Shame and self-acceptance in continued flux: qualitative study of the embodied experience of significant weight loss and removal of resultant excess skin by plastic surgery

This study explored the embodied experience of body change using a qualitative design. Eight previous plastic surgery patients of a London hospital took part in in-depth, semi-structured interviews 1 year post a plastic surgery procedure to remove excess skin around their abdomen, resulting from weight loss. Participant interviews were analysed using Interpretative Phenomenological Analysis. Two sub-themes titled 'Shame of the hidden body' and 'Lack of acceptance; the future focused body' are presented in this article. Findings are considered in relation to theories of 'Body Shame' and in the current cultural context

Recommodification of the Social Determinants of Health

Background Decommodification is the extent to which living standard is independent of market position. In recent decades, some states have embarked on a process of recommodification, restricting the alternatives to participating in the market. This study has investigated how recommodification of unemployment healthcare and pensions are correlated with health inequalities. Methods Using Health Survey for England and the Swedish Living Conditions Survey, this study computes the magnitude of health inequalities in Sweden and England and correlates the magnitude of inequalities with measures of recommodification. In stage 1, the odds ratio of Not good health/having visited a doctor was computed using logistic regression for each year, using the employed and the high educated as the reference categories. In stage 2, the log (odds ratios) of poor health or doctor visits computed in stage 1 were correlated with the net replacement rate/price of primary care using linear regression. Results Health inequalities between the employed and the unemployed were significantly higher in both England and Sweden in 2011 than in 1991, a period during which unemployment benefit was recommodified in both countries. The association between health inequality and net replacement rate was much stronger in Sweden. Health inequalities increased slightly among English pensioners, while those of the Swedish sample remained steady. This is not what we would expect from the development of recommodification in the two countries: Sweden recommodified while England did not. 3 For groups with similar needs, the higher educated are more likely to seek healthcare. There were no trends in inequality in access to healthcare in Sweden. Conclusion This study has shown that recommodification is associated with health inequalities, especially in Sweden, and that inequalities in replacement rates are associated with health. However, the links between recommodification and health are context-dependent

Trends in Associations Between Sickness Absence Before the Age of 65 and Being in Paid Work After the Age of 65: Prospective Study of Three Total Population Cohorts

The increasing workforce participation at higher ages may impact social insurance systems, however, this has hardly been studied at all. We studied associations between sociodemographic factors and prior sickness absence and disability pension, with having paid work and sickness absence after age 65, and if such associations changed over time. We used longitudinal register data regarding three cohorts of all residents in Sweden who turned 65 in 2000, 2005, or 2010 (N = 50,000, 68,000, and 99,000, respectively). Although employment rates when aged 66-71 increased between the cohorts, associations of sociodemographic factors with paid work and sickness absence, when aged 66-71 did not. Both sickness absence and disability pension when aged 60-64 were negatively associated with working past 65. Sickness absence when aged 60-64 was positively associated and disability pension was negatively associated with sickness absence after 65. Possibilities to remain in paid work with different health conditions need to be strengthened to avoid inequalities when raising the retirement age

Taking your participants home: Self care within the research process

Background: On the long and often stressful road to qualifying as a Counselling Psychologist the issue of self care is addressed early within the training. Yet this idea of self care relates to therapeutic practice, with little consideration of self care during the research process. With the training route now at Doctoral level, all practitioners will undertake a significant research project as part of the qualifying portfolio. Aims and Scope: This paper explores the process issues encountered in conducting research into the experience of Childhood Sexual Abuse (CSA), and raises questions about the way self-care is addressed within the research process. The article reflects upon a Content Analysis of 202 personal accounts of CSA with the aim of exploring the presence of Stockholm syndrome and PTSD within CSA. Literature from self care within the clinical application of psychology and trauma-based work is discussed as a starting point for the development of self care within a research context. Conclusion: Recommendations are made for changes in research practice and ethical review, and a clear role for Counselling Psychologists to lead in this development

Evidence of Mechanical Alloying in Bali Milled ZrO2-Y2O3 System Based on HRTEM Image Processing Analysis

