Improving quality of mother-infant relationship and infant attachment in socioeconomically deprived community in South Africa: randomised controlled trial

Objective To assess the efficacy of an intervention designed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances. Design Randomised controlled trial. Setting Khayelitsha, a peri-urban settlement in South Africa. Participants 449 pregnant women. Interventions The intervention was delivered from late pregnancy and for six months postpartum. Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting. The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother. Women in the control group received no therapeutic input from the research team. Main outcome measures Primary outcomes: quality of mother-infant interactions at six and 12 months postpartum; infant attachment security at 18 months. Secondary outcome: maternal depression at six and 12 months. Results The intervention was associated with significant benefit to the mother-infant relationship. At both six and 12 months, compared with control mothers, mothers in the intervention group were significantly more sensitive (6 months: mean difference=0.77 (SD 0.37), t=2.10, P<0.05, d=0.24; 12 months: mean difference=0.42 (0.18), t=-2.04, P<0.05, d=0.26) and less intrusive (6 months: mean difference=0.68 (0.36), t=2.28, P<0.05, d=0.26; 12 months: mean difference=-1.76 (0.86), t=2.28, P<0.05, d=0.24) in their interactions with their infants. The intervention was also associated with a higher rate of secure infant attachments at 18 months (116/156 (74%) v 102/162 (63%); Wald=4.74, odds ratio=1.70, P<0.05). Although the prevalence of maternal depressive disorder was not significantly reduced, the intervention had a benefit in terms of maternal depressed mood at six months (z=2.05, P=0.04) on the Edinburgh postnatal depression scale). Conclusions The intervention, delivered by local lay women, had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment, factors known to predict favourable child development. If these effects persist, and if they are replicated, this intervention holds considerable promise for use in the developing world. Trial registration Current Controlled Trials ISRCTN25664149.

Improving quality of mother-infant relationship and infant attachment in socioeconomically deprived community in South Africa: randomised controlled trail

Objective To assess the efficacy of an intervention designed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances. Design Randomised controlled trial. Setting Khayelitsha, a peri-urban settlement in South Africa. Participants 449 pregnant women. Interventions The intervention was delivered from late pregnancy and for six months postpartum. Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting. The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother. Women in the control group received no therapeutic input from the research team. Main outcome measures Primary outcomes: quality of mother-infant interactions at six and 12 months postpartum; infant attachment security at 18 months. Secondary outcome: maternal depression at six and 12 months. Results The intervention was associated with significant benefit to the mother-infant relationship. At both six and 12 months, compared with control mothers, mothers in the intervention group were significantly more sensitive (6 months: mean difference=0.77 (SD 0.37), t=2.10, P<0.05, d=0.24; 12 months: mean difference=0.42 (0.18), t=−2.04 , P<0.05, d=0.26) and less intrusive (6 months: mean difference=0.68 (0.36), t=2.28, P<0.05, d=0.26; 12 months: mean difference=−1.76 (0.86), t=2.28 , P<0.05, d=0.24) in their interactions with their infants. The intervention was also associated with a higher rate of secure infant attachments at 18 months (116/156 (74%) v 102/162 (63%); Wald=4.74, odds ratio=1.70, P<0.05). Although the prevalence of maternal depressive disorder was not significantly reduced, the intervention had a benefit in terms of maternal depressed mood at six months (z=2.05, P=0.04) on the Edinburgh postnatal depression scale). Conclusions The intervention, delivered by local lay women, had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment, factors known to predict favourable child development. If these effects persist, and if they are replicated, this intervention holds considerable promise for use in the developing world.

Teaching Zambian traditional birth attendants to monitor growth of infants : evaluation of an education program

