Functional outcome after sacrospinous hysteropexy for uterine descensus

The study aimed to evaluate urogenital symptoms, defecatory symptoms and quality of life before and after a sacrospinous hysteropexy for uterovaginal prolapse. Seventy-two women with symptomatic uterovaginal prolapse were treated with sacrospinous hysteropexy. Before and after surgery, urogenital and defecatory symptoms and quality of life were assessed with a validated questionnaire. Anatomical outcome was assessed by means of pelvic examination before and after surgery. The mean follow-up time was 12.7 months. Scores on all domains of urogenital symptoms and defecatory symptoms, except for the pain and fecal incontinence domain, improved significantly. Also, quality of life improved on all domains. No major complications were encountered

Racism as a determinant of health: a systematic review and meta-analysis

Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants.<br /

The sacrospinous ligament: conveniently effective or effectively convenient?

The sacrospinous ligament has been used for over 50 years as a convenient structure for treating vaginal vault and more recently, uterine prolapse. The procedure has evolved over the years and its efficacy has been hotly debated with invariable comparisons made to abdominal sacral colpopexy. Mesh surgery has introduced a newer dimension to the debate. This review is an attempt to clarify the anatomy, reflect on various techniques and offer a critique on the current ‘status’ of the sacrospinous ligament

Developing Culturally Sensitive Care in Japan: Comparison of Competence in Healthcare and Education

Competence in culturally sensitive care in healthcare has been included into the Japanese medical school curriculum since 2001 and will be integrated into the Japanese nursing school curriculum in 2018. Since the concept of competence in culturally sensitive care is new to the Japanese healthcare education, we need to gain knowledge about the concept from other forward-thinking countries. However, when introducing the concept of competence in culturally sensitive care from foreign countries to Japan, the knowledge and experiences of those countries should be considered

Using the FRIENDS Programs to Promote Resilience in Cross-Cultural Populations

Childhood and adolescence is a time of rapid biological, psychological, and social growth. Prevalence rates around the world currently estimate approximately one in five adolescents experience mental health difficulties. As factors are increasingly implicated in the etiology of behavioral and emotional difficulties, clinicians and researchers have identified the need for resilience-enhancing prevention programs. The current authors redefine resilience as not only being able to navigate towards and negotiate for resources in the face of adversity, but also to embrace positive life challenges. This chapter discusses protective and risk factors of emotional well-being in youths to provide a framework for the development of resilience-building programs. A brief review of resilience enhancement in youths is provided as well as introduction to the FRIENDS protocol, four socio-emotional skills programs. The FRIENDS programs are robustly supported and the only program endorsed by the World Health Organization for the prevention and treatment of anxiety and depression in children and youth (Prevention of mental disorders: Effective interventions and policy options, Geneva, Switzerland, 2004). Description of the FRIENDS programs, research evaluating intervention outcomes, and strategies to adapt techniques for use in diverse youth populations are also included. Lastly, recent innovations in conceptualization, research, assessment, and treatment of resilience as well as future directions for research are discussed