Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression 2. Impact on the mother-child relationship and child outcome

Background: Postnatal depression is associated with adverse child cognitive and socio-emotional outcome. It is not known whether psychological treatment affects the quality of the mother-child relationship and child outcome. Aims: To evaluate the effect of three psychological treatments on the mother-child relationship and child outcome. Method: Women with post-partum depression (n=193) were assigned randomly to routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy The women and their children, were assessed at 43, [8 and 60 months post-partum. Results: Indications of a positive benefit were limited. All three treatments had a significant benefit on maternal reports of early difficulties in relationships with the infants, counselling gave better infant emotional and behaviour ratings at 18 months and more sensitive early mother-infant interactions. The treatments had no significant impact on maternal management of early infant behaviour problems, security of infant-mother attachment. Infant cognitive development or any child outcome at 5 years. Conclusions: Early intervention was of short-term benefit to the mother-child relationship and infant behaviour problems. More-prolonged intervention may be needed. Health visitors could deliver this.

Treatment of child anxiety. an exploratory study of the role of maternal anxiety and behaviours in treatment outcome

Anxiety disorders are common among parents of anxious children and have been found to impede child treatment outcomes, yet it is unclear whether it is parental anxiety that needs to be targeted in therapy or associated parental behaviours. Twenty-two children (6-12 years) with a current anxiety disorder and their mothers received cognitive-behavioural treatment (CBT) for child anxiety. In addition, of the 12 mothers who met criteria for a current anxiety disorder, 6 received CBT for their own disorder. Assessments were made of the mother-child interaction. The main findings were: (1) children did less well from treatment where their mothers had a current anxiety disorder; (2) treatment of maternal anxiety disorder did not improve child treatment outcome; and (3) maternal overinvolvement and expression of fear was associated with child treatment outcome. The results suggest that in the context of maternal anxiety disorder, child treatment outcome may be improved by specifically targeting parenting behaviours. Copyright (C) 2008 John Wiley & Sons, Ltd.

A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: realistic synthesis of the evidence

Background: Preventing childhood overweight and obesity has become a major public health issue in developed and developing countries. Systematic reviews of this topic have not provided practice-relevant guidance because of the generally low quality of research and the heterogeneity of reported effectiveness. Aim: To present practice-relevant guidance on interventions to reduce at least one measure of adiposity in child populations that do or do not contain overweight or obese children. Design: Systematic review of eligible randomized, controlled trials or controlled trials using a novel approach to synthesizing the trial results through application of descriptive epidemiological and realistic evaluation concepts. Eligible trials involved at least 30 participants, lasted at least 12 weeks and involved non-clinical child populations. Results: Twenty-eight eligible trials were identified to 30 April 2006. Eleven trials were effective and 17 were ineffective in reducing adiposity. Blind to outcome, the main factor distinguishing effective from ineffective trials was the provision of moderate to vigorous aerobic physical activity in the former on a relatively 'compulsory' rather than 'voluntary' basis. Conclusions: By using a novel approach to synthesizing trials, a decisive role for the 'compulsory' provision of aerobic physical activity has been demonstrated. Further research is required to identify how such activity can be sustained and transformed into a personally chosen behaviour by children and over the life course. (C) 2007 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.

A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development

Background Few studies of the effects of postnatal depression on child development have considered the chronicity of depressive symptoms. We investigated whether early postnatal depressive symptoms (PNDS) predicted child developmental outcome independently of later maternal depressive symptoms. Methods In a prospective, longitudinal study, mothers and children were followed-up from birth to 2 years; repeated measures of PNDS were made using the Edinburgh Postnatal Depression Scale (EPDS); child development was assessed using the Bayley Scales II. Multilevel modelling techniques were used to examine the association between 6 week PNDS, and child development, taking subsequent depressive symptoms into account. Results Children of mothers with 6 week PNDS were significantly more likely than children of non-symptomatic mothers to have poor cognitive outcome; however, this association was reduced to trend level when adjusted for later maternal depressive symptoms. Conclusion Effects of early PNDS on infant development may be partly explained by subsequent depressive symptoms.

