Description:
•The occurrence of urinary incontinence was higher in women with breast cancer.•Women with breast cancer experienced higher distress and impact of urinary symptoms.•Routine screening and offer of treatment for urinary symptoms may be indicated. One of the sequalae of breast cancer treatments may be pelvic floor (PF) dysfunction such as urinary incontinence (UI), faecal incontinence (FI), and pelvic organ prolapse (POP). The aim of this study was to compare the occurrence and related distress and impact of PF dysfunction between women with and without breast cancer. Women with and without breast cancer participated in this cross-sectional study. The Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire were used to quantify the prevalence and related distress, and impact of PF dysfunction. Factors associated with PF outcomes were examined using logistic and linear regressions while controlling for known risk factors for PF dysfunction (age, body mass index, and parity). 120 women with breast cancer, and 170 women without breast cancer responded. The occurrence of any type of UI was higher in women with breast cancer than women without breast cancer (percentage difference=17% 95% CI: 7, 29). Women with breast cancer experienced higher impact of urinary symptoms (mean difference=18.2 95% CI: 8.9, 27.7) compared to those without. Multivariable analysis indicated that having breast cancer (β 0.33 95%CI: 0.08, 0.51) was the strongest predictor of greater impact of urinary symptoms. Women with breast cancer reported a higher occurrence and impact of urinary symptoms than women without breast cancer. While further studies are required to confirm our findings, routine screening and offering treatment for urinary symptoms may be indicated for women with breast cancer.
Description:
Objectives: Living alone is a risk factor for depressive symptoms among older men, and is likely to occur due to belongingness needs being unmet. It is proposed the living alone-sense of belonging and living alone-depressive symptoms relations are stronger for gay men than heterosexual men, due to different family circumstances. This research tested a moderated mediation model, specifically whether the relationship between living alone and depressive symptoms is mediated by sense of belonging, and whether the living alone-sense of belonging and living alone-depressive symptoms relationships are moderated by sexual orientation. Method: A community sample of 169 Australian gay men aged 65 to 93 years and 187 Australian heterosexual men aged 65 to 94 years completed the Psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale. Results: Results supported the simple mediation model, with living alone being associated directly and indirectly with depressive symptoms via sense of belonging. The conditional indirect effect of living alone on depressive symptoms via sense of belonging was not significant, and therefore the moderated mediation model was not supported. Conclusion: Results imply that older men who live alone are at increased risk of depressive symptoms directly and indirectly via lower levels of sense of belonging.
Description:
Objectives: Higher levels of depression have been documented among older adults who reside in an assisted living facility, compared with those who remain in their own homes. The aims of the current study were to test whether the relationship between housing type and depressive symptoms was mediated by a sense of belonging and whether housing type and sense of belonging interact to influence the depressive symptoms among older adults (moderation model).Method: A sample of 257 older adults who lived in their own homes and 166 older adults who lived in an assisted living facility completed the psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale.Results: Results showed that a sense of belonging partially mediated the relationship between housing type and depressive symptoms, such that living in a nursing home was associated with lower levels of belonging, and lower levels of belonging were, in turn, associated with higher levels of depressive symptoms. Residing in an assisted living facility was associated with depressive symptoms at low and average levels of belonging.Conclusion: Results highlight the need for more research on the role of sense of belonging as an influencing factor on depressive symptoms among institutionalised older adults for both theoretical and treatment goals.
Description:
Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.
Description:
Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.