The high infant mortality in Zambia is largely attributable to malnutrition. It is exacerbated by the inability of mothers to recognise threats to nutritional status and take corrective action. Advice in ‘Health Centres’ is often inaccessible to mothers. The Traditional Birth Attendants (TBAs) work with pregnant women in local communities, and the purpose of this study was to develop and implement an educationprogram in growth monitoring and nutrition for the TBAs and then to evaluate its effects. Twenty five TBAs from two peri-urban areas of Kitwe were enrolled in this pilot study and eighteen completed the program. The researcher developed and taught a program to the TBAs over ten days. A pretest was given before the teaching program to enable the researcher to obtain information about the knowledge and skills of the TBAs. Following the teaching program the TBAs were re-tested, with the same questionnaire. Focus groups were conducted to enable the TBA to provide information on the teaching materials and the education program. The TBAs then returned to their communities and put into practice the skills and knowledge they had learned for six months. Their practice was monitored by a trained Public Health Nurse. The researcher also surveyed 38 pregnant women about their knowledge of growth monitoring and nutrition before the TBAs went into the field to work with their local communities. The same questionnaire used with the pregnant women was administered to 38 new mothers with children aged 0 to 6 months to gain information of their knowledge and skills following the work of the TBAs. The program was evaluated by assessing the extent to which TBAs knowledge and skills were increased, the knowledge and understanding of a selection of their clients and the rates of malnutrition of infants in the area under study. The results from the research clearly indicated that the teaching program on growth monitoring and nutrition given to the selected group of TBAs had a positive effect on their knowledge and skills. It was found that the teaching developed their knowledge, practical skills, evaluative skills. That they were able to give infants’ mothers sound advice regarding their children’s nutrition was revealed by the mother’s increased knowledge and the decrease in numbers of malnourished children in the study areas at the conclusion of the research. The major outcomes from the study are: that Zambian TBAs can be taught to carry out an expanded role; field experience is a key factor in the teaching program; making advice available in local communities is important; and preliminary data on the Zambian experience were generated. Recommendations are: The pilot program should be expanded with continuing support from the Health Department. Similar educational programs should be introduced into other areas of Zambia with support from the Ministry of Health. That in administering a teaching program: Sufficient time must be allocated to practical work to allow poorly educated women to attain the basic skills needed to master the complex skills required to competently reduce faltering in their communities. The teaching materials to illustrate nutritional principles for feeding programs must be developed to suite locally available foods and conditions. Methods of teaching should suit the local area, for example, using what facilities are locally available. The timing of the teaching program should be suitable for the TBAs to attend. This may vary from area to area, for example it may be necessary to avoid times traditionally given to fetching water or working in the fields. For similar reasons, the venue for the teaching program should be suitable to the TBAs. The teachers should go into the TBAs’ community rather than causing disruption of the TBAs’ day by expecting them to go to the teacher. Data should be collected from a larger group of TBAs and clients to enable sophisticated statistical analysis to complement data from this pilot program. The TBAs should be given recognition for their work and achievement. This is something which they asked for. They do not ask for payment, rather acknowledgment through regular follow up and approbation.

Watching clouds over country : reconsidering Australian indigenous perspectives about environmental change and climate change

This paper considers an Indigenous perspective on the rapidly transforming Australian environment and the impact of world climate change. It is largely based upon a National Climate Change Adaptation and Research Facility (NCCARF) research project, in progress, that is seeking to translate a south-eastern Australian Indigenous perspective of how climate change affects 'country'. The project involves direct community consultation and workshops, framed by a literature review and longstanding author involvements with Indigenous communities in planning, design and native title projects, and will discuss conclusions being raised. Importantly, this discourse is being formulated with peri-urban based Indigenous communities whom are well educated and deeply involved with statutory and strategic planning processes and native title debates.

Words, oral libraries and environmental responses : an Australian indigenous perspective to climate change adaptation

Climate change adaptation and mitigation continues to be a prevalent discourse in this country and internationally in both the sciences and the arts. While various types and degrees of change are evident, the quantification of these changes including their scope and diversity have challenged conventional sciences. This is demonstrated in their inability to succinctly answer key questions about change including the degree of change and associated patterns and consequences. Most of this discourse is nested in a temporal band comprising the last 100-200 years of data and evidence, and very much informed by Western science perspectives and protocols. Little attempt has been made to engage with Australian Indigenous communities whom possess environmental knowledge of some 10,000-100,000 years albeit embedded in their artistic and oral narrative 'histories'. This paper explores the role and values that Australian Aboriginals, the Indigenous peoples of the Australian content, can offer in shedding new light on this discourse While focusing upon a cross-peri-urban Indigenous investigation, it examines this discourse though the lens of their words, terms, sentences as a vehicle to better understand a longitudinal perspective about climate change adaptation pertinent to Australia.

