Does mothers' postnatal depression influence the development of imitation?

Background: Links between mothers' postnatal depression (PND) and children's cognition have been identified in several samples, but the evidence is inconsistent. We hypothesized that PND may specifically interfere with infants' imitation, an early learning ability that features in early mother-infant interaction and is linked to memory, causal understanding and joint attention. 

Methods: A randomly controlled experiment on imitation was embedded into a longitudinal study of a representative sample of firstborn British infants, whose mothers were assessed for depression using the SCAN interview during pregnancy and at 6 months postpartum. At a mean of 12.8 months, 253 infants were presented with two imitation tasks that varied in difficulty, in counterbalanced order. 

Results: The infants of mothers who experienced PND were significantly less likely than other infants in the sample to imitate the modelled actions, showing a 72% reduction in the likelihood of imitation. The association with PND was not explained by sociodemographic adversity, or a history of depression during pregnancy or prior to conception. Mothers' references to infants' internal states during mother-infant interaction at 6 months facilitated imitation at 12 months, but did not explain the link with PND. 

Conclusions: The findings support the hypothesis that associations between PND and later cognitive outcomes may partly derive from effects of the mother's illness on infants' early learning abilities. Support for infants' learning should be considered as an age-appropriate, child-focused component of interventions designed to ameliorate the effects of PND.

The African Pediatric Fellowship Program: Training in Africa for Africans

Africa has a significant burden of childhood disease, with relatively few skilled health care professionals. The African Paediatric Fellowship Programme was developed by the Department of Pediatrics and Child Health at the University of Cape Town to provide relevant training for African child health professionals, by Africans, within Africa. Trainees identified by partner academic institutions spend 6 months to 2 years training in the Department of Pediatrics and allied disciplines. They then return to their home institution to build practice, training, research, and advocacy. From 2008 to 2015, 73 physicians have completed or are completing training in general pediatrics or a pediatric subspecialty. At 1 year posttraining, 98% to 100% are practicing back in their home institution. The impact of the returning fellows is evident from their practice interventions, research collaborations, and positions as stakeholders who can change health care policies. Thirty-three centers in 13 African countries are partners with the program, and the program template is now followed by other partner sites in Africa. Increasing and retaining the skills pool of African child health specialists is building a network of motivated, highly skilled clinicians who are equipped to advance child health in Africa.

Sexual Abuse in Malawi: Patterns of Disclosure

Potential human immunodeficiency virus transmission makes prompt disclosure of child sexual abuse in Africa critical. The pattern of disclosure of 133 children presenting to the largest hospital in Malawi were analyzed. Eighty percent presented early enough for effective use of HIV postexposure prophylaxis. Seventy-five percent of children made a disclosure of child sexual abuse; 29% spontaneously and 47% after prompting. Disclosures were most commonly made to a parent, and age did not affect the pattern of disclosure. The number of children reporting child sexual abuse is increasing, possibly because of increasing awareness, availability of services, and fear of HIV. Although prompt disclosure rates were relatively high, facilitating easier disclosure of child sexual abuse by a free telephone help-line and better training of teachers may be helpful. 

Sexual abuse of children in low-income settings:time for action

In this article, child sexual abuse in low-income settings is reviewed, including the extent of the problem, the way children present, and how they should be managed. Liaising with other agencies, training in all aspects of sexual abuse and creating an environment that is conducive to good care by all groups involved is essential. Technical details of medical examination are not covered as appropriate guidelines are accessible.

Endomyocardial fibrosis:the first report from Malawi

Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy of unknown aetiology previously unreported in Malawi. Six Malawian children (three males) aged between 12 and 16 years who presented with EMF in 2009/10 are described. Five were from the Southern Highlands.

“I just can’t, I am frightened for my safety, I don’t know how to work with her” Practitioners’ experiences of client violence and recommendations for future practice

To what extent is the therapist-client relationship damaged following client perpetuated violence and what steps can we take to diminish its impact? Much of the information we have on client violence comes from multiple mental health disciplines in the US and the UK over the last 20-30 years and has formed a useful, though sometimes dated and sporadic, quantitative baseline to delineate a range of issues. However, there is limited systematic research on how practitioner psychologists process the violence in the course of their everyday practice and how this impacts the therapist-client dynamic. Using Interpretative Phenomenological Analysis (IPA), we explored seven therapists’ experiences of client violence across a range of work sites – acute psychiatric hospital wards, forensic hospital wards and community mental health teams. Three main themes were documented: processing the moment-to-moment experience of client violence; professional vulnerabilities and needs as a result of client violence; and the ruptured therapeutic relationship. Strategies for supporting practicing psychologists and providing continuing professional care for clients include challenging self-doubt and re-energizing professional competencies as well as repairing ourselves and repairing the therapeutic relationship. Recommendations for credentialing and regulatory bodies in relation to client violence are also highlighted.

