Accessing Trauma- and Violence-Informed Breastfeeding Support from Primary Care Providers among Women with Histories of Intimate Partner Violence: An Exploratory Interpretive Description Study.

BACKGROUND: Intimate partner violence (IPV) is a wicked social problem affecting women of all social strata and geographical location, globally. Pregnancy may be a time of heightened risk of IPV and more deleterious outcomes. Breastfeeding - a protective factor for maternal and child well-being - may be jeopardized or more challenging for women experiencing IPV. This study explored the experiences of postpartum women with histories of IPV who sought trauma- and violence-informed breastfeeding support from primary care providers. METHODS: Using interpretive description and philosophically underpinned by intersectionality, in-depth semi-structured interviews were completed at 12-weeks postpartum with five breastfeeding mothers with a history of IPV who sought breastfeeding support from a family physician clinic employing a trauma- and violence-informed (TVIC) model of care. FINDINGS: Four themes and two sub-themes shed light onto the experience of accessing breastfeeding support for women with a history of IPV and the perceived barriers that they faced when attempting to accesses this support, including: 1) The (demoralizing) navigation of the perinatal system; 2) Fostering trust: i) "It's support, but it's also knowledge"; and ii) TVIC: feeling safe and feeling "I mattered"; 3) Informal support: partners, family, and friends; and 4) Baby in focus: overcoming challenges and building confidence. CONCLUSIONS: TVIC may aid in the development of trusting therapeutic relationships, in turn improving access to breastfeeding support, breastfeeding self-efficacy, and breastfeeding success for women who experience violence. Further research on the implementation and evaluation of TVIC for perinatal breastfeeding education and care among women is required.

Progress or burden? Formal description of every apparently new species available in collections is neither necessary nor useful.

A new species of the Sub-Saharan spider genus Quamtana Huber, 2003 is described that has been collected in garden centers in Poland and the UK. Its closest known relative is probably Q.lotzi Huber, 2003, known from Free State Province in South Africa. Working on the premise that placing species in time and space is the fundamental task of taxonomy, and acknowledging that we cannot provide biologically meaningful spatial information for this species, we prefer open nomenclature to make this species known to science without formally describing it, using the unique provisional name Quamtana sp. ZFMK Ar 24490 aff.lotzi. We argue that the judicious use of open nomenclature can serve to improve the quality of species lists, reducing the noise in large-scale analyses of biodiversity data. We expand this argument to 'fragmentary' species descriptions in general, such as single-sex descriptions in large genera with many male-only and female-only descriptions. Not every taxonomic act allowed by the Code is necessarily beneficial. Under certain conditions, the informal description of a putatively new species may serve science better than a formal description based on inadequate material or data.

Altimella gen. nov., a new genus of Cicurinidae (Arachnida, Araneae) from Xizang, China, with description of two new species.

Altimella Wang & Zhang, gen. nov., a new genus belonging to Cicurinidae, is established, and two new species are described, Altimellanedong Wang & Zhang, sp. nov. (♂♀, type species) and A.ngamring Wang & Zhang, sp. nov. (♂♀), from Xizang, China. Detailed descriptions of somatic features and genital characteristics, photos of the habitus, photos and drawings of the copulatory organs, and a distribution map are provided.

Body schema and body image as internal representations of the body, and their disorders. An historical review.

Since the early 1900s, the terms body schema and body image denoted the internal representations of the body. Bonnier's (1905, Revue Neurologique, 13, 605) schema is a conscious spatial representation of the size, shape, and position of the body, and of body parts, whose dysfunction brings about aschématia, and hypo-, hyper-, and paraschématia. The two schemata of Head and Holmes (1911, Brain, 34, 102) are an unconscious plastic postural schema, for the maintenance of posture and balance and for the coding of the position of body parts, and a conscious superficial schema, for the localisation of somatosensory stimuli. Pick's (1922, Psychologische Forschung, 1, 303) body schema refers to a structural description of the body, including the position of body parts and their spatial relationships, defective in autotopagnosia. Schilder's (1935, The image and appearance of the human body) body image is a comprehensive construct, covering physiological, evolutional, neurological and neuropsychological, psychiatric and sociological aspects. Lhermitte's (1939, L'image de notre corps) image, based on the views of the abovementioned authors, is defective in bodily neuropsychological disorders. The two terms have been used interchangeably, to denote (hemi-)asomatognosia, anosognosia, autotopagnosia, depersonalisation, personal neglect, phantom and supernumerary limbs, somatoparaphrenia. Their properties have been summarized with general dichotomies: schema for action in space ("where" system), image for perception ("what" system), after primary sensory processing. While schema and image fractionated into multiple representations of aspects of the body, the two terms are still used to refer to some of these representations, and to their disorders.

