NSAIDs: GI risk with a past history of peptic ulceration

In this Drug points article the author describes a case of osteoarthritic pain where prescribing diclofenac resulted in gastrointestinal ulceration and comments on the issues it raises.

Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression 2. Impact on the mother-child relationship and child outcome

Background: Postnatal depression is associated with adverse child cognitive and socio-emotional outcome. It is not known whether psychological treatment affects the quality of the mother-child relationship and child outcome. Aims: To evaluate the effect of three psychological treatments on the mother-child relationship and child outcome. Method: Women with post-partum depression (n=193) were assigned randomly to routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy The women and their children, were assessed at 43, [8 and 60 months post-partum. Results: Indications of a positive benefit were limited. All three treatments had a significant benefit on maternal reports of early difficulties in relationships with the infants, counselling gave better infant emotional and behaviour ratings at 18 months and more sensitive early mother-infant interactions. The treatments had no significant impact on maternal management of early infant behaviour problems, security of infant-mother attachment. Infant cognitive development or any child outcome at 5 years. Conclusions: Early intervention was of short-term benefit to the mother-child relationship and infant behaviour problems. More-prolonged intervention may be needed. Health visitors could deliver this.

Mothers' attributions following their child's diagnosis of autistic spectrum disorder: exploring links with maternal levels of stress, depression and expectations about their child's future

Although the impact of autism spectrum disorders (ASDs) on the family is well recognized, the way mothers attempt to make sense of the diagnosis is largely unexplored. However, in other disabilities, attributions have been shown to predict a variety of outcomes including maternal wellbeing and engagement in treatment. Using Weiner's (198S) three-dimensional model, 16 mothers were interviewed to examine the nature and impact of their beliefs about their child's ASD using semi-structured interviews and measures of depression, parenting stress and expectations for their child's future. The findings suggested that mothers made a diverse and complex range of attributions that were consistent with Weiner's dimensions of locus of cause, stability and controllability. The nature of their attributions reflected particular difficulties associated with ASDs, such as uncertainties regarding cause and prognosis. Taking account of mothers' search for meaning will better enable professionals to support families following diagnosis.

Component processes of early reading, spelling, and narrative writing skills in Turkish: a longitudinal study

The study examined: (a) the role of phonological, grammatical, and rapid automatized naming (RAN) skills in reading and spelling development; and (b) the component processes of early narrative writing skills. Fifty-seven Turkish-speaking children were followed from Grade 1 to Grade 2. RAN was the most powerful longitudinal predictor of reading speed and its effect was evident even when previous reading skills were taken into account. Broadly, the phonological and grammatical skills made reliable contributions to spelling performance but their effects were completely mediated by previous spelling skills. Different aspects of the narrative writing skills were related to different processing skills. While handwriting speed predicted writing fluency, spelling accuracy predicted spelling error rate. Vocabulary and working memory were the only reliable longitudinal predictors of the quality of composition content. The overall model, however, failed to explain any reliable variance in the structural quality of the compositions

Tropospheric temperature trends: history of an ongoing controversy

Changes in atmospheric temperature have a particular importance in climate research because climate models consistently predict a distinctive vertical profile of trends. With increasing greenhouse gas concentrations, the surface and troposphere are consistently projected to warm, with an enhancement of that warming in the tropical upper troposphere. Hence, attempts to detect this distinct ‘fingerprint’ have been a focus for observational studies. The topic acquired heightened importance following the 1990 publication of an analysis of satellite data which challenged the reality of the projected tropospheric warming. This review documents the evolution over the last four decades of understanding of tropospheric temperature trends and their likely causes. Particular focus is given to the difficulty of producing homogenized datasets, with which to derive trends, from both radiosonde and satellite observing systems, because of the many systematic changes over time. The value of multiple independent analyses is demonstrated. Paralleling developments in observational datasets, increased computer power and improved understanding of climate forcing mechanisms have led to refined estimates of temperature trends from a wide range of climate models and a better understanding of internal variability. It is concluded that there is no reasonable evidence of a fundamental disagreement between tropospheric temperature trends from models and observations when uncertainties in both are treated comprehensively