Clinical Outcomes involving the Use of Extracorporeal Magnetic Innervation in the Treatment of Urinary Incontinence

ABSTRACT CLINICAL OUTCOMES INVOLVING THE USE OF EXTRACORPOREAL MAGNETIC INNERVATION IN THE TREATMENT OF URINARY INCONTINENCE by KATHY E. DAVIS Urinary incontinence affects approximately 25 million Americans, significantly diminishing their function and quality of life. It is estimated that 50% of all women will experience some form of urinary incontinence in their lifetime. Although women are disproportionately affected by urinary incontinence, 69% of men who have undergone prostatectomy also report post-surgical incontinence. Extracorporeal Magnetic Innervation (ExMI) is a novel conservative approach to the treatment of urinary incontinence. As a patient sits fully clothed on a chair, an electromagnet delivers a timed magnetic field that penetrates the pelvic floor, inducing a nerve impulse that prompts contractions of the muscles of the pelvic floor. When the magnet is switched off, the muscles relax. This forced, passive exercise of the pelvic floor muscles serves to build endurance and strengthen the muscles supporting the bladder during times of physical stress such as coughing, laughing or running. This study is a descriptive, retrospective analysis of data collected from a specialty continence center within a major Atlanta metropolitan outpatient facility. The records for all patients who received ExMI from 2000 to 2012 were reviewed. Of the 43 patients who had received ExMI, 35 met study inclusion criteria. Eight patients were eliminated from the study. Four of these patients experienced ExMI benefits for conditions unrelated to urinary incontinence and are discussed. Data were analyzed using descriptive and inferential statistics. . The majority of the patients were women (n=26, 74%); most patients had stress urinary incontinence (n=16, 46%) or mixed urinary incontinence (n=12, 34%). The patient outcome was determined by comparing the pad usage before treatment and at the end of treatment (16 weeks). The average number of pads used daily was significantly reduced to 1.6 3 + 0.94 (p\u3c.0001). Treatment with ExMI for urinary incontinence was briefly popular in the United States shortly after it was introduced. Although ExMI is used extensively across Europe and Asia, very few studies on the efficacy of ExMI appear in the literature. These results will add to this body of knowledge

CONSOLIDATION IN THE FRESH FLORIDA GRAPEFRUIT PACKING INDUSTRY

First-order, homogeneous, stationary Markov models are used to compare patterns of adjustment among Florida fresh grapefruit packers between the 1970/71-1983/84 and 1987/88-1999/00 periods, and 1970/71-1994/95 and 1995/95-1999/00 periods, respectively. Despite sweeping aggregate trends impacting fresh produce markets, there was insufficient evidence to identify significant differences in the patterns of adjustment in the packing sector during the later time periods. Comparisons with actual firm numbers are indicative of an industry near equilibrium. While individual firms enter and exit the different states, currently there are no profound structural changes pointing to major concentration.Industrial Organization,

Fresh Grapefruit Supply-Chain Adjustments: Consolidation in Produce Packing?

This study evaluates long-term structural adjustments in fresh grapefruit packing under aggregate market pressures, including those from retail concentration. While individual firms enter and exit, Markov-model results are indicative of an industry near equilibrium with little expectation of change in the distribution of firm sizes given existing patterns of sector adjustment. Estimation of Lorenz curves and corresponding Gini coefficients fully support Markov analysis findings. Lags in the packing sector adjustment process in the face of sweeping forces of change in fresh produce markets are likely to put this sector at a relative disadvantage within the supply chain.Crop Production/Industries,

Legislative Decision Making on Education Issues: A Qualitative Study

The purpose of this descriptive, single case study was to provide knowledge and insight about state education policy-making, specifically, the process by which education-related bills pass through a legislature. This study was also designed to identify factors of influence shaping legislative decision-making as perceived by lawmakers and observers of the legislative process. Sources of evidence included interviews, direct observation, archival records, public records documentation, and tape recordings of committee meetings and Senate floor sessions. Results show that a bill\u27s fate is subject to many planned and unplanned sequential steps, and to a collection of diverse personalities that drive the legislative process. Trust forms the foundation upon which other factors depend including bill sponsors, party leadership, lobbyists, fellow legislators, and constituents

