Background
Consistent with evidence from high income countries, we previously showed that, in an informal peri-urban settlement in a low-middle income country, training parents in book-sharing with their infants benefitted infant language and attention (Vally et al., 2015). Here, we investigated whether these benefits were explained by improvements in carer-infant interactions in both book-sharing and non-book-sharing contexts. We also explored whether infant socio-emotional development benefitted from book-sharing.
Methods
We conducted a randomized controlled trial in Khayelitsha, South Africa. Carers of 14–16 month-old infants were randomized to 8 weeks’ training in book-sharing (n = 49) or a wait list control group (n = 42). In addition to the cognitive measures reported previously, independent assessments were made at base line and follow-up of carer-infant interactions during book-sharing and toy play. Assessments were also made, at follow-up only, of infant pro-social behaviour in a ‘help task’, and of infant imitation of doll characters’ non-social actions and an interpersonal interaction. Eighty-two carer-infant pairs (90%) were assessed at follow-up. (Trial registration ISRCTN39953901).
Results
Carers who received the training showed significant improvements in book-sharing interactions (sensitivity, elaborations, reciprocity), and, to a smaller extent, in toy-play interactions (sensitivity). Infants in the intervention group showed a significantly higher rate of pro-social behaviour, and tended to show more frequent imitation of the interpersonal interaction. Improvements in carer behaviour during book-sharing, but not during toy play, mediated intervention effects on all infant cognitive outcomes, and tended to mediate intervention effects on infant interpersonal imitation.
Conclusions
Training in book sharing, a simple, inexpensive intervention that has been shown to benefit infant cognitive development in a low-middle income country, also shows promise for improving infant socio-emotional outcomes in this context. Benefits are mediated by improvements in carer-infant interactions, particularly in book-sharing contexts.
Anatomists are well placed to tackle the transition from face-to-face to blended learning approaches as a result of the rapidly forced changes brought about by Covid-19. The subject is extremely visual and has therefore previously been a target for the development of technology enhanced learning initiatives over the last ten years. Today's students have come to expect the integration of technology in the classroom and remotely. They adjust quickly to the innovative use of new applications and software and have begun to integrate it within their own workflow for note taking and study aids. Given the intense drive towards blended deliveries of anatomy as a result of the Covid-19 pandemic, it is easy to picture how the benefits of working in partnership with students (in order to achieve many of these aims) would be possible, particularly in difficult subjects like neuroanatomy. In doing so, it provides anatomists with new opportunities to engage students in a way that aligns well with best practice frameworks for engaging students through partnership. The current United Kingdom guidelines set out by Advance HE (a professional membership scheme for promoting excellence in higher education) strongly encourages the higher education community to seek out appropriate academic contexts where a balance of power can be struck between staff and student to create a community of practice. If such an approach can be fully embraced by anatomists, a strong argument can be made for seizing the opportunity to optimize the benefits of student partnership work in this discipline.
C trachomatis is a potentially significant pathogen in this population of urban homosexual men. Screening programs such as these are valuable as health-promotion exercises.
Improving the uptake of vaccination in pregnancy has been highlighted as a priority by the World Health Organisation, yet establishing the optimal location for delivery of the antenatal vaccination program remains a topic of debate internationally. In many countries, antenatal vaccines are usually delivered within Primary Care (under the lead of general practitioners [GPs] or family physicians), yet this often presents a logistic barrier to accessing vaccination, and increasing evidence demonstrates that embedding vaccination within routine antenatal care visits may significantly improve uptake. In this commentary, we discuss recent evidence to support this approach, including anonymous feedback from patients and staff at our own institution, in which a dedicated midwife-led vaccine clinic has recently been set up. Furthermore, we highlight a number of individual and institution-level barriers which would need addressing before this approach can be routinely adopted, and suggest targets for future education and research.
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