Twenty-minute pad test: comparison of infusion of 250 ml of water with strong-desire amount in the bladder in women with stress urinary incontinence

OBJECTIVE: The objective was to compare the sensitivity of the 20-min pad test by infusion of 250 ml of water with the strong-desire amount in the bladder in women with stress urinary incontinence (SUI). STUDY DESIGN: Eighty-three women with SUI were enrolled between November 2005 and January 2006. The 20-min pad test by infusion of 250 ml of water was performed before urodynamic study (UDS). The strong-desire amount pad test was done after UDS. The results were analyzed by Pearson's chi(2) and Wilcoxon's signed-rank tests. RESULTS: The sensitivity by infusion of the strong-desire amount was better than infusion of 250 ml of water in the 20-min pad test (P<0.001). In the quantitative study, the two pad tests had fair agreement and the pad weight results of the infusion of the strong-desire amount were statistically higher than the infusion of 250 ml of water (P=0.0004). CONCLUSIONS: The infusion of the strong-desire amount had better sensitivity measured by the 20-min pad test in women with SUI compared with infusion of 250 ml of water in the bladder.     

Factors associated with postoperative recovery after laparoscopic and abdominal hysterectomy

Objectives

To determine whether the day-by-day recovery of general wellbeing was faster in women undergoing laparoscopic hysterectomy than in total abdominal hysterectomy and to analyse the association between stress coping and sick-leave and the day-by-day recovery measured as general wellbeing.

Study design

A randomised multicentre trial conducted in five hospitals in the South East of Sweden. Hundred and twenty-five women scheduled for hysterectomy for benign conditions were enrolled in the study and 117 women completed the study. Fifty-five women were randomised to abdominal hysterectomy and 62 to laparoscopic hysterectomy. Day-by-day recovery of general wellbeing was measured by a visual analogue scale 1 week preoperatively, 35 days postoperatively, and during 1 week 6 months postoperatively. Stress-coping capability was measured preoperatively using a specific psychometric measurement. Sick-leave was granted with an initial period of 14 days and prolonged on patient demand with 7 days periods.Effects of operating method and stress-coping ability on the day-by-day recovery adjusted for postoperative complications and analgesics were analysed by means of analysis of variance for repeated measurements.

Results

No significant difference was found in the day-by-day recovery of the general wellbeing between the operating methods. Stress-coping ability did significantly influence the day-by-day recovery of general wellbeing. Duration of sick-leave was associated with the occurrence of postoperative complications but not with stress-coping ability.

Conclusions

The day-by-day recovery of general wellbeing is not faster in laparoscopic hysterectomy than in abdominal hysterectomy. Women with high stress-coping abilities have a better outcome in general wellbeing than women with low stress-coping capacity. Identification of women with low stress-coping abilities and prevention of complications might be of benefit for improving postoperative wellbeing.     

Predictors of women's perceptions of the childbirth experience

OBJECTIVE: To determine the factors that predict women's perceptions of the childbirth experience and to examine whether these vary with the type of birth a woman experiences. DESIGN: Prospective cohort study. SETTING: The postpartum units of two eastern Canadian hospitals. PARTICIPANTS: Six hundred fifty two women and their newborns. DATA COLLECTION: Data were collected in hospital at 12 to 48 hours postpartum using self-report questionnaires and chart review. MAIN OUTCOME MEASURE: Perception of the childbirth experience was measured for women having a vaginal and emergency cesarean birth using the Questionnaire Measuring Attitudes About Labor and Delivery and planned cesarean birth using the Modified Questionnaire Measuring Attitudes About Labor and Delivery. RESULTS: Of the 20 predictors of women's childbirth perceptions, the strongest were type of birth; degree of awareness, relaxation, and control; helpfulness of partner support; and being together with the infant following birth. CONCLUSIONS: Of the predictors of a quality birth experience, most were amenable to nursing interventions: enhancement of patient awareness, relaxation, and control; promotion of partner support; and provision of immediate opportunities for women to be with their babies.     

