125 research outputs found
Cocoabsent? Representations of Race and Boyhood in Infant and Toddler Media
No full textThe hit streaming series Cocomelon has become a household name for many families with infants, toddlers, and kids at heart. Cocomelon introduces our youngest population(s) to a Western world that privileges flawed and utopian post-racial perspectives. I contend that the show presents a perspective on race and identity that glorifies color-blindness and ignores racial differences that would educate children about the complexity and beauty of diversity. This commentary imagines a Black infant and toddler boyhood in children’s media that prioritizes race, culture, and identity and recommends other children’s programs that invest in culturally diverse representations of childhood.Published articl
Intracutaneous or subcutaneous sterile water injection compared with blinded controls for pain management in labour
No full textExtent: 40p.Background: Intracutaneous or subcutaneous injection of sterile water is rapidly gaining popularity as a method of pain relief in labour and it is therefore essential that it is properly evaluated. Adequate analgesia in labour is important to women worldwide. Sterile water injection is inexpensive, requires basic equipment, and appears to have few side effects. It is purported to work for labour pain. Objectives: To determine the efficacy of sterile water injections for relief of pain (both typical contraction pain and intractable back pain) during labour compared to placebo (isotonic saline injections) or non-pharmacological interventions, and to identify any relevant effects on mode and timing of delivery, or safety of both mother and baby. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 May 2011), MEDLINE, and EMBASE (January 2010 to 30 May 2011), together with reference lists in retrieved studies and review articles. Selection criteria: We included randomised, double blind, controlled studies using intracutaneous or subcutaneous sterile water injections for pain relief during labour. There were no restrictions on birth place, parity, risk, age, weight, gestation, or stage of labour. Potential comparators were placebo (saline) and non-pharmacological interventions (e.g. hypnosis or biofeedback). Data collection and analysis: Two review authors independently assessed eligibility and quality of trials, and extracted data. We resolved any disagreements or uncertainties by discussion with a third review author. Primary outcome measures were at least 50% pain relief, or at least 30%, pain relief, patient global impression of change of at least 'good', mode of delivery, perinatal morbidity and mortality, maternal complications and adverse events. Secondary outcomes were women with any pain relief, use of rescue analgesia, and treatment group average pain relief. We made explicit judgements about potential biases in the studies. Main results: We included seven studies, with 766 participants: four used intracutaneous injections, two subcutaneous, and one both. All reported on low back pain in labour only. Methodological quality was good, but four studies were at high risk of bias due to small size of treatment groups, incomplete outcome data, and performance bias. All studies reported treatment group mean or median scores, finding greater reduction in pain for sterile water. However, failure to demonstrate a normal distribution for pain intensity or relief, and use of different scales, meant meta-analysis was inappropriate. No study reported primary dichotomous efficacy outcomes. One reported the number self-scoring 4/10 cm or more reduction in pain; significantly more had this outcome with sterile water (50% to 60%) than with placebo (20% to 25%). There was no significant difference between sterile water and saline for rates of caesarean section (risk ratio (RR) 0.58, 95% confidence interval (CI) 0.33 to 1.02), instrumental delivery (RR 1.31, 95% CI 0.79 to 2.18), rescue analgesia (RR 0.86, 95% CI 0.44 to 1.69), timing of delivery, or Apgar scores. Two studies reported that more women treated with sterile water would request the same analgesia in future. No study reported on women's satisfaction with pain relief, women's sense of control in labour, women's satisfaction with the childbirth experience, mother/baby interaction, rates of breastfeeding, maternal morbidity, infant long-term outcomes, or cost. No adverse events were reported other than transient pain with injection, which was worse with sterile water. Authors' conclusions: The outcomes reported severely limit conclusions for clinical practice. We found little robust evidence that sterile water is effective for low back or any oth er labour pain. Neither did we find any difference in delivery or other maternal or fetal outcomes. Further large, methodologically rigorous studies are required to determine the efficacy of sterile ...Sheena Derry, Sebastian Straube, R Andrew Moore, Heather Hancock, Sally L Collin
Marianne Moore and the Lessons of Multiplicity
No full textThe intrinsically multiple work of American poet Marianne Moore (1887-1972) presents special challenges to her editors, as evidenced by the ever-increasing number of editions of her work. In this essay the author, editor of three such editions, reflects on questions about poetic making and representation that underlie editorial work, focusing in particular on the virtues and pitfalls particular to print and digital editions.L’œuvre intrinsèquement multiple de Marianne Moore (1887-1972) présente à ses éditeurs des difficultés presque insurmontables, comme l’atteste le nombre toujours croissant d’éditions de ses poèmes. Dans cet article, l’auteure, qui a elle-même publié trois de ces éditions, se penche sur les questions de création et de représentation poétiques qui sous-tendent ce type de travail éditorial, pour souligner les vertus mais aussi les dangers propres aux éditions papier et aux éditions numériques
