Attachment to mother and father at transition to middle childhood

The present study investigated concordance between representations of attachment to mother and attachment to father, and convergence between two narrative-based methods addressing these representations in middle childhood: the Manchester Child Attachment Story Task (MCAST) and the Secure Base Script Test (SBST). One hundred and twenty 6-year-old children were assessed by separate administrations of the MCAST for mother and father, respectively, and results showed concordance of representations of attachment to mother and attachment to father at age 6.5 years. 75 children were additionally tested about 12 months later, with the SBST, which assesses scripted knowledge of secure base (and safe haven), not differentiating between mother and father attachment rela- tionships. Concerning attachment to father, dichotomous classifications (MCAST) and a continuous dimension cap- turing scripted secure base knowledge (MCAST) converged with secure base scriptedness (SBST), yet we could not show the same pattern of convergence concerning attach- ment to mother. Results suggest some convergence between the two narrative methods of assessment of secure base script but also highlight complications when using the MCAST for measuring attachment to father in middle childhood

Assessment of Mycobacterium tuberculosis transmission in Oxfordshire, UK, 2007-12, with whole pathogen genome sequences: An observational study

Background: Patients born outside the UK have contributed to a 20% rise in the UK's tuberculosis incidence since 2000, but their effect on domestic transmission is not known. Here we use whole-genome sequencing to investigate the epidemiology of tuberculosis transmission in an unselected population over 6 years. Methods: We identified all residents with Oxfordshire postcodes with a Mycobacterium tuberculosis culture or a clinical diagnosis of tuberculosis between Jan 1, 2007, and Dec 31, 2012, using local databases and checking against the national Enhanced Tuberculosis Surveillance database. We used Illumina technology to sequence all available M tuberculosis cultures from identified cases. Sequences were clustered by genetic relatedness and compared retrospectively with contact investigations. The first patient diagnosed in each cluster was defined as the index case, with links to subsequent cases assigned first by use of any epidemiological linkage, then by genetic distance, and then by timing of diagnosis. Findings: Although we identified 384 patients with a diagnosis of tuberculosis, country of birth was known for 380 and we sequenced isolates from 247 of 269 cases with culture-confirmed disease. 39 cases were genomically linked within 13 clusters, implying 26 local transmission events. Only 11 of 26 possible transmissions had been previously identified through contact tracing. Of seven genomically confirmed household clusters, five contained additional genomic links to epidemiologically unidentified non-household members. 255 (67%) patients were born in a country with high tuberculosis incidence, conferring a local incidence of 109 cases per 100000 population per year in Oxfordshire, compared with 3·5 cases per 100000 per year for those born in low-incidence countries. However, patients born in the low-incidence countries, predominantly UK, were more likely to have pulmonary disease (adjusted odds ratio 1·8 [95% CI 1·2-2·9]; p=0·009), social risk factors (4·4 [2·0-9·4]; p<0·0001), and be part of a local transmission cluster (4·8 [1·6-14·8]; p=0·006). Interpretation: Although inward migration has contributed to the overall tuberculosis incidence, our findings suggest that most patients born in high-incidence countries reactivate latent infection acquired abroad and are not involved in local onward transmission. Systematic screening of new entrants could further improve tuberculosis control, but it is important that health care remains accessible to all individuals, especially high-risk groups, if tuberculosis control is not to be jeopardised. Funding: UK Clinical Research Collaboration (Wellcome Trust, Medical Research Council, National Institute for Health Research [NIHR]), and NIHR Oxford Biomedical Research Centre. © 2014 Walker et al. Open Access article distributed under the terms of CC BY