Spirituality and Basketball Fanship: An Interpretative Phenomenological Analysis and Synthesis

The world of competitive sport affords an individual the opportunity to enter a spiritual community adding meaning that transcends one’s current understanding of life (Parry et al. 2007). Previously established dimensions of sports fanship (group affiliation, psychological commitment and team identification) share characteristics commonly associated with religious or spiritual affiliation indicating that fans may generate substantial life meaning from observing sporting encounters. In the present study, 12 male basketball fans (M=32.42; SD=7.97) completed semi-structured interviews immediately prior to viewing a competitive match at the 2011 European Basketball Championships (Vilnius, Lithuania). Interviews were structured under four headings; 1) the most memorable moment as a basketball fan, 2) thoughts, feelings and emotions attached to their team, 3) affiliation to the team in the context of the fan’s meaning of life, 4) connection with members of the fan’s sporting community. Interpretative Phenomenological Analysis was employed to analyse interview transcripts. Raw data clustered into four dimensions; 1) devotion, 2) obscure emotions, 3) connectedness, and 4) universal values. The results indicate that sports fanship is characterised by, and synonymous with, an established understanding of spirituality derived from membership of wider spiritual and/or religious communities. The findings hold implications for the marketing and membership of local, amateur and professional sports clubs and brands, as well as community development, health and welfare.

The Influence of Causal Explanations and Diagnostic Labeling on Psychology Students’ Beliefs About Treatments, Prognosis, Dangerousness and Unpredictability in Schizophrenia

This study explored views of 566 Italian psychology students about schizophrenia. The most frequently cited causes were psychological traumas (68%) and heredity (54%). Thirty-three percent of students firmly believed that people with the condition could recover. Reporting heredity among the causes, and identifying schizophrenia were both associated with prognostic pessimism, greater confidence in pharmacological treatments and lower confidence in psychological treatments. Schizophrenia labeling was also associated with higher perception of unpredictability and dangerousness. Compared to first year students, fourth/fifth year students more frequently reported heredity among the causes, and were more pessimistic about schizophrenia recovery. Stigma topics should be included in future psychologists’ education.

Development of a Parent Version of the Manchester-Minneapolis Quality of Life Survey for use by Parents and Crers of UK Children: MMQL-UK (PF).

Background Although it is now widely endorsed that children should as far as possible rate their own health related quality of life (HRQL), there are situations where proxy information on child HRQL may be useful, especially where a child is too ill or young to provide their own HRQL assessment. There is limited availability of generic HRQL scales that have a parallel child and parent version and that are reliable, valid, brief, comprehensible and suitable for use in UK populations. The aims of this study were therefore to develop and validate a parent version of the anglicised Manchester-Minneapolis Quality of Life child form (MMQL-UK (CF)) and to determine the level of association between the child and parent versions of this form. Methods This study was undertaken concurrently with the anglicisation and validation of the MMQL, a measure of HRQL developed for use with children in North America. At that time, no parent version existed, so the MMQL form for children (MMQL-UK (CF)) was used as the basis for the development of the MMQL-UK parent form (PF). The sample included a control group of healthy children and their parents and five exemplar groups; children diagnosed with asthma, diabetes or inflammatory bowel disease and their parents, children in remission from cancer and their parents and children in public care and their carers. Consistency of the MMQL-UK (PF) components were assessed by calculating Cronbach's alpha. Validation of the parent questionnaire was undertaken by comparing MMQL-UK (PF) component scores with comparable components on the proxy PedsQL™ quality of life scales, comparing MMQL-UK (PF) component scores between parents of healthy and chronic disease children and by comparison of component scores from children and their parents or carers. Reproducibility and responsiveness were assessed by retesting parents by follow-up questionnaires. Results A total of 874 children (completing MMQL-UK (CF)) and 572 parents or carers (completing MMQL-UK (PF)) took part in the study. The internal consistency of all the MMQL-UK (PF) components exceeding the accepted criterion of 0.70 and the construct validity was good with moderate correlations being evident between comparable components of the MMQL-UK (PF) and the proxy PedsQL™. Discriminant validity was demonstrated with significant differences being identified between parents of healthy children and those with chronic conditions. Intra-class correlations exceeded 0.65 for all MMQL-UK (PF) components demonstrating good reproducibility. Weak to moderate levels of responsiveness were demonstrated for all but social functioning. The MMQL-UK (PF) showed moderate parent-child correlation with the MMQL-UK (CF) for all components. The best correlations were seen for those components measuring the same construct (Pearson's r ranged from 0.31 to 0.61, p < 0.01 for equivalent components). Conclusion The MMQL-UK (PF) showed moderate to good correlations with the MMQL-UK (CF) component scores. The MMQL-UK (PF) will be of use when comparing child and parent/carer perception of the impact of a child's condition on their HRQL or where the child is too ill or young to provide their own report.

