Breastfeeding and postpartum depression: state of the art review

Objective: To review the literature on the association between breastfeeding and postpartum depression. Sources: A review of literature found on MEDLINE/ PubMed database. Summary of findings: The literature consistently shows that breastfeeding provides a wide range of benefits for both the child and the mother. The psychological benefits for the mother are still in need of further research. Some studies point out that pregnancy depression is one of the factors that may contribute to breastfeeding failure. Others studies also suggest an association between breastfeeding and postpartum depression; the direction of this association is still unclear. Breastfeeding can promote hormonal processes that protect mothers against postpartum depression by attenuating cortisol response to stress. It can also reduce the risk of postpartum depression, by helping the regulation of sleep and wake patterns for mother and child, improving mother’s self efficacy and her emotional involvement with the child, reducing the child’s temperamental difficulties, and promoting a better interaction between mother and child. Conclusions: Studies demonstrate that breastfeeding can protect mothers from postpartum depression, and are starting to clarify which biological and psychological processes may explain this protection. However, there are still equivocal results in the literature that may be explained by the methodological limitations presented by some studies.

Mother’s depression at childbirth does not contribute to the effects of antenatal depression on neonate’s behavioral development

Background: Maternal depression is a worldwide phenomenon that has been linked to adverse developmental outcomes in neonates. Aims: To study the effect of antenatal depression (during the third trimester of pregnancy) on neonate behavior, preference, and habituation to both the mother and a stranger’s face/voice. To analyze mother’s depression at childbirth as a potential mediator or moderator of the relationship between antenatal depression and neonate behavioral development. Method: A sample of 110 pregnant women was divided in 2 groups according to their scores on the Edinburgh Postnatal Depression Scale during pregnancy (EPDS; ≥10, depressed; <10, non-depressed). In the first 5 days after birth, neonatal performance on the Neonatal Behavioral Assessment Scale (NBAS) and in the ‘Preference and habituation to the mother’s face/voice versus stranger’ paradigm was assessed; each mother filled out an EPDS. Results: Neonates of depressed pregnant women, achieved lower scores on the NBASs (regulation of state, range of state, and habituation); did not show a visual/auditory preference for the mother’s face/voice; required more trials to become habituated to the mother’s face/voice; and showed a higher visual/auditory preference for the stranger’s face/voice after habituation compared to neonates of non-depressed pregnant women. Depression at childbirth does not contribute to the effect of antenatal depression on neonatal behavioral development. Conclusion: Depression even before childbirth compromises the neonatal behavioral development. Depression is a relevant issue and should be addressed as a routine part of prenatal health care.

Anxiety and depression symptoms in women and men from early pregnancy to 3-months postpartum: parity differences and effects

This study aimed to investigate both anxiety and depression symptoms from early pregnancy to 3-months postpartum, comparing women and men and first and second-time parents. Methods: A sample of 260 Portuguese couples (N=520), first or second-time parents, recruited in an Obstetrics Out-patients Unit, filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the 1st, 2nd and 3rd pregnancy trimesters, childbirth, and 3-months postpartum. Results: A decrease in anxiety and depression symptoms from early pregnancy to 3-months postpartum was found in both women and men, as well as in first and second-time parents. Men presented less anxiety and depression symptoms than women, but the same pattern of symptoms over time. Second-time parents showed more anxiety and depression symptoms than first-time parents and a different pattern of symptoms over time: an increase in anxiety and depression symptoms from the 3rd trimester to childbirth was observed in first-time parents versus a decrease in second-time parents. Limitations: The voluntary nature of the participation may have lead to a selection bias; women and men who agreed to participate could be those who presented fewer anxiety and depression symptoms. Moreover, the use of self-report symptom measures does not give us the level of possible disorder in participants. Conclusions: Anxiety and depression symptoms diminish from pregnancy to the postpartum period in all parents. Patterns of anxiety and depression symptoms from early pregnancy to 3-months postpartum are similar in women and men, but somewhat different in first and second time parents. Second-time parents should also be considered while studying and intervening during pregnancy and the postpartum.

