KdG University of Applied Sciences and Arts

INTRODUCTION Perinatal loss, encompassing stillbirth and neonatal death, can have profound physical and psychological consequences for parents. Effective communication by healthcare professionals during this sensitive period is critical. This study aimed to explore how bereaved parents and professionals experienced verbal and non-verbal communication during perinatal loss. METHODS A qualitative, in-depth interview study following grounded theory principles was conducted in Flanders, Belgium, between January and June 2021. Participants were purposively selected via a hospital ward. Face-to-face (n=8) and online (n=13) interviews were carried out by two midwife researchers who were aware of potential biases related to personal/professional interests. A group of bereaved parents and professionals provided feedback during the project. Qualitative analysis was conducted using NVIVO, employing open and axial coding to identify themes. RESULTS Eleven bereaved parents and ten professionals participated. Six themes emerged: 1) navigating time and adjusting pace; 2) recognition of parenthood in woman and partner; 3) clear, honest information for shared decision-making; 4) authentic contact while leaving room for alone time; 5) gentle and sensitive verbal communication; and 6) professionals’ self-care. Parents valued clear, honest communication, acknowledgment of their parenthood, and the ability to make informed decisions. Healthcare professionals emphasized the challenge of providing adequate time and presence amidst busy schedules, but recognized the importance of empathy and sensitivity. CONCLUSIONS Compassionate, patient-centered care with effective verbal and non-verbal communication is vital in supporting bereaved parents during perinatal loss, and it continues to be a challenge. Findings can guide clinical practice to inform professional training initiatives and inform intervention development.

INTRODUCTION Women with a migration background face significant barriers to accessing perinatal mental health support. This study aims to explore the needs, barriers and facilitators regarding perinatal mental health support in women with a first-generation migration background and how they experience support within their own community. METHODS We conducted qualitative in-depth face-to-face interviews with mothers who gave birth within 12 months preceding the interview, recruited from an Antwerp maternity ward between August and September 2022. Three midwife researchers conducted interviews at the participants' home, using an interpreter if needed. A midwife researcher with relevant expertise reviewed the final manuscript. Two researchers independently performed qualitative inductive content analysis and constant comparison of audio transcripts using NVIVO. RESULTS Of the 11 participants, none reported mental health issues at the time of the interview. However, four mothers shared experiences indicative of postnatal depression, highlighting significant challenges such as isolation, language barriers, and a lack of awareness about mental health support. Recurring themes included the importance of professionals taking the time and making efforts to provide accessible information, navigating language barriers, differences in participants' openness toward discussing mental health, the importance of having a close network available for psychological support, and practical aspects inhibiting access. Overall, participants reported a desire for more culturally sensitive care and information about available support. CONCLUSIONS Findings underscore the urgent need for tailored perinatal mental health support that is easy to access, emphasizing awareness and training for professionals, especially midwives, to meet diverse needs. Recognizing this population's variety is essential.

While there is growing consensus on the benefits of natural outdoor play environments for children, the impact of such spaces on the wellbeing of early childhood practitioners remains unknown. Using an exploratory qualitative design, this study unraveled the positive outcomes of greening outdoor spaces in childcare centers in Flanders (Belgium) and the challenges that it may encompass. Eleven in-depth interviews were conducted with professionals who were recently involved in such transformations. Through a thematic analysis seven outcomes were identified: (1) reduced workload, (2) calmer children and less conflicts, (3) more job fulfillment, (4) a sense of peace, (5) a place to enjoy, (6) more little pleasures, and (7) more chances for meeting up with colleagues. Challenges arose mainly in relation to (1) health and safety concerns, (2) transitions, (3) resources, and (4) team spirit. The results indicate that the establishment of natural outdoor spaces in childcare centers can benefit practitioners’ wellbeing in several ways. As such, this study calls for a broader understanding of the importance of green experiences in early childhood education and care. Our insights should be taken into consideration when designing natural outdoor spaces for childcare centers as well as in developing personnel policies on staff wellbeing. Further research is needed, however, to determine the generalizability of research findings and the extent and kind of green experience that is necessary to obtain the positive outcomes.

