Vibrating vaginal balls to improve pelvic floor muscle performance in women after childbirth: Preliminary results (recruitment and survey) of a randomised controlled feasibility trial

Background: Vibrating vaginal pelvic floor training balls are available in Austria and Germany to enhance women’s pelvic floor muscles and thus prevent urinary incontinence and other pelvic floor problems following childbirth. Nonetheless, there is currently little empirical knowledge to substantiate their use or assess their relative effectiveness in comparison to current standard care, which involves pelvic floor muscle exercises [1]. Aims/research question: This feasibility trial aims at assessing practical issues and feasibility of a future randomised controlled trial (RCT) to determine the effectiveness of vibrating vaginal pelvic floor training balls for postpartum pelvic floor muscle rehabilitation, at monitoring harms of the experimental intervention, and at exploring women´s perspectives on and experiences with the interventions and the trial [2]. Methods: Design: Single blind, randomised controlled feasibility trial with two parallel groups. 56 women from six weeks until six months postpartum are recruited in Vienna and randomised into one of two intervention groups to use either vibrating vaginal balls or a comparator pelvic floor muscle exercises for 12 weeks. As this is a feasibility study, study design features (recruitment, selection, randomisation, intervention and concordance, retention, data collection methods/tools, sample size calculation for full trial) are assessed, and participants’ views and experiences are surveyed. Tested outcome measure, collected before and after the intervention, is pelvic floor muscle performance as reported by participants and measured by perineometry by a blinded assessor. Descriptive and inferential statistics and content analysis serve the preparation of the future trial. Results: The results of this feasibility trial will inform the design and conduct of a full randomised controlled trial and provide insight into the experiences of women regarding the interventions and study participation. At the conference, preliminary results concerning recruitment and participants´ opinion and experiences will be presented. Relevance: Knowledge about pelvic floor muscle rehabilitation after childbirth enables midwives to promote women´s pelvic floor health. Recommendations/conclusions: Recommendations/conclusions of this ongoing study will be available at the conference and focus on the feasibility of the planned RCT and on midwifery practice. Ethical considerations: Approved by the ethics committees of the Medical University of Vienna and City University London. Trial registration: NCT02355327. Financing: This is a PhD project, funded by a City University London Scholarship

Vaginal cones or balls to improve pelvic floor muscle performance and urinary continence in women post partum: A quantitative systematic review

Objectives: The vaginal use of cones or balls aims to increase muscle performance and thereby prevent or treat urinary incontinence. To date, no systematic review has focused on the effectiveness of these devices specifically during the postpartum period. The objectives of this review were: to compare the effectiveness of vaginal cones or balls for improvement of pelvic floor muscle performance and urinary continence in the postpartum period to no treatment, placebo, sham treatment or active controls; to gather information on effect on perineal descent or pelvic organ prolapse, adverse effects and economical aspects. Design: Quantitative systematic review Data Sources: 14 scientific databases (including PubMed and CINAHL) and the world-wide web; experts were contacted for published and unpublished data. Review Methods: Studies had to be randomised/quasi-randomised trials and have female participants up to one year after childbirth. The intervention is compared to no treatment, placebo, sham treatment or active controls. Outcome measures relate to pelvic floor muscle performance or urinary incontinence. Studies were selected, “risk of bias” assessed, and data extracted by two reviewers independently with inter-reviewer agreement. Main Findings: One study met the inclusion criteria; its original data were re-analysed. In an intention-to-treat analysis, compared with the control group, the cone group showed a statistically significant lower rate of urinary incontinence; compared with the exercise group, the prevalence was similar. However, the validity of the analysis is limited. Conclusions and implications: The evidence gained from this systematic review is very limited. The use of cones may be helpful for urinary incontinence after childbirth, but further research is needed

Vaginal cones or balls to improve pelvic floor muscle performance and urinary continence in women postpartum: a quantitative systematic review and meta-analysis protocol

Aim: To identify, critically appraise and synthesise the best current evidence on the use of vaginal cones or balls to improve pelvic floor muscle performance and urinary continence in women post partum. Background: The vaginal use of cones or balls is a pelvic floor muscle training method that aims to enhance muscle performance and thereby prevent or treat urinary incontinence. Nonetheless to date, no systematic review has focused on the effectiveness of these devices specifically during the postpartum period. Design: Quantitative systematic review with potential meta-analysis Methods: The review will be undertaken by searching 14 scientific databases (including PubMed and CINAHL, without date restriction) and the world-wide web; experts will also be contacted for published and unpublished data. Included studies must be randomised or quasi-randomised trials and have female participants until one year after childbirth. The intervention will be compared to no treatment, placebo, sham treatment or active controls. Outcome measures will relate to pelvic floor muscle performance or urinary incontinence. Studies will be selected, “risk of bias” assessed, and data extracted by two reviewers independently. Following inter-reviewer agreement of included studies, data will be checked after entry into systematic review processing software. If appropriate, data will be synthesised by meta-analysis; if this is not possible, a narrative review only will be undertaken. Discussion: The information gained from this systematic review will help midwives, nurses, other health professionals and women after childbirth decide how to promote female pelvic floor health and in defining further areas of study

Finding a Repository with the Help of Machine-Actionable DMPs: Opportunities and Challenges

Finding a suitable repository to deposit research data is a difficult task for researchers since the landscape consists of thousands of repositories and automated tool support is limited. Machine-actionable DMPs can improve the situation since they contain relevant context information in a structured and machine-friendly way and therefore enable automated support in repository recommendation. This work describes the current practice of repository selection and the available support today. We outline the opportunities and challenges of using machine-actionable DMPs to improve repository recommendation. By linking the use case of repository recommendation to the ten principles for machine-actionable DMPs, we show how this vision can be realized. A filterable and searchable repository registry that provides rich metadata for each indexed repository record is a key element in the architecture described. At the example of repository registries we show that by mapping machine-actionable DMP content and data policy elements to their filter criteria and querying their APIs a ranked list of repositories can be suggested.  [This paper is a conference pre-print presented at IDCC 2020 after lightweight peer review.