Physical activity, health-related quality of life and depression during pregnancy

This study examines physical activity patterns among women, from pre-pregnancy to the second trimester of pregnancy, and the relationship between physical activity status based on physical activity guidelines and health-related quality of life (HRQoL) and depression over pregnancy. 56 healthy pregnant women self reported physical activity, HRQoL and depression at 10-15 and 19-24 weeks of pregnancy and physical activity before pregnancy. Whereas vigorous leisure physical activity decreased after conception, moderate leisure physical activity and work related physical activity remained stable over time. The prevalence of recommended physical activity was 39.3% and 12.5% in the 1st and 2nd trimesters of pregnancy respectively, and 14.3% pre-pregnancy. From the 1st to the 2nd pregnancy trimester, most physical HRQoL dimensions scores decreased and only mental component increased, independently of physical activity status. No changes in mean depression scores were observed. These data suggest that physical activity patterns change with pregnancy and that physical and mental components are differentially affected by pregnancy course, independently of physical activity status.

Mother’s anxiety and depression and associated risk factors during early pregnancy: effects on fetal growth and activity at 20–22 weeks of gestation

To examine effects of mother's anxiety and depression and associated risk factors during early pregnancy on fetal growth and activity. Repeated measures of mother's anxiety (State-Anxiety Inventory (STAI-S)) and depression (Edinburgh Postnatal Depression Scale (EPDS)) and related socio demographics and substance consumption were obtained at the 1st and 2nd pregnancy trimesters, and fetus' (N = 147) biometric data and behavior was recorded during ultrasound examination at 20-22 weeks of gestation. Higher anxiety symptoms were associated to both lower fetal growth and higher fetal activity. While lower education, primiparity, adolescent motherhood, and tobacco consumption predicted lower fetal growth, coffee intake predicted lower fetal activity. Vulnerability of fetal development to mother's psychological symptoms as well as to other sociodemographic and substance consumption risk factors during early and mid pregnancy is suggested.

Comorbid depression and anxiety effects on pregnancy and neonatal outcome

The effects of comorbid depression and anxiety were compared to the effects of depression alone and anxiety alone on pregnancy mood states and biochemistry and on neonatal outcomes in a large multi-ethnic sample. At the prenatal period the comorbid and depressed groups had higher scores than the other groups on the depression measure. But, the comorbid group had higher anxiety, anger and daily hassles scores than the other groups, and they had lower dopamine levels. As compared to the non-depressed group, they also reported more sleep disturbances and relationship problems. The comorbid group also experienced a greater incidence of prematurity than the depressed, the high anxiety and the non-depressed groups. Although the comorbid and anxiety groups were lower birthweight than the non-depressed and depressed groups, the comorbid group did not differ from the depressed and anxiety groups on birth length. The neonates of the comorbid and depressed groups had higher cortisol and norepinephrine and lower dopamine and serotonin levels than the neonates of the anxiety and non-depressed groups as well as greater relative right frontal EEG. These data suggest that for some measures comorbidity of depression and anxiety is the worst condition (e.g., incidence of prematurity), while for others, comorbidity is no more impactful than depression alone.

Mother's anxiety and depression during the third pregnancy trimester and neonate's mother versus stranger's face/voice visual preference

Background: Neonates show visual preference for their mother's face/voice and shift their attention from their mother to a stranger's face/voice after habituation. Aim: To assess neonate's mother versus stranger's face/voice visual preference, namely mother's anxiety and depression during the third pregnancy trimester and neonate's: 1) visual preference for the mother versus the stranger's face/voice (pretest visual preference), 2) habituation to the mother's face/voice and 3) visual preference for the stranger versus the mother's face/voice (posttest visual preference). Method: Mothers (N=100) filled out the Edinburgh Postnatal Depression Scale (EPDS) and the State Anxiety Inventory (STAI) both at the third pregnancy trimester and childbirth, and the “preference and habituation to the mother's face/voice versus stranger” paradigm was administered to their newborn 1 to 5 days after childbirth. Results: Neonates of anxious/depressed mothers during the third pregnancy trimester contrarily to neonates of non-anxious/non-depressed mothers did not look 1) longer at their mother's than at the stranger's face/voice at the pretest visual preference (showing no visual preference for the mother), nor 2) longer at the stranger's face/voice in the posttest than in the pretest visual preference (not improving their attention to the stranger's after habituation). Conclusion: Infants exposed to mother's anxiety/depression at the third gestational trimester exhibit less perceptual/social competencies at birth.

