Secondary "Hybrid Reconstruction" Concept with Silicone Implants After Autologous Breast Reconstruction - Is It Safe and Reasonable?

BACKGROUND The use of autologous tissue for breast reconstructive surgery following mastectomy has become routine and allows for excellent symmetry and aesthetic results. However, in some cases, the amount of tissue available from the utilized flaps is not enough to achieve the desired outcome. The use of autologous fat grafting, as well as other techniques, has been described to deal with such problems. However, though well-established, these techniques may also fail to achieve the desired results. The aim of this study was to highlight the opportunity to improve aesthetic results using a secondary prosthesis underneath the previously used free flap and to examine whether this is a safe and reasonable procedure. MATERIAL AND METHODS In our study we included patients with unsatisfied aesthetic results after free flap procedures (DIEP, S-GAP, TMG, and FCI) between 2011 and 2018. In each case described, a secondary prosthesis was placed underneath the original flap in order to improve symmetry, shape and projection. Patient age, indication for surgery, adjuvant therapy, complications and outcomes have been registered. A 12-point scale was established to analyze patient satisfaction and aesthetic outcome. RESULTS Overall "operative success" was achieved in all 13 patients (14 flaps) evaluated. At 12 months after reconstruction, all aesthetic scores collected were between good and excellent. In contrast to other studies, we chose a secondary approach for the flap augmentation and we used the epipectoral pocket for the placement of the implant. In our series, low rates of early and late post-operative complications were observed, with a high overall rate of satisfaction. CONCLUSIONS The demonstrated "Hybrid Breast Reconstruction" approach, using an implant underneath a free flap autologous breast reconstruction, provided a safe and reliable option to optimize breast reconstruction outcomes.

Speed of person perception affects immediate and ongoing aesthetic evaluation.

Recent studies have shed light on how aesthetic judgments are formed following presentations lasting less than a second. Meanwhile, dedicated neural mechanisms are understood to enable the rapid detection of human faces, bodies, and actions. On the basis of cognitive studies of: (i) the speed and acuity of person perception, and (ii) preferential attention given to human imagery (e.g., faces and bodies), we hypothesize that the visual detection of humans in portraits increases the magnitude and stability (i.e., similarity to later responses) of aesthetic ratings. Ease of person perception is also expected to elicit longer durations of preferential viewing time, a surplus measure of viewing behavior that should be positively related to subsequent ratings. To test these ideas, we use a set of cubist portraits previously established to be more or less categorizable in terms of the aggregate time required to perceive the depicted person. Using these images, we track aesthetic judgments made following short and unconstrained presentations; in an intervening task, we measure viewing behavior when subjects are able to selectively reveal regions of these images. We find that highly categorizable artworks (those that require less time to identify the figure as human) elicit higher and more predictive aesthetic ratings following 30 ms presentations while also eliciting longer viewing durations. Changes in ratings throughout the task are positively correlated with cumulative viewing time; critically, an image's categorizability level further moderates the strength of this relationship. These results demonstrate that a particular kind of visual object recognition - the recognition of human forms - modulates aesthetic preferences at a glance, subsequent viewing patterns, as well as rating changes over time.

Zen and the Art of Living Mindfully: The Health-Enhancing Potential of Zen Aesthetics.

Amidst the burgeoning enthusiasm for mindfulness in the West, there is a concern that the largely secular 'de-contextualized' way in which it is being harnessed is denuding it of its potential to improve health and well-being. As such, efforts are underway to 're-contextualize' mindfulness, explicitly drawing on the wider framework of Buddhist ideas and practices in which it was initially developed. This paper aims to contribute to this, doing so by focusing on Zen Buddhism, and in particular on Zen aesthetic principles. The article concentrates on the seven principles identified by Hisamatsu (1971) in his classic text Zen and the Fine Arts: kanso (simplicity); fukinsei (asymmetry); koko (austere sublimity); shizen (naturalness); daisuzoku (freedom from routine); sei-jaku (tranquillity); and yugen (profound grace). The presence of these principles in works of art is seen as reflecting and communicating insights that are central to Buddhism, such as non-attachment. Moreover, these principles do not only apply to the creation and appreciation of art, but have clear applications for treating health-related issues, and improving quality of life more generally. This paper makes the case that embodying these principles in their lives can help people enhance their psychosomatic well-being, and come to a truer understanding of the essence of mindful living.

