Urinary incontinence persisting after childbirth : extent, delivery history, and effects in a 12-year longitudinal cohort study

© 2015 Royal College of Obstetricians and Gynaecologists. Funded by •Wellbeing of Women/Royal College of Obstetricians and Gynaecologists •Health Research Council of New Zealand

To what extent does the Health Professions Admission Test-Ireland predict performance in early undergraduate tests of communication and clinical skills? – An observational cohort study

Background: Internationally, tests of general mental ability are used in the selection of medical students. Examples include the Medical College Admission Test, Undergraduate Medicine and Health Sciences Admission Test and the UK Clinical Aptitude Test. The most widely used measure of their efficacy is predictive validity.A new tool, the Health Professions Admission Test- Ireland (HPAT-Ireland), was introduced in 2009. Traditionally, selection to Irish undergraduate medical schools relied on academic achievement. Since 2009, Irish and EU applicants are selected on a combination of their secondary school academic record (measured predominately by the Leaving Certificate Examination) and HPAT-Ireland score. This is the first study to report on the predictive validity of the HPAT-Ireland for early undergraduate assessments of communication and clinical skills. Method. Students enrolled at two Irish medical schools in 2009 were followed up for two years. Data collected were gender, HPAT-Ireland total and subsection scores; Leaving Certificate Examination plus HPAT-Ireland combined score, Year 1 Objective Structured Clinical Examination (OSCE) scores (Total score, communication and clinical subtest scores), Year 1 Multiple Choice Questions and Year 2 OSCE and subset scores. We report descriptive statistics, Pearson correlation coefficients and Multiple linear regression models. Results: Data were available for 312 students. In Year 1 none of the selection criteria were significantly related to student OSCE performance. The Leaving Certificate Examination and Leaving Certificate plus HPAT-Ireland combined scores correlated with MCQ marks.In Year 2 a series of significant correlations emerged between the HPAT-Ireland and subsections thereof with OSCE Communication Z-scores; OSCE Clinical Z-scores; and Total OSCE Z-scores. However on multiple regression only the relationship between Total OSCE Score and the Total HPAT-Ireland score remained significant; albeit the predictive power was modest. Conclusion: We found that none of our selection criteria strongly predict clinical and communication skills. The HPAT- Ireland appears to measures ability in domains different to those assessed by the Leaving Certificate Examination. While some significant associations did emerge in Year 2 between HPAT Ireland and total OSCE scores further evaluation is required to establish if this pattern continues during the senior years of the medical course.

To what extent has research conducted by the GaWC Research Network aided our understanding of large EU law firm geography?

This thesis explores whether a specific group of large EU law firms exhibited multiple common behaviours regarding their EU geographies between 1998 and 2009. These potentially common behaviours included their preferences for trading in certain EU locations, their usage of law firm alliances, and the specific reasons why they opened or closed EU branch offices. If my hypothesis is confirmed, this may indicate that certain aspects of large law firm geography are predictable – a finding potentially of interest to various stakeholders globally, including legal regulators, academics and law firms. In testing my hypothesis, I have drawn on research conducted by the Globalization and World Cities (GaWC) Research Network to assist me. Between 1999 and 2010, the GaWC published seven research papers exploring the geographies of large US and UK law firms. Several of the GaWC’s observations arising from these studies were evidence-based; others were speculative – including a novel approach for explaining legal practice branch office change, not adopted in research conducted previously or subsequently. By distilling the GaWC’s key observations these papers into a series of “sub-hypotheses”, I been able to test whether the geographical behaviours of my novel cohort of large EU law firms reflect those suggested by the GaWC. The more the GaWC’s suggested behaviours are observed among my cohort, the more my hypothesis will be supported. In conducting this exercise, I will additionally evaluate the extent to which the GaWC’s research has aided our understanding of large EU law firm geography. Ultimately, my findings broadly support most of the GaWC’s observations, notwithstanding our cohort differences and the speculative nature of several of the GaWC’s propositions. My investigation has also allowed me to refine several of the GaWC’s observations regarding commonly-observable large law firm geographical behaviours, while also addressing a key omission from the group’s research output.