Identification of distinct physical activity profiles through adolescence: a longitudinal qualitative description study.

Introduction: We aimed to better understand longitudinal physical activity experiences among initially active adolescents and to identify and describe distinct physical activity profiles. Methods: A sample of 23 physically active participants [52% female; mean age = 12.2 (0.6) years at study inception] were selected from the MATCH study to take part in this nested qualitative descriptive study. Participants were interviewed once a year for six years. Following individual-level analyses, profiles were identified based on similarity of longitudinal experiences. Results: Four profiles captured participants' experiences: Independents (those who progressively seek activities that cater to their pursuit of autonomy); Multitaskers (those who participate in many different sports as an integral part of their lifestyle); Specialists (those who are dedicated to becoming the best they can be at one sport); Undecided (those who take part in physical activity to occupy time). Discussion: The exploration of longitudinal physical activity experiences led to the identification of distinct profiles that could be targets for tailored interventions, theory development, and participation models.

Four new species of the genus Yunguirius (Araneae, Agelenidae) from China.

Four new species of Yunguirius B. Li, Zhao & S.Q. Li, 2023 are described from China, namely: Yunguiriusparvus Wei & Liu, sp. nov. (♀), Yunguiriustrigonus Wei & Liu, sp. nov. (♀), Yunguiriuswangqiqiae Wei & Liu, sp. nov. (♀), and Yunguiriusxiannushanensis Wei & Liu, sp. nov. (♀).

A Zero-Shot Learning Approach for Blockage Detection and Identification Based on the Stacking Ensemble Model.

A data-driven approach to defect identification requires many labeled samples for model training. Yet new defects tend to appear during data acquisition cycles, which can lead to a lack of labeled samples of these new defects. Aiming at solving this problem, we proposed a zero-shot pipeline blockage detection and identification method based on stacking ensemble learning. The experimental signals were first decomposed using variational modal decomposition (VMD), and then, the information entropy was calculated for each intrinsic modal function (IMF) component to construct the feature sets. Second, the attribute matrix was established according to the attribute descriptions of the defect categories, and the stacking ensemble attribute learner was used for the attribute learning of defect features. Finally, defect identification was accomplished by comparing the similarity within the attribute matrices. The experimental results show that target defects can be identified even without targeted training samples. The model showed better classification performance on the six sets of experimental data, and the average recognition accuracy of the model for unknown defect categories reached 72.5%.

Culpeper's herbal The English Physitian and its debt to apothecary John Parkinson.

In this textual comparison of seventeenth-century herbals, I show in detail that most of the descriptions and medicinal uses of English herbs included in Culpeper's small folio The English Physitian (1652) and its enlargement of the following year were lifted straight out of the works of John Parkinson, apothecary. This was a deliberate act by Culpeper, to make available to the people of England the best information on native plant medicines for use in treating their illnesses. He attacked the College of Physicians of London, whom the great majority of the population could not afford to engage, for trying to keep this knowledge secret. Among later historians of the herbal tradition, Culpeper's work was not accorded the same status as the great English herbals of William Turner, John Gerard, and John Parkinson, not because this borrowing was recognised but because its astrological content worked to divert attention from the quality and source of much of its guidance on treatment. Even contemporaries of Culpeper did not recognise the extent of the borrowing. Comparisons also reveal the limitations of Culpeper's powers of plant description and his lack of interest in the developing science of botany. The editorial decisions Culpeper made to reduce a great folio herbal to a much smaller book to be sold for 3d touch on domestic and other non-medical uses, while points of discussion common to both authors such as the doctrine of signatures and superstitious beliefs about plants are explored.