Description:
Aims and objectives To investigate the prevalence of depression in the third trimester of pregnancy and identify the related demographic risk factors. Background Antenatal depression as a disabling and treatable disease has a wide-ranging impact on perinatal women and has received extensive attention from researchers. Design A cross-sectional survey was conducted at three public hospitals. Methods Demographic questionnaire was developed from the literature review, and depression was assessed using the Edinburgh Postnatal Depression Scale. A binary logistic regression model was used to assess the association between depression and demographic predictors. STROBE checklist for cross-sectional studies was applied in this paper (see Appendix S1). Result A total of 773 pregnant women participated in the study. 29.6% of participants scored more than 9 points on Edinburgh Postnatal Depression Scale. In the final logistic model, living in rural area, marital satisfaction, assisted reproductive technology, lacking of prenatal health knowledge and life events were strongly significantly associated with antenatal depression. Moreover, living in an extended family, without Medicare insurance, unemployed, working as civil servants or healthcare workers, and lower household income also predicted antenatal depression. However, education level, smoking or drinking before pregnancy was found not to be associated with antenatal depression. Conclusion Our findings suggest that the prevalence of antenatal depression was high. Satisfied with the current marital status, pregnancy without assisted reproductive technology, knowledge of perinatal care and no life events recently were considered as the protective factors for antenatal depression. Relevance to clinical practice Antenatal psychological interventions should focus on how to improve the marital satisfaction and the relationship with their family members. More attentions should be paid to the women who have had some life events recently or received assisted reproductive technology for pregnancy.
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Background: As the number of immigrants grows, the health of Chinese immigrant women, especially their perinatal health, has gradually attracted public attention. Our review has two main purposes. First, estimate the prevalence of postpartum depressive symptoms in Chinese immigrant women, and then determine risk factors for postpartum depressive symptoms among these women. Methods: The following databases: MEDLINE, Embase, Scopus, Web of Science, PsycINFO and PubMed were used in literature search from their commencements until November 21st 2017. The Joanna Briggs Institute (JBI) Critical Appraisal instruments were used to evaluate the quality of the article. Four studies met the inclusion criteria, contributed to our review and meta-analysis. Result: The prevalence of postpartum depression is high in Chinese immigrant women. Risk factors for postpartum depression in Chinese immigrant women were defined as lack of social support, unstable economic status, and acculturation. Conclusion: There have been few studies on postpartum depression among Chinese immigrant women. Existing studies have shown a high prevalence of postpartum depression in Chinese immigrant women. Moreover, there is an urgent need for studies on postpartum depression among Chinese immigrant women informing better understanding, programs of care and improving the perinatal health status of Chinese immigrant women. (C) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Description:
Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
Description:
Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
Description:
Objective: To assess the prevalence of Trichomonas vaginalis in two island populations of Vanuatu using the Pap smear as the screening technique. Study design: Women were randomly selected from specific sites on the islands of Efate (urban setting) and Ambae (rural setting). Pap smears were collected, screened and reported. Setting: The first collection site was the Women's Health/Antenatal Care Clinic at Vila Central Hospital in Port Vila, the capital city located on the island of Efate, and the second collection site was a rural village on a sparsely populated inhabited northern island, Ambae. Participants: A total of 905 Ni-Vanuatu women participants: Efate (n = 562) 62%, and Ambae (n = 343) 38%. The mean age was 35.8 years: Efate 32.6 years, and Ambae 40.8 years. Main outcome measure: The presence or absence of T. vaginalis in these Pap smears was documented during the study's cervical screening process. Results: The overall prevalence of T. vaginalis within the study participants was 25.3%. Almost half of the infected sample group were in the age group of 30-39 years (43.8%). The prevalence of T. vaginalis in Efate was 14.7%, compared with 43.4% in Ambae. Conclusion: The prevalence of T. vaginalis in Vanuatu women is significantly higher compared with developed countries. Women in rural settings are less likely to have access to sexually transmitted disease prevention and treatment programs, thus contributing to high infection rates compared with women in urban settings. Cultural and educational differences in the rural setting might also contribute to higher sexually transmitted disease rates among these women.
