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Low- and middle-income countries (LMIC) are increasingly experiencing the double burden of malnutrition. Studies to identify ‘double-duty’ actions that address both undernutrition and overweight in sub-Saharan Africa are needed. We aimed to identify acceptable behaviours to achieve more optimal feeding and physical activity practices among both under- and overweight children in Rwanda, a sub-Saharan LMIC with one of the largest recent increases in child overweight.
We used the Trials of Improved Practices (TIPs) method. During three household visits over 1·5 weeks, we used structured interviews and unstructured observations to collect data on infant and young child feeding practices and caregivers’ experiences with testing recommended practices.
An urban district and a rural district in Rwanda.
Caregivers with an under- or overweight child from 6 to 59 months of age (n 136).
We identified twenty-five specific recommended practices that caregivers of both under- and overweight children agreed to try. The most frequently recommended practices were related to dietary diversity, food quantity, and hygiene and food handling. The most commonly cited reason for trying a new practice was its benefits to the child’s health and growth. Financial constraints and limited food availability were common barriers. Nearly all caregivers said they were willing to continue the practices and recommend them to others.
These practices show potential for addressing the double burden as part of a broader intervention. Still, further research is needed to determine whether caregivers can maintain the behaviours and their direct impact on both under- and overweight.
‘Minority’ literally refers to a group that makes up less than half of a whole, but in the politico-legal discourse that surrounds culture, it has less to do with numbers and rather more with balances of power. So while it would be problematic to describe the Welsh heard by the Romantic-era gentleman traveller in Wales as a ‘minority’ language (because it would have been spoken by the majority at that time), it would be correct to describe this language as oppressed, though the said traveller is more likely to have described it as a vestige, some fascinating survival of the past. ‘Minority’ describes the results of a process that takes place over time, and has to do with power and powerlessness, both economic and political.
In Europe the term grew out of a political concern for minorities, especially in the aftermath of war (Okey 2000), but of course has a comparable evolution in other parts of the world. It also extends to other groups such as the ‘disabled’, or (and here's proof that it has little to do with numbers) women, or can refer to ethnicity, race, wealth, religion or sexual orientation (see sex/sexuality), and its main collocations are ‘ethnic’, ‘language’ and ‘rights’. It is also a word in a major language that has been imposed on ‘minorities’ from the outside, in the same way that whole languages have been imposed by one powerful group on another (such as French imposed on Bretons). Translation studies have shown how the ‘minority’, in writing in the imposed language, can subvert it from within, by creating texts that are ‘radically bilingual’ (Mehrez 1992, 132). Taking a similar trajectory, this term, imposed from without, mainly used by politicians and sociolinguists, was seized, only to be shaken off.
Travel writing is necessarily about crossing borders between cultures, and there is invariably a power relation separating different cultures. The attitude of travel writing in majority languages (and this is the main source material used in travel writing studies to date) towards less powerful or ‘minority’ cultures, and the ethical question of travelling all over these is varied and evolving. Of course, travel and tourism shoulder some of the blame for the decline of cultural difference, even of language death (Minhinnick 1993; Cronin 2010, 335; 2014, 16).
Retrospective reports of lifetime experience with mental disorders greatly underestimate the actual experiences of disorder because recall error biases reporting of earlier life symptoms downward. This fundamental obstacle to accurate reporting has many adverse consequences for the study and treatment of mental disorders. Better tools for accurate retrospective reporting of mental disorder symptoms have the potential for broad scientific benefits.
We designed a life history calendar (LHC) to support this task, and randomized more than 1000 individuals to each arm of a retrospective diagnostic interview with and without the LHC. We also conducted a careful validation with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition.
Results demonstrate that—just as with frequent measurement longitudinal studies—use of an LHC in retrospective measurement can more than double reports of lifetime experience of some mental disorders.
The LHC significantly improves retrospective reporting of mental disorders. This tool is practical for application in both large cross-sectional surveys of the general population and clinical intake of new patients.
