An exploration of the experiences of mothers who breastfeed long-term: What are the issues and why does it matter?

Background: The World Health Organization (WHO) promotes breastfeeding for 2 years and beyond. Despite this, only 25% of women in the United Kingdom are breastfeeding at all by 6 months postpartum, with a minority of women breastfeeding beyond the first year. Those who do often report feeling ridiculed or alienated in their choice. Here, the aim was to examine the experiences of women who chose to breastfeed longer term and to seek insight into the ways they felt breastfeeding could be normalized past infancy. Subjects and Methods: The study combined two qualitative datasets that explored maternal attitudes and experiences toward longer-term breastfeeding. In Study 1 a combination of methods was used, including interviews, to explore the challenges, attitudes, and experiences faced by women who had breastfed for over 6 months postpartum. In Study 2, 1,319 mothers who were pregnant or had an infant 0-2 years old completed an open-ended questionnaire exploring their attitudes toward longer-term breastfeeding. Results: Mothers who had experience of longer-term breastfeeding described how they faced negative attitudes and criticism from others, including the perceptions that longer-term breastfeeding was comical, bizarre, and pointless. Mothers discussed ways in which longer-term breastfeeding could be normalized rather than promoted, targeting health professionals and society instead of encouraging mothers themselves. Key ideas included greater visual representation, increasing knowledge and removing stigma. Conclusions: Longer-term breastfeeding needs to be normalized to increase acceptance and in turn reduce the negative attitudes that mothers often face despite following WHO guidance. Greater support is needed from health professionals and in health policy. © Mary Ann Liebert, Inc

Liminal Roles as a Source of Creative Agency in Management: The Case of Knowledge-Sharing Communities

Studies suggest that the experience of liminality – of being in an ambiguous, ‘betwixt and between’ position – has creative potential for organizations. We contribute to theory on the link between liminality and creative agency through a study of the coordinators of ‘knowledge-sharing communities’; one of the latest examples of a ‘neo-bureaucratic’ practice that seeks to elicit innovative responses from employees while intensifying control by the organization. Through a role-centred perspective, our study found that both the structural and interpretive aspects of coordinators’ role enactments promoted a degree of creative agency. ‘Front-stage’ and ‘back-stage’ activities were developed to meet the divergent expectations posed by senior management and community members, and the ambiguity of their roles prompted an array of different role interpretations. Our findings contribute to theory by showing how the link between liminality and creative agency is not confined to roles and spaces (consultancy work, professional expertise) that are positioned across organizational boundaries, or free from norms and expectations, but may also apply to roles that are ambiguously situated within organizational contexts and which are subject to divergent expectations. This shows how neo-bureaucratic forms may be both reproduced and renewed through the creative responses of individual managers

Selection for Replicases in Protocells

PMCID: PMC3649988This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Participatory instructional redesign by students and teachers in secondary education: effects on perceptions of instruction

Könings, K. D., Brand-Gruwel, S., & Van Merriënboer, J. J. G. (2011). Participatory instructional redesign by students and teachers in secondary education: effects on perceptions of instruction. Instructional Science, 39(5), 737–762.Students’ perceptions of instruction are important because they direct the learning of students. The fact that teachers have only limited knowledge of these perceptions is likely to threaten the effectiveness of learning, because congruence between interpretations of an instructional intervention is necesarry for its optimal use. This study examines participatory design as a strategy for taking student perceptions into account in instructional re/design. Participatory design meetings of groups of teachers and seven co-designing students in a secondary education setting identified changes to improve the regular education process. The results on changes in student perceptions, perceived-desired discrepancy, and teacher-student disagreement showed some improvement for the co-designers but, unexpectedly, limited or even negative effects for the non-co-designing students. Possible causes are discussed. Participatory design seems to have potential for improving education, but further research is needed

Baseline Religion Involvement Predicts Subsequent Salivary Cortisol Levels Among Male But not Female Black Youth

