Incontinence in Individuals with Rett Syndrome: A Comparative Study

Frequency and type of incontinence and its association with other variables were assessed in females with Rett Syndrome (RS) (n = 63), using an adapted Dutch version of the ‘Parental Questionnaire: Enuresis/Urinary Incontinence’ (Beetz et al. 1994). Also, incontinence in RS was compared to a control group consisting of females with non-specific (mixed) intellectual disability (n = 26). Urinary incontinence (UI) (i.e., daytime incontinence and nocturnal enuresis) and faecal incontinence (FI) were found to be common problems among females with RS that occur in a high frequency of days/nights. UI and FI were mostly primary in nature and occur independent of participants’ age and level of adaptive functioning. Solid stool, lower urinary tract symptoms and urinary tract infections (UTI’s) were also common problems in females with RS. No differences in incontinence between RS and the control group were found, except for solid stool that was more common in RS than in the control group. It is concluded that incontinence is not part of the behavioural phenotype of RS, but that there is an increased risk for solid stool in females with RS

Anxiety Levels in Children with Autism Spectrum Disorder:A Meta-Analysis

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescenc

Seasonal Patterns of Body Temperature Daily Rhythms in Group-Living Cape Ground Squirrels Xerus inauris

Organisms respond to cyclical environmental conditions by entraining their endogenous biological rhythms. Such physiological responses are expected to be substantial for species inhabiting arid environments which incur large variations in daily and seasonal ambient temperature (Ta). We measured core body temperature (Tb) daily rhythms of Cape ground squirrels Xerus inauris inhabiting an area of Kalahari grassland for six months from the Austral winter through to the summer. Squirrels inhabited two different areas: an exposed flood plain and a nearby wooded, shady area, and occurred in different social group sizes, defined by the number of individuals that shared a sleeping burrow. Of a suite of environmental variables measured, maximal daily Ta provided the greatest explanatory power for mean Tb whereas sunrise had greatest power for Tb acrophase. There were significant changes in mean Tb and Tb acrophase over time with mean Tb increasing and Tb acrophase becoming earlier as the season progressed. Squirrels also emerged from their burrows earlier and returned to them later over the measurement period. Greater increases in Tb, sometimes in excess of 5°C, were noted during the first hour post emergence, after which Tb remained relatively constant. This is consistent with observations that squirrels entered their burrows during the day to ‘offload’ heat. In addition, greater Tb amplitude values were noted in individuals inhabiting the flood plain compared with the woodland suggesting that squirrels dealt with increased environmental variability by attempting to reduce their Ta-Tb gradient. Finally, there were significant effects of age and group size on Tb with a lower and less variable Tb in younger individuals and those from larger group sizes. These data indicate that Cape ground squirrels have a labile Tb which is sensitive to a number of abiotic and biotic factors and which enables them to be active in a harsh and variable environment

Continence technologies whitepaper: Informing new engineering science research

Advances in healthcare technology for continence have historically been limited compared to other areas of medicine, reflecting the complexities of the condition and social stigma which act as a barrier to participation. This whitepaper has been developed to inspire and direct the engineering science community towards research opportunities that exist for continence technologies that address unmet needs in diagnosis, treatment and long-term management. Our aim is to pinpoint key challenges and highlight related research opportunities for novel technological advances. To do so, we draw on experience and expertise from academics, clinicians, patients and patient groups linked to continence healthcare. This is presented in four areas of consideration: the clinical pathway, patient perspective, research challenges and effective innovation. In each we introduce seminal research, background information and demonstrative case-studies, before discussing their relevance to engineering science researchers who are interested in approaching this overlooked but vital area of healthcare

Standard urotherapy for children with neurodevelopmental disabilities: A systematic review

Objectives: Standard urotherapy (SU) is regularly used as a first-line intervention for children with incontinence. It is suggested that SU is also effective for children with neurodevelopment disabilities (NDs) when altered to the specific needs of these children. The aim of the review was to answer the following research questions: (a) what was the effectiveness of SU interventions in children with ND?, (b) which procedures and protocols were utilized during SU?, (c) what was the role of parents during SU?, and (d) what was the current evidence base regarding SU and children with NDs? Methods: Four electronic databases (i.e., Embase, PsychInfo, PubMed, Web of Science) were searched in accordance with the JBI methodology for mixed methods systematic reviews (MMRS) in the Joanna Briggs Institute (JBI) manual for Evidence Synthesis. The Mixed Method Appraisal Tool (MMAT) from JBI was utilized to determine the methodological quality of the studies. Results: The search resulted in the inclusion of five articles related to SU in children with ND, indicating that research relating to SU and NDs is scarce. Results of the review indicate that SU resulted in a complete or partial positive response in 30% of the children with NDs (N = 114) based on the criteria listed by the International Children’s Continence Society (ICCS). When using criteria by the authors of the included articles, the results indicate that 59% of the children achieved full continence. Most importantly, the evidence suggests that most children showed improved symptoms (e.g., reduction in urinary/fecal accidents, schedule-dependent continence) even if full continence was not obtained. Conclusions: The review indicated that SU could be beneficial as a first-line treatment for children with NDs. Individualizing treatment to the needs of the child, parental involvement, follow-up appointments, and adding adjuncts when SU alone is not effective seem to be beneficial for this specific population. However, research relating to this topic is scarce and therefore more research needs to be completed regarding the role of parents and effective guidelines specific to different NDs. Implications for future research are discussed