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Abstract Background Birth Preparedness and Complication Readiness (BPCR) interventions are widely promoted by governments and international agencies to reduce maternal and neonatal health risks in developing countries; however, their overall impact is uncertain, and little is known about how best to implement BPCR at a community level. Our primary aim was to evaluate the impact of BPCR interventions involving women, families and communities during the prenatal, postnatal and neonatal periods to reduce maternal and neonatal mortality in developing countries. We also examined intervention impact on a variety of intermediate outcomes important for maternal and child survival. Methods We conducted a systematic review and meta-analysis of randomized trials of BPCR interventions in populations of pregnant women living in developing countries. To identify relevant studies, we searched the scientific literature in the Pubmed, Embase, Cochrane library, Reproductive health library, CINAHL and Popline databases. We also undertook manual searches of article bibliographies and web sites. Study inclusion was based on pre-specified criteria. We synthesised data by computing pooled relative risks (RR) using the Cochrane RevMan software. Results Fourteen randomized studies (292 256 live births) met the inclusion criteria. Meta-analyses showed that exposure to BPCR interventions was associated with a statistically significant reduction of 18% in neonatal mortality risk (twelve studies, RR = 0.82; 95% CI: 0.74, 0.91) and a non-significant reduction of 28% in maternal mortality risk (seven studies, RR = 0.72; 95% CI: 0.46, 1.13). Results were highly heterogeneous (I 2 = 76%, p < 0.001 and I 2 = 72%, p = 0.002 for neonatal and maternal results, respectively). Subgroup analyses of studies in which at least 30% of targeted women participated in interventions showed a 24% significant reduction of neonatal mortality risk (nine studies, RR = 0.76; 95% CI: 0.69, 0.85) and a 53% significant reduction in maternal mortality risk (four studies, RR = 0.47; 95% CI: 0.26, 0.87). Pooled results revealed that BPCR interventions were also associated with increased likelihood of use of care in the event of newborn illness, clean cutting of the umbilical cord and initiation of breastfeeding in the first hour of life. Conclusions With adequate population coverage, BPCR interventions are effective in reducing maternal and neonatal mortality in low-resources settings.

<b><i>Background:</i></b> With recent changes in legislation regulating recreational and medical cannabis use around the globe, increased use in pregnancy is to be expected. <b><i>Objectives:</i></b> To investigate the association between cannabis use during pregnancy and birth outcomes. <b><i>Method:</i></b> Data from the Norwegian Mother and Child Cohort Study (MoBa), a prospective pregnancy cohort, were used. Participants were recruited from all over Norway between 1999 and 2008: 9,312 women with 10,373 pregnancies who reported use of cannabis before or in pregnancy. Women reported on their illegal drug use before pregnancy and at pregnancy weeks 17/18 and 30 and at 6 months postpartum. Linear regression was used to estimate crude and adjusted effects of prenatal cannabis exposure on birth outcomes. <b><i>Results:</i></b> In 10,101 pregnancies, women had used cannabis before pregnancy but not during pregnancy. In 272 pregnancies, women had used cannabis during pregnancy, and among these, in 63 pregnancies, women had used cannabis in at least 2 periods. In adjusted analyses for potential confounders, only cannabis use during at least 2 periods of pregnancy showed statistically significant effects on birth weight. The effect was observed in the complete cohort (<i>B</i> = −228 g, 95% CI = −354 to −102, <i>p</i> &#x3c; 0.001) and for the subgroup where information about the child's father was available (<i>B</i> = −225 g, 95% CI = −387 to −63, <i>p</i> = 0.01). Our results may indicate that prolonged use causes more harm, whereas short-term use did not indicate adverse effects on birth outcomes. <b><i>Conclusions:</i></b> There was a statistically significant and clinically relevant association between the use of cannabis during pregnancy and reduced birth weight. Clinicians should screen not only for cannabis use but also for the length and intensity of use as part of a comprehensive substance use screening.

Alcohol binge drinking is on the increase in the young adult population, and consumption during pregnancy can be deleterious for foetal development. Maternal alcohol consumption leads to a wide range of long-lasting morphological and behavioural deficiencies known as foetal alcohol spectrum disorders (FASD), associated with neurodevelopmental disabilities. We sought to test the effects of alcohol on neuroimmune system activation and its potential relation to alcohol-induced neurodevelopmental and persistent neurobehavioural effects in offspring after maternal alcohol binge drinking during the prenatal period or in combination with lactation. Pregnant C57BL/6 female mice underwent a procedure for alcohol binge drinking either during gestation or both the gestation and lactation periods. Adult male offspring were assessed for cognitive functions and motor coordination. Early alcohol exposure induced motor coordination impairments in the rotarod test. Object recognition memory was not affected by maternal alcohol binge drinking, but Y-maze performance was impaired in pre- and early postnatal alcohol-exposed mice. Behavioural effects were associated with an upregulation of pro-inflammatory signalling (Toll-like receptor 4, nuclear factor-kappa B p65, NOD-like receptor protein 3, caspase-1, and interleukin-1β), gliosis, neuronal cell death and a reduction in several structural myelin proteins (myelin-associated glycoprotein, myelin basic protein, myelin proteolipid protein and myelin regulatory factor) in both the prefrontal cortex and hippocampus of adult mice exposed to alcohol. Altogether, our results reveal that maternal binge-like alcohol consumption induces neuroinflammation and myelin damage in the brains of offspring and that such effects may underlie the persistent cognitive and behavioural impairments observed in FASD. ; This study was supported by grants from the European Union's Horizon 2020 research and innovation programme 2014-2020 under Grant Agreement No 634143, the Spanish Ministry of Economy, Innovation and Competitiveness (SAF2013-41761-R-FEDER; SAF2015-69187-RFEDER; SAF2016-75347-R; SAF2016-75966-R), the Spanish Ministry of Health (Retic-ISCIII-RD/12/0028/007 and RD/12/0028/0024- FEDER), the Plan Nacional sobre Drogas (#2014/020, #2014/010 and #2016/004) and the Generalitat de Catalunya (2014SGR34). R. Lopez-Arnau position was funded by an institutional programme of the Universitat de Barcelona in collaboration with the Obra Social of the Fundacio Bancaria La Caixa.

Article Details: Received: 2020-09-07 | Accepted: 2020-10-19 | Available online: 2020-12-31https://doi.org/10.15414/afz.2020.23.04.241-247The contents of polychlorinated biphenyls (PCBs) were determined in raw cow's milk, feed and soil samples from three regions of Slovak Republic (SR) depending on the environmental regional classification of SR. Total 60 pool milk samples from undisturbed environment (Novoť area), moderately disturbed environment (Tulčík area), and from strongly disturbed environment (Čečejovce area) collected in April, July and September were extracted, purified by gel permeation chromatography (GPC) and analyzed using the gas chromatography with electron capture detector method (GC-ECD). Thirty feed samples of total mixed ration (TMR) were collected in April and September and after the extraction and purification by GPC were analyzed using gas and liquid chromatography (GLC). Fifteen soil samples collected in April were analyzed using the GC-ECD. All samples of raw milk, feed and soil were under the limit of quantification (LOQ) from all regions and did not exceed the limits set by European Commission. There were no seasonal differences in the PCBs levels in the milk, feed and soil samples. The milk PCBs consumption from these locations has no negative impact on consumer's health. The results indicate the decreasing trend in PCBs occurrence in the environment and food sources. Despite this positive findings, there is a constant need to monitor environmental burden of PCBs in the different regions of Slovakia where mainly food of animal origin is produced and to recognize another sources of PCBs that may impact the food chain.Keywords: polychlorinated biphenyls, PCB, cow milk, cows, SlovakiaReferencesAHMADKHANIHA, R., NODEHI, R.N., RASTKARI, N. and AGHAMIRLOO, H.M. (2017). Polychlorinated biphenyls (PCBs) residues in commercial pasteurized cows' milk in Tehran, Iran. 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Background: While substantial progress has been made globally towards achieving United Nations Millennium Development Goal 4 (MDG 4) on child mortality, the decline is not sufficient to reach the targets set for 2015. The South Asian region, which includes India, was to achieve the MDG 4 target of 39 deaths per 1000 live births by 2015 but was estimated to have reached only 61 by 2011. A part of this under-achievement is due to the gender-differentials in child mortality in South-Asia. The inherent biological advantage of girls, reflected inlower mortality rates as compared to boys globally, is neutralized by their sociocultural disadvantage in India. The availability of technology for prenatal sex determination has promoted sex-linked abortions. Current government efforts include a law that regulates the use of ultrasound and other diagnostic techniquesfor prenatal testing of sex and a conditional cash transfer (CCT) scheme thatinvests a certain amount of funds at the birth of a girl child to attain maturity when the girl turns 18 years of age. This thesis describes the trends in genderspecific mortality during the period 1992-2011 and gender differentials in causes of death among children (paper I), compares gender differentials in child survivalby socio-economic status of the family (paper II), explores the contribution of non-specific effects of diphtheria-tetanus-pertussis (DTP) vaccination to the excess mortality among girls (paper III), and evaluates the impact of CCT schemes of the government and explores community attitudes and practices related to discrimination of girls (paper IV). Methods and Results: This study is set in Ballabgarh Health and DemographicSurveillance System (HDSS) of Haryana State in North India that covered a population of 88,861 across 28 villages in 2011. This study uses the electronic database that houses all individuals enumerated in the HDSS for the period 1992-2011 along with other demographic, socio-economic and health utilization variables. Sex ratio at birth (SRB) was adverse for girls throughout the study period, varying between 821 to 866 girls per 1000 boys. Overall, under-five mortality rates during the period 1992-2011 remained stagnant due to the increasing neonatal mortality rate and decreasing mortality in subsequent age groups. Mortality rates among girls were 1.6 to 2 times higher than boys during the post-neonatal period (1-11 months) as well as in the 1-4 year age group. Girls reported significantly higher mortality rates due to prematurity (relative risk of 1.52; 95% CI = 1.01-2.29); diarrhoea (2.29;1.59-3.29), and malnutrition (3.37; 2.05-5.53) during 2002-2007. The SRB and neonatal mortality rate were consistently adverse for girls in the advantaged groups. In the 1-36 month age group, girl children had higher mortality than boys in all SES groups. The age at vaccination for and coverage with ivabstractBacillus Calmette–Guérin, DTP, polio and measles vaccines did not differ by sex. There was significant excess mortality among girls as compared to boys in the period after immunization with DTP, for both primary (hazard ratio of 1.65; 95% CI 1.17-2.32) and DTPb (2.21; 1.24-3.93) vaccinations until the receipt of the next vaccine. No significant excess mortality among girls was noted after exposure to BCG (1.06; 0.67-1.67) or measles (1.34; 0.85-2.12) vaccine. A community survey showed poor awareness of specific government schemes for girl children. Four-fifths of the community wanted government to help families with girl children financially. In-depth interviews of government programme implementers revealed the themes of "conspiracy of silence" that was being maintained by general population, underplaying of the pervasiveness of the problem coupled with a passive implementation of the programme and "a clash between politicians trying to cash in on the public sentiment of need for subsidies for girl children and a bureaucratic approachof accountability which imposed lot of conditionalities and documentations to access these benefits". While there has been some improvement in investment in girl children for immunization and education during the period 1992 to 2010, these were also seen among boys of the same houses and daughters in-laws who come from outside the state where such schemes are not in place. Conclusions: In the study area, girl children continue to be disadvantaged a tall periods in their childhood including in utero. In the short run, empowerment of individuals by education and increasing wealth without a concomitant change in culture of son-preference is harmful as it promotes the use of sex determination technology and female feticide to achieve desired family size and composition. There is a need to carefully review the use of health-enhancing technologies including vaccines so that they do not cause more harm to society. Current government efforts to address the gender imbalance are not working, as these are not rooted in a larger social context.

