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1.
Nurs Educ Perspect ; 45(1): 31-36, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37404039

RESUMO

AIM: The aim of this study was to evaluate the effects of a virtual mindfulness meditation intervention on stress and anxiety levels of 145 nursing students. BACKGROUND: Because of the twin demands of classroom and clinical workloads, nursing students experience greater amounts of stress and anxiety than the average college student. Mindfulness meditation is a promising method to alleviate stress and anxiety. METHOD: A pretest-posttest randomized controlled design was used. Participants received either weekly mindfulness meditation recordings or recordings on nursing information. Participants completed the Perceived Stress Scale and the Generalized Anxiety Disorder-7 Scale. RESULTS: A two-way mixed analysis of variance and follow-up simple main effects tests revealed that participants in the experimental group, who received meditation recordings, experienced significantly lower levels of stress and anxiety on posttest surveys than the control group. CONCLUSION: Mindfulness meditation can reduce stress and anxiety levels in nursing students. This can improve students' overall mental and physical well-being.


Assuntos
Meditação , Atenção Plena , Estudantes de Enfermagem , Humanos , Atenção Plena/métodos , Estresse Psicológico/prevenção & controle , Ansiedade/prevenção & controle
2.
Issues Ment Health Nurs ; 45(7): 724-733, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38776548

RESUMO

The undergraduate mental health nursing course is an optimal time to address stigma and prejudice, while developing positive student attitudes toward those who live with mental health conditions. A quasi-experimental, pretest-posttest, nonequivalent-group study with a sample of undergraduate nursing students in New York City (N = 126) was conducted to determine the impact of an undergraduate mental health nursing course on attitudes toward people living with a general mental illness, depression, or schizophrenia. The intervention resulted in a significant reduction in total prejudice scores toward those with a general mental illness when compared to the control (p = 0.033, partial η2 = 0.062). The intervention had no significant impact on total prejudice scores regarding those with depression, or schizophrenia. Subscale analysis revealed the intervention significantly reduced attitudes of fear/avoidance regarding general mental illness (p = 0.040, partial η2 = 0.058) and schizophrenia (p < 0.001, partial η2 = 0.164). There was no impact on authoritarian or malevolent attitudes. Though some attitudes were not amenable to change, this study provides evidence that positive attitudes can be cultivated through undergraduate nursing education. Curricular reform is needed to reduce all facets of prejudice and best prepare future nurses to care for those with mental health conditions.


Assuntos
Atitude do Pessoal de Saúde , Medo , Transtornos Mentais , Preconceito , Enfermagem Psiquiátrica , Estudantes de Enfermagem , Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Enfermagem Psiquiátrica/educação , Transtornos Mentais/psicologia , Estudantes de Enfermagem/psicologia , Estigma Social , Bacharelado em Enfermagem , Cidade de Nova Iorque , Esquizofrenia , Currículo
3.
Issues Ment Health Nurs ; 45(4): 391-398, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38241519

RESUMO

INTRODUCTION: Mental health recovery is a critical concept that needs to be thoroughly understood and supported by nurses. Undergraduate nurse educators have the opportunity to clarify misconceptions and cultivate positive recovery attitudes. AIM: To assess the impact of an undergraduate nursing course on attitudes toward mental health recovery and the relationship between recovery attitudes and prejudice toward those who experience a mental illness. METHODS: A quasi-experimental pretest-posttest, nonequivalent-control group study was conducted using a sample of undergraduate nursing students in New York City (N = 126). The intervention group was assigned to an undergraduate mental health nursing course and the control group to a pediatric/maternal health nursing course. Attitudes toward mental health recovery and prejudice were measured at the beginning and end of the semester. Two-way mixed analyses of variance were used to determine the differences in students' attitudes. Pearson product-moment correlation analyses were used to assess the relationship between prejudice toward people who experience a mental illness and attitudes toward recovery. RESULTS: The mental health nursing course had no measurable impact on students' recovery attitudes. However, there was a moderate-to-strong inverse relationship between recovery attitudes and prejudice toward those who experience a general mental illness (r = -0.54), depression (r = -0.60), or schizophrenia (r = -0.43). CONCLUSIONS: Curriculum reform is needed to optimize the impact of undergraduate education on students' attitudes. Possible changes include a more holistic approach to mental health that does not over accentuate the biomedical model, the use of nontraditional clinical sites that provide students an opportunity to interact with those further along in their recovery, and the inclusion of those in recovery in curriculum development. As there was a moderate-to-strong inverse relationship between recovery attitudes and prejudice, educational interventions that positively impact one may also impact the other. Further research is needed to investigate if the relationship is causal.


