Supporting Employee Lactation: Do U.S. Workplace Lactation Benefit Mandates Align with Evidence-Based Practice?

Within the United States, there are governmental benefits and policies in place to support breastfeeding mothers as they return to work. However, the effectiveness and inclusiveness of these policies is not always clear. Because of this, breastfeeding at work, in general, and governmental workplace mandates, specifically, often receive negative press and social media attention as women struggle to reconcile their workplace and lactation demands. To provide evidence-based recommendations for how to best support breastfeeding employees, we use an organizational science perspective to review the existing research for evidence on the (1) effectiveness of the existing legal benefits and supports within the US, and (2) barriers or facilitators that impact benefit success. Through this, we identify areas for improvement and provide suggestions for policy

Driving Simulator Performance Across the Lifespan: A Preliminary Study

OBJECTIVES Normal aging is associated with decline in abilities that may put an individual at increased riskfor a crash. Older individuals may have slowed processing speed and motor responses, a reduceduseful field of view (Ball et al., 1988), and greater difficulty with mental rotation (Armstrong etal., 1998). Although collision rates increase with age (Transportation Research Board, 1988), ithas been argued that specific age-related functional impairments, and not age itself, put one atrisk (Ball & Owsley, 2003). The goal of this study was to examine the relationship betweenaging and performance on driving simulations assessing specific components of driving—accident avoidance, divided attention, and navigation—and the degree to which they predict onroaddriving performance.METHODSForty control drivers (age 22 to 84; \u3c 50 yo, n = 14; 50-70 yo, n = 13; and \u3e 70 yo, n = 13)completed 3 simulations and an on-road driving evaluation. Exclusion criteria includedneurologic confounds, substance use and psychiatric disorders, as well as abnormalneuropsychological performance (based upon demographically-corrected norms). Thesimulations were presented on a Pentium III PC computer using a 17” monitor at 1280 x 1024resolution, and running STISIM Drive version 2.0 software (Systems Technology, Inc.;Hawthorne, CA). Hardware included a steering wheel, turn signal, and brake/accelerator pedals.The simulations consisted of 1) Advanced Routine and Emergency Driving (ARED), a 15-minute route simulating city/country driving, in which drivers must obey traffic signs, pass cars,and respond to high-risk crash scenarios; 2) Virtual City (VC), in which drivers must navigate toand from a location in a 5 x 5 block simulated city, and 3) Divided Attention, in which driversare to maintain a constant speed and lane position while responding to divided attention tasks inthe corner of the monitor. Participants also completed a 35-minute on-road assessment. Lastly,participants were assessed on a battery of neuropsychological tests. Earlier versions of thesimulations were predictive of on-road driving performance in an HIV-infected cohort (Marcotteet al., 2004). RESULTSThe three groups performed similarly on ARED (crashes, speeding tickets), as well as on the VCtask when the map was oriented to the same direction as the participant. On the other hand, olderparticipants had significantly more difficulty navigating when their orientation on the map wasreversed (e.g., the \u3c 50 group took 1.2 blocks beyond optimum to return from the destination; the50-70 and \u3e 70 years old groups took approximately 7.5 blocks). The three groups performedsimilarly with respect to lane deviation on the Divided Attention task, but the older groups hadincreased variability in speed maintenance, and the oldest group failed to respond to a greaternumber of divided attention stimuli (\u3c 50 yo = .3 (.83), 50-70 yo = 1.0 (1.3), \u3e 70 yo = 3.6 (2.7)).Although only one participant failed the on-road drive (50-70 yo), the percent of driversconsidered marginal or worse increased with age (7% vs. 25% vs. 55%). In a logistic regression,the simulator variables that best discriminated safe vs. marginal on-road came from the DividedAttention task: the number of missed stimuli and speed deviation, both of which require an intactuseful field of view and the shifting of gaze away from the roadway. Age did not enter into amodel that included these variables.CONCLUSIONSIn this study of normal, healthy controls, older participants drove similarly to young-to-middleaged participants on a simulation that most closely approximated real driving. Consistent withcognitive declines seen in normal aging, older participants had greater difficulty on a taskrequiring navigating when map orientation was reversed (perhaps indicative of impairedegocentric spatial abilities), as well as on a measure of driving-related divided attention, witholder participants appearing to allocate more attention to the roadway at the cost of attending andresponding to peripheral cues. Although older drivers had more difficulty during the on-road test,these difficulties were a function of deficits in the ability to divide attention efficiently, ratherthan aging per se.REFERENCESArmstrong, C.L., & Cloud, B. (1998). The emergence of spatial rotation deficits in dementia andnormal aging. Neuropsychology, 12(2), 208-217.Ball, K.K., Beard, B.L., Roenker, D.L., Miller, R.L., & Griggs, D.S. (1988). Age and visualsearch: Expanding the useful field of view. J Opt Soc Am A, 5(12), 2210-2219.Ball, K., & Owsley, C. (2003). Driving competence: It\u27s not a matter of age. J Am Geriatr Soc,51(10), 1499-1501.Marcotte, T.D., Wolfson, T., Rosenthal, T.J., Heaton, R.K., Gonzalez, R., Ellis, R.J., et al.(2004). A multimodal assessment of driving performance in HIV infection. Neurology, 63(8),1417-1422.Transportation Research Board. (1988). Transportation in an Aging Society, Vol 1. Washington,D.C.: National Research Council