Occupational exposure to particulate matter and respiratory symptoms in Portuguese swine barn workers

Certain environmental conditions in animal and plant production have been associated with increased frequency in respiratory illnesses, including asthma, chronic bronchitis, and hypersensitivity pneumonitis, in farmers occupationally exposed in swine production. The aim of this study was to characterize particulate matter (PM) contamination in seven Portuguese swine farms and determine the existence of clinical symptoms associated with asthma and other allergy diseases, utilizing the European Community Respiratory Health Survey questionnaire. Environmental assessments were performed with portable direct-reading equipment, and PM contamination including five different sizes (PM0.5, PM1.0, PM2.5, PM5.0, PM10) was determined. The distribution of particle size showed the same trend in all swine farms, with high concentrations of particles with PM5 and PM10. Results from the questionnaire indicated a trend such that subjects with diagnosis of asthma were exposed to higher concentrations of PM with larger size (PM2.5, PM5, and PM10) while subjects with sneezing, runny nose, or stuffy nose without a cold or flu were exposed to higher concentrations of PM with smaller size (PM0.5 and PM1). Data indicate that inhalation of PM in swine farm workers is associated with increased frequency of respiratory illnesses.

Avaliação da participação em crianças e jovens com paralisia cerebral, na ilha de S. Miguel, Açores

Introdução: Nas crianças/jovens com Paralisia Cerebral (PC), as limitações motoras repercutem-se em limitações funcionais e, consequentemente, na diminuição da participação em ocupações. Sendo as manifestações da PC diferentes de indivíduo para indivíduo, estas vão refletir, dependendo da gravidade, quadro motor, ambiente físico e social, diferentes níveis de participação. Objetivo: O objetivo deste estudo foi avaliar a relação entre a idade, sexo e grau de comprometimento motor e a participação em crianças/jovens com diagnóstico de paralisia cerebral com idades compreendidas entre os 5 e os 18 anos na ilha de São Miguel. Amostra e Métodos: 25 crianças de ambos os sexos (5- 18 anos), sinalizadas em instituições especializadas de reabilitação e em Centros de Atividades Ocupações (CAO’s) na Ilha de São Miguel – Açores. Foram aplicados dois instrumentos de avaliação às crianças/jovens, Gross Motor Function Measure e Quality of Upper Extremity Skills Test, e foram entregues aos pais os outros dois instrumentos para autopreenchimento, Assessment of Life Habits e Child Health Questionnaire – Parent- Form 50. Na análise estatística, recorreu-se a testes como o Kolmogorov-Smirnov, Tstudent ou Mann-Whitney, teste de Fisher, teste de Spearman e ANOVA. Resultados: Não foram encontradas relações significativas entre a idade e o sexo e o nível de participação das crianças/jovens com PC. Contrariamente, ao avaliarmos a relação entre o grau de participação e o grau de afetação verificamos que esta é significativa (p=0,004). Conclusão: Na nossa amostra não se encontrou uma influência da idade e do sexo com a frequência da participação (relações não foram significativas). Contudo, pode-se concluir que as crianças/jovens que apresentam menos limitações motoras, como as que se enquadram no nível I/II da Gross Motor Function Classification System, apresentam níveis de participação maiores do que as que apresentam níveis de afetação motora maiores (Nível V)