Reinventing D'Jillong : current regeneration initiatives challenging the identity and place of Geelong

Australian regional city regeneration in Australia is increasingly becoming an important topic as they attempt to position themselves mid-way between larger discourses about capital cities and peri-urban landscapes. Historically these cities, like Newcastle, Wollongong and Geelong, have been marginalised in infrastructure and planning support systems, yet subject to erratic Commonwealth and State funded initiatives that have divested major specific-purpose complexes into their cities. Such has been as a consequence of of 'decentralisation' and 'regionalisation' political platforms, but also to address employment and voting needs. As an example, Geelong embraced contemporary industrialism, particularly automotive, and built on its port and wool export capacities. Politics, intransigence and lack of economic investment compounded the failure to create quality urban fabric and enable innovative planning. With this legacy, this regional city finds itself at the cusp of heavy industry disintegration, education and health sectorial growth, population increases aided by regional escapism, and a lethargic city centre. In attempting to redress these trends, Geelong is consciously attempting to re-image itself, regenerate key sections of its urban fabric, but also manage the regional escapism (sea change / tree change) phenomena. This paper critiques the larger context, and then uses three examples - "Vision 2" in the city centre, the Mega Port proposal, Fyansford Green and the Moolap salt marsh - as foils to reflect whether these initiatives are and can assist the facilitation of city structural change, economic renewal and enhanced urban design and place-making outcomes.

The gardens on Anlaby - a utopian dream

Anlaby Station is the oldest sheep stud in South Australia (SA) dating back to 1839. The gardens have been noted as significant exemplars, Beames & Whitehill (1992), Swinbourne (1982), and in Pastoral Homes of Australia (1911) published by The Pastoral Review, wherein Anlaby was described as “being of no particular beauty architecturally . But the gardens are unique.” The Anlaby property is on the SA State Heritage Register and the Anlaby Gardens are listed in the Oxford Companion to Australian Gardens (2002). The beginnings of Anlaby in 1839 are integral to the colonial expansion of the interior of South Australia. Anlaby at this time was a completely self-contained community within a sheep station containing a survival garden, much like a self- contained English manor-village. The process of land sales offered by the SA government enabled Anlaby to expand, wherein wealth flowed and gradually the survival garden style at Anlaby was transformed into an extensive decorative garden style. This enabled the garden to act as a backdrop for major South Australian society and public gatherings. The driving force behind the garden during its height was the fashionable plant trends in the United Kingdom. This is evidenced by the inclusion of an extensive stove house, grotto, roses and the Gardenesque style of plantings. Traditional English head gardeners were also employed to manage the garden. The realisation of the beauty of native plants was never allowed in the inner world of this landscape; it always remained on the perimeter. The owner’s vision of the garden was Utopian, however, due to climatic forces, the dream was not fully realised. The challenge now lies in preserving this Utopian dream for future generations. This paper considers the historical evolution of the property, its context as a historical exemplar and the challenges facing its future conservation having regard to Adelaide peri-urban, climate change, and differing owner economic circumstances.

Preferência alimentar e identificação das principais fontes de repasto sanguíneo de fêmeas Lutzomyia (Diptera: Psychodidae) em áreas endêmicas para leishmaniose visceral na grande Natal

