| 1. |
- Krips, M., et al.
(author)
-
ACA CI observations of the starburst galaxy NGC 253
- 2016
-
In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 592:L3
-
Journal article (peer-reviewed)abstract
- Context. Carbon monoxide (CO) is widely used as a tracer of the molecular gas in almost all types of environments. However, several shortcomings of CO complicate usaging it as H-2 tracer, such as its optical depth effects, the dependence of its abundance on metallicity, or its susceptibility to dissociation in highly irradiated regions. Neutral carbon emission has been proposed to overcome some of these shortcomings and hence to help revealing the limits of CO as a measure of the molecular gas. Aims. We aim to study the general characteristics of the spatially and spectrally resolved carbon line emission in a variety of extragalactic sources and evaluate its potential as complementary H-2 tracer to CO. Methods. We used the Atacama Compact Array to map the [CI](P-3(1)-P-3(0)) line emission in the nearby starburst galaxy NGC 253 at unprecedented angular resolution (similar to 3 ''). This is the first well-resolved interferometric [CI] map of an extragalactic source. Results. We have detected the [CI] line emission at high significance levels along the central disk of NGC 253 and its edges where expanding shells have previously been found in CO. Globally, the distribution of the [CI] line emission strongly resembles that of CO, confirming the results of previous Galactic surveys that [CI] traces the same molecular gas as CO. However, we also identify a significant increase of [CI] line emission with respect to CO in (some of) the outflow or shocked regions of NGC 253, namely the bipolar outflow emerging from the nucleus. A first-order estimate of the [CI] column densities indicates abundances of [CI] that are very similar to the abundance of CO in NGC 253. Interestingly, we find that the [CI] line is marginally optically thick within the disk. Conclusions. The enhancement of the [CI]/CO line ratios (similar to 0.4-0.6) with respect to Galactic values (
|
|
| 2. |
- Carniani, S., et al.
(author)
-
Extended ionised and clumpy gas in a normal galaxy at z=7.1 revealed by ALMA
- 2017
-
In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 605
-
Journal article (peer-reviewed)abstract
- We present new ALMA observations of the [O III] 88 mu m line and high angular resolution observations of the [C II] 158 mu m line in a normal star forming galaxy at z = 7.1. Previous [C II] observations of this galaxy had detected [C II] emission consistent with the Ly alpha redshift but spatially slightly off set relative to the optical (UV-rest frame) emission. The new [C II] observations reveal that the [C II] emission is partly clumpy and partly diffuse on scales larger than about 1 kpc. [O III] emission is also detected at high significance, off set relative to the optical counterpart in the same direction as the [C II] clumps, but mostly not overlapping with the bulk of the [C II] emission. The off set between different emission components (optical/UV and different far-IR tracers) is similar to that which is observed in much more powerful starbursts at high redshift. We show that the [O III] emitting clump cannot be explained in terms of diffuse gas excited by the UV radiation emitted by the optical galaxy, but it requires excitation by in-situ (slightly dust obscured) star formation, at a rate of about 7 M circle dot yr(-1). Within 20 kpc from the optical galaxy the ALMA data reveal two additional [O III] emitting systems, which must be star forming companions. We discuss that the complex properties revealed by ALMA in the z similar to 7.1 galaxy are consistent with expectations by recent models and cosmological simulations, in which differential dust extinction, differential excitation and different metal enrichment levels, associated with different subsystems assembling a galaxy, are responsible for the various appearance of the system when observed with distinct tracers.
|
|
| 3. |
- de Boer, T A, et al.
(author)
-
Pelvic organ prolapse and overactive bladder.
- 2010
-
In: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 29:1, s. 30-9
-
Research review (peer-reviewed)abstract
- AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms depend on the prolapsed compartment and/or stage of the prolapse? *What is the possible pathophysiology of OAB in POP? *Do OAB symptoms and DO change after conservative or surgical treatment of POP? METHODS: We searched on Medline and Embase for relevant studies. We only included studies in which actual data about OAB symptoms were available. All data for prolapse surgery were without the results of concomitant stress urinary incontinence (SUI) surgery. RESULTS: Community- and hospital-based studies showed that the prevalence of OAB symptoms was greater in patients with POP than without POP. No evidence was found for a relationship between the compartment or stage of the prolapse and the presence of OAB symptoms. All treatments for POP (surgery, pessaries) resulted in an improvement in OAB symptoms. It is unclear what predicts whether OAB symptoms disappear or not. When there is concomitant DO and POP, following POP surgery DO disappear in a proportion of the patients. Bladder outlet obstruction is likely to be the most important mechanism by which POP induces OAB symptoms and DO signs. However, several other mechanisms might also play a role. CONCLUSIONS: There are strong indications that there is a causal relationship between OAB and POP.
|
|
| 4. |
- Kirk, KM, et al.