Pregnancy massage reduces prematurity, low birthweight and postpartum depression

Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group. The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.

Prenatal dysthymia versus major depression effects on maternal cortisol and fetal growth

To determine differences between pregnant women diagnosed with Dysthymia versus Major Depression, depressed pregnant women (N=102) were divided by their diagnosis into Dysthymic (N=48) and Major Depression (N=54) groups and compared on self-report measures (depression, anxiety, anger, daily hassles and behavioral inhibition), on stress hormone levels (cortisol and norepinephrine), and on fetal measurements. The Major Depression group had more self-reported symptoms. However, the Dysthymic group had higher prenatal cortisol levels and lower fetal growth measurements (estimated weight, femur length, abdominal circumference) as measured at their first ultrasound (M=18 weeks gestation). Thus, depressed pregnant women with Dysthymia and Major Depression appeared to have different prenatal symptoms.

Chronic prenatal depression and neonatal outcome

Four hundred and thirty pregnant women were recruited at approximately 22 weeks gestation at prenatal clinics. Of these, 86 (20%) were diagnosed as depressed. The women were seen again at approximately 32 weeks gestation and after delivery. Chronicity of depression was evidenced by continuing high depression scores in those women diagnosed as depressed. Comorbid problems were chronically high anxiety, anger, sleep disturbance, and pain scores. Less optimal outcomes for the depressed women included lower gestational age and lower birthweight of their newborns.

Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships

Prenatally depressed women (N=47) were randomly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group. Self-reported leg pain, back pain, depression, anxiety and anger decreased more for the massaged pregnant women than for the control group women. In addition, the partners who massaged the pregnant women versus the control group partners reported less depressed mood, anxiety and anger across the course of the massage therapy period. Finally, scores on a relationship questionnaire improved more for both the women and the partners in the massage group. These data suggest that not only mood states but also relationships improve mutually when depressed pregnant women are massaged by their partners.

Postpartum Depression: Is it a condition affecting the mother-infant interaction and the development of the child across the first year of life?

Noting that maternal depression is common during a baby's first year, this study examined the interaction of depressed and non-depressed mother-child dyads. A sample of 26 first-time mothers with postpartum depression at the third month after birth and their 3-month-old infants was compared to a sample of 25 first-time mothers with no postpartum depression at the third month after birth and their 3-month-old infants. The observations were repeated at 6 months and again at 12 months postpartum. The samples were compared for differences in mother interaction behavior, mother's infant care, mother's concern with the baby, infant behavioral difficulties, infant mental and motor development, and infant behavior with the observer. Among the findings are the following: (1) depressed mothers' interaction behavior and care of their infants are less adequate than the non-depressed mothers' interaction behavior and care of their infants at 3, 6, and 12 months postpartum; (2) infants' interaction behaviors during feeding and face-to-face interaction with depressed mothers are less adequate than infants' interactions with non-depressed mothers at 3, 6, and 12 months postpartum; (3) mother-infant interactions are less adequate in the depressed mother dyads than the non-depressed dyads at 3, 6, and 12 months postpartum; (4) depressed mothers are less concerned about their infants than non-depressed mothers at 3, 6, and 12 months postpartum; (5) infants of depressed mothers have more behavioral difficulties at 3, 6, and 12 months postpartum than infants of non-depressed mothers; (6) infants of depressed mothers had lower mental and motor development rates at 6 and 12 months postpartum than infants of non-depressed mothers; and (7) infants of non-depressed mothers behaved in a more positive way with the observer than the infants of depressed mothers. (AS)

Economía, Política y Sociedad Colonial. Elites y sociedades indígenas y campesinas en Córdoba y la Gobernación del Tucumán. Colonial Economy, Politics and Society. Elites and Indigenous-Peasant Societies in Cordoba and "Gobernación del Tucumán"

