Predictors of Engagement in Postpartum Weight Self-management Behaviours in the First 12 Weeks After Birth

Aim To explore factors that influence postpartum weight self-management behaviours. Transitions Theory and the Integrated Theory of Health Behaviour Change guided selection of variables. Transition conditions, level of patient activation and social facilitation were examined for association with postpartum weight self-management behaviours. Background Retention of pregnancy weight increases risk of overweight and obesity later in life. Little is known about what women do to self-manage return to pre-pregnant weight and how providers can influence their behaviours. Design Prospective, longitudinal, correlational. Methods Data collection occurred from March through October, 2013. One hundred and twenty-four women completed surveys during postpartum hospitalization; telephone interviews were completed by 91 women at 6 weeks and 66 women at 12 weeks. Standard and hierarchical multiple regression methods were used for analyses. Results Transition difficulty was negatively associated with patient activation and immediate postbirth patient activation was positively associated with eating behaviours at 6 weeks, eating behaviours at 12 weeks and physical activity at 12 weeks. Social support and social influence were not significant predictors in the regression models. Conclusion Patients experiencing a difficult postpartum transition have lower activation levels; those less activated are less probably to engage in weight self-management behaviours in the 12 weeks following their baby\u27s birth. Patient activation level should be considered in tailoring promotion of healthy postpartum weight management

Clue, Code, Conjure: The Epistemology of American Detective Fiction, 1841-1914

This dissertation posits American detective fiction between 1841 and 1914 as a meaningful category and interrogates forms of knowledge used in this genre. The conventional wisdom on detective fiction creates a dichotomy of British and American production, with British detective fiction in a rational style dominating in importance into the 1920s, and American detective fiction dominating in importance with the hard-boiled style of the 1930s and \u2740s (as described by Raymond Chandler). This dissertation argues that American detective fiction is a meaningful category before and beyond the hard-boiled style. Abductive reasoning, a form of logic based on observation, hypothesis, and confirmation, is the characteristic mode of detection in fiction. Abductive reasoning requires the use of background knowledge to draw conclusions. Therefore, cultural context and beliefs become part of the interpretive process. Works by Edgar Allan Poe, Metta Victor, Anna Katharine Green, Mark Twain, Pauline Hopkins, Edwin Balmer and William MacHarg, and Arthur B. Reeve are used in this study to demonstrate the wide variety of knowledge sources considered relevant in this period. The clearest unit of information in detective fiction is the clue: an object or occurrence that provides critical information toward solving the mystery. The detective figure is the master interpreter of clues, with the observational skills, knowledge base, and imagination to identify and interpret information that others do not. The period of 1841 to 1914 saw extensive industrialization, geographic expansion, and racial turmoil in the United States. Forensic science advanced both technically and culturally as part of a larger movement toward scientific management. The transition to scientific thinking as depicted in detective fiction is, however, significantly complicated by continuing reliance on sentimental and sensational elements such as magic, religion, and intuition and on community-based ethics

Advancing Women, Changing Lives A Comprehensive Evaluation of the Gap Inc. P.A.C.E. Program

Globally the garment industry is one of the biggest employers of low-skilled women workers. Despite their large numbers in the workforce, relatively few female garment workers advance to higher-level positions as they have limited opportunities to acquire the skills that would enable their professional and personal growth. In response to this need, Gap Inc. initiated the P.A.C.E. (Personal Advancement & Career Enhancement) workplace education program to teach women the managerial, interpersonal, organizational and other practical skills needed to move forward in work and in life. This report summarizes findings from program evaluations conducted by ICRW from 2009 - 2013 at six factory sites where P.A.C.E. is implemented - two in India and one each in Cambodia, Vietnam, Bangladesh and China.Research findings from these robust, multi-country evaluations demonstrate that P.A.C.E. is an effective, sustainable and scalable model that yields high returns for women, their families and the businesses where they work

Demographic, clinical, and treatment characteristics of the juvenile primary fibromyalgia syndrome cohort enrolled in the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry.

