Caesarean Birth vs. Vaginal Delivery: Effects upon Maternal Satisfaction, Maternal Confidence and Maternal Perception of the Newborn Behaviour

In order to test the hypothesis that caesarean birth has negative consequences upon newly mothers’ satisfaction and perceptions, women delivering by caesarean birth (WCB) were compared with women delivering by vaginal birth (WVB). Subjects: 180 newly mothers; 93 WCB and 87 WVB. Instruments: A Socio-Demographic Questionnaire developed for this research, the Childbirth Perceptions Questionnaire and the Mother and Baby Scales. Results: WCB had significantly lower scores in perceptions of baby as alert/responsive and nearly significant lower scores for baby as alert during feeds. WVB showed a significantly higher level of satisfaction with delivery and conduct during labour, as also had significantly lower scores for perceptions of baby as irritable during feeds and for lack of confidence in feeds. After controlling for the kind of anesthesia received in labour, three conclusions must be taken into account: 1) between WCB with regional anaesthesia and WCB with general anaesthesia there is only one significant difference, with the former having higher scores for perception of baby as alert during feeds; 2) between WVB with regional anaesthesia and WVB with no anaesthesia there are only two significant differences, with the former having higher scores for lack of confidence in feeding and having lower scores for global confidence; 3) between WCB with regional anaesthesia and WVB with regional anaesthesia four significant differences emerge, with the former having a lower level of satisfaction with delivery and conduct in labour and having lower scores for perception of baby as alert responsive, and also having higher scores of perception of baby as irritable in feeds and higher scores for lack of confidence in feeding. Data seem compatible with the hypothesis that caesarean birth has some negative consequences upon mothers’ satisfaction and perceptions and, for this reason, psychological surveys should constitute a routine procedure in maternity hospitals, especially when newly mothers pertain to families affected by risks of psychological or social nature.

Aggressive incidents inside a Montreal barroom involving patrons, barmaids and bouncers : a micro level examination of routine activity theory

Objectives: This article further examines the phenomenon of aggression inside barrooms by relying on the “bouncer-ethnographer” methodology. The objective is to investigate variations in aggression through time and space according to the role and routine of the target in a Montreal barroom. Thus, it provides an examination of routine activity theory at the micro level: the barroom. Methods: For a period of 258 nights of observation in a Canadian barroom, bouncers completed reports on each intervention and provided specific information regarding what happened, when and where within the venue. In addition, the bouncer-ethnographer compiled field observations and interviews with bar personnel in order to identify aggression hotspots and “rush hours” for three types of actors within barrooms: (a) bouncers, (b) barmaids and (c) patrons. Findings: Three different patterns emerged for shifting hotspots of aggression depending on the target. As the night progresses, aggressive incidents between patrons, towards barmaids and towards bouncers have specific hotspots and rush hours influenced by the specific routine of the target inside the barroom. Implications: The current findings enrich those of previous work by pointing to the relevance of not only examining the environmental characteristics of the barroom, but also the role of the target of aggression. Crime opportunities follow routine activities, even within a specific location on a micro level. Routine activity theory is thus relevant in this context, because as actors in differing roles follow differing routines, as do their patterns of victimization.

Improving the role of equity crowdfunding in Europe's capital markets. Bruegel Policy Contribution Issue 2014/09, August 2014

Crowdfunding is a growing phenomenon that encompasses several different models of financing for business or other ventures. Despite the hype, equity crowdfunding is still the smallest part of the crowdfunding market. Because of its legal framework, Europe has been at the forefront of equity crowdfunding market development. Equity crowdfunding is more complex than other forms of crowdfunding and requires proper checks and balances if it is to provide a viable channel for financial intermediation in the seed and early-stage market in Europe. It is important to explore this new channel of funding for young and innovative firms given the critical role these start-ups can play job creation and economic growth in Europe. We assess the potential role of equity crowdfunding in the overall seed and early-stage financing market and highlight the potential risks of equity crowdfunding. We describe the current state of play in this nascent industry, considering both the innovations introduced by market operators and existing regulation. Currently in Europe there is a patchwork of national legal frameworks related to equity crowdfunding and this should be addressed in a harmonised way.

