Surgical treatment of penile curvature

OBJECTIVE: To review long-term efficacy and complications of surgical treatment of penile curvature in a Chinese population. DESIGN: Retrospective review. SETTING: Regional hospital, Hong Kong. PATIENTS. Patients who underwent surgical treatment of penile curvature between January 1997 and March 2005 inclusive. INTERVENTION: Penile curvature corrective surgery. MAIN OUTCOME MEASURES: Penile curvature recurrence, early and late complications. RESULTS: Of 22 patients who underwent surgical treatment of penile curvatures, 19 had congenital and three had acquired diseases. The mean angle of deformity was 52.5 (range, 20-90) degrees. Ten patients had Nesbit procedures, ten had modified Nesbit procedures, and two underwent vein grafting. Twenty patients had residual or recurrent penile curvatures at a mean follow-up of 50.9 months. Fifteen patients had less than 30 degrees curvature and five had 30 to 60 degrees curvature. Early complications included wound infection (n=3), penile skin necrosis (n=1) treated by skin graft, and urethral injury (n=1). Three patients had erectile dysfunction; four complained of glans paraesthesia. Penile shortening (mean, 1.4 cm) and palpable knots were common late complications. A total of 19 patients were satisfied with the final outcomes. CONCLUSIONS: Surgical treatment of penile curvature produces long-term patient satisfaction. Preoperative counselling on potential recurrence and common minor complications is crucial to produce favourable outcomes.published_or_final_versio

Allocation and funding of speech and language therapy for children with developmental language disorders across Europe and beyond

Background: Children with Developmental Language Disorder (DLD) have a significant deficit in spoken language ability which affects their communication skills, education, mental health, employment and social inclusion. Aim: The present study reports findings from a survey by EU network COST ACTION 1406 and aims to explore differences in service delivery and funding of SLT services for children with DLD across Europe and beyond. Methods and procedures: The survey was completed by 5024 European professionals. COST countries were grouped into Nordic, Anglo-Saxon, Continental, Mediterranean, Central/Eastern and Non-European categories. The use of direct, indirect and mixed interventions, and their relationship to funding available (public, private or mixed) were considered for further analysis. Outcomes and results: The results revealed that for direct therapy, there were more cases than expected receiving private funding. For indirect therapy, fewer than expected received private and more than expected public funding. For mixed therapy, fewer cases than expected received private funding. Conclusions and implications: The results implies that other factors than evidence-based practices, practitioners experience, and patient preferences, drive choices in therapy. More research is needed to gain a better understanding of factors affecting the choice of therapy

Hotline update of clinical trials and registries presented at the American College of Cardiology Congress 2010: ACCORD, INVEST, NAVIGATOR, RACE II, SORT OUT III, CSP-474, DOSE, ASPIRE and more

This article gives an overview on a number of novel clinical trials in the field of cardiovascular medicine, which were presented during the Late Breaking Clinical Trial Sessions at the 59th annual meeting of the American College of Cardiology in Atlanta, USA, from 14th March to 16th March 2010. The data were presented by leading experts in the field with relevant positions in the trials. These comprehensive summaries should provide the readers with the most recent data on diagnostic and therapeutic developments in cardiovascular medicine similar as previously reported (Schirmer SH, van der Laan AM, Bohm M, Mahfoud F in Clin Res Cardiol 98:691–699, 2009; Maier LS, Schirmer SH, Walenta K, Jacobshagen C, Bohm M in Clin Res Cardiol 98:413–419, 2009)

The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle

Background: Routine outcome measurement (ROM) is important for assessing the clinical effectiveness of health services and for monitoring patient outcomes. Within Child and Adolescent Mental Health Services (CAMHS) in the UK the adoption of ROM in CAMHS has been supported by both national and local initiatives (such as government strategies, local commissioning policy, and research). Methods: With the aim of assessing how these policies and initiatives may have influenced the uptake of ROM within two different CAMHS we report the findings of two case-note audits: a baseline audit conducted in January 2011 and a re-audit conducted two years later in December 2012-February 2013. Results: The findings show an increase in both the single and repeated use of outcome measures from the time of the original audit, with repeated use (baseline and follow-up) of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) scale increasing from 10% to 50% of cases. Re-audited case-notes contained more combined use of different outcome measures, with greater consensus on which measures to use. Outcome measures that were applicable across a wide range of clinical conditions were more likely to be used than symptom-specific measures, and measures that were completed by the clinician were found more often than measures completed by the service user. Conclusions: The findings show a substantial improvement in the use of outcome measures within CAMHS. These increases in use were found across different service organisations which were subject to different types of local service priorities and drivers

