Childhood obesity: should primary school children be routinely screened? A systematic review and discussion of the evidence

Background: Population monitoring has been introduced in UK primary schools in an effort to track the growing obesity epidemic. It has been argued that parents should be informed of their child's results, but is there evidence that moving from monitoring to screening would be effective? We describe what is known about the effectiveness of monitoring and screening for overweight and obesity in primary school children and highlight areas where evidence is lacking and research should be prioritised. Design: Systematic review with discussion of evidence gaps and future research. Data sources: Published and unpublished studies ( any language) from electronic databases ( inception to July 2005), clinical experts, Primary Care Trusts and Strategic Health Authorities, and reference lists of retrieved studies. Review methods: We included any study that evaluated measures of overweight and obesity as part of a population-level assessment and excluded studies whose primary outcome measure was prevalence. Results: There were no trials assessing the effectiveness of monitoring or screening for overweight and obesity. Studies focussed on the diagnostic accuracy of measurements. Information on the attitudes of children, parents and health professionals to monitoring was extremely sparse. Conclusions: Our review found a lack of data on the potential impact of population monitoring or screening for obesity and more research is indicated. Identification of effective weight reduction strategies for children and clarification of the role of preventative measures are priorities. It is difficult to see how screening to identify individual children can be justified without effective interventions.

Theory of mind in children with traumatic brain injury

Objective: This study was designed to examine the existence of deficits in mentalizing or theory of mind (ToM) in children with traumatic brain injury (TBI). Research design: ToM functioning was assessed in 12 children aged 6-12 years with TBI and documented frontal lobe damage and compared to 12 controls matched for age, sex and verbal ability. Brief measures of attention and memory were also included. Main outcome and results: The TBI group was significantly impaired relative to controls on the advanced ToM measure and a measure of basic emotion recognition. No difference was found in a basic measure of ToM. Conclusion: Traumatic brain damage in childhood may disrupt the developmental acquisition of emotion recognition and advanced ToM skills. The clinical and theoretical importance of these findings is discussed and the implications for the assessment and treatment of children who have experienced TBI are outlined.

Recalled relationships with parents and perceptions of professional support in mothers of infants treated for cleft lip

This study examined whether individual differences in perception of the quality of professional support available at a time of stress may be associated with security of attachment. We developed a new measure of parents' perceptions of emotional and practical support provided by a wide range of professionals involved in the treatment of infants with cleft lip. it showed good internal reliability and stability over 4 months. Mothers of 102 infants with cleft lip, with or without cleft palate, completed the measure at 2 and 6 months, together with the Parental Bonding Instrument and the General Health Questionnaire. Mean scores reflecting how much they could trust or talk frankly, or share their worst fears, with professionals, and the extent to which they saw them as a source of useful information or practical help, were lower among mothers with recollections of low maternal care in childhood, or high control. This was the case at 2 and 6 months, and there were some indications of an increasing contribution of low maternal care from 2 to 6 months. The associations were not explained by current depression. Further research is needed to clarify the role of attachment processes in parents' responses to serious medical conditions in their children, and into the implications for the way professionals in paediatric services provide support.

Evidence for unusual spatial location coding in Williams syndrome: an explanation for the local bias in visuo-spatial construction tasks?

Individuals with Williams syndrome (WS) display poor visuo-spatial cognition relative to verbal abilities. Furthermore, whilst perceptual abilities are delayed, visuo-spatial construction abilities are comparatively even weaker, and are characterised by a local bias. We investigated whether his differentiation in visuo-spatial abilities can be explained by a deficit in coding spatial location in WS. This can be measured by assessing participants' understanding of the spatial relations between objects within a visual scene. Coordinate and categorical spatial relations were investigated independently in four participant groups: 21 individuals with WS; 21 typically developing (TD) children matched for non-verbal ability; 20 typically developing controls of a lower non-verbal ability; and 21 adults. A third task measured understanding of visual colour relations. Results indicated first, that the comprehension of categorical and coordinate spatial relations is equally poor in WS. Second, that the comprehension of visual relations is also at an equivalent level to spatial relational understanding in this population. These results can explain the difference in performance on visuo-spatial perception and construction tasks in WS. In addition, both the WS and control groups displayed response biases in the spatial tasks. However, the direction of bias differed across the groups. This finding is explored in relation to current theories of spatial location coding. (c) 2005 Elsevier Inc. All rights reserved.

