Trauma-sensitive yoga: a collective case study of the trauma recovery of women impacted by Intimate Partner Violence (IPV)

Intimate Partner Violence (IPV) is defined as a pattern of abusive and controlling behaviors that an individual perpetuates physically, psychologically, emotionally, spiritually, economically, and/or sexually against his or her intimate partner (World Health Organization, 2013b). More than 1 in 3 women in the United States have experienced IPV at some point in their lifetime (The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report, 2010). Further, more than a third of women who have been impacted by Intimate Partner Violence (IPV) develop PTSD (DeJonghe, Bogat, Levendosky, & Von Eye, 2008; Van der Kolk et al., 2014). Despite the high incidence of PTSD in women impacted by IPV, there seems to be a gap addressing the needs of this clinical population due to the ambiguity on the efficacy of current treatment interventions for PTSD. Serious limitations such as high drop out rates and nonresponse rates persist in studies of even well-established and heavily researched interventions such as Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), suggesting that these interventions may not be effective for all trauma survivors (Schottenbauer et al., 2008). In recent years, neuroscientists such as Porges (2001, 2003) have shed new light and understanding on trauma by suggesting that social behavior has a neurobiological basis. It may be that until traumatized individuals increase physiological awareness of their body, conventional trauma treatment approaches that are cognitively oriented may have limited effectiveness (Emerson, 2011; Scaer, 2005). Trauma-sensitive yoga (TSY), a structured body-oriented yoga practice, is one of the novel approaches specifically designed to help trauma survivors recover from trauma. Although research on TSY is in its infancy, several scholars have found evidence for its efficacy as an intervention for significantly reducing participants’ PTSD symptoms (Dick, Niles, Street, DiMartino, & Mitchell, 2014; Mitchell et al., 2014; Van der Kolk et al., 2014). While this is useful information, these researchers have not yet considered how TSY facilitates trauma recovery beyond what is reflected in PTSD scores. However, identifying nuances in individual recovery is central to informing more tailored interventions specific to survivors’ diverse trauma recovery needs (Dutton, 2009). To fill this gap in the extant literature, the purpose of this study was to study adult female IPV survivors’ perceptions of trauma recovery as facilitated by TSY. In particular, the researcher sought to develop an in-depth and unique contextual understanding on five women’s trauma recovery experiences using a collective case study research design. Findings from this study revealed individual and collective themes across cases that support the use of TSY to facilitate trauma recovery in multidimensional ways. Themes from the benefits of TSY on women’s trauma recovery included (a) physiological benefits, (b) emotional benefits, (c) spiritual benefits, (d) cognitive benefits, (e) enhanced perception of self and others, (f) shift in perspective on time, (f) self-care, and (g) application of positive coping strategies. The findings indicate that TSY offers a versatile approach to meeting the diverse needs of women impacted by IPV-related trauma. Contrary to the proposition that TSY is suited for all complex trauma survivors, the findings also suggest that TSY classes may be contraindicated for certain complex trauma survivors

Linking research and practice to address domestic and sexual violence: Lessons learned from a statewide conference with researchers and practitioners

Purpose - There is a growing emphasis on the need to integrate research and practice in the fields of domestic and sexual violence. However, additional research is needed to identify strategies for key stakeholders to use to bridge research and practice in these areas. The paper aims to discuss these issues.Design/methodology/approach - The current study analyzed qualitative data collected during a statewide conference for researchers and practitioners whose work addresses domestic and/or sexual violence.Findings - The findings provide information about building effective researcher-practitioner collaborations, developing methodologically sound studies that address practice-relevant research questions, and identifying steps that funders, state coalitions, researchers, and practitioners can take to advance the integration of research and practice.Research limitations/implications - Additional research is needed to evaluate specific approaches to better integrating research and practice related to domestic and sexual violence.Practical implications - Researcher-practitioner collaborations offer numerous benefits to advancing research and practice related to domestic and sexual violence. Additional guidance and tangible support is needed to foster these collaborations.Originality/value - This study used data collected during an innovative conference that brought together researchers and practitioners. The data have implications for furthering the integration of research and practice related to domestic and sexual violence