Most physical interventions for musculoskeletal pain in children and adolescents cannot be reproduced in clinical practice: a meta-research study of randomized clinical trials.

INTRODUCTION: Conservative treatments such as physical therapies are usually the most indicated for the management of musculoskeletal pain; therefore, a detailed description of interventions enables the reproducibility of interventions in clinical practice and future research. The objective of this study is to evaluate the description of physical interventions for musculoskeletal pain in children and adolescents. METHODS: We considered randomized controlled trials that included children and adolescents between 4 and 19 years old with acute or chronic/persistent musculoskeletal pain. We included physical therapies related to all types of physical modalities aimed at reducing the intensity of pain or disability in children and adolescents with musculoskeletal pain. The description of interventions was assessed using the Template for Intervention Description and Replication (TIDieR) checklist. We performed electronic searches in the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, PsyINFO and PEDro up to April 2024. The description of physical interventions was presented using frequencies, percentages and 95% confidence intervals (CIs) of the TIDieR checklist items described in each study. We also calculated the total TIDieR score for each study and presented these data as mean and standard deviation. RESULTS: We included 17 randomized controlled trials. The description measured through the TIDieR checklist scored an average of 11 (5.2) points out of 24. The item of the TIDieR that was most described was item 1 (brief name) and most absent was item 10 (modifications). CONCLUSION: The descriptions of physical interventions for the treatment of musculoskeletal pain in children and adolescents are partially described, indicating the need for strategies to improve the quality of description to enable true clinical reproducibility.

Age-related changes in connected speech production: evidence from eye-tracking in the culturally adapted picture description task.

Purpose: Age-related changes in connected speech production remain a subject of debate, yielding inconsistent findings across various tasks and measures. This study aimed to investigate the effects of aging on picture description tasks using two types of pictures: a standardized picture (the Beach picture) and a culturally and linguistically modified picture tailored for Korean speakers (the Han River picture). Method: Twenty-four young adults and 22 older adults participated in two picture description tasks while their eye movements were recorded. Word-level linguistic variables were used to assess informativeness (Correct Information Units per minute) and productivity (noun and verb counts per utterance) of connected speech production. Eye-movement measures were employed to evaluate real-time cognitive processing associated with planning connected speech (pre-speech fixation counts and durations; eye fixations before the speech onset of each utterance). Results and conclusions: The findings revealed age-related declines in linguistic measures, with older adults exhibiting decreased CIUs per minute and smaller counts of nouns and verbs per utterance. Age-related changes in eye movement measures were evident in that older adults displayed longer pre-speech fixation durations. Unlike younger adults, older adults exhibited higher pre-speech fixation counts on the Han River picture compared to the Beach picture, suggesting cognitive challenges in performing the task that requires producing more words and detailed descriptions. These results suggest that aging is associated with reduced informativeness and productivity of connected speech, as well as a decline in cognitive processing efficiency.

Beliefs and experiences of educators when involved in the design of a Learning-by-concordance tool: A qualitative interpretative study.

BACKGROUND: Based on the involvement of qualified educators in its design, the Learning-by-Concordance tool aims to promote the learning of reasoning in contexts of uncertainty. However, data are still scarce on the experience of educators in terms of sharing and exposing their reasoning processes using this tool. PURPOSE: This study sought to explore the beliefs and experiences of educators when involved in the design of a Learning-by-Concordance tool. METHOD: This research used a descriptive qualitative design. Four dialogue groups were conducted with educators with different roles and responsibilities while designing a Learning-by-Concordance tool. A descriptive interpretative analysis of educators' verbatim quotes was done. FINDINGS: A total of 14 participants took part in the study. The results show the discomfort of educators despite their recognized expertise. Three themes emerged: 1- the need to be reassured by the opinions of colleagues; 2-feeling like impostors; and 3- concerns for the quality of instructional supports. CONCLUSIONS: The role taken by educators for teaching reasoning in contexts of uncertainty is to draw on practical experience where different types of knowledge intersect and are mobilized, to overcome feelings of insecurity, and to engage in close and authentic conversation with learners.

