It’s hard work,but it’s worth it: the task of keeping children adherent to isoniazid preventive therapy

Setting:

Isoniazid preventive therapy (IPT) offers children protection against tuberculosis (TB), but it has been difficult to implement, particularly in developing countries.

Objective:

To understand what encourages or inhibits children from adhering to IPT.

Design:

In-depth interviews were conducted with two parents of children adherent to IPT and two staff members from three primary health care clinics in high TB prevalence communities. Themes explored were knowledge and attitudes towards IPT, problems in accessing and adhering to treatment, and community responses.

Results:

Parents administering treatment valued it positively, realised their children’s risk of TB, and were positive about the clinic. Nurses acknowledged that resistance to treatment remained, with some parents not wanting to acknowledge risk nor willing to make the effort for their children; there was also considerable misinformation about IPT. Clinic nurses acknowledged problems of staff shortages, lengthy waiting times and conflict between staff and community members. Adherence was affected by social problems, stigma about TB and its link to the human immunodeficiency virus, and the extended treatment period.

Conclusion:

Parents who maintained adherence to the IPT regimen showed that it was possible even in very difficult circumstances. Further effort is required to improve some of the clinic services, correct misinformation, reduce stigma and provide support to parents.     

‘I don’t think it’s risky,but…’: pregnant women’s risk perceptions of maternal drinking and smoking

In Switzerland, official recommendations relating to alcohol and tobacco use during pregnancy are based on a zero-tolerance policy. However, epidemiological research indicates that some pregnant women do not adhere to the abstinence principle, and this raises the issue of how pregnant women identify and respond to health risks. This article draws on a sociocultural study of 50 mainly white, partnered and educated pregnant women carried out in Switzerland between May 2008 and June 2009. The study used semi-structured interviews that examined how and in what ways pregnancy had changed women’s consumption of alcohol and tobacco and their perceptions of their riskiness. In this article we draw on these data to examine participants’ perceptions of the risks of smoking and drinking during pregnancy. We examine three main issues: women’s understandings of official recommendations, their contextualisation of risk in daily life and the moral issues which they saw surrounding smoking and drinking during pregnancy. We found that the women in our study perceived drinking and smoking during pregnancy as different types of risks with different meanings. The participants contextualised official recommendations about drinking during pregnancy and had their own views about its riskiness. In contrast all participants saw smoking as harmful and risky irrespective of the level of consumption. The pregnant women in our study saw smoking during pregnancy as a risk-taking behaviour and a failure to act in the best interest of the foetus. In contrast, under certain conditions, they saw moderate drinking of alcohol during pregnancy as acceptable and responsible behaviour.     

Credit where credit is due: Pakistan’s role in reducing the global burden of reproductive,maternal, newborn,and child health (RMNCH)

Factors contributing to Pakistan’s poor progress in reducing reproductive, maternal, newborn, and child health (RMNCH) include its low level of female literacy, gender inequity, political challenges, and extremism along with its associated relentless violence; further, less than 1% of Pakistan’s GDP is allocated to the health sector. However, despite these disadvantages, Pakistani researchers have been able to achieve positive contributions towards RMNCH-related global knowledge and evidence base, in some cases leading to the formulation of WHO guidelines, for which they should feel proud. Nevertheless, in order to improve the health of its own women and children, greater investments in human and health resources are required to facilitate the generation and use of policy-relevant knowledge. To accomplish this, fair incentives for research production need to be introduced, policy and decision-makers’ capacity to demand and use evidence needs to be increased, and strong support from development partners and the global health community must be secured.     

Credit where credit is due: Pakistan’s role in reducing the global burden of reproductive,maternal, newborn,and child health (RMNCH)

Factors contributing to Pakistan’s poor progress in reducing reproductive, maternal, newborn, and child health (RMNCH) include its low level of female literacy, gender inequity, political challenges, and extremism along with its associated relentless violence; further, less than 1% of Pakistan’s GDP is allocated to the health sector. However, despite these disadvantages, Pakistani researchers have been able to achieve positive contributions towards RMNCH-related global knowledge and evidence base, in some cases leading to the formulation of WHO guidelines, for which they should feel proud. Nevertheless, in order to improve the health of its own women and children, greater investments in human and health resources are required to facilitate the generation and use of policy-relevant knowledge. To accomplish this, fair incentives for research production need to be introduced, policy and decision-makers’ capacity to demand and use evidence needs to be increased, and strong support from development partners and the global health community must be secured.

