Prevalence of Urinary Incontinence and Probable Risk Factors in a Sample of Kurdish Women

Objectives: The most common manifestation of pelvic floor dysfunction is urinary incontinence (UI) which affects 15–50% of adult women depending on the age and risk factors of the population studied. The aim of this study was to determine the probable risk factors associated with UI; the characteristics of women with UI; describe the types of UI, and determine its prevalence. Methods: A cross-sectional study was conducted between February and August 2011, in the Maternity Teaching Hospital of the Erbil Governorate, Kurdistan Region, northern Iraq. It included 1,107 women who were accompanying patients admitted to the hospital. A questionnaire designed by the researchers was used for data collection. A chi-square test was used to test the significance of the association between UI and different risk factors. Binary logistic regression was used, considering UI as the dependent variable. Results: The overall prevalence of UI was 51.7%. The prevalence of stress, urgency, and mixed UI was 5.4%, 13.3% and 33%, respectively. There was a significant positive association between UI and menopause, multiparity, diabetes mellitus (DM), chronic cough, constipation, and a history of gynaecological surgery, while a significant negative association was detected between UI and a history of delivery by both vaginal delivery and Caesarean section. Conclusion: A high prevalence of UI was detected in the studied sample, and the most probable risk factors were multiparity, menopausal status, constipation, chronic cough, and DM

Flow Equation for Supersymmetric Quantum Mechanics

We study supersymmetric quantum mechanics with the functional RG formulated in terms of an exact and manifestly off-shell supersymmetric flow equation for the effective action. We solve the flow equation nonperturbatively in a systematic super-covariant derivative expansion and concentrate on systems with unbroken supersymmetry. Already at next-to-leading order, the energy of the first excited state for convex potentials is accurately determined within a 1% error for a wide range of couplings including deeply nonperturbative regimes.Comment: 24 pages, 8 figures, references added, typos correcte

Extranodal Natural Killer/T-cell Lymphoma in a Child with a Prior History of Nasal Trauma: a Case Report

Introduction: Facial lesions usually have a benign self-limited prognosis, but in rare cases they have a poor outcome. Extranodal natural killer/T-cell lymphoma (ENK/TCL) is a rare aggressive lesion presenting with a midline facial lesion that can easily be misdiagnosed. Diagnosis is often difficult and requires a thorough clinical examination and the use of immunohistochemistry for analysis of biopsies. Such malignancies affecting the head and neck area provide an interesting but difficult diagnosis. The purpose of this article is to report a severe case of ENK/TCL-nasal type in a boy with a previous history of nasal trauma. Case presentation: An 11-year-old boy was referred to the maxillofacial unit of Sulaimany Teaching Hospital, Iraq, with midline facial destruction. The patient stated that about 6 months prior he had fallen down and suffered nasal trauma; 3 months after the trauma, an asymptomatic ulcer appeared and gradually increased in size. Two biopsies were performed with no conclusive results. In the third biopsy, histology showed atypical lymphoid tissue surrounded by intense necrosis. The diagnosis was confirmed by immunohistochemistry. The treatment of choice was chemotherapy followed by radiotherapy. The patient had a satisfactory response but 2 months later during chemotherapy the patient unfortunately died from a pulmonary embolism. Conclusion: Suspicious midline ulcerative lesions in the head and neck region must have ENK/TCL considered in the differential diagnosis and repeated biopsies may be necessary to confirm the diagnosis

Extranodal Natural Killer/T-cell Lymphoma in a Child with a Prior History of Nasal Trauma: a Case Report

Introduction: Facial lesions usually have a benign self-limited prognosis, but in rare cases they have a poor outcome. Extranodal natural killer/T-cell lymphoma (ENK/TCL) is a rare aggressive lesion presenting with a midline facial lesion that can easily be misdiagnosed. Diagnosis is often difficult and requires a thorough clinical examination and the use of immunohistochemistry for analysis of biopsies. Such malignancies affecting the head and neck area provide an interesting but difficult diagnosis. The purpose of this article is to report a severe case of ENK/TCL-nasal type in a boy with a previous history of nasal trauma. Case presentation: An 11-year-old boy was referred to the maxillofacial unit of Sulaimany Teaching Hospital, Iraq, with midline facial destruction. The patient stated that about 6 months prior he had fallen down and suffered nasal trauma; 3 months after the trauma, an asymptomatic ulcer appeared and gradually increased in size. Two biopsies were performed with no conclusive results. In the third biopsy, histology showed atypical lymphoid tissue surrounded by intense necrosis. The diagnosis was confirmed by immunohistochemistry. The treatment of choice was chemotherapy followed by radiotherapy. The patient had a satisfactory response but 2 months later during chemotherapy the patient unfortunately died from a pulmonary embolism. Conclusion: Suspicious midline ulcerative lesions in the head and neck region must have ENK/TCL considered in the differential diagnosis and repeated biopsies may be necessary to confirm the diagnosis

