Identifying the most reliable and valid bladder health screening tool: a systematic review

<p><b>Purpose:</b> Lower urinary tract symptoms are common in advancing age and a major cause of disability through avoidance of activity and social engagement. This systematic review aimed to identify the most valid and reliable brief screening tool for these symptoms or bladder problems, to incorporate into a health promotion programme for older adults to facilitate discussion about self-management.</p> <p><b>Method:</b> Review eligibility criteria included studies published between 1990 and November 2018, reporting the validity, reliability and/or acceptability of bladder health screening tools. Six electronic databases were searched.</p> <p><b>Results:</b> Twenty-two studies were included. Three screening tools met the criteria: International Prostate Symptom Score (IPSS); International Consultation on Incontinence Questionnaire Urinary Incontinence Short-Form; Bladder Control Self-Assessment Questionnaire (B-SAQ). Test–retest reliability for total scores of the IPSS and International Consultation on Incontinence Questionnaire Urinary Incontinence Short-Form was acceptable. All three questionnaires showed evidence of acceptable levels of internal consistency and of convergent validity.</p> <p><b>Conclusion:</b> Having favourable psychometric scores compared to the B-SAQ and for ease of use and trustworthiness of a simple questionnaire, the IPSS and International Consultation on Incontinence Questionnaire Urinary Incontinence Short-Form met the criteria for recommendation for raising awareness and bladder health promoting interventions to reduce associated disability.Implications for Rehabilitation</p><p>Lower urinary tract symptoms are common in advancing age and a major cause of disability through avoidance of activity and social engagement.</p><p>Lower urinary tract symptoms can be prevented or improved through self-management strategies.</p><p>Help-seeking levels for lower urinary tract symptoms is low but could be improved through continence promotion interventions.</p><p>The International Prostate Symptom Score and the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form are bladder health screening questionnaires which would be appropriate to use as part of a continence promotion intervention to help prompt discussions and raise awareness and subsequently improve symptoms and associated disability.</p><p></p> <p>Lower urinary tract symptoms are common in advancing age and a major cause of disability through avoidance of activity and social engagement.</p> <p>Lower urinary tract symptoms can be prevented or improved through self-management strategies.</p> <p>Help-seeking levels for lower urinary tract symptoms is low but could be improved through continence promotion interventions.</p> <p>The International Prostate Symptom Score and the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form are bladder health screening questionnaires which would be appropriate to use as part of a continence promotion intervention to help prompt discussions and raise awareness and subsequently improve symptoms and associated disability.</p

Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

Objective: Impairment of mental well-being (anxiety, depression, stress) is common among people with multiple sclerosis (PwMS). Treatment options are limited, particularly for anxiety. The aim of this study was to update our previous systematic review (2014) and evaluate via meta-analysis the efficacy of mindfulness-based interventions (MBIs) for improving mental well-being in PwMS. Methods: Systematic searches for eligible randomised controlled trials (RCTs) were carried out in seven major databases (November 2017, July 2018), using medical subject headings and key words. Studies were screened, data extracted, quality appraised and analysed by two independent reviewers, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Mental well-being was the primary outcome. Random effects model meta-analysis was performed, with effect size reported as standardised mean difference (SMD). Results: Twelve RCTs including 744 PwMS were eligible for inclusion in the systematic review, eight had data extractable for meta-analysis; n=635. Ethnicity, socioeconomic status, comorbidity and disability were inconsistently reported. MBIs varied from manualised to tailored versions, lasting 6–9 weeks, delivered individually and via groups, both in person and online. Overall SMD for mental well-being (eight studies) was 0.40 (0.28–0.53), p&lt;0.01, I2=28%; against active comparators only (three studies) SMD was 0.17 (0.01–0.32), p&lt;0.05, I2 =0%. Only three adverse events were reported. Conclusions: MBIs are effective at improving mental well-being in PwMS. More research is needed regarding optimal delivery method, cost-effectiveness and comparative-effectiveness

