New postnatal urinary incontinence: obstetric and other risk factors in primparae.

Objective To identify obstetric and other risk factors for urinary incontinence which occurs during pregnancy or after childbirth. Design Questionnaire survey of women. Setting Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand). Population 3405 primiparous women with singleton births delivered during one year. Methods Questionnaire responses and obstetric casenote data were analysed using multivariate analysis to identify associations with urinary incontinence. Main outcome measures Urinary incontinence at three months after delivery first starting in pregnancy or after birth. Results The prevalence of urinary incontinence was 29%. New incontinence first beginning after delivery was associated with higher maternal age (oldest versus youngest group, odds ratio, OR 2.02, 95% CI 1.35 to 3.02); and method of delivery (caesarean section versus spontaneous vaginal delivery, OR 0.28, 95% CI 0.19 to 0.41). There were no significant associations with forceps delivery (OR 1.18, 95% CI 0.92 to 1.51) or vacuum delivery (OR 1.16, 95% CI 0.83 to 1.63). Incontinence first occurring during pregnancy and still present at three months was associated with higher maternal body mass index (BMI > 25, OR 1.68, 95% CI 1.16 to 2.43), and heavier babies (birthweight in top quartile, OR 1.56, 95% CI 1.12 to 2.19). In these women, caesarean section was associated with less incontinence (OR 0.39, 95% CI 0.27 to 0.58) but incontinence was not associated with age. Conclusions Women have less urinary incontinence after a first delivery by caesarean section whether or not that first starts during pregnancy. Older maternal age was associated with new postnatal incontinence, and higher body mass index and heavier babies with incontinence first starting during pregnancy. The effect of further deliveries may modify these findings

Integrating Species Traits into Species Pools

Despite decades of research on the species‐pool concept and the recent explosion of interest in trait‐based frameworks in ecology and biogeography, surprisingly little is known about how spatial and temporal changes in species‐pool functional diversity (SPFD) influence biodiversity and the processes underlying community assembly. Current trait‐based frameworks focus primarily on community assembly from a static regional species pool, without considering how spatial or temporal variation in SPFD alters the relative importance of deterministic and stochastic assembly processes. Likewise, species‐pool concepts primarily focus on how the number of species in the species pool influences local biodiversity. However, species pools with similar richness can vary substantially in functional‐trait diversity, which can strongly influence community assembly and biodiversity responses to environmental change. Here, we integrate recent advances in community ecology, trait‐based ecology, and biogeography to provide a more comprehensive framework that explicitly considers how variation in SPFD, among regions and within regions through time, influences the relative importance of community assembly processes and patterns of biodiversity. First, we provide a brief overview of the primary ecological and evolutionary processes that create differences in SPFD among regions and within regions through time. We then illustrate how SPFD may influence fundamental processes of local community assembly (dispersal, ecological drift, niche selection). Higher SPFD may increase the relative importance of deterministic community assembly when greater functional diversity in the species pool increases niche selection across environmental gradients. In contrast, lower SPFD may increase the relative importance of stochastic community assembly when high functional redundancy in the species pool increases the influence of dispersal history or ecological drift. Next, we outline experimental and observational approaches for testing the influence of SPFD on assembly processes and biodiversity. Finally, we highlight applications of this framework for restoration and conservation. This species‐pool functional diversity framework has the potential to advance our understanding of how local‐ and regional‐scale processes jointly influence patterns of biodiversity across biogeographic regions, changes in biodiversity within regions over time, and restoration outcomes and conservation efforts in ecosystems altered by environmental change

