54,369 research outputs found

    Women’s Experiences of Accessing Breastfeeding and Perinatal Health Support in the Context of Intimate Partner Violence: An Interpretive Description Study

    Get PDF
    Background: Women experiencing intimate partner violence are at a heightened risk of negative perinatal and breastfeeding outcomes. This study explored the experiences of accessing breastfeeding support for women who endorse a history of intimate partner violence. A study of five in-depth semi-structured interviews were completed at 12-weeks postpartum with breastfeeding mothers with a history of intimate partner violence. Findings: Women expressed difficulties in accessing a healthcare provider who had specialized skill in breastfeeding support. Trust in their healthcare provider, built through displays of compassion and competence, was important to mitigate obstacles experienced during care access for this population. Trauma-and-violence-informed care principles were beneficial to the development of the therapeutic relationship in perinatal care. Women placed value on breastfeeding support received from both healthcare providers and social supports, which impacted mothers’ perceived breastfeeding support and self-efficacy. Further, mothers described increased levels of breastfeeding self-efficacy after engaging in a trauma-and-violence-informed care program aimed at supporting breastfeeding. Conclusions: Trauma-informed care may aid in the development of trust in the therapeutic relationship, which in turn impacts access to breastfeeding support and breastfeeding self-efficacy. The inclusion of trauma-and-violence informed principles in perinatal care may be effective at mitigating barriers to access for women who endorse a history of intimate partner violence. health care on how to employ trauma-informed breastfeeding care to may lead to better support for this population

    Examination of a Brief, Self-Paced Online Self-Compassion Intervention Targeting Intuitive Eating and Body Image Outcomes among Men and Women

