Why is prior consultation not yet an effective tool for conflict resolution? : the case of Peru

Objective. To evaluate whether preoperative vaginal preparation routines influence postoperative infectious morbidity in vaginal hysterectomy and to analyze risk factors for postoperative infectious morbidity. Design. Retrospective, longitudinal cohort study. Setting. Forty -three hospitals in Sweden, participating in the Swedish National Register for Gynecological Surgery. Population. All 6,496 women who were enrolled in the Register and underwent vaginal or laparoscopically assisted vaginal hysterectomy between 1 January 2000 and 1 February 2008. Methods. Register data were collected prospectively using doctors forms and patient questionnaires. Information about vaginal preparation routines in the clinics were achieved retrospectively by an e-mail survey. Multiple logistic regression analyses models were used to determine associations and risk factors. Main outcome measures. Infectious morbidity within 6-8 weeks postoperatively. Results. No significant differences were seen in postoperative infectious morbidity in long term between vaginal preparation using saline or chlorhexidine solution or no cleansing. At discharge from hospital, those who had had vaginal cleansing using saline solution had a significantly higher risk of postoperative infections. Risk factors for infectious morbidity were young age, obesity, peroperative injury of the urinary bladder, operative time and duration of hospital stay. Protective were prophylactic antibiotics and concomitant prolapse surgery. Conclusions. Saline solution should not be used for vaginal cleansing due to a higher risk of infectious morbidity in the immediate postoperative period. Infectious morbidity may be reduced further by employing preventive measures such as meticulous surgical technique, preoperative weight reduction in obese women and minimizing time in hospital.Original Publication:Preben Kjölhede, Shefqet Halili and Mats Lofgren, Vaginal cleansing and postoperative infectious morbidity in vaginal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery, 2011, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, (90), 1, 63-71.http://dx.doi.org/10.1111/j.1600-0412.2010.01023.xCopyright: Informa Healthcarehttp://informahealthcare.com

Формування компетентностей студентів педагогічних вузів при навчанні основам інформаційних технологій

(uk) У статті розглядається компетентнісний підхід, що полягає в набутті та розвитку у студентів набору ключових, загальногалузевих, предметних, професійних та інформаційних компетентностей.(ru) В статье рассматривается компетентносный подход, который заключается в приобретении и развитии у студентов набора ключевых, общеотраслевых, предметных, профессиональных и информационных компетентностей

Micromechanistic analysis of fatigue in aluminium silicon casting alloys

Due to increasingly stringent environmental legislation, there is a requirement for lower emissions and greater overall efficiency of light vehicle diesel (LVD) engines. This continues to be achieved through the optimisation of design and careful selection of the materials used in key LVD engine components, for example pistons, so that they are lighter and can operate at higher temperatures. Pistons are non-serviceable parts and so must be able to withstand the fatigue and high temperature environment of the car engine. It is therefore important to understand the mechanisms of fatigue in these alloys to help inform alloy development for the next generation of pistons. Pistons are typically produced from multi-component Al-Si casting alloys. These alloys exhibit a complex, multiphase microstructure comprising α-aluminium as the matrix with silicon particles and several intermetallic phases. Previous research on Al-Si casting alloys has demonstrated that porosity is detrimental to fatigue life as cracks initiate freely at pores. However, with improved casting techniques porosity can be greatly reduced and other microstructural features influence fatigue life. In particular, Si particles have been shown to play an important role in the initiation and subsequent propagation of fatigue cracks. This study assesses the role of Si content and other microstructural features on fatigue behaviour by testing a set of well-characterised multi-component, Al-Si casting alloys with varying Si content. Fatigue initiation behaviour was investigated at room temperature using S-N and short fatigue crack growth experiments. Pores, Si particles and intermetallic phases were shown to cause fatigue crack initiation. In a 0.67wt% Si containing alloy, large-scale porosity was observed and was the foremost reason for fatigue initiation. In two alloys the Al9FeNi phase was observed to be the most detrimental hard particle causing fatigue crack initiation. Nanoindentation results showed that Al9FeNi had a lower hardness and higher modulus than Si and so Al9FeNi may be expected to fracture preferentially, consistent with the fatigue results. X-ray computed tomography demonstrated that all the alloys investigated contained a complex, interconnected, intermetallic sub-structure. As a result, the micromechanisms of fatigue are different to those in conventional particulate Al-Si alloys because particle fracture is required to ensure a level of crack continuity. At room temperature and 350˚C, and at low and high crack growth rates, the crack tip may be described as a diffuse region of micro-damage and intact ligaments. It is the extent of this damage in the alloys that controls the crack growth rates exhibited and simple trends between the Si content and roughness, reported for particulate systems, do not hold true in the alloys investigated in this study. The balance of the micromechanisms of fatigue was shown to be dependent on temperature. This highlights the importance of fatigue studies at temperatures that are characteristic of those experienced in service.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Long-term outcome of porcine skin graft in surgical treatment of recurrent pelvic organ prolapse. An open randomized controlled multicenter study

