A Comparative Study of Transvaginal Tape, Transobturator Tape Outside-in, and Transvaginal Tape-obturator Inside-out Surgical Procedures in the Treatment of Stress Urinary Incontinence

The aim of this work was to use the Urinary Distress Inventory (UDI-6) and Incontinence Impact Quality of Life (IIQ-7) questionnaires to compare 3 surgical techniques for stress urinary incontinence: the transvaginal tape (TVT) (105 women), the transobturator tape outside-in (TOT) (43 women), and the transvaginal tape-obturator inside-out (TVT-O) (54 women). There were no significant differences in frequent urination, urine leakage related to the feeling of urgency, urine leakage related to physical activity, or small amounts of urine leakage. TVT-operated women had a lower percentage of micturition difficulties compared with TOT women. TVT-O-operated women described slight discomfort in the genital area compared with the TVT technique, but this difference was not significant when compared with the TOT technique. When utilizing the UDI-6 and IIQ-7 scoring modifications before and after surgery, no difference among these 3 techniques is apparent.

A influência do consumo de álcool no insucesso escolar dos alunos do ensino secundário de São Vicente - Cabo Verde

O álcool é a substância mais consumida pelos adolescentes e jovens, e a idade do início e o padrão de consumo têm sido uma das preocupações, particularmente, dos sectores da saúde e da educação. Este consumo está associado a um conjunto de consequências negativas para a vida do adolescente, entre as quais a dificuldade de aprendizagem e o baixo rendimento escolar. Portanto, a prevenção do consumo de álcool nas escolas, constitui uma via consensual para tentar controlar o problema. Esta dissertação tem como objectivo conhecer o padrão de consumo de álcool dos alunos do ensino secundário em São Vicente (Cabo Verde) e estudar a sua relação com o insucesso escolar. Aplicámos um questionário anónimo a uma amostra de 500 alunos, com idade entre 12 e 21 anos, das 5 escolas secundárias públicas da ilha. Após uma análise exploratória dos dados e uma análise univariada verificou-se que o consumo de álcool podia estar relacionado com o insucesso escolar. Neste sentido, construímos modelos de regressão logística para estudar tal relação. Os resultados evidenciam que o primeiro contacto com o álcool ocorre numa idade precoce e o padrão de consumo, genericamente, varia em função da faixa etária e do género. Entretanto, independentemente do género e da faixa etária, o consumo ocorre fundamentalmente aos fins – de – semana e na companhia dos amigos. Após o controlo dos factores de confusão, o consumo de álcool permaneceu como um factor de risco para o insucesso escolar e verificámos que a probabilidade de um aluno ter insucesso escolar aumenta com a frequência de consumo. Os resultados do estudo alertam para a necessidade de uma intervenção de toda a comunidade educativa e dos sectores da saúde no sentido de implementar medidas que visem o combate ao consumo de álcool entre os alunos, e adolescentes de uma forma geral.

Iowa Commission on the Status of African Americans Annual Report, Fiscal Year 2006

A Public Intellectual recently suggested that I read the book Life Out Of Context by the very productive writer Walter Mosley. In this book, Mosley began to summarize a speech that was given by Harry Belafonte. Belafonte made a comparison between a particular Olympic relay race and the Civil Rights Movement. In the race, an experienced runner stumbled a little while passing the baton, and the race was lost. For Belafonte, this momentary slip was a metaphor for the failure of the Civil Rights Movement to “pass the baton” to the younger generation as “it moved past its original phase and into the latter part of the century.” Regardless of your views of the strengths and weaknesses of the Civil Rights Movement, I think all of us would agree that the current issues facing Black Iowa today--e.g., the need for economic development, increased educational achievement and more political involvement in our communities--demand our immediate attention and action. This urgency requires that we cross generational, class, and territorial boundaries within the state to collaborate among ourselves and with others to deal constructively with these issues. We cannot afford to have another “momentary slip.” Serving as the Administrator for ICSAA allows me to serve Black Iowa in a significant way, and Kimberly Cheeks and I in this Division look forward to the work ahead over the next several months and years. Working closely with Walter Reed, Director of the Department of Human Rights, along with so many others across this state, we are keenly aware that we are provided with a great opportunity to positively impact the quality of life for African-Americans in Iowa.