Land, rights and the gift: the Countryside and Rights of Way Act 2000 and the negotiation of citizenship

The Countryside and Rights of Way Act came into force at the end of 2000 with,as part of its content, new provisions relating to public access to the English and Welsh countryside. In this paper we review the main elements of the Act and assess its meaning in relation to citizenship, territoriality and the place of land in English law and society. We invoke Mauss’s (1954)concept of Gift to explain the process of brokerage being made over access and rights in the countryside. In conclusion we reflect on the Act as being indicative of a wider move towards Bromley’s (1998)post-feudal scenario for land and its governance.

The child in wolf’s clothing: the meanings of the ‘wolf’ and questions of identity in Jack London’s White Fang

The criticism of Jack London’s work has been dominated by a reliance upon ideas of the ‘real’, the ‘authentic’ and the ‘archetypal’. One of the figures in London’s work around which these ideas crystallize is that of the ‘wolf’. This article will examine the way the wolf is mobilized both in the criticism of Jack London’s work and in an example of the work: the novel White Fang (1906). This novel, though it has often been read as clearly delimiting and demarcating the realms of nature and culture, can be read conversely as unpicking the deceptive simplicity of such categories, as troubling essentialist notions of identity (human/animal, male/female, white/Indian) and as engaging with the complexity of the journey in which a ‘small animal … becomes human-sexual by crossing the infinite divide that separates life from humanity, the biological from the historical, “nature” from “culture” ’ (Althusser 1971: 206).

The child and imperial return: the mystery of Edwin Drood

The Mystery of Edwin Drood has often been read as an Imperial text, just as Dickens's work has repeatedly been considered in relation to its construction of childhood. Despite this, 'the child' has either been avoided in criticism of Dickens's last novel, or has actively been read as absent. In this essay, I return the ‘repressed’ child to a reading of Drood, and through this disrupt appeals to a hard-impacted Imperial structure I understand to be made within criticism of it.

Drug control, human rights, and the right to the highest attainable standard of health: a reply to Saul Takahashi

A recent article in this journal challenged claims that a human rights framework should be applied to drug control. This article questions the author’s assertions and reframes them in the context of socio-legal drug scholarship, aiming to build on the discourse concerning human rights and drug use. It is submitted that a rights-based approach is a necessary, indeed obligatory, ethical and legal framework through which to address drug use and that international human rights law provides the proper scope for determining where interferences with individual human rights might be justified on certain, limited grounds.

Are gay rights Islamophobic? A critique of some uses of the concept of homonationalism in activism and academia

The concept of ‘homonationalism’ refers to deployments of gay rights for racist and Islamophobic ends, resulting in the consolidation of more sexually inclusive, but racially exclusionary, ideas of citizenship. This article critiques some of the analyses that the concept has inspired in both activist and academic contexts. The critique concentrates on two texts, showing that they make inappropriate rhetorical moves and inaccurate or unsubstantiated claims, and that rather than unearthing structural undercurrents of racism from certain texts or events, they project such structures onto them. While the validity of ‘homonationalism’ as an analytical category is not disputed, some of its propounders assume its explanatory power to be greater than it appears to be. The implications of this critique for gay rights activism and reform are explored.

Rights, symbolic violence and the micro-politics of the rural: the case of the Parish Paths Partnership scheme

In this paper microlevel politics and conflict associated with social and economic change in the countryside and linked changes in rural governance are explored with a focus upon research carried out on a recent rural policy initiative aimed at local 'empowerment'. This acts as a touchstone for a wider theoretical discussion. The paper is theorised within a conceptual framework derived and extended from the work of Pierre Bourdieu and others in order to explore case studies of the English Countryside Commission's Parish Paths Partnership scheme. The micropolitics involved with this scheme are examined and used to highlight more general issues raised by increased 'parish empowerment' in the 'postrural'.