Background We developed the ACP+ intervention to support nursing home staff with implementation of advance care planning. While ACP+ was found to improve staff’s self-efficacy, it did not change their knowledge about advance care planning. Aim To describe the level of implementation, mechanisms of impact, and contextual factors. Design Process evaluation embedded in a cluster randomized controlled trial in nursing homes (NCT03521206). Throughout and immediately following the 8-month ACP+ implementation, we collected weekly diaries, post-training surveys, attendance records, facility data, and conducted interviews ( n = 32). We applied descriptive statistics and thematic analysis. Setting and participants Management, staff, and ACP+ trainers in seven intervention homes. Results Although most participants reported they valued ACP+, 33% of eligible staff across nursing homes attended training (range: 6%–69%) and only a few reported they felt ready to engage in actual care planning conversations. Half of all nursing homes adapted parts of the intervention (e.g., more/fewer/shortened training; assigning a coordinating role for practical management). Enough time to consolidate skills, and management support were key for staff engagement in advance care planning, and limited time and staff shortages were significant barriers. Staff reported increased awareness of the importance of advance care planning and felt there was a more systematic way of organizing advance care planning. Conclusions There was limited staff engagement. Management ownership, clear roles, and collaborative practices may enhance nursing home advance care planning. Accessible and ongoing training for all staff, and ample practical learning opportunities are needed.

Mental well-being in emerging adulthood (18–29y) can come under severe strain. A healthy diet may support a smooth transition and promote high mental well-being among emerging adults. Several systematic reviews have confirmed that a healthy diet can increase mental health in a general adult population, but so far, no systematic review or meta-analysis has summarized experimental evidence of dietary interventions on mental wellbeing. This study conducted a systematic review and meta-analysis of experimental studies into the effects of dietary interventions on mental wellbeing in emerging adults. Nineteen studies were included in the systematic review, of which thirteen in the meta-analysis. The meta-analysis showed a small but significant effect (g = 0.296, 95% CI 0.110–0.481, p = .002). Review findings show that certain dietary interventions have consistent positive effects on some but not all wellbeing indicators (taking breakfast, Mediterranean diet) whereas others show mixed effects on mental wellbeing (fruit and vegetable consumption). Chocolate consumption showed mixed to very short-lived effects (3 min.) on wellbeing. In sum, a Mediterranean diet and its components (cereal and protein breakfast, fruit and vegetables) may promote mental wellbeing among emerging adults. More experimental studies with larger sample sizes are needed to allow moderator analyses to further understand differences in effects between types of dietary interventions and types of wellbeing outcomes. Trial Registration This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews under the number CRD42020165113.

Microfibrillated cellulose forms a tiny and dense fiber network with beneficial properties such as low density, low oxygen permeability, and excellent mechanical strength and stiffness of the elementary fibers. Common production processes utilize batch processing such as grinding, homogenization, or microfluidization in combination with chemical or enzymatic fiber pretreatment. However, the disintegration of the hierarchical cellulose microstructure requires enormously high energy input and is limited to very low solid fiber content, which renders the material economically less interesting. The need for alternative and continuous processing routes is currently high. Therefore, softwood cellulose pulp fibers are pre-treated by swelling in various solvents, including a selection of ionic liquids (IL), deep-eutectic solvents (DES), and natural deep eutectic solvents (NADES), studying the influences of different swelling media and conditions concerning the variations in fiber morphology and microstructure. In a second step, the tendency for fibrillation under homogenization in small-scale lab conditions or large-scale twin-screw extrusion is investigated. The swelling kinetics highly depends on substituting the alkyl chain of imidazolium chloride (IL) to provide homogeneous swelling favorable for fibrillation. The selection of optimum parameters (temperature, time, substrate concentration, water, stirring) leads to controlled swelling and unfolding of the individual elementary fibrils without complete dissolution. Potassium carbonate/glycerol (DES) swelling requires longer treatment times. It induces almost no variations in cellulose structure while processing conditions in choline chloride/urea or choline chloride/glycol (NADES) are better controllable compared to ionic liquids with a critical balance between fiber disintegration, dissolution, and fluent homogenization.

The past few decades have witnessed an unprecedented surge in health-related mobile applications. However, most of these applications primarily focus on lifestyle domains such as sleep, fitness, and nutrition. A notable stride in this landscape involves the emergence of applications catering specifically to rehabilitation needs. This expert review aims to provide an encompassing overview of the wide spectrum of apps available for both assessment and rehabilitation. It delves into the existing constraints associated with these tools and deliberates on the potential avenues for future advancements and integration for future advancements and integration. The transformative potential of this mobile, affordable, and user-friendly technology in reshaping the field of rehabilitation sciences will be highlighted. This article underscores how harnessing these innovations can elevate accessibility and effectiveness in the rehabilitation processes, leading to improved overall outcomes and wellbeing. Keywords: mHealth, rehabilitation, smartphone, technology, telerehabilitation, mobile applications

