Improving quality of mother-infant relationship and infant attachment in socioeconomically deprived community in South Africa: randomised controlled trial

Objective To assess the efficacy of an intervention designed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances. Design Randomised controlled trial. Setting Khayelitsha, a peri-urban settlement in South Africa. Participants 449 pregnant women. Interventions The intervention was delivered from late pregnancy and for six months postpartum. Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting. The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother. Women in the control group received no therapeutic input from the research team. Main outcome measures Primary outcomes: quality of mother-infant interactions at six and 12 months postpartum; infant attachment security at 18 months. Secondary outcome: maternal depression at six and 12 months. Results The intervention was associated with significant benefit to the mother-infant relationship. At both six and 12 months, compared with control mothers, mothers in the intervention group were significantly more sensitive (6 months: mean difference=0.77 (SD 0.37), t=2.10, P<0.05, d=0.24; 12 months: mean difference=0.42 (0.18), t=-2.04, P<0.05, d=0.26) and less intrusive (6 months: mean difference=0.68 (0.36), t=2.28, P<0.05, d=0.26; 12 months: mean difference=-1.76 (0.86), t=2.28, P<0.05, d=0.24) in their interactions with their infants. The intervention was also associated with a higher rate of secure infant attachments at 18 months (116/156 (74%) v 102/162 (63%); Wald=4.74, odds ratio=1.70, P<0.05). Although the prevalence of maternal depressive disorder was not significantly reduced, the intervention had a benefit in terms of maternal depressed mood at six months (z=2.05, P=0.04) on the Edinburgh postnatal depression scale). Conclusions The intervention, delivered by local lay women, had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment, factors known to predict favourable child development. If these effects persist, and if they are replicated, this intervention holds considerable promise for use in the developing world. Trial registration Current Controlled Trials ISRCTN25664149.

A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents

Cognitive behaviour therapy (CBT) for young people with obsessive compulsive disorder (OCD) has become the treatment of first choice. However, the literature is largely based on studies emphasising exposure and response prevention. In this study, we report on a randomised controlled trial of CBT for young people carried out in typical outpatient clinic conditions which focused on cognitions. A randomised controlled trial compares 10 sessions of manualised cognitive behavioural treatment with a 12-week waiting list for adolescents and children with OCD. Assessors were blind to treatment allocation. 21 consecutive patients with OCD aged between 9 and 18 years were recruited. The group who received treatment improved more than a comparison group who waited for 3 months. The second group was treated subsequently using the same protocol and made similar gains. In conclusion, CBT can be delivered effectively to young people with OCD in typical outpatient settings.

The evolution of strategy: thinking war from antiquity to the present

Latin had no word for "strategy", but the East Romans, whom we call the Byzantines, did. This book tracks the evolution of the concept of warfare being subjected to higher political aims from Antiquity to the Present, using Greek, Latin, French, Spanish, Italian, English and German sources. It tracks the rise, fall, and resurrection of the belief in the Roman and later the medieval and early modern world that warfare was only legitimate if it pursued the higher goal of a just peace, which in the 19th century gave way to a blinkered concentration on military victory as only war aim. It explains why one school of thought, from Antiquity to the present, emphasised eternal principles of warfare, while others emphasised, in Clausewitz's term, the "changing character of war". It tracks ideas from land warfare to naval warfare to air power and nuclear thinking, but it also stresses great leaps and discontinuities in thinking about strategy. It covers asymmetric wars both from the point of view of the weaker power seeking to overthrow a stronger power, and from the stronger power dealing with insurgents and other numerically inferior forces. It concludes with a commentary of the long-known problems of bureaucratic politics, non-centralised command and inter-service rivalry, which since the 16th century or earlier has created obstacles to coherent strategy making.

