Cross-cultural representations of dementia: an exploratory study.

Background: An ageing global population will bring a significant increase in the prevalence of dementia, with the need for a collaborative international effort to combat this public health challenge being increasingly recognised. To be successful, this cooperation must be sensitive to the different cultural environments in which dementia is positioned, which shape the variety of clinical, political and social approaches to the condition worldwide. The aim of this project is to examine the social representations of dementia among people from three countries with different health care systems.

Winnipeg radon testing: comparison of test durations, effects of house characteristics, and efficacy of floor-drain seals.

A research study has investigated the correlation of radon test data for three testing periods obtained in a set of 50 homes. The homes were part of the housing stock in a long-established subdivision in Winnipeg, Manitoba, for which it was initially hypothesized that a high percentage of homes had radon levels above the Canadian guideline. Co-linear tests, all commencing on the same date, were conducted over periods of 5 d, 30 d, and 91 d under closed building conditions during the 2009-10 heating season using electret ion radon detectors, supplemented in some instances by measurements with a continuous radon monitor.

A randomized trial of urodynamic testing before stress-incontinence surgery.

Background: Urodynamic studies are commonly performed in women before surgery for stress urinary incontinence, but there is no good evidence that they improve outcomes.

Methods: We performed a multicenter, randomized, noninferiority trial involving women with uncomplicated, demonstrable stress urinary incontinence to compare outcomes after preoperative office evaluation and urodynamic tests or evaluation only. The primary outcome was treatment success at 12 months, defined as a reduction in the score on the Urogenital Distress Inventory of 70% or more and a response of "much better" or "very much better" on the Patient Global Impression of Improvement.

Radiologic images of retrograde ureterography before and after release of bilateral sacrospinous ligament fixation sutures.

Ureteral injury or compromise can occur after pelvic floor reconstruction for prolapse. Therefore, it is routine to perform intraoperative urethrocystoscopy at end of the operative case to confirm ureteral patency. We show retrograde ureterogram before and after release of fixation sutures from bilateral sacrospinous ligament fixation performed for stage III vaginal prolapse.

Patient expectations did not predict outcome of drug and behavioral treatment of urgency urinary incontinence.

Objectives: : This study aimed to determine whether expectations of treatment outcomes in women participating in a drug and behavioral treatment trial for urge urinary incontinence are related to patient factors, demographics, health-related locus of control, and treatment outcomes.

Methods: : Baseline assessments included expectations (improvement in bladder condition, time to improvement in bladder condition, and duration of improvement) and the Medical Health Locus of Control (MHLC) scale. Outcomes were measured by the Patient Global Impression of Improvement scale (PGI-I) at the end of active treatment (10 weeks) and 8 months after trial start.

Mixed incontinence: comparing definitions in non-surgical patients.

Purpose: We aimed to explore operational definitions of mixed urinary incontinence (MUI) for use in incontinence outcomes research for non-surgical patient populations.

Methods: A secondary analysis of women with urge incontinence or urge predominant MUI enrolled in the Urinary Incontinence Treatment Network BE-DRI randomized clinical trial was performed. Subjects were characterized at baseline for urinary incontinence severity and incontinence subtype (stress or urge) using the Medical, Epidemiologic, and Social Aspects of Aging (MESA) questionnaire, the Urogenital Distress Inventory, and a 7-day urinary diary.

Patient satisfaction with stress incontinence surgery.

Aims: To identify predictors and correlates of patient satisfaction 24 months after Burch colpopexy or autologous fascial sling for treatment of stress urinary incontinence (SUI).

Methods: Participants were the 655 randomized subjects in the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr). Variables potentially associated with satisfaction were tested in bivariate analysis, including demographics, baseline clinical characteristics of incontinence, and outcomes on validated subjective and objective measures.

Retropubic versus transobturator midurethral slings for stress incontinence.

Background: Midurethral slings are increasingly used for the treatment of stress incontinence, but there are limited data comparing types of slings and associated complications.

