1,373 research outputs found

    The effects of menopausal vasomotor symptoms and changes in anthropometry on breast cancer etiology

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    One of the strongest predictors of breast cancer risk is mammographic density; however, incomplete understanding of the mechanisms relating density to risk has limited its use as a marker for breast cancer susceptibility. Hormone fluctuations during the menopausal transition may influence declines in mammographic density and may also trigger the onset of menopausal vasomotor symptoms (VMS), which have been associated with lower breast cancer risk. The effects of hormone changes on density, VMS, and breast cancer risk are complicated by external factors such as changing body mass and hormone therapy use during the menopausal transition. We evaluated the association between change in BMI and change in mammographic density using volumetric measurement methods. We found that an annual increase in BMI was associated with a decrease in absolute dense volume and percent dense volume. Longitudinal studies of density and breast cancer, or those using density to reflect breast cancer risk, should consider controlling for BMI gain/loss to understand the independent relationship between density and risk. We further investigated the association of VMS and percent mammographic density. We observed no overall association, but found some evidence of an inverse relationship among perimenopausal women and those using hormone therapies. This suggests that an association between VMS and breast cancer risk is not strongly mediated by changes in breast density. Finally, we evaluated VMS and incident breast cancer risk. VMS were associated with a 38% reduction in risk. Adjustment for endogenous hormone levels did not alter our results, suggesting that endogenous hormones play a lesser role in the association between VMS and breast cancer risk than previously hypothesized. These studies further our understanding of breast cancer etiology. If confirmed, the association between VMS and breast cancer risk could propose VMS as an easily measured factor that could enhance risk prediction. Our findings that this association is not strongly mediated through breast density nor endogenous hormone levels raise provocative questions regarding the mechanisms that link VMS to breast cancer risk. Extending our knowledge of breast cancer etiology through new measurement methods and risk factors may lead to improved risk prediction and opportunities for disease prevention

    Holy Spirit, holy conflict: toward Wesleyan pneumatological leadership in conflict transformation

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    This thesis develops a practical Wesleyan approach to leadership in conflict transformation, aimed toward guiding leaders and communities in conflict situations. The thesis analyzes a conflicted situation in the United Methodist Church (UMC) through a case study of the UMC General Conferences of 2012 and 2016, supplemented by interviews that draw wisdom from leaders in the field. It then creates a dialogue with the biblical witness, contemporary movements in pneumatology, and leadership theory. Particular attention is given to John Wesley’s pneumatological thinking and practices as a transformative leader. Both the contextual and theological analyses reveal human capacities and failures to relate with God, self, and neighbor, as well as the movements of the Holy Spirit in situations of conflict and transformation. The thesis concludes with practical guidance for UMC congregations and other bodies to support and expand the work of transformative leadership in situations of conflict

    Storage of Organic Matter and Transport of Fluids in the Eagle Ford Shale

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    Subsurface models can be used to improve the efficiency of oil and gas extraction and geological carbon sequestration in shale formations. However, models are limited by a lack of information about how pores store organic matter and how fluids access and interact with those pores through fluid transport. Neutron scattering and neutron imaging were combined with conventional methods of geochemical analysis to investigate organic matter storage, pore-solvent interaction, and fluid flow in shales. To investigate organic matter storage and pore-solvent interactions, porosity in shale was examined after solvent extraction with neutron scattering and compared to unextracted samples. Additionally, Gas Chromatography ─ [dash] Mass Spectrometry was used to determine the amount and type of organic matter extracted with various solvents. We found that longer chained hydrocarbons may be stored in pores greater than 270 nm [nanometers]. We also found that the organic solvents used in extraction procedures caused changes in shale pore structure, including a decrease in porosity. This was predominately attributed to matrix-bound kerogen swelling to fill spaces once occupied with bitumen.Fluid flow was also measured to determine critical parameters for subsurface models. Neutron imaging was used to measure spontaneous imbibition of various fluids into shale fractures of different orientations. Imbibition data was then fit to a model and contact angles, an important parameter for fluid flow modeling, were determined. The fit of the model was heavily influenced by the width of the fractures. However, lack of variation among the imbibition rate with various fluids indicated that the rate was relatively unaffected by chemical reactions at the solution/mineral interface. Calculated contact angles for various fluids in the Eagle Ford Shale ranged from about 60° to 89.6°, with differences arising due to fluid properties and orientation of the bedding in the shales. These studies have led to a better understanding of parameters influencing organic matter storage and fluid flow in shales necessary for accurate subsurface modeling

    Steps for engaging young children in research: the toolkit

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    Spatio-temporal judgements of observed actions : Contrasts between first- and third-person perspective after motor priming.

