Effective network security monitoring: from attribution to target-centric monitoring

Network security monitoring remains a challenge. As global networks scale up, in terms of traffic, volume and speed, effective attribution of cyber attacks is increasingly difficult. The problem is compounded by a combination of other factors, including the architecture of the Internet, multi-stage attacks and increasing volumes of nonproductive traffic. This paper proposes to shift the focus of security monitoring from the source to the target. Simply put, resources devoted to detection and attribution should be redeployed to efficiently monitor for targeting and prevention of attacks. The effort of detection should aim to determine whether a node is under attack, and if so, effectively prevent the attack. This paper contributes by systematically reviewing the structural, operational and legal reasons underlying this argument, and presents empirical evidence to support a shift away from attribution to favour of a target-centric monitoring approach. A carefully deployed set of experiments are presented and a detailed analysis of the results is achieved.

Fruit and vegetable intake and risk of incident of type 2 diabetes: results from the consortium on health and ageing network of cohorts in Europe and the United States (CHANCES)

BACKGROUND/OBJECTIVES: There is limited information to support definitive recommendations concerning the role of diet in the development of type 2 Diabetes mellitus (T2DM). The results of the latest meta-analyses suggest that an increased consumption of green leafy vegetables may reduce the incidence of diabetes, with either no association or weak associations demonstrated for total fruit and vegetable intake. Few studies have, however, focused on older subjects.

SUBJECTS/METHODS: The relationship between T2DM and fruit and vegetable intake was investigated using data from the NIH-AARP study and the EPIC Elderly study. All participants below the age of 50 and/or with a history of cancer, diabetes or coronary heart disease were excluded from the analysis. Multivariate logistic regression analysis was used to calculate the odds ratio of T2DM comparing the highest with the lowest estimated portions of fruit, vegetable, green leafy vegetables and cabbage intake.

RESULTS: Comparing people with the highest and lowest estimated portions of fruit, vegetable or green leafy vegetable intake indicated no association with the risk of T2DM. However, although the pooled OR across all studies showed no effect overall, there was significant heterogeneity across cohorts and independent results from the NIH-AARP study showed that fruit and green leafy vegetable intake was associated with a reduced risk of T2DM OR 0.95 (95% CI 0.91,0.99) and OR 0.87 (95% CI 0.87,0.90) respectively.

CONCLUSIONS: Fruit and vegetable intake was not shown to be related to incident T2DM in older subjects. Summary analysis also found no associations between green leafy vegetable and cabbage intake and the onset of T2DM. Future dietary pattern studies may shed light on the origin of the heterogeneity across populations.European Journal of Clinical Nutrition advance online publication, 17 August 2016; 

Model-driven development of sensor network applications with optimization of non-functional constraints

Wireless sensor networks (WSNs) differ from conventional distributed systems in many aspects. The resource limitation of sensor nodes, the ad-hoc communication and topology of the network, coupled with an unpredictable deployment environment are difficult non-functional constraints that must be carefully taken into account when developing software systems for a WSN. Thus, more research needs to be done on designing, implementing and maintaining software for WSNs. This thesis aims to contribute to research being done in this area by presenting an approach to WSN application development that will improve the reusability, flexibility, and maintainability of the software. Firstly, we present a programming model and software architecture aimed at describing WSN applications, independently of the underlying operating system and hardware. The proposed architecture is described and realized using the Model-Driven Architecture (MDA) standard in order to achieve satisfactory levels of encapsulation and abstraction when programming sensor nodes. Besides, we study different non-functional constrains of WSN application and propose two approaches to optimize the application to satisfy these constrains. A real prototype framework was built to demonstrate the developed solutions in the thesis. The framework implemented the programming model and the multi-layered software architecture as components. A graphical interface, code generation components and supporting tools were also included to help developers design, implement, optimize, and test the WSN software. Finally, we evaluate and critically assess the proposed concepts. Two case studies are provided to support the evaluation. The first case study, a framework evaluation, is designed to assess the ease at which novice and intermediate users can develop correct and power efficient WSN applications, the portability level achieved by developing applications at a high-level of abstraction, and the estimated overhead due to usage of the framework in terms of the footprint and executable code size of the application. In the second case study, we discuss the design, implementation and optimization of a real-world application named TempSense, where a sensor network is used to monitor the temperature within an area.

Na Condição de Prostituta, Que Redes de Suporte Social?

