Como falar sobre incontinência: Uma lista de controlo

Incontinence is the medical term used to describe the involuntary loss of urine or faeces. Women, men, girls, boys and people of all genders, at any age, can experience incontinence. A person with incontinence can experience leakage occasionally, regularly or constantly; and leakage can happen at any time, day or night. A person may also experience leakage of urinary or faecal matter due to not being able to get to the toilet in time or not wanting to use the toilet facilities available. This is known as social, or functional, incontinence. In many low- and middle-income countries (LMICs) understanding of incontinence is still in its early stages: the term ‘incontinence’ may not be known, knowledge of the condition is rare, and the provision of support is lacking. Those who experience incontinence may face stigma due to having the condition, and this may affect their willingness or confidence to talk about it. There is a need to better understand incontinence in LMICs, and how best to support people living with the condition to improve their quality of life. This requires having conversations with individuals that experience the condition, and with individuals who care for those who do: they will have the lived experiences of what it means to live with incontinence practically, emotionally and socially for them and their families. Living with incontinence can have a range of impacts on the people living with it and their carers. These include increased stress and distress; additional needs for water and soap; and restricted ability to join in community activities, school or work. Living with incontinence can also lead to a range of protection issues. The potential challenges that people face may be quite diverse and may vary between people and households. The checklist below, and corresponding page references to ‘Incontinence: We Need to Talk About Leaks’ can be used to increase your understanding of incontinence and the options available to support people living with the condition; and provide guidance on how to have conversations to understand how best to support people living with incontinence in your area.Please also see the accompanying document: Incontinence: We Need to Talk About Leaks at https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/15728L’incontinence est le terme médical pour décrire la perte involontaire d’urine ou de matières fécales. Les femmes, les hommes, les filles et les garçons, quels que soient leur genre et leur âge, peuvent souffrir d’incontinence. Une personne qui souffre d’incontinence peut connaître des fuites occasionnelles, régulières ou constantes et les fuites peuvent survenir à tout moment du jour ou de la nuit. Une personne peut aussi subir des fuites urinaires ou fécales parce qu’elle n’est pas capable d’arriver aux toilettes à temps ou lorsqu’elle ne veut pas utiliser les toilettes à sa disposition. On parle alors d’incontinence sociale, ou fonctionnelle. Dans nombre de pays à revenu faible et intermédiaire (PRFI), l’incontinence est encore bien mal comprise : le terme même d’incontinence peut être ignoré, les connaissances sur cette pathologie sont encore rares et la fourniture d’un soutien fait défaut. Les personnes qui vivent avec l’incontinence peuvent être confrontées à une stigmatisation en raison de leur pathologie, de sorte qu’elles peuvent manquer de confiance et ne pas être disposées à en parler. Il est nécessaire de mieux comprendre l’incontinence dans les PRFI et la meilleure façon d’aider les personnes qui vivent avec cette pathologie afin d’améliorer leur qualité de vie. Cela nécessite d’échanger avec des individus qui en souffrent ainsi que leurs aidants : ces personnes sauront ce que cela veut dire que vivre avec l’incontinence d’un point de vue pratique, affectif et social pour elles et pour leur famille. Vivre avec l’incontinence peut avoir une foule de répercussions sur les personnes qui en souffrent et sur leurs aidants. Parmi celles-ci figurent un stress et une détresse accrus ; des besoins supplémentaires en eau et en savon ; moins de possibilités pour participer