    Get PDF
    Ideals for appearance and body image are pervasive in Western culture in which men and women are portrayed with unrealistic and often unattainable standards (Ferguson, 2013; Martin, 2010). Exposure and reinforcement have created a culture of social acceptance and internalization of these ideals, contributing to pervasive body image disturbance (i.e., body dissatisfaction; Fallon et al., 2014; Stice, 2001; Thompson & Stice, 2001; Thompson et al., 1999). Research has suggested that body dissatisfaction is expressed differently across sexes (Grossbard et al., 2008), with attention to thin ideals among women and muscular ideals among men. Body dissatisfaction has been linked to numerous poor outcomes, including dieting, unhealthy weight control behaviors, disordered eating, and increased psychopathology. Although dieting is one of the primary mechanisms employed to reduce body dissatisfaction (Thompson & Stice, 2001), research has shown that such efforts are contraindicated as dieting predicts weight gain over time (Pietiläinen et al., 2012) as well as preoccupation with food, disordered eating, eating disorders, emotional distress, and higher body dissatisfaction (Grabe et al., 2007; Johnson & Wardle, 2005; Neumark- Sztianer et al., 2006; Paxton et al., 2006; Tiggemann, 2005). Restrictive dietary behaviors suppress physiological cues to eat (e.g., hunger) that presents a vulnerability to eating in response to alternative cues, both internal (e.g., emotions) and external (e.g., availability of food). Intuitive eating is a non-restrictive approach to eating that encourages adherence to internal physiological cues to indicate when, what, and how much to eat (Tylka, 2006) and has demonstrated an inverse relationship with disordered eating, restrained eating, food preoccupation, dieting, body dissatisfaction, and negative affect (Bruce & Ricciardelli, 2016). Self-compassion, relating to oneself in a caring and supportive manner (Neff, 2003a), has been proposed as a pathway to increase intuitive eating and reduce body dissatisfaction (Neff & Knox, 2017; Schoenefeld & Webb, 2013; Webb & Hardin, 2016). Research has highlighted the efficacy of self-compassion interventions in addressing weight-related concerns (Rahimi-Ardabili et al., 2018) as well as brief experiential exercises for reducing body dissatisfaction (Moffitt et al., 2018). Additionally, there is a growing body of evidence supporting the efficacy of internet-based self-compassion interventions (Mak et al., 2018; Kelman et al., 2018; Nadeau et al., 2020). The purpose of the current study was to examine the effectiveness of a brief, self-paced online self-compassion intervention targeting body image and adaptive eating behaviors and potential mechanisms of change (e.g., self-compassion and psychological flexibility) among undergraduate men and women. This study also examined outcomes among men and women in the area of self-compassion, body dissatisfaction, and intuitive eating as research has highlighted the need to determine who benefits more from self-compassion interventions (Rahimi-Ardabili et al., 2018). The study compared a one-hour, self-guided online self-compassion intervention to an active control condition. The intervention was comprised of psychoeducation, experiential exercises, and mindfulness practice designed to increase self-compassion surrounding body image and eating behaviors. In contrast, the active control condition consisted of self-care recommendations and self-assessments for nutrition, exercise, and sleep. The study was administered over three parts (e.g., baseline, intervention, and follow-up) in which variables of interest were assessed at each time point. Outcome variables included self-compassion, intuitive eating, disordered eating, body appreciation, muscle dysmorphia, internalized weight bias, fear of self-compassion, and psychological inflexibility. Participants were randomized on a 2:1 intervention to control ratio at the second time point in order to make comparisons between groups while simultaneously having sufficient power for examining mediation and moderation within the treatment condition. Overall, 1023 individuals (64% women, Mage = 18.9, 67.4% white) signed informed consent and participated in at least one part of the study whereas 101 participants (71% women, Mage = 19.3, 71% white) completed all three study portions. As predicted, self-compassion was correlated with all variables of interest, and all study variables were correlated with each other (p < .01). In contrast to hypothesized outcomes, the self-compassion condition failed to demonstrate improvements across time or between conditions on all study outcomes. These results persisted when participants were screened for levels of intuitive eating as well. Contrary to prediction, internalized weight bias, muscle dysmorphia, and fear of self-compassion demonstrated increased levels within the intervention condition and decreases in the control condition. There were significant gender differences on multiple outcome variables, with men demonstrating higher levels of self-compassion and body appreciation whereas women endorsed higher levels of disordered eating, internalized weight bias, muscle dysmorphia, and psychological inflexibility. Additionally, there were significant gender interactions for internalized weight bias, body appreciation, and muscle dysmorphia. The interactions existed such that men demonstrated increased internalized weight bias and muscle dysmorphia across time whereas women displayed decreased weight bias and muscle dysmorphia. The opposite pattern was found within body appreciation; women demonstrated increased body appreciation across time while men reported decreased levels of body appreciation. Despite this study’s intent to examine underlying mechanisms of change, the condition in which participants were randomly selected did not have any relationship, positive or negative, with the outcome variables of interest. As such, mediation within the current study was not conducted as it would violate statistical assumptions required to examine this hypothesis. Finally, upon examining the moderating relationship of fear of self-compassion between self-compassion and outcome variables, there were main effects for self-compassion on intuitive eating, emotional eating, internalized weight bias, body appreciation, and psychological inflexibility as well as main effects of fear of self-compassion on psychological inflexibility. There were significant interactions for intuitive eating and emotional eating, such that as fear of self-compassion increased, the effect of self-compassion on intuitive eating decreased, and the effect of self-compassion on reducing emotional eating behaviors decreased. Overall, the brief, self-paced online intervention delivered in the current study did not prove to be an effective means for improving self-compassion, intuitive eating, body appreciation, disordered eating, muscle dysmorphia, and psychological inflexibility. Nevertheless, the relationships between self-compassion and outcome variables of interest throughout the study mirror that of the existing literature. Findings from this study, in general, were also consistent with differences between men and women despite a gap in the research for intervention outcomes. Although fear of self-compassion demonstrated a moderating effect on the relationship between self-compassion and intuitive eating as well as emotional eating, this does not account for the lack of significant findings. The context surrounding this study, such as the COVID-19 pandemic, provided a considerable challenge to examining the efficacy of the current intervention. However, the findings of this study suggest future research will likely need to identify ways to enhance the delivery of experiential exercises that encourage engagement, provide a safe and warm environment for participants, and create flexibility and willingness surrounding painful and difficult experiences in order to undermine internalized and socially accepted beliefs about body image and eating behaviors