Suplementos alimentares para gestão de peso corporal:

Os suplementos alimentares para emagrecer são um apelo irresistível para quem procura uma forma de perder peso “sem sacrifícios” e “sem esforço”. Com efeito, estamos perante um mercado sazonal em expansão em que a menção “natural” parece tranquilizar os consumidores esquecendo que a eficácia e segurança destes produtos necessita ser avaliada. Nesse contexto, o presente estudo teve como objetivo efetuar a caraterização dos consumidores de suplementos alimentares para emagrecer, da zona centro de Portugal, avaliar o seu grau de satisfação com os produtos e ainda o possível risco que envolve o consumo destes produtos sobretudo quando ingeridos concomitantemente com medicamentos. Recorreu-se a um questionário anónimo, confidencial e de preenchimento voluntário, distribuído em farmácias, parafarmácias e dietéticas e/ou ervanárias maioritariamente do concelho de Viseu e Figueira da Foz. A recolha dos dados decorreu entre os meses de abril e julho de 2014. E tinha como critérios de inclusão ser maior de 18 anos, ambos os sexos e saber ler e escrever. Acorreram 304 indivíduos. A análise dos dados foi feita recorrendo a testes estatísticos adequados a cada caso. O presente estudo ao caracterizar o perfil de consumidores de suplementos alimentares encontrou uma população, maioritariamente feminina (88,5%) com grau de instrução elevado, secundário e superior, nas faixas etária dos 25-44 anos (59,4%), casados ou em união de facto. Apresentavam excesso de peso e obesidade (54%), sem hábitos de prática de exercício físico e com alimentação desequilibrada. Estes preferem adquirir os suplementos alimentares para emagrecer nas farmácias embora a decisão de consumir estes produtos seja pessoal (32,7%). Para aconselhamento preferem o farmacêutico (17,6%) e apenas 4,2% recorrem ao médico. Revelaram ainda consumir estes produtos por um período de tempo limitado, entre 1-3 meses e estarem satisfeitos com os resultados obtidos após o consumo de suplementos alimentares (63,1%). Constituindo os efeitos secundários dos suplementos alimentares uma preocupação legítima verificamos que a maioria dos inquiridos (93,3%) não refere qualquer efeito indesejável, os restantes indivíduos que revelaram aparecimento de ações indesejáveis disseram ter-se dirigido ao farmacêutico para reportar a situação. As patologias com maior prevalência entre os consumidores foram doenças endócrinas, nutricionais e metabólicas, seguida das perturbações mentais e comportamentais e por fim as doenças cardiovasculares a que correspondem os principais grupos terapêuticos encontrados: psicofármacos, medicamentos usados em patologias do sistema endócrino e antihipertensores. Cerca de 25,8% dos inquiridos que consumiam suplementos alimentares para emagrecer utilizavam concomitantemente estes fármacos. A análise dos cinco suplementos alimentares para emagrecer maioritariamente consumidos pela amostra (57,8%) evidenciou a existência de possíveis interações com os grupos de fármacos mais utilizados. Os resultados obtidos mostram por um lado, a necessidade de esclarecer o conceito de que nem tudo o que é natural é inócuo e por outro lado, ressaltam a importância no ato de venda do aconselhamento individual, adaptado a cada consumidor (com ou sem medicação), por um profissional de saúde com conhecimentos no âmbito da gestão e fisiologia de peso corporal e conhecimento sólido sobre a eficácia e segurança destes suplementos.

Análise nutricional de dietas publicadas em revistas não científicas destinadas ao público feminino

