Pelvic-floor-muscle-training adherence “modifiers” : a review of primary qualitative studies : 2011 ICS State-of-the-Science Seminar research paper III of IV

Aims This review aims to locate and summarize the findings of qualitative studies exploring the experience of and adherence to pelvic floor muscle training (PFMT) to recommend future directions for practice and research. Methods Primary qualitative studies were identified through a conventional subject search of electronic databases, reference-list checking, and expert contact. A core eligibility criterion was the inclusion of verbatim quotes from participants about PFMT experiences. Details of study aims, methods, and participants were extracted and tabulated. Data were inductively grouped into categories describing “modifiers” of adherence (verified by a second author) and systematically displayed with supporting illustrative quotes. Results Thirteen studies (14 study reports) were included; eight recruited only or predominantly women with urinary incontinence, three recruited postnatal women, and two included women with pelvic organ prolapse. The quality of methodological reporting varied. Six “modifiers” of adherence were described: knowledge; physical skill; feelings about PFMT; cognitive analysis, planning, and attention; prioritization; and service provision. Conclusions Individuals' experience substantial difficulties with capability (particularly knowledge and skills), motivation (especially associated with the considerable cognitive demands of PFMT), and opportunity (as external factors generate competing priorities) when adopting and maintaining a PFMT program. Expert consensus was that judicious selection and deliberate application of appropriate behavior change strategies directed to the “modifiers” of adherence identified in the review may improve PFMT outcomes. Future research is needed to explore whether the review findings are congruent with the PFMT experiences of antenatal women, men, and adults with fecal incontinence.

Caracterización clínica de pacientes pediátricos con tumores cerebrales primarios en un hospital de Bogotá entre 2007-2014

Introducción: En la población pediátrica los tumores cerebrales son la segunda causa de cáncer, la dificultad en su identificación produce tardanza en su diagnóstico y pocos estudios de caracterización han sido realizados en Colombia. Se realizó un estudio para identificar las características en el curso de la enfermedad. Materiales y Métodos: Estudio observacional, descriptivo, de corte transversal con pacientes pediátricos con tumores cerebrales primarios en la clínica infantil Colsubsidio entre 2007-2014. Se revisaron sistemáticamente las historias clínicas de niños con este diagnóstico en patología y posteriormente se desarrolló un análisis univariado de estos. Resultados: 56 niños fueron incluidos, encontrando que el número de consultas previas al diagnóstico fueron más de 4 con un promedio de tiempo entre la evolución de los síntomas y el diagnóstico de 161,1 días. Para la clasificación de la OMS los más frecuentes fueron los embrionarios y astrocíticos, entre estos el meduloblastoma es el más común por histología (14,29%), 50% de los pacientes presentaron remisión y 29,41% fallecieron. Discusión: Los tumores cerebrales primarios son una patología frecuente y con alta morbimortalidad. Este estudio mostró datos epidemiológicos y clínicos similares a la literatura respecto al sexo, edad, tipo de tumor y amplios rangos de tiempo en la evolución de síntomas lo que muestra la naturaleza variable de la enfermedad; se evidencia el diagnóstico tardío en pacientes reconsultantes por el mismo síntoma lo que es frecuente en estos pacientes al igual que en otros estudios nacionales.

Talent in first, second, and third graders: teachers’ perspectives vs. educational reality

The article addresses the subject of talent by emphasizing different conceptions about talent and by proposing an approach to this theme, from the point of view of talent in boys and girls. It also provides an analysis of research conducted with first, second, and third graders in public and private schools of the Costa Rican Education System. Using questionnaires and observations of the dynamics of the classroom as measurement tools, this study contrasts teachers` expectations about their students’ talent with the reality of the class environment, pointing out the existing abyss between teachers’ beliefs and their professional practices.

The ILC's Articles on Responsibility of States for Internationally Wrongful Acts: Completion of the Second Reading

In 2001 the International Law Commission finally adopted on second reading the Draft Articles on Responsibility of States for Internationally Wrongful Acts with commentaries, bringing to an end nearly 50 years of ILC work on the subject. This article reviews the final group of changes to the text, focusing on the definitions of ‘injury’ and ‘damage’, assurances of non‐repetition in the light of the LaGrand case, procedural aspects of countermeasures and the controversy over measures taken in response to a breach by states which are not individually injured. The focus of debate now turns to the UNGA Sixth Committee, which will have to decide what to make of the Draft Articles. The ILC itself recommended an initial resolution taking note of the Articles, with subsequent consideration (after a period of years) of a possible diplomatic conference with a view to concluding a convention. This modest proposal allows for further reflection on the text and may help to avoid possibly divisive and inconclusive debate in the Sixth Committee. At the same time it allows time for better understanding of the many changes made as compared with the first reading text (1996).

A second order control-volume finite-element least-squares strategy for simulating diffusion in strongly anisotropic media

An unstructured mesh �nite volume discretisation method for simulating di�usion in anisotropic media in two-dimensional space is discussed. This technique is considered as an extension of the fully implicit hybrid control-volume �nite-element method and it retains the local continuity of the ux at the control volume faces. A least squares function recon- struction technique together with a new ux decomposition strategy is used to obtain an accurate ux approximation at the control volume face, ensuring that the overall accuracy of the spatial discretisation maintains second order. This paper highlights that the new technique coincides with the traditional shape function technique when the correction term is neglected and that it signi�cantly increases the accuracy of the previous linear scheme on coarse meshes when applied to media that exhibit very strong to extreme anisotropy ratios. It is concluded that the method can be used on both regular and irregular meshes, and appears independent of the mesh quality.