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Effective treatment of maternal antenatal depression may ameliorate adverse neurodevelopmental outcomes in offspring. We performed two follow-up rounds of children at age 2 and age 5 whose mothers had received either specialized cognitive-behavioural therapy or routine care for depression while pregnant. Of the original cohort of 54 women, renewed consent was given by 28 women for 2-year follow-up and by 24 women for 5-year follow-up. Child assessments at the 2-year follow-up included the Parenting Stress Index (PSI), Bayley Scales of Infant Development (BSID-III) and the Child Behaviour Checklist (CBCL). The 5-year follow-up included the Wechsler Preschool and Primary Scales of Intelligence (WPPSI-III) and again the CBCL. Treatment during pregnancy showed significant benefits for children’s development at age 2, but not at age 5. At 2 years, intervention effects were found with lower scores on the PSI Total score, Parent Domain and Child domain (d=1.44, 1.47, 0.96 respectively). A non-significant trend favoured the intervention group on most subscales of the CBCL and the BSID-III (most notably motor development: d =0.52). In contrast, at 5-year follow-up, no intervention effects were found. Also, irrespective of treatment allocation, higher depression or anxiety during pregnancy was associated with higher CBCL and lower WPPSI-III scores at 5 years. This is one of the first controlled studies to evaluate the long-term effect of antenatal depression treatment on infant neurodevelopmental outcomes, showing some benefit. Nevertheless, caution should be taken interpreting the results because of a small sample size, and larger studies are warranted.

The success of the Counter-Reformation in Ireland following the restoration of the Catholic hierarchy was a remarkable achievement. Between 1618 and 1630 Rome made a staggering nineteen episcopal appointments in a kingdom that was ruled by a Protestant king. Documenting the achievements of the initial period only paints half the picture, however. The implementation of the Tridentine reforms and the thorny issue of episcopal authority brought the religious orders into a head-on collision with the secular clergy. This protracted dispute lasted for a decade, most notably in the diocese of Dublin where an English secular priest, Paul Harris, led a hostile attack on the Franciscan archbishop, Thomas Fleming. The longevity of the feud, though, owed at least as much to the intervention of Lord Deputy Sir Thomas Wentworth as it did to the internal tensions of the Catholic Church. Despite Wentworth’s influential role, he has been largely written out of the conflict. This article addresses the lacunae in the current historiography and argues that the lord deputy’s interference was a decisive factor in exacerbating the hostilities between the secular and regular clergy in early seventeenth-century Ireland.

Introduction: Existing resources to support adolescents with acquired brain injury (ABI) in transition from school to the ‘adult world’ are variable. This study evaluated an intervention using a coaching approach to support adolescents during this transition phase.

Method: The study design was a parallel-group randomised controlled trial (RCT). Participants (n = 43) aged 14–19 years were randomised to intervention (n = 21) or no-intervention control (n = 21) conditions. The intervention group received six coaching sessions over an average of 22 weeks. Outcome measures evaluated changes reported by the adolescent (satisfaction, emotional functioning and hope) and their parent (participation, behaviour and support needs).

Results: Relative to baseline, there was no significant improvement for those in the intervention group in comparison to the control group on any of the outcome measures.

Conclusion: The results of this RCT do not support coaching as an intervention for adolescents with ABI.