A protocol to evaluate the taxonomic health of Neotropical species of Nasutitermes (Termitidae, Nasutitermitinae).

Herein a protocol is proposed to summarize the taxonomic situation for species, using the Neotropical Nasutitermes Dudley (Nasutitermitinae) as a test. The objective of this protocol is to allow comparisons between the available taxonomic information for species, and to provide objective criteria for assessing the information gaps for each taxon in order to prioritize topics for future investigation. Key aspects of taxonomic practice (condition of type specimens, helpfulness of descriptions and figures, compilation of distribution data, molecular data) were noted, the data were tabulated, and the taxa ranked. In addition, specific notes for each species have been included that may help to improve the solutions to the problems raised here.

The fourth species of Sinamma Lin & Li, 2014 (Araneae, Tetrablemmidae) from China.

Background: Sinamma Lin & Li, 2014 is a small tetrablemmid genus distributed in China, with three currently known species: Sinammaoxycera Lin & Li, 2014 from Guangxi Zhuang Autonomous Region and S.quadrata Tong & Li, 2022 and S.yingae Tong & Li, 2022 from Guangdong Province. New information: While examining spider specimens obtained by sifting leaf litter from Danxiashan National Nature Reserve in Guangdong Province of China, we discovered a new species of the genus Sinamma, S.danxia sp. nov., which is described here.

Probabilistic Representation Differences between Decisions from Description and Decisions from Experience.

For mathematically identical risky decisions, different choices can be made depending on whether information about outcomes and their probabilities is learned by description or by experience, known as the description-experience gap. However, it is unclear whether different ways of obtaining information lead to different representation forms of probability, resulting in a description-experience gap. The current study investigates the representation formats of the alternative options' probability for decisions from description and decisions from experience. The experiments measured the relative error of probability estimation in percentage and frequency forms for the two types of decisions in low and medium-to-large probability situations. The results demonstrate that for decisions from description in medium-to-large probability scenarios, the estimation error was lower in percentage form than in frequency form, with equally near-perfect estimates in small-probability scenarios. Nevertheless, in decisions from experience, the accuracy of estimation in percentage form was lower than in frequency form in both low and medium-to-large probability situations. This suggests that decision makers in decisions from description tend to represent the probability information in percentage form. However, in decisions from experience, they tend to represent probability in frequency form. The utilization of different formats for probability representation is one of the factors that contribute to the description-experience gap.

In Pursuit of a Person-Centered Approach to Care Delivery: A Qualitative Descriptive Study of the Patient Experience of a Long-Term Conditions Clinic in General Practice.

Innovative ways of working are emerging in health care to meet the complex needs of people living with multiple long-term conditions. While these initiatives are often measured for their health and economic outcomes, few studies prioritize the patient experience. This qualitative descriptive study is one of a few studies exploring the patient experience of attending a dedicated long-term conditions annual review clinic in a primary care setting in England. The service model aims to provide a person-centered, holistic approach to the management and support of people living with multiple long-term conditions. The study presents findings from in-depth interviews with 12 participants. Data analyzed through framework analysis revealed four themes relating to the patient experience: the clinic as a place, continuity, staying healthy, and partnership opportunities. Results highlight the challenges to providing personalized care. We found that attendance at the clinic prompted self-care behaviors, however, patients wanted a more holistic, integrated, and consistent service that provided continuity of therapeutic relationships that involved them in decision-making and care planning. We conclude that the experience of patients in this study suggests this service model can enable patients to manage their health and improve well-being, however, while a person-centered philosophy may underpin service models, our research shows that ensuring this philosophy is born out in service delivery and recognized by patients is problematic. Therefore, service providers need to recognize the values and perspectives of patients, aligning these with the design and delivery of services.

Environmental Factors for Sustained Telehealth Use in Mental Health Services: A Mixed Methods Analysis.

