Major epidemiological changes in sudden infant death syndrome : a 20-year population-based study in the UK

Background Results of case-control studies in the past 5 years suggest that the epidemiology of sudden infant death syndrome (SIDS) has changed since the 1991 UK Back to Sleep campaign. The campaign's advice that parents put babies on their back to sleep led to a fall in death rates. We used a longitudinal dataset to assess these potential changes. Methods Population-based data from home visits have been collected for 369 consecutive unexpected infant deaths (300 SIDS and 69 explained deaths) in Avon over 20 years (1984—2003). Data obtained between 1993 and 1996 from 1300 controls with a chosen “reference” sleep before interview have been used for comparison. Findings Over the past 20 years, the proportion of children who died from SIDS while co-sleeping with their parents, has risen from 12% to 50% (p<0·0001), but the actual number of SIDS deaths in the parental bed has halved (p=0·01). The proportion seems to have increased partly because the Back to Sleep campaign led to fewer deaths in infants sleeping alone—rather than because of a rise in deaths of infants who bed-shared, and partly because of an increase in the number of deaths in infants sleeping with their parents on a sofa. The proportion of deaths in families from deprived socioeconomic backgrounds has risen from 47% to 74% (p=0·003), the prevalence of maternal smoking during pregnancy from 57% to 86% (p=0·0004), and the proportion of pre-term infants from 12% to 34% (p=0·0001). Although many SIDS infants come from large families, first-born infants are now the largest group. The age of infants who bed-share is significantly smaller than that before the campaign, and fewer are breastfed. Interpretation Factors that contribute to SIDS have changed in their importance over the past 20 years. Although the reasons for the rise in deaths when a parent sleeps with their infant on a sofa are still unclear, we strongly recommend that parents avoid this sleeping environment. Most SIDS deaths now occur in deprived families. To better understand contributory factors and plan preventive measures we need control data from similarly deprived families, and particularly, infant sleep environments

‘Has anyone here seen Amos?’ – re-establishing ‘prophetic imagination’ at the centre of religious education and formation

In 1989 Australian author and illustrator Bob Graham published a children’s book entitled Has anyone here seen William? This article seeks to construct a parallel narrative in relation to the category of the prophet, with a particular focus on the need to engage in prophetic imagination within the twin contexts of religious education (hereafter R.E.) and formation. In doing so it also makes reference to one of the archetypical biblical prophets - Amos. The article’s primary interlocutor is scripture scholar Walter Brueggemann (1982, 2002a, 2002b) who has written on topics as diverse as scripture exegesis and the theology of pain and homecoming. He has also written prominently on prophetic imagination, understood as the capacity to stand outside the dominant discourse or power structure of one’s day and critique it. As we will demonstrate throughout the article, Brueggemann’s scholarship in this area is complemented and refined through contact with the African-American philosopher Cornel West’s (1999) approach to prophetic critique, along with other commentators. Held together, both thinkers impel us to consider why teaching ‘about prophets’ needs to be complemented by an explicit cultivation of prophetic imagination, and how this might be seeded in crucial contexts such as religious education and formation. Following a brief introduction (part one) the second part explores the nature of the prophetic challenge. Part three focuses on recovery of the prophetic imagination, while part four examines ways to cultivate the prophetic imagination today. The final section considers conclusions and future directions in relation to topics raised throughout the paper

Investigating sudden unexpected deaths in infancy and childhood and caring for bereaved families : an integrated multiagency approach

The sudden unexpected death of an infant or child is one of the worst events to happen to any family. Bereaved parents expect and should receive appropriate, thorough, and sensitive investigations to identify the medical causes of such deaths. As a result, several parallel needs must be fulfilled. Firstly, the needs of the family must be recognised—including the need for information and support. Further, there is the need to identify any underlying medical causes of death that may have genetic or public health implications; the need for a thorough forensic investigation to exclude unnatural causes of death; and the need to protect siblings and subsequent children. Alongside this, families need to be protected from false or inappropriate accusations. Limitations in the present coronial system have led to delays or failures to detect deaths caused by relatives, carers, or health professionals. Several recent, highly publicised trials have highlighted the possibilities of parents facing such accusations. As a result of this the whole process of death certification has come under intense scrutiny. We review the medical, forensic, and sociological literature on the optimal investigation and care of families after the sudden death of a child. We describe the implementation in the former county of Avon of a structured multiagency approach and the potential benefits for families and professionals

We Look Back, We Also Look Ahead

Neil McNeil High School Celebrates 50 Year

Repo Market Microstructure in Unusual Monetary Policy Conditions

The financial turmoil that began in mid-2007 produced severe stress in interbank markets and prompted significant changes in central banks’ funding operations. We examine the changing characteristics of ECB official interventions through the crisis and assess how they affected the efficiency and reliability of the secondary repo market as a mechanism for the distribution of interbank funding. The limit orderbook from the BrokerTec electronic repo trading platform is reconstructed to provide a range of indicators of participating banks’ aversion to the risk of failing to fund their liquidity needs. These indicators anticipate similar variables from ECB reverse repo auctions and are also affected by surprise outcomes of auctions.Repo, Financial crisis, liquidity, market microstructure, monetary policy operations

Hotspots and Coldspots: Household and village-level variation in orphanhood prevalence in rural Malawi

We explore the spatial distribution of orphans in two areas of Malawi. We first review pertinent themes in qualitative data collected in our research sites. Then, using spatial analysis, we show how positive and negative clusters of orphans—which we term orphanhood "hotspots" and "coldspots"—can be found at the village and sub-village levels. In the third and longest section of the paper, and using multilevel analyses with both simple and complex variance structures, we evaluate the relationship between the presence of orphans and a range of individual, household and village-level characteristics, including households' spatial relationship to each other and to other local sites of significance. This series of analyses shows that the most important covariates of orphan presence are the density of settlement, household size, and religious characteristics, with the latter measured simultaneously at both household and village-level. Other characteristics like education, reported mortality levels and HIV infection, are wholly unrelated to orphan prevalence at all analytic levels. Wealth and various spatial characteristics are only marginally associated with orphan prevalence. We conclude by reviewing some difficulties in explaining causal mechanisms underlying these observed relationships, and discussing conceptual, theoretical and programmatic implications.Africa, AIDS/HIV, Malawi, multilevel model, orphan prevalence, orphans, spatial analysis

Production of y* resonances by low energy k(^-) mesons

This thesis is a preliminary account of work carried out to examine the characteristics of the isospin I=1 and I=0 channels K(^-)p→Ʌ π and K(^-)p→Σ π •» at primary momenta between150 and 480 Mev/c. The experiment used the British National Hydrogen Bubble Chamber at the Rutherford Laboratory with a Track Sensitive Target configuration, which provided gamma ray detection. Two approaches are adopted to separate these normally ambiguous channels. The first is a statistical separation of the kind used by previous workers, the second uses the gamma ray detection of the Track Sensitive Target to resolve these two channels directly. The results of the two methods are compared and are in good agreement. The presence of the Ʌ (1520) is clearly demonstrated in the determination of the branching ratio of K(^-)p→Ʌ π to K(^-)p→Ʌ + neutrals, as a function of momentum, and in the angular distribution of the Σ in the K(^p) centre of mass system. There is no evidence for the Σ (1480) resonance