     

Factors of social adjustment to school: child’s personality,family and pre‐school

The role of child’s characteristics (gender, cognitive ability, mother‐perceived personality traits), family environment (maternal education, self‐reported parenting practices) and pre‐school experience (at least three years vs. no experience) in social adjustment to school, reflected through teacher reports on social competence and internalising and externalising behaviours, was investigated with six‐year‐olds (N = 366). Three blocks of factors, i.e. child, family and pre‐school, explained up to 19% of variance in social adjustment with child’s characteristics accounting for the major part. Family variables contributed significant, though small, portions of variance to social competence and internalising behaviour over and above the child factors. Pre‐school experience was additionally predictive of lower incidence of internalising behaviour and more frequent externalising behaviour.     

Gender Stereotypes and Preconception Health: Men’s and Women’s Expectations of Responsibility and Intentions to Engage in Preventive Behaviors

Maternal and Child Health Journal - Introduction As mounting evidence underscores the importance of both men and women taking steps before pregnancy to improve reproductive outcomes, public health...     

Correction to: The Effects of Race,Gender, and Gender-Typed Behavior on Children’s Friendship Appraisals

Archives of Sexual Behavior - The funding information stated for Bin Zuo (BZ) in the Acknowledgements of this article as originally published was incorrect.     

“It’s natural and healthy,but I don’t want to see it”: Using Entertainment-Education to Improve Attitudes Toward Breastfeeding in Public

While it has been well established that breastfeeding provides the best nourishment for children, few women achieve the recommended breastfeeding duration. Negative media messages have been identified as one explanation for the lack of individual and public support for breastfeeding. This study explored the influence of media on the knowledge and attitudes of a nearly childless population to ascertain if and how entertainment media can positively impact perceptions of breastfeeding. Using cultivation and parasocial interaction, this research measured entertainment television’s effect on breastfeeding attitudes using randomized-group experiments involving 375 students. Overall, participants generally held positive attitudes but were uncomfortable seeing breastfeeding. Moreover, results indicate that viewing a prime-time television clip that depicted public breastfeeding not only significantly lessened the extent to which participants believed that breastfeeding was a private activity but also improved attitudes and support for breastfeeding in public. This study concludes that more pro-breastfeeding media messages in entertainment media could help create a climate conducive to breastfeeding success.     

Diatomological aspects of the Fenn’s and Whixall Mosses complex (Shropshire,UK)

Peat bogs are unique and important habitats for biodiversity at the species and ecosystem level where low pH of water plays a major role. The main objective of the present study was to compare the benthic diatom assemblage structure of the selected part of the Fenn’s and Whixall Mosses complex in order to verify whether selected sampling sites differ from each other. The complex is a cut-over, lowland raised mire, which is a National Nature Reserve (NNR) and a Site of Special Scientific Interest (SSSI). Altogether 92 diatom species were identified in 72 benthic samples collected between September 2008 and August 2009 from six selected sampling sites. Statistical cluster analysis was used to classify diatom samples and to observe the structure of diatom assemblages. The results of this analysis grouped the data set into 3 clusters with 24 samples from each of the two sampling sites in one cluster. Such a clear division shows that pH of water has an impact on the species composition, the richness and diversity of benthic diatom assemblages.     

‘Prevention is better than cure,but …’: Preventive medication as a risk to ordinariness?

Preventive health remains at the forefront of public health concerns; recent initiatives, such as the NHS health check, may lead to recommendations for medication in response to the identification of ‘at risk’ individuals. Little is known about lay views of preventive medication. This paper uses the case of aspirin as a prophylactic against heart disease to explore views among people invited to screening for a trial investigating the efficacy of such an approach. Qualitative interviews (N = 46) and focus groups (N = 5, participants 31) revealed dilemmas about preventive medication in the form of clashes between norms: first, in general terms, assumptions about the benefit of prevention were complicated by dislike of medication; second, the individual duty to engage in prevention was complicated by the need not to be over involved with one's own health; third, thepotential appeal of this alternative approach to health promotion was complicated by unease about the implications of encouraging irresponsible behaviour among others. Though respondents made different decisions about using the drug, they reported very similar ways of trying to resolve these conflicts,drawing upon concepts of necessity and legitimisation and the special ordinariness of the particular drug.     

Specific antibodies to cow’s milk proteins in infants: effect of early feeding and diagnosis of cow’s milk allergy

Purpose  

To investigate whether specific IgA, IgG, IgG1 and IgG4 responses to cow’s milk proteins differ between infants with cow’s milk allergy and infants with cow’s milk related symptoms (control subjects), and whether early feeding affects these responses as well as specific IgE.