Determining the extent to which L1 learner choices influence the L2 : exploring semantic and syntactic choices

This study tests Jiang’s (2004) 3-stage model of second language (L2) vocabulary acquisition. Jiang observed continued first language (L1) [Korean] semantic mediation in L2 processing among advanced L2 speakers. We hypothesise, however, that mediation might depend on the developing proficiency of the L2 learner and the relationship between L1 and L2. We explored the extent to which L1 background influences the processing of semantics and syntax in L2 (English). Three different L1 subject groups (n=30 per group): English, European, and Japanese. L1 European speakers were tested because their L1 shares the same word order as the L2, in contrast to L1 Japanese speakers. Two reaction time (RT) experiments were conducted to determine whether strings of words accurately reflect English syntax or semantics. Using the L1 English subject group as a control, we compared the choices made by our three groups. We also examined the L2 (English) learners’ vocabulary size. Overall the RTs were slower for incorrect syntactic word strings. The syntax RTs of the European and Japanese groups showed differences between correct and incorrect strings. However, the Japanese group showed no difference between SVO correct and incorrect strings. The semantic RTs did not differ between the L2 groups but the control group was faster. Initial findings suggest that L2 word order judgement latencies are mediated more by L1 word order; however, L2 semantic judgement latencies seem less mediated by differences in L1 word order. The findings are discussed in light of Jiang’s model and how the role of L1 word order is closer related to L2 syntactic processing than semantic processing. References Jiang, N. (2004) ‘Semantic transfer and its implications for vocabulary teaching in a second language’. The Modern Language Journal, 88 (3), pp.416-432

Individual, social and home environment determinants of change in children\u27s television viewing: the Switch-Play intervention

Understanding potential determinants of change in television (TV) viewing among children may enhance the effectiveness of programs targeting this behaviour. This study aimed to investigate the contribution of individual, social and home environment factors among 10-year-old Australian children to change in TV viewing over a 21-month period. A total of 164 children (49% boys) completed a 19-lesson (9-month) intervention program to reduce TV viewing time. Children completed self-administered surveys four times over 21 months (pre- and post-intervention, 6- and 12-month follow-up). Baseline factors associated with change in TV viewing during the intervention and follow-up periods were: &lsquo;asking parents &ge;once/week to switch off the TV and play with them&rsquo; (21.6 min/day more than those reporting &lt;once/week, p = 0.007); being able to &lsquo;watch just 1 h of TV per day&rsquo; (26.1 min/day less than those who could not, p = 0.010); &lsquo;watching TV no matter what was on&rsquo; (36.6 min/day more than those who did not, p &lt; 0.001); and &lsquo;continuing to watch TV after their program was over&rsquo; (33.0 min/day more than those who did not, p = 0.006). With every unit increase in baseline frequency of TV viewing with family and friends, children spent on average 4.0 min/day more watching TV over the 21-month period (p = 0.047). Baseline number and placement of TVs at home did not predict change in children\u27s TV viewing over the 21 months. Greater understanding of the family dynamics and circumstances, as well as the individual and social determinants of TV viewing, will be required if we are to develop effective strategies for reducing TV viewing in children.<br /

Salmonid Angling in the Gisborne District: application of the river values assessment system (RiVAS)

The River Values Assessment System (RiVAS) was applied by a River Expert Panel to ten resource and user attributes to assess 13 rivers in the Gisborne District for their salmonid angling value. The method was applied to differentiate rivers of national significance (n=4: Ruakituri River, Koranga River, Motu River, Opato Stream), regional significance (n=5: Waitahaia River, Waingakia Stream, Raukokore River, Takaputahi River, Hangaroa River) and local significance (n=2: Wharekopae River, Mangapoike River). The data available from the National Angling Survey were debated by the Expert Panel (low survey responses), so the Expert Panel relied on their own assessments for most attributes. The Panel undertook an independent assessment and three rivers on the cusp of significance thresholds were adjusted with reference to the Panel assessments.This work was mostly funded by the Ministry of Science and Information as part of the Envirolink grant 1012-GSDC92

