Feeling Beyond Words: Exploring the Relationship between Mothers with Eating Disorders and their Toddlers

Literature on mothers with an eating disorder diagnosis has focused almost exclusively on identification of deficits, for both the mother and the infant. This literature suggests that, from conception through to the postnatal period, a mother with an eating disorder may experience challenges. These may be difficulty conceiving or problems with mood and eating disorder behaviours, both in the pre- and post-natal period. However, few studies provide a context in which to understand the challenges identified for mothers and their infants. This study aimed to counter this by exploring the intersubjective experience of the relationship between mothers with eating disorders and their toddlers. This qualitative psychosocial study conducted three in-depth case studies with mothers with eating disorders and their toddlers. Using psychoanalytic research methods, two infant observations and one free association narrative interview were analysed and interpreted against the backdrop of a robust supervision structure. The case study findings suggest that each mothers’ eating disorder can be understood as a response to relational isolation early in life. Despite these difficulties, each mother found ways to cope with motherhood, and to maintain a ‘good enough’ relationship with their toddlers. Specific aspects of parenting appeared difficult for mothers. These related to underlying difficulties manifested in their eating disorder presentation, and were often seen in interactions around food. These findings have clear clinical implications to rethink training for health professionals as well as supporting the benefits of taking a holistic and inclusive family focused approach to interventions for the treatment of eating disorders

Atlantic Legacies: Free Women of Color And The Changing Notions Of Womanhood In The Long Nineteenth Century

This dissertation focuses on three free-born African-descended women who defied expectations and prejudices to live previously unthinkable lives in the nineteenth century. The project uses their biographies to illustrate how, as black and mixed-ancestry émigrés from the Americas living in Europe, they adopted and adapted the evolving notions of ideal womanhood. As a result they expanded who could be identified as a true, redemptive or new woman. The project shows how they used the tenets of these ideals to live life on their terms. The dissertation is set in an era dominated by white males, and defined by the enslavement and marginalization of African-descended people who were deemed to be intellectually and morally inferior. The project approaches its subjects’ adoption of the social mores of the dominant society as a denial of subordination and an autoethnographic expression. By engaging with the norms of the dominant culture they practiced a type of marronage. While typically used in terms of enslavement, when looked at as a form of resistance and as a way of gaining independence and self-determination, marronage is applicable to these subjects who used established structures to break the old order. The project demonstrates how three African-descended Euro-American women live the life they wanted and left an Atlantic legacy that paved the way for subsequent generations of Atlantic women to do the same

The Fashion of Frill: The Art of Impression Management in the Atlanta Lolita and Japanese Street Fashion Community

The Atlanta Lolita and Japanese Street Fashion Community is a multifaceted fashion community that developed in the early 2000s. The majority of the members wear Lolita fashion which is a fusion of Victorian era dress, Rococo costume, and various Japanese street fashions. Lolita fashion developed on the streets of Tokyo Japan in the 1990s and has since spread across the world. The Atlanta Lolita and Japanese Street Fashion Community heavily relies on the building and maintenance of impressions by its members. In this thesis, I analyze face-to-face and virtual community organization, fashion, and photography to illustrate how members of the community build their impressions, how they are maintained, or how they are threatened

Intergenerational Community Engagement Strategy to Minority Families in Urban Housing Developments Suffering from Generational Issues in the Pioneer Homes and Central Village on the Southside of Syracuse, New York

