897 resultados para Kalin, Maija: Coping with problems of understanding


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Introduction Provoked vestibulodynia (PVD) is the most frequent cause of genito-pelvic pain/penetration disorder (GPPPD) and is associated with negative psychological and sexual consequences for affected women and their partners. PVD is often misdiagnosed or ignored and many couples may experience a sense of injustice, due to the loss of their ability to have a normal sexual life. Perceiving injustice has been documented to have important consequences in individuals with chronic pain. However, no quantitative research has investigated the experience of injustice in this population. Aim The aim of this study was to investigate the associations between perceived injustice and pain, sexual satisfaction, sexual distress, and depression among women with PVD and their partners. Methods Women diagnosed with PVD (N = 50) and their partners completed questionnaires of perceived injustice, pain, sexual satisfaction, sexual distress, and depression. Main Outcome Measures (1) Global Measure of Sexual Satisfaction Scale; (2) Female Sexual Distress Scale; (3) Beck Depression Inventory-II; and (4) McGill-Melzack Pain Questionnaire. Results After controlling for partners' age, women's higher level of perceived injustice was associated with their own greater sexual distress, and the same pattern was found for partners. Women's higher level of perceived injustice was associated with their own greater depression, and the same pattern was found for partners. Women's higher perceived injustice was not associated with their own lower sexual satisfaction but partners' higher perceived injustice was associated with their own lower sexual satisfaction. Perceived injustice was not associated with women's pain intensity. Conclusion Results suggest that perceiving injustice may have negative consequences for the couple's sexual and psychological outcomes. However, the effects of perceived injustice appear to be intra-individual. Targeting perceived injustice could enhance the efficacy of psychological interventions for women with PVD and their partners.

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Introduction Provoked vestibulodynia (PVD) is a highly prevalent and taxing female genital pain condition. Despite the intimate nature of this pain and the fact that affective factors such as anxiety have been shown to modulate its manifestations, no study has yet explored the emotional regulation of couples in which the woman suffers from PVD. Aim Ambivalence over emotional expression (AEE) is an emotional regulation variable that quantifies the extent to which a person is comfortable with the way she or he expresses emotions. We examined whether the dyadic AEE of couples in which the woman suffers from PVD was differentially associated with women's pain and couples' psychological, sexual, and relational functioning. Methods Couples (N = 254), in which the woman suffered from PVD, completed the AEE questionnaire. A couple typology of dyadic AEE was created. Main Outcome Measures Dependent measures for both members of the couple were the global measure of sexual satisfaction scale, the Beck depression inventory II, and the revised dyadic adjustment scale. The female sexual function index and the sexual history form were used to assess the sexual function of women and men, respectively. Women also completed the pain rating index of the McGill pain questionnaire. Results Couples, in which both partners were considered low on AEE, had the highest scores on sexual satisfaction (P = 0.02) and function (P < 0.01), the lowest depression scores (P < 0.01), and the best dyadic adjustment (P = 0.02). No difference in pain intensity was found between couples. Conclusions Findings suggest that, for couples in which the woman suffers from PVD, an emotional regulation that is low in ambivalence in both partners is associated with better psychological, sexual, and relational outcomes. Results indicate that emotional regulation may be important to consider in the assessment and treatment of couples coping with PVD.

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Livestock keeping is increasingly becoming more popular in Kampala, the capital city of Uganda. However, lack of feed is a real challenge. Inadequate feed supply in urban areas is due to many interacting factors, which include among others land shortage, high cost of feeds, climate risks and poor quality of feeds. The objective of this study was to identify and examine the effectiveness of the strategies adopted by livestock farmers in urban and peri-urban areas of Kampala, Uganda to cope with feed scarcity. A total of 120 livestock farmers from Kampala were interviewed using a structured questionnaire. Dairy cattle (48.3%) and chickens (37.5%) were the most common species, followed by pigs (34.2%), goats (26.7%) and sheep (3.3%). Farm size was generally small both in terms of herd size and total landholding. Cattle and pig farmers in urban and peri-urban areas of Kampala ranked feed scarcity as their first major constraint, while chicken farmers had high cost of feeds. These farmers have adopted several strategies for coping with feed scarcity. Among the major coping strategies adopted were: changing of feed resources based on availability and cost (37.5%), purchasing of feed ingredients in bulk (29.7%), using crop/food wastes (26.6%), harvesting of forages growing naturally in open access lands (23.4%) and reducing herd size (17.2%). However, most of the coping strategies adopted were largely aimed at dealing with the perennial challenge of feed scarcity on a day-by-day basis rather than dealing with it using sustainable and long-term strategies.