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    When observing actions, motor simulation processes aid the prediction and understanding of future events. A central issue concerns whether such action simulation serves social functions of interpreting other people, where performance is predicted to be better when third-person perspective (3PP) actions are viewed; or whether it is most beneficial to guide self actions, whereby the first-person perspective (1PP) would be advantageous. We show that in a spatio-temporal judgement task there is an advantage for the prediction of 1PP. However, this is only detected after motor priming whereby participants perform the observed actions prior to making spatio-temporal judgements. The results, firstly, confirm that we draw on our motor experience for the accurate simulation and prediction of action. Secondly, the results suggest that such experience facilitates more accurate state estimation for actions perceived in the 1PP which map more closely onto visual input of self-generated action. More forward prediction error is retained for 3PP viewed actions, which may however have the benefit of compensating for the uncertainty involved in interacting with others

    The hand-held fan and the Calming Hand for people with chronic breathlessness : a feasibility trial

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    INTRODUCTION: The battery operated hand-held fan ("fan") and the Calming Hand (CH), a cognitive strategy, are interventions used in clinical practice to relieve chronic breathlessness. OBJECTIVE: To test the feasibility of a phase III randomised controlled trial (RCT) evaluating the impact of the fan and/or CH compared with exercise advice alone for the relief of chronic breathlessness due to respiratory conditions. METHODS: Single site, feasibility "2x2" factorial, non-blinded, mixed-methods RCT. Participants randomly allocated to four groups: fan + exercise advice vs CH + exercise advice vs fan + CH + exercise advice vs exercise advice alone. Measures included: recruitment, acceptability; data quality and study outcomes (baseline, day 28); modified incremental shuttle walk test (mISWT), recovery time from exertion-induced breathlessness, Life-space, General Self-Efficacy Scale and breathlessness numerical rating scales. Willing participants and carers were interviewed at study end. RESULTS: Recruitment/acceptability/data completion: 53 people were screened, 40 randomised and completed; (mean age 72 years (SD 9.8), 70% male). There were few missing data (2 mISWT). Recovery time [seconds] from exertion-induced breathlessness showed most improvement for the fan; mean reduction from baseline -33.5 vs CH mean increase from baseline 5.7. This represents a recovery speed at day 28 -20.4% faster for the fan vs 4.1% slower for the CH. Qualitative data indicated participants valued the faster recovery and identified the fan as a useful "medical" device, but found the CH unhelpful. CONCLUSION: A phase III RCT is feasible. Mixed-method data synthesis supports recovery time as a novel, meaningful outcome measure

    Alcohol Consumption Among Cannabis Users in Vermont

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    Objective: To examine the relationship between cannabis and alcohol consumption in Vermont; after the legalization of cannabis in 2018. Methods: We used Vermont\u27s Behavioral Risk Factor Surveillance System (BRFSS) survey; this data included only participants who had reported alcohol use in the past year (n = 3,781). We used multiple linear regression to compare frequency of cannabis use against days per month of alcohol consumption and binomial logistic to compare regression to the frequency in which cannabis was used against the odds of Heavy Alcohol Consumption (HAC). Results: We found that low and moderate cannabis users had more days of alcohol consumption on average than non-users. High cannabis users, however, had fewer days on average than non-users of cannabis. Additionally, compared to non-users, low, moderate, and high cannabis use was associated with increased odds of HAC. Conclusion: Our results suggest that cannabis use may be predictive of alcohol consumption, so individuals, clinicians, and policymakers should be aware of how cannabis use could impact a person\u27s overall health picture