BackgroundTo describe the demographic, clinical, and treatment characteristics of youth diagnosed with juvenile primary fibromyalgia syndrome (JPFS) who are seen in pediatric rheumatology clinics.MethodsInformation on demographics, symptoms, functioning, and treatments recommended and tried were obtained on patients with JPFS as part of a multi-site patient registry (the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry). Data were summarized using descriptive statistics. In a subset of patients completing registry follow-up visits, changes in symptoms, pain, and functioning were evaluated using growth modeling.ResultsOf the 201 patients with JPFS enrolled in the registry, most were Caucasian/White (85%), non-Hispanic (83%), and female (84%). Ages ranged from 9 to 20 years (M = 15.4 + 2.2). The most common symptoms reported were widespread musculoskeletal pain (91%), fatigue (84%), disordered sleep (82%), and headaches (68%). Pain intensity was rated as moderate to severe (M = 6.3 + 2.4/10). Scores on measures of functioning indicated mild to moderate impairment, with males observed to report significantly greater impairments. For the 37% of the initial cohort having follow-up data available, indicators of function and well-being were found to either worsen over time or remain relatively unchanged.ConclusionsThe symptoms of JPFS remained persistent and disabling for many patients treated by pediatric rheumatologists. Further study appears warranted to elucidate gender differences in the impact of JPFS symptoms. Work also is needed to identify accessible and effective outpatient treatment options for JPFS that can be routinely recommended or implemented by pediatric rheumatology providers

On the existence and uniqueness of the eigenvalue decomposition of a parahermitian matrix

This paper addresses the extension of the factorisation of a Hermitian matrix by an eigenvalue decomposition (EVD) to the case of a parahermitian matrix that is analytic at least on an annulus containing the unit circle. Such parahermitian matrices contain polynomials or rational functions in the complex variable z, and arise e.g. as cross spectral density matrices in broadband array problems. Specifically, conditions for the existence and uniqueness of eigenvalues and eigenvectors of a parahermitian matrix EVD are given, such that these can be represented by a power or Laurent series that is absolutely convergent, at least on the unit circle, permitting a direct realisation in the time domain. Based on an analysis on the unit circle, we prove that eigenvalues exist as unique and convergent but likely infinite-length Laurent series. The eigenvectors can have an arbitrary phase response, and are shown to exist as convergent Laurent series if eigenvalues are selected as analytic functions on the unit circle, and if the phase response is selected such that the eigenvectors are Hölder continuous with α>½ on the unit circle. In the case of a discontinuous phase response or if spectral majorisation is enforced for intersecting eigenvalues, an absolutely convergent Laurent series solution for the eigenvectors of a parahermitian EVD does not exist. We provide some examples, comment on the approximation of a parahermitian matrix EVD by Laurent polynomial factors, and compare our findings to the solutions provided by polynomial matrix EVD algorithms

Adaptation to Cesarean Birth: Implementation of an International Multisite Study

The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women’s perceptions of and responses to cesarean birth. The need for the study arose from the concern that women’s childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of study sites revealed opportunities for examination of the influence of the contextual stimuli of culture and geographic region on the women’s adaptation to cesarean birth. Strategies used to foster integration of teaching, practice, and research are discussed

Weight-Management Information Needs of Postpartum Women

Purpose: To describe the weight loss information-seeking behaviors of postpartum women. Study Design and Methods: The study is part of a larger longitudinal descriptive study of factors associated with women\u27s self-management of their gestational weight loss after birth. Participants answered questions about weight loss information they planned to access, had received, wished they had received, and desired sources of information. A total of 250 women were enrolled during the postpartum hospital stay; 179 completed a 4-month follow-up. Results: A large portion of the sample (53.3% of normal weight women, 79% of overweight women, and 81.4% obese women) identified plans to seek weight loss information, yet nearly 85% received no information from healthcare providers by 4 months postpartum. The most frequently reported desired information topics fell under the category of specific strategies to lose weight. The majority of women in the sample had access to online health information from home, work, or a library; however, more White women had this access than did Black or Hispanic women. Clinical Implications: Postpartum hospital nurses are in a unique position to provide high-quality information with strategies for managing postpartum loss of gestational weight. Provision of high-quality online or print information can provide the foundation for successful weight-management support for prevention of gestational weight retention and long-term maintenance of a healthy weight