Assuntos
Bacharelado em Enfermagem , Recuperação da Saúde Mental , Estudantes de Enfermagem , Criança , Humanos , Atitude do Pessoal de Saúde , Estudantes de Enfermagem/psicologia , Otimismo , Inquéritos e Questionários
4.
Int Urogynecol J ; 34(3): 707-716, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35588320

RESUMO

INTRODUCTION AND HYPOTHESIS: Overactive bladder (OAB) and urinary incontinence (UI) are prevalent in older women. We investigated relations of toileting behaviors and urinary urge cues to OAB and UI in women ≥ 65 years. We tested mediation hypotheses that toileting behaviors lead to higher sensitivity to urinary urge cues (the mediator), which leads to both OAB and UI. METHODS: An e-panel was recruited to respond to an electronic survey that included demographic information, Urinary Cues Scale version 2, Toileting Behaviors-Women's Elimination Behaviors (TB-WEB) scale, and the International Consultation on Incontinence Questionnaire Short Forms for Urinary Incontinence (ICIQ-SF-UI) and Overactive Bladder (ICIQ-SF-OAB). Descriptive statistics were conducted; correlation matrices were created to explore relationships among major variables. Regression analyses were conducted to test our mediation hypotheses. RESULTS: There were 338 respondents with average age 70.9 (SD + 5.55) years. Most were white, overweight or obese, and had UI. Urinary urge cues fully mediated the relationship of TB-WEB with OAB. Urinary urge cues partially mediated the relationship of TB-WEB with UI; the direct effect of toileting behaviors on UI remained significant. Age and body mass index had significant partial correlations with UI but not with OAB. DISCUSSION: Toileting behaviors appear to contribute to sensitivity to urinary cues, which are related to both OAB and UI. Toileting behaviors have indirect effects on OAB and both indirect and direct effects on UI. Interventions to change toileting behaviors and extinguish urinary cues are needed. CONCLUSIONS: Behavioral and conditioning factors contribute to UI in older women.


Assuntos
Bexiga Urinária Hiperativa , Incontinência Urinária , Humanos , Feminino , Idoso , Sinais (Psicologia) , Inquéritos e Questionários
5.
Issues Ment Health Nurs ; 44(8): 778-786, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37459622

RESUMO

INTRODUCTION: The undergraduate mental health nursing course may be an optimal time to cultivate students' positive attitudes toward people living with a mental illness. AIM: To determine the impact of an undergraduate mental health nursing course on students' attitudes toward people living with a mental illness, depression, and schizophrenia. METHOD: A quasi-experimental single-group pretest posttest study was conducted using a sample of undergraduate nursing students in New York City (N = 44). Self-reported measures of prejudice toward those living with a mental illness were collected at the beginning of a mental health nursing course and again at its conclusion. RESULTS: A statistically significant decrease in prejudice scores was found concerning mental illness (p = .03, d = 0.23), depression (p = .01, d = 0.31), and schizophrenia (p = .013, d = 0.34). Subscale analysis revealed significant decreases in the fear/avoidance and unpredictability subscales. Yet no significant change was found in the subscales of authoritarianism and malevolence for any of the three conditions. DISCUSSION: A mental health course led to a modest decrease in prejudice. However, certain facets of prejudice remain unchanged. IMPLICATIONS FOR PRACTICE: Major curricular reform is needed to optimize the impact of undergraduate nursing education.


Assuntos
Bacharelado em Enfermagem , Transtornos Mentais , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Atitude do Pessoal de Saúde , Transtornos Mentais/psicologia , Preconceito
6.
Int Urogynecol J ; 33(6): 1463-1472, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35113178

