Extraordinary exposed in early motherhood - a qualitative study exploring experiences of mothers with type 1 diabetes

<p>Abstract</p> <p>Background</p> <p>Women with type 1 diabetes face several challenges during pregnancy, childbirth and in relation to breastfeeding. It is therefore of utmost importance to consider their need for specific support, early postpartum as well as in daily life after discharge from maternity care. Few studies have investigated these aspects of healthcare. The aim of this study was to explore experiences after childbirth regarding breastfeeding, glycemic control, support and well-being in women with type 1 diabetes.</p> <p>Methods</p> <p>A hermeneutic reflective life world research approach was used in this qualitative study. Data was gathered through audio-recorded focus group discussions and individual interviews with 23 women with type 1 diabetes, 6-24 months after childbirth. After verbatim transcription, the text was analyzed in order to identify themes of meaning and a conclusive interpretation of the explored phenomenon.</p> <p>Results</p> <p>Experiences of extraordinary exposure challenged the women with type 1 diabetes in their transition to early motherhood. The exposure included a struggle with breastfeeding, although with a driving force to succeed. Everyday life was filled with uncertainty and unpredictability related to one's own unstable glycemic control and the women down-prioritized their own needs in favor of the child. A feeling of being disconnected from professional care further contributed to the experiences of extraordinary exposure.</p> <p>Conclusion</p> <p>In early motherhood women with type 1 diabetes have a great need for support in managing daily life postpartum, which requires contemporary approaches to overlap insufficient linkage between health care professionals in maternity and child health care, and diabetes care.</p

Why was this transfusion given? Identifying clinical indications for blood transfusion in health care data

Loan R van Hoeven,1,2 Aukje L Kreuger,3,4 Kit CB Roes,1 Peter F Kemper,2,4 Hendrik Koffijberg,5 Floris J Kranenburg,3,4,6 Jan MM Rondeel,7 Mart P Janssen1,2 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; 2Transfusion Technology Assessment Department, Sanquin Research, Amsterdam, the Netherlands; 3Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; 4Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands; 5Department of Health Technology &amp; Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands; 6Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands; 7Department of Clinical Chemistry, Isala, Zwolle, the Netherlands Background: To enhance the utility of transfusion data for research, ideally every transfusion should be linked to a primary clinical indication. In electronic patient records, many diagnostic and procedural codes are registered, but unfortunately, it is usually not specified which one is the reason for transfusion. Therefore, a method is needed to determine the most likely indication for transfusion in an automated way.Study design and methods: An algorithm to identify the most likely transfusion indication was developed and evaluated against a gold standard based on the review of medical records for 234 cases by 2 experts. In a second step, information on misclassification was used to fine-tune the initial algorithm. The adapted algorithm predicts, out of all data available, the most likely indication for transfusion using information on medical specialism, surgical procedures, and diagnosis and procedure dates relative to the transfusion date.Results: The adapted algorithm was able to predict 74.4% of indications in the sample correctly (extrapolated to the full data set 75.5%). A kappa score, which corrects for the number of options to choose from, was found of 0.63. This indicates that the algorithm performs substantially better than chance level.Conclusion: It is possible to use an automated algorithm to predict the indication for transfusion in terms of procedures and/or diagnoses. Before implementation of the algorithm in other data sets, the obtained results should be externally validated in an independent hospital data set. Keywords: indication for transfusion, selection algorithm, electronic health record dat

Seduced by the dark side: integrating molecular and ecological perspectives on the influence of light on plant defence against pests and pathogens.

Plants frequently suffer attack from herbivores and microbial pathogens, and have evolved a complex array of defence mechanisms to resist defoliation and disease. These include both preformed defences, ranging from structural features to stores of toxic secondary metabolites, and inducible defences, which are activated only after an attack is detected. It is well known that plant defences against pests and pathogens are commonly affected by environmental conditions, but the mechanisms by which responses to the biotic and abiotic environments interact are only poorly understood. In this review, we consider the impact of light on plant defence, in terms of both plant life histories and rapid scale molecular responses to biotic attack. We bring together evidence that illustrates that light not only modulates defence responses via its influence on biochemistry and plant development but, in some cases, is essential for the development of resistance. We suggest that the interaction between the light environment and plant defence is multifaceted, and extends across different temporal and biological scales

Pesticide removal from waste spray-tank water by organoclay adsorption after field application; an approach for a formulation of cyprodinil containing antifoaming/defoaming agents

Purpose Many studies report depuration data of water containing pesticides based on study performed using active ingredients. Nevertheless, the major part of the commercial formulations contains additives/adjuvant or are manufactured with the technology of microencapsulation which may influence the depuration processes. Therefore the main objective of this work was to develop and test a pilot scheme for decontaminating water containing pesticides, for substances formulated with antifoaming/defoaming agents. Methods The Freundlich adsorption coefficients of formulation of new generation fungicide cyprodinil onto the organoclay Cloisite 20 A have been determinate, in laboratory, in order to predict the efficiency of this organoclay on removing the fungicide from the waste spray-tank water. Subsequently, the adsorption tests were repeated in the pilot system in order to test the practical operation of the depuration scheme. Results The results obtained from the laboratory adsorption tests have been successfully confirmed by the results in the adsorption tests with the pilot system, with a removal of cyprodinil higher than 96% over a few hours. The passing of the organoclay - cyprodinil suspension trough a layer of biomass has shown a 100 % recover of the organoclay at the surface of the biomass in one week. Regarding the waste disposal, for instance the organoclay composted after the treatment, cyprodinil doesn\u2019t show any significant dissipation after 90 days. Conclusion The depuration scheme developed showed to be efficient for decontaminating water containing pesticides, for substances formulated with antifoaming/defoaming agents, but additional treatments for the adsorbed residues still appear to be necessary even for moderate persistent pesticide as cyprodinil. Furthermore, a significant conclusion of this study concerns the high influence of pesticides formulation on the decontamination process of water containing these compounds, which should be taken into account for the development of innovative decontamination systems, especially for practical applications