El estudio de los posibles factores tanto protectores como de riesgo que puedan favorecer o dañar a la mujer durante el embarazo y, por tanto, al niño en el período prenatal y postnatal, se ha convertido hoy en una necesidad y en un objetivo prioritario de salud mundial. Uno de los objetivos de la Atención Temprana es la realización de programas de seguimiento para prevenir, detectar y tratar secuelas en el desarrollo infantil. El seguimiento es el modo de comprobar si el desarrollo se está produciendo dentro de unas pautas de normalidad. Si la detección y el seguimiento de poblaciones de riesgo son unas tareas claves en la atención temprana, no lo son menos la realización de estudios longitudinales que toman a la población normal como objeto de estudio. Actualmente, en diversos países de la Comunidad Europea se están llevando a cabo importantes estudios aleatorizados con seguimiento longitudinal (proyectos NUHEAL, EARNEST, Red de Excelencia INMA) para evaluar el desarrollo global de los niños sanos y el desarrollo mental, en particular. Dentro de los factores asociados al desarrollo mental se encuentran el desarrollo psicomotor y el desarrollo somático. Numerosos estudios muestran que el peso, la talla y el perímetro cefálico son predictores de trastornos del desarrollo cuando se trata de una población de alto riesgo o con alguna patología. El objetivo principal de este estudio es describir la evolución del neurodesarrollo en niños sanos desde el sexto al vigésimo mes de vida. En este artículo se presentan parte de los resultados del Proyecto Europeo NUHEAL. ; The study of the possible protector factors and the risk factors can favour or harm women during pregnancy, and so, the infant during the pre- and post-natal periods, has today become a necessary and a high priority objective of world health. In agreement with this proposal, carrying out follow-up programs to prevent, detect and treat consequences in infant development is one of the objectives of Early Care (EC). The follow-up is the way to verify whether the development of the child is occurring within the guidelines of normalcy, or if there is a suspicion that he may be suffering from delays. In order to do this in an appropriate way, one of the necessary conditions is to have access to the tables and instruments that include up-to-date parameters of the course of overall development in the normal population. If the detection and follow-up of risk populations is a key task in the context of early attention, so are the longitudinal studies that use the normal population as the focus of their study. Currently, in various countries in the European Union, important follow-up studies are being carried out of a multi-disciplinary nature (EARNEST Project, NUHEAL Project, and Spanish INMA Network), with the purpose of evaluating the development of the child in general and, specifically, his mental development. These studies take into account, among others, a series of parameters that contemplate the eating habits of the mother, exposure to environmental contaminants, styles of care and the physical, mental and social follow-up of the development of the children up to ages that include adolescence.

Background: Prenatal inflammation has been proposed as an important mediating factor in several adverse pregnancy outcomes. C-reactive protein (CRP) is an inflammatory cytokine easily measured in blood. It has clinical value due to its reliability as a biomarker for systemic inflammation and can indicate cellular injury and disease severity. Elevated levels of CRP in adulthood are associated with alterations in DNA methylation. However, no studies have prospectively investigated the relationship between maternal CRP levels and newborn DNA methylation measured by microarray in cord blood with reasonable epigenome-wide coverage. Importantly, the timing of inflammation exposure during pregnancy may also result in different effects. Thus, our objective was to evaluate this prospective association of CRP levels measured during multiple periods of pregnancy and in cord blood at delivery which was available in one cohort (i.e., Effects of Aspirin in Gestation and Reproduction trial), and also to conduct a meta-analysis with available data at one point in pregnancy from three other cohorts from the Pregnancy And Childhood Epigenetics consortium (PACE). Secondarily, the impact of maternal randomization to low dose aspirin prior to pregnancy on methylation was assessed. Results: Maternal CRP levels were not associated with newborn DNA methylation regardless of gestational age of measurement (i.e., CRP at approximately 8, 20, and 36 weeks among 358 newborns in EAGeR). There also was no association in the meta-analyses (all p > 0.5) with a larger sample size (n = 1603) from all participating PACE cohorts with available CRP data from first trimester (< 18 weeks gestation). Randomization to aspirin was not associated with DNA methylation. On the other hand, newborn CRP levels were significantly associated with DNA methylation in the EAGeR trial, with 33 CpGs identified (FDR corrected p < 0.05) when both CRP and methylation were measured at the same time point in cord blood. The top 7 CpGs most strongly associated with CRP resided in inflammation and vascular-related genes. Conclusions: Maternal CRP levels measured during each trimester were not associated with cord blood DNA methylation. Rather, DNA methylation was associated with CRP levels measured in cord blood, particularly in gene regions predominately associated with angiogenic and inflammatory pathways. ; This work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (National Institutes of Health, Bethesda, MD, USA), and the EAGeR trial was specifically funded under contract numbers HHSN267200603423, HHSN267200603424, HHSN267200603426, and HHSN275201300023I-HHSN2750008. SL was supported by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences. Main funding of the epigenetic studies in INMA was grants from Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041), Spanish Ministry of Health (FIS-PI04/1436, FIS-PI08/1151 including FEDER funds, FIS-PI11/00610, FIS-FEDER-PI06/0867, FIS-FEDER-PI03-1615, MS13/00054, CP18/00018), Generalitat de Catalunya-CIRIT 1999SGR 00241, Fundació La marató de TV3 (090430), EU Commission (261357-MeDALL: Mechanisms of the Development of ALLergy), and European Research Council (268479-BREATHE: BRain dEvelopment and Air polluTion ultrafine particles in scHool childrEn). The general design of the Generation R Study is made possible by financial support from the Erasmus Medical Center, Rotterdam; the Erasmus University Rotterdam; the Netherlands Organization for Health Research and Development; and the Ministry of Health, Welfare and Sport. The EWAS data was funded by a grant from the Netherlands Genomics Initiative (NGI)/Netherlands Organisation for Scientific Research (NWO), Netherlands Consortium for Healthy Aging (NCHA; project nr. 050-060-810), by funds from the Genetic Laboratory of the Department of Internal Medicine, Erasmus MC, and by a grant from the National Institute of Child and Human Development (R01HD068437). This project received funding from the European Union's Horizon 2020 research and innovation programme (633595, DynaHEALTH: 733206, LIFECYCLE) and from the European Joint Programming Initiative "A Healthy Diet for a Healthy Life" (JPI HDHL, NutriPROGRAM project, ZonMw the Netherlands no.529051022; and Precise project, ZonMw the Netherlands no. P75416). LD has received funding from the European Joint Programming Initiative. The PREDO study has been funded by the Academy of Finland, EraNet Neuron, EVO (a special state subsidy for health science research), University of Helsinki Research Funds, the Signe and Ane Gyllenberg Foundation, the Emil Aaltonen Foundation, the Finnish Medical Foundation, the Jane and Aatos Erkko Foundation, the Novo Nordisk Foundation, the Päivikki and Sakari Sohlberg Foundation, and the Sigrid Juselius Foundation granted to members of the PREDO study board. Methylation assays were funded by the Academy of Finland.

El Salvador is the smallest country in Central America, and one of the most densely populated in the world. El Salvador is among the countries most affected by weather-related events and other hazards, incurring annual losses of around 2.5 percent of GDP. Worldwide, it ranks second highest for risk exposure to two or more hazards and highest for the total population at a relatively high risk of mortality. Furthermore, climate change is expected to increase the frequency and severity of weather, related events. The new Administration is committed to making El Salvador more 'productive, educated, and safe' by promoting inclusive growth and resilience. The World Bank Group's (WBG) proposed new CPF intends to promote inclusive growth and to foster resilience, with a focus on policy levers that could contribute to break the vicious circles in a sustainable manner. The proposed CPF is aligned with the Government's priorities and informed by the WBG's recent SCD. To strengthen the mutually-reinforcing foundations of inclusive growth, the proposed WBG engagement would support objectives which seek to: (i) build capacity to create safer communities for economic development; (ii) improve secondary-school attainment; (iii) enhance youth employability and skills; and (iv) increase access to finance. To foster sustainability and resilience, the proposed CPF seeks to: (v) promote the efficiency of public spending; and (vi) build capacity to manage disasters and environmental challenges. Taking into account the challenges faced by El Salvador, the WBG wishes to provide a modest but catalytic role through the implementation of these six objectives.