RESUMO

INTRODUCTION AND HYPOTHESIS: Obstetric lacerations complicate the majority of deliveries. The application of standardized guidelines for assessing delivery trauma has not been assessed thoroughly in the United States. We recently identified gaps in US midwives' clinical assessment of delivery trauma. We conducted a cross-sectional national survey of practicing obstetricians in the USA to characterize their classification of obstetric lacerations. We hypothesized that attending obstetricians' identification and diagnosis of delivery trauma would be similar to our findings for midwives with frequent inaccuracy. METHODS: We recruited clinically active obstetricians through the Pregnancy-Related Care Research Network. We asked participants to classify (from written definitions) and diagnose (from standard illustrations) common forms of vaginal delivery trauma using the widely employed perineal laceration degree system. We performed bivariate analysis of high- and low-scoring respondents and logistic regression to model characteristics associated with higher diagnostic accuracy. RESULTS: Of the 162 respondents who started the survey, 76% (123) were included for analysis (22% of solicited emails). Overall, we found wide variation in response accuracy with as few as 62% of respondents correctly classifying certain types of lacerations. Only 49 out of 123 (40%) use the Sultan third-degree subclassification system and 67 out of 123 (52%) continue to use the midline/median approach for episiotomies. Providers reporting fewer deliveries per month and fewer publicly insured patients earned higher scores. CONCLUSIONS: Obstetricians in a nationally representative US perinatal provider network inconsistently identify perineal and nonperineal lacerations. We found important clinical knowledge gaps, suggesting that vaginal delivery diagnoses in obstetric quality studies and pelvic floor research might be inaccurate.


Assuntos
Lacerações , Complicações do Trabalho de Parto , Canal Anal/lesões , Estudos Transversais , Parto Obstétrico/efeitos adversos , Episiotomia/efeitos adversos , Feminino , Humanos , Lacerações/etiologia , Complicações do Trabalho de Parto/diagnóstico , Períneo/lesões , Gravidez , Fatores de Risco
7.
Am J Obstet Gynecol ; 224(1): 67.e1-67.e18, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33130030

RESUMO

BACKGROUND: Pelvic organ prolapse is common, but the underlying etiologies are poorly understood, which limits our current prevention and treatment options. OBJECTIVE: Our primary objective was to compare the uterosacral ligament histologic features in women with and without prolapse using the novel pelvic organ prolapse histologic quantification system. Our secondary aim was to determine whether composite histologic findings in uterosacral ligaments are associated with prolapse risk factors. STUDY DESIGN: This was a prospective cohort study in which paracervical uterosacral ligament biopsies were performed at the time of hysterectomy for primary prolapse or other benign gynecologic indications and processed for histologic evaluation. The pelvic organ prolapse quantification system was used to determine the prolapse stage. In this study, 9 prominent histologic features were semiquantitatively scored using the pelvic organ prolapse histologic quantification system in a blinded fashion and compared between prolapse and control groups. Unbiased principal component analysis of these scores was independently performed to identify potential relationships between histologic measures and prolapse risk factors. RESULTS: The histologic scores of 81 prolapse and 33 control ligaments were analyzed. Compared with the control group, women in the prolapse group were significantly older and more likely to be in the menopausal phase. There was no difference in the number of vaginal deliveries, body mass index, hormone use, or smoking status between the groups. To control for baseline differences, patients were also stratified by age over 40 years and menopausal status. Compared with the control group, the prolapse ligaments in the premenopausal group had significantly more loss of smooth muscle fibers within the fascicles (P<.001), increased inflammatory infiltrates of neutrophils within the tissue and perineural inflammatory cells (P<.01 and P=.04, respectively), and reduced neointimal hyperplasia (P=.02). Prolapse ligaments in the postmenopausal group exhibited elevated adipose content compared with that of the control group (P=.05). Amount of fibrillar collagen, total nonvascular smooth muscle, and muscle fiber vesicles of prolapse ligaments did not differ in either the premenopausal or postmenopausal group compared with that of the control group. Unbiased principal component analysis of the histologic scores separated the prolapse ligaments into 3 phenotypes: (1) increased adipose accumulation, (2) increased inflammation, and (3) abnormal vasculature, with variable overlap with controls. Posthoc analysis of these subgroups demonstrated a positive correlation between increasing number of vaginal deliveries and body mass index with increasing adipose content in the adipocyte accumulation and inflammatory phenotype and increasing neointimal hyperplasia in the vascular phenotype. However, only the relationship between vaginal delivery and adipocytes was significant in the adipose phenotype (R2=0.13; P=.04). CONCLUSION: Histologic phenotypes exist in pelvic support ligaments that can be distinguished using the pelvic organ prolapse histologic quantification system and principle component analysis. Vaginal delivery is associated with aberrant adipose accumulation in uterosacral ligaments. Our findings support a multifactorial etiology for pelvic organ prolapse contributing to altered smooth muscle, vasculature, and connective tissue content in crucial pelvic support structures. To confirm these associations and evaluate the biomechanical properties of histologic phenotypes of prolapse, larger studies are warranted. Closing this gap in knowledge will help optimize personalized medicine and help identify targets for prevention and treatment of this complex condition.