As definições tradicionais de prostituição tendem a enfatizar três aspectos: a existência de uma interacção de tipo sexual, a existência de uma retribuição económica por essa interacção e a existência de indiferença afectiva entre as partes envolvidas, isto é entre cliente e prostituta (Machado & Gonçalves, 2002) O conceito de “rede” tem surgido recentemente nos mais diversos domínios e com inúmeras designações associadas, pelo que pode falar-se de redes em áreas e aplicações tão diversas, pois é usado para “designar uma grande variedade de objectos e de fenómenos”. Os vínculos numa rede primária são, assim, essencialmente de natureza afectiva, não havendo qualquer formalidade na relação. Já as redes secundárias reportam-nos aos membros da nossa rede com os quais estabelecemos relações num contexto formal e com objectivos funcionais (Guadalupe, 2009) Tendo em conta o objecto de estudo, pretende-se com este trabalho de pesquisa, perceber quais as redes de suporte desta população, bem como a eficácia da rede em relação aos vínculos afectivos. Podemos assim apurar que relativamente às redes de suporte primárias estas prostitutas têm mais perto de si os seus companheiros e em seguida os seus filhos, mantendo, 29.4 % uma boa relação com a sua família e uma percentagem igual uma má relação familiar. Relativamente às redes de suporte secundárias, uma parte desta população recorre a politicas sociais activas, implementadas pelo Ministério do Trabalho e da Segurança Social operacionalizadas pela Segurança Social de Coimbra para o apoio social. Ao nível da intervenção social directa, recorrem à Associação Existências para o apoio emocional, psicossocial e de aconselhamento em contexto de gabinete ou em contexto outreach. /

Influence of frequent nightmares on REM sleep-dependent emotional memory processing

La littérature suggère que le sommeil paradoxal joue un rôle dans l'intégration associative de la mémoire émotionnelle. De plus, les rêves en sommeil paradoxal, en particulier leur nature bizarre et émotionnelle, semblent refléter cette fonction associative et émotionnelle du sommeil paradoxal. La conséquence des cauchemars fréquents sur ce processus est inconnue, bien que le réveil provoqué par un cauchemar semble interférer avec les fonctions du sommeil paradoxal. Le premier objectif de cette thèse était de reproduire conceptuellement des recherches antérieures démontrant que le sommeil paradoxal permet un accès hyper-associatif à la mémoire. L'utilisation d'une sieste diurne nous a permis d'évaluer les effets du sommeil paradoxal, comparativement au sommeil lent et à l’éveil, sur la performance des participants à une tâche sémantique mesurant « associational breadth » (AB). Les résultats ont montré que seuls les sujets réveillés en sommeil paradoxal ont répondu avec des associations atypiques, ce qui suggère que le sommeil paradoxal est spécifique dans sa capacité à intégrer les traces de la mémoire émotionnelle (article 1). En outre, les rapports de rêve en sommeil paradoxal étaient plus bizarres que ceux en sommeil lent, et plus intenses émotionnellement ; ces attributs semblent refléter la nature associative et émotionnelle du sommeil paradoxal (article 2). Le deuxième objectif de la thèse était de préciser si et comment le traitement de la mémoire émotionnelle en sommeil paradoxal est altéré dans le Trouble de cauchemars fréquents (NM). En utilisant le même protocole, nos résultats ont montré que les participants NM avaient des résultats plus élevés avant une sieste, ce qui correspond aux observations antérieures voulant que les personnes souffrant de cauchemars soient plus créatives. Après le sommeil paradoxal, les deux groupes, NM et CTL, ont montré des changements similaires dans leur accès associatif, avec des résultats AB-négatif plus bas et AB-positif plus grands. Une semaine plus tard, seul les participants NM a maintenu ce changement dans leur réseau sémantique (article 3). Ces résultats suggèrent qu’au fil du temps, les cauchemars peuvent interférer avec l'intégration de la mémoire émotionnelle pendant le sommeil paradoxal. En ce qui concerne l'imagerie, les participants NM avaient plus de bizarrerie et plus d’émotion positive, mais pas négative, dans leurs rêveries (article 4). Ces attributs intensifiés suggèrent à nouveau que les participants NM sont plus imaginatifs et créatifs à l’éveil. Dans l'ensemble, les résultats confirment le rôle du sommeil paradoxal dans l'intégration associative de la mémoire émotionnelle. Cependant, nos résultats concernant le Trouble de cauchemars ne sont pas entièrement en accord avec les théories suggérant que les cauchemars sont dysfonctionnels. Le groupe NM a montré plus d’associativité émotionnelle, de même que plus d'imagerie positive et bizarre à l’éveil. Nous proposons donc une nouvelle théorie de sensibilité environnementale associée au Trouble de cauchemar, suggérant qu'une sensibilité accrue à une gamme de contextes environnementaux sous-tendrait les symptômes uniques et la richesse imaginative observés chez les personnes souffrant de cauchemars fréquents. Bien que davantage de recherches doivent être faites, il est possible que ces personnes puissent bénéficier e milieux favorables, et qu’elles puissent avoir un avantage adaptatif à l'égard de l'expression créative, ce qui est particulièrement pertinent lorsque l'on considère leur pronostic et les différents types de traitements.