The Tully-Fisher Relation of Barred Galaxies

We present new data exploring the scaling relations, such as the Tully-Fisher relation (TFR), of bright barred and unbarred galaxies. A primary motivation for this study is to establish whether barredness correlates with, and is a consequence of, virial properties of galaxies. Various lines of evidence suggest that dark matter is dominant in disks of bright unbarred galaxies at 2.2 disk scale lengths, the point of peak rotation for a pure exponential disk. We test the hypothesis that the TF plane of barred high surface brightness galaxies is offset from the mean TFR of unbarred galaxies, as might be expected if barred galaxies are ``maximal'' in their inner parts. We use existing and new TF data to search for basic structural differences between barred and unbarred galaxies. Our new data consist of 2-dimensional Halpha velocity fields derived from SparsePak integral field spectroscopy (IFS) and V,I-band CCD images collected at the WIYN Observatory for 14 strongly barred galaxies. We use WIYN/SparsePak (2-D) velocity fields to show that long-slit (1-D) spectra yield reliable circular speed measurements at or beyond 2.2 disk scale lengths, far from any influence of the bar. This enables us to consider line width measurements from extensive TF surveys which include barred and nonbarred disks and derive detailed scaling relation comparisons. We find that for a given luminosity, barred and unbarred galaxies have comparable structural and dynamical parameters, such as peak velocities, scale lengths, or colors. In particular, the location of a galaxy in the TF plane is independent of barredness. In a global dynamical sense, barred and unbarred galaxies behave similarly and are likely to have, on average, comparable fractions of luminous and dark matter at a given radius. (abridged)Comment: Accepted for publication in the ApJ (September 1, 2003 issue, v594). Appendix figures with I-band image and superimposed 2-D velocity field plus rotation curves must be downloaded separately (due to size constraints) from http://www.astro.ubc.ca/people/courteau/public/courteau03_TFbars.ps.g

Persistent urinary incontinence and delivery mode history: a six-year longitudinal study.

Objective: To investigate the prevalence of persistent and long term postpartum urinary incontinence and associations with mode of first and subsequent delivery. Setting: Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand). Design: Longitudinal study Population: 4214 women who returned postal questionnaires 3 months and 6 years after the index birth. Methods: Symptom data were obtained from both questionnaires and obstetric data from case-notes for the index birth and the second questionnaire for subsequent births. Logistic regression investigated the independent effects of mode of first delivery and delivery mode history. Main outcome measures: Urinary incontinence – persistent (at 3 months and 6 years after index birth) and long-term (at 6 years after index birth). Results: The prevalence of persistent urinary incontinence was 24%. Delivering exclusively by Caesarean section was associated with both less persistent (OR= 0.46, 95% CI 0.32 to 0.68) and long term urinary incontinence (OR=0.50, 95% CI 0.40 to 0.63). Caesarean section birth in addition to vaginal delivery however was not associated with significantly less persistent incontinence (OR 0.93, 95%CI 0.67 to 1.29). There were no significant associations between persistent or long-term urinary incontinence and forceps or vacuum extraction delivery. Other significantly associated factors were increasing number of births and older maternal age. Conclusions: The risk of persistent and long term urinary incontinence is significantly lower following Caesarean section deliveries but not if there is another vaginal birth. Even when delivering exclusively by Caesarean section, the prevalence of persistent symptoms (14%) is still high

Using Technology to Engage Preservice Elementary Teachers in Learning about Scientific Inquiry

Elementary teachers are often required to teach inquiry in their classrooms despite having had little exposure to inquiry learning themselves. In a capstone undergraduate science course preservice elementary teachers experience scientific inquiry through the completion of group projects, activities, readings and discussion, in order to develop a sense of how inquiry learning takes place. At the same time, they learn science content necessary for teacher licensure. The course exposes students to different pathways of scientific discovery and to the use of the computer both as a tool for conducting inquiry-based investigations and as a means of collecting and sharing student opinions. The students involved have many misconceptions about science and it is often difficult for them to distinguish science from pseudoscience. Computer simulations are used to help students understand that difference. In addition, a classroom response system using “clickers” is used to poll studentopinions on controversial issues and to stimulate discussion

Trophicâ specific responses to migration in empirical metacommunities

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154529/1/oik12963.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154529/2/oik12963_am.pd

"It's like being the hero of your own story": perceptions of musical skill development for the beginner cellist