Problem In the Seventh-day Adventist Churches Fundamental Beliefs, Fundamental Belief #13 The Remnant and Its Mission, pages 168-178 of the Seventh-day Adventist Church Manual (Church Manual, 172), there is no mention pertaining to the closing versus of Matthew 28. Yet within the evangelism endeavors, there is a lack of the elements of intergenerational ministry to families in low-income housing as a methodology in which to fulfill this mission. While the adage If we get the children, we will get the parents has been used in attempts to do ministry among low-income households, the lack of a systematic intergenerational evangelistic method to reach the entire family in a low-income neighborhood is lacking. This ever-present struggle to minister to the families in these low-income households in urban America will continue to have negative impacts upon the growth of the Seventh-day Adventist Church in the urban regions of the United States of America unless intergenerational ministry is conducted outside of the church. Method The project was completed in five phases. The first phase dealt with creating two intergenerational groups of six people each, with three males and three females in per group. Additionally, each group had a mixture of generations, which included Baby Boomers, Generation Xers (Gen X), and Millennials. The second phase involved a PowerPoint presentation to the Mount Carmel Seventh-day Adventist Church body for the purpose of intergenerational ministry in the church and as an effective tool for community engagement. The third phase involved the training of two small intergenerational groups of six people each, which are the two groups created from phase one, through the North American Division (NAD) training modules, entitled Community Services and Urban Ministry Certification Program. The fourth phase of the project involved an intergenerational group of five people who were responsible for assessing the work being done with the families. This intergenerational focus group was comprised of four generations: Baby Boomers, Gen X, Millennials and Generation Z. The fifth and final phase involved the small intergenerational groups of six going door to door as a unit into the low-income housing projects to locate families with which to work for a period of 30 days. Results The study revealed that intergenerational learning and ministry to families in low-income housing developments can be effective. Regarding the learning aspect of the groups, the generations were able to work and learn together in a manner that caused each person to have a shift in one\u27s thinking, seeing ministry concepts from varying generational lenses and perspectives. Secondarily, the study revealed that when families in a low-income housing development are engaged by a family unit to be a family within a family and assist with basic needs, there is more friendship, connection, and positive synergy transpiring. Conclusions Each church functioning in an urban center among low-income residents should train their members in intergenerational small-group ministry to work with families in an intergenerational manner alongside partner families. Additionally, the church should research low-income housing neighborhoods near the church to effectively assign intergenerational small groups to various houses within that community

Facility-based capacity assessment of emergency care services in public hospitals in Zambia

In sub-Saharan Africa, the shift in disease burden from infections to non-communicable disease and injury highlights the need for effective and efficient emergency care. Despite this, emergency care is a neglected sector of the health system in most low and middle-income countries. Funding and resource allocations are often small and have little impact on the development of emergency care systems, and provision of emergency care is therefore frequently left to under-trained and/or under-prepared nurses or clinical officers. In order to develop effective emergency care systems, one must first identify strengths and challenges in existing systems. The aim of this study was to determine facility-based emergency care capacity in public hospitals in Zambia. This descriptive cross-sectional study comprised of a total of 23 facilities: seven districts, 12 general and four central hospitals. Data were collected using a standardised Emergency Care Assessment Tool (ECAT); developed in 2013 by AFEM to ascertain facilities' strengths and weaknesses in the delivery of the emergency care services for five sentinel conditions and maternal health. The ECAT was administered through one-on-one interviews with designated personnel working in emergency receiving areas. The assessment tool consists of six main themes relating to the ability to provide care for patients suffering from respiratory failure, shock, altered mental status, severe pain, trauma and maternal health. The majority of facilities were able to perform almost all the procedures across all themes. However, some procedures, which were highly technical and required personnel with specialist training or specialised equipment, were not performed at all facilities. The level of the facility also dictated whether a procedure could be performed where higher-level health facilities like central hospitals were able to perform more procedures than lower-level facilities due to higher numbers of trained personnel, more equipment and supplies, and better infrastructure. Maternal health was covered in almost all (>90%) hospitals. Across all themes, the most frequent reasons for not performing procedures were lack of supplies (n=137) followed by no training (n=136), no infrastructure (n=35) and no human resources (n=34). At the central level, the most frequent reason for not performing procedures was no supplies (n=16), whereas at district and general levels the most frequent reason was no training. Overall, most facilities were able to offer basic emergency care services. However, there is limited capacity of training and supplies across all facilities, as well as a lack of infrastructure and policies for emergency care in lower-level facilities. Zambian hospitals can provide basic emergency care, but there is need to enhance training and improve on provision of supplies to enable facilities to provide emergency care. Focus must also be on development of policies relating to emergency care to guide and standardise procedures. Capacity building should be more focused at district and general hospitals to improve emergency care across all levels of health facilities, as it will reduce the burden at central level and improve patient outcomes since these are first-line access points for patients