When producing fruit juices, the pomace, containing the seeds, is left as a byproduct. In this study, cold-pressed blackcurrant, raspberry, blackberry, blueberry, strawberry, and sea buckthorn seed oils and their seed meals were characterized to explore possible commercial applications. The fatty acid (FA) composition, sterol content, tocopherol content, total polyphenolic content (TP), color, ferric reducing antioxidant power (FRAP), and free-radical scavenging capacity (DPPH assay) were determined. The levels of TP ranged from 8.9 to 19.3 mg GAE/100 g of oil with the highest TP content observed in blackcurrant oil. Concerning the antioxidative activity, sea buckthorn oil and blackberry oil performed best, both exhibiting high FRAP and DPPH scavenging activities. The fatty acid profiles of all oils showed that the main polyunsaturated fatty acids were linoleic acid (C18:2) and α-linolenic acid (C18:3). When studying the sterol and tocopherol content, the highest total amount of sterols (4500 mg/kg) as well as the highest total amount of tocopherols (1036 mg/kg) were observed in blackberry oil. It can be concluded that the cold-pressed berry seed oils examined in this study exhibit interesting characteristics for further commercialization. Moreover, the seed meal is a valuable byproduct that contains high amounts of polyphenols and has a high level of antioxidant activity.

Thermogenesis, electro-chemical physiology (ECP), and electro-mechanical activities (EMAs) are fundamental facets of cellular functioning that are associated with powering, coherence, homeostasis, sensing, and response to stimuli. The classical Hodgkin–Huxley–Katz purview of ECP is derived from Nernst-based foundations for dilute solutions, whereas cellular milieus are mostly highly packed colloidal coacervates, with various types/levels of macromolecules (ions), interactions, and ordering of water. It has also been established that trans-membrane potential (TMP) manifestation can also be affected by adsorption of ions and effective charge separation (1e processes), necessitating the questioning and expansion of classical purviews. Further, we have demonstrated that the traditional explanation of electrogenic/stoichiometric and vitally deterministic bidirectional pumping/channeling of ions by membrane proteins (such as Na,K-ATPase) as the rationale for resting/dynamic TMP variations is untenable. In stark contrast, the murburn purview of ECP-EMAs acknowledges the complexity and discretization of the organization of water, ions, and macromolecules within the cell and does not solicit selective ion-pumping or TMP-based powering/propagation rationales. Herein, we summarize the murburn rationale for the molecular to macroscopic integration of processes such as thermogenesis, kinetic Na–K differentiation at the cell membrane, visual signal transduction and neuronal impulse relay, Complex V mediated mechano-chemostat function, flagella-based motility, etc., and discuss the alteration of cellular volume/tenor in muscle cell contraction. We assert that the membrane-embedded proteins/enzymes cannot use ATP to work against the natural laws of physics. Therefore, the classical perception of membrane-based ion pumps must be jettisoned to make way for the thermodynamics-friendly murburn purview.

Bioenergetics is the study of how life-activities are powered within the cell. This also deals with the interactive exchange of matter/radiation between cellular components and their environment, and the accompanying changes thereof. The acclaimed bioenergetics paradigm has relied on “electron transport chains” and selective/stoichiometric electrogenic “ion-pumping” mediated by vectorial protein-embedded membranes. Therein, an electrochemical gradient was deemed to be the driving force for chemical reactions leading to ATP production, physical thermogenesis by uncoupling proteins, and complex electromechanical processes like information relay along the axon. On one hand, this vitally deterministic perception requires the membrane proteins to “intelligently” manipulate ion-fluxes and generate/harness an electrochemical gradient by a gambit-type logic. At the other hand, it also seeks that the same gradient should cyclically control the membrane-proteins’ activity. Our recent pursuits have questioned such traditional perspectives and advocated the alternate explanation of murburn concept, leading to a revamping of the macroscopic treatments of overall thermodynamic, kinetic, mechanistic, and evolutionary (probability) considerations. The current review aims to consolidate the murburn paradigm of bioenergetics, wherein murzymes initiate redox processes by effective charge separation and diffusible reactive species formation, enabling cells to work as simple chemical engines. Herein, we discuss the reaction chemistry of some simple enzyme systems and also delve into protein complex arrays mediated powering routines like mitochondrial respiration-thermogenesis and chloroplast-centered photosynthesis. Furthermore, we remark that the “water–ion–molecules” phase continuum is actually discretized into dynamically fluctuating coacervates and express concern over the marginalization of sound chemico-physical ideas by the bioenergetics community.

