15 resultados para pelvic floor

em Deakin Research Online - Australia


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This pilot study attempted to examine the additional efficacy of interferential therapy in reducing the symptoms of urinary stress and urge incontinence. Twenty-four subjects were randomly allocated to the experimental group, which received interferential therapy plus pelvic floor exercises, or the control group, which received pelvic floor exercises only. Treatment was given three times a week for 4 weeks. Subjects were given urinary diaries to record urinary symptoms (including frequency of passing urine and number of times woken by desire to pass urine) for 5 days prior to and after treatment. Perineometer readings, pad weighing test and start/stop test were also performed in a physiotherapy clinic before and at completion of treatment regimes. Significant improvements were observed in all the outcome variables in the experimental group, but in only the perineometer readings in controls. When the changes from pre- to post-treatment were compared between the two groups, four of the dependent variables did not reach statistical significance. Power analysis indicated that the sample size for each group needed to be 70 for all results to be statistically significant. This study shows that interferential therapy plus pelvic floor exercise appears to be a more effective treatment modality than pelvic floor muscle strengthening exercise alone for incontinence, but a larger trial with longer followup is needed before definitive conclusions can be reached.

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This study investigated the frequency, nature and experience of urinary incontinence in post-natal women. Surveys were completed by 224 women, 50% of whom indicated that they had experienced accidental urine loss. The majority of women who had experienced any symptoms were moderately to greatly bothered by them. A variety of strategies were used to manage the problem; however, 42% of the women who experienced accidental urine loss had taken no action to ease the problem. Women received information about urinary incontinence and pelvic floor exercises from a variety health care professionals, but this was not consistently provided. The implications of these findings are discussed.

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This study compares the effectiveness of Bayesian networks versus Decision Trees in modeling the Integral Theory of Female Urinary Incontinence diagnostic algorithm. Bayesian networks and Decision Trees were developed and trained using data from 58 adult women presenting with urinary incontinence symptoms. A Bayesian Network was developed in collaboration with an expert specialist who regularly utilizes a non-automated diagnostic algorithm in clinical practice. The original Bayesian network was later refined using a more connected approach. Diagnoses determined from all automated approaches were compared with the diagnoses of a single human expert. In most cases, Bayesian networks were found to be at least as accurate as the Decision Tree approach. The refined Connected Bayesian Network was found to be more accurate than the Original Bayesian Network accurately discriminated between diagnoses despite the small sample size. In contrast, the Connected and Decision Tree approaches were less able to discriminate between diagnoses. The Original Bayesian Network was found to provide an excellent basis for graphically communicating the correlation between symptoms and laxity defects in a given anatomical zone. Performance measures in both networks indicate that Bayesian networks could provide a potentially useful tool in the management of female pelvic floor dysfunction. Before the technique can be utilized in practice, well-established learning algorithms should be applied to improve network structure. A larger training data set should also improve network accuracy, sensitivity, and specificity.

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Objective:
To identify the prevalence and correlates of three types of pelvic pain (dysmenorrhoea, dyspareunia, and other chronic pelvic pain [CPP]) in a nationally representative sample of Australian women.

Design and setting:
The CPP survey was part of a broader national study of health and relationships. Computer-assisted telephone interviews were administered to a random sample of 8656 Australian households; 4366 women aged between 16 and 64 years were interviewed in 2004 and 2005. Eighteen of the more than 200 potential survey questions related to pelvic pain.

Main outcome measures:
Self-reports of dysmenorrhoea, dyspareunia, and any other CPP not associated with sexual intercourse or menstruation.

Results:
Data on 1983 women aged 16–49 years who were still menstruating and sexually active were analysed. Prevalences were 71.7% for dysmenorrhoea, 14.1% for dyspareunia and 21.5% for other CPP; 23.3% of women reported no pelvic pain of any kind. Severe pain was reported by 15.0% (95% CI, 13.0%–17.1%) of women with dysmenorrhoea, 7.8% (95% CI, 5.0%–11.9%) of women with dyspareunia and 20.0% (95% CI, 16.1%–24.6%) of women with other CPP. Just over a third (34.2%) of women who reported any pain had sought advice from a health professional. Women reporting CPP were also likely to report other health conditions, most notably depression and anxiety. There were clear associations between CPP and sexual difficulties, pregnancy and pregnancy outcomes.

Conclusions:
Rates of pelvic pain in Australian women are high. General practitioners need to be ready to discuss these issues with patients, particularly in relation to underlying anxiety and depression.

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Introduction: Recent international prevalence studies of pelvic pain in men have estimates ranging between 2% and 10%. These studies conclude that it is an important international health problem.

