Treating postpartum emotional distress by a short-term psychodynamic infant-parent intervention integrated with child health center care

Objective: The thesis had two aims. (1) To qualitatively explore the perspectives of CHC nurses’ (study I) parents’ (II) and psychotherapists’ (III) in receiving/offering SPIPIC (Short-term Psychodynamic Infant-Parent Intervention at Child health centers) and CHC nurses and psychotherapists’ experiences of participating/offering supervision at CHC (I and III). (2) To quantitatively evaluate SPIPIC outcomes on parent-reported depression and child social-emotional functioning (IV). Methods: Data collection was conducted on six CHCs. The first aim was achieved through in-depth interviews with 15 CHC nurses, 13 parents and eight psychotherapists. The material was interpreted using hermeneutic analysis method. The second aim was achieved through a naturalistic survey at CHC where SPIPIC treatments also took place. Two subsamples participated; (1) Families that signaled emotional distress constituted the “SPIPIC Group”. Initially 100 mothers and 59 fathers participated. (2) Families that did not signal any emotional distress during recruitment constituted the “Norm Group”. Initially, 81 mothers and 60 fathers participated. Instruments: Ages and Stages Questionnaire: Social Emotional (ASQ:SE), Edinburgh Postnatal Depression Scale (EPDS), social and medical background data and patient and treatment factors estimated by the psychotherapists after completion of treatment. Results: Study I. The nurses appreciated the availability, the opportunity to learn more about emotional problems, and the psychotherapist as a beneficial resource for parents and children. The criticism included that sometimes there was no transparency on the part of psychotherapists as well as clear frameworks for therapy and supervision. Study II. The parents appreciated nurses who asked about their emotional distress and SPIPIC’s easy accessibility. Psychotherapists who had a holistic family perspective and succeeded in switching between insight promotion and supportive efforts were particularly appreciated. Especially, “the insecure parent” and “the parent in crisis” were served by SPIPIC. Study III. Therapists corresponding to the adaptive approach found ways of collaborating with the nurses and were well integrated in the CHC paradigm. Their supervisions helped the nurses to bridge somatic and psychological perspectives. This approach required that the psychotherapist had a positive view of herself as a therapist, had a high transparency in her work, courage to raise uncomfortable questions and that she worked on the nurses’ commission. The psychotherapist also needed to encompass complex socio-cultural situations in junction with parents’ emotional problems. Study IV. Multilevel growth modeling analysis showed a significant decrease in mothers’ depression and children’s social-emotional functioning. The proportion of mothers who were depressed according to the index “clinically significant change” was halved, from 2/3 to 1/3. Half of them reached “reliable change” on depression estimates and 14% on children estimates. Mothers with higher initial depression estimates tended to have more therapy sessions. Single mothers initially had higher rates of depression than those living with the child’s father. The higher the level of education, the faster the mothers’ depression estimate dropped. Child function estimation was associated with whether or not the child had a medical diagnosis. Fathers’ depression outcomes were inconspicuous, but their ratings of infant functioning improved. Conclusions: SPIPIC seems to contribute to reducing maternal depression and concerns about the child’s social-emotional functioning in both parents. Psychotherapists should work at CHC to allow parents access to psychological care. CHC nurses should receive frequent supervision from the psychotherapist to develop skills, observation and identification of these families as well as good interprofessional collaboration

Laboratory analyses for assessing the potential for biogas production of various agricultural residues in Greece

