[Laparoscopic management of genital prolapse by lateral suspension using mesh: a series of 377 patients]

Genital prolapse is frequent and can be found in about 50% of parous women. Its etiology is complex and multifactorial. Predisposing factors include: genetics (connective tissue disorders, family history); general state (age, parity, weight, smoking, obstructive pulmonary disease); trauma (carrying heavy loads, intense physical exercise); or iatrogenic (post hysterectomy). Treatment can be conservative or surgical and depends mainly on the severity of symptoms. Developments in surgical techniques and synthetic material in the last 20 years enabled us to use minimally invasive procedures with improved post operative course and decreased recurrence rates.

An empirical examination of the integration of causal attribution and social learning theories in achievement situations

Using path analysis, the present investigation sought to clarify possible operational linkages among constructs from social learning and attribution theories within the context of a self-esteem system. Subjects were 300 undergraduate university students who completed a measure of self-esteem and indicated expectancies for success and minimal goal levels for an experimental task. After completing the task and receiving feedback about their performance, subjects completed causal attribution and self-esteem questionnaires. Results revealed gender differences in the degree and strength of the proposed relations, but not in the mean levels of the variables studied. Results suggested that the integration of social learning and attribution theories within a single conceptual model provides a better understanding of students' behaviors and self-esteem in achievement situations.

The Blue Dog Coalition: Impact of a Single-Issue Caucus from the 104th to the 110th Congress

The Blue Dog Coalition is an informal organization of legislators within the House of Representatives that strives to influence policy on fiscal responsibility, attract the attention of the electorate, They are a group that elicits wide range of reactions covering the length of the political spectrum, but despite this, their claims of special defense of fiscal conservatism within the Democratic Party have gone relatively undocumented by the academic community.This project has integrated a party literature with a caucus literature, in the attempt of building a novel framework for research. Work on polarization, the significance of parties, the purpose and history of caucuses all have been fused in such away that the Blue Dogs have created an opportunity to test broad congressional questions on a caucus-microcosm scale. Three important questions have emerged from the many possible avenues of exploration on the topic: How does admission into the Blue Dog Coalition effect voting behavior - measured by interest, ideology, and party unityscores? How does party leadership delegate prestigious committee assignments, a traditional indicator of partisan favor and influence, towards Blue Dogs? Can we use the Blue Dog Coalition as an indicator of fiscal conservatism? To each of these questions, a number of interesting results emerged. Blue Dogs, in the 104th scored higher in conservative interest group scores, more towards the center in ideological methods, and lower in party unity Dogs began to behave closer to their Democratic counterparts. In addition, membership on these select committees rose from a very small number to greater proportional parity within the Democratic Party. Perhaps most interesting, the Blue Dog Coalition does behave as a significant, independent predictor effect on NTU scores, a variable used to demonstrate fiscal conservatism. This research has shown, first and foremost, that it is useful and practical to applyold arguments within the party literature to a smaller, caucus level of analysis that is relatively untouched by the political science field. For the Blue Dogs, specifically, we have tested the validity of their claims in an attempt to reach broader questions ofdemocratic responsibility and electoral clarity. This work, and other work I have drawn upon, has barely scratched the surface on Blue Dog Democrats and other caucuses of comparable influence and popularity, and there remains a wealth of research material onthis caucus alone to be explored by scholars in the field of congressional politics.

Personality Factors of Women Participating in College Athletics

There exists some discrepancy considering the overall health and well-being of young women in sports and performance domains. The current study aimed to examine self-reported levels of perfectionism, body esteem, and social support among college women participating in organized sports and dance. A total of 103 participants completeda series of questionnaires intended to capture these major variables of interest. Results upheld one of three major hypotheses, specifically in regards to between-group differences for lean and non-lean sport athletes. One of the most important findings wasthat among lean sport participants the relationship between body esteem and social support was statistically significant and positive, and among non-lean sport participants this same relationship was nonsignificant and negative. The applied implication of thisfinal finding is discussed, with particular emphasis on potential strategies for upholding the positive relationship between body esteem and social support among lean sport athletes.