aux activités communautaires, fréquenter un établissement scolaire ou aller travailler. Vivre avec l’incontinence peut aussi entraîner différents risques d’abus et de violence. Les problèmes auxquels se heurtent les personnes qui souffrent d’incontinence peuvent être très divers et varier en fonction des personnes et des ménages. Cet aide-mémoire accompagne le guide intitulé « Incontinence : Il faut que nous parlions de fuites » (https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/15728). Utilisés ensemble, ils peuvent améliorer vos connaissances sur l’incontinence et les options à votre disposition pour aider les personnes qui vivent avec. En outre, ils vous donneront des conseils sur la manière d’échanger afin de comprendre comment aider au mieux les personnes qui vivent avec l’incontinence dans votre localité.Cet aide-mémoire accompagne le guide intitulé « Incontinence : Il faut que nous parlions de fuites » (https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/15728). Utilisés ensemble, ils peuvent améliorer vos connaissances sur l’incontinence et les options à votre disposition pour aider les personnes qui vivent avec. En outre, ils vous donneront des conseils sur la manière d’échanger afin de comprendre comment aider au mieux les personnes qui vivent avec l’incontinence dans votre localité.Incontinência é o termo médico usado para descrever as perdas involuntárias de urina ou de fezes. Mulheres, homens, raparigas, rapazes e pessoas de todos os sexos e em qualquer idade podem ter incontinência. Uma pessoa com incontinência pode ter perdas de urina ou de fezes esporádicas, regulares ou constantes; e essas perdas podem dar-se a qualquer hora, dia ou noite. Uma pessoa também pode ter perdas de matéria fecal ou urinária por não conseguir chegar a tempo à casa de banho ou por não querer usar as instalações sanitárias disponíveis. Chama-se a esse tipo de incontinência «incontinência social» ou «funcional». Em muitos Países de Baixo e Médio Rendimento (PBMR), o conhecimento da incontinência está ainda na sua fase inicial: o termo «incontinência» pode ser desconhecido, o conhecimento deste estado clínico é raro e há falta de apoio. As pessoas que têm incontinência podem ser estigmatizadas por causa disso, o que pode afectar a sua vontade ou confiança para falar sobre esta questão. É preciso compreender melhor a incontinência nos PBMR e qual a melhor forma de apoiar as pessoas que vivem com ela, para melhorar a sua qualidade de vida. Isto exige conversar com indivíduos que têm incontinência e com quem cuida deles: essas pessoas têm a experiência concreta do que significa viver com a incontinência do ponto de vista prático, emocional e social, para elas próprias e para as suas famílias. A incontinência pode ter uma série de impactos sobre as pessoas que vivem com ela e sobre os seus cuidadores. Estes impactos são o aumento do stress e da angústia; maior necessidade de água e sabão; e pouca capacidade de participar em actividades comunitárias, escolares ou laborais. Viver com incontinência também pode levar a uma série de questões de protecção. Os desafios que as pessoas podem enfrentam são bastante diversos e podem variar de pessoa para pessoa e de lar para lar. A lista de controlo que se segue e as respectivas referências às páginas de “Precisamos de falar sobre incontinência” podem ser usadas para aumentar os seus conhecimentos sobre incontinência e sobre as opções disponíveis para apoiar as pessoas que vivem com ela, e dar orientações sobre como ter conversas para compreender a melhor maneira de apoiar as pessoas que vivem com incontinência na sua zona.Esta lista de controlo acompanha o guia “Precisamos de falar sobre incontinência” (https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/15728) – usados em conjunto, estes dois documentos podem aumentar os seus conhecimentos sobre incontinência e sobre as opções disponíveis para apoiar as pessoas que vivem com ela, e dar orientações sobre como ter conversas para compreender a melhor maneira de apoiar as pessoas que vivem com incontinência na sua zona.Funded by the Swedish International Development Cooperation (Sida)