Alcohol and Alcohol-related Diseases: An Introduction to the Book -- I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects I Alcohol consumption: Epidemiology, policies and legal aspects II Alcohol addiction: Introduction and diagnosis Alcohol addiction: Introduction and diagnosis II Alcohol addiction: Introduction and diagnosis II Alcohol addiction: Introduction and diagnosis III Treatment of alcohol addiction Treatment of alcohol addiction III Treatment of alcohol addiction III Treatment of alcohol addiction III Treatment of alcohol addiction III Treatment of alcohol addiction III Treatment of alcohol addiction III Treatment of alcohol addiction Fetal Alcohol Spectrum Disorders (FASD) IV Fetal Alcohol Spectrum Disorders (FASD) IV Fetal Alcohol Spectrum Disorders (FASD) Structural and functional central nervous system pathology in alcohol addi V Structural and functional central nervous system pathology in alcohol addi V Structural and functional central nervous system pathology in alcohol addi V Structural and functional central nervous system pathology in alcohol addi V Structural and functional central nervous system pathology in alcohol addi V Structural and functional central nervous system pathology in alcohol addi VI Risk factors for Alcohol Addiction and Lessons from Basic Science Risk factors for Alcohol Addiction and Lessons from Basic Science VI Risk factors for Alcohol Addiction and Lessons from Basic Science VI Risk factors for Alcohol Addiction and Lessons from Basic Science VI Risk factors for Alcohol Addiction and Lessons from Basic Science VII Alcohol-related liver disease: Diagnosis Alcohol-related liver disease: Diagnosis VII Alcohol-related liver disease: Diagnosis VII Alcohol-related liver disease: Diagnosis VII Alcohol-related liver disease: Diagnosis VII Alcohol-related liver disease: Diagnosis Medical aspects of alcohol consumption and alcohol-related liver disease VIII Medical aspects of alcohol consumption and alcohol-related liver disease VIII Medical aspects of alcohol consumption and alcohol-related liver disease VIII Medical aspects of alcohol consumption and alcohol-related liver disease VIII Medical aspects of alcohol consumption and alcohol-related liver disease -- Epidemiology of Alcohol and Opioids Epidemiology of Alcohol-related Liver Disease in Europe Epidemiology of Alcohol-related Liver Disease in Romania Epidemiology of Alcohol-related Liver Disease in China Epidemiology of Alcohol-related Liver Disease in Russia Alcohol and mortality: First Preliminary Lessons from a Prospective 15 year Follow-up Study#xa0; Legal aspects of alcohol intake: A Romanian perspective COVID-19 and Alcohol Use Disorder The Principles of Policies to Reduce the Burden of Liver Disease Medical Treatment of Alcohol use Disorder: A Multidisciplinary Approach Diagnosis of Alcohol use Disorder and Identification of Unhealthy Alcohol Consumption#xa0; State Markers of Alcohol Use and their Application Addictions Neuroclinical Assessment Evidence-based Behavioral Treatments Approved, Promising, and Experimental Medications for Treatment of Alcohol Use Disorder#xa0; Comorbidity with substance use disorders and/or psychiatric disorders Treatment of Adolescents Transcranial Magnetic Stimulation in Addiction Therapies The Clinical Benefits of Non-Abstinent Outcomes in Alcohol Use Disorder Treatment: Evidence from Clinical Trials and Treatment Implications; Laboratory Based Approaches To Medications Development For Alcohol Addiction Emergency Room: Acute Alcohol Intoxication and Other Alcohol-related Acute Problems Including Alcohol Withdrawal Syndrome Introductory comments on FASD and the Collaborative Initiative on FASD Image Analysis of Neurofacial Effects of Prenatal Alcohol Exposure From Surviving to Thriving": A Focused Review of Interventions for Fetal Alcohol Spectrum Disorders to Guide a Shift Toward Strengths-Based Intervention Development. Structural and Functional Imaging of Alcohol's Effects on the Brain Brain Microstructure in Alcohol Addiction: Characterization of Diffusion-based MRI Biomarkers, Neuropathological Substrates, and Functional Consequences Determinants of Risk Developmental Trajectories for Risky and Harmful Alcohol Use: Lessons from the IMAGEN Consortium Impulsivity and Alcohol Use Disorder Brain-Immune Mechanisms in Alcohol Use Disorder Targeting Neuroimmune Signaling in Alcohol Use Disorder: Opportunities for Translation Brain Alterations and Cognitive Deficits Induced by Alcohol Use Disorder The Genetics of Alcohol Use Disorder Alcohol Responses as Phenotypic Markers of AUD Risk - Lessons from Longitudinal Studies#xa0; Early Life Adversity as a Risk Factor in Alcohol Addiction Animals Models Used to Study Alcohol Use Disorder Alcohol Use Disorder: Stress, Negative Reinforcement, and Negative Urgency Laboratory Parameters in Heavy Drinkers Histology of Alcohol-related Liver Disease Non-Invasive Fibrosis Assessment in Alcohol-Related Liver Disease Noninvasive Biomarker Screening and Alcohol-Related Liver Disease in the General Population Evidence for Red Blood Cell-derived Aspartate Aminotransferase in Heavy Drinkers#xa0; Fibrosis Screening of Alcohol-related Liver Disease Based on Elastography Portal Hypertension in ALD The impact of alcohol components in ulcerative colitis and Crohn's disease Coagulation Disorders in Patients with Alcoholic Liver Cirrhosis Hepato-renal Syndrome in Patients with Alcohol-related#xa0;Liver Disease Acute Liver Failure Due to Alcohol Intoxication- therapeutic Options Medical aspects of alcohol consumption and alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease IX Molecular mechanisms of of alcohol-related liver disease X Severe alcoholic hepatitis Severe alcoholic hepatitis X Severe alcoholic hepatitis X Severe alcoholic hepatitis X Severe alcoholic hepatitis Alcohol-related damage of other organs XI Alcohol-related damage of other organs XI Alcohol-related damage of other organs XI Alcohol-related damage of other organs XII Alcohol and cancer Alcohol and cancer XII Alcohol and cancer Center experiences for the interdisclipninary managment of alcohol use XIII Center experiences for the interdisclipninary managment of alcohol use -- Management of Acute Alcohol Withdrawal: Practical Considerations and Role of Comorbidities Pathophysiology of Ethanol and Unexplained Observations Ethanol Metabolism Modulation of Alcohol-related Liver Disease by Obesity and Diabetes The Genetics Of Alcohol-Related Liver Disease (ALD) Mechanisms of Alcohol-related Liver Cirrhosis Alcoholic Fibrosis/Cirrhosis And Its Reversibility Alterations in Methionine Metabolic Pathway in the Pathogenesis of Alcohol-associated Liver Disease Mitochondria and Alcohol Hepatic Iron Overload in Heavy Drinkers: Molecular Mechanisms and Relation to Hemolysis and Enhanced Red Blood Cell Turnover Ethanol-Mediated Bone Marrow Toxicity And Impaired Erythropoiesis: Implications For Alcohol-Related Liver Disease The "Matrisome" and Alcohol-related Liver Disease MicroRNAs and Alcohol-associated Liver Disease Intestinal bacteria and bacterial endotoxin in the development and therapy of alcohol-related liver disease Microbiota and alcoholic liver disease Alcohol Potentiates HIV-induced Hepatotoxicity via Induction of Lysosomal Damage in Hepatocytes Pathophysiology Of Alcoholic Hepatitis: Emerging Role Of Enhanced Red Blood Cell Turnover#xa0; Diagnosis and Staging of Disease-severity in Symptomatic Alcoholic Hepatitis Management of Severe Forms of Alcoholic Hepatitis Mechanisms of Recovery from and Strategies for Survival of Severe Alcoholic Hepatitis and ACLF The Role of Liver Biopsy and Hepatic Venous Pressure Gradient for the Diagnosis and Prognosis of Severe Al oholic Hepatitis Skeletal Muscle and Adipose Tissue; Targets or Relays for Interorgan Axis in Alcohol-induced Tissue Injury? Alcoholic Cardiomyopathy: Pathogenic Aspects Ethanol and heart failure: A clinical perspective Wernicke-Korsakoff Syndrome Mechanisms of Alcohol-mediated Cancer ; Alcohol and Cancer: The Epidemiological Evidence Alcohol-related Cancers of the Esophagus, Head and Neck, and Stomach in East Asians Model for Secondary Health Care Alcohol Services Optimising the Response to Alcohol Use Disorders in Acute Hospitals The Interdisciplinary Approach to AUD: What a Hepatologist can do in a Resource Limited Setting. .

Importance: Both low and high gestational weight gain have been associated with adverse maternal and infant outcomes, but optimal gestational weight gain remains uncertain and not well defined for all prepregnancy weight ranges. Objectives: To examine the association of ranges of gestational weight gain with risk of adverse maternal and infant outcomes and estimate optimal gestational weight gain ranges across prepregnancy body mass index categories. Design, setting, and participants: Individual participant-level meta-analysis using data from 196 670 participants within 25 cohort studies from Europe and North America (main study sample). Optimal gestational weight gain ranges were estimated for each prepregnancy body mass index (BMI) category by selecting the range of gestational weight gain that was associated with lower risk for any adverse outcome. Individual participant-level data from 3505 participants within 4 separate hospital-based cohorts were used as a validation sample. Data were collected between 1989 and 2015. The final date of follow-up was December 2015. Exposures: Gestational weight gain. Main outcomes and measures: The main outcome termed any adverse outcome was defined as the presence of 1 or more of the following outcomes: preeclampsia, gestational hypertension, gestational diabetes, cesarean delivery, preterm birth, and small or large size for gestational age at birth. Results: Of the 196 670 women (median age, 30.0 years [quartile 1 and 3, 27.0 and 33.0 years] and 40 937 were white) included in the main sample, 7809 (4.0%) were categorized at baseline as underweight (BMI <18.5); 133 788 (68.0%), normal weight (BMI, 18.5-24.9); 38 828 (19.7%), overweight (BMI, 25.0-29.9); 11 992 (6.1%), obesity grade 1 (BMI, 30.0-34.9); 3284 (1.7%), obesity grade 2 (BMI, 35.0-39.9); and 969 (0.5%), obesity grade 3 (BMI, ≥40.0). Overall, any adverse outcome occurred in 37.2% (n = 73 161) of women, ranging from 34.7% (2706 of 7809) among women categorized as underweight to 61.1% (592 of 969) among women categorized as obesity grade 3. Optimal gestational weight gain ranges were 14.0 kg to less than 16.0 kg for women categorized as underweight; 10.0 kg to less than 18.0 kg for normal weight; 2.0 kg to less than 16.0 kg for overweight; 2.0 kg to less than 6.0 kg for obesity grade 1; weight loss or gain of 0 kg to less than 4.0 kg for obesity grade 2; and weight gain of 0 kg to less than 6.0 kg for obesity grade 3. These gestational weight gain ranges were associated with low to moderate discrimination between those with and those without adverse outcomes (range for area under the receiver operating characteristic curve, 0.55-0.76). Results for discriminative performance in the validation sample were similar to the corresponding results in the main study sample (range for area under the receiver operating characteristic curve, 0.51-0.79). Conclusions and relevance: In this meta-analysis of pooled individual participant data from 25 cohort studies, the risk for adverse maternal and infant outcomes varied by gestational weight gain and across the range of prepregnancy weights. The estimates of optimal gestational weight gain may inform prenatal counseling; however, the optimal gestational weight gain ranges had limited predictive value for the outcomes assessed. ; Avon Longitudinal Study of Parents and Children (ALSPAC): Funded by grant 102215/2/13/2 from the UK Medical Research Council and Wellcome, core support from the University of Bristol, grant R01 DK10324 from the US National Institutes of Health, grant agreement 669545 from the European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013), award MC_UU_12013/5 from the UK Medical Research Council, and Dr Lawlor is a National Institute for Health Research senior investigator (NF-SI-0611-10196). Cohort of Newborns in Emilia Romagna (CoNER): No funding reported. Danish National Birth Cohort (DNBC): The Danish Epidemiology Science Centre initiated and created the DNBC and this center was established by the Danish National Research Foundation via a major grant. Additional support was obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation. The 7-year follow-up study was supported by award 195/04 from the