Impact of Psychological Contract Violations: Stories from Educators

Psychological contracts have been researched for over 50 years and have been used as the basis for studies in business, industry, and education. In this study, the researchers aimed to share the impact of psychological contract violations (PCV) upon individuals in educational institutions. Psychological contract literature is focused primarily on the impact of the breach on employee morale, organizational commitment, and work product. This study adds to the literature by giving voice to educators, allowing them to share their stories and provides a foundation for a more extensive research project later. Using a focus group methodology, the researcher allowed the participants to respond to questions pertaining to psychological contract breaches or violations in writing and then followed by an openended question session to give the participants the opportunity to provide additional detail. The educators who took part in the focus groups were asked if they had ever experienced a psychological contract breach related to teaching, service, or research. If they answered yes, they were asked to describe the situation. Teachers enter the profession for many reasons; however, the teachers who leave the profession before retirement often cite workplace issues as a reason for leaving. Understanding the role of PCVs have on the attrition may lead to more teachers remaining in the field, saving institutions financial resources related to the loss of teachers from the field

Home-School Relationships: A Qualitative Study with Diverse Families

This qualitative case study explored how families from diverse cultural backgrounds understood family involvement in the context of early childhood care and educational settings. Participants in the study included nine members from six families who had children enrolled in three early childhood care and education programs. The primary method of data collection included in-depth interviews with the parents of these children. A second data source was obtained through non-participant observations in each of the three programs. Findings revealed that the way families understand parent involvement is strongly influenced by issues of ethnicity, social class, level of education, and language

Adult Day Care Staff Education to Improve Communication and Behavioral Management Skills

AbstractIneffective communication and behavioral management skills are quality and safety issues that were identified at a local adult day care facility in the Southwest United States. Administrators at the facility identified a knowledge gap in communication and behavior management techniques for patients with cognitive impairment. An educational program, with a PowerPoint presentation and verbal feedback as key components, was developed and used to address the identified gap in practice related to individuals with cognitive impairments at the facility. The adult learning theory and the plan-do-study-act model provided supportive frameworks for program development and staff education. The project question explored whether a staff education program would improve staff knowledge and confidence in behavioral management skills for patients at the adult day care facility. The educational program content was evaluated by three experts with over 20 years of experience working with cognitively impaired patients. Program content was found to be applicable and informative for the adult day care staff. Participation in this project was limited due to the COVID-19 pandemic requirements. The PowerPoint was presented to two participants via the Zoom video conferencing platform. Pre and post survey results completed by the participants had ratings of 5 (excellent) for all items for both pre and post surveys. Although staff participation was limited, the project has the potential to promote social change through an increase in staff knowledge, prompting more effective communication among staff and patients, and thus improving patient outcomes at a local adult day care center

The use of computer models to predict temperature and smoke movement in high bay spaces

The Building and Fire Research Laboratory (BFRL) was given the opportunity to make measurements during fire calibration tests of the heat detection system in an aircraft hangar with a nominal 30.4 (100 ft) ceiling height near Dallas, TX. Fire gas temperatures resulting from an approximately 8250 kW isopropyl alcohol pool fire were measured above the fire and along the ceiling. The results of the experiments were then compared to predictions from the computer fire models DETACT-QS, FPETOOL, and LAVENT. In section A of the analysis conducted, DETACT-QS AND FPETOOL significantly underpredicted the gas temperature. LAVENT at the position below the ceiling corresponding to maximum temperature and velocity provided better agreement with the data. For large spaces, hot gas transport time and an improved fire plume dynamics model should be incorporated into the computer fire model activation routines. A computational fluid dynamics (CFD) model, HARWELL FLOW3D, was then used to model the hot gas movement in the space. Reasonable agreement was found between the temperatures predicted from the CFD calculations and the temperatures measured in the aircraft hangar. In section B, an existing NASA high bay space was modeled using the CFD model. The NASA space was a clean room, 27.4 m (90 ft) high with forced horizontal laminar flow. The purpose of this analysis is to determine how the existing fire detection devices would respond to various size fires in the space. The analysis was conducted for 32 MW, 400 kW, and 40 kW fires

Polyribosome targeting to microtubules: enrichment of specific mRNAs in a reconstituted microtubule preparation from sea urchin embryos

This is the publisher's version, also available electronically from http://jcb.rupress.org/content/127/4/973.A subset of mRNAs, polyribosomes, and poly(A)-binding proteins copurify with microtubules from sea urchin embryos. Several lines of evidence indicate that the interaction of microtubules with ribosomes is specific: a distinct stalk-like structure appears to mediate their association; ribosomes bind to microtubules with a constant stoichiometry through several purification cycles; and the presence of ribosomes in these preparations depends on the presence of intact microtubules. Five specific mRNAs are enriched with the microtubule-bound ribosomes, indicating that translation of specific proteins may occur on the microtubule scaffolding in vivo