Expressive intent, ambiguity, and aesthetic experiences of music and poetry.

A growing number of studies are investigating the way that aesthetic experiences are generated across different media. Empathy with a perceived human artist has been suggested as a common mechanism [1]. In this study, people heard 30 s excerpts of ambiguous music and poetry preceded by neutral, positively valenced, or negatively valenced information about the composer's or author's intent. The information influenced their perception of the excerpts-excerpts paired with positive intent information were perceived as happier and excerpts paired with negative intent information were perceived as sadder (although across intent conditions, musical excerpts were perceived as happier than poetry excerpts). Moreover, the information modulated the aesthetic experience of the excerpts in different ways for the different excerpt types: positive intent information increased enjoyment and the degree to which people found the musical excerpts to be moving, but negative intent information increased these qualities for poetry. Additionally, positive intent information was judged to better match musical excerpts and negative intent information to better match poetic excerpts. These results suggest that empathy with a perceived human artist is indeed an important shared factor across experiences of music and poetry, but that other mechanisms distinguish the generation of aesthetic appreciation between these two media.

Fatores motivacionais relacionados à prática de atividades físicas em idosos / Motivational factors related to the practice of physical activities of the elderly / Factores de motivación relacionados con la actividad física en los adultos mayores

O objetivo deste estudo foi investigar os fatores motivacionais de idosos para praticarem atividades físicas regularmente. A amostra foi composta por 77 idosos de ambos os sexos, com idade entre 55 e 90 anos, que estavam praticando atividades físicas há pelo menos um mês nos núcleos de esporte e lazer do município de Indaiatuba. Para a coleta dos dados, foi utilizado o IMPRAF-54 (Inventário de Motivação para a Prática Regular de Atividades Físicas), um instrumento que abrange seis dimensões da motivação para a prática de atividades físicas: controle do estresse, saúde, sociabilidade, competitividade, estética ou prazer. Os resultados mostram que o principal fator motivacional para os idosos é a saúde. Depois da saúde, aparecem empatados a sociabilidade, o prazer e o controle do estresse e, por fim, a estética e a competitividade. Com esses dados, é possível conhecer o que estimula os idosos a frequentarem as aulas e planejá-las de forma apropriada, abarcando os seus interesses, considerando-os de maneira integral.

The aim of this study was to investigate the motivational factors for older adults to practice physical activities regularly. The sample consisted of 77 elderly of both genders, aged 55 to 90 years and who were practicing physical activities for at least a month in centers of sports and leisure in the city of Indaiatuba. The inventory IMPRAF-54 (Motivation for the Regular Practice of Physical Activity Inventory) was used for data collection. This instrument covers 6 dimensions of motivation for the practice of physical activities: stress control, health, sociability, competitiveness, aesthetic and pleasure. The results showed that the main motivational factor for the elderly is health. After health, sociability, pleasure and control of stress appear tied and, finally, aesthetics and competitiveness. With these results, it is possible to know what encourages older adults to attend classes and to plan for them properly, including their interests and considering them holistically.