Lundbeck Foundation and award SSVF 0646 from the Danish Medical Research Council. Étude des Déterminants pré et postnatals du développement et de la santé de l'ENfant (EDEN): Supported by the French foundation for medical research, the French national agency for research, the French national institute for research in public health (IRESP: TGIR cohorte santé 2008 program), the French ministry of health, the French ministry of research, the INSERM bone and joint diseases national research and human nutrition national research programs, Paris-Sud University, Nestlé, the French national institute for population health surveillance, the French national institute for health education, the European Union FP7 programs (2007-2013; HELIX, ESCAPE, ENRIECO, and Medall projects), the French diabetes national research program through a collaboration with the French association of diabetic patients, the French agency for environmental health safety (now ANSES), the Mutuelle Générale de l'Education Nationale (a complementary health insurance), the French national agency for food security, and the French-speaking association for the study of diabetes and metabolism. Family and Children of Ukraine (FCOU): Supported by the Fogarty International Center at the US National Institutes of Health, the US National Institute of Environmental Health Sciences, the US Centers for Disease Control and Prevention, the US Environmental Protection Agency, and the National Academy of Medical Sciences of Ukraine. Genetica e Ambiente: Studio Prospettico dell'Infanzia in Italia (GASPII): Supported by the Italian ministry of health. Groningen Expert Center for Kids with Obesity (GECKO Drenthe): Supported by an unrestricted grant from Hutchison Whampoa Ltd and funding from the University of Groningen, Well Baby Clinic Foundation Icare, Noordlease, the Paediatric Association of the Netherlands, and Youth Health Care Drenthe. Genetics of Glucose regulation in Gestation and Growth (Gen3G): Supported by operating grant 20697 from the Fonds de recherche du Québec en santé, operating grant MOP 115071 from the Canadian Institute of Health Reseach, a grant from Diabète Québec, and operating grant OG-3-08-2622-JA from the Canadian Diabetes Association. Generation R: The general design of the study received financial support from Erasmus MC, University Medical Center Rotterdam, Erasmus University Rotterdam, the Netherlands Organization for Health Research and Development, the Netherlands Organisation for Scientific Research and the Ministry of Health, Welfare, and Sport, and the Ministry of Youth and Families. The research leading to these results received funding from the European Union Horizon 2020 Research and Innovation Programme under grant 733206 (LifeCycle Project). Dr Jaddoe received grant ERC-2014-CoG-648916 from the European Research Council. Dr Gaillard received grant 2017T013 from the Dutch Heart Foundation, grant 2017.81.002 from the Dutch Diabetes Foundation, and grant 543003109 from the Netherlands Organisation for Health Research and Development. Generation XXI: Funded by Programa Operacional de Saúde–Saúde XXI, Quadro Comunitário de Apoio III and Administração Regional de Saúde Norte (Regional Department of Ministry of Health), by POCI-01-0145-FEDER-016837 through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology (Portuguese Ministry of Science, Technology, and Higher Education) under the project PathMOB, by FCT PTDC/DTP-EPI/3306/2014 (Risco cardiometabólico na infância: desde o início da vida ao fim da infância), by POCI-01-0145-FEDER-006862 and UID/DTP/04750/2013 (Unidade de Investigação em Epidemiologia-Instituto de Saúde Pública da Universidade do Porto), and FCT investigator contract IF/01060/2015 awarded to Dr A. C. Santos. Growth, Exercise and Nutrition Epidemiological Study In preSchoolers (GENESIS): Supported by a research grant from Friesland Hellas. German Infant Nutritional Intervention plus environmental and genetic influences (GINIplus): Supported for the first 3 years by the Federal Ministry for Education, Science, Research, and Technology (intervention group) and Helmholtz Zentrum Munich (observation group). The 4-, 6-, 10-, and 15-year follow-up examinations were covered from the respective budgets of the 5 study centers (Helmholtz Zentrum Munich, Research Institute at Marien-Hospital Wesel, LMU Munich, TU Munich, IUF-Leibniz Research-Institute for Environmental Medicine at the University of Düsseldorf) and by funding from the European Commission 7th Framework Programme (MeDALL project), Mead Johnson, and Nestlé and grant FKZ 20462296 from the Federal Ministry for Environment (awarded to IUF Düsseldorf). Norwegian Human Milk Study (HUMIS): Funded by award FP7/2007-2013 from the European Commission 7th Framework Programme, grant 289346 from European Union EarlyNutrition project, and by funds for project 213148 from the Norwegian Research Council's MILPAAHEL programme. INfancia y Medio Ambiente (INMA)-Sabadell: Funded by grant Red INMA G03/176 from the Instituto de Salud Carlos III in Spain and grant 1999SGR 00241 from the Generalitat de Catalunya-CIRIT. INMA-Valencia: Funded by grants FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1 from the European Commission, grants G03/176, FIS-FEDER PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, Miguel Servet FEDER CP11/00178, CP15/00025, and CPII16/00051 from the Instituto de Salud Carlos III in Spain, and grants UGP 15-230, UGP-15-244, and UGP-15-249 from the Generalitat Valenciana, Foundation for the Promotion of Health and Biomedical Research of Valencia Region. INMA-Gipuzkoa: Funded by grants FISFIS PI06/0867, FIS-PS09/0009 0867, and Red INMA G03/176 from the Instituto de Salud Carlos III in Spain, grants 2005111093 and 2009111069 from the Departamento de Salud del Gobierno Vasco, and grants DFG06/004 and FG08/001 from the Provincial Government of Guipúzcoa. INMA-Menorca: This study was funded by grant Red INMA G03/176 from the Instituto de Salud Carlos III in Spain. Child, parents and health: lifestyle and genetic constitution (KOALA): Data collection from pregnancy up to the age of 1 year was supported by grants from Royal Friesland Foods, the Triodos Foundation, the Phoenix Foundation, the Raphaël Foundation, the Iona Foundation, the Foundation for the Advancement of Heilpedagogie, the Netherlands Organisation for Health Research and Development (2100.0090), the Netherlands Asthma Foundation (3.2.03.48 and 3.2.07.022), and the Netherlands Heart Foundation (2008B112). Krakow Cohort: Funded by grants R01ES010165 and R01ES015282 from the US National Institute of Environmental Health Sciences and by funding from the Lundin Foundation, the John and Wendy Neu Family Foundation, the Gladys and Roland Harriman Foundation, and the Anonymous Foundation. Influences of Lifestyle-Related Factors on the Immune System and the Development of Allergies in Childhood plus the influence of traffic emissions and genetics (LISAplus): Mainly supported by grants for the first 2 years from the Federal Ministry for Education, Science, Research, and Technology, the Helmholtz Zentrum Munich, the Helmholtz Centre for Environmental Research-UFZ, the Research Institute at Marien-Hospital Wesel, and a pediatric practice in Bad Honnef. The 4-, 6-, 10-, and 15-year follow-up examinations were funded by the respective budgets of the involved partners (the Helmholtz Zentrum Munich, the Helmholtz Centre for Environmental Research-UFZ, the Research Institute at Marien-Hospital Wesel, a pediatric practice in Bad Honnef, and the IUF–Leibniz-Research Institute for Environmental Medicine at the University of Düsseldorf), by grant FKZ 20462296 from the Federal Ministry for Environment (awarded to IUF Düsseldorf), and by support from the European Commission 7th Framework Programme (MeDALL project). LUKAS Cohort: Funded by EVO/VTR grants, grants 139021 and 287675 from the Academy of Finland, grant QLK4-CT-2001-00250 from the European Union, and funding from the Juho Vainio Foundation, the Foundation for Pediatric Research, the Päivikki and Sakari Sohlberg Foundation, the Finnish Cultural Foundation, and the National Institute for Health and Welfare in Finland. Norwegian Mother and Child Cohort Study (MoBa): Supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research, contract N01-ES-75558 with the US National Institute of Environmental Health Sciences, and grants UO1 NS 047537-01 and UO1 NS 047537-06A1 from the US National Institute of Neurological Disorders and Stroke. Nascita e INFanzia: gli Effetti dell'Ambiente (NINFEA): Partially funded by the Compagnia San Paolo Foundation and by the Piedmont Region. Prevention and Incidence of Asthma and Mite Allergy (PIAMA): Supported by the Organization for Health Research and Development, the Organization for Scientific Research, the Asthma Fund, the Ministry of Spatial Planning, Housing, and the Environment, and the Ministry of Health, Welfare, and Sport (all organizations in the Netherlands). Piccolipiù Project: Financially supported by CCM grants during 2010 and 2014 from the Italian National Center for Disease Prevention and Control and funding (art 12 and 12 bis D.lgs 502/92) from the Italian Ministry of Health. PRegnancy and Infant DEvelopment (PRIDE Study): Supported by grants from the Netherlands Organization for Health Research and Development, the Radboud Institute for Health Sciences, and the Lung Foundation Netherlands. Project Viva: Funded by grants R01 HD034568 and UG3OD023286 from the US National Institutes of Health. Polish Mother and Child Cohort Study (REPRO_PL): Funded by grants DEC-2014/15/B/NZ7/00998 and FP7 HEALS 603946 from the National Science Centre in Poland and grant 3068/7.PR/2014/2 from the Polish Ministry of Science and Higher Education. Exposure of Preschool-Age Greek Children (RHEA): Financially supported by European Commission projects FP6-2003-Food-3-NewGeneris, FP6-STREP Hiwate, FP7-ENV.2007.1.2.2.2, FP7-2008-ENV-1.2.1.4 Envirogenomarkers, FP7-HEALTH-2009-single stage CHICOS, FP7-ENV.2008.1.2.1.6, FP7-HEALTH-2012, and 211250-Escape and proposals 226285 ENRIECO and 308333 HELIX and by the Greek Ministry of Health. Slovak PCB Study: Support was provided by grants R01 CA096525, R03 TW007152, P30 ES001247, P30 ES023513, and K12 ES019852 from the US National Institutes of Health. STEPS: This study was supported by the University of Turku, Abo Akademi University, the Turku University Hospital, the City of Turku, the Juho Vainio Foundation, and the Yrjö Jahnsson Foundation and by grants 121569 and 123571 from the Academy of Finland. Southampton Women's Survey (SWS): Supported by funding from the Medical Research Council, the National Institute for Health Research Southampton Biomedical Research Centre, the University of Southampton, Dunhill Medical Trust, and the University Hospital Southampton National Health Service Foundation Trust, FP7/2007-2013 from the European Commission 7th Framework Programme, and grant 289346 from the European Union EarlyNutrition project.

In 2008, when food prices rose precipitously to record highs, international attention and local policy in many countries focused on safety nets as part of the response. Now that food prices are high again, the issue of appropriate responses is again on the policy agenda. This note sets out a framework for making quick, qualitative assessments of how well countries' safety nets prepare them for a rapid policy response to rising food prices should the situation warrant. The framework is applied using data from spring 2011, presenting a snap?shot analysis of what is a dynamically changing situation. Based on this data safety net readiness is assessed in 13 vulnerable countries based on the following criteria: the presence of safety net programs, program coverage, administrative capacity, and to a lesser degree, targeting effectiveness. It is argued that these criteria will remain the same throughout time, even if the sample countries affected will be expected to vary. Based on this analysis the note highlights that though a number of countries are more prepared than they were in 2008, there is still a significant medium term agenda on safety net preparedness in the face of crisis. In this context, strategic lessons from the 2008 food crisis response are presented to better understand the response options and challenges facing governments and policy makers. The note concludes by calling for continued investment and scale up of safety nets to mitigate poverty impacts and help prevent long term setbacks in nutrition and poverty.

