Peer-mentoring for first-time mothers from areas of socio-economic disadvantage: a qualitative study within a randomised controlled trial

Objective: To explore the difficulties experienced by lay-workers, women and health professionals involved in a peer-mentoring programme for first-time mothers living in socially disadvantaged areas. Design: Qualitative study; semi-structured interviews with lay-worker peer-mentoring programme participants at two separate stages of the programme (antenatal and postnatal). Setting: Community based. Participants: 11 women receiving peer-mentoring support (from first hospital antenatal visit to one year postnatal); 11 lay-workers; 2 research midwives. Results: Lay-workers had difficulty initiating contact with women and failure to establish contact affected their morale adversely. They felt that women understood their intended role poorly and attempted to develop relationships with them by sharing personal experiences and offering friendship; women who participated in the programme appreciated this. Developing a peer-mentor relationship was difficult if women lacked interest in the programme or in continuing contact. External influences on peer-mentoring uptake and delivery included family and friends who could prevent or encourage women’s participation and cause difficulties for the lay-worker both in delivering support and arranging follow-up. Lay-workers providing support to women from a different ethnic background experienced difficulties relating to both language and culture: these were perceived to affect peer-mentor relationships adversely. Major personal difficulties for lay-workers related to time constraints in reconciling mentoring requirements with demands of family and other work. Informing midwives of these difficulties helped identify solutions through training and ongoing professional support for the lay-workers. Conclusions: Lay-worker peer support is appreciated by first time mothers but difficulties in initiating contact, developing peer-mentor relationships and external influences such as family, ethnicity and time constraints are relevant to poor uptake and high staff turnover. In developing peer support programmes, awareness of potential difficulties and of how professional support can help resolve these should improve uptake and thus optimise the evaluations of their effectiveness.

A RCT of peer-mentoring for first-time mothers in socially disadvantaged areas (the moments study)

Objective: Interventions to reduce health inequalities for young children and their mothers are important: involving peers is recommended, but evidence of value for this approach is limited. The authors aimed to examine the effect of an innovative tailored peer-mentoring programme, based on perceived needs, for first-time mothers in socio-economically deprived communities. Design: Randomised controlled trial; parallel qualitative study with purposive samples using semistructured interviews. Setting: Socio-economically disadvantaged areas, Belfast. Participants: Primigravidae, aged 16-30 years, without significant co-morbidity. Intervention: Peer-mentoring by a lay-worker fortnightly during pregnancy and monthly for the following year, tailored to participants' wishes (home visits/telephone contacts), additional to usual care. Main outcome measures: Infant psychomotor and mental development (Bayley Scales of Infant Development (BSID-II)) at 1 year, assessed by an observer blinded to group allocation. Mothers' health at 1 year postnatal (SF-36). Results: Of 534 women invited, 343(64%) participated; 85%, with their children, completed outcome assessments (140 of 172 intervention; 152 of 171 controls). Intervention and control groups did not differ in BSID-II psychomotor (mean difference 1.64, 95% CI -0.94 to 4.21) or mental (-0.81, -2.78 to 1.16) scores, nor SF-36 physical functioning (-5.4, -11.6 to 0.7) or mental health (-1.8, -6.1 to 2.6). Women valued advice given in context of personal experience of child-rearing. Mentors gained health-related knowledge, personal skills and new employment opportunities. Conclusions: Despite possible longer-term social advantage, this peer-mentoring programme showed no benefit for infant development or maternal health at 1 year. Further rigorous evaluation of important outcomes of complex interventions promoting health for children in socially disadvantaged communities is warranted. Trial registration no: ISRCTN 55055030.

How the sublime became "now": time, modernity and aesthetics in Lyotard's rewriting of Kant

Writing in the late 1980s, Nancy gives as examples of the "recent fashion for the sublime" not only the theoreticians of Paris, but the artists of Los Angeles, Berlin, Rome, and Tokyo. At the beginning of the twenty-first century, the sublime may of course no longer seem quite so "now" as it did back then, whether in North America, Europe, or Japan. Simon Critchley, for one, has suggested that, at least as regards the issue of its conceptual coupling to "postmodernism," the "debate" concerning the sublime "has become rather stale and the discussion has moved on." Nonetheless, if that debate has indeed "moved on"-and thankfully so-it is not without its remainder, particularly in the very contemporary context of a resurgence of interest in explicitly philosophical accounts of art, in the wake of an emergent critique of cultural studies and of the apparent waning of poststructuralism's influence-a resurgence that has led to a certain "return to aesthetics" in recent Continental philosophy and to the work of Kant, Schelling, and the German Romantics. Moreover, as Nancy's precise formulations suggest, the "fashion" [mode] through which the sublime "offers itself"-as "a break within or from aesthetics"-clearly contains a significance that Critchley's more straightforward narration of shifts in theoretical chic cannot encompass. At stake in this would be the relation between the mode of fashion and art's "destiny" within modernity itself, from the late eighteenth century onwards. Such a conception of art's "destiny," as inextricably linked to that of the sublime, is not unique to recent French theory. In a brief passage in Aesthetic Theory, Adorno also suggests that the "sublime, which Kant reserved exclusively for nature, later became the historical constituent of art itself.... [I]n a subtle way, after the fall of formal beauty, the sublime was the only aesthetic idea left to modernism." As such, although the term has its classical origins in Longinus, its historical character for "us," both Nancy and Adorno argue, associates it specifically with the emergence of the modern. As another philosopher states: "It is around this name [of the sublime] that the destiny of classical poetics was hazarded and lost; it is in this name that ... romanticism, in other words, modernity, triumphed."

