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To prioritise and refine a set of evidence-informed statements into advice messages to promote vegetable liking in early childhood, and to determine applicability for dissemination of advice to relevant audiences.
A nominal group technique (NGT) workshop and a Delphi survey were conducted to prioritise and achieve consensus (≥70% agreement) on 30 evidence-informed maternal (perinatal and lactation stage), infant (complementary feeding stage) and early years (family diet stage) vegetable-related advice messages. Messages were validated via triangulation analysis against the strength of evidence from an Umbrella review of strategies to increase children’s vegetable liking, and gaps in advice from a Desktop review of vegetable feeding advice.
A purposeful sample of key stakeholders (NGT workshop, n=8 experts; Delphi survey, n=23 end-users).
Participant consensus identified the most highly ranked priority messages associated with the strategies of: ‘in-utero exposure’ (perinatal and lactation, n=56 points); and ‘vegetable variety’ (complementary feeding, n=97 points; family diet, n=139 points). Triangulation revealed two strategies (‘repeated exposure’ and ‘variety’) and their associated advice messages suitable for policy and practice, 12 for research and four for food industry.
Supported by national and state feeding guideline documents and resources, the advice messages relating to ‘repeated exposure’ and ‘variety’ to increase vegetable liking can be communicated to families and caregivers by healthcare practitioners. The food industry provides a vehicle for advice promotion and product development. Further research, where stronger evidence is needed, could further inform strategies for policy and practice, and food industry application.
To critically review the literature regarding workplace breast-feeding interventions and to assess their impact on breast-feeding indicators.
A systematic review and meta-analysis was conducted. Electronic searches for workplace intervention studies to support breast-feeding, without restriction on language or study design, were performed in PubMed, CENTRAL, CINAHL, Embase, Web of Science, Business Source Complete, ProQuest-Sociology and ProQuest-Social Science to 13 April 2020. A meta-analysis of the pooled effect of the programmes on breast-feeding indicators was conducted.
The search identified 10 215 articles; fourteen studies across eighteen publications met eligibility criteria. Programmes were delivered in the USA (n 10), Turkey (n 2), Thailand (n 1) or Taiwan (n 1). There were no randomised controlled trials. The pooled OR for exclusive breast-feeding at 3 or 6 months for participants v. non-participants of three non-randomised controlled studies was 3·21 (95 % CI 1·70, 6·06, I2 = 22 %). Despite high heterogeneity, other pooled outcomes were consistently in a positive direction with acceptable CI. Pooled mean duration of breast-feeding for five single-arm studies was 9·16 months (95 % CI 8·25, 10·07). Pooled proportion of breast-feeding at 6 months for six single-arm studies was 0·76 (95 % CI 0·66, 0·84) and breast-feeding at 12 months for three single-arm studies was 0·41 (95 % CI 0·22, 0·62). Most programmes were targeted at mothers; two were targeted at expectant fathers.
Workplace programmes may be effective in promoting breast-feeding among employed mothers and partners of employed fathers. However, no randomised controlled trials were identified, and better-quality research on workplace interventions to improve breast-feeding is needed.
There is a paucity of long-term prospective disaster studies of the psychological sequelae among survivors.
At 1½ and 25 years after the Spitak earthquake, 142 early adolescents from two cities were assessed: Gumri (moderate–severe exposure) and Spitak (very severe exposure). The Gumri group included treated and not-treated subjects, while the Spitak group included not-treated subjects. Instruments included: DSM-III-R PTSD-Reaction Index (PTSD-RI); DSM-5 PTSD-Checklist (PCL); Depression Self-Rating Scale (DSRS); and Center for Epidemiological Studies-Depression Scale (CES-D).