États limites de piliers de pont en béton armés de cerces

Les leçons tirées des tremblements de terre passés ont permis d’introduire un nouveau concept dans l’étude des structures: le dimensionnement basé sur la performance (DBP). Depuis des décennies, ce concept est utilisé dans l'aéronautique et la construction automobile. Son but principal consiste à fixer à l'avance la performance de la structure souhaitée. Autrement dit, on prédit son niveau d'endommagement éventuel après l'avoir soumis à un état de contrainte. Une phase expérimentale permet de vérifier si la performance souhaitée a été atteinte, et si c'est le cas, on lance une chaîne de production. Cependant, malgré le succès du concept, son application en génie civil était limitée. En effet, chaque ouvrage de génie civil est unique, tout comme le sol sur lequel il est construit. D'autre part, les moyens techniques et économiques ne permettaient guère de soumettre un ouvrage à un tremblement de terre afin de s'assurer que les prévisions de performance ont été atteintes. Par conséquent, l'application du dimensionnement basé sur la performance dans la construction des ponts et des bâtiments était très difficile. Les progrès effectués dans l`évaluation de l'aléa sismique, les installations expérimentales et les applications informatiques ont récemment favorisé l'introduction du DBP dans les codes de construction. L'utilisation du concept de DBP est devenue courante dans la réhabilitation et la conception parasismique des structures. Les codes de calcul parasismique des structures (par exemple le CSA S6-06) le recommandent dans la conception des nouvelles structures et l'adaptent en cherchant des améliorations par rapport aux anciennes structures construites suivant les anciens codes. Le DBP consiste à dimensionner les structures de pont à partir du niveau de performance souhaité et de l'aléa sismique de la zone de construction. On associe à chaque niveau de performance un état limite, qui est lui-même lié à un endommagement physique d'un des éléments structuraux. D'où l'importance de définir les états limites par les codes et les normes réglementaires. La finalité étant que la capacité demeure supérieure à la demande. De ce fait, il est indispensable de connaître la performance sismique des piliers construits selon les recommandations des anciennes normes. Dans cette optique, un pilier de pont à échelle réelle fut construit et testé dans le laboratoire du Centre de recherche en génie parasismique et en dynamique des structures (CRGP) de l'Université de Sherbrooke. Le spécimen a été construit conformément au détail de ferraillage de l'armature transversale. Celui-ci a présenté une série d'endommagement dont le déroulement s'est réalisé comme suit: la fissuration du béton, la plastification de l'armature longitudinale, l'écrasement du béton d'enrobage, le flambement de plusieurs barres longitudinales et la rupture d'une barre en compression. Les résultats de ces recherches ont révélé que le pilier possédait une grande capacité à dissiper de l'énergie, un excellent taux d'amortissement et une ductilité en déplacement de 7,28 alors que les codes préconisent au moins 3,0

Standardisation et validation de techniques luminométriques pour évaluer la propreté des équipements d'alimentation des veaux en pré-sevrage

