Can incontinence be cured? A systematic review of cure rates

Background Incontinence constitutes a major health problem affecting millions of people worldwide. The present study aims to assess cure rates from treating urinary (UI) or fecal incontinence (FI) and the number of people who may remain dependent on containment strategies. Methods Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and PEDro were searched from January 2005 to June 2015. Supplementary searches included conference abstracts and trials registers (2013–2015). Included studies had patients ≥ 18 years with UI or FI, reported treatment cure or success rates, had ≥ 50 patients treated with any intervention recognized in international guideline algorithms, a follow-up ≥ 3 months, and were published from 2005 onwards. Title and abstract screening, full paper screening, data extraction and risk-of-bias assessment were performed independently by two reviewers. Disagreements were resolved through discussion or referral to a third reviewer where necessary. A narrative summary of included studies is presented. Results Most evidence was found for UI: Surgical interventions for stress UI showed a median cure rate of 82.3% (interquartile range (IQR), 72–89.5%); people with urgency UI were mostly treated using medications (median cure rate for antimuscarinics = 49%; IQR, 35.6–58%). Pelvic floor muscle training and bulking agents showed lower cure rates for UI. Sacral neuromodulation for FI had a median cure rate of 38.6% (IQR, 35.6–40.6%). Conclusions Many individuals were not cured and hence may continue to rely on containment. No studies were found assessing success of containment strategies. There was a lack of data in the disabled and in those with neurological diseases, in the elderly and those with cognitive impairment. Surgical interventions were effective for stress UI. Other interventions for UI and FI showed lower cure rates. Many individuals are likely to be reliant on containment strategies

Vegetation trend in the east Kimberley region : an analysis of ground monitoring data from 1991-1998

This document summarises the analyses carried out on the ground monitoring data from the Kimberley region of Western Australia as part of the Natural Heritage Trust project 953024 - ‘\u27Development of Information Products for Reporting Rangeland Changes.

In search of professional consensus in defining and reducing low-value care

Care that confers no benefit or benefit that is disproportionately low compared with its cost is of low value and potentially wastes limited resources. It has been claimed that low-value care consumes at least 20% of health care resources in the United States — the comparable figure in Australia is unknown but there is emerging evidence of overuse of diagnostic tests and therapeutic procedures. Very few clinical interventions are of no value in every clinical circumstance, and efforts to label interventions as being so will meet with professional resistance. In the context of complex and highly individualised clinical decisions, nuanced clinical judgements of experienced and well informed clinicians are likely to outperform any service-level measurement and incentive program aimed at recognising and reducing low-value care. Public policy interventions should focus on supporting clinician-led efforts to seek professional consensus on what constitutes low-value care and the best means for reducing it

Vegetation trend in the east Kimberley region : an analysis of ground monitoring data from 1991-1998

This document summarises the analyses carried out on the ground monitoring data from the Kimberley region of Western Australia as part of the Natural Heritage Trust project 953024 - ‘\u27Development of Information Products for Reporting Rangeland Changes.

The two-dimensional anharmonic oscillator II: the microwave spectrum of silyl isocyanate, SiH3NCO

The J + 1 ← J transitions (J = 2, 3, 4, 5, and 6) in the microwave spectrum of SiH3NCO have been assigned for the vibrational ground state and for the vibrational states v10 = 1, 2, and 3. The results for v10 = 0 confirm earlier work. The vibration-rotation constants show a remarkable variation with v10 and l10. To a large extent the anomalous behavior of these constants has been explained in terms of a strongly anharmonic potential function for the ν10 vibrational mode

The two-dimensional anharmonic oscillator I: vibration-rotation constants of fulminic acid, HCNO

The lowest-wavenumber vibration of HCNO and DCNO, ν5, is known to involve a largeamplitude low-frequency anharmonic bending of the CH bond against the CNO frame. In this paper the anomalous vibrational dependence of the observed rotational constants B(v5, l5), and of the observed l-doubling interactions, is interpreted according to a simple effective vibration-rotation Hamiltonian in which the appropriate vibrational operators are averaged in an anharmonic potential surface over the normal coordinates (Q5x, Q5y). All of the data on both isotopes are interpreted according to a single potential surface having a minimum energy at a slightly bent configuration of the HCN angle ( 170°) with a maximum at the linear configuration about 2 cm−1 higher. The other coefficients in the Hamiltonian are also interpreted in terms of the structure and the harmonic and anharmonic force fields; the substitution structure at the “hypothetical linear configuration” determined in this way gives a CH bond length of 1.060 Å, in contrast to the value 1.027 Å determined from the ground-state rotational constants. We also discuss the difficulties in rationalizing our effective Hamiltonian in terms of more fundamental theory, as well as the success and limitations of its use in practice

The two-dimensional anharmonic oscillator III: the CCC bending mode of C3O2

Newly observed data on the rotational constants of carbon suboxide in excited vibrational states of the low-wavenumber bending vibration ν7 have been successfully interpreted in terms of the two-dimensional anharmonic oscillator wavefunctions associated with this vibration. By combining these results with published infrared and Raman spectra the vibrational assignment has been extended and a refined bending potential for ν7 has been derived: this has a minimum at a bending angle of about 24° at the central C atom, with an energy maximum at the linear configuration some 23 cm−1 above the minimum. From similar data on the combination and hot bands of ν7 with ν4 (1587 cm−1) and ν2 (786 cm−1) the effective ν7 bending potential has also been determined in the one-quantum excited states of ν4 and ν2. The effective ν7 potential shows significant changes from the ground vibrational state; the central hump in the ν7 potential surface is increased to about 50 cm−1 in the v4 = 1 state, and decreased to about 1 cm−1 in the v2 = 1 state. In the light of these results vibrational assignments are suggested for most of the observed bands in the infrared and Raman spectra of C3O2

Hockey looks to \u27armies\u27 in Intergenerational Report: experts react

Australia must encourage older Australians and women to enter and stay in the workforce in order to increase productivity and protect future prosperity, according to the Intergenerational Report released by Treasurer Joe Hockey today