El objetivo de este estudio fue investigar los factores motivacionales de los adultos mayores a la práctica de actividad física regular. La muestra consistió en 77 hombres y mujeres de edad avanzada, comprendidas entre 55 y 90 años y que practicaban actividad física durante al menos 1 mes en los núcleos de deporte y el ocio en la ciudad de Indaiatuba. Para recopilar los datos, se utilizó el IMPRAF-54 (Inventario de Motivación para La Actividad Física Regular), un instrumento que cubre 6 dimensiones de la motivación para la actividad física: manejo del estrés, salud, sociabilidad, competitividad, estética y placer. Los resultados muestran que el principal factor de motivación para las personas mayores es la salud. Después de salud, aparecerá atada sociabilidad, placer y manejo del estrés y, por último, la estética y la competitividad. Con estos datos, es posible saber que anima a las personas mayores para asistir a clases y planificar de manera adecuada, más abarcadora de sus intereses, considerándolos de manera integral.

Indifference to dissonance in native Amazonians reveals cultural variation in music perception.

by biology remains debated. One widely discussed phenomenon is that some combinations of notes are perceived by Westerners as pleasant, or consonant, whereas others are perceived as unpleasant,or dissonant. The contrast between consonance and dissonance is central to Western music and its origins have fascinated scholars since the ancient Greeks. Aesthetic responses to consonance are commonly assumed by scientists to have biological roots, and thus to be universally present in humans. Ethnomusicologists and composers, in contrast, have argued that consonance is a creation of Western musical culture. The issue has remained unresolved, partly because little is known about the extent of cross-cultural variation in consonance preferences. Here we report experiments with the Tsimane'--a native Amazonian society with minimal exposure to Western culture--and comparison populations in Bolivia and the United States that varied in exposure to Western music. Participants rated the pleasantness of sounds. Despite exhibiting Western-like discrimination abilities and Western-like aesthetic responses to familiar sounds and acoustic roughness, the Tsimane' rated consonant and dissonant chords and vocal harmonies as equally pleasant. By contrast, Bolivian city- and town-dwellers exhibited significant preferences for consonance,albeit to a lesser degree than US residents. The results indicate that consonance preferences can be absent in cultures sufficiently isolated from Western music, and are thus unlikely to reflect innate biases or exposure to harmonic natural sounds. The observed variation in preferences is presumably determined by exposure to musical harmony, suggesting that culture has a dominant role in shaping aesthetic responses to music.

The Influence of God and Providence on Happiness and the Quality of Life of Patients Benefiting from Aesthetic Medicine Treatments in Poland.

The research reveals the impact of a belief in god and god's Providence on the happiness and quality of life of patients benefiting from aesthetic medicine treatments in Poland (country where over 90 % of society declare to be deeply devout). The work also examines age and sex of the patients benefiting from beauty treatments (botulinum toxin, fillers, medical peels and needle mesotherapy), their quality of life and also the impact of various factors, including God and Divine Providence on their happiness. The research shows the analysis of factors influencing the successes or failures in the past year and presents the comparison of patients who have benefited from the aesthetic medicine treatments (cosmetic medicine) to the common average Polish citizens.

Personalidad sobreadaptada y homeopatía / Personality sobreadaptada and homeopathy

El presente trabajo está destinado a describir una estructura de personalidad que se observa cada vez con mayor frecuencia, muy favorecida por la actual “cultura del éxito”. Quienes la presentan son personas que sostienen un excesivo ajustea la realidad exterior y a sus exigencias, disociando necesidades y posibilidades emocionales y corporales. Se establece la relación del cuadro psicopatológico con algunos remedios homeopáticos. (AU)

This paper is intended to describe a personality structure that is observed with increasing frequency, favored by the current "culture of success". Those who have are people who argue overshootingto external reality and demands decoupling emotional and physical needs and possibilities. The relationship of psychopathology with some homeopathic remedies set. (AU)

Personalidad sobreadaptada y homeopatía / Personality sobreadaptada and homeopathy

El presente trabajo está destinado a describir una estructura de personalidad que se observa cada vez con mayor frecuencia, muy favorecida por la actual “cultura del éxito”. Quienes la presentan son personas que sostienen un excesivo ajustea la realidad exterior y a sus exigencias, disociando necesidades y posibilidades emocionales y corporales. Se establece la relación del cuadro psicopatológico con algunos remedios homeopáticos.

