review highlighted that based on current systematic review evidence it would be premature to consider introducing any of the identified interventions into midwifery training or practice. However there were a number of examples of possible interventions worthy of further research including midwifery led models of care in the prevention of postpartum depression, psychological and psychosocial interventions for treating postpartum depression and facilitation/co-ordination of parent-training programmes. No reviews were identified that supported a specific midwifery role in maternal mental health and well-being in pregnancy, and yet, this is the point of most intensive contact.

Key conclusions and implications for practice: This systematic review of systematic reviews provides a valuable overview of the current strengths and gaps in relation to maternal mental health interventions in the perinatal period. While there was little evidence identified to inform the current role of midwives in maternal mental health, the review provides the opportunity to reflect on what is achievable by midwives now and in the future and the need for high quality randomised controlled trials to inform a strategic approach to promoting maternal mental health in midwifery.

The role of imitation in video-based interventions for children with autism.

Objective: The aim of this paper is to bridge the gap between the corpus of imitation research and video-based intervention (VBI) research, and consider the impact imitation skills may be having on VBI outcomes and highlight potential areas for improving efficacy.

Method: A review of the imitation literature was conducted focusing on imitation skill deficits in children with autism followed by a critical review of the video modelling literature focusing on pre-intervention assessment of imitation skills and the impact imitation deficits may have on VBI outcomes.

Results: Children with autism have specific imitation deficits, which may impact VBI outcomes. Imitation training or procedural modifications made to videos may accommodate for these deficits.

Conclusions: There are only six studies where VBI researchers have taken pre-intervention imitation assessments using an assortment of imitation measures. More research is required to develop a standardised multi-dimensional imitation assessment battery that can better inform VBI.

An Integrated Sensing System for Monitoring the Corrosion Activity in Concrete Blocks Exposed at Hangzhou Bay Bridge

This paper discusses the importance of integrated sensing systems comprising techniques that give different types of data from a structure exposed to the marine environment so that its service life could reliably be predicted. For this purpose, a novel sensor combination was designed and installed in concrete panels which were exposed to Hangzhou Bay Bridge in China. The integrated sensor probe was used to monitor the cover concrete as well as the reinforcement. The sensor probes were connected to a monitoring station, which enabled access and control of the data remotely from Belfast, UK. The initial data obtained from the monitoring station gives interesting information on the early age properties of concrete and distinct variations in these properties with different types of concrete. This paper also reports the variation in electrical properties of different concrete samples and environmental data in response to the marine exposure condition at Hangzhou bay bridge.

Coal Combustion Residuals valorisation through the production of compressed masonry brick

The Niger Coal Society (Societé Nigérienne de Charbon – SONICHAR) produces electricity for local consumption in Tefereyre, 75 km north-west from Agadez, Niger. The coal combustion residuals production is about 150,000 tons per year. In order to reduce this environmental burden and to valorize these by-products, a study focusing on their physical and chemical features as well as on the mechanical resistance of compressed brick has been undertaken. Physical characterization of coal slag, chemical and lixiviation tests have been carried out, assessing the material main parameters, verifying the presence of hazardous composites and elements and comparing the obtained results with the findings of an in-deep literary review. Cement powder has been chosen as stabilizing agent as a preliminary option. Four different dosages have been tested and bricks have been produced with a hand-operated press. Compressive strength has been tested at different days of curing. Results show remarkable uniaxial compressive strengths (UCS) for all the mixes after cure, ranging from 4MPa up to more than 20MPa for the highest stabilization ratio. UCS higher than 5MPa have been observed for 20% and 30% cement stabilization ratios after only 7 days of cure, reaching respectively about 11MPa and 13MPa after 45 days. In conclusion obtained bricks show good mechanical resistance and low weight. No health threat has been detected from the obtained sample. Study developments are oriented towards the feasibility of the utilization of low-cost, locally available stabilization means, notably clay and cohesive soils, and on thermal properties assessment.