Part two of an interview with Julia Casey. Topics include: Food that was purchased and prepared when Julia was growing up. Formalities between the Italians in her neighborhood. How the children would play. The Roxbury neighborhood house that started a girls club and the types of activities they participated in. The nurses and doctors who would visit the neighborhood. Home remedies for sickness. How Julia and her husband met. How their marriage was received by their families. What it means to be Italian. Julia did not grow up in a religious community. What it was like to move to Fitchburg from Boston. The different expectations of boys and girls in Julia's family. Julia's children and their jobs. How speaking proper Italian has benefited Julia. ; 1 JULIA: In, in these little -- I mean, they still have the same candleholders. I've got them on my dining room table, but, but they didn't have -- I don't remember the candles. I remember these little wicks. I'm gonna ask my friend about that. And they would float on top, and you would think it would be kind of dangerous, wouldn't you? But I still remember these little candles they would keep bringing. Now, that was one of the customs, but they have special foods on the 19th of March. It was I think the Feast of St. Joseph, if I'm not mistaken. INTERVIEWER: Yeah, it is. Mm-hmm. JULIA: And the lady across the street would make that little Italian pasta they called orzo, and I think it was a type of barley. They would make the actual grain itself and the orzo pasta, O-R-Z-O—you can buy it in any market today—it was shaped like that. But they would make a dish from, I think, I think it might've been barley, and they made that on the Feast of St. Joseph. That was the custom where they came from. INTERVIEWER: Did they also make -- I don't remember what it's called -- but fried dough, little pizzas? JULIA: No, that was not, not common. I didn't know any -- no, and we didn't eat pizza, not like they do today. I know that my father, there was a barroom about a mile away from us, an Italian barroom in another Italian section, and that then made pizzas. And very, very seldom did I ever know of anyone who made pizza. You know, one of the ways that they did was they used to dip bread in tomato sauce, which is all pizza is, but I never actually knew families who made pizza. That didn't come into fashion until long after the war. INTERVIEWER: So living with all of these different people, no one really made pizzas? JULIA: No, no one made pizza that I knew of, you know.2 INTERVIEWER: Mm-hmm. JULIA: And nobody made lasagna. And raviolis, very seldom did anybody make raviolis. Why, I remember that in the [Piedmontese] family they would make these very fine Italian sausages with white wine, you know. Some of them made bread, but it was a problem because the bread man from the Italian, the big Italian bakeries in Boston, would come through the street. We -- they went out shopping but they went out mostly to buy different kinds of meat and specialties. But we had food then, clocks with fresh food, fish. The chicken man came, vegetable man came through the streets, and the women would just buy what they needed right on the street. On Saturdays they'd go shop; everybody went out with bags. They'd go into downtown Boston and buy special things that they, you know, couldn't get, but for the most part they went shopping once a week. They would go to their special stores to buy, you know, different kinds of spaghetti and pasta. They used to buy them in big boxes, some of the families, 10, 20-pound boxes of fine -- long, long spaghetti. And they didn't have the varieties that they have now, you know, but I mean, if they wanted salamis they'd have to go to the Italian delicatessens where they sold the different kinds of salami and everybody ate different kinds, you know. My father would go in and bring home these packages. The markets -- we went to the -- in the north, and with Petrini and Baldini, and they would slice the salami paper-thin and they'd weigh it out on gorgeous pieces of wax paper in beautiful, even rolls, every kind all rolled up. You know, he'd bring them home and we'd go crazy. Italian bread and salami, those are our idea of living, prosciutto, you know, salame crudo, salame cotto, [unintelligible - 00:05:11]. And they used to make -- my mother made lintels with a special, big liver sausage and other kinds of, 3 you know, pork sausage, and that was a dish that they had once in a while. So the food was very -- it was, whatever house you went into there was a different tradition. Every region had different… INTERVIEWER: Was there a lot of sharing? JULIA: No. I wouldn't say that, no. There was -- they maintained, really, a great deal of respect and formality. You know my mother lived with these families, 13, 18, 20 years, she would never think of going downstairs without, you know, knocking on the door and saying permesso when someone answered. You always said permesso before you entered. INTERVIEWER: Mm-hmm. JULIA: She -- and they referred to each other as signora. They didn't call each other by their first names for many, many, many years, you know. INTERVIEWER: Even with the… JULIA: Unless they were said, unless you were told, you know, "Call me Angelina," "Call me Celestina." They knew the first names, but they really observed quite a formality. INTERVIEWER: Is that among people even in the same region, from…? JULIA: No, if they were from the same region, you know, then they would call each other that, that way. But from another area, until they got to really know each other, quite a while, you know. They -- some of the southern Italians worked in stitching shops. We had a family who had a pants -- he was in manufactured pants, and various of his women relatives and men relatives were in downtown Boston, you know. Most of them did well; they were frugal people. Their children bought automobiles, very few of the originals, you know, immigrants, bought any. So we had a kind of a clear street for playing. That's why we were able to play jump rope and hoist the 4 green sail and red rover and hide and seek. We played all these games on the street. The girls who were a little bit older than we were, they'd come out of the laundries, and if we'd be playing double-dutch jump rope, they'd come and swing -- we're talking long clotheslines -- swinging long clotheslines in the street, double-dutch, you know. Now, I think only the black girls do it, very complicated. INTERVIEWER: Yeah, the cities. I think it's popular in the cities still. JULIA: Yeah. Well, now you have too many cars. You don't have any clear spaces to play things like that. The boys made -- what do they call them, I don't know, scooters out of roller skates of two by fours on orange crates [laughter] and go whizzing along the street with these homemade things, you know. INTERVIEWER: Did the girls ever do that? Do they ever borrow these scooters? JULIA: No, we were, we were not tomboys. As I said, our mothers kept an eye on us, and they would play stickball, the boys. We would play catch, among the girls. But -- and we belonged to a settlement house, a bunch of us did, and they took us to camp… INTERVIEWER: Was there any…? JULIA: In fact, I still have a picture of a group of us. INTERVIEWER: The settlement house, was there any…? JULIA: The Roxbury neighborhood house on Albany Street, which was there for, maybe, 50, 75 years. Its special work was to help the immigrants integrate into American ways of society, and they provided clubs. Somebody came to our street and started up a library, a girls' club, and as a result of that group -- and it was one of the Boston's Brahm-, a woman from the Boston Brahmin family who, you know, belonged to -- this was their way of doing social work, women that were brought up very well-educated in the Back Bay or Beacon Hill area of Boston, belonged to these old families 5 whose, many of whose ancestors had made their money on merchant ships, you know. And that was one of the works that they did. And they take to our street, and the street next to ours, and they started a girls' club. They would bring books, and we learned to do a little crafts, knitting, and then eventually, we joined the neighborhood house and they had a camp in Bennington, New Hampshire, to which we went, and they would take us to wealthy homes for once a year, say, for picnics out in the country. And then at the neighborhood house, we put on plays. I remember one time we went to Simmons College, and a group of us put on a play, Little Lord Fauntleroy. One of us had a green velvet costume, put it on for the students, and then we danced, and we talked about different things. And as I said, we did some crafts and they encouraged whatever they saw, for instance, they -- I liked classical music. I don't know why because, you know, I mean, in that generation very few people had pianos—but they did have phonographs, you know. We didn't. But somehow I was attracted to classical music and I was able to get tickets to the youth concerts at Symphony Hall through the neighborhood house. And it was wonderful, you know. In fact, the girls that grew up after us did the same thing. They belonged to the neighborhood house and had their own little group. INTERVIEWER: Now, is this a place that really catered to the Italians? JULIA: No, it catered to -- Roxbury was sort of in the area, there were a lot of Italians there, but it didn't cater to them especially. There were people, you know, from other groups and this -- the odd part was that our neighborhood was not connected to any other neighborhood. It was isolated; that's what made it so close. Many of the young people that grew up there married each other. That's one of the reasons that the families maintained contacts, you know. 6 A number of people that I knew married other people from the neighborhood, and so from one, you would hear the news of what's going on with others even though they lived in faraway suburbs through those family connections. INTERVIEWER: Mm-hmm. JULIA: But we didn't interact with other Italian neighborhoods at all. We had this industrial area that we had a big playground that the kids on my street didn't use very well, and it was right next to our elementary school. But our families would never let us go to these industrial areas in the afternoon or night; that's why we were confined to our streets. INTERVIEWER: And that's where you'd play. JULIA: Right. INTERVIEWER: So when you were part of the Roxbury neighborhood house, was that your first exposure, really, to other ethnic groups? JULIA: But we stayed together; the girls from my street stayed together in their own group, and we did not interact unless we were -- and we put on our own little plays. Oh, we put on a supper one night for the staff of the neighborhood house, the head of it. Dear God, what was her name? Her brother was a very, a world-famous Shakespearean actor. I can still see him now—tall and thin, with great refinement. These women were all college graduates. Some of them had gone to the Simmons School of Social Work. At that time that was a very important area of study. You know, at the house in Chicago, these women became -- well, it was called social workers but not the same way as they do in the Welfare Department. This was real social work. And the house was an offshoot of the settlement house movement that started with our house in Chicago. They had them all over the east, eastern part of the country, you know, so they'd seen all 7 different kinds of ethnic groups. But they were very refined women. They taught piano, they taught music, and they had a library. They got college girls to come in and help tutor students who wanted to be tutored. They provided many services. They went out into the neighborhoods. And they, along with our elementary school nurse, provided wonderful medical services for those neighborhoods. My sister, who was born two years after I was—I said she was my brother's twin—was very seriously brain-damaged, and the result of that was that, you know, my mother's life was pretty terrible for the -- until she died, she was a serious epileptic, at ten. INTERVIEWER: She was epileptic until she was ten? Is that it? JULIA: She died when she was eleven. INTERVIEWER: Old enough. JULIA: At the age of ten, when she was about ten or eleven, my mother found herself pregnant with my youngest sister. And the visiting nurses used to come to the street, whom I think, it might've been through the Metropolitan Insurance Company. They would come in their blue uniforms, and they would visit all these Italian women who had any need for any kind of medical service. If one of them was pregnant, she came and spoke to you and advised you how to take care of yourself. She did the prenatal work. You didn't go to the hospital or a doctor if she advised you, but she did notify the hospital of when the birth was expected. INTERVIEWER: Mm-hmm. JULIA: But she gave you, you know, information on good health and hygiene and what you needed to eat. Because the Italian women, they were naturals at this, except my mother, who had grown up in a family that was extremely reserved and she knew absolutely nothing when she came. You know, they didn't -- you grew up in Italian families in rural areas, then you, knew because they taught. 