Methods: We performed a multicenter, randomized equivalence trial comparing outcomes with retropubic and transobturator midurethral slings in women with stress incontinence. The primary outcome was treatment success at 12 months according to both objective criteria (a negative stress test, a negative pad test, and no retreatment) and subjective criteria (self-reported absence of symptoms, no leakage episodes recorded, and no retreatment).

Mixed incontinence: comparing definitions in women having stress incontinence surgery.

Objective: To develop an empirically derived definition of mixed urinary incontinence (MUI) for use in incontinence outcomes research.

Methods: Participants in a randomized trial comparing the fascial sling and. Burch colposuspension were assessed using standardized measures including the Medical, Epidemiologic and Social Aspects of Aging (MESA), UI questionnaire, the Urogenital Distress Inventory (UDI), 3-day urinary diary and urodynamic studies (UDS).

Estrogen stimulates the human endometrium to express a factor(s) that promotes vascular smooth muscle cell migration as an early step in microvessel remodeling.

Vascular smooth muscle cell (VSMC) migration is a pivotal early step in blood vessel remodeling; however, very little is known about the regulation of this process in the human endometrium during the menstrual cycle. In this study, explants of human endometrium were incubated with estradiol and/or progesterone and the conditioned medium (CM) applied to cultures of VSMC to test the hypothesis that estrogen and progesterone stimulate endometrial cells to secrete a factor(s) that promotes VSMC migration. Endometrial explants were composed of highly organized glands and stroma.

Behavioral therapy to enable women with urge incontinence to discontinue drug treatment: a randomized trial.

Background: Women with urge urinary incontinence are commonly treated with antimuscarinic medications, but many discontinue therapy.

Objective: To determine whether combining antimuscarinic drug therapy with supervised behavioral training, compared with drug therapy alone, improves the ability of women with urge incontinence to achieve clinically important reductions in incontinence episodes and to sustain these improvements after discontinuing drug therapy.

Design: 2-stage, multicenter, randomized clinical trial conducted from July 2004 to January 2006.

The development of quality control standards for radiation therapy equipment in Canada.

Among the essential components of a comprehensive quality assurance program in radiotherapy are the quality control protocols to be used on the equipment and, in particular, the performance objectives and criteria. In the present work, we describe the development of a suite of quality control documents for use across Canada. Following a generic format, we are generating concise, clear standards for the most commonly used equipment in radiotherapy, with the emphasis on performance measures.

Burch colposuspension versus fascial sling to reduce urinary stress incontinence.

Background: Many surgical procedures are available for women with urinary stress incontinence, yet few randomized clinical trials have been conducted to provide a basis for treatment recommendations.

Methods: We performed a multicenter, randomized clinical trial comparing two procedures--the pubovaginal sling, using autologous rectus fascia, and the Burch colposuspension--among women with stress incontinence. Women were eligible for the study if they had predominant symptoms associated with the condition, a positive stress test, and urethral hypermobility.

Factors associated with incontinence frequency in a surgical cohort of stress incontinent women.

Objective: The aim of this study was to identify factors associated with urinary incontinence severity at baseline in women undergoing surgery for stress incontinence.

Study Design: Baseline data were obtained from 650 women (age 28 to 81 years) with stress incontinence participating in a randomized surgical trial. Severity of incontinence was defined by the mean number of incontinence episodes per day recorded in a 3-day bladder diary.

Ketone enolization with lithium dialkylamides: the effects of structure, solvation, and mixed aggregates with excess butyllithium.

The effects of lithium dialkylamide structure, mixed aggregate formation, and solvation on the stereoselectivity of ketone enolization were examined. Of the lithium dialkylamides examined, lithium tetramethylpiperidide (LiTMP) in THF resulted in the best enolization selectivity. The stereoselectivity was further improved in the presence of a LiTMP-butyllithium mixed aggregate.