How to classify the Oldest Old according to Health Status: A study of 1160 subjects belonging to 552 90+ Italian sibships characterised by familial longevity recruited within the GeHA EU project

The health status of the oldest old, the fastest increasing population segment worldwide, progressively becomes more heterogeneous, and this peculiarity represents a major obstacle to their classification. We compared the effectiveness of four previously proposed criteria (Franceschi et al., 2000; Evert et al., 2003; Gondo et al., 2006; Andersen-Ranberg et al., 2001) in 1160 phenotypically fully characterized Italian siblings of 90 years of age and older (90+, mean age: 93 years; age range: 90–106 years) belonging to 552 sib-ships, recruited in Northern, Central and Southern Italy within the EU-funded project GEHA, followed for a six-year-survival. Main findings were: (i) ‘‘healthy’’ subjects varied within a large range, i.e. 5.2% (Gondo), 8.7% (Evert), 17.7% (Franceschi), and 28.5% (Andersen-Ranberg); (ii) Central Italy subjects showed better health than those from Northern and Southern Italy; (iii) mortality risk was correlated with health status independently of geographical areas; and (iv) 90+ males, although fewer in number, were healthier than females, but with no survival advantage. In conclusion, we identified a modified version of Andersen-Ranberg criteria, based on the concomitant assessment of two basic domains (cognitive, SMMSE; physical, ADL), called ‘‘Simple Model of Functional Status’’ (SMFS), as the most effective proxy to distinguish healthy from not-healthy subjects. This model showed that health status was correlated within sib-ships, suggesting a familial/genetic component.

Quantification of singlet oxygen generation from photodynamic hydrogels

Recently, we described a series of novel porphyrin-impregnated hydrogels capable of producing microbicidal singlet oxygen (1O2) on photoactivation. Indirect assessment of the efficacy of 1O2 production from such hydrogels has been previously described using microbiological techniques, but here we report a novel, direct method of quantification. Anthracene-9,10-dipropionic acid (ADPA) is known to irreversibly form an endoperoxide on reaction with 1O2, causing photobleaching of its absorbance band at approximately 378 nm. Here, the reaction of this probe is exploited in a novel way to provide a simple, inexpensive, and convenient measurement of 1O2 generation from the surface of porphyrin-incorporated photosensitising hydrogels, with the ability to account for effects due to hydrogel porosity. Ingress of the probe into the materials was observed, with rates of up to 3.83 x 103 s-1. This varied by up to 200-fold with material composition and surface modification. Rates of 1O2 generation in these porphyrin-incorporated hydrogels, after compensating for ADPA ingress, ranged from 1.86x103 – 5.86x103 s-1. This work demonstrates a simple and straightforward method for direct 1O2 quantification from porous materials, with general utility.

A Novel Approach for Axle Detection in Bridge Weigh-In-Motion Systems

Bridge weigh-in-motion (B-WIM), a system that uses strain sensors to calculate the weights of trucks passing on bridges overhead, requires accurate axle location and speed information for effective performance. The success of a B-WIM system is dependent upon the accuracy of the axle detection method. It is widely recognised that any form of axle detector on the road surface is not ideal for B-WIM applications as it can cause disruption to the traffic (Ojio & Yamada 2002; Zhao et al. 2005; Chatterjee et al. 2006). Sensors under the bridge, that is Nothing-on-Road (NOR) B-WIM, can perform axle detection via data acquisition systems which can detect a peak in strain as the axle passes. The method is often successful, although not all bridges are suitable for NOR B-WIM due to limitations of the system. Significant research has been carried out to further develop the method and the NOR algorithms, but beam-and-slab bridges with deep beams still present a challenge. With these bridges, the slabs are used for axle detection, but peaks in the slab strains are sensitive to the transverse position of wheels on the beam. This next generation B-WIM research project extends the current B-WIM algorithm to the problem of axle detection and safety, thus overcoming the existing limitations in current state-of–the-art technology. Finite Element Analysis was used to determine the critical locations for axle detecting sensors and the findings were then tested in the field. In this paper, alternative strategies for axle detection were determined using Finite Element analysis and the findings were then tested in the field. The site selected for testing was in Loughbrickland, Northern Ireland, along the A1 corridor connecting the two cities of Belfast and Dublin. The structure is on a central route through the island of Ireland and has a high traffic volume which made it an optimum location for the study. Another huge benefit of the chosen location was its close proximity to a nearby self-operated weigh station. To determine the accuracy of the proposed B-WIM system and develop a knowledge base of the traffic load on the structure, a pavement WIM system was also installed on the northbound lane on the approach to the structure. The bridge structure selected for this B-WIM research comprised of 27 pre-cast prestressed concrete Y4-beams, and a cast in-situ concrete deck. The structure, a newly constructed integral bridge, spans 19 m and has an angle of skew of 22.7°.