Reducing Prescription Drug Abuse in Iowa, January 5, 2011

Prescription drug abuse is the nation’s fastest-growing drug problem, as outlined by the White House Office of National Drug Control Policy’s 2011 national plan “Responding to America’s Prescription Drug Abuse Crisis.” The urgency of the challenge is underscored in other reports, including a recent analysis by the Centers for Disease Control (CDC) that said: “Overdoses involving prescription painkillers are at epidemic levels and now kill more Americans than heroin and cocaine combined.” According to the CDC, more than 40 people die in America every day from overdoses involving narcotic pain relievers such as hydrocodone (Vicodin), oxycodone (Oxycontin), methadone and oxymorphone (Opana). In Iowa, the situation is similar, at least in some ways. Prescription drug abuse is one of the fastest-growing forms of substance abuse in our state too, though its scope is smaller and on a more manageable scale when compared with most other states. The Iowa Department of Public Health, Bureau of Vital Statistics, reports the drug overdose deaths of at least 130 Iowans over the last three years (2008-2010) due to non-heroin opioids (i.e., prescription pain relievers such as oxycodone, hydrocodone and methadone), nearly as many as for the previous eight years combined (149 from 2000-2007).

Constructive thinking skills and impulsivity dimensions in conduct and substance use disorders: differences and relationships in an adolescents' sample.

Impact of conduct disorder (CD) and substance use disorder (SUD) on constructive thinking skills and impulsivity was explored. 71 offending adolescents were assessed for CD and SUD. Furthermore, the constructive thinking inventory, the immediate and delayed memory tasks and the UPPS impulsive behaviour scale were administered. Results showed that youths with CD, independently from SUD, presented higher personality impulsivity (urgency) and altered constructive thinking skills (categorical thinking and personal superstitious thinking). Furthermore, trait-impulsivity explained variation in constructive thinking skills. The implications of these results were discussed.

Phenotyping maize for adaptation to drought

The need of a better adaptation of crops to drought is an issue of increasing urgency. However, enhancing the tolerance of maize has, therefore, proved to be somewhat elusive in terms of plant breeding. In that context, proper phenotyping remains as one of the main factors limiting breeding advance. Topics covered by this review include the conceptual framework for identifying secondary traits associated with yield response to drought and how to measure these secondary traits in practice.

Pilot Construction Project for Granular Shoulder Stabilization, TR-634, 2013

Granular shoulders need to be maintained on a regular basis because edge ruts and potholes develop, posing a safety hazard to motorists. The successful mitigation of edge-rut issues for granular shoulders would increase safety and reduce the number of procedures currently required to maintain granular shoulders in Iowa. In addition, better performance of granular shoulders reduces the urgency to pave granular shoulders. Delaying or permanently avoiding paving shoulders where possible allows more flexibility in making investments in the road network. To stabilize shoulders and reduce the number of maintenance cycles necessary per season, one possible stabilizing agent—acidulated soybean oil soapstock—was investigated in this research. A pilot testing project was conducted for selected problematic shoulders in northern and northeastern Iowa. Soapstock was applied on granular shoulders and monitored during application and pre- and post-application. Application techniques were documented and the percentage of application success was calculated for each treated shoulder section. As a result of this research, it was concluded that soybean oil soapstock can be an effective stabilizer for granular shoulders under certain conditions. The researchers also developed draft specifications that could possibly be used to engage a contractor to perform the work using a maintenance-type construction contract. The documented application techniques from this project could be used as guidance for those who want to apply soapstock for stabilizing granular shoulders but might not be familiar with this technique.

Speed-cohesion trade-offs in collective decision making in ants and the concept of precision in animal behaviour

In decision making, speed-accuracy trade-offs are well known and often inevitable because accuracy depends on being well informed and gathering information takes time. However, trade-offs between speed and cohesion, that is the degree to which a group remains together as a single entity, as a result of their decision making, have been comparatively neglected. We combine theory and experimentation to show that in decision-making systems, speed-cohesion trade-offs are a natural complement to speed-accuracy trade-offs and are therefore of general importance. We then analyse the decision performance of 32 rock ant, Temnothorax albipennis, colonies in experiments in which accuracy of collective decision making was held constant, but time urgency varied. These experiments reveal for the first time an adaptive speed-cohesion trade-off in collective decision making and how this is achieved. In accord with different time constraints, colonies can decide quickly, at the cost of social unity, or they can decide slowly with much greater cohesion. We discuss the similarity between cohesion and the term precision as used in statistics and engineering. This emphasizes the generality of speed versus cohesion/precision trade-offs in decision making and decision implementation in other fields within animal behaviour such as sexually selected motor displays and even certain aspects of birdsong. We also suggest that speed versus precision trade-offs may occur when individuals within a group need to synchronize their activity, and in collective navigation, cooperative hunting and in certain escape behaviours.

