Breast feeding practices and views among diabetic women: a retrospective cohort study

Objective: to explore the pattern and experiences of breast-feeding practices among diabetic women. Design: retrospective cohort study using maternal records and postal questionnaires in a Baby-Friendly hospital. Participants: diabetic mothers including women with gestational diabetes, and type 1 and 2 diabetes mellitus. Findings: from the total group of respondents, 81.9% intended to breast feed. The actual breast feeding rates were 81.9% at birth, 68.1% at 2 weeks and 28.7% at 6 months postpartum. Major themes that were identified from women's experiences included information and advice, support vs. pressure, classification and labelling, and expectations. Conclusions: more than two-thirds of the diabetic women intended to breast feed and actually did breast feed in this study. For both the total study population and the type 1 and 2 diabetics alone, more than half were still breast feeding at 2 weeks postpartum, and approximately one-third were still breast feeding at 6 months postpartum. Implications for practice: structured support, provided for women through Baby-Friendly initiatives, was appreciated by the diabetic women in this study. The extent to which this support influenced the highly successful breast feeding practices in this group of women needs focused investigation. The need for a delicate balancing act between pressure and advice in order to prevent coercion was noted.</p

Evaluation of long-term counselling at a community health service for women who are on a low income

Aims. Given the lack of research evaluating long-term counselling, coupled with the lack of women-only counselling services, the present study evaluated the long-term counselling service offered by a women-only community health centre. Method. The research ascertained: 1) the characteristics of 155 service users pre-counselling, 2) the views and experiences of 75 service users post-counselling and 3) pre-post-counselling clinical change in 98 service users via the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). Results. Unemployment, low income and reports of abuse were related to poorer mental health as measured by the CORE-OM. Content analysis of open-ended questions revealed that women felt supported, comfortable and gained insight through the counselling relationship. They also reported positive changes in their lives, relationships, health behaviours, and psychological wellbeing. Post-counselling improvements were found in CORE-OM scores. Conclusions. Long-term counselling in a women-only environment for socially disempowered women may be beneficial. A research-informed approach to counselling and therapy evaluation, which acknowledges the social context of psychological distress, should be taken across institutions

A sanctuary of tranquillity in a ruptured world: evaluating long-term counselling at a women’s community health centre

The longitudinal study described in this article evaluated long-term counselling provided at a women’s health centre in the UK for service users on low incomes. The article focuses on the qualitative aspect of the study in which 59 women were interviewed individually before and/or after their counselling. The interviews explored how women make sense of long-term counselling in the context of their gendered experiences and complex needs. The data were analysed using thematic analysis informed by a feminist orientation and attachment theory. Four main themes emerged:‘violence and loss in the context of female oppression’, ‘a sanctuary for women’, ‘non-medicalised long-term counselling in a safe setting’, and ‘benefits of the long view’. Participants attributed various benefits to receiving long-term counselling in a women-only environment. These included gaining employment; reduced suicidal ideation, anxiety and depression; improved physical health, improved confidence and being able to make positive changes in their relationships. The women interviewed post-counselling valued long term-counselling in this context, in contrast to short-term therapy in a medicalised environment. Wider implications with regards to clinical practice and research are discussed

Continuous sedation until death: The everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium

Copyright © 2014 Raus et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Background - Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress. Methods - This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology. Results - The participants’ responses can be captured as different dimensions of ‘closeness’, i.e. the degree to which one feels connected or ‘close’ to a certain decision or event. We distinguished four types of ‘closeness’, namely emotional, physical, decisional, and causal. Using these four dimensions of ‘closeness’ it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility. Conclusion - Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these factors help care providers and relatives to distinguish continuous sedation from euthanasia.The Economic and Social Research Council (UK), the Research Foundation Flanders (BE), the Flemish Cancer Association (BE), the Research Council of Ghent University (BE), the Netherlands Organization for Scientific Research (NL) and the Netherlands Organization for Health Research and Development (NL)

Speciation by host switch in brood parasitic indigobirds

A growing body of empirical and theoretical work supports the plausibility of sympatric speciation(1-3), but there remain few examples in which all the essential components of the process are well understood. The African indigobirds Vidua spp. are host-specific brood parasites. Indigobird nestlings are reared along with host young, and mimic the mouth markings of their respective hosts(4-6). As adults, male indigobirds mimic host song(4-7), whereas females use these songs to choose both their mates and the nests they parasitize(8). These behavioural mechanisms promote the cohesion of indigobird populations associated with a given host species, and provide a mechanism for reproductive isolation after a new host is colonized. Here we show that all indigobird species are similar genetically, but are significantly differentiated in both mitochondrial haplotype and nuclear allele frequencies. These data support a model of recent sympatric speciation. In contrast to the cuckoo Cuculus canorus, in which only female lineages are faithful to specific hosts(9,10), host switches have led to speciation in indigobirds because both males and females imprint on their hosts(8,11).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62510/1/nature01863.pd

Quantifying similarity in animal vocal sequences: Which metric performs best?