La contamination des équipements d’alimentation des veaux en pré-sevrage est une préoccupation de santé importante dans l’industrie laitière, et peut être associée à une augmentation des taux de morbidité et de mortalité. Les producteurs laitiers et intervenants ont donc besoin d’un outil pratique, rapide et fiable pour évaluer la propreté des équipements, compte tenu que l’évaluation visuelle seule est insuffisante. Les objectifs de cette étude sont de développer une méthode standardisée pour évaluer la propreté de plusieurs équipements grâce à la luminométrie, d’estimer la prévalence de contamination et décrire les pratiques de gestion recommandées pour le nettoyage. Un total de 7 troupeaux laitiers du Québec a été choisi par convenance. Après l’évaluation visuelle de l’hygiène, la propreté des équipements a été évaluée par écouvillonnage direct pour les seaux et les tétines avec des écouvillons Hygiena UltraSnap®. Une technique de rinçage a été utilisée pour les tubes à gaver, les biberons et les distributrices automatiques de lait (AMF) avec des écouvillons UltraSnap®, AquaSnap® et MicroSnap®. Pour valider la technique d’écouvillonnage direct des seaux, une étape avec le même opérateur et entre plusieurs opérateurs a été réalisée, ainsi qu’une culture bactérienne conventionnelle. Au total, 519 écouvillons ont été prélevés sur 201 équipements. La contamination médiane (intervalle interquartile) en RLU pour le biberon, le tube à gaver, l’AMF, le seau et la tétine est de 2 (1;6), 2 (0;12), 52 (19;269), 886 (128;7,230) et 899 (142;6 928), respectivement. La technique d’écouvillonnage direct, qui consiste à écouvillonner directement la surface d’un équipement, a montré une excellente corrélation pour la fidélité intra-opérateur (corrélation intra-classe (ICC) = 0,93; IC95%: 0,88-0,96). La fidélité inter-opérateur (2 sessions avec 3 opérateurs différents) a montré une corrélation élevée (ICC = 0,88; IC95%: 0,78-0,94 pour la 1ère session et ICC = 0,89; IC95%: 0,79-0,95 pour la 2e). Le score visuel (qui grade de 1 à 4 la propreté des équipements selon la quantité de matières organiques) des tubes à gaver, de l’AMF et des seaux a été positivement associé aux valeurs du luminomètre. Une corrélation positive entre la culture bactérienne et l’écouvillonnage direct des seaux a été trouvée pour l’UltraSnap (rho de Spearman (rs) = 0,653; IC95%: 0,283-0,873; P = 0,0003) et le MicroSnap (rs = 0,569; IC95%: 0,309-0,765; P = 0,002). Cette étude décrit une technique standardisée d’écouvillonnage à la ferme pour évaluer le statut hygiénique des équipements par luminométrie, qui peut être intégrée dans la gestion des problèmes de santé des veaux laitiers en pré-sevrage.The contamination of equipment used to feed pre-weaned calves is an important health issue for the dairy industry, which can be associated with increased morbidity and mortality rates. Therefore, dairy producers and consultants need a practical, quick, and reliable tool to assess equipment cleanliness, since visual assessment alone is insufficient. The objectives of this cross-sectional study are to develop a standardized robust method to evaluate the cleanliness of several types of feeding equipment on-farm by using luminometry, with special emphasis on a direct swabbing technique to sample buckets, and to estimate the prevalence of contamination and the recommended management practices for cleaning and describing equipment. A total of 7 Quebec commercial dairy herds were selected conveniently. Following visual hygiene scoring, the cleanliness of available piece of feeding equipment was assessed using direct surface swabbing for buckets and nipples with Hygiena Ultra-Snap® swabs. A liquid rinsing technique was used for esophageal feeders, bottles, and automatic milk feeders (AMF) with UltraSnap®, AquaSnap®, and MicroSnap® swabs. To validate the direct swabbing technique of buckets, a comparison within and between operators was realized, as well as a conventional bacterial culture. A total of 519 swab samples were obtained from 201 pieces of equipment. The median (interquartile range) contamination in RLU for a bottle, esophageal feeder, AMF, bucket and nipple was 2 (1;6), 2 (0;12), 52 (19;269), 886 (128;7,230) and 899 (142;6,928), respectively. The direct swabbing technique, which consists in swabbing directly the surface of an equipment, showed an excellent correlation for inter-rater reliability (intraclass correlation (ICC) = 0.93; 95%CI: 0.88–0.96). The inter-operator (2 sessions with 3 different operators) reliability showed high correlation (ICC = 0.88; 95%CI: 0.78–0.94 for the 1st session, and ICC = 0.89; 95%CI: 0.79–0.95 for the 2nd session). The visual score (who ranks equipment cleanliness from 1 to 4 according to the quantity of organic matter) of esophageal feeders, AMF and buckets was positively associated with luminometer values. A positive correlation between bacterial culture and direct swabbing of buckets was found for the UltraSnap (Spearman’s rho (rs) = 0.653; 95%CI: 0.283–0.873; P = 0.0003) and MicroSnap (rs = 0.569, 95%CI: 0.309–0.765; P = 0.002). This study describes a standardized and practical on-farm swabbing technique for assessing the hygienic status of feeding equipment by luminometry, which can be integrated in the investigation of preweaning dairy calves’ health problems