91 research outputs found

    Pain self-management in HIV-infected individuals with chronic pain: a qualitative study

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    OBJECTIVE: Chronic pain in individuals with HIV is a common, impairing condition. Behavioral interventions for chronic pain specifically tailored to this population have yet to be developed. We assert that understanding self-management strategies already used by persons living with these conditions is an essential first step, and is the objective of this investigation. DESIGN: We conducted a thematic analysis of qualitative data from 25 in-depth interviews with individuals with HIV and chronic pain. RESULTS: The primary pain self-management strategies articulated by participants were: physical activity; cognitive and spiritual strategies; spending time with family and friends and social support; avoidance of physical/social activity; medication-centric pain management; and substance use. CONCLUSIONS: Some of these strategies may be viewed as beneficial and overlap with known HIV self-management strategies (cognitive strategies), whereas others may have negative health consequences (substance use). Interventions that incorporate healthy self-management strategies may be particularly effective in improving both HIV and pain outcomes

    The prevention of lower urinary tract symptoms (PLUS) research consortium: A transdisciplinary approach toward promoting bladder health and preventing lower urinary tract symptoms in women across the life course

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    Lower urinary tract symptoms (LUTS) are highly prevalent in women, and are expected to impose a growing burden to individuals and society as the population ages. The predominance of research related to LUTS has focused on underlying pathology, disease mechanisms, or the efficacy of treatments for women with LUTS. Although this research has been vital for helping to reduce or ameliorate LUTS conditions, it has done little to prevent the onset of LUTS. Health promotion and prevention require an expansion of scientific inquiry beyond the traditional paradigm of studying disease mechanisms and treatment to the creation of an evidence base to support recommendations for bladder health promotion and, in turn, prevention of LUTS. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) introduced the concept of prevention as an important priority for women's urologic research as a prelude to supporting the formation of the Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium. In this article, we introduce the PLUS research consortium to the scientific community; share the innovative paradigms by which the consortium operates; and describe its unique research mission: to identify factors that promote bladder health across the life course and prevent the onset of LUTS in girls and women

    U.S. adolescent and adult women\u27s experiences accessing and using toilets in schools, workplaces, and public spaces: A multi-site focus group study to inform future research in bladder health

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    The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women\u27s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by gatekeepers (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course

    Association of Low Dietary Intake of Fiber and Liquids with Constipation: Evidence from the National Health and Nutrition Examination Survey (NHANES)

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    Epidemiological studies support an association of self-defined constipation with fiber and physical activity, but not liquid intake. The aims of this study were to assess the prevalence and associations of dietary fiber and liquid intake to constipation

    Prevention of Lower Urinary Tract Symptoms Research Consortium focus group Study of Habits, Attitudes, Realities, and Experiences of Bladder health