(author)
-
The Anorexia Nervosa Genetics Initiative: Study description and sample characteristics of the Australian and New Zealand arm
- 2017
-
In: The Australian and New Zealand journal of psychiatry. - : SAGE Publications. - 1440-1614 .- 0004-8674. ; 51:6, s. 583-594
-
Journal article (peer-reviewed)abstract
- Anorexia nervosa is a severe psychiatric disorder with high mortality rates. While its aetiology is poorly understood, there is evidence of a significant genetic component. The Anorexia Nervosa Genetics Initiative is an international collaboration which aims to understand the genetic basis of the disorder. This paper describes the recruitment and characteristics of the Australasian Anorexia Nervosa Genetics Initiative sample, the largest sample of individuals with anorexia nervosa ever assembled across Australia and New Zealand.Methods:Participants completed an online questionnaire based on the Structured Clinical Interview Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) eating disorders section. Participants who met specified case criteria for lifetime anorexia nervosa were requested to provide a DNA sample for genetic analysis.Results:Overall, the study recruited 3414 Australians and 543 New Zealanders meeting the lifetime anorexia nervosa case criteria by using a variety of conventional and social media recruitment methods. At the time of questionnaire completion, 28% had a body mass index ⩽ 18.5 kg/m2. Fasting and exercise were the most commonly employed methods of weight control, and were associated with the youngest reported ages of onset. At the time of the study, 32% of participants meeting lifetime anorexia nervosa case criteria were under the care of a medical practitioner; those with current body mass index < 18.5 kg/m2were more likely to be currently receiving medical care (56%) than those with current body mass index ⩾ 18.5 kg/m2(23%). Professional treatment for eating disorders was most likely to have been received from general practitioners (45% of study participants), dietitians (42%) and outpatient programmes (42%).Conclusions:This study was effective in assembling the largest community sample of people with lifetime anorexia nervosa in Australia and New Zealand to date. The proportion of people with anorexia nervosa currently receiving medical care, and the most common sources of treatment accessed, indicates the importance of training for general practitioners and dietitians in treating anorexia nervosa.
|
|
| 5. |
- Sykes, D, et al.
(author)
-
Characteristics of female outpatients with urinary incontinence participating in a 6-month observational study in 14 European countries
- 2005
-
In: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 52:Suppl 2, s. 13-23
-
Journal article (peer-reviewed)abstract
- Objective: To describe the characteristics, of women seeking treatment for Symptoms of urinary incontinence (UI) in European countries. Design: Prospective urinary incontinence research (PURE) was a 6-month, observational, pan-European Study, primarily aimed at determining the direct costs of urinary incontinence treatment. The secondary objectives of PURE were to describe the impact of UI on health-related quality of life (HRQoL) in treatment seeking patients and to illustrate the treatment patterns For UI in Europe. Setting: One thousand and Fifty-five physicians from 14 European Countries, including general practitioners (GPs), gynaecologists, urologists and geriatricians, observed women seeking treatment For their UI and recorded data at the first observation and then prospectively at 3 and 6 months after the first observation during the normal course of therapy. Subjects: Women of at least 18 years of age who had experienced urinary leakage in the 12 months prior to enrolment in the study, who were seeking treatment or under treatment for UI and who presented within the normal,11 Course of UI care were included in the 6 months study. The first observation characteristics of the patients are described here. Methods: Demographic characteristics, as well as disease and treatment status at first observation were explored using descriptive summary statistics to gain an understanding Of the Population studied. Results: In total, 9487 women took part in PURE, with the largest patient groups from Germany, Spain and the UK/Ireland. The majority of women were post-menopausal and had a mean age of 60.7 years, were not current smokers and tended to be overweight (BMI > 25.0). Overall, mixed UI symptoms were more common than SUI and UUI as defined by clinical opinion (SUI 38%, MUI 42% and UUI 18%), and by a two-item questionnaire, the S/UIQ (SUI 29%. MUI 58% and UUI 13%). Around half of the patients (48%) suffered from their symptoms for less than 2 years before consulting a physician; 28% delayed seeking treatment for 3-5 years, with 13% waiting for 6-10 years and the remaining 11% waiting for 11 or more years. Conclusions: Some of the described patients' characteristics may provide important information to clinicians to enable them to take a more active approach to case-finding, which Will ultimately benefit the incontinent patient.
|
|
| 6. |
- Monz, B, et al.