A field study on characteristics and diversity of gene expression in the liver of dairy cows during the transition period

Metabolic and endocrine adaptations to support milk production during the transition period vary between individual cows. This variation between cows to adapt to lactation may have a genetic basis. The present field study was carried out to determine hepatic adaptations occurring from late pregnancy through early lactation by measuring mRNA abundance of candidate genes in dairy cows on-farm. Additionally, the objective was to observe the diversity in inter-individual variation for the candidate genes that may give indications where individual adaptations at a molecular level can be found. This study was carried out on-farm including 232 dairy cows (parity >3) from 64 farms in Switzerland. Blood and liver samples were collected on d 20+/-7 before parturition, on d 24+/-2, and on d 89+/-4 after parturition. Blood plasma was assayed for concentrations of glucose, nonesterified fatty acids, beta-hydroxybutyrate, cholesterol, triglycerides, urea, albumin, protein, insulin, insulin-like growth factor-1, leptin, 3,5,3'-triiodothyronine, and thyroxine. Liver samples were obtained at the same time points and were measured for mRNA abundance of 26 candidate genes encoding enzymes and nuclear receptors involved in gluconeogenesis, fatty acid beta-oxidation, fatty acid and triglyceride synthesis, ketogenesis, citric acid cycle, cholesterol synthesis, and the urea cycle. The cows in the present study experienced a marked metabolic load in early lactation, as presented by changes in plasma metabolites and hormones, and responded accordingly with upregulation and downregulation of almost all candidate genes involved in metabolic processes in the liver. The observed inter-individual variation for the candidate genes, which was highest for acetyl-CoA-carboxylase and glycerol-3-phosphate dehydrogenase 2, should be further investigated to unravel the regulation at molecular level for optimal adaptive performance in dairy cows.

Running in Heels: an Analysis of Advertisements By Female Senate Candidates

Female candidates have become more successful in the political arena, specifically in the United States Senate. Today, females make up twenty percent of the total Senate seats. Despite this increase, females are still underrepresented in Washington. As such, understanding the roadblocks to equality will help us achieve parity. In an attempt to understand various challenges that female senatorial candidates face, this project looks at a specific element of their campaign, TV advertisements. Assessing candidate advertisements will help us understand whether gender affects strategic campaign decisions. Specifically, this project investigates the relationship between candidate gender and casting and setting of TV advertisements. Does gender influence the makeup of political ad spots? In order to understand this relationship more completely, I employ both quantitative data and case study analysis for same-gender and mixed-gender primary and general election contests in 2004 and 2008. Ultimately, candidate gender has little to no effect on casting of senatorial advertisements across both election cycles. Despite this variation in casting, we observe consistent findings across three settings, the political setting, the home setting, and the neighborhood setting. In both 2004 and 2008, female candidates use smaller proportions of ad frames with the political setting in comparison to their male counterparts. Female candidates in both election cycles also employed greater proportions of ad frames with the home and neighborhood setting compared to male candidates. These discrepancies point to a distinction in advertisement strategy depending on gender of the candidate.

Greek Life and God Attachment: the Interaction of Sorority Influence and Religiosity on Women's Body Shame

The present study investigated the relationships between sorority women’s internalization of Greek thin ideals and body image, and dimensions of sorority women’s religiosity and body image. A combined relationship among sorority women’s internalization of Greek thin ideals, body image, and religiosity was also examined. Based on previous research it was expected that women’s internalization of Greek thin ideals would be associated with worse body image (in terms of body shame, body esteem, and drive for thinness) and that women’s religiosity (in terms of secure attachment to God) would be associated with better body image. Combinations of Greek thin ideal internalization and God attachment were expected to significantly predict changes in women’s body image. Women completed a series of survey measures assessing their awareness and internalization of Greek sociocultural thin ideals and their sense of community within their particular sorority. Women also completed a series of survey measures assessing their body shame, body esteem, and drive for thinness, in addition to survey measures assessing dimensions of their religiosity. The study’s findings revealed that women’s internalization of Greek thin ideals was associated with worse body image outcomes and that anxious attachment to God was associated with worse body image outcomes, particularly in relation to body shame. Moderation analyses revealed that Greek thin ideal internalization significantly interacted with anxious God attachment to predict body shame.