Background: When children commence learning a musical instrument, they are introduced to a diverse range of skills from the cognitive, expressive and psychomotor domains. Children’s capacity to adopt and integrate these musical skills can directly affect their progress and influence ongoing interest. However, as many of these skills are unfamiliar to the beginner musician, their development requires specialised support, deliberate attention and focussed practice. The outcomes of these learning processes can also be a critical to children’s future musical engagement. Children’s lived experience of musical instrument skill acquisition is rarely examined in music education research; therefore, the current paper adopts a novel case study approach to investigate how children perceive and manage musical skill development. Intrapersonal factors and interpersonal relationships including those with the teacher, who is the principal researcher, are also examined. Aims: 1. To investigate seven-year-old children’s lived experience of cello skill development within the first 18-months of tuition. 2. To investigate how children’s musical skill development is affected by intrapersonal factors and interpersonal relationships. 3. To investigate how the experience and perceptions of skill development in early learning influences children’s longer-term musical engagement. Method: Through a longitudinal Action Research methodology, 14 seven-year-old children’s lived experiences of learning the cello were tracked across the first 18-months of tuition. Interpretative Phenomenological Analysis of interviews with the children and their parents were integrated with the teacher-researcher’s recorded observations from work with the children. Results: During the early stages of learning, children prioritised the development of skills in one of the three learning domains and this was attributed to initial competencies and affinities at the beginner level. As tuition progressed, teaching and learning challenges included ensuring that all skill sets developed according to the children’s individual, differentiated needs. Central to this developmental process was how the children’s intrapersonal factors interacted with their interpersonal relationships to shape their learning behaviour at home and in the instrumental music studio. Regardless of skill level or ability, all of the children measured their process in musical skill development through critical evaluation of their sound production. The children’s sophisticated perception of sound included discerning nuanced difference in quality of tone, intonation, volume, fluency and timbre. Production of an ideal sound that integrated these qualities was described as an aspirational goal in practice and performance. Sound was perceived also by the children as a powerful conduit for self-expression and musical communication. In this context, musical skill development fulfilled children’s creative needs and satisfied their desire to be seen and hear by others as capable musicians. This result generated growth in the children’s sense of agency and autonomy. When the complex process of skill attainment, sound production and musical expression was achieved successfully, students experienced transformed representations of their internal selves that positively impacted their emotional states. These transformative experiences were linked to a close affinity with their cello and this was evidenced by the children’s use of language devices such as metaphor, simile, analogy and imaginative narrative to describe how skill development strengthened their bond with the instrument. Further, some children ascribed anthropomorphic traits to their instruments, defining them as a person or ally and assigning names and gender pronouns. Investigation of students’ learning over time indicated that children who experienced beneficial interpersonal growth and productive interpersonal relationships through musical skill development maintained active longer-term musical engagement. These children described imagining themselves in positive performance and learning environments in their projected musical futures. Taken together, the findings from this investigation of children’s perceptions of musical skill development highlight how instrumental music learning can profoundly affect children’s inner worlds. The breadth and depth of the experience contributed to the children’s enjoyment in engagement and affected motivation to continue with their musical development. Conclusions: This research, conducted by the teacher as researcher, makes a unique contribution to the literature by identifying the importance of children’s perception of sound in the process of cognitive, physical and emotional engagement with musical skill development. It identifies how this can have a transformative effect on a child’s sense of self and influence their future musical engagement. Implications: Monitoring children’s perception of sound production and its impact on musical expression in the development of skills in the three learning domains is integral to instrumental music teaching and fosters meaningful, ongoing engagement outcomes

Malaria Control in Complex Humanitarian Emergencies

War, famine, civil conflict, and political persecution displacing large populations often leads to severe disruptions in health services, disease control programs, food distribution systems, and loss of shelter. When the dimensions of the crisis overwhelm the local and international communities' ability to respond quickly and effectively, significant morbidity and mortality result in what is termed a complex humanitarian emergency. The public health consequences have been most severe in underdeveloped nations where most deaths are caused by communicable diseases, which include malaria. This paper describes and analyses the factors that contribute to malaria morbidity and mortality and proposes effective measures to combat them.Les conflits armés, les famines, les guerres civiles, les persécutions politiques déplaçant de grandes portions de la population provoquent souvent de graves perturbations dans les services de santé, les programmes de contrôles sanitaires, les structures de distributions alimentaires, et entraînent fréquemment la perte du gîte ou de l'abris. Quand l'ampleur de la crise submerge les capacités locales et internationales à y répondre promptementet efficacement, le résultat de ce que l'on appelle une urgence humanitaire complexe est un accroissement significatif de la condition maladive et de la mortalité des populations en cause. Les conséquences en termes de santé publique sont particulièrement graves dans les nations sous-développées, où un plus grand nombre de pertes de vie sont dues à des maladies transmissibles, incluant notamment la malaria. Cet article décrit et analyse la série de facteurs contribuant à la condition maladive et à la mortalité liés à la malaria, et propose des mesures effectives pour combattre ces facteurs

Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes : randomised controlled trial

© 2013 Royal College of Obstetricians and Gynaecologists. Funded by Royal College of Obstetricians and Gynaecologists, London, UK; Health Research Council of New Zealand. Grant Number: RG 819/06 New Zealand Lottery Grant Board Health Services Research Unit, University of Aberdeen Chief Scientist Office of the Scottish Government Health DirectoratesPeer reviewedPostprin