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The ideas on which this paper is based are drawn from my thesis “Interactivity in Museums. A Relationship Building Perspective” written in 2007 for the fulfillment of the Master Degree in Museology at the Reinwardt Academy in Amsterdam. The main arguments are that the notion of Interactivity conceptualized within a technological orientation coupled with the pedagogic approach of mere information transmission need to be reconsidered; that Interactivity in museums is a conception both misinterpreted and under-implemented; and that the problems of understanding Interactivity will resolve by identifying the aspects which define Interactivity and most importantly focus on why they matter in a broader socio-cultural context within museums. Without an intention to attribute all the developments and advances associated with new museological practice, in some deterministic way, solely to politics and economic change, I argue that the new strategies adopted by museums towards progression and broader accessibility –at least regarding interactivity, seem to be linked more with a dominant commercialization of culture and education, than with a belief towards an effect on social change through the promotion of social interaction within a pluralistic and multicultural society, acknowledging the diversity of nature, opinion and practices, which can be combined instead of contrasting each other.

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A university degree is effectively a prerequisite for entering the archaeological workforce in the UK. Archaeological employers consider that new entrants to the profession are insufficiently skilled, and hold university training to blame. But university archaeology departments do not consider it their responsibility to deliver fully formed archaeological professionals, but rather to provide an education that can then be applied in different workplaces, within and outside archaeology. The number of individuals studying archaeology at university exceeds the total number working in professional practice, with many more new graduates emerging than archaeological jobs advertised annually. Over-supply of practitioners is also a contributing factor to low pay in archaeology. Steps are being made to provide opportunities for vocational training, both within and outside the university system, but archaeological training and education within the universities and subsequently the archaeological labour market may be adversely impacted upon by the introduction of variable top-up student fees.

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Rationale: In UK hospitals, the preparation of all total parenteral nutrition (TPN) products must be made in the pharmacy as TPNs are categorised as high-risk injectables (NPSA/2007/20). The National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors in the UK since August 2003. This study reports on types of error associated with the preparation of TPNs, including the stage at which these were identified and potential and actual patient outcomes. Methods: Reports of compounding errors for the period 1/2004 - 3/2007 were analysed on an Excel spreadsheet. Results: Of a total of 3691 compounding error reports, 674 (18%) related to TPN products; 548 adult vs. 126 paediatric. A significantly higher proportion of adult TPNs (28% vs. 13% paediatric) were associated with labelling errors and a significantly higher proportion of paediatric TPNs (25% vs. 15% adult) were associated with incorrect transcriptions (Chi-Square Test; p<0.005). Labelling errors were identified equally by pharmacists (42%) and technicians (48%) with technicians detecting mainly at first check and pharmacists at final check. Transcription errors were identified mainly by technicians (65% vs. 27% pharmacist) at first check. Incorrect drug selection (13%) and calculation errors (9%) were associated with adult and paediatric TPN preparations in the same ratio. One paediatric TPN error detected at first check was considered potentially catastrophic; 31 (5%) errors were considered of major and 38 (6%) of moderate potential consequence. Five errors (2 moderate, 1 minor) were identified during or after administration. Conclusions: While recent UK patient safety initiatives are aimed at improving the safety of injectable medicines in clinical areas, the current study highlights safety problems that exist within pharmacy production units. This could be used in the creation of an error management tool for TPN compounding processes within hospital pharmacies.

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The assumption that negligible work is involved in the formation of new surfaces in the machining of ductile metals, is re-examined in the light of both current Finite Element Method (FEM) simulations of cutting and modern ductile fracture mechanics. The work associated with separation criteria in FEM models is shown to be in the kJ/m2 range rather than the few J/m2 of the surface energy (surface tension) employed by Shaw in his pioneering study of 1954 following which consideration of surface work has been omitted from analyses of metal cutting. The much greater values of surface specific work are not surprising in terms of ductile fracture mechanics where kJ/m2 values of fracture toughness are typical of the ductile metals involved in machining studies. This paper shows that when even the simple Ernst–Merchant analysis is generalised to include significant surface work, many of the experimental observations for which traditional ‘plasticity and friction only’ analyses seem to have no quantitative explanation, are now given meaning. In particular, the primary shear plane angle φ becomes material-dependent. The experimental increase of φ up to a saturated level, as the uncut chip thickness is increased, is predicted. The positive intercepts found in plots of cutting force vs. depth of cut, and in plots of force resolved along the primary shear plane vs. area of shear plane, are shown to be measures of the specific surface work. It is demonstrated that neglect of these intercepts in cutting analyses is the reason why anomalously high values of shear yield stress are derived at those very small uncut chip thicknesses at which the so-called size effect becomes evident. The material toughness/strength ratio, combined with the depth of cut to form a non-dimensional parameter, is shown to control ductile cutting mechanics. The toughness/strength ratio of a given material will change with rate, temperature, and thermomechanical treatment and the influence of such changes, together with changes in depth of cut, on the character of machining is discussed. Strength or hardness alone is insufficient to describe machining. The failure of the Ernst–Merchant theory seems less to do with problems of uniqueness and the validity of minimum work, and more to do with the problem not being properly posed. The new analysis compares favourably and consistently with the wide body of experimental results available in the literature. Why considerable progress in the understanding of metal cutting has been achieved without reference to significant surface work is also discussed.

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This paper uses the social model of disability to examine visually impaired children's experiences of their housing and neighbourhoods and finds that they did not experience any significant problems with the design of them. The source of their problems was within these environments, and was caused by factors such as the intensity of movement, for example, from flows of traffic. We conclude by discussing the social policy implications of these findings.