Aims: The aims of this study were to establish the first population-based study of pelvic pain in Australian men, and identify correlates with men's sexual and reproductive histories and other health conditions.

Methods: A representative household sample of 4,290 Australian men aged 16–64 years completed a computer-assisted telephone interview. They were asked about their experiences of pain in the pelvic region during the past 12 months.

Main Outcome Measures
: Prevalence of correlates of pain associated with sexual intercourse, pain associated with urination, and pelvic pain not associated with intercourse or urination.

Results: Five percent of men reported pain during urination, 5% reported pain related to sexual intercourse, and 12% of men reported other chronic pelvic pain. There was little overlap in reporting any of the three types of pelvic pain, with 18% of men reporting some form of pelvic pain. Men reporting any of the pain conditions were significantly more likely than other men to report a sexual experience when they had felt forced or frightened. Men reporting pain during intercourse and/or chronic pelvic pain were significantly more likely than other men to report same sex experience. All three groups of men with pelvic pain were more likely than other men to report some form of sexual difficulties. A report of ever receiving a diagnosis of depression or a report of anxiety was significantly associated with all forms of pelvic pain.

Conclusions
: More than one man in six report having some form of pelvic pain in the past 12 months. It is likely that men would benefit from a discussion about possible symptoms during consultations with their physicians.

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The creation of an electronic limit order book is discussed as the basis for distinguishing between the floor trading and screen trading of derivative instruments. Distinguishing between FTP and ETP in terms of market transparency allows investors to contemplate the trade-off between the 2 platforms. Distinguishing between FTP and ETP in terms of memory preservation allows practitioners to contemplate the different experiences when analyzing floor data and screen data. A comparable set of floor and screen data is used to examine the impact on the trading dynamics and price discovery of LIFFE's FTSE 100 index futures market when trading is automated on LIFFE CONNECT. The dynamics in the quote change equation is shortened when moving from the floor to screen sample. Using the model's measure of trade informativeness, it is found that in 4 out of 5 daily sub-samples, screen trades are more than twice as informative as floor trades. Variability within a system of equations is explained more by order size history than trade size history.

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Female disadvantage has been the explanation given in previous studies to explain the under-representation of laywomen who achieve principalships in Catholic Education. Women, themselves, have overcome many of the barriers that disadvantage them. These include an apparent inability to cope with financial management and time constraints due to family commitments. The introduction of Equal Opportunity legislation and related programmes has assisted this process, but as my research shows the under-representation of women in principalship in proportion to the numbers of women teachers in Catholic Education still remains. This thesis examines the phenomenon in three dioceses in three Australian states. I have investigated this problem using a feminist research approach which is characterised by an emphasis on the significance of everyday life. Statistical material as to percentages of teachers in comparison with percentages of female principals was collected; dates of formulation and acceptance of relevant policies at diocesan levels were checked and questionnaires compiled. The questionnaires were distributed to appropriate stakeholders. Following the compilation of data from the questionnaires, themes emerged which provided the initial questions for focus groups made up of male and female principals and potential principals. These focus groups were then conducted in all three dioceses. Through all stages I carried out cross-referencing with my own journal sentries (Power, 1993—1999) . The qualitative and quantitative data generated from the focus groups was examined and analysed drawing on feminist concepts. I have found two major features emerging from the materials that I have generated. The first was the unpredictable, ambiguous and often contradictory relations that occur within Catholic Education, and how they were experienced by lay women. This aspect gave rise to the title of my thesis: 'Dancing on a Moving Floor' as many women felt the rules changed the closer they got to achieving principalship. Then both male and female participants highlighted 'male advantage' in terms that have been identified in other education systems, but this factor emerged as being further heightened in Catholic Education and occurring at systemic, organisational and individual levels. I have made a number of policy recommendations that could possibly change attitudes and practices for each of these levels. I conclude with some suggestions for further research.

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This thesis explored the conundrum of the trauma narrative requiring a suspension of disbelief from the reader, whilst simultaneously being acknowledged as bona fide truth. This paradox was examined via the identification of common themes and writerly techniques used in both trauma testimony and trauma novels.

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Despite the great benefits that it can potentially contribute to modern workplace environment, raised floor system (RFS) encountered many barriers in the process of its applications for the fitout of office buildings in the Australian construction industry. Through a set of comprehensive research activities, the significant influence factors (SIFs) and problems associated with the RFS fitout implementation are identified. Further discussion of these SIFs and problems unearths a range of project level critical factors (PLCFs) pertaining to the RFS fitout design, construction, operation and maintenance, which presents firsthand checklists for the project team to review in the project delivery process. These factors need to be accommodated appropriately in order to enhance the implementation of the RFS fitout in Australian office buildings. Following a constructability study, a framework was developed by integrating these SIFs and PLCFs into the delivery of the RFS fitout in an aim to enhance the project constructability and minimize problems in the RFS service performance.