Methods for the thematic synthesis of qualitative research in systematic reviews

<p>Abstract</p> <p>Background</p> <p>There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies.</p> <p>Methods</p> <p>We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved.</p> <p>Results</p> <p>We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses.</p> <p>Conclusion</p> <p>We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.</p

New constraints on muon-neutrino to electron-neutrino transitions in MINOS

This paper reports results from a search for ν_μ → ν_e transitions by the MINOS experiment based on a 7×10^(20) protons-on-target exposure. Our observation of 54 candidate ν_e events in the far detector with a background of 49.1±7.0(stat)±2.7(syst) events predicted by the measurements in the near detector requires 2sin^2(2θ_(13))sin^2θ_(23)<0.12(0.20) at the 90% C.L. for the normal (inverted) mass hierarchy at δ_(CP)=0. The experiment sets the tightest limits to date on the value of θ_(13) for nearly all values of δ_(CP) for the normal neutrino mass hierarchy and maximal sin^2(2θ_(23))

Search for sterile neutrino mixing in the MINOS long-baseline experiment

A search for depletion of the combined flux of active neutrino species over a 735 km baseline is reported using neutral-current interaction data recorded by the MINOS detectors in the NuMI neutrino beam. Such a depletion is not expected according to conventional interpretations of neutrino oscillation data involving the three known neutrino flavors. A depletion would be a signature of oscillations or decay to postulated noninteracting sterile neutrinos, scenarios not ruled out by existing data. From an exposure of 3.18×10^(20) protons on target in which neutrinos of energies between ∼500  MeV and 120 GeV are produced predominantly as ν_μ, the visible energy spectrum of candidate neutral-current reactions in the MINOS far detector is reconstructed. Comparison of this spectrum to that inferred from a similarly selected near-detector sample shows that of the portion of the ν_μ flux observed to disappear in charged-current interaction data, the fraction that could be converting to a sterile state is less than 52% at 90% confidence level (C.L.). The hypothesis that active neutrinos mix with a single sterile neutrino via oscillations is tested by fitting the data to various models. In the particular four-neutrino models considered, the mixing angles θ_(24) and θ_(34) are constrained to be less than 11° and 56° at 90% C.L., respectively. The possibility that active neutrinos may decay to sterile neutrinos is also investigated. Pure neutrino decay without oscillations is ruled out at 5.4 standard deviations. For the scenario in which active neutrinos decay into sterile states concurrently with neutrino oscillations, a lower limit is established for the neutrino decay lifetime τ_3/m_3>2.1×10^(-12) s/eV at 90% C.L