Critical Civic Engagement: Creating Yards and Building Community at Predominately White Institutions
No full textThis article details the journey of a Black Greek professor who created yards on a predominately white campus. This piece of scholarship challenges the historical narrative of the civic engagement movement and considers equity and inclusion with existing civic engagement literature. Specifically, this research contends that civic engagement scholarship must consider the historical legacy of historically Black Greek letter organizations, their commitment to service, and undergraduate education. The construction of “yards” is a civic engagement initiative that builds meaningful connections between college campuses and local communities
An exploration into the psychotherapeutic treatment of orthorexia nervosa from a feminine perspective
No full textThe aim of this dissertation is not only to investigate the presenting symptoms of the
condition known as orthorexia nervosa (ON). It also seeks to understand the underlying
structures that may be sustaining this form of disordered eating. To date the
relationship between obsessive–compulsive disorder and orthorexia nervosa has not
been sufficiently examined. Through a psychoanalytic lens, the author looks at how the
creation of the obsessional structure could be used to explore and understand new
eating disorders. The research examines how a psychodynamic perspective could be
used to treat this clientele. Furthermore, the dissertation will consider the social
discourse surrounding eating disorders and how a feminine approach can be used to
bridge the gap, between psyche and soma in the quest for wholeness
An exploration of the psychotherapeutic dynamic in the role of loss in creative expression, melancholia and depression.
No full textThe melancholia and depression that follows loss can often be an enthusiastic
bedfellow to creativity. In this dissertation the author attempts to uncover the link
between the melancholia and depression resulting from the loss of the object,
following the Oedipal separation, and ensuing creative expression. This creative
expression involves an attempt to recreate the lost object through the medium of free
association, in the guises of symbolization and language. The dissertation considers
the theories of Sigmund Freud, Melanie Klein and Julia Kristeva in relation to this
subject. It explores Freud’s examination of the role played by the lost object in
melancholia, as opposed to mourning which is considered a more natural and
healthier reaction to the loss of the object. Klein’s main focus is on the subject’s
attempts to recover the lost object through the imaginative use of symbolization and
language. Kristeva also relates the importance of memory, imagination and symbolic
language to art in an attempt to fill the empty space left by the lost object, as a way of
coping with the grief and melancholia that can result. All three emphasise the
psychotherapeutic alliance as a way of creating a potential space for the client to
freely express their creative side, therefore giving them the opportunity of recovery
Shame – The mist of the therapy room
No full textShame is an innate affect built into human nature by evolution, with the purpose of protecting the self and social relationships. Adaptive shame is healthy and crucial for self-identity and navigating relationships with others. However, core shame or toxic shame can result from repeated inappropriate shaming during childhood. In this dissertation the author seeks to uncover the neurophysiological and psychological development of shame in order to determine how a therapist might recognise deep-rooted shame in their clients. The neurophysiological development is looked at through Stephen Porges’ polyvagal theory. The psychological construct presented is informed by object relations theory and attachment theory. Defence mechanisms which are commonly used to control, avoid or deny shame are explored in order to identify patterns which might point the therapist towards the presence of core shame. The therapeutic implications of shame are explored along with a number of approaches which have been considered useful when working with shame
Assessing bone microstructure at the distal radius in children and adolescents using HR-pQCT: A methodological pilot study
No full textWe examined the use of high-resolution peripheral quantitative computed tomography (HR-pQCT [XtremeCT; Scanco Medical, Switzerland]) to assess bone microstructure at the distal radius in growing children and adolescents. We examined forearm radiographs from 37 children (age 8–14 yr) to locate the position of the ulnar and radial growth plates. We used HR-pQCT to assess bone microstructure in a region of interest (ROI) at the distal radius that excluded the growth plate (as determined from the radiographs) in all children (n = 328; 9–21 yr old). From radiographs, we determined that a ROI in the distal radius at 7% of bone length excluded the radial growth plate in 100% of participants. We present bone microstructure data at the distal radius in children and adolescents. From the HR-pQCT scans, we observed active growth plates in 80 males (aged 9.5–20.7 yr) and 92 females (aged 9.5–20.2 yr). The ulnar plate was visible in 9 male and 17 female participants (aged 11.2 ± 1.9 yr). The HR-pQCT scan required 3 min with a relatively low radiation dose (<3 μSv). Images from the radial ROI were free of artifacts and outlined cortical and trabecular bone microstructure. There is currently no standard method for these measures; therefore, these findings provide insight for investigators using HR-pQCT for studies of growing children.