Early bare-metal stent thrombosis presenting with cardiogenic shock: a case report

<p>Abstract</p> <p>Introduction</p> <p>Although stents have improved the safety and efficacy of percutaneous coronary interventions, coronary stent thrombosis remains a serious complication.</p> <p>Case presentation</p> <p>We present the case of a 64-year-old Caucasian man from Greece, with symptoms and electrocardiographic findings suggestive of acute inferior myocardial infarction, who complained of chest pain and rapidly developed cardiogenic shock 48 hours after primary percutaneous coronary intervention.</p> <p>Conclusion</p> <p>The most common cause of early bare-metal stent thrombosis is stent malapposition. Intravascular ultrasound is the preferred method to recognize predictors of coronary events that are not detected by angiography.</p

Synergistic interaction and biochar improvement over co-torrefaction of intermediate waste epoxy resins and fir

This study investigated the synergistic effect of co-torrefaction with intermediate waste epoxy resins and fir in a batch-type reactor towards biochar improvement. The synergistic effect ratio was used to judge the interaction between the two materials assisted by statistical tools. The main interaction between the feedstocks was the catalytic reaction and blocking effect. Sodium presented in the intermediate waste had a pronounced catalytic effect on the liquid products during torrefaction. It successfully enhanced the volatile matter emissions and exhibited an antagonistic effect on the solid yield. Different from the catalytic reaction that occurred during short retention time, the blocking effect was more noticeable with a longer duration, showing a synergistic effect on the solid yield. Alternatively, a significantly antagonistic effect was exerted on oxygen content, while the carbon content displayed a converse trend. This gave rise to a major antagonistic effect on the O/C ratio which was closer to coal for pure materials torrefaction. The other spotlight in this study was to reuse the tar as a heating value additive. After coating it onto the biochar, the higher heating value could be increased by up to 5.4%. Although tar is considered as an unwanted byproduct of torrefaction treatment, the presented data show its high potential to be recycled into useful calorific value enhancer. It also fulfills the scope of waste-to-energy in this study

Synergies for Improving Oil Palm Production and Forest Conservation in Floodplain Landscapes

Lowland tropical forests are increasingly threatened with conversion to oil palm as global demand and high profit drives crop expansion throughout the world’s tropical regions. Yet, landscapes are not homogeneous and regional constraints dictate land suitability for this crop. We conducted a regional study to investigate spatial and economic components of forest conversion to oil palm within a tropical floodplain in the Lower Kinabatangan, Sabah, Malaysian Borneo. The Kinabatangan ecosystem harbours significant biodiversity with globally threatened species but has suffered forest loss and fragmentation. We mapped the oil palm and forested landscapes (using object-based-image analysis, classification and regression tree analysis and on-screen digitising of high-resolution imagery) and undertook economic modelling. Within the study region (520,269 ha), 250,617 ha is cultivated with oil palm with 77% having high Net-Present-Value (NPV) estimates ($413/ha?yr–$637/ha?yr); but 20.5% is under-producing. In fact 6.3% (15,810 ha) of oil palm is commercially redundant (with negative NPV of $-299/ha?yr-$-65/ha?yr) due to palm mortality from flood inundation. These areas would have been important riparian or flooded forest types. Moreover, 30,173 ha of unprotected forest remain and despite its value for connectivity and biodiversity 64% is allocated for future oil palm. However, we estimate that at minimum 54% of these forests are unsuitable for this crop due to inundation events. If conversion to oil palm occurs, we predict a further 16,207 ha will become commercially redundant. This means that over 32,000 ha of forest within the floodplain would have been converted for little or no financial gain yet with significant cost to the ecosystem. Our findings have globally relevant implications for similar floodplain landscapes undergoing forest transformation to agriculture such as oil palm. Understanding landscape level constraints to this crop, and transferring these into policy and practice, may provide conservation and economic opportunities within these seemingly high opportunity cost landscapes

