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.

Health professionals’ and patients’ perspectives on pelvic floor muscle training adherence : 2011 ICS State-of-the-Science Seminar research paper IV of IV

Aims There is scant information on pelvic floor muscle training (PFMT) adherence barriers and facilitators. A web-based survey was conducted (1) to investigate whether responses from health professionals and the public broadly reflected findings in the literature, (2) if responses differed between the two groups, and (3) to identify new research directions. Methods Health professional and public surveys were posted on the ICS website. PFMT adherence barriers and facilitators were divided into four categories: physical/condition, patient, therapy, and social-economic. Responses were analyzed using descriptive statistics from quantitative data and thematic data analysis for qualitative data. Results Five hundred and fifteen health professionals and 51 public respondents participated. Both cohorts felt “patient-related factors” constituted the most important adherence barrier, but differed in their rankings of short- and long-term barriers. Health professionals rated “patient-related” and the public “therapy-related” factors as the most important adherence facilitator. Both ranked “perception of PFMT benefit” as the most important long-term facilitator. Contrary to published findings, symptom severity was not ranked highly. Neither cohort felt the barriers nor facilitators differed according to PFM condition (urinary/faecal incontinence, pelvic organ prolapse, pelvic pain); however, a large number of health professionals felt differences existed across age, gender, and ethnicity. Half of respondents in both cohorts felt research barriers and facilitators differed from those in clinical practice. Conclusions An emphasis on “patient-related” factors, ahead of “condition-specific” and “therapy-related,” affecting PFMT adherence barriers was evident. Health professionals need to be aware of the importance of long-term patient perception of PFMT benefits and consider enabling strategies.

Scoping review of adherence promotion theories in pelvic floor muscle training : 2011 ics state-of-the-science seminar research paper I of IV

Aims This paper, the first of four emanating from the International Continence Society's 2011 State-of-the-Science Seminar on pelvic-floor-muscle training (PFMT) adherence, aimed to summarize the literature on theoretical models to promote PFMT adherence, as identified in the research, or suggested by the seminar's expert panel, and recommends future directions for clinical practice and research. Methods Existing literature on theories of health behavior were identified through a conventional subject search of electronic databases, reference-list checking, and input from the expert panel. A core eligibility criterion was that the study included a theoretical model to underpin adherence strategies used in an intervention to promote PFM training/exercise. Results A brief critique of 12 theoretical models/theories is provided and, were appropriate, their use in PFMT adherence strategies identified or examples of possible uses in future studies outlined. Conclusion A better theoretical-based understanding of interventions to promote PFMT adherence through changes in health behaviors is required. The results of this scoping review and expert opinions identified several promising models. Future research should explicitly map the theories behind interventions that are thought to improve adherence in various populations (e.g., perinatal women to prevent or lessen urinary incontinence). In addition, identified behavioral theories applied to PFMT require a process whereby their impact can be evaluated.

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.

Health professionals’ and patients’ perspectives on pelvic floor muscle training adherence : 2011 ICS State-of-the-Science Seminar research paper IV of IV

Aims There is scant information on pelvic floor muscle training (PFMT) adherence barriers and facilitators. A web-based survey was conducted (1) to investigate whether responses from health professionals and the public broadly reflected findings in the literature, (2) if responses differed between the two groups, and (3) to identify new research directions. Methods Health professional and public surveys were posted on the ICS website. PFMT adherence barriers and facilitators were divided into four categories: physical/condition, patient, therapy, and social-economic. Responses were analyzed using descriptive statistics from quantitative data and thematic data analysis for qualitative data. Results Five hundred and fifteen health professionals and 51 public respondents participated. Both cohorts felt “patient-related factors” constituted the most important adherence barrier, but differed in their rankings of short- and long-term barriers. Health professionals rated “patient-related” and the public “therapy-related” factors as the most important adherence facilitator. Both ranked “perception of PFMT benefit” as the most important long-term facilitator. Contrary to published findings, symptom severity was not ranked highly. Neither cohort felt the barriers nor facilitators differed according to PFM condition (urinary/faecal incontinence, pelvic organ prolapse, pelvic pain); however, a large number of health professionals felt differences existed across age, gender, and ethnicity. Half of respondents in both cohorts felt research barriers and facilitators differed from those in clinical practice. Conclusions An emphasis on “patient-related” factors, ahead of “condition-specific” and “therapy-related,” affecting PFMT adherence barriers was evident. Health professionals need to be aware of the importance of long-term patient perception of PFMT benefits and consider enabling strategies.