8 And, in fact, my mother even had a midwife, one of them had midwives who were… they were trained in folk medicine, you know. They weren't like the [unintelligible - 00:18:09]. That was why some of the births were pretty bad. INTERVIEWER: Oh. JULIA: But anyway, they would help each other by, you know, in that way, but they -- the visiting nurses and the school nurse. The school nurse, if she detected a problem with any student in the school, either from information by the teachers or -- we also had physical examinations, and doctors would come in once a year, and physically examine every child. She detected vision problems. If they detected anything, like they would catch phases of diabetes, they would catch all kinds of problems. The visiting nurse would immediately visit that child's family, and she would make the arrangements to have the child sent for examinations at Boston City Mass General, wherever there was specialists for whatever they saw, you went. Once a year you brought five cents, a bus would pull up to the school in relays, and everybody went to the dentist in Forsyth Clinic. For five cents, they did pulling and filling, and this is where the dentists were trained, so the student dentists would take care of you. INTERVIEWER: Do you feel that the settlement house then had changed your life in any way? JULIA: Oh, definitely. You know what? It performed wonderful services. In the first place it taught us, it taught -- besides the playing that we did on the street, it brought us into a little bit more of the American way, you know. It brought a little more cohesion, and we learned to do things that we couldn't have learned on our own. Although, on our street they used to put on, like, shows, so we'd dance in -- strictly amateur, and one of the mothers made crepe 9 paper costumes. She could run them up so rapidly, I could still remember this purple crepe dress that was [laughter] with ruffles and a [unintelligible - 00:20:43] here, a ruffles on the skirt, and I still keep in touch with her daughter. INTERVIEWER: Wow. JULIA: They were clever. This lady would go into the stores and see something in the window, a dress. And she'd fix it in her mind and come home and cut out a pattern out of newspapers from what she remembered, and she would produce dresses for her daughters. INTERVIEWER: So it exposed you more to an American way of life? JULIA: Yeah, it did. And you know, besides our old school teachers, they spoke beautiful English. INTERVIEWER: Were you going to school with mostly Italians? JULIA: Yeah. INTERVIEWER: Only Italians, or…? JULIA: Well, I would say a lot. The Irish had more or less moved away from that section of Roxbury, even though our parish church was St. Patrick, and the Irish had moved well up beyond Dudley Street because they were by that time much more affluent. INTERVIEWER: Mm-hmm. But it sounds like the neighborhood that you grew up in was so harmonious. JULIA: Yeah. INTERVIEWER: Did you ever feel any sense of conflict when you went to school or outside the confines of the neighborhood? JULIA: We did. We felt that, so there must've been a lot of what we used to refer to as American kids, who are probably mostly Irish descent. But we didn't have very -- we had hardly anything to do with them at all. There was one Irish family, the Kellys, and they went to parochial school, but actually they married into the Italian community. And that was the only Irish family I knew. INTERVIEWER: Mm-hmm.10 JULIA: My father had a few Irish tenants who we didn't think too much of. Going to the Depression they would never pay their rents, you know, but then… INTERVIEWER: In that six-family house that your father owned, were there other relatives living in the house? JULIA: No. INTERVIEWER: No? JULIA: No. There were, you know, strange people who came. And during the Depression men sold wine, you know. In fact, even during Prohibition some of them did. We would find taxis coming into the street, and I don't know how people got, you know, the names of people who would sell the wine but if you had no money, or very little money, you made money any way you could, you know. INTERVIEWER: Mm-hmm. JULIA: So. INTERVIEWER: So what about the other families from different regions? Would you call them by regions? JULIA: They were very -- they were, yeah. INTERVIEWER: I heard… JULIA: Calabrese, Baresi, Sicilian, yeah. INTERVIEWER: But when you referred to them I heard you just mentioned a little while ago that… JULIA: Yeah, Piedmontese. We had about four or five Piedmontese family. And of course, their dialect was even different. And that's next to Lombardi, but see, their dialect takes from the [unintelligible - 00:23:56]. INTERVIEWER: Oh, I see. JULIA: Right. INTERVIEWER: And where does yours? JULIA: More, you know, we -- down to the east of Lombardi is the Venetian province, and then you go up into the Tyrol, which today 11 is bordered by Austria. So the northern Italians, they don't put final vowels on their words. They chop it off, you know. INTERVIEWER: Yeah. So I was -- I've been noticing your pretty green eyes. Where did you get those? JULIA: All Italians have their, you know, you'll -- there's a brown-eyed type, but you can find green-eyed Italians in Sicily. INTERVIEWER: Really? JULIA: Oh, yes. Hazel, you know. INTERVIEWER: Mm-hmm. JULIA: Grey from my mother and father. They didn't have brown eyes. Nobody in my family had brown eyes. INTERVIEWER: Hmm. Wandering in your neighborhood, was there a woman that people would go to for advice, or…? JULIA: On the next street there was a lady who apparently had been, you know -- there were many ways to educate people, have always have been. And some people were very wise. She was in America a lot longer than the other women. She had a big family with grown, with grown-up sons, so she was -- and she came from a family where she was told a great many things and learned many things. So yes, there were some women who knew about things, but since they all came from different regions they all knew their own customs, and they had different ways of treating, you know, headaches, or -- I remember my grandmother used to slice potatoes and put them inside wrapped, fold them into a cloth, and when somebody had a headache, my aunt did that, too. They would put these sacks of potatoes in this cloth; they would just tie the cloth and bath with them. I don't know why. They used to string garlic if they thought a child had worms, and a child would wear this string of garlic around his neck. And if you had a boil, my mother would cook linseed flower. They'd buy them in the drugstore, only in the Italian drugstore, and you would 12 make poultice—that was very common. Some people used bread and water, and you would have this thing on whatever bump you had that you wanted to [unintelligible - 00:26:47]. They were really strep infections, but they didn't know strep infections, you know. There were boils, and if you have a little infection in your finger or thumb, you'd wrap it up in bread and water with a bandage or poultice of some kind. Even the American doctors would recommend them. They'd tell you, you got -- check moisture and heat would cause these things to mature. INTERVIEWER: Did you notice that different regions…? JULIA: They would bring chamomile -- yes, Mrs. Mucci downstairs kept herbs, dried herbs, chamomile and what they referred to in America as mallow [unintelligible - 00:27:41] and I -- if that [unintelligible - 00:27:44] grew here, I had a plant one time. And they would buy these dried herbs at the Italian drugstores, and they would make teas out of them. You would drink them. If you had indigestion, the northern Italians would buy it in liquor stores. It was called Fernet, F-e-r-n-e-t. It's actually an [unintelligible - 00:28:10] in medicine containing a great deal of -- bitter, bitter! But many times you'd go visiting in, after you wake, sometimes before, you would get a tiny glass of Fernet. Branca – that was the trademark. It came in a green bottle. And it was co-, it was a digestive. It was -- because it was so bitter, it was considered to be good for your stomach. INTERVIEWER: So no matter what your age, you would get that? JULIA: Then we -- everybody had Belowski. INTERVIEWER: What's that? JULIA: May I give you either some hot tea or coffee? You must be exhausted. INTERVIEWER: No, I'm fine. I'm fine. It's not much longer. Thank you. JULIA: And get you as hot as broth, or as a broth.13 INTERVIEWER: No, I'm fine. Do you need something? JULIA: I get like this once in a while. But yes, I don't wanna move this thing. INTERVIEWER: I can take it off if you'd like. JULIA: I find the only thing is -- part of the [unintelligible - 00:29:15]. Five months ago he's a co-host by the senior -- high-styled program on FA-TV, so we call him the Mike Wallace… INTERVIEWER: And you've been married [unintelligible - 00:29:32] years? JULIA: [Unintelligible - 00:29:32], Linda. Linda! [Unintelligible - 00:29:35] HUSBAND: Oh, pardon my cold hand. JULIA: That's my husband, Phil. INTERVIEWER: Nice to meet you. HUSBAND: My pleasure. JULIA: In his museum of … in New… museum about neckties that I paid a fortune for. HUSBAND: Well, I sure got TV exposure today. JULIA: Yeah. He get to… who did you interview today? HUSBAND: I interviewed a very interesting 91-year old woodcarver. JULIA: Oh, my heavens. HUSBAND: Louis [Charpentier]. And then that was followed up by a group of Irish step dancers. And I didn't do anything on that, so they just dragged me from dancing, so all I could do was say, hello and goodbye. INTERVIEWER: Oh. HUSBAND: It was frustrating. JULIA: You know, Edcel Johnson wants you to let him know when that program is on now. HUSBAND: Oh, I'd bet they… JULIA: Teddy, too.14 HUSBAND: I bet -- all right. I bet they did that thing so I -- in my notebook there. INTERVIEWER: Was it a cable TV show? JULIA: Yes. It's at ATV. You know, the informational video… HUSBAND: It started innocently enough. I'm on the board for an organization called The Resources for the Elderly, and their primary function is to sponsor the Meals, Meals on Wheels and the Elderly Nutrition Program. Like they some -- it goes back about three, four years ago. It's been quite a while. They started this program—these are all volunteers and all seniors—it's called Senior Lifestyles. And as a TV show material that is supposedly of interest to the seniors, and it, it's partly information and partly entertainment. And so, as I say, I'm on the board for the Resources, and we were having a board meeting, and it just so happened that the woman who was then serving as host for the program for some time decided that that was enough for her, so they're looking for somebody to fill in as a host for the TV show. And one of the board members [woke] up and said, "Mr. Casey would be a good replacement." And somebody else said, "Yes, indeed. He would be great." JULIA: Oh, he loves women. HUSBAND: And I couldn't think of any reason why I couldn't or wouldn't do it, so before I knew it I had been drafted and I was serving as host to it. Then that's what I do. It's on once a month, and they have two half-hour segments. Usually last -- monthly only has one half-hour, but today we have two half-hour segments, and the first one was this Louis Charpentier. And my god, he was -- you know that guy we saw in the coffee shop? JULIA: I thought he was gonna be easy… HUSBAND: No, no, no. This is… JULIA: … interviewing famous carpenter. Oh, Louis Charpentier.15 HUSBAND: … this Louis, he is -- he claims to be 91 years old. JULIA: Oh, my heavens. INTERVIEWER: He looks wonderful. He does. JULIA: Did you see any of his work? INTERVIEWER: No. HUSBAND: I used to… JULIA: I think they have it at the library? HUSBAND: He used to be head of the plastics industry. And the plastics industry was an organization, apparently, that did work for all of the plastic shops in and around… JULIA: When you came with your ham sandwich a little mustardy. INTERVIEWER: I thought… JULIA: I thought you'd have sandwich. You've got to listen to me talk for four hours and have nothing. HUSBAND: Yeah. I'll have a ham sandwich. INTERVIEWER: Well, you have to get those though, because you said you had to wait… HUSBAND: Oh, that's all right. JULIA: I'm gonna call the lady and tell them you're gonna be a little late. HUSBAND: But anywho, this Louis is something else, and he was -- he started his woodcarving when he was only about two years old, apparently, while he had a carving that sold his home up to the farm up in -- well, back and around or back there, and there was the oxen that was plowing, there was his