Movies and the Enchanted Mind : Emotional Comprehension and Spiritual Meaning Making Among Young Adults in Contemporary Sweden

The outcome of an empirical audience study in Sweden including questionnaires, focus groups and ten in-depth individual interviews discussing favorite films supports claims about viewers as active and playful (cf. Frampton 2006, Hoover 2006, Plantinga 2009). The soft side of mediatization processes is illustrated showing young adults experiencing enchantment through films (Jerslev 2006, Partridge 2008, Klinger 2008, Oliver & Hartmann 2010). The outcome is in line with a growing number of empirical case studies which support conclusions that both thinking and behavior are affected by film watching (Marsh 2007, Suckfüll 2010, Oliver & Hartmann 2010, Axelson 2014). The results of the interviews exploring specific scenes of idiosyncratic relevance support theories about fiction films as important sources for moral and spiritual reflection (Partridge 2004, Zillman 2005, Lynch 2007, Plantinga 2009).  The concept thick viewing is proposed for capturing these moments of film experience when profound and enchanted emotional interpretations take place.

Famílias Unipessoais Idosas: um estudo das redes sociais pessoais de idosos que vivem sós

Objetivos: O presente estudo tem como objetivo analisar as características estruturais, funcionais e relacionais-contextuais das redes sociais pessoais de famílias unipessoais idosas. Metodologia: Utilizámos para recolha de dados um questionário para caracterizar sociodemograficamente a amostra, o Instrumento de Análise da Rede Social Pessoal (versão para idosos) (IARSP-Idosos) (Guadalupe, 2010; Guadalupe e Vicente 2012) e a escala de solidão UCLA (Neto, 1989). Participantes: A amostra é constituída por 567 indivíduos com média de idades de 75,53 anos, maioritariamente do sexo feminino (63,0%; n = 357). Predominam os sujeitos casados (53,7%; n = 304), com filhos (87,8%; n = 498) e em situação de coabitação (n = 450; 79,4%). Contudo, 20,6% (n = 117) vivem sós, constituindo as famílias unipessoais. Resultados: As redes sociais dos idosos têm em média 7,99 elementos, predominantemente familiares (M = 76,89%). Os participantes percecionam um nível elevado de apoio por parte das suas redes. São redes coesas, pouco dispersas e os contactos entre os elementos são frequentes. As mulheres, os indivíduos solteiros, viúvos ou divorciados e os idosos sem filhos têm uma maior probabilidade de viverem sós (p < 0,05) e estes apresentam uma maior probabilidade de necessitar de apoio social formal (p < 0,05). As famílias unipessoais, quando comparadas com os que não vivem sós, apresentam um maior número de campos relacionais e maior proporção de relações de amizade e de vizinhança (p < 0,05). Têm menor perceção de apoio material e instrumental, informativo, companhia social, acesso a novos vínculos e reciprocidade de apoio (p < 0,05). Além disso, referem menor frequência de contactos e uma maior dispersão geográfica (p < 0,05). Nas famílias unipessoais, observou-se a existência de correlações negativas significativas (p < 0,05) entre a percepção de solidão e o tamanho da rede, a proporção das relações familiares na rede, o apoio emocional e informativo e a reciprocidade de apoio. CONCLUSÃO: Os idosos com famílias unipessoais percecionam menor apoio por parte das suas redes, tendo uma maior propensão à solidão. É fundamental, ao longo do ciclo vital, promover a quantidade e qualidade dos vínculos, no sentido de manter a efetividade do suporte das redes mesmo quando se vive só. / Objectives: The present study aims to analyze the structural, functional and relational-contextual characteristics of older single-person households. Methodology: We used as instruments a questionnaire to evaluate sociodemographic data, the Instrumento de Análise da Rede Social Pessoal (version for elderly people: IARSP-Idosos) (Guadalupe, 2010; Guadalupe e Vicente 2012) and the UCLA Loneliness Scale (Neto, 1989). Participants: The sample consists of 567 individuals with an average age of 75.53 years, mostly females (63.0%; n = 357). There is a predominance of married individuals (53.7%; n = 304) with children (87.8%; n = 498). Older people live mainly in cohabitation (n = 450; 79.4%), however 20.6% oh them live alone, constituting one-person households. Results: The elderly personal social networks have 8 elements, on average, with a predominance of family relationships (M = 76.89%). The participants perceived a high level of support from their networks. In general the networks are cohesive, with low dispersion and have frequent contacts. The women, single, widowed or divorced and childless elderly are more likely to live alone (p < 0.05) and to need social services support (p < 0.05). The single-person households, compared with those who do not live alone, have a greater number of relational fields and a higher proportion of friendships and neighborhood relations (p < 0.05). They have a lower perception of material and informative support, social company and acess to new ties and reciprocal support (p < 0.05). They also refer lowest frequency of contacts and a wider geographical dispersion (p < 0.05). In single-person households there was a negative significant correlation between the perception of loneliness and the social network size, the proportion of family relationships in the network, emotional and informational support and reciprocal support. Conclusions: The elderly single-person households perceived less support from their networks and a greater propensity to loneliness. It is critical to promot the quality of ties, rather then their quantity, throughout the life cycle, in order to maintain the network effectiveness even when the person lives alone.

