The effect of moderate gestational alcohol consumption during pregnancy on speech and language outcomes in children: a systematic review

Consensus has not been reached on safe alcohol consumption recommendations during pregnancy. The National Institutes for Care and Health Excellence (NICE) in the UK suggest that one to two drinks not more than twice per week is safe. However, the speech and language effects of even low levels of alcohol use among offspring are unknown. The aim of this study was to review systematically the evidence on studies of the effect of low to moderate levels of alcohol consumption during pregnancy (up to 70 grams of alcohol per week) compared to abstinence on speech and language outcomes in children.

Text-messaging as a Tool for Medication Adherence and Behavior Change in Disease Management among Patients with Coronary Heart Disease

Background: Evidence-based medication and lifestyle modification are important for secondary prevention of cardiovascular disease but are underutilized. Mobile health strategies could address this gap but existing evidence is mixed. Therefore, we piloted a pre-post study to assess the impact of patient-directed text messages as a means of improving medication adherence and modifying major health risk behaviors among coronary heart disease (CHD) patients in Hainan, China.

Methods: 92 CVD patients were surveyed between June and August 2015 (before the intervention) and then between October and December 2015 (after 12 week intervention) about (a) medication use (b) smoking status,(c) fruit and vegetable consumption, and (d) physical activity uptake. Acceptability of text-messaging intervention was assessed at follow-up. Descriptive statistics, along with paired comparisons between the pre and post outcomes were conducted using both parametric (t-test) and non-parametric (Wilcoxon signed rank test) methods.

Results: The number of respondents at follow-up was 82 (89% retention rate). Significant improvements were observed for medication adherence (P<0.001) and for the number of cigarettes smoked per day (P=.022). However there was no change in the number of smokers who quitted smoking at follow-up. There were insignificant changes for physical activity (P=0.91) and fruit and vegetable consumption.

Food preferences and weight change during low-fat and low-carbohydrate diets.

UNLABELLED: Understanding associations between food preferences and weight loss during various effective diets could inform efforts to personalize dietary recommendations and provide insight into weight loss mechanisms. We conducted a secondary analysis of data from a clinical trial in which participants were randomized to either a 'choice' arm, in which they were allowed to select between a low-fat diet (n = 44) or low-carbohydrate diet (n = 61), or to a 'no choice' arm, in which they were randomly assigned to a low-fat diet (n = 49) or low-carbohydrate diet (n = 53). All participants were provided 48 weeks of lifestyle counseling. Food preferences were measured at baseline and every 12 weeks thereafter with the Geiselman Food Preference Questionnaire. Participants were 73% male and 51% African American, with a mean age of 55. Baseline food preferences, including congruency of food preferences with diet, were not associated with weight outcomes. In the low-fat diet group, no associations were found between changes in food preferences and weight over time. In the low-carbohydrate diet group, increased preference for low-carbohydrate diet congruent foods from baseline to 12 weeks was associated with weight loss from 12 to 24 weeks. Additionally, weight loss from baseline to 12 weeks was associated with increased preference for low-carbohydrate diet congruent foods from 12 to 24 weeks. Results suggest that basing selection of low-carbohydrate diet or low-fat diet on food preferences is unlikely to influence weight loss. Congruency of food preferences and weight loss may influence each other early during a low-carbohydrate diet but not low-fat diet, possibly due to different features of these diets. CLINICAL TRIAL REGISTRY: NCT01152359.

Institutions, Innovation, and Grassroots Change: Alternatives to Transnational Governance in the Global South