father, there was the house he lived in and his school, the whole bit. INTERVIEWER: So do you interview these people? HUSBAND: I interview them. I try to make intelligent conversation with them. JULIA: I have made intelligent conversations with them. HUSBAND: The thing that makes this fascinating is that I usually don't know until I arrived at the studio who is going to be the guest for the day. INTERVIEWER: Oh, that's difficult.16 HUSBAND: I have to -- I know it was… INTERVIEWER: Oh, Julia was just telling me about the tapes that you found in the [unintelligible - 00:34:30]. HUSBAND: Yes. INTERVIEWER: That's remarkable, especially because here I am two days later. JULIA: I know. INTERVIEWER: All about Italian dinner. JULIA: And on the other tape, what I said -- think it's a, seems to be a little illogical, I was wanting to say the least. In the other tape, you would have to guess who the family Christmas but then I'd read, since I wrote it all out, it's more logical, you know. It's more -- or less of a timely sequence. But I do give you the information I've given you about the broth. INTERVIEWER: Okay. JULIA: And… INTERVIEWER: It'll be interesting to make a… JULIA: Oh, yeah. I'm gonna make myself a sandwich if I can figure out how to open this slice of cheese. INTERVIEWER: Do you want some help? JULIA: Oh, I -- oh, here it is. Heavens! I thought. What's the matter with this? INTERVIEWER: How does your husband feel marrying an Italian? JULIA: It was an adjustment; let us put it that way. INTERVIEWER: Was it? JULIA: I met him… thank you for this. INTERVIEWER: Yes. HUSBAND: Tried one this morning. INTERVIEWER: Oh. So who made these? HUSBAND: The man I interviewed, Louis Charpentier. INTERVIEWER: Oh.17 JULIA: Oh, he gives you -- oh, I've seen him do that at the Historical Society where he teaches you how he got started. HUSBAND: Right. JULIA: And he tries to teach everybody that they can do the same thing. INTERVIEWER: Oh, so he was -- his work is just so good. Oh, he's so… HUSBAND: No, he used to work in plastic. And as I say, he works for -- he works in an organization that designed methods for making just about anything you wanted, buttons or, how do you say, [unintelligible - 00:36:18] or whatever it was called for… JULIA: I know he's just working now. He's in the library and… HUSBAND: No, no. He's retired. JULIA: Yeah. But where is his work? I know he started, he started on display somewhere. HUSBAND: Yes. It's in a home. He has it at home, because I asked him if it was all insured and he said that it was. JULIA: I don't know how… INTERVIEWER: So Phil, let me ask you, how did you feel marrying an Italian? HUSBAND: Oh, wow, it… JULIA: You should ask his mother. HUSBAND: No, we -- and now seriously, we had a problem. It's not because I married an Italian, no. It's just that my mother didn't particularly like Julia, unfortunately. I'm not sure what the root of her prejudice was. It might have been because of her heritage, or it might have been just because my mother didn't want me to get married at that point, although I was not exactly a teenager. I had come home from the war, and I was a book. But whatever reason or reasons my mother had she didn't actually… didn't actually -- she didn't oppose the marriage, but she didn't support it, and she didn't even show up for it. My father and my sister came. JULIA: Though she was my [unintelligible - 00:37:48], she cooked. She was great to the children.18 HUSBAND: Oh, yeah. That's right. She loved the, she loved her grandchildren. She was very -- and they had a great time. JULIA: She was very generous to me in many ways. HUSBAND: My son approved of Grandma's cooking, and they had a good time visiting her. And we all, every holiday, we make sure that there was a delegation that went to Grandma, though we tried and made a compromise. INTERVIEWER: Mm-hmm. Now, did you -- where did you grow up? HUSBAND: I grew up in Roxbury prior to the days when Roxbury had the… with the ethnic… JULIA: Now it is. HUSBAND: It is now. When I was -- I was there prior to that. INTERVIEWER: Thank you. JULIA: Lemon juice? INTERVIEWER: Thank you. HUSBAND: And by one of those strange coincidences, Julia lived the one part of Roxbury, I was in another. We had never laid eyes on each other before the war. Did she tell you about how…? INTERVIEWER: No. I don't know how you met. No. HUSBAND: Well, we met -- it was like something out of one of those [unintelligible - 00:39:12] that tells -- she had that series of how people tell how they -- I was in the Navy during World War II in an organization called the [CVs], and I was stationed overseas in New Guinea. I met her brother, who was in the combat engineers, and there was this [unintelligible - 00:39:37]. So I got to know him, and his platoon was involved in the invasion of the Philippines. They were moving out agents. So he said to me, he said, "Phil," he said, "we're going to be cut off from correspondence for a while. Would you do me a big favor and write to my mother and tell her that if you don't hear from me, not to worry, I'm all right?" So I said, "Sure, all right." And I did 19 that, I wrote to his mother, and his mother who was living in Roxbury, I sent a letter to Washington where my girlfriend was thankfully employed as a government girl. And I -- with instructions for her to answer this letter. So she answered the letter, and Julia and I started corresponding, and that's how we get to know each… JULIA: Fifteen months. HUSBAND: And then after the war, when I came home, I… JULIA: It was all over. HUSBAND: And then there… INTERVIEWER: What? What was all over? JULIA: It was all over. He was hooked. INTERVIEWER: Oh, he was flirting as soon as he saw you. HUSBAND: Then there was some kind of a breakdown in the romance, and we had separated. [Unintelligible - 00:41:00] and we get back together again and we could get married in 19… INTERVIEWER: How did her parents feel about her marrying an Irishman? HUSBAND: Oh, as far as I know… JULIA: Horrible. HUSBAND: Yeah. INTERVIEWER: Oh, with him? JULIA: My father… HUSBAND: There was a point in time when her father didn't care who she marries and who would take her off his hands. INTERVIEWER: Oh. JULIA: I was going to [unintelligible - 00:41:24]. HUSBAND: Yeah. I was even supposed to get a bicycle, a motorcycle for marrying her. JULIA: "Philly, I give you motorcycle [unintelligible - 00:41:34]." HUSBAND: No, but she… JULIA: You better [unintelligible - 00:41:38]20 HUSBAND: Neither one of those gifts materialized so, anyhow. No, I liked her father and mother. And of course, I had -- I was very friendly with her brother and sister. And so, we had the wedding, and that was a [unintelligible - 00:41:57] together. INTERVIEWER: How was she different from the, let's say, Irish girls that you went to school with? HUSBAND: Oh, she was a different. -- I didn't actually – I didn't know that many girls when I was going to school because you have to remember that when I was going to school, this was in the days when the boys went to one school and the girls went to another. Boy's school was an English high school. JULIA: But in elementary school… HUSBAND: Elementary was all boys because of… JULIA: Oh, you did? HUSBAND: Yeah. That's -- I went to the all… JULIA: Oh, I didn't know that. HUSBAND: With the nuns [unintelligible - 00:42:34]. JULIA: Well, I was actually the first female person you ever met. HUSBAND: No, not exactly. I met… JULIA: You may have seen New Guinea. HUSBAND: You have to define, there, the word "met." Kind of -- you were the first female that I was—let's put it this way—that I little became involved with. JULIA: Well. No. That's enough. INTERVIEWER: Well, we're in all kinds of things today. JULIA: Are you gonna have a ham sandwich? HUSBAND: Yes. I'll have a ham sandwich. So what is this project here? INTERVIEWER: This is a project that's recording the experiences of -- by Italian-American family in the Fitchburg and Leominster area. HUSBAND: Oh, yes.21 INTERVIEWER: But we had seen Julia at a -- one of the Italian night, the films that Fitchburg State College had put on, and Julia started talking extensively after the movie, Big Night, I think it was called Big Night. HUSBAND: Yes. INTERVIEWER: And we realized it was someone that maybe we'd like to talk to because she seems to know so much about the culture. HUSBAND: Yeah. And she is the one member of her family that has -- that is interested in the [unintelligible - 00:43:57] of the family extensively. JULIA: I was also the first one born in this country of my family. INTERVIEWER: Your family. HUSBAND: She was born in this country, which makes her an Italian-American, but she maintained contact, through her mother, maintained contact with Italy. She knows how to speak Italian, including the dialects of northern Italy. And now she is in the process of learning how to speak… INTERVIEWER: Right. HUSBAND: She's starting again. Yeah. INTERVIEWER: Now, were there any surprises though when you married…? JULIA: Yeah. Seven. INTERVIEWER: That's -- wow. Seven children, right. But the Italian culture, I'm wondering… HUSBAND: No, I didn't have any problem with that. I was very fond of her family. Wherever her family gathered then there was a party. And her family had always been most cordial to me. INTERVIEWER: What do your children consider themselves? HUSBAND: They consider -- when they think about it, they… you probably have to ask them how much they consider themselves to be Italian. JULIA: More than half. HUSBAND: Well, I don't know whether they really think about it.22 JULIA: They went to the parochial school in Dorchester, and their last name was Casey. So they fit right in. Even though there were a lot of Italians. And by this time, Dad is gone. You know, we're not immigrants anymore. Your father was a professional man who's a graduate of Boston College, and so that they didn't have to go through that. They… HUSBAND: I came up here; this is the first place I've ever been to where they couldn't spell Casey. They would actually went, "Case-, how do you spell that?' And I thought at first they were kidding me, because down in the Boston area there was a very large population of Irish-Americans. There's still a lot of Irish down there, some of them from Ireland itself, and some of them are there illegally. INTERVIEWER: And what traditions do you try to carry on in your family? JULIA: Well, the traditions are that they know that I'm intensely interested in the Italian part of the family. I have furniture, for instance. I have, you know, [unintelligible - 00:46:38] for years and other pieces that my mother gave me when she was… HUSBAND: They have -- girls have a lot of respect for Italian culture, and one of them had been over to Italy. Take your time. JULIA: This was an -- how did you get involved with this? INTERVIEWER: I'll call you all out when it's all right because… JULIA: Are we going to meet again? INTERVIEWER: I don't think so, unless you… when I leave, feel the need to talk about something else. JULIA: Are you -- do you need -- I would like to, if possible, because I had -- now, I have four appointments this afternoon, and I would like -- I was trying to figure out how I could get copies of these tapes. INTERVIEWER: I could have that done for you at Fitchburg State College. So I'll call you… JULIA: And you have more than one? INTERVIEWER: Probably. I'll call you next week…23 JULIA: All right. INTERVIEWER: Okay? Okay. So what does it mean to be Italian to you? JULIA: It doesn't, it doesn't mean that I have been all my life aware of the great contributions that the Italians have made. But I became more aware of them as I grew older, and it made a strong attachment to family. And as I said, I still have -- my close friends are still the kids that grew up, that I grew up with, they're still the people that I grew up with, even though we all live in different places. It means certain types of food. It means, especially to me, it means this age of almost 80, I am determined foreigner, and I have -- it means that whenever I meet anybody that is Italian, that speaks Italian -- to me there's quite a big difference between the northern and southern Italian. I've always been made of… INTERVIEWER: Tell me what you just said, always been aware of… JULIA: I've always been aware of the vast differences among the people from this one peninsula that juts out into the Mediterranean, that there is such a difference in everything about them—the food and the way they speak—and it's made me very, very aware of the differences that a language can develop into, almost different languages within a cohesive place, you know. We have this boot that goes down into the ocean split down the middle by this range of mountains, and yet every section you go to, because it was at one time a collection of city states—and somebody brought that up the other day in class, it was a collection of city states—and yet my mother's experiences and the way she spoke and lived