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Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately.
Aims
To determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective).
Method
We conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI).
Results
The best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure.
Conclusions
This study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.
Kant holds that some nonhuman animals “are acquainted with” objects, despite lacking conceptual capacities (“understanding”). What does this tell us about his theory of human cognition? Numerous authors have argued that this is a significant point in favour of Nonconceptualism—the claim that, for Kant, sensible representations of objects do not depend on the understanding. Against this, I argue that Kant’s views about animal minds can readily be accommodated by a certain kind of Conceptualism. It remains viable to think that, for Kant, (i) humans’ sensible representations necessarily represent objects as temporally structured in ways that allow us to have thoughts about them, and (ii) such representations are produced, and could only be produced, by the understanding. This allows Conceptualists to maintain that humans’ sensible representations depend on the understanding, while accepting that animals have sensible representations of objects too. We must, therefore, reassess both the warrant for Nonconceptualism and the shape Conceptualist readings must take.
Frederick Wollaston Hutton (1836–1905) was a geologist and a supporter of Darwinian theory. He emigrated to New Zealand in 1866, became Professor of Biology at Canterbury College, and won awards both in Britain and Australasia for his work on the natural history of New Zealand. He published scientific papers on biology and zoology as well as geology and, with James Drummond, wrote two popular works, Nature in New Zealand (1902) and The Animals of New Zealand (1904). The latter was extremely successful. It was revised and expanded the following year, and this fourth edition was published in 1923. The book focuses on native vertebrates, so the bulk of the content relates to birds, of which Hutton had published a catalogue in 1871. It also describes marine mammals, reptiles, and bats, and gives brief coverage to introduced species. There are 154 illustrations, and indexes of Maori, English and scientific names.
The reputation of Erasmus in the period after his death has been the object of considerable interest in recent years following the impression made by Marcel Bataillon's Érasme et l'Espagne (Paris, 1937) and, more recently, by Andreas Flitner's essay Erasmus im Urteil seiner Nachwelt (Tübingen, 1952). The vicissitudes of an influence felt to be important, yet at the same time widely suspect, is something of a critical index to European moral sentiment. It is clear also that the reception of this influence has differed with the climate of opinion from country to country as well as from time to time, and it would seem desirable to fill up the outline, so admirably sketched by Flitner, at points where our present information is relatively thin. One such point is to be found in France in the latter part of the sixteenth century.
“‘There's some herb that's good for everybody except for them J. that thinks they're sick when they ain't,’ announced Mrs. Todd, with a truly professional air of finality. ‘Come, William, let's have Sweet Home, an’ then mother'll sing Cupid an' the Bee for us.'” Accuracy in detail is a merit that no one would deny to the work of Sarah Orne Jewett and hence some time ago, on reading the words just quoted from The Country of the Pointed Firs, the present writer was puzzled at finding Cupid and the Bee linked with Sweet Home in a setting meant to call up nothing but the homely reality of Maine. The title suggested Theocritus (pseudo-Theocritus) or an Anacreon (pseudo-Anacreon) unlikely to be much on the mind of Mrs. Todd or her aged mother. Sweet Home is duly sung, but we hear no more of Cupid and the Bee. One only gathers that to Miss Jewett in 1896 it had the color of an old song suitable to the age of the singer. As I had long been noting down occurrences of the theme,
The problem of the relationship of the endocrine system to personality and its disorders has long been an intriguing one. The literature abounds with the views of the psychiatrist, physiologist, pathologist and endocrinologist, and still there remains a multitude of challenging questions unanswered. The ætiology of personality disorders, that of the psychoses, and the true function of the endocrines and their working mechanism have never been satisfactorily determined. To establish scientifically any ætiological factor in medicine one must make a definite diagnosis of the entity, identify the ætiological factor, the specific pathological picture, and the influence of specific therapy.