31 research outputs found

    Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison

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    In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE

    Differential predictors of acute post-surgical pain intensity after abdominal hysterectomy and major joint arthroplasty

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    Author's personal copyBACKGROUND Psychological factors have a significant role in post-surgical pain, and their study can inform pain management. PURPOSE The aims of this study are to identify psychological predictors of post-surgical pain following abdominal hysterectomy (AH) and major joint arthroplasty (MJA) and to investigate differential predictors by type of surgery. METHOD One hundred forty-two women undergoing AH and 110 patients undergoing MJA were assessed 24 h before (T1) and 48 h after (T2) surgery. RESULTS A predictive post-surgical pain model was found for AH and MJA yielding pre-surgical pain experience and pain catastrophizing as significant predictors and a significant interaction of pre-surgical optimism and surgery type. Separate regression models by surgery type showed that pre-surgical optimism was the best predictor of post-surgical pain after MJA, but not after AH. CONCLUSIONS Findings highlight the relevance of psychological predictors for both surgeries and the value of targeting specific psychological factors by surgery type in order to effectively manage acute post-surgical pain.Supported by a project grant (PTDC/SAU-NEU/108557/2008) and by a PhD grant (SFRH/BD/36368/2007) from the Portuguese Foundation of Science and Technology, COMPETE, and FEDE

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

    Collaboration and communication: Building a research agenda and way of working towards community disaster resilience

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    Purpose The purpose of this paper is to provide a case study of Participatory Action Research (PAR), reporting on a collaboration, communication and disaster resilience workshop in Sydney, Australia. The goal of the workshop was to explore the challenges that organisations perceive as blockages to building community disaster resilience; and, through collaborative practitioner-led activities, identify which of those challenges could be best addressed through a deeper engagement with communication research. Design/methodology/approach The authors link communication, collaboration and disaster resilience through the lens of PAR, detailing how communication and resilience experts can collaborate to improve disaster prevention, management and mitigation practice. Findings The authors identify a number of theoretical considerations in understanding horizontal and vertical interfaces for improved communication. The authors also highlight how practical collaborative workshops can draw on communication researchers to facilitate collaborative resilience activities. PAR is shown to help move participant focus from resolving inter/intra-organisational tensions to facilitating public good, offering evidence-based recommendations which will foster a more reflexive and communicative approach to building disaster resilient communities. Research limitations/implications This paper does not seek to apply community resilience to the general public, no community representatives were present at the workshop. This does not mean that the focus is on organisational resilience. Rather the authors apply PAR as a way to help organisations become more engaged with PAR, communication research and collaborative practice. PAR is a tool for organisations to use in building community resilience, but also a means to reflect on their practice. Whilst this should help organisations in building more resilient communities the take up of practice by participants outside of the workshop is a matter for future research. Practical implications This method of collaborative resilience building could significantly improve the shared responsibility amongst key organisations, mobilising skills and building awareness of integrated resilience thinking in practice for stakeholders in disaster management activities. Originality/value This paper provides original evidence-based research, showing the linkages between communication theory, collaboration practice and the tools used by organisations tasked with building community resilience. This innovative synthesis of skills can aid in building PAR led disaster resilience across prevention, preparation and mitigation activities for all potential hazards, threats and/or risks, however, it will be particularly of interest to organisations engaged in community resilience building activities

    The Power of Bioenergy-Related Standards to Protect Biodiversity

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    The sustainable production of bioenergy is vital to avoiding negative impacts on environmental goods such as climate, soil, water, and especially biodiversity. We propose three key issues that should be addressed in any biodiversity risk-mitigation strategy: conservation of areas of significant biodiversity value; mitigation of negative effects related to indirect land-use change; and promotion of agricultural practices with few negative impacts on biodiversity. Focusing on biodiversity concerns, we compared principles and criteria set to address biodiversity and other environmental and social issues in seven standards (defined here as commodity-based standards or roundtables, or relevant European legislation): five voluntary initiatives related to bioenergy feedstocks, the Renewable Transport Fuel Obligation (United Kingdom), and the European Renewable Energy Source Directive. Conservation of areas of significant biodiversity value was fairly well covered by these standards. Nevertheless, mitigation of negative impacts related to indirect land-use change was underrepresented. Although the EU directive, with its bonus system for the use of degraded land and a subquota system for noncrop biofuels, offered the most robust standards to mitigate potential negative effects, all of the standards fell short in promoting agricultural practices with low negative impacts on biodiversity. We strongly recommend that each standard be benchmarked against related standards, as we have done here, and that efforts should be made to strengthen the elements that are weak or missing. This would be a significant step toward achieving a bioenergy industry that safeguards Earth's living heritage

    A Framework to Conduct and Report on Empirical User Studies in Semantic Web Contexts

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    Semantic Web technologies are being applied to increasingly diverse areas where user involvement is crucial. While a number of user interfaces for Semantic Web systems have become available in the past years, their evaluation and reporting often still suffer from weaknesses. Empirical evaluations are essential to compare different approaches, demonstrate their benefits and reveal their drawbacks, and thus to facilitate further adoption of Semantic Web technologies. In this paper, we review empirical user studies of user interfaces, visualizations and interaction techniques recently published at relevant Semantic Web venues, assessing both the user studies themselves and their reporting. We then chart the design space of available methods for user studies in Semantic Web contexts. Finally, we propose a framework for their comprehensive reporting, taking into consideration user expertise, experimental setup, task design, experimental procedures and results analysis
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