    Machine learning based adaptive soft sensor for flash point inference in a refinery realtime process

    Get PDF
    In industrial control processes, certain characteristics are sometimes difficult to measure by a physical sensor due to technical and/or economic limitations. This fact is especially true in the petrochemical industry. Some of those quantities are especially crucial for operators and process safety. This is the case for the automotive diesel Flash Point Temperature (FT). Traditional methods for FT estimation are based on the study of the empirical inference between flammability properties and the denoted target magnitude. The necessary measures are taken indirectly by samples from the process and analyzing them in the laboratory, this process implies time (can take hours from collection to flash temperature measurement) and thus make it very difficult for real-time monitorization, which in fact results in security and economical losses. This study defines a procedure based on Machine Learning modules that demonstrate the power of real-time monitorization over real data from an important international refinery. As input, easily measured values provided in real-time, such as temperature, pressure, and hydraulic flow are used and a benchmark of different regressive algorithms for FT estimation is presented. The study highlights the importance of sequencing preprocessing techniques for the correct inference of values. The implementation of adaptive learning strategies achieves considerable economic benefits in the productization of this soft sensor. The validity of the method is tested in the reality of a refinery. In addition, real-world industrial data sets tend to be unstable and volatile, and the data is often affected by noise, outliers, irrelevant or unnecessary features, and missing data. This contribution demonstrates with the inclusion of a new concept, called an adaptive soft sensor, the importance of the dynamic adaptation of the conformed schemes based on Machine Learning through their combination with feature selection, dimensional reduction, and signal processing techniques. The economic benefits of applying this soft sensor in the refinery's production plant and presented as potential semi-annual savings.This work has received funding support from the SPRI-Basque Gov- ernment through the ELKARTEK program (OILTWIN project, ref. KK- 2020/00052)

    Uso de las histonas circulantes y sus modificaciones post-traduccionales como biomarcadores en sepsis y shock séptico