Assuntos
Ligamentos/fisiopatologia , Prolapso de Órgão Pélvico/fisiopatologia , Sacro , Útero , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Fenótipo , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença
8.
Int Urogynecol J ; 32(7): 1745-1753, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32399907

RESUMO

INTRODUCTION AND HYPOTHESIS: Clinical quality improvement relies on accurate understanding of current practice. We performed a cross-sectional national survey of certified nurse-midwives (CNMs) assessing classification and identification of obstetric anal sphincter injury (OASI) and other delivery lacerations. We hypothesized laceration diagnoses are frequently inaccurate, and delivery records for obstetric lacerations may be of questionable quality. METHODS: We emailed 6909 American College of Nurse Midwives members an internet-based survey link. Of respondents, we included clinically active CNMs who perform at least one delivery per month. We evaluated laceration knowledge and application using standard descriptive text and images and asked about processes for recording lacerations in the delivery record. RESULTS: We received 1070 (15.5%) completed surveys and 832 (77.8%) met inclusion criteria. Over 50% characterized their OASI training and ability to identify OASI as good/excellent. Most (79%) had never attended education review on OASI. The overall accuracy for classification and identification of perineal lacerations ranged from 49 to 99%. Non-perineal lacerations were frequently categorized using the perineal/OASI system. Half of respondents (51%) document their deliveries in an electronic medical record but a quarter (28%) are not personally responsible for approving delivery data. Younger participants without a doctoral degree, with self-assessed good/excellent laceration training, and caring for < 50% publicly insured patients had higher accuracy for laceration identification and diagnosis. CONCLUSIONS: We found high rates of inaccurate laceration diagnosis and inappropriate application of the perineal OASI degree system, suggesting education and training are needed. Clinical studies that rely on delivery diagnosis of OASI may not be reliable.


Assuntos
Lacerações , Enfermeiros Obstétricos , Complicações do Trabalho de Parto , Canal Anal/lesões , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Lacerações/epidemiologia , Complicações do Trabalho de Parto/epidemiologia , Complicações do Trabalho de Parto/etiologia , Períneo/lesões , Gravidez , Fatores de Risco
9.
Int Urogynecol J ; 32(7): 1907-1915, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32789812

RESUMO

INTRODUCTION AND HYPOTHESIS: Patient safety data including rates of obstetric anal sphincter injury (OASI) are often derived from hospital discharge codes. With the transition to electronic medical records (EMRs), we hypothesized that electronic provider-entered delivery data would more accurately document obstetric perineal injury than traditional billing/diagnostic codes. METHODS: We evaluated the accuracy of perineal laceration diagnoses after singleton vaginal deliveries during one calendar year at an American tertiary academic medical center. We reviewed the entire hospital chart to determine the most likely laceration diagnosis and compared that expert review diagnosis (ExpRD) with documentation in the EMR delivery summary (EDS) and ICD-9 diagnostic codes (IDCs). RESULTS: We retrospectively selected 354 total delivery records. OASI complicated 56 of those. 303 records (86%) were coded identically by the EDS and IDCs. Diagnoses from the IDCs and the EDS were mostly correct compared with ExpRD (sensitivity = 96%, specificity = 100%). There was no systematic over- or under-diagnosis of OASI for either the EDS (p = 0.070) or the IDCs (p = 0.447). When considering all laceration types the EDS was correct for 21 (5.9%) lacerations that were incorrect according to the IDCs. Overall, the EDS was more accurate (p < 0.05) owing to errors in IDC minor laceration diagnoses. CONCLUSIONS: Electronic medical record delivery summary data and EMR-derived diagnostic codes similarly characterize OASI. The EDS does not improve OASI reporting, but may be more accurate when considering all perineal lacerations. This assumes that providers have correctly identified and categorized the lacerations that they record in the EMR.


