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.     

The Collegiate Learning Assessment: facts and fantasies

The Collegiate Learning Assessment (CLA) is a computer administered, open-ended (as opposed to multiple-choice) test of analytic reasoning, critical thinking, problem solving, and written communication skills. Because the CLA has been endorsed by several national higher education commissions, it has come under intense scrutiny by faculty members, college administrators, testing experts, legislators, and others. This article describes the CLA's measures and what they do and do not assess, how dependably they measure what they claim to measure, and how CLA scores differ from those on other direct and indirect measures of college student learning. For instance, analyses are conducted at the school rather than the student level and results are adjusted for input to assess whether the progress students are making at their school is better or worse than what would be expected given the progress of "similarly situated" students (in terms of incoming ability) at other colleges.     

Factors associated with 'feeling suicidal': the role of sexual identity

This paper examines factors associated with feeling suicidal in a large sample of urban men in Sydney and Melbourne, aged 18-50, including heterosexual, gay and bisexual men, HIV antibody positive and HIV antibody negative. As in previous research, sexuality (being homosexual or bisexual) was found to be a major predictor of suicidality. The research went some way towards explaining the close relationship between feeling suicidal and sexual orientation. Sexuality interacts with feeling bad in that, once men feel moderately bad/depressed, they are more likely to feel suicidal if they are homosexual or bisexual than if they are heterosexual. In addition, the research found that experience of verbal abuse and physical assault (harassment) increased feeling suicidal for both heterosexual and gay/bisexual men, not just for homosexual men as suggested by previous research, and that social isolation in the form of living alone is a further risk factor. Seeking counseling help and taking sexual risks were also independently associated with feeling suicidal. These actions may result from feeling suicidal rather than the reverse, and their association with feeling suicidal warrants further research. Many of the 46 independent variables examined in the research, including HIV antibody status and closeness to the HIV/ AIDS epidemic, were related to feeling suicidal only through their association with being gay/bisexual. Celibacy and general risk taking were not related to feeling suicidal in this study.     

Discrimination of SM-identified individuals

The belief that sadomasochism (SM) is violence or abusive behavior has resulted in harassment, physical attacks, and discrimination against SM-identified individuals. Historically, they were often opposed by self-identified feminists. One reason the women who practiced SM were targeted was the official opposition to sadomasochistic practices promulgated by the National Organization for Women (NOW). Current statistics of incidents of discrimination, harassment and physical attacks against SM-identified individuals and SM groups are compiled by the National Coalition for Sexual Freedom (NCSF).     

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.     

从五个方面介绍海明威

雅克·巴赞在他一九四五年所著的《美国教师》一书中主张,为了鼓励年轻人阅读,应该允许他们有什么书就读什么书。他还说即使是劣等怍品也是好的。此话也许有道理,但在很多情况下,向年轻的读者介绍一位象海明威那样身分的作家,对他们阅读的开始阶段会有更好的影响。海明威大概是世界范围内作品流传最广、最受尊敬的二三位作家之一,把他的作品作为阅读的起点,可谓终身的乐趣和享受。结合以下五个方面对海明威的介绍,初读者可以加深对他作品的理解。