A Família nas Redes Sociais Pessoais de Idosos

Objetivos: Analisar as caraterísticas sociodemográficas e das redes sociais pessoais dos idosos de acordo com a composição das redes centrada na família. Metodologia: Para caraterizar as redes sociais pessoais utilizámos o Instrumento de Análise da Rede Social e Pessoal – Idosos (IARSP-idosos) (Guadalupe, 2010; Guadalupe e Vicente, 2012) e um questionário para descrever sociodemograficamente a amostra. Participantes: A amostra é constituída por 567 idosos (M = 75,53 anos), com predominância do sexo feminino (64,1%). A maioria é casada (53,8%) e detém a 4ª classe (51,3%). Os participantes, na sua maioria, têm filhos (87,8%) e não vivem sós (79,4%). Resultados: As redes são compostas em média por 8 elementos, dominadas por laços familiares (M = 76,90%). São redes coesas, com relações interpessoais duradouras, com pouca dispersão geográfica e elevada frequência de contactos. O apoio percebido nas redes é sobretudo emocional e informativo. Quanto à sua composição, 43,7% dos idosos têm uma rede exclusivamente familiar, 53,4% redes com família e outros campos relacionais e apenas 2,8% apresentam redes sem família. Os idosos com 76-85 anos, casados e com agregado familiar numeroso têm maior probabilidade de pertencer a redes exclusivamente familiares. Os idosos mais jovens e divorciados tendem a pertencer a redes mais diversificadas, enquanto as mulheres e os indivíduos solteiros e sem filhos têm maior probabilidade de não ter laços familiares nas suas redes, compensando a sua ausência com relações de amizade e de vizinhança. As redes exclusivamente familiares estão associadas a maior perceção de apoio emocional, material e instrumental, companhia social e reciprocidade de apoio. As redes com família e outras composições caraterizam-se por ter mais elementos e uma maior dispersão geográfica. As redes sem família são as mais reduzidas e são normalmente homogéneas para o género feminino e a nível etário, no grupo idoso. Conclusões: Fica patente o papel central das famílias nas redes e no apoio informal. Contudo, será essencial potenciar a diversificação e manutenção dos vínculos promovendo o acesso a novos contactos ao longo de todo o ciclo vital, de forma a garantir uma rede social pessoal diversificada e efetiva, em vínculos e recursos, que complemente as necessidades e favoreça o bem-estar da pessoa idosa. / Objectives: To analyze the sociodemographical and personal social networks characteristics of the elderly according to the composition of the networks centered on the families. Methodology: For characterizing the personal social networks we used the Instrumento de Análise da Rede Social Pessoal (IARSP-Idosos) (Guadalupe, 2010; Guadalupe e Vicente, 2012) and for sociodemographic characteristics we used a questionnaire. Participants: The sample consisted of 567 elderly (M = 75.53 years), mainly female (64.1%). The majority are married (53.8%) and have the 4th grade (51,3%). Overall the participants have offspring (87.8%) and do not live alone (79.4%). Results: On average, the networks have 8 elements, mostly relatives (M = 76.90%). The networks are cohesive, long-lasting, have a low geographical spread and we observed a high frequency of contacts. The networks provide mostly emotional (M = 2.64) and informative support (M = 2.37). Regarding its composition, 43.7% of the elderly have an exclusively family network, 53.4% have networks with family members and other relational fields and only 2.8% have no relatives in their networks. The elderly whose age is between 76-85 years, married and with a large household are more likely to belong to exclusively family networks. Younger and divorced elderly tend to belong to more diverse networks, as women and individuals unmarried and without offspring are more likely to do not have family bounds in their networks, with a higher proportion of friends and neighbors. Exclusively family networks are associated with greater perception of emotional, material and instrumental support, social company and reciprocal support. Networks with family and other fields are characterized by having more elements and a greater geographical spread. The social networks without family are smaller and are usually homogeneous for female gender and age, in the elderly group. Conclusions: The role of families in providing informational support is clear. However, it will be essential to enhance the diversification and maintain ties that promote access to new contacts throughout our entire life, to ensure a diversified social network that will be effective in bonds and resources that complement the needs and encourages the well-being of the elderly.

