Advances in the surgical management of prolapse

Prolapse is an extremely common condition, for which 11% of women will have a surgical procedure at some point in their lives. The recurrence rate after most of the traditional surgical procedures is high and upto 29% of women who have had surgery for prolapse will require a further operation. In order to improve the surgical outcome, there is currently much interest in the use of grafts to augment traditional repairs and new procedures have been developed using specifically developed grafts. These have been combined with minimally invasive surgical techniques in an attempt to reduce surgical morbidity. These procedures may improve the outcome of surgery for prolapse. However, there is currently a lack of long-term data from randomized trials to demonstrate their effectiveness and safety.     

Four criteria to evaluate providers' service-delivery response to new contraceptive introduction

This article presents an evaluation framework developed to assess the first-level effects of introducing the Standard Days Method (SDM) in Peru Ministry of Health clinics. Four questions are asked: 1) To what extent do providers routinely achieve SDM service delivery standards? 2) Is the time invested in SDM delivery consistent with program norms? 3) How does SDM delivery compare with delivery of established methods? and 4) How does SDM introduction affect delivery of established methods? A study at 62 clinics demonstrated the framework's usefulness. The Standard Days Method introduction had positive overall effects on the quality of care but provider training needed adjustments.     

Forced online: push factors of internet sexuality: A preliminary study of online paraphilic empowerment

Online sexual behavior may be more completely explained by integrating a Pull Factor analysis, centering on the characteristics of the Internet that make it an appealing outlet for sexuality (e.g., "Triple A Engine") and a Push Factor analysis, centering on characteristics of the offline world that disallow fulfillment of sexual desires. This new framework is utilized in explaining paraphilic (unconventional) sexualities online. Because paraphilics are members of highly concealable, horizontal and rare sexual minorities, they are pushed online by mainstream society. Online, paraphilics interact with similar others, and through lurking, re-learning and self-disclosing, may become sexually empowered. Clinical ramifications of attainment of positive sexual-social identity via empowerment are discussed, as are possible affects on public policy.     

How does leaving home affect marital timing? An event-history analysis of migration and marriage in Nang Rong, Thailand

This study examines the effects of migration on marital timing in Thailand between 1984 and 2000 using prospective and retrospective survey data from Nang Rong. In contrast to previous results in the literature, event-history analysis of the longitudinal data reveals a positive, not a negative, effect of lagged migration experience on the likelihood of marriage. The findings also indicate gender differences. Migration's positive impact is independent of other life events for women but is completely "explained" by employment for men.     

Women's experience of revealing perinatal bladder function--implications for midwifery care

Comments of women engaged in a longitudinal study of urinary leaking from first trimester to 12 months following birth provide the data for this paper. Useful insights into the factors contributing to the maintenance of silence and ways to break the barriers to discussion of urinary incontinence before, during and following pregnancy were revealed. Given the prevalence of 30% of Australian women experiencing urinary leaking following pregnancy, it is imperative that midwives engage in discussion and support prevention of this unwelcome outcome of childbirth.     

A midwife program of newborn resuscitation

A very small proportion of newborns fail to establish a normal respiratory pattern without some assistance at birth and newborns requiring resuscitative measures at birth should have a skilled practitioner able to provide it. In this small hospital midwives felt unskilled in newborn resuscitation and paediatricians were not always immediately available. A stakeholder group gathered to discuss the problem. A training program was implemented that improved the skills, confidence and support of the attending midwife to resuscitate the newborn effectively. The aim was to improve the outcome for the infant whilst maintaining the mother's choice of birthing in a small local hospital close to family and friends.     

公司文化:美国高等教育的新威胁

为民主而斗争是一项政治任务,也是一项教育任务.要促进充满活力的民主文化的产生,最根本的就是要认识到,教育必须被作为公共利益来看待.使高等教育沦为公司文化的附庸违反了教育支持和发展包含民主在内的公共空间的重要社会规则.从汤姆斯·杰佛逊到约翰·杜威,再到C.赖特·米尔斯,赞颂教育对于民主公共生活的根本的重要性成为一个悠久的传统.     

Activism among older women in Quebec, Canada: changing the world after age 65

The aim of this article is to examine senior women's involvement experience in Quebec, Canada. Study results are based on a qualitative methodology, and shed light on family history and continuity in the involvement trajectory, diversity in terms of group type and involvement practices, and gender differences in involvement. The meaning that older women attribute to their involvement is also addressed, including attitudes toward feminism. The discussion highlights the extent to which older women's involvement has been marked by their life trajectories, above and beyond their age. In sum, their involvement in the private and public spheres is quite impressive.     

A model of substance abuse risk: adapting to the Sri Lankan context

This study translated and validated the Substance Use Risk Profile Scale (SURPS) among 13 to 18 year old Sri Lankan adolescents attending school. A standard systematic translation procedure was followed to translate the original SURPS into Sinhala language. A Delphi process was conducted to determine judgmental validity of Sinhala SURPS. Confirmatory factor analysis was performed to test the translated version against the original theoretical model of the SURPS. Test-retest and internal consistency were used to ensure reliability. A few terms in one of the items posed some difficulty in translating into Sinhala. Adequate judgmental validity was determined except for one item, which was modified to suit the Sri Lankan setting. The four subscales introversion/ hopelessness, impulsivity, sensation seeking and anxiety sensitivity showed satisfactory test-retest reliability estimates of .74, .68, .76, and .88, respectively. The Sinhala SURPS is applicable in Sri Lankan context. Several implications based on the results are discussed.     

荒唐父亲沉迷网络游戏，现实中的“秒杀”酿悲剧

2002年,随着单位效益一天天滑坡,曾相钱下岗了。感到生活无望的妻子和他离了婚,把两个儿子扔给了他。那时,曾相钱的大儿子曾强15岁,小儿子曾壮13岁;曾相钱又当爹又当娘,生活被搅成了一锅粥。