We investigated, using high resolution electron microscopy and image processing, the early stages of the mechanical alloying process of a mixture of zirconia and yttrium oxide powders. Molar fraction of yttrium oxide was 0.10. We focused our investigation on the grain boundary region and the region of overlapping layers of zirconia and yttria. Fourier filtering revealed, at the atomic level, one possible sequence of alloying, which occurred in the grain boundary and in the overlapping layers

Working with trauma : interpersonal and process issues in therapy for people suffering from the effects of traumatic experience

While the issue of avoidance in PTSD is well-documented in terms of symptom presentation, little has been done to address the problem posed to therapists of clients engaging in an avoidance of traumatic material within therapy. The current study uses a two-part approach, combining quantitative and qualitative methods to address avoidance in therapy for PTSD. In Part 1, a correlational design is used to compare clients' coping styles of "monitoring" and "blunting" (Miller, 1980) with change in symptoms over a course of therapy. The results indicate some support for the notion that coping style is relevant to symptom change over a course of therapy for PTSD. A blunting coping style was found to be significantly negatively correlated with degree of improvement in intrusive thoughts and a monitoring coping style significantly positively correlated with improvement in avoidance symptoms over the period. However, the possibility that these results are a function of significant correlations at the outset of therapy is considered. Furthermore, the low response rate resulted in the collection of insufficient data to fully test the hypotheses and, as a result, the study was treated as an exploratory, preliminary analysis and used to highlight research questions for a second phase of the research. In Part 2 of the study, a discourse analytic approach was used to generate avoidant discursive practices in transcribed material from therapy sessions with clients with PTSD. Both clients and therapists were found to use a range of discursive practices which resulted in the conversation moving away from expressions of negative affect or an exploration of traumatic material. Putative explanations for the observed behaviours are discussed and the need for therapists to be aware of these processes and their own emotional reactions to client's traumatic memories is emphasised. Differences in presentation between clients with histories of sexual abuse and those experiencing non-abusive isolated experiences of trauma are raised. The nature of avoidance within therapy is discussed and the impact of the overarching discourse of the therapeutic setting and the associated roles and power dynamics within the dyad are explored. Implications for improving the effectiveness of therapy and suggestions for future research in the field of avoidance in PTSD are proposed and, in particular, a call made for a more process-focused and "dyad-orientated" approach to practice and research in this area

Trajectory analyses in insurance medicine studies : Examples and key methodological aspects and pitfalls

Background Trajectory analyses are being increasingly used in efforts to increase understanding about the heterogeneity in the development of different longitudinal outcomes such as sickness absence, use of medication, income, or other time varying outcomes. However, several methodological and interpretational challenges are related to using trajectory analyses. This methodological study aimed to compare results using two different types of software to identify trajectories and to discuss methodological aspects related to them and the interpretation of the results. Methods Group-based trajectory models (GBTM) and latent class growth models (LCGM) were fitted, using SAS and Mplus, respectively. The data for the examples were derived from a representative sample of Spanish workers in Catalonia, covered by the social security system (n = 166,192). Repeatedly measured sickness absence spells per trimester (n = 96,453) were from the Catalan Institute of Medical Evaluations. The analyses were stratified by sex and two birth cohorts (1949-1969 and 1970-1990). Results Neither of the software were superior to the other. Four groups were the optimal number of groups in both software, however, we detected differences in the starting values and shapes of the trajectories between the two software used, which allow for different conclusions when they are applied. We cover questions related to model fit, selecting the optimal number of trajectory groups, investigating covariates, how to interpret the results, and what are the key pitfalls and strengths of using these person-oriented methods. Conclusions Future studies could address further methodological aspects around these statistical techniques, to facilitate epidemiological and other research dealing with longitudinal study designs.Peer reviewe

Evidence of Mechanical Alloying in Ball Milled ZrO2-Y2 O3 System Based on HRTEM Image Processing Analysis

We investigated, using high resolution electron microscopy and imageprocessing, the early stages of the mechanical alloying processof a mixture of zirconia and yttrium oxide powders. Molar fractionof yttrium oxide was 0.10. We focused our investigation on thegrain boundary region and the region of overlapping layers of zirconiaand yttria. Fourier filtering revealed, at the atomic level, onepossible sequence of alloying, which occurred in the grain boundaryand in the overlapping layers