Stimulation of the tibial nerve: a protocol for a multicentred randomised controlled trial for urinary problems associated with Parkinson’s disease—STARTUP

Introduction Parkinson’s disease is the second most common chronic neurodegenerative condition with bladder dysfunction affecting up to 71%. Symptoms affect quality of life and include urgency, frequency, hesitancy, nocturia and incontinence. Addressing urinary dysfunction is one of the top 10 priority research areas identified by the James Lind Alliance and Parkinson’s UK. Objectives Conduct a randomised controlled trial (RCT) targeting people with Parkinson’s disease (PwP) who have self-reported problematic lower urinary tract symptoms, investigating the effectiveness of transcutaneous tibial nerve stimulation (TTNS) compared with sham TTNS. Implement a standardised training approach and package for the correct application of TTNS. Conduct a cost-effectiveness analysis of TTNS compared with sham TTNS. Methods and analysis An RCT of 6 weeks with twice weekly TTNS or sham TTNS. Participants will be recruited in 12 National Health Service neurology/movement disorder services, using a web-based randomisation system, and will be shown how to apply TTNS or sham TTNS. Participants will receive a weekly telephone call from the researchers during the intervention period. The trial has two coprimary outcome measures: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the International Prostate Symptom Score. Secondary outcomes include a 3-day bladder diary, quality of life, acceptability and fidelity and health economic evaluation. Outcomes will be measured at 0, 6 and 12 weeks. A sample size of 208 randomised in equal numbers to the two arms will provide 90% power to detect a clinically important difference of 2.52 points on the Internatioanl Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and of 3 points in the International Prostate Symptom Score total score at 12 weeks at 5% significance level, based on an SD of 4.7 in each arm and 20% attrition at 6 weeks. Analysis will be by intention to treat and pre defined in a statistical analysis plan Ethics and dissemination East of Scotland Research Ethics Service (EoSRES), 18/ES00042, obtained on 10 May 2018. The trial will allow us to determine effectiveness, safety, cost and acceptability of TTNS for bladder dysfunction in PWP. Results will be published in open access journals; lay reports will be posted to all participants and presented at conferences. Trial registration number ISRCTN12437878; Pre-results

Self‑management of overactive bladder at home using transcutaneous tibial nerve stimulation: a qualitative study of women’s experiences

Abstract Background Transcutaneous tibial nerve stimulation (TTNS) has been used to treat overactive bladder (OAB), however patient experiences and views of this treatment are lacking. The aim of this study was to explore women’s experiences of OAB and TTNS treatment and the perceived factors influencing participation and adherence. Methods Semi-structured, individual interviews conducted as part of a mixed-methods, randomised, feasibility trial of self-managed versus HCP-led TTNS. Interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis was undertaken using Booth et al. (Neurourol Urodynam. 2017;37:528–41) approach. Results 16 women were interviewed, 8 self-managing TTNS at home and 8 receiving TTNS in twice-weekly hospital clinic appointments. Women self-managing OAB considered TTNS easy to administer, flexible and favourably ‘convenient’, especially when the participant was bound by work and other life commitments. In contrast to OAB symptoms ‘dominating life’, self-managing bladder treatment was empowering and fitted around home life demands. Flexibility and control engendered by self-management, facilitated women’s willingness to participate in TTNS. Women attending a hospital clinic for TTNS enjoyed the social aspects but found the routine appointments constrained their lives. Motivation to continue TTNS in the longer term was dependent on perception of benefit. Conclusions This study provides novel insights into women’s experiences of self-managing their OAB using TTNS compared to HCP-led management in the clinical setting. It highlights positive experiences self-managing TTNS at home and a willingness to continue in the longer term, facilitated by ease of use and convenience. Trial Registration 1/11/2018: ClinicalTrials.gov Identifier: NCT03727711