Effects of biochar and the earthworm Eisenia fetida on the bioavailability of polycyclic aromatic hydrocarbons and potentially toxic elements

Polycyclic aromatic hydrocarbons (PAHs) and potentially toxic elements (PTEs) were monitored over 56 days in calcareous contaminated-soil amended with either or both biochar and Eisenia fetida. Biochar reduced total (449 to 306mgkg(-1)) and bioavailable (cyclodextrin extractable) (276 to 182mgkg(-1)) PAHs, PAH concentrations in E. fetida (up to 45%) but also earthworm weight. Earthworms increased PAH bioavailability by >40%. Combined treatment results were similar to the biochar-only treatment. Earthworms increased water soluble Co (3.4 to 29.2mgkg(-1)), Cu (60.0 to 120.1mgkg(-1)) and Ni (31.7 to 83.0mgkg(-1)) but not As, Cd, Pb or Zn; biochar reduced water soluble Cu (60 to 37mgkg(-1)). Combined treatment results were similar to the biochar-only treatment but gave a greater reduction in As and Cd mobility. Biochar has contaminated land remediation potential, but its long-term impact on contaminants and soil biota needs to be assessed.

Incorporating languages into histories of war: a research journey

This article discusses the ways in which languages can be integrated into histories of war and conflict, by exploring ongoing research in two case studies: the liberation and occupation of Western Europe (1944–47), and peacekeeping/peace building in Bosnia-Herzegovina (1995–2000). The article suggests that three methodological approaches have been of particular value in this research: adopting an historical framework; following the “translation” of languages into war situations; and contextualizing the figure of the interpreter/translator. The process of incorporating languages into histories of conflict, the article argues, has helped to uncover a broader languages landscape within the theatres of war.

Improving quality of mother-infant relationship and infant attachment in socioeconomically deprived community in South Africa: randomised controlled trail

Objective To assess the efficacy of an intervention designed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances. Design Randomised controlled trial. Setting Khayelitsha, a peri-urban settlement in South Africa. Participants 449 pregnant women. Interventions The intervention was delivered from late pregnancy and for six months postpartum. Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting. The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother. Women in the control group received no therapeutic input from the research team. Main outcome measures Primary outcomes: quality of mother-infant interactions at six and 12 months postpartum; infant attachment security at 18 months. Secondary outcome: maternal depression at six and 12 months. Results The intervention was associated with significant benefit to the mother-infant relationship. At both six and 12 months, compared with control mothers, mothers in the intervention group were significantly more sensitive (6 months: mean difference=0.77 (SD 0.37), t=2.10, P<0.05, d=0.24; 12 months: mean difference=0.42 (0.18), t=−2.04 , P<0.05, d=0.26) and less intrusive (6 months: mean difference=0.68 (0.36), t=2.28, P<0.05, d=0.26; 12 months: mean difference=−1.76 (0.86), t=2.28 , P<0.05, d=0.24) in their interactions with their infants. The intervention was also associated with a higher rate of secure infant attachments at 18 months (116/156 (74%) v 102/162 (63%); Wald=4.74, odds ratio=1.70, P<0.05). Although the prevalence of maternal depressive disorder was not significantly reduced, the intervention had a benefit in terms of maternal depressed mood at six months (z=2.05, P=0.04) on the Edinburgh postnatal depression scale). Conclusions The intervention, delivered by local lay women, had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment, factors known to predict favourable child development. If these effects persist, and if they are replicated, this intervention holds considerable promise for use in the developing world.

Thromboxane A2 inhibition of SKCa after NO synthase block in rat middle cerebral artery

NO/prostanoid independent, EDHF-mediated hyperpolarization and dilation in rat middle cerebral arteries is mediated solely by endothelial cell IK(Ca). However, when the NO-pathway is also active, both SK(Ca) and IK(Ca) contribute to EDHF responses. As the SK(Ca) component can be inhibited by stimulation of thromboxane A(2) (TxA(2)) TP receptors and NO has the potential ability to inhibit thromboxane synthesis, we investigated whether TxA(2) might explain loss of functional input from SK(Ca) during NOS inhibition in cerebral arteries. EXPERIMENTAL APPROACH: Rat middle cerebral arteries were mounted in a wire myograph. Endothelium-dependent responses to the PAR2 agonist, SLIGRL were assessed as simultaneous changes in smooth muscle membrane potential and tension. KEY RESULTS: Responses were obtained in the presence of L-NAME as appropriate. Inhibition of TP receptors with either ICI 192,605 or SQ 29,548, did not affect EDHF mediated hyperpolarization and relaxation, but in their presence neither TRAM-34 nor apamin (to block IK(Ca) and SK(Ca) respectively) individually affected the EDHF response. However, in combination they virtually abolished it. Similar effects were obtained in the presence of the thromboxane synthase inhibitor, furegrelate, which additionally revealed an iberiotoxin-sensitive residual EDHF hyperpolarization and relaxation in the combined presence of TRAM-34 and apamin. CONCLUSIONS AND IMPLICATIONS: In the rat middle cerebral artery, inhibition of NOS leads to a loss of the SK(Ca) component of EDHF responses. Either antagonism of TP receptors or block of thromboxane synthase restores an input through SK(Ca). These data indicate that NO normally enables SK(Ca) activity in rat middle cerebral arteries.

