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In a sample of 483 women interviewed in the last trimester of pregnancy, 3.3 per cent were doubtful about whether they would breastfeed and 17 per cent expressed a clear intention not to do so. Possible psychiatric and social factors associated with not wishing to breastfeed were examined and a number of important associations emerged. In particular, psychiatric morbidity, working-class status, a number of indices of economic hardship, being young, already having children, and lack of a stable relationship were all significantly associated with not wishing to breastfeed. When a log linear analysis was conducted three of these factors were found to be independently associated with not wishing to breastfeed: being young, already having children, and not having a stable relationship. These findings have implications for early intervention.

We have measured 43 transitions in the pure rotational and fundamental vibrational spectra of 18 OH + . These data, together with all ground state transitions and combination differences of OH + and 16 OH + available from the literature, have been fit to an explicity internuclear distance dependent rovibrational Hamiltonian to yield several descriptions of the OH + potential function. Significant adiabatic and rotationally and vibrationally nonadiabatic corrections are required to fit all 407 isotopomeric transitions simultaneously. Similar fits are also performed on the closed shell species ArH + , yielding an approximate vibrational correction to the recently determined experimental permanent dipole moment of that ion.

This report describes a computer system that generates reconstructions of film autoradiographs of the cerebral cortex. The reconstructions preserve 4 dimensions of the data including the (1) rostro-caudal and (2) medio-lateral cortical dimensions, (3) cortical thickness and (4) optical density value. This system is especially useful as it removes the subjectivity in analyzing the autoradiographs and provides a method for objectively reconstructing large amounts of data.

A computer system for the analysis of computed tomography and positron emission tomography scans of the brain is described. The system, called TOAP (Tomographic Overlay and Analysis Program), permits the registration of user specified slices from a digital brain atlas with the tomographic images. Regions of interest can then be defined with respect to the atlas. The system thus affords an objective and reproducible means for the analysis of tomographic images.

A system was constructed to allow direct visualization of the coronary microcirculation of a beating rat heart under a microscope. An electrocardiogram (EKG) triggered strobe is used on the video recording and display system to "stop" the action of the beating heart so the surface microvessels can be directly observed. Experimental results are recorded on videotape and played back for frame-by-frame analysis of the data using digital image extraction, image enhancement and edge detection. The digital image processing techniques are designed for multi-purpose applications using recorded video images.

A retrospective study was undertaken of 25 families and their 26 ill children attending the first children's hospice in the United Kingdom. The study examined the family's perceptions of the care offered and the impact of chronic and life threatening illness. Eighteen (72%) of the families felt they had been well supported by the hospice and valued the family like atmosphere, perceiving the staff to be friendly, approachable, and helpful. The actual nature of hospice care, in an environment with other terminally ill children, was, however, considered a drawback for a few families. A number of families still had unmet needs, notably appropriate child minding when away from the hospice. The impact of chronic life threatening illness on the families was substantial. The parents (particularly the mothers), the index children, and their siblings all experienced much higher levels of psychological symptomatology than would have been expected from normal samples. While families felt greatly helped over symptom control, a proportion remained very worried about certain symptoms, particularly breathlessness, seizures, and pain. A high proportion of families were experiencing financial and employment difficulties as a result of their children's illnesses.

Background Antenatal depression (AD) is a major public health issue but evidence regarding its prevalence and associated factors in low and middle-income countries (LMICs) is limited. The aim of the study was to estimate the prevalence and identify risk factors for AD among Brazilian pregnant women. Methods All women living in the urban area of the city of Pelotas, Southern Brazil, with confirmed pregnancy and estimated delivery date in the year 2015, were invited to take part. Eligible pregnant women were recruited from health services. Symptoms of antenatal depression were assessed using the Edinburgh Postnatal Depression Scale (EPDS) by face-to-face interviews. A cutoff-point of 13 or more was used to define probable AD. Results EPDS scores were available for 4130 women. The prevalence of AD was 16% (95%CI 14·9–17·1). After adjustment for potential confounders, the factors most strongly associated with higher EPDS scores were a previous history of depression (PR 2·81; 95%CI 2·44-3·25), high parity (PR 1·72; 95%CI 1·38-2·15 - ≥2 children vs. 1 child) and maternal education (PR 5·47; 95%CI 4·22-7·09 - 0–4 vs. ≥12 years of formal education). Limitations EPDS was administered through face-to-face interviews rather than questionnaires and some women may have felt uncomfortable reporting their symptoms leading to underreporting and consequently underestimation of the prevalence found. Conclusion AD prevalence is substantially higher in Brazil than in high-income countries (HICs) but similar to other LMICs. Our study identified relevant risk factors that may be potential targets to plan interventions, particularly a history of depression., Highlights • The proportion of women with antenatal depression (EPDS ≥13) was 16%. • Antenatal depression is about 60% higher in Brazil than in HICs. • Antenatal depression is mainly influenced by socioeconomic disadvantage in Brazil. • A history of depression was the strongest predictor of antenatal depressive symptoms. • Over 1/3 of the mothers with a history of depression reported antenatal depressive symptoms.