Description:
ObjectiveLevels of suicidal behavior among gay men are a significant concern. The Interpersonal Theory of Suicide proposes that being unpartnered is a risk factor for suicidal behavior due to thwarted belongingness; however, this has yet to be tested empirically. Recent studies also indicate that the two components of hope, agency and pathways, may be protective against suicidal behavior. The first aim of the current study was to investigate whether thwarted belongingness mediates the relationship between relationship status and suicidal behavior in gay men. The study also examined whether agency and pathways weaken the association between relationship status and thwarted belongingness, and whether agency weakens the relation between thwarted belongingness and suicidal behavior. MethodA sample of 370 self-identified gay men aged from 18 to 66 years old (M = 26.13, SD = 8.02) completed the Suicidal Behaviors Questionnaire-Revised, the Interpersonal Needs Questionnaire-Revised, and the Adult Dispositional Hope Scale. ResultsResults showed that thwarted belongingness mediated the relationship between relationship status and suicidal behavior. The hypothesized moderated-mediation models were not supported. ConclusionsThese findings have implications for the development of interventions that aim to reduce suicidal behaviors in gay men.
Description:
Spasticity is one of the most important causes of disability after stroke. In spite of high incidence of spasticity, little is known about the relationship between the occurrence and the development of spasticity. This study aimed to determine risk-factors of post stroke spasticity. This was an observational study of 149 persons with first ever stroke. The following parameters were assessed: Stroke severity, Spasticity, Disability and Joint contracture. Prevalence of spasticity was between 17–25% during the first 3 months after stroke. The onset of spasticity was 13.79% and 4.16% at 1 and 3 months after stroke respectively. The prevalence of spasticity in the upper extremity was significantly more than lower extremity at 1 month. Spasticity was significantly more severe in the upper extremity than lower extremity. In patients with hemorrhagic stroke Odds ratios of spasticity was 2.5 times more than persons with ischemic stroke (P = 0.0210. The Odds ratios of severe spasticity at 1 and 3 months were 1.66 and 1.75 times more than the first week (P = 0.024, P = 0.042 respectively). Post stroke spasticity is more common in persons with hemorrhagic stroke, severe paresis and lower functional abilities. The most incidence of spasticity happens in the first month after stroke.
Description:
Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12 center dot 6% (2 years preprogramme implementation) to 2 center dot 6% (6 years postprogramme implementation) (P < 0 center dot 001). Audits between 2003 and 2011 of 4368 patient medical records identified compliance with pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital.
Description:
Objective To test the feasibility of general practice nurse (GPN)-led screening for clinically significant symptoms of anxiety (CSSA) in older people and to estimate the prevalence of CSSA. Methods General practice nurse-led screening for CSSA was undertaken in eight general practices by integrating the five-item Geriatric Anxiety Inventory-Short Form (GAI-SF) into the annual 75 years and older health assessment (75+ HA). Prevalence rates were calculated, and field notes were analysed. Results Over 30 months, 736 patients were screened for CSSA, with a detected prevalence rate of 20.1%. The application of the GAI-SF into the 75+ HA was feasible and readily accepted by patients. Conclusions The five-item GAI-SF is an age-appropriate screening tool for CSSA in general practice settings. Further research is warranted, particularly in relation to the development and implementation of evidence-informed, general practice-based interventions for CSSA that can be effectively delivered to meet the needs of older people.
Description:
Objective To test the feasibility of general practice nurse (GPN)-led screening for clinically significant symptoms of anxiety (CSSA) in older people and to estimate the prevalence of CSSA. Methods General practice nurse-led screening for CSSA was undertaken in eight general practices by integrating the five-item Geriatric Anxiety Inventory-Short Form (GAI-SF) into the annual 75 years and older health assessment (75+ HA). Prevalence rates were calculated, and field notes were analysed. Results Over 30 months, 736 patients were screened for CSSA, with a detected prevalence rate of 20.1%. The application of the GAI-SF into the 75+ HA was feasible and readily accepted by patients. Conclusions The five-item GAI-SF is an age-appropriate screening tool for CSSA in general practice settings. Further research is warranted, particularly in relation to the development and implementation of evidence-informed, general practice-based interventions for CSSA that can be effectively delivered to meet the needs of older people.