Surgical treatment of stress urinary incontinence using the tension-free vaginal tape-obturator system (TVT-O) technique

OBJECTIVE: The purpose of the research was to provide a review of the efficacy of the TVT-O technique for the surgical treatment of stress urinary incontinence (SUI) and to assess surgical and postsurgical complications related to this technique. STUDY DESIGN: An initial assessment was carried out on 44 women who underwent TVT-O surgery between 16 September 2004 and 1 February 2005. The follow-ups after 3 and 12 months were attended by 37 and 35 patients, respectively. All 44 patients were included for the statistical estimation of intra- and postoperative complications, whereas improvement in the quality of life was assessed only in those patients who came for a follow-up visit. To assess the efficacy of the treatment, the participants were surveyed using the King questionnaire on the day preceding surgery and during a follow-up visit 3 and 12 months after surgery. The participants whose scores from the two questionnaires changed > or =90% were deemed to be cured. A considerable improvement in quality of life was recorded when the score was 89-75%. With scores of 74-50%, there was a reduction in SI symptoms. However, when the score was 50-0%, no improvement in quality of life was reported, and in participants with scores <0% the quality of life deteriorated. Statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS) V. 10.0, with the Spearman correlation and Chi-squared tests. The results were considered statistically significant when P<0.05. RESULTS: After 12 months, total cure was achieved in 15 participants (42.8%), significant improvement was noted in 6 (17.1%), SUI symptoms abated in 4 (11.4%), no improvement was noted in 7 (20%), and quality of life deteriorated in 3 (8.7%). CONCLUSION: TVT-O surgery is an efficient and reasonably safe method of SUI treatment in women. The ease of use, short duration of surgery and hospitalisation, minor postsurgical discomfort and a small proportion of complications make this method acceptable to patients. With regard to the results of treatment, additional patients should be analysed for a longer period of time.     

经阴道无张力尿道中段悬吊术治疗女性压力性尿失禁28例围术期护理体会

目的:探讨经阴道无张力尿道中段悬吊术(TVT)治疗女性压力性尿失禁的护理方法。方法:回顾性分析行TVT手术治疗的28例女性压力性尿失禁患者的护理资料,术前做好充分准备,术后加强对伤口的护理,密切观察病情变化,观察有无排尿困难、出血、感染等并发症。结果:本组24例术后排尿功能恢复良好,4例因膀胱不稳定或感染发生排尿困难,经持续导尿、膀胱训练及药物治疗后均恢复排尿功能。结论:对女性压力性尿失禁患者行TVT手术,并给予术前充分准备和术后严密观察护理,可减少术后并发症的发生,促进患者康复。     

COVID-19-related fear,stress and depression in school principals: impacts of symptoms like COVID-19, information confusion,health-related activity limitations,working hours,sense of coherence and health literacy

BackgroundSchool principals have been reported to have a higher prevalence of burnout and psychological problems than their colleagues. During the pandemic, extra workload and pressure from unprecedented situations potentially cause fear, stress and depression. Therefore, we aimed to explore associated factors of stress, fear of COVID-19 (F-CoV-19S) and depressive symptoms among school principals.MethodsA cross-sectional online survey was conducted in Taiwan from 23 June to 16 July 2021. Data of 413 school principals were collected, including socio-demographic factors, COVID-19-related factors, work-related information, health status, sense of coherence (SoC), health literacy (HL), F-CoV-19S, stress and depression. Multiple linear and logistic regression models were utilized to explore associations.ResultsSchool principals with symptoms like COVID-19 (S-COVID-19-S), or with health-related activity limitations had a higher score of stress (B = 0.92; p = .039) (B = 1.52; p < .001) and a higher depression likelihood (OR = 3.38; p < .001) (OR = 3.06; p < .001), whereas those with a better SoC had a lower stress score (B = −1.39; p < .001) and a lower depression likelihood (OR = 0.76; p = .020). School principals confusing about COVID-19-related information had a higher score of stress (B = 2.47; p < .001) and fear (B = 3.77; p < .001). The longer working time was associated with a higher fear score (B = 1.69; p = .006). Additionally, school principals with a higher HL score had a lower stress score (B = −1.76; p < .001), a lower fear score (B = −1.85; p < .001) and a lower depression likelihood (OR = 0.53; p = .043).ConclusionsHealth-related activity limitations, S-COVID-19-S, COVID-19-related information confusion and longer working hours were positively associated with at least one mental health problem (e.g. stress, fear and depression), whereas better SoC and HL showed the benefits to mitigate fear, stress and depressive symptoms in school principals. Our study provides evidence for appropriate strategies to improve principals’ mental health during the pandemic.