Case studies on supporting people with incontinence in humanitarian and low- and middle-income countries (LMICs)

A compilation of case studies related to incontinence in low- and middle-income countries (LMICs), including in humanitarian context

Does maternal exposure to an environmental stressor affect offspring response to predators?

There is growing recognition of the ways in which maternal effects can influence offspring size, physiological performance, and survival. Additionally, environmental contaminants increasingly act as stressors in maternal environments, possibly leading to maternal effects on subsequent offspring. Thus, it is important to determine whether contaminants and other stressors can contribute to maternal effects, particularly under varied ecological conditions that encompass the range under which offspring develop. We used aquatic mesocosms to determine whether maternal effects of mercury (Hg) exposure shape offspring phenotype in the American toad (Bufo americanus) in the presence or absence of larval predators (dragonfly naiads). We found significant maternal effects of Hg exposure and significant effects of predators on several offspring traits, but there was little evidence that maternal effects altered offspring interactions with predators. Offspring from Hg-exposed mothers were 18% smaller than those of reference mothers. Offspring reared with predators were 23% smaller at metamorphosis than those reared without predators. There was also evidence of reduced larval survival when larvae were reared with predators, but this was independent of maternal effects. Additionally, 5 times more larvae had spinal malformations when reared without predators, suggesting selective predation of malformed larvae by predators. Lastly, we found a significant negative correlation between offspring survival and algal density in mesocosms, indicating a role for top-down effects of predators on periphyton communities. Our results demonstrate that maternal exposure to an environmental stressor can induce phenotypic responses in offspring in a direction similar to that produced by direct exposure of offspring to predators

Disposable Platform Provides Visual and Color-Based Point-of-Care Anemia Self-Testing

Anemia, or low blood hemoglobin (Hgb) levels, afflicts 2 billion people worldwide. Currently, Hgb levels are typically measured from blood samples using hematology analyzers, which are housed in hospitals, clinics, or commercial laboratories and require skilled technicians to operate. A reliable, inexpensive point-of-care (POC) Hgb test would enable cost-effective anemia screening and chronically anemic patients to self-monitor their disease. We present a rapid, standalone, and disposable POC anemia test that, via a single drop of blood, outputs color-based visual results that correlate with Hgb levels. METHODS. We tested blood from 238 pediatric and adult patients with anemia of varying degrees and etiologies and compared hematology analyzer Hgb levels with POC Hgb levels, which were estimated via visual interpretation using a color scale and an optional smartphone app for automated analysis. RESULTS. POC Hgb levels correlated with hematology analyzer Hgb levels (r = 0.864 and r = 0.856 for visual interpretation and smartphone app, respectively), and both POC test methods yielded comparable sensitivity and specificity for detecting any anemia (n = 178) (/dl) (sensitivity: 90.2% and 91.1%, specificity: 83.7% and 79.2%, respectively) and severe anemia (n = 10) (/dl) (sensitivity: 90.0% and 100%, specificity: 94.6% and 93.9%, respectively). CONCLUSIONS. These results demonstrate the feasibility of this POC color-based diagnostic test for self-screening/self-monitoring of anemia. TRIAL REGISTRATION. Not applicable. FUNDING. This work was funded by the FDA-funded Atlantic Pediatric Device Consortium, the Georgia Research Alliance, Children\u27s Healthcare of Atlanta, the Georgia Center of Innovation for Manufacturing, and the InVenture Prize and Ideas to Serve competitions at the Georgia Institute of Technology

Anti-CD45 Pretargeted Radioimmunotherapy Prior to Bone Marrow Transplantation without Total Body Irradiation Facilitates Engraftment From Haploidentical Donors and Prolongs Survival in a Disseminated Murine Leukemia Model

s / Biol Blood Marrow Transplant 19 (2013) S211eS232 S228 chemotherapy was HIDAC (1-3 grams/m2 for 6-8 doses)/ Etoposide(15-40mg/kg) in 16 patients and growth factor alone in one patient. Median time from diagnosis to ASCT was 4.2 (range 3.6-7) months. Preparative regimen for ASCT was Busulfan (3.2mg/kg x 4)/Etoposide (60 mg/kg) in 12 patients and high dose melphalan in 5 patients. The median CD34 cells infused was 4.9 x 10e6/kg (range 2.8 to 15.9).All patients engrafted with a median time to neutrophil engraftment of 11 (range10-12) days. The median time to platelet engraftment was 20 (range15-40) days. The median length of inpatient stay during the ASCT admission was 14 (range 10-25) days. One patient died of progressive disease 14 months post ASCT. Two patients died in remission on day 53 (sepsis) and day 836 (unknown cause) post ASCT. Fourteen patients (82%) are currently alive in complete remission. at a median follow-up of 20 (range 140) months post ASCT. Conclusion: Consolidation of good risk AML patients with ASCT following induction of complete remission is safe and effective in preventing relapse in good risk AML patients