The effectiveness of Nurture and Play: a mentalisation-based parenting group intervention for prenatally depressed mothers.

AIM: This randomised control trial (RCT) study examined the effectiveness of a mentalisation-based perinatal group intervention, Nurture and Play (NaP), in improving mother-infant interaction quality and maternal reflective functioning and in decreasing depressive symptoms. BACKGROUND: Few preventive prenatal interventions have been developed for primary health care settings for mothers with depressive symptoms. Furthermore, previous prenatal intervention studies have only concentrated on reducing depressive symptoms and have not directly addressed enhancing optimal parenting qualities. METHODS: The participants were 45 pregnant women with depressive symptoms. Women in the randomly assigned intervention group (n = 24) participated in the manualised, short-term NaP intervention group from pregnancy until the baby's age of seven months, whereas control group women received treatment as usual (TAU). Maternal emotional availability (EA), reflective functioning (RF) and depressive symptoms were measured before the intervention and at the infants' 12 months of age, and changes were evaluated using repeated measure analyses of variances (ANOVAs). FINDINGS: The results showed that the intervention group displayed higher maternal sensitivity and RF and more reduction in depressive symptoms than the control group when babies were 12 months old. These findings provide preliminary support for the effectiveness of the NaP intervention.

Effects of evacuation in late adulthood: analyzing psychosocial well-being in three cluster groups of Finnish evacuees and non-evacuees.

OBJECTIVES: We studied the long-term effects of early separation among aging Finnish evacuees and non-evacuees. A broad set of outcome variables reflecting the psychosocial well-being of both groups in 2005 was analyzed. The role of resilience was also analyzed. METHOD: To identify persons with similar patterns of psychosocial well-being among both evacuated (n = 887) and non-evacuated persons (n = 1748), a cluster analysis was conducted, using the mixture model of latent class analysis/latent profile analysis method. The psychosocial well-being of the evacuees and non-evacuees in 2005 was predicted by multinomial logistic regression analysis, with the nominal cluster variable as the dependent variable. RESULTS: Although the evacuees had experienced early separation trauma, they were not faring worse than the non-evacuees regarding psychosocial well-being in 2005. Favorable rearing home circumstances are a protective factor during the entire life span, when the psychosocial well-being of both groups was predicted in 2005. Sense of coherence was a significant predictor of psychosocial well-being. To rejoin the rearing family was stressful for many evacuees. CONCLUSION: The results show that even long-term separation from one's parents during childhood must be understood as representing a developmental context which makes the emergence of problems either less likely or more likely, depending on other risk and protective factors in both the rearing home and the foster family. After the war, when the evacuees returned home the families should have received help and support to amend the reunion.

Human naturally occurring and adaptive regulatory T cells secrete high levels of leukaemia inhibitory factor upon activation.

Leukaemia inhibitory factor (LIF) is a member of the IL-6 cytokine family which signals through cognate receptors and activates target genes involved in survival, apoptosis, proliferation, differentiation and suppression of differentiation in different cell types. Binding of LIF to the LIFRalpha/gp130 receptor complex has been shown to activate the Janus kinase-signal transducer and activator of transcription 3 pathway. Here we show that activation of naturally occurring and adaptive regulatory T cells leads to increased LIF expression which is abrogated by cyclic adenosine monophosphate. Furthermore, the LIF receptors gp130 and LIFRalpha are upregulated on the surface of activated T cells and signal transducer and activator of transcription 3 phosphorylation is increased. Interestingly, LIF was not required for suppressive function but rather appeared to have a stimulatory effect on T cells that served to modulate and counteract immunosuppression by regulatory T cells.

Finnish children in foster care: evaluating the breakdown of long-term placements.

Save the Children studied risk factors associated with placement disruption or breakdown in cases where long-term foster care was intended. Before their placement in 180 foster families, most of the 234 children studied (75%) had experienced neglect. The followup time after initial placement averaged four years and two months. Achieving long-term beneficial foster care placement of children of varied ages and experiences with abuse and neglect, involved considering the needs of the foster parents who may or may not have their own children or other children in their care. Some children were reunified with their parents; careful evaluation is needed before such reunion.

Correlation between speech outcome and cephalometric dimensions in patients with diastrophic dysplasia.

Diastrophic dysplasia (DTD) is a recessively inherited form of osteochondrodysplasia, presenting with disproportionate short stature and multiple orthopedic problems. The clinical oral manifestations include either cleft palate or submucous cleft palate in at least half of the patients. Histological studies have shown alterations in growth plate, articular, laryngeal, tracheal, and ear cartilages. Mutations in the DTDST gene, which codes for the sulphate transporter membrane protein, are responsible for the disease. Thirty-three patients were studied for speech characteristics and their correlation with cephalometric dimensions. Hyponasality was observed in 13 and misarticulation of /R/, /S/, or /L/ sounds in 17 of the 33 patients. Neither of these correlated with the occurrence of palatal deformities. Hyponasality was atypical and did not correlate with the obtained nasalance scores. Cephalometric measurements reflecting the size of the orofacial area of the vocal tract were short in the DTD patients compared with those in the healthy controls. The specific speech characteristics in DTD probably result from both the altered size and shape of the vocal tract and the structural and functional abnormalities of the laryngeal and tracheal cartilages.

Velopharyngeal function in association with artificial obstruction of the nose: a videonasendoscopic study.

Artificial obstruction of the nose can make the nasal cavity a cul-de-sac resonator, which has clearly audible consequences. The present study compares videonasendoscopic views of the velopharyngeal mechanism in test words uttered with the nose open and obstructed in 20 subjects with a Pierre Robin sequence and in 6 subjects without this sequence. A velopharyngeal flap was constructed on 12 subjects. Videonasendoscopic findings were assessed by 3 judges with acceptable agreement. The results indicated that impairment of velopharyngeal function occurred significantly more often in subjects with a velopharyngeal flap. This was attributed to aerodynamic reasons. Clinical implications of the results are discussed.

Velopharyngeal function in cleft patients undergoing maxillary advancement.

Maxillary advancement may result in movement of the posterior border of the hard palate with its soft palate attachment, which may cause impairment of velopharyngeal (VP) function. We examined VP function before and after Le Fort I osteotomy in 15 cleft lip and palate patients. The extent of maxillary advancement was measured by means of standard cephalometric radiographs taken before and after the operation. VP function was evaluated in terms of perceptual speech assessments, pressure-flow data and nasalance scores preoperatively and 2, 6 and 12 months after the operation. The results showed that maxillary advancement resulted in impairment of VP function in 4 (27%) of the patients.