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In the UK, postnatal depression is more common in British South Asian women than White Caucasion women. Cognitive–behavioural therapy (CBT) is recommended as a first-line treatment, but there is little evidence for the adaptation of CBT for postnatal depression to ensure its applicability to different ethnic groups.
Aims
To evaluate the clinical and cost-effectiveness of a CBT-based positive health programme group intervention in British South Asian women with postnatal depression.
Method
We have designed a multicentre, two-arm, partially nested, randomised controlled trial with 4- and 12-month follow-up, comparing a 12-session group CBT-based intervention (positive health programme) plus treatment as usual with treatment as usual alone, for British South Asian women with postnatal depression. Participants will be recruited from primary care and appropriate community venues in areas of high South Asian density across the UK. It has been estimated that randomising 720 participants (360 into each group) will be sufficient to detect a clinically important difference between a 55% recovery rate in the intervention group and a 40% recovery rate in the treatment-as-usual group. An economic analysis will estimate the cost-effectiveness of the positive health programme. A qualitative process evaluation will explore barriers and enablers to study participation and examine the acceptability and impact of the programme from the perspective of British South Asian women and other key stakeholders.
Basic vaccination is important to protect children from infectious diseases and illnesses. Adequate levels of vaccination coverage reduce the morbidity and mortality burden among children and promote their physical and mental development. This study aimed to assess the association between basic childhood vaccination and the cognitive and learning ability of school children in India. Nationally representative follow-up data on 6183 children from the Indian Human Development Surveys conducted in 2004–05 and 2011–12 (IHDS I & II) were analysed. Children aged 8–10 years who had received all basic vaccines by the age 12 months performed better in a maths test than partially vaccinated or unvaccinated children (OR: 1.87, 95% CI: 1.48, 2.35). Similarly, fully vaccinated children performed better in writing tasks than partially vaccinated or unvaccinated children (OR: 1.77, 95% CI: 1.44, 2.18). Likewise, fully vaccinated children had better reading skills than fully unvaccinated children (OR: 1.60, 95% CI: 1.23, 2.09). The results suggest that enhancing child vaccination coverage can have significant benefits beyond health and can potentially improve the long-term educational outcomes of children.
Vitamin D deficiency has been commonly reported in elite athletes, but the vitamin D status of UK university athletes in different training environments remains unknown. The present study aimed to determine any seasonal changes in vitamin D status among indoor and outdoor athletes, and whether there was any relationship between vitamin D status and indices of physical performance and bone health. A group of forty-seven university athletes (indoor n 22, outdoor n 25) were tested during autumn and spring for serum vitamin D status, bone health and physical performance parameters. Blood samples were analysed for serum 25-hydroxyvitamin D (s-25(OH)D) status. Peak isometric knee extensor torque using an isokinetic dynamometer and jump height was assessed using an Optojump. Aerobic capacity was estimated using the Yo-Yo intermittent recovery test. Peripheral quantitative computed tomography scans measured radial bone mineral density. Statistical analyses were performed using appropriate parametric/non-parametric testing depending on the normality of the data. s-25(OH)D significantly fell between autumn (52·8 (sd 22·0) nmol/l) and spring (31·0 (sd 16·5) nmol/l; P < 0·001). In spring, 34 % of participants were considered to be vitamin D deficient (<25 nmol/l) according to the revised 2016 UK guidelines. These data suggest that UK university athletes are at risk of vitamin D deficiency. Thus, further research is warranted to investigate the concomitant effects of low vitamin D status on health and performance outcomes in university athletes residing at northern latitudes.
To assess whether disparities in energy consumption and insufficient energy intake in India have changed over time across socio-economic status (SES).
Design:
This cross-sectional, population-based survey study examines the relationship between several SES indicators (i.e. wealth, education, caste, occupation) and energy consumption in India at two time points almost 20 years apart. Household food intake in the last 30 d was assessed in 1993–94 and in 2011–12. Average dietary energy intake per person in the household (e.g. kilocalories) and whether the household consumed less than 80 % of the recommended energy intake (i.e. insufficient energy intake) were calculated. Linear and relative risk regression models were used to estimate the relationship between SES and average energy consumed per day per person and the relative risk of consuming an insufficient amount of energy.
Setting:
Rural and urban areas across India.
Participants:
A nationally representative sample of households.
Results:
Among rural households, there was a positive association between SES and energy intake across all four SES indicators during both survey years. Similar results were seen for energy insufficiency vis-à-vis recommended energy intake levels. Among urban households, wealth was associated with energy intake and insufficiency at both time points, but there was no educational patterning of energy insufficiency in 2011–12.
Conclusions:
Results suggest little overall change in the SES patterning of energy consumption and percentage of households with insufficient energy intake from 1993–94 to 2011–12 in India. Policies in India need to improve energy intake among low-SES households, particularly in rural areas.
This book challenges the assumption that Franz Schubert (1797–1828), best known for the lyricism of his songs, symphonies and chamber music, lacked comparable talent for drama.
By
Joe Davies, College Lecturer in Music at Lady Margaret Hall, University of Oxford.,
James William Sobaskie, Associate Professor of Music at Mississippi State University and serves as Book Reviews Editor of Nineteenth-Century Music Review.
As Lorraine Byrne Bodley suggests in the first chapter of our volume, Franz Schubert was thought a failure in the field of dramatic music throughout much of the twentieth century. This perception stemmed in part from the lack of critical acclaim for certain of his large-scale stage works, as well as ignorance of other projects that were never performed nor closely studied. For instance, the melodrama Die Zauberharfe (D. 644) and the Singspiel Die Zwillingsbrüder (D. 647) were briefly staged in Vienna during 1820, but they attracted little attention and enjoyed no revivals during the composer's lifetime. Regrettably, the more substantial operas Alfonso und Estrella (D. 732; 1822) and Fierabras (D. 796; 1823) were never produced, while several other promising theatrical endeavours, including Adrast (D. 137; 1817), Claudine von Villa Bella (D. 239; 1815), and Der Graf von Gleichen (D. 918; 1827), as well as the sacred oratorio Lazarus (D. 689; 1820), remained incomplete at his death. Without positive critical reception of these works, and no demonstrable evidence of their influence on later composers, the opinion arose that Schubert lacked the capacity for dramatic music.
Many factors seem to have conspired to limit Schubert's success in the venerable vocal domain. Italian and French opera remained dominant in early nineteenthcentury Vienna, and new, home-grown works were hard-pressed to compete. The unique achievements of Mozart's Die Entführung aus dem Serail (K. 384; 1782) and Die Zauberflöte (K. 620; 1791) were difficult to duplicate and had not yet led to a strong, clearly defined German tradition, while the implications of Carl Maria von Weber's Der Freischutz (Op. 77; 1821) had not yet been fully realized. There was limited local financial support for opera at the time, and, quite understandably, benefactors hesitated to take chances on unproven artists. Certainly the implications of the newly emerging Romantic aesthetic for dramatic music were not quite clear. And of course, Schubert needed to earn a living and could not focus solely on opera. While this survey surely represents an over-simplification of the composer's creative circumstances, it appears that the time just was not right for Schubert to contribute to traditionally recognized dramatic genres.