Background: Compared to Whites, Blacks are exposed to higher levels of chronic stress in the United States. As a result, major Black-White differences exist in the baseline and response of cortisol. Yet, the potential association between baseline religiosity and subsequent cortisol levels of Blacks are not known. Objectives: In the current study we aimed to determine the association between baseline religious behaviors and daytime salivary cortisol level among male and female Black youth. Materials and Methods: With a longitudinal design, data came from wave 1 (1994) and wave 6 (2000) of a cohort from an urban area in the Midwest of the United States. The study followed 227 Black adolescents (109 males and 118 females) for six years. Socio-demographics and religious behaviors (frequency of participation in religious activities) were measured at baseline. Base morning cortisol level at wave 6 was the outcome. We fitted a linear regression model to test the association between baseline religiosity at wave 1 and cortisol level at wave 6, while baseline age, socio-economics, and psychological symptoms were controlled. Results: In the pooled sample, frequency of participation in religious activities at baseline was negatively associated with mean cortisol level at follow up (r = -0.29, P > 0.01) among all, males (r = -0.38, P > 0.01), but not females (r = -.20, P > 0.05). Frequency of participation in religious activities remained a significant predictor of subsequent cortisol level (b = -0.283, 95% CI = -.107 - -0.022) while the effect of age, socioeconomics, and psychological symptoms were controlled. We could only find such an association among male Black youth (b = -0.368, 95% CI = -0.148 - -0.024) but not female Black youth (b = -0.229, 95% CI = -.113 - 0.011). Conclusions: Religiosity has been used as a coping mechanism among Blacks. Religiosity may also be related to stress regulation among Black youth. Future studies need to test complex associations between race, sex, religiosity, chronic stress, coping, and function of hypothalamo-pituitary-adrenal (HPA). It is not known whether male Black youth who are and those who are not religious differently cope with stress associated with daily discrimination and living in disadvantaged neighborhoods

Group-based memory rehabilitation for people with multiple sclerosis: subgroup analysis of the ReMiND trial

Background/Aim: Memory problems are frequently reported in people with multiple sclerosis (MS). These can be debilitating and affect individuals and their families. This sub-group analysis focused on the effectiveness of memory rehabilitation in patients with MS. Methods: Data were extracted from a single blind randomised controlled trial, the ReMiND trial, which also included participants with traumatic brain injury and stroke. Participants were randomly allocated to compensation or restitution treatment programmes, or a self-help control. The programmes were manual-based and comprised two individual and ten group sessions. Outcome measures included assessments of memory, mood and activities of daily living. A total of 39 patients with MS participated in this study (ten males (26%), 29 females (74%); mean±SD age: 48.3±10.8 years). Results: Comparison of groups showed no significant effect of treatment on memory, but there were significant differences between compensation and restitution on self-report symptoms of emotional distress at both 5- (p=0.04) and 7-month (p=0.05) follow-up sessions. The compensation group showed less distress than the restitution group. Conclusions: Individuals with MS who received compensation memory rehabilitation reported significantly less emotional distress than those who received restitution. Further research is needed to explore why self-reported memory problems did not differ between groups

Search for Kaluza-Klein Graviton Emission in ppˉp\bar{p} Collisions at s=1.8\sqrt{s}=1.8 TeV using the Missing Energy Signature

We report on a search for direct Kaluza-Klein graviton production in a data sample of 84 ${pb}^{-1}$ of \ppb collisions at $\sqrt{s}$ = 1.8 TeV, recorded by the Collider Detector at Fermilab. We investigate the final state of large missing transverse energy and one or two high energy jets. We compare the data with the predictions from a $3+1+n$-dimensional Kaluza-Klein scenario in which gravity becomes strong at the TeV scale. At 95% confidence level (C.L.) for $n$=2, 4, and 6 we exclude an effective Planck scale below 1.0, 0.77, and 0.71 TeV, respectively.Comment: Submitted to PRL, 7 pages 4 figures/Revision includes 5 figure

Measurement of the average time-integrated mixing probability of b-flavored hadrons produced at the Tevatron

We have measured the number of like-sign (LS) and opposite-sign (OS) lepton pairs arising from double semileptonic decays of $b$ and $\bar{b}$-hadrons, pair-produced at the Fermilab Tevatron collider. The data samples were collected with the Collider Detector at Fermilab (CDF) during the 1992-1995 collider run by triggering on the existence of $\mu \mu$ and $e \mu$ candidates in an event. The observed ratio of LS to OS dileptons leads to a measurement of the average time-integrated mixing probability of all produced $b$-flavored hadrons which decay weakly, $\bar{\chi} = 0.152 \pm 0.007$ (stat.) $\pm 0.011$ (syst.), that is significantly larger than the world average $\bar{\chi} = 0.118 \pm 0.005$.Comment: 47 pages, 10 figures, 15 tables Submitted to Phys. Rev.