The Impact of Parental Psychological Control on College Students’ Relational Aggression and Friendship Quality

The present study investigated the relationships between parental psychological control and college students’ relational aggression and friendship quality. Based on previous research, it was expected that parents’ use of psychological control would be associated with students’ increased use of relational aggression with peers and lower friendship quality. Students completed a series of survey measures assessing their mothers’ and fathers’ use of psychological control, behavioral control, and warmth/acceptance. Students also completed a series of survey measures assessing their friendship quality, social skills, relational aggression, self-esteem, and social desirability. The study’s findings revealed that parental psychological control was associated with and predicted students’ increased use of relational aggression with peers. Parental psychological control was also associated with students’ lower friendship quality. However, parents’ use of psychological control did not predict students’ friendship quality after accounting for the influence of students’ personal and peer relationship variables. This finding suggests that characteristics of peer relationships may play a larger role than parenting behaviors in shaping college students’ friendships. The study also found that students who displayed higher levels of relational aggression had lower quality friendships. Other findings revealed that the relationship between parental psychological control and students’ friendship quality can be partially explained by students’ use of relational aggression with peers. Students’ friendship quality can also help to explain the influence of parental psychological control on students’ relational aggression. In addition, the study found that combinations of parenting behaviors were more informative predictors of students’ relational aggression and friendship quality than psychological control alone. Finally, this study revealed the importance of assessing participants’ social desirability when measuring sensitive personal qualities such as relational aggression, friendship quality, and self-esteem. Overall, this study contributes to the field of research on parental psychological control by revealing its effects on college students’ relational aggression and friendship quality.

Current Changes in the Lifestyle and Mental Health of Teenagers

The group studied 1,253 students from various types of schools chosen randomly from those in Prague and Budejovice in order to evaluate the life styles, prevailing value standards, attitudes and behavioural patterns of Czech adolescents. The respondents (including 614 men and 639 women with an average age of 16.4 years) completed questionnaires containing standard scales focusing on feelings about social life, conservative and authoritarian tendencies, levels of self-esteem, general health, eating attitudes and behaviour The adolescents showed a relatively high level of conformity with authoritarian, conservative tendencies and with a dictate of power, rigid conventionality, ethnocentrism and low inner tolerance of differences, their scores being higher than those found in Western European countries. These tendencies were stronger among students outside Prague and those attending vocational schools. As the level of education rose, the sense of fatality and social determination decreased, indicating a higher share of responsibility for events in the surrounding world. When changes of life style were considered, adolescents can be expected to adapt more easily to more risky, socially attractive and manifest models of attitudes and behaviour. On the one hand, adolescents were often involved in sports, and young women in particular often showed a extreme concern and care for their own bodies. On the other hand, one quarter of respondents smoked, one fifth reported serious problems with alcohol and one quarter had already had some experience with drugs. One third of young men and one quarter of young women reported regular consumption of alcohol, and 6.5 percent of men and 3.6 percent of women regularly smoked marihuana or hashish. For the majority of adolescents, life conditions and conformity seem to be more important than the sense of active choice and responsibility for one's own life.

[Needs and expectations of Tamil women attending an antenatal care department at a Swiss university hospital]

It has been noted that immigrant women often initiate prenatal care late in their pregnancy and thus may be inadequately prepared for their birth experience. This leads to poorer maternal outcomes and higher morbidity statistics compared to Swiss women. Tamil women of Sri Lanka represent the largest group of immigrant women being seen at the antenatal care clinic of a Swiss University Hospital. To get a deeper understanding of their needs and expectations relative to their antenatal care, a qualitative study was undertaken. Problem centred interviews were conducted with seven Tamil women before and after delivery. An interpreter was consulting. Data were analyzed using content analysis methods as described by Mayring. Four main themes emerged, demonstrating the need of the women and their resulting expectation: 1) to receive esteem--to show respect and attention; 2) to consult with somebody--to ensure communication; 3) to alleviate worries and fear--to give a sense of security and be in charge; and 4) to make up for lack of experience and knowledge--to pass on experience and knowledge. The quality of the relationships to caregivers is viewed as pivotal and seems to influence Tamil women's satisfaction and their motivation to receive prenatal care.