Leishmaniasis are endemic diseases wild spread in the New and Old World, caused by the flagelated protozoan Leishmania. In the New World, the distribution of different forms of leishmaniasis is mostly in tropical regions. In the State of Rio Grande do Norte, Northeast Brazil, 85% of the captured sand flies fauna is Lutzomyia longipalpis. The distribution of the sand fly vector in the state overlaps with the disease distribution, where the presence of sand flies is associated with presence of animals shelters. The aim of this study was to analyse the blood meal preference of sand flies vector from the genus Lutzomyia spp. in laboratory conditions, to verify the vector life cicle at different temperatures sets and to identify the main blood meal source in endemic areas for visceral leishmaniasis (VL) at peri-urban regions of Natal. Sand flies samples were collected from the municipalities of São Gonçalo do Amarante and Nísia Floresta where female sand flies were grouped for the colony maintenance in the laboratory and for the analysis of the preferred source of sand fly blood meal in natural environment. The prevalence of blood meal preference and oviposition for the females sand flies was 97% for Cavia porcellus with oviposition of 19 eggs/female; 97% for Eqqus caballus with 19 eggs/female; 98% for human blood with 14 eggs/female; 71.3% for Didelphis albiventris with 8.4 eggs/female; 73% for Gallus gallus with 14 eggs/female; 86% for Canis familiaris with 10.3 eggs/female; 81.4% for Galea spixii with 26 eggs/female; 36% for Callithrix jachus with 15 eggs/female; 42.8% for Monodelphis domestica with 0% of oviposition. Female sand flies did not take a blood meal from Felis catus. Sand flies life cycle ranged from 32-40 days, with 21-50 oviposition rates approximately. This study also showed that at 32°C the life cycle had 31 days, at 28° C it had 50 days and at 22°C it increased to 79 days. Adjusting the temperature to 35°C the eggs did not hatch, thus blocking the life cycle. A total of 1540 sand flies were captured, among them, 1.310 were male and 230 were female. Whereas 86% of the sand flies captured were Lu. longipalpis as compared to 10.5% for Lu. evandroi and, 3.2% for L. lenti and 0.3% for Lu whitmani. The ratio between female and male sandfly was approximately 6 males to 1 female. In Nísia Floresta, 50.7% of the collected females took their blood meal from armadillo, 12.8% from human. Among the female sand flies captured in São Gonçalo do Amarante, 80 of them were tested for the Leishmania KDNA infectivity where 5% of them were infected with Leishmania chagasi. Female Lutzomyia spp. showed to have an opportunistic blood meal characteristic. The behavioral parameters seem to have a higher influence in the oviposition when compared to the level of total proteins detected in the host s bloodstream. A higher Lu. longipalpis life cycle viability was observed at 28°C. The increase of temperature dropped the life cycle time, which means that the life cycle is modified by temperature range, source of blood meal and humidity. Lu longipalpis was the most specie found in the inner and peridomiciliar environment. In Nísia Floresta, armadillos were the main source of blood meal for Lutzomyia spp. At São Gonçalo do Amarante, humans were the main source of blood meal due to CDC nets placed inside their houses

Produção do espaço e transformações urbanas no litoral sul de João Pessoa - PB

This present work has as its objective the analysis of transformations relating to the production processes in the Southern littoral urban space of the city of João Pessoa PB. The research estimated that the urban space is the product, means and condition of the society which produces it. The object-area of this inquiry is constituted of five districts: Altiplano Cabo Branco, Portal do Sol, Ponta do Seixas, Penha and Costa do Sol. The urban expansion which occurs in this area is characterized by the appearance of sufficient contradictory space phenomenona. On the other hand, the launching of real estate products such as the horizontal closed condominiums, directed towards the upper class, and the occurrence of areas of irregular occupation, inhabited by lower socioeconomic class and with a great lack of infrastructure and basic urban services, revealing the social contradictions. Due to this, processes such as auto-segregation and segregation imposed beyond the precarious and delinquent inclusion, has become the determining characteristic of this part of the city in analysis. The study also takes into account the appreciation of the new urban environmental zoning of Altiplano do Cabo Branco and from this moment on, start the discussion about the tendencies of urban expansion in this area, due to the interests and strategies of the real estate sector and the prominent role of the government in the current valorization process of urban soil of the area. The presence of residuals of agricultural businesses indicates a typical picture of the peri-urban areas configuring what we observe today at the Southern littoral of João Pessoa

Phlebotomine (Diptera: Psychodidae) survey and some considerations about epidemiological aspects of canine leishmaniasis in Rio Claro city, São Paulo, Brazil.

Between 2000 and 2004, 170 sand flies were captured in urban or peri-urban areas of the Rio Claro city, SP, Brazil. Nyssomyia neivai, the main LTA vector species in São Paulo territory, corresponded to 124 specimens (72,94%) of the total number of captured insects. Incidence of American Cutaneous (LTA) and Visceral leishmaniasis (LVA) is increasing in human and dogs in São Paulo State. Rio Claro city is located in the center-east region of the State. During 2001 and 2003, two cases of alochtonus canine LVA and an autochthonous case of canine LTA were locally diagnosed. Results indicate the risk of LVA establishment in this region. Possible role of alternative vectors in leishmaniasis transmission is discussed.