Objetivos de Vida e Satisfação na Vida Conjugal em Pais/Progenitores de Crianças com Autismo

Introdução: A presença do diagnóstico de autismo numa criança é algo marcante no seio familiar. Implica inúmeros desafios para os seus pais/progenitores, podendo influenciar os objetivos delineados para as suas vidas e a satisfação na relação conjugal. Os nossos objetivos foram: caraterizar progenitores de crianças com autismo quanto aos objetivos de vida e satisfação na vida conjugal e explorar as associações existentes entre estas duas variáveis (e com variáveis sociodemográficas e relativas ao apoio recebido). Não deixamos de explorar os níveis de depressão, ansiedade, e stress, vivenciados por estes pais. Metodologia: 66 progenitores (sexo feminino, n = 52, 78,8%; idade média, M = 40,2, DP = 6,45) de crianças com autismo preencheram um questionário sociodemográfico, o Teste dos objetivos de vida/PIL-R, a Escala de Avaliação da Satisfação em Áreas da Vida Conjugal/EASAVIC e a Depression, Anxiety and Stress Scale-21/DASS-21. Resultados: Os progenitores revelaram valores médios de objetivos de vida (PIL-R). Foi na dimensão vivencial (PIL-R) e nas dimensões Comunicação e Intimidade Emocional (satisfação em áreas da vida conjugal/EASAVIC) que os progenitores apresentaram valores médios mais elevados. No caso da DASS-21, foi na escala Stress que os progenitores apresentaram valores mais elevados. Porém, em todas as dimensões da DASS-21, os níveis encontrados foram normais. Não se verificaram diferenças estatisticamente significativas por sexo em todas as dimensões do PIL-R, da EASAVIC e DASS-21. Ambas as dimensões do PIL-R, dimensional e existencial, bem como a sua pontuação total mostraram estar associadas com todas as dimensões da EASAVIC (satisfação em áreas da vida conjugal). As três dimensões da DASS-21 (Depressão, Ansiedade e Stress) revelaram estar associada (negativamente) com praticamente todas as dimensões da EASAVIC e do PIL-R. Os progenitores que pertenciam a associações de apoio apenas se diferenciaram dos progenitores que pertenciam a um grupo (de apoio e partilha) numa rede social na dimensão Ansiedade, com estes últimos a apresentarem um nível mais elevado. Discussão: Neste estudo (ainda que numa amostra de tamanho reduzido), inovador pelo tema explorado, os níveis dos objetivos de vida e de satisfação em áreas da vida conjugal (bem como de sintomas de psicopatologia) pareceram “não sofrer” o impacto associado ao facto dos progenitores terem um filho com autismo. Os objetivos de vida mantidos por estes pais influenciam a sua satisfação com a vida conjugal e vice-versa, indicando a importância das equipas que trabalham com estes pais não esquecerem a promoção destas variáveis. / Introduction: The presence of the diagnosis of autism in a child is something remarkable in the family. Involves many challenges for parents/progenitors, which can influence the goals they define in their lives and their satisfaction with the marital relationship. Our objectives were to characterize parents of children with autism on the objectives of life and satisfaction with marital life and explore the associations between these two variables (and with sociodemographic and support variables). We will not forget to explore the levels of depression, anxiety, and stress, experienced by these parents. Methodology: 66 parents (females, n = 52, 78.8%, mean age, M = 40.2, SD = 6.45) of children with autism completed a sociodemographic questionnaire, the Test of Life Goals/PIL-R, the Areas of Marital Satisfaction Rating Scale/EASAVIC and the Depression, Anxiety and Stress Scale-21/DASS-21. Results: Parents showed a mean value of life goals (PIL-R). Was in the experiential dimension (PIL-R) and the Communication and Emotional Intimacy dimensions (satisfaction in areas of marital life/EASAVIC) that the parents presented higher mean values. Regarding DASS-21, Stress was the scale in which the parents had higher values. However, in all the DASS-21, levels were “normal”. There were no statistically significant differences by gender in all the PIL-R, EASAVIC and DASS-21 scales. Both dimensions of the PIL-R, dimensional and existential, as well as the total score were found to be associated with all the dimensions of EASAVIC (satisfaction in areas of marital life). The three dimensions of the DASS-21 (Depression, Anxiety and Stress) revealed to be associated (negatively) with virtually all dimensions of the EASAVIC and the PIL-R. Parents who belonged to associations only differed from the parents from a social network group (of support and sharing) in the anxiety dimension, with the later presenting an higher level. Discussion: In this study (even if in a small sample size), innovative by the theme explored, levels of life goals and satisfaction in areas of marital life (as well as symptoms of psychopathology) seemed not to suffer from the impact of the parents having a child with autism. The life goals held by these parents influence their satisfaction with marital life and vice versa, indicating the importance of teams working with these parents of not forgetting the promotion of these variables.