OBJECTIVES/SPECIFIC AIMS: Early life stress is known to greatly impact neurodevelopment during critical periods, conferring risk for various psychopathologies, including the onset and exacerbation of schizophrenia and anxiety disorders. The endocannabinoid system is highly integrated into the stress response and may be one means by which early life stress produces such deleterious effects. Using a naturalistic, ecologically valid animal model, this study explored interactions between the stress response and endocannabinoid systems within the cerebellum, a region dense with the CB1 endocannabinoid receptors and shown to be susceptible to stress. METHODS/STUDY POPULATION: This study explored behavioral and neural impacts of early life stress in Long-Evans rats reared with or without limited access to bedding material during postnatal day (PND) 2-9. Corticosterone (CORT) levels were measured at PND8 and 70. During PND50-70, rats were assessed on Novel Object Recognition to test memory, Rotarod to evaluate cerebellar integrity, Elevated Plus Maze to assay anxiety, Social Preference, and Eyeblink Conditioning, a cerebellar-dependent and endocannabinoid-mediated task. Lipid analysis was performed on PND70 tissue samples of cerebellar interpositus (IP) nucleus via high-performance liquid chromatography and tandem mass spectrometry. RESULTS/ANTICIPATED RESULTS: Both male and female rats experiencing early life stress exhibited significantly impaired recognition memory (N = 16-20/group). Female rats having undergone stress exhibited decreased social preference compared to normally reared females (N = 11/group). Stressed males showed facilitated eyblink conditioning compared to normally reared males (N = 7-9/group). There were no group differences in rotarod or elevated plus maze performance or CORT levels at PND8 or 70 across rearing groups. At PND70, male rats experiencing early life stress exhibited a significant decrease in 2-arachidonoyl glycerol (2-AG) and arachidonic acid levels in the IP nucleus compared to normally reared males (N = 8-9/group). Compared to normally reared females, those experiencing early life stress exhibited a significant increase in prostaglandin E2 levels in the IP nucleus (N = 6-7/group). DISCUSSION/SIGNIFICANCE OF IMPACT: Early life stress, induced by limited bedding, resulted in sex-specific behavioral and lipid impairments. Results suggest that stress causes long-term alterations in endocannabinoid dynamics in males in the cerebellar IP nucleus and sex-related lipids in female cerebellum. These changes may contribute to observed long-term behavioral aberrations. Moreover, findings suggest these behavioral changes may be the result of negative-feedback dysfunction (as evidenced by decreased endocannabinoids in males) or increased neural inflammation or proliferation (as evidenced by increased prostaglandins in females). Future analysis will quantify mRNA and protein for cannabinoid receptors to better characterize aberrations to this system. Moreover, other neural regions dense with cannabinoid receptors (i.e., PFC, hippocampus) will be investigated. This work provides a basis for understanding stress impacts on the development of cognitive deficits observed in psychotic and anxiety disorders. Specifically, facilitation of eyblink conditioning complements research in humans with anxiety disorders. Broadly, understanding stress-related endocannabinoid dysregulation may provide insights into risks for, and the development of, psychopathology and uncover novel therapeutic targets with high translational power.
The third edition of Hamlet offers a completely new introduction to this rich, mysterious play, examining Shakespeare's transformation of an ancient Nordic legend into a drama whose philosophical, psychological, political, and spiritual complexities have captivated audiences world-wide for over 400 years. Focusing on the ways in which Shakespeare re-imagined the revenge plot and its capacity to investigate the human experiences of love, grief, obligation, and memory, Heather Hirschfeld explores the play's cultural and theatrical contexts, its intricate textual issues, its vibrant critical traditions and controversies, and its history of performance and adaptation by celebrated directors, actors, and authors. Supplemented by an updated reading list, extensive illustrations and helpful appendices, this edition also features revised commentary notes explicitly designed for the student reader, offering the very best in contemporary criticism of this great tragedy.