Received: February 23rd, 2021 ; Accepted: May 27th, 2021 ; Published: June 8th, 2021 ; Correspondence: [email protected], [email protected] produces significant amounts of agricultural and livestock waste. For the needs of this study, Greece was divided into a Northern and a Southern part and relevant proposals were made for residues that can be used for energy production, through anaerobic digestion. For Northern Greece, this study concluded that the most abundant residues and potential substrates for anaerobic digestion valorisation are those of maize, inedible vegetables (including greenhouse vegetables), cattle manure, as well as the residues of beer and wine industry. For Southern Greece, the corresponding substrates are those of maize, inedible vegetables, sheep/goat manure and residues of wine, tomato, orange and olive processing, respectively. Based on the physicochemical characterization of individual feedstocks, corn silage, tomato husks, watermelon, malt, cattle manure, orange, and olive processing residues (olive pomace) were considered as the most suitable feedstocks for anaerobic digestion. Biochemical Methane Potential (BMP) assays for Northern Greece were also performed, testing the most abundant and appropriate residues for anaerobic digestion (of this area), namely corn silage, cattle manure and malt, in order to define their BMP yield as well as their prospective optimum mixtures. It was concluded that the BMP of the mono-substrates is in accordance with literature, while there were no statistically significant differences in the methane yield of all tested mixtures. The residual biomass originating from the three main categories of the agricultural sector (crop residues, agro-industrial residues, and animal manure) in Northern Greece can be efficiently valorised via anaerobic co-digestion, without observing, though, any synergistic effects on methane production

Gate-to-gate life cycle assessment of biosurfactants and bioplasticizers production via biotechnological exploitation of fats and waste oils

BACKGROUND: This study investigated the biotransformation of fats and waste oils towards glycolipid biosurfactants and bioplasticizers. The ecological performance and environmental impacts of the bioprocesses were evaluated aiming to assess their present environmental status and thus suggest future improvements using LCA methodology. RESULTS: Biosurfactants, namely rhamnolipids and sophorolipids were obtained via fermentation. Bioplasticizers, Fatty Acid Ethyl Esters (FAEE) and Monoglycerides (MAG), were developed via enzymatic catalysis with selected enzymes in mesophilic temperatures via ethanolysis and glycerolysis, respectively. The study revealed that air emissions, electricity and thermal energy requirements are the key contributors to the potential environmental impacts in the LCIA. More specifically, rhamnolipids production has less energetic needs compared to sophorolipids manufacturing, resulting thus to lower environmental impacts. The increased thermal requirements of MAG production phase is the main contributor to their negative environmental performance, with the overall energy consumption for MAG production being 3-fold higher than the FAEE formation phase. CONCLUSIONS: The assessment identified that among the biosurfactant production processes, the sophorolipids production resulted to 22.7% higher environmental impact compared to rhamnolipids. Similarly, FAEE production can be classified as a more environmental friendly process compared to MAG, resulting to 67% lower environmental impact based on the environmental indicators assessed

Στατιστική ανάλυση αξιολόγησης θεραπευτικής παρέμβασης Πολυοικογενειακής Θεραπείας και Ψυχοεκπαίδευσης στις Διαταραχές Πρόσληψης Τροφής