    Get PDF
    La sepsis es una afección potencialmente mortal causada por una respuesta anormal del huésped a una infección, produciendo respuestas fisiológicas alteradas que dañan los propios tejidos del paciente y pueden provocar disfunción orgánica e incluso la muerte. Asimismo, algunos pacientes sépticos progresan a shock séptico, caracterizado por alteraciones circulatorias, celulares y metabólicas sustanciales que aumentan el riesgo de mortalidad. A pesar de que la sepsis se caracteriza por un mal funcionamiento del sistema inmunológico, lo que a su vez conduce a una respuesta inmune alterada e inmunosupresión, la alta complejidad de la fisiopatología de la sepsis requiere una mayor investigación para comprender las respuestas inmunes que ocurren durante la sepsis. Asimismo, las histonas extracelulares circulantes han ganado relevancia como mediadores citotóxicos en la sepsis, ya que actúan como patrones moleculares asociados a daño, que inducen estrés oxidativo y activan el inflamasoma NLRP3. Estos mecanismos median la activación de la piroptosis, un mecanismo de muerte celular programada que produce inflamación mediante la expresión de IL-18, IL-1β and IL-1α. Sin embargo, a pesar de la evidencia de activación del inflamasoma en las células inmunes durante la sepsis, se desconoce si las histonas extracelulares son capaces de activar los inflamasomas endoteliales y sus consecuencias. En este trabajo destacamos el papel previamente desconocido de las histonas extracelulares, mediando la activación del inflamasoma NLRP3 y la piroptosis en las células endoteliales, contribuyendo a la disfunción endotelial y la desregulación de la respuesta inmune mediada por el endotelio. Asimismo, también demostramos cómo la acetilación de histonas disminuye la activación de la piroptosis. Además, demostramos que la piroptosis se produce en pacientes con shock séptico y los niveles de histonas circulantes se correlacionan con la expresión de citoquinas proinflamatorias y citoquinas piroptóticas, la liberación de factores de adhesión endotelial y la gravedad de la enfermedad. Proponemos la piroptosis mediada por histonas como un nuevo objetivo para desarrollar intervenciones clínicas. De manera similar, hemos analizado las respuestas inmunorelacionadas que ocurren durante las primeras etapas de la sepsis con el objetivo de proporcionar nuevos datos comparando las cantidades de citoquinas, inmunomoduladores y otros mediadores endoteliales en pacientes críticamente enfermos no sépticos, sépticos y de shock séptico. Nuestro enfoque ayudará a caracterizar rápidamente las respuestas inmunes alteradas en pacientes sépticos y de shock séptico ingresados en la Unidad de Cuidados Intensivos. Finalmente analizamos el papel de la metilación del ADN en el control del sistema inmune séptico. Nuestros resultados demostraron el papel central de la metilación del ADN modulando la respuesta molecular en los pacientes de shock séptico y contribuyendo a la inmunosupresión, a través de la alteración de los patrones de metilación de los promotores de IL-10 y TREM-2.Sepsis is a life-threatening condition caused by an abnormal host response to an infection that produce altered physiological responses which damages own tissues of the patient and can result in organ dysfunction and in some cases death. Likewise, a subset of septic patients progresses to septic shock, characterized by substantial circulatory, cellular and metabolic abnormalities, which substantially increase the risk of mortality. Sepsis is characterized by a malfunction of the immune system and it can lead to an altered immune response and immunosuppression. Moreover, the high complexity of the pathophysiology of sepsis requires of further investigation to characterize the immune responses in sepsis and septic shock. Likewise, circulating extracellular histones have gained relevance as cytotoxic mediators in sepsis pathophysiology, since they act as damage-associated molecular patterns, which induce oxidative stress and activate NLRP3 inflammasome. Subsequently, inflammasome mediates pyroptosis activation, a programmed cell death mechanism that produces inflammation through the release of IL-18, IL-1β and IL-1α. However, despite inflammasome activation may occur in immune cells during sepsis, it is unknown if this process also takes place in endothelial cells and particularly whether extracellular histones are capable of activating endothelial inflammasomes and their consequences. In this work we highlight a previously unknown role for extracellular histones, that mediates the activation of NLRP3 inflammasome and pyroptosis in endothelial cells by contributing to endothelial dysfunction and the dysregulation of the immune response mediated by endothelium. Likewise, we demonstrated how histone acetylation decreases pyroptosis activation. Furthermore, we show how pyroptosis occurs in septic shock patients and how circulating histone levels correlate with the expression of pro-inflammatory and pyroptotic cytokines, the release of endothelial adhesion factors and septic shock severity. We propose histone-mediated pyroptosis as a new target to develop clinical interventions. Similarly, we have analyzed the immune-related responses occurring during the early stages of sepsis with the aim of providing new data by comparing the amounts of cytokines, immune modulators and other endothelial mediators in critically-ill non-septic patients, septic and septic shock patients. Our approach will help to rapidly characterize the altered immune responses in septic and septic shock patients admitted in the Intensive Care Unit. Finally, we also analyzed the role of DNA methylation in the control of septic immune system. Our results demonstrated the central role of DNA methylation modulating the molecular response in septic shock patients and contributing to immunosuppression, through the alteration of DNA methylation patterns of IL-10 and TREM2 promoters

    Towards the development of care management in community care for elderly people in Korea

    Get PDF
    This study is concerned with the feasibility of several forms of care management in the development of community care for elderly people in Korea. Chapter one introduces the background of community care in Korea in the light of demographic, socio-economic, and political realities. This chapter reviews the changing Korean society as a barometer to understand the scope, size, and speed of social needs, especially community care for elderly people, over the last few decades. Chapter two explores various definitions, concepts, and theories of community, community care, and care management by building upon trends previously established in the research. This helps to identify the different models of care management and the pre-conditions necessary for the application of different models in Korea. Chapter three explores what factors have affected the development of community care, and what community dare has achieved for elderly people in the UK. Especially, care management in community care for elderly people in the UK is examined in detail. Chapter four details the findings of field research on community care for elderly people in Korea. This covers the needs of elderly people and their carers, and the social worker's tasks and available resources. The potential for the use of care management based on the findings of field research is assessed. Chapter five investigates whether the UK models of care management are suitable for Korean society, which interventions are useful for developing care management, and the strategies, and principles involved

