The Hordaland Women's Cohort: A prospective cohort study of incontinence, other urinary tract symptoms and related health issues in middle-aged women

<p>Abstract</p> <p>Background</p> <p>Urinary incontinence (UI) is a prevalent symptom in middle-aged women, but data on incidence is limited and rarely reported. In order to analyze incidence, remission, or development patterns of severity and types of UI, we have established a 15-year prospective cohort (1997–2012).</p> <p>Methods</p> <p>The Cohort is based on the national collection of health data gathered from county studies (CONOR). Hordaland Health Study (HUSK) is one of them from Hordaland County. Each of the county studies may have local sub-studies and our Cohort is one of them. The Cohort included women aged 40–45 in order to have a broad approach to women's health including UI and other lower urinary tract symptoms (LUTS). A onefifth random sampling from HUSK was used to create the Cohort in 1997–1999. For the necessary sample size a preliminary power calculation, based on a 70% response rate at inclusion and 5% annual attrition rates was used. The Cohort is planned to collect data through questionnaires every second year for the 15-year period from 1997–2012.</p> <p>Discussion</p> <p>The Cohort represents a relatively large random sample (N = 2,230) of about 15% of the total population of women born between 1953–57 in the county of Hordaland. Our data shows that the cohort population is very similar to the source population. The baseline demographic, social and medical characteristics of the Cohort are compared with the rest of women in HUSK (N = 7,746) and there were no significant differences between them except for the level of education (P = 0.001) and yearly income (P = 0.018), which were higher in the Cohort population. Urological characteristics of participants from the Cohort (N = 1,920) were also compared with the other participants (N = 3,400). There were no significant statistical differences except for somewhat more urinary continence (P = 0.04), more stress incontinence (P = 0.048) and smaller amount of leakage (P = 0.015) in the Cohort. In conclusion, the Cohort ispopulation-based, with little selection bias, and thus is a rather unique study forinvestigating UI and LUTS in comparison with many other projects with similar purposes.</p

The challenges and opportunities of conducting a clinical trial in a low resource setting: The case of the Cameroon mobile phone SMS (CAMPS) trial, an investigator initiated trial

Conducting clinical trials in developing countries often presents significant ethical, organisational, cultural and infrastructural challenges to researchers, pharmaceutical companies, sponsors and regulatory bodies. Globally, these regions are under-represented in research, yet this population stands to gain more from research in these settings as the burdens on health are greater than those in developed resourceful countries. However, developing countries also offer an attractive setting for clinical trials because they often have larger treatment naive populations with higher incidence rates of disease and more advanced stages. These factors can present a reduction in costs and time required to recruit patients. So, balance needs to be found where research can be encouraged and supported in order to bring maximum public health benefits to these communities. The difficulties with such trials arise from problems with obtaining valid informed consent, ethical compensation mechanisms for extremely poor populations, poor health infrastructure and considerable socio-economic and cultural divides. Ethical concerns with trials in developing countries have received attention, even though many other non-ethical issues may arise. Local investigator initiated trials also face a variety of difficulties that have not been adequately reported in literature. This paper uses the example of the Cameroon Mobile Phone SMS trial to describe in detail, the specific difficulties encountered in an investigator-initiated trial in a developing country. It highlights administrative, ethical, financial and staff related issues, proposes solutions and gives a list of additional documentation to ease the organisational process

Residential electricity pricing in China

The paper aims to evaluate the implications of the new residential pricing system in China by examining price and income elasticity of demand by different household types. We use pre-reform annual panel data for 29 provinces over a fourteen year period, from 1998 to 2011, applying feasible generalize least squares models. The price and income elasticities for household sector are -0.412, and 1.476 at nation level, -0.300 and 1.550 in urban areas and -0.522 and 1.093 in rural areas respectively. With regional effects, the price and income elasticities are -0.146 and 1.286 for urban households in coastal provinces and -0.772 and 1.259 for urban households in inland provinces respectively. The empirical results reveal that there is important heterogeneity in the responsiveness to electricity price changes according to household income level and location

Distribution and characteristics of overdeepenings beneath the Greenland and Antarctic ice sheets: Implications for overdeepening origin and evolution

Glacier bed overdeepenings are ubiquitous in glacier systems and likely exert significant influence on ice dynamics, subglacial hydrology, and ice stability. Understanding of overdeepening formation and evolution has been hampered by an absence of quantitative empirical studies of their location and morphology, with process insights having been drawn largely from theoretical or numerical studies. To address this shortcoming, we first map the distribution of potential overdeepenings beneath the Antarctic and Greenland ice sheets using a GIS-based algorithm that identifies closed-contours in the bed topography and then describe and analyse the characteristics and metrics of a subset of overdeepenings that pass further quality control criteria. Overdeepenings are found to be widespread, but are particularly associated with areas of topographically laterally constrained ice flow, notably near the ice sheet margins where outlet systems follow deeply incised troughs. Overdeepenings also occur in regions of topographically unconstrained ice flow (for example, beneath the Siple Coast ice streams and on the Greenland continental shelf). Metrics indicate that overdeepening growth is generally allometric and that topographic confinement of ice flow in general enhances overdeepening depth. However, overdeepening depth is skewed towards shallow values – typically 200 to 300 m – indicating that the rate of deepening slows with overdeepening age. This is reflected in a decline in adverse slope steepness with increasing overdeepening planform size. Finally, overdeepening long-profiles are found to support headward quarrying as the primary factor in overdeepening development. These observations support proposed negative feedbacks related to hydrology and sediment transport that stabilise overdeepening growth through sedimentation on the adverse slope but permit continued overdeepening planform enlargement by processes of headward erosion

Should the surgeon or the general practitioner (GP) follow up patients after surgery for colon cancer? A randomized controlled trial protocol focusing on quality of life, cost-effectiveness and serious clinical events

This trial has been registered at ClinicalTrials.gov. The trial registration number is: NCT00572143.© 2008 Augestad et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

The distribution of heavy metals in sediments of Sörfjord, West Norway

The bottom sediments of Sörfjord, West Norway, contain unusually high concentrations of Ag, Ba, Bi, Cd, Cu, In, Pb, Sb, Sn, and Zn. The concentrations of Zn and Pb reach ∼ 10% by weight in some sediments. The concentrations of most of the elements are positively correlated, those of Pb, Cd, and Cu with Zn being particularly well developed; correlations also exist between Sb and Zn, and Ag and Cu. The concentrations of the metals in the bottom sediments decrease southwards and northwards from a locality close to a source of industrial waste