A Novel Nonparametric Density Estimator

We present a novel nonparametric density estimator and a new data-driven bandwidth selection method with excellent properties. The approach is in- spired by the principles of the generalized cross entropy method. The pro- posed density estimation procedure has numerous advantages over the tra- ditional kernel density estimator methods. Firstly, for the first time in the nonparametric literature, the proposed estimator allows for a genuine incor- poration of prior information in the density estimation procedure. Secondly, the approach provides the first data-driven bandwidth selection method that is guaranteed to provide a unique bandwidth for any data. Lastly, simulation examples suggest the proposed approach outperforms the current state of the art in nonparametric density estimation in terms of accuracy and reliability.

Yehoshua Gitay: 'What is He Doing?'

This article provides a response to an article by Yehoshua Gitay, ‘Prophetic Criticism—"What are they Doing?": The Case of Isaiah—A Methodological Assessment’ (JSOT 96), in which he assesses the articles in the volume, New Visions of Isaiah. These articles were originally delivered as papers to the Formation of the Book of Isaiah Seminar of the Society of Biblical Literature. Gitay characterizes the entire work of the Seminar as having a redaction-critical focus. I argue that to characterize my article as representing a redaction-critical approach is to misunderstand what others and I were doing as participants in the Isaiah seminar. My article was in fact a critique of redaction criticism and its author-centred approach to textual meaning.

Does participation in a pain course based on the international association for the study of pain's curricula guidelines change student knowledge about pain?

The People in Pain course was set up as a joint initiative of the Departments of Occupational Therapy and Physiotherapy within the School of Health and Rehabilitation Sciences at The University of Queensland. It was instigated in response to the publication of Pain Curricula for Occupational Therapy and Physiotherapy by the International Association for the Study of Pain (IASP) in 1994 (1). The first year it was offered, the "People in Pain" course comprised 14 h of lecture content. It was then expanded to encompass 28 h of lectures and seminar involvement. OBJECTIVES: To evaluate the impact of participation in a university pain course that meets the IASP pain curricula guidelines to increase health professional students' knowledge about pain. METHODS: Students who participated in the People in Pain course over the first three years were invited to complete the Revised Pain Knowledge and Attitudes Questionnaire (R-PKAQ) pre- and postcourse. Data obtained from 22 students in the short course formed a pilot project, and data from 22 students in the longer version of the course were used in the present study. RESULTS: Examination of the correlation matrix indicated substantial correlations between all R-PKAQ subscales except physiological basis of pain and pharmacological management of pain. In both the pilot project during the first year of the course and the expanded course in the following two years, significant improvement was found in the students' knowledge on five of the six subscales of the R-PKAQ: physiological basis of pain, psychological factors of pain perception, assessment and measurement of pain, cognitive-behavioural methods of pain relief, and pharmacological management of pain. Improvements in the developmental aspects of pain perception subscale failed to reach significance. CONCLUSIONS: An integrated pain course developed according to the pain curriculum guidelines developed by the IASP resulted in increased student knowledge regardless of the length of the program attended.

Gest??o de pessoas na administra????o p??blica japonesa

Este ensaio ?? resultado da participa????o da autora do Seminar on Public Personnel Administration For Middle Level Officials (Semin??rio sobre Administra????o de pessoal no servi??o p??blico para servidores ocupantes de cargos equivalentes a dire????o e assessoramento) promovido pela National Personnel Authority do Governo Japon??s (NPA) e pela Japan International Cooperation Agency (JICA). A NPA ?? a ag??ncia central para administra????o de pessoal civil do governo japon??s. Entre suas principais fun????es est??o o planejamento e a implementa????o dos concursos p??blicos, as recomenda????es para a melhoria das condi????es de trabalho, incluindo quest??es como remunera????o e limites de horas de trabalho, e a defini????o de diretrizes para capacita????o e gest??o por desempenho. A JICA, por sua vez, ?? a ag??ncia de coopera????o japonesa respons??vel por promover os programas de treinamento para pa??ses em desenvolvimento com o intuito de apoiar os esfor??os de auto-aprimoramento para gera????o de progresso econ??mico e melhoria na vida dos cidad??os desses pa??ses. A JICA seleciona anualmente cerca de 8 mil participantes de 150 pa??ses e ??reas do mundo. Os tipos de atividades desenvolvidas s??o programas de treinamento em grupo, de longo prazo (ex.: mestrados e doutorados) e programas focados na realidade de um pa??s ou regi??o. O semin??rio em quest??o classifica-se na primeira modalidade de treinamento em grupo e contou com a participa????o de 11 servidores com atua????o na ??rea de gest??o de pessoas do Brasil, Gana, Kosovo, L??bano, Nepal, Ruanda, Ilhas Salom??o, Sri Lanka, Tail??ndia, Trinidade e Tobago.