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Numerical forecasts of the atmosphere based on the fundamental dynamical and thermodynamical equations have now been carried for almost 30 years. The very first models which were used were drastic simplifications of the governing equations and permitting only the prediction of the geostrophic wind in the middle of the troposphere based on the conservation of absolute vorticity. Since then we have seen a remarkable development in models predicting the large-scale synoptic flow. Verification carried out at NMC Washington indicates an improvement of about 40% in 24h forecasts for the 500mb geopotential since the end of the 1950’s. The most advanced models of today use the equations of motion in their more original form (i.e. primitive equations) which are better suited to predicting the atmosphere at low latitudes as well as small scale systems. The model which we have developed at the Centre, for instance, will be able to predict weather systems from a scale of 500-1000 km and a vertical extension of a few hundred millibars up to global weather systems extending through the whole depth of the atmosphere. With a grid resolution of 1.5 and 15 vertical levels and covering the whole globe it is possible to describe rather accurately the thermodynamical processes associated with cyclone development. It is further possible to incorporate sub-grid-scale processes such as radiation, exchange of sensible heat, release of latent heat etc. in order to predict the development of new weather systems and the decay of old ones. Later in this introduction I will exemplify this by showing some results of forecasts by the Centre’s model.

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In The Conduct of Inquiry in International Relations, Patrick Jackson situates methodologies in International Relations in relation to their underlying philosophical assumptions. One of his aims is to map International Relations debates in a way that ‘capture[s] current controversies’ (p. 40). This ambition is overstated: whilst Jackson’s typology is useful as a clarificatory tool, (re)classifying existing scholarship in International Relations is more problematic. One problem with Jackson’s approach is that he tends to run together the philosophical assumptions which decisively differentiate his methodologies (by stipulating a distinctive warrant for knowledge claims) and the explanatory strategies that are employed to generate such knowledge claims, suggesting that the latter are entailed by the former. In fact, the explanatory strategies which Jackson associates with each methodology reflect conventional practice in International Relations just as much as they reflect philosophical assumptions. This makes it more difficult to identify each methodology at work than Jackson implies. I illustrate this point through a critical analysis of Jackson’s controversial reclassification of Waltz as an analyticist, showing that whilst Jackson’s typology helps to expose inconsistencies in Waltz’s approach, it does not fully support the proposed reclassification. The conventional aspect of methodologies in International Relations also raises questions about the limits of Jackson’s ‘engaged pluralism’.

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Some recent winters in Western Europe have been characterized by the occurrence of multiple extratropical cyclones following a similar path. The occurrence of such cyclone clusters leads to large socio-economic impacts due to damaging winds, storm surges, and floods. Recent studies have statistically characterized the clustering of extratropical cyclones over the North Atlantic and Europe and hypothesized potential physical mechanisms responsible for their formation. Here we analyze 4 months characterized by multiple cyclones over Western Europe (February 1990, January 1993, December 1999, and January 2007). The evolution of the eddy driven jet stream, Rossby wave-breaking, and upstream/downstream cyclone development are investigated to infer the role of the large-scale flow and to determine if clustered cyclones are related to each other. Results suggest that optimal conditions for the occurrence of cyclone clusters are provided by a recurrent extension of an intensified eddy driven jet toward Western Europe lasting at least 1 week. Multiple Rossby wave-breaking occurrences on both the poleward and equatorward flanks of the jet contribute to the development of these anomalous large-scale conditions. The analysis of the daily weather charts reveals that upstream cyclone development (secondary cyclogenesis, where new cyclones are generated on the trailing fronts of mature cyclones) is strongly related to cyclone clustering, with multiple cyclones developing on a single jet streak. The present analysis permits a deeper understanding of the physical reasons leading to the occurrence of cyclone families over the North Atlantic, enabling a better estimation of the associated cumulative risk over Europe.

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Purpose This research explored the use of developmental evaluation methods with community of practice programmes experiencing change or transition to better understand how to target support resources. Design / methodology / approach The practical use of a number of developmental evaluation methods was explored in three organisations over a nine month period using an action research design. The research was a collaborative process involving all the company participants and the academic (the author) with the intention of developing the practices of the participants as well as contributing to scholarship. Findings The developmental evaluation activities achieved the objectives of the knowledge managers concerned: they developed a better understanding of the contribution and performance of their communities of practice, allowing support resources to be better targeted. Three methods (fundamental evaluative thinking, actual-ideal comparative method and focus on strengths and assets) were found to be useful. Cross-case analysis led to the proposition that developmental evaluation methods act as a structural mechanism that develops the discourse of the organisation in ways that enhance the climate for learning, potentially helping develop a learning organization. Practical implications Developmental evaluation methods add to the options available to evaluate community of practice programmes. These supplement the commonly used activity indicators and impact story methods. 2 Originality / value Developmental evaluation methods are often used in social change initiatives, informing public policy and funding decisions. The contribution here is to extend their use to organisational community of practice programmes.