Simple Summary High-altitude Andean streams are fragile ecosystems that require urgent actions such as bioassessment for proper environmental management. In the present study, we investigated the distribution and composition of the macroinvertebrate community in relation to the environmental variables in the Antisana river basin (Andean–Ecuadorian region). Macroinvertebrates were sampled at fifteen localities to predicate ecological condition which were expressed by the Biological Monitoring Working Party Colombia (BMWP-Col) index, the Andean Biotic Index (ABI) and the Andean–Amazon Biotic Index (AAMBI), and their main feeding traits as indicators of ecological functionality. Results show that dissolved oxygen saturation and total phosphorus, ammonia and conductivity contributed significantly to the composition of taxa and functional feeding groups (FFGs). Taxa and FFG diversity were most abundant at sites with the best ecological conditions. Shredders were, in general, dominant and especially abundant in the medium-high-quality sites. Predators were almost absent throughout the study, but they were collected from low-quality sites, showing greater tolerance to the presence of human disturbance. The BMWP-Col index seems to be the best fit for this ecosystem, showing a significant difference in FFG between the index classes compared to the other indices evaluated. The results of the present investigation may be regarded as a fundamental starting point and used in the future bioassessment works in other tropical Andean streams, especially where their resilience is threatened by poorly managed human activities. Abstract High-elevation tropical streams are under increasing threat from human activities and climate change. Specifically, Ecuadorian Andean streams require priority actions such as bioassessment (e.g., biodiversity and functional ecology of macroinvertebrates) in order to generate adequate environmental management policies. Therefore, we investigated the distribution and composition of the macroinvertebrate taxa and their functional feeding groups in relation to the environmental variables in the Antisana river basin (Andean–Ecuadorian Region). We sampled macroinvertebrates from 15 locations to assess ecological conditions (ECs), expressed as the Biological Monitoring Working Party Colombia (BMWP-Col) classes, the Andean Biotic Index (ABI) and the Andean–Amazon Biotic Index (AAMBI). Results indicate that dissolved oxygen saturation, elevation, nutrient concentration and conductivity contributed significantly to the composition of the taxa and functional feeding groups (FFGs). Taxa diversity and FFGs were more abundant in the best EC sites. Shredders (SH) were, overall, dominant and abundant at sites with medium-high ECs. Scrapers constituted the second most prevalent assemblage, exerting dominance at moderate ecological conditions (high altitude and high oxygen saturation). Collector–gathers (CGs) are less sensitive to contamination than the previous two groups but were equally abundant at medium-high EC sites. Collector–filterers (CFs) and parasites (PAs) were less abundant, although the presence of the former was slightly related to better environmental conditions. Predators (PRs) were almost absent throughout the study, but they were collected from poor EC sites. CGs, PAs and PRs showed more tolerance to the presence of human disturbances (e.g., hydraulic constructions or slope erosion). The BMWP-Col index seems to be the best fit for this ecosystem, showing a significant difference in FFG between the index classes, compared to the other indices evaluated. The results of this investigation may be regarded as a fundamental starting point and used in future bioassessment work in other similar ecosystems, particularly high-altitude tropical Ecuadorian streams.

Background The development of anthropogenic activities has generated a decline in aquatic fauna populations, and amphibians have been the most affected. The decline of batrachofauna is concerning, as 41% of all species worldwide are endangered. For this reason, rapid, efficient, and non-invasive biodiversity monitoring techniques are needed, and environmental DNA (eDNA) is one such tool that has been sparsely applied in Ecuador. This technique has allowed scientists generates information on species diversity and amphibian community composition from a water sample. This study applied eDNA-based biomonitoring analyses and visual encounter surveys (VES) as inventory techniques to identify the diversity of aquatic amphibians in the Tena River micro-basin (TRMB). Methods The experimental design was divided into three components: (1) fieldwork: all amphibians were recorded by the VES technique and water samples were collected; (2) laboratory work: DNA isolation from amphibian tissue samples and eDNA-containing filters, amplification, electrophoresis, and sequencing were performed; (3) Data analysis: a local DNA reference database was constructed, and eDNA sequence data were processed for classification, taxonomic assignment, and ecological interpretation. Results Using both eDNA and VES, we detected 33 amphibian species (13 with eDNA only, five with VES only, and 15 with both methods). These species belonged to six amphibian families: Hylidae being the richest with 14 species (three eDNA, one VES, and 10 with both methods), followed by Strabomantidae with nine species (six eDNA, one VES, and two with both methods). All families were detected with both methods, except for the Aromobatidae, having one single record ( Allobates aff. insperatus ) by VES. Individually, eDNA detected 28 species and had a detection probability (DP) of 0.42 CI [0.40–0.45], while VES recorded 20 species with a DP of 0.17 CI [0.14–0.20]. Similarly, using VES, Cochranella resplendens was detected for the first time in TRMB, while with eDNA, four mountain frogs Pristimantis acerus, Pristimantis eriphus, Pristimantis mallii , and Pristimantis sp. (INABIO 15591) previously recorded at 1,518 m.a.s.l. at altitudes below 600 m.a.s.l. were detected. Conclusions Results obtained in this study showed that eDNA-based detection had a greater capacity to detect amphibians in aquatic environments compared to VES. The combination of VES and eDNA improves the sensitivity of species detection and provides more reliable, robust, and detailed information. The latter is essential for developing conservation strategies in the Ecuadorian Amazon.