O não-lugar dos professores nos entrelugares de formação continuada

O artigo faz uma análise dos sistemas de representação de professores, delegados eleitos para participarem do GT — Formação e Valorização do Magistério, por ocasião da realização do Seminário Estadual de Política Educacional do Espírito Santo, sobre os processos de formação continuada desenvolvidos pela Secretaria de Educação. Utiliza como referencial de análise as categorias de não-lugar, lugar, espaços-tempos e comunidades compartilhadas, a partir das obras de Lefebvre (1983), Augé (1994), Certeau (2001) e Santos (2000), dentre outros. Trabalha com metodologia baseada em coleta de dados por meio de questionário composto de questões abertas e fechadas. Aponta como resultado que o sistema de representação de professores enuncia a necessidade de instauração de processos de formação continuada voltados para a "utópica" de constituição de um coletivo escolar que supere, por meio de comunidades compartilhadas, o não-lugar por eles ocupado até então.

Um seminário dispositivo : a humanização do Sistema Único de Saúde (SUS) em debate

O artigo discute o processo de construção do seminário "Humanização do SUS em Debate" indicando sua conexão com os desafios atuais do SUS e com as proposições da Política Nacional de Humanização (PNH). Apresenta os princípios e diretrizes da Política Nacional de Humanização do SUS e seu processo de construção, discutindo os diversos sentidos do termo humanização. Ao final é indicada a aposta metodológica do seminário que se destinou a promover um amplo debate sobre a humanização do SUS, por meio de rodas de conversação que objetivavam a interface com profissionais que atuam na formação dos trabalhadores do SUS, responsáveis pela produção de conhecimento na área da saúde e pela formação dos acadêmicos neste campo.

"Procedural Strategy" by Carlos Pinto de Abreu, lawyer

Como Carlos Pinto de Abreu refere e bem, no seu livro e no seminário, entre juízes, partes ou sujeitos processuais, advogados ou solicitadores, magistrados do Ministério Público ou testemunhas, peritos ou funcionários, encontramos “pessoas que podem ser mais ou menos sérias”, por sinal “motivadas por outros interesses que não os de servir a Verdade e a Justiça”; Abstract: Carlos Pinto de Abreu as regards and well in his book and seminar, between judges, parties or procedural subject, lawyers or solicitors, prosecutors and witnesses, experts or officials, found "people who may be more or less serious" , by the way "motivated by interests other than those serving the Truth and Justice".

WAML World Congress: Direito Médico Mundial em Portugal

Eis que existem boas notícias científicas em Portugal. O WAML World Congress é o maior e mais prestigiado congresso mundial de direito médico. E, desta vez, vai ter lugar em Portugal, mais em concreto na Cidade capital do Mondego, Coimbra, entre os próximos dias 2 e 7 de Agosto de 2015. O seu Presidente ou Chairman, será o especialista português em direito médico, professor da Faculdade de Direito da Universidade de Coimbra, Doutor André Gonçalo Dias Pereira. Especialista que já esteve a fazer um excelente Seminário em Barcelos, Escola Superior de Gestão do Instituto Politécnico do Cávado e do Ave, no dia 26 de Maio de 2014, com o título de “O Direito da Concorrência: análise de um caso real”. Tema que relacionou com a poderosa indústria farmacêutica, entre outros aspectos conexos. § Behold, there are good scientific news in Portugal. The WAML World Congress is the largest and most prestigious world congress of medical law. And this time, will take place in Portugal, more specifically in the Mondego capital city, Coimbra, between 2nd and August 7, 2015. The President or Chairman, will be the Portuguese expert in medical law professor Faculty of Law, University of Coimbra, Doctor André Gonçalo Dias Pereira. Specialist who has been doing an excellent Seminar in Barcelos, School of Management Cávado Polytechnic Institute and Ave, on May 26, 2014, with the title "The Competition Law: analysis of a real case." Theme related to the powerful pharmaceutical industry, and other related aspects.

“The Voiceless in Goan Historiography”

This essay was presented at the first Seminar on Indo-Portuguese History (ISIPH-I) organized in Goa by Rev. Dr. John Correia-Afonso, S.J. in November 1978. It represented a call for a critical revision of Goan historiography in the post-colonial era, following Goa's liberation and the 25th April 1974 change in Portugal. The essay was a sort of manifesto and definition of research plan for the newly established Xavier Centre of Historical Research. The article surveys critically the documentary sources little tapped until recently. Includes the first ever analysis of the records relating to the Pastoral Visits in Goa, a prized source of information for the socio-economic history of Goa in the 19th century.

From Christianization of Karma to Lusotropicalism and Lusosphere

The Portuguese arrival in India marked the beginning of the age of modern globalization that has been sustained until very recently in conditions that were favourable for the western domination of the globe. Adam Smith analyzed the origin of the wealth of nations in pre-Gamic and post-Gamic eras. It is presently experiencing tremors that were predicted by Andre Gunder Frank in his ReOrient, which the bulk of the western sociologists and economists sought to ignore. For Gunder Frank the past five centuries saw an ephemeral rise of the West, exploring and exploiting the pre-existent markets of China and India. He saw these making a comeback.