Prevalence and factors associated with anxiety during the COVID-19 pandemic among Malaysians: a cross-sectional study

The COVID-19 pandemic is a significant public health threat with wide-reaching psychological implications. The drastic changes in lifestyle due to the implementation of the movement control order (MCO) were associated with adverse effects on mental health. This study aimed to examine the prevalence of anxiety among Malaysians during the COVID-19 pandemic and its associated factors. The following questionnaires were self-administered online through google form which included: (i) Generalised Anxiety Disorder-7; (ii) Short Boredom Proneness Scale; (iii) Short Scale for Measuring Loneliness in Large Surveys; and (iv) The World Health Organisation (WHO) well-being index. Higher scores denoted higher levels of anxiety, boredom, loneliness, and well-being. Out of the 543 participants, more than half (55.2%) reported mild (25.6%), moderate (13.8%) to severe (19.8%) anxiety. Multiple logistic regression showed higher odds of moderate to severe anxiety were reported among those divorced/separated/widowed (aOR 6.778, 95% CI [1.200, 38.296]), adults aged 25 to 34 years (aOR 2.038, 95% CI [1.049, 3.958]), 35 to 44 years (aOR 2.279, 95% CI [1.064, 4.882]), and with higher boredom levels (aOR 1.063, 95% CI [1.035, 1.092]). One in five Malaysians surveyed experienced severe anxiety. Adults within the working age range (between 25 and 44 years old) were at higher odds of having anxiety. Boredom increased the odds of anxiety compared to loneliness, well-being and coping. Thus, addressing the risk factors through public health messages is deemed important

Supporting perinatal anxiety in the digital age; a qualitative exploration of stressors and support strategies

Background The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research in this area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Methods Women who were either pregnant or within one-year postpartum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed. Results Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions This work provides unique insight into potential sources of anxiety for women in the perinatal period, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA

Proactive and politically skilled professionals: What is the relationship with affective occupational commitment?

The aim of this study is to extend research on employee affective commitment in three ways: (1) instead of organizational commitment the focus is on occupational commitment; (2) the role of proactive personality on affective occupational commitment is examined; and (3) occupational satisfaction is examined as a mediator and political skills as moderator in the relationship between proactive personality and affective occupational commitment. Two connected studies, one in a hospital located in the private sector and one in a university located in the public sector, are carried out in Pakistan, drawing on a total sample of over 400 employees. The results show that proactive personality is positively related to affective occupational commitment, and that occupational satisfaction partly mediates the relationship between proactive personality and affective occupational commitment. No effect is found for a moderator effect of political skills in the relationship between proactive personality and affective occupational commitment. Political skills however moderate the relationship between proactive personality and affective organizational commitment

Are men’s perceptions of sexually dimorphic vocal characteristics related to their testosterone levels?

Feminine physical characteristics in women are positively correlated with markers of their mate quality. Previous research on men’s judgments of women’s facial attractiveness suggests that men show stronger preferences for feminine characteristics in women’s faces when their own testosterone levels are relatively high. Such results could reflect stronger preferences for high quality mates when mating motivation is strong and/or following success in male-male competition. Given these findings, the current study investigated whether a similar effect of testosterone occurs for men’s preferences for feminine characteristics in women’s voices. Men’s preferences for feminized versus masculinized versions of women’s and men’s voices were assessed in five weekly test sessions and saliva samples were collected in each test session. Analyses showed no relationship between men’s voice preferences and their testosterone levels. Men’s tendency to perceive masculinized men’s and women’s voices as more dominant was also unrelated to their testosterone levels. Together, the results of the current study suggest that testosterone-linked changes in responses to sexually dimorphic characteristics previously reported for men's perceptions of faces do not occur for men's perceptions of voices

The Saudi experiment with career guidance

Saudi Arabia has recently embarked on an ambitious experiment with career guidance. The country has identified that career guidance offers a range of potential cultural, educational and economic benefits. These include supporting the Saudisation of the workforce, the development of the vocational education system and the engagement of the Saudi ‘youth bulge’ in the labour market and wider society. However, the country has a weak tradition of career guidance and a need to develop new policies and systems rapidly. The Saudi Ministry of Labour has driven the development of the country’s new career guidance system and has sought to learn from global best practice. However, Saudi Arabia offers a very different context from those where career guidance has flourished. Particularly distinctive features of Saudi society include its limited civil society, the central role that religion plays, the place of women, the role of oil within the economy and the high level of migrant workers in the labour market. Taken together these issues offer challenges of culture, theory, policy and practice. Negotiating these challenges and building an organic body of theory and practice will be critical to the success or otherwise of the Saudi experiment with career guidance.N/