Conservation tillage in organic farming

Organic farmers are interested in adopting conservation tillage to preserve soil quality and fertility and to prevent soil erosion. Within the framework of a French national study, we compared conventional (ploughing) and conservation tillage systems in organic farming for arable and vegetable cropping systems. Field experiments and on-farm surveys were conducted in several regions of France in order to assess the effects of different tillage systems on soil fertility (physical, chemical, biological) and on weed and crop development. Conservation tillage techniques induced a more compact soil, an increase of carbon and microorganisms in the first soil layer, and an increase of earthworm biomass for very superficial tillage. Weed control was only a major problem for the very superficial tillage, which in turn generated lower crop yields than conventional tillage. The main issues raised by this programme deal with the long-term effects of these techniques on soil fertility, and the improvement of conservation tillage techniques in organic farming

High-resolution microwave frequency dissemination on an 86-km urban optical link

We report the first demonstration of a long-distance ultra stable frequency dissemination in the microwave range. A 9.15 GHz signal is transferred through a 86-km urban optical link with a fractional frequency stability of 1.3x10-15 at 1 s integration time and below 10-18 at one day. The optical link phase noise compensation is performed with a round-trip method. To achieve such a result we implement light polarisation scrambling and dispersion compensation. This link outperforms all the previous radiofrequency links and compares well with recently demonstrated full optical links.Comment: 11 pages, 5 figure

A Qualitative Exploration of Community Ownership of a Maternity Waiting Home Model in Rural Zambia

Context Ownership is an important construct of sustainability for community-based health programming, though it is often not clearly defined or measured. We implemented and evaluated a community-driven maternity waiting home (MWH) model in rural Zambia. We engaged stakeholders at all levels and provided intensive mentorship to an MWH governance committee comprised of community-selected members. We then examined how different stakeholders perceive community ownership of the MWH. Methods We conducted 42 focus group discussions with community stakeholders (pregnant women, fathers, elders, and community health volunteers) and 161 in-depth interviews with MWH stakeholders (health facility staff, district health officials, and MWH governance committee and management unit members) at multiple time-points over 24 months. We conducted a content analysis and triangulated findings to understand community ownership of the MWH and observe changes in perceptions of ownership over time. Results Community members’ perceptions of ownership were related to their ability to use the MWH and a responsibility toward its success. Community and MWH stakeholders described increasingly more specific responsibilities over time. Governance committee and management unit members perceived their ability to represent the community as a crucial component of their role. Multiple respondent types saw collaboration between the governance committee and the health facility staff as key to allowing the MWH to meet its goal of serving the community. Conclusion The perceptions of community ownership evolved as the intervention became more established. Use of the MWH, and clear understanding of roles and responsibilities in management of the MWH, seemed to foster feelings of community ownership. To improve the sustainability of community-based maternal and child health programs, interventions should be accessible to target communities and clear roles should be established among stakeholders

Long-distance frequency transfer over an urban fiber link using optical phase stabilization

We transferred the frequency of an ultra-stable laser over 86 km of urban fiber. The link is composed of two cascaded 43-km fibers connecting two laboratories, LNE-SYRTE and LPL in Paris area. In an effort to realistically demonstrate a link of 172 km without using spooled fiber extensions, we implemented a recirculation loop to double the length of the urban fiber link. The link is fed with a 1542-nm cavity stabilized fiber laser having a sub-Hz linewidth. The fiber-induced phase noise is measured and cancelled with an all fiber-based interferometer using commercial off the shelf pigtailed telecommunication components. The compensated link shows an Allan deviation of a few 10-16 at one second and a few 10-19 at 10,000 seconds

Vegetation sensors as a tool for plant population identification and corn grain yield estimation.