This paper is intended to describe a personality structure that is observed with increasing frequency, favored by the current "culture of success". Those who have are people who argue overshootingto external reality and demands decoupling emotional and physical needs and possibilities. The relationship of psychopathology with some homeopathic remedies set.

From everyday emotions to aesthetic emotions: towards a unified theory of musical emotions.

The sound of music may arouse profound emotions in listeners. But such experiences seem to involve a 'paradox', namely that music--an abstract form of art, which appears removed from our concerns in everyday life--can arouse emotions - biologically evolved reactions related to human survival. How are these (seemingly) non-commensurable phenomena linked together? Key is to understand the processes through which sounds are imbued with meaning. It can be argued that the survival of our ancient ancestors depended on their ability to detect patterns in sounds, derive meaning from them, and adjust their behavior accordingly. Such an ecological perspective on sound and emotion forms the basis of a recent multi-level framework that aims to explain emotional responses to music in terms of a large set of psychological mechanisms. The goal of this review is to offer an updated and expanded version of the framework that can explain both 'everyday emotions' and 'aesthetic emotions'. The revised framework--referred to as BRECVEMA--includes eight mechanisms: Brain Stem Reflex, Rhythmic Entrainment, Evaluative Conditioning, Contagion, Visual Imagery, Episodic Memory, Musical Expectancy, and Aesthetic Judgment. In this review, it is argued that all of the above mechanisms may be directed at information that occurs in a 'musical event' (i.e., a specific constellation of music, listener, and context). Of particular significance is the addition of a mechanism corresponding to aesthetic judgments of the music, to better account for typical 'appreciation emotions' such as admiration and awe. Relationships between aesthetic judgments and other mechanisms are reviewed based on the revised framework. It is suggested that the framework may contribute to a long-needed reconciliation between previous approaches that have conceptualized music listeners' responses in terms of either 'everyday emotions' or 'aesthetic emotions'.

Family-centred care during midface advancement with a rigid external device: what do families need?

Midface advancement with distraction osteogenesis using the rigid external device (RED) is an effective but invasive treatment to correct the hypoplastic midface. This study draws up an inventory of the stressors, needs and coping strategies of families during this treatment, to determine the best conditions for family-centred care. Data were collected by reviewing the patients' files and administering semi-structured interviews. The data were analysed using the software program Atlas.ti and were re-analysed by an independent researcher. Parents and patients were interviewed separately. Fourteen families participated. Four patients had an absolute indication for surgery. All families were eager to have the patient's facial appearance improved. Nevertheless, despite psychological counselling, they experienced stress when confronted with the changed facial appearance. Another stressor was weight loss. Six patients were in a state of acute malnutrition and needed supplementary feeding. We conclude that the best conditions for family-centred care should be aligned to the different phases of treatment. Leading up to surgery it is important to screen families' expectations regarding aesthetic, functional and social outcomes and to assess their capacity to cope with the long treatment and effects of changed facial appearance. Peer contact and psychosocial training to increase self-esteem are tools to enhance co-operation and satisfaction. During the distraction and stabilisation phase, we advise the monitoring of nutritional intake and weight. During all phases of treatment easy accessibility to the team is recommended.

Mindful art.

Bullot & Reber (B&R) begin asking if the study of the mind's inner life can provide a foundation for a science of art. Clearly there are many epistemological problems involved in the study of the cognitive and affective basis of art appreciation. I argue that context is key. I also propose that as long as the "mind's life" continues to be perceived as an "inner" intracranial phenomenon, little progress can be made. Mind and art are one.

Reconciling beauty and utility in early city planning: the contribution of John Nolen.

