The Blue Girandole & The Grand Hotel: Reconsiderations of Sodom and Gomorrah in Proust\u27s À la recherche du temps perdu

Senior Project submitted to The Division of Languages and Literature of Bard College

Maternal Provision of Mother\u27s Milk and Birth Trauma in the Neonatal Intensive Care Unit: A Grounded Theory Analysis

Less than half of very low birth weight (VLBW, \u3c 1500 grams) infants are discharged from the neonatal intensive care unit (NICU) receiving mother’s own milk (MOM), despite its demonstrated importance. Nevertheless, few studies have explored the impact of maternal perceived trauma (MPT) on infant feeding outcomes. The purpose of this study is to describe MPT among mothers of hospitalized VLBW infants and examine infant feeding outcomes with MPT. This analysis is derived from a grounded theory study exploring the maternal provision of milk among a convenience sample of mothers with VLBW infants at a Midwest NICU. This study utilized semi-structured interviews and content analysis to identify common themes (n=30). Data were analyzed using Dedoose, web-based data management and analytical software. A preliminary analysis identified trauma as a prominent theme. Trauma was defined as a mother’s perceived inability to process an experience at the time of the event, a lack of understanding during the time of an event, and the rapid decline of either maternal or infant health. The occurrence of MPT (n=865) was reported most frequently in women described as Black (46%), multipara (57%), married (75%), and ages \u3e 30 (57%). The MPT frequency was greater with cesarean (54%) and hypertensive (71%) births. The MPT frequency with MOM was 63%, but only 23% with exclusive MOM at discharge. This study’s limitations include using a single hospital location and only English-speaking mothers, making the results less generalizable. Additionally, the interviewer’s Latina racial identity may have led to a sense of kinship with some mothers. A better understanding of MPT and those at risk for MPT will allow providers the opportunity to identify interventions to increase MOM feedings at discharge proactively

Readiness to use physical activity as a smoking cessation aid: a multiple behaviour change application of the Transtheoretical Model among quitters attending Stop Smoking Clinics

Objective: Physical activity (PA) reduces cigarette cravings during smoking abstinence. However, little is known about quitters’ use of PA. This study aimed to: (1) determine the extent of quitters’ past and current use of PA as a cessation aid, while attempting to quit; (2) examine the relationship between use of PA and quitter characteristics and cognitions, within the Transtheoretical Model framework. Methods: Self-report surveys were completed by 181 smokers attending Stop Smoking Services in England and Scotland. Results: Twenty-two percent of quitters reported currently using PA to control their smoking, and 35% had used it during a previous quit attempt. Those in a more advanced stage of readiness for using PA as a cessation aid, held more positive beliefs regarding self-efficacy and outcome efficacy. Conclusion: Quitters were more likely to use PA to help them quit when they had greater belief in their own ability to use PA and in the efficacy of PA to help them to quit, and were also meeting weekly PA targets for health. Practice implications: Strategies by stop smoking advisors that aim to enhance client self-efficacy and outcome efficacy beliefs regarding PA as a cessation aid may help to increase the use of this behavioural strategy, since it seems that most quitters do not use PA

Demystifying the dissertation: learning through magic

Session - Explained use of magic; taught students a trick; students performed tricks; supported students to make links between the process and their dissertation; explored skills to support dissertation writing

Demystifying the dissertation: learning through magic

Session - Explained use of magic; taught students a trick; students performed tricks; supported students to make links between the process and their dissertation; explored skills to support dissertation writing

Insulin therapy and dietary adjustments to normalize glycemia and prevent nocturnal hypoglycemia after evening exercise in type 1 diabetes: a randomized controlled trial