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    AimThe study purpose is to explore adolescent and adult women’s experiences, perceptions, beliefs, knowledge and behaviours related to bladder health across the life course using a socioecological perspective. Lower urinary tract symptoms affect between 20-40% of young adult to middle-aged women, with symptoms increasing in incidence and severity with aging. There is limited evidence to address bladder health promotion and prevention of dysfunction. This first study of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium is designed to address gaps in existing qualitative research in this area.DesignThis focus group study will be implemented across seven geographically diverse United States research centres using a semi-structured focus group guide informed by a conceptual framework based on the socioecological model.MethodsThe study was approved in July 2017. A total of 44 focus groups composed of 6-8 participants representing six different age categories (ranging from 11 to over 65 years) will be completed. We aim to recruit participants with diverse demographic and personal characteristics including race, ethnicity, education, socioeconomic status, urban/rural residence, physical/health conditions, and urinary symptom experience. Six of the focus groups will be conducted in Spanish and translated into English. Focus group transcripts will undergo content analysis and data interpretation to identify and classify themes and articulate emerging themes.DiscussionThis foundational qualitative study seeks to develop an evidence base to inform future research on bladder health promotion in adolescent and adult women.ImpactThis study has the potential to provide new insights and understanding into adolescent and adult women’s lived experience of bladder health, the experience of lower urinary symptoms and knowledge and beliefs across the life course.ç ®ç æ ¬ç  ç©¶ç ç ®ç æ ¯ä» ç¤¾ä¼ ç æ å­¦ç è§ åº¦,æ ¢è®¨é å° å¹´å æ å¹´å¥³æ §å ¨äººç è¿ ç¨ ä¸­ä¸ è è ±å ¥åº·ç ¸å ³ç ç» éª ã è§ å¿µã 信念ã ç ¥è¯ å è¡ ä¸ºã ä¸ å°¿è·¯ç ç ¶å½±å 20-40%ç 中é å¹´å¥³æ §,é ç å¹´é¾ ç å¢ é ¿,ç ç ¶ç å ç ç å 严é ç¨ åº¦é ½å ¨å¢ é ¿ã å ³äº ä¿ è¿ è è ±å ¥åº·å é¢ é ²å è ½é ç¢ ç è¯ æ ®æ é ã æ ¬æ¬¡é¢ é ²ä¸ å°¿è·¯ç ç ¶(PLUS)ç  ç©¶è ç ç ç  ç©¶æ ¯é¦ ä¸ªå ³äº æ­¤æ ¹é ¢ç ç  ç©¶,æ ¨å ¨è§£å ³ç °æ ç å® æ §ç  ç©¶å ¨è¿ æ ¹é ¢ç å·®è· ã è®¾è®¡è¯¥é¡¹ç ¦ç ¹å° ç» ç  ç©¶å° å ¨ä¸ ä¸ªä¸ å ä½ ç½®ç ç¾ å ½ç  ç©¶ä¸­å¿ è¿ è¡ ,ä»¥å ºäº ç¤¾ä¼ ç æ 模å æ¦ å¿µæ¡ æ ¶ç å ç» æ å ç ç ¦ç ¹å° ç» æ å 为æ 导ã æ ¹æ³ è¯¥ç  ç©¶äº 2017å¹´7æ è ·å¾ æ ¹å ã ç ±6-8å 代表6ä¸ªä¸ å å¹´é¾ ç±»å «(ä» 11å² å °65å² ä»¥ä¸ )ç å ä¸ è ç» æ å ±44ä¸ªç ¦ç ¹å° ç» ã æ 们计å æ å ä¸ å äººå £å ä¸ªäººç ¹å¾ ç å ä¸ è ,ä¾ å¦ ç§ æ ã ç§ æ æ¸ æº ã æ è ²ç» å ã ç¤¾ä¼ ç» æµ å °ä½ ã å ä¹¡å± æ° ã èº«ä½ /å ¥åº·ç ¶å µå æ³ å°¿ç³»ç» ç ç ¶ç» å ã å ­ä¸ªç ¦ç ¹å° ç» ç ç  ç©¶å° ä»¥è¥¿ç ­ç è¯­è¿ è¡ ,å¹¶ç¿»è¯ æ è ±è¯­ã ç ¦ç ¹å° ç» ç èª æ ¬å° è¢«ç ¨äº å 容å æ å æ °æ ®è§£é ,ä»¥ç¡®å® å å ç±»ä¸»é¢ ,并é æ æ °å ºç °ç ä¸»é¢ ã è®¨è®ºè¿ é¡¹å ºç¡ æ §ç å® æ §ç  ç©¶æ ¨å ¨ä¸ºæ é« æ ªæ ¥é å° å¹´å æ å¹´å¦ å¥³ç è è ±å ¥åº·ç ç  ç©¶æ ä¾ è¯ æ ®å ºç¡ ã å½±å è¿ é¡¹ç  ç©¶æ å ¯è ½æ ä¾ å ³äº é å° å¹´å æ å¹´å¦ å¥³ç è è ±å ¥åº·ç ç æ´»ç» éª ,ç» éª ç ä¸ å°¿è·¯ç ç ¶å ç ¥è¯ å ç æ³ ç 人ç è¿ ç¨ ä¸­æ °ç è§ è§£å ç 解ãPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151981/1/jan14148_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151981/2/jan14148.pd

    Prevalence and Trends of Symptomatic Pelvic Floor Disorders in U.S. Women

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    To estimate the prevalence and trends of these pelvic floor disorders in U.S. women from 2005–2010

    The impact of fecal and urinary incontinence on quality of life 6 months after childbirth

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    The objective of the study was to investigate the impact of postpartum fecal incontinence (FI) and urinary incontinence (UI) on quality of life (QOL)

    Host Porphobilinogen Deaminase Deficiency Confers Malaria Resistance in Plasmodium chabaudi but Not in Plasmodium berghei or Plasmodium falciparum During Intraerythrocytic Growth

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    An important component in host resistance to malaria infection are inherited mutations that give rise to abnormalities and deficiencies in erythrocyte proteins and enzymes. Understanding how such mutations confer protection against the disease may be useful for developing new treatment strategies. A mouse ENU-induced mutagenesis screen for novel malaria resistance-conferring mutations identified a novel non-sense mutation in the gene encoding porphobilinogen deaminase (PBGD) in mice, denoted here as PbgdMRI58155. Heterozygote PbgdMRI58155 mice exhibited ~50% reduction in cellular PBGD activity in both mature erythrocytes and reticulocytes, although enzyme activity was ~10 times higher in reticulocytes than erythrocytes. When challenged with blood-stage P. chabaudi, which preferentially infects erythrocytes, heterozygote mice showed a modest but significant resistance to infection, including reduced parasite growth. A series of assays conducted to investigate the mechanism of resistance indicated that mutant erythrocyte invasion by P. chabaudi was normal, but that following intraerythrocytic establishment a significantly greater proportions of parasites died and therefore, affected their ability to propagate. The Plasmodium resistance phenotype was not recapitulated in Pbgd-deficient mice infected with P. berghei, which prefers reticulocytes, or when P. falciparum was cultured in erythrocytes from patients with acute intermittent porphyria (AIP), which had modest (20-50%) reduced levels of PBGD. Furthermore, the growth of Pbgd-null P. falciparum and Pbgd-null P. berghei parasites, which grew at the same rate as their wild-type counterparts in normal cells, were not affected by the PBGD-deficient background of the AIP erythrocytes or Pbgd-deficient mice. Our results confirm the dispensability of parasite PBGD for P. berghei infection and intraerythrocytic growth of P. falciparum, but for the first time identify a requirement for host erythrocyte PBGD by P. chabaudi during in vivo blood stage infection.The authors were supported by an International Macquarie University Research Excellence Scholarship (CS), the NHMRC (490037, 605524, APP1047090, and APP1066502), the Australian Research Council (DP120100061) and the National Collaborative Research Infrastructure (NCRIS) via the Australian Phenomics Network (APN)
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