Gynaecological operations: do they improve sexual life?

Aim of the study was to determine if gynaecological operations have an effect on sexual function using the current medlined literature. We performed a Medline search using the terms "sexual life/function after operative gynaecological treatment", "sexual life/function after operations for gynaecological problems", "sexual life/function after hysterectomy", "sexual life/function, incontinence" and "sexual life/function, pelvic organ prolapse". Reviews were excluded. We divided the operations into four groups of (1) combined prolapse and incontinence operations, (2) prolapse operations only, (3) incontinence operations only and (4) hysterectomy and compared pre-to postoperative sexual outcome. Thirty-six articles including 4534 patients were identified. Only 13 studies used a validated questionnaire. The other authors used self-designed and non-validated questionnaires or orally posed questions by the examiner to determine sexual function. Prolapse operations particularly posterior repair using levator plication seem to deteriorate sexual function, incontinence procedure have some worsening effect on sexual function and hysterectomy seems to improve sexual function with no differences between subtotal or total hysterectomy. Gynaecological operations do influence sexual function. However, little validated data are available to come to this conclusion.

Arctic network builders : the Arctic Coal Company's operations on Spitsbergen and its relationship with the environment

In 1906, two American industrialists, John Munroe Longyear and Frederick Ayer, formed the Arctic Coal Company to make the first large scale attempt at mining in the high-Arctic location of Spitsbergen, north of the Norwegian mainland. In doing so, they encountered numerous obstacles and built an organization that attempted to overcome them. The Americans sold out in 1916 but others followed, eventually culminating in the transformation of a largely underdeveloped landscape into a mining region. This work uses John Law’s network approach of the Actor Network Theory (ANT) framework to explain how the Arctic Coal Company built a mining network in this environmentally difficult region and why they made the choices they did. It does so by identifying and analyzing the problems the company encountered and the strategies they used to overcome them by focusing on three major components of the operations; the company’s four land claims, its technical system and its main settlement, Longyear City. Extensive comparison between aspects of Longyear City and the company’s choices of technology with other American examples place analysis of the company in a wider context and helps isolate unique aspects of mining in the high-Arctic. American examples dominate comparative sections because Americans dominated the ownership and upper management of the company.

Different anticoagulation strategies in off-pump coronary artery bypass operations: a European survey

In order to determine anticoagulation strategies in OPCAB a questionnaire survey among 750 European cardio-thoracic surgeons was performed. Questions addressed volume of OPCAB procedures performed, intra- and perioperative heparinization and antiplatelet therapy, as well as perioperative management. A total of 325 (43.7%) questionnaires were returned and validated. Perioperative protocols for administration of antiplatelets differed among the respondent surgeons. Perioperative prophylaxis of thrombosis (low or high molecular weight heparin) is performed by 78%. Intraoperative heparin dosage range between 70 U/kg to 500 U/kg, 60% of respondents prefer a low-dose regimen (< or = 150 U/kg). Correspondingly, the lowest activated clotting time (ACT) during surgery is accepted to be 200 s by 24%, 250 s by 18% and 300 s by 26% of surgeons. Protamine is used by 91% of respondents, while 52% perform a 1:1 reversal. A cell-saver and antifibrinolytics are used by 70% and 40%, respectively. Interestingly, 56% of respondents think bleeding in OPCAB patients is not reduced when compared to on-pump CABG. In addition, 34% of respondents believe there is an increased risk of early graft occlusion following OPCAB. This survey demonstrates widely different intra- and perioperative anticoagulation strategies for OPCAB procedures among European surgeons.

Learning Software-Maintenance Tasks in the Transition Phase of Offshore Outsourcing Projects: Two Learning-Theoretical Perspectives

The increasing practice of offshore outsourcing software maintenance has posed the challenge of effectively transferring knowledge to individual software engineers of the vendor. In this theoretical paper, we discuss the implications of two learning theories, the model of work-based learning (MWBL) and cognitive load theory (CLT), for knowledge transfer during the transition phase. Taken together, the theories suggest that learning mechanisms need to be aligned with the type of knowledge (tacit versus explicit), task characteristics (complexity and recurrence), and the recipients’ expertise. The MWBL proposes that learning mechanisms need to include conceptual and practical activities based on the relative importance of explicit and tacit knowledge. CLT explains how effective portfolios of learning mechanisms change over time. While jobshadowing, completion tasks, and supportive information may prevail at the outset of transition, they may be replaced by the work on conventional tasks towards the end of transition.

Knowledge Transfer Processes in the IS Offshore Outsourcing Transition: A Conceptual Model

Despite promising cost saving potential, many offshore software projects fail to realize the expected benefits. A frequent source of failure lies in the insufficient transfer of knowledge during the transition phase. Former literature has reported cases where some domains of knowledge were successfully transferred to vendor personnel whereas others were not. There is further evidence that the actual knowledge transfer processes often vary from case to case. This raises the question whether there is a systematic relationship between the chosen knowledge transfer process and know-ledge transfer success. This paper introduces a dynamic perspective that distinguishes different types of knowledge transfer processes explaining under which circumstances which type is deemed most appropriate to successfully transfer knowledge. Our paper draws on knowledge transfer literature, the Model of Work-Based Learning and theories from cognitive psychology to show how characteristics of know-ledge and the absorptive capacity of knowledge recipients fit particular knowledge transfer processes. The knowledge transfer processes are conceptualized as combinations of generic knowledge transfer activities. This results in six gestalts of know-ledge transfer processes, each representing a fit between the characteristics of the knowledge process and the characteristics of the knowledge to be transferred and the absorptive capacity of the knowledge recipient.

Divergent evolutionary processes associated with colonization of offshore islands

Oceanic islands have been a test ground for evolutionary theory, but here, we focus on the possibilities for evolutionary study created by offshore islands. These can be colonized through various means and by a wide range of species, including those with low dispersal capabilities. We use morphology, modern and ancient sequences of cytochrome b (cytb) and microsatellite genotypes to examine colonization history and evolutionary change associated with occupation of the Orkney archipelago by the common vole (Microtus arvalis), a species found in continental Europe but not in Britain. Among possible colonization scenarios, our results are most consistent with human introduction at least 5100 bp (confirmed by radiocarbon dating). We used approximate Bayesian computation of population history to infer the coast of Belgium as the possible source and estimated the evolutionary timescale using a Bayesian coalescent approach. We showed substantial morphological divergence of the island populations, including a size increase presumably driven by selection and reduced microsatellite variation likely reflecting founder events and genetic drift. More surprisingly, our results suggest that a recent and widespread cytb replacement event in the continental source area purged cytb variation there, whereas the ancestral diversity is largely retained in the colonized islands as a genetic ‘ark’. The replacement event in the continental M. arvalis was probably triggered by anthropogenic causes (land-use change). Our studies illustrate that small offshore islands can act as field laboratories for studying various evolutionary processes over relatively short timescales, informing about the mainland source area as well as the island.