Background: The mental health service delivery gap remains high globally. Appropriate telehealth use may increase capacity through flexible remote care provision. Despite the historical lack of telehealth integration into publicly funded mental health services, during COVID-19 lockdowns, services rapidly switched to telephone and audiovisual care provision. In Aotearoa New Zealand (NZ), this was abandoned when no longer required by COVID-19 restrictions. This study explores environmental factors associated with telehealth implementation and ongoing use or discontinuation across a multiregional outpatient mental health service. This work contributes to understanding system-level factors influencing telehealth use and thus informs policy and practice in postpandemic environments. Methods: This mixed methods study applied an interpretive description methodology. Semistructured interviews with 33 mental health clinicians were thematically analysed. Qualitative findings were reframed and evaluated using time series analyses of population-level quantitative data (prior to and throughout the pandemic). Findings were synthesised with qualitative themes to develop an understanding of environmental factors contributing to telehealth use. Results: Findings highlighted an increase in clients assessed by mental health services and declining clinician numbers, contributing to pressure placed on clinicians. There was a lack of culture supporting telehealth, including limited awareness, leadership, and champions to facilitate implementation. Some teams provided services suited to telehealth; other subspeciality teams had limited applications for telehealth. There was a general lack of policy and guidelines to support telehealth use and limited technical support for clinicians unfamiliar with audiovisual software. Conclusion: Disorganised telehealth adoption in the study regions provides insight into wider environmental drivers affecting telehealth uptake. For telehealth to become a workable service delivery mode following COVID-19, stewardship and culture shifts are required, including policy development, technical support, and resources to support clinical teams. Telehealth may address growing service demand by improving interfaces with primary care and providing timely access to specialist input.

"Social science is explanation or it is nothing." Introduction to a debate.

This essay introduces contributions to a special section, which documents and extends a debate on the proposition "Social Science is Explanation or it is Nothing" held at the London School of Economics on October 13th, 2022. It discusses the history of the "Group for Theoretical Debates in Anthropology" led by Tim Ingold, Peter Wade and Soumhya Venkatesan, which has handed down a list of credible candidates for issues that had a chance of engaging every anthropologist, including students and those with interdisciplinary interests. It raises questions about the specific affordances of debates as forms of academic engagements. It argues that the chosen proposition concerning explanation invites a discussion about the contributions of the social sciences at a time when impulses from science and technology studies as well as fruitful exchanges across the boundary between "theory" and "method" have helped us moved beyond the older question as to whether or not sociology is "a science".

First Description of a Large Clinical Series of Fetal Alcohol Spectrum Disorders Children and Adolescents in Reunion Island, France.

BACKGROUND: Despite several diagnostic guidelines, Fetal Alcohol Spectrum Disorders (FASDs) remain underdiagnosed or misdiagnosed, delaying the care of these patients and support for families. OBJECTIVE: This study aims to help professionals caring for these children and their families to suspect this diagnosis earlier and to provide the most appropriate follow-up. METHODS: A retrospective chart review with monocentric recruitment was performed at the Genetics Unit of the University Hospital of Reunion Island. A total of 147 children and adolescents with FASDs were included. RESULTS: Prenatal alcohol exposure was associated with paternal alcohol consumption in 42.9%, and a high rate of prematurity (33.3%) was observed. Sixty percent of children or adolescents were placed in foster families. Learning difficulties without cognitive deficits were found in 65.8% of cases (50/76). Postural control and fine motor skills disabilities were described, respectively, in 54.7% (35/64) and 72.5% (50/69) of cases. A systematic genetic assessment was carried out, identifying in these FASD patients an associated Copy Number Variation (CNVs) in 22.6% of cases. CONCLUSION: Children with FASDs combine significant vulnerabilities, associating exposure to alcohol during the preconception and/or the prenatal period, prematurity, complex familial and sociocultural living conditions, and a genetic anomaly in almost a quarter of cases.

Comparing GPT-4 and Human Researchers in Health Care Data Analysis: Qualitative Description Study.