Hemoptysis, a developing world perspective

BACKGROUND: Hemoptysis is a significant clinical presentation in respiratory medicine. Often a life threatening emergency, it mandates prompt assessment and intervention. Various investigations and management protocols are proposed globally, to advocate a standardized approach towards patients presenting with hemoptysis. It is the etiology, however, that has been known to influence clinical outcome and prognosis. With marked contrast in geographical patterns of pulmonary pathologies, etiological agents for hemoptysis vary over the world. Studies in West, usually demonstrate neoplastic and non-granulomatous causes to be the leading agents for hemoptysis. The diagnostic accuracy of various investigations and efficacy of management alternatives has been established there. Developing nations differ in their burden of diseases of lung. Lack of health resources and initiative often prevent quality research in critical areas. DESIGN: This is a retrospective observational study with a cross-sectional design in which charts of all patients admitted with the presentation of haemoptysis in the past ten years will be reviewed, at Aga Khan University Hospital, Karachi, Pakistan. A series of variables, based on previous literature on haemoptysis related to the objectives of present study, will be determined in the study. Demographics, co-morbids and etiology will be determined. Findings of various investigation modalities and their accuracy in localizing the bleeding site will be determined. Efficacy of different management strategies will also be observed. Also observed will be any complications and follow-up. DISCUSSION: Pakistan is a third world nation of over 150 million, established as highly endemic for pulmonary tuberculosis. To date no study has been generated to look into hemoptysis patterns, in this nation. Lack of evidence based medicine poses a major hindrance towards confident decision-making in the approach towards a patient presenting with hemoptysis in this country. This study is devised to obtain the first insight in this direction, from this part of the world. The etiologies, accuracy of various investigations and efficacy of treatment options will be investigated. The results and conclusions will prove to be of value not just for health administrators in this country, but many other regions that share similarities in patterns of pulmonary pathologies

Matrix metalloproteinase-9 activity and a downregulated Hedgehog pathway impair blood-brain barrier function in an <i>in vitro</i> model of CNS tuberculosis

Central nervous system tuberculosis (CNS TB) has a high mortality and morbidity associated with severe inflammation. The blood-brain barrier (BBB) protects the brain from inflammation but the mechanisms causing BBB damage in CNS TB are uncharacterized. We demonstrate that Mycobacterium tuberculosis (Mtb) causes breakdown of type IV collagen and decreases tight junction protein (TJP) expression in a co-culture model of the BBB. This increases permeability, surface expression of endothelial adhesion molecules and leukocyte transmigration. TJP breakdown was driven by Mtb-dependent secretion of matrix metalloproteinase (MMP)-9. TJP expression is regulated by Sonic hedgehog (Shh) through transcription factor Gli-1. In our model, the hedgehog pathway was downregulated by Mtb-stimulation, but Shh levels in astrocytes were unchanged. However, Scube2, a glycoprotein regulating astrocyte Shh release was decreased, inhibiting Shh delivery to brain endothelial cells. Activation of the hedgehog pathway by addition of a Smoothened agonist or by addition of exogenous Shh, or neutralizing MMP-9 activity, decreased permeability and increased TJP expression in the Mtb-stimulated BBB co-cultures. In summary, the BBB is disrupted by downregulation of the Shh pathway and breakdown of TJPs, secondary to increased MMP-9 activity which suggests that these pathways are potential novel targets for host directed therapy in CNS TB

SILAC-based proteomic quantification of chemoattractant-induced cytoskeleton dynamics on a second to minute timescale

Cytoskeletal dynamics during cell behaviours ranging from endocytosis and exocytosis to cell division and movement is controlled by a complex network of signalling pathways, the full details of which are as yet unresolved. Here we show that SILAC-based proteomic methods can be used to characterize the rapid chemoattractant-induced dynamic changes in the actin–myosin cytoskeleton and regulatory elements on a proteome-wide scale with a second to minute timescale resolution. This approach provides novel insights in the ensemble kinetics of key cytoskeletal constituents and association of known and novel identified binding proteins. We validate the proteomic data by detailed microscopy-based analysis of in vivo translocation dynamics for key signalling factors. This rapid large-scale proteomic approach may be applied to other situations where highly dynamic changes in complex cellular compartments are expected to play a key role