BackgroundPostpartum depression (PPD) has a 20% 3-month prevalence rate. The consequences of PPD are significant for the mother, infant, and the family. There is a need for preventive interventions for PPD, which are effective and accessible; however, many barriers exist for women who attempt to access perinatal depression prevention programs. Internet interventions for the treatment and prevention of depression are widely accepted as efficacious and may overcome some of the issues pertaining to access to treatment barriers perinatal women face. However, internet interventions offered without any human support tend to have low adherence but positive outcomes for those who do complete treatment. Internet support groups often have high levels of adherence but minimal data supporting efficacy as a treatment for depression. Taken together, these findings suggest that combining the treatment components of individual interventions with the support provided by an internet support group might create an intervention with the scalability and cost-effectiveness of an individual intervention and the better outcomes typically found in supported interventions.ObjectivesThis study aimed to describe the development of a cognitive behavioral therapy (CBT) internet intervention with peer support to prevent PPD and examine preliminary depression and site usage outcomes.MethodsUser-centered design groups were used to develop the internet intervention. Once the intervention was developed, women who were 20 to 28 weeks pregnant with symptoms of depression (Patient Health Questionnaire-8 scores of 5-14) but who had no major depression diagnosis were enrolled in a randomized controlled trial (RCT) to compare 8 weeks of a CBT-based internet intervention with peer support to an individual internet intervention designed to prevent PPD. Assessments took place at baseline, 4 weeks, 8 weeks (end of treatment), and then 4 weeks and 6 weeks postpartum.ResultsA total of 25 women were randomized. Of these, 24 women completed the RCT. Patient Health Questionnaire-9 scores at 6 weeks postpartum remained below the clinical threshold for referral for treatment in both groups, with depression measures showing a decrease in symptoms from baseline to postpartum. At 6 weeks postpartum, only 4% (1/24) met the criteria for PPD. There was no difference between groups in adherence to the intervention, with an average of 14.55 log-ins over the course of treatment.ConclusionsResults suggest women were responsive to both peer support and individual internet interventions to prevent PPD and that peer support may be a useful feature to keep participants adherent.Trial RegistrationClinicalTrials.gov NCT02121015; https://clinicaltrials.gov/ct2/show/NCT02121015 (archived by WebCite at http://www.webcitation.org/765a7qBKy)
Ethyl levulinate is a diesel additive that has received special attention recently due to its potential for production in large quantities from inexpensive feedstocks. Several processes have been developed for the conversion of biomass into levulinic acid and ethyl levulinate, and an economic analysis of these routes would indicate the main hindering factors of their commercialization. This Review focuses on filling this gap in current knowledge by gathering data from scientific papers and patents to create a simulation to analyze processes by focusing on the production of ethyl levulinate in nine countries or regions across the globe. The key indicator to analyze the economic feasibility of ethyl levulinate production is a comparison of its minimum selling price to the local wholesale price of diesel on an energy basis. Processes simulated in Brazil, China, and India presented promising results with feedstocks such as sugarcane bagasse and rice residues. Also, the integration of ethyl levulinate production into existing ethanol plants is a factor that may improve process economics. Overall, this Review specifies key factors in economic and environmental performances of the processes to indicate research topics that could achieve high impact on industrial‐scale processes once matured.
Middle childhood is a relative lacuna in behavioral attachment research. We examined antecedents, correlates, and implications of parent-child attachment at age 10 in a longitudinal study of community families from a Midwestern US state (N=102, mothers, fathers, and children). Dimensions of security, avoidance, ambivalence, and disorganization of children’s attachment to each parent were observed in lengthy naturalistic interactions and assessed using Iowa Attachment Behavioral Coding (IABC). IABC scores were meaningfully associated with history of parental responsiveness (7–80 months) and with earlier and concurrent attachment security, assessed with other established instruments (parent- and observer-rated Attachment Q-Set at 25 months, children’s reports at age 8 and 10). Structural equation modeling analyses revealed that the overall history of responsive care was meaningfully associated with Security, Avoidance, and Disorganization at age 10, in both mother-child and father-child relationships, and that most recent care uniquely predicted Security. IABC scores were also meaningfully related to a broad range of measures of child adaptation at ages 10–12. Cumulative history of children’s security from infancy to middle childhood, integrating measures across relationships and methodologies, also predicted child adaptation at ages 10–12.
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