Palliative Medicine:Scoping the level and extent of service provision to people with intellectual disability at end of life Poster Presentation

Background: Concerns exist about the end of life care
that people with intellectual disabilities receive. This population
are seldom referred to palliative care services and
inadequate data sets exist about their place of death.
Aim: To scope the extent of service provision to people
with intellectual disabilities at the end of life by specialist
palliative care and intellectual disability services in one
region of the United Kingdom.
Methods: As part of a larger doctoral study a regional survey
took place of a total sample (n=66) of specialist palliative
care and intellectual disability services using a postal
questionnaire containing forty items. The questionnaire
was informed by the literature and consultation with an
expert reference group. Data were analysed using SPSS to
obtain descriptive statistics.
Results: A total response rate from services of 71.2%
(n=47) was generated. Findings showed a range of experience
among services in providing end of life care to people
with intellectual disabilities in the previous five years, but
general hospitals were reported the most common place of
death. A lack of accessible information on end of life care
for people with learning disabilities was apparent. A few
services (n=14) had a policy to support this population to
make decisions about their care or had used adapted Breaking
Bad News guidelines (n=5) to meet their additional
needs. Both services recognised the value of partnership
working in assessing and meeting the holistic needs of
people with intellectual disabilities at end of life.
Conclusions: A range of experience in caring for people
with intellectual disabilities was present across services,
but more emphasis is required on adapting communication
for this population to facilitate them to participate in their
care. These findings could have international significance
given that studies in other countries have highlighted a
need to widen access to palliative care for this group of
people.

Map of Tiber Creek, from its mouth to the extent of tide water : [Washington D.C.].

Covers area now occupied by the Mall.

Investigation of un-American propaganda activities in the United States : Hearings before a Special Committee on Un-American Activities, House of Representatives, Seventy-fifth Congress, third session-Seventy-eighth Congress, second session, on H. Res. 282, to investigate (1) the extent, character, and objects of un-American propaganda activities in the United States, (2) the diffusion within the United States of subversive and un-American propaganda that is instigated from foreign countries or of a domestic origin and attacks the principle of the form of government as guaranteed by our Constitution, and (3) all other questions in relation thereto that would aid Congress in any necessary remedial legislation.

Martin Dies, chairman.

ASSESSMENT OF ASPEN AND NORTHERN HARDWOODS EXTENT IN THIRTY THREE COUNTIES OF UPPER/LOWER MICHIGAN

The importance of the United States' wood and wood byproducts as biomass feedstocks is increasing as the concern about security and sustainability of global energy production continues to rise. Thus, second generation woody feedstock sources in Michigan, e.g., hybrid poplar and hybrid willow (Populus spp.), are viewed as a potential source of biomass for the proposed biofuel ethanol production plant in Kinross, MI. It is important to gain an understanding of the spatial distribution of current feedstock sources, harvesting accessibility via the transportation infrastructure and land ownerships in order to ensure long-term feedstock extent. This research provides insights into the current extent of aspen and northern hardwoods, and an assessment of potential for expanding the area of these feedstock sources based on pre-European settlement conditions. A geographic information system (GIS) was developed to compile available geospatial data for 33 counties located within 150 miles of the Kinross facility. These include present day and pre-European settlement land use/cover, soils, road infrastructure, and land ownerships. The results suggest that a significant amount of northern hardwoods has been converted to other land use/cover types since European settlement, and the "scattering" of aspen stands has increased. Furthermore, a significant amount of woody biomass is available in close proximity to the existing road network, which can be effectively utilized as feedstock. Potential aspen and northern hardwoods restoration areas are identified in the vicinity of road networks which can be used for future woody feedstock production.