Υπόβαθρο και σκοπός: Οι διαταραχές πρόσληψης τροφής (ΔΠΤ) εμφανίζονται με αυξημένη συχνότητα στην εφηβεία και επηρεάζουν την ομαλή ψυχοσωματική ανάπτυξη του εφήβου. Οι νεότερες τάσεις στην αντιμετώπιση των ΔΠΤ στρέφονται σε εντατικά θεραπευτικά προγράμματα, όπως το μοντέλο Πολυοικογενειακής Θεραπείας και το πρόγραμμα Ψυχοεκπαίδευσης των οικογενειών. Σκοπός της μελέτης ήταν να διερευνηθεί αν μετά την ολοκλήρωση των παρακολουθήσεων οι οικογένειες των πασχόντων αφενός θα επιβαρύνονται λιγότερο ψυχολογικά και αφετέρου θα αντιμετωπίζουν καλύτερα τη διαταραχή και το πάσχον μέλος, όπως θα αξιολογηθεί από τα ερωτηματολόγια EDSIS και AESED αντίστοιχα. Ένας δευτερεύων στόχος ήταν να εξεταστεί αν επαληθεύονται τα ευρήματα άλλων χωρών που δείχνουν ότι η Πολυοικογενειακή θεραπεία είναι πιο αποτελεσματική σε σχέση με την Ψυχοεκπαίδευση στην αντιμετώπιση των ΔΠΤ. Μέθοδος: Πραγματοποιήθηκε προοπτική έρευνα μέλλοντος δύο ομάδων, με συνεργασία των φορέων που συμμετέχουν στο πρόγραμμα «Βήματα Εμπρός». Η 1η ομάδα ακολούθησε Ψυχοεκπαιδευτική παρέμβαση με 107 γονείς ασθενών με Ψυχογενή Ανορεξία (ΨΑ) και η 2η ακολούθησε το μοντέλο της Πολυοικογενειακής Θεραπείας με 40 γονείς ασθενών που έπασχαν από ΔΠΤ. Τα εργαλεία που χρησιμοποιήθηκαν ήταν το ερωτηματολόγιο AESED, που μετράει την κλίμακα προσαρμοστικότητας και ικανότητας διαχείρισης στις ΔΠΤ, και το ερωτηματολόγιο EDSIS που παρέχει την κλίμακα μέτρησης των επιπτώσεων των συμπτωμάτων της ΔΠΤ. Μετά το τέλος της θεραπευτικής εβδομάδας συλλέχθηκαν τα ερωτηματολόγια AESED και EDSIS και προγραμματίσθηκαν άλλες τρεις συναντήσεις παρακολούθησης τους επόμενους έξι μήνες (το 2ο, τον 4ο και τον 6ο μήνα). Προς στατιστική αξιοποίηση των ερωτηματολογίων AESED και EDSIS, προσαρμόσθηκαν και δοκιμάσθηκαν διάφορα γραμμικά μικτά μοντέλα τυχαίας σταθεράς και τυχαίας κλίσης, και πραγματοποιήθηκε έλεγχος των συγχυτικών παραγόντων, όπως το ιατρικό ιστορικό των συμμετεχόντων. Αποτελέσματα: Δεν βρέθηκε διαφοροποίηση μεταξύ του προγράμματος Ψυχοεκπαίδευσης και του μοντέλου της Πολυοικογενειακής θεραπείας, με βάση τα ερωτηματολόγια AESED και EDSIS (pvalue=0.5596 και pvalue=0.278 αντίστοιχα). Η παρέλευση των δύο πρώτων μηνών, μετά τη θεραπευτική εβδομάδα, συσχετίστηκε με στατιστικά σημαντική (pvalue<0.001), μείωση των βαθμολογιών AESED και EDSIS, ενώ οι διαφορές μεταξύ των επόμενων συναντήσεων ήταν στατιστικά μη σημαντικές. Οι γονείς που παρακολούθησαν το πρόγραμμα Ψυχοεκπαίδευσης παρουσίασαν στη 2η συνάντηση παρακολούθησης μείωση των αρχικών βαθμολογιών AESED και EDSIS κατά 8.5 και 9.4 μονάδες αντίστοιχα, ενώ οι γονείς της Πολυοικογενειακής θεραπείας παρουσίασαν μείωση κατά 8.6 και 9.4 μονάδες. Στις επόμενες δύο συναντήσεις παρακολούθησης δεν υπήρξε στατιστικά σημαντική διαφοροποίηση των βαθμολογιών AESED και EDSIS σε σχέση με τη 2η συνάντηση. Το είδος θεραπείας επέδρασε σημαντικά στις διαστάσεις του AESED αποφυγή και τροποποιήσιμη ρουτίνα (pvalue<0.05), έλεγχος της οικογένειας (pvalue<0.001), και εθελοτυφλία (pvalue<0.05), ενώ οι βαθμολογίες των διαστάσεων του ερωτηματολογίου EDSIS δεν διαφοροποιήθηκαν μεταξύ των δύο θεραπειών. Οι διαστάσεις κοινωνική απομόνωση (EDSIS) και εθελοτυφλία (AESED) βρέθηκαν στατιστικά μη σημαντικές (pvalue>0.05), αντιστεκόμενες στις αλλαγές που επιφέρουν οι θεραπευτικές παρεμβάσεις. Ο έλεγχος των συγχυτικών παραγόντων έδειξε ότι οι μεταβλητές ιατρικό ιστορικό της μητέρας και του πατέρα ήταν στατιστικά σημαντικές (t=-2.64 με pvalue=0.0096 και t=-2.64 με pvalue=0.0011 αντίστοιχα). Οι απώλειες κατά την παρακολούθηση ξεπέρασαν το 38.3%. Συζήτηση και συμπεράσματα: Το είδος της θεραπευτικής παρέμβασης δεν διαδραμάτισε κάποιο ρόλο στη βελτίωση της προσαρμοστικότητας, της ικανότητας διαχείρισης και της αντιμετώπισης των ειδικών δυσκολιών στις ΔΠΤ. Η θεραπεία ήταν αυτή που επέφερε τη μείωση των βαθμολογιών στις κλίμακες των δύο ερωτηματολογίων καθώς, η συμμετοχή των συγγενών σε ομαδική θεραπεία, βελτίωσε την ψυχολογική τους διάθεση και τον τρόπο που αντιμετωπίζουν τη διαταραχή και το πάσχον μέλος. Η ανοδική τάση που παρατηρήθηκε στις βαθμολογίες των ερωτηματολογίων EDSIS και AESED στην τελευταία συνάντηση παρακολούθησης υποδεικνύει υποτροπή των συμπτωμάτων των συγγενών. Λόγω των υψηλών ποσοστών απώλειας (άνω του 38%) κατά την παρακολούθηση αφενός τα αποτελέσματα είναι πιθανό να παρερμηνευτούν