«Det er mer til omsorgen enn retningslinjer og prosedyrer»: En kvalitativ intervjustudie om jordmors erfaringer med omsorgen til den overvektige kvinnen i fødsel

Hensikt: Å utforske jordmødres erfaring med omsorgen til den overvektige kvinnen i fødsel. Metode: Kvalitativ metode. Individuelle semistrukturerte intervju ble gjennomført med åtte jordmødre. Systematisk tekstkondensering inspirert av Malterud ble brukt i analysen av materialet. Resultater: Vi kom frem til tre kategorier etter analyse. Den første kategorien beskrev at retningslinjene for den overvektige kvinnen både var en trygghet og kunne gi frustrasjon hos jordmødrene. Å være underlagt retningslinjer gjorde det utfordrende for jordmødre å gi individuelt tilpasset omsorg. Den andre kategorien viser hvordan jordmødrene fremmer det normale i fødselen ved å ikke fremheve risikoen, men ha en beredskap. Hun styrker kvinnen til å ha tro på seg selv, være til stede og med mål om å gi kvinnen en god fødselsopplevelse og fremme en normal fødsel. Den siste kategorien beskriver jordmødres fremgangsmåte og utfordringer ved bruk av informasjon som et hjelpemiddel for medbestemmelse. Konklusjon: Jordmødre arbeider for å fremme det normale hos en kjent risikogruppe, hvor de utfordres i balansegangen mellom medikaliserte retningslinjer og ønsket om en naturlig tilnærming. Jordmødrene arbeider kvinnesentrert, helhetlig og styrker kvinnen ved å gi medbestemmelse, mestringsstrategier og flytte fokuset bort fra negative tilnærminger og følelser. En demedikalisert tilnærming og jordmødres perspektiv bør integreres i retningslinjer i fødselsomsorgen for overvektige kvinner. Nøkkelord: obesity, midwife, guidelines, childbirth, normal birth, empowermen

The waxy mutation in sorghum and other cereal grains reshapes the gut microbiome by reducing levels of multiple beneficial species

Waxy starches from cereal grains contain \u3e90% amylopectin due to naturally occurring mutations that block amylose biosynthesis. Waxy starches have unique organoleptic characteristics (e.g. sticky rice) as well as desirable physicochemical properties for food processing. Using isogenic pairs of wild type sorghum lines and their waxy derivatives, we studied the effects of waxy starches in the whole grain context on the human gut microbiome. In vitro fermentations with human stool microbiomes show that beneficial taxonomic and metabolic signatures driven by grain from wild type parental lines are lost in fermentations of grain from the waxy derivatives and the beneficial signatures can be restored by addition of resistant starch. These undesirable effects are conserved in fermentations of waxy maize, wheat, rice and millet. We also demonstrate that humanized gnotobiotic mice fed low fiber diets supplemented with 20% grain from isogenic pairs of waxy vs. wild type parental sorghum have significant differences in microbiome composition and show increased weight gain. We conclude that the benefits of waxy starches on food functionality can have unintended tradeoff effects on the gut microbiome and host physiology that could be particularly relevant in human populations consuming large amounts of waxy grains

Optoelectronic devices : synthesis, analysis, and application of functional materials

The field of optoelectronics is booming, as it involves important, functional electrical-to-optical and optical-to-electrical transducers. This dissertation contains efforts in three important areas of optoelectronics – electrode modification, light-emitting electrochemical cells (LEECs), and solar cells. Two ubiquitous metal oxide electrodes – indium tin oxide (ITO) and titanium dioxide (TiO₂) – have been chemically modified using the electrochemical reduction of iodonium salts to enhance interfacial charge transfer properties in devices. The surface coverage was controllable and monolayer to multilayer growth was achieved, resulting in passivation of the electrochemical reactivity of the electrode from 9 to 73%. X-ray photoelectron spectroscopy confirmed the presence of modifiers on the electrode that were either bound to surface hydroxyl groups or strongly physisorbed. LEECs have been fabricated from a series of ionic iridium(III) complexes to examine the effect of bulky, hydrophobic phenyl substituents. The modified complexes displayed band gap tuning and increased quantum yields. Devices doped with LiPF₆ displayed reduced response times, modest lifetimes, and peak luminances as high as 5425 cd/m², 50% higher than the corresponding salt-free device and nearly double the luminance of the parent complex. The best complex benefited from the increased stability and limited self-quenching imparted by the phenyl substituents, while maintaining a large band gap and nearly planar ligand torsion angles, which further improves emission efficiency. Additionally, it was found that the coordination strength and identity of the counteranion can have a significant effect on the emission wavelength in the solid state. Hybrid materials were fabricated with a conductive, organic zinc metallopolymer and inorganic semiconducting ZnO nanoparticles (NPs) for photovoltaic applications. Electropolymerization allowed for tunability of the metallopolymer thickness and zinc seed points were evenly dispersed throughout, providing NP nucleation sites. ZnO NPs were grown directly on the conducting polymer backbone and all throughout the film, affording improved physical and electronic contact between the materials. Transmission electron microscopy confirmed that increasing the number of ZnO growth cycles from 4 to 6 resulted in an increase of the average NP diameter from 2.7 to 3.7 nm. Additionally, electrochemical studies revealed that as the diameter increased, the NP band gap decreased, following the quantum confinement effect.Chemistr