Transnational governance has been advanced as a viable option for regulating commodities produced in emerging economies—where incapable or unwilling states may undersupply institutions requisite for overseeing supply chains consistent with the quality, safety, environmental, or social standards demanded by the global marketplace. Producers from these jurisdictions, otherwise left with few venues for securing market access and price premiums, ostensibly benefit from whatever pathways transnational actors offer to minimize barriers to entry—including voluntary certification for compliance with a panoply of public and private rules, such as those promulgated by NGOs like the Fair Trade Federation or multinational retailers like Wal-Mart. Yet, such transnational “sustainability” governance may neither be effective nor desirable. Regulatory schemes, like third-party certification, often privilege the interests of primary architects and beneficiaries—private business associations, governments, NGOs, and consumers in the global North—over regulatory targets—producers in the global South. Rather than engaging with the international marketplace via imported and externally-driven schemes, some producer groups are instead challenging existing rules and innovating homegrown institutions. These alternatives to commercialization adopt some institutional characteristics of their transnational counterparts yet deliver benefits in a manner more aligned with the needs of producers. Drawing on original empirical cases from Nicaragua and Mexico, this dissertation examines the role of domestic institutional alternatives to transnational governance in enhancing market access, environmental quality and rural livelihoods within producer communities. Unlike the more technocratic and expert-driven approaches characteristic of mainstream governance efforts, these local regulatory institutions build upon the social capital, indigenous identity, “ancestral” knowledge, and human assets of producer communities as new sources of power and legitimacy in governing agricultural commodities.

Inequality, the Welfare State, and Demographic Change

This dissertation is a three-part analysis examining how the welfare state in advanced Western democracies has responded to recent demographic changes. Specifically, this dissertation investigates two primary relationships, beginning with the influence of government spending on poverty. I analyze two at-risk populations in particular: immigrants and children of single mothers. Next, attention is turned to the influence of individual and environmental traits on preferences for social spending. I focus specifically on religiosity, religious beliefs and religious identity. I pool data from a number of international macro- and micro-data sources including the Luxembourg Income Study (LIS), International Social Survey Program (ISSP), the World Bank Databank, and the OECD Databank. Analyses highlight the power of the welfare state to reduce poverty, but also the effectiveness of specific areas of spending focused on addressing new social risks. While previous research has touted the strength of the welfare state, my analyses highlight the need to consider new social risks and encourage closer attention to how social position affects preferences for the welfare state.

Climate change adaptation planning under uncertainty in Ho Chi Minh City, Vietnam: a case study on institutional vulnerability, adaptive capacity and climate change governance

Climate change is expected to have wide-ranging impacts on urban areas and creates additional challenges for sustainable development. Urban areas are inextricably linked with climate change, as they are major contributors to it, while also being particularly vulnerable to its impacts. Climate change presents a new challenge to urban areas, not only because of the expected rises in temperature and sea-level, but also the current context of failure to fully address the institutional barriers preventing action to prepare for climate change, or feedbacks between urban systems and agents. Despite the importance of climate change, there are few cities in developing countries that are attempting to address these issues systematically as part of their governance and planning processes. While there is a growing literature on the risks and vulnerabilities related to climate change, as yet there is limited research on the development of institutional responses, the dissemination of relevant knowledge and evaluation of tools for practical planning responses by decision makers at the city level. This thesis questions the dominant assumptions about the capacity of institutions and potential of adaptive planning. It argues that achieving a balance between climate change impacts and local government decision-making capacity is a vital for successful adaptation to the impacts of climate change. Urban spatial planning and wider environmental planning not only play a major role in reducing/mitigating risks but also have a key role in adapting to uncertainty in over future risk. The research focuses on a single province - the biggest city in Vietnam - Ho Chi Minh City - as the principal case study to explore this argument, by examining the linkages between urban planning systems, the structures of governance, and climate change adaptation planning. In conclusion it proposes a specific framework to offer insights into some of the more practical considerations, and the approach emphasises the importance of vertical and horizontal coordination in governance and urban planning.

