The infant feeding activity and nutrition trial (INFANT) an early intervention to prevent childhood obesity : cluster-randomised controlled trial

Background : Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours (poor diet, low physical activity and high sedentary behaviour) from their inception. These factors include the rapidly increasing prevalence of fatness throughout childhood, the instigation of obesity-promoting behaviours in infancy, and the tracking of these behaviours from childhood through to adolescence and adulthood. The Infant Feeding Activity and Nutrition Trial (INFANT) aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents. The intervention, conducted with parents over the infant's first 18 months of life, will use existing social networks (first-time parent's groups) and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours, and reduced sedentary behaviours in infancy.

Methods/Design : This cluster-randomised controlled trial, with first-time parent groups as the unit of randomisation, will be conducted with a sample of 600 first-time parents and their newborn children who attend the first-time parents' group at Maternal and Child Health Centres. Using a two-stage sampling process, local government areas in Victoria, Australia will be randomly selected at the first stage. At the second stage, a proportional sample of first-time parent groups within selected local government areas will be randomly selected and invited to participate. Informed consent will be obtained and groups will then be randomly allocated to the intervention or control group.

Discussion : The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge this will be the first randomised trial internationally to demonstrate whether an early health promotion program delivered to first-time parents in their existing social groups promotes healthy eating, physical activity and reduced sedentary behaviours. If proven to be effective, INFANT may protect children from the development of obesity and its associated social and economic costs.

Is life history a barrier to dispersal? Contrasting patterns of genetic differentiation along an oceanographically complex coast

Extreme variation in early life-history strategies is considered a moderately good predictor of genetic subdivision and hence dispersal for a range of marine species. In reality, however, a good deal of population differentiation must reflect historical effects, more subtle variation in life histories, and, particularly, the interaction of larvae with oceanographic processes. Using a combination of allozyme and microsatellite markers, we show that the large-scale genetic structure of populations of three species (direct and planktonically developing cushion stars and a planktonic developing sea anemone that is also asexually viviparous) varies consistently, in line with the predicted capacity for dispersal within three geographic regions. We detected high levels of genetic subdivision for the direct developing cushion star (FST = 0.6), low levels for the planktonically developing cushion star (FST = 0.009), and intermediate levels for the sexual/asexual sea anmone (FST = 0.19). These patterns are exhibited despite the highly variable patterns of current movement and the presence of biogeographic barriers. Our results suggest that, although there is large scale genetic differentiation for two species, patterns of population connectivity are remarkably consistent within major regions and do not reflect variation in major oceanographic processes or genetic discontinuity coincident with biogeographic boundaries.

Symptoms of depression and difficulty initiating sleep from early adolescence to early adulthood: a longitudinal study

STUDY OBJECTIVES: To assess the direction of the relationship and degree of shared associations between symptoms of depression and difficulty initiating sleep (DIS) from early adolescence to early adulthood. DESIGN: Cross-sectional and longitudinal assessment of the symptoms of depression-DIS association from early adolescence (age 13 y) to early adulthood (age 23 y). SETTING: Hordaland, Norway. PARTICIPANTS: There were 1,105 individuals (55% male) who took part in the Norwegian Longitudinal Health Behaviour Study (NLHB) and participated at least once across seven data collection waves during the years 1990-2000. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Characteristic data were obtained during the first assessment. Symptoms of depression and instances of DIS were assessed during each data collection wave. Symptoms of depression and DIS were associated in all data waves, and one-step cross-lagged bivariate correlations were significant and comparatively high for both factors. Structural equation modelling indicated that DIS and symptoms of depression at wave 1 remain relatively stable across waves (all P < 0.001), and a significant and consistent unidirectional cross-lagged effect was noted running from symptoms of depression to DIS from early adolescence to early adulthood. DIS is only marginally and inconsistently associated with the lagged symptoms of depression score across waves. CONCLUSIONS: These results suggest that symptoms of depression established in early adolescence are a moderate predictor of difficulty initiating sleep (DIS) in early adulthood, whereas the reverse association of DIS predicting depression was not convincingly supported. These findings are in contrast to previous findings that suggest sleep problems as a risk factor for the later development of depression.

