A Delphi study to validate competency-based criteria to assess undergraduate midwifery students' competencies in the maternity ward

Background: workplace learning plays a crucial role in midwifery education. Twelve midwifery schools in Flanders (Belgium) aimed to implement a standardised and evidence-based method to learn and assess competencies in practice. This study focuses on the validation of competency-based criteria to guide and assess undergraduate midwifery students’ postnatal care competencies in the maternity ward. Method: an online Delphi study was carried out. During three consecutive sessions, experts from workplaces and schools were invited to score the assessment criteria as to their relevance and feasibility, and to comment on the content and their formulation. A descriptive quantitative analysis, and a qualitative thematic content analysis of the comments were carried out. A Mann-Whitney U-test was used to investigate diferences between expert groups. Findings:eleven competencies and fifty-six assessment criteria were found appropriate to assess midwifery students’ competencies in the maternity ward. Overall median scores were high and consensus was obtained for all criteria, except for one during the first round. Although all initial assessment criteria (N=89) were scored as relevant, some of them appeared not feasible in practice. Little difference was found between the expert groups. Comments mainly included remarks about concreteness and measurability. Conclusion: this study resulted in validated criteria to assess postnatal care competencies in the maternity ward

Decision Support System Mine -The Management Model

The Decision Support System MINE has been developed for the analysis of regional water policies in open-pit lignite mining areas. It is based on a two-level model approach. The first-level planning model is used for the estimation of rational strategies of long-term development applying dynamic multi-criteria analysis. Therefor simplified submodels are used for a rough time discretization (yearly time steps and larger). The second-level management model considers managerial/operational aspects for shorter time steps (monthly and yearly) employing more comprehensive submodels. It is a classic simulation model. For selected submodels stochastic simulation (Monte Carlo method) is used in order to consider random inputs (e.g. hydrological inflow and water demand). This model serves for the verification of strategies obtained in the planning model, for the verification of simplified submodels used in the first-level model, and for the specification of strategies. Starting with the description of the position of the management model within the DSS MINE the structure of the management model is given. The used submodels for surface water/groundwater interaction and water quality are described. In the Appendix computer subroutines of some submodels are given being suitable for a more general application

Reduction of female copulatory damage by resilin represents evidence for tolerance in sexual conflict

Intergenomic evolutionary conflicts increase biological diversity. In sexual conflict, female defence against males is generally assumed to be resistance, which, however, often leads to trait exaggeration but not diversification. Here, we address whether tolerance, a female defence mechanism known from interspecific conflicts, exists in sexual conflict. We examined the traumatic insemination of female bed bugs via cuticle penetration by males, a textbook example of sexual conflict. Confocal laser scanning microscopy revealed large proportions of the soft and elastic protein resilin in the cuticle of the spermalege, the female defence organ. Reduced tissue damage and haemolymph loss were identified as adaptive female benefits from resilin. These did not arise from resistance because microindentation showed that the penetration force necessary to breach the cuticle was significantly lower at the resilin-rich spermalege than at other cuticle sites. Furthermore, a male survival analysis indicated that the spermalege did not impose antagonistic selection on males. Our findings suggest that the specific spermalege material composition evolved to tolerate the traumatic cuticle penetration. They demonstrate the importance of tolerance in sexual conflict and genitalia evolution, extend fundamental coevolution and speciation models and contribute to explaining the evolution of complexity. We propose that tolerance can drive trait diversity

Nichtokulomotorische Augenbeteiligung bei Möbius-Sequenz

Zusammenfassung: Die Möbius-Sequenz betrifft nicht nur die Okulomotorik, sondern auch die Augen selbst. Das Sehen der Patienten kann durch das Syndrom erheblich beeinträchtigt sein. Daher bedarf es regelmäßiger augenärztlicher Kontrolle

Diagnose und Therapie okulomotorischer Defizite bei Patienten mit Möbius-Sequenz

Zusammenfassung: Der Artikel gibt einen Überblick über das Spektrum möglicher Motilitätseinschränkungen und Stellungsanomalien der Augen bei Patienten mit Möbius-Sequenz. Die augenmuskelchirurgischen Behandlungsoptionen werden diskutiert und es wird ein operatives Stufenschema vorgestell

Associations between coronal mass ejections and interplanetary shocks

Nearly continuous complementary coronal observations and interplanetary plasma measurements for the years 1979-1982 are compared. It is shown that almost all low latitude high speed coronal mass ejections (CME's) were associated with shocks at HELIOS 1. Some suitably directed low speed CME's were clearly associated with shocks while others may have been associated with disturbed plasma (such as NCDE's) without shocks. A few opposite hemisphere CME's associated with great flares seem to be associated with shocks at HELIOS

Effects of windbreak species and mulching on wind erosion and millet yield in the Sahel

In an on-station agroforestry experiment conducted in south-west Niger, the effects of seven windbreak species and of a soil mulch made from crop residue on wind erosion and pearl millet (Pennisetum glaucum) production were monitored. Within a distance of 20 m, strips of the perennial grass, Andropogon gayanus, reduced total annual soil flux by 6–55% and hedges of Bauhinia rufescens 2 m in height reduced soil flux by 47–77% compared with unsheltered control plots. No significant overall windbreak effect on millet stover and grain yields was found. In contrast, erosion reduction and yield increases due to mulch application were highly significant. Soil mulch is a promising alternative to complex windbreak–millet cropping systems in regions where direct economic benefits for farmers are not ensured by windbreak