Predictive Analytics and Decision Support for Heart Failure patients

Thesis (Master's)--University of Washington, 2016-08

Combinative Aspects of Leadership Style and Emotional Intelligence

Purpose – The purpose of this paper is to examine whether the leader’s emotional intelligence influences the leader’s preferences for different ways of combining leadership behaviors (i.e. combinative aspects of leadership style). Design/methodology/approach – The authors used a hybrid design to collect the data to avoid common-method biases. The authors described a high-stress workplace in a vignette and asked participants to rank four styles of combining a task-oriented leadership (i.e. Pressure) statement and a socio-emotional leadership (i.e. Support) statement. The authors then asked participants to complete a Likert-scale based questionnaire on emotional intelligence. Findings – The authors found that leaders who prefer to provide Support immediately before Pressure have higher levels of emotional intelligence than do leaders who prefer the three other combinative styles. Leaders who prefer to provide Pressure and Support separately (i.e. provide Pressure 30 minutes after Support) have the lowest levels of emotional intelligence. Research limitations/implications – A key implicit assumption in the work is that leaders do not want to evoke negative emotions in followers. The authors did not take into account factors that influence leadership style which participating managers would be likely to encounter on a daily basis such as the relationship with the follower, the follower’s level of performance and work experience, the gender of the leader and the gender of the follower, the hierarchical levels of the leader and follower, and the followers’ preferred combinative style. The nature of the sample and the use of a hypothetical scenario are other limitations of the study. Practical implications – Providing leadership behaviors that are regarded as effective is necessary but not enough because the emotional impact of leadership behaviors appears to also depend on how the behaviors are configured. Originality/value – This is the first study to show that the emotional intelligence of leaders is related to their preferences for the manner in which they combine task and social leadership statements. Furthermore, two-factor theories of leadership propose that the effects of task and social leadership are additive. However, the findings show that the effects are interactive.

Pathways to emotional closeness in neonatal units - a cross-national qualitative study.

BACKGROUND: Research shows evidence for the importance of physical and emotional closeness for the infant, the parent and the infant-parent dyad. Less is known about how, when and why parents experience emotional closeness to their infants in a neonatal unit (NU), which was the aim of this study. METHODS: A qualitative study using a salutogenic approach to focus on positive health and wellbeing was undertaken in three NUs: one in Sweden, England and Finland. An 'emotional closeness' form was devised, which asked parents to describe moments/situations when, how and why they had felt emotionally close to their infant. Data for 23 parents of preterm infants were analyzed using thematic networks analysis. RESULTS: A global theme of 'pathways for emotional closeness' emerged from the data set. This concept related to how emotional, physical, cognitive and social influences led to feelings of emotional closeness between parents and their infants. The five underpinning organising themes relate to the: Embodied recognition through the power of physical closeness; Reassurance of, and contributing to, infant wellness; Understanding the present and the past; Feeling engaged in the day to day and Spending time and bonding as a family. CONCLUSION: These findings generate important insights into why, how and when parents feel emotionally close. This knowledge contributes to an increased awareness of how to support parents of premature infants to form positive and loving relationships with their infants. Health care staff should create a climate where parents' emotions and their emotional journey are individually supported.

Adolescent boys’ health : managing emotions, masculinities and subjective social status

The health of adolescent boys is complex and surprisingly little is known about how adolescent boys perceive, conceptualise and experience their health. Thus, the overall aim of this thesis was to explore adolescent boys’ perceptions and experiences of health, emotions, masculinity and subjective social status (SSS). This thesis consists of a qualitative, a quantitative and a mixed methods study. The qualitative study aimed to explore how adolescent boys understand the concept of health and what they find important for its achievement. Furthermore, the adolescent boys’ views of masculinity, emotion management and their potential effects on wellbeing were explored. For this purpose, individual interviews were conducted with 33 adolescent boys aged 16-17 years. The quantitative study aimed to investigate the associations between pride, shame and health in adolescence. Data were collected through a cross-sectional postal survey with 705 adolescents. The purpose of the mixed methods study was to investigate associations between SSS in school, socioeconomic status (SES) and self-rated health (SRH), and to explore the concept of SSS in school. Cross-sectional data were combined with interview data in which the meaning of SSS was further explored. Individual interviews with 35 adolescents aged 17-18 years were conducted. In the qualitative study, data were analysed using Grounded Theory. In the quantitative study, statistical analyses (e.g., chi-square test and uni- and multivariable logistic regression analyses) were performed. In the mixed method study, a combination of statistical analyses and thematic network analysis was applied. The results showed that there was a complexity in how the adolescent boys viewed, experienced, dealt with and valued health. On a conceptual level, they perceived health as holistic but when dealing with difficult emotions, they were prone to separate the body from the mind. Thus, the adolescent boys experienced a difference between health as a concept and health as an experience (paper I). Concerning emotional orientation in masculinity, two main categories of masculine conceptions were identified: a gender-normative masculinity and a non-gender-normative masculinity (paper II). Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite that their expressions are in contrast to each other. Non-gender-normative masculinity included an orientation towards sincerity, emphasising the personal values of the boys. Emotions were expressed more independently of peer group norms. The findings suggest that different masculinities and the expression of emotions are intricately intertwined and that managing emotions is vital for wellbeing. The present findings also showed that both shame and pride were significantly associated with SRH, and furthermore, that there seems to be a protective effect of experiencing pride for health (paper III). The results also demonstrated that SSS is strongly related to SRH, and high SRH is related to high SSS, and further that the positioning was done in a gendered space (paper IV). Results from all studies suggest that the emotional and relational aspects, as well as perceived SSS, were strongly related to SRH. Positive emotions, trustful relationships and having a sense of belonging were important factors for health and pride was an important emotion protecting health. Physical health, on the other hand, had a more subordinated value, but the body was experienced as an important tool to achieve health. Even though health was mainly perceived in a holistic manner by the boys, there were boys who were prone to dichotomise the health experience into a mind-body dualism when having to deal with difficult emotions. In conclusion, this thesis demonstrates that young, masculine health is largely experienced through emotions and relationships between individuals and their contexts affected by gendered practices. Health is to feel and function well in mind and body and to have trusting relationships. The results support theories on health as a social construction of interconnected processes. Having confidence in self-esteem, access to trustful relationships and the courage to resist traditional masculine norms while still reinforcing and maintaining social status are all conducive to good health. Researchers as well as professionals need to consider the complexity of adolescent boys’ health in which norms, values, relationships and gender form its social determinants. Those working with young boys should encourage them to integrate physical, social and emotional aspects of health into an interconnected and holistic experience.

Challenges Facing Long Term Foster Carers: Exploration of the Nature of Psychoanalytic Parent/Carer Support