Measles vaccination and antibody response in autism spectrum disorders

Objective: To test the hypothesis that measles vaccination was involved in the pathogenesis of autism spectrum disorders (ASD) as evidenced by signs of a persistent measles infection or abnormally persistent immune response shown by circulating measles virus or raised antibody titres in children with ASD who had been vaccinated against measles, mumps and rubella (MMR) compared with controls. Design: Case-control study, community based. Methods: A community sample of vaccinated children aged 10-12 years in the UK with ASD (n = 98) and two control groups of similar age, one with special educational needs but no ASD (n = 52) and one typically developing group (n = 90), were tested for measles virus and antibody response to measles in the serum. Results: No difference was found between cases and controls for measles antibody response. There was no dose-response relationship between autism symptoms and antibody concentrations. Measles virus nucleic acid was amplified by reverse transcriptase-PCR in peripheral blood mononuclear cells from one patient with autism and two typically developing children. There was no evidence of a differential response to measles virus or the measles component of the MMR in children with ASD, with or without regression, and controls who had either one or two doses of MMR. Only one child from the control group had clinical symptoms of possible enterocolitis. Conclusion: No association between measles vaccination and ASD was shown.

Transatlantic spaces: production, location and style in 1960s-1970s action-adventure TV series

This paper argues that transatlantic hybridity connects space, visual style and ideological point of view in British television action-adventure fiction of the 1960s–1970s. It analyses the relationship between the physical location of TV series production at Elstree Studios, UK, the representation of place in programmes, and the international trade in television fiction between the UK and USA. The TV series made at Elstree by the ITC and ABC companies and their affiliates linked Britishness with an international modernity associated with the USA, while also promoting national specificity. To do this, they drew on film production techniques that were already common for TV series production in Hollywood. The British series made at Elstree adapted versions of US industrial organization and television formats, and made programmes expected to be saleable to US networks, on the basis of British experiences in TV co-production with US companies and of the international cinema and TV market.

Perspectives on community representation within the Extractive Industries Transparency Initiative: experiences from south-east Madagascar

This article critically examines the nature and quality of governance in community representation and civil society engagement in the context of trans-national large-scale mining, drawing on experiences in the Anosy Region of south-east Madagascar. An exploration of functional relationships between government, mining business and civil society stakeholders reveals an equivocal legitimacy of certain civil society representatives, created by state manipulation, which contributes to community disempowerment. The appointment of local government officials, rather than election, creates a hierarchy of upward dependencies and a culture where the majority of officials express similar views and political alliances. As a consequence, community resistance is suppressed. Voluntary mechanisms such as Corporate Social Responsibility (CSR) and the Extractive Industries Transparency Initiative (EITI) advocate community stakeholder engagement in decision making processes as a measure to achieve public accountability. In many developing countries, where there is a lack of transparency and high levels of corruption, the value of this engagement, however, is debatable. Findings from this study indicate that the power relationships which exist between stakeholders in the highly lucrative mining industry override efforts to achieve "good governance" through voluntary community engagement. The continuing challenge lies in identifying where the responsibility sits in order to address this power struggle to achieve fair representation.

Intrusions in trauma and psychosis: information processing and phenomenology

Background: Intrusions are common symptoms of both posttraumatic stress disorder (PTSD) and schizophrenia. Steel et al (2005) suggest that an information processing style characterized by weak trait contextual integration renders psychotic individuals vulnerable to intrusive experiences. This ‘contextual integration hypothesis’ was tested in individuals reporting anomalous experiences in the absence of a need-for-care. Methods: Twenty-six low schizotypes and twenty-three individuals reporting anomalous experiences were shown a traumatic film with and without a concurrent visuo-spatial task. Participants rated post-traumatic intrusions for frequency and form, and completed self-report measures of information processing style. It was predicted that, due to their weaker trait contextual integration, the anomalous experiences group would (1) exhibit more intrusions following exposure to the trauma-film; (2) display intrusions characterised by more PTSD qualities and (3) show a greater reduction of intrusions with the concurrent visuo-spatial task. Results: As predicted, the anomalous experiences group reported a lower level of trait contextual integration and more intrusions than the low schizotypes, both immediately after watching the film, and during the following seven days. Their post-traumatic intrusive memories were more PTSD-like (more intrusive, vivid and associated with emotion). The visuo-spatial task had no effect on number of intrusions in either group. Conclusions: These findings provide some support for the proposal that weak trait contextual integration underlies the development of intrusions within both PTSD and psychosis.