Diferenças de gêneros nos grupos de brincadeira na rua: a hipótese de aproximação unilateral

Este estudo investigou aspectos da diferenciação sexual em brincadeiras de crianças/adolescentes na rua. Participaram 668 pessoas entre 1 e 18 anos (245 meninas – 423 meninos), moradores/visitantes de três ruas num bairro da periferia de Belém, durante 1 ano. Foram observadas diferenças de gênero quanto à participação na rua e à variedade de subcultura lúdica. Observou-se predominância dos meninos na rua, segregação e tipificação sexual nas brincadeiras e maior penetração das meninas na subcultura masculina. Os dados sobre composição dos grupos, segregação, tipificação e preferência por brincadeiras levam à hipótese de aproximação unilateral entre os grupos de gênero.

A importância do Anopheles darlingi Root, 1926 e Anopheles marajoara Galvão e Damasceno, 1942 na transmissão de malária no município de Macapá/AP - Brasil

A malária no município de Macapá é principalmente peri urbana, áreas estas caracterizadas por ressaca, pela presença de fragmentos de floresta e assentamentos desordenados (invasões). O objetivo deste estudo foi verificar a importância dos Anopheles darlingi e Anopheles marajoara na transmissão de malária em Macapá. O estudo foi realizado de outubro de 2007 a setembro de 2008, na comunidade de Lagoa dos Índios, Macapá. Foram coletados 4.601 mosquitos, dos quais 3.029 foram Anopheles marajoara (65,8%), 917 Anopheles darlingi (19,9%), 429 Anopheles braziliensis (9,3%), 208 Anopheles triannulatus (4,5%), 18 Anopheles peryassui (0,4%) e cinco Anopheles nuneztovari (0,1%). Apenas 32,8% dos espécimes foram coletadas no intradomicilio (1.511) e 67,2% no peridomicilio (3.090). O Indice de Picada Homem Hora do An. darlingi no intradomicilio variou entre 0 a 6,5 e no peridomicilio de 0 a 22 picadas homem hora. Já para o An. marajoara a variaçao foi de 0 a 22 no intradomicilio e de 0 a 175,5 no peridomicilio. A analise das exúvias e da dissecção de genitália resultaram na confirmaçao das duas espécies estudadas, An. darlingi e An. marajoara, e que o An. marajoara é a única espécie do complexo albitarsis circulante na área. A abundância dos vetores flutuou associada com o padrão sazonal das chuvas. An. darlingi é mais abundante no final e inicio das chuvas, enquanto o An. marajoara esteve presente em alta densidade durante todo o período de chuvas. Dos 4.601 mosquitos testados, 100 foram positivos para plasmódios humanos pelo método de ELISA, resultando em uma taxa de infecção de 2,17%. Dos 3.029 An. marajoara testados 71 (2,34%) foram positivos e dos 917 An. darlingi, 28 (3,05%). Este estudo demonstrou que as duas espécies estudadas mantêm a transmissão de malária durante todo o ano, ratificando assim a importância das mesmas.

Seasonal genetic partitioning in the neotropical malaria vector, Anopheles darlingi

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Implicações geomorfológicas das alterações do escoamento superficial pela urbanização: análise dos processos erosivos na bacia hidrográfica do córrego Tucunzinho (São Pedro - SP)

This paper presents an evaluation of the geomorphological implications of urban runoff on the evolution of linear erosion processes in peri-urban areas. The Tucunzinho watershed (São Pedro/SP) case was chosen because it presents linear erosive forms in which the dynamic is associated with urban expansion into fragile areas and implantation of inadequate dissipation devices. The method proposed by the Soil Conservation Service (SCS) was adopted to obtain the Curve Number (CN) and runoff hydrographs of different sectors of the basin. The coverage classification (use and occupancy) was based on analysis of aerial photographs of two periods (1962 and 2006, updated in the field in 2011). The IPHS1 model was used for the simulation and analysis of the hydrological behavior for both the pre-urban occupation and the current occupation. The hydrogeomorphological analysis helped understand the influence of the urban run-off on the erosion dynamics, clearly showing the ineffectiveness of dissipation energy devices in the area, which has a natural susceptibility to erosion due to litho-soil characteristics.

A aplicação da abordagem do Tecnógeno na identificação e classificação dos terrenos e depósitos tecnogênicos no ambiente urbano de Guarapuava-PR

Pós-graduação em Geografia - FCT