Oral contraceptives and cervical cancer--further findings from the Oxford Family Planning Association contraceptive study.

In 1983, we reported results from the Oxford Family Planning Association contraceptive study regarding the association between oral contraceptives (OCs) and cervical neoplasia, after a 10 year follow-up of a cohort of 17,000 women. Further findings from this study are reported here after an additional 12 years of follow-up. A nested case--control design was used in which cases were all women diagnosed under 45 years of age with invasive carcinoma (n = 33), carcinoma in situ (n = 121) or dysplasia (n = 159). Controls were randomly selected from among cohort members and matched to cases on exact year of birth and clinic attended at recruitment to study. Conditional logistic regression analysis was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) associated with various aspects of OC use relative to never users adjusted for social class, smoking, age at first birth and ever use of diaphragm or condom. Ever users of OCs had a slightly elevated OR for all types of cervical neoplasia combined (OR = 1.40, 95% CI 1.00-1.96). Odds ratios were highest for invasive carcinoma (OR = 4.44, 95% CI 1.04-31.6), intermediate for carcinoma in situ (OR = 1.73, 95% CI 1.00-3.00) and lowest for dysplasia (OR = 1.07, 95% CI 0.69-1.66). The elevated risk associated with OC use appeared to be largely confined to current or recent (last use in the past 2 years) long-term users of OCs. Among current or recent users, ORs for all types of cervical neoplasia combined were 3.34 (95% CI 1.96-5.67) for 49-72 months of use, 1.69 (95% CI 0.97-2.95) for 73-96 months and 2.04 (95% CI 1.34-3.11) for 97 or more months. These results suggest a possible effect of OC use on later stages of cervical carcinogenesis, although residual confounding due to sexual factors or human papillomavirus (HPV) infection cannot be ruled out

Photonic mode density effects on single-molecule fluorescence blinking

We investigated the influence of the photonic mode density (PMD) on the triplet dynamics of individual chromophores on a dielectric interface by comparing their response in the presence and absence of a nearby gold film. Lifetimes of the excited singlet state were evaluated in ordet to measure directly the PMD at the molecules position. Triplet state lifetimes were simultaneously determined by statistical analysis of the detection time of the fluorescence photons. The observed singlet decay rates are in agreement with the predicted PMD for molecules with different orientations. The triplet decay rate is modified in a fashion correlated to the singlet decay rate. These results show that PMD engineering can lead to an important suppression of the fluorescence, introducing a novel aspect of the physical mechanism to enhance fluorescence intensity in PMD-enhancing systems such as plasmonic devices

The Cyprus Women’s Health Research (COHERE) initiative: normative data from the SF-36v2 questionnaire for reproductive aged women from the Eastern Mediterranean

Purpose: Describe the health-related quality of life for a representative cohort of women aged 18–55 in Northern Cyprus. Methods: We utilised the SF-36-Health-Survey-version-2 (SF-36v2) questionnaire as part of the COHERE Initiative study to calculate the eight physical and mental subscale scores, as well as the two overall summary measures for physical and mental health, where we present results using Cyprus-specific scoring as well as scores based on the test developers’ algorithms. We examined associations between sociodemographic characteristics for both scores. Results: A total of 7089 women fully completed the SF-36v2 questionnaire (mean age = 36.9), which was reliable and valid in this population. We observed better physical health in ages 18–25 compared to 46–55 (53.32 vs. 46.72 (p < 0.001)) and better mental health in women aged 46–55 compared to 18–25 (52.07 vs. 47.95 (p < 0.001)). Women in employment had better physical and mental health compared to those who were unemployed (physical: 50.25 vs 49.95, p < 0.001 and mental: 50.25 vs 49.24, p = 0.083) and scores increased as educational attainment increased (physical: 47.55 for primary to 51.58 for postgraduate, mental: 48.88 to 50.59, p < 0.001). Turkish Cypriot women had higher scores than Turkish women (physical: 50.42 vs 49.30, mental: 50.43 vs 49.10, p < 0.001). Conclusion: These are the first population normative values published from a large representative sample of women between 18 and 55 years from the Eastern Mediterranean region. We found better physical health in younger women and better mental health in older women. Turkish Cypriot women and non-migrant women had better mental health, and HRQOL was highest in those in paid employment and those with a higher educational achievement

WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity

BACKGROUND: Health care planning for chronic pelvic pain (CPP), an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. METHODS: We identified data available from Medline (1966 to 2004), Embase (1980 to 2004), PsycINFO (1887 to 2003), LILACS (1982 to 2004), Science Citation index, CINAHL (January 1980 to 2004) and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid) if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate >80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies. RESULTS: There were 178 studies (459975 participants) in 148 articles. Of these, 106 studies were (124259 participants) on dysmenorrhoea, 54 (35973 participants) on dyspareunia and 18 (301756 participants) on noncyclical pain. There were only 19/95 (20%) less developed and 1/45 (2.2%) least developed countries with relevant data in contrast to 22/43 (51.2%) developed countries. Meta-regression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5%) high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%. CONCLUSION: There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where valid data were available, a high disease burden of all types of pelvic pain was found

Routine outcome monitoring en benchmarking: hoe kunnen we behandelresultaten op een zorgvuldige manier vergelijken?