[ABSTRACT FROM AUTHOR]Peer reviewedFinal article publishedGrowth plateBone imagingBone microstructureHR-pQC
Enhancing a somatic maturity prediction model
No full textPurpose
Assessing biological maturity in studies of children is challenging. Sex-specific regression equations developed using anthropometric measures are widely used to predict somatic maturity. However, prediction accuracy was not established in external samples. Thus, we aimed to evaluate the fit of these equations, assess for overfitting (adjusting as necessary), and calibrate using external samples.
Methods
We evaluated potential overfitting using the original Pediatric Bone Mineral Accrual Study (PBMAS; 79 boys and 72 girls; 7.5–17.5 yr). We assessed change in R2 and standard error of the estimate (SEE) with the addition of predictor variables. We determined the effect of within-subject correlation using cluster-robust variance and fivefold random splitting followed by forward-stepwise regression. We used dominant predictors from these splits to assess predictive abilities of various models. We calibrated using participants from the Healthy Bones Study III (HBS-III; 42 boys and 39 girls; 8.9–18.9 yr) and Harpenden Growth Study (HGS; 38 boys and 32 girls; 6.5–19.1 yr).
Results
Change in R2 and SEE was negligible when later predictors were added during step-by-step refitting of the original equations, suggesting overfitting. After redevelopment, new models included age × sitting height for boys (R2, 0.91; SEE, 0.51) and age × height for girls (R2, 0.90; SEE, 0.52). These models calibrated well in external samples; HBS boys: b0, 0.04 (0.05); b1, 0.98 (0.03); RMSE, 0.89; HBS girls: b0, 0.35 (0.04); b1, 1.01 (0.02); RMSE, 0.65; HGS boys: b0, −0.20 (0.02); b1, 1.02 (0.01); RMSE, 0.85; HGS girls: b0, −0.02 (0.03); b1, 0.97 (0.02); RMSE, 0.70; where b0 equals calibration intercept (standard error (SE)) and b1 equals calibration slope (SE), and RMSE equals root mean squared error (of prediction). We subsequently developed an age × height alternate for boys, allowing for predictions without sitting height.
Conclusion
Our equations provided good fits in external samples and provide an alternative to commonly used models. Original prediction equations were simplified with no meaningful increase in estimation error.Peer reviewedFinal article publishedPeak height velocityMaturationAdolescentsCalibrationGrowth modellin
Bone microstructure at the distal tibia provides a strength advantage to males in late puberty: An HR‐pQCT study
No full textBone is a complex structure with many levels of organization. Advanced imaging tools such as high‐resolution (HR) peripheral quantitative computed tomography (pQCT) provide the opportunity to investigate how components of bone microstructure differ between the sexes and across developmental periods. The aim of this study was to quantify the age‐ and sex‐related differences in bone microstructure and bone strength in adolescent males and females. We used HR‐pQCT (XtremeCT, Scanco Medical, Geneva, Switzerland) to assess total bone area (ToA), total bone density (ToD), trabecular bone density (TrD), cortical bone density (CoD), cortical thickness (Cort.Th), trabecular bone volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular spacing standard deviation (Tb.Sp SD), and bone strength index (BSI, mg2/mm4) at the distal tibia in 133 females and 146 males (15 to 20 years of age). We used a general linear model to determine differences by age‐ and sex‐group and age × sex interactions (p < 0.05). Across age categories, ToD, CoD, Cort.Th, and BSI were significantly lower at 15 and 16 years compared with 17 to 18 and 19 to 20 years in males and females. There were no differences in ToA, TrD, and BV/TV across age for either sex. Between sexes, males had significantly greater ToA, TrD, Cort.Th, BV/TV, Tb.N, and BSI compared with females; CoD and Tb.Sp SD were significantly greater for females in every age category. Males' larger and denser bones confer a bone‐strength advantage from a young age compared with females. These structural differences could represent bones that are less able to withstand loads in compression in females.Peer reviewedFinal article publishedpediatricsbonebone microstructurebone pQCTbone strengt
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