Objective. To determine the long-term objective and subjective outcomes of use of a porcine skin graft (Pelvicol(TM)) compared with conventional colporrhaphy in recurrent pelvic organ prolapse surgery and to analyze risk factors and safety. Design. Open randomized controlled multicenter study. Setting. Eight Swedish hospitals. Population. 135 consecutive women with recurrent cystocele and/or rectocele admitted for vaginal prolapse surgery; 132 completed the study, 64 were randomly allocated to receive conventional colporrhaphy and 68 to Pelvicol. Methods. Conventional anterior and posterior colporrhaphy and colporrhaphy with use of Pelvicol(TM) mesh reinforcement. Clinical evaluation by means of pelvic organ prolapse quantification (POP-Q) and symptom questionnaire preoperatively, three months and three years postoperatively. Main outcome measures. Anatomical and subjective outcome.? Recurrence was defined as POP-Q=stage 2. Results. At three-month follow-up, early recurrence/surgical failures occurred significantly more often in the Pelvicol(TM) group, but at the three-year follow-up the recurrence rates were similar. The recurrence rates in the anterior compartment were 5762% and 4423% in the posterior compartment for the colporrhaphy and Pelvicol(TM) groups, respectively. Symptoms were substantially and equally reduced in the two groups after surgery. Sexual activity and function did not seem to be affected adversely in any group. The complication rate was low. Risk factors for anatomical recurrence were age, body mass index and preoperative stage of the prolapse. Conclusions. With the surgical technique used in this study, Pelvicol(TM) did not provide advantages over conventional colporrhaphy in recurrent pelvic organ prolapse concerning anatomical and subjective outcomes

The use of didactic games in the language development of preschool children with mental developmental disturbances

Darbā tiek akcentēta bērna valodas veicināšanas iespējas izmantojot didaktiskās rotaļas. Šos jautājumus savos darbos apskatījuši un analizējuši daudzi pedagogi un psihologi: •bērnu ar garīgās attīstības traucējumiem pedagoģiskais un psiholoģiskais raksturojums – S. Liepiņa, Ļ. Vigotskis, K. Dēķens; •valodas attīstības sekmēšanas pedagoģiskie līdzekļi – R. Kaņepēja, Dz. Lieģeniece, V. Golubina, M. Montesori; •didaktiskās rotaļas un to nozīme valodas attīstībā bērniem ar garīgās attīstības traucējumiem – D. Elkoņins, Ļubļinska, M. Skatkins, S. Šmakovs. Veiktais darbs ļauj secināt, ka pārdomāti organizējot valodas attīstības nodarbības un izmantojot dažādas didaktiskās rotaļas, tiek attīstīta, bagātināta un pilnveidota valodas attīstība bērniem ar garīgās attīstības traucējumiem. Atslēgas vārdi: valoda, saskarsme, garīgās attīstības traucējumi, didaktiskā rotaļa, vide.The diploma work consists of three parts.The work emphasizes the opportunity to develop childs language with a help of didactic games. Many pedagogues and psychologist have touched upon and analyzed the points related to this theme: •Pedagogical and Psychological Characterization of Intellektualy challenged Children – S. Liepina, L. Vigotskis, K. Dekens; •Pedagogical Tools for Speech Development – R. Kanepeja, Dz. Liegeniece, V. Golubina, M. Montesori; •Didactic Games and their Significance in Language Development for Intellectually Chhallenged Children – D. Elkonin, A. Lublinska, Dz. Dzintare, M. Skarhins, S. Smakovs. From the work can be cocluded that language development for intellectually challenged children is enriched with – out and organized language development activities together with didactic role play. Keywords: Language, Impediments to Intellectual, Didctic (Role) Play, Impediments