El PROBLEMA OBJETO de estudio es la economía, la política y la sociedad colonial en Córdoba y en la Gobernación del Tucumán, durante el período colonial e incluso el de su crisis, con especial atención sobre las transformaciones de las sociedades campesinas e indígenas y sus relaciones con el estado colonial, la iglesia y el sector privado. El ESPACIO a analizar será del de la Gobernación del Tucumán entendido como espacio jurisdiccional que incluía varias regiones con alto grado de relacionamiento, profundizándose sobre la situación de la región de Córdoba, teniendo en cuenta las características de las sociedades originarias, el sistema de dominación colonial, el sistema judicial, el sistema económico de explotación y el proceso de evangelización, así como las formas de resistencia y adaptación de las sociedades indígenas que devendrán en sectores campesinos. Entendemos que es importante tomar como UNIDAD DE ANALISIS al espacio que durante la colonia ocupaba la Gobernación del Tucumán en tanto permite realizar un análisis de largaduración sobre las transformaciones de las sociedades indígenas y campesinas, ya que el mismo casi coincide con el del antiguo Tawantinsuyu y con el del "interior argentino" del siglo XIX. LOS OBJETIVOS ESPECIFICOS consistirán en analizar a) el sistema de dominación colonial en sus especificidades normativas, en el Tucumán en general y en Cordoba en particular, comparandolo con el implementado en las zonas centrales del virreinato peruano para comprender las causas que pudieron haber incidido en las dinámicas específicas que en estas tierras asumieron los procesos de reproducción, transformación, adaptación y etnogénesis de las sociedades indígenas que persistieron, y el paulatino tránsito de una parte de ellas hacia la conformación de sociedades campesinas. b) dichos procesos de transformación de las sociedades indígenas y campesinas y explorando sus formas de resistencia y adaptación. c) las características del sistema de dominación colonial, particularmente las múltiples y cambiantes relaciones entre estado, iglesia y poder privado así como entre las diversas instancias de poder político (local y regional). d) las políticas desplegadas en el sistema judicial y sus consecuencias en términos del acceso a la justicia de los sectores subalternos. HIPÓTESIS. a) Si bien luego de la conquista y durante el período colonial las sociedades indígenas sufrieron una fuerte desestructuración, investigaciones recientes nos han permitido conocer que varias de ellas lograron persistir como "pueblos de indios" y como economías étnicas transformadas, todo lo cual explicamos por el grado de complejidad social preexistente, la capacidad de adaptación de dichas sociedades a las imposiciones del sistema de dominación y explotación colonial y con las acciones de resistencia desplegadas. b) Dentro del universo de las sociedades desestructuradas, se irán conformando unidades domésticas campesinas con características socio-culturales y con lógicas específicas de reproducción bien particulares en lo referido a sus formas de acceso a los recursos, el uso de la energía disponible y a las formas de producción y participación mercantil. METODOS Y FUENTES. Se recuperan metodologías y perspectivas de la historia económica social y de la etnohistoria; y en los proyectos específicos se incorporan también las provenientes de la demografía, historia eclesiástica, historia política y análisis de redes. Al tratarse de una investigación histórica, el análisis crítico de las fuentes provendrá de la reconstrucción de su contexto de producción, de su entrecruzamiento y confrontación. La documentación inédita a consultar será completa y variada y proveniente de distintos repositorios: AGI, ABNB, AGN, AHPBA, AHPC, AAC. En general se ESPERA profundizar nuestros proyectos en curso (que están orientados al análisis de los grupos subalternos de la Gobernación del Tucumán) mientras se continúa con la formación de recursos humanos.

Energía Eólica en Argentina: una cuestión estratégica hacia la Economía del Hidrógeno. Wind Energy in Argentina: a strategic subject towards the Hydrogen Economy.