Key messages:

• School principals with health-related activity limitations or with symptoms like COVID-19 were more likely to be stressed and depressed.
• Higher levels of stress and fear were observed in school principals who confused about COVID-19-related information, and who had longer working time than before the pandemic.
• Better sense of coherence and higher health literacy could potentially mitigate the fear, stress and depressive symptoms in school principals.

     

Perception of Portuguese Consumers Regarding Food Labeling

Food labels are the first information tool used by consumers in the purchase and consumption of food products. Food labeling is a tool that can influence the consumers’ perception of quality and, in turn, their food choice. This study characterizes and demonstrates the importance of labeling and the degree of consumers’ perception and literacy about food labels through the application of an online questionnaire. The results obtained, in a sample of n = 467, showed that Portuguese consumers have the habit of reading the label and recognizing its importance but do not understand all the information contained in the label. They have an easier time understanding the front-of-pack labeling systems, especially those presented through symbols/colors. Thus, it demonstrates the need for greater education and literacy in the areas of food and nutrition so that through the reading and interpretation of labels, consumers can make informed food choices.     

颈交感神经干离断对应激大鼠NO及胃粘膜血流量的影响

目的研究颈交感神经干离断(TCST)对浸水大鼠胃粘膜血流量(GMBF)的影响。方法30只雄性SD大鼠随机分为三组,每组10只。Ⅰ组为正常对照组;Ⅱ组为浸水对照组;Ⅲ组为TCST后浸水组。Ⅰ组、Ⅱ组将大鼠颈交感神经干暴露、分离,不离断;Ⅲ组TCST并将断端结扎。将Ⅱ、Ⅲ组大鼠垂直浸水[水温(23±1)℃]至剑突水平,6 h后取出,测定各组GMBF,评价粘膜损伤程度。硝酸还原酶法测定血清及胃粘膜一氧化氮(NO)含量。结果Ⅱ组胃粘膜见出血及糜烂,Ⅲ组粘膜损伤程度显著轻于Ⅱ组;Ⅲ组与Ⅱ组比较,GMBF显著升高,两者分别为(130.0±14.5)和(68.9±12.7)pu(P<0.01);Ⅱ组和Ⅲ组的溃疡指数(UI)分别为50.1±12.3和26.6±9.4(P<0.01);Ⅱ组大鼠的血清及胃粘膜的NO值显著高于Ⅰ组(P<0.01);Ⅲ组的血清NO值与Ⅱ组比较显著减少(P<0.01)。结论TCST可增加浸水应激大鼠的GMBF,对胃粘膜损伤有保护作用;其机制可能有NO的参与。     

改良阴道前壁修补术联合盆底电刺激治疗56例压力性尿失禁临床效果探讨

目的：探讨应用改良阴道前壁修补术联合盆底电刺激治疗压力性尿失禁的临床效果。方法回顾性分析2010年5月-2013年5月期间,该院行改良阴道前壁修补术联合盆底电刺激治疗的56例压力性尿失禁患者的临床资料,将其作为观察组,并选择同期单纯行改良阴道前壁修补术治疗的60例患者,将其作为对照组,比较两组患者的临床治疗效果。结果在观察组患者中,治疗的总有效率为92.86%;对照组患者中,治疗的总有效率为83.33%。观察组优于对照组,组间差异有统计学意义(P<0.05)。结论应用改良阴道前壁修补术联合盆底电刺激治疗压力性尿失禁,效果明显。