Swiss residents' speciality choices--impact of gender, personality traits, career motivation and life goals

BACKGROUND: The medical specialties chosen by doctors for their careers play an important part in the development of health-care services. This study aimed to investigate the influence of gender, personality traits, career motivation and life goal aspirations on the choice of medical specialty. METHODS: As part of a prospective cohort study of Swiss medical school graduates on career development, 522 fourth-year residents were asked in what specialty they wanted to qualify. They also assessed their career motivation and life goal aspirations. Data concerning personality traits such as sense of coherence, self-esteem, and gender role orientation were collected at the first assessment, four years earlier, in their final year of medical school. Data analyses were conducted by univariate and multivariate analyses of variance and covariance. RESULTS: In their fourth year of residency 439 (84.1%) participants had made their specialty choice. Of these, 45 (8.6%) subjects aspired to primary care, 126 (24.1%) to internal medicine, 68 (13.0%) to surgical specialties, 31 (5.9%) to gynaecology & obstetrics (G&O), 40 (7.7%) to anaesthesiology/intensive care, 44 (8.4%) to paediatrics, 25 (4.8%) to psychiatry and 60 (11.5%) to other specialties. Female residents tended to choose G&O, paediatrics, and anaesthesiology, males more often surgical specialties; the other specialties did not show gender-relevant differences of frequency distribution. Gender had the strongest significant influence on specialty choice, followed by career motivation, personality traits, and life goals. Multivariate analyses of covariance indicated that career motivation and life goals mediated the influence of personality on career choice. Personality traits were no longer significant after controlling for career motivation and life goals as covariates. The effect of gender remained significant after controlling for personality traits, career motivation and life goals. CONCLUSION: Gender had the greatest impact on specialty and career choice, but there were also two other relevant influencing factors, namely career motivation and life goals. Senior physicians mentoring junior physicians should pay special attention to these aspects. Motivational guidance throughout medical training should not only focus on the professional career but also consider the personal life goals of those being mentored.

Epidemiological, social, diagnostic and economic evaluation of population screening for genital chlamydial infection

OBJECTIVES: To investigate epidemiological, social, diagnostic and economic aspects of chlamydia screening in non-genitourinary medicine settings. METHODS: Linked studies around a cross-sectional population-based survey of adult men and women invited to collect urine and (for women) vulvovaginal swab specimens at home and mail these to a laboratory for testing for Chlamydia trachomatis. Specimens were used in laboratory evaluations of an amplified enzyme immunoassay (PCE EIA) and two nucleic acid amplification tests [Cobas polymerase chain reaction (PCR), Becton Dickinson strand displacement amplification (SDA)]. Chlamydia-positive cases and two negative controls completed a risk factor questionnaire. Chlamydia-positive cases were invited into a randomised controlled trial of partner notification strategies. Samples of individuals testing negative completed psychological questionnaires before and after screening. In-depth interviews were conducted at all stages of screening. Chlamydia transmission and cost-effectiveness of screening were investigated in a transmission dynamic model. SETTING AND PARTICIPANTS: General population in the Bristol and Birmingham areas of England. In total, 19,773 women and men aged 16-39 years were randomly selected from 27 general practice lists. RESULTS: Screening invitations reached 73% (14,382/19,773). Uptake (4731 participants), weighted for sampling, was 39.5% (95% CI 37.7, 40.8%) in women and 29.5% (95% CI 28.0, 31.0%) in men aged 16-39 years. Chlamydia prevalence (219 positive results) in 16-24 year olds was 6.2% (95% CI 4.9, 7.8%) in women and 5.3% (95% CI 4.4, 6.3%) in men. The case-control study did not identify any additional factors that would help target screening. Screening did not adversely affect anxiety, depression or self-esteem. Participants welcomed the convenience and privacy of home-sampling. The relative sensitivity of PCR on male urine specimens was 100% (95% CI 89.1, 100%). The combined relative sensitivities of PCR and SDA using female urine and vulvovaginal swabs were 91.8% (86.1, 95.7, 134/146) and 97.3% (93.1, 99.2%, 142/146). A total of 140 people (74% of eligible) participated in the randomised trial. Compared with referral to a genitourinary medicine clinic, partner notification by practice nurses resulted in 12.4% (95% CI -3.7, 28.6%) more patients with at least one partner treated and 22.0% (95% CI 6.1, 37.8%) more patients with all partners treated. The health service and patients costs (2005 prices) of home-based postal chlamydia screening were 21.47 pounds (95% CI 19.91 pounds, 25.99) per screening invitation and 28.56 pounds (95% CI 22.10 pounds, 30.43) per accepted offer. Preliminary modelling found an incremental cost-effectiveness ratio (2003 prices) comparing screening men and women annually to no screening in the base case of 27,000 pounds/major outcome averted at 8 years. If estimated screening uptake and pelvic inflammatory disease incidence were increased, the cost-effectiveness ratio fell to 3700 pounds/major outcome averted. CONCLUSIONS: Proactive screening for chlamydia in women and men using home-collected specimens was feasible and acceptable. Chlamydia prevalence rates in men and women in the general population are similar. Nucleic acid amplification tests can be used on first-catch urine specimens and vulvovaginal swabs. The administrative costs of proactive screening were similar to those for opportunistic screening. Using empirical estimates of screening uptake and incidence of complications, screening was not cost-effective.