Contains fulltext : 157216.pdf (publisher's version ) (Open Access)Achtergrond: Het structureel meten van de resultaten van een behandeling in de geestelijke gezondheidszorg en het vergelijken daarvan tussen instellingen helpen om inzicht te krijgen in het effect van behandelingen in de reguliere praktijk. Doel: Geven van een overzicht van de kwesties die van belang zijn bij het vergelijken van instellingen. Methode: Analyseren van documentatie en beleidsinformatie over en praktijkervaring met routine outcome monitoring (rom). Resultaten: We beschrijven knelpunten die kunnen ontstaan bij het vergelijken van instellingen en formuleren oplossingsrichtingen voor deze knelpunten. Daarbij staat centraal dat het werken met rom een groeiproces is, waarbij men experimenteert met verschillende oplossingsrichtingen en op basis van ervaringen definitieve keuzes maakt. Conclusie: Het is leerzaam om instellingen te vergelijken, zowel onderling als met 'best practices' (benchmarking). Instellingen verschillen echter in cliëntenpopulaties, meetprocedures en instrumentarium. Een zinvolle vergelijking is op termijn toch mogelijk.5 p

Baropodometry on women suffering from chronic pelvic pain - a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Previous studies have associated chronic pelvic pain with a stereotyped pattern of movement and posture, lack of normal body sensations, a characteristic pain distribution. We aimed at evaluating if these postural changes are detectable in baropodometry results in patients with chronic pelvic pain.</p> <p>Methods</p> <p>We performed a prospective study in a university hospital. We selected 32 patients suffering from chronic pelvic pain (study group) and 30 women without this pathology (regular gynecological work out - control group). Pain scores and baropodometric analysis were performed.</p> <p>Results</p> <p>As expected, study group presented higher pain scores than control group. Study and control groups presented similar averages for the maximum pressures to the left and right soles as well as soles supports in the forefeet and hind feet. Women suffering from chronic pelvic pain did not present differences in baropodometric analysis when compared to healthy controls.</p> <p>Conclusions</p> <p>This data demonstrates that postural abnormalities resulting from CPP could not be demonstrated by baropodometric evaluation. Other postural measures should be addressed to evaluate pelvic pain patients.</p

Electroinduced two-nucleon knockout and correlations in nuclei

We present a model to calculate cross sections for electroinduced two-nucleon emission from finite nuclei. Short-range correlations in the wave functions and meson-exchange contributions to the photoabsorption process are implemented. Effects of the short-range correlations are studied with the aid of a perturbation expansion method with various choices of the Jastrow correlation function. The model is used to investigate the relative importance of the different reaction mechanisms contributing to the A(e,e$'$pn) and A(e,e$'$pp) process. Representative examples for the target nuclei $^{12}$C and $^{16}$O and for kinematical conditions accessible with contemporary high-duty cycle electron accelerators are presented. A procedure is outlined to calculate the two-nucleon knockout contribution to the semi-exclusive (e,e$'$p) cross section. Using this technique we investigate in how far semi-exclusive (e,e$'$p) reactions can be used to detect high-momentum components in the nuclear spectral function.Comment: 51 pages, Latex, uses epsf.sty and elsart.sty, 17 figures (in eps format

The Ultimate Fate of Supercooled Liquids

In recent years it has become widely accepted that a dynamical length scale {\xi}_{\alpha} plays an important role in supercooled liquids near the glass transition. We examine the implications of the interplay between the growing {\xi}_{\alpha} and the size of the crystal nucleus, {\xi}_M, which shrinks on cooling. We argue that at low temperatures where {\xi}_{\alpha} > {\xi}_M a new crystallization mechanism emerges enabling rapid development of a large scale web of sparsely connected crystallinity. Though we predict this web percolates the system at too low a temperature to be easily seen in the laboratory, there are noticeable residual effects near the glass transition that can account for several previously observed unexplained phenomena of deeply supercooled liquids including Fischer clusters, and anomalous crystal growth near T_g

Exercise repetition rate measured with simple sensors at home can be used to estimate Upper Extremity Fugl-Meyer score after stroke

IntroductionIt would be valuable if home-based rehabilitation training technologies could automatically assess arm impairment after stroke. Here, we tested whether a simple measure—the repetition rate (or “rep rate”) when performing specific exercises as measured with simple sensors—can be used to estimate Upper Extremity Fugl-Meyer (UEFM) score.Methods41 individuals with arm impairment after stroke performed 12 sensor-guided exercises under therapist supervision using a commercial sensor system comprised of two pucks that use force and motion sensing to measure the start and end of each exercise repetition. 14 of these participants then used the system at home for three weeks.ResultsUsing linear regression, UEFM score was well estimated using the rep rate of one forward-reaching exercise from the set of 12 exercises (r2 = 0.75); this exercise required participants to alternately tap pucks spaced about 20 cm apart (one proximal, one distal) on a table in front of them. UEFM score was even better predicted using an exponential model and forward-reaching rep rate (Leave One Out Cross Validation (LOOCV) r2 = 0.83). We also tested the ability of a nonlinear, multivariate model (a regression tree) to predict UEFM, but such a model did not improve prediction (LOOCV r2 = 0.72). However, the optimal decision tree also used the forward-reaching task along with a pinch grip task to subdivide more and less impaired patients in a way consistent with clinical intuition. At home, rep rate for the forward-reaching exercise well predicted UEFM score using an exponential model (LOOCV r2 = 0.69), but only after we re-estimated coefficients using the home data.DiscussionThese results show how a simple measure—exercise rep rate measured with simple sensors—can be used to infer an arm impairment score and suggest that prediction models should be tuned separately for the clinic and home environments

A Numerical Examination of the Performance of Small Magnetic Nozzle Thrusters

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143040/1/6.2017-4721.pd