Metal artifact reduction in 68^{68}Ga-PSMA-11 PET/MRI for prostate cancer patients with hip joint replacement using multiacquisition variable-resonance image combination

BACKGROUND PET/MRI has a high potential in oncology imaging, especially for tumor indications where high soft tissue contrast is crucial such as genitourinary tumors. One of the challenges for PET/MRI acquisition is handling of metal implants. In addition to conventional methods, more innovative techniques have been developed to reduce artifacts caused by those implants such as the selective multiacquisition variable-image combination (MAVRIC-SL). The aim of this study is to perform a quantitative and qualitative assessment of metal artifact reduction in $^{68}$Ga-PSMA-11 PET/MRI for prostate cancer patients with hip joint replacement using a selective MAVRIC-SL sequence for the whole pelvis. METHODS We retrospectively analyzed data of 20 men with 37 metal hip implants diagnosed with PCA, staged or restaged by $^{68}$Ga-PSMA-11 PET/MRI from June 2016 to December 2017. Each signal cancellation per side or metal implant was analyzed on the reference sequence LAVA-FLEX, as well as T1-weighted fast spin echo (T1w-FSE) sequence and MAVRIC-SL. Two independent reviewers reported on a four-point scale whether abnormal pelvic $^{68}$Ga-PSMA-11 uptake could be assigned to an anatomical structure in the tested sequences. RESULTS The smallest averaged signal void was observed on MAVRIC-SL sequences with a mean artifact size of 26.17 cm$^{2}$ (range 12.63 to 42.93 cm$^{2}$, p < 0.001). The best image quality regarding anatomical assignment of pathological PSMA uptakes in the pelvis by two independent readers was noted for MAVRIC-SL sequences, followed by T1w-FSE with excellent interreader agreement. CONCLUSIONS MAVRIC-SL sequence allows better image quality in the surrounding of hip implants by reducing MR signal voids and increasing so the accuracy of anatomical assignment of pathological $^{68}$Ga-PSMA-11 uptake in the pelvis over LAVA-FLEX and T1w-FSE sequences

Vibrating vaginal balls to improve pelvic floor muscle performance in women after childbirth: a protocol for a randomised controlled feasibility trial

AIM: This paper presents a feasibility trial protocol the purpose of which is to prepare for a future randomised controlled trial to determine the effectiveness of vibrating vaginal pelvic floor training balls for postpartum pelvic floor muscle rehabilitation. BACKGROUND: Vibrating vaginal pelvic floor training balls are available in Austria to enhance women's pelvic floor muscles and thus prevent or treat urinary incontinence and other pelvic floor problems following childbirth. Nonetheless, there is currently little empirical knowledge to substantiate their use or assess their relative effectiveness in comparison to current standard care, which involves pelvic floor muscle exercises. DESIGN: Single blind, randomised controlled feasibility trial with two parallel groups. METHODS: It is planned to recruit 56 postpartum women in Vienna, who will be randomised into one of two intervention groups to use either vibrating vaginal balls or a comparator pelvic floor muscle exercises for 12 weeks. As this is a feasibility study, study design features (recruitment, selection, randomisation, intervention concordance, data collection methods and tools) will be assessed and participants' views and experiences will be surveyed. Tested outcome measures, collected before and after the intervention, will be pelvic floor muscle performance as reported by participants and measured by perineometry. Descriptive and inferential statistics and content analysis will serve the preparation of the future trial. DISCUSSION: The results of this feasibility trial will inform the design and conduct of a full randomised controlled trial and provide insight into the experiences of women regarding the interventions and study participation

Carnacion Tells Her Tale

This item is part of the Arizona Agriculture and Rural Life, 1820-1945 collection. For more information about this collection, email [email protected]

Estudio sobre lineamientos, incentivos y regulación para el manejo de los Pasivos Ambientales Mineros (PAM), incluyendo cierre de faenas mineras: Bolivia (Estado Plurinacional de), Chile, Colombia y el Perú

Las actividades mineras, además de reportar beneficios sociales y económicos, deben internalizar de manera efectiva los impactos ambientales y sociales que generan. Para dar cumplimiento a estos desafíos se considera indispensable proveer de lineamientos sobre los incentivos para la regulación de los Pasivos Ambientales Mineros (PAMs), incluyendo el cierre de faenas mineras. Este informe presenta un análisis detallado de como Bolivia (Estado Plurinacional de), Chile, Colombia y Perú enfrentan su propia realidad en relación a la situación de los PAMs, con la finalidad última de responder a una actualización y compilación de la información ya existente,y de identificar de los desafíos y recomendaciones que estos países se plantean en el camino hacia la mejor gestión de la minería en su territorio.Resumen .-- Introducción .-- I. Contextualización: Estado Plurinacional de Bolivia. Chile. Colombia. Perú .-- II. Base legal. A. Definiciones de Pasivo Ambiental Minero (PAM). B. Legislación sobre Pasivos Ambientales Mineros (PAM). C. Legislación sobre cierre de faenas. D. Legislación ambiental general atingente. E. Regímenes de propiedad-responsabilidad .-- III. Instrumentos de Gestión Integral de Pasivos Ambientales Mineros (PAMs) .-- IV. Conclusiones y recomendaciones