Long-term effects of heart transplantation: the gap between physical performance and emotional well-being

The purpose of our study was to assess physical and emotional factors in heart transplant patients. A prospective design was used to compare patients' physical symptoms, emotional complaints, and restrictions at admission to the waiting list, immediately after, and 1 and 5 years after heart transplantation. Thirty-three patients were included (30 male, 3 female) in the study. Their mean age at admission was 48 +/- 10.2 years. Of these, 23 suffered from cardiomyopathy, 8 from coronary heart disease, and 2 from valvular insufficiency. At admission, the patients suffered from symptoms of cardiac insufficiency, and were restricted in sports, gardening, hobbies, sexual life, job, food-intake, and mobility. More than three-fourths rated their physical and emotional status as moderate to poor. Emotionally, they suffered from irritability, restlessness, depression, psychic lability, lowered drive, lack of social contact, low self-esteem, and anxiety. At the end of rehabilitation (4-8 weeks after the operation), all physical and emotional complaints, as well as restrictions had significantly decreased (p < 0.0001 to p < 0.001), except for trembling, numbness of hands/feet, and food-intake. One year postoperatively, patients reported even fewer physical complaints (p < 0.01). Three-fourths rated their physical and emotional status good or excellent. Five years postoperatively--in contrast to physical status, restrictions, and physical complaints--the emotional complaints had increased significantly (p < 0.0001). Patients reported excellent physical performance up to 5 years postoperatively. On the other hand, the study revealed that their emotional well-being had significantly deteriorated from 1 to 5 years postoperatively. Attention should, therefore, not only be paid to the good physical health of the survivors, but also to the worsening of their emotional status.

Low self-esteem prospectively predicts depression in adolescence and young adulthood

Low self-esteem and depression are strongly correlated in cross-sectional studies, yet little is known about their prospective effects on each other. The vulnerability model hypothesizes that low self-esteem serves as a risk factor for depression, whereas the scar model hypothesizes that low self-esteem is an outcome, not a cause, of depression. To test these models, the authors used 2 large longitudinal data sets, each with 4 repeated assessments between the ages of 15 and 21 years and 18 and 21 years, respectively. Cross-lagged regression analyses indicated that low self-esteem predicted subsequent levels of depression, but depression did not predict subsequent levels of self-esteem. These findings held for both men and women and after controlling for content overlap between the self-esteem and depression scales. Thus, the results supported the vulnerability model, but not the scar model, of self-esteem and depression.