In the history of city planning, the dichotomy between the aesthetic aspirations of the City Beautiful and City Practical movements is overstated. The aesthetic impulse did not disappear but persisted as an important thread through the development of comprehensive planning approaches into the 1920s. The nexus between beauty and utility was negotiated and expressed across four main discourses: broad social improvement, aesthetic functionality, economic rationality, and holistic design. Ultimately, beauty became wedded to utility within the very nature of the comprehensive city plan itself. The work of the leading city planner John Nolen is central to an understanding of these historic continuities and informed the early evolution of city planning theory and practice. Nolen's challenge to the City Beautiful paradigm, while still retaining an artistic sensibility, reaestheticizes scholars' appreciation of the City Practical.

Aesthetic expressions illuminating the lived experience of Thai ICU nurses caring for persons who had a peaceful death.

This article, through art and aesthetic expression, illustrates and illuminates the experiences of persons caring for those who had peaceful deaths in intensive care units (ICUs) in southern Thailand. Aesthetic expression, categorized as a descriptive thematic experience, enhanced the appreciation of the experiences, which has implications for holistic end-of-life care.

Tuning-in to the beat: Aesthetic appreciation of musical rhythms correlates with a premotor activity boost.

Listening to music can induce us to tune in to its beat. Previous neuroimaging studies have shown that the motor system becomes involved in perceptual rhythm and timing tasks in general, as well as during preference-related responses to music. However, the role of preferred rhythm and, in particular, of preferred beat frequency (tempo) in driving activity in the motor system remains unknown. The goals of the present functional magnetic resonance imaging (fMRI) study were to determine whether the musical rhythms that are subjectively judged as beautiful boost activity in motor-related areas and if so, whether this effect is driven by preferred tempo, the underlying pulse people tune in to. On the basis of the subjects' judgments, individual preferences were determined for the different systematically varied constituents of the musical rhythms. Results demonstrate the involvement of premotor and cerebellar areas during preferred compared to not preferred musical rhythms and indicate that activity in the ventral premotor cortex (PMv) is enhanced by preferred tempo. Our findings support the assumption that the premotor activity increase during preferred tempo is the result of enhanced sensorimotor simulation of the beat frequency. This may serve as a mechanism that facilitates the tuning-in to the beat of appealing music.

See Josephus: viewing first-century sexual drama with Victorian eyes.

This article looks first at how the art of J.W. Waterhouse responds to the classical world: how complex the scene of reception is, triangulated between artist, the ancient past, and his audiences, and extended over time. Second, it looks at how this scene of reception engages with a specific Victorian problematic about male sexuality and self-control. This is not just a question of Waterhouse using classics as an alibi for thinking about desire, but also of the interference of different models of desire and different knowledges of the classical world in the reception of the painting's narrative semantics.

Beneficios de la experiencia de ocio estético / Benefits of the aesthetic experience of leisure

El tema de este artículo trata sobre los beneficios que nos proporciona la experiencia de ocio estético. Parte de la capacidad que tienen las obras de arte para ser portadoras de valores y para desarrollar valores en el receptor que las acoge. Eso significa que las obras de arte, aunque se sitúen en el horizonte estético, despliegan su riqueza hacia otros ámbitos de gran interéspara el crecimiento personal. En este trabajo se esbozan algunos valores de la experiencia de ocio estético en la formación de la mente, en la comprensión de la realidad y en la comprensión del otro o de los otros seres humanos. La experiencia de ocio estético nos proporciona una nueva forma de ver que tiene una función descubridora . Las obras de arte colaboran en nuestra propia formación, transformando nuestra mirada, ahondándola, modificando nuestra perspectiva, situándonos en el punto de vista de los otros. El arte descubre y anticipa la realidad, contrastando conductas, actitudes, valores. Sus imágenes son un ámbito de conocimiento y comunicación. Nos invitan a profundizar en el descubrimiento del mundo, interrogándonos sobre la realidad. El artista crea una forma que nos invita a compartir y con ello a enriquecer la experiencia. Muestra imágenes de la vida captada en las categorías existenciales que delinean al hombre. Su construcción imaginaria se compromete en un decir sobre el ser humano que ilumina nuestra realidad, en un horizonte de comprensión compartido por todos.Más allá de la dimensión lúdica, la experiencia estética de ocio se enmarca en una dimensión creativa valiosa para nuestro desarrollo personal. (AU)