Rehabilitation of memory following brain injury (ReMemBrIn): study protocol for a randomised controlled trial

Background Impairments of memory are commonly reported by people with traumatic brain injuries (TBI). Such deficits are persistent, debilitating, and can severely impact quality of life. Currently, many do not routinely receive follow-up appointments for residual memory problems following discharge. Methods/Design This is a multi-centre, randomised controlled trial investigating the clinical and cost-effectiveness of a group-based memory rehabilitation programme. Three hundred and twelve people with a traumatic brain injury will be randomised from four centres. Participants will be eligible if they had a traumatic brain injury more than 3 months prior to recruitment, have memory problems, are 18 to 69 years of age, are able to travel to one of our centres and attend group sessions, and are able to give informed consent. Participants will be randomised in clusters of 4 to 6 to the group rehabilitation intervention or to usual care. Intervention groups will receive 10 weekly sessions of a manualised memory rehabilitation programme, which has been developed in previous pilot studies. The intervention will include restitution strategies to retrain impaired memory functions and compensation strategies to enable participants to cope with their memory problems. All participants will receive a follow-up postal questionnaire and an assessment by a research assistant at 6 and 12 months post-randomisation. The primary outcome is the Everyday Memory Questionnaire at 6 months. Secondary outcomes include the Rivermead Behavioural Memory Test-3, General Health Questionnaire-30, health related quality of life, cost-effectiveness analysis determined by the EQ-5D and a service use questionnaire, individual goal attainment, European Brain Injury Questionnaire (patient and relative versions), and the Everyday Memory Questionnaire-relative version. The primary analysis will be based on intention to treat. A mixed-model regression analysis of the Everyday Memory Questionnaire at 6 months will be used to estimate the effect of the group memory rehabilitation programme. Discussion The study will hopefully provide robust evidence regarding the clinical and cost-effectiveness of a group-based memory rehabilitation intervention for civilians and military personnel following TBI. We discuss our decision-making regarding choice of outcome measures and control group, and the unique challenges to recruiting people with memory problems to trials

Trajectories of maternal symptoms of anxiety and depression. A 13-year longitudinal study of a population-based sample

<p>Abstract</p> <p>Background</p> <p>There is a lack of population-based studies of developmental trajectories following mothers throughout the whole child-rearing phase and there are few longitudinal studies focusing on both symptoms of depression and anxiety. The aim of the current study is to identify latent trajectory groups based on counts of symptoms of anxiety and depression among mothers throughout the child-rearing phase and the relations of the latent groups to maternal socio-demographic variables.</p> <p>Methods</p> <p>Data is from a prospective, longitudinal study of nearly 1000 families in Norway followed from when the index children were 18 months until they were 14.5 years old (the TOPP study). The study used latent profile analysis (LPA) to identify latent groups of mothers with distinct trajectories across time of symptom counts. Latent group differences on socio-demographic variables were tested with one-way ANOVAs, chi-square tests and exact tests.</p> <p>Results</p> <p>Six trajectories based on maternal scores from six waves of data collection of symptoms of anxiety and depression were identified; a 'No symptoms' group with mothers without symptoms; a 'Low' group with mothers reporting low symptom levels; a 'Moderate-low' group with mothers reporting moderately low symptom levels; a 'Moderate' group with mothers with moderate symptoms; a 'High-chronic' group with mothers with overall high symptom levels; and a 'Low-rising' group with mothers starting with a low symptom level that increased over time. The mothers in the High-chronic symptom group differed from the other mothers on several socio-demographic variables. They were significantly younger than the mothers in the Low group comprising the oldest mothers. The mothers in the High-chronic group had significantly lower education, were less likely to have paid work and were less likely to be living with a partner than the mothers in the other groups.</p> <p>Conclusions</p> <p>The study shows socio-demographic differences between mothers classified into six trajectory groups based on symptoms of anxiety and depression covering 13 years of the child-rearing period. Specific socio-demographic risk factors characterised mothers in the High-chronic symptom group. Identifying subgroups with enduring problems might inform more targeted preventive efforts.</p