Entertainment education theory and practice in HIV/AIDS communication: a South Africa / United Kingdom comparison

Within development communication, gaps remain in theory and practice: communication innovations are taking place which either do not incorporate theory or fail to challenge the assumptions of development communication and HIV/AIDS theory. This can lead to the implementation of unsuccessful interventions that lack theoretical frameworks or to uninformed practice, making it difficult to replicate. Further, research has demonstrated that Entertainment Education (EE) interventions have a measurable impact on behaviour in areas such as HIV/AIDS prevention. Given the transitions in EE practice and evidence of its impact, EE theory and practice can contribute insight into these challenges. A pilot study investigated these dilemmas within the context of the monitoring and evaluation of development communication. Framing this discussion is the concept of South-North dialogue, using comparative analysis of EE interventions to distil lessons through contrasting experiences in two diverse settings. It holds as a principle that lessons from the experience of EE in the Southern context can inform lessons for the North. Further, comparison of the case studies can generate insights for the broader development communication field. We present four case studies, informed by key informant interviews, of EE interventions in the UK and South Africa. We address how communication is defined in planning, implementation and evaluation, highlighting how it often misses the importance of 'listening'. The case studies show that HIV/AIDS communication, and development communication more broadly, has not internalised ideas of evaluation and listening in communication. Successes in the case studies can be partially attributed to responsiveness and context-specificity rather than following rigid planning templates, such as those found in some development communication literature. This indicates the importance of flexibility and responsiveness to context for both development communication and HIV/AIDS communication.

Experience of international students from developing countries in negotiating technology for learning

International students are important economically and culturally, bringing diversity and an international perspective enriching learning experiences in classrooms. With the global transformations eLearning has become an important element of students’ higher education experience in developed countries. Although students of developed countries have digital exposure at an early age, many students from developing countries, on the journey of becoming international students, are inadequately prepared for eLearning. The lack of digital skills, prior experience, cultural differences and language barriers together with the drastic changes in learning environments require international students to not only adapt to the host environment but also to negotiate technology for learning. The scarcity of research exploring the eLearning experiences of international students from developing countries and the benefits of this understanding is discussed in an effort to promote research in this area.

Effects of second language on cognition in English users of L2 Japanese

It is now established that certain cognitive processes such as categorisation are tightly linked to the concepts encoded in language. Recent studies have shown that bilinguals with languages that differ in their concepts may show a shift in their cognition towards the L2 pattern primarily as a function of their L2 proficiency. This research has so far focused predominantly on L2 users who started learning the L2 in childhood or early puberty. The current study asks whether similar effects can be found in adult L2 learners. English speakers of L2 Japanese were given an object classification task involving real physical objects, and an online classification task involving artificial novel objects. Results showed a shift towards the L2 pattern, indicating that some degree of cognitive plasticity exists even when a second language is acquired later in life. These results have implications for theories of L2 acquisition and bilingualism, and contribute towards our understanding of the nature of the relationship between language and cognition in the L2 user’s mind.

A genome-wide association meta-analysis identifies new childhood obesity loci

Multiple genetic variants have been associated with adult obesity and a few with severe obesity in childhood; however, less progress has been made in establishing genetic influences on common early-onset obesity. We performed a North American, Australian and European collaborative meta-analysis of 14 studies consisting of 5,530 cases (≥95th percentile of body mass index (BMI)) and 8,318 controls (<50th percentile of BMI) of European ancestry. Taking forward the eight newly discovered signals yielding association with P < 5 × 10(-6) in nine independent data sets (2,818 cases and 4,083 controls), we observed two loci that yielded genome-wide significant combined P values near OLFM4 at 13q14 (rs9568856; P = 1.82 × 10(-9); odds ratio (OR) = 1.22) and within HOXB5 at 17q21 (rs9299; P = 3.54 × 10(-9); OR = 1.14). Both loci continued to show association when two extreme childhood obesity cohorts were included (2,214 cases and 2,674 controls). These two loci also yielded directionally consistent associations in a previous meta-analysis of adult BMI(1).

In at the Deep End. Impressions of farming in a year gaining experience: 1952-3; 1978-85

The book describes a wide variety of students’ experiences in their practical year prior to entering University to study BSc Agriculture. Until comparatively recently it was the normal requirement for all such students, whether or not they already had home farming experience, to gain a full year’s experience of practical agriculture – and to write a report thereon. This record of 41 students’ reports of the pre-entry year begins with Paul’s own experience in the early 1950s before 41 reports from 30 or more years ago. The essays provide compelling and fascinating stories, well-articulated with clear acknowledgement for most part of the humanity and the warmth with which each student was treated by farmers and farm workers alike, despite the difference in both age and experience (considerable!). [This summary is an extract from the full overview which is archived here together with the book.]

Assessment and management of anxiety disorders in children and adolescents

Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm.