White Moths

This collection navigates the process of grief after the speaker’s loss of both parents. The speaker struggles to connect with both the dead and the living through her physical intimacy and relationship with a troubled lover. These poems explore and exhume the speaker’s buried memories, moving from moments of wry humor to meaningful and sometimes painful discovery. Ultimately, these poems attempt to reach beyond the self, to transform loss and loneliness from a human condition into a musical tool of art for human connection.

RGS14 (414)-mediated prevention of an episodic memory loss: a study of molecular mechanism

A large proportion of human populations suffer memory impairments either caused by normal aging or afflicted by diverse neurological and neurodegenerative diseases. Memory enhancers and other drugs tested so far against memory loss have failed to produce therapeutic efficacy in clinical trials and thus, there is a need to find remedy for this mental disorder. In search for cure of memory loss, our laboratory discovered a robust memory enhancer called RGS14(414). A treatment in brain with its gene produces an enduring effect on memory that lasts for lifetime of rats. Therefore, current thesis work was designed to investigate whether RGS14(414) treatment can prevent memory loss and furthermore, explore through biological processes responsible for RGS-mediated memory enhancement. We found that RGS14(414) gene treatment prevented episodic memory loss in rodent models of normal aging and Alzheimer´s disease. A memory loss was observed in normal rats at 18 months of age; however, when they were treated with RGS14(414) gene at 3 months of age, they abrogated this deficit and their memory remained intact till the age of 22 months. In addition to normal aging rats, effect of memory enhancer treatment in mice model of Alzheimer´s disease (AD-mice) produced a similar effect. AD-mice subjected to treatment with RGS14(414) gene at the age of 2 months, a period when memory was intact, showed not only a prevention in memory loss observed at 4 months of age but also they were able to maintain normal memory after 6 months of the treatment. We posit that long-lasting effect on memory enhancement and prevention of memory loss mediated through RGS14(414) might be due to a permanent structural change caused by a surge in neuronal connections and enhanced neuronal remodeling, key processes for long-term memory formation. A neuronal arborization analysis of both pyramidal and non-pyramidal neurons in brain of RGS14(414)-treated rats exhibited robust rise in neurites outgrowth of both kind of cells, and an increment in number of branching from the apical dendrite of pyramidal neurons, reaching to almost three times of the control animals. To further understand of underlying mechanism by which RGS14(414) induces neuronal arborization, we investigated into neurotrophic factors. We observed that RGS14 treatment induces a selective increase in BDNF. Role of BDNF in neuronal arborization, as well as its implication in learning and memory processes is well described. In addition, our results showing a dynamic expression pattern of BDNF during ORM processing that overlapped with memory consolidation further support the idea of the implication of this neurotrophin in formation of long-term memory in RGS-animals. On the other hand, in studies of expression profiling of RGS-treated animals, we have demonstrated that 14-3-3ζ protein displays a coherent relationship to RGS-mediated ORM enhancement. Recent studies have demonstrated that the interaction of receptor for activated protein kinase 1 (RACK1) with 14-3-3ζ is essential for its nuclear translocation, where RACK1-14-3-3ζ complex binds at promotor IV region of BDNF and promotes an increase in BDNF gene transcription. These observations suggest that 14-3-3ζ might regulate the elevated level of BDNF seen in RGS14(414) gene treated animals. Therefore, it seems that RGS-mediated surge in 14-3-3ζ causes elevated BDNF synthesis needed for neuronal arborization and enhanced ORM. The prevention of memory loss might be mediated through a restoration in BDNF and 14-3-3ζ protein levels, which are significantly decreased in aging and Alzheimer’s disease. Additionally, our results demonstrate that RGS14(414) treatment could be a viable strategy against episodic memory loss.

Ecosystem structure in disturbed and restored subtropical seagrass meadows

Shallow seagrass ecosystems frequently experience physical disturbance from vessel groundings. Specific restoration methods that modify physical, chemical, and biological aspects of disturbances are used to accelerate recovery. This study evaluated loss and recovery of ecosystem structure in disturbed seagrass meadows through plant and soil properties used as proxies for primary and secondary production, habitat quality, benthic metabolism, remineralization, and nutrient storage and exchange. The efficacy of common seagrass restoration techniques in accelerating recovery was also assessed. Beyond removal of macrophyte biomass, disturbance to seagrass sediments resulted in loss of organic matter and stored nutrients, and altered microbial and infaunal communities. Evidence of the effectiveness of restoration actions was variable. Fill placement prevented additional erosion, but the resulting sediment matrix had different physical properties, low organic matter content and nutrient pools, reduced benthic metabolism, and less primary and secondary production relative to the undisturbed ecosystem. Fertilization was effective in increasing nitrogen and phosphorus availability in the sediments, but concurrent enhancement of seagrass production was not detected. Seagrass herbivores removed substantial seagrass biomass via direct grazing, suggesting that leaf loss to seagrass herbivores is a spatially variable but critically important determinant of seagrass transplanting success. Convergence of plant and sediment response variables with levels in undisturbed seagrass meadows was not detected via natural recovery of disturbed sites, or through filling and fertilizing restoration sites. However, several indicators of ecosystem development related to primary production and nutrient accumulation suggest that early stages of ecosystem development have begun at these sites. This research suggests that vessel grounding disturbances in seagrass ecosystems create more complex and persistent resource losses than previously understood by resource managers. While the mechanics of implementing common seagrass restoration actions have been successfully developed by the restoration community, expectations of consistent or rapid recovery trajectories following restoration remain elusive.

The role of agriculture and food consumption in tropical conservation

A growing human population, shifting human dietary habits, and climate change are negatively affecting global ecosystems on a massive scale. Expanding agricultural areas to feed a growing population drives extensive habitat loss, and climate change compounds stresses on both food security and ecosystems. Understanding the negative effects of human diet and climate change on agricultural and natural ecosystems provides a context within which potential technological and behavioral solutions can be proposed to help maximize conservation. The purpose of this research was to (1) examine the potential effects of climate change on the suitability of areas for commercial banana plantations in Latin America in the 2050s and how shifts in growing areas could affect protected areas; (2) test the ability of small unmanned aerial vehicles (UAVs) to map productivity of banana plantations as a potential tool for increasing yields and decreasing future plantation expansions; (3) project the effects on biodiversity of increasing rates of animal product consumption in developing megadiverse countries; and (4) estimate the capacity of global pasture biomass production and Fischer-Tropsch hydrocarbon synthesis (IGCC-FT) processing to meet electricity, gasoline and diesel needs. The results indicate that (1) the overall extent of areas suitable for conventional banana cultivation is predicted to decrease by 19% by 2050 because of a hotter and drier climate, but all current banana exporting countries are predicted to maintain some suitable areas with no effects on protected areas; (2) Spatial patterns of NDVI and ENDVI were significantly positively correlated with several metrics of fruit yield and quality, indicating that UAV systems can be used in banana plantations to map spatial patterns of fruit yield; (3) Livestock production is the single largest driver of habitat loss, and both livestock and feedstock production are increasing in developing biodiverse tropical countries. Reducing global animal product consumption should therefore be at the forefront of strategies aimed at reducing biodiversity loss; (4) Removing livestock from global pasture lands and instead utilizing the biomass production could produce enough energy to meet 100% of the electricity, gasoline, and diesel needs of over 40 countries with extensive grassland ecosystems, primarily in tropical developing countries.^

Pelvic-Floor Rehabilitation, Part 2 : Pelvic-Floor Reeducation With Interferential Currents and Exercise in the Treatment of Genuine Stress Incontinence in Postpartum Women : A Cohort Study

Background and Purpose. This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI). Subjects. Eight female subjects with urodynamically established GSI persisting more than 3 months after delivery participated in the study. The subjects ranged in age from 24 to 37 years (X̅=32, SD=4.2). Methods. This was a descriptive multiple-subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise program. Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The treatment intervention was measured using three separate variables. Maximum muscle contractions (pretraining, during training, and posttraining) were measured indirectly as pressure, using perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test. Self-reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated measures analysis of variance (ANOVA), a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. Results. The results indicated that maximum pressure generated by pelvic-floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became continent, and three others improved. A follow-up survey 1 year later confirmed the consistency of these results. Conclusion and Discussion. The results suggest that the proposed physical therapy program may influence postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative physical therapy protocol.

Conservative management for female urinary incontinence and pelvic organ prolapse review 2013 : summary of the 5th International Consultation on Incontinence

Aims The objective of the 5th International Consultation on Incontinence (ICI) chapter on Adult Conservative Management was to review and summarize the new evidence on conservative management of urinary incontinence (UI) and pelvic organ prolapse (POP) in order to compile a current reference source for clinicians, health researchers, and service planners. In this paper, we present the review highlights and new evidence on female conservative management. Methods Revision and updates of the 4th ICI Report using systematic review covering years 2008–2012. Results Each section begins with a brief definition and description of the intervention followed by a summary, where possible, of both the state and level of evidence for prevention and treatment, and ends with a “grade of recommendation.” The paper concludes with areas identified as requiring further research. Conclusions For UI, there are no prevention trials on lifestyle interventions. There are, however, few new intervention trials of lifestyle interventions involving weight loss and fluid intake with improved levels of evidence and grade of recommendation. Outside of pre- and post-natal pelvic floor muscle training (PFMT) trials for the prevention of female UI, there is a dearth of PFMT prevention trials for women with UI. PFMT remains the first-line treatment for female UI with high levels of evidence and grades of recommendation. Bladder training levels of evidence and grades of recommendation are maintained. For POP, new evidence supports the effectiveness of physiotherapy in the treatment of POP and there are now improved levels of evidence and grades of recommendation.

Cognitive and Visual Speech Contributions to Speech Perception in Challenging Listening Conditions

Speech perception routinely takes place in noisy or degraded listening environments, leading to ambiguity in the identity of the speech token. Here, I present one review paper and two experimental papers that highlight cognitive and visual speech contributions to the listening process, particularly in challenging listening environments. First, I survey the literature linking audiometric age-related hearing loss and cognitive decline and review the four proposed causal mechanisms underlying this link. I argue that future research in this area requires greater consideration of the functional overlap between hearing and cognition. I also present an alternative framework for understanding causal relationships between age-related declines in hearing and cognition, with emphasis on the interconnected nature of hearing and cognition and likely contributions from multiple causal mechanisms. I also provide a number of testable hypotheses to examine how impairments in one domain may affect the other. In my first experimental study, I examine the direct contribution of working memory (through a cognitive training manipulation) on speech in noise comprehension in older adults. My results challenge the efficacy of cognitive training more generally, and also provide support for the contribution of sentence context in reducing working memory load. My findings also challenge the ubiquitous use of the Reading Span test as a pure test of working memory. In a second experimental (fMRI) study, I examine the role of attention in audiovisual speech integration, particularly when the acoustic signal is degraded. I demonstrate that attentional processes support audiovisual speech integration in the middle and superior temporal gyri, as well as the fusiform gyrus. My results also suggest that the superior temporal sulcus is sensitive to intelligibility enhancement, regardless of how this benefit is obtained (i.e., whether it is obtained through visual speech information or speech clarity). In addition, I also demonstrate that both the cingulo-opercular network and motor speech areas are recruited in difficult listening conditions. Taken together, these findings augment our understanding of cognitive contributions to the listening process and demonstrate that memory, working memory, and executive control networks may flexibly be recruited in order to meet listening demands in challenging environments.

Pelvic-Floor Rehabilitation, Part 2 : Pelvic-Floor Reeducation With Interferential Currents and Exercise in the Treatment of Genuine Stress Incontinence in Postpartum Women : A Cohort Study

Background and Purpose. This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI). Subjects. Eight female subjects with urodynamically established GSI persisting more than 3 months after delivery participated in the study. The subjects ranged in age from 24 to 37 years (X̅=32, SD=4.2). Methods. This was a descriptive multiple-subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise program. Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The treatment intervention was measured using three separate variables. Maximum muscle contractions (pretraining, during training, and posttraining) were measured indirectly as pressure, using perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test. Self-reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated measures analysis of variance (ANOVA), a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. Results. The results indicated that maximum pressure generated by pelvic-floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became continent, and three others improved. A follow-up survey 1 year later confirmed the consistency of these results. Conclusion and Discussion. The results suggest that the proposed physical therapy program may influence postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative physical therapy protocol.

Conservative management for female urinary incontinence and pelvic organ prolapse review 2013 : summary of the 5th International Consultation on Incontinence

Aims The objective of the 5th International Consultation on Incontinence (ICI) chapter on Adult Conservative Management was to review and summarize the new evidence on conservative management of urinary incontinence (UI) and pelvic organ prolapse (POP) in order to compile a current reference source for clinicians, health researchers, and service planners. In this paper, we present the review highlights and new evidence on female conservative management. Methods Revision and updates of the 4th ICI Report using systematic review covering years 2008–2012. Results Each section begins with a brief definition and description of the intervention followed by a summary, where possible, of both the state and level of evidence for prevention and treatment, and ends with a “grade of recommendation.” The paper concludes with areas identified as requiring further research. Conclusions For UI, there are no prevention trials on lifestyle interventions. There are, however, few new intervention trials of lifestyle interventions involving weight loss and fluid intake with improved levels of evidence and grade of recommendation. Outside of pre- and post-natal pelvic floor muscle training (PFMT) trials for the prevention of female UI, there is a dearth of PFMT prevention trials for women with UI. PFMT remains the first-line treatment for female UI with high levels of evidence and grades of recommendation. Bladder training levels of evidence and grades of recommendation are maintained. For POP, new evidence supports the effectiveness of physiotherapy in the treatment of POP and there are now improved levels of evidence and grades of recommendation.

Resiliencia y desempeño organizacional

El cambio hoy se reconoce como el principal reto que enfrentan las empresas. Desde diversas ciencias como la biología, la psicología y la dirección se vienen estudiando las diferentes variables que tienen relación con los procesos de ajuste y adaptación que los individuos y las organizaciones desarrollan cuando disrupciones de diverso tipo se materializan en el entorno. En las últimas décadas se ha contemplado el estudio de la resiliencia como una característica que pueden desarrollar las organizaciones. Por ello, es un tema de estudio interesante, tanto desde los individuos como desde las organizaciones. Se revisan en este artículo los conceptos de resiliencia, resiliencia individual y organizacional, así como las relaciones que surgen entre dichos conceptos para explicar el desempeño organizacional.

El concepto de duelo en los familiares de los desaparecidos : una revisión de la literatura

Este trabajo de grado tiene por objetivo realizar una revisión de literatura que dé cuenta de las características conceptuales del duelo que viven los familiares de los desaparecidos, en un contexto de desaparición forzada de personas como ilícito internacional de los derechos humanos. Para ello se exploraron libros de consulta reconocidos en el tema, artículos de revistas indexadas de los últimos diez años, y jurisprudencia de la Corte Interamericana de Derechos Humanos de casos de desapariciones forzada. Se presenta la definición de la desaparición forzada como ilícito internacional en DDHH, una categorización de víctimas, el desarrollo del concepto de duelo general y para estos casos y su aplicabilidad a los casos de la Corte IDH. Se encontró que los hallazgos dados por la teoría son aplicados en los dictámenes de esta corte, con un discurso de reivindicación de derechos y reparación integral. Se recomiendan futuras investigaciones en propuestas terapéuticas.

Quando a morte antecede o nascimento: atuação do enfermeiro especialista em saúde materna e obstetrícia na assistência à mulher que vivência uma morte fetal

A perda gestacional é uma experiência dolorosa e complexa para a mãe/casal. O enfermeiro surge como promotor da adaptação á perda. Com esta intervenção, pretendo assegurar boas práticas de enfermagem na assistência às mulheres/casais em situação de perda gestacional. Foi realizado um estudo qualitativo em que se realizaram entrevistas a mulheres que vivenciaram perda gestacional e aos Enfermeiros Especialistas de Saúde Materna e Obstétrica como prestadores de cuidados. Os resultados mostram que os enfermeiros consideram a perda gestacional uma experiência difícil de vivenciar, identificando necessidades de formação. As mulheres referem diferenças na abordagem por parte dos enfermeiros aquando dos cuidados recebidos, falta de apoio e necessidade de encaminhamento após a alta hospitalar. Efetuou-se formação aos enfermeiros com peritos da área e desenvolveram-se procedimentos para uniformizar os cuidados. Foi criado um procedimento para uniformizar a prática e materiais de suporte para o apoio na prestação de cuidados de enfermagem; WHEN THE DEATH ANTECIPATES THE BIRTH: MIDWIVES' ROLE IN ASSISTANCE TO WOMENWHO EXPERIENCE FETAL DEATH. ABSTRACT: Pregnancy loss is a painful and complex experience to the mother/couple. The nurse is the promoting agent to the loss adaptation. With this project, I intend to ensure good nursing practices in assisting women/couples who experience a pregnancy loss. A qualitative study was performed, in which interviews were conducted to women who experienced a pregnancy loss and to nurse-midwives who provided care. Results demonstrated that nurse-midwives find pregnancy loss as a difficult experience, identifying educational needs. Women relate differences in the nurse-midwives’ approach during care, lack of support and the need of follow-up after hospital discharge. Nurse-midwives were subjected to training with experts and procedures were developed in order to standardize care. A practice standardizing procedure and educational materials were created to support nursing practice.

