Shame if you do, Shame if you don't: Women's experiences of infant feeding

Emotions such as guilt and blame are frequently reported by non-breastfeeding mothers, and fear and humiliation is experienced by breastfeeding mothers when feeding in a public context. In this paper we present new insights into how shame-related affects, cognitions and actions are evident within breastfeeding and non-breastfeeding women’s narratives of their experiences. As part of an evaluation study of the implementation of the UNICEF UK Baby Friendly Initiative (BFI) Community Award within two primary (community-based) care trusts in North West England, 63 women with varied infant feeding experiences took part in either a focus group or an individual semi-structured interview to explore their experiences, opinions and perceptions of infant feeding. Using a Framework Analysis approach and drawing on Lazare’s categories of shame, we consider how the nature of the event (infant feeding) and the vulnerability of the individual (mother) interact in the social context to create shame responses in some breastfeeding and non-breastfeeding mothers. Three key themes illustrate how shame is experienced and internalised through ‘exposure of women’s bodies and infant feeding methods’, ‘undermining and insufficient support’ and ‘perceptions of inadequate mothering’. The findings of this paper highlight how breastfeeding and non-breastfeeding women may experience judgement and condemnation in interactions with health professionals as well as within community contexts, leading to feelings of failure, inadequacy and isolation. There is a need for strategies and support that address personal, cultural, ideological and structural constraints of infant feeding

Incorporating patient partner scores into high stakes assessment : an observational study into opinions and attitudes

Peer reviewedPublisher PD

Can Everyone Benefit from Social Integration?

There is no matching mechanism that satisfies integration monotonicity and stability. If we insist on integration monotonicity, not even Pareto optimality can be achieved: the only option is to remain segregated. A weaker monotonicity condition can be combined with Pareto optimality but not with path independence, which implies that the dynamics of social integration matter. If the outcome of integration is stable, integration is always approved by majority voting, but a non-vanishing fraction of agents always oppose segregation. The side who receives the proposals in the deferred acceptance algorithm suffers significant welfare losses, which nevertheless become negligible when societies grow large

Development of an occupational advice intervention for patients undergoing lower limb arthroplasty (the OPAL study)

Background: There are an increasing number of patients of working age undergoing hip and knee replacements. Currently there is variation in the advice and support given about sickness absence, recovery to usual activities and return to work after these procedures. Earlier, sustainable, return to work improves the health of patients and benefits their employers and society. An intervention that encourages and supports early recovery to usual activities, including work, has the potential to reduce the health and socioeconomic burden of hip and knee replacements. Methods/design: A two-phase research programme delivered over 27 months will be used to develop and subsequently test the feasibility of an occupational advice intervention to facilitate return to work and usual activities in patients undergoing lower limb arthroplasty. The 2 phases will incorporate a six-stage intervention mapping process: Phase 1: Intervention mapping stages 1–3: 1 Needs assessment (including rapid evidence synthesis, prospective cohort analysis and structured stakeholder interviews) 2 Identification of intended outcomes and performance objectives 3 Selection of theory-based methods and practical strategies Phase 2: Intervention mapping stages 4–6: 4 Development of components and materials for the occupational advice intervention using a modified Delphi process 5 Adoption and implementation of the intervention 6 Evaluation and feasibility testing The study will be undertaken in four National Health Service (NHS) hospitals in the United Kingdom and two Higher Education Institution. Discussion: OPAL (Occupational advice for Patients undergoing Arthroplasty of the Lower limb) aims to develop an occupational advice intervention to support early recovery to usual activities including work, which is tailored to the requirements of patients undergoing hip and knee replacements. The developed intervention will then be assessed with a specific focus on evaluating its feasibility as a potential trial intervention to improve speed of recovery to usual activities including work

Top Trading Cycles, Consistency, and Acyclic Priorities for House Allocation with Existing Tenants