A procura do corpo ideal está fortemente ligada à perda de peso, sendo insistentemente abordada na comunicação social, a imagem corporal, têm conotações mais relacionadas com a moda do que com verdadeiros riscos para a saúde das pessoas. A sociedade atual cultiva a boa aparência física, "o conhecido estar em forma", associada a um ideal estético de magreza e, ao mesmo tempo, apela ao consumo de alimentos de elevada densidade calórica. Na busca do corpo ideal, as dietas de emagrecimento publicadas nas revistas poderão ser uma ajuda na concretização deste objetivo. É fácil encontrar em qualquer quiosque, papelaria ou supermercado estrategicamente colocadas, inúmeras revistas que atribuem à imagem corporal honras de primeira página. Na verdade, estas revistas não científicas divulgam dietas para todos os gostos e situações: dietas específicas para emagrecimento localizado, dietas de preparação para a praia ou para corrigir excessos cometidos em épocas festivas. Embora sabendo-se que estas “auto –dietas” constituem um dos métodos mais utilizados para a perda de peso corporal, não se sabe o número de seguidores que elas têm atualmente. Neste contexto, uma vez que a maior delas não contêm informação nutricional, é importante estar alerta para alguns problemas que podem resultar da ingestão recorrente e sem supervisão deste tipo de dietas. Neste âmbito e dada a pertinência do tema, constituiu objetivo principal do presente trabalho, a análise nutricional de dietas publicadas em revistas não científicas, destinadas ao público feminino em termos de macronutrientes e micronutrientes, sendo também considerado o número de refeições/dia e a variedade de alimentos recomendados. Assim, foram analisadas 15 dietas (497 refeições) publicadas em revistas destinadas ao público feminino, adquiridas entre o ano de 2009 e 2011. A conversão de alimentos em nutrientes foi feita através dos programas informáticos MedPoint e FatSecret. As dietas apresentaram valores energéticos totais (V.E.T.) médios diários, compreendidos entre 378,0 ± 53,8 Kcal e 2335,0 ± 135,0 Kcal. A avaliação dos macronutrientes revelou um teor proteico entre os 32,0 ± 3,6 % e os 12,0 ± 0,1% do total energético Os hidratos de carbono oscilaram entre 63,0 ± 0,1% e 43,0 ± 3,6%. Já a dieta mais rica em lípidos totais apresentava um valor médio de 32,0 ± 9,3% contra os 14,0 ± 0,1% do valor mais baixo encontrado. Nenhuma das dietas assegurava o valor recomendado de ingestão de fibra quando comparada com a dose diária recomendável (DDR). Relativamente à análise dos micronutrientes (vitamina D, vitamina E; vitamina C; vitamina B2, Ácido fólico, cálcio, fósforo, ferro, zinco), somente um tipo de dieta apresentou valores médios diários concordantes com as recomendações preconizadas. Considerando que as dietas analisadas tinham como objetivo a perda rápida de peso, estas revelaram-se maioritariamente hipocalóricas apresentando desequilíbrios e carências de determinados macronutrientes e micronutrientes que poderão, quando mantidas num período de tempo alargado ter consequências graves no desenvolvimento de carência ou outras patologias.

Enjeux éthiques en radiologie diagnostique : comment la bioéthique peut-elle contribuer à une meilleure radioprotection du patient?

Bien que les technologies d’imagerie soient un acquis réel de la médecine moderne, leur introduction ne semble pas avoir été précédée d’une démarche réflexive suffisante qui aurait permis d’anticiper les multiples enjeux que rencontre la pratique radiologique actuelle. En effet, à force de se focaliser sur les acquis techniques et scientifiques, le cadre de radioprotection en place semble ne pas avoir suffisamment considéré l’apport essentiel que représente la connaissance des aspects sociaux, éthiques et humains que peuvent amener des domaines comme la bioéthique. Cette insuffisance fait en sorte que l’on se retrouve aujourd’hui face à des enjeux importants relatifs à la radioprotection du patient comme la surutilisation des examens radiologiques ou encore le manque d’information des acteurs du milieu face aux risques des rayonnements. Après un état des lieux des enjeux éthiques en radiologie diagnostique ayant un impact sur la radioprotection médicale des patients, un enjeu majeur de la pratique actuelle, qui est la justification inadéquate des prescriptions d’examens radiologiques, sera analysé selon une approche par principes. De cet exercice, visant à démontrer comment l’éthique peut concrètement contribuer à la radioprotection, découle l’impératif d’une vision nouvelle et globale permettant de proposer des pistes de solution aux controverses liées à l’utilisation actuelle de l’imagerie. Dans une perspective de santé des populations, il est important de contribuer à la diminution de la banalisation du recours au rayonnement ionisant dans la pratique médicale diagnostique en alliant bioéthique et radioprotection. Ce projet de recherche se veut être une étape limitée, mais nécessaire dans l’établissement de ce dialogue interdisciplinaire.

Lancelot of the Laik; a Scottish metrical romance, (about 1490-1500 A.D.) re-edited from a manuscript in the Cambridge University Library,

"A loose paraphrase of not quite fourteen folios of the first three volumes of the French romance of Lancelot du Lac."--Pref.

Occupational safety and health in the screening of municipal solid waste in Coop Cidade Limpa of Santo André

This paper presents exploratory search held in cooperative Coop Cidade Limpa, Santo André – São Paulo. It is aimed at verifying risks of accidents and occupational diseases in the screening of Municipal Solid Waste. The study started from the following question: What are the risks posed to workers in the sorting of waste in cooperatives? It was performed through on-site observation, accompanied by interviews with the members in their work activities. The data were used to describe the risks of accidents and industrial diseases. It demonstrated the awareness of people regarding the risks in dealing with waste and cooperative processes.