(author)
-
A description of health care provision and access to treatment for women with urinary incontinence in Europe - A five-country comparison
- 2005
-
In: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 52:Suppl 2, s. 3-12
-
Journal article (peer-reviewed)abstract
- Background: Female urinary incontinence is a prevalent condition, but only about one-third of women seek treatment. Objectives: To describe the health care provision for women with urinary incontinence from a European perspective, selecting France, Germany, Spain, Sweden, and the United Kingdom as examples, and to investigate whether specific barriers for treatment exist. Methods: Available health care system information, a literature review and clinical expert information identified patterns of treatment provision. Results: In Spain, Sweden, and the UK, access to medical care in general is primarily through the general practitioners. However, in Spain and Sweden, women with urinary incontinence can directly visit specialists. In France and Germany, women have equal access to either general practitioners or specialists. Aside from general practitioners. gynaecologists play a major role ill urinary incontinence care in all countries except the UK. In Germany, urologists are also involved in initial female urinary incontinence cared however, only in about 16% of women. There are no waiting lists in France and Germany for appointments with physicians or procedures, contrary to Spain, which has long waiting lists. Access to general practitioners in the UK is unrestricted whereas advanced diagnosis and treatment in secondary care requires long waits. A specific Swedish policy mandates that no woman is required to wait longer than,3 months for incontinence visits and related surgery. In Sweden and the UK, specialist nurses and other health care workers provide incontinence set-vices. Almost all treatment options for urinary incontinence are at least in part reimbursed. However, various co-payments and fees in France, Germany, Spain and Sweden exist and constitute out-of-pocket expenses for women if no complementary additional private health insurance is available. In some countries, financial incentives for physicians to provide incontinence services are low, raising concerns about their interest to engage in continued patient care. Conclusions: Information about service provision in Europe for women with urinary incontinence is limited and makes it difficult to understand barriers to treatment seeking. A broad European perspective may promote optimised treatment access in the future for this widespread and under-recognised condition.
|
|
| 7. |
- Monz, B, et al.
(author)
-
Patient-reported impact of urinary incontinence - Results from treatment seeking women in 14 European countries
- 2005
-
In: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 52:Suppl 2, s. 24-34
-
Journal article (peer-reviewed)abstract
- Objectives: To describe the patient-reported impact of urinary incontinence (UI) in treatment-seeking women in Europe. Design: PURE was a non-interventional, observational study, which aimed to describe the direct costs of treatment for European women seeking treatment for UI. A secondary Study objective was to describe the impact of UI on health-related quality of life (HRQoL) by UI subtype and severity of disease. This paper presents the results from quality of life assessments as well as bothersomeness and interference with daily activities from the first study observation. Subjects: Nine thousand four hundred and eighty-seven European women who had UI symptoms in the last 12 months were enrolled. Their UI symptoms were frequently those defined as mixed urinary incontinence (MUI) and were moderate to severe in nature. Measurements: HRQoL was assessed at the first observation using the urinary Incontinence-specific Quality of Life Questionnaire (I-QOL) and the EQ-5D, a generic quality of life questionnaire. Data collected from EQ-5D provided insight into the patients' general health perception, while the I-QOL data indicated how affected the women were about their UI symptoms. Higher EQ-5D and I-QOL scores represent better quality of life. Patients were asked to indicate how much UI symptoms limited selected activities and to indicate the degree to which they found their symptoms to be bothersome. Results: Overall, the median self-rated health status on the EQ-5D visual analogue scale (VAS) was 70.0 and the median EQ-5D health state index was 0.85, with small but noticeable differences observed between countries. Of the five health dimensions of the EQ-5D, patients' self-care appeared to be the least affected by UI, with fewer than 10% of the women reporting that they had some problems. Between 20 and 40% of patients had some problems with their mobility and usual activities, or had pain/discomfort or anxiety/depression. However, the impact of existing co-morbidity was not assessed and may have affected some women's scoring of the EQ-5D domains. The mean total I-QOL score overall was 57.7 and of the three subscales of the I-QOL, psychosocial impact had the highest overall scores, representing fewer problems, with lower scores observed for the avoidance and limiting behaviour subscale, and even lower scores for the social embarrassment subscale. The greatest patient-reported impact of UI symptoms on activities was on exercise, with more than 45% of patients moderately to totally limited in this activity. In most of the countries, more than 60% of the women reported that they were moderately to extremely bothered by their UI symptoms. Conclusions: There was considerable impact of UI on HRQoL in a treatment seeking population, as demonstrated by the disease-specific quality of life scale and by the high percentage of patients who were bothered by their symptoms.
|
|
| 8. |
- Riemsma, R., et al.