The extended Infant Feeding, Activity and Nutrition Trial (InFANT Extend) Program : a cluster-randomized controlled trial of an early intervention to prevent childhood obesity

BACKGROUND: Understanding how we can prevent childhood obesity in scalable and sustainable ways is imperative. Early RCT interventions focused on the first two years of life have shown promise however, differences in Body Mass Index between intervention and control groups diminish once the interventions cease. Innovative and cost-effective strategies seeking to continue to support parents to engender appropriate energy balance behaviours in young children need to be explored. METHODS/DESIGN: The Infant Feeding Activity and Nutrition Trial (InFANT) Extend Program builds on the early outcomes of the Melbourne InFANT Program. This cluster randomized controlled trial will test the efficacy of an extended (33 versus 15 month) and enhanced (use of web-based materials, and Facebook® engagement), version of the original Melbourne InFANT Program intervention in a new cohort. Outcomes at 36 months of age will be compared against the control group. DISCUSSION: This trial will provide important information regarding capacity and opportunities to maximize early childhood intervention effectiveness over the first three years of life. This study continues to build the evidence base regarding the design of cost-effective, scalable interventions to promote protective energy balance behaviors in early childhood, and in turn, promote improved child weight and health across the life course. TRIAL REGISTRATION: ACTRN12611000386932 . Registered 13 April 2011.

Cross-fostering reduces obesity induced by early exposure to monosodium glutamate in male rats

Maternal obesity programmes a range of metabolic disturbances for the offspring later in life. Moreover, environmental changes during the suckling period can influence offspring development. Because both periods significantly affect long-term metabolism, we aimed to study whether cross-fostering during the lactation period was sufficient to rescue a programmed obese phenotype in offspring induced by maternal obesity following monosodium L-glutamate (MSG) treatment. Obesity was induced in female Wistar rats by administering subcutaneous MSG (4 mg/g body weight) for the first 5 days of postnatal life. Control and obese female rats were mated in adulthood. The resultant pups were divided into control second generation (F2) (CTLF2), MSG-treated second generation (F2) (MSGF2), which suckled from their CTL and MSG biological dams, respectively, or CTLF2-CR, control offspring suckled by MSG dams and MSGF2-CR, MSG offspring suckled by CTL dams. At 120 days of age, fat tissue accumulation, lipid profile, hypothalamic leptin signalling, glucose tolerance, glucose-induced, and adrenergic inhibition of insulin secretion in isolated pancreatic islets were analysed. Maternal MSG-induced obesity led to an obese phenotype in male offspring, characterized by hyperinsulinaemia, hyperglycaemia, hyperleptinaemia, dyslipidaemia, and impaired leptin signalling, suggesting central leptin resistance, glucose intolerance, impaired glucose-stimulated, and adrenergic inhibition of insulin secretion. Cross-fostering normalized body weight, food intake, leptin signalling, lipid profiles, and insulinaemia, but not glucose homeostasis or insulin secretion from isolated pancreatic islets. Our findings suggest that alterations during the lactation period can mitigate the development of obesity and prevent the programming of adult diseases.

Belonging as a force of agency : an exploration of immigrant children’s everyday life in early childhood settings

The notion of agency is being used with increasing frequency in early childhood policies, replacing traditional assumptions about young children’s immaturity and their role as mere recipients of adults’ arrangements. Agency is thus both an educational aspiration as well as a signifier of a strong rights-based political commitment to countering views of children as immature and incompetent. This article develops the argument that agency is inherently a sociocultural product that is driven by children’s clear attempts to bond with others and to develop a sense of belonging. Using examples of the everyday experiences of two Chinese immigrant children in an early childhood centre, the article considers ways in which agency was exercised by the children in an unfamiliar sociocultural setting because they wanted to belong. Some crucial issues are highlighted for practice and policy development in the area of immigrant children’s education, arguing that the shaping of early childhood education requires an attention to children’s ‘invisible’ capabilities, needs to belong and ‘small’ everyday life realities.

Parent-proxy and child self-reported health-related quality of life: using qualitative methods to explain the discordance

Background: Although parent-proxy reports of health-related quality of life (HRQOL) are only moderately correlated with child reported HRQOL, it remains unknown why these scores differ. The aim of this study was to use a qualitative methodology to examine why parents and children report different levels of HRQOL.

Method: The sample consisted of 15 parent–child pairs. A think-aloud technique was used where parents and children were given a generic HRQOL instrument (KIDSCREEN) and instructed to share their thoughts with the interviewer. Qualitative analyses were conducted to assess whether parents and children base their answer on different experiences or reasoning, have different response styles, or interpret the items differently.