(1) Between 1½ and 25 years, PTSD rates and mean scores decreased significantly in the three groups (over 50%). However, at 25 years 9.1–22.4% met DSM-5 PTSD criteria. (2) At 1½ years, the Spitak group had higher PTSD-RI (p < 0.001) and DSRS scores (p < 0.001) compared to the Gumri-not-treated group. At 25 years, the Spitak group that had experienced fewer post-earthquake adversities (p < 0.03), had a greater decrease in PTSD-RI scores (p < 0.02), and lower CES-D scores (p < 0.01). (3) Before treatment, PTSD-RI and DSRS scores did not differ between the Gumri-treated and not-treated groups. At 25-years, the Gumri-treated group showed a greater decrease in PTSD-RI scores (p < 0.03), and lower mean PTSD-RI (p < 0.02), PCL (p < 0.02), and CES-D (p < 0.01) scores. (4) Predictors of PTSD symptom severity at 25-years included: home destruction, treatment, social support, post-earthquake adversities, and chronic medical illnesses.
Post-disaster PTSD and depressive symptoms can persist for decades. Trauma-focused treatment, alleviation of post-disaster adversities, improving the social ecology, and monitoring for chronic medical illnesses are essential components of recovery programs.
The Pueblo population of Chaco Canyon during the Bonito Phase (AD 800–1130) employed agricultural strategies and water-management systems to enhance food cultivation in this unpredictable environment. Scepticism concerning the timing and effectiveness of this system, however, remains common. Using optically stimulated luminescence dating of sediments and LiDAR imaging, the authors located Bonito Phase canal features at the far west end of the canyon. Additional ED-XRF and strontium isotope (87Sr/86Sr) analyses confirm the diversion of waters from multiple sources during Chaco’s occupation. The extent of this water-management system raises new questions about social organisation and the role of ritual in facilitating responses to environmental unpredictability.
Studies examining productive syntax have used varying elicitation methods and have tended to focus on either young children or adolescents/adults, so we lack an account of syntactic development throughout middle childhood. We describe here the results of an analysis of clause complexity in narratives produced by 354 speakers aged from four years to adulthood using the Expressive, Receptive, and Recall of Narrative Instrument (ERRNI). We show that the number of clauses per utterance increased steadily through this age range. However, the distribution of clause types depended on which of two stories was narrated, even though both stories were designed to have a similar story structure. In addition, clausal complexity was remarkably similar regardless of whether the speaker described a narrative from pictures, or whether the same narrative was recalled from memory. Finally, our findings with the youngest children showed that the task of generating a narrative from pictures may underestimate syntactic competence in those aged below five years.
To explore GPs’ experiences of managing recurrent urinary tract infections (RUTIs) and their views on the use of herbal medicines for this condition.
RUTIs are an important problem commonly managed in primary care. Antibiotic prophylaxis is an effective treatment for acute infections but growing microbial resistance, adverse effects, and the lack of sustained long-term benefits mean that novel treatments are required. There are a number of promising reports of herbal medicines being used to treat RUTIs.
A total of 15 GPs (seven female; aged 34–59 years; in practice from 3 to 31 years) were purposively sampled and took part in semi-structured face-to-face and telephone interviews. Interviews were digitally recorded, transcribed, and analysed using inductive thematic analysis. Data collection and analysis proceeded iteratively to allow emerging themes to inform subsequent interviews.
Participants were aware of the disabling effect of RUTIs on women’s lives. GPs experienced significant challenges in their management of RUTIs with decisions about the provision of antibiotics being particularly complex. While some participants were open to the possibility of herbal treatment options they required more research into effectiveness and safety, better regulation of herbal practitioners, and assurance about herbal quality control and potential herb–drug interactions.