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The trend towards smaller and lighter, more environmentally friendly vehicles is accelerating, as the petrol price rises and the CO2 reduction target becomes more strict. As a key enabling technology, light-weight but low-cost structure plays an important role in promoting the use of fibre reinforced polymer matrix composites in automotive applications. In this work an experimental investigiation is carried out to design, manufacture and analyse a stiffened composite structure, aiming at achieving required bending and torsional strength and stiffness at the minimum weight. One major application of this new lightweight structure is the load-bearing floor component. Some initial results from this work are presented in this paper.

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Human-induced changes to habitats can have deleterious effects on many species that occupy them. However, some species can adapt and even benefit from such modifications. Artificial reefs have long been used to provide habitat for invertebrate communities and promote local fish populations. With the increasing demand for energy resources within ocean systems, there has been an expansion of infrastructure in near-shore benthic environments which function as de facto artificial reefs. Little is known of their use by marine mammals. In this study, the influence of anthropogenic sea floor structures (pipelines, cable routes, wells and shipwrecks) on the foraging locations of 36 adult female Australian fur seals (Arctocephalus pusillus doriferus) was investigated. For 9 (25%) of the individuals, distance to anthropogenic sea floor structures was the most important factor in determining the location of intensive foraging activity. Whereas the influence of anthropogenic sea floor structures on foraging locations was not related to age and mass, it was positively related to flipper length/standard length (a factor which can affect manoeuvrability). A total of 26 (72%) individuals tracked with GPS were recorded spending time in the vicinity of structures (from <1% to >75% of the foraging trip duration) with pipelines and cable routes being the most frequented. No relationships were found between the amount of time spent frequenting anthropogenic structures and individual characteristics. More than a third (35%) of animals foraging near anthropogenic sea floor structures visited more than one type of structure. These results further highlight potentially beneficial ecological outcomes of marine industrial development.

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Little is known about the motor control of the lumbo-pelvic musculature in microgravity and its simulation (bed-rest). Analysis of spectral and temporal electromyographic variables can provide information on motor control relevant for normal function. This study examined the effect of 56-days of bed-rest with 1-year follow-up in 10 male subjects on the median frequency and the activation timing in surface electromyographic recordings from five superficial lumbo-pelvic muscles during a repetitive knee movement task. Trunk fat mass (from whole body-composition measurements) and movement accuracy as possible explanatory factors were included. Increased median frequency was observed in the lumbar erector spinae starting late in bed-rest, but this was not seen in its synergist, the thoracic erector spinae (p<.0001). These changes persisted up to 1-year after bed-rest and were independent of changes in body-composition or movement accuracy. Analysis suggested decreases of median frequency (p<.0001) in the abdominal and gluteal muscles to result from increased (p<.01) trunk fat levels during and after bed-rest. No changes in lumbo-pelvic muscle activation timing were seen. The results suggest that bed-rest particularly affects the shorter lumbar erector spinae and that the temporal sequencing of superficial lumbo-pelvic muscle activation is relatively robust.

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To understand the effects of a resistive vibration exercise (RVE) countermeasure on changes in lumbo-pelvic muscle motor control during prolonged bed-rest, 20 male subjects took part in the Berlin Bed-Rest Study (in 2003-2005) and were randomised to a RVE group or an inactive control group. Surface electromyographic signals recorded from five superficial lumbo-pelvic muscles during a repetitive knee movement task. The task, which required stabilisation of the lumbo-pelvic region, was performed at multiple movement speeds and at multiple time points during and after bed-rest. After excluding effects that could be attributed to increases in subcutaneous fat changes and improvements in movement skill, we found that the RVE intervention ameliorated the generalised increases in activity ratios between movement speeds (p⩽0.012), reductions in lumbo-pelvic extensor and flexor co-contraction (p=0.058) and increases in root-mean-square electromyographic amplitude (p=0.001) of the lumbar erector spinae muscles. Effects of RVE on preventing increases in amplitude-modulation (p=0.23) of the lumbar erector spinae muscles were not significant. Few significant changes in activation-timing were seen. The RVE intervention during bed-rest, with indirect loading of the spine during exercise, was capable of reducing some, but not all, motor control changes in the lumbo-pelvic musculature during and after bed-rest.