Assuntos
Lacerações , Canal Anal/lesões , Parto Obstétrico , Registros Eletrônicos de Saúde , Feminino , Humanos , Lacerações/diagnóstico , Lacerações/epidemiologia , Períneo/lesões , Gravidez , Estudos Retrospectivos , Fatores de Risco
10.
Int Urogynecol J ; 31(3): 591-604, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-30877353

RESUMO

INTRODUCTION AND HYPOTHESIS: There are no data on midwives' knowledge and management of obstetric anal sphincter injuries (OASIs) in the USA. We performed a cross-sectional national survey characterizing OASI practice by certified nurse midwives (CNMs), hypothesizing that few midwives personally repair OASIs and that there are gaps in CNM OASI training/education. METHODS: We emailed a REDCap internet-based survey to 6909 American College of Nurse Midwives members (ACNM). We analyzed responses from active clinicians performing at least one delivery per month, asking about OASI risks, prevention, repair, and management. We summarized descriptive data then evaluated OASI knowledge by patient and provider characteristics. RESULTS: We received 1070 (15.5%) completed surveys, and 832 (77.8%) met the inclusion/exclusion criteria. Participants were similar to ACNM membership. Respondents most frequently identified prior OASI (87%) and nutrition (71%) as antepartum OASI risk factors and, less frequently, nulliparity (36%) and race (22%). Identified intrapartum risks included forceps delivery (94%) and midline episiotomy (88%). When obstetric laceration is suspected, 13.6% of respondents perform a rectal examination routinely. Only 15% of participants personally perform OASI repair. Overall, participants matched 64% of evidence-based answers. OASI education/training courses were attended by 30% of respondents, and 44% knew of OASI protocols within their group/institution. Of all factors evaluated, the percent of evidence-based responses was only different for respondent education/CME and protocols. CONCLUSIONS: Quality initiatives regarding OASI prevention and management may improve care. Our data suggest OASI training for midwives may improve delivery care in the US. Further studies of other obstetric providers are needed.


Assuntos
Tocologia , Enfermeiros Obstétricos , Canal Anal , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Períneo , Gravidez
11.
Nurs Educ Perspect ; 41(6): 358-360, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31609820

RESUMO

Review of 145 experimental and quasi-experimental studies of teaching strategies in nursing education revealed that 52 percent were published outside the United States, 80 percent with undergraduate students. Seventy-seven percent assessed learning outcomes, and 80 percent had statistically significant findings. A surge in studies since 2010 showed no increase in methodological rigor. Two thirds had sample sizes less than 100, 77 percent were quasi-experimental, and 23 percent were one-group designs. Few authors published more than one experimental study of teaching methods. Findings underscore the need for more sophisticated methods and more funding for nursing education research.


Assuntos
Bacharelado em Enfermagem , Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Aprendizagem , Pesquisa em Educação em Enfermagem , Ensino
12.
Neurourol Urodyn ; 38(5): 1378-1383, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30939224

RESUMO

AIMS: Although physiological factors have a role in nocturia, research suggests that behavioral processes, especially classical conditioning may also play an important role in nocturia and other lower urinary tract symptoms. The study aimed to assess the relationship of stimulus-associated urges during the day to nocturia in a sample of women aged 18 to 40, after controlling for physiological symptoms (eg, overactive bladder [OAB]; daytime frequency). METHODS: An online study was conducted using a panel of 356 female participants between the ages of 18 to 40. One-third of the participants self-reported an OAB diagnosis as determined by their physician. Almost 80% of participants reported having at least one nocturnal voiding per night. Participants completed the Urinary Cues Questionnaire, which assessed the frequency with which respondents experienced the urge to urinate in the presence of a variety of cues and the Overactive Bladder Screening Scale (OABSS), which assesses symptoms of OAB syndrome. RESULTS: Controlling for OABSS scores and daytime urinary frequency, the Situational Cues Subscale had a significant relationship with nocturia such that with each unit increase in the subscale, the probability of nocturia increased by 12% to 14% depending on the definition of nocturia. DISCUSSION: Behavioral techniques, such as habituation to decrease the association between awakening at night and feeling an urge to urinate, may be an appropriate intervention to mitigate nocturnal urination. Theoretically, this would translate to decreasing this disorder throughout the lifespan, if behavioral techniques could be effectively utilized in early adulthood.