The effects of productivity on profitability: a case study at firm level using an activity-based costing approach

Productivity and profitability are important concepts and measures describing the performance and success of a firm. We know that increase in productivity decreases the costs per unit produced and leads to better profitability. This common knowledge is not, however, enough in the modern business environment. Productivity improvement is one means among others for increasing the profitability of actions. There are many means to increase productivity. The use of these means presupposes operative decisions and these decisions presuppose informationabout the effects of these means. Productivity improvement actions are in general made at floor level with machines, cells, activities and human beings. Profitability is most meaningful at the level of the whole firm. It has been very difficult or even impossible to analyze closely enough the economical aspects of thechanges at floor level with the traditional costing systems. New ideas in accounting have only recently brought in elements which make it possible to considerthese phenomena where they actually happen. The aim of this study is to supportthe selection of objects to productivity improvement, and to develop a method to analyze the effects of the productivity change in an activity on the profitability of a firm. A framework for systemizing the economical management of productivity improvement is developed in this study. This framework is a systematical way with two stages to analyze the effects of productivity improvement actions inan activity on the profitability of a firm. At the first stage of the framework, a simple selection method which is based on the worth, possibility and the necessity of the improvement actions in each activity is presented. This method is called Urgency Analysis. In the second stage it is analyzed how much a certain change of productivity in an activity affects the profitability of a firm. A theoretical calculation model with which it is possible to analyze the effects of a productivity improvement in monetary values is presented. On the basis of this theoretical model a tool is made for the analysis at the firm level. The usefulness of this framework was empirically tested with the data of the profit center of one medium size Finnish firm which operates in metal industry. It is expressedthat the framework provides valuable information about the economical effects of productivity improvement for supporting the management in their decision making.

Que lo urgente no relegue lo importante: absentismo vs. productividad

[spa] El debate sobre la productividad de los empleados públicos se mezcla a menudo con alusiones al grado de absentismo de estos. Existe la percepción de que la productividad es baja y el absentismo es muy preocupante y principal causa de la primera. Sin embargo, esta presumida relación causa-efecto es, en muchos casos, cuestionable. Por ello quisimos conocer la opinión de quienes tienen responsabilidad política, directiva o de gestión sobre la ocupación pública. Para ello realizamos una encuesta entre personas con dicho perfil en las Administraciones catalanas (142 encuestados). Un primer análisis nos permite aventurar que el absentismo no es tan apabullante; sin embargo, sí que preocupa la dudosa veracidad de las motivaciones de muchas de las bajas de corta duración. También destaca que la gran mayoría de los entrevistados crea que se debe incidir menos en la presencia efectiva del empleado y más en la fórmula de flexibilidad horaria y de logro de objetivos. Estas y otras observaciones nos llevan a cuestionarnos si la urgencia por combatir un nivel de absentismo que ni los datos ni la percepción entre gestores públicos le confieren el atributo de alarmante nos aleja de lo que sí es importante: la productividad.

Ohjauksen ja neuvonnan vaikutukset sepelvaltimoiden ohitusleikkauspotilaiden terveyskäyttäytymiseen, terveyteen ja toimintakykyyn

Effects of counseling and guidance on health behavior, health, and functional abilities of coronary artery bypass (cab) patients Hospital periods of heart patients are brief and full of activity today, and for that reason, the meaning of counseling and guidance becomes emphasized. The present intervention study started based on observations of staff members at the heart organization. According to these observations, there were gaps in counseling and guidance intended for coronary artery bypass (CAB) patients. The purpose of the present intervention study was to describe and evaluate the program on counseling and guidance organized for patients who were referred to CAB operations. More specifically, the study was to assess its short-term (3-month), intermediate (6-month), and long-term (12-month) effects on health behavior, health, and functional abilities of CAB patients of any age on one hand and elderly on the other, as well as on their mortality. The data consisted of those individuals having coronary heart disease (CHD) and living in Uusimaa (n = 365) who went through their first CAB operation at the Helsinki University Hospital between May 7th, 1998 and December 31st, 2001. Based on the need of urgency, they were divided into two groups: 1) surgery with regular referral procedure (non-acute) or 2) surgery in the acute phase of CHD. Randomization into an intervention and a control group was separately carried out within these two groups. A subgroup was formed by including those 65 years or older who were operated on with regular referral procedure. Data on health behavior, health, and functional abilities were gathered with survey questionnaires. Times and causes of death were examined January 1st, 1998 through December 31st, 2004. Intervention included counseling and guidance in small groups. The intervention of the non-acutely operated patients was implemented prior to and following surgery, whereas the intervention of the acutely operated patients was implemented after surgery alone. The control group received regular health care services. Counseling and guidance contributed in positive terms to the frequency of alcohol use among non-acutely operated men and to the frequencies of exercise and functional ability among women. The intervention was also capable of having an effect on the exercise frequencies of elderly and acutely operated men. The present intervention did not have an effect on the body mass index, whereas it had barely a slight effect on the health status of the CAB patients. The findings of the intervention and generalizations resulting from them must be viewed critically because the data analysis utilized a multi-testing situation, many variables, and several subgroups. The study did not involve intention to treat analysis. Additionally, a loss of patients was great especially among the elderly and acutely operated patients.