Identificación/caracterización del problema: El abastecimiento energético en base a fuentes no tradicionales o recursos no renovables es un tema altamente estratégico en las agendas de los Estados. El petróleo se está agotando y las existencias no alcanzarán para abastecer el consumo mundial.Esto ha llevado a Gobiernos a implementar alternativas de producción energética basadas en fuentes no tradicionales, tales como el Hidrógeno (H2), lo cual creará una Economía basada en el Hidrógeno.Argentina cuenta con una matriz energética dependiente en un 90 por ciento del petróleo y con reservas certificadas de petróleo y gas natural para 8,6 y 9,4 años respectivamente. Sin duda, los desafíos próximos serán: a) crear las herramientas necesarias para minimizar una potencial crisis energética en el corto plazo, y b) desarrollar políticas energéticas que articulen su autoabastecimiento e inserción en la Economía del Hidrógeno. Dado que Argentina cuenta con uno de los recursos renovables más importantes del mundo, "el viento", tiene condiciones inmejorables para obtener Hidrógeno (H2) por electrólisis del agua, utilizando energía eléctrica proveniente de fuentes renovables como la eólica (EE). Es por ello que apostar al desarrollo local del H2 basado en la EE nos ofrecerá como país, un rol estratégico en la futura Economía del Hidrógeno.Objetivo General: Identificar la actual Matriz Energética Argentina y reconocer los factores limitantes y oportunidades para la diversificación de la misma, utilizando la Energía Eólica (EE) como pilar hacia la Economía del Hidrógeno (Econo-H2). El fin último será esbozar herramientas de política energética e instrumentos regulatorios pertinentes, que sirvan de base para la formulación de una macro política energética.Metodología de Investigación: Se utilizarán técnicas de análisis de la siguiente información:a) Documental (textos, artículos, información periodística)b) Técnica, Legal y administrativa) Oral (Declaraciones oficiales-privadas y entrevistas)d) Visual (imágenes, gráficos y mapas)e) Datos (cronológicos, estadísticos y geográficos)Resultados esperados: La formulación de herramientas de política energética y de instrumentos regulatorios pertinentes, que sirvan de base para la formulación de una macro política energética que considere la Energía Eólica (EE) como un pilar fundamental para la diversificación de la matriz energética actual. Asimismo se reflexionará sobre la importancia de asociar la EE a la producción masiva del hidrógeno (H2) para la inserción y proyección futura de la Argentina hacia la Economía del Hidrógeno.Importancia del Proyecto: Argentina ha ratificado el protocolo de Kioto y forma parte de la Johannesburg Renewable Energy Coalition (JREC), por la cual ha asumido compromisos para fijar políticas nacionales de incentivo para el desarrollo de uso de energías renovables.Sin embargo, y a pesar de una serie de iniciativas y leyes promulgadas relacionadas a uso de energías renovables, hasta la fecha, no se ha logrado cumplir con metas concretas.Consideramos que uno de los factores fundamentales que ha dificultado esto, se basa en la ausencia de una política de Estado de mediano y largo plazo que incluya a las energías renovables como un objetivo concreto y un sistema de instrumentos y planes complementarios que acompañen dicha política.

Polish immigrants in Ireland's black economy: a phenomenological investigation

The purpose of this thesis is to answer the research question ‗why do some Polish migrants engage in shadow employment in the Republic of Ireland?‘ The individual and group interviews, which were conducted in August 2011 with thirteen Polish migrants, living and working in Ireland, generated the answer to the research question. Interviewees‘ responses were analysed from the point of view of the literature that examines the various factors within the topics of migration and the black economy. The thesis begins with theoretical background information regarding the enlargement of the European Union and the economic situation of Poland and Ireland. Then migration theories are explained and Polish and Irish migration history is presented. Next, the issue of the black economy and shadow employment is developed with a focus on its presence in Poland and Ireland. The following section is dedicated to the research methodology that was adopted to ensure effective collection of the information. The issues of the qualitative and quantitative research, phenomenological approach to the research and interviews as data collection are raised in that section. The last part of the thesis is based on an analysis of the respondents‘ statements. It explores interviewees‘ experience of life and work in Ireland. The main part of that section develops the reasons why do Polish workers engage in shadow employment in the Republic of Ireland. Simultaneously, it provides the answers to the research question of this thesis.