California : A history of Upper and Lower California from their first discovery to the present time, comprising an account of the climate, soil, natural productions, agriculture, commerce, Sc. A full view of the missionary establishments and condition of the free and domesticated indians. With an appendix relation to steam navigation in the Pacific. Illustrated with a new map, plans of the harbours, and numerous engravings

UANL

Les éléments entourant le passage à l'acte sous forme de co-délinquance au Québec

Les premières études recensées ayant traité de la co-délinquance ont plus de cent ans. Comme il s’agit d’un sujet qui a de l’histoire, il y a eu une grande évolution dans la façon d’aborder la question et dans les méthodologies employées. Mais, ce n’est que depuis quelques années que la co-délinquance est étudiée par l’entremise de données d’arrestations policières et c’est ce type de données qui sera utilisé pour répondre à l’objectif principal, celui-ci étant la détermination des conditions expliquant le recours ou non à la co-délinquance pour commettre une infraction criminelle. De plus, pour répondre à notre objectif de recherche, nous avons opté pour une théorie structurante du crime, approche qui n’avait jamais été utilisé auparavant dans les études sur la co-délinquance. Comme méthodologie, nous avons utilisé un échantillon composé de 9 103 participations criminelles, de 8 243 événements distincts et de 3 356 individus et plusieurs prédicteurs ont été analysés afin de déterminer lesquels expliquent le mieux la co-délinquance. L’âge, le genre, les antécédents criminels, l’urbanité et le type de crimes sont toutes des variables qui ont été considérées. L’urbanité représente une nouveauté dans ce type de recherche, puisque nous avons recensé que très peu d’études ayant abordées la question. Alors, que pour le type de crime, nous l’avons détaillé, comme aucune étude sur la co-délinquance ne l’a fait auparavant (23 catégories d’infractions). Ce détail nous permet donc de bien cibler l’impact de chaque délit sur le recours à la co-délinquance. Le résultat émergeant des analyses de régression logistique est que le recours à la co-délinquance s’explique principalement par le type de crime commis, certains actes criminels sont plus propices à la co-délinquance que d’autres. Nous constatons également que les autres variables analysées ont très peu ou pas d’impact sur le recours à la co-délinquance, que ce soit l’âge, le genre, les antécédents criminels ou même l’urbanité.

Henry C. Carey et le système américain d’économie contre l’impérialisme du libre-échange britannique : son passage au New York Tribune

Les débats économiques au 19e siècle, loin d’être l’apanage du monde universitaire, étaient aux États-Unis un des principaux objets de contentieux entre les partis politiques et ceux-ci trouvaient écho dans la sphère publique. Les journaux étaient alors le principal moyen de communiquer les opinions des différents partis. La présente étude vise à mettre en contexte et cerner la position des écrits du plus important économiste américain de son époque, Henry Charles Carey (1793-1879), reconnu comme tel par J.S. Mill et Karl Marx en leur temps, lors de la décennie de 1850 dans le journal le plus influent de cette période, le New York Tribune. Pour ce faire, il a fallu au préalable identifier les articles non signés de Carey dans le journal, ce qui n’avait auparavant jamais été fait. Au moment d’écrire dans le principal organe américain qui défendait la protection aux États-Unis afin d’industrialiser le pays, Carey était alors le représentant le plus prééminent du système américain d’économie. Ce dernier, fondé sur les écrits d’Alexander Hamilton, prônait l’industrialisation des États-Unis et l’intervention de l’État pour défendre le bien commun, s’opposant ainsi à l’école libérale anglaise basée sur les écrits d’Adam Smith. Conceptuellement, la pensée économique de Carey se situe dans la tradition des Autres Canon, basée sur la production et l’innovation. Ceci le mena à s’opposer avec vigueur tant au malthusianisme qu’à la division internationale du travail, justifiée théoriquement par la thèse de l’avantage comparatif de Ricardo. En effet, dans son analyse, la volonté exprimée au milieu du 19e siècle par l’Angleterre de devenir l’atelier du monde et de faire du reste des nations des producteurs de matières premières sous un régime de libre-échange n’était rien d’autre que la continuation de la politique coloniale par d’autres moyens. Pour Carey, la spécialisation dans l’exportation de matières premières, notamment défendue par les planteurs du Sud des États-Unis, loin d’être bénéfique au pays, était le sûr gage de la pauvreté comme les cas de l’Irlande et de l’Inde le démontraient.