WHEN GLOBAL CONSERVATION MEETS LOCAL LIVELIHOODS: PEOPLE AND PARKS IN CENTRAL AMERICA

SummaryNational park and related forest conservation efforts tend to emanate from core areas of the world and are often imposed on rural people living on forest fringes in the least developed regions of lesser developed countries. We address the social and cultural processes that ensue when center-originatingconservation meets local people with their resource-dependent livelihoods, and how these vary under different circumstances. We examine and compare local people’s environmental andforest-related values and behaviors, using cultural models, after the establishment of national parks in two countries with very different social and environmental histories—Costa Rica and Honduras. We find that external cultural models were widely adopted by local people—hegemonic to the extent of structuring even discourse opposing conservation. Local people often expressed environmental values, but used formulaic language that suggested that these values were not well integrated with other aspects of their life and often not motivating. We pay particular attention to relationships between environmental values and livelihood values, and the varying ways that new, local environmental discourses and values emerge that mediate between these often conflicting value spheres.The recent international increase in national parks is a phenomenon of globalization, and often imposes new conservation practices and environmental values onto local people. While these new national parks have some broad public benefits that can be thought of as global, e.g. their role in preventing biodiversity loss and climate change, it is also true that few concrete benefits accrue to local people and that parks often impose great costs on local people in the form of lost land, diminished access to resources, and diminished autonomy as national governments and internationalorganizations extend into local life in new ways.These changes have serious repercussions for local people, often threatening their livelihoods and well-being in significant ways. Yet our results suggest that local people may be willing to work with park managers to co-inhabit landscapes when park managers are able to accommodate local livelihood needs.Keywords: National parks, Central America, Costa Rica, Honduras, forest conservationResumenLos parques nacionales y otros esfuerzos de conservación forestal tienden a surgir en las principales áreas núcleo del mundo, y por lo general son impuestos a los pobladores de espacios rurales que habitan franjas forestales de los países en vías de desarrollo.Este artículo se enfoca en los procesos sociales y culturales que se originan a partir de la imposición de estas áreas de conservación y sobre cómo se ve afectada la subsistencia de los pobladores que dependen de los recursos naturales de dichas áreas. También se evalúan y comparan los valores y comportamientos relacionados con el ambiente, percibidos por los pobladores con el establecimiento de parques nacionales, en dos países con historias sociales y ambientales muy diferentes como lo son Costa Rica y Honduras; para lo cual se utilizaron modelos culturales. Al respecto, se encontró que varios modelos culturales externos, que fueron ampliamente adoptados por los pobladores locales, han llegado a ser hegemónicos, afectando la conservación. Los habitantes del lugar estaban disconformes con respecto a los nuevos valores ambientales, porque estos, por un lado, no estaban adecuadamente integrados con otros aspectos de su vida, y por la escasa motivación en materia de conservación ambiental.De esta forma, se resalta la relación entre los valores ambientales y los valores de sus forma de vida;entre las nuevas formas de ruptura y los valores emergentes que median entre la esfera de valores conflictivos.El reciente aumento internacional de parques naciones es un fenómeno de globalización, y en consecuencia, impone nuevas prácticas de conservación y valores ambientales a los habitantes de estas localidades. Mientras estos nuevos parques nacionales generan algunas ventaja públicas, que pueden ser pensadas como globales (p.ej. su papel en la prevención de la pérdida de diversidad biológica y el cambio de clima), también ocasionan escasos beneficios para las comunidades, al imponer elevados costos para los pobladores locales como lo son: la pérdida de tierras, la disminución en el acceso a los recursos y la reducción de la autonomía, ya sea ante el gobierno nacional u organizaciones internaciones que extienden sus acciones políticas a la vida local en todas sus nuevas formas. Estos cambios repercuten drásticamente en los habitantes del lugar, lo cual a menudo amenaza, en general, el sustento y el bienestar, de modo significativo.Los resultados sugieren que los habitantes del lugar podrían estar dispuestos a trabajar con los gerentes del parque para co-habitar paisajes cuando éstos sean capaces de priorizar las necesidades de sobrevivencia de las formas de vida de los habitantes.Palabras clave: parques nacionales, América Central, Costa Rica, conservación forestal

Predicting behaviour to reduce stroke risk in at-risk populations : the role of beliefs

Aims: Changing behaviour to reduce stroke risk is a difficult prospect made particularly complex because of psychological factors. This study examined predictors of intentions and behaviours to reduce stroke risk in a sample of at-risk individuals, seeking to find how knowledge and health beliefs influenced both intention and actual behaviour to reduce stroke risk. Methods: A repeated measures design was used to assess behavioural intentions at time 1 (T1) and subsequent behaviour (T2). One hundred and twenty six respondents completed an online survey at T1, and behavioural follow-up data were collected from approximately 70 participants 1 month later. Predictors were stroke knowledge, demographic variables, and beliefs about stroke that were derived from an expanded health belief model. Dependent measures were: exercise and weight loss, and intention to engage in these behaviours to reduce stroke risk. Findings: Multiple hierarchical regression analyses showed that, for exercise and weight loss respectively, different health beliefs predicted intention to control stroke risk. The most important exercise-related health beliefs were benefits, susceptibility, and self-efficacy; for weight loss, the most important beliefs were barriers, and to a lesser degree, susceptibility and subjective norm. Conclusions: Health beliefs may play an important role in stroke prevention, particularly beliefs about susceptibility because these emerged for both behaviours. Stroke education and prevention programmes that selectively target the health beliefs relevant to specific behaviours may prove most efficacious.

Low Vision

The care of low-vision patients is termed vision rehabilitation, and optometrists have an essential role to play in the provision of vision rehabilitation services. Ideally, if patients stay with one optometrist or practice, their low-vision care becomes part of a continuum of eye care, from the time when they had normal vision. If progressive vision loss occurs, the role of the optometrist changes from primary eye care only to one of monitoring vision loss and gradually introducing low-vision care, especially magnification and advice on lighting and contrast, in conjunction with other vision rehabilitation professionals.