(author)
-
Can incontinence be cured? A systematic review of cure rates
- 2017
-
In: Bmc Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 15:63
-
Journal article (peer-reviewed)abstract
- Background: Incontinence constitutes a major health problem affecting millions of people worldwide. The present study aims to assess cure rates from treating urinary (UI) or fecal incontinence (FI) and the number of people who may remain dependent on containment strategies. Methods: Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and PEDro were searched from January 2005 to June 2015. Supplementary searches included conference abstracts and trials registers (2013-2015). Included studies had patients >= 18 years with UI or FI, reported treatment cure or success rates, had >= 50 patients treated with any intervention recognized in international guideline algorithms, a followup >= 3 months, and were published from 2005 onwards. Title and abstract screening, full paper screening, data extraction and risk-of-bias assessment were performed independently by two reviewers. Disagreements were resolved through discussion or referral to a third reviewer where necessary. A narrative summary of included studies is presented. Results: Most evidence was found for UI: Surgical interventions for stress UI showed a median cure rate of 82.3% (interquartile range (IQR), 72-89.5%); people with urgency UI were mostly treated using medications ( median cure rate for antimuscarinics = 49%; IQR, 35.6-58%). Pelvic floor muscle training and bulking agents showed lower cure rates for UI. Sacral neuromodulation for FI had a median cure rate of 38.6% (IQR, 35.6-40.6%). Conclusions: Many individuals were not cured and hence may continue to rely on containment. No studies were found assessing success of containment strategies. There was a lack of data in the disabled and in those with neurological diseases, in the elderly and those with cognitive impairment. Surgical interventions were effective for stress UI. Other interventions for UI and FI showed lower cure rates. Many individuals are likely to be reliant on containment strategies.
|
|
| 9. |
- Smith, N., et al.
(author)
-
Where Do Women With Urinary Incontinence Find Information About Absorbent Products and How Useful Do They Find It?
- 2019
-
In: Journal of Wound Ostomy and Continence Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1071-5754. ; 46:1, s. 44-50
-
Journal article (peer-reviewed)abstract
- PURPOSE: This study aimed to determine from what sources women with urinary and dual urinary and fecal incontinence sought and received information about incontinence and absorbent products. We also evaluated source utility. DESIGN: Descriptive, embedded, mixed-methods study with qualitative interviews nested into a survey design in a modified explanatory sequence. SUBJECTS AND SETTING: The target population was community-dwelling women in Canada who used containment products to manage urinary incontinence. Three hundred fifteen women completed the online survey, and 9 participated in interviews. METHOD: Quantitative data were collected using an online survey that was advertised in multiple locations, including continence and urogynecology clinics, non-for-profit health Web sites, and social media. Descriptive statistics were used for analysis. Using initial quantitative data results, a semistructured interview guide was designed to gain further insight. Local survey participants were invited to interviews at the end of the survey. Interview transcripts were coded using content analysis. The codes were then collapsed into categories and finally themes. RESULTS: The most common sources of information (n = 284/315) were retail outlets (43%) and television/radio (42%). The greatest percentages of "useful" or "very useful" resources were healthcare professionals (83%). Content analysis identified 5 themes: (1) using existing knowledge, (2) seeking knowledge, (3) finding the right pad, (4) being safe and secure, and (5) perceptions of healthcare professionals' roles. Product choice was made through trial and error; women drew information from a variety of sources, including product labels. Perceptions of helpfulness of experiences with healthcare professionals varied. CONCLUSION: Although women used multiple sources when selecting containment products, they did not receive information in a manner that suited their needs, resulting in a trial-and-error approach to product selection. Healthcare professionals should actively give information on containment products during their assessment of continence in patient encounters.
|
|
| 10. |
- Wagg, A S, et al.
(author)
-
Overactive bladder syndrome in older people
- 2007
-
In: BJU Int. ; 99:3, s. 502-9
-
Journal article (peer-reviewed)abstract
- The overactive bladder symptom complex (OAB) is the commonest cause of urinary incontinence in older people, and is usually due to underlying detrusor overactivity, and as such is a treatable condition. Older people are a heterogeneous group, which includes fit community-dwelling individuals and those with significant medical comorbidity; thus the requirements of care for this group are many and varied. The International Continence Society definition of the frail elderly, those aged >65 years with continence problems, who by virtue of comorbidity are house-bound or living in an institution, is clearly not applicable to all. However, many conditions begin to appear in later life and practitioners need to be aware of the need to manage these, and their treatment, when dealing with older people. Studies of medication for OAB have included the elderly and there is evidence of an equivalent benefit in younger people. The impact of treatment on the cognitively impaired and those receiving acetylcholinesterase inhibitors is discussed.
|
|