Issues in the public presentation and interpretation of the archaeology of Hadrian's Wall and other frontiers of the Roman Empire are explored and addressed here. A central theme is the need for interpretation to be people-focussed, and for visitors to be engaged through narratives and approaches which help them connect with figures in the past: daily life, relationships, craft skills, communications, resonances with modern frontiers and modern issues all provide means of helping an audience to connect, delivering a greater understanding, better visitor experiences, increased visiting and spend, and an enhanced awareness of the need to protect and conserve our heritage. Topics covered include re-enactment, virtual and physical reconstruction, multi-media, smartphones, interpretation planning and design; while new evidence from audience research is also presented to show how visitors respond to different strategies of engagement. Nigel Mills is Director, World Heritage and Access, The Hadrian's Wall Trust. Contributors: Genevieve Adkins, M.C. Bishop, Lucie Branczik, David J. Breeze, Mike Corbishley, Jim Devine, Erik Dobat, Matthias Flück, Christof Flügel, Snezana Golubovic, Susan Greaney, Tom Hazenberg, Don Henson, Richard Hingley, Nicky Holmes, Martin Kemkes, Miomir Korac, Michaela Kronberger, Nigel Mills, Jürgen Obmann, Tim Padley, John Scott, R. Michael Spearman, Jürgen Trumm, Sandra Walkshofer, Christopher Young.
Many visitors (and would-be visitors) to the Antonine Wall World Heritage Site find the task of interpreting and understanding the visible archaeological remains somewhat challenging. Over a number of years in the role of Head of Multimedia in the Hunterian Museum, and as an Associate Lecturer with the School of Computing Science at the University of Glasgow, the author has been exploring ways of addressing this issue. Multimedia technologies have the potential to aid in the presentation and interpretation of archaeological sites, and their associated artefacts held in local museums collections, for a wide range of public audiences.
The coming of age of interactive digital information and communication technologies has provided cultural heritage organisations with a range of opportunities to utilise these ever more flexible digital technologies to provide access to their cultural resources in increasingly innovative ways. The advent of the World Wide Web, over 20 years ago now, presented heritage organisations with a unique opportunity to provide access to their resources to a truly global audience. Resources which hitherto were only available to those fortunate enough to live within travelling distance of archaeological sites or museum collections were suddenly accessible via the then new medium of web technology. Moreover, many museums around the world saw the potential to turn this new medium into additional virtual display space in which to reveal many artefacts that had been languishing in storage or in reserve collections.
It is not difficult to find images of the Romans and information about Ancient Rome in contemporary sources. There are cartoons, picture books for young children, Hollywood films, television comedies, websites, school textbooks and popular histories for the general public, children's toys and violent computer games. This chapter discusses why the Romans and their barbarian enemies have been badly or incorrectly portrayed so often and for so long. In the UK, school textbooks from the 19th century and throughout most of the 20th century have often failed to present what classical texts, archaeologists and historians have revealed. More than that, these early school resources hardly ever presented any evidence for the authors' bold statements of presumed fact. This chapter also discusses the role of information books for children and the use of cartoons in storybooks about the Romans.
Although schools had existed since the early medieval period in Britain there was little opportunity for most children, and especially for girls, to be educated until parish schools became more common in the 17th century. The Education Act of 1870 created the opportunity to build secular day schools all over the country. School Boards were established in most districts and built public elementary schools, many of which still survive today as primary schools. Many children were educated at home in the 19th century and this promoted the growth of suitable textbooks for mothers or governesses to use in the home. Several history textbooks were written by women, sometimes using pen names, which demonstrated publishers' understanding of the market available to them.
‘But Dad, history is boring and the Romans are the most boring bit of it all.’ I may have paraphrased my son's attempted justification for not doing homework but the essence of his argument is, and was, very plain. A similar argument was deployed always when discussing going to visit one of the site museums on Hadrian's Wall; and yet a walk along the Wall where ‘British war parties’ (children), waiting in ambush for Roman supply columns (parents), were routinely ‘flushed-out’ by Roman scouts (the dog) but rallied to win the ensuing battle, were, for a time, one of the most attractive of weekend activities.
Where have we, as teachers, academics and interpreters gone so badly wrong? How have we managed to make the Romans such a hated topic? Readers may think I overreact but on a very brief and totally unsystematic survey (conducted in the last few minutes with two of my children and eight of their friends, home for lunch from school), the result was almost unanimous: the Romans are the most boring part of history — with one dissenter identifying ‘Medicine Through Time’ (although, when pressed by his peers, he acknowledged that the worst bit of this was ‘The Romans and the beginning of public health’ as there was no gruesome dissection or surgery to talk of …).