The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study

There is converging evidence that 1%-2% of women develop post-traumatic stress disorder (PTSD) as a result of childbirth. The current study aimed to explore the long-term effects of childbirth-related PTSD on women, their relationship with their partner and their relationship with their child. Semi-structured interviews were carried out with six women who reported clinically significant PTSD after birth, ranging from 7 months to 18 years beforehand. Interviews were transcribed and analysed using thematic analysis. Childbirth-related PTSD was found to have wide-ranging effects on women and their relationships. Women reported changes in physical well-being, mood and behaviour, social interaction, and fear of childbirth. Women reported negative effects on their relationship with their partner, including sexual dysfunction, disagreements and blame for events of birth. The mother-baby bond was also seriously affected. Nearly all women reported initial feelings of rejection towards the baby but this changed over time. Long-term, women seemed to have either avoidant or anxious attachments with their child. It is concluded that childbirth-related PTSD can have severe and lasting effects on women and their relationships with their partner and children. Further research is needed to compare this to normal difficulties experienced by women after having children

The Application of Scenario Based Recurrent Training to Teach Single Pilot Resource Management (SRM) Under the FAA Industry Training Standards (FITS) Program

Research indicates that improving a pilot\u27s capability to exercise sound judgment and make informed and timely decisions may significantly improve flight safety. One approach to this problem is the introduction of scenario-based training (SBT) into flight training curriculums. At the request of the Cirrus Owner\u27s and Pilots Association (COPA), the author developed and conducted four 3-hour scenario based seminars embodying these concepts and collected initial data from the 54 participants. A longitudinal study of this initial group will form the basis for additional research

Women's experiences of pregnancy, childbirth, and the postnatal period in the Gambia: A qualitative study

Objective: In sub-Saharan African countries, there are unique cultural factors and adverse physical conditions that contribute to women's experiences of pregnancy and birth. The objective of this study was to qualitatively explore women's experiences of pregnancy, childbirth, the postnatal period, and maternal psychological distress in The Gambia. Design and methods: Semi-structured interviews were carried out with 55 women who had given birth within the previous year. Results: Thematic analysis identified five themes: (1) transition to adulthood, (2) physical difficulties, (3) value of children in relation to others, (4) children as a strain, and (5) going through it alone. The results suggest that having a child is a defining point in women's lives associated with happiness and joy. However, women also described situations which could lead to unhappiness and distress in the perinatal period. A child conceived out of wedlock or a baby girl can be sources of distress because of negative cultural perceptions. The strain of having a child, particularly the additional financial burden, and minimal support from men were also a concern for women. Finally, women recognized the danger associated with delivery and expressed recurrent worries of complications during childbirth which could result in the death of them or the baby. Conclusions: Further research is needed to identify women vulnerable to psychological distress so that health services and target interventions can be developed accordingly

Longitudinal static optical properties of hydrogen chains: finite field extrapolations of matrix product state calculations

We have implemented the sweep algorithm for the variational optimization of SU(2) x U(1) (spin and particle number) invariant matrix product states (MPS) for general spin and particle number invariant fermionic Hamiltonians. This class includes non-relativistic quantum chemical systems within the Born-Oppenheimer approximation. High-accuracy ab-initio finite field results of the longitudinal static polarizabilities and second hyperpolarizabilities of one-dimensional hydrogen chains are presented. This allows to assess the performance of other quantum chemical methods. For small basis sets, MPS calculations in the saturation regime of the optical response properties can be performed. These results are extrapolated to the thermodynamic limit.Comment: Submitted to J. Chem. Phy

Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms

Background: Many women experience childbirth as traumatic and 2% develop post-traumatic stress disorder (PTSD). This study examined the role of health practitioner support and personal control during birth as predictors of PTS symptoms, adjusting for vulnerability factors of prior trauma, depression, control beliefs and birth intervention. It also investigated interactions between support, prior trauma and birth intervention and their association with PTS symptoms. Methods: A prospective longitudinal survey of 138 women recruited from UK NHS maternity clinics. Measures were taken in pregnancy, three-weeks and three-months after the birth. Results: Support and control during birth were not predictive of postnatal PTS symptoms. However, support was predictive of PTS symptoms in a subset of women with prior trauma (beta = -.41, R2 = 16%) at both three-weeks and three-months postpartum. The interaction of birth intervention and support was associated with PTS symptoms three-months after birth, the relationship between support and PTS symptoms was stronger in women experiencing more intervention. Conclusions: Low support from health practitioners is predictive of postnatal PTS symptoms in women who have a history of trauma. Longer-term effects of low support on postnatal PTS symptoms are also found in women who had more intervention during birth