Lääkintähuollon ja materiaalihallinnon yhtenäisen RFID-seurannan perusteita

Tässä diplomityössä tarkastellaan radiotaajuisen tunnistamisteknologian (RFID) seurannan yhtenäisiä perusteita puolustusvoimien lääkintähuollolle ja materiaalihallinnolle. Nykytilaa selvitettiin pääpainona lääkintähuollon ja materiaalihallinnon osa-alueet ja samalla tarkasteltiin koko puolustusvoimien RFIDtekniikan käyttöä. Puolustusvoimissa RFID-teknologiaa käytetään myös vaatehuollon ja kulunvalvonnan toiminnoissa. Tämän työn teoriaosuudessa tarkastellaan RFID-tekniikkaa ja sen komponentteja sekä niiden hyödyntämistä eri sektoreilla ja logistiikassa. Työn empiirisessä osuudessa selvitetään, mitkä ovat puolustusvoimien tarpeet RFID:n käytöllä ja vaatimuksia ensihoidon kiireellisyysluokittelulle (TRIAGE) sekä materiaalihallinnon ja niiden kautta saatavalle tilannekuvalle. Työn tuloksena saadaan perusteita puolustusvoimien RFID-ratkaisujen suunnittelun pohjaksi.

An analytic approach to distribution logistics strategic management

Logistics management is increasingly being recognised by many companies to be of critical concern. The logistics function includes directly or indirectly many of the new areas for achieving or maintaining competitive advantage that companies have been forced to develop due to increasing competitive pressures. The key to achieving a competitive advantage is to manage the logistics function strategically which involves determining the most cost effective method of providing the necessary customer service levels from the many combinations of operating procedures in the areas of transportation, warehousing, order processing and information systems, production, and inventory management. In this thesis, a comprehensive distribution logistics strategic management process is formed by integrating the periodic strategic planning process with a continuous strategic issues management process. Strategic planning is used for defining the basic objectives for a company and assuring co operation and synergy between the different functions of a company while strategic issues management is used on a continuous basis in order to deal with environmental and internal turbulence. The strategic planning subprocess consists of the following main phases: (1) situational analyses, (2) defining the vision and strategic goals for the logistics function, (3) determining objectives and strategies, (4) drawing up tactical action plans, and (5) evaluating the implementation of the plans and making the needed adjustments. The aim of the strategic issues management subprocess is to continuously scan the environment and the organisation for early identification of the issues having a significant impact on the logistics function using the following steps: (1) the identification of trends, (2) assessing the impact and urgency of the identified trends, (3) assigning priorities to the issues, and (4) planning responses to the, issues. The Analytic Hierarchy Process (AHP) is a systematic procedure for structuring any problem. AHP is based on the following three principles: decomposition, comparative judgements, and synthesis of priorities. AHP starts by decomposing a complex, multicriteria problem into a hierarchy where each level consists of a few manageable elements which are then decomposed into another set of elements. The second step is to use a measurement methodology to establish priorities among the elements within each level of the hierarchy. The third step in using AHP is to synthesise the priorities of the elements to establish the overall priorities for the decision alternatives. In this thesis, decision support systems are developed for different areas of distribution logistics strategic management by applying the Analytic Hierarchy Process. The areas covered are: (1) logistics strategic issues management, (2) planning of logistic structure, (3) warehouse site selection, (4) inventory forecasting, (5) defining logistic action and development plans, (6) choosing a distribution logistics strategy, (7) analysing and selecting transport service providers, (8) defining the logistic vision and strategic goals, (9) benchmarking logistic performance, and (10) logistic service management. The thesis demonstrates the potential of AHP as a systematic and analytic approach to distribution logistics strategic management.

O CONHECIMENTO PEDAGÓGICO DOS DOCENTES DE QUÍMICA DO ENSINO SUPERIOR

This study aims to investigate the pedagogical knowledge of Higher Education Chemistry teachers. From the perspective of qualitative research, questionnaires were given, there was documentary analysis and were interviewed twenty-six teachers of the Institute of Chemistry of an institution of state public higher education of São Paulo. Discussed the relevance of pedagogic disciplines in Postgraduate courses and participation in monitoring programs and teacher training in higher education teacher formation. It was found that most teachers lack pedagogical training and some do not show interest in the subject, but look for ways to overcome the difficulties encountered. The results obtained demonstrate the urgency to rethink and reorganize the PostGraduate courses before the real need for training of teachers for higher education.

Fístulas digestivas no trauma

Digestive fistulas are associated with significant morbidity and mortality, representing mayor challenges regarding diagnosis and the requiring management according physiopathologic basis, including hydroeletrolytic therapy, antibiotics, nutritional support, selected surgical handling and skin care. Most of these lesions are postoperative complications, especially in urgency and traumatic situations. Our objective is to revise important aspects regarding gastrointestinal tract fistulas secondary to trauma, emphasizing classification, physiopathology, diagnosis, complications and treatment.