Urinary incontinence

The reasons why urinary incontinence can be regarded as a women's health issue are explored. Emancipatory action research was used to develop an understanding of women's experience of UI. A number of important issues concerning the use of emancipatory action research in the social sciences in general, and nursing in particular, are addressed.

Frailty, aging, and incontinence in the elderly : an interactive case-based discussion of best practices

Urinary incontinence and frailty are both highly prevalent in older adults. Workshop goals include review of available evidence on frailty and differentiation from normal physiological aging. The influence of frailty on continence in older adults will be examined. Presentations will explore associated risks such as falls, pressure ulcers, and nursing home placement, as well as barriers and facilitators of continence care in various living environments. The role of urodynamics and various treatments will be considered. A majority of the session will focus on interactive discussion of case-based examples of common but challenging clinical situations seen in frail older adults.

Residents' perspectives on urinary incontinence : a review of literature

Background: Individuals in residential aged care facilities experience urinary incontinence more than any other single population. Despite these factors, the impact of the condition on their quality of life, their perspectives of living with the condition, and their preferences for care have received little research attention.

Aim: To provide a descriptive overview of research about; the impact of urinary incontinence on residents’ quality of life; residents’ perspectives of having urinary incontinence; and their preferences for continence care’.

Design: A descriptive review of literature.

Method: A broad search was undertaken for qualitative and quantitative research that evaluated residents’ quality of life related to urinary incontinence; their perspectives on having urinary incontinence, and their preferences for managing it. Data were displayed in tabular format, summarized, and described.

Results: Ten studies were identified and reviewed (six qualitative and four quantitative). They reveal many residents’ value having independent bowel and bladder function, but believe that incontinence in inevitable and intractable. Some adopt self management strategies, however considerable barriers hinder their ability to maintain continence and manage incontinence. Residents often have low expectations, and hence decline further evaluation and treatment. Some express satisfaction with continence care even if this care is not consistent with their preferences. Little is known about how cognitively impaired residents perceive their condition. However some individuals with cognitive impairment respond with acute anxiety when carers’ attempt to provide continence care.

Conclusion: Residents’ perspectives on incontinence and preferences for continence care relate to low expectations for improvement. Such misconceptions should be addressed and residents and their family members should be given a range of options from which to choose. As urinary incontinence impacts on residents’ quality of life, it is also important that continence care is delivered in a participative and sensitive way.

Bayesian networks and decision trees in the diagnosis of female urinary incontinence

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.

Response to long-distance relocation in Asian elephants (Elephas maximus) : monitoring adrenocortical activity via serum, urine, and feces

Understanding how elephants respond to potentially stressful events, such as relocation, is important for making informed management decisions. This study followed the relocation of eight Asian elephants from the Cocos (Keeling) Islands to mainland Australia. The first goal of this study was to examine patterns of adrenocortical activity as reflected in three different substrates: serum, urine, and feces. We found that the three substrates yielded very different signals of adrenocortical activity. Fecal glucocorticoid metabolites (FGM) increased as predicted post-transport, but urinary glucocorticoid metabolites (UGM) were actually lower following transport. Serum cortisol levels did not change significantly. We suggest that the differences in FGM and UGM may reflect changes in steroid biosynthesis, resulting in different primary glucocorticoids being produced at different stages of the stress response. Additional studies are needed to more thoroughly understand the signals of adrenocortical activity yielded by different substrates. The second goal was to examine individual variation in patterns of adrenal response. There was a positive correlation between baseline FGM value and duration of post-transfer increase in FGM concentration. Furthermore, an individual's adrenocortical response to relocation was correlated with behavioral traits of elephants. Elephants that were described by keepers as being “curious” exhibited a more prolonged increase in FGM post-transfer, and “reclusive” elephants had a greater increase in FGM values. Future research should investigate the importance of these personality types for the management and welfare of elephants.

Anaerobic biodigestion of pigs feces in the initial, growing and finishing stages fed with diets formulated with corn or sorghum

Objetivou-se avaliar a produção e a qualidade do biogás e do biofertilizante obtidos em biodigestores abastecidos com dejetos de suínos, nas fases inicial, crescimento e terminação, alimentados com dietas formuladas à base de milho ou sorgo. Foram utilizados 20 biodigestores de bancada, com tempo de retenção hidráulica de 30 dias, e cargas diárias que continham 4,0 a 6,0% de sólidos totais (ST) e 3,6 a 5,2% de sólidos voláteis (SV). Nos efluentes dos biodigestores, foram verificados teores médios de ST variando de 1,6 a 2,0% e de SV entre 1,2 e 1,6%. As reduções médias de ST foram de 57,7 a 64,7% e de SV de 61,7 a 69,0%, sendo que houve diferença somente na fase de terminação, na qual as maiores reduções médias foram para biodigestores abastecidos com dejetos de animais alimentados com dietas à base de milho. Nos biodigestores abastecidos com dejetos de animais em fase inicial e de crescimento, alimentados com dietas formuladas à base de milho, foram verificadas maiores produções médias de biogás e os maiores potenciais médios de produção de biogás. Os potenciais médios obtidos foram 0,033; 0,181; 0,685; 0,788 e 1,132 m³ por kg de afluente, estrume, ST adicionados, SV adicionados e SV reduzidos, respectivamente. Não foram verificadas diferenças quanto ao teor médio de metano no biogás entre dietas e fases. As concentrações médias dos nutrientes N, P, K, Ca, Mg, Na, Fe, Mn, Zn e Cu no afluente e efluente dos biodigestores variaram entre as dietas e fases.

Comparison of DNA-extraction methods and Selective Enrichment broths on the detection of Salmonella Typhimurium in swine feces by polymerase chain reaction (PCR)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)