αφετέρου, υφίσταται αδυναμία αξιολόγησης, της εγκυρότητας της έρευνας. Η επανάληψη της έρευνας με μεγαλύτερο και πιο ποικίλο δείγμα καθίσταται επιβεβλημένη για εξαγωγή πιο αξιόπιστων αποτελεσμάτων.Background and Objectives: Eating disorders (ED) occur with increased frequency in puberty and affect the adolescent's smooth psychosomatic development. Newer trends in treatment of ED are focused on intensive care programs, such as the Multi-family therapy model and the Psychoeducation program. The purpose of this study was to examine whether the findings of other countries that show that Multi-family therapy is more effective than Psychoeducation treatment in treating ED, are being verified. A secondary objective was to examine whether the families of sufferers on the one hand would be less psychologically burdened and on the other hand to better deal with the disorder and the affected member, as assessed by the EDSIS and AESED questionnaires after the survey was completed. Methods: A Parallel group design study of two groups was carried out in collaboration with the actors involved in the "Steps Forward" program. The first group followed Psychoeducational intervention with 107 parents of Anorexia Nervosa (AN) patients and the 2nd followed the model of Multi-family therapy with 40 parents of patients suffering from ED. The tools used were the AESED questionnaire, which measures the accommodation and enabling scale for ED, and the EDSIS questionnaire providing the scale of measurement of an ED symptom impact scale. After the end of the treatment week, the AESED and EDSIS questionnaires were collected and three follow-up sessions were scheduled in the next six months (2nd, 4th and 6th months). In order to statistically evaluate the AESED and EDSIS questionnaires several linear mixed models with random intercept and random slope were fitted and tested, and confounders, such as the medical history of the participants, were tested. Results: No difference was found between the Psychoeducation program and the Multi-family therapy model, based on the AESED and EDSIS questionnaires (pvalue=0.5596 and pvalue=0.278, respectively). The first two months, after the treatment week, were associated with a statistically significant (pvalue <0.001) reduction in the AESED and EDSIS scores, while the differences between subsequent meetings were statistically insignificant. Parents attending the Psychoeducation program showed a reduction in the initial AESED and EDSIS scores by 8.5 and 9.4 points respectively at the 2nd follow-up meeting, while the parents of Multi-family reported a decrease of 8.6 and 9.4 points. In the next two follow-up meetings there was no statistically significant differentiation of the AESED and EDSIS scores compared to the 2nd meeting. The type of treatment significantly affected the dimensions of AESED, avoidance & modifying routine (pvalue<0.05), control family (pvalue<0.001) and turning a blind eye (pvalue<0.05), while the dimensions of the EDSIS questionnaire were not differentiated between the two therapies. The dimensions of social isolation (EDSIS) and turning a blind eye (AESED) were found to be statistically insignificant (pvalue>0.05), resisting the changes brought by the therapeutic interventions. Control of confounding factors showed that mother and father's medical history variables were statistically significant (t =-2.64 with pvalue=0.0096 and t=-2.64 with pvalue=0.0011 respectively). The loss to follow-up exceeded 38.3%. Discussion and Conclusions: The type of therapeutic intervention did not play a role in improving the accommodation, the enabling scale and addressing the special difficulties in ED. The treatment was the one that reduced the scores on the two questionnaire scales as the relatives' involvement in group therapy improved their psychological mood and the way they treat the disorder and the sufferer. The upward trend observed in EDSIS and AESED questionnaire scores at the last follow-up meeting suggest relapse of relatives symptoms. Due to the high loss rates (over 38%) in the follow-up, the results are likely to be misinterpreted, and the validity of the research is inadequate. Repeating research with a larger and more varied sample makes it imperative to export more reliable results