Assuntos
Sinais (Psicologia) , Noctúria/fisiopatologia , Bexiga Urinária Hiperativa/fisiopatologia , Micção/fisiologia , Adolescente , Adulto , Feminino , Humanos , Autorrelato , Inquéritos e Questionários , Adulto Jovem
13.
Neurourol Urodyn ; 37(1): 284-290, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28464244

RESUMO

AIMS: Although anecdotal reports of urinary urgency at one's front door are common in overactive bladder syndrome (OAB), little research has been done on how one's front door and other stimuli are related to urinary symptoms. We hypothesized that individuals with OAB would have higher scores on the Urinary Cues Questionnaire, developed for this study to assess stimulus-associated urinary urges, than those without OAB. METHODS: Online surveys were administered to 328 women age 18-40 years recruited from a respondent panel maintained by CINT such that one-third of the sample reported a diagnosis of OAB. The survey assessed OAB symptoms and the frequency with which participants associated 42 stimuli with the urge to urinate. RESULTS: Psychometric analyses showed internal consistency estimates of the Urinary Cues Questionnaire of α = 0.97 and a test-retest correlation of 0.91. Women with OAB had significantly higher Urinary Cues Scores than those without OAB, with a t-test showing a large effect size of d = 1.49 (95%CI 1.24, 1.74), P < 0.001. DISCUSSION: Behavioral treatments aimed at reducing the response to cues may be useful in OAB, but more research is needed on both treatment implications and on the trajectory of symptom development.


Assuntos
Sinais (Psicologia) , Bexiga Urinária Hiperativa/psicologia , Incontinência Urinária de Urgência/psicologia , Adolescente , Adulto , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Autorrelato , Inquéritos e Questionários , Adulto Jovem
14.
Neurourol Urodyn ; 37(7): 2048-2052, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-27653805

RESUMO

AIMS: Nocturia, or waking up at night to void, is a highly prevalent and bothersome lower urinary tract symptom. However, the applied treatment modalities do not improve symptoms in about half of the patients. The aim of this report is to generate new ideas for future nocturia research, with special emphasis on the role of sleep physiology and sleep disorders. METHODS: The following is a report of the presentations and subsequent discussion of the Nocturia Think Tank session at the annual meeting of the International Consultation on Incontinence Research Society (ICI-RS), which took place in September 2015 in Bristol. General information about the organization of the ICI-RS meeting can be found on the website "www.ici-rs.org." An overview of challenges within the existing evidence, future research ideas, and results of research with regard to nocturia and sleep were presented. RESULTS AND CONCLUSION: In order to optimize the management of nocturia and nocturnal polyuria (NP), future research has to focus on the development of unambiguous terminology regarding nocturia and NP, the role of renal function profiles and simplified frequency volume charts as guidance of individualized therapy and the role of sleep disorders such as periodic limb movements during sleep and habitual voiding as a response to awakening. Neurourol. Urodynam. 37:2048-2052, 2018. © 2016 Wiley Periodicals, Inc.


Assuntos
Noctúria/fisiopatologia , Noctúria/terapia , Sono/fisiologia , Adolescente , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Noctúria/diagnóstico , Síndrome da Mioclonia Noturna/complicações , Síndrome da Mioclonia Noturna/fisiopatologia , Poliúria/diagnóstico , Poliúria/fisiopatologia , Poliúria/terapia , Estudos Retrospectivos , Adulto Jovem
16.
Nurs Res ; 66(1): 49-53, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27977567

RESUMO

BACKGROUND: Near-falls are a frequent, but not commonly studied, occurrence in the elderly Black population and may be related to prospective falls. OBJECTIVES: The purpose of this paper is to examine the relationship of near-falls to demographic characteristics, use of assistive devices, gait, and physical activity levels in elderly Blacks. METHODS: Community-dwelling, elderly Black patients aging 65 and older and attending two clinics of the Mount Sinai Hospital in Harlem in New York City were recruited. The number of near-falls during the past year was self-reported using the Elderly Falls Screening Test. The Rapid Assessment of Physical Activity was used to assess aerobic and anaerobic activity levels. Backward stepwise logistic regression was used to identify predictors of near-falls. RESULTS: A total of 120 elderly Black adults took part in the study. Prevalence of occasional or frequent near-falls was 52.5%. In the final trimmed model, time of the 5-m observed walk (OR = 1.41, p = .001) and being male (OR = 3.68, p = .02) were significant predictors of near-fall experiences. DISCUSSION: Future research needs to be done in elderly Black populations to determine what factors may contribute to men experiencing more near-falls and on the relation between near-falls and falls.