Electrochemical Modification of Indium Tin Oxide Using Di(4-nitrophenyl) Iodonium Tetrafluoroborate

Optoelectronic applications often rely on indium tin oxide (ITO) as a transparent electrode material. Improvements in the performance of such devices as photovoltaics and light-emitting diodes often requires robust, controllable modification of the ITO surface to enhance interfacial charge transfer properties. In this work, modifier films were deposited onto ITO by the electrochemical reduction of di­(4-nitrophenyl) iodonium tetrafluoroborate (DNP), allowing for control over surface functionalization. The surface coverage could be tuned from submonolayer to multilayer coverage by either varying the DNP concentration or the number of cyclic voltammetry (CV) grafting scans. Modification of ITO with 0.8 mM DNP resulted in near-monolayer surface coverage (4.95 × 10¹⁴ molecules/cm²). X-ray photoelectron spectroscopy (XPS) analysis confirmed the presence of 4-nitrophenyl (NO₂Ph) moieties on the ITO surface through the detection of a NO₂ nitrogen signal at 405.6 eV after grafting. Further XPS evidence suggests that the NO₂Ph radicals do not bond to the surface indium or tin sites, consistent with modification occurring either through bonding to surface hydroxyl groups or through strong physisorption on ITO. CV in the presence of an electroactive probe and electrochemical impedance spectroscopy (EIS) were used to investigate the electronic effects that modification via DNP has on ITO. Even at submonolayer coverage, the insulating organic films can reduce the current response to ferrocene oxidation and reduction by more than 25% and increase the charge transfer resistance by a factor of 10

Association between liver enzymes and bone mineral density in Koreans: a cross-sectional study

Abstract Background Osteoporosis is a major health concern for both men and women, and associated fractures incur substantial economic burden. While there are a multitude of studies on bone mineral density (BMD) and liver diseases, not many studies have assessed the association between liver enzyme levels and BMD in homogeneous populations. Methods The current study investigated the association between serum liver enzyme levels and BMD at various sites in Koreans. Out of 21,517 surveyees of the 5th Korean National Health and Nutrition Examination Survey (2010–2012), 7160 participants’ data on BMD, serum liver enzymes, and full covariate data were included for cross-sectional analysis. BMD at the femoral neck, lumbar spine, entire femur, and whole body was assessed using dual energy X-ray absorptiometry (DEXA), and liver enzymes included aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma(γ)-glutamyl transferase (GGT) levels. Differences in participant characteristics by BMD and liver enzyme levels were analyzed, and complex sample design regression analysis adjusted for multiple covariates was performed to assess the relationship between liver enzymes and BMD. Results Negative associations were seen with GGT and BMD at all sites (P ≤ 0.02), ALT with lumbar spine (P = 0.0013), and AST with lumbar BMD (P = 0.0009). In particular, GGT presented strong negative associations with BMD in postmenopausal women and elder men. Conclusions This study demonstrates a negative relationship between liver enzyme levels and BMD, and suggests that a significant association exists between osteoporosis/decreased BMD and liver disorders

Additional file 1: Table S1. of Analysis of medical service use of knee osteoarthritis and knee meniscal and ligament injuries in Korea: a cross-sectional study of national patient sample data

Diagnostic codes of knee disorders following the Korean Standard Classification of Diseases, 6th revision (KCD-6) adapted from the International Classification of Diseases, 10th revision. (ICD-10) (DOCX 20 kb