Lower Cortisol Activity is Associated with First-Time Driving while Impaired

Driving while impaired (DWI) is a grave and persistent high-risk behavior. Previous work demonstrated that DWI recidivists had attenuated cortisol reactivity compared to non-DWI drivers. This suggests that cortisol is a neurobiological marker of high-risk driving. The present study tested the hypothesis that this initial finding would extend to first-time DWI (fDWI) offenders compared to non-DWI drivers. Male fDWI offenders (n = 139) and non-DWI drivers (n = 31) were exposed to a stress task, and their salivary cortisol activity (total output and reactivity) was measured. Participants also completed questionnaires on sensation seeking, impulsivity, substance use, and engagement in risky and criminal behaviors. As hypothesized, fDWI offenders, compared to non-DWI drivers, had lower cortisol reactivity; fDWI offenders also showed lower total output. In addition, cortisol activity was the most important predictor of group membership, after accounting for alcohol misuse patterns and consequences and other personality and problem behavior characteristics. The findings indicate that attenuated cortisol activity is an independent factor associated with DWI offending risk at an earlier stage in the DWI trajectory than previously detected.

A hearing aid orientation pamphlet for clinical use with first-time hearing aid users

This paper discusses the use of a pamphlet to help first-time hearing aid users adjust to their hearing aids.

First detection of methylgermylene in the gas phase and time-resolved study of some of its reactions

A new transient species has been produced and detected by the gas-phase, 193 nm laser flash photolysis of 1,3,4-trimethylgermacyclopent-3-ene, TMGCP. The species has strong visible absorptions in the wavelength region 450−520 nm (maximum at 485 nm) and is attributed to the germylene, MeGeH. Time-resolved kinetic studies have led to the first rate constants for its reactions with GeH4, Me2GeH2, C2H2, C2H4, C3H6, i-C4H8, TMGCP, MeOH, HCl, and SO2. The reactivity of MeGeH is compared to those of GeH2 and GeMe2. The Me-for-H substituent effect varies according to reaction type and is not constant from GeH2 to MeGeH to GeMe2.

Sustained monitoring of the Southern Ocean at Drake Passage: past achievements and future priorities

Drake Passage is the narrowest constriction of the Antarctic Circumpolar Current (ACC) in the Southern Ocean, with implications for global ocean circulation and climate. We review the long-term sustained monitoring programmes that have been conducted at Drake Passage, dating back to the early part of the twentieth century. Attention is drawn to numerous breakthroughs that have been made from these programmes, including (a) the first determinations of the complex ACC structure and early quantifications of its transport; (b) realization that the ACC transport is remarkably steady over interannual and longer periods, and a growing understanding of the processes responsible for this; (c) recognition of the role of coupled climate modes in dictating the horizontal transport, and the role of anthropogenic processes in this; (d) understanding of mechanisms driving changes in both the upper and lower limbs of the Southern Ocean overturning circulation, and their impacts. It is argued that monitoring of this passage remains a high priority for oceanographic and climate research, but that strategic improvements could be made concerning how this is conducted. In particular, long-term programmes should concentrate on delivering quantifications of key variables of direct relevance to large-scale environmental issues: in this context, the time-varying overturning circulation is, if anything, even more compelling a target than the ACC flow. Further, there is a need for better international resource-sharing, and improved spatio-temporal coordination of the measurements. If achieved, the improvements in understanding of important climatic issues deriving from Drake Passage monitoring can be sustained into the future.

Prevalence of hepatitis B and C serological markers among first-time blood donors in Brazil: A multi-center serosurvey

Little data are available on the seroprevalence of, and risk factors for hepatitis B and C viruses (HBV and HCV) infection in Latin American countries. A multi-center serosurvey was conducted among 3,598 first-time blood donors (65% men) from Sao Paulo, Salvador and Manaus in Brazil. The gender-specific seroprevalences of antibodies against hepatitis B core antigen (anti-HBc) and of the hepatitis B surface antigen (HBsAg) in anti-HBc-positive sera were measured, and risk factors analyzed by gender. The gender-specific seroprevalences of antibodies against HCV (anti-HCV) were measured, but risk factors for HCV were not determined. Anti-HBc and HBsAg seroprevalences were not significantly different in men [101/2,341 (4.31%) and 4/2,229 (0.18%), respectively] and women [65/1,237 (5.25%) and 8/ 1,169 (0.68%), respectively], whereas the seroprevalence of anti-HCV was higher in women (12/1,238 [0.97%] vs. 9/2,353 [0.38%]; odds ratio [OR] = 2.49; 95% confidence interval [Cl]: 1.0-6.0). No significant difference for HBV infection was found across the three study sites or by ethnic group. The seroprevalence of anti-HBc increased with age, but decreased with education level in both genders. Lifetime number of sexual partners was associated with anti-HBc prevalence among men (OR = 1.95; 95% Cl: 1.2-3.1), but not women. The seroprevalence of HBV and HCV was low among Brazilian blood donors, and exposure increased with age in both genders.