Assuntos
Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Avaliação Geriátrica/métodos , Comportamentos Relacionados com a Saúde/etnologia , Características de Residência , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Nível de Saúde , Humanos , Vida Independente , Masculino , Cidade de Nova Iorque , Prevalência , Fatores de Risco
17.
J Wound Ostomy Continence Nurs ; 44(2): 181-187, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28267126

RESUMO

The aim of this review was to identify etiological environmental factors related to incontinence in children and adults. A variety of etiological environmental factors for the development of incontinence were identified. In children, these encompass stressful life events and trauma, family dysfunction, parental psychopathology, school-related stressors, toilet or "potty" training, fluid consumption habits, housing conditions, and the availability of toilets. In adults, physical exercise, obesity, working conditions, fluid intake, and the availability of toilets play a role. Intervening variables such as hormonal variations due to work shifts have also been identified as influencing the likelihood of incontinence. Current research suggests that environmental factors influence the development of incontinence in children and adults. The interactions between biological factors, the immediate environment, and intervening variables need to be explored in greater detail. Practical solutions to reduce barriers to adequate fluid intake and healthy toileting habits should be implemented in school and work settings.


Assuntos
Comportamentos Relacionados com a Saúde , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Adulto , Criança , Análise Fatorial , Feminino , Humanos , Masculino , Obesidade/complicações , Comportamento Sedentário , Apoio Social
18.
Int Urogynecol J ; 27(11): 1697-1704, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27091643

RESUMO

INTRODUCTION AND HYPOTHESIS: The uterosacral (USL) and cardinal ligaments (CL) provide support to the uterus and pelvic organs, and the round ligaments (RL) maintain their position in the pelvis. In women with pelvic organ prolapse (POP), the connective tissue, smooth muscle, vasculature, and innervation of the pelvic support structures are altered. Rodents are commonly used animal models for POP research. However, the pelvic ligaments have not been defined in these animals. In this study, we hypothesized that the gross anatomy and histological composition of pelvic ligaments in rodents and humans are similar. METHODS: We performed an extensive literature search for anatomical and histological descriptions of the pelvic support ligaments in rodents. We also performed anatomical dissections of the pelvis to define anatomical landmarks in relation to the ligaments. In addition, we identified the histological components of the pelvic ligaments and performed quantitative analysis of the smooth muscle bundles and connective tissue of the USL and RL. RESULTS: The anatomy of the USL, CL, and RL and their anatomical landmarks are similar in mice, rats, and humans. All species contain the same cellular components and have similar histological architecture. However, the cervical portion of the mouse USL and RL contain more smooth muscle and less connective tissue compared with rat and human ligaments. CONCLUSION: The pelvic support structures of rats and mice are anatomically and histologically similar to those of humans. We propose that both mice and rats are appropriate, cost-effective models for directed studies in POP research.


Assuntos
Ligamentos/anatomia & histologia , Modelos Animais , Pelve/anatomia & histologia , Útero/anatomia & histologia , Vagina/anatomia & histologia , Animais , Tecido Conjuntivo/patologia , Feminino , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Músculo Liso/patologia , Prolapso de Órgão Pélvico/patologia , Ratos , Ratos Sprague-Dawley
20.
J Sex Med ; 11(8): 2039-47, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24963841

RESUMO

INTRODUCTION: Cycling is growing in popularity among women. As in men, it is associated with genital neuropathies and decreased sensation in female riders. However, there is a gap in research and information addressing the relationship between cycling and female sexual dysfunction (FSD) in women. AIMS: To review the literature investigating pelvic floor injuries and sexual dysfunction in female cyclists. METHODS: Searches in several electronic databases were conducted, and relevant articles that met the inclusion criteria were identified for critical review. MAIN OUTCOME MEASURES: The main outcome measure to be determined was the strength of the current body of evidence in published literature of a correlation between cycling-related pelvic floor injuries and FSD. RESULTS: Data on FSD from cycling-related injuries in women are limited. Research indicates that bicycle setup and riding equipment may be contributing factors. Women's ergonomics and physiology interact differently with the bicycle than men's. Current evidence offers insufficient foundation to recommend various effect-mitigating equipment and products. CONCLUSIONS: While gender-specific cycling products offer a promising direction for protecting women riders, studies addressing FSD and pelvic floor injuries in women cyclists are inadequate to indicate clear etiology or provide treatment recommendations. Current evidence is also insufficient to recommend effect-mitigating equipment and products.


Assuntos
Ciclismo/fisiologia , Diafragma da Pelve/lesões , Disfunções Sexuais Fisiológicas/etiologia , Adulto , Ciclismo/lesões , Desenho de Equipamento , Feminino , Humanos
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