Deriving the Hirshfeld partitioning using distance metrics

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Variational determination of the second-order density matrix for the isoelectronic series of beryllium, neon and silicon

The isoelectronic series of Be, Ne and Si are investigated using a variational determination of the second-order density matrix. A semidefinite program was developed that exploits all rotational and spin symmetries in the atomic system. We find that the method is capable of describing the strong static electron correlations due to the incipient degeneracy in the hydrogenic spectrum for increasing central charge. Apart from the ground-state energy various other properties are extracted from the variationally determined second-order density matrix. The ionization energy is constructed using the extended Koopmans' theorem. The natural occupations are also studied, as well as the correlated Hartree-Fock-like single particle energies. The exploitation of symmetry allows to study the basis set dependence and results are presented for correlation-consistent polarized valence double, triple and quadruple zeta basis sets.Comment: 19 pages, 7 figures, 3 tables v2: corrected typo in Eq. (52

CONSUMER TESTING OF COMMERCIAL MEDIUM GRAIN RICE VARIETIES

CONSUMER TESTING OF COMMERCIAL MEDIUM GRAIN RICE VARIETIE

The oceanography of the New York Bight

The New York Bight consists of the waters lying between Cape May, New Jersey, and Montauk Point, Long Island. A portion of the general southwesterly current known as the Coastal Drift lies in the seaward part of the Bight. Inshore from the Coastal Drift is an area of complex hydrography where the combined outflows of the Hudson River and other rivers enter the sea. In the region where the New Jersey and Long Island coastlines converge, an area 25 nautical miles on each side has been studied at all seasons of the year. This area extends from Sandy Hook southward to a point off Seaside Heights, eastward to 73°15' W longitude, north to the Long Island shore, and westward to Rockaway Inlet. The depth of water in the area averages about 90 feet, except in the innermost part of the Hudson Canyon which runs roughly northwest-southeast across most of the survey area. In the Canyon, depths in excess of 240. feet are found within the limits of the area studied. The hydrographic conditions in the area are in essence similar to those off the mouths of other large rivers. The combined flows of the Hudson and other rivers entering the surveyed area discharge enough fresh water annually to replace about one-half of the total volume of water under the 600 square miles of sea surface extensively surveyed. The salinity within the area is nearly as high as that of adjacent coastal water, however, and the actual quantity of river water within the area at any time rarely exceeds one percent of the total volume of water. Quantitative evaluation of these factors has led to the conclusion that there is an active circulation within the area which rapidly disperses the introduced river effluent. Many surveys of coastal and estuarine waters have been made. Outstanding among these are the survey of the River Tees, (1931, 1935), of the Tamar Estuary, (Hartley and Spooner, 1938; Milne, 1938), and of Alberni Inlet, (Tully, 1949). The general principles of estuarine circulations may be summarized as follows: In order to remove the added river water there must be a non-tidal drift of mixed water in a net seaward direction. When river flow remains constant, a steady state distribution of fresh and salt water throughout the estuary is attained, and at such times the net transport of river water seaward through any complete cross section of the estuary exactly equals the contribution of fresh water from the river during the same interval of time. As the mixture containing the river water moves seaward it gets progressively more saline, as additional sea water is entrained. In order to provide this sea water there must be a counter drift having a net flow in a landward direction. Superimposed on these necessary parts of the circulation are tidal and wind currents. The velocities of the tidal currents are commonly much greater than the velocity of the non-tidal drift, making the latter difficult to measure directly. It can be inferred, however, from the distribution of river water, as derived from the salinity distribution. Using the river water in this way we have evaluated the exchanges of the waters within the New York Bight. Tully (1949) has analyzed the circulation in Alberni Inlet by similar methods. Tidal current measurements made by the Coast and Geodetic Survey at various locations in the northwestern corner of the surveyed area are summarized by Marmer (1935). At Scotland Lightship, which is the location of the stations at the western end of Section A in Figure 1, the total excursion which results from the flood or ebb tidal currents is less than two miles. The currents at Ambrose Lightship, about five miles to the eastward, produce displacements only about half as great. The tidal displacements throughout the rest of the area are presumed to be less than these. The pattern of distribution of properties will be displaced, therefore, a distance less than ±1 mile at various stages of the tide. This distance is small in comparison to the size of the area surveyed, especially when considering the fact that distances between stations ranged from 5 to 8 miles. It was unnecessary, therefore, to attempt to take comparable stations at similar stages of the tide. Other considerations, beside its interesting hydrography, have contributed to the choice of this area for study. Because it is adjacent to centers of dense population and heavy industrial concentration, the New York Bight serves the conflicting purposes of waste disposal and recreation. Sewer effluents and industrial wastes enter the area by way of the rivers. Sewage sludges are barged out and dumped within the region studied. During the period covered by our surveys, The National Lead Company commenced operations to barge and discharge at sea the waste from its titanium plant at Sayreville, New Jersey. Since iron was a major constituent of this waste, analyses for iron in the water were made at each station, and the results have been valuable in checking the rate of the circulation which was computed from the distribution of river effluent. The New York Bight is also used extensively for recreational purposes. Because the area is readily and cheaply accessible by public transportation it must serve the recreational demands of a large part of the population of metropolitan New York. Sport fishing, bathing and boating are the principal recreational activities. Small but valuable commercial fisheries for shellfish and fin-fish also exist. The purpose of this study was to investigate the hydrographic processes in the New York Bight since they have an important bearing on the general problems of coastal oceanography and a knowledge of them should lead to a more successful evaluation and utilization of the area for the diverse purposes it must serve