Tail biting is a major welfare and economic problem in intensive pig production. The objectives of this study were to (1) determine tail lesion prevalence at a German abattoir, (2) test for associations between meat inspection findings and tail lesions, (3) assess the agreement between tail necrosis recorded during meat inspection and scored from pictures and (4) test whether the tail biting management tool ‘Schwanzbeiß-Interventions-Programm’ (SchwIP) had an effect on tail lesion prevalence. A total of three observers scored tail lesions from pictures of 43 328 pigs from 32 farms where SchwIP had been applied, and of 36 626 pigs from 32 control farms. Tail lesions were classified as score 0: no visible lesion, score 1: mild lesion, score 2: severe lesion and score 3: necrosis. In addition, complete loss of tail (CL) was recorded. Tail necrosis was the only tail-related carcase finding recorded by meat inspectors. (1) Tail lesion prevalences in pigs from control farms were 23.6% for score 1, 1.02% for score 2, 0.55% for score 3 and 0.41% for CL. The combined prevalence of any lesion and/or CL was 25.4%. (2) Pleurisy, lung findings, signs of inflammation in the legs, arthritis and abscesses were the most frequent meat inspection findings (prevalences of 8.46%, 8.09%, 2.99%, 0.83% and 0.23%, respectively; n=79 954 pigs). Leg inflammation, arthritis and abscesses were more prevalent in pigs with tail lesions of any degree compared with pigs without tail lesions (3.39% v. 2.83%, 1.06% v. 0.75% and 0.39% v. 0.17%, respectively; all P<0.001, n=79 954 pigs). Pigs with severe tail lesions also had more lung findings (2.00% v. 0.17%, P<0.001). (3) Tail necrosis scored during meat inspection resulted in lower prevalence than scored from pictures (0.22% v. 0.69%; n=79 954 SchwIP and control farm pigs). (4) Although tail lesion prevalence was significantly higher in pigs from SchwIP than in pigs from control farms during the first 3 months (32.2% v. 23.8%, P=0.015), it was not significantly higher during the remainder of the year (22.6 v. 26.9, 24.4 v. 21.4 and 24.0 v. 28.0, second, third and fourth quarters, respectively). In conclusion, meat inspection results in much lower tail lesion prevalences than tail lesion assessment from pictures, even if only the category ‘necrosis’ is compared. Advising farms on tail biting using the management tool SchwIP helped to decrease the prevalence of tail lesions on problem farms.

Semantic dementia causes progressive communication difficulties that significantly impact on the person and their family. There is a paucity of research examining conversation skills in this condition and associated interventions to support interaction, such as life-story work. This study used a multiple case study design to: (a) explore the everyday conversation experiences of five individuals with semantic dementia and their spouses; and (b) examine how intervention using interaction-focused life-story work could support communication needs. A total of 74 home visits were conducted over a longitudinal period. An innovative combination of conversation analysis of video and audio data alongside biographical interviewing was used. Information derived from these strands was utilised to design an individually tailored life-story intervention. Cross-case analysis examined the contribution of life-story work to interaction and other aspects of care. Results showed that a range of challenges and skills were present within conversation. Life-story work was delivered in all cases using a variety of formats and the work could be conceptualised under various points of connection: interactional, emotional, new, practical and future. Detailed assessment was important to define aims for intervention and appropriate format(s) for life-story work for the individual concerned. Outcomes for communication in this study were not solely about supporting the telling of facts about the person's life but represented a broader focus to facilitate embodied and emotional connections. This study demonstrates that creativity within life-story work is important to foster social interaction, beyond information exchange, using both verbal and non-verbal behaviours. In addition, video data show promise for exploring in-the-moment outcomes for research and practice, particularly to capture the non-verbal dimensions of this work.