We study the house allocation with existing tenants model (Abdulkadiroğlu and Sönmez, 1999) and consider rules that allocate houses based on priorities. We introduce a new acyclicity requirement and show that for house allocation with existing tenants a top trading cycles (TTC) rule is consistent if and only if its underlying priority structure satisfies our acyclicity condition. Next we give an alternative description of TTC rules based on ownership-adapted acyclic priorities in terms of two specific rules, YRMH-IGYT (you request my house - I get your turn) and efficient priority rules, that are applied in two steps. Moreover, even if no priority structure is a priori given, we show that a rule is a top trading cycles rule based on ownership-adapted acyclic priorities if and only if it satisfies Pareto-optimality, individual-rationality, strategy-proofness, consistency, and either reallocation-proofness or non-bossiness

Oxide Dispersion Strengthened Nickel Based Alloys via Spark Plasma Sintering

Oxide dispersion strengthened (ODS) nickel based alloys were developed via mechanical milling and spark plasma sintering (SPS) of Ni–20Cr powder with additional dispersion of 1.2 wt% Y2O3 powder. Furthermore, 5 wt% Al2O3 was added to Ni–20Cr–1.2Y2O3 to provide composite strengthening in the ODS alloy. The effects of milling times, sintering temperature, and sintering dwell time were investigated on both mechanical properties and microstructural evolution. A high number of annealing twins was observed in the sintered microstructure for all the milling times. However, longer milling time contributed to improved hardness and narrower twin width in the consolidated alloys. Higher sintering temperature led to higher fraction of recrystallized grains, improved density and hardness. Adding 1.2 wt% Y2O3 to Ni–20Cr matrix significantly reduced the grain size due to dispersion strengthening effect of Y2O3 particles in controlling the grain boundary mobility and recrystallization phenomena. The strengthening mechanisms at room temperature were quantified based on both experimental and analytical calculations with a good agreement. A high compression yield stress obtained at 800 °C for Ni–20Cr–1.2Y2O3–5Al2O3 alloy was attributed to a combined effect of dispersion and composite strengthening

Smoking in film in New Zealand: measuring risk exposure

BACKGROUND: Smoking in film is a risk factor for smoking uptake in adolescence. This study aimed to quantify exposure to smoking in film received by New Zealand audiences, and evaluate potential interventions to reduce the quantity and impact of this exposure. METHODS: The ten highest-grossing films in New Zealand for 2003 were each analysed independently by two viewers for smoking, smoking references and related imagery. Potential interventions were explored by reviewing relevant New Zealand legislation, and scientific literature. RESULTS: Seven of the ten films contained at least one tobacco reference, similar to larger film samples. The majority of the 38 tobacco references involved characters smoking, most of whom were male. Smoking was associated with positive character traits, notably rebellion (which may appeal to adolescents). There appeared to be a low threshold for including smoking in film. Legislative or censorship approaches to smoking in film are currently unlikely to succeed. Anti-smoking advertising before films has promise, but experimental research is required to demonstrate cost effectiveness. CONCLUSION: Smoking in film warrants concern from public health advocates. In New Zealand, pre-film anti-smoking advertising appears to be the most promising immediate policy response

Positive relationships between association strength and phenotypic similarity characterize the assembly of mixed-species bird flocks worldwide

Competition theory predicts that local communities should consist of species that are more dissimilar than expected by chance. We find a strikingly different pattern in a multicontinent data set (55 presence-absence matrices from 24 locations) on the composition of mixed-species bird flocks, which are important sub-units of local bird communities the world over. By using null models and randomization tests followed by meta-analysis, we find the association strengths of species in flocks to be strongly related to similarity in body size and foraging behavior and higher for congeneric compared with noncongeneric species pairs. Given the local spatial scales of our individual analyses, differences in the habitat preferences of species are unlikely to have caused these association patterns; the patterns observed are most likely the outcome of species interactions. Extending group-living and social-information-use theory to a heterospecific context, we discuss potential behavioral mechanisms that lead to positive interactions among similar species in flocks, as well as ways in which competition costs are reduced. Our findings highlight the need to consider positive interactions along with competition when seeking to explain community assembly