‘Black Settlers’: Hybridity, Neoliberalism and Ecosystemic Change Among Tonga Farmers of Southern Zambia, 1964-2008

This dissertation examines a process of indigenous accumulation among Tonga farmers in Zambia’s Southern Province. In the 1970s multiple authors concluded that capitalist farmers had emerged among Tonga agro-pastoralists, predominantly within private titled holdings. Relying on archival research, newspapers, secondary sources and extensive oral testimony this thesis fills a 35-year gap on the topic, providing insights into the social and environmental impacts of neoliberal policy among African peasants and capitalist farmers. In contrast to dominant narratives of the post-independence period, this study argues that Zambia did experience a developmental process post-independence, which saw significant achievements made in the agricultural sector, including the doubling of national cattle stocks. The data reveals a painful process of disarticulation beginning in the late 1980s. Following neoliberal adjustment, we observe significant heterogeneity in production systems, some regional specialization, and processes of migration. Most importantly, the thesis uncovers processes of overwhelming ecosystemic change that contributed to livestock epidemics of severe scale and scope. Amazingly, this went largely undocumented because of the simultaneous crisis of the state, which left the national statistics office and other state bodies incapable of functioning from the late 1980s into the 2000s. In response, the Zambian state has introduced a number of neodevelopmental initiatives in the sector, yet the lack of animal traction remained up to 2008 and agricultural production declined, while more capitalized farmers (largely white, and/or with foreign direct investment) have become more significant players in the country. This thesis provides compelling evidence to challenge dominant economic thinking of the Washington institutions as well as many of the common Marxian formulations.

An ethnographic investigation into gender and language in the Northern Ireland Assembly

This paper investigates the extent to which the negative evaluation of one of the women Ministers in the Northern Ireland Assembly can be attributed to gender. Interviews with politicians as well as the Minister herself illuminate this discussion by identifying the ‘gendered discourses’ that are drawn upon when describing the Minister’s communicative style in debates. Close analyses of transcripts of debates offer a description of some elements of this style, and find that while the Minister is confrontational in debates and ‘stands her ground’, she does not take part in illegal interventions that disrupt the debate floor and are characteristic of the Assembly as a whole. Although the construction of the Minister’s unpopularity can be attributed to a complex interplay of factors, it can be concluded that it is partly the way she draws on gendered linguistic resources that leads her to be negatively judged by her peers.

Gender, Power and Political Speech: Women and Language in the 2015 UK General Election

Gender, Power and Political Speech explores the influence of gender on political speech by analyzing the performances of three female party leaders who took part in televised debates during the 2015 UK General Election campaign. The analysis considers similarities and differences between the women and their male colleagues, as well as between the women themselves; it also discusses the way gender - and its relationship to language - was taken up as an issue in media coverage of the campaign.

Individual differences in speech and language ability profiles in areas of high deprivation

Speech and language ability is not a unitary concept; rather, it is made up of multiple abilities such as grammar, articulation and vocabulary. Young children from socio-economically deprived areas are more likely to experience language difficulties than those living in more affluent areas. However, less is known about individual differences in language difficulties amongst young children from socio-economically deprived backgrounds. The present research examined 172 four-year-old children from socio-economically deprived areas on standardised measures of core language, receptive vocabulary, articulation, information conveyed and grammar. Of the total sample, 26% had difficulty in at least one area of language. While most children with speech and language difficulty had generally low performance in all areas, around one in 10 displayed more uneven language abilities. For example, some children had generally good speech and language ability, but had specific difficulty with grammar. In such cases their difficulty is masked somewhat by good overall performance on language tests but they could still benefit from intervention in a specific area. The analysis also identified a number of typically achieving children who were identified as having borderline speech and language difficulty and should be closely monitored

Modelling the niche for a marine vertebrate: A case study incorporating behavioural plasticity, proximate threats and climate change

[EN] The integration of satellite telemetry, remotely sensed environmental data, and habitat/environmental modelling has provided for a growing understanding of spatial and temporal ecology of species of conservation concern. The Republic of Cape Verde comprises the only substantial rookery for the loggerhead turtle Caretta caretta in the eastern Atlantic. A size related dichotomy in adult foraging patterns has previously been revealed for adult sea turtles from this population with a proportion of adults foraging neritically, whilst the majority forage oceanically. Here we describe observed habitat use and employ ecological niche modelling to identify suitable foraging habitats for animals utilising these two distinct behavioural strategies. We also investigate how these predicted habitat niches may alter under the influence of climate change induced oceanic temperature rises.