Enquiring about traumatic experiences in psychosis: A comparison of case notes and self-report questionnaires

Purpose: Studies have found an association between a history of trauma and the presence of psychotic symptoms. Despite the research evidence it appears to be the case that many clinicians are not routinely asking about traumatic experiences. This study aims to ascertain the level of agreement between rates of self-reported trauma and that which is recorded in case notes.

Methods: The study population was drawn from all individuals with a confirmed diagnosis of psychosis, residing within a defined catchment area. Rates of childhood trauma, lifetime trauma and trauma related to the Troubles in Northern Ireland recorded in participants’ case notes were compared to their responses on self-report questionnaires: THQ, CTQ and TREQ.

Results: Relatively high levels of trauma were reported by participants on the self-report measures that were administered. The rates of trauma recorded in case note records were similar to that found in other studies. Also in line with other research were poor levels of agreement between self-report and case note data.

Conclusion: High levels of lifetime, childhood and trauma related to the Troubles in Northern Ireland were found when the individuals in the sample were directly assessed for the purposes of this study. In contrast much lower rates were recorded in patient notes on routine clinical assessment. The results suggest that clinicians do not routinely enquire about trauma histories with this population and as a result, case notes underestimate trauma prevalence.

A randomized controlled trial of an early-intervention, computer-based literacy program to boost phonological skills in 4- to 6-year-old children

Background: Many school-based interventions are being delivered in the absence of evidence of effectiveness (Snowling & Hulme, 2011, Br. J. Educ. Psychol., 81, 1).Aim: This study sought to address this oversight by evaluating the effectiveness of the commonly used the Lexia Reading Core5 intervention, with 4- to 6-year-old pupils in Northern Ireland.Sample: A total of 126 primary school pupils in year 1 and year 2 were screened on the Phonological Assessment Battery 2nd Edition (PhAB-2). Children were recruited from the equivalent year groups to Reception and Year 1 in England and Wales, and Pre-kindergarten and Kindergarten in North America.
Methods: A total of 98 below-average pupils were randomized (T0) to either an 8-week block (inline image = 647.51 min, SD = 158.21) of daily access to Lexia Reading Core5 (n = 49) or a waiting-list control group (n = 49). Assessment of phonological skills was completed at post-intervention (T1) and at 2-month follow-up (T2) for the intervention group only.
Results: Analysis of covariance which controlled for baseline scores found that the Lexia Reading Core5 intervention group made significantly greater gains in blending, F(1, 95) = 6.50, p = .012, partial η2 = .064 (small effect size) and non-word reading, F(1, 95) = 7.20, p = .009, partial η2 = .070 (small effect size). Analysis of the 2-month follow-up of the intervention group found that all group treatment gains were maintained. However, improvements were not uniform among the intervention group with 35% failing to make progress despite access to support. Post-hoc analysis revealed that higher T0 phonological working memory scores predicted improvements made in phonological skills.
Conclusions: An early-intervention, computer-based literacy program can be effective in boosting the phonological skills of 4- to 6-year-olds, particularly if these literacy difficulties are not linked to phonological working memory deficits.

Accountability for Responsibility: An assessment of the Transnational Capitalist Class' role in driving a Global CSR Agenda

Globalisation has led to the establishment of a new hierarchy of leadership. At the helm is the Transnational Capitalist Class (TCC) , which oversees the direction of Multi National Corporations (MNCs) at a global level. Can the TCC, as leaders in the governance agenda, drive a global CSR agenda, or, perhaps, the question should be: do they want to drive a CSR agenda?
The hypothesis of this article is that, as the structure of global leadership and governance has changed, so too has the potential for aligning national CSR agendas to a globally accepted standard. This is unlikely due to systematic limitations inherent in a transitional structural realignment of global leadership. Whereas the design of global leadership has changed due to processes of globalization, the bodies that can regulate this leadership have not developed at the same pace. Regulation on issues such as CSR remains at national, federal and supra-­-national levels suggesting that TCCs have a free reign in dictating agenda. This new class (TCC) may bear a responsibility for CSR but there is a lack of accountability if it is not fulfilled.