Current research supports a link between maternal depression and difficult child temperament. The direction of effect is often assumed to be from parent to child, but few studies have addressed child to parent effects. In a large cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC) (N=14663), we aimed to further existing knowledge by investigating the relationship between maternal and paternal depressive symptoms and child temperament, and determining the direction of any effects found. Data was collected at 2 time-points (when the children were 6 and 24 months old), using the Edinburgh Postnatal Depression Scale and the Mood and Intensity subscales of the Carey Temperament Scales. Significant parent to child effects were seen, with maternal and paternal depressive symptoms at Time 1 leading to more difficult temperament at Time 2. Father to child effects were significant only in male children. Little evidence was found for child to parent effects.

Risk of antenatal depression has been shown to be elevated in Southern Africa and can impact maternal and child outcomes, especially in the context of the Human Immunodeficiency Virus (HIV). Brief screening methods may optimize access to care during pregnancy, particularly where resources are scarce. This research evaluated shorter versions of the Edinburgh Postnatal Depression Scale (EPDS) to detect antenatal depression. This cross-sectional study at a large primary health care (PHC) facility recruited a consecutive series of 109 antenatal attendees in rural South Africa. Women were in the second half of pregnancy and completed the EPDS and Structured Clinical Interview for Depression (SCID). The recommended EPDS cutoff (≥13) was used to determine probable depression. Four versions, including the 10-item scale, seven-item depression, and novel three- and five-item versions developed through regression analysis, were evaluated using receiver operating characteristic (ROC) analysis. High numbers of women 51/109 (47 %) were depressed, most depression was chronic, and nearly half of the women were HIV positive 49/109 (45 %). The novel three-item version had improved positive predictive value (PPV) over the 10-item version and equivalent specificity to the seven-item depression subscale; the novel five-item provided the best overall performance in terms of ROC and Cronbach's reliability statistics and had improved specificity. The brevity, sensitivity, and reliability of the short and ultrashort versions could facilitate widespread community screening. The usefulness of the novel three- and five-item versions are underscored by the fact that sensitivity is important at first screening, while specificity becomes more important at higher levels of care. Replication in larger samples is required.

Childhood emotional maltreatment has been associated with a higher risk for maltreating one's own offspring. In the current study, we explored a possible role of oxytocin in mediating the association between childhood emotional maltreatment and participants' interpretation of infant facial expressions. Oxytocin levels were measured in 102 female participants using saliva samples. They rated the mood of thirteen infants with happy, sad and neutral facial expressions. Emotional maltreatment indirectly influenced responses to happy infant faces by modulating oxytocin levels: higher self-reported emotional maltreatment was related to higher levels of salivary oxytocin which were in turn related to a more positive evaluation of happy infant expressions, but not to the evaluation of sad infant expressions. Oxytocin receptor polymorphism rs53576 did not moderate the relation between maltreatment experiences and salivary oxytocin levels. Early emotional maltreatment might indirectly affect emotional information processing by altering the oxytonergic system.

The 2-[18F]fluoro-2-deoxy-D-glucose technique was used to measure regional cerebral glucose utilization by human subjects during functional activation. Normal male volunteers subjected to one or more sensory stimuli (tactile, visual, or auditory) exhibited focal increases in glucose metabolism in response to the stimulus. Unilateral visual hemifield stimulation caused the contralateral striate cortex to become more metabolically active than the striate cortex ipsilateral to the stimulated hemifield. Similarly, stroking the fingers and hand of one arm with brush produced an increase in metabolism in the contralateral postcentral gyrus, compared with the homologous ipsilateral region. The auditory stimulus, which consisted of a monaurally presented factual story caused an increase in glucose metabolism in the auditory cortex in the hemisphere contralateral to the stimulated ear. These results demonstrate that the technique is capable of providing functional maps in vivo related to both body region and submodality of sensory information in the human brain.

A study of staff stress and job satisfaction was undertaken in a children's hospice. In addition factors were investigated which might be stressful or which helped staff to manage in difficult circumstances. Three quarters were under comparatively little stress and in general showed very few psychological symptoms but a distinct subgroup were under a great deal of stress. A number of factors, notably recent personal bereavement and unresolved grief about a death that had occurred before they came to work at the hospice, distinguished this small group. Job satisfaction was generally high. The main sources of stress were: the sense of impotence staff felt when they were unable to relieve perceived needs or distress; dealing with negative responses in families, and conflicts within the staff group. The most important mitigating factors were: the informal support that staff provided for each other in this small cohesive working unit, the homelike atmosphere of the hospice, and the diversity of professional and personal skills among the staff group. The implications of these findings for reducing stress among staff dealing with dying people are discussed; this includes not only staff on paediatric wards, intensive care and neonatal units, but also community paediatric nurses.