1. Many animals communicate using sequences of discrete acoustic elements which can be complex, vary in their degree of stereotypy, and are potentially open-ended. Variation in sequences can provide important ecological, behavioural, or evolutionary information about the structure and connectivity of populations, mechanisms for vocal cultural evolution, and the underlying drivers responsible for these processes. Various mathematical techniques have been used to form a realistic approximation of sequence similarity for such tasks. 2. Here, we use both simulated and empirical datasets from animal vocal sequences (rock hyrax, Procavia capensis; humpback whale, Megaptera novaeangliae; bottlenose dolphin, Tursiops truncatus; and Carolina chickadee, Poecile carolinensis) to test which of eight sequence analysis metrics are more likely to reconstruct the information encoded in the sequences, and to test the fidelity of estimation of model parameters, when the sequences are assumed to conform to particular statistical models. 3. Results from the simulated data indicated that multiple metrics were equally successful in reconstructing the information encoded in the sequences of simulated individuals (Markov chains, n-gram models, repeat distribution, and edit distance), and data generated by different stochastic processes (entropy rate and n-grams). However, the string edit (Levenshtein) distance performed consistently and significantly better than all other tested metrics (including entropy, Markov chains, n-grams, mutual information) for all empirical datasets, despite being less commonly used in the field of animal acoustic communication. 4. The Levenshtein distance metric provides a robust analytical approach that should be considered in the comparison of animal acoustic sequences in preference to other commonly employed techniques (such as Markov chains, hidden Markov models, or Shannon entropy). The recent discovery that non-Markovian vocal sequences may be more common in animal communication than previously thought, provides a rich area for future research that requires non-Markovian based analysis techniques to investigate animal grammars and potentially the origin of human language.We thank Melinda Rekdahl, Todd Freeberg and his graduate students, Amiyaal Ilany, Elizabeth Hobson, and Jessica Crance for providing comments of on a previous version of this manuscript. We thank Mike Noad, Melinda Rekdahl, and Claire Garrigue for assistance with humpback whale song collection and initial categorisation of the song, Vincent Janik and Laela Sayigh for assistance with signature whistle collection, Todd Freeberg with chickadee recordings, and Eli Geffen and Amiyaal Ilany for assistance with hyrax song collection and analysis. E.C.G is supported by a Newton International Fellowship. Part of this work was conducted while E.C.G. was supported by a National Research Council (National Academy of Sciences) Postdoctoral Fellowship at the National Marine Mammal Laboratory, AFSC, NMFS, NOAA. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the National Marine Fisheries Service. We would also like to thank Randall Wells and the Sarasota Dolphin Research Program for the opportunity to record the Sarasota dolphins, where data were collected under a series of National Marine Fisheries Service Scientific Research Permits issued to Randall Wells. A.K. is supported by the Herchel Smith Postdoctoral Fellowship Fund. Part of this work was conducted while A.K. was a Postdoctoral Fellow at the National Institute for Mathematical and Biological Synthesis, an Institute sponsored by the National Science Foundation through NSF Award #DBI-1300426, with additional support from The University of Tennessee, Knoxville.This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1111/2041-210X.1243

Microscopic mechanism for mechanical polishing of diamond (110) surfaces

Mechanically induced degradation of diamond, as occurs during polishing, is studied using total--energy pseudopotential calculations. The strong asymmetry in the rate of polishing between different directions on the diamond (110) surface is explained in terms of an atomistic mechanism for nano--groove formation. The post--polishing surface morphology and the nature of the polishing residue predicted by this mechanism are consistent with experimental evidence.Comment: 4 pages, 5 figure

Shell-model calculations for the three-nucleon system

We use Faddeev's decomposition to solve the shell-model problem for three nucleons. The dependence on harmonic-oscillator excitations allowed in the model space, up to $32 \hbar\Omega$ in the present calculations, and on the harmonic-oscillator frequency is studied. Effective interactions derived from Nijmegen II and Reid93 potentials are used in the calculations. The binding energies obtained are close to those calculated by other methods. The structure of the Faddeev equations is discussed and a simple formula for matrix elements of the permutation operators in a harmonic-oscillator basis is given. The Pauli principle is properly treated in the calculations.Comment: 11 pages. REVTEX. 6 PostScript figure

A Vehicular Traffic Flow Model Based on a Stochastic Acceleration Process

A new vehicular traffic flow model based on a stochastic jump process in vehicle acceleration and braking is introduced. It is based on a master equation for the single car probability density in space, velocity and acceleration with an additional vehicular chaos assumption and is derived via a Markovian ansatz for car pairs. This equation is analyzed using simple driver interaction models in the spatial homogeneous case. Velocity distributions in stochastic equilibrium, together with the car density dependence of their moments, i.e. mean velocity and scattering and the fundamental diagram are presented.Comment: 27 pages, 6 figure