Vaginal cleansing and postoperative infectious morbidity in vaginal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery

Objective. To evaluate whether preoperative vaginal preparation routines influence postoperative infectious morbidity in vaginal hysterectomy and to analyze risk factors for postoperative infectious morbidity. Design. Retrospective, longitudinal cohort study. Setting. Forty -three hospitals in Sweden, participating in the Swedish National Register for Gynecological Surgery. Population. All 6,496 women who were enrolled in the Register and underwent vaginal or laparoscopically assisted vaginal hysterectomy between 1 January 2000 and 1 February 2008. Methods. Register data were collected prospectively using doctors forms and patient questionnaires. Information about vaginal preparation routines in the clinics were achieved retrospectively by an e-mail survey. Multiple logistic regression analyses models were used to determine associations and risk factors. Main outcome measures. Infectious morbidity within 6-8 weeks postoperatively. Results. No significant differences were seen in postoperative infectious morbidity in long term between vaginal preparation using saline or chlorhexidine solution or no cleansing. At discharge from hospital, those who had had vaginal cleansing using saline solution had a significantly higher risk of postoperative infections. Risk factors for infectious morbidity were young age, obesity, peroperative injury of the urinary bladder, operative time and duration of hospital stay. Protective were prophylactic antibiotics and concomitant prolapse surgery. Conclusions. Saline solution should not be used for vaginal cleansing due to a higher risk of infectious morbidity in the immediate postoperative period. Infectious morbidity may be reduced further by employing preventive measures such as meticulous surgical technique, preoperative weight reduction in obese women and minimizing time in hospital.Original Publication:Preben Kjölhede, Shefqet Halili and Mats Lofgren, Vaginal cleansing and postoperative infectious morbidity in vaginal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery, 2011, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, (90), 1, 63-71.http://dx.doi.org/10.1111/j.1600-0412.2010.01023.xCopyright: Informa Healthcarehttp://informahealthcare.com