Introduction Evening-time exercise is a frequent cause of severe hypoglycemia in type 1 diabetes, fear of which deters participation in regular exercise. Recommendations for normalizing glycemia around exercise consist of prandial adjustments to bolus insulin therapy and food composition, but this carries only short-lasting protection from hypoglycemia. Therefore, this study aimed to examine the impact of a combined basal-bolus insulin dose reduction and carbohydrate feeding strategy on glycemia and metabolic parameters following evening exercise in type 1 diabetes. Methods Ten male participants (glycated hemoglobin: 52.4±2.2 mmol/mol), treated with multiple daily injections, completed two randomized study-days, whereby administration of total daily basal insulin dose was unchanged (100%), or reduced by 20% (80%). Participants attended the laboratory at ∼08:00 h for a fasted blood sample, before returning in the evening. On arrival (∼17:00 h), participants consumed a carbohydrate meal and administered a 75% reduced rapid-acting insulin dose and 60 min later performed 45 min of treadmill running. At 60 min postexercise, participants consumed a low glycemic index (LGI) meal and administered a 50% reduced rapid-acting insulin dose, before returning home. At ∼23:00 h, participants consumed a LGI bedtime snack and returned to the laboratory the following morning (∼08:00 h) for a fasted blood sample. Venous blood samples were analyzed for glucose, glucoregulatory hormones, non-esterified fatty acids, β-hydroxybutyrate, interleukin 6, and tumor necrosis factor α. Interstitial glucose was monitored for 24 h pre-exercise and postexercise. Results Glycemia was similar until 6 h postexercise, with no hypoglycemic episodes. Beyond 6 h glucose levels fell during 100%, and nine participants experienced nocturnal hypoglycemia. Conversely, all participants during 80% were protected from nocturnal hypoglycemia, and remained protected for 24 h postexercise. All metabolic parameters were similar. Conclusions Reducing basal insulin dose with reduced prandial bolus insulin and LGI carbohydrate feeding provides protection from hypoglycemia during and for 24 h following evening exercise. This strategy is not associated with hyperglycemia, or adverse metabolic disturbances

Psychometric evaluation of the Pain Assessment in Advanced Dementia scale in an acute general hospital setting

BACKGROUND: People with dementia are at risk of unplanned hospital admissions and commonly have painful conditions. Identifying pain is challenging and may lead to undertreatment. The psychometric properties of the Pain Assessment in Advanced Dementia (PAINAD) scale, in medical inpatients with dementia have not been evaluated. METHODS: A secondary data analysis from a longitudinal study of 230 people with dementia admitted to two acute general hospitals in London, UK. Internal consistency, inter-rater reliability, test-retest reliability, concurrent validity, construct validity and discriminant validity of PAINAD were tested at rest and in movement. RESULTS: This predominantly female (65.7%) sample had a mean age of 87.2 (Standard Deviation; SD = 5.92) years. Inter-rater reliability showed an intra-class correlation (ICC) of 0.92 at rest and 0.98 in movement, test-retest reliability ICC was 0.54 at rest and 0.66 in movement. Internal consistency was 0.76 at rest and 0.80 in movement (Cronbach's α). Concurrent validity was weak between PAINAD and a self-rating level of pain (Kendall's Tau; τ = 0.29; p > 0.001). There was no correlation between PAINAD and a measure of behavioural and psychological symptoms of dementia, suggesting no evidence of convergent validity. PAINAD scores were higher during movement than rest, providing evidence of discriminant validity (z = -8.01, p < 0.001). CONCLUSIONS: We found good inter-rater reliability and internal consistency. The test-retest reliability was modest. This study raises concerns about the validity of the PAINAD in general acute hospitals. This provides an insight into pain assessment in general acute hospitals which may inform further refinements of the PAINAD

A modern(ist) mode: fashion, 1910, and the limits of modernism

Since the British Association of Modernist Studies conference in Glasgow, December 2010, which considered Virginia Woolf’s famous assertion that “on or about December 1910, human character changed”, there has been a resurgence of interest in modernism’s origins. Developed from a paper given at this conference, this article interrogates the modernist construction of chronological limits, examining why such limits were imposed. Engaging with Woolf’s statement, it considers her claims from a hitherto unexplored angle – from the perspective of modern fashion. Focusing on the 1910/1911 season, and Paul Poiret’s revolutionary catalogue illustrated by Georges Lepape, it asks firstly whether Woolf’s claims can be substantiated, and secondly, and more importantly, whether limits themselves are a critically useful way of ordering and interpreting the past