Lifestyle interventions remain the cornerstone therapy for non-alcoholic fatty liver disease (NAFLD). This randomised controlled single-blind clinical trial investigated the effect of Mediterranean diet (MD) or Mediterranean lifestyle, along with weight loss, in NAFLD patients. In all, sixty-three overweight/obese patients (50 (sd 11) years, BMI=31·8 (sd 4·5) kg/m2, 68 % men) with ultrasonography-proven NAFLD (and elevated alanine aminotransferase (ALT) and/or γ-glutamyl transpeptidase (GGT) levels) were randomised to the following groups: (A) control group (CG), (B) Mediterranean diet group (MDG) or (C) Mediterranean lifestyle group (MLG). Participants of MDG and MLG attended seven 60-min group sessions for 6 months, aiming at weight loss and increasing adherence to MD. In the MLG, additional guidance for increasing physical activity and improving sleep habits were given. Patients in CG received only written information for a healthy lifestyle. At the end of 6 months, 88·8 % of participants completed the study. On the basis of intention-to-treat analysis, both MDG and MLG showed greater weight reduction and higher adherence to MD compared with the CG (all P<0·05) at the end of intervention. In addition, MLG increased vigorous exercise compared with the other two study groups (P<0·001) and mid-day rest/naps compared with CG (P=0·04). MLG showed significant improvements in ALT levels (i.e. ALT<40 U/l (P=0·03) and 50 % reduction of ALT levels (P=0·009)) and liver stiffness (P=0·004) compared with CG after adjusting for % weight loss and baseline values. MDG improved only liver stiffness compared with CG (P<0·001) after adjusting for the aforementioned variables. Small changes towards the Mediterranean lifestyle, along with weight loss, can be a treatment option for patients with NAFLD.

China's response to the recent Syria crisis at the UN Security Council represents a crucial case in China's approach to intervention in that it breaks from China's recent practice of becoming more permissive regarding intervention. Instead, China actively worked to ensure that a firm line was drawn to separate intervention from foreign-imposed regime change. It did so by employing three diplomatic innovations: exercising multiple, successive vetoes; expanding discourse to delegitimize intervention as “regime change” by Western powers; and engaging in norm-shaping of the international community's “responsibility to protect” post-intervention. Together, these three innovations highlight China's desire to firmly separate the intervention norm from that of regime change. Using a variety of primary sources, the article also draws insights from interviews with foreign policy elites in Beijing, New York and New Delhi.

To date, Ireland has been a leading light in the provision of youth mental health services. However, cognisant of the efforts of governmental and non-governmental agencies working in youth mental health, there is much to be done. Barriers into care as well as discontinuity of care across the spectrum of services remain key challenges. This editorial provides guidance for the next stage of development in youth mental care and support that will require significant national engagement and resource investment.

The purpose of this Editorial is to summarise the key recommendations of the Lancet Commission on Dementia Prevention, Intervention, and Care, reporting on the best available evidence to date on what we can do to prevent and intervene for dementia. We briefly describe the new life-course model of dementia prevention incorporating nine modifiable risk factors and their potential effect in reducing individuals’ risk of dementia. We also summarise the recommendations of the report about which pharmacological, psychological, and social interventions are effective, and improve outcomes for people with dementia and their families. Recent developments highlight that there is good potential for the prevention of dementia. Progress in evidence-based approaches indicate the potential for dementia care to be of high-quality and widely accessible. Acting upon this knowledge now will reduce the global burden of dementia and improve the lives of people living with dementia and their families.

A pilot study of the effectiveness of guided access to websites that provide information on intervention options for children with autism spectrum disorder (ASD) was conducted with 12 parents of preschool-aged children with ASD. Guided access to reliable websites that included information about the efficacy of interventions for ASD (Raising Children Network, 2006–2014; Research Autism, 2006–2014) was provided in the format of a DVD presentation. The guidelines for choosing interventions provided on the Raising Children Network (2009) website were reiterated and assistance was provided with navigation and interpretation of the sites. Participants reported the guided access to reliable websites as useful and also reported an increased level of confidence in making intervention decisions after using the package. However, the guided access did not appear to influence the factors that parents considered important in decision-making, their understanding of the level of research support for interventions, nor their desire to use different interventions. Implications for future research and attempts to disseminate information to parents are discussed.

Large numbers of refugee children are arriving in high-income countries. The evidence to date suggests that they have mental health needs that are higher than for the general population and that these are exacerbated by the numbers of traumatic events they have experienced and the post-migration stressors they continue to be exposed to. The importance of a thorough and thoughtful assessment is discussed. Treatments of note are described for post-traumatic stress disorder, family functioning, general mental health problems and school environments. Future opportunities to operationalise outcome measures, develop multimodal interventions and utilise implementation science methodology are considered.