Advances of Mathematical Morphology and Its Applications in Signal Processing

This thesis describes some advances of Mathematical Morphology (MM), in order to improve the performance of MM filters in I-D signal processing, . especially in the application to power system protection. MM methodologies are founded on set-theoretic concepts and nonlinear superpositions of signals and images. The morphological operations possess outstanding geometrical properties which make it undoubted that they are efficient image processing methods. However in I-D signal processing, MM filters are not widely employed. To explore the applications of MM for I-D signal processing, our contributions in this area can be summarized in the following two aspects. Firstly, the fram.ework of the traditional signal processing methods is based on the frequency domain representation of the signal and the analysis of the operators' transfer function in the frequency domain. But to the morphological operations, their representations in the frequency domain are uncertain. In order to tackle this problem, this thesis presents our attempt to describe the weighted morphological dilation in the frequency domain. Under certain restrictions to the signal and the structuring element, weighted dilation is transformed to a mathematical expression in the frequency domain. Secondly, although the frequency domain analysis plays an important role in signal processing, the geometrical properties of a signal such as the shape of the signal cannot be ignored. MM is an effective method in dealing with such problems. In this thesis, based on the theory of Morphological Wavelet (MW), three multi-resolution signal decomposition schemes are presented. They are Multiresolution Morphological Top-Hat scheme (MMTH), Multi-resolution Morphov logical Gradient scheme (MMG) and Multi-resolution Noise Tolerant Morphological Gradient scheme (MNTMG). The MMTH scheme shows its significant effect in distinguishing symmetrical features from asymmetrical features on the waveform, which owes to its signal analysis operator: morphological Top-Hat transformation, an effective morphological technique. In this thesis, the MMTH scheme is employed in the identification of transformer magnetizing inrush curr~nt from internal fault. Decomposing the signal by MMTH, the asymmetrical features of the inrush waveform are exposed, and the other irrelevant components are attenuated. The MMG scheme adopts morphological gradient, a commonly used operator for edge detection in image and signal processing, as its signal analysis / operator. The MMG scheme bears significant property in characterizing and recognizing the sudden changes with sharp peaks and valleys on the waveform. Furthermore, to the MMG scheme, by decomposing the signal into different levels, the higher the level is processed, the more details of the sudden changes are revealed. In this thesis, the MMG scheme is applied for the design of fault locator of power transmission lines, by extracting the transient features directly from fault-generated transient signals. The MNTMG decomposition scheme can effectively reduce the noise and extract transient features at the same time. In this thesis, the MNTMG scheme is applied to extract the fault generated transient wavefronts from noise imposed signals in the application of fault location of power transmission lines. The proposed contributions focus on the effect of weighted dilation in the frequency domain, constructions of morphological multi-resolution decomposition schemes and their applications in power systems.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-66315

The impact of mode of anaesthesia on postoperative recovery from fast-track abdominal hysterectomy: a randomised clinical tria

The influence of preoperative vaginal cleansing on postoperative infectious morbidity in abdominal total hysterectomy for benign indications

Objective. To evaluate whether vaginal cleansing reduces the risk of postoperative infection after abdominal total hysterectomy on benign indications and to analyze risk factors. Design. Retrospective cohort study. Setting. All clinics including patients in the Swedish National Register for Gynecological Surgery. Population. All 7,193 women who underwent abdominal total hysterectomy for benign indications from 2000 to 2007. Methods. Information on clinic routines for preoperative vaginal cleansing was obtained retrospectively in a postal survey. Associations between routines for vaginal cleansing and structured data from the Register were analyzed by means of multivariate logistic regression models. The main effect variable was postoperative infections defined as infections treated with antibiotics within six to eight weeks postoperatively, reported by the patient or the physician. Main outcome measures. Prevalence and risk factors for postoperative infections. Results. Prevalence of postoperative infections was 14.4%. The prevalence did not differ between those having had vaginal cleansing using chlorhexidine and those without vaginal cleansing, whereas using saline solution was encumbered with a significantly increased risk. Risk factors for postoperative infections were age 60, obesity, smoking, weight of the uterus, duration of hospital stay, blood transfusion, and peroperative injury of the urinary bladder or ureter. Conclusion. Vaginal cleansing using chlorhexidine solution did not reduce the risk of postoperative infections, whereas vaginal cleansing using saline solution seemed to increase the risk. Some risk factors for postoperative infectious morbidity seem to be preventable.This is an electronic version of an article published in:Preben Kjölhede, Shefqet Halili and Mats Lofgren, The influence of preoperative vaginal cleansing on postoperative infectious morbidity in abdominal total hysterectomy for benign indications, 2009, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, (88), 4, 408-416.ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA is available online at informaworldTM: http://dx.doi.org/10.1080/00016340902795345Copyright: Taylor & Francishttp://www.tandf.co.uk/journals/default.as