Essays on Environmental and Health Economics

Thesis (Ph.D.)--University of Washington, 2016-06

Functional recycling of C2 domains throughout evolution: A comparative study of synaptotagmin, protein kinase C and phospholipase C by sequence, structural and modelling approaches

The C2 domain is one of the most frequent and widely distributed calcium-binding motifs. Its structure comprises an eight-stranded beta-sandwich with two structural types as if the result of a circular permutation. Combining sequence, structural and modelling information, we have explored, at different levels of granularity, the functional characteristics of several families of C2 domains. At the coarsest level,the similarity correlates with key structural determinants of the C2 domain fold and, at the finest level, with the domain architecture of the proteins containing them, highlighting the functional diversity between the various subfamilies. The functional diversity appears as different conserved surface patches throughout this common fold. In some cases, these patches are related to substrate-binding sites whereas in others they correspond to interfaces of presumably permanent interaction between other domains within the same polypeptide chain. For those related to substrate-binding sites, the predictions overlap with biochemical data in addition to providing some novel observations. For those acting as protein-protein interfaces' our modelling analysis suggests that slight variations between families are a result of not only complementary adaptations in the interfaces involved but also different domain architecture. In the light of the sequence and structural genomic projects, the work presented here shows that modelling approaches along with careful sub-typing of protein families will be a powerful combination for a broader coverage in proteomics. (C) 2003 Elsevier Ltd. All rights reserved.

Sexual abuse, antisocial behaviour and substance use: gender differences in young community adolescents

Objective: To investigate gender-specific relationships between self-reported sexual abuse, antisocial behaviour and substance use in a large community sample of adolescents. Method: A cross-sectional study of students aged, on average, 13 (n = 2596), 14 (n = 2475) and 15 years (n = 2290), from 27 schools in South Australia with a questionnaire including sexual abuse, frequency and severity of substance use, depressive symptomatology (CES-D), family functioning (McMaster Family Assessment Device), and antisocial behaviour (an adapted 22-item Self-Report Delinquency Scale). Logistic regression analyses using HLM V5.05 with a population-average model were conducted. Results: In the model considered, reported sexual abuse is significantly independently associated with antisocial behaviour, controlling for confounding factors of depressive symptomatology and family dysfunction, with increased risks of three- to eightfold for sexually abused boys, and two- to threefold for sexually abused girls, compared to nonabused. Increased risks of extreme substance use in sexually abused girls (age 13) and boys (ages 13-15) are more than fourfold, compared to nonabused. Age differences were not statistically significant. Conclusion: Childhood sexual abuse is a risk factor for the development of antisocial behaviour and substance use in young adolescents. Clinicians should be aware of gender differences.

Major Depressive Disorder, Suicidal Ideation, and Suicide Attempt in Twins Discordant for Cannabis Dependence and Early-Onset Cannabis Use

Background: Previous research has reported both a moderate degree of comorbidity between cannabis dependence and major depressive disorder (MDD) and that early-onset cannabis use is associated with increased risks for MDD. Objective: To examine whether associations between both lifetime cannabis dependence and early cannabis use and measures of MDD, suicidal ideation, and suicide attempt persist after controlling for genetic and/or shared environmental influences. Design: Cross-sectional survey of twin pairs discordant for lifetime cannabis dependence and those discordant for early cannabis use. Setting: General population sample of twins (median age, 30 years). Participants: Two hundred seventy-seven same-sex twin pairs discordant for cannabis dependence and 311 pairs discordant for early-onset cannabis use (before age 17 years). Main Outcome Measures: Self-report measures of DSM-IV-defined lifetime MDD, suicidal ideation, and suicide attempt. Results: Individuals who were cannabis dependent had odds of suicidal ideation and suicide attempt that were 2.5 to 2.9 times higher than those of their non-cannabis-dependent co-twin. Additionally, cannabis dependence was associated with elevated risks of MDD in dizygotic but not in monozygotic twins. Those who initiated cannabis use before age 17 years had elevated rates of subsequent suicide attempt (odds ratio, 3.5 [95% confidence interval, 1.4-8.6]) but not of MDD or suicidal ideation. Early MDD and suicidal ideation were significantly associated with subsequent risks of cannabis dependence in discordant dizygotic pairs but not in discordant monozygotic pairs. Conclusions: Comorbidity between cannabis dependence and MDD likely arises through shared genetic and environmental vulnerabilities predisposing to both outcomes. In contrast, associations between cannabis dependence and suicidal behaviors cannot be entirely explained by common predisposing genetic and/or shared environmental predispositions. Previously reported associations between early-onset cannabis use and subsequent MDD likely reflect shared genetic and environmental vulnerabilities, although it remains possible that early-onset cannabis use may predispose to suicide attempt.