The parents of children with life threatening or terminal illnesses were interviewed about their experiences of the way in which they were told the diagnosis. The interview was piloted on 25 families and then administered in a semistandardised manner to a further 45 families. Parents were asked how satisfied they were with the initial discussion about the diagnosis: 23 families were satisfied with how much information they were given; 22 with the information concerning prognosis; 20 with the pacing of the information; 33 with who was present; 32 with arrangements for follow up; and 26 were satisfied overall with the initial discussion. Clear patterns emerged about which elements of the discussion parents appreciated or resented. For example, they valued an open, sympathetic, direct, and uninterrupted discussion of the diagnosis in private that allowed sufficient time for them to take the news in and for doctors to repeat and clarify information. They disliked evasive or unsympathetic brief interviews. All parents remembered vividly the manner in which the diagnosis was imparted, and some were still preoccupied with this many years later. Analyses were carried out to test the possibility that reports of satisfaction and dissatisfaction were a function of current depression and anxiety, but no evidence was found for this.

A prospective study of 483 pregnant women was undertaken to examine possible associations of social and psychiatric factors with both low birth weight (less than 2500 g) and preterm delivery (less than 37 weeks' gestation). As few babies were born before term (n = 14) or with a low birth weight (n = 14) further analyses were conducted to investigate predictors of absolute birth weight and gestational age. Low income was found to be an independent predictor of birth weight when birth weight was treated both as a dichotomous and as a continuous variable. Unemployment was found to be associated with absolute birth weight. Although this effect was statistically accounted for by low income, a low income was frequently caused by unemployment. Smoking independently predicted absolute birth weight and tended to be associated with preterm delivery. None of the factors investigated was associated with gestational age. In contrast with previous findings, factors such as social class, adverse life events, and psychiatric state were not associated with birth outcome. The mechanism underlying the association between low income and low birth weight requires further investigation.

A software for developing, editing and displaying a 3-D computerized anatomic atlas of a human brain is described. The objective of this atlas is to serve as a reference in identifying various structures in CT scans.

Human infants need prolonged, intensive caregiving to survive and thrive. Human infants’ dependency is unlike many other newborn animals that are mobile shortly after birth, allowing them a much larger degree of independence from their parents. This chapter reviews the emerging evidence for the way that underlying human brain systems support the parent-infant relationship. Starting with the earliest elements of the parent-infant relationship, orienting to infant cues, it demonstrates how the human brain is optimized to perceive cues across multiple sensory modalities rapidly and efficiently. This “parental instinct” in response to infant cues appears to be present for nonparents as well as parents, demonstrating how our parental capacities are well substantiated in the brain prior to parenthood. The chapter also shows how the expertise gained through parenting experience changes the structural and functional properties of the brain in ways that may optimize future caregiving.

Detailed examination of several aspects of feeding was carried out on a representative sample of a defined geographical population of children with Down syndrome. The examination included standardised assessments both of oral-motor function and of parent-child interaction. The findings suggest that the development of oral-motor function in children with Down syndrome not only lags behind intellectual development, but also follows an aberrant pathway. In particular, specific aspects of tongue and jaw function were impaired together with problems initiating and maintaining a smooth sequence of feeding actions. Also, parent-child interactions, as in studies on play, tended to be more controlling. Parents of children with Down syndrome do not spontaneously report the extent of their child's feeding problems unless specific enquiry is made, preferably accompanied by observation of feeding.

In 2002, over 110 000 people entered Britain to seek asylum—a 250% increase in five years.1 Children, who comprise at least a quarter of asylum seekers, are exposed to numerous risk factors for psychological disturbance, including exposure to violence, forced displacement, and multiple losses. 2 The rates of mental health problems in refugee children are uncertain, but the few studies that have been done suggest that refugee children incur significant morbidity.2 We examined the rates of psychological disturbance in a sample of UK children who were refugees and compared them with a group of children who were from an ethnic minority but were not refugees and a group of indigenous white children. ### Participants, methods, and results The six schools in Oxford with the largest number of refugee children agreed to participate. At these schools, all 115 children who were refugees or seeking asylum were identified, …

We used 18-F-fluoro-2-deoxyglucose positron emission tomography (PET) and computed tomography (CT) to study eight patients with homonymous hemianopias or quadrantanopias due to ischemic lesions of the visual pathways. Four patients with ischemic damage to all or part of the occipital lobe had decreased glucose metabolism in the affected region. Three patients with ischemic damage limited to the optic radiations had decreased glucose metabolism in the portion of striate cortex appropriate for the visual field defect. Changes in glucose metabolism frequently occurred in the undamaged ipsilateral thalamus and visual association areas.

Quiet sunspots with well-developed penumbrae show running intensity waves with period running around 300 sec. The waves appear connected with umbral flashes of exactly half the period. Waves are concentric, regular, with velocity constant around 10 km/sec. They are probably sound waves and show intensity fluctuation in H alpha centerline or wing of 10 to 20%. The energy is tiny compared to the heat deficit of the umbra.