    Study of models for the nominal power characterization of a photovoltaic generator and the power estimation of different photovoltaic technologies in Lima, Peru

    Get PDF
    This work investigates two main aspects related to photovoltaic: systems and module characterization and performance modeling. The first part aims to characterize a PV generator located in Spain with a nominal power of 109.44 kW under standard test conditions according to the datasheet. An operational photovoltaic system's nominal power is a valid parameter for determining its current operational state. The applicability of a standard procedure to estimate the nominal power of an operating generator, proposed by Martínez-Moreno and based on Osterwald's model, is investigated. However, the standard procedure does not specify how to deal with experimental data when unexpected behavior impedes the nominal power estimation under operating conditions. During the 6-month study, the power-irradiance relation showed a hysteresis effect with varying amplitudes throughout the campaign. Adding a data filter that removes the non-linear part of the data proves necessary to estimate the nominal power, complementing Martinez-Moreno's procedure to enable the generators' characterization. The second part contributes to closing a knowledge gap in the performance behavior and predictability of multiple PV technologies in Peru. The quality of two simple analytical models for estimating the outdoor performance of three different photovoltaic module technologies in Lima was investigated. Osterwald's and the Constant Fill Factor models were applied to estimate the maximum power delivered by an Aluminum Back Surface Field, a Heterojunction with Intrinsic Thin-layer, and an amorphous/microcrystalline thin-film tandem PV module. The results point that both models overestimate the expected power compared to the measured one. Implementing a correction factor adjusts the estimated maximum power by both models. This correction factor allows us to estimate losses, calculate an adequate nominal power and minimize the estimated power error. The normalized root mean square error and mean bias error determine the implemented methodology's quality. The two crystalline silicon-based technologies present a similar behavior throughout the year. However, both differ considerably from the tandem one during different months, implying that the ambient variables have other seasonal impacts on their performance

    Making Sense of Ayahuasca Non-Sense: A critical study of UK groups consuming a psychoactive plant mixture and their struggle to find religious meaning

    Get PDF
    How we make sense of ourselves, and the cosmos is an ongoing concern, guided by the people we meet, environments we exist within, and plants we consume. Having spent over a year observing forty-nine participants within three UK-based ayahuasca churches, it is clear that the psychoactive 'brew' ayahuasca creates intense changes to how individuals think about themselves and the world they live in. At the heart of the ayahuasca experience are non-sensical hallucinations and visions, which often exist outside of perceptual understanding, leaving individuals feeling lost in an unknowable universe. As we will come to see, making sense of non-sensical ayahuasca experiences requires individuals to negotiate multiple 'common-sense' views of reality. Taking a view that mind is something that happens within life, this ethnographic study uses participant observation, interviews, conversations, personal diaries, and my experiences as an ayahuasca tourist to detail how making sense of reality is also an act of making oneself. In so doing, I argue that ayahuasca hallucinations and visions function as a source of ongoing mental innovation, facilitating preferred views of reality throughout these psychoactive churches. Critically, we will see how frequent ayahuasca consumption engenders in-depth beliefs in the supernatural, and in particular, devotion to the goddess Ayahuasca, who functions as the unchallengeable road to knowing oneself and reality. Acting as an otherworldly guide, the immaterial goddess Ayahuasca plays a key part in how individuals convert non-sensical experiences into sense, while providing practical advice for how to achieve salvation. Problematically though, positioning the universe and oneself as predominantly supernatural tends to erode beliefs in the physical world, leaving these churches with incoherent views of reality, and at the periphery of everyday social life. As such, church doctrines seem increasingly unable to cope with life outside of their groups, and thus, tactically stigmatise competing views of reality as sinful and individuals espousing such heresies as under the control of malevolent demonic beings. Not surprisingly, this binary belief in a good and evil cosmos is a powerful regulatory force dictating what reality is within these churches, and who church members can claim to be
    • …
    corecore