A computer-based aid for communication between patients with limited English and their clinicians, using symbols and digitised speech.

Background: Problems of communication are an important barrier on the pathway to healthcare for patients with limited or no ability in the majority language of the country in which they live. Solutions involving interpreters who have to be booked in advance, or using unqualified friends or family members to translate, are highly unsatisfactory.

Aim: This paper describes a computer-based approach to alleviating the situation.

Association between antenatal depression and low birthweight in a developing country.

Objective: There is a high prevalence of depression in south Asian women. We aimed to examine the association between antenatal depression and low birthweight (LBW) in infants in a rural community in Rawalpindi, Pakistan.

Method: A total of 143 physically healthy mothers with ICD-10 depression in the third trimester of pregnancy and 147 non-depressed mothers of similar gestation were followed from birth.

Maternal depression increases infant risk of diarrhoeal illness: --a cohort study.

Aims: To examine the associations between postnatal depression in mothers and diarrhoeal illness in their infants in the first year of life in a low-income country.

Methods: Using a prospective cohort design, 265 infants (n = 130 of mothers having a depressive episode according to the International Classification of Diseases, 10th revision, at 3 months postnatal and n = 135 of psychologically well mothers) living in rural Rawalpindi, Pakistan, were followed up for 1 year. Frequency of diarrhoeal episodes was measured fortnightly by health workers using a standard questionnaire.

Geographical variation in neonatal phenotype.

Background: Recent studies have shown associations between size and body proportions at birth and health outcomes throughout the life cycle, but there are few data on how neonatal phenotype varies in different populations around the world.

Methods: Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria, and Jamaica (n=22,067) were used to characterize geographical differences in phenotype in singleton, live-born newborns. Measurements included birth weight, placental weight, length, head, chest, abdominal and arm circumferences, and skinfolds.

Geographical variation in relationships between parental body size and offspring phenotype at birth.

Background: Size and body proportions at birth are partly determined by maternal body composition, but most studies of mother-baby relationships have only considered the effects of maternal height and weight on offspring birth weight, and few have examined the size of effects. Paternal size and body composition also play a role, primarily through the fetal genome, although few studies have investigated relationships with neonatal phenotype.

Methods: Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria and Jamaica were used to investigate the effects of maternal measures (derived at 30 weeks' gestation, n=16,418), and also paternal size (n=3,733) on neonatal phenotype, for singleton, live-born, term births.

Impact of maternal depression on infant nutritional status and illness: a cohort study.

Background: The risk for emotional and behavioral problems is known to be high among children of depressed mothers, but little is known about the impact of prenatal and postnatal depression on the physical health of infants.

Objective: To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country.

Design: Prospective cohort study.

Up the garden path and over the edge: where might health-seeking behaviour take us?

The concept of health-seeking behaviour continues to permeate the development literature, and this paper reviews the main approaches. However, it also suggests that health-seeking behaviour is a somewhat over-utilized and under-theorized tool. Although it remains a valid tool for rapid appraisal of a particular issue at a particular time, it is of little use as it stands to explore the wider relationship between populations and health systems development.

Mothers' mental health and infant growth: a case-control study from Rawalpindi, Pakistan.

Background: Epidemiological studies in Pakistan show high rates of depression in women, while rates of malnutrition in children are also high. This study aimed to determine whether poor maternal mental health is associated with an increased risk of infant undernutrition.

Methods: Clinic-based case-control study.

How well are hospitals preventing iatrogenic HIV? A study of the appropriateness of blood transfusions in three hospitals in the Ashanti region, Ghana.

A study on the appropriateness of blood and blood product transfusions took place in three hospitals over a 3-week period in July/August 1990 in the Ashanti region of Ghana. Clinical records of all blood transfusion recipients within the period were examined for the appropriateness of the transfusions based on preset criteria. Nearly 1 in 5 (17%) of all blood transfusion episodes in the hospitals were avoidable according to these criteria.