Sexual abuse and suicidality: gender differences in a large community sample of adolescents

Objective: A cross-sectional study of gender specific relationships between self-reported child sexual abuse and suicidality in a community sample of adolescents. Method: Students aged 14 years on average (N = 2,485) from 27 schools in South Australia completed a questionnaire including items on sexual abuse and suicidality, and measures of depression (Centre for Epidemiological Studies Depression Scale), hopelessness (Beck Hopelessness Scale), and family functioning (McMaster Family Assessment Device General Functioning Subscale). Data analysis included logistic regression. Results: In boys, self-report sexual abuse is strongly and independently associated with suicidal thoughts, plans, threats, deliberate self-injury, and suicide attempts, after controlling for current levels of depression, hopelessness, and family dysfunction. In girls, the relationship between sexual abuse and suicidality is mediated fully by depression, hopelessness, and family dysfunction. Girls who report current high distress about sexual abuse, however, have a threefold increased risk of suicidal thoughts and plans, compared to non-abused girls. Boys who report current high distress about sexual abuse have 10-fold increased risk for suicidal plans and threats, and 15-fold increased risk for suicide attempts, compared to non-abused boys. Fifty-five percent (n = 15) of sexually abused boys attempted suicide versus 29% (n = 17) girls. Conclusions: A history of sexual abuse should alert clinicians, professionals and caters in contact with adolescents, to greatly increased risks of suicidal behavior and attempts in boys, even in the absence of depression and hopelessness. Distress following sexual abuse, along with depression and hopelessness indicate increased risk of suicidal behavior in girls, as well as boys. (C) 2004 Published by Elsevier Ltd.

Australian veterinarians who work with horses: attitudes to work and career

Objective To describe the attitudes to their work and career of those Australian veterinarians who work with horses. Method Questionnaires were mailed to 866 veterinarians who had been identified as working with horses, and 87% were completed and returned. Data were entered onto Excel spreadsheets, and analysed using the SAS System for Windows. Results The main attractions of veterinary work with horses were the horses themselves and the equine industries, but working outdoors and with rewarding clients, and the satisfaction of successful outcomes were attractions for many. The list of disadvantages was longer, and included unreasonable and disagreeable clients as well as those who provided inadequate facilities, could not control their horses or did not care for them. The physical demands and risks of injury, the amount of time required, low rates of return and difficulties in collecting payment, were other major disadvantages. Some mentioned concerns about litigation, unethical behaviour, and recruiting and retaining veterinarians competent with horses. For many in mixed practice, the difficulties in affording modern equipment, and of developing and maintaining their own competence with horses, was a real concern. More than three-quarters of the respondents reported that their careers had lived up to expectations and that they would become veterinarians again; 70% of equine veterinarians would become an equine veterinarian again. Almost all (93%) of the respondents were either very glad, or 'generally glad though with some misgivings' that they had done the veterinary course. Older veterinarians reported suffering less stress, and being more content with their career, than younger colleagues. Conclusions The advantages of doing veterinary work with horses outweigh the disadvantages for most veterinarians, especially those well advanced in their careers.

Modern environmental improvement pathways for the coal power generation industry in Australia

In this work we assess the pathways for environmental improvement by the coal utilization industry for power generation in Australia. In terms of resources, our findings show that coal is a long term resource of concern as coal reserves are likely to last for the next 500 years or more. However, our analysis indicates that evaporation losses of water in power generation will approach 1000 Gl (gigalitres) per year, equivalent to a consumption of half of the Australian residential population. As Australia is the second driest continent on earth, water consumption by power generators is a resource of immediate concern with regards to sustainability. We also show that coal will continue to play a major role in energy generation in Australia and, hence, there is a need to employ new technologies that can minimize environmental impacts. The major technologies to reduce impacts to air, water and soils are addressed. Of major interest, there is a major potential for developing sequestration processes in Australia, in particular by enhanced coal bed methane (ECBM) recovery at the Bowen Basin, South Sydney Basin and Gunnedah Basin. Having said that, CO2 capture technologies require further development to support any sequestration processes in order to comply with the Kyoto Protocol. Current power generation cycles are thermodynamic limited, with 35-40% efficiencies. To move to a high efficiency cycle, it is required to change technologies of which integrated gasification combined cycle plus fuel cell is the most promising, with efficiencies expected to reach 60-65%. However, risks of moving towards an unproven technology means that power generators are likely to continue to use pulverized fuel technologies, aiming at incremental efficiency improvements (business as usual). As a big picture pathway, power generators are likely to play an increasing role in regional development; in particular EcoParks and reclaiming saline water for treatment as pressures to access fresh water supplies will significantly increase.