    The Design and Impact of a Rural Community Supported Doula Program

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    Objective: to evaluate the design and impact of a doula program in rural Vermont by exploring client demographics and perspectives on the doula care received. This research aims to better understand the population the program serves, the specific challenges they face, and how to mitigate these challenges in the perinatal and post-partum period with a social work model of doula care. Design: a qualitative, descriptive study giving voice to the client experience of a doula program steeped in a social work model of care. Methods: semi-structured interviews carried out in July and August of 2021. Interviews were coded and analyzed thematically. Setting: A doula program offered by a mental health agency, offering doula services for clientele with a mental health diagnosis and qualifications for VT Medicaid. Results: Significant portions of participants reported life challenges due to lack of resources, abuse, and mental health concerns, of which having a social-work focused doula was helpful in terms of logistical and emotional support. Without a doula, access and experience of healthcare during the prenatal, birthing, and post-partum period would have been more challenging for the population interviewed. Themes that arose included doula as logistical support, the doula’s role in emotional/mental health support, and the doula as educator and advocate for a socioeconomically high-risk population. Key conclusions and implications for practice: The WCMHS Doula Program is serving a high-risk population which would be beyond the reaches of more typical doula models. Doula work that is within the field of social work increases access and mitigates challenges that other doula models do not. Placing doula services within a community mental health agency and offering case management style doula care allows the services to make great impact on the lives and wellbeing of people who would otherwise face significant challenges in accessing healthcare. This has large implications for increasing equity of doula offerings and makes great strides in improving birth outcomes and experiences for an at-risk population. This study indicates the value of a social work model of doula care and the importance of bringing doula services to populations that have historically been left without access. Key words: doula, case management, at-risk population, rural health, pregnancy, childbirth support, advocacy, health equit

    The Association of Maternal Obesity and Race with Pregnancy Weight Gain and Small for Gestational Age Infant Birth: The Effect of Prenatal Care

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    Objective: To examine the association of maternal obesity, race/ethnicity, and prenatal care on high gestational weight gain (GWG) and small for gestational age (SGA) infant birth. Methods: This was a retrospective cohort study of births included in the PRAMS Phase 8 dataset (2016-2017). The study population was 53,893 non-diabetic women with a singleton in-hospital birth between 37 and 42 weeks gestational age. Results: Only obese non-Hispanic white and Hispanic women showed a consistent decrease in adjusted odds of high GWG as prenatal care visit category increased. Only non-Hispanic white women showed a lower increase in adjusted odds of an SGA infant birth with more compared to intermediate prenatal care. Conclusions: The effectiveness of prenatal care in reducing high GWG varies by race for women with a BMI outside a healthy range. More prenatal care did not reduce SGA infant births amongst overweight or obese women. Policy implications: Interventions to improve prenatal care delivery for overweight or obese women should consider race

    The effect of locomotion on early visual contrast processing in humans

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    Most of our knowledge about vision comes from experiments in which stimuli are presented to immobile human subjects or animals. In the case of human subjects, movement during psychophysical, electrophysiological or neuroimaging experiments is considered to be a source of noise to be eliminated. Animals used in visual neuroscience experiments are typically restrained and, in many cases, anaesthetized. In reality however, vision is often used to guide the motion of awake, ambulating organisms. Recent work in mice has shown that locomotion elevates visual neuronal response amplitudes (Erisken et al., 2014; Fu et al., 2014; Lee et al., 2014; Mineault et al., 2016; Niell and Stryker, 2010) and reduces long-range gain control (Ayaz et al., 2013). Here we use both psychophysics and steady-state electrophysiology to ask whether similar effects of locomotion on early visual processing can be measured in humans. Our psychophysical results show that brisk walking has little effect on subjects’ ability to detect briefly-presented contrast changes and that co-oriented flankers are, if anything, more effective masks when subjects are walking. Our electrophysiological data were consistent with the psychophysics, indicating no increase in stimulus-driven neuronal responses whilst walking and no reduction in surround suppression. In summary we find evidence that early contrast processing is altered by locomotion in humans but in a manner that differs from that reported in mice. The effects of locomotion on very low-level visual processing may differ on a species-by-species basis and may reflect important differences in the levels of arousal associated with locomotion
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