Objectives This presentation aims to present sexual health professionals with practical advice on creating, publishing and disseminating new educational source material on a global scale. Drawing on the combined experience of the presenters a framework shall be presented, starting at the early stages of an emerging idea, covering topics as conceptualization of topics, outlining gaps in educational material, deciding on type and form of educational material, gathering a dream team, partnering up with professional organizations, fund raising, etc. to create new educational material usable both in the training of new health care professionals and the lifelong learning of practicing health care professionals. Methods An inside look at the developmental process behind the soon to be published Springer Nature textbook ‘Sexuality & Midwifery’ shall function as a case example allowing a step by step reflection on the developmental process of creating globally, free accessible educational material on sexual health. Results . Conclusions While sexuality and sexual health should be a part of the educational curriculum of all professionals active in healthcare settings, it remains a topic easily passed over in many healthcare oriented training programmes around the world, both in medical, paramedical and psychological curricula. Educationalists often find it difficult to include sexuality into degree programmes. The lack of ready to use educational material can makes it daunting even for motivated educationalists to adequately incorporate sexuality into training programmes. On the other hand sexual health experts willing to share their knowledge for educational purposes could use help when it comes to getting from an idea to a fully worked out and easily accessible new educational resource. The framework and practical advice provided in this presentation can help sexual health experts make their ideas for new educational tools become reality. Conflicts of Interest No conflicts of interest are present.

Graduated compression is widely used for medical application to prevent perioperative venous thromboembolism, but other applications such as sportswear can potentially also benefit from it. A tight-fit cycling shirt meant to ensure the correct position during cycling and prevent injuries was designed. The aim of this study was to improve garment pattern design from the aspect of clothing pressure for providing support and enhancing comfort to the user. This paper investigates the suitability of pressure maps from 3D fashion design software CLO 3D for design and in particular its capability to discriminate between various materials and cycling postures. Moreover, the impact of the mechanical properties of fabric was analyzed. In particular, virtual prototyping tool CLO 3D and pressure mapping were employed to achieve the required graduated compression while ensuring fit and comfort. Pattern adjustments were iteratively performed until stress, strain, and pressure maps showed adequate fit and pressure of the cycling garment on the virtual cyclist in static and dynamic cycling positions. The impact of fabric types on garment fit has been shown by generating the stress, strain, and pressure maps with a virtual simulation. It was found that the visualized pressure on the human body model shows distributions that are related to contact between body and garment, and large compression stresses occur in the lower parts of the two shirts. Evident garment deformation was shown at hip level, upper arm, lower front side seam, and front neck, which can reduce garment wear comfort and freedom of movement. The output was found to be sufficiently accurate to optimize the garments based on material and cycling posture.

Air quality currently poses a major risk for human health. Currently, diesel is widely used as fuel and is a significant source of nitrogen oxides (NOx) and particulate matter (PM), both hazardous to human health. A good alternative for mineral diesel is biodiesel, not only for the improvement of hazardous components in the exhaust gases but also because it can be produced in view of a circular economy. Biodiesel consists of a mix of different fatty acid methyl esters, which can react with oxygen. As a consequence, the oxidation stability of biodiesel has to be studied, because the oxidation of biodiesel could affect the performance of the engine due to the wear of injectors and fuel pumps. The oxidation stability could also affect the quality of the exhaust gases due to increases in NOx and PM. The basic question we try to answer in this communication is: ‘Can we find an optimal fatty acid composition in order to have a maximal oxidation stability?’ In this article, we try to find the optimal fatty acid composition according to the five most common fatty acid methyl esters present in biodiesel in order to reach a maximal oxidation stability. The measurements and statistical analysis show, however, that there is no useful regression model because there are statistically significant two- and three-way interactions among the different fatty acids.