The Behavior of Hydroxyl Units of Synthetic Goethite and its Dehydroxylated Product Hematite

The behavior of the hydroxyl units of synthetic goethite and its dehydroxylated product hematite was characterized using a combination of Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD) during the thermal transformation over a temperature range of 180-270 degrees C. Hematite was detected at temperatures above 200 degrees C by XRD while goethite was not observed above 230 degrees C. Five intense OH vibrations at 3212-3194, 1687-1674, 1643-1640, 888-884 and 800-798 cm(-1), and a H2O vibration at 3450-3445 cm(-1) were observed for goethite. The intensity of hydroxyl stretching and bending vibrations decreased with the extent of dehydroxylation of goethite. Infrared absorption bands clearly show the phase transformation between goethite and hematite: in particular. the migration of excess hydroxyl units from goethite to hematite. Two bands at 536-533 and 454-452 cm(-1) are the low wavenumber vibrations of Fe-O in the hematite structure. Band component analysis data of FTIR spectra support the fact that the hydroxyl units mainly affect the a plane in goethite and the equivalent c plane in hematite.

International human resource management in the introductory HRM course

This paper explores the extent to which students in the introductory HRM course in US institutions are likely to be exposed to information on international and cross-cultural aspects of HRM. Two methods are used: (1) an analysis of international content in fifteen popular introductory HRM textbooks and (2) a survey of professors teaching introductory HRM. The vast majority of responding instructors said their classes got some exposure to international issues in HRM, and most introductory texts included some relevant content. Critiques of international boxed features and dedicated IHRM chapters are provided, and suggestions for improving the quality and depth of IHRM content in introductory textbooks are made.

Destination Positioning Slogans - Analysis of Themes used by New Zealand Regional Tourism Organisations

A significant gap in the tourism and travel literature exists in the area of tourism destination branding. Although brands have been used as sources of differentiation in consumer goods markets for over a century, academic research attention towards destination branding has only been reported since the late 1990s. Three important components of the brand construct are brand identity, brand position and brand image. While interest in applications of brand theory to practise in tourism is increasing, there is a paucity of published research in the literature to guide destination marketing organisations (DMOs). In particular there have been few reported analyses of destination brand positioning slogans. The focus of this paper is on destination brand position slogans, which represent the interface between brand identity and brand image. Part of a wider investigation of DMO slogans worldwide, and in keeping with the conference location, the paper focuses on analysis of slogans used by New Zealand RTOs. The slogans are examined in terms of the extent to which they have been limited to ephemeral indifference. In other words, have they stood the test of time and do they effectively differentiate through a meaningful proposition? Analysis of the slogans indicates very few could be characterised as memorably distinctive. This reflects the complexity involved in capturing the essence of a multi-attributed destination in a succinct and focused positioning slogan, in a way that is both meaningful to the target audience and effectively differentiates the destination from competitors offering the same benefits.

Integrating science through Bayesian Belief Networks : case study of Lyngbya in Moreton Bay

Bayesian Belief Networks (BBNs) are emerging as valuable tools for investigating complex ecological problems. In a BBN, the important variables in a problem are identified and causal relationships are represented graphically. Underpinning this is the probabilistic framework in which variables can take on a finite range of mutually exclusive states. Associated with each variable is a conditional probability table (CPT), showing the probability of a variable attaining each of its possible states conditioned on all possible combinations of it parents. Whilst the variables (nodes) are connected, the CPT attached to each node can be quantified independently. This allows each variable to be populated with the best data available, including expert opinion, simulation results or observed data. It also allows the information to be easily updated as better data become available ----- ----- This paper reports on the process of developing a BBN to better understand the initial rapid growth phase (initiation) of a marine cyanobacterium, Lyngbya majuscula, in Moreton Bay, Queensland. Anecdotal evidence suggests that Lyngbya blooms in this region have increased in severity and extent over the past decade. Lyngbya has been associated with acute dermatitis and a range of other health problems in humans. Blooms have been linked to ecosystem degradation and have also damaged commercial and recreational fisheries. However, the causes of blooms are as yet poorly understood.