Feasibility and Acceptability of a Web-Based Treatment with Telephone Support for Postpartum Women With Anxiety: Randomized Controlled Trial

BACKGROUND: Postpartum anxiety can have adverse effects on the mother and child if left untreated. Time constraints and stigma are common barriers to postpartum treatment. Web-based treatments offer potential flexibility and anonymity. What Am I Worried About (WaWa) is a self-guided treatment based on cognitive-behavioral and mindfulness principles for women experiencing postpartum anxiety. WaWa was developed in Australia and consists of 9 modules with optional weekly telephone support. WaWa was adapted to a Web-based version for use in England (Internet-based What Am I Worried About, iWaWa). OBJECTIVE: This study aimed to investigate the feasibility (engagement and usability) and acceptability (usefulness, satisfaction, and helpfulness) of iWaWa among English postpartum women with anxiety. METHODS: Postpartum (<12 months) women with mild-to-severe anxiety were recruited anonymously via social media during an 8-week period. Participants were randomized to the iWaWa treatment (8 weeks) or wait-list control group. Treatment and study feasibility and acceptability were assessed after the treatment, and anxiety symptoms were assessed at baseline, 8 weeks postrandomization, and 12 weeks postrandomization (treatment group only) using Web-based questionnaires. Semistructured telephone interviews were carried out after the treatment period for a more in-depth exploration of treatment acceptability and feasibility. RESULTS: A total of 89 eligible women were recruited through social media and randomized into the treatment (n=46) or wait-list control group (n=43). Women were predominantly Caucasian, well-educated, married, on maternity leave, first-time mothers and reported moderate levels of anxiety. Dropout rates were high, especially in the treatment group (treatment: 82%, 38/46; wait-list control: 51%, 22/43). A total of 26 women started iWaWa with only 2 women completing all 9 modules. Quantitative and qualitative data suggest iWaWa was experienced as generally useful and helpful. Participants enjoyed iWaWa's accessibility, anonymity, and weekly reminders, as well as the introduction to the principles of cognitive-behavioral therapy (CBT) and mindfulness. However, iWaWa was also experienced as not user-friendly enough, too long, and not smartphone-friendly. Parts of the content were experienced as not always relevant and appropriate. Participants felt that iWaWa could be improved by having it in a smartphone app format and by making the content more concise and inclusive of different parenting styles. CONCLUSIONS: Despite interest in iWaWa, the results suggest that both the study and iWaWa were not feasible in the current format. However, this first trial provides useful evidence about treatment format and content preferences that can inform iWaWa's future development, as well as research and development of Web-based postpartum anxiety treatments, in general, to optimize adherence. TRIAL REGISTRATION: ClinicalTrials.gov NCT02434406; https://clinicaltrials.gov/ct2/show/NCT02434406 (Archived by WebCite at http://www.webcitation.org/6xTq7Bwmd)