was so different from everyone else's on my street. So being an Italian, to me, meant that I had to adjust to -- when I went to school I felt very out of it, because I started school in Lexington. My father bought a house in Lexington for a few years, and I had -- I just felt a complete foreigner because I spoke hardly any English myself since we were isolated in Lexington.24 But I -- after I came back to Boston, then I had to adjust and get used to all of the different -- the girls who came from different Italian families, all of them, were. They spoke differently, their parents spoke differently; they had all these different ways of doing things. And that adjustment was a wonderful experience for me. And it means -- now, I don't think so much of modern Italy. I feel that in some ways they've grown excessively. I've heard other people made this comment, too. I've read a couple of books that said the same thing, that they've become excessively materialistic. Certainly, you know, religion -- we were not, I will say another thing, we were not a religious community. The women -- the praying that was done, the observation of religion was private. Everybody didn't lead the street and go to church on Sunday. The young kids that were making their first communion, they had to go to church. We went to church in a group, but mothers and fathers for the most part didn't go near the church. The church was run by Irish priests; nobody understood the Italians, and we hardly ever saw a priest. And so it's very different from this situation here in Fitchburg where the Italians set up their own church on top of an Irish community that moved out, you know, the Irish community and church was St. Bernard's. The Italians, back 75 years ago, decided that long ago, that they wanted their own church, and they set it up, they found an Italian priest. And we were not -- women prayed on Sunday morning, sometimes you could look up at certain windows and a woman would be sitting there with an open book which was, obviously, a [unintelligible - 00:52:54] in Italian, and she would be reading her prayers. This is [unintelligible - 00:52:59]. They observed some of the saints' days, but it was not a community that went to church. Ever. INTERVIEWER: Now, what about making first communion and confirmation? Would you go into the north end?25 JULIA: No. Some of them did. INTERVIEWER: Mm-hmm. JULIA: A couple of the families sent their daughters into the north end to make -- but most of us that were the same age, there were, you know, about two or three or four at that time, then they would go to the parish church, you know, in a group, and that was also beyond the industrial area. So it was maybe a 15-minute, 20-minute walk, and we went because the nuns, where they have were training the kids in the catechism, we went to Sunday school. Then, because they didn't want us walking to that neighborhood, as we grew older, we started going to the Jesuit church, the Immaculate Concepcion in the south end, which was an enormous church but not a parish church. But then I belonged to the choir there; some of us joined the choir. And that was an all-American experience; there was no Italians. INTERVIEWER: So Fitchburg in 1968? JULIA: I cried all the time. I didn't -- I never wanted to leave Boston. You know, I did spend a very good experience, first, the college community… INTERVIEWER: Say that again? The college community? JULIA: The college community is a wonderful place. I've always been a reader. In that respect, the kind of reading that I did was quite different from what other girls on my street did, and I am unable to explain that. I am unable to explain the direction in which my own, which you might call intellectual growth. Well, I went to an all-girls high school, and I don't know why I was attracted to classical music and literature. And I mean, I practically lived at the public library. As a matter of fact it was his branch, too. His branch of the public library, he lived on the other side of it, but you know, until my brother met him in New Guinea and he wrote to my mother, I had never a clue that he was around.26 INTERVIEWER: So when you came to Fitchburg did you make any connections with Italian people? JULIA: Not at first. Not at first, because I was still taking care of the family. Later, then, as my children grew up and they met -- because we went to St. Camillus, and that is not an ethnic church, you know. So later -- actually, in the last 10 years, I would say, I… I've met 10, 20 youths through my children. My daughter married into a Fitchburg Italian. For a little while we joined the Sons of Italy. I joined the Virginia Eleanor Lodge, and I didn't keep it up, but you know, I've met a lot… INTERVIEWER: [Unintelligible - 00:56:16] speaking, what did your parents and the parents down street, what did they want for their children? JULIA: All they wanted was for them to grow up and to go to work. The girls were not encouraged to go to school. My sister, who, as I said, who came along 13 years after I did, was first college graduate on the street. She went to, she got… INTERVIEWER: Pick it up. You said… JULIA: My sister, Mary Louise, was the first girl to go to college in our entire neighborhood. INTERVIEWER: Now, how did that happen? JULIA: She was fairly smart in school, and she was in the class of 1952 at the same high school I had gone to in a girls' high school in Boston, and she got a teacher's scholarship. And she decided she wanted to be a nurse, and how she was scared, oh, instead of going into a hospital program… INTERVIEWER: This was in… JULIA: Back… out! Instead of going in to a three-year hospital program, somebody put it into her mind to go to Boston College, a four-year degree course. Actually she went. INTERVIEWER: Wow.27 JULIA: She went out of her work at Boston City, quite a bit of it, so she could live at home and the hospital was five minutes away. She took part of her affiliation there. INTERVIEWER: Now, what did your parents think of that since they really wanted you to go to work? JULIA: Well, they felt that we should go to work. They didn't, you know -- but when Louise came along they had been sufficiently Americanized, but nobody, nobody encouraged. They expected the girls would grow up, get jobs in factories, or if they went to high school, find a job in an office and then get married. INTERVIEWER: What about the boys? JULIA: The boys, none of them went to college either, although some of them were quite smart. And one family, the boys went to college on their own. They were a little bit older than the rest. And then they -- some of them got jobs in technical areas, like different labs and in MIT, and they would stop taking courses along the job training. But almost -- one young man, which is a surprise to everyone, we knew one boy from that street that went to college; he became an officer in the Navy. No one else in his family did. There were five or six children in the family, neither girls nor boys went to college, and he was a little older than I was, and he actually went on to law school. Why? I have no idea, because his parents never spoke a word of English. And he was Sicilian, you know, and yet he went. So when I said "yet he went," it sounds like a put-down, it really isn't. It's just that none of us were encouraged to go to college, nobody. My mother couldn't understand why I was constantly reading, but it was because, you know, I worked. I mean, I helped my father in the house, peeling just because they would whitewash them. I haven't done anything like that since I got married. I refuse to do it, because that six-family house took it out of all our hides. People would move out, 28 you'd have a terrible mess, you know, you not only have the problem of trying to collect miserable rents, but every time a new family moved in, me and my father be washing and cleaning and my mother and I went after, cleaned up after all of them, and it was a -- it was really the -- it wasn't until many years afterwards, and it wasn't too long before they died, that some of the older families that had owned houses themselves sold them, and some of them came to live in my father's house. And that was a good experience. They paid their rent and very respectful, which was a surprise, because in the beginning they have a… INTERVIEWER: Is it important for the Italians to have a clean house? JULIA: Some of them. Some of them wasn't, you know. INTERVIEWER: Anything else that you'd like to add? I've been here a long time now. [Laughter] JULIA: No, I think that I -- they all -- I wanna add this: that the older that I have gotten, the more I appreciate where I grew up, dirt street and all, the more I realized the goodness and the cleverness, the ability of people from other regions of Italy, the more I appreciate the beauty of that language and what, what is world's known about the Italian culture in general. And I think that my mother and father provided me with, if nothing else, an openness about accepting people from everywhere, you know. That I got from them. Well, we're very gregarious. I appreciated all the different types of humor they had, different cooking. So then since I've left my neighborhood, I feel like I fit in everywhere. The college community? No problem. The Italian community? No problem. Where am I? I feel that I fit in, and it definitely came from this upbringing. INTERVIEWER: Okay. Could your children say the same thing? They've been brought up some way different?29 JULIA: There is one, a teacher, Maria is a schoolteacher. Kath has always done office work, she's the only one that [unintelligible - 01:02:38] go to college, but there wasn't because she couldn't -- you know, he's in the fire department, he's an electrical engineer in Boston working on the big date. [Unintelligible - 01:02:51] American, an Irish girl from Fitchburg. My son, Steven, was working for the Waste Water Treatment Plant in Burke and was attending Fitchburg State. He had gone three years to Texas -- I remember my Louis, feeling that we cooked very differently from anybody he knew, and he thought it was strange, you know, that -- I thought it was strange that other people didn't cook all this stuff then [laughter]. But my Julian, who's the youngest, is a technical writer for Lotus for Boston College. Julian went to UMass, Cathy went -- enjoyed our lives here, we've gotten used to the Georgia life here, the ones I have done. INTERVIEWER: Okay. JULIA: I learned Spanish on the job. That was the other thing that the Italian did for me. I was assigned to the Department of Public Welfare after I took that six-month refresher course. And gradually, by taking in-service examinations, I went from clerk stenographer to sort of an administrative job, and I was in the Child Support Enforcement Unit. We had a great many women coming in from Puerto Rico, all of whom spoke Spanish, and many of them brought in interpreters. Well, after I listened for a while, I suddenly realized I understood what they were saying and, if I had enough courage, I could begin to speak the Spanish language. And as a result I did. And I used to be able to conduct the interviews in Spanish. I didn't need the interpreter, you know. So that was another thing that I got out of learning Italian. Now, the proper Italian is a great surprise to me. I don't know how I started that. I'm sure I'm the only one that grew up where I grew 30 up that speaks it, and it's -- I compare it to people learning to play the piano by ear. I was so accustomed to all these different dialects that gradually the proper Italian, especially when I went to Italy, even for short periods of time, and I began to listen—and my aunt used to listen to the radio, Italian programs on the radio—and somehow the language has come. I'm fluent, but I'm not grammatical perfectly. I have to feel my way through the grammar. But I'm fluent, I can say most things that I want to say in ordinary -- and I don't know why. I feel now that I know things about myself like everyone as you grow older, that I have a gift for languages, although the grammar was difficult for me. We were only allowed to take French. In junior high school, French was the only language that was offered, and I had a bad time with the grammar. But as I've grown older, I find I can -- I've been able to master the language. I can speak, and everybody understands me. Why? I don't know. INTERVIEWER: It's a gift? JULIA: You know, even my -- when I meet the occasional person that came into the office, all the workers that came in, the Spanish-speaking workers, they all used to laugh because [laughter] there I was, I could say what I wanted to say in Spanish, and they'd all make, you know, little conversation, and I'd always talk to them. Well it isn't everyone that gets to have an audience like that. [Laughter] INTERVIEWER: [Laughter] I enjoyed it. Thank you. JULIA: I'm gonna call my friends and tell them that I will be there. I'm working…/AT/jf/jc/es