The Spanish Ambassador and Samuel Daniel's Vision of the Twelve Goddesses: A New Document [with text]

The performance of Samuel Daniel's masque The Vision of the Twelve Goddesses at court on January 8, 1604 took place in the midst of the preliminary negotiations that would lead to the signing of the Anglo-Spanish peace at Somerset House the following August. Philip III sent a special ambassador to England to congratulate James on his accession, and a series of tussles between Juan de Tassis and his French counterpart ensued. As a recently-discovered document in the Archivo General de Simancas reveals, Anna of Denmark intervened personally to insure that de Tassis, and not the Frenchman, attended the masque. This was a clear signal of James and Anna's peace aims, which de Tassis conveyed to the King of Spain; moreover, he enclosed in his dispatch a text of Daniel's masque which he clearly considered both political intelligence and of interest to the theater-loving Hapsburg monarch. The Simancas text of the Daniel masque is a new version, hitherto unknown, which adds to our knowledge of the circumstances in which the first Stuart masque was performed. Here we present a transcription and annotated translation of both de Tassis' letter and the text of the masque he had compiled for Philip III. (B. C.-E. and M. H.)

Women, other "fresh” workers, and the new manufacturing workforce of interwar Britain

Structural, organizational, and technological changes in British industry during the interwar years led to a decline in skilled and physically demanding work, while there was a dramatic expansion in unskilled and semiskilled employment. Previous authors have noted that the new un/semiskilled jobs were generally filled by “fresh” workers recruited from outside the core manufacturing workforce, though there is considerable disagreement regarding the composition of this new workforce. This paper examines labour recruitment patterns and strategies using national data and case studies of eight rapidly expanding industrial centres. The new industrial workforce is shown to have been recruited from a “reserve army” of workers with the common features of relative cheapness, flexibility, and weak unionization. These included women, juveniles, local workers in poorly paid nonindustrial sectors, such as agriculture, and (where these other categories were in short supply) relatively young long-distance internal migrants from declining industrial areas.

Beyond the "liberal peace"

The article critically reviews the contributions to the understanding of contemporary peacebuilding practices of several recent contributions to the peacebuilding literature, including the 2011 World Development Report. It examines some of the conceptual problems with recent criticisms of the "liberal peace", and proposes that the concept of "liberal peace" should be abandonned as it lacks any analytical purchase.

In vitro evaluation of the fermentation properties and potential prebiotic activity of caprine cheese whey oligosaccharides in batch culture systems

The prebiotic effect of oligosaccharides recovered and purified from caprine whey, was evaluated by in vitro fermentation under anaerobic conditions using batch cultures at 37ºC with human faeces. Effects on key gut bacterial groups were monitored over 24h by fluorescence in situ hybridisation (FISH), which was used to determine a quantitative prebiotic index score. Production of short-chain fatty acids (SCFAs) as fermentation end products was analysed by high-performance liquid chromatography (HPLC). Growth of Bifidobacterium spp was significantly higher (p ≥ 0.05) with the purified oligosaccharides compared to the negative control. Lactic and propionic acids were the main SCFAs produced. Antimicrobial activity of the oligosaccharides was also tested, revealing no inhibition though a decrease in Staphylococcus aureus and Escherichia coli growth. These findings indicate that naturally extracted oligosaccharides from caprine whey could be used as new and valuable source of prebiotics.