This research study investigates the role and impact of psychoanalytically-informed short-term parent work with long-term foster carers of looked-after children, in support of the foster placement. The study reflects on the data gathered from four child assessments and five foster families seen by a psychoanalytic child psychotherapist for four sessions each. It draws on psychoanalytic ideas from a range of theoretical traditions, exploring such concepts as trauma, defences, compulsion to repeat, psychological-mindedness, ‘container/contained’ (Bion) and ‘holding environment’ (Winnicott). One distinctive contribution of this research is what it adds to our already existing understanding of the defences (or responses) aroused in the carer when faced with the intense and distressing affect associated with the child’s early trauma; and the impact of this legacy of trauma on the child, on the carer and on the wider Social Services system. Applying Grounded Theory and psychoanalytically-informed clinical case study methodology to the research material, the study breaks down the data analysis into seven stages of coding, from the initial reading of the data to the eventual development of two key hypotheses. One of the predominant themes that emerged from the analysis was the carer’s capacity to remain focused on the child’s emotional needs and how this in turn was linked to the direction of the therapist’s focus. The successive analyses of the data culminated in the hypothesis that the more the therapist focused on the carer and the carer’s emotional states in the course of the parent work, the more the carer was enabled to focus on the child’s emotional needs. As the system of categories emerged according to the themes exemplified in the sessions, a particular focus of analysis became the concept of psychologicalmindedness, considered under several sub-categories: displaying insightful comments; awareness of the child’s bodily states; awareness of the child’s affect; the carer’s ability to recognize the child’s defences; and the carer’s ability to make links between the child’s current difficulties and the child’s past experiences. Through this analysis it became apparent that degree of psychological-mindedness was closely linked to the individual carer’s capacity to metabolize the child’s distressed and distressing communication. This in turn led to a deeper exploration of the situations that were particularly challenging for the carers: i.e., instances when the child was compelled to repeat past traumatic emotional states and as a result was communicating intense distress. This exploration eventually generated the second hypothesis: that in reaction to the child’s distress, the response of each carer could be plotted somewhere along a spectrum, from either distancing themselves from the child’s emotional state to seeking excessive closeness with the child (merging). The next stage of the analysis developed four new categories of carer responses to the distressed child: identification and distancing from the child; identification and merging with the child; the category that describes the carer’s psychologicalmindedness as being ‘impaired’; and ‘good enough’ caring. This then led to an exploration of the carer’s own defences at these most challenging times. This research demonstrates clearly that even within the short space of four sessions of weekly psychoanalytic parent work, it is possible to achieve significant improvement in a carer’s capacity to bear the child’s compulsion to repeat early traumas, and to help the carers become more emotionally available to provide the child with effective psychological parenting at such difficult and challenging times. Key words: looked-after children; long-term foster carers; psychoanalytic short-term parent work; trauma; compulsion to repeat; psychological-mindedness; empathy; defences; psychoanalytically-informed clinical case study research methodology; Grounded Theory research methodology.

DEVELOPMENT OF A DECISION/DEPLOYMENT SUPPORT TOOL FOR VARIABLE SPEED LIMITS IN RECURRENT CONGESTION

Traffic demand increases are pushing aging ground transportation infrastructures to their theoretical capacity. The result of this demand is traffic bottlenecks that are a major cause of delay on urban freeways. In addition, the queues associated with those bottlenecks increase the probability of a crash while adversely affecting environmental measures such as emissions and fuel consumption. With limited resources available for network expansion, traffic professionals have developed active traffic management systems (ATMS) in an attempt to mitigate the negative consequences of traffic bottlenecks. Among these ATMS strategies, variable speed limits (VSL) and ramp metering (RM) have been gaining international interests for their potential to improve safety, mobility, and environmental measures at freeway bottlenecks. Though previous studies have shown the tremendous potential of variable speed limit (VSL) and VSL paired with ramp metering (VSLRM) control, little guidance has been developed to assist decision makers in the planning phase of a congestion mitigation project that is considering VSL or VSLRM control. To address this need, this study has developed a comprehensive decision/deployment support tool for the application of VSL and VSLRM control in recurrently congested environments. The decision tool will assist practitioners in deciding the most appropriate control strategy at a candidate site, which candidate sites have the most potential to benefit from the suggested control strategy, and how to most effectively design the field deployment of the suggested control strategy at each implementation site. To do so, the tool is comprised of three key modules, (1) Decision Module, (2) Benefits Module, and (3) Deployment Guidelines Module. Each module uses commonly known traffic flow and geometric parameters as inputs to statistical models and empirically based procedures to provide guidance on the application of VSL and VSLRM at each candidate site. These models and procedures were developed from the outputs of simulated experiments, calibrated with field data. To demonstrate the application of the tool, a list of real-world candidate sites were selected from the Maryland State Highway Administration Mobility Report. Here, field data from each candidate site was input into the tool to illustrate the step-by-step process required for efficient planning of VSL or VSLRM control. The output of the tool includes the suggested control system at each site, a ranking of the sites based on the expected benefit-to-cost ratio, and guidelines on how to deploy the VSL signs, ramp meters, and detectors at the deployment site(s). This research has the potential to assist traffic engineers in the planning of VSL and VSLRM control, thus enhancing the procedure for allocating limited resources for mobility and safety improvements on highways plagued by recurrent congestion.