BACKGROUND: Large language models including GPT-4 (OpenAI) have opened new avenues in health care and qualitative research. Traditional qualitative methods are time-consuming and require expertise to capture nuance. Although large language models have demonstrated enhanced contextual understanding and inferencing compared with traditional natural language processing, their performance in qualitative analysis versus that of humans remains unexplored. OBJECTIVE: We evaluated the effectiveness of GPT-4 versus human researchers in qualitative analysis of interviews with patients with adult-acquired buried penis (AABP). METHODS: Qualitative data were obtained from semistructured interviews with 20 patients with AABP. Human analysis involved a structured 3-stage process-initial observations, line-by-line coding, and consensus discussions to refine themes. In contrast, artificial intelligence (AI) analysis with GPT-4 underwent two phases: (1) a naïve phase, where GPT-4 outputs were independently evaluated by a blinded reviewer to identify themes and subthemes and (2) a comparison phase, where AI-generated themes were compared with human-identified themes to assess agreement. We used a general qualitative description approach. RESULTS: The study population (N=20) comprised predominantly White (17/20, 85%), married (12/20, 60%), heterosexual (19/20, 95%) men, with a mean age of 58.8 years and BMI of 41.1 kg/m2. Human qualitative analysis identified "urinary issues" in 95% (19/20) and GPT-4 in 75% (15/20) of interviews, with the subtheme "spray or stream" noted in 60% (12/20) and 35% (7/20), respectively. "Sexual issues" were prominent (19/20, 95% humans vs 16/20, 80% GPT-4), although humans identified a wider range of subthemes, including "pain with sex or masturbation" (7/20, 35%) and "difficulty with sex or masturbation" (4/20, 20%). Both analyses similarly highlighted "mental health issues" (11/20, 55%, both), although humans coded "depression" more frequently (10/20, 50% humans vs 4/20, 20% GPT-4). Humans frequently cited "issues using public restrooms" (12/20, 60%) as impacting social life, whereas GPT-4 emphasized "struggles with romantic relationships" (9/20, 45%). "Hygiene issues" were consistently recognized (14/20, 70% humans vs 13/20, 65% GPT-4). Humans uniquely identified "contributing factors" as a theme in all interviews. There was moderate agreement between human and GPT-4 coding (κ=0.401). Reliability assessments of GPT-4's analyses showed consistent coding for themes including "body image struggles," "chronic pain" (10/10, 100%), and "depression" (9/10, 90%). Other themes like "motivation for surgery" and "weight challenges" were reliably coded (8/10, 80%), while less frequent themes were variably identified across multiple iterations. CONCLUSIONS: Large language models including GPT-4 can effectively identify key themes in analyzing qualitative health care data, showing moderate agreement with human analysis. While human analysis provided a richer diversity of subthemes, the consistency of AI suggests its use as a complementary tool in qualitative research. With AI rapidly advancing, future studies should iterate analyses and circumvent token limitations by segmenting data, furthering the breadth and depth of large language model-driven qualitative analyses.

Dissociating Cerebellar Regions Involved in Formulating and Articulating Words and Sentences.

We investigated which parts of the cerebellum are involved in formulating and articulating sentences using (i) a sentence production task that involved describing simple events in pictures; (ii) an auditory sentence repetition task involving the same sentence articulation but not sentence formulation; and (iii) an auditory sentence-to-picture matching task that involved the same pictorial events and no overt articulation. Activation for each of these tasks was compared to the equivalent word processing tasks: noun production, verb production, auditory noun repetition, and auditory noun-to-picture matching. We associate activation in bilateral cerebellum lobule VIIb with sequencing words into sentences because it increased for sentence production compared to all other conditions and was also activated by word production compared to word matching. We associate a paravermal part of right cerebellar lobule VIIIb with overt motor execution of speech, because activation was higher during (i) production and repetition of sentences compared to the corresponding noun conditions and (ii) noun and verb production compared to all matching tasks, with no activation relative to fixation during any silent (nonspeaking) matching task. We associate activation within right cerebellar Crus II with covert articulatory activity because it activated for (i) all speech production more than matching tasks and (ii) sentences compared to nouns during silent (nonspeaking) matching as well as sentence production and sentence repetition. Our study serendipitously segregated, for the first time, three distinct functional roles for the cerebellum in generic speech production, and it demonstrated how sentence production enhanced the demands on these cerebellar regions.