This article deals with the benefits provided by the experience of aesthetic leisure. It starts from the capacity of works of art to communicate values and to develop them in the audience. Although placed in an aesthetic horizon, works of art are able to contribute also to other s of human growth. This article points out some values of the experience of aesthetic leisure in the formation of mind and the understanding of reality and of the other. The experience of aesthetic leisure provides us with a new way of seeing that has a discovering function. Works of art collaborate in our education, transforming and deepening our gaze, modifying our perspective and placing ourselves in the point of view of the others. Art discovers and anticipates reality, contrasting behaviours, attitudes and values. Its images are a realm of knowledge and communication and invite us to look deeply into the world, questioning ourselves about reality. The artist creates a form and invites us to share it and, thus, to enriche our experience. The artist shows images of life, which are taken from the existential categories that constitute humanity. His or her imaginary construction engages in a way of talking about the human being that throws light on our reality and places it in a comprehension horizon shared by all.Beyond the ludic dimension, the aesthetic experience of leisure belongs to a creative dimension that is valuable for our personal development. (AU)

Beneficios de la experiencia de ocio estético / Benefits of the aesthetic experience of leisure

El tema de este artículo trata sobre los beneficios que nos proporciona la experiencia de ocio estético. Parte de la capacidad que tienen las obras de arte para ser portadoras de valores y para desarrollar valores en el receptor que las acoge. Eso significa que las obras de arte, aunque se sitúen en el horizonte estético, despliegan su riqueza hacia otros ámbitos de gran interéspara el crecimiento personal. En este trabajo se esbozan algunos valores de la experiencia de ocio estético en la formación de la mente, en la comprensión de la realidad y en la comprensión del otro o de los otros seres humanos.La experiencia de ocio estético nos proporciona una nueva forma de ver que tiene una función descubridora . Las obras de arte colaboran en nuestra propia formación, transformando nuestra mirada, ahondándola, modificando nuestra perspectiva, situándonos en el punto de vista de los otros. El arte descubre y anticipa la realidad, contrastando conductas, actitudes, valores. Sus imágenes son un ámbito de conocimiento y comunicación. Nos invitan a profundizar en el descubrimiento del mundo, interrogándonos sobre la realidad. El artista crea una forma que nos invita a compartir y con ello a enriquecer la experiencia. Muestra imágenes de la vida captada en las categorías existenciales que delinean al hombre. Su construcción imaginaria se compromete en un decir sobre el ser humano que ilumina nuestra realidad, en un horizonte de comprensión compartido por todos.Más allá de la dimensión lúdica, la experiencia estética de ocio se enmarca en una dimensión creativa valiosa para nuestro desarrollo personal.

This article deals with the benefits provided by the experience of aesthetic leisure. It starts from the capacity of works of art to communicate values and to develop them in the audience. Although placed in an aesthetic horizon, works of art are able to contribute also to other s of human growth. This article points out some values of the experience of aesthetic leisure in the formation of mind and the understanding of reality and of the other. The experience of aesthetic leisure provides us with a new way of seeing that has a discovering function. Works of art collaborate in our education, transforming and deepening our gaze, modifying our perspective and placing ourselves in the point of view of the others. Art discovers and anticipates reality, contrasting behaviours, attitudes and values. Its images are a realm of knowledge and communication and invite us to look deeply into the world, questioning ourselves about reality. The artist creates a form and invites us to share it and, thus, to enriche our experience. The artist shows images of life, which are taken from the existential categories that constitute humanity. His or her imaginary construction engages in a way of talking about the human being that throws light on our reality and places it in a comprehension horizon shared by all.Beyond the ludic dimension, the aesthetic experience of leisure belongs to a creative dimension that is valuable for our personal development.