Exile Vol. XIX No. 2

POETRY speckled day by Richard Carothers 3 Looking-Glass by Doug Cox 3 February fog scooves in by H. 8 Surface Tension by Glenn Bard 9 Closing by Doug Cox 10 southwest bazaar by Val Evans 16 Haiku sequence By Suzanne B. Dean 17 summertime by Richard Carothers 18 The Desirability of Being a Line by Laurie Wharton 18 The Blatant Morning by Phil Mercurio 23 sweet nothings by Linda Anderson 23 Alone In Bed by Val Evans 24 Walls and the Fallen Woman by H. 26-27 A Victim of Need by Suzanne B. Dean 28 PHOTOGRAPHY by Tamera Iverson 1, 18 by John Bildahl 9, 15 by Anne G. English 25 by Richard E. Bergen 27 by Bruce Andre 28 ARTWORK The Road to Calvary by Sheila Rollit 4 Norwegian Sadness by Tamera Iverson 11 by Ann Merrill 16 by Jude Hasel 17 by Pat Victory 22 by Wilson R. Baldridge 26 FICTION To My Grandmother by Robb Knuepfer 5-8 First Monday in July by Joe L. Bolster III 12-14 Glad About A Lot Today by John Fergus 19-22 A city stands by Suzanne B. Dean 24-2

Admixture between ancient lineages, selection, and the formation of sympatric stickleback species-pairs

Ecological speciation has become a popular model for the development and maintenance of reproductive isolation in closely related sympatric pairs of species or ecotypes. An implicit assumption has been that such pairs originate (possibly with gene flow) from a recent, genetically homogeneous ancestor. However, recent genomic data have revealed that currently sympatric taxa are often a result of secondary contact between ancestrally allopatric lineages. This has sparked an interest in the importance of initial hybridization upon secondary contact, with genomic reanalysis of classic examples of ecological speciation often implicating admixture in speciation. We describe a novel occurrence of unusually well-developed reproductive isolation in a model system for ecological speciation: the three-spined stickleback (Gasterosteus aculeatus), breeding sympatrically in multiple lagoons on the Scottish island of North Uist. Using morphological data, targeted genotyping, and genome-wide single-nucleotide polymorphism data, we show that lagoon resident and anadromous ecotypes are strongly reproductively isolated with an estimated hybridization rate of only ∼1%. We use palaeoecological and genetic data to test three hypotheses to explain the existence of these species-pairs. Our results suggest that recent, purely ecological speciation from a genetically homogeneous ancestor is probably not solely responsible for the evolution of species-pairs. Instead, we reveal a complex colonization history with multiple ancestral lineages contributing to the genetic composition of species-pairs, alongside strong disruptive selection. Our results imply a role for admixture upon secondary contact and are consistent with the recent suggestion that the genomic underpinning of ecological speciation often has an older, allopatric origin

Pelvic floor muscle training for female urinary incontinence: development of a programme theory from a longitudinal qualitative case study

BackgroundUrinary incontinence (UI) negatively affects the well-being of women globally. Pelvic Floor Muscle Training (PFMT) is a complex intervention that aims to decrease UI symptoms. Information about how the multiple complex components involved in PFMT achieve and maintain the desired effect are rarely studied as a whole. The evidence base lacks data about how women experience PFMT over time and in the longer-term. This study explored women’s experiences of biofeedback-assisted PFMT and PFMT alone, to identify and understand what influenced self-reported adherence to PFMT, and UI outcomes over time.MethodsThis rigorous longitudinal qualitative case study, nested within a randomised controlled trial, recruited forty cases (women with stress or mixed UI; 20 in biofeedback-assisted and 20 in PFMT alone group). A case included up to four semi-structured interviews with each woman (prior to starting PFMT, end of treatment [6 months], 12 months, 24 months). Analysis followed case study analytic traditions, resulting in a Programme Theory about PFMT from the perspectives of women with UI.FindingsThe theory demonstrates factors that motivated women to seek UI treatment, and how these influenced long-term adherence. Therapists who delivered PFMT played a crucial role in supporting women to know how to undertake PFMT (to have capability). Some, but not all, women developed self-efficacy for PFMT. Where women did not have PFMT self-efficacy, adherence tended to be poor. When women had PFMT self-efficacy, the conditions to support adherence were present, but contextual factors could still intercede to inhibit adherence. The intercession of contextual factors was individual to a woman and her life, meaning any particular contextual factor had inconsistent influences on PFMT adherence over time for individual women and exerted varying influences across different women.ConclusionLong term adherence to PFMT is a complex interaction between many different factors. Enquiring about an individual woman’s motivation to seek treatment and understanding the contextual factors that affect an individual woman will enable a practitioner to support longer-term adherence

Evaluation of a program to educate disadvantaged parents to enhance child learning

Abstract This study reported a pilot trial of the Hands-On Parent Empowerment (HOPE) program, a 30-session program designed to instruct parents from disadvantaged backgrounds how to teach learning skills to their preschool children. The participants included 13 parents who newly migrated into Hong Kong from mainland China. The parents were required to complete questionnaires on child behavior problems, parental stress, social support, and self-efficacy before, during, and after intervention. The children were assessed on the Wechsler Preschool and Primary Scale of Intelligence-Revised and the Peabody Picture Vocabulary Test before and after intervention. The results indicated a significant decrease in parent-reported child behavior problems and parental stress, an increase in Performance IQ and vocabulary knowledge among the children. These improvements were also observed by preschool principals. The pilot experience provides insights for social work practice in terms of inter-sectoral collaboration, program content, duration, and intensity in early support for challenged families

Qualitative Studies Linked to Trials of Complex Interventions: what does case study methodology have to offer

PosterOutput Type: Poste

Orbital leiomyosarcoma metastasis presenting prior to diagnosis of the primary tumor.

Leiomyosarcomas, neoplasms of smooth muscle, are rarely found within the orbit. Orbital leiomyosarcoma may be primary, metastatic, or secondary to radiation. When they are metastatic, patients almost exclusively have a history of a primary leiomyosarcoma, often occurring in the spermatic cord, skin, gastrointestinal tract, or the uterus. We present the case of 48-year-old woman who presented with a metastatic orbital leiomyosarcoma, which was identified before the primary tumor