Absract: The estimated corn grain yield is dependent on plant density and should be monitored from the beginning of its development, especially between the phenological stages V3 and V10, since these stages are more responsive to management strategies. This study aimed to evaluate the efficiency of two methods [normalized difference vegetation index (NDVI) and plant occupation index (POI)] to estimate the density of corn plants, in order to identify the plant population in different phenological stages and corn grain yield. Two field experiments were conducted in two crop seasons and treatments consisted of four plant densities (4, 6, 8 and 10 plants m-2). The NDVI measurements of the vegetative canopy were performed in the growth stages V4, V5, V6, V7, V8 and V9 (2014) and V3, V5, V6, V8, V9, V10 and V13 (2015/2016). For the POI, the measurements were performed in the stages V5, V6, V8 and V9, in both crop seasons. The different plant densities were efficient in generating variability in the NDVI and POI values throughout the corn crop development cycle, and both tools were efficient in identifying density variations. It was observed that these tools should be used between the V4 and V9 growth stages. KEYWORDS: Zea mays L., normalized difference vegetation index, plant occupation index. Resumo: Sensores de vegetação como ferramenta para identificação de população de plantas e estimativa de produtividade de grãos de milho A produtividade estimada de grãos do milho é dependente a densidade de plantas e deve ser monitorada desde o início de seu desenvolvimento, principalmente entre os estágios fenológicos V3 e V10, visto que são mais responsivos a estratégias de manejo. Objetivou-se avaliar a eficiência de dois métodos [índice de vegetação por diferença normalizada (NDVI) e índice de ocupação de plantas (POI)] para estimar a densidade de plantas de milho, a fim de identificar a população de plantas em diferentes estádios fenológicos e a produtividade de grãos de milho. Dois experimentos de campo foram conduzidos em duas safras agrícolas e os tratamentos consistiram em quatro densidades de plantas (4, 6, 8 e 10 plantas m-²). As medições de NDVI do dossel vegetativo foram realizadas nos estágios de crescimento V4, V5, V6, V7, V8 e V9 (2014) e V3, V5, V6, V8, V9, V10 e V13 (2015/2016). Para o POI, as medições foram realizadas nos estádios V5, V6, V8 e V9, em ambas as safras. As diferentes densidades de plantas foram eficientes em gerar variabilidade nos valores de NDVI e POI ao longo do ciclo de desenvolvimento da cultura, e ambas as ferramentas foram eficientes para identificar as variações na densidade. Verificou-se que essas ferramentas devem ser utilizadas entre os estádios de crescimento V4 e V9. PALAVRAS-CHAVE: Zea mays L., índice de vegetação por diferença normalizada, índice de ocupação de plantas

Evaluating implementation effectiveness and sustainability of a maternity waiting homes intervention to improve access to safe delivery in rural Zambia: A mixed-methods protocol

Background: In low-income countries such as Zambia, where maternal mortality rates are persistently high, maternity waiting homes (MWHs) represent one potential strategy to improve access to safe delivery, especially for women living in remote areas. The Maternity Homes Access in Zambia project (MAHMAZ) is evaluating the impact of a MWH model on women’s access to safe delivery in rural Zambia. There is a growing need to understand not only the effectiveness of interventions but also the effectiveness of their implementation in order to appropriately interpret outcomes. There is little evidence to guide effective implementation of MWH for both immediate uptake and to promote sustainability in this context. This protocol describes a study that aims to investigate the effectiveness of the implementation of MAHMAZ by not only documenting fidelity but also identifying factors that influence implementation success and affect longer-term sustainability. Methods: This study will use mixed methods to evaluate the implementation effectiveness and sustainability of the MAHMAZ intervention. In our study, “implementation effectiveness” means to expand beyond measuring fidelity to the MWH model and includes assessing both the adoption and uptake of the model and identifying those factors that facilitate or inhibit uptake. Sustainability is defined as the routine implementation of an intervention after external support has ended. Quantitative methods include extracting data from existing records at the MWHs and health facilities to analyze patterns of utilization, and conducting a routine health facility assessment to determine facility-level factors that may influence MWH implementation and woman-level outcomes. We will also conduct an experience survey with MWH users and apply a checklist to assess fidelity to the MWH model. Qualitative methods include in-depth interviews and focus group discussions with MWH users, community members and other stakeholders. Qualitative data will be analyzed using an integrated framework drawing constructs from the Consolidated Framework for Implementation Research and the Conceptual Framework for Sustainability. Discussion: The findings from this evaluation will be shared with policymakers formulating policy affecting the implementation of MWH and may be used as evidence for programmatic decisions by the government and supporting agencies in deciding to take this model to scale