Life cycle assessment (LCA) of end-of-life dairy products (EoL-DPs) valorization via anaerobic co-digestion with agro-industrial wastes for biogas production

BACKGROUND: The aim of the present study was to assess the environmental impacts of End-of-Life Dairy Products (EoL-DPs) management via their co-treatment with agro-industrial wastes (AgW) in a centralized biogas facility located in Cyprus using a gate-to-gate LCA approach. Two different scenarios were examined under the framework of this project. In the first one, co-treatment of EoL-DPs with various AgW (in a 20/80, w/w, ratio) was evaluated in a one-stage mesophilic anaerobic digestion (AD) process. In the second scenario, the same amount of EoL-DPs were acidified before methanogenesis with AgW in order to improve biogas production. RESULTS: Prior acidification of EoL-DPs showed a better environmental performance compared to the results obtained upon direct co-digestion in a mesophilic digester, having a total impact of 52.44 Pt against 57.13 Pt respectively. Biogas production upon acidification, and therefore energy yield, was higher reaching up to 22.88 m3 CH4/ton of feed (229.25 kWh/ton of feed), compared to 17.45 m3 CH4/on of feed (174.85 kWh/ton of feed) for the case where no pretreatment was performed. CONCLUSIONS: The acidification of EoL-DPs enhanced the environmental performance of the process by reducing its impact by 8.2% (in Pt equivalents). The energy consumption of the biogas plant mixing equipment was identified as the process hotspot. However, further analysis of the environmental performance of the proposed process is required by extending the system’s boundaries towards a Cradle-to-Grave approach

Queue Management in Network Processors

Abstract: -One of the main bottlenecks when designing a network processing system is very often its memory subsystem. This is mainly due to the state-of-the-art network links operating at very high speeds and to the fact that in order to support advanced Quality of Service (QoS), a large number of independent queues is desirable. In this paper we analyze the performance bottlenecks of various data memory managers integrated in typical Network Processing Units (NPUs). We expose the performance limitations of software implementations utilizing the RISC processing cores typically found in most NPU architectures and we identify the requirements for hardware assisted memory management in order to achieve wire-speed operation at gigabit per second rates. Furthermore, we describe the architecture and performance of a hardware memory manager that fulfills those requirements. This memory manager, although it is implemented in a reconfigurable technology, it can provide up to 6.2Gbps of aggregate throughput, while handling 32K independent queues

New Waves of IoT Technologies Research – Transcending Intelligence and Senses at the Edge to Create Multi Experience Environments

The next wave of Internet of Things (IoT) and Industrial Internet of Things (IIoT) brings new technological developments that incorporate radical advances in Artificial Intelligence (AI), edge computing processing, new sensing capabilities, more security protection and autonomous functions accelerating progress towards the ability for IoT systems to self-develop, self-maintain and self-optimise. The emergence of hyper autonomous IoT applications with enhanced sensing, distributed intelligence, edge processing and connectivity, combined with human augmentation, has the potential to power the transformation and optimisation of industrial sectors and to change the innovation landscape. This chapter is reviewing the most recent advances in the next wave of the IoT by looking not only at the technology enabling the IoT but also at the platforms and smart data aspects that will bring intelligence, sustainability, dependability, autonomy, and will support human-centric solutions.acceptedVersio