The Case for Visual Analytics of Arsenic Concentrations in Foods

Arsenic is a naturally occurring toxic metal and its presence in food could be a potential risk to the health of both humans and animals. Prolonged ingestion of arsenic contaminated water may result in manifestations of toxicity in all systems of the body. Visual Analytics is a multidisciplinary field that is defined as the science of analytical reasoning facilitated by interactive visual interfaces. The concentrations of arsenic vary in foods making it impractical and impossible to provide regulatory limit for each food. This review article presents a case for the use of visual analytics approaches to provide comparative assessment of arsenic in various foods. The topics covered include (i) metabolism of arsenic in the human body; (ii) arsenic concentrations in various foods; (ii) factors affecting arsenic uptake in plants; (ii) introduction to visual analytics; and (iv) benefits of visual analytics for comparative assessment of arsenic concentration in foods. Visual analytics can provide an information superstructure of arsenic in various foods to permit insightful comparative risk assessment of the diverse and continually expanding data on arsenic in food groups in the context of country of study or origin, year of study, method of analysis and arsenic species

The course of traumatic pancreatitis in a patient with pancreas divisum: a case report

BACKGROUND: The peculiar anatomy of pancreatic ducts in pancreas divisum (PD) may interfere with the development of acute chronic pancreatitis. In the presented case, PD influenced the evolution of lesions after pancreatic trauma. CASE PRESENTATION: A 38 years old patient refferred to our hospital with recurrent episodes of mild pancreatitis during the last two years. The first episode occurred four months after blunt abdominal trauma. Endoscopic Retrograde Cholangiopancreatography, Magnetic Resonance Imaging of upper abdomen and Magnetic Resonance Cholangiopancreatography disclosed pancreas divisum, changes consistent with chronic pancreatitis in the dorsal pancreatic duct, atrophy in the body and tail of the pancreas and a pseudocyst in the pancreatic head, that was drained endoscopically. CONCLUSION: Pancreas Divisum may interfere with the evolution of posttraumatic changes in the pancreas after blunt abdominal trauma

Measurement of the Atmospheric Muon Charge Ratio at TeV Energies with MINOS

The 5.4 kton MINOS far detector has been taking charge-separated cosmic ray muon data since the beginning of August, 2003 at a depth of 2070 meters-water-equivalent in the Soudan Underground Laboratory, Minnesota, USA. The data with both forward and reversed magnetic field running configurations were combined to minimize systematic errors in the determination of the underground muon charge ratio. When averaged, two independent analyses find the charge ratio underground to be 1.374 +/- 0.004 (stat.) +0.012 -0.010(sys.). Using the map of the Soudan rock overburden, the muon momenta as measured underground were projected to the corresponding values at the surface in the energy range 1-7 TeV. Within this range of energies at the surface, the MINOS data are consistent with the charge ratio being energy independent at the two standard deviation level. When the MINOS results are compared with measurements at lower energies, a clear rise in the charge ratio in the energy range 0.3 -- 1.0 TeV is apparent. A qualitative model shows that the rise is consistent with an increasing contribution of kaon decays to the muon charge ratio.Comment: 16 pages, 17 figure

A Study of Muon Neutrino Disappearance Using the Fermilab Main Injector Neutrino Beam

We report the results of a search for muon-neutrino disappearance by the Main Injector Neutrino Oscillation Search. The experiment uses two detectors separated by 734 km to observe a beam of neutrinos created by the Neutrinos at the Main Injector facility at Fermi National Accelerator Laboratory. The data were collected in the first 282 days of beam operations and correspond to an exposure of 1.27e20 protons on target. Based on measurements in the Near Detector, in the absence of neutrino oscillations we expected 336 +/- 14 muon-neutrino charged-current interactions at the Far Detector but observed 215. This deficit of events corresponds to a significance of 5.2 standard deviations. The deficit is energy dependent and is consistent with two-flavor neutrino oscillations according to delta m-squared = 2.74e-3 +0.44/-0.26e-3 eV^2 and sin^2(2 theta) > 0.87 at 68% confidence level.Comment: In submission to Phys. Rev.

Measurement of neutrino velocity with the MINOS detectors and NuMI neutrino beam

The velocity of a ~3 GeV neutrino beam is measured by comparing detection times at the near and far detectors of the MINOS experiment, separated by 734 km. A total of 473 far detector neutrino events was used to measure (v-c)/c=5.12.910-5 (at 68% C.L.). By correlating the measured energies of 258 charged-current neutrino events to their arrival times at the far detector, a limit is imposed on the neutrino mass of mnu&lt;50 MeV/c2 (99% C.L.)