Results: There was discordance between parents and children, in terms of rating scale and in terms of the reasoning for their answer. Children tended to have different response styles to parents, where for example, children tended to provide extreme scores (highest or lowest score) and base their response on one single example, more than parents. Parents and children interpreted the meaning of the items very similarly.

Discussion: This study provides evidence to suggest that discordance among parent-child pairs on KIDSCREEN scores may be as a result of different reasoning and different response styles, rather than interpretation of items. These findings have important implications when parent-proxy reported HRQOL is used to guide clinical/treatment decisions.

Study of 'post-critical' thought and religious epistemology : with special reference to Michael Polanyi, Paul Tillich and Thomas F. Torrance

Explores the foundational problem in epistemology posed by Immanuel Kant and illustrates, from the 'post-critical' position, with special reference to Michael Polanyi, Paul Tillich and Thomas F. Torrance, how they serve as alternative philosophical and religious responses to the Kantian critical philosophy.

The act of giving: a pilot and feasibility study of the My Life Story programme designed to foster positive mental health and well-being in adolescents and older adults

Twelve pairs of adolescent students were linked to an older adult in aged care in this pilot study on intergenerational interaction. Triads met weekly for eight weeks with the aim of writing a Life Review Book for the older adult. At the conclusion of the study, participants were interviewed to gain an understanding of their experiences and meaning of the programme. Thematic analysis of the interviews revealed four major themes: breaking down the stereotypes, recognition of heterogeneity, satisfaction from ‘making the effort’ and personal gain through making a contribution. Measures of psychological well-being were also administered pre- and post-delivery of the programme. This revealed that both age groups could and would complete all aspects of the programme. It was concluded from the findings that the intergenerational programme is feasible in the context of adolescent and older adult intergenerational relationships, and a potential influence on well-being for those who take part.

Location, perception and dissolution of form 1991-1993

The thesis covers a series of two and three-dimensional installations created in the investigation of both metaphorical and literal perceptions of form. The journey leads from the idea of painted-related dissolution of form in the early works, to the translation from three-dimensional to two-dimensional installations, and lastly, to experimentation with sound works where non-physical form is explored.

Precarious decencies: negotiating creative (im)mortalities, in life, together

This paper takes up the question of what might hinder the collaborative impulse among artists and specifically poets, and offers—as one possible answer—the complication posed by the urge of an artist for immortality, or for their (individual) name to live on. The paper begins by returning to a moment in Plato, namely that of the Symposium and its observations concerning the connection between poiesis (making) and a questing after immortality. Contrasting with what seems like Plato's broadly positive framing, the paper takes up a second reading of immortality (or the 'will-to-live') found in an early text of the Yogic canon, that of Patanjali's Yoga Sutras. In this second text, written somewhat later than Plato's, the will-to-live is framed otherwise, as one of five afflictions that can be 'made thin' by practice. The paper's wager is that, viewed in this way, as an affliction, the will-to-live (or urge for immortality) deserves consideration as a hindrance to the impulse towards collaboration. Noting, however, that in the poiesis of writing poetry, where there is both the making of things and the action of making things, this creative constellation always contains the tempering solution to its own inherent lures. Writing, although providing fuel for immortal appetites (due to what it makes), also works to temper the worst of this same impulse via the contribution of practice—as dedication, craft and community-as-practice. The practice of writing, therefore, is already at play, and can be emphasised explicitly for any poet or maker who also wants to be able to want to collaborate. The practice of writing, then, and its turn away from investments in identity, works to thin out the more destructive face of an urge for a dubious eternity that can eclipse our ability to work together creatively with others in this life.

Indonesia`s struggle Jemmaah Islamiyah and the soul of Islam

Traces the religious, cultural and political development of JI, and argues that it has important features in common with other organisations linked to al Qaeda. Based on extensive research in Indonesia, Barton assesses the level of support for JI and the Indonesian government's success in dealing with the threat it poses.

The relationship between religion, spirituality, psychological adjustment, and quality of life among people with multiple sclerosis

The present research was comprised of two studies that aimed to explore the role of religious and spiritual variables in the psychological adjustment and quality of life of people with Multiple Sclerosis (MS). In study 1, religious behavior and objective levels of spirituality and religiosity were not significantly related to psychological adjustment or quality of life among people with MS. Positive religious coping was negatively related to psychological adjustment and quality of life